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Biomedical subjects

M Mishima

Publications and source records attributed to M Mishima.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Key grafts in emergency aortocoronary bypass surgery].

We evaluated relations with operative results of emergency aortocoronary bypass grafting to severity of residual stenotic lesion after surgery in patients with impending myocardial infarction or acute myocardial infarction. Mortality in patients with residual stenotic lesion whose score more than 15 is 66%. Mortality in patients with residual stenotic lesion whose score less than 15 is 5%, excluding patients died with noncardiac cause. Four of 6 patients (66%) with residual stenotic lesion whose score more than 5 have residual angina after the operation. None of fourteen patients with residual stenotic lesion whose score less than 5 has residual angina after the operation. In theory, we could save their lives with only one graft in 76% patients and cure their angina with less than 2 grafts in 72% patients. These grafts are key grafts.

Aged↗
PubMed1989

Glucagon in the metabolic and nutritional management after total pancreatectomy--a case report.

The effects of exogenous glucagon on a totally pancreatectomized patient were evaluated in both the acute postoperative and convalescent periods. In the acute postoperative phase, glucagon stabilized the blood glucose level and allowed the administration of an adequate amount of energy, while during the convalescent period, it proved useful in promoting the metabolism of lipids and amino acids and maintaining liver function. Moreover, we developed a glucagon aerosol which enabled frequent administration without causing major discomfort to the patient and raised the blood glucagon to satisfactory level.

Amino Acids↗
PubMed1989

A study on graft-versus-host reaction (GVHR) by Simonsen's splenomegaly assay. Cells and antigen systems involved in induction of GVHR.

Cells and histocompatibility antigen systems involved in graft-versus-host reactions (GVHR) were analyzed using Simonsen's splenomegaly assay employing various combinations of donor and F1 hybrid recipients mice. Most of the cells proliferating in spleens of mice undergoing GVHR were J11d+, and had histological features of cells of the hematopoietic lineage. The proportions of CD3+ T cells were decreased in the spleens. Disparity at minor histocompatibility determinants of AKR, I-E and H-2D regions between B10.A(4R) donors and (4R X AKR) F1 recipients evoked only negligible GVHR. On the contrary, disparity at H-2K and/or I-A regions appeared to be sufficient to permit induction of full GVHR. When surface markers of donor spleen cells were analyzed, it was shown that Thy-1+ and/or MEL-14+ cells caused a strong effect on GVHR. Further, either CD4+ or CD8+ T cell subset could induce significant GVHR. However, synergistic influences of these two T cell subsets on one another in GVHR were observed. The present results raise the possibility of using Simonsen's assay along with a number of reagents to identify the contribution of subsets of T lymphocytes and in analyzing precise contributions of cellular components from both donor and recipient, and also of the target antigen systems of the recipient that contribute to early events involved in GVHR.

Animals↗
PubMed1989

Promotion of nasal absorption of insulin by glycyrrhetinic acid derivatives. I.

Nasal absorption of insulin in rats was enhanced by addition of sodium glycyrrhetinate (GA Na), dipotassium glycyrrhizinate (GZ K2), and carbenoxolone (glycyrrhetinic acid hydrogen succinate) disodium salt (GAHS Na2). The latter agent was the most effective. On addition of 1% GAHS Na2, plasma immunoreactive insulin levels in rats showed a maximum level of 0.75 mU/ml at 15 min and plasma glucose levels were decreased to about 25 mg/dl after nasal administration of 10 U/kg insulin. In a comparison of the absorption rates of insulin by nasal and intravenous (i.v.) routes in rats, nasal absorptions of 10 U/kg insulin in the presence of 1% GAHS Na2, 0.5% GA Na and 1% GZ K2 were 26.5%, 13.2% and 14.5% of that in the case of a 5 U/kg i.v. dose, respectively. Hemolytic activies of GAHS Na2, GA Na and GZ K2 were milder than those of Na caprate and Na laurate, and nasal leucine aminopeptidase activity was more strongly inhibited by GAHS Na2 than by medium chain fatty acid salts, sodium glycocholate, GA Na or GZ K2. Therefore, it is suggested that GAHS Na2 is a very useful promoter which dose not irritate the nasal mucosal membrane or degrade insulin.

Absorption↗
PubMed1989

Enzymatic and chemical stability of 2',3'-dideoxy-2',3'-didehydropyrimidine nucleosides: potential anti-acquired immunodeficiency syndrome agents.

