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Biomedical subjects

M Munakata

Publications and source records attributed to M Munakata.

At least 163 records · Page 9Linked to original sources
PubMed1992

Circadian blood pressure variation in patients with renovascular hypertension or primary aldosteronism.

Circadian blood pressure (BP) variation were studied in patients with renovascular hypertension (RVH) and primary aldosteronism (PA). Ambulatory BP (ABP) was monitored every 5 min for 24 hrs in a ward setting in 23 patients with PA and 17 patients with RVH (13 patients with unilateral renal arterial stenosis and 4 with bilateral stenosis). In patients with RVH, ABP was monitored before and after treatment with a converting enzyme inhibitor or percutaneous transluminal angioplasty. Plasma renin activity (PRA) was high before percutaneous transluminal angioplasty in almost all patients with RVH and low in those with PA. Ordinary circadian BP variation, i.e. nocturnal fall and diurnal rise in BP, was confirmed in the patients with unilateral or bilateral renal artery stenosis. Percutaneous transluminal angioplasty successfully normalized both BP and PRA in those with RVH. Normal circadian BP variation was observed in those with RVH before the treatment with a converting enzyme inhibitor or percutaneous transluminal angioplasty as well as during treatment with the former and after treatment with the latter. Circadian BP variation in the patients with RVH was affected by the pathogenesis of renal artery stenosis alone, i.e, fibromuscular hyperplasia and atherosclerosis; with fibromuscular hyperplasia normal circadian BP variation was observed, while with atherosclerosis, nocturnal BP fall was restricted or eliminated. Circadian BP variation in those with PA before and after excision of adrenal adenoma was essentially similar to that in normal subjects and essential hypertensive patients. From these it seems that in patients with RVH or PA, circadian BP variation is not affected by hypertension per se or by pathogenesis of hypertension.

Adenoma↗
PubMed1992

Effect of slow release nifedipine tablets in patients with essential hypertension.

The antihypertensive effect of slow release nifedipine (CAS 21829-25-4) tablets (20 mg, Adalat) administered once or twice daily was studied in patients with essential hypertension of WHO stage I or II. Ambulatory blood pressure was monitored by a finger volume oscillometric device every 5 min for 24 h before and during the treatment with nifedipine. Whether administered once or twice daily, nifedipine tablets dit not change the pattern of circadian blood pressure variation; i.e. diurnal rise and nocturnal fall. Twice daily administration induced a significant downward shift in the blood pressure pattern. In other words, further hypotensive effect was observed during the night when the blood pressure was already low. On the other hand, administration once daily in the morning lowered daytime blood pressure without affecting blood pressure during the night. The duration of action of nifedipine tablets administered once daily was 12 h or more. In the acute experiment using 20 mg tablets of nifedipine, plasma concentration of nifedipine was well correlated with the percentage change in mean blood pressure. The minimal effective plasma concentration of nifedipine was estimated to be 13.4 ng/ml. However, in chronic treatment, nifedipine lowered blood pressure at the plasma concentration of 10 ng/ml. The results indicate that nifedipine tablets administered once daily provide an effective antihypertensive regimen for controlling daytime hypertension with minimal antihypertensive effect during the night.

Adult↗
PubMed1992

[Functional evaluation of possible cytokine receptors on airway smooth muscle: modification of airway smooth muscle responses by cytokines].

Recently, the role of activated T-cell derived cytokines in the pathophysiology of asthma has been recognized. In this study, we evaluated the effects of interleukin-2 (IL-2) and gamma interferon (IFN-gamma) on contractile and relaxing responses of guinea-pig tracheal strips in isometric tension measurement system. IL-2 enhanced carbachol (Carb)- and KCl-induced contraction, and attenuated isoproterenol (Iso)-induced relaxation. IFN-gamma had little effect on Carb and KCl contraction, but enhanced Iso relaxation. These effects of cytokines were abolished by denuding epithelium from tracheal strips. These results suggest that IL-2 and IFN-gamma are able to affect functions of non-immune cells in the airway, and that the airway epithelium has some role in the effects of cytokines on airway responses.

Animals↗
PubMed1992

[A case of round atelectasis associated with spontaneous pneumothorax].

A 59-year-old female was admitted for spontaneous pneumothorax. After evacuation, the chest X-ray film showed a round mass lesion at the left hilum. Following curettage and bronchoalveolar lavage of the left B3c, the mass became smaller, suggesting the diagnosis of round atelectasis. This is the first report of round atelectasis complicated by spontaneous pneumothorax. The mechanism of this case is suggested to resemble that of round atelectasis associated with pleural effusion.

