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Biomedical subjects

K Shimamoto

Publications and source records attributed to K Shimamoto.

At least 199 records · Page 11Linked to original sources
PubMed1996

Serial changes of left atrial thrombus in mitral stenosis: transesophageal echocardiographic studies in candidates for balloon mitral commissurotomy.

BACKGROUND: Little is known concerning therapeutic modification of left atrial thrombus in mitral stenosis and its formation after successful balloon valvuloplasty (percutaneous transvenous mitral commissurotomy [PTMC]). OBJECTIVE: To test the roles of the clinical use of anticoagulant therapy and PTMC, serial changes in left atrial thrombus were examined by transesophageal echocardiography in 80 patients with mitral stenosis. RESULTS: No difference in embolic history, New York Heart Association functional class, cardiac rhythm, left atrial size or mitral valve area was found between patients with (n=23) and without (n=57) left atrial thrombus. Diuretic use was the prevalent factor for left atrial thrombi, which were dissolved completely in seven (30.4%) and partially in eight (34.7%) of the patients by adequate warfarin. However, after PTMC (n=53), newly formed thrombus was observed in four of 51 (7.8%) patients, which correlated with left atrial size (at least 50mm), atrial fibrillation and poorly controlled warfarin (thrombo test: 63.8 +/- 18.8% versus 35.9 +/- 17.7%, P<0.005). The newly formed thrombi were dissolved within several weeks. CONCLUSION: Left atrial thrombus in symptomatic mitral stenosis exhibits elusive characteristics and should be strictly monitored even after successful PTMC by transesophageal echocardiography in order to achieve adequate anticoagulation.

Atrial Function, Left↗
PubMed1996

[Fundamental study of lung-cancer screening by helical CT: second report: evaluation of CT images using normal volunteers].

In order to examine the use of helical computed tomography (CT) in lung cancer screening, we evaluated the effects of tube current and table feed speed on image quality. CT images of normal volunteers, which were scanned under various tube currents (150mA, 100mA, 50mA) and various table feed speeds (15mm/sec, 20mm/sec, 25mm/sec, 30mm/sec), were visually evaluated by experienced diagnostic radiologists. The images were not affected by decreasing the milliamperage. However, as table feed speed increased, images were evaluated as significantly worse. Particularly, since the degradation of the images scanned at greater than 25mm/sec was remarkable, they were judged to be unacceptable for detection of the abnormality. In conclusion, a tube current of less than 50mA and table feed speed of less than 20mm/sec are suitable in the application of helical CT for lung cancer screening.

Adult↗
PubMed1995

[Mechanism of inhibition of aldosterone secretion by a Ca2+ channel blocker in patients with essential hypertension and patients with primary aldosteronism].

Three studies were conducted in order to investigate the suppressive effects of a calcium antagonist on aldosterone secretion and a possible mechanism. Study 1: A long-term (4 weeks) treatment with slow-release nifedipine (Nif), 40-60 mg/day, was performed in 9 in-patients with essential hypertension (EHT). Mean arterial pressure (MAP), plasma renin activity (PRA), plasma angiotensin II levels (pAII) and plasma aldosterone concentration (PAC) were determined before and after Nif treatment. Study 2: In another 7 in-patients with EHT, Nif treatment (40-60 mg, 7-10 days) was carried out to study its effect on aldosterone secretion in response to 2-hour ambulation, angiotensin II (AII) infusion (2.5 ng/kg/min, for 1-hour) and ACTH injection (2.5 mg i.v.). Study 3: The effects of Nif (40-60 mg/day, for 7-10 days) on MAP, PAC, serum potassium, potassium clearance (Ck) and changes in PAC or plasma cortisol levels in response to ACTH injection (2.5 mg i.v.) were studied in 6 in-patients with primary aldosteronism (PA). In patients with EHT, MAP was reduced significantly at 1 week and 4 weeks after the administration of Nif. PRA and pAII increased significantly, though the increase of PAC was not significant. In the low-renin EHT group, PAC was reduced significantly (Study 1). The increase of PAC in response to 2-hour ambulation or AII infusion was inhibited by Nif, but no inhibition of aldosterone response to ACTH was observed (Study 2). In patients with PA, Nif lowered MAP, PAC, and Ck, and elevated serum potassium concentration significantly. On the other hand, Nif had no effect on the aldosterone or cortisol response to ACTH (Study 3). These results indicated that the hypotensive effect of Nif is due in part to the inhibition of aldosterone secretion from the adrenal gland both in patients with EHT and in those with PA. Regarding the mechanism of the inhibition of aldosterone secretion by Nif, these data suggest that in patients with EHT, inhibition of the aldosterone response to AII is the most important factor, although it was not clear from this study whether Nif inhibits the potassium-induced aldosterone release or not. In patients with PA, ACTH-induced aldosterone secretion was not inhibited by Nif and the reduction of PAC is not likely via inhibition of AII action since the renin-angiotensin system is markedly suppressed. Reduced cytosolic calcium concentration in the adenomatous tissue by Nif may have something to do with the lowered aldosterone synthesis in PA.

