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Biomedical subjects

M Fujimori

Publications and source records attributed to M Fujimori.

At least 19 recordsLinked to original sources
PubMed1992

Immunochemical characterization of rat testicular asparagine synthetase.

We studied immunochemical properties of rat testicular asparagine synthetase. Western blot analysis of testis extract with polyclonal antibody raised against purified asparagine synthetase revealed an immunoreactive band at 62 kDa. The pancreas, brain, thymus, and spleen also showed 62-kDa bands. The intensities of these bands were roughly proportional to the specific activities of the enzyme in these tissues. The antibody showed some degree of cross-reactivity to asparagine synthetases from human, beef, pig, mouse, guinea pig, chicken, and frog, but not carp. But the enzyme from human HL-60 cells and lower vertebrates reacted with the antibody less strongly than enzyme from rats. The N-terminal amino acid sequence of the enzyme, determined by the Edman degradation method, in 10 recovered residues was identical to that of human asparagine synthetase deduced from corresponding cDNA (I.L. Andrulis et al., 1987, Mol. Cell. Biol. 7, 2435-2443). Immunohistochemical staining of the testis showed the presence of asparagine synthetase mainly in Sertoli cells in the seminiferous tubules.

Amino Acid Sequence↗
PubMed1992

Adenomatous goitre: therapeutic strategy, postoperative outcome, and study of epidermal growth factor receptor.

A total of 377 patients with histologically proven adenomatous goitre was operated on, 34 as a second operation, and assessed for postoperative outcome (including the incidence of unsuspected malignancy) and immunohistochemical localization of epidermal growth factor receptor. In primary surgery, enucleation of all the nodules was carried out. Patients requiring reoperation showed multicystic degenerate nodules involving one or both lobes. A coexistent cancer was observed in 18 patients (4.8 per cent). The immunohistochemically detected expression of epidermal growth factor receptor in adenomatous goitre was more evident in patients with multinodular lesions. Near-total lobectomy of the involved side(s) is desirable for the prevention of recurrence and complications after operation.

Adolescent↗
PubMed1992

Heterozygosity of the major histocompatibility complex controls the autoimmune disease in (NZW x BXSB) F1 mice.

In the F1 hybrid of phenotypically normal NZW (H-2z) and systemic lupus erythematosus (SLE)-prone BXSB mice (H-2b), features of the disease became more severe than those seen in the BXSB mice, regardless of the presence or absence of the Yaa (Y-chromosome-linked autoimmune acceleration) mutant gene. To determine whether the gene(s) linked to the major histocompatibility complex (MHC) of NZW mice is involved in this event, we developed the H-2-congenic NZW.H-2d strain and compared the severity of autoimmune disease between (NZW x BXSB) F1 (H-2z/b) and (NZW.H-2d x BXSB) F1 mice (H-2d/b). The H-2z/b, but not H-2d/b, heterozygous F1 mice of both sexes showed an accelerated, higher incidence of proteinuria and a more severe thrombocytopenia than did the BXSB mice. In NZW x (NZW x BXSB) F1 backcross mice, the H-2z/b heterozygous progeny showed more severe disease than did the H-2z/z homozygotes. Thus, disease-accelerating events in (NZW x BXSB) F1 mice are linked to the H-2z/b heterozygosity. Because H-2d/z heterozygosity plays a crucial role for SLE in (NZB x NZW) F1 mice, in which SLE features differ from those in (NZW x BXSB) F1 mice, the present observations may imply that the different but related MHC heterozygosity acts as a predisposing genetic element in these different SLE syndromes.

Age Factors↗
PubMed1992

Evidence of intrathyroidal accumulation of TSH receptor antibody in Graves' disease.

To clarify the intrathyroidal accumulation of TSH receptor antibody (TR-ab) produced in the thyroid, adrenalin was injected directly into the thyroid artery of patients with Graves' disease during surgery, allowing serial determination of the TR-ab levels in the thyroidal venous blood. Nine surgical patients (3M and 6F) with Graves' disease and receiving anti-thyroid drugs preoperatively for a period of one to four years were enrolled in this study. Comparison between pre- and posttreatment TR-ab levels revealed continuous increments from the pretreatment levels within 15 min of the injection in five (55.6%) of the nine patients. In three of the five patients, TR-ab levels that had been negative before adrenalin injection became positive 1 min after injection. It is assumed that the increase in the TR-ab level is due to adrenalin-induced constriction of the capillaries in the thyroid tissues, resulting in a voluminous flow of the TR-ab retained in the thyroid into the vein. These findings indicate that the TR-ab level in the peripheral blood does not necessarily reflect precisely the abnormal immunological condition in the Graves' thyroid.

