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Biomedical subjects

M Mishima

Publications and source records attributed to M Mishima.

At least 127 records · Page 7Linked to original sources
PubMed1993

A rho-like protein is involved in the organisation of the contractile ring in dividing sand dollar eggs.

Sand dollar eggs were microinjected with botulinum C3 exoenzyme, an ADP-ribosyltransferase from Clostridium botulinum that specifically ADP-ribosylates and inactivates rho proteins. C3 exoenzyme microinjected during nuclear division interfered with subsequent cleavage furrow formation. No actin filaments were detected in the equatorial cortical layer of these eggs by rhodamine-phalloidin staining. When microinjected into furrowing eggs, C3 exoenzyme rapidly disrupted the contractile ring actin filaments and caused regression of the cleavage furrows. C3 exoenzyme had no apparent effect on nuclear division, however, and multinucleated embryos developed from the microinjected eggs. By contrast, C3 exoenzyme did not affect the organisation of cortical actin filaments immediately after fertilisation. Only one protein (molecular weight 22,000) was ADP-ribosylated by C3 exoenzyme in the isolated cleavage furrow. This protein co-migrated with ADP-ribosylated rhoA derived from human platelets when analysed by two-dimensional gel electrophoresis. These results strongly suggest that a rho-like, small GTP-binding protein is selectively involved in the organisation and maintenance of the contractile ring.

ADP Ribose Transferases↗
PubMed1993

Dermal patch anaesthesia: comparison of 10% lignocaine gel with absorption promoter and EMLA cream.

The analgesic effects of transdermally applied 10% lignocaine aquagel containing 3% glycyrrhetinic acid monohemiphthalate disodium (as an absorption enhancer) and EMLA cream were compared on the forearms of 34 adult volunteers in a double-blind fashion. The mean pinprick pain scores (graded by noting the number of painful pinpricks out of five) at 30, 60 and 90 min after application and 30 min after removal of the anaesthetics were 3.3 (0.3) (mean SE), 1.2 (0.3), 0.3 (0.1) and 0.3 (0.1) respectively, in the lignocaine gel group. Corresponding scores were 3.5 (0.3), 1.5 (0.3), 0.7 (0.2) and 0.1 (0.1) respectively, in the EMLA group. Insertion of a 26-gauge needle into the treated skin to a depth of 1 mm at 90 min after application was not painful in 91% of the volunteers in the lignocaine gel group and 88% of those in the EMLA group. There was no significant difference in any of the corresponding pain scores between the two groups.

Administration, Cutaneous↗
PubMed1993

Late reperfusion for acute myocardial infarction limits the dilatation of left ventricle without the reduction of infarct size.

BACKGROUND: While previous clinical studies have shown a possible beneficial effect of the reperfusion performed at a relatively late phase of acute myocardial infarction ("late reperfusion") in preventing left ventricular enlargement, the mechanism has not been clarified. METHODS AND RESULTS: Of 89 patients with an initial anterior myocardial infarction, reperfusion was successful in 69. These 69 were divided into three groups according to the time required to achieve reperfusion after the onset of symptoms: early-reperfused (< 3 hours from the onset to reperfusion; n = 22), intermediate-reperfused (3 to 6 hours from the onset to reperfusion; n = 28), and late-reperfused (> 6 hours from the onset to reperfusion; n = 19). The 20 patients whose infarct-related artery were occluded in the acute phase as well as 1 month later was classified as nonreperfused. Infarct size, evaluated as defect volume by 201Tl single-photon emission computed tomography 1 month after the onset, was 1593 +/- 652 units (mean +/- SD) in the late-reperfused group, significantly larger (P < .05) than that of the intermediate-reperfused (1066 +/- 546 U) or the early-reperfused groups (372 +/- 453 U) but not different from that of the nonreperfused group (1736 +/- 562 U). Wall motion abnormality index as well as global ejection fraction evaluated by left ventriculography 1 month after the onset showed that late reperfusion did not preserve the left ventricular wall motion and function. These results indicate that the earlier reperfusion decreased the size of the infarction and preserved left ventricular function, whereas late reperfusion (> 6 hours after onset) did not limit infarct size or preserve left ventricular function. In contrast, the end-diastolic volume index did not differ significantly among the early-reperfused (50 +/- 15 mL/m2), intermediate-reperfused (54 +/- 14 mL/m2), and late-reperfused (53 +/- 19 mL/m2) groups; those were significantly smaller than that of the nonreperfused group (68 +/- 12 mL/m2; P < .05). Left ventriculographic data obtained in both the acute and chronic phase in 39 patients showed that left ventricular volumes increased significantly during the course of myocardial infarction only in the nonreperfused group. CONCLUSIONS: Late reperfusion appeared to prevent ventricular dilatation acute myocardial infarction independent of the limitation of infarct size.

