[Shoulder stiffness and elasticity of the muscle].
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Adult↗
Biomedical subjects
H Takagi
Publications and source records attributed to H Takagi.
[Total pelvic exenteration for primary and locally recurrent rectal cancer].
Thirteen patients with advanced carcinoma of the lower colon and no evidence of extrapelvic metastasis were submitted to total pelvic exenteration with urinary diversion. The operative mortality rate was 7.7%. Determinate 5-year survival rate of 40% was achieved. Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Six patients with deeply invading recurrent lesions had pelvic exenteration combined with sacral resection. This procedure seems a reasonable treatment for palliation and the chance of cure in selected patients. CT examination of the pelvis is very valuable for the early detection and localization of recurrence.
Adult↗
[Case of surgical treatment of aorto-pulmonary window].
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Adult↗
[Classification of variables and statistical analysis].
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Analysis of Variance↗
[Acute traumatic hydrocephalus].
We have experienced two rare cases of acute traumatic hydrocephalus which developed within several hours after head injury. Case 1. A 4-year-old boy was stuck by an automobile. After losing consciousness for a few minutes, he became agitated and vomited. He was brought to our hospital 3 hours after accident. On admission, he scored 8 points on the Glasgow Coma Scale. CT scan on admission disclosed slightly enlarged ventricles, but there were no findings indicating cerebral contusion nor intracranial hemorrhage. His state of consciousness gradually deteriorated, thereafter right sided convulsive seizures occurred. 7 hours after accident, CT scan was repeated and demonstrated a marked enlargement of the ventricles. Continuous ventricular drainage was performed. The ventricular fluid was slightly bloody. After the ventricular drainage, the state of consciousness improved rapidly. 6 days after the accident, ventricular drainage was discontinued. Afterward, size and shape of the ventricles became nearly normal and the patient was discharged 36 days after the head injury without any neurological deficits. Case 2. A 3-year-old girl was buried under a burden. 30 minutes after the accident, her consciousness began to deteriorate with vomiting. She was brought to our hospital 3 hours after the accident. On her arrival, she scored 13 points on Glasgow Coma Scale. CT scan, which performed 4.5 hours after the accident, showed slightly enlarged ventricles and intraventricular hemorrhage in the third and fourth ventricles. Her state of consciousness gradually worsened with generalized seizures. Repeated CT scan 8 hours after the accident, demonstrated a marked enlargement of the ventricles. Following ventricular drainage, the patient's state of consciousness improved rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease↗
[Clinical and pathological studies on changes of interlobular bile ducts in acute viral hepatitis with zonal necrosis].
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Acute Disease↗
[Pelvic exenteration combined with sacral resection for recurrent rectal cancer. The roles of carcinoembryonic antigen and pelvic computed tomography for early detection].
Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. CT study of the pelvis revealed recurrent tumor images in relation to the adjacent pelvic structures. Six patients with deeply invading recurrent lesions were subjected to pelvic exenteration combined with sacral resection. No postoperative deaths were encountered. The postoperative sharp drops of serum CEA levels are useful for judging the adequacy of this procedure. The follow-up status of the 6 patients is as follows, respectively: 16 months dead from pulmonary & hepatic metastasis, 11 months and 9.5 months alive without symptoms but with slightly elevated CEA level, and 5 months, 2 months and 2 weeks alive with no evidence of disease. All patients who were relieved of perineal or sciatic nerve pain are now able to walk without any assistance or trouble. Total en bloc residual pelvic exenteration combined with sacral resection is a reasonable treatment for locally recurrent rectal cancer.
Adult↗
Distribution and origins of neurotensin-containing fibers in the nucleus ventromedialis hypothalami of the rat: an experimental immunohistochemical study.
The distribution and origins of neurotensin (NT)-containing fibers in the nucleus ventromedialis hypothalami (VM) of the rat were investigated experimentally using an indirect immunofluorescence technique. A dense plexus of NT-like immunoreactive (NTI) fibers which was composed of very fine varicosities was identified in the VM. Although they were distributed throughout its entire rostrocaudal extent, the distribution was uneven. The highest density was identified in the dorsomedial part of the VM. In the central part, a less numerous but still moderate number of NTI fibers was detected in its dorsal part. But in a ventrolateral direction, they decreased in number and in the ventrolateral part only a few NTI fibers were seen. The present study demonstrated experimentally that these fibers originate from the medial nucleus of the amygdaloid complex (AM), since destruction of the AM resulted in a marked reduction of NTI fibers ipsilaterally in the VM. These findings suggest that the AM influences the VM's functions via neurotensin-like immunoreactive fibers.
