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Biomedical subjects

S Kubo

Publications and source records attributed to S Kubo.

At least 343 records · Page 19Linked to original sources
PubMed1990

[Clinical evaluation of therapy for aspiration pneumonia with imipenem/cilastatin sodium].

In an open, prospective, multicenter trial the clinical efficacy of imipenem/cilastatin sodium (IPM/CS) for the treatment of 14 cases with aspiration pneumonia was investigated. The mean age was 75.4 years old. Diseases of central nervous system were present in 11 cases, cardiovascular diseases, pulmonary diseases and diabetes mellitus in 2 cases each respectively. Seven cases were community-acquired and another seven were hospital-acquired. Six cases were moderate and 8 cases were severe. Causative organisms were determined in 9 cases (64.3%), multiple causative organisms were isolated in 3 cases. Isolated organisms were Staphylococcus aureus (4), Pseudomonas aeruginosa (3), Klebsiella pneumoniae (3), Escherichia coli (1), Acinetobacter calcoaceticus (1). Detection of anaerobes was not attempted. Clinical effects of IPM/CS were excellent in 3, good in 8, fair in 2, poor in 1, the efficacy rate was thus 78.6%. P. aeruginosa was isolated from 2 out of 3 cases in which therapy with IPM/CS failed. Monotherapy with IPM/CS appears to be highly effective for cases of aspiration pneumonia, but the disease due to IPM-resistant P. aeruginosa is an exception.

Aged↗
PubMed1990

[Transesophageal Doppler echocardiography in the diagnosis of atrial septal defect].

To assess the usefulness of transesophageal Doppler echocardiography (TEE) in diagnosing atrial septal defect (ASD), we studied eight cases with secundum type ASD, in which the diagnosis was confirmed by cardiac catheterization and surgery. In all cases, TEE provided clear images of the interatrial septum with its defect. Shunt flow through the defect was observed by color Doppler technique, and its velocity was measured using the FFT mode. In two cases, right-to-left shunt blood flow was detected. Two types of probes were used in this study, a lateral scanning probe and a longitudinal scanning probe. The scanning plane of the former was perpendicular to the axis of the probe, and that of the latter was parallel to it. The two probes facilitated the measurement of the two right-angled dimensions, with which we could calculate the defect area, assuming the defect to be an ellipse. The volume of a left-to-right shunt was obtained by multiplying the defect area by the integration of flow velocity against time. Shunt volume per cardiac cycle obtained by this method correlated well with that obtained by the Fick's method during cardiac catheterization. In six cases without a right-to-left shunt, the coefficient of correlation was 0.98, and in all eight cases it was reduced to 0.72. Thus, we concluded that TEE is useful for diagnosing and evaluating ASD.

Adolescent↗
PubMed1990

[Clinical usefulness of transesophageal Doppler echocardiography].

The usefulness of transesophageal Doppler echocardiography (TEE) was assessed in patients with various cardiovascular diseases including 15 patients with dissecting aortic aneurysm (DAA), two with thoracic aneurysm, 16 with ischemic heart disease and 14 with acquired valvular diseases. In dissecting aortic aneurysms, TEE provided clear images of the intimal flaps even in the aortic arch and descending aorta in which clear images could not be obtained by conventional external Doppler echocardiography. The entry site was detected in 11 of the 15 (73%) cases using TEE, but in only three of the 15 cases using conventional Doppler technique. In two cases of true aortic aneurysms, TEE provided clear images of the aneurysm in the descending thoracic aorta, which was discriminated precisely from DAA. In valvular disease, all four valves (aortic, pulmonary and atrio-ventricular valves) were easily observed without disturbance by any other tissues using a transesophageal approach. In addition, valve aneurysms in the posterior mitral leaflets were detected using TEE in two cases. In two cases of mitral stenosis, a thrombus was observed in the left atrial appendage. These findings were confirmed during surgery, but could not be obtained by the conventional external studies. In 16 cases, TEE was performed during aorto-coronary bypass surgery under general anesthesia. In two of these cases, left ventricular assist devices were applied after surgery. In these cases, where conventional Doppler echocardiography was not applicable, cardiac function could be monitored by TEE. Thus, TEE is useful not only in evaluating morphological function in the cardiovascular system but also in monitoring cardiac hemodynamics during and after heart surgery.

