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Biomedical subjects

T Shibata

Publications and source records attributed to T Shibata.

At least 541 records · Page 30Linked to original sources
PubMed1994

[Coronary artery bypass grating 13 years after pneumonectomy].

Coronary artery bypass grafting (CABG) in a patient who had undergone left pneumonectomy for lung cancer 13 years earlier is described. Preoperative pulmonary function was reduced; percent vital capacity was 55% and percent forced expiratory volume in 1 second was 77%. Triple CABG was performed with saphenous vein grafts. A retractor designed for use in harvesting of the internal thoracic artery was useful to obtain a good operative view because the heart had shifted to the left. Oxygen tension of the arterial blood decreased transiently after extracorporeal circulation. The early postoperative course was uneventful and the patient was discharged on day 57 after the operation. This is the first report, to the best our knowledge, of CABG after pneumonectomy for lung cancer in Japan. We think it possible, with careful management, to perform open heart surgery on a patient after pneumonectomy if pulmonary function is adequate.

Aged↗
PubMed1994

[Molecular marker for detecting hypercoagulable state].

We measured various coagulable factors and molecular markers in plasma and serum in the disease group including DIC, DIC suspect, thrombosis, acute myocardial infarction, angina pectoris, sepsis, malignant tumor and type II diabetes and the healthy subject group, and surmised the intravascular coagulative-fibrinolytic activity in each disease group compared with the healthy group. Additionally we selected parameters useful for early detection of the pre-thrombotic state and hypercoagulable state. As a result, of the parameters for the coagulative system, those considered useful were the assay of soluble fibrin monomer complexes using the synthetic substrate (FM.Oita), assay of soluble fibrin monomer complexes using HPLC(SFMC.Oita) and thrombin-anti-thrombin III complex (TAT) in this order. Of the parameters for the fibrinolytic system, those considered useful were FDP assay using ELISA (FDP.Oita) and plasmin-alpha 2 plasmin inhibitor complex (PIC). This FDP.Oita had a considerably high detection sensitivity compared with the FDP assay (Diayatron Co.) using the latex photometric immunoassay which has been commercially available. When measurement was made with plasma and serum in the subject disease group as the sample by the high sensitivity assays mentioned above, it was made clear that both the coagulative activity and fibrinolytic activity are increased, albeit with some differences in intensity, in all the disease groups compared with the healthy group. In order for the hypercoagulable state and pre-thrombotic state to be detected, it is important to know the balance between the coagulative activity and fibrinolytic activity. According to the results of the present experiment, a significant directly proportional correlation was recognized between FM.Oita and FDP.Oita and between TAT and FDP.Oita. Therefore, examination of these ratios will be a more detailed indicator of coagulative-fibrinolytic activity than the TAT/PIC ratio, PAI-1/TPA ratio and ATIII/alpha 2 PI ratio hitherto in use. If useful molecular markers such as FM.Oita are measured over time in various cases and these data are compiled and analyzed statistically, it will not be long before the criteria for the hypercoagulable state and pre-thrombotic state are established.

Angina Pectoris↗
PubMed1994

[Surgical treatment for cardiac diseases in patients with concomitant malignant tumor].

Between April 1984 and December 1992, 8 patients with concomitant malignant tumor were treated surgically for cardiac disease. The mean age was 58 years (range: 51 to 69), and there were 6 males and 2 females. There were 2 cases of ischemic heart disease, 3 cases of valvular heart disease, and 1 case of atrial septal defect (ASD). Gastric cancer was present in 4 cases, malignant tumor of hepatobiliary tract in 2, rectal cancer in 1, and lung cancer in 1. All patients were operated on in a two-stage fashion. In 6 cases, cardiac surgery including coronary artery bypass grafting (4 patients) and valve replacement (2 patients) were performed with an average of 58 days prior to the tumor resection. The other 2 patients underwent radical operation for a gastric or rectal cancer, followed by cardiac surgery for ASD or mitral stenosis about 2 months later. One patient died of respiratory failure 56 days after lobectomy following coronary artery bypass. There was one late death of local recurrence of rectal cancer 2 years after the operation. In conclusion, good surgical result can be expected with sequential operations for cardiac disease and malignant tumor, if curative resection of the tumor is possible.

Aged↗
PubMed1994

[Case report of intraatrial RL-shunt after the repair of ventricular septal perforation].

