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Biomedical subjects

K Uezono

Publications and source records attributed to K Uezono.

At least 55 records · Page 3Linked to original sources

Pathophysiology in malignant hypertension: with special reference to the renin-angiotensin system.

Pathophysiology of malignant hypertension, of which underlying disease was essential hypertension (EHT) in 33 cases and chronic glomerulonephritis (CGN) in 26 cases, was studied with reference to the renin-angiotensin system. Plasma renin activity (PRA) was significantly higher in the EHT than in the CGN group, and angiotensin II antagonist [Sar1, Ile8]angiotensin II (AIIA) induced a significant lowering of blood pressure only in the former group. PRA was linearly correlated with both pretreatment mean blood pressure (MBP, r = 0.474, n = 29, p less than 0.01) and serum creatinine (r = 0.540, n = 29, p less than 0.01) in the EHT group but not in CGN patients, although there was an inverse correlation between PRA and serum sodium in both groups. Multiple regression analysis revealed that PRA was independently related to MBP, serum creatinine, and serum sodium in the EHT group, but not in the CGN group. These results suggest that the renin-angiotensin system plays a significant role in elevating blood pressure and deteriorating renal function in malignant hypertension derived from EHT, but it is less important in CGN related hypertension.

1-Sarcosine-8-Isoleucine Angiotensin II↗

Circaseptan rhythm in sodium and potassium excretion in salt-sensitive and salt-resistant Dahl rats.

Six salt-sensitive (S) and six salt-resistant (R) male Dahl rats were housed in metabolic cages under LD 12:12 (L 0600-1800). High-salt (8%) and low-salt (0.4%) diets were available to half the S and R rats, respectively for 4 hr during a 24-hr span (feeding 1800-2200). Urine was collected at 4-hr intervals for 30 days. Sodium and potassium were determined by ion-specific electrode. Apart from circadian rhythmicity, a circaseptan rhythm in sodium and potassium excretion came to the fore in the rats on the high-salt diet only, with a phase difference of about 180 degrees between sodium and potassium. These rhythms were not detectable in the animals eating their usual-low salt diet. The ability to induce circaseptan variations in renal function may lend itself to the chronotherapeutic utilization of such cycles in achieving optimal therapeutic effects or minimizing undesirable side effects of different forms of treatment.

Animals↗

Individualized principal component analysis of endocrine circannual variability.

The technique of principal component (PC) analysis (PCA) of multivariate observations is a method that allows dimension reduction of multivariate data for further analysis. It is here introduced as a means of selecting chronobiologically important variables that can be further studied by an analysis of variance. The use of PCA is illustrated for a study of major temporal sources of human endocrine variability. Contributions to temporal variability by seven steroidal and six nonsteroidal hormones are compared in samples available at 100-min intervals for 24 hr in three seasons for each of three clinically healthy individuals: an adolescent woman, a menstrually cycling woman, and a postmenopausal woman. On an individualized basis, it is ascertained that the first principal component, a new variable, is primarily determined by steroids and that PCA can single out variables displaying interseasonal (circannual) differences validated as statistically significant by a subsequent analysis of variance. The variables here scrutinized and identified as contributing to the PC, however, need not all differ with statistical significance along the scale of the seasons. The steroids contributing the first principal component are DHEA-S and an estrogen in all three individuals studied, cortisol and aldosterone in two of them, and 17-OH progesterone in one case.

Adolescent↗

Is single oral administration of captopril beneficial in screening for primary aldosteronism?

Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured in 19 cases with primary aldosteronism (PA) and in 72 with essential hypertension (EHT) to differentiate the two disorders during the following conditions on normal salt diet: after overnight recumbency (basal state) and 2 hours after oral administration of 25 mg of captopril. Screening criteria were determined so that all PA patients were diagnosed as positive, and their specificities were compared with those of other conventional screening methods for PA. After captopril administration, the specificity of a criterion based on a combination of PAC and PAC/PRA ratio was 93% and positive predictive value was 79%. This criterion was superior to blood pressure response to angiotension II analog infusion, PRA on salt depletion, and to PAC on salt loading. However, higher specificity (97%) and positive predictive value (90%) were obtained from a criterion based on a combination of basal PAC and PAC/PRA ratio. Therefore, the use of a combination criterion based on PAC and PAC/PRA ratio at basal state rather than after captopril administration may give a satisfactory result in the screening for PA.

Adult↗

Circadian characteristics of urinary melatonin from clinically healthy young women at different civilization disease risks.

