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Biomedical subjects

M Shindo

Publications and source records attributed to M Shindo.

At least 145 records · Page 8Linked to original sources

[Spinal neural mechanisms in voluntary movements].

Spinal circuits are utilized not only in reflex movements but also in voluntary movements. Their functions are many-fold such as reciprocal inhibition, output control of motoneurones, integration of central and peripheral inputs in motoneurones, or increase in selectivity of muscle contraction etc. The brain controls the activity of spinal circuits depending on the movements required, by controlling the activity of interneurones in the reflex pathways. In the case of the soleus, the activity of reciprocal Ia inhibition and Ib inhibition increases during voluntary contraction of the antagonists. The increase in both inhibition takes place during contraction as weak as 1-2% of the maximum, suggesting that the interneurones can be fired by the descending commands alone without any peripheral inputs. Such central control is beneficial in suppressing stretch reflexes in the antagonistic muscles which follows voluntary movements. On the other hand, the activity of recurrent inhibition of the soleus is enhanced during weak contraction of the muscle, but depressed during medium strength contraction and strongly depressed during strong contraction. Such supraspinal control of Renshaw cells improves the balance between the preciseness in controlling movements and the crude muscle power required. Importance of spinal circuitry during voluntary movement should be emphasized.

H-Reflex↗

Conditioning effect in single human motoneurones: a new method using the unitary H reflex.

1. A new method for the study of spinal reflexes using single motor units is described. 2. The excitability of a motoneurone is assessed as the 'critical firing stimulus' (CFS), which is the difference between the test stimulus intensity needed to reach the threshold for the lowest threshold Ia fibres and the intensity which evokes firing of a motor unit with the probability of 50% (FP50%). The intensity with FP50% is obtained by modulating stimulator output. When the motor unit is fired by a stimulus, the next intensity is decreased, and vice versa. The Ia threshold is defined as the threshold for homonymous monosynaptic peaks in PSTHs during contraction of the muscle examined. 3. A conditioning effect is represented as a change in CFS, the extent being expressed as a percentage of the unconditioned CFS. 4. Effects obtained by conditioning stimulation with the new and conventional H reflex methods are compared. The sensitivities are almost the same and the extents of the effects have highly correlated linear relations for the two methods. 5. The advantages of the new method are (1) that it shows reflex activities on a single motoneurone, (2) that it is applicable both to muscles at rest and during contraction, and (3) that it quantifies conditioning effects as percentages of the size of test Ia EPSPs.

Adult↗

The physical state of the negative strand of hepatitis C virus RNA in serum of patients with chronic hepatitis C.

Negative strands of the hepatitis C virus (HCV) genome (a positive-stranded RNA virus) have been found in a nuclease-resistant form in the serum of patients with HCV infections. We determined whether a complete negative-strand copy is present in the serum, whether the negative strand is particle-associated, and finally, whether it is virion-associated and encapsidated like the positive (genomic) strand. Isopyknic sucrose and cesium chloride density ultracentrifugation followed by a strand-specific reverse transcription-polymerase chain reaction on the collected fractions was performed to determine whether both positive and negative strands were associated with similar particles. Both strands comigrated to approximately the same density (1.11-1.16 g/cm3) in sucrose. After treatment of the plasma with detergent (0.1% Nonidet P-40) to remove the viral envelope and centrifugation on cesium chloride gradients, the positive strands shifted to a density of 1.35 g/cm3, and the negative strands were not detected. By using antibodies specific for the HCV core or envelope glycoproteins E1 or E2 coated onto the wells of a microtiter plate, it was possible to specifically bind HCV or viral cores to the solid phase. Pelleted virus particles were resuspended in either PBS or PBS with 0.1% Nonidet P-40 to expose the core. These pellets were then incubated in antibody-coated microtiter wells. RNA extracted from the bound and unbound fractions was tested for HCV RNA. The anti-core antibody was able to bind positive strands but not negative strands only in detergent-treated samples. In the nondetergent-treated pellets, the anti-E1 and -E2 bound the positive strand, but only anti-E1 bound the negative strands. These findings indicate that while both strands of HCV RNA can be detected in serum, the positive strand is encapsidated within the enveloped core, and the negative strand appears to be in a membrane particle associated with the viral envelope protein E1 but does not appear to be within the HCV core of circulating virions.

