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Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

At least 595 records · Page 33Linked to original sources

[A case of liver cirrhosis associated with chronic subdural hematoma and hepatic encephalopathy].

A 58-year-old male liver cirrhosis patient, who had a history of recurrent hepatic encephalopathy, was admitted to our hospital because of clouding of consciousness. He had an episode of recent head trauma. On admission, he was drowsy and exhibited flapping tremor, fetor hepaticus and ascites. Laboratory data showed an increase in blood ammonia level, and a decrease in peripheral thrombocytes, serum albumin and prothrombin value. A ratio of branched-chain to aromatic amino acids was reduced. Antibody against hepatitis C virus was positive. His electroencephalogram showed bilaterally large synchronous slow waves. He was treated with intravenous branched-chain amino acids, and recovered. Cranial computed tomography on day 9 demonstrated a crescent shaped area of low density in the right frontotempoparietal subdural region. He was diagnosed as chronic subdural hematoma, which was treated surgically. It has been suggested that chronic subdural hematomas develop as a complication of hemostatic deficiency due to liver cirrhosis.

Chronic Disease↗

Effect of different doses of aluminium hydroxide on renal deterioration and nutritional state in experimental chronic renal failure.

To investigate the effects of aluminium hydroxide (AH), a phosphate binder, on the progress of chronic renal diseases, high doses (9.6 g/kg/day, group ADR-H), moderate doses (2.4 g/kg/day, group ADR-M), and low doses (1.2 g/kg/day, group ADR-L) of the compound, were orally administered for 34 weeks to rats with Adriamycin (ADR)-induced focal glomerular sclerosis. Serum creatinine and blood urea nitrogen were significantly lower in either group ADR-H or ADR-M than in group ADR at week 34. Urinary protein excretion was significantly lower in group ADR-H than in group ADR in all observation periods and was also lower in group ADR-M than in group ADR at weeks 28 and 32. Both glomerular sclerosis and tubular change were significantly less severe in group ADR-H, while tubular change was less marked in group ADR-M than in group ADR. These results revealed that phosphate depletion was induced, and progressive renal failure was ameliorated in proportion to the dosing of AH. On the other hand, body weight was significantly smaller in group ADR-H than in group ADR in more than half of the observation period. In conclusion, a high dose of AH may adversely affect the nutritional state irrespective of having an extremely protective effect on progress of renal dysfunction. Appropriate doses of AH should be used to prevent the renal deterioration.

Administration, Oral↗

A new ergopeptide, CBM 36-733, improves ischaemic cerebral metabolism in spontaneously hypertensive rats.

The authors have examined the protective effects of CBM 36-733 (2-methyl-alpha-ergocryptine) on experimental cerebral ischaemia in spontaneously hypertensive rats (SHR). SHR aged 6 months were divided into four groups; a vehicle-treated group, and CBM 36-733 0.01, 0.1 or 1.0 mg/kg i.v. treated groups. After anaesthesia, the bilateral common carotid artery was ligated (BCL) and supratentorial cerebral ischaemia was produced for 1 h. Cerebral blood flow to the parietal cortex was repeatedly measured by the H2 clearance technique. Brain tissue lactate, adenosine triphosphate (ATP) and pyruvate were determined by enzymatic methods. By BCL, cerebral cortical blood flow decreased to 9-19% of the resting value at 30 min and further to 5-11% at 60 min. Blood flow reduction was not altered by CBM 36-733 administration. At 1 h ischaemia, brain tissue lactate greatly increased to 27.5 +/- 2.6 (mean +/- SEM) mmol/kg in the vehicle-treated SHR, while it showed less increase, to 7.5 +/- 1.4, in the CBM 36-733 0.1 mg/kg group. Brain ATP decreased to 1.31 +/- 0.05 in vehicle-treated SHR after 1 h BCL, but it changed little, retaining almost normal levels (2.60 +/- 0.19) in rats treated with 0.1 mg/kg CBM 36-733, followed by 1.0 and 0.01 mg/kg, suggesting a beneficial effect of CBM 36-733 on the ischaemic cerebral metabolism. The present results suggest that CBM 36-733 has a protective effect on the brain against ischaemia by improving cerebral metabolism while not affecting haemodynamics.

Adenosine Triphosphate↗

Endoscopic removal of inflammatory fibroid polyps of the stomach.

Three cases of gastric inflammatory fibroid polyp removed by endoscopic polypectomy are reported. All lesions were located in the gastric antrum or prepyloric region, and their depth was restricted to the submucosa. The correct diagnosis was obtained, and the digestive symptoms disappeared after polypectomy. In contrast to observations in previous reports, we believe these lesions are suitable for removal by endoscopic means, provided they are small in size and strictly submucosal in location.

Aged↗

[A case of metoclopramide-induced neuroleptic malignant syndrome with cerebrospinal fluid lactic acidosis].

