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Biomedical subjects

Y Usuda

Publications and source records attributed to Y Usuda.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Portal and peripheral blood insulin concentrations and arterial ketone body ratio before and after glucose infusion during gastrectomy].

The effect of glucose infusion on portal and peripheral blood immunoreactive insulin (IRI) concentrations and arterial ketone body ratio (AKBR) during gastrectomy were evaluated on twenty patients divided into two groups. Portal and peripheral blood IRI concentrations, AKBR, total ketone body concentration (TKB: acetoacetate + beta-hydroxybutyrate), and blood glucose were determined before and 30, 60, and 120 minutes after 25g glucose infusion in 30 minutes in ten patients (group 1) and 50 g glucose infusion in 30 minutes in ten patients (group 2). In both groups, the rate of increase in the portal blood IRI concentration was markedly higher than that in the peripheral blood IRI concentration after glucose infusion and AKBR increased and TKB decreased with the increase of the portal blood IRI concentration. These findings suggest that the peripheral blood IRI concentration does not reflect the pancreatic insulin secretion after glucose infusion during surgery and that portal insulin plays an important role for elevating and maintaining AKBR at higher levels. On the other hand, in both groups, the blood glucose had its peak just after completion of glucose infusion and then decreased gradually. After glucose infusion, however, the blood glucose in group 2 increased markedly and was significantly higher than that in group 1. It is suggested that, during surgery, glucose infusion rate of 50 g in 30 minutes may be too rapid.

Blood Glucose↗
PubMed1995

Hamster pulmonary endocrine cells with neural cell adhesion molecule (NCAM) immunostaining.

Pulmonary endocrine cells of Syrian golden hamster were stained for neural cell adhesion molecule (NCAM) with indirect fluorescent immunostaining and observed with a confocal laser scanning microscope equipped with an argon laser. Sections 100 microns thick of hamster lung fixed with phosphate-buffered 4% paraformaldehyde were prepared. The sections were incubated with rat monoclonal antibody against NCAM, followed by fluorescence-labeled antibody against rat immunoglobulin. Some were doubly immunostained for NCAM and one of the following endocrine markers: neuron-specific enolase, calcitonin gene-related peptide and serotonin. Expression of NCAM in the hamster airway epithelium was seen in cell nests resembling neuroepithelial bodies (NEBs). NCAM immunostaining was positive at the lateral cell borders between the cells composing the nest, but negative at the border with the adjacent, presumably non-endocrine cells. Double immunostaining confirmed that the grouped cells with NCAM immunoreactivity were of an endocrine nature, but that single endocrine cells did not show NCAM immunoreactivity. An electron microscopic study with NCAM immunostaining confirmed the light microscopic study. These suggest that NCAM expression could be important for the morphogenesis of NEBs. A confocal laser microscope was used to make three-dimensional images of NEBs after NCAM immunostaining and the spatial interaction between NEBs and the surrounding microenvironment was studied.

Animals↗
PubMed1995

Alkaline phosphatase reactivity in rabbit airway epithelium: a potentially useful marker for airway basal cells.

The purpose of this study was to investigate alkaline phosphatase (ALPase) reactivity in rabbit airway epithelial cells. Acetone-fixed, methyl benzoate and xylene-cleared (AMeX-treated) paraffin sections of trachea, bronchus, and lung tissue were stained by an azo dye coupling method for ALPase and examined by light microscopy. Electron histochemical staining was also performed in order to study the sensitivity and specificity of reactivity in each cell type. ALPase reactivity at the light microscopic level was observed exclusively in tracheo-bronchial basal cells, and not in bronchiolar basal cells. By electron microscopy, ALPase reactivity was noted in 97.9% of basal cells in the trachea, 97.0% of basal cells in the bronchus, and 94.5% of basal cells and 15.4% of Clara cells in the bronchiole. This was also true for dispersed tracheal epithelial cells. Reactivity was rarely observed in ciliated cells, non-goblet-type secretory cells, and undetermined cells. The reactivity was heat-labile, levamisole-sensitive, and of a non-specific type. These findings indicate that basal cells of rabbit trachea and bonchus have fairly high specificity for ALPase of a non-specific isozyme (92.2% and 95.6%, respectively). Therefore, ALPase is considered to be a useful marker for these cells.

Alkaline Phosphatase↗
PubMed1995

[A trial of clinical application of sparfloxacin for treating mycobacterial infections].

