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Biomedical subjects

K Takada

Publications and source records attributed to K Takada.

At least 271 records · Page 15Linked to original sources
PubMed1997

Fifteen-year follow-up of acquired renal cystic disease - a gender difference.

In 1979, 96 patients who had undergone hemodialysis for a mean of 3 years and 4 months were entered into this study. This follow-up study revealed that the bilateral kidney volume significantly increased over 10 years in 33 male patients. Kidneys were found to have enlarged 2.7 times over the 10-year follow-up period. However, in 24 females kidney volume did not change over 10 years. This paper reports further results in 39 dialysis patients (21 males and 18 females) who were followed from the 10th to 15th year. In male patients, mean volume was 196 +/- 218 ml (mean +/- SD) at the 10th year and had significantly increased to 225 +/- 213 ml at the 15th year (p < 0.02). In female patients, mean kidney volume was 78 +/- 51 ml at the 10th year and had increased to 117 +/- 91 ml at the 15th year (p < 0.01). The enlargement in kidney volume during the recent 5 years was 1.26 +/- 0.39-fold in males and 1.43 +/- 0.45-fold in females. These rates did not significantly differ between males and females. During this recent 5-year period, there were no surgical cases due to renal cell carcinoma. Therefore, over the entire patient-time dialysis period, there were 6 renal cell carcinomas in 1,470 patient years. In conclusion, 10- to 15-year follow-up studies of kidney size revealed that the enlargement in the kidney due to acquired cysts persisted in male patients, but the rate of increase slowed after 13.0 years of hemodialysis, while the enlargement in the kidney in female patients became significant at 17.7 years of hemodialysis, revealing the slowly progressive nature of acquired cysts in women.

Adult↗
PubMed1997

Inactivation of the tumor suppressor gene on 11q13 in brothers with familial acrogigantism without multiple endocrine neoplasia type 1.

Two of three brothers (the second and third brothers) and their uncle (their mother's brother) presented acrogigantism without multiple endocrine neoplasia type 1 (MEN 1). An invasive macroadenoma was found in the second brother, and it was histologically confirmed as a sparsely granulated GH cell adenoma. Two distinct microadenomas were found in the third brother, and these were histologically diagnosed as a mixed GH cell and PRL cell adenoma and a sparsely granulated GH cell adenoma, respectively. The loss of heterozygosity (LOH) was analyzed in two adenomas (GH cell adenoma from the second brother and a mixed GH cell and PRL cell adenoma from the third brother) by determining microsatellite polymorphisms of DNAs from tumors and patients' leukocytes. The LOH was found on the chromosome 11q13, whereas LOH was not detected on 1p31-36, 2p, 3p, 4, 5, 6p, 7, 8, 9p21-22, 12p, and 19q13 in both pituitary adenomas examined. The haplotype analysis showed that the same haplotype on 11q13 was found in their mother and the unaffected first brother as well as in the affected uncle and two brothers. The deleted alleles on chromosome 11q13 in the tumors of two affected brothers were, however, restricted to those transmitted from their unaffected father. These data suggest that inactivation of the MEN 1 gene or other tumor suppressor genes on chromosome 11q13 plays an important role for the development of our familial acrogigantism without MEN 1.

Adenoma↗
PubMed1997

Absorption of oligodeoxynucleotide by suppository from rat rectal route.

Rectal absorption of 32-mer phosphorothioate deoxynucleotides (S-Oligo) in the rat was attempted with the aid of a suppository containing oleic acid and a surfactant. Although, the suppository without adjuvant did not show detectable blood levels, that containing over 10% oleic acid enabled the absorption of S-Oligo with tmax at 2 h postdosing.

Administration, Rectal↗
PubMed1997

The results of transsphenoidal surgery for 44 consecutive acromegalic patients.

A series of 44 patients with acromegaly underwent transsphenoidal surgery between 1987 and 1996. The early postoperative mean basal GH level < 5 ng/ml or < 3 ng/ml was achieved in 43 (97.7%) or 38 (86.4%) out of 44 patients, respectively. Preoperative abnormal GH secretory response to TRH, GnRH and oral glucose administration was restored to normal both after surgery and at the time of the final follow-up in all patients whose early postoperative mean basal GH levels were reduced to < 3 ng/ ml, whereas they remained abnormal in those with mean basal GH levels of > or = 3 ng/ml. In contrast, insulin-like growth factor 1 (IGF-1) levels, when measured by the extraction method, tended to be reduced gradually to normal between 6 months and 2 years after surgery in some patients with a successful operation. Therefore, 34 (87.1%) out of 39 patients who have been followed up longer than 6 months met the following stringent criteria at the time of the final follow-up: mean basal GH level < 3 ng/ml, a normal IGF-1 level, and normal GH response to TRH, GnRH and oral glucose administration. In this series, the most unfavorable preoperative factor influencing operative outcome is tumor invasion of the cavernous sinus. Our results clearly indicate that selective adenomectomy by transsphenoidal surgery is the therapy of first choice in any patient with acromegaly and that the complete biochemical cure of acromegaly can be achieved in 87% of patients by surgery alone with an acceptable low surgical morbidity.

