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Biomedical subjects

M Shindo

Publications and source records attributed to M Shindo.

At least 163 records · Page 9Linked to original sources
PubMed1993

Antiviral therapy of hepatitis C--present and future.

The current recommendations for therapy of chronic hepatitis C are a 6-month course of alpha-interferon in doses of 3 million units 3 times weekly. Patients should have compensated chronic liver disease with elevations in serum aminotransferases, serologic evidence of hepatitis C virus (HCV) infection and chronic hepatitis by liver biopsy. At present, a long-term beneficial response to alpha-interferon occurs in only 10-25% of patients. The modest long-term response rate and the restricted recommendations for use of interferon leave several unresolved issues regarding therapy of this disease. Do patients with atypical, severe or advanced disease warrant therapy? What is the optimal dose and duration of treatment? How can one increase the response rate to interferon? How can one predict which patients are likely to benefit from therapy? Which patients are likely to relapse if therapy is stopped? Ultimately, what is needed to answer these issues are better techniques to assess HCV infection and monitor therapy as well as more effective and better-tolerated agents that can be used alone or in combination with alpha-interferon.

Antiviral Agents↗
PubMed1993

Crossover comparison between the depressor effects of low and high work-rate exercise in mild hypertension.

1. The relationship between work-rate and the antihypertensive effect of exercise in hypertensives, and the mechanism of that effect, were investigated by a crossover clinical trial. 2. Ten mild hypertensives were randomly divided into two groups. One group performed low work-rate exercise (LWE) on a cycle ergometer for 10 weeks (blood lactate threshold; approximately 50% of maximum oxygen consumption [Vo2max]). After a 10 week interval without exercise training, these subjects were then switched to a high work-rate exercise (HWE) regimen (4 mmol/L of blood lactate; approximately 75% of Vo2max) for another 10 weeks. In the other group, the order of exercise training was reversed. Since two patients withdrew from the protocol during HWE periods, statistical analysis was performed on the data from the remaining eight patients. There were no order effects observed in any of the data from the two groups. 3. During both LWE and HWE, resting blood pressure (BP) fell significantly after the initiation of exercise therapy (P < 0.05). Furthermore, the overall effects of 10 weeks of LWE and HWE on BP were not significantly different. 4. The work-rate at the lactate threshold, which reflects physical fitness, had increased significantly by 16 W (P < 0.01) after the LWE period and by 11 W (P < 0.01) after the HWE. 5. During the LWE period, changes in haemodynamic and humoral variables were not significant, except for a reduction in plasma norepinephrine at week 10 (P < 0.05). In the HWE period, changes in haemodynamic and humoral variables were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Hormone treatment related bone mineral content changes in Japanese women with endometriosis.

The effects of a GnRH agonist and danazol on bone mineral content (BMC) in Japanese women with endometriosis were investigated. Nineteen women with laparoscopically confirmed endometriosis were treated with buserelin (900 micrograms/d administered intranasally, 10 cases) or with danazol (400 mg/d p.o., 9 cases) for 6 months. Trabecular BMC of the 3rd lumbar vertebra was measured using quantitative computerized tomography before treatment, at the end of treatment and 6 months after treatment by the same radiologist who was not informed about the drug used. Serum estradiol and the biochemical parameters of bone metabolism were also measured. A significant decrease in BMC (10% on average; maximum 25.4%) was observed at the end of treatment with buserelin (p < 0.01) and this loss was only partially recovered 6 months after treatment. In the danazol group, however, a slight gain in BMC was observed. Buserelin suppressed serum estrogen levels much more than danazol did. Parameters of bone resorption tended to increase in the buserelin group. Because treatment with buserelin, but not with danazol, was always associated with a significant decrease in BMC at L3, repeated usage of buserelin may lead to cumulative bone loss in patients with endometriosis.

Adult↗
PubMed1993

Intravenous glucose tolerance test-derived glucose effectiveness in physically trained humans.

