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Biomedical subjects

H Shiotani

Publications and source records attributed to H Shiotani.

At least 19 recordsLinked to original sources

Apoptosis in the normal olfactory epithelium of the adult guinea pig.

Among nerve cells of vertebrates, the olfactory epithelia are uncommon in their capacity for cell turnover. Apoptosis is well known to play a key role in maintaining homeostasis in continuously renewing tissues. We examined whether true apoptosis occurred in the normal olfactory epithelia of healthy adult guinea pigs using nucleic acid labeling. Subsequently, apoptosis was recognized in olfactory nerve cells, indicating that apoptosis might play a role in turnover of the olfactory epithelium.

Animals

Primary pericardial mesothelioma demonstrated by magnetic resonance imaging.

A 24-year-old man was hospitalized for an investigation of cardiac enlargement. Serum hyaluronic acid was increased to 238 ng/ml. Echocardiogram showed pericardial effusion with an area of increased density adjacent to the anterolateral wall of the left ventricle. A soft-tissue mass within the pericardial space was enhanced with gadolinium DTPA on magnetic resonance imaging. Open biopsy confirmed the presence of a malignant mesothelioma. Magnetic resonance imaging provided useful information regarding the tumor.

Adult

Efficient gene targeting in the filamentous fungus Alternaria alternata.

To characterize homologous recombination of transforming DNA in the filamentous fungus Alternaria alternata, we have compared the frequencies of gene targeting by circular and linear DNA fragments in the fungus. The A. alternata BRM1 gene, which is an essential gene for melanin biosynthesis, was selected as a target locus. BRM1 targeting events are easily identified because loss of function leads to a change in mycelial color from black to light brown. We constructed targeting vectors by inserting 0.6 to 3.1 kb internal BRM1 segments into a plasmid containing the hygromycin B phosphotransferase gene. When circular plasmids were used, melanin-deficient (Mel-) transformants accounted for 30 to 80% of hygromycin B-resistant (HyR) transformants, correlating closely with the size of the BRM1 segment in the transforming DNA. Restriction enzyme digestion within the BRM1 region greatly enhanced the frequency of gene targeting: integration of the linear plasmids was almost completely attributable to homologous recombination, regardless of the size of the BRM1 segments. Plasmids carrying both BRM1 segments and rDNA segments were transformed into the fungus to examine the effect of the number of target copies on homologous recombination. Using the circular plasmids, Mel- transformants accounted for only 5% of HyR transformants. In contrast, when the linear plasmid produced by restriction enzyme digestion within the BRM1 segment was used, almost all transformants were Mel-. These results indicate that homologous integration of circular molecules in A. alternata is sensitive to the length of homology and the number of targets, and that double-strand breaks in transforming DNA greatly enhance homologous recombination.

Alternaria

Significance of detection of enterovirus RNA in myocardial tissues by reverse transcription-polymerase chain reaction.

Enteroviruses are known to have association with human myocarditis and dilated cardiomyopathy (DCM). We screened biopsy specimens from patients with active myocarditis or DCM, and myocardial tissues from autopsy cases without cardiac diseases using polymerase chain reaction (PCR) gene amplification. Positive enteroviral signals were demonstrated from 4 of 5 patients with active myocarditis (80%), 7 of 42 patients with DCM(17%) and 3 of 27 autopsies (11%). Out of 7 PCR positive patients with DCM, 3 cases showed hypertrophy and disarray of cardiocytes, fibrosis in the interstitium, and a few inflammatory infiltrates. The remaining 4 cases with DCM and 3 PCR positive autopsy cases did riot exhibit histological findings compatible with those in myocarditis. Our results support the observations that enteroviruses are common aetiologic agents of myocarditis, and some cases of DCM. Our results also suggest the possibility that in some cases enteroviruses may persist in the myocardium without causing apparent pathological changes.

Adult

Hypertrophic cardiomyopathy in patients with diabetes mellitus associated with mitochondrial tRNA(Leu)(UUR) gene mutation.

