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Biomedical subjects

T Miki

Publications and source records attributed to T Miki.

At least 883 records · Page 49Linked to original sources
PubMed1987

A case of hyponatremia in panhypopituitarism caused by the primary empty sella syndrome.

A 64-year-old woman was admitted for evaluation of hyponatremia. She was maintained on hypertonic saline administration. Without this therapy, the serum Na concentration decreased progressively to 127 mEq/L and the plasma osmolality to 254 mOsm/Kg H2O, on Day 3. At that time, the concentration of antidiuretic hormone (ADH) was as high as 3.5 pg/ml. A skull radiogram revealed an enlarged sella turcica. Computed tomography (CT) revealed a low density in the sella, and magnetic resonance imaging revealed equal intensity of the sella turcica and the cerebrospinal fluid. A diagnosis of empty sella syndrome was made by metrizamide cisternography in conjunction with CT scanning. A diagnosis of panhypopituitarism was made by endocrine function tests. 123I-thyroidal uptake was 6% when her serum TSH was 10.9 microU/ml, suggesting that she might also have primary hypothyroidism. When this patient was given glucocorticoid before levothyroxine replacement, her serum Na concentration rose up to about 140 mEq/L and a normal relationship between her plasma ADH level (2.4 pg/ml) and plasma osmolality (281 mOsm/kg H2O) was restored. Therefore, it was suggested that ADH hypersecretion induced by the glucocorticoid deficiency might in part contribute to the development of hyponatremia. This is the case of primary empty syndrome associated with panhypopituitarism, in whom initial symptom was caused by hyponatremia.

17-Hydroxycorticosteroids↗
PubMed1987

Analysis of steroid 21-hydroxylase gene in five unrelated Japanese patients with 21-hydroxylase deficiency.

DNA samples from five unrelated Japanese patients with 21-hydroxylase (21-OHase) deficiency were studied by Southern analysis using human 21-OHase cDNA. Patterns seen after digestion with not only TaqI but also KpnI showed that two out of the five patients were homozygous for a deletion of the 21-OHase B gene. This result supports the report that the 21-OHase B gene is functional. In the other three, smaller mutations might be responsible for the disorder. The parents of one of the two patients with the deletion had a common ancestor. Hybridization patterns of DNA from members of the family of the patient were consistent with an autosomal recessive mode of inheritance of the deletion that correlates with the clinical phenotype. The deletion segregated with HLA-Aw 24; Bw 61; Cw 3. Heterozygous carriers of 21-OHase deficiency could be detected by comparing the patterns as well as the HLA haplotypes in this family. The application of the family study to the prenatal diagnosis is also discussed.

Adrenal Hyperplasia, Congenital↗
PubMed1987

[A study on the immunologic effects in workers exposed to low levels of toluene-diisocyanate (TDI)].

Forty-three workers exposed to low levels of toluene diisocyanate (TDI) during the process of producing polyurethane forms were examined immunologically for IgG, A, M, and E and serum enzyme activities such as serum angiotensin converting enzyme (SACE), serum lysozyme (SLZM) and glycylproline dipeptidyl aminopeptidase (GP-DAP). Air concentration of TDI was annually measured in various places of work during the past five years from 1979 to 1983. The results obtained in the present study were as follows. 1. The air concentration of TDI at all places of work was below the permissible concentration level of 0.02 ppm throughout the study period. 2. Subjective symptoms and abnormal findings on chest X-ray considered directly related to TDI exposure were not observed. 3. No remarkable abnormal findings in blood cell counts and in serum biochemical studies could be seen in any of the workers. 4. The serum IgG levels in workers directly exposed to TDI were significantly higher (p less than 0.05) than those in workers indirectly exposed to TDI and in non-exposed workers. 5. In the study of serum enzymatic activity, SLZM activity in workers exposed directly to TDI was significantly higher (p less than 0.01) than those in workers indirectly exposed to TDI and in non-exposed workers.

Adult↗
PubMed1987

A family case with autosomal-dominantly inherited pituitary dwarfism.

