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Biomedical subjects

M Takada

Publications and source records attributed to M Takada.

At least 199 records · Page 11Linked to original sources
PubMed1997

Comparisons of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification.

The purpose of this study was to examine the commonly available methods of noninvasively assessing bone mineral status across three defined female populations to examine their interrelationships, compare their respective abilities to reflect age- and menopause-related bone loss, discriminate osteoporotic fractures, and classify patients diagnostically. A total of 47 healthy premenopausal (age 33 +/- 7 years), 41 healthy postmenopausal (age 64 +/- 9 years), and 36 osteoporotic postmenopausal (age 70 +/- 6 years) women were examined with the following techniques: (1) quantitative computed tomography of the L1-L4 lumbar spine for trabecular (QCT TRAB BMD) and integral (QCT INTG BMD) bone mineral density (BMD); (2) dual X-ray absorptiometry of the L1-L4 posterior-anterior (DXA PA BMD) and L2-L4 lateral (DXA LAT BMD) lumbar spine, of the femoral neck (DXA NECK BMD) and trochanter (DXA TROC BMD), and of the ultradistal radius (DXA UD BMD) for integral BMD; (3) peripheral QCT of the distal radius for trabecular BMD (pQCT TRAB BMD) and cortical bone mineral content (BMC) (pQCT CORT BMC); (4) two radiographic absorptiometric techniques of the metacarpal (RA METC BMD) and phalanges (RA PHAL BMD) for integral BMD; and (5) two quantitative ultrasound devices (QUS) of the calcaneus for speed of sound (SOS CALC) and broadband ultrasound attenuation (BUA CALC). In general, correlations ranged from (r = 0.10-0.93) among different sites and techniques. We found that pQCT TRAB BMD correlated poorly (r < or = 0.46) with all other measurements except DXA UD BMD (r = 0.62,p < or = 0.0001) and RA PHAL BMD (r = 0.52, p < or = 0.0001). The strongest correlation across techniques was between QCT INT BMD and DXA LAT BMD (r = 0.87, p < or = 0.0001), and the weakest correlation within a technique was between pQCT TRAB BMD and pQCT CORT BMC (r = 0.25,p < or = 0.05). Techniques showing the highest correlations with age in the healthy groups also showed the greatest differences among groups. They also showed the best discrimination (as measured by the odds ratios) for the distinction between healthy postmenopausal and osteoporotic postmenopausal groups based on age-adjusted logistic regression analysis. For each anatomic site, the techniques providing the best results were: (1) spine, QCT TRAB BMD (annual loss, -1.2% [healthy premenopausal and healthy postmenopausal]); Student's t-value [not the T score], 5.4 [healthy postmenopausal vs. osteoporotic postmenopausal]; odds ratio, 43 [age-adjusted logistic regression for healthy postmenopausal vs. osteoporotic postmenopausal]); (2) hip, DXA TROC BMD (-0.46; 3.5; 2.2); (3) radius, DXA UD BMD (-0.44; 3.3; 1.9) and pQCT, CORT BMC (-0.72; 2.9; 1.7); (4) hand, RA PHAL (-0.51; 3.6; 2.0); and (5) calcaneus, SOS (-0.09; 3.4; 2.1) and BUA (-0.52; 2.6; 1.7). Despite these performance trends, the differences among sites and techniques were statistically insignificant (p > 0.05) using age-adjusted receiver operating characteristic (ROC) curve analysis. Nevertheless, kappa score analysis (using -2.0 T score as the cut-off value for osteopenia and -2.5 T score for osteoporosis) showed that in general the diagnostic agreement among these measurements in classifying women as osteopenic or osteoporotic was poor, with kappa scores averaging about 0.4 (exceptions were QCT TRAB/INTG BMD, DXA LAT BMD, and RA PHAL BMD, with kappa scores ranging from 0.63 to 0.89). Often different patients were estimated at risk by using different measurement sites or techniques.

Absorptiometry, Photon↗
PubMed1997

A new trabecular region of interest for femoral dual X-ray absorptiometry: short-term precision, age-related bone loss, and fracture discrimination compared with current femoral regions of interest.

