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Biomedical subjects

H Iida

Publications and source records attributed to H Iida.

At least 127 records · Page 7Linked to original sources
PubMed1999

Effect of the platelet-derived growth factor antagonist trapidil on mesangial cell proliferation in rats.

Platelet-derived growth factor (PDGF) is known as a potent mediator in the proliferation of mesangial cells in culture and in mesangial proliferative nephritis. The present study was undertaken to evaluate the effect of trapidil, an antagonist of PDGF, on mesangial cell proliferation in culture and in anti-Thy-1.1 nephritis in rats. Trapidil significantly inhibited 3H-thymidine incorporation in the mesangial cells stimulated by PDGF BB and suppressed mesangial cell proliferation in culture in a dose-dependent manner. In anti-Thy-1.1 nephritis, a significant reduction in the number of total glomerular cells and also proliferating (proliferating cell nuclear antigen positive) cells was demonstrated on day 7 in the rats treated with trapidil as compared with controls. Although renal function expressed as blood urea nitrogen and creatinine levels did not differ between rats with and without trapidil treatment, the present results suggest a salutary effect of trapidil on mesangial cell proliferation. PDGF, therefore, could play an important role in mediating mesangial cell proliferation.

Animals↗
PubMed1999

Effect of intravenous dipyridamole on cerebral blood flow in humans. A PET study.

BACKGROUND AND PURPOSE: Dipyridamole increases the concentration of circulating adenosine, which is a potent vasodilator, by inhibition of uptake of adenosine into the erythrocytes, and hence produces coronary vasodilation. However, the effects of dipyridamole on cerebral circulation is not pronounced. This study investigates the effects of intravenous dipyridamole on cerebral blood flow (CBF) in humans with use of positron emission tomography (PET). METHODS: In each of 13 healthy subjects, CBF was measured using (15)O-labeled water and PET at rest and during hypercapnia, hypocapnia, and dipyridamole stress; corresponding CBF values were then compared. RESULTS: CBF values during dipyridamole stress were significantly lower than those measured at rest. The dipyridamole stress PaCO(2) was also significantly lower than the resting PaCO(2). The change in CBF during dipyridamole stress relative to PaCO(2) closely followed the relationship between CBF and PaCO(2) during hypocapnia. CONCLUSIONS: These results indicate that the observed decrease in CBF during dipyridamole stress was caused by a decrease in PaCO(2) rather than by any direct action of dipyridamole on CBF. The decrease in PaCO(2) during dipyridamole stress was most likely due to hyperventilation, which was a side effect of adenosine. These results support the hypothesis that circulating adenosine is largely prevented from binding to adenosine receptors of cerebral vessels by the blood-brain barrier.

Aged↗
PubMed1999

Screening for aetiology of thrombophilia: a high prevalence of protein S abnormality.

We systematically screened for the aetiology of thrombophilia in 115 patients with venous, arterial and small vessel thromboses. Forty-one patients (36% of those we examined) suffering from a variety of thromboses, including deep vein thrombosis, pulmonary embolism, arterial occlusion, cerebral infarction, Moyamoya disease and ulcerative colitis, were characterized either with positive lupus anticoagulants or with decreased activities of protein S, protein C, antithrombin III and/or plasminogen. Eight mutation sites were confirmed in 11 thrombotic patients using gene analysis. Decreased protein S activity was found with a high incidence (23 out of 115) in Japanese patients who suffered from not only venous thrombosis but also arterial and small vessel thrombosis. We emphasize here the important role of protein S in the pathogenesis of thrombosis in the Japanese population.

Adolescent↗
PubMed1999

Abnormal coronary flow profiles at rest and during rapid atrial pacing in patients with hypertrophic cardiomyopathy.

