Biomedical subjects

M Shibata

Publications and source records attributed to M Shibata.

931 records · Page 52Linked to original sources

PubMedDate not supplied

Immunohistochemical localization of calcitonin gene-related peptide in the human gastric mucosa.

BACKGROUND/AIM: There have been only a few studies on the distribution of calcitonin gene-related peptide (CGRP) in the human stomach, in which it was stated that CGRP fibers are rare in that organ. The aim of the present study was to investigate the immunohistochemical localization of CGRP in the human gastric mucosa obtained by endoscopic biopsy from patients with gastric ulcers. METHODS: Immunohistochemistry was carried out according to the indirect immunoperoxidase method using an anti-human CGRP antibody. Biopsies were taken from the ulcer margin in 18 patients (age 37-78, average 57.4 years) and from two endoscopically normal portions (antrum and body) in 7 other patients (age 36-65, average 51.0 years). One biopsy specimen was obtained from each portion. RESULTS: Twelve of the eighteen biopsy specimens from the ulcer margin, 6 of the 7 biopsy specimens from normal portions of the antrum and 3 of the 7 biopsy specimens from normal portions of the body showed CGRP-immunoreactive staining. Intense staining was more marked in the specimens from the ulcer margin compared to those of the normal portions. CONCLUSIONS: CGRP immunoreactivity was observed in the human gastric mucosa in considerable abundance, and it is presumed that CGRP might participate in a restoration mechanism of the ulcer.

Adult↗

PubMedDate not supplied

Low-dosage intravenous immunoglobulin in the management of a patient with acquired von Willebrand syndrome associated with monoclonal gammopathy of undetermined significance.

We report herein the case of a 69-year-old Japanese man with acquired von Willebrand syndrome associated with monoclonal gammopathy of undetermined significance who developed IgG1-kappa antibodies against von Willebrand factor (VWF). The patient was urged to undergo tooth extractions because of alveolar pyorrhea, and a low-dosage intravenous immunoglobulin (IV-Ig) therapy (0.3 g of IgG/kg/day for 3 days) was chosen for him. On the 4th day after the infusion, VWF antigen and VWF ristocetin cofactor increased to 40 and 78% of the control, respectively, and dental extractions were performed successfully. On the 7th day, these values reached a maximum, i.e. 95 and 160% of the control, respectively. Then, they quickly decreased to 35 and 75% on the 10th day, and 6 months later, they became 16 and <3% of the control, respectively. Upon analysis of plasma VWF multimers (VWFMs) in this patient, those with large to medium molecular masses more selectively disappeared before the IV-Ig infusion than did those with small molecular masses. On the 4th day, the pattern of VWFMs was completely normalized and appeared to persist until the 10th day. Six months later, a small amount of large to medium-sized VWFMs was still present, but at 7-8 months, the pattern of VWFMs became almost the same as that before infusion. Throughout the patient's clinical course, the activity of plasma VWF-cleaving protease, which specifically cleaves the Tyr842-Met843 bond of the subunit and reduces its multimeric sizes, was quite normal (95-119%). These results provided consistent evidence that the selective absence of VWFMs with large to medium molecular masses in this patient is caused by the heightened clearance of a complex of IgG inhibitor and VWFMs from the circulation, presumably through IgG binding to the Fc receptor of macrophages. Furthermore, these results also indicated that a low-dosage IV-Ig therapy is effective enough for hemostatic management for programmed surgery.

ADAM Proteins↗

PubMedDate not supplied

[Awareness and feelings of elderly patients and their families concerning disease during terminal hospitalization--malignancy versus non-malignancy].

We conducted a questionnaire survey on the awareness and feelings of elderly patients and their families concerning their diseases and prognosis during terminal hospitalization. Sixty-five families of 177 patients who died at our hospital in 1992 answered questions concerning estimation of the prognosis, understanding of the disease, satisfaction regarding explanation of the disease, wish to be informed of the diagnosis, feelings during hospitalization, and whether the family revealed the diagnosis to the patient. Patients with malignancy were not informed of the true diagnosis at this time. As to estimation of the prognosis, patients aged 70 or older who did not expect "cure" of their diseases at first were significantly fewer, and those anticipating "death" just before dying were significantly more frequent than those under age 70. In patients with malignancy, those aged 70 or older foresaw "incurability" at first significantly more frequently than those under age 70. Patients with malignancy knew the diagnosis in significantly fewer cases, believed the false diagnosis significantly more frequently, and showed dissatisfaction with the explanation of the disease significantly more frequently, than those with non-malignancy. Proportions of the family who told the diagnosis to the patient were 11.8% in malignancy and 38.8% in non-malignancy with statistical significance. These data indicate that medical care during terminal hospitalization should be modified principally based on informed consent, if that is the wish of the patient.

