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Biomedical subjects

T Kamada

Publications and source records attributed to T Kamada.

At least 703 records · Page 39Linked to original sources

Effects of spontaneous respiration on right and left ventricular function: evaluation by respiratory and ECG gated radionuclide ventriculography.

To clarify the mechanism of inspiratory reduction of left ventricular (LV) stroke volume (SV) during spontaneous respiration, we measured right and left ventricular volume changes from expiration to inspiration using radionuclide ventriculography with respiratory gating technique. In this method, scintigraphic data were acquired in a list mode with ECG R wave triggers and respiratory volume curve derived from respiratory flowmeter. Cardiac cycles occurring during the second halves of inspiratory and expiratory phases were separately selected and used to produce multigated images for the respective phases. Twelve patients with normal LV ejection fraction (EF) (greater than 50%) and right ventricular (RV) EF (greater than 40%) and without pulmonary diseases were studied. LV end-diastolic volume (EDV) decreased during inspiration in all subjects (by 11 +/- 5%), whereas LV end-systolic volume (ESV) was insignificantly changed. Accordingly, LVSV decreased during inspiration in all subjects (by 17 +/- 7%). LVEF decreased from 64 +/- 6% during expiration to 60 +/- 6% during inspiration (p less than 0.001). In contrast to the left ventricle, RVEDV and RVSV increased during inspiration by 13 +/- 11% and 22 +/- 18%, respectively. RVESV did not change significantly. RVEF increased from 48 +/- 6% during expiration to 52 +/- 5% during inspiration (p less than 0.05). These results indicate that inspiratory reduction of LVSV during spontaneous respiration is due to a decrease in LVEDV which may be derived from an increase in RVEDV during inspiration through the mechanism of ventricular interdependence.

Aged↗

The role of radiotherapy in the management of maxillary sinus carcinoma.

From 1971 to 1983, a total of 208 patients with maxillary sinus carcinomas were treated at Department of Radiology, Hokkaido University School of Medicine, 38 by Method I (radiation + surgery + intraarterial 5-fluorouracil [5-Fu] infusion), and 170 by Method II (radiation + surgery). Radiation doses ranged from 30 to 50 Gy over 3 to 5 weeks in Method I and 52 to 58 Gy over 4 weeks in Method II. Overall actuarial survival rate at 5 years was 45.6%. No statistical difference in survival rates was found between Method I and Method II. With respect to T stage, absolute 5-year survival rates were 100% (4/4) for T2, 49.5% (52/105) for T3, and 24.4% (11/45) for T4. From our data, no advantage in the use of intra-arterial 5-Fu infusion was demonstrated; the local failures in Method I developed earlier and more frequently than in Method II. The ultimate failures for all patients were 46.8%. Since 1980 when treatment planning by using computerized tomography scans and immobilization device was initiated, improvement in survival rate while reducing an incidence of eye complications has been accomplished.

Adult↗

Gentamicin inhibits Na+-dependent D-glucose transport in rabbit kidney brush-border membrane vesicles.

We studied the effect of gentamicin on Na+-dependent D-glucose transport into brush-border membrane vesicles isolated from rabbit kidney outer cortex (early proximal tubule) and outer medulla (late proximal tubule) in vitro. We found the same osmotically active space and nonspecific binding between control and gentamicin-treated brush-border membrane vesicles. There was no difference in the passive permeability properties between control and gentamicin-treated brush-border membrane vesicles. Kinetic analyses of D-glucose transport into 1 mM gentamicin-treated brush-border membrane vesicles demonstrated that gentamicin decreased Vmax in the outer cortical preparation, while it did not affect Vmax in the outer medullary preparation. With regard to Km, there was no effect of gentamicin in any vesicle preparation. When brush-border membrane vesicles were incubated with higher concentrations of gentamicin, Na+-dependent D-glucose transport was inhibited dose-dependently in both outer cortical and outer medullary preparations. Dixon plots yield inhibition constant Ki = 4 mM in the outer cortical preparation and Ki = 7 mM in the outer medullary preparation. These results indicate that the Na+-dependent D-glucose transport system in early proximal tubule is more vulnerable to gentamicin toxicity than that in late proximal tubule.