Adult↗
PubMed1995

[The significance of platelet alpha 2-adrenoceptor and sympathetic nerve activity in the hypertensive mechanism under essential hypertension--with special reference to pressor response to norepinephrine].

Although many studies have examined the metabolism of catecholamines and cardiovascular responsiveness to norepinephrine in essential and various experimental hypertension, the role of sympathetic nervous system in the pathogenesis of hypertension has not been elucidated. In this study, therefore,the role of sympathetic nerve activity related to platelet alpha 2-adrenoceptor was investigated to clarify the mechanism in which sympathetic nervous system augments the blood pressure elevation in patients with essential hypertension (EHT). Tritiated yohimbine binding was used to estimate platelet membrane alpha 2-adrenoceptor characteristics in 27 hospitalized patients with mild to moderate EHT and 27 normotensive subjects (NT) receiving a regular diet containing 120mEq/day of sodium and 75mEq/day of potassium. In this study, mean arterial pressure (MAP) and plasma norepinephrine concentration (pNE) was significantly higher in EHT than those in NT. Total binding sites (Bmax) and dissociation constant (Kd) for 3H-yoshimbine in EHT was also significantly higher than those in NT. There was a significant positive correlation between Bmax and age in NT, but not in EHT. A significant positive correlation was observed between the pressor response to infused norepinephrine (NE-R:increments in MAP induced by i.v. infused 0.2 micrograms/kg/min of NE) and Bmax both in NT and EHT. On the other hand, no significant correlation was found between NE-R and Kd in NT and EHT. In addition, Bmax was correlated inversely with PNE in both NT and EHT. These findings suggest that down-regulation mechanism exists in platelet alpha 2-adrenoceptor number responded to PNE levels. Moreover, the increased density of alpha-adrenoceptor might have something to do with the augmented NE-R in EHT, indicating an important pathophysiological role of this receptor in the hypertensive mechanisms in EHT.

Adult↗
PubMed1995

A type I element composed of the hexamer (ACGTCA) and octamer (CGCGGATC) motifs plays a role(s) in meristematic expression of a wheat histone H3 gene in transgenic rice plants.

Type I element (CCACGTCACCGATCCGCG) is a well-conserved regulatory element found in proximal promoter region of a certain class of plant histone genes, that is composed of two independent cis-acting elements of the hexamer (ACGTCA) and the reverse-oriented octamer (GATCCGCG) motifs. To investigate functional role(s) of the type I element in regulation of a wheat histone H3 gene (TH012) promoter activity in vivo, base substitution mutations were introduced into the element and activities of the mutated promoters were examined in cultured rice cells, and in regenerated roots and anther walls of transgenic rice plants by employing a GUS reporter system. Mutations of each or both of the hexamer and the octamer motifs caused a reduction in the promoter activity in protoplasts transfected transiently or stably transformed calli. The mutation of the octamer motif with or without the mutation of the hexamer motif caused a marked reduction of the promoter activity in the root meristem of transgenic rice although the mutation of the hexamer motif alone caused a weak reduction. In contrast to these results, no effect of the mutations of either the hexamer or the octamer motif was found in the anther wall in which replication-independent activity of the H3 promoter was observed. Our results suggested that the hexamer and the octamer motifs may play important role(s) in regulation of replication-dependent but not of replication-independent expression of the wheat histone H3 gene.

