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Biomedical subjects

A Nakashima

Publications and source records attributed to A Nakashima.

At least 109 records · Page 6Linked to original sources
PubMed1990

[A case of acute potassium bromate intoxication].

We experienced a case of a 44 year old man who had ingested potassium bromate solution for suicide attempt. Soon after the ingestion, nausea, vomiting, abdominal pain and diarrhea developed in him. Several hours later, he began to complain of auditory disturbance and, in addition, anuric acute renal failure occurred. Direct hemoperfusion and hemodialysis was performed on the patient for the treatment purpose. Five weeks later, he was released from hemodialysis procedure. Gradually, on the other hand, progressing anemia was observed until 90th hospital day, which slowly improved thereafter. Further, pruritus, lower leg pain, headache, tinnitus and loss of sense of taste, etc. were observed in the clinical course. Renal biopsy was performed on the 119th hospital day and the specimen showed the regenerative stage of acute tubular necrosis. In our case, acute renal failure was reversible and, many other clinical manifestations were observed. However slight anemia and irreversible severe auditory disturbance remained unimproved.

Acute Kidney Injury↗
PubMed1990

[Reproducibility of peak expiratory flow rate measured at home].

In 8 stable patients with chronic asthma, the reproducibility of peak expiratory flow rate (PEFR) measured and recorded 4 times per day for longer than 1 month at home and at work was assessed. Average %PEFRs of individuals through the periods observed were higher than 80%, and coefficients of variation were less than 10% regardless of the time measured. This suggested that a decrease in %PEFR more than 10% reflects early phase of deterioration of airways narrowing and frequent measurement of PEFR is essential for long-term management and for self-assessment of chronic asthma.

Adolescent↗
PubMed1990

[Bucillamine-associated membranous nephropathy in a patient with rheumatoid arthritis].

A case of bucillamine-associated membranous nephropathy in a patient with rheumatoid arthritis was reported. A 34 year-old woman was admitted to our hospital because of proteinuria in September, 1988. Rheumatoid arthritis had been diagnosed in April, 1988, and had been treated with bucillamine (disease modifying anti rheumatic drug) and amfenac (nonsteroidal antiinflammatory drug). The renal biopsy specimens showed Stage I membranous nephropathy, on both electron and immunofluorescence microscopy. Proteinuria decreased after the drugs were withdrawn despite continued RA symptoms. These results were consistent with drug induced nephropathy. Since bucillamine has some resemblances in its structure and pharmacologic action to D-penicillamine, which sometimes induces membranous nephropathy, it is thought that the nephropathy in this case was caused by an adverse reaction to bucillamine.

Adult↗
PubMed1990

[A case of blue rubber-bleb nevus syndrome with CAPD].

The first case of blue-rubber-bleb nevus syndrome treated with CAPD in Japan was presented. As operation for A-V fistula construction could not be performed due to the skin lesions, she was obliged to have CAPD treatment. She has been visiting our hospital for regular check-ups.

Female↗
PubMed1990

[Disturbance of the autonomic nerve system in patients with chronic renal failure--represented by variation coefficient of R-R intervals in the ECG as a parameter].

Autonomic nerve dysfunction in patients with chronic renal failure has of late become an issue to be investigated. R-R intervals in resting electrocardiograms were measured to evaluate activities of the cardiac parasympathetic nerve system. A total of 140 patients with chronic renal failure were studied to be compared with 20 normal controls (cont.) and 39 with diabetes mellitus (DM). Of these patients 15 were subjected to conservative treatment (CRF), while 125 patients were undergoing hemodialysis due to chronic renal failure-100 of them derived from chronic glomerulonephritis (HD) and 25 from diabetes mellitus (DM.HD). The variation coefficient of the R-R interval (CVRR) was measured after the subject patients had rested for over 15 minutes before a dialysis session. The mean CVRR were 2.15 +/- 1.25% in CRF group, 2.36 +/- 1.37% in HD and 1.37 +/- 0.99% in DM.HD. These values were significantly lower than in control group (4.70 +/- 2.64%). On the other hand, the value in DM.HD group, as shown above, was significantly lower than in HD. In CRF group the CVRR values lowered as residual renal functions decreased. No significant correlations between CVRR S and the duration of hemodialysis treatment were noted among the groups. In HD group the CVRR S were significantly lower in patients with hypotensive tendency during hemodialysis than in those who enjoyed good control of blood pressure. These results suggest that the measurement of CVRR S can be of help in evaluating autonomic nerve dysfunction in patients with chronic renal failure.

