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Biomedical subjects

A Takagi

Publications and source records attributed to A Takagi.

At least 235 records · Page 13Linked to original sources
PubMed1989

[Prognosis of intra-arterial chemo-embolization in metastatic liver cancer].

We treated 63 patients (pts) suffering from metastatic liver cancer with intra-arterial infusion chemotherapy, and analysed 44 of their for survival since the first treatment with regard to the primary foci of cancer and the method of intra-arterial therapy. Via the superficial femoral artery, we performed superselective hepatic catheterization by Seldinger's method. Three types of intraarterial therapy were used: Gelfoam embolization with mitomycin-C (MMC) in 12 pts (GS-TAE), capillary chemo-embolization with MMC-Lipiodol emulsion in 28 pts (LP-TAI) and "one-shot" slow infusion of MMC or cisplatinum in 4 pts. Fifty-percent survival was 189 days in pts with metastases from colo-rectal cancer (n = 20), 109 days from gastric cancer (n = 9), 100 days from pancreatobiliary cancer (n = 5) and 240 days from breast cancer (n = 7). More than one-year survival was obtained in 13 out of the 40 pts (32.5%). Survival of 12 pts, treated with GS-TAE regimen, was not significantly superior to that of 28 pts with LP-TAI regimen. Hence, we conclude that LP-TAI is the treatment of choice in chemo-embolization for unresectable liver metastases, because it causes less damage to the hepatic arterial beds, and facilitates repeat intraarterial therapy in these pts.

Cisplatin↗
PubMed1989

[Muscle fiber type abnormalities in bulbospinal muscular atrophy. Comparison with amyotrophic lateral sclerosis].

Bulbospinal muscular atrophy (BSA) is a distinct clinical type of chronic spinal muscular atrophy of adult onset, which was first reported by Kennedy et al. Histochemical findings of involved muscles are poorly described. In the present study, the muscle fiber type was studied on biopsied specimens by the histochemical method. The results were compared with those of amyotrophic lateral sclerosis (ALS). Muscle specimens were obtained mainly from biceps brachii muscles of 7 cases of BSA and 10 cases of ALS. Both group of patients were matched in respect to age, sex and stage of muscle weakness. The following results were obtained. Histopathological findings of BSA are classed as stage 4 abnormalities of Jennekins. Both fiber type grouping and type 2B deficiency are more frequent in BSA than in ALS. Type 2C fiber seems to be more in ALS than in BSA. Atrophy factor of Dubowitz is the same in BSA and in ALS. Hypertrophy factor is more prominent in BSA than in ALS. Significant correlation between fiber type grouping and type 2B deficiency was confirmed in muscles from other neurogenic atrophy. Since there is a significant association of the type 2B deficiency with fiber type grouping, type 2B fiber might be transformed to type 2A during the reinnervation process. The adaptation to the increased activities of the survived muscles and motoneurons might be contributory to the transformation, which is already known to occur in normal subjects during the endurance training.

Adult↗
PubMed1989

[Ultrasound imaging of muscles in Duchenne muscular dystrophy].

The ultrasound imaging of quadriceps, gastrocnemius and soleus muscles was performed in 30 patients with Duchenne muscular dystrophy (DMD) and 16 control subjects. In controls, the skeletal muscle itself was scarcely echogenic. However, bone surface and fascia were clearly echogenic. The transverse scan of muscle in all DMD patients showed an increased echogenicity, which made the echo from bone or fascia less intense. The abnormal muscle echo was graded according to Heckmatt et al. From the quantitative aspect, there was a significant correlation between disability scale of DMD patients and abnormal echogenicity of the quadriceps muscle. A similar correlation was also observed between results of manual muscle testing the ultrasound imaging. The soleus muscle was usually less abnormal than the gastrocnemius in the ultrasound imaging. Thus, the ultrasound imaging seemed to provide an important information for the clinical assessment of DMD patients.

Adolescent↗
PubMed1989

[HTLV-I associated myelopathy (HAM) complicated with chronic polymyositis].

The patient was a 49-year-old woman. Since her age of 42, she noticed a proximal weakness of both legs. She also experienced pedal paresthesia and urinary frequency. Physical examination disclosed a diffuse goiter and bilateral Babinski sign. Results of EMG and muscle pathology were compatible with the diagnosis of polymyositis. Treatment with prednisolone improved muscle weakness, urinary difficulties and struma. 7 years later, HTLV-I antibody happened to be strongly positive both in serum and CSF. Then most of her neurological problems were attributed to HAM. However, recent studies of re-biopsy muscle specimens disclosed scattered necrotic fibers, phagocytosis and endomysial or perivascular infiltration of inflammatory cells. These infiltrating cells were classed mostly as helper/inducer T cells. These observations suggested the coexistence of polymyositis in the present case as well. So far, the combination of HAM and polymyositis has not been reported. It seems important to decide if HTLV-I could induce chronic polymyositis as in the case of HIV infections.