Acromegaly↗
PubMed1997

Incisor crossbite and repaired unilateral cleft lip and palate: changes in jaw movement and temporalis muscle activity before and after edgewise treatment--case report.

OBJECTIVE: To examine the changes in jaw movement and temporalis muscle activity of a patient with unilateral cleft lip and palate before and after edgewise treatment. DESIGN: Clinical case study. SETTING: University dental hospital, department of orthodontics. PATIENT: A 12-year 3-month-old male with incisor crossbite, molar malocclusion, and repaired unilateral cleft lip and palate who had completed first-phase orthodontic treatment. MAIN OUTCOME MEASURES: This patient was treated with an edgewise appliance. Jaw movement and temporalis muscle activity during the chewing of a hard gummy jelly were recorded at 2 kHz from the sixth to the twentieth stroke before edgewise treatment and after a retention period of 2 years. RESULTS: Optimum intercuspation of teeth was achieved. The reversed crossing jaw-movement pattern before treatment changed to a normal grinding after treatment. The posterior temporalis muscle on the chewing side exhibited an earlier burst than the contralateral one during chewing at the post-treatment stage, as is observed in cases with good occlusion. CONCLUSION: Improvement in the occlusion using an edgewise appliance is necessary for acquiring a good masticatory function in patients with incisor crossbite, molar malocclusion, and cleft lip and palate.

Child↗
PubMed1997

Application of a colon delivery capsule to 5-aminosalicylic acid and evaluation of the pharmacokinetic profile after oral administration to beagle dogs.

Pressure-controlled colon delivery capsule (PCC) containing 5-aminosalicylic acid (5-ASA) for the treatment of inflammatory bowel disease (IBD) was prepared and evaluated by an in vivo experiment using beagle dogs. As a reference drug, sulfasalazine (SASP), prodrug of 5-ASA, was used as a plain gelatin capsule preparation. After the oral administration of SASP at the does of 25.0 mg/kg, the mean time when the plasma 5-ASA concentration reaches to its maximum (Tmax) was 9.0 hr. In the case of 5-ASA administered in PCC, at the doses of 12.5 and 25.0 mg/kg, Tmaxs were 5.3 and 5.3 hr, respectively. Although the time for the first appearance of 5-ASA into the systemic circulation was almost the same value between SASP capsule and PCC containing 5-ASA, longer Tmax was observed from SASP capsule than from PCC. These results suggest that this 5-ASA preparation would be an useful dosage form for the therapy of IBD from the point of avoiding the side effect of sulfapyridine, one of the metabolites of SASP.

Administration, Oral↗
PubMed1997

[Diagnosis of Epstein-Barr virus-associated gastric carcinoma and its background gastric mucosa].

Recently, the presence of Epstein-Barr virus(EBV) in almost 7% of gastric carcinoma lesions was reported. From our observation, EBV-associated gastric carcinomas located mainly in the gastric body, and moderate to poorly differentiated adenocarcinoma with lymphoid infiltration, as currently reported. Macroscopically, there were mainly thick and ulcerated lesions, EBV-associated gastric carcinomas had close relation with intestinal metaplasia, and EBV could be suspected to provide the immortalized epithelial cells.

Adenocarcinoma↗
PubMed1997

[Intravenous anesthesia by continuous administration of midazolam and fentanyl].

We examined the amount and method of administration of midazolam and fentanyl for intravenous anesthesia. Intravenous anesthesia was induced by intravenous administration of fentanyl 0.2-0.3 mg, followed by a minimal sleeping-inducing dose of midazolam, and then an additional 0.2 mg of fentanyl before starting the operation. To maintain anesthesia, a half dose of the first dose of midazolam was administered every hour, and a continuous intravenous injection of fentanyl at 0.08 microgram-1. kg-1.min-1 was also performed. It is suggested that these doses are the most suitable for obviating the use of antagonist. Also, by using a continuous administration, the dose of fentanyl can be reduced, and it is possible to stabilize circulation. Without the use of nitrous oxide during intravenous anesthesia, it is necessary to double the dose of fentanyl administered.

Adult↗
PubMed1997

Serum concentrations of free ubiquitin and multiubiquitin chains.

