Search PubMed⌕ Search

Biomedical subjects

K Nishimura

Publications and source records attributed to K Nishimura.

At least 505 records · Page 28Linked to original sources
PubMed1995

Bronchodilating effects of combined therapy with clinical dosages of ipratropium bromide and salbutamol for stable COPD: comparison with ipratropium bromide alone.

Several studies have suggested that anticholinergics are at least equal to or may be superior to beta agonists in the treatment of stable COPD. However, since most previous studies have been performed to evaluate the bronchodilating effects of these two agents at relatively high doses, the clinical value of combining these two agents still is under debate. The purpose of this study was to determine if combination therapy with ipratropium bromide and salbutamol, in clinically available dosages, is superior in bronchodilation to ipratropium bromide alone. Twenty-six male patients (mean age, 67.5 +/- 5.9 years; FEV1, 0.87 +/- 0.32 L) with stable COPD were studied in randomized, double-blind, placebo-controlled experiments. On five separate days, all the patients received one of the following: (1) 40 micrograms ipratropium bromide, (2) 80 micrograms ipratropium bromide, (3) 40 micrograms ipratropium bromide plus 200 micrograms salbutamol, (4) 80 micrograms ipratropium bromide plus 400 micrograms salbutamol, or (5) placebo, using metered-dose inhalers (MDIs). Spirometry was assessed before and 15, 30, 60, 90, and 120 min after inhalation. Positive FEV1 responses to combined dosages of 80 micrograms ipratropium bromide and 400 micrograms salbutamol were significantly greater than responses to any other treatment regimen. Significantly greater responses also were achieved by combining 200 micrograms salbutamol with 40 micrograms ipratropium bromide compared with 40 micrograms ipratropium bromide alone. Combination therapy with 200 micrograms salbutamol and 40 micrograms ipratropium bromide produced a significantly greater effect on forced vital capacity than therapy with 80 micrograms ipratropium bromide alone. No significant differences were found between the responses induced by therapy with 80 and 40 micrograms ipratropium bromide. No adverse reactions to any regimen were noted throughout the study. In conclusion, combining the standard dosages of ipratropium bromide and salbutamol may provide greater bronchodilation than doubling the standard dosage of ipratropium bromide in patients with COPD.

Aged↗
PubMed1995

The additive effect of theophylline on a high-dose combination of inhaled salbutamol and ipratropium bromide in stable COPD.

STUDY OBJECTIVE: To determine the additive effect of oral theophylline in patients with stable COPD who received both inhaled salbutamol, 400 micrograms, and ipratropium bromide, 80 micrograms, four times daily administered with a metered-dose inhaler. DESIGN: Twenty-four male patients with stable COPD (FEV1, 0.96 +/- 0.43 L; 36.8 +/- 17.0 percent predicted [% pred]) completed a randomized, double-blind, placebo-controlled crossover trial with oral theophylline for 4 weeks. MEASUREMENTS AND RESULTS: The average serum theophylline level was 15.0 +/- 5.5 micrograms/mL during treatment. On the whole, without inhalation of bronchodilators, FEV1 was 0.93 +/- 0.42 L during the placebo period and 1.00 +/- 0.43 L (significantly different from placebo; p < 0.01) during the theophylline period. At 15 and 60 min after inhalation of salbutamol, 400 micrograms, and ipratropium, 80 micrograms, the FEV1 with placebo was 1.12 +/- 0.43 L and 1.14 +/- 0.46 L, respectively, and the FEV1 with theophylline was 1.18 +/- 0.45 L (p < 0.01) and 1.20 +/- 0.47 L (p < 0.01), respectively. Daily peak expiratory flow rate also improved. Daily symptom scores were not significantly different between theophylline and placebo periods. Nevertheless, eight patients reported a subjective benefit during the theophylline administration period, and they were thus considered subjective responders. While FEV1 after inhalation was significantly improved during the theophylline periods in subjective responders (change in FEV1 between theophylline and placebo treatment 15 min after inhalation, 3.1 %pred; 60 min, 3.5 %pred), postbronchodilator FEV1 was not significantly different between the placebo and theophylline periods in subjective nonresponders (15 min, 1.7 %pred; 60 min, 1.6 %pred). CONCLUSIONS: On the whole, theophylline has a small bronchodilating effect but does not improve the symptoms of patients with stable COPD. However, one third of patients with COPD may respond subjectively to theophylline. The additive bronchodilating effect of theophylline may be related to the symptomatic improvement in subjective responders.

