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Biomedical subjects

T Shimoyama

Publications and source records attributed to T Shimoyama.

At least 127 records · Page 7Linked to original sources
PubMed1999

[A case of leukemic lymphoma complicated by M-proteinemia: effectiveness of long-term daily administration of oral low-dose etoposide in continuing remission].

A 51-year-old man was admitted with systemic lymph node adenopathy. Hematological examination on admission revealed leukocytosis, and 35% of leukocytes were classified as pathologically abnormal. Moreover, increases in serum IgM (kappa type) and plasma viscosity were recognized. Following biopsy of the lymph node, a diagnosis of non-Hodgkin's lymphoma (diffuse, mixed type) was made. After the implementation of combination chemotherapy, the results of hematological and physical examinations improved. As the nadir receded, serum IgM increased once more, and nine courses of chemotherapy were necessary. In order to promote steady progress toward discharge, etoposide therapy was instituted. Subsequent low-dose etoposide therapy at 50 mg/day rarely resulted in an increase in serum IgM, subjective or objective adverse effects, except for mild lekopenia. After discharge the patient was placed on intermittent etoposide therapy and remained in a state of remission for approximately 11 months. Fortunately, his rehabilitation was successful, and he returned temporarily to his former position. The 2nd remission has continued for approximately seven months. Consequently, long-term low-dose etoposide therapy is speculated to be a significantly useful therapeutic technique for intractable malignant lymphoma.

Administration, Oral↗
PubMed1999

[Eradication of Helicobacter pylori in Japan].

Twenty five years has passed since the re-discovery of Helicobacter pylori. Many people have studied on this organism since that time. Some mechanisms about gastric mucosal inflammation have been clarified, and pathogenesis of peptic ulcer formation and gastric cancer have been solved. H. pylori infection is related to chronic gastritis, peptic ulcer, gastric carcinoma, and MALToma. In 1998, it was reported that gastric cancer occurred in H. pylori infected mongolian gerbils. In Japan, the prevalence of peptic ulcer and gastric cancer is very high. Therefore, the treatment for H. pylori infection is necessary to prevent occurrence of these diseases. To treat H. pylori infection, various regimen have been tried. Triple therapy with PPI and two antibiotics is recommended for cure of H. pylori infection in European and US guidelines. Some guidelines for management of H. pylori infection and regimen were shown in this part.

Animals↗
PubMed1999

[Emergency coronary artery bypass grafting for left main coronary artery disease].

Emergency coronary artery bypass grafting (CABG) for acute coronary syndrome due to left main coronary artery (LMCA) disease still remains to be a therapeutic challenge. Seventy consecutive patients underwent CABG for LMCA disease were divided into two groups, that is 21 patients with emergency CABG (Group E) and 49 with scheduled CABG (Group S). There were four in-hospital deaths (mortality rate: 19.1%) in Group E and two (4.1%) in Group S. Three of 4 deaths in Group E had cardiogenic shock associated with acute myocardial infarction (AMI) preoperatively, and low output syndrome followed by multiple organ failure postoperatively. All of four deaths cases received intermittent cold GIK cardioplegia as an intraoperative myocardial protection. On the other hand, seven cases, received retrograde continuous warm blood cardioplegia (CWBC), including AMI with shock due to LMCA occlusion and concomitant CABG and valve replacement complicated with aortic regurgitation, all survived operations. In conclusion, retrograde CWBC may be useful as an intraoperative myocardial protection in emergency CABG for AMI with shock due to LMCA occlusion.

Adult↗
PubMed1999

[Leukocytapheresis for ulcerative colitis].

Leukocytapheresis(LCAP) and Granulocytapheresis(GCAP) are classified as extracorporeal circulation therapy(ECCT). These therapies are a novel, effective way to treat patients with ulcerative colitis(UC). During 7 weeks of intensive therapy(LCAP weekly, predonisolone(PSL) 30-80 mg/day), UC patients treated with LCAP revealed significant improvements on their subjective and objective symptoms compared to patients treated with PSL intravenous administration. Moreover, LCAP has been recognized as safer than other drugs for UC. In our previous study, only 9.9% out of 1,978 LCAP sessions showed some side effects, and most were mild and temporary. Therefore, LCAP could be the first choice to treat UC patients who resist and/or reveal severe complications against ordinary drug therapies.

