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Biomedical subjects

K Masuo

Publications and source records attributed to K Masuo.

At least 37 records · Page 2Linked to original sources
PubMed1995

Enhancement of insulin sensitivity by troglitazone lowers blood pressure in diabetic hypertensives.

The association of hypertension with insulin resistance has been reported. Troglitazone (CS-045) is a newly developed antidiabetic agent that enhances insulin sensitivity. Its antidiabetic effects have been confirmed in diabetic animals and patients. The present study was performed to evaluate whether the amelioration of hyperinsulinemia by troglitazone lowers blood pressure in essential hypertensives. Troglitazone was administered orally to 18 outpatients with essential hypertension complicated by mild diabetes at a dose of 200 mg twice a day for 8 weeks. Blood pressure was decreased from 164 +/- 3/94 +/- 2 mm Hg to 146 +/- 3 (P < .001)/82 +/- 3 (P < .05) mm Hg at 8 weeks of the treatment period. Pulse rate did not change. Fasting plasma glucose changed from 159 +/- 10 mg/dL to 144 +/- 14 mg/dL at 8 weeks (P < .05). Plasma insulin (IRI) levels changes from 9.1 +/- 1.2 microU/mL to 6.3 +/- 0.8 microU/mL at the endpoint of treatment (P < .1). Decrease in mean blood pressure from the control period to the endpoint of the treatment correlated significantly with decrease in IRI (r = 0.59, P < .05). In summary, troglitazone treatment induces improvement in both glucose metabolism and blood pressure control in essential hypertensive patients with diabetes mellitus. These results suggest that insulin resistance or plasma insulin level plays a role in the pathogenesis of essential hypertension.

Aged↗
PubMed1995

Hormonal mechanisms in blood pressure reduction during hemodialysis in patients with chronic renal failure.

To elucidate the hormonal mechanisms of blood pressure (BP) reduction during hemodialysis in patients with chronic renal failure (CRF), we performed this study using 7 normotensive (NT) and 17 hypertensive (HT) patients who were strictly matched in age, body weight, body weight gain from the last HD, and duration of HD. Blood pressure, pulse rate, plasma norepinephrine (NE), and plasma dopamine levels were used as indices of sympathetic nerve activity, before, at 50% of hemodialysis (HD) and at 100% of HD (at the end of HD) on the third day after the last HD. As hemodialytic BP reduction was defined as BP decline of more than 10% in pre-HD mean BP, in normotensive patients with CRF, hemodialytic BP reduction was recognized in 0/7 (0%) at 50% of HD and 4/7 (57%) at 100% of HD, and in hypertensive patients it was recognized in 3/17 (18%) at 50% of HD and 4/17 (24%) at 100% of HD. Percentile changes in plasma NE levels increased slightly following hemodialysis in normotensive patients with hemodialytic BP reduction and in hypertensives without BP reduction, while those in normotensives without BP reduction and in hypertensives with BP reduction did not change. However, percentage changes in plasma dopamine (DA) levels decreased significantly at the end of HD (NT; p < 0.05, HT; p < 0.01) following hemodialysis in both normotensive and hypertensive patients with hemodialytic BP reduction, while changes in patients without BP reduction, percentage changes in DA did not change (patients with BP reduction vs. patients without BP reduction). In conclusion, hemodialytic BP reduction may be predisposed by abnormal sympathetic nerve responsiveness.

Adult↗
PubMed1994

A case of Crohn's disease limited to the appendix, showing a portentous ultrasonographic finding.

A case of Crohn's disease limited to the appendix is reported. A preoperative ultrasonic study of the lower right abdomen revealed an interesting appearance that we named the "milky way sign." Microscopic findings in the resected specimen confirmed that the sign represented adipose tissue of the mesoappendix that had become involved by transmural inflammation. This seems to be highly suggestive of Crohn's disease.

Adipose Tissue↗
PubMed1994

Antihypertensive effects of the neutral endopeptidase inhibitor SCH 42495 in essential hypertension.

