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Biomedical subjects

T Nishida

Publications and source records attributed to T Nishida.

At least 325 records · Page 18Linked to original sources

[Case of benign metastaxsizing leiomyoma of the lungs].

A 51-year-old woman with bilateral multiple pulmonary metastases of uterine leiomyoma was reported. The patient had undergone a hysterectomy for uterine myoma in 1976. In 1981, routine chest roentgenograms showed three nodular lesions in the right lung with well-defined margins. The patient received no treatment because she was asymptomatic. In January 1993, she consulted a gynecologist because of acute lower abdominal pain and an abdominal mass, and bilateral pulmonary tumors were found. The retroperitoneal solid tumor was extirpated in the first operation, and histological findings showed that it was a benign leiomyoma. The pulmonary tumors, extirpated in the second operation, were benign leiomyoma, also. The clinical course and histological findings suggested that this was a case of benign metastasizing leiomyoma. This disease is rare, 21 case have been reported in Japan.

Female↗

[Three cases of tuberculous mediastinal lymphadenitis].

Mediastinal lymph node involvement is uncommon in intrathoracic tuberculosis. We report three cases of this disease, each of which had a different clinical course. Chest CT scans showed preferential involvement of right paratracheal nodes, central areas of relatively low density with peripheral rim enhancement after injection of contrast medium. Specimens obtained by mediastinoscopy and fiberoptic bronchoscopy revealed acid-fast bacilli in all cases. In view of its relative frequency, tuberculous mediastinal lymphadenitis in adults must be distinguished from other causes of mediastinal masses.

Adult↗

An ultrastructural and lectin-histochemical study on the seminiferous epithelium of the common tree shrew (Tupaia glis).

The seminiferous epithelium of the common tree shrew (Tupaia glis) was investigated using transmission electron microscopy and lectin-histochemistry. It was compared with that of shrews examined in previous studies. Some peculiar structures were detected in the tree shrew spermatid at the electron microscopic level. The most characteristic feature was the disposition of mitochondria in early spermatids. In cap and early acrosome-phase spermatids, mitochondria accumulated in one area of the spermatid cytoplasm and then dispersed in the late acrosome phase. Subsequently they again clustered to form the middle piece of spermatozoa. While the lamellar structure was clearly seen in the caudal region of the spermatid nucleus, it gradually disappeared during the process of elongation. The dilated area in the postacrosomal space of early round spermatids was also characteristic. The dilation was not detected in elongated spermatids. These structures were not recognised in the seminiferous epithelium of shrews. With respect to lectin histochemistry, the binding patterns in the spermatid acrosome of the tree shrew were similar to those of the musk shrew. However, PNA and BPA, which reacted with the Sertoli cell cytoplasm of the musk shrew, showed no reaction in the tree shrew Sertoli cell. Thus, except for some lectin binding patterns in the spermatid acrosome, no close similarity was recognised in the morphology of the seminiferous epithelium between tree shrews and shrews.

Acrosome↗

[Visual evaluation of liver function with 99mTc-GSA scintigraphy: interobserver variation and intraobserver variation].

We introduced a new imaging grade to evaluate liver function with 99mTc-GSA and studied its diagnostic value using interobserver variation and intraobserver variation. One hundred four patients with liver disease were injected 185 MBq/3 mg of 99mTc-GSA. Anterior images of cardiac blood-pool and liver at 5 min after injection were divided into four grades on the basis of following four categories. Faint cardiac blood-pool image, without clear demonstration of its peripheral boundary was classed in grade I; weaker cardiac blood-pool than liver was grade II; almost same appearance of blood-pool with liver was grade III and stronger blood-pool than liver was grade IV. Three radiologists reviewed the images independently. They followed the same process three months after initial evaluation. kappa-Test was employed to evaluate the goodness of agreement. Three pairs in the first reading showed excellent interobserver agreement (0.88, mean kappa-value) and another three pairs in the first and second reading also showed excellent intraobserver agreement (0.87, mean kappa-value). Quantitative indices obtained from time-activity curves for blood-pool and liver showed significant differences across four groups. Plasma retention rate of indocyanine green also showed significant difference between grade II and grade III. Imaging grade possesses high intra- and interobserver agreement and provides a good discrimination for liver function.

Adolescent↗

Successful twenty-four-hour canine lung preservation with lazaroid U74500A.

