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Biomedical subjects

T Omae

Publications and source records attributed to T Omae.

At least 199 records · Page 11Linked to original sources
PubMed1985

Pharmacokinetics of a new angiotensin I converting enzyme inhibitor (alacepril) after oral dosing in fasting or fed states.

The plasma concentration and urinary excretion of a newly developed angiotensin I converting enzyme inhibitor, alacepril (which is converted to captopril after absorption), were investigated in seven normal healthy subjects. Fifty milligrams of the drug was administered orally either in the fasting or in the fed state. In the fasting state, the time of maximal plasma concentration (tmax) was 1 hour for free captopril, 1.7 hours for protein-conjugated captopril, and 1.6 hours for total captopril. The biologic t1/2 of free, protein-conjugated, and total captopril was 1.9, 4.2, and 5 hours, respectively. In the fed state, neither tmax nor t1/2 changed, except that the tmax of free captopril was prolonged to 1.9 hours (P less than 0.01). Cumulative urinary excretion of free captopril at 8 hours was 35% of the drug administered in the fasting state and that of total captopril at 24 hours was 59%. These data did not differ significantly from those obtained after food intake. The biologic t1/2 of free captopril after alacepril dosing was longer than in previous studies of captopril per se. Because biologic or clinical effects have not been studied, it should be left conjectural whether alacepril is a longer-acting angiotensin I converting enzyme inhibitor. A prolonged effect of the drug can be expected by its administration after a meal.

Administration, Oral↗
PubMed1985

Radiographic and endoscopic findings in penicillin-related non-pseudomembranous colitis.

The characteristic findings of barium enema and colonofiberscopic studies and their changes over time were investigated in 10 patients with penicillin-related non-pseudomembranous colitis. Radiographic examination within 6 days of onset revealed abnormal findings such as narrowing of the lumen, loss of haustral markings, thumb-printing, transverse ridging, and saw-toothed irregularities. These findings tended to be more pronounced on the right than on the left side of the colon. Endoscopy revealed lesions characterized by mucosal reddening, edema, and hemorrhage, without definite ulceration or erosion. In 5 of the 10 patients, non-continuous distribution of the lesions was noted. In 4 patients, the rectum was unaffected. Reversion to normal occurred within an average of 15.7 days following onset of the symptoms. Thus, for an accurate diagnosis of this disease, barium enema and/or total colonoscopy should be performed within 6 days of onset.

Adolescent↗
PubMed1985

Clinicopathological study of the heart and coronary arteries of autopsied cases from the community of Hisayama during a 10-year period. Part V. Comparison of autopsy findings with electrocardiograms--Q.QS items of the Minnesota Code.

In a longitudinal study of a general population in Hisayama, Japan, 339 persons aged 40 years or over at death were autopsied during the period November 1, 1961-October 31, 1971. In 308 of these people, electrocardiograms taken at the periodic examinations were available, and Q.QS items of the Minnesota Code were recorded in 49 persons. The sensitivity of item 1-1 to autopsy-proven old myocardial infarction was 0.32 and the specificity was 0.95. Using the estimated prevalence of old myocardial infarction in this community--77 per 100,000--the proportion of persons without old myocardial infarction among those with item 1-1 in the general population (PF+) was 0.9954 and the proportion of persons with old myocardial infarction among those without item 1-1 (PF-) was 0.0005. The sensitivity of items 1-1 and 1-2 to old myocardial infarction was 0.43 and the specificity was 0.94. PF+ of items 1-1 and 1-2 was 0.9949 and PF- was 0.0005. These large values of PF+ mean that more than 99 per cent of persons with these items are probably false positives if these items are used as a screening test for this disease in the general population of this community, i.e., that these items cannot be defined as a definite myocardial infarction.

Aged↗
PubMed1985

Rapidly progressive renal deterioration in partially nephrectomized rats with experimental membranous nephropathy.

The effects of nephron loss on the clinical and histological picture of experimental membranous nephropathy were examined for 18 weeks in five-sixths nephrectomized rats with Heymann nephritis (HN-5/6N group). Heymann nephritis-induced rats without nephrectomy (HN group), normal rats with 5/6 nephrectomy (5/6N group) and normal rats without nephrectomy (control group) were also examined for comparison. A rapidly progressive increase in urinary protein, BUN and serum creatinine was observed after renal ablation in the HN-5/6N group. Light microscopic study revealed global or segmental sclerosis in most of the glomeruli, crescent formation in some of the glomeruli and marked tubulointerstitial changes. Electron microscopic study demonstrated vacuolation and necrosis of podocytes, detachment of podocytes from the glomerular basement membrane (GBM) and fibrin exudation into Bowman's space. Proteinuria was also marked but renal function was not impaired in the HN group. In the 5/6N group, proteinuria was mild and elevation in BUN and serum creatinine was apparent but not progressive. There were no differences in the depositions of IgG, C3 and electron-dense materials on GBM between the HN-5/6N group and the HN group. In conclusion, renal mass reduction associated with high flow and pressure to the remnant glomeruli could lead to extensive glomerular sclerosis and to a deterioration in renal function, in the case of pre-existing nephritic lesions.