Bronchoalveolar Lavage Fluid↗
PubMed1992

[Case report of collagen lung in SLE presenting with cough variant asthma: relation between the localization of responsible receptors and cough].

A 27-year-old nonsmoking woman complained of cough and chest oppression for two years since an episode of pneumonia. Clinical tests showed decrease in FEV1.0 during attacks of coughing and evidence of bronchial hypersensitivity. While these events fitted the picture of bronchial asthma, the nonwheezing cough suggested cough variant asthma. Antinuclear antibody and anti-ds DNA antibody were increased and leukopenia was recognized, suggesting the diagnosis of systemic lupus erythematosus (SLE). Bronchoalveolar lavage showed lymphocytic alveolitis and decreased T4/T8. These results were suggestive of collagen lung induced by SLE. Inhalation challenge with capsaicin and rapid intravenous injection of lobelin and alinamin indicated that peripheral c-fiber receptors were involved in the induction of coughing. We conclude that the peripheral lesion of collagen lung stimulates the peripheral c-fiber receptors, leading to cough variant asthma.

Adult↗
PubMed1992

[A case of Swyer-James syndrome with bilateral lesions].

A 16-year-old female was admitted for the treatment of bronchial asthma. She had a history of measles pneumonia at four years of age. Her chest radiograph revealed right unilateral hyperlucency. She was diagnosed as having Swyer-James syndrome from the results of computed tomography, pulmonary angiography, bronchoscopy, and perfusion-ventilation scintigrams, which revealed unsuspected bilateral involvement, and irregularity of severity and distribution. In addition, she had a hypoplastic right upper bronchus, pulmonary hypertension, pneumothorax, and bronchial asthma. The findings of bilateral involvement, irregular distribution, and bronchial lesions strongly suggest that the etiology in this case was damage to the airways caused by measles infection in childhood.

Adolescent↗
PubMed1991

Assessment of age-dependent changes in circadian blood pressure rhythm in patients with essential hypertension.

The effects of age on the circadian blood pressure rhythm of patients with untreated essential hypertension (n = 133, World Health Organization stage I or II) were compared with those of normotensive subjects (n = 91). Subjects were classified into three groups by age: young (less than 40 years old), adult (40-59 years old) and old (greater than or equal to 60 years old). Blood pressure was monitored every 5 min for 24 h, using a finger volume oscillometric device under fixed external conditions. The single cosinor method was used to evaluate circadian rhythm. There was no difference in the amplitude of circadian systolic or diastolic blood pressure rhythm among the different normotensive and essentially hypertensive age groups although a wide distribution of amplitude was noted within each group. The distribution of amplitude was wider in the hypertensive than in the normotensive groups. The amplitude of circadian blood pressure rhythm was independent of the mesor level. On the other hand, the amplitude of circadian heart rate rhythm decreased with increasing age both in normotensive subjects (P less than 0.05, young versus adult or old) and hypertensive patients (P less than 0.01, young and old versus adult). The acrophase of circadian systolic blood pressure rhythm in young hypertensives was greater than that in adult or old hypertensives (P less than 0.05, for both). Such age-dependent changes were not observed in the normotensive groups. Consequently, the acrophase of circadian systolic or diastolic blood pressure rhythm in young hypertensives was larger than that in young normotensives (P less than 0.05, for both systolic and diastolic blood pressure).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Spectral and waveform characteristics of fine and coarse crackles.

Two acoustically different types of lung crackles, fine and coarse, occur in different pathophysiological conditions. To differentiate these crackles from objective characteristics of frequency information, crackles were recorded from 16 patients with pulmonary fibrosis judged clinically to have "fine" crackles and from 10 with chronic bronchitis who had mainly "coarse" crackles. Time expanded waveforms (1/4 cycle duration, initial deflection width, two cycle duration, and 9/4 cycle duration; duration of the first 1/4, 2/4, 8/4, and 9/4 cycles of crackle waveforms) were examined and fast Fourier transform analysis (peak and maximum frequencies) was performed. All waveform measurements for fine crackles were significantly smaller than those for coarse crackles. Peak and maximum frequencies for fine crackles were significantly higher than those for coarse crackles. Although there was some overlap in these values for individual crackles between the two groups when average values of these measurements were calculated for each patient, there was no overlap between fine and coarse crackles and the two groups could be clearly separated. Log peak frequency and log maximum frequency correlated better with 9/4 cycle duration (r = 0.85, 0.84) and two cycle duration (r = 0.87, 0.86) than with 1/4 cycle duration (r = 0.66, 0.77) or initial deflection width (r = 0.67, 0.79). Early and late segments of crackles have different characteristics, probably related to the origin of the sound and the resonance of the lung respectively. These results suggest that spectral and waveform characteristics may help to improve the accuracy of pulmonary auscultation and increase knowledge of how crackles are generated.

