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H Takagi

Publications and source records attributed to H Takagi.

At least 649 records · Page 36Linked to original sources
PubMed1994

Partial hepatectomy for hepatocellular carcinoma in a patient with hemophilia: a case report.

We describe successful partial hepatectomy for hepatocellular carcinoma (HCC) in a 43-year-old man with severe factor VIII deficiency (hemophilia A). Tumor size and plasma alpha-fetoprotein (AFP) decreased spontaneously prior to surgery. HCC was found in the anterior superior segment of the liver, with invasion of the diaphragm. A limited partial resection of the liver and diaphragm was performed. The administration of factor VIII during and immediately after surgery resulted in no postoperative bleeding complications. Macroscopic findings revealed hemorrhage and necrosis throughout the intrahepatic portion of the tumor. Viable HCC cells were recognized histologically in the intrahepatic tumor and infiltrating the diaphragm. In patients with hemophilia there is a tendency for HCC to hemorrhage, which may obscure the diagnosis. Appropriate administration of factor VIII permits the safe resection of HCC in hemophilia A.

Adult↗
PubMed1994

[Organ xenotransplantation using human complement regulatory factor gene].

For the success of xenotransplantation, hyperacute rejection must be controlled. Hyperacute rejection is induced by the activation of complement system via alternative pathway and/or classical pathway. Complement regulatory factors can inhibit activation of complement system via the both pathways. To overcome hyperacute rejection in organ xenotransplantation, gene engineering in the establishment of xeno-endothelial cells and transgenic animals (mouse and pig) using human complement regulatory factors are studied. In the near future, transgenic pig using human complement regulatory factor genes can be used as a potential donor in organ xenotransplantation.

Animals↗
PubMed1994

Effect of prolonged delayed graft function on long-term graft outcome in cadaveric kidney transplantation.

One-hundred-and-twenty-six cadaveric renal transplantations were analyzed for the effect of post-transplant renal function on graft outcome. Thirty-one grafts functioned immediately after transplantation (Group 1), 54 grafts failed to function temporarily up to 8 posttransplant days as evidenced by urine output < 400 ml/day or hemodialysis support (Group 2), 33 grafts showed temporary nonfunction > 8 days (Group 3) and 8 grafts never functioned (group 4). Five-year graft failure rates were 6.5% (2/31), 13.0% (7/54), 42.4% (14/33) and 100% (8/8) for Groups 1, 2, 3 and 4, respectively. Actuarial 5-year graft survivals were 89.4%, 84.8%, 50% and 0% for Groups 1, 2, 3 and 4, respectively (p < 0.05). The most common cause of graft failure was the chronic rejection in 13, of which 9 were in Group 3. Acute rejection episodes during the first 3 months post-transplant in Group 3 (15 of 33, 45.5%) was slightly higher than that in Group 1 (10 of 30, 33.3%) or Group 2 (19 of 54, 35.2%) but the differences were not significant. Acute rejection episodes were associated with graft loss only 1 of 19 (5.3%) patients in Group 2 whereas 9 of 15 (47.4%) were seen in Group 3. The authors conclude that prolonged DGF is associated with a higher incidence of graft failure, particularly secondary to chronic rejection after 1 year posttransplant. Moreover, acute rejection based on prolonged DGF probably plays a major role in the development of chronic rejection.

Adolescent↗
PubMed1994

[A case of acute cervical spinal epidural hematoma caused by extradural arterio-venous malformation].

