Biomedical subjects
Publications and source records attributed to K Shimazu.
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A 56 year old woman with large cell lung carcinoma complained of an unpleasant sweet taste (dysgeusia). She developed hyponatraemia caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Dysgeusia disappeared when serum sodium normalised and recurred when hyponatraemia relapsed. Dysgeusia was the initial and only symptom of SIADH in this case.
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BACKGROUND: Acquired idiopathic generalized anhidrosis (AIGA) represents a heterogeneous clinical syndrome including sudomotor neuropathy and failure of the sweat glands. However, most AIGA cases comprise idiopathic pure sudomotor failure (IPSF), a distinct subgroup without sudomotor neuropathy or sweat gland failure. METHODS: Eight patients with IPSF (mean +/- SD age 20 +/- 5 years) were assessed by thermoregulatory and pilocarpine-induced sweating tests, as well as emotional sweating using sudorometer (4 cases), microneurography of skin sympathetic nerve activity (2 cases), and skin biopsies from the forearm or axilla (3 cases). RESULTS: Clinical features of IPSF comprise early onset; acute or sudden onset; concomitant sharp pain or cholinergic urticaria over the entire body; lack of autonomic dysfunction other than generalized anhidrosis; elevated serum IgE levels; and marked response to steroid. Sudomotor function testing revealed complete absence of thermoregulatory sweating, but well-preserved emotional sweating; pilocarpine did not induce sweating, and microneurography revealed that bursts of skin sympathetic nerve activity were not decreased; and skin biopsy displayed no morphologic abnormalities in sweat glands. The first two findings suggest lesions on the postsynaptic side of the nerve-sweat gland junction. CONCLUSION: The lesions in IPSF may be in the muscarinic cholinergic receptors of sweat glands. Allergic mechanisms are probably involved in its pathophysiology.
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A 53-year-old female presented with abdominal pain, and computed tomography scan revealed a small, calcified lesion in the wall of the transverse colon. The symptoms later disappeared spontaneously, and she remained in good health. However, four years later, she developed lancinating abdominal pain and was admitted to our hospital. A large tumor with calcification was found in the left upper abdominal cavity. Curative resection of the tumor was performed, and the histology was compatible with extraskeletal osteosarcoma. We speculated that the tumor originated from the colonic wall, because a small calcification was observed in the wall of the transverse colon four years before surgery. To the best of our knowledge, this is the first report of primary colonic osteosarcoma.
We investigated whether soy protein's alcohol-extractable components (SPEs; mainly consisting of isoflavones) have the ability to attenuate glomerular injury in male Imai rats of a spontaneous focal segmental glomerulosclerosis model. Male Imai rats were fed a casein-based diet with and without SPEs. Group 1 (Cont) was fed a standard diet without additional SPEs, and groups 2 (SPE-1) and 3 (SPE-2) were fed a standard diet supplemented with a semipurified alcohol extract of soy protein, 0.05 and 0.10 g/100 g of diet, respectively. Body weight, urinary protein level, serum constituents, and systolic blood pressure were evaluated every 4 weeks from 12 through 28 weeks of age. At 28 weeks of age, rats were studied morphologically. Growth rates were not different among the three groups throughout the experiment. SPE-supplemented diets resulted in less proteinuria and less hyperlipidemia. The decline in renal function shown by blood urea nitrogen and creatinine clearance was less marked in the animals fed the SPE-supplemented diets. Each SPE-supplemented diet equally induced less glomerular hypertrophy and less renal histological damage compared with nonsupplemented diets. The present study showed a beneficial effect of a semipurified alcohol extract of soy protein on glomerular disease.
The expression of a winged-helix transcription factor, Foxa2/HNF3beta, is essential for development of the node and the notochord. We examined the node/notochord enhancer of mouse Foxa2 for sequence motifs conserved across vertebrate species. We cloned Foxa2 genes from chicken and fish, and identified the respective node/notochord enhancers that were active in transgenic mouse embryos. Comparison of the sequences of the enhancers revealed three evolutionally conserved sequence motifs, CS1, CS2 and CS3. Mutational analysis of the mouse enhancer indicated that CS3 is indispensable for gene expression in the node and the notochord, while CS1 and CS2 are required to augment enhancer activity. These motifs do not correspond to the consensus binding sequences of transcription factors known to be involved in node/notochord development.
