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Biomedical subjects

K Shimamoto

Publications and source records attributed to K Shimamoto.

At least 181 records · Page 10Linked to original sources
PubMed1997

Urinary kallikrein in Dahl-Iwai salt-sensitive and -resistant rats.

This study was designed to evaluate the differences between the renal kallikrein in newly established Dahl-Iwai rats under salt loading and that of Sprague-Dawley rats (SD). Urinary kallikrein quantity and activity was markedly lower in Dahl-Iwai rats than in SD even during the control period. Moreover, kallikrein quantity and activity in Dahl-Iwai salt-sensitive rats (SS) were clearly diminished in comparison with salt-resistant rats (SR). The kallikrein activity/ quantity ratio was also lower in SS and SR than in SD during the control period. After salt loading, systolic blood pressure increased only in SS. Kallikrein activity in SS and SR, and kallikrein quantity in SS were increased, whereas those in SD did not change. Although the kallikrein activity/quantity ratio in SR reached the same level in SD after salt loading, that in SS was lower throughout the experiment. These results suggest that Dahl-Iwai rats are less able hereditarily to produce renal kallikrein and that there may exist structurally abnormal kallikrein that may have a lower activity. Different kinetics of renal kallikrein between SS and SR by salt loading might be explained by kallikrein inhibitors or abnormal kallikrein or nonkallikrein kininogenase. These different kinetics of renal kallikrein may play some role on blood pressure elevation in SS.

Animals↗
PubMed1997

Propylthiouracil-induced rapidly progressive glomerulonephritis associated with antineutrophil cytoplasmic autoantibodies.

We present a case study of a 52-year-old female patient with hyperthyroidism which had been diagnosed at the age of 35. However, the malfunction of thyroid had been poorly controlled. Thyroid function was returning to normal after the administration of propylthiouracil (PTU) 300 mg/day, however purpura appeared in both lower extremities. Renal function deteriorated rapidly, and the patient was admitted to our hospital. According to the biopsies, leukocytoclastic vasculitis in the skin was apparent, and crescent formation was observed in the glomerulus. Serological examination revealed positive antineutrophil cytoplasmic autoantibodies (ANCA) against proteinase 3 (Pr3) and myeloperoxidase (MPO). Antinuclear autoantibody was positive. After cessation of PTU and administration of prednisolone, the purpura disappeared and ANCA were becoming negative. Renal function recovered gradually. Thyroid function was kept within normal range using iodine solution. Thus, it is strongly suggested that PTU-induced rapidly progressive glomerulonephritis associated with ANCA.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1997

[Prostaglandin and kallikrein-kinin systems].

We reviewed the recent advances in the molecular characterization of prostanoid and bradykinin receptors. Prostanoids and bradykinin exert versatile actions in diverse tissues and cells through specific cell surface receptors. Molecular biological studies revealed the primary structure of eight types and subtypes of prostanoid receptors from various species. These include the thromboxane A2 receptor, prostacyclin receptor, prostaglandin (PG) F receptor, PGD receptor and four subtypes of PGE receptor (EP1, EP2, EP3 and EP4). There are four subtypes of bradykinin receptor (BK1, BK2, BK3 and BK4), but it is still unknown about the detail of BK3 and BK4. These results also have achieved the remarkable development in the field of human hypertension.

Animals↗
PubMed1997

Appropriate hematocrit levels of erythropoietin supplementary therapy in end-stage renal failure complicated by coronary artery disease.

