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Biomedical subjects

M Takada

Publications and source records attributed to M Takada.

At least 55 records · Page 3Linked to original sources
PubMed2001

Efficacy of therapeutic drug monitoring in prevention of hypoglycemia caused by cibenzoline.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of our therapeutic drug monitoring (TDM) services in cibenzoline therapy using the risk of hypoglycemia as an end point. METHODS: The TDM services of cibenzoline were introduced in March 1998. If the serum concentrations of cibenzoline deviated from the therapeutic range, adjustment of dosage was recommended. In addition, the physicians were recommended to pay attention to the hypoglycemia induced by cibenzoline. A series of case-control studies were performed before and after introduction of TDM services. After introduction of TDM services of cibenzoline, four case-control studies were performed every 6 months between March 1998 and February 2000 (stage 2 between March 1998 and August 1998; stage 3 between September 1998 and February 1999; stage 4 between March 1999 and August 1999; stage 5 between September 1999 and February 2000) using the same method as in the previous study which had been performed between September 1997 and February 1998 (stage 1). The TDM data of inpatients and outpatients between March 1998 and February 2000 were reviewed. RESULTS: A significantly increased risk of hypoglycemia was observed for users of cibenzoline during stage 1 [crude odds ratio (OR) 10.4; 95% confidence interval (CI) 2.7-40.3], stage 2 (crude OR 3.1; 95% CI 1.0-9.0), and stage 3 (crude OR 3.8; 95% CI 1.2-12.7). However, during stage 4 and stage 5, no significantly increased risk of hypoglycemia was observed. There was no significant difference between the mean doses during stage 1 and stage 5. However, there was a significant difference in the distributions of the trough levels among the four stages. During stage 4 and stage 5, the percentage of samples with a trough level of 200-400 ng/ml was higher than during stage 2 and stage 3. During stage 2, the percentage of samples with a trough level over 400 ng/ml was 42.9%. Furthermore, the risk of hypoglycemia associated with cibenzoline use decreased together with the increase in the percentage of outpatients whose serum concentrations of cibenzoline had been measured in the past. The risk of hypoglycemia associated with cibenzoline use decreased after introduction of TDM of cibenzoline. CONCLUSION: Dose adjustment based on TDM and the physicians' increased recognition of hypoglycemia associated with cibenzoline use were beneficial for those patients treated with cibenzoline in order to prevent hypoglycemia.

Adult↗
PubMed2001

Cu2+ reveals amiloride-induced activation and blocking of non-selective cation channel in larval bullfrog skin.

The non-selective cation channel (NSCC) in the larval bullfrog skin contributes to the short-circuit current (SCC) across the skin. The effects of amiloride and acetylcholine on the SCC were examined in the presence or absence of Cu2+ to determine whether the amiloride binding site mediating activation or that mediating inhibition of the channel is blocked by Cu2+ and whether amiloride and acetylcholine share a common binding site on the NSCC. The skin of tadpoles raised in aldosterone was examined with K-Ringer present on the apical side to potentiate the SCC. Amiloride (10(-4) M) transiently increased SCC in the absence of Cu2+. Apical application of 500 microM Cu2+ increased the SCC. In the presence of Cu2+, amiloride decreased the SCC. In contrast, acetylcholine (1 mM) transiently increased SCC whether Cu2+ was present or not. These results suggest that there are two binding sites for amiloride on the NSCC, whereby the site that activates the channel is blocked by Cu2+ while the site that inhibits it is not, and that the binding sites for acetylcholine and amiloride may be different.

Acetylcholine↗
PubMed2001

A case of pulmonary hypoplasia associated with intrauterine brainstem necrosis.

UNLABELLED: An infant with intrauterine brain death accompanied by pulmonary hypoplasia is reported. The fetus was delivered after 36 weeks gestation, 5 weeks after fetal movements ceased. The child died 4 h after birth. Pulmonary hypoplasia and remote brainstem necrosis associated with multicystic encephalomalacia were found at autopsy. CONCLUSION: These findings suggest that damage to brainstem respiratory centres had led to pulmonary hypoplasia through the absence of fetal respiratory movement.

Adolescent↗
PubMed2001

Genetic analysis of a local recurrent tumor after colonic polypectomy.

After polypectomy, the cut end of the polyp is usually examined by light microscopy to assess the risk of recurrent cancer. Here, we report a recurrent tumor that appeared in the colon 6 years after polypectomy, although cancer cells were not observed in hematoxylin and eosin-stained sections of the cut end of the primary polyp. Retrospectively, the primary polyp and the recurrent tumor were analyzed for mutations of the p53 gene. We detected p53 mutations in the primary polyp, even in the cut end of the polyp. The same set of two p53 mutations was detected in the recurrent tumor. These observations indicate a common origin of the primary tumor and the recurrent tumor. We conclude that it is important to analyze p53 mutations in colonic polyps, especially when the cut end of the polyp is difficult to evaluate histologically, in order to predict recurrence.

