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Biomedical subjects

K Shimanuki

Publications and source records attributed to K Shimanuki.

At least 19 recordsLinked to original sources
PubMed2001

Pneumatosis intestinalis in the small bowel of an adult: report of a case.

We present the case of a 70-year-old man found to have pneumatosis of the small intestine. An abdominal computed tomography (CT) scan detected massive intramural air in the entire circumference of the small intestine without any venous gas. During emergency surgery, 80 cm of the small bowel was removed. The pathological findings of thrombi in the resected specimen thus indicated that surgical intervention should be immediately performed in patients with pneumatosis throughout the small intestine. CT was useful for confirming the presence of intramural gas in pneumatosis of the small intestine. The presence of a massive amount of intramural gas in the entire small intestine circumference on the CT findings is thus considered to be an early indication of bowel infarction.

Aged↗
PubMed1999

Evaluation of perioperative administration of methylprednisolone sodium succinate and urinary trypsin inhibitor for prevention of surgical stress.

The authors could confirm that the laparoscopy-assisted cholecystectomy (LAC) elicited less postoperative biological responses compared to the ordinary cholecystectomy under laparotomy (OCL), when granulocyte elastase (GE)-alpha1-protease inhibitor complex (GEcomplex), interleukin-6, pancreatic secretory trypsin inhibitor (PSTI) and alpha1-antitrypsin (alpha1-AT) were used as biological response markers. Perioperative administrations of methylprednisolone sodium succinate (MPSL: 10 mg/kg body weigh) or MPSL with urinary trypsin inhibitor (UTI) could suppress such postoperative reactions after OCL down to the levels after LAC, especially immediately after surgery. Preoperative MPSL followed by continuous infusion of UTI for 3 days exerted the most prominent suppressive effects on these markers compared to the effect of the preoperative MPSL alone as well as the preoperative administration of MPSL followed by UTI infusion for only one hour. Bolus administration of MPSL induced no lymphocytopenia. Decreased plasma level of alpha1-AT immediately after operation is thought to be due to consumption in binding to GE as well as other lysosomal enzymes, while production of rapid turn over proteins are still not accelerated in the liver. In early postoperative phase after administration of MPSL, administration of UTI was efficacious to prevent fluctuation of biological response markers. Clinical applications of these drugs might be approved especially for those patients with poor risk.

Adult↗
PubMed1997

A case of retroperitoneal abscess: an unusual complication of cholecystitis and choledocholithiasis.

A man, 73 years old, who developed acute biliary tract infection complicated with retroperitoneal abscess formation in iliopsoas region was reported. The magnetic resonance imaging was especially effective to delineate the lesion, extending from the subhepatic down to the iliopsoas muscle. The echo-guided fine needle aspiration technique was successful to make the lesion subside.

Abscess↗
PubMed1996

Distribution of transforming growth factor-beta and its receptors in gastric carcinoma tissue.

The distribution of the three mammalian isoforms of transforming growth factor (TGF)-beta (TGF-beta 1, -beta 2, and -beta 3) as well as their signaling receptors, TGF-beta type I and type II receptors (T beta R-I and T beta R-II, respectively), in gastric carcinoma tissue was examined by immunohistochemistry using specific antibodies. Tissue specimens were obtained from 25 cases of gastric carcinoma, which were classified into two groups according to Lauren's classification, i.e. 15 cases of diffuse carcinoma and 10 cases of intestinal carcinoma. In normal gastric mucosa apart from carcinoma nests, all of TGF-beta 1, -beta 2, -beta 3, T beta R-I and T beta R-II were clearly demonstrated in fundic glands. In sharp contrast, none of them was detectable in surface mucous cells. In carcinoma cells, strong staining for TGF-beta 1, -beta 2 and -beta 3 was obtained only in diffuse-type carcinoma. In particular, carcinoma cells scattered as single cells or small nests had a tendency to show strong staining for TGF-betas. The receptors tended to be distributed concomitantly with the ligands, and diffuse-type carcinoma showed stronger receptor staining than intestinal-type carcinoma. In cancer stroma, TGF-betas and receptors were detected in both diffuse and intestinal types, but the area with positive staining was wider and more dispersed in diffuse-type carcinoma than in intestinal carcinoma. These results suggest that TGF-beta may contribute in part to the variety of histogenesis and mode of progression of gastric carcinoma.