A case of metoclopramide-induced neuroleptic malignant syndrome with cerebrospinal fluid (CSF) lactic acidosis was reported. A 44-year-old Japanese woman noted tarry stool on July 2, 1988 and was treated with metoclopramide and cimetidine for nausea and vomiting. Hydroxyzine pamoate was also administered for insomnia at 3:10 am and she became comatose with muscle rigidity at 3:40-4:30 am on July 3. Tachycardia and high fever (39.5 degrees C) were evident at 8:00 am on July 4. She was transferred to the Kyushu University Hospital. On admission, serum creatine kinase was elevated to 1640 IU/1; MM fraction was 100%. She was diagnosed as malignant syndrome. Cerebrospinal fluid was normocellular with protein 38 mg/dl and glucose 122 mg/dl. Cerebrospinal fluid lactate increased markedly to 3.43 mmol/l, CSF pH was 7.264, HCO3- 14.4 mEq/l, indicating CSF metabolic acidosis. She became afebrile after the 10th hospital day, and gradually but completely recovered within a month. She was discharged on August 16, 1988. The anti-dopaminergic activity of metoclopramide was considered to be primarily responsible for the development of malignant syndrome in this case. Cerebrospinal fluid lactic acidosis seemed to reflect hyperpyrexia or malignant syndrome induced derangement of the brain metabolism.

Acidosis, Lactic↗

[Treatment of Yusho patients with cholestyramine].

Six typical Yusho patients (3 men, 48-58 years old, and 3 women, 45-55 years old) were treated with cholestyramine, 8-12 g/day, for 24 weeks. Improvement of some symptoms, such as arthralgia and malaise, was observed in 2 men, although this effect was non-specific. None of the patients showed increment of excretion of polychlorinated biphenyl or polychlorodibenzofuran into feces.

Cholestyramine Resin↗

Endoscopic findings in carcinoid tumor of the duodenum.

The endoscopic findings in six patients with carcinoid tumor of the duodenum were analyzed. Radiographic and endoscopic examinations revealed a smooth and round elevation (measuring 5-20 mm in diameter) in the duodenal bulb. In three patients, the lesion was accompanied by an irregularly shaped erythematous depression, a characteristic endoscopic finding of this tumor. Because the endoscopic forceps biopsy technique led to an accurate diagnosis, we wish to stress the clinical value of the endoscopic modalities.

Adult↗

Endoscopic removal of gastric lipoma: diagnostic value of endoscopic ultrasonography.

A 47-yr-old male with gastric lipoma is presented. X-ray and endoscopic examinations revealed a submucosal tumor on the posterior wall of the gastric antrum. Endoscopic ultrasonography demonstrated the hyperechoic mass in the submucosa without continuity to the muscularis propria, by which the lesion was diagnosed as lipoma. The lesion was successfully removed by endoscopic polypectomy without complications. The cross-sections of the removed specimens were quite consistent with the ultrasonographic findings. Endoscopic ultrasonography is valuable in assessing the exact extent of the tumor and in determining whether or not endoscopic polypectomy is called for.

Gastroscopy↗

Acute effects of antihypertensive agents on cerebral blood flow in hypertensive rats.

The acute effects of various antihypertensive agents on cerebral blood flow and mean arterial pressure (MAP) were studied in anesthetized (amobarbital 100 mg/kg) spontaneously hypertensive rats. Cerebral blood flow in the cortex and thalamus was measured by the hydrogen clearance method before and during a 60-min i.v. infusion of calcium antagonist (nifedipine), angiotensin converting enzyme inhibitor (captopril) or beta-blocker (propranolol). Nifedipine, 30 or 150 micrograms/kg per h, decreased dose dependently the MAP by 20 or 31%, and concomitantly increased cortical blood flow by 28 or 74%, and thalamic blood flow by 51 or 64%, respectively. Captopril, 10 or 100 mg/kg per h, decreased MAP by 7 or 14%, but changed cerebral blood flow minimally. In contrast, propranolol, 1.0 or 5.0 mg/kg per h, decreased MAP by 13 or 11%, with a concomitant reduction of cortical and thalamic blood flow by 20 or 15 and 33 or 37%, respectively. It is concluded that the changes in cerebral blood flow in response to hypotension are varied by antihypertensive drugs depending on the direct or indirect effect of the drugs (dilatation or constriction) on cerebral vessels. Nifedipine seems to dilate while propranolol constricts cerebral vessels.

Animals↗

Effects of recombinant leukocyte interferon on serum immunoglobulin concentrations and lymphocyte subpopulations in chronic hepatitis B.

