PubMed Health⌕ Search

Biomedical subjects

T Sekihara

Publications and source records attributed to T Sekihara.

At least 19 recordsLinked to original sources
PubMed1992

Leisure time physical activity and insulin resistance in young obese students with hypertension.

To investigate the hypothesis that insulin resistance plays a role in the etiology of hypertension and hyperlipidemia, we measured serum lipid levels, the fasting glucose/insulin ratio, and the insulin response to oral glucose (GTT) in a group of young obese subjects (n = 21) with hypertension and normal glucose tolerance and in normotensive subjects (n = 36) with normal glucose tolerance, matched for age and body mass index. Leisure time physical activity was evaluated by a questionnaire outlining three levels of physical activities during leisure time. Subjects with hypertension had higher fasting serum insulin (19 +/- 2 v 13 +/- 1 microU/mL, P < .01) and lower fasting glucose/insulin ratio (5.3 +/- 0.2 v 7.1 +/- 0.5 mg/dL/microU/mL, P < .01) than normotensive subjects. Subjects with hypertension had higher peak serum insulin and lower plasma glucose area/insulin area ratio in response to glucose (1.8 +/- 0.2 v 2.4 +/- 0.2 mg/dL/microU/mL, P < .05) than normotensive subjects. Serum total cholesterol, low-density cholesterol, and triglycerides were higher in the obese hypertensive subjects than in obese normotensive ones. Blood pressure correlated with either fasting serum insulin, fasting glucose/insulin ratio, or glucose area/insulin area ratio during GTT. The level of leisure time physical activities was lower in obese hypertensive subjects than in obese normotensive ones. There were significant correlations between the levels of physical activity and the fasting plasma glucose/insulin ratio (r = 0.371, P < .01) or the fasting serum insulin concentration (r = -0.282, P < .05). The study provided evidence that a low level of leisure time physical activity is associated with insulin resistance and resultant hyperinsulinemia, which are the key metabolic abnormalities that link hypertension, obesity, and hyperlipidemia in young subjects.

Adolescent↗
PubMed1992

[Double filtration plasma pheresis was effective on the recurrence of pulmonary hemorrhage after renal transplantation: report of a case].

A 35-year old female with an autoimmune disease complaining of recurrent hemoptysis and macrohematuria had received a renal transplantation from her mother. After transplantation, recurrence of pulmonary hemorrhage occurred twice. First recurrence followed the peritonitis with ileal perforation. Steroid pulse therapy had no effect on this recurrence, while double filtration plasmapheresis was effective. During this treatment, renal function was not failed. Second recurrence followed acute rejection that was cured with the OKT3-rescue therapy. DFPP therapy was effective on this episode. Pulmonary hemorrhage was caused by auto immune reaction and acute rejection caused by transplant immune reaction were recognized independently, and they needed different treatment. According to this clinical course, we consider the relation between auto immune reaction and transplant immune reaction was as follows. T cell activation caused by primary transplant immune reaction may have no direct influence on auto immune reaction. Peritonitis and rejection may induce auto immune reaction. We suppose that this auto immune reaction was caused by humoral factor, because auto immune reaction was controlled by DFPP.

Adult↗
PubMed1992

[A case of shock following intravesical formalin instillation].

A case of shock following intravesical formalin instillation for massive bladder hemorrhage owing to post-radiation cystitis is reported. A 79-year-old woman had been treated with external irradiation for cancer of the uterine body in 1981. She was suffering from massive hematuria after hysterectomy in 1988. No hemostatic procedures were effective. Then we instilled 10% formalin into her bladder. After the instillation she entered a state of allergic shock.

Administration, Intravesical↗
PubMed1991

Effect of L-dopa in young patients with hypertension.

The effects of L-dopa on blood pressure, heart rate, plasma renin activity, norepinephrine, epinephrine and prolactin were studied in a randomized single-blind trial in 36 patients with essential hypertension. In response to L-dopa, 250 mg administered orally, the blood pressure decreased significantly as compared with the results of placebo treatment. The heart rate and plasma norepinephrine and epinephrine were unchanged. The plasma renin activity and prolactin decreased as a result of L-dopa administration. The administration of a peripheral DA2 dopamine receptor blocker, domperidone (20 mg, orally) prevented the L-dopa-induced reduction in plasma prolactin but failed to block the fall in blood pressure and plasma renin activity. These results suggest that the blood pressure-lowering effect of L-dopa may be mediated through multiple sites involving D1 dopamine receptors, the central nervous system, and the renin-angiotensin system.

Adult↗
PubMed1991

[Ectopic parathyroid adenoma: a case report].

