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Biomedical subjects

S Fujimoto

Publications and source records attributed to S Fujimoto.

At least 595 records · Page 33Linked to original sources

[Relationship between anaerobic threshold and breathlessness during exercise].

We studied the possibility that during incremental exercise anaerobic threshold (AT) is associated with an increase in breathlessness in subjects with increased impedance or respiratory system. Six patients with chronic lung diseases (CLD) and six healthy subjects performed cycle ergometer exercise under two conditions; with free resistive loading and with 9 cmH2O/l/sec of inspiratory resistive loading (IRL). Ventilation, respiratory pattern, VO2, VCO2, were measured every 15 sec by a metabolic cart, Minato Respiromonitor RM 300. AT was determined by V-slope method. Mouth occlusion pressure (P0.1) was also measured in six subjects during exercise. The subjects selected a number of modified Borg scale (psi) to express their breathlessness during exercise by pushing a electrically potentiated remote button. Slopes of changes in psi with increasing work-load, delta psi/delta watt-slope, were calculated before and after V-slope AT, and each inflection point of VE, respiratory rate, VT/Ti, and VCO2. In order to evaluate which parameters are the most responsible for a change in psi, statistical significance (P-value) in changes of slope of each parameters were compared. The delta psi-slope increased with the highest significance after AT point. Under IRL the significance was more pronounced. There was a highly significant linear correlation between P0.1 and psi during exercise both under free resistive loading and IRL. In addition the increase of P0.1 with incremental exercise was characterized by a presence of inflection at a workload of V-slope AT in most of the subjects. From these results it was concluded that anaerobic threshold was closely associated with an increase of breathlessness during exercise via enhancing respiratory motor command.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Studies of clinical usefulness of new tumor markers of ovarian cancer, CA 54/61 and CA 602--CA 602 assay reagent kit, performance its normal value and correlations with other tumor markers].

We made a preclinical study of a newly developed tumor maker, CA 602, and its clinical study using serum samples available from 58 institutions located throughout Japan. In the preclinical study, a CA 602 assay kit was investigated for the reproducibility and precision of assay results; and in the clinical study, the kit was investigated for the normal value of the marker, for variations in assay result with age, menstrual cycle and term of pregnancy, and for correlations of assay results with those of other tumor markers. The tests of the kit for simultaneous reproducibility and interval reproducibility of assay results, and the results of analytical recovery and dilution tests were all favorable; the kit proved to be reliable in both precision and reproducibility. For the study, 2 cutoff levels were set: mean + 2 SD of healthy subjects, i.e., 63 U/ml, and the level which permits the maximal efficiency of differential diagnosis of benign from malignant ovarian tumors, i.e., 90 U/ml. The assay results showed that CA 602 levels were low in women aged 50 and over; the levels were high in the first half of pregnancy, and also high in the menstrual period to the early follicular phase. The assay results of CA 602 also proved to be intimately correlated with those of CA 125, which suggested that the 2 markers might be analogous to each other. CA 602 proving to be of high reproducibility even in the range of concentrations below the cutoff value, the measurement with the marker appeared to be of high precision, capable of detecting even the slightest variations in the antigen. CA 602 therefore appears of great value in the early detection of recurrent ovarian cancers.

Adolescent↗

[Assessment of fetal lung maturity using newly developed immunological measurement of fetal pulmonary surfactant apoprotein-A in amniotic fluid].

The level of immunoreactive lung surfactant apoprotein A (SP-A) was determined with a newly developed one-step ELISA kit (TDR-20) in 217 samples obtained by transabdominal or transvaginal amniocentesis from 217 pregnant women with high risk pregnancy. The lecithin/sphingomyelin ratio (L/S ratio) by two-dimensional thin layer chromatography, disaturated phosphatidylcholine (DSPC) values, shake test and the stable microbubble method were done simultaneously to compare diagnostic reliability in estimating fetal lung maturity. Amniotic fluid SP-A levels increased with advancing gestational age and correlated well with the values obtained by the other methods. When the cut-off SP-A value for the assessment of lung maturity was set at 1,700ng/ml in the amniotic fluid obtained within 24h before delivery, the true-negative rate for RDS was 71% and the true-positive rate for non-RDS was 83%. The sensitivity, specificity and accuracy were 100%, 83% and 88%, respectively. These results are comparable with those for the L/S ratio, DSPC determination and the stable microbubble method, and were slightly better than those for the shake test. In conclusion, this newly developed ELISA kit for the measurement of amniotic fluid SP-A is more effective than other methods currently available for the evaluation of fetal lung maturity, when it is considered that it requires only 0.2ml of amniotic fluid and provides results in only 2h without technical difficulties.

