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Biomedical subjects

A Shibata

Publications and source records attributed to A Shibata.

At least 235 records · Page 13Linked to original sources
PubMed1993

A hospital-based case-control study on hepatocellular carcinoma in Fukuoka and Saga Prefectures, northern Kyushu, Japan.

Three hundred and sixty-eight case-control sets (male 287 pairs; female 81 sets) were collected for a hospital-based case-control study of primary hepatocellular carcinoma (HCC) conducted in Northern Kyushu, Japan. All incident cases of HCC were collected weekly from the inpatients (aged 40-69) of the Second Department of Internal Medicine, Kurume University Hospital between April, 1986 and May, 1992. One control for a male case and 4 controls for a female case were sampled, being matched to a case on age (same 5-year age class), sex, residence (prefecture) and time of hospitalization (within 2 months after a case interview) from the inpatients of two general hospitals in Kurume. Information was collected by interview in person by a well-trained interviewer and from a review of hospital records by the authors. Multivariate analyses based on a conditional logistic regression model without an interaction term revealed that hepatitis B surface antigen (HBsAg) positive status (odds ratio (OR) = 8.67; 95% confidence interval (95%CI) = 2.54-29.57), history of blood transfusion over 10 years previously (2.40; 1.26-4.56), parental history of hepatic diseases (2.31; 1.11-4.80) and heavy alcohol drinking (60 < or = drink-years) by age 40 (3.23; 1.61-6.51) were statistically significant risk factors of male HCC. Univariate analysis for females also showed an elevated OR of HBsAg (7.58; 1.96-29.35). Although the sample size was limited, univariate analysis indicated that anti-hepatitis C virus antibody by c100-3 antigen positive status had a statistically significant OR for HCC in both sexes.

Adult↗
PubMed1993

Effect of granulocyte-macrophage colony-stimulating factor on chemotherapy-induced granulocytopenia in patients with malignancies.

To investigate the effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on cytotoxic chemotherapy-induced granulocytopenia, we performed an open nonrandomized clinical trial in 46 patients with malignancies receiving cytotoxic chemotherapy regimen. Twenty-six patients who received two cycles of the identical chemotherapy regimen and had granulocytopenia less than 1 x 10(9) cells/l after the first cycle of chemotherapy were eligible for this study. They received 60, 125 or 250 micrograms/m2/day of rhGM-CSF randomly. The nadirs of peripheral granulocytes demonstrated significantly much higher levels in all dosages studied than those of control cycles. The duration of granulocytopenia was shortened with rhGM-CSF support. Such granulocyte recovery appeared in parallel with increasing dosages of GM-CSF, thus, infections with febrile episodes were reduced. Toxicity of rhGM-CSF was generally well tolerated.

Adult↗
PubMed1993

Phase II study of recombinant human granulocyte-macrophage colony-stimulating factor in myelodysplastic syndrome and aplastic anemia.

As phase II study, we treated 18 patients with myelodysplastic syndrome (MDS) and 37 patients with aplastic anemia (AA) with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for 14-28 days. Administration of rhGM-CSF resulted in a dose-dependent increase in circulating granulocyte counts, which was statistically significant in patients with AA. There were no consistent changes in monocyte and lymphocyte counts. Although no increase in both thrombocyte and erythrocyte counts was detected in the majority of the patients, a response of both lineages to rhGM-CSF, in addition to granulocyte lineage, was observed in 3 patients. Drug-associated adverse events developed in 28 patients (51%). The most frequent adverse event was fever. In general, the treatment with rhGM-CSF was well tolerated. The results suggest that rhGM-CSF is effective for patients with MDS and AA.

Adolescent↗
PubMed1993

Acute effect of percutaneous transvenous mitral commissurotomy on ventilatory and hemodynamic responses to exercise. Pathophysiological basis for early symptomatic improvement.

