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Biomedical subjects

M Shindo

Publications and source records attributed to M Shindo.

At least 127 records · Page 7Linked to original sources

Role of endogenous ouabain-like substance during graded exercise in hypertensive individuals.

Changes in plasma endogenous ouabain-like substance (EOLS) and plasma noradrenaline, along with changes in blood pressure (BP), heart rate, and blood lactate concentration, were investigated in hypertensive individuals during strenuous exercise testing. Thirteen (4 men and 9 women) middle-aged (34-63 years, mean 50 +/- 2 years) patients with mild essential hypertension underwent graded multistage submaximal exercise testing on a cycle ergometer. The workload in each exercise test was increased depending on the individual's physical fitness until they reached 75-80% of the predicted age-adjusted maximal heart rate prescribed by the American College of Sports Medicine. Systolic (S) BP rose by 67 +/- 9 mm Hg (P < 0.001), mean (M) BP by 28 +/- 3 mm Hg (P < 0.001), diastolic (D) BP by 9 +/- 2 mm Hg (P < 0.005) and heart rate by 79 +/- 6 beats/min (P < 0.001) after submaximal graded exercise. The blood lactate concentration and plasma noradrenaline increased significantly (+3.40 +/- 0.34 mmol/l and +895 +/- 94 pg/ml respectively, P < 0.001). Although the change in EOLS was not significant, it showed a strong positive correlation with the change in plasma noradrenaline (R = 0.760, P < 0.001). These results suggest that EOLS may participate in modifying sympathetic vasoconstriction during submaximal graded exercise.

Adult↗

[Neuroprotective therapy for amyotrophic lateral sclerosis (ALS)].

Amyotrophic lateral sclerosis (ALS) is a typical intractable disease affecting the primary and secondary motoneurones resulting in generalized muscular atrophy and weakness with or without spasticity. Dysphagia, dysarthria, and respiratory difficulty are symptoms which cause restriction of ADL and death. Recent achievement in understanding neuronal death in ALS has invited trials on various drugs aiming at neuroprotection and prolongation of the course of ALS. They include inhibition of excitotoxicity of amino acids, suppression of free radicals by lecithinized SOD and various neurotrophic factors. Significant prolongation of life span was obtained by riluzole in a US-Europe trial, but the effects were insignificant in the Japanese nation-wide trial.

Amyotrophic Lateral Sclerosis↗

Increase in reciprocal Ia inhibition during antagonist contraction in the human leg: a study of motor units and the H reflex.

1. The change in reciprocal Ia inhibition of soleus motoneurones produced by stimulation of the common peroneal nerve was investigated by the use of twenty-three soleus motor units as well as the soleus H reflex in six normal subjects during tonic pretibial contraction. 2. In the motor unit experiments, motoneuronal excitability was measured as the 'critical firing stimulus' (CFS), which is the difference between the test stimulus intensity needed to reach the threshold for the lowest threshold Ia fibres and the intensity which evokes firing of a motor unit with the probability of 50%. The conditioning effect, assessed from the change in the CFS, was expressed as a percentage of the unconditioned CFS. 3. At a conditioning intensity of 0.95 times the motor threshold value, there was Ia inhibition in sixteen of the twenty-three motor units (69.6%) at rest. Of these sixteen motor units, twelve showed increases in inhibition at intervals below 2.0 ms during pretibial contraction. In four of the remaining seven units, inhibition first appeared during contraction. There was no significant decrease in inhibition at any time during contraction. 4. Based on the conventional H reflex, reciprocal Ia inhibition increased during very weak (below 2% of the maximum) voluntary dorsiflexion and continued to increase at a slightly stronger (3-8% of the maximum) contraction, then decreased continuously when contraction was strengthened further. Maximal inhibition occurred at a relatively strong contraction when a weak conditioning stimulus was used, and vice versa. 5. We conclude that the activity of reciprocal Ia inhibitory interneurones increases during tonic antagonist contraction. The previous controversy about this inhibition is the result of occlusion at the Ia interneuronal level.

Adult↗

Hepatic hepatitis C virus RNA as a predictor of a long-term response to interferon-alpha therapy.

