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Biomedical subjects

K Kuramoto

Publications and source records attributed to K Kuramoto.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Psoas lymph node metastasis in patients with carcinoma of the uterine cervix].

Enlargement of lymph nodes between the psoas muscle and lumbar spine was demonstrated on CT in three of 14 cases having Stage IIb and III uterine cervical carcinoma with iliac or paraaortic lymphadenopathy. In two of these, the adjacent lumbar vertebral body was destroyed. We define psoas lymph nodes to include all lymph nodes located between the psoas muscle and the spine. Psoas lymph nodes may be divided into upper and lower groups: the upper group distributed along the lumbar arteries above in level of L4-L5 and the lower group distributed along the lumbar branches of the iliolumbar arteries below L5. There appears to be paravertebral communication between these two groups. The region of the psoas lymph nodes should be scrutinized in interpretating CT in patients with malignant pelvic tumors which have already spread to iliac or paraaortic lymph nodes. Obliteration of fat plane between psoas muscle and lumbar vertebra is a clue to the presence of enlargement of the psoas lymph nodes on CT. Massive enlargement of psoas lymph nodes may be difficult to distinguish from metastasis to psoas muscle. In such cases, MR imaging would be of help to differentiate these two conditions.

Adult↗
PubMed1990

Regulation of the cytosolic free calcium concentration by Na+ spikes in immature cerebellar neurons with N-methyl-D-aspartate receptors.

N-Methyl-D-aspartate and glycine increased the cytosolic free calcium concentration ([Ca]in) in medium-sized cerebellar neurons. Spontaneous changes in [Ca]in were occasionally observed in NMDA-responsive cells, but large increases in [Ca]in were triggered only through depolarizations by adding veratridine or K+ channel blockers in every cell examined. The [Ca]in increase was suppressed by voltage-dependent Na+ and Ca2+ channel blockers and by an inhibitory transmitter (GABA), suggesting that the generation of Na+ spikes is involved in the increase in [Ca]in.

Action Potentials↗
PubMed1990

[Gastric cancer and obstructive uropathy].

In recent 5 years, we have experienced 24 cases of advanced gastric cancer associated with obstructive uropathy. Included were 19 cases of undifferentiated, 3 cases of differentiated and 2 cases of unknown histological type. Obstructive uropathy is diagnosed based on the typical radiological findings such as dilatation and delayed demonstration of the upper collecting systems. Pathologically, undifferentiated type of gastric cancer had tendency to spread infiltrating along the vessels, nerves and the lymphatics without alteration of the ordinary anatomical structures. In such cases, mucosal surface of the urinary tract tended to be spared in spite of extensive tumor invasion. It was proven that several radiological findings were characteristic of urinary tract involvement secondary to gastric cancer. Either thread-like ureteral stricture by IVU or ring-like appearance of the ureter by CT is one of those typical findings. Renal sinus involvement may occur continuously to diffuse retroperitoneal invasion and it appears as a thickened wall of renal pelvis or soft tissue mass directly extending into the fatty tissue of renal sinus by CT. In such cases IVU has less diagnostic ability because of the lack of mucosal destruction. If the urinary bladder is involved, it typically shows chestnut-bur appearance by IVU and diffuse wall thickening by CT. In cases of advanced gastric cancer, particularly in cases of histologically undifferentiated type, CT and IVU images should be carefully interpreted in consideration of the infiltrative art of tumor extension.

Adenocarcinoma↗
PubMed1990

[Radiation tolerance of partially irradiated liver in a multidisciplinary treatment for hepatoma].

