Search PubMed⌕ Search

Biomedical subjects

H Takaki

Publications and source records attributed to H Takaki.

At least 55 records · Page 3Linked to original sources
PubMed1997

Closed-loop identification of carotid sinus baroreflex open-loop transfer characteristics in rabbits.

In the circulatory system, a change in blood pressure operates through the baroreflex to alter sympathetic efferent nerve activity, which in turn affects blood pressure. Existence of this closed feedback loop makes it difficult to identify the baroreflex open-loop transfer characteristics by means of conventional frequency domain approaches. Although several investigators have demonstrated the advantages of the time domain approach using parametric models such as the autoregressive moving average model, specification of the model structure critically affects their results. Thus we investigated the applicability of a nonparametric closed-loop identification technique to the carotid sinus baroreflex system by using an exogenous perturbation according to a binary white-noise sequence. To validate the identification method, we compared the transfer functions estimated by the closed-loop identification with those estimated by open-loop identification. The transfer functions determined by the two identification methods did not differ statistically in their fitted parameters. We conclude that exogenous perturbation to the baroreflex system enables us to estimate the open-loop baroreflex transfer characteristics under closed-loop conditions.

Animals↗
PubMed1997

Insulin resistance as an independent risk factor for carotid artery wall intima media thickening in vasospastic angina.

Studies have shown the presence of insulin resistance together with compensatory hyperinsulinemia in vasospastic angina as well as obstructive coronary artery disease. There is growing evidence that the development of coronary atherosclerosis may be closely related to systemic atherosclerosis as well as coronary spasm. However, no information is available about the possible relationship between insulin resistance and the existence of carotid atherosclerosis in vasospastic angina without segmental stenosis or luminal irregularities in coronary angiograms. To evaluate the independent effect of insulin resistance on carotid intima media thickening, we performed insulin sensitivity tests (steady-state plasma glucose method) on 40 patients with vasospastic angina and 24 control subjects with angiographically intact coronary arteries. Both oral glucose tolerance tests and lipid analyses were performed. Using B-mode ultrasonography, we assessed intima media thickness and plaque formation of common carotid arteries in these subjects. The steady-state plasma glucose level in the vasospastic angina group was about twofold higher than that of the control group, confirming the presence of insulin resistance in patients with vasospastic angina. The patients with vasospastic angina showed a significant increase in the average intima media thickness of the carotid wall and frequency of plaque formation, although they were comparable to the control subjects in risk factors other than insulin resistance. The intima media thickness was correlated with age (r = .62, P < .001), 2-hour insulin area (r = .45, P < .01), and steady-state plasma glucose level (r = .68, P < .0001) in patients with vasospastic angina. Similar correlations were observed in the control subjects. Multiple regression analyses of data indicated that 67% of the variation in the intima media thickness could be accounted for by age, steady-state plasma glucose level, and cigarette-years in vasospastic angina. In addition, differences in IMT were independently related to vasospastic angina. These results suggest that insulin resistance in association with compensatory hyperinsulinemia may be an important pathogenic factor for the development of coronary artery spasms and systemic early atherosclerosis.

Adult↗
PubMed1996

Mediastinal lymphangiomas in adults: CT findings.

Mediastinal lymphangioma is rare in adults, and there are few reports of their computed tomographic (CT) findings. We present the CT results in three cases of mediastinal lymphangioma. One showed a well-defined, multilocular, water-density mass enveloping mediastinal structures, without their displacement or compression; one presented as a well-defined, homogeneous, water-density mass in the right paratracheal region; and one was associated with hemorrhage into cysts and a significant increase in size over 5 years. CT is useful for diagnosis and evaluation of the extent or contents of mediastinal lymphangiomas.

Adolescent↗
PubMed1996

Experimental studies on bovine Hyena disease induced by administration of excessive vitamin AD3E premix, vitamin A, or vitamin D3.

