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Biomedical subjects

K Otani

Publications and source records attributed to K Otani.

At least 145 records · Page 8Linked to original sources
PubMed1995

Inhibition of trazodone metabolism by thioridazine in humans.

To clarify the involvement of cytochrome P4502D6 (CYP2D6) in the metabolism of trazodone, the effects of coadministration of thioridazine, which is an inhibitor of this isozyme, on plasma concentrations of trazodone and its active metabolite m-chlorophenylpiperazine (m-CPP) were studied. The subjects were 11 depressed patients receiving trazodone at bedtime for 1-18 weeks. The dose was 150 mg in 10 patients and 300 mg in one. Thioridazine 40 mg/day was coadministered for 1 week, and blood samplings were performed before and after the coadministration. Thioridazine significantly (p < 0.001) increased plasma concentrations of both trazodone (713 +/- 252 vs. 969 +/- 370 ng/ml) and m-CPP (61 +/- 22 vs. 94 +/- 34 ng/ml). The present study thus suggests that CYP2D6 is involved in the metabolism of trazodone.

Adult↗
PubMed1995

Enantioselective determination of mianserin and its desmethyl metabolite in plasma during treatment of depressed Japanese patients.

A method for the analysis of the enantiomers of mianserin and its main metabolite desmethylmianserin in plasma using a chiral AGP high performance liquid chromatography column is described. In the majority of 66 depressed Japanese patients, the concentration of the more active S(+)-mianserin was higher than that of the R(-)-enantiomer. The mean S/R ratio was 1.9 +/- 0.9 (SD) (range 0.5-4.8). The concentration of S(+)-varied between 19 and 223 nM, while that of the R(-)-mianserin varied between 14 and 72 nM. Among 42 of the 66 plasma samples in which the enantiomers of desmethylmianserin could be measured, the R-form predominated in all but one. S-Desmethylmianserin was in most of the samples present in concentrations of < 10 nM (limit of detection). Analysis of the enantiomers of mianserin and desmethylmianserin might allow the establishment of a closer relationship between plasma levels and clinical effects.

Adult↗
PubMed1995

Bilateral painful epileptic seizures of the hands.

Secondary sensory seizures (SSS) are very rare epileptic seizures. A 14-year-old male patient with habitual painful seizures of the backs of both hands since the age of four is reported. The painful seizures were rarely followed by impairment of consciousness. Ictal EEG showed 4 to 6Hz rhythmic waves over the right anterior and mid-temporal area following complaints of pain. The absence of tumorous lesions on brain CT or MRI, childhood onset and the absence of combined seizures were characteristic features of this case compared with other patients reported to have SSS.

Brain↗
PubMed1995

High-performance liquid chromatographic determination of trazodone and 1-m-chlorophenylpiperazine with ultraviolet and electrochemical detector.

A high-performance liquid chromatographic (HPLC) assay was developed for the determination of trazodone and its metabolite, 1-m-chlorophenylpiperazine (m-CPP), in plasma. The high level of trazodone in plasma was detected by ultraviolet absorbance at 254 nm and the low level of m-CPP in plasma was detected by coulometric electrochemical detection at 840 mV on the series arrangement of two detectors. Pilsicainide as an internal standard for both compounds was monitored by both detectors. Trazodone and m-CPP in plasma were extracted by a rapid and simple procedure based on CN bonded-phase extraction, and C8 reversed-phase HPLC separation. Determination was possible for trazodone in the concentration range 100-2000 ng mL-1 and for m-CPP in the concentration range 5-100 ng mL-1. The recoveries of trazodone and m-CPP added to plasma were 81.0-84.2 and 68.0-73.2%, respectively, with coefficients of variation of less than 7.3 and 8.2%, respectively. The method is applicable to high level monitoring of trazodone and low level monitoring of m-CPP in plasma of healthy volunteers and patients treated with trazodone.

Chromatography, High Pressure Liquid↗
PubMed1995

[Minimally differentiated hypoplastic leukemia].

