Search PubMed⌕ Search

Biomedical subjects

M Shindo

Publications and source records attributed to M Shindo.

293 records · Page 17Linked to original sources
PubMedDate not supplied

Blood pressure and hormonal responses to aerobic exercise.

Twelve patients with essential hypertension (WHO stages I-II) were subjected to mild aerobic exercise for 10 to 20 weeks. The time course of changes in the resting blood pressure and multiple hormonal responses (plasma catecholamines, prostaglandin E, renin-angiotensin system, kallikrein-bradykinin system) were monitored. Depressor response of both systolic and diastolic pressures was seen, and after 5 weeks of exercise blood pressure stabilized at a significantly lower level. Adjustment of work load in response to increased physical fitness at the 10th week produced further reduction of blood pressure especially in diastole. After exercise therapy we found significant reductions in plasma catecholamine levels, and increases in levels of plasma prostaglandin E and the urinary excretion of sodium. A reduction in systolic/diastolic (mean) pressures by more than 20/10 (13) mm Hg was seen in 50% of patients after 10 weeks and in 78% after 20 weeks of exercise. Those who achieved effective blood pressure fall after 10 weeks of training (n = 6) were compared with the rest (n = 6). This analysis revealed that the initial value of plasma renin activity of the former was significantly lower than that of the latter. Significant negative correlations (r = -0.78) also were observed between the blood pressure reduction and corresponding initial value of plasma renin activity. These results indicate that exercise therapy is a potent nonpharmacological tool for the treatment of essential hypertension, especially of the low renin type. Both diminished sympathoadrenergic activity and enhancement of prostaglandin mechanisms might be responsible for the falls in arterial pressure.

Adult↗
PubMedDate not supplied

Spontaneous reactivation of hepatitis B virus replication in HBsAg carriers who seroconverted from HBeAg to anti-HBe.

Twenty one patients with chronic liver disease (CLD), type B, who were persistently positive for anti-HBe after disappearance of HBeAg, were studied for serial measurement of HBV DNA and DNA-P in serum in relation to the elevation of alanine aminotransferase (ALT). Patients were selected and allocated to two groups on the basis of having been seen for at least 3 years and having been found to have either fluctuating, or normal ALT levels during the course of their disease activity. Nine patients have had fluctuating or sustainingly abnormal ALT levels and the remaining 12 have had sustainingly normal ALT levels for at least 3 years follow-up period after anti-HBe seroconversion. In 2 patients, ALT levels were persistently elevated with positive HBV DNA and DNA-P in serum, and in 6, ALT levels were fluctuated between normal range and more than six times the normal, in whom serum HBV DNA and DNA-P became also positive with ALT elevation. In one patient, serum HBV DNA and DNA-P became transiently positive with ALT elevation. On the contrary, 12 patients with normal ALT levels were persistently negative for both HBV DNA and DNA-P in serum. Therefore, we may conclude that in patients with anti-HBe positive CLD, type B, ALT elevation is associated with reactivation of HBV replication.

Adult↗
PubMedDate not supplied

Geriatric trauma patients at a suburban level-I trauma center in Japan.

BACKGROUND: Despite the increases in the aged population in Japan, there are little data on geriatric patients with traumatic injuries. A prospective clinical study was carried out to evaluate the use of the emergency medical services (EMS) system, mechanisms of injury, and prehospital assessment and triage of elderly victims of trauma. PATIENTS AND METHODS: From July 1996 through June 1997, a group of geriatric trauma (Group G, n = 22) and a control group of younger trauma patients (n = 173) were compared with respect to transfer method to an Emergency Center (direct or indirect), Revised Trauma Scores on the scene of the accident (RTS-1) and on admission to the Emergency Center (RTS-2), and outcome (survival). RESULTS: The mean values for RTS-1 in the Control Group (Group C) were not different from those in Group G, but RTS-2 of the indirect-transfer patients (IP) in Group G were significantly lower than were those for Group C. Group G mortality rates were significantly higher than were the control rates (p = 0.0001). The mortality rate of the IP subgroup was significantly lower than that of the direct transfer subgroup (DP) (30/68 vs. 5/70, p < 0.0001) in the Group C, but mortality rate of the IP subgroup exceeded that of the DP subgroup of Group G (8/14 vs. 5/8). CONCLUSION: The data suggest that in geriatric-age patients, direct transfer patients have a lower mortality rate than do indirect transfer patients when controlled for ISS. Therefore, it seems that a different set of triage criteria should be developed and implemented for geriatric-age victims with trauma-induced injuries and that those who meet these more stringent criteria should be transferred directly to a Trauma Center.

Accidents, Traffic↗
PubMedDate not supplied

New modality of radiation therapy under increased tumor oxygen tension with angiotensin II: a pilot study.

Elevation of the mean arterial blood pressure to approximately 150 mmHg by infusion of angiotensin II (AT II) resulted in a selective increase of blood flow in tumor tissue. A concomitant increase in tumor oxygen tension was also observed, suggesting the possibility of hyperbaric oxygenation radiation therapy. By controlling the infusion rate of AT II, mean blood pressure was increased up to 1.5-fold of normotension, and radiation was given (AT II-RT). Forty-one patients with recurrent tumors after intensive radiation therapy or with locally far advanced tumors were treated. Using an uneven dose fractionation scheme, total dose ranged from 5,100 to 7,800 cGy. The radiation response to the tumor was quite good. Including three complete responders, more than 50% tumor regression was obtained in 24 patients (58.5%), less than 50% in 13 (31.7%) and no effect in four (9.7%). On the other hand, damage to normal tissue was minimal, and no serious morbidity was experienced. For example, comparing the results in the two groups of lung cancer patients treated with or without AT II, superiority of AT II-RT was indicated. The curative ability of AT II-RT will be investigated further.

Angiotensin II↗