The effects of the excessive administration of the vitamin AD3E(V-AD3E) premix, vitamin A (V-A) or vitamin D3 (V-D3) on experimental development of Hyena disease in the calves were examined. Hyena disease was recognized in 4 calves, both of the 2 calves administered a high dose of V-AD3E premix (V-A 3,000,000, V-D3 300,000, and V-E 1,200 IU/day, V-AD3E group), 1 of the 2 calves administered a half dose of the V-AD3E premix, and 1 of the 2 calves administered only V-A (V-A 3,000,000 IU/day, V-A group) when each vitamin was administered orally for 10 days from 1 week after birth. Both of 2 calves administered only V-D3 (V-D3 300,000 IU/day) did not developed. In the 4 calves with Hyena disease (Hyena calves), the plasma retinylpalmitate showed high values which was suggesting the hypervitaminosis A, and the epiphysial growth plate was narrow and destroyed structure of column. Compared with the Hyena calf in the V-A group, the Hyena calves in the V-AD3E group showed earlier appearance time of Hyena disease, lower growth rate and shorter lengths of fore and hind limb bones. In conclusion, the present findings suggested that excessive V-A administration to suckling calves might cause Hyena disease by V-A effects to the epiphysial growth plate, moreover such effects may be promoted by the V-D3.

Aging↗
PubMed1996

Changes in bone metabolism and epiphysial growth plate in bovine Hyena disease induced by administration of vitamin AD3E premix or Vitamin A.

The changes in bone metabolism and morphology of chondrocytes in bovine Hyena disease caused by administration of vitamin AD3E premix (V-AD3E) or vitamin A (V-A) were examined. At the each age, 5 calves were used. Among them, Hyena disease was recognized in 3 calves; a calf administered a high dose of V-AD3E premix (V-A 3,000,000, V-D3 300,000, and V-E 1,200 I.U./day), a calf administered a half dose of the V-AD3E premix, and a calf administered only V-A 3,000,000 I.U./day. The remaining calves without Hyena disease were a calf administered only V-D3 300,000 I.U./day and a control calf. Each agent was administered orally for 10 days from 1 week after birth. In the 3 calves with Hyena disease, the bone metabolism in bone histomorphometry of ilium was in the state of low turnover at the age of 50 days. The bone volume was small at the age of 12 months. The epiphysial growth plates of the distal femurs and the proximal tibias partially disappeared and the chondrocyte lacunas in them were flattened. The matrix fibers of epiphysial growth plates were thinner in diameter and higher in density than those of the control calf. In the calf administered only V-D3, the values of bone volume decreased with aging. In conclusion, Hyena disease may be caused by excessive administration of V-A, because hypervitaminosis A suppressed the activity of differentiation and proliferation in chondrocytes and osteoblasts, and excessive administration of V-D3 may promote these actions.

Animals↗
PubMed1996

[Standardization of use of 4-F size catheter for selective transcatheter angiography and intervention of abdomen].

To evaluate the safety and efficacy of a new 4 French (F) catheter/sheath system with large lumina for selective abdominal arteriography and intervention, the usefulness of the 4F sheath (4F group, 88 patients) was compared with that of a 5.5F sheath and a 7F sheath (5.5F group, 7F group, 156 patients). The compression time of the arterial puncture site and the ambulation time in the 4F group were significantly shorter than those in the 5.5F and 7F groups. The hemorrhagic complication rate in the 4F group (15%) was less than those in the 5.5F group (23%) and 7F group (27%). The severity of hemorrhagic complications in the 4F group (hematoma 2.3%, woozing 14%, and rhexis 0%) was significantly less than in the 5F group (3%, 21%, 0%) and 7F group (11%, 19%, 2.4%). The controlability of the 4F catheter as compared with a 5F catheter was estimated in 35 patients by questionnaire. The torque transmissibility and the endurability of the kink of the 4F catheter were poor in comparison with the 5F catheter. However, with respect to the ability to follow over a guidewire, the 4F catheter showed great advantage over the 5F catheter. It is concluded that the 4F catheter/sheath system is feasible for general use in selective abdominal arteriography and interventions.

Abdomen↗
PubMed1995

Insulin resistance associated with compensatory hyperinsulinemia as an independent risk factor for vasospastic angina.