Amniotic Fluid↗

[Evaluation of physical fitness and exercise performance in patients with chronic pulmonary emphysema].

Physical fitness was studied in patients with chronic pulmonary emphysema using Kraus-Weber methods in addition to pulmonary function and exercise tolerance. In Kraus-Weber tests, explosive strength of abdominal muscles in these patients were within the normal range, but both abdominal and back muscle endurance were significantly diminished compared to age-matched controls. On the other hand, flexibility was not different between the patients and the controls, although large variation was present. Exercise performance as assessed by 6 minutes' walk distance in patients was significantly correlated with FEV1.0, DLco and maximal inspiratory mouth pressure, as well as explosive strength of abdominal muscles and abdominal and back muscle endurance capacity. Treadmill walking training for 20 minutes with a load greater than 80% VO2max, twice a week for 2 months was performed in 11 patients with mild to moderate pulmonary emphysema. Six minutes' walk distance (6MD) was significantly prolonged with improvement of back muscle endurance and flexibility. Another walking training consisting of five repetitions of two minutes' near maximal walking and a two minute interval of rest was performed in 6 patients with severe pulmonary emphysema. 6MD tended to increase with improvement of both back and abdominal muscle endurance. However, pulmonary function tests and VO2max showed no significant changes after both types of training. Improved walked distance after the training was significantly correlated with improved VO2 at AT. Furthermore VO2, VE, HR and lactate production during exercise at the same load were significantly decreased compared to pre-training. Dyspnea sensation measured by modified Borg scale during exercise was improved after the training. It is concluded that a physical training program adapted to the condition of the individual patients could improve exercise performance, and should be prescribed in addition to medication.

Aged↗

Role of multipotent fibroblasts in the healing colonic mucosa of rabbits. Ultrastructural and immunocytochemical study.

Light- and electron microscopy and immunocytochemistry were used to study the healing colonic mucosa of rabbits after experimental excision. Between 3 and 5 days, abundant young fibroblasts which retained many features of mesenchymal cells invaded the growing capillaries into the loose connective tissue of the healing colonic mucosa. Our electron microscopy revealed the transformation of these young fibroblasts into smooth muscle cells, into histiocyte-like cells involved in phagocytotic activity, and into vasoformative cells incorporated into the growing capillaries. The mitotic proliferation of pre-existing smooth muscle cells at the ulcer margin did not seem to be the major reason for re-establishment of the muscular tissue. The present immunocytochemistry revealed an active production of fibronectin in rough endoplasmic reticulum in the young fibroblasts. This may mean that this glycoprotein is involved in the re-establishment of both connective and muscular tissues by enhancement of adhesion and chemoattractant activities of such cells. In addition, the immunoreaction of endothelial cells of the growing capillaries suggests a role of this glycoprotein in the acceleration of the neocapillarization.

Animals↗

[Development of specific immunotherapy for cancer].

We developed CTL therapy against cancer as an cancer specific immunotherapy. The primary CTL therapy showed certain efficacy on advanced cancer patients. However, when ratio of monocyte population in peripheral blood lymphoid cells (PBL) of advanced cancer patients increases more than that of CD8+ T cell population, so that CD8+ T cell/M3 ratio is less than 1, CTL directed to cancer cannot be induced in PBL and the primary CTL therapy is not materialized for these patients. Monocyte-macrophages in these patients release a suppressive factor(s) capable of inhibiting CTL induction and proliferation at induction phase but not inhibiting cytotoxic activity in target cell lysis at effector phase. Furthermore, these monocytes expressed strong message of TGF beta. If most of increased monocytes of PBL from advanced cancer patients are removed by a nylon wool column method from the PBL, CTL directed to cancer cells can be induced even in PBL of advanced cancer patients with high frequency, this improved CTL therapy against cancer showed remarkable efficacy as the cancer specific immunotherapy in various advanced cancer patients without any side effects.

Adult↗

[Phase III study of DWA2114R for ovarian cancer].

