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Biomedical subjects

Keiko Oikawa

Publications and source records attributed to Keiko Oikawa.

6 recordsLinked to original sources

Relationship between double product break point, lactate threshold, and ventilatory threshold in cardiac patients.

A double product break point (DPBP) occurs simultaneously with both ventilatory threshold (VT) and lactate threshold (LT) in normal subjects. We sought to determine whether a DPBP also occurs in cardiac patients and to investigate correlations between DPBP, VT and LT (study 1). We also evaluated a non-invasive DPBP measurement system that determined blood pressure automatically by the cuff method (study 2). Study 1 comprised 15 patients [8 men and 7 women, mean (SD) age 47.7 (11.1) years] who performed cardiopulmonary exercise tests on a cycle ergometer. The double product was defined as the product of heart rate and direct systolic blood pressure. Arterial blood samples were obtained for measurement of lactate, pyruvate, pH, and norepinephrine levels. VT was determined by gas analysis, and LT was determined as the lactate/pyruvate ratio. DPBPs were detected in all 15 patients. Double product slopes above the DPBP were significantly greater than those below the DPBP (286.2 vs 98.5/W, P<0.001). The lactate/pyruvate ratio increased, arterial pH decreased, and plasma norepinephrine concentration increased above the DPBP. DPBP had strong positive correlations with VT ( r=0.93) and LT ( r=0.95). Study 2 comprised 65 cardiac patients. The DPBP was detected in 89.2% of patients and correlated closely with VT. We conclude that DPBP occurs near VT and LT in cardiac patients during incremental exercise, that the noninvasive DPBP measurement method is comparable to the invasive method, and that DPBP may be as useful an index of exercise intensity in patients with cardiac disease as VT or LT.

Adult↗

Glucocorticoids and dehydroepiandrosterone sulfate ameliorate ischemia-induced injury of the cochlea.

This study aimed to evaluate the effects of steroidal drugs on the functional recovery of the cochlea after transient ischemia. Albino guinea pigs were subjected to transient cochlear ischemia of 30 min duration, and the threshold shifts of the compound action potential (CAP) from the pre-ischemic values were evaluated 4 h after ischemia. Pre-ischemic administration of a glucocorticoid, prednisolone or methylprednisolone, significantly ameliorated the post-ischemic CAP threshold shifts as compared with control animals at a relatively wide range of doses. Post-ischemic administration of these glucocorticoids also exhibited protective effects. Pre-ischemic administration of dehydroepiandrosterone sulfate significantly decreased the post-ischemic CAP threshold shifts 4 h after ischemia. The present results indicate that glucocorticoids and dehydroepiandrosterone sulfate possess therapeutic effects against ischemic injury of the cochlea, such as idiopathic sudden sensorineural hearing loss.

Action Potentials↗

Involvement of poly(ADP-ribose) synthetase in acoustic trauma of the cochlea.

We investigated effects of poly(ADP-ribose) synthetase (PARS) inhibitors on acoustic trauma. Albino guinea pigs were intravenously given 3-aminobenzamide, nicotinamide or 3-aminobenzoic acid (an inactive analog of 3-aminobenzamide) just prior to exposure to a 2 kHz pure tone of 120 dB sound pressure level (SPL) for 10 minutes. The threshold of the compound action potential (CAP) and the amplitude of distortion-product otoacoustic emissions (DPOAEs) were measured before and 4 hours after the acoustic overexposure. Statistically significant decreases in the CAP threshold shifts and significant increases in the DPOAE amplitudes were observed 4 hours after the acoustic overexposure in the animals treated with 3-aminobenzamide or nicotinamide, whereas 3-aminobenzoic acid did not exert any protective effect. These results strongly suggest that excessive activation of PARS is involved in generation of the acoustic trauma.

Acoustic Stimulation↗

[Clinical application of exercise testing in heart failure].

Patients with heart failure frequently complain of fatigue and/or dyspnea during daily life. These exertional symptoms can be evaluated by the cardiopulmonary exercise testing. Peak oxygen uptake, anaerobic threshold(AT), the ratio of the increase in minute ventilation to the increase in carbon dioxide output(VE-VCO2 slope), the slope of the increase in oxygen uptake relative to the increase in work rate (delta VO2/delta WR), and the time constant of oxygen uptake (tau on) are reported to be useful to assess the severity and prognosis of heart failure patient. The information obtained from cardiopulmonary exercise testing can be used to select therapeutic option to improve both functional capacity and prognosis, and to identify patients with the greatest need for cardiac transplantation.

Anaerobic Threshold↗

[Relationship between exercise capacity and brain natriuretic peptide in patients after cardiac surgery].

OBJECTIVES: Physical training in cardiac patients can increase exercise capacity and reduce plasma brain natriuretic peptide(BNP) concentration, but these effects may depend on the etiology of cardiac disease. The change in exercise capacity and BNP during the training period were investigated in patients with different cardiac diseases. METHODS: Ninety-one patients after coronary artery bypass grafting(CABG) and 78 patients after valve replacement (VR) underwent a symptom-limited incremental cardiopulmonary exercise test before (1 month) and 6 months after physical training. Anaerobic threshold and peak oxygen uptake(peak-Vo2) were measured during the cardiopulmonary exercise test. Before each cardiopulmonary exercise test, a blood sample was obtained in the resting condition for measuring BNP. RESULTS: Anaerobic threshold and peak-Vo2 were increased significantly from 1 month to 6 months in both groups. BNP in the CABG group indicated a tendency to decrease (194.6 +/- 155.3-->144.2 +/- 232.2 pg/ml, p < 0.1) from 1 month to 6 months. BNP in VR group was significantly decreased (159. 9 +/- 115.5-->112.8 +/- 131.7 pg/ml, p < 0.05) during the training period. The CABG group showed a significant negative correlation between peak-Vo2 and BNP at 1 month(r = -0.28, p < 0.01) and at 6 months(r = -0.39, p = 0.001). The VR group showed a significant negative correlation between peak-Vo2 and BNP at 6 months(r = -0.32, p < 0.01), but not at 1 month. CONCLUSIONS: Six months of physical training in patients after cardiac surgery may improve exercise capacity and reduce BNP. BNP concentration in the VR group before physical training did not reflect functional capacity.

Aged↗

Outer hair cells functionally and structurally deteriorate during reperfusion.

Transient ischemia of the cochlea was induced in 65 albino guinea pigs by pressing the labyrinthine artery, and the effects of cochlear reperfusion on cochlear potentials (endocochlear potential, compound action potential and cochlear microphonics (CM)) and structural changes in hair cells were examined. Although 15 min ischemia did not elevate the post-ischemic CM pseudo-threshold as compared with the pre-ischemic value, ischemia of 30 min or longer significantly elevated the CM pseudo-threshold. CM amplitude tended to progressively decrease during the reperfusion period in the animals subjected to 45 or 60 min ischemia. After transient ischemia, outer hair cells (OHCs) were swollen and exhibited alterations of the nucleus. Severer structural deterioration of OHCs was induced by 4 h reperfusion than ischemia itself when the ischemic period was 45 or 60 min. Perilymphatic perfusion of dimethylthiourea, a hydroxyl radical scavenger, partially ameliorated the elevation of the CM pseudo-thresholds and the structural changes of OHCs. These results indicate that cochlear reperfusion induces functional and structural deterioration of OHC probably by hydroxyl radical generation.

Action Potentials↗