Search PubMed⌕ Search

Biomedical subjects

K Hiwada

Publications and source records attributed to K Hiwada.

At least 199 records · Page 11Linked to original sources
PubMed1995

[Small cell lung cancer that appeared as a strange shape on chest X-ray films].

A 70-year-old man was admitted for diagnosis of an abnormal shadow on chest X-ray film. Chest X-ray films and chest tomograms showed a club-like shadow close to the pulmonary artery. The tumor was diagnosed as a small cell lung cancer, after transbronchial biopsy. The patient underwent chemotherapy and radiation therapy. This patient had small cell lung cancer that appeared on chest X-ray films to have a strange shape.

Aged↗
PubMed1995

Clinical evidence for an association between left ventricular geometric adaptation and extracardiac target organ damage in essential hypertension.

OBJECTIVES: To elucidate an association between left ventricular geometric adaptation to sustained hypertension and preclinical extracardiac target organ damage in essential hypertension. We also studied the clinical significance of neurohumoral factors for cardiovascular structural changes. DESIGN: One hundred and forty patients with essential hypertension were divided into four subgroups, based on left ventricular mass index and relative wall thickness. With respect to extracardiac target organ damage, we measured the funduscopic grade of retinal changes and serum creatinine levels. RESULTS: Among the hypertensive patients, only 19 (14%) had a typical concentric hypertrophy (increase in left ventricular mass index and relative wall thickness). Hypertensive patients with concentric hypertrophy had the most advanced funduscopic abnormalities and the greatest renal involvement, and hypertensive patients without left ventricular hypertrophy had the least extracardiac target organ damage. Plasma renin activity and plasma aldosterone concentration were higher in hypertensive patients with than in those without concentric hypertrophy. In a multiple regression model there was a strongly significant correlation between the degree of left ventricular mass index and the severity of hypertensive retinopathy and renal involvement, independent of office blood pressure. CONCLUSIONS: These results clearly demonstrate that echocardiographically determined left ventricular mass and geometry stratify extracardiac target organ damage in patients with essential hypertension more closely than office blood pressure. The present study also suggests that, in addition to blood pressure load, the renin-angiotensin-aldosterone system appears to play an important role in myocardial hypertrophy and peripheral vascular damage in hypertension.

Aldosterone↗
PubMed1995

[Development of infection with Aspergillus flavus in woman being treated for allergic pulmonary Aspergillosis caused by Aspergillus fumigatus].

A 36-year-old woman who raised plants in a large greenhouse came to our hospital because of a cough and purulent sputum. A chest X-ray film showed infiltrative shadows in the left middle lung field. Aspergillus fumigatus was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left B5. Biopsy specimens revealed hyphae elements of aspergillus species and eosinophils in a plug of viscous material. Also, eosinophils and lymphocytes had infiltrated through bronchial epithelium without aspergillus species. She was given a diagnosis of allergic aspergillosis caused by Aspergillus fumigatus. Fluconazole was given and her symptoms and infiltrative shadows improved. Seventy days after treatment with fluconazole began, her symptoms recurred along with an abnormal shadow in the left upper lung field on a chest x-ray film. Aspergillus flavus, but not Aspergillus fumigatus, was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left lung (S1+2). Biopsy specimens of the lung showed eosinophilic pneumonia. She was treated with itraconazole and her symptoms and abnormal radiographic shadows disappeared. She had no asthmatic attack or central bronchiectasis du ring the illness. This was a case of allergic pulmonary aspergillosis without asthmatic symptoms. It is interesting that one species of aspergillus was replaced by another during treatment.

Adult↗
PubMed1995

End-organ damage in essential hypertension in the elderly.