OBJECTIVE: To identify predictors of a long-term response to interferon-alpha therapy in chronic hepatitis C and to determine whether hepatitis C virus (HCV) was eradicated in patients with chronic hepatitis C who had a long-term response to therapy. DESIGN: A retrospective analysis. SETTING: In- and outpatient liver clinic of a municipal hospital in Japan. PATIENTS: 47 patients with chronic hepatitis C who responded to interferon-alpha were divided into two groups: 22 patients with a long-term response (serum aminotransferase levels remained normal for > 1 year after therapy) and 25 patients with a short-term response (serum aminotransferase levels increased again after therapy). MEASUREMENTS: Genotyping of HCV, titers of HCV RNA in liver and serum samples (using the reverse transcriptase-polymerase chain reaction), histologic activity index, and liver histologic tests during and 1 year after therapy. RESULTS: Among the 22 long-term responders, HCV RNA was no longer detectable in liver and serum samples of 21 (95%) at the end of therapy and remained undetectable in the serum of 20 (91%) and in the liver of 19 (86%) 1 year after therapy. Liver histologic tests improved substantially immediately after therapy and 1 year after therapy in the long-term responders; however, 18 (82%) of these patients still had mild, chronic hepatitis. Among the 25 short-term responders, HCV RNA was still detected in the liver of 19 (76%) and in the serum of 9 (36%) at the end of therapy. Multivariate logistic regression analysis showed that the persistent presence of hepatic HCV RNA at the end of therapy was the strongest predictor of relapse. CONCLUSION: These findings suggest that HCV infection was eradicated in most of the long-term responders to interferon-alpha therapy because HCV RNA could no longer be detected in their serum and liver samples and because a significant improvement gradually occurred in their liver histologic results. The persistent presence of hepatic HCV RNA at the end of therapy was the most important predictor of relapse.

Adult↗

The association among fat distribution, physical fitness, and the risk factors of cardiovascular disease in obese women.

The purpose of this study was to see whether fat distribution and physical fitness are independent risk factors of cardiovascular diseases in obese women. Seventy-four obese women aged 19 to 65 years participated in this study. The data were collected on plasma lipid profiles, plasma glucose and insulin during an oral glucose tolerance test, blood pressure, fat distribution determined by the waist to hip ratio (WHR), total body fat determined by the hydrostatic weighing method and a direct measurement of blood lactate threshold. Significant correlations were found between WHR and plasma cholesterol (TC), plasma LDL cholesterol (LDL-c) and LDL-c to the plasma HDL cholesterol ratio (LDL-c/HDL-c), independent of age, percent body fat, and VO2 per lean body mass at blood lactate threshold (LT). On the other hand, LT was significantly related to the area under the curve of insulin during OGTT (insulin area) and DBP, independent of age, percent body fat, and WHR. In conclusion, both fat distribution and physical fitness are considered to be independently related to some important risk factors in obese women after adjustment for percent body fat.

Adipose Tissue↗

Progressive decrease in heteronymous monosynaptic Ia facilitation with human ageing.

To evaluate functional change in the spinal reflex pathway with ageing, we studied heteronymous Ia facilitation from the quadriceps to soleus muscle in 30 normal volunteers (aged 24-68 years). The size of the test H-reflex of the soleus muscle was adjusted to 25% that of the maximal M-response. The conditioning stimulus was adjusted to 1.5-fold the motor threshold to stimulate all the Ia fibres in the femoral nerve. Facilitation was quantified as the slope of the very early part of facilitation, within 0.8 ms of onset. This procedure enabled us to evaluate the extent of monosynaptic Ia facilitation without contamination by other effects. The extent of facilitation decreased linearly with age. This decrease in facilitation could reflect a decrease in the number of Ia fibres and in their conduction velocities, and an increase in presynaptic inhibition on Ia terminals. The increase in presynaptic inhibition may be an adaptive phenomenon in the ageing of the neuromuscular system or, alternatively, a deteriorating process with decreasing flexible supraspinal modulation.

Adult↗

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations in elderly men and women.

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations were examined in 30 elderly men and women. These subjects were randomly divided into two groups. The training group [n = 15; 7 men and 8 women; mean age 75.5 (SD 5.6) years] agreed to take part in physical training using a treadmill with an exercise intensity at the blood lactate concentration threshold for 30 min 3-6 times a week for 9 months. The other group [n = 15; 7 men and 8 women; mean age 73.7 (SD 4.4) years] did not perform any particular physical training and was followed as the control. Following this training period the high density lipoprotein-cholesterol (HDL-C) had increased significantly (P < 0.01) while the total cholesterol (TC):HDL-C ratio had decreased significantly (P < 0.01) in the training group after 9 months but had not changed in the control group. The TC, triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) had not changed significantly in either group. No significant difference was seen between the groups throughout the period for TC. LDL-C or TG. There was, however, a significant correlation between the initial TC:HDL-C ratio and the change in the TC:HDL-C ratio following 3 months of training (P < 0.05). After 1 month of detraining in 5 patients, the HDL-C had decreased significantly (P < 0.05) while the TC:HDL-C had increased significantly in the training group (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Contributing factors influencing type III open tibial fractures.