A 69-year-old woman suffered from bilateral renal stones. Laboratory examinations showed primary hyperparathyroidism. Neck exploration including left hemithyroidectomy and partial thymectomy failed to reveal the abnormal parathyroid gland. Localization studies were done for an ectopic parathyroid adenoma. Repeated selective arteriography with digital subtraction technique revealed an ectopic parathyroid adenoma in the upper mediastinum. Computed tomography, ultrasonotomography and selective venous sampling also confirmed this finding. Subsequently, mediastinal exploration with partial sternotomy was performed and the ectopic parathyroid adenoma was removed. We discuss the preoperative localization studies for ectopic parathyroid adenoma.

Adenoma↗
PubMed1990

Comparison of clinic and home blood pressure levels and the role of the sympathetic nervous system in clinic-home differences.

Plasma and urine norepinephrine, epinephrine and home blood pressure were measured in 48 young hypertensive men (mean age, 21 years) and 25 matched normotensive controls. Plasma samples were drawn following 30 min rest in the clinic and 24 h urine samples were collected at home. Twenty-one hypertensive patients were given a single dose of clonidine (150 micrograms orally). Changes in blood pressure, heart rate and plasma norepinephrine were assessed. Twenty-five of the hypertensive patients were found to have a normal home blood pressure (defined from records of the normotensive subjects). The other group of patients maintained a high home blood pressure. In comparison to normal subjects, patients with a high home blood pressure were characterized by higher urinary norepinephrine and epinephrine excretion and higher plasma epinephrine. Patients with a normal home blood pressure had normal heart rate at home, normal plasma and urinary catecholamines. However, the two groups of hypertensives could not be distinguished on the basis of clinic blood pressure, plasma or urinary catecholamines due to considerable overlap. At 90 min after oral clonidine administration, the plasma norepinephrine and blood pressure levels were decreased in both groups of hypertensives to a similar extent. The changes in heart rate were significantly smaller in patients with a high home blood pressure than in those with a normal home blood pressure. These results suggest that the patients with a high home blood pressure tended to have a high sympathetic nerve activity. However, the two groups of hypertensives could not be separated on the basis of plasma or urinary catecholamine measurements.

Administration, Oral↗
PubMed1990

Effect of captopril on plasma prolactin in patients with essential hypertension.

The effects of the angiotensin-converting enzyme inhibitor captopril on blood pressure, heart rate, plasma prolactin, and renin activity were examined in a single-blind, placebo-controlled trial on 30 patients with essential hypertension (15 given drug, 15 placebo). Captopril, 25 mg administered orally, reduced the blood pressure and increased the plasma renin activity. Captopril decreased mean plasma prolactin from 17.5 +/- 1.4 ng/mL to 9.1 +/- 1.0 ng/mL (p less than 0.001). Significant correlation was found between captopril-induced change from control values of plasma prolactin (delta plasma prolactin) vs delta plasma renin activity (r = -0.688, p less than 0.001). These results suggest that acute administration of captopril was accompanied by a reduction in plasma prolactin and that this reduction may be of clinical significance during therapy of hypertension.

Adult↗
PubMed1990

[Transitional cell carcinoma of the ureter with an inverted growth pattern which was accompanied with bladder tumor: a case report].

The patient was a 75-year-old man who complained of macrohematuria which had set in from April 12, 1988. Under the clinical diagnosis of bladder tumor, total cystectomy with ureterosigmoidostomy was performed on June 25. During his surgery, we discovered a polypoid lesion of the right ureter close to the common iliac artery. The tumor was peanut-sized and had a stalk suggesting benign nature, so we resected it. Postoperative pathological examination revealed the tumor was transitional cell carcinoma (grade 2) with an inverted growth pattern. Though we could find no signs of tumor recurrence, the presence of tumor's residuum could not be ruled out. We performed nephroureterectomy of the right side on December 19. Follow-up on July 1, 1989 this patient revealed no tumor recurrence.

Aged↗
PubMed1990

[Unilateral hydronephrosis with hypertension due to ureteral endometriosis].

A 35-year-old female patient was hospitalized for a headache. She was referred to our department for the evaluation of right hydronephrosis noted on the excretory urogram which was performed as part of a hypertensive diagnostic study. Endocrine examination revealed renal hypertension. Excretory urogram and antegrade pyelography showed obstruction of the lower part of the right ureter. On surgical exploration, the lower part of the right ureter was surrounded by brown tissue. Complete hysterectomy and ureterovesiconeostomy were performed. Histologically, the brown tissue around the ureter was diagnosed as endometriosis. One year after the operation, excretory urogram showed normal urinary tract and the blood pressure was 130/80 mmHg. Endometriosis is a common gynecological disease but ureteral endometriosis is relatively rare. Review of the Japanese literature disclosed 16 previous cases of ureteral endometriosis and we report the 17th case with a review of the literature.

