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Biomedical subjects

S Shoji

Publications and source records attributed to S Shoji.

At least 181 records · Page 10Linked to original sources
PubMed1995

Heat-insoluble cryoglobulin in a patient with essential type I cryoglobulinemia and massive cryoglobulin-occlusive glomerulonephritis.

We report a case of type I essential cryoglobulinemia with massive cryoglobulin-occlusive glomerulonephritis, in which the clinical course and the physical characteristics of the cryoglobulin were unusual. Nine years before appearance of cryoglobulin, this 54-year-old man noted edema and purpura of the lower extremities. Renal biopsy performed 2 years later showed large amounts of amorphous, weakly eosinophilic, weakly periodic acid-Schiff (PAS)-positive materials occluding the glomerular capillaries. Immunostaining showed the material to be weakly immunoglobulin (Ig) G positive, and electron microscopy showed homogeneous, electron-dense deposits. Nephrotic syndrome and azotemia did not respond to steroid treatment, and dialysis was begun 5 years after the biopsy. A small amount of cryoglobulin was first detected 2 years later, 9 years after the onset of disease. The cryoglobulin had a white gelatinous appearance, was resistant to resuspension, and did not redissolve when rewarmed to 37 degrees C. Immunoelectrophoresis of the cryoglobulin, which partially dissolved at 54 degrees C, showed it to be composed of monoclonal IgG-kappa and a small amount of albumin. We consider that the unusual physical characteristics of the cryoglobulin in this case precipitated a massive cryoglobulin-occlusive glomerulonephritis, which progressed to end-stage renal failure in the absence of significant cryoglobulinemia during the initial onset of disease.

Cryoglobulinemia↗
PubMed1995

Malignant hyperthermia in a patient with Becker muscular dystrophy: dystrophin analysis and caffeine contracture study.

We present a 17-year-old boy with Becker muscular dystrophy (BMD) who developed hyperthermia and heart failure after general anesthesia. He presented clinical features of malignant hyperthermia (MH), and had masseter spasm and elevated body temperature (38.7 degrees C) with very high serum CK activity (107,000 IUl-1). Dystrophin tests confirmed a clinical diagnosis of BMD in the patient, i.e. faint and patchy immunostaining pattern of skeletal muscle, truncated dystrophin protein and a deletion of exons 3 and 4 of the dystrophin gene. To inquire into the mechanism of MH associated in the patient, we tested caffeine contracture reaction by the skinned fiber method. We found an increased sensitivity to caffeine only in type 1 muscle fibers. The rate of Ca(2+)-induced Ca2+ release (CICR) was normal, suggesting that the mechanism of "MH" observed in our patient with BMD is not the same as that of classical MH. A possible mechanism might be related to derangements of the sarcoplasmic reticulum membrane in BMD, which sensitize the membrane to caffeine or other agents.

Adolescent↗
PubMed1995

Cigarette smoke stimulates release of neutrophil chemotactic activity from cultured bovine bronchial epithelial cells.

1. Recruitment of neutrophils into the airway is a prominent feature of chronic bronchitis, a syndrome often associated with exposure to cigarette smoke. Since bronchial epithelial cells are the 'first' lung cells to come into contact with smoke, these cells may be responsible for neutrophil recruitment into the airway by release of neutrophil chemotactic activity in response to cigarette smoke. 2. To evaluate this hypothesis, we prepared bovine bronchial epithelial cells and measured their ability to release neutrophil chemotactic activity following exposure to cigarette smoke. Bronchial epithelial cells were prepared by overnight digestion with protease, filtered through 100-microns Nitex mesh and resuspended in Dulbecco's modified Eagle medium supplemented with 10% fetal calf serum and antibiotics and cultured at 2 x 10(6) cells in 2 ml of medium in 35-mm culture dishes. After 4 days, dishes were rinsed and refed with medium without fetal calf serum and incubated with and without 1:10 diluted smoke extract for 6 h at 37 degrees C. The neutrophil chemotactic activity of the supernatant fluids was measured by the blindwell chamber technique. 3. Cigarette smoke itself added to medium did not stimulate chemotaxis. In contrast, cigarette smoke did stimulate the release of neutrophil chemotactic activity from bovine bronchial epithelial cells [15 +/- 3 (control) versus 74 +/- 5 (smoke), P < 0.01]. 4. This neutrophil chemotactic activity was dialysable, pepsin and acid stable, heat sensitive and lipid extractable. Sephadex G-75 column chromatography demonstrated two peaks of neutrophil chemotactic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Case report: thyrotropin-releasing hormone-induced myoclonus and tremor in a patient with Hashimoto's encephalopathy.