Glucose effectiveness (SG) and insulin sensitivity of sedentary and physically trained males were estimated by the minimal model approach. Trained subjects, who ran 86 +/- 10 km/wk and had 37% higher maximal oxygen consumption than that of sedentary subjects (56.2 +/- 1.2 vs. 40.9 +/- 1.4 ml.kg-1 x min-1, P < 0.01), were studied 16 h and 1 wk after their last training session. After overnight fasting, glucose was administered intravenously (300 mg/kg body wt) within 2 min, and insulin was infused (approximately 13-20 mU/kg given over 5 min) from 20 to 25 min after administration of glucose. Glucose disappearance constant values as an estimate of glucose tolerance were significantly higher in trained subjects after 16 h and 1 wk of their training session (3.29 +/- 0.48 and 3.60 +/- 0.64%/min) than in sedentary subjects (1.92 +/- 0.30%/min, P < 0.05). Insulin sensitivity in trained subjects measured after 16 h and 1 wk of their last training session (26.2 +/- 4.4 and 24.3 +/- 6.0 x 10(-5) min-1 x pM-1) was also higher than that of sedentary subjects (10.3 +/- 1.2 x 10(-5) min-1 x pM-1, P < 0.05). SG, the ability of glucose itself to increase peripheral glucose uptake and suppress hepatic glucose output, was significantly higher in trained subjects after 16 h and 1 wk of their last training session (0.028 +/- 0.003 and 0.030 +/- 0.004/min) than in sedentary subjects (0.017 +/- 0.002/min, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Flat wart of the urethra caused by human papillomavirus type 16.

A rare case of urethral flat wart caused by human papillomavirus (HPV) type 16 was reported. A 34-year-old male consulted our department with a complaint of urethral bleeding. A pair of symmetrical white flat warts combined with ulcer at the urethral meatus were found. Microscopic examination of the specimen demonstrated koilocytosis of the epithelium. In immunohistochemical study it was positive for HPV and HPV type 16 was detected by polymerase chain reaction.

Adult↗
PubMed1993

Transmigration routes and a delayed systemic hypotension in rats after intraperitoneal injection of endotoxin from Escherichia coli.

An intraperitoneal injection of endotoxin (ETX; 3 mg/kg) to rats caused gradual decrease in the systemic arterial blood pressure for up to 3 hr, together with decrease in heart rate, increase in hematocrit, and changes in the core temperature (an initial increase and a subsequent decrease). Pretreatment of rats with indomethacin (10 mg/kg, p.o.) prevented the decrease in the systemic blood pressure and the changes in other three parameters. The intraperitoneal injection of ETX also induced a gradual increase in exudation of plasma for up to 3 hr, with increased levels of prostaglandin (PG) E2 and 6-keto-PGF1 alpha in the peritoneal exudate. Indomethacin inhibited the exudation of plasma. The levels of ETX in the arterial and portal venous plasmas began to increase 5 min after the intraperitoneal injection of ETX, and reached levels on the order of micrograms per milliliter plasma 10-20 min after the injection. The levels of ETX in the right and left thoracic lymph nodes, but not in the mesenteric lymph nodes, increased in parallel with those in the systemic arterial plasma. In conclusion, the delayed hypotension may be attributable to the mesenteric vasodilatation induced by PGs generated in the peritoneal cavity, and the ETX injected entered the systemic circulation mainly through lymphatic vessels, but in the initial stage, a part of ETX may be transmigrated into portal vein through damaged intestine.

Animals↗
PubMed1993

[Stiff-man syndrome].

The Stiff-man syndrome is a rare disease, which is characterized by continuous muscular rigidity and painful muscle spasm. Although large dose diazepam, baclofen, clonazepam, or clonidine benefit the symptoms significantly, the pathophysiology had been unknown until recently. In 1988 and 1990, Solimena et al. reported autoantibody against glutamic acid decarboxylase in sera and cerebrospinal fluids. Plasmapheresis was then applied to a patient with this syndrome, and the symptoms and the electromyographic activities decreased dramatically. The syndrome is likely to be an autoimmune disease, but further detailed studies are required as to the cause and pathophysiology and immunological treatment must should be established.

Autoimmune Diseases↗
PubMed1993

[Quantitative assessment of improvement in perfusion after coronary bypass grafting: assessed by thallium-201 bull's eye subtraction polar map method].

To assess redistribution (RD) and improvement in regional perfusion after coronary bypass grafting (CABG) on thallium-201 SPECT images quantitatively, the Bull's eye subtraction polar (BS) map was created. BS map was created after subtraction of a normalized bull's eye polar map from another normalized polar map. The quantitative assessment on this map was compared to the visual qualitative analysis in 23 patients (115 segments) who received CABG. All of the improved segments after CABG showed > or = 15% on the BS map. On the other hand, 60% of the non improved segments showed < 10% on the BS map. Furthermore, 67% of the RD segments showing > or = 15% on the BS map before CABG improved in perfusion by > or = 15% on the BS map after CABG. On the BS map, an excellent correlation was observed between the extent of redistribution before CABG and the extent of improvement after CABG. Thus, BS map permits quantitative assessment of improvement in perfusion on T1 SPECT imaging, and this technique seems to be valuable for predicting improvement in perfusion after CABG.

Adult↗
PubMed1993

CT of retropharyngeal lymph node metastasis from maxillary carcinoma.

