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Biomedical subjects

T Ashida

Publications and source records attributed to T Ashida.

At least 37 records · Page 2Linked to original sources
PubMed2000

Serum levels of vascular endothelial growth factor and transforming growth factor-beta1 in patients with atrial fibrillation undergoing defibrillation therapy.

We have previously reported that pulsatile mechanical stretch in vitro induced rapid secretion of vascular endothelial growth factor (VEGF) by cultured cardiac myocytes and that the stretch-induced secretion of VEGF was mainly mediated by secretion of transforming growth factor (TGF)-beta1 by cardiac myocytes in an autocrine fashion. To investigate whether tachycardia-induced mechanical overload increases serum levels of VEGF and TGF-beta1, we investigated the serum levels of VEGF and TGF-beta1 in patients with atrial fibrillation undergoing defibrillation therapy. The serum VEGF level before defibrillation was significantly increased in 13 out of 20 patients (89.48 +/- 16.09 pg/ml [mean +/- SE]). After defibrillation, the serum VEGF level in these 13 patients significantly (p = 0.019) decreased (65.04 +/- 16.61 pg/ml [mean +/- SE]), although it increased slightly in one patient. The serum TGF-beta1 level before defibrillation therapy (13.01 +/- 1.97 pg/ml [mean +/- SE]) in these 12 patients also decreased after defibrillation therapy (11.47 +/- 2.06 pg/ml [mean +/- SE]). The changes in serum VEGF level significantly correlated with those in the serum TGF-beta1 level in these 12 patients (r = 0.73, p < 0.05, n = 12). Our data suggest that tachyarrhythmia-induced mechanical overload can increase the serum VEGF level, which can be a useful clinical marker for relative myocardial oxygen shortage in such patients.

Aged↗
PubMed2000

Distinct increase in hematocrit associated with paroxysm of atrial fibrillation.

In a previous study we found that hemoconcentration, which was identified by an increase in hematocrit, occured during a paroxysm of atrial fibrillation. In the present study we investigated the changes in hematocrit from sinus rhythm to paroxysm in 10 patients who had multiple paroxysms of atrial fibrillation in order to assess the ranges of the changes in hematocrit among the paroxysms. In these patients hematocrit was measured simultaneously with electrocardiographic recording during 3 or more paroxysms and sinus rhythm just before each paroxysm. The changes in hematocrit varied among the paroxysms. The maximum increase in hematocrit in each patient ranged from 3.5 to 8.0 points with an average of 5.1 points. Such a distinct increase in hematocrit which abruptly develops with a paroxysm of atrial fibrillation may be a potential risk for thrombus formation.

Aged↗
PubMed2000

Transient mitral regurgitation following vagal stimulation-induced ventricular arrhythmia in rabbits: a color Doppler echocardiographic study.

BACKGROUND AND AIM OF THE STUDY: Cervical vagal stimulation in rabbits frequently causes systolic murmur with bigeminy due to premature ventricular contractions. The bigeminy disappears in a few minutes, but the systolic murmur persists for a few days. Peculiar lesions of the mitral valves, mitral annulus and papillary muscles, and an increase in left atrial weight, frequently develop in a week. In this study, color Doppler echocardiography was used to examine whether the systolic murmur was due to mitral regurgitation. METHODS: Echocardiographic monitoring was carried out in anesthetized rabbits restrained in the supine position. RESULTS: Doppler echocardiography and phonocardiography showed systolic murmur at 6 h, three days, and at one, two, three and four weeks after vagal stimulation. At 6 h after stimulation, phonocardiography showed systolic click and late systolic murmur; Doppler echocardiography showed marked mitral regurgitation. The systolic murmur and mitral regurgitation were attenuated and the papillary muscle was swollen three days after vagal stimulation. Following stimulation, mitral regurgitation disappeared within one week, and papillary muscle swelling improved after three weeks. CONCLUSION: Doppler echocardiography confirmed that systolic murmur caused by vagal stimulation in rabbits was due to mitral regurgitation.

Animals↗
PubMed2000

Successful graft-versus-leukemia effect of second bone marrow transplantation on relapsed leukemia cutis that was refractory to intensive chemotherapy and donor lymphocyte transfusions in a patient with acute monocytic leukemia.

We report a patient with acute monocytic leukemia (AMoL; M5) who received a second bone marrow transplantation (BMT) with graft-versus-leukemia (GVL) effect on relapsed leukemia cutis, which had been refractory to intensive chemotherapy and donor lymphocyte transfusions (DLTs). A 21-year-old woman was diagnosed with AMoL and achieved complete remission after intensive chemotherapy. The patient received a nonmanipulated allogeneic BMT from her HLA-identical father. Skin tumors developed in her upper extremities, chest, and thigh 11 months after BMT. Leukemia cutis was confirmed by skin biopsy. There was no evidence of relapse in bone marrow. The patient received several courses of chemotherapy and DLTs for the skin relapse, but the skin tumors persisted. The patient then received a second BMT from the same donor. On day 80, grade II acute graft-versus-host disease developed, and the remaining skin tumors were eradicated on day 98, most probably because of GVL effect.