The authors investigated the possibility of a thyrotropin-releasing hormone-related mechanism in a 43-year-old Japanese woman with Hashimoto's encephalopathy who experienced three relapses closely associated with the menstrual cycle. Her symptoms began at ovulation, worsened during the luteal phase, and improved during the menstruation phase. No abnormalities were found by brain magnetic resonance imaging and cerebral angiography. Intravenous administration of thyrotropin-releasing hormone induced symptoms of myoclonus and tremor similar to those observed during an exacerbation. The intensity and duration of involuntary movements induced by thyrotropin-releasing hormone were dose-dependent. The patient's symptoms were controlled effectively by thyroxine replacement therapy. On the basis of these findings, thyrotropin-releasing hormone may have an important role in Hashimoto's encephalopathy.

Adult↗
PubMed1995

Single photon emission computed tomography using N-isopropyl-p-[123I]iodoamphetamine in spinocerebellar degeneration.

We investigated the clinical usefulness of N-isopropyl-p-[123I]iodoamphetamine single photon emission computed tomography (SPECT) for diagnosis of spinocerebellar degeneration. The uptake in the cerebellar hemispheres and vermis was decreased in sporadic cerebelloolivary atrophy (Holmes, n = 9) and sporadic olivopontocerebellar atrophy (OPCA, n = 6). The uptake in the pons was decreased in OPCA. The decrease of the uptake in the cerebellum and the pons was associated with clinical severity in OPCA. Our results show that semiquantitative SPECT analysis differentiates between the Holmes type and OPCA.

Adult↗
PubMed1995

Histamine activates bronchial epithelial cells to release inflammatory cytokines in vitro.

Airway epithelial cells have a potential to produce cytokines which are relevant to airway inflammation. To elucidate the mechanisms of their regulation, we focused on the effects of three chemical mediators [histamine, platelet-activating factor (PAF) and endothelin-1] important in the pathogenesis of bronchial asthma. Histamine, but not PAF or endothelin-1, showed a dose-dependent stimulatory effect on the release of interleukin-6, interleukin-8 and granulocyte-macrophage colony-stimulating factor by normal and transformed human bronchial epithelial cells when studied 6 h after the treatment. The process required protein synthesis as evaluated by the effect of cycloheximide, and was mainly via H1 receptor. We concluded that histamine might be involved in the activation of airway epithelial cells to release inflammatory cytokines in allergic responses.

Bronchi↗
PubMed1995

Identification of Mycobacterium avium complex isolated in eastern and central Japan by using DNA probes.

An attempt was made to identify Mycobacterium avium and Mycobacterium intracellulare in the M. avium intracellulare complex (MAC) isolated in the Tohoku (38 strains) and Tokai (30 strains) districts of Japan by using DNA probes which are specific for M. avium, M. intracellulare and M. tuberculosis complex, respectively. The incidence of M. avium infection (82%) by far exceeded that of M. intracellulare infection in the Tohoku district of eastern Japan. In the Tokai district of central Japan, the incidence of M. avium infection (57%) were slightly larger than that of M. intracellulare infection. Five of 68 strains showed a positive reaction with two different DNA probes. Thus a possibility of mixed infection could not be ruled out, because reference strains showed a positive reaction with only one species-specific DNA probe.

DNA Probes↗
PubMed1995

Cortical auditory disorder caused by bilateral temporal infarctions.