Base Sequence↗

A resected case of giant leiomyosarcoma of the pancreas.

Leiomyosarcoma of the pancreas is very rare. We report a case of giant leiomyosarcoma of the pancreas treated by distal pancreatectomy. A 53-year-old female was admitted with an large abdominal mass. Computed tomography, magnetic resonance imaging, and ultrasonography revealed a huge tumor adjacent to the pancreas. However, we could not identify the primary organ with these imagings. Angiographic findings strongly suggested that the tumor originated from the pancreas, as main feeding arteries arose from the great pancreatic artery. Fourteen days after trans-catheteric arterial embolization, we performed a distal pancreatectomy with splenectomy; the patient's postoperative course was uneventful. Histologically, we confirmed the diagnosis as a leiomyosarcoma originating from the pancreas.

Female↗

Detection and quantitation of hepatitis C virus RNA in serum using the polymerase chain reaction and a colorimetric enzymatic detection system.

A sensitive, non-isotopic method for detecting and quantifying hepatitis C virus (HCV) RNA in serum using the reverse transcriptase-polymerase chain reaction (RT-PCR) and a hybridization specific, colorimetric biotin-avidin peroxidase detection system has been developed. The sensitivity of the PCR-colorimetric system was determined using RNA synthesized from cloned HCV cDNA. The assay could detect as few as 10 molecules of HCV RNA, comparable to the sensitivity achieved with double PCR using nested primers. Thus, this colorimetric assay can detect low levels of HCV RNA in serum and appears to be quantitative, suggesting that this technique may be applied to rapid screening of large numbers of samples and to monitor the effect of antiviral therapy.

Animals↗

Immediate internal fixation for open fractures of the long bones of the upper and lower extremities.

Immediate open reduction with internal fixation was performed on 66 open fractures (54 patients) of the long bones in the upper or lower extremity, including one clavicle. Using the classification system of Gustilo, there were 13 (20%) type I, 30 (45%) type II, 11 (16%) type IIIA, six (9%) type IIIB, and six (9%) type IIIC soft tissue injuries. Thirty-two patients had associated major multiple trauma. Eighty-eight percent of the patients had good functional results using a modification of Katenjian's criteria. There were three late deep infections (4.5%), all at the sites of type III fractures. The nonunions occurred in four open fractures (6.1%). We conclude that, if a complete and timely debridement can be accomplished, immediate internal fixation of open fractures allows for improvement in ultimate function and a decrease in mortality in patients with multiple trauma. This procedure should be performed in selected patients who have type III open fractures, with careful attention to the general status of the patient and the severity of the soft tissue wound at the fracture site.

Adolescent↗

Temporary interruption of the left renal vein as an adjunct to resection of interaortocaval pheochromocytoma.

Although the left kidney has a number of venous collaterals, the collateral venous drainage is not always sufficient to allow permanent ligation of the venous trunk. Interruption and reanastomosis of the left renal vein were performed as an adjunct to dissection of extra-adrenal pheochromocytoma arising in the interaortocaval space. Reconstruction of the interrupted vein is a simple and reasonably acceptable technique to preserve the ipsilateral renal function. This maneuver, though practiced infrequently, facilitates the juxtarenal surgeries exposure of which is seriously hampered by the anatomical disposition of the left renal vein.

Adult↗

Dynamic properties of the posterior cricoarytenoid muscle.

The aim of this research was to investigate the contractile properties of the posterior cricoarytenoid (PCA) muscle. Simultaneous measurements were made of the isometric force, temperature, and electromyographic activity of the dorsal cricoarytenoid muscle of anesthetized dogs during supramaximal stimulation of the recurrent laryngeal nerve for twitch and tetanic contraction. The conduction delay between stimulation of the recurrent nerve at the level of the larynx and the onset of the muscle action potential averaged 2.0 +/- 0.2 milliseconds (ms), and the latent period between the onset of electrical activity of the muscle and the onset of contraction had a mean duration of 3.3 +/- 0.8 ms. The mean of isometric contraction times found was 33.3 +/- 2.0 ms, shorter than most previous studies of canine PCA muscle. Tetanic frequency defined as smooth contraction was higher than previous estimates. Considerations of scaling of physiological time based on animal mass were applied to analysis of the experimental findings to make possible systematic comparison of previous findings across species and animal size.