We defined a new region of interest (ROI) for femoral Ward's triangle, centered on the femoral neck axis including comparatively trabecular-rich bone. Forty-seven premenopausal, 39 healthy postmenopausal, and 35 osteoporotic postmenopausal women with vertebral fractures were evaluated comparing the new with the standard femoral ROIs, using a Hologic QDR-2000. Additionally, spinal dual X-ray absorptiometry (DXA) was performed. The short-term precision error of the new ROI expressed as the root mean square of the coefficient of variations was 1.34% for premenopausal women, 1.69% for healthy postmenopausal women, and 2.46% for osteoporotic postmenopausal women. Bone mineral density (BMD) values of the new ROI correlated highly with those of the standard femoral ROIs (r = 0.91 - 0.96) and the spinal BMD (r = 0.74). Age-related bone loss of the new ROI was 0.75% per year (r = 0.66) in healthy women, which was approximately 1.5 times higher than the bone loss of the standard femoral ROIs, except for Ward's triangle. Regarding the intergroup discrimination, the t-value of the new ROI was similar to the t-value of Ward's triangle, and the intergroup percent decrements in BMD of the new ROI approximated those of Ward's triangle. For discriminating women with vertebral fractures, the new ROI demonstrated odds ratios of 1.6 similar to most ROIs but lower than that of the trochanteric region. The new, substantially trabecular ROI appears to be an alternative to the Ward's ROI traditionally used in femoral DXA having improved short-term precision and comparable sensitivity.

Absorptiometry, Photon↗
PubMed1997

Diagnostic validity of bone metabolic markers for bone metastasis.

We measured bone resorption markers in tumor patients with and without bone metastases and evaluated the diagnostic validity of these biochemical parameters in the diagnosis of neoplastic bone involvement. On the basis of radiography and bone scintigraphy findings, subjects were divided into 3 groups, 83 patients without bone metastases (META(-)), 22 patients with 1 or 2 bone metastases (META(+)) and 22 patients with more than 3 bone metastases (META(++)). Among the biochemical markers, urinary pyridinoline (PYR), circulating C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen (NTx) were especially sensitive and specific and increased significantly not only in META(++) but also even in META(+). The efficacy of several bone metabolic markers in differentiating between patients with and without bone metastases was evaluated by receiver-operating characteristic (ROC) analysis, and PYR, ICTP and NTx were proved to have high diagnostic validity (area under the ROC curve; 0.75 for PYR, 0.77 for ICTP and 0.77 for NTx). Furthermore, their odds ratios showed significantly high values for both META(+) and META(++)(to META(++); 7.91 for PYR, 5.33 for ICTP and 5.70 for NTx). On the other hand, urinary deoxypyridinoline (DPYR) and serum total alkaline phosphatase (ALP) showed relatively low sensitivities, the odds ratio of ALP in particular being insignificant. In conclusion, several bone metabolic markers were proved to be useful in the diagnosis of bone metastases in patients with malignancies, particularly PYR, ICTP and NTx had rather high diagnostic validities among all markers examined in this study.

Adult↗
PubMed1997

In vivo treatment of bullfrog tadpoles with aldosterone potentiates ACh-receptor channels, but not amiloride-blockable Na+ channels in the skin.

Amiloride-blockable Na(+) channels participate in active Na(+) transport across adult, but not larval, bullfrog skin. Their development is induced in vitro by culturing the tadpole skin with aldosterone. When tadpoles were raised in aldosterone (5 x 10(-7) M) for 2 weeks, however, neither development of such channels nor localization of antigen A, a marker of adult-type epidermis, was seen, the skin still being of the larval type. In contrast, aldosterone treatment did potentiate (by a factor of two) the activity of the acetylcholine receptor (ACh-receptor) channel, a functional marker of larval-type skin. The short-circuit current (SCC) across the skin, far from being inhibited by amiloride, was stimulated by both amiloride and ACh. The nystatin-stimulated SCC was about twice its control amplitude, suggesting that the aldosterone treatment also potentiated the activity of the Na(+) pump.

Aldosterone↗
PubMed1997

Clinical analysis of recurrent subarachnoid hemorrhage after neck clipping surgery.

The clinical features of recurrent subarachnoid hemorrhage (SAH) after neck clipping surgery were investigated in a series of 1,436 consecutive patients treated between 1980 and 1994, and seven patients treated prior to 1980. Recurrent SAH occurred within 1 month in seven patients and between 1.5 and 20 years in 20 patients (mean interval 9.2 years) from the first surgery. The patients were aged from 31 to 76 years (mean 49.8 years) at the first SAH. There were 19 females and eight males. Recurrent SAH occurred at the same site as the prior aneurysms in 12 cases, at an infundibular dilatation in three cases, de novo aneurysms in nine cases, untreated multiple aneurysms in two cases, and unknown in one case. The main causes for early recurrent SAH were incomplete clipping or untreated multiple aneurysms, whereas late recurrent SAH was due to de novo aneurysms, untreated multiple aneurysms, or regrowth aneurysm at the prior site. The outcomes of late recurrent SAH were good in eight cases, moderate disability in two, severe disability in three, and dead in seven, whereas most cases of early recurrent SAH resulted in poor outcome. Immediate postoperative angiography is desirable in cases with incomplete clipping, because early recurrent SAH resulted in poor outcomes. De novo or regrowth aneurysms caused late recurrent SAH, so follow-up angiography is strongly recommended for young patients, even if complete clipping was achieved.

