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Biomedical subjects

M Shirahama

Publications and source records attributed to M Shirahama.

At least 37 records · Page 2Linked to original sources
PubMed1992

Intestinal anisakiasis: US in diagnosis.

Eighteen consecutive patients with intestinal anisakiasis were studied with high-resolution ultrasound (US) and barium studies. US showed markedly thickened bowel loops associated with luminal narrowing, swelling of Kerckring folds, and decreased peristalsis. A small amount of ascitic fluid around the bowel loops was found, and cytologic examinations of the ascites revealed a dense infiltration of eosinophils. Barium studies demonstrated segmental mucosal edema of the small intestine: The most common site was the distal ileum, and the mean length of the edematous lesion was 19 cm. All patients underwent treatment of symptoms without laparotomy, and their symptoms disappeared by the eighth day after onset. Patients with acute abdominal symptoms should be asked about the intake of raw or undercooked fish. If the above US features are found, the diagnosis of intestinal anisakiasis must be seriously considered to avoid unnecessary surgical treatment.

Adult↗
PubMed1992

[Information value of clinical signs and stat tests as indicators of female outpatient urinary tract infection].

This study was designed to evaluate signs and stat tests as an indicator of lower urinary tract infection in female subjects with urogenital complaints at an out-patient clinic. Of various symptoms including hematuria, pollakiuria, dysuria, urinary retention, and micturition pain, pain during micturition was present in 48% of 25 patients with urinary tract infections and in 4% of 27 patients without urinary tract infections, and was the sign with the highest positive predictive value. Comparison and discrimination of the infection and non-infection groups using a single laboratory valuable yielded significant F-statistics for urinary leukocyte esterase (14.5) and leukocyte count in urinary sediment (31.1), and revealed large Mahalanobis' distances for the same variables. Multivariate analysis using a discriminant function of categorical data (Hayashi's Suryoka type 2) revealed that combining occult blood with leukocyte esterase in the urine or combining red cell count with leukocyte count in sediment did not yield substantially smaller misclassification error than did leukocyte esterase alone or leukocyte count alone. It was concluded that neither urinary occult blood nor red cell count in sediment contribute substantially to the prediction of urinary tract infection. For the purpose of detecting urinary tract infection among outpatients, a receiver-operating characteristic analysis demonstrated that the optimal cut-off point in sediment was 3 or more leukocytes per microscopic high power field (x 400). Urinary leukocyte esterase was found to have limitations for use in screening, because its optimal decision level is equivalent to trace esterase reading on the dipstick test.

Ambulatory Care↗
PubMed1991

Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson's disease.

Wilson's disease associated with hepatic failure is not common and the underlying mechanism triggering the event is not known at present. We treated a 28-year-old Japanese woman with Wilson's disease who developed hepatic failure associated with hemolytic crisis just after delivery. She was diagnosed as having Wilson's disease at 12 years of age, at which time she started taking D-penicillamine. She had previously delivered two children without difficulty. When she found out she was pregnant this time, she stopped taking D-penicillamine in contrast to taking it faithfully during her first two pregnancies. On the day of delivery of her full-term baby, jaundice developed accompanied with severe hemolytic crisis. Plasma exchanges and blood transfusion were performed and D-penicillamine administration was started again. She gradually recovered and apparently was following a good clinical course. However, on day 30 the second hemolytic crisis occurred and subsequent liver failure led her to death on day 50. At autopsy her liver was cirrhotic and showed massive necrosis. Prophylactic oral administration of D-penicillamine and careful observation are therefore recommended to prevent hemolytic crisis during the perinatal period.

Adult↗
PubMed1991

[Relationship between referral and patient characteristics].

In order to evaluate the relationship between referral and patient characteristics, 594 new patients utilizing Saga Medical School general clinic were studied using a questionnaire and chart review. Results obtained are as follows: 1) Fifty-eight patients (10%) came for follow-up of mass screening tests, 174 patients (29%) were self-referral, the remaining 362 patients (61%) were under previous care by other physicians. Only 64 patients (11%) had a referral letter. 2) Those patients who were not advised to visit our clinic by non-medical personnel, patients who were seriously ill, elderly patients, residents in distant area, and those with medical problems tended to have a referral letter. 3) Of the 64 patients having referral letters, 15 (23%) took the initiative in asking their previous doctor to write a referral letter. Patients who were highly educated had a greater tendency to request referral letters. 4) The reasons cited by the patients without a referral letter included "Did not think of the necessity" (22%), "Wanted to confirm diagnosis" (22%), "Did not want to make the doctor lose face" (16%), "No improvement in symptoms" (14%) These results indicate that education of patients and the general public, and establishing good physician-patient communication and trust are necessary for increasing the use of referral letter.