Chronic Disease↗
PubMed1989

[Clinical implications of enhanced caffeine contracture in malignant hyperthermia (MH) and Duchenne muscular dystrophy (DMD)].

The caffeine contracture response was studied on the skinned muscle fiber in patients with MH episodes or with DMD. An abnormally enhanced caffeine contracture was observed in 12 out of 14 subjects with MH episodes and 11 out of 13 patients with DMD. The extent of abnormality was almost the same in both group of patients. Ca-induced Ca release (CICR) of the sarcoplasmic reticulum was also analyzed on the same specimens. CICR was increased in 3 out of 4 cases with MH episodes, but it was decreased or unchanged in 4 patients with DMD. It was suggested that the mechanism of abnormal caffeine contracture might not be the same between MH and DMD. Thus, adverse anesthetic reactions, which are occasionally reported in DMD, could be different from genuine MH in its pathophysiology. However, before concluding this issue, further studies seem necessary concerning the molecular mechanism of abnormal Ca release. In the meantime, studies of caffeine contracture on the skinned fiber are helpful as one of predictive tests of MH and related disorders.

Adolescent↗
PubMed1988

B-cell lineage acute lymphoblastic leukemia with i(7q) and t(9;9)(p22;p24).

A 61-year-old Japanese male with acute lymphoblastic leukemia (ALL) is reported. Surface marker examinations revealed that the leukemic cells were of a B-cell lineage; the cells had common ALL antigens, Ia-like antigens, and B1 and B4 antigens. Chromosome analysis showed abnormalities of t(9;9)(p22;p24), as well as an isochromosome for the long arm of chromosome 7. The heritable fragile site at 9p was not detected in the peripheral blood cells of this patient at remission phase.

Antigens, Neoplasm↗
PubMed1988

Frequency and localization of congenital anomalies of the middle and inner ears: a human temporal bone histopathological study.

This study investigated congenital anomalies occurring in the middle and the inner ears, with particular attention to their features, localizations, and frequencies. One hundred human temporal bones obtained from 73 individuals, aged 31 gestational weeks to 39 years, each of whom had anomalies of the middle ear and/or inner ear, were used for this study. The temporal bones had been removed at autopsy, fixed, dehydrated, embedded in celloidin, and sectioned horizontally or vertically at 20 microns. Every 10th horizontal section or every 20th vertical section was stained with hematoxylin and eosin, mounted and studied under a light microscope. In the middle ear the structure most often found to be anomalous was the facial nerve; in the inner ear it was the lateral semicircular canal. The implications of the anomalies observed are discussed as they relate to fetal development, dysfunction of the ear, and clinical interpretation of diagnostic radiological studies.

Adolescent↗
PubMed1988

Primary adrenal lymphoma. Report of an autopsy case.

A rare case of malignant lymphoma of the adrenal gland in a 68-year-old male is reported. Autopsy revealed bilateral and symmetrical adrenal tumors (lt: 54 g, rt: 39 g) and almost complete effacement of both adrenal glands, while no tumors were present in other organs or systemic lymph nodes. Both adrenal tumors histologically presented a picture of diffuse malignant lymphoma of mixed cell type. Microscopic involvement in both lungs, spleen, liver, lymph node, bone marrow and both kidneys was found. Immunohistochemically, the positive reactions shown by the lymphoma cells were of B cell type, i.e., observed using antibodies to the leukocyte common antigens, MB-1, LN-1, LN-2 and LN-3, but not by anti-factor VIII-related antigen or MT-1. Examination of peripheral blood obtained just before the patient died showed the presence of 18% atypical cells. This lymphoma was considered to have transformed to a leukemic phase, at least at the end stage. To the author's knowledge, this is the second case of primary adrenal lymphoma to be reported in Japan, and the first case showing formation of bilateral and symmetrical tumors.

Adrenal Gland Neoplasms↗
PubMed1988

Computer-aided three-dimensional reconstruction and measurement of the vestibular end-organs.

