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Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

At least 145 records · Page 8Linked to original sources
PubMed1999

Difference in the incidence of cough induced by angiotensin converting enzyme inhibitors: a comparative study using imidapril hydrochloride and enalapril maleate.

To compare the incidence of cough between two angiotensin converting enzyme (ACE) inhibitors, imidapril and enalapril, comparative crossover study was performed in 489 patients (228 men and 261 females) with essential or renal parenchymal hypertension. Patients were randomly assigned to one of two treatment groups, a group receiving imidapril for 12 wk (Period I) followed by enalapril for 12 wk (Period II), and a group in which the order of drugs was reversed. The occurrence of cough during treatment was monitored by questionnaire in all cases. There were no differences in background characteristics between the two groups. The incidence of cough during Period I was 15.2% (32/210) in the group initially treated with imidapril (Group IE) and 38.6% (85/220) in the group initially treated with enalapril (Group EI), the difference being statistically significant (p < 0.001). During Period I, decrease in blood pressure was observed in 63.9% (115/180) of Group IE and 64.6% (115/178) of Group EI patients. In approximately half of the patients in Group EI who developed cough during Period I and in whom the treatment was subsequently switched to imidapril, cough subsequently disappeared. It was concluded that the incidence of cough was significantly less under imidapril than under enalapril treatment, while there was no difference in the antihypertensive effects of the two ACE inhibitors.

Administration, Oral↗
PubMed1999

[Multicenter prospective survey of prognosis of hypertensive elderly outpatient under antihypertensive treatment--morbidity and mortality of cardiovascular diseases and cancer].

Although calcium-channel blockers and angiotensin-I-converting enzyme inhibitors are often used for treatment of hypertension in the elderly in Japan compared to those in the United States and in European countries, there have been few investigations on the prognosis of the elderly receiving these antihypertensive treatments. The Research Group for "Guidelines on the Treatment of Hypertension in the Elderly" collaborated with the Comprehensive Research Projects on Aging and Health group of the Ministry of Health and Welfare of Japan in performing a 3-year survey on the outcome of 700 hypertensive elderly outpatients (> or = 60 years) receiving treatment of antihypertensive drugs. Antihypertensive drugs including dihydropyridine-type calcium channel blockers, beta blockers, angiotensin-I-converting enzyme inhibitors, diltiazem, diuretics and old-type antihypertensives (hydralazine, budralazine, and centrally acting drugs such as clonidine, methyldopa and guanabenz) were administered to 71.3%, 30.4%, 26.2%, 14.0%, 8.6%, and 6.4% of the 642 elderly patients surveyed for three years, at the time of registration, respectively. Morbidity and mortality rates of total cerebro-cardiovascular diseases, stroke, and heart diseases, were 27.6 and 7.81/1,000 patient-years, 15.1 and 3.6/1,000 patient-years, 10.4 and 4.2/1,000 patient-years, respectively. These results were similar or even better than those of megatrials of antihypertensive treatments for elderly patients in Europe and United States. After adjustment for potential confounding factors, multiple logistic analysis revealed that a past history of ischemic heart disease, use of the old-type antihypertensive drugs, male gender, and diastolic high blood pressure were independent risk factors for the morbidity of cerebro-cardiovascular diseases taking the group of non-cerebro-cardiovascular disease as the reference group. We also identified 22 cases of newly occurred malignancies including 7 fatal cases. However, none of the antihypertensives was significantly related to the occurrence of malignancies. These results lead support to the tendencies in the use of antihypertensive drugs in Japan.

Aged↗
PubMed1999

[An autopsy case of pulmonary embolism due to renal angiomyolipoma in an elderly woman].

An 86-year-old woman with a 13-year history of hypertension was admitted because of consciousness disturbance, hypotension, tachycardia, and cyanosis at her extremities. Enhanced computed tomography showed a thrombus in the truncus pulmonalis and right pulmonary artery, and also showed a left renal mass and a right renal cyst. Under a diagnosis of pulmonary embolism we started anticoagulant therapy, but the patient died five days after admission. At autopsy, a saddle-like thrombus was found in the truncus pulmonalis and bilateral trunks of pulmonary arteries. Microscopic examination showed smooth muscle cells in the thrombus. We could not find any other thrombus in the inferior vena cava, intrapelvic veins, nor in veins of lower extremities by milking. We also found tumors in both kidneys. Microscopically all tumors were diagnosed as angiomyolipoma. There were many fibrin thrombi in the sinuses of the tumors but there was no evidence of malignancy. We finally diagnosed pulmonary embolism due to renal angiomyolipoma because there was no other thrombus origin and microscopically the same smooth muscle cells were found both in the renal tumor and the pulmonary thrombus. There is only one case report concerning pulmonary embolism due to renal angiomyolipoma which happened during operative treatment. The treatment method of renal angiomyolipoma is determined by tumor size and symptoms, and usually intensive treatment is not performed in cases without symptoms. Our patient had no symptoms until the onset of severe complication of pulmonary embolism, suggesting that radical treatment is necessary for renal angiomyolipoma with a thrombus even when there are no symptoms.

