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Biomedical subjects

K Hiwada

Publications and source records attributed to K Hiwada.

At least 253 records · Page 14Linked to original sources
PubMed1992

Monitoring of serum KL-6 antigen in a patient with radiation pneumonia.

Serum marker KL-6 antigen has been reported to be a valuable indicator of the disease activity of interstitial pneumonia. It is not clear how sensitive the serum KL-6 antigen level is in reflecting histologic changes in lung tissues. We report here the results of serial measurements of serum KL-6 antigen in a 76-year-old male patient with radiation pneumonia. Serum KL-6 antigen levels were more sensitive than lactate dehydrogenase and procollagen type III N-terminal peptide. The level of serum KL-6 antigen appears to reflect the histologic changes of the lung more sensitively than does C-reactive protein.

Aged↗
PubMed1992

Circulating antigen KL-6 and lactate dehydrogenase for monitoring irradiated patients with lung cancer.

To determine the sensitivity of serum KL-6 and serum lactate dehydrogenase for detecting the contraction of radiation pneumonitis, 15 patients with lung cancer who had radiation therapy were monitored. Six of the patients contracted radiation pneumonitis (pneumonitis group) and the other patients did not (control group). Serum levels of KL-6 were significantly (p less than 0.05) elevated according to the complication of radiation pneumonitis in all patients of the pneumonitis group. In the control group, however, one-sided changes of KL-6 level were not observed. In the pneumonitis group, serum LDH levels were not significantly changed. However, there was a strong correlation between the altered levels of KL-6 and those of LDH (r = 0.992). These observations indicate that the same cytopathologic changes may cause the elevation of serum KL-6 level and the elevated activity of serum LDH in the patients with radiation pneumonitis, and that KL-6 is much more sensitive than LDH for detecting radiation pneumonitis.

Adenocarcinoma↗
PubMed1992

Interleukin 6 activity in pleural effusion. Its diagnostic value and thrombopoietic activity.

We measured interleukin 6 (IL-6) concentrations in the pleural fluid of various patients to determine its role in pathophysiology and diagnosis by using specific functional bioassay. IL-6 levels were significantly higher in exudate than in transudate (79.3 +/- 176.2 U/ml [n = 55] vs 1.7 +/- 1.8 U/ml [n = 12]; p < 0.01). Tuberculous effusion contained a significantly higher amount of IL-6 than malignant effusion (181.3 +/- 176.2 U/ml [n = 13] vs 29.4 +/- 71.5 U/ml [n = 29]; p < 0.005). Pleural IL-6 levels were invariably higher than serum IL-6 levels, and both were significantly correlated (n = 21, r = 0.632; p < 0.02). Pleural IL-6 levels were significantly correlated with lactate dehydrogenase (LDH) in pleural fluid (r = 0.392; p < 0.01), ratio of pleural/serum LDH (r = 0.571; p < 0.01), pleural adenosine deaminase activity (r = 0.599; p < 0.01), and serum C-reactive protein (r = 0.494; p < 0.01). Furthermore, IL-6 levels were significantly correlated with peripheral blood platelet counts (r = 0.447; p < 0.001). These results suggest that (1) IL-6 is produced locally in pleural space, (2) pleural IL-6 level is helpful for differential diagnosis, and (3) locally produced IL-6 could leak to circulation and cause systemic effects such as the induction of C-reactive protein and thrombocytosis.

Adenosine Deaminase↗
PubMed1992

Torsade de pointes induced by hypocalcemia in a postoperative patient with thyrotoxicosis.

A 29-year-old woman with a long-term history of Graves' disease was admitted for thyroidectomy. Torsade de pointes occurred after the subtotal thyroidectomy. The level of her serum calcium was lower than normal. After administration of calcium gluconate intravenously, torsade de pointes disappeared and was no longer recorded. It is assumed that her torsade de pointes was caused by hypocalcemia as a complication of subtotal thyroidectomy.

Adult↗
PubMed1992

Fatal pulmonary hypertension in a patient with mixed connective tissue disease: report of an autopsy case.

A 34-yr-old woman with mixed connective tissue disease (MCTD) who died of heart failure due to pulmonary hypertension (PH) is reported. She showed various symptoms and signs over the previous 8 yr, including lymphadenopathy, Raynaud's phenomenon, polyarthralgia, sclerodactylia, esophageal disturbance, PH, Sjögren's syndrome and renal tubular acidosis. Autopsy findings revealed severe intimal proliferation with marked luminal narrowing of the small arteries in the lung. Echocardiographic and mechanocardiographic methods were very useful for assessment of the degree of right ventricular dysfunction associated with PH on the early stage of MCTD.

Adult↗
PubMed1992

[A case of "pure" progressive autonomic failure in an elderly male].