The enzymatic and chemical stability of three 2',3'-dideoxy-2',3'-didehydropyrimidine nucleosides has been studied. Chemical degradtion of the analogues was measured in the pH range of 1.0-9.0. 2',3'-Dideoxy-2',3'-didehydrocytidine (DDCN) degraded rapidly under acidic conditions, but the chemical stability was greater under basic conditions. The chemical degradation of 2',3'-dideoxy-2',3'-didehydrouridine (DDUN) and 2',3'-dideoxy-2',3'-didehydrothymidine (DDTN) was not pH dependent and was faster than that of cytarabine. Enzymatic degradation of DDCN, DDUN and DDTN was not observed in human plasma, though cytarabine was degraded enzymatically under the same conditions. DDCN was also not degraded in the presence of mouse kidney cytidine deaminase.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Preliminary clinical experience with intermittent coronary sinus occlusion in combination with thrombolytic therapy in acute myocardial infarction.

Previous experimental studies have clarified the effectiveness of intermittent coronary sinus occlusion or ICSO. We evaluated the clinical feasibility, safety and effectiveness of ICSO in the patients with acute myocardial infarction (AMI) who were treated with concomitant thrombolytic therapy. Implementation of ICSO was obtained in 76% of the eligible patients. Twelve patients with evolving anteroseptal infarction treated with ICSO + thrombolysis were compared with 12 patients with anterior AMI treated with thrombolysis alone. Baseline characteristics were comparable between the two groups. Adverse effects of ICSO on hemodynamics, hematologic parameters and ventricular arrhythmias were not detected. Enzymatic infarct size, myocardial lactate metabolism in the acute phase, and left ventricular wall motion and Tl-201 perfusion defect at follow-up in ICSO group were slightly improved compared with controls.

Adult↗
PubMed1989

Metabolic fate of strychnine in rats.

1. The urinary and faecal excretions of radioactivity, in rats dosed with 3H-strychnine at 0.5 mg/kg subcutaneously, were approx. 30% and 65% of the dose in 7 days, respectively. The radioactivity was mostly excreted within 24 h. 2. Approx. 6% and 3% dose was excreted into urine and faeces, respectively, as unchanged strychnine. 3. Urinary metabolites were extracted from rat urine and purified by silica gel column, t.l.c. and h.p.l.c. Six urinary metabolites, namely, strychnine N-oxide, 21 alpha,22 alpha-dihydroxy-22-hydrostrychnine, 21 alpha,22 beta-dihydroxy-22-hydrostrychnine, 2-hydroxy-strychnine, strychnine 21,22-epoxide and 16-hydroxystrychnine, were identified by comparison with authentic samples by g.l.c.-mass spectrometry. The major metabolites of strychnine in vivo was strychnine 21,22-epoxide.

Animals↗
PubMed1989

[Measurement of blood flow of saphenous vein graft with Doppler catheter].

We investigated the measurement of blood flow of saphenous vein graft by Doppler Catheter. Under operation of femoro-popliteal bypass graftings (3 cases with 5 grafts of arteriosclerosis obliterans) with reversed saphenous vein grafts, blood flow of saphenous vein graft was measured. At the same time, blood flow of saphenous vein graft was measured by electromagnetic flowmeter. And the values obtained by Doppler Catheter (y) and those obtained by electromagnetic flowmeter (x) were compared. As a result, a good corelationship (y = 0.752 x -14.9, r = 0.836, p = 0, n = 20) was obtained. In conclusion, we suggest that the values of saphenous vein graft can be measured by Doppler Catheter. We actually measured the blood flow of saphenous vein graft with CABG. The measurement was thought to be possible.

Arteriosclerosis Obliterans↗
PubMed1989

[Limitation of RI imaging in evaluating lung function test--development of new methods].