Adult↗
PubMed1990

[A case of remission in metastatic lung tumor from hepatocellular carcinoma after combined CDDP and PSK therapy].

Discussed is the case of a 71-year-old man with multiple large hepatocellular carcinomas. His serum AFP level had markedly increased to 115 X 10(4) ng/ml. His AFP level also elevated and multiple lung metastatic tumors appeared after the second TAE therapy of 30 mg ADM, 10 mg MMC. To arrest these rises 100 mg of CDDP was given intravenously, followed by 3.0 g/day of PSK given orally. Five months later, shadows of the metastatic tumor disappeared and AFP to 540 ng/dl. As the mechanism responsible this improvement, it is felt that the CDDP attacked the metastatic tumors directly, and that this was aided by the follow-up immunotherapy with PSK. The abscopal effect of TAE also may have played a role.

Adjuvants, Immunologic↗
PubMed1990

Secretion of an interleukin 1-like activity by acute monocytic leukemia cells which inhibits growth of fibroblasts.

Acute monocytic leukemia cells (AMoL cells), obtained by leukapheresis, were cultured in vitro. In response to lipopolysaccharide, AMoL cells produced a large amount of thymocyte proliferation activity. The crude supernatants from AMoL cells inhibited fibroblast growth, in a dose-dependent manner. Upon gel filtration, the thymocyte proliferation activity had a molecular mass of 37,000 and 17,000 daltons, and was heat labile and fairly resistant to freezing and thawing. The fractions containing thymocyte proliferation activity additionally possessed an inhibitory activity for the growth of fibroblasts. These results suggest that AMoL cells may participate in the progress of the disease (leukemia), by secreting these cytokines.

Adult↗
PubMed1990

[A study of familial case histories of hepatocellular carcinoma--285 cases in Saga Prefectural Hospital].

We studied whether familial case histories of a liver cancers might be associated with the high mortality rate from liver cancers in Saga prefecture. Examined were 285 familial case histories of a hepatocellular carcinoma (HCC) incurred by parents, siblings, and children during the past 10 years. Familial case histories of patients with a gastric cancer and/or apoplexy also were studied as controls. The incidence of various types of cancers, including liver cancers and gastric cancers, in the family members of the HCC group was found to be the same as seen in family members of the gastric cancer group, but higher than in the families of the apoplexy group. Further, the HCC incidence rate in family members in the HCC group was not high as compared to the average for the whole of Japan. The HBsAg was not found to be associated with the rate of liver cancer in family members in the HCC group. Also, there was no high incidence of liver cancer was observed in children of parents with a liver cancer. From these results, we have concluded that high incidence of liver cancer seen in Saga prefecture was not associated with any familial clustering of HCC cases.

Adolescent↗
PubMed1989

[Analysis of 293 cases of hepatocellular carcinoma of recent ten years--I. Epidemiology, anamnesis and tumor occupying rate].

Two hundred and ninety-three cases of hepatocellular carcinoma (HCC) admitted to the key hospital of the rural area of western Japan, Saga Prefectural Hospital, during 10 years since 1979 to 1988 were analysed retrospectively. The male to female ratio was 3.7 to 1 and the ratio of HBs-Ag positive to negative was 3.5 to 1. The peak of the age distribution was seventh decade. The incidence increased annually, especially in HBs-Ag negative males. Their past history of blood transfusion was considered as an etiology of HCC in 19 (9.9%). The HCC was diagnosed approximately 10 years earlier in habitual drinkers than non-habitual drinkers of both positive and negative HBs-Ag. The incidence of small tumors is associated with the past history of chronic liver disease, negativity of HBs-Ag, lack of symptoms and old age.

Adult↗
PubMed1989

[Analysis of 293 cases of hepatocellular carcinoma of recent ten years--II. Diagnosis, therapy and prognosis].

Two hundred and ninety-three cases of hepatocellular carcinoma (HCC) of recent ten years during 1979 and 1988 were analysed on its diagnosis, therapy and prognosis. Angiography was the most useful diagnostic method for the first 5 years. During recent 5 years and for the tumor with size less than 2 cm, however, ultrasonography was the best method. 24.7% cases showed negative AFP and only 42.5% cases showed the level over 400 ng/ml. According to the tumor occupying-rate at the diagnosis, the number of cases of E1 had increased annually, the other cases being unchanged. 88.6% cases had liver cirrhosis microscopically as being reported previously. As a therapy TAE was most frequently performed, followed by operation, arterial infusion of antitumor drugs et al. The prognosis of the patients depended on the tumor occupying-rate. For the case of E1, the prognosis was the best by the therapy of ethanol injection therapy, operation and TAE. For the cases with tumor of larger than E1, frequent TAE was the best. From these results we concluded that we must make efforts to find small tumors to get the good prognosis.

