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Biomedical subjects

M Hongo

Publications and source records attributed to M Hongo.

At least 145 records · Page 8Linked to original sources
PubMed1985

[Cardiac involvement in systemic amyloidosis: myocardial scintigraphic evaluation].

To assess the clinical significance of technetium-99m-pyrophosphate (Tc-99m-PYP), -methylene diphosphonate (Tc-99m-MDP) and thallium-201 (Tl-201) myocardial scintigraphy in the diagnosis of cardiac amyloidosis and in the differential diagnosis of cardiac diseases, 12 patients with biopsy-proved systemic amyloidosis (seven with familial amyloid polyneuropathy (FAP) and five with primary amyloidosis) were investigated. The results obtained were as follows: In 10 patients (six with FAP and four with primary amyloidosis) studied by Tc-99m-PYP scintigraphy, two (FAP one, primary amyloidosis one) had diffusely positive myocardial uptake, which was of greater intensity than that of the sternum. Six (four FAP; two primary amyloidosis) also had diffusely positive myocardial uptakes, but the intensity was less than that of the sternum. The remaining two (one FAP; one primary amyloidosis) had only equivocal myocardial uptakes. Two of these patients also had hepatic uptakes and another had both hepatic and thyroid uptakes. The intensity of myocardial uptake of Tc-99m-PYP in patients with echocardiographic left ventricular hypertrophy and/or highly refractile myocardial echoes, so-called granular sparkling appearance (GS) was slightly greater than that in patients with neither myocardial hypertrophy nor GS. FAP had slightly less intensity than primary amyloidosis. In 29 persons with other cardiac diseases and normal subjects examined by Tc-99m-PYP scintigraphy, seven (two dilated cardiomyopathy; two sarcoidosis; three hypertensive heart disease) also had diffusely positive myocardial scans of mild or moderate degree. However, none of them had marked myocardial or other tissue uptakes. Both Tc-99m-PYP and -MDP scintigraphic studies were performed in four patients (three FAP; one primary amyloidosis). In Tc-99m-MDP scintigraphy, diffusely positive myocardial uptakes were observed in two patients with FAP and the remaining two had negative scans. The intensity of Tc-99m-MDP myocardial uptake in each patient was significantly lower than that of Tc-99m-PYP uptake. Tl-201 scintigraphy was carried out in 10 patients (six FAP; four primary amyloidosis). Left ventricular hypertrophy was found in six patients and right ventricular visualization in five. Although electrocardiograms in seven of 10 patients showed QS patterns in the right to mid precordial leads, similar to that seen in antero-septal and extensive anterior myocardial infarctions, neither myocardial perfusion defect nor low uptake on Tl-201 images was detected in nine of them. The scintigrams in another one, which showed low uptake at the apical portion of the left ventricle, were considered normal.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1985

[Study on transfer of aztreonam into female genital organs].

Aztreonam (AZT) is a newly developed beta-lactam antibiotic for use of intravenous injection. It is the first drug in the world of monobactam series with the structural characteristic of monocyclic beta-lactam. The antimicrobial spectrum of AZT is unique, having little or no susceptibility against Gram-positive organisms and anaerobes, but showing high susceptibility against aerobic Gram-negative rods including Pseudomonas. One gram of AZT was given intravenously to 32 patients prior to abdominal total hysterectomy for uterine myoma. Bilateral uterine arteries were clamped at 0.25, 0.5, 1, 2, 4, 8 or 12 hours after administration, and serum samples and uterine tissues were taken for the measurement of AZT concentration by bioassay method. Little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half-lives of both being 2.11 hours. The initial concentrations were estimated to be 68.0 micrograms/ml and 63.9 micrograms/ml, respectively. While the peak concentrations of the portio vaginalis, cervix uteri, myometrium and oviduct were obtained at about 10 minutes, those of the endometrium and ovary were at 18.2 minutes and 31.3 minutes, respectively. They were as follows; the portio vaginalis 50.0 micrograms/g, the cervix uteri 43.6 micrograms/g, the myometrium 29.8 micrograms/g, the oviduct 44.7 micrograms/g, the endometrium 27.3 micrograms/g, the ovary 29.0 micrograms/g. After showing peak, tissue levels were kept fairly high up to 3 hours, then decreased gradually as time passed up to approximately 8 hours. Judging from its favorable transfer into the uterine tissues and MICs against main clinical isolates in the field of obstetrics and gynecology, AZT is evaluated to be clinically useful in the treatment of obstetrical and gynecological infections.

