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Biomedical subjects

K Takeda

Publications and source records attributed to K Takeda.

At least 775 records · Page 43Linked to original sources
PubMed1993

Relief of acute lower limb ischemia with percutaneous fenestration of intimal flap in a patient with type III aortic dissection--a case report.

Acute right lower limb ischemia developed in a patient with type III aortic dissection. Aortography revealed complete occlusion of the right common iliac artery by dissecting intima. Immediately percutaneous transfemoral fenestration with angioplasty balloon catheter was performed and marked improvement was obtained in clinical symptoms and angiographic findings. Unfortunately the patient died of rupture of the thoracic aorta about eleven hours after the procedure. The cause of death was not thought to be related to this procedure. The authors conclude that percutaneous fenestration should be considered as the treatment of choice for visceral or limb ischemia due to acute aortic dissection.

Aortic Dissection↗
PubMed1993

Human thyroxine-binding globulin gene: complete sequence and transcriptional regulation.

T4-binding globulin (TBG) is a glycoprotein of hepatic origin which transports thyroid hormone in serum. To characterize the human TBG (hTBG) gene, we studied its genomic organization, promoter activity, and regulation. To this purpose, we isolated from liver a complete hTBG cDNA clone containing the 5'-untranslated region and localized the transcription start site (TSS). The analysis of genomic clones revealed that the hTBG gene consists of five exons and that its exon-intron organization is similar to that of other members of the serine protease inhibitor family. The first exon (exon 0) is a short noncoding sequence located 1.62 kilobase pairs (kbp) upstream from exon 1. Potential cis-acting transcriptional regulatory elements including a TATA box, a CAAT box, and a hepatocyte nuclear factor-1 binding motif were identified in the upstream region. A reporter gene in which 3.2 kbp of the 5'-flanking region, including exon 0, was inserted upstream of the bacterial chloramphenicol acetyltransferase gene showed significant activity when transfected into a hepatblastoma-derived (HepG2) cell line. The phorbol ester, 12-O-tetradecanoylphorbol-13-acetate, down-regulated the promoter activity by more than 80% and completely inhibited hTBG synthesis, whereas thyroid hormone, glucocorticoid, estrogen, and nicotinic acid had little, if any, effect. A series of 5'-deletions revealed that the fragment -218 to +4 from the TSS had the highest promoter activity, nearly 1000-fold greater than the promoterless chloramphenicol acetyltransferase construct. When nonhepatocyte-derived cell lines (CV-1 and CHO) were tested, promoter activity was reduced by a factor of 100, showing that the promoter works in liver-specific manner. The region -218 to -102 contains liver-specific enhancer elements, since deletion to nucleotide -101 resulted in a profound reduction of the promoter activity in HepG2 cells but not in CV-1 or CHO cells. On the other hand, mutational disruption of the putative hepatocyte nuclear factor-1 site (located 65 bp upstream of the TSS) completely abolished the promoter activity in all cell lines, indicating that this site is absolutely required for the transcription of the hTBG gene.

Amino Acid Sequence↗
PubMed1993

Characterization of two acidic polysaccharides having immunological activities from the root of Panax ginseng.

Two acidic polysaccharides, named ginsenan PA and ginsenan PB, were isolated from the root of Panax ginseng C. A. Meyer. They were homogeneous on electrophoresis and gel chromatography, and their molecular masses were estimated to be 1.6 x 10(5) and 5.5 x 10(4), respectively. They are composed of L-arabinose: D-galactose: L-rhamnose: D-galacturonic acid: D-glucuronic acid in the molar ratios of 11:22:1:6:1 (ginsenan PA) and 3:7:2:8:1 (ginsenan PB), in addition to small amounts of O-acetyl groups. Almost all (ginsenan PA) and part (ginsenan PB) of the hexuronic acid residues exist as methyl esters. Reduction of carboxyl groups, methylation analysis, nuclear magnetic resonance and periodate oxidation studies indicated that their structural features include mainly both alpha-arabino-beta-3,6-galactan type and rhamnogalacturonan type structural units. Both polysaccharides showed remarkable reticuloendothelial system-potentiating activity in a carbon clearance test, pronounced anti-complementary activity and alkaline phosphatase-inducing activity in a dose dependent manner.

