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Biomedical subjects

T Shima

Publications and source records attributed to T Shima.

At least 91 records · Page 5Linked to original sources
PubMed1996

Validity of B-mode ultrasonographic findings in patients undergoing carotid endarterectomy in comparison with angiographic and clinicopathologic features.

BACKGROUND AND PURPOSE: Determining factors for performing carotid endarterectomy (CEA) are the severity of carotid stenosis and the presence of plaque ulcerations. Precise detection of these factors is important. The aim of this study was to assess the applicability of using B-mode ultrasonography for diagnosing carotid lesions in patients undergoing CEA. METHODS: B-mode examinations were performed on 64 Japanese patients (68 arteries) who subsequently underwent CEA. In each case, the appearance of plaque on B-mode was classified into one of two types: heterogeneous or homogeneous; plaque echogenicity was expressed as hypoechoic, isoechoic, or hyperechoic. Surface characteristics such as ulceration also were examined, and the degree of carotid artery stenosis was calculated. The B-mode findings were compared with angiographic and pathological features. RESULTS: B-mode accurately visualized macroscopic ulceration and surface irregularity in 93.8% of the lesions examined, which was superior to angiography. Fifty-four lesions (79.4%) were of the heterogeneous type and 14 lesions (20.6%) were of the homogeneous type on B-mode. Microscopically, 57.4% of the heterogeneous-type lesions demonstrated fibrous change. The frequency of calcification was higher in the heterogeneous lesions than in the homogeneous lesions. CONCLUSION: B-mode ultrasonography findings can provide information about macroscopic and microscopic characteristics of carotid lesions.

Adult↗
PubMed1996

Acute and chronic regulation of serum sex hormone-binding globulin levels by plasma insulin concentrations in male noninsulin-dependent diabetes mellitus patients.

This study was undertaken to investigate the relationship of the serum sex hormone-binding globulin (SHBG) levels with the plasma insulin concentration and with the insulin resistance in male subjects with noninsulin-dependent diabetes mellitus (NIDDM). This investigation comprised 12 patients with NIDDM and 16 normal subjects matched for age, sex, and body mass index (BMI). There was a significant increase in insulin levels (P < 0.03) and a decrease in SHBG levels (P < 0.01) in the diabetic group as compared with those of the normal group. The sex hormone and plasma insulin levels were measured in NIDDM patients undergoing exercise and dietary therapy. Insulin sensitivity was evaluated by the hyperinsulinemic euglycemic clamp technique expressed as the glucose infusion rate (GIR) before and after the treatment. The SHBG levels correlated significantly with the insulin concentrations (r = -0.643, P < 0.05) and with the GIR (r = 0.615, P < 0.05) before the treatment. The SHBG levels (P < 0.02) and GIR (P < 0.01) increased, and the insulin concentrations (P < 0.01) decreased significantly during the treatment. The SHBG levels showed a negative and significant correlation with the plasma insulin concentrations at the end of the clamp study before (r = -0.615, P < 0.05) and after (r = -0.626, P < 0.05) the treatment. These findings suggest that, in the hyperinsulinemic state, plasma insulin has a direct effect on the SHBG levels. SHBG levels decreased significantly during the clamp study before (P < 0.02) and after (P < 0.01) the treatment. This may represent the acute effect of insulin on the SHBG levels. Briefly, these results suggest that insulin may directly affect the SHBG levels and that SHBG may constitute an index of the insulin resistance only in the hyperinsulinemic state.

Blood Glucose↗
PubMed1996

[Postoperative analgesic requirements after various operations].

The difference in postoperative analgesic requirements for operations involving 11 sites was assessed in 1100 patients. Pain relief was mainly attained by epidural administration of bupivacaine 0.25% on demand. Postoperative analgesic was required most frequently after thoracotomy, followed by gastrectomy with left diagonal approach, gastrectomy with median approach, operation for colon cancer, cholecystectomy and hysterectomy. After hip operation, periproctal operation, radical mastectomy, appendectomy and herniorrhephies, total analgesic requirement was similar and the minimum amount required. In conclusion, there was a high degree of correlation between the severity of the pain and the site of the operation.

Analgesics↗
PubMed1996

[Usefulness of reaction times in high-cortical recognition tasks].

