Cardiac and plasma catecholamine responses to exercise in patients with hyperthyroidism.
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Adult↗
Biomedical subjects
M Saitoh
Publications and source records attributed to M Saitoh.
Response of sympathetic nervous system activity to exercise in patients with congestive heart failure.
To investigate the serial sympathetic nervous system response to exercise, plasma norepinephrine (NE) and epinephrine (E) concentrations were measured at rest, during each stage of treadmill exercise, and immediately and 5 minutes after exercise in 68 congestive heart failure (CHF) patients (NYHA functional class I 24, II 25, III 19) and 30 normal subjects. Circulatory responses of NYHA class II patients increased at early stages of exercise. Systolic blood pressure and double product at peak exercise were significantly lower in NYHA class III patients. Plasma NE response of NYHA class I patients was similar to that of normal subjects. However, plasma NE at rest, and during and after exercise were significantly higher in NYHA classes II and III patients than in normal subjects and NYHA class I patients (peak NE (pg ml-1); Normals: 547 +/- 37, I: 535 +/- 53, II: 867 +/- 87, III: 1033 +/- 157). There was no significant difference in plasma E levels among the four groups. NE response to exercise was augmented according to the severity of heart failure, which suggested compensatory activation of sympathetic nervous system activity. Circulatory responses were reduced in NYHA class III patients despite the exaggerated compensatory activation of the sympathetic nervous system. Blunted circulatory responses to increased NE concentration in NYHA class III patients might relate to a decreased cardiac responsiveness to sympathetic activity in severe CHF patients.
Adult↗
Forty year review of bacterial endocarditis in infants and children.
From 1950 through 1989 at Tokyo University's Department of Pediatrics, 25 children were treated for bacterial endocarditis. Twenty-two of these patients had previously been diagnosed as suffering from congenital heart disease. Twenty one of the 25 patients had positive blood cultures. Streptococcus viridans was the most common organism isolated, although the incidence of Streptococcus viridans infection has decreased in the last 20 years. In present series only a few post-surgical cases with congenital heart disease occurred. There were three deaths which all occurred prior to 1965.
Adolescent↗
Calcium mobilization and glycoprotein IIb-IIIa complex ligands in epinephrine-stimulated platelets.
In the presence of extracellular Ca2+, epinephrine induces a rise in cytoplasmic Ca2+ ([Ca2+]i) that is associated with fibrinogen binding to the platelet surface, platelet aggregation, and enhancement of the thrombin-stimulated [Ca2+]i rise and protein phosphorylation. Whether the [Ca2+]i rise induced by epinephrine results from Ca2+ entry associated with fibrinogen binding to its receptor on the platelet surface, the glycoprotein (gp) IIb-IIIa complex, is unknown. To determine the importance of the occupancy of the gp IIb-IIIa receptor on platelet function after epinephrine administration, we studied the effects of two monoclonal antibodies (M-148 and 7E3) and two synthetic peptide analogues to fibrinogen (synthetic tetrapeptides Arg-Gly-Asp-Ser (RGDS) and dodecapeptide His-His-Leu-Gly-Gly-Ala-Lys-Gln-Ala-Gly-Asp-Val [gamma-(400-411)]), all of which bind to gp IIb-IIIa and inhibit fibrinogen binding and platelet aggregation on the epinephrine-induced rise in [Ca2+]i and enhancement of thrombin's phosphorylation of the 47-kDa substrate of protein kinase C (p47). None of the gp IIb-IIIa ligands significantly enhanced or inhibited the epinephrine-induced [Ca2+]i rise or its augmentation of p47 phosphorylation after thrombin administration; however, the synergistic [Ca2+]i rise that follows addition of both epinephrine and thrombin was reduced by both antibodies and both peptides. Thus ligand binding of gp IIb-IIIa does not influence the epinephrine-induced [Ca2+]i rise or its promotion of protein kinase C activation by thrombin; these events can be dissociated from the synergistic [Ca2+]i rise.
