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Biomedical subjects

K Takeuchi

Publications and source records attributed to K Takeuchi.

At least 127 records · Page 7Linked to original sources

A reverse flow-metabolism mismatch pattern: a new marker of viable myocardium with greater contractility during dobutamine stress than myocardium with a flow-metabolism mismatch pattern.

Few studies have investigated the contractility of myocardium with a reverse flow-metabolism pattern; that is, greater uptake of nitrogen- 13-ammonia (NH3) than fluorine- 18-fluorodeoxyglucose (FDG) on positron emission tomography (PET). This study examined the contraction thickening represented by count increase in ECG-gated FDG-PET of myocardium with a reverse flow-metabolism pattern during low-dose dobutamine stress. Fifty-four patients with myocardial infarction were studied. Relative NH3 and FDG uptake (%NH3, %FDG) and %count increase were measured in 216 apical and 216 lateral segments on ECG-gated FDG-PET. The %count increase during low-dose dobutamine stress was greater in myocardium with a reverse flow-metabolism mismatch pattern than in myocardium with a flow-metabolism mismatch pattern (35.9+/-25.7% vs 24.6+/-15.9%, p=0.0221 in apical segments, and 38.4+/-22.6% vs 27.6+/-18.4%, p=0.0040 in lateral segments) despite smaller %FDG. A reverse flow-metabolism mismatch pattern should be noted as a new marker of viable myocardium with greater contractility during dobutamine stress than myocardium with a flow-metabolism mismatch pattern.

Aged↗

Enhancement of peptone-induced gastric acid secretion in streptozotocin-induced diabetic rats.

We compared the acid secretory response to peptone in normal and streptozotocin-induced diabetic rats. Animals were injected with streptozotocin and used after 5 weeks of diabetes with blood glucose levels of >350 mg/dl. Under urethane anesthesia, 2 ml peptone solution (2-8%) was instilled in the stomach through an acute fistula every 30 min. Peptone increased acid secretion in a concentration-dependent manner in normal rats, the maximal response being obtained at 8%. Likewise, the increased acid response was observed in diabetic rats, yet the maximal response observed at 4% was significantly greater than that in normal rats. In both cases, this response was inhibited potently by famotidine as well as YM-022 (a CCKB antagonist) and partially inhibited by atropine. Peptone increased luminal histamine and plasma gastrin levels in both normal and diabetic rats, and the former response was significantly greater in diabetic animals. The altered acid secretion and histamine output in diabetic rats were reverted by insulin treatment. Pentagastrin- but not histamine-induced acid secretion was also increased in diabetic rats. We conclude that peptone-induced acid secretion is increased in diabetic conditions. This phenomenon is insulin-dependent and associated with an enhanced release of histamine but not with an increased sensitivity of the parietal cells.

Animals↗

Bioelectrical impedance analysis in the clinical management of a pregnant woman undergoing dialysis.

We report a case of successful pregnancy in a woman who was initially diagnosed with renal failure in mid-pregnancy. She was started on hemodialysis, and her fluid balance was serially monitored with bioelectrical impedance analysis. Her body weight decreased and bioelectrical impedance values increased, along with resolution of pulmonary edema in the process of the removal of excessive fluid retention with hemodialysis. The bioelectrical impedance values decreased immediately after the usual dose of oral ritodrine was administered, partly because producing sodium and water retention by ritodrine were enhanced in the setting of fluid imbalances. This decrease preceded the onset of pulmonary edema, while no changes were noted in maternal body weight before hemodialysis. These results suggest that the serial measurement of bioelectrical impedance values enables more reliable and earlier detection of abnormal water retention in pregnant women undergoing dialysis than the effect of body weight changes.

Adult↗

Fusion of the nucleoporin gene, NUP98, and the putative RNA helicase gene, DDX10, by inversion 11 (p15q22) chromosome translocation in a patient with etoposide-related myelodysplastic syndrome.

We report a 50-year-old man who developed therapy-related myelodysplastic syndrome after treatment with etoposide-including chemotherapy for extratesticular germ cell tumor. Chromosomal analysis showed inversion 11 (p15q22) translocation. Reverse transcriptase-polymerase chain reaction amplification of patient RNA showed a fusion transcript of nucleoporin gene NUP98, and putative DEAD-box RNA helicase gene DDX10. NUP98 is implicated in the transformation through aberrant nucleocytoplasmic transport. DDX10 is suggested to be involved in ribosome assembly. The NUP98-DDX10 fusion transcript may promote the development of secondary hematological malignancies caused by DNA-topoisomerase II inhibitors through aberrant nucleocytoplasmic transport and/or alteration in ribosome assembly.

Antineoplastic Agents, Phytogenic↗

Schwannoma in the sigmoid colon: report of a case.