A phase III study of DWA2114R for ovarian cancer was carried out in CAP regimen by a cooperative study group consisting of 42 institutions. The response rate of 31 cases for DWA2114R regimen was 38.7% and out of 30 cases for CDDP regimen 46.7%. No significant differences were observed between the two regimens in efficacy, adverse reactions, and abnormalities in laboratory findings except for red blood cell and creatinine clearance, but the incidence of thrombocytopenia was likely to be lower in DWA2114R than in CDDP regimen. Since the DWA2114R regimen did not need hydration, or require diuretics, DWA2114R is more useful in the treatment of ovarian cancer than cisplatin.

Adult↗

The toxic effects of bis (tributyltin) oxide on the rat thoracic aorta.

The toxic effects of bis (tributyltin) oxide (TBTO) on the ultrastructure and permeability of rat thoracic aorta were studied electron microscopically and the accumulation sites of tin were determined with an X-ray microanalyzer. Male Wistar rats received 0.05ml/kg of TBTO as an emulsion in 1 ml of distilled water through a stomach tube. After time intervals of 2, 4, 6, 8, 10, 12 h after intubation, thoracic aortae were isolated and prepared for electron microscopy. Marked swelling of mitochondria in the aortic endothelial cells appeared at 4 h after TBTO treatment. By x-ray microanalysis, tin L-alpha peaks (3.44 keV) were obtained from these swollen mitochondria. Subendothelial edema progressed between 6 and 8 h after TBTO treatment. By tracer experiment, it was seen that large amounts of peroxidase reaction products filled the expanded subendothelial space. At 12 h after TBTO treatment, degenerative changes of the endothelial cells were prominent. These results indicated that orally administered TBTO accumulated in the mitochondria of the endothelial cells of thoracic aorta. The direct toxic effects of TBTO on mitochondria might induce severe damage to the endothelial cells and cause disturbance of the permeability barrier function of the endothelial layer and subendothelial edema.

Animals↗

[Nd-YAG laser treatment for central airway lesions].

YAG laser treatment was conducted in 55 patients with central airway lesions over the last 8 years. The malignant lesions comprised 1 primary tracheal cancer, 1 chondroma of the trachea, 34 primary lung cancer, and 10 metastatic lung tumor. The benign lesions comprised one each of hamartoma, lipoma, bronchial lithiasis, post-tracheotomy granuloma, and bronchial web, and 3 other cases. Nd-YAG laser treatment was performed in 55 patients with airway lesions, with a success rate of 73%. The success rates in the above patients were 70% for primary lung cancer, 60% for metastatic lung tumor, 100% for primary tracheal cancer and chondroma of trachea, and 89% for benign lesions. In 34 patients with primary lung cancer, palliative widening of the airway was planned with the exception of 2 patients with endoscopically early lung cancer for whom curative vaporization was intended, 6 months-survival rate was 59.3% in patients in whom various combined treatments were performed after the laser treatment. For all patients with hamartoma or lipoma in those with benign lesions, curative vaporization was performed. The severe complication of lethal massive hemoptysis occurred in 3 patients. We consider that Nd-YAG laser treatment is a powerful therapeutic means of performing lifesaving or emergency, curative, and supplemental treatment.

Adult↗

[Dyspnea and ventilatory muscle function during exercise on air and oxygen breathing in patients with chronic obstructive pulmonary disease (COPD)].

Exercise performance and dyspnea in COPD patients have been shown to be improved with supplemental oxygen, although the exact mechanisms resulting in the improvement are still unclear. The purpose of the present study was to investigate a possible relationship between ventilatory muscle function and sensation of dyspnea (modified Borg Scale) during exercise on 20% O2 and 30% O2. Eight patients with COPD (FEV1 1.06 L +/- 0.30 L) exercised on a treadmill two times breathing compressed air or 30% oxygen with a one hour rest in between. The electrical activity of the diaphragm (EMGdi) was recorded with esophageal electrodes, and that of the sternomastoid muscle (EMGsm) was recorded from the fine wire electrodes. The ratio of high frequency (150 to 350 Hz) to low frequency (20 to 47 Hz) power (H/L) of EMGdi was analyzed to assess diaphragmatic fatigue, which was defined as a 20% fall of H/L ratio from the control value. Flow, volume, O2 Saturation (SaO2), esophageal pressure (Pes) and transdiaphragmatic pressure (Pdi) were measured. Tension time index (TTdi) was calculated from Pdi and the ratio of inspiratory time to total time for one cycle (Ti/Ttot). At rest, we measured maximal esophageal pressure (Pesmax), maximal transdiaphragmatic pressure (Pdimax), maximal integrated EMGdi (EMGdimax) and EMGsm (EMGsmmax). Incremental exercise was discontinued by dyspnea. The walking distance achieved was increased in all patients on 30% O2. Dyspnea and desaturation were significantly improved on 30% O2 breathing, and the onset of diaphragmatic fatigue was delayed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[The experimental and clinical study of hyperthermia with thermosensitizer for gastric cancer patients with peritoneal seeding].

