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Biomedical subjects

K Shingu

Publications and source records attributed to K Shingu.

At least 91 records · Page 5Linked to original sources

Cloning and characterization of two novel aldo-keto reductases (AKR1C12 and AKR1C13) from mouse stomach.

In contrast to hepatic hydrosteroid dehydrogenases (HSDs) of the aldo-keto reductase family (AKR1C), little is known about a stomach one. From a mouse stomach cDNA library, we isolated two clones encoding proteins of 323 amino acid residues. They exhibited 93.2% amino acid sequence identity and 64-68% with any known HSDs. Recombinant proteins expressed in Escherichia coli reduced 9,10-phenanthraquinone with NAD(P)H as cofactor. The mRNAs were exclusively expressed in stomach, liver and ileum. The present study demonstrates that these proteins are new members of the HSD subfamily and they are named AKR1C12 and AKR1C13. Immunohistochemical analysis suggests that they are involved in detoxification of xenobiotics in the stomach.

Alcohol Oxidoreductases↗

Tumor Marker Levels Elevate False-Positively in Postsurgical Breast Cancer Patients with High sGPT Levels or with Receiving Oral 5-FU or Its Derivatives.

BACKGROUND: False elevation of tumor marker levels (TM) has been encountered in some postsurgical breast cancer patients. METHODS: We investigated 33 postsurgical breast cancer patients whose TM (CEA, CA15-3, NCC-ST-439, or BCA225) measured every 3 months, showed elevation 3 times in a row in a 6-month period, and in whom metastases were not detected at theend of the 6-month period. Nine patients developed recurrence within 36 months of the end of the 6-month period and 24 patients did not develop recurrence for more than 36 months after the end of the 6-month period. RESULTS: Seven patients who stopped treatment with oral 5-FU or its derivatives because of severe nausea and appetite loss did not develop recurrence. Normalization of TM (CEA, NCC-ST-439, or BCA225) manifested within 3 months of the interruption of the medication. Six patients who showed simultaneous increase in serum glutamic-pyruvic transaminase (sGPT) and TM (CEA or BCA225) in the initial 6months did not develop recurrence. Three of 6 patients did not take any anti-cancer drugs. Correlation coefficiencies of sGPT with CEA in 4 patients were 0.467, 0.569, 0.738, and 0.910 and those of sGPT with BCA225 in 3 patients were 0.663, 0.826, and 0.840. CONCLUSION: A false-positive increase in CEA, NCC-ST-439 or BCA225 might be caused by treatment with oral 5-FU or its derivatives. CEA or BCA225 elevates false-positively in patients with high sGPT levels.

Journal Article↗

Awake tracheal intubation through the intubating laryngeal mask.

PURPOSE: To report successful awake insertion of the intubating laryngeal mask (Fastrach) and subsequent tracheal intubation through it, in a patient with predicted difficult tracheal intubation, due to limited mouth opening, and difficult ventilation through a facemask, due to a large mass at the corner of the mouth. CLINICAL FEATURES: A 53-yr-old woman with a large post-gangrenous mass on the right cheek to the angle of the mouth was scheduled for its resection. The right side of her face was damaged by a bomb attack followed by cancrum oris 50 yr ago. The distance between the incisors during maximum mouth opening was 2 cm and that between the gums on the right side < 1 cm. After preoxygenation and 50 micrograms fentanyl and 30 mg propofol i.v., propofol was infused at 2 mg.kg-1.hr-1. Lidocaine, 8%, was sprayed on the oropharynx. A #4 intubating laryngeal mask was inserted with a little difficulty. A fibrescope was passed through a 7.5-mm ID RAE tracheal tube, and the combination was easily passed through the laryngeal mask into the trachea. General ansthesia was then induced. Finally, the intubating laryngeal mask was removed, while the RAE tube was being stabilized using an uncuffed 6.0-mm ID tracheal tube. CONCLUSION: Awake tracheal intubation through the intubating laryngeal mask is a useful technique in patients with limited mouth opening in whom ventilation via a facemask is expected to be difficult.

Anesthetics, Intravenous↗

Triterpenoid saponins of Acanthopanax nipponicus leaves.

Five new triterpenoid saponins, nipponosides A-E (1, 3-6), were isolated from Acanthopanax nipponicus leaves, along with a known saponin, kalopanaxsaponin G (2). Nipponosides A-E were characterized as the 28-O-alpha-L-rhamnopyranosyl(1-->4)-beta-D-glucopyranosyl(1-->6)-beta -D-glucopyranosyl ester of 3-oxohederagenin, oleanolic acid 3-O-beta-D-glucopyranoside, gypsogenin 3-O-beta-D-glucopyranoside, 3beta,23,29-trihydroxyolean-12-en-28-oic acid, and 3beta,20alpha, 23-trihydroxy-30-nor-olean-12-en-28-oic acid, respectively. The structures of these new compounds were based on chemical and spectral methods.