BACKGROUND: It is generally believed that coronary artery spasm plays an important role in the progression of obstructive coronary artery disease. Since insulin resistance together with hyperinsulinemia plays an important role in the pathogenesis of coronary atherosclerosis, we investigated the association of hyperinsulinemia and insulin resistance with vasospastic angina (VAP). METHODS AND RESULTS: The study population consisted of 60 patients with VAP and 42 control subjects (62 subjects with normal glucose tolerance and 40 with impaired glucose tolerance). Insulin sensitivity was determined by the steady-state plasma glucose (SSPG) method for nondiabetic, normotensive, nonobese subjects (16 control subjects, 16 obstructive coronary artery disease patients, and 16 VAP patients). Compared with the control group, the 2-hour insulin area (area under the plasma insulin concentration-time curve) during a 75-g oral glucose tolerance test was significantly higher in both VAP groups with normal and impaired glucose tolerance. A high frequency of vasospastic angina was observed in subjects with clustered risk factors for insulin resistance syndrome, suggesting a close association of VAP with this syndrome. In stepwise discriminant analysis, the 2-hour insulin area was significantly associated with VAP independent of other risk factors. SSPG level in VAP was about twofold over control, indicating the presence of insulin resistance in patients with VAP. However, no differences were found between patients with VAP and obstructive coronary artery disease with respect to mean SSPG level. CONCLUSIONS: SSPG level was significantly elevated in patients with VAP and obstructive coronary artery disease compared with control subjects. This indicates that hyperinsulinemia is secondary to insulin resistance, both of which are thought to play important roles as risk factors for VAP in the early atheromatous lesion and in the future development of occlusive lesions when chronically present.

Angina Pectoris, Variant↗
PubMed1995

Delayed improvement in exercise capacity with restoration of sinoatrial node response in patients after combined treatment with surgical repair for organic heart disease and the Maze procedure for atrial fibrillation.

BACKGROUND: Although the Maze procedure successfully restores sinus rhythm in patients with heart disease and atrial fibrillation, it is still uncertain whether an addition of the Maze procedure in cardiac surgery is beneficial for exercise performance of the patients after surgery. METHODS AND RESULTS: The Maze procedure was performed in 25 patients (age, 37 to 70 years) during valve surgery (18 patients) or closure of atrial septal defect (7 patients). A cardiopulmonary exercise test using ramp incremental protocol (15 W/min) was performed before and 1 month, 6 months, and 1 year after surgery. Sinus conversion was obtained in 23 of 25 patients 1 month after surgery. However, sinoatrial (SA) node response to exercise was attenuated by surgery: Mean heart rate (HR) was 83 +/- 13/min at rest, 94 +/- 13/min at 60 W, and 107 +/- 17/min at peak exercise. Peak oxygen uptake (PVO2) was unchanged at this period (before, 17.6 +/- 4.5 mL.min-1.kg-1; 1 month after, 17.5 +/- 4.2 mL.min-1.kg-1). Thereafter, SA node response was restored 6 months after surgery: Mean HR was 84 +/- 13/min at rest, 104 +/- 16/min at 60 W, and 130 +/- 20/min at peak exercise (P < .01 versus 1 month). PVO2 was also improved at this period (20.7 +/- 4.0 mL.min-1.kg-1, P < .01). The increase in PVO2 from 1 month to 6 months after surgery was correlated with the increase in peak HR (y = 0.73x +/- 3.6, r = .79). There were no further changes in heart rate response or PVO2 from 6 months to 1 year after surgery. CONCLUSIONS: Atrial fibrillation was successfully treated by combined treatment with surgical repair for organic heart disease and the Maze procedure. However, SA node response to exercise was attenuated early after surgery. Thus, exercise capacity was improved at the late phase after surgery, which was related to the extent of restoration in SA node response.

Adult↗
PubMed1995

Percutaneous transvenous mitral commissurotomy immediately restores quick response of VO2 to mild exercise despite insignificant increases in peak VO2.

