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Biomedical subjects

T Fujinami

Publications and source records attributed to T Fujinami.

At least 91 records · Page 5Linked to original sources
PubMed1990

Nodular glomerulosclerosis in a patient showing impaired glucose tolerance.

We report a case showing typical diabetic nodular glomerulosclerosis without retinopathy or other apparent clinical findings of DM except for impaired glucose tolerance. The 57-year-old man had a family history but no personal history of DM. In an extensive examination for DM, the results of funduscopy, daily profile of serum glucose and hemoglobin Alc were entirely within normal limits. However, the oral glucose tolerance test was abnormal. A renal biopsy showed typical nodular lesions (Kimmelstiel-Wilson's lesions). Previously, the interesting feature of transient proteinuria had been recognized. Although hypocellular nodular lesions by light microscopy are characteristic of diabetic nephropathy, renal amyloidosis, carbon disulfide intoxication, multiple myeloma and light chain disease, we concluded that the present lesions had resulted from diabetic nephropathy based on the family history, patient history, impaired glucose tolerance, immunofluorescent findings and electron microscopic observations.

Diabetic Nephropathies↗
PubMed1990

Reduction in blood viscosity by treatment with coenzyme Q10 in patients with ischemic heart disease.

The effects of coenzyme Q10 (CoQ10) on blood viscosity were studied in twelve patients (mean age 49 +/- 16 years) with ischemic heart disease. Twenty mg of CoQ10 was orally administered three times daily for two months (total dose 60 mg per day). Blood viscosity was measured with a cone-plate type viscometer at the shear rates of 37.5, 75, 150, and 375 s-1. Yield shear stress was calculated from Casson's plot. Blood viscosity decreased at each shear rate after the administration of CoQ10. Yield shear stress decreased significantly by the treatment with CoQ10. Hematocrit and fibrinogen were also measured, but showed no significant change. These results suggest that CoQ10 decreases the blood viscosity, i.e., improves the rheological properties of blood in ischemic heart disease.

Administration, Oral↗
PubMed1990

[A case of chronic recurrent pulmonary embolism treated by pulmonary embolectomy and Günther vena caval filter implantation].

A case report of chronic recurrent pulmonary embolism treated by embolectomy and Günther vena caval filter. A 62-year-old man had suffered from dyspnea on effort for 4 years, and his feeling of dyspnea had gradually increased during the past 3 months. On the day of admission he was in a preshock state, and his pulmonary artery pressure was very high at 90/30 mmHg. Pulmonary blood perfusion scintigraphy showed multiple defects of isotope uptake. Immediately after the scintigraphy, pulmonary embolectomy was performed while using extracorporeal circulation. The operation was successful and his physical activity was markedly improved. After the operation, anti-coagulant and anti-platelet therapies were continued, but recurrence of pulmonary emboli was detected by scintigraphy, and some thrombi were found by venography in deep veins of the lower parts of both legs. To prevent recurrent pulmonary embolism, a Günther vena caval filter was inserted into the inferior vena cava. We considered this case as an acute worsening of chronic recurrent pulmonary embolism and we had the impression that pulmonary embolectomy is a very effective therapeutic method for serious pulmonary embolism, and that insertion of the Günther vena caval filter is a very easy and safe procedure.

Chronic Disease↗
PubMed1989

Type A behavior pattern in Japanese employees: cross-cultural comparison of major factors in Jenkins Activity Survey (JAS) responses.

The responses to the Japanese edition of the Jenkins Activity Survey (JAS) (Form C) were analyzed in 1682 male employees of a Japanese enterprise to investigate the characteristics of the Type A behavior pattern (TABP) in Japan. When the occupational level was controlled, the mean values of the Type A score were found to be quite similar to those of the Western Collaborative Group Study (WCGS), although those of factor H scores were considerably lower than those of the WCGS. Additionally, the results of a factor analysis conducted on the responses to JAS questions showed that the factor structure of the responses was basically equal to that found in the WCGS. In contrast to factor J of the WCGS, however, Japanese factor J did not comprise the items which signaled rises in positions or incomes in recent years. The results of this study indicate that the JAS is able to measure the TABP in Japan, at least concerning its three component factors. Furthermore, they suggest that the TAPB is not necessarily reinforced in Japanese occupational environments.

Coronary Disease↗
PubMed1989

Diagnosis of arteriosclerosis obliterans by impedance technique with special reference to relative blood flow of the lower extremity.