Sixty-seven years-old female, who was an atomic bomb survivor in Hiroshima, was pointed out as having leukopenia and anemia in 1991. She was referred to Tsukuba University Hospital in June 1992. Her peripheral blood count showed pancytopenia- 2,600/microliters WBC, 10.5 g/dl hemoglobin, and 80,000/microliters platelets- at that time. BM biopsy revealed hypoplastic marrow and increased peroxidase-negative blasts (32.8%). Surface marker analysis of the blasts showed a feature of CD2+ CD33+ CD34+ CD13+ CD3-. Electronmicroscopically, myeloperoxidase was positive. She was diagnosed as having hypoplastic leukemia of which the blasts had a feature of AML-M0 by FAB-group. After 6 months' silent period, her pancytopenia became profound. We successfully reduced the blasts by BAM therapy. However, she died of bacterial pneumonia during the myelosuppressive state. This is a case of minimally differentiated hypoplastic AML.

Aged↗
PubMed1995

[Anterior nerve roots enhancement on MRI in a case of Guillain-Barré syndrome].

A 4-year-old girl with Guillain-Barré syndrome (GBS) showed the abnormal enhancement on MRI in the anterior nerve roots corresponding to the region of her muscle weakness on the 26th day of illness. The enhancement on MRI almost disappeared on the 89th day of illness, when her symptoms had more improved. We think that enhanced spinal MRI is useful to reveal the involved nerve roots and the degree of the illness in GBS.

Child, Preschool↗
PubMed1995

[Acid phosphatase].

Explore the source record for details and available documents.

Acid Phosphatase↗
PubMed1994

A Japanese patient with the Costello syndrome.

The Costello syndrome is characterized by dwarfism, unique cutaneous lesions, distinct facial gestalt, and mental retardation. We present a Japanese patient with the Costello syndrome. She showed high serum IgM level during the early infantile period. Nissen's fundplication was carried out to treat severe gastroesophageal reflux. Endocrinological investigations revealed a partial deficiency of growth hormone.

Abnormalities, Multiple↗
PubMed1994

An evaluation of a new lactic acid polymer drug delivery system: a preliminary report.

A new drug delivery system, made of a mixture of DL-lactic acid polymer and a copoly (L-lactic acid/delta-valerolactone) polymer (LAP) containing varying concentrations of Ofloxacin, has been evaluated. Results revealed that a LAP drug delivery system containing 0.03% Ofloxacin inhibited the in vitro growth of clinically derived Staphylococcus aureus and Pseudomonas aeruginosa. Further, in an in vivo situation in rats, at 1 week after the wound was inflicted, no infection was macroscopically seen in split-thickness wounds that had been covered by LAP drug delivery system containing 0.5 or 0.03% Ofloxacin, and more than 80% of the wound area had epithelialised.

Animals↗
PubMed1994

Mechanisms of the development of trazodone withdrawal symptoms.

Three cases developed withdrawal symptoms of trazodone despite gradual discontinuation of therapeutic doses of the drug. This report suggests that effects of trazodone and its metabolite m-chlorophenylpiperazine on the serotonergic system, which may result in noradrenergic rebound after discontinuation, and short half-lives of these compounds are involved in the development of these symptoms. From a clinical point of view, we suggest that trazodone should be tapered off at a very slow rate.

Adult↗
PubMed1994

Correlation between prolactin response and therapeutic effects of zotepine in schizophrenic patients.

The correlation between prolactin response and therapeutic effects of zotepine, as assessed by the Brief Psychiatric Rating Scale, was studied in 24 schizophrenic patients (12 males, 12 females), after 4 weeks of treatment. The daily dose was 100 mg in the first week, and 200 mg for the next 3 weeks. There were significant (p < 0.05) positive correlations between changes in serum prolactin concentration and amelioration scores of positive or total symptoms in males only. Thus, prolactin response may reflect therapeutic effects of zotepine, at least in males.

Adolescent↗
PubMed1994

Adverse effects of zotepine and their relationship to serum concentrations of the drug and prolactin.

Adverse effects of zotepine, an antipsychotic drug, and their relationship to serum concentrations of the drug and prolactin were investigated in 28 schizophrenic in-patients. The daily dose was 100 mg during the first week and 200 mg during the next 3 weeks. Adverse effects were evaluated by the UKU Side Effect Rating Scale (21 items). The mean (+/- SD) total UKU score at the end of the study was 3.1 +/- 2.5, indicating mild adverse effects. The scores of psychic adverse effects at 2 weeks and total adverse effects at 3 and 4 weeks were significantly higher in nonresponders than in responders (p < 0.05). Furthermore, there was a significant inverse correlation between percent improvement in total Brief Psychiatric Rating Scale (BPRS) scores and total UKU scores at 4 weeks (p < 0.05). These results suggest a relationship between poor clinical response and increased adverse effects during zotepine treatment. Only the scores of akathisia at 2 weeks showed a significantly positive correlation with serum zotepine concentrations (p < 0.05). No correlation was found between prolactin response and neurological adverse effects.

