Search PubMed⌕ Search

Biomedical subjects

K Shindo

Publications and source records attributed to K Shindo.

At least 181 records · Page 10Linked to original sources
PubMed1990

[Calf impedance plethysmographic evaluation of peripheral sympathetic nerve activity--comparison with microneurographic analysis].

Although the method of impedance plethysmography made it possible to evaluate the vascular resistance of lower extremities, the actual correlation to the sympathetic nerve activity is not known. We performed examinations of microneurography and impedance plethysmography of the lower extremities, in six healthy volunteers, placed on a tilting table. Blood pressure, heart rate, muscle nerve sympathetic activity to calf muscles (microneurography), calf vascular resistance (impedance plethysmography) were simultaneously recorded with increasing angles of the head-up tilting (0, 30, 60 degrees). With the increase of tilting angles, sympathetic nerve activity and the calf vascular resistance significantly increased and these values were statistically correlated to the increase of tilting angles (expressed as sine function). Moreover, a statistically significant positive correlation was observed between the sympathetic nerve activity and vascular resistance. We concluded that the impedance plethysmographic method for measurement of calf vascular resistance is a good indicator for evaluating the peripheral sympathetic nerve activity.

Adult↗
PubMed1990

[123I-iodoamphetamine single photon emission computed tomography in three patients with amyotrophic lateral sclerosis].

We examined the 123I-iodoamphetamine SPECT for 3 patients with ALS, who were clinically diagnosed. Patient 1 was a 31-years-old man, who had bilateral muscle weakness of his upper extremities, and spasticity in lower extremities. Patient 2 was a 51-years-old woman, who had marked weakness of her upper extremities and bulbar sign. Patient 3 was a 68-years-old man, who had severe degree of marked weakness of his upper extremities and mild bulbar signs. Cerebral cognitive function were all normal in three patients. Computed tomographic and magnetic resonance imagings showed moderate degree of cortical atrophy in patient 1, but no abnormalities in patients 2 and 3. In 123I-IMP SPECT, however, hypoperfusion were recognized on the bilateral fronto-parietal border zone areas in these three patients with ALS. It was suggested that patients with ALS showed varying degrees of impaired perfusion in the fronto-parietal border zone areas in spite of normal cognitive functions.

Adult↗
PubMed1990

[A clinicopathological study on patients with bladder cancer treated with cystectomy].

A clinical and histopathological investigation was made on 170 patients with bladder cancer who underwent total cystectomy at our institutions between 1982 and 1986. The overall 5-year survival rates of patients with pTis + pTa, pT1, pT2, pT3, pT3b and pT4 were 100, 71.8, 60.7, 39.2, 31.4 and 0% respectively, those of patients with G1, G2 and G3 were 100%, 67.6%, 35.7% respectively. As for histopathological growth and spread pattern (INF), intramural lymphatic invasion (ly) and venous invasion (v), INF beta, INF gamma, ly2, v (+) showed the worst prognosis. These histopathological factors were considered to be closely correlated to each other. Studies on these histopathological factors are very important in planning the subsequent therapy.

Adult↗
PubMed1990

[Impedance plethysmographic evaluation of sympathetic activity to lower extremity].

Impedance plethysmographic analysis was performed in two cases of late cortical cerebellar atrophy (LCCA) and two cases of Shy-Drager syndrome. Blood pressure, heart rate and peripheral hemodynamics (arterial blood flow and vascular resistance of lower extremity) were measured during head-up tilting. In cases of LCCA, there was no decrease of blood pressure by tilting up. Impedance plethysmography showed significant increase in vascular resistance of lower extremity and heart rate was also increased. In cases of Shy-Drager syndrome, however, marked decrease of blood pressure was shown during tilting up, while there was no significant change in heart rate and vascular resistance of lower extremity was decreased. Therefore, in cases of Shy-Drager syndrome, decrease of peripheral sympathetic activity to lower extremity was suggested. Impedance plethysmography of lower extremity is simple, non-invasive and useful method to assess the status of peripheral sympathetic activity.

Aged↗
PubMed1990

[Cefpiramide: antibacterial activity, pharmacokinetics, and clinical evaluation].

