Search PubMed⌕ Search

Biomedical subjects

S Yagi

Publications and source records attributed to S Yagi.

At least 109 records · Page 6Linked to original sources
PubMed1997

Long-term evaluation of combined antihypertensive therapy with lisinopril and a thiazide diuretic in patients with essential hypertension.

For the treatment of hypertension, the combination of an angiotensin-converting enzyme (ACE) inhibitor and a thiazide diuretic is supported by multiple lines of evidence, because these drugs have synergistic action and are expected to cancel out each other's adverse side effects. However, the long-term outcome of this combination antihypertensive therapy is not entirely clear. In the present multicenter open trial, we investigated the long-term efficacy and safety of combined antihypertensive therapy with an ACE inhibitor, lisinopril, and a thiazide diuretic, trichlormethiazide. A total of 466 patients with essential hypertension were treated with lisinopril alone (monotherapy group, n = 360) or with a combination of lisinopril with trichlormethiazide (combination therapy group, n = 106) for 1 year. The average blood pressure was effectively lowered to below 150/90 mmHg in both the monotherapy and the combination therapy groups throughout the study period. The average maintenance dose of lisinopril was lower when combined with thiazide than when given alone (9.8 vs. 11.5 mg/day, p < 0.001). Dry cough was the major side effect of lisinopril; no severe adverse effects were observed. The incidence of cough was not significantly different between the monotherapy group (13.1%) and the combination therapy group (11.3%). The increase in serum potassium observed in the monotherapy group was reversed by the concurrent use of the thiazide diuretic in the combination therapy group. Fasting blood glucose was significantly reduced in the monotherapy group; the reduction observed in the combination therapy group was not significant. Thus, the present results provide useful information as to the effectiveness and safety of combined antihypertensive therapy with lisinopril and a thiazide in comparison with monotherapy with lisinopril.

Adult↗
PubMed1997

[Changes in the extent of mitral regurgitation during hemodialysis: color Doppler echocardiographic study].

The changes in the extent of mitral regurgitation (MR) during maintenance hemodialysis patients were studied in six patients with MR by color Doppler echocardiography. M-mode, two-dimensional and color Doppler echocardiography were performed before and every hour during hemodialysis. The severity of MR was evaluated by a semiquantitative grading system and maximal MR area. Hemodialysis removed 2.1 +/- 0.9/body fluid. Blood pressure and heart rate did not change systematically by hemodialysis. Left atrial, left ventricular end-diastolic and end-systolic dimensions were significantly decreased by hemodialysis (p < 0.05). Stroke volume and left ventricular wall stress were also significantly decreased (p < 0.01). MR area was significantly smaller at the end of hemodialysis compared to pre-hemodialysis (49.0 +/- 20.5 vs 171.0 +/- 49.2 mm2, p < 0.05). During hemodialysis, the extent of MR was continuously decreased. In two out of six patients, the MR jet disappeared. The extent of MR may depend on the fluid volume removed by hemodialysis because the MR area diminished more as more fluid was removed. No major disorders of the mitral complex were detected when the MR area was decreased rapidly to less than 60 mm2 in response to the removal of a small amount of fluid. The dry weight should be determined as the body weight when MR is as small as possible by color Doppler echocardiography.

Adult↗
PubMed1997

[Urgent replacement of aortic arch and descending aorta following replacement of ascending aorta for Stanford a aortic dissection--a case report].

A 37-year-old male who was on chronic dialysis regimen for IgA nephropathy developed acute Stanford A type aortic dissection. Replacement of the ascending aorta was performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open distal anastomosis technique. The site of the intimal tear in the ascending aorta was resected and the gelatin-resorcin-formaldehyde (GRF) glue was applied to both stumps. The outside of dissecting aortic wall was reinforced with Teflon-felt strips. Two months after the operation, the patient required an urgent operation due to threatening spindle evolution of a persisting dissection in the descending aorta. Replacement of the total arch and the descending aorta was carried out via the median sternotomy with the left anterior thoracotomy, and a subclavian incision. Continuous veno-venous hemofiltration was initiated immediately after both operations and the water balance was maintained well. The patient was discharged 1 month postoperatively. It was suggested that the inside of the dissected aortic wall should be also reinforced even when the GRF glue was used in patients who have a fragile intimal flap and a wide tear.

