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T Nishimura

Publications and source records attributed to T Nishimura.

At least 361 records · Page 20Linked to original sources

[A case of pulmonary arteriovenous fistula beneath the surface of the lung].

A 19-year-old woman complaining of exertional dyspnea was admitted to our hospital with an abnormal shadow on the left side of the chest. Laboratory examination revealed polycythemia and hypoxemia. Pulmonary angiogram demonstrated a pulmonary arteriovenous fistula beneath the surface of the left S10. Partial resection of the left S10 was performed. The wall of the arteriovenous fistula was flimsy and seemed to rupture easily. The sister of this patient also had a peripheral pulmonary arteriovenous fistula and suffered from repeating epistaxis. Rendu-Osler-Weber disease was diagnosed in both, and the sister underwent partial resection of the right S7, which contained the fistula. Their postoperative courses were uneventful. Hemothorax and hemoptysis are lethal complications of arteriovenous fistulae. In order to avoid the rupture of fistulae, surgical resection is the most reliable treatment. Pulmonary arteriovenous fistulae beneath the surface of the lung should be resected.

Adolescent↗

SPECT findings in mitochondrial encephalomyopathy.

UNLABELLED: We investigated the alterations in regional cerebral blood flow (rCBF) in mitochondrial encephalomyopathy (MEM), using [123I]N-isopropyl-p-iodoamphetamine (IMP) or 99mTc-hexamethyl propyleneamine oxime SPECT in 10 MEM patients. METHODS: Four of the patients had MEM with lactic acidosis and strokelike episodes (MELAS), 2 had Kearns-Sayre syndrome (KSS), 1 had myoclonic epilepsy with ragged red fibers (MERRF) and 3 had cytochrome C oxidase deficiency (CCOD). Cerebral perfusion reserve was obtained from 6 patients (3 MELAS, 1 MERRF, 1 KSS, 1 CCOD) for a comparative analysis using the split-dose 123I-IMP SPECT method before and after the injection of acetazolamide. RESULTS: All patients with MELAS showed focal hypoperfusion in the parietal and/or occipital lobes. Follow-up studies (3 MELAS patients) revealed extension or improvement in the abnormal perfusion. The hypoperfused lesions were correlated with abnormal CT/MRI findings. Perfusion was normal in 1 MERRF, 2 KSS and 3 CCOD patients, whereas CT/MRI findings in 1 MERRF, 1 KSS and 1 CCOD patient were abnormal. The cerebral perfusion reserve in 3 MELAS patients was decreased significantly compared with that in patients with other types of MEM (MELAS 7.4%, other MEM 33.8%; p < 0.05). CONCLUSION: The rCBF was altered specifically in patients with MELAS, suggesting that brain perfusion SPECT will be useful in diagnosing and assessing such patients. The decreased cerebral perfusion reserve in patients with MELAS may represent an important feature of the pathogenesis of the strokelike episodes. The SPECT findings of patients with other types of MEM (MERRF, KSS and CCOD) were normal.

Adolescent↗

[Identification of aneuploids in uncultured amniotic fluid cells by interphase fluorescence in situ hybridization].

We report the diagnosis of aneuploids in uncultured amniotic fluid cells by the use of interphase fluorescence in situ hybridization (FISH). About a dozen of cases was studied to detect chromosome aneuploids (trisomies 13, 18 and 21, and monosomy X), especially those in the perinatal period. Results of FISH experiments in each specimen were compared with those of conventional chromosome analysis, and showed no discrepancy between them in most cases. FISH analysis revealed that four 18-trisomies had two different cells, one of which showed two fluorescence signals and the other three signals, the result indicating a maternal cell contamination. Thus, special attention should be paid when FISH analysis is adopted to the diagnosis in uncultured amniotic fluid cells in order to avoid misdiagnosis that may originate in maternal cell contamination.

Amniotic Fluid↗

Basic and clinical studies on the measurement of tau protein in cerebrospinal fluid as a biological marker for Alzheimer's disease and related disorders: multicenter study in Japan.

