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Biomedical subjects

Y Hirokawa

Publications and source records attributed to Y Hirokawa.

At least 73 records · Page 4Linked to original sources

[A survey of intestinal parasites of the foreign laborers (Indonesians and Filipinos) in Ishikawa Prefecture].

A survey of intestinal parasites was conducted on 198 foreign workers aged 19-27 from Inodonesia and Philippines. They work for a private company in Ishikawa Prefecture as technical trainee. On the base of stool examination, 94 (71%) out of 133 Indonesians and 48 (74%) of 65 Filipinos had intestinal helminths and/or protozoan infections. The prevalence of Ascaris lumbricoides, Trichuris trichura and Hookworm was 4.5, 64.1, 10.6%, respectively. In addition, the positive rate of the cyst of Entamoeba coli, Endolimax nana, Blastocystis hominis and Giardia lumblia was 11.1, 5.6, 4.5 and 2.0%, respectively. No E. histolytica was found; however, counter current immunoelectrophoresis revealed that one out of 112 sera possessed the antibody against the antigen of HK-9 strain of E. histolytica. Sixty-three cases of trichuriasis were treated with mebendazole at a dose of 200 mg/day x 3 consecutive days. Re-examination revealed that 53 (85.5%) of them were cured.

Adult↗

Effects of long-term xamoterol in idiopathic dilated cardiomyopathy.

In prospective study, the beta 1-partial agonist xamoterol (200 mg daily) was given to 26 patients with idiopathic dilated cardiomyopathy (DCM) in addition to conventional therapy with digitalis, diuretics and vasodilators. The patients were followed for 35 +/- 15 months (6-53 months). Cardiothoracic ratio (CTR), left ventricular end-diastolic dimension (LVDD) and exercise heart rate decreased, and exercise duration, fractional shortening (FS) and ejection fraction (EF) increased after xamoterol therapy. Twenty-one patients survived and one patient dropped out at 7 months. Twelve of the 20 patients improved their NYHA functional class. Blood norepinephrine concentration (NE), LVDD, FS, EF and pulmonary capillary wedge pressure (PCWP) after xamoterol were significantly better in survivors than in non-survivors. Survival rate at 3 years was 83%. The results suggest that adjunctive xamoterol therapy in DCM has a beneficial effect on hemodynamics and symptoms. Prognosis will be satisfactory if improvement in parameters such as NE, LVDD, FS, EF and PCWP is seen during xamoterol therapy.

Adrenergic beta-Agonists↗

Risk factors and the effects of xamoterol in idiopathic dilated cardiomyopathy.

A long-term follow-up study was performed for 110 patients with idiopathic dilated cardiomyopathy (DCM) for 34 +/- 12 months (range 3-122 months). Thirteen patients died of heart failure, 15 of sudden death and one of non-cardiac death. The 3- and 5-year survival rates were 78 and 62%, respectively. The important factors in predicting the 3-year survival rate were left ventricular end-diastolic volume index (LVEDVI > or = 150 ml/m2 = 66%, < 150 ml/m2 = 93%, p < 0.01), myocardial cell diameter (> 25 microns = 42%, < or = 25 microns = 87%, p < 0.05) and sustained ventricular tachycardia (VT present = 32%, absent = 85%, p < 0.01). In a prospective study, 26 patients with DCM were given a beta 1-partial agonist, xamoterol (200 mg daily) and were followed for 35 +/- 15 months (6-53 months). The cardiothoracic ratio, left ventricular end-diastolic dimension and exercise heart rate decreased, and the exercise duration, fractional shortening and ejection fraction increased after xamoterol therapy. The 3-year survival rate was 83%. These results suggest that the important factors in predicting the survival rate of DCM patients were LVEDVI, myocardial cell diameter and the occurrence of VT. Adjunctive xamoterol therapy in DCM had a beneficial effect on hemodynamics and symptoms.

Adolescent↗

[Alteration ratio of lung field CT numbers of full inspiration to end expiration scans in chronic obstructive pulmonary diseases].