Left ventricular function and morphology were assessed using M-mode echocardiography in 3 patients with diabetes mellitus associated with mitochondrial tRNA(Leu)(UUR) gene mutation, who were free of clinical, electrocardiographic, or thallium scan evidence of ischemic heart disease. Echocardiograms revealed hypertrophic cardiomyopathy in all 3 patients. Hypertrophy of the interventricular septum was mild in Cases 1 and 3 (12 and 13 mm, respectively) and severe in Case 2 (22 mm) (normal 7-10 mm). When they had neither signs nor symptoms suggestive of congestive heart failure, percentage fractional shortening (%FS), an index of wall motion of the left ventricle (normal > 28%), was normal in Cases 2 and 3 (28 and 32%, respectively) whereas it was slightly decreased in Case 1 (22%). In Case 1 with mild hypertrophy, the development of congestive heart failure was associated with a marked decrease in %FS to 13%; this patient responded well to diuretics and captopril and %FS rose to 22%. However, a mild decrease in %FS to 21% caused congestive heart failure in Case 2 with severe hypertrophy. His response to treatment was marginal. The present study indicates that mitochondrial DNA analysis should be done in patients with diabetic cardiomyopathy, and that sequential echocardiography is invaluable for the detection of hypertrophic cardiomyopathy and the management of subsequent myocardial dysfunction in patients with mitochondrial diabetes mellitus and cardiomyopathy.

Adult

[Exercise-nitroglycerine technetium-99m-2-methoxy isobutyl isonitrile tomoscintigraphic imaging for identifying diseased coronary vessels: comparison with thallium-201 standard exercise-redistribution study].

A same-day double injection protocol employing 99mTc-methoxy isobutyl isonitrile (MIBI) and myocardial single-photon emission computed tomography (SPECT) for detecting coronary heart disease (CAD) was assessed in 21 patients. Our exercise-nitroglycerin (NTG) MIBI study was performed as follows: 150 MBq 99mTc-MIBI was injected at peak exercise, and after 5 minutes 0.3 mg of NTG was sublingually administered. Then, SPECT was performed 1 hour later. Immediately after the 1st imaging, patients were injected of 750 MBq 99mTc-MIBI and were reimaged 1 hour later. Within 1 month, all patients were underwent standard exercise redistribution SPECT thallium (Tl) study. Of the 126 myocardial segments evaluated, 81 were judged as normal by both techniques, while the presence of stress defects were demonstrated in 37 segments (Agreement: 94%). Vessel sensitivities were 75% by MIBI and 67% by Tl. Specificities were 90% by MIBI and 93% by Tl. For the pattern of reversibility in myocardial segments with stress defects, the agreement was 73%. In conclusion, our exercise-NTG MIBI may be safely performed, giving results equivalent to those of standard stress-redistribution thallium studies.

Angina Pectoris

[Myocardial SPECT with iodine-123-labeled beta-methyl-branched fatty acid in patients with angina pectoris].

To evaluate the usefulness of 123I-BMIPP as a tracer of fatty acid metabolism in patients with angina pectoris, we performed rest BMIPP myocardial SPECT and stress 201Tl SPECT in 20 patients with angina pectoris. BMIPP SPECT was evaluated in the defected regions with Tl redistribution. Abnormal findings in BMIPP were observed in 11 of 20 patients and in 14 of 29 myocardial segments with Tl redistribution. Such decreased uptake was observed more often in patients with multivessel disease (64% vs. 12%). In addition, the decreased BMIPP uptake was seen more often in the segments exhibiting hypokinesis than the segments showing with normal wall motion. Thus, BMIPP imaging may be available to detect myocardial ischemia, particularly in patients with severe coronary disease.

Aged

[Clinical usefulness of the quantitative assessment of exercise thallium-201 myocardial imaging in patients with ischemic heart disease].

To clarify the significance of the quantitative analysis of the area of decreased activity in exercise thallium-201 myocardial imaging, 42 patients with one vessel disease (20 patients with angina pectoris without myocardial infarction, 22 patients with old myocardial infarction: MI) were evaluated by exercise thallium scan and compared with clinical findings and wall motion assessed by left ventriculography (LVG). Patients with MI were divided into two groups by LVG (Mild MI: MI with only hypokinesis on LVG, Severe MI: MI with akinesis or dyskinesis on LVG). The degree of defected area was expressed by the ratio of the counts of defected area to the normal area (Relative Activity: RA). RA of the area of decreased activity in patients with angina was higher than that of patients with MI (77.5 +/- 4.59% vs. 65.7 +/- 7.85%, p < 0.05). RA of the area of decreased activity in patients with mild MI was higher than that of patients with severe MI (69.5 +/- 4.78% vs. 61.3 +/- 8.45%, p < 0.01). The above results suggest that the regional thallium-201 uptake ratio in the scintigram may help to differentiate viable zones from necrotic ones and detect the degree of MI.

