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Biomedical subjects

N Tanabe

Publications and source records attributed to N Tanabe.

At least 73 records · Page 4Linked to original sources
PubMed1996

[High-dose inhaled beclomethasone in long-term management of chronic severe asthma--usefulness and dose-dependence].

We studied the usefulness of 18 weeks of therapy with two high doses of inhaled beclomethasone dipropionate (BDP) in the management of severe asthma in adults. The patients had asthma symptoms that had not been controlled by combination therapy with BDP (800 micrograms/day) and bronchodilators. They were divided into two groups. Patients in group A (n = 16) were treated with 1800 micrograms/day of BDP and bronchodilators. Patients in group B (n = 10) were treated with 1400 micrograms/day of BDP and bronchodilators. BDP was inhaled via a large spacer (Volumatic). Eleven patients in group A and 6 patients in group B had been given an oral steroid regularly before the study. Asthma symptom scores, peak expiratory flow (PEF), pulmonary function, bronchial reactivity to methacholine, the total amount of oral steroid, and adrenocortical function were recorded. Results. 1) Clinical characteristics before the start of the study did not differ between groups. 2) Asthma symptom scores decreased to a greater extent in patients who received the higher dose of BDP than in those who received the lower dose. 3) Only the higher dose of BDP significantly increased evening and morning % PEF, as measured 6 weeks and 8 weeks after the start of the treatment. 4) Only the higher dose of BDP significantly increased the FEV1 and the PC20 for methacholine. FVC did not increase. 5) Only the higher dose of BDP significantly decreased the total amount of oral steroid needed to control asthma. 6) Results of the rapid ACTH test indicated that neither dose of BDP suppressed adrenocoritical function. Furthermore, the serum cortisol level measured early in the morning increased to within the normal range in the three patients in whom oral steroid therapy could be reduced or stopped after treatment. These data indicate that 1800 micrograms of BDP per day is more effective than 1400 micrograms/day at the beginning of long-term management of severe chronic asthma in adults whose symptoms are not controlled with the combination of 800 micrograms/day BDP and bronchodilators. Therapy with a higher dose (at least 1600 micrograms/day) of an inhaled steroid is more useful and should be promptly begun to treat severe asthma.

Administration, Inhalation↗
PubMed1996

[Prognostic value of acute pulmonary vascular response to oxygen inhalation in patients with chronic obstructive pulmonary disease].

Seventy-two patients with chronic obstructive pulmonary disease (COPD) underwent right heart catheterization when they were clinically stable and the relationship between length of survival and acute pulmonary vascular response to 100% oxygen inhalation was studied. Oxygen inhalation significantly reduced mean pulmonary arterial pressure (PPA), cardiac index (CI), and pulmonary arteriolar resistance (PAR). The percent change in PAR (% delta PAR) was used as an index of the acute pulmonary vascular response to 100% oxygen inhalation. Each patient was classified as a responder (% delta PAR > or = 15%) or a nonresponder (% delta PAR < 15%). The cumulative survival rates of these two groups were compared. Responders survived significantly longer than did nonresponders (mean survival times were 2571 days and 1432 days, respectively). The two groups did not differ significantly in anthropometic data, pulmonary hemodynamics, or blood gas data measured at base line during air inhalation. However, FEV1 and VC were significantly lower in nonresponders than in responders. The % delta PAR was not significantly related to age, PPA, PAR on air inhalation, FEV1, FEV1%, VC or VC%. We conclude that the pulmonary vascular response to oxygen inhalation (% delta PAR) may be an independent prognostic factor in patients with COPD.

Administration, Inhalation↗
PubMed1996

[Clinical effects of beni-koji in mild essential hypertension--a multi-center double-blind comparison with placebo].