Administration, Inhalation↗
PubMed1995

Effects of macrophage colony-stimulating factor on folliculogenesis in gonadotrophin-primed immature rats.

The effect of macrophage colony-stimulating factor (M-CSF) on folliculogenesis and ovulation was studied. Folliculogenesis and ovulation were induced in immature female rats with a s.c. injection of equine chorionic gonadotrophin (eCG), followed 48 h later by human chorionic gonadotrophin (hCG). The ovulation rate was measured after the following treatments. (1) Graded doses of human M-CSF (1-300 x 10(3) iu per rat) were administered i.p. daily for 3 consecutive days. (2) M-CSF (100 x 10(3) iu) was administered i.p. at designated times between 96 h before and 10 h after hCG injection. (3) Rabbit anti-human M-CSF polyclonal antibody (5 micrograms) was administered into the left ovarian bursa at designated times between 49 h before and 10 h after hCG injection. In addition, the effect of M-CSF on ovarian macrophages was investigated using immunohistochemistry with mouse anti-rat macrophage monoclonal antibody, TRPM-3. The treatment with M-CSF (> 30 x 10(3) iu per rat) significantly increased the ovulation compared with controls in a dose-dependent manner. This stimulatory effect of M-CSF was observed when it was administered between 96 h and 49 h before hCG injection. The ovarian intrabursal administration of anti-M-CSF antibody significantly inhibited the number of ovulated ova from the treated ovaries compared with either those from control rats or from the contralateral untreated ovaries between 24 h before and 3 h after hCG injection. The immunohistochemistry revealed that M-CSF increased the number of ovarian macrophages in growing follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Effect of breed type and sex on the fatty acid composition of subcutaneous and intramuscular lipids of finishing steers and heifers.

Effects of breed type and sex on the fatty acid composition of subcutaneous neutral lipid and intramuscular neutral and phospholipids of longissimus lumborum muscle were investigated using 145 steers and 82 heifers that consisted of pure Japanese Black and Holstein and crossbreds among Japanese Black, Holstein, Japanese Brown, and Charolais. Steers and heifers were reared on a high plane of nutrition and were fed the same concentrate diet and rice straw. All animals were slaughtered serially and carcass composition was determined by dissection of the left side of the carcass. Breed type and sex differences of fatty acid percentages of carcass lipids were compared by adjusting the percentages to mean carcass fat percentages. Heifers had higher contents of 18:1 and total monounsaturated fatty acids in subcutaneous and intramuscular neutral lipids than steers (P < .05). The fatty acid composition of intramuscular phospholipids differed between sexes for 16:0, 20:1, and 20:5, but the differences were small. Breed differences were significant (P < .05) in steers for 16:0, 16:1, 18:1, and total saturated and monounsaturated fatty acids in both subcutaneous and intramuscular neutral lipids, and iso-16:0, 16:0, and total saturated fatty acids in phospholipids, respectively. However, in heifers, fewer fatty acids differed (P < .05) among breed types in the neutral lipids. It is suggested that the Japanese Black has a genetic predisposition for producing carcass lipids containing higher concentrations of monounsaturated fatty acids than Holstein, Japanese Brown, or Charolais.

Animals↗
PubMed1995

[Value of PSA/gamma-Sm ratio (P/S ratio) for diagnosis of prostate cancer in patients with urinary retention].