OBJECTIVE: To investigate an appropriate hematocrit (Hct) for managing renal anemia complicated by angina pectoris at rest. DESIGN: Nonrandomized, retrospective and prospective observational study. SETTING: Sapporo Medical University Hospital, Sapporo, Japan. PATIENTS: Thirty-two anemic patients (aged 62 +/- 10 years, range 40 to 78) with rest angina in end-stage renal failure. INTERVENTIONS: Serial changes of exercise tolerance (estimated metabolic equivalents [METs] on stress electrocardiography produced by improvement of patients' Hct, using recombinant human erythropoietin (rHuEPO). Adverse effects, such as deteriorating systemic hypertension, were investigated with regard to the severity of coronary arteriographic findings (Leaman's score) and cardiac events within a six-month period. MAIN RESULTS: Higher Hct was clearly correlated with better estimated METs: when Hct was less than 20%, MET was 1.4 +/- 0.5; with 20% < or = Hct < 25% 2.1 +/- 1.4; with 25% < or = Hct < 30% 3.1 +/- 1.6; and with 30% < or = Hct < 35% 4.9 +/- 1.1. Patients with cardiac events (elective balloon angioplasty [n = 5], bypass surgery [n = 1], myocardial infarction [n = 2] and hospital death from congestive heart failure [n = 3]) had advanced coronary lesions compared with patients without coronary events (Leaman's score 15.9 +/- 9.3 versus 7.3 +/- 4.4, respectively, P < 0.01) and lower exercise capacity at 25% < or = Ht < 30% (estimated METs 2.4 +/- 1.2 versus 3.9 +/- 1.9, respectively, P < 0.05). Moreover, there was an inverse linear correlation between estimated METs and Leaman's score only when Hct was over 25%. In prospectively examined subjects (n = 16), Hct 35% or greater without systemic hypertension was obtained in only seven (44%), and no additional effect on exercise tolerance was expected when Hct was 35% or greater. CONCLUSIONS: Managing renal anemia with 30% < or = Hct < 35% with rHuEPO is considered an appropriate therapy in patients with end-stage renal failure complicated by rest angina.

Adult↗
PubMed1997

Transposon tagging in rice.

To develop an efficient gene isolation method for rice we introduced the maize Ac/Ds system into rice. Extensive analysis of their behavior in rice for several generations indicated that Ac and Ds in the presence of Ac transposase gene actively transpose in rice. A wide spectrum of mutations affecting growth, morphogenesis, flowering time and disease resistance have been obtained in the population carrying Ac/Ds and some of them were genetically analyzed. Main efforts are currently being made to isolate genes responsible these mutations. In addition, a number of Ac/Ds were mapped on chromosomes and mapped elements will be used in the future for directed tagging of genes with known chromosomal positions.

Cloning, Molecular↗
PubMed1997

Sustained right ventricular dyskinesis complicated by right ventricular infarction.

We encountered a 66-yr-old man with acute left inferior and right ventricular infarction. Tomographic radionuclide ventriculography and Fourier analysis clearly demonstrated reduced wall motion in the inferior walls of both ventricles and markedly delayed phase angles in the inferior right ventricular segment, indicating dyskinesis, which was confirmed by two-dimensional echocardiography and contrast right ventriculography. Four years later, right ventricular dyskinesis was still present and corresponded to a right ventricular perfusion defect on 99mTc-labeled tetrofosmin tomogram. Right ventricular imaging with tomographic radionuclide ventriculography with Fourier analysis and 99mTc-labeled myocardial tomography demonstrates that, even after improved global function and hemodynamics, right ventricular dyskinesis related to right ventricular perfusion defect can be sustained for several years. Thus, these imaging techniques may contribute to diagnosing right ventricular infarction and investigating the pathophysiology.

Aged↗
PubMed1996

Captopril potentiates the myocardial infarct size-limiting effect of ischemic preconditioning through bradykinin B2 receptor activation.

