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Biomedical subjects

S Terashima

Publications and source records attributed to S Terashima.

At least 55 records · Page 3Linked to original sources
PubMed1992

Malignant hyperthermia caused by intravenous lidocaine for ventricular arrhythmia.

We encountered a case of malignant hyperthermia caused by intravenous lidocaine which had been administered as treatment for a ventricular arrhythmia. The patient, a 72-year-old male, was admitted with chronic renal failure and aortic valvular stenosis. His chronic renal failure progressed, and congestive heart failure developed, and ventricular arrhythmias occurred frequently. For the treatment of these arrhythmias, lidocaine was injected and continuous infusion was started. Despite initial improvement in symptoms and laboratory data following hemofiltration, refractory ventricular tachycardia occurred. The patient was treated with large doses of lidocaine. His body temperature rose to a maximum of 41.7 degrees C, and generalized muscular twitching was observed before he lost consciousness. Serum and urinary myoglobin levels became elevated. This abnormally high fever was relieved only by dantrolene sodium. After we made a diagnosis of malignant hyperthermia and stopped the lidocaine infusion, the high fever resolved quickly. It is important to note that malignant hyperthermia can be caused by lidocaine and amide-linked local anesthetics.

Aged↗
PubMed1992

[A successfully treated case of acute renal failure due to acute immune hemolytic anemia and nontraumatic rhabdomyolysis induced by streptomycin reinjection].

A case of acute immune hemolytic anemia associated with non-traumatic rhabdomyolysis (NTR) induced by streptomycin (SM) reinjection, which developed acute renal failure, has been reported. A 70-year-old female was admitted to our hospital because of sudden macroscopic hematuria after reinjection of 1g. SM. Laboratory findings on admission were as follows; hemoglobin and myoglobin were positive in urine. RBC 129 x 10(4)/microliters, Hb 4.9g/dl, Ht 11.1%, reticulocytes 52/1000, serum indirect billirubin 3.8g/dl, LDH 9, 230 WU, BUN 149mg/dl, Cr 7.9mg/dl, myoglobin 1, 400ng/ml and haptoglobin 10.6mg/dl. The drug lymphocyte stimulating test of SM was positive (215%). A direct antiglobulin test was also positive. An indirect antiglobulin test was negative, but became positive after incubation with SM. These observations made the diagnosis of SM-induced hemolytic anemia associated with NTR. On the second hospital day she developed anuria, and was put on hemodialysis treatment. Two months after the acute hemolytic episode and acute renal failure she recovered and is presently in good health without recurrence.

Acute Disease↗
PubMed1992

[Regional myocardial coronary blood flow reserve in hypertrophic cardiomyopathy assessed by digital subtraction coronary angiography].

Using digital subtraction coronary angiography (DSA), we evaluated the regional myocardial coronary blood flow reserve (rMFR) in 18 patients with hypertrophic cardiomyopathy (HCM). There were 13 patients with asymmetrical septal hypertrophy (ASH), and 5 with asymmetrical apical hypertrophy (AAH). Eight subjects without apparent cardiac abnormality served as controls. Relations between the rMFR and regional wall thickness as determined by echocardiography were also investigated. Peak contrast density (Cm) and time to Cm (Tm) were measured from digital angiograms at the middle and distal ventricular septum (VS) and at the apical and left ventricular posterior wall (PW). The rMFR of each region of interest was expressed as the ratio of Cm/Tm at the baseline and at peak hyperemic response induced by intracoronary administration of papaverine. The rMFR was significantly lower at the VS and apex in HCM than in controls: middle VS, 1.9 +/- 0.5 vs 3.9 +/- 0.5, p < 0.001; distal VS, 2.0 +/- 0.5 vs 4.4 +/- 0.9, p < 0.001; and the apex, 2.0 +/- 0.7 vs 4.5 +/- 1.6, p < 0.01. However, it did not differ at the PW; 2.6 +/- 0.9 vs 3.0 +/- 0.9 between the 3 groups. The middle VS and apex, where the wall was the thickest, had the lowest rMFR in ASH and AAH. Furthermore, at the VS and apex, a curvilinear relationship was observed between the rMFR and wall thickness (rMFR = -0.88 in WT + 2.39, r = -0.57, p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The effect of percutaneous transluminal coronary angioplasty on anaerobic threshold in patients with angina pectoris.