It is known that serum prostate specific antigen (PSA) in urinary retention due to benign prostatic hypertrophy (BPH) increase. To evaluate prognostic value of the ratio of serum PSA to gamma-seminoprotein (P/S Ratio) for prostate cancer (PC) in patients with urinary retention, we have studied the P/S Ratio at the initial examination in 33 patients with untreated PC (10 with and 23 without urinary retention) and 193 patients with untreated BPH (38 with and 155 without urinary retention) histopathologically diagnosed at our hospital between January, 1992 and December, 1993. The results were as follows: 1) The mean P/S ratio of PC patients was significantly higher than that of BPH patients in both groups with and without urinary retention. 2) When the cut off value of P/S Ratio was determined to be 1.35, the highest efficiency, 59.3% was obtained in the group without urinary retention. The sensitivity and specificity were 65.2% and 91.0%. 3) In the group with urinary retention, the efficiency was also the highest, 80.0% with a cut off value of 1.35. The sensitivity and specificity were 80.0% and 100%. 4) In all patients, the efficiency was 64.6%, the sensitivity was 69.7%, and the specificity was 92.7% with a cut off value of 1.35. 5) Positive rate of serum PSA in BPH patients with urinary retention was 47.4% and that in BPH patients without urinary retention was 17.4%. The mean P/S ratio of the BPH patients with urinary retention was significantly lower than that of BPH patients without urinary retention, which suggested that the serum free PSA increase in the former.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

[Dosimetry using the right angle firing neodymium: YAG laser fiber for treating canine prostate].

For assessment of the dosimetric and optimal efficacy of Visual Laser Ablation of the Prostate (VLAP), depth, surface area and volume of thermal penetration of the prostate were determined in 14 adult canines. All prostates were irradiated using the right angle laser fiber (Urolase, Bard, USA) with neodymlum (Nd): YAG laser application. In Group 1 animals, treatment was conducted at 40 watts for 60 seconds (2400 jules) and in Group 2, at 60 watts for 60 seconds (3600 jules). Each prostate was dissected out and examined macro and microscopically at 3 days and 1, 2, 4, 8 and 12 weeks after surgery. Mean depth of prostatic penetration, surface area and volume of prostatic tissue ablation in each treatment were 4.75 +/- 1.25 mm, 4.13 +/- 1.13 cm2, 3.39 +/- 1.58 cm3 in Group 1 and 5.75 +/- 1.25 mm, 4.80 +/- 1.95 cm2, 4.36 +/- 1.99 cm3 in Group 2, respectively. Histologically, coagulation necrosis and chronic inflammatory changes of the prostatic stroma became evident in 1 to 4 weeks, and reepithelization in the cavity could be observed at 8 to 12 weeks following the treatment. From these result, it would appear that photoirradiation of canine prostate by the right angle laser fiber brings about cavity formation and that more effective dosimetry with maximum penetration in the canine prostate is possible at 60 watts for 60 seconds of pulse duration. Based on these findings, Nd:YAG laser therapy should find a broader scope of clinical application in the management of benign prostatic hyperplasia.

Animals↗
PubMed1995

[Primary pulmonary alveolar proteinosis--clinical observation of 68 patients in Japan].