OBJECTIVES: To investigate the role of kinin in preconditioning against infarction, the present study assessed the effect of captopril, a kininase II inhibitor, on preconditioning and arterial plasma kinin levels. BACKGROUND: Recent studies suggest a possible contribution of kinin to preconditioning against infarction. However, its role and the site of kinin production remain uncharacterized. METHODS: Six groups of rabbits (n = 6 to 13) underwent 30-min coronary occlusion and 3-h reperfusion. The infarct size and area at risk were determined by tetrazolium staining and fluorescent particles, respectively. Arterial blood was sampled under baseline conditions, before the 30-min ischemia and after reperfusion for radioimmunoassay of the kinin level. RESULTS: Infarct size expressed as a percentage of area at risk (%IS/AR) was 42.9 +/- 2.9% (mean +/- SEM) in the control group, 34.5 +/- 3.3% in the group preconditioned with 2 min of ischemia/5 min of reperfusion and 41.7 +/- 5.1% in the group given captopril (1 mg/kg body weight) alone before the 30-min ischemia. These %IS/AR values were not significantly different between the three groups. However, a combination of captopril and subsequent preconditioning with 2 min of ischemia markedly limited %IS/AR to 21.2 +/- 2.4%. This potentiation of 2 min of preconditioning by captopril was not observed when 2 micrograms/kg body weight of Hoe 140, a specific bradykinin B2 receptor antagonist, was administered before preconditioning (%IS/AR = 41.2 +/- 5.7%), whereas Hoe 140 alone did not modify infarct size (%IS/AR = 38.5 +/- 5.1%). Arterial plasma kinin levels were comparable between the control rabbits, the group given captopril alone and the group that received captopril plus 2 min of preconditioning at baseline (3.8 +/- 1.0, 6.3 +/- 1.9 and 5.2 +/- 1.7 pg/ml, respectively), and there was no significant change in kinin levels after the captopril injection or the combination of captopril plus 2 min of preconditioning. CONCLUSIONS: The present results indicate that captopril is capable of potentiating preconditioning without increasing the arterial kinin level and that the beneficial effect of captopril can be inhibited by Hoe 140. These findings support the hypothesis that kinin produced locally in the heart during preconditioning may contribute to the cardioprotective mechanism through bradykinin receptor activation.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

Syntheses and conformational analyses of glutamate analogs: 2-(2-carboxy-3-substituted-cyclopropyl)glycines as useful probes for excitatory amino acid receptors.

An hypothesis that each subtype of glutamate receptors requires a specific conformation of L-glutamate for its selective activation was examined using the conformationally constrained analogs of L-glutamate, L-2-(2-carboxycyclopropyl)glycines (CCGs), and L-2-[2-carboxy-3-(methoxymethyl)cyclopropyl)glycines (MCGs). All MCG isomers were newly synthesized in a stereoselective manner via the common synthetic intermediate 5a starting with the oxazolidine aldehyde 1. The synthesis of the four MCG isomers was characterized by a stereoselective inversion of alpha-cyclopropyl acyl anion (e.g., from 10 to 11). The spectroscopic studies, in particular, pH vs J correlation experiments of CCGs and MCGs using 1H NMR and their molecular mechanics calculations, revealed that these analogs possessed an antiperiplanar conformation regarding the H-C2-C1'-H bond as a majority among the other possible rotamers in aqueous solution. The fact that each CCG and MCG exhibited potent and selective activities to the distinct types of glutamate receptors allowed us to extract an active conformation of L-glutamate. Thus, the conformational requirement of metabotropic glutamate receptors was speculated to be the anti-anti conformation (aa-A) because the conformations of CCG-1 and cis and trans-MCG-I, selective agonists of the receptors, closely mimicked the rotamer A of L-glutamate. On the other hand, N-methyl-D-aspartate and kainate receptors, representative ionotropic glutamate receptors, would require glutamate g+g+ rotamer E which was deduced from the conformation-activity relationship studies of the selective agonists CCG-IV, cis-MCG-IV, and trans-MCG-IV and the related analogs.

Animals↗
PubMed1996

Ischemic colitis during interferon-alpha treatment for chronic active hepatitis C.

Between 1991 and 1994, at Hoshigaoka Koseinenkin Hospital, we treated 280 patients with chronic hepatitis C with interferon (IFN), and ischemic colitis occurred in two patients (0.7%) during the treatment. Melena appeared in case 1 in the 2nd month after the initiation of IFN-alpha treatment, and in case 2 in the 6th month. In both patients, longitudinal ulcerations in the descending colon were revealed by urgent colonoscopy, and these resolved within 2 weeks after discontinuation of the IFN treatment. It appears that ischemic colitis was associated with the IFN treatment, suggesting that attention should be paid to this possible complication.

