Search PubMed⌕ Search

Biomedical subjects

K Takakura

Publications and source records attributed to K Takakura.

At least 325 records · Page 18Linked to original sources

Malignant growth hormone-secreting pituitary adenoma with hematogenous dural metastasis: case report.

A rare case of growth hormone-secreting pituitary adenoma with hematogenous metastasis to the dura mater of the cerebral convexity is presented. Immunohistological staining was essential to the diagnosis. The histological findings demonstrated that the metastasis was blood-borne. Extensive removal of the tumor and postoperative chemotherapy resulted in partial remission. The mechanism of metastasis, the histological findings, the treatment, and the prognosis are discussed.

Adenoma↗

Primary leiomyosarcoma of the dura mater. Case report.

A rare case of leiomyosarcoma arising from the dura mater is presented. A definite histological diagnosis was based on the electron microscopic features. Extensive removal of the tumor and postoperative radiation therapy resulted in complete remission. The etiology and the origin of this tumor are discussed.

Aged↗

Leptomeningeal and orbital benign lymphophagocytic histiocytosis. Case report.

An extremely rare case of isolated histioproliferative lesions arising from the subarachnoid space of the left occipital convexity and the orbit is presented. The presence of histiocytes showing lymphophagocytosis and positivity for S-100 protein staining confirmed that the lesions represented extranodal forms of sinus histiocytosis with massive lymphadenopathy.

Adult↗

[Metastatic hepatoma presenting as intracranial hemorrhage: report of two cases].

Metastasis of hepatoma to the central nervous system is rare, although hepatoma is a relatively common malignant tumor in Japan. Much rarer is metastatic hepatoma presenting as intracranial hemorrhage and there have been only 4 cases reported in the past. Here, we report two such rare cases with a literature review. Case 1 was a 26 years-old female with a history of 60% hepatic resection in the diagnosis of hepatocellular carcinoma. Later, she developed bilateral lung metastasis. She was admitted with complaints of headache, nausea and vomiting. Neurological findings were clear consciousness, right homonymous hemianopsia and bilateral papilledema. CT showed high-density mass in the left occipital lobe. Evacuation of hematoma and removal of tumor were performed. Pathological diagnosis was hepatocellular carcinoma of clear cell type. Later, two other hemorrhage occurred from different metastatic lesions in the left occipital lobe and the right occipital lobe, and the patient underwent two more surgeries. The patient died of lung metastasis, three months from neurological onset. Case 2 was a 42 years-old male who developed an intracranial tumor adjacent to the right temporal bone without a history of hepatoma. The tumor was removed, which turned out to be hepatocellular carcinoma pathologically. Three months later, on admission, the patient showed sudden neurological deterioration into deep coma. CT showed an irregular high-density mass in the right temporal lobe and evacuation of hematoma coupled with tumor removal was performed. Pathology was of trabecular type. Later, intracranial recurrence and bony metastasis to C5, L3 and the left iliac bone appeared.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Intravenous hydrocortisone in large doses in the treatment of delayed ischemic neurological deficits following subarachnoid hemorrhage--results of a multi-center controlled double-blind clinical study].

Glucocorticoid in high dose has known to reduce vascular sensitivity to various vasoconstrictive stimuli. It inhibits phospholipase to reduce production of prostaglandins. It stabilizes the cell membrane and prevents cerebral edema. All these pharmacological effects indicate possible usefulness of this drug for the treatment of cerebral ischemia due to vasospasm. Based on these theoretical backgrounds a multi-center controlled double blind clinical study was carried out. The patient who showed manifestations of delayed cerebral ischemia due to vasospasm were selected for this study. As soon as the clinical manifestation appeared, the patient was given either 3 grams of hydrocortisone intravenously in a 60 ml solution or the placebo. The administration was repeated 6 times with interval of 12 hours. The patients were allowed to be treated according to the independent protocol of each institute except for the maximum daily use of glucocorticoid. The effect of the therapy was evaluated at 4th, 7th day and 1 month after the initiation. The study involved 52 institutes and a total of 140 patients, seventy-one patients who received hydrocortisone (group A) and 69 patients who received placebo (group P) was analysed. There were no significant differences in background data between both groups. In patients with grade I, II or III on admission, the favorable effects of hydrocortisone were demonstrated on changes in neurological findings. In group A, there were significantly more cases of improvement at 4th day for orientation about place and person. At 1 month or on discharge group A showed significant improvement almost in every aspect of neurological findings including mental, speech and motor functions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Response to antitumor agents of human transplantable glioma implanted into chorioallantoic membrane of chick embryo].