The anaerobic threshold (AT) is regarded an objective parameter for evaluating exercise tolerance, but its relationship to the improvement of myocardial ischemia remains uncertain. To investigate this relationship, submaximal treadmill exercise tests were performed for 15 consecutive patients with angina pectoris who had undergone successful percutaneous transluminal coronary angioplasty (PTCA). Before and after PTCA, the AT was determined using cardiorespiratory monitoring, while the patients were receiving their usual vasodilator medications. 1) Before PTCA, the minute oxygen uptake (VO2) at the AT correlated well with the peak VO2 (r = 0.92, p < 0.002). The VO2 at the AT, however, showed less correlation (r = 0.71, p < 0.002) with the VO2 at ST segment depression, while the latter parameter correlated closely with the peak VO2 (r = 0.91, p < 0.002). 2) After PTCA, exercise time, peak VO2, and the double product at peak exercise increased significantly (from 640.1 +/- 212.2 to 772.9 +/- 230.0 sec, p < 0.001, from 19.1 +/- 5.2 to 22.4 +/- 4.9 ml/min/kg, p < 0.05, and from 19.7 +/- 5.0 x 10(3) to 23.7 +/- 4.5 x 10(3), p < 0.001, respectively). However, the VO2 at the AT did not increase significantly (from 15.8 +/- 4.1 to 16.6 +/- 3.5 ml/min/kg, p = NS). The heart rate, systolic blood pressure, and double product at the AT did not change significantly. In conclusion, in patients with angina pectoris, the AT is apparently related to the onset of myocardial ischemia. However, the AT does not necessarily reflect acute improvement of myocardial ischemia immediately after PTCA.

Aged↗
PubMed1991

Active transport pumps of HVA and DOPAC in dopaminergic nerve terminals.

The effect of the membrane potential on the efflux of HVA and DOPAC from DA neurons was studied in anesthetized (1% halothane in gas mixture of 70% N2O and 30% O2) cats. Extracellular DA, HVA and DOPAC were measured continuously from the putamen, the hypothalamus, the thalamus, the raphe nuclei and the cortex using brain microdialysis technique combined with HPLC-ED monoamine measurements. HVA and DOPAC concentrations were highest in the putamen and lowest in the cerebral cortex. Extracellular HVA levels exceed those of the DOPAC. Increases in the extracellular potassium from 4 to 120 mM invariably produced decreases of the extracellular HVA and DOPAC in all the tested brain regions. These decreases were inversely proportional to the extracellular potassium concentration. Thus, it is concluded that the HVA and the DOPAC are extruded from inside the cell to the extracellular space by active mechanisms of transport similar to that reported for 5-HIAA in serotonergic neurons.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1991

Temperature neurons in the crotaline trigeminal ganglia.

1. Intrasomal recordings were made with microelectrodes from 153 warm (infrared) neurons in the trigeminal ganglia of 36 crotaline snakes, Trimeresurus flavoviridis. Background discharges were observed at room temperature. The 153 warm neurons were classified into two groups: 81 were sensitive to less than or equal to 10 mg of von Frey hair mechanical stimulation (warm T + M neuron), and 72 were insensitive to up to 100 mg or more of mechanical stimulation (warm T neuron). For T + M and T neurons the receptive fields were all located in the pit organ. The mechanically sensitive field of warm T + M neurons located within the infrared receptive field on the pit membrane was less than 1 mm in diameter, and there was only one field per neuron. 2. Electrophysiological parameters were measured. These measurements included membrane potential, action potential amplitude, time of peaking, time duration at the resting membrane potential level, afterhyperpotential (AHP) height and AHP time to half-decay, and maximum rates of depolarization and repolarization. No difference in action potential parameters between the means of these two submodality groups was observed. 3. Intracellular horseradish peroxidase (HRP) labeling was used for defining the warm neuron profile. The somata of warm T and warm T + M neurons and T- or Y-shaped bifurcations of the axon were observed in the ganglion. At the bifurcation point, nodes of Ranvier were observed, but without broad triangular expansion. Diameters of the central axons were thinner than those of the peripheral or stem axons. There were no differences between the mean diameters of the two submodalities. 4. The central axons of warm T and T + M neurons projected to the lateral descending nucleus of the trigeminal nerve (LTTD). Their synaptic boutons were found in the LTTD. No branching of the axons to the principal sensory nucleus or the descending nucleus of the trigeminal nerve was found. These results were the same for six warm T and eight warm T + M neurons. 5. Conduction velocities of the peripheral fibers were measured by stimulating superficial branches of the maxillary nerve electrically. Three groups of conduction velocity were identified in the compound potentials. The conduction velocity of the peak action potential of the warm T fibers was 6.9 +/- 1.2 (SD) m/s (n = 18), that of the T + M fibers 6.7 +/- 0.9 m/s (n = 23). These fell into the second group of the compound potentials.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1991

