Search PubMed⌕ Search

Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

At least 667 records · Page 37Linked to original sources
PubMed1989

Effects of salt restriction on blood volume, hemodynamics and humoral factors in hypertensive patients with chronic glomerulonephritis.

In order to elucidate the pressor mechanism in renal parenchymal hypertension, we examined blood volume, hemodynamics, and humoral factors, before and after salt intake restriction from 10 to 2 g daily, in patients with chronic glomerulonephritis (GN), with and without hypertension, and in a normotensive control group. Such salt restriction reduced body weight, blood volume, cardiac index (CI) and urinary sodium excretion equally in all groups, whereas mean blood pressure was reduced by 16 mm Hg in only ten hypertensive GN, but not in normotensive GN and the control group. In hypertensive GN the reduction of blood pressure was accompanied by blunt responses in the total peripheral resistance index (TPRI) and plasma norepinephrine (PNE). By contrast, in normotensive GN and the control group the reduction of CI was compensated for by increased TPRI, resulting in unchanged blood pressure. Among GN with and without hypertension, changes in TPRI by salt restriction were significantly correlated with changes of PNE. In conclusion, renal parenchymal hypertension is sustained by elevated vascular resistance and increased plasma norepinephrine as well. Blood pressure reduction by salt restriction is consistent with the low responses in TPRI and PNE.

Adolescent↗
PubMed1989

Effects of human recombinant erythropoietin on anaemia, systemic haemodynamics and renal function in predialysis renal failure patients.

Seven anaemic patients with predialysis chronic renal failure were treated with human recombinant erythropoietin. Anaemia was improved, with a 31% increase in haematocrit, but blood pressure increased in all patients with an average of 12% in systolic (P less than 0.01), 14% in diastolic (P less than 0.05) and 13% in mean blood pressure (P less than 0.05). Blood volume was significantly increased by an average of 12%. Cardiac output increased in three of seven patients, and total peripheral resistance in four. GFR, RBF and RPF were not changed but filtration fraction increased significantly (P less than 0.05). It is suggested that blood pressure elevation might be developed as a result of volume expansion, elevated cardiac output, and increased total peripheral resistance.

Anemia↗
PubMed1989

Linear erosions on Kerckring's folds may be diagnostic of Zollinger-Ellison syndrome.

Endoscopy of the upper gastrointestinal tract was performed in eight patients with Zollinger-Ellison syndrome (ZES) and in 20 patients with stomal ulcer (non-ZES). All ZES patients had hypergastrinemia and a positive secretin provocation test. In three ZES patients studied before gastric surgery, edematous or erosive changes were present in the second portion of the duodenum. In the seven ZES patients studied postoperatively, examination revealed erosive changes in the distal portion of the duodenum and/or upper jejunum. These changes were frequently in a line on the uppermost part of Kerckring's folds. In the non-ZES patients, however, endoscopy revealed no erosive change in the distal part of the duodenum. We propose that such linear erosions on Kerckring's folds may be diagnostic of ZES.

Adult↗
PubMed1989

Spontaneous regression of primary malignant lymphoma of the stomach in two nontreated Japanese.

Two patients with primary malignant lymphoma underwent spontaneous regression. One was a 40-year-old woman with a large ulcerating tumor on the greater curvature of the gastric antrum. This tumor shrank spontaneously, leaving only a small shallow ulcer. The resected specimen showed a minute focus of malignant lymphoma in the ulcer base. The other was a 73-year-old man who had a tumor with central ulceration on the posterior wall of the gastric antrum. Endoscopic biopsy revealed a malignant lymphoma. This tumor disappeared 60 days later. The patient refused surgery and remains well with no evidence of recurrent disease at this writing, 44 months later. Although there have been several case reports of spontaneous regression, partial or complete, of gastric malignant lymphoma, our cases seem to be the ones best proven.

Adult↗
PubMed1989

Worsening of anemia by angiotensin converting enzyme inhibitors and its prevention by antiestrogenic steroid in chronic hemodialysis patients.

The effects of angiotensin converting enzyme (ACE) inhibitors and their combined use with an antiestrogenic steroid on erythropoiesis were investigated in patients on chronic hemodialysis (CHD). Hematocrit was decreased by 10% or more in 6 of 12 patients who received either captopril or enalapril for 2-6 months. Erythropoietin (Epo) and angiotensin II (AII) were significantly reduced in these patients. When treatment with mepitiostane was combined with ACE inhibitor, anemia was significantly improved but without evidence of changes in circulating Epo concentrations or indices of renin-angiotensin activity. The reduction of AII and Epo formation by ACE inhibitors seems to play an important role in the worsening of anemia in patients on CHD; addition of an antiestrogenic steroid should be considered.

