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Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

At least 451 records · Page 25Linked to original sources
PubMed1994

Effects of lysosomal protease inhibitors on the degradation of acetylated low density lipoprotein in cultured rat peritoneal macrophages.

The effect of protease inhibitors, leupeptin and pepstatin A, on the metabolism of acetylated low density lipoprotein (acetyl-LDL) was investigated in cultured rat peritoneal macrophages and compared with that of chloroquine. While both leupeptin and pepstatin inhibited the proteolytic degradation of 125I-acetyl-LDL, a combination of both showed an additive effect. Similar to chloroquine, both protease inhibitors diminished [3H] oleate incorporation into cellular cholesteryl[3H] oleate and increased cholesterol content of macrophages. These results suggest that both thiol protease and cathepsin D participate in the physiological degradation of apolipoprotein in macrophages. The inhibition of apolipoprotein degradation seemed to have an effect on cholesterol metabolism in macrophages cultured with acetyl-LDL.

Acetylation↗
PubMed1994

[An adult case of basal encephalomeningocele with recurrent meningitis].

A 35-year-old man developed meningitis for the first time at the age of 23. Thereafter, he repeatedly suffered from meningitis for six times before he was admitted to our clinic. Each meningitis was preceded by upper respiratory infection. Chronic infection in the head and neck, fracture of the skull base, liquorrhea, Mollaret meningitis, and acquired immunodeficiency were all ruled out. Nasal fiberscope examination revealed a palpating white tumor in the left olfactory cleavage. Coronal CT scanning demonstrated encephalomeningocele at the left ethmoidal cavity. The encephalomeningocele was surgically repaired and the patient has been free from further meningitis. The causal relationship between the encephalomeningocele and recurrent meningitis was discussed.

Adult↗
PubMed1994

[A case of acute idiopathic pandysautonomia complicated with acute pancreatitis and liver injury].

A case of acute idiopathic pandysautonomia (AIPD) complicated with acute pancreatitis and liver injury was reported. A 43-year-old woman acutely developed abdominal pain, low grade fever, lymphoadenopathy and generalized erythema in May 1992. She was found to have autonomic dysfunctions, such as orthostatic hypotension, hypohidrosis, paralytic ileus and urinary retention. A systematic investigation of autonomic function revealed an impairment of both sympathetic and parasympathetic post-ganglionic nerves. Serum concentrations of amylase, lipase, elastase 1, and transaminase and amylase creatinine clearance ratio were elevated in the early stage of the disease. No significant serological findings for viral infections were detected to suggest any special etiology of the disease; the symptoms gradually improved, although incompletely, after several months from the onset. AIPD complicated with acute pancreatitis or liver injury is uncommon. A possible link between undetectable viral infection and AIPD was discussed.

Acute Disease↗
PubMed1994

Hyperinsulinaemia and blood pressure in a general Japanese population: the Hisayama Study.

OBJECTIVES: To study the relationship between serum insulin and blood pressure, as well as the prevalence of hypertension according to the insulin level in a general Japanese population. DESIGN: In 1988 a cross-sectional community survey was conducted among Hisayama residents aged 40-79 years. METHODS: A total of 1073 males and 1407 females (72.5 and 80.5% of the total population, respectively) underwent comprehensive investigation, including a 75-g oral glucose-tolerance test. Fasting and 2-h serum insulin levels were measured by radioimmunoassay. RESULTS: The sum of the fasting and 2-h postloading insulin levels was significantly correlated with the systolic blood pressure (SBP; r = 0.18 and 0.26 for males and females, respectively) and the diastolic blood pressure (DBP; r = 0.24 and 0.19, respectively) in the subjects not receiving antihypertensive drugs. In multiple regression analysis the correlation with blood pressure remained significant in both sexes even after controlling for age, body mass index, alcohol intake, smoking, a family history of hypertension, serum total cholesterol and fasting plasma glucose. The age- and sex-adjusted prevalence of hypertension (SBP > or = 160 mmHg or DBP > or = 95 mmHg, or both, or receiving drug treatment) increased significantly with an increase in the sum of fasting and 2-h postload insulin levels in both the non-obese subjects (body mass index < 25 kg/m2) and the obese subjects (body mass index > or = 25 kg/m2). Multiple logistic regression showed that the sum of fasting and 2-h postload insulin levels was a significant factor with an independent relationship to hypertension, even after taking the other risk factors into account. CONCLUSION: The present study suggests that hyperinsulinaemia is related to hypertension in a general Japanese population.

Adult↗
PubMed1994

Crossover comparison of the effects of enalapril and captopril on potassium homeostasis in patients with mild hypertension.

