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Biomedical subjects

M Shimizu

Publications and source records attributed to M Shimizu.

At least 613 records · Page 34Linked to original sources
PubMed1996

Early gastric cancer of adenosquamous carcinoma type: report of a case and review of literature.

We report a case of adenosquamous carcinoma of the stomach which involved only the mucosa and submucosa, but was found to have already metastasized to a regional lymph node and the liver at surgery. Adenosquamous carcinomas of the stomach are rare and usually invade deeply into the muscular layer. Those limited to the mucosa and submucosa are extremely rare, and only seven cases have been reported to date. It was interesting that in our case, 80% of the tumor in the stomach and lymph node was composed of squamous cell carcinoma and 20% consisted of adenocarcinoma, whereas the metastases in the liver consisted entirely of adenocarcinoma. The literature on this type of gastric carcinoma is reviewed and the possible histogenesis of this tumor is discussed.

Aged↗
PubMed1996

Endocrine effects of IL-1 alpha and beta administered in a phase I trial to patients with advanced cancer.

Previous primate and rodent studies suggested that interleukin-1 alpha (IL-1 alpha) caused changes in the secretion of pituitary, adrenal, thyroid, and gonadal hormones, as well as acute-phase reactants. Plasma samples were obtained after IL-1 alpha and beta treatment in cancer patients to document the changes in endocrine function suggested by the animal models. Successive groups of patients were treated at IL-1 alpha doses of 0.01, 0.03, 0.1, 0.3, and 1.0 microgram/kg, given daily as a 15-min intravenous bolus. IL-1 beta was given at 0.1 microgram/kg by the same route and time course. After the first dose of IL-1, statistically significant elevations of a.m. and p.m. cortisol, growth hormone (GH), and prolactin (PRL) occurred. Thyroid-stimulating hormone (TSH) and C-reactive protein (CRP) were elevated by the sixth treatment day. Testosterone decreased significantly in male patients. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were more variable but decreased in most patients. The changes in cortisol, GH, PRL, TSH, CRP, FSH, LH, and testosterone resolved after treatment and did not result in clinically apparent endocrinopathies. Bolus doses of IL-1 alpha and beta cause significant changes in many endocrine laboratory parameters and influence the in vivo activities of multiple homeostatic endocrine functions in human beings.

Acute-Phase Proteins↗
PubMed1996

Brain SPECT of Creutzfeldt-Jakob disease.

SPECT imaging with I-123 IMP or Tc-99m HMPAO was performed in two patients with Creutzfeldt-Jakob disease to evaluate abnormalities in brain perfusion. In the first patient, there was decreased perfusion of the left frontal, parietal, and temporal lobes. CT and MRI were negative. In the second patient, there was patchy perfusion and slightly decreased perfusion of the right hemisphere. MRI revealed slight brain atrophy and bilateral high intensity areas in the basal ganglia on T2 weighted images. Subsequent SPECT imaging revealed severely decreased perfusion of the entire brain. Subsequent MRI demonstrated severe brain atrophy.

Aged↗
PubMed1996

A case of serotonin syndrome induced by concomitant treatment with low-dose trazodone and amitriptyline and lithium.

We describe a patient treated with trazodone, amitriptyline and lithium carbonate who developed anxiety, restlessness, tremor, myoclonus, hyperreflexia, diaphoresis, rigidity and hyperthermia. The constellation of findings was diagnostic of serotonin syndrome. Although doses of trazodone and amitriptyline were relatively low, serotonin syndrome developed in this patient. It is suggested that the combination with lithium facilitated the effect of central serotonergic responses mediated by trazodone and amitriptyline.

Amitriptyline↗
PubMed1996

Scintigraphic study of malignant melanoma with 123I-iodoamphetamine.

N-isopropyl-p-I-123-iodoamphetamine (123I-IMP) is extracted by the brain in proportion to regional blood flow. It is particularly useful in the clinical assessment of various pathological conditions related to altered cerebral flow. Moreover, it has been reported that 123I-IMP is avidly incorporated into melanin and melanotic melanoma. We evaluated 123I-IMP scintigraphy using either planar or single photon emission tomography (SPET) studies in 10 patients with malignant melanoma. The patients were classified into two groups according to the tumour site: Group A, six patients with primary or metastatic cutaneous malignant melanoma of the extremity with planar scintigraphy; Group B, four patients with primary malignant melanoma of other organs with planar scintigraphy and SPET. In Group A, tumour uptake was demonstrated in four of six patients; in Group B, three of four patients had tumour accumulation on SPET and planar scintigraphy. SPET revealed the exact tumour localization, even in the case of a tumour located in the lung. These results suggest that planar scintigraphy using 123I-IMP is useful in the detection of malignant melanoma. Furthermore, more clear tumour localization is possible with SPET, even in the case of a tumour located in the lung.