The authors report a rare case of acute cervical epidural hematoma caused by the hemorrhage from extradural arterio-venous malformation. The patient was a 74-year-old Japanese man with a past history of total gastrectomy after being diagnosed as having gastric cancer 12 years before. Six hours prior to admission, the patient had experienced a sudden episode of severe nuchal pain radiating to both scapular areas, followed by rapid development of left-side Brown-Sequard Syndrome below the C4 cord level, and urinary incontinence. Plain cervical X-ray films did not show any destructive lesion suggesting a metastatic tumor. T1 and T2 weighted images of MRI demonstrated a high intensity mass lesion, suggesting an acute epidural hematoma, extending from C3 to C6 and compressing severely the left side spinal cord posteriorly. Twelve hours after the onset of symptoms, emergency laminectomy from C3 to C6 was performed and a fresh epidural clot with small vascular tissue was totally removed. Histological examination of the small vascular tissue in the hematoma revealed arterio-venous malformation. The postoperative recovery of the patient was dramatic. He regained full muscle strength and there was complete disappearance of sensory deficits 2 weeks after the operation. Although acute spinal epidural hematoma caused by extradural arterio-venous malformation is a rare clinical entity, MRI is the most helpful diagnostic tool for this condition. It should be stressed that accurate neuroradiological diagnosis and prompt surgical decompression of the spinal cord are essential to obtain an excellent surgical outcome.

Acute Disease↗
PubMed1994

[Bronchial carcinoid tumor with multiple brain metastasis].

Carcinoid tumor is regarded as a tumor with low grade malignancy, mostly originating from the gastrointestinal tract with little danger of metastasis. The authors encountered a very rare case of bronchial carcinoid tumor that had multiple metastasis to the intracranial space. The characteristics of radiological and hormonal examinations of this tumor are reported and discussed. The patient was a 73-year-old woman who gradually developed unsteadiness in walking and somnolence in daytime one month prior to admission. Those symptoms were aggravated and she began to vomit. On admission, neurological examination showed slight ataxia of left upper and lower extremities and dominant truncal ataxia. Chemical and hormonal examinations of blood and urine showed, gastrin was 230 pg/ml (37-172), ACTH was 67 pg/ml (< 60), serotonin was 565 ng/ml (53-200), and urinary 5-HIAA was 9.9 mg/day (0.8-4.8). Tumor markers (CEA, AFP, HGG, NSE) were all negative. Radiological examinations (chest X-P, CT scan) of her lung demonstrated a 3 x 3 cm tumor mass adjacent to the hilum of the left lower lobe. CT-scan of the head demonstrated cystic tumor in the vermis of the cerebellum (3 x 3 cm), the right posterior parietal lobe and the right temporal lobe. The wall of each tumor was enhanced by contrast medium. T1 weighted MRI demonstrated the walls of cystic tumors as iso intensity and the contents as low and high intensity with niveau formation. Little edema was recognized around the tumors. The wall of each cystic tumor was enhanced by Gd-DTPA.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Intraportal endovascular ultrasonography in pancreatic cancer--a new technique for the diagnosis of portal vein invasion: a preliminary report.

BACKGROUND: Intraportal endovascular ultrasonography was performed to diagnose portal vein invasion in pancreatic cancer. METHODS: In six patients the intravascular ultrasonographic catheter was introduced during operation through the superior mesenteric vein into the intrahepatic portal vein. The catheter was gradually withdrawn and the cross-sectional images of the area under investigation were recorded. The findings of intraportal endovascular ultrasonography were compared with the histologic findings of the resected specimen, preoperative computed tomographic scan and arterial portogram. RESULTS: The wall of the portal vein was visualized as an echogenic band with a thickness of 0.5 to 1.0 mm. Lymph nodes along the portal vein could also be visualized. In three of four resected cases, the wall of the portal vein was intact and portal vein invasion was diagnosed as negative by intraportal endovascular ultrasonography. In one of the resected cases, the portal vein invasion was diagnosed by intraportal endovascular ultrasonography only. These findings were confirmed by histologic examination. In two unresected cases, the portal invasion of the tumor was diagnosed as positive by imaging diagnosis including intraportal endovascular ultrasonography. This finding was confirmed by operative findings. In all patients portal invasion of the tumor could be diagnosed accurately. CONCLUSIONS: Intraportal endovascular ultrasonography provides important information about the resectability of pancreatic cancer.

Aged↗
PubMed1994

New neonatal extracorporeal membrane oxygenation circuit with a self-regulating blood pump.

