[Socio-medical management of the aged. Demographic aspect].
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Biomedical subjects
Publications and source records attributed to T Kuroda.
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Primary hyperparathyroidism was investigated using the presence of basic fibroblast growth factor (bFGF) from the immunohistochemical viewpoint with an anti-bFGF antibody in hyperplastic parathyroid glands of patients with multiple endocrine neoplasia type I (MEN-I) and of patients with non-MEN. The results corresponded well with the data from the DNA analysis. Twenty-five hyperplastic parathyroid glands from 11 patients with MEN-I and 38 glands from 20 patients with non-MEN primary hyperparathyroidism were stained immunohistochemically according to the avidin-biotin-peroxidase complex procedure. When 50% or more of the cells appeared uniformly stained, it was judged positively stained. In addition, 18 hyperplastic parathyroid glands from patients with MEN-I patients and 24 hyperplastic parathyroid glands from non-MEN patients were also analyzed for DNA using flow cytometry. The ratio of positively stained hyperplastic parathyroid glands was 72% in MEN-I patients and 18% in non-MEN patients. The difference between the two groups was significant (p < 0.01). The nodules consisted of oxyphilic cells in 7 of 25 hyperplastic parathyroid glands from MEN-I patients and in 10 of 38 hyperplastic parathyroid glands from non-MEN patients, and all the cells were positive for bFGF. There was no significant correlation between bFGF staining and the DNA ploidy pattern. bFGF possibly plays a role in the development of parathyroid gland hyperplasia, especially in MEN-I patients. The increase of oxyphilic cells may be correlated with the expression of bFGF.
The effects of food, antibiotics, diclofenac sodium (DS) and methotrexate (MTX) on oral bioavailability (BA) of MTX were examined in rats. Feeding didn't vary the plasma concentrations after intravenous dosing of 0.5 mg/kg MTX, but enhanced those after oral dosing, and the oral BA. The twice daily oral doses of 40 mg/kg neomycin sulfate (NS) or mixed antibiotics (200 mg/kg NS + 200 mg/kg streptomycin sulfate + 200 mg/kg bacitracin) for 5 days didn't influence the plasma concentrations after intravenous dosing of 0.5 mg/kg MTX, but induced the decreased Cmax and the delayed MRT after oral dosing. The plasma concentrations after intravenous or oral dosing of 2.5 mg/kg MTX in rats orally dosed with 1 or 5 mg/kg/day DS for 4 days were similar to those in the control rats, while the pre-treatment of 25 mg/kg/day DS delayed the elimination of MTX but didn't change the oral BA. The plasma concentrations after intravenous or oral dosing of 2.5 mg/kg MTX in rats, which received the intermittent oral doses of 7.5 mg/kg/3 doses/week MTX for 4 weeks, were comparable to those in the control rats, but the daily pre-treatment of 0.2 mg/kg/day MTX for 4 weeks increased the plasma concentrations after oral dosing, and the BA.
We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.
Two phased-array scanning methods can be used for volumetric transesophageal echocardiographic imaging: (1) pull-back "breadloaf" reconstruction, and (2) rotation "fan-like" reconstruction. The purpose of this study was to (1) test accuracy and precision of pull-back versus rotational geometries for three-dimensional volume determination, and (2) test accuracy of the resulting surface/volume rendered images. The endoscope shaft was inserted into a tube with the handle connected to a stepper device. Seventeen balloons (61 to 471 ml) were put into a water bath consecutively. Two scans were performed: (1) pull-back: the probe was withdraw in 1 mm steps to obtain parallel "breadloaf" slices, and (2) rotational: the probe was rotated in increments of 1.8 degrees, 3.6 degrees, or 5.4 degrees to obtain "fan-like" slices. Each image was digitized for computer analysis. The data were interpolated into 128 x 128 x 128 voxels for three-dimensional reconstruction. Volume measurement was done using a stereometric random marking method. Volumes obtained from the reconstructed images were compared with the true volume (weight) by linear regression analysis. Excellent correlation between measured and actual volumes was obtained from rotation scans as follows: for 1.8 degrees steps (r = 0.9987, SEE = 6.5 ml), for 3.6 degrees steps (r = 0.9959, SEE = 11.5 ml), and for 5.4 degrees steps (r = 0.9943, SEE = 13.5 ml). The pull-back scans showed r = 0.9990, SEE = 5.8 ml. Three-dimensional surface/volume rendered images of the balloons indicate that 1.8 degrees rotation scans are almost as good as 1 mm pull-back scans. We conclude that volume measurements from rotation scans in vivo will not be hindered by scan geometry or software interpolation.
BACKGROUND: Abnormal fatty acid metabolism persists in hibernating myocardium, even after reperfusion. This study was designed to determine whether the K+ channel opener, nicorandil, improves fatty acid utilization after percutaneous transluminal coronary angioplasty (PTCA). METHODS: Patients undergoing elective PTCA were randomly assigned to treatment (group N, n = 26) or control groups (group C, n = 22). Group N received intracoronary and intravenous nicorandil during PTCA. Myocardial fatty acid use and perfusion were quantitatively evaluated by means of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid single photon emission computed tomography (I-123 BMIPP SPECT) and thallium-201 (Tl-201) imaging before PTCA, 72 hours after PTCA, and 3 months after PTCA. Left ventricular function was also evaluated by means of contrast ventriculography before and 3 to 6 months after PTCA. RESULTS: The 1-123 BMIPP defect score in group N significantly decreased, from 28%+/-13% to 20%+/-20% after PTCA and to 18%+/-17% 3 months later. In contrast, the I-123 BMIPP defect score in group C increased from 28%+/-20% to 36%+/-15% (P<.05 versus group N) after PTCA, then returned to 28%+/-17% (P<.05 versus group N) 3 months after PTCA. Recovery of left ventricular function paralleled the recovery of I-123 BMIPP uptake. CONCLUSIONS: Nicorandil improves the recovery of myocardial fatty acid utilization and cardiac function after PTCA. K(ATP) channel activation may have a protective effect during coronary artery occlusion and improve subsequent recovery.