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Biomedical subjects

K Shimada

Publications and source records attributed to K Shimada.

At least 649 records · Page 36Linked to original sources
PubMed1996

Guide wire-induced coronary artery spasm during percutaneous transluminal coronary angioplasty. A case report.

Coronary artery spasm induced by a guide wire is a very rare complication of percutaneous transluminal coronary angioplasty (PTCA). The authors describe a patient who developed coronary vasoconstriction distal to the dilated lesion during PTCA, which was refractory to intracoronary nitroglycerin and intravenous calcium antagonist injection and balloon angioplasty but responded promptly and completely to withdrawal of the guide wire from the coronary artery, suggesting that the spasm had been induced by the guide wire.

Aged↗
PubMed1996

Demonstration of the nasal septal branches of the sphenopalatine artery by use of a new intravascular injection method.

We injected a new injection material into the external carotid artery using a new method, which led to the successful demonstration of the nasal septal branches of the sphenopalatine artery in human cadavers. The result shows the trunk of the artery divided into three main branches, the upper two of which run toward Little's area. We believe that the knowledge of septal branches, shown in a photograph, is very useful, not only for nasal treatment, but also for anatomic demonstration to students.

Aged↗
PubMed1996

Metallopeptidase inhibitors induce an up-regulation of endothelin-converting enzyme levels and its redistribution from the plasma membrane to an intracellular compartment.

Endothelin-converting enzyme is a phosphoramidon-sensitive membrane metallopeptidase that catalyses the final step in biosynthesis of the potent vasoactive endothelin peptides. Immunomagnetic separation technology and immunohistochemistry have been used to demonstrate the co-localisation of endothelin-converting enzyme with the established ectoenzyme, aminopeptidase N, on the surface of endothelial cells. Unlike aminopeptidase N, however, endothelin-converting enzyme is seen to associate in clusters on the plasma membrane which can be distinguished from caveolae both biochemically and immunologically. Pre-treatment of endothelial cells with the metallopeptidase inhibitors phosphoramidon or thiorphan in the range 0.01-100 microM produced a dose-dependent increase in the levels of endothelin-converting enzyme protein and its accumulation in an intracellular compartment. No corresponding change in the levels of endothelin-converting enzyme-1 mRNA was detected under these conditions, nor in the levels of the closely related metalloenzyme, endopeptidase-24.11. The phosphoramidon and thiorphan-dependent increase is not due to direct inhibition of endothelin-converting enzyme not endopeptidase-24.11 but, rather, to an inhibition of the selective turnover of endothelin-converting enzyme protein.

Animals↗
PubMed1996

Separation and characterization of monoglucuronides of vitamin D(3) and25-hydroxyvitamin D(3) in rat bile by high-performance liquid chromatography.

The separation and characterization of vitamin D(3)- and 25-hydroxyvitamin D(3)-monoglucuronides, biliary metabolites obtained from rats dosed with D(3) and 25-hydroxyvitamin D(3) per os, respectively, were carried out by HPLC. The glucuronide fractions were obtained from bile specimens by the combined use of a Bond Elut C18 cartridge, for solid phase extraction, and a lipophilic gel (piperidinohydroxypropyl Sephadex LH-20), for ion-exchange chromatography. Each glucuronide was identified by comparison with an authentic sample in three ways: its chromatographic behavior, that of its fluorescent labeled derivative using 4-[4-(6-methoxy-2-benzoxazolyl)phenyl]-1,2,4-triazoline-3,5- dione and data obtained following enzymatic hydrolysis using beta-glucuronidase.

Animals↗
PubMed1996

l-Menthol, oleic acid and lauricidin in absorption enhancement of free and sodium salt of diclofenac using ethanol treated silicone membrane as model for skin.