The antihypertensive effects and safety of a novel neutral endopeptidase inhibitor, SCH 42495, were investigated in hypertensive patients. A multicenter, open clinical trial was conducted in 27 patients with essential hypertension, WHO Stage I or II. Mean age was 64 +/- 1 years. After 2 to 4 weeks of a placebo run-in, 50 mg twice daily, was started, with the dose increased to 100 mg twice daily, and 200 mg twice daily, every 2 weeks, if necessary, to achieve a predetermined response. Blood pressure and pulse rate were monitored every 2 weeks. Blood chemistry, plasma atrial natriuretic peptide (ANP), and plasma cGMP levels were determined before and after the 8-week treatment period. Blood pressure was significantly reduced, from 171 +/- 1/100 +/- 1 mm Hg to 146 +/- 3/84 +/- 2 mmHg (P < .001) at the end of the 8-week treatment period. No change in pulse rate was noted. Efficacy rate was evaluated in 25 patients treated for 4 weeks or more. Efficacy rate was 44% with 50 mg twice daily, 60% with 100 mg twice daily, and 80% with 200 mg twice daily. Adverse reactions such as headaches and palpitation were observed in six patients (22.2%), with treatment discontinued in five. Significant correlation was observed between increment in plasma ANP levels and blood pressure reductions (r = -0.53, P < .05). Increase in plasma cGMP was positively correlated with increments in plasma hANP (r = 0.80, P < .001). SCH 42495 has potent antihypertensive effect associated with an enhancement of endogenous hANP and may be clinically useful as a new class of antihypertensive drug.

Aged↗
PubMed1993

The usefulness of postoperative continuous epidural morphine in abdominal surgery.

The influence of continuous epidural morphine on the recovery course of intestinal activity, urinary function, and ambulation after surgery was studied in 40 patients who underwent either gastrectomy for gastric cancer or cholecystectomy for cholelithiasis. Compared with a control group of patients whose postoperative pain was managed by pentazocine or hydroxyzine as before, the length of time before passing flatus or faeces was significantly shortened in the morphine groups (P < 0.05). Following gastrectomy, the urinary catheter was able to be removed significantly earlier in the morphine group (P < 0.05) although there was no statistical difference between both cholecystectomy groups. The morphine group experienced no difficulty with postoperative ambulation and exercise, although the difference in time before ambulation between the two groups was not considered significant. The results of this study led us to conclude that the postoperative continuous epidural infusion of morphine would be more beneficial following major abdominal surgery than the conventionally used methods of administering postoperative analgesia.

Abdomen↗
PubMed1993

The significance of preoperative chemotherapy for early gastric carcinoma.

In order to achieve a complete prognosis for early gastric carcinoma, a greater effort must be made to improve its present treatment, considering the small percentage of patients who still die from recurrence despite the prompt initiation of surgery. Over the past 9 years, 26 patients with early gastric carcinoma have undergone surgical resection after receiving preoperative chemotherapy in the form of oral 5-FU or 5'-DFUR in our institute. The effectiveness of preoperative chemotherapy was evaluated by histopathological examination of the resected stomachs. Of a total of 24 patients with depressed type gastric cancer, 19 were histologically found to have a cancerless area within the cancerous lesion, 8 of whom were classified as being over Grade 1b. Gross changes were observed in 13 of these 24 patients. The frequency of multiple early gastric cancer occurring in patients who had not received chemotherapy was 11.6%, whereas in those who had received chemotherapy it was 3.8%. The findings of this study thus indicate that preoperative chemotherapy is useful for reducing minute cancer foci and microscopic metastatic lesions.

Adult↗
PubMed1992

[Drug compliance in the elderly].

In order to clarify the characteristics of elderly patients concerning their attitudes toward taking prescribed medicine, self-reported compliance with prescriptions was compared among different age groups. We performed a survey in 626 outpatients and their attending physicians in 4 of our affiliated hospitals, and analyzed self-reported compliance by the patients to the prescription and their answers to questions related to drug-taking along with the diagnoses and prescriptions reported by the physician. The number of prescribed medicine was 2.3 tablets on the average for patients younger than 40, while 5.1 tablets were prescribed for patients over 70. However, self-reported compliance was best in patients over 70 than in other age groups. Compliance was good in 76% of patients who answered that the amount of medicine was appropriate, while good compliance was lower in those who thought the prescription excessive (67%). Likewise, compliance of patients who had concerns with drug side effects or who were not feeling well under medication was lower than that of patients who felt well under medication. Prescriptions for after lunch were most liable to be forgotten than those for other times of the day. Moreover, a high percentage of elderly patients attended more than 2 departments or medical facilities, and one third of those patients did not inform the physician of the fact suggesting that they were at higher risks of overdosing and unexpected drug interaction. Furthermore, the percentage of patients who did not receive explanation from physicians was higher in the elderly thus demonstrating that elderly patients have quite different characteristics in attitude with regard to medicine from younger age group patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Orthostatic and postprandial blood pressure reduction in patients with essential hypertension.