Animals↗
PubMed1985

Neurogenic hypertension in the Guillain-Barré syndrome.

We report a case of Guillain-Barré syndrome associated with hypertension. The hypertension was related to glossopharyngeal and vagal nerve impairment. Plasma noradrenaline concentration (NA) and plasma renin activity (PRA) were elevated. The possible mechanism of the neurogenic hypertension produced by the sino-aortic denervation is discussed.

Adolescent↗
PubMed1985

Pathophysiology and outcome of hypertensive subjects.

Pathophysiology, outcome and some therapeutic problems of hypertension were described. Frequency of secondary hypertension and its underlying diseases in a hypertensive population greatly varied by study population. In the adult general population (Hisayama study) it was estimated to be 3.8%. Significance of various tests was evaluated in the diagnosis of renovascular hypertension and primary aldosteronism. Consideration of sodium balance in the evaluation was very necessary. The usefulness of captopril test was emphasized. Blood pressure was tended to decrease in upright posture and ambulation in cases with essential hypertension responding to acute sodium depletion by a significant reduction in blood pressure. In the observation of diurnal rhythm of urinary sodium excretion, the peak phase appeared about 3 hours earlier in essential hypertension than in normal control and 5 to 6 hours later in primary aldosteronism and Cushing syndrome. Sympathoadrenal function was activated in young borderline hypertensives but not in middle-aged ones. Outcome of hypertension accompanying diabetes mellitus was poor. Cardiovascular disease and renal failure occurred much frequently. Significance of hypertension as a risk factor of cardiovascular disease was described based on the data obtained through prospective epidemiological study (Hisayama Study). Hypertension was significantly correlated with stroke but not with myocardial infarction. Serum cholesterol level did not significantly correlate with both stroke and myocardial infarction. Reduction in stroke incidence in recent years was described in relation to the changes in risk factors of cardiovascular diseases. Pathophysiology and outcome of malignant hypertension (KW III-IV) were described in relation to underlying disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Effect of blood pressure on the progression rate of renal impairment in chronic glomerulonephritis.

An effect of high blood pressure on the progression of renal functional deterioration was studied in 23 cases of chronic glomerulonephritis, which showed progressive renal functional impairments during the long-term follow-up period. The slope-of-regression line, which was obtained from the relation between reciprocal serum creatinine concentration (1/Cr) and observation time, was expressed as a progression rate and was evaluated on an association with blood pressure level. The progression rate was found to correlate significantly with the level of diastolic blood pressure (p less than 0.001). It is concluded that the elevation of blood pressure is one of the factors that contribute to the progression of renal functional impairment in chronic glomerulonephritis.

Adult↗
PubMed1985

Role of renin angiotensin aldosterone on minimal change nephrotic syndrome.

Plasma volume (PV), plasma renin activity (PRA) and plasma aldosterone (PA) were examined serially at the edema forming stage, the stage of diuresis, and the stage of remission in 11 patients. These patients were steroid responsive, minimal change nephrotic syndrome with normal kidney function. PV was expressed as a percentage of the normal reference value, which was obtained from PV and body height in 44 normal volunteers. PV decreased significantly at the edema-forming stage and increased at the stage of the diuresis. A significant inverse correlation was obtained between PV and PRA. PRA correlated significantly with PA. The amount of 24 hour urinary sodium excretion severely reduced at the edema-forming stage and increased at the stage of diuresis: thus showing a significant inverse correlation with PA. In conclusion, renin-angiotensin-aldosterone system plays a role as a compensatory mechanism to the intravascular volume status in minimal change nephrotic syndrome, but, its' contribution to the genesis of edema is unsusceptible.

Adolescent↗
PubMed1984

[A simple radioimmunoassay determination of urinary aldosterone using 125I-labeled ligand [ALDOCTK-125KIT] and its clinical application].

A method of radioimmunoassay for urinary aldosterone excretion (AER) using 125I-labeled ligand [ALDOCTK-125KIT] is described. The sensitivity, specificity, reproducibility and accuracy of this method were compared with the 3H-RIA method previously reported. Since the extraction method using ALDOCTK-125KIT was considered to be preferable to the direct method, the former method was applied to the present study. An excellent correlation was found between the values determined by the 3H-RIA method and the extraction method (r = 0.935, p less than 0.001, Y = 0.89X + 0.80, n = 146). The within-assay and the between-assay coefficient of variation was 7.7--15.0% and 9.7--12.2%, respectively. As a clinical application, the circadian variation of AER was investigated in 5 control subjects and groups of essential hypertension (EHT), primary aldosteronism (PA), chronic glomerulonephritis (CGN) and Cushing's syndrome, each of which consisted of 5 patients, all of which had serum creatinine concentrations of less than 1.2 mg/dl. Under a control diet containing 10 g of salt per day, urine was collected in 4-hour pools starting at 8:00 for the ensuing 24 hours, and AER was determined by means of both 3H-RIA and the extraction method. The difference of the values between the peak and the nadir in each subject was statistically significant, and marked and identical circadian variations of AER with the peak and the nadir at the period of 4:00 to 12:00 and 20:00 to 4:00 were observed in the control, EHT, PA and CGN groups. In the Cushing group, however, the circadian variation of AER was different from the other 4 groups: the peak and the nadir of AER occurred at the period of 20:00 to 24:00 and 4:00 to 8:00, respectively. The circadian variation of AER became more obvious in all groups including the Cushing, when each value was expressed in the percentage of the mean. AER under the control diet was 9.38 +/- 2.04 micrograms/day in the control subjects. In PA and CGN, AER was significantly higher, and in the Cushing group, it was significantly lower than that observed in the control. However, no difference was found in AER between the control and EHT. AERs in both 4-hour and 24-hour urine specimens measured by ALDOCTK-125KIT were consistent with those by the 3H-RIA method.

