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Biomedical subjects

T Sekihara

Publications and source records attributed to T Sekihara.

34 records · Page 2Linked to original sources

Effect of captopril on plasma prolactin in patients with essential hypertension.

The effects of the angiotensin-converting enzyme inhibitor captopril on blood pressure, heart rate, plasma prolactin, and renin activity were examined in a single-blind, placebo-controlled trial on 30 patients with essential hypertension (15 given drug, 15 placebo). Captopril, 25 mg administered orally, reduced the blood pressure and increased the plasma renin activity. Captopril decreased mean plasma prolactin from 17.5 +/- 1.4 ng/mL to 9.1 +/- 1.0 ng/mL (p less than 0.001). Significant correlation was found between captopril-induced change from control values of plasma prolactin (delta plasma prolactin) vs delta plasma renin activity (r = -0.688, p less than 0.001). These results suggest that acute administration of captopril was accompanied by a reduction in plasma prolactin and that this reduction may be of clinical significance during therapy of hypertension.

Adult↗

[Transitional cell carcinoma of the ureter with an inverted growth pattern which was accompanied with bladder tumor: a case report].

The patient was a 75-year-old man who complained of macrohematuria which had set in from April 12, 1988. Under the clinical diagnosis of bladder tumor, total cystectomy with ureterosigmoidostomy was performed on June 25. During his surgery, we discovered a polypoid lesion of the right ureter close to the common iliac artery. The tumor was peanut-sized and had a stalk suggesting benign nature, so we resected it. Postoperative pathological examination revealed the tumor was transitional cell carcinoma (grade 2) with an inverted growth pattern. Though we could find no signs of tumor recurrence, the presence of tumor's residuum could not be ruled out. We performed nephroureterectomy of the right side on December 19. Follow-up on July 1, 1989 this patient revealed no tumor recurrence.

Aged↗

[Unilateral hydronephrosis with hypertension due to ureteral endometriosis].

A 35-year-old female patient was hospitalized for a headache. She was referred to our department for the evaluation of right hydronephrosis noted on the excretory urogram which was performed as part of a hypertensive diagnostic study. Endocrine examination revealed renal hypertension. Excretory urogram and antegrade pyelography showed obstruction of the lower part of the right ureter. On surgical exploration, the lower part of the right ureter was surrounded by brown tissue. Complete hysterectomy and ureterovesiconeostomy were performed. Histologically, the brown tissue around the ureter was diagnosed as endometriosis. One year after the operation, excretory urogram showed normal urinary tract and the blood pressure was 130/80 mmHg. Endometriosis is a common gynecological disease but ureteral endometriosis is relatively rare. Review of the Japanese literature disclosed 16 previous cases of ureteral endometriosis and we report the 17th case with a review of the literature.

Adult↗

[Left ventricular function after prolonged exercise].

To determine whether depressed left ventricular (LV) contractile function can occur after exhaustive exercise, echocardiographic studies were performed in eleven athletes before, at the finish (9 minutes) and during recovery (15 hour) after the Biwa Lake Ironman Triathlon (3.2 km Swim, 161 km Bike, 32 km Run). Before racing and during recovery, the studies were performed both at rest and after brief exercise (10-15 minutes). Heart rates after brief exercise were comparable to those attained after racing. Digitized M mode echocardiographic data as to wall thickness, cavity dimension, fractional shortening (FS) and peak circumferential shortening (maxVcf) were obtained. When we compared race finish to pre-race brief exercise, the LV end-diastolic dimension (EDD) was reduced (46 +/- 7 vs 47 +/- 6 mm, less than 0.05) and FS declined (33 +/- 5 vs 39 +/- 6%, p less than 0.05). In spite of reduced wall stress, maxVcf decreased. Individual percent reductions in FS were not correlated with decrease in EDD, but correlated with increases in EDS. Although a persistent reduction in cavity size was observed during recovery, FS and maxVcf returned toward the baseline. The results suggest that prolonged strenuous exercise may result in impaired LV function in part because of a reversible depression in the contractile state.

Adult↗

[Retroperitoneal lymph node dissection for testicular tumor with renal autotransplantation: a case report].

A case of testicular tumor (embryonal cell carcinoma with choriocarcinoma) in a 42-year-old man treated with renal autotransplantation is presented. After four courses of chemotherapy (carboplatin, vinblastine and bleomycin), we performed retroperitoneal lymph node dissection. At the operation, one of the swelling lymph nodes involved left renal artery completely, so we performed left renal autotransplantation and promoted more effective lymph node dissection. After the operation, renal function was impaired but returned completely in a short time. Autotransplantation provides excellent bench visualization of renal lesions and stable graft function. Therefore, this procedure should be taken into consideration when nephrectomy cannot be avoided.

Adult↗

[Vesicorectal fistula associated with Crohn's disease: a case report].

A 41-year-old man was hospitalized, complaining of fecaluria and right lower abdominal pain. He was diagnosed to have vesicorectal fistula. Wedge resection of bladder and rectum, and partial resection of ileocecal legion were performed. Pathological diagnosis was Crohn's disease. Postoperative course was uneventful and no recurrence was observed. Including our case, 32 cases of enterovesical fistula due to Crohn's disease have been reported in the Japanese literature.

Adult↗

Increased sympathetic nerve activity at home in young subjects with hypertension.

Plasma and urine norepinephrine, epinephrine, plasma renin activity and aldosterone were measured in 11 young men (mean age, 21 years) with a high blood pressure in the clinic who maintained a high home blood pressure and 12 men with an elevated clinic blood pressure who had a normal home blood pressure. Plasma samples were drawn following 30 min rest in the clinic, and 24-hour urine samples were collected at home. The two groups of hypertensives could not be distinguished on the basis of clinic blood pressure, plasma norepinephrine, epinephrine, renin activity or aldosterone. Patients with a high home blood pressure were characterized by a high urinary norepinephrine excretion. These results suggest that the patients whose blood pressure remained elevated at home had an increased sympathetic nerve activity at home.