Adult↗
PubMed1997

[A case of leukocytosis after massive blood transfusion for postpartum hemorrhagic shock].

We experienced the perioperative management of a hemorrhagic shock associated with postpartum uterine rupture. After the emergency abdominal total hysterectomy, massive blood transfusion was required to maintain the hemodynamics and the laparotomy for hemostasis was performed on the 1st, 2nd and 7th ICU day. Total amount of transfused blood products was 37,000 ml during one week. The patient immediately developed DIC and acute renal failure. Laboratory data showed increased leukocyte count (the peak value was 56,100 microliters-1 on the 12th ICU day), and neutrophilic fraction was more than 90% of leucocyte. After the decrease in CRP, the decrease in total bilirubin concentration was delayed. There were no other signs of infection and no remarkable change in MOF score. There was a discrepancy between this leukocytosis and the severity of organ dysfunction, and the cause of the leukocytosis was unknown.

Female↗
PubMed1997

[Bronchospasm due to anaphylactic reaction to Hydroxyethyl starch (HESPANDER)].

A 14-year-old male without any history of allergic disorders developed severe bronchospasm with skin rash 15 min. after the administration of hydroxyethyl starch (HES) during thoratic epidural anesthesia supplemented with N2O-sevoflurane-O2 anesthesia. Aminophylline, hydrocortisone, and epinephrine were administered. These treatments were effective, and the airway pressure was restored to normal ranges within 3 hrs. After the operation, the patient was extubated, because the results of the arterial blood gas examinations recovered to normal ranges. Plasma histamine and complement levels were almost within normal limits, but IgE levels were approximately 5 times higher than normal. Subsequent immediate skin test with hydroxyethyl starch showed an immunologically positive response. These results demonstrate evidence that an anaphylactic reactions could occur just after the start of HES infusion. Severe adverse reactions to HES are very rare, but it is important to keep the possibility always in mind.

Adolescent↗
PubMed1997

[Effect of Chorei-to on spontaneous discharge of urinary stones after extracorporeal shock wave lithotripsy (ESWL)].

To enhance stone elimination following extracorporeal shock wave lithotripsy (ESWL), we administered Tsumura Chorei-to to 74 patients who underwent the procedure at Kinki University School of Medicine and Kanbara Hospital between July 1990 and March 1991. We established a control group of 75 patients without medication. There was no significant difference between the two groups in terms of gender, age, stone size (mostly less than 20 mm), and stone position. The mean number of days required for complete stone elimination was 16.0 days in the Chorei-to administration group being significantly shorter than the 21.5 days in the control group (p < 0.001). These findings suggested that Chorei-to effectively enhanced the spontaneous discharge of fragmented stones following ESWL.

Adult↗
PubMed1997

Phase II studies of gemcitabine for non-small cell lung cancer in Japan.

To determine the activity and toxicity of gemcitabine (2',2'-difluorodeoxycytidine), three phase II single-agent studies have been conducted in patients with non-small cell lung cancer in Japan. In an early phase II study, 17 previously treated and 47 untreated patients were treated with gemcitabine. Gemcitabine was given intravenously at a dose of 800 mg/m2 or 1,000 mg/m2 once a week for 3 weeks followed by a week of rest, repeating every 4 weeks. Although none of the patients with prior therapy responded, eight (17%) of 47 previously untreated patients showed a partial response. Toxicities of grade 3 or greater included leukopenia (12.5%), thrombocytopenia (6.3%), and anemia (15.6%). We entered 73 patients (group A) and 67 patients (group B) into two late phase II studies. All patients had no previous chemotherapy and had measurable disease. Gemcitabine was administered at a starting dose of 1,000 mg/m2/wk for 3 weeks followed by a week of rest. The dose was escalated to 1,250 mg/m2 if severe toxicity was not seen in the previous course. Nineteen of 73 patients (26%) had a partial response (95% confidence interval, 16.5% to 37.6%) in group A. Of 67 patients, 14 (20.9%) showed a partial response (95% confidence interval, 11.9% to 32.6%) in group B. Grade 3 or greater anemia and leukopenia occurred, respectively, in 15 (20.5%) and seven (9.6%) patients in group A and in nine (13.4%) and seven (10.4%) patients in group B. Grade 3 thrombocytopenia was observed in one patient (1.4%). Other toxicities including hepatic toxicity, fatigue, nausea/vomiting, and fever were mild and transient. Pulmonary toxicity was observed in five patients, two of whom died of respiratory insufficiency. The median durations of response were 19.6 weeks in group A and 20 weeks in group B, and median survival times were 44 and 39 weeks, respectively. In conclusion, gemcitabine is an active agent against non-small cell lung cancer with very mild toxicities. These results suggest that gemcitabine has potential utility on an outpatient basis. Further trials in combination with other active agents are warranted.