Acute Disease↗
PubMed1997

[Genetic organization of GBV-C].

Genome of GBV-C have 5' and 3' untranslated region and a coding region of 2842 amino acid. In comparison with other flaviviruses, GBV-C lacks the sequence coding typical CORE protein at the N terminus of putative polyprotein. In the putative structure region, E1 and E2, three potential glycosylation sites(Asn-X-Ser/Thr) were conserved in all isolates. In the putative NS3 region, conserved elements found in RNA helicases with nucleotide triphosphate(NTP) binding motif, GSGKS(residue 1097-1101) and DECH(residue 1184-1187), were observed. In addition, a sequence motif found in all viral RNA-dependent RNA polymerase, GDD(residue 2587-2589) was also conserved in NS5B region.

Amino Acid Sequence↗
PubMed1997

[Three-dimensional transesophageal echocardiographic assessment for prosthetic valves].

We evaluated three-dimensional transesophageal echocardiographic assessment of the implanted mechanical valves by rotational scanning method. Patients were 7 mitral valve replacement and one aortic valve replacement, 2 mitral and aortic valve replacement. In 2 cases of 7 mitral valve replacement, the prosthetic valve regurgitation was evaluated using by color Doppler echocardiography. In this study, multiplane transesophageal probe was used. It rotated at 2-degree intervals from 0 to 180 degrees and the three-dimensional reconstruction was performed by echo scan workstation system (TOMTEC Inc, Munich, Germany). In mitral valve replacement cases, the valve motion of bileaflet valve (St. Jude Medical valve and ATS valve) were showed very clearly. The struts was easily recognized in the St. Jude Medical valve (SJM valve) cases. In one of SJM valve cases, the pannus formation was revealed, but it did not disturb valve motion. The prosthetic valve regurgitation can be seen accurately. However, aortic valve and ball valve cases cannot be reconstructed because of artifact from prosthetic valve and ultrasonic direction. The prosthetic valve regurgitation, pannus formation which was difficult to be showed in two-dimensional echocardiography and relationship between annulus and sewing cuff can be evaluated by this three-dimensional echocardiography. In this study, this system has some problems, for example real-time evaluation is impossible, aortic valve and ball valve cases cannot be reconstructed. However, we think that this new technology is suitable for evaluating valve thrombus, valve dysfunction and paravalvular leakage. In conclusion, the three-dimensional echo-cardiography demonstrated, reliable and accurate examination, and it can evaluate various complications of prosthetic valve.

Adult↗
PubMed1996

Small intestinal metastasis from esophageal carcinoma associated with small intestinal obstruction: report of a case.

The small intestine is rarely involved with metastatic tumors from outside the abdomen, and few case reports have been documented in the literature. We describe herein what to our knowledge is the third case of a solitary metastasis from squamous cell carcinoma (SCC) of the esophagus being found in the jejunum, causing small intestinal obstruction.

Carcinoma, Squamous Cell↗
PubMed1996

Endothelin-mediated effect of erythropoietin on blood pressure and renal hemodynamics in hypertensive rats.

