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Biomedical subjects

K Takayanagi

Publications and source records attributed to K Takayanagi.

At least 127 records · Page 7Linked to original sources
PubMed1990

Cardiac rupture following acute myocardial infarction in systemic lupus erythematosus: case report.

A thirty-three year-old woman with systemic lupus erythematosus (SLE) suffered from acute myocardial infarction. Prednisolone 20 mg/day was used because the signs of SLE, such as fever and decreased serum C3, levels, became aggravated on the fifth hospital day of acute myocardial infarction. Fatal cardiac rupture occurred on the twenty-second hospital day. At autopsy, extensive myocardial infarction with coronary artery thrombi and diffuse coronary arteritis were revealed. The rare clinical picture of a fatal cardiac rupture in the later phase of acute myocardial infarction and the precise dosage of prednisolone for her SLE are described.

Adult↗
PubMed1990

Headache angina with fatal outcome.

We report 2 fatal cases of angina pectoris in patients who complained primarily of headache during the ischemic attack. The first patient, who was hospitalized because of headache and chest pain, demonstrated repeated ST-segment elevation and fatal ventricular fibrillation on ambulatory ECG monitoring. The second patient had post-infarction angina preceded by headache and by ST-segment elevation in the precordial leads. She eventually died of reinfarction. The mechanism of the headache in relation to the angina pectoris is discussed.

Aged↗
PubMed1990

Coronary artery disease associated with aortitis syndrome in older patients.

Coronary artery disease associated with aortitis syndrome was studied in relation to the coronary artery lesions and age. Four (21%) of 19 patients with aortitis syndrome had coronary artery disease and the mean age of the 4 patients was 53 +/- 14 years. The coronary artery lesions included ostial stenosis in 2 patients and main branch stenosis in 2, but both types of lesion were isolated. The latter patients were older and had coronary lesions like arteriosclerosis on angiogram. Myocardial infarction and congestive heart failure were not present, but a severe coarctation of the aorta was observed in the latter. It was suggested that coronary artery disease might not be rare past middle age, and might include coronary ostial stenosis caused by aortitis and coronary main branch stenosis probably based on secondary arteriosclerosis whose onset was past middle age.

Adult↗
PubMed1990

[Comparison of two-dimensional echocardiography and Tl-201 SPECT in the evaluation of ischemic heart disease].

To ascertain the influence of severity of coronary stenosis and the presence or absence of collateral circulations on echocardiographic (2DE) asynergy or abnormal myocardial perfusion by exercise Tl-201 SPECT, we performed a correlative study of 40 patients undergoing coronary angiography, including 27 with myocardial infarction and 13 with angina pectoris, whose mean age was 55 years. Each view of the left ventricle (LV) obtained by both methods was assigned to five segments; i.e., anterior, septal, inferior, lateral and apical. The correlation of abnormal segments was investigated using both methods. The segments showing a severe perfusion defect coincided those with severe asynergy. Among 116 segments with normal perfusion, 99 (85%) revealed normal wall motion, but the remaining 15% showed asynergy. Among 84 segments with abnormal myocardial perfusion, 26 (31%) had normal wall motion, and most of these were non-infarcted regions. Concerning the severity of coronary artery stenosis, greater than 99% coronary arterial stenoses existed in most of the segments showing a complete defect or incomplete redistribution on Tl-201 SPECT and akinesis or hypokinesis on 2DE. Collaterals were observed in 22% of the segments with a complete defect and 66% of segments with incomplete redistribution; whereas, there was no significant correlation between the severity of LV wall motion abnormality and the presence or absence of collaterals. The severity of asynergy is possibly related to the severity of abnormal myocardial perfusion, however, asynergy could occur at the site of ischemic regions where Tl-201 SPECT can not detect the abnormalities. In patients with myocardial infarction who show incomplete redistribution by exercise Tl-201 SPECT, temporal ischemia of collaterals might cause such a perfusion abnormality.