Adolescent↗
PubMed1999

Comparison of pathologic changes in Helicobacter pylori-infected Mongolian gerbils and humans.

Helicobacter pylori has been recognized as a pathogen causing gastroduodenal disease, with adequate evidence to prove this relation in clinical research. Available animal models, however, were inadequate until 1995, when a new animal model of H. pylori infection was established using Mongolian gerbils. In this study we compared pathological changes in seven H. pylori-infected Mongolian gerbils with ulcers to five patients with gastric ulcer who underwent operation. All of the animals showed positive reactions for both H. pylori culture and serum anti-H. pylori antibody titer. All human subjects had H. pylori on the mucosal surface. Thus, inflammatory cell infiltration in the pyloric gland area was observed throughout almost all layers in the animals. In contrast, inflammation was observed in the surface layer of the mucosa in the pyloric gland area in the human subjects. Lymph follicle formation was observed more often in humans than in the animals. Inflammation of the fundic gland area in both groups was weaker than of the pyloric gland area and was observed within the mucosa. Histological changes observed in both groups were chronic active gastritis, lymph follicles, and intestinal metaplasia in the stomach. H. pylori-associated gastritis in humans is characterized by erosion, inflammation with neutrophil infiltration, lymph follicles, intestinal metaplasia, and atrophy. These findings are similar to those in this animal model. Thus, H. pylori infection might participate in the pathogenesis of gastroduodenal mucosal damage. In conclusion, the Mongolian gerbil is a good animal model for H. pylori-associated gastric diseases, and it might be useful for investigating the pathogenesis of H. pylori infection.

Adult↗
PubMed1999

Molecular and clinical study of familial adenomatous polyposis for genetic testing and management.

Familial adenomatous polyposis (FAP) is an inherited predisposition to colorectal cancer characterized by the development of numerous adenomatous polyps, predominantly in the colorectal region. Germline mutations of the adenomatous polyposis coli (APC) gene are responsible for familial adenomatous polyposis. We examined germline mutations of the APC gene and clinical features among eighty-seven individuals who consisted of thirty-nine FAP-patients, thirty-seven of their family members with a 1 in 2 risk of predisposition to this disease, and eleven normal persons. We accurately identified nine heterozygotes, among individuals with a 1 in 2 risk by genetic testing, without the uncertainty of the recurrence risk calculated by Bayes' theorem. Six of the nine heterozygotes were confirmed to have colorectal polyps by colonoscopic examination. Since they were diagnosed at 12.7 years-of-age on average, and were no more than 20 years old, they could be treated to prevent colorectal cancer. Based on the genotype-phenotype correlation, we concluded that the germline mutations responsible for the sparse polyps phenotype of FAP-patients tend to locate from codon 1055 in the proximal region of the APC gene, while those for the profuse type locate from codon 1102 in the distal region. Among the thirty-nine FAP-patients, we found that those with the germline mutations within codon 1055 and codon 1262 had colorectal carcinomas of an advanced stage, at a high rate (71.4%). Special attention and aggressive intervention is needed in these patients and relatives at risk. With reasonable and appropriate management, it should be possible to prolong and improve the quality of life of those family members both affected and at risk.

Adenomatous Polyposis Coli↗
PubMed1998

Infiltration of peroxidase-producing eosinophils into the lamina propria of patients with ulcerative colitis.

Little information is available to explain the pathogenesis of ulcerative colitis (UC). In this study, we focused on eosinophils in the lamina propria of the mucosa of patients with UC in the active phase. Biopsy specimens were taken from 17 patients with UC in the active phase, 17 in the inactive phase, and 20 control patients, and submitted for histochemical staining for peroxidase and chloroacetate esterase for microscopic examination. Both peroxidase-producing and chloroacetate esterase-producing cells in the lamina propria increased markedly in the active phase (8.3 +/- 3.1/0.01 mm2 and 6.6 +/- 2.7/0.01 mm2, respectively), compared with values in the inactive phase (0.8 +/- 0.6/0.01 mm2 and 1.3 +/- 0.6/0.01 mm2) or in the controls (1.3 +/- 0.8/0.01 mm2 and 1.3 +/- 0.4/0.01 mm2). Triple staining for peroxidase, chloroacetate esterase, and nonspecific esterase in the specimens revealed that the peroxidase-producing cells constituted a different population from that of neutrophils, macrophages/monocytes, or basophils. A monoclonal antibody specific for eosinophil peroxidase stained almost all infiltrated peroxidase-producing cells. These results indicated that eosinophils with strong peroxidase activity had infiltrated the lamina propria in UC, suggesting an allergic background and the involvement of released peroxidase in the mucosal damage characteristic of UC.