Adult↗
PubMed1985

[Study on the transfer of cefminox into female genital organs].

One gram of cefminox (CMNX, MT-141) was injected intravenously to a total of 29 patients prior to abdominal total hysterectomy and drug levels in the uterine and adnexal tissues were bioassayed. Serum samples and uterine tissues were taken at 0.25, 0.5, 1, 2, 4 or 6 hours after the administration, when bilateral uterine arteries were clamped. As to serum levels no difference has seen between cubital venous serum and uterine arterial serum, the half-lives being 2.32 hours and 2.22 hours, respectively. The peak level was 66.7 micrograms/ml for both. The drug level in tissues reached its peak at 15 minutes in the myometrium and cervix uteri, at 30 minutes in the endometrium, portio vaginalis and oviduct and at 1 hour in the ovary. The mean peak level was the highest for the oviduct (55.3 micrograms/g), followed by the portio vaginalis (47.7 micrograms/g), the cervix uteri (46.2 micrograms/g), the myometrium (42.8 micrograms/g), the ovary (37.3 micrograms/g) and the endometrium (34.2 micrograms/g) in this order. After reached the highest levels, the tissue levels decreased gradually in the same manner as the serum levels. From these results it was shown that CMNX is well transferred into various female genital tissues to achieve concentrations higher than MICs for organisms isolated clinically with high incidences in the field of gynecology and obstetrics. It was assumed from these results that CMNX is clinically useful enough in the treatment of genital organ infections.

Adult↗
PubMed1984

Effects of nifedipine in achalasia and in patients with high-amplitude peristaltic esophageal contractions.

We studied the esophageal effects of nifedipine in 20 patients with achalasia (20 mg sublingually) and nine patients with high-amplitude peristaltic esophageal contractions (nutcracker esophagus) (20 mg orally). In patients with achalasia, nifedipine decreased lower esophageal sphincter (LES) pressure by approximately 30%. In ten patients with achalasia, plasma nifedipine concentrations were 45.3 +/- 17.7 and 57.4 +/- 12.8 ng/mL (means +/- SEM) at 30 and 60 minutes, respectively, after drug administration. In patients with nutcracker esophagus, nifedipine decreased LES pressure by approximately 50% and contraction amplitude in the body of the esophagus by approximately 25%. After comparison was made with our previous results in normal subjects, we concluded that (1) nifedipine decreased LES pressure in patients with achalasia to a similar extent to that noted in normal subjects; (2) plasma concentrations measured after 20 mg of nifedipine given sublingually to achalasic patients were similar to those found under similar circumstances in normal subjects; and (3) nifedipine decreased LES pressure and contraction amplitude in patients with nutcracker esophagus to a greater extent than was found in normal subjects. These results suggest that double-blind, placebo-controlled clinical trials of nifedipine in the treatment of achalasia or nutcracker esophagus are indicated.

Esophageal Achalasia↗
PubMed1984

Comparison of effects of nifedipine, propantheline bromide, and the combination on esophageal motor function in normal volunteers.

