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Biomedical subjects

T Shiigai

Publications and source records attributed to T Shiigai.

At least 55 records · Page 3Linked to original sources
PubMed1993

Hypoglycaemic hemiplegia: a repeat SPECT study.

During a hypoglycaemic right hemiplegia induced by a deliberate overdose of oral hypoglycaemics, brain CT and angiography revealed no abnormalities. SPECTs made one day and six days later showed relative hypoperfusion in the left hemisphere. Repeat SPECT study suggested that the left hemisphere was more vulnerable than the right in the cerebral blood perfusion. This vulnerability might provoke the right hemiplegia in a critical condition, such as severe hypoglycaemia.

Adult↗
PubMed1993

Unusual neuroradiological findings in systemic lupus erythematosus.

A 47-year-old woman affected by systemic lupus erythematosus (SLE) presented with headache, fever, splenomegaly and edema of the lower extremities. CT showed diffuse low density in the cerebral white matter and marked splenomegaly in the abdomen. T2-weighted MR images showed diffuse high intensity lesions in the white matter. After immunosuppressive therapy with prednisolone, there was marked improvement in the cranial CT and MR appearances. The underlying pathological process was probably edema secondary to a lupus microangiopathy. SLE can be complicated by a widespread abnormality of the white matter with marked radiological changes but few neurological signs. In the present case, only an episodic mild hemiparesis for 3 weeks without seizure and psychiatric disturbance was found neurologically during the whole clinical course.

Activities of Daily Living↗
PubMed1993

High serum lipoprotein(a) levels are an independent risk factor for cerebral infarction.

BACKGROUND AND PURPOSE: This study was conducted to evaluate the role of high serum lipoprotein(a) levels in a group of patients with a relatively early onset of cerebral infarction as a whole and in a subgroup with the perforating artery occlusion subtype of cerebral infarction. METHODS: Fifty-four patients with cerebral infarction, the onset of which was before age 65 years (37 men, 17 women; mean age, 61.9 +/- 7.7 years) were examined in this study. When patients with atrial fibrillation were excluded to omit cardiac embolic strokes from analysis, the group consisted of 45 patients. The patients were classified into two subtype groups, the perforating artery occlusion group and the cortical artery occlusion group, by using magnetic resonance imaging. Lipoprotein(a) levels were measured by an enzyme-linked immunosorbent assay. Four biochemical variables (serum levels of lipoprotein(a), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides) and other potential risk factors such as hypertension, diabetes mellitus, smoking habits, alcohol intake, and family history were analyzed by stepwise logistic regression to determine the independent and significant risk factors for cerebral infarction without atrial fibrillation. RESULTS: The incidence of subjects with serum lipoprotein(a) levels > or = 42.6 mg/dL, which is the 95th percentile level of the control subjects, was significantly increased in the total cerebral infarction group (P < .025) and the perforating artery occlusion group (P < .025) compared with the control group. In addition, by using stepwise logistic regression analysis in the total and perforating artery occlusion patient groups we identified three independent and significant risk factors: hypertension, a low high-density lipoprotein cholesterol level, and a high serum lipoprotein(a) level. In the cortical artery occlusion group, the sample size was not large enough for the statistical analysis. Diabetes mellitus is the only known factor that correlates with serum lipoprotein(a) levels, but there were no significant correlations between serum lipoprotein(a) levels and history of diabetes mellitus or fasting blood sugar. CONCLUSIONS: These findings indicate that high serum lipoprotein(a) levels are an independent risk factor in the development of cerebral infarction when subjects with atrial fibrillation were excluded from the total group and the perforating artery occlusion subtype group.

Adult↗
PubMed1993

Measurement of glomerular filtration rate by free vitamin B12 clearance.

We determined the vitamin B12 clearance using an ultrafiltration technique and assessed whether the clearance of this vitamin B12 could be used to estimate the glomerular filtration rate (GFR). Fourteen subjects (5 had renal disease, 7 had diabetes mellitus, one had liver cirrhosis and one had cholelithiasis) divided into two groups were studied (group 1, 5 patients without vitamin B12 preloading; group 2, 9 patients with vitamin B12 preloading). Vitamin B12 clearance was significantly correlated with inulin clearance (r = 0.81, p < 0.001) in group 1; group 2 showed an even better correlation (r = 0.94, p < 0.001) with the presaturated vitamin B12 binding protein. In group 2, the mean inulin and vitamin B12 clearance values do not differ significantly (40.3 +/- 13.6 vs 48.2 +/- 17.2 ml/min), but there was a significant difference between mean inulin and creatinine clearance (40.3 +/- 13.6 vs 64.9 +/- 19.9 ml/min, p < 0.05). In conclusion, vitamin B12 clearance appears to be a more reliable method of estimating GFR than creatinine clearance.

Adult↗
PubMed1993

An experimental study of chondrogenesis and osteogenesis in rat submandibular gland induced by implantation of demineralized dentin.

