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Biomedical subjects

M Shindo

Publications and source records attributed to M Shindo.

At least 91 records · Page 5Linked to original sources
PubMed1998

Dynamics of the carbohydrate chains attached to the Fc portion of immunoglobulin G as studied by NMR spectroscopy assisted by selective 13C labeling of the glycans.

A systematic method for 13C labeling of the glycan of immunoglobulin G for NMR study has been developed. A mouse immunoglobulin of subclass IgG2b has been used for the experiment. On the basis of chemical shift and linewidth data, it has been concluded that (1) the mobility of the carbohydrate chain in IgG2b is comparable to that of the backbone polypeptide chain with the exception of the galactose residue at the nonreducing end of the Man alpha 1-3 branch, which is extremely mobile and (2) agalactosylation does not induce any significant change in the mobility. The results obtained indicate that even in the agalactosyl from the glycans are buried in the protein. Biological significance of the NMR results obtained is also briefly discussed.

Animals↗
PubMed1998

Mild exercise activates renal dopamine system in mild hypertensives.

OBJECTIVE: The role of renal dopamine in the early depressor effect of exercise was evaluated in hypertensives. METHODS: After a general clinical observation period of 4 weeks, 29 essential hypertensives were divided into two groups. The exercise group (n=16) underwent blood lactate threshold exercise using a cycle ergometer for 60 min three times a week for 4 weeks. RESULTS: In the non-exercise group (n=13), blood pressure (BP) and humoral variables did not change significantly (from 150+/-3/93+/-2 to 145+/-2/94+/-1 mm Hg). In the exercise group (n=16), resting BP was significantly reduced from 158+/-2/92+/-2 at week 0 to 145+/-3/85+/-3 mm Hg at week 4. The increase in urinary free dopamine excretion (from 248+/-14 to 276+/-24 ng/mg Cr) at week 4 was significantly higher than that in the non-exercise group (from 220+/-31 to 196+/-27 ng/mg Cr). In the exercise group, urinary kallikrein activity also increased significantly from 173.0+/-35.4 at week 0 to 320.3+/-63.3 ng bradykinin/min/mg Cr at week 4. These changes in urinary free dopamine excretion and urinary kallikrein activity were negatively correlated with the change in BP. The change in urinary sodium excretion was also negatively correlated with the change in plasma volume index. Moreover, the change in urinary free dopamine excretion was positively correlated with the changes in urinary kallikrein activity and urinary sodium excretion. The change in renal decarboxylation rate of DOPA (3,4-dihydroxyphenylalanine) positively correlated with the changes in urinary free dopamine excretion and urinary sodium excretion, and was negatively correlated with the change in systolic BP. CONCLUSION: These results suggest that exercise triggered renal dopamine generation and activation of renal kallikrein-kinin system, resulting in natriuresis and BP reduction in the early phase (4 weeks) of mild exercise.

Adult↗
PubMed1998

Clinical aspects of indocyanine green pharmacokinetics following portal vein administration.

AIMS: This study was performed to demonstrate that measurement of the clearance of indocyanine green (ICG) following portal vein administration (CLpv) is more useful than that following peripheral vein administration (CLiv) for evaluating intrinsic clearance and hepatic blood flow. METHODS: Eight patients, aged 55.9 +/- 8.8 years, who underwent partial hepatectomy were studied. ICG was administrated to all patients via peripheral and portal veins before and after enflurane anaesthesia and soon after surgery. ICG concentrations were measured by h.p.l.c. Non-compartmental analysis was applied to the ICG time-concentration data obtained. The area under the curve (AUC), clearance (CL), mean residence time (MRT) and volume of distribution (V) were calculated using this method of analysis. RESULTS: CLpv was significantly decreased from 26.4 +/- 13.2 ml kg(-1) min(-1) before anaesthesia, to 19.5 +/- 7.0 (P < 0.05) and 12.7 +/- 5.3 (P < 0.01) ml kg(-1) min(-1), respectively, during anaesthesia and after partial hepatectomy; These values were 72.1% (P < 0.01) and 48.5% (P < 0.01) of that observed at percutaneous transhepatic portography (PTP). CLiv was significantly decreased from 14.6 +/- 5.3 ml kg(-1) min(-1) before anaesthesia, to 9.4 +/- 3.6 (P < 0.05) and 9.8 +/- 4.1 (P < 0.05) ml kg(-1) min(-1), respectively, after partial hepatectomy and 12 h after operation; These values were 68.9% (P < 0.05) and 73.5% (P < 0.05) of the value at PTP. The other pharmacokinetic parameters examined, V and MRT, did not change significantly during anaesthesia or after surgery. CONCLUSION: The clearance of ICG after portal administration was useful for estimating hepatic blood flow and intrinsic clearance in perioperative management of liver surgery.