To elucidate the characteristics of end-organ damage in essential hypertension in the elderly, the progression of end-organ damage, with respect to deterioration of renal function and changes in the optic fundi, were compared between young and elderly essential hypertensive patients with the same left ventricular mass index (LVMI). Forty five elderly hypertensive patients (age > or = 65 years) were matched with 40 young patients (age < or = 55 years) for sex and LVMI. All studies were performed under hospitalisation to uniform the background of diet and daily activity. Compared with young hypertensive patients, elderly patients were characterised to have advanced end-organ damage. In young patients, the levels of progression of end-organ damage were significantly correlated with each other, while in elderly patients no relation was observed. In young patients, LVMI was significantly correlated with urinary and plasma noradrenaline, PRA and 24 h blood pressure. In elderly patients, LVMI correlated only with 24 h systolic blood pressure.

Adult↗
PubMed1995

Contractile properties of left ventricular myocytes isolated from spontaneously hypertensive rats: effect of angiotensin II.

OBJECTIVE: This study was undertaken to clarify whether the myocardial dysfunction observed in the hypertensive heart is an intrinsic property of the myocyte or not. MATERIALS AND METHODS: We investigated left ventricular function and contractile function of myocytes from 30-week-old spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). We also evaluated the effect of angiotensin II on contractile function of myocytes from both rats. RESULTS: The time constant of isovolumic pressure fall was significantly greater in SHR (13.2 +/- 0.6 ms) than in WKY (10.3 +/- 0.5 ms). The extent of shortening in isolated myocytes was significantly higher in SHR (11.3 +/- 0.4%) than in WKY (9.8 +/- 0.4%, P<0.01). Both the normalized maximal velocity of shortening and the normalized maximal velocity of relengthening were significantly greater in SHR (2.12 +/- 0.08 and 2.10 +/- 0.08 s-1; both P<0.01) than in WKY (1.76 +/- 0.06 and 1.75 +/- 0.07 s-1). Angiotensin II caused significant decreases in the extent of shortening, the normalized maximal velocity of shortening and the normalized maximal velocity of relengthening in isolated myocytes from SHR, but these parameters were unchanged in WKY. CONCLUSIONS: These results suggest that left ventricular diastolic dysfunction in SHR is not due to an intrinsic abnormality of the cardiac myocytes, and that angiotensin II suppresses the function of myocytes from hypertrophied hearts.

Animals↗
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

Difference in sero-diagnostic values among KL-6-associated mucins classified as cluster 9.

KL-6 classified as Cluster 9 (MUC-I) is a circulating high-molecular-weight mucin-like molecule. Serum level of KL-6 was measured by a sandwich assay using KL-6 antibody as not only a catcher but also as a tracer. We established 2 additional monoclonal antibodies (MAbs), LISA 101 and EH-123, reacting with KL-6 epitopes different from the epitope recognized by KL-6 antibody. The KL-6-associated mucins detected by the sandwich assay using LISA 101 or EH-123 antibody as a catcher and KL-6 antibody as a tracer were designated as LISA 1-6 and CAM 123-6 respectively. The diagnostic values as the serum markers of KL-6, LISA 1-6 and CAM 123-6 were evaluated measuring their levels in the same serum from healthy individuals and from patients with pulmonary, pancreatic and breast adenocarcinomas. KL-6 was increased abnormally at high rates of more than 50% in pancreatic cancer and in benign lung diseases, LISA 1-6 only in pancreatic cancer, and CAM 123-6 only in pulmonary adenocarcinoma. In benign lung diseases, however, LISA 1-6 and CAM 123-6 were increased abnormally at the rates of only 5.3% and 0% respectively. These observations clearly indicate that LISA 1-6 and CAM 123-6 constitute a part of KL-6, but that they are superior to KL-6 as tumor markers for pancreatic cancer and for pulmonary adenocarcinoma respectively, because of their much lower false-positive rates.

Adenocarcinoma↗
PubMed1994

Effects of long-term treatment with sustained-release nicardipine on left ventricular hypertrophy and function in patients with essential hypertension.

