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Biomedical subjects

E Murakami

Publications and source records attributed to E Murakami.

At least 55 records · Page 3Linked to original sources
PubMed1995

Dilated cardiomyopathy defines serum autoantibodies against G-protein-coupled cardiovascular receptors.

In order further to identify the prevalence of anti-receptor autoantibodies in the sera of patients with dilated cardiomyopathy (DCM), we attempted to detect autoantibodies against a series of G-protein-coupled cardiovascular receptors in a well-defined population of DCM patients from Japan. Peptides corresponding to the sequences of the second extracellular loops of the human beta 1 and beta 2 adrenoceptors, alpha 1 adrenoceptors, M2 muscarinic acetylcholine receptors and angiotensin II-1 (AT1) receptors were used as antigens in an enzyme immunoassay to screen the sera from patients with DCM (n = 28). Nine sera from patients with DCM (32%) and 2 sera from healthy subjects (9%) recognized the beta 1 adrenoceptor peptide. Ten sera from patients (36%) and 3 sera from healthy subjects (13%) recognized the M2 receptor peptide. Thirty-six per cent of the patients with autoantibody against the beta 1 adrenoceptor peptide. Ten sera from patients (36%) and 3 sera from healthy subjects (13%) recognized the M2 receptor peptide. Thirty-six per cent of the patients with autoantibody against the beta 1 adrenoceptor had autoantibody against the M2 receptor. However, no significantly high frequencies of autoantibodies against the beta 2 adrenoceptor, alpha 1 adrenoceptor and AT1 receptor were found in DCM patients. Our results demonstrate that a subgroup of patients with DCM have a specific spectrum of autoantibodies which are specifically directed against the second extracellular loops of the beta 1 adrenoceptors and M2 muscarinic receptors rather than other cardiovascular receptors.

Adult↗
PubMed1995

Detection of perioperative coronary vasospasm on iodine-123-MIBG, thallium-201 and iodine-123-BMIPP myocardial SPECT images.

A 64-yr-old woman, who had no history of anginal attack, underwent cholecystectomy under general anesthesia. A few hours after successful surgery, the EKG showed T-wave inversions with QT-interval prolongations and torsades de pointes. The [123I]MIBG scintigraphic findings revealed marked denervation in the anteroseptal and inferoposterior myocardium, whereas 201TI myocardial SPECT showed only slightly reduced tracer uptake in those areas. The [123I]BMIPP scans showed abnormal fatty acid metabolism in the anteroseptal myocardium. Coronary angiogram detected no fixed stenosis, but coronary vasoconstriction in the left anterior descending artery was induced by intracoronary injection of acetylcholine. In our patient, the findings of cardiac imaging with [123I]MIBG, 201TI and [123I]BMIPP led to coronary angiography and the final diagnosis of probable perioperative coronary vasospasm.

3-Iodobenzylguanidine↗
PubMed1995

[A case of invasive thymoma with myasthenia gravis and pure red cell aplasia].

The patient was a 42-year-old man whose main complaints were ptosis, diplopia and muscle weakness. Chest X-ray film revealed a right hilar mass and chest CT showed a solid mass at right anterior superior mediastinum. Laboratory studies revealed myasthenia gravis (MG) on EMG and pure red cell aplasia (PRCA) on hematology. An extended thymectomy, including the thymoma, was performed. Thrombocytopenia appeared postoperatively, but it improved when a platelet transfusion was given. Steroid was administered for postoperative adjuvant therapy, and the MG and PRCA were alleviated. This rare case of simultaneous MG and PRCA as complications of a thymoma is reported.

Adult↗
PubMed1995

Effect of age on left ventricular geometric patterns in hypertensive patients.

OBJECTIVES: To investigate the effect of age on left ventricular structure and geometry in hypertensive patients, we studied the relationship between age and echocardiographic variables in patients with uncomplicated essential hypertension. PATIENTS AND METHODS: We divided 168 patients with hypertension into three groups according to age: young (<40 years), middle-aged (40-59 years) and an elderly group (> or = 60 years). They were further categorized according to relative wall thickness and the left ventricular mass index. We then evaluated the prevalence of left ventricular geometric patterns in these patients according to age. RESULTS: The left ventricular end-diastolic dimension decreased with age, both in normotensive control subjects and in hypertensive patients. The magnitude of this decrease was similar for both. The relative wall thickness and left ventricular mass index were greater in the hypertensive patients than in the normotensive control subjects, and these increased with age both in the controls and the hypertensives. The differences between normotensives and hypertensives in these variables remained unchanged with age. The prevalence of a normal left ventricle (normal relative wall thickness and left ventricular mass index) in the hypertensive patients decreased with age. Conversely, the prevalence of concentric remodeling (increased relative wall thickness with normal left ventricular mass index) and concentric hypertrophy (increased relative wall thickness and left ventricular mass index) increased with age. CONCLUSIONS: These results demonstrate that age significantly affects left ventricular structure both in normotensive control subjects and in hypertensive patients. Thus, the differences in left ventricular geometric patterns with age may have important implications in assessing left ventricular structure and geometric patterns in hypertensive patients.