Aged↗
PubMed1998

Functional outcomes of "floating elbow" injuries in adult patients.

OBJECTIVES: To assess elbow function, complications, and problems of floating elbow fractures in adults receiving surgical treatment. DESIGN: Retrospective clinical review. SETTING: Level I trauma center in Kanagawa, Japan. PATIENTS: Fourteen patients with fifteen floating elbow injuries, excluding one immediate amputation, seen at the Kitasato University Hospital from January 1, 1984, to April 30, 1995. INTERVENTION: All fractures were managed surgically by various methods. In ten cases, the humeral and forearm fractures were treated simultaneously with immediate fixation. In three cases, both the humeral and forearm fractures were treated with delayed fixation on Day 1, 4, or 7. In the remaining two cases, the open forearm fracture was managed with immediate fixation and the humerus fracture with delayed fixation on Day 10 or 25. MAIN OUTCOME MEASUREMENTS: All subjects underwent standardized elbow evaluations, and results were compared with an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function during daily activities. Complications such as infections, nonunions, malunions, and refractures were investigated. RESULTS: Mean follow-up was forty-three months (range 13 to 112 months). At final follow-up, the mean elbow function score was 79 points, with 67 percent (ten of fifteen) of the subjects having good or excellent results. The functional outcome did not correlate with the Injury Severity Score of the individual patients, the existence of open injuries or neurovascular injuries, or the timing of surgery. There were one deep infection, two nonunions of the humerus, two nonunions of the forearm, one varus deformity of the humerus, and one forearm refracture. CONCLUSION: Based on the present data, we could not clarify the factors influencing the final functional outcome after floating elbow injury. These injuries, however, potentially have many complications, such as infection or nonunion, especially when there is associated brachial plexus injury. We consider that floating elbow injuries are severe injuries and that surgical stabilization is needed; beyond that, there are no specific forms of surgical treatment to reliably guarantee excellent results.

Activities of Daily Living↗
PubMed1998

Blood pressure lowering effect of low intensity aerobic training in elderly hypertensive patients.

PURPOSE: The purpose of this investigation was to determine the effect of 9 months of low intensity aerobic training on blood pressure in elderly hypertensive patients who were receiving antihypertensive medication. METHODS: The training group (N = 13; mean age 75.4 +/- 5.4 yr) agreed to take part in physical training using a treadmill with an exercise intensity at the blood lactate threshold (LT) for 30 min three to six times a week for 9 months. The rest (N = 13; mean age 73.1 +/- 4.2 yr) served as controls. RESULTS: The resting systolic (-15 +/- 8 mm Hg), mean (-11 +/- 6 mm Hg), and diastolic blood pressures (-9 +/- 9 mm Hg) decreased significantly after 3 months of training and the blood pressure of all participants stabilized at a significantly lower level by the end of the study (9 months) in the training group, whereas no significant changes in blood pressure were found in the control group. Both the pretraining systolic and diastolic blood pressure of those recruited patients negatively correlated with those changes after the training (SBP: P < 0.01; DBP: P < 0.05, respectively). After 1 month of detraining in five patients, the blood pressure levels were similar to those in the pretraining state. The LT increased significantly in the training group (P < 0.01). CONCLUSION: In conclusion, an additional antihypertensive effect of mild aerobic training at the LT was confirmed in elderly patients receiving antihypertensive medication. The cessation of such training in five patients, however, resulted in a relatively rapid return to pretraining levels within a month.