Aged↗
PubMed1996

Simultaneous assessment of regional adrenergic activity and perfusion with 123I-MIBG and 201Tl in congestive heart failure.

Simultaneous assessment of regional adrenergic activity and perfusion with 123I-meta-iodobenzylguanidine (123I-MIBG) and 201Tl in various organs was performed in 13 patients with congestive heart failure (CHF) and 13 subjects without heart failure. In order to reduce the crosstalk of 201Tl to the 123I energy window to less than 5%, a dose of 123I-MIBG more than five times greater than that of 201Tl was administered following 201Tl scintigraphy. Regional uptake of 201Tl (%dose) was significantly increased in the heart (left ventricle) and lung (both P < 0.01) in the patients with CHF. The increased global cardiac uptake could have been related to the enlarged left ventricle. The patterns of regional uptake of 123I-MIBG (% dose) at 15 min were similar to those of 201Tl, suggesting that early 123I-MIBG uptake could in part depend on regional perfusion in both groups. At 3 h, regional uptake of 123I-MIBG was significantly increased in the heart, lung and kidney (all P < 0.01) in the patients with CHF. The delayed 123I-MIBG uptake indicates the degree of neuronal accumulation of the tracer, and therefore reflects adrenergic activity. Interestingly, the cardiac 123I-MIBG (adrenergic activity) to 201Tl (unit of perfusion) ratio decreased significantly in the heart (P < 0.01) but increased significantly in the kidney (P < 0.01) in the patients with CHF compared with the control group. Cardiac 123I-MIBG washout was also significantly increased in the CHF patients. Moreover, the cardiac 123I-MIBG:201Tl ratio was negatively correlated with plasma norepinephrine concentration (r = -0.74, P < 0.01), but positively correlated with LVEF (r = 0.60, P < 0.01). These data suggest that there may be impairment of both the neuronal uptake function and the vesicular storage function in the failing heart, and an increment in neuronal uptake function in the kidneys in patients with CHF. We suggest that dual-tracer scintigraphy is a useful non-invasive method for the simultaneous assessment of adrenergic activity and perfusion in various organs in patients with heart failure.

3-Iodobenzylguanidine↗
PubMed1996

Epidemiological analysis of prognosis of 496 Japanese patients with progressive systemic sclerosis (SSc). Scleroderma Research Committee Japan.

For the first time, we performed an epidemiological study of SSc in Japan to study the factors influencing prognosis, survival rate and cause of death of Japanese SSc patients and to compare our data with those from foreign countries. Prognosis of 496 Japanese patients with progressive systemic sclerosis (SSc) was analyzed based on clinical data described in case cards provided by the members of the Scleroderma Research Committee of the Japanese Ministry of Health and Welfare. The essential observation period was from 5 to 20 years, at ending in 1994. Ninety patients died (males 11, females 79). The age of onset of the deceased patients was significantly higher than that of surviving patients (deceased, 45.6 yrs, surviving 41.3 yrs). Statistically significant factors for a poor prognosis were as follows: Barnett type III > type II > type I, positive for anti-Scl-70 antibody, negative for anti-centromere antibody. The survival rate at 5 years after the onset of the disease was 0.937, followed by 0.82 at 10 years, 0.567 at 20 years and 0.40 at 30 years after the onset. Sex was not a predictor for prognosis, although male patients died at an earlier stage of the disease. The most common causes of death were heart failure, pulmonary insufficiency, lung fibrosis, and renal failure. Twenty-four patients had cancer of which 13 were lung cancers. The current status of the survival rate and prognostic factors of 496 Japanese SSc patients is summarized. In future, more well-controlled studies using the same criteria should be performed for the better understanding and management of SSc.

Adult↗
PubMed1996

Cutaneous myiasis due to Dermatobia hominis in Japan.

A 29-year-old man with a furuncle-like lesion brought in a maggot on the next day after his first visit to our clinic. He said it moved out from the eruption spontaneously. He had previously visited Parana and Sao Paulo in Brazil before he noticed the symptom. The maggot was confirmed to be a third instar larva of Dermatobia hominis. Japanese cases of cutaneous myiasis are reviewed.

