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Biomedical subjects

H Shibata

Publications and source records attributed to H Shibata.

At least 721 records · Page 40Linked to original sources

Circadian rhythm of blood pressure in primary aldosteronism and renovascular hypertension--analysis by the cosinor method.

The circadian rhythm of blood pressure in 11 patients with primary aldosteronism (ALD) and 15 patients with unilateral renovascular hypertension (RVH) was analyzed using the cosinor method which fits a cosine function to a series of data. In ALD, both systolic (SP) and diastolic blood pressures (DP) increased in the late evening; the amplitude and acrophase of the circadian rhythm for SP were 7.3 (5.3 to 9.3, mean and 95% confidence limits) mmHg and 20:47 (19:42 to 21:52) hours, respectively, and for DP 2.6 (1.3 to 3.9) mmHg and 21:34 (19:40 to 23:28) hours, respectively. After excision of an adrenal adenoma in 6 patients, the circadian rhythm of SP and DP was abolished. In RVH, the acrophase of the circadian rhythm of SP and DP differed by about 12 hours; the amplitude and acrophase for SP were 5.7 (3.9 to 7.5) mmHg and 17:49 (16:35 to 19:02) hours, respectively, and for DP 1.5 (0.2 to 2.7) mmHg and 6:08 (2:44 to 9:31) hours, respectively. After various surgical interventions in 8 patients, the circadian rhythm of SP persisted with little change in acrophase, while that of DP disappeared. The difference in circadian rhythm suggests a difference in mechanisms of blood pressure control in ALD and RVH.

Adenoma↗

Delay time correction of the gas analyzer in the calculation of anatomical dead space of the lung.

By means of a mathematical model, we have studied a way to correct the delay time of the gas analyzer in order to calculate the anatomical dead space using Fowler's graphical method. The mathematical model was constructed of ten tubes of equal diameter but unequal length, so that the amount of dead space varied from tube to tube; the tubes were emptied sequentially. The gas analyzer responds with a time lag from the input of the gas signal to the beginning of the response, followed by an exponential response output. The single breath expired volume-concentration relationship was examined with three types of expired flow patterns of which were constant, exponential and sinusoidal. The results indicate that the time correction by the lag time plus time constant of the exponential response of the gas analyzer gives an accurate estimation of anatomical dead space. Time correction less inclusive than this, e.g. lag time only or lag time plus 50% response time, gives an overestimation, and a correction larger than this results in underestimation. The magnitude of error is dependent on the flow pattern and flow rate. The time correction in this study is only for the calculation of dead space, as the corrected volume-concentration curves does not coincide with the true curve. Such correction of the output of the gas analyzer is extremely important when one needs to compare the dead spaces of different gas species at a rather faster flow rate.

Gases↗

Effects of restraint on baroreflex sensitivity in altering heart rate and heat production in rats.

When systemic arterial pressure was elevated with phenylephrine (PHE) at 13 degrees C, heart rate (HR), and heat production (M) associated with shivering were greatly suppressed in rats. The magnitude of suppression increased proportionally with increasing doses of PHE. During restraint, however, such a suppression of HR and M with PHE was attenuated, indicating that restraint reduced baroreflex sensitivity in altering HR and shivering in rats.

Animals↗

[Therapeutic effect of cefotaxime against severe infections in patients with hematopoietic diseases].

Seventy-five patients with severe infection accompanying hematologic disorder, including leukemia and malignant lymphoma, were treated with cefotaxime (CTX). CTX was administered by intravenous drip infusion at a daily dose ranging from 4 to 16 g for terms of 3 to 21 days. The total doses were ranged from 12 to 226 g. The results obtained were as follows: Clinical effects: Excellent in 20 cases, good in 21 cases, fair in 7 cases and poor in 27 cases. The efficacy rate was 54.7% (41/75). Clinical effectiveness on isolated organisms (27 cases): In single infection (21 cases), the efficacy rates were 80% for Gram-positive cocci, including S. aureus and 63.6% for Gram-negative bacilli other than P. aeruginosa. In mixed infection (6 cases), the rate was 50.0%. There were no significant differences in the efficacy rates for those patients who were grouped by the initial number of neutrophil (less than 100, 101--500 and over 501/mm3). There were no significant difference in the efficacy rates for those patients who were grouped by the initial number of lymphocyte (less than 500 and over 501/mm3). Side effects and abnormal laboratory findings: One case of skin rash and 2 cases of elevated GOT and GPT were observed. CTX was therefore considered as a clinically useful antibiotic for the severe infections even in neutropenic state in patients suffering from malignant hematological diseases.

Adolescent↗

[The clinical effects of a new antiviral 9-(2-hydroxyethoxymethyl) guanine (aciclovir) against herpes virus infections].