The alteration ratio of lung field CT numbers in different respiratory phases was studied in 52 patients with chronic pulmonary obstructive disease (COPD) and 20 subjects with normal lung. The 52 patients with COPD consisted of 30 with clinically diagnosed chronic pulmonary emphysema (CPE), 15 with suspected CPE (sCPE) and seven with bronchial asthma (BA). The 20 subjects with normal lung were divided into two groups according to age. CT images were obtained in each case under different respiratory conditions, i.e., full inspiration and end expiration. The following parameters were employed for numerical evaluation: %(I-E)Apex = (MLDApexI-MLDApexE/MLDApexE x 100 %(I-E)Mid = (MLDMidI-MLDMidE)/MLDMidE x 100 %(I-E)Base = (MLDBaseI-MLDBaseE)/MLDBaseE x 100 %(I-E)Whole = (MLDWholeI-MLDWholeE)/MLDWholeE x 100 where MLD is mean lung density and the letters I and E stand for full inspiration and end expiration, respectively. The small letters Apex, Mid, Base and Whole stand for apex cut, mid-thorax cut, base cut and whole lung, respectively. The values of %(I-E)Whole were significantly different between disease groups except for those between the sCPE and BA groups. The values of %(I-E)Whole showed a good positive correlation with FEV1.0% (r = 0.79) and V25/H (r = 0.80) and a good negative correlation RV/TLC (r = -0.75). Diagnostic differentiation of COPDs by %(I-E)Whole values identified 80% of CPE cases and 91% of normal lung cases. In the sCPE group, the values of %DLco in patients with %(I-E)Whole above 9% were smaller than those in patients with %(I-E)Whole under 9%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Analysis of pyrophillitosis by high-resolution computed tomography].

High-resolution computed tomography (HR-CT) was performed on 20 patients with pyrophilitosis. Small nodular opacities in these patients could be divided by HR-CT into two types, namely, tiny irregular branching structures (TIB) and small round opacities (SRO). TIB had a centrilobular distribution and were characteristic of pyrophillitosis. SRO had both centrilobular and perilobular distributions and were considered to be changes modified by the aspiration of silica. Large opacities (LO) of pyrophillitosis were classified into three types, that is, spherical type, flat type parallel to the bronchus and flat type parallel to the thoracic wall. The spherical type was seen in patients exposed to both pyrophillite and silica, while the flat types were seen in patients exposed to only pyrophillite and were characteristic opacities of pyrophillitosis. Pulmonary emphysema was found in only one patient with pyrophillitosis, whereas mediastinal lymph node swelling and calcification were seen in most patients with pyrophillitosis. HR-CT is useful in making a more accurate evaluation of these lesions.

Aged↗

Prognostic factors for patients with osseous metastasis: a multi-institutional prospective study.

A multi-institutional prospective study for the analysis of prognostic factors for patients with osseous metastasis was performed. From February 1986 through June 1988, a total of 216 patients were included in this study. Cox's regression model made it clear that the most significant overall prognostic factor was primary site (p = 0.0002). In the lung cancer group, performance status (p = 0.0036) and metastasis of organs than bone (p = 0.0105) were also significant prognostic factors. In the breast cancer group, no significant factors were obtained. In the hepatoma group, the values for alkaline phosphatase (ALP) (p = 0.0021), lactate dehydrogenase (LDH) (p = 0.0195), and sex (p = 0.0264) proved significant. In the group of other cases, the most significant prognostic factor was the value for urinary hydroxyproline/creatinine ratio (p = 0.0001), followed by the pain score of RTOG (p = 0.0018). These factors and actual survival periods obtained in this study will be useful for the future stratification of patients for individualized optimal radiation schedules.

Adult↗

Phase II randomized clinical trial of LC9018 concurrently used with radiation in the treatment of carcinoma of the uterine cervix. Its effect on tumor reduction and histology.

The clinical efficacy of LC9018, a biological response modifier prepared from heat-killed Lactobacillus casei YTT9018, used in combination with radiation was studied in a randomized controlled trial on 61 patients with carcinoma of the uterine cervix of Stage IIB or III. The combination therapy with LC9018 demonstrated a significant effect on tumor reduction, compared with radiation therapy alone, at the cumulative doses of 15-Gy and 30-Gy external irradiation (P less than 0.05). Histologic study confirmed that LC9018 also enhanced the therapeutic effect of the irradiation. Moreover, LC9018 seemed to be useful in protecting the patients from leukopenia during radiotherapy. This study suggests that LC9018, when used in combination with radiotherapy, will be an effective adjuvant immunotherapeutic agent. More studies in a large series of patients will, however, be needed to establish its long-term efficacy, safety, and effects on both prognosis and enhancing radiotherapy.