Antihypertensive effects of beni-koji were studied using 29 outpatients with mild hypertension in a placebo-controlled double-blind comparative fashion. After a 4-week vehicle (apple juice) run-in period, 13 patients were assigned to receive beni-koji aqueous extracts containing juice once daily (27 g of beni-koji eq. per day) for 8 weeks and 16 were assigned to vehicle. Two patients assigned to the vehicle group did not complete the study. In addition to casual blood pressure, 24-hr non-invasive ambulatory blood pressure (ABP) was monitored in 6 patients given the beni-koji drink and 5 patients given the vehicle. 1) In the beni-koji group, both casual systolic and diastolic pressure decreased significantly during the treatment period (from 150 +/- 10/96 +/- 6 mmHg to 140 +/- 10/89 +/- 10 mmHg, p < 0.01). The averages of the 24-hr blood pressure recorded in ABP (24-BP) also significantly decreased (from 141 +/- 17/95 +/- 13 mmHg to 132 +/- 21/86 +/- 10 mmHg, p < 0.05) when compared with those of the control period. Casual pressure normalized (less than 140/90 mmHg) in 4 patients who received beni-koji. Circadian variation of the blood pressure by ABP showed a significant decrease during the daytime. 2) In the vehicle group, casual systolic pressure did not change significantly (from 155 +/- 8 mmHg to 151 +/- 12 mmHg), but diastolic pressure decreased significantly (98 +/- 7 mmHg to 93 +/- 6 mmHg). Casual blood pressure did not normalize in any of the patients and 24-BP did not change significantly. 3) Summative evaluation of safety showed that no problems appeared in the beni-koji group. In conclusion, beni-koji appears to be an effective and safe food material for mild essential hypertension. The mechanism of the antihypertensive effect of beni-koji still remains to be investigated.

Antihypertensive Agents↗
PubMed1996

Sudden death of adults in Japan.

Epidemiological features, risk factors and preventive methods of sudden death (SD) derived from studies the authors have performed since 1987 together with colleagues in Niigata University School of Medicine were reviewed. When SD was defined as death occurring within 24 hours of the onset of symptoms, the annual incidence was 145/100,000 for people aged 15 years and older in Niigata Prefecture. The incidence increased sharply along with the advance of age, while the proportion of SD to natural death due to circulatory diseases was higher in younger people. Though diseases of the circulatory system made up approximately 90 percent of all causes of death, SD due to ischemic heart disease was less frequent in Japan than in western countries. SD showed various patterns in seasonal and "within-a-day" occurrences according to sex, age and cause of death. The months of the highest SD occurrence differed by occupation and matched the busiest work periods. A decrease in sleeping hours and mental stress experienced during the preceding week were related to the occurrence of both sudden death and non-fatal acute myocardial infarction. People having structural circulatory diseases were shown to be predisposed to SD when stress occurred, because fatal arrhythmia is easily induced by the above factors in such people. Health examinations were shown to have preventive effects, though limited, against SD. Differences in the resuscitated rates in cases where a witness was present and where one was not indicates that educating people about correct resuscitation methods is important to minimizing SD.

Adolescent↗
PubMed1995

Effects of Mg2+ on the stimulation-induced changes in transmitter release at the frog neuromuscular junction.

Four components of stimulation-induced changes in neurotransmitter release are known as the synaptic plasticity at the frog neuromuscular junction. These are: fast and slow facilitation, augmentation and potentiation, classified by their decay time constants after repetitive nerve stimulation. Most experiments support the view that fast facilitation is caused by residual Ca2+. However, the causes of the other three components are not clear. We have studied electrophysiologically the effect of Mg2+ on these three components. Transmitter release was estimated by the amplitudes of endplate potential (EPP) and by the frequencies of miniature endplate potential (MEPP). The increase in the transmitter release by nerve stimulation is described as the product of four components. The magnitude of potentiation of MEPP frequencies after a tetanic nerve stimulation (100 Hz, 5000 times) increased markedly in high Mg2+ concentrations. Conversely, the magnitude of augmentation (MEPP frequencies and EPP amplitude) decreased in the higher Mg2+ Ringer solution.

Animals↗
PubMed1995

[Benefits and adverse effects of post-operative radiation therapy after radical cystectomy for patients with advanced bladder cancer].

BACKGROUND: The benefits and adverse effects of post-operative irradiation for advanced bladder cancer patients were investigated. METHODS: Ten patients with pT3b, pT4 or pN+ bladder cancer who underwent radical cystectomy at Yamanashi Medical University hospital during 7 years and 3 months from October 1983 to December 1991 received adjuvant chemotherapy and radiotherapy (Group 1). During the same period, six patients with recurrent tumor after radical cystectomy were treated by radiotherapy (Group II). Stages of the primary tumors were pT2 in 1, pT3a in 2, pT3b in 6 and pT4 in 7 cases. In addition, 10 of 16 patients (63%) had positive nodes. RESULTS: During the follow up period, seven patients died of cancer, and one died of other cause. As a result eight patients (5 in Group I, 3 in Group II) are alive. The cumulative 5-year survival rate is 50%. However, nine of the 16 patients (56%) suffered from the small bowel obstruction as an adverse effect of irradiation. Six patients required resection of the small bowel or bypass surgery. CONCLUSIONS: Radiation after radical cystectomy seemed to be effective for the local control of the tumor, but the adverse effect to the digestive system was very severe and common.

