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Biomedical subjects

K Shibasaki

Publications and source records attributed to K Shibasaki.

At least 55 records · Page 3Linked to original sources

[Clinical evaluation of serum immunosuppressive acidic protein (IAP) and acid soluble glycoproteins (ASP) in patients with malignant tumors].

In order to study the clinical significance of IAP and ASP, we have measured serum concentration of IAP and ASP in patients with different cancer types including digestive organs, head and neck. Significantly higher correlation (coefficient of correlation = 0.924) was found between IAP and ASP. IAP and ASP levels were elevated in about 60-80% of cancer from digestive organs except hepatocellular carcinoma, and in about 56-100% of head and neck tumor. There was no correlation between IAP, ASP and various tumor markers (CEA, CA19-9, AFP) in all malignancies except pancreatic cancer. There was positive correlation between CEA and IAP, ASP in pancreatic cancer. IAP and ASP levels were significantly higher in patients with cancer having evidence of disease than the patients with cancer who had no evidence of disease, and so the determination of IAP and ASP was clinically useful for the diagnosis of tumor existence. At the time of diagnosis of recurrence, the levels of IAP and ASP were elevated in about 70% of patients with cancer recurrence. There was a definite relation between IAP, ASP and the gastric cancer stage. In later state (stage III and IV), serum IAP and ASP levels were significantly higher than the levels of stage I and II. In hepatocellular carcinoma without liver cirrhosis, the levels of IAP and ASP were higher than the patients with cirrhosis. The determination of IAP and ASP seems to be useful for monitoring clinical course, judgement of therapeutic effects.

Carcinoembryonic Antigen↗

[Clinical significance of serum acid soluble glycoproteins (ASP) and immunosuppressive acidic protein (IAP) in inflammatory diseases and liver diseases].

In order to study the clinical significance of ASP and IAP, we have measured serum concentration of ASP and IAP in 259 patients with inflammatory diseases, non-inflammatory diseases, autoimmune diseases and liver diseases. Significantly higher correlation (coefficient of correlation = 0.922) was found between ASP and IAP. There were good correlation between ASP, IAP levels and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Coefficient of correlation were 0.705 and 0.673 between ESR and ASP, IAP; 0.621 and 0.623 between CRP and ASP,IAP, respectively. There were food correlations between ASP levels and thrombo test (TT) and hepaplastin test (HPT). The positive rate and mean concentration of ASP, IAP in patients with inflammatory diseases were significantly higher than noninflammatory diseases. It is suggested that serum ASP, IAP could be one of the useful indicator for evaluating the clinical course of patients with inflammatory diseases. Serum concentration of ASP, IAP in patients with chronic liver diseases were lower than normal subjects, especially serum levels in patients with decompensated liver cirrhosis and chronic hepatitis (active) were significantly lower than normal subjects. In patients with hepatoma with cirrhosis, serum levels of ASP, IAP were significantly lower than the hepatoma patients without cirrhosis. The determination of ASP, IAP in liver diseases seems to be useful for evaluating the severity of diseases, the effects of therapy and the forecast of prognosis.

Autoimmune Diseases↗

[Clinico-statistical study of medical complication in dental patients].

Eight hundred and fifty two cases, who were introduced from the Dental Hospital to Department of Internal medicine, Medical Hospital at Niigata, The Nippon Dental University, were examined for medical complications. About one hundred and fifty cases were introduced per year from the Dental Hospital, which consisted of about 15% of the total outpatients in the Department of Internal medicine. The age distribution showed a high incidence of patients in their 50's. The number of patients over 60 years old was 220 (25.8%), and the number of patients over 65 years old was 160 (18.8%). There was then a high percentage of elder patients. The reason for the initial medical examinations was the need for a pre-operative medical examination in 42.6% of the total cases. Concerning medical complications among the patients, the highest incidence was hypertension in 116 cases (13.6%); the second highest was hepato-biliary and pancreatic diseases in 114 cases (13.4%); and heart diseases in 81 cases (9.5%). Eighteen cases of HBs antigen positive (2.1%) were seen among the patients with liver diseases. Among those with blood diseases, anemia showed the highest incidence, and a small number had leukemia and hemophilia. Diabetes mellitus showed up in 39 cases (4.6%), most of them being more than 40 years of age. Mentally and physically handicapped patients accounted for 30 cases. Half of them were from the pre-operative examination area, like tooth extraction.