Amygdala↗
Separate involvement of the spinal noradrenergic and serotonergic systems in morphine analgesia: the differences in mechanical and thermal algesic tests.
Experiments using 3 analgesic tests, the tail-pinch, hot-plate and tail-flick methods, were done to evaluate the roles of the spinal noradrenergic and serotonergic systems in the production of morphine analgesia in rats. To deplete noradrenaline or serotonin in the spinal cord, 6-hydroxydopamine or 5,6-dihydroxytryptamine was given intrathecally. 6-Hydroxydopamine suppressed the antinociceptive effects of morphine injected systemically or intracerebrally (into the nuclei reticularis gigantocellularis and paragigantocellularis or into the periaqueductal gray matter) in the tail-pinch test, but not significantly in the hot-plate and tail-flick tests. Conversely, 5,6-dihydroxytryptamine suppressed the antinociceptive effects of systemically given morphine in the hot-plate test, but not significantly in the tail-pinch and the tail-flick tests. The results not only provide further evidence for the involvement of the descending inhibitory systems in morphine antinociception, but also show that the extent of participation of the spinal noradrenergic and serotonergic systems in the effects of morphine has to be carefully assessed as different analgesic tests (tail-pinch, tail-flick and hot-plate) yield different results.
Animals↗
Neo-kyotorphin (Thr-Ser-Lys-Tyr-Arg), a new analgesic peptide.
The amino acid sequence of a newly isolated pentapeptide, neo-kyotorphin from bovine brain was synthetically verified to be Thr-Ser-Lys-Tyr-Arg corresponding to the C-terminal portion of hemoglobin alpha-chain. The synthetic neo-kyotorphin showed the dose-dependent analgesia in mice which was approximately equal to that of Leu-enkephalin.
Amino Acid Sequence↗
Fine structural studies on a type of somatostatin-immunoreactive neuron and its synaptic connections in the rat neostriatum: a correlated light and electron microscopic study.
Somatostatin-immunoreactive neurons in the rat neostriatum were studied by correlated light and electron microscopy using the peroxidase-antiperoxidase immunocytochemical technique. Immunoreactivity was localized in neuronal perikarya and processes. The perikarya were of spindle or fusiform shape (average length 16.9 microns) and were found in all parts of the neostriatum. From each neuron there arose two to four straight immunoreactive dendritelike processes, which could frequently be traced as far as about 130 microns from their perikaryon. Immunoreactive varicose axonlike processes were occasionally found, some of which were proximal axons of identified immunoreactive cells. Nine of the light microscopically identified neurons showing somatostatin-immunoreactivity were studied in the electron microscope; two of them had proximal axons with varicosities. Each neuron had an oval or elongated nucleus, which was always indented. These morphological features correspond well to those of certain "medium-size aspiny" neurons classified by Golgi studies. Although the immunoreactive endproduct was diffusely located throughout the neuron, it was characteristically located in the saccules and large granules (diameter 133 nm) of the Golgi apparatus, and large immunoreactive vesicles of similar size to those in the Golgi apparatus frequently occurred in all parts of axon. Very little synaptic input was found on the perikarya and dendrites of somatostatin-immunoreactive neurons. The perikarya and proximal dendrites received both symmetrical and asymmetrical synaptic input, while the distal dendrites usually received boutons that formed asymmetrical contacts. The somatostatin-immunoreactive boutons contained pleomorphic electron-lucent vesicles (diameter 39.3 nm) and a few large immunoreactive granular vesicles; these boutons always formed symmetrical synapses. Their postsynaptic targets were dendritic shafts, spines, and unclassified dendritic profiles. On the other hand, the varicosities of identified proximal axons of somatostatin-positive neurons did not form typical synapses, since they lacked clusters of small vesicles, but some of them were in direct apposition (via membrane specializations) to unlabelled perikarya or dendrites. It is concluded that somatostatin is a useful marker for a particular type of neuron in the neostriatum. The presence of somatostatin immunoreactivity in synaptic boutons is consistent with the view that somatostatin could be a neurotransmitter in the neostriatum.