Carbohydrate Sequence↗

Ethical considerations in anaesthesia journals.

It has been shown that instructions to authors in nonanaesthesia biomedical journals often fail to require authors to state that the study was approved by an ethics committee and informed consent obtained from participants; articles also often omit mentioning these points. We examined 11 English-language journals, which are listed in the 'Anesthesiology' category of 1995 SCI Journal Citation Reports, to see whether the instructions to authors of anaesthesia journals mention the following ethical factors: approval of the study by an ethics committee, informed consent, redundant publication, fraud, authorship, conflict of interest and protection of patients' privacy. We also examined 673 articles which appeared in these anaesthesia journals ( July to December issues of 1996) to see whether they stated acquirement of ethics committee approval and informed consent. All journals addressed the avoidance of redundant publications and unjustifiable authorship. Ten journals required approval of studies and signatures from all authors, eight journals mentioned informed consent. Only seven required the disclosure of any conflict of interest and the protection of patients' privacy. More than 90% of the articles stated that the study was approved and informed consent obtained.

Anesthesiology↗

Prevention of needle-stick injury. Efficacy of a safeguarded intravenous cannula.

One possible method of reducing the incidence of needle-stick injury is to use needles with safeguard mechanisms. The needle of the Insyte AutoGuard intravenous cannula can be retracted into the safety barrel. One hundred patients were randomly allocated to receive either an 18-gauge conventional Insyte intravenous cannula (group C) or the AutoGuard cannula (group AG) to assess the ease of use and efficacy of the AutoGuard device. It was possible to insert the cannula into the vein within two attempts in all patients; there was no significant difference between two groups with respect to ease of insertion. No problems, such as inadvertent withdrawal of the needle, occurred during insertion in any patient. Handling the withdrawn needle was judged significantly safer in group AG than in group C (p < 0.001). Blood contamination often occurred where a withdrawn needle was placed in group C, whereas no blood stain was detected in any case in group AG (p < 0.001). The AutoGuard cannula provides safer handling of a withdrawn needle without reducing its ease of insertion.

Adolescent↗

Effects of nitrous oxide on haemodynamic and electroencephalographic responses induced by tetanic electrical stimulation during propofol anaesthesia.

We studied the effect of nitrous oxide on haemodynamic and electroencephalographic responses caused by noxious stimulation during propofol anaesthesia. Thirty-four patients (ASA I-II) were anaesthetised with propofol 3 mg x kg(-1) and were randomly allocated to receive either 60% nitrous oxide in oxygen or 40% oxygen in air. Anaesthesia was maintained using propofol infusion of 10 mg x kg(-1) x h(-1) for the first 10 min, 8 mg x kg(-1) x h(-1) for the next 10 min and 6 mg x kg(-1) x h(-1) thereafter. Thirty minutes after the induction of anaesthesia, tetanic electrical stimulation (80 mA, 100 Hz) was applied to the ulnar nerve. Tetanic stimulation significantly increased blood pressure and heart rate in both groups (p < 0.005 or less), but did not induce any arousal pattern on the electroencephalograph. Nitrous oxide significantly attenuated the tetanic stimulation-induced increase in blood pressure (p < 0.05 or less), but not the heart rate.

Adult↗

Electroencephalographic arousal response during tracheal intubation and laryngeal mask airway insertion after induction of anaesthesia with propofol.

Laryngoscopy and tracheal intubation, or insertion of a laryngeal mask airway may lead to an arousal response on the electroencephalogram. We studied whether more intense stimulation (laryngoscopy and tracheal intubation) causes a greater arousal response than less intense stimulation (laryngeal mask airway insertion). Thirty-four patients (ASA I-II) were anaesthetised with propofol 3 mg.kg-1, followed by vecuronium 0.15 mg.kg-1 and a propofol infusion of 10 mg.kg-1.h-1. Three minutes after induction of anaesthesia, either laryngoscopy and tracheal intubation (n = 18), or laryngeal mask airway insertion (n = 16) was performed. Laryngoscopy and tracheal intubation caused a significantly greater increase in blood pressure (but not heart rate) than laryngeal mask airway insertion (p < 0.05). Electroencephalogram responses were not different. More intense stimulation does not cause a greater arousal response during propofol anaesthesia.

