Biomedical subjects

G Mitani

Publications and source records attributed to G Mitani.

11 recordsLinked to original sources

PubMed1986

Efficacy and safety of medium- and high-dose diltiazem alone and in combination with digoxin for control of heart rate at rest and during exercise in patients with chronic atrial fibrillation.

We evaluated the efficacy and the safety of medium-(240 mn/day) and high-dose (360 mg/day) diltiazem alone and in combination with digoxin when used for control of heart rate in 12 patients with chronic atrial fibrillation. Medium-dose diltiazem was comparable to therapeutic dose of digoxin at rest (88 +/- 19 vs 86 +/- 12 beats/min) but superior during peak exercise (154 +/- 23 vs 170 +/- 20 beats/min; p less than .05). High-dose diltiazem resulted in better control of heart rate than digoxin both at rest (79 +/- 17 beats/min; p less than .05) and exercise (136 +/- 25 beats/min; p less than .05) but was associated with side effects in 75% of the patients. Combined therapy of digoxin and diltiazem enhanced the effect of digoxin alone and resulted in significantly better control of heart rate at rest (67 +/- beats/min with medium-dose and 65 +/- beats/min with high-dose diltiazem) and during peak exercise (132 +/- 32 and 121 +/- 24 beats/min, respectively). However, the difference in heart rate between these two doses was not significant. Reduction of heart rate combined with concomitant effect on blood pressure resulted in a significant fall in pressure-rate product at rest from 10,077 +/- 1708 mm Hg/min on digoxin alone to 7877 +/- 1818 mm Hg/min after the addition of medium-dose diltiazem (p less than .05) and during exercise form 25,670 +/- 3606 to 18,439 +/- 4115 mm Hg/min (p less than .05). Continued therapy with digoxin combined with diltiazem 240 mg/day for 21 +/- 8 days in nine patients showed persistent effect on heart rate and blood pressure without any toxic manifestations or change in serum digoxin (1.5 +/- 0.4 vs 1.3 +/- 0.4 ng/ml) or plasma diltiazem concentrations (204 +/- 72 vs 232 +/- 129 ng/ml). In conclusion, medium-dose diltiazem when combined with digoxin is an effective and safe regimen for the treatment of patients with chronic atrial fibrillation and enhances digoxin-mediated control of heart rate both at rest and during exercise.

Adult↗

PubMed1983

In vivo staining test with methylene blue for bladder cancer.

An in vivo staining test with 0.2 per cent methylene blue was applied to 129 patients with bladder tumor and 16 patients with chronic cystitis within a 6-year interval. Although normal mucosa did not pick up the stain nonpapillary in situ and microinvasive carcinomas did so frequently. Moderate dysplasia was stained in about half of the patients. The intensity of the stain in papillary tumors was correlated with the histologic anaplasia (grade). Grade 1 tumors were stained poorly or unstained in 86 per cent of the tests, whereas grades 2 and 3 tumors picked up the stain in 74 and 96 per cent of the tests, respectively. Even a tiny tumor, if poorly differentiated, was identified easily by the blue stain. The histologic anaplasia of tumors could be assessed roughly according to the intensity of the stain. However, chronic cystitis occasionally took up the stain, especially in cases of marked inflammatory infiltrate a deep stain was recognized. To differentiate nonpapillary early cancer from chronic cystitis the addition of a cytologic examination may be necessary.

Biopsy↗

PubMed1979

Surreptitious use of warfarin.

The authors present the case of a 61-year-old woman who became increasingly sensitive to her warfarin. When she remained anticoagulated during a 2-month period off of warfarin a plasma analysis detected warfarin indicating she was taking the anticoagulant surreptitiously. This patient demonstrated features of factitious illness including a background of unsatisfactory childhood relationships, average intelligence, a lack of psychosis, and no obvious secondary gain. Surreptitious use of anticoagulants should be considered in all cases of unexplained hemorrhagic symptoms with low prothrombin activity.

Denial, Psychological↗

PubMed1975

A clinico-pathological survey of exophytic tumors of the urinary bladder. I. An analysis of the structure of the fibro-vascular cores with special references to the clinical prognosis.

In this paper the results of the clinicopathological study on a total of 79 bladder tumor cases are presented. They are principally related to the stromal proliferation or branching of the tumors. The tumor cases consist of those with a good prognosis as well as those with a poor prognosis. In the former category there are 61 cases with a long survival history (with or without recurrence); the remainder (18 cases) had a history of a short survival (dying within 2 years). Histologically there was a marked difference in the regularity of the stromal branching of the tumor between those cases with a long survival history and those cases with a short survival history. In the former group the regular type of stromal branching was predominant; in the latter group the irregular type was predominant.

Cell Division↗

PubMed1974