1. The role of the sympathetic nervous system in orthostatic and postprandial blood pressure reduction in patients with essential hypertension was studied in 13 hypertensive patients and 10 age-matched normotensive subjects. 2. The blood pressure (BP), pulse rate, and plasma norepinephrine (NE) were measured: (i) every minute for 20 min in the upright position after overnight recumbency (ii) every 30 min after food intake for 3 h in the supine position. 3. Orthostatic BP reduction (greater than 13 mmHg in mean BP) was observed in eight hypertensive patients with a maximum after 4 min. Seven of these patients showed postprandial hypotension (greater than 13 mmHg) with a maximum 90 min after eating, while none of the normotensives exhibited such BP reductions. Before and during the tests the plasma NE levels were higher in hypertensive patients than in the normotensives. The plasma NE level was increased from 370 +/- 80 to 790 +/- 110 pg/mL 4 min after standing (P less than 0.01) in hypertensive patients and from 220 +/- 40 to 530 +/- 90 pg/mL (P less than 0.01) in normotensive subjects. The plasma NE level was decreased 90 min after food intake from 390 +/- 90 to 260 +/- 80 pg/mL in hypertensives. Changes in plasma NE correlated with those in mean BP after standing for 4 min (r = 0.379, P less than 0.05) and also with those 90 min after food intake (r = 0.457, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Preoperative chemotherapy and anti-cancer effect of gastric carcinoma].

For the purpose of the study of macroscopical and histopathological anti-cancer effects, preoperative cancer chemotherapy was performed in 31 cases with gastric carcinoma. Gastric carcinoma with preoperative chemotherapy showed advanced cancer in 15 cases, and early cancer in 16 cases. During preoperative chemotherapy, the drug 5-Fu or 5'-DFUR was administered orally. The results were as follows; i) Macroscopical change of early cancer cases with anti-cancer chemotherapy showed the onset and healing of ulceration in the cancerous lesion and the change of granular pattern in the IIc floor. ii) Early cancer cases had a multi-centric histopathological anti-cancer effect which showed regenerative epithelium in the cancerous lesion. iii) The extent of the histopathological anti-cancer effect in advanced carcinoma showed greater in the deep layer of cancer invasion. Consequently, morphological changes of early cancer cases with chemotherapy are similar to the cases without chemotherapy. The onset of cancer damage in advanced carcinoma is in the cancer invasive zone, deep layer.

Administration, Oral↗
PubMed1990

[A progressive gastric cancer in which preoperative oral chemotherapy resulted in a histopathological "Grade 2" rating].

This paper describes a case of a Borrmann type 3 gastric cancer, in which the preoperative intermittent oral administration of 5'-DFUR over a short term resulted in a histopathological rating of Grade 2. A 56-year-old man preoperatively received an intermittent, oral administration of 5'-DFUR, 2, 100 mg/day. An upper gastrointestinal series and endoscopy revealed macroscopically an extremely slight remission. Histopathologically, however, a widespread, remarkable degeneration of cancer cells and fibrinogenesis of the framework were observed, these results leading to a change of rating to Grade 2.

Adenocarcinoma↗
PubMed1990

[Prognosis of gastric carcinoma sited in the cardiac part determined by the type of esophageal invasion].

A study has been made of type and prognosis of esophageal invasions exhibited by gastric carcinomas sited in the cardiac part of the stomach. Examined were 14 such cases of an adenocarcinoma with an esophageal invasion. Histopathologically, the invasions into the esophagus were classified into 4 types of severity, from 1 to 4, according to the depth of the invasion into the esophago-gastric junction (EGJ) and the pattern of the invasion to the oral side (thoracic side). The prognosis was found to be good for EGJ invasion that had penetrated to the pm and/or sm layer only, whereas it was very bad if the invasion had penetrated the entire EGJ wall (the pm, sm, mp, and the sa) and the infiltrative pattern had reached the oral side (thoracic side). Almost all patients given a type 4 classification soon had a recurrence after surgery and did not live beyond two years. Thus, a close relationship has been noted between the type of invasion into the esophagus and the prognosis.

Adenocarcinoma↗
PubMed1989

[Possibility of performing a modified operation on the depressed type early gastric carcinoma].

To study of the possibility of performing a modified operation in cases of a depressed early gastric carcinoma, we have investigated the possibility of stage I early gastric carcinoma detection. Examined were 196 cases of depressed early gastric carcinomas out of a total of 394 cases of a depressed gastric carcinoma. Further, the relationship between lymph node metastasis and the clinicopathological indicators was the following: 1) the macroscopical type grade was simple IIc; 2) the size of tumor was less than 50 mm; 3) the ulceration in the cancerous lesion was under (a) shallow Ul-II; and 4) the depressed floor showed a granular pattern. According to these indicators, we feel that it is possible to detect stage I early depressed carcinoma prior to operation.

Gastrectomy↗
PubMed1986

Effects of memantine on the frog neuromuscular junction.