BACKGROUND: Because a roller pump used in a conventional extracorporeal membrane oxygenation (ECMO) circuit with a roller pump cannot change the output automatically according to the venous return, ECMO management requires considerable personnel to prevent serious mechanical complications. An automatic blood pump will make ECMO less laborious and safer. METHODS: Takagi's self-regulating blood pump was modified for neonatal ECMO. The new ECMO circuit was tested in a simulation circuit, in puppies, and in two neonates clinically. Self-regulation of the pump was studied in response to various hemodynamic conditions. RESULTS: The priming volume including a membrane lung and a heat exchanger was about 90 ml. The maximum flow was 700 ml/min in the simulation circuit, 101 ml/min/kg in puppies, and 113 and 135 ml/min/kg in two newborns, respectively. ECMO flow was self-regulating and stable in response to hemodynamic changes. The blood pumps remained functional for more than 400 hours in puppies and 67 and 149 hours in the two newborns, respectively. CONCLUSIONS: The new automatic ECMO circuit is more reliable and requires less personnel than a conventional ECMO circuit.

Animals↗
PubMed1994

Tumor localization as a prognostic factor in hepatocellular carcinoma.

We investigated the significance of tumor localization as a contributory factor in the prognosis of hepatocellular carcinoma. A trend toward a better survival rate was noted in the 57 patients whose tumors were confined to the left hepatic lobe [left lobe group] as compared with the 146 patients whose tumors were located strictly in the right hepatic lobe [right lobe group]. The difference in survival was significant (p < 0.02) in stage I and stage II disease, but equivalent survival rates were seen in stage III and stage IV disease. The right lobe group patients with stage I or stage II disease who underwent lobectomy or segmentectomy had a better survival rate than those undergoing subsegmentectomy or limited resection (p < 0.001). But in the left lobe group, no difference was observed with various operative procedures. These results lead us to speculate that tumor localization might be a contributory factor in the postoperative prognosis, and an important determinant of the operative approach to hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1994

Prognosis of cancer of the duodenal papilla of Vater in relation to clinicopathological tumor extension.

Between 1981 and 1991, cancer of the duodenal papilla of Vater was surgically treated in 26 out of 28 cases (92%). Twenty-five patients underwent pancreatoduodenectomy and one had a total pancreatectomy. There were no surgical or hospital deaths in these 26 patients. Their five-year cumulative survival rate was 52%. In the 26 patients, we submitted the surgically removed tissue specimens to histopathological examination and performed immunohistochemical analysis using antibodies against various gastrointestinal cancer antigens. We analyzed the results in relation to the prognosis. The histological stage of the cancer was found to correlate with the prognosis. Patients having cancer invading the pancreatic parenchyma had a particularly poor prognosis. Some exhibited perineural invasion. Patients with cancer invasion into the pancreatic parenchyma frequently showed a grade II positive response to immunohistochemical staining, with a staining pattern similar to that of pancreatic duct cell carcinoma. In patients in whom cancer invasion did not extend beyond the sphincter of Oddi, the five-year survival rate was 100%. Therefore, cancer of the papilla of Vater which has not invaded beyond the the sphincter of Oddi, may be regarded as early cancer of the papilla of Vater. These results indicate that surgical procedures for cancer of the papilla of Vater should be selected on the basis of an accurate preoperative evaluation of cancer invasion by various imaging techniques (chiefly endoscopic ultrasonography), and that the treatment of advanced cancer of the papilla of Vater requires not only extensive surgical resection but also a more effective multi-disciplinary treatment plan.

Adult↗
PubMed1994

The fate of intravenously injected endotoxin in normal rats and in rats with liver failure.

The elimination of endotoxin from the blood was studied in rats with D-galactosamine-induced liver failure and in normal controls after intravenous injection of various doses of endotoxin. Endotoxin was found to localize in liver tissue by immunohistochemical staining with factor C, which is derived from amebocyte lysate of the horseshoe crab and which reacts specifically with endotoxin. Before injection, the blood endotoxin concentrations were normal both in control rats and in rats with liver failure. The blood concentrations of endotoxin were significantly higher after intravenous injection of endotoxin in the D-galactosamine-induced liver failure group (p < 0.05) and decreased much more slowly (p < 0.05). Endotoxin concentrations were also significantly higher after in vitro incubation with plasma from rats with liver failure (p < 0.05). After intravenous injection of endotoxin (1 mg/kg), endothelial and Kupffer cells in the liver sinusoids were positively stained for endotoxin in the control group, but not stained or faintly stained in the liver failure group. Endotoxemia in liver failure thus results from reduced inactivation of endotoxin in plasma and from impaired hepatic clearance.