Isolated growth hormone (GH) deficiency (IGHD) is detected in 1/10 of pituitary dwarfism, but there are only a few reports on IGHD as an autosomal-dominant trait. We found one family with autosomal-dominantly inherited IGHD and examined their pituitary functions and GH genomes. Brothers (9.5 year and 11 year) and their mother (37 year) were diagnosed as having IGHD and their grandmother and uncle also seemed to have IGHD. All of their heights were under "mean-4.0 S.D.". Cerebral tomography of brothers and their mother all showed "empty sella", and GH-releasing hormone (GRH) tests showed no responses of GH not only to bolus intravenous injections but also after repeated intramuscular injections of GRH (100 micrograms/day) for 7 days. Although genetic analysis (Southern blotting method) could not detect any mutations in their GH genomes, the IGHD lesion of them seemed to be pituitary in origin.

Adult↗
PubMed1987

Scintigraphy in nontraumatic femoral head necrosis.

We performed serial 99mTc-MDP bone scintigraphy of nontraumatic femoral head necrosis in 14 hips of 10 patients. The uptake of isotope was decreased in the very early stage, and either variable or increased at the stage when symptoms appeared. A variable uptake changed to increased uptake in 3 of 10 patients, but there was no hip in which an increased uptake changed to a variable uptake. No relationship was demonstrated between the scintigraphic appearance of the femoral head and the pain and function of the hip.

Adult↗
PubMed1987

[Salvage surgery following chemotherapy of advanced testicular cancer].

Advanced testicular cancer is best treated with cisplatinum-based combination chemotherapy. Fifty-two patients with advanced disease were treated with cisplatinum, vinblastine, and bleomycin (PVB therapy). The PVB therapy produced 53.8% complete and 46.3% partial remissions. Of 24 patients failing to achieve complete remission, 18 underwent retroperitoneal lymphadenectomy either to remove persistent residual mass (in 12 patients) or to confirm a clinical complete response (in 6 patients), 4 patients underwent resection for residual pulmonary lesions, one patient underwent resection for cervical mass, and 2 patients underwent craniotomy for metastatic brain lesions. Scarring was found in 10 patients (40%), teratoma in 7 (28%), and active cancer in 8 (32%). All 10 patients with fibrous tissue and 5 of 7 patients with teratoma have been continuously free of disease. However, only 3 of 8 patients with active cancer are alive without evidence of disease. The salvage surgery achieved a 17.3% disease-free status. As the final result, of the 52 patients, 35 (67.3%) are alive with no evidence of disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[A case of signet ring cell carcinoma of the urinary bladder].

A 51-year-old man was hospitalized with complaints of gross hematuria and terminal micturition pain. Cystoscopy revealed a low columnar tumor at the dome of the bladder. Ultrasonography and X-ray CT also demonstrated the same shape of tumor and no evidence of invasion to adjacent organs. Gastrointestinal examination, including upper gastrointestinal series and barium enema failed to reveal any primary tumor. The serum CEA level was 2.3 ng/ml, which was not elevated. Total cystectomy with ileal conduit and adjuvant chemotherapy consisting of cyclophosphamide, adriamycin and cisplatinum was performed. He died of a recurrent tumor 2 years and 2 months after the operation. Besides our experience of primary signet ring cell carcinoma of the urinary bladder, a review of the literature is reported.

Adenocarcinoma, Mucinous↗
PubMed1987

Retrovirus produced by a lymphoid cell line from an infant with acute lymphoblastic leukemia.