The effects of long-term treatment with sustained-release nicardipine (nicardipine SR) on left ventricular hypertrophy and function were studied. Ten uncomplicated essential hypertensive patients with left ventricular hypertrophy, aged 61 +/- 7.6 years old, were treated with nicardipine SR alone for an average of 20 months (range: 12-26 months). All patients underwent echocardiography for assessment of left ventricular diameters and function before and after the treatment. At the end of the treatment, systolic and diastolic blood pressures significantly decreased from 176.0 +/- 13.9 to 140.0 +/- 14.3 mm Hg and from 97.0 +/- 5.3 to 77.4 +/- 7.2 mm Hg, respectively (each P < 0.01), while heart rate did not change (73.8 +/- 14.6 vs. 69.9 +/- 13.5 beats/min). The left ventricular mass index significantly decreased from 132.1 +/- 14.4 to 114.4 +/- 15.7 g/m2 (P < 0.01) due to significant reductions in both interventricular septal thickness (P < 0.01) and left ventricular posterior wall thickness (P < 0.05). The ejection fraction (EF), fractional shortening (FS), peak shortening rate (PSR), and peak lengthening rate (PLR) were also improved significantly by the treatment (EF and FS, P < 0.05; PSR and PLR, P < 0.01). Significant inverse relationships existed between end-systolic wall stress and peak shortening or lengthening rate before the treatment (r = 0.80, P < 0.05; r = 0.86, P < 0.05, respectively). These relationships were unchanged after the treatment. Nicardipine SR reduced left ventricular hypertrophy and improved both left ventricular systolic and diastolic functions without causing any consistent augmentation of intrinsic left ventricular function in essential hypertensive patients with left ventricular hypertrophy.

Aged↗
PubMed1994

Contractile dysfunction in the diabetic-rat heart is an intrinsic abnormality of the cardiac myocyte.

1. In order to clarify whether the myocardial dysfunction observed in diabetic-rat hearts is an intrinsic property of the myocytes or not, we investigated cardiac function and myocyte contractile function in diabetic rats 5 weeks after the injection of streptozotocin. 2. Maximal and minimal dP/dt and time constant of isovolumic pressure fall were measured using a micromanometer in diabetic and age-matched control rats. 3. Isolated myocytes were enzymically obtained from each rat heart and were stimulated at 1 Hz (37 degrees C) in a buffer containing 1.5 mmol/l Ca2+. The images of myocyte contractions were recorded by a video system. Normalized maximal velocity of shortening (maximal velocity of cell shortening/resting cell length; s-1), normalized maximal velocity of relengthening (maximal velocity of cell relengthening/resting cell length; s-1) and extent of shortening [(twitch amplitude/resting cell length) x 100; %] were analysed by a digitalized computer as contractile functions of the myocyte. 4. The maximal and minimal dP/dt in diabetic rats (7876, 5341 mmHg/s) were significantly lower than those in control rats (9349, 7876 mmHg/s). The time constant of isovolumic pressure fall in diabetic rats (12.7 ms) was significantly greater than that in control rats (8.6 ms). Moreover, the normalized maximal velocity of shortening, normalized maximal velocity of relengthening and extent of shortening in myocytes from diabetic rats (1.40 s-1, 1.38 s-1, 9.5%) were significantly lower than those in myocytes from control rats (1.64 s-1, 1.60 s-1, 11.8%). 5. These results suggest that contractile impairment in this diabetic-rat heart model is mainly due to an intrinsic abnormality of the cardiac myocytes.

Animals↗
PubMed1994

Glucose intolerance exaggerates left ventricular hypertrophy and dysfunction in essential hypertension.

