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Biomedical subjects

T Shimoyama

Publications and source records attributed to T Shimoyama.

At least 199 records · Page 11Linked to original sources

Two cases of symptomatic elongated styloid process.

Two cases of elongated styloid process are reported. The first occurred in a 27-year-old man whose only complaint was pain when moving the jaw, and its differential diagnosis was comparatively simple. The second case occurred in a 33-year-old woman, for whose condition differential diagnosis was more difficult, as she presented many symptoms, including neuralgic pain in the face and neck, pain in the pharynx when swallowing, and pain in the region of the temporomandibular joint, radiating to the subauricular and submandibular regions. Following surgical shortening of the elongated styloid process through an intraoral approach, both patients' symptoms disappeared or were improved.

Adult↗

Surgical advancement of the mandible through sagittal ramus osteotomy.

The sagittal split-ramus osteotomy (SSRO) technique has gained widespread acceptance, for it can be easily adapted to correct a wide variety of mandibular abnormalities. However, in spite of its many advantages, numerous investigators have reported postoperative relapse following mandibular advancement surgery. SSRO was performed on four patients with deficiency of mandibular growth which had led to characteristic protrusion of the maxilla. In three of the four cases, postoperative skeletal relapse occurred, which was corrected by postoperative orthodontic treatment.

Adult↗

[An enzyme-linked immunosorbent assay determining anti-principal neutralizing determinant antibodies using synthetic peptides deduced from cDNA sequences of HIV-1 V3 loop domain].

The V3 domain, one of the hypervariable regions of gp 120 in HIV-1 possesses principal type-specific neutralizing determinant (PND). The V3 domain has the epitopes for class I major histocompatibility antigens of cytotoxic-T lymphocyte and helper-T-lymphocyte recognition sites, and also has major determinants for cell tropism towards macrophage, microglia, and human brain-derived fibroblast. Therefore, establishment for the assay of anti-PND antibodies in patients with HIV-1 infection appears to be important for the estimation on developing AIDS in these patients. We here describe a simple enzyme-linked immunosorbent assay (ELISA) for the measurement of anti-PND antibodies found in Japanese hemophiliacs. ELISA was performed using synthetic peptides, each 15 amino acid residues deduced from cDNA sequences of seven HIV-1 V3 domain mutants, which include 5 North-American and European strains (IIIB, MN, RF, SC, and WMJ-2) and 2 African strains (Af1. Con and Af2, Con). The specific antibody binding to each peptide was determined after subtraction of the non-specific binding from the total. In 49 control sera from healthy individuals with HIV-1 antibody negative, the absorbance (M +/- 1SD) at 405 nm was -0.002 +/- 0.064. Then, the cut off value was determined to be M + 4SD. In 48 hemophiliac sera with HIV-1 antibody negative, the absorbance was uniformly less than the cut off value. However, among 44 hemophiliac sera with HIV-1 antibody positive, the anti-PND antibodies were detected in the following frequencies; 2 for IIIB, 20 for MN, 1 for RF, 1 for Af1. Con, and 5 for Af2. Con.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Serodiagnosis↗

[The use of a laryngeal mask in a newborn infant with Nager acrofacial dysostosis].

A newborn female infant born at 41 week gestation with Nager acrofacial dysostosis had no congenital abnormalities in her parents and closed relatives. Her mother had uncomplicated pregnancy and normal delivery. Endotracheal intubation was attempted, because she developed apnea on her delivery, but it was not successful. She was transported immediately to our university hospital with mask ventilation. A laryngeal mask was placed after several trials of intubation, and ventilation was carried out successfully. We consider that the use of a laryngeal mask is one of the best ways in a case of difficult intubation.

Abnormalities, Multiple↗

Double-blind comparative study of sulfasalazine and controlled-release mesalazine tablets in the treatment of active ulcerative colitis.

To evaluate the effect of a controlled-release mesalazine tablet, in patients with ulcerative colitis (UC), a multicenter double-blind study was carried out, using sulfasalazine (500 mg tablet) as the control drug. The mesalazine tablet contained 250 mg of ethyl cellulose-coated mesalazine granules. The patients were assigned to two groups, one to receive mesalazine tablets (1500 mg/day) and a sulfasalazine placebo (group M) and the other to receive sulfasalazine tablets (3000 mg/day) and a mesalazine placebo (group S). The test medications were administered orally for 4 consecutive weeks. The study subjects were selected from among patients with mild to moderate active UC, and 118 patients were enrolled. Concomitant use of steroids and immunosuppressors was prohibited during the study period. Of the 118 patients, 9 dropped out. A total of 109 complete records were thus obtained, 52 in group M and 57 in group S. There was no difference in the improvement of clinical symptoms and endoscopic findings between the two groups. The overall safety, based on adverse reactions and laboratory data, was higher, at 86.5%, for group M (n = 52), compared to 66.7% for group S (n = 57). The general usefulness, based on the improvement and safety, was higher, at 65.3%, for group M (n = 49), compared to 45.6% for group S (n = 57). The controlled-release mesalazine tablet thus appears to be useful in the treatment of mild to moderate active UC.