Adult↗
PubMed1994

Urinary carnitine excretion in patients with heart failure.

To evaluate the fatty acid metabolism in heart failure, the semiquantitative analysis of urinary free carnitine and acylcarnitine was made by fast atom bombardment mass spectrometry (FABMS) in 22 patients (mean age 67.3 years) with heart failure and 19 age-matched healthy controls (average age 60.4 years). Urinary excretion of free carnitine was 0.20 +/- 0.118 ratio/mg creatinine in the healthy controls and 1.32 +/- 1.170 ratio/mg creatinine in the patients with heart failure. The latter value was significantly higher (p < 0.01). Patients with heart failure were classified into two groups according to the urinary free carnitine concentration. One was the high excretion group (2.19 +/- 0.102 ratio/mg creatinine, 12 cases) and the other was the low excretion group (0.37 +/- 0.212 ratio/mg creatinine, 10 cases). In the high excretion group, urinary acetylcarnitine was also increased, but no significant abnormalities were observed in the urinary organic acid profile. In the high group, 1 patient was classified as NYHA class III and 11 as NYHA class IV. Four patients died in the hospital. In the low excretion group, five patients were classified as NYHA class III and five as NYHA class IV. Only one patient died in the hospital. In the high group, patients with severe and prolonged heart failure tended to maintain higher values of urinary free carnitine. We could not find any abnormalities in fatty acid metabolism in patients with heart failure, but it is suspected that the patients who excrete large amounts of free carnitine into the urine, namely the patients with severe heart failure, have some possibility of carnitine deficiency.

Acetylcarnitine↗
PubMed1994

Effects of LDL apheresis on restenosis after angioplasty.

We performed long-term maintenance LDL apheresis therapy on patients with hypercholesterolemia after undergoing PTCA, and investigated the therapeutic effects of reducing serum cholesterol, LDL-cholesterol and Lp(a). LDL apheresis significantly reduced serum lipids and was an efficacious therapy in the prevention of recurrent stenosis after PTCA.

Adult↗
PubMed1994

Gallium-67 citrate scintigraphy in idiopathic pericarditis--report of a case.

We report a case of idiopathic pericarditis in a 71-year-old woman without a friction rub or electrocardiographic changes suggestive of pericardial inflammation. She noticed dyspnea and palpitation on exertion about 40 days before admission. After admission, pericardial effusion and inflammatory reactions, such as elevated C-reactive protein, were found. Moreover, gallium-67 citrate scintigraphy revealed abnormal isotope accumulation over the cardiac silhouette. Therefore, she was diagnosed as having "active" pericarditis. The finding with the gallium scan became negative with steroid therapy. In this case, a gallium scan was very useful in assessing and monitoring the course of pericardial inflammation.

Aged↗
PubMed1994

[A study of hyperreactivity test thresholds over the last 9 years in asthmatics].

We have regularly performed acetylcholine hyperreactivity tests (Ach-HRT) on asthmatics on their first visit to our allergy clinic, and gained the impression that Ach-HRT thresholds have risen over the last nine years. We studied the thresholds in four different years: 1983, '85, '87 and '91 in 578 male cases and 680 female cases. Our findings were as follows. 1) The Ach-HRT threshold increased in the last 9 years, especially in the asthmatic group aged from 20 to 59 years old. 2) We studied the factors which might affect Ach-HRT in this age group. No significant difference were seen in the percent of peripheral blood eosinophil count and in clinical severities. The mean percent of baseline FEV1.0 was high in '91 and low in '83. We studied the Ach-HRT threshold in case with good pulmonary function whose %FEV1.0 was over 90% and found that the Ach-HRT threshold was high in '91 and low in '83. 3) The number of extrinsic cases increased gradually in number over the 9 years, and a high Ach-HRT threshold was clearer in the extrinsic cases. We concluded that the mean Ach-HRT threshold of our patients was rising especially in the extrinsic cases.

Acetylcholine↗
PubMed1994

[Clinical significance of cat allergens in adult asthmatics--a study of inhalation provocation tests].

We performed a bronchial provocation tests on 40 adult cat sensitive asthmatics to study the clinical significance of cat allergens. Immediate asthmatic responses (IAR) and/or late asthmatic responses (LAR) were provoked in 29 out of the 40 cases. IAR alone was provoked in 12 cases (30%), LAR alone in 7 cases (17.5%), dual asthmatic responses (DAR) in 10 cases (25%), and no asthmatic response in 11 cases (27.5%). There was no statistical significance in the following parameters among the groups: age, baseline of FEV1.0% and of %MMF, RAST score to cat epithelium and log value of PC20 in acetyl-choline airway hyperreactivity tests. The frequency in contact history with cat was lower in LAR alone (14%) than in the other two groups (78% in DAR, 70% in no asthmatic response). High RAST scores and low PC20 values were more frequent in DAR than in the other groups. Asthmatic responses were found in 15 out of 22 cases (68.2%) with a cat contact history and in 10 out of 16 cases (62.5%) without a contact history. These prevalence rates were the same. We concluded that cat allergens were an important factor not only for child asthmatics but also for adult asthmatics.

