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Biomedical subjects

H Kishimoto

Publications and source records attributed to H Kishimoto.

At least 181 records · Page 10Linked to original sources
PubMed1991

Cardiac function and exercise capacity of diabetic patients.

To evaluate the relationship between cardiac function at rest and the exercise capacity of diabetic patients, left ventricular function and exercise capacity were evaluated in 15 non-insulin-dependent male diabetic patients. Isovolumic relaxation time (IRT) and the PEP/LVET ratio were obtained by simultaneous echophonocardiograms, electrocardiograms, and recordings of the carotid arterial pulse. VO2 at anaerobic threshold was obtained from a cycle ergometer exercise test with expired gas analysis. Patients were divided into two groups: those with IRT less than 90 msec (Group 1) and those with IRT greater than or equal to 90 msec (Group 2). Group 2 patients had a lower VO2 at anaerobic threshold than Group 1 (Group 1: 17.4 +/- 3.6, Group 2: 12.9 +/- 2.5 ml/min/kg; M +/- SD, p less than 0.05). There was a good correlation between the IRT at rest and delta HR, defined as the change in heart rate from rest to anaerobic threshold (r = 0.666, p less than 0.01), and between delta HR and the beat-to-beat variation in R-R interval at rest (r = 0.637, p less than 0.02). There was also a good correlation between VO2 at anaerobic threshold and IRT (r = 0.555, p less than 0.05), and between VO2 at anaerobic threshold and delta HR (r = 0.858, p less than 0.01). Our data suggests that both left ventricular diastolic function and cardiac sympathetic nervous system reflexes, reflected by delta HR, may affect the exercise capacity of diabetic patients. Thus, IRT obtained by a non-invasive method may provide a useful index for cardiovascular response to exercise in diabetic patients without coronary artery disease.

Adult↗
PubMed1991

Lipoprotein metabolism in normolipidemic obese women during very low calorie diet: changes in high density lipoprotein.

We examined changes in high density lipoprotein (HDL) metabolism during a very low calorie diet weight reduction program in 6 massively obese normolipidemic women. The diet protocol consisted of a 1st low calorie diet (LCD; 1440, 1280, and 880 kcal daily for 1 week, each, in succession), a 1st very low calorie diet (VLCD; 420 kcal daily for 4 weeks, using Optifast 70), intermission (880 kcal daily for 1 week), the 2nd VLCD (4 weeks) and the 2nd LCD (880 and 1280-1440 kcal daily for 1 week, each). Mean body weight reduction was 18.9 kg. HDL-cholesterol, more specifically HDL2-cholesterol, reduced transiently during the 1st VLCD, intermission, and 2nd VLCD periods, and tended to increase in the 2nd LCD. Apolipoprotein (apo) A-I showed a similar change to HDL-cholesterol. However, apo A-II decreased persistently throughout the weight reduction program, and the apo A-I/apo A-II ratio increased significantly in the later part of the program. Serum triglyceride, apo B, and lipoprotein lipase (LPL) activity in post-heparin plasma did not change. These data suggest that the observed decrease in HDL-cholesterol was not due to a reduction in very low density lipoprotein-derived HDL production or to an LPL deficiency, but was consistent with reduction in chylomicron-derived HDL formation following dietary fat restriction.

Adult↗
PubMed1991

[Modified Fontan operation for a single ventricle with a nonconfluent pulmonary artery].

A 8-year-old boy with a double inlet right ventricle with a non-confluent pulmonary artery was operated on with a modified Fontan operation. He had right isomerism, right aortic arch, bilateral superior caval veins, and left-sided inferior caval vein. Hepatic veins were separately drained to the right-side atrium. Left Blalock-Taussig shunt and right central shunt operations had been previously performed. Firstly, we had reconstructed the central pulmonary artery with a 16 mm porcine pericardial roll to unify the nonconfluent pulmonary arteries. Secondly, about 2 months after the first operation, we performed a modified Fontan operation. Systemic venous return from the inferior caval vein and the hepatic veins were drained to a reconstructed pericardial roll with an intraatrial Gore-Tex graft, and bilateral superior caval veins were also anastomosed to the roll. The structure of the pulmonary arterial system is one of the most important factors to determine the outcome of a modified Fontan operation. Even if the central pulmonary artery is absent, however, a modified Fontan operation is applicable for the patient whose peripheral pulmonary arteries have enough growth.

Blood Vessel Prosthesis↗
PubMed1991

[Ventricular septation combined with arterial switch for a patient with double inlet left ventricle with right sided rudimentary right ventricle and ventriculoarterial discordance].