Animals↗

[Anti-interferon antibody in chronic hepatitis C].

We studied anti-interferon (IFN) antibody in serial serum samples, obtained from 34 patients with chronic hepatitis C treated with IFN (HLBI, recombinant IFN-alpha 2a or-2b, HuIFN-beta). Anti-IFN antibody was measured by Western blotting, Anti-IFN antibody was detected in nine (8.1%) of the 111 samples. Two patients treated with recombinant IFN-alpha 2a developed neutralizing anti-IFN antibody, with the development of clinical resistance to IFN therapy, while none of 32 patients treated with either HLBI, recombinant IFN-alpha 2b or HuIFN-beta developed anti-IFN antibody. Anti-IFN antibody was developed in one patients one month after IFN. It is believed that Western blotting, used in this study, is a useful method to evaluate the incidence and clinical significance of anti-IFN antibody.

Adult↗

Angiotensin II formation by an alternative pathway during exercise in humans.

OBJECTIVE: We postulated a 'kinin-tensin system' in which angiotensin II (Ang II) is cleaved by one or more serine protease independent of renin or angiotensin converting enzyme (ACE). The aim was to determine whether this alternative Ang II-forming pathway by serine proteases participates in the rise in plasma levels of Ang II during exercise in humans. DESIGN AND METHODS: The study consisted of two double-blind crossover experiments. in experiment 1 six healthy volunteers who had been taking either placebo (group P) or the ACE inhibitor captopril (150 mg/day for 3 days; group C) performed a cycle ergometer graded exercise test at four different exercise intensities: stage 1, half of the intensity at the blood lactate threshold (WLT); stage 2, the intensity at WLT; stage 3, the intensity at 4 mmol/l blood lactate; and stage 4, an intensity between stage 3 and maximum intensity. In experiment 2 the same volunteers took captopril (150 mg/day for 3 days) and performed exercise at an intensity corresponding to 90% of the 4 mmol/l blood lactate intensity for 30 min during intravenous drip injection of a serine protease inhibitor, nafamostat [NAF; 0.2 mg/kg per h; NAF(+) group] or saline [NAF(-) group]. RESULTS: In experiment 1 plasma Ang II levels increased from at rest to after exercise in both groups P and C. Although there was a significant treatment effect, captopril did not significantly alter the exercise-induced changes in Ang II level. In experiment 2 the increase in Ang II level after 30 min exercise in the NAF(+) group was significantly lower than in the NAF(-) group. CONCLUSIONS: These results suggest the presence of an alternative Ang II-forming pathway independent of ACE, and that one or more NAF-sensitive serine protease is responsible, at least partly, for generating Ang II during exercise.

Adult↗

Urinary kallikrein activity is increased during the first few weeks of exercise training in essential hypertension.