The effects of two types of angiotensin converting enzyme (ACE) inhibitors, enalapril (long-acting) and captopril (short-acting), on serum electrolytes and circadian rhythm of urinary electrolyte excretions were compared in relation to aldosterone status in patients with essential hypertension and normal renal function. Enalapril (5 mg once daily) and captopril (12.5 mg t.i.d.) were administered to 11 patients for 1 week each in a crossover fashion. Blood sampling in the early morning and 4-hour split urinary sampling for 24 hours were performed on the last day of control and each treatment periods. Enalapril and captopril significantly reduced blood pressure to similar levels. Enalapril but not captopril significantly inhibited plasma aldosterone concentration and urinary aldosterone excretion. Neither drug apparently altered serum or urinary Na levels. Both drugs significantly decreased urinary K excretion (p < 0.05, control: 44 +/- 4 mEq/day, captopril: 39 +/- 2 mEq/day, enalapril: 39 +/- 2 mEq/day; mean +/- SEM), but did not significantly alter serum K level (control: 4.1 +/- 0.1 mEq/l, captopril 4.2 +/- 0.2 mEq/l, enalapril 4.3 +/- 0.1 mEq/l). The circadian rhythm (acrophase) of urinary K excretion was not affected by either drug, while the amplitude was decreased by both, as assessed by the cosinor method. In summary, although enalapril caused more sustained inhibition of aldosterone secretion compared with captopril, both drugs showed similar effects on the K homeostasis in patients with mild essential hypertension.

Aldosterone↗
PubMed1994

Open clinical studies on a new angiotensin II receptor antagonist, TCV 116.

OBJECTIVES: The goals of these preliminary studies were to evaluate the effects of a new angiotensin II receptor antagonist, TCV 116, on the daytime blood pressure profile in hospital inpatients with essential hypertension, and to evaluate the clinical efficacy and safety of this agent in outpatients with essential hypertension. SUBJECTS: In study 1, daytime blood pressure changes were studied in 28 inpatients with mild to moderate essential hypertension (systolic blood pressure > or = 150 mmHg, diastolic blood pressure > or = 90 mmHg). In study 2, 55 outpatients with essential hypertension (systolic blood pressure > or = 160 mmHg, diastolic blood pressure > or = 95 mmHg) were enrolled in a dose-finding study. METHODS: In study 1, after a 1-week placebo run-in period, blood pressure and the pulse rate were measured every 2 h except at night. TCV 116 monotherapy was started at 1 mg/day and increased stepwise at 3- to 5-day intervals to 2, 4 and 8 mg/day until a predetermined reduction in blood pressure was achieved. The daytime profiles of blood pressure and the pulse rate were again monitored at the end of the treatment period. In study 2, after a 4-week placebo run-in period, TCV 116 alone was administered for 2 weeks at 1 mg/day. The dose was then increased to 2 mg/day and stepwise at 2-week intervals to 4 and 8 mg/day until a predetermined reduction in blood pressure was achieved. The total treatment period was 8-12 weeks. RESULTS: In study 1, a sufficient reduction in blood pressure was achieved in 19 of 28 patients (68%), with blood pressure significantly reduced at all measurement points, compared with the placebo run-in period. No differences were seen in the pulse rate. The only adverse reaction reported was a rash in one patient. In study 2, a sufficient reduction in blood pressure was achieved in 42 out of 55 patients (76%). The cumulative efficacy rate increased dose-dependently (15% at 1 mg/day, 38% at 2 mg/day, 60% at 4 mg/day and 76% at 8 mg/day). No differences were seen in the pulse rate. Adverse reactions were reported in three out of 55 patients (5.5%). No dry cough was reported by any of the patients. CONCLUSIONS: TCV 116, an angiotensin II receptor antagonist, has potential as an antihypertensive agent. A dose of 4-8 mg once per day appears to be appropriate for the treatment of patients with mild to moderate essential hypertension.

Benzimidazoles↗
PubMed1994

Hypertension and ageing impair acetylcholine-induced vasodilation in rats.

OBJECTIVE: To investigate the influence of hypertension and ageing on the in vivo effect of acetylcholine on blood pressure and regional vascular conductance and the inhibitory effect of NG-monomethyl-L-arginine (L-NMMA), an inhibitor of nitric oxide synthesis, on the effects of acetylcholine. METHODS: Male spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats aged 3-4, 7-8 and 20-26 months, were anaesthetized with pentobarbital. After sino-aortic denervation, regional blood flow in the left common carotid, superior mesenteric, right renal and right femoral arteries was measured with pulsed Doppler flowmeters. After pretreatment with indomethacin (2 mg/kg intravenously), bolus injections of acetylcholine (0.03, 0.1 and 0.3 microgram/kg intravenously) were given with or without L-NMMA (20 mg/kg intravenously). RESULTS: Dose-dependent hypotensive responses to acetylcholine were significantly smaller in SHR than in WKY rats in each age group. Ageing reduced the hypotensive effect of acetylcholine in both SHR and WKY rats. In rats aged 3-4 and 7-8 months acetylcholine-induced increases in regional vascular conductances were significantly smaller in SHR than in WKY rats. Ageing reduced acetylcholine-induced increases in regional vascular conductances in WKY rats. L-NMMA had little effect on the responses to acetylcholine in both SHR and WKY rats. Sodium nitroprusside had similar effects in SHR and WKY rats and in age groups within each strain. CONCLUSION: The in vivo vasodilatory action of acetylcholine, which appeared to be partly independent of nitric oxide, was impaired by hypertension and age.