The influence of glucose intolerance, the preclinical stage of diabetes mellitus, on the progression of left ventricular hypertrophy and left ventricular dysfunction in essential hypertension, was assessed with two-dimensional M-mode echocardiography in age- and sex-matched essential hypertensive patients with (n = 28) or without (n = 44) glucose intolerance, and normotensive control subjects (n = 29). Left ventricular mass index in hypertensive patients with glucose intolerance was significantly higher than that in hypertensive patients without glucose intolerance (mean +/- SD, 115.6 +/- 28.2 v 102.1 +/- 22.1 g/m2; P < .05). Left ventricular diastolic function as reflected by peak lengthening rate was reduced in glucose-intolerant hypertensive patients than in hypertensive patients without glucose intolerance (2.68 +/- 0.71 v 3.16 +/- 0.82/sec; P < .05). End-systolic wall stress/left ventricular end-systolic volume index, an index of left ventricular contractility, was reduced more in glucose-intolerant hypertensive patients than in hypertensive patients without glucose intolerance (2.75 +/- 0.55 v 3.13 +/- 0.55 10(3) dyn.m2/cm2.mL-1; P < .01). These findings suggest that glucose intolerance accelerates progression of left ventricular hypertrophy and deteriorates left ventricular diastolic function and contractility in essential hypertension.

Blood Glucose↗
PubMed1994

A new serum tumor marker, CAM 123-6, highly specific to pulmonary adenocarcinoma.

KL-6, a circulating mucin-like glycoprotein, is a pulmonary adenocarcinoma-associated antigen and is also regarded as an indicator of disease activity of interstitial pneumonitis. KL-6 has extensive heterogeneous antigenic determinants and consists of multiple heterogeneous antigen molecules. We have searched for circulating KL-6-associated glycoproteins with superior diagnostic value to KL-6 as a tumor marker for pulmonary adenocarcinoma. A new murine monoclonal antibody EH-123 reacting with an asialosugar chain on KL-6 was established. A new KL-6-associated molecule detected by a bimonoclonal bideterminant sandwich assay using the EH-123 antibody as a catcher and horseradish peroxidase-labeled KL-6 as a tracer was designated as CAM 123-6. In 59% (22 of 37) of patients with pulmonary adenocarcinoma, serum levels of CAM 123-6 were abnormally elevated and the positive rate increased with the progression of clinical stage. Elevated levels were not detected in normal individuals or in patients with benign lung diseases, other histologic types of lung cancer, gastric cancer, colon cancer or breast cancer. CAM 123-6 was more specific to pulmonary adenocarcinoma than carcinoembryonic antigen (CEA), but the sensitivity of CAM 123-6 for pulmonary adenocarcinoma was similar to that of CEA. CAM 123-6 is a promising candidate as a serum tumor marker for pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1994

A case of central diabetes insipidus with spontaneous remission after 8 years of the disease.

A 55-year-old male smoker developed polyuria and polydipsia in November 1983. A water deprivation study revealed a defect in the urine concentrating function, which was corrected by vasopressin. Plasma antidiuretic hormone (ADH) was not increased by smoking. His condition was well controlled by deamino-D-arginine vasopressin. However, since February 1992 he has become completely free from the need for medication to control his urine volume. Re-evaluation studies with water deprivation and smoking revealed dramatic improvements in the urine concentrating function and ADH response. A patient with idiopathic diabetes insipidus with spontaneous remission after 8 years is reported.

Diabetes Insipidus↗
PubMed1994

Augmentation of baroreceptor reflex function by oral calcium supplementation in essential hypertension.

1. We studied the effect of oral calcium supplementation (1.0 g/day) for 1 week on baroreceptor reflex function and the lability of blood pressure in association with the changes in autonomic nervous activity in 14 hospitalized patients with mild to moderate essential hypertension (nine males and five females, mean age of 56 +/- 11.2 (s.d.) years). 2. Baroreceptor reflex sensitivity (BRS) was determined by the change in R-R intervals in response to the pressor response induced by phenylephrine injection. We measured coefficient of variation of R-R interval (CVR-R) and urinary excretion of catecholamines to evaluate the mechanism of change in BRS. We also used coefficient of variation of blood pressure (CVBP) and error of single cosinor analysis as parameters for lability of 24-h blood pressure. 3. The means of 24-h systolic and diastolic blood pressures showed no significant changes after calcium supplementation for 1 week. BRS and CVR-R were significantly increased by calcium supplementation. Daily excretions of norepinephrine and epinephrine corrected by creatinine were unchanged. Both CVBP and error of 24-h systolic blood pressure showed a significant decrease after calcium treatment. 4. These results indicate that oral calcium supplementation augments baroreceptor reflex function, in part through an enhancement of parasympathetic nervous activity, resulting in reduction of the lability of blood pressure in patients with mild to moderate essential hypertension.

