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Biomedical subjects

M Nishikawa

Publications and source records attributed to M Nishikawa.

At least 757 records · Page 42Linked to original sources

A case of insulin autoimmune syndrome associated with small insulinomas and rheumatoid arthritis.

Twenty five cases of insulin autoimmune syndrome including this case has been reported so far without having the pathogenesis clarified. This paper describes a case which suggests one aspect of pathogenesis. The patient, a housewife concurrently had insulinoma and severe rheumatoid arthritis, complaining of hypoglycemic syncope attacks. During the attacks her blood sugar levels ranged from 19 to 22 mg%. Her serum extractable immunoreactive insulin (IRI) and insulin binding antibody levels were 557 microunits/ml and 0.390 mU/ml, respectively. gamma-Globulin-bound insulin was also measured electrophoretically. Bio-Gel P 10 column chromatography eluted almost all IRI at the void volume at pH 7.4 and a smaller but significant IRI peak also at pH 3.0. Selective angiography revealed a tumor-like staining in the pancreas body. Pancreatectomy relieved her of hypoglycemic attacks. Histology disclosed two small insulinomas. Insulinoma, rheumatoid arthritis and insulin autoimmune syndrome coexisted in this case, suggesting some causal relationship among them.

Adenoma, Islet Cell↗

Post-partum transient thyrotoxicosis: report of two cases.

Two patients with post-partum transient thyrotoxicosis associated with painless thyroiditis and low radioactive iodine uptake were described. The surreptitious use of thyroid hormones or iodine was excluded. Although the clinical course was compatible with that of subacute thyroiditis, passing through the hyperthyroid, euthyroid, hypothyroid and recovery phase, the patients showed a sustained elevation of serum anti-thyroglobulin antibody titer during the entire phase of the disease. Moreover, the histological findings obtained by the thyroid biopsy performed in a case were characteristic of chronic lymphocytic thyroiditis. Furthermore, it was of interest that the disease recurred following every delivery in 2 cases, suggesting the possible role of immunological changes induced by pregnancy and delivery in the etiology of this disease.

Adult↗

Transient thyrotoxicosis associated with painless thyroiditis and low radioactive iodine uptake.

We describe a patient with transient thyrotoxicosis and low radioactive iodine uptake by the thyroid. Although the clinical course in this patient was compatible with subacute thyroiditis, she did not experience pain or tenderness in the neck. The use of thyroid hormones or iodine was excluded. The substantial level of thyroid antibody in serum was present during the entire phase of the disease. Histological findings on thyroid biopsy were characteristic of chronic lymphocytic thyroiditis. Furthermore, it was remarkable that the histological abnormalities improved spontaneously during the course of several months, with the spontaneous recovery of clinical signs and biochemical abnormalities.

Adult↗

A-Cell and gut glucagon in normal and depancreatized dogs. Inhibition by somatostatin and insulin.

The effect of somatostatin (SRIF) and of insulin on the plasma levels of immunoreactive glucagon (IRG) and glucose was examined in normal (N) and depancreatized (PX) dogs. The infusion of SRIF (3 microgram/min for 15 min) caused a rapid decrease of the total IRG measured by means of an antiglucanon serum (AGS 10) which cross reacts with extracts of intestinal mucosa. This decrease was due primarily to a fall in the IRG fraction measured by an antiserum (AGS 18) specific for the carboxyl terminus of pancreatic or A-cell IRG. When the dose of SRIF was increased to 10 microgram/min for 90 min, the difference between total and A-cell IRG in the systemic blood also decreased, indicating that other IRG fractions, such as gut IRG, had also been suppressed. The introduction of 50 ml of a 5% glucose solution into a loop of ileum was followed by an increase of gut IRG measured in the regional mesenteric blood. This response was suppressed by the infusion of SRIF (3 microgram/min). Insulin suppressed the basal level of total IRG, but did not alter the gut IRG response to glucose. The SRIF- and insulin-induced reduction in plasma IRG was not associated with a reduction in plasma glucose, suggesting that the high levels of total and A-cell IRG observed in depancreatized dogs were not essential for the maintenance of hyperglycemia.

Animals↗

Middle meningeal--middle cerebral artery anastomosis for cerebral ischemia.

A new technique of anastomosing the middle meningeal artery to a cortical branch of the middle cerebral artery is described. A case is presented in which the operation was technically successful and the immediate clinical result was good. Long-range follow-up is necessary and a larger series will be needed for study before the merits of the technique can be judged adequately. The advantages and disadvantages of this technique are described, as well as possible indications and future studies.

Blood Vessel Prosthesis↗

Endothelial damage in microvascular anastomosis: to splint or not to splint?

When performing a microvascular anastomosis, some surgeons use a splint and others do not. We compared the difference in intravascular reactions observed in the carotid artery of the rat anastomosed with these two techniques by observation with a scanning electron microscope. Thrombus formation was more prominent in the artery anastomosed using a splint. The difference was most remarkable 20 minutes after anastomosis. With time, the difference became less remarkable and was no longer present by seven days. By fourteen days, the anastomotic site was covered with neoendothelium. It is concluded that there is little difference in the final outcome achieved by the two methods.

Animals↗

[Studies on the biological action of uterine RNA in rat implantation (author's transl)].

With a view to investigating the mechanism of the action of estrogen involved in nidation, the biologically active rat uterine RNA thereby derived was extracted and then administered in the uterine cavity of castrated rats to observe the ensuing morphological changes in the endometrium and compare them with those resulting from the administration of decidual RNA which is non-estrogenised. There was a tendency toward increasing proliferation noted in the endometrial epithelium of the castrated rats 48 hours after the administration of the biologically active uterine RNA, as in the endometrial epithelium of animals receiving estradiol-17beta. There was also an increase in the number of 3H-thymidine-labelled cells present in the endometrial epithelium of animals so treated. On the other hand, no such changes were observed following the administration of the RNA pretreated with RNase. In the case of castrated rats administered with the RNA in the uterine cavity under progesterone priming, the endometrial epithelium as the site of increase in the number of the radio-labelled cells at 24 hours was found to be superseded by the stromal cells at 48 hours. A similar phenomenon of transfer was seen with regard to the site of an increase in the mitosis index caused by pretreatment with colchicine. An observation of the endometrium of castrated rats 72 hours after the administration of decidual RNA disclosed that the stroma was mildly edematous with the stromal cells somewhat swollen, but without any such changes in the endometrial epithelium as seen following the administration of the biologically active uterine RNA. These findings led us to administer such biologically active substances as uterine RNA, decidual high molecular RNA, human chorionic RNA, rat placental RNA (L15) and early pregnant rat uterine RNA (L4) separately in the uterine cavity of delayed implantation rats to determine whether any one or more of these RNAs had a nidation promoting effect just like estrogen. As a result, nidation was found to be induced in animals administered with 1 approximately 100 microgram of the biologically active uterine RNA or 100 microgram of early pregnant rat uterine RNA. No nidation was provoked by other specimens of RNA. A study was then made of blastocysts recovered by the flush-out technique from the uterus of animals receiving 1 approximately 10microgram of human chorionic RNA or 10microgram of rat placental RNA, which failed to induce nidation. It was shown that these blastocysts were dormant morphologically. From these results it is apparent that both biologically active uterine RNA and early pregnant rat uterine RNA are effective in promoting nidation. It is also suggested that, in the process of implantation of fertilized eggs, nidatory estrogen may first promote RNA synthesis in the endometrium and then exhibit its action through the medium of RNA thus synthesized.

Animals↗