Sparfloxacin seems to be a good candidate for antimycobacterial treatment. However, there have been no clinical studies. We experienced 2 SPFX-treated cases, who could not use other antimycobacterial agents because of side effect, we tried SPFX-treatment on these cases. Good results were obtained, however, for long time use to prevent side effects, we tried SPFX every second day and monitored the serum levels of SPFX. SPFX-every second day treatment gave good clinical results and adequate serum levels of SPFX were observed.

Aged↗
PubMed1995

[Pharmacokinetic study of sparfloxacin in patients receiving regular hemodialysis].

We investigated the in vivo kinetics of sparfloxacin (SPFX), an oral quinolone, in the hemodialytic patients. SPFX was orally administrated in a single dose of 200 mg to each of five hemodialytic patients, on a day that they were not receiving hemodialysis therapy. After dosing, the blood samples were collected periodically at 2, 4, 6, 8, 12, 24, 25, 27, 29, 48, 72 hours. Concentration of the unchanged SPFX in the plasma samples were measured by HPLC. The peak plasma levels of SPFX in the hemodialytic patients did not differ greatly from patients with renal failure (5 < Ccr<20 ml/min). Average T 1/2 beta of SPFX was 25.7 hours, and it was prolonged compared to the patients with renal failure (who were not receiving hemodialysis) and a group of young healthy volunteers. Based on these results, we believe those hemodialytic patients may be administrated with the drug once every other day, as long as normal doses are used.

Administration, Oral↗
PubMed1995

[A case of p-ANCA positive necrotizing vasculitis associated with Graves' disease].

A 22-year-old female who had been suffering from Graves' disease developed p-ANCA positive necrotizing vasculitis. Her Graves' disease has been treated with propylthiouracil (PTI) for 6 years, which failed to improve serum TSH. She developed transient and recurrent polyarthralgia 4 years before. Because of microscopic hematuria and polyarthralgia, She visited our hospital last year. She had hypergammaglobulinemia and microhematuria at that time. But no autoantibody was noted except anti-microsomal antibody at that time. Skin biopsy from her finger subdermal nodule revealed necrotizing vasculitis of small vessels. Serum p-ANCA was positive. She was admitted under the diagnosis of p-ANCA positive necrotizing vasculitis. Renal biopsy revealed mesangium proliferative glomerulonephritis. Since she developed telescoped sediments after admission, predonisolone (PSL) 50 mg daily was started. Clinical and laboratory findings improved quite well. PSL was gradually tapered after 6 weeks. She is being maintained in good condition on tapering doses of both PSL and PTI. The coincidence of Graves' disease and vasculitis is rare. This case may provide some important immunological insights into the study of pathogenesis of necrotizing vasculitis and Graves' disease.

Adult↗
PubMed1995

[Portal and peripheral blood immunoreactive insulin concentrations after glucose infusion during gastrectomy].

We evaluated portal and peripheral blood immunoreactive insulin concentrations (IRI) after glucose infusion in patients undergoing gastrectomy. Seventy-four patients were divided into following two groups: 68 received 25g glucose infusion in an hour (glucose group), and the remainder received no glucose (control group). Portal blood IRI level in glucose group was about thirty-fold higher than that in control group. However, peripheral blood IRI did not correlate with portal blood IRI in glucose group. In addition, significant negative correlation between portal blood IRI and blood glucose was observed in glucose group. Our results reveal that adequate pancreatic insulin secretion occurs after glucose infusion during gastrectomy, but peripheral blood IRI does not reflect this pancreatic insulin secretion. The results also suggest that blood glucose may be regulated by the liver under these conditions.

Aged↗
PubMed1995

[Portal blood immunoreactive insulin concentration after glucose infusion in elderly patients during gastrectomy compared with younger patients].

We evaluated the effect of aging on portal blood immunoreactive insulin concentration, AKBR, and keton body concentration (acetoacetate + beta-hydroxybutyrate) after glucose infusion (25 g glucose in an hour) in patients undergoing gastrectomy. Twenty-seven patients studied were elderly (above 65 years) and twenty-eight were younger (below 60 years). There was no significant difference in portal blood immunoreactive insulin concentration after glucose infusion between the two groups of patients. In elderly patients, however, AKBR was significantly lower and keton body concentration was significantly higher than those in younger patients, and these imply that suppression of ketogenesis and activation of hepatic mitochondrial function due to insulin may be reduced in elderly patients. These findings suggest that, during gastrectomy, pancreatic insulin secretion may not be impaired in elderly patients, but insulin action may be attenuated with aging.