We compared reaction times for high-cortical recognition tasks with kana-searching test in a group of 46 normal individuals aged 21 to 83 who gain a full score in Mini-Mental State. The following tasks of reaction time were used; simple reaction time (SRT), choice reaction time (CRT), memory scanning time (MST), and visual searching time (VST). The results were consistent and demonstrated that mean reaction time of 46 individuals increased in difficult tasks such as MST or VST. All reaction times increased depending on aging, which became longer in difficult tasks. Score of kana-searching test was correlated with MST and VST, but did not correlate with SRT and CRT. These findings suggest that reaction times may be useful for mass-screening of high-cortical functions in different ages as well as the kana-searching test.

Adult↗
PubMed1996

[A fluoroscopic analysis of the catheters abnormally placed in the epidural space].

In order to know how the catheters are placed abnormally in the epidural space, we inserted the epidural catheters under fluoroscopy. The catheter was placed straightly upward when the epidural puncture was done in the center of epidural space. When the puncture site was nearly close to the side wall of epidural space, we could not insert catheter at all. When the tip of the needle was near the side wall and the inserting catheter slipped upward, catheter was placed straight. When the catheter wedged at the side wall, it made loop and curled or kinked. We thought that the cause of abnormal location of the catheters in epidural space is the right angle between the wall of the epidural space and the direction of catheter.

Adult↗
PubMed1996

Taurine in the liver. The function of taurine conjugated with bile acids.

1. Taurine had cytoprotective effects on hepatocytes under hyperoxic or hypoxic condition in the presence of Ca2+. 2. Bile acids had toxic effects on hepatocytes; there was no significant difference in the toxicity between free bile acids and taurine-conjugated bile acids. 3. The mobility of the membranes, examined by 31P-NMR, decreased after treatment with taurine or free bile acids, but increased after treatment with taurine-conjugated bile acids. 4. The fluidity of the membranes, measured by ESR, did not change after treatment with taurine, but decreased after treatment with free bile acids and increased after treatment with taurine-conjugated bile acids. In conclusion, because most bile acids are conjugated with taurine in the liver after administration of taurine, the influence of taurine-conjugated bile acids has to be taken into consideration in estimating the functions of taurine in the liver.

Animals↗
PubMed1995

Protein kinase C-independent activation of Raf-1 and mitogen-activated protein kinase by leukotriene B4 in guinea pig eosinophils.

Leukotriene B4 (LTB4) and phorbol 12-myristate 13-acetate (PMA) were found to activate serine/threonine kinase c-Raf-1 (Raf-1) and mitogen-activated protein (MAP) kinase in guinea pig eosinophils. Raf-1 was activated by both compounds in a time- and dose-dependent fashion, and the activation by each paralleled that of MAP kinase. The LTB4 receptor antagonist ONO-4057 prevented the LTB4-induced activation of Raf-1 and MAP kinase, but had no effect on the PMA-induced activation of these kinases. The protein kinase C (PKC) inhibitors, (+/-)1-O-hexadecyl-2-O-methylglycerol (AMG-C16) and bisindolylmaleimide (GF 109203X), suppressed the PMA-induced activation of Raf-1 and MAP kinase, but not the LTB4-induced activation of both kinases. Our findings suggest that the activation of Raf-1 and MAP kinase by LTB4 involves a PKC-independent pathway.

Animals↗
PubMed1995

Use of EPR oximetry with India ink to measure the pO2 in the liver in vivo in mice.

The partial pressure of oxygen (pO2) of the liver in vivo in unanesthetized mice was determined using electron paramagnetic resonance (EPR) oximetry with India ink. The EPR spectra were obtained using a low-frequency (1.2 GHz) EPR spectrometer with a loop gap cavity resonator. The line width of the India ink used in this experiment was reversibly broadened by oxygen and was particularly sensitive to pO2 below 30 torr. After the administration of India ink into the tail vein, the India ink particles were taken up mainly by Kupffer cells in the liver and in part by phagocytes in the spleen. The pO2 measured in the normal liver was about 14 torr and was constant for the 2-week experimental period. The pO2 decreased when measured at 1, 2, and 6 days after treatment with hepatotoxin (carbon tetrachloride (CCl4)); within 2 weeks, it returned almost to the initial level. Measurements by EPR at sacrifice of controls and CCl4-treated mice indicated that more than 90% of the India ink went to the liver; the spleen contained 4.7% of total amount in control mice and 8.8% in CCl4-treated mice when measured 2 weeks after the treatment. These data indicate the usefulness of India ink for measuring the pO2 of the liver in vivo and that the pO2 in the Kupffer cells is decreased when the liver is damaged by CCl4.

