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Biomedical subjects

K Kimoto

Publications and source records attributed to K Kimoto.

At least 55 records · Page 3Linked to original sources

Relation of C4b-binding protein to athero-sclerosis of the descending thoracic aorta.

C4b binding protein (C4bp) is a regulator of the classical pathway of the complementing system. It forms a complex with protein S which serves as a cofactor of coagulation inhibitor, protein C. We have reported that C4bp is an acute phase reactant and associated with total cholesterol and triglyceride concentrations (Biochim. Biophys. Acta 963 (1988) 98-108). This suggests a possible association of C4bp with athero-sclerosis. We examined the relation of C4bp levels and the severity of atherosclerosis of the descending thoracic aorta in 98 Japanese men. The severity of aortic atherosclerosis was assessed by average sclerotic length (ASL) and average sclerotic area (ASA), using transesophageal echocardiography. After adjustment for age, C4bp levels increased significantly with increasing ASL and ASA. The association remained significant even after adjusting for total cholesterol, hypertension, smoking, drinking, body mass index, fasting blood sugar, and uric acid. Immunohistochemical analysis of specimens of the descending thoracic aorta from autopsies, demonstrated the presence of C4bp in the foamy macrophages of fatty streaks and the necrotic core of atheromatous plaque. These findings indicate that the serum level of C4bp can serve as an independent indicator of aortic athero-sclerosis.

Adult↗

Relationship of cigarette smoking to the severity of coronary and thoracic aortic atherosclerosis.

We studied the relationship of cigarette smoking to the severity of coronary and thoracic aortic atherosclerosis in 116 men who received coronary angiography and transesophageal echocardiography. Severity of coronary atherosclerosis was assessed in terms of Gensini's score (GS), and that of thoracic aortic atherosclerosis was assessed by the average sclerotic length (ASL) and average sclerotic area (ASA). The plasma fibrinogen levels were significantly positively correlated with smoking, and fasting blood sugar levels tended to be positively associated with smoking. GS was inversely associated with serum levels of high density lipoprotein (HDL) cholesterol. ASL and ASA were positively associated with age, fasting blood sugar levels and plasma fibrinogen levels, and these associations were statistically significant. Analysis of covariance was used to examine the net association between cigarette smoking and GS, ASL or ASA controlling for age, total cholesterol, HDL cholesterol, fasting blood sugar and plasma fibrinogen. We found that GS, ASL, and ASA were all significantly increased with increasing number of cigarette years. Additional adjustment for other risk factors (triglyceride, uric acid, body mass index, alcohol use and hypertension) also showed a strong independent contribution of smoking to GS, ASL and ASA. We concluded that the cumulative exposure to cigarette smoking was an independent indicator of the severity of coronary atherosclerosis as well as thoracic aortic atherosclerosis.

Adult↗

Evaluation of abnormal signal-averaged electrocardiograms in young athletes.

Our objectives in this study were to determine the incidence of abnormal signal-averaged ECG (SAECG) and its relation to the extent and type of exercise in young healthy athletes, and to evaluate the association, if any, between the development of abnormal SAECGs and vigorous exercise. The presence of abnormal SAECG was evaluated in 796 athletes (mean age 19 years), and its relation to findings on 12-lead electrocardiogram, echocardiogram, and the presence arrhythmias was studied using Holter monitoring. An SAECG was considered abnormal when any one of the three following criteria was met: filtered QRS duration of more than 114 msec, root-mean-square voltage in the terminal 40 msec of less than 20 muV, or a voltage of less than 40 muV for more than 38 msec. Abnormal SAECGs were present in 68 (8.5%) of the athletes and were associated with a smaller left ventricular mass. Athletes who performed anaerobic exercise tended to exhibit a high incidence of abnormal SAECGs, which was associated with a smaller left ventricular mass. No serious ventricular arrhythmias were observed on 24 h Holter monitoring or during the follow-up period of 20 +/- months. There were no sudden cardiac deaths. Continuous anaerobic exercise may induce abnormal SAECGs through the development of delayed myocardial conduction or electrical inhomogeneity in cardiac tissue. Te presence of an abnormal SAECG was unrelated to the development of arrhythmias in young athletes.