Adult↗

Leukocytapheresis therapy with leukocyte removal filter for inflammatory bowel disease.

Leukocytapheresis (LCAP) with a leukocyte removal filter was administered to 44 patients with inflammatory bowel disease (IBD), diagnosed as ulcerative colitis (UC) in 25 and Crohn's disease (CD) in 19. Clinical and blood examinations showed no side effects in any of the patients. During intensive therapy, clinical improvement was recognized in 21 of the 25 UC patients (84%), 8 of whom had an excellent response, and in 16 of the 19 CD patients (84.2%), 4 of whom had an excellent response. The clinical improvement continued throughout the maintenance therapy in 19 of the UC patients (76%) and in 12 of the CD patients (63.2%). In both the UC and the CD patients, flow cytometry study showed that those who had improved generally had high values for the percentages of HLADR+, HLADR+CD3+, HLADR+CD8+, and CD11a+CD8+ cells before the first LCAP, and that these values decreased to near the normal range after both intensive and maintenance therapy. In the patients who showed poor response, in contrast, the values had been at or near normal before the initial LCAP administration. The clinical improvement and the findings on flow cytometry suggest that LCAP exerts an immuno-modulatory effect and is an effective therapy for patients with IBD in whom conventional drug treatments have failed.

Case-Control Studies↗

Long-term follow-up study of ulcerative colitis in Japan.

To clarify the long-term prognosis of Japanese patients with ulcerative colitis, we investigated the cumulative colectomy rate and the survival rate, and compared the results with reports from Western countries. The subjects were 778 patients who had visited 8 hospitals from 1973 to 1990. A total of 114 of the 778 patients (14.7%) had required colectomy and 21 (2.7%) had died. These rates were higher in the patients who had total colitis, and in those who had acute fulminant type of severe type. There were no significant differences in these rates according to age of onset (under 29 years, 30-49 years, and more than 50 years). The cumulative colectomy rate increased rapidly within 2 years after onset. Thereafter, the rate increased gradually, by 1%-2% per year. In patients with total colitis, 14.1% required colectomy within 2 years. The age at onset had no effect on this rate. The cumulative survival rate decreased gradually throughout the first 10 years, the rate being 96.2% in the 10th year. No deaths occurred in the 11-18th years after onset. Despite our inclusion of more patients with total or severe colitis, our results were similar to or slightly superior to those reported from Western countries; this may be attributed to a temporal bias.

Adolescent↗

Efficacy of nutritional therapy for active Crohn's disease.

We investigated the effect of nutritional therapy with an elemental diet (ED) for active Crohn's disease. One hundred and thirty-nine patients with Crohn's disease were enrolled in this study. Remission was judged to be present when the International Organization of Inflammatory Bowel Disease score was < or = 1 and the CRP and ESR values were within the respective normal ranges. An amount of 30kcal per 1kg of ideal body weight (IBW) per day was administered enterally, and the effect on the induction of remission in relation to various patient background factors, such as disease type, history of bowel resection, and the presence/absence of complications, was determined. An excellent remission rate was achieved in those patients to whom an adequate amount of ED could be administered. Remission rates were lower in the patient groups with any of the following complications: stenotic bowel lesions, abdominal masses, fistulas, and anal lesions. Even in those groups in which stenotic lesions or abdominal masses were present, when adequate amounts of ED could be administered, the remission rate did not differ from that in the groups without these complications. The remission rates in the groups with and without fistulas at any site, including fistulas in the anal region, were 40.0% and 82.5%, respectively, with remission being considerably easier to achieve in the patients without fistulas. Similarly, remission was difficult to achieve when anal lesions were present. These results suggest that, for active Crohn's disease, nutritional therapy with ED ( > or = 35kcal/kg IBW) should be enthusiastically administered, and in patients in whom the presence of complications necessitates therapy for 3 months or more, this point be considered to indicate a possible surgical approach.

Adult↗

Combination therapy with mucosal protective agent for the eradication of Helicobacter pylori.

OBJECTIVE: To investigate the effect of plaunotol in combination with proton-pump inhibitors on Helicobacter pylori eradication in patients with gastric ulcer. PATIENTS AND METHODS: We studied 65 H. pylori-positive gastric ulcer patients. They were randomly assigned to five treatment groups: omeprazole (group I, n = 8), lansoprazole (group II, n = 13), lansoprazole+plaunotol (group III, n = 12), lansoprazole+clarithromycin (group IV, n = 16) and lansoprazole+plaunotol+clarithromycin (group V, n = 16). Ulcer status was diagnosed by endoscopy and H. pylori status by culture, histology, a urease test and a urea breath test at baseline, and after 8 and 12 weeks. The clearance and eradication rates were compared in each group. RESULTS: The healing rates in groups I-V were 100, 92, 100, 100 and 100%, respectively; clearance rates were 0, 23, 42, 50 and 75%, respectively; and eradication rates were 0, 0, 8, 38 and 69%, respectively. CONCLUSION: Combination therapy with plaunotol is efficacious for the eradication of H. pylori in gastric ulcer patients.