Animals↗
Ligation and catheterization of the hepatic artery for palliative treatment of malignant hepatic tumors.
Eleven unresectable hepatoma patients and three metastatic tumor patients with colonic cancer underwent ligation and/or catheterization of the hepatic artery of the main tumor-bearing zone. Mitomycin C (liquid or microcapsulated) or Adriamycin were administered via the catheter intermittently or continuously with a portable pump device. In follow-up study the tumor size was frequently visualized by arteriography via the cannula. Some tumors became smaller with calcification. The levels of alpha-Fetoprotein of CEA in some cases dropped remarkably and stayed low for a fairly long period. There was no immediate postoperative death. Six of 11 unresectable hepatoma patients survived longer than 8 months with a maximum survival of 17.5 months. Two of three metastatic patients have survived more than 11 months at this writing. This method seems effective for prolongation of patient survival.
Aged↗
Pelvic exenteration combined with sacral resection for recurrent rectal cancer.
Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Computed tomographic (CT) study of the pelvis revealed recurrent tumor images in relation to the adjacent pelvic structures. Five patients with deeply invading recurrent lesions were submitted to pelvic exenteration combined with sacral resection. No postoperative deaths were encountered. The postoperative sharp drops of serum CEA levels are useful for judging the adequacy of this procedure. The follow-up status of the 5 patients, respectively: 14 months alive with pulmonary metastasis, 9 months alive without symptoms but with slightly elevated CEA levels, and 8 months, 3 months, and 3 weeks alive with no evidence of disease. All patients who were relieved of perineal or sciatic nerve pain are now able to walk without any assistance or trouble. Total en bloc residual pelvic exenteration combined with sacral resection is a reasonable treatment for locally recurrent rectal cancer.
Aged↗
Experimental immunohistochemical studies on the distribution and origins of substance P in the medial preoptic area of the rat.
Distribution of substance P (SP)-positive fibers in the medial preoptic area (POM) of the rat and their origins were examined using indirect immunofluorescence. A very high density of SP-positive fibers was seen in the POM throughout its entire rostro-caudal extent. However, the distribution of these fibers was not even; the highest density was detected in the medial part of the POM, with less dense but still numerous fibers in the lateral part. On the other hand, in this area a small number of SP-positive cells could be found; a few cells were scattered in the rostral part and, in the caudal part, several cells could be seen in the ventral part of the POM. The origins of SP-positive fibers in the POM were experimentally examined. Since the destruction of the ventro-lateral part of the anterior hypothalamus (vlAH), where numerous SP-positive cells were seen, resulted in a marked decrease of SP-positive fibers in the POM on the operated side, the majority of these fibers may originate from SP-positive cells in the vlAH. The fine structure of SP-positive terminals in the POM were investigated by electron-microscopic immunohistochemical techniques. Immunoreactive terminals contained a few large granular vesicles together with numerous small vesicles, and they made synaptic contacts mainly with dendrites which were devoid of immunoreactive materials. Two different synaptic contacts could be distinguished: one asymmetrical (Gray's type I) and the other symmetrical (Gray's type II), with the latter being predominant.
Animals↗
Localization of substance P-like immunoreactivity in neurons and nerve terminals in the neostriatum of the rat: a correlated light and electron microscopic study.