Studies on aldose reductase inhibitors from natural products. IV. Constituents and aldose reductase inhibitory effect of Chrysanthemum morifolium, Bixa orellana and Ipomoea batatas.

The hot water extracts of Chrysanthemum morifolium, Bixa orellana and Ipomoea batatas, were found to have potent inhibitory activity towards lens aldose reductase (AR). Ellagic acid (4) was isolated from C. morifolium and I. batatas, isoscutellarein (7) from B. orellana and 3,5-dicaffeoylquinic acid (10) from I. batatas, respectively, as potent inhibitors.

Aldehyde Reductase↗
PubMed1991

Quantitative measurements of balloon-to-artery ratios in coronary angioplasty.

To determine the optimal balloon-to-artery ratio in percutaneous transluminal coronary angioplasty (PTCA), the effects of balloon size on the extent of residual stenosis, the incidence of coronary dissection, and the percentage of cases requiring repeat PTCA for restenosis were examined retrospectively. Fifty consecutive patients who underwent elective PTCA for simple and discrete lesion localized in the left anterior descending coronary artery were selected for this study. To measure the absolute cross-sectional area of the adjacent control segment of the artery, we developed a new method of quantitative coronary angiography, a hybrid of cinevideodensitometry and the edge detection method. The balloon-to-artery ratio was calculated as the cross-sectional area ratio between the control segment adjacent to the stenosis and the balloon which was visually selected by the operator during PTCA. Residual stenosis was determined as the percent area of stenosis by our hybrid method using cinevideodensitometry. The balloon-to-artery ratio ranged from 0.4 to 2.4, and a weak but significant inverse correlation (r = -0.51) was observed between the balloon-to-artery ratio and the extent of residual stenosis. In 23 patients whose balloon-to-artery ratios were less than 1.0, residual stenosis was greater (59.9 +/- 11.9% vs 46.0 +/- 19.6%, p < 0.05), and the percentage of repeat PTCA was higher (26% vs 4%, p < 0.05) than in the group of 27 patients whose balloon-to-artery ratios were higher than 1.0. The incidence of coronary dissection was similar in the 2 groups (9% vs 15%, ns). The percent area of stenosis before PTCA, the number of inflations, the inflation pressures, and the inflation times were also similar between these 2 groups. We concluded that the optimal balloon size is slightly more than the control segment dimensions of simple and discrete isolated stenoses of the left anterior descending artery treated at lower inflation pressures, and that an accurate measurement method of the coronary arterial dimensions is necessary to determine this optimal balloon size.

Angioplasty, Balloon, Coronary↗
PubMed1991

[A prominent retrograde flow in coronary artery in patients with hypertrophic cardiomyopathy].