Evaluation Studies as Topic

Hematoma of the interatrial septum associated with complete atrioventricular block.

A 70-year-old man who had been treated for tongue cancer began to suffer from repeated syncopal attacks. His electrocardiogram indicated complete atrioventricular block. A permanent pacemaker was implanted. He was well for about 2 years after which time he developed dyspnea, suffered from general fatigue, and then suddenly died. A postmortem examination revealed a hematoma approximately 4 x 4. cm in size in the interatrial septum, connected to a noncoronary sinus and rupture of the noncoronary leaflet, which compressed the tricuspid and aortic valves. This hematoma might have been related to the conduction disturbance caused by destructive compression on the conduction system, and his death by the rupture of the noncoronary leaflet.

Aged

The clinical and prognostic significance of dipyridamole Tl-201 emission computed tomography in patients with dilated cardiomyopathy.

To clarify the clinical significance of regional myocardial perfusion abnormality of the left ventricle in dilated cardiomyopathy (DCM), 20 patients with DCM underwent dipyridamole Tl-201 emission computed tomography (ECT). The subjects were divided into 2 groups: group 1 had (n = 9) reversible defects and group 2 (n = 11) had persistent defects only. Group 2 patients significantly advanced heart failure and significantly poorer prognoses than group 1 (55% vs 11% in 2 years survival rate, p less than 0.05). The echocardiographic left ventricular end-diastolic dimension was larger in group 2 than group 1 (68.3 +/- 8.2 mm vs 61.9 +/- 4.0 mm, p less than 0.05) and % fractional shortening was smaller in group 2 than group 1 (18.0 +/- 4.5% vs 24.5 +/- 6.9%, p less than 0.05). Moreover, 12 of the 13 segments with reversible defect showed fairly well preserved left ventricular wall motion, whereas 35 of 58 segments with persistent defect had severely impaired wall motion (1/13 vs 35/58, p less than 0.01). Dipyridamole Tl-201 ECT demonstrated conclusively that the two types of defects (reversible and persistent) are useful to evaluate not only the abnormal myocardial perfusion but also myocardial damage and the prognosis in DCM.

Aged

[Hypertrophic non-obstructive cardiomyopathy assessed by dipyridamole thallium single photon emission computed tomography: comparisons with hypertrophic cardiomyopathy with a dilated heart].

Thallium-201 (Tl) single photon emission computed tomography (SPECT) after dipyridamole infusion (0.56 mg/kg) was performed in 23 patients with hypertrophic non-obstructive cardiomyopathy (HNCM) and in seven patients with HCM simulating dilated cardiomyopathy (HCM-DCM) to clarify the mechanism and clinical significance of decreased coronary vasodilatory reserve. The coronary vasodilatory reserve in the hypertrophied area assessed by SPECT was compared with the findings of echocardiography, left ventriculography and endomyocardial biopsy. 1. Eleven patients with HNCM had no perfusion defects in the hypertrophied area (group I), but the other 12 patients (52.2%) had such defects (group II). All seven patients with HCM-DCM had perfusion defects in the anterior or septal walls (group III). Redistribution was observed in 11 of the 12 patients in group II and in three of the seven patients in group III. 2. The regional washout rate was relatively low in the upper septum in group II and in the anterior wall and upper septum in group III. Thus, coronary vasodilatory reserve in the hypertrophied area was decreased in groups II and III. 3. Echocardiographically, the degree of hypertrophy did not differ between groups I and II, but the latter had significantly greater left ventricular diastolic dimension (42.3 mm vs 49.5 mm: p less than 0.05) and lower percent fractional shortening (%FS) (43.7% vs 35.6%: p less than 0.05). However, group III showed thinner left ventricular wall, much greater diastolic dimension (60.9 mm vs 49.5 mm: p less than 0.05), and lower %FS (24.0% vs 35.6%: p less than 0.05) than did those of group II. 4. On left ventriculography, those in group II showed larger left ventricular end-diastolic volume index (93.9 ml/m2 vs 79.7 ml/m2: p less than 0.05) than that of group I. Left ventricular ejection fraction showed the same tendency, but this was not statistically significant. 5. On endomyocardial biopsy, the specimens of the patients in group II had significantly higher percent fibrosis than did those of group I (11.4% vs 6.8%: p less than 0.05). These findings suggest that the mechanism of decreased coronary vasodilatory reserve in the hypertrophied area may be related to myocardial fibrosis, and this decrease may induce left ventricular dysfunction and compensatory dilatation.

Adult