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Biomedical subjects

N Yamada

Publications and source records attributed to N Yamada.

At least 1,027 records · Page 57Linked to original sources
PubMedDate not supplied

Corticosteroid-induced psychotic and mood disorders: diagnosis defined by DSM-IV and clinical pictures.

The authors investigated long-term outcome and treatment strategy of corticosteroid-induced psychotic and mood disorders as defined by DSM-IV. Review of medical records of 2,069 referral patients revealed 18 applicable patients. Their clinical characteristics, longitudinal courses, and treatments were studied. The authors identified 15 patients with mood disorder and 3 patients with psychotic disorder. Increasing doses or resumption of corticosteroids had the strongest influence on the psychiatric course. These two corticosteroid-induced psychiatric disorders may have different pathophysiological substrates closely related to patient vulnerability. Effective psychopharmacological treatment options were indicated with consideration being given to the underlying diseases.

Adult↗
PubMedDate not supplied

Effects of FL-386 on faecal lipid excretion in humans.

A newly synthesized inhibitor of pancreatic lipase and micelle formation, FL-386, was administered at a dose of 400 mg (in the diet, for seven consecutive days) to nine healthy adult volunteers, and changes in faecal mass, frequency of defaecation, and properties of the stools were observed. High performance liquid chromatography and gas-liquid chromatography were used to analyse the faeces for short-chain carboxylic acids, neutral sterols, bile acids, fats and hydroxyfatty acids. FL-386 had little effect on the amounts and composition of short-chain carboxylic acids, neutral sterols, and bile acids excreted, nor did it produce changes in the composition of fatty acids, or the percentages of hydroxyfatty acids in the stool. However, in those patients treated with FL-386, the faecal mass was increased, and stools were softer and contained increased amounts of fatty acids. The compound did not produce particularly fatty stools. It was concluded that FL-386 induces slight disturbance in the digestion and absorption of dietary lipids.

Adult↗
PubMedDate not supplied

Effect of an alpha-glucosidase inhibitor on intestinal fermentation and faecal lipids in diabetic patients.

Eight non-insulin-dependent diabetes mellitus patients, in whom oral hypoglycaemic agents were not effective, were treated with an alpha-glucosidase inhibitor, AO-128 (0.9 mg/day) for 6 months. After 6 months of treatment there was a statistically significant decrease in the blood glucose level 1 and 2 h postprandially. The 2 h blood glucose level was also significantly reduced after 2 months' treatment. The insulin and HbA1c levels after 2 and 6 months' treatment were lower than those before administration. Faecal weight, the frequency of bowel movements, the ratio of hydroxy fatty acids to total fatty acids, and faecal short-chain carboxylic acid content were all increased significantly during treatment. The initially hard stools became normal or soft, although no actual diarrhoea developed. Both faecal bile-acid excretion and the ratio of primary bile acids to total bile acids were increased significantly after 2 months, but they showed some recovery towards the pretreatment levels after 6 months' treatment. There was no distinct change in neutral sterol and fatty acid excretion. Breath hydrogen excretion showed a slight increase after treatment. These results suggest that intestinal fermentation was promoted and the intestinal transit time was shortened by AO-128 administration.

Adult↗
PubMedDate not supplied

Changes in plasma fatty acid profile in Japanese patients with chronic pancreatitis.

The serum zinc, prealbumin, retinol-binding protein and carotene concentrations and the plasma fatty acid composition were determined to assess the nutritional condition of 24 patients with chronic pancreatitis compared with that of 20 healthy controls. The daily food intake and faecal fat excretion of the two groups were also measured. In the chronic pancreatitis group, the calorie and fat intakes were significantly lower than those of the controls. Serum levels of zinc, prealbumin and carotene were also significantly lower than those of the controls. Percentages of plasma linoleic and arachidonic acids were low, while percentages of palmitoleic acid, eicosapentaenoic acid and docosahexaenoic acid were high. Fish oil intake correlated negatively with plasma linoleic acid concentration (P < 0.05). The above results indicate that the relatively high intake of fish oil and the relatively low intake of dietary fat in Japanese patients with chronic pancreatitis with a mild degree of steatorrhoea results in an abnormally low plasma level of linoleic acid.

Adult↗
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Effects of pancreatic digestive enzymes, sodium bicarbonate, and a proton pump inhibitor on steatorrhoea caused by pancreatic diseases.

