Biomedical subjects

Toru Takemura

Publications and source records attributed to Toru Takemura.

3 recordsLinked to original sources

PubMed2006

Immediate effect of Shakuyaku-kanzo-to on muscle cramp in hemodialysis patients.

We administered 2.5 g of Shakuyaku-kanzo-to granule to 61 patients who had muscle cramp during hemodialysis (HD) sessions and examined its immediate effects. We selected 10 patients who wanted to take the drug at home, out of cases, for whom the drug was effective on the study described above and had them take the drug in the same way at the beginning of muscle cramp at home examined the effects. In the study during HD sessions, muscle cramp and its associated pain disappeared in 5.3 +/- 3.9 min on average in 54 out of 61 cases. In the study of patients who took the drug at home, muscle cramp disappeared within 10 min in all cases. Shakuyaku-kanzo-to is thought to be very useful for muscle cramp during HD sessions of hemodialized patients because it has immediate effects by its oral administration on the occasion of cramp. With regard to the muscle cramp, which appears at home after HD sessions, the patients can cope with it by taking the drug by themselves. This is an epoch-making therapy, for it was impossible to cope with muscle cramp except in hospitals because the therapy of muscle cramp was limited to intravenous infusion of hypertonic solutions of dextrose, mannitol, and saline during HD sessions.

Administration, Oral↗

PubMed2005

[Sevelamer:hydrochloride].

The recent global breakthrough in the field of renal osteodystrophy is the inhibitory effect of sevelamer hydrochloride on the progression of coronary artery calcification, which was revealed with EBCT (Electron beam computed tomography) 1) approximately 3). It has been found that the degree of coronary artery calcification assessed with EBCT is proportional to the mortality risk by the coronary artery stenosis and by myocardial infarction in non-hemodialysis patients 4) approximately 10). In 2004 in Japan Matsuoka and Iseki et al showed for the first time in the world that coronary artery calcification assessed by EBCT was correlated with mortality 11). In Japan, however, it is difficult to administer sevelamer hydrochloride to many patients because of constipation as its side effect. Its prescription rate is 26.8% and its single administration rate is only 15.4% 12). We explained fully to the patients that sevelamer hydrochloride seldom caused coronary artery calcification. And we used sorbitol, an osmotic purgatives, with sevelamer hydrochloride. Moreover, we gradually replaced calcium carbonate with sevelamer hydrochloride in supper at first. With protocol above, we succeeded in having 86.7% of the patients take sevelamer hydrochloride 12). We think that it is important to increase the intake rate of sevelamer hydrochloride in order to prevent coronary artery calcification and to aim at the long survival of the patients.

Calcinosis↗

PubMed2005

[Treatment of adynamic bone disease with the complete replacement from calcium carbonate to sevelamer hydrochloride].

The aim of this study was to examine the therapeutic effect of hypocalcemic stimulation caused by sevelamer hydrochloride (SH) administration on adynamic bone disease (ABD). The subjects were 28 maintenance hemodialysis (HD) patients who had remained in ABD state in spite of no administration of vitamin D(3) since HD induction (15 males and 13 females;12 diabetic patients and 16 non-diabetic patients). The mean age was 61.8+/-9.5 years and the mean HD duration was 5.5+/-3.9 years. The calcium concentration in the dialysate was 3.0 mEq/L. We made the final daily dose of SH after two months the same as the first daily dose of calcium carbonate (CC) in the following manner. At first we administered only CC at breakfast and lunch and SH at supper. And for the next two weeks we administered CC at breakfast and SH at lunch and supper. And for the final two weeks we administered only SH. After that we increased the dose of SH as much as possible. We evaluated the therapeutic effect of the above treatment on ABD using intact-osteocalcin (iOC) [Teijin. Tokyo] as a marker before and 6, 12 months after the beginning of the replacement. If iOC Ievel of 30 to 70 ng/mL showed normal tumover bone (NTB), 5 cases (17.9%) changed into NTB in 6 months. 9 cases (32.1%) changed into NTB in 12 months and one case (3.6%) changed into ostitis fibrosa in 12 months. It is thought that SH is effective for the treatment of ABD but we have to be careful for ostitis fibrosa.

Aged↗