Ubiquitin, which can conjugate with cellular proteins, is classified into two forms: free ubiquitin and multiubiquitin chains. The latter is active as a signal for degradation of the targeted proteins. We found both forms in human serum and, using two immunoassays, quantitated them in sera from healthy subjects and patients with some diseases. Because of putative leakage of erythrocyte ubiquitin, hemolytic serum and serum obtained after long incubation (> 1-2 h) of blood at room temperature were excluded. Serum concentrations of multiubiquitin chains and free ubiquitin were substantially higher in rheumatoid arthritis and hemodialysis patients, respectively, than healthy subjects. Additionally, in acute viral hepatitis, serum multiubiquitin chain concentrations were increased in the acute phase, decreased in the recovery phase, and correlated with alanine and aspartate aminotransferase activities (r = 0.676 and 0.610, P < 0.0001 and < 0.001, respectively). Therefore, serum ubiquitin may have prognostic value.

Acute Disease↗
PubMed1997

Fermentation product analysis in the identification of black-pigmented bacteria from periodontitis.

A quantitative procedure is described for the analysis of fermentation products of eight representative black-pigmented Gram-negative anaerobic bacterial strains (Porphyromonas gingivalis 381, Porphyromonas gingivalis ATCC 33277, Prevotella intermedia ATCC 25611, Prevotella nigrescens ATCC 33563, Prevotella melaninogenica ATCC 25845, Prevotella denticola ATCC 33185, and Prevotella loescheii ATCC 15930) from oral sites in humans, using gas-liquid chromatography. This procedure for the identification of clinical isolates was carried out and the results were in agreement with those obtained by other chemical, biochemical and serological assays. The isolates were classified as Prevotella intermedia, Prevotella nigrescens and two serotype groups of Porphyromonas gingivalis, based on the quantity of fatty acids.

Antibodies, Bacterial↗
PubMed1997

Prediction of wall motion improvement after coronary revascularization in patients with postmyocardial infarction: diagnostic value of dobutamine stress echocardiography and myocardial contrast echocardiography.

The diagnostic value of dobutamine stress echocardiography, myocardial contrast echocardiography and dipyridamole stress thallium-201 single photon emission computed tomography (SPECT) for predicting recovery of wall motion abnormality after revascularization was evaluated in 13 patients with postmyocardial infarction. Seventeen segments showed severe wall motion abnormalities before revascularization. Nine segments which had relatively good Tl uptake on delayed SPECT images despite severely abnormal wall motion were opacified during myocardial contrast echocardiography, and showed improved wall motion after revascularization. In contrast, three segments which had poor Tl uptake and severely abnormal wall motion were not opacified during myocardial contrast echocardiography, and showed no improvement in wall motion during dobutamine stress echocardiography and after revascularization. The following three findings were assumed to be signs of myocardial viability: 1) good Tl uptake on delayed SPECT images; 2) improved wall motion by dobutamine stress echocardiography; and 3) positive opacification of the myocardium by myocardial contrast echocardiography. Myocardial contrast echocardiography had the highest sensitivity (100%) and negative predictive value (100%). Delayed SPECT images had the highest specificity (100%) and positive predictive value (100%). Dobutamine stress echocardiography had a sensitivity of 83.0%, specificity of 80.0%, positive predictive value of 90.9%, and negative predictive value of 66.7%, respectively. Myocardial contrast echocardiography showed the lowest specificity (60.0%). The techniques of dobutamine stress echocardiography and SPECT, though noninvasive, may underestimate wall motion improvement after revascularization. Further examination by myocardial contrast echocardiography is recommended to assess myocardial viability for determining the indications for coronary revascularization in spite of its invasiveness.

Cardiotonic Agents↗
PubMed1997

Drug dependence study on vigabatrin in rhesus monkeys and rats.