Adolescent↗

Blood pressure response to a calcium entry blocker in normotensive subjects with or without a family history of hypertension.

The possibility that a familial background of hypertension might influence the blood pressure response to a calcium entry blocker was evaluated in 15 normotensive relatives of patients with essential hypertension and 18 normotensive subjects with no family history of hypertension. Under control conditions, blood pressure, heart rate, plasma noradrenaline, adrenaline, and renin activity did not differ between the two groups. Nifedipine, at a dose of 10 mg administered sublingually, lowered the blood pressure and increased the heart rate, plasma noradrenaline, and renin activity. The normotensive relatives of patients with essential hypertension did not differ in their responses from the normotensive subjects with no family history of hypertension, with the exception of plasma noradrenaline thirty minutes after nifedipine. These results provide evidence to suggest that there is no functional abnormality with increased dependency of vascular smooth muscle tone on calcium influx in the prehypertensive state.

Adult↗

[Study of voiding disturbances in elderly males. III. Analysis of flow rates and patterns in uroflowmetric studies: comparison between children, young adults and elderly men].

We performed uroflowmetric study in 8 boys (7 approximately 14 years old), 20 young adults (19 approximately 39 years old) and 552 elderly men (40 approximately 93 years old) with a DISA 21C10 mictiometer, and obtained 753 studies. Uroflowmetric studies were classified into 6 patterns: N type (normal), NB type (neurogenic bladder: wave-like curve), OB type (obstructive diseases: flat curve), AP type (anterior peak), PP type (posterior peak) and OT type (others). We studied the relationship between age and uroflowmetry with patterns and flow rates (maximum flow rate = MFR, average flow rate = AFR). In men over 19 years old, flow rates (MFR, AFR) decreased proportionally with age (MFR: 2.9 ml/s/10 years old, AFR: 1.6 ml/s/10 years old). In elderly men (over 40 years old), the N type flow curve decreased and OB type flow curves increased gradually with age.

Adolescent↗

Urinary dopamine excretion in normotensive subjects with or without family history of hypertension.

To define the role of the renal dopaminergic system in the pathogenesis of essential hypertension, urinary free dopamine excretion was examined in 23 normotensive subjects who had one or more first-degree relatives with essential hypertension, and also in 36 matched control subjects without any such family history. The group urinary dopamine excretion and urinary sodium excretion were not different. However, a significant urine dopamine-sodium relationship was apparent in the controls but not in the relatives due to relatively high dopamine output in those with lower sodium excretion. The two groups were similar as regards blood pressure (BP), plasma renin activity (PRA), prolactin and catecholamines. These findings demonstrate an alteration in the urine dopamine-sodium relationship in some normotensive subjects with genetic risk of hypertension.

Adult↗

Effect of a calcium entry blocker on blood pressure, plasma renin activity, aldosterone and catecholamines in normotensive subjects.

The effects of the calcium entry blocker nifedipine on blood pressure, heart rate, plasma renin activity, aldosterone, noradrenaline and adrenaline were studied in 23 normotensive subjects in the supine and upright positions. Nifedipine, 10 mg administered sublingually, lowered mean blood pressure and increased heart rate, plasma noradrenaline and renin activity without increasing plasma aldosterone in the supine position. The increase in plasma aldosterone in response to upright posture was inhibited by nifedipine, whereas the rise in plasma noradrenaline was augmented. These results suggest that intracellular calcium is important as a regulator of aldosterone secretion as well as of vascular tone in normotensive subjects.

Adolescent↗

A case of malignant hemangioendothelioma of the stomach.

A case of malignant hemangioendothelioma of the stomach is reported. The patient was a 21-year-old female who developed bloody stool. Pathological studies on the stomach revealed a gastric submucosal tumor. This tumor was growing on the outside of the stomach wall and formed a large abdominal mass. Evidence of metastases was detected in the liver, omentum and parietovisceral peritoneum. Biopsies were taken of the gastric mucosa and the metastatic lesions of the liver and omentum, and histological studies on these specimens led to the diagnosis of malignant hemangioendothelioma. A laparoscopic examination yielded very interesting findings: the presence of small red tumors on the omentum and the parietovisceral peritoneum. The usefulness of laparoscopic examination in the diagnosis of malignant hemangioendothelioma of the stomach is stressed.

Adult↗

Plasma prolactin, renin and catecholamines in young normotensive and borderline hypertensive subjects.

It has been reported that patients with essential hypertension have high plasma prolactin levels and suggested that reduced central dopaminergic activity may be a factor in the pathogenesis of essential hypertension. This study examines the influence of posture on plasma prolactin, plasma catecholamines, plasma renin activity, blood pressure and heart rate in 24 patients with borderline hypertension (age 19 +/- 1 years) and 20 normotensive subjects matched for age and body mass index. Supine plasma prolactin levels were similar in both groups [borderline hypertension, 11.3 +/- 0.7 ng/ml; normotensive, 10.7 +/- 0.8 ng/ml (mean +/- s.e.m.)] and no increase in plasma prolactin was observed after 10 min standing in both groups. Normotensive and borderline hypertensive subjects had similar values for supine and upright plasma renin activity and plasma norepinephrine. There were no significant correlations between supine plasma prolactin and supine blood pressure, supine plasma renin activity or plasma norepinephrine when data from both normotensive and borderline hypertensive subjects were combined. These results may provide indirect evidence against the occurrence of reduced central dopaminergic activity in borderline hypertension.

Adult↗