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Biomedical subjects

O Iimura

Publications and source records attributed to O Iimura.

At least 235 records · Page 13Linked to original sources
PubMed1984

A case of normotensive primary aldosteronism--comparison with 13 previously experienced cases with hypertension.

A 47-year-old woman with normotensive primary aldosteronism is reported. In this case, hypopotassemia was found, but the patient's blood pressure was within the normal range. Her condition was diagnosed as primary aldosteronism without hypertension, which is very rare, based on an increased level of plasma aldosterone concentration, low plasma renin activity, and a typical finding of aldosterone-producing adenoma by adrenal scintigraphy. In the present case, similar values for urinary volume, renal function, plasma aldosterone concentration, plasma renin activity, plasma volume, total exchangeable sodium, urinary kallikrein excretion and a similar weight of the resected adenoma, but a shorter duration between the onset of symptom and hospital admission were observed as compared with those in 13 previously experienced cases of primary aldosteronism with hypertension. Thus, a shorter duration of primary aldosteronism appears to be an important factor in explaining the mechanism of normotension. However, we were unable to reach a definite conclusion and this is only a hypothesis. Further investigation will be required to clarify the mechanism of normotension in primary aldosteronism.

Adenoma↗
PubMed1984

A simple and sensitive method for determination of human urinary kallikrein activity (kininogenase activity), using human low molecular weight kininogen.

Human low molecular weight kininogen was partially purified and applied to the measurement of human glandular kallikrein as a substrate. The prepared human low molecular weight kininogen did not contain any significant amounts of kinin generating or destroying enzymes. When ethanol was added to the assay tube to stop the enzyme reaction, the substrate was almost completely removed from the incubation solution. Moreover, less than 1.25% ethanol had no effect on the kinin radioimmunoassay. These data suggest that the measurement of generated kinin can be done directly after the addition of ethanol. In this assay system, control tubes were unnecessary since the small volume of the urine samples (0.5 to 2.0 nl) contained negligible amounts of endogenous kinin. In a comparison of the availability as a substrate for human urinary kallikrein among human, dog and bovine low molecular weight kininogens, the enzyme activity was 5 or 100 times as high in the human substrate as in the dog and bovine substrates, suggesting that a human substrate is best for the human enzyme. A significant correlation was found between our previous method using bovine substrate and this method for human urinary kallikrein activity. In both methods, urinary kallikrein excretions were significantly lower in patients with essential hypertension and higher in those with primary aldosteronism, respectively. This simple, specific and sensitive kininogenase assay system seems to be very useful for investigating the physiological or pathophysiological role of the renal kallikrein-kinin system in hypertensive and renal diseases.

Animals↗
PubMed1984

Electrocardiographic abnormalities in cerebrovascular accidents.

In order to assess the relationship of electrocardiographic (ECG) changes in acute cerebrovascular accidents (CVA) to the locations of the cerebral lesions, ECG records and brain computerized tomographic (CT) scans which were taken within 48 hours of CVA onset were examined in 39 patients without heart disease and/or treatment with cardiovascular drugs. The ECG was normal in 25% (3/12) of basal ganglial CVA, 22% (2/9) of frontal CVA and 36% (4/11) of temporo-parietal CVA. Nonspecific ST-T changes occurred in basal ganglial CVA (25%), frontal CVA (22%), temporo-parietal CVA (18%) and in the other categories of CVA locations. Corrected QT interval (QTc) elongation was observed not only in frontal (22%), but also in basal ganglial CVA (25%), temporo-parietal CVA (36%) and cerebellar CVA (50%). There were no ECG changes specific to a particular CVA location. These findings suggest that widely distributed neurons and pathways within the central nervous system may influence ECG.

Adult↗
PubMed1984

An ectopic, ACTH producing, oncocytic carcinoid tumor of the thymus: report of a case.

A 39-year-old man with an ACTH producing oncocytic carcinoid of the thymus is reported here. His symptoms were pigmentation, facial and pretibial edema, and high blood pressure. Endocrinological examination revealed the ectopic ACTH syndrome and, especially, high content in the intrathoracic venous blood. On histological examination, the tumor was found to be composed of uniform eosinophilic cells, with no argentaffin granules being demonstrated. Ultrastructural findings revealed a large number of mitochondria and numerous distinct electron-dense neurosecretory granules in the cytoplasm. Abnormally high levels of ACTH, beta-endorphin and gamma-MSH were also found in this tumor tissue. By total extirpation of the tumor, clinical symptoms and laboratory data were entirely normalized.