We examined experimentally and clinically the effect of misonidazole (MISO), a hypoxic cell radiosensitizer, in combination with hyperthermia. First, tissue blood flow and tumor growth of xenoplanted human gastric cancer in nude mice were measured after treatment with MISO 500 mg/kg ip plus hyperthermia at 40.5, 42.0 and 43.5 degrees C. Also clinically, 17 advanced gastric cancer patients with peritoneal seeding underwent intraperitoneal hyperthermic perfusion (IPHP). They were given MISO 1.45 g/m2 po twice (12 hours and 5 hours before IPHP). And plasma MISO levels were measured. MISO plus hyperthermia produced a more prolonged decrease of the tumor blood flow than hyperthermia alone. At 43.5 degrees C, TbF recovered 2 days after the treatment. MISO plus hyperthermia also made tumor growth delay more marked than hyperthermia alone. In gastric cancer patients treated with MISO plus IPHP, T 1/2 of serum MISO was 7.7 hours and the AUC was 1,087 micrograms.hr/ml. There were no side effects observed which were caused by MISO. Thus MISO can be an effective thermosensitizer when used in combination with hyperthermia.

Animals↗

[A study of preclinical and clinical usefulness of new tumor markers of ovarian carcinoma, CA 54/61 and CA 602. 1. Evaluation of the diagnostic accuracy of CA 54/61, a study of the normal range of its values and its correlation with other tumor markers].

We made a preclinical study of CA 54/61, a recently developed marker of ovarian tumors, and also conducted a clinical study of it using serum samples collected from 58 institutions located throughout Japan. This paper describes the results of the preclinical study of the CA 54/61 marker that were obtained with a kit based on an enzyme immunoassay (EIA), and also the findings with the kit in the clinical study pertaining to the normal range of its values, its values relative to age, menstrual cycle, and pregnancy, and its correlations with other tumor markers. The tests for reproducibility of assay results, the analytical recovery test, and the dilution test all gave favorable results: the marker proved reliable in both precision and reproducibility. Two cut-off values were used: the mean + 2 S.D. of the mean for healthy subjects, or 20 U/ml; and the value for the maximum diagnostic efficacy, i.e., 12 U/ml. The assay results did not vary greatly with either age, menstrual cycle or pregnancy stage, which suggested that CA 54/61 might be a marker less liable to be affected by physiological conditions prevailing at the time of sample collection. The result correlated poorly with those of assays with other markers; thus CA 54/61 proved to differ in property from the previously recognized tumor markers.

Adolescent↗

[An analysis on prognostic significance of histopathologic risk factor in uterine endometrial carcinoma].

Prognostic risk factors in histopathologic findings were analyzed in the data for one hundred and thirteen patients with uterine endometrial carcinoma who were treated surgically. Univariate survival analysis with Kaplan-Meier methods revealed that the nuclear grade (p less than 0.005), lymph-vascular space invasion (p less than 0.005), histologic grade (p less than 0.01) and histologic type (p less than 0.01) correlated with the patient's prognosis. Among surgical FIGO stages II and III, there was similar significance in the correlations in the nuclear grade (p less than 0.05), lymph-vascular space invasion (p less than 0.0001) and histologic type (p less than 0.05), although there was difference (p less than 0.05) only between grade 1 and grade 3 in the histologic grade. Multivariate survival analysis with a proportional hazard regression model showed that the nuclear grade (p less than 0.005) and lymph-vascular space invasion (p less than 0.01) correlated significantly with the prognosis. The hazard ratios with a 95% confidence interval for each of these factors were 19.2 (3.2-115.7) and 16.9 (2.1-135.3), respectively. The 3-year survival rate was 98% for a hazard ratio less than 64.7, and 45% for one more than 67.4, between which there was a significant difference (p less than 0.0001). And univariate survival analysis of this hazard ratio also revealed strong correlations with the patient's prognosis. These results suggest that it is of great importance to adopt the hazard model including such factors as the nuclear grade and lymph-vascular space invasion in estimating the patient's prognosis and proceeding to adequate post-operative therapy for individual patient.