The development of a diagnostic marker for earlier and more accurate clinical diagnosis of Alzheimer's disease (AD) is essential to identify AD patients during life unequivocally. The purpose of this study was to investigate the basic performance and clinical significance of tau level measurement in the cerebrospinal fluid (CSF) using an enzyme-linked immunosorbent assay (ELISA) developed by Innogenetics. The ELISA system showed reliable reproducibility and good linearity. For clinical studies, the CSF samples from a variety of patients (n = 332) were examined. They were classified into the four groups: Alzheimer's disease (AD); neurodegenerative disease (ND); cerebrovascular diseases (VD); and a neurological control (NC) group. The CSF-tau levels for AD, ND, VD and NC were 426 +/- 234 pg/ml, 239 +/- 157 pg/ml, 216 +/- 136 pg/ml, and 188 +/- 103 pg/ml, respectively. The CSF-tau level of the AD group was significantly higher than that of the other groups (p < 0.001). The CSF-tau levels increased during follow-up. The measurement of the tau level in CSF is shown to be a useful marker to confirm a clinical diagnosis of AD.

Aged↗

[A comparison of a 3 day course with a 2 week course of oral prednisolone in patients with chronic asthma].

To investigate an appropriate duration of short course of a oral prednisolone (PSL), we compare the results of a 3 day course of PSL (3D) with those of a 2 week course of PSL (2W) in 20 patients with chronic asthma. All subjects had been inhaling beclomethasone dipropionate (BDP, mean daily dose: 1325 micrograms), and had been self-monitoring their peak expiratory flow rate (PEF) for at least 6 months. Mean +/- SE of the best PSL-induced PEF in 2W (2W-best) was not different from that in 3D (397 +/- 29 and 356 +/- 23 L/min, respectively, p = 0.26). Mean weekly morning PEF/2W-best before and 1, 2, 3 and 4 weeks after PSL was 60, 76, 80, 76 and 76% in 2W, and 63, 73, 67, 67 and 65% in 3D, respectively. Both changes over the course of time were significant. The frequency of emergency room visits and/or unscheduled hospital visits was not significantly different between 2W and 3D. However, both the frequency of use of inhaled beta 2 agonists and the symptom score significantly decreased only in 2W. Seven patients (35%) did not need additional oral PSL during the 4-week period after initiating 3D, and among these patients, emergency room visits and/or unscheduled hospital visits were completely controlled. In conclusion, although the effect of 3D was inferior than that of 2W, it was a sufficient duration in 35% of the patients, and thus, may be appropriate as a initial duration of rescue course of oral steroids.

Administration, Oral↗

[Two cases of solitary peripheral pulmonary arterial aneurysm].

We report two very rare cases of solitary peripheral pulmonary arterial aneurysm. Case 1: An 83-year-old man treated for myocardial infarction died of multiple organ failure and hemoptysis. Autopsy disclosed rupture of a pulmonary arterial aneurysm 1.5 cm in diameter in the right A3. Case 2: A 75-year-old man was found to have a pulmonary arterial aneurysm, 3 cm in diameter of the right A1. Surgical treatment was not indicated, because of severe pulmonary emphysema. The aneurysms in these two cases were idiopathic: (1) there were no histologic findings that would implicate specific chronic inflammation. (2) the period from the occurrence of secondary pulmonary hypertension to hemoptysis was short, and there was no (3) history of trauma.

Aged↗

Iodine-123-iomazenil and iodine-123-iodoamphetamine SPECT in major cerebral artery occlusive disease.

UNLABELLED: Iodine-123-iomazenil (IMZ) is a SPECT ligand for central-type benzodiazepine receptors, which are located only on neurons. We evaluated the feasibility of using IMZ SPECT for identifying neuronal damage in patients with the chronic phase of thrombotic cerebral ischemia. METHODS: We studied 15 patients with angiographically-confirmed unilateral severe occlusive lesions (occlusion or > 70% stenosis) in the carotid system. IMZ SPECT images obtained 180 min after injection of 167-222 MBq IMZ were analyzed. The regional cerebral blood flow and perfusion reserve were evaluated for comparison with IMZ SPECT findings, using the split-dose 123I-iodoamphetamine (IMP) SPECT method, coupled with intravenous injection of 1 g acetazolamide. On both SPECT images, the count ratio of the affected to the nonaffected whole MCA territory (A/NA ratio) and of the contralateral to the ipsilateral cerebellar cortex (C/I ratio) were determined. RESULTS: The A/NA ratio with IMZ was significantly higher than that with IMP (94.5% +/- 6.2% versus 91.4% +/- 6.6%, p < 0.005), although a significantly positive correlation was found between these two ratios (r = 0.854, p < 0.0001). The C/I ratio with IMP was decreased significantly in 5 patients compared with that in normal subjects, whereas the C/I ratio with IMZ was decreased in only 1 patient. There was no significant correlation between the A/NA ratio with IMZ and the perfusion reserve in the affected MCA territory. In 2 of 5 patients with a decreased A/NA ratio (<90%) with IMZ, decreased blood flow with preserved perfusion reserve and cerebral hemispheric atrophy were observed, which suggested the influence of neuronal loss due to chronic ischemia. CONCLUSION: These findings indicate that IMZ SPECT, which provides new information regarding neuronal damage after ischemic insult to the brain, is useful for evaluating thrombotic cerebral ischemia.