A 78-year-old woman with ventricular septal perforation (VSP) after acute myocardial infarction was described in this report. Arterial oxygen tension (PaO2) extremely decreased after the repair of VSP. There was the marked difference in blood oxygen tension between left atrial blood and radial arterial blood, and trans-esophageal color echogram showed the intra-atrial RL shunt. Autopsy showed a small atrial septal defect (ASD) at foramen ovale. Right atrial pressure was higher than left atrial pressure after the repair of VSP because of right heart failure. These made the postoperative management complicated.

Aged↗
PubMed1994

[Studies on cell-mediated immunity (CMI) in the glomeruli: immunization with GBM antigen from Masugi nephritis in Wistar-Kyoto rats].

The role of cell-mediated immunity in glomerular injury has been extensively studied, but the precise mechanism remains obscure. This study was undertaken to determine whether the homologous glomerular basement membrane (GBM) combined heterogeneous anti-GBM antibody would induce cell-mediated immunity. Wistar-Kyoto rats were divided into three groups; group I rats were immunized with homologous GBM antigen that was derived from Masugi nephritis and emulsified in complete Freund's adjuvant (CFA); group II rats were immunized with homologous GBM antigen that was derived from normal rats and emulsified in CFA; group III rats were immunized with CFA only. Group I rats demonstrated proteinuria on days 7 and 10 after immunization. Histologically, mesangial cell proliferation and cell infiltration were observed in the glomeruli. No changes in tubulointerstitial tissue. CD4-positive cells, CD8-positive cells and macrophages were found in the glomeruli, and mononuclear cells were found in the glomerular capillary lumen. Group II and Group III rats demonstrated no proteinuria and no histological changes. These findings indicated that the altered GBM obtained antigenicity and induced cell-mediated immunity in the glomeruli.

Animals↗
PubMed1994

[Changes in liver tissue amino acids during hemorrhagic shock].

Changes in amino acids in liver tissue during hemorrhagic shock were examined in eight mature mongrel dogs using the microdialysis method. The mean blood pressure was maintained at 50 mmHg by exsanguination, and the values of liver tissue amino acids after 30 minutes showed significant decreases of aspartate, glutamate, histidine, glutamine, glycine and taurine. The decrease of taurine was especially marked. The values dropped further 30 minutes after returning the blood into circulation with some exceptions. These results suggest the possibility that hemorrhagic shock causes reduction in uptake of amino acids by the liver or consumption of amino acids in the liver, and that bile acid metabolism appears to be disturbed by the marked drop in the taurine level. It is necessary to give careful consideration to the possible existence of reduced amino acid metabolism in the liver in the treatment of hemorrhagic shock.

Amino Acids↗
PubMed1994

[A pregnant woman with convulsion treated with diazepam which was reversed with flumazenil just prior to cesarean section].

A 37 year-old female in 36th week gestation with convulsion treated with intravenous diazepam underwent an emergency cesarean section. Just prior to induction of anesthesia flumazenil was administrated intravenously to reverse the effects of diazepam in both mother and fetus. Cesarean section was successful under general anesthesia (N2O-pentazocine). The neonate's Apgar score was 6 points at 1 minute and 7 points at 5 minutes after delivery. We conclude that intravenous administration of flumazenil just prior to Cesarean section is effective in a patient with convulsion treated with diazepam.

Adult↗
PubMed1994

[Management for subarachnoid hemorrhage with negative initial angiography].

Subarachnoid hemorrhage (SAH) is commonly caused by ruptured aneurysm or arteriovenous malformation which is detected by cerebral angiogram. However, since angiograms sometimes cannot show the origin of SAH, we review 12 cases (6.3% of total SAH) to assess the management of these cases. We divided the 12 cases into three groups. Group A (occulted aneurysm group) consisted of six cases of which aneurysms were detected by repeated angiographies in four, and by surgical procedures in two. Group U (unknown etiology group) consisted of five cases. Their follow up periods varied from 7 months to 7 years 11 months, and all of them recovered well and had no episode of rebleeding. Group R (rebleeding group) consisted of one case which fatally re-bled on the second day. Group A tended to be Hunt and Hess grade 3, and Fisher group 3 or 4. In contrast, group U tended to be H and H grade 1 or 2, and Fisher group 2. However by their clinical and neuroradiological findings alone, it was not possible to distinguish the two groups certainly. This means that the patients whose initial angiography does not show the origin of bleeding must be cared for as an occult aneurysm case. Twice repeated angiograms should be programmed. In our cases the first was carried out on the seventh day in the hope that the reason for vasospasm of the parent artery might be shown to be a hidden aneurysm. The second was carried out sometime between the 14th and 21st day because of thrombolysis in the aneurysm, and because it was necessary to relieve vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Official inspection estimated production of coal-tar dyes (including dye aluminum lakes) in 1993-1994].