We developed two methods for determining the regional distribution of (1) RV/TLC and air trapping during forced expiration and (2) the ratio or pulmonary blood volume to blood flow. 1) The regional distributions of RV/TLC and air trapping ratio: A.T.R. (air trapping caused by forced expiration) were measured in respiratory disease cases and normal subjects using Xe-133 gas. In normal subjects, RV/TLC gradually decreased from the apex to the base of the lung. A.T.R. was very low in all lung fields. In chronic emphysema (CPE), both RV/TLC and A.T.R. were much higher than the value in normal subjects at the highly diseased areas. In contrast, in case of diffuse panbronchiolitis (DPB), RV/TLC remained within the normal range and A.T.R. was increased considerably in the diseased regions. These results suggest that airway obstruction occurs only during the forced expiration in DPB. 2) The regional distribution of the ratio of pulmonary blood volume to blood flow (tau p) were measured in a normal subject and a case of mitral regurgitation. In both subjects, the distribution of 1/tau p consisted of three zones: upper, middle and lower. The distribution of 1/tau p was constant in the middle zone, but, in the upper and lower zones, it decreased in proportion to the distance from the middle zone. In the case of mitral regurgitation, the middle zone shifted to the apex. Applying the results to the lung perfusion model proposed by West, it was suggested that these phenomena might reflect the increase of the pulmonary venous pressure and the perfusion disorder in the lower lung.

Blood Volume↗
PubMed1989

[Impedance analysis using the random noise oscillation method and a body box].

The frequency characteristics (at 10-40 Hz) of airway (Za) and tissue (Zt) impedances in patients with chronic bronchitis (CB), chronic pulmonary emphysema (CPE) and interstitial pneumonitis (IP) were examined using the random noise oscillation method and a body box. Compared with normal subjects, Zar (r:real part) was elevated in cases of CB, but not in those with CPE. Zai (i:imaginary part) was decreased in cases of CB and CPE. Applying an electromechanical analogy to these results, it was inferred that CB increases both central and peripheral airway resistance, while CPE only increases peripheral resistance. In CPE, but not in CB, Ztr fell; only Zti decreased in IP, which suggests a decrease in mass per unit of lung tissue in CPE and a loss of pulmonary compliance in IP. We also measured the impedance of a dog with acute pulmonary edema induced by oleic acid. Zar an Ztr were increased but Zti was decreased, which corresponded with the increase of airway resistance due to hypersecretion and the decrease of lung compliance. We conclude that this method is useful in differentiating interstitial disorders from COLD, and also CB from CPE, because it can detect lung stiffness and can identify sites of airway narrowing.

Adult↗
PubMed1989

[Serial myocardial lactate metabolic changes after intracoronary thrombolysis in evolving myocardial infarction].

To ascertain whether early intracoronary reperfusion (less than 3 hours) preserves aerobic myocardial metabolism in acute myocardial infarction, serial changes in trans-cardiac lactate extraction after intracoronary thrombolysis were examined in 35 patients with acute anteroseptal myocardial infarction. Eight patients without intracoronary reperfusion served as controls. In the chronic phase, we also observed abnormally contracting myocardial segments as an index of infarct size and the regional ejection fraction as an index of chronic regional cardiac function. In the early reperfusion group (less than 3 hours; 15 cases), positive lactate extraction was restored; there were small abnormally-contracting segments and a high regional ejection fraction. However, the intermediate reperfusion group (3-5 hours; 10 cases) had sustained anaerobic lactate extraction, large abnormally-contracting segments and a low regional ejection fraction. The late reperfusion (greater than 5 hours; 10 cases) group showed apparent aerobic lactate extraction, but had large abnormally-contracting segments and a low regional ejection fraction. Thus, early reperfusion preserves aerobic lactate metabolism and good ventricular function in the chronic phase.

Heart Ventricles↗
PubMed1989

[Uncommon calcification of a pheochromocytoma: a case report].

A 62-year-old man with a 2-year history of hypertension was referred for evaluation of severe back pain, but his blood pressure was normal during his hospital stay. Plain radiography and excretory urography demonstrated central and eggshell-like calcification in the left suprarenal area. Computed tomographic scan confirmed similar shapes for the left adrenal calcifications. Laboratory examination revealed that the urinary normetanephrine was elevated. Left adrenal venography showed that the mass was in the middle to lower portion of the left adrenal gland. The most likely diagnosis was, calcified pheochromocytoma. The left adrenal tumor was removed surgically through a thoracolumbar incision on September 19, 1985. The blood pressure rose to 186/102 mmHg at the time of tumor manipulation. The tumor was a markedly hard mass, which was 3.5 x 3.5 x 3.0 cm and weighed 20 g. The histopathologic diagnosis was calcified pheochromocytoma. The patient remained symptomless after the operation.