BACKGROUND: Improvement of exertional dyspnea occurs immediately after percutaneous transvenous mitral commissurotomy (PTMC), but the pathophysiological basis for this early symptomatic improvement has not been elucidated. METHODS AND RESULTS: Exercise hemodynamic measurement and exercise ventilatory measurement with arterial blood gas analysis were performed in 21 patients aged 50.4 +/- 9.5 years (mean +/- SD) with symptomatic mitral stenosis before and a few days after PTMC. Exercise ventilatory measurement were also performed in 14 normal control subjects aged 48.9 +/- 4.9 years. After PTMC, mitral valve area increased (from 1.0 +/- 0.3 to 1.7 +/- 0.3 cm2, P < .001), mean mitral gradient (from 12.2 +/- 5.2 to 5.2 +/- 2.2 mm Hg, P < .001), and mean left atrial pressure (from 18.7 +/- 6.1 to 12.1 +/- 4.0 mm Hg, P < .001) decreased. All patients experienced significant symptomatic improvement soon after PTMC. Comparison of hemodynamic parameters at the same ergometer work rate showed a significant decrease in pulmonary artery systolic pressure (from 77 +/- 18 to 67 +/- 14 mm Hg, P < .001) and diastolic pressure (from 36 +/- 10 to 28 +/- 7 mm Hg, P < .001) and a significant increase in cardiac output (from 6.4 +/- 1.4 to 8.1 +/- 1.9 L/min, P < .001). Despite the improvement in exercise hemodynamics and symptoms, exercise capacity determined by peak oxygen uptake (from 18.0 +/- 2.9 to 18.6 +/- 3.1 mL.kg-1 x min-1) and anaerobic threshold (from 11.7 +/- 2.4 to 12.0 +/- 2.4 mL.kg-1 x min-1) remained unchanged. Excessive exercise ventilation, as assessed by the slope of the regression line between expired minute ventilation and carbon dioxide output, decreased significantly from 37.2 +/- 6.7 to 33.9 +/- 5.8 (P < .001), but remained significantly higher than that in the normal subjects (27.9 +/- 3.6, P < .01). The ratio of total dead space to tidal volume and total dead space per breath during exercise decreased significantly after PTMC (P < .05). The change in excessive exercise ventilation after PTMC was correlated with the change in dead space to tidal volume ratio (r = .59). CONCLUSIONS: Significant relief of exertional dyspnea immediately after PTMC is not accompanied by an improvement in exercise capacity. A decrease in excessive ventilation due to a decrease in physiological dead space resulting from hemodynamic improvement partly contributes to the early relief of symptoms after PTMC. However, lung compliance, which was not measured in the present study, may have changed after PTMC. This change may also contribute to the symptomatic improvement.

Anaerobic Threshold↗
PubMed1993

Alterations of binding characteristics of alpha 1-,beta 1-adrenoceptors and Ca2+ binding sites in the myocardium of spontaneously hypertensive rats (SHR) by chronically administered bunazosin, atenolol, ketanserin and verapamil.

The effects of chronic treatment with bunazosin, atenolol, ketanserin and verapamil on the myocardium of the spontaneously hypertensive rat (SHR) were examined by the radioligand binding assay method using [3H]prazosin, [125I]iodocyanopindolol and [3H]nitrendipine binding to alpha 1- and beta 1-adrenergic receptors and Ca2+ binding sites. The norepinephrine concentration in the rat myocardium was also determined. (1) All of these drugs lowered the elevated blood pressure of the SHR. (2) Only ketanserin administration increased the Kd value of the alpha 1-adrenoceptor in the SHR. (3) Administration of atenolol and ketanserin to the SHR decreased the Bmax value of the beta 1-adrenoceptor. (4) Verapamil, bunazosin and atenolol also lowered the Bmax values of the Ca2+ binding sites of SHRs. (5) All drugs except for atenolol lowered the norepinephrine concentration in the myocardium of the SHR. These findings suggest that the SHR has an abnormality of the alpha 1- and beta 1-adrenoceptors and Ca2+ binding site of the myocardium, that the drugs had a beneficial effect on these receptors, that the drugs could also lower the high norepinephrine content in the myocardium of the SHR and that some of these drugs also affected the binding characteristics of other types of membrane receptors.

