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Biomedical subjects

K Kiyohara

Publications and source records attributed to K Kiyohara.

31 records · Page 2Linked to original sources
PubMed1988

Hypothalamic-pituitary-thyroidal axis alterations in bulimic patients.

The hypothalamic-pituitary-thyroidal axis was studied in 17 normal-weight patients with bulimia. Basal levels of serum thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3), and thyrotropin (TSH) were determined in all patients; responses of TSH and T3 to thyrotropin-releasing hormone (TRH) were investigated in nine patients. Mean basal serum T4, T3, and TSH concentrations were significantly lower in the patients than in the normal control subjects but serum rT3 levels were essentially the same. In nine patients TSH responses to TRH were normal in five, delayed in three, and low in one. The maximum increase in serum TSH and TSH net secretory response were not significantly different from those of control subjects. With respect to the T3 response to TRH, various indices in patients appeared significantly lower than in the control subjects. These results suggest that normal-weight patients with bulimia have abnormalities in the hypothalamic-pituitary-thyroidal axis.

Adult↗
PubMed1988

Prolactin responses to hypoglycemia and thyrotropin-releasing hormone in anorexia nervosa.

Although prolactin (PRL) responses to thyrotropin-releasing hormone (TRH) have been described by many investigators, PRL secretion after insulin stimulation has rarely been documented in patients with anorexia nervosa (AN). We investigated PRL responses to TRH (500 micrograms) and insulin (0.1 U/kg) in 19 women with AN and 10 normal women. Levels of PRL stimulation at 60 min and later following insulin administration were significantly lower in AN than in normal women. PRL increased by at least 10 micrograms/ml after insulin in 42% of women with AN and in 70% of normal women. The maximum PRL increase (max delta PRL) did not differ after the two stimulations in the normal women. However, in AN, the max delta PRL after insulin stimulation (17.2 +/- 4.0 micrograms/l, mean +/- SEM) was significantly lower than that after TRH (49.1 +/- 6.4 micrograms/l). These findings suggest that anorectic women may have a disturbance in hypothalamic functions. Insulin-induced hypoglycemia is useful to determine the integrity of the hypothalamic-pituitary axis for PRL secretion, in combination with TRH stimulation.

Adolescent↗
PubMed1988

[A case of neonatal meningitis due to Flavobacterium meningosepticum successfully treated with cefmetazole and cefotaxime].

A 3-day-old male infant, weighing 3,413 g and a gestational age of 38 weeks developed neonatal meningitis due to Flavobacterium meningosepticum. Treatment with cefmetazole and cefotaxime led him to a complete recovery without neurologic deficit. Of 82 previously published cases under 1 year old, 41 cases died and 16 of survivors developed hydrocephalus because the organism was resistant to many antibiotics. Therapy of meningitis due to the organism has not been standardized but the early laboratory identification and the choice of effective and safe antibiotics determined by antimicrobial sensitivity test improve the outcome.

Cefmetazole↗
PubMed1987

Serum thyrotropin (TSH) responses to thyrotropin-releasing hormone (TRH) in patients with anorexia nervosa and bulimia: influence of changes in body weight and eating disorders.

Serum thyrotropin (TSH) responses to thyrotropin-releasing hormone (TRH) were studied in 47 women with anorexia nervosa (AN) (group I) and in 11 bulimic patients of normal weight (group II). In group I, TSH responses were low in nine patients, delayed in 32 and normal in six. Patients with a normal TSH response had a lesser degree of anorexia than those with a delayed TSH response. Bulimia and vomiting were more frequently observed in the low response group. The maximum increase in TSH concentrations following TRH administration in the group I patients with vomiting (4.0 +/- 0.90 microU/ml, mean +/- S.E.) was significantly lower than that in the group I patients without vomiting or in normal controls (11.2 +/- 0.82 microU/ml and 11.1 +/- 2.34 microU/ml, respectively). Twenty-five patients with abnormal TSH responses in group I were retested after weight gain. Initially, TSH responses were low in six and delayed in 19. Following weight recovery, responses continued to be abnormal in five of the six and in eight of the 19, respectively. The symptoms of eating disorders continued in all patients with abnormal TSH responses even after weight recovery, whereas patients with normal responses after weight gain recovered from all symptoms. Of 11 patients in group II, six had abnormal TSH responses to TRH; the responses were delayed in four and low in two. Patients with normal responses had a lesser degree of eating disorder, compared with abnormal responders. These observations suggest that abnormal TSH responses in patients with AN were not necessarily due to weight loss alone; rather, they may be related to the eating disorder itself.