OBJECTIVE: To determine whether the renal kallikrein-kinin and dopamine systems participate in lowering blood pressure during mild exercise in hypertensives. DESIGN: After a general clinical observation period of 4 weeks, 27 essential hypertensives were divided into two groups. The exercise group underwent blood lactate threshold exercise, using a cycle ergometer for 60 min three times a week for 10 weeks. The non-exercise group was observed at the outpatient clinic. Blood pressure and humoral parameters were measured at weeks 0, 1, 2, 4 and 10 in both groups. METHODS: Blood pressure was measured indirectly with an automatic blood pressure recorder. Twenty-four-hour urinary kallikrein activity (by kininogenase assay), total or free dopamine and total noradrenaline (by high-performance liquid chromatography) were also measured. RESULTS: In the non-exercise group blood pressure and humoral parameters did not change. In the exercise group the change in resting blood pressure between weeks 0 and 10 was statistically significant. The change in 24-h urinary kallikrein activity of the exercise group was significantly greater than that of the non-exercise group between weeks 0 and 1 and weeks 0 and 2. Moreover, the change in systolic blood pressure (SBP) between weeks 0 and 2 was negatively correlated with the change in urinary kallikrein activity between weeks 0 and 2, the change in total dopamine between weeks 0 and 2 was negatively correlated with the change in diastolic blood pressure in the same period, and the change in SBP between weeks 0 and 10 was positively correlated with the change in total noradrenaline in the same period in the exercise group. Subjects with a relatively high baseline urinary kallikrein activity had a significantly greater change in SBP between weeks 0 and 10 than subjects with a relatively low baseline activity. CONCLUSIONS: The renal kallikrein-kinin and dopamine systems may participate in lowering blood pressure during the first few weeks of exercise training. The subsequent reduction of sympathetic activity may be involved in maintaining the lowered blood pressure. Mild exercise is more effective in reducing blood pressure in hypertensives who have a relatively high basal renal kallikrein-kinin system activity.

Adult↗

[A case of transverse myelopathy caused by pyogenic vertebral osteomyelitis having extended from a pedal ulcer].

A 64-year-old man who had suffered from diabetes mellitus and a recurrent intractable ulcer of the foot developed subacute transverse myelopathy with severe inflammatory reactions. Magnetic resonance imaging (MRI) revealed destructive lesions in both upper thoracic and lumbar spines. In plain X-ray film, although intervertebral spaces of the lumbar spines were apparently normal on the supine position, they became narrow spaces on the sitting position. The aspiration biopsy from the intervertebral spaces of the lumbar spines showed non-specific necrotic tissues. These findings suggested that the destruction of the intervertebral disks also occurred simultaneously. According to the clinical course and radiological studies, we diagnosed this patient as pyogenic osteomyelitis, and performed the antibiotics therapy. Although he showed no change in his signs and symptoms due to transverse myelopathy, radiological studies exhibited an improvement of both the lumbar and thoracic lesions. In addition, MRI studies in the lumbar lesions revealed low intensity signals on both T1 and T2 weighted images before the antibiotics therapy. It was suggested that lumbar lesions were older than the thoracic lesions. Serial studies including bone X-ray film and MRI were not only useful for the diagnosis of pyogenic osteomyelitis but also for an evaluation of the lesions.

Diabetic Foot↗

[Efficacy of interferon combined glycyrrhizin therapy in patients with chronic hepatitis C resistant to interferon therapy].

To assess the efficacy of interferon (IFN) combined with a large dose of glycyrrhizin (SNMC) therapy in patients with chronic hepatitis C who were resistant to interferon therapy alone, we studied 8 patients with chronic hepatitis C who did not respond to the initial interferon therapy. Initially all of 8 patients received 6 million units of alpha-IFN intramuscularly, three times a week, for 3 months and their serum alanine transaminase (ALT) did not decrease more than 50% at the end of therapy and returned to pretreatment levels after therapy. Six months later, all of these patients received alpha-IFN (6 MU) combined with 80 ml of SNMC intravenously, three times a week for 6 months. Prior to the initial IFN therapy alone, all of the patients were positive for anti-HCV and HCV RNA in the serum. With IFN therapy, serum HCV RNA became negative in 4 of 8 patients and HAI score decreased significantly although their ALT levels did not decrease more than 50%, while with IFN combined with SNMC therapy, ALT levels decreased approximately 70% in all patients (one became normal), serum HCV RNA became negative in 2 and HAI scores did not change significantly. There was no significant differences in decrease of HCV RNA titers and HAI scores between two therapy except the ALT levels. These findings suggest that IFN combined SNMC therapy does not appear to be more beneficial than IFN therapy alone.

Adult↗

Diagnosis of chronic hepatitis C: comparison of immunoassays and the polymerase chain reaction.