Adolescent↗
PubMed1984

Cerebrospinal fluid lactate and pyruvate concentrations in patients with malignant hypertension.

Lactate and pyruvate concentrations and acid-base parameters in cerebrospinal fluid (CSF) and arterial blood were measured in 21 patients with malignant hypertension ( MHT ), 19 with benign hypertension (BHT) and 21 normotensive subjects (NT). Average values for CSF lactate and lactate/pyruvate (L/P) ratio were significantly higher in MHT (1.90 +/- 10 mM/1, 19.2 +/- 1.0) than in either BHT (1.50 +/- 0.05 mM/l, 15.7 +/- 0.7) or NT (1.44 +/- 0.04 mM/1, 15.7 +/- 0.4). There was a linear correlation between CSF lactate and CSF pressure (r = 0.565, P less than 0.01), and the latter was also related to mean arterial pressure exceeding 150 mm Hg (r = 0.553, P less than 0.01). Such increases in the acid metabolites in CSF indicate that brain metabolism becomes anaerobic in MHT , probably due to increased intracranial pressure. Increased cerebrovascular permeability is also discussed as participating in causal mechanisms.

Adult↗
PubMed1984

Natural history of borderline hypertension in the Hisayama community, Japan--I. The relative prognostic importance of transient variability in blood pressure.

Long-term prognosis of borderline hypertensives was studied in a prospective population survey carried on since 1961 in the town of Hisayama, Japan. Five consecutive BP recordings on 1621 subjects aged 40 and over were obtained at entry, and the variability in BP between the first and fifth readings was taken into account when classifying the subject into categorical groups. Even with an estimated variability in BP in several measurements on one occasion, a large fluctuation in BP was observed in both the borderline hypertensives and the normotensives. Borderline hypertensives with a transient elevation in BP more frequently died from cardiovascular disease than did those without BP elevation, as estimated by the long-term cumulative mortality. However, there was no difference in the frequency of hypertension-related organ damage between these two groups at entry.

Adult↗
PubMed1984

Factors influencing the healing rate of gastric ulcer in hospitalised subjects.

A multiple linear regression analysis was carried out on 75 inpatients with gastric ulcer. In order to elucidate the effects of various factors - endoscopic and roentgenological findings, age, sex, medical history, and drugs such as antacids, anticholinergics or both - on the healing rate, these factors were compared between those with ulcer which healed within eight weeks after treatment and those which did not. In patients over 50 years of age, alcohol consumption of over 60 g per day until admission, duration of present ulcer pain for over three months, single ulcer, ulcer located in the lesser curvature and uneven elevation around the ulcer, there was significant delaying effect on ulcer healing. Drug ingestion, sex, smoking habits until admission, size, depth, and shape of ulcer, coexisting gastritis, and past and family history of ulcer disease had no significant effect on healing after eight weeks. The patients with less than two unfavourable factors (n = 46) had the best healing rate (100%) compared with those with three (n = 20) or four or more (n = 9) unfavourable factors. The healing rate of the latter two groups was 60% and 22%, respectively (p less than 0.001). A prognostic score based on these six factors represents the severity of gastric ulcer disease with regard to the healing rate in patients prescribed antacids, and/or anticholinergic drugs.

Adult↗
PubMed1984

Renal amyloidosis associated with crescentic glomerulonephritis.

A case of renal amyloidosis coincidentally associated with crescentic glomerulonephritis is described. A 59-year-old female with 30 years' history of rheumatoid arthritis developed nephrotic syndrome followed by rapid deterioration of renal function. Among 28 glomeruli in a kidney biopsy specimen, glomerular amyloid deposition was present in 17 and crescent formation in 20. Only one glomerulus was free from amyloid deposition or crescent. The amyloid deposition was clearly demonstrated by congo red, thioflavin-T staining as well as electron-microscopic examination. Glomerular deposition of immunoglobulins and/or complements were not noted. While cyclophosphamide, dipyridamole, and heparin followed by pulse methylprednisolone were given, the renal function deteriorated progressively and dialysis was initiated. Renal function, however, recovered partially without medication after peritoneal dialysis of 3 months' duration. The second renal biopsy revealed the progression of glomerular amyloid deposition and the increase in fibrous component of crescent.

Amyloidosis↗