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S Shiomi

Publications and source records attributed to S Shiomi.

At least 73 records · Page 4Linked to original sources
PubMed1997

Expression and internal feedback regulation of ACC synthase and ACC oxidase genes in ripening tomato fruit.

We have examined whether or not a positive feedback regulation of gene expression for 1-aminocyclopropane-1-carboxylate (ACC) synthase and ACC oxidase also operates in ripening tomato (Lycopersicon esculentum) fruit during the burst of ethylene production. Two cDNA fragments for ACC synthase and one for ACC oxidase were cloned with high homology to already known genes involved in ethylene biosynthesis in ripening tomato fruit. Accumulation of mRNAs which hybridize to these cDNA probes were induced in mature green fruit within two days by treatment with propylene. In the fruit ripened from the turning stage, red color development, ethylene production, ACC content, and activities of ACC synthase and ACC oxidase increased as maturity progressed. The abundance of two ACC synthase and one ACC oxidase mRNAs in the fruit increased from the turning to pink stage and were followed by a slight decline towards the red stage. These increases in mRNAs abundance with ripening were prevented to a large extent by treatment with the ethylene action inhibitor, 1-methylcyclopropene (MCP). This was most pronounced in the fruit treated with MCP at the turning stage, in which the accumulation of ACC synthase and ACC oxidase transcripts was almost completely eliminated in the first two d, precisely the same stage at which the control fruit had the greatest level of each mRNA accumulation. The inhibition of transcript accumulation recovered to the control level within two to four d. MCP also decreased ethylene biosynthetic activity, although this decrease did not reflect the reduction in the mRNAs accumulation. These results suggest that a strong positive feedback regulation is involved in ethylene biosynthesis at the gene transcriptional level in tomato fruit, even at the stage with a burst of ethylene production.

Alkenes↗
PubMed1997

Transient liver accumulation of Tc-99m phytate in hepatocellular carcinoma after percutaneous ethanol injection.

PURPOSE: We report that colloid liver scanning gave early evidence of the return to normal of Kupffer cell functions after ethanol injections into the liver. PATIENT AND METHODS: A 71-year-old man with hepatocellular carcinoma received percutaneous ethanol injections twice of 15 mL of ethanol, 1 week apart. RESULTS: Abdominal CT after the second injection showed an irregularly shaped low-density area in the left side of the tumor, extending outside the tumor. Liver imaging with To-99m phytate 10 days later showed increased activity at the corresponding site. Thirty days after the second injection, liver imaging did not show high activity. CONCLUSIONS: Ethanol that leaked into the normal part of the liver probably temporarily activated Kupffer cell function.

Aged↗
PubMed1997

Evaluation of fulminant hepatic failure by scintigraphy with technetium-99m-GSA.

UNLABELLED: We evaluated the usefulness of hepatic receptor imaging with 99mTc-diethylenetriaminepentaacetic acid galactosyl human serum albumin (GSA) to establish the diagnosis and prognosis of fulminant hepatic failure (FHF). METHODS: Of the 20 patients, 8 had acute hepatitis and 12 had FHF. Computer acquisition of gamma-camera data started just before the injection of 185 MBq 99mTc-GSA and stopped 20 min later. Time-activity curves for the heart and liver were generated from regions of interest (ROIs) for the whole liver and precordium. A receptor index was calculated by division of the radioactivity of the liver ROI by that of the liver plus heart ROIs 15 min after the injection. An index of blood clearance was calculated by division of the radioactivity of the heart ROI at 15 min by that of the heart ROI 5 min after the injection. RESULTS: The receptor index was less than 0.83 in all patients with FHF, but it was more than 0.83 in all patients with acute hepatitis. The index of blood clearance was more than 0.72 in all patients with FHF but less than 0.72 in all patients with acute hepatitis. All six survivors of FHF had receptor indices of 0.58 or more, but in five of the six patients who later died, the receptor index was 0.58 or less. The index of blood clearance was 0.85 or less in all survivors but 0.85 or more in the same five patients who later died. CONCLUSION: Hepatic receptor imaging with 99mTc-GSA facilitated the evaluation of hepatic function reserve and was useful in establishing the diagnosis and prognosis of FHF.

Acute Disease↗
PubMed1997

Changes in results of Gallium-67-citrate scanning after interferon therapy for chronic hepatitis C.