Animals↗
PubMed1993

New interpretation of systolic time intervals from active cross-bridge model.

Using an active cross-bridge model proposed by the authors, it has been established theoretically that cross-bridge activation rate (Ka) of the left ventricular myocardium, which might correspond to the rate of binding of Ca2+ with troponin C, is approximately expressed as a simple formula: Ka = 3/electromechanical systole (sec-1), although no definitive biological proof has yet been provided for the equation. One hundred eighteen patients without significant cardiac disease and 6 patients who had atrioventricular block with a permanent pacemaker were evaluated to determine the Ka value of the normal human left ventricular myocardium (test 1), and to examine the effect of changes in heart rate (test 2) as well as afterloading (test 3) or dobutamine infusion (test 4) on Ka. The pacing rate was increased from 50 to 110 beats/min at 20-beat increments in test 2. Arterial pressure was elevated by angiotensin II infusion in test 3, and 7 subjects received a continuous dobutamine infusion in test 4. The Ka value was found to be related to heart rate, to be increased by dobutamine infusion, and to be decreased by myocardial lengthening due to afterloading. Dependence of Ka on heart rate appeared to result from changes in myocardial length. The Ka value corrected for heart rate (Kac) had an average variation of only 4.6%, and was unrelated to age or myocardial length in individual subjects. Thus, the Kac value of normal human left ventricular myocardium appears to be nearly constant between individuals but to be increased by catecholamine infusion or myocardial shortening.

Adult↗
PubMed1993

[Combined effect of glucocorticoid and TJ-114 (Tsumura Sairei-to)].

TJ-114 (Tsumura Sairei-to) is a powdered extract made from 12 Chinese herbal drugs. TJ-114 is used against various nephrotic diseases and used as an inhibitory treatment for the side effects of glucocorticoids. We expected that TJ-114 would increase the survival ratio of rats given a high dose of glucocorticoid. Therefore, in this study, we investigated the combined effects of glucocorticoid and TJ-114 in rats. An ointment containing fluocinolone acetonide (FA) was applied on the back of 7-week-old Wistar male rats for various periods. TJ-114 was administered orally at the doses of 0.5, 1.0 or 2.0 g/kg simultaneously. The combination with TJ-114 suppressed the loss of body weight by FA. The survival ratio of the FA group was 50%, but it was 83% for the group treated with FA in combination with 0.5 g/kg TJ-114 and no deaths were observed in the other drug combined group. With a lower dose of FA, we investigated its hematological effects and determined the white blood cell (WBC) count. Although the lymphocytes were decreased by FA, the combination with TJ-114 depressed this decrease of lymphocytes significantly. Furthermore, TJ-114 significantly suppressed the insulin increase elicited by FA. Macroscopic observations showed atrophy and decreases in the weights of the thymus, spleen and adrenal, all being target organs of glucocorticoid. The combination with TJ-114 decreased these effects of FA. Moreover, microscopic examinations revealed that FA induced the degeneration of lymphocytes and lymphocyte depletion in the cortex of the thymus, caused atrophy of the white pulp, decreased the extramedullary hematopoiesis of the spleen, and caused the atrophy of zona fasciculata in the adrenal cortex. The combination with TJ-114 depressed these effects significantly. These results suggest that TJ-114 suppresses the adverse side effects of gucocorticoids.

Administration, Oral↗
PubMed1993

Clonidine improves central attenuation of the baroreflex in spontaneously hypertensive rats.

To determine whether clonidine can improve the central alteration of the baroreflex in SHR, the centrally cut end of the aortic depressor nerve was electrically stimulated in SHR with intravenously administered clonidine. Aortic depressor nerve (ADN) stimulation elicited depressor and sympatho-inhibitory responses in a frequency-dependent manner in WKY and SHR. These responses were significantly smaller in SHR than in WKY. The attenuated depressor and sympatho-inhibitory responses to ADN stimulation in SHR were restored following i.v. injections of clonidine, although the drug did not affect the responses to ADN stimulations in WKY. These findings suggest that clonidine can improve central attenuation of the baroreflex in hypertension.

Adrenergic Fibers↗
PubMed1993

Evaluation of aortic regurgitation using cine magnetic resonance imaging.