Animals↗
PubMed1994

Autologous blood transfusion for hepatectomy in patients with cirrhosis and hepatocellular carcinoma: use of recombinant human erythropoietin.

BACKGROUND: We evaluated the benefit of autologous blood transfusion and the effect of recombinant human erythropoietin (rh-EPO) on preoperative autologous blood donation for hepatectomy in patients with cirrhosis. METHODS: Forty-two patients with cirrhosis and hepatocellular carcinoma underwent hepatectomy, 21 of whom (group A) donated autologous blood before operation. Eleven of these patients (group A1) were administered rh-EPO before operation, and ten patients (group A2) were untreated. Twenty-one patients (group B) did not donate autologous blood. RESULTS: The frequency of homologous blood transfusion was 24% in group A and 62% in group B (p < 0.05). Preoperative erythropoiesis increased markedly in group A1, and postoperative erythropoietin production was not suppressed in this group. Postoperative hematocrits recovered significantly more rapidly in patients transfused with only autologous blood. Postoperative serum total bilirubin concentrations were significantly higher in patients with transfused homologous blood. CONCLUSIONS: Autologous blood transfusion yields clinically superior results for hepatectomy in patients with cirrhosis when compared with homologous transfusion. Preoperative rh-EPO administration minimizes presurgical decreases in hematocrit caused by autologous blood donation.

Adult↗
PubMed1994

[The clinical effect of chemotherapy with 5-FU and low-dose CDDP in patients with advanced gastric cancer].

A trial of FP therapy, a novel systemic chemotherapy consisting of 5-FU and low-dose CDDP, was carried out in patients with advanced gastric cancer and the clinical effects were evaluated. Five hundred mg/body/day of 5-FU was continuously administered via the central venous catheter for 7 consecutive days and 10mg/day of CDDP was rapidly administered with 500ml saline on days 1-5. The regimen was repeated for at least 4 weeks. The FP therapy was carried out in 22 cases, including several patients who underwent FP as an adjuvant therapy; 1 CR, 2PR's 1MR and 2NC's were obtained among the 6 patients with clinically evaluable lesions, resulting in a response rate of 50%. In four cases, the FP therapy was given as a neoadjuvant therapy, and histopathological examination of the resected specimen revealed histological effects exceeding Grade 2 in all 4 cases. Bone marrow suppression was the most commonly observed side effect, but renal dysfunction and nausea were not found. FP therapy is considered an effective therapy against advanced gastric cancer, from the viewpoint of both the clinical and adverse effects, in comparison with conventional regimen consisting of 5-FU and a single and large dose of CDDP.

Adenocarcinoma↗
PubMed1994

Endothelin-mediated cell signaling and proliferation in cultured rabbit corneal epithelial cells.