The clinical effects of a new anti-viral 9-(2-hydroxymethoxymethyl) guanine (Aciclovir) against Herpes virus infections have been investigated. The patients had malignant tumours or auto-immune disease complicated by shingles and chicken pox due to Vaicella zoster virus (VZV) (43 cases), Herpes simplex virus (HSV) (10 cases) and 9 cases which were clinically diagnosed as Herpes, though the virus was not confirmed as the causative agent. As a general principle the dosage of Aciclovir was 5 mg/kg, t. i. d. for 5 days by slow intravenous infusion. The clinically effective rate against VZV was 93%, being excellent in 42% and against HSV it was 80%, being excellent in 40% and when the results of the cases of unknown origin were included it was excellent in 40% and the cumulative effective rate was 88%. Concerning the efficacy in reduction of pain, swelling, disappearance of vesicles and new scab formation, the effect was most noticeable after the third day of treatment. Treatment given early in the disease is likely to provide better results. Concerning side effects, one of 62 patients had proteinuria and the other had a drug rash and an abnormal liver function test. It is likely that the combination of treatment and the primary disease had some influence, but the cause/effect relationship to Aciclovir treatment is not clear.

Acyclovir↗

[Phase II study with methyl-6[[[2-chloroethyl) nitrosoamino] carbonyl] amino]-6-deoxy-alpha-D-glucopyranoside (MCNU) in hematological malignancies].

A total of 117 cases with hematological malignancies were treated with MCNU at doses of 70-100 mg/m2. Following are the results obtained. 1. MCNU showed a marked depression of cells in the cases with CML, polycythemia vera and thrombocythemia. The low level of cells was maintained for 2 to 7 months. 2. A good response was observed in several cases with blastic crises of CML. 3. No response was observed in two cases with acute leukemia. 4. Although a fair response was observed in several cases with malignant lymphoma or multiple myeloma, moderate bone marrow suppression was observed in a majority of the cases.

Adult↗

[Cooperative studies on clinical effect of cefotetan for severe infections combined with hematologic disorders].

Seventy-six patients with severe infection accompanying hematologic disorders including leukemia and lymphoma were treated with intravenous drip infusion of cefotetan (CTT). Of the 66 cases in whom the efficacy could be evaluated, 22 cases responded markedly and 16 cases moderately, the effective rate being 57.6%. It is impressed that more cases responded markedly to CTT than to any other antibiotics previously studied. None of the cases revealed serious side effects attributable to CTT. These results indicate that CTT is an effective and safe antibiotic for the treatment of severe infection accompanying hematologic disorders. As CTT was administered to special cases under marked decrease of neutrocyte, the importance of neutrocyte in the treatment of infection was also indicated.

Adolescent↗

[Early phase II study of PL-AC [N4-palmitoyl-(1-beta-D-arabinofuranosyl) cytosine] on hematopoietic malignancies].

Twenty-one patients with hematopoietic malignancies including 6 previously untreated, 9 pretreated, and in relapse, 5 in complete remission and one in partial remission all were treated with PL-AC. The patients consisted of 12 acute myelocytic leukemias, 4 acute monocytic leukemias, 2 acute lymphocytic leukemias, one erythroleukemia, one malignant lymphoma and one chronic monocytic leukemia. PL-AC was given orally at a dosage of 50-1200 mg daily. Mean total dosage was 4.74 g (0.6-15.25), and the mean administration period was 3.43 days (1-122). days Responses were observed in 4 out of 9 pretreated patients by a decrease of blast cells in the peripheral blood. Partial remission was obtained in one case which lasted 8 months. Out of 5 previously untreated acute leukemias, one partial remission and 4 hematological responses were observed. The plasma concentration of Ara-C was maximal at 3 hours and was not detectable after 12 hours. Side effects observed were nausea in 5 patients vomiting in one patient and liver dysfunction in one patient. These side effects however were not so severe as to stop drug administration. PL-AC may be administered in doses ranged 150-250 mg for 2-3 weeks without any severe side effects, and with some clinical effects.

Administration, Oral↗

Classification of acute non-lymphocytic leukemia according to the distribution picture of peroxidase activity and cell size: correlation between the classification and therapeutic response.

