Search PubMed⌕ Search

Biomedical subjects

T Umeda

Publications and source records attributed to T Umeda.

At least 217 records · Page 12Linked to original sources
PubMed1989

Pheochromocytoma associated with Behçet's disease.

A 32-yr-old man was admitted to our clinic complaining chiefly of paroxysmal attacks of headaches and palpitations. He had had intermittent episodes of joint pains, erythema nodosum-like eruptions of the lower limbs, oral aphtha, and a fever lasting for three years. Ultrasonography, computerized tomography and magnetic resonance imaging scanning showed a mass in the left adrenal gland. A diagnosis of pheochromocytoma was made from the elevated plasma and urinary catecholamines and abnormal uptake of 131I-metaiodobenzylguanidine. The tumor was successfully removed, and the patient's plasma and urinary catecholamine levels returned to within the normal range. High fever, aphtha of the mouth, erythema of the lower extremities and genital ulcers were, however, frequently observed. A diagnosis of Behçet's disease was then established. The association of the pheochromocytoma with Behçet's disease was thought to be a chance one: to our knowlege, this has been the first case of a pheochromocytoma associated with Behçet's disease.

Adrenal Gland Neoplasms↗
PubMed1988

[Lateralisation of aldosterone-producing adenoma in primary aldosteronism].

Four lateralizing methods were carried out in 14 patients with primary aldosteronism (PA): ultrasonography, CT scan, adrenal scintiscan and determination of adrenal venous aldosterone levels. In all cases, unilateral aldosterone-producing adenomas were verified by surgery. Of four lateralizing methods, determination of adrenal venous aldosterone, in spite of high diagnostic value, has two big problems: difficulty in selective catheterization of right adrenal vein and dilution of adrenal vein efflux from non-adrenal sources. To solve these problems, cortisol (C, micrograms/dl) levels along with aldosterone (A, ng/dl) were determined in samples from the left adrenal vein (LAV) and the inferior vena cava (IVC) in 8 patients with PA, and the (LAV A/C)/(IVC A/C) ratio was calculated. That ratio was also obtained in 7 patients with other types of hypertension for comparison. Accuracy of lateralisation by ultrasonography, CT scan and adrenal scintiscan was 23%, 64% and 69% respectively, in the first studies. Those rates changed to 23%, 93% and 85% when the second studies were performed. Venous blood was obtained from both adrenal veins in 46% (6/13), while lateralisation of adenoma was also predicted in 46% (6/13) by the measurement of aldosterone concentrations alone. On the other hand, (LAV A/C)/(IVC A/C) ratios were 3.54-6.98 in the cases of left APA, 0.15-0.98 in those of right APA and 1.10-2.86 in cases of other types of hypertension. There was no overlap of ratios among the three groups, resulting in correct prediction of lateralisation in all cases (8/8) of APA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1988

The effect of low and high NaCl diets on oral glucose tolerance.

The effects of low and high NaCl diets on plasma glucose and insulin responses to glucose ingestion were investigated in 15 patients with essential hypertension. Oral glucose (75 g) tolerance tests were carried out while patients were taking diets with low (2 g/day) and high (20 g/day) NaCl content. Fasting plasma glucose and insulin levels were both significantly lower during ingestion of the high NaCl diet (p less than 0.05). After glucose ingestion, the incremental areas under the two hour plasma glucose and insulin curves were significantly smaller during ingestion of the high NaCl diet (glucose p less than 0.005 and insulin p less than 0.025). These findings that low NaCl diets increase the glycemic response to glucose loads suggest that use of NaCl restriction for the treatment of essential hypertension may not always be desirable.

Adult↗
PubMed1988

[Salt sensitivity and central dopaminergic activity in patients with essential hypertension].

The pathophysiological role of the central dopaminergic mechanism in human essential hypertension (EH) is still unknown. We studied on the relationship between the dopaminergic activity and the salt-sensitivity. Twenty three hospitalized patients with EH were divided into the salt-sensitive group (SS, n = 12) or non salt-sensitive group (NSS, n = 11) by their responses whether they caused more than 8% increase in mean blood pressure (MBP) when the dietary salt was increased from 2g/day to 20g/day for 7 days of each. The change of central dopaminergic activity by the salt load was evaluated by the decrement of plasma prolactin (PRL) response to small dosage (25 micrograms) of thyrotropin releasing hormone. The mean percent change of PRL response by the salt load in the SS group was -6.5 +/- 8.3% (mean +/- SEM), which was significantly lower than 26.8 +/- 5.5% in the NSS group (p less than 0.01). There was a significant negative correlation between the percent changes of PRL response and the percent changes of MBP by the salt load (r = -0.448, p less than 0.05). These results suggested that the rise in blood pressure by salt load in SS patients with EH might be due to a reduced activity of the central dopaminergic mechanism.