Adolescent↗
PubMed1992

[Effect of intravenous pirenzepine on hemodynamics and gastric juice volume as well as pH in surgical patients].

The effects of pirenzepine on blood pressure, heart rate and gastric juice volume as well as pH were evaluated and compared with those after atropine and cimetidine in 54 adult patients divided into five groups. Patients in Groups A, P, AP, AC and ACP received atropine, pirenzepine, atropine plus pirenzepine, atropine plus cimetidine, or atropine, cimetidine plus pirenzepine, respectively. Atropine 0.5 mg and cimetidine 200 mg were given intramuscularly 60 min before induction of anesthesia, and pirenzepine 10 mg was given intravenously 5 min before induction. Gastric juice was aspirated just after, 60 and 120 min after induction of anesthesia. Mean blood pressure and heart rate remained unchanged following intravenous pirenzepine in Group P, whereas heart rate increased significantly in Groups AP and ACP. There were no significant differences in mean volume and pH of gastric juice among the groups just after and 120 min after induction of anesthesia, although gastric volume in Group AC was significantly less than in Groups P, AP and ACP 60 min after induction. Gastric pH increased gradually and gastric volume decreased slightly following intravenous pirenzepine. The incidence of samples with a pH higher than 2.5 was greater in Group AC than in Group P just after and 60 min after induction, whereas there was no difference between the two groups after 120 min. We conclude that intravenous pirenzepine 10 mg is effective to reduce gastric juice volume and acidity, and it should be given at least 60 min before induction of anesthesia.

Adult↗
PubMed1992

Epidural opioids for postoperative pain relief following hepatectomy.

Postoperative pain relief with epidural morphine or buprenorphine and intramuscular morphine was investigated in 67 patients undergoing hepatectomy. When the patient first complained of pain after surgery, 1 or 2mg of epidural morphine, or 0.06 mg of epidural buprenorphine given either at T 10-11 or L 3-4, or 0.1 mg/kg of morphine intramuscularly was administered. Lumbar epidural morphine 2mg, as well as thoracic epidural morphine 2mg, produced excellent and long-lasting pain relief. Nine of 12 patients receiving thoracic epidural buprenorphine 0.06 mg were completely pain-free. Thoracic epidural morphine 1 mg and lumbar epidural buprenorphine 0.06 mg produced incomplete analgesia. Analgesic duration of intramuscular morphine tended to be shorter than that of 2 mg of epidural morphine. PaCO2 increased significantly following thoracic epidural morphine 2 mg, although PaCO2 did not change after lumbar epidural morphine 2 mg. No patient had serious side effects. The lumbar epidural administration of 2 mg morphine may be recommended for postoperative analgesia following hepatectomy.

Adult↗
PubMed1992

[Perioperative management of patients on maintenance hemodialysis: serum potassium and hemodynamic changes during anesthesia].

Serum potassium and hemodynamic changes were studied during anesthesia in 32 patients on chronic hemodialysis (HD) who received the last HD either 24 hours (12 patients; Group A) or 3 hours (20 patients; Group B) prior to surgery. Preanesthetic removal of body water by HD in Group A (2,400 +/- 1,100 ml) was significantly greater than that of Group B (1,200 +/- 500 ml). Preanesthetic serum potassium values were 4.7 +/- 0.6 and 4.1 +/- 0.4mEq.l-1 in Groups A and B respectively. Anesthesia was induced and maintained with N2O-O2 plus halothane or enflurane. Six patients in Group A (50%) developed hypotension during anesthesia. In contrast, hypotension was noted in only one patient (5%) in Group B. On the other hand, in Group B, 3 patients (15%) developed hyperkalemia (serum K greater than 6mEq.l-1), although no patient had hyperkalemia in Group A. The excessive removal of body water by preoperative HD should be avoided because hypotension often develops during anesthesia. Since the risk of hyperkalemia is not low, we should measure serum potassium during anesthesia when HD is performed immediately before anesthesia and removal of body water appears to be inadequate even if preanesthetic serum potassium value is normal.

Adult↗
PubMed1992

[A clinical study of the significance of the gradient between feeding arterial tissue polypeptide antigen (TPA) and draining venous TPA in assessing the risk for recurrent breast cancers].

The incidence of postoperative recurrence of primary breast cancers in 73 patients was correlated with the blood levels of tissue polypeptide antigen (TPA) in peripheral veins (V-TPA), feeding arteries (A-TPA), draining veins (V-TPA) and the gradient between the TAP levels in draining veins and feeding arteries (V-A TPA). With progression in the stage of the cancers, all parameters were increased. In stages II and III, the mean level of V-TPA was significantly higher than the mean level of A-TPA (p less than 0.05). In each stage, each parameter was increased in the patients with recurrences when compared with the levels in the patients with no recurrences. In patients with V-A TPA gradients greater than 30 U/L, the rate of recurrence was significantly higher when compared with patients with gradients less than 30 U/L (p less than 0.05). The clinical significance of this finding is that patients with V-A TPA gradient greater than 30 U/L should be closely followed because of the increased risk of recurrences.