Erythropoietin (EPO) has been reported to induce hypertension in hemodialysis patients with family history of hypertension. In this study, to reveal the mechanism of EPO-induced hypertension, we examined the acute effect of EPO on blood pressure (BP) and renal hemodynamics in genetically hypertensive rats, and we also tested the effect of BQ-123, an endothelin ETA-receptor blocker, on EPO-induced changes in hemodynamics. Male spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY), aged 9-12 wk, were anesthetized, and BP was monitored through the carotid artery. Renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured before and after an intravenous injection of EPO (1,000 U/kg body wt). In another group of SHR, BQ-123 was continuously infused (1.2 mg.kg body wt-1.h-1) during the experiments. The acute injections of EPO increased BP significantly in SHR in a dose-dependent manner, whereas WKY did not show a significant increase in BP after EPO injections. The effect of EPO on BP in SHR was blocked by BQ-123. In SHR, an acute injection of EPO decreased RPF significantly (from 1.78 +/- 0.16 to 1.49 +/- 0.18 ml.min-1.100 g body wt-1, P < 0.05) without a change in GFR, whereas WKY did not show significant changes in either RPF or GFR. The effect of EPO on RPF in SHR was completely blocked by BQ-123 (from 1.92 +/- 0.26 to 1.88 +/- 0.28 ml.min-1.100 g wt-1, NS). EPO caused a significant increase in plasma endothelin ET-1 in SHR (from 2.3 +/- 0.6 to 6.3 +/- 1.6 pg/ml, P < 0.05), but not in WKY. In conclusion, acute administration of EPO raised blood pressure and reduced RPF in SHR, and these vasoconstrictive effects of EPO are mediated via ETA receptors by an enhanced ET-1 release.

Animals↗
PubMed1996

Successful erythropoietin treatment for severe anemia in nephrotic syndrome without renal dysfunction.

A 62-year-old woman presented with nephrotic syndrome and severe anemia although the renal function was not impaired. Renal biopsy revealed the histology of membranoproliferative glomerulonephritis, and the proteinuria was resistant to steroid therapy. Iron deficiency, bleeding and other causes of anemia were ruled out, however, her serum erythropoietin level was inappropriately low. The anemia was rapidly corrected by administration of recombinant human erythropoietin. It is suggested that inappropriately low erythropoietin level, in part at least, accounts for the anemia in nephrotic syndrome. It is proposed that erythropoietin therapy should be taken into consideration for severe anemia in nephrotic syndrome even when the renal function is not impaired.

Anemia↗
PubMed1996

An epitope chimeric antigen for the hepatitis C virus serological screening test.

The epitope chimeric antigen, CepCM, composed of the 9 selected major epitope regions (two in NS3, two each in the NS4 of two genotypes, two each in the core of two genotype, and one in the core in hepatitis C virus (HCV) polypeptide), was expressed as a fusion protein of the trpE peptide in E. coli. An ELISA test using this antigen produced the same judgements with most of the panel sera as a second generation HCV screening kit. Though discrepancies were found in twelve samples (5% of the samples), further analysis revealed that eleven samples were indeterminate sera as judged by an immunoblot test. The reactivity found in several seroconversion series sera suggested that CepCM has superior reactivity to HCV infected sera than some second generation kits. These data indicated that an epitope chimeric antigen with a man-made sequence will be a excellent tool for a diagnostic test kit.

Antigens, Viral↗
PubMed1996

Long-term effects of doxazosin, an alpha 1-blocker, on serum lipids in hypertensive patients.

Nowadays practical antihypertensive therapy involves not only simple normalization of blood pressure but also a reduction of the risks of cardiovascular disease. In this multicenter open-label study, the long-term effects of doxazosin, an alpha 1-adrenergic receptor blocker, on serum lipids were prospectively investigated in 253 patients with essential hypertension. They were treated with doxazosin for 1 year. The averaged the blood pressure was maintained at levels lower than 150/90 mmHg throughout 1 year, but heart rate did not increase. After 3 months of doxazosin therapy, total and low density lipoprotein-cholesterol levels in serum were significantly reduced by 3.3% and 3.4%, respectively, and these levels were maintained throughout the study period. This effect of doxazosin on serum lipids was especially prominent in patients with hypercholesterolemia. In addition, the lipid profile of these patients was favorably altered even when other antihypertensive drugs or lipid-lowering drugs had already been used or were used concurrently. These results constitute useful information for physicians who treat hypertension with alpha 1-blockers to reduce the overall risk of cardiovascular disease.