Adult↗
PubMed1988

A sensitive radioimmunoassay of alpha human atrial natriuretic polypeptide using monoclonal antibody recognizing human form ring structure.

A monoclonal antibody (C351) against alpha human atrial natriuretic polypeptide (alpha hANP) recognizing human form ring structure was established and applied to a radioimmunoassay of plasma alpha hANP. The minimum detectable amount in terms of 10% radioligand displacement relative to zero dose were 0.28 fmol/tube, corresponding to 0.7 fmol/ml in plasma after extraction using Sep-Pak C18 cartridges. When the mean plasma levels at recumbent position in fasted morning were compared in 10 young (less than 30 years) and 10 elderly (greater than or equal to 50 years) healthy subjects taking normal sodium diet, it was slightly higher in the latter (3.2 +/- 0.4 vs 4.7 +/- 0.5 fmol/ml, mean +/- SE, p less than 0.05). After i.v. infusion of hypertonic saline (2.5% NaCl) at a rate of 0.24 ml/kg/min for 20 min in 6 normal subjects (26 to 35 years), it was increased from 4.1 +/- 0.4 to 5.9 +/- 0.7 fmol/ml (p less than 0.01). In 6 patients with essential hypertension (34 to 57 years), it was elevated with high salt intake, i.e. 3.3 +/- 0.3, 3.9 +/- 1.03 and 7.6 +/- 1.5 fmol/ml under 34, 170 and 340 mEq NaCl/day for 7 days, respectively. From these results, the radioimmunoassay of plasma IR-alpha hANP using MAb C351 seems to be quite suitable to detect rather small changes at low plasma concentrations and to investigate a physiological importance of alpha hANP in man.

Adult↗
PubMed1988

Is salt sensitivity in essential hypertension affected by ageing?

To investigate the question of whether the salt sensitivity of blood pressure in human essential hypertension is affected by ageing, the salt-sensitivity index was determined in 54 hospitalized patients with essential hypertension, aged 26-67 years (mean +/- s.d. 46.9 +/- 9.5 years) as well as plasma inhibition of Na+,K+-ATPase (sodium-pump inhibitor), erythrocyte sodium and potassium concentrations and fractional excretion of lithium. The salt-sensitivity index was calculated as the percentage change in mean blood pressure when the dietary sodium content was increased from 34 mmol/day (low sodium) to 340 mmol/day (high sodium) for 8 days each. Despite wide range of ages, age showed no correlation with the salt-sensitivity index, the sodium-pump inhibitor, the erythrocyte Na+:K+ ratio or fractional excretion of lithium. Furthermore, the distribution of the salt-sensitivity index did not differ between older (greater than or equal to 45 years old) and younger (less than 45 years old) age groups. In contrast, the distribution of this index was correlated positively with the change in sodium pump inhibition induced by a sodium load (r = 0.415, P less than 0.05) and negatively with the fractional excretion of lithium (r = -0.725, P less than 0.01). The erythrocyte Na+:K+ ratio tended to be higher in patients with a salt-sensitivity index of 10% than in those with an index of less than 5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Isolation from a coastal fish of Vibrio hollisae capable of producing a hemolysin similar to the thermostable direct hemolysin of Vibrio parahaemolyticus.

A vibrio isolated from the intestine of a coastal fish was identified as Vibrio hollisae by its biochemical characteristics. The isolate reacted with the gene probe for the thermostable direct hemolysin of Vibrio parahaemolyticus. The hemolysin produced by the isolate from the fish had traits identical to those of the thermostable direct hemolysin-like hemolysin produced by a clinical strain of V. hollisae.

Animals↗
PubMed1988

Thyroid functions in patients with various chronic liver diseases.