Ninety-five patients with severe open tibial fractures (96 fractures) were treated with nonoperative treatment alone (NO group, n = 16), immediate internal fixation (I group, n = 22), delayed internal fixation (D group, n = 34), or external fixation (EF group, n = 24). The D group was divided into a delayed internal fixation group following nonoperative treatment (D1 group, n = 14), and a delayed internal fixation group following external fixation (D2 group, n = 20). Using the classification system of Gustilo, there were 43 type IIIA, 42 type IIIB, and 11 type IIIC open tibial fractures. There were 17 deep infections (type IIIA, n = 3; IIIB, n = 12; IIIC, n = 2). The difference in the deep infection rate (DIR) between the type IIIA and type IIIB fractures was statistically significant (7.0% vs. 28.0%, p < 0.05). The DIRs in groups NO, I, D1, D2, and EF were 12.5, 27.3, 7.1, 35, and 4%, respectively. There was a significant difference in DIR between the D2 group and the EF group. The DIR in the D (D1 + D2) group and group I showed no significant difference. There was no relationship between the DIR and either Injury Severity Score or skin closure time. The authors of this study, therefore, do not feel there is an advantage to immediate internal fixation over delayed procedures for Gustilo type III open fractures of the tibia. However, careful attention must be given to the application of delayed internal fixation, especially intramedullary nailing, after external fixation.

Adolescent↗

Evaluation of abnormal signal-averaged electrocardiograms in young athletes.

Our objectives in this study were to determine the incidence of abnormal signal-averaged ECG (SAECG) and its relation to the extent and type of exercise in young healthy athletes, and to evaluate the association, if any, between the development of abnormal SAECGs and vigorous exercise. The presence of abnormal SAECG was evaluated in 796 athletes (mean age 19 years), and its relation to findings on 12-lead electrocardiogram, echocardiogram, and the presence arrhythmias was studied using Holter monitoring. An SAECG was considered abnormal when any one of the three following criteria was met: filtered QRS duration of more than 114 msec, root-mean-square voltage in the terminal 40 msec of less than 20 muV, or a voltage of less than 40 muV for more than 38 msec. Abnormal SAECGs were present in 68 (8.5%) of the athletes and were associated with a smaller left ventricular mass. Athletes who performed anaerobic exercise tended to exhibit a high incidence of abnormal SAECGs, which was associated with a smaller left ventricular mass. No serious ventricular arrhythmias were observed on 24 h Holter monitoring or during the follow-up period of 20 +/- months. There were no sudden cardiac deaths. Continuous anaerobic exercise may induce abnormal SAECGs through the development of delayed myocardial conduction or electrical inhomogeneity in cardiac tissue. Te presence of an abnormal SAECG was unrelated to the development of arrhythmias in young athletes.

Adult↗

Plasma free and sulfoconjugated dopamine before and after a half-marathon.

To elucidate whether increased plasma levels of free dopamine (F-DA) after exercise are due to deconjugation of sulfoconjugated (S-) DA in plasma, we compared the changes in plasma F- and S- DA, as well as changes in both the S- and F- forms of epinephrine (E) and norepinephrine (NE), after running a half-marathon. Free catecholamines (F-CAs) were measured by automated high-performance liquid chromatography (HPLC). Total (F+S) CAs were determined using an efficient deconjugation method as follows; 1200 microliters plasma was incubated with 152 mU arylsulfatase (AS) for 30 min at pH 7.6. The plasma levels of F-CA (pg/ml) (mean +/- SEM) all increased significantly (p < 0.01) after the half-marathon; i.e., F-DA increased from 13.3 +/- 5.7 to 176.3 +/- 32.2; F-E from 58.0 +/- 12.3 to 764.3 +/- 136.4; F-NE from 246.6 +/- 15.2 to 3082.0 +/- 690.3. OF S-CAs, S-E (from 127.8 +/- 26.0 to 1218.2 +/- 190.8) and S-NE (from 717.1 +/- 61.6 to 5586.9 +/- 761.9) also increased, but, in contrast, among the S-CAs, only the increase in S-DA (from 5324.9 +/- 1967.3 to 7359.6 +/- 1627.9) was not statistically significant. Sulfoconjugation may play an important role in inactivating F-DA as well as F-NE and -E, that are released into plasma in response to vigorous exercise. Thus, plasma F-DA is unlikely to be derived through deconjugation of plasma S-DA.

Adult↗

Effects of red-pepper diet on the energy metabolism in men.