Adenocarcinoma↗
PubMed2001

Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanyl-ketamine.

PURPOSE: This study was conducted to investigate hemodynamic and cardiac stability during anesthesia induction and intubation, using propofol plus fentanyl, propofol plus ketamine, and propofol plus fentanyl and ketamine. METHODS: Forty-five adult patients were randomly allocated to one of three groups according to the agents used for induction: propofol (2 mg/kg) plus fentanyl (3 microg/kg) (PF), propofol (2 mg/kg) plus ketamine (0.1 mg/kg) (PK), and propofol (2 mg/kg) plus fentanyl (3 microg/kg) plus ketamine (0.1 mg/kg) (PFK). Hemodynamic responses were assessed by measuring changes in blood pressure (BP), heart rate (HR), and cardiac output (CO; using dye dilution combined with pulse dye densitometry [PDD]). RESULTS: BP and HR changes during the induction of anesthesia tended to be greater in the PK group than in the PF and PFK groups. After the injection of propofol, the cardiac index (CI) fell significantly below baseline values in the PF and PFK groups, but remained unchanged in the PK group. After tracheal intubation, BP and HR increased significantly only in the PF and PK groups, and reached a level significantly above baseline values only in the PK group. The CO responses to tracheal intubation were: PK group > PF group > PFK group. CONCLUSION: A combination of propofol plus fentanyl plus ketamine would provide greater reduction of fluctuations in hemodynamic variables associated with induction of anesthesia and tracheal intubation than combinations of propofol plus fentanyl or propofol plus ketamine.

Clinical Trial↗
PubMed2001

Somatotopic arrangement and corticocortical inputs of the hindlimb region of the primary motor cortex in the macaque monkey.

Using Japanese monkeys, we examined the somatotopic organization of the hindlimb region of the primary motor cortex (MI) with intracortical microstimulation. In the hindlimb region of the MI, areas representing distal movements (digits and ankle joints) were basically surrounded by those representing proximal movements (knee and hip joints). Thus, the hindlimb region of the MI has a nested or horseshoe-like somatotopic representation. We then examined the topographic organization of corticocortical projections to the hindlimb region of the MI by the retrograde double-labeling technique: one monkey received paired injections of Fast blue (FB) and Diamidino yellow (DY) into hindlimb or forelimb representation of the MI, respectively, while two monkeys received those of FB and DY into proximal or distal representation of the hindlimb region of the MI, respectively. The neurons projecting to the hindlimb region of the MI were located in cortical areas largely separate from those projecting to the forelimb region of the MI. On the other hand, we found a substantial overlap of corticocortical neurons projecting to the proximal and distal parts of the hindlimb region of the MI in the dorsal division of the premotor cortex and the cingulate motor areas.

Animals↗
PubMed2001

Organization of inputs from cingulate motor areas to basal ganglia in macaque monkey.

The cingulate motor areas reside within regions lining the cingulate sulcus and are divided into rostral and caudal parts. Recent studies suggest that the rostral and caudal cingulate motor areas participate in distinct aspects of motor function: the former plays a role in higher-order cognitive control of movements, whereas the latter is more directly involved in their execution. Here, we investigated the organization of cingulate motor areas inputs to the basal ganglia in the macaque monkey. Identified forelimb representations of the rostral and caudal cingulate motor areas were injected with different anterograde tracers and the distribution patterns of labelled terminals were analysed in the striatum and the subthalamic nucleus. Corticostriatal inputs from the rostral and caudal cingulate motor areas were located within the rostral striatum, with the highest density in the striatal cell bridges and the ventrolateral portions of the putamen, respectively. There was no substantial overlap between these input zones. Similarly, a certain segregation of input zones from the rostral and caudal cingulate motor areas occurred along the mediolateral axis of the subthalamic nucleus. It has also been revealed that corticostriatal and corticosubthalamic input zones from the rostral cingulate motor area considerably overlapped those from the presupplementary motor area, while the input zones from the caudal cingulate motor area displayed a large overlap with those from the primary motor cortex. The present results indicate that a parallel design underlies motor information processing in the cortico-basal ganglia loop derived from the rostral and caudal cingulate motor areas.

Action Potentials↗
PubMed2001

Immunohistochemical localization of voltage-gated calcium channels in substantia nigra dopamine neurons.

The rhythmic firing of dopaminergic (DA) neurons in the substantia nigra pars compacta (SNc) is thought to be mediated by nifedipine-sensitive Ca(2+) channels, although an involvement of omega-conotoxin-sensitive Ca(2+) channels is also suggested. In an attempt to localize such Ca(2+) channels at both the regional and cellular levels, their expression and distribution patterns were