A 5-year-old boy with double inlet left ventricle and ventriculoarterial discordance (SDD type) underwent ventricular septation with arterial switch procedure. Previously he had received pulmonary arterial banding at 3 months-old. Preoperative cardiac catheterization revealed Qp/Qs 1.26, Pp/Ps 0.19 and LVEDV was 315% of normal (as left ventricle). Arterial switch with Lecompte modification was performed in order to separate ventricle with straight patch could be done. Post operative course was uneventful and patient was extubated 4 post operative day. These procedures had employed in this patient as follows; 1) systemic ventricle could be constructed with morphological left ventricle with mitral valve. 2) left ventricular outflow tract stenosis due to ventricular outlet foramen occasionally observed in conventional procedure such as intraventricular rerouting could be prevented, and 3) ventricular septation could be easy and simple with straight patch.

Aorta↗
PubMed1991

[Clinicopathologic study of various lung diseases with bronchiolitis obliterans organizing pneumonia (BOOP) pattern in open lung biopsy].

The histologic findings of BOOP are nonspecific, and the diagnosis of idiopathic BOOP is one of exclusion. We studied the clinicopathologic features of various lung diseases with histopathological appearance of bronchiolitis obliterans organizing pneumonia (BOOP) pattern in open lung biopsy specimens. The 17 patients with BOOP pattern studied included idiopathic BOOP (n = 7), unclassified interstitial pneumonia (n = 1), collagen vascular disease (n = 3, RA 1, PM/DM 2), hypersensitivity pneumonitis (HP, n = 2), eosinophilic pneumonia (EP, n = 1), multiple lung abscesses (n = 1), limited form of Wegener's granulomatosis (n = 1), and pneumocystis carinii pneumonia associated with adult T cell leukemia (n = 1). There were no differences in clinical symptoms, laboratory data, respiratory function, and cytological findings in bronchoalveolar lavage fluid (BALF) between cases of idiopathic BOOP and other lung diseases. The duration of clinical symptoms was less than one year in 16 patients (one case had no symptoms). Chest X-rays showed bilateral patchy, nodular, or reticular shadows in all cases. Multiple patchy migratory shadows were only observed in cases of idiopathic BOOP or EP. Organizing pneumonia was recognized in the transbronchial lung biopsy specimens of all patients with idiopathic BOOP, HP or EP. Regarding prognosis, relapses occurred in idiopathic BOOP (n = 5), polymyositis, EP, limited form of Wegener's granulomatosis, and Pneumocystis carinii pneumonia. Four patients with idiopathic BOOP relapsed when steroid therapy was decreased or stopped. These findings indicate that idiopathic BOOP should be differentiated from other lung diseases, and these patients should be followed for a long period of time.

Adult↗
PubMed1991

[Timing of operation based on evaluation of postoperative left ventricular contractility in patients with aortic regurgitation].

To evaluate the effect of aortic valve replacement on left ventricular function in aortic regurgitation, the ratio of end-systolic wall stress to end-systolic volume index (ESS/ESVI) and standard ejection phase indexes of left ventricular function were measured angiographically in 29 patients with isolated, chronic aortic regurgitation before and an average of 26 months after aortic valve replacement. The patients were divided into three groups based on preoperative left ventricular volume at end-systole (ESVI); 12 patients had an ESVI smaller than 100 ml/m2 (group I), 11 had an ESVI of 100 to 200 ml/m2 (group II) and 6 had an ESVI greater than 200 ml/m2 (group III). Postoperatively, end-diastolic volume index and ESVI decreased markedly in all 3 groups and end-systolic stress also decreased. Systolic pump performance assessed as ejection phase indexes improved in all groups with group I and group II showing normal or near-normal ejection fraction, while group III still had a depressed ejection fraction. Left ventricular contractile function as assessed by ESS/ESVI improved significantly in each group postoperatively. After operation, group I patients had normal values. However, both group II and group III still had a subnormal ratio, suggesting a depressed contractility despite normal or near normal systolic pump performance. Surgical correction for aortic regurgitation should be considered before a preoperative ESVI exceeds 100 ml/m2, to preserve postoperative left ventricular contractility.

Adult↗
PubMed1991

[Five cases of tuberculosis occurring in an accounting office during 5-year period].