The mechanism of l-menthol, oleic acid and lauricidin as enhancers on percutaneous absorption was examined using diclofenac (DH) as a hydrophobic drug and sodium diclofenac (DNa) as a hydrophilic drug in in vitro diffusion experiments with two kinds of membranes: ethanol-treated and untreated silicone membranes; these were models for the lipid and pore pathways of skin. A 20% w/w ethanol-aqueous solution decreased the flux of DH but increased the flux of DNa significantly across the treated membrane compared with those fluxes across the untreated membrane, suggesting that DH penetrated by the lipid pathway and DNa by the pore pathway. The permeability of DNa through the pore pathway decreased significantly across the treated membrane with the addition of oleic acid and lauricidin. l-Menthol increased the permeability coefficients of DH and DNa more in a treated membrane than in an untreated one, showing the same tendency as in rat skin. Thus, while oleic acid and lauricidin did not increase the permeation of DNa by the pore pathway, l-menthol appeared to enhance the permeation of the drug by both the lipid and pore pathways.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

[Quantitative analysis of chlorpheniramine maleate in cough and cold drugs by ion-pair high-performance liquid chromatography for the simultaneous determination of chlorpheniramine and maleate].

A simple, rapid and convenient chromatographic method, which permits the simultaneous determination of chlorpheniramine (CP) and maleate (MA), recently developed by the authors was applied to the analysis of chlorpheniramine maleate (CPM) in cough and cold drugs. In this method, a Capcell Pak C8 column and an isocratic mobile phase containing 15% methanol, 50 mM KH2PO4 and 5mM tetra-n-butylammonium phosphate as an ion-pair reagent were used. By using the mobile phase adjusted to pH 3.0 with orthophosphoric acid, fumaric acid, MA, CP, acetaminophen (paracetamol), caffeine, and m- and p-hydroxybenzoic acid as candidates for an internal standard were eluted separately within 17 min. Detection was carried out with UV detector at 215 nm. Under the same conditions, five other antihistamines analogous to CPM were also separated. The calibration graphs for CP and MA showed good linearity in the range of 0.5-10 nmol (0.195-3.9 micrograms) per 20 microliters injection, respectively. The proposed method was successfully applied to the simultaneous determination of CP and MA, i.e., CPM analysis, in commercial cough and cold drugs which pharmaceutical forms were tablet, granule and syrups.

Antitussive Agents↗
PubMed1996

Vasospastic angina after chemotherapy by with carboplatin and etoposide in a patient with lung cancer.

We report here a case of vasospastic angina following the administration of Carboplatin (CBDCA) and Etoposide (VP-16) in a patient with small cell lung carcinoma. Although these drugs are commonly used to treat small cell lung carcinoma, there has been no previous report of vasospastic angina in a patient without a history of heart disease. Therefore, we should be aware of the possibility that vasospastic angina may develop even in a patient without any history of heart disease. While calcium antagonist and isosorbide dinitrate are generally helpful for preventing vasospastic angina, these drugs could not completely suppress vasospastic angina in this case.

Aged↗
PubMed1996

Prediction of hemodynamic conditions by noninvasive arterial tonometry in mitral stenosis.

To predict the hemodynamic conditions in patients with mitral stenosis (MS), continuous blood pressure responses were monitored noninvasively at the bedside by arterial tonometry during the Valsalva maneuver in 18 MS patients aged 54.2 +/- 9.1 (40 approximately 77) years (6 men, 12 women). Two indices during the Valsalva maneuver (blood pressure decline value at phase III (BPdec) and subsequent blood pressure overshoot value at phase IV (BPov)) were compared with hemodynamic data obtained by the cardiac catheterization method, and the correlations between the changes in these parameters were examined. In these 18 patients, BPdec showed a significant negative correlation with the mean diastolic pressure gradient between the left atrium and left ventricle and showed a significant negative correlation with pulmonary capillary wedge pressure (PCWP) (r = - 0.62, p < 0.01, r = - 0.53, p < 0.05, respectively). Mitral valve area (MVA) showed a significant positive correlation with BPdec (r = + 0.63, p < 0.01). Similarly, BPov showed a significant positive correlation with cardiac output (CO), cardiac index (CI) and MVA (r = + 0.60, p < 0.01, r = + 0.64, p < 0.01, r = + 0.65, p < 0.01, respectively). Thus, continuous monitoring of blood pressure by arterial tonometry during the Valsalva maneuver is useful for predicting the hemodynamic conditions in patients with MS.

