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Biomedical subjects

M Sakurai

Publications and source records attributed to M Sakurai.

At least 505 records · Page 28Linked to original sources

[Changes in intracellular pH of working muscle during constant and stepwise incremental load exercise].

In this study, subjects performed wrist flexion in isokinetic manner by using CYBEX dynamometer while their right forearm was attached in a MR magnet. 31P-MR spectra were obtained from wrist flexor muscles before and throughout the exercise. Intracellular pH of muscle was calculated from the chemical shift between phosphocreatine (PCr) and inorganic phosphate (Pi). Fifteen Japanese males volunteered as subjects. They performed two experimental protocols, i. e. constant load test (CT) and stepwise incremental load test (IT). In CT, 10 of the subjects were participated. After 2 minutes rest, wrist flexion of 10, 20, 30, 40 or 50% of maximal voluntary contraction force (MVC) was performed at 2 seconds intervals for 15 minutes. In IT, 14 including 9 of CT were participated. They performed wrist flexion in incremental contraction force of 5 steps from 10% to 50% of MVC for 3 minutes in each step. Changes in intracellular pH of muscle against contraction level show non-linear relationships both in CT and IT. From this relationship we calculated the contraction level at which pH was 6.9 (%MVC6.9). Mean values of obtained %MVC6.9 by CT and by IT were 29.3 and 30.0% of MVC, respectively. And, significant correlation was found between %MVC6.9 by CT and by IT. This result shows that %MVC6.9 was a reproducible index independent of the type of exercise test, i. e. constant or incremental load test, and might reflect the physiological characteristics of the muscle.

Exercise↗

Thresholds for decrease in intracellular pH and increase in blood lactate during progressive exercise: 31P-MRS study.

The purpose of this study was to compare the intramuscular and the intravascular events in relation to energy metabolism during progressive arm exercise. Twelve healthy untrained Japanese males participated in this study as subjects. They performed wrist flexion in a ramp incremental load of 0.14 W/min until exhaustion. 31P-MR spectra were obtained from wrist flexor muscle before and throughout the exercise. Venous blood was also sampled from antecubital vein with one minute interval during the exercise, and a change in plasma lactate concentration (La) was observed. Intracellular pH (pH) was calculated from a chemical shift between phosphocreatine (PCr) and inorganic phosphate (Pi) of the 31P-MR spectra. Change in pH showed a threshold behavior during exercise. Threshold points at decline in pH (pHT), increase in Pi/PCr (PT), and increase in La (LT) were determined by piecewise linear regression analysis of minutes-by-minutes data. Mean values of pHT, PT and LT were 43.0, 42.5, and 24.8% of maximal work rate, respectively. LT was significantly smaller than pHT and PT. This result suggests that lactic acidosis has already existed when pH is kept at resting level, and pHT reflects the capacity of remaining intracellular biochemical homeostasis, which might be one of the physiological indices of muscle fatigue.

Adult↗

Long-term treatment with 1 alpha-hydroxyvitamin D3 with calcium supplement in spinal osteoporotic patients.

The long-term effect of 1 alpha-hydroxyvitamin D3 and calcium lactate in osteoporotic patients was evaluated by the bone mineral density (BMD) measured at the distal one third and one sixth of the radius and by the vertebral fracture rate. Forty-five osteoporotic patients medicated for 1 to 13 years (treated group) and 11 osteoporotic patients with no medication for 1 to 3 years (control group) were compared. The BMD of the treated group remained unchanged for the first 4 (one-third site) and 6 years (one-sixth site), followed by significant decreases, whereas that of the control group decreased significantly at the second and third year. The effect on BMD was more prominent in the patients with lower initial BMD. The vertebral fracture rate of the treated group was significantly less than that in the control group at the third year. No serious side effects were recognized. Overall, we believe 1 alpha-hydroxyvitamin D3 with calcium supplement can be considered a safe and effective agent for long-term use in osteoporotic patients.

Aged↗

Clinical evaluation of BPAA patch in the treatment of extremity trauma.