Cine magnetic resonance imaging (MRI) was used to assess aortic regurgitation (AR) in 13 patients with valvular disease and 3 normal subjects, and the results were compared to color Doppler flow mapping findings. AR produced a signal void in the left ventricle during the diastolic phase in all patients by MRI. There were no false positive or negative results compared with echocardiographic findings. Visual grading of cine MRI gave results similar to color flow Doppler echocardiography (88%). The distance and the area of aortic regurgitation using MRI correlated well with color Doppler flow mapping (r = 0.82 and 0.88). However, measurements of distance and area by color flow Doppler tended to be larger than those by cine MRI. With current techniques echocardiography may overestimate the severity of AR as compared with cine MRI. In addition, MRI gives clinically useful information in patients in whom transthoracic Doppler echocardiography is not adequate.

Adult↗
PubMed1993

Effect of isosorbide dinitrate infusion on the canine left ventricular force-length relationship.

Recently, the slope (Ec) of the left ventricular (LV) end-systolic force-diameter (Fes-Des) relationship has been proposed as a new index for assessing myocardial contractility. Using this relationship, the effects of ISDN on LV myocardial contractility were evaluated in 10 healthy adult mongrel dogs. After the intravenous infusion of propranolol and atropine to produce autonomic blockade, the inferior vena cava was gradually occluded for 20 sec to decrease preload while the dogs were kept apneic. The LV diameter was measured by ultrasonic crystals and LV pressure was measured by a micromanometer. After the control measurements, the dogs received intravenous ISDN (1, 5, 10, or 50 micrograms/kg/min), and inferior vena caval occlusion was repeated. Ec and the extrapolated diameter intercept (D0) of the LV Fes-Des relationship were determined for each dog from the end-systolic data. The differences in heart rate between the control state and ISDN infusion at any dose were not statistically significant. The Ec and D0 values also showed no significant changes with ISDN infusion (Ec: 80 +/- 19, 83 +/- 20, 84 +/- 17, 82 +/- 24, and 87 +/- 24 g/cm for 0, 1, 5, 10, and 50 micrograms/kg/min, respectively. D0: 1.38 +/- 0.42, 1.38 +/- 0.40, 1.38 +/- 0.38, 1.34 +/- 0.40, and 1.36 +/- 0.40 cm for 0, 1, 5, 10, and 50 micrograms/kg/min, respectively). These findings suggested that intravenous ISDN did not affect myocardial contractility in the normal in situ canine left ventricle.

Animals↗
PubMed1993

[Immunohistochemical study of borderline thyroid lesions with special reference to relationships among nuclear features, type IV collagen and malignancy of follicular lesions].

It is very difficult to differentiate follicular adenoma from follicular carcinoma in thyroid follicular lesions. The authors investigated the biological behavior of these thyroid follicular lesions using immunohistochemical techniques. Specimens taken from normal thyroid, 2 cases; follicular adenoma, 9; atypical adenoma, 7; and follicular carcinoma, 8; were observed. Proliferating cell nuclear antigen (PCNA) is a marker of cellular proliferation. Nucleoli are also increased in number and move to the nuclear margin in cases of cellular proliferation. The PCNA labeling index was calculated by counting the number of PCNA-positive cells per 2,000 tumor cells. PCNA labeling indices were 0.025% in the normal thyroid, 1.41% in follicular adenoma, 5.73% in atypical adenoma, and 6.16% in follicular carcinoma, respectively. Nucleoli retaining rate of the tumor cells were 40.0% in follicular adenoma, 63.7% in atypical adenoma, and 71.8% in follicular carcinoma. Rates of nucleolus margination were 20.9% in follicular adenoma, 34.4% in atypical adenoma, and 36.0% in follicular carcinoma. Changes in the basement membrane were morphologically classified into three groups as follows; membrane structure almost preserved (group I), partial discontinuity (breaks) (group II), and widespread absence of membrane structure (group III), based on immunohistochemical investigation of Type IV collagen. Group I was demonstrated in 8 cases of follicular adenoma and one case of atypical adenoma. Group II was observed in one case of follicular adenoma, 3 cases of atypical adenoma and 3 cases of follicular carcinoma. In addition, group III was noted in 3 cases of atypical adenoma and 5 cases of follicular carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma, Follicular↗
PubMed1993

[The left ventricular force-length relationship in patients with heart failure].