Adult↗
PubMed1996

Nitric oxide inhibits intracellular adhesion molecule-1 expression in rat mesangial cells.

This study tested whether nitric oxide modulates the expression of intercellular adhesion molecule-1 (ICAM-1) expression in glomerular mesangial cells. In an enzyme-linked immunosorbent assay, interleukin 1 beta (IL-1 beta; 10 ng/mL) increased ICAM-1 molecule expression on cultured rat mesangial cell surface in a time-dependent manner. Addition of the nitric oxide donors 3-morpholino-sydnonimine (SIN-1) or sodium nitroprusside significantly suppressed IL-1 beta-induced ICAM-1 molecule expression in a dose-dependent manner. The inhibitory effect of SIN-1 was abolished in the presence of a nitric oxide scavenger hemoglobin, but not in the presence of superoxide dismutase or pyrrolidine dithiocarbamate. Addition of 8-bromo-cyclic GMP showed no significant effect on IL-1 beta-induced ICAM-1 expression. In Northern blot analysis, the expression of ICAM-1 mRNA was barely detected in unstimulated cells, whereas ICAM-1 gene transcripts were clearly expressed after exposure to IL-1 beta for 3 h, and addition of SIN-1 decreased IL-1 beta-induced ICAM-1 mRNA accumulation. These results suggest that nitric oxide suppresses ICAM-1 expression in IL-1 beta-stimulated mesangial cells, independent of cGMP formation.

Animals↗
PubMed1996

Relationship between dyspnea in daily life and psycho-physiologic state in patients with chronic obstructive pulmonary disease during long-term domiciliary oxygen therapy.

We examined the relationships among dyspnea ratings in daily life, the physiologic state, and anxiety and depression of fifty-two patients with chronic obstructive disease (COPD) during long-term domiciliary oxygen therapy (LTOT). Clinical ratings of dyspnea were assessed by the visual-analog scale (VAS) during eight types of basic behavior in indoor daily life. Analysis of the physiologic state included forced expiratory volume in 1 second (FEV1.0), and arterial blood gas (PaO2, PaCO2) at rest while breathing room air. The hospital anxiety and depression (HAD) scale, which consists of 14 questions, was used to assess the degree of anxiety (HAD-A) and depression (HAD-D). The mean age of the patients was 69.5 +/- 10.8 year (SD), and the duration of LTOT was 944 +/- 739 days. The mean values were 0.77 +/- 0.45 L for FEV1.0, 57.7 +/- 7.4 Torr for PaO2, and 47.4 +/- 8.1 Torr for PaCO2. FEV1.0 was correlated with PaCO2(r = -0.548, p < 0.0001), but it was not correlated with PaO2. High correlation was noted between HAD-A and HAD-D (r = 0.693, P < 0.0001), whereas correlation was not noted between HAD and the physiologic state. VAS was significantly correlated with FEV1.0 (r = 0.320, p < 0.05), as well as with HAD-A (r = 0.358, p < 0.01) and HAD-D (r = 0.444, p < 0.01). Dyspnea ratings were found to be influenced by anxiety and the depression state, and also by the degree of flow limitation in patients with COPD during LTOT. In contrast, the physiologic state scarcely influenced the anxiety and depression state. Thus, psychotherapy may play an important role in the reduction of dyspnea sensation, which is an important determinant of quality of life.

Activities of Daily Living↗
PubMed1996

[A case of bilateral testicular torsion in a neonate].

A case of testicular torsion in the newborn is presented. A 8-day-old infant with bilateral intrascrotal swelling since birth was referred to us. Bilateral testicular torsion was suspected and operation was carried out at the same day. We operatively found extravaginal torsion of the bilateral spermatic cord. The bilateral testis appeared extensively necrotic, but we repaired the torsion and performed bilateral orchiopexy because of bilateral torsion. We could not palpate well the bilateral testis in one year, probably due to an atrophy. Sixty-nine cases of testicular torsion in the newborn including our case from Japanese literatures were reviewed and discussed. Especially forty-seven cases were presented at birth.

Atrophy↗
PubMed1996

[Results of antireflux surgery in infants with vesicoureteral reflux].