The effects of memantine, an adamantane derivative, on neuromuscular transmission in the frog sartorius muscle preparation were studied by measuring the endplate current (EPC) by the voltage clamp method. Memantine (0.5-50 microM) reduced the peak amplitude and shortened the duration of the EPC, and the membrane voltage-peak EPC relationship became non-linear. Since it decreased the quantal height of the EPC without affecting the mean quantal content, the effects were considered to be mainly postsynaptic. Noise analysis revealed that memantine decreased the mean lifetime of the ACh-activated channel. In addition, lineweaver-Burk analysis of the response to ionophoretically applied carbamylcholine showed that memantine acted essentially as a linear mixed-type inhibitor. Thus memantine seems to block neuromuscular transmission by reacting with the ACh receptor-ion channel complex in both the open and closed states.

Acetylcholine↗
PubMed1985

[Clinical studies on excretion in biliary tract with the antibiotic cefotiam].

Cefotiam (CTM) was administered through 1 hour intravenous drip infusion for the patients performed biliary tract surgery. The concentration of CTM in serum, gallbladder tissue and the excretion in bile of the choledochus were measured. Twenty-one patients performed cholecystectomy were followed the concentration of CTM in the gallbladder tissue and the results were studied with pharmacokinetic analysis. The simulation curve, which was described by computer system in two-compartment open model, showed the maximal concentration of CTM in the serum was 60.3 micrograms/ml at 1 hour after infusion and that in the gallbladder tissue was 27.1 micrograms/g at 1.07 hours. The concentration of CTM in the gallbladder tissue was presumed to be in proportion to that of CTM in the serum. Six patients performed bile drainage were followed the concentration of CTM in bile of the choledochus for 6 hours after infusion. The maximal concentration was 215.2 +/- 62.7 micrograms/ml at 3 hours after injection, and the mean biliary recovery was 1.66 +/- 0.55% through 6 hours. Neither any side effects nor any abnormal values in the laboratory analysis of samples were observed for CTM.

Bile↗
PubMed1985

Hypotensive mechanism of potassium supplementation in salt-loaded patients with essential hypertension.

To investigate the hypotensive mechanism of potassium supplementation, blood pressure responses and hormonal changes were measured during KCl supplementation in salt-loaded patients with essential hypertension. Ten patients with essential hypertension were placed on low sodium intake, high sodium intake, and high sodium intake with KCl supplementation. Blood pressure increased during NaCl loading and decreased during KCl supplementation. The levels of urinary sodium and fractional sodium excretion increased after KCl supplementation. Reduction in blood pressure after KCl supplementation was correlated with an increase in blood pressure after NaCl supplementation, i.e., potassium sensitivity and sodium sensitivity were correlated. Plasma PGE2 and norepinephrine increased after KCl loading. Increases in plasma PGE2 were correlated with a reduction of blood pressure by KCl. These results indicate that natriuresis and hypotensive action of KCl are associated with increased PGE2 production, and the sympathetic nerve activity suggests a compensatory increase for the decrease in blood pressure.

Blood Pressure↗
PubMed1983

[Effect of aging on blood catecholamine under 3 conditions of sodium intake--comparison between normal subjects and patients with essential hypertension].

Increased sympathetic nervous activity may play an important role in the pathogenesis of essential hypertension. It is well-known that both dietary sodium intake and age influence plasma norepinephrine (P-NE). There are many reports on comparative studies of P-NE in patients with essential hypertension and normotensive controls. However, there are few studies on changes in plasma catecholamines in both the aging and salt intake states. The present study was undertaken to evaluate the effect of age on sympathetic nervous activity in patients with essential hypertension and normal controls under low (UNa V 29 +/- 3 mEq/day), regular (UNa V 133 +/- 8 mEq/day) and high (UNa V 324 +/- 12 mEq/day) sodium regimens. The catecholamine levels were analyzed by THI methods after HPLC separation. Twenty-four hour urinary norepinephrine, epinephrine and electrolyte (Na+, K+) excretion on day 5 of each regimen was also determined. On day 6 morning, supine and upright P-NE, plasma epinephrine and plasma renin activity were determined after blood pressure and pulse rate measurement. Subjects were separated according to age as follows: young (less than 40 y.o.), middle-aged (40 approximately 60 y.o.) and old (greater than 60 y.o.). P-NE in hypertensives was significantly higher than in normals under any three sodium intakes. There was a significantly positive correlation between age and P-NE, but only in normal controls under three sodium intakes and not in hypertensive patients under any three sodium regimens. In the young group of hypertensive patients, P-NE was significantly higher than that of normal controls. These results suggest that the increased sympathetic nervous activity plays an important role in the pathogenesis and maintenance of essential hypertension, and this is particularly obvious in young patients.

Adolescent↗