Animals↗

Two distinct calcitonin gene-related peptide-containing peripheral nervous systems: distribution and quantitative differences between the iris and cerebral artery with special reference to substance P.

The present study first shows that calcitonin gene-related peptide(CGRP)-like immunoreactive (CGRPI) nerve fibers in the cerebral arteries contained substance P (SP) and originated from small- to medium-sized CGRPI cells exhibiting SP immunoreactivity (SPI) in the trigeminal ganglion. The iris contained CGRPI/SPI-costorage nerve fibers and many CGRPI fibers lacking SPI. These fibers originated from large CGRPI cells lacking SPI in the trigeminal ganglion. The heterogenous subpopulations of CGRPI fibers in the iris suggest that CGRP is involved in a variety of functions in this structure.

Animals↗

Origins and distribution of calcitonin gene-related peptide-containing nerves in the wall of the cerebral arteries of the guinea pig with special reference to the coexistence with substance P.

The origins and overall distribution of calcitonin gene-related peptide-like immunoreactivity (CGRPI) in the wall of the cerebral arteries were investigated in the guinea pig by using whole-mounts. Two types of CGRPI fibers were seen; one forming dense fiber bands, located among the periadventitial nerves, and the other forming a meshwork. CGRPI fibers in the periadventitial nerves often leave these nerves to form a meshwork, of a density that varies according to the diameter or location of the blood vessel. The present study showed that CGRPI fibers in the walls of the carotid arterial system originated from the trigeminal ganglion, and those in the vertebrobasilar arterial system from other origins besides the trigeminal ganglion. We also examined the coexistence of this peptide with substance P-like immunoreactive (SPI) structures in a single neuron system. Double staining immunocytochemistry showed that the patterns of the running of CGRPI and SPI fibers in the wall of the cerebral arteries were similar, and this method also demonstrated the presence of neurons containing both CGRPI and SPI structures in single cells of the trigeminal ganglion, which is the major origin of these fibers in the cerebral arteries.

Animals↗

Hepatic microcirculation in Zucker fatty rats.

We have developed a microscopic analyzing system for studying in vivo hepatic microcirculation, and measured the sinusoidal erythrocyte flow velocity simultaneously in the various sinusoids. With this system and organ reflectance spectrophotometry, the pathophysiological role of microcirculation and of energy metabolism in Zucker fatty rats were studied. The results were as follows: The erythrocyte flow velocity in the predominant sinusoids in the fatty rats was similar to that of the control rats, but the intersinusoidal erythrocyte flow was undetected in the fatty liver. Index of regional hepatic blood volume, regional hepatic blood flow and oxygen saturation of Hb decreased significantly in the fatty rats. The estimated in vivo oxygen consumption was not changed in the fatty liver. From these data, it is concluded that in Zucker fatty rats a marked fatty infiltration causes a decreased hepatic tissue blood flow and volume, but relatively homogeneous erythrocyte flow with an increased extraction of oxygen compensated the decreased vascular beds and maintained normal energy metabolism.

Animals↗

Imaging platelet deposition on Dacron bifurcation grafts in man: quantification by a dual-tracer method using 111In-labeled platelets and 99mTc-labeled human serum albumin.

A dual tracer technique using 111In-labeled platelets and 99mTc-labeled human serum albumin was applied to evaluate the thrombogenicity of Dacron bifurcation arterial grafts. The level of platelet accumulation over the whole of the graft was estimated from the ratio of 111In-platelet radioactivity deposited on the vascular wall to these radioactivity circulating in the blood pool, i.e., the platelet-accumulation index (PAI). Furthermore, the PAI value was calculated for each pixel in digitized images and the PAI distribution image (PAI image) was reconstructed. Eighteen patients with DeBakey knitted Dacron bifurcation grafts and 11 normal volunteers were studied. Of the 18 patients, 11 had no graft occlusion (group I) and the remaining 7 (group II) had occlusion. The mean PAI value (+/- SD) over the whole of the graft in group I was 32.6% +/- 33.7% as compared to -8.8% +/- 4.5% in the control group (P less than 0.01). In group I, the PAI value over the entire graft decreased with the age of the graft (r = -0.763; P less than 0.01). In contrast, in group II, platelet accumulation did not diminish with time and persisted beyond the time of which platelet accumulation was no longer found in group I. Moreover, analysis of the PAI images revealed enhanced platelet accumulation on the proximal part of the graft to be more frequent in group II than in group I (6/7 vs 0/11; chi 2c = 10.55; P less than 0.005). The method used for platelet imaging in the present study may be useful in the study of platelet reactions on Dacron arterial prostheses.