Schwann cell tumor occurring in the intestines is rare. A 68-year-old female came to our hospital because of hematemesis. Barium enema and colonoscopic examination revealed submucosal tumor in the sigmoid colon. Laboratory data showed mild anemia. No other abnormal finding was found in the blood chemistry. Tumor marker levels of carcinoembryonic antigen (CEA), CA19-9, alpha feto protein (AFP) and neuron specific enolase (NSE) were within normal limits. The exploratory laparotomy confirmed a large sigmoid colon tumor. She received sigmoid colectomy. The resected specimen was a submucosal tumor with central depression, measuring 4.7 x 3.5 x 3.0 cm in size. The cut surface of the tumor was yellowish hue with necrosis. Histological examination showed spindle-shaped tumor cells with palisading comma-shaped nuclei and the nuclear pleomorphism. Immunohistochemical examination revealed that the tumor was positive for S-100 protein staining, and negative for Actin and for H.H.F. staining. These findings showed that this tumor was of Schwann cell origin. We report here the case in detail of a schwannoma in the sigmoid colon.

Aged↗

[Study on endoscopic sinus surgery management of chronic sinusitis with nasal polyps].

Endoscopic sinus surgery is commonly used to treat chronic sinusitis. Subjects were 79 chronic sinusitis patients--50 men and 29 women aged 17 to 79 years (average: 50.6 years) undergoing endoscopic sinus surgery in our department from January 1993 to December 1997. Mean follow-up was 17.5 months. We evaluated preoperative staging of chronic sinusitis based on Kennedy staging. Most were stage 3. This type of staging was not effective in predicting nasal polyp relapse. We found that cases with diffuse polyposis and associated disease such as bronchial asthma or aspirin-induced asthma tended to experience a polyp relapse. Our results suggest that postoperative treatment is important in maintaining patency of the ostiomeatal complex, nasal polyp or edematous mucosa relapse must be treated early in on in occurrence.

Adolescent↗

Comparison of the attachment of Escherichia coli O157:H7, Listeria monocytogenes, Salmonella typhimurium, and Pseudomonas fluorescens to lettuce leaves.

Attachment of Escherichia coli O157:H7, Listeria monocytogenes, Salmonella Typhimurium, and Pseudomonas fluorescens on iceberg lettuce was evaluated by plate count and confocal scanning laser microscopy (CSLM). Attachment of each microorganism (approximately 10(8) CFU/ml) on the surface and the cut edge of lettuce leaves was determined. E. coli O157:H7 and L. monocytogenes attached preferentially to cut edges, while P. fluorescens attached preferentially to the intact surfaces. Differences in attachment at the two sites were greatest with L. monocytogenes. Salmonella Typhimurium attached equally to the two sites. At the surface, P. fluorescens attached in greatest number, followed by E. coli O157:H7, L. monocytogenes, and Salmonella Typhimurium. Attached microorganisms on lettuce were stained with fluorescein isothiocyanate and visualized by CSLM. Images at the surface and the cut edge of lettuce confirmed the plate count data. In addition, microcolony formation by P. fluorescens was observed on the lettuce surface. Some cells of each microorganism at the cut edge were located within the lettuce tissues, indicating that penetration occurred from the cut edge surface. The results of this study indicate that different species of microorganisms attach differently to lettuce structures, and CSLM can be successfully used to detect these differences.

Bacterial Adhesion↗

Penetration of Escherichia coli O157:H7 into lettuce tissues as affected by inoculum size and temperature and the effect of chlorine treatment on cell viability.

Penetration of Escherichia coli O157:H7 into iceberg lettuce tissues and the effect of chlorine treatment on cell viability were evaluated. Attachment of different inoculum levels (10(9), 10(8), and 10(7) CFU/ml) was examined by determining the number of cells at the surface and the cut edge of lettuce leaves (2 by 2 cm). E. coli O157:H7 attached preferentially to cut edges at all inoculum levels, with greater attachment per cm2 of lettuce at higher inoculum levels. A longer attachment time allowed more cells to attach at both sites. Immunostaining with a fluorescein isothiocyanate-labeled antibody revealed that cells penetrated into lettuce leaves from cut edges. Cells showed greater penetration when lettuce was held at 4 degrees C compared with 7, 25, or 37 degrees C and were detected at an average of 73.5 +/- 16.0 microm below the surfaces of cut tissues. Penetrating cells were mostly found at the junction of lettuce cells. The viability of attached cells after treatment with 200 mg/liter (200 ppm) of free chlorine for 5 min was examined by plating on tryptic soy agar and by a nalidixic acid elongation method. Although chlorine treatment caused significant reduction in attachment (0.7- and 1.0-log reduction at surfaces and cut edges, respectively), cells remained attached at high numbers (7.9 and 8.1 log CFU/cm2 at surfaces and cut edges, respectively). Elongated cells were observed in stomata and within the tissues of the lettuce, indicating they were protected from contact with chlorine.