Adult↗
PubMed1989

Effect of autografting on the diameter of collagen fibrils in human postburn wounds.

The effect of skin grafts on the size of collagen fibrils in autografted human burn wounds was examined. In autografted burn wounds, the mean (+/- standard deviation) diameter of collagen fibrils was 61.16 +/- 15.18 nm, against 39.77 +/- 6.51 nm in ungrafted burn wounds. This result indicates that autografts (0.1 mm thick) promote the maturation of collagen in burn wounds.

Actin Cytoskeleton↗
PubMed1989

Xanthogranulomatous pyelonephritis.

Four patients with xanthogranulomatous pyelonephritis are presented; all patients were male and their symptoms were not urinary but nonspecific. Three of the patients are from a low socioeconomic class and did not have adequate medical services; therefore, we suggest that the disease is underreported.

Child, Preschool↗
PubMed1988

Coronary artery aneurysms and congestive heart failure--possible long-term course of Kawasaki disease in an adult--a case report.

Multiple coronary artery aneurysms, rarely seen in patients with atherosclerotic heart disease, can be frequently observed in children with Kawasaki disease. However, their long-term clinical courses still remain obscure. A thirty-nine-year-old male came to our clinic because of congestive heart failure. A left ventriculogram revealed highly reduced wall motion. A coronary angiogram showed left main trunk aneurysm with complete occlusion of the left anterior descending artery and ramification of the right coronary artery close to the ostium. Six months after discharge, he died suddenly. On autopsy, aneurysms were observed in the left main trunk and right coronary artery, together with an old anteroseptal myocardial infarction. Although he did not have a clear history of febrile disease in childhood, he was highly suspected to be a long-term survivor of Kawasaki disease because of the unique form and distribution of the coronary artery aneurysms.

Adult↗
PubMed1988

Effectiveness of continuous arteriovenous hemofiltration for patients with refractory heart failure.

Continuous arteriovenous hemofiltration (CAVH) was carried out in 8 patients with refractory congestive heart failure. All these patients had heart failure and oliguria for over 24 hours and intensive treatment with digitalis, diuretics, catecholamines and vasodilators was prescribed. Hemodynamics were followed closely during CAVH. During CAVH, pulmonary arterial pressure and pulmonary capillary wedge pressure were significantly reduced in all patients, the right atrial pressure decreased in 6 with right cardiac failure, the heart rate decreased in 3 with tachycardia and the blood pressure and cardiac index were elevated in 3 with hypotension. These observations show that CAVH can be performed safely and effectively in patients with congestive heart failure, oliguria and hypotension.

Adult↗
PubMed1988

[Intraspinal lipoma in an infant: a case report of MRI study].

A 6-month-old boy having intraspinal lipoma with lumbosacral subcutaneous lipoma and occult spinal dysraphism is described. CT scan and magnetic resonance imaging (MRI) are demonstrated. On admission, the patient showed no neurological deficits. Lumbosacral hemangioma and subcutaneous lipoma were noticed on physical examination. A plain spinal roentogenogram revealed occult spinal dysraphism extending from L 4 level down to the sacral region. A plain CT scan disclosed a round-shaped low density area surrounded by a relatively high density area corresponding to the neural tissue in the spinal canal. MRI (1.5-T superconducting system) with sagittal views clearly showed an oval-shaped high signal intensity (SI) area-an intraspinal lipoma-with the neural tissue running longitudinally within and on its surface. The lipoma appeared to be attached to the spinal cord at L 1/2 level. On operation, we found an extramedullary lipoma which had a certain connection to the sacral epidural adipose tissue with an opening of the dural sac, as far as the subcutaneous lipoma. Tethered cord and thickened filum terminale were not identified. Generally, lipoma is demonstrated as a low density area of approximately -90 H.U. on a CT scan. In MRI, we can obtain a high contrast between the lipoma, the spinal cord, and the cerebrospinal fluid, since they are shown as a high, an intermediate, and a low SI area respectively, on T1-weighted spin echo images. Furthermore, sagittal section of MRI is regarded as a potent diagnostic modality to get the precise anatomy of the spinal cord lesion. These short spin echo images can be taken in a relatively brief time. It is a great advantage for patients with spinal lipoma, who are usually infants. MRI is considered to be a quite useful modality to diagnose spinal lipoma, and is able to lead to an early diagnosis non-invasively and accurately, facilitating appropriate surgical treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1987

Pulmonary agenesis with esophageal atresia and tracheoesophageal fistula.

