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Biomedical subjects

T Nishimura

Publications and source records attributed to T Nishimura.

At least 739 records · Page 41Linked to original sources
PubMed1993

[The significance of 201Tl/123I MIBG (metaiodobenzylguanidine) mismatched myocardial regions for predicting ventricular tachycardia in patients with idiopathic dilated cardiomyopathy].

123I-MIBG (MIBG) regional defects in myocardial regions with preserved 201Tl (Tl) uptake have been observed in patients with idiopathic dilated cardiomyopathy (DCM). To evaluate whether the presence of Tl/MIBG mismatched regions is related to the occurrence of ventricular tachycardia (VT), we performed myocardial dual SPECT imaging with Tl (111 MBq) and MIBG (111 MBq) in 17 patients with DCM, 11 (Gp A) with and 6 (Gp B) without VT. Myocardial dual SPECT imaging was performed at 15 minutes after and 4 hours after the tracer injection. The regional tracer uptake was scored visually in 6 segments of the basal, middle, and apical short-axial images and in 2 apical segments of the midventricular vertical long-axial image by a four-point scoring system (0 = normal, 1 = moderate, 2 = severe and 3 = complete defect). Then, the severity of tracer maldistributions was assessed by the difference between total defect scores (TDSs) of Tl and MIBG (delta TDS). TDS was not different between Gps A and B in both Tl and MIBG images. However, delta TDS was larger in Gp A than in Gp B (13.5 +/- 6.5 vs. 5.8 +/- 3.0, p < 0.05). Also, the number of segments with the mismatched tracer uptake was larger in Gp A than in Gp B (12.5 +/- 3.0 vs. 8.3 +/- 1.5, p < 0.01). In the electrophysiologic study, we found that the fractionated area corresponded to the mismatched region in 3 of 5 patients in Gp A. These results suggest that regional sympathetic denervation is a possible factor which provocates VT, and myocardial dual SPECT imaging with Tl and MIBG is a useful method for predicting VT in patients with DCM.

3-Iodobenzylguanidine↗
PubMed1993

[Clinical application of transrectal ultrasonic therapy to nonbacterial prostatitis and prostatodynia cases which were resistant to conventional drug therapy].

A total of 25 patients with nonbacterial prostatitis and prostatodynia which were resistant to conventional drug therapy underwent 5 minutes course of transrectal ultrasonic therapy in association with application of 1% hydrocortisone acetate cream to the anterior rectal wall for consecutive 8 days. The efficacy of the treatment was evaluated only by comparison of symptom scores for subjective symptoms obtained before and after treatment. Excellent results, which were defined as more than 70% reduction of symptom scores after treatment, were obtained in 5 (27.8%) among 18 evaluable cases in which symptom scores before treatment were more than 4, good (40-69% reduction of scores) in 4 (22.2%), fair (10-39% reduction of scores) in 4 (22.2%) and poor (less than 10% reduction of scores) in 5 (27.8%). Because of good clinical efficacy and the absence of complication, transrectal ultrasonic therapy combined with hydrocortisone acetate cream application was thought to be useful for the treatment of nonbacterial prostatitis and prostatodynia cases which responded poorly to the conventional therapy.

Administration, Topical↗
PubMed1993

[Changes in right ventricular hemodynamic function by unilateral pulmonary arterial occlusion test].

We performed unilateral pulmonary arterial occlusion test (UPAO) for the preoperative evaluation of lung function in patients undergoing lung resection. In this test, the main pulmonary artery of either side is occluded to simulate postoperative functional status. In order to evaluate the right ventricular hemodynamic function, we measured right ventricular ejection fraction (RVEF) and right ventricular end-diastolic volume index (RVEDVI) throughout UPAO by thermodilution method. We investigated the relationships between changes in right ventricular hemodynamic function and postoperative complications related to cardiac functions, namely arrhythmias or heart failure. Thirty-four patients without heart disease prior to lung resection were examined by UPAO, and RVEF and RVEDVI were measured. Analyses demonstrated that changes in RVEF were inversely correlated with changes in RVEDVI. In 6 cases, RVEDVI increased from control by over 20% during UPAO. All of these patients had postoperative cardiac complications. The hypothetical ventricular function curves showed a large increase in RVEDVI relative to right ventricular stroke work index (RVSWI), suggesting a decrease in right ventricular function. In conclusion, these results suggest that changes in RVEDVI during UPAO may predict postoperative cardiac complications in patients undergoing pulmonary resection.

Adult↗
PubMed1993

Binding ability of complement receptor CR1 to C3 bound on the surface of M+ group A streptococci.