Base Sequence↗
PubMed1995

Effects of angiotensin receptor antagonist and angiotensin converting enzyme inhibitor on insulin sensitivity in fructose-fed hypertensive rats and essential hypertensives.

This study was designed to investigate the effects of angiotensin II (AII) receptor antagonist and angiotensin converting enzyme (ACE) inhibitor on insulin resistance, and the mechanism by which ACE inhibitor improves insulin-dependent glucose uptake (insulin sensitivity) in an insulin-resistant hypertensive rat model (fructose-fed rats, FFR) and in essential hypertensives (EHT). Male Sprague-Dawley rats were fed on fructose-rich or standard chow for 4 weeks and treated either with 10 mg/kg/day of delapril (n = 8), 1 mg/kg/day of TCV-116 (AII receptor antagonist; n = 13), or vehicle (n = 9) for the latter 2 weeks. Steady-state plasma glucose (SSPG) was measured with the subjects in the conscious state; simultaneously, we infused insulin (2.5 mU/kg/min) and glucose (8 mg/kg/min) to determine insulin sensitivity in each group. Thirteen EHT were hospitalized and the 2-h euglycemic hyperinsulinemic glucose clamp (GC) method was performed in a fasting condition before and after 2 weeks' administration of TCV-116 (8 mg/day) in 7 EHT and of delapril (120 mg/day) in 6 EHT. Insulin sensitivity was evaluated as M-value calculated from the infusion rate of glucose. Mean blood pressure (MBP) was higher in FFR (137.7 +/- 73.8 mm Hg, P < .05) compared to controls (120.8 +/- 2.7 mm Hg), and was lower in both the delapril (108.1 +/- 6.3 mm Hg, P < .05) and TCV-116 (112.8 +/- 4.3 mm Hg, P < .05) groups than in FFR.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1995

Glibenclamide, a blocker of ATP-sensitive potassium channels, abolishes infarct size limitation by preconditioning in rabbits anesthetized with xylazine/pentobarbital but not with pentobarbital alone.

The role of ATP-sensitive potassium channels (KATP) in the mechanism of ischemic preconditioning (PC) is controversial, partly because descriptions of inhibition of PC by KATP blockers in the literature are inconsistent. We sought a reason for the discrepant findings regarding the effects of glibenclamide (Glib), a specific blocker of KATP, in preventing the reduction of infarct size (IS) induced by PC. The effect of Glib pretreatment (0.3 mg/kg i.v.) on PC was examined in three conditions: (a) when PC was performed with 3- and 5-min ischemia (i.e., potency of PC differs), (b) when rabbits were pretreated with prazosin and metoprolol (0.15 mg/kg i.v. each) to reduce myocardial O2 consumption, and (c) when xylazine was added to pentobarbital anesthesia. In rabbits under pentobarbital anesthesia, the left coronary artery was occluded for 30 min and then reperfused. The area at risk (AAR) and IS were determined 72 h after reperfusion in the first series of experiments and 3 h after reperfusion in the second and third series. IS as a percentage of AAR (%IS/AR) were 31.7 +/- 2.8 and 19.6 +/- 2.5% (SEM) after PC with 3- and 5-min ischemia, respectively, values significantly smaller than %IS/AR in the untreated control group (49.2 +/- 3.3%). The limitation of IS observed with 3- or 5-min PC was not prevented by Glib. Glib also failed to block %IS/AR reduction by PC, even when rate-pressure product (RPP) was reduced to approximately 65% by prazosin/metoprolol (Praz/Met) pretreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1995

Intracranial pheochromocytoma--a case of noradrenaline-secreting glomus jugulare tumor.

A 43-year-old female was admitted for a labile hypertension and depression. High levels of plasma and urinary noradrenaline strongly suggested a pheochromocytoma. However, clinical investigations revealed a normal adrenal gland and thoraco-abdominal region. Venous samples from multiple sites indicated and increase in noradrenaline in the left jugular vein. Using computed tomography and Gadolinium DTPA (diethylene triamine pentaacetic acid)-enhanced dynamic MR (magnetic resonance) imaging, a tumor was discovered in the cerebello-pontine angle. Carotid angiography showed the feeder arteries clearly. Therefore, the tumor was classified as a noradrenaline-secreting glomus jugulare tumor fed by the carotid artery. After embolization and subsequent medical therapy, blood pressure was well controlled. Twenty cases of intracranial pheochromocytoma have been reported to date. This is the second such case in Japan.

