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Biomedical subjects

M Ishihara

Publications and source records attributed to M Ishihara.

At least 253 records · Page 14Linked to original sources
PubMed1991

[Long-term prognosis after reperfusion therapy with emergency coronary angioplasty for acute myocardial infarction].

The influence of emergency coronary angioplasty (PTCA) for acute myocardial infarction on long-term survival was investigated. We followed 141 patients treated with emergency PTCA and 202 patients treated with thrombolytic therapy alone for a median of 1,157 days and a median of 2,133 days, respectively. All were initially completely occluded at the infarct-related coronary artery (IRCA). Actuarial survival curves were compared and independent predictors of late cardiac death were determined using Cox's proportional hazard model between overall patients and patients whose IRCA was at the proximal site of the left anterior descending artery (LAD). 1. Actuarial survival curves were similar in 2 groups. 2. Independent predictors of late cardiac death in overall follow-up patients were advanced age over 65 years (p < 0.03), a history of previous myocardial infarction (p < 0.03), severer stage of the Killip class on admission (p < 0.003), and the infarct-related proximal LAD (p < 0.01). 3. Among patients with the proximal LAD, the actuarial survival curve was better in those treated with emergency PTCA than in those treated with thrombolytic therapy alone (p < 0.01). 4. Among patients with the proximal LAD, independent predictors of late cardiac death were advanced age over 65 years (p < 0.03), treatment with thrombolytic therapy alone (p < 0.03), left ventricular ejection fraction < or = 40% (p < 0.06), and occluded IRCA on predischarge angiograms (p < 0.08). Among patients with the occluded proximal LAD, those treated with emergency PTCA showed better long-term survival rate than did patients with thrombolytic therapy alone, and this may be explained by higher successful reperfusion rates in the former than in the latter.

Aged↗
PubMed1991

[Prediction and prevention of reocclusion after coronary thrombolysis for acute myocardial infarction based on analysis of the coronary morphology with angiography].

Morphology of the affected coronary artery in acute myocardial infarction was qualitatively analyzed to predict the incidence of reocclusion after intracoronary thrombolysis. In 274 patients with 75% or more residual stenosis after successful thrombolysis, the morphology of the stenosis underlying the acute thrombus was graded as 75% or more (type A, n = 195), or less than 75% (type B, n = 79). Eighty-one patients with type A stenosis and 39 of 79 patients with type B stenosis were treated with immediate PTCA following thrombolysis. In 154 patients treated without PTCA, the severity of type A stenosis on chronic angiography remained unchanged after thrombolysis (87 +/- 7%-->86 +/- 14%); whereas, regression of the stenosis was noted in patients with type B stenosis (85 +/- 6%-->53 +/- 32%, p < 0.001). After thrombolysis, reocclusion occurred in 31 of 117 patients with type A stenosis, but in only 2 of 40 patients with type B stenosis (26.5% vs 5.0%, p < 0.02). Reocclusion was prevented by PTCA in patients with type A stenosis (26.5% vs 8.6%, p < 0.01), but not in patients with type B stenosis (5.0% vs 10.3%, p = ns). Qualitative analysis of coronary morphology after thrombolysis can facilitate the prediction of the occurrence of reocclusion and may provide a framework for selection of therapy.

Angioplasty, Balloon, Coronary↗
PubMed1991

[Quantitative evaluation of right ventricular function by transesophageal echocardiography: report of a case with classical right ventricular infarction].

We were able to diagnose right ventricular infarction (RVI) by transesophageal echocardiography (TEE) in a patient with acute inferior infarction, and it was confirmed by cardiac catheterization. To evaluate right ventricular (RV) function quantitatively, area shortening (AS) and regional AS (rAS) were measured from RV images obtained by TEE. The AS correlated with RV ejection fraction obtained by radionuclide angiography (r = 0.72). The patient with RVI showed depressed RV function by AS measurement with decreased rASs of all regions in the acute phase. In the chronic phase, RV function of the patient improved, especially in the region of the ventricular septum and apex regions. These results indicate availability of TEE and that RV function can be evaluated by TEE.

Aged↗
PubMed1991

[Immunogenetic mechanism of Behçet's disease].