Amphetamines↗

Surgical outcome on combined procedures of lens extraction, intraocular lens implantation, and vitrectomy during removal of the epiretinal membrane.

BACKGROUND AND OBJECTIVE: The authors evaluated the outcome of combined procedures of lens extraction, intraocular lens implantation, and vitrectomy during procedures for the removal of the epiretinal membrane, and attempt to clarify which factors affected the outcome of surgery. PATIENTS AND METHODS: Surgery for the removal of the epiretinal membrane was performed and a 2-year follow-up program was maintained for 32 eyes at the authors' clinic during the past 5 years. The combined procedure was undertaken in 15 eyes, whereas a simple vitrectomy was performed in 17 eyes. Results were analyzed by postoperative ophthalmoscopic and slit-lamp examinations for visual acuity and complications. RESULTS: Six months after surgery, visual acuity improved similarly in both groups. But, 2 years after surgery, 11 eyes (65%) that underwent a simple vitrectomy showed decreased visual acuity due to the advancement of cataracts. The postoperative visual acuity at 6 months correlated to preoperative visual acuity, and the advancement of cataracts tended to correlate inversely to the age of the patients. Major complications did not occur in any of the cases. CONCLUSION: Earlier surgical management is better for treatment of the epiretinal membrane, and a combined procedure has advantages in cost reduction and is less troublesome, especially for elderly patients.

Adult↗

Fluorine-18-fluorodeoxyglucose PET identification of cardiac metastasis arising from uterine cervical carcinoma.

Cardiac metastasis of uterine cervical carcinoma is rare. We describe a patient with a past history of uterine cervical carcinoma who presented with metastasis to the heart, lungs and distant lymph nodes 3 yr after surgery and chemotherapy. Since the patient complained of chest pain and demonstrated electrocardiogram abnormalities, we performed echocardiography, electron beam CT and MRI, which revealed a tumor in the right ventricular wall. The tumor was assessed by 67Ga scintigraphy and 18F-fluorodeoxyglucose (FDG) PET scanning. The mean differential 18F-FDG uptake ratio of the tumor was 7.9, suggesting malignancy, which was later confirmed by myocardial biopsy. Information about the extent of the tumor and partial necrosis within it was provided by 18F-FDG PET. Although both radionuclide imaging techniques also detected metastatic lesions in the lungs and lymph nodes, 18F-FDG PET scanning detected small lesions more sensitively than 67Ga scintigraphy.

Adult↗

[Evaluation of clinical utility of 99mTc-MIBI scintigraphy in the localization of thyroid, breast and lung/mediastinum tumors--a report of multicenter phase III clinical trials].

Phase III clinical study in 136 patients diagnosed or strongly suspected of thyroid, lung/mediastinum or breast cancer was performed to determine clinical utility of 99mTc-MIBI in the localization of tumors, and the results in 135 were evaluated. Except taste peculiar in 43 patients and nausea in one, no adverse events were reported. Seven abnormal changes in vital signs and 27 in clinical laboratories were noted, which were all judged as having no or unlikely relationship to the agent. Out of 177 malignant lesions, 156 (88%) were detected with 99mTc-MIBI regardless of their histology or location. Of 6 benign tumors, 3 were detected. Fifteen sites of false positive in 11 malignant tumor patients and 5 sites in 6 patients with non-tumor disease were observed. Our study indicates that 99mTc-MIBI is a safe and excellent agent for the localization of tumors. Especially, the fact that 99mTc-MIBI detected remote metastatic lesions with high sensitivity is a great advantage over the other conventional imaging modalities.

Adult↗

Manipulation of Th1/Th2 balance in vivo by adoptive transfer of antigen-specific Th1 or Th2 cells.