Radiation tolerance of the partially irradiated liver was studied in eight patients with primary hepatoma treated by a multimodal approach. Seven patients were treated by transarterial embolization therapy (TAE) with Lipiodol-MMC, and two patients were treated by operation, combined with radiotherapy. Six patients had liver cirrhosis and the other one had renal dysfunction. Respiration-gated irradiation was employed to reduce a treatment volume for seven patients. Radiation portals were carefully tailored using the embolized Lipiodol or a metal clip inserted into the tumor as references. Two or three portals were used for each patient. The treatment volume ranged from 64 to 1400 cm3. The target dose ranged from 50.4 Gy to 81.0 Gy, from 73.5 to 108.6 in TDF. Liver function tests (GOT, GPT, LDH, ALP, ChE and total Bilirubin) were examined for 30 weeks after initiation of irradiation. Three patients showed abnormal value in more than 5 tests. Of these three patients, the hepatic hilum was included in the treatment volume in two, and the tumor progressed during the observation period in two. Leukopenia and thrombopenia were observed, but these values were not below 2000 and 40000/mm3, respectively, although the thrombocyte count before irradiation was below 100000/mm3 in 7 patients. AFP titers decreased after the treatment in six out of seven patients with abnormally elevated pretreatment titer. The survival period after staring irradiation was 6.5 to 25 months. "The volume dose" did not correlate well with the degree of the liver function aggravation.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗
PubMed1990

Pseudohypertension in the elderly.

Pseudohypertension is a condition in which indirect blood pressure measured by the cuff method overestimates the true intra-arterial blood pressure. Despite the clinical importance of pseudohypertension, reports regarding its prevalence are scarce. We compared direct measurements of brachial arterial blood pressure with those measured indirectly by the cuff method in 59 healthy volunteers aged greater than 65 years, with or without hypertension, in order to investigate the prevalence of pseudohypertension in the elderly. The average systolic blood pressure of 161.5 mmHg obtained by the indirect method was significantly lower than the 169.2 mmHg obtained by the direct method was not significantly different from the 76.9 mmHg obtained by the direct method. Only one volunteer was observed in whom the indirect cuff method overestimated the diastolic blood pressure by greater than 10 mmHg, which was defined as pseudohypertension. Thus, the prevalence of pseudohypertension was only 1.7%. The difference in systolic blood pressure between the two methods was 8.7 mmHg in Osler-positive cases and was not significantly different from the 6.9 mmHg observed in Osler-negative cases. Pulse wave velocity was significantly correlated with the systolic blood pressure (y = 11.4x + 66.1, r = 0.65, P less than 0.05). No correlation was observed between the pulse wave velocity and direct/indirect pressure differences for either systolic or diastolic measurements. These results show that the prevalence of pseudohypertension is very low in a non-selected elderly population and that Osler's maneuver was not related to the pressure difference between the direct and indirect methods.

Aged↗
PubMed1990

[A clinical study of hypertrophic obstructive cardiomyopathy in the elderly].

Seven elderly patients with hypertrophic obstructive cardiomyopathy (HOCM), who had the three following characteristics on echocardiograms 1) extremely thickened septum, 2) systolic anterior motion of the mitral valve, 3) mid systolic semi-closure of the aortic valve, were clinically evaluated. Ages ranged from 73 to 86 years old (average 78.9% yr.) and all were women. None had not a family history of hypertrophic cardiomyopathy but they had mild hypertension. Six patients showed a significant high voltage on the ST-segment and T-wave abnormalities ("strain" pattern). The left ventricular posterior wall as well as the septum was thickened in 5 and the remaining 2 showed asymmetrical septal hypertrophy (ASH) on echocardiograms. The left ventricular cavity was narrowed due to left ventricular hypertrophy and the shape of the left ventricular cavity was ovoid in all patients. The aorto-septal angles in these 7 patients were 80 degrees to 120 degrees. In addition, proximal septal bulge in all and anterior displacement of the mitral posterior leaflet due to the mitral ring calcification (MRC) in some patients contributed to the narrowing of the left ventricular outflow tract, and the mitral valve was pulled up toward the septum because of the good left ventricular systolic function (ejection fraction: 70 to 94% by echocardiography) and blood was ejected at a high velocity through a narrowed outflow tract (Venturi effect). Pressure gradients in the left ventricular outflow tract was 38 to 146 mmHg in 5 examined by cardiac catheterization. Biopsy specimens were obtained from 2 patients, showing hypertrophic myocytes (diameter: 20 to 30 micron) in 2 and mild disarray in 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Spatial fibre architecture of Mm. pectorales in macaques: their morphological, phylogenetical, and functional implications.