Antibodies, Monoclonal↗
Interaction of nitric oxide and cGMP with signal transduction in activated platelets.
Although nitric oxide (NO), one of the endothelium-derived relaxing factors, prevents formation of platelet aggregates, the mechanism by which this occurs is not fully understood. Accordingly, the effect of NO on signal transduction of gel-filtered human platelets was measured and compared with that of a cell-permeant guanosine 3',5'-cyclic monophosphate (cGMP) analogue, 8-bromo-cGMP (8-BrcGMP). NO inhibited the rise in intracellular Ca2+ concentration ([Ca2+]i), phosphorylation of the 47-kDa substrate (p47) of protein kinase C (PKC), serotonin secretion, and phosphatidic acid production induced by thrombin or the endoperoxide analogue U-46619. Similar effects were seen with 8-BrcGMP, and NO induced a concentration-related rise in cGMP. Neither NO nor 8-BrcGMP inhibited platelet aggregation, [Ca2+]i mobilization, or serotonin secretion induced by the Ca2+ ionophores A23187 or ionomycin or directly activated PKC purified from platelets. However, both NO and 8-BrcGMP enhanced p47 phosphorylation induced by the Ca2+ ionophores without augmenting phosphatidic acid production. Thus, if [Ca2+]i is elevated, a rise in cGMP enhances PKC activation. Both NO and 8-BrcGMP, however, prevent Ca2+ mobilization and platelet aggregation induced by receptor-mediated agonists by interfering with signal transduction at a point proximal to phospholipase C activation.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
Serum IgA class anti-IgA antibody in IgA nephropathy.
IgA class anti-IgA antibody was sought by an immunoabsorbent technique in sera from patients with IgA nephropathy (IgA-N, n = 62), other forms of primary glomerulonephritis (PGN, n = 41), seropositive rheumatoid arthritis (RF-positive, n = 18) and normal controls (c, n = 50). IgA-N (31%) and RF-positive (56%) patients showed a significant increase in IgA anti-IgA antibody levels. The subclass of IgA anti-IgA antibody was predominantly IgA1 in both IgA-N and RF-positive patients. Size analysis revealed the dimer/monomer ratio to be significantly increased in IgA-N patients compared with that of RF-positive patients (p = 0.03). These results indicate the possible existence of the dimeric form of IgA class anti-IgA antibody in the circulation of IgA-N patients.
Antibodies, Anti-Idiotypic↗
[Autonomic nervous activity in patients with chronic liver disease especially liver cirrhosis].
Fifty three patients with liver cirrhosis and other chronic liver disease were divided into three different groups according to severity (group I: non-cirrhotic group, group II: compensated cirrhotic group, group III: decompensated cirrhotic group) and were studied with regard to their autonomic nervous and general nervous activity. To estimate the patients' autonomic nervous activity, they were examined on the following items: 1) their subjective symptoms, 2) orthostatic dysregulation, 3) coefficient of variation in R-R interval in ECG (CVR-R) at rest, 4) minimum heart rate (MHR) at night, CVR-R at MHR at night, disparity in MHR between day and night (all three of these items measured using the Holter ECG), 5) serum adrenalin, noradrenaline, cyclic AMP, and cyclic GMP. Meanwhile, general nervous activity was evaluated by measuring the reaction time to sound and light stimuli and by performing a number connection test. Cardiac function was also measured using radionuclide angiography to study its relationship to autonomic nervous disturbance in patients with chronic liver disease. The results of autonomic nervous function tests, especially CVR-R at rest, MHR at night, CVR-R at MHR at night and the disparity in MHR between day and night, indicated a marked lowering of autonomic nervous function in group III. In the serological examination, serum noradrenaline. and cyclic GMP levels were significantly higher in groups II and III. The evaluation of general nervous function showed that the reaction time to sound and light stimuli was significantly slower in group III than in group I. The cardiac function test revealed no statistically significant differences between the groups. In conclusion, autonomic nervous disturbance in patients with chronic liver disease seems to increase gradually as the disease progresses and to emerge as a distinct clinical symptom chiefly at the decompensated stage of liver cirrhosis.