BACKGROUND: Lipid peroxidation is known to contribute to ischemia-reperfusion injury. U74500A is a 21-aminosteroid (lazaroid) that prevents lipid peroxidation without corticoid side effects. We examined the effect of U74500A on lung preservation using a canine orthotopic single left lung transplantation model. METHODS: Twelve adult mongrel dogs underwent left lung allotransplantation. The lungs of the donor dogs were flushed with University of Wisconsin solution (50 ml/kg). Six donor dogs were pretreated with U74500A (5 mg/kg intravenously) before preservation (group L, n = 6), whereas those dogs without pretreatment served as controls (group C, n = 6). Allografts were stored in University of Wisconsin solution for 24 hours at 1 degrees C. Left single lung transplantations were performed by means of standard technique. Before reperfusion, recipients in group L received another dose of U74500A. Arterial blood gas analysis and hemodynamic measurements were made by occluding the right pulmonary artery to evaluate the transplanted left lung function at a inspired oxygen fraction of 1.0. Serum lipid peroxide level was measured after 2 hours of reperfusion. RESULTS: Arterial oxygen tension, arterial carbon dioxide tension, and left pulmonary vascular resistance at 6 hours after reperfusion were significantly better in group L than in group C (arterial oxygen tension: 510 +/- 66 and 219 +/- 149 mm Hg; arterial carbon dioxide tension: 47 +/- 16 and 68 +/- 14 mm Hg; left pulmonary vascular resistance: 2412 +/- 826 and 3904 +/- 1251 dyn center dot sec/cm5, group L and group C, respectively). Serum lipid peroxide level was significantly lower in group L (0.25 +/- 0.24 nmol/ml) than in group C (0.92 +/- 0.53). CONCLUSIONS: The administration of U74500A prevented lipid peroxidation and preserved pulmonary allograft function after 24 hours of ischemia.

Animals↗

[Combination of irinotecan hydrochloride (CPT-11) and cisplatin as a new regimen for patients with advanced ovarian cancer].

It has been reported that the antitumor effect of CPT-11 is manifested through the inhibition of topoisomerase I by SN-38 which is an active metabolite of CPT-11 produced by intracellular carboxylesterase, and that CPT-11 is effective against recurrent ovarian carcinoma. We investigated the antitumor effect and adverse reactions in the combined therapy with CPT-11 and CDDP in patients with prior chemotherapy for recurrent carcinoma, and in 7 patients without prior chemotherapy, consisting of 4 patients with postoperative adjuvant chemotherapy for clear cell carcinoma and 3 patients with metastatic ovarian carcinoma. CDDP was administered on day 1 and CPT-11 was administered three times on days 1, 8 and 15. The dose of both CDDP and CPT-11 was 50 mg/m2 or 60 mg/m2. Adverse reactions were investigated in all patients and the antitumor effect was assessed in 12 patients with recurrent carcinoma who had measurable lesions. (1) The DLF was neutropenia. The neutrophil count nadiar occurred on day 18 or 19. Grade 3 or 4 adverse reactions were observed in 60% or more of the patients, but they disappeared following short term administration of G-CSF. In patients with recurrent carcinoma given CDDP and CPT-11 at 60 mg/m2, the incidence of grade 3 or 4 adverse reactions and number of occasions on which CPT-11 administration had to be postponed were higher than those in patients given 50 mg/m2. (2) Mild platelet reduction was observed. (3) Grade 3 or 4 diarrhea was observed in 3.2% of patients with recurrent carcinoma and in 7.7% of patients with metastatic ovarian carcinoma. (4) The antitumor effect was evaluated in 12 patients with recurrent carcinoma: CR in 2 patients. PR in 3, NC in 6, and PD in one. The response rate was 41.7%. (5) An antitumor effect was observed in 2 patients with serous carcinoma and in one patient each with mucous carcinoma, clear cell carcinoma and endometrial carcinoma. In conclusion, adverse reactions caused by the combination therapy with CPT-11 and CDDP (CPT-11: 50-60 mg/m2 on days 1, 8 and 15, CDDP: 50-60 mg/m2 on day 1) can be relieved by short term administration of G-CSF and it is suggested that the combination therapy may be effective in treating ovarian carcinoma.