Aged↗

[Clinico-statistical study of inpatients and autopsied cases in our clinic].

The statistics of clinical observation at Department of Internal Medicine, Nippon Dental University at Niigata from July 1981 to December 1987 (duration 6.5 years) were as follows: Total number of inpatients: 1,238, Total number of death cases: 106. Findings include: 1) Ratio of male patients to female patients 1.34:1.00. Male deceased patients to female deceased patients 1.52:1.00. 2) Average patients number hospitalized per year was 200. The high percentaged of certain advanced aged groups was reflected by the recent demographic changes in the society in general.; in their 60's 46.0%, in their 70's 24.3%, in their 80's 6.7%. In these age groups, female number is tendency to increase the number of male. 3) The diseases of inpatients were mostly due to the digestive tract, which accounted for 60.4% of the total. Of this percentage, 65% was due to hepato-biliary diseases. 4) The death statistics of malignant tumor was 68.9%; Benign diseases being 31.1%. Male patients died from hepatocellar carcinoma, lung cancer, colon cancer and stomach cancer, in descending order. Females died from cancer of the biliary tract, stomach cancer and hepatocellular carcinoma, again, in descending order. 5) 71.7% of all deaths were caused by the digestive tract, in particular, hepatocellular carcinoma, cancer of the biliary tract, liver cirrhosis and primary biliary cirrhosis, all belonging primarily to the hepato-biliary disease group. 6) As a result of 58 autopsies performed for 106 death cases, 32 cases had complete autopsies and 26 cases had partial organ punctures.

Aged↗

Thoracic disc herniation. Surgical treatment in 23 patients.

The authors' surgical procedure for the treatment of symptomatic thoracic disc herniation has consisted of total discectomy of the involved intervertebral disc, followed by intervertebral body fusion using autogenous iliac bone through an anterior approach. The authors prefer the extrapleural approach to the thoracic vertebrae because of simplified postoperative care with minimum surgical interference with respiratory function. During the past 16 years, 23 patients with symptomatic thoracic disc herniation have been treated by this procedure. Preoperatively all 23 patients presented with some measure of paraplegia, with difficulty in walking. Their clinical presentation was analyzed and diagnostic aids to the thoracic disc herniation by radiographic examinations were assessed. The radiographic abnormality of ossification of the yellow ligament (OYL) coinciding with the involved thoracic disc level was noted. The results in all 23 patients with this procedure were favorable. Based on the results of this series, this procedure is recommended for the treatment of symptomatic thoracic disc herniation.

Adult↗

Ossification of the ligamentum flavum of the thoracic spine in adult kyphosis.

Ossification of the ligamentum flavum has been recognised as a definite clinical entity as is ossification of the posterior longitudinal ligament. The incidence of both is high in Japan. This study demonstrates that the incidence of ossification of the ligamentum flavum in persons who have a kyphosis of the thoracic or lumbar spine is higher than in those who do not. It is considered that localised mechanical stress affecting the ligamentum flavum is a contributing factor to the development of ossification, together with the generalised factors which may favour bone formation. However, the aetiology of this lesion is still obscure as is that of ossification of the posterior longitudinal ligament.

Adult↗

The surgical reconstruction of fractures and fracture dislocations of the thoraco-lumbar spine.