BACKGROUND: The stromal-epithelial cell interaction is essential for epithelial morphogenesis. Recently, the specific stromal cell type adipocytes, which abundantly exist in perirenal adipose tissue, have been suggested to affect the biological behavior of some epithelial cell types. However, adipocyte-renal epithelial cell interaction remains unclear. We thus examined the effects of adipocytes on the morphogenesis of renal epithelial cells. METHODS: The renal epithelial cell line, Madin-Darby canine kidney (MDCK), cells were cultured in three-dimensional collagen gel matrix with or without mature unilocular adipocytes. Cultures cells were examined by histochemistry, immunohistochemistry, and electron microscopy. RESULTS: Adipocytes extensively promoted the tubule formation of MDCK cells in two different manners. In the first type, after approximately 20% of MDCK cells actively adhered to adipocytes; they organized double-cell structured tubules between the adipocytes and the gel, contacting directly with the entire surface of the adipocytes. In the second type, approximately 70% of MDCK cells apart from adipocytes also formed tubules that had no contact with adipocytes. The component cells of both tubule types at the apical side showed microvilli and peanut agglutinin lectin-positive stain. These cells at the basal side had the basal lamina and type IV collagen-positive stain. CONCLUSIONS: These results indicate that the specific stromal cell type adipocytes cause MDCK cells to organize the well-polarized tubular structures in two different manners according to their direct and indirect interactions, suggesting that adipocytes may be involved in the regulatory mechanism of renal epithelial morphogenesis.
We report two cases of alpha-fetoprotein producing gastric cancer (AFPGC) with multiple liver metastases showing marked response to continuous HAI chemotherapy with adriamycin (ADM). In both cases, 5-FU 500 mg/body/day and Leucovorin (LV) 30 mg/body/day was infused continuously for 7 days and ADM 30 or 60 mg/body/day was infused continuously for 4 hours on day 7 as preoperative HAI chemotherapy. The primary gastric lesions were reduced and became resectable. After gastrectomy, they were treated with 4-hour continuous HAI of ADM 30 or 60 mg/body with or without 5-FU and LV once a week several times in our outpatient clinic. After these treatments, the multiple liver metastases were reduced remarkably, with a marked decrease of serum AFP levels. During these treatments, neither patient showed remarkable side effects, so they could work as before. This frequently low-dose ADM administration resulted in a high local response without severe side effects.
T lymphocytes are probably of pathogenic importance in Guillain-Barré syndrome (GBS). Blood samples from 31 patients with GBS and from 25 healthy controls were studied with flow cytometry. Subsets of the CD4 population were determined: CD4+CD29+ (helper-inducer) cells and CD4+CD45RA+ (naive or suppressor-inducer) cells. Recently, deviations of circulating CD8 populations have been noticed. Therefore, subsets of the CD8 population were also determined: CD8+CD11b dull (suppressor-effector) cells and CD8+ CD11b bright (cytotoxic-effector/NK) cells. During the active stage of GBS, significantly increased proportions of CD4+HLA-DR+ (activated CD4+) cells and CD4+CD29+ cells were found compared to those in control samples (p < 0.0005, p < 0.05, respectively). The proportion of CD8+CD11b dull cells was significantly lower than that in the control samples (p < 0.005). Sequential analysis showed a decrease in the proportion of CD4+HLA-DR+ cells and CD4+CD29+ cells from the active to the convalescent stage (p < 0.05, p < 0.005, respectively). The proportion of CD8+CD11b dull cells was low in GBS patients with high disease severity.
