Search PubMed⌕ Search

Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

At least 397 records · Page 22Linked to original sources
PubMed1995

[Urinary incontinence in elderly patients in the chronic stage of stroke].

One hundred and six elderly patients with chronic stroke who were admitted to Seiai Rehabilitation Hospital were studied regarding urinary incontinence. The average age of the subjects was 74 +/- 8 years old, ranging from 60 to 94 years. Seventy three of the 106 patients (69%) had urinary incontinence which was found in 72% of brain infarction, 61% of brain hemorrhage and 67% of subarachnoid hemorrhage. The prevalence of urinary incontinence in cases of brain stem, thalamic, and putaminal hemorrhage was 80%, 67% and 46%, while that in cases of cortical infarction and infarct of perforating arteries was 84% and 68%, respectively. The rate of urinary incontinence was significantly higher in those aged 75 years or over (p < 0.05), those with poor activities of daily living (ADL, p < 0.005), or with dementia (p < 0.001). Dementia was a complicating factor more frequently in aged patients (p < 0.05) and in those with poor ADL (p < 0.001), although no correlation was seen between age and ADL (p = 0.08). These results indicated the high prevalence of urinary incontinence in elderly inpatients with chronic stroke, which is significantly related to impairment of mental and physical activities.

Activities of Daily Living↗
PubMed1995

Matrix-associated latent TGF-beta with latent TGF-beta binding protein in the progressive process in adriamycin-induced nephropathy.

BACKGROUND: A progressive increase in latent transforming growth factor-beta (TGF-beta) secretion from diseased tissue was revealed in our previous work using adriamycin (ADR)-nephropathy (Kidney Int 45:525-36, 1994). Latent TGF-beta is composed of mature TGF-beta and latency-associated peptide (LAP) with or without latent TGF-beta-binding protein (LTBP). LTBP has been reported to contribute to either matrix-association or activation of latent TGF-beta. LTBP also seems to play a key role in the renal lesions of this model. The present study was designed to show the secretion of latent TGF-beta with LTBP and the location of LTBP in renal tissue in ADR-nephropathy. EXPERIMENTAL DESIGN: The renal cortical tissue specimens were sampled at Weeks 4, 8, and 16 after the injection of ADR or saline (control) for cortical tissue culture and immunohistology. TGF-beta in the conditioned medium was assayed by immunoprecipitation and bioassay using mink lung epithelial cells. An immunohistochemical study was performed to examine the localization of LTBP, ED-1-positive macrophages, and extracellular matrix proteins including laminin, fibronectin, and collagen type I and type III. RESULTS: A TGF-beta bioassay revealed a progressive increase in latent TGF-beta secretion from the cortex of diseased kidney. Free LTBP and LTBP-LAP complex with mature TGF-beta were immunoprecipitated by anti-LTBP Ab from the cortical culture medium. An immunohistochemical study using anti-LTBP Ab demonstrated that LTBP localization was restricted to the glomeruli and the arterioles in the control cortex. In the ADR rats at Week 4, a faint deposition of LTBP was observed in the interstitium around the glomeruli. At Week 8 or 16, LTBP was accumulated in the sclerosing glomeruli or fibrous interstitium, where ECM proteins and infiltrating ED-1-positive macrophages were intensely located. CONCLUSIONS: Our results indicated that latent TGF-beta with LTBP was localized in association with the extracellular matrix in the sclerotic and fibrotic tissue in this model. Matrix-associated latent TGF-beta with LTBP may thus play an important role in the progressive process of glomerulosclerosis and interstitial fibrosis in ADR-nephropathy.

Animals↗
PubMed1995

[Laboratory findings in patients with Yusho: 26 year follow-up study].

To evaluate chronic effect of PCBs on laboratory findings, peripheral blood cells and biochemical parameters were studied in 74 patients with Yusho in 1994. Serum level of triglyceride was elevated in 21 cases (28.4%) of these patients. Serum triglyceride levels showed statistically significant correlation with body mass index (Quetelet Index) and blood PCB concentration. We conclude that hypertriglyceridemia in patients with Yusho is not frequent and it may be associated with both obesity and blood PCB concentration.

Adult↗
PubMed1995

Ambulatory blood pressure monitoring in elderly hypertensives treated with the new calcium antagonist, pranidipine (OPC-13340).