Adult↗
PubMed1999

Crystallization and preliminary x-ray analysis of beta-amylase from Bacillus polymyxa.

A truncated beta-amylase (E.C. 3.2.1.2) from Bacillus polymyxa has been crystallized using the hanging-drop vapour-diffusion method at 277 K. The crystals belong to the orthorhombic space group P212121 with cell dimensions a = 64.6, b = 141.9, c = 155.1 A and diffract to 2.5 A resolution. The asymmetric unit containing three protein molecules was derived from an electron-density map calculated at 4 A resolution using MIR phases. This gives a Vm value of 2.36 A3 Da-1.

Bacillus↗
PubMed1999

Rationale for time-qualified reference standards for 24-hour blood pressure values and their circadian rhythms in Japanese normotensive adults: a study by the Ambulatory Blood Pressure Monitoring Research Group.

The aim of this study was to demonstrate that blood pressure (BP) has to be standardized according to its circadian variability, including the properties shown in its circadian rhythm. The BP time-qualified standards were derived from a sample of 644 clinically healthy normotensive Japanese subjects (320 males, 324 females; age range, 18-93 years), stratified by age-group and gender, who underwent noninvasive ambulatory monitoring according to a fixed protocol. The monitored data series shows that BP exhibits a within-day variability at any age of life in both males and females. Additionally, the monitored data series shows that BP exhibits a significant circadian rhythm at any age of life in both males and females. The age- and sex-related reference limits for the BP within-day variability constitute the time-qualified standards against which both the casual and monitored BP measurements can be compared in order to detect whether or not they are compatible with normotension. The reference limits for the BP circadian rhythm represent the rhythmometric standards against which the BP oscillatory curve can be compared in order to detect whether or not they are compatible with a physiological circadian rhythm.

Adolescent↗
PubMed1999

[An 88-year-old woman with symptoms of intoxication due to a small dose of digoxin].

An 88-year-old woman was admitted to our hospital because of palpitations, dyspnea, orthopnea and appetite loss. On admission, small crackles were heard on her lower back, and her liver was swollen. Chest rentogenogram showed cardiomegaly (cardio-thoracic ratio 65.5%) and bilateral pleural effusion. Electrocardiograms showed atrial fibrillation with an average heart rate of 95 per minute. Echocardiography revealed mitral stenosis. Because the patient was considered to be suffered from heart failure due to mitral stenosis with atrial fibrillation, furosemide (20 mg per day) and digoxin (0.25 mg per day) was started. After digoxin had been raised to a dose of 0.50 mg per day because of sustained rapid ventricular response on the fourth hospital day, she complained of nausea and vomiting. Serum digoxin concentration was 2.55 ng/ml on the next day, and 1.08 ng/ml 96 hours after discontinuing digoxin. There was no complaint after digoxin was restarted with a dose of 0.05 mg per day. She complained of nausea again on the third day when the digoxin was raised to a dose of 0.083 mg in a blinded study. This observation indicates that digoxin intoxication could occur even in the smaller dose of digoxin than usual in the elderly.

Aged↗
PubMed1999

[The deterioration of regimen comprehension in self-attending elderly patients and the effect of tutorials by pharmacists].

The purpose of this study was to assess whether regimen comprehension deteriorates in the elderly without obvious mental disability. Eligible patients were elderly who could visit hospitals by themselves. We recruited 138 patients (age: 43-89, 75 males and 63 females, underlying diseases: hypertension, hyperlipidemia, arrhythmia etc.) from our outpatient clinic. The participants were tested with a regimen comprehension scale (RCS: Jpn J Geriat 1997; 34:209-214). The differences in scores among individuals increased with age. Scores of 5 or less were recorded in 10 of 69 patients aged 65 or more, but in non of 69 patients aged less than 65 (p < 0.01). The 60 patients who could not get full marks were classified into 2 groups: the tutored group (T) who were tutored by pharmacists about taking drugs, and the non-tutored group (N). Both group were tested again with RCS to evaluate the effect of tutorial. In T-group (n = 28), the second scores increased significantly (from 7.2 +/- 0.9 to 8.6 +/- 2.0 (m +/- SD); p < 0.01). Although the second scores showed a tendency to increase in N-group (n = 29), there was no statistical significance. In 7 patients who obtained less than a score of 5 on the RCS and age- and gender-matched controls who received full marks on the RCS, the HDS-R test failed to show any differences between the two groups. Thus, we concluded that even in the self-attending elderly patients, the regimen comprehension deteriorated with age, and tutorials were considered to be effective.