CT findings for retropharyngeal lymph node metastasis in 25 patients with histologically proven carcinoma of the maxillary sinus and with no prior treatment were evaluated retrospectively. Four lateral retropharyngeal node metastases (16%, 4/25) could be identified by CT. All retropharyngeal metastatic nodes were located between the ipsilateral internal carotid artery and the longus colli muscle at the level of the first cervical vertebral body. The metastatic nodes ranged from 8 mm to 35 mm in size at the long axis. The risk of retropharyngeal node metastasis depends on the degree of carcinoma involvement to the posterior nasal cavity, the posterior ethmoid sinuses, the sphenoid sinuses, the palate (soft and hard) and the nasopharynx. This study indicates that CT is useful for detecting these lymph node metastases.

Adult↗
PubMed1993

Relationships of lipid and glucose metabolism with waist-hip ratio and physical fitness in obese men.

The waist-hip ratio (WHR) is an indirect index of abdominal type obesity which has been shown to be strongly correlated with the risk of coronary heart disease. Empirically, men who have a higher WHR seem to have a lower level of physical fitness. In the present study, the relationships of lipid and glucose metabolism with WHR and physical fitness were examined in 207 Japanese obese men. Physical fitness was evaluated by the oxygen uptake at the onset of blood lactate accumulation (OBLA-VO2; ml/kg/min) which corresponds to 4 mmol/l of blood lactate during graded exercise test and is one of the best indicators of the muscle oxidative capacity. The WHR and percentage of body fat (% body fat) were significantly correlated with OBLA-VO2. The WHR and % body fat were significantly related to each other. After adjusting for % body fat, a significant negative correlation was observed between the WHR and OBLA-VO2 (r = -0.24; P < 0.05). A multiple linear regression was calculated for parameters relating to lipids, and glucose and insulin areas separately, when the WHR, OBLA-VO2, % body fat and age were entered as independent variables. OBLA-VO2 significantly showed a negative relationship with triglyceride (TG), HDL-C/total cholesterol, and the insulin area, while the WHR was only independently related to TG. From these results, we conclude that the physical fitness level evaluated by OBLA-VO2, which represents the capacity of the aerobic metabolism in muscle, may thus be a determinant of lipid and glucose metabolism in obese men.

Adult↗
PubMed1993

Event-related potentials, reaction time, and cognitive state in patients with Parkinson's disease.

ERPs, RT, and cognitive state in 53 patients with PD were studied. The peak latency of P300 and the RT in PD patients were significantly prolonged in the advanced stage of illness. The cognitive state in PD patients was characterized by impairment of attention, recent memory, and constructional ability in categories of the Folstein Mini-Mental State Examination. The significant association between neurophysiological and neuropsychological measurements suggests that these measurements reflect a disrupted aspect of cognitive function in PD patients.

Aged↗
PubMed1992

Failure to detect vertical transmission of hepatitis C virus.

OBJECTIVE: To search for transmission of hepatitis C virus (HCV) from infected mothers to their infants. DESIGN: Prospective clinical, serologic, and molecular biologic follow-up (at least 3 months) of the infants of mothers with anti-HCV antibody. SETTING: A county hospital providing primary and referral care in high-risk obstetrics (perinatology). PATIENTS: Twenty-three mothers with anti-HCV antibody and their 24 infants. METHODS: An enzyme-linked immunosorbent assay (EIA) and a four-antigen recombinant immunoblot assay (RIBA) were used to test for anti-HCV antibody; serum HCV RNA was measured in two independent laboratories by reverse transcription and polymerase chain reaction (PCR) using nested primers in the 5'-noncoding region. Infant samples were tested for HCV RNA by PCR at delivery and after 3 to 6 months of follow-up. Each sample was tested at least four times in two independent laboratories. RESULTS: Twenty-nine of 648 mothers (4.5%; 95% Cl, 3.0% to 6.4%) had anti-HCV antibody; these women had 30 babies. Twenty-three mothers and their 24 babies were followed at least 3 months (mean follow-up, 52 weeks). Of the 23 mothers, 21 (91%; Cl, 72% to 99%) had a reactive RIBA; one woman had an indeterminate RIBA and was positive for HCV RNA by PCR. In 16 of 23 mothers (70%; Cl, 47% to 87%), PCR yielded a positive result in both laboratories. The mean maternal alanine aminotransferase (ALT) level was 1.6 times the normal value. All the babies had anti-HCV antibody in cord-blood samples, but antibody disappeared or diminished in strength in interval samples, and no infant had evidence of active production of anti-HCV antibody. Only 1 of 24 (4%; Cl, 0.1% to 21%) cord-blood samples was HCV RNA positive, and none of 24 (0%; Cl, 0% to 14%) follow-up samples was positive for HCV RNA by PCR in either laboratory. Four mothers and one baby had antibody to HIV. CONCLUSIONS: Infant anti-HCV antibody is most likely acquired passively in utero, and vertical transmission of HCV is uncommon.