Adult↗
PubMed1990

Human pancreas scintigraphy using iodine-123-labeled HIPDM and SPECT.

The pancreatic affinity of iodine-123-labeled HIPDM (N,N,N'-trimethyl-N'-(2-hydroxy-3-methyl-5-iodobenzyl)-1,3-propane diamine) ([123I]HIPDM) was studied in 18 cases (5 normal volunteers, 7 cases with pancreas cancer, and 6 with chronic pancreatitis). In the normal cases, the pancreas was visualized in the planar images as early as 3 hr, and again at 20 hr postinjection. Single-photon emission computed tomography (SPECT) performed following 3-hr planar scintigraphy, provided excellent pancreas images without an overlap of activity in the liver or spleen. The mean pancreas-to-liver (P/L) ratio was 1.26 +/- 0.22 in normal controls. With the exception of one case of massive calcification in the pancreas, the entire pancreas could be observed in the cases with chronic pancreatitis, but the P/L ratio was 0.74 +/- 0.15, significantly lower than that of normal cases. Defective areas of the distal portion of the pancreas were clearly seen in those with cancer of the pancreas. The results of our study indicate that [123I] HIPDM may have clinical potential as a human pancreas imaging agent.

Adult↗
PubMed1990

[The use of Pugh score to evaluate the prognostic and therapeutic influence of drinking in patients with decompensated liver cirrhosis].

The aim of this study is to evaluate the clinical usefulness of Pugh score in the prognosis of the patients (pts.) with decompensated liver cirrhosis (DLC). To determine the influence of heavy drinking with respect to the prognosis of DLC patients, 128 cases of DLC were divided into two groups including the 31 heavy drinker group (Group A) and 97 non-alcoholic group (Group B). At the time of admission, the both groups showed similar Pugh score. However, after initial two hospitalized weeks, Group A started to show significantly lower points of Pugh score than that of in Group B. Fifteen pts. (48%) in Group A and 55 pts. (57%) in Group B had greater than 9 in Pugh score at the time of admission. In Group A, 10 of 15 pts. declined the scores after initial two weeks and 9 of them lived more than one year after admission. In contrast, none of those 55 pts. in Group B declined their Pugh score after admission and 45 of them died within one year. It was concluded that Pugh score was extremely useful to evaluate the prognosis of DLC pts., and DLC pts. who had greater than 9 Pugh score were seemed to be critical. It was suggested that DLC pts. due to heavy drinking tend to improve Pugh score comparing to no alcoholic DLC pts.

Adult↗
PubMed1990

[Clinical effect of oxybutynin hydrochloride (1 mg/tablet)].

The clinical efficacy of oxybutynin hydrochloride was studied on 21 patients with neurogenic bladder or unstable bladder complaining of urinary frequency, urgency and urgent incontinence. Oxybutynin hydrochloride (1 mg/tablet) was administered orally for 26.7 days, on average, 3 mg per day in 3 and 6 mg per day in 18 patients and the usefulness of this drug was assessed subjectively and objectively. Of 21 patients treated, 9 had neurogenic bladder and 10 had unstable bladder. Urinary frequency was normalized in 6 out of 16 (37.5%), urgency ceased in 6 out of 17 (35.7%) and urgent incontinence disappeared in 9 out of 14 (50%) patients. The mean volume at the first desire to void and the maximum cystometric capacity increased significantly on the cystometrogram after the administration of oxybutynin hydrochloride (p less than 0.01). Furthermore, the maximum vesical pressure decreased significantly (p less than 0.05). The maximum urinary flow rate increased slightly (p less than 0.1) and the residual urine volume significantly increased (p less than 0.05) after medication, although no changes were observed in tidal voiding volume or mean urinary flow rate. Of 20 patients, 9 showed improvement globally (45%), although no subjective or objective improvement was observed in 4 (20%) patients. Marked side effects were observed in 5 cases (two of acute urinary retention, each of increased urgency, residual urine and liver dysfunction), and side effects were seen in 10 of the 21 (47.6%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1990

[Clinical study of male patients with primary biliary cirrhosis (PBC)].