Adrenergic alpha-Antagonists↗
PubMed1993

Cardiomyopathic hamster hearts: long-term effects of drugs on catecholamine contents and binding characteristics of alpha 1- and beta 1-adrenergic receptors.

Changes were examined in myocardial catecholamine content and alpha 1- and beta 1-adrenoceptors during the development of cardiomyopathy in Syrian hamsters (Bio 14.6) and age-matched healthy controls. In addition, the effects of bunazosin, atenolol, xamoterol, ketanserin, and verapamil on the catecholamine content and [3H]prazosin, [3H]CGP12177 bindings to alpha 1- and beta 1-adrenergic receptors of myocardium were compared with those of the controls. (1) Lower norepinephrine and dopamine levels were observed in 35-week-old cardiomyopathic hamster hearts than in the controls. There was, however, a tendency for a slight decrease of alpha 1- and beta 1-adrenoceptors in cardiomyopathic hamsters. (2) Administration of bunazosin induced lower dopamine values in 18-week-old cardiomyopathic hamsters. (3) Xamoterol induced a higher Kd value for beta 1-adrenoceptors and lower dopamine content than for those with cardiomyopathy. Ketanserin also induced a higher Bmax value than for cardiomyopathy. Thus, drug treatments clearly change catecholamine content and binding characteristics of the adrenoceptors which play an important role in the development of cardiac hypertrophy and heart failure.

Adrenergic alpha-Antagonists↗
PubMed1993

[The incidence of atherosclerotic lesions of the carotid artery in people of one community].

Carotid sonography were conducted in people of one community (122 males and 243 females) in 1990 and 1991. The intima-media thickness (IMT) in the main trunk and bifurcation-bulb areas of bilateral carotid arteries were measured in 122 males. IMTs of four areas increased with aging. In all cases, the average IMT of the right main trunk was 0.8 +/- 0.1 mm (mean +/- SD) and those of the remaining three areas were 0.9 +/- 0.2 mm. The IMT of the right bifurcation area in males aged 75 years or older was the thickest; i.e., 1.1 +/- 0.3 mm. Therefore, atherosclerotic lesions (AL) were defined as an IMT of 1.5 mm or more. The incidence of AL increased along with aging both in males and females. In those who were less than 65 years old, the incidence in males was 12.8% (10/78) and that in females was 9.0% (12/134). In those who were 65 years old or older, the incidence in males was 31.8% (14/44) and that in females was 26.9% (29/109). The incidence of AL tended to increase rapidly from 65 years of age in both males and females. Moreover, the incidence of AL in bilateral carotid arteries increased along with aging as well. Since IMT, the incidence of AL and that of AL in bilateral carotid arteries increased with aging, we considered that these parameters could be used as indices of the degree of general atherosclerosis.

Adult↗
PubMed1993

Alternation in the fusion complex during constant pacing of sustained ventricular tachycardia.

In a patient with sustained ventricular tachycardia (VT), we observed two different conduction times through the reentry circuit at the critical paced cycle length. The cycle length of the VT was 420 msec and overdrive pacing initially performed at a paced cycle length of 400 msec and repeated at decrements of 10 msec until the VT was interrupted at a paced cycle length of 320 msec. During rapid pacing, constant fusion and progressive fusion were confirmed. The first post-pacing return cycle was identical to each paced cycle length. The conduction time between the stimulus artifact and the orthodromically captured electrogram at the left ventricle was constant at 350 msec in each paced cycle length. However, only at a pacing cycle length of 360 msec two conduction times were alternatively observed, one of 350 msec and the other of 365 msec. When the conduction time changed from 350 msec to 365 msec, morphological alternation both in the surface QRS complex and in the orthodromically captured electrogram was evident. Dual slow pathways or a single slow pathway with plural exits from the reentry circuit is a likely mechanism of the alternation.

Aged↗
PubMed1993

Pleomorphic ventricular tachycardia arising from a new site during antiarrhythmic drug therapy.