Breast↗
PubMed1992

[Hemodynamic and catecholamine responses during enflurane anesthesia for pheochromocytoma].

Twelve patients underwent surgical removal of pheochromocytoma under enflurane anesthesia. Changes in systemic and pulmonary hemodynamics and plasma catecholamine level were studied during anesthesia. Anesthesia was slowly induced by face mask with nitrous oxide and enflurane with minimal circulatory changes. Tracheal intubation was smoothly performed using pancuronium or vecuronium without excessive catecholamine release and elevation of blood pressure. Although enflurane anesthesia did not inhibit catecholamine release during tumor manipulation, blood pressure and heart rate were controlled successfully with vasodilators such as phentolamine, prostaglandin E1 and nicardipine, and antiarrhythmic agents such as propranolol and lidocaine. We conclude that enflurane is an agent of choice for the resection of pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1992

Fine-scale mapping of the gene responsible for multiple endocrine neoplasia type 1 (MEN 1).

We have constructed a high-resolution genetic linkage map in the vicinity of the gene responsible for multiple endocrine neoplasia type 1 (MEN1). The mutation causing this disease, inherited as an autosomal dominant, predisposes carriers to development of neoplastic tumors in the parathyroid, the endocrine pancreas, and the anterior lobe of the pituitary. The 12 markers on the genetic linkage map reported here span nearly 20 cM, and linkage analysis of MEN1 pedigrees has placed the MEN1 locus within the 8-cM region between D11S480 and D11S546. The markers on this map will be useful for prenatal or presymptomatic diagnosis of individuals in families that segregate a mutant allele of the MEN1 gene.

Alleles↗
PubMed1991

Allelotype study of primary hepatocellular carcinoma.

Accumulation of mutations in oncogenes and tumor suppressor genes transforms a normal cell to a malignant cell by allowing it to escape from normal control of growth. In order to learn (a) how many tumor suppressor genes are involved in the tumor progression of hepatocellular carcinoma, (b) whether there is any association among allelic losses of chromosomes, or (c) whether integration of hepatitis B virus into host DNA influences any particular chromosomal losses, we have examined loss of heterozygosity with 44 restriction fragment length polymorphism markers in 46 cases of hepatocellular carcinoma. The markers represented all chromosomal arms except 5p, 8p, 9p, 18p, and acrocentric chromosomes. Allelic losses in tumors indicated that five tumor suppressor genes, located on chromosomes 5q, 10q, 11p, 16q, and 17p, may be involved in this cancer. However, no significant associations were observed among the various allelic losses or between the integration of hepatitis B virus and chromosomal losses. Furthermore, a deletion map for chromosome 16q indicated the localization of a tumor suppressor gene between q22 and q24 and that for chromosome 17p suggested the existence of a second tumor suppressor gene in addition to the p53 gene.

Alleles↗
PubMed1991

The problems encountered in the surgical management of primary hyperparathyroidism.

The problems encountered in the diagnosis and treatment of primary hyperparathyroidism were studied in 69 cases. The accuracy of imaging for hyperplasia was less than that for adenoma or carcinoma and the major causes for multiple operations were a failure to locate the four glands and mediastinal adenoma. The intravenous administration of high doses of calcitonin could reduce the serum calcium level of patients in hypercalcemic crisis. Carcinoma required ipsilateral modified radical neck dissection because of lymph node metastases, and non-medullary thyroid carcinoma was often associated with primary hyperparathyroidism. We found removal of the parathyroid adenoma and biopsy or extirpation of only one macroscopically normal gland to be a fully satisfactory procedure after bilateral neck exploration and attempting to identify at least four glands.

Adenoma↗
PubMed1991

Anti-triiodothyronine autoantibodies in a euthyroid woman: confirmation of immunoglobulin G antibodies employing protein A column chromatography.

The presence of thyroid hormone autoantibodies was investigated in a 48-year-old non-goitrous woman with high levels of serum total T3 and free T3. Her other thyroid function tests were normal. The presence of thyroid hormone autoantibodies were assessed in serum, acid-charcoal treated serum, IgG fractions and in a purified IgG fraction. the IgG fraction was separated from serum by a protein A-Sepharose CL-4B column chromatography and purified by gel filtration chromatography using Sephacryl S 200. Sera from normal individuals were used as controls. The results showed that the increased serum total and free T3 levels were caused by the presence of anti-T3 IgG autoantibodies. The results also indicate that protein A column chromatography is useful as a screening method for gross qualitative analyses of thyroid hormone autoantibodies.