ACTH Syndrome, Ectopic↗
PubMed1984

Study on the renal kallikrein-kinin system in normal and low renin subgroups of essential hypertension.

In order to investigate the role of the renal kallikrein-kinin (K-K) system in normal (NRH) and low renin (LRH) subgroups of essential hypertension (EHT), daily excretions of urinary kallikrein (KAL) quantity and activity, kinin (KIN), total and pre-KAL, and kininase I and II were measured in 21 normotensives (NT), 29 patients with NRH and 16 patients with LRH. The daily excretions of both KAL quantity and activity, total and pre-KAL, and KIN were significantly lower in NRH and LRH than in NT. That of kininase I was significantly higher in NRH and LRH than in NT, but that of kininase II was not. In comparing NRH and LRH, the urinary excretions of KAL activity and KIN were lower in LRH than in NRH, and that of kininase I was higher in LRH than in NRH. The KAL/total KAL ratio did not show any significant difference among NT, NRH and LRH. These findings suggest that the suppression of the renal K-K system in EHT seems to be due to both the decrease of KAL through the pre-KAL synthesis in the kidney and an increase of kininase I activity, but not to the inhibition of conversion from pre-KAL to active KAL and the more obvious suppression of this system in LRH than in NRH may be partly explained by KAL inhibitors and/or increased kininase I activity.

Adult↗
PubMed1983

The role of the renal kallikrein-kinin system in sodium metabolism in normal and low renin essential hypertension.

In order to investigate the pathophysiological role of the renal kallikrein-kinin system in renin subgroups of essential hypertension, the quantity and activity of urinary kallikrein, urinary kinin excretion, and correlations of kallikrein and kinin excretions with renal sodium handling in the renal tubules were studied in 17 normal subjects, 23 patients with normal renin and 12 patients with low renin essential hypertension. Urine samples were collected by the 2-hour clearance method in the early morning. The quantity and activity of urinary kallikrein, and the urinary excretion of kinin were significantly lower in both low and normal renin patients than in normal subjects. Comparing the normal renin and the low renin group, no significant difference was found in the quantity of urinary kallikrein, while the activity of urinary kallikrein and urinary kinin excretion were significantly lower in low renin patients than in normal renin ones. Fractional excretions of sodium (FENa) and inorganic phosphorus (FEP), which reflect renal tubular and proximal tubular sodium reabsorption, respectively, were significantly lower in the low renin patients than in the normal renin ones. A significantly positive correlation was observed between the urinary kallikrein activity or urinary kinin excretion and FENa or FEP in both normal subjects and normal renin patients, but not in low renin patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

The role of L-carnitine in the pathogenesis of cardiomegaly in patients with chronic hemodialysis.

Many reports have suggested that cardiac dysfunction with cardiomegaly is more often observed in patients with chronic hemodialysis. Moreover, cardiac dysfunction has been thought as one of the most important factors affecting the prognosis of these patients. In this study, in order to clarify the role of l-carnitine in the pathogenesis of cardiomegaly, 33 patients with chronic hemodialysis were studied using the multivariate analysis method. Among the factors which may affect cardiac function, the following 10 variables were examined. 1) age, 2) duration of dialysis, 3) plasma carnitine, 4) serum total cholesterol, 5) serum HDL-cholesterol, 6) triglyceride, 7) systolic blood pressure, 8) diastolic blood pressure, 9) left ventricular voltage on a electrocardiogram at rest and 10) hematocrit. The plasma carnitine levels in these patients were markedly reduced and inversely correlated with the cardiothoracic ratio (CTR) on the chest X-ray films (r = 0.38, p less than 0.05). In principal component analysis, the CTR was closely related to hematocrit and plasma carnitine levels. By multiregression analysis, both hypo-carnitinemia and anemia were independently shown to be important causes of cardiomegaly. Thus, it is suggested that the cardiomegaly in patients with chronic hemodialysis may be improved by supplemental therapy with l-carnitine, even in cases with severe anemia.

Adolescent↗
PubMed1983

Plasma antidiuretic hormone levels in patients with normal and low renin essential hypertension, and secondary hypertension.