Rhythm characteristics in the about-daily (circadian) and about-yearly (circannual) frequency ranges were assessed for urinary melatonin. Clinically healthy women in Minnesota, USA, and Kyushu, Japan, were sampled around the clock once in 1-4 seasons. Possible differences that could reflect the large difference in breast cancer incidence in these two geographic locations were investigated. Each subject's risk of developing breast cancer, cardiovascular diseases resulting from an elevated blood pressure, and emotional conditions was numerically evaluated according to epidemiologic questionnaires. A prominent circadian rhythm characterizes urinary melatonin in both populations, peaking in the middle of the night. The American women exhibit a larger circadian rhythm-adjusted mean (mesor) than do the Japanese women. A circannual rhythm is also apparent in the North American women, but not in the Japanese women. The circadian mesor of urinary melatonin correlates negatively with the risk score of emotional depression and positively with that of developing cardiovascular diseases.

Adolescent↗

Circadian characteristics of urinary epinephrine and norepinephrine from healthy young women in Japan and U.S.A.

Clinically healthy diurnally active young adult women were studied during the same season (March) at the Universities of Kyushu (Fukuoka City, Japan) and of Minnesota (Minneapolis, U.S.A.), under comparable conditions, except that the habitual diets were not changed. The subjects (20 Japanese and 16 Americans of mixed Caucasian background) were studied over a single 24-hr span. Urine was collected at 4-hr intervals. A circadian rhythm in total urinary norepinephrine excretion showed similar characteristics in Japanese and Americans. In epinephrine excretion, the Japanese women showed a statistically significantly higher amplitude with higher peak values, but no statistically significant difference in the rhythm-adjusted mean. This intergroup difference is strictly time dependent; it does not come to the fore in urine samples covering the nocturnal rest span of the subjects.

Adult↗

[Plasma aldosterone concentration in patients with primary aldosteronism in the last decade].

We analyzed the chronological variation of plasma aldosterone concentration (PAC) in 27 surgically confirmed patients with primary aldosteronism (PA) during the period from 1975 to 1984. PAC values in PA-patients were significantly higher than those in 82 age-matched patients with essential hypertension (EHT). However, although average PAC in the PA-patients declined consistently in recent years, no chronological trend of PAC was observed in the EHT-patients. Therefore, the distributions of PAC in the two groups of patients overlapped in the last few years. Such chronological variations of PAC in the PA-patients were not related to serum potassium concentration, blood pressure level on admission, duration of hypertension, or diameter of the adrenal adenomas. In some recently observed cases of PA, not only was the basal PAC relatively low, PAC also responded to either salt depletion or salt loading. These findings could not be explained simply by the change of methodology for PAC determination but rather by the technological advance of diagnostic radiology. As a result, PA might be diagnosed in the early stages or before becoming fullblown. Further study should be necessary to clarify the exact mechanism.

Adult↗

The renin-angiotensin-aldosterone system and circadian rhythm of urine variables in normotensive and hypertensive subjects.

Forty-two middle-age male subjects, aged from 47 to 54 years old, were divided into three groups; 14 normotensives (NT), 16 borderline hypertensives (BHT) and 12 hypertensives (HT). The environmental effects were neutralized as much as possible by keeping their activities synchronized and their plasma and urine variables simultaneously investigated using the same protocol as under normal physiologic conditions. The circadian rhythms of urinary excretions of Na, K, Cl, creatinine, aldosterone, adrenaline and noradrenaline were analyzed by a multivariate method (cosinor method). Both systolic and diastolic blood pressure were statistically significantly different among the three groups and body weight was greater in HT than in NT. Other plasma and urine variables examined, however, were not significantly different among the three groups. A statistically significant circadian rhythm was detected in the urine variables. The rhythm characteristics, such as the mesor, amplitude and acrophase, of the urine variables except for the acrophase of urinary Na excretion were not significantly different among the three groups; the circadian acrophase of urinary Na in HT and BHT appeared significantly earlier than in NT. The pathophysiological and clinical significance of the earlier appearance of the circadian acrophase of urinary Na in hypertensive subjects still remains a unique characteristic requiring further investigation.

Aldosterone↗

Relationship of urinary kallikrein excretion to renal water and sodium excretion.

