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Biomedical subjects

K Murakami

Publications and source records attributed to K Murakami.

At least 1,045 records · Page 58Linked to original sources
PubMed1986

Cortisol responsiveness to insulin-induced hypoglycemia in Cushing's syndrome with huge nodular adrenocortical hyperplasia.

A 51-yr-old male patient with a 3 yr history of Cushing's syndrome is described. The baseline plasma cortisol level was elevated, while the plasma ACTH levels remained at an undetectable level. Dynamic testing of pituitary-adrenal function revealed no suppression after 8 mg of dexamethasone, and there was no response to metyrapone or CRF, while plasma cortisol showed a hyperresponse to synthetic ACTH. Plasma cortisol responded to insulin-induced hypoglycemia without an obvious ACTH response. These and the computerized tomography data suggested a "huge" bilateral nodular adrenocortical hyperplasia which was later confirmed by surgery. The left and right adrenal glands weighed 55 and 76 g, respectively. In vitro experiments, using the adrenal tissue, showed that there was an adrenal cortisol response to 1-39 ACTH but not to regular insulin, arginine vasopressin, angiotensin II, norepinephrine or epinephrine. These results indicate that plasma cortisol responded to a slight hypoglycemia-induced plasma ACTH change which was not detected in the ACTH radioimmunoassay or to factors other than ACTH which might be induced by hypoglycemia.

Adrenal Cortex↗
PubMed1986

[A false aneurysm caused by rupture of a double velour Dacron graft. A case report].

A 71-year-old man was operated for a complete occlusion of the left common iliac artery caused by arteriosclerosis obliterans. Cross-over bypass was performed from the right external iliac artery to the left superficial femoral artery in June 1978, using a Double Velour Dacron graft (Cooley) 8 mm in diameter. In February 1985, the patient noticed the pulsatile mass in his left groin. Angiography showed a false aneurysm at the distal anastomosis of the graft. On operation, 2 aneurysmal dilatations were found on the distal anastomosis. After resection of the aneurysms, the reconstruction was established by EPTFE graft successfully. The resected specimen showed that one of the aneurysms was caused by the anastomotic failure of the distal portion of the graft, but that the other was the false aneurysm caused by rupture of the implanted graft. Two ruptured holes were confirmed to be 20 X 25 mm, 10 X 15 mm in size respectively, 10 mm proximal to the anastomotic aneurysm. Rupture of the Dacron arterial prosthesis is a rare complication. Only 23 cases have been reported in the United States. But some literatures show that the incidence of the failure of the Dacron prosthesis was about 3%. Therefore, we should make a long-term follow-up to the patients implanted Dacron arterial prostheses.

Aged↗
PubMed1986

[The protocol of informing cancer patients of their condition].

The seven points we must consider in informing cancer patients of their condition are as follows: It is necessary that informing the patient has one or more of the following purposes: Patients have a right to know the truth. Any patient who desires to know the nature of his own disease has a right to be told. To avoid legal action. In cases where information is uncertain, which may cause difficulty for the patient. To avoid the burden of fabricating an untrue explanation. To help the patient bear radical treatment such as surgery, radiation and/or chemotherapy. To allow the patient to put an end to his/her life's work or finalize problems of property. To help the patient see the need to change his/her way of life. Are the conditions sufficient or not? Almost all these conditions must be clear. Is there any constructive purpose in informing the patient? Does the patient have a rational and receptive character? Is the patient in a mentally stable condition? Is these personal experience of death in the patient's family. Does the patient have a sure faith, thoughts and/or views of life and death? Is there enough cooperative work among the medical team? Is there enough cooperative work among the patient's family? Who tells the truth to the patient? Is there a need to inform the patient in stages? At what stage of the disease is the patient told? Where is the patient told? Comprehensive care must be given after informing the patient of his/her condition.

Aftercare↗
PubMed1986

Effect of temperature on the kinetics of the yeast AMP deaminase.

The temperature dependence of the kinetics of the yeast AMP deaminase was examined using the purified enzyme and the permeabilized yeast cells. The increase in the enzyme affinity for the substrate AMP was accompanied by the decrease in the maximal velocity with the decreasing temperature in the absence and presence of ATP. The apparent Km for AMP was lowest at 15-20 degrees C, and the affinity was decreased below and above this temperature. The rate of the AMP deaminase reaction remained constant over a wide range of temperature in the presence of physiological AMP concentrations. The temperature dependent change in kinetic properties of AMP deaminase may contribute to the control of the yeast glycolytic flux under the condition of lower temperature environments.

AMP Deaminase↗
PubMed1986

[Augmentation by serrapeptase of tissue permeation by cefotiam].

Cefotiam (CTM) is a new cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative microorganisms. Cephalosporins are widely used for prophylaxis of infections in patients undergoing thoracotomy. Augmentation by serrapeptase on tissue permeation of CTM was examined in 35 thoracotomy patients with lung cancer. The subjects were divided into two groups according to the method of the administration of CTM. Group I consisted of 17 subjects, each of whom received a single dose of 2 g of CTM alone by an instillation for 30 minutes. Group II consisted of 18 subjects, each of whom received a combination of CTM and serrapeptase; serrapeptase was given 2 tablets (10 mg) each time for three times/day until the day before surgery, and then CTM was administered by the same procedure. The following results were obtained: Individual difference was observed for the permeation of CTM into tissues. Pathologic differences also affected the permeation. Nevertheless, the CTM levels in pulmonary tissues reached about a half of those in the blood in both the single dose group and the combination group, hence sufficient concentrations exceeding MIC80 for main microorganisms that caused infections in the lung were obtained. The concentrations of CTM in inflammatory tissues have showed lower levels than those of normal tissues in both CTM single dose and the combination groups. Decrease of blood flow volume may have contributed to the reduction in levels of CTM in the inflammatory tissues. The ratio of the concentration of the drug in pulmonary tissues to that in the blood was 29.1 +/- 2.5% in the single dose group, and 44.2 +/- 6.0% in the combination group, the latter showing quite a significant increase (P less than 0.05). Combined administrations of CTM and serrapeptase deserves more trials in the case when surgical treatments of the lung are performed. An antiinflammatory effect of serrapeptase in the respiratory system is expected, and in addition, the combined use of CTM and serrapeptase should stimulate permeation of the antibiotic into tissues.

Adult↗