Simultaneous recordings of impedance cardiography of the chest and impedance plethysmography of the lower extremity were performed on 105 limbs with or without arteriosclerosis obliterans (ASO) documented by angiography. The ratios of blood flow to the lower extremity--leg stroke volume/cardiac stroke volume--(LSV/CSV) were 11.2 +/- 3.3% in normal male subjects, 11.1 +/- 5.5% in normal female subjects, and 3.1 +/- 1.2% in lower extremities with ASO, respectively. The normal value (range) for LSV/CSV calculated from the normal groups by the percentile method was between 4.9% and 17.8%, and the diagnostic accuracy of this value was 100% for sensitivity and 97.5% for specificity. LSV/CSV is a good index for the diagnosis of ASO and makes it possible to minimize error when expressed as an absolute value.

Arteriosclerosis Obliterans↗
PubMed1989

[A case report of IgD myeloma with acute renal failure and deposition of lambda light chain along the tubular basement membrane].

A case of IgD lambda type multiple myeloma that developed acute renal failure was presented. Histopathologic studies revealed apparent myeloma cast nephropathy with typical giant cells and light chain deposition along tubular basement membrane and inter-peritubular interstitium. Glomerular deposits of light chain were absent by electron and immunofluorescent microgram. The presented case showed a very uncommon histopathologic findings of unusual deposits of light chain, to tubulo-interstitium except for glomeruli, in addition to vertically rare IgD myeloma. A sixty-year old female who was suffered from acute renal failure and treated by hemodialysis for one month was admitted to our institute. Physical examinations revealed ill-apparent and emaciated uremic patient on admission. Laboratory and radiological studies demonstrated IgD lambda type monoclonal protein and numerous punched out appearance of skull bone. The diagnosis of IgD lambda myeloma was confirmed with aspiration bone marrow test. Anti-myeloma therapy of melphalan and prednisolone have started, however, fatal arrhythmia suddenly suffered the patient and resuscitation attempts failed to get any success one week after admission. Renal necropsy was performed and specimens were studied by light, immunofluorescent and electron microscope.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1989

[A case with polyarteritis nodosa associated with acute renal failure and pericardial cyst].

Polyarteritis nodosa (PN) is a disease characterized by vasculitis of multiple organs, and it is complications of kidney and heart are fatalistic factor. Myocardial infarction and pericarditis are well known as cardiac involvement of PN. The pericardial cysts are uncommon disease and it originated in the mesenchymal tissue during fetal life. There has been no report that pericardial cyst undergoing with PN. The present paper was the first report about case with enlargement of pericardial cyst caused by vasculitis. A 64-years old female was referred for acute renal failure and mediastinal tumor. The diagnosis of PN was confirmed with the renal biopsy showing the typically histological features of necrotizing angitis, renal angiography showing vascular irregularity in the renal arterioles and clinical features such as fever, hypertension and skin lesion. The mediastinal tumor was identified with enlargement of pericardial cyst diagnosed by computer tomography (CT) and magnetic resonance imaging (MRI), and ultrasonic cardiography (UCG) revealed pericardial effusion. Enlargement of pericardial cyst, pericardial effusion and acute renal failure were due to vasculitis as a partial manifestation of PN. Under the steroid administration, sequentially recovery of renal function and disappearance of pericardial cyst and pericardial effusion were observed.

Acute Kidney Injury↗
PubMed1989

[Urinary calcium excretion in toxemia of pregnancy].

The amount of urinary calcium excretion is an useful marker for distinction between patient with preeclampsia and normal pregnancy of chronic hypertension has been reported. This study was performed to investigate the extent and the etiology of decrease in urinary calcium excretion in toxemia of pregnancy. The subjects in this study were 20 patients with severe toxemia of pregnancy (group T) and 20 subjects with normal pregnancy (group N). In these subjects, serum calcium (s-Ca), phosphate (s-Pi) and uric acid (s-UA) and urinary calcium (u-Ca), phosphate (u-Pi) and uric acid (u-UA) were measured. The values of u-Ca and u-Pi in the group T were significantly decreased than the group N (p less than 0.001, p less than 0.01). The values of s-Ca and s-Pi made no distinction between group T and group N. There was significant relationships between u-Ca and, s-UA (r = -0.70), clearance of UA (r-0.82), Ccr (r = 0.64), and FEca: Cca/Ccr (r = 0.87). These results indicated that the decrease of u-Ca was evident in severe toxemia of pregnancy. And the decrease of u-Ca has resulted from increase of tubular reabsorption. The change of u-Ca of patients with toxemia was studied. After the onset of toxemia, u-Ca was decreased rapidly (less than 50 mg/day) and u-Ca was restored to the normal range (more than 100 mg/day) promptly after delivery. The value of u-Ca was over 100 mg/day in the second pregnancy that developed on toxemia of pregnancy among the cases who has severe toxemia in the first pregnancy. However, toxemia of pregnancy have relapsed in the case with low u-Ca excretion of less than 100 mg/day during the second pregnancy.