Aged↗
PubMed1995

[Cystic disease of the kidney].

The kidney is one of the most common sites of cyst. Since cystic disease of the kidney includes various disorders, it is difficult to classify the diseases systematically. It appears that the classification of the American Academy of Pediatrics is suitable for clinical side for the present. In this paper the cystic disease of the kidney is explained on actual cases. Recently, development of imaging diagnosis is contributing widely to the diagnosis of the diseases. Treatment of the diseases, however, is not established satisfactorily. It is hoped that the mechanism of occurrence of the diseases is known further and that regulation of the classification and establishment of the treatment will become available.

Aged↗
PubMed1995

[A case of idiopathic pulmonary arteritis with positive anti-myeloperoxidase antibodies].

A 38-year-old woman was referred to our hospital for severe pulmonary hypertension (pulmonary arterial pressure 63/36 mmHg). Digital subtraction angiography showed complete obstruction of the right main pulmonary artery and severe stenosis of the left main pulmonary artery. Although there were no symptoms or signs of systemic arterial lesions, the initial diagnosis was aortitis syndrome with pulmonary arterial involvement, and prednisolone therapy was started (60 mg/day). Pulmonary arterial pressure decreased to 53/12 mmHg. At a dosage of 20 mg/day, however, multiple nodular shadows were present on the X-ray film of the chest, but they disappeared after the dosage was increased. The level of anti-myeloperoxidase antibodies in her serum changed at almost the same time as multiple nodular shadows appeared on the chest X-ray film. Because anti-MPO antibodies have been never detected in patients with aortitis syndrome, polyangitis overlap syndrome was suspected. However, we found no evidence of systemic vasculitis; that is, vasculitis in other organs, including the kidney and the skin. Therefore, we made a diagnosis of idiopathic pulmonary arteritis with positive anti-MPO antibodies.

Adult↗
PubMed1994

Acute occlusion due to coronary dissection as a PTCA complication resolved by reentry achieved by pulling an inflated balloon in the true lumen.

We experienced 2 patients in whom conventional percutaneous methods were not useful for acute occlusions sequel to coronary angioplasty. Acute occlusions seemed to be caused by large dissections. Pulling an inflated balloon at the dissected lesions achieved reentry from the false lumen to the true lumen, thus resolving collapse of the true lumen and recanalizing the occluded coronary artery.

Angioplasty, Balloon, Coronary↗
PubMed1994

[Results of radical cystectomy for bladder cancer].

During 7 years and 3 months from October 1983 to December 1990, 68 patients underwent radical cystectomy for primary bladder cancer at Yamanashi Medical College. Of these 68 bladder cancers, 16 were superficial and 52 were invasive. Among the 52 patients with invasive cancer, a combination chemotherapy of methotrexate and cisplatin and/or radiotherapy were given in 18 as an adjuvant therapy. All the adjuvant therapies were performed after the operation except for 2 patients with T4 bladder cancer who received chemotherapy before the operation. There were 23 recurrences and 25 deaths, 20 from bladder cancer and 5 from other causes. Of 20 bladder cancer deaths, 17 deaths (85%) were observed within 2 years after the operation. The 5-year survival rates were 92% for stage pTa-pT1, 83% for stage pT2, 80% for stage pT3a, 24% for stage pT3b and 43% for stage pT4-T4, respectively. A significant difference (p < 0.05) in survival curve was observed between pT3a and pT3b. The 5-year survival rate for pT2-pT3a without nodal metastases was as high as 89% (95% confidence limits 75 to 100%) although 18 out of 19 patients received no adjuvant therapy. On the other hand, the 5-year survival rate for pT3b-pT4 without nodal metastases (25%) was as low as that of patients for any T category with nodal metastases (35%). Most patients with tumor confined within bladder wall seemed to be cured by surgery only. Therefore, any adjuvant chemotherapy with severe side effects seemed not to be justified for these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Relation of pulmonary vascular response to pressure-flow relationship during incremental exercise in patients with chronic obstructive pulmonary disease (COPD)].

