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Biomedical subjects

T Tomizawa

Publications and source records attributed to T Tomizawa.

At least 19 recordsLinked to original sources
PubMed2001

Diabetes mellitus with left transverse sinus thrombosis and right transverse sinus aplasia.

A 67-year-old woman with diabetes mellitus was hospitalized due to a throbbing headache. She appeared neurologically normal, except for meningeal irritation. The cerebrospinal fluid pressure was high. There was increased fluid protein without an increased cell count. Brain CT scan showed no abnormality, however, brain magnetic resonance angiography (MRA) showed complete right transverse sinus stasis and partial left transverse sinus stasis, indicating bilateral transverse sinus thrombosis. At this time thrombin anti-thrombin III complex (TAT) and prothrombin fragment F1+2 (PTF1+2) indicating hypercoagulation had increased. Urokinase, followed by aspirin and ticlopidine hydrochloride were administered. After diet therapy and transient insulin administration, her blood glucose levels improved. By the 22nd day, the headache had disappeared. Subsequently, brain MRA showed left transverse sinus blood flow recovery and complete right transverse sinus stasis, while carotid angiography showed recovered left transverse sinus but right transverse sinus defect. TAT and PTF1+2 levels improved concomitantly with better blood glucose control. We diagnosed this case as left transverse sinus thrombosis because of the hypercoagulable state resulting from diabetes mellitus accompanied by right transverse sinus aplasia.

Aged↗
PubMed2001

Acute gastric dilatation accompanied by diabetes mellitus.

A 72-year-old man with diabetic triopathy was hospitalized with methicillin resistant staphylococcus aureus pneumonia. Six hours after the admission, his abdomen was fully expanded. An abdominal X-ray showed gastric dilatation. After insertion of a gastric tube to extract gastric air, his abdomen was flat and gastric dilatation improved. A positive Schellong test and decreased coefficient of RR interval in electrocardiogram variation indicated autonomic neuropathy, which may explain the reason for gastric hypomotility. Acute gastric dilatation in this patient may have occurred due to gastric hypomotility as a result of diabetic autonomic neuropathy in addition to gastric motility inhibition resulting from gastric autonomic nerve stimulation by bacterial toxin.

Acute Disease↗
PubMed2000

Mycobacterium avium complex pleuritis accompanied by diabetes mellitus.

A 72-year-old woman with diabetic nephropathy was hospitalized with peripheral edema in the extremities and weight increase. After diuretics and human serum albumin administration, her condition improved. From the 15th day she had run a subfever and her breathing was diminished in the left lower lung field. A plain chest X-ray film showed pleural effusion over the left lung field. The fluid was exudative. Fluid cultures were negative. A tuberculin reaction was negative. Polymerase chain reaction method disclosed mycobacterium avium complex, indicating rare pleuritis due to mycobacterium avium complex. Eighteen days after chemotherapy, pleural effusion disappeared. Although her hemoglobin A1c (HbA1c) levels were maintained from 6.0 to 6.5% over 4 years, urinary albumin excretion levels and serum creatinine levels increased, indicating deteriorating diabetic nephropathy. Serum albumin levels remained low (3.3-3.6 g/dl). Malnutrition, impaired cellular immunity and apparently abnormal microvascular circulation due to diabetes mellitus may consequently have induced pleuritis due to mycobacterium avium complex.

Aged↗
PubMed2000

Effect of bezafibrate or pravastatin on serum lipid levels and albuminuria in NIDDM patients.

Lipid abnormalities in diabetic patients, particularly in those with nephropathy, may be partially due to deteriorating atherosclerosis. Therefore, strict control of the lipid metabolism in addition to glycemic control is desirable. Whether or not lipid lowering drugs prevent albuminuria in diabetic patients in the long term remains unclear. This study involved 71 NIDDM patients with hypercholesterolemia (group A: n = 37, group B: N = 34). The effect of bezafibrate (group A) or pravastatin (group B) on the cholesterol (CH) content of apolipoprotein AI, B100 containing particles or remnant-like particles (RLP) or urinary albumin excretion was studied over 4 years. The CH content in apolipoprotein B100 particles after treatment with either bezafibrate or pravastatin decreased significantly (group A: 24.7%, group B: 26.6%). The CH content in RLP after treatment with bezafibrate showed a significant decrease (67.9%). Apolipoprotein AI after treatment with bezafibrate showed a significant increase (10.9%). Apolipoprotein B100 after treatment with either drug decreased significantly (group A: 19.8%, group B: 23.4%). The urinary albumin excretion rate after treatment with either drug showed no significant change over 4 years. Bezafibrate and pravastatin appear to be useful in the preventive treatment of albuminuria as well as in lowering lipid levels in NIDDM patients.

