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Biomedical subjects

H Takagi

Publications and source records attributed to H Takagi.

At least 793 records · Page 44Linked to original sources
PubMed1992

[The results and problems of surgical treatment of cancer of the duodenal papilla of Vater].

Twenty six of 28 cases (92.9%) of cancer of duodenal papilla of Vater were resected from 1981 to 1990. Twenty five pancreatoduodenectomy and one total pancreatectomy were performed. Operative death and hospital death were not observed. Three year and five year cumulative survival rates of resected cases were 58% and 52% respectively. There was relatively good correlation between pathological cancer extension and postoperative prognosis. Postoperative prognosis of the cases which had cancer extension to the pancreas was extremely poor. But the prognosis of the cases of cancer within Oddi muscle was extremely good. Immunohistochemical staining using anti CEA, anti CA19-9 and anti DUPAN 2 was studied and Grade III staining pattern was observed only in the cases which had cancer invasion to the pancreas. Preoperative diagnosis of cancer extension using endoscopic ultrasonography and appropriate choice of the operative procedure are important. Extended operation and effective adjuvant therapy are necessary for advanced cases of cancer of the duodenal papilla.

Adult↗
PubMed1992

[Effect of M1 blocker or H2 blocker on gastric secretion during anesthesia and surgery].

Effect of pirenzepine, famotidine or a combination of both agents on gastric secretion during anesthesia and surgery was evaluated in 42 surgical patients ranged in age from 17 y to 70 y. They underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under either neuroleptanesthesia or enflurane anesthesia. They received either pirenzepine 10 mg, famotidine 20 mg or the combination of both agents intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured during 3 hours after the administration of these agents. A continued decrease in volume and acidity of gastric juice was observed 3 hrs after the administration of the agents both in the pirenzepine group and in the famotidine group. Efficacy of the combination of pirenzepine and famotidine on gastric secretion tended to be more prominent than that of either pirenzepine or famotidine alone.

Adolescent↗
PubMed1992

[Primary intracranial melanoma: a case report].

A rare case of primary intracranial melanoma is presented in a 34-year-old man with initial symptoms of persistent headache. In magnetic resonance imaging(MRI), this case had all the characteristic findings of intracranial melanoma which had been reported previously. In 123I-iodoamphetamine-single photon emission CT (123I-IMP-SPECT), abnormal accumulation of 123I-IMP was recognized in early and late phase imaging, which was very specific to the lesion. This is the first report of 123I-IMP-SPECT performed on a primary intracranial melanoma. Tumor mass originated from pia mater was surgically resected, but the dissemination of tumor cells was recognized macroscopically. Pathological examination of the specimen showed very little malignant changes of melanoma cells, which was in contrast to the previous reports. Although, no standard chemotherapy of the primary intracranial melanoma has been established, DAV therapy to the dissemination of tumor cells into the subarachnoid space, and intravenous administration of interferon-beta were performed in this case. Methods of differential diagnosis and treatments of primary intracranial melanoma are reviewed and discussed.

Adult↗
PubMed1992

[Long-term results of terminal esophago-proximal gastrectomy for esophageal varices].

Between 1973 and 1991, 193 patients underwent terminal esophagoproximal gastrectomy (TEPG) for esophageal varices. One hundred and sixty patients (84%) were cirrhotics. Ten patients (5.2%) were died within hospital stay. In 116 elective patients who had been free from hepatocellular carcinoma during therapeutic courses, the 5- and 10-year survival rates were 77% and 62% in Child A, and 62% and 38% in Child B, respectively. There was a significant difference between the two groups (p < 0.05). Postoperative rebleeding from esophageal varices was infrequent within 5 years but increased after 5 years especially in Child B and Child C. For patients with these recurrent varices, endoscopic injection sclerotherapy was very effective and improved the prognosis. The survival rate of patients with extremely decreased platelet counts was not different from that of patients without. There were no other severe complications after TEPG. We conclude that TEPG would be indicated firstly for elective or prophylactic cases unless they have severe hepatic damage.

Esophageal and Gastric Varices↗
PubMed1992

Familial juvenile nephronophthisis and renal transplantation in two siblings.

Familial juvenile nephronophthisis (FJN) is a hereditary renal disease, characterized by a juvenile onset and the development of medullary cysts and progressive renal damage. The pathogenesis of FJN remains unknown, and at present, no rational therapy other than renal transplantation is available. We describe two cases in siblings in whom there were no extrarenal complications, such as retinopathy or central nervous system involvement. Both patients display juvenile onset of the disease and end-stage renal failure. The brother received a kidney from his father, and the sister received a kidney from her mother. Recurrence of the underlying disease has not so far been found in the transplanted kidney.