Forty-five patients with pancreatic steatorrhoea (27 with calcified pancreatitis, 13 with non-calcified pancreatitis, two with pancreaticoduodenectomy, one with total pancreatectomy, and two with pancreatic cancer) were divided into four groups and given the following medication for 2 to 4 weeks: 4 to 6 g/day of sodium bicarbonate (group I); 9 g/day of high-lipase pancreatin (lipase, 56,600 U/g, Fédération Internationale Pharmaceutique (FIP); group II); 12 to 24 tablets or 9.0 g of commercial pancreatic enzyme preparations (group III); or 50 mg of omeprazole (group IV). Faecal fat excretion was evaluated before and after drug administration. Faecal fat excretion was reduced by 2.9 g (range, 1.7 to 5.0 g) in group I; 8.8 g (range, 2.9 to 39.9 g) in group II; 10.8 g (range, 2.3 to 21.8 g) in group III; and 4.3 g (range, 3.6 to 5.6 g) in group IV. The pancreatic digestive enzyme preparation was more effective than sodium bicarbonate and agents that raise the pH of the upper small intestine (such as proton-pump inhibitors) in reducing faecal fat excretion. The results indicate that all of the preparations used are effective against mild pancreatic steatorrhoea. If the condition is more advanced, however, a massive dosage of pancreatic digestive enzyme and possibly the combined use of an agent to raise the pH of the upper small intestine are likely to be effective.

Adult↗
PubMedDate not supplied

Faecal triglycerides and fatty acids in the differential diagnosis of pancreatic insufficiency and intestinal malabsorption in patients with low fat intakes.

To investigate possible parameters for the differential diagnosis of steatorrhoea in patients with low fat intakes, faecal specimens were analysed from 15 patients with steatorrhoea due to chronic pancreatitis and seven patients with steatorrhoea due to intestinal malabsorption. The fat intakes of the patients ranged from 30.1 to 60 g, less than the average in American and European patients. The group with pancreatic steatorrhoea showed a significantly lower faecal output than the group with intestinal steatorrhoea but the two groups did not differ significantly in their total faecal fat excretion or concentration. The percentage triglycerides and the molecular ratio of triglycerides to fatty acids in the faeces were significantly higher (P < 0.01) in the group with pancreatic steatorrhoea than in those with intestinal steatorrhoea. The molecular percentage ratio of triglycerides to fatty acids was 6.8 +/- 2.2 for the chronic pancreatitis group and 2.4 +/- 1.0 for the intestinal malabsorption group; while the respective faecal hydroxy fatty acid contents were 3.1 +/- 3.6% and 10.1 +/- 3.3% (means +/- SDs). These latter two parameters appeared to be the most valuable for distinguishing the two forms of steatorrhoea.

Adult↗
PubMedDate not supplied

Interferon-induced sudden hearing loss.

With the increasing long-term use of interferon (IFN), several new adverse effects have been recognized. Very little attention, however, has been paid to auditory acuity. We encountered 3 cases of sudden hearing loss associated with IFN. We then conducted a prospective study to assess the auditory function of 73 patients receiving IFN. Auditory disability (tinnitus and/or hearing loss) occurred in 32 patients (43.8%) during IFN therapy, among which audiometry documented sensorineural hearing loss in 27 cases (36.9%); 17 (48.6%) of the 35 patients receiving IFN-beta had auditory disability, including hearing loss in 13 cases (37.1%), and 15 (39.5%) of 38 patients receiving IFN-alpha suffered from auditory disability. There was not much difference between the influences of IFN-alpha and -beta. Auditory disability frequently developed in the later stages of treatment, and most patients recovered 7-14 days after the discontinuation of IFN. The results demonstrate that sudden hearing loss can occur as a side effect of treatment with IFN. This may reveal the association between autoimmunity and sudden hearing loss.

Adult↗
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Ultrastructural observations of small blood vessels in leprosy patients.

In lepromatous leprosy, blood vessels revealed the luminal protrusions of endothelial cells containing M. leprae and thickening of the basement membrane of endothelial and smooth cells. Endothelial projections with increased pinocytotic vesicles were more often encountered in lepromatous leprosy than in the other types of leprosy. On the other hand, in tuberculoid leprosy, the extensive rough endoplasmic reticulum suggesting protein synthesis was observed in the endothelial cells compared with the other types of leprosy and non-specific lesions. It seems that the blood vessels associated with hyperfunction and proliferation in the endothelium could aggravate the degenerative changes in peripheral nerve fibers including the Schwann cells.

Endothelium, Vascular↗
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Comparison of sensitivities of uterine cells in their proliferation responding to epidermal growth factor and estrogen between neonatal and postneonatal mice.