Adult↗
PubMed1997

[Long-term beneficial effect of dual chamber pacing in a patient with hypertrophic obstructive cardiomyopathy].

Dual chamber (DDD) pacing therapy was effective to reduce the left ventricular outflow tract pressure gradient for a long time in a patient with pharmacotherapy-resistant hypertrophic obstructive cardiomyopathy. A 52-year-old man with pharmacotherapy-resistant pressure gradient was treated by a DDD pacemaker implantation, because the pressure gradient was proved to be reduced (94-->16 mmHg) by transient DDD pacing with an atrioventricular delay of 50 msec. Hemodynamics and ventricular wall thickness were serially observed after the implantation for 2 years. The pressure gradient progressively decreased during the pacing period, at 4 months and 2 years follow-up, (10-->2 mmHg) and during the sinus rhythm period (60-->25 mmHg), and left ventricular ejection fraction and end-diastolic volume index were increased. Although the ventricular wall thickness remained constant, the systolic anterior motion of the mitral valve and A/E were reduced during the pacing period in the echocardiography. During the acute effect of DDD pacing, the pressure gradient reduction seemed to be related to dilatation of the left ventricular outflow tract induced by a change of contraction modality of the intraventricular septum. Improved left ventricular diastolic function may contribute to the pressure gradient reduction during extended periods of pacing therapy.

Cardiac Pacing, Artificial↗
PubMed1997

[Clinical evaluation of 2 mg granisetron tablet for nausea and vomiting induced by anticancer drugs including cisplatin].

1. The clinical efficacy and safety of the 2 mg granisetron tablet were assessed in 32 mainly lung cancer patients who were to receive treatment with anticancer drugs including CDDP. 2. One 2 mg granisetron tablet was administered prophylactically one hour before the start of CDDP administration. 3. Based on the development of nausea and vomiting in 24 hours after the start of CDDP administration, the study medication was judged to be "remarkably effective" or "effective" in 71.0% (22/31) of cases. 4. The study medication was judged to be "safe" in 96.9% (31/32) of cases, without causing any adverse reactions. 5. The above results indicate that the 2 mg granisetron tablet is safe and useful.

Adult↗
PubMed1997

[A case of empyema with a bronchopleural fistula treated by a pedicle muscle flap with the thick parietal pleura].

A 65-year-old male with a bronchopleural fistula of 10 mm in diameter underwent thoracoplasty combined with a pedicle muscle flap following open thoracic window. He had been treated by gastrectomy and right upper lobectomy because of gastric perforation and lung tuberculosis before empyema. Sterilization for the empyema cavity through the thoracic window was done for 255 days, obliteration of the empyema cavity was achieved by a muscle flap with the thick parietal pleura. The parietal pleura which was not separated from the intercostal pleura which was not separated from the intercostal muscle was used for reinforcement of the muscle flap against the high intra-tracheal pressure. There was no postoperative relapse of empyema for 9 months.

Aged↗
PubMed1997

[Combined deficiency in neutrophil functions after bone marrow transplantation and the in vitro effect of granulocyte colony-stimulating factor].

In order to investigate the mechanism of susceptibility to bacterial infection after bone marrow transplantation (BMT), we evaluated the neutrophil functions at 1, 3, 6, and 12 months after hematological reconstitution in a 29-year-old AML patient who received allogeneic bone marrow transplantation. Acute graft-versus-host disease (GVHD) was grade I, and chronic GVHD was not present. The patient exhibited complications of upper and lower respiratory infections several times after BMT, all of which subsided within a month. Chemotactic responses toward all three chemotactic factors, random mobility, phagocytosis, superoxide (O2-) release and bactericidal activity were severely impaired early after reconstitution. These neutrophil functions gradually improved with time after BMT, and all normalized at 12 months after reconstitution of transplanted bone marrow. Both O2- release and bactericidal activity of neutrophils were significantly enhanced at 6 and 12 months after marrow reconstitution following pretreatment of 50 ng/ml of granulocyte colony-stimulating factor (G-CSF) in vitro. These findings suggest that the combined disorders in neutrophil functions in early phase after BMT may play an important role in susceptibility to bacterial infections until one year after BMT. Administration of G-CSF, which potentiates the bactericidal activity of neutrophils, is recommended for preventing infectious complications and for treating prolonged and unmanageable infections after BMT.