Adult↗
PubMed1990

[Left ventricular function after prolonged exercise].

To determine whether depressed left ventricular (LV) contractile function can occur after exhaustive exercise, echocardiographic studies were performed in eleven athletes before, at the finish (9 minutes) and during recovery (15 hour) after the Biwa Lake Ironman Triathlon (3.2 km Swim, 161 km Bike, 32 km Run). Before racing and during recovery, the studies were performed both at rest and after brief exercise (10-15 minutes). Heart rates after brief exercise were comparable to those attained after racing. Digitized M mode echocardiographic data as to wall thickness, cavity dimension, fractional shortening (FS) and peak circumferential shortening (maxVcf) were obtained. When we compared race finish to pre-race brief exercise, the LV end-diastolic dimension (EDD) was reduced (46 +/- 7 vs 47 +/- 6 mm, less than 0.05) and FS declined (33 +/- 5 vs 39 +/- 6%, p less than 0.05). In spite of reduced wall stress, maxVcf decreased. Individual percent reductions in FS were not correlated with decrease in EDD, but correlated with increases in EDS. Although a persistent reduction in cavity size was observed during recovery, FS and maxVcf returned toward the baseline. The results suggest that prolonged strenuous exercise may result in impaired LV function in part because of a reversible depression in the contractile state.

Adult↗
PubMed1990

[Retroperitoneal lymph node dissection for testicular tumor with renal autotransplantation: a case report].

A case of testicular tumor (embryonal cell carcinoma with choriocarcinoma) in a 42-year-old man treated with renal autotransplantation is presented. After four courses of chemotherapy (carboplatin, vinblastine and bleomycin), we performed retroperitoneal lymph node dissection. At the operation, one of the swelling lymph nodes involved left renal artery completely, so we performed left renal autotransplantation and promoted more effective lymph node dissection. After the operation, renal function was impaired but returned completely in a short time. Autotransplantation provides excellent bench visualization of renal lesions and stable graft function. Therefore, this procedure should be taken into consideration when nephrectomy cannot be avoided.

Adult↗
PubMed1990

[Vesicorectal fistula associated with Crohn's disease: a case report].

A 41-year-old man was hospitalized, complaining of fecaluria and right lower abdominal pain. He was diagnosed to have vesicorectal fistula. Wedge resection of bladder and rectum, and partial resection of ileocecal legion were performed. Pathological diagnosis was Crohn's disease. Postoperative course was uneventful and no recurrence was observed. Including our case, 32 cases of enterovesical fistula due to Crohn's disease have been reported in the Japanese literature.

Adult↗
PubMed1989

Increased sympathetic nerve activity at home in young subjects with hypertension.

Plasma and urine norepinephrine, epinephrine, plasma renin activity and aldosterone were measured in 11 young men (mean age, 21 years) with a high blood pressure in the clinic who maintained a high home blood pressure and 12 men with an elevated clinic blood pressure who had a normal home blood pressure. Plasma samples were drawn following 30 min rest in the clinic, and 24-hour urine samples were collected at home. The two groups of hypertensives could not be distinguished on the basis of clinic blood pressure, plasma norepinephrine, epinephrine, renin activity or aldosterone. Patients with a high home blood pressure were characterized by a high urinary norepinephrine excretion. These results suggest that the patients whose blood pressure remained elevated at home had an increased sympathetic nerve activity at home.

Adolescent↗
PubMed1987

Blood pressure response to a calcium entry blocker in normotensive subjects with or without a family history of hypertension.

The possibility that a familial background of hypertension might influence the blood pressure response to a calcium entry blocker was evaluated in 15 normotensive relatives of patients with essential hypertension and 18 normotensive subjects with no family history of hypertension. Under control conditions, blood pressure, heart rate, plasma noradrenaline, adrenaline, and renin activity did not differ between the two groups. Nifedipine, at a dose of 10 mg administered sublingually, lowered the blood pressure and increased the heart rate, plasma noradrenaline, and renin activity. The normotensive relatives of patients with essential hypertension did not differ in their responses from the normotensive subjects with no family history of hypertension, with the exception of plasma noradrenaline thirty minutes after nifedipine. These results provide evidence to suggest that there is no functional abnormality with increased dependency of vascular smooth muscle tone on calcium influx in the prehypertensive state.

Adult↗