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Biomedical subjects

R Kinoshita

Publications and source records attributed to R Kinoshita.

At least 19 recordsLinked to original sources
PubMed1994

Polyarthritis associated with hepatitis C virus infection.

Two cases of polyarthritis associated with hepatitis C infection are reported. In Patient 1, stiffness and polyarthritis occurred during the acute stage of hepatitis. The arthritic symptoms lasted for 4 months. A transient polyarthritis recurred 4 yr later. The persistent presence of anti-hepatitis C viral antibodies was noted. Hepatitis C viral RNA (HCV RNA) was identified in the serum using the polymerase chain reaction proving that the patient was a carrier. In Patient 2, polyarthritis occurred associated with chronic hepatitis C liver disease. Synovial biopsy showed infiltration of mononuclear cells. HCV RNA was demonstrated in both serum and SF. These cases suggest an aetiologic association between arthritis and hepatitis C antigenaemia.

Adult↗
PubMed1993

[Intranasal administration of nitroglycerin solution and nitroglycerin spray during general anesthesia].

Nitroglycerin spray is a newly developed nitroglycerin (TNG) form, which delivers 0.3 mg of TNG with each spray emission. We compared the efficacy of intranasal administration of TNG spray and that of TNG solution during general anesthesia. Nineteen patients were randomly assigned to receive either 0.3 mg TNG solution (Solution group) or 0.3 mg TNG spray (Spray group) intranasally. Peak elevation of plasma TNG occurred 2 min after drug administration in both groups, and the plasma level decreased to an ineffective level after 10 min. The plasma TNG of the spray group was significantly higher than that of the solution group for 3 min. Two min after drug administration, systolic blood pressure decreased significantly in both groups, and this level persisted for 10 min. Diastolic blood pressure also decreased in the spray group, but not in the solution group. Heart rate increased significantly in both groups 2 min after drug administration. Oxygen index (PaO2/FIO2) decreased significantly in both groups, and the level persisted 10 min after administration. Although no significant differences were found between two nitroglycerin forms in any of these hemodynamic and respiratory parameters, nitroglycerin spray may have clinical advantages because of reliability in its effect, ready availability, ease of application and high stability.

Administration, Intranasal↗
PubMed1993

[Diagnosis of pheochromocytoma using 131I-MIBG scintigraphy].

131I-MIBG scintigraphy was performed on 18 patients with pheochromocytoma and 25 patients with essential hypertension. In comparison of grade of 131I-MIBG accumulation in various organs the heart accumulation of pheochromocytoma group was significantly lower than that of essential hypertension group. And between the positive and false negative accumulation group of pheochromocytoma reverse relationship was observed between the heart and tumor. The results of 131I-MIBG scintigraphy for pheochromocytoma included 78% sensitivity, 100% specificity, and 90% accuracy. False negative accumulation of tumors were shown at 6 lesions in 4 cases. On the bases of CT and operative findings, false negative accumulation was observed not only in very small tumors, but also in large cystic tumors with a small amount of tumor tissue or totally hemorrhagic necrosis within the tumor.

3-Iodobenzylguanidine↗
PubMed1991

[Anesthetic and postoperative management of a patient with Gilbert's syndrome and another with Dubin-Johnson syndrome].

Anesthesia and postoperative management of a patient with Gilbert's syndrome and one with Dubin-Johnson syndrome is reported. The former patient underwent open heart surgery and the latter had a partial resection and reconstruction of the esophagus. The anesthetics used in these two cases were fentanyl and nitrous oxide. The patient with Gilbert's syndrome had remarkable perioperative complications. On the other hand, the patient with Dubin-Johnson syndrome developed conjugated hyperbilirubinemia after the 2nd postoperative day. On the 5th postoperative day, his serum and direct bilirubin levels were elevated to 19.3 mg.dl-1 and 12.8 mg.dl-1, respectively. Therefore, we had to perform daily plasmapheresis on this patient for four days. Thereafter, his serum bilirubin level decreased gradually.

Adolescent↗
PubMed1990

[Clinical evaluation of isosorbide dinitrate (ISDN) spray: a study on the plasma concentrations of ISDN and on its hemodynamic effects using three administration routes].

The effects of ISDN spray has been evaluated using oral, nasal or tracheal routes in patients under enflurane anesthesia. These 30 patients were in ASA I or II physical status without cardiovascular, kidney or liver diseases. Under enflurane anesthesia, hemodynamic parameters (blood pressure and heart rate), blood gas and plasma concentration of ISDN were measured at several points before and after drug administration. The plasma concentration reached a maximum point (C max) 4 min after drug administration in the oral group (O-group) and nasal group (N-group), and the values obtained were 48.4 +/- 5.4 ng.ml-1 and 87.4 +/- 13.8 ng.ml-1 respectively. The C max of the N-group was significantly higher than that of O-group (P less than 0.05). In the O- and N-groups, systolic blood pressure decreased 10% and 17%, after 4 min (P less than 0.05) and recovered 20 after min. Diastolic blood pressure decreased in both groups after 4 min (P less than 0.05). Heart rate significantly increased in the N-group (P less than 0.05), and continued to change up to 60 min after drug administration. In both groups, PaO2/FIO2 decreased 14% and 9% after 10 min (P less than 0.01). In the tracheal group, plasma concentration did not increase and these hemodynamic changes were not observed. These results suggest that nasal route of ISDN spray is the best route of administration.