In case of chemotherapy against brain tumors, it is most important to choose suitable drugs for brain tumors, since human tumors have different drug sensitivity and growth. Heretofore, the nitrosourea-induced rat glioma cell, such as C6, or immunodeficient mice were usually used for predicting the drug sensitivity of brain tumors. We took notice of Murphy's system for the chemosensitivity test, in which a human tumor is transplanted into the chorioallantoic membrane (CAM) of a chick embryo. By modifying the conventional Murphy's system, we studied the efficiency of this system in predicting the drug sensitivity of brain tumors. First, we compared the result of a drug sensitivity test using CAM of a chick embryo with that using nude mice. Next we studied the effect of chemotherapeutic agents against brain metastasis of a chick embryo caused by the intravenous injection of mouse B16 melanoma cells. The tumor reduction rate of the sensitivity test using a chick embryo tended to agree with that using nude mice. In the drug sensitivity test against brain metastasis, ACNU was the most effective. This result supports the result of the clinical study. In conclusion, the drug sensitivity test using a chick embryo is thought to be useful and the advantages or disadvantages of this system are discussed.

Allantois↗

[Antineoplastic effect of prostaglandins on human glioma in athymic nude mice].

The prostaglandins (PG) are known to have various physiological effects. Some series of prostaglandins such as PG D2 have been reported to inhibit growth of tumor cells. In this study, the growth-inhibitory effects of PG A2, PG D2, PG J2 and 6-keto PGE1 were investigated in nude mice receiving subcutaneous transplant of human brain tumor. One to two milligram of prostaglandins was given intraperitoneally every day for three weeks. Tumor volumes were measured twice weekly and the tumor reduction rates (treated/control) were evaluated. T/C rate treated with PG D2 or PG A2 was 50-60% respectively. The effectiveness of PG J2 or 6-keto PGE1 was inferior to that of PG A2 or PG D2. But in the evaluation of antitumor effects of PG J2, we must consider the fact that the activity of PG J2, is liable to be lost. The effect of PG D2 on proliferation of cultured glioma cells was also studied. At concentrations of 10 micrograms/ml, PG D2 strongly inhibited the proliferation of glioma cells. However, precise mechanism of prostaglandin action is presently unknown. Further studies are required to clarify the mechanism of antitumor effects of prostaglandins.

Alprostadil↗

[Chemosensitivity test for human gliomas].

In case of chemotherapy against brain tumors, it is most important to choose suitable drugs for brain tumors, since human tumors have different drug sensitivity and growth. Heretofore, human tumor clonogenic assays or human glioma-bearing nude mice models were usually used for predicting the drug sensitivity of brain tumor. Human tumor clonogenic assays are one of the best in vitro tests for anticancer drug activity. However, plating efficiency is low, sometimes preventing evaluation of drug sensitivity, and the slow growth of colonies means that culture time is long. Assays using immunodeficient mice are used for predicting the drug sensitivity of human tumors; usually results reflect the sensitivity of the parent tumor. However, procedure using athymic nude mice are slow and expensive. We took notice of Murphy's system for the chemosensitivity test, in which a human tumor is transplanted into the chorioallantoic membrane (CAM) of a chick embryo, because in this system, various kinds of human tumors could be grafted in high rate. By modifying the conventional Murphy's system, we studied the efficiency of this system in predicting the drug sensitivity of brain tumors. We compared the result of a drug sensitivity test using CAM of a chick embryo with that using nude mice. First, we studied the effect of chemotherapeutic agents such as ACNU, bleomycin. Next, we studied the effect of combination treatment of CAP or CAPF. The tumor reduction rate of the sensitivity test using a chick embryo tended to agree with that using nude mice.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Studies of the factors affecting the reduction of chronic subdural hematoma: effect of preoperative factors with special reference to cerebral atrophy].