Adrenergic alpha-2 Receptor Antagonists↗
PubMed1996

Effect of trichlormethiazide and captopril on nitric oxide synthase activity in the kidney of deoxycorticosterone acetate-salt hypertensive rats.

Nitric oxide (NO) production is reduced in patients with essential hypertension and in some experimental models. We have investigated the effect of trichlormethiazide and captopril on NO synthase (NOS) activity and glomerular damage in the kidney of deoxycorticosterone acetate (DOCA)-salt hypertensive rats. DOCA-salt rats were induced with weekly injections of DOCA (30 mg/kg body weight (BW) and 1% saline in drinking water after right nephrectomy. As antihypertensive therapies, CAP (captopril, 40 mg/kg BW) and TCM (trichlormethiazide, 10 mg/kg BW) were given after induction of DOCA-salt hypertension. The increased blood pressure was significantly lowered by TCM, but not by CAP after 5 weeks. Nitrite production in kidney slices was suppressed in DOCA-salt rats, and immunoreactivity for both brain-type NOS (B-NOS) in macula densa and endothelial-type NOS (EC-NOS) in renal vessels was decreased. TCM significantly increased the nitrite production in the kidney slices and B-NOS immunoreactivity, whereas these changes were less in CAP. Glomerulosclerosis score was significantly higher in DOCA-salt rats, and TCM ameliorated renal damage more effectively than CAP. These results indicate that the reduced nitrite production in the kidney of DOCA-salt hypertensive rats was increased more effectively by trichlormethiazide than by captopril, via increased immunoreactivity for B-NOS in the macula densa, and prevented renal damage.

Animals↗
PubMed1996

Effect of tryptophan metabolites on fluorescent granules in the Malpighian tubules of eye color mutants of Drosophila melanogaster.

Fluorescent granules that are stained with Nile blue sulfate are present in larval Malpighian tubules in the wild type strain of Drosophila melanogaster, Oregon-R. These granules emit a weak blue fluorescence and most of them are about 2 microns or more in diameter. The ommochrome precursor 3-hydroxy-kynurenine (3-HK) is actively transferred into the tubules of Oregon-R. Changes in the fluorescent granules in the Malpighian tubules on administration of ommochrome precursors were investigated in eye color mutants of Drosophila. The fluorescent granules in the tubules of the nonautonomous mutants v;bw and cn bw emit a strong blue fluorescence and most of them are about 1 micron or less in diameter. When v;bw and cn bw larvae were cultured on medium supplemented with kynurenine or 3-HK, respectively, the fluorescence intensity of their granules decreased, and their size increased. These additions resulted in almost equal accumulation of 3-HK to that in Oregon-R. On the other hand, no 3-HK accumulated in the tubules of larvae of the autonomous mutants bw;st, ltd bw and w, which lack the fluorescent granules. These findings indicate that the fluorescent granules are an important intracellular site for uptake or storage of ommochrome precursors in larval Malpighian tubules of Drosophila.

Animals↗
PubMed1996

[A case report of a left atrial ball thrombus at 16 years after mitral valve replacement].

A free floating ball thrombus in left atrium is very rare, only 2 cases that develop ball thrombus after mitral valve replacement (MVR) have been reported. This case was a 55-year-old female who underwent MVR and tricuspid annuloplasty (TAP) in 1978. After 16 years, she developed replaced mitral valve stenosis due to pannus formation and tricuspid regurgitation (TR), with a free floating ball thrombus in the giant left atrium. A ball thrombus was taken out, and Re-MVR and tricuspid valve replacement (TVR) was carried out. Post operative course was uneventful. Because a free floating ball thrombus easily causes "Hole-in-one" sudden death, early surgical treatment must be considered.

