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Biomedical subjects

T Shirota

Publications and source records attributed to T Shirota.

At least 19 recordsLinked to original sources

Primary omental gamma/delta T-cell lymphoma involving the central nervous system.

Gamma/delta T-cell lymphoma (GDTL) is an uncommon lymphoma that was initially reported to involve only the liver and spleen. GDTL other than the hepatosplenic type is extremely rare. Frequent primary sites include skin and subcutaneous tissue, intestine, or nasal region. We report a case of GDTL of the omentum in a 54 year-old-man. The tumor cells are CD2-, CD3+, CD4-, CD5-, CD8+, CD56+, TIA-1+, granzyme B+/-. They expressed the identical phenotype of intestinal GDTL. The patient was treated with 2 courses of CHOP which comprised cyclophosphamide, doxorubicin, vincristine and prednisolone, and 3 courses of EPOCH which comprised etoposide, prednisolone, vincristine, cyclophosphamide and doxorubicin. However, he failed to obtain remission. During the fourth course of EPOCH, muscle weakness of the lower extremities developed and intracranial masses were observed by computed tomographic scan of the brain. Dissemination of lymphoma to the central nervous system was considered and it may be attributable to the expression of CD56 in this case. High dose methotrexate (HD-MTX) chemotherapy successfully eliminated the omental tumor and reduced the size of the intracranial masses, thus HD-MTX appears to be an effective treatment against GDTL.

Central Nervous System↗

Mineralized bone loss in partially edentulous trabeculae of ovariectomized rabbit mandibles.

OBJECTIVE: The purpose of this study was to evaluate trabeculae changes in partially edentulous bone in ovariectomized rabbits. BACKGROUND: Numerous clinical studies have suggested that the greater risk for oral bone loss in females may be correlated with osteoporosis after menopause. Knowledge of trabecular changes in partially edentulous bone in animals with loss of ovarian function may be beneficial in the diagnosis and treatment of partially edentulous patients of postmenopausal women. METHODS: Twelve adult female Japanese white rabbits were examined. The mandibular incisors were initially extracted to simulate the partially edentulous bone. Six animals were bilaterally ovariectomized and the other six sham-ovariectomized 12 weeks after tooth extraction. The partially edentulous parts of distal mandibular bodies were processed undecalcified 12 weeks after ovariectomized or sham-ovariectomized surgeries and examined by quantitative trabecular bone histomorphometry. RESULTS: In ovariectomized rabbits, there were significant increases in trabecular separation, osteoid volume, osteoid thickness, osteoid width, eroded surface, and mineral apposition rate, and a significant decrease in trabecular number. CONCLUSION: The results of sparser trabecular structure, more trabecular osteoid, and increased trabecular bone turnover demonstrate mineralized bone loss in partially edentulous trabeculae of ovariectomized rabbit mandibles and suggest that the same loss may occur in postmenopausal women.

Analysis of Variance↗

Clinical pathway for impalpable or small lung lesions treated with coil marking and thoracoscopy.

OBJECTIVES: Advances in computed tomography are detecting increasingly impalpable or small pulmonary lesions. We propose a clinical pathway for managing such lesions. METHODS: We conducted a retrospective study in a community teaching hospital to describe the hospital schedules of 18 patients having 19 lesions 10 mm or less and ground glass attenuation. Under computed tomography, a coil (Complex Helical Fibered Platinum Coil-18) was placed at the proximal side of the lesion. Using thoracoscopy and radiographic fluorography, we conducted partial lung resection targeting the coil the next day, adding lobectomy, if required. RESULTS: Final diagnosis included primary and metastatic lung cancer (n = 14), atypical adenomatous hyperplasia (n = 1), and benignancy (n = 4). Patients were admitted 2* days before surgery (*Numbers are medians). On postoperative day 3, chest tubes were removed. Epidural analgesia was continued for 5 days. On postoperative day 7, patients were discharged. Their admission charge was a total of yen 979,610. CONCLUSIONS: The hospital course above may be applied to the clinical pathway for managing impalpable or small lung lesions.

Adenocarcinoma, Bronchiolo-Alveolar↗

Penetration of the duodenum by an ingested needle with migration to the pancreas: report of a case.