Administration, Oral↗
PubMed1994

Myocardial scintigraphic characteristics in patients with primary aldosteronism.

To evaluate the difference in myocardial damage between primary aldosteronism and untreated essential hypertension, we performed thallium-201 myocardial single-photon emission computed tomography in 10 patients with primary aldosteronism and 10 patients with essential hypertension who were matched for age, sex, blood pressure, and the severity of left ventricular hypertrophy for primary aldosteronism. From the analysis of thallium-201 myocardial scintigraphy, extent score was calculated. Extent score was significantly higher in primary aldosteronism than in essential hypertension (45.8 +/- 23.5% versus 9.5 +/- 7.3%, P < .01). After operation, blood pressure significantly decreased, and the precordial voltages (SV1 + RV5) and left ventricular mass indexes were significantly reduced in patients with primary aldosteronism. Extent score was also significantly improved. These results suggest that despite the same severity of myocardial hypertrophy between primary aldosteronism and essential hypertension, the myocardial damage estimated by thallium-201 myocardial scintigraphy is more severe in primary aldosteronism than in essential hypertension. Extent score was useful for evaluation of the severity of myocardial damage in hypertensive patients.

Echocardiography↗
PubMed1994

Evaluation of aortic distensibility in patients with essential hypertension by using cine magnetic resonance imaging.

In order to evaluate the exact distensibility in various parts of aorta in hypertensive patients, the authors performed cine magnetic resonance (MR) in 30 normal control (NC) subjects and 30 hypertensive (HT) patients whose age and sex were matched. Cine MR was carried out at transverse sections in the ascending, descending, and abdominal aorta. Aortic diameter and area were measured in the frames of the maximum and the minimum aortic area. Aortic distensibility was calculated from the following formula: (Max area-Min area)/(Min area x delta P), where delta P is pulse pressure. Cardiac parameters were measured with echocardiography in all subjects. Aortic distensibility was significantly lower in HT patients than in NC subjects at each transverse section (P < 0.01). Minimum diameter index (Min diameter/body surface area) and cardiac function parameter showed no significant differences between NC and HT groups. From these findings, it is suspected that hypertension is a strongly contributing factor that promotes aortic sclerosis.

Adult↗
PubMed1994

Evaluation of short axial blood flow pattern in thoracic descending aorta by use of tagging cine magnetic resonance.

The authors, for the first time, evaluated the short axial blood flow profile by using tagging cine magnetic resonance (MR). Cine MR was performed on 15 healthy volunteers aged 51.5 +/- 23.1 (SD) years. The transverse plane of the thoracic descending aorta was imaged at the middle level of the left ventricle. Two or four radial tags, whose thickness was 3 mm width each, were established to the short axial image of the descending aorta at 2 msec and 300 msec following the R wave of the subjects' QRS complex on the electrocardiogram. They observed the flow patterns and measured the rotating flow velocity of the thoracic descending aorta in early systole and late systole from the following formula: v = d/t, (v = velocity, d = displacement of tags over the interval, t = time interval between the time of presaturation and the time of imaging). In the short axial image of the descending aorta, 13 subjects showed the clockwise rotation of tags in the supine position from the foot side view. Flow image of the other 2 subjects showed as undefined. Rotating flow velocity was 1.63 +/- 0.88 cm/sec in early systole and was 1.37 +/- 1.11 cm/sec in late systole. Tagging cine MR is useful to evaluate the blood flow profile in the thoracic descending aorta.

Adult↗