Pranidipine (OPC-13340), a new dihydropyridine calcium antagonist, was given to 9 elderly hypertensive inpatients aged 64-79 years. Once-daily administration of pranidipine (1-2 mg) for 1-2 weeks decreased the 24-h average BP significantly from 167/92 mmHg to 150/83 mmHg without any change in pulse rate (PR) or the variabilities of BP and PR. The reduction of BP was observed exclusively during daytime (171/95 mmHg to 153/86 mmHg, p < 0.01 for SBP, p < 0.05 for DBP), while BP reduction during nighttime was significant only for DBP (157/84 mmHg to 146/79 mmHg, p > 0.05 for SBP, p < 0.05 for DBP). The analysis of the circadian rhythm by the cosinor method revealed that the acrophases of BP and PR were not changed significantly by the treatment with pranidipine. No adverse effects such as flushing and headache developed during the treatment. These results suggest that once-daily treatment with pranidipine is safe and exerts a sufficient antihypertensive effect during daytime with mild reduction of nighttime BP in elderly hypertensives. Furthermore, it does not alter the circadian patterns or variabilities of BP and PR. Thus, pranidipine may be useful as a monotherapy for elderly hypertensives.

Aged↗
PubMed1995

Evidence for an immunological pathogenesis of thrombocytopenia in chronic liver disease.

OBJECTIVES: To elucidate the role of platelet-associated IgG (PA-IgG) in the mechanism of thrombocytopenia associated with chronic liver disease. METHODS: Platelet count in blood, PA-IgG, and scintigraphic spleen/liver ratio as a marker of splenomegaly was examined in 214 individuals, including 16 controls showing nonspecific reactive change in liver biopsy and 198 patients with chronic liver disease. RESULTS: The mean blood platelet count decreased significantly according to severity of liver disease, from control to liver cirrhosis. PA-IgG levels increased significantly in relation to severity of liver disease, as did spleen/liver ratio. In chronic hepatitis or liver cirrhosis, an inverse correlation was found between platelet counts and PA-IgG levels. An inverse correlation was also observed between platelet count and spleen/liver ratio in liver cirrhosis. The splenic embolization resulted in a significant rise in platelet count and a significant fall in PA-IgG in the 14 cirrhotic patients. CONCLUSIONS: These results may give support to evidence for an immunological mechanism mediated by PA-IgG for the thrombocytopenia occurring in chronic liver disease. In the case of liver cirrhosis, this mechanism would act in addition to platelet pooling in the spleen on thrombocytopenia. PA-IgG may also have an important role in thrombocytopenia associated with chronic hepatitis, in which splenic platelet pooling is less marked.

Adult↗
PubMed1995

[A diabetic patient with bilateral carotid stenosis who developed neovascular glaucoma following cataract surgery].

A 67-year-old diabetic man suffered from right neovascular glaucoma following the ipsilateral cataract surgery. Three years later, he underwent left cataract surgery and again developed left neovascular glaucoma after the operation. Fluorescein angiogram showed a marked delay in retinal circulation. Moreover, severe stenosis of bilateral carotid origins and reflux of bilateral ophthalmic arteries were ascertained by neurosonographical examination such as duplex cervical echography and transcranial Doppler, as well as an angiogram. Brain imaging demonstrated asymptomatic watershed infarction in the left parieto-occipital cortex. Chronic ocular ischemia caused by carotid stenosis is one of the decisive risk factors for secondary glaucoma after cataract surgery. Preoperative neurosonographical screening tests are required to decrease ocular surgery complications, especially in the aged, and diabetic patients.

Aged↗
PubMed1995

[Clinical application of magnetoencephalography for brain infarction].

Magnetoencephalography (MEG) is a noninvasive functional imaging technique that provides information regarding neuronal activity with high spatial resolution. Analyses of spikes and slow waves in various brain disorder have performed using spontaneous magnetic field, and functional mapping studies have performed using evoked magnetic field. The goal of this study was to determine the characteristics of MEG findings in these two magnetic fields for ischemic stroke patients. In the first examination, we recorded the spontaneous magnetic activity with a 37-channel neuromagnetometer and counted the number of equivalent current dipoles (neuromagnetic sources) which were divided into 6 groups with different frequencies of every 4 Hz. There were much more dipoles below 8 Hz in stroke patients than in normal controls, which tended to distribute in the hypoperfusion area near the infarct. In the second examination, we recorded auditory evoked responses for tone burst stimuli and analyzed the localization of dipoles for the 100-m.sec. component after the onset of the stimuli. The dipoles lay near the Heschl gyrus in most of control group. On the contrary, they often distributed apart from the Heschl gyrus in stroke patients with severely damaged regional oxygen metabolism measured by positron emission tomography, indicating an inappropriate response for auditory stimuli. In conclusion, MEG brought interesting informations for the brain function of stroke patients.