Adjuvants, Immunologic↗

[A multiinstitutional prospective randomized study of radiation therapy of bone metastasis. II. Prognostic factors].

A prospective randomized study for the analysis of optimal schedule for the patients with bone metastases was performed. From February 1986 through January 1987, a total of 131 patients entered on this trial. The data from 129 patients out of 131 were available for the analysis of prognostic factors by Cox's regression model. As a whole, it was clear that first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0001), second primary site (p = 0.0001), third pain score (p = 0.0005) and fourth other organ metastasis except bone (p = 0.0006). In the group of lung cancer, first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0007), second multiplicity of bone metastasis (p = 0.0113), and third pain score (p = 0.0270).

Bone Neoplasms↗

Sustained ventricular tachycardia responsive to verapamil in patients with hypertrophic cardiomyopathy. Clinical and electrophysiological assessment of drug efficacy.

Recently, we examined 2 cases of hypertrophic cardiomyopathy (HCM) presenting with sustained ventricular tachycardia (VT). One case was a 62 year old male with midventricular hypertrophy and monomorphic sustained VT. After admission, the efficacies of procainamide, disopyramide, aprindin, flecainide, mexiletine and verapamil were evaluated by means of continuous electrocardiographic monitoring. Verapamil prevented the recurrence of sustained VT and markedly reduced the frequency and number of runs of nonsustained VT. In the electrophysiologic study, rapid VT was induced by double extrastimuli at the right ventricular apex. Intravenous verapamil at a dose of 10 mg prevented the induction of VT. The patient was discharged on verapamil and remains asymptomatic after 3 months of follow up. The other case was a 34 year old female who was a survivor of cardiac arrest. Monomorphic VT was observed on emergency admission and was converted to sinus rhythm by direct current cardioversion after resuscitation. In the electrophysiologic study, rapid VT was induced by double extrastimuli at the right ventricular outflow tract. Verapamil at a dose of 10 mg prevented the induction of VT. These 2 cases of HCM are rare in that they presented with sustained VT. It is also of interest that verapamil, which has been used conventionally in HCM, prevented VT.

Adult↗

Acute and chronic effects of xamoterol in idiopathic dilated cardiomyopathy.

Xamoterol, a beta 1-partial agonist, was given to 10 patients with idiopathic dilated cardiomyopathy in NYHA functional classes II and III. The acute and chronic effects of xamoterol were assessed by changes in effort tolerance measured by multistage bicycle ergometry, echocardiography, radionuclide ventriculography and right heart catheterization. The acute effect was determined after a single intravenous injection of 0.2 mg/kg of xamoterol. Exercise heart rate decreased from 117 +/- 10 (mean +/- 1 SD) to 97 +/- 19 beats/min (p less than 0.01), but blood pressure and cardiac index were unaffected. When the drug was given orally at 200 mg/day for 3 months, exercise duration increased from 4.2 +/- 2.3 to 6.4 +/- 2.4 min (p less than 0.01), echocardiographic ventricular ejection fraction from 29 +/- 12 to 33 +/- 14% (NS) and radionuclide left ventricular ejection fraction from 37 +/- 11 to 45 +/- 14% (p less than 0.01), while pulmonary wedge pressure during exercise decreased from 40 +/- 10 to 31 +/- 10 mmHg (p less than 0.01). It may be concluded that xamoterol, by its action as a partial agonist, demonstrated both beta-agonist and antagonist effects in patients with idiopathic dilated cardiomyopathy. It thereby had beneficial effects on left ventricular function with resultant improvements in effort tolerance and subjective symptoms during long term treatment.

Adult↗

Xamoterol in patients with dilated cardiomyopathy: an increase in beta-receptors in lymphocytes.