In order to investigate the immunogenetic mechanism of Behçet's disease, frequencies of HLA antigens were studied in patients. The subjects consisted of 66 patients and 99 normal controls. A lymphocyte cytotoxicity test was used for typing HLA-A, -B, -C, -DR, -DQ antigens. HLA-DP antigens were analyzed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. A significant increase of HLA-B15 was observed in the patients. In contrast, no significant difference was observed in HLA-Bw52 which possesses only two different amino acids from HLA-B15. On the contrary, frequencies of HLA-A11, HLA-Aw33, HLA-B35, HLA-B44 and HLA-DQw1 were significantly lower in the patients than in the controls. No significant difference was observed in HLA-DP antigens. These results suggest that Behçet's disease involves both disease susceptibility factors and disease resistance factors and that such genetic factors are mapped within or very close to the HLA-B gene in the class I gene region. Additionally class II HLA-DQ antigen is associated with disease resistance factors.

Amino Acid Sequence↗
PubMed1991

[Acute nephrotoxicity by CDDP (on tubular damage)].

Cisplatin (CDDP) is known to cause a nephrotoxic side effect. By using urinary trehalase which is localized renal tubular brush border, we examined an acute cisplatin nephrotoxicity. 1) With less than 300 mg of CDDP, urinary trehalase activity in the 1st day was significantly increased than preadministration. And urinary beta 2-MG was significantly increased in the 2nd day. But urinary NAG was not significantly increased. 2) With 300 mg or more of CDDP, urinary trehalase, beta 2-MG and NAG were more increased than preadministration. Urinary trehalase and beta 2-MG were inclined to increment. But urinary NAG was not inclined to decrement. Above all, renal tubular damage is reversible with less than 300 mg of CDDP, but is irreversible with 300 mg or more of CDDP.

Acetylglucosaminidase↗
PubMed1991

[A clinical study of the relation between time to reperfusion and infarct size].

Observations made in animal models of reperfusion in acute myocardial infarction have shown that early reperfusion results in myocardial salvage. But the relation between the time of reperfusion and myocardial salvage is not clear in human patients. If earlier reperfusion provides smaller infarct size, reperfusion therapy initiated in the first 1 hour should be the most beneficial. In this study, we compared the results of therapy initiated in the first 1 hour (group A, n = 19) with treatment started 1 to 24 hours after the onset of chest pain (group B, n = 652). The infarct location, development of collateral vessels, number of diseased vessels and reperfusion rate of thrombolysis in the two groups didn't differ. There was a statistically insignificant trend towards total occlusion of the infarct artery in group A (89.5% vs 69.7%, p less than 0.1). Peak CPK and changes in left ventricular ejection fraction (delta EF) were assessed in patients with total occlusion of the left anterior descending artery and successful reperfusion (n = 8 in group A, n = 120 in group B). There was no difference in peak CPK (3281 +/- 2192Iu/l vs 3490 +/- 1811Iu/l) and delta EF (6.3 +/- 17.1% vs 5.8 +/- 11.9%). These findings suggest that there is no relation between the time of reperfusion and myocardial salvage in human patients.

Coronary Angiography↗
PubMed1990

Immunohistochemical differentiation of basal cell epithelioma from cutaneous appendages using monoclonal anti-glycoprotein antibody TNKH1. Its application in Mohs' micrographic surgery.