Adolescent↗
PubMed1996

Progressive systemic sclerosis sine scleroderma which developed after exposure to epoxy resin polymerization.

Progressive systemic sclerosis (PSS) sine scleroderma is well known as a special form of scleroderma. Because of its rarity, its pathogenesis has not yet been elucidated. We experienced a 33-year-old man who developed PSS sine scleroderma while working with epoxy resin polymerization. He had short white frenulum linguae, diffuse hyperpigmentation and facial telangiectasia, positive antinuclear antibody, and pulmonary dysfunction, but not acrosclerosis or sclerodactylia. Modest dermal collagen proliferation in the forearm skin confirmed PSS sine scleroderma. Epoxy resin polymerizer appears to be a potent causative agent for PSS sine scleroderma as well as for generalized morphea-like PSS.

Adult↗
PubMed1996

Tissue factor and thrombomodulin expression on keratinocytes as coagulation/anti-coagulation cofactor and differentiation marker.

Immunohistochemistry was used to investigate the expression of tissue factor (TF) as a coagulation factor and thrombomodulin (TM) as an anticoagulation cofactor in the epidermis. TM was expressed on Malpighian layer keratinocytes while TF was located on the supra-Malpighian layer. Epidermal shave extracts were biologically active for both factors. Keratinocytes cultured in high calcium, but not low calcium media, expressed both TF and TM. In pemphigus vulgaris pemphigus foliaceus and bullous pemphigoid, TF expression was increased on keratinocytes shielding the blister compared to the down-regulated TM expression by keratinocytes around the blister.

Biomarkers↗
PubMed1996

Cellular differentiation and development of pyloric mucosal metaplasia in the human gall-bladder.

The development of pyloric mucosal metaplasia (PMM) with regard to cellular differentiation in the human gallbladder was studied by mucin staining (paradoxical concanavalin A (Con A), galactose oxidase-Schiff (GOS) and alcian blue (pH 2.5) PAS (AB-PAS) and immunohistochemistry (pepsinogen II (PgII) and SH-9, and proliferating cell nuclear antigen (PCNA). PMM was divided into three stages of development by three-dimensional (3D) computer graphic reconstruction analysis. In the early stage, a transitional zone of PCNA positive cells was observed between areas of SH-9 and/or GOS reactive cells and class III and/or Pg II positive cells in flat monolayered epithelium. In the middle stage, shallow pits became apparent as areas enlarged, with these becoming deeper in the advanced stage, whereby SH-9 and/or GOS reactive cells and class III and/or Pg II positive cells were observed at the upper and lower portion of the pits, respectively, with PCNA-positive cells forming a narrow zone between the two cell populations. Consequently, the structure of PMM gradually resembles that of the normal gastric pyloric mucosa.

Cell Differentiation↗
PubMed1996

Monitoring the native cardiac output during femoral venoarterial cardiopulmonary bypass support.

To manage postcardiotomy patients with cardiopulmonary bypass support (CPS), it is very important to evaluate the native cardiac function. In 5 postcardiotomy cases without CPS, the alternative thermodilution outputs by right ventricular (RV) injection were compared with simultaneous thermodilution outputs by standard right atrial (RA) injection. Cardiac output determined by RV injections, ranging from 3.4 to 10.1 L/min, showed close agreement with the values by RA injections (r = 0.993). Four cases with postcardiotomy profound heart failure were placed on femoral venoarterial CPS and managed with monitoring native cardiac output determined by an RV injection thermodilution method. It was very easy and reasonable to decide the pump flow relative to native cardiac output. The cardiac output determined by RV injection provides a means of accurate evaluation for the failing heart in postcardiotomy cases with venoarterial CPS and optimizes the staged weaning off CPS or the change to a pneumatic pulsatile ventricular assist device for long-term assist.

Adult↗
PubMed1996

Agonist and antagonist properties of beta 3-adrenoceptors in human omental and mouse 3T3-L1 adipocytes.