In order to investigate the antidiuretic hormone (ADH) in essential hypertension and secondary hypertension, plasma ADH levels were measured in normal subjects, in patients with normal and low essential hypertension, and in other patients with various forms of secondary hypertension. Plasma ADH levels were significantly lower in low renin essential hypertension and higher in malignant hypertension than in normal subjects. The plasma ADH levels tended to be lower in renal hypertension and primary aldosteronism, and higher in renovascular hypertension, but these differences were not statistically significant. From these results, it appeared that ADH might play a role in malignant hypertension, but not in the other hypertensive diseases.

Adolescent↗
PubMed1983

A case of 17 alpha-hydroxylase deficiency with special reference to the renal kallikrein-kinin system.

In a 26-year-old male with 17 alpha-hydroxylase deficiency, endocrinological examinations were performed not only after, but also before the onset of clinical signs and symptoms. In addition, the pathophysiological role of the renal kallikrein-kinin system was investigated in this patient. In spite of the fact that this disease is congenital, in the mechanism of its onset, this patient had a period of endocrinological normality before onset; that is, 9 months before onset, both ACTH and cortisol were within the normal range, although the former would be significantly higher and the latter significantly lower than normal values after the onset. In this case, both urinary kallikrein and kininase excretions abnormally increased and then returned to normal after dexamethasone treatment.

Adrenal Cortex Hormones↗
PubMed1983

Generalized epilepsy in a patient with hypokalemic periodic paralysis and cardiac arrhythmia.

A 17-year-old female who had Hypokalemic periodic paralysis with arrhythmia developed syncopal attacks. Although syncope in this rare disorder has been attributed to ventricular tachycardia or ventricular fibrillation, the clinical manifestation, electroencephalogram, serum electrolytes and blood sugar at the attack, and the results of lumbar puncture indicated that idiopathic generalized epilepsy was the cause of the syncopal attacks in the present case. To our knowledge, this is the first case report of the association of epilepsy with periodic paralysis and arrhythmia in the literature.

Adolescent↗
PubMed1983

The excretion of human urinary kallikrein quantity and activity in normal and low renin subgroups of essential hypertension.

In both low and normal renin essential hypertensive groups, urinary excretion of kallikrein quantity by direct radioimmunoassay and activity by kininogenase assay were significantly lower than those in normal subjects. In comparing between normal and low renin groups, no difference was found in kallikrein quantity, while kallikrein activity tended to be lower in the low renin group than in the normal renin group. A significant positive correlation was observed between kallikrein quantity and activity in the normal subjects, the normal renin group and the low renin group. However, the slope of the regression line in the low renin group was significantly more moderate than that in the normal renin group, and tended to be more moderate than that in normal subjects. The addition of kallikrein inhibitors (aprotinin and gabexate mesilate) resulted in a significant suppression of enzymatic activity but not of enzyme quantity. These findings suggest that suppression of the renal kallikrein system in both groups of essential hypertension was confirmed by the decreased excretion of kallikrein both as enzyme quantity and activity, and that in the mechanism of the suppression of urinary kallikrein activity in the low renin group, the renal kallikrein inhibitors may play some role.

Adult↗
PubMed1983

[Case of hepatocellular carcinoma with a marked reduction in the tumor size induced by PSK administration alone].

A 56-year-old man was admitted to our hospital because of right abdominal pain. The edge of the liver was felt 4.5 fingers breadth below the xiphoid process. AFP was 20100 ng/ml and CEA was 5.6 ng/ml. The chest X-ray indicated existence of lymphangitis and some nodular density suggesting lung metastasis in the both lower-lung fields. 99mTc-phytate liver scan showed a large defect along the antero-inferior margin of the right hepatic lobe, which revealed an abnormal uptake of 67Ga-citrate. Ultrasonograms demonstrated a solid mass, 8 X 9 cm, in the right lobe of the liver. A CT-scan of the abdomen also showed a large, rounded, low attenuation mass with central necrosis in the right hepatic lobe: the pancreas and the remaining retroperitoneal structures appeared normal. Following the administration of PSK alone, 3 g daily, for three months, a remarkable regression of both hepatomegaly and lung metastasis was observed. Liver scan, ultrasonograms and CT-scan showed a striking resolution of the intrahepatic mass except central necrosis. AFP decreased to 33.7 ng/ml and CEA was 8.2 ng/ml. After about one year, however, ultrasonogramms showed a newly growing solid mass, 3.5 X 3.5 cm, in the left lobe of the liver. A needle biopsy specimen was taken from the intrahepatic mass, and it was interpreted as hepatoma. He is now healthy.

Carcinoma, Hepatocellular↗