To examine the mechanism of myocardial ischemia in hypertrophic cardiomyopathy (HCM), coronary flow velocity was measured in the left anterior descending coronary artery (LAD) using a Doppler guide wire in 11 patients with HCM and in 8 normal controls. The average peak velocity (APV), percent increase of APV (%APV), and APV during systole (Vs) and diastole (Vd) were calculated at rest and during rapid atrial pacing. The APV in HCM reached a peak value at a heart rate of 90 beats/min, while in the controls the APV increased continuously until the heart rate reached 130 beats/min [%APV (130 beats/min); 103+/-30% in HCM vs 139+/-23% in controls, p<0.04]. During rapid atrial pacing, Vs in the controls increased, whereas Vs in HCM decreased further. During high-rate pacing, Vd in HCM reached a peak value at a heart rate of 90 beats/min, whereas in the controls, Vd increased continuously until the heart rate reached 130 beats/min. The acceleration rate of early diastolic flow was significantly lower in HCM than in the controls (1.85+/-0.66 vs 3.18+/-1.62 m/s2, p<0.03). This abnormal response might be due to an increase in the reverse systolic flow and a decrease in the diastolic flow, probably caused by a slow acceleration of early diastolic flow velocity in the LAD.

Adult↗
PubMed1999

Hypoglycemia induced by interaction between clarithromycin and disopyramide.

A 59-year-old man receiving hemodialysis was hospitalized due to severe hypoglycemic attack. The patient had been treated with disopyramide (50 mg/day) because of paroxysmal atrial fibrillation. Hypoglycemia occurred after taking clarithromycin (CAM, 600 mg/day), a macrolide antibiotic. The serum disopyramide concentration reached 8.0 micrograms/ml (23.6 microM) in the presence of CAM, while it was 1.5 micrograms/ml before the addition of CAM. A 75 g oral glucose tolerance test and daily profiles of blood glucose value showed that blood glucose levels were significantly lower in the presence of CAM and disopyramide compared to that in the absence of these drugs. The Turner index in the presence of CAM and disopyramide was significantly higher than that in the absence of these drugs, suggesting that a toxic concentration of disopyramide enhanced insulin secretion, resulting in the induction of hypoglycemic attacks, in which the inhibitory effects of CAM on the hepatic chytochrome P-450 might be involved. QT and QTc intervals were prolonged in the presence of CAM and disopyramide, but torsades de points were not observed in this patient receiving nicorandil (15 mg/day). Thus, it should be taken into account that life-threatening hypoglycemia may result from the interaction between clarithromycin and disopyramide.

Anti-Arrhythmia Agents↗
PubMed1999

Adrenocortical insufficiency associated with long-term high-dose fosfestrol therapy for prostatic carcinoma.

A 59-year-old man was admitted to our hospital because of muscular pain, weakness, and anorexia. He had been treated with 600 mg/day of fosfestrol, a synthetic estrogen, for 10 years for prostatic carcinoma. Endocrinological studies demonstrated adrenocortical insufficiency due to inadequate ACTH secretion. After initiation of glucocorticoid replacement therapy, his symptoms subsided rapidly. To our knowledge, an association between estrogenic agents, including fosfestrol, and secondary adrenocortical insufficiency has not been previously reported. Physicians who treat patients with long-term and high-dose strong estrogenic agents should be cautious about the possible emergence of secondary adrenocortical insufficiency.

Adrenal Insufficiency↗
PubMed1999

Impaired free fatty acid uptake in skeletal muscle but not in myocardium in patients with impaired glucose tolerance: studies with PET and 14(R,S)-[18F]fluoro-6-thia-heptadecanoic acid.