The circadian rhythms of urine volume and urinary excretion of sodium, potassium, kallikrein, and aldosterone were analyzed by a multivariate method (cosinor method) in 20 healthy Japanese women on an ordinary diet. The relationship of urinary kallikrein and aldosterone excretion to urine volume and urinary sodium and potassium excretion was studied by assessing the correlation of the circadian rhythms. The acrophases in the circadian rhythms of urine volume (16:51) and urinary sodium excretion (16:55) appeared after the acrophase of urinary kallikrein excretion (15:28). There was a highly significant correlation between the circadian rhythm of urinary kallikrein excretion and the circadian rhythms of urine volume (r = 0.948) and urinary sodium excretion (r = 0.921). These results suggest that the renal kallikrein-kinin system participates in the regulation of renal water and sodium excretion in persons on an ordinary diet. A highly significant relationship between the acrophases in the circadian rhythms of urine volume and sodium excretion (r = 0.935) also suggests that water and sodium excretion may have a mutual influence on the kidneys. There were positive correlations between the circadian rhythms of potassium excretion and kallikrein excretion and potassium excretion and sodium excretion; and the latter relationship was relatively closer than the former. The acrophase in the circadian rhythm of aldosterone excretion did not correlate well with the acrophases of the other urine variables including sodium excretion.

Adult↗

Comparison of circadian rhythms of the renin-angiotensin-aldosterone system and electrolytes in clinically healthy young women in Fukuoka (Japan) and Minnesota (USA).

Circadian rhythms of the renin-angiotensin-aldosterone (R-A-A) system and electrolytes were evaluated in young healthy Fukuokan (Japan) and Minnesotan (USA) women. A similar protocol was used and each group remained on its usual diet. Blood was taken for 24 h at 4 h intervals from 8 a.m. during which time urine samples were also collected. The determinations in both groups were made in a laboratory in Japan. Plasma renin activity, plasma aldosterone concentration and aldosterone excretion rate showed similar circadian rhythms in both groups. However, those values at each sampling time and each span were always significantly higher in the Americans while the urinary Na and Cl excretions and blood pressure were higher in Japanese. The significant differences in the R-A-A system and blood pressure levels between these two groups may be due to the large amount of salt consumed by the Japanese.

Adult↗

Average urinary excretion of sodium in 24 hours can be estimated from a spot-urine specimen.

We assessed to what extent sodium intake can be estimated from the sodium content of a spot-urine specimen (spot-UNa) collected within 4 hours after the first voiding upon awakening but before breakfast. Subjects were asked to collect spot-urine and 24-hour urine specimens other than the spot-urine for a 3-day period, either successively or intermittently. The coefficient of correlation between spot-UNa and urinary excretion of sodium in 24 hours (24-h UNa) collected on the first day was 0.47. When the coefficient of the variation of creatinine excretion in the spot-urine was above 20%, the sample was discarded as the "outlier', and in this case the coefficient of correlation was 0.725. A marked fluctuation of creatinine excretion in spot-urine was considered to represent technical errors at the time of the spot-urine collection. The coefficient of variation of intra-individual 24-h UNa exceeded 20%, suggesting that a single determination of 24-h UNa does not represent the individual average of daily urinary excretion of sodium. It is concluded that the determination of a substantial number of spot-urine specimens to estimate daily salt ingestion of a given subject may be more reliable than a single determination of 24-h UNa, if the "outlier' of creatinine excretion in spot-urine specimen is excluded from the determination of spot-UNa. The average urinary excretion of sodium in 24 hours by the Japanese subjects investigated here was 218 +/- 67 mEq.

Adult↗

[Plasma cortisol concentrations and circadian rhythm in healthy young Japanese and caucasians (author's transl)].

We report herein a method of solid-phase radioimmunoassay (RIA) for assessment of plasma cortisol concentration using 125I-labeled ligand [CORTCTK-125]. Plasma cortisol concentrations and its circadian rhythm in healthy young Japanese and American whie women were also evaluated using CORTCTK-125. Nineteen Japanese women, of an average age of 20.3 +/- 0.1 years, and 12 Caucasians of mixed ethnic origin (Minnesota), average 20.0 +/- 0.5 years, were studied using a similar protocol. The distribution of the menstrual stage of the two groups was similar. Blood was drawn from each subject into EDTA containers at 4-hour intervals starting at 0800 on one day and was continued for the ensuing 24 hours. The samples were immediately placed in a refrigerated centrifuge at 4 degrees C, and then stored at -20 degrees C until the assay. The samples from Minnesota were packed in dry ice and brought by air to Japan. Determinations of plasma cortisol concentration in samples from both groups were carried out at Kyushu University. Advantages of the solid-phase RIA method are as follows: (1) 0.05 ml of plasma or serum was sufficient for determination of plasma cortisol concentrations, (2) no other solvents or solutions for the extraction or purification were required, (3) the procedure was simple and readily facilitated, and (4) the concentration of cortisol in heparin-plasma was somewhat higher than that in serum or EDTA-plasma, but there was no statistical difference. Plasma cortisol concentrations in the samples from the Japanese (19.73 +/- 1.44 on the first and 18.94 +/- 1.32 microgram/dl on the second day) and that of the American group (17.48 +/- 2.38 and 19.37 +/- 2.16 microgram/dl, respectively) at 0800 was similar. The average value of 7 determinations at 4-hour intervals was 11.01 +/- 2.00 microgram/dl in the Japanese and 10.29 +/- 1.05 microgram/dl in the American group. A remarkable and similar circadian rhythm was observed in both groups with a peak at 0800 and with nadirs at 2000 in the Japanese (4.80 +/- 0.45 microgram/dl) and 2400 in the American group (5.18 +/- 0.83 microgram/dl). There were statistically significant differences between the values at the peak and the nadir. The related subjects were then classified into Group-F (9 subjects) and Group-T (9); the former included high body mass index [BMI: body weight(kg)/body height(m)2] of more than 24.0, and the latter included a relatively lower BMI of less than 21.5. The circadian rhythm of both groups revealed a similar pattern, whereas plasma cortisol concentration was always higher in Group-F than in Group-T, at all 7 determinations. There were no significant differences except for the value at 0400. Furthermore, the average values of plasma cortisol concentration and circadian rhythm were compared; the group with a larger body surface area (BSA) (Group-L) and the group with a smaller BSA (Group-S). No difference was found in the plasma cortisol concentration of Group-L and -S, and the circadian rhythm was similar in both groups...