Adult↗

[A case of rhinocerebral phycomycosis].

Rhinocerebral phycomycosis is an uncommon opportunistic infection with ubiquitous fungi of the class Phycomycetes, starting in the nose and extending to the paranasal sinuses and then intracranially. The condition is often characterized by poor prognosis because of occlusion of the internal carotid artery. This disease is commonly associated with predispositions such as uncontrolled diabetes mellitus, which is the most common, immunosuppressive states and metabolic bankruptcy including leukemia, lymphoma, myeloma, malnutrition, uremic or diarrheal acidosis, severe burns, anemia, carcinoma, radiotherapy, liver cirrhosis, hemochromatosis, tuberculosis, septicemia, long-term medication of steroid, antibiotics and antimetabolite, drug addiction, cytotoxic drug administration and AIDS. Cases with unknown predisposition, however, have been infrequently reported in the literature. The authors report a case of rhinocerebral phycomycosis in which concurrence of Candida species instead of the above-mentioned common predispositions was considered a potential predisposition. To our knowledge, only 1 report in which Candida species are referred to as a potential predisposition for this disease has been previously issued. A 85-year-old man was admitted to our hospital on March 2, 1994 because of generalized convulsion. He had received a total extirpation of an ascending colon cancer in July 1993. On admission, physical inspection showed no abnormalities and neurological examination revealed obtunded consciousness without other abnormalities. He had no diabetes mellitus. Hematological and blood chemistry values were normal except for CA19-9 of 45 U/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Laparoscopic adrenalectomy: comparison with open adrenalectomy.

The results of the first 6 cases of laparoscopic adrenalectomy were compared with the most recent 11 consecutive cases of traditional open adrenalectomy for the treatment of benign adrenal tumor. In both groups, all the tumors were less than 4 cm in diameter and were removed successfully with no significant complications. The weight of the resected specimen and estimated blood loss were not significantly different in the two groups, and none of the patients needed a blood transfusion. Although laparoscopic adrenalectomy required a significantly longer operation time (median 230 min vs. 165 min for an open operation), the postoperative recovery estimated by the duration of restricted oral intake or walking was shorter, and the incidence of patients requiring postoperative parenteral analgesics was also significantly lower in laparoscopic adrenalectomy. Although the number of patients treated with the laparoscopic procedure is still small, these results suggest that laparoscopic adrenalectomy is a minimally invasive alternative to open adrenalectomy and, with further improvement of the operative technique and equipment, may become a more reliable and standard procedure for the treatment of benign adrenal tumor.

Adrenal Gland Neoplasms↗

[Usefulness of 5-FU high-dose continuous therapy at home in patients with recurrent gastric and colon cancer].

Recurrence of gastric cancer or colon cancer was observed in some patients who received 5-fluorouracil (5-FU) high-dose continuous Methotrexate (MTX)-Leucovorin (LV) therapy (FML therapy) previously. 5-FU high-dose 48-hours continuous therapy (5-FU therapy) as maintenance therapy for the patients was performed in the hospital and successively at home. The patients included 3 with recurrent gastric cancer and 2 with recurrent colon cancer: there were 4 males and 1 female, the mean age was 51.8 years (33-59 years). All patients had received FML therapy during the hospital stay before the maintenance chemotherapy at home. 5-FU therapy (30 mg/kg/day x 2 days/w), 30.2 courses on an average (11-40 courses), was performed through a catheter (Port-A-Cath), which was introduced into the right subclavian vein and placed under the skin, with a Baxter infusion pump. The concentration of 5-FU was 197 +/- 172-401 +/- 127 ng/ml between the 2nd and 48th hour. Adverse reaction included anorexia in 5 patients, stomatitis in 4, pigmentation in 4, leukopenia in 3, neuropathy in 2 and alopecia in 1. The therapy was effective for 10.4 months on an average (4-18 months) and the mean survival period was 12.0 months (7-18 months).

Adult↗

[Study of two cases of active pulmonary tuberculosis complicated by lung cancer].