TNKH1, which was primarily developed to detect differentiated melanocytic tumor cells, was found to recognize basal keratinocytes of hair follicle and some basal keratinocytes of human epidermis. Thus, TNKH1 decorated the basal cells of following structures: epidermis (39 of 54, only part of each specimen [OPES]), upper hair follicle (one of 24, OPES), lower hair follicle (21 of 21, very high rate of each specimen [VHES]), sebaceous duct (14 of 15, VHES), sebaceous gland (ten of 14, germinative cells near duct), eccrine duct (three of 19, OPES). Epithelial tumors, considered to be derived from or differentiating toward hair follicle such as trichilemmoma (one of one, VHES) and basal cell epithelioma (BCE) (32 of 32, VHES) were labeled not only in the peripheral cells but in their entirety. On the other hand, epidermal tumors, such as seborrheic keratosis (ten of 11, OPES), actinic keratosis (two of three, OPES), and squamous cell carcinoma (one of two, OPES), showed an irregular peripheral basal cell staining as in normal epidermis. The apocrine sweat apparatus and eccrine secretory portion were negative. Eccrine ductal tumors such as syringoma (two tested), eccrine acrospiroma (one), and eccrine carcinoma (two) were TNKH1 negative. Taking advantage of this total labeling of BCE versus peripheral labeling of the hair follicle, the authors could distinguish BCE tissue from other structures clearly. Among confusing structures the upper hair follicle and the eccrine duct were excluded easily because of their negative staining with TNKH1. The lower hair follicle was TNKH1 positive but only in the outer basal layer, whereas the BCE was TNKH1 positive in its entire basaloid cells. The result indicated that TNKH1 will be a useful antibody in Mohs' micrographic surgery.

Antibodies, Monoclonal↗
PubMed1990

Serum thyroglobulin concentration as an indicator for assessing thyroid stimulation in patients with Graves' disease during antithyroid drug therapy.

PURPOSE: The purpose of this study was to elucidate the mechanism of regulation of serum thyroglobulin concentration in patients with Graves' disease and to establish the clinical usefulness of this measurement. PATIENTS AND METHODS: Serum thyroglobulin concentration was analyzed in relation to serum thyrotropin receptor antibody (TRab) titer and thyrotropin concentration in 166 patients with Graves' disease without thyroglobulin antibody. RESULTS: A total of 113 patients were treated and had been kept euthyroid for at least 10 months with methimazole and underwent a triiodothyronine (T3) suppression test. At the time of the T3 suppression test, the serum thyroglobulin concentration (ng/mL) was 33 +/- 31 in 80 of them with T3-suppressible (radioiodine uptake less than 12%) thyroids, negative TRab titers (less than 15% displacement), and normal serum thyrotropin concentrations (0.1 to 3.0 mU/L). Patients with T3-non-suppressible thyroids were divided into three subgroups according to serum TRab titers and thyrotropin concentrations: those with a negative TRab titer and a normal serum thyrotropin concentration (n = 9), those with a positive TRab titer and a normal thyrotropin concentration (n = 18), and those with a positive TRab titer and undetectable thyrotropin (n = 6). Serum thyroglobulin concentrations (ng/mL) were 116 +/- 40 in the first group, 249 +/- 194 in the second group, and 399 +/- 205 in the third group. In the other 39 methimazole-treated patients, 72 determinations of serum thyroglobulin concentration were performed either before or during treatment without the T3 suppression test, and it correlated well with the TRab titer but not with the serum thyrotropin concentration. In 14 patients who became hypothyroid due to excess methimazole, the serum thyroglobulin concentration increased concurrently with elevation of the serum thyrotropin concentration and normalized during thyroxine supplementation. In treated patients with T3-suppressible thyroids, the serum thyroglobulin concentration was similar among those with positive (n = 54) and negative (n = 26) microsomal antibody, indicating that the presence of Hashimoto's thyroiditis does not profoundly affect the serum thyroglobulin level. Among 80 patients with T3-suppressible thyroids who were followed without methimazole for a mean period of 31.1 months, eight (10%) experienced a clinically overt recurrence of hyperthyroidism. Serum thyroglobulin concentration and TRab titer (%) in these eight patients were 188.1 +/- 101.7 and 27.8 +/- 12.6, respectively. Thyroglobulin and TRab did not increase in the patients who remained euthyroid (n = 71) or who experienced subclinical recurrence (n = 1). CONCLUSIONS: Abnormal thyroid stimulator(s) and thyrotropin synergistically (if both are present in the serum) or independently (if either one is present) stimulate thyroglobulin secretion in patients with Graves' disease. Therefore, serum thyroglobulin concentration can be a useful means of assessing the degree of thyroidal stimulation and, if serum thyrotropin is normal or suppressed, correlates well with thyroidal stimulation even in patients with a negative TRab titer.

Adult↗
PubMed1990

Arterial injury-induced smooth muscle cell proliferation in rats is accompanied by increase in polyamine synthesis and level.