An antiserum, to substance P has been used to study the neostriatum of rats which has received intracerebral injections of colchicine. Both cell bodies and nerve fibres were found to display immunoreactivity. Some of the fibres were swollen and could be traced back to their parent cell body. Examination in the electron microscope of structures that had first been identified in the light microscope showed that there are two different types of substance P-immunoreactive cell body. The first kind (type I) of immunoreactive cell body was of medium size and had a smooth surfaced nucleus. It displayed the ultrastructural features typical of medium-size spiny neurons. Identified axons of type I neurons gave rise to immunoreactive axon collaterals within the neostriatum: boutons along these collaterals were found to form symmetrical synaptic contacts. The second kind (type II) of immunoreactive cell body was also of medium-size and had a round or oval shape, but the nucleus was deeply indented and was surrounded by a thin rim of cytoplasm. Synaptic input to this neuron was sparse and consisted of small boutons that made symmetrical contacts with the perikaryon and proximal dendrites. Many immunoreactive dot-like structures could be seen in the light microscope: upon examination in the electron microscope these were found to be boutons. All fifty-six synaptic boutons that were studied made symmetrical synaptic contacts. These boutons were indistinguishable from the boutons of axon collaterals of identified type I immunoreactive neurons. The most common postsynaptic structures were dendrites, including some dendritic spines, although synapses between immunoreactive boutons and several perikarya, and an axon initial segment were observed. The morphological features of the immunoreactive boutons in the neostriatum were very similar to one type of substance P-immunoreactive bouton in the substantia nigra and to a bouton type in the substantia nigra which is labelled following the anterograde transport of horseradish peroxidase from the striatum. It is suggested that there are two kinds of substance P-containing neurons in the striatum and that one of these is likely to belong to the medium-spiny class. The latter type of neuron is probably the source of the striatonigral substance P-containing projection and of the immunoreactive boutons within the striatum. The finding of substance P-immunoreactive synaptic boutons within the neostriatum provides a morphological basis for the view that substance P might serve as a neurotransmitter in the neostriatum.
Animals↗
Sites of analgesic action of dynorphin.
Analgesic effects of dynorphin and dynorphin-(1-13) injected into various regions of the CNS of rats were investigated using the tail pinch method. Dynorphin and dynorphin-(1-13) produced a dose-dependent analgesic effect when injected into the third ventricle (3rd vent.) or the nuclei reticularis gigantocellularis and paragigantocellularis (NRGC-NRPG) and the analgesic activity of dynorphin was 3 to 5 times more potent than that of dynorphin-(1-13). These peptides in higher doses elicited transient "barrel-rolling" and rigidity in behavior. On the other hand, when injected intrathecally, dynorphin exerted an analgesia accompanied by paralysis of hindlimbs which were long lasting. But its analgesic activity was less effective as compared with the 3rd vent. and NRGC-NRPG injections.
Analgesia↗
Comparison of analgesic potencies of mu, delta and kappa agonists locally applied to various CNS regions relevant to analgesia in rats.
Analgesic potencies of relatively selective agonists for mu, delta and kappa subtypes of opioid receptors, morphine, [D-Ala2,D-Leu5]-enkephalin (DADL) and ethylketocyclazocine (EKC), respectively, were examined with the tail-pinch test in the rat, when microinjected into the brain stem regions relevant to analgesia such as the nucleus reticularis paragigantocellularis (NRPG), nucleus raphe magnus (NRM) and periaqueductal gray matter (PAG), and into the lumbar subarachnoid space (LSS). Morphine, DADL and EKC produced dose-dependent analgesic effects at the NRPG, NRM, PAG and LSS. The ED50 values indicated that morphine was more potent than DADL at the NRPG and LSS but less at the NRM and PAG. EKC was the weakest at all the injection sites. Further, naloxone (0.1 mg/kg, s.c.) significantly antagonized the analgesic effect of morphine but not that of DADL or EKC at the NRPG. These findings suggest that mu, delta and kappa subtypes of opioid receptors mediate analgesia, and that the extent of contribution of each subtype to the production of analgesia differs among the CNS sites examined in this study.
Analgesics, Opioid↗
Effects of morphine on noxious stimuli-induced release of substance P from rabbit dorsal horn in vivo.
We investigated the effects of morphine on the noxious mechanical stimuli-induced release of immunoreactive substance P (iSP) from the rabbit dorsal horn in vivo. Systemic morphine in a dose of 10 mg/kg, but not 1 mg/kg, inhibited the iSP release induced by noxious stimuli, although both dosages inhibited the nociceptive responses of rabbits to the stimuli. The inhibitory effect of morphine (10 mg/kg) on the iSP release was partially or completely antagonized by the local application of naloxone or prazosin, respectively, to the dorsal horn. The local application of methysergide did not affect the morphine action. The inhibitory effect of morphine (10 mg/kg) on the iSP release was diminished in acute spinal animals. These results suggest that the inhibition of the evoked release of substance P participates only in the action of the larger dose of morphine, and that this inhibition of the substance P release may be mediated by opioid receptors and the noradrenergic system, but not the serotonergic system, in the spinal cord.
Animals↗