UNLABELLED: We analyzed the site of VT origin and the induction mode of VT in 9 patients who showed new VT morphologies with different bundle branch block patterns after administering antiarrhythmic drug(s). In all patients, VT exhibiting the clinical morphology was induced in the drug free state. (1) VT origin: In 6 patients, VTs showing LBBB pattern had a site of origin at the right ventricular free wall, and VTs with RBBB pattern originated from the left ventricular free wall. VT from the intraventricular septum of the right ventricle showed RBBB pattern in two patients and VT with LBBB pattern arose from the posteroseptum of the left ventricle in one patient. (2) VTs with new morphologies: After administering drug(s), VTs with new morphologies were induced in 18 studies and the mean cycle length of these VTs was not different from that in the control study. Among them, the induction mode was less aggressive in 4 of 7 drug studies and more aggressive in 1 study. (3) VTs with the same morphology: VTs with morphologies identical to those of the clinical VTs were induced in 15 studies. However, the drugs' effect was evident. The mean cycle length of these VTs was significantly prolonged, and VTs were induced by less aggressive modes or at longer coupling intervals. IN CONCLUSION: (1) After administering drug(s), different electrophysiologic characteristics were observed between the VTs with new morphologies and the VTs with the same morphology. (2) If a new VT was induced by less aggressive modes after administering drug(s), the drug(s) might act to facilitate inducibility: proarrhythmic effect.

Adolescent↗
PubMed1993

Renal effects of different types of protein in healthy volunteer subjects and diabetic patients.

OBJECTIVE: To evaluate the effects of acute loading of protein from different sources on the glomerular filtration rate. RESEARCH DESIGN AND METHODS: A total of 6 healthy volunteer subjects and 6 diabetic patients with normoalbuminuria were studied before and after ingestion on separate days of tuna fish containing 0.7 g/kg body wt of protein, boiled egg white containing the same amount of protein as the tuna fish, or boiled egg white containing 1.4 g/kg body wt of protein. Furthermore, to study the possible role of prostaglandins and amino acids in the response of GFR to protein loading, urinary excretion of prostaglandins, and plasma levels of amino acids were measured during these tests. RESULTS: In normal subjects, the GFR rose significantly (P < 0.01) after ingestion of tuna fish. No significant differences were found between GFR before and after ingestion of the different amounts of egg white. The GFRs of the diabetic patients after ingestion of each of the meals were similar to the responses in healthy volunteers. Plasma levels of Gly and Ala (amino acids known to induce glomerular hyperfiltration) were higher after ingestion of tuna fish than after administration of egg white in all subjects. No differences were found in the plasma concentrations of any amino acids except Gly and Ala after loads of tuna fish and egg white containing 1.4 g/kg of protein. Urinary 6-keto-PGF1a excretion increased significantly (P < 0.01) after tuna fish loading, but did not change after egg white challenge. CONCLUSIONS: These findings could be explained either by differences in renal vasodilatory prostaglandin secretion or by increased plasma levels of Gly and Ala, which were increased only after ingestion of tuna fish. Thus, egg white has renal effects on GFR different from those of tuna fish, independent of the quantity of protein ingested.

Adult↗
PubMed1993

Levels of serum granulocyte colony-stimulating factor in patients with chronic myeloid leukemia.

To clarify the patho-physiologic role of granulocyte colony-stimulating factor (G-CSF) in chronic myeloid leukemia (CML), we determined the serum levels of G-CSF in various stages of CML using a very sensitive method: chemiluminescence enzyme immunoassay (CLEIA). This method makes it possible to estimate very low levels of serum G-CSF. In the present study, serum samples from 25 patients in chronic phase and 16 in blastic crisis, as well as samples from 33 healthy volunteers were investigated. The serum G-CSF levels in chronic phase of CML (2.95 +/- 3.91 pg/ml) were significantly lower than those in normal controls (15.92 +/- 6.53 pg/ml) and in blastic crisis of CML (15.52 +/- 17.65 pg/ml) within a range of very low levels (p < 0.001, p < 0.02). Moreover, a reverse correlation between blood neutrophil counts and serum G-CSF levels were clearly demonstrated for CML including blastic crisis (r = 0.405, p < 0.02). Interestingly, a sequential parallel relation was observed between serum G-CSF levels and neutrophil alkaline phosphatase (NAP) scores for a patient with CML in chronic phase. Our observations indicate that a negative feedback mechanism exists between peripheral neutrophils and serum G-CSF levels in the chronic phase of CML, and that very low levels of G-CSF in chronic phase of CML might be an important cause for the low NAP scores.