We studied 10 male and 23 female patients with PBC to determine whether the clinical and histological features of this disease differed in male and female patients. There were no significant difference between men and women in age distribution and biochemical examinations. In female patients, autoimmune associated conditions such as sicca syndrome, Raynaud syndrome and arthritis were observed 22%, 13% and 36%, respectively. By contrast, no male patients developed those conditions. 80% of the male patients and 70% of the female patients belonged to asymptomatic PBC, and early histological stage, such as Scheuer's I and II were observed 90% of the male patients and 78% of the female patients, respectively. No male patients showed clinical or histological progression during follow-up period (median was 64 months). Nevertheless, not a few female patients showed progression including 3 cases who died during the follow-up period (median was 47 months). We concluded that male patients with PBC tend to have favorable prognosis comparing to female patients.

Adult↗
PubMed1990

[Histological study on possibility of senile dementia diagnosis in forensic autopsy cases].

Forensic autopsied brains from 57 cases were examined to establish histopathological criteria for normal aging and senile dementia. Senile plaques, neurofibrillary tangles (NFT), amyloid angiopathy and lipofuscin deposits were quantified in the occipital lobe and in the hippocampus. Histopathological data were analysed by the image analyzer. The primitive senile plaque (SPP) and lipofuscin deposits were observed over age of 50. The senile plaque with core (SPC) and NFT were presented in the cases above 70 year of age. There were close correlation between the individual age in non-demented, and the number, size and occupation ratio of SPC in the occipital lobe and hippocampus. In the dementia cases, the occupation ratio of SPC in the hippocampus and the number of SPP in the occipital cortex were significantly increased against the non-demented group.

Aged↗
PubMed1989

Assessment of transesophageal Doppler echography in dissecting aortic aneurysm.

To assess the clinical value of transesophageal Doppler echography in the diagnosis of dissecting aortic aneurysm, both transesophageal and conventional echograms were performed in 22 cases of dissecting aortic aneurysm. Of the 22 patients, 17 underwent angiography; 8, X-ray computed tomography; 4, both; and 12, surgery. The performance of each method was assessed in the following four segments: A, ascending aorta; B, aortic arch; C, thoracic descending aorta; and D, upper abdominal aorta. The results by angiography were presumed to be correct. In the group of 17 patients who underwent angiography, the rate of correct detection of an intimal flap using the transesophageal approach was 100% in all four segments, significantly better than detection by the conventional approach (segment A, 65%; segment B, 47%; segment C, 35%; segment D, 53%) (p less than 0.01), and the rate of correct detection of the entry sites using the transesophageal approach was 100%, significantly better than that by conventional approach (42%) (p less than 0.05). X-ray computed tomography was not capable of detecting the site of entry in all cases. The presence of thrombus, aortic regurgitation and pericardial hemorrhage were all revealed clearly by the transesophageal approach, and the results were partly proved by other methods. In conclusion, transesophageal Doppler echography provides a rapid and accurate method of diagnosing and evaluating dissecting aortic aneurysm and permits prompt initiation of appropriate treatment.

Adult↗
PubMed1989

Structure-activity relationship of endothelin: importance of charged groups.

Endothelin (ET)-related peptides including ET-1 (1-39) were synthesized, and their constricting activity in rat pulmonary artery rings and pressor activity in unanesthetized rat were measured to elucidate their structure-activity relationship. The vasoconstrictor activities of ET-2, ET-3 and sarafotoxin S6b were one-half, one-60th and one-third that of ET-1, respectively. Such differences in biological activities should mainly arise from sequence heterogeneity at the N-terminal portion, especially at positions 4 to 7. All of the blocked ETs at the amino or carboxyl termini showed greatly decreased activities. A monocyclic analog, in which Cys3 and Cys11 were replaced by Ala, showed one-third the activity of ET-1; however, its deamino dicarba analog was almost completely inactive. Significant activities were retained even with replacement of amino acids at positions Ser4, Ser5, Leu6, Met7, Lys9, Tyr13, and Trp21 by Ala, Ala, Gly, Met(0), Leu, Phe, and Tyr or Phe, respectively. On the other hand, replacement of Asp8, Glu10 and Phe14 by Asn, Gln and Ala, respectively, resulted in complete loss of the biological activity. These results indicated that two disulfide bonds in ET molecule were not essential for the expression of vasoconstricting activity. Both terminal amino and carboxyl groups, carboxyl groups of Asp8 and Glu10, and the aromatic group of Phe14 seemed to be contributing, more or less, to the expression of the biological activities.