A twin neonate with esophageal atresia, tracheoesophageal fistula, and agenesis of the right lung from consanguinous parents is reported. The twin brother was normal. The baby eventually made a good recovery after delayed primary esophageal anastomosis. Thirteen similar cases have been reported in the literature but all died.

Abnormalities, Multiple↗
PubMed1987

Chemical properties of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton.

The aqueous layer was isolated from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method. After ultracentrifugation, the precipitate was designated as lipopolysaccharide-like substance (LLS) fraction and the chemical composition was compared with that of bacterial LPS. The LLS fraction consists of 35.2% carbohydrate, 3.8% amino sugar, 36.4% lipid, 15.2% protein, and 0.3% phosphorus. Neutral sugars were detected as rhamnose, arabinose, xylose, 4-O-methylmannose, mannose, galactose, and a small amount of erythrose, fucose and glucose by gas-liquid chromatography (GLC), but 2-keto-3-deoxyoctonic acid was not detected in the LLS by thiobarbituric acid test and high voltage paper electrophoresis. Fatty acids detected by GLC were decanoic acid (C10: 0), dodecanoic acid (C12: 0), dodecenoic acid (C12: 1), tridecenoic acid (C13: 1), tetradecanoic acid (C14: 0), hexadecanoic acid (C16: 0), hexadecenoic acid (C16: 1), and octadecenoic acid (C18: 1). With SDS-polyacrylamide gel electrophoresis, bacterial LPS showed many orderly bands, while the banding pattern of the leptospiral LLS was very simple. These findings demonstrate that the physicochemical properties and chemical composition of LLS fraction from Leptospira are different from those of LPS extracted from gram-negative bacteria such as Enterobacteriaceae, and suggesting that Leptospira has no typical LPS.

Amino Sugars↗
PubMed1987

Biological activities of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton.

The biological activities of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method were studied in mice. The addition of 12.5 micrograms/ml or more of LLS fraction increased the incorporation of [3H]thymidine into in vitro cultured spleen cells of C57BL/6 mice, while the activity of the LLS fraction was about 20 times weaker than that of Salmonella typhimurium lipopolysaccharide (LPS). Pretreatment of murine spleen cells with rabbit anti-mouse thymocyte antiserum did not diminish the mitogenic activity of leptospiral LLS, and the LLS could not increase the incorporation of [3H]thymidine into thymocytes, suggesting that LLS acts on a B-lymphocyte population of lymphocytes. When sheep erythrocytes and LLS fraction were injected intraperitoneally into BALB/c mice, LLS exhibited an enhancing effect on antibody response in vivo. However, lethal toxicity of the LLS fraction was about 500 times lower than that of LPS in C57BL/6 mice loaded with galactosamine. No antitumor activity of leptospiral LLS (250-1,000 micrograms/mouse) against the ascites form of Ehrlich carcinoma in ddY mice was observed. The biological activities of the LLS fraction from the organism were weaker than those of gram-negative bacterial LPS, suggesting that Leptospira possesses no typical LPS.

Adjuvants, Immunologic↗
PubMed1986

Effects of digitalis intoxication on pacemaker rhythm and synchronization in rabbit sinus node.