Adult↗
PubMed1989

[A clinico-pathological study of hepatocellular carcinoma patients with other primary malignancies].

In examining 293 patients with a hepatocellular carcinoma (HCC), 27 patients (9.2%) were found to have another primary malignancy located elsewhere. Of this number, fifteen were male and twelve were female, with ages that ranged from 53 to 81 years (mean 67.3 + 8.9 years). Twenty-four of these patients were found to have two other malignancies, where in 13 had both malignancies with a one year interval and other 11 after more than one year. The remains, three patients, had triple malignancies. These associated cancers included eight gastric cancers, four uterine, four colon cancers and other such cancers. The proportion of females with double cancers was higher than in those with only an HCC, although there were no difference in the HBsAg, age, past history of blood transfusion, the positive rate of familial malignancy, and the HCC between those with solely an HCC and those with other cancers as well. This suggests that the occurrence of an HCC concomitant with or followed by the development of another primary malignancy is not rare.

Aged↗
PubMed1988

Human Ia-associated invariant chain gene has multiple transcription initiation sites in CLL cells.

We show a northern transfer experiment revealed two mRNA of Ia-associated invariant chain (In) gene in chronic lymphocytic leukemia (CLL) cells which are approximately 1580 and 1440 nucleotides in length. Primer extension experiment shows that less prominent transcript was found to initiate 140 nucleotides upstream from the major cap site. The newly identified cap site was preceded by CG rich sequence but no typical promotor sequence. Southern hybridization analysis with In cDNA probe indicates no recombination or amplification of In gene in the CLL cells. This is the first documented example of such a mode of expression in malignant cells in vivo.

Base Sequence↗
PubMed1988

Lack of evidence for a pyruvate kinase isozyme shift in hepatocytes of the regenerating rat liver.

1. Pyruvate kinase isozyme shift in a regenerating rat liver was studied. Rats were subjected to a 70% hepatectomy and the liver homogenate or hepatocyte preparations were obtained from the regenerating liver. 2. Using thin layer polyacrylamide gel electrophoresis, liver homogenates from an intact normal rat appeared to contain the L-type isozyme in the greatest number and M2-type to a lesser extent. 3. The ratio of the M2- to L-type increased in the preparations obtained from the regenerating liver. 4. In the hepatocyte preparations prepared from a regenerating rat liver by the conventional method, a small amount of M2-type isozyme was detected. 5. However, the M2-type isozyme was hardly detected in the highly purified hepatocyte preparations prepared using Percoll. 6. Similar results were obtained by separation of the enzyme by DEAE cellulose column chromatography. 7. These results suggest that there is no pyruvate kinase isozyme shift from L- to M2-type in hepatocytes in the course of regeneration. 8. The increased M2-type isozyme in the regenerating rat liver is considered to originate from nonparenchymal cells.

Animals↗
PubMed1988

Kupffer cells may autoregulate interleukin 1 production by producing interleukin 1 inhibitor and prostaglandin E2.

Rat Kupffer cells stimulated with bacterial lipopolysaccharide (LPS) produced high levels of interleukin 1 (IL-1), as determined by thymocyte proliferation assay. Indomethacin revealed a dose-dependent augmentation in IL-1 production, in parallel with a dose-dependent reduction in prostaglandin E2 production by Kupffer cells. The addition of exogenous prostaglandin E2, dibutyryl cAMP, or isoproterenol led to a dose-dependent suppression of IL-1 production. The supernatant from LPS-stimulated Kupffer cells also contained factors that inhibited IL-1-induced thymocyte proliferation. Upon gel filtration, two inhibitory peaks, at apparent MW of 27,000 and 6000, were obtained. The latter but not the former fraction also affected interleukin 2 (IL-2)-induced thymocyte proliferation. Increasing amounts of IL-1 overcame the inhibitory activity derived from the 27,000 MW fractions. These results suggest to us that prostaglandin E2 and IL-1 inhibitor released by Kupffer cells may be involved in negative self-control in regulating IL-1 production and its action.