Androstanols↗
PubMed1989

A sensitive thyroid stimulating hormone assay for screening of thyroid functional disorder in elderly Japanese.

The use of a screening test for thyroid functional disorder by sensitive thyroid stimulating hormone assay in the elderly was investigated. The basal thyroid stimulating hormone levels predicted the response of thyroid stimulating hormone to thyrotropin releasing hormone; it was suppressed in 99 (99.0%) of 100 hyperthyroid patients. Therefore, not only primary hypothyroidism but also hyperthyroidism can be excluded when the serum thyroid stimulating hormone levels are normal. An epidemiological study was then performed on 2,421 (76.7%) of the Japanese general population aged 40 or over recruited from the residents in Hisayama town and also in 122 residents between 20 and 40 years of age. Additional free T4 measurement was necessary in about 10% of the residents with abnormal TSH levels to confirm the diagnosis of hyperthyroidism or distinguish latent from overt hypothyroidism. There was a significant correlation between age and serum thyroid stimulating hormone levels after logarithmic conversion (r = 0.1533, P less than .001). The prevalence of thyroid dysfunction found in 1,026 males and in 1,395 females aged 40 or over was, respectively: hyperthyroidism, less than 0.1% and 0.2%, latent (subclinical) hypothyroidism, 3.2% and 5.5%, and overt hypothyroidism, 0.4% and 0.7%. We conclude that the screening with this sensitive thyroid stimulating hormone assay and additional free T4 measurement is useful for detection of patients with thyroid functional disorder.

Adult↗
PubMed1989

Cerebrospinal fluid lactate in patients with diabetes mellitus and hypoglycaemic coma.

Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 20 patients with diabetes mellitus but without disturbance of consciousness and five who recovered from hypoglycaemic coma. CSF lactate was slightly but significantly higher in diabetes mellitus (1.78, SEM 0.04 m mol/l) than that in 15 control subjects (1.40, SEM 0.05 m mol/l). In those who recovered from hypoglycaemic coma, CSF lactate was markedly elevated to 2.45-4.43 m mol/l. CSF glucose concentrations, however, were substantially the same between treated hypoglycaemic and diabetes mellitus groups. These findings indicate that CSF lactate levels increase with glycaemic levels in diabetes mellitus owing to enhanced glucose influx into glycolytic pathway of the brain, and also increases in treated hypoglycaemic coma probably due to mitochondrial dysfunction or damage.

Brain Damage, Chronic↗
PubMed1989

Regional cerebral blood flow and metabolism in patients with transient global amnesia: a positron emission tomography study.

In four patients who experienced transient global amnesia (TGA), clinical features and neuroradiological findings including positron emission tomography (PET) were studied within three months of the episodes, and compared with those in seven cases with cerebral transient ischaemic attacks (TIA). None of TGA patients had a previous history or significant risk factors for the cerebrovascular diseases. Their electroencephalogram, brain CT and angiogram for the head and neck were almost normal. PET study showed better preserved cerebral blood flow and oxygen metabolism in each area of the brain in patients with TGA compared with those with TIA in whom focal reductions of flow and metabolism were evident. These observations suggest that TGA is caused by reversible circulatory and/or metabolic disturbance, of which mechanism might be different from that in TIA.

Amnesia↗
PubMed1989

Red cell folate concentrations in patients with Crohn's disease on parenteral nutrition.

To examine changes in the folate concentrations in red cell during relatively long-term total parenteral nutrition (TPN), 10 Japanese patients with Crohn's disease (7 males), the mean Crohn's disease activity index on admission being 211, were given folic acid in a dose of 400 micrograms/day (AMA-FDA formulation) or 800 micrograms/day for 6-16 weeks (mean 10.5). The red cell folate concentrations were determined before TPN and once every week or 2-4 weeks thereafter. The folate concentrations were very low even after TPN with folic acid of 400 micrograms/day. In those given 800 micrograms of daily folic acid, the folate levels tended to increase, but did not reach the normal range. We propose that folic acid over 800 micrograms/day or a double dose of AMA-FDA formulation should be prescribed for Crohn's disease treated with long-term TPN.

