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Biomedical subjects

Y Shinohara

Publications and source records attributed to Y Shinohara.

At least 19 recordsLinked to original sources
PubMed1992

Detection of a new mutant alpha-1-antichymotrypsin in patients with occlusive-cerebrovascular disease.

A new mutant alpha-1-antichymotrypsin (variant ACT) was found by direct sequencing and PCR-single strand conformation polymorphism (PCR-SSCP). This variant ACT was a point mutation of exon V of ACT, with the substitution of Met by Val. Four out of six individuals with this variant ACT had occlusive-cerebrovascular disease, leading to one hypothesis that there might be an association between this mutation and occlusive-cerebrovascular disease.

Base Sequence↗
PubMed1992

Identification of two enhancer elements in the gene encoding the type 1 glucose transporter from the mouse which are responsive to serum, growth factor, and oncogenes.

The type 1 glucose transporter (GLUT1) gene encodes an integral membrane glycoprotein responsible for facilitating transfer of glucose across plasma membrane and is rapidly activated by serum, growth factors, and by oncogenic transformation. To elucidate the molecular mechanisms of regulation of GLUT1 gene expression, we isolated and characterized the mouse GLUT1 gene. DNA elements regulating transcription of the gene were analyzed in transient expression assays after transfection of NIH/3T3 cells with a low background chloramphenicol acetyltransferase (CAT) vector system pSVOOCAT. We identified two enhancer elements; the first one is located 2.7 kilobases upstream of the cap site of the gene which contains the homologous sequences with two 12-O-tetradecanoylphorbol-13-acetate-responsive elements (TREs), a serum response element, a cyclic AMP-responsive element (CRE) and three GC boxes, and the second one is located in the second intron of the gene which contains the homologous sequences with two TREs and one CRE. With the promoter alone the transcription of the gene is activated by src, only slightly activated by ras and is not activated by serum and platelet-derived growth factor. When the gene is accompanied by one of these enhancers, the transcription is activated by all these stimuli.

3T3 Cells↗
PubMed1992

Alpha-1-antichymotrypsin variant detected by PCR-single strand conformation polymorphism (PCR-SSCP) and direct sequencing.

A new mutant alpha-1-antichymotrypsin (variant ACT) was found by polymerase chain reaction single strand conformation polymorphism and direct sequencing. In this variant ACT, two bases (AA) were deleted from codon 391. This resulted in a different amino acid sequence downstream of the deletion point, elongating the peptide chain by 10 amino acids.

Amino Acid Sequence↗
PubMed1992

An autopsy case of invasive pituitary adenoma (prolactinoma) with rapid fatal clinical course due to streptococcal meningitis.

A 44-year-old male suffered epistaxis and headache of sudden onset and was diagnosed as having suppurative meningitis due to streptococci. Four days after the onset of symptoms, he died despite treatment with antibiotics. Destruction and ballooning of the sella turcica was revealed by a plain head X-ray examination during the clinical course. At autopsy, a massive tumorous lesion extended from the ballooned sella turcica to the paranasal cavities, nasopharynx and facial bone, and this had resulted in suppurative meningitis. The tumor was also disseminated to the basal skull. The tumor cells possessed prominent nuclear atypia and were immunohistochemically positive for prolactin. This was diagnosed as a case of pituitary adenoma with markedly invasive pathological findings and a rapid and fatal clinical course.

Adenoma↗
PubMed1992

Intracranial paramedian hourglass-shaped dermoid associated with hereditary steatocystoma multiplex.

This is the first report to describe the coexistence of two rare diseases, intracranial paramedian hourglass-shaped dermoid and steatocystoma multiplex. A 46-year-old female with a history of steatocystoma multiplex, bradydactylies and kyphosis showed oscillopsia, ataxia and hemifacial spasm. MRI findings suggested a giant dermoid cyst extending from the left middle temporal fossa to the cerebellopontine angle, and this was confirmed surgically. We propose the involvement of some genetic factor or pathological process common to both disorders, steatocystoma multiplex and dermoid. From the clinical point of view, patients with cystic skin lesion should also be checked for intracranial lesion.

Brain Neoplasms↗
PubMed1992

[Treatment of rejection with deoxyspergualin after renal transplantation].