Five cases of pulmonary tuberculosis occurred in an accounting office during 5-year period. Patients 1 and 2 were hospitalized in January and March respectively in 1984. Patients 3 and 4 were found to have abnormal shadows in 1987. Patient 5 was admitted to our hospital in July, 1988. Patients 1 and 2 showed a similar pattern of drug resistance. The desk of Patient 3 was located in front of the desk of Patient 1. Retrospective review of chest X-ray film of Patient 3 taken two years before admission revealed that active contagious tuberculosis had been misdiagnosed as inactive type, resulting in delayed treatment. Patients 4 and 5 worked near to Patient 3 for the past two years. PPD skin test was carried out on 47 workers in the same room and other rooms as well. The distribution of maximum diameters of erythema for workers in the same room did not show a bimodal distribution, but the mean diameter (30.6 +/- 16.4 mm) was larger than that (22.3 +/- 17.2 mm) for workers in other rooms. Preventive administration of Isonicotinic acid hydrazide (INH) was made for 10 workers. These observations suggest that routine chest X-ray film should be carefully checked, and PPD skin test should be performed to those at risk of tuberculosis infection.

Accounting↗
PubMed1990

Computerized EEG in schizophrenic patients.

We undertook a study of electroencephalograms (EEGs) in 30 right-handed, untreated patients (27.3 +/- 10.0 years; hebephrenic, 16; paranoid, 12; residual, 2) who fulfilled ICD-9 criteria for schizophrenia and compared them with sex- and age-matched controls by using the percentage of power in six EEG frequency bands calculated as a fraction of total power. T-statistic significance probability mapping (t-SPM) showed that, compared with normal controls, schizophrenics had more slow activity (delta, theta, and alpha 1) in the parieto-occipital regions, and more fast activity (beta 1) in the occipital regions. In contrast, alpha 2 activity decreased strikingly in the occipital regions and this decreased activity extended over much of the head. These findings were thought to indicate both cerebral hypofunction and excitability in acute untreated schizophrenia.

Adult↗
PubMed1990

Fracture incidence and bone mineral density of the distal radius in Japanese children.

The incidence of fractures of the distal radius in Japanese persons under 20 years of age was determined, and the bone mineral density of the radius was measured in 236 healthy Japanese children. The peak incidence of fractures occurred at 13 years of age (807 per 100,000) in boys and at 11 (300 per 100,000) in girls. Bone mineral density increased with age, but the rate of increase was not equal at the metaphysis and the diaphysis in the parapubertal period. The metaphyseal/diaphyseal ratio of bone mineral density was lowest at the age of 12-13 years in boys and 11 years in girls. The age at the peak incidence of fractures thus coincided with the age at which the metaphyseal/diaphyseal density ratio was lowest. Thus, it is suggested that low bone mineral density at the metaphysis may be the cause of the high incidence of these fractures in adolescence.

Adolescent↗
PubMed1990

The incidence of fractures of the proximal femur and the distal radius in Tottori prefecture, Japan.

We report the incidence of proximal femur and distal radius fractures in Tottori prefecture, Japan. In 1986 and 1987, 573 proximal femoral fractures and 1576 distal radial fractures were registered in this district. The age- and sex-specific incidence rates of these two fractures are lower among Japanese than among European or North American whites, according to previous reports. Thus, it was concluded that the incidence rates of these two fractures are lower in Japanese than in Caucasians.

Adolescent↗
PubMed1990

Cell division-associated expression of an epitope, KH17, on early developing thymocytes.

A newly established monoclonal antibody, KH17, detects a unique epitope temporarily expressed on early developing CD3-thymocytes confined to a cycling stage. KH17 is detectable on a part of CD4-CD8-,CD4-CD8+, and CD4+CD8+ cells, but not on CD4+CD8- thymocytes. By four-color flow cytometry analysis using KH17, we were able to define the heterogeneity of immature CD4-CD8- thymocytes by the expression of KH17 and IL-2R. In Thy-1-congeneic bone marrow chimeras, the appearance of KH17-IL-2R+ thymocytes preceded the increase of KH17+IL-2R- cells. The antibody could also divide CD3-CD4-CD8+ cells into two subpopulations, KH17+ and KH17-, which showed a continuum. In the fetal thymus there was a rapid and dramatic increase of KH17-CD4+CD8+ thymocytes concomitant with a decrease of KH17+CD4-CD8+ thymocytes in later gestation days. KH17 is not expressed on resting peripheral T cells, but is expressed on a large proportion of Con A-activated blastic spleen cells. The KH17 molecules precipitated from Con A-activated spleen cells were 55 and 75 kd polypeptides, but different from IL-2R subunits.

Animals↗
PubMed1990

Ultrastructural and histological studies on closure of the mouse ductus arteriosus.