Adolescent↗
PubMed1989

Effect of phosphate binders on the course of chronic renal failure in rats with focal glomerular sclerosis.

To investigate the effect of phosphate binders on the progress of renal functional deterioration, aluminium hydroxide (AL) or calcium carbonate (CA) was administered to adriamycin (ADR)-induced progressive renal failure model rats. Urinary protein excretion was reduced in ADR rats treated with AL (ADR-AL group) or CA (ADR-CA group), compared to those without the treatment (ADR group). Urinary phosphate excretion, serum phosphate concentration, and calcium-phosphate product were significantly lower in the ADR-AL and ADR-CA groups than in the ADR group. At week 34, increased serum creatinine, glomerular sclerosis and tubulointerstitial alterations, being marked in the ADR group, were ameliorated in the ADR-AL and ADR-CA groups. However, there was no significant difference in body weight and serum total protein among the three groups. We conclude that AL and CA could both prevent chronic progressive renal deterioration in focal glomerular sclerosis induced by ADR, and preserve the nutritional condition.

Aluminum Hydroxide↗
PubMed1989

Cerebral ischemia in spontaneously hypertensive rats with type 2 (noninsulin-dependent) diabetes mellitus, cerebral blood flow and tissue metabolism.

The present study was designed to examine the effect of chronic type 2 (noninsulin-dependent) diabetes mellitus on cerebral blood flow and metabolism during cerebral ischemia induced by bilateral carotid artery occlusion in spontaneously hypertensive rats. Diabetes was produced by streptozotocin treatment in 2-day neonates and the experiment was performed at the age of 5 months. The level of mean arterial pressure was not different between diabetic and nondiabetic rats. At 1 h after ischemia, cerebral blood flow was decreased to 1% of the resting value and supratentorial lactate was increased by 8-fold of control, being virtually the same in both groups of rats. In contrast, reduction of cerebral ATP was much less in diabetic rats (1.64 +/- 0.15 mmol/kg) than in nondiabetic rats (0.74 +/- 0.07 mmol/kg) (p less than 0.001); ATP in nonischemic control is 2.80-2.85 mmol/kg. These results could not be explained by the difference in cerebral blood flow between the groups during ischemia. The results suggest that chronic mild hyperglycemia exerts rather a protective effect on the brain against ischemic insult. Effective utilization of metabolites, such as glucose and ketone bodies, may play an important role to minimize metabolic derangements in the ischemic brain in type 2 diabetic-hyperglycemic rats.

Adenosine Triphosphate↗
PubMed1989

Alpha- and beta-adrenergic receptors of noradrenergic innervation modulate the lower limits of cerebral and cerebellar blood flow autoregulation in spontaneously hypertensive rats.

The effects of alpha- and beta-adrenergic receptors on the lower limits of cerebral (CBF) and cerebellar blood flow (CeBF) autoregulation were examined in spontaneously hypertensive rats. CBF and CeBF were measured during hemorrhagic hypotension in rats treated with adrenergic blockers, phenoxybenzamine (PBZ) or propranolol (PPL), using a hydrogen clearance method. The lower limits for CBF beyond which blood flow was decreased steeply were 72% of resting values in the control, 44 in the PBZ and 80 in the PPL group. Similar tendency was also observed for CeBF. In the control group, the reducing rates of mean arterial pressure (MAP) to decrease CBF by 15 and 30% of the resting values were 33% (58 mm Hg) of the resting MAP and 46% (80 mm Hg), respectively, and those to reduce CeBF to the same extent were 35% (61 mm Hg) and 52% (92 mm Hg), respectively. In the PBZ group, the respective reducing rates of MAP were 52% (71 mm Hg) and 65% (88 mm Hg), respectively, for CBF and 50% (68 mm Hg) and 65% (88 mm Hg), respectively, for CeBF. In contrast, in the PPL group, those rates were 22% (39 mm Hg) and 32% (56 mm Hg), respectively, for CBF, and 23% (40 mm Hg) and 30% (52 mm Hg), respectively, for CeBF, being significantly smaller than those in the control and the PBZ groups (p less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Age and hypertension promote endothelium-dependent contractions to acetylcholine in the aorta of the rat.