Albuminuria↗
PubMed1999

Hyperkalemia probably reverses the antiarrhythmic effects of amiodarone: a case report.

Sustained monomorphic ventricular tachycardia (VT) developed in a 58-year-old man with acute myocardial infarction and end-stage renal disease. Amiodarone was effective in preventing VT recurrence. Sustained VT was not induced during an electrophysiologic study. However, VT recurred during accidental hyperkalemia, which was caused by the change of dialysis therapy from peritoneal dialysis to hemodialysis. VT subsided with correction of hyperkalemia. Thereafter, VT did not recur as long as the serum potassium concentration was kept within the normal range. Several months later, the patient died suddenly because poor dietary compliance resulted in an increase in his potassium concentration. This case suggests that hyperkalemia may reverse the potent antiarrhythmic effects of amiodarone.

Acute Kidney Injury↗
PubMed1998

Insertion/deletion polymorphism in intron 16 of the ACE gene and left ventricular hypertrophy in patients with end-stage renal disease.

We studied the relationship between polymorphism in intron 16 of the angiotensin-converting enzyme (ACE) gene and left ventricular (LV) hypertrophy in uremic patients treated with hemodialysis therapy. The LV parameters were not different for age-, hematocrit-, and blood pressure-matched patients in DD, ID, and II genotype groups. The most important factor for LV hypertrophy was systolic blood pressure, which correlated with the posterior wall thickness (r=0.35; P=0.001) and LV mass index (LVMI; r=0.23; P=0.032). Among nonhypertensive patients, the frequency of interventricular septum (IVS) hypertrophy (>12 mm) and hypertrophy in LVMI (>145 g/m2) was significantly greater in patients with the DD genotype than in I allele-positive (+) patients. The odds rate for IVS hypertrophy was 5.04 (95% confidence interval, 1.15 to 24.8). These data suggest that the DD genotype of the ACE gene polymorphism is a contributory factor for the development of LV hypertrophy in patients with end-stage renal disease (ESRD).

Age Factors↗
PubMed1998

Prader-Willi syndrome with elevated follicle stimulating hormone levels and diabetes mellitus.

A 21 -year-old man with Prader-Willi syndrome (PWS) was hospitalized due to hyperglycemia. After diet therapy and transient insulin administration, his blood glucose levels improved. Based on the fact that his urinary C-peptide levels increased, the diabetes mellitus may have been due to insulin resistance with obesity. In addition, his testes had become atrophied. Testosterone levels remained low even after human chorionic gonadotropin (HCG) administration. Luteinizing hormone (LH) levels were also low after LH releasing hormone (LHRH) administration. The LH response increased slightly after daily LHRH administration, indicating hypothalamic hypogonadism. Follicle stimulating hormone (FSH) levels were, however, high and increased after LHRH administration. The selective FSH elevation may have been due to the accompanying idiopathic oligospermia.

Adult↗
PubMed1998

Diabetes mellitus accompanied by nonocclusive colonic ischemia.

A 70-year-old man with diabetic triopathy was hospitalized with left lower quadrant abdominal pain and tenderness, muscle guarding and absent bowel sounds. Three hours after admission, creatine phosphokinase (CPK) was elevated and an abdominal plain film X-ray showed intestinal gas retention, indicating paralytic ileus due to inferior mesenteric artery occlusion. Urokinase (60,000 units/day) and heparin (10,000 units/day) were administered. Angiography showed no occlusion in the mesenteric artery. On the 16th day, the abdominal signs had disappeared and CPK was normalized. We diagnosed this case as nonocclusive colonic ischemia because of the hemorheological abnormalities due to diabetic triopathy and the hypercoagulable state.

Aged↗
PubMed1998

Effect of nephropathy on the composition of apolipoprotein-containing particles in NIDDM.

We investigated the effect of nephropathy on the composition of apolipoprotein-containing particles in non-obese NIDDM patients with normocholesterolemia. Sixty-seven normal control subjects (group A), 48 NIDDM patients without nephropathy (group B) and 36 NIDDM patients with nephropathy (group C) were studied. Apolipoprotein AI or B100 containing particles (Apo AI or Apo B100) were isolated by immunoaffinity columns prepared with monoclonal antibodies. The total cholesterol (CH), esterified cholesterol (EC) and free cholesterol (FC) content in these particles was analyzed. Both the EC/FC ratio levels in Apo AI and in Apo B100 in group C were significantly higher than those in group A or B. Both the CH in Apo AI/apolipoprotein AI ratio and in Apo B100/apolipoprotein B100 ratio levels in group C were significantly lower than those in group A or B. The insulin resistance index showed significant positive correlation with the EC/FC ratio levels in Apo AI and in Apo B100, and showed significant negative correlation with the CH levels in Apo AI/apolipoprotein AI ratio and the CH levels in Apo B100/apolipoprotein B100 ratio levels in group C. Those compositional changes of lipoproteins in NIDDM patients with nephropathy may reflect partial insulin resistance and deteriorating atherosclerosis.