Anti-Bacterial Agents↗

Parotid sialolithiasis in a child.

The occurrence of sialolithiasis in children is uncommon, while parotid sialolithiasis in children is rare. A case of parotid sialolithiasis arising in a 4-year-old girl is presented.

Child, Preschool↗

Serum anti-Helicobacter pylori antibodies and gastritis.

We investigated the relationship between the severity of Helicobacter pylori-associated gastritis and serum anti-H. pylori antibodies. A total of 158 consecutive patients underwent upper gastroduodenal endoscopy. At the time of endoscopy, three biopsy specimens were taken from the antrum and the body of the stomach for culture of H. pylori, CLO test, and histology. Specimens with a negative rapid urease test and no organisms found by culture were judged to be H. pylori-negative. The GAP test used for the antibody measurement is a kit designed to measure serum IgG, IgA, and IgM antibodies. The severity of gastritis was classified according to the Sydney System. The sensitivity and specificity of the IgG antibody measurement kit was 98.3 and 71.4%, respectively. The sensitivity and specificity of the IgM antibody measurement kit was 14.3 and 60.8%, respectively. The sensitivity and specificity of the IgA antibody measurement kit was 45.1 and 100%, respectively. Serum anti-H. pylori IgG antibody titers were correlated significantly with the severity of inflammation in both the antrum and body. Significant associations were found between serum anti-H. pylori IgG and IgA antibody titers and the development of atrophic gastritis. These results suggest that measurement of serum anti-H. pylori antibody titers is useful in the diagnosis of H. pylori infection and severity of gastritis.

Antibodies, Anti-Idiotypic↗

A clinico-epidemiological analysis of Helicobacter pylori (H. pylori) by Southern blotting with A urease gene probe.

Helicobacter pylori (H. pylori) is a gram-negative bacillus thought to be involved in such diseases of the upper gastrointestinal tract as gastritis, peptic ulcers, and gastric cancer. Urease is regarded as the factor responsible for the pathogenic nature of this bacterium. Therefore, in our examination of the genetic polymorphism of H. pylori, by means of Southern blotting, we used the urease gene as a probe. The Southern blot patterns of H. pylori isolated from different patients differed greatly, the inter-individual variation being so marked that it allowed approximate distinction between individual patients. The Southern blot patterns of individual strains of H. pylori did not change, even when they were stored and passed from generation to generation in our laboratory. These results suggest that DNA fingerprints with a urease gene probe will be useful in epidemiologically tracing H. pylori infection. Almost all strains of H. pylori isolated from different sites in the stomach of a patient on different occasions showed the same pattern, allowing us to confirm that only one strain of H. pylori was responsible for H. pylori infection in individual patients.

Blotting, Southern↗

Management of acute leukemia during pregnancy: from the results of a nationwide questionnaire survey and literature survey.

In March, 1993, a questionnaire was sent to 362 gynecological and obstetric offices of national, prefectural and municipal hospitals and private university hospitals with 250 beds or more. Answers were collected from 260 institutions. Thus, this study analyzed 39 patients with acute leukemia during pregnancy collected by the questionnaires survey and 64 cases reported in the Japanese literatures during 1975-1993 (total 103 patients). The weeks of pregnancy were defined as the 1st (< 15th week), 2nd (16th-27th week), and 3rd (> 28th week) trimesters. The time of diagnosis of leukemia during pregnancy changed from 25% in the 2nd trimester and 62% in the 3rd trimester during 1975-1984 to 39% and 48% after 1985, respectively. After 1985, the remission rate was 72% in the questionnaire group and 75% in the group from literatures. There was no statistical difference. The 50% survival period was 12 months in the group during 1975-1984, but 25 months in the group after 1985. The survival was significantly longer in the patients whose induction therapy was started before delivery than in those treated after delivery. The results suggest that the treatment for acute leukemia during pregnancy should be initiated as soon as possible after the diagnosis of leukemia, with carefully selected regimens. It is important that the time of delivery should be selected considering the maternal and fetal conditions after consultation with an obstetrician.

Adult↗

Comparison of the functional occlusal plane in adults with class III malocclusion showing open bite and non-open bite.

A retrospective study of lateral cephalograms of 24 Japanese adults with Class III malocclusion was made in order to compare the angles of the horizontal plane between open bite and non-open bite cases. The following results were obtained: i) There was no significant difference in the angle of the NF-upper occlusal plane between the open bite and non-open bite groups. ii) There were significant differences between the two groups in the angle of the SN-upper and lower occlusal planes, the FH-upper and lower occlusal planes and MP-lower occlusal plane. There was also a significant difference between the groups in the distance from the Xi point to the upper occlusal plane. iii) In both the open bite and non-open bite groups there was a wide variation in occlusal plane angles, compared with normal cases.

Adolescent↗