Adult↗

[A case-control study of ovarian cancer to identify its risk factors].

To analyze the association between the potential risk factors and ovarian cancer, we conducted a case-control study from October, 1994 to January, 1996 in northern Kyushu. We interviewed 78 patients whose ovarian cancer was histologically confirmed, and 346 controls, selected from women at mass screening, who had not ever suffered from a cancer or an ovarian disorder. An odds ratio (OR) and its 95% confidence interval (95% CI) were estimated by the conditional logistic regression method. As a result, it was found that the risk was significantly increased for a family history of ovarian cancer in a mother or a sister (OR = 2.85, 95% CI 1.01-8.08), for heavier maximum body weight in the past (trend, OR = 1.31, 95% CI 1.06-1.63), and for larger maximum body mass index (trend, OR = 1.30, 95% CI 1.06-1.60). Conversely, the risk was significantly decreased with the number of parities (trend, OR = 0.57, 95% CI 0.39-0.83), and with experience in having ever taken oral contraceptive pills (OR could not be calculated, p < 0.05). The positive relationship of maximum body weight or maximum body mass index to the ovarian cancer risk may in part explain the recent increase in the incidence of ovarian cancer in Japan.

Alcohol Drinking↗

[Anesthetic management of a patient complicated with restrictive cardiomyopathy for gastrectomy].

Restrictive cardiomyopathy is a rare condition characterized with endomyocardial fibrosis, which interferes diastolic ventricular filling. A 52-year-old man with a 38 year history of dyspnea on effort presented with advanced gastric cancer. Subtotal gastrectomy under general anesthesia was scheduled. Preoperative examination showed biventricular dysfunction, impaired liver function and chronic renal failure. General anesthesia was induced using fentanyl, pancuronium and isoflurane, and maintained with nitrous oxide/oxygen, isoflurane and fentanyl. Extensive invasive monitoring included arterial blood pressure, central venous pressure, pulmonary artery pressure and oxygen saturation of mixed venous blood as indices of left-sided pump function. Dopamine and nitroglycerin infusion was also started after the tracheal intubation. Although a transient improvement of cardiac function was noted after the removal of ascites 5 liter, restricted fluid administration induced desaturation of mixed venous blood and tachycardia. The start of low dose prostaglandin E1 markedly improved cardiac output without hypotension, while an increase of intravenous nitroglycerin did not prove to be beneficial. PGE1 was more selective in decreasing left ventricular afterload, while nitroglycerin produces greater decrease of preload.

Alprostadil↗

[A case of ASD with SLE treated with Carmeda BioActive surface circuit in cardiopulmonary bypass system].

A 61-year-old woman of ASD complicated with SLE was operated on. We used a heparin coating Carmeda BioActive Surface (CBS) in cardiopulmonary bypass circuit for the purpose to prevent the postoperative complications due to the reduced complement activation by SLE. This system could prevent the decline of the reduced complement activation during cardiopulmonary bypass and after operation. The management of steroid therapy for SLE patient, usefulness of heparin coating CBS system for hypocomplement disease were discussed.

Anti-Inflammatory Agents↗

Expression of MAGE-1, MAGE-2, MAGE-3/-6 and MAGE-4a/-4b genes in ovarian tumors.

MAGE genes encoding tumor-rejection antigens recognized by cytotoxic T lymphocytes are expressed at the mRNA level in various malignant tumors. We have investigated the expression of genes MAGE-1, -2, -3/-6 and -4a/-4b at the mRNA level in malignant and non-malignant ovarian tumors as well as in normal ovaries by reverse transcription-polymerase chain reaction. MAGE-1, -2, -3/-6 and -4a/-4b were expressed in 12, 5, 11 and 4 of 58 malignant tumors, respectively. The majority of these MAGE-mRNA-positive tumors were histologically surface-epithelial-stromal tumors, in particular serous adenocarcinomas. They mostly consisted of either advanced-stage or recurrent tumors. In contrast, neither benign tumors nor normal ovaries expressed any of the MAGE genes investigated. A 46-kDa MAGE-1 protein was identified in MAGE-1-mRNA-positive serous adenocarcinomas by immunoblot analysis with polyclonal anti-MAGE-1 antibody. These results provide important information for specific immunotherapy of ovarian serous adenocarcinomas with MAGE gene products.

