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Biomedical subjects

K Takase

Publications and source records attributed to K Takase.

297 records · Page 17Linked to original sources

[An adult case of primary antiphospholipid syndrome presenting recurrent anterior spinal artery syndrome].

A 50-year-old man suffered from sudden onset of paraplegia, sensory impairment of the lower extremities and difficulty urinating. These symptoms spontaneously resolved, and he was able to walk again within 10 days. After 2 months' observation, he experienced a relapse with identical symptoms. Neurological examination revealed paraplegia, hypalgesia and hypesthesia in the lower extremities and difficulty urinating. Position and vibration senses were preserved in the extremities. Knee jerk was mildly hyperreflexic on the left, but pathological reflexes were not present. He had such risk factors for arteriosclerosis as diabetes mellitus, hypercholesterolemia and smoking. Although antinuclear antibodies were negative, he repeatedly showed high anticardiolipin antibody titers. MRI showed a T2-hyperintense lesion of the anterior portion of the spinal cord at Th9-10 levels. Neither arteriovenous malformation nor fistula was found on MR angiography. Abdominal CT revealed no abnormality in the descending aorta. Cervical ultrasonogram showed arterioslerotic lesions on the right common carotid artery. This is the first report of recurrent spinal cord infarction in an adult patient associated with primary antiphospholipid syndrome. Recurrence of the spinal cord infarction in this case may have been facilitated by the presence of risk factors for arteriosclerosis.

Anterior Spinal Artery Syndrome↗

Splenectomy enhances liver regeneration through tumor necrosis factor (TNF)-alpha following dimethylnitrosamine-induced cirrhotic rat model.

BACKGROUND/AIMS: We demonstrated that partial splenic embolization for hematological disorders in cirrhotic patients also improved liver function. Therefore, we investigated the mechanism of the beneficial effects of splenectomy on a rat cirrhotic model. METHODOLOGY: 1) Rats were administered DMN (dimethylnitrosamine) after splenectomy (splenectomized DMN rats) or a sham operation (DMN rats). 2) After completion of DMN administration, a tumor necrosis factor-alpha inhibitor (E3330) was administered on the same day as the splenectomy. Histological examination and cytokine expressions were analyzed. RESULTS: The splenectomy apparently reduced liver damage. This may be partially due to the enhancement of liver regeneration since the proliferating cell nuclear antigen labeling index in the DMN-treated liver was significantly increased by splenectomy. Tumor necrosis factor-alpha was down-regulated in the DMN rats, whereas its expression was preserved in the splenectomized DMN rats. There were no apparent differences in the number of Kupffer cells between the splenectomized DMN and the DMN rats, suggesting that the down-regulation of tumor necrosis factor-alpha may contribute to the reduction of Kupffer cells' function. In addition, a tumor necrosis factor-alpha production inhibitor (E3330) significantly reduced the proliferating cell nuclear antigen labeling index after splenectomy. CONCLUSIONS: Splenectomy, in this model, may promote liver regeneration by preserving Kupffer cell function, especially the secretion of tumor necrosis factor-alpha.

Animals↗

Hepatocellular carcinoma associated with hemophagocytic syndrome.

Hepatocellular carcinoma may manifest various paraneoplastic syndromes. There are some reports describing hematological change due to hepatocellular carcinoma. However, there have been no reports on hepatocellular carcinoma accompanied by hemophagocytic syndrome. We report here for the first time a 51-year-old man with a liver tumor and pancytopenia. Since the patient had showed a strong hemorrhagic diathesis because of thrombocytopenia, we treated him with blood transfusion, but there was no response. Thereafter, we administered the anticancer agents thinking that the hematological change was due to the liver tumor. Though a slight curative effect was obtained, we had to discontinue the treatment because the patient complained of severe side effects. Finally, the patient died of acute cholangitis. Although we could not determine the cause of the pancytopenia before he died, autopsy findings indicated that hemophagocytic syndrome had occurred. Hemophagocytic syndrome related to a solid tumor very rarely occurs. However, when malignant tumor is accompanied by pancytopenia, hemophagocytic syndrome should be considered.

Bone Marrow↗

Impact of hepatitis B and C virus infection on the clinical prognosis of alcoholic liver cirrhosis.