We determined MIC values of cefpiramide (CPM) against clinical isolates from 100 patients who were subjected to total hysterectomy between April 1986 and March 1988. We also investigated the concentrations of CPM in uterine tissue and assessed the clinical efficacy of postoperative prophylaxis. 1. Against bacteria isolated from clinical materials the MIC80 values of CPM were as follows: Staphylococcus epidermidis 1.56 micrograms/ml, Enterococcus faecalis 25 micrograms/ml, and Escherichia coli 6.25 micrograms/ml. 2. Peak concentrations of CPM in various tissues and tissue/serum ratios of AUC were as follows: cervix uteri 35 micrograms/g (39.5%), perimetrium 43 micrograms/g (44.9%), endometrium 39 micrograms/g (51.6%), myometrium 28 micrograms/g (26.8%), oviduct 67 micrograms/g (41.9%), and ovary 27 micrograms/g (45.8%). In all tissues examined CPM concentrations were above 4 micrograms/g after 600 minutes. 3. Serum half-lives were T 1/2(alpha) = 13.2 minutes and T 1/2(beta) = 260.2 minutes. 4. The efficacy rate in postoperative prophylaxis was 97.9%. 5. No serious side effects were observed.

Bacterial Infections↗
PubMed1990

[Long-term follow-up results of TUL (transurethral ureterolithotripsy)].

We experienced 112 cases of urolithiasis treated with transurethral ureterolithotripsy (TUL) between December, 1985 and September, 1988. We analyzed 35 patients treated with TUL and who had come to our hospital to be examined by cystography, renal ultrasonography, plain X-ray, and urinalysis more than 3 months later. The follow-up term ranged from 3 to 30 months after TUL. The patients were treated using a 12Fr Stortz rigid lithotripter or flexible uretero-fiberscope with electrohydraulic lithotripter. Urinalysis, kidney-ureter-bladder X-ray (KUB), ultra-sonography and cystogram were the main disciplines for follow-up. Urinalysis revealed 4 cases of hematuria, 3 cases of hematopyuria and 2 cases of pyuria. KUB showed no newly formed stones, but 2 cases of ureteral stones had moved from the kidneys. Renal ultrasonography demonstrated no hydronephrosis of operated side, except for 1 case of mild hydronephrosis, who had had severe hydronephrosis preoperatively. We searched for vesicoureteral reflux (VUR) in 34 of the long-term follow-up patients after TUL, but no VUR was seen on their cystograms. No significant late complications of TUL were observed. No harmful effects of ureteral dilation during transureteral operation were found even in long-term follow-up patients.

Adult↗
PubMed1989

The deconjugation ability of bacteria isolated from the jejunal fluids in the blind loop syndrome with high 14CO2 excretion--using the breath analysis technique and thin-layer chromatography.

Five patients with blind loop syndrome (Billroth II) were examined by measuring 14CO2 specific activity of expired breath samples taken at intervals after a meal containing glycine-1-14C cholate. The 5 patients tested showed a marked increase of 14CO2 specific activity. Furthermore, the ability of deconjugation of bacteria isolated from the jejunal fluids in the efferent loop of these patients was tested by thin layer chromatography. The bacterial species identified from the samples were as follows: enterococcus, Lactobacillus (L) buchneri, L. bifidus, L. brevis, Eubacterium (E) lentum, Bacteroides (B) vulgaricus, B. filamentosum, Corynebacterium (C) granulosum, Escherichia (E) coli, Staphylococcus (S) epidermidis, and Aerobacter (A) aerogenes. These species of bacteria, except E. coli and A. aerogenes, showed the deconjugation ability by which conjugated bile acids in ox gall was hydrolyzed. Administration of chloramphenicol (1g per day for 14 days orally divided doses) to the 5 patients reduced 14CO2 specific activity significantly. On the other hand, 9 healthy men (control subjects) who were tested showed a flat curve, and 8 of the 9 had no growth of bacteria isolated from the jejunal fluids. The remaining healthy man showed an overgrowth of E. coli and Pseudomonas (P) aeruginosa, but the species did not have the ability of deconjugation. Thus, we concluded that the patients with blind loop syndrome(Billroth II) had the bacterial overgrowth in the efferent loop that contained species with deconjugation ability, and, as a result the bacterial overgrowth contributed to causing abnormalities (increased deconjugation) in the metabolism of bile acids in the small intestine. When the concentration of conjugated bile acids in the small intestine was reduced to levels below the critical micellar concentration by several factors, fat malabsorption and subsequent steatorrhea were induced (1,-4). Furthermore, H. Fromm and A. F. Hofmann presented in vivo that the patients with blind loop syndrome had fat malabsorption and the patients who had a high 14CO2 output after oral administration of glycine-1-14C cholate showed a low 14CO2 output after oral administration of antibiotic drug (5,6). However, there has been no report on the deconjugation ability of bile acids of bacteria isolated from the jejunal fluids in the efferent loop of patients with Billroth II who had positive breath tests.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacteria↗
PubMed1989

Factors affecting postoperative ventilatory support in patients with cardiac cachexia.