Adult↗
PubMed1993

Potential errors in measuring the phase difference between chest flow and mouth flow.

We have previously reported that the phase difference between chest and mouth flows was a useful indicator of obstructive lung disease. In this paper, we calculated the effects of (i) airway reactance, (ii) extrathoracic airway shunt impedance, (iii) heating and humidification of the inspired air, (iv) abdominal gas volume, and (v) respiratory quotient on the measurement of the phase difference between chest flow (Vc) and mouth flow (Vm) using computer simulations. When the airway impedance was approximated as simple airway resistance, the phase difference (theta r) was calculated to be 0.8% less than the phase difference (theta s) calculated from the airway impedance (Za), including airway inertance and shunt compliance, in the normal lung. theta s became larger than theta r when the peripheral resistance increased, but did not exceed 5%. The extrathoracic airway shunt impedance effect did not exceed 0.1%, regardless of the respiratory frequency, airway impedance or thoracic gas volume. The influence of heating and humidification of the inspired air on the phase difference was calculated to be within 5%. The effect of abdominal gas was highly dependent on the abdominal gas volume and the respiratory pattern, but was calculated to be within 5%. The influence of the respiratory quotient was calculated to be negligible. As a result, it was concluded that none of the factors discussed above are an obstacle to the clinical application of this method for the evaluation of pathological changes in obstructive airway disorders.

Airway Resistance↗
PubMed1993

[Clinical significance of dystrophin test for patients with various neuromuscular diseases--immunofluorescence and immunoblot analyses of dystrophin abnormalities].

The dystrophin test was performed on skeletal muscle specimens from 81 cases with various neuromuscular diseases by using two new monoclonal antibodies. The results were compared with those obtained by using four polyclonal antibodies. These monoclonal and polyclonal antibodies were raised against various portions of the dystrophin molecule. On immunohistochemical analysis, the two new monoclonal antibodies showed the same staining pattern as the four polyclonal antibodies. Non-specific immunostaining of the cytoplasm, often seen with polyclonal antibodies, was not observed with monoclonal antibodies. With the application of monoclonal antibodies, the connective tissue sometimes showed non-specific immunostaining which originated from the second fluorescent antibody. On immunoblot analysis, one of the two monoclonal antibodies, antibody 4-4 C 5, showed weak immunoreactivity, and the 400 kDa dystrophin band was not detected. Three cases out of 15 with Duchenne muscular dystrophy (DMD), and one case out of 3 with limb-girdle type muscular dystrophy which had previously been diagnosed on the basis of clinical data, were found to have non-dystrophin-related muscular dystrophy, and Becker muscular dystrophy (BMD), respectively. Three and two of five cases were diagnosed as DMD and BMD, respectively, though clinical diagnosis had not been possible because they were too young. Clinical diagnosis of congenital muscular dystrophy was confirmed in 9 patients by the dystrophin test. Only one of three certain DMD carriers had a so-called mosaic staining pattern. We conclude that all six antibodies are useful tools for the diagnosis of neuromuscular diseases, because of their high specificity for dystrophin.

Adolescent↗
PubMed1993

[Transdermal application of 10% lidocaine-gel for management of pain associated with herpes zoster].

We have developed transdermally applicable 10% lidocaine aqueous gel containing an absorption promoter and applied it for 15 patients suffering from severe pain in acute or subacute phase of herpes zoster. The patients, consisting of 7 males and 8 females with a mean age 58.5 +/- 13.0 (SD) yrs, had skin eruptions of herpes zoster for the past 2 months. Lidocaine-gel was applied locally to the diseased skin with or without an occlusive dressing. In 14 of the 15 patients (93%), a remarkable reduction of pain (below 10% of pretreatment level) was obtained after 9.9 +/- 5.6 (SD) times of lidocaine-gel treatments. There was no adverse systemic reactions or local skin damages. None of them developed post-herpetic neuralgia. The lidocaine-gel treatment appears to be very useful for reduction of pain associated with acute or subacute phase of herpes zoster.