Percutaneous transvenous mitral commissurotomy (PTMC) increases peak oxygen uptake (VO2) chronically, but not acutely, despite early symptomatic improvements. Analysis of transient VO2 responses to submaximal exercise (an exercise regimen more comparable to the patients' daily activities than that provided by maximal exercise testing), may be sensitive in detecting the acute hemodynamic benefits of PTMC. Since no methods are available to accurately estimate the transient response of VO2, we developed a new technique, using random exercise. In 15 patients who underwent successful PTMC, we repeated the conventional maximal exercise test and the random exercise test before and within a few days after PTMC. For the random exercise test, we intermittently imposed upright bicycle exercise at 50 W, according to a random binary sequence, while measuring breath-by-breath VO2. After determining the transfer function relating workload to VO2, we computed the high resolution VO2 response to a hypothetical step increase in exercise. Despite improvements in resting hemodynamics and New York Heart Association (NYHA) Class, peak VO2 improved insignificantly (952 +/- 271 vs 1,029 +/- 342 ml/min, P = 0.063) shortly after successful PTMC. In contrast, the amplitude of the VO2 step response increased significantly in the early-to-mid portion (28-76s; P < 0.01-0.05). The remaining portion was unchanged. Consequently, the time constant shortened from 64 +/- 26 to 48 +/- 22s (P < 0.05). The maximal Borg scale value during random exercise decreased significantly (13.1 +/- 1.8 vs 11.4 +/- 1.1; P < 0.01). We conclude that the VO2 step response, using the random exercise test, is more sensitive than peak VO2 in detecting the functional improvement that is coupled with the hemodynamic improvement immediately after PTMC.

Adult↗
PubMed1995

Mucin-producing tumor of the lung: CT findings.

Primary lung tumors and pulmonary metastases with a large mucin content are relatively rare, and reports of CT findings are scarce. We present the CT images of patients with mucinous bronchioloalveolar carcinoma and lung metastasis of mucinous adenocarcinoma of the colon. The CT findings include a uniform low attenuation (4.5 and 7.8 HU), irregular margins, and slight enhancement after intravenous injection of contrast medium.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1995

Uneven fatty replacement of the pancreas: evaluation with CT.

PURPOSE: To determine the computed tomographic (CT) features of uneven fatty replacement of the pancreas and clarify their radiologic and clinical importance. MATERIALS AND METHODS: CT scans from 80 patients with uneven fatty replacement of the pancreas were reviewed. Uneven fatty replacement of the pancreas was classified into two types. In type 1, the posterior aspect of the head of the pancreas was spared from intense fatty replacement. In type 2, the focal area around the common bile duct (CBD) was spared from fatty replacement. Each type was divided into two subgroups on the basis of whether the body and tail of the pancreas showed intense fatty replacement (type a = negative for intense fatty replacement, type b = positive for intense fatty replacement). Findings from endoscopic retrograde cholangiopancreatography performed in five patients, histopathologic examination in one patient, and clinical examination in all 80 patients were also evaluated. RESULTS: Twenty-eight patients (35%) had type 1a replacement, 29 (36%) had type 1b replacement, nine (11%) had type 2a replacement, and 14 (18%) had type 2b replacement. In all patients, the anterior aspect of the head of the pancreas showed distinctly lower attenuation at CT. CONCLUSION: Fatty replacement is more severe in the anterior aspect of the head of the pancreas. The posterior aspect of the head of the pancreas and the area around the CBD tended to be spared.

Adult↗
PubMed1995

[Clinical significance of lymphadenopathy in the upper abdomen; ultrasound demonstration].

Little attention has been paid to the ultrasound differentiation of benign abdominal lymphadenopathy from the malignant type. We reviewed 133 ultrasound examinations of 116 patients with lymphadenopathy seen over the upper abdomen and high retroperitoneum to clarify the differences in ultrasound findings of enlarged lymph nodes caused by benign and malignant abdominal diseases. The location, number, internal texture, size, length/thickness ratio of the lymph nodes, and relation with hepatitis virus infection were evaluated. Among 75 patients with benign diseases, 63 patients showed liver dysfunction and 42/65 (65%) showed positive hepatitis C virus antibody (HCV-Ab). Enlarged lymph nodes were seen over the common hepatic artery or hepatoduodenal ligament in 84%. Most patients had fewer than 4 enlarged nodes, and 46 patients had a single enlarged node. The length/thickness ratio of nodules was more than 2.5 in 63%. In 41 patients with malignant diseases, enlarged lymph nodes tended to be more widespread in location, larger in number, and smaller in length/thickness ratio than those of benign diseases. Lymphadenopathy over the common hepatic artery or hepatoduodenal ligament may suggest the presence of chronic active hepatitis, especially relating to HCV infection, even though hepatic sonotexture is normal on ultrasound examination.

Abdomen↗
PubMed1994

Diagnostic value of recovery time measured by body surface mapping in patients with congenital long QT syndrome.