UNLABELLED: Gallium-67 scanning is useful for early diagnosis and grading of interstitial lung disease. In a study of the side effects of interferon (IFN) on the lungs of patients with chronic hepatitis C, we performed 67Ga scanning before and after IFN therapy. METHODS: The 66 subjects who underwent at least one scanning, before IFN therapy, were 8 patients with chronic persistent hepatitis (CPH), 21 with chronic aggressive hepatitis 2A (CAH-2A), 25 with chronic aggressive hepatitis 2B (CAH-2B) and 12 with cirrhosis. All had underlying hepatitis C viral infection. Of those patients, 20 were examined again within 1 mo after IFN therapy. Patients received an intravenous injection of 340 MBq 67Ga-citrate and were imaged 72 hr later. ROIs were established for anterior views of the lungs (Lu), liver (Li) and soft tissue of the upper arm as background (B). The counts per unit size of each region of interest were used in calculation of the ratios Lu/B and Li/B. RESULTS: The medians of Lu/B were 2.46 in CPH, 2.56 in CAH-2A, 2.50 in CAH-2B and 2.47 in cirrhosis. These differences were not statistically significant. The medians of Li/B were 6.42 in CPH, 6.14 in CAH-2A, 5.11 in CAH-2B and 4.03 in cirrhosis. The differences between the median Li/B of cirrhotic patients and the medians for patients with CPH, CAH-2A and CAH-2B were significant. After therapy, Lu/B was higher than before in 16 of the 20 patients and lower in the four other patients; the overall rise was significant (Wilcoxon rank-sum test). Li/B was higher than before in 11 of the 20 patients and lower in the nine other patients. CONCLUSION: IFN caused uptake of the radionuclide to increase in most patients. This method showed changes in the accumulation of 67Ga-citrate that could have been missed if the results had been inspected by eye. IFN can cause interstitial lung disease, but unlike other drugs with this side effect, the onset seems to be gradual enough to be detected quantitatively by 67Ga scanning.

Adult↗
PubMed1996

Accumulation of Tc-99m HMDP in hepatic metastasis from colon carcinoma without detectable calcification.

A 51-year-old man was found to have hepatic metastasis from colon carcinoma. Bone scintigraphy with 99mTc-hydroxymethylene diphosphonate showed a ringlike accumulation corresponding to the hepatic mass, which was without calcification on computed tomography. Treatment with chemotherapeutic agents was started. After 4 months, computed tomography showed that the mass was smaller than before and that the margin was calcified. The extraosseous accumulation of the radionuclide may be evidence supporting earlier speculation on calcification that could not yet be detected by computed tomography.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Hepatic distribution of blood flow from the superior or inferior mesenteric vein mapped by portal scintigraphy with iodine-123-iodoamphetamine.

UNLABELLED: We previously reported the clinical meaning of measurements of the relative contributions of the superior and inferior mesenteric veins with [123I]iodoamphetamine after oral (in an enteric capsule) and rectal administration. The same method was used to map blood flow in the liver from both of these veins in 82 subjects, 31 with chronic hepatitis and 51 with cirrhosis. METHODS: Three hours after administration of a capsule containing 22.8 MBq of [123I]iodoamphetamine, data showing hepatic blood flow from the superior mesenteric vein were collected for 10 min. Next, 111 MBq of [123I]iodoamphetamine was administered rectally and data showing hepatic blood flow from the inferior mesenteric vein were collected for 30 min. Shunt indices from the superior and inferior mesenteric veins were calculated from these data. RESULTS: In patients with chronic hepatitis, blood from the superior mesenteric vein flowed into the right lobe or both lobes, but, in some patients with cirrhosis, blood from this vein flowed into the left lobe. In some patients with chronic hepatitis, blood from the inferior mesenteric vein flowed into the left lobe, but, in most patients with cirrhosis, the liver was not visualized during this examination and evaluation was not possible. Of the 53 patients in whom blood flow from both veins could be evaluated, 47 had blood from the two veins mixed to some extent in the liver and 6 had portal streamlining, with blood from the superior mesenteric vein going to the right lobe and blood from the inferior mesenteric vein going to the left lobe. CONCLUSION: These results suggest that blood flow in the superior and inferior mesenteric veins can be found mixed in the liver in most subjects with liver disease.

Amphetamines↗
PubMed1996

Diagnosis by routine scintigraphy of hepatic reticuloendothelial failure before severe liver dysfunction.