Calcium↗
PubMed1989

Changes in blood viscosity following nifedipine administration and its relation to the contents of adenosine triphosphate and 2,3-diphosphoglyceric acid in red blood cells in patients with angina pectoris.

The effect of oral administration of nifedipine (Adalat) on whole blood viscosity in patients with angina pectoris was investigated. Whole blood viscosity at a low shear rate of 37.5 s-1 was significantly reduced from 7.90 +/- 0.18 cP to 7.30 +/- 0.27 cP (1 cP = 1 mPa x s) after nifedipine administration (p less than 0.01), though the value at the high shear rate of 375 s-1, Casson yield stress value and Casson viscosity hardly decreased. Content of adenosine triphosphate (ATP) and 2,3-diphosphoglyceric acid (2,3-DPG) in the erythrocytes affecting blood viscosity, especially low shear rate viscosity, showed little change, and the hematocrit value was little varied either. Nifedipine, a Ca antagonist, has been known to inhibit Ca entry into the cells. These findings suggest that nifedipine reduces whole blood viscosity, especially low shear rate value, due to inhibition of Ca entry into the red blood cells, without increasing metabolic changes of ATP or 2,3-DPG in the erythrocytes, though measurement of Ca content in erythrocyte was unsolved.

2,3-Diphosphoglycerate↗
PubMed1988

Detection of impaired left ventricular function in coronary artery disease with acceleration index in the first derivative of the transthoracic impedance change.

In order to detect impaired left ventricular (LV) function in coronary artery disease (CAD) patients using acceleration index (Ac) of impedance cardiography (ICG), exercise ICG was performed in 29 patients with chest pain but without CAD (Group 1) and 21 patients with CAD (Group 2), and their resting values were compared with 30 healthy controls (Group 3). The acceleration index, which reflects indirectly aortic blood flow acceleration, was calculated as the ratio of dZ/dtmax to its accelerating time (AT). At rest, the values for Ac in Groups 1, 2, and 3 were 23 +/- 10, 15 +/- 6, and 36 +/- 13 omega/s2, respectively. There were significant differences between Group 1 versus 3, 2 versus 3, and 1 versus 2 (all p less than 0.001). At maximal exercise, Ac showed the largest percent change among the various indices used in this study. An increase of 198% for Group 2 was markedly lower than that of 250% in Group 1 (40 +/- 14 vs. 68 +/- 24 omega/s2, p less than 0.001). With a value of less than or equal to 40 omega/s2, Ac can detect the CAD patients, with a sensitivity of 62% and specificity of 90%, superior to stress ECG using CM5 lead. It is concluded that: (1) Ac is the sole index capable of distinguishing not only between the normals and diseased groups, but also between CAD patients and suspected CAD cases at rest. (2) Ac is a remarkably sensitive index for detecting impaired LV function at maximal exercise. (3) Exercise ICG is useful for predicting CAD from the population predisposing to CAD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Changes of HDL subfraction concentration and particle size by intralipid in vivo.

The effects of the artificial triglyceride-phospholipid emulsion (10% intralipid) on HDL subfraction were studied in vivo. After a 14-h fast, subjects received intralipid via a 4-h infusion. Serum lipoproteins were analyzed before and at 4 and 6 h after the start of the infusion. At 4-h the following acute changes by infusion were observed. Triglyceride, phospholipid, free cholesterol, and esterified cholesterol in chylomicrons and VLDL increased. HDL2 as well as triglyceride, phospholipid, free cholesterol and protein within the HDL2 increased, while HDL3 decreased. An increase in HDL3 triglyceride was observed. The masses of apo A-I and A-II in the HDL2 density interval rose while these parameters fell in HDL3. There were decreases of apo C-II and C-III in the HDL subfractions and elevations in chylomicrons and VLDL. The particle size of the HDL subfractions increased. However, most of these acute changes at 4 h tended to disappear by 6 h. These results suggest that there is exchange of lipids and reversible transfer of apo C-II and C-III between HDL subfractions and intralipid, and conversion of HDL3 to HDL2 followed by the reverse conversion of HDL2 to HDL3 as the synthetic emulsion is cleared from the plasma.

Adult↗