Xamoterol, a partial-beta 1 agonist, was administered orally (100 mg, twice daily) to healthy volunteers (n = 8) and to patients with heart failure (n = 8) for one week. The density (Bmax) and affinity (Kd) of lymphocyte beta-receptors were lower in the patients with heart failure than in the healthy volunteers (Bmax = 931 +/- 214 vs 1466 +/- 373 sites/cell, and Kd = 0.60 +/- 0.11 vs 1.07 +/- 0.14 nM). During treatment with xamoterol, Bmax (7169 +/- 3768 and 7749 +/- 3807 sites/cell) and Kd (6.01 +/- 3.84 and 9.06 +/- 4.66 nM) increased strikingly (p less than 0.01) in both groups. For 12 months, xamoterol (100 mg bd) was given in the same manner to 10 patients with dilated cardiomyopathy. The long-term effects after three and 12 months were assessed. Xamoterol reduced the cardiothoracic ratio from 57 +/- 6% to 55 +/- 5% after three months and 54 +/- 5% after 12 months of treatment (both p less than 0.05), and increased exercise tolerance from 5 +/- 2 min to 7 +/- 2 min and to 7 +/- 2 min (p less than 0.01, p less than 0.05). Echocardiographic fractional shortening increased from 13 +/- 6% to 20 +/- 8% (p less than 0.01) and to 20 +/- 10% (p less than 0.05). Pulmonary wedge pressure during exercise at the same work load decreased from 40 +/- 12 mmHg to 25 +/- 9 mmHg (p less than 0.01) in three months; whereas pulmonary wedge pressures during exercise or at rest in 12 months were unchanged. Exercise heart rate decreased from 118 +/- 9 beats/min to 106 +/- 6 beats/min in three months (p less than 0.01), but was unchanged in 12 months. Bmax and Kd of the beta-receptors increased from 1024 +/- 413 sites/cell and 0.67 +/- 0.27 nM to 1976 +/- 497 sites/cell and 1.60 +/- 0.42 nM (both p less than 0.01), respectively, in three months, and 1584 +/- 650 sites/cell (NS) and 1.21 +/- 0.54 nM (p less than 0.05), respectively, in 12 months. It is concluded that xamoterol improves exercise tolerance, hemodynamics and resolves subjective symptoms for certain patients with dilated cardiomyopathy by its actions as a beta-agonist and beta-antagonist during longterm treatment.

Adaptation, Physiological↗

[Potentiation of chemotherapeutic activity by a Chinese herb medicine juzen-taiho-toh].

Antitumor activity of Juzen-Taiho-Toh (JTX) and combination effect of JTX with antitumor agents were studied using murine tumors. In order to determine the antitumor activity of JTX, mice inoculated ip with IMC carcinoma (1 X 10(6) cells/CDF1 mouse), sarcoma-180(1 X 10(6) cells/ICR mouse) or Meth-A fibrosarcoma (1 X 10(6) cells/BALB/c mouse) were treated with JTX (12.5-50 mg/kg/day) ip on day 1 through day 10, and the survival days of mice were examined. Treatment with 25 mg/kg/day produced 38.7% increase of life span against IMC carcinoma. However, no antitumor effect was observed on solid form of these tumors by the daily treatment with JTX. Combination effect of JTX and antitumor agents was also examined. ICR mice inoculated sc with 1 X 10(6) cells of sarcoma-180 on day 0 were treated with JTX (2,000 mg/kg/day) po on day-7 through day 30. In addition, some of these groups received mitomycin C (5 mg/kg), cytoxan (67 mg/kg) or adriamycin (2.5 mg/kg) iv on days 3, 8 and 11, and the size of tumor grown in sc site was measured by a caliper. In combination with JTX, mitomycin C resulted in a significantly greater tumor growth inhibition than could be obtained with mitomycin C alone. Secondly, BALB/c or C57BL/6 mice inoculated sc with 1 X 10(4) cells of Meth-A fibrosarcoma or 1 X 10(5) cells of B16 melanoma on day 0 were treated with JTX (2,000 mg/kg/day) po on day 1 through day 30. Some of these group received ip with mitomycin C (3 mg/kg), adriamycin (2 mg/kg), 5-FU (33 mg/kg) or cytoxan (67 mg/kg) on days 3, 6, 9, 12, 15 and 18. From this result, the group treated with JTX and mitomycin C also showed a higher tumor-growth inhibition. Thus, a combination of a high dose of mitomycin C with JTX was more effective than mitomycin C alone.

Animals↗