The clinical features of 68 Japanese patients (53 men and 15 women; mean age 44 years) with primary pulmonary alveolar proteinosis were reviewed. Pulmonary alveolar proteinosis was diagnosed from histologic findings after open lung biopsy (n = 7) or transbronchial lung biopsy (n = 61). Major symptoms were a dry cough (24.2%) and dyspnea or shortness of breath on exertion (51.5%), but one third of the patients were asymptomatic. Crackles were audible in 30% of the patients, but clubbing (6%) and cyanosis (4%) were rare. Ten patients had been occupationally exposed to dust. Slightly less than half (46%) of the patients first presented with symptoms, and the remainder (54%) first presented with abnormal pulmonary infiltrates seen on chest roentgenograms taken during general health examinations. Many patients had abnormally high levels of LDH and CEA in serum (62% and 63%, respectively). Restrictive pulmonary dysfunction (%VC < 80%) was seen in 31% of the patients, an abnormally low DLco (%DLco < 70%) was seen in 62%,m and hypoxemia (PaO2 < 80 mmHg) was seen in 67%. Arterial blood gas tension was closely correlated with the severity of disease in these patients. Chest roentgenograms usually showed bilateral symmetric alveolar infiltrates, mainly distributed from hilar areas toward the pleura, but on CT scans many of the shadows were mixed with alveolar and interstitial infiltrates of various extent along the pulmonary arteries and bronchi. There was no apparent relation between chest roentgenographic findings and chest CT findings in these patients. Neither the extension nor other characteristics of shadows in the chest roentgenograms and chest CT scans were closely related to symptoms, laboratory data, or pulmonary function in these patients. Symptoms were alleviated and chest roentgenographic findings improved in 82% of the 51 patients who underwent therapeutic bronchoalveolar lavage, and in 94% of the 17 patients who did not undergo that procedure. In patients who underwent therapeutic bronchoalveolar lavage and also in those who recovered spontaneously, both diffusing capacity and blood gas values improved significantly. When compared to the patients who did not undergo therapeutic bronchoalveolar lavage, significantly more of those who did undergo that procedure has initial PaO2 values below 60 mmHg, and fewer of them had values greater than 80 mmHg. Thus, a PaO2 below 60 mmHg may be an indication for therapeutic bronchoalveolar lavage in patients with this disease. During the follow-up period (mean 5 years, range 2 months to 23 years), four patients had pneumothorax and none died of pulmonary alveolar proteinosis.

Adult↗
PubMed1995

[Surgical treatment of congenital aortic stenosis by aortoseptal approach].

Between 1975 and 1994, six patients under 15 years old with congenital aortic stenosis underwent relief of left ventricular outflow tract obstruction (LVOTO) by aortoseptal approach. Although we got satisfactory relief of LVOTO in all patients, there were two late deaths. In one patient with residual ventricular septal defect (VSD), intractable ventricular arrhythmia developed 12 years postoperatively. Although the residual VSD closure was performed, the patient died of the arrhythmia. The another one who was the youngest 4-year-old boy suddenly died 4 months postoperatively. The detail about his death was unknown, but we presumed ischemic heart attack as the cause of his death. In 3 of remaining survived 4 patients, we encountered a few complications. They were right ventricular outflow obstruction, coronary artery injury and conduction system injury. All complications and problems we encountered in this series were related to the incision and the reconstruction of aortoseptal approach. In conclusion, the aortoseptal approach is effective technique for relief of LVOTO, but on the other hand it is invasive and not so safe operation. So we should be cautious about these complications and problems.

Adolescent↗
PubMed1995

[High flow priapism following a straddle-injury-induced arteriocavernosal fistula: a case report].

A 26-year-old man with high flow priapism after blunt perineal trauma, is described herein. Patient evaluation included intracavernal blood-gasometry, cavernography, color flow Doppler sonography. The blood-gasometry showed pH 7.413, pO2 77.9 mmHg, pCO2 41.0 mmHg, HCO2- 26.1 mmol/L, BE 2.0 mmol/L. By direct cavernosography, pooling of contrast agent was seen at the root of the penis. Color flow Doppler sonography revealed pulsatile, turbulent flow within left corpus cavernosum. Our case was diagnosed as high flow priapism from these findings. Detumescence was not achieved by an alpha-adrenergic agent. Superselective embolization of the deep artery of the penis with autologous blood clot was performed with good results. Our case demonstrates that this procedure is a safe and effective therapy for high flow priapism and that erectile function can return to normal.

Adult↗
PubMed1995

Antihypertensive properties of a new long-acting angiotensin converting enzyme inhibitor in renin-dependent and independent hypertensive models.