Aged↗

High frequency of class 3 allele in the human insulin gene in Japanese type 2 (non-insulin-dependent) diabetic patients with a family history of diabetes.

The restriction fragment length polymorphism in the 5' flanking region of the human insulin gene was studied in 155 nonobese Japanese subjects. The subjects consisted of 36 Type 2 (non-insulin-dependent) diabetic patients with a family history of diabetes mellitus, 42 Type 2 diabetic patients without a family history of diabetes, 42 Type 1 (insulin-dependent) diabetic patients, and 35 healthy volunteers who served as control subjects. It was demonstrated that, in Japanese healthy subjects and diabetic patients, the incidence of the insertion into 5' flanking region of the insulin gene was found to be significantly lower (p less than 0.05) than those in Caucasians and other races already investigated. Even though the class 3 gene allelic frequency in Type 2 diabetic patients without a family history of diabetes (0.060) was not higher than that in healthy subjects (0.014), in nonobese Type 2 diabetic patients with a family history of diabetes the allelic frequency of the inserted class 3 gene (0.111) was found to be significantly higher (p less than 0.02) than that in control subjects. These data suggest that the insulin gene polymorphism relates to the aetiology of diabetes mellitus.

Adult↗

Estimated hepatic oxygen consumption in patients with chronic liver diseases as assessed by organ reflectance spectrophotometry.

We investigated the estimated hepatic oxygen consumption by reflectance spectrophotometry during peritoneoscopy and the rate of in vitro oxygen consumption of liver slices obtained by liver biopsy using the oxygen electrode apparatus in patients with chronic liver diseases. The estimated hepatic oxygen consumption decreased concomitantly with the decrease in blood supply, expressed as the regional hepatic blood hemoglobin concentration, and it was significantly decreased in cirrhosis compared to chronic hepatitis. The estimated hepatic oxygen consumption also was significantly correlated with the serum albumin level, 15-min retention rate of indocyanine green, and prothrombin time. There was no correlation between the estimated hepatic oxygen consumption calculated from the reflectance spectra and the rate of in vitro oxygen consumption measured by the oxygen electrode apparatus. Most cirrhotic liver slices had a respiratory rate comparable to that in chronic hepatitis. Thus, it is concluded that the reduction of estimated hepatic oxygen consumption in cirrhosis of the liver is mainly due to the reduction of oxygen supply secondary to the decrease of hepatic blood flow.

Adult↗

Hemodynamics of the gastric mucosa and gastric ulceration in rats and in patients with gastric ulcer.

The microcirculation is the fundamental nutrient supply and waste removal system of all tissues. Recent improvements in spectrophotometric technique have made possible the noninvasive assessment of oxygen supply and utilization in the gastric mucosa. The authors have utilized such methods to assess gastric mucosal hemodynamics. The technique permitted further clarification of the roles of the gastric microcirculation, mucosal oxygenation, and acid secretion in the pathogenesis of stress ulcers in the stomach of rats. Furthermore, it provided important information on the function of gastric mucosal hemodynamics in the healing of gastric ulcers in man. The technique is described along with the authors' correlation studies between spectrophotometric data and other techniques for measuring gastric blood flow (hydrogen gas clearance and aminopyrine clearance methods and direct electromagnetic flowmeter techniques) and the prevention of ulcerogenesis.

Animals↗

Oral OPC-8212 for the treatment of congestive heart failure: hemodynamic improvement and increased exercise capacity.