Proliferation of smooth muscle cells (SMC), enhancement of polyamine biosynthesis and increase in polyamine level in response to deendothelialization in the rat aorta were studied. [3H]Thymidine incorporation into SMC in aortas denuded with a balloon catheter began 25 h after injury, and maximal incorporation occurred 33-37 h after injury. Afterwards, [3H]thymidine incorporation declined, approaching the baseline level, but was slightly higher than that of sham-operated controls until 14 days after injury. Intimal thickening started 7 days after injury, and peaked at 21 days. Prior to these proliferative changes in aortic SMC, a rapid and transient increase in ornithine decarboxylase (ODC) activity was observed within 8 h after injury. There was no significant difference in ODC activity between injured and intact aortas after 4 days. The levels of polyamines, putrescine, spermidine, and spermine increased and were maximal at 48 h after injury, 8.1, 3.4 and 1.4 times the control levels, respectively. Increased levels of polyamines, in particular spermidine, continued until 7 days after injury. These results suggest that the enhancement of polyamine synthesis and the increased polyamine content of the aorta play important roles in the proliferation of SMC and in the development of intimal thickening, particularly in the initial proliferative response of medial SMC after deendothelialization.

Animals↗
PubMed1990

[Investigation on clinical efficacy and passage into ascites of cefminox in diffuse peritonitis associated with infantile acute appendicitis].

Cefminox (CMNX), one of newly developed cephamycin antibiotics, was administered to 7 cases of diffuse peritonitis associated with infantile acute appendicitis to determine its concentrations in the blood, the appendiceal tissue and the purulent ascites and simultaneously to investigate its clinical efficacy. CMNX was intravenously injected at a dose of 20 mg/kg (at a maximum amount of 1.0 g/body) before operation and intravenously by bolus injection or by drip infusion twice daily after operation for 3 to 11 days in a total dose of 2.36 to 14.06 g. Fourteen strains of bacteria were isolated from the purulent ascites: Escherichia coli was isolated from 6 cases but superinfections in 5 cases. MICs of CMNX against these isolated organisms were at or lower than 3.13 micrograms/ml for 12 out of 14 strains. CMNX penetrated into the appendiceal tissue and the purulent ascites very well. The concentrations in the pus reached higher than those in the tissue in about 1 hour after administration and were found to reach as high as 9.63 micrograms/ml in 5 hours after administration. Its clinical efficacies were excellent in 4 cases, good in 2 cases and poor in 1 case. No subjective or objective adverse reactions were observed nor any abnormalities were found in laboratory examinations.

Acute Disease↗
PubMed1990

[Acute myocardial infarction with patent infarct-related artery: selection of treatment based on qualitative analysis of coronary angiograms during the acute phase].

To evaluate the benefit of emergency coronary angioplasty (PTCA) among patients with acute myocardial infarction having patent infarct-related arteries, we investigated 104 patients who received thrombolysis and/or PTCA within 24 hrs after onset of symptoms. The morphology of coronary artery lesions was qualitatively assessed by angiography and categorized as symmetrical or asymmetrical narrowing with smooth margins (S-group, 72 cases) and asymmetrical narrowing in the form of convex intraluminal obstruction representing a thrombus (T-group, 32 cases). Soon after intervention, angiographic success (residual stenosis less than 75%) was achieved in 85% with PTCA (92% in the T-group vs 82% in the S-group) and in 29% without PTCA (53% vs 16%). At hospital discharge, the figures were 82% with PTCA (75% vs 87%) and 43% without PTCA (73% vs 30%). The incidence of re-infarction and/or total occlusion of the infarct-related artery was 9% with PTCA in both the T- and S-groups but 26% in those without PTCA (6% in the T-group vs 31% in the S-group). These data suggest that in patients with patient infarct-related arteries and severe original stenosis, PTCA has an advantage over thrombolysis alone. Qualitative analysis of coronary morphology by angiography provides a framework for selecting adequate therapy.

Adult↗
PubMed1990

Examination of toxicity of diisopropylammonium dichloracetate (DADA), remedies for cardiac diseases, toward isolated rat hepatocytes.

