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Sekido Noritoshi; Kawai Koji; Akaza Hideyuki; Koiso Kenkichi 《Japanese journal of clinical oncology》1995,25(4):164-167
Between July 1991 and December 1994 at Tsukuba Gakuen Hospital,we treated 19 consecutive men with advanced adenocarcinoma ofthe prostate (five at stage C, four at stage D1 and 10 at stageD2). Of these, 14 patients underwent castration (two patients)or received LH-RH analogue (12 patients) plus chlormodinoneacetate for combined androgen blockade. We report three representativecases of sequential prostate specific antigen (PSA) elevationfollowing initial response to this combined androgen blockade.Discontinuation of chlormadinone acetate resulted in declineof the serum PSA level. This suggests that trial chlormadinoneacetate withdrawal in patients showing increasing levels ofPSA during combined androgen blockade should be considered beforeinitiation of alternative treatment. 相似文献
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Takuya Yamashita Yukinori Moriyama Naoyuki Sata Naokazu Hamada Takashi Horinouchi Shigeru Amitani Kenkichi Miyahara Kentaro Setoyama Kazuhiro Misumi Hiroshi Sakamoto 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(2):64-68
OBJECTIVES: The exact role of pressure gradient across the prosthetic valve estimated from Doppler flow velocity remains controversial. This in-vivo study was designed to assess the actual discrepancy between Doppler and catheter measurements of the pressure gradients for small bileaflet prosthetic valves in the aortic position. METHODS: Bileaflet prosthetic valves (19 mm-ATS) were implanted into the aortic position in pigs, and pressure gradients across the valves were examined by volume loading under right heart bypass. The pressure gradient obtained by catheter was defined as the conventional peak-to-peak gradient between the left ventricle and aorta. The peak Doppler gradients were calculated from the maximal instantaneous Doppler velocity with the ultrasound probe positioned on the diaphragm at the level of the cardiac apex. RESULTS: There were strong correlations between pressure gradients and cardiac output. The Doppler gradient was constantly higher than the catheter values, and the resultant discrepancy between Doppler and catheter measurements was directly dependent on cardiac output (y=9.9x+0.6, r2=0.55). For cardiac output > or = 5.0 L/min, the difference between Doppler and catheter gradients reached 40 mmHg, and maximum differences of up to 80 mmHg were observed. CONCLUSIONS: In view of the presence of striking overestimation of catheter gradient by Doppler measurement, Doppler ultrasound should be used cautiously to assess small-size bileaflet prosthetic valve function with consideration of the patient's hemodynamic state. 相似文献
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Naoyuki Sata Yasuhiro Tanaka Syusaku Suzuki Ryouzou Kamimura Hiroharu Mifune Kazuo Nakamura Kenkichi Miyahara Terukatsu Arima 《Circulation journal》2003,67(12):1053-1058
The aim of this study was to evaluate the effectiveness of an angiotensin-converting enzyne inhibitor (ACEI, quinapril) or angiotensin II receptor blocker (ARB, candesartan) on atrial natriuretic peptide (ANP) activity in rats with hypertension induced by nitric oxide (NO) inhibition. ACEI and ARB have a number of pharmacologic effects, including blood pressure reduction, myocardial preservation, and an unknown effect in the circulation. The changes in ANP in NO inhibitor-induced hypertensive rats were evaluated in order to elucidate the interaction between ANP and NO in the regulation of blood pressure. Thirty-six rats were divided into 4 groups and administered the experimental agents for 8 weeks: group Control was given regular food (n=9), group N(G)-nitro-L-arginine (L-NNA) was administered L-NNA (25 mg. kg(-1). day(-1), n=9), group ACEI was administered L-NNA and quinapril (10 mg. kg(-1). day(-1), n=9), and group ARB was administered L-NNA and candesartan (10 mg. kg(-1). day(-1), n=9). Blood pressure, plasma ANP, atrial ANP, ANP mRNA, and ANP granules were measured. A significant elevation in blood pressure was observed in group L-NNA. However, there were no increases in plasma ANP (L-NNA: 138.8+/-64.4, Control: 86.7+/-36.4), ANP mRNA (L-NNA: 2.2+/-1.0, Control: 1.7+/-0.5) or ANP granules (L-NNA: 61.1+/-10.2, Control: 64.5+/-8.5). No increase in blood pressure was seen in groups ACEI and ARB. However, plasma ANP (ACEI: 1,392.3+/-1,034.4, ARB: 1,142.8+/-667.3), ANP mRNA (ACEI: 52.8+/-29.1, ARB: 42.9+/-21.2), and ANP granules (ACEI: 122.5+/-23.4, ARB: 136.3+/-33.2) increased significantly. NO inhibitor-induced hypertension caused no changes in ANP concentrations. However, the ACEI and ARB had a direct effect on the induction of ANP secretion. The findings suggest that ANP secretion is directly effected by ACEI and ARB, which seems to play a key role in lowering blood pressure, relieving heart failure symptoms, and preserving the myocardium. 相似文献
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Yutaka Matsubara Hideaki Uchiyama Takahiro Higashi Ai Edagawa Hirokuni Ishii Shigeyuki Nagata Kenkichi Hashimoto Daihiko Eguchi Hirofumi Kawanaka Toshirou Okuyama Masahiro Tateishi Daisuke Korenaga Kenji Takenaka 《Surgery today》2014,44(6):1018-1025