A new contractility index (Ec) is proposed based on the slope of the left ventricular (LV) end-systolic force-length relationship. The Ec values of normal human hearts are relatively constant. The present study investigated the Ec values of 16 cases of heart failure in 11 patients with old myocardial infarction and 5 with dilated cardiomyopathy in NYHA functional class 1 to 3. The LV end-systolic pressure (Pes) and dimension (Des) were estimated simultaneously by intraarterial cannulation and LV echocardiography. The LV pressure decreased from 111 +/- 17 to 90 +/- 14 mmHg after intravenous infusion of nitroglycerin. The LV Fes-Des relationship was found to be nearly linear and the slope (Ec) and extrapolated dimension intercepts (Do) were obtained as 60 +/- 22 g/cm and 2.7 +/- 1.2 cm, respectively. The values of Ec and Do were both proportional to the baseline Des value. Our model predicts that the Ec value reflects intracellular peak Ca2+ concentrations ([Ca2+]) of the myocardium and/or myosin ATPase activity. The present results suggest that the working myocardium of a failing heart increases [Ca2+] and/or myosin ATPase activity to compensate for depressed LV pump function due to myocardial damage.

Adult↗
PubMed1993

[A case of coccidioidomycosis with central nervous system involvement].

We report a 44-year-old Japanese man with chronic meningitis due to coccidoiodomycosis. He was admitted to our hospital because of pneumonia after the business trip to Phoenix, Arizona. Coccidioid immitis was cultured from periathric abscess on the sternoclavicular joint. He became asymptomatic by 5-FC administration. One year later, however, he complained of headache and fever. Coccidiodial meningitis was diagnosed by cerebrospinal fluid (CSF) examination. Both systemic and intrathecal administration of miconazole and oral itraconazole were ineffective. While meningitis was not cured for three years, normal pressure hydrocephalus (NPH) developed. CSF cell count fell into normal range after administration of fluconazole (800 mg/day) for thirteen months, but NPH continued. This is the first report of coccidiodimycosis with CNS involvement in Japan.

Adult↗
PubMed1993

[Postoperative pain relief by continuous epidural infusion: a comparison of three solutions].

The effect of three solutions on postoperative pain relief by continuous epidural infusion was studied. Seventy-five patients after upper or lower abdominal surgeries were assigned to one of three groups and the postoperative pain relief was evaluated for 48 hours. Group I: bolus injection of buprenorphine (Bn) 0.1 mg + saline (S) 8 ml and continuous infusion (2 ml.h-1) of Bn 0.8 mg + S 92 ml; Group II: bolus injection of Bn 0.1 mg + 0.5% bupivacaine (Bc) 4 ml + S 4 ml and continuous infusion of Bn 0.8 mg + S 92 ml; Group III: bolus injection of Bn 0.1 mg + 0.5% Bc 4 ml + S 4 ml and continuous infusion of Bn 0.8 mg + 0.5% Bc 40 ml + S 60 ml. The combination of buprenorphine with low-dose bupivacaine (Group III) offered the most effective postoperative analgesia in three groups without increasing the frequency of adverse effects induced by epidural administration of local anesthetics. However, even in Group III, the percentage of patients complaining of pain at bed rest was still high during early postoperative period (56% at 6 hours postoperatively). The results suggest that further consideration is necessary on agents selection and dosage adjustment for the postoperative epidural analgesia.

Aged↗
PubMed1993

[Propriospinal myoclonus--a case report].