Both intracellular calcium ions and neural input are important in esophageal smooth muscle contraction. The aim of this study was to compare the effects of well-tolerated doses of the calcium-channel blocker, nifedipine (20 mg sublingually/buccally) with the anticholinergic, propantheline bromide (15 mg orally) and the combination of these two agents on esophageal motor function. Seven healthy volunteers underwent manometric evaluation after nifedipine, propantheline bromide, the combination, and placebo on different days. Lower esophageal sphincter pressure decreased significantly (P less than 0.05 vs basal and placebo) by 32% after nifedipine, but fell only 21% after propantheline bromide. After the combination lower esophageal sphincter pressure fell by 45% (P less than 0.05 vs basal and placebo and nifedipine alone). Contraction amplitude in the body of the esophagus decreased significantly (P less than 0.05 vs basal and placebo) by 26% after propantheline bromide, but fell only 11% after nifedipine. The combination led to a decrease of 37% in contraction amplitude, but this was not significantly different from that obtained with propantheline bromide alone. No drug or combination had any effect on other manometric parameters. These data show that in the normal subjects studied with the above doses: (1) nifedipine has a greater effect than propantheline bromide on the lower esophageal sphincter; (2) propantheline bromide has a greater effect than nifedipine on esophageal contraction amplitude; and (3) the combination of nifedipine and propantheline bromide has an enhanced effect on both lower esophageal sphincter pressure and esophageal contraction amplitude.

Administration, Oral↗
PubMed1984

[Study on transfer of ceftriaxone into female genital organs].

One gram of ceftriaxone (Ro 13-9904, CTRX), a new cephalosporin antibiotic, was given intravenously to a total of 25 patients prior to abdominal total hysterectomy for uterine myoma with or without small benign ovarian tumor. Bilateral uterine arteries were clamped at 0.5, 1, 2, 6, 12 and 24 hours after administration, and serum samples and uterine tissues were taken for the measurement of CTRX concentration by bioassay method. A little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half-lives being 8.0 and 7.9 hours, respectively. The initial concentrations were estimated to be 153 micrograms/ml and 160 micrograms/ml, respectively. The tissue peak concentrations were obtained at 30 minutes in the myometrium, portio vaginalis, oviduct and ovary, and at 1 hour in the endometrium and cervix uteri. These were 41, 51, 51, 39, 42 and 47 micrograms/g, respectively. The tissue concentrations after peak decreased in the same manner as the serum concentrations. Judging from its favorable transfer into the uterine tissues, CTRX was evaluated to be clinically useful in the treatment of obstetrical and gynecological infections.

Cefotaxime↗
PubMed1984

[A computed tomographic study of aneurysms of the sinus of Valsalva].

Computed tomography (CT) was performed for four patients with aneurysms of the sinus of Valsalva (each of the Konno types IVSD and IV, false aneurysm projecting into the interatrial septum, and annulo-aortic ectasia). Aneurysms were detected in three cases, and the sizes closely correlated with those of the resected specimens. However, a relatively small and mobile aneurysm of the IV type was not detected. Apparently, relatively large size (more than 10-20 mm) and immobility were necessary for the detection by CT. Reconstruction of CT images facilitated localization of the aneurysm and determining the extent of annulo-aortic ectasia. Rupture of an aneurysm was identified by observing the time course of CT values in the cardiac chambers using dynamic CT. However, better time resolution of CT is necessary for more precise diagnosis. Two-dimensional echocardiography is more convenient and diagnostically effective than CT. However, CT is a useful and non-invasive examination which overcomes the technical difficulties inherent in echocardiography, such as disturbances by the lung and other artifacts.

Adult↗
PubMed1984

Effects of nifedipine on esophageal motor function in humans: correlation with plasma nifedipine concentration.