OBJECTIVES: The prognosis of hepatic reticuloendothelial failure is said to be poor. Scanning with the radiocolloid 99mTc phytate is needed for diagnosis; as a rule; only seriously ill patients are so investigated. We use 99mTc phytate for liver scans of almost all inpatients with liver disease. This routine made diagnosis of a mild form or early stage of the disease possible. We evaluated the clinical findings of the five patients we have diagnosed, in an attempt to find why four survived. METHODS: Radiocolloid scans were taken starting 20-30 min after the intravenous injection of 111 MBq of 99mTc phytate. Hepatobiliary images were taken by use of 99mTc pyridoxylidine-5-methyl trytophan, and hepatic receptor images were taken by use of 99mTc-labeled diethylenetriaminepentaacetic acid coupled with galactosyl human serum albumin. RESULTS: The livers were not visible in the radiocolloid scans, so the diagnosis of hepatic reticuloendothelial failure was considered. In the two other imaging examinations, the livers were visible. The cause was identified as heavy alcohol intake in four cases and toluene hepatotoxicity in one case. Histological examinations showed cirrhosis in two patients; the three other patients did not have cirrhosis. All five patients had anemia, and three had infections. One patient died of multiple organ failure, and the four other patients survived. Long-term observation by radiocolloid scanning was possible in one patient in whom radionuclide uptake into the liver rose as hepatic function improved. CONCLUSIONS: This disorder is associated with a temporary decrease in Kupffer cell function and hence is liable to be complicated by infection, which can result in death. If the cause is removed promptly, recovery is likely. There being a mild form of this disease, previously not generally diagnosed, probably accounts for the outcomes being good in all of our patients except the one patient with severe liver dysfunction at the time of diagnosis.

Adult↗
PubMed1996

Fulminant hepatic failure monitored by technetium-99m-DTPA-galactosyl-human serum albumin scintigraphy.

We describe a 43-yr-old woman with fulminant hepatic failure whose progress was monitored scintigraphically using 99m-Tc-galactosyl-human serum albumin (99mTc-GSA). On admission, the liver was atrophic and the heart was delineated distinctly by scintigraphy with 99m-Tc-GSA. The receptor index, calculated by dividing the radioactivity of the liver region of interest by the radioactivity of the liver plus heart regions of interest at 15 min post-tracer injection, was very low. As the patient's condition improved, the right lobe of the liver enlarged while the left lobe became atrophic; after 4 mo, the left lobe almost completely disappeared. Delineation of the heart gradually became less distinct, and the receptor index slowly increased. Hepatic receptor imaging with 99m-Tc-GSA can define both the hepatic functional reserve and morphological changes of the liver, so it is useful for the diagnosis and follow-up study of fulminant hepatic failure.

Adult↗
PubMed1995

Randomised trial of effects of interferon-alpha on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis.

Patients with chronic active hepatitis C and cirrhosis often develop hepatocellular carcinoma. Interferon (IFN) seems to be effective in some patients but whether it prevents carcinogenesis is unknown. In a prospective randomised controlled trial, we evaluated the effects of IFN-alpha in cirrhotic patients with HCV infection because of their high risk of hepatocellular carcinoma. 90 patients with compensated chronic active hepatitis C with cirrhosis were randomly allocated to receive IFN-alpha (6 MU three times weekly for 12-24 weeks) (45 patients) or symptomatic treatment (45 controls), and were followed up for 2-7 years. In nine controls, alanine aminotransferase (ALT) decreased to less than 80 IU/L but did not stay in the normal range. In 19 patients given IFN-alpha, ALT decreased to less than 80 IU/L (in seven patients, it became and stayed normal; p = 0.011, Wilcoxon rank-sum test). However, the mean change in ALT was not significantly different between the two groups. The mean change in peak alpha-fetoprotein values was smaller in patients given IFN-alpha than in controls (p = 0.021). The mean change in the serum albumin level was higher in the IFN-alpha group (p < 0.001). The histological activity index in the 12 IFN-alpha patients undergoing a second biopsy after therapy was improved (p = 0.031). Hepatitis C viral RNA disappeared in seven (16%) of the 45 IFN-alpha patients (95% CI, 7-29%) and in none of the 45 controls (0-8%; p = 0.018). Hepatocellular carcinoma was detected in two (4%, 1-15%) IFN-alpha patients and 17 (38%, 24-54%) controls (p = 0.002, Wilcoxon signed-rank test). The risk ratio of IFN-alpha treatment versus symptomatic treatment was 0.067 (0.009-0.530; p = 0.010 Cox's proportional hazards). IFN-alpha improved liver function in chronic active hepatitis C with cirrhosis, and its use was associated with a decreased incidence of hepatocellular carcinoma.