Alkaline Phosphatase↗
PubMed1993

Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) after chemotherapy in patients with non-Hodgkin's lymphoma; a placebo-controlled double blind phase III trial.

To assess the clinical and hematopoietic effects of rhGM-CSF, a placebo-controlled double blind multicenter phase III study was undertaken in patients with non-Hodgkin's lymphoma receiving cytotoxic chemotherapy. Sixty-two patients who had granulocytopenia (< 1 x 10(3)/microliters) after the first cycle of chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone were enrolled. After the second cycle of chemotherapy with the same regimen, patients randomly received either rhGM-CSF (125 micrograms/m2/day) or placebo for 14 days (rhGM-CSF; 31 patients and placebo; 31 patients). Administration of rhGM-CSF induced a significant increase in granulocytes mainly with neutrophils, eosinophils and monocytes, but elevation of lymphocytes, platelets, and reticulocytes was not induced. Median days of granulocytes less than 1 x 10(3)/microliters in patients receiving rhGM-CSF were significantly shorter than in patients receiving placebo (p = 0.001). Adverse reactions encountered with rhGM-CSF, and observed in 58% of the patients were never life-threatening and always rapidly reversible. They included fever, nausea and vomiting, diarrhea, skin eruption, and malaise. These results suggest that rhGM-CSF can be safely administered to prevent neutropenia after chemotherapy in patients with non-Hodgkin's lymphoma.

Adolescent↗
PubMed1993

Significance of glomerular deposition of plasmin-alpha 2-plasmin inhibitor complexes in various glomerulopathies.

To elucidate the relationship between glomerular deposition of plasmin-alpha 2-plasmin inhibitor complexes (PIC) and renal lesions or dysfunction, 25 patients with various glomerulopathies and various degrees of renal injuries were examined. Glomerular PIC deposition was found in eight patients (group A), and other 17 patients showed no deposition (group B). PIC was found mainly in the mesangium and along the capillary loops. Group A showed significantly more severe hematuria (p < 0.05) than group B. Group A showed a significant decrease in glomerular filtration rate (GFR; p < 0.05): the mean values being 60.8 +/- 39 in group A and 94.5 +/- 32 ml/min in group B. Group A showed a significant decrease in the phenolsulfonphthalein excretion test (p < 0.05). There was no significant difference in the mean values of plasma PIC, D-dimer, and thrombin-antithrombin III complexes (TAT) between two groups. Histologically, group A showed a significantly high incidence of adhesion (p < 0.05), crescentic formation (p < 0.05), endothelial swelling and/or detachment (p < 0.01), tubulointerstitial changes (p < 0.01), and glomerular deposition of platelet factor 4 (p < 0.01). The present study demonstrates that glomerular PIC deposition reflects the existence of activation of coagulation and fibrinolysis within the glomeruli and suggests that glomerular PIC deposition plays a part in the progression of renal injuries in various glomerulopathies.

Antifibrinolytic Agents↗
PubMed1993

[Peripheral neuropathy in large granular lymphocytic leukemia].