Oxygen uptake (OU) and cell viability (CV) of isolated rat hepatocytes as a part of the indexes of hepatopathy were determined following treatment with DADA, the active principle of pangamic acid. DADA increased OU at high concentrations, but not at low ones. However, CV became higher as the concentration became lower. DADA led to no remarkable toxicity when used alone. When the mixture of DADA and calcium gluconate was tested, DADA showed no palliative action; nor did it when combined with other hepatotoxins such as trapidil, rifampicin, hexobarbital, thiopental sodium, and Citanest-octapressin.

Animals↗
PubMed1990

Determination of 2,5-hexanedione and N-methylformamide in urine by gas chromatography.

Methods for the clinical testing of 2,5-hexanedione and N-methylformamide, urinary metabolites of n-hexane and N,N-dimethylformamide, respectively, were established by capillary column GLC. Recovery rates of 2,5-hexanedione and N-methylformamide from urine were 80.2-108.9% and 99.6-104.2%, respectively. Coefficients of variation (C.V.) for the amount of each product added were 3.1%, 1.8% (intra-assay) and 5.7%, 3.3% (inter-assay), respectively. The concentration ranges of metabolites from urine of healthy subjects without exposure to these organic solvents were less than or equal to 0.5 mg/l (2,5-hexanedione), less than or equal to 1.5 mg/l (N-methylformamide), respectively.

Air Pollutants, Occupational↗
PubMed1990

Elevated plasma atrial natriuretic peptide level in the early phase of microalbuminuria in patients with non-insulin-dependent diabetes mellitus.

Plasma atrial natriuretic peptide (ANP) levels were examined in 66 patients with non-insulin-dependent diabetes mellitus (NIDDM), and in 9 age-matched normal controls and 18 hypertensive controls. The diabetic patients were classified into three groups according to random urine albumin/creatinine ratio (ACR, mg/g or mg/88.4 nM); group 1 (normo-albuminuria, ACR less than 20, n = 34), group 2 (borderline microcalbuminuria, 20 less than or equal to ACR less than 100, n = 17) and group 3 (manifest microalbuminuria and macroalbuminuria, 100 less than or equal to ACR less than 2000, n = 15). Plasma ANP levels (pg per ml) were significantly elevated in group 2 (46.0 +/- 19.0 SD) when compared with either normal controls (23.8 +/- 14.2), group 1 (28.9 +/- 15.6) or group 3 (26.0 +/- 12.9). This increase in plasma ANP levels was not related to hypertension. Furthermore, plasma ANP levels correlated positively with log(ACR) among the patients with ACR under 100 (groups 1 and 2 combined, r = 0.4701, p less than 0.01). These results suggest that an elevated plasma ANP level in the early phase of microalbuminuria possibly plays a pathophysiological role in the development of nephropathy in NIDDM patients.

Albuminuria↗
PubMed1990

[Allergic individuals to Japanese cedar or orchard grass consist of two subgroups based on the sensitization to Dermatophagoides pteronyssinus].

One hundred and twenty-six allergic subjects were divided into three groups based on the RAST results for Dermatophagoides pteronyssinus (D.p) and Japanese cedar (J.C.). We compared sex, age of examination for RAST, serum IgE, family history of allergic diseases, prevalence rate of bronchial asthma (BA) and allergic rhinitis (AR), and onset of AR among three groups. No significant difference in the other variables except serum IgE and prevalence rate of BA was found between the group with D.p-positive and J.C.-positive RAST and the group with D.p-positive and J.C.-negative RAST. The group with positive RAST for D.p and J.C. showed lower age of the examination, higher serum IgE, higher incidence of allergic family history, higher prevalence rate of BA, and lower onset age of AR than the group with negative RAST for D.p and positive RAST for J.C. We suggested that in J.C. RAST-positive group there might be two different subgroups distinguished by RAST result for D.p Similar results were obtained from the assessment of RAST for Orchard grass instead of J.C.

Adolescent↗
PubMed1989

[Effect of remission induction chemotherapy on blood coagulability in patients with gynecological malignancies].