Adult↗
PubMed1991

Population study of ambulatory blood pressure in a rural community in northern Japan.

A cross sectional survey was performed on ambulatory blood pressure (ABP) in a rural community in northern Japan. ABP was measured in 468 participants (148 men and 320 women, or 27.3% of the less than or equal to 20 year-old population in the study region) with a Colin ABPM 630, an ABP monitoring system. ABP was determined every 30 min for 24 hr. All-day average of 24 hr ambulatory systolic, (SBP) and diastolic BP (DBP) in these subjects were 121.5 +/- 11.8 and 71.7 +/- 8.0 mmHg (mean +/- S.D.), respectively. Ambulatory SBP and DBP levels increased gradually with an increase in age in both sexes. The age dependent increase in SBP was, however, extremely small in men compared with that in the casual SBP of the ordinary Japanese reported. The minimal age-dependent increase in ambulatory SBP in men reflects a high ambulatory SBP in those below 50 years-old as well as a minimal increase in ambulatory SBP in those over 50. Ambulatory SBPs in women were lower than those in men until they reach the age of 50 years. Ambulatory SBP levels in men and women were similar after their 60's. Ambulatory DBP tended to fall or remain at the same level after 60 years-old. Thus, a greater pulse pressure was observed in elderly subjects. Casual SBP and DBP in the ordinary Japanese were significantly higher than the daytime average ambulatory SBP and DBP in all age groups of both sexes in the population except those in their 20's. The results suggests that ABP has different clinical characteristics and may have a different clinical significance from casual BP.

Adult↗
PubMed1991

[A prospective study of lung cancer in cases of idiopathic interstitial pneumonia (IIP)].

The incidence of lung cancer in 45 patients (37 males and 8 females), who were originally diagnosed as having idiopathic interstitial pneumonia (IIP), was studied prospectively by following them 4 to 10 years. As controls, sex-, age-, and smoking history matched patients with chronic obstructive lung disease (COLD) were also surveyed for the same follow up period. In addition, the differences in clinical findings between those with and without lung cancer were examined. Eight out of 45 patients with IIP (18%) developed lung cancer (adenocarcinoma; 4, small cell carcinoma; 3, squamous cell carcinoma; 2, including one double cancer). All lung cancer patients were male smokers. Looking only at males, 8 out of 37 patients with IIP (21.6%) developed lung cancer. This incidence was significantly higher than that of the male COLD group (2.2%, less than 0.01). In clinical findings, IIP patients with lung cancer had the characteristics of the chronic type of IIP (lack of volume loss on chest radiographic milder dyspnea, not on steroid treatment) when compared with those who did not develop lung cancer.

Adenocarcinoma↗
PubMed1991

[A case of hypereosinophilic syndrome followed by bronchial asthma, intraventricular thrombus, and duodenitis].

We report a 43-year-old male with hypereosinophilic syndrome. The patient has had eosinophilia since the age of 25. He developed bronchial asthma at 41 years of age. In the following year, he consulted a gastroenterologist because of fever and abdominal discomfort. Upper gastrointestinal study showed duodenitis. At the age of 43 years, there was slight fever, watery diarrhea, and eosinophilia. Examination in our department disclosed hypereosinophilic syndrome associated with duodenitis, endomyocarditis with an intraventricular thrombus, and bronchial asthma caused by house dust. Both prednisolone and aspirin were administered with improvement of eosinophilia and partial thrombolysis. Assays of IL-3, GM-CSF, and IL-5 revealed increased activity of IL-5, GM-CSF, and IL-3 in this order. Especially IL-5 has by far the strongest activity in these cytokines. IL-5 may play an important role in the development of hypereosinophilic syndrome.

Adult↗
PubMed1991

[Characterization of childhood onset asthma in the adult asthmatic population].