PURPOSE: To determine if there is endothelin-mediated regulation of cell signaling and proliferation in rabbit corneal epithelium. METHODS: Endothelin-1 (ET-1) gene and protein expression by the rabbit corneal epithelial (RCE) cells were analyzed by polymerase chain reaction, sequence analysis, and enzyme immunoassay. DNA synthesis was characterized by [3H]-thymidine uptake. Endothelin receptor linkage to cell signaling pathways was determined based on measurements of the dose dependent effects of ET-1, ET-2, and ET-3 on intracellular Ca2+ concentration ([Ca2+]i) transients in fura-2-loaded cells, and of ET-1 on phosphoinositide turnover and cAMP accumulation in the isolated rabbit corneal epithelium. RESULTS: The authors detected the mRNA for prepro ET-1 in RCE cells, and ET-like immunoreactivity was identified in conditioned culture medium. ET-1 (1 nM) maximally stimulated [3H]-thymidine uptake by twofold (EC50 = 0.3 nM). Endothelins elicited transient increases in [Ca2+]i with a rank order of potency of ET-1 > or = ET-2 >> ET-3. These increases consisted of both intracellular Ca2+ mobilization and influx of Ca2+ from the bathing solution. Intracellular mobilization was linked to increases in IP3 turnover because 1 microM ET-1 increased IP3 content by 48% from its control value (EC50 = 23 nM), whereas Ca2+ influx occurred through a non-L-type Ca2+ channel because preexposure to 1 microM nicardipine did not affect either the height or the duration of a [Ca2+]i transient. One micromolar of ET-1 was required to elicit a significant increase in cAMP accumulation of 69% from its control value. This increase was dependent on the presence of Ca2+ in the bathing solution and was comparable to and nonadditive with that of the Ca2+ ionophore, A23187 (1 microM). CONCLUSION: These data suggest that endothelin production by primary cultures of RCE cells can mediate an increase in cell proliferation through an ETA receptor subtype. This receptor subtype appears to be involved based on the rank order of potency of ETs to elicit [Ca2+]i transients, increases in phosphoinositide turnover, and cAMP accumulation.

Animals↗
PubMed1994

Characterization of glucose transporter in cultured human retinal pigment epithelial cells: gene expression and effect of growth factors.

PURPOSE: To investigate gene and protein expression of glucose transporter isoforms in cultured human retinal pigment epithelial cells. To investigate growth factor-dependent stimulation of glucose transport and the effect of growth factors on the gene and protein expression in retinal pigment epithelial cells. METHODS: Glucose transport activity was analyzed by [3H]2-deoxyglucose uptake studies. Gene and protein expression of glucose transporter isoforms were analyzed by polymerase chain reaction, Northern blot analysis, and Western blot analysis. RESULTS: Polymerase chain reaction, nucleotide sequencing, and Southern blot analyses revealed that the retinal pigment epithelial cells express GLUT-1, -3, and -5 genes. Northern and Western blot analysis detected only GLUT-1 transcripts and protein. A 24-hour exposure to fetal bovine serum (15%), basic fibroblast growth factor (50 ng/ml), platelet-derived growth factor (10 ng/ml), epidermal growth factor (50 ng/ml), and insulin-like growth factor-1 (50 ng/ml) significantly stimulated [3H]2-deoxyglucose uptake in cultured human retinal pigment epithelial cells. Western blot analysis showed that serum and platelet-derived growth factor induced an increase of GLUT-1 protein in the membrane preparation in the cells. Serum, fibroblast growth factor, platelet-derived growth factor, and insulin-like growth factor-1 did not increase GLUT-1 gene expression to an appreciable level, as shown by Northern blot analysis. CONCLUSION: Cultured human retinal pigment epithelial cells dominantly express GLUT-1 gene and protein with minor expression of GLUT-3 and -5 genes. Fetal bovine serum, fibroblast growth factor, platelet-derived growth factor, epidermal growth factor, and insulin-like growth factor-1 significantly, although modestly, increase glucose transport activity of the cells.

Base Sequence↗
PubMed1994

GABA-ergic and substance P-ergic double-innervation to noradrenergic neurons in the rat locus coeruleus.

Synaptic contacts between noradrenaline (NA) neurons and GABA (gamma-aminobutyric acid) afferents and/or substance P (SP) afferents in the locus coeruleus (LC) were examined by a combination of immunoelectron microscopic mirror method and double-immunostaining method. For visualization of NA and GABA, we used antibodies against NA and GABA synthesizing enzymes, i.e., tyrosine hydroxylase (TH) and glutamic acid decarboxylase (GAD). GAD-immunoreactive (IR) and SP-IR axon terminals often made synaptic contacts with NA neurons, respectively. Furthermore, we identified that a single NA neuron simultaneously receives synaptic inputs from GAD-IR and SP-IR afferents. These NA neurons made symmetrical synaptic contacts with GAD-IR axon terminals and asymmetrical contacts with SP-IR axon terminals. This suggests that central NA neuronal mechanisms are affected by GABA and SP neurons in a different manner.

Animals↗