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Biomedical subjects

K Kumano

Publications and source records attributed to K Kumano.

At least 91 records · Page 5Linked to original sources

[Absorption, distribution, metabolism and excretion of T-3761, a new quinolone derivative, in experimental animals].

We studied the absorption, distribution, metabolism and excretion of T-3761, a new quinolone derivative, in experimental animals. The following results were obtained. 1. The peak serum levels of T-3761 after a single oral administration to various fasting animals at a dose of 5 mg/kg were high in the order of rats, dogs, mice and rabbits, showing favorable absorption in all animals except for rabbits. In mice and rats, T-3761 showed higher peak serum levels than ofloxacin and ciprofloxacin but T-3761 were more rapidly eliminated from serum than ofloxacin and ciprofloxacin. 2. Tissue concentrations of T-3761 in rats were similar to those of ofloxacin but its ratio of tissue to serum levels were lower than those of ofloxacin. 3. Urinary excretion of T-3761 as active form until 24 hours after oral administration was 27.3%, 63.1%, 41.0% and 63.3% in mice, rats, rabbits and dogs, respectively. Only unchanged T-3761 was detected as active form in urine of all animals tested. In rats, urinary concentrations until 2 hours after administration were higher than those of ofloxacin. 4. Biliary excretion of T-3761 in mice and rats were 2.9% and 1.4% as active form. 5. The absorption of T-3761 was not different in male and female rats or 8 and 14 weeks old rats. The meal lowered absorption of T-3761 in rats. There was no significant difference in serum levels, urinary excretion and distribution to tissues after multiple administration of T-3761 comparing with its single administration. 6. In rats with liver dysfunction induced by D-galactosamine, the serum levels and urinary excretion were slightly higher than in normal rats. On the other hands, in rats with kidney dysfunction induced by HgCl2, the serum levels were significantly higher and urinary excretion of T-3761 was significantly lower than in normal rats. Above results show that T-3761 has unique characteristics in absorption, excretion and distribution after oral administration to animals among new quinolones, i.e., T-3761 was eliminated rapidly and poorly distributed to tissues but showed superior absorption and high peak serum levels.

Administration, Oral↗

[Effect of direct pulsatile peritoneal dialysis on peritoneal permeability and lymphatic absorption in the rat].

Continuous vibration of the abdominal wall with a small electric vibrator was conducted to enhance peritoneal mass transport in rats with normal kidney function. Thirty ml of either 2.5% or 4.25% dextrose dialysate containing creatinine, urea and dextran 70 was infused intraperitoneally and was allowed to dwell for 30-240 min with or without abdominal wall vibration at the rate of 80 Hz. The mass transfer area coefficient (KA) of small molecular solutes and peritoneal lymphatic absorption were investigated. Peritoneal dialysis with vibration for 60 min increased the KA of urea, creatinine and glucose by 12%, 15%, 27%, respectively, without changes in ultrafiltration and lymphatic absorption. This effect may be attributed to enhanced mixing of dialysate in the peritoneal cavity and the increased peritoneal effective blood flow. This concept can be applied to short-term dwell dialysis, such as automated peritoneal dialysis.

Absorption↗

[Detection of glomerular and non-glomerular red blood cells by automated urinary sediment analyzer].

There is increasing interest in the examination of urine sediment to differentiate between glomerular and non-glomerular hematuria. A newly developed automated urinary sediment analyzer was used for this purpose. It clearly recognized red blood cells, white blood cells, epithelial cells, bacteria and crystals by their cell size and fluorescent intensity. Ninety-eight urine samples from 31 glomerular and 67 non-glomerular lesions were analyzed by the analyzer and 69 samples, by light microscopy. According to the analysis of their histograms, a forward scatter (FSC) intensity of less than 126, where 80% of the smaller red blood cells were observed, was diagnosed as glomerular hematuria. A FSC intensity of more than 84, where 80% of the large red blood cells were counted, was non-glomerular hematuria. An FSC intensity between 84 and 126 was considered to be the overlap zone of glomerular and non-glomerular hematuria. The sensitivity for glomerular red blood cells was found to be 100% and specificity, 92.54% by means of flow cytometric analysis. On the other hand, light microscopic analysis yielded 95.83% sensitivity and 93.33% specificity for glomerular lesions. Flow cytometric analysis of the urinary red blood cells was concluded to be a fast, simple and reliable method to differentiate glomerular and non-glomerular hematuria.

Adolescent↗

Inhibition of mesothelial cell growth and protein synthesis by heparin.

Heparin, routinely used in peritoneal dialysis, has been found to have various effects, mainly inhibitory. Its infusion into the peritoneal cavity may adversely affect mesothelial cell growth and regeneration. Thus we wished to determine if heparin inhibits mesothelial cell growth and is does-dependent. Rat mesothelial cells were incubated for 3 days and 6 days with 200, 100, 20, 2, and 0.5 U/mL of heparin. Cellular proliferation and protein synthesis were determined by liquid scintillation counting after 24-hour pulses with 3H-thymidine and 3H-leucine. Heparin at 2 and 0.5 U/mL had no significant effect on radionuclide uptake. At 100 U/mL heparin inhibited radionuclide uptake by at least 50%. These findings indicate that heparin in small concentrations may be harmless, but at higher concentrations is inhibitory to mesothelial cell growth and proliferation.