Adult↗
PubMed1995

Influence of aging on insulin sensitivity in essential hypertensives and normotensives.

Insulin resistance and hyperinsulinemia have been linked with essential hypertension. Age-associated increases in glucose intolerance and hypertension are also well established. To clarify the influence of aging on the insulin sensitivity, euglycemic hyperinsulinemic glucose clamp technique was carried out in 41 normotensive subjects and 42 patients with essential hypertension. The subjects of these groups were divided into two subgroups: young (< 40 years old) and middle-elderly (> or = 40 years old). Insulin sensitivity was assessed as M-value, the rate at which glucose must be infused to maintain a basal blood glucose level. In normotensive subjects, the young subgroup had a significantly higher M-value than did the middle-elderly subgroup. There was a significant negative correlation between age and M-value in normotensive subjects. On the other hand, there was no significant difference in M-value between the young and middle-elderly subgroups in the patients with essential hypertension. The age did not correlate with M-value in the hypertensive group. The normotensive subjects showed a significantly lower M-value than the hypertensive patients in the young group, but not in the middle-elderly group. These results indicate that 1) insulin sensitivity declines with age in normotensive subjects and that 2) insulin sensitivity is already diminished in the early stage of hypertension, and no further decrease in insulin sensitivity occurs with aging in essential hypertensive patients.

Adult↗
PubMed1995

Renal dopaminergic activity in patients with primary aldosteronism.

To clarify the role of renal dopaminergic activity in patients with primary aldosteronism (PA), urinary excretion of free dopamine (DA) and the conversion ratio of DA from l-dopa in the kidney were investigated in 8 patients with PA and 10 normotensive subjects (NT). All subjects were hospitalized and received a standard diet (Na 120 mEq, K 75 mEq/day) and 2 h renal clearance test was performed. Plasma l-dopa concentration (p-DOPA), creatinine clearance (Ccr), urinary excretion of sodium (UNaV) and DA (uDA) as well as fractional excretion of sodium (FENa) were measured. No significant difference was found in UNaV or FENa between NT and PA, or between before and after adrenalectomy (Adx) in PA. UDA was significantly higher in PA than NT, and decreased significantly after Adx. There was no difference in the product of Ccr X p-DOPA between NT and PA, or between before and after Adx in PA. The ratio of uDA/(Ccr X p-DOPA) was significantly higher in PA than NT. After Adx this ratio decreased significantly to the normal range. These results suggest that (1) renal dopaminergic activity is augmented and contributes to the escape phenomenon in PA, and (2) augmented renal DA production in PA might be caused by an increase of conversion to DA from l-dopa at the renal proximal tubules.

Adenoma↗
PubMed1995

The role of renal natriuretic depressor systems on hypertensive mechanisms in reduced renal mass hypertensive rats.

The pathophysiological role of renal natriuretic depressor systems and endogenous digitalis like factor (EDLF) on blood pressure (BP) elevation was studied in reduced renal mass rats (RRM) with saline loading for a model of volume dependent hypertension. Fifty-four male Sprague-Dawley rats were operated on to remove varying proportions of their kidney mass (5/6 RRM, n = 13; 4/6 RRM, n = 16; 3/6 RRM, n = 12) or sham operated (control, n = 13). They were given 1% saline to drink for 4 weeks. BP was elevated significantly at the 1st week in 5/6 RRM and continued to increase until the 4th week, but this was not seen in the other 3 groups. Urine volume (UV) and urinary sodium excretion (UNaV) increased after saline loading in all groups. Urinary kallikrein excretion was significantly lower in order of the 5/6, 4/6 and 3/6 RRM at the basal state and after saline loading. A significant negative correlation was observed between urinary kallikrein and BP. Urinary PGE2 was increased in each RRM in order of the 5/6, 4/6 and 3/6 RRM groups. A significant positive correlation was observed between urinary PGE2 and BP, UV or UNaV. The basal urinary DA excretion was significantly lower in 3 RRMs than in the control. After saline drinking, urinary DA increased in 3 RRMs, while differences disappeared in the control and RRMs. Urinary EDLF increased immediately after the initiation of saline loading in all groups, except the control group, and returned to the basal level 2 weeks later in 3/6 and 4/6 RRM. Only in 5/6 RRM, the urinary EDLF remained higher than the basal level.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Effects of hyperinsulinemia under the euglycemic condition on calcium and phosphate metabolism in non-obese normotensive subjects.