Aged↗
PubMed1998

Evaluation of potential fat emboli during placement of intramedullary nails after orthopedic fractures.

STUDY OBJECTIVE: To evaluate material with high echogenicity demonstrated by transesophageal echocardiography (TEE) during the reamed intramedullary nailing procedure in long-bone fracture patients, and to analyze BAL fluid (BALF) in these patients as well as in those with the fat embolism syndrome (FES). DESIGN: Prospective cohort study. SETTING: Emergency and critical care center of a university hospital. PATIENTS: Fifteen patients with long-bone fractures in whom reamed intramedullary nailing was performed, and five patients diagnosed with FES. MEASUREMENTS: During reamed nailing procedures, TEE was performed. We measured the differential cell counts, percentage of lipid-laden cells, and albumin concentration in BALF after the operation. We compared TEE findings and BALF analysis in the surgical patients. In addition, we compared BALF findings in the surgical patients and in the FES patients. RESULTS: We divided 15 patients who underwent TEE into three subtypes based on the appearance of embolic material within the chambers of the right heart. The lipid-laden cells in BALF increased significantly in those patients with highly echogenic material by TEE (p < 0.05). The percentage of the lipid-laden cells in BALF was not significantly different between the TEE patients and those with FES. On the other hand, FES patients showed a statistically significant increase in leukocyte counts and albumin concentration (p < 0.05). CONCLUSIONS: The highly echogenic material seen in TEE during reamed intramedullary nailing could be fat globules on the basis of BALF analysis. However, all patients with large emboli by TEE do not develop FES. A factor other than mechanical obstruction by fat globules may be necessary for the development of FES.

Adolescent↗
PubMed1998

[Adenoid cystic carcinoma of the prostate. A case report].

Adenoid cystic carcinoma is most commonly encountered in the salivary glands. It is rarely found in the prostate but distinctive variant of prostatic adenocarcinoma. This case report is thought to be the first one in the Japanese literature. A 51-year-old man was admitted with urinary difficulties and frequency since one month. Digital rectal examination revealed an enlarged stony hard prostate. The transurethral prostatectomy was performed and the histopathological diagnosis was the adenoid cystic carcinoma. PSA and PAP were normal. The findings of computerized tomography suggested the invasion to the bladder and rectum. Therefore the total pelvic excenteration was carried out. He subsequently received radiation therapy (50 Gy to the pelvis), anti-androgen therapy and three courses of chemotherapy using Cisplatin, Peplomycin, Epirubicin and so on. But the metastatic disease involving the liver and pelvic lymph nodes developed, and he died two years seven months postoperatively.

Carcinoma, Adenoid Cystic↗
PubMed1998

Problems of various fixation methods for open tibia fractures: experience in a Japanese level I trauma center.

Two hundred thirty-seven patients with open tibial fractures (245 fractures) were treated as follows: nonoperative stabilization alone (Nonop group, n = 54); immediate open reduction and internal fixation (ORIF group, n = 47); delayed ORIF (D-ORIF group, n = 109); or external fixation (EF group, n = 35). The D-ORIF group was further divided into ORIF after nonoperative treatment (Nonop/ORIF, n = 86), and ORIF after external fixation (EF/ORIF, n = 23). The open tibial fractures were classified as follows: 42 type I (no infections), 107 type II (4 infections), 43 type IIIA (3 infections), 42 type IIIB (12 infections), and 11 type IIIC (2 infections), with significant differences in infection rate between type IIIB and type I, type II, or type IIIA. The deep infection rates in Nonop, ORIF, Nonop/ORIF, EF/ORIF, and EF groups were 3.7%, 12.8%, 5.8%, 30.4%, and 2.9%, respectively. There were significant differences in deep infection rates between the EF/ORIF and Nonop/ORIF, and the EF group. The mean period of fracture healing for type IIIB fractures was delayed. The mean time to union of the EF/ORIF was significantly longer than that of the ORIF, Nonop/ORIF, and EF groups, respectively. Complete and consecutive debridement procedures and early soft-tissue coverage should be done to avoid wound infection, especially in type IIIB fractures. Delayed internal fixation after external fixation had the highest risk of infection, mandating meticulous wound management in such patients.