Pathophysiology and clinical significance of a systolic backward flow in the epicardial coronary artery have not been elucidated. Using a 20 MHz Doppler catheter, we assessed coronary flow velocity waveforms in the left anterior descending coronary artery in 19 patients with hypertrophic cardiomyopathy (HCM) and 11 patients without apparent cardiac abnormalities as control subjects. Systolic flow fraction was smaller in HCM than in controls. Only 4 patients with HCM showed a prominent retrograde flow persisting during almost the entire systole. All the 4 had marked cavity obliteration and two of them had systolic intraventricular pressure gradients of 80 and 110 mmHg respectively. Exercise thallium-201 ECT revealed that myocardial hypoperfusion was more frequent in those 4 patients. Through these observations, it is concluded that a high intramyocardial systolic pressure combined with a relatively low coronary perfusing pressure may result in a large systolic retrograde flow in the left epicardial coronary artery, and that it may be related to myocardial ischemia in patients with HCM.

Adult↗
PubMed1991

[Evaluation of coronary arterial stenosis before and after PTCA: visual estimation versus computer-assisted analysis].

Coronary arteriogram of 34 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were evaluated visually and by computer-assisted analysis, that employed an edge detection method and cine-videodensitometry. The results of visual estimation were in general agreement with those of computer-assisted analysis for determination of percent area of stenosis in severe stenosis, and percent diameter of stenosis in slightly stenotic lesions. Before PTCA, the findings obtained by densitometry agreed with those using the edge detection method. However, after PTCA, the results were significantly different. This discrepancy may have been due to asymmetric morphologic changes in the luminal cross sectional area immediately after PTCA, which could not be assessed by the edge detection method in a single-plane view. Through these studies it was concluded that the densitometry is most useful for evaluating the effects of PTCA.

Absorptiometry, Photon↗
PubMed1990

Efflux of 5-HIAA from 5-HT neurons: a membrane potential-dependent process.

The effect of the membrane potential on the efflux of 5-HIAA from 5-HT neurons was studied in anesthetized (halothane: 1% in gas mixture of N2O: 70% and O2: 30%) cats. The endogenous 5-HT and its metabolite 5-HIAA were measured continuously from the cortex, the thalamus, the hypothalamus and the raphe nuclei using brain microdialysis technique combined with HPLC-ED monoamine measurements. Membrane potential variations were induced by changing the extracellular concentration of potassium through the microdialysis membrane. The levels of the extracellular 5-HIAA varied according to the different regions of the brain, being highest in the hypothalamus and lowest in the cerebral cortex. Increases in the extracellular potassium from 4 to 120 mM invariably produced a decrease of the extracellular 5-HIAA in all the tested brain regions. This decrease was inversely proportional to the logarithm of extracellular potassium concentration. Thus, it is postulated that the 5-HIAA is moved from inside the cell to extracellular space by an active mechanism of transport electrically coupled to the membrane potential.

Animals↗
PubMed1990

Studies on aldose reductase inhibitors from medicinal plant of "sinfito," Potentilla candicans, and further synthesis of their related compounds.

For several years we have screened natural products having aldose reductase (AR) inhibitory activity. 3,3',4-Tri-O-methylellagic acid 4'-sulfate potassium salt (2) was isolated from a Mexican herb "Sinfito" (Potentilla candicans) as a potent AR inhibitory active constituent. 2 was more potent (IC50 = 8.0 x 10(-8)M) than ellagic acid, which is one of the natural inhibitors of AR. So we examined the synthesis of ellagic acid derivatives and found that the sulfate group is one of the important function.

Aldehyde Reductase↗
PubMed1990

[Regional myocardial coronary blood flow reserve in hypertrophic cardiomyopathy assessed by digital subtraction coronary angiography].

Previous observations suggest the presence of ischemia in the disproportionately thickened interventricular septum (IVS) of patients with hypertrophic cardiomyopathy (HCM), although the details remain obscure. Utilizing digital subtraction coronary angiography (DSA) with LAO projection before and after intracoronary papaverine (P) injection, we evaluated regional myocardial coronary blood flow reserve (rMFR) consecutively 18 patients with HCM, and compared it with that of 8 patients without apparent cardiac abnormality (C). Time-density curves were obtained from digital angiograms of the myocardial region of interest. We measured peak contrast density (Cm) and time to peak contrast (Tm). An index of rMFR was calculated as the quotient of Cm/Tm before and after P. In HCM, rMFR in IVS and apex was significantly lower than that of C (Mid-IVS: 1.9 +/- 0.5 vs 3.9 +/- 0.5, p less than 0.001; Low-IVS: 2.0 +/- 0.5 vs 4.4 +/- 0.9, p less than 0.001; Apex: 2.0 +/- 0.7 vs 4.5 +/- 1.6, p less than 0.01). There was correlation between the impairment of rMFR and the extent of hypertrophy in HCM. In conclusion, we could state that, in HCM, the region of impaired myocardial coronary blood flow reserve is localized. In HCM, DSA is useful in evaluating myocardial coronary blood flow reserve.

