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Biomedical subjects

A Nakashima

Publications and source records attributed to A Nakashima.

At least 91 records · Page 5Linked to original sources
PubMed1992

Effects of diltiazem and noradrenaline on extracellular potassium changes in the globally ischaemic rat heart.

OBJECTIVE: The aim was to investigate the effects of a calcium antagonist (diltiazem) and a catecholamine (noradrenaline) on extracellular potassium accumulation during global ischaemia. METHODS: Extracellular potassium concentration ([K+]e) was measured during 30 min global ischaemia in the isolated rat heart using a valinomycin potassium sensitive electrode. Contracture development during ischaemia was measured throughout with an intraventricular balloon inserted into the left ventricle and myocardial adenine nucleotides were measured in separate series of hearts. RESULTS: In control hearts, [K+]e showed a characteristic triphasic change during 30 min global ischaemia. This consisted of an early rising phase followed by a transient falling phase after the initial peak of [K+]e, and then a late rising phase. Diltiazem suppressed the rate of rise of [K+]e during early ischaemia, but extended the time course of the early [K+]e rise with the higher dose, abolishing the transient falling phase of [K+]e. During late ischaemia, the rise in [K+]e was attenuated by diltiazem. Noradrenaline also suppressed the early extracellular potassium accumulation, but in contrast to diltiazem, hastened the time course of the late [K+]e rise. CONCLUSIONS: Although diltiazem suppresses the early potassium loss during ischaemia as previously described, the drug also decreases the [K+]e fall by some as yet unknown mechanism, so that the [K+]e level becomes higher than control during the falling phase.

Adenosine Triphosphate↗
PubMed1992

Anti-eye muscle antibodies and hypothyroid Graves' disease: a case report.

We report the case of a 70-year-old man who developed hypothyroidism associated with TSH receptor antibodies and severe ophthalmopathy during lithium therapy. He had received lithium therapy for more than 20 years for manic depression, when ophthalmopathy (class VI of the American Thyroid Association classification) and mild hypothyroidism developed. Orbital magnetic resonance imaging indicated marked enlargement of the superior, medial and inferior rectus muscles in the left eye. He had anti-eye muscle antibodies in his serum, detected by Western blotting and quantified by chromatoscanning, as well as anti-TSH receptor antibodies. He was treated with supplementation of levothyroxine and four cycles of methylprednisolone pulse therapy. After the pulse therapy, both anti-eye muscle antibodies and anti-TSH receptor antibodies decreased and disappeared in parallel with the improvement in eye symptoms and signs. These observations suggest the importance of anti-eye muscle antibodies as clinical markers in the development of thyroid-associated ophthalmopathy.

Aged↗
PubMed1992

Methyldopa-induced colitis in a patient with membranoproliferative glomerulonephritis.

A 76-year-old man with membranoproliferative glomerulonephritis complicated by methyldopa-induced colitis is reported. Eight months after administration of methyldopa, mucous bloody stool was noted. A barium enema examination showed disappearance of haustra and a spastic rectosigmoid with pseudo-polyposis. Biopsy specimens obtained from the sigmoid mucosa revealed interstitial edema and small inflammatory cells. After cessation of methyldopa treatment, the sigmoid findings, blood pressure, and proteinuria were improved, suggesting that methyldopa not only induced the acute colitis but also worsened the nephrotic syndrome in this patient.

Acute Disease↗
PubMed1992

Sweet's syndrome associated with subacute necrotizing lymphadenitis.

A 34-year-old man with Sweet's syndrome associated with subacute necrotizing lymphadenitis is reported. Histological examination of an erythematous, painful, cutaneous plaque revealed a dermal interstitial neutrophilic infiltrate. A biopsy specimen obtained from an inguinal lymph node showed granulomatous formation, consisting of histiocytes, with central necrosis in the paracortex and macrophages in the sinus. Although the causes of the two diseases remain obscure, this appears to be the first report of Sweet's syndrome associated with subacute necrotizing lymphadenitis.

Adult↗
PubMed1992

[Clinical study on benefit and safety of frequent inhalation of aerosolized procaterol hydrochloride in aged acute asthmatics].