Adenocarcinoma↗
PubMed1996

Non-surgical treatment of splenic cyst, using with installation of minocycline chloride.

Solitary splenic cysts are relatively rare and usually asymptomatic. However, large ones sometimes show clinical manifestations. Non-surgical treatment of a solitary splenic cyst by instillation of minocycline chloride is described. Minocycline chloride was instilled into the splenic cyst through a pig-tail catheter indwelt under ultrasonographic guidance. Low concentration of minocycline chloride (200 mg diluted in 100 ml of saline) was not effective to reduce discharge from the splenic cyst. Discharged volume was markedly reduced after the instillation of high concentration of minocycline chloride (2000 mg diluted in 100 ml of saline). Eight weeks after this treatment, fluid discharge ceased. After 1 year, there was no findings of enlargement of the cyst. Ultrasonogram guided percutaneous instillation of minocycline chloride is a safe, easy, and useful procedure for treatment of a solitary and benign splenic cyst.

Aged↗
PubMed1994

Serum lidocaine and MEGX concentrations after pharyngeal anesthesia for gastroscopy.

In 20 patients undergoing topical anesthesia for gastroscopic examination, serum concentrations of lidocaine and its metabolite, monomethylglycinexylidide (MEGX), were measured. Patients were divided randomly into two groups: a gel group, in which 5 ml of 2% lidocaine gel was applied to the throat for 20 minutes; and a solution group, in which 40 ml of 2% lidocaine solution was administered by gargling for five minutes. The effect of oropharyngeal anesthesia was comparable in both groups. In the gel group, the serum levels of lidocaine and MEGX were not elevated at 15 minutes after application of the anesthetic. However, in the solution group, a rise in both serum lidocaine and MEGX at 15 minutes after anesthesia was detected in some of the patients (40%). Increased serum MEGX concentrations, which correlated well with serum lidocaine concentrations, were associated with the age of the patient (r = 0.606; p < 0.05), but not with height or weight. As a topical anesthetic for endoscopic examination, we prefer lidocaine gel to lidocaine solution, because the latter might be absorbed more rapidly and unpredictably in some, especially aged patients.

Adult↗
PubMed1994

Molecular weight analysis of cow's milk antigens in neonate sera.

Some food antigens (Ag) can be detected in serum immunoglobulin G (IgG) antibodies (Ab) following ingestion. These Ag may thus be essential for inducing the production of IgE or IgG antibodies, which may in turn lead to the onset of atopic diseases such as atopic dermatitis, allergic rhinitis and asthma. The molecular weights (MW) of these Ag have yet to be determined. To select samples for MW analysis of circulating food Ag, we measured the concentrations of cow's milk (CM) Ag in the sera of 88 neonates by radio-immunoassay. They were found present in 20 samples of the sera. Twelve of the samples were analyzed for Ag MW by immunoblotting. Several bands appeared for one of the samples. Their MW were < 13,000 and no native CM proteins could be detected.

Animals↗
PubMed1994

[A case of liver metastasis of leiomyosarcoma of residual stomach successfully treated by TAE and intra-hepato-arterial chemotherapy with infusion-a-port with administration of epirubicin].

A 60-year-old man who had a partial gastrectomy for gastric cancer 10 years ago was referred to our hospital for further examination for liver tumor. He was diagnosed as leiomyosarcoma of residual stomach associated with liver metastases. After preoperative transarterial embolization (TAE) with epirubicin of the anterior branch of right hepatic artery, residual stomach was resected, and the reservoir catheter and infusion arterial port were implanted. He was treated by intra-hepato-arterial chemotherapy of epirubicin. The patient has remained well for 2 years and 3 months without apparent complications.