Amino Acid Sequence↗

Evidence that portal vein decompression improves survival of canine quarter orthotopic liver transplantation.

The minimum graft volume still remains unclear in reduced-size liver transplantation (RLT). This study reports the improved survival of canine RLT using a quarter graft with the aid of a portahepatic vein shunt (PHVS). In beagles, the donor liver was reduced to the right lateral and caudate lobes (quarter graft) with or without provision of PHVS, and transplanted orthotopically in the recipient. The PHVS was established by an end-to-end anastomosis of the portal vein branch and the hepatic vein in the resected left lateral lobe. Liver chemistries including arterial blood ketone body ratio (AKBR) were serially measured during and after surgery. All seven animals with PHVS survived more than 3 days (mean +/- SD; 5.3 +/- 1.7 days), whereas all six without PHVS died within 3 days (1.8 +/- 0.8 days, P < 0.01). Portal vein pressures immediately after recirculation in animals with and without PHVS were 8.5 +/- 1.2 mmHg and 16.9 +/- 3.1 mmHg, respectively (P < 0.01). Regardless of the presence or absence of PHVS, AKBR dropped to a level lower than 0.7 during the anhepatic period and returned promptly to above 1.0 as early as 30 min after recirculation. Thereafter, the AKBR values in animals with PHVS remained higher than 1.0, whereas those in animals without PHVS showed a progressive decrease, showing a statistically significant difference between the two groups after 12 hr (P < 0.05). Graft function, as assessed by AKBR, was well correlated with survival and other liver chemistries. These results indicate that, in an extreme RLT, portal hypertension is a risk factor predisposing to graft failure, most likely by increasing microvascular injury after recirculation.

Animals↗

Esterification of oxysterols by human plasma lecithin-cholesterol acyltransferase.

In the present study, lecithin-cholesterol acyltransferase (LCAT) catalyzed esterification of oxysterols was investigated by using discoidal bilayer particles (DBP) containing various oxysterols, phosphatidylcholines, and apolipoprotein A-I. The esterified oxysterols were analyzed by high pressure liquid chromatography, gas chromatography, and mass spectrometry. LCAT esterified all oxysterols tested that are known to be present in human plasma. The esterification yields in almost all cases were relatively high, often as high as the yield of cholesterol esterification. When DBP preparations containing 27-hydroxycholesterol and various phosphatidylcholines were used for the LCAT reaction, both monoesters and diesters were produced. The mass spectrometry analysis showed that the monoester was produced by the esterification of the 3 beta-hydroxyl group and not the 27-hydroxyl group. The diesters were apparently produced by the esterification of the 27-hydroxyl group only after the esterification of the 3 beta-hydroxyl group. Phosphatidylcholine containing a saturated acyl group at sn-1 position and an unsaturated acyl group at sn-2 position gave generally high esterification yield. The esterification of various oxysterols was compared by using DBP containing dioleoyl-phosphatidylcholine and individual oxysterols. All oxysterols produced 3 beta-oleoyl monoesters. Unlike 27-hydroxycholesterol, 25-hydroxycholesterol, 7 alpha-hydroxycholesterol, 7 beta-hydroxycholesterol, or cholestanetriol did not produce diesters. Various factors influencing the formation of the monoesters and diesters from 27-hydroxycholesterol were investigated. When dioleoyl-phosphatidylcholine was used as the acyl donor, prolonged dialysis of DBP preparations and increase in the ratio of the enzyme concentration to substrate particle concentration increased the diester formation. Significant amounts of diesters were also produced by using 1-palmitoyl-2-oleoyl-phosphatidylcholine and other phosphatidylcholines as the acyl donors. By analyzing the conditions of monoester and diester formation, a scheme for the LCAT reaction pathway was proposed.

Apolipoprotein A-I↗

Effects of temperature on motor unit action potentials during isometric contraction.

The effect of temperature on motor unit action potential (MUAP) configuration and recruitment was studied using automatic decomposition electromyography (ADEMG) recordings from a concentric needle electrode placed in the first dorsal interosseous (FDI) muscle of 10 normal adult subjects during isometric contraction. Focally cooling the FDI resulted in prolonged MUAP duration (P < 0.001, ANOVA), a finding congruent with those of Buchthal. Focal ulnar cooling at the elbow resulted in the increased MUAP frequency. In contrast to previous studies, there were no significant differences in amplitude or turns. Greater understanding of normal motor unit electrophysiology is necessary to improve diagnostic accuracy of EMG testing.

