Biomedical subjects
Publications and source records attributed to S Hirata.
An 18-year-old patient had right-sided hypertrophic obstructive cardiomyopathy. His case was quite unique in that the intensity of the systolic murmur was apparently decreased during the inspiratory phase and increased during the expiratory phase (reversed Rivero-Carvallo's sign).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 28 year old woman with Hashimoto's disease was treated with desiccated thyroid and triiodothyronine (T3). She improved steadily during the first 2 to 3 months and thyroidal function tests turned to normal. Then, in spite of continuing treatment, her serum T4 level decreased gradually and she became fatigued. A serum T3 radioimmunoassay manifested an interference pattern suggested anti-T3 antibody in her serum. Ethanol-extracted serum T3 and T4 levels were low in spite of ingestion of desiccated thyroid or synthetic T3 and T4, suggesting intestinal malabsorption of T3 and T4. Antibodies against T3 and T4 were identified in her serum; affinity constants were 1.16 X 10(10) and 8.73 X 10(8) l/mol respectively. After treatment with synthetic T3 and/or T4 for 20 months, the titer of anti-T3 and anti-T4 antibodies decreased, and impaired intestinal absorption of thyroid hormone improved. Then, after desiccated thyroid treatment was reinstituted, the anti-T3 antibody titer again increased and intestinal absorption of thyroid hormone decreased. These results suggest the oral immunization against thyroid hormones. There was associated impairment in intestinal absorption of thyroid hormone presumably secondary to the anti-T3 and anti-T4 antibodies.
Explore the source record for details and available documents.
A 31-year-old woman, whose chief complaint was back pain, was found to have an echocardiographic abnormality suggestive of a left atrial myxoma. Angiography clearly showed a large radiolucent mass protruding from the left atrium into the left ventricle during diastole. X-rays of the sacrum disclosed the presence of a malignant tumour. Biopsy specimens taken from the tumour in the sacral plexus showed a malignant neurilemmoma. Despite extensive chemotherapy, widespread metastases developed and the patient died four months after admission. Necropsy disclosed three discrete tumours in the left atrium, which were found to be malignant neurilemmoma, shown on histology to be metastases from the primary in the sacral plexus.
The greater cardiac oxygen consumption (VO2) under pressure than under volume load has been accounted for by the greater ventricular wall force under pressure load. We cannot fully agree with this because the wall force has not always been uniquely correlated with VO2. We attempted to account for the greater VO2 under pressure load by the ventricular systolic pressure-volume area (PVA), which we previously showed uniquely correlated with VO2. In isolated supported canine hearts, we produced servo-controlled ejecting contractions the stroke work (SW) of which was doubled from control by doubling ejection pressure (P) with comparable stroke volume (SV) and by doubling Sv with comparable P. Despite comparable increments in SW from 370 to 680 mmHg.ml under two different loads, VO2 and PVA increased significantly more under pressure load (from 0.033 ml O2/beat and 800 mmHg.ml to 0.0560 and 1,800, respectively) than under volume load (increasing to 0.038 and 1,200, respectively; P less than 0.01). These results suggested to us a new mechanism underlying the greater VO2 under pressure load.
In order to study the metabolism of acetate transferred from dialysate, the plasma concentrations of organic acids including the tricarboxylic acid cycle (TCA cycle) intermediates were measured during hemodialysis in a comparative study between acetate dialysate and bicarbonate dialysate in 17 patients on maintenance hemodialysis treatment. Continuous measurements of serum concentrations of these organic acids during hemodialysis were performed using the filtrate obtained through an ultrafiltrate sampling device. The organic acids were measured by isotachophoresis. Serum acetate, malate and citrate concentration increased with time in acetate dialysis compared with bicarbonate dialysis. Correlations were found between these organic acids. Isocitrate became detectable when the serum acetate concentration was over 7 mmol/l which was correlated to the acetate concentration, and was accompanied by the development of symptoms. The above results suggest that an acetate overload on the patients during acetate dialysis affects acetate metabolism through the TCA cycle resulting in an accumulation of organic acids in the serum and the development of symptoms.
Explore the source record for details and available documents.
Poor R wave progression (PRWP) in the precordial leads on the electrocardiogram in an often used but ill-defined electrocardiographic finding of antero-septal myocardial infarction. In view of the fact that the cross-sectional echocardiogram (CSE) provides a reliable method for detecting the presence and location of regional asynergy associated with acute myocardial infarction, 47 patients (myocardial infarction; 27, other disease; 20) with PRWP were selected to investigate whether or not CSE could be useful for differentiating the cases showing PRWP with myocardial infarction from those without myocardial infarction. On CSE, the left ventricle was divided into 9 segments, and to grade the severity of segmental asynergy, each segment was assigned a numerical score based upon the type of wall motion. These scores were assigned as follows; hyperkinesis: -1, normal: 0, hypokinesis: +1, akin sis: +2, and dyskinesis: +3 (Heger, 1979). The total wall motion index (WMI) was obtained by summing the scores for each of the 9 segments. And the antero-septal WMI was also obtained by summing the scores for each of the antero-septal segments. The antero-septal WMI in patients with myocardial infarction (4.45 +/- 2.59) was significantly greater than that in patients with other diseases (-0.1 +/- 2.38) (p less than 0.001). The antero-septal WMI equal to or more than +3 was found to be the most useful parameter in identifying the cases with myocardial infarction (sensitivity: 81.5%, specificity: 85.0%). Consequently, it can be concluded that CSE is quite useful for differentiation of PRWP between the cases with or without myocardial infarction.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Cefamandole (CMD) was intravenously drip infusion administered at daily dose of 400 mg/kg to the neonate with purulent meningitis caused by E. coli which was resistant to ABPC. In clinical application, CMD was evaluated as effective, although 6 mg/kg/day of GM given concomitantly. No adverse effect and abnormal laboratory findings were observed. This study would support the clinical usefulness of CMD in severe neonatal infection especially like meningitis.