Adult↗
Fenestration of the intracranial internal carotid artery--case report.
A rare case of fenestration of the intracranial internal carotid artery (ICA) was identified by angiography in a 51-year-old female with suspected subarachnoid hemorrhage. Only two similar cases have been reported previously. Fenestration tends to develop on the right side and near the bifurcation of the ophthalmic artery. Congenital factors at the 4 mm embryonic stage may be involved in the fenestration of the intracranial ICA.
Carotid Artery, Internal↗
[Mechanical properties and functions of the urinary bladder. I. Stretch behavior of the bladder in vivo].
A stretch test in vivo for living material was newly developed and applied to the dog bladder. The stress-strain curve of the bladder was speed-dependent and with hysteresis. The mechanical properties of the bladder in vivo was essentially viscoelastic. The stress-strain curve of a normal living bladder was downward convex and rose very slowly. On the other hand, that of an extirpated bladder or neurogenic bladder after denervation of the pelvic nerves demonstrated a rapid elevation. A computer analysis based on a visco-elastic simulation model proposed by Glantz was carried out to evaluate changes of the curve under various conditions, which successfully demonstrated the mechanical properties of the bladder. The model proposed by Glantz explained the mechanical properties of the bladder wall. The following formula represented the stress-strain curve by the model: psi = -beta(psi + alpha)2/gamma + beta(psi + alpha) C + alpha 2 beta e beta ct/gamma psi: force, alpha & beta: elastic constant, gamma: viscous constant. According to their properties, alpha was designated as proportional stiffness and beta as exponential stiffness. The three constants, alpha, beta and gamma for the stress-strain curve obtained experimentally from the bladder under different conditions were calculated by computer analysis. Both proportional and exponential stiffness elevated in the extirpated bladder. In the denervated bladder, changes of the constants were not significant immediately after cutting the pelvic nerves. However, the proportional stiffness (alpha) elevated remarkably two weeks after the cutting. Compared with these abnormal bladders, the elastic constants in the normal living bladder were very low. The viscous constant did not change under any conditions that were examined in this study.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
[Mechanical properties and functions of the urinary bladder. II. Mechanical properties of the bladder evaluated by cystometrogram as a urine reservoir and in expulsion].
Cystometry may be considered as a stretch test for the bladder wall. In the 1st report, it was stated that the properties of the bladder were well explained as a visco-elastic model proposed by Glantz and a formula for the stress-strain curve was proposed. In this 2nd report, another formula representing theoretical cystometrogram derived from the former formula, is proposed. Using this formula, the three constants (alpha, beta, gamma) of a normal living bladder, extirpated bladder and pelvic nerve-cutting bladder were calculated by computer analysis. They corresponded well to those obtained from the actual stress-strain curve of the bladder. Thus one can obtain these constants by computer analysis from an ordinary clinical cystometrogram without performing stretch test of the bladder. The three constants in the formula at voiding were also calculated by the same computer analysis of voiding cystometrogram. Among the three, only the proportional stiffness (alpha) elevated 10 times higher at bladder contraction than that at relaxation. This fact suggests that the bladder can void automatically by its mechanical properties, when the proportional stiffness (alpha) is changed by the switching of nerve stimulation. The detailed theory on the formula will be published in English elsewhere.
Animals↗
[A new method of intraarterial high dose chemotherapy for unresectable hepatomas using direct hemoperfusion under hepatic venous isolation (HVI.DVP)].