Free fatty acids (FFAs) are an important substrate for myocardial and skeletal muscle metabolism, and increased availability and oxidation of FFA are suggested to be associated with insulin resistance. This study was undertaken to assess whether myocardial or muscle uptake of FFA is altered in patients with impaired glucose tolerance (IGT). Eight healthy men (control group; age 48+/-1 years, BMI 25+/-1 kg/m2, mean +/- SE) and eight men with IGT (glucose-intolerant group; age 49+/-1 years, BMI 29+/-1 kg/m2) were studied in the fasting state. Myocardial oxygen consumption and blood flow and myocardial and femoral muscle FFA uptake rates were measured with positron emission tomography (PET) and [15O]O2, [15O]H2O, [15O]CO, and 14(R, S)-[18F]fluoro-6-thia-heptadecanoic acid ([18F]FTHA), a fatty acid tracer trapped into the cell after undergoing initial steps of beta-oxidation. Serum glucose and insulin concentrations were higher in the glucose-intolerant group during the PET study, but FFA concentrations were comparable between the groups. No differences between the groups were observed in the myocardial blood flow, oxygen consumption, fractional FTHA uptake rates, or FFA uptake indices (5.6+/-0.4 vs. 5.2+/-0.4 pmol x 100 g(-1) x min(-1), glucose-intolerant versus control, NS). In the femoral muscle, fractional FTHA uptake (0.0062+/-0.0003 vs. 0.0072+/-0.0003 min(-1), P = 0.044) and FFA uptake indices (0.30+/-0.02 vs. 0.43+/-0.04 min(-1), P = 0.020) were significantly lower in the glucose-intolerant group than in the control group. In conclusion, when studied at the fasting state and normal serum FFA concentrations, subjects with IGT have similar myocardial but lowered femoral muscle FFA uptake. This finding argues against the hypothesis that an increased oxidation of serum FFA, via the competition of glucose and FFA as fuel sources, is the primary cause for impaired peripheral glucose utilization and insulin resistance commonly observed in IGT.

Coronary Circulation↗
PubMed1999

[Coronary artery bypass grafting technique to minimize the usage of metallic materials].

Some metallic materials are widely used for coronary artery bypass surgery. There is no problem using the metallic materials themselves. However, metallic artifact interferes with the interpretation and reduces the sensitivity of the MRI. To minimize the utilization of metallic materials, we applied absorbable nonmetallic clips and used an ultrasonically activated scalpel to harvest the arterial grafts. We also applied polyester suture instead of the stainless steel sternal wire. We believe this technique will allow increased MRI usage for patients who undergo coronary artery bypass surgery.

Coronary Artery Bypass↗
PubMed1999

[Measurement of cerebral blood flow the blood sampling method using 99mTc-ECD: simultaneous scintigram scanning of arterial blood samples and the brain with a gamma camera].

To measure regional cerebral blood flow (rCBF) by blood sampling using 99mTc-ECD we devised a method of measuring the radioactive concentration in arterial blood sample with a gamma camera. In this method the head and a blood sample are placed within the same visual field to record the SPECT data of both specimens simultaneously. The results of an evaluation of the counting rate performance, applying the 30 hours decaying method using 99mTc solution showed that this method is not comparable to the well-type scintillation counter and in clinical cases the active concentration in arterial blood sample remained well within the dynamic range. In addition, examination of the influence of scattered radiation from the brain by the dilution method showed that it was negligible at a distance of more than 7.5 cm between the brain and the arterial blood sample. In the present study we placed a head-shaped phantom next to the sample. The results of the examinations suggested that this method is suitable for clinical application, and because it does not require a well-type scintillation counter, it is expected to find wide application.

Blood Specimen Collection↗
PubMed1999

[Estimation of healthy reference intervals for elderly people through the use of outpatient data].

It is important to determine transferable reference intervals as well as uniformity in measured values for inter-regional and inter-institutional availability of clinical test results. For that purpose, the National Committee for Clinical Laboratory Standards (NCCLS) issued forth guidelines in 1995. Some regional institutions in Japan are making efforts to determine normal reference intervals based on these guidelines. We, the Fukuoka Five Hospitals Group, have selected 3,375 healthy reference individuals and have determined the normal reference intervals for the age groups of 20-29, 30-39, 40-49, and 50-59 years old. The rapidly increasing percentage of elderly people gives rise to ever increasing health-care needs for the elderly, which requires normal reference intervals for older age groups. However, we were unable to collect the required number of the reference individuals above 60 years of age. To obtain reference intervals with adequate reliability and usefulness temporally, we made use of the laboratory data of outpatients at Kyushu University Hospital, and were then easily able to collect the required number of elderly individuals. By performing a very simple selection from among the outpatients, our outpatient group became virtually indistinguishable from the group of healthy reference individuals established by us, with regard to many clinical tests, thus enabling us to estimate reference intervals for older age groups. This approach could be adopted in other regions.