Animals↗
PubMed1989

ADP-ribosylation of 24-26-kDa GTP-binding proteins localized in neuronal and non-neuronal cells by botulinum neurotoxin D.

Clostridium botulinum D (strain South Africa) produces ADP-ribosyltransferase which modifies eukaryotic 24-26-kDa proteins. ADP-ribosyltransferase activity was associated with a neurotoxin of 150 kDa (Dsa toxin) as confirmed by the elution profile of Dsa toxin from high performance anion-exchange column. The 24-kDa substrate of Dsa toxin-catalyzed ADP-ribosylation was detected in several tissues examined including rat brain, heart, and liver; bovine adrenal medulla; sea urchin eggs; electric organs of electric fish; and cell lines of neural (N18, N1E115, NS20Y, NG108, PC12, and C6) and non-neural (3T3) origins, suggesting its ubiquitous localization in eukaryotic cells. On the other hand, the 26-kDa substrate was detected only in membrane fractions of neural tissues and neuronal cells, suggesting its specific localization in membrane of nerve terminals. ADP-ribosylation of both the 24-kDa substrate in PC12 membrane and the 24-26-kDa substrates in rat brain membrane was potentiated by either divalent cations or guanine nucleotides, whereas adenine nucleotides did not affect the ADP-ribosylation reaction. Trypsin digestion of the 24-kDa substrate in PC12 membrane and the 24-26-kDa substrates in rat brain membrane extract produced different tryptic fragments indicative of the structural difference between the 24- and 26-kDa substrates. Both the 24- and 26-kDa substrates were less sensitive to trypsin digestion before being ADP-ribosylated by Dsa toxin than after, suggesting the conformational alterations of the 24-26-kDa proteins induced by ADP-ribosylation. These results suggest that Dsa toxin modifies two distinct low molecular mass GTP-binding proteins by ADP-ribosylation to alter their putative function(s).

ADP Ribose Transferases↗
PubMed1989

Chromosomal location of the gene encoding the murine acute-phase protein serum amyloid P-component (SAP).

A full-length cDNA clone, pmSAP3, encoding, the serum P component (SAP), has been used to search for DNA fragment length variation among mouse strains previously analyzed for differences in endogenous SAP levels. Three alleles were found using EcoRI-digested DNA. The finding of a single 5.4-kb fragment, allele d, in DNA from DBA/2J mice suggests the presence of a single Sap locus. Segregation of DNA fragment associated with Sapb and Sapd alleles was analyzed in three sets of recombinant inbred (RI) strains. The strain distribution pattern found for the Sap alleles was identical to that of alleles of Ly-9 in 43 individual RI strains, suggesting tight linkage with Ly-9 on mouse chromosome 1. In the BXD RI strains, the SDP of the Sap locus, defined by the difference in the endogenous SAP level, is also identical to the SDP of the DNA fragments. We propose to redesignate the Sap locus to include both the structural element defined by the DNA polymorphism and the regulatory element involved in the regulation of SAP synthesis. The Sap locus is the major genetic element contributing to the regulation of SAP production. Other genetic factors are also involved, as shown by the presence of nonparental phenotypes in the individual BXH RI strains.

Alleles↗
PubMed1989

Peripheral hemodynamic effects of captopril in patients with congestive heart failure.