We have recently developed a simple method of high dose chemotherapy using HVI.DHP. The effect of HVI.DHP was evaluated in the elimination of anticancer drugs. Adriamycin (ADR: 3mg/kg), mitomycin C (MMC:1mg/kg) and cisplatin (CDDP: 2mg/kg) were given to mongrel dogs through the hepatic artery with or without HVI.DHP. The drug removal rates were similar in three drugs. Area under the curve and peak systemic level of each drug were substantially reduced by means of HVI.DHP, the values of ADR, MMC and CDDP being 17.4 and 6.2%, 4.5 and 5.9%, and 24.6 and 23.1%, respectively, of the corresponding values of simple hepatic artery infusions. Ten patients with unresectable hepatomas were treated by intraarterial high dose ADR (100-150mg/m2) using HVI.DHP. All except for two patients with catheter related complications recovered uneventfully and showed marked reductions of serum alpha-fetoprotein. Complete response was observed in one and partial response in five patients, for an overall response rate of 60%. Systemic toxicities of ADR were minimized: no cardiotoxicity, leucopenia less than 1000 cells/mm3 in one and mild hair loss in six patients. On the basis of these results, we consider this method to be an attractive therapeutic option for hepatic tumors.
Animals↗
[Evaluation of cardiac complications in patients with Duchenne muscular dystrophy using echocardiography--a comparison between patients with and without mechanical ventilation].
Two-dimensional echocardiography and Doppler echocardiography were performed in 19 patients with Duchenne muscular dystrophy for evaluating right ventricular overload and left ventricular function. Five of 19 patients were treated with mechanical ventilation. We defined right ventricular overload as right ventricular enlargement and the presence of paradoxical ventricular septal motion. The right ventricular dimensions in patients with mechanical ventilation were significantly larger than in patients without mechanical ventilation (p less than 0.01). All the patients with and without mechanical ventilation showed no significant right ventricular enlargement and none of them showed paradoxical ventricular septal motion. As for left ventricular function, there were no significant differences in the incidence of regional or diffuse wall motion abnormalities between two groups. However, the left ventricular fractional shortening was significantly lower in patients with mechanical ventilation than in patients without it (p less than 0.05), and the incidence of mitral regurgitation was significantly higher in the former than in the latter (p less than 0.01). Our findings suggest that right ventricular function is preserved even in patients with respiratory failure by appropriate respiratory treatment. Therefore, we should give attention to the progression of left ventricular dysfunction in long term prognosis.
Adolescent↗
[Non-Hodgkin's lymphoma of the nasal cavity and paranasal sinuses: clinicopathologic study of ten cases].
Ten patients with non-Hodgkin's lymphoma originated in the nasal cavity (four patients) and in the paranasal sinuses (six patients) were treated mainly with irradiation and combination chemotherapy including adriamycin. According to the TNM AJC staging system, four patients were in stage T1-T2, and six patients were in stage T3-T4. Nine patients, other than one with stage IV (Ann Arbor) disease, achieved complete remission. Death due to lymphoma occurred in four patients, 4 to 39 months following diagnosis. Three of these patients developed systemic extranodal dissemination, and died in a short time after relapse. Death due to second malignancies occurred in two patients. One died of acute myelogenous leukemia, and the other died of colon cancer, 26 and 53 months after diagnosis, respectively. Four patients were alive and disease-free, from 23 to 68 months following diagnosis (median 40 months). Out of four patients who died of disease, three were in stage T3-T4, and one was in stage T1. Two patients with stage T1 originated in the nasal cavity were both alive and disease-free. Except for lymphomas with stage T1 originated in the nasal cavity, more intensive chemotherapy should be instituted in an attempt to achieve better disease-free survival.
Adult↗
Clinical significance of hypouricemia in hospitalized patients.
Serum uric acid was measured in 586 normal subjects and 1,220 hospitalized patients. Hypouricemia was noted in 0.34% of the normal subjects and 2.54% of the hospitalized patients. Among hospitalized patients with hypouricemia, 22 were on medication, including allopurinol, anticancer drugs, antibiotics and glucocorticoids. Twenty-one patients had liver disorders and 11 of them had received transfusions. Neoplastic diseases were noted in 14 patients. Thus, hypouricemia was found to be relatively common in hospitalized patients, and seems to be caused mainly by medication, neoplastic diseases, liver disorders and transfusions.