We studied the hemodynamic effects of frequent inhalation of aerosolized procaterol hydrochloride (PRC) in the treatment of status asthmaticus. Twenty patients were enrolled and divided into 2 groups; younger group (less than 55 years; n = 11) and older group (more than 55 years; n = 9). All patients were treated with intravenous hydrocortisone (4 mg/kg/4 h) and PRC inhalation (30 micrograms; 0.3 ml) every hour via a jet nebulizer with 3 l/min oxygen for four consecutive days. Holter ECG monitoring was performed on the 1st, 4th, and 7th days of hospitalization to evaluate mean heart rate, tachycardiac incidence, and arrhythmias. Blood pressure, serum potassium levels, and peak expiratory flow rate (PEFR) were measured on the same day. Even though the total dosage of inhaled PRC on the 1st day was 496.4 +/- 62.61 micrograms for the younger group and 490.0 +/- 36.73 micrograms for the older group (p = NS), total arrhythmic ratios were less than 1% in both group. Both blood pressure and heart rate decreased with improvement of symptoms and PEFR value. Serum potassium levels tended to decline according to the administered dosage of PRC (p < 0.01); however, severe hypokalemia less than 3.0 mmol/l was not observed. We conclude that frequent inhalation of PRC (up to 500 micrograms/day) via a jet nebulizer provides rapid relief from acute asthmatic attacks, and is safe clinically even in aged asthmatics receiving intravenous steroids.

Administration, Inhalation↗
PubMed1992

[A case of primary anterior mediastinal embryonal carcinoma: report of a case].

A 15-year-old man was admitted to our hospital because of chest pain. The chest x-ray film and CT scan revealed a large anterior superior mediastinal mass. The serum alpha-fetoprotein (AFP) value was raised. Percutaneous biopsy of the tumor suggested embryonal carcinoma. The tumor was totally removed. Postoperatively combination chemotherapy including CDDP was performed. However the patient died of tumor recurrence 8 months after operation. AFP is very useful for its diagnosis and the follow-up of the clinical course.

Adolescent↗
PubMed1992

Human fibrinogen heterogeneity: the COOH-terminal residues of defective A alpha chains of fibrinogen II.

Fibrinogen fraction I (340 kDa) and fraction II (305 kDa) were isolated by glycine precipitation. The subunit chains of the two fractions were separated, after reduction, by reverse-phase high performance liquid chromatography. The amino acid compositions of the B beta and tau chains of fibrinogen II were identical with those of fibrinogen I. In contrast, the A alpha chains of fibrinogen II were composed of two populations, one comprising homogeneous, intact A alpha chains and the other consisting of heterogeneous, deficient A alpha chains (A alpha' chains) of lengths varying according to the sizes of their COOH-terminal defects. The molar ratio of the A alpha to the A alpha' chains in fibrinogen II was 1.16:1. The amino acid composition and sequence analyses of the TPCK-trypsin peptides derived from the A alpha' chains revealed that the COOH-terminal residues of the A alpha' chains were mainly Asn-269, Gly-297 and Pro-309. These results indicate that the fibrinogen II molecule is asymmetrical and can be represented by the formula (A alpha) (A alpha')(B beta)2(tau)2 and that fibrinogen II cannot be a plasmin degradation product of fibrinogen I.

Amino Acid Sequence↗
PubMed1992

Excellent durability of the Hancock porcine bioprosthesis in the tricuspid position. A sixteen-year follow-up study.

From February 1975 to August 1981, 23 consecutive patients underwent tricuspid valve replacement, which was either isolated (six patients) or combined with the replacement of other valves (17) by means of a standard, glutaraldehyde-preserved Hancock porcine bioprostheses. Patients' ages ranged from 9 to 53 (mean 36.2) years. The follow-up period ranged from 0.2 to 16.5 years (mean 9.1) and was complete in 100% of all cases. Structural valve failure of the tricuspid Hancock valve was noticed in two patients, a 9-year-old boy and a 13-year-old girl 3.4 and 16.5 years after implantation, respectively. The actuarial freedom rate from structural valve failure at 10 years was 94 +/- 6%. There were six tricuspid prosthesis-related events: structural valve failure in two and valve thrombosis, anticoagulant-related bleeding, prosthetic valve endocarditis, and periprosthetic leak in one each, respectively. The actuarial freedom from these events at 10 years was 78 +/- 10%. Five pairs of aortic/mitral-tricuspid Hancock valves were explanted simultaneously from the same patients after 8.1 to 13.9 (mean 11.4) years postoperatively. A gross examination showed no valve dysfunction in the explants from the tricuspid position, but degenerative changes with valve dysfunction in those from the mitral and aortic position were observed (none of five versus five of seven; p < 0.03). We concluded that the selection of a Hancock bioprosthesis in the tricuspid position is acceptable because of the low incidence of prosthesis-related complications and the excellent durability of more than 10 years.

Actuarial Analysis↗
PubMed1992

[A case of recurrent liver tumor from gastric cancer responding remarkably to hepatic arterial infusion of large doses of mitomycin C and 5-fluorouracil].