Adrenal Gland Neoplasms↗
PubMed1989

A study on type II collagen-induced arthritis in allogeneic bone marrow chimaeras.

In the present investigation, the incidence, day of onset and severity of type II collagen (IIC)-induced polyarthritis (CA) in allogeneic bone marrow chimaeras were compared. These chimaeras were prepared by using reciprocal combinations between DBA/1J (H-2q, Igh-1c, Hc1), which are highly susceptible to CA, and SWR/J (H-2q, Igh-1c, Hc0), which are CA resistant, strains of mice. The four kinds of chimaeras, [SWR----DBA/1], [DBA/1----DBA/1], [DBA/1----SWR] and [SWR----SWR], were shown to be full chimaeras. [SWR----DBA/1] and [DBA/1----DBA/1] chimaeras showed serum C5 antigens and most of these mice developed CA, even though severity of CA in [SWR----DBA/1] chimaeras was less than that in [DBA/1----DBA/1] syngeneic chimaeras. By contrast, [DBA/1----SWR] and [SWR----SWR] chimaeras completely lacked serum C5 and did not develop CA at all. However, most of these chimaeras produced considerable total IgG and IgG2a antibodies to IIC in the sera after immunization with the antigens, although differences in the serum levels of IgG2a antibodies were seen between [SWR----DBA/1] and [DBA/1----SWR] allogeneic chimaeras. The present results demonstrate directly a crucial role of complement cascade in the induction and development of CA and reveal that lymphoid cells of SWR mice potentially have the ability to develop CA. Differences in severity of the CA observed in some of these chimaeras, however, could not be readily explained by differences in C5 concentrations alone.

Animals↗
PubMed1989

[Evaluation of respiratory disability in patients of respiratory diseases using relationships between ventilatory drive, ventilation and thoracic pump function during exercise].

We studied the parameters of breathing control during exercise in patients with respiratory diseases for the evaluation of respiratory disability. The ventilatory drive during the same load exercise was increased in patients with respiratory diseases compared with that in normal subjects. In addition, the ratio of ventilation to ventilatory drive during exercise was decreased in patients with respiratory diseases. Impairment of rapid thoracic movement was suggested to be one of the mechanical limitations for ventilation in these patients, based on the findings of smaller esophageal pressure fluctuation during maximum ventilation of 40 respirations per minute than that in normal subjects. Flow at 0.1 sec after initiation of inspiration was designated V0.1. The increase of the ratio of V0.1 at rest to that at maximum voluntary inspiration (V0.0 (rest)/V0.1 (max)) indicate the grade of respiratory disability showing the impossibility of rapid movement of thorax as a parameter of thoracic pump function. It was recognized that the decrease of VE/P0.1 during incremental exercise indicated ventilatory insufficiency.

Exercise Test↗
PubMed1988

The role of intracoronary thrombus in unstable angina: angiographic assessment and thrombolytic therapy during ongoing anginal attacks.

Intracoronary thrombus is regarded as a potentially important factor in the etiology of unstable angina, but the incidence of intracoronary thrombus in unstable angina has not been clearly defined. To determine the occurrence of intracoronary thrombus during ongoing angina pectoris, coronary angiography was performed during spontaneous ischemic attacks in 37 patients with prolonged rest angina. All patients exhibited significant (greater than 50%) stenoses of at least one major coronary artery. Of the 37 patients, 21 (57%) had intracoronary thrombus in major coronary arteries, whereas 14 (38%) had fixed narrowings without evidence of intracoronary thrombus and two exhibited coronary spasm. ST segment elevation was observed in 16 of 21 patients with thrombus and in all of the patients with coronary spasm, but all the patients with organic stable obstruction showed ST segment depression. Twenty of the 21 patients with thrombus improved after thrombolytic therapy with intracoronary injection of urokinase; obstructed arteries were reopened, or narrowings were attenuated, with relief of ischemic symptoms. In patients with fixed obstructions, the rate-pressure product during active symptoms was significantly higher than during an asymptomatic period, indicating that a transient increase in myocardial oxygen demand may contribute to the ischemic attack in these patients. A high incidence (71%) of recurrent symptoms was observed in patients with intracoronary thrombus even after successful thrombolysis, in contrast to a much lower incidence (36%) in those without intracoronary thrombus. Myocardial infarction within 4 weeks after catheterization was observed more frequently in patients with intracoronary thrombus (24%) than in those without thrombus (7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