Adolescent↗
[The changes in von Willebrand factor multimer in a course of thrombotic thrombocytopenic purpura].
A 51 year-old woman with severe thrombocytopenia, hemolytic anemia, renal failure and loss of consciousness, and significant decrease in plasma large multimer of von Willebrand Factor (vWF) was diagnosed as having thrombotic thrombocytopenic purpura (TTP). She was treated with plasma exchange, anti-platelet agents and steroids. Although she showed temporary improvement and return of vWF multimer to a normal level, her symptoms reappeared, vWF large multimer level showed a remarkable increase, and she died because of pulmonary bleeding. It would be important that the vWF multimer bands changed in the course of TTP.
Female↗
Color Doppler flow imaging in interventional ultrasound of the kidney.
Color Doppler flow imaging has been used as a supplementum to the ultrasound guidance in 16 renal biopsies, 8 nephrostomies and 6 renal cyst punctures. Puncture of intrarenal vessels could be avoided and fluid flow as in aspiration of cyst fluid or urine and drug injection could be monitored. No complications occurred in this series. Although this new technique has some problems such as low resolution of the sonogram, low frame rate and high price of the equipment, these are not essential and will be solved in the near future. It is concluded that color Doppler monitoring is a new promising adjunct in interventional ultrasound.
Biopsy↗
[Clinical studies on cefuzonam for acute peritonitis due to perforated appendicitis. Tissue concentration and clinical efficacy].
A clinical study on cefuzonam (CZON), a new parenteral cephalosporin antibiotic, was performed in 22 patients with acute appendicitis. CZON in a dose of 1 g was administered by intravenous bolus injection or intravenous drip infusion for 60 minutes. In the appendices, concentrations of CZON were 0.066-21.7 micrograms/g in normal or slight catarrhal cases, 0.173-11.7 micrograms/g in moderate phlegmous cases and 0.116-12.1 micrograms/g in serious gangrenous perforated cases. The concentration of CZON in appendixes was not directly proportional to the degree of pathological change of inflammation. 6 patients with acute peritonitis due to perforated appendicitis were treated with CZON of 2 g/day for 5-10 days. The clinical effect was good in 5 cases, fair in 1 case of the above 6. The clinical efficacy rate was 83%. Side effects were not notable in the patients.
Acute Disease↗
[Clinical significance of immunophenotype in diffuse non-Hodgkin's lymphoma: with special emphasis on the clinical characteristics of T-cell lymphoma].
The clinical significance of immunophenotyping of the non-Hodgkin's lymphomas (NHL) is still controversial. Therefore, we evaluated the prognostic significance of T- and B-cell phenotype in 102 patients having diffuse non-Hodgkin's lymphoma who had been treated in a majority with Adriamycin-containing regimens. The significant differences in pretreatment clinical variables between the two patient groups were the higher frequency of markedly elevated LDH (greater than or equal to X 2 normal) and the lower frequency of decreased cholesterol level in B-NHL (p less than 0.05). Patients with B-NHL had a higher complete remission (CR) rate (77% vs 59%: p = NS), a significantly better overall survival (62% vs 34% at 3-years: p less than 0.05) and longer duration of remission for all patients (50% vs 27% at 3-years: p less than 0.05). Among forty-five patients with stages III and IV disease of nodal origin (excluding those with diffuse small cleaved histology), the B-cell group was associated with a better prognosis; a higher CR rate (68% vs 41%: p = NS) and a longer duration of remission for all patients (44% vs 12% at 2-years: p less than 0.05). Furthermore, for patients with T-cell phenotype, the primary site was the only prognostic factor; the patients whose disease originated from Waldeyer's ring, nasal cavity, and paranasal sinuses, achieved a better CR rate (92% vs 40%: p less than 0.05) and a longer duration of remission for all patients (48% vs 15% at 2-years: p less than 0.05). We conclude that advanced T-cell lymphoma of nodal origin is a subgroup of patients with very poor prognosis if treated with less intensive chemotherapeutic regimens.
Adolescent↗