Demineralized dentin pieces were implanted in 18 rat submandibular glands to examine the chondrogenesis and osteogenesis in pleomorphic adenoma of the salivary gland. After 7 days of implantation, a large amount of cartilage tissue was found next to the inner portions of the implanted pieces, and small amounts of the osteoid and cartilage tissues were detected next to the outer portions. A small amount of bone tissue was found in contact with the cartilage 10 days after the implantation. In the inner portions, invasions of capillaries and a small amount of osteoid tissue were noted. These histological findings resembled those of endochondral ossification. Large amounts of bone tissue and resorption of the implant were observed after 14 days. It has been suggested that cartilage and bone are produced by bone morphogenetic proteins (BMP) in demineralized dentin resulting in chondrogenesis followed by osteogenesis in submandibular gland. Apparently, undifferentiated mesenchymal cells are produced by implantation, undergo dedifferentiation, and are redifferentiated into chondroblasts and osteoblasts in the presence of BMP. These results suggest that chondrogenesis and osteogenesis in the submandibular gland are induced by BMP. It is possible that the chondroid tissues in pleomorphic adenoma of the salivary glands are induced by proteins such as BMP.

Adenoma, Pleomorphic↗
PubMed1993

An experimental study of osteogenesis by autografted dental pulp, periodontal ligament, and bone marrow in vivo.

Osteogenic activity of autografted dental pulp, periodontal ligament, and bone marrow of rat in vivo was investigated. Immunolocalization of ALPase in situ was also studied. One month after the transplantation, osteodentin was formed in all the dental pulp transplants (100%), bone or cementum like tissues were created in 20% of periodontal ligament transplants, and bone like tissues were in 20% of bone marrow transplants. After two months, osteodentin was produced in all the dental pulp transplants (100%) and bone like tissue were in 50% of both periodontal ligament and bone marrow transplants. Immunohistochemically, positive reactions to ALPase in situ were detected in cells just below the odontoblast layers in dental pulp, surface layers of alveolar bone in periodontal ligament, and endosteal membrane of bone marrow space. From these results, it was suggested that the cells of these three kinds of tissue can be termed osteogenic-fibroblasts in vivo.

Alkaline Phosphatase↗
PubMed1992

Iatrogenic acute spinal epidural abscess with septic meningitis: MR findings.

A contaminated catheter used in epidural anesthesia in a 71-year-old female produced acute epidural abscess and septic meningitis. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in a culture of the epidural pus. Both T1- and T2-weighted MR images showed low intensity mass lesion compressing the thecal sac behind the vertebral body L3. The low intensity lesion was probably pus with gas component. In these low intensity lesions in MR findings with gas component, MR was superior to myelography because it visualized both the degree of compression to the thecal sac and extension of the lesion in all directions.

Abscess↗
PubMed1992

Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of 2 cases and review of the literature.

Fifty-nine cases of glycyrrhizin (licorice)-induced hypokalemic myopathy (GIHM), 2 females treated in our departments (85 and 73 years old) and 57 cases reported in the literature were studied, and conditions leading to the onset, factors, clinical manifestations, laboratory assessments, muscle biopsy findings, treatment and outcome were discussed. The 59 GIHM cases comprised 32 men, 25 women and 2 patients without record of sex; the average age was 55.2 years. In many cases, conditions leading to the onset of GIHM were habitual licorice ingestion, ingestion of antituberculosis agents containing licorice and long-term ingestion of licorice-containing agents for chronic gastritis, chronic hepatitis or chronic dermatitis. The combined use of hypotensive diuretic agents increased the risk of GIHM in an overwhelming number of cases. The main clinical symptom was flaccid quadriplegia in almost all cases, with muscle pain in 32.2% and peripheral dysesthesia in the extremities, manifested mainly by numbness (27.1%). Laboratory findings included a mean serum K+ value of 1.98 mEq/l (56 GIHM cases), a mean creatine kinase of 5,385.7 IU/l (n = 30), a mean blood aldosterone concentration of 2.92 ng/dl (n = 30; normal: 2.0-13.0 ng/dl) and a mean plasma renin activity of 0.17 ng/ml/h (n = 27; normal: 0.8-4.4 ng/ml/h). Muscle biopsy was performed in 17 of the 59 cases with resultant findings of myopathic changes consisting mainly of phagocytosis, necrotic fibers, vacuolar degeneration, together with sporadic neurogenic changes. Complete cure was attained in 57 of the 59 cases of GIHM by discontinued ingestion of glycyrrhizin (licorice) and potassium supplement.

Aged↗
PubMed1992

TIAs in a spontaneously dissecting aneurysm of the internal carotid artery--a case report.

A spontaneous internal carotid artery dissection of an aneurysmal form is reported. The patient, a fifty-eight-year-old man, had manifested recurrent transient left hemiparesis, dysesthesia of the left upper limb, and dysarthria for three months. After administration of ticlopidine, the transient ischemic attacks completely disappeared. Three months later, the follow-up angiographic study revealed the same form of dissection in the same portion as compared with the initial study. Conservative therapy was successful.