Adolescent↗
PubMed1994

[Hypomelanosis of Ito associated with hemimegalencephaly].

A girl aged 1 year and 2 months with hypomelanosis of Ito was reported. She suffered from intractable epileptic seizures since the second day after birth. Characteristic bizarre hypopigmented skin lesions were seen on her left shoulder and extended in a linear fashion to the flexion side of the left upper extremity. Brain MRI revealed diffuse enlargement of the left hemisphere, dilatation of the left lateral ventricle, and neuronal migration anomalies, indicating hemimegalencephaly. The types of her seizures were secondarily generalized or unilateral initially, followed by infantile spasms at 1.5 month. Around 4 months of age, frequent partial seizures appeared. Her seizures were intractable despite vigorous anticonvulsant therapy. As patients with hypomelanosis of Ito are frequently associated with neurological abnormalities, brain MRI studies were thought to be essential in detecting central nervous system anomalies, particularly in the presence of early onset intractable seizures.

Brain↗
PubMed1994

[Surgical treatment of traumatic rupture of the bicuspid aortic valve: case report].

A 64-year-old female was admitted to our hospital with the complaints of chest oppression and dyspnea, 3 months after the traffic accident. She was operated on with the diagnosis of aortic regurgitation and bicuspid aortic valve. The tear of aortic valve was detected in the anterior cusp, and the size of the tear was 12 mm. The aortic valve replacement was performed and her postoperative course was uneventful. In the pathological study of the cusps, the tear was originated from trauma without inflammatory changes. This is the first report of traumatic rupture of the bicuspid aortic valve in Japan.

Aged↗
PubMed1993

Decreased blood coagulation activities in carbohydrate-deficient glycoprotein syndrome.

The carbohydrate-deficient glycoprotein (CDG) syndromes are a newly recognized group of inherited metabolic diseases. We report a Japanese brother and sister with a CDG syndrome. Both patients showed decreased activities of blood coagulation Factor XI and of the coagulation inhibitor protein C. In one of them there was also a somewhat decreased activity of Factor IX and of antithrombin III. Isoelectric focusing of antithrombin III revealed a decrease of negatively charged fractions and an increase of more cathodal bands. Furthermore, there was a discrepancy between activity and antigen level of Factor VIII and protein C. The patients had an incidental deficiency of factor XII. This is the first detailed report on blood coagulation systems in the CDG syndromes. These blood coagulation abnormalities may explain at least in part the thrombotic or haemorrhagic complications of the CDG syndromes.

Antithrombin III↗
PubMed1993

Steady-state plasma concentrations of mianserin and its major active metabolite, desmethylmianserin.

The steady-state plasma concentrations of mianserin and its major active metabolite, desmethylmianserin, were measured in 76 depressed patients receiving 30 mg of mianserin at bedtime. There were considerable inter-individual variations in the steady-state plasma concentrations of these compounds; the plasma concentrations of mianserin plus desmethylmianserin were within the therapeutic range suggested previously by us in only 43% of the patients. With advancing age, the plasma concentrations of mianserin increased significantly, while those of mianserin plus desmethylmianserin remained unchanged. Sex, smoking, and coadministration of benzodiazepines did not affect the drug's metabolism. There was no evidence that the kinetics of these compounds were nonlinear with increasing doses. The present study thus suggests that measuring the plasma concentrations of mianserin and desmethylmianserin contributes to rational treatment with this drug, that age, sex, smoking, and coadministration of benzodiazepines are not important factors in determining the dose, and that these compounds have linear kinetics.

Adult↗
PubMed1993

Prediction of plasma concentrations of mianserin and desmethylmianserin at steady state from those after an initial dose of mianserin.

The relationships between the plasma concentrations of mianserin and desmethylmianserin at 18 h after initial dosing and those at steady state were studied in 19 depressed patients receiving 30 mg of mianserin at bedtime. Significant linear relationships were observed for mianserin, desmethylmianserin, and mianserin plus desmethylmianserin. The present study thus suggests that the plasma concentrations of these compounds after an initial dose of mianserin can be used for the prediction of an optimal dose.

Adult↗