Administration, Intranasal↗
PubMed1985

Increased lysyl oxidase activity in culture medium of nonparenchymal cells from fibrotic livers.

Lysyl oxidase, which plays an important role in collagen deposition in chronic liver diseases, was studied in nonparenchymal cell cultures from fibrotic human livers. Liver biopsy specimens were obtained from control patients without apparent hepatic disease, and from patients with chronic persistent hepatitis, chronic active hepatitis, or liver cirrhosis. Nonparenchymal cells from biopsy specimens were cultured. At the third passage of the culture, lysyl oxidase activity was measured in the culture medium and cell layer. Most of the activity in the culture medium of cirrhotic liver cells was significantly higher than that in the medium of liver cells from controls or from patients with chronic hepatitis, whereas no significant difference in activity was noted between chronic persistent hepatitis and chronic active hepatitis cells. In patients with chronic hepatitis, lysyl oxidase activity in the culture medium from liver cells of alcoholics was significantly higher than that in the medium from liver cells of nonalcoholics. Thus, increased lysyl oxidase activity was found in the medium of nonparenchymal cell cultures from patients with cirrhosis and from alcoholics with chronic hepatitis. This increased activity may be related to fibrotic processes in the liver.

Adolescent↗
PubMed1984

Immunoprophylaxis of hepatitis A of the children by immune serum globulin.

An outbreak of hepatitis A occurred in Kyoto. Immune serum globulin was administered prophylactically to children who had not yet developed the disease. However 52 children in succession contracted hepatitis A. Late injections of immune serum globulin had no effect on the clinical course. Middle injections suppressed only jaundice. Early or preexposure injection suppressed the disease remarkably. All who had overt hepatitis A seroconverted to positive antibody to hepatitis A virus. In inapparent infection, those who had slight elevation of transaminase developed passive active immunization irrespective of pre or postexposure administration of immune serum globulin. Three children who might block hepatitis A virus completely had no change of transaminase and failed to establish passive active immunization.

Adolescent↗
PubMed1981

Chronic hepatitis B: correlation between viral replication and clinical course.

Twenty carriers of hepatitis B virus (HBV) were followed for two to seven years, and their histologic progression was correlated with HBV core-associated DNA polymerase (DNAP) activity as a marker of viral replication. Seventeen patients were divided into two groups according to their pattern of viral replication: group 1, consistently high levels of DNAP; group 2, low levels of DNAP. Chronic persistent hepatitis predominated in group 1; chronic active hepatitis predominated in group 2. The three remaining patients were consistently negative for DNAP. In two patients in group 2, prominent viral replication preceded a transient increase in transaminase levels, as in acute hepatitis. Although groups 1 and 2 were distinct in their patterns of viral replication, they did not differ significantly in histologic progression. Thus, viral replication is related, at least in part, to hepatic cell necrosis but does not correlate closely with progression to liver cirrhosis.

Adult↗
PubMed1980

Indirect hyperbilirubinemia in HBV carriers.

Indirect hyperbilirubinemia without any other abnormalities of liver function tests was seen in 14.3% in HBV carriers and 1.2% in controls in the previous study. In order to clarify the mechanism of hyperbilirubinemia in HBV carriers, 33 HBV carriers with normal liver functions regardless of hyperbilirubinemia and with no past history of acute hepatitis were investigated clinically. Most of HBV carriers with indirect hyperbilirubinemia revealed any other abnormalities of liver functions during the over 2 years observation. Histological examinations of 4 HBV carriers with hyperbilirubinemia presented no evidence of obvious hepatitis. There was no significant correlation between bilirubin, ICG and/or BSP clearance in HBV carriers with hyperbilirubinemia. The above mentioned facts suggest that indirect hyperbilirubinemia in HBV carriers was not caused by organic changes of hepatocytes but might be the results of, at least in part, its functional disturbances. Family studies of HBV carriers with hyperbilirubinemia suggested that some but not all the HBV carriers with indirect hyperbilirubinemia might not have a genetic background in common with patients with Gilbert's syndrome. The persistent infection of HBV in hepatocytes might play an important role of metabolic derangement of bilirubin and make a constitutional defect of bilirubin metabolism manifest.

Bilirubin↗