A 68-year-old man was admitted to our hospital because of postural hypotension in July 1991. He was also suffering from anhydrosis, urinary disturbances, constipation and impotence. He had not developed signs of Parkinsonism, cerebellar or peripheral neuropathy four years from the onset. Various autonomic function tests showed sympathetic and parasympathetic dysfunction of mainly postganglionic origins. Thus we diagnosed this patient as "pure" progressive autonomic failure ("pure" PAF). "Pure" PAF is a new entity described by Bannister and Oppenheimer in 1982. It shows symptoms of autonomic failure without other neurological disturbances which manifest as Shy-Drager syndrome. Treatment with L-DOPS increased his blood pressure level and attenuated his symptoms due to orthostatic hypotension.

Aged↗
PubMed1992

Anti-caldesmon monoclonal antibody reverses the inhibition of actomyosin Mg(2+)-ATPase activity by caldesmon.

Five mouse monoclonal antibodies, CaD 1-5, against chicken gizzard caldesmon were prepared. One of them (CaD4) was characterized by means of immunoblotting and its effect on actomyosin Mg(2+)-ATPase activity. CaD4 recognized the tropomyosin-binding site of caldesmon. CaD4 reversed the caldesmon-induced inhibition of actomyosin Mg(2+)-ATPase activity in a dose-dependent manner. These results suggest that the epitope recognized by CaD4 is an important domain for the function of caldesmon on the actinmyosin interaction in the smooth muscle contraction-relaxation system.

Actomyosin↗
PubMed1992

Regulation of the gene expression of type-1 angiotensin II receptor in spontaneously hypertensive rats.

Regulation of the gene expression of type-1 angiotensin II receptor (AT1) by treatment with manidipine, a calcium channel blocker, or delapril, an angiotensin converting enzyme inhibitor, for one week was assessed in the adrenal gland, heart, kidney, and brain from spontaneously hypertensive rats (SHR). Tissue AT1 receptor messenger RNA (mRNA) content was measured by reverse transcriptase-polymerase chain reaction. Treatment with manidipine (3 mg/kg/day) or delapril (30 mg/kg/day) lowered systolic blood pressure (SBP) significantly (p < 0.01) (delta SBP; -73 mmHg or -67 mmHg, respectively). Although delapril markedly increased plasma renin activity (PRA), manidipine did not alter PRA. AT1 receptor mRNA content in the adrenal gland was significantly (p < 0.01) decreased by treatment with manidipine or delapril. In contrast, cardiac AT1 receptor mRNA content was significantly (p < 0.01) increased by treatment with either agent. There was no significant change in renal and brain AT1 receptor mRNA contents. These findings suggest that although the expression of AT1 receptor gene depends on the circulating renin-angiotensin system (RAS), it is regulated independently in a tissue-specific manner via the local RAS in each tissue of SHR.

Adrenal Glands↗
PubMed1992

Renal and extra-renal renin gene expression in spontaneously hypertensive rats.

To study the effect of antihypertensive therapy on the regulation of renin gene expression, the levels of tissue renin messenger RNA (mRNA) were measured after treatment with a calcium channel blocker (manidipine hydrochloride 3 mg/kg/day) or an angiotensin-converting enzyme inhibitor (delapril hydrochloride 30 mg/kg/day), administered orally for 1 week, in spontaneously hypertensive rats (SHR). Male SHR, aged 15 weeks old, were used in this study (n = 5 per group). Control rats were administered the vehicle alone. Tissue total RNA was isolated from kidney, adrenal gland, heart, and brain tissue, and tissue RNA was reverse-transcribed to complementary DNA (cDNA), which was specifically amplified by polymerase chain reaction with labeled-primers for the rat renin gene. The radioactivity of the cDNA products was measured directly. Although delapril increased plasma renin activity (PRA) about 5-fold compared with the control group, manidipine did not change PRA. The kidney renin mRNA content was increased about 6-fold by treatment with delapril. Manidipine and delapril significantly decreased the renin mRNA content in the heart (p < 0.01 and p < 0.05, respectively). The level of renin mRNA in the adrenal gland and brain tissues was not significantly changed by treatment with either drug. These results suggest that tissue renin gene expression in SHR is regulated by a tissue-specific process independent of the circulating renin-angiotensin system.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1992

Renin gene restriction fragment length polymorphisms in a Japanese family with a high incidence of essential hypertension.

1. Human renin gene restriction fragment length polymorphisms (RFLP) were compared in a Japanese family which has a high incidence of essential hypertension. 2. RFLP of human renin gene were observed in three restriction enzymes, Mbo I, Bgl I and Hind III; 1.4 kb and 1.0 kb [Mbo I], 5.0 kb and 9.0 kb [Bgl I] and 9.0 and 6.2 kb [Hind III]. 3. Plasma renin activity was not associated with blood pressure. 4. Renin gene RFLP were not cosegregated with essential hypertension in this Japanese family.

Adult↗
PubMed1992

[Tl-201 myocardial scintigraphic findings in patients with aortic regurgitation].