The QT interval of the resting 12-lead electrocardiogram is normal or borderline in some patients with congenital long QT syndrome (LQTS). Recently, several in vivo experimental studies have shown that the time of maximum dV/dt in the ST-T segment is correlated with the time of local ventricular recovery. The purpose of this study was to examine the value of the body surface recovery time measured by 87-lead body surface mapping for detecting LQTS. Body surface mapping and 12-lead electrocardiography were performed simultaneously in 18 patients with LQTS and 40 controls of similar age and sex. The recovery time (RT), that is, the interval between QRS onset and the time of maximum dV/dt in the ST-T segment, was measured automatically by computer from each of the 87 mapping leads, and the corrected RT (RTc) was calculated by Bazett's method. The QT interval was measured from each of the 12 standard electrocardiographic leads, and the corrected QT (QTc) interval was also calculated. The maximum RT and RTc, the minimum RT and RTc, and the RT and RTc dispersions (difference between maximum and minimum RT and RTc in each patient) were significantly longer in the LQTS group than in the control group. In addition, a maximum RT of 390 msec, a maximum RTc of 430 msec 1/2, an RT dispersion of 170 msec, and an RTc dispersion of 170 msec1/2 separated the 2 groups completely (i.e., no overlap). The maximum QT and QTc, the minimum QT and QTc, and the QT and QTc dispersions (difference between maximum and minimum QT and QTc in each patient) were also significantly longer in the LQTS group than in the control group. However, the maximum QTc was normal (< or = 440 msec1/2) or borderline (< or = 460 msec1/2) in 5 of the 18 LQTS patients, and none of these parameters clearly separated the 2 groups. These results suggest that measurement of RT by 87-lead body surface mapping is useful for diagnosing latent or borderline LQTS.

Adolescent↗
PubMed1994

Apolipoprotein E5 and E7 in apparently healthy Japanese males: frequencies and relation to plasma lipid levels.

In order to determine the frequencies of apolipoproteins (apo) E5 and E7 and their relation to plasma lipid levels, apo E phenotypes were determined in 608 healthy Japanese male adults by two-dimensional gel electrophoresis. Apo E5 and E7 were observed in 2.8% of the subjects, in addition to the three common apo E isoforms, E2, E3, and E4. Apo E5 was divided into two subtypes based on the migration rate on SDS/PAGE, E5f is the type with faster migration and E5s slower migration. The gene frequencies were: the epsilon 3 allele, 0.841; the epsilon 4 allele, 0.095; the epsilon 2 allele, 0.049; the epsilon 7 allele, 0.009; the epsilon 5 allele encoding apo E5f (the epsilon 5f allele), 0.004; and the epsilon 5 allele encoding apo E5s (the epsilon 5s allele), 0.001. The five individuals with apo E5f and the eleven with apo E7 were heterozygotes and normocholesterolemic. Also plasma apo B and apo E levels were not increased in any subjects with apo E5f or apo E7. The data suggests that apo E5f and E7 are not rare in the Japanese population but that neither apo E5f nor E7 are associated with hypercholesterolemia in most of the heterozygotes.

Adult↗
PubMed1994

[Imaging and clinical significance of hepatic portal venous gas seen in adult patients].

In 10 adult patients with hepatic portal venous gas (HPVG), the clinical significance of HPVG and the efficacy of X-ray computed tomography (CT) were evaluated. HPVG was associated with ischemic bowel disease (n = 3), trauma (n = 4), liver abscess (n = 1), sepsis (n = 1), and unknown etiology (n = 1). The diagnostic ability of CT for the detection of HPVG was far superior to that of plain abdominal radiograph. Of 9 patients who underwent CT, HPVG located in the left hepatic lobe in all patients, and also in right hepatic lobe in 7 patients. Gas could be recognized in the left lobe and the anterior segment of the right lobe more clearly than in the posterior segment of the right lobe because of its larger amount of intravenous collection. The mortality rate of our cases was 100%. Gas was demonstrated simultaneously in the portal vein radicles and hepatic veins on CT in 4 patients with no clinical evidence of sepsis, which suggested the possibility of intraparenchymal shift of gas from the portal vein into the hepatic vein. In a single case with sepsis, gas was noted in various vessels, including arteries, in addition to the portal venous system. The authors conclude that HPVG is still a grave sign in Japan and prompt appropriate treatment is required. CT may be of great value in the early detection of HPVG and may indicate its etiology.

Abdominal Injuries↗