Antibodies, Monoclonal↗
PubMed1997

Immediate-type human insulin allergy successfully treated by continuous subcutaneous insulin infusion.

A 63-year-old insulin-dependent diabetic woman was hospitalized with itchy skin wheals at the injection sites of human insulin. After intradermal skin testing was performed, the erythema and wheal was recorded immediately. The increased titer of human insulin-specific IgE antibody indicated immediate-type allergy against human insulin. Administration of an anti-allergic drug or desensitization for human insulin every 2 hours was not effective. After continuous subcutaneous insulin infusion (CSII) therapy was performed, both the itching and wheal disappeared. The process may be a desensitization through CSII. CSII may be useful in the treatment for human insulin allergy.

Diabetes Mellitus, Type 1↗
PubMed1996

Familial type V hyperlipoproteinemia with hyper-remnant-like particle-cholesterol accompanied with apolipoprotein E3/E4 phenotype.

A 41-year-old woman and her 2 sons had Type V hyperlipoproteinemia. Interestingly, the patient and her younger son had higher levels of remnant-like particle (RLP)-cholesterol than her elder son; the former two had apolipoprotein E phenotype E3/E4, while the latter had E3/E3. Hyper-RLP-ch levels may be associated with the apolipoprotein E4 phenotype. Moreover, after administration of bezafibrate, the patient's triglyceride, RLP-cholesterol and RLP-triglyceride levels decreased markedly and the chylomicron fraction disappeared. Further studies may be necessary to determine if hypertriglyceridemic patients with or without apolipoprotein E4 show a greater reduction in serum TG levels with lipid-lowering agents.

Adult↗
PubMed1996

Serum lipid and lipoprotein metabolism after glucose ingestion in NIDDM and IGT patients. Apolipoprotein-containing particles.

OBJECTIVE: Through analysis of apolipoprotein-containing particles after glucose ingestion, we determined abnormal lipid metabolism in NIDDM patients and subjects with impaired glucose tolerance (IGT) without obesity or hyperlipidemia. RESEARCH DESIGN AND METHODS: Apolipoprotein (apo) AI- or B100-containing particles or remnant-like particles (RLPs) were isolated by immunoaffinity columns prepared with monoclonal antibodies. The cholesterol contents in these particles after glucose ingestion (0, 30, 60, and 120 min) were analyzed in 18 nonobese NIDDM patients, 18 nonobese IGT subjects, and 33 normal control subjects. RESULTS: Changes in cholesterol content in apo B100 particles after oral glucose ingestion decreased significantly in both the NIDDM group and the IGT group; the changes were insignificant in the nondiabetic group. Changes in cholesterol content in the apo AI particles after oral glucose ingestion showed no differences between the three groups. Changes in cholesterol content in RLPs after oral glucose ingestion increased significantly in both the NIDDM group and IGT group; the changes were insignificant in the nondiabetic group. The changes in apo B100 after oral glucose ingestion decreased significantly in the three groups; however, apo AI after oral glucose ingestion showed no change in the three groups. CONCLUSIONS: The cholesterol content in apo B100 particles might decrease and the cholesterol content in RLPs might increase after oral glucose ingestion in not only NIDDM patients but also IGT subjects. The changes may be partially due to insulin resistance.

Apolipoprotein A-I↗
PubMed1996

[Preclinical and clinical studies on the efficacy of bifonazole in patients with tinea pedis at 10 years after approval. Part 1. Susceptibility to bifonazole of clinical isolates of dermatophytes].

An investigation was carried out to determine whether or not here had been any changes in the susceptibility of clinically isolated strains of Trichophyton metagrophytes and Trichophyton rubrum (both leading causes of tinea) to bifonazole, an imidazole derivative and antifungal for topical use. Susceptibility was measured in 107 strains of these fungi isolated from clinical samples during a study on the treatment of tinea pedis with Mycospor cream in 1995, 42 strains isolated and stored in 1990, and 39 strains isolated and stored prior to development of the drug. The results are as follows: (1) There was no distinct difference in the susceptibility to bifonazole of T. mentagrophytes strains isolated before 1986 and those isolated in 1990 or 1995. (2) T. rubrum strains isolated before 1986 were slightly more susceptible to bifonazole than those isolated in 1995, while the 1990 strains were slightly less susceptible than the 1995 strains, but the difference was not significant. (3) The highest MICs of bifonazole for all the T. mentagrophytes and T. rubrum strains isolated from before 1986 and those in 1995 were relatively low, being 2.5 micrograms/ml and 1.25 micrograms/ml, respectively. These results suggest that no resistance or reduced susceptibility to bifonazole has emerged among clinical isolates of dermatophytes since the development of the drug.