A lymphoid cell line CK-a was established from peripheral blood of an infant with acute lymphoblastic leukemia of non-T, non-B cell type with mediastinal tumor. The CK-a cells were positive for surface immunoglobulins, Epstein-Barr virus-specific nuclear antigen, HLA-DR and Leu 12 antigens, and negative for sheep erythrocyte-rosette-receptor, and Leu 1, 2, 3 and 4 antigens. Budding particles were detected in electron micrographs of ultrathin sections of the CK-a cells. In the culture media of CK-a cells, particles with a buoyant density of 1.16 g/ml and labeled with [3H]uridine and [35S]methionine but not with [3H]thymidine were found to carry reverse transcriptase activity which preferred Mg2+ to Mn2+. Enveloped particles of 80 to 120 nm in diameter were detected in the fractions at 1.16 g/ml by electron microscopy. Thus, the particles had properties compatible with a definition of Retroviridae, and were tentatively named CK virus (CKV). The genome size of CKV RNA determined by agarose-acrylamide composite gel electrophoresis was 6.1 +/- 0.2 kb. Immune electroblotting assay detected antibody reactive with a CKV protein with a molecular weight of 67,000 in the serum of the patient, but not in sera of an adult T cell leukemia patient and healthy controls. No syncytia were formed by mixed cultures of CK-a and XC cells.

Antibodies, Viral↗
PubMed1987

Loss of genes on chromosome 22 in medullary thyroid carcinoma and pheochromocytoma.

Using polymorphic DNA markers, we compared the constitutional and tumor genotypes of patients with multiple endocrine neoplasia type 2A (MEN2 A). We found loss of constitutional heterozygosity at the D22S9 locus in one out of 9 medullary thyroid carcinomas (MTCs). No loss of heterozygosity was detected at 12 other loci in any of the MTCs tested. Loss of heterozygosity at D22S9 and/or D22S1 was also demonstrated in 2 out of 5 pheochromocytomas tested. These results suggest that loss or mutation of a gene on chromosome 22 may play an important role in tumorigenesis in MEN2A.

Adrenal Gland Neoplasms↗
PubMed1987

[Review of ureteral carcinoma as seen in mapping of the cystectomized bladder].

The incidence of unexpected ureteral carcinoma on mapping and recurrence of upper urinary tract urothelial cancer was examined in 160 patients who had undergone total cystectomy for vesical cancer and complete mapping of the specimens between May, 1978 and June, 1986 at our Center. Unexpected carcinoma in the ureteral stump was found in 5 patients (3.1%) and recurrent cancer in the upper urinary tract developed in 2 (1.3%) of the 160 patients. The incidence was higher in the recurrent bladder cancer cases, and also higher in patients with non-visible, high grade and superficial tumors of the bladders.

Aged↗
PubMed1987

[Exercise echocardiography and clinical features in patients with mitral valve prolapse].

To assess left ventricular (LV) functional reserve and prognosis in patients (pts) with idiopathic mitral valve prolapse (MVP), we performed ergometer exercise echocardiography for 10 normal subjects and 30 MVP pts without or with mild mitral regurgitation (MR). These 30 pts were followed for 2-8 years (mean 4.5). Percent changes (delta%FS) of % fractional shortening (%FS) during exercise at initial study in MVP pts and normal subjects were 7 +/- 7 and 11 +/- 3%, respectively. Based on delta%FS, MVP pts were divided into two groups; Group I: 13 cases with delta%FS less than 5%, Group II: 17 cases with delta%FS greater than or equal to 5%. The incidence of cardiac symptoms was higher in Group I than in Group II (85 vs 41%, p less than 0.05). ST-T changes on standard 12 lead ECG and life-threatening arrhythmias on Holter ECG were more frequently observed in Group I (38 vs 18%, 58 vs 20%). During follow-up period, M-mode echo measurements did not change in Group II, but LV end-diastolic dimension, LV end-systolic dimension and left atrial dimension significantly increased (p less than 0.05, p less than 0.01, p less than 0.01, respectively), and %FS significantly decreased (p less than 0.01) in Group I without any changes of MR severity. Thus, some MVP pts with impaired cardiac reserve detected by exercise echo may develop progressive deterioration of cardiac function even without significant MR.

Adult↗
PubMed1987

[Pulsed Doppler echocardiographic findings in 117 professional cyclists].