Aged↗
PubMed1995

[Does a tracheal bifurcation shift upward due to increased intraabdominal pressure during laparoscopic surgery?].

To evaluate the influence of increased intraabdominal pressure on a position of tracheal bifurcation, we measured the distance from the tracheal bifurcation to the tip of the endotracheal tube which is fixed on a patient's mouth during a laparoscopic surgery. The distance decreased from 3.5 +/- 1.9 to 3.1 +/- 1.9 cm (P < 0.05) at mean intraabdominal pressure of 8.7 mmHg. This result suggests that the ventilation may become difficult due to the occlusion of the tip of the endotracheal tube by a tracheal bifurcation or due to inadvertent single lung ventilation under inappropriately deep intubation.

Abdomen↗
PubMed1994

[Effect of celiac plexus block and thoracic epidural block on arterial ketone body ratio].

We evaluated the effect of intraoperative celiac plexus block (CPB) and thoracic epidural block (TEB) on arterial ketone body ratio (AKBR) in the patients undergoing total or partial gastrectomy. Mean arterial pressure (MAP), heart rate, AKBR, and arterial blood gas were measured at the end of esophago-jejunostomy, gastro-duodenostomy, or gastro-jejunostomy (pre-block) and at the end of operation (post-block), respectively. After pre-block measurement, CPB with 99.5% ethanol 15-20 ml was carried out in 8 patients with advanced gastric cancer (CPB group); TEB with 2% lidocaine was performed on 8 patients (TEB group); and neither CPB nor TEB was done on 8 patients (control group). A significant reduction in MAP was observed after CPB and TEB. There was no difference in the degree of MAP decrease between CPB group and TEB group. No change in MAP was observed in control group. In CPB group significant decreases in AKBR, pH, and BE were induced by CPB. However, there were no difference in AKBR, pH, and BE between pre-block values and post-block values in TEB group as in the control group. These findings suggest that ethanol used in CPB reduces the redox state of hepatic mitochondria and increases lactate. Therefore we should pay attention to the changes in AKBR, pH, and BE after celiac plexus block with ethanol.

Aged↗
PubMed1994

[Effect of dopamine and prostaglandin E1 on portal venous oxygenation].

We evaluated the effects of dopamine (DA) and PGE1 on portal venous oxygenation in patients undergoing gastrectomy. Thirty-two patients studied were anesthetized with isoflurane and nitrous oxide in oxygen. They were divided into three groups: DA was infused at a rate of 3 micrograms.kg-1.min-1 in 10 patients (DA group), PGE1 was infused at a rate of 0.02 microgram.kg-1.min-1 in 10 patients (PGE1 group), and the remainders did not receive DA nor PGE1 (control group). There were no significant differences in PaO2 and SaO2 among three groups. However, portal venous PO2 and SaO2 in DA and PGE1 group were significantly higher than those in the control group. These results suggest that DA and PGE1 elevate the portal venous PO2 and SO2 by increasing splanchnic blood flow more than its oxygen uptake or without increasing splanchnic oxygen uptake, and increase the oxygen supply to the liver.

Aged↗
PubMed1994

[Arterial ketone body ratio and its modification by PGE1 in elderly patients during gastrectomy].

We evaluated the change in arterial ketone body ratio (AKBR), which is a parameter to indicate the liver cells, during gastrectomy, and effect of PGE1 on its change in the elderly patients, compared with the younger patients. Twenty patients studied were elderly (above 65 years) and twenty were younger (below 60 years). PGE1 was administered in 10 elderly and 10 younger patients, and the remainders did not receive PGE1. Decrease in AKBR during the resection of stomach and immediate increase in AKBR after the resection of stomach were observed in younger patients. On the other hand, prolonged decrease in AKBR after the resection of stomach was observed in elderly patients. Administration of PGE1 accelerated the restoration of AKBR after the resection of the stomach in elderly patients and caused an increase in AKBR during the resection of stomach in younger patients. These findings suggest that hepatic functional capacity in elderly patients is less than that in younger patients, and that administration of PGE1 has a protective effect on liver in both elderly and younger patients.

Aged↗
PubMed1993

[Clinical pharmacology and efficacy of S-1108].