Aged↗
PubMed1996

Activation of adenosine receptors before ischemia enhances tolerance against myocardial stunning in the rabbit heart.

OBJECTIVES: This study examined whether stimulation of adenosine receptors before ischemia enhances myocardial resistance to stunning in vivo. BACKGROUND: We previously demonstrated the attenuation of myocardial stunning by ischemic preconditioning through adenosine receptor activation in rabbits. METHODS: 1) To confirm the efficacy of an intravenous infusion of adenosine to stimulate adenosine receptors in the heart, we assessed the effect of an adenosine infusion on the inotropic response to an isoproterenol challenge. 2) Myocardial stunning was induced by 10 min of coronary occlusion and reperfusion. The regional thickening fraction was monitored by an epicardial Doppler sensor. Rabbits were pretreated with either no drug (control group), adenosine, 8-phenyltheophylline or a combination of 8-phenyltheophylline plus adenosine. RESULTS: An intravenous infusion of adenosine at 0.15 mg/kg body weight per min attenuated by 50% the elevation of left ventricular dP/dtmax by isoproterenol (0.075 microgram/kg per min). The same dose of adenosine infused for 15 min before ischemia significantly improved the postischemic recovery of the thickening fraction, and the thickening fraction at 30 min reperfusion was 76.8 +/- 3.3% (mean +/- SE) of the baseline value, which was significantly higher than the control value (42.9 +/- 4.5%). The relation between thickening fraction and systolic left ventricular pressure after reperfusion was shifted toward higher thickening fraction by adenosine. This beneficial effect of adenosine was not detected in rabbits given 8-phenyltheophylline before adenosine, and 8-phenyltheophylline-treated rabbits showed a time course of thickening fraction similar to that in the control group. CONCLUSIONS: An intravenous infusion of adenosine is capable of protecting rabbit hearts against stunning through adenosine receptor activation.

Adenosine↗
PubMed1996

The rab16B promoter of rice contains two distinct abscisic acid-responsive elements.

To localize abscisic acid (ABA)-inducible gene expression of rab16 genes, rab16A promoter was linked to the gusA reporter gene encoding beta-glucuronidase and introduced into rice (Oryza sativa L.) plants. The activity of rab16A promoter was induced by ABA and osmotic stresses in various tissues of vegetative and floral organs. In anthers and embryos, rab16A promoter was active in the absence of ABA. To elucidate cis-elements of the rab16 promoter that confer ABA-inducible expression, variously modified 40-bp fragments (-264 to -225) of the rab16B promoter were fused to a truncated (-46 bp) cauliflower mosaic virus 35S minimal promoter, and their activities in protoplasts were analyzed. The transient assays revealed that the 40-bp fragment consists of two separate ABA-responsive elements, motif 1 (AGTACGTGGC) and motif III (GCCGCGTGGC). Motif I and motif III are both required for ABA induction; however, each can substitute for the other. Further analyses of these motifs indicated that motif III has a distinct DNA sequence specificity as an ABA-responsive element from motif I, suggesting that the two motifs interact with different transcription factors in vivo.

Abscisic Acid↗
PubMed1996

Effects of hyperinsulinaemia on renal function and the pressor system in insulin-resistant obese adolescents.

1. In the present study, using the euglycaemic hyperinsulinaemic glucose clamp technique, we investigated the effects of hyperinsulinaemia on sodium-water metabolism and the pressor system in obesity, both of which have been reported to be closely associated with insulin resistance and/or hyperinsulinaemia. 2. Sixteen obese young subjects and 24 non-obese young subjects who were all normotensives, participated in this study. The 2 h euglycaemic hyperinsulinaemic glucose clamp was performed in a fasting state. The mean glucose infusion rate needed to maintain a fasting blood sugar level (FBS) during the last 30 min of the clamp was used as an indicator of insulin sensitivity (M-value). Before and after the clamp, the following parameters were measured: creatinine clearance (Ccr); urinary excretion of sodium (UNaV); fractional excretion of sodium (FENa); plasma renin activity (PRA); plasma aldosterone concentration (PAC) and plasma noradrenaline concentration (PNA). 3. The M-value was significantly lower in obese subjects compared with non-obese subjects, although FBS and fasting immunoreactive insulin levels were similar in both groups. UNaV and FENa fell only in obese subjects during the clamp, while Ccr showed no significant change in either group. PNA and PRA increased significantly and PAC tended to increase in both groups. 4. These results suggest that obese subjects have insulin resistance with respect to glucose metabolism, but that urinary sodium excretion and the pressor system remain insulin-sensitive; the sensitivity of the sodium retaining action to hyperinsulinaemia was actually higher in obese subjects than in non-obese subjects. Therefore, if compensatory endogenous hyperinsulinaemia was raised by insulin resistance, these two factors may lead to chronic sodium retention and pressor system stimulation and, in turn, to hypertension in obesity.