Sixty patients have undergone surgical reconstruction of the injured thoraco-lumbar spine during the period 1968 to 1978 at the Spinal Unit of the National Murayama Hospital. The aim of treatment of any fracture, dislocation, or fracture-dislocation of the spine is to render it stable and painfree. This is best achieved by reduction and stabilisation of the involved segment of the spinal column. Where the posterior ligaments and intervertebral disc are ruptured healing of these structures with return to normal stability cannot be anticipated. In order to obtain permanent stability at the affected vertebral level we elect to perform anterior intervertebral fusion.

Adult↗

Vertebral metastases and spinal cord compression.

Clinical interest in spinal compression and resultant paraplegia due to metastases has mounted in recent years. This has stimulated attention to the neuropathology of the condition. Fourteen cases of spinal cord compression due to vertebral metastases are compared with over 100 traumatic cases. In the traumatic lesions there is central haemorrhagic necrosis leading to cavitation and gliosis with nerve root regeneration in the late stages. In the metastatic cases, lesions are often peripheral, pie-shaped and are related to vascular factors. The neuropathology of cord necrosis due to metastatic spinal disease is therefore different to trauma. These observations have clinical importance in planning treatment.

Adult↗

Percutaneous embolisation of major spinal cord artery as a treatment for intractable spasticity.

Based on the angiographic findings of the injured spinal cord percutaneous embolisation of Adamkiewicz's artery was carried out to control intractable spasticity in ten cases of late stage spinal cord paralysis. The purpose of this procedure was to interrupt the reflex arcs of the lower extremities by decreasing the blood supply to the lumbar enlargement. Results were excellent in two cases, good in five and poor in three. Major effects were found in adduction and flexion spasticity of the hip joints and bladder function was always preserved in these patients. It is speculated that occlusion of Adamkiewicz's artery mainly affected the lower thoracic and the upper lumbar segments. Anastomosis between the anterior spinal artery and the two posterior spinal arteries might have provided sufficient collateral blood circulation to the conus level. It is emphasised that the percutaneous embolisation of Adamkiewicz's artery reduced the intractable spasticity of the lower extremities without changes in the voiding function of the automatic bladder.

Adult↗

Therapeutic effects of tiopronin on chronic hepatitis: a double-blind clinical study.

The efficacy of tiopronin (2-mercaptopropionyl glycine) 600 mg daily in the treatment of chronic active or chronic persistent hepatitis has been assessed in a double-blind controlled clinical trial of 12 weeks involving 165 Japanese patients with histologically proven disease. Treatment with the drug was associated with a significant improvement in abnormalities of serum transaminase and gamma glutamyl transpeptidase, with reversion towards baseline values on stopping the drug. Improvement was independent of the histological classification of the disease, or HBsAg status. The drug was well tolerated with few side-effects. The results of this short-term study indicate that tiopronin may be of value in the treatment of chronic hepatitis.

Acyltransferases↗

An experimental study of early ultrastructural changes in the injured spinal cord.

Experimental hemisection injury of rat spinal cord was undertaken in order to examine Wallerian degeneration of ascending and descending tracts, and alterations in neurons and synapses. By light microscopy degeneration of axons was recognized first at 72 hours post-operatively. On the other hand, EM study revealed axonal degeneration 24 hours post-operatively. There were several ultrastructural changes in the early stages after hemisection injury. Increase in number of lysosomes in neurones was believed to be related to "autolysis" of the injured spinal cord. Another noteworthy finding was the "separation" of boutons. The mechanisms considered to account for these findings were deafferentation and oedema.

Afferent Pathways↗

Spinal osteotomy to correct kyphosis in spinal tuberculosis.

Twenty-seven patients with severe tuberculous kyphosis have been treated at the National Murayama Hospital between 1966 and 1977. We have undertaken curettage of the foci and vertebral osteotomy through an anterior approach, followed by gradual correction with a halo pelvic distraction apparatus and subsequent vertebral fusion. Choice of this method depends upon the age of the patient, the degree of kyphosis before correction, and the presence of concomitant lesions. Details of postoperative management are given and their importance is emphasized. The major risks of correction are discussed and precautions suggested.

Adolescent↗