Propriospinal myoclonus is one type of myoclonus that is proposed to originate in the spinal cord and spread up and down via propriospinal tract. There are a few reports describing the detailed electrophysiological findings of this myoclonus. In this communication, we present the results of electrophysiological analysis of a patient with propriospinal myoclonus. A 23-year-old woman suddenly noticed abdominal pain, which spontaneously faded in a few hours. Irregular involuntary flexion jerks of the trunk appeared spontaneously without pain or hiccups after this episode. It involved the bilateral axial muscles; sternocleidomastoid muscles (SCM), paravertebral muscles (PVM), abdominal muscles (ABD), and intercostal muscles (ICM), but not the limb muscles. It was worsened by the mental stress, but not by her posture or position. While she slept, the jerks were not observed. Routine laboratory examinations were all normal. Magnetic resonance imaging of the spinal cord revealed no abnormalities. The electrophysiological studies done on this patient are polymyography, back-averaging of the EEG activity preceding spontaneous jerks (jerk-locked averaging (JLA), and movement related cerebral potential (MRCP) preceding the involuntary jerks and voluntary abdominal movements. No EEG activities preceding the myoclonus were demonstrated by JLA or MRCP. No MRCP recorded preceding the myoclonus suggests that the jerk is not a self-initiated or externally triggered voluntary movement. Polymyography revealed that the jerks involved the bilateral axial muscles including SCM, PVM, ICM, and ABD, but not the limb muscles. Homologous muscles were activated synchronously. The duration of EMG bursts was variable ranging 50 to 250 ms in these muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Comparison of buprenorphine and fentanyl for postoperative pain relief by continuous epidural infusion].

This study examined analgesic efficacy and adverse effects of buprenorphine and fentanyl for the postoperative pain relief by continuous epidural infusion. Fifty patients after upper or lower abdominal surgeries were assigned to two groups and buprenorphine and fentanyl were epidurally administered postoperatively. Buprenorphine (B) group received bolus injection of B 0.1mg + saline 8 ml and continuous infusion of B 0.8 mg+saline 92 ml (2 ml.h-1). Fentanyl group received bolus injection of F 0.1 mg+saline 6 ml and continuous infusion of F 0.6 mg+saline 84 ml (2 ml.h-1). There was no significant difference between the two groups in the analgesic efficacy, which became lower from 2 to 12 hours postoperatively. However, compared with buprenorphine group, the incidence of nausea or vomiting and dizziness was significantly less in the fentanyl group (11 vs. 4 cases and 7 vs. 1 cases). These results imply that the major site of action of epidurally administered fentanyl is the spinal cord. In contrast, analgesic effect of epidural buprenorphine appears to be enhanced by the supraspinal action. We conclude that fentanyl is superior to buprenorphine for postoperative pain relief by continuous epidural infusion.

Abdomen↗
PubMed1993

[Phase II clinical study of 99mTc-MAG3].

Phase II clinical study of mercaptoacetylglycyl-glycylglycinate (99mTc) technetium (99mTc-MAG3), a new scintigraphic and renographic agent, was performed to evaluate its safety, clinical usefulness and optimal dosage at 5 institutions in total 88 patients with mild renal or urinary disorders. There was no case showed adverse reaction in patients studied and the administration of the agent was proved to be safe. The effectiveness of the agent was evaluated and revealed to be effective in all cases analyzed. A range of dosage 200-400 MBq was found to be optimal, from image quality and clinical information obtained. It is concluded that 99mTc-MAG3 is a safe and useful radiopharmaceutical for the diagnosis of renal dynamic function.

Adolescent↗
PubMed1993

[Congenital extradural cyst causing a 30-year history of myelopathy with long-term remission].

We reported a peculiar case of a patient with a thoracic extradural cyst, who had a 30-year history of thoracic-myelopathy with a very long-term remission. A 42-year-old male was admitted to our hospital complaining of gait disturbance and hypesthesia of his bilateral lower limbs. Neurological examination revealed that he had spastic paraparesis and hypesthesia of all sensory modalities below Th11/12 dermatomes. Investigation of his past history disclosed that he had experienced gait disturbance due to paraplegia 29 years previously and had been able to move only with the aid of wheel-chairs. However these signs had resolved themselves gradually in a period of 3 years, and after that he had been able to live almost without any neurological handicaps until the recent appearance of weakness in both of his legs. Neuroradiological study revealed that plain X-Ps of the thoracic spine showed thinning of the pedicles and widening of the interpedicular distances between Th4-Th7 vertebrae. The old iodine contrast media injected 29 years previously for myelography in an other hospital was also observed. MRI showed a dorsal cystic mass compressing the thoracic spinal cord and subarachnoid space. Myelography showed also that the spinal cord and subarachnoid space were compressed anteriorly between the level of Th3 to Th7 by the dorsal mass. CT myelography disclosed that soon after the injection of contrast media a small part of the cyst was visualized as having direct communication with the subarachnoid space. The contrast media penetrated the major part of the cyst only 19 hours after its injection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