Adult↗
PubMed1990

[Coronary artery disease and the results of coronary bypass surgery in diabetics].

To evaluate the influence of diabetes mellitus on coronary artery disease and the results of coronary bypass surgery, a review was made of 63 consecutive patients undergoing isolated saphenous vein aortocoronary bypass, of whom 38 patients (G-1) were nondiabetic, 9 patients (G-2) had impaired glucose tolerance, and 16 patients (G-3) were diabetic. The severity of coronary artery disease was assessed using an angiographic grading system. Among three patient groups, there was no difference in total coronary score per patient reflecting total extent of disease (G-1; 15.7 +/- 5.5, G-2; 14.1 +/- 5.9, G-3; 17.1 +/- 6.3, mean +/- S.D.) and the incidence of diffusely diseased vessels. The mean number of diseased vessels (greater than 50% stenosis) per patient was 2.5 +/- 0.6 in G-1, 2.6 +/- 0.7 in G-2, and 2.5 +/- 0.7 in G-3, and the mean number of bypass grafts per patient was 2.3 +/- 0.9, 2.2 +/- 0.9, and 2.1 +/- 0.7, respectively. Coronary luminal diameters and the severity of atherosclerotic changes of coronary arteries at the site of graft anastomosis, studied intraoperatively, were similar in all groups. Vein graft blood flows and early graft patency in diabetics (112 +/- 55 ml/min, 96.9%, respectively) were also similarly good as those in the other groups (98 +/- 49 ml/min, 91.4% in G-1, and 92 +/- 39 ml/min, 94.1% in G-2). Overall hospital mortality was 1.6% (one of 63). The only death from meningoencephalitis occurred in the diabetic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMed1989

Acute thrombosis of the inferior vena cava and hepatic veins in patients with Budd-Chiari syndrome: CT demonstration.

We reviewed the CT findings in 17 patients with angiographically proved Budd-Chiari syndrome to determine the ability of CT to show acute thrombosis of the inferior vena cava (IVC) and hepatic veins. In eight patients with membranes (web or band) in the IVC, no thrombus was detected with CT or angiography. In the other nine patients, thrombi in the IVC and/or hepatic veins were seen as intraluminal filling defects that did not change in appearance on precontrast and postcontrast CT scans. Attenuation values of intraluminal filling defects of the IVC ranged from 38 to 42 H in four patients. High-attenuation intraluminal filling defects (60-70 H) of the IVC (five patients) and hepatic veins (one of five patients) were detected. Of these five patients, four had acute symptoms and one had chronic vague symptoms. The underlying disease was a web or band in the IVC and hepatic veins in three patients, invasive hepatocellular carcinoma in one, and injury to the IVC wall during hepatectomy in one. Inferior venacavography showed occlusion of the hepatic segment of the IVC in all five patients. Additional angiograms obtained by injection of contrast medium after a catheter tip was placed in the occluded hepatic IVC showed numerous filling defects suggestive of thrombi of recent onset, which correlated with the high-attenuation thrombi seen on CT scans in two patients. In the remaining three patients, high-attenuation areas in the IVC and hepatic veins also were considered to represent thrombi of recent onset because the attenuation values later decreased to 33-42 H. Spontaneous reduction in diameter of the thrombosed segment of the IVC was observed in four of the five patients. Knowledge of the CT features of acute thrombosis of the IVC and hepatic veins is useful in the early diagnosis of Budd-Chiari syndrome.

Acute Disease↗
PubMed1989

[A case of hepatoma treated successfully with a percutaneous intratumoral injection of CDDP-PC-lipiodol suspension].

Reported is a case that was treated successfully with a percutaneous intratumoral injection of a CDDP-PC-Lipiodol Suspension (CPLS) of the viable tumor cells of a hepatoma after arterial injection therapy. Although the size of the viable tumor cells remained almost unchanged, a marked reduction in the level of the plasma AFP (484 ng/ml-35 ng/ml) was obtained after the percutaneous injection. No major complication was encountered except for minimal vomiting and mild transient abnormalities of the liver functions.

Aged↗
PubMed1989

[Graves' disease complicated with systemic lupus erythematosus (SLE): a case report].