Aged↗
PubMed1999

[Distribution and function of angiotensin II receptor subtypes--central nervous system].

AT1 receptors are predominant in the brain of monkeys and rabbits, while AT2 receptors are relatively abundant in the rat brain. In the human brain, all of the angiotensin II receptors in the forebrain, midbrain, pons, medulla and spinal cord are AT1 receptors, and AT2 receptors are found only in the cerebellum. Angiotensin II in the brain increases water and sodium intake, raises blood pressure, attenuates baro-reflex function, and increases vasopressin secretion. These cardiovascular actions of angiotensin II are exclusively mediated by AT1 receptors. Since the mice whose AT2 receptors are knocked out show the increase in blood pressure, the decrease in body temperature, and some alterations in behavior, these receptors may also play roles in the central nervous system.

Angiotensin II↗
PubMed1999

[Serum immunoglobulin concentrations and autoantibodies in patients with Yusho].

To evaluate chronic immune effects of polychlorinated biphenyl (PCB), serum immunoglobulin concentrations and autoantibodies were studied in 79 patients with Yusho in 1997. Serum levels of immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) were elevated in 10 cases (12.7%), 19 cases (24.1%) and 7 cases (8.9%), respectively. Autoatibodies were present in some patients of Yusho; 10 cases (12.7%) for rheumatoid factor and 36 cases (45.6%) for antinuclear antibody. LE factor was not detected. There were no significant correlations between blood PCB concentrations and serum immunoglobulin concentrations, or presence of autoantibodies. We conclude that antinuclear antibody in patients with Yusho is frequent, although it may not be associated with blood PCB concentration.

Adult↗
PubMed1999

[Angiotensin II receptor antagonists as the agents to treat cerebrovascular disease].

Recently, several antagonists of angiotensin II receptors (AII-A) have been developed and are now used as antihypertensive agents. The regional cerebral blood flow appears to show typical changes during the course of cerebral ischemia and AII-A may have a favorable effect on the flow in some situations. Moreover, activation of the renin-angiotensin system plays an important role in the development of cerebrovascular lesions in chronic hypertension. Because several enzymes appear to produce angiotensin II in the absence of classical renin-angiotensin system, it is possible that angiotensin II is produced in some blood vessels even after inhibition of the activity of ACE. Thus, AII-A may be more effective to treat cerebrovascular lesions during hypertension than ACE inhibitors.

Angiotensin Receptor Antagonists↗
PubMed1999

Hepatocellular carcinoma with metastasis to the rib complicated by hemothorax. An autopsy case.

A 64-year old man was admitted to our hospital with multiple hepatocellular carcinoma (HCC) lesions in the liver, lung and bone. Three weeks after admission, the patient became complicated with right upper chest pain. A chest radiograph showed a marked increase in right pleural effusion. Thoracentesis demonstrated a hemothorax. Despite treatment with a continuous pleural tap and blood transfusions, the patient's clinical status worsened and he developed severe dyspnea. His right pleural effusion might be considered to be caused by a rupture of the HCC metastasis in the right 2nd rib. The patient died due to respiratory and hepatic failure 26 hours after his occurring the pleural effusion. An autopsy revealed moderately differentiated HCC in the liver, lung and bone. The HCC metastasis of the right 2nd rib was found to have torn the nearby pleura. We described a rare case in which hemothorax was caused by a ruptured rib-based HCC.

Bone Neoplasms↗
PubMed1999

[Epidemiologic aspects of ulcerative colitis in Japan--comparison with other countries].

In this review, recent data of epidemiological characteristics of ulcerative colitis in Japan were presented, and compared to those of other areas in the world. Hospital-based investigation in 1991 revealed that the prevalence was 18.12/100,000, and the incidence was 1.95/100,000. The incidence in Japan is much lower than in Europe and in north America where strikingly higher incidence(7-14/100,000) have been reported. There were not any differences in male/female ratio and age of onset between Japan and Western countries. While the incidence in Western countries has reported to be stable, the value increased greatly during the past 25-year period in Japan.

Aged↗
PubMed1999

Long-term treatment of portosystemic encephalopathy with oral branched-chain amino acids--a case report.

We treated a 68-year-old male patient of hepatic encephalopathy with oral branched chain amino acids-enriched formula (Aminoleban EN) in addition to lactulose. His encephalopathy was successfully controlled with this therapy for more than a year despite the high blood ammonia levels. Repeated amino acids analyses demonstrated that the deranged branched chain to aromatic amino acids ratio was attenuated with long-term Aminoleban EN administration both in plasma and in cerebrospinal fluid. Oral branched-chain amino acid supplement was very useful in improving the chronic portosystemic or hepatic encephalopathy in this patient.

Administration, Oral↗