To elucidate the rates of appearance of hepatocellular carcinoma (HCC) and the prognosis of alcoholic liver cirrhosis upon infection with hepatitis virus, we retrospectively studied 190 consecutive patients. The patients were divided into three groups based on whether they were exposed either to hepatitis B virus (HBV), hepatitis C virus (HCV) or not. The cumulative survival rate of the alcoholic liver cirrhosis patients with hepatitis B surface antigen (HBsAg) was significantly lower than that in those with hepatitis C antibody (anti-HCV). Most alcoholic liver cirrhosis patients without hepatitis virus infection died of liver failure, gastrointestinal (G1) bleeding, or other diseases. However, alcoholic liver cirrhosis patients with anti-HCV tended to die of HCC. The cumulative HCC appearance rate in alcoholic liver cirrhosis patients without HBsAg or anti-HCV was 7% at the end of the fifth year after the diagnosis of cirrhosis and 15% at the end of the tenth year. However; the HCC appearance rate was about 20% at the end of the fifth year after the diagnosis of cirrhosis and about 50% at the end of the tenth year in both alcohol drinkers with HBsAg or anti-HCV. These data suggest that hepatitis virus infection may modify the prognosis for alcoholic liver cirrhosis patients, especially in the development of carcinogenesis.

Adult↗

Comparison of screening methods for hepatocellular carcinomas in patients with cirrhosis.

To determine the most suitable screening methods for hepatocellular carcinomas (HCCs), we investigated 45 cases with HCCs. Ultrasonography, computed tomography (CT) scan and measurement of alpha-fetoprotein (AFP) were regularly performed. Thirty-two cases (72%) were detected initially by ultrasonography. Fourteen out of 23 cases (61%) with tumors 20 mm or less in diameter and 11 out of 12 cases (91%) with 21-30 mm tumors were detected initially by.ultrasonography. For the initial detection of tumors sized 20 mm or less, the mean interval of ultrasonography was 3.54 months, unlike the 5.67 months for tumors sized over 21 mm. There was no significant difference between tumor size and measurement interval in AFP levels or CT scan examinations. From these results, we suggest that a suitable screening schedule would be every three months by ultrasonography.

Aged↗

Serologic and pathogenetic studies on avian reoviruses isolated in Japan.

Eighty-nine avian reoviruses isolated from diseased and clinically normal chickens were classified serologically using antisera against five prototype strains. Eighty-three strains were classified into five serotypes; six strains were untypable. Most of the cytopathogenic strains that produced a clear cytopathic effect (CPE) in chicken embryo fibroblasts (CEFs) were highly pathogenic for chicken embryos (80% or more mortality via the allantoic sac) and for chicks (severe footpad swellings and tenosynovitis). These strains were classified into a single serotype represented by the TS-142 prototype strain. However, 10 strains that could not produce a clear CPE in CEFs showed very low pathogenicity for embryos and chicks, and these strains were serologically different from the TS-142 prototype strain. There was a strong relationship between pathogenicity and serotype. About 17% of the isolates were considered highly pathogenic.

Animals↗

Long term follow-up for patients with liver cirrhosis after partial splenic embolization.

BACKGROUND/AIMS: Fifteen cases of liver cirrhosis (LC) were examined to determine whether the partial splenic embolization (PSE), done to improve hematological disorders, could also improve liver function for at least 12 months. MATERIALS AND METHODS: Peripheral blood count, serological and coagulatory examination were retrospectively examined before PSE, 6 months and 12 months after PSE. RESULTS: Hematological disorders were improved (p < 0.01) and persisted at improved levels in all cases. In patients in Child A or Child B classification, the levels of cholinesterase, total cholesterol and prothrombin time were also improved significantly after PSE (p < 0.05). However, those parameters were not improved in Child C classification. CONCLUSION: PSE may improve not only hematological disorders but also liver functions for at least one year.

Adult↗

Long-term effect of prophylactic endoscopic injection sclerotherapy on liver function.

BACKGROUND/AIMS: The aim of this study was to investigate the long term effect of prophylactic endoscopic injection sclerotherapy (EIS) on liver function. METHODOLOGY: This study was a retrospective investigation of seventy-eight patients with liver cirrhosis, whose liver function was classified as Child's A before follow-up. Laboratory data were retrospectively examined before and after follow-up, and a comparison was made between the EIS group (n=21) and the non-treated group (n=57). RESULTS: In the 3 or more years of follow-up, cholinesterase and total cholesterol levels deteriorated in several severe-variceal cases. However, these levels did not deteriorate over the 3 or more years of follow-up in the EIS group. CONCLUSION: Prophylactic endoscopic injection sclerotherapy among patients with early stage LC may prevent the deterioration of liver function.

Aged↗

Hepatocellular carcinoma in primary biliary cirrhosis: a case report and review of the Japanese literature.

We present a 66 year-old woman in the cirrhotic stage of primary biliary cirrhosis (PBC), who developed hepatocellular carcinoma (HCC). All serological tests for hepatitis B virus (HBV) and hepatitis C virus (HCV) were negative. We surveyed 16 reported cases (13 females and 3 males) of PBC associated with HCC in Japan. The presence of HCV RNA was determined by the polymerase chain reaction in all of the patients, 3 of whom (19%) were HCV RNA-positive. Although patients with PBC rarely develop HCC, it is suggested that HCV infection may play a minor role in the development of HCC in Japanese patients with PBC.

Aged↗