A distribution picture was prepared on the basis of the correlation between peroxidase activity and cell size in leukemic cells using an automated leukocyte differential counter (Hemalog-D). From this, acute nonlymphocytic leukemia was classified into three groups in which the therapeutic response was examined. The leukemic cells of Group I were medium or large and were negative or weakly positive to peroxidase. These cells were characterized by their location in the upper part of the normal lymphocyte distribution. The leukocyte differential count, measured by a computer on the basis of the distribution picture, showed an increase in large unstained cells (LUC) and lymphocytes. The leukemic cells of Group II were large and positive to peroxidase and were characterized by their location in the right upper part, across the region of LUC, monocytes, basophil and neutrophil leukocytes as seen in the distribution picture. The findings of Hemalog-D showed an increase in LUC, remainder and neutrophil leukocytes. The leukemic cells of Group III were medium-sized and moderately or strongly positive to peroxidase. This group was characterized by their location in the lower part of normal neutrophil leukocytes and Hemalog-D showed an increase in neutrophil leukocytes. A total of 71 patients with acute nonlymphocytic leukemia were assessed according to this classification. Group I (14 patients): 11 with acute myelogenous leukemia (AML), 2 with acute monocytic leukemia (AMoL) and 1 with acute myelomonocytic leukemia ( AMMoL ); Group II (17 patients): 7 with AML and 10 with AMoL; Group III (40 patients): 28 with AML, 4 with AMoL, 1 with AMMoL and 7 with acute promyelocytic leukemia (APL). These groups were treated with the protocol (DCMP two step, BH-AC DMP, BH-AC AMP) established by the Yamada Leukemia Study Group of the Japan Welfare Ministry Cancer Research Project (chairman Yamada, K). The complete remission rate was 35.7% in Group I, 58.8% in Group II and 85.0% in Group III. The difference between Groups I and III was statistically significant (P less than 0.005), as was the difference between Groups II and III (P less than 0.1), while that between Groups I and II was not significant. The median survival was 12 months in Group I, 9 months in Group II and 15 months in the Group III and the difference between Groups I and III was statistically significant (P less than 0.05). Group III included a small number of AMoL and APL patients in addition to AML, while Groups I and II consisted mainly of patients with AMoL and AML.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

[Autopsy case of pancreatic carcinoma associated with B-cell derived lymphoma].

An autopsy case a 75-year-old man, with papillary adenocarcinoma of the pancreas associated with wide-spread metastasis from a malignant lymphoma is reported. We discuss the markedly lower incidence of pancreatic cancer in syncronal association with lymphoma. We applied an immunoperoxidase method (PAP) in the diffuse large-cell lymphoma to determine the immunological phenotype and found mu heavy chains and lambda light chains in the lymphoma cells. This suggests that the tumor cells were derived from B-lymphocytes.

Adenocarcinoma, Papillary↗

Efficacy of laminar air flow room with or without clean nursing for preventing infection in patients with acute leukemia.

The clinical effectiveness of bioclean rooms was studied in relation to prevention of infection during treatment for induction of remission of acute leukemia. According to the steps in clean patient care, patients were divided into three groups, Group A consisting of 106 patients who were accommodated in laminar air flow (LAF) rooms under strictly clean nursing, Group B consisting of 99 patients who were treated in disinfected rooms with LAF without any clean nursing techniques and Group C consisting of 188 patients who stayed in conventional wards. Since all patients were treated with antileukemic drugs and preventive administration of antimicrobial drugs under the same regimen, any difference between groups should be attributable to LAF or LAF and clean nursing. A marked and stepwise reduction in the incidence of infection between Groups A, B and C was observed. A statistically significant reduction in pneumonia, upper respiratory tract infection, periproctitis and skin abscesses was also observed in Groups A and B. As to the causative organisms, a relative increase in incidence of infections caused by Pseudomonas aeruginosa and Escherichia coli and a decrease in those caused by Proteus and fungi were observed in Groups A and B, as compared with Group C. These data suggest that pneumonia etc. may be exogenous infections and that Proteus and fungi are exogenous organisms, while Pseudomonas aeruginosa and Escherichia coli are endogenous bacteria. These data seem very helpful for setting up several steps in bioclean rooms for effective and economic patient care.

Adult↗

[Clinical evaluation of high dose intravenous injection of fosfomycin on the severe infections associated with the treatment of haematological disorders].

Fosfomycin (FOM) was administered intravenously to 65 cases of severe infections complicated with 62 cases of several haematological disorders. Out of 65 cases, 45 were treated with high doses FOM, i.e., 8 g per day or more. Another 20 cases were treated in usual doses of 4--6 g per day. Causative organisms were isolated from 52 cases of which 32 cases were Gram-negative bacilli and 19 cases were Gram-positive cocci. The effective rate of FOM was 57.8% in the high-dose treatment group (26/45) and 45.0% in the usual-dose treatment group (9/20), but the significant difference was not defined. Among 32 cases with Gram-negative bacilli infections, including Pseudomonas aeruginosa or Serratia marcescens, 15 cases were effective (47%). On the contrary, 14 out of 19 cases with Gram-positive cocci infections were effective (74%). Thirteen cases (50.0%) were effective even in which neutrophils were less than 500/cmm before FOM administration. Severe side effects were not observed, without 2 cases. One was skin eruption due to drug allergy and the other was suspected to be interstitial pneumonitis, but not confirmed pathologically. These data suggest that high dose treatment of FOM were useful for the severe infections even in neutropenic state in haematological disorders.

Adolescent↗