The dependence potential of vigabatrin (gamma-vinyl GABA; R(-)/S(+)-4-amino-5-hexenoic acid, CAS 60643-86-9, MDL 71,754) was assessed in rhesus monkeys and rats. In the test of cross physical dependence potential, morphine- and barbital-dependent monkeys were both withdrawn from the respective drugs and the ability of vigabatrin to suppress the withdrawal signs was assessed. In morphine-dependent monkeys, subcutaneous doses of vigabatrin at 256 and 1000 mg/kg did not suppress withdrawal signs while subcutaneous doses of codeine phosphate at 4 and 8 mg/kg clearly suppressed the withdrawal signs. In barbital-dependent monkeys, subcutaneous and intravenous dose of vigabatrin, both at 1000 mg/kg, did not suppress the withdrawal signs, while intragastric doses of diazepam at 8 and 16 mg/kg clearly suppressed them. Thus, while the cross-physical dependence potential of codeine/morphine and of diazepam/barbital was clearly observable, vigabatrin appeared to have no such potential. In the test of physical dependence-producing potential with the drug-admixed food method in rats, vigabatrin and diazepam were given to rats mixed with food for 28 days in an increasing dosage schedule, followed by feeding a drug-free diet to observe withdrawal signs for 7 days. Upon withdrawal, no decrease in food intake or body weight was observed in the vigabatrin-treated groups, and the gross condition of the animals did not differ from that in the control group. In contrast, food intake and body weight decreased markedly in the diazepam group, and most rats showed hyperreactivity to external stimuli. Thus, while the physical dependence-producing potential of diazepam was clearly demonstrated, such potential was not shown with vigabatrin. In the test of reinforcing effect, 4 monkeys were allowed to self-administer pentobarbital at 1 mg/kg/infusion, or vigabatrin at 16, 32, and 64 mg/kg/infusion, intravenously through an indwelling catheter. Each drug was preceded and followed by saline self-administration for at least 7 days. Active self-administration of pentobarbital was observed in all monkeys tested, while the self-administration rate of vigabatrin did not differ from saline. Thus, while the reinforcing effect of pentobarbital was clearly observed, such effect was not observable with vigabatrin. Based on these results, it was considered that vigabatrin was devoid of dependence potential.

Analgesics, Opioid↗
PubMed1997

[Female autopsy case of Seitelberger's connatal form of Pelizaeus-Merzbacher disease].

We report here an autopsy case of connatal Pelizaeus-Merzbacher disease, the second from Japan. Her clinico-pathological findings were essentially the same as those of the first case that we reported previously. The clinical course of this patient was 19 years in duration. Pathologically myelin had disappeared from the entire central nervous system, whereas that of the peripheral nervous system was preserved. Axons appeared also intact except for torpedo formation in the cerebellum. Demyelinated areas showed isomorphic gliosis. Recent studies have revealed impairment of proteolipid protein synthesis in classical Pelizaeus-Merzbacher disease, the causative gene of which being located on the X chromosome. Thus, this disease is inherited as an X-linked recessive trait. However we report herein a sporadic female case in a non-consanguineous family. Therefore, we propose that this disease might have another causative gene and/or another mode of inheritance.

Adult↗
PubMed1997

[Anesthetic management of a patient with Duchenne's muscular dystrophy undergoing radical repair for tetralogy of Fallot].

This report describes a 13-month-old-girl with Duchenne's muscular dystrophy (DMD) who had radical repair for tetralogy of Fallot safely. Patients with DMD are considered to be at risk of malignant hyperthermia (MH). Drugs for induction and maintenance were chosen from a list of agents rarely associated with MH. To wash out the inhalation anesthetics from the equipment, oxygen was circulated continuously for 24 hours. Dantrolene sodium was kept readily available in case of MH occurrence. Differential diagnosis during surgery is difficult in term of the episodes of MH and complications of cardiac surgery, as cardiac surgery is also associated with tachycardia, tachyarrhythmias, metabolic asidosis and red colored urine, which are frequently accompanied by MH. Although increased levels of CK, GOT, LDH and myoglobin strongly support the diagnosis of MH, such evidence can only be confirmed after operation. Fortunately, these factors recovered to the normal range without treatment by dantrolene sodium. During the cardiac surgery, treatment of MH may be delayed due to its late confirmation.

Anesthesia, General↗
PubMed1997

[The family function of patients on home oxygen therapy and their main caregivers].

We examined family APGAR scores in patients on home oxygen therapy (n = 101) and their main caregivers (n = 91), and compared them with those obtained from members of a seniors' club who were not on home oxygen therapy themselves, nor had any family members on home oxygen therapy. Furthermore, the relationship between the main caregivers recognition of the patients' mental state and the patients' CESD score was examined. Family APGAR scores for the main caregivers were significantly lower than those of the patients (p < 0.002), or the seniors' club members (p < 0.004). Since most the main caregivers were women, we compared family APGAR scores of the female main caregivers and the age-matched female members of the seniors' club, revealing that the satisfaction of the female main caregivers with the "adaptation" component of the APGAR score (the component dealing with support given when something troublesome happens), was significantly lower than that of the members of the seniors' club (p < 0.0001). The CESD of the patients whom the main caregivers recognized as depressed was significantly higher. Thus, we concluded that satisfaction of the main caregivers with family function who were family members was low, and that the role of the main caregivers is important in alleviating the depression of patients on home oxygen therapy.

Aged↗