In a multicenter clinical trial, the efficacy and usefulness of the BPAA Patch in the treatment of extremity trauma were evaluated in 64 patients and the safety was tested in 70 patients. In 89.1% of the patients studied, the final overall improvement was rated "moderate" or better, and no adverse reactions were reported. The results of this study indicate that the BPAA Patch is a highly useful topical antiinflammatory-analgesic agent for use in the treatment of pain and inflammatory symptoms following trauma.

Administration, Topical↗

[Home oxygen therapy using liquid oxygen system].

Home oxygen therapy (HOT) for patients with chronic respiratory failure has been believed to increase the quality of life and to improve the prognosis of such patients. In Japan, HOT for chronic respiratory failure has been supported by health insurance since March 1985. Since then, patients with HOT have increased progressively, and it has been reported that there are now over 20,000 patients with HOT. The oxygen concentrator which extracts oxygen from atmospheric air has been commonly used as the oxygen delivery system. Recently the liquid oxygen system has provided an attractive, convenient source of oxygen. Since April 1990, HOT using liquid oxygen system has been supported by health insurance, and its use will become widespread in Japan. A major characteristic of this system is that oxygen condensed into a liquid form allows storage of a larger supply. This system consists of two parts: stationary type which stores the liquid oxygen, and a portable type which can easily be refilled with oxygen a larger source. In the present study, we examined the efficacy of portable liquid oxygen in 50 patients with chronic pulmonary diseases including patients with chronic respiratory failure who had PaO2 < 55 mmHg during air breathing. We measured changes of ten minutes walking distance (10 MD) and blood gas analysis with and without portable liquid oxygen. We also performed on estimation of efficacy of liquid oxygen by questionnaires in patients receiving liquid oxygen for HOT. We did not find a significant improvement of 10 MD with portable liquid oxygen, but found a significant improvement of arterial oxygen tension at the end of walking.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Dioxide↗

[Clinical experience of a percutaneous ventricular support for profound heart failure following acute myocardial infarction--a case report].

Percutaneous biventricular support with centrifugal pump was applied to a 59-year-old man with profound heart failure following acute myocardial infarction. Direct coronary angioplasty was performed under percutaneous cardiopulmonary support (PCPS). After angioplasty, he could not be weaned from PCPS under IABP. We used percutaneous left ventricular support (PLVS) with transseptal left atrial cannulation. PLVS could not maintain effective assist flow and he developed a cardiogenic shock again. PCPS was added to PLVS, and percutaneous biventricular support was started. Assist flow ranged 1.7-3.0 L/min in PLVS, and 1.7-2.0 L/min in PCPS, and total assist flow was 3.4 L/min. Pulsatile pressure was obtained by adding IABP. The patient was successfully weaned from PCPS in 26 hours and PLVS in 118 hours. Patient is alive and well one year after PLVS. Combination of PLVS and PCPS is an effective ventricular support system, being less invasive than conventional method with thoracotomy, and may be useful for profound heart failure.

Heart Failure↗

[Clinical evaluation of imipenem/cilastatin sodium against infections in compromised children (malignancy, hematological disease, collagen disease)].

Eighteen immuno-compromised children (malignancies, hematological diseases, collagen diseases) with neutropenia and infections were treated with imipenem/cilastatin sodium (IPM/CS), and the efficacy and the safety of the drug were evaluated. 1. Responses to IPM/CS were excellent in 13 patients, good in 1, and fair in 4. None of the patients displayed a poor response to the treatment thus the efficacy rate was 77.8%. 2. Of 5 patients with sepsis, 4 had excellent or good responses. IPM/CS was effective against sepsis caused by Enterococcus faecalis and Pseudomonas aeruginosa. 3. In patients with severe neutropenia (WBC less than 100/mm3), the efficacy rate was 70%. 4. As for side effects, elevations of GOT and GPT were observed in 1 patient with liver cirrhosis. These results indicate that IPM/CS is safe and effective in immuno-compromised children with neutropenia and infections.

Adolescent↗

[Malignant lymphoma occurring subsequent to autoimmune disease].