Adolescent↗
PubMed1998

[A case of acquired immune deficiency syndrome presenting acute lumbosacral polyradiculopathy due to opportunistic infection of cytomegalovirus].

We reported a case of acquired immune deficiency syndrome (AIDS) with acute lumbosacral polyradiculopathy (ALSP), resulting from the opportunistic infection of cytomegalovirus (CMV). A 22-year-old Thai woman noticed weakness of the both legs, and two weeks later, she became unable to walk and had the difficulty of voiding. Neurological examination revealed flaccid paraplegia, sensory disturbance of the both legs, areflexia of the patella and ankle, and urinary retention. She could not move the legs on either side except for ankle flexion or extension, and the passive elevation of the leg brought about severe sacral pain. Radiological examinations, including lumbar MRI, failed to reveal abnormal findings. The needle EMG showed an acute denervation of the lower leg muscles, and the lumbar puncture yielded a colorless fluid containing 2,097/cu mm WBC (polynuclear 88%), 412 mg/dl protein and 45 mg/dl glucose. The serum HIV-1 antibody was positive with a marked loss of CD4 lymphocytes (31/cu mm). In CSF, the DNA of CMV was detected in the polymerase chain reaction (PCR) method. In addition, large round cells with intranuclear or cytoplasmic inclusions showing immunopositivity for the CMV antibody were present. Ganciclovir (daily dose: 400 mg, every 12 h) was administered for two weeks, but the painful numbness gradually extended to the trunk. For AIDS patients, ALSP caused by the CMV infection is a rare neurological complication, and this is the first case report in Japan. Progressive flaccid paraplegia with sensory disturbance, radicular pain, or bladder dysfunction are characteristic symptoms, and CSF pleocytosis with elevated protein or hypoglycorrhachia provides a diagnostic clue for clinicians. In addition, the CMV-DNA amplification in the PCR method or immunohistochemical approach from CSF is a useful procedure.

AIDS-Related Opportunistic Infections↗
PubMed1997

Human TNF receptor-associated factor 5 (TRAF5): cDNA cloning, expression and assignment of the TRAF5 gene to chromosome 1q32.

Tumor necrosis factor (TNF) receptor-associated factors (TRAFs) are signal transducers for members of the TNF receptor superfamily. We previously identified murine TRAF5 (mTRAF5) and showed that it specifically interacts with the lymphotoxin-beta receptor (LT-beta R) and activates the transcription factor NF-kappa B. Here we have cloned the human TRAF5 homologue (hTRAF5) by cross hybridization with mTRAF5 cDNA. hTRAF5 cDNA is composed of 2894 nucleotides with a 557-amino-acid open reading frame that exhibits 77.5 and 80% identity to mTRAF5 at the nucleotide and amino acid levels, respectively. Northern blot analysis revealed that hTRAF5 mRNA is expressed in all visceral organs. Western blotting revealed that hTRAF5 protein was abundantly expressed in the human follicular dentritic cell line, FDC-1, and to a much lesser degree in several tumor cell lines. Interspecific backcross mapping revealed that Traf5 is located in the distal region of mouse chromosome 1, which shares a region of homology with human chromosome 1q. Fluorescence in situ hybridization confirmed regional localization to human chromosome 1q32.

Amino Acid Sequence↗
PubMed1997

Identification of the anaerobic threshold using double product in patients with coronary artery disease.

This study compared the ventilatory threshold with the double-product break point in 104 patients with cardiovascular disease during ramp treadmill testing. The high correlation (r = 0.81) between the double-product break point and the ventilatory threshold, even in patients taking beta blockers, suggests the former method is a viable noninvasive alternative for identifying the anaerobic threshold in patients with cardiovascular disease, particularly when expired gas analysis is not appropriate or available.

Adrenergic beta-Antagonists↗