Carboxylic Ester Hydrolases↗
PubMed1998

Placental ecto-ATP diphosphohydrolase: its structural feature distinct from CD39, localization and inhibition on shear-induced platelet aggregation.

Human placental ecto-ATP diphosphohydrolase (ATPDase), an 82 kDa single-chain glycoprotein, was purified to high specific activity using a specific murine monoclonal antibody MK33 (IgG1-kappa). Structurally, protein-based analysis showed this enzyme to be almost identical to that of CD39 lymphoid cell activation antigen deduced by cDNA sequencing (Maliszewski CR, et al, J Immunol 1994; 153:3574); but differing in the NH2-terminal amino acid sequence, suggesting that placental ecto-ATPDase is most likely an isoform of CD39 generated by alternative splicing of the pre-mRNA. Functionally, placental ecto-ATPDase totally inhibits the secondary platelet aggregation induced by agonists at a final concentration (f.c.) of 1 microgram/ml. The purified enzyme (1 microgram/ml, final), pre-incubated with washed platelets prior to alpha-thrombin stimulation, completely inhibits the activation of platelet glycoprotein (GP) IIb/IIIa, thereby blocking the binding of fibrinogen or von Willebrand factor to platelets. Further, under different shear stresses, the enzyme modulates platelet aggregation differently. Low shear stress-induced platelet aggregation is blocked by this enzyme in a dose-dependent manner and is totally blocked at f.c. 0.5 microgram/ml. Under high shear stress, however, this protein at a f.c. of 0.5 microgram/ml mediates almost complete disaggregation of platelets without affecting the initial aggregation. Using immunohistochemical analysis, this enzyme was observed to be localized at the syncytiotrophoblasts of placental microvilli and the endothelial cells (ECs) of the umbilical vein obtained at full-term normal delivery, but scarcely at the ECs of the umbilical artery.

Adenosine Triphosphatases↗
PubMed1998

Angiomyolipomatous hamartoma of the tongue.

Extrarenal angiomyolipoma is a rare subtype of benign lipomatous tumor composed of adipose tissue, blood vessels, and smooth muscle. We report a 60-year-old woman who developed an angiomyolipomatous tumor of the tongue and discuss the differential diagnosis along with a review of the literature. The term angiomyolipomatous hamartoma is proposed for the present lesion to distinguish it from classic oral angiomyolipoma.

Actins↗
PubMed1998

Intravenous myofibroblastic pseudotumour of the buccal mucosa.

An intravenous pseudotumour at a traumatised site of the buccal mucosa of a 68-year-old woman is described. The lesion was composed of reactive spindle cell proliferation, merging of haphazard bizarre cells and inflammatory elements. Cellular morphology and immunohistochemical profile of proliferating cells reflected that of myofibroblasts. Conceivably, these cells may be derived from indigenous vascular smooth muscle cells. The present case represents a unique type of a reparative process intimately related to the tissue damage.

Aged↗
PubMed1998

Successful engraftment of unrelated cord blood stem cells for familial erythrophagocytic lymphohistiocytosis. Kinki Cord Blood Bank.

Familial erythrophagocytic lymphohistiocytosis (FEL) is an autosomal recessive disorder that can only be corrected by stem cell transplantation. One of our patients with FEL in second complete remission underwent successful cord blood stem cell transplantation (CBSCT); the donor was an HLA one-locus mismatched and unrelated individual. The conditioning regimen consisted of BU/CY/VP-16. The transfused cell dose was 6.8 x 10(7)/kg, which contained 1.36 x 10(5)/kg of CD34 cells and 3.4 x 10(4)/kg of CFU-GM. After CBSCT, there were no major infectious complications. Acute grade I GVHD was well controlled. Neutrophil counts reached >0.5 x 10(9)/l by day 20 and platelet counts reached >50 x 10(9)/l by day 40. Deficient natural killer activity returned to normal after the transplant. The patient recovered well more than 7 months after receiving CBSCT, without showing evidence of chronic GVHD. We recommend CBSCT for FEL patients who have no HLA-matched siblings or unrelated donors.

Child, Preschool↗