Adult asthma is composed of two groups; childhood type in which asthma begins in childhood, and adult type which starts in adult life. To characterize childhood-onset asthma in the adult asthmatic population, we selected 171 patients with asthma who were treated at Hokkaido University Hospital and examined the time of onset, atopic factors (family history of asthma, skin tests, IgE (RIST, RAST], eosinophil counts, and clinical severity. We then compared these factors between childhood type and adult type. Thirty-three patients out of 171 (19.3%) developed asthma during childhood, mostly before the age of 5. The age of onset in the rest of the 138 patients was equally distributed from 20 to 60 years. Asthma rarely begun between 10 and 15 years. In childhood type, 15 of 33 patients (45%) had continuous symptoms from childhood, and 18 of 33 patients (55%) experienced remission of their asthma and recurrence at an adult age. The group with childhood-type asthma was younger than that with adult-type asthma (32.5 +/- 13.9 (SD) and 49.7 +/- 14.2 years (mean +/- SD), respectively, p less than 0.001). There were no significant differences in atopic factors except for a higher incidence of positive skin reaction and high IgE (RAST) score in childhood type than in adult type. Steroid dependent asthma was less frequent in childhood type than in adult type (10.5% and 37.7%, respectively, p less than 0.01). These results suggest that patients with childhood type are younger and have asthma of milder severity, and it is easier to determine specific antigens in childhood type than in adult type.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Effect of almitrine in acute canine lung injury induced by paraquat].

The effects of intravenously administered almitrine (0.3 or 1.0 micrograms/kg/min, for 30 min) on hemodynamics and pulmonary gas exchange were assessed in eight dogs with acute lung injury induced by paraquat under controlled ventilation. Arterial blood gases, pulmonary and systemic hemodynamics, and ventilation-perfusion distribution (VA/Q) using the multiple inert gas elimination technique were examined before (control) and during infusion of almitrine. Almitrine produced significant increases in mean pulmonary arterial pressure from 17.4 +/- 3.3 (control, mean +/- SD) to 20.4 +/- 1.5 mmHg (1.0 micrograms/kg/min), and in total pulmonary vascular resistance. There was no change in other hemodynamic parameters, arterial gas tensions, or VA/Q distribution. These results indicate that almitrine causes pulmonary vasoconstriction without changing ventilation-perfusion distribution in dogs with paraquat-induced lung injury.

Acute Disease↗
PubMed1990

Determination of the minimal concentrations of contact activation factors in deficient substrate plasmas required to assess accurately factor XII, factor XI, factor IX, and high molecular weight kininogen.

Using combined deficient plasmas prepared by passage of a deficient plasma over an anti-factor XI-monoclonal antibody column, we have determined the threshold concentrations of each coagulation factor of contact phase in factor-deficient substrate plasmas required to determine accurately the functional activities of factor XII, factor XI, factor IX and high molecular weight kininogen (HMWK). In order to reliably quantitate factor XI and factor IX activity levels, at least 20% factor XII and 20% factor XI, respectively, were required in the deficient substrate plasmas. In the assessment of factor XII activity, approximately 40% factor XI was required in the factor XII-deficient substrate plasma. On the other hand, only 11-12% factor XI or HMWK was required in the deficient substrate plasmas in the assessment of these two clotting factors. Our data emphasize that deficiencies of other clotting factors may reduce the apparent activity of the clotting factor in question if their concentration is rate-limiting in the clotting assay.

Blood Coagulation Disorders↗
PubMed1990

Determination of clinical accuracy and nocturnal blood pressure pattern by new portable device for monitoring indirect ambulatory blood pressure.

The accuracy and clinical application of a new portable device for measuring ambulatory blood pressure (BP) (ABPM 630, Nippon Colin, Nagoya, Japan) were assessed. The device uses a conventional arm cuff inflated by CO2 gas from a compact cartridge and is based on a cuff-oscillometric as well as a Korotkoff sound (microphone) technique. Blood pressure values obtained by ABPM 630 were compared with those measured by the auscultatory method. With the microphone method the mean differences from the auscultatory method were -0.28 +/- 6.15 mm Hg (mean +/- SD) for SBP and 0.96 +/- 6.28 mm Hg for DBP (n = 256), while for the cuff-oscillometric method the mean differences were -1.77 +/- 6.07 mm Hg for SBP and 3.06 +/- 6.87 mm Hg for DBP (n = 297). There was a highly significant correlation between BP values measured by the auscultatory method and ABPM 630. In 40 untreated subjects, 24 h BP was monitored simultaneously with the ABPM 630 and with a finger volume-oscillometric device (UBP-100, UEDA, Tokyo, Japan). The daytime average of SBP with the former (126 +/- 11.6 mm Hg) was almost the same as that with the latter (123 +/- 16.0 mm Hg), while the nighttime average in the former (117 +/- 9.7 mm Hg) was significantly higher than that in the latter (108 +/- 14.1 mm Hg, P less than .01). Only 4 out of 40 subjects experienced no sleep disturbance from the arm-cuff inflation. Five of the 40 subjects complained that their sleep was frequently interrupted by the arm-cuff inflation.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