Brain↗
PubMed1995

[Transient achromatopsia caused by cardioembolic brain ischemia].

A 51-year-old right-handed man with dilated cardiomyopathy, sleep apnea and atrial fibrillation suddenly suffered from transient color imperception, which completely recovered next morning. During the attack, both color naming and color pointing were severely disturbed, while he could correctly state the colors of named objects. There were no additional neuropsychological disturbances such as aphasia, alexia and prosopagnosia. Brain MRI revealed a new ischemic change, i.e. laminar cortical necrosis, in the right fusiform gyrus as a causative lesion as well as old asymptomatic infarcts in the left middle cerebral arterial territory. Cardioembolism was considered to be responsible for the development of brain ischemia. The transient achromatopsia is a rarely reported disease and this case appears to support 'ischemia' as its etiology.

Brain Ischemia↗
PubMed1994

A clinicopathologic study of small flat colorectal carcinoma.

BACKGROUND: Recent studies have noted that small flat carcinomas do exist in the human colon, but their clinicopathologic features have not been fully delineated. METHODS: A clinicopathologic study of 62 flat colorectal carcinomas (FCC) and 80 polypoid colorectal carcinomas (PCC) was performed. FCC were defined for the study as colorectal adenocarcinomas confined to the mucosa or submucosa, macroscopically characterized as slightly elevated, often nearly flat, and sometimes with central shallow depressions. RESULTS: In intramucosal and submucosal invasive carcinomas, the mean size of FCCs was significantly smaller than that of PCCs, (P < 0.001). When compared with PCCs, FCCs were found more often in the proximal colon, less frequently well differentiated, and had fewer adenomatous remnants. In submucosal invasive cases, FCCs showed more frequent deep invasion (67 versus 32%, P < 0.05) and lymphovascular permeation (41% versus 16%, P < 0.05) compared with PCCs. CONCLUSIONS: These results suggest that FCCs are characterized by frequent deep invasion with lymphovascular permeation even when small, and that they may be more prevalent away from the rectosigmoid area.

Adenocarcinoma↗
PubMed1994

Hypercoagulable state under low-intensity warfarin anticoagulation assessed with hemostatic markers in cardiac disorders.

The hemostatic condition under low-intensity anticoagulation in cardiac disorders is not fully elucidated. The aim of this study was to ascertain whether hemostatic molecular markers are a useful assessment for anticoagulation to detect the hypercoagulable state. A hematologic study was performed in 75 outpatients, without thromboembolic episodes, treated with low-intensity anticoagulation (average international normalized ratio [INR] 1.72) because of potential cardiac sources of arterial emboli, and in 40 age-matched control subjects. The average level of thrombin-antithrombin III complex (TAT) was significantly lower in patients than in control subjects (p = 0.005), and the mean value of D-dimer was not statistically different between patients and control subjects. Although TAT correlated moderately with D-dimer (r = 0.45, p = 0.0001), INR did not correlate with TAT or D-dimer. Elevated TAT > 3.0 ng/ml and/or D-dimer S 150 ng/ml were observed in 15 patients (20.0%), whereas the remaining 60 patients (80.0%) had no obvious increase in the level of TAT or D-dimer at overall INR. Antithrombin III activity did not correlate significantly with INR, but protein C activity and free protein S antigen showed a significant negative relation to INR (r = 0.82, r = 0.62, respectively, p = 0.0001). Low-intensity anticoagulation was sufficient to reduce coagulation and subsequent fibrinolytic activation in cardiac disorders, but may not be sufficient in some patients with elevated TAT or D-dimer concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Antithrombin III↗
PubMed1994

Early detection of nonpolypoid cancers in the rectal remnant in patients with familial adenomatous polyposis/Gardner's syndrome.