Deoxyspergualin (DSG), which is a new immunosuppressive drug developed in Japan, is expected to be an immunosuppressant for the treatment of rejection, because it has immunosuppressive action different from that of other drugs. In the present study we used DSG to treat renal allograft rejection of in total 17 cases; 6 cases with acute rejection, 8 with chronic rejection and 3 with acute on chronic rejection. We infused DSG very slowly over 3 hours at a dose of 3-7 mg/kg/day for 5-7 days. Four cases (44.4%) with acute or acute on chronic rejection showed excellent response to DSG, three cases (33.3%) showed fair response and two cases (22.3%) did not respond at all. We also used DSG in patients with chronic rejection. In many of them, the increase in serum creatinine was suppressed. Ten of the total patients (58.8%) developed side effects including leukocytopenia, thrombocytopenia, numbness of the fact etc. No patients needed discontinuation of DSG. From the above results, we think that DSG is a safe and effective drug to treat acute rejection. Furthermore, we could get the results which suggest that DSG is effective for the treatment of chronic rejection.

Adolescent↗
PubMed1992

[A case of syringomyelia with proximal dominant muscle weakness and without superficial sensory disturbance].

A 43-year-old woman had noticed muscular weakness in her arms for four years before her admission. Muscle weakness and atrophy were prominent in the bilateral deltoid muscles, but muscular strength was almost unimpaired in the bilateral forearms and intrinsic muscles. There was no sign of sensory impairment except vibratory sensation. EMG revealed neuropathic NMU. X-P of the cervical spine showed enlargement of the spinal canal diameter, and MRI of the spinal cord revealed a large syrinx. On the basis of metrizamide CT and cranial MRI, a diagnosis of syringomyelia with Chiari malformation (type I) was made. Despite the presence of a large syrinx extending from C 1 to Th 11, the only detectable neurological sign was proximal weakness of the upper extremities simulating myopathy.

Adult↗
PubMed1992

[Cerebrovascular CO2 reactivity in patients with dementia due to multiple infarction in the territory of the perforating artery].

In order to clarify the pathophysiology of dementia due to multiple infarction in the territory of the perforating artery, the reactivity of cerebral vessels to increased carbon dioxide tension was examined in patients with multiple cerebral infarction with or without dementia. The subjects studied were 11 patients with multi-infarct dementia (MID) (age 57-82 years old, mean +/- S.D. 72 +/- 8) and 16 patients with multiple infarction without dementia (MI) (age 51-81 years old, mean +/- S.D. 69 +/- 9). The diagnosis of cerebral infarction was based on the clinical signs and symptoms and findings of magnetic resonance imaging (MRI). Only patients with cerebral infarction located in the perforator territories were included in this study. Dementia was diagnosed by DSM-IIIR criteria. The extent of periventricular high intensity area (PVH) on the T2-weighted image of MRI was classified into 3 subgroups by the criteria of Gerard et al with some modifications. Cerebral blood flow (CBF) was measured by the 133Xe intravenous injection method using a Cerbrograph (Novo), and gray matter flow (F1) and initial slope index (ISI) were calculated. The cerebrovascular reactivity to CO2 was estimated as the increase in F1 or ISI per unit increase in PaCO2 (delta F1/delta PaCO2 or delta ISI/delta PaCO2, respectively) during inhalation of 5% CO2 and as %increase in F1 or ISI per unit increase in PaCO2 (delta F1%/delta PaCO2 or delta ISI%/delta PaCO2, respectively) during inhalation of 5% CO2. 1. CO2 reactivity in both groups. delta F1/delta PaCO2 in the MI and MID groups were 3.2 +/- 1.4 ml/100 g/min/mmHg and 2.0 +/- 1.4, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[A case of hepatic hydrothorax treated by pleuro-venous shunt].

We reported a successful pleuro-venous shunt operation (Pl-V shunt) for a patient of liver cirrhosis with secondary hydrothorax. A 78-year-old female was admitted to our hospital because of severe dyspnea and palpitation. Chest x-ray film revealed right sided massive pleural effusion. Over several weeks the chest tube drainaged about 1,500 ml of transudative fluid per day. We performed Pl-V shunting and pleural effusion subsequently decreased in amount and dyspnea disappeared. This Pl-V shunting is thought to be useful for such a patient with massive pleural effusion which failed to respond to medical therapy.