We present a 55-year-old man who suddenly became afflicted with a bilateral auditory disturbance. Auditory acuity was preserved relatively well. Brainstem auditory evoked potentials (BAEPs) were normal. Middle latency auditory evoked potentials (MLAEPs) revealed the total absence of all waves. Brain computed tomography (CT) showed infarctions of the temporal lobes bilaterally, involving the superior temporal and transverse temporal gyri. The recognition of verbal and nonverbal sounds was also impaired. Brain CT, MLAEPs and auditory recognition tests were useful in diagnosing the cortical auditory disorder.

Auditory Diseases, Central↗
PubMed1995

Hypertrophic cranial pachymeningitis with spinal epidural granulomatous lesion.

A 67-year-old woman with a one-year history of tinnitus and headache had multiple cranial nerve palsies of V, VII, VIII, IX, X, XI and spastic paraparesis. She also had a secretory otitis media. Gd-DTPA-enhanced magnetic resonance imaging (MRI) revealed hypertrophy of the dura of the posterior fossa and spinal epidural mass which extended from C7 to T10. A biopsy of the epidural mass showed chronic granulomatous change. These lesions were completely cured with administration of antibiotics. We believe this case of double-lesion of hypertrophic cranial pachymeningitis and spinal epidural granulomatous lesion originated from a bacterial infection secondary to the secretory otitis media.

Aged↗
PubMed1995

Growth of parathyroid gland in uremic patients on maintenance hemodialysis.

High-resolution, real-time ultrasonography was performed in 245 uremic patients on maintenance hemodialysis and the growth of the enlarged parathyroid glands was compared with the clinical and biochemical signs during follow-up periods of 12 months. The total volume of the parathyroid glands was significantly correlated with the serum C-terminal parathyroid hormone (C-PTH; r = 0.379, p = 0.0001) and calcium levels (r = 0.252, p = 0.0224). After 12 months, the total volume of the enlarged parathyroid glands and serum C-PTH or calcium levels were correlated more closely than in the initial study (r = 0.615, p = 0.0001, and r = 0.489, p = 0.0002, respectively). Both the serum C-PTH levels and the total volume of the enlarged parathyroid glands increased significantly (p = 0.0001), while the ratio between the serum C-PTH levels and the volume of the parathyroid glands decreased significantly (p = 0.0001). There was no difference in the clinical and biochemical signs except for the serum aluminum levels between the patients with and without an increased gland volume. These results suggest that the growth of parathyroid glands may progress more rapidly than the increase in the serum PTH levels, independent of the serum calcium levels, in uremic patients on maintenance hemodialysis.

Adolescent↗
PubMed1995

Impaired vitamin D metabolism and response in spontaneously diabetic GK rats.

Several studies of diabetes mellitus patients have demonstrated abnormalities in calcium, phosphate and vitamin D metabolism. In an earlier study, the authors reported impaired renal processing of phosphate in spontaneously diabetic GK rats, an animal model of type II diabetes mellitus. In the present study, which represents an extension of the earlier study, vitamin D metabolism and response are examined in 20-week-old GK rats. Serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] was found to be lower in GK rats than in Wistar rats. After intraperitoneal administration of 0.5 micrograms/kg 1,25-(OH)2D, serum calcium increased in GK rats, but not in Wistar rats, while serum phosphate remained unchanged in GK rats, but increased in Wistar rats. Although serum 1,25-(OH)2D rose abruptly in 3 h and decreased thereafter in both GK and Wistar rats, the decrease in serum 1,25-(OH)2D at 6 h was more marked in GK rats than in Wistar rats. Serum 24,25-dihydroxyvitamin D was consistently higher in GK rats than in Wistar rats. Northern blotting and dot blotting with use of a cDNA probe for the 24-hydroxylase gene showed an increased expression of the gene in the kidney of GK rats. These results demonstrate impaired vitamin D metabolism in GK rats. Increased activity of 24-hydroxylase, in addition to impaired phosphate metabolism, may play a role in impaired vitamin D metabolism in GK rats.

Animals↗
PubMed1995

Influence of serum phosphate on the efficacy of oral 1,25-dihydroxyvitamin D3 pulse therapy.