BACKGROUND: Invasive cancer occurs in the rectal remnant of patients with familial adenomatous polyposis (FAP). METHODS: A long term surveillance proctoscopy program was performed on 25 patients with an established diagnosis of FAP or Gardner's syndrome. RESULTS: The surveillance revealed small nonpolypoid cancer of the rectal remnant in two patients. One cancer, which measured 5 mm, was restricted to the mucosa, whereas the other, measuring 10 mm at its greatest dimension had invaded the submucosa. On proctoscopy, both the lesions were characterized by a reddish depression, surrounded by marginal elevations. Both of these cancers were composed of well differentiated adenocarcinoma without any adenomatous component. CONCLUSIONS: The authors' experience suggests that nonpolypoid cancers do exist in FAP/Gardner's syndrome and that careful follow-up seems necessary in patients with a diagnosis, especially in consideration of the possible development of nonpolypoid lesions.

Adenocarcinoma↗
PubMed1994

Postoperative recurrence in patients with intestinal Behçet's disease.

PURPOSE: The postoperative course of intestinal Behçet's disease was studied in nine patients who had undergone a total of 15 operations due to intestinal ulcers. METHODS: These patients were followed up for an average of 6.0 years (range, 1 year, 3 months to 13 years, 10 months) after each operation and they were repeatedly examined by double-contrast radiography and/or colonofiberscopy. RESULTS: Recurrence of intestinal ulcers was observed in 12 (80 percent) of the 15 surgical cases. The incidence (50 percent) of postoperative recurrence in six cases in which intraoperative endoscopy revealed no abnormality in the retained intestine was lower than that (100 percent) in nine cases without this examination. Recurrent intestinal lesions in most cases were demonstrated as multiple aphthoid ulcers in the ileum near the ileocolectomy, or as one or two deep ulcers at the ileocolectomy site. The recurrent ulcers were successfully treated by various medical therapies, but the effectiveness of these therapies was only temporary. CONCLUSION: In the case of this disease, intraoperative endoscopy may be useful for preventing postoperative recurrence and periodic follow-up examination with radiography and endoscopy should be performed, even after surgery.

Adult↗
PubMed1994

Role of nonpolypoid neoplastic lesions in the pathogenesis of colorectal cancer.

PURPOSE: The aim of this study was to investigate the role of nonpolypoid neoplastic lesions of the colorectum in the pathogenesis of colorectal cancer. METHODS: We retrospectively compared the incidence of cancer between polypoid and nonpolypoid lesions detected by colonoscopy during the period of 1991 to 1992. RESULTS: Of the 686 lesions in 336 patients included in the investigation, 644 lesions were regarded as polypoid, either sessile, semipedunculated, or pedunculated, while 42 lesions were recognized as small nonpolypoid lesions characterized by minimal elevation with depression on colonoscopy. The incidence of cancer in adenoma or pure cancer was significantly higher in the nonpolypoid lesions (19.0 percent) than in the polypoid lesions (6.8 percent, P < 0.01), especially in the lesions found in the rectum or in the sigmoid colon. In addition, all 8 nonpolypoid cancers were pure cancers, whereas 26 of the 44 polypoid cancers contained adenoma. The nonpolypoid cancers were smaller and they invaded the submucosa more frequently than did the polypoid cancers. CONCLUSIONS: Nonpolypoid lesions are more likely to be a precursor of advanced cancer in the colorectum than usual polyps. Colonoscopists should strive hard to detect these lesions with a view to cancer surveillance, even though they are generally found less frequently than polyps.

Adenoma↗
PubMed1994

Preventive effect of immunosuppressive agents against indomethacin-induced small intestinal ulcers in rats.

The mechanism of nonsteroidal antiinflammatory drug-induced intestinal ulcers is not clearly understood. To evaluate whether immunosuppressants have a preventive effect against indomethacin-induced gastrointestinal damage, we investigated the effects of prednisolone, cyclosporin, and the newly developed immunosuppressant FK-506 in intracolonically indomethacin-treated rats: 24 mg/kg of indomethacin, administered intracolonically for two days, caused gastric ulcers and two types of small intestinal ulcers (longitudinal ulcers and scattered small ulcers). Pretreatment with intraperitoneal immunosuppressants reduced the size of gastric ulcers. Both cyclosporin (10 mg/kg) and FK-506 (1 mg/kg, 2 mg/kg) treatments significantly reduced the incidence and the length of the longitudinal ulcers of the small intestine when compared to the vehicle-treated controls, whereas prednisolone (20 mg/kg) did not show any preventive effect. Furthermore, the number of small scattered ulcers of the small intestine was significantly reduced by the high dose of FK-506 (2 mg/kg), but not by cyclosporin or prednisolone. These findings indicate that immunosuppressants have protective and antiinflammatory effects in indomethacin-induced gastroenteropathy, suggesting that cytokines may be important mediators in the pathogenesis of enteropathy induced by nonsteroidal antiinflammatory drugs.