Female↗
PubMed1992

[Clinical evaluation of lumbosacral nerve root and lateral stenosis using coronal MR imaging].

MR imaging is being used more frequently to study the lumbar spine and is becoming the modality of choice in the assessment of patient with low back pain. Using a new technique of coronal and half coronal scan with MR imaging, it was possible to visualize L4, L5 and S1 nerve roots accurately. We described the MR findings of lateral stenosis using this technique. Several characteristic MR findings were identified, and the most important one was nerve root impingement in the intervertebral foramen. We consider that coronal and half coronal scan with MR imaging is useful in diagnosis of lateral stenosis.

Adult↗
PubMed1992

Sensitivity of serological assays to identify blood donors with hepatitis C viraemia.

Blood donors at high risk of hepatitis C virus (HCV) infection were tested for viraemia by the polymerase chain reaction (PCR). PCR results were accepted as positive only if reactive in 3 of 4 tests and if confirmed in an independent laboratory. The sera were also tested by 6 different assays to determine the ability of current serological assays to detect viraemic blood donors. Of 19 PCR-positive sera, only 13 (68%) were detected by the most sensitive of the serological assays. If these results are confirmed, automated PCR assays may be required for blood-donor screening to prevent transmission of HCV.

Blood Donors↗
PubMed1992

Long-term follow-up of patients with chronic hepatitis C treated with alpha-interferon.

We reanalyzed the results of a pilot study of recombinant alpha-interferon therapy for chronic non-A, non-B hepatitis in light of the recent discovery of the hepatitis C virus and the development of diagnostic assays for this agent. Stored serum samples from 10 patients treated between 1984 and 1986 were tested for antibody to hepatitis C virus and hepatitis C virus RNA before, during and after therapy. In addition, the current clinical, serum biochemical and virological statuses of these patients were evaluated to determine the long-term effects of interferon therapy. All patients had evidence of hepatitis C virus infection, with hepatitis C viral RNA, antibody to hepatitis C virus or both markers detectable in serum. Serum hepatitis C virus RNA was found to disappear in seven of eight patients whose aminotransferase levels became normal with interferon therapy but remained present in two patients who did not respond to therapy. Levels of hepatitis C virus RNA decreased and disappeared when serum aminotransferases fell to normal levels but rose with subsequent elevation of aminotransferase levels in two patients who had relapses in disease when interferon was stopped. During a follow-up of 3 to 6 yr, hepatitis C virus RNA remained undetectable in the six patients whose serum aminotransferase levels remained normal after interferon therapy. However, neither initial titers of hepatitis C virus RNA nor disappearance of viral RNA from serum during treatment predicted a sustained response. Thus long-term beneficial responses to alpha-interferon can occur in patients with chronic hepatitis C and are associated with sustained loss of hepatitis C virus RNA from serum.

Chronic Disease↗
PubMed1992

A pilot study of ribavirin therapy for chronic hepatitis C.

Interferon-alpha therapy is of proven efficacy in chronic hepatitis C, but it is not universally effective and may be associated with intolerable side effects. Ribavirin is a nucleoside analog with a broad spectrum of antiviral action. We conducted an uncontrolled pilot study of ribavirin therapy in 13 patients with chronic hepatitis C. Ribavirin was given for 6 mo, in a dose that was increased, at 2-mo intervals, from 600 mg to 1,000 mg to 1,200 mg/day. Serum ALT levels gradually decreased in all 13 treated patients; the mean percentage of decrease was 67% (from 210 U/L [range = 109 to 593] to 63 U/L [range = 22 to 108 U/L]; p = 0.0006) after 6 mo of treatment. Serum aminotransferase levels fell to the normal range in four patients (31%). In the 3 to 6 mo after cessation of ribavirin therapy, serum aminotransferase activities gradually rose to near pretreatment levels in all but one patient. Therapy was associated with a significant decrease in the geometric mean titer of hepatitis C virus RNA in serum (1:1,981 vs. 1:199; p less than 0.02) although no patients lost hepatitis C virus RNA from serum during therapy. No significant improvement was seen in liver histological appearance. Ribavirin therapy resulted in mild, reversible hemolysis; no patient exhibited symptomatic anemia. These findings suggest that ribavirin has a beneficial effect in patients with chronic hepatitis C, although further studies are needed to determine how ribavirin is best used.

Adult↗