The ductus arteriosus in mice was studied by light and electron microscopy for a certain time span (from day 15 of gestation to 16 weeks after birth). In the intima, subendothelial intimal cells began to appear at day 17 of gestation, while actual constriction of the ductus arteriosus progressed rapidly after birth, beginning always at the site adjacent to the ductus arteriosus-aorta junction. At 3 h postnatally, the ductus arteriosus showed complete occlusion (functional closure), which was due mainly to constriction of the medial smooth muscle cells. At this stage, intimal cells (endothelial and subendothelial intimal cells), which occupied the ductal lumen, demonstrated ultrastructural features of undifferentiated cells. However, all the intimal cells 3 weeks after birth and thereafter were revealed to have electron-microscopic features of mature smooth muscle cells. The smooth muscle cells of the media and intima decreased progressively in number with advancing deposition of stromal collagen and elastic fibers in the ductal wall.

Animals↗
PubMed1990

Glutaric aciduria type II: autopsy study of a case with electron-transferring flavoprotein dehydrogenase deficiency.

An autopsy study of glutaric aciduria type II in a 62-day-old Japanese boy is presented. The diagnosis was made by analysis of organic acids in the urine. Immunoblot analysis of liver homogenate confirmed the diagnosis, revealing absence of electron-transferring flavoprotein dehydrogenase. The major findings were fatty changes of variable degree in many organs and tissues, the most severe being found in cardiac myocytes, hepatocytes, renal tubular epithelium, and skeletal muscle fibers. Other pertinent findings included multicystic and dysplastic kidney, pulmonary alveolar proteinosis, and spongiosis and gliosis of the spinal cord. The thymus was markedly depleted, and lymphocytes in the lymph nodes were mainly B cells. Although some of these changes may have been secondary to the sepsis and immunosuppression complicating 2 months of intensive care, the abnormal organic acid metabolism with severe acidosis may have been a significant contributing factor.

Acidosis↗
PubMed1990

[Behçet's disease associated with multiple cerebral aneurysms and downhill esophageal varices caused by superior vena cava obstruction: a case report].

A 62-year-old woman who had suffered from Behçet disease since 1975 was admitted to Kawasaki Municipal Hospital because of severe headache and consciousness disturbance in July 1988. The emergency brain CT scan showed subarachnoid hemorrhage. Despite clipping the neck of the cerebral aneurysm, she died of cerebral herniation. Post-mortem examination revealed four aneurysms on the anterior part of the circle of Willis: 1) at the first bifurcation of the right middle cerebral artery 2) at the bifurcation of the left internal carotid artery 3) at the anterior communicating artery 4) at the left middle cerebral artery. The complete obstruction of the superior vena cava and downhill esophageal varices with no evidence of portal hypertension were also observed. This case had downhill esophageal varices induced by vena caval obstruction as a quite rare symptom of vasculo-Behçet's disease and also complicated with congenital multiple aneurysms of cerebral arteries.

Behcet Syndrome↗
PubMed1990

[The influence of pulmonary regurgitation on left ventricular function after repair of tetralogy of Fallot].

The influence of right ventricular (RV) volume overload by pulmonary regurgitation (PR) on left ventricular (LV) function was evaluated postoperatively in 23 patients with tetralogy of Fallot (TF). The age at operation was 3.1 +/- 1.7 (mean +/- SD) years. The age at postoperative study was 5.9 +/- 2.0 years. We determined RV end-diastolic volume (%RVEDV), RV ejection fraction (EF), %LVEDV, LV end-systolic volume (%LVESV), LVEF, and LV end-systolic stress (ESS)/%LVESV. Patients were divided into 2 groups on the basis of presence or absence of RV volume overload by PR as follows: The %RVEDV (175 +/- 23%) of group 1 (n = 10) was 150% greater than normal RVEDV. Group 2 (n = 13) had normal %RVEDV (108 +/- 23%). Preoperatively, there had been no differences in hemoglobin, %RVEDV, RVEF, %LVEDV, LVEF, and in the ratio of average cross-sectional area of the left and right pulmonary arteries to cross-sectional area of the normal right pulmonary artery between the 2 groups. Moreover, there were no differences in age at repair, or during postoperative study, nor in the postoperative ratio of RV to LV systolic pressure between the 2 groups. RVEF was significantly less in group 1 than in group 2 (0.53 +/- 0.05 vs 0.58 +/- 0.05, p less than 0.05). %LVEDV and %LVESV in group 1, 138 +/- 10% and 171 +/- 30% respectively, were significantly greater than those in group 2, 116 +/- 11% and 133 +/- 20% respectively (p less than 0.001 in %LVEDV and p less than 0.01 in %LVESV).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Volume↗
PubMed1990

[SPA method; monitoring of bone mass during the treatment of osteoporosis].

Accuracy and precision are indispensable to evaluate bone mass by non-invasive bone mineral measurement. In this paper, the methodological problems, such as measuring site and positioning errors of bone are described. Furthermore, the methods of monitoring of bone mass during ADFR treatment and double blind study for osteoporosis are also discussed.

Absorptiometry, Photon↗