The authors report six cases of non-Hodgkin's lymphoma (NHL) (3B-cell type, one T-cell type, one non-T non-B cell type, one unclassified type) occurring subsequently to autoimmune diseases. The patients were females aged 43 to 70 (median 61). Rheumatoid arthritis was most frequent as the preceding autoimmune disease, and the intervals from the onset of an autoimmune disease to that of NHL were 10 to 36 years (median 20). Polyclonal hypergammaglobulinemia was seen in 4 cases, lymphocytopenia in 3 cases, and conversion to negative PPD reaction in 2 cases. Only one patient had been given corticosteroids, and immunosuppressive agents may not contribute much to the development of lymphoma in patients with autoimmune diseases.

Adult↗

Effect of topical epinephrine on permeability of blood-aqueous barrier in human eyes.

The time-course of changes in the effects of topical epinephrine on the aqueous flow and the coefficient of protein entry into the anterior chamber (k(in)) were determined in 12 normal human subjects. Before and after instillation of 1.25% epinephrine in one eye, protein concentration in the anterior chamber (Ca) was determined from aqueous flare intensity using the laser flare-cell meter, and aqueous flow rate was determined by fluorophotometry. The k(in) was calculated from the Ca, plasma protein concentration, and aqueous flow rate. A single instillation of epinephrine affected neither the Ca nor the aqueous flow rate significantly. The calculated value of the k(in) showed no significant changes at any time of determination, which implied that a single instillation of epinephrine is insufficient to affect the permeability of the blood-aqueous barrier to plasma protein in the normal human eye.

Adult↗

[Topical timolol and blood-aqueous barrier permeability to protein in human eyes].

The effect of topical 0.5% timolol on the permeability of the blood-aqueous barrier to plasma protein was studied in ten young normal volunteers. Before and after instillation of timolol in one eye, simultaneous measurements of aqueous flow rate, f(t), by fluorophotometry and protein concentration in the anterior chamber, Ca(t), with a laser flare-cell meter were made in both eyes at hourly intervals. The coefficient of protein entry into the anterior chamber was calculated using an equation formulating protein dynamics in the anterior chamber from the changes in f(t), Ca(t), and plasma protein concentration. The Ca(t) in the treated eye showed a maximum increase of 37 +/- 4% (mean +/- SEM) as compared with that in the fellow eye 5 hours after instillation, while the f(t) in the treated eye showed a maximum reduction of 30 +/- 4% 2 hours after instillation. The intraocular pressure in the treated eye showed a maximum reduction of 3.0 +/- 0.3 mmHg 2 hours after instillation. No significant changes were found in the coefficient of protein entry in the anterior chamber between before and after timolol instillation or between timolol-treated and fellow untreated eyes. These results indicated that topical 0.5% timolol does not affect the permeability of the blood-aqueous barrier to plasma protein significantly.

Administration, Topical↗

[der(1;7) (q10;p10) in three patients with malignant hematologic disorders].

The chromosome der(1;7) (q10;p10) is a derivative chromosome consisting of the short arm of chromosome 7 and the long arm of chromosome 1. We observed this abnormality in three patients with acute myeloblastic leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative disorder (MPD). Case 1 was a 76-yr-old male with a history of IgG myeloma treated with melphalan, cyclophosphamide, vincristine, and prednisolone (MEVP). AML-M1 developed one and half years after discontinuation of the MEVP therapy. Case 2 was a 39-yr-old male with MDS. Case 3 was a 56-yr-old male with refractory anemia with excess of blasts in transformation that evolved from primary myelofibrosis. Chromosome analyses revealed der(1;7) (q10;p10) in bone marrow cells of the three patients. All patients failed to respond to chemotherapy, and died within four months after the diagnosis. Thus, der (1;7) (q10;p10) may indicate a very poor prognostic outcome in patients with malignant hematologic disorders.

Adult↗

[Pharmacokinetic, bacteriological and clinical studies on cefprozil in pediatric patients].