Adult↗

Three-dimensional structure of the micro-blood vessels in thyroid tumors analyzed by immunohistochemistry coupled with image analysis.

The structure of micro-blood vessels, one of the most important factors influencing the tumor growth and tumor metastasis among histological types of thyroid malignancy, was analyzed immunochemically by staining tissues for platelet endothelial cell adhesion molecule-1 (PECAM-1). Human thyroid tumor tissue obtained at surgery, consisting of 18 cases of papillary carcinoma, 9 cases of follicular carcinoma, and 9 cases of anaplastic carcinoma were fixed in formalin solution, and paraffin sections were made. They were stained for PECAM-1 using the avidin-biotin complex (ABC) technique. The volume of the blood vessels and their three-dimensional (3D) structure were analyzed using an image analyzer. The volume ratios of blood vessels in thyroid tissues were: normal tissues, 1.10%; papillary carcinoma, 3.01%; follicular carcinoma, 8.13%; and anaplastic carcinoma, 0.91%. Ratios in malignant tumors were larger than in normal tissues, except for anaplastic carcinoma. The typical 3D structure of micro-blood vessels was histopathologically varied: branching tree-like blood vessels in papillary carcinomas; vessels of varied diameter surrounding follicle structure in follicular carcinomas; and simple and immature vessels in anaplastic carcinomas. The volume and 3D structure of micro-blood vessels in thyroid malignant tumors differed from those in normal tissues, and varied according to histological classification.

Adenocarcinoma, Follicular↗

Re-evaluation of appropriate size of the laryngeal mask airway.

We have assessed 32 males and 31 females in a randomized, crossover study to see if there was any difference in the correct positioning of the laryngeal mask, optimal ventilation (defined as no gas leak around the mask at an airway pressure of 18 cm H2O) and cuff visibility between sizes 4 and 5 masks in males and sizes 3 and 4 in females. The position of the mask in relation to the glottis was assessed using a fibreoptic bronchoscope. There was no significant difference in correct positioning between the two sizes in either sex. Gas leak was significantly less frequent for a larger than a smaller mask (P < 0.01 for both sexes), whereas the cuff was more often seen in the mouth with larger masks (P < 0.02 for males and P < 0.01 for females). Therefore, larger masks (size 4 in females and size 5 in males) provided a better seal than smaller sizes without worsening the relative position of the mask to the glottis; however, the larger mask came up within the mouth more often, which could interfere with tonsillectomy and could increase the risk of sore throat or lingual nerve damage.

Adult↗

Clonidine inhibits and phorbol acetate activates glutamate release from rat spinal synaptoneurosomes.

UNLABELLED: Glutamate is a major neural transmitter of noxious stimulation in the spinal cord. We measured glutamate release from rat spinal synaptoneurosomes by using an enzyme-linked fluorimetric assay. Glutamate was released from spinal cord synaptoneurosomes in response to the addition of 30 mM potassium chloride, 1 mM 4-aminopyridine, or 1 microM ionomycin in the presence of external calcium. There was less release of glutamate in the absence, versus the presence, of external calcium. Clonidine significantly reduced the level of glutamate released from the spinal cord synaptoneurosomes. Tetradecanoyl phorbol acetate, an activator of protein kinase C, enhanced glutamate release. Forskolin, a protein kinase A activator, had no effect on the glutamate efflux. Our data indicate that glutamate released in the spinal cord is dependent on protein kinase C but is independent of the protein kinase A pathway. They also suggest that the inhibition of glutamate release may be the underlying mechanism of antinociception by clonidine at the spinal cord level. IMPLICATIONS: We demonstrated that synaptoneurosomes from rat spinal cord could release glutamate in response to depolarization. We showed that an activator of protein kinase C increased glutamate released from spinal cord synaptoneurosomes but that clonidine decreased it. Glutamate release may be one of the mechanisms of antinociception at the spinal cord level.

4-Aminopyridine↗

[Use of the intubating laryngeal mask for tracheal intubation in three patients with difficult airways].

The intubating laryngeal mask has a potential role for tracheal intubation in patients with difficult airways, but there have been only reports of the techniques of blind tracheal intubation through the intubating laryngeal mask. The success rate of blind intubation at the first attempt may be merely 50-60% even in patients with normal airways. We report the use of the intubating laryngeal mask for tracheal intubation in three patients with difficult airways, in whom a tube was easily inserted through the laryngeal mask into the trachea either blindly, using a fiberoptic bronchoscope or using a lighted stylet.

Adult↗