This study was undertaken to compare age-related changes in endothelium-dependent vascular responses in both hypertensive and normotensive rats. Aorta from normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) aged 4-6 weeks (young), 3-6 months (adult), and 12-25 months (old) were examined for relaxation to acetylcholine, adenosine 5'-triphosphate (ATP), and sodium nitroprusside. Rubbed (endothelium denuded) aorta from all groups displayed neither relaxation nor contraction to acetylcholine. Maximal relaxation responses to acetylcholine were reduced progressively with increasing age in unrubbed aorta of both SHR and WKY rats. In addition, acetylcholine caused not only dose-dependent relaxations at lower concentrations but also increases in tension at higher concentrations in unrubbed aorta of old WKY rats as well as adult and old SHR. However, indomethacin completely inhibited the tension development. As a result, aorta treated with indomethacin demonstrated similar acetylcholine-induced, endothelium-dependent relaxations in all groups. The thromboxane A2 synthetase inhibitor (E)-7-phenyl-7-(3-pyridyl)-6-heptanoic acid (CV-4151) partially but significantly depressed the increases in tension in aorta of old WKY rats. The degrees of endothelium-dependent relaxations to ATP and endothelium-independent relaxations to sodium nitroprusside were almost similar in all groups. These findings suggest that the release of or vascular responsiveness to endothelium-derived relaxing factor in the aorta is well maintained through senescence in both strains and that, in the aorta of not only SHR but also old normotensive WKY rats, the endothelium releases contracting factors that may be thromboxane A2 and other vasoconstrictor prostanoids.

Acetylcholine↗
PubMed1989

Hemorrhagic transformation in cerebral embolism.

We studied the mechanism of hemorrhagic infarction after acute cerebral embolism in 160 patients by brain computed tomography and angiography. Hemorrhagic infarction during the month after the embolic event was evident in 65 patients (40.6%). Initial angiography a median of 1.5 (range 1-60) days after the event revealed occlusion of the cerebral arteries in 117 of 142 patients (82.4%), and reopening of the vessels was observed in 56 (94.9%) of 59 patients who had follow-up angiography a median of 20 (range 3-47) days after the event. The incidence of hemorrhagic infarction was higher in patients greater than or equal to 70 years old (31 of 61, 50.8%) than in those aged 50-69 years (27 of 72, 37.5%) or less than 50 years (seven of 27, 25.9%) (greater than or equal to 70 vs. less than 50, p less than 0.05). In patients with moderate or large infarcts, hemorrhagic infarction developed in 50.0% or 51.5%, respectively, while in those with small infarcts it developed in only 2.9% (p less than 0.05). No correlation was found between hemorrhagic infarction and history of hypertension or blood pressure during the acute stage of stroke. Thrombolytic and/or anticoagulant therapy did not affect the incidence of hemorrhagic infarction (40.0% with vs. 40.7% without therapy) but tended to cause massive hematoma. Our results indicate that hemorrhagic transformation in cerebral embolism is caused not only by reopening of the occluded vessels but also by other factors such as age and size of the infarct. Hypertension per se seems to be less important for hemorrhagic infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Hypotensive effects of nifedipine in patients with primary hyperparathyroidism: case reports.

Nifedipine was administered orally to 2 patients with primary hyperparathyroidism before and after parathyroidectomy. The operation lowered serum calcium concentration and parathyroid hormone but did not alter plasma renin activity, plasma aldosterone concentration, and serum magnesium. The hypotensive effects of nifedipine were markedly enhanced with the decrease in serum calcium concentration following parathyroidectomy. Thus, the level of serum calcium concentration may modulate the hypotensive effect of nifedipine in humans.

Aged↗
PubMed1989

Effect of single-administration captopril on plasma and urinary vasopressin in normotensive subjects and patients with essential hypertension and primary aldosteronism.

Effects of a single administration of captopril on plasma and urinary vasopressin (AVP) were examined in 8 normotensive (NT) female volunteers, 17 patients with essential hypertension (EHT) and 2 patients with primary aldosteronism (PA). Orally-administered captopril (25 mg) had no effect on plasma AVP levels in the three groups. However, urinary excretion of AVP decreased significantly after use of captopril in both NT and EHT subjects (-57% and -67%, respectively), and also in PA subjects. The magnitude of reduction in urinary AVP was significantly correlated with the pretreatment levels of plasma renin activity (r = 0.85) and plasma aldosterone concentration (r = 0.88) in NT subjects. Such correlation was not found in EHT subjects. These results suggest that captopril decreases AVP secretion in both normotensive and hypertensive subjects, but the relation of the magnitude in AVP reduction by captopril to the peripheral renin-angiotensin system might be different.

Adult↗