A case of a penetration of the duodenum by a needle with migration to the pancreas in a 50-year-old man is reported herein. The patient was referred to us with a chief complaint of diarrhea. An abdominal plain roentgenogram showed a needle in the upper abdominal area. An abdominal computed tomography scan and contrast X-ray revealed the foreign body to be located outside of the duodenum and in the head of the pancreas. An emergency operation was therefore performed on the first day and the needle in the head of the pancreas was thus extirpated safely. A perforation of the gastrointestinal tract by an ingested foreign body is difficult to accurately and quickly diagnose when no peritonitis or abscess formation is observed. Therefore, the use of contrast X-ray is considered to be useful in the diagnosis of such a perforation.

Contrast Media↗

Bone mineral density in mandibles of ovariectomized rabbits.

The purpose of this study was to evaluate the association between loss of ovarian function and bone mineral density changes in the mandibles of ovariectomized rabbits using peripheral quantitative computed tomography. Twenty-four adult female Japanese white rabbits were used in this experiment. The mandibular incisors were initially extracted to create implant bone. Twelve animals were bilaterally ovariectomized and the other twelve sham-ovariectomized 12 weeks after tooth extraction. All rabbits were sacrificed at 4 and 12 weeks after ovariectomy and sham-ovariectomy, with 6 rabbits in each of the four resultant groups. The edentulous parts of distal mandibular bodies were measured by peripheral quantitative computed tomography. There were significant decreases in total bone mineral density and trabecular bone mineral density in the mandibles of rabbits at 12 weeks post-ovariectomy. The results demonstrate the mineralized bone loss in the mandibles of ovariectomized rabbits.

Animals↗

[Multiple myeloma with Sweet disease developing from monoclonal gammopathy of undetermined significance and Sjögren syndrome].

A 57-year-old woman was diagnosed as having monoclonal IgG kappa gammopathy of undetermined significance with Sjögren syndrome. Five years later, she was admitted with an increased level of serum IgG and diagnosed as having multiple myeloma. After admission, fever and painful erythema developed. Combined chemotherapy with adrenal cortical steroid diminished the skin lesions. Erythema recurred during treatment with granulocyte colony-stimulating factor for neutropenia due to chemotherapy. A biopsy specimen from the skin revealed dense neutrophilic infiltration in the dermis, and a diagnosis of Sweet disease was made.

Female↗

Nephrotic syndrome caused by protein thrombi in glomerulocapillary lumen in Waldenström's macroglobulinaemia.

Waldenström's macroglobulinaemia (WM) is described as a disorder of plasmacytoid lymphocytes. The renal complications of WM are less common and severe than those of multiple myeloma. We present a case of WM complicated by nephrotic syndrome. A biopsy specimen of the kidney revealed the intraglomerular thrombi of immunoglobulin M paraprotein. Corticosteroid pulse therapy and plasmapheresis were effective in improving proteinuria and reducing protein thrombi. The nephrotic syndrome caused by protein thrombi in WM may be reversible, at least in its early stage.

Aged↗

Acute effects of moderate exercise on serum lipids, lipoproteins and apolipoproteins in sedentary young women.

1. The aim of the present study was to examine the effects of moderate exercise on serum lipids, lipoproteins and apolipoproteins in seven sedentary young women under controlled conditions. 2. The subjects exercised on separate days for 30 or 60 min at an intensity of 60% of maximal oxygen uptake on a cycle ergometer. Total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), HDL2-C, HDL3-C, low-density lipoprotein-cholesterol, apolipoproteins A-I, A-II and B were measured in the serum at the end of the 60 min rest period before each exercise, immediately after the performance of each exercise and at 30 min and 1, 2 and 24 h after each exercise. 3. The results showed that there were no significant differences between the pre- and postexercise samples for any of the parameters tested. 4. The results of the present study suggest that a single bout of exercise designed to simulate a typical training workout has no noticeable effect on serum lipids, lipoproteins and apolipoproteins in normal sedentary young women who have normal lipid profiles, are in the follicular phase of their menstrual cycle and who consume a relatively low-fat diet.

Adult↗

Effect of ovariectomy on bone remodeling adjacent to hydroxyapatite-coated implants in the tibia of mature rats.