We evaluated a series of first- and second-generation enzyme-linked immunoassays for anti-HCV and compared the findings to those with two confirmatory assays, the recombinant immunoblot assay and serum HCV RNA, in patients with chronic hepatitis C, primary biliary cirrhosis, and chronic hepatitis B. All second-generation immunoassays had good sensitivities (98-100%). Interestingly, detection of HCV RNA had a sensitivity of only 93%, although it was 100% specific. The recombinant immunoblot assay and a peptide-based immunoassay also had good specificity (97% and 100%, respectively), whereas the second-generation immunoassay based on recombinant proteins had a high rate of false positivity, particularly among patients with primary biliary cirrhosis and hyperglobulinemia (specificity 68%). Thus, the diagnosis of HCV infection appears to require the use of more than one test. Whereas a second-generation enzyme-linked immunoassay can be used as an initial test, a confirmatory test (such as recombinant immunoblot assay or determination of hepatitis C viral RNA) may be required if the diagnosis remains uncertain.

Cohort Studies↗

[Usefulness of 201T1C1-SPECT in the evaluation of radiation and chemotherapy for brain tumors].

We investigated the usefulness of Thallium-201 chloride single photon emission computed tomography (T1-SPECT) in the evaluation of radiation and chemotherapy for brain tumors. The subjects were 9 cases (10 tumors) of malignant astrocytomas. T1-SPECT was performed before and immediately after irradiation and/or intraarterial infusion of ACNU. In 5 of 10 tumors, T1-index already changed 1 or 2 months before tumor size changed on the CT. Our results suggested that T1-SPECT was useful for evaluating the viability of tumor.

Aged↗

Neuromuscular response in man to repetitive nerve stimulation.

Paired stimulation has been used extensively in clinical neurophysiology. We studied change in the sizes of compound muscle action potentials (CMAPs) and compound nerve action potentials (CNAPs) in humans after a single electrical stimulus to the peripheral nerve. For the paired stimuli, potentials elicited by the first stimuli were used as the test responses. When the interstimulus intervals were varied, the second potentials underwent refractoriness and then were facilitated up to 20-30 ms, thereafter being depressed for 160-200 ms. When intensities were graded at fixed intervals for motor fibers the maximal effect was obtained with liminal stimulation, but was no longer observed at supramaximal stimulation. When the intensity used to obtain M-responses was half the maximum, maximal facilitations were 35% (CNAP) and 17% (CMAP) of the first potential, the respective maximal depressions being 13% and 42%. When the sizes of the two CNAPs were equalized by adjusting the second stimuli, the CMAP was facilitated (26%) up to 65 ms, thereafter being depressed (13%). These results must be taken into account when making clinical examinations that use paired stimulation.

Action Potentials↗

Clinical and serological differentiation of autoimmune and hepatitis C virus-related chronic hepatitis.

Recent reports have focused on the difficulty in differentiating autoimmune hepatitis from chronic hepatitis C due to the high prevalence of anti-HCV in autoimmune hepatitis. The aim of this study was to identify clinical, biochemical, and serological variables that would help distinguish these two diseases. Pretreatment clinical and biochemical variables were compared from 17 patients with steroid-responsive autoimmune chronic active hepatitis and 62 patients with chronic hepatitis C. Serum samples from these patients were tested for autoantibodies and for anti-HCV by first- and second-generation ELISA, recombinant immunoblot assay, and HCV RNA by polymerase chain reaction. Patients with autoimmune hepatitis were more likely to be symptomatic (94% vs 47%, P < 0.005) and jaundiced (76% vs 0%, P < 0.005) at the time of referral. Anti-HCV was found in 53% of patients with autoimmune hepatitis, but only two were positive by immunoblot assay and only one of these had detectable HCV RNA. Antinuclear antibody (ANA) was detected in 21% of patients with chronic hepatitis C, although usually at a lower titer than in autoimmune hepatitis (geometric mean titer = 1:160 vs 1:500, P < 0.003). Patients with chronic hepatitis C who were ANA positive were older than those who were ANA negative, although there were no other differences in clinical or biochemical features between these groups. In particular, there was no difference in response rate to antiviral therapy. Thus, autoantibodies are frequently found in chronic hepatitis C, especially in older subjects, but appear to be clinically insignificant. Anti-HCV is frequently present in autoimmune hepatitis but is rarely confirmed by tests of higher specificity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