Adult↗
PubMed1999

[Scatter correction in myocardial thallium SPECT: needs for optimization of energy window settings in the energy window-based scatter correction techniques].

Accuracy and limitation of energy-window based scatter correction techniques have been evaluated for myocardial 201Tl SPECT by means of Monte Carlo simulation. In particular, projection view-dependency of energy distribution of the scattered photons was evaluated. Two geometrical configurations were simulated: namely a homogeneous cylindrical radioactivity located asymmetrically in a homogeneous cylindrical phantom, and a homogeneous ring radioactivity positioned at the myocardial region of a human thorax phantom. Energy spectra were recorded for each projection, and accuracy of the triple-energy window (TEW) method was then evaluation for both phantoms. The energy distribution of the scattered photons was apparently dependent on the projection view. TEW also demonstrated systematic overcorrection for the scatter because of multiple photo peaks around 80 KeV, and more importantly, the error was highly dependent on the projection view. The error reached to 35-38% for the view that is the closest to the 201Tl radioactivity (anterior view in case of the myocardial ring phantom), and was approximately 20% in the opposite view. This view-dependency of the error remained for other energy window settings, and was found to cause significant artifact in the reconstructed myocardial images, typically causing a defect in the anterior myocardial wall. Thus, this study demonstrated the need for optimizing the window settings for each projection view in all energy window-based scatter correction methods.

Heart↗
PubMed1999

Iterative reconstruction based on median root prior in quantification of myocardial blood flow and oxygen metabolism.

UNLABELLED: The aim of this study was to compare reproducibility and accuracy of two reconstruction methods in quantification of myocardial blood flow and oxygen metabolism with 15O-labeled tracers and PET. A new iterative Bayesian reconstruction method based on median root prior (MRP) was compared with filtered backprojection (FBP) reconstruction method, which is traditionally used for image reconstruction in PET studies. METHODS: Regional myocardial blood flow (rMBF), oxygen extraction fraction (rOEF) and myocardial metabolic rate of oxygen consumption (rMMRO2) were quantified from images reconstructed in 27 subjects using both MRP and FBP methods. For each subject, regions of interest (ROIs) were drawn on the lateral, anterior and septal regions on four planes. To test reproducibility, the ROI drawing procedure was repeated. By using two sets of ROIs, variability was evaluated from images reconstructed with the MRP and the FBP methods. RESULTS: Correlation coefficients of mean values of rMBF, rOEF and rMMRO2 were significantly higher in the images reconstructed with the MRP reconstruction method compared with the images reconstructed with the FBP method (rMBF: MRP r = 0.896 versus FBP r = 0.737, P < 0.001; rOEF: 0.915 versus 0.855, P < 0.001; rMMRO2: 0.954 versus 0.885, P < 0.001). Coefficient of variation for each parameter was significantly lower in MRP images than in FBP images (rMBF: MRP 23.5% +/- 11.3% versus FBP 30.1% +/- 14.7%, P < 0.001; rOEF: 21.0% +/- 11.1% versus 32.1% +/- 19.8%, P < 0.001; rMMRO2: 23.1% +/- 13.2% versus 30.3% +/- 19.1%, P < 0.001). CONCLUSION: The MRP reconstruction method provides higher reproducibility and lower variability in the quantitative myocardial parameters when compared with the FBP method. This study shows that the new MRP reconstruction method improves accuracy and stability of clinical quantification of myocardial blood flow and oxygen metabolism with 15O and PET.

Adult↗
PubMed1999

[Indication and outcome in emergent coronary artery bypass graft for acute coronary syndrome].

Among 462 cases receiving coronary artery bypass graft (CABG) during the period from November 1991 to January 1999, emergency operation was performed within 24 hours for 27 cases. Male-to-female ratio was 21:6, and age of patients ranged from 50 to 83 years (average age: 65.9 years). Intra aortic balloon pumping (IABP) was used from preoperative period for 25 cases, and PCPS was used for one case. Operation was performed under cardiac arrest in 25 cases and under ventricular fibrillation in 2. Average number of grafts was 2.4 +/- 1.0 and perioperative mortality was 25.9%. The results of emergency cases were extremely low compared with mortality of palliative operation of 3.4%, whereas mortality has been improved to 12.5% (2/16) in the last two years. These results suggest that it is important for the improvement of the outcome in emergency CABG to prevent aggravation of circulatory dynamics and to shift to operation under stable conditions.