Toxic doses of digitalis can induce severe arrhythmias in the sinus node. Since digitalis is known to induce electrical uncoupling in heart tissues, it is possible that the arrhythmias may be mediated by cell-to-cell uncoupling leading to desynchronization of pacemaker cells. We investigated this possibility using intracellular recordings and two different preparations of isolated rabbit sinus node. First, the whole sinus node region with the crista terminalis and a portion of right atrium were exposed to 2 microM ouabain in the presence of atropine (0.09 microM) and propranolol (0.77 microM). With ouabain superfusion, there was a gradual increase in spontaneous discharge, conduction delay, pacemaker shifts, and arrhythmias associated with multiple pacemaker sites. Interaction between pacemakers rapidly decreased, and finally atrial arrest was observed. Second, thin strips of sinus node were placed in a three-compartment bath. Superfusion of the central segment (1.0-1.5 mm) with 1-5 microM ouabain led to tachycardia and apparent conduction delay, followed by asynchronous firing and phasic interactions between pacemakers across the central segment. These interactions diminished in the course of intoxication, indicating a gradual increase of electrical uncoupling induced by the drug. All effects were reversible on washout. We conclude that digitalis-induced arrhythmias in the sinus node result from cell-to-cell uncoupling and loss of synchrony between pacemaker cells. The pattern of arrhythmias can be predicted by the phasic interactions between the pacemakers.

Action Potentials↗
PubMed1986

[Transfer of cefotetan into exudates from excoriated skin wounds].

Transfer of cefotetan (CTT) into exudates from excoriated skin wounds was studied in 9 adult patients. Each subject was given an intravenous bolus injection of 50 mg/kg of body weight. Concentrations of CTT in serum and in exudate fluid were determined by bioassay using Escherichia coli NIHJ as the test organism. The mean (+/- S.D.) CTT concentration in serum reached 274.3 +/- 78.3 micrograms/ml at 30 minutes after the injection and decreased to 30.0 +/- 12.0 micrograms/ml at 8 hours after the injection. The peak value of CTT in exudate fluid was 143.1 +/- 22.3 micrograms/ml at 1 hour. Eight hours after the injection, the mean concentration in the exudate was 25.7 +/- 21.1 micrograms/ml. The data obtained were analysed pharmacokinetically: CTT concentrations in serum were analysed by two-compartment model, and those in exudate fluid from excoriated skin wounds were analysed by the model in which skin was considered as a small part of the peripheral compartment. Thus T1/2(beta) of CTT levels in serum was calculated as 2.38 hours, AUC0----infinity was 1,000.2 micrograms X hr/ml and Vd was 164.5 ml/kg. Tmax and Cmax of CTT levels in exudates were calculated as 1.05 hours and 131.2 micrograms/ml, respectively.

Adult↗
PubMed1985

Purpura fulminans in neonates and childhood.

Three cases of purpura fulminans are reported. A five-year-old boy was successfully treated for purpura fulminans but had autoamputation of both legs and autolysis of bladder and urethra. He did not show any sign of shock at the onset of the disease. However, before an irreversible change of the skin lesion and organ involvement occurred, prompt diagnosis was effected, and aggressive treatment was given. An eight-day-old girl suffered from purpura fulminans at her four extremities, skull, bladder, ovary and vagina. Interesting findings were obtained in case 2, who had a positive family history. Several black spots in the extremities had disappeared spontaneously before admission, whereas the other lesions got progressively worse, with subsequent severe attack. Her general condition was not parallel to the severity of the disease. A 20-day-old boy had purpura fulminans after severe aspiration pneumonia, and showed a typical clinical course of the disease. In all patients, sudden drop of Hb and leukocytosis occurred after the skin lesion appeared. The diagnosis was unequivocal in these cases. Clotting time and FDP were good indicators of the progress of the disease in conjunction with the clinical features. Prompt diagnosis and aggressive therapy are necessary, not according to the patient's condition, but according to the laboratory findings and the serious nature of the disease. Internal haemorrhage must be considered as well as the skin lesion, this being a fatal complication.

Child, Preschool↗