The number of official inspections of coal-tar dyes and their aluminum lakes from April 1993 till March 1994 were 734 in total, with the quantity which passed inspection amounting to 213 tons in Japan. Data for production by color for each month are summarised in Table 1, and by each producing company in Table 2. The food coal-tar dye produced in the largest quantity was Food Yellow No. 4, occupying a 42.9% proportion of the total during this period.

Chemical Industry↗
PubMed1993

On the possibility of autolysosomal processing of skein-like inclusions. Electron microscopic observation in a case of amyotrophic lateral sclerosis.

Hyaline-like inclusions (HLIs) and skein-like inclusions (SLIs) were recently observed in the lower motor neurons in amyotrophic lateral sclerosis (ALS). HLIs mainly consist of randomly arranged neurofilaments and abnormally large (about 15 nm) fibrils, while SLIs comprise bundles of the abnormally large fibrils alone. Although the abnormal fibrils have been reported to be ubiquitinated in both types of inclusions, their final catabolic destination in the neurons is unknown. Electron microscopic observation of the lower motor neurons in an ALS case revealed several neurons containing SLIs in addition to ones containing HLIs. Bundles of SLIs, which were located close to HLIs or were observed by themselves without an HLI, were frequently associated with flattened cisterns; some were wrapped, some were completely sequestrated, and some were demarcated together with a portion of moderately electron dense cytoplasm by cisterns or double-membraned units. These features resemble reported early stages in the formation of autolysosomes, and thus indicate that at least some of the bundles of SLIs or parts of them in the lower motor neurons in ALS undergo degradation through the autolysosomal pathway.

Amyotrophic Lateral Sclerosis↗
PubMed1993

Protein anatomy: spontaneous formation of filamentous helical structures from the N-terminal module of barnase.

This paper reports the conformation of the N-terminal module (24 amino acid residues) of barnase in aqueous solution. This module contains the first of three helices in the intact protein. Circular dichroism spectra showed the peptide fragment to have a predominantly random coil structure immediately following dissolution in aqueous solution and to be gradually converted to a helical structure at 5 degrees C. This was mediated by aggregation, and an electron micrograph indicated the aggregate to be comprised of filamentous helical structures. Scanning tunneling microscopy showed the filamentous structures to be made up of protofilamentous structures containing many disks apparently stacked on top of each other. A monomer of the peptide predominantly took on a random coil conformation in aqueous solution and the multimer, a stable helical structure. A local amino acid sequence would thus appear to determine the secondary structure corresponding to that in a native protein but stability to be governed by other factors such as tertiary interactions. Helical wheel representation indicated the peptide fragment to have the features of an amphiphilic helix. Hydrophobic burial may provide the driving force for producing a stable helical structure in aqueous solution.

Amino Acid Sequence↗
PubMed1993

Glial plasmalemmal vesicles: a subcellular fraction from rat hippocampal homogenate distinct from synaptosomes.

By a Percoll density-gradient centrifugation of rat hippocampal homogenate, we found a novel subcellular fraction (specific gravity approximately 1.046 g/ml), besides synaptosomes (approximately 1.060 g/ml), which showed a high activity of Na(+)-dependent glutamate uptake. The initial rate of the glutamate uptake in this fraction was as high as twice that in synaptosomes. Activities of choline acetyltransferase and high affinity choline uptake were, on the other hand, much lower. gamma-Aminobutyric acid uptake activity was nearly equivalent in both fractions. Electron microscopic observations revealed that the fraction was morphologically different from synaptosomal or myelin fractions, but mainly consisted of two different types of empty membrane vesicles; irregular (0.3-0.8 micron in diameter) and spheroid type (0.2 micron). The immunoreactivity to glial fibrillary acidic protein was appreciably high in this fraction. The marker enzyme analysis showed the fraction was rich in plasma membranes. On the basis of these results, the fraction is termed glial plasmalemmal vesicles (GPV). We analyzed kinetically the reaction of Na(+)-dependent glutamate uptake by GPV comparing with that by synaptosomes. Km values for glutamate in GPV was 4.7 microM and Vmax was 33 nmol/mg/min, while in synaptosomes 11 microM and 17 nmol/mg/min, respectively. Hill coefficients of Na+ activation in GPV and synaptosomes were 1.1 and 2.0, respectively. Thus, the mechanism or transporter molecule in glial cells for Na(+)-dependent glutamate transport is likely to be different from that in neurons.