Female↗
PubMed1996

[A case of abdominal tuberculous lymphadenitis diagnosed by percutaneous needle biopsy under ultrasound control and followed up by ultrasound imaging].

A case of abdominal tuberculous lymphadenitis diagnosed by percutaneous needle biopsy under ultrasound control and followed up by ultrasound imaging was reported. A 63 years-old male was admitted to a certain hospital complaining of dizziness and diplopia. Chest roentgenogram showed bilateral infiltrative shadows in the upper lung fields and Mycobacterium tuberculosis was detected in cultures from specimens of gastric aspiration. Abdominal ultrasound examination and computed tomography showed abdominal lymph nodes swelling. Needle biopsy under ultrasound control was performed, and the specimens showed necrosis and Mycobacterium tuberculosis was positive by culture. He was diagnosed as lung tuberculosis with abdominal tuberculous lymphadenitis and admitted to our hospital for anti-tuberculous chemotherapy. Ultrasound examination done every two weeks showed diminution in size of the lymph nodes after a month of anti-tuberculous therapy. For the diagnosis of abdominal lymph node swelling, a needle biopsy under ultrasound control is safe and useful technique, and a ultrasound examination is also valuable to follow up the course of abdominal tuberculous lymphadenitis.

Abdomen↗
PubMed1996

Effects of antihypertensive drugs on nitric oxide synthase activity in rat kidney.

Nitric oxide production has been reported to be reduced in hypertensive patients. In this study, we investigated the effects of antihypertensive drugs such as calcium channel blocker, amlodipine, alpha 1-adrenoceptor blocker, doxazosin and angiotensin converting enzyme (ACE) inhibitor, imidapril on nitric oxide synthase (NOS) activity in the kidneys of L-NAME-induced hypertensive rats. An increased blood pressure in L-NAME-induced hypertensive rats was significantly decreased by these antihypertensives to the same extent at four weeks. Nitrite production from the kidney slices was significantly suppressed in L-NAME-induced hypertensive rats. This suppression of nitrite production was reversed to the control level in the rats treated with amlodipine, and significantly enhanced by doxazosin and imidapril. Immunoreactivity for both the brain-type NOS in the macula densa and endothelial cell-type NOS in renal vasculature was diminished in L-NAME rats, and antihypertensive therapies, especially doxazosin and imidapril, increased NOS immunostaining. The increased glomerulosclerosis score in the L-NAME group was significantly lowered by the treatment with doxazosin and imidapril. In conclusion, a decreased NOS activity in L-NAME-induced hypertensive rats was significantly increased by alpha 1-adrenoceptor blockers and ACE inhibitors in the kidney, and this increased NOS activity may have a role in the prevention of glomerulosclerosis.

Adrenergic alpha-Antagonists↗
PubMed1996

Experiences of postcardiotomy assist: pneumatic ventricular assist device or venoarterial bypass with percutaneous cardiopulmonary support.

From October 1982 to the present, 16 patients have been supported by a pneumatic ventricular assist device (VAD). Since April 1990, we have introduced a venoarterial bypass (VAB) with percutaneous cardiopulmonary support (PCPS) system. This PCPS system was used in 12 patients. The long-term survival rate of PCPS cases (41%) was much better than that of VAD cases (19%). The main cause of death in VAD cases was multiple organ failure (MOF). Although VAB was initiated more recently than VAD, the duration on support was longer in the VAD group than in the VAB group. Because of the longer support duration and the presence of many patients with MOF, coagulopathy deteriorated more readily in the VAD group than in the VAB group. In the case of postcardiotomy cardiopulmonary bypass weaning or low-output syndrome (LOS), the VAB with PCPS system should be applied first under intraaortic balloon pumping assist because of its simplicity and low cost. Thereafter, VAD should be applied in cases refractory to VAB support.

Adult↗