Adolescent↗
PubMed1992

[Radioimmunodetection of colorectal cancer, using anti-CEA monoclonal antibody CEA 102: whole IgG versus F(ab')2 fragments].

In order to improve cancer imaging with radiolabeled antibodies, three factors appeared to be of particular importance: (1) The selection of the most favorable monoclonal antibody directed to tumor-associated antigen. (2) The use of F(ab')2 or Fab fragments. (3) Selection of the most convenient isotope. Monoclonal antibody CEA 102 was produced by immunization by purified CEA, and its F(ab')2 fragments were compared with whole IgG as a radiotracer for radioimmunodetection of the colorectal cancer. Fragments were eliminated from the circulation twice as fast as whole IgG, and tumor-to-background ratio was achieved more than 1 at 2-3 days with F(ab')2, but 6-7 days with whole IgG in tumor bearing nude mice. In clinical study, F(ab')2 demonstrated clear image on the 1 at day after injection, whereas achievement of the image was possible on the 3rd day in whole IgG. These results indicated that fragments are preferred over whole IgG. Therefore fragments make it possible to preclude dual isotope subtraction methods, and omit the long delays before imaging. They also make it possible to use short half life radionuclides with excellent photon properties, such as 123I and 99mTc.

Animals↗
PubMed1992

[Large volume intraperitoneal chemotherapy as treatment for the peritoneal carcinomatosis from gastric cancer].

Gastric cancer sometimes spread to peritoneal surfaces in the absence of lymphatic or hematogenous metastases. For the treatment of peritoneal carcinomatosis, we applied large volume intraperitoneal chemotherapy (L.V.I.C.). In L.V.I.C., drugs were administered with large volume of saline through the reservoir buried in the subcutaneous tissue of the abdominal wall. We used mitomycin C (MMC), 5-fluorouracil (5-FU) and CDDP and examined the pharmacokinetics of these drugs when they were administered by this method to the patients of peritoneal carcinomatosis. A marked pharmacokinetic advantage was observed when 5-FU and CDDP were administered. AUC of these drugs were much larger than that of MMC. In vitro sensitivity test (SDI test) was useful for the selection of adequate drugs for each patient. On this method, drugs were distributed widely in the abdominal cavity and the patients could be taken this treatment repeatedly as out-patient. L.V.I.C. seems to fulfill the need for a safe, effective and acceptable delivery system of intraperitoneal chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Fundus hemorrhage in patients with intracranial hemorrhage caused by cerebrovascular disease--its clinical significance].

To clarify the significance of fundus hemorrhage in the acute stage of intracranial hemorrhage due to cerebrovascular disease (HCVD), the incidence of such hemorrhage (retinal, preretinal, and subhyaloid hemorrhage) was examined and its correlations with the severity of the disturbance of consciousness and the prognosis were investigated. Two hundred sixteen HCVD patients with intracranial hemorrhage were the subjects of this study, including 87 cases of subarachnoid hemorrhage (SAH), 60 cases of hypertensive intracerebral hemorrhage (HICH), 54 cases of arteriovenous malformation (AVM), and 15 cases of Moyamoya disease. Fundus hemorrhage was recognized in 41 cases of SAH (47%), 5 cases of HICH (8%), 3 cases of AVM (6%), and 2 cases of Moyamoya disease (13%). The incidence of fundus hemorrhage was significantly higher in SAH than in the other type of HCVD associated with intracranial hemorrhage. Among patients with severe disturbance of consciousness (JCS 100-300), fundus hemorrhage was recognized in 69% with SAH, 13% with HICH, 17% with AVM, and none with Moyamoya disease. Therefore, patients with both fundus hemorrhage and severe disturbance of consciousness in the acute stage are most likely to have SAH, but HICH and AVM should be also taken into consideration. In patients with slight disturbance of consciousness (JCS 0-30), fundus hemorrhage was only noted in SAH (27%) and not in other types of HCVD associated with intracranial hemorrhage. Thus, SAH is highly likely to be the primary HCVD associated with intracranial hemorrhage, if we recognize fundus hemorrhage in patients with slight disturbance of consciousness in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Hemorrhage↗
PubMed1991

Effects of endothelin on adrenergic neurotransmission in the dog kidney.

Endothelin infused into the renal artery (0.3-3 ng/kg per min) of anesthetized dogs suppressed the increases in renal venous plasma norepinephrine (NE) concentration and calculated NE efflux induced by renal nerve stimulation at low frequencies (0.7-1.2 Hz) but not at high frequencies (2-3.5 Hz). Endothelin failed to affect the decrease in renal blood flow induced by renal nerve stimulation or exogenous NE. These findings suggest that endothelin inhibits NE release during a slight rise in renal nerve activity, while it does not affect alpha-adrenoceptor-mediated vasoconstriction in the dog kidney.

Animals↗