Adolescent↗
PubMed1987

Abnormal serum prolactin responses to luteinizing hormone-releasing hormone (LHRH) in patients with anorexia nervosa and bulimia.

Abnormal responses of serum prolactin (PRL) to luteinizing hormone-releasing hormone (LHRH) stimulation have been observed in anovulatory women and in hypogonadal patients. Various endocrinological abnormalities have been demonstrated in patients with anorexia nervosa (AN). The present study was undertaken to further investigate responses of serum PRL, growth hormone (GH), luteinizing hormone (LH) and follicle stimulating hormone (FSH) to LHRH stimulation in 65 patients with AN and in 12 patients with bulimia before therapy and in the AN patients after several months of treatment, and in comparison to 12 normal women of the same age. Serum PRL responses to LHRH were positive (peak PRL levels greater than 25 ng/ml and delta increase in PRL greater than 10 ng/ml) in 16.9% of AN and 16.6% of bulimic patients; they were negative (absent) in all controls. Following restoration of the AN patients to normal body weight, the PRL responses to LHRH became normalized in those patients whose eating disorder behavior also returned to normal. However, in those patients whose eating disorder patterns continued to be abnormal, abnormal PRL responses persisted. The bulimic patients were of normal body weight, and yet had abnormal PRL responses. Thus, the responses of PRL correlated more closely with the behavior of the underlying eating disorder rather than with body weight gain or normal body weight.

Adolescent↗
PubMed1987

[Primary malignant fibrous histiocytoma of the breast, report of a case].

Although malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma of adult, it rarely arises in the breast tissue. Only seven cases have been previously reported in Japan. One case of the MFH of the mammary gland is presented in this paper. A 39 year old woman, who had received no radiation, was referred to our hospital due to a painful right breast lump. Excisional biopsy revealed yellowish white soft tumor with an obscured margin. Histological, tumor was composed of spindle shaped cells of a storiform pattern, which was diagnosed as MFH of the breast. Radical mastectomy (Br + Mj + Ax) was added to this patient. The tumor invaded to the fat tissue without metastasis to the axillary lymph nodes. We performed the post-operative adjuvant chemotherapy of Adriamycin. She made an uneventful recovery and is now free of disease eleven months postoperatively.

Adult↗
PubMed1986

Hypothalamic-pituitary-thyroidal dysfunctions in anorexia nervosa.

There are clinical similarities between anorexia nervosa and hypothyroidism. Circulating levels of T4 and particularly T3 have been reported to be low in this eating disorder. Previous reports have, however, shown normal basal levels of serum TSH with normal or delayed responses to TRH. To assess thyroid function and the hypothalamic-pituitary axis in 21 women with anorexia nervosa, serum levels of free and total thyroid hormones, binding proteins, and TSH employing an extremely sensitive assay (detection limit = 0.02 microU/ml) were measured. Serum T4, free T4, T3, free T3, TSH, TBG and TBPA concentrations were significantly lower and rT3 levels were significantly higher in anorexia nervosa patients than in normal controls. A delayed TSH response to TRH was noted in 66% of patients, hyporesponsiveness was seen in another 24%, and a normal response in only 10%. In 10 anorexia nervosa patients studied after weight gain, T4, T3, free T3, TSH, TBG and TBPA were significantly increased, and rT3 was significantly decreased. No change in mean free T4 levels with weight gain was noted. Other parameters of hypothalamic dysfunction in anorexia nervosa have been reported and the present data suggest that apparent hypothalamic hypothyroidism occurs perhaps as an adaptation to prolonged starvation.