To evaluate the myocardial damage associated with aortic regurgitation, thallium-201 myocardial scintigraphy was performed in 13 patients with aortic regurgitation. The data obtained by thallium-201 single photon emission computed tomography were expressed as the extent score, and were compared with data by echocardiography. The results were as follows: 1. In 11 of 13 patients, there were moderate Tl defects in the distribution of bull's eye map, 80% in the apex, 50% in the inferior and lateral regions, 30% in the anterior region and 10% in the septal region. The mean extent score was 22.3 +/- 11.0%. 2. The extent score correlated with the increase in aortic regurgitant flow volume. The extent score according to the Sellers' classifications II, III, and IV was 13.8 +/- 3.7%, 20.1 +/- 9.8% and 31.9 +/- 10.2%, respectively. 3. There was a good negative correlation between the extent score and fractional shortening (r = -0.66, p < 0.01), however, no significant correlation was observed between the extent score and the left ventricular end-diastolic volume. These results suggest that Tl defects in patients with aortic regurgitation are mainly due to myocardial ischemia associated with a decrease in coronary perfusion pressure and that the extent score may sensitively reflect the severity of myocardial damage in cases with aortic regurgitation.

Adult↗
PubMed1992

[A case of middle aged women with isolated left coronary ostial stenosis].

A-50-year-old woman was admitted to our hospital for the examination of exertional chest pain. She had no coronary risk factors. No hormonal disorders were observed. Physical and laboratory examinations revealed that she had not suffered from syphilis or aortitis syndrome or any other inflammatory diseases. An exercise electrocardiogram (Master's test) demonstrated ST segment depression in V3-6, II, III and a VF. On coronary angiography, a 75% stenosis of the left coronary ostial stenosis was found, but no abnormality was found in other arterial trees. The patient was diagnosed as having isolated coronary ostial stenosis. She underwent coronary bypass surgery from the aorta to the circumflex artery and the anterior descending coronary artery. She is now completely asymptomatic. A review of the literature together with this patient reveals the following characteristics of patients with isolated coronary ostial stenosis. Firstly, the patients are almost always middle aged woman with no coronary risk factors. Secondly, the involved coronary artery is the left main coronary artery, so its obstruction results in a serious condition. Therefore, though its pathogenesis remains to be determined, isolated left coronary ostial stenosis seems to be a distinct clinical entity.

Age Factors↗
PubMed1992

Family history study on hypertension in Japan.

1. Familial aggregation of hypertension was determined in 187 Japanese nuclear families. The necessary data on family and case history particularly concerning the hypertensive status were obtained by personal interviews of outpatients at six local hospitals, using a specifically designed questionnaire. 2. From the family history of the 187 living index children (single ascertainment), 134 pairs of parents were informative. Of 819 children, excluding index cases, the number of hypertensives, normotensives and status unknown were 224, 274 and 187, respectively. Individuals under 30 were classified as unknown. 3. For a child given the birth order, empirical risk to be hypertensive was calculated from the proportion of hypertensives to normotensives plus hypertensives. 4. Irrespective of parental mating types, among a simplex family of hypertension the index cases of the first-born child were more than the others. 5. There was no birth order effect in risk among multiplex families of hypertension. 6. There was no increase of hypertensive offsprings observed when the mother was hypertensive.

Family↗
PubMed1992

[A case of anomalous course of the pulmonary vein with a tracheobronchus].

A 28-year-old man was admitted to our hospital for further evaluation of a loop-like abnormal shadow in the middle lower lung field on chest X-ray film. Pulmonary angiograms demonstrated staining of the abnormal shadow during the venous phase. The abnormal vein descended from the right upper lobe to the middle lobe and then tortuously made a loop upward to drain into the left atrium. A part of the right apical vein was stenosed. The right apical segmental bronchus directly branched from the trachea. These observations indicate that the abnormalities may have originated in the prenatal period. Cases of anomalous course of the pulmonary vein are very rare.

Adult↗
PubMed1992

Ectopic ACTH-producing adenocarcinoma of the stomach.

A 73-year-old female was admitted to our hospital because of weight loss and pretibial edema. Plasma levels of adenocorticotropic hormone (ACTH) and cortisol were elevated, and neither hormone showed circadian rhythm. Dexamethasone (2 mg for 2 days) failed to reduce the urinary excretion of 17-hydroxycorticosteroids and the plasma cortisol level. The stomach biopsy specimens showed a moderately-differentiated papillo-tubular adenocarcinoma. Computed tomography of the abdomen showed multiple metastases to the liver. Immunohistochemical staining of the autopsy specimens showed immunoreactive ACTH in the primary tumor cells of the stomach as well as the metastatic tumor cells of the liver. On the basis of the clinical, histological and immunohistochemical findings, we diagnosed this patient as having ectopic ACTH syndrome caused by adenocarcinoma of the stomach.

ACTH Syndrome, Ectopic↗
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↗