Adenocarcinoma↗

Nuclear S1 proteins from the starfish Asterina pectinifera.

Nuclear S1 proteins are a group of proteins apparently ubiquitous in vertebrate cell nuclei. They were originally isolated at pH 4.9 from the supernatant of rat liver nuclei mildly digested with DNase I. In the present study, under the conditions identical to those employed for vertebrate cells, we identified two S1 proteins in the starfish Asterina Pectinifera. Their molecular weights are 47,200 and 39,000. This finding suggests widespread occurrence of S1 proteins in eukaryotes and their basic function in the cell nucleus.

Animals↗

Significance of the concentrated red cell and albumin priming method with particular reference to anaphylatoxin generation.

Anaphylatoxins generated by cardiopulmonary bypass were observed in basic and clinical studies (n = 120 in the latter). In vitro immunoglobulin fractions denatured by oxygen bubbling produced C4a, C3a, and C5a, but albumin identically treated did not. Therefore concentrated red cells with albumin were used to prime homologous blood for clinical application during cardiopulmonary bypass. Complement levels were compared with type of oxygenator (bubble or membrane) and the ratio of primed homologous blood to circulating autologous blood volume. With the bubble oxygenator at a low ratio of homologous to autologous blood (arbitrarily defined as less than 20%), C3a levels during cardiopulmonary bypass tended to be lower in the concentrated red cells plus albumin priming group than in the ordinary priming group (p less than 0.1, at 60 and 90 minutes of cardiopulmonary bypass). C4a and C3a levels increased less after protamine administration with concentrated red cells plus albumin priming (p less than 0.05, p less than 0.01, respectively, 90 minutes after protamine) than with ordinary priming. Such changes in the membrane oxygenator group were less remarkable. Thus C3a levels were approximately the same in both oxygenator groups primed with concentrated red cells plus albumin. The higher the homologous to autologous ratio, the steeper the C4a and C3a increase from the beginning of cardiopulmonary bypass with the bubble oxygenator. This tendency was less remarkable in the membrane oxygenator group. Early postoperative pulmonary function was improved by concentrated red cells plus albumin priming, especially in the bubble oxygenator group. In conclusion, (1) oxygenator systems primed with concentrated red cells plus albumin produced less anaphylatoxin than those with homologous blood, especially with the bubble oxygenator, and (2) our clinical results support the importance of immunoglobulin denatured by oxygen bubbling in anaphylatoxin generation (by means of the classical pathway), as shown by our in vitro study.

Anaphylatoxins↗

M3 cholinoceptors and P2y purinoceptors mediating relaxation of arteries in spontaneously hypertensive rats at prehypertensive stages.

Muscarinic cholinoceptor and purinoceptor subtypes were determined in femoral and mesenteric artery strips from spontaneously hypertensive rats (SHR) at prehypertensive stages. Acetylcholine (ACh), carbachol and oxotremorine induced endothelium-dependent relaxations during contractions evoked by 5-hydroxytryptamine. The order of relative potency of the agonists was ACh greater than carbachol = oxotremorine in the prehypertensive SHR and Wistar Kyoto rats (WKY). Schild plot data for muscarinic cholinoceptor antagonists obtained with carbachol or oxotremorine as agonist indicated that the arteries of prehypertensive SHR and WKY possessed M3 cholinoceptors mediating relaxation. The relaxation responses of the prehypertensive SHR and WKY arteries to ATP were inhibited by reactive blue 2 but not altered after P2x purinoceptors had been desensitized by alpha,beta-methylene ATP, which suggests that the arteries possessed P2y purinoceptors mediating relaxation. The responses of the femoral and mesenteric arteries from prehypertensive SHR to ACh, carbachol and ATP were similar to those of WKY arteries, although the response of the prehypertensive SHR artery to oxotremorine was significantly increased compared to that of the WKY artery. The results suggest that M3 cholinoceptor- and P2y purinoceptor-mediated relaxations are not changed in prehypertensive SHR arteries as compared to those in WKY arteries.

Acetylcholine↗