In 14 patients with severe congestive heart failure, the effects of captopril on the forearm circulation were evaluated with strain gauge plethysmography. Changes in plasma renin activity, angiotensin II, norepinephrine, epinephrine, bradykinin, prostaglandin E2, and 6-keto-prostaglandin F1 alpha concentrations were also measured. To determine whether the prostaglandins contribute to the peripheral hemodynamic response to captopril, the hemodynamic and hormonal measurements were repeated after pretreatment with indomethacin, an inhibitor of prostaglandin synthesis. Ninety minutes after administering a single dose of captopril (25 mg), mean blood pressure and venous pressure decreased (p less than 0.01 and p less than 0.05, respectively), forearm blood flow and maximum venous volume increased (p less than 0.05 for both), and forearm vascular resistance and forearm venous tone decreased (p less than 0.05 for both). Captopril also improved forearm venous distensibility (p less than 0.05). Pretreatment with oral indomethacin (50 mg) significantly blunted all of these captopril-induced hemodynamic changes. The blockage of the renin-angiotensin system by captopril was unaltered by indomethacin pretreatment. Captopril significantly increased plasma bradykinin, prostaglandin E2, and 6-keto-prostaglandin F1 alpha (p less than 0.05 for each). Indomethacin pretreatment did not affect the captopril-induced increase in bradykinin, but it did completely eliminate the increase in the prostaglandins. Plasma catecholamines did not change with captopril. These data suggest that the vasodilator prostaglandins play a significant role in captopril's peripheral vasodilative effects in congestive heart failure.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Measurement of human portal blood flow by continuous thermodilution.

We wanted to use the Ganz thermistor catheter, developed to measure blood flow in human coronary sinuses, to measure portal venous flow, which is greater. We prepared a model circuit with a high flow rate and studied the method for suitability and reproducibility of the measurements. Correlation was close between the measured and calculated flow rates when the thermal indicator was injected at the rate of 48 ml/min. Measurements were highly reproducible. The catheter was then tested clinically. It was inserted into the portal trunk during percutaneous transhepatic catheterization to measure the portal venous flow. Measurements in patients with cirrhosis of the liver were close to those reported by other workers, and were reproducible. The results suggest that this method will be useful for the continuous local measurement of portal venous flow that varies with time, and will provide information about portal circulation in hepatic disease.

Adult↗
PubMed1989

Age-associated changes in renal glomeruli of mice.

To investigate age-associated changes in renal glomeruli of C57BL/6 female mice, we used a single radial immunodiffusion method to measure albumin excretion. Up to 100 mg/dl in urine samples was regarded as microalbuminuria. The mean amount of urinary albumin increased from 14.0 mg/dl at 6 months to 151.1 mg/dl at 24 months of age. Microalbuminuria occurred in 64.6% of tested mice by the time they were 24 months old, and 10% of the mice had marked albuminuria (more than 100 mg/dl) at that time. Parallel morphological study showed that renal mesangial changes were also age-dependent. Mesangial cell proliferation and spike lesions in glomerular capillary walls appeared in aged mice with microalbuminuria, and were then followed by diffuse glomerular sclerosis accompanied by marked albuminuria. Histological scores on damage in the renal mesangium with changes of glomerular basement membrane increased significantly with age from a mean score of 0 at 6 months to 3.24 at 24 months of age. Immunofluorescent study showed a marked deposition of IgG and IgM, but no complement component C3 in enlarged mesangium. Electron microscopic examination of diffuse sclerotic glomeruli in aged mice revealed amyloid substances. These results suggest that assays of albuminuria could be a useful method for early detection of age-associated renal deterioration.

Aging↗
PubMed1989

Necrotizing fasciitis of the middle third of the face. A case report.

A 48-year-old man with necrotizing fasciitis in the right middle third face is presented. The patient had uncontrolled diabetes mellitus and liver cirrhosis. The condition was controlled by early diagnosis, prompt surgical management and adjunctive broad spectrum antibiotic cover after entering hospital, the curettage of the necrotizing tissue of the right cheek was especially effective.

Diabetes Complications↗
PubMed1989

Cardiorenal effects of an orally active dopamine prodrug (TA-870) in patients with congestive heart failure.

The effects of TA-870, a newly synthesized orally active dopamine prodrug, on the cardiorenal functions were investigated in 12 patients with severe chronic congestive heart failure. A single oral dose of TA-870 (1,200 mg) improved left ventricular fractional shortening and mean circumferential velocity on M-mode echocardiography (p less than 0.01 for both). Renal plasma flow and glomerular filtration rate improved with TA-870 (p less than 0.01 and p less than 0.05, respectively); urine volume and sodium excretion increased (p less than 0.01 for both). Blood pressure and heart rate did not change during the 4-h experimental period. Mean plasma free dopamine levels peaked 1 h after dosing. These data suggest that the cardiorenal effects of oral TA-870 are comparable with those of continuous intravenous injections of dopamine. Thus, TA-870 appears to be a useful alternative drug to intravenous dopamine.

Adult↗