In patients with a moderate degree of renal insufficiency, restriction of dietary phosphate suppresses PTH secretion by increasing serum calcitriol. However, this may not operate in advanced renal failure. The present study was designed to evaluate the influence of serum phosphate levels on PTH secretion in oral 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] pulse therapy. 22 patients with secondary hyperparathyroidism [carboxy-terminal PTH (c-PTH) concentration: 19.5+/-13.9 ng/ml, mean +/-SD] received oral doses of 1,25(OH)2D3 (3.0-4.0 micrograms) twice a week, each at the end of hemodialysis, for 12 weeks. Doses of phosphate binders remained unchanged throughout this period. Patients were divided into two groups: group A (11 subjects) with mean serum phosphate levels of less than 6.0 mg/dl and group B (11 subjects) with levels of 6.0 mg/dl and above. There was no significant difference in the average corrected serum calcium levels. The reduction in serum intact PTH levels was greater in group A than in group B. A negative correlation (r = -0.48; p < 0.05) was observed between mean serum phosphate levels and the percent decrease in serum c-PTH levels. The findings of this study indicate an important role for dietary phosphate reduction in oral 1,25(OH)2D3 pulse therapy and suggest that serum phosphate reduction may play a part in suppressing PTH secretion through a mechanism independent of 1,25(OH)2D3 and plasma calcium levels.

Administration, Oral↗
PubMed1995

[Creatine kinase (CK)].

Creatine kinase is a key enzyme for energy metabolism of contraction and relaxation in skeletal muscle. This enzyme also correlated to mitochondrial oxidative phosphorylation. Distribution of this enzyme is quite wide, including skeletal muscle, myocard, central nervous system, and smooth muscle. Creatine kinase has three main isoenzymes; CK-MM, CK-MB, and CK-BB. Mitochondrial isoenzyme (CKm) is the fourth isoenzyme migrating electrophoretically toward the cathode. Moreover serum creatine kinase isoenzyme (mainly CK-MB and CK-BB) and lesions in the myocard, skeletal muscle, central nervous system, gastrointestinal system, renal and urogenital systems, or acute psychosis, intoxication, pregnancy, labor, and cord blood are also explained. A compendium on CK-BB is also done.

Biomarkers↗
PubMed1995

[A case in which bronchorrhea was alleviated by oral erythromycin and inhalation of beclomethasone and furosemide].

A 55-year-old woman with bronchorrhea and bronchial asthma was admitted to our hospital in June, 1992. On admission, she was producing a large volume of sputum (200 ml) each day. The volume decreased with oral administration of erythromycin and inhalation of beclomethasone. Next, inhalation of furosemide was added to the regimen, which lead to symptomatic improvement in mucus clearance, although the sputum increased in volume. The concentrations of albumin, fucose, sialic acid, and phosphatidylcholine in the sputum changed with these treatments, as did the lecithin/sphingomyelin ratio. These observations suggest that these drugs affect not only the quantity but also the quality of sputum.

Administration, Inhalation↗
PubMed1995

[Mononeuropathy multiplex in a patient receiving interferon alpha therapy for chronic hepatitis C].

We report a case of mononeuropathy multiplex due to interferon alpha (IFN alpha) therapy for chronic hepatitis C. A 61-year-old man received IFN alpha (natural type 6 x 10(6) IU), every day for two weeks and three times a week for 22 weeks by intramuscular injection. Seventeen weeks after the initiation of IFN alpha therapy, he noticed painful dysesthesia, muscle weakness and muscular atrophy of the left lower extremity. Neurological examination revealed weakness of the left iliopsoas, quadriceps femoris and femoral adductor muscles, hypesthesia and dysesthesia. Electromyogram showed neuropathic change in the left vastus lateralis muscle. Muscle computed tomography showed muscular atrophy of the left lower extremity. Two months after discontinuation of the IFN alpha therapy, dysesthesia and muscle weakness of the left lower extremity improved spontaneously. He was diagnosed as mononeuropathy multiplex of the left femoral nerve and obturator nerve caused by IFN alpha therapy. Attention must be paid to dysesthesia, muscle weakness and muscular atrophy when IFN alpha therapy is initiated.

Chronic Disease↗