Aortic Dissection↗
PubMed1992

[Non-Hodgkin lymphoma with Ki-1 antigen: a case report].

An 89-year-old female with fever, lymphoadenopathy and swelling of both upper extremities was admitted. The pathological specimen of enlarged lymph node showed diffuse anaplastic large cell lymphoma, reacted with the antibody Ki-1 (CD 30), and was diagnosed as Ki-1 lymphoma. She was successfully treated with CPM 700 mg (day 1), ADM 20 mg (day 1), VCR 1 mg (day 1) and PSL 60 mg (day 1-5). She showed improved quality of life. This case can be a model for treatment of elderly patients.

Aged↗
PubMed1991

Paroxysmal choreoathetosis precipitated by movement, sound and photic stimulation in a case of arterio-venous malformation in the parietal lobe.

A patient is presented with paroxysmal choreoathetosis precipitated by movement, sound and photic stimulation associated with an arterio-venous malformation (AVM) who responded to carbamazepine treatment. Hemodynamic circulatory disorder of the sensory-motor cortices having AVM may alter striatal function and produce paroxysmal choreoathetosis. This finding supports the concept that paroxysmal choreoathetosis results from an abnormality at the connections between basal ganglia and cerebral cortices.

Acoustic Stimulation↗
PubMed1991

Marked hypokalemic rhabdomyolysis with myoglobinuria due to diuretic treatment.

A 74-year-old male was admitted to hospital with acute rhabdomyolysis and myoglobinuria due to hypokalemia. The hypokalemia resulted from diuretic treatment. He had no family history of myopathy, and no diarrhea and vomiting. The neurological examination revealed painful quadriplegia. The blood pressure was 160/74 mm Hg. Laboratory examination showed hypokalemic and hypochloremic metabolic alkalosis (serum K 1.5 mEq/l, serum Cl 89 mEq/l, base excess + 20.9, HCO3- 44.9 mmol/l, pH 7.563) and marked elevations of serum CPK, LDH, GOT, GPT and myoglobin. Endocrinological and renal functions were normal. Muscle biopsy revealed marked necrosis with remarkable phagocytosis and vacuolar degeneration. The cessation of diuretics and intravenous infusion of potassium chloride resulted in a marked improvement in clinical and laboratory findings. The diuretics-induced hypokalemic myopathy is rare in the literature.

Aged↗
PubMed1990

Polycystic kidney of autosomal dominant inheritance, polycystic liver and congenital hepatic fibrosis in a single kindred.

A family with clear evidence of concomitant congenital hepatic fibrosis, polycystic liver and adult-type polycystic kidney is reported. The autosomal dominant inheritance of polycystic kidney in association with either liver cyst or hepatic fibrosis in this family suggests that various combinations of hepatic and renal fibrocystic lesions are possible to occur. Additionally, in the proband a very rare association of congenital hepatic fibrosis and cerebral aneurysm was present.

Adult↗
PubMed1990

Decreased production and responsiveness of interleukin 2 in lymphocytes of patients with nephrotic syndrome.

Production of and responsiveness to interleukin 2 (IL-2) were evaluated in lymphocytes from 18 patients with nephrotic syndrome. The IL-2 production of T cells, when stimulated with autologous non-T cells separated on a polystyrene resin column, was significantly decreased in patients with minimal-change nephrotic syndrome. No significant difference in the level of IL-2 production was noted between minimal-change nephrotic syndrome patients in the nephrotic stage and those in remission. The IL-2 production was also significantly decreased in lymphocytes from patients with membranous nephropathy. The responsiveness to IL-2 was inconstant among patients with nephrotic syndrome. These results indicate that the immune system of regulating IL-2 production is impaired in patients with nephrotic syndrome.

Adolescent↗
PubMed1989

A lithium clearance study of sodium reabsorption at the proximal tubule in liver cirrhosis with ascites.

Since the reabsorption of lithium occurs almost exclusively in the proximal tubule and is associated with that of sodium, the fractional excretion of lithium (FELit) ws examined in 18 patients with cirrhosis in order to examine the reabsorption rate of sodium at the proximal tubule. As expected, the fractional excretion of sodium (FENa) was significantly lower in cirrhotic patients with ascites (0.43 +/- 0.10%, mean +/- SEM) than in cirrhotic patients without ascites (0.75 +/- 0.14%, P less than 0.05) and healthy controls (0.82 +/- 0.17%, P less than 0.05). By contrast, there was no significant difference in FELit among cirrhotic patients with ascites (16.7 +/- 2.0%), cirrhotic patients without ascites (15.4 +/- 2.0%) and controls (17.4 +/- 1.5%). It is unlikely, therefore, that in cirrhotic patients with ascites, the impaired sodium excretion is solely caused by the abnormal sodium reabsorption capacity of the proximal tubule.

Absorption↗