We have investigated the possibility that the Th1/Th2 balance in vivo may be modulated by adoptive transfer of Th1 or Th2 cells induced in vitro. Thl cells were induced from I-Ad-binding OVA323-339-specific T-cell receptor-transgenic (TCR-Tg) mouse spleen cells by culturing with OVA323-339 peptide and antigen presenting cells (APC) in the presence of IL-2, IL-12 and anti-IL-4 mAb. Th2 cells were induced from TCR-Tg mouse spleen cells by culturing with IL-2, IL-4 and anti-IL-12 mAb in addition to OVA323-339 plus APC. Immunomodulating activities of both Th1 and Th2 cells were determined by their effect on delayed type hypersensitivity (DTH) responses or cytokine production. No significant DTH responses (footpad swelling) were observed in untreated BALB/c mice following a single injection of OVA323-339-pulsed syngeneic spleen cells. However, adoptive transfer of Th1 cells into BALB/c mice induced strong dose dependent DTH responses in response to I-Ad-bound OVA323-339 but not unrelated peptide. In contrast, only slight DTH responses were detected in BALB/c mice transferred with Th2 cells. In parallel with the DTH responses, increased levels of serum IFN-gamma were demonstrated in mice adoptively transferred with Th1, while no significant increase was observed in Th2-transferred mice. In vitro analysis also demonstrated that both spleen cells and popliteal lymph node cells prepared from Th1-transferred mice showed Th1-type cytokine production, while cells obtained from Th2-transferred mice revealed Th2-dominant cytokine production. Such immune deviation induced by antigen-specific Th1 cells was demonstrated up to three months after cell transfer. Therefore, it may be possible to manipulate the Th1/Th2 balance in vivo by adoptive transfer of antigen-specific Th1 or Th2 cells.

Adoptive Transfer↗

Actions of barium on rapidly inactivating potassium current in bullfrog sympathetic neurons.

Whole-cell/voltage-clamp recordings were made from dissociated bullfrog sympathetic neurons to examine the inhibitory actions of barium (0.01-3 mM) on a rapidly inactivating A-type potassium current (IA). The IC50 value was about 0.9 mM. Barium (1 mM) approximately halved the maximum amplitude of IA (approximately 1.7 nA near 0 mV) without significantly affecting a voltage for the 50%-activation (approximately -40 mV) and that for the 50%-inactivation (approximately -90 mV), nor did it affected the time course of IA. The results suggest that the barium block is independent of the kinetics of the A-channels in bullfrog sympathetic neurons.

Animals↗

Screening of fungal beta-xylanases for production of acidic xylooligosaccharides using in situ reduced 4-O-methylglucuronoxylan as substrate.

Fungal beta xylanases were screened for production of acidic xylooligomers from 4-O-methylglucuronoxylan. In situ reduced hardwood xylan was used as substrate because the products of neutral- and acidic-branched xylooligomers help define substrate specificity of the enzymes. Borohydride reduction in situ transformed 30% of 4-O-methyl-alpha-D-glucopyranosyluronic acid residues into 4-O-methyl-alpha-D-glucopyranosyl residues and reduced C-1 end groups in the xylan backbones. A total of ten beta-xylanase fractions from four fungi were partially purified by chromatography by anion exchange and molecular sieving, and graded qualitatively for enzymatic hydrolysis of the substrate. The yield of acidic xylooligomers was highly affected by whether alpha-glucuronidases were present in the beta-xylanase fractions. Some fractions gave free 4-O-methyl-alpha-D-glucopyranosyluronic acid, but none of the enzyme fractions could release free 4-O-methyl-alpha-D-glucose. Among the beta-xylanase fractions studied, xylanase II of Trichoderma viride was the best producer of aldotetraouronic acid [2-O-(4-O-methyl-alpha-D-glucopyranosyluronic acid)-D-xylotriose]. The results obtained suggested that there was a difference in the steric hindrance of the branch point on fungal beta-xylanases between 4-O-methyl-alpha-D-glucopyranosyl and 4-O-alpha-D-glucopyranosyluronic acid residues.

Basidiomycota↗

Failure of parturition in mice lacking the prostaglandin F receptor.