Adult↗
PubMed1994

Differences in cardiac function changes between diabetic and non-diabetic hemodialysis patients.

The main cause of death in chronic hemodialysis patients is heart failure. We studied cardiac function prospectively in diabetic and non-diabetic patients who had recently been started on hemodialysis. We analyzed the mechanocardiograms and echocardiograms in addition to routine blood chemistry tests, chest X-rays, and electrocardiograms of ten hemodialysis patients at our hospital from 1989 to 1991. Ejection fraction (EF) and fractional shortening (FS) were not significantly different between diabetic patients and non-diabetic patients at the start of hemodialysis. After starting hemodialysis, EF and FS declined in diabetic patients. In contrast, non-diabetic patients did not show any changes in EF and FS during hemodialysis. The results demonstrated a poor prognosis in cardiac systolic function in hemodialysis patients with diabetes mellitus.

Adult↗
PubMed1993

Left ventricular cardiac structure and diastolic function in isolated systolic hypertension in the elderly.

We examined the left ventricular cardiac structure and the diastolic function in patients with isolated systolic hypertension (ISH; SBP > or = 160 mmHg and DBP < 90 mmHg) in the elderly. We studied 17 patients with ISH, 24 age-matched patients with essential hypertension (EHT; DBP > or = 90 mmHg) and 17 normotensive controls (NT; SBP < 140 mmHg and DBP < 90 mmHg). EHT were divided into two groups based on the mean wall thickness (MWT) of the left ventricle. Group 1 patients (EHT-I, n = 12) had a MWT < 10 mm and group 2 patients (EHT-II, n = 12) had a MWT > or = 10 mm. We measured left ventricular end-diastolic dimension (LVDd), end-systolic dimensions (LVDs), left ventricular mass index (LVMi) and left ventricular isovolumic relaxation time (IRT) to assess the left ventricular cardiac structure and the diastolic function by M-mode echocardiography. LVDd was significantly smaller in ISH than in NT, EHT-I and EHT-II (P < 0.01). Relative wall thickness was greatest in ISH because of both the decreased chamber size and the increased left ventricular wall thickness. LVMi in ISH was similar to that in EHT-I, but IRT in ISH was significantly longer than that in EHT-I (P < 0.05). These results suggest that ISH in the elderly shows a left ventricular concentric hypertrophy and a severely impaired diastolic function.

Aged↗
PubMed1992

Response of plasma renin-angiotensin system to a single captopril administration in patients receiving long-term treatment with captopril.

1. The responses of angiotensin II (AII), AIII, aldosterone and plasma renin activity (PRA) to a single dose of captopril were investigated in hypertensive patients receiving long-term (more than 1 year) captopril therapy (CT patients) and compared with those of non-treated hypertensive patients (NT patients). 2. Baseline levels of AII and aldosterone were significantly lower in CT patients than in NT patients. AIII tended to be lower and PRA was slightly higher in CT than in NT patients, but these differences were not significant. 3. A single administration of captopril (50 mg orally) significantly decreased plasma levels of AII, AIII and aldosterone as well as blood pressure in both CT and NT patients. 4. These results demonstrate that chronically repeated administration of captopril to hypertensive patients effectively reduces the daily blood pressure and concomitantly the plasma AII level to acceptable levels in patients with no experience of ACE inhibition.

Aldosterone↗
PubMed1992

Effect of L-threo-3, 4-dihydroxyphenylserine on orthostatic hypotension in a patient with spinal cord injury.

A 72-year-old female who underwent the extirpation of metastatic intraspinal tumor showed an extremely wide variation of blood pressure with recurrent episodes of syncope due to paroxysmal hypotension. Treatment of the patient with salt supplement and L-threo-3, 4-dihydroxyphenylserine, an exogenous precursor of norepinephrine, markedly improved the syncopal attack as well as the daily activity.

Adenocarcinoma↗
PubMed1992

Impairment of baroreceptor reflex in patients with phaeochromocytoma.

We examined the baroreceptor reflex sensitivity (BRS) in two patients with adrenal phaeochromocytoma because of their wide BP fluctuations. These patients showed greatly reduced values for BRS, which returned to normal with marked improvements of BP fluctuations soon after the removal of phaeochromocytoma. In these patients, circulating blood volume was normal and episodic rises in BP occurred without detectable increases in plasma catecholamines. From these observations, a marked impairment of baroreceptor function is considered to be one of the determinants for the wide BP fluctuation in patients with phaeochromocytoma.

Adrenal Gland Neoplasms↗