Animals↗
PubMed1994

Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis.

We report two cases of urogenital malignancies, prostatic cancer in a 72-year-old man and urinary bladder carcinoma in a 50-year-old man, that developed during maintenance haemodialysis. The former patient responded to hormonal therapy with diethylstilboestrol and is still alive on maintenance haemodialysis, but the latter patient did not respond to treatment, being past cure in the far advanced stage. There are few clinical symptoms suggesting the existence of urogenital malignancies in dialysis patients and screening methods such as urine cytology or roentgenology must be restricted because of extremely reduced urine volume. However, the high incidence of urogenital malignancies in such patients is well recognized. Screening examinations with ultrasonography and/or CT scan following digital rectal examination or testing for serum prostate-specific antigen should be performed at least every 6 months.

Aged↗
PubMed1994

Inhibitory effects of antihypertensive drugs on mesangial cell proliferation after anti-thymocyte serum (ATS)-induced mesangiolysis in spontaneously hypertensive rats.

The effects of antihypertensive drugs on mesangial cell proliferation were studied in spontaneously hypertensive rats (SHR) with anti-thymocyte serum (ATS)-induced glomerulo-nephritis. Rats were treated with either enalapril (Group 1), nifedipine (Group 2), or reserpine + hydrochlorothiazide + hydralazine (Group 3), or were untreated (Group 4). The animals were sacrificed 2, 4 and 7 days after ATS injection and the glomerular cell number and degree of mesangial area expansion were examined. A marked, similar decrease in glomerular nuclear cell number (NC) due to severe mesangiolysis was observed in all of the groups on day 2. Thereafter, an increase in NC reflecting mesangial cell proliferation after mesangiolysis occurred in Group 4 on days 4 and 7. In Group 1 and 2, the NC was significantly smaller than that in Group 4 on days 4 and 7, indicating suppression of mesangial cell proliferation. In Group 3, however, the number of NCs did not differ from that in Group 4 on days 4 and 7, indicating a lack of such suppression by conventional antihypertensive drugs. The degree of mesangial area expansion (MS) showed the same pattern as mesangial cell proliferation. That is, the rapid increases in MS seen in Group 4 on days 4 and 7 were apparently suppressed in Groups 1 and 2, but not in Group 3. Our in vivo observations that both an angiotensin converting enzyme (ACE) inhibitor and a calcium channel blocker suppress mesangial cell proliferation and mesangial area expansion suggest that these agents have practical implications in the treatment of mesangial proliferative glomerular diseases through the suppression of excess mesangial cell proliferation.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1994

Spontaneous remission of diabetes arrests progression of nephropathy in streptozotocin-treated spontaneously hypertensive rats.

Although antihypertensive therapy retards the progression of diabetic nephropathy associated with hypertension, it is not known whether glycemic control reverses or arrests diabetic nephropathy under untreated hypertension. We previously reported that spontaneous remission of diabetes occurred in the neonatal streptozotocin (STZ) model of spontaneously hypertensive rats (SHR) after 28 weeks of age, whereas hypertension persisted. Thus, we studied diabetic nephropathy before and after the recovery from hyperglycemia in this model. Two-day-old male SHR were injected intraperitoneally with STZ or vehicle for control. Hypertension was developed and maintained in both STZ and control groups in a similar degree. Before the amelioration of hyperglycemia, urinary albumin excretion increased progressively in STZ-treated SHR as compared with control (24 weeks; 1.6 +/- 0.5 mg/day, 17.5 +/- 2.3 mg/day, P < 0.001), and renal and glomerular hypertrophies were seen with mesangial expansion in STZ-treated SHR. However, along the recovery from hyperglycemia, urinary albumin excretion did not increase in the STZ-treated group, while it consistently increased in the control group (52 weeks; 25.4 +/- 10.0 mg/day, 29.7 +/- 11.4 mg/day, not significant). Furthermore, there were no significant differences in renal weight, glomerular tuft area, and the incidence of glomerular sclerosis between the two groups at 52 weeks of age. This study suggests that glycemic control may be effective for diabetic nephropathy even in the coexistence of untreated hypertension.

Aging↗