Aged↗

PubMedDate not supplied

Left hepatic trisegmentectomy for intraductal papillary cholangiocarcinoma: report of a case.

We present a rare case of intraductal papillary cholangiocarcinoma in a 69 year-old man which was treated with left hepatic trisegmentectomy. The hepatic bile ducts were dilated by intraductal masses, which had extended into the intrahepatic bile ducts without involvement of the posterior inferior segmental duct (B6). The patient underwent left hepatic trisegmentectomy with hilar duct resection. The tumors in the posterior superior segmental duct (B7) were resected and biliary reconstruction was performed with a jejunal loop. Post-operative recovery was good, and the patient survived for 7 months after surgery.

Aged↗

PubMedDate not supplied

Blood reflux into cartridges for dental anesthesia: detection in residual solution.

The study examines blood reflux into cartridges under infiltration anesthesia. When imitation examination was carried out using Pontamine blue dye solution in 7 kinds of syringes using cartridges, dye reflux was observed in all of them. Dye reflux was observed in all but 1 of 4 kinds of cartridges on the market. The amounts of protein in residual anesthetic solution of cartridges after infiltration anesthesia were quantitatively measured by a dye binding method. Human hemoglobin was also measured by enzyme immunoassay (EIA). The detection rates of protein and human hemoglobin were 26.2% (85/324) and 24.2% (24/99), respectively. Study results show that blood reflux cannot be avoided in the cartridge system so reuse of residual anesthetic solution from cartridges should be prohibited as quickly as possible to avert risk of cross-infection of HB and AIDS virus.

Anesthesia, Dental↗

PubMedDate not supplied

A case report of Paget's disease of the breast treated with radiotherapy alone.

Paget's disease of the breast is a rare form of breast cancer. Patients with nipple-areolar disease alone and no palpable mass have an excellent prognosis. Although there is some argument about the treatment of this type of Paget's disease, only two reports have been published on the role of conservative treatment. This report discusses a case of limited Paget's disease of the nipple and areola of the breast which was treated by radiation alone without limited surgery.

Breast Neoplasms↗

PubMedDate not supplied

Hypothalamic neuronal responses to cytokines.

Fever has been extensively studied in the past few decades. The hypothesis that hypothalamic thermosensitive neurons play a major role in both normal thermoregulation and in fever production and lysis has particularly helped to advance our understanding of the neuronal mechanisms underlying the response to pyrogens. Furthermore, new data in the study of host defense responses induced by pyrogenic cytokines such as interleukin 1, interferon alpha 2, tumor necrosis factor alpha, and interleukin 6 have demonstrated that those factors have multiple, yet coordinated, regulatory activities in the central nervous system, so that our understanding of the role of the brain in the activity of these agents requires a new perspective and dimension. Thus, recent evidence from our laboratory indicates that blood-borne cytokines may be detected in the organum vasculosum laminae terminalis and transduced there into neuronal signals. Such signals may then affect distinct, but partially overlapping, sets of neuronal systems in the preoptic area of the anterior hypothalamus, mediating directly and/or indirectly the array of various host defense responses characteristic of infection that are thought to be induced by blood-borne cytokines.

Biological Factors↗

PubMedDate not supplied

Chondrosarcoma of the trachea. A case report and literature review.

The cytologic presentation of a case of chondrosarcoma of the trachea in a 72-year-old man is described. A mass detected on routine chest roentgenogram and defined by CT scan was used to make a touch imprint smear during partial tumor resection. The cytologic findings included round or polygonal cells with occasional binucleation, round hyperchromatic nuclei and prominent nucleoli, present in an amorphous pink-violet or light-blue background containing fragments of chondroid tissue. The histopathology was interpreted as a low-grade chondrosarcoma. Cartilaginous tumors of the trachea should be considered in the differential diagnosis of upper airway obstruction.

Aged↗

PubMedDate not supplied

Autoregulation of histamine release via the histamine H3 receptor on mast cells in the rat skin.

The autoregulation of the histamine release via the histamine H3 receptor in the periphery was studied in vivo and in vitro. Antidromic electrical stimulation of the sciatic nerve caused a significant increase in histamine release in the subcutaneous perfusate in the rat hindpaw. (R)alpha-methylhistamine, a specific H3 receptor agonist, significantly and dose-dependently inhibited the increase in release of histamine by antidromic stimulation at intravenous doses of 0.25-2 mg/kg. Thioperamide (2 mg/kg, intraperitoneally), a specific H3 antagonist, prevented the inhibitory effect of (R)alpha-methylhistamine. Substance P perfusion (5-50 microM) also elicited a significant increase in histamine, and a significant inhibition by (R)alpha-methylhistamine and the antagonism of thioperamide were observed. (R)alpha-methylhistamine inhibited the histamine release by substance P from rat peritoneal mast cells in vitro, and thioperamide reduced the response to (R)alpha-methylhistamine. These data suggest that mast cells may have histamine H3 receptors, and that histamine probably modulates its own release through the H3 receptor in neurogenic inflammation.