Short course regimens; 2HRZ (E)(S)/4HR (E), 6HRS (E)/3-6HR and 6-9HR have been accepted as a standard chemotherapy (SC) for initial treatment of pulmonary tuberculosis in Japan. We studied the frequency of the treatment completion, the causes of the treatment failure and the outcome of the patients in whom INH or RFP was discontinued within 6 months after starting SC. The subjects included 597 newly diagnosed culture positive pulmonary tuberculosis patients admitted to 16 national hospital in 1996. Results were as follows. 1. In 47 (7.9%) of the 597 patients, either INH (19; 3.2%) or RFP (33; 5.5%) was discontinued. These 47 cases were defined as a SC incompleted group and the other 550 as a SC completed group. 2. The patients in the SC incompleted group were seen more frequently in the ages of 20s (11.9%), 50s (10.9%), 60s (11.7%) or 70s (11.4%). 21 (13.6%) of 154 female patients and 26 (5.9%) of 443 male patients were in the SC incompleted group. 3. The causes of cessation of INH or RFP were drug side effects (33; 5.5%), drug resistance (10; 1.7%) and complications or underlying diseases (8; 1.3%). 4. Fever or eruption (19; 3.2%) and drug induced hepatitis (12; 2.0%) were frequently seen as drug related side effects causing the cessation of INH or RFP. 5. The rate of culture negative conversion of TB bacilli at 6 months after the start of the treatment was 98.9% in the SC completed and 88.9% in the SC incompleted group respectively. In the SC incompleted group, there were three cases continuously positive and two other patients who relapsed and became culture positive again. In these five patients, INH or RFP was discontinued because of drug resistance.
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Laparoscopic adrenalectomy has been used to remove a wide variety of adrenal neoplasms. Although several laparoscopic approaches to the adrenal gland have been described, the lateral transabdominal approach has several advantages when compared with other approaches for laparoscopic adrenalectomy. From October 1995 to July 1999, we performed laparoscopic adrenalectomies on 16 patients, including eight posterior retroperitoneal approaches and eight lateral transabdominal approaches. Sixteen patients, ranging in age from 23 to 69 years, were treated for the following conditions: non-functioning adenoma, four patients; aldosteronoma, seven patients; pheochromocytoma, three patients; Cushing's adenoma, two patients. The average tumor size was 2.5 +/- 0.5 cm (1.8-3.0 cm, median 2.4 cm) in the lateral transabdominal approach, 1.2 +/- 0.8 cm (0.8-3.2 cm, median 1.75 cm) in the posterior retroperitoneal approach. Average operative time of lateral transabdominal approach was significantly shorter than that of the posterior retroperitoneal approaches (mean 129 min vs 269 min, P = 0.0005). Conversion to laparotomy was required in one patient in the posterior approach. Postoperative complication occurred in one pneumothorax in the lateral transabdominal approach and two subcutaneous emphysemas in the posterior retroperitoneal approach. There was no statistical difference in blood loss during the operation in the two groups. There was no mortality in either group. The lateral transabdominal approach is a safe and efficient technique for the removal of the adrenal neoplasms. Compared with other approaches, this technique has a wider working space and also good exposure for removing the adrenal gland.
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Argatroban, one of the arginine derivatives, has been reported to have a safe and potent antithrombin action. This compound is active in several animal models of thrombosis and also has been shown to improve general neurological symptomatology, general subjective symptomatology and general daily behavior in the patients with acute thrombosis. This was considered to reflect remarkable improvement of microcirculation. No published clinical data, however, exist on the effect of argatroban on cerebral blood flow (CBF) change during acute stroke. Three patients with acute cerebral infarction were subjected to this study. Intravenous argatroban injection (2.5 mg/hr) was continued in 48 hours. Regional CBF (rCBF) was measured before and after injection of argatroban using Xe-CT method. Argatroban increased CBF not only in the injured side hemisphere or penumbra, but also contralateral side of lesion in the patients with acute cerebral infarction.
We report a 26-year-old woman with autosomal recessive juvenile parkinsonism (AR-JP). Her parents made consanguineous marriage. The disease started with dystonic posture of legs 20 years prior to the admission (6 years old). The equinovarus foot appeared at 9 years old and parkinsonism gradually developed. These symptoms were remarkably improved after sleep. Levodopa was effective on her parkinsonian symptoms. However, the response to levodopa gradually reduced. On admission, she presented with a masked face, marked rigidity, moderate retropulsion, postural tremor in the upper limbs and mild hyperreflexia in the lower limbs. Mutational analysis revealed homozygous deletion of exon 4 in perkin gene. This patient has youngest age of onset for ARJP to our knowledge.