A 69-year-old man underwent subtotal gastrectomy for gastric cancer in 1989. He was diagnosed with recurrent liver tumors at 9 months after the operation. Mitomycin C and 5-Fluorouracil were infused repeatedly into hepatic artery, at total doses of 170 mg and 15 g, respectively. Metastatic tumors disappeared in liver by this therapy. There were no side effects such as liver dysfunction, bone marrow suppression and anorexia in spite of the large amount of anti-cancerous agents. This case suggested that hepatic arterial infusion of a large amount of anti-cancerous agents is a good method for liver metastasis from gastric cancer.

Aged↗
PubMed1991

Synthesis of biologically active adenovirus preterminal protein in insect cells using a baculovirus vector.

A DNA fragment encoding the polyhedrin promoter of Autographa californica multiple nuclear polyhedrosis virus (AcMNPV strain) was constructed using overlapping oligodeoxyribonucleotides (oligos), which included the 5'-untranslated leader sequence of the polyhedrin-encoding gene. This DNA fragment was cloned into an intermediate transfer vector (pKX105) providing a unique BamHI site for the insertion of foreign genes. The Escherichia coli lacZ gene was first cloned at the BamHI site of pKX105 and the XhoI-KpnI fragment containing the lacZ gene was transferred to another plasmid vector (pEI) consisting of flanking AcMNPV sequences (pEI-lacZ). The E. coli beta-galactosidase that was produced in the infected insect cells using the recombinant virus constituted about 10% of the total cytoplasmic proteins. The pKX105 plasmid was also modified to give rise to pTT-lacZ which consisted of the lacZ gene under the control of the Rous sarcoma virus long terminal repeat promoter to facilitate rapid screening of the baculoviral recombinants in which the gene of interest was cloned under the control of the polyhedrin promoter. The efficiency of these transfer vectors was verified by obtaining high levels of expression of the adenovirus(Ad)-encoded preterminal protein (pTP) which is involved as a protein primer in the initiation of Ad DNA replication. The baculovirus-produced pTP was immunoprecipitable using rabbit polyclonal antibodies raised against a hydrophilic domain of pTP. The pTP protein was localized in the nucleus of the infected insect cells, and was biologically active in the in vitro Ad type 2 (Ad2) replication initiation assay.

Adenoviruses, Human↗
PubMed1991

Effects of glibenclamide and nicorandil on cardiac function during ischemia and reperfusion in isolated perfused rat hearts.

We examined influences of a blocker (glibenclamide) and an opener (nicorandil) of the ATP-sensitive potassium (KATP) channel on extracellular K concentration [( K+]e), as well as the myocardial function and metabolites during global ischemia and reperfusion in Langendorff-perfused rat heart preparation. In control hearts, [K+]e began to rise 20 s after the onset of ischemia up to an initial peak (8.3 +/- 0.3 mM) at 2.5 +/- 0.7 min, then fell to 6.0 +/- 0.8 mM after 8.2 +/- 0.7 min, and then rose progressively to 14.6 +/- 0.8 mM at the end of 30 min of ischemia. Glibenclamide (50 microM) reduced the initial peak of [K+]e to 7.2 +/- 0.3 mM (P less than 0.01), and nicorandil (200 microM) increased it to 9.4 +/- 0.6 mM (P less than 0.01). There were no significant differences in [K+]e values among all groups at the end of ischemia. During ischemia, nicorandil decreased the time to mechanical arrest from 1.9 +/- 0.1 min to 1.5 +/- 0.1 min, whereas it was increased by glibenclamide to 2.7 +/- 0.4 min. In control hearts, the time to onset of ischemic contracture was 14.7 +/- 1.8 min. Nicorandil delayed onset of contracture and glibenclamide accelerated it. Thus we have confirmed that some part of the early increase in [K+]e during ischemia is attributable to K+ efflux through the KATP channel in our model, and opening of the KATP channel may contribute to a rapid reduction of the contractility of the ischemic myocardium that subsequently protects the myocardium against further ischemic injury.

Adenosine Triphosphate↗
PubMed1991

[The clinical benefit of high dose inhalation therapy with beclomethasone dipropionate for patients with chronic bronchial asthma].

Conventional doses of aerosolized beclomethasone dipropionate (BDP) of up to 400 micrograms/day by inhalation has often failed to normalize the pulmonary function of chronic adult patients. Therefore it may be necessary to administer the individual maximum dose of BDP to reduce bronchial inflammation. In 13 patients (2 males and 11 females, mean age 49.2 +/- 3.7 years old) with chronic asthma whose minimum %PEFRs were lower than 80% under treatment with conventional doses of BDP, the clinical benefit of high dose inhalation therapy with BDP was studied for four consecutive weeks by comparing % peak expiratory flow rate (%PEFR) measured four times a day both before and 10 minutes after inhaled procaterol (PCR) in a cross-over fashion. Mean morning %PEFRs before inhaled PCR during the first two weeks with a lower dose of BDP (419 +/- 24 micrograms/day) and during the following two weeks with a higher dose of BDP (904 +/- 55 micrograms/day) were 60.6 +/- 3.1% and 77.5 +/- 4.1%, respectively (p less than 0.01). Average increases in %PEFR during the higher dose period before and after inhaled PCR were 12.1% and 12.4%, respectively, which was observed by the end of the first week after the start of higher dose of BDP in 12 out of 13 patients. Since there were no adverse reactions such as hoarseness, oral thrush and candidiasis during the period with higher doses of BDP, it was concluded that we should promptly employ higher doses of BDP in patients who did not respond satisfactorily to conventional doses of BDP.