The antihypertensive properties of a new long-acting, angiotensin-I-converting enzyme (ACE) inhibiting agent, (2S,3aS,7aS)-1-(N2-nicotinoyl-L-lysyl-gamma-D-glutamyl) octahydro-1H-indole-2-carboxylic acid (CAS 116662-73-8, DU-1777), were investigated orally in various experimental models of hypertension in comparison to a standard ACE inhibitor, lisinopril. The hypotensive potency of DU-1777 was not as marked as that of lisinopril in renin-dependent hypertensive models, i.e., two-kidney one-clip renal hypertensive rats (2K-1C RHR) (ED-20mmHg: 3.1 versus 1.0 mg/kg) or two-kidney two-clip renal hypertensive dogs (2K-2C RHD) (ED-20 mmHg: 2.5 versus 1.0 mg/kg), though the actions of the two drugs were both long-lasting and dose-related. When spontaneously hypertensive rats (SHR) were used, however, DU-1777 was as active as lisinopril (ED-20 mmHg: 17.9 versus 13.6 mg/kg). The most distinguishing results with DU-1777 were its hypotensive effects in renin-independent hypertensive models. In contrast to lisinopril, the drug produced a sustained and dose-related hypotensive effect in DOCA salt hypertensive rats (DOCA-HR) and one-kidney one-clip renal hypertensive rats (1K-1C RHR). There exists an inconsistency between the long duration of the agent's hypotensive action in all tested hypertensive models and its short duration of ACE inhibiting activity as demonstrated both in vivo and ex vivo. The sustained antihypertensive action of DU-1777 cannot be reasoned solely with respect to ACE inhibition, suggesting some additional mechanisms of action yet to be defined.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1995

[Effect of one year of treatment with inhaled beclomethasone dipropionate on airway hyperresponsiveness in stable chronic asthma].

To study the effects of an inhaled steroid on airway hyperresponsiveness (AHR) in chronic stable asthma, AHR was measured every month for 1 year in seven patients after their asthma had stabilized, i.e., when they had no wheezing or dyspnea, and their peak expiratory flow rates (PEFR) were at least 80 percent of the highest value. During the study period, no patient wheezed or had dyspnea, and daily variation in PEFR was less than 20 percent. In six patients, FEV1 was stable, and PEFR was always at least 80 percent of the highest value. AHR became less severe, by a factor of at least 2, in five of these six patients, but one patient's condition did not improve. The one patient whose PEFR fell below 80 percent of the highest value had more than a 4-fold increase in the severity of AHR. In conclusion, the severity of AHR can be reduced, even in patients with chronic stable asthma, if daily PEFR can be maintained in an optimal range by long-term use of inhaled corticosteroids.

Administration, Inhalation↗
PubMed1995

Effects of cementum-impregnated gelatine membrane on early healing following periodontal flap surgery.

The purpose of this study was to investigate the initial healing response of surgically flapped periodontal tissues in the presence of gelatine membrane compounded with particles of cementum. Four monkeys with no periodontal disease were used in this experiment. Full thickness flaps were raised and recession type defects were created on the buccal side of the maxillary lateral incisors and second premolars. Exposed root surfaces were thoroughly curetted, and composite cementum-impregnated membranes placed directly onto planed root surfaces. Flaps were then sutured back to the original position. Animals were sacrificed at 2, 4, 7 and 10 post-surgical days, and block specimens including the tooth, gingiva and bone were subsequently processed for light and electron microscopy. The resultant analysis revealed that gelatine membranes were partially resorbed at 2 days post-surgery and completely resorbed by 10 postoperative days. In the early stages of gelatine resorption, most liberated cementum particles accumulated on planed dentin surface but some became demineralized within the surgical wound. Cementoblast-like cells with well-developed rough endoplasmic reticulum appeared on the root surface 7 days following surgery. Newly synthesized collagen fibrils aligned parallel to the root surface were seen at 10 post-surgical days. The results suggest that the newly developed composite membrane enhances the formation of new periodontal attachment.

Animals↗
PubMed1995

[A case of bilateral testicular metastases from carcinoma of the stomach].