Bacterial Adhesion↗

[Development of lymphocytes].

Many subtypes in malignant lymphoma, especially those of B-cell lineage, have been established by linking morphologically each of them to one of the normal lymphoid development stages. Recent researches justified some of those entities in terms of clinical aspects and biological natures. Moreover, new techniques and findings in immunology settled many problems in the disease which had been unsolved by conventional ones. Single cell analysis on somatic hypermutation, for instance, shed light on the nature of Hodgkin's disease. A good knowledge of lymphocyte development makes it easier to understand malignant lymphoma, and is very important to hematologists and hematopathologists dealing with the disease. Development of lymphoid tissue and recent advances in this field will be briefly reviewed.

Animals↗

[Prediction of restenosis after percutaneous transluminal coronary angioplasty using coronary flow reserve. Kansai Doppler Guide Wire Study Group].

This multi-center prospective study attempted to predict restenosis after percutaneous transluminal coronary angioplasty(PTCA) using coronary flow reserve. Intracoronary blood flow velocity was measured in 47 patients(37 males, 10 females, mean age 66 +/- 9 years) with a Doppler guide wire, following successful PTCA. Twenty-four patients had prior myocardial infarction. After successful PTCA, a Doppler guide wire was placed at the distal portion of the target lesion, and coronary blood flow velocity was measured before and during intravenous administration of adenosine triphosphate. Follow-up coronary angiography was performed 154 +/- 69 days after PTCA, and the diameter stenosis of the target lesion was measured using quantitative coronary angiography. Follow-up angiography showed restenosis in 13 patients(28%). Sensitivity and specificity for predicting restenosis were low(50%, 45%, respectively) with a post-PTCA% diameter stenosis cut-off point of 27%. Sensitivity and specificity were 67% and 61% with a minimal lumen diameter cut-off of 1.8 mm. The reference coronary artery diameter(cut-off point 2.5 mm) was better for predicting restenosis(sensitivity 78% and specificity 76%). Sensitivity and specificity were 62% and 67%, respectively, using coronary flow reserve(cut-off point 2.0). The restenosis rate of patients with a reference diameter of more than 2.5 mm was 10%, but 54% for those with less than 2.5 mm(p < 0.05). In patients with a reference diameter of less than 2.5 mm, coronary flow reserve was useful for predicting restenosis(cut-off point 1.9, sensitivity 71% and specificity 83%). Coronary flow reserve is useful for predicting restenosis after PTCA, when combined with reference coronary artery diameter.

Aged↗

Effects of preinfarction angina on myocardial injury in patients with acute myocardial infarction: a study with resting 123I-BMIPP and 201T1 myocardial SPECT.

METHODS: Recent studies have suggested that patients with preinfarction angina have smaller infarcts and a better in-hospital outcome than those without angina. The mechanisms responsible for limitation of infarct size in the presence of preinfarction angina are unclear. We examined the effects of preinfarction angina on myocardial injury in patients with the first acute myocardial infarction with resting 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) 201TI myocardial scanning performed within 1 mo of infarction. RESULTS: Of 136 patients tested, 48 (35%) had preinfarction angina within 72 h before infarction, whereas 88 (65%) did not. BMIPP and 201TI defects were scored in 9 segments of the left ventricle (0 = normal, 1 = mild defect, 2 = moderate defect, 3 = severe defect, and 4 = no uptake). The total defect score was defined as the sum of the defect scores. There was no significant difference in percentage diameters of stenoses of infarct-related arteries, collateral circulation, total defect scores for BMIPP, or 201TI between the groups with and without preinfarction angina. However, the ratio of total defect score for 201TI to that for BMIPP was significantly smaller for patients with than for those without preinfarction angina (0.64 +/- 0.21 versus 0.74 +/- 0.25, respectively; P = 0.007). CONCLUSION: Preinfarction angina did not affect the areas at risk in acute myocardial infarction, as shown by BMIPP defect, but decreased necrotic myocardium in the areas at risk, as shown by 201TI defect, and increased metabolically damaged but viable myocardium, as shown by BMIPP and 201TI mismatch through unidentified mechanisms other than collateral circulation (e.g., ischemic preconditioning).

Angina, Unstable↗

Thrombopoietin enhances neutrophil production by bone marrow hematopoietic progenitors with the aid of stem cell factor in congenital neutropenia.