Aged↗
PubMed1999

A novel splice acceptor site mutation which produces multiple splicing abnormalities resulting in protein S deficiency type I.

In an attempt to explore the molecular mechanisms for protein S deficiency, a patient with such a deficiency was examined at the DNA, RNA and protein levels. Nucleotide analyses revealed that the proband, the mother and the grandmother had a G-->C substitution in the invariant AG dinucleotide at the splicing acceptor site of intron A/exon 2. This patient was heterozygous for this substitution and the mutant allele was inherited from the proband's mother and grandmother. Reverse transcription-polymerase chain reaction analysis demonstrated several kinds of splicing abnormalities such as exon skipping and cryptic splicing, in addition to correct splicing. Semiquantitation of mRNA for the protein S gene revealed that the amount of the proband's mRNA was reduced to 60% of normal. Thus, this mutation impaired the normal processing of mRNA for the protein S gene, resulting in the subject's severe protein S deficiency.

Adolescent↗
PubMed1999

[Validation and optimization of the use of standardized arterial input function in N-isopropyl-p[123I]iodoamphetamine cerebral blood flow SPECT].

UNLABELLED: Use of a standardized arterial input function and calibrating it by a single blood sample has been proposed to assess quantitatively cerebral blood flow using N-isopropyl-p[123I]iodoamphetamine (IMP) and single-photon emission computed tomography. This study was intended to validate this approach using a larger number of measured arterial radioactivity curves in the clinical setting. METHOD: Arterial input function was measured for 50 patients at rest following the i.v. IMP, and its inter-subject variation was assessed. Difference between smokers and non-smokers in addition to effects of acetazolamide administration were particularly investigated. We also evaluated the accuracy of the calibration procedures by means of either a single blood sample or a continuous arterial blood withdrawal sampling for an early period. RESULTS: Inter-subject variation of the observed arterial input function appeared not to show large variations among the 50 patients, thus suggesting the validity of using the standardized arterial input function for the IMP SPECT study. There was a significant difference in the shape of the arterial input function between the smokers and non-smokers, but the calibration at an optimized sampling time provided the area-under-the curve (AUC) that was not significantly different between the two groups. The arterial input function after the acetazolamide showed no significant difference as compared with the shape at rest. The calibration of the standardized input function by means of the early integration of individual curve did not show better accuracy except for a short period of AUC (i.e., < 20 min) for longer integration period > 10 min. CONCLUSION: Thus, use of the standardized arterial input function has been validated for the IMP SPECT study. The single blood sampling procedure for calibrating the standardized input function has also been validated, and has been shown to provide better accuracy compared with the continuous withdrawal procedure.

Adult↗
PubMed1998

Fluorescence derivatizing procedure for 5-hydroxytryptamine and 5-hydroxyindoleacetic acid using 1,2-diphenylethylenediamine reagent and their sensitive liquid chromatographic determination.

A pre-column derivatization method using a fluorogenic reagent, 1,2-diphenylethylenediamine (DPE) was studied for the sensitive HPLC determination of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA), which are biosubstances used in the diagnosis of several diseases. For the quantitative determination, the biogenic indole compounds were converted to their corresponding fluorescent derivatives with DPE in the presence of potassium hexacyanoferrate (III) at room temperature, and then the derivatives were separated by reversed-phase liquid chromatography with fluorescence detection. The chromatographic detection limits of the fluorescent peaks at a signal-to-noise ratio of 3 were 0.3 fmol for 5-HT and 0.2 fmol for 5-HIAA. The proposed method permits the simultaneous quantification of 5-HT and 5-HIAA at concentrations higher than 2.4 nM in human urine without a clean-up procedure.

Chromatography, High Pressure Liquid↗