Animals↗

Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders.

Sixty-five patients who underwent wide laminectomy, Cotrel-Dubousset instrumentation, and fusion for lumbar degenerative disorders were reviewed radiographically to investigate the incidence and contributing factors of the postfusion instability at the adjacent segments immediately above or below the level of fusion. Thirty-four were men and 31 were women. The mean age was 55.8 years. The average follow-up time was 39 months. Postfusion instability was studied at a total of 107 adjacent segments in 65 patients. The incidence of postfusion instability noted at final follow-up was 24.6% (15 of 61 patients). The incidence was significantly more often observed in the adjacent segments above the fusion than below the fusion, at rates of 25.5 and 2.6%, respectively. The most common instability was posterior translation (9 of 15 patients). Regarding contributing factors for instability at the adjacent segment above the fusion levels, the age of patients was the most significant factor. The incidence was 36.7% (11 of 30 patients) in older patients (> 55 years old) and 12% (3 of 25 patients) in younger patients (< 55 years old). In four patients with a preoperative of > 3 mm anterior translation, instability progressed further postoperatively. To prevent postoperative instability, attention must be paid especially above the fusion levels of the elderly and the preoperative minimal anterior translation.

Adult↗

Pedicle screws and bone mineral density.

STUDY DESIGN: Thirty-five consecutive patients who underwent surgeries for decompression, and one-level fusions with Cotrel-Dubousset pedicle screws for spinal canal stenosis were included in this study. The relationship between bone mineral density of the lumbar spine and the rate of successful fusion and screw problems was studied. OBJECTIVES: Bone mineral density of the third lumbar vertebral body was measured by quantitative computed tomography preoperatively, and the degree of osteoporosis was graded by radiographic films of lumbar spines. The films were followed with anteroposterior and lateral dynamic radiographic examinations of lumbar spines. These examinations were evaluated clinically after surgery. Follow-up duration was at least 19 months, with a mean of 28 months. SUMMARY OF BACKGROUND DATA: The mean bone mineral density of all the patients was 117.1 mg/mL (SD = 42.5). The rate of successful fusion was 88.6%, the non-union rate was 5.7%, and the rate of fusions that were undetermined was 5.7%. The incidence of screw loosening occurred in 5.7% of the patients, screw breakage occurred in 5.7% of patients, and symptomatic screws related to non-union were present in 5.7% of patients. The degree of bone mineral density or radiographic gradings of osteoporosis and the successful fusion or the incidence of symptomatic screws, which were defined as screws related to non-union, were not related. METHODS: The patients were divided into two groups. One group consisted of 12 patients who had less than 100 mg/mL of bone mineral density, with a mean of 72.0 mg/mL (SD = 21.2). The other group consisted of 23 patients who had more than 100 mg/mL of bone mineral density, with a mean of 140.6 mg/mL (SD = 30.0). The rate of successful fusion or non-union and the rate of screw problems such as screw loosening or screw breakage were compared in the two groups. The presence of bony trabeculation in grafted bone is the most important criterion for successful fusion. RESULTS: A statistical difference did not occur between the two groups. Non-union, screw breakage, and screw loosening were observed in patients with both increased and decreased bone mineral density and those with increased and decreased grade osteoporosis. Radiographic grading of osteoporosis was not correlated to bone mineral density, but patients with unexpected bone mineral density were frequent in this series. CONCLUSIONS: The use of decompression and pedicle screws for spinal canal stenosis due to degenerative lumbar disorders can be done safely with one-level fusion in patients with decreased bone mineral density if patients with grade III osteoporosis are excluded. Bone mineral density is more reliable than radiographic grading to evaluate the degree of osteoporosis and should be included in the preoperative evaluation of patients with osteoporosis.

Bone Density↗

A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis.

STUDY DESIGN: The authors employed a new mode of treatment for spinal tuberculosis consisting of single stage posterior instrumentation and fusion without anterior debridement. Ten patients were operated upon in this manner. Chemotherapy was instituted 2 weeks preoperatively and continued for a mean period of 11 months. Cotrel-Dubousset or a comparable system was used for fixation. OBJECTIVES: Patients were followed for 3 monthly intervals with serial anteroposterior and lateral x-rays, erythrocyte sedimentation rate, physical examination, and patients' self reports. The mean follow up period was 24.2 months (range, 17-36 months). METHODS: Measurement of kyphosis angle in the lateral x-ray view was used to evaluate treatment. RESULTS: Only a 3.4 degrees mean loss of correction was observed over the follow-up period. All patients were satisfied. CONCLUSION: Our results show that posterior rigid fixation and chemotherapy provide satisfactory stabilization, reduce surgical morbidity, and prevent development of late kyphosis in selected patients with Pott's disease of the thoracolumbar spine.