We studied the effects of the calcium-channel blocker nifedipine on esophageal smooth muscle function in 10 normal volunteers. Lower esophageal sphincter pressure and relaxation and esophageal contraction amplitude, peristalsis, velocity, and duration after wet swallows were determined before and for 120 min after the sublingual/buccal administration of placebo and of nifedipine in doses of 10, 20, 30, and 40 mg. Blood samples for measurement of plasma nifedipine concentration were obtained at baseline and every 30 min during this 120-min period. Nifedipine led to decreases in sphincter pressure of 13.3%, 29.9%, 34.3%, and 35.1% as the dose was increased from 10 mg to 40 mg. These changes were significantly (p less than 0.05) different from baseline and placebo for the 20-, 30-, and 40-mg doses and were more sustained with the higher doses, lasting as long as 90 min. Contraction amplitude fell 5.3%, 5.9%, 13.5%, and 19.6% at the corresponding doses. These changes were significantly (p less than 0.05) different from baseline and placebo only for the 30- and 40-mg doses, with the effect lasting up to 60 min. Peak plasma nifedipine concentration ranged from 28.7 +/- 3.7 ng/ml (mean +/- SEM) after 10 mg to 138.7 +/- 43.7 ng/ml after 40 mg of the drug, and occurred at either the 30- or 60-min measurement. The mean percent of decrease in sphincter pressure and contraction amplitude in the esophageal body correlated (p less than 0.001) with plasma nifedipine levels. There were no changes in sphincter relaxation or in peristalsis, velocity, or duration of contraction with any dose of nifedipine. It is concluded that (a) nifedipine significantly decreases lower esophageal sphincter pressure and contraction amplitude in the body of the esophagus, (b) the effect on sphincter pressure requires a lower dose of nifedipine and is more marked than that on contraction amplitude, and (c) the effects on both sphincter pressure and contraction amplitude correlate with plasma nifedipine levels. Calcium-channel blockers such as nifedipine may have a role in the treatment of motility disorders of the lower esophageal sphincter or esophageal body, and further controlled clinical studies are indicated.

Adult↗
PubMed1983

Disturbances of the alimentary tract motility and hypermotilinemia in the patients with diabetes mellitus.

Lower esophageal sphincter pressure (LESP), gastric emptying, small bowel transit time and plasma motilin levels were measured in diabetics and normal subjects in order to investigate the disturbances of the alimentary tract motility and the participation of motilin in these motility disorders. Hypermotilinemia was observed in all diabetics with or without autonomic neuropathy. Low response of LESP to tetragastrin found in diabetics with autonomic neuropathy could not be explained by motilin. Gastric emptying was highly correlated with fasting plasma motilin levels and a significantly accelerated gastric emptying observed in diabetics without complications or diabetics with diarrhea was considered to be due to hypermotilinemia. On the contrary, no significant correlation was observed between small bowel transit time and plasma motilin levels, suggesting no participation of endogenous motilin in the regulation of small bowel transit.

Adolescent↗
PubMed1983

[Study on transfer of T-1982 (cefbuperazone) into female genital organs].

One gram of T-1982 (cefbuperazone), a new cephamycin antibiotic, was given intravenously to a total of 28 patients prior to abdominal total hysterectomy for uterine myoma or benign ovarian tumor. Bilateral uterine arteries were clamped at 0.25, 0.5, 1, 2, 4 hours or 6 hours after administration, and serum samples and uterine tissues were taken for the measurement of T-1982 concentration by bioassay method. A little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half lives being 1.88 hours and 1.74 hours, respectively. The initial concentrations were estimated to be 99.9 micrograms/ml and 103.2 micrograms/ml, respectively. The peak concentrations were obtained at 30 minutes in the endometrium, myometrium, oviduct and ovary, and at 1 hour in the cervix uteri and portio vaginalis. These were 45.2 micrograms/g, 22.4 micrograms/g, 36.1 micrograms/g, 19.9 micrograms/g, 27.6 micrograms/g and 23.4 micrograms/g, respectively. The tissue concentrations thereafter decreased in the same manner as the serum concentrations. Judging from its favorable transfer into the uterine tissues and MICs against clinical isolates often seen in the field of obstetrics and gynecology, T-1982 was evaluated to be clinically useful in the treatment of obstetrical and gynecological infections.

Cephamycins↗
PubMed1983

[Usefulness of dynamic computed tomography in the diagnosis of thoracic aortic aneurysms].