Antineoplastic Agents↗
PubMed1995

Evaluation of portal circulation through the superior mesenteric vein with an enteric capsule of [123I]iodoamphetamine.

We report a method by which the contribution of the superior mesenteric vein to the portal blood flow can be evaluated noninvasively. An enteric-coated capsule containing [123I]iodoamphetamine is given by mouth 3h before the examination. The data obtained are treated by computer to calculate the portal shunt index (SI) through the superior mesenteric vein. The SI was higher for more severe liver disorders, Increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis. The SI was higher in cirrhotic patients than in chronic hepatitis patients or healthy volunteers (both, P < 0.0001). The SI was higher in cirrhotic patients with esophageal varices than in such patients without varices (P < 0.05). The SI was higher in cirrhotic patients with ascites than in such patients without ascites (P < 0.001). The SI was higher in cirrhotic patients with encephalopathy than in those without encephalopathy (P < 0.01). Correlation was significant between the SI and classical indicators of functional reserve. This method is clinically useful.

Administration, Oral↗
PubMed1995

Primary biliary cirrhosis complicated by severe hypoxemia.

The case reported here is of a 61-year-old woman diagnosed with hepatopulmonary syndrome. She had had severe hypoxemia for 5 years. In room air, her arterial oxygen tension was low, and although we anticipated that treatment with oxygen would increase it, the treatment failed to do so. Pulmonary perfusion imaging with Tc-99m-labelled macroaggregated albumin showed an arterio-venous shunt in the lungs. Blood tests and liver scanning with Tc-99m-labelled galactosyl human serum albumin showed abnormalities of liver function, and per-rectal portal scintigraphy with Tc-99m pertechnetate showed severe portal hypertension. Inspection of a biopsy specimen taken under ultrasonographic guidance showed primary biliary cirrhosis of Scheuer stage I. The causes of hepatopulmonary syndrome are unknown, but seem to include a decrease in hepatic functional reserve, portal hypertension, or other factors. The development of hepatopulmonary syndrome due to portal hypertension in this patient is of interest.

Biopsy↗
PubMed1995

Diagnosis of chronic liver disease from liver scintiscans by fuzzy reasoning.

UNLABELLED: We investigated the possibility that fuzzy reasoning might be used to standardize diagnosis of liver disease based on scintigraphic results and compared the results with those obtained when scintiscans were scored conventionally. METHODS: Seventy-five patients with chronic liver disease (11 patients had chronic persistent hepatitis, 26 had chronic aggressive hepatitis and 38 had cirrhosis) and 25 controls were studied. Another 75 patients with hepatitis or cirrhosis were examined to test the effectiveness of the membership functions. Liver scintiscans were taken 20 min after the intravenous injection of 111 MBq of 99mTc-phytate. Fuzzy reasoning was used to evaluate the following five items: the ratio of the sizes of the left and right lobes, splenomegaly, radioactivity in the bone marrow, deformity of the liver and distribution of radioactivity in the liver. The degree of conformity to each of the three liver diseases being investigated was substituted into the membership function for the conclusion. The center of gravity for each patient's results was calculated. Conventional scoring was made with three levels for each of the five items examined by fuzzy reasoning. RESULTS: Distinctions between chronic persistent hepatitis and chronic aggressive hepatitis were difficult to assess with fuzzy reasoning and conventional scoring. The diagnostic accuracy was 95% for patients with cirrhosis and 88% for patients with chronic hepatitis with fuzzy reasoning. With conventional scoring the accuracy was 86% for patients with cirrhosis and 75% for patients with chronic hepatitis. When fuzzy reasoning was used to examine the other 75 patients with chronic liver diseases, the accuracy was 93% for patients with cirrhosis and 86% for patients with chronic hepatitis. CONCLUSION: The method is simple and can be used routinely in clinical settings.

Adult↗
PubMed1995

Clinical usefulness of evaluation of portal circulation by per rectal portal scintigraphy with technetium-99m pertechnetate.