Mice lacking the gene encoding the receptor for prostaglandin F2alpha (FP) developed normally but were unable to deliver normal fetuses at term. Although these FP-deficient mice showed no abnormality in the estrous cycle, ovulation, fertilization, or implantation, they did not respond to exogenous oxytocin because of the lack of induction of oxytocin receptor (a proposed triggering event in parturition), and they did not show the normal decline of serum progesterone concentrations that precedes parturition. Ovariectomy at day 19 of pregnancy restored induction of the oxytocin receptor and permitted successful delivery in the FP-deficient mice. These results indicate that parturition is initiated when prostaglandin F2alpha interacts with FP in ovarian luteal cells of the pregnant mice to induce luteolysis.

Animals↗

Assembly and regulation of the CD40 receptor complex in human B cells.

CD40 is a member of the tumor necrosis factor (TNF) receptor superfamily. Studies with human B cells show that the binding of CD154 (gp39, CD40L) to CD40 recruits TNF receptor- associated factor 2 (TRAF2) and TRAF3 to the receptor complex, induces the downregulation of the nonreceptor-associated TRAFs in the cell and induces an increased expression of Fas on the cell surface. Combined signaling through the interluekin 4 receptor and CD40 induces an increased expression of Fas with a commensurate increase in the level of TRAF2, but not TRAF3, that is recruited to the receptor complex. In contrast, engagement of the membrane immunoglobulin and CD40 limits Fas upregulation and reduces the recruitment of TRAF2, relative to TRAF3, to the CD40 receptor complex. These studies show that the TRAF composition of the CD40 receptor complex can be altered by signals that influence B cell differentiation.

B-Lymphocytes↗

The role of phorbol ester-sensitive protein kinase C isoforms in lymphokine-activated killer cell-mediated cytotoxicity: dissociation between perforin-dependent and Fas-dependent cytotoxicity.

Treatment of lymphokine-activated killer (LAK) cells with phorbol ester (PMA) caused the downmodulation of LAK activity concomitantly with the inhibition of serine esterase (SE) release, which has been shown as a marker for perforin-dependent cell-mediated cytotoxicity. The reduction of perforin-dependent LAK activity by PMA-treatment appeared to be due to the disappearance of PMA-sensitive protein kinase C (PKC) isoforms such as PKC alpha, gamma, epsilon, theta. In contrast, Fas-mediated LAK activity was refractory against PMA-induced downregulation. Treatment of LAK cells with PMA caused a disappearance of cytotoxicity against Fas L5178Y tumor cells, while cytotoxicity against Fas+ transfectants was not affected by PMA treatment. Moreover, Fas-mediated LAK activity of perforin-knockout mice was not inhibited by PMA treatment. These results clearly demonstrated that Fas-mediated cytotoxicity could be dissociated from perforin-mediated cytotoxicity by their different requirement of PMA-sensitive PKC isoforms.

Animals↗

Involvement of IL-4-producing Vbeta8.2+ CD4+ CD62L- CD45RB- T cells in non-MHC gene-controlled predisposition toward skewing into T helper type-2 immunity in BALB/c mice.

It was found that freshly isolated BALB/c CD4+ T cells produced high levels of IL-4 and IL-10 in response to immobilized anti-CD3 mAb, while C57BL/6 CD4+ T cells produced low amounts of IL-4 and IL-10. The high IL-4-producing ability of BALB/c mice was demonstrated to be genetically dominant and it was controlled by non-MHC gene (or genes). The cells responsible for IL-4 production in BALB/c mice were defined as TCRVbeta8.2+ CD4+ CD62L- CD45RB- memory-type T cells, which were distinct from NK1.1+ CD4+ NKT cells. Although these memory-type T cells were also detected in C57BL/6 mouse spleen at the same frequency, they showed a functionally different property from BALB/c CD4+ CD62L- CD45RB- T cells in terms of IL-4 production. The fact that germfree BALB/c mouse spleen cells also produced high levels of IL-4 suggested that the IL-4 producer in BALB/c mice might be developed under the influence of unknown factors other than environmental Ags. The CD4+ CD62L- CD45RB- T cells obtained from BALB/c mice accelerated the development of IL-4-producing memory-type CD4+ T cells from CD4+ CD62L+ CD45RB+ naive T cells prepared from OVA-specific TCR-transgenic mice. Therefore, IL-4-producing CD4+ CD62L- CD45RB- T cells might play an important role in the preferential induction of Th2-dominant immunity in BALB/c mouse strain.

Animals↗