Antitubercular Agents↗

Complication of silastic dural substitute 20 years after dural plasty.

A 63-year-old woman was admitted because of right hemiparesis. Both computed tomography scan and magnetic resonance imaging revealed a mass lesion in the left parieto-occipital lobe. Twenty years previously, meningioma of the left parieto-occipital region was removed at another hospital, and a dural plasty was performed using a silastic dural substitute. The patient was operated on under the diagnosis of recurrent meningioma. However, most of the mass lesion was composed of an old hematoma, which seemed to be a complication of the silastic dural substitute.

Aged↗

[Changes of plasma endothelin level in the early post-renal transplantation period].

Endothelin (ET) has been suggested to be involved in acute graft rejection of kidney transplantation and cyclosporin A (CsA) nephrotoxicity. For clarification of the pathophysiological role of ET in the early post-transplantation period, plasma endothelin-1 (ET-1) was measured by specific radioimmunoassay in renal transplant recipients, patients on maintenance hemodialysis (HD) and healthy volunteers. Twelve transplant recipients were used in this study, 8 of whom were living related subjects and 4 cadaver. Plasma ET-1 and graft function were measured each day, from 1 day prior and 7 days following transplantation and every week up to 5 weeks postoperatively. Plasma ET was measured in 20 other transplant recipients with stable function (serum creatinine < or = 1.8 mg/dl), 20 maintenance HD patients with no residual renal function and 6 healthy volunteers. Mean plasma ET-1 was 13.0 +/- 4.5 pg/ml in 20 recipients with stable graft function, 21.7 +/- 6.5 in 20 HD patients and 1.5 +/- 0.4 in healthy volunteers. These differences are statistically significant (p < 0.02). Plasma ET-1 showed significant decrease from 21.8 +/- 7.2 pg/ml prior to transplantation to 12.8 +/- 4.0 when urinary output reached more than 1000 ml in living and cadaveric transplantation subjects. All three acute vascular rejections clearly indicated histologically increased plasma ET-1 accompanied by an increase in serum creatinine. A significant positive liner correlation was noted between plasma ET-1 and serum creatinine during the first week following living transplantation. Two patients with clinically and histologically suspected CsA nephrotoxicity showed transient increase in plasma ET-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Ultrafiltration failure in a peritoneal dialysis patient due to a marked increase in lymphatic absorption a case report].

A peritoneal dialysis patient was reported who had ultrafiltration loss due to a marked increase in lymphatic absorption and peritoneal membrane permeability. A 33-year-old male was transferred from hemodialysis to peritoneal dialysis because of acute subdural hematoma. His complicated history included left testicular tumor with retroperitoneal lymph node metastasis in 1982. He was treated with CDDP, Etoposide, Bleomycin, Vinblastine sulfate and Vincristine and received operation of retroperitoneal lymph node dissection in 1982. He had been on hemodialysis since 1983 due to cisplatinum nephropaty. Ultrafiltration failure was found immediately following the insertion of Tenckhoff catheter without malfunction of peritoneal catheter. Peritoneal equilibrate test and lymphatic absorption measurement showed a high permeability peritoneum with a marked increase in lymphatic absorption rate (3.7 ml/min). These two factors were thought to result in ultrafiltration loss. CAPD with 4-6 times exchange daily did not maintain ultrafiltration, because it gave approximately 2000 ml negative water balance every day. He was well maintained on a short time exchange intermittent peritoneal dialysis (IPD) with cycler using 18 L for 8 hours. We concluded that increased lymphatic absorption is one of the important factors for ultrafiltration fafilure and IPD with frequent exchange by cycler is suitable for the patient with ultrafiltration loss.

Absorption↗

[Effects of osmotic agents for cold kidney preservation].

The beneficial effect of UW solution may result from its ability to prevent tissue edema during cold storage. This study was conducted to determine which impermeant was effective in this regard during cold storage of a rat kidney in solution. Functional and morphological studies were made on a rat isolated perfused kidney (IPK) following 24 hour-cold storage in various tested solutions. Right nephrectomy was performed in 95 male rats by the method of Nishitsutsuji-Uwo et al and the kidney was perfused and stored at 4 degrees C for 24 hours as follows: glucose (194 mM) as a control, mannitol, sucrose, raffinose (140 mM in each), lactobionate (100 mM), raff + lact, hydroxyethyl starch 20, 40 (5%) with electrolyte composition essentially the same as that of Euro-Collins or UW solution. Kidneys stored for 24 hrs at 4 degrees C were perfused by the IPK apparatus. The perfusate flow rate was adjusted to maintain the renal arterial perfusion pressure at 100 mmHg. Raff, raff + lact or UW solution showed significantly higher fractional reabsorption of sodium than the control with no change in renal hemodynamics. The release of LDH into the perfusate was significantly less in raffinose than the control. Raffinose may thus be considered to function effectively as an impermeant for cold kidney preservation and molecule size would appear more important than negative charge for rat kidney preservation.

Animals↗