In this study, we report on two patients diagnosed with active pulmonary tuberculosis who later developed complications of lung cancer. In both instances, lung cancer was not detected until after cessation of tuberculostatic drugs. Both patients were initially considered to be experiencing exacerbation of pulmonary tuberculosis. Patient 1 was a 77-year-old female. A roentgenogram of her chest revealed a cavitary lesion with infiltration into the right lung field. Her sputum tested positive for acid-fast bacilli. Although she was treated with isoniazid (INH), rifampicin (RFP) and streptomycin sulfate (SM), the RFP and INH treatments had to be discontinued due to liver dysfunction. Her general condition was deteriorated, and pleural effusion appeared on a subsequent chest roentgenogram. Primary squamous-cell lung cancer was confirmed by conducting a transbronchial biopsy. Patient 2 was a 59-year-old male. A roentgenogram of his chest revealed multiple cavitary lesions with infiltration into the bilateral lung field. His sputum also tested positive for acid-fast bacilli. Although he was treated with INH, RFP and SM, INH and RFP treatment had to be discontinued due to liver dysfunction and high fever. The shadow infiltrating the left lung field subsided, but a massive shadow appeared in the right lung field. Primary small-cell lung cancer was confirmed after conducting a sputum cytology. The patients was then administered cisplatin and etoposide. Patient 1 was diagnosed with lung cancer five months after being admitted to the hospital, and Patient 2 ten months after admission. Both patients succumbed due to lung cancer at seven and 26 months, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Plasmin and thrombin inhibitors in essentially untreated patients with coronary artery spasm.

We examined activities or levels of plasmin and thrombin inhibitors in essentially untreated patients with angiographically documented coronary artery spasm. The patients received the ergonovine malate provocation test and were classified into two groups: (a) those with significant coronary artery spasm that produced reduction of the internal luminal diameter of 50% or greater with chest pain and change of electrocardiography (n = 18), and (b) those without coronary artery spasm (n = 17). There was no significant differences in alpha 1-antitrypsin and alpha 2-macroglobulin levels, and C1-inactivator activity between the control and patients with coronary artery spasm. On the other hand, the lower antithrombin III and alpha 2-plasmin inhibitor activities were noted in patients with coronary artery spasm than the control. Thrombin/antithrombin III complex and alpha 2-plasmin inhibitor/plasmin complex levels were significantly higher in coronary artery spasm patients. These results suggest that the coagulation and fibrinolytic systems may maintain their equilibrium in untreated patients with coronary artery spasm.

Antifibrinolytic Agents↗

Regulation of vascular angiotensin release.

To investigate the regulatory mechanism of the vascular renin-angiotensin system, we perfused isolated rat hind legs with plasma-free buffer and quantified angiotensin peptides in the perfusate. Angiotensin release from hind legs was increased in rats pretreated with losartan (DuP 753) and rats fed a low sodium diet with subsequent furosemide and was decreased in nephrectomized rats and rats given dexamethasone, ethynylestradiol, and triiodothyronine. Using these models, we have attempted to identify which step or component of angiotensin metabolism determines angiotensin release level. Changes caused by these manipulations in plasma renin concentration and basal angiotensin release from hind legs were almost parallel, whereas plasma angiotensinogen concentration and the angiotensin release changed in opposite directions. Infusion of renin in hind legs caused a marked increase in angiotensin release and continued even 1 hour after cessation of renin infusion. Infusion of angiotensinogen did not alter the angiotensin release. Angiotensin clearance and angiotensin I conversion were not affected by either nephrectomy or losartan pretreatment. Aortic renin messenger RNA level was extremely low and not increased by nephrectomy or losartan pretreatment, although kidney renin messenger RNA level was increased by losartan pretreatment. These results provide evidence that plasma renin of kidney origin is the major source of vascular functional renin and plays the determining role in the regulation of vascular angiotensin release. Plasma-derived or locally produced angiotensinogen, locally produced renin, converting enzyme, and angiotensin clearance are not considered to be the primary determinant in the regulation of vascular angiotensin release in these acute and subacute experimental models.

Angiotensin I↗

[Transesophageal echocardiography in atherosclerosis].