PURPOSE: The purpose of this study was to examine the effects of estrogen deficiency on bone remodeling adjacent to implants in the tibia of mature rats. MATERIALS AND METHODS: Hydroxyapatite-coated implants were placed bilaterally in the proximal metaphysis of the tibia of 18 female Wistar rats (48 weeks old), and ovariectomy was performed 168 days later. As a control, sham ovariectomy was performed in a similar group of 18 rats. Six animals from each group were killed at 28, 84, and 168 days after ovariectomy. Undecalcified sections were prepared, and changes in the bone tissue around the implants were evaluated histologically. Histomorphometric measurements were made with a computer-based image analyzer to quantify the unit bone mass around each implant and the amount of implant-bone contact. RESULTS: In the cortical bone area, ovariectomy induced only a slight decrease in bone contact with the implant, compared with that in the sham-operated rats. However, both the bone volume around the implant and implant-bone contact were significantly decreased in the cancellous bone area in ovariectomized rats compared with the sham-operated rats. CONCLUSION: Thinning of the bone trabeculae holding dental implants may occur with estrogen deficiency.

Animals↗

Adult T-cell leukemia/lymphoma with initial deafness.

In July 1995, a 43-year-old Japanese man presented with deafness in the right ear. On hospital admission, he had deafness in both ears and right facial palsy. Variously sized lymphoid cells with convoluted nuclei were observed in the cerebrospinal fluid. Surface marker analysis revealed monoclonality of T lymphocytes in the spinal fluid. Similar abnormal cells were observed in peripheral blood and bone marrow. Biopsy specimens of the stomach and prostate showed tight proliferation of large lymphoid cells in the interstitium and epithelium. Antibody against human T-lymphotrophic virus type 1 (HTLV-1) was present. The diagnosis of non-Hodgkin's lymphoma, diffuse type, was made. Seven months later, the patient died of sepsis. Autopsy revealed multiple lymphadenopathy in the abdomen and the infiltration of atypical lymphocytes to the pancreas, kidneys, and other organs. A monoclonal band of HTLV-1 provirus was detected by Southern blot analysis. To our knowledge, this is the first report of adult T-cell leukemia/lymphoma with auditory nerve abnormalities as the initial symptom.

Adult↗

Myelodysplastic syndrome terminating in erythropoietic protoporphyria after 15 years of aplastic anemia.

The authors report a case of aplastic anemia in which refractory anemia, a subtype of myelodysplastic syndrome (MDS), developed 15 years after the onset and was subsequently followed by erythropoietic protoporphyria (EPP). Defects of stem cells in MDS are thought to be responsible for the disturbance of the heme biosynthetic pathway, leading to the development of EPP.

Anemia, Aplastic↗

Helicobacter pylori infection correlates with severity of reflux esophagitis: with manometry findings.

The role of Helicobacter pylori infection in the development and exacerbation of reflux esophagitis was investigated. The prevalence of Helicobacter pylori infection, the severity of atrophic gastritis, and esophageal motility (determined by esophageal manometry by an infusion catheter method) were assessed in patients with mild (n = 46) and severe (n = 27) reflux esophagitis and subjects without reflux (n = 28). Compared with the prevalence of Helicobacter pylori infection in the non-reflux group, the prevalence in the mild and severe reflux groups (60.7%, 47.8%, and 14.8%, respectively) was significantly (P < 0.05) lower. Atrophic gastritis was milder in both reflux groups than in the non-reflux group. The degree of gastritis was also milder in the severe reflux group than in the mild reflux group. The esophageal sphincter pressure was significantly (P < 0.05) lower in the reflux groups than in the non-reflux group, and the amplitude of primary peristalsis was significantly (P < 0.05) lower in the severe reflux group than in the non-reflux group. There were no significant differences between reflux patients with and without Helicobacter pylori infection in the parameters of esophageal manometry. These data imply that a low prevalence of Helicobacter pylori infection may result in a milder grade of atrophic gastritis, and consequently, exacerbate reflux esophagitis.

Analysis of Variance↗

Interobserver and intraobserver variation in endoscopic assessment of GERD using the "Los Angeles" classification.

BACKGROUND: A new endoscopic classification of gastroesophageal reflux disease (GERD) has been proposed, and the term mucosal break has been introduced to describe mucosal damage. This new classification was evaluated by endoscopists with different levels of experience. METHODS: Fifty endoscopic photographs for each of 20 randomly selected patients with GERD were assessed retrospectively by three groups of seven endoscopists classified by experience: group 1 (100 to 500 procedures), group 2 (500 to 3000), and group 3 (more than 3000). The new classification was modified by adding grade 0 to describe healed mucosal breaks, so that there were five grades. All photographs were assessed twice at an interval of more than 1 week, and kappa statistics were used to determine observer variation. RESULTS: Interobserver variation within group 3 (kappa = 0.39, n = 21) and between groups 3 and 2 (kappa = 0.36, n = 49) was significantly different (p < 0.01) from that between groups 3 and 1 (kappa = 0.26, n = 49). Intraobserver variation in group 1 (kappa = 0.39, n = 7) was significantly different (p < 0.01) from that in group 2 (kappa = 0.51, n = 7) and group 3 (kappa = 0.54, n = 7). CONCLUSIONS: Observer variation depends on level of endoscopic experience. Only experienced endoscopists should use the new classification for grading of GERD.