A case of bilateral testicular metastases from carcinoma of the stomach is reported. A 39-year-old man was admitted to our hospital under the diagnosis of carcinoma of the stomach. During the hospitalization, the bilateral scrotal contents had become swollen and painful, but we could not resect this lesion because of his critical condition. Then he died of carcinoma of the stomach. The autopsy revealed that he had bilateral testicular metastases from carcinoma of the stomach. Including our case, 10 cases of testicular metastases from carcinoma of the stomach are reported in the Japanese literature. We mainly discuss the route of metastasis.

Adenocarcinoma↗
PubMed1995

[Immunological study of the postoperative adjuvant treatment with interferon gamma in patients with renal cell cancer--measurement of peripheral blood lymphocyte subsets with three color flow cytometry].

The antitumoral effects of interferon (IFN) against renal cell carcinomas (RCC) are considered to consist of a direct tumoricidal activity and an indirect action related to the host immune system. Monitoring to T lymphocytes is an immunological parameter to evaluate the antitumoral effects of IFN. To examine in detail the change of CD8 positive cells reported previously, we analyzed the change of the peripheral blood T lymphocyte subsets using three color flowcytometry during the period of IFN-gamma administration. We administered recombinant interferon gamma (rIFN-gamma) to the patients with renal cell cancer. Eighteen patients received a prophylactic injection of rIFN-gamma (300 x 10(4) units per week) after nephrectomy. Among them three patients developed distant metastases and one had local recurrence after the start of rIF-gamma therapy. We evaluated the immunological change by measurement of the peripheral blood lymphocyte subsets consisting of activated cytotoxic T lymphocytes (ACTL), activated suppressor T lymphocytes (ASTL), activated suppressor-inducer T lymphocytes (AITL), cytotoxic T lymphocytes (CTL), helper T lymphocytes (HTL), and suppressor-inducer T lymphocytes (SITL), from the start of rIFN-gamma injection. We also estimated the natural killer (NK) activity by a cytolytic test at the same points. NK activity consecutively increased throughout the period of administration of rIFN-gamma. We found significant enhancement of ACTL at the sixth month (P < 0.05), ASTL at the third month (P < 0.01) and NK activity at the second week, the first month, the third month and the sixth month (P < 0.01) after the start of rIFN-gamma injection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Xanthoma of the bladder.

We report a case of xanthoma of the bladder incidentally discovered during transurethral ureteral lithotripsy for a right ureteral stone and histopathologically diagnosed by cold cup biopsy. Xanthoma, a disorder of the lipid metabolism without tumorous or inflammatory changes, is rare in the bladder with only 7 cases reported previously. Interestingly, 5 of these 7 cases were reported in the Japanese literature, as were cases of xanthogranulomatous cystitis. We have no explanation for this occurrence. Xanthoma, caused by macrophages with the ability to phagocytose, is a benign lesion. It is necessary to continue careful followup by cystoscopy to determine if xanthoma increases or decreases in size.

Humans↗
PubMed1995

[Efficacy of high-dose beclomethasone in patients with stable chronic obstructive pulmonary disease].

To study the role of inhaled steroids in treating patients with chronic obstructive pulmonary disease (COPD), 1.6 mg of beclomethasone dipropionate (BDP) were given for 2 weeks after 0.5 mg/kg of oral prednisolone (PSL) for 2 weeks to 43 patients with COPD (mean age 68.7 +/- 5.2 years, mean baseline FEV1, 1.13 +/- 0.44 L). When responders to a corticosteroid (PSL or BDP) were defined as those with a post-steroid EFV1/baseline FEV1 > or = 115% and a post-steroid FEV1-baseline FEV1 > or = 0.2 L, 12 out of 43 patients responded to 30 mg of PSL for 2 weeks and 13 responded to 1.6 mg of BDP for 2 weeks. We considered those 17 patients who responded to 2 weeks of PSL or 2 weeks of BDP or both, to be possible steroid responders, and they continued inhaling BDP for 4 more weeks. In 8 of these 17 patients (19%), FEV1 had increased by the end of the 6 weeks. Inhaled BDP was considered useful in treating some patients with COPD.

Administration, Inhalation↗