Administration, Cutaneous↗
PubMed1992

Dynamic control of breathing during exercise and hypercapnia.

The dynamic influences of end-tidal CO2 and exercise on ventilation are compared when CO2 and exercise are imposed separately and when they are imposed simultaneously. Five human subjects are studied. The subjects performed three trials: random work rate forcing, random CO2 inhalation and their simultaneous loading. The work rate was varied between 20 and 80 W as a pseudorandom binary sequence. The concentration of inspired CO2 was varied randomly between 0 and 7 per cent, adjusted so that it produced approximately the same amount of ventilatory fluctuations as the random work load. The relative contribution of each variable was analysed using multivariate autoregressive analysis at frequencies ranging from 0.1 to 1 cycle min-1. The results show that the dynamics of the response to CO2 inhalation, exercise and their combination are nonlinear and that the combination of CO2 inhalation and exercise magnifies the nonlinear behaviour. Ventilation is largely unaffected by either work rate or end-tidal CO2 at 1 cycle min-1. During simultaneous CO2 and work rate forcing, ventilation tends to follow the change in the end-tidal CO2.

Adult↗
PubMed1992

Temporal increase in resting coronary blood flow causes an impairment of coronary flow reserve after coronary angioplasty.

Impaired coronary flow reserve immediately after coronary angioplasty may be attributed to an increase in resting coronary blood flow. To test this hypothesis we measured great cardiac venous flow (GCVF) at rest and during rapid atrial pacing before and immediately after angioplasty in 22 patients with significant narrowing of the left anterior descending artery and 12 patients (control group) with minimal narrowing. A follow-up (6 months) study was also done in seven patients. Immediately after angioplasty the coronary flow reserve (peak GCVF during pacing/resting GCVF) was not fully restored (1.5 +/- 0.36 before angioplasty, 1.76 +/- 0.42 after angioplasty, and 2.13 +/- 0.33 in the control group). Resting coronary vascular resistance (2.4 +/- 0.9 mm Hg/ml/min) was significantly decreased after angioplasty (2.0 +/- 0.8 mm Hg/ml/min), whereas coronary vascular resistance during rapid pacing was fully restored to normal. Resting hyperemia was restored 6 months later, whereas coronary vascular resistance during pacing was unaltered. In five patients, however, slight ischemic ST-T changes were observed during rapid pacing, even after successful angioplasty associated with a decrease in the lactate extraction ratio. These results indicate that the impaired coronary flow reserve immediately after angioplasty may be attributed mainly to the temporal but significant increase in resting coronary flow, although impaired coronary vascular response to augmented myocardial oxygen demand may also be partially involved.

Aged↗
PubMed1992

Phase differences between chest and mouth flows in patients suffering from pulmonary disease.

The phase difference (PD) between mouth flow and chest flow during rest breathing was measured in pulmonary diseased patients using a body box and the results were compared with normal subjects. Whereas the PD increased in patients with chronic pulmonary obstructive disease (COPD) compared to normal subjects, PD was found to be normal in patients with interstitial pulmonary fibrosis (IPF) (Normal: 2.94 +/- 1.25, COPD: 11.32 +/- 4.17*, IPF: 2.62 +/- 1.67 degrees; *P < 0.01). PD correlated well with FEV1.0/VC%, PFR, RV/TLC, VTG and Ra (r: -0.759, -0.672, -0.788, 0.666, 0.606). From an in-depth analysis of the results, we suggest that the factors which increase PD in COPD patients include hyperinflation of the lung, increases in airway resistance and increases in the parallel inhomogeneity of airway resistance accompanied by an unevenness of alveolar pressures. PD was thought to be clinically useful for the evaluation of the pathological stages of COPD because it reflects the overall clinical manifestations in COPD patients.

Adult↗
PubMed1992

Adverse effects of epinephrine in patients with advanced left ventricular dysfunction: analysis of ventriculo-arterial coupling.