Animals↗
PubMed1988

Production of hepatocyte stimulating factor of rat Kupffer cells induced by lipopolysaccharide: partial characterization and effects on alpha 2 macroglobulin gene expression in cultured adult rat hepatocytes.

Primary cultured rat Kupffer cells stimulated with lipopolysaccharide (LPS) produced a hepatocyte stimulating factor (HSF), which enhanced the synthesis of acute phase protein, alpha 2-macroglobulin (alpha 2M), in adult rat hepatocytes. The Kupffer cell derived-HSF (KC-HSF), enhanced the synthesis of alpha 2M over 100 fold by primary cultured adult rat hepatocytes, in the presence of dexamethasone (Dex). The synthesis of albumin was not stimulated by the factor, even in the presence of Dex. The alpha 2M mRNA increased exponentially starting at 3 hr after addition of the factor. Therefore, the synthesis of alpha 2M stimulated by KC-HSF is probably controlled at the pretranslational phase. The LPS stimulated production of the KC-HSF was inhibited by actinomycin D. The HSF was precipitated between 35% and 65% saturation with ammonium sulfate and collected in the over 30,000 daltons fraction, by molecular sieving. Sephacryl S-200 gel chromatography revealed two distinct forms of HSF with apparent molecular weights of approximately 30,000 and 100,000 daltons. The majority of the activity was recovered in the latter fraction. Isoelectric chromatofocusing of the 100,000 daltons form of HSF yielded a single peak of activity with an apparent isoelectric point (pI) of 4.2. Each fraction contained the interleukin-1 (IL-1) activity, determined by thymocyte proliferation assay. These results show that Kupffer cells produce a cytokine, KC-HSF with IL-1 activity but different properties, as seen on the on Sephacryl S-200 gel filtration and isoelectrofocusing from known mouse or human IL-1.

Animals↗
PubMed1988

Kinetics and parameters of the induction of interleukin 1 secretion by rat Kupffer cells.

Rat Kupffer cells stimulated with bacterial lipopolysaccharide (LPS) produced high levels of interleukin 1 (IL-1), determined by assaying the thymocyte proliferating activity. The unstimulated Kupffer cells secreted no detectable activity. LPS-induced production of IL-1 activity was dose-dependent and as little as 0.1 micrograms/ml of LPS induced the IL-1 production. Thirty minutes were required for LPS to induce sufficient amounts of IL-1 activity. IL-2 activity was not detected in the Kupffer cell culture medium. Another soluble agent, N-acetylmuramyl-L-alanyl-D-isoglutamine, or phagocytable agents, silica and zymosan, also stimulated IL-1 production by Kupffer cells, whereas phorbol myristate acetate did not. Kinetic studies revealed a rapid increase in both intra- and extracellular IL-1 activity within 1 hr following the addition of LPS, with a peak at 6 hr. This IL-1 activity produced by Kupffer cells was heat labile, resistant to freezing and thawing and precipitated with 65% ammonium sulfate. Upon gel filtration, the activity was present in three peaks of approximately 110, 35 and 15 kd. The hepatocyte stimulating activity, when assayed by alpha 2-macroglobulin inducing activity, was detected in the first two peaks but not in the third peak. These studies suggest that LAF activity is distinct from hepatocyte stimulating activity at least in the molecular weight.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1987

Differentiation of mononucleosis from hepatitis by sonographic measurement of spleen size.

Spleen size in patients with infectious mononucleosis (IM) was measured using ultrasound, and the findings were compared with data obtained in cases of acute viral hepatitis (AVH). The size was expressed as the spleen index (SI) or the product of the longitudinal and transverse diameters, expressed in cm2, of the maximum cross-sectional area of the spleen. A normal value obtained from 28 healthy individuals was 15 +/- 7 cm2. The SI (mean +/- SD) of patients with AVH and IM were 38 +/- 7 cm2 and 88 +/- 26 cm2, respectively. When the SIs were divided into five groups--grade 0 (0-25), grade I (26-50), grade II (51-75), grade III (76-100), and grade IV (100+), 83.3% of the patients with AVH were graded as Grade 0 or I, whereas 88.9% patients with IM belonged to higher grades. Splenomegaly with a SI value over 75, grade III or IV, strongly suggests IM when IM and AVH are being considered in the absence of other potential causes of splenomegaly. Because the clinical features of IM sometimes resemble those of AVH, it is often difficult to differentiate the two entities. The measurement of spleen size could be a significant supplemental aid in the diagnosis of IM in primary medicine, before clinical data can be obtained.

Adult↗