Adult↗

Up-regulation of integrin alpha 5 beta 1 expression by interleukin-6 in rabbit corneal epithelial cells.

Interleukin-6 (IL-6) has been shown to promote the attachment of rabbit corneal epithelial cells to fibronectin-coated substratum and ex vivo migration of the cells on the corneal stroma. To examine whether IL-6 promotes cell attachment through up-regulation of expression of integrin alpha 5 beta 1, i.e., the major cell surface fibronectin receptor, we quantified the levels of both alpha 5 and beta 1 subunit transcripts by reverse transcription-polymerase chain reaction in cultured rabbit corneal epithelial cells pretreated with various concentrations of IL-6. The levels of both alpha 5 and beta 1 mRNAs were dose-dependently elevated by IL-6, attaining 1.5- and 1.8-fold increases, respectively, at 10 ng/ml. The stimulatory effect of IL-6 was transient; the levels of both subunit mRNAs reached a maximum 1 h after the addition of IL-6 and returned to the basal levels after 6 h. The IL-6-induced up-regulation of integrin alpha 5 and beta 1 mRNAs was also confirmed by Northern blot analysis. These results indicate that the increased attachment of corneal epithelial cells to fibronectin and enhanced ex vivo migration on corneal stroma by IL-6 is, at least in part, due to the temporal up-regulation of integrin alpha 5 beta 1 expression in corneal epithelial cells.

Amino Acid Sequence↗

Laparoscopic extramucosal myectomy with anterior fundoplication (Dor) for esophageal achalasia using intraoperative manometry.

Laparoscopic extramucosal myectomy with anterior fundoplication according to the Dor technique was performed on a 24-year-old-woman. Intraoperative inflation of a pneumatic balloon made the operative procedures such as extended submucosal dissection quite easy. Intraoperative gastrofiberscopy was useful for confirming that the remaining mucosal layer was not injured after completion of myectomy. Intraoperative manometry confirmed a complete decompression of the high-pressure zone in the lower esophageal sphincter. Complete relief of the symptoms has been recognized for 6 months after operation without any medication. It is considered that these laparoscopic procedures including intraoperative inflation of a pneumatic balloon, gastrofiberscopy, and intraoperative manometry can be used as a standard operation for esophageal achalasia.

Adult↗

Spontaneous splenic rupture during the course of a rubella infection: report of a case.

We report herein the case of a 26-year-old man who suffered a spontaneous splenic rupture during the course of a rubella infection. Initially, he presented with a high fever accompanied by a skin rash extending from the body trunk to the extremities and was admitted to hospital 3 days after onset for sudden upper abdominal pain radiating to both shoulders. On admission, he was pale and sweating with hypotension. An abdominal ultrasonographic study revealed a collection of fluid in the perisplenic space and exploratory laparotomy confirmed an intraabdominal hemorrhage from a ruptured spleen. The patient was treated by splenectomy and recovered uneventfully. The excised spleen was found to be moderately enlarged with a denuded capsule. Because the patient had no history of any external trauma and a positive serological test for rubella, we concluded that rubella contributed to the spontaneous splenic rupture in this case.

Adult↗

Selective posterior rhizotomy for children with cerebral palsy: a 7-year experience.

Although selective posterior rhizotomy (SPR) was pioneered as early as 1913, only over the past decade has the procedure gained popular use for the treatment of spasticity in cerebral palsy. The medical knowledge base regarding this procedure is expanding, and surgical techniques continue to be revised. We present our 7 years of experience in treating spastic cerebral palsy using SPR. The aspects of preoperative evaluation used by the multidisciplinary team to determine candidacy are outlined. The surgical procedure is detailed with a particular emphasis on the role of intraoperative nerve root stimulation to aid in selection for rootlet sectioning. Historical nerve stimulation protocols are reviewed and compared to our findings over the years. The functional goals are discussed in the context of the postoperative evaluation and therapies. Specific outcome in relation to joint range of motion, self care tasks, and ambulation is reported. The paper outlines a concise overview of our experiences and will assist the clinician in defining a protocol and expectations for SPR.

Activities of Daily Living↗