Autoantibodies↗
PubMed1991

[The effect of intravenous injection of isosorbide dinitrate on the hypertension during general anesthesia: a multi-center controlled study].

The antihypertensive effect of intravenous injection of isosorbide dinitrate (ISDN) was evaluated in 137 patients undergoing elective surgery during general anesthesia [neuroleptanesthesia (NLA) or enflurane-nitrous oxide-oxygen-anesthesia (GOE)]. ISDN in dose of 20 micrograms.kg-1 or 40 micrograms.kg-1 was given as a bolus injection in 30 sec. ISDN produced a significant decrease in arterial pressure and central venous pressure; the maximum decrease was observed in 7 min after administration of ISDN. The antihypertensive effect of ISDN was dose-dependent, but there was no significant difference between two groups of patients given 20 or 40 micrograms.kg-1, or between those anesthetized with NLA or GOE. ISDN did not significantly alter heart rate, thereby causing a significant decrease in rate pressure product which reflects myocardial oxygen demand. The results suggest that a bolus injection of ISDN is a simple, practical and effective means of controlling hypertension during general anesthesia.

Adult↗
PubMed1991

[Hyponatremia during transurethral resection of the prostate].

In a retrospective study of 222 patients who underwent transurethral resection of the prostate under spinal anesthesia, plasma sodium levels during the operation were examined. The weight of prostate resected, the volume of irrigating fluid used and the duration of the operative procedure influenced the changes in plasma sodium levels. But, these changes were not statistically significant. The rise in central venous pressure values was associated with the absorption of irrigating fluid as evidenced by a drop in plasma sodium. The central venous pressure was monitored in 77 patients. There was a statistically significant correlation between the degree of hyponatremia and the rise in central venous pressure (P less than 0.001). The rise in central venous pressure reflected a change in the patient's cardiovascular status and it was, therefore, possible to treat the hyponatremia quickly and effectively. Central venous pressure monitoring is helpful in determining hyponatremia before it becomes clinically manifest.

Aged↗
PubMed1991

[Clinical evaluation of operative procedure for differentiated carcinoma of isthmus of the thyroid].

We studied 19 patients who had undergone operation for differentiated carcinoma of isthmus of the thyroid in Shinshu University Hospital from 1967 to 1986. Regarding the operations, total thyroidectomy was performed in 6 cases, subtotal thyroidectomy in 8 cases, lobectomy in one case and isthmectomy in 4 cases. In 12 cases, lymph node dissection was carried out. Among these 12 cases, 6 cases (50%) had evidence of metastasis. Intraglandular metastasis was found in 3 cases. There were no relationship between tumor size and nodal metastasis. From these results, we do not think that total thyroidectomy is indicated in the case of differentiated carcinoma of isthmus of the thyroid. In conclusion, subtotal thyroidectomy with bilateral modified radical neck dissection is sufficient as the operative procedure for differentiated carcinoma of isthmus of the thyroid.

Adenocarcinoma↗
PubMed1991

[General anesthesia for cesarean section in a patient with Marfan's syndrome associated with dissecting aortic aneurysm].

A 23-year-old woman with Marfan's syndrome was scheduled for Cesarean section at 31 week gestation because of progressive aortic dissection. Since she had undergone two surgical corrections for scoliosis (Harrington rod instrumentation) 5 and 12 years ago, we selected general anesthesia. She had been taking diltiazem and propranolol for hypertension and tachycardia. Anesthesia was induced with thiopental 75 mg iv followed by O2-N2O-enflurane (4%) by face mask. Following iv administration of vecuronium 4 mg and tracheal injection of 4% lidocaine 120 mg, the trachea was intubated without a significant hemodynamic change. Anesthesia was maintained with O2-N2O-enflurane (0.5-1.5%) before delivery. Following delivery, enflurane was discontinued and small doses of fentanyl iv (total 0.2 mg) were given with iv infusion of nitroglycerin (0.2-0.5 micrograms.kg-1.min-1) during surgery. Bleeding after delivery was controllable by iv infusion of oxytocin. The Apgar score was good (9 at 1 min and 10 at 5 min respectively). Post-operative course was uneventful. Therapeutic abortion or Cesarean section should be performed as soon as possible in a patient with dissecting aortic aneurysm because of increasing risk of aneurysm rupture during pregnancy. During the surgery, minimal hemodynamic changes are required to prevent the rupture.

Adult↗