Factors affecting early v late weaning from ventilatory support after cardiac surgery were retrospectively compared in 15 patients with cardiac cachexia. These patients were divided into two groups based on the duration of postoperative ventilatory support, group I (n = 7) less than two days (22 +/- 8 hours) and group II (n = 8) over three days (140 +/- 125 hours). Findings in 14 randomly selected patients without cardiac cachexia who underwent cardiac valve replacement were also examined. Comparisons were made between the groups in regards to the following parameters: (1) preoperatively: anthropometric, biochemical, and immunologic parameters of nutritional status, hepatic function, cardiothoracic ratio (CTR) on chest x-ray, and data from cardiac catheterization; (2) intraoperatively and postoperatively: anesthetic drugs, duration of surgery, cardiopulmonary bypass (CPB), aortic cross-clamp, and postoperative use of inotropes. The anthropometric measurements, cell-mediated immunity, and hepatic function were significantly decreased in all patients with cachexia, but with no significant differences between the groups. Serum transferrin levels, which increased in patients with cachexia, showed no significant difference between the groups. The levels of serum albumin were significantly lower in cachectic patients than in patients without cachexia; they were significantly higher in group II than in group I. The durations of surgery and CPB were significantly longer in group II, but there was no significant difference in the duration of aortic clamping between the groups. The postoperative use of inotropes was higher in group II. These results indicate that group II patients were nutritionally as well sustained as group I. However, they had less satisfactory cardiac function, and therefore required a longer duration of postoperative ventilatory support.

Blood Pressure↗
PubMed1989

A case of spontaneous rupture of ureter due to ureteral stone in G syndrome.

A case of spontaneous rupture of ureter with formation of urinoma due to ureteral stone, which was noticed in an infant with G syndrome, is described. Investigation revealed that the patient had bilateral vesicoureteric reflux. The urinary tract anomalies in G syndrome are discussed.

Abnormalities, Multiple↗
PubMed1989

Granulocytopenia and thrombocytopenia associated with combination therapy of amphotericin B and low-dose flucytosine in a patient with cryptococcal meningitis.

A patient was admitted complaining of fever and headache. He was suspected of meningitis due to nuchal rigidity, and a lumbar puncture was performed. The patient was diagnosed as having cryptococcal meningitis, as Cryptococcus neoformans was found in an India ink preparation of the cerebrospinal fluid. Both amphotericin B and low-dose flucytosine (50 mg/kg/d) were concomitantly administered to the patient and his clinical symptoms improved. However, the combination therapy induced granulocytopenia and thrombocytopenia, which resolved after discontinuance of the drugs. Amphotericin B alone failed to cause granulocytopenia or thrombocytopenia. These results suggest that the mechanisms of granulocytopenia and thrombocytopenia may be toxic reactions to flucytosine in the azotemic state caused by amphotericin B. Our report emphasizes the need for clinicians to monitor for granulocytopenia and thrombocytopenia in patients receiving treatment with both amphotericin B and flucytosine, even when flucytosine is administered in a low dose.

Adult↗
PubMed1989

[Study of long-survival cases with liver metastasis of colorectal cancer by hepatic arterial infusion chemotherapy].

We performed arterial infusion chemotherapy through hepatic artery in 33 patients with liver metastasis of colorectal cancer. Regarding the survival rate, the 1-year survival rate was 55.6% and the 5-year rate was 27.8% in cases of H2, and 1-year as 28.9% in H3. According to criteria of Saito-Koyama, the response rate was 24.2%, including 2 CR and 6 PR cases. There were more patients with H2 factor and without peritoneal dissemination who survived for one year and more. The dose of 5-FU was 9.6 +/- 3.6 g in case of longer survivals and 5.1 +/- 3.0 g in non-responders. There were significant differences between them. The pretreatment value of CEA was lower than 100 ng/ml in 8 of 11 longer survivals, and the CEA values were decreased after this treatment in 9 of 11 responders. On the other hand, it was noted that the non-responders had a higher level of CEA such as more than 100 ng/ml, and in these cases CEA was not decreased after treatment. There are two favourable responders who are still living 9 and 5 years after successful treatment. Their pretreatment value of CEA was lower at 13.6 and 23.8 ng/ml, respectively, and these levels were decreased to 1.0 ng/ml with administration of 5-FU with ADM and 5-FU with MMC. It was concluded that arterial infusion chemotherapy was good for treatment of metastatic liver tumors from colorectal cancers.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Clinical evaluation of second-look operations in colorectal cancer].