Animals↗
PubMed1995

Allergic rhinitis in laboratory workers caused by occupational exposure to guinea pigs: an immunological and clinical study.

Occupational exposure in laboratory workers to various animals can result in clinically significant respiratory allergies. We used clinical and immunological methods to study five laboratory workers who exhibited symptoms of nasal allergy upon occupational exposure to guinea pigs. As compared with a control group of ten nonallergic laboratory workers, the symptomatic workers generally had positive skin test reactions for allergens derived from the urine, saliva, and pelts of the guinea pigs. The study group with symptoms also showed high serum levels of specific IgE and demonstrated an immediate, positive reaction to nasal provocation testing with urine-derived antigen. However, specific IgG values in the sera of these patients did not differ significantly from control values. Overall results indicated that a type 1 allergy was involved.

Adult↗
PubMed1995

Clinical findings in patients with recurrent intracerebral hemorrhage.

BACKGROUND: The use of computerized tomography has led to the detection of second intracerebral hemorrhage (ICH) in some patients. There have, however, only been a few clinical studies of second ICH. SUBJECTS AND METHODS: Thirty patients with a second ICH were analyzed according to clinical criteria. These patients comprised 5.9% of all patients admitted to Chugoku Rosai Hospital for ICH between 1984 and 1992. RESULTS: The mean interval between the first and second ICH was 27.7 months (range 1-144). The incidence of second hemorrhage was especially high within the first year after the initial ICH. Twelve patients bled bilaterally into the basal ganglia or thalamus during either the first or second attack. Most of these patients had poor outcomes and prognoses. The nine patients with good prognoses included patients with high activity of daily living (ADL) prior to the second attack, and those with neurologic grade 1 following the second attack. All of these patients were managed with conservative therapy. The 10 patients who underwent surgery had poor prognoses. CONCLUSIONS: The incidence of second ICHs is greater than that of initial ICHs. Many patients who experience a second ICH will have a poor prognosis, possibly worse than expected. Surgical therapy should not be recommended in such patients, since our data suggest that they will not do well even after surgery.

Activities of Daily Living↗
PubMed1995

New tumor clips for the removal of large or deep-seated tumors: technical note.

We describe newly developed tumor-holding clips, which have been applied in more than 50 patients with large or deep-seated tumors. We devised various kinds of standard tumor clips by modifying Sugita aneurysm clips. Our new tumor clips permit gentle, steady, and easy retraction of the tumor in any direction without disturbance of the operative field. With the use of these clips, a surgeon can operate with both hands. From our experience of removing more than 50 tumors, we confirm that our tumor clips are useful for the removal of large or deep-seated tumors.

Brain Neoplasms↗
PubMed1995

[Immunohistochemical study on temporal bone of autopsy cases with Mycobacterium leprae infection].

Three temporal bones were obtained en bloc from autopsy cases with lepromatous leprosy from the middle cranial fossa side after removing the brain. After fixation with 10% formalin followed by sufficient decalcification, the specimens were embedded in paraffin en bloc and cut serially to stain every 10th section with hematoxylin and eosin (H&E) for anatomical orientation. An immunohistochemical study with anti-neurofilament, anti-MBP (myelin basic protein), anti-BCG (Bacillus Calmette-Gue'rin) and anti-PGL (Mycobacterium leprae-specific antiphenolic glycolipid-I) antibodies were performed to vestibular, cochlear and facial nerves, respectively, on the basis of anatomical orientation of the adjacent H&E sections. In one of three cases, positive staining by anti-PGL antibodies was recognized only in the facial nerve both in its internal auditory meatal and tympanic portions. However, even in this case, no neural damage was observed either by anti-neurofilament nor anti-MBP stainings. This finding supports the possibility of central neural infection by Mycobacterium leprae.

Aged↗
PubMed1995

[The characteristic feature of myocardial imaging with 123I-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid in hypertrophic cardiomyopathy with asymmetric septal hypertrophy].