To investigate the effect of long-term athletic training on the heart, pulsed Doppler echocardiography was performed in 117 male professional cyclists (Group C: 20-59 years of age), and 40 age- and sex-matched untrained normal controls (Group N). According to age, the subjects in each group were categorized in two subgroups: 74 cyclists (Group CI), 20-39 years of age and 43 cyclists (Group CII), 40-59 years of age; 24 control subjects (Group NI), 20-39 years of age and 16 control subjects (Group NII), 40-59 years of age. The average durations as professional cyclists were eight years in Group CI and 29 years in Group CII. The ratios of pre-ejection period to ejection time (LV-PEP/ET, RV-PEP/ET) as obtained from Doppler flow velocity patterns of the left and right ventricles (LV, RV) were used as parameters of systolic function. The peak flow velocities during rapid filling (LV-R, RV-R) and atrial systole (LV-A, RV-A), and the ratio of A to R (LV-A/R, RV-A/R) were used as parameters of diastolic filling dynamics. The parameters of systolic function of both ventricles and those of diastolic filling dynamics of the RV did not differ between Group C and Group N, Group CI and Group NI, and Group CII and Group NII. Study of the diastolic filling dynamics of the LV disclosed that Group C had a significantly higher LV-A/R (p less than 0.05) than did Group N; therefore, no significant differences between Group CI and Group NI, and Group CII had a significantly lower LV-R (p less than 0.005) and a higher LV-A/R (p less than 0.005) than did Group NII. Twenty-four hour ambulatory ECG monitoring was performed for 49 cyclists. Thirty cyclists aged 20-39 years were categorized in two groups according to their LV-A/R values: eight cyclists (Group A) with the LV-A/R greater than the mean + SD value (0.69) in Group NI and 22 cyclists (Group B) with the LV-A/R lower than or equal to 0.69. Nineteen cyclists aged 40-59 years were separated into two groups according to the LV-A/R value: 11 cyclists (Group A) with the LV-A/R values greater than the mean + SD value (0.89) in Group NII, and eight cyclists (Group B) with the LV-A/R equal to or less than 0.89.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

[A trial diagnosis of latent dilated cardiomyopathy].

To diagnose latent dilated cardiomyopathy (latent DCM), we performed loading echocardiography with Angiotensin II and ergometer exercise in 41 patients. Twenty-one patients were suspected of having latent DCM because of histories, of heart failure of myocarditis; 10 patients had DCM; and 10 normal persons served as controls. On angiotensin II loading, cardiac function deteriorated in the DCM group, but it was maintained in the normal controls. Nine patients in the latent DCM group showed the same pattern as normals (L1-group), and 12 did as the DCM group (L2-group). Although % fractional shortening, end-diastolic and end-systolic dimensions of the left ventricle did not differ between the L1 and L2-groups, the A/R, the ratio of the pulsed Doppler echocardiogram at the left ventricular inflow tract, was larger and the exercise change of the % fractional shortening and exercise tolerance were less in the L2-group than in the L1-group. Furthermore, the biopsy findings of the L2-group were similar to those of the DCM group in terms of myocardial degeneration, myocardial hypertrophy and interstitial fibrosis. Thus, patients in the L2-group were thought to have a risk for DCM, and were cases of latent DCM. Angiotensin II loading is thought to be useful for diagnosing such cases.

Angiotensin II↗
PubMed1987

The fate of hypertrophic chondrocytes in growth plates transplanted intramuscularly in the rabbit.

Sixteen implants of fetal growth cartilage of New Zealand white rabbits of both sexes were implanted intramuscularly into an adult animal of the opposite sex. Endochondral ossification was recognized in 11 of the 16 implants. The sex of the osteoblasts and chondrocytes was determined by counting the sex chromatin body in five areas of abundant endochondral ossification. The bone grown adjacent to the implant was predominantly of recipient type in all of the specimens (p less than 0.01). Most of the chondrocytes gradually lost stainability to Feulgen-Schiff stain as they matured, and only a few cells were stained in the calcified zone, indicating the deterioration of nuclear DNA. Thus, the majority of the growth plate chondrocytes are considered to die and be replaced by osteoblasts of a different origin.

Animals↗