Adult↗
PubMed1997

[Effect on 5'-deoxy-5-fluorouridine (5'-DFUR) of pyrimidine nucleoside phosphorylase (PyNPase), matrix metalloprotease and serum IAP values. Hokuriku Colorectal Cancer Chemotherapy Study Group].

PyNPase activity, MMPs activity and serum IAP values were measured in tumor tissues from colorectal cancer patients who had been divided into two groups, one given preoperative 5'-DFUR and the controls. PyNPase activity of the preoperative administration group was approximately equivalent to that of the controls. In the control group, correlations were assessed between PyNPase activity and activities of MMP1 and MMP3. To assess the effect of 5'-DFUR on the activity of MMPs, we divided patients into two groups, a high and a low PyNPase activity group. Although there was no correlation with MMPs activity of the preoperative administration group and the control group in the low PyNPase activity group, the activities of MMP1 and MMP9 of the control group were significantly higher in the high PyNPase activity group. Moreover, the serum IAP value of the administration group was significantly lower than that of the control group. These results indicated that PyNPase activity was thus suggested to be somehow related to MMPs activity and serum IAP values.

Adult↗
PubMed1997

Two optimal prefilter cutoff frequencies needed for SPECT images of myocardial perfusion in a one-day protocol.

OBJECTIVE: The purpose of this study was to determine if cutoff frequencies of two-dimensional Butterworth filters need to be changed, depending upon the amount of radiopharmaceutical administered in one-day protocols for reconstructing SPECT images of myocardial perfusion. METHODS: A scintilation camera and a phantom were used with 2.2 MBq and 10.6 MBq 99mTc. These activities corresponded to the approximate amounts used in our one-day myocardial perfusion imaging protocol. The projection data were collected in 30 positions spread over 180 degrees. Thirty- and 150-sec acquisitions per position were performed to obtain the study and the high-quality reference images. Thirteen cutoff frequencies of the filter were used to reconstruct the SPECT images. Optimal cutoff frequencies were determined by visual assessment and by calculating the normalized mean square error (n.m.s.e). These results were then compared. The same protocol was used to image three volunteers with no heart disease and the images were evaluated visually. RESULTS: In the phantom study, the optimal cutoff frequencies were 0.225 cycles/pixel for 2.2 MBq, and 0.275 cycles/pixel and 0.25 cycles/pixel for 10.6 MBq by visual inspection, and were 0.225 cycles/pixel and 0.275 cycles/pixel by calculating the n.m.s.e., respectively. In the patient study, the lower cutoff frequency of 0.20 cycles/pixel was optimal for the exercise study (low dose), while the higher cutoff frequencies of 0.275 cycles/pixel was optimal for the resting study (high dose). CONCLUSION: The optimal cutoff frequencies differed for the two activity levels. Cutoff frequencies should be changed according to the amounts of radiopharmaceuticals used for the first and the second examinations in one-day protocols.

Heart↗
PubMed1997

Role of substance P in experimental allergic conjunctivitis in guinea pigs.

The role of substance P in experimental allergic conjunctivitis induced by egg albumin was investigated with guinea pigs. Increase in vascular permeability of the conjunctiva induced by antigen was significantly inhibited after repeated application of capsaicin. Substance P contents in the conjunctiva of guinea pig were decreased by topical instillation of antigen to the eyes, suggesting that substance P was released from the conjunctiva due to antigen-antibody reaction. Moreover, subconjunctival injection of substance P resulted in a dose-related conjunctivitis, and vascular permeability in the conjunctiva was also increased by substance P. In substance P-induced conjunctivitis, a significant edema was observed in the bulbar and palpebral conjunctiva, but no hyperemia was noted in all instances. Histamine contents of the conjunctiva and tears were not influenced by subconjunctival injection of substance P. However, topical application of antigen and subconjunctival injection of compound 48/80 caused a significant decrease in histamine content, and content of tear was increased by both treatments. An increase in vascular permeability induced by antigen application was significantly inhibited by intravenous injection of FK-888, which is a specific and potent NK1 receptor antagonist. From these results, it is suggested that substance P is responsible for allergic conjunctivitis to some extent, and the conjunctival hyperpermeability induced by substance P occurs through NK1 receptor on the blood vessels, rather than by the direct action on the conjunctival mast cells during allergic conjunctival reactions.

Animals↗