Adult↗
PubMed1998

Invasion depth diagnosis of depressed type early colorectal cancers by combined use of videoendoscopy and chromoendoscopy.

BACKGROUND: Depressed type early colorectal cancers are found less frequently than other polypoid cancers although they have a higher submucosal invasion rate. Recently videocolonoscopy and chromoendoscopy have become available and precise descriptions of these lesions are now routine. Because endoscopic mucosal resection is designated for intramucosal and focally extended submucosal (m-sm1) cancers, an evaluation of the characteristic findings indicating invasion depth with these modalities is important. METHODS: Between January 1991 and March 1996, 64 depressed type early colorectal cancers were detected and treated. When a faint abnormality of the mucosa was suspected by routine videocolonoscopy, 0.1% of indigo carmine solution was sprayed on the mucosal surface (chromoendoscopy). Colonoscopic findings of m-sm1 cancers and moderately and massively extended submucosal (sm2-3) cancers were retrospectively reviewed and compared with confirmed histologic findings. RESULTS: Characteristic colonoscopic findings needed for surgical operation were as follows: (1) expansion appearance, (2) deep depression surface, (3) irregular bottom of depression surface, and (4) folds converging toward the tumor. By using these findings, the invasion depth of depressed type early colorectal cancers could be correctly determined in 58 of 64 lesions (91%). CONCLUSIONS: Characteristic colonoscopic findings obtained by a combination of videocolonoscopy and chromoendoscopy are useful for determination of the invasion depth of depressed type colorectal cancers, an essential factor in choosing a treatment modality.

Colon↗
PubMed1998

Centrifugal leukocyte apheresis for ulcerative colitis.

Corticosteroids are effective in bringing about clinical remission for ulcerative colitis. However, relapsed cases are frequently refractory to corticosteroids. In addition, the long-term use of corticosteroids often causes serious side effects. We have already reported that leukocyte apheresis using a centrifugal procedure was effective for patients with corticosteroid-resistant ulcerative colitis after conducting a pilot study in 14 patients. In the present paper, the clinical efficacy of leukocyte apheresis using a centrifugal procedure was evaluated again for corticosteroid-resistant ulcerative colitis. Twenty-three patients with corticosteroid-resistant severely active ulcerative colitis were treated by centrifugal leukocyte apheresis. Eighteen patients (78.3%) achieved clinical remission which was evaluated by the clinical activity index within 4 weeks after apheresis. Both colonoscopic and histological examinations confirmed the beneficial effect of this procedure. No significant side effects were noticed throughout the therapy.

Adult↗
PubMed1998

Remission of hypertension: retrospective observations over a period of 20 years.

To clarify the background and outcome of hypertensive patients who have remission of their elevated blood pressure (BP) after a course of antihypertensive drug therapy, we designed a retrospective observational study. The clinical records of 106 hypertensive men and women (BP, 164.3/104.4 mmHg) given antihypertensive drug treatment and subsequently examined every 1 to 3 mo for more than 20 yr were reviewed. The patients were divided into two groups: those who had remission (R-group) and those who did not have remission (N-group). Patients were considered in remission if no significant elevation in BP was observed for more than 1 yr after withdrawing their medication. Remissions ranging in duration from 1.6 to 21.7 yr (average duration, 6.3 yr) occurred in 19 of 106 patients (17.9%). However, anti-hypertensive drug treatment was eventually restarted in 17 of the 19 patients. Before treatment, comparison of the R-group and N-group revealed no differences with respect to age, body weight, BP, or serum creatinine. In contrast, the proportion of patients who lacked high-voltage deflections in their electrocardiograms (ECG) as well as that of patients whose BP was well-controlled by a single medication was significantly greater in the R-group than in the N-group (12/19 vs. 22/87, p < 0.05 and 10/19 vs. 13/87, p < 0.001, respectively). In addition, body weight in the R-group decreased significantly by the time drug therapy was withdrawn (p < 0.01). Finally, significantly more patients (14 of 19 patients) entered remission in the spring and summer (p < 0.05) than at other times of the year. We conclude that remission occurs in a subset of well-controlled hypertensive patients and may persist for several years or more. However, in the majority of patients, antihypertensive drug treatment will usually need to be restarted at some point. Patients who lack ECG high-voltage deflections and who are successfully treated with a single therapeutic agent are most likely to experience remission. Moreover, it appears that withdrawing patients from drug therapy in the spring or summer is more likely to yield a favorable outcome than at other times of the year.

Adult↗
PubMed1998

Sustained hemoconcentration in patients with chronic atrial fibrillation, a potential risk for stroke and thromboembolic complications. A retrospective study.