A 25 year old man had been subjected to subtotal thyroidectomy under the diagnosis of Graves' disease. About a year later the patient developed systemic lupus erythematosus (SLE). Reports on cases of Graves' disease complicated with SLE have barely been observed so far. Consequently, the authors reckoned, with reference to the other literatures on the subject, our case worth reporting.

Adult↗
PubMed1989

[Coronary artery bypass grafting in a patient with Sjögren's syndrome and other autoimmune diseases].

Coronary arterial involvement in collagen disease is a very rare complication. Particularly in Sjögren's syndrome is there no report of coronary artery bypass grafting (CABG). We report a 68-year-old woman with various autoimmune diseases who underwent successful CABG for unstable angina pectoris. She had a history of Sjögren's syndrome, hypothyroidism, thrombocytopenia and lupoid hepatitis, and had been on the regimens of prednisolone and levothyroxine sodium during the last 4 years. Two months prior to admission when the doses of these drugs were increased, she began to complain of angina on mild exertion and occasionally even at rest. Selective coronary angiograms revealed 75% stenosis at Seg. 2 and 99% stenosis at Seg. 6. Based on these findings and severity of the angina, saphenous vein CABG to the posterior descending and the left anterior descending branches was performed. Despite the associated autoimmune diseases, the patient's postoperative course was uneventful and she is now doing well with no attack of angina, 12 months following the operation.

Aged↗
PubMed1989

[Serological and histological study of lupus nephritis with special reference to anti-SSA antibody].

Systemic lupus erythematosus (SLE) is a disease of unknown etiology in which many organs are damaged by deposition of pathogenic autoantibodies and immune complexes Clinically lupus nephritis occurs about 50% in SLE Many studies revealed the association between autoantibodies and lupus nephritis However, the pathogenetic role of autoantibodies in lupus nephritis remains obscure. To elucidate the pathogenetic role of anti-SSA antibody in lupus nephritis, 32 patients with SLE were evaluated by serological and histological methods. Enzyme-linked immunosorbent assay for anti-SSA antibody was developed for this study. It was confirmed that this assay was specific, did not detect autoantibodies other than anti-SSA antibody. The levels of anti-SSA antibody determined by this assay significantly correlated with the levels determined by double immunodiffusion (p less than 0.01). The level of anti-SSA antibody greater than or equal to 200 units was regarded as positive. The serum levels of antinuclear antibody, anti-DNA antibody, anti-RNP antibody, anti-SSA antibody, anti-SSB antibody, C3, and C4 were also determined. Renal biopsy materials were evaluated according to the WHO criteria, and activity index (AI), chronicity index (CI), and pathologic score (PS) were calculated according to Austin et al. The patients were divided into group A (AI greater than or equal to 4, n = 17) and group B (AI less than or equal to 3, n = 15) The levels of anti-DNA antibody were significantly higher in group A than in group B (p less than 0.05). The frequency of positive anti-SSA antibody in group A (70.6%) was greater than in group B (23.3%) significantly (p less than 0.05). However, there were no differences in the levels of anti-nuclear antibody, anti-DNA antibody, anti-RNP anti-body, anti-SSA antibody, anti-SSB antibody, C3, and C4 between group A and group B. Then these patients were divided into group I (anti-SSA greater than or equal to 200 units, n = 17) and group II (anti-SSA less than 200 units, n = 15). AI and CI were greater than in group I than in group II significantly (p less than 0.05). The frequency of pericarditis in group I (35.3%) was greater than group II (6.7%) (p = 0.061), but the frequencies of the other clinical manifestations were not different. AI was correlated with anti-DNA antibody significantly (p less than 0.01), but there were no correlations between other serological data and parameters.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1989

[PTCA and coronary artery bypass operation prior to subsequent surgery of gastric cancer in patients with coronary artery disease].

Two patients with coronary artery disease required operation for gastric cancer. In one patient with single vessel disease, 37 days later after successful PTCA, gastric resection for early gastric cancer was performed without any cardiac complication. The other patient with severe three vessel disease initially underwent coronary artery bypass operation, and 13 days later gastric resection for advanced cancer was performed. This patient developed supraventricular arrhythmia as a sole complication which was easily controlled by medical treatment. In both cases, fentanyl was used as an anesthetic agent and nitroglycerin was continuously administered intravenously during the perioperative period. ECG, central venous pressure, and direct arterial pressure were also carefully monitored. We feel that noncardiac operation such as gastric resection can be performed without major cardiac complications even shortly after coronary artery bypass operation.