Adult↗
PubMed1990

[Assessment of transient dilation of the left ventricular cavity in patients with hypertrophic cardiomyopathy by exercise thallium-201 scintigraphy].

Exercise Tl scintigraphy (EX-Tl) provides a noninvasive means of identifying myocardial perfusion abnormalities in patients (pts) with hypertrophic cardiomyopathy (HCM). We have noted that some pts with HCM have a pattern of transient dilation of the left ventricle (LV) on the immediate post exercise images as compared with 3 hour redistribution images. We presumed that left ventricular dilation was caused by subendocardial hypoperfusion. So we studied transient dilation of the LV in 50 pts with HCM and 20 controls (C). Initial and delayed conventional short tomographic images were obtained after reconstruction of 30 projections acquired over 180 degrees. Thirty six radii every 10 degrees were generated from the center of the middle myocardial images of the short axis. An area surrounded by the thirty six points of maximal count on each radius was calculated in initial and delayed images. Transient Dilation Index (TDI) as an index of dilation was determined by dividing an area in initial image by an area in delayed image. TDI in pts with HCM was larger than that in C. Pts with HCM were classified into the two groups, Group A: TDI greater than 1.11 (mean + 2 SD in C), 24 pts, Group B: TDI greater than 1.11, 26 pts. Frequency of pts with history of chest pain in Group A was higher than that in Group B, and frequency of pts with positive exercise ECG in Group A was higher than that in Group B. End diastolic volume in Group B did not change 10 minutes after exercise by radionuclide ventriculography. In conclusion, transient dilation of the LV in pts with HCM by EX-Tl is in appearance, and may reflect subendocardial ischemia.

Adult↗
PubMed1989

Studies on aldose reductase inhibitors from natural products. II. Active components of a Paraguayan crude drug "Para-parai mí," Phyllanthus niruri.

Aldose reductase (AR) inhibitory activity-directed fractionation of the 70% ethanolic extract of Para-parai mí, Phyllanthus niruri, has led to the isolation of three active components, ellagic acid (1), brevifolin carboxylic acid (4) and ethyl brevifolin carboxylate (5). Among them, 1 showed the highest inhibitory activity, being about 6 times more potent than quercitrin, which is a known natural inhibitor of AR.

Aldehyde Reductase↗
PubMed1989

[The effect of protease inhibitors in shock].

UNLABELLED: Protease inhibitors, such as ulinastatin and gabexate mesilate, are widely used for the patients in shock state. The purpose of this study was to evaluate the effects of these protease inhibitors on renal protection and coagulofibrinolytic disorders. The obtained results were as follows: 1. Ulinastatin studies. 1) Beta 2-microglobulin (BMG) excretion and N-acetyl-beta-D-glucosaminidase (NAG) activity in urine were increased in cases of emergency operation (10 patients) compared with elective operation (38 patients). 2) In canine experimental model of renal ischemia, ulinastatin significantly improved urine volume and urine NAG levels. 3) Administration of ulinastatin suppressed urine NAG level in 12 patients, but BMG level did not significantly change. 2. Gabexate mesilate (FOY) studies. 1) All patients in shock state showed coagulofibrinolytic disorders. Especially remarkable hypercoagulability was observed in 21 patients. 2) FOY suppressed platelet aggregation and the release of beta-thromboglobulin and platelet factor 4. 3) In 24 patients, administration of FOY markedly increased the antithrombin III levels in early postoperative period. 4) Fibrinolytic system was not affected any significant changes with administration of FOY. CONCLUSION: Our results suggested that protease inhibitors are useful for management of the patients in shock state.

Animals↗