We examined the response of ventriculo-arterial coupling to epinephrine in 19 patients with normal left ventricular function and with left ventricular dysfunction of various degrees using a conductance catheter. They were divided into three groups: group I, seven patients without left ventricular wall motion abnormality; group II, six patients with ejection fraction of 45-60%; group III, six patients with ejection fraction of 28-40%. Changes in the slope of the end-systolic pressure-volume relationship (end-systolic elastance), the effective arterial elastance, the ratio of effective arterial elastance to end-systolic elastance and the ventricular work efficiency during administration of two different doses of epinephrine (0.05 and 0.1 micrograms/kg/min) were compared among the three groups. At baseline there were no significant differences among the three groups in the ratio of effective arterial elastance to end-systolic elastance, or ventricular work efficiency. At the lower dose of epinephrine, the mean ratio of effective arterial elastance to end-systolic elastance decreased and the mean ventricular work efficiency increased in any groups. At the higher dose of epinephrine the mean ratio of effective arterial elastance to end-systolic elastance further decreased and the mean ventricular work efficiency further increased in groups I and II. However, the mean ratio of effective arterial elastance to end-systolic elastance did not decrease but the mean ventricular work efficiency even decreased in group III. Thus, in patients with advanced left ventricular dysfunction, even a high dose of epinephrine does not modulate the ventriculo-arterial coupling to increase ventricular work efficiency.

Aged↗
PubMed1992

Dermal patch anesthesia: pain-free puncture of blood access in hemodialysis patients.

Clinical application of dermal patch anesthesia to relieve pain at venous cannulation of blood-access was studied in hemodialysis patients. Aqueous gel of 10% lidocaine base with 3% glycyrrhetinic acid monohemiphthalate disodium (GA MHPh 2Na) was applied for 60 minutes to the skin of the patients. Degree of pain was expressed as a pain score. Analgesic effect of the lidocaine gel was evaluated in 16 patients in a placebo-controlled, double-blind, cross-over design by comparing the gel with lidocaine with a placebo gel without lidocaine. The mean pin-prick pain score (1.0 +/- 0.5) in the lidocaine gel patch (n = 16) was significantly lower than that (2.3 +/- 0.3) in the placebo gel patch (P < 0.01). In 8.8% of the patients, blood pressure was elevated after venous cannulation, but this tendency was modified by dermal patch anesthesia with the lidocaine gel. Plasma concentration of lidocaine was under the detection limit of assay (< 0.05 micrograms/mL) after dermal patch anesthesia in six subsequent dialysis treatments.

Administration, Cutaneous↗
PubMed1992

Dermal patch anaesthesia for venous cannulation with 10% lignocaine gel containing glycyrrhetinic acid monohemiphthalate disodium as an absorption promoter.

The clinical efficacy of transdermal 10% lignocaine gel mixture containing 3% w/w glycyrrhetinic acid monohemiphthalate disodium as an absorption promoter was evaluated at venous cannulation in 17 paediatric (6-11 years) and 17 adult (29-65 years) patients. After about 60 min of occlusive application, the mean (SD) pinprick pain score was 0.7 (0.7) in the paediatric group, compared with 1.4 (1.3) in the adults (p less than 0.05). Twenty-five patients (14 children and 11 adults) who had a pinprick score of 0 or 1 underwent venous cannulation without intradermal local anaesthetic. The mean (SD) pain scores at venepuncture showed no significant differences between children and adults.

Administration, Cutaneous↗
PubMed1992

Role of atrial contraction and synchrony of ventricular contraction in the optimisation of ventriculoarterial coupling in humans.