A previous study demonstrated that although M+ bacteria bound C3, mainly C3b and iC3b, via the classical pathway of complement activation, they were not phagocytosed by polymorphonuclear leucocytes (PMN). To elucidate this mechanism, we attempted to distinguish between the possibilities that M+ bacteria are effectively adhering to PMN but are not being endocytosed, or that the C3 deposited on M+ bacteria is not able to interact with the complement receptors on PMN. In the present study, we studied the interaction of C3-coated M+ bacteria with complement receptor CR1, which was isolated from the stroma of human erythrocytes. We show that the isolated complement receptor CR1 can associate with C3-coated M+ bacteria as well as with C3-coated M- bacteria, and the C3 deposited on M+ bacteria is cleaved and releases a C3 fragment in the presence of factor I and liquid-phase CR1. These results suggest that the C3 bound on the surface of M+ bacteria is able to promote adherence to the complement receptor CR1 on PMN. We also studied the distribution of C3 deposited on M+ bacteria in normal human serum (NHS) or normal human plasma (NHP). By immunofluorescence, we show that the C3 bound to M+ bacteria in NHS was deposited uniformly over the surface of the bacteria. On the other hand, the C3 bound to M+ bacteria in NHP was deposited at both ends between adjacent daughter cocci. The results suggest that an additional factor contained in NHP is related to the enhancement of anti-phagocytic activity of M+ bacteria.

Antibodies↗
PubMed1993

[Clinical evaluation of S-1108 in pediatric field].

Nine pediatric patients with bacterial infections (5 cases of tonsillitis, 3 cases of impetigo and 1 case of UTI) were treated with S-1108, and the efficacy and the safety were evaluated. The clinical responses to S-1108 treatment were excellent in 7 cases and good in 2. The efficacy rate was 100%. Bacteriologically, the causative organisms (Streptococcus pyogenes, Staphylococcus aureus, Haemophilus parainfluenzae and Escherichia coli) were eradicated. No clinical side effects were observed. Elevation of CK in 2 cases and eosinophilia in 1 case were noted.

Bacteria↗
PubMed1993

[Evaluation of left ventricular early diastolic function by first pass radionuclide angiocardiography after dipyridamole infusion in patients with coronary artery disease--comparison with exercise test].

To evaluate the left ventricular early diastolic function after dipyridamole infusion or during exercise, the first pass radionuclide angiocardiography (FPRA) by a multicrystal gamma camera (SIM-400) was performed in 32 patients with coronary artery disease (CAD) and 14 normal subjects. Dipyridamole was administered intravenously (0.56 mg/kg in 4 min). The first third filling fraction (FF 1/3) and the first third mean filling rate (MFR 1/3) were calculated from the time-activity curve. FF 1/3 decreased and MFR 1/3 increased in both normal subjects and patients with CAD during exercise. After dipyridamole infusion, FF 1/3 and MFR 1/3 unchanged in normal subjects, in contrast, FF 1/3 and MFR 1/3 decreased in patients with CAD. Thus, dipyridamole infusion FPRA is more sensitive method to detect early diastolic dysfunction in patients with CAD than FPRA during exercise.

Aged↗
PubMed1993

[Two cases of primary progressive non-fluent aphasia].

Two patients were described with a five to seven-year history of primary progressive non-fluent aphasia. One patient developed atypical trascortical motor aphasia with marked anarthria, which has led to mutism. Magnetic resonance (MR) imaging showed lobar atrophy of the frontal lobe accentuated in the bilateral superior frontal gyri, the left middle frontal gyrus, the left anterior cingulate gyrus and the left operculum with some extension into the left temporal lobe. Single photon emission computed tomography (SPECT) scans demonstrated a decrease of regional cerebral blood flow (rCBF) in the atrophic site. The patient was clinically and neuroradiologically diagnosed as having Pick's disease. Another patient presented with atypical Broca's aphasia, which has worsened with slowly progressive right hemiparesis. Mitigated, sometimes complete, echolalia was also observed. MR imaging and SPECT scans showed mild atrophy and a decrease of rCBF in the left perisylvian region involving the frontal operculum, while a positron emission tomographic study disclosed diffuse hypometabolism in the left hemisphere. We pointed out that the features of primary progressive aphasia were frequently atypical in the light of classical classification of aphasia and that non-fluent aphasia might be observed even in the early stage of cortical degenerative processes.

Aphasia, Broca↗
PubMed1993

[Quantitative assessment of cerebral blood flow by 123I-IMP SPECT: venous sampling method with hand warming in the water bath].