The pectoral muscles of the 2 monkeys, Macaca fuscata and M. fascicularis, were described particularly in the light of 3 dimensional fibre architecture. There existed throughout the muscles the rotation in the same direction and radiation of fibre bundles as well as the consecutive and multi-stratified structure; This architectural design suggested that the deep pectoral masses of the mammals were derived from the caudal portion of the primitive pectoral plane through fibre migration caused by the whole muscle rotation, probably in response to the functional necessity peculiar to the mammalian locomotion.

Animals↗
PubMed1990

[Development of coronary atherosclerosis in the elderly].

The role of aging, hypertension and plasma cholesterol in the development of coronary atherosclerosis was examined in 3569 consecutive autopsy cases, aged 60 to 99 years, at the Tokyo Metropolitan Geriatric Hospital. The prevalence of coronary atherosclerosis increased with aging. Both systolic and diastolic hypertension were related to the prevalence of coronary atherosclerosis. High plasma cholesterol (230 mg/dl) was related to increased prevalence of coronary atherosclerosis. This effect was observed in a hypertensive group, but not in a normotensive group. To define the effect of hypertension on vascular diseases, endothelial cells from spontaneously hypertensive rats (SHR) were obtained and characterized in terms of cellular response. Cellular Ca2+ level in response to A23187 was significantly enhanced in SHR compared to normotensive Wistar-Kyoto rats (WKY). Thus, aging, hypertension and high plasma cholesterol are risk factors for coronary artery atherosclerosis in the elderly.

Aged↗
PubMed1990

[Percutaneous gastrostomy].

Enteral feeding is the preferred method of nutritional management in malnourished patients with intact gastrointestinal function. Although the surgical gastrostomy is usually effective, its morbidity and mortality is still not negligible. Recently, alternative percutaneous method for placement of gastrostomy tube have been developed and several large series have been published in the English literatures. Since May 1986 we have performed percutaneous gastrostomy on over 30 patients and there were only one major morbidity but no procedure-related mortalities. The purpose of this paper is to describe our experience and to discuss its potential problems.

Gastrostomy↗
PubMed1989

[Pulmonary infarction associated with bronchogenic carcinoma].

Pulmonary infarction may be associated with bronchogenic carcinoma. Radiopathological correlation was performed in four patients. There were two cases of squamous cell carcinoma, one case of adenocarcinoma and one case of large cell carcinoma. Infarcts in patients with squamous cell carcinoma were obscured on plain radiographs by a large primary tumor or atelectasis of the affected lobe. Infarcts in adenocarcinoma and large cell carcinoma were clearly demonstrated on plain radiographs; 1 to 2 cm in size, round or polygonal in shape, blurred in margin, and located at the periphery of the same lobe as the primary tumor. Rapid appearance of infarcts was helpful in distinguishing from intrapulmonary metastasis. Invasion of the pulmonary artery, pulmonary vein and bronchial wall in hilar region was thought to be responsible for pulmonary infarction. Pulmonary infarct should be considered in patients with centrally invasive bronchogenic carcinoma, when a small ill-defined opacity appears at the periphery of the involved lobe over a short period.

Aged↗
PubMed1989

Highly sensitive enzyme immunoassay of human interferon-beta 1.