Animals↗
PubMed1993

Enzyme immunoassay and characterization of pancreatic stone proteins in human urine.

An enzyme immunoassay of pancreatic stone protein (PSP) in human urine was developed. Mean analytical recovery of pure PSP-S2-5 added to urine was 102.3% (SD 5.9%), and the precision of the assay was 2.0-2.7% within an assay and 2.5-2.9% between assays. In healthy volunteers (age 20-55 years), the mean value of the PSP concentration, expressed as ratios to urine creatinine, was 129 +/- 88 (mean +/- SD) micrograms/g without any differences for sex. Urine PSP correlated with urine N-acetylglucosaminidase (NAG) (r = 0.354). The molecular forms of immunoreactive PSP in urine were characterized by using cation exchange chromatography (Mono S), SDS-PAGE, N-terminal sequence, and enzyme immunoassay analysis. The urine PSP, eluted at the position corresponding to PSP-S2-5 on cation exchange chromatography, was converted to PSP-S1 by trypsin digestion. The difference in mobility on SDS-PAGE between urine PSP and PSP-S2-5 seems to be due to a glycosylated undecapeptide (N-terminal 1-11). The proposed method offers a sensitive, specific, and reproducible tool for laboratory analysis of human urine PSP levels.

Acetylglucosaminidase↗
PubMed1993

Metallosis caused by alumina ceramic screw fixation of grafted bone in a bipolar hip endoprosthesis.

We report a case of metallosis due to ceramic fragments in the inner bearing surface of the polyethylene cup of a bipolar hip prosthesis with fracture of the alumina ceramic screws used for grafted bone fixation. After bone-grafting acetabuloplasty with a Bateman bipolar endoprosthesis, gradual migration of the outer head occurred, and fracture of the screws was observed. Seven years after the operation, radiographs showed severe metallosis of the surrounding tissues. At revision, marked wear of the inner head was seen. Detailed examination revealed that many rough-edged ceramic particles originating from the fractured ceramic screws had become embedded in the inner surface of the polyethylene bearing insert. These extremely hard ceramic fragments had entered the prosthetic joint space during joint movement, thereafter causing continuous abrasion of the metal head. After revision, the concentration of the constituents of the prosthesis alloy in the serum decreased toward control levels. To prevent serious complications like those in the present case, screws should be inserted more than 1 cm from the outer head of a bipolar endoprosthesis, and the outer head should be removed as soon as possible if it comes into contact with the screws.

Acetabulum↗
PubMed1993

Secretory component and lactoferrin in pure pancreatic juice in chronic pancreatitis.

To evaluate pathophysiological roles of proteins in pancreatic secretion, immunoreactive lactoferrin (LF) and secretory component (SC) were measured in the first fraction of the pure pancreatic juice obtained endoscopically from 17 control, 21 suspected (SCP), 14 noncalcified (NCP), and 14 calcified chronic pancreatitis (CCP) subjects. The protein and amylase tended to decrease both in concentration and output from control to CCP. LF concentration was elevated in CCP (18.0 +/- 4.9 micrograms/ml) when compared with controls (2.3 +/- 0.2 micrograms/ml), and LF output in NCP (12.3 +/- 3.8 micrograms/min) was increased from controls (3.8 +/- 0.6 micrograms/min). The combination of high LF concentration with low protein output was observed in 10/14 in CCP but 0/14 in NCP and can be a biochemical discriminator of CCP from NCP. SC concentrations were also elevated in NCP (8.5 +/- 2.0 micrograms/ml) and CCP (5.6 +/- 1.6 micrograms/ml) from controls (1.2 +/- 0.2 micrograms/ml). SC outputs in SCP (9.8 +/- 3.1 micrograms/min) and NCP (21.1 +/- 4.8 micrograms/min) were increased from controls (1.7 +/- 0.3 micrograms/min), but there was no further increase in CCP. Hypersecretion of LF and SC in chronic pancreatitis is different, especially in CCP, although the mechanisms for hypersecretion are unknown.

Adult↗