Aged↗
PubMed1992

[Neuromyopathy induced by halothane anesthesia and muscle relaxants for status asthmaticus--report of 2 patients].

Two patients with status asthmaticus (a 30-year-old female and a 48-year-old male) who developed flaccid quadriplegia and sensory impairment of glove and stocking type after treatment with halothane, muscle relaxants (pancuronium and vecuronium) and steroid are described. They noted motor and sensory impairment immediately after recovery from control ventilation for treatment of status asthmaticus. Histochemical examinations of biopsied muscle demonstrated the necrosis and regeneration of muscle fibers and small diameters in type I fibers. These results suggested that the involvement of muscle (myopathy) was a consequence of the harmful action of halothane and muscle relaxants together with steroids on muscle fibers with subclinical fragility. The sensory impairment (neuropathy) was considered to have been produced mainly by the halothane together with muscle relaxants and aminoglycosides.

Adult↗
PubMed1992

[Acute hepatitis A (HA) presenting findings of meningoencephalitis].

A 39-year-old man, who had high grade fever and headache for 4 days was admitted to our hospital because of generalized seizure and disturbance of consciousness. He was pyrexial, but not icteric. Neurological examination revealed disorientation, nuchal rigidity and bilateral Babinski reflexes. Laboratory test results included the following: GOT 1,740 U/l, GPT 2,800 U/l, bilirubin 1.2 mg/dl, serum IgM-HA antibody cut-off index 6.8. CSF was clear, with 10 leukocytes/mm3 and protein level of 108 mg/dl. Head CT and MRI revealed no abnormality. An EEG demonstrated diffuse slowing. During the following 2 days, he had increased obtundation and labored breathing. In the second week of hospitalization his neurological conditions and liver function test results improved. A diagnosis of HA was confirmed by a finding of serum IgM-HA antibody. The neurological findings, CSF findings and clinical course indicated acute meningoencephalitis in association with HA. To our knowledge, there have been only 4 previous case reports of meningoencephalitis associated with serologically confirmed HA infection. HA virus infection might pass unnoticed, as many cases of HA infection remain anicteric or subclinical. Therefore, HA virus should also be considered as one of the etiological agents in meningoencephalitis.

Acute Disease↗
PubMed1992

[A successfully treated case of empyema with a large tracheal fistula after a radical operation of esophageal cancer by fixation and plombage with major pectoral muscle flap].

We reported a successfully treated case of empyema with a large tracheal fistula which had developed after a radical operation of esophageal cancer (reconstructed with stomach). This 59-year-old male was treated by the method of fixation and plombage with major pectoral muscle flap and thoracoplasty, because we could not use the omentum that were frequently used nowadays for closure of the fistula. The size of the tracheal fistula was a large as the main bronchus bronchoscopically. Postoperative care were the following, the endotracheal tube was inserted from the tracheal stoma to the left main bronchus and 9 days left hemi-ventilation was performed. Continuous suction was performed at the same time from the right main bronchus in order to prevent secretion and blood pour into the left lung. Bronchoscopical examination done 28 postoperative day, the small fistula remained the tip of the muscle flap. But 72 postoperative day, the surface of the fixed muscle flap was replaced by normal bronchial mucomembrane and tracheal fistula was obliterated. Major pectoral muscle could be used as local flap to obliterate empyema cavity associated with tracheal fistula. We believe that utilizing an muscle flap for those who had undergone abdominal operation like our case is a valuable method.

Empyema↗
PubMed1992

[Long-term prognosis of nonoperative acute epidural hematoma in children].

Computed tomography(CT) scan has revealed that certain acute epidural hematomas(AEH) don't need operative therapies. But, it is difficult to determine especially in childhood, whether AEH compressing the brain for a short-term would or would not effect the function of the central nervous system in the future. For this reason, the authors report the long-term prognosis of nonoperative AEH in children. Twelve children suffering from AEH were transported to our clinic. On admission, they had no neurological deficits and CT scan revealed hematomas that had maximum thickness of 5-19 mm without midline shift. With nonoperative therapy they were discharged and the hematomas disappeared within 3-12 weeks. After long-term follow-up (3-10 years), it was shown that they had no epileptic episodes, and no changes in their school study records. Also, the Yatabe-Guilford personality test revealed no abnormal data. These data suggest that children can be cured who suffer from AEH with no neural deficits, and in whom the maximum thickness of the AEH is less than 20 mm, and in whom there is no midline shift in CT scan, can be cured without undergoing an operation, and will have a good long-term prognosis.