OBJECTIVE: To examine the effects of pacing modes on the interaction between the left ventricle and arterial system in humans. DESIGN: The slope of the end systolic pressure-volume relation (end systolic elastance), effective arterial elastance, the ratio of effective arterial elastance to end systolic elastance, and mechanical energy efficiency were compared under different pacing modes (atrial, atrioventricular, and ventricular). PATIENTS: Nine male patients with sick sinus syndrome who had cardiac catheterisation for diagnosis and to see whether they needed a pacemaker. INTERVENTIONS: A conductance catheter with tip-manometer was inserted into the left ventricle to obtain pressure-volume loops, and two pacing catheters were inserted into the right atrium and into the right ventricle respectively. RESULTS: End systolic elastance was lower in atrioventricular pacing than in atrial pacing, but effective arterial elastance was not significantly different. End systolic elastance was lower in ventricular pacing than in atrioventricular pacing, and effective arterial elastance was higher in ventricular pacing than in atrioventricular pacing. Consequently the ratio of effective arterial elastance to end systolic elastance was lowest in atrial pacing and highest in ventricular pacing, and mechanical energy efficiency was highest in atrial pacing and lowest in ventricular pacing. CONCLUSIONS: Atrial contraction and synchronous ventricular contraction independently optimise ventriculoarterial coupling in terms of a transfer of energy. Thus atrial pacing gives the best ventriculo-arterial coupling among these pacing modes.

Adult↗
PubMed1992

A comparative study of transdermal 10% lidocaine gel with and without glycyrrhetinic acid monohemiphthalate disodium for pain reduction at venous cannulation.

The clinical benefits of transdermal 10% lidocaine base gels with and without 3% glycyrrhetinic acid monohemiphthalate disodium (GAMHPh) for reduction of pain at venous cannulation were compared in a randomized, double-blind fashion in 24 surgical patients. After about 60 min of occlusive transdermal application, the mean pinprick pain score (1.3 +/- 1.5) in the GAMHPh group (n = 12), graded by noting the number of painful pinpricks out of five, was significantly less than that (2.5 +/- 1.7) in the control group (n = 12) (P less than 0.05). Twelve patients (eight in the GAMHPh group and four in the control group) who had a pinprick score less than 1 underwent venous cannulation without intradermal injection of a local anesthetic. The pain score at venipuncture, graded by the patients on a scale of 5, was significantly less in the GAMHPh group than that in the control group (1.9 +/- 1.1 vs 3.3 +/- 1.0, P less than 0.05). Erythema observed in 8 of the 24 patients was the only adverse local reaction. Addition of 3% GAMHPh to the lidocaine gel is useful in promoting transdermal lidocaine absorption.

Administration, Cutaneous↗
PubMed1992

Skin pretreatments for shortening onset of dermal patch anesthesia with 3% GA MHPh 2Na-10% lidocaine gel mixture.

Three types of skin pretreatments (stripping with adhesive tape, scrubbing with Skin-Pure jelly, and cleaning with benzine) were studied in 21 volunteers to determine whether the pretreatments could shorten the application period of transdermal 3% GA MHPh 2Na-10% lidocaine gel. Before application of the gel, each subject received skin pretreatment on the volar surface of one forearm. Then, the lidocaine gel soaked in a round sponge was applied on both the pretreated area of the forearm and the unpretreated contrast area of the other forearm. A pain score was obtained from each subject at 30, 45, 60, and 75 min after placement of the dermal patch by noting the number of painful pinpricks of five delivered. The mean pain scores on the pretreated side were significantly lower at 30, 45, and 60 min in the stripping study group and at 45 and 60 min in the cleaning study group, compared with the corresponding scores on the unpretreated side (P less than 0.05). Skin pretreatments, such as stripping and cleaning, are useful for shortening the onset of the dermal patch anesthesia.

Administration, Cutaneous↗
PubMed1992

[Evaluation of chemotherapy of unresectable non-small cell lung cancer].

For this evaluation, a comparison was made of survival of 34 patients with non-small cell lung cancer who had undergone chemotherapy (Group B) with that of 38 patients without this chemotherapy (Group A). Group B had received neither radiotherapy for primary lesions nor bronchial artery infusion of anticancer drugs, and the chemotherapeutic regimen was CDDP + VDS or CDDP + VDS + MMC chemotherapy. MST of this group was significantly longer than that of Group A (4.5 months vs 7.3 months. P less than 0.01), but the PS features of the two groups differed significantly. A comparison was thus made of survival for PS 1-2 cases in both groups (Group A: 17 cases, Group B: 27 cases). MST of group A and B were 6.8 and 9.8 months, respectively (P less than 0.05). The efficacy of the treatment for prolonging survival in terms of age, sex, PS, histology, T factor, N factor and M factor was evaluated by multivariate analysis using the proportional hazard model of Cox. The results obtained indicated the chemotherapy significantly prolonged survival.

Aged↗