Adolescent↗
PubMed1996

Bilateral deoxycorticosterone-secreting adrenocortical adenoma.

A case of a 58-year-old man with bilateral deoxycorticosterone (DOC)-secreting adrenocortical adenoma is reported. Before surgery, plasma levels of DOC and corticosterone were markedly elevated, but both adrenal hormone levels normalized after the surgical removal of the bilateral adrenal tumors. The histologic examination revealed bilateral adrenocortical adenoma, but curiously, the tissue concentrations of DOC and corticosterone were elevated only in the right adrenal gland.

Adrenal Cortex Neoplasms↗
PubMed1996

Analysis of candidate genes for insulin resistance in essential hypertension.

To clarify the genetic basis of insulin resistance in hypertension, case-control association studies were performed to examine candidate genes for insulin resistance in hypertension. Since the main site of insulin resistance in hypertension is glycogen synthesis in skeletal muscle, genes that encode molecules involved in this pathway, i.e. insulin receptor (INSR), insulin-responsive glucose transporter (GLUT4) and glycogen synthase (GSY), were studied. In addition, since recent studies suggest the contribution of beta3 adrenergic receptor to the insulin resistance syndrome, the gene encoding beta3 adrenergic receptor (ADRB3) was also studied. Frequency of homozygotes for common C allele of a microsatellite polymorphism in the INSR gene was higher in the hyperinsulinemia group, but not in the normoinsulinemia group of hypertensive patients than in normotensive control subjects. Insulin sensitivity, however, was not significantly different between hypertensive patients with C/C genotype and those without this genotype. No significant differences were observed in the distribution of alleles or genotypes of the GLUT4, GSY and ADRB3 genes between hyperinsulinemia and normoinsulinemia groups of hypertensive patients or between these groups and the control group. These data suggest that the INSR polymorphism is associated with hyperinsulinemia, but not with insulin resistance, in hypertension.

Case-Control Studies↗
PubMed1996

Renovascular hypertension with massive proteinuria.

A 65-year-old woman with renovascular hypertension and massive proteinuria is reported. Her urinary protein ranged from 3 to 5 g/day. Serum potassium was 2.9 mEq/l. Plasma renin activity and plasma aldosterone concentration were very high. A CT scan disclosed atrophy of the left kidney. Renogram showed a non-functioning pattern of the left kidney. An abdominal aortogram showed complete occlusion of the left renal artery at its ostium. After left nephrectomy, her high blood pressure and urinary protein were normalized. It seemed that the massive proteinuria was mainly due to some endocrinological effect of the left kidney.

Aged↗
PubMed1996

The mechanisms of the improvement of insulin sensitivity by angiotensin converting enzyme inhibitor.