Embolization, Therapeutic↗
PubMed1993

Lidocaine metabolite formation as a measure of perioperative liver function.

In order to determine whether lidocaine metabolism, as the formation of monoethylglycinexylidide (MEGX), could be used as a quantitative index of perioperative liver function, serum levels of MEGX in 31 surgical patients were measured and compared with the results of conventional liver function tests. A significant correlation was found between the values of MEGX and ICGR15 in 20 of the 31 patients. The values of ICGR15 were lower than 20% in patients whose MEGX values were above 60 ng/ml and 20% or higher in those with MEGX values of lower than 60 ng/ml. There was also a significant correlation between MEGX values and antithrombin III values, and between MEGX values and the postoperative maximum levels of aspartate aminotransferase. However, no correlation was found between MEGX values and other preoperative conventional liver function tests in any of the 31 patients. We suggest that a cut-off MEGX value of 60 ng/ml be used as an indicator for satisfactory preoperative liver function. MEGX formation could be a useful prognostic index for patients who have undergone surgical procedures for liver disease, and employed as a quantitative assessment of perioperative liver function.

Adult↗
PubMed1993

Immunosuppressive factors detected during convalescence in a patient with severe serum sickness induced by carbamazepine.

We report on a patient with severe serum sickness induced by carbamazepine in whom anticarbamazepine IgG antibodies were detected in the serum. The T cells of the patient showed impairment of phytohemagglutinin-induced proliferation, and hypergammaglobulinemia was evident. The clinical features and immunological abnormalities were compatible with immunoblastic lymphadenopathy. Immunosuppressive factors were also detected in the patient. Their molecular weights ranged from 20,000 to 30,000 as evaluated by Sephadex G-200 gel filtration. Such immunosuppressive cytokines were not detected in other patients with carbamazepine allergy who did not develop the clinical manifestations of immunoblastic lymphadenopathy. These results suggest that the T cell functional deficiency of immunoblastic lymphadenopathy is induced by these immunosuppressive cytokines.

Carbamazepine↗
PubMed1993

[Evaluation of lidocaine metabolite (monoethylglycinexylidide) as a liver function test].

In order to determine whether or not the lidocaine metabolism, monoethylglycinexylidide (MEGX) formation, could be used as a liver function test, we measured the serum levels of MEGX in 38 patients. There were significant correlations between values of MEGX (MEGX15, MEGX30, AUC15-30, AUC0-180) and conventional liver function tests (ICG R15, AT III, T. Bil). It appeared that value of MEGX 30 had maximum factor loading on conventional liver function tests by using principal component analysis. The advantage of adapting the MEGX formation as a liver function test of drug metabolism is simplicity of the method. MEGX formation could be useful index of the total liver function.

Evaluation Studies as Topic↗
PubMed1992

An immunodominant haptenic epitope of carbamazepine detected in serum from patients given long-term treatment with carbamazepine without allergic reaction.

An anticarbamazepine antibody was detected in the serum of a patient with severe carbamazepine-induced serum sickness. We found that the patient's T cells and IgG antibody recognized an epitope which appeared in subjects showing an allergic reaction, as well as that in subjects who showed no allergic reaction, after long-term carbamazepine therapy. These results show that an anti-carbamazepine immune response does not occur in the majority of subjects who undergo long-term carbamazepine therapy without developing allergic symptoms, although the immunodominant haptenic epitope of carbamazepine is present in their sera.

Carbamazepine↗
PubMed1992

Possible role of Streptococcus pyogenes in mucocutaneous lymph node syndrome. XV. Potential utility of streptococcal pyrogenic exotoxin toxoid for the prophylaxis and treatment of MCLS.