The aim of this study was to elucidate the characteristic feature of myocardial imaging with 123I-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid (BMIPP) in the patients with hypertrophic cardiomyopathy (HCM). In 26 patients with asymmetric septal hypertrophy (ASH), the imaging data were acquired for 15 minutes after the injection of 123I-BMIPP by the emission computed tomography (ECT). ECT image was divided into 17 segments to score the severity of the defect in each segment using a 5-point grading system from score 3 to score -1; score 3 = severely decreased tracer uptake, score 2 = moderately decreased tracer uptake, score 1 = mildly decreased tracer uptake, score 0 = normal and score -1 = increased tracer uptake. Reduced uptake (Defect Score > or = 2) was frequently observed in septal portion of anterior wall (65%), septal portion of posterior wall (62%) and apical wall (73%). Defect score was higher in septal portion of anterior wall (p < 0.001), septal portion of posterior wall (p < 0.01) and apical wall (p < 0.01) than in the ventricular septum. This result indicates that in hearts with ASH, 123I-BMIPP image reveals severely impaired fatty acid metabolism in these regions. With the reference of the previous report about histologic features in necropsy hearts with HCM, myocardial fatty acid metabolic disorder shown by reduced 123I-BMIPP uptake is closely related to the histological abnormalities in hearts with HCM.

Adult↗
PubMed1995

[CT findings of primary pulmonary cryptococcosis].

Ten cases of primary pulmonary cryptococcosis are presented. The patients' ages ranged from 19 to 71 years and all were males. All patients underwent chest X-ray, tomography and CT (two cases were in additional to HRCT). The most common radiographic findings were single masses (70%) which had to be differentiated from lung cancer or pulmonary tuberculosis. The second pattern of involvement was that of multiple nodules (20%) which may be mistaken for tuberculosis. The third was an infiltrative pneumonitis shadow (10%). By means of CT (HRCT), we revealed that most cryptococcosis lesions exist in the posterior segments (S2, S1, S6 and S1+2) and show cavity formation (30%). Therefore, CT, especially HRCT, may be useful for the differentiation of pulmonary cryptococcosis from neoplasm.

Adult↗
PubMed1994

[A case of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus].

A 50-year-old man was admitted to our hospital for the evaluation of hypocalcemia and the treatment of diabetes mellitus. Seven months before admission, he sometimes felt thirst and polyuria, and 4 months before admission, he went to a doctor to check his blood glucose and was diagnosed as having diabetes mellitus which had suddenly developed. At that time he was treated with sulfonylurea, but his diabetic control was very poor. At the time of admission to our hospital, the patient's serum calcium (Ca) level was 5.7 mg/dl, phosphorus (P) 5.0 mg/dl, and fasting blood glucose 308 mg/dl, but urinary ketone bodies were not detected. High sensitive assay of parathyroid hormone (HS-PTH), intact PTH and C-terminus PTH concentrations were under the level of detection. TSH level was slightly high (6.1 mu U/ml) with positive antimicrosomal and antithyroglobulin antibodies but thyroid hormone levels were within normal limits. TRH test showed over-response of TSH. Based on Ellsworth-Howard test, we made the diagnosis of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus. He was treated with insulin twice a day and reached good control, and he was also administered 1 alpha-OH-D3 and calcium lactate resulting in an increase of serum Ca level after 2 weeks. These findings suggest that this case may be a polyglandular autoimmune (PGA) syndrome type 1 reported by Neufeld, which is very rare in Japan. The type of diabetes mellitus of this case is controversial. It is, however, necessary to pay attention to the decrease of the patient's insulin-secreting activity because autoimmune disorders are accompanied by this case.

Diabetes Mellitus, Type 1↗
PubMed1994

Expression and characterization of a fusion protein between the catalytic domain of poly(ADP-ribose) polymerase and the DNA binding domain of the glucocorticoid receptor.

A fusion protein comprising the DNA-binding region of the glucocorticoid receptor and the catalytic domain of poly(ADP-ribose) polymerase was constructed. This chimeric protein was expressed both in E. coli and in eukaryotic cells and was recognized by antibodies to both polymerase and the glucocorticoid receptor. Similar to polymerase, the chimera produced bona fide poly (ADP-ribose) polymers covalently bound to protein and was inhibited by 3-aminobenzamide. Like the authentic glucocorticoid receptor, the fusion protein formed a stable complex with DNA containing the glucocorticoid response element. In mammalian cells, the fusion protein significantly and specifically inhibited the ability of the glucocorticoid receptor to stimulate a reporter construct. These results indicate that polymerase activity can be targeted to specific DNA sequences and modulate gene expression.

Adenosine Diphosphate Ribose↗