Acetylcholine↗
PubMed1994

Clinicopathological study of poststreptococcal glomerulonephritis in the elderly.

In order to characterize the clinical features in elderly patients with poststreptococcal glomerulonephritis (PSGN), 31 patients, who were both histologically and immunologically proven to be PSGN, were divided up into 3 groups according to age; elderly patients being 55 years or older (n = 7), middle-aged patients being 40 to 54 years old (n = 7) and younger patients being 20 to 39 years old (n = 17). Renal functional impairment as indicated by serum creatinine levels of over 2.0 mg/dl, developed in 4 of the elderly patients and later completely improved at the end of the follow-up period (178.9 +/- 150.7 days). On the other hand, none of the middle-aged and younger patients revealed any renal function impairment. Hypertension was observed more frequently in elderly patients than in younger patients, and was 86% and 6% at the time of admission, respectively. In addition, 43% of elderly patients remained hypertensive at the time of discharge. There was no difference in total protein, ASO, CH50, the degree of proteinuria or proliferative and exudative features in renal histology among the three groups. None of the elderly patients with PSGN died or developed persistent renal failure. In conclusion, elderly patients with PSGN had a high incidence of renal functional impairment and hypertension compared to the younger patients on admission, however, their short-term prognosis seems to be favorable.

Adult↗
PubMed1994

[Nephrotic syndrome due to membranous glomerulopathy in hypocomplementemic urticarial vasculitis syndrome;--a case report].

We report a case of hypocomplementemic urticarial vasculitis syndrome (HUVS) with membranous glomerulopathy in a 62-year-old man who had a 2-month history of secondary iritis. He was transferred to our hospital because of uncontrollable edema and respiratory dysfunction. Physical examination revealed anasarca, pulmonary edema, hypertension and urticaria-like eruption on his arms. Urinalysis, blood chemistry and serological studies showed massive proteinuria (10.5g/day) with numerous granular casts, hypoalbuminemia (1.5g/dl), renal dysfunction (creatinine; 1.6mg/dl, BUN; 86mg/dl), hypercholesterolemia (total cholesterol; 455mg/dl), positive results for antinuclear factor, microsome test, thyroid test, lupus anticoaglant, antithyroglobulin test and rheumatoid factor, but LE cell or double-strand anti DNA antibody was negative. Serum complement levels were persistently low as CH50 of 13 U/ml and Clq of 6.0 micrograms/dl. The patient serum precipitated with normal human Clq by immunodiffusion analysis, indicating the presence of anti-Clq antibody. Renal biopsy revealed membranous glomerulopathy with prominent fine granular deposition of Clq along the glomerular basement membrane by immunofluorescent study and subepithelial dense deposit by electron microscopy. Corticosteroid treatment was ineffective for hypocomplementemia and nephrotic syndrome. Acute subendocardial infarction occurred on the 25th hospital day and he died of acute respiratory distress syndrome on the 45th hospital day. Autopsy revealed leucocytoclastic vasculitis in the alveolar wall. HUVS was confirmed by clinical symptoms, such as iritis and urticaria-like eruption, serum anti-Clq antibody, the absence of any specific autoantibody for systemic lupus erythematosus (SLE) and leucocytoclastic vasculitis in the alveolar wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1994

[Hypersplenism in liver cirrhosis].

Hypersplenism is defined as the association of anemia, leukopenia, or thrombocytopenia with bone marrow hyperplasia and splenomegaly. Hypersplenism is common in liver cirrhosis and frequent in patients with portal hypertension. The effects of portacaval shunt are variable; hypersplenism hardly ever improves but rarely develops after surgery. Since the spleen is a major component of the mononuclear phagocyte system, splenectomy reduces antibody synthesis. Although splenectomy abolishes hypersplenism, it may lead to sepsis. Recently, partial splenic embolization, using gelform injected directly into the splenic artery, has been performed in patients with cirrhosis. Partial splenic embolization induces an increase in the number of circulating blood cells. In addition, the levels of albumin, hepaplastintest, cholesterol and cholinesterase are increased significantly after treatment. Partial splenic embolization rarely causes problems and may actually be beneficial.