To investigate the role of kinins in augmentation of insulin sensitivity by angiotensin converting enzyme inhibitor (ACEI), the effects of ACEI (delapril) on the insulin resistance in fructose-fed rats (FFR) were evaluated with or without the administration of bradykinin receptor antagonist (Hoe 140). Male Sprague-Dawley rats were fed on fructose rich chow (FFR) or standard chow (control) for 4 weeks and treated with 10 mg/kg/day of delapril with or without Hoe 140 (0.5 mg/kg/day) for an additional 2 weeks. Steady state plasma glucose (SSPG) and steady state plasma insulin (SSPI) were determined while the rats were conscious. Insulin (2.5 mU/kg/min) and glucose (8 mg/kg/min) were simultaneously infused to determine insulin sensitivity in each group. Mean blood pressure (MBP), SSPG and SSPI were significantly higher in FFR than in control, and were significantly lower in the FFR+delapril than in FFR+vehicle. There were no difference in MBP, SSPG and SSPI between FFR+delapril+vehicle and FFR+delapril+Hoe 140. We concluded that the main mechanisms of improving the insulin sensitivity by ACEI may not be the enhancement of kinins but the suppression of angiotensin II in FFR.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

[Guidelines on treatment of hypertension in the elderly, 1995--a tentative plan for comprehensive research projects on aging and health-- Members of the Research Group for "Guidelines on Treatment of Hypertension in the Elderly", Comprehensive Research Projects on Aging and Health, the Ministry of Health and Welfare of Japan].

We propose the following guidelines for treatment of hypertension in the elderly. 1. Indications for Treatment. 1) Age: Lifestyle modification is recommended for patients aged 85 years and older. Antihypertensive therapy should be limited to patients in whom the merit of the treatment is obvious. 2) Blood pressure: Systolic BP > 160 mmHg, diastolic BP > 90 approximately 10 mmHg. Systolic BP < age + 100 mmHg for those aged 70 years and older. Patients with mild hypertension (140-160/ 90-95 mmHg) associated with cardiovascular disease should be considered for antihypertensive drug therapy. 2. Goal of Therapy for BP: The goal BP in elderly patients is higher than that in younger patients (BP reduction of 10-20 mmHg for systolic BP and 5-10 mmHg for diastolic BP). In general, 140-160/< 90 mmHg is recommended as the goal. However, lowering the BP below 150/85 should be done with caution. 3. Rate of Lowering BP: Start with half the usual dose, observe at the same dose for at least four weeks, and reach the target BP over two months. Increasing the dose of antihypertensive drugs should be done very slowly. 4. Lifestyle Modification: 1) Dietary modification: (1) Reduction of sodium intake is highly effective in elderly patients due to their high salt-sensitivity. NaCl intake of less than 10 g/day is recommended. Serum Na+ should be occasionally measured. (2) Potassium supplementation is recommended, but with caution in patients with renal insufficiency. (3) Sufficient intake of calcium and magnesium is recommended. (4) Reduce saturated fatty acids. Intake of fish is recommended. (2) Regular physical activity: Recommended exercise for patients aged 60 years and older: peak heart rate 110/minute, for 30-40 minutes a day, 3-5 days a week. (3) Weight reduction. (4) Moderation of alcohol intake, smoking cessation. 5. Pharmacologic Treatment: 1) Initial drug therapy. First choice: Long-acting (once or twice a day) Ca antagonists or ACE inhibitors. Second choice: Thiazide diuretics (combined with potassium-sparing diuretic). 2) Combination therapy. (1) For patients without complications, either of the following is recommended. i) Ca antagoinst + ACE inhibitor, ii) ACE inhibitor + Ca antagonist (or low-dose diuretics), iii) diuretic + Ca antagonist (or ACE inhibitor), iv) beta-blockers, alpha 1-blockers, alpha + beta blockers can be used according to the patho-physiological state of the patient. (2) For patients with complications. Drug(s) should be selected according to each complication. 3) Relatively contraindicated drugs. beta-Blockers and alpha 1-blockers are relatively contraindicated in elderly patients with hypertension in Japan. Centrally acting agents such as reserpine, methyldopa and clonidine are also relatively contraindicated beta-Blockers are contraindicated in patients with congestive heart failure, arteriosclerosis obliterans, chronic obstructive pulmonary disease, diabetes mellitus (or glucose intolerance), or bradycardia. These conditions are often present in elderly subjects. Elderly subjects are susceptible to alpha 1-blocker-induced orthostatic hypotension, since their baroreceptor reflex is diminished. Orthostatic hypotension may cause falls and bone fractures in the elderly.

Aged↗