The uteri of mice up to 20 days after birth show estrogen-independent growth, although their growth is accelerated by estrogen, while the growth of the uteri of mice after 20 days completely depends on estrogen. In the present study, we compared the sensitivities of uterine cells in their proliferation responding to epidermal growth factor (EGF) and diethylstilbestrol (DES) between 5-day-old and 25-day-old ovariectomized mice. A single subcutaneous injection of EGF at doses of 0.25 and over 0.25 microgram/g body weight (BW) increased 3H-thymidine uptake by the whole uterus dose-dependently in both 25-day-old and 5-day-old mice, and a maximal increase in the 3H-thymidine uptake was attained at a dose of 1 microgram/g BW of EGF in both mice. A single subcutaneous injection of DES at 0.001 and over 0.001 microgram/g BW increased 3H-thymidine uptake by the whole uterus dose-dependently in both 25-day-old and 5-day-old mice, and a maximal increase was attained at 0.004 microgram/g BW of DES in both mice. EGF and DES increased labeling indices of both the epithelium and stroma in both 25-day-old and 5-day-old mice. The present results suggest that sensitivities of uterine cells of neonatal mice in their proliferation responding to EGF and DES are similar to those of postneonatal mice.

Age Factors↗
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Successful emergency treatment with a transjugular intrahepatic portosystemic shunt for life-threatening Budd-Chiari syndrome with portal thrombotic obstruction.

We report successful treatment of acute severe Budd-Chiari syndrome with portal venous thrombosis. The prognosis of patients with this condition is poor, because the therapeutic options are limited. A 38-year-old woman with polycythemia vera was admitted in a critical condition, and Budd-Chiari syndrome complicated by portal venous thrombosis was diagnosed. Tissue plasminogen activator and urokinase were infused systemically and were partially effective. Transjugular intrahepatic portosystemic shunting to reduce the high portal venous pressure was performed successfully and, eventually, her general condition improved. Our experience indicates that emergency transjugular intrahepatic portosystemic shunting is an effective therapeutic modality for controlling portal hypertension in patients with severe Budd-Chiari syndrome with portal venous thrombosis.

Adult↗
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Castration induces apoptosis in the male accessory sex organs of Fas-deficient lpr and Fas ligand-deficient gld mutant mice.

The role of the Fas ligand-Fas system in castration-induced apoptosis in the epithelia of the ventral prostate (VP), seminal vesicle (SV), coagulating gland (CG) and epididymis (Ep) was investigated using lpr/lpr, and gld/gld mutant mice which are deficient in Fas and Fas ligand, respectively. The degree of apoptosis in the epithelium was quantitatively estimated by an apoptotic index (a percentage of apoptotic cells). The weights (mg/10 g body weight) of the VP, SV, CG and Ep of lpr/lpr and gld/gld mice were similar to those of normal +/+ mice and castration decreased the weights of the VP, SV, CG and Ep in these three kinds of mice to similar levels. Castration also increased the apoptotic indices in these organs reaching maximum on days 2-6 after castration. There was no significant difference in the apoptotic index of these organs among +/+, lpr/lpr and gld/gld mice on days 0-8 after castration. Agarose gel electrophoresis of DNAs extracted from the VP, SV, CG and Ep of +/+, lpr/lpr and gld/gld mice on day 4 after castration showed a ladder pattern. The present results suggest that the Fas ligand-Fas system plays little role in castration-induced apoptosis in the mouse male accessory sex organs such as the VP, SV, CG and Ep.

Animals↗
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Extraluminal air bubble on computed tomography.

We present two cases of gastrointestinal perforation associated with a tiny extraluminal air bubble on computed tomography (CT). The air bubble was located at the round ligament of the liver in a patient of perforated duodenal ulcer and at the intraperitoneal space adjacent to the perforated site of the anterior gastric wall in the other patient. A small amount of fluid was also seen at the round ligament in the second patient. The region of the round ligament of the liver should be carefully scrutinized for the presence of extraluminal air or fluid in patients with acute abdominal symptomatology.

Adult↗
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Watanabe heritable hyperlipidemic rabbit. Animal model for familial hypercholesterolemia.