Anemia, Macrocytic↗
PubMed1994

[A case of Weber's syndrome due to gradual expansion of a basilar bifurcation aneurysm].

We report an 82-year-old female who developed Weber's syndrome following gradual expansion of a basilar bifurcation aneurysm. The patient first developed subarachnoid hemorrhage at the age of 78. Cerebral angiography showed an intracranial aneurysm of 1 cm diameter at the bifurcation of the basilar artery. Three years later, the patient was readmitted because both CT and MRI at that time revealed that the lumen of the aneurysm was filled with an organizing thrombus. On her third admission at the age of 82, the diameter of the aneurysm was expanded to 2.5 cm and Weber's syndrome had developed. On T2-weighted MRI, a central low-intensity area surrounded by a high-intensity zone were evident in the aneurysm, suggesting the formation of an organized or organizing thrombus. Repeated MRI examinations are useful for following the expansion of a thrombosed aneurysm.

Aged↗
PubMed1994

[Point mutation of T3 receptor-beta gene and syndrome of inappropriate secretion of TSH].

Thyroid hormone receptors (TRs) are bound to the T3-responsive element of DNA as dimers and heterodimerization with TR-auxiliary protein (TRAP) strongly enhances this binding. In affected members of families with the thyroid hormone resistance syndrome, significant point mutations have been identified in the hormone-binding domain of one of the two alleles of the TR beta gene, especially in two "hot spot" regions, avoiding the regions required for DNA binding, dimerization or binding to TRAP. These findings suggested that DNA-binding and receptor dimerization are important for dominant negative inhibition by the mutant TR, which is responsible for thyroid hormone resistance in a heterozygous patient with a point mutation in the TR beta gene.

DNA↗
PubMed1993

Cancer in Peutz-Jeghers syndrome.

BACKGROUND: Peutz-Jeghers (P-J) syndrome has been found to be associated with an increased risk of malignant neoplasia. METHODS: The authors reviewed the clinical courses of eight patients with P-J syndrome (four male and four female patients, ranging in age from 8 to 55 years), who had been followed up for as long as 12 years. The diagnosis of this syndrome was based on the evidence of characteristic mucocutaneous pigmentations and gastrointestinal hamartomatous polyposis. RESULTS: Four cases of malignant neoplasm among the eight patients were found. In a 25-year-old woman, an extremely well-differentiated adenocarcinoma of the uterus cervix was found at the initial examination. A gastric cancer in a 32-year-old woman, duodenal cancers in a 43-year-old man, and a pancreatic cancer in a 60-year-old man also were identified 12, 10, and 5 years after the time of initial examinations, respectively. Two of these patients died of the effects of the tumor soon after. CONCLUSION: The authors' experience confirms a veritable malignant potency in P-J syndrome and suggests that an intensive follow-up of gastrointestinal and extra-gastrointestinal sites is needed in patients with this syndrome.

Adolescent↗
PubMed1993

Isradipine attenuates the ischemia-induced release of dopamine in the striatum of the rat.

We examined the effect of isradipine, a blocker of L-type voltage-sensitive Ca2+ channels (VSCCs), on the ischemia-induced release of dopamine in the rat striatum. Perfusion of 200 micrograms/ml isradipine in the striatum did not alter extracellular dopamine concentrations monitored by microdialysis. However, a marked increase (145-fold) in dopamine level during forebrain ischemia, developed by bilateral carotid artery occlusion, was attenuated significantly by 37% by isradipine whereas the intensity of ischemia, monitored by striatal blood flow, was unchanged. These results suggest that isradipine attenuates the ischemia-induced release of dopamine via blockade of L-type VSCCs on dopaminergic neurons.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1993

Diagnosis of primary early gastric lymphoma. Usefulness of endoscopic mucosal resection for histologic evaluation.

BACKGROUND AND METHODS: Eight patients thought to have primary early gastric lymphoma were studied to evaluate the usefulness of endoscopic mucosal resection for the diagnosis of reactive lymphoid hyperplasia (RLH) or malignant lymphoma. RESULTS: In these patients, conventional endoscopic forceps biopsy did not provide a definite histologic diagnosis. Endoscopic ultrasonography (EUS) demonstrated that the disease was limited to the mucosa and the submucosa in all patients, without any paragastric lymph node involvement, so endoscopic mucosal resection was performed to obtain specimens large enough to include the submucosa. As a result, primary early gastric lymphoma was diagnosed in five patients, for whom subsequent gastrectomy confirmed the diagnosis. CONCLUSIONS: The authors recommend that endoscopic mucosal resection be performed in patients thought to have primary early gastric lymphoma and for whom a definite diagnosis can not be made by conventional endoscopic forceps biopsy.

Adult↗