Five patients with thoracic aortic aneurysms, two saccular and three dissecting aneurysms, were examined by dynamic computed tomographic (CT) scanning. A Siemens Somatom 2 was employed. Dynamic scanning is the method by which plural serial images can be obtained in single operation. We used three serial images in a 5-second scan following a 3-second interval. After rapid manual injection of 30 ml of 76% megluminc amidotrizoate sodium into the right antecubital vein, scans of 4 mm section were performed three times and subsequently conventional scans four times. Serial changes in the same section and changes in the CT number against time in regions of interest in the image were investigated. Saccular aneurysms was difficult to distinguish from mediastinal tumors on the plain chest X-ray films. However, it was confirmed by the dynamic CT scanning demonstrating free communication between the aorta and the abnormal lumen, because the latter was filled with contrast medium, and the time of appearance, and the peak and washout of a contrast medium were almost the same between two lumens. In dissecting aneurysms, it was able to recognize both the false and true lumens as double channels in the aorta. We observed the different mode of dissection between the ascending and descending aorta in one case, and observed the twisting of an intimal flap in variable parts of the aorta in another case. Furthermore, it was possible to confirm the difference of blood flow pattern between the false and true lumens by dynamic CT. Because CT has a high quality image resolution, and especially, dynamic CT provides the serial changes in the same section after injection of contrast medium, both CT and dynamic CT are useful non-invasive imaging techniques for evaluating thoracic aortic aneurysms.

Adult↗
PubMed1983

[Hypereosinophilic syndrome associated with giant negative T waves and left precordial high voltage. Echocardiographic and tomographic findings of a case].

We reported a case of hypereosinophilic syndrome with an apical thrombus obstructing left ventricular cavity near the apex and apical hypertrophy of the left ventricle demonstrated by echocardiography and computed tomography. Abnormal laboratory findings included a white blood cell count of 22,800/mm3 with 64 per cent of eosinophils, high serum IgE level, and eosinophilic abscess formation in the lymph node specimen. The electrocardiogram showed left precordial high voltage and giant negative T waves in leads V4-5. Two-dimensional echocardiograms revealed an abnormal mass obstructing the left ventricular cavity. Computed tomography demonstrated marked apical hypertrophy of the left ventricle and a filing defect of 24 X 31 mm, which attached to the interventricular septum. Because of the lack of its movement on echocardiograms and significant differences in CT numbers from various portions of the myocardium, the abnormal mass in the left ventricle was considered to be a thrombus. In this case, both echocardiography and computed tomography were very useful to understand structural relationship among the thrombus, interventricular septum and surrounding left ventricular walls, and to assess myocardial thickness of the apex. In addition, it is of particular interest that hypereosinophilic syndrome was associated with marked apical hypertrophy of the left ventricle.

Echocardiography↗
PubMed1983

[Diagnosis of left atrial masses by computed tomography: with special reference to the differentiation between mural thrombi and myxomas].

Computed tomographic features of left atrial mural thrombi were compared with those of left atrial myxomas using a third generation system. In seven of 23 patients with mitral valvular disease, computed tomography (CT) demonstrated a total of 12 left atrial mural thrombi. There was calcification in about one-third of the thrombi and marked calcification of the mitral valve in all the seven cases. Mean CT value of the 12 thrombi ranged from +17.5 to +89.8 Hounsfield units (HU) (average +44.5 HU), and in only one it was below +20 HU. All thrombi appeared to be heterogeneous and irregular in shape such as elliptic, triangular or flat on cross-sectional tomogram. In addition, reconstructed coronal and sagittal imagings from serial CT images were very useful for localizing the calcification in the thrombi and determining the site of the attachment of the thrombi to the atrial wall. On the other hand, calcification of the tumor or mitral valve was not detected in two patients with left atrial myxomas by CT. The mean CT value of myxoma was averaged +30.2 HU, which was lower than that of thrombi. Both myxomas were ovoid in shape and appeared to be homogeneous in CT images. ECG gated CT revealed pendular movement of the tumor which prolapsed through the mitral orifice into the left ventricular inflow tract during diastole and backed into the left atrium during systole, although it was slightly difficult to detect the site of the attachment of the tumor. In conclusion, we should evaluate appearances, calcification of the mitral valve, mean CT value, shape and movement in the computed tomographic diagnosis of left atrial masses. In consideration of these characteristic findings, differentiation between mural thrombi and myxomas could be made.

Adult↗