Aged↗
PubMed1989

[Three cases of intralobar pulmonary sequestration--demonstration of an aberrant artery by contrast CT].

Three cases of intralobar pulmonary sequestration, whose aberrant arteries could be demonstrated by contrast CT were reported. We confirmed these aberrant arteries both by selective angiography and/or surgical resection. We conclude that contrast CT may be of great use and benefit in the radiological workup of suspected cases of pulmonary sequestration proceeding to angiography.

Adult↗
PubMed1989

[Clinical assessment of prosthetic valve replacement of the right-sided cardiac valves: mechanical or bioprosthesis?].

Clinical results with mechanical and bioprosthetic valve replacements for tricuspid and/or pulmonary positions were reviewed. Between February 1975 and December 1985, 34 bioprostheses (B) (22 Hancock, 9 Ionescu-Shiley and 3 Carpentier-Edwards pericardial) and 18 mechanical prostheses (M) (St. Jude Medical) were implanted in our institute excluding hospital death. Group with B included 29 tricuspid valve replacements and 5 pulmonary valve replacements. Group with M included 9 tricuspid valve replacements, 7 pulmonary valve replacements and 1 both valve replacements. The cumulative follow-up period was 207.2 patient-years (p-t) in group B and 55.0 p-y in group M. The incidence of valve failure was 0.48 +/- 0.48% per p-y in group B and 7.27 +/- 3.64% per p-y in group M (p less than 0.001). The incidence of valve-related events was 1.93 +/- 0.97% per p-y in group B and 9.09 +/- 4.07% per p-y in group M (p less than 0.001). At 3 years, the percent free of valve failure was 100 +/- 0% in group B and 76.8 +/- 10.2% in group M (p less than 0.05). Fourteen bioprosthetic valves (B') and 10 mechanical valves (M') were implanted at the right-sided cardiac valve position alone. The cumulative follow-up period was 94.2 p-y in group B' and 32.3 p-y in group M'. The incidence of valve-related events was 1.06 +/- 1.06% per p-y in group B' and 12.4 +/- 6.19% per p-y in group M' (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Anemia in patients on continuous ambulatory peritoneal dialysis (CAPD)].

Inhibitors of erythropoiesis found in the blood of uremic patients have been implicated as some of the causes of anemia in chronic renal failure. As a treatment to remove the inhibitors, continuous ambulatory peritoneal dialysis (CAPD) is thought to be more effective than hemodialysis. Some researchers have reported that CAPD has improved anemic state in hemodialysis patients. However, there have been some cases of severe anemia seen in CAPD patients. To access the effect of the CAPD, we have performed serial examination on hemoglobin (Hb) and hematocrit (Ht) in 5 uremic patients under CAPD treatment. Hb levels in 4 and Ht in 3 of 5 patients have been known to be increased. One patient was shown to have no increment on the levels of Hb and Ht. On the other hand, further investigation has been down to access the effect of the recombinant human erythropoietin (r-HuEPO: Chugai pharmaceutical) on anemic patients, in whom no effect was noticed by treatment of CAPD. One severe anemic patient, who had been undergoing the treatment of CAPD for two years, was given r-HuEPO intravenously. The patient showed the increment on the levels of Hb and Ht, and the decreases on the levels of serum iron and ferritin. However, the patient has developed hypertension. In conclusion, CAPD was known to be not always effective for the increment of Hb and Ht, while r-HuEPO was very effective for the improvement of severe anemia in CAPD patients which enabls them to lead better social life for them.

Adult↗
PubMed1988

Double valve replacement for infective endocarditis in a hemodialysis patient: a case report.

A 57-year-old man who was in end stage renal failure underwent an aortic and mitral valve replacement for the progression of cardiac dysfunction, secondary to Staphylococcus aureus infective endocarditis. Cardiac surgery was performed using a Hemo-Concentrator during cardiopulmonary bypass, 82 months following the initiation of hemodialysis. This is the second report in the literature of a successful double valve replacement for infective endocarditis and congestive heart failure in a chronic hemodialysis patient.

Aortic Valve↗