A highly sensitive sandwich enzyme immunoassay for human interferon-beta 1 (HuIFN-beta 1) was developed. HuIFN-beta 1-containing samples and horseradish peroxidase (HRP)-labeled mouse anti-HuIFN-beta 1 monoclonal antibody (Fab') were incubated overnight at 2-10 degrees C in the wells of a 96-well microtiter plate, onto which affinity-purified rabbit anti-HuIFN-beta 1 polyclonal antibody was coated. The EIA was able to detect 0.5 IU/ml of HuIFN-beta 1, thus showing higher sensitivity than bioassay. The values obtained by the EIA closely paralleled those obtained by bioassay in the concentration which bioassay can detect. In order to detect the concentration below 0.5 IU/ml of HuIFN-beta 1, the avidin/biotin-amplified EIA was also developed. The use of biotinylated mouse anti-HuIFN-beta 1 monoclonal antibody (F(ab')2) and HRP-avidin in the EIA made it possible to detect 0.1 IU/ml of HuIFN-beta 1. These EIAs were applied for the studies such as process control of HuIFN-beta 1 production, pharmacokinetics of HuIFN-beta 1, and determination of serum level of HuIFN-beta 1 in healthy subjects.

Antibodies, Monoclonal↗
PubMed1989

Double-blind studies of calcium antagonists in the treatment of hypertension in Japan.

Japanese studies of six calcium antagonists are reviewed, and the antihypertensive response to these drugs is analyzed in groups of young, middle-aged, and old subjects. The phase III clinical trials were performed in double-blind group studies that compared the calcium antagonist with a standard drug. In accordance with the guidelines for the clinical evaluation of antihypertensive agents, patients with a blood pressure level greater than or equal to 160/95 mm Hg after receiving a placebo for 4 weeks were enrolled in the study. The test drug was then administered for 12 weeks. A decrease in blood pressure by 20/10 mm Hg from the pretreatment level or a blood pressure level below 149/89 mm Hg was considered to indicate a response. The response rates for nicardipine, diltiazem, nifedipine tablets, long-acting nicardipine, nilvadipine, and nitrendipine were 64.6, 67.4, 68.6, 69.7, 70.7, and 65.9%, respectively. The average pretreatment blood pressure level was 170-175/100 mm Hg, and the average decrease in blood pressure was about 25/14 mm Hg. The reproducibility of the response rate of nicardipine used as a standard drug was shown in four different double-blind studies, where the response rate ranged from 65 to 72%. Side effects were observed in 8-18% of subjects, and the rate of side effects was also found to be reproducible in nicardipine studies. In severe hypertension unresponsive to diuretics and beta-blockers, response rates ranged from 79 to 93%. The antihypertensive response to calcium antagonists was not related to age, but correlated with the pretreatment blood pressure level. Therefore, calcium antagonists are effective and useful in treating mild, moderate, and severe hypertension in patients of all ages.

Calcium Channel Blockers↗
PubMed1989

Nonvalvular atrial fibrillation as a cause of fatal massive cerebral infarction in the elderly.

By studying 3,408 consecutive autopsied elderly patients, we found that two thirds of the 132 massive cerebral infarctions (86) were embolic, of cardiac origin. Embolic infarction associated with nonvalvular atrial fibrillation was seen in 48 cases (36%), half due to the first stroke. Embolic infarction associated with heart disease other than nonvalvular atrial fibrillation was seen in 23 cases (17%), and that from nonbacterial thrombotic endocarditis was seen in 15 cases (11%). Thrombotic infarction or infarction of nonembolic cardiac origin was found in only 39 cases (30%). Of 56 patients with fatal massive cerebral infarction who died less than or equal to 2 weeks after their stroke, 25 (45%) had embolic strokes associated with nonvalvular atrial fibrillation. Our study shows that nonvalvular atrial fibrillation is a very important cause of fatal massive cerebral infarction in the elderly.

Aged↗
PubMed1989

Calcium-activated neutral protease inhibitor (E-64c) and reperfusion for experimental myocardial infarction.