The second look operation (SLO) for early detection of recurrent tumor is indicated rarely because of the advance in diagnostic techniques such as imaging radiology, tumor marker serology and colonofiberscopy. The SLO was performed in 21 out of 362 curative cases of colorectal cancer resected in our department; 13 for re-elevation of plasma CEA level (Group 1), 6 for unclear symptoms or signs (Group 2) and 2 for postchemotherapy or postirradiation (Group 3). Liver metastases were found in four cases in group 1 and two in group 2. Nothing was found in three cases in group 1 and two in group 2. In group 3 the radical operation was carried out in all cases following SLO with good survival results. In group 1 and 2 the excisional rate of liver metastases in 57%, its salvage rate 75%, and the excisional rate of the lymph nodes is 50%, with a salvage rate of 100%. The SLO today is indicated for cases of asymptomatic re-elevation of CEA titer, for cases of undeterminable signs or for cases of postchemotherapeutic or postirradiation improvement.

Adult↗
PubMed1989

[Sleep apnea in well-controlled myasthenia gravis].

UNLABELLED: Polygraphic monitoring of the respiratory status during sleep provides a definitive test for the presence of the sleep apnea syndrome. This syndrome has been recognized in various kinds of neurological disorders. However, as far as we know, there have been no reports of describing the sleep apnea syndrome in myasthenia gravis (MG). We conducted overnight polygraphic sleep studies of 10 patients of clinically well-controlled MG. PATIENTS: We examined 10 patients of MG (4 men and 6 women). The subtypes of MG were IIA(1), IIB(8) and V(1) according to Osserman's criteria. RESULTS: Six patients, with an average age of 47.8 and the average duration of 6.2 years, had polysomnographically obstructive and central types of sleep apnea, appearing longer than 10 seconds and more than 30 times in one night. Their mean Apnea Index (AI) was 14.6. The duration of mean apnea was 23.4 seconds and 99.0 times the average frequency. On the other hand, in four patients of MG, averaged age at 30.8 and for a 0.9-year duration, the sleep apnea syndrome was never seen. Therefore, the longest duration of MG tended to have the sleep apnea syndrome. DISCUSSION: Six out of the 10 patients of MG had obstructive and central types of the sleep apnea syndrome. Since their respiratory functions examined in a daytime were normal and the physical findings concerned with MG were well controlled by medications, our findings of nocturnal sleep apnea might be indicative of a central cholinergic system disturbance in MG during sleep.

Adult↗
PubMed1988

BCG induced killer cell activity.

To investigate the mechanism of Bacillus de Calmette Guérin (BCG) bladder instillation therapy, the killer cell activity induced in peripheral blood mononuclear cells (PBMNCs) after BCG instillation was examined. Significant cytotoxic activity against natural killer (NK) cell resistant target tumor cells was detected after 3 days of instillation. To characterize this BCG induced cytotoxic activity further, human PBMNCs were cultured with BCG in vitro. From 24 h maximum cytotoxicity was obtained and continued for 3 days, then decreased slightly. Neither a DNA synthesis inhibitor Cytosine-arabinoside (Ara-C) nor a cytotoxic T cell (CTL) generation inhibitor Cyclosporine A inhibited this killer cell activation. Monoclonal antibody treatment revealed that both precursor and effector cells are Leu1-, 3a-, 7+, 11b+. The recognition specificity from cold target competition experiments was selective. Taken together NK type precursor was activated with BCG into NK type effector which has wider spectrum of target cells than usual NK cell.

Cyclosporins↗
PubMed1988

[A clinico-statistical study of testicular tumors--a reevaluation of 90 cases at the Nagasaki University Hospital and affiliated hospitals].

We have treated 90 cases of testicular tumors at our institutes from April, 1962 to March, 1986. Of 75 which were germ cell type tumors, 35 were a seminoma, for which the 5-year survival rate was 100% for patients in stage I, and 50% for those in stage III, respectively. Forty cases were non-seminomas, and all cases determined as being in stage I survived for 5 years, whereas 47.6% cases of those in stage III survived for 4.5 years. Thirty-six percent of those with a stage I germ cell tumor were treated with a orchiectomy alone, while other cases also combined radiotherapy and/or chemotherapy. Almost all cases of an advanced tumor received combined retroperitoneal lymph node resection, radiotherapy and/or chemotherapy. Patients with an advanced nonseminomatous tumor showed better a survival rate if they were given CDDP chemotherapy.

Dysgerminoma↗