Adult↗

Antihypertensive effect of E-643, a new alpha-adrenergic blocking agent.

To determine whether E-643, a new alpha-blocking agent, would reduce the blood pressure, regardless of the posture, a 1 mg dose was given 3 times daily for 7 consecutive days, to 8 male and 7 female inpatients, aged 37--73 years, with essential hypertension. Blood pressure and pulse rate were measured daily in the supine, sitting and standing positions. Before and after the treatment with E-643, plasma levels of noradrenaline, adrenaline, dopamine-beta-hydroxylase, renin and aldosterone were determined, samples being obtained with the subjects recumbent and after standing upright for 60 min. A significant reduction in the systolic and diastolic blood pressures was evident in the supine (172 +/- 31/100 +/- 12 leads to 151 +/- 28/89 +/- 14 mmHg), sitting (158 +/- 22/101 +/- 11 leads to 138 +/- 28/89 +/- 15 mmHg) and standing (153 +/- 32/103 +/- 21 leads to 129 +/- 31/89 +/- 20 mmHg) positions. The reduction in blood pressure remained unchanged throughout the period of administration of E-643. Pulse rate was not affected when the subjects were supine (67 +/- 10 leads to 69 +/- 10 beats/min), but was increased in the sitting (68 +/- 10 leads to 73 +/- 9 beats/min) and standing (73 +/- 10 leads to 81 +/- 11 beats/min) positions. The increased pulse rate tended to decline during continued administration of E-643. Treatment with E-643 produced no significant change in plasma levels of adrenaline, noradrenaline, dopamine-beta-hydroxylase, renin and aldosterone. The antihypertensive effect of treatment was more prominent in the patients with higher levels of plasma catecholamines and dopamine-beta-hydroxylase, and was less prominent in those with higher plasma renin and aldosterone. Two patients had temporary bouts of dizziness and visual disturbances, but there were no subjective complaints during treatment.

Adrenergic alpha-Antagonists↗

Differences and similarities among circadian characteristics of plasma renin activity in healthy young women in Japan and the United States.

A circadian rhythm of plasma activity (PRA) was demonstrated for both Japanese and North American women, the latter mostly Caucasians of mixed ethnic origin. The results were based on blood samples withdrawn at 4-hour intervals during a 24-hour span (in March 1978) from 20 subjects from Fukuoka (average age 20.4 +/- 0.1 years) and 16 subjects from Minneapolis (average age 20.2 +/- 0.4 years). The rhythms in the two populations showed similarities in some characteristics and differences in others. The timing of high values, i.e., of acrophases, objectively assessed by curve-fitting (and of corresponding 95 per cent confidence limits) was at 07(36) (05(00), 10(16) and 06(32) (03(00), 10(00) for Japan and USA, respectively. As objective measures of the extent of predictable rhythmic change mean amplitudes, in nanograms per milliliter per hour (ng/ml/hour), were similar (0.31 and 0.32); a statistically significant difference (P less than 0.05) was found in mean amplitudes expressed as percentage of the rhythm-adjusted average. Mean rhythm-adjusted average values (mesors) were lower in women from Japan than in those from the United States: (1.64 +/- 0.14 and 2.39 +/- 0.23 ng/ml/hour, respectively; P less than 0.01). A statistically significant difference in dietary salt, indicated by differences between the Japanese and North American women in the urinary excretion of sodium and chloride (P less than 0.05), almost certainly contributed to these results.

Adolescent↗