We examined the effects of granulocyte colony-stimulating factor (G-CSF), stem cell factor (SCF), and thrombopoietin (TPO), alone or in combination, on the generation of neutrophils by bone marrow (BM) cells from three patients with severe congenital neutropenia (SCN) through the use of a serum-deprived liquid culture system. Synergistic effects of G-CSF and SCF on the neutrophil production by BM CD34+CD38+c-kit+ cells were observed in SCN patients as well as in normal controls. The addition of TPO to the culture containing G-CSF and SCF further augmented the growth of neutrophils in the two groups. Single-cell culture experiments revealed that the three-factor combination caused increases in both the number and size of neutrophil colonies compared with G-CSF + SCF in normal BM cells, whereas only a significant increment in the colony size was observed in SCN patients. Even in the presence of SCF or SCF + TPO, the concentrations of G-CSF necessary for the substantial production of neutrophils by CD34+CD38+c-kit+ cells were higher in two patients compared with the levels obtained by normal control cells. In addition, TPO did not accelerate the maturation of neutrophilic cells supported by G-CSF + SCF. When BM CD34+CD38-c-kit+ cells were targeted, the addition of TPO to the culture containing G-CSF and SCF was required for significant neutrophil colony growth in the two groups. These results suggest that TPO enhances the G-CSF-dependent neutrophil production with the aid of SCF in this disorder.

ADP-ribosyl Cyclase↗

[Rheumatoid vasculitis with multiple intestinal ulcerations: report of a case].

Rheumatoid vasculitis is a relatively uncommon complication of rheumatoid arthritis (RA). It shows wide variety of extra-articular features including skin and neurologic involvement, but rarely shows gastrointestinal involvement. We describe a 79-old-man of rheumatoid vasculitis manifesting as small bowel multiple ulcerations accompanied by perforation of the descending colon diverticulum. The patient was admitted to our hospital with rectal bleeding and severe anemia. He had had rheumatoid arthritis for more than 10 years with treatment of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose prednisone. Upper endoscopy or colonoscopy revealed no evidence of bleeding. Suddenly he developed cramping abdominal pain, and emergency operation was performed. Segments of the descending colon and small bowel were resected to reveal perforation of the descending diverticulum and severe multiple ulcer of small bowel. The pathological examination showed multiple ulcerations of the small intestine was caused by vasculitis.

Aged↗

"Malignant struma ovarii" with peritoneal metastasis: report of two cases.

Malignant struma ovarii with metastasis in an extremely rare form of ovarian carcinoma. We describe two cases of malignant struma ovarii that demonstrated widespread peritoneal metastases. In the second case described here, furthermore, the tumor recurred II years later in the contralateral ovary and omentum, while the primary tumor previously was pure struma ovarii with no evidence of metastasis. Although thyroid tumors themselves are characterized by a long latent interval, patients with benign thyroid tissue arising in nonthyroidal organs with or even without dissemination should be managed with caution and need appropriate long-term follow-up after the initial surgery.

Adult↗

Liposarcoma of the uterine cervix: case report.

A case of primary liposarcoma of the cervix is described in a 49-year-old woman with a fungating cervical mass which was diagnosed as liposarcoma on the basis of cytologic features and the intracellular lipids. Most of the adipocytes and vacuolated lipoblasts were positive for S- 100 protein. The mass was well circumscribed and limited to the superficial cervical stroma. A total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy was performed. There was no clinical evidence of metastasis two years after the operation.

Female↗

Successful resection of superior mesenteric artery aneurysm. A case report and review of the literature.

Superior mesenteric artery aneurysms are rare, comprising only 8% of all visceral artery aneurysms. Aneurysms at the site are very susceptible to rupture, irrespective of size and may be difficult to manage even in the case of elective surgery. In the absence of serious complicating factors, the treatment of choice is excision of the aneurysm and reconstruction of the artery, if necessary, to maintain patency. We report the successful resection of an aneurysm and the subsequent reconstruction of the superior mesenteric artery which was directly anastomosed to the aorta after resection of an aneurysm.

Anastomosis, Surgical↗

[Clinical efficacy of immunotherapy with house dust in the patients with perennial nasal allergy].

We tried to elucidate the relation of age and severity with the efficacy of immunotherapy. The subjects included 51 patients with perennial allergic rhinitis who had immunotherapy for more than a year. Symptom scores, serum total IgE levels, Dermatophagoides pteronyssinus specific IgE, and peripheral blood eosinophils counts were evaluated before, half a year, one year and two years after the onset of immunotherapy. 64% of the children's group and 69% of the adults' group of patients showed significant improvement in their nasal symptoms, showing that age is not a factor influencing the efficacy of immunotherapy. The severity of the disease influenced the clinical efficacy; the more severe the disease, the poorer the efficacy of the immunotherapy. Periphipheral blood eosinophils counts gradually decreased after the onset of immunotherapy. High eosinophil counts before immunotherapy predicted poor efficacy of the immunotherapy.

Adolescent↗