A 16-year old woman with LGL leukemia developed peripheral neuropathy. She showed virus-associated hemophagocytic syndrome (VAHS)-like signs including high fever, liver dysfunction, huge splenomegaly, hepatomegaly and pancytopenia. The presence of chronic active EB virus infection was proved by marked high titers for IgG and IgA antibodies to the Epstein-Barr viral capsid and early antigens and low titers of antibody to Epstein-Barr nuclear antigens. She showed dysesthesia and paresthesia of bilateral lower extremities with marked swelling and tenderness, and later developed muscular weakness and atrophy with areflexia of lower extremities. Findings of the central nervous system dysfunction were not observed except for the acceleration of jaw jerk. Pleocytosis and increased protein levels in the cerebrospinal fluid were found. Pulse therapy of methyl-prednisolone and high dose intravenous immunoglobulin therapy (20 g/day for 3 days) were effective for neurological findings. The increased neopterin in the cerebrospinal fluid suggested that peripheral neuropathy was caused by activated macrophages.

Adolescent↗
PubMed1993

A case-control study of risk factors for proliferative vitreoretinopathy in aphakia.

A case-control study was performed to elucidate the risk factors of proliferative vitreoretinopathy (PVR) in aphakia. Twenty-five aphakic eyes with rhegmatogenous retinal detachment accompanied by PVR were compared with the control group of 156 aphakic eyes with rhegmatogenous retinal detachment without PVR. Unconditional logistic regression analysis identified the following risk factors for developing PVR in order of significance: choroidal detachment (odds ratio 15.41, 95% confidence interval 3.29-72.09), duration of retinal detachment longer than one month (odds ratio 12.07, 95% confidence interval 3.53-41.26), occurrence of retinal detachment within one year following cataract surgery (odds ratio 6.2, 95% confidence interval 1.64-23.47), and history of vitreous loss in cataract surgery (odds ratio 3.91, 95% confidence interval 1.28-11.92).

Adolescent↗
PubMed1993

Combination therapy with rhGM-CSF and rhEpo for two patients with refractory anemia and aplastic anemia.

Because GM-CSF possesses burst-promoting activity (BPA) and megakaryocyte colony-stimulating activity (Meg-CSF) as well as stimulating activity on granulocyte-macrophage progenitors, and erythropoietin (Epo) has thrombopoietin-like activity, the combination therapy of GM-CSF and Epo seems to be more effective for stimulating erythropoiesis and thrombocytopoiesis in patients with pancytopenia. For this reason, the combination therapy of recombinant human GM-CSF (rhGM-CSF) and rhEpo was performed in two patients with refractory anemia (RA) and aplastic anemia (AA). Epo-unresponsive anemia was remarkably improved by adding rhGM-CSF to Epo and the effect lasted for 1 1/2 months in a patient with RA, but severe anemia occurred again immediately after the discontinuation of Epo. The neutralizing antibodies against GM-CSF were not demonstrated at the phase when anemia re-progressed in this patient. In a patient with AA, anemia and thrombocytopenia, which were refractory to previous administration of rhGM-CSF, responded to the combined administration of GM-CSF and Epo. Although the effects were maintained for 3 1/2 months, the anemia and thrombocytopenia became worse again after the administration of rhGM-CSF was changed from daily to every other day. These findings suggest the usefulness of combination therapy of GM-CSF and Epo for patients with pancytopenia.

Adult↗
PubMed1993

[A case of cryptococcal meningitis in an HTLV-1 carrier].

We report a case of 73-year-old male HTLV-I carrier with cryptococcal meningitis. The patient, who was born in Taiwan, has raised golden pheasants for ten years and bantams for five years. Antibody to HIV was negative. Flow cytometric study of the peripheral lymphocytes showed reduced CD4+CD45RA+ (naive cells) and increased CD4+CD45RO+ (memory cells), CD3+CD25+ and CD3+ HLA-DR(DR)+ cells. Lymphocyte responses to phytohemagglutinin and concanavalin A were depressed. Cerebrospinal fluid (CSF) cells and serum and CSF antigen to cryptococcal neoformans were decreased by therapy with fluconazole and flucytosine. Although the naive, memory and CD3+DR+ cell abnormalities showed no change, the CD45RA/CD45RO ratio and CD3+CD25+ level tended to improve. Opportunistic infections such as cryptococcal meningitis may be induced by severe decreases in naive cells and increases in memory cells in HTLV-I carriers.

Aged↗