Acute Disease↗
PubMed1992

Effect of erythropoietin in continuous ambulatory peritoneal dialysis patients: comparison between intravenous and intraperitoneal administration.

The administration of recombinant human erythropoietin (rHuEPO) in CAPD patients is usually done subcutaneously. Only a few authors have reported on its intraperitoneal (IP) administration. We compared the effect of IP administration of rHuEPO in CAPD patients to that of intravenous (IV) administration. Ten anemic CAPD patients injected rHuEPO into their dialysis bag once a day, 3 times a week, for 18 weeks. The initial dose was 12,000 U. The dwell time of the exchanges with rHuEPO was about 6 hours. Nine other anemic CAPD patients were treated with IV rHuEPO once a week for 18 weeks. The initial dose was 6000 U. In the IP group the hematocrit rose from 24.04 +/- 2.7% to 33.3 +/- 3.8% (mean +/- SD). In the IV group 2 patients were excluded from the efficiency evaluation. In 7 of the 9 patients in the IV group, the hematocrit rose from 23.27 +/- 2.6% to 32 +/- 5.5% (mean +/- SD). The intraperitoneal administration of rHuEPO in CAPD patients is sufficient in improving anemia, although it requires a much larger dosage to yield the same level of improvement as the one obtained with the intravenous administration. However, in patients on continuous cycling peritoneal dialysis or IP dialysis, a smaller dosage during the prolonged dwell time may be effective.

Anemia↗
PubMed1992

[Two sibling patients with late-onset familial amyloidotic polyneuropathy and atypical clinical manifestations].

Brothers (case 1 and case 2) had familial amyloidotic polyneuropathy type 1 (FAP type 1) confirmed with sural nerve biopsy and DNA analysis. Both patients were unique in that their ages at onset were 56 and 52, and that their only manifestation was sensori-motor polyneuropathy, without clinically apparent autonomic involvements such as orthostatic hypotension, sweat dysfunction and sphincter dysfunction, or severe organ involvement such as gastrointestinal features and myocardial involvement after the onset. They are also unique in that their parents were healthy. The initial manifestation was sensori-motor polyneuropathy starting in the lower extremities. These atypical manifestations made the diagnosis of FAP type 1 difficult in the present cases. Based on reports in the literature and the present cases, there might be a tendency that in patients with late-onset FAP type 1 the clinical manifestations are generally mild and autonomic involvement and organ disturbance are absent or mild. In the etiological diagnosis of polyneuropathy, FAP type 1 should be considered especially in steadily progressive patients.

Age Factors↗
PubMed1992

[Survey of MRSA infection in Ibaraki-ken--Ibaraki Association for infectious diseases].

This study which was undertaken at several major hospitals in Ibaraki-ken revealed that, 1) the proportion of Staphylococcus aureus in all the isolates ranged from 5% to 17% and the prevalence of MRSA in isolates of Staphylococcus aureus varied from 51% to 82% depending upon each individual hospital. 2) the clinical response to FOM and CMZ combination therapy was 88.9% and, to FOM and CZON was 57.1% showing no statistical differences between the two regimens. 3) in vitro analyses assessed by the FIC index of 251 isolates revealed that FOM had an additive or synergistic effect with CMZ in 53.8%, with CZON in 66.9%, with minocycline (MINO) in 43.8%, with cefamandole (CMD) in 61.8%, with cefazolin (CEZ) in 62.9% and with imipenem/cliastatin sodium (IPM/CS) in 68.9% at all isolates. 4) the cumulative curve of susceptibility to single CMZ and the combination of CMZ and FOM revealed that the blood levels of CMZ at 3 hours after intravenous administration covered 57% of isolates when used alone and 82% of isolates when in combination with FOM. The blood levels of CZON at 3 hours covered 5% of isolates when used alone and 41% when in combination with FOM. The extent of the therapeutic effect increased from 6% to 42% by CMD, from 12% to 54% by CEZ, from 20% to 58% by IPM/CS and from 78% to 84% by MINO. The combination of CMZ and FOM was found to be the most effective for enhanced effects on MRSA in vitro.

Anti-Bacterial Agents↗