CT scan and MRI were used for evaluating the degree or extent of atherosclerotic lesion. However, these methods do not show characteristics of the aortic wall and the hemodynamics surrounding atherosclerotic lesion. Recently, evaluation of the severity of aortic atherosclerosis, especially the thoracic aorta, and the proximal portion of the coronary artery, became possible by transesophageal echocardiography. This article reviews the diagnosis of aortic atherosclerosis and coronary atherosclerosis, using transesophageal echocardiography.

Aortic Diseases↗

Expression and purification of human angiotensinogen in Chinese hamster ovary cells.

We have produced human angiotensinogen in Chinese hamster ovary (CHO) cells. The expression products were purified to homogeneity by a single column chromatography and its 17 amino-terminal sequences were identical to those of the native protein. We demonstrated the recombinant human angiotensinogen to be a substrate for human renin.

Amino Acid Sequence↗

Pancreatic arteriovenous malformation with pancreatitis involving a pancreatico-venous fistula.

An arteriovenous malformation of the pancreas is a very rare disease, but its presentation is distinct and unique. In this report, we describe a patient who presented with this malformation which was localized in the tail of pancreas and demonstrated by abnormal angiography findings. The patient was a 60-year-old male with severe left hypochondralgia. Angiography revealed an increased blood volume in the tail of the pancreas with arteriovenous shunting. Secondary pancreatitis caused by the arteriovenous malformation was suspected by abnormal laboratory data, and confirmed by histology from the resected tail of the pancreas. This is a very rare report in which pancreatic arteriovenous malformation involving a pancreatico-venous fistula was confirmed by endoscopic retrograde cholangiopancreatography (ERCP).

Arteriovenous Fistula↗

A study of recording accuracy in linear measurements displayed by sirognathograph.

The recording accuracy of Sirognathograph (Siemens, West Germany) was conducted by means of an experimental apparatus. Diagrams of mandibular border movements in three dimensional directions were performed. The results showed the distortion was not recognized within 5 mm of primary condition in a subject, but slightly between 5 mm and 10 mm. In a distance of more than 15 mm, a considerable distortion was increased until at the maximum opening position.

Dental Equipment↗

[Schedule sensitivity in human operant behavior: instructed versus shaped verbal behavior].

Presses on left and right buttons by undergraduate students occasionally produced points exchangeable for money, according to a multiple random-ratio random-interval schedule. During interruptions in the schedule, the subjects were required to fill out sentence-completion guess sheets about how they should press the buttons to gain the points available. Three of six subjects were instructed about the rules of button pressing (the instructed group), whereas the others received no instructions but their guesses were shaped with differential points also worth money (the shaped group). The schedule was changed so that button pressing relying on the instructed or shaped rules substantially decreased the available points in the contact condition but not in the no-contact condition. A schedule change in the no-contact condition produced no performance change in either groups. In the contact condition, shaped group subjects showed a performance change, whereas instructed group subjects did not until they temporarily encountered an extinction schedule. When the no-contact condition was reintroduced, sensitive responding occurred in the shaped group but not in the instructed group suggesting that prior experience in the contact condition increased the schedule sensitivity of the shaped group. The findings clearly demonstrated that responding was more sensitive to schedule changes when the rules were shaped than when they were instructed.

Adult↗

Studies on the techniques of topical application with fluoride gel. III: Oral fluoride retention following three different topical application techniques in young adults.

Eighteen young adults volunteered to be subjects for topical fluoride gel application using the paint-on technique with cotton pellets and two tray techniques with improved sponge tray and a custom-fitted tray. The subjects' teeth were dried with compressed air, and the fluoride gel was applied topically for four minutes. The amounts of fluoride applied and/or recovered from the mouth were measured, and those retained in the mouth were also estimated for each technique. Furthermore, the amounts of excessive gel that were wiped off with a gauze and expectorated one minute after application were also evaluated, and these efforts were effective in reducing the amounts of oral fluoride retention. The net amounts of fluoride that were orally retained in each technique were very small (1.6 to 3.0 mg). It was found that the application techniques in the present study had no risks of causing some deleterious effects by applying excessively large amounts of fluoride.

Adult↗