To investigate immune effects of interferon (IFN) therapy in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B, serum immunoglobulin concentrations and peripheral lymphocyte subpopulations were sequentially studied before, during, and after therapy in nine patients who were treated with recombinant human alpha-IFN in doses ranging from 3 to 10 million units per day for 28 days. Serum immunoglobulin A levels decreased significantly, from 414 +/- 23 mg/dl (mean +/- SE) to 379 +/- 28 mg/dl (P less than 0.05), after the first week of therapy and to a bottom value of 323 +/- 20 mg/dl (P less than 0.001) at the fourth week. Immunoglobulin G levels decreased significantly, from 2603 +/- 175 to 2328 +/- 169 mg/dl (P less than 0.005), after the first week of therapy and to a bottom value of 2005 +/- 199 mg/dl (P less than 0.001) at the fourth week. Immunoglobulin M levels were also reduced significantly after 3 weeks of therapy (from 229 +/- 23 to 188 +/- 15 mg/dl; P less than 0.01). These reductions in immunoglobulins A, G, and M returned to pretreatment levels by 4 months after the end of the therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Ischemic flow threshold for striatal dopamine release in rats.

To determine the level of cerebral blood flow reduction which causes striatal dopamine release, extracellular dopamine and cerebral blood flow was simultaneously determined using in vivo brain dialysis and a hydrogen clearance method, respectively, in the striatum of spontaneously hypertensive rats before and during experimental cerebral ischemia. The ischemic flow threshold for neurotransmitter dopamine release was found to be 20% of the resting value or 8-10 ml/100g/min of cerebral blood flow, being similar to those for energy and membrane failures.

Animals↗

Efficacy and safety of carvedilol in renal hypertension. A multicenter open trial.

Carvedilol, a novel beta-blocker with a vasodilating action, was given either alone (monotherapy) or with diuretics (combination therapy) to 42 patients with renal hypertension. The hypotensive effect, safety, and optimal dose were investigated. In all, 23 untreated patients (16 men and 7 women; average age, 56.4 +/- 2.5 years) made up the monotherapy group and 19 diuretic-treated patients (11 men and 8 women; average age, 56.4 +/- 2.5 years) comprised the combined therapy group. All subjects had an initial blood pressure (BP) of greater than 160/95 mmHg and were started on 5 mg/day oral carvedilol. The dose was gradually increased to a maximum of 20 mg/day, or until either the BP was reduced to less than 149/89 mmHg or the reduction in mean BP was greater than 13 mmHg compared with baseline levels. The total study period was 8 weeks. With monotherapy, the BP and heart rate decreased significantly from 167/102 to 150/94 mmHg and from 81 to 74 beats/min, respectively. With combined therapy, the BP and heart rate fell significantly from 176/103 to 142/85 mmHg and from 81 to 70 beats/min, respectively. Responders were defined as subjects with a BP of less than or equal to 149/89 mmHg or those showing a fall of greater than or equal to 13 mmHg in mean BP. Responders accounted for 52.2% of the monotherapy group and 73.6% of the combination therapy group. Orthostatic hypotension was not seen in either group. Serum creatinine and blood urea nitrogen (BUN) levels were not altered by administration of carvedilol. Dizziness was noted by 1 of the 23 subjects in the monotherapy group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗

Small bowel transit time measured by hydrogen breath test in patients with anorexia nervosa.

The gastrocecal transit time was measured in 10 patients suffering from anorexia nervosa, using a lactulose hydrogen breath test, and was compared with the orocecal transit time in 11 healthy controls. One of the 10 patients and one of the 11 controls were excluded from this study because of no discernible increase in hydrogen excretion. The transit time was significantly prolonged in patients with anorexia nervosa compared with controls (117 min +/- 31 SD vs 81 min +/- 33 SD, P less than 0.02). In addition to delayed gastric emptying, which has hitherto been well known, the small bowel transit time was considered to be prolonged in patients with anorexia nervosa. Both these abnormalities seem to contribute to the development of various gastrointestinal symptoms in patients with anorexia nervosa.

Adolescent↗

Long-term follow-up of 2529 patients reveals gastric ulcers rarely become malignant.

To examine the relationship between peptic ulcer and gastric cancer, we investigated 2529 patients with peptic ulcer diagnosed from 1963 to 1975. During the follow-up period of 9-23 years, we found 38 in whom gastric cancer developed or who died of gastric cancer. Included were nine in whom gastric cancer was detected at the same site as the gastric ulcer initially diagnosed, and 22 in whom the gastric cancer was detected at another site. In the remaining seven, gastric cancer was given on the death certificate, but the details were unknown. When the data on gastric ulcer initially diagnosed were reevaluated, gastric cancer was suspected or could not be completely ruled out in seven of the nine in whom gastric cancer was detected at the same site. In the remaining two, a diagnosis of benign ulcer was made even when the initial data were reviewed. In these two, however, there was the possibility that the initially diagnosed gastric ulcer represents a phase of the "malignant cycle." The number of deaths from gastric cancer in patients with gastric ulcer was significantly low, compared with that expected and computed by the age- and sex-matched general population. These results suggest that gastric ulcers rarely become malignant.

Adolescent↗