In order to clarify an alteration in thyroid functions in patients with chronic liver diseases, serum total and free thyroxine (T4, FT4), total and free triiodothyronine (T3, FT3), total reverse T3 (rT3), thyrotropin (TSH), thyroxine-binding globulin (TBG) concentrations, and T3 uptake (T3U) were measured by radioimmunoassays in 53 patients with chronic hepatitis (CH), 24 patients with compensated liver cirrhosis (LC), 17 patients with hepatocellular carcinoma associated with LC (HCC), and 40 normal subjects. Serum T4, T3, and rT3 in CH, and serum rT3 in HCC were significantly increased, while serum T4 in LC and serum T3 in HCC were significantly decreased. Serum TBG was increased and T3U was decreased in these patients. Serum TBG in CH and LC correlated positively with transaminase, and inversely with prothrombin time. FT4 and T4/TBG ratios in CH and LC and FT3 and T3/TBG ratios in LC and HCC were significantly decreased. Although T4/TBG ratios in HCC and T3/TBG ratios in CH were significantly decreased, FT4 in HCC and FT3 in CH were not decreased. The ratio of rT3/T3 in CH and LC correlated with various liver function tests. FT3 in LC and HCC correlated inversely with BSP (45') and positively with KICG. No differences in serum TSH values were found between chronic liver diseases and normal subjects. From these results, it was concluded that the thyroid functions in patients with chronic liver diseases were affected by the decrease in serum thyroxine, elevated serum TBG, the degree of which is in proportion to that of the liver cell damage, and impaired peripheral conversion of T4 to T3, the degree of which is in proportion to that of the hepatic dysfunction.

Adolescent↗
PubMed1988

An incidentally discovered case of Cushing's syndrome without clinical signs.

This paper describes a middle-aged man in whom an adrenal mass was incidentally discovered by upper abdominal echogram. Physical examination revealed no signs of Cushing's syndrome. The plasma cortisol level at 0800 h was within the normal range, but the diurnal rhythm had disappeared. Plasma ACTH was undetectable throughout the whole day. Urinary 17-OHCS was slightly increased and was not suppressed by 2 mg or 8 mg dexamethasone. Metyrapone test and CRF test revealed no response. A left adrenalectomy was performed and histological diagnosis of the removed tumor was an adrenal adenoma. After operation, oral steroid supplementation was necessary. These data suggest that the autonomous cortisol secretion by the tumor accounted for all his daily cortisol secretion, but it was too small to be clinically functional. We propose that every patient with an incidentally discovered adrenal mass should be subjected to endocrinological evaluations.

17-Hydroxycorticosteroids↗
PubMed1988

Periodic fluctuation of blood pressure and its management in a patient with pheochromocytoma. Case report and review of the literature.

The case of a 69 year old man with a right adrenal pheochromocytoma who manifested cyclic fluctuations of blood pressure with a cycle length of 9 to 13 min is reported. We collected and reviewed 14 similar cases previously reported in the literature. In these cases, right adrenal pheochromocytoma was most common, while 1 case involved the left adrenal and 2 cases were of extra-adrenal origin. The incidence in males was twice that in females and the median age was 45.3 years. Although a good correlation between the blood pressure and plasma norepinephrine concentrations was observed in our patient, the exact mechanism for the cyclic fluctuations of blood pressure is not known. In our patient, both YM-09538 and bunazosin were effective in controlling severe hypertension preoperatively. YM-09538 induced significant increases in urinary norepinephrine concentrations (1327 +/- 238 micrograms/day), while bunazosin induced a significant decrement in urinary norepinephrine concentrations (475 +/- 188 micrograms/day) compared with pretreatment levels (900 +/- 42 micrograms/day) (p less than 0.01). These observations indicated that bunazosin as a postsynaptic alpha-adrenergic receptor blocker interfered with release of norepinephrine from the tumor and thus might be beneficial in the management of elevated blood pressure in patients with pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1988

A direct radioimmunoassay for serum 11-deoxycortisol.

A simple direct radioimmunoassay for 11-deoxycortisol in serum is described. A new type of bridge heterologous 125I labeled 11-deoxycortisol was prepared and was applied to the direct radioimmunoassay. Low and high levels of 11-deoxycortisol in serum were sensitively determined by the direct radioimmunoassay.

17-Hydroxycorticosteroids↗
PubMed1988

[Five-year trend in new patients with prostatic carcinoma].

Seventy-four new cases of prostatic carcinoma treated between 1981 and 1985 were analyzed. The patients were between 40 and 86 years old with a mean age of 72.2 +/- 7.7 years. More than 70% of the patients had clinical stage C and D carcinoma. All cases proved histologically to be adenocarcinoma of the prostate. Eighteen patients had well differentiated, 21 moderately differentiated and 35 poorly differentiated adenocarcinoma. Various hormonal treatments were performed as the initial treatment in 88.9% (64/72) of the cases. Among them, 37 cases were treated by estrogen and 22 cases by luteinizing hormone releasing hormone analogues. Fourteen of 64 patients (21.9%) who received hormonal treatment discontinued the therapy within 10.1 +/- 9.1 months because of relapse of the disease or no therapeutic response. Salvage therapy following hormonal treatment were chemotherapy (9/14) and radiation therapy (4/14). During the 5-year follow up 12.1% (9/74) of the patients died due to prostatic carcinoma.

Adult↗