The effect of acute insulin infusion on the metabolism of calcium (Ca) and phosphate (P) was examined in 17 healthy subjects. They were hospitalized and kept on a constant diet for 5 days, and an euglycemic hyperinsulinemic glucose clamp was applied. Synthetic human insulin was infused at the rate of 40 mU/m2/min for 2 hr, and glucose was also infused to maintain basal glucose levels of each subject. The control study was performed in 8 of the 17 subjects, into whom 10% xylitol was infused for 2 hr at the rate of 100 ml/hr. The plasma insulin concentrations were 7.94 +/- 0.35 and 62.3 +/- 14.3 mU/liter before and after the glucose clamp technique, but serum free Ca ion was increased significantly (p < 0.05), and serum P and serum parathyroid hormone (PTH) were decreased significantly (p < 0.001). Creatinine clearance did not change during the glucose clamp technique. Urinary excretion of Ca (UCaV) was significantly higher after the glucose clamp than the control study. Fractional excretion of Ca (FECa) was increased significantly (p < 0.05), and urinary excretion of P (UPV) and fractional excretion of P (FEP) were decreased significantly (p < 0.05) under the hyperinsulinemic condition. The results suggested that, under the conditions of euglycemic hyperinsulinemia by glucose clamp technique, insulin increased the serum free Ca ion, and as a result, PTH was suppressed. Decreased PTH might induce calciuresis and enhance tubular P reabsorption under hyperinsulinemia. Insulin increased serum free Ca ion might relate to the vasodilating action of insulin by its decrease of intracellular free Ca ion in vascular smooth muscle.

Adult↗
PubMed1995

Significance of renal kininases in patients with primary aldosteronism.

To elucidate the significance of renal kininases in primary aldosteronism (PA), urinary total kininase, kininase I, II and neutral endopeptidase 24.11 (NEP) were examined and evaluated for the regulation mechanisms of these kininases. Total kininase, kininase I and NEP were significantly higher in PA than in normotensives (NT), whereas no difference was found for kininase II. Moreover, 42% of total kininase consisted of unknown kininase(s), different from kininase I, II or NEP. There were significantly positive correlations between plasma aldosterone concentration and total kininase, kininase I and unknown kininase(s) in PA. After the adrenalectomy, urinary kininases decreased into normal ranges, and unknown kininase(s) were negligible. These findings suggested that: 1) kininase I and NEP are accelerated in PA; 2) unknown kininase(s) differing from kininase I, II or NEP may exist in PA; 3) mineralocorticoids may regulate renal kininases; and 4) accelerated renal kininases may play some role in disorders of the renal water-sodium metabolism and in high blood pressure in PA.

Adrenalectomy↗
PubMed1995

Significance of renal kininases in patients with Cushing's syndrome.

To further clarify the significance of renal kininases in patients with Cushing's syndrome, daily urinary excretions of total kininase, kininase I, Ii and neutral endopeptidase 24.11 (NEP) were examined and evaluated for the relations between plasma cortisol level and these kininases. Urinary total kininase kininase I, II and NEP were significantly higher in patients with Cushing's syndrome than in normotensives. There was a significant positive correlation between plasma cortisol level and total kininase or NEP, and the same tendency was observed between plasma cortisol level and kininase I. After adrenalectomy, urinary kininases decreased to normal levels. These findings suggested that: 1) kininase I, II and NEP are accelerated in Cushing's syndrome; 2) glucocorticoids may regulate renal kininases; and 3) accelerated renal kininases may play some role in disorders of the renal water-sodium metabolism and in high blood pressure in Cushing's syndrome.

Adrenalectomy↗