Adolescent↗
PubMed1986

Changes in the hypothalamic-pituitary-thyroid axis during acute starvation in non-obese patients.

We investigated changes in the hypothalamic-pituitary-thyroid axis before, during, and after fasting in twenty-one non-obese euthyroid patients with psychosomatic diseases. Blood samples for free T3 (FT3), T3, free T4 (FT4), T4, reverse T3 (rT3), and TSH were obtained from all patients before and on the 5th day of fasting, and in 11 of the same individuals on the 5th day of refeeding. Serum TSH and T3 responses to TRH were also evaluated in 10 patients before and on the 5th day of fasting. During the fast, FT3, T3 and TSH levels decreased significantly and rT3 levels increased significantly whereas FT4 and T4 levels remained within the normal range. Maximal delta TSH, peak TSH levels, max delta T3, peak T3 levels, and net secretory responses to TRH decreased significantly. Peak TSH levels and max delta TSH to TRH correlated well with basal levels of TSH. A statistically significant negative correlation between basal levels of FT4 and TSH was observed. After refeeding, there was a significant increase only in TSH which returned to prefasting values. These results demonstrated that in a state of "low T3" during acute starvation a reduction in serum T3 might depend partly on TSH-mediated thyroidal secretion.

Adolescent↗
PubMed1984

[A long-term follow-up study of patients with chronic lymphocytic thyroiditis--with special reference to histological findings].

It is generally believed that in the long-term observation of chronic thyroiditis, the goiter decreases in size with thyroid hormone therapy and the thyroid function drops gradually. On the other hand, the histological changes in so-called Hashimoto's thyroiditis have been recognized to show progressive loss of epithelium and increased fibrosis. In this study, goiter size, thyroid function, thyroid microsomal and thyroglobulin antibodies and histology in needle biopsy were investigated in 75 patients with chronic thyroiditis during an interval of more than ten years. Among 75 cases, 8 (11%) were hypothyroid at the first medical examination. Among 21 cases who received no treatment, 7 (33%) became hypothyroid during the period of more than ten years. Among 54 cases with thyroid hormone therapy, 16 (30%) showed a remarkable reduction in size of goiter, but among 21 cases without thyroid hormone therapy only 3 (14%) showed a remarkable reduction. This paper discusses changes in titers of thyroidal antibodies in 47 cases. Among these 47 cases, 21 increased titer of thyroglobulin antibody during the period of more than ten years. 10 (48%) out of these 21 cases showed a remarkable reduction in size of goiter. But among 11 cases with a decrease of titer of thyroglobulin antibody, only one (9%) showed a remarkable reduction in size of goiter. On the other hand, titer of thyroid microsomal antibody increased in 33 cases. 9 (27%) out of these 33 cases showed a remarkable reduction in size of goiter. Only one (13%) of 8 cases, which decreased titer of thyroid microsomal antibody, showed a remarkable reduction in size of goiter.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗
PubMed1984

[A successfully treated case of Wolff-Parkinson-White syndrome with Ebstein's anomaly complicated with protein-losing gastroenteropathy].

A 17-year-old male underwent the division of the double accessory pathways under the diagnosis of Wolff-Parkinson-White (WPW) syndrome. At this time, we perceived that Ebstein's anomaly was combined with WPW syndrome, but we didn't treat Ebstein's anomaly, because it was slight. After this operation he relieved from the tachycardia attack completely. Ten months later, he was re-admitted to our hospital because of cardiomegaly and systemic edema. Hypoproteinemia was pointed out. On the basis of the intracardiac catheterization and 131I-RISA test, it was made to be sure that hypoproteinemia was caused by the protein-losing gastroenteropathy due to the tricuspid valve regurgitation of Ebstein's anomaly. After the tricuspid valve replacement with Hancock valve, protein-losing into the gastrointestinal tract disappeared. The aggravation of the tricuspid regurgitation was unrelated to the division of the accessory pathways, and was caused by the natural course of Ebstein's anomaly.

Adolescent↗