The Watanabe heritable hyperlipidemic (WHHL) rabbit has proved to be an invaluable animal model of human familial hypercholesterolemia. The mutant low density lipoprotein (LDL) receptor in the WHHL rabbit lacks four amino acids in the third repeat unit of the receptor-binding domain. By the criterion of LDL binding, the WHHL rabbit is receptor-negative; although the receptor is synthesized, it is very slowly glycosylated, and little may reach the cell surface. WHHL rabbits develop fatty intimal streaks and later complicated atherosclerotic lesions, as do cholesterol-fed rabbits. The lipoproteins accumulating in their blood include not only LDL but also remnants of very low density lipoproteins (VLDL). Chylomicron metabolism, however, appears to be normal. Metabolic studies have shown that VLDL are synthesized and secreted by the liver at normal rates, and no particles containing apolipoprotein B-100 are secreted in lipoproteins of higher density. VLDL remnants are metabolized sluggishly, and a much larger fraction than normal is converted to LDL, which, therefore, accumulate not only because of impaired removal, but also as a result of increased formation from VLDL precursors. Both metabolic studies and the responsiveness of WHHL rabbits to dietary perturbations and drugs that affect the number of LDL receptors on hepatocytes suggest that the LDL receptor on cell surfaces in WHHL rabbits recognizes some VLDL remnants, but not LDL. These receptors may also participate in the metabolism of chylomicron remnants.

Animals↗
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[Which time constant of left ventricular relaxation is the most sensitive measure in acute myocardial ischemia?].

To investigate which time constant of isovolumic left ventricular pressure (LVP) decay is the most sensitive measure in acute myocardial ischemia, the time constant of isovolumic relaxation (IR) was calculated by two different models, the semilogarithmic model assuming a zero of LVP decline (TL) and an exponential model (Texp) with an asymptote (extrapolated baseline pressure to which LVP would fall if decay continued indefinitely), in 10 patients before and during ergonovine-induced vasospastic angina. Two time constants were derived from the exponential method as the times for LVP at peak negative dP/dt to decline by 1/e (Texp (1/e)) and by one half (Texp (1/2)). Three changes in LVP during isovolumic relaxation were analyzed and fitted to the two models described above: the LVP from the peak negative dP/dt 1) to when LVP fell to 5 mmHg above LV end-diastolic pressure (EDP), 2) until 40 msec had passed, and 3) to the LVP level 5 mmHg above LVEDP during coronary spasm. There were significant increases in TL, Texp (1/e) and Texp (1/2) in each period of the LVP during vasospastic angina. However, no significant change in Texp or asymptote was observed during angina. We concluded that TL measured by the semilogarithmic model assuming a zero of LVP decline and Texp (1/e) or Texp (1/2) derived from the exponential model are adequately sensitive for detecting acute myocardial ischemia due to coronary spasm.

Adult↗
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Short-chain carboxylic acid in the feces in patients with pancreatic insufficiency.

Short-chain carboxylic acids in the feces of 12 patients with chronic pancreatitis having steatorrhea and 18 healthy subjects were determined by high-performance liquid chromatography. The fecal amount of the patients with chronic pancreatitis was increased to about twice that of the control, and the fat in the feces increased to eight times. The excretion of short-chain carboxylic acids increased to about three times. The short-chain carboxylic acid concentration regarded as derived from protein or amino acid, such as iso-butyrate, isovalerate, and n-valerate, was significantly increased in patients with chronic pancreatitis. From the above results, our data suggest that there is maldigestion of protein besides that of carbohydrate. And we confirmed that these data are an in-vivo illustration of the phenomena which have been studied in-vitro experiments, when fecal bacteria were incubated with peptide or amino acids as a substrate.

Adult↗
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Fat-soluble vitamins in patients with chronic pancreatitis (pancreatic insufficiency).

The fat-soluble vitamin contents in the blood (vitamins A, D, E, and K) were determined in 12 patients with chronic pancreatitis (exocrine pancreatic insufficiency) and in 20 healthy adults by the HPLC and CPBA methods. In addition, 9 g (3 g x 3 times) of high potency pancreatin was given to 11 patients with chronic pancreatitis (CP) for approximately 1 month and changes in the blood fat-soluble vitamin levels were evaluated before and after the treatment. The major component of vitamin E was alpha-tocopherol. The mean alpha-tocopherol level in normal individuals was 0.97 mg/dl, while it was significantly reduced in CP patients (p < 0.01). The vitamin A, D, and K levels had also been reduced in patients with CP, but the differences were not significant (although some patients in this group exhibited significant reductions from the levels of normal individuals). Only the blood vitamin E level showed a significant correlation with the fecal fat excretion or the fat absorption rate. None of the patients with CP exhibited an overt fat-soluble vitamin deficiency (i.e., the deficiency of fat-soluble vitamins was at a subclinical level). These results indicated that CP patients suffer from a latent fat-soluble vitamin deficiency and that the vitamin E level is closely related to a dysfunction of fat digestion. It was suggested that the dietary intake of each fat-soluble vitamin should be evaluated further.

Adult↗