Adult↗

Bone reactions to titanium screw implants in ovariectomized animals.

OBJECTIVE: The purpose of this study was to investigate the reactions of bone tissue after the placement of implants into the tibiae of osteopenic model rats. STUDY DESIGN: Commercially pure titanium screw implants were placed in the bilateral proximal tibial metaphyses 168 days after ovariectomy had been performed on 12-week-old female Wistar rats. For control purposes, implants were similarly placed in sham-ovariectomy rats. The healing process was examined histologically by means of undecalcified sections at various intervals from 7 to 168 days after implantation. Through use of an automated imaging analytic system, changes in relative bone mass and implant-bone contact were histomorphometrically evaluated. RESULTS: In the cortical bone area, only a slight difference in bone contact was noted with the implant until 28 days after implantation. However, ovariectomy significantly affected bone contact at 56 days after implantation. The rate of bone contact in the cancellous bone area and the relative bone mass around the implant were significantly lower in the test group than in the control group. CONCLUSIONS: It is considered that a decrease in bone mass causes a reduction in the contact area between implant and bone and may also cause a reduction in the supporting ability of the implant because of thinning of the surrounding bone tissue.

Animals↗

Bone reactions around hydroxyapatite-coated implants in ovariectomized rats.

OBJECTIVE: The purpose of this study was to investigate bone reaction after implantation in an estrogen-deficient state by examining the changes in bone reactions within tissue surrounding implants in ovariectomized rats. STUDY DESIGN: Ninety-six 12-week-old female Wistar rats were used in the study; they were divided into 2 groups, an ovariectomized group and a sham-operated group. Hydroxyapatite-coated implants were placed in the proximal metaphyses of the tibiae 21 days after surgery. The tibiae were examined histologically by undecalcified sections at various intervals from 7 to 168 days after surgery. RESULTS: In the cortical bone area of the ovariectomized rats, the procedure did not induce any apparent changes in bone volume around the implant or in bone contact with the implant in comparison with the sham-operated rats. In contrast, both bone volume around the implant and contact of the implant with new bone were significantly decreased in the cancellous bone area in the ovariectomized rats in comparison with the sham-operated rats. CONCLUSIONS: Ovariectomy did not seriously affect bone healing after the placement of implants in cortical bone areas, but it reduced the bone contact ratio and the bone in the cancellous bone area.

Acid Phosphatase↗

Oxygen uptake, heart rate, and blood lactate responses during and following karate training.

PURPOSE: The purpose of this study was to examine whether each exercise and an entire karate training session can achieve: 1) accepted training intensity thresholds for effective aerobic capacity training, 2) energy expenditure (EE) thresholds for total body mass and fat weight loss, and 3) elevation in excess postexercise oxygen consumption (EPOC). METHODS: We investigated physiological responses during five types of karate training: basic techniques without (S-Basics) and with (M-Basics) movements, sparring techniques without (TECH I) and with (TECH II) an opponent, and kata. RESULTS: The mean percent of maximal oxygen uptake (%VO2max) and HR (%HRmax) for S-Basics were below the accepted threshold (60% of HRmax or 50% of VO2max) and for M-Basics, TECH I and TECH II were above the threshold for increasing VO2max. For kata and the entire 70 min of karate training, the mean %HRmax were slightly above the threshold, and %VO2max were slightly below the threshold. The mean EPOC measured for 5 min immediately following 70 min of karate training did not differ from the resting VO2. The mean EE resulting from 70 min of karate exercise and EPOC were 2355.4+/-316.3 kJ and 38.8+/-32.7 kJ, respectively. CONCLUSIONS: Although the training intensity of karate exercises studied was moderate and the effects of karate training on EPOC were minimal, the mean value of EE was well above the accepted threshold for total body mass and fat weight loss.

Adult↗