OBJECTIVE: Portal circulation, in particular the contribution of the inferior mesenteric vein, can be evaluated in a relatively noninvasive way by per rectal portal scintigraphy (J Nucl Med 1988; 29:460-5). The clinical usefulness of the method was evaluated. METHODS: A solution containing technitium-99m pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. By analyses of the curves, the per rectal portal shunt index (SI) was calculated. RESULTS: The SI was higher for disorders that were more severe, increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis, and the SI was higher in cirrhotic patients than in patients with chronic hepatitis or in healthy subjects. The SI was significantly higher when a complication (varices, ascites, or encephalopathy) was present. Correlation between the SI and classic indicators for functional reserve was significant. The SI was significantly related to survival according to results of regression analysis by Cox's proportional hazards model. On the basis of the SI when patients were first examined, the patients with cirrhosis were divided into three groups of roughly equal size: group A, SI under 30%; group B, SI between 30 and 70%; and group C, SI over 70%. The survival rate was lower in group B than in A, lower in group C than in A, and lower in group C than in B. CONCLUSIONS: This method is clinically useful, especially in establishing the prognosis.

Humans↗
PubMed1994

[To avoid complications during laparoscopic cholecystectomy].

Laparoscopic cholecystectomy is now becoming a safe procedure for the benign cholecystic diseases. But the differences, for example in the method of access to peritoneal cavity, visual field, and tools, between laparoscopic surgery and open surgery results in different complications. The purpose of this paper is to discuss how to avoid complications during laparoscopic cholecystectomy. A hundred consecutive patients were expected to receive an elective laparoscopic cholecystectomy from April 1991 to November 1992 in our clinic. Two patients were converted to open cholecystectomy. The reasons for conversion were uncontrollable bleeding from cystic artery and common-bile duct injury. Two other patients were obliged to undergo laparotomy due to post-operative bile leakage. Arterial bleeding from abdominal wall caused by inserting trocar was experienced in one case. Improvement of the equipment and surgical technique have got rid of these complications. We think it is still necessary to do intra-operative examinations such as cholangiography or ultrasonography. The previous two cases with complication of biliary injury underwent laparoscopic cholecystectomy without intraoperative examinations. We could have avoided these complications if intraoperative examinations were used. To prevent the complication of bleeding from abdominal wall, we have been carrying out a unique method. After the introduction of these procedures, we have never experienced any of these complications.

Bile Ducts↗
PubMed1994

Use of immobilized histidine in assay for endotoxin in patients with liver disease.

The Limulus amebocyte lysate (LAL) test has the disadvantage of being influenced by various inhibitors and activators. We have developed a method for the LAL reaction that involves the specific adsorption and isolation of endotoxin using a membrane filter unit and immobilized histidine; in this present study we used the method to measure endotoxin in the plasma of patients with acute or chronic liver disease. The adsorbed endotoxins are separated from LAL-inhibitors or -activators by the membrane filter unit, and their activity is directly assayed with the LAL reagent in a filter cup without any inhibition or activation. The study population consisted of 23 subjects, 3 with fulminant hepatitis and 20 with cirrhosis (9 with esophageal varices and 11 without). All 3 (100%) of the samples of plasma from patients with fulminant hepatitis were positive for endotoxin, as were the samples of 7 (78%) of the 9 patients with cirrhosis and esophageal varices, and 2 (18%) of the 11 patients with cirrhosis but without such varices. The results suggested that this method appears to be useful for assaying the concentration of endotoxin in patients with fulminant hepatitis or cirrhosis of the liver.

Acute Disease↗
PubMed1994

Osteopenia in primary biliary cirrhosis and cirrhosis of the liver in women, evaluated by dual-energy X-ray absorptiometry.

To study bone involvement in primary biliary cirrhosis (PBC), we used dual-energy X-ray absorptiometry to measure bone mineral density (BMD) in Japanese women with PBC and with cirrhosis of the liver. In both groups, in each decade up to 60 years of age, the mean BMD of the lumbar spine was not significantly different from that in healthy Japanese women; however, in patients aged 60 years or more, the level was significantly lower both in the patients with PBC (P < 0.001) and in those with cirrhosis of the liver (P < 0.01). Patients with PBC were also examined by single-photon absorptiometry. The BMD of the radius in the patients with PBC was less changed than that of the lumbar vertebrae; thus, the bone changes in PBC seem to be greater in spongy than in cortical bone.

Absorptiometry, Photon↗