We investigated the effects of dietary red pepper on the energy metabolism in male subjects. In the first experiment, after having a standardized dinner on the previous evening, the subjects consumed a breakfast (650 kcal) either with or without 10 g of red pepper. For 150 min after the meal, they took a rest and their expired gas was collected. During the initial 30 min after the meal, the energy expenditure tended to be higher in the red-pepper diet period than in the control diet period. For the remaining 120 min, no difference in the energy expenditure was found between the red-pepper diet period and the control diet period. However the carbohydrate oxidation was significantly higher in the red-pepper diet period than in the control diet period while the lipid oxidation was lower in the red-pepper diet period than in the control diet period for 150 min after the meal. In the second experiment, the subjects consumed a breakfast with 10 g of red pepper after an oral administration of propranolol or a placebo. The propranolol abolished the increase in energy expenditure during the initial 30 min due to the meal containing red pepper. For the remaining 120 min, no difference in energy expenditure was found between the propranolol period and the placebo period. These results suggest than an increase in the energy expenditure after the meal containing red pepper appeared only immediately after the meal ingestion and a red-pepper diet increases the carbohydrate oxidation without increasing total energy expenditure for 150 min after the meal. And an increase in the energy expenditure immediately after the meal containing red pepper is considered to be caused by beta-adrenergic stimulation.

Adult↗

The virological and histological states of anti-hepatitis C virus-positive subjects with normal liver biochemical values.

We investigated anti-hepatitis C virus (HCV) titers, HCV RNA levels in liver and serum, genetic variability in the hypervariable region of the genome, the form of the virus in the circulation, and liver histology in 21 anti-HCV-positive subjects with sustained normal liver biochemical values. Titer of anti-HCV was determined by second generation anti-HCV-passive hemagglutination assay, and HCV RNA levels were semiquantitated by reverse transcriptase polymerase chain reaction (PCR). In 19 (90%) of the 21 subjects who had a higher titer of anti-HCV (> or = 2(14)), HCV RNA was detected in both serum and liver, and histological examination showed minimal or mild chronic hepatitis in all. In the remaining 2 patients who had a lower titer of anti-HCV, HCV RNA was not detected in serum and liver, and liver histology was normal. Anti-HCV titers and HCV RNA levels in serum and liver in the 19 HCV RNA-positive subjects were compared with those levels in the 41 patients with biopsy-proven chronic hepatitis C and elevated serum aminotransferase levels as a control group. There were no significant differences in viral levels in serum and liver between the two groups. To further investigate virological differences between the two groups with regard to degree of genetic variability and the form in the circulation, we performed the PCR-single strand conformation polymorphism (PCR-SSCP) of the hypervariable region 1 and the immunoprecipitation analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[The prevention of cancer chemotherapy-induced emesis with granisetron and clonazepam].

The antiemetic efficacy of a combination of granisetron and clonazepam was investigated in 39 gynecological cancer patients treated with cisplatin. Granisetron (3 mg/body/day) was administered by intravenous drip infusion before and 24 hours after anticancer drug administration, and clonazepam was taken orally twice a day. With a combination of granisetron and clonazepam, excellent efficacy was found in 87% (34/39) of the cases. Delayed emesis occurred in 38% (13/34), but the degree of nausea was mild. Clinically, antiemetic therapy with a combination of granisetron and clonazepam demonstrated superior antiemetic effects and seems to be useful for controlling nausea and vomiting associated with cancer chemotherapy.

Administration, Oral↗

[A case of severe sarin poisoning in the sarin attack in Matsumoto--one-year follow-up of clinical findings, and laboratory data].

A patient severely poisoned with sarin in the Sarin Attack in Matsumoto is described. A 19-year-old man was exposed to sarin at 23:00 on 27 June, 1994. At 1:00 of the following day, a rescue team found and brought him to the hospital. His blood pressure was 150-80mmHg and the heart rate was 120/min with frequent premature ventricular contractions (PVC). His respiration was shallow and copious salivation and excretion from the respiratory tract were observed. Consciousness disturbance, generalized convulsion, severe miosis and fasciculation of tongue, facial muscle and extremities were also marked. Serum cholinesterase was 21 U/l (normal 109-249) and acetylcholinesterase in erythrocyte (E-AchE) was 0.1U/l (normal 1.2-2.0). Electroencephalogram (EEG) 30 hours after exposure showed polispike and wave complexes. Ventilatory assistance, forced urination and injection of diazepam and atropin improved his general condition and he was discharged 18 days after exposure. Three months after exposure, E-AchE was normalized and there was no complaint. But one year after exposure, EEG showed epilecpic discharges during sleep, and Holter electrocardiogram showed frequent PVC. As no clinical cases of severe sarin poisoning like this patient was reported, a longterm follow-up of this patient is very important.

Adult↗