Mice made tolerant to streptococcal pyrogenic exotoxin (SPE) by neonatal inoculation with SPE emulsified in incomplete Freund's adjuvant demonstrated early thrombocytopenia followed by thrombocytosis. This state is the perfect counterpart of patients with mucocutaneous lymph node syndrome (MCLS). We have hypothesized that by inducing tolerance to SPE, the biological activities of the toxin might play leading roles in the pathogenesis of MCLS. In the present investigations, the efficacy of SPE on the prophylaxis and treatment of diseases caused by Streptococcus pyogenes (including MCLS) were monitored using the murine model system accompanied with a platelet-counting technique. The mice, rendered tolerant due to neonatal SPE inoculation and followed by immunization with SPE toxoid about 1 month prior to the provocative injections with SPE, demonstrated an almost complete lack of response to the provocation, keeping platelet counts within the normal range of values (except for a marginally significant thrombocytosis 7 days postprovocation). Moreover, anti-SPE titers of the sera from the mice sacrificed on day 35, at which point the observation was terminated, were proved to be markedly elevated when compared with controls. These findings seem to suggest that immunization with the toxoid could overcome tolerance, resulting in the production of an antitoxin. In a second experiment that examined the effect of administration with rabbit antiserum raised against the toxoid, the antiserum-treated mice demonstrated a transitory thrombocytosis on 7 days postprovocation with SPE, followed by an abrupt decrease in the number of platelets from day 10 onward.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Membranous septal aneurysm with aortic regurgitation: a case report].

A case of membranous septal aneurysm with aortic regurgitation (AR) in a 13-year-old male was reported. As AR was progressed rapidly in this case, aneurysmorrhaphy of membranous septal aneurysm and aortic valve plication were performed. The postoperative coarse was uneventful. It was considered that the course of AR was prolapse of aortic valve related with membranous septal aneurysm.

Adolescent↗
PubMed1992

[A case of re-expansion pulmonary edema following water seal drainage for spontaneous pneumothorax--management with right and left-separated mechanical ventilation].

A 23-year-old male with complete collapse of the right lung due to spontaneous pneumothorax was admitted 11 days after its onset. Paying close attention to the re-expansion pulmonary edema (REPE), water seal drainage was performed. Following couple episodes of persistent severe cough, four hours later, he developed dyspnea and began to expectorate frothy massive sputum. Chest X-ray revealed pulmonary edema of the entire right lung field. Measurement of total proteins and neutrophil elastase in airway exudates showed 5.5 g/dl (ratio to plasma, 0.89) and 7000 micrograms/l, respectively. Because of marked difference of compliance between bilateral lungs, management with right and left-separated mechanical ventilation and PEEP applied only to the right lung was performed. Although transient mediastinal deviation to the left was observed, successful management was achieved by the maneuver. High concentrations of total proteins and neutrophil elastase in edema fluid suggest that increased vascular permeability due to endothelial cell injury via activated neutrophils is mainly responsible for REPE. In the present case, rapid expansion of the collapsed lung accelerated by severe cough seems to be a predisposing factor of REPE. In patient with prolonged pneumothorax, suppression of cough is thought to be important for the prevention of REPE even with water seal drainage.

Adult↗
PubMed1991

Possible role of Streptococcus pyogenes in mucocutaneous lymph node syndrome. XII. Variable responses of platelets in MCLS seem to be explainable by streptococcal pyrogenic exotoxin.

As a model system for mucocutaneous lymph node syndrome (MCLS), we have advocated and used mice which had been rendered tolerant to Streptococcus pyogenes-associated antigens by neonatal infection with group A beta-hemolytic streptococci, because these mice have shown a variety of peculiar bioimmunological characteristics bearing a striking resemblance to those of MCLS patients. The results of our current investigations reaffirmed the reliability of the animal model by indicating that mice subjected to neonatal infection with S. pyogenes, or inoculation with streptococcal pyrogenic exotoxin (SPE) in Freund's adjuvant, were perfect counterparts of patients with MCLS on account of their platelet activation and hyperaggregability in response to provocative treatment, which are familiar findings in this disease.

Animals↗