In 12 patients (38 courses) with gynecological malignancies who had been treated with remission induction chemotherapy, we measured the levels of ESR, Platelet, PT, APTT, Hepa T, AT III, alpha 2 PI, FDP and D-dimer, and we also measured such molecular markers as Fibrinopeptide A (FPA), Fibrinopeptide B beta 1-42 (FPB beta 1-42), and Fibrinopeptide B beta 15-42 (FPB beta 15-42) before and after chemotherapy. Then the relation between the post chemotherapeutic trends and prognosis for patient with gynecological malignancies were investigated. 1) Before chemotherapy, the levels of ESR, FDP, D-dimer and FPB beta 1-42 were increased, PT and APTT were shortened significantly in cases on groups IIIrd and IVth stage compared with in cases on groups Ist and IInd stage (p less than 0.05). The levels of FPA were also high, but there was no significant differences. The levels of FPB beta 15-42 were almost same in both groups. However, the each markers indicated the existence of chronic DIC in cases of group IIIrd and IVth stage. 2) One week after chemotherapy, the levels of ESR, fibrinogen, FDP and FPA were decreased, while FPB beta 1-42 and FPB beta 15-42 were increased, suggesting elevated fibrinolytic activity. Two weeks after chemotherapy, there was stronger tendency to coagulation dominant again, but it was only temporary. Three weeks after chemotherapy, the hemostatic balance was regained. 3) In patient with complete remission after effective chemotherapy, their coagulability data were showed within normal range, however, some cases with poor prognosis were not able to obtain the recovery of hemostatic balance, and the levels of molecular markers were significantly elevated. Coagulative activity was more enhanced than fibrinolytic activity in patients with progressive gynecological malignancies, but hemostatic balance was maintained clinically. The hemostatic balance was disrupted by the chemotherapy, but this balance was regained for the IIIrd week. Accordingly, the recovery of hemostatic balance with effective chemotherapy is related to the prognosis for patients with gynecological malignancies, and the levels of molecular markers may be able to expect the prognosis for patients.

Adult↗
PubMed1989

Correlations between heparan sulfate metabolism and hepatoma growth.

A rat hepatoma cell line (Gershenson et al., Science, 170:859-861, 1970) contains a dynamic steady-state pool of free heparan sulfate (HS) chains in the nucleus that increases in amount when growing cells reach confluence (Fedarko and Conrad, J. Cell Biol., 102:587-599, 1986). In logarithmically growing cells labeled with 35SO4(2-) steady-state levels of [35SO4]HS in the nucleus are altered by a variety of culture conditions. Rapidly dividing cells (doubling time = 18-22 h) growing under optimized conditions had steady-state levels of nuclear HS within the range of 40-50 pmol 35SO4 in nuclear HS/10(6) cells. The steady-state levels of nuclear HS were lowered by several changes in culture conditions, including 1) additions of 1 mM p-nitrophenyl-beta-D-xyloside, 0.25-0.5 mM (+)-catechin, 0.5 ng/ml transforming growth factor beta, 20 ng/ml phorbol-12-myristate-13-acetate, 1 mM dibutyryl cAMP, or 1 mM inositol-2-PO4; 2) decreased levels of D-glucose; or 3) deletions of serum, insulin, or inositol. In all cases lowering of the nuclear HS level was accompanied by an increase in the cell doubling times, suggesting a correlation in which nuclear HS levels must be optimized for maximal growth rates. When cells cultured under optimal growth conditions reached confluence, the level of nuclear HS increased threefold and the cells stopped dividing. The same culture conditions that lowered the steady-state levels of HS in the logarithmically growing cells prevented this rise in the nuclear HS as the cells reached confluence and resulted in loss of contact inhibition and overgrowth of the confluent cultures. These observations suggest a second correlation in which elevated nuclear HS levels are found when cell growth is inhibited at confluence; prevention of this rise results in continued growth. Consistent with this correlation between elevated nuclear HS and reduced growth rates, it was observed that addition of either 0.5 microgram/ml hydrocortisone or 0.05 microgram/ml retinoic acid to the culture medium of logarithmically growing cultures resulted in increases in steady-state levels of nuclear HS that were accompanied by increased cell doubling times. The two agents that increased the levels of nuclear HS in logarithmically growing cultures had little effect on levels of nuclear HS in confluent cells or on contact inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