We studied the pharmacokinetics of a new cephem antibiotic, S-1108, in patients with impaired kidney functions. Serum and urinary levels of S-1006 were determined after oral administration of S-1108 at 150 mg to 9 patients with renal dysfunction. In patients with severe renal impairment, high serum levels were maintained over long periods of time. Urinary excretion rates of S-1006 were lower as degrees of kidney failure were severer. S-1108 was administered to treat 27 patients with respiratory tract infections, and its clinical efficacy and safety were evaluated. The clinical efficacies were good in 26 patients, but poor in 1, yielding an efficacy rate of 96.3%. As to adverse reactions; diarrhea was observed in one case. Laboratory tests revealed elevated GOT and GPT in 1, and elevated gamma-GTP in another. These abnormalities, however, were slight and no severe side effects were caused by the drug.

Administration, Oral↗
PubMed1993

[Clinical evaluation and pharmacology of DQ-2556 in the patients with compromised renal function].

We studied the pharmacokinetics of a new cephem antibiotic, DQ-2556, in patients with impaired kidney function. The peak concentrations of the compound in the serum were observed irrespective of the degree of kidney failure 5 minutes after its bolus administration of 1.0 g intravenously, and no significant difference was observed in the concentrations among the patients. On the other hand, the decrease in its concentrations in the serum was impeded in proportion to degrees of kidney failure and, in particular, hemodialysis patients showed markedly delayed clearance of the drug from the serum; the half-lives in the serum (beta phase) were prolonged to ca. 6 hours in patients with severe kidney failure (Ccr ca. 20 ml/min) and did so markedly to ca. 17 to 21 hours in patients with hemodialysis as compared with ca. 2.5 hours in patients with slight kidney failure (Ccr ca. 50 ml/min). Urinary excretion rates (0-to-24 hours values) were ca. 70% in patients with slight kidney failure, ca. 60% in patients with moderate kidney failure and ca. 40% in patients with severe kidney failure, showing a tendency toward a decline in relation to increasing degrees of kidney failure. The compound showed a satisfactory dialytic property. The clinical efficacy and safety of DQ-2556 were evaluated upon administering if at daily doses of 0.5 g b.i.d. and 1.0 g b.i.d. for 7 and 14 consecutive days respectively, in patients with lower respiratory tract infections. The clinical efficacies were excellent in 2 patients, good in 11 and poor in 2, yielding a efficacy rate of 86.7%. No side effects were observed, though, a neutrophil sedimentation ratio decreased in a patient, and a down-shift of prothrombin activities was observed in another. These results suggest that DQ-2556 is useful for lower respiratory tract infections, but in patients with kidney failures it is required to seek the most suitable regimen since the excretion rates of the compound decrease as degrees of kidney failure become severer.

Adult↗
PubMed1992

[Change in arterial ketone body ratio during gastrectomy and mastectomy].

We evaluated the influence of operative procedure on arterial ketone body ratio (AKBR), which indicates the function of the liver cells, in patients undergoing gastrectomy or mastectomy. AKBR during the stomach resection was significantly lower than that during the breast resection. A significant reduction in AKBR due to induced hypotension was observed in mastectomy group. SGOT and SGPT increased significantly in gastrectomy group, but unchanged in mastectomy group on the first and the seventh postoperative days. On the first post-operative day, SGOT and SGPT in gastrectomy group were significantly higher than those in mastectomy group. These findings suggest that influence of operative procedure on the liver during gastrectomy is more serious than that during mastectomy.

Adult↗
PubMed1992

[Clinical pharmacology and efficacy of levofloxacin in elderly patients].

We studied a newly developed oral quinolone antimicrobial agent, levofloxacin (LVFX, DR-3355), and obtained the following results. 1. Serum and urine levels of LVFX were determined after oral administration of LVFX 100 mg to 11 elderly patients with various degrees of renal function insufficiencies. The patients were classified according to creatinine clearance (Ccr) values into Group I (n = 1, Ccr greater than or equal to 70 ml/min), Group II (n = 4, 40 less than or equal to Ccr less than 70 ml/min), and Group III (n = 6, Ccr less than 40 ml/min). The peak levels of LVFX did not differ greatly among the 3 groups, but in patients with severely impaired renal functions, serum concentrations decreased more slowly than in those with slightly and moderately impaired renal functions, and high serum levels were maintained over a long period. Urinary excretion of LVFX diminished in relation to degrees of renal failure. 2. LVFX was administered to treat 13 elderly patients with respiratory tract infections. Clinical responses were good in all patients with a high efficacy rate of 100%. Laboratory tests revealed eosinophilia in 1 case. The symptom was mild, however, and no severe side effects due to the drug were observed.

Aged↗