Cefprozil (CFPZ, BMY-28100), a new oral cephem antibiotic, was studied for its antibacterial activities, absorption and excretion upon administration. Its clinical efficacies were also studied in pediatric patients with infections. A study on antibacterial activities of CFPZ against 11 clinical isolates including 6 species found that its activities against Staphylococcus aureus, alpha-hemolytic Streptococcus, Escherichia coli and Haemophilus influenzae were equal or superior to those of CCL. When CFPZ was given to patients orally at 15 mg/kg, maximum serum concentration was obtained between 1 to 2 hours after administration and urinary excretion rate in the first 6 hours was 33.8 +/- 17.6%. Clinical evaluation was done in a total of 25 patients with various infections. Responses were excellent in 15 cases and good in 10 cases, hence the efficacy rate was 100%. As side effect, soft stool was found in 1 case, and eosinophilia in 2 cases and elevation of GOT and GPT in 1 case were found as abnormal laboratory test results, but none of them was serious. It appears that CFPZ is an effective and safe antibiotic in the field of pediatrics.

Bacteria↗

[Evaluation of panipenem/betamipron in pediatric field].

Panipenem/betamipron (PAPM/BP), a mixture of a newly synthesized carbapenem antibiotic panipenem (PAPM) and N-benzoyl-beta-alanine, betamipron (BP), was evaluated for pharmacokinetics, in vivo and in vitro antimicrobial effect, and clinical efficacy in pediatric patients. Intravenous drip infusion of either 10 mg/10 mg/kg or 20 mg/20 mg/kg of PAPM/BP for 30 minutes resulted in maximum plasma concentrations of 36.6 micrograms/ml and 92.5 micrograms/ml, half lives (T 1/2 beta) of 1.17 hours and 0.88 hours, and urinary excretion until 6 hours of 29% and 17.7%, respectively. Antibacterial activities of PAPM against Gram-positive cocci and Gram-negative rods isolated from pediatric patients were equal to or slightly stronger than those of imipenem, ceftazidime, cefoperazone, and piperacillin. Clinical effects of PAPM/BP evaluated in 17 patients were as follows; excellent in 8 cases, good in 8 cases, and fair in 1 case. The overall efficacy rate was 94.1%. Elevations of GOT and/or GPT were observed in 2 patients and transient eosinophilia was observed in 1 patient.

Adolescent↗

[A case of vasovagal syncope associated with venipuncture].

A 33 year-old-man presented recurrent syncopal episodes after venipuncture. This was sometimes associated with seizure. It was also noted that the syncope was aroused by mental stress. The patient was admitted to the department of neurological medicine because of epilepsy. Cardiac arrest of more than 15 seconds was detected during the venipuncture-prooshed syncope test. He had normal routine testing, holter monitoring, head CT scan, carotid sinus massage, valsalva maneuver etc. The syncope was similar to a malignant vasovagal one which has no typical warning signs. He had recurrent syncopal episodes without typical prodrome. Therefore a DDD pacemaker was implanted. It has not been completely established as effective in the treatment of vasovagal syncope, but for the treatment of syncope involving cardioinhibitory action, dual chamber pacing in considered as the main treatment available.

Adult↗

[A case report of a paraesophageal bronchogenic cyst and an esophageal cyst].

There are relatively few paraesophageal bronchogenic and esophageal cysts in mediastinal tumors. It is often difficult to distinguish between these cysts. Case 1: 11 year old, male with no symptoms. An abnormal tumor shadow was revealed by chest roentgenogram. Before operating, CT, MRI and other laboratory tests were suggested that the tumor was neurogenic. A cyst with a pedicle connected to the esophageal muscle layer was found during the operation. Pathological examination confirmed a bronchogenic cyst lined with cartilage. Case 2: 38 year old female with epigastralgia. Upper gastrointestinal series revealed that the thoracic esophagus was smoothly compressed from the outside. CT and MRI showed a well-defined cystic mass in the posterior mediastinum. The cyst bordered the esophagus, but there was no direct communication between them. The pathological findings showed the presence of a double layer of smooth muscle without cartilage which was diagnosed as an esophageal cyst.

Adolescent↗