Analysis of Variance↗

PubMedDate not supplied

Tetraphasic actions of local anesthetics on central nervous system electrical activities in cats.

BACKGROUND AND OBJECTIVES: The effects of seven local anesthetics, mepivacaine, bupivacaine, etidocaine, dibucaine, prilocaine, procaine, and tetracaine, on the central nervous system (CNS) electrical activities were studied in five cats with each agent. METHODS: Brain electrodes were implanted chronically in the cortex, amygdala, hippocampus, and midbrain reticular formation. The cortical, amygdala, and hippocampus electroencephalograms (EEGs), reticular multiunit activity (R-MUA), and heart rate were recorded. Drugs were administered intravenously with constant rates of equipotent doses until EEG seizures appeared. Effects of lidocaine, 1 mg.kg-1.min-1, were studied for comparison. The rates of infusion were: mepivacaine, 1 mg.kg-1.min-1; procaine, 4 mg.kg-1.min-1; bupivacaine and tetracaine, 0.25 mg.kg-1.min-1; etidocaine, 0.5 mg.kg-1.min-1; dibucaine, 0.15 mg.kg-1.min-1; and prilocaine, 3 mg.kg-1.min-1. The effects of 10-15 times higher rates of infusion were also studied in two cats with each drug. RESULTS: During the slow rates of infusion, a tetraphasic sequence of changes, common to all agents, was observed: the initial stage represented by diffuse EEG slowing and a suppression of the R-MUA; the second stage by low voltage fast wave EEG and an activation of the R-MUA; the third stage by reappearance of slow wave EEG and a suppression of the R-MUA; and the fourth stage by an epileptiform EEG and an activation of the R-MUA. These changes in EEG were not typical in some cats administered procaine, bupivacaine, prilocaine, and dibucaine. During the high rates of infusion, suppressive stages in the R-MUA were less dominant and activations dominated. High rates of infusion of mepivacaine produced sudden epileptic activities in EEG. Tetracaine, procaine, etidocaine, and bupivacaine in the high rates of infusion produced slow waves for a short period, prior to seizure activities in the EEG. Dibucaine or prilocaine in high rates of infusion could not produce seizure activities in the EEG, but slow waves and isoelectrical EEG, which were accompanied with idioventricular rhythm followed by ventricular fibrillation. CONCLUSIONS: All local anesthetics have similar tetraphasic CNS actions and whether the expression of CNS intoxication with subconvulsive doses is excitation or suppression may possibly be dependent on the brain drug level and its rate of increase.

Anesthetics, Local↗

PubMedDate not supplied

[Genotoxic modification of nucleic acid bases and biological consequences of it. Review and prospects of experimental and computational investigations].

The review is presented of experimental and computational data on the influence of genotoxic modification of bases (deamination, alkylation, oxidation) on the structure and biological functioning of nucleic acids. Pathways are discussed for the influence of modification on coding properties of bases, on possible errors of nucleic acid biosynthesis, and on configurations of nucleotide mispairs. The atomic structure of nucleic acid fragments with modified bases and the role of base damages in mutagenesis and carcinogenesis are considered.

Alkylation↗

PubMedDate not supplied

Congenital multiple arterioportal fistula: a case report treated with portocaval shunt.

A case of 48-year-old man, with diffuse arterioportal fistula (APF) considered congenital in origin, is described. The patient presented with recurring intractable variceal hemorrhage which was treated by endoscopic ligation or sclerotherapy. In this case, gastroduodenal artery and branches of mesenterial artery were diffusely involved, so these lesions could not be resected. Portocaval shunt between the superior mesenteric vein and the right iliac vein was successfully performed. Follow-up endoscopic examination one year later revealed no evidence of esophageal and gastric varices. To our knowledge, this is the second case in which a patient underwent portocaval shunt successfully for congenital APF.

Arteriovenous Fistula↗

PubMedDate not supplied

Angiolymphoid hyperplasia with eosinophilia.

We report a case of angiolymphoid hyperplasia with eosinophilia (ALHE). Histologically, some vessels were lined with plump endothelial cells. Infiltration by lymphocytes, histiocytes and eosinophils was marked. An arteriovenous malformation and vessels occluded by endothelial cell hyperplasia were present. PCNA staining gave positive results for the nuclei of many of the plump endothelial cells. Electron-microscopic findings disclosed increased metabolic activity in the cells. These observations suggest that the plump endothelial cells, characteristic of ALHE, have high metabolic activity. These results suggest that blood flow is increased by arteriovenous malformations and that blood pressure is elevated by occlusion, resulting in hyperplasia of plump endothelial cells and accelerated neovascularization.

Adult↗