The chronic effects of the oral administration of OPC-8212 (3,4-dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2(1H)-quinolinon e) on resting hemodynamics and exercise capacity were assessed in 15 patients with congestive heart failure (NYHA II-IV). Doses of 30 or 60 mg per day were given per os over 3.0 weeks on average (range 2-6 weeks). Multigated radionuclide ventriculography and multistage exercise testing were performed before and during OPC-8212 therapy to assess the changes in left ventricular volume and exercise capacity respectively. Systolic blood pressure showed a slight increase (from 123 +/- 3 to 129 +/- 4 mmHg) during OPC-8212 therapy, while heart rate was unchanged (69 +/- 3 vs 67 +/- 3 beats/min). The left ventricular end-diastolic volume index decreased from 127 +/- 9 to 107 +/- 7 ml/m2, and ejection fraction and the P/V index (the ratio of peak systolic pressure to left ventricular end-systolic volume index) increased during OPC-8212 therapy (from 27% +/- 3% to 30% +/- 4% and from 1.5 +/- 0.2 to 2.0 +/- 0.3 mmHg/ml/m2 respectively). NYHA functional class was improved in 9 of 15 patients, and the average peak work load achieved during exercise testing increased from 27 +/- 6 to 47 +/- 7 W. No significant adverse effect was observed in any patient. These results indicate that OPC-8212 enhances the inotropic state and, hence, reduces heart size with no change in heart rate. Moreover, it increases exercise capacity. Thus, OPC-8212 is an inotropic agent with promise for application in the long-term treatment of congestive heart failure.

Administration, Oral↗

Echo-Doppler velocimeter in the diagnosis of hypertensive patients: the renal artery Doppler technique.

The renal blood flow velocity characteristics in 8 normal controls, 19 essential hypertensive patients and 8 hypertensive patients with renovascular disease were evaluated using echo-Doppler velocimetry. Two different approaches for ultrasonic detection of the renal artery, the translumbar and the transabdominal approach, were used. Renal Doppler sonograms were analyzed by measuring the acceleration index and the peak-systolic frequency/end-diastolic frequency (S/D) ratio. Renovascular patients who required surgery were examined before and after angioplasty. Doppler signals could be detected in all 35 subjects by using the translumbar approach. The acceleration index of the affected renal arteries significantly correlated to the percent stenosis of the renal artery determined by angiography. The acceleration index in the affected renal artery was improved by surgical treatment. The S/D ratio in essential hypertensives was significantly higher than that in the normal controls. There was a significant inverse correlation between the S/D ratio and creatinine clearance. Echo-Doppler velocimetry is considered to be useful in the diagnosis of renovascular disease and also in the evaluation of abnormalities of renal vascular resistance in hypertensive patients.

Adolescent↗

Role of adenosine in hyperemic response of coronary blood flow in microembolization.

To investigate the pathophysiology of acute embolization of small coronary vessels and the role of adenosine in this abnormality, regional coronary blood flow (CBF), coronary vascular resistance, arteriovenous O2 difference, lactate extraction ratio, and adenosine release were studied in 39 anesthetized open-chest dogs after acute coronary embolization with microspheres of three different diameters (15 +/- 1, 94 +/- 8, and 293 +/- 23 microns). In 16 dogs, the left anterior descending coronary artery was embolized by repetitive injections of 15-microns microspheres, up to 4.4 +/- 0.4 X 10(5)/g myocardium; at this point CBF, determined by the electromagnetic flowmeter at the proximal site of the artery, was reduced toward zero. Up to 37% of total embolization, resting CBF increased to 175 +/- 36% of control; thereafter it decreased almost linearly as the extent of embolization was increased. After embolization, coronary arteriovenous O2 difference was significantly (P less than 0.01) decreased with a marked release of adenosine in the coronary vein. Despite a hyperemic flow response of CBF in the embolized area, myocardial ischemia was not prevented; maximal increase in CBF after 100-microns microsphere embolization (141 +/- 11% of control CBF, n = 6) was significantly (P less than 0.05) less than that in 15-micron microsphere embolization, whereas 300-microns microsphere embolization minimally increased CBF (123 +/- 13%, P greater than 0.1; n = 5). Hyperemic flow remained unchanged for at least 3 h when adenosine was persistently released. Theophylline significantly attenuated this response. These results indicate that in embolization with microspheres less than 300 microns in diameter, hyperemic response of coronary blood flow occurs, probably due to the hyperemia of nonoccluded vessels in the adjacent area of ischemic foci to adenosine released from the ischemic myocardium.

Adenosine↗