BACKGROUND: Due to the advancement of prenatal and postnatal ultrasound screening in addition to better understanding by pediatricians, more infants have been detected to have vesicoureteal reflux. There are still debates, however, about their management whether to take conservative or surgical treatment. METHODS: We analysed clinical courses of 51 children with primary reflux undergoing antireflux surgery when they were under 1 year. RESULTS: A total of 41 infants (80%) presented with febrile urinary tract infections. The first UTI was seen as early as 7th day after birth, with the average age of 2 months. Seven infants had hydronephrosis detected by prenatal ultrasound, and 2 were identified by neonatal screening ultrasonography. Sixty-eight of 86 reflux ureters (79%) showed high grade reflux (grade IV approximately V). All the other 18 ureters with mild to moderate grade of reflux except one accompanied with contralateral high grade reflux. One ureter with grade II reflux was associated with contralateral obstructed meganreter. Renal parenchymal abnormalities, either with scarring and/or small kidney, were identified in 64 kidneys (74%) at or before the reimplantation. The operation was done as early as 1 month-old with the average age of 5.6 months. Among the children, 24 (47%) underwent anti-reflux surgery before 6 month-old. Smallest infant weighted 2500 gr at the time of operation. Reimplantation was done by the Cohen transverse advancement technique in 75 ureters (87%). The modified Politano-Leadbetter method in 6 with Hutche's diverticulum, and the Glenn-anderson advancement method in 5 with moderate to mild reflux. Two dilated ureters were treated with folding of the intravesical segment. Follow-up voiding cystourethrogram of 49 children at 6 months revealed no evidences of persistent reflux. There were no patients with obstruction of reimplantation except one with slight upper-tract dilatation. One infant revealed new low grade contralateral reflux, and he is being observed. Two children presented pyelonephritis after the operation. CONCLUSION: Our success rate of 100% in antireflux surgery enables us to continue our policy to perform early operative interventions in infants with high grade reflux. In addition to the meticulous and careful technique, the conditions for successful results include; 1) A through checkup of the lower tracts by VCG and endoscopy. 2) Find the better operative instruments for the small bladder. 3) Do not hesitate to perform the ureteral tapering. 4) Make good use of operative loupe.

Age of Onset↗
PubMed1996

Structural determination of stevastelins, novel depsipeptides from Penicillium sp.

Structures of novel immunosuppressants, stevastelin A, B and B3(1) were determined by their spectroscopic and chemical studies. Three stevastelins were shown to be cyclic depsipeptides composed of a fatty acid and three amino acid moieties. The sequence of these moieties was determined to be as 3,5-dihydroxy-2,4-dimethylstearylvalylthreonyl (or O-sulfonylthreonyl in stevastelin A)-O-acetylserine. Cyclic structures were shown to be formed by ester linkages between the carboxylic group of the O-acetylserine moiety and the 5-hydroxy group of the fatty acid moiety in stevastelin A and B, and the 3-hydroxy group of the fatty acid moiety in stevastelin B3.

Anti-Bacterial Agents↗
PubMed1996

Absolute structural determination of stevastelin B.

Stevastelin B, obtained from a culture of a Penicillium sp. NK374186, is a novel depsipeptide containing three amino acids and 3,5-dihydroxy-2,4-dimethylstearic acid. The stereochemistry of the three amino acids was determined by HPLC analysis, and the relative configuration of the 3,5-dihydroxy-2,4-dimethylstearic acid was elucidated by chemical conversion and NMR analysis. The absolute stereochemistry of stevastelin B was determined by synthetic methods.

Anti-Bacterial Agents↗
PubMed1996

[Femoral testis: report of three cases].

Three patients were referred to our clinic with the chief complaint of emptiness of the right scrotal contents. Every physical examination in these patients revealed a little-finger-tip sized mass corresponding to the normal testis at the right side of the femoral region. Right orchiopexy by the dartos-pouch technique was successfully performed. On every surgical exploration of these patients, the gubernaculum was fixed to the femoral skin and the testis was found to be normal in size. Our cases are the 2nd, 3rd and 4th cases of femoral testis, reported in the Japanese literature.

Child, Preschool↗