It is very valuable for temporal bone morphologists to be able to recognize temporal bone serial sections in three dimensions and to be able to measure temporal bone structures three-dimensionally. We can now do 3-dimensional reconstruction to visualize the structures of vestibular endorgans (utricular and saccular maculae) and measure these endorgans in space by means of a small computer system and software that we developed. As well as obtaining the dimensions--such as length and area--of the utricular and saccular maculae, we also found that (1) most of the utricular macula lies in one plane, which is the same as the plane of the lateral semicircular canal, (2) the saccular macula is shaped like part of a sphere, and (3) the angle between the two maculae is less than a right angle. Such knowledge is indispensable to the evaluation of the function of the utricular and saccular maculae.

Acoustic Maculae↗
PubMed1988

Neuroleptic malignant syndrome: caffeine contracture of single muscle fibers and muscle pathology.

The neuroleptic malignant syndrome (NMS) is similar to anesthesia-induced malignant hyperthermia (MH) in three major clinical features: hyperthermia, muscular rigidity, and myoglobinuria. In eight cases of NMS, we studied caffeine contracture of single skinned muscle fibers. Sensitivity of the sarcoplasmic reticulum to caffeine was abnormally increased in six of the eight cases. Morphologic studies showed type 2B fiber atrophy in all six cases examined, and there were necrotic fibers in two cases. Since skeletal muscle is affected in NMS, these patients may be susceptible to MH.

Adolescent↗
PubMed1988

Residual beta-cell function and metabolic stability in insulin-dependent diabetes mellitus.

Using the modified sensitive method of measurement of urinary C-peptide immunoreactivity (CPR) excretion, we studied whether positive correlation between residual beta-cell function and metabolic consequence is present in insulin-dependent diabetes mellitus (IDDM) or not. After urinary CPR excretions were measured for 3 days in 40 IDDM, they were divided to three groups: group A, urinary CPR excretion less than 1 microgram/day (n = 16); group B, 1-4 micrograms/day (n = 15); group C, greater than or equal to 4 micrograms/day (n = 9). All subjects were treated with intensive insulin therapy for 1-2 months, and 1) fasting blood glucose (FBS) for one week, 2) 24-hr urinary sugar excretion (US) for one week, 3) M-value for daily variation of blood glucose, and 4) hemoglobin A1 (HbA1) were measured before and after intensive insulin treatment. And, we calculated mean and standard deviation (S.D.) of FBS and US. After intensive insulin therapy, a significant difference of the S.D. of FBS was seen between group A and group B (p less than 0.01). And, a significant difference of M-value was found between group A and group B (p less than 0.05). As significant differences were observed between group A and group B, which could not be divided into two groups by conventional CPR measurement, it seems likely that metabolic stability in IDDM mainly result from minimal remaining residual beta-cell function.

Adolescent↗
PubMed1988

Congenital middle and inner ear anomalies.

For this study, 100 human temporal bones from 73 individuals, aged 31 gestational weeks to 39 years, each with anomalies of the middle and/or inner ear, were studied to identify the features, locations, and frequencies with which congenital anomalies occurred in these structures. The temporal bones had been removed at autopsy, fixed, dehydrated, embedded in celloidin, sectioned horizontally or vertically at 20 microns, stained with hematoxylin and eosin, and studied under a light microscope. The anomaly in the middle ear most often found was wide dehiscence of the facial canal; hypoplastic cochlea was most frequently observed anomaly in the inner ear. The implications of these findings for development of the ear during fetal life are discussed.

Ear, Inner↗
PubMed1988

[Preoperative chemoembolization of iopamiron-solved adriamycin and lipiodol on hepatocellular carcinoma--clinicopathological study of ten surgical cases].

Preoperative chemoembolization was performed in 10 patients with hepatocellular carcinoma. The therapeutic regimen included Adriamycin (ADM) solved in nonionic contrast media, Iopamiron and Lipiodol (LP). Two to four ml of the solution, containing 20-40 mg of ADM, was mixed with 5-10 ml of LP by "pumping" method. This emulsion was infused superselectively into the hepatic artery by the balloon-occluded method. The regimen contained no permanent embolic material (e.g., Gelfoam or Ivaron). Dense deposition of LP in the tumor was seen on the CT scan 3-4 weeks after TAI. Surgical specimens, resected 3-12 weeks after TAI, revealed total necrosis of the tumor in 4 cases, subtotal necrosis (more than 80% on the cut surface) in 3 cases, and partial necrosis (less than 80%) in 3 cases. Tumor invasion in the fibrous capsules was necrosed in 4/7 of the cases. Tumor thrombi in the portal vein were also necrosed in 2/4. Our new method is more effective than the previous ones of LP and ADM without Iopamiron, and is equally effective as the regimen using LP, anticancer drugs, and permanent embolic materials.

Adult↗