Antifungal Agents↗
PubMed1996

[Fundamental and clinical studies on the efficacy of bifonazole in patients with tinea pedis at 10 years after approval. Part 2. Clinical evaluation].

The usefulness of bifonazole (Mycospor), a topical imidazole antifungal agent approved 10 years ago, was evaluated for the treatment of tinea pedis. Mycospor cream was applied by 141 patients with tinea pedis once daily for 4 233ks, and the clinical efficacy and adverse reactions (as well as any correlations with susceptibility of isolates and the mycological activity of the agent against these isolates) were studied. The results were then compared to those of a previous study. The following results were obtained. 1. Mycological activity Mycological examination results became negative in 63.2% (36/57) of the patients with plantar tinea pedis, in 94.1% (32/34) of those with interdigital tinea pedis, and in 74.7% (68/91) of all tinea pedis patients. 2. Mycological activity and MIC No correlation was found between the MICs of bifonazole against the pathogenic fungi and the rate of eradication on mycological examination. 3. Improvement of symptoms The improvement rates for local symptoms were 82.5% for plantar tinea pedis, 85.7% for interdigital tinea pedis, and 83.7% for all tinea pedis. 4. Clinical efficacy Good clinical efficacies were found in 61.4% of the patients with plantar tinea pedis, in 88.6% of those with interdigital tinea pedis, and in 71.7% of all patients. 5. Safety Regarding adverse reactions, what seemed to be contact dermatitis was reported in 5 out of 127 cases (3.9%). The reaction decreased or disappeared in all cases. 6. Usefulness Mycospor was found to be useful in 64.9% of patients with plantar tinea pedis, in 88.6% of those with interdigital tinea pedis, and in 73.9% of all tinea pedis patients. 7. Comparison with former results The results obtained in the present clinical study were comparable to those obtained in patients with tinea pedis treated in a double-blind comparative study conducted during the development of as a new topical antifungal agent. From the above results, Mycospor cream was confirmed to be still useful, although it has been used widely for the topical treatment of cutaneous mycoses in the past 10 years since its approval.

Adult↗
PubMed1995

[Role of pharmacist in cancer pain management].

It is essential for patients to have understanding of the significance of morphine administration and to cope well with its side effects, as it leads to enhancement of the analgesic effects of morphine in the treatment of cancer pain. Since August 1993 we have used the booklet "Relieving Pain Effectively--Manual for Patients" and have consulted up to date approximately 670 patients about taking narcotics. The initial information eliminates the anxiety before taking morphine--we set up the time that each patient should take medicine to fit their life-style and explain about the the medicine and its side-effects. For this reason, the above information takes approximately 30 to 60 minutes per patient. We guide the patient over to over till the pain and side-effects have disappeared and file a "Morphine Education Record" with the details. We also prepare a "Pain and Side-Effect Control Sheet" that consists of 6 items and a pain scale where 0 equals no pain and no side-effect and 5 equals most pain and side-effects. Patients select the scale themselves every day. Pharmacists provide the information to a doctor and advise him on steps against side-effects, selection of dose, interval and rescue-dose. This is a report on the role of the pharmacist in patient narcotics guideline for cancer pain management.

Humans↗
PubMed1993

Safety and efficacy of amlodipine. A new once-daily calcium antagonist in non-hypertensive patients with coronary artery disease.

To analyze the effects of the treatment of 5 mg amlodipine on blood pressure and heart rate with a 24-hour ambulatory blood pressure monitoring device and to evaluate its antiischemic efficacy using treadmill exercise testing, 7 non-hypertensive patients with coronary artery disease were studied. The systolic and diastolic blood pressure and heart rate recorded over the entire day and during daytime did not change significantly after the treatment. On the other hand, the systolic blood pressure decreased significantly at night (122 +/- 19-->113 +/- 17 mmHg, p < 0.05) after treatment, but the change can be considered to be within the physiological range. Exercise duration increased significantly after the administration of amlodipine (9.7 +/- 4.8-->11.1 +/- 4.9 min, p < 0.05). Systolic blood pressure, heart rate and rate-pressure product decreased significantly and in addition, ST segment depression was significantly less marked (-0.25 +/- 0.09-->-0.21 +/- 0.09 mV, p < 0.05) after treatment, when compared at the same level of work load. Therefore, the new once-daily calcium antagonist amlodipine is safe and efficacious in non-hypertensive patients with coronary artery disease.

Amlodipine↗