The pharmacological properties of the native human beta 3-adrenoceptor are poorly defined. In the present study, the agonist and antagonist properties of beta 3-adrenoceptors in human omental and mouse 3T3-L1 adipocytes were compared by measuring lipolysis in the absence or presence of adrenoceptor blockers. Methodological experiments revealed that all three beta-adrenoceptors were functionally expressed in both types of adipocytes. This makes the human and the mouse cells directly comparable in pharmacological studies. CGP 12177 was a selective partial beta 3-adrenoceptor agonist in both cell types with a pD(2) of about 7.5. The order of potency of classical non-selective adrenoceptor agonists, when determined during blockade of beta 1-, beta 2- and alpha 2-adrenoceptors, was isoprenaline>noradrenaline>adrenaline in both human and 3T3-L1 adipocytes. This is different from the order of potency of the same agonists at the beta 1- or beta 2-adrenoceptors. The sensitivity of the beta 3-adrenoceptor to these catecholamines, expressed as pD(2) values, were virtually identical in both adipocyte types. Isoprenaline, noradrenaline, and adrenaline were almost full agonists in both cell types (intrinsic activity from 74% or 95%) during combined beta 1, beta 2- and alpha 2-adrenoceptor blockade. Antagonist potencies (expressed as pA(2) and using CGP 12177 as agonist) at the alpha 3-adrenoceptor were similar in both adipocyte types: bupranolol>propranolol>metoprolol. The corresponding pA(2) values for bupranolol, propanolol and metoprolol were about 7, 6 and 5, respectively in both species. In conclusion, the pharmacological properties of classical catecholamines, beta-adrenoceptor blockers and CGP 12177 are almost identical at the beta 3-adrenoceptors of human omental adipocytes and 3T3-L1 adipocytes.

Adipose Tissue↗
PubMed1996

Toxicodynamic analysis of cardiac effects induced by four cholinesterase inhibitors in rats.

The cardiac effect of edrophonium (2-20 mumol kg-1), pyridostigmine (0.5-5 mumol kg-1), neostigmine (0.05-0.5 mumol kg-1) and ambenonium (0.02-0.3 mumol kg-1) was investigated after intravenous administration to rats. For pyridostigmine and neostigmine, the heart rate decreased in a dose-dependent manner, and then gradually recovered to the basal level at about 10 min. Rapid decrease of heart rate was observed after edrophonium and ambenonium administration, and rapid recovery to the basal level within 1 min. For ambenonium, a dose-dependent tachycardiac response was observed. The time-course of heart rate change was analysed by the effect-compartment model. Significant correlation was observed between bradycardiac EC50 values obtained by effect-compartment model analysis and inhibitory constant (Ki) to acetylcholinesterase in-vitro, suggesting that the bradycardiac response was induced by inhibition of this enzyme and following elevation of acetylcholine concentration in the synaptic elect. On the other hand, the tachycardiac EC50 values of edrophonium and ambenonium based on the effect-compartment model analysis were similar to dissociation constants (Kd) of these drugs to muscarinic receptors in-vitro, suggesting that the tachycardiac activity of these drugs may be associated with antagonistic activity to postsynaptic muscarinic receptors. We conclude that, clinically, edrophonium and ambenonium are safer drugs than pyridostigmine and neostigmine, at least as regards muscarinic side-effects, including bradycardia.

Animals↗
PubMed1996

Histological assessment of chronic pancreatitis at necropsy.

AIMS: To evaluate the histological criteria used to diagnose chronic pancreatitis; and to assess interobserver variation among general pathologists. METHODS: Forty five cases of chronic pancreatitis diagnosed in necropsy were reviewed to determine whether the diagnosis was acceptable retrospectively. These cases were diagnosed initially as chronic pancreatitis in the final necropsy report complied by general pathologists. In reviewing these cases, special attention was paid to irregular fibrosis and destruction of the lobular architecture. RESULTS: The 45 cases were re-assigned to seven different diagnostic categories: chronic pancreatitis, 21 (47%) cases; interstitial fibrosis with or without chronic inflammation, 11 (24%) cases; repair stage of acute pancreatitis, four (9%) cases; severe fatty infiltration, three (7%) cases; chronic inflammation without interstitial fibrosis, two (4%) cases; haemochromatosis, one (2%) case; and undetermined, three (7%) cases. CONCLUSIONS: The histological spectrum of chronic pancreatitis was very wide and it was often misdiagnosed. Acinar atrophy, acinar dilation and intralobular fibrosis were diagnostic of chronic pancreatitis. Differential diagnoses include the repair stage of acute pancreatitis, severe fatty infiltration and haemochromatosis. Recognition of these findings may help to reduce overdiagnosis of chronic pancreatitis.

Acute Disease↗