Administration, Inhalation↗
PubMed1990

[Differential diagnosis between nonhyperfunctioning adenoma and adrenal metastasis on adrenocortical scintigraphy].

Adrenocortical scintigraphy using I-131-adosterol was performed in six cases of nonhyperfunctioning adenoma incidentally discovered on CT scans and four cases of adrenal metastasis. In all six cases of nonhyperfunctioning adenoma, there was increased uptake of of the I-131-adosterol on the side of the adrenal mass discovered at CT. In three of four cases of adrenal metastasis, there was no uptake of the I-131-adosterol on the side of the mass detected at CT. Uptake was symmetrical in one case of adrenal metastasis. Adrenocortical scintigraphy is able to differentiate nonhyperfunctioning adenoma from adrenal metastasis in recognition of increased uptake of I-131-adosterol on the side of the adrenal mass discovered on CT scans.

Adenoma↗
PubMed1990

Fibrin-dependent activation of plasminogen by a proteolytic digest of streptokinase.

Among four enzymatic digests of streptokinase (SK), the smallest peptide with plasminogenolytic activity was in a tryptic digest; it had a molecular weight of 29,000. A complex of this peptide, SK29, and human plasminogen hydrolysed human fibrin, but a complex of native streptokinase and human plasminogen hydrolysed both human and bovine fibrin. The complex with SK29 caused amidolysis of the synthetic substrate S-2251 in the presence of human fibrin, but was inactive in the presence of human fibrinogen, bovine fibrinogen or bovine fibrin. Analysis of the amino terminal sequence of SK29 indicated that cleavage by trypsin was on the carboxyl side of lysine, the 59th amino acid of streptokinase. These results suggest that the conformational changes caused by human fibrin formation resulted in the generation of an active site of human plasminogen by SK29.

Amino Acid Sequence↗
PubMed1990

[A clinical trial to determine whether intravenous aminophylline is indispensable in the treatment of status asthmaticus].

In Japan, intravenous aminophylline (AMP) is considered as the first treatment of choice for status asthmaticus, whereas inhaled beta 2-agonist is considered to be of no value for acute severe asthma. To determine the optimal therapy for acute asthma, the authors clinically investigated bronchodilating effects and the clinical role of aerosolized beta 2-agonist inhalation and intravenous AMP in 55 patients with status asthmaticus. Patients were classified into two groups treated without intubation and with artificial ventilation. Intravenous steroid (equivalent to 4 mg/kg of hydrocortisone) was administered in all cases. Further, all patients were randomly divided into two subgroups according to treatment regimen, i.e. repeated inhalation of aerosolized beta 2-agonists only, and combined with intravenous AMP. In all groups, the duration of treatment was significantly shorter in the subgroups treated with repeated aerosolized beta 2-agonist inhalation than those treated with intravenous AMP. The failure of intravenous AMP to effect more rapid or profound improvement both in objective and subjective parameters suggested that inhaled beta 2-agonist with intravenous steroid should be a rational choice in the initial treatment of acute asthma. Moreover, inhaled beta 2-agonist used optimally produces good bronchodilation several times greater than that produced by intravenous AMP. We concluded that repeated inhalation of aerosolized beta 2-agonists is the drug of choice combined with intravenous steroid regardless of the severity of attacks for short-term therapy of acute severe asthma, and that intravenous AMP may have only minor bronchodilating effects.

Administration, Inhalation↗
PubMed1990

[A case of Fabry's disease detected by renal biopsy findings].

A 39 year-old man was found to have mild proteinuria by urinary examination since one year ago. He was for the first time diagnosed as having Fabry's disease by histopathological and electronmicroscopic findings of the renal biopsy specimens, which showed the presence of numerous vacuolated cells and electron dense bodies inside the cells. The level of WBC alpha-galactosidase was significantly lower than normal level. The pedigree of this patient showed a familial history of various types of renal disease. One of the patient's brothers also showed decreased level of WBC alpha-galactosidase, who has been treated by maintenance hemodialysis for 2 years. It is concluded that early diagnosis of this disease through renal biopsy and WBC alpha-galactosidase level is important to manage the future course of patients with Fabry's disease.

Adult↗