The authors examined the preoperative factors affecting the reduction of chronic subdural hematoma (CSDH). A new method was developed to calculate the reduction rate of CSDH using CT volumetry technique. Postoperative serial CT films were examined and each hematoma volume was calculated by microcomputer. A postoperative exponential decrease of hematoma volume was observed, and the log-transformation of the hematoma volume turned the curve to a linear decrease. The least square method was used to fit an exponential curve, and the half reduction date (HRD) was calculated from the fitting curve. This HRD represents a mathematical indicator of the reduction rate of CSDH. Using this technique, the relationships between this HRD and the following parameters were examined in 61 patients. The preoperative factors examined are as follows; 1) patient's age, 2) preoperative hematoma volume, 3) CT number of the hematoma, 4) time interval between the head injury and the onset of symptom, and 5) the degree of cerebral atrophy. The degree of cerebral atrophy was calculated by means of a simple approximate formula as described by one of the authors (K.N.). Patient's age and the hematoma volume were correlated with HRD, and the correlation coefficients were 0.346 (p less than 0.01) and 0.298 (p less than 0.05) respectively. On the other hand, preoperative CT findings and the duration from the trauma had no correlation with HRD. Cerebral atrophy has hitherto been thought to affect the reduction of hematoma. However, our quantitative study revealed no correlation between cerebral atrophy and the reduction of hematoma rate. This unexpected result may be attributed to the difference between cerebral atrophy and cerebral elasticity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Factors possibly influencing the prognosis of oligodendroglioma.

Fifty-seven cases of oligodendroglioma (including eight cases of malignant oligodendroglioma) treated at the University of Tokyo Hospital between 1961 and 1985 were analyzed for factors influencing the survival rate. Factors related to a poor outcome were findings of malignancy and symptoms of dementia. Survival rate and postoperative survival period were not influenced significantly by radiation therapy, extent of resection, tumor characteristics, or ABO blood groups.

Adolescent↗

[Treatment of recurrent craniopharyngioma].

Treatment results on 48 patients with "recurrent" craniopharyngioma treated by surgery or/and radiation are analyzed. Median relapse-free survival time was 43.6 months in patients treated initially with radiation and 22.2 months without. Operative death occurred in 17% of all patients and in 3 out of six patients after total removal. The five- and ten-year survival rates were 91.7% and 66.8%, respectively, for 14 patients treated with combined surgery and radiation therapy. For 26 patients treated with surgery, the survival rates were 20.3% and 10.1%. All of 6 patients, who had received both initial and later radiotherapy, were well 1/2 to 18 years later without clinical evidence of radiation injury. These results lead us to the following conclusions: 1) A radical surgery in recurrent cases has the higher risks of mortality and morbidity than that of the first radical surgery. 2) Radiation therapy improved the survival rate of patients with "recurrent" craniopharyngioma. 3) After initial radiation therapy, additional irradiation was allowed based on the scale of nominal standard dosage and the estimation of "decay factor".

Adolescent↗

Antigenic heterogeneity of carcinoembryonic antigen in the circulation defined by monoclonal antibodies against the carbohydrate moiety of carcinoembryonic antigen and closely related antigens.

Six mouse monoclonal antibodies reactive with carcinoembryonic antigen (CEA) were prepared and used for the analysis of the antigenic heterogeneity of CEA in patient sera. Their reaction specificity and the chemical nature of antigenic epitopes recognized by them were analyzed by radioimmunoassay on the basis of reactivities with different preparations of CEA, normal fecal antigen 2, and nonspecific cross-reacting antigen 2 before and after chemical and/or enzymatic treatment. Two antibodies, F3-30 and F4-82, raised with CEA were reactive with different peptide epitopes on the antigen molecules and revealed a quite universal reactivity with all CEA, normal fecal antigen 2, or nonspecific cross-reacting antigen 2 preparations tested. The serum CEA values obtained with these antibodies were highly correlated with those obtained with conventional radioimmunoassays for CEA. The other four antibodies (F4-11 and F33-37 raised with CEA, F8-52 with normal fecal antigen 2, and F48-60 with nonspecific cross-reacting antigen 2) were found to recognize carbohydrate epitopes with different specificities and revealed very heterogeneous reactivities. The serum CEA values estimated with these four antibodies were highly variable depending on the antibody used, suggesting that the expression of carbohydrate epitopes on the CEA molecules in patient sera was quite heterogeneous. The antigenic heterogeneity of the carbohydrate epitopes was detected even in a single patient serum by affinity chromatography. The causes that give rise to the difference in CEA values between the Roche and the Daiichi kits were analyzed on the basis of reactivities of three groups of patient sera, which showed extremely different ratios for the Roche and Daiichi kits, with monoclonal anti-carbohydrate antibodies. The results obtained suggest that, at least in part, the diversity of antigenic expression on carbohydrate chains on the CEA molecules in patient sera and the variation in specificity or quantity of anti-carbohydrate antibodies in the polyclonal antibody preparations used for the respective assay systems may result in the differences in the estimated CEA values.

Antibodies, Monoclonal↗