We examined the efficacy of the combination of coronary reperfusion and calcium-activated neutral protease (CANP) inhibitor (E-64c) for the treatment of acute myocardial infarction in dogs. In 34 dogs, the left anterior descending artery (LAD) was occluded and reperfused after 1 hour (Groups A and B). In the remaining 49 dogs, the LAD was ligated (Groups C and D). E-64c (100 mg/kg, Groups A and C) or vehicle (Groups B and D) was injected intravenously before and after the coronary occlusion or ligation. After 24 hours the hearts were removed. The proportion of the infarct size in the LAD perfusing area (risk zone) in Group A was 47.3 +/- 9.7%, significantly lower than in Group C (54.8 +/- 8.2%, p less than 0.05) or Group D (58.7 +/- 10.0%, p less than 0.01). There was a significant difference between Group B (52.9 +/- 8.6%) and Group D as well (p less than 0.05). The effects of reperfusion (p = 0.0016) and E-64c (p = 0.0226) per se on infarct size were significant, but the combination of reperfusion and E-64c was not additive. The decrease in CPK activity in the risk zone was significantly lower in the reperfused group (p = 0.0001). The mCANP activity was higher in the border zone and lower in the infarct zone. The trend in the mu CANP activity was similar to that of mCANP. Thus, treatment with a CANP inhibitor in the early phase of acute myocardial infarction may be marginally beneficial in combination with reperfusion.

Animals↗
PubMed1989

Isolated right ventricular infarction resulting from thrombotic occlusion of a hypoplastic right coronary artery.

Three cases of isolated right ventricular infarction resulting from thrombotic occlusion of a hypoplastic right coronary artery were found in 4,000 consecutive autopsies performed at Tokyo Metropolitan Geriatric Hospital. The incidence of isolated right ventricular infarction was 0.08%. The clinical profile of the first case was characterized by shock, pulmonary congestion, pleural effusion, decreased V1R and V2R on ECG, a small elevation of CPK and transaminase, elevation of fibrin degenerative products and decreased platelet count. The patient responded to volume expansion, heparin and catecholamines. One year later she died from cerebral bleeding. In the second case, mild aortic regurgitation and atrial fibrillation were present. He died suddenly during an episode of pneumonia. In the third case, there was chronic obstructive lung disease, atrial fibrillation and lung cancer. He died of respiratory failure. On autopsy, the coronary arteries revealed a marked left dominant and right hypoplastic pattern in all cases. The right coronary artery perfused only the free wall of the right ventricle. Complete occlusion of the hypoplastic right coronary artery resulted in isolated right ventricular infarction. In addition, chronic pulmonary disease and arrhythmia may be contributory.

Aged↗
PubMed1989

[Pharmacokinetics and pharmacodynamics of antihypertensive drugs in the elderly].

In order to study pharmacokinetics and pharmacodynamics of antihypertensive drugs in the elderly, plasma concentration and blood pressure response to 4 antihypertensive drugs with different modes of action (captopril, nifedipine retard tablet, bunazosin, arotinolol) were measured in young and elderly hypertensive patients without liver or renal dysfunction after oral administration of each drug. Systolic and diastolic blood pressure fell after 25 mg of captopril in both groups and the rate of decrease in each group was similar. Plasma concentration of captopril at 1 and 2 hours after administration in the elderly group tended to be higher than in the young group. Suppression of angiotensin-converting enzyme activity persisted longer in the elderly group than in the young group. The area under the curve (AUC) of captopril in the elderly group (335.4 +/- 98.6 hr.2ng/ml) was significantly greater than in the young group (186.7 +/- 79.9) (p less than 0.005), while no significant differences in Cmax, Tmax and T1/2 were observed. The percent decrease in systolic blood pressure in the elderly group (25.2 +/- 10.2%) after 1 hour of nifedipine tablet (20 mg) was significantly higher than in the young group (16.6 +/- 1.5%) (p less than 0.05). Cmax and AUC of nifedipine in the elderly tended to be higher than in the young group (303.5 v.s. 210.0 ng/ml and 1258.9 v.s. 725.1 hr.ng/ml, p less than 0.1, respectively). The percent decrease of diastolic blood pressure after 2 mg of bunazosin was also significantly higher in the elderly group than in the young group (p less than 0.05).2+ antihypertensive response after captopril and arotinolol in two groups.

Adult↗