Twenty-eight COPD patients underwent right heart catheterization while in clinically stable condition. Pulmonary vascular response to oxygen was evaluated by the percent change in pulmonary arteriolar resistance after 100% oxygen inhalation (% delta PAR), and its relation to the pressure-flow relationship during incremental exercise was assessed. Mean pulmonary arterial pressure (PPA) during exercise was plotted against the cardiac index (C.I.) from rest to maximal exercise in each patient. In most of the patients, the changes in PPA were nearly linear to the C.I. Therefore, a slope could be obtained from the regression equation in each patient. Patients were divided into two groups according to whether their % delta PAR was greater than 20 defined as a responder (RES), or less than five defined as a non-responder (N-RES). Seven out of 28 patients were RES, nine were N-RES, RES showed a higher %FEV1.0 level, C.I. and stroke volume index (S.I.) at maximal exercise, and a lower level of RV/TLC as well as slope. The slope correlated significantly with %DLCO (r = -0.724, p < 0.01), baseline PAR (r = 0.562, p < 0.01) and % delta PAR (r = -0.522, p < 0.01). These results suggest that the diminished pulmonary vascular bed, and the distensibility of pulmonary vessels, appear to contribute to the steepness of the slope and reduced % delta PAR in patients with COPD.

Administration, Inhalation↗
PubMed1993

Angiotensin II receptors in the rat urinary bladder smooth muscle: type 1 subtype receptors mediate contractile responses.

Angiotensin II (Ang II) receptors in the rat urinary bladder smooth muscle were investigated by in vitro responses of smooth muscle strips to exogenous Ang II stimulation and in radioligand binding assays. Ang II (10(-10) M. to 10(-5) M.) caused a potent contractile response in a concentration-dependent manner. Using the recently developed nonpeptide subtype-selective antagonists, the Ang II-induced contractile response was further characterized. The Ang II-induced contractile response was inhibited weakly by the type 2 subtype (AT2)-selective antagonist PD123319 but was potently inhibited by the type 1 subtype (AT1)-selective antagonist DuP 753 with a pA2 value of 9.03, suggesting that the response is mediated predominantly by AT1 receptors. [125I]Ang II was used to specifically label a single class of binding sites with a dissociation constant of 0.31 nM. and a maximal binding capacity of 41.5 fmol./mg. of protein. DuP 753 could completely antagonize the binding of Ang II in a particulate fraction of rat bladder (Ki = 14 nM), whereas PD123319 did not have any effect in the concentration range of 10(-9) to 10(-5) M. The results suggest that AT1 receptors rather than AT2 receptors predominantly mediate Ang II-induced contraction in the rat urinary bladder.

Angiotensin II↗
PubMed1993

[The incidence of atherosclerotic lesions of the carotid artery in people of one community].

Carotid sonography were conducted in people of one community (122 males and 243 females) in 1990 and 1991. The intima-media thickness (IMT) in the main trunk and bifurcation-bulb areas of bilateral carotid arteries were measured in 122 males. IMTs of four areas increased with aging. In all cases, the average IMT of the right main trunk was 0.8 +/- 0.1 mm (mean +/- SD) and those of the remaining three areas were 0.9 +/- 0.2 mm. The IMT of the right bifurcation area in males aged 75 years or older was the thickest; i.e., 1.1 +/- 0.3 mm. Therefore, atherosclerotic lesions (AL) were defined as an IMT of 1.5 mm or more. The incidence of AL increased along with aging both in males and females. In those who were less than 65 years old, the incidence in males was 12.8% (10/78) and that in females was 9.0% (12/134). In those who were 65 years old or older, the incidence in males was 31.8% (14/44) and that in females was 26.9% (29/109). The incidence of AL tended to increase rapidly from 65 years of age in both males and females. Moreover, the incidence of AL in bilateral carotid arteries increased along with aging as well. Since IMT, the incidence of AL and that of AL in bilateral carotid arteries increased with aging, we considered that these parameters could be used as indices of the degree of general atherosclerosis.

Adult↗
PubMed1993

Erythroderma and marked atypical lymphocytosis mimicking cutaneous T-cell lymphoma probably caused by phenobarbital.

A 56-year-old man had been treated with phenobarbital seven weeks prior to admission. One month after initiation of administration of phenobarbital, fever, skin rash and lymphadenopathy occurred. Nine days later, marked atypical lymphocytosis, eosinophilia and hepatic injury was noticed. The histology of the biopsied skin was indistinguishable from lymphoma. CHOP-therapy was started but the patient was followed without further treatment because of polyclonal T-lymphocytosis. Afterward, clinical and hematologic improvement ensued and he has been well until now, 52 months later. The marked T-lymphocytosis observed in this case is probably a lymphoid leukemoid reaction secondary to hypersensitivity to phenobarbital.

Dermatitis, Exfoliative↗