Hemoconcentration has been observed during paroxysms of atrial fibrillation and at the early stage of chronic atrial fibrillation. The present study was designed to determine how long the hemoconcentration continues after complete transition to atrial fibrillation from sinus rhythm by retrospective long-term observation of 9 patients with chronic atrial fibrillation and 18 age-gender matched control patients. Hematocrit levels significantly increased with transition to chronic atrial fibrillation from sinus rhythm (from 44.88 +/- 0.87% to 46.87 +/- 1.12%, p < 0.01) and remained high for at least another 4 years. They remained unchanged throughout the observation period in the control patients. There is a significant difference in the hematocrit level between patients with chronic atrial fibrillation and control patients (p < 0.001). The hemoconcentration may present a potential risk for stroke and thromboembolic complications.

Aged↗
PubMed1998

[Long-term follow up of QRS axis deviation].

It has been already described that the average axis of QRS complex is deviated by aging as well as various diseases, such as ventricular overload or bundle branch block. In this study, we first tested the hypothesis that the extra-cardiac factor changes with aging, such as the body shape or diaphragm position, which are represented by body weight (WT) and/or cardiac-thoracic ratio (CTR), are the main cause of QRS axis deviation. In 28 cases including 1 right (RAD) and 27 left axis deviation (LAD) patients whose QRS axis have been deviated during observed periods, WT and X-ray CTR were compared to the degree of axis deviation. Unfortunately no clear relationship was found among these parameters. On the other hand, in 8 cases out of 27 LAD patients, confirmed or suspected left anterior hemiblock (LAH) was found by vector electrocardiogram. Pathological studies showed that the degeneration of the stimulation pathway occurred with aging and it caused the bundle branch block. Therefore, we conclude that the degenerative change in left anterior stimulation pathway by aging should be, at least, one of the cause of the QRS axis deviation.

Aged↗
PubMed1998

[Effects of antihypertensive treatment on the thickening of the basal portion of the interventricular septum in essential hypertension].

Previous echocardiographic studies have indicated that the basal portion of interventricular septum is locally thickened in many patients with essential hypertension. This retrospective study investigated whether this localized thickening is decreased by antihypertensive treatment. Twenty-four patients with mild essential hypertension (15 males, 9 females, mean [+/- SD] 55 +/- 9 years) were selected who had local thickening at the basal portion of interventricular septum (> or = 11 mm) on echocardiograms recorded within 3 months after the first visit and were followed up by echocardiography 6 months or more after the start of antihypertensive treatment. Interventricular septal wall thickness at the mid portion (IVST), posterior wall thickness (PWT), left ventricular mass index (LVMI), aorto-septal angle, blood flow velocity in left ventricular outflow tract, and the thickness of the basal portion of interventricular septum (septal wall maximum thickness within 1.5 cm apex side from the joint of interventricular septum and aorta in the long-axis view of B-mode echocardiograms) were measured. Blood pressure was significantly decreased from 152.7 +/- 8.7/93.1 +/- 8.0 mmHg to 140.0 +/- 8.2/86.6 +/- 8.2 mmHg by treatment (p < 0.0001). The thickness of the basal interventricular septum was significantly reduced by treatment from 12.3 +/- 1.7 mm to 10.3 +/- 1.4 mm (p < 0.0001). Mean IVST, PWT and LVMI were slightly reduced by treatment, but the differences were not statistically significant. These results suggest that the thickening of basal interventricular septum is induced by high blood pressure, and the measurement of the thickness of basal interventricular septum might be a useful tool to estimate and monitor the effect of antihypertensive treatment in patients with mild essential hypertension.

Adult↗
PubMed1998

[Transient mitral regurgitation induced by vagal stimulation in rabbits: a Doppler echocardiographic study].

Cervical vagal stimulation in rabbits frequently causes systolic murmur with bigeminy due to premature ventricular contractions. The bigeminy disappears in a few minutes, but the systolic murmur persists for a few days. The present study used Doppler echocardiography to examine whether or not this systolic murmur is due to mitral regurgitation. Electrocardiographic monitoring was performed on anesthetized rabbits forced into the supine position. Doppler echocardiography was performed in the animals which showed systolic murmur 6 hours, 3 days, and 1, 2, 3 and 4 weeks after vagal stimulation. Six hours after vagal stimulation, phonocardiography detected systolic click and late systolic murmur, and Doppler echocardiography detected marked mitral regurgitation. The systolic murmur and mitral regurgitation were attenuated and the papillary muscle was swollen 3 days after vagal stimulation. The mitral regurgitation disappeared within a week and swelling of the papillary muscle improved 3 weeks after vagal stimulation. Doppler echocardiography confirmed that the systolic murmur observed in rabbits after vagal stimulation is due to transient mitral regurgitation.

Animals↗