In order to establish a noninvasive, quantitative method for measuring regional cerebral blood flow (rCBF) by N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) SPECT, we attempted to employ continuous venous sampling instead of arterial sampling. Forty two patients with cerebrovascular diseases were classified into two groups, with (group II: n = 35) and without (group I: n = 7) hand warming. In group II, either hand was warmed, wrapping in a hot blanket (group IIA) or immersed in a 44 degrees C water bath (group IIB). In each patient, immediately after intravenous bolus injection of 222 MBq IMP, arterial and venous blood samples were collected continuously for 5 min from the radial artery and the cubital vein, respectively. By octanol extraction, IMP was divided into the unmetabolized and metabolized fraction. The ratio of 123I-IMP radioactivity of venous blood compared to arterial blood (pass ratio, referred as %PR) was calculated in three fractions, whole blood, unmetabolized, and metabolized fraction. By using these parameters, we assessed the possibility to estimate the amount of unmetabolized IMP fraction of arterial blood, usually used as an input function, from venous samples. In group I, %PR demonstrated a considerable variation between individuals (whole IMP, 47.5 +/- 24.6% (mean +/- SD): unmetabolized IMP, 46.0 +/- 24.5%: metabolized IMP, 51.8 +/- 27.4%). In group II, especially in group IIB, both increase of %PR value and the decrease in variation (whole, 77.9 +/- 5.6%: unmetabolized, 75.7 +/- 5.7%: metabolized, 86.7 +/- 8.7%) were observed, which permitted the further calculation based on the assumption that %PR value was constant in each IMP fraction (whole blood and unmetabolized fraction).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Interesting findings of RI venogram in a case with obstruction of inferior vena cava due to compression by the ruptured abdominal aortic aneurysm].

99mTc-MAA venography was performed in a patient with ruptured abdominal aortic aneurysm into inferior vena cava (IVC). Obstruction of lower portion of IVC was considered to be due to the compression by ruptured abdominal aortic aneurysm, which was confirmed at surgery. Subsequent scintigram revealed abnormally high RI uptake in the whole liver and a hot spot in the middle antero-inferior segment of liver, which may be characteristic for such a condition.

Aged↗
PubMed1993

Investigation of the clinical value of assessing renal size on computed tomography in autosomal dominant polycystic kidney disease.

We examined relationship between serum creatinine concentration (Scr) and renal size on CT scans on 32 occasions in 25 patients with autosomal dominant polycystic kidney disease (ADPKD). As a result, a significant correlation was observed when the Scr was less than 5 mg/dl, as shown by the correlation coefficient (r) and P values of 0.803 and 0.0001, respectively. However, these values changed to 0.482 and 0.0093, respectively when 2 cases with Scr 6.2 and 6.4 mg/dl were included, and further changed to 0.005 and 0.9775 when an additional 4 cases with Scr 7.8, 9.9, 11.1 and 20.1 mg/dl were included. Renal size is therefore thought to be a useful parameter of renal function when the Scr is less than 5 mg/dl in ADPKD, but not when the Scr exceeds 6 mg/dl, and is regarded as useless for predicting the time at which dialysis would be required.

Creatinine↗
PubMed1993

[Increased lung uptake and transient left ventricular dilatation at stress myocardial scintigraphy with 99mTc-MIBI].

On exercise 201Tl scintigraphy in coronary artery disease, left ventricular transient dilatation (LVTD) and increased lung uptake were noted as a marker of multivessel critical stenosis. To compare the two markers of 99mTc-methoxyisobutyl isonitrile (MIBI) and 201Tl, planar and SPECT myocardial scintigraphy were performed with both radiopharmaceuticals in 27 patients with ischemic heart disease. Lung uptake (lung/max myocardial ratio) of MIBI was significantly lower than that of 201Tl, but the relationship of the lung uptake was linearly correlated (r = 0.77). The LVTD ratio (mean radial ratio = m-RR) was determined by the mean radius of the immediate postexercise short axial image by that of rest (redistribution) image. There was no significant correlation between the m-RR of 201Tl and that of MIBI (r = 0.27). We suggest that the mechanism of LVTD is due to not only subendmyocardial ischemia but also another factors.

Aged↗
PubMed1993

[Clinical studies on flomoxef in neonates].

Clinical studies on flomoxef (FMOX) were performed in neonates and the results obtained are summarized as follows. Treatment with FMOX was made in 4 cases of neonatal bacterial infections; 2 cases of sepsis (suspected) and 1 case each of infection of umbilicus and staphylococcal scalded skin syndrome. Results obtained were excellent in 1 case, good in 3 cases. No significant side effects due to the drug were observed in any cases.

Cephalosporins↗
PubMed1993

[Clinical studies of cefditoren pivoxil in pediatric field].

We have carried out clinical studies on cefditoren pivoxil (CDTR-PI, ME1207) in granules. The results are summarized as follows. Treatment with CDTR-PI was made for 14 cases of pediatric bacterial infections: 4 cases of tonsillitis, 2 cases of pneumonia, 3 cases of scarlet fever, 3 cases of impetigo, 1 case of subcutaneous abscess and 1 case of urinary tract infection. Results obtained were excellent in 12 cases, good in 1 case and poor in 1 case. No significant side effects due to the drug were observed.

Bacterial Infections↗
PubMed1993

Phosphorylated neurofilament accumulation in neuronal perikarya by cyclosporin A injection in rat brain.

Cyclosporin A, a calcineurin inhibitor, was administered into the rat hippocampus. Seven days after drug administration the effects of phosphatase activity suppression in the brain to changes in neuronal cytoskeletal proteins were studied. Rat brain homogenates injected with cyclosporin A showed 16-38% suppression of Ca/calmodulin-dependent phosphatase activity measured by 32P released from 32P-labeled histone, indicating that cyclosporin A acts as an inhibitor of calcineurin after binding with cyclophilin in the brain. Hematoxylin-eosin staining revealed many basophilic neurons in the pyramidal layer of hippocampus, cerebellum, thalamus and cerebral cortex. Immunohistochemical study with anti-phosphorylated neurofilament 200kDa antibody showed positive staining of neuronal perikarya of these basophilic neurons. The number of immunopositive neurons with anti-phosphorylated neurofilament 200KDa increased with the concentration of cyclosporin A injected into the brain, indicating a dose-dependent effect of the compound. Staining with anti-dephosphorylated neurofilament 200KDa (SMI-32) was decreased in neuronal perikarya of cyclosporin A injected brains compared with that of control brains injected with dimethyl sulfoxide alone, suggesting an increased phosphorylation of neurofilament 200KDa subunit protein. The perikarya of these basophilic neurons were not stained with anti-PHF (paired helical filaments) or anti-tau antibodies. Immunostaining with anti-ubiquitin was not increased in these cells. Immunostaining with anti-calcineurin A and anti-calcineurin B showed positive staining of neurons in hippocampus, cerebellum and caudate nucleus both in experimental and control brains. Calcineurin B immunoreactivity was more intense in pyramidal cells in hippocampus injected with cyclosporin A than in controls. Western blot study with antibody against calcineurin A revealed significantly more degradation products of calcineurin A in cyclosporin A injected brains. The present data suggest that cyclosporin A inhibits calcineurin activity in the brain, which results in increased phosphorylation of perikaryal neurofilaments. Since abnormal phosphorylation is speculated in the pathological process of Alzheimer's disease, the results will help elucidate the participation of phosphatase in the pathology of cytoskeletal proteins in Alzheimer's disease.

Animals↗
PubMed1993

[A unilateral large demyelinating lesion in the cerebral white matter with slowly progressive hemiplegia and intrathecal JC virus antibody production].

A 59-year-old male patient presented in 1991 with left-sided hemiplegia and hemihypesthesia and left homonymous hemianopsia, which had developed for the preceding 12 months. The cerebrospinal fluid (CSF) level of protein was mildly elevated, oligoclonal IgG band was initially negative, but finally positive and myelin basic protein was absent. Magnetic resonance imaging and X-ray computed tomography (CT) of the brain revealed a unilateral demarcated lesion extending around the posterior horn and triagular part of the right lateral ventricle, apparently capped by remarkably gadolinium enhancement at its front, which had no mass effect, and several small isolated plaques were also observed in other areas of the brain. All lesions appeared as high intensity areas on T2 weighted images and hypodense areas on CT. The JC virus hemagglutination-inhibition antibody titers were 1:32 in serum and 1:8 in CSF; the antibody titer ratio and index both suggested an intrathecal antibody production. Pathological examination of brain biopsy specimen taken from the large lesion demonstrated profound demyelination with preservation of axons, a large number of macrophages and spotted perivascular lymphocyte cuffings. Based on this experience, we discussed the features in this case which differentiated it from multiple sclerosis, leukodystrophy and typical progressive multifocal leukoencephalopathy (PML). Diffuse-disseminated sclerosis or transitional sclerosis was most likely so far as the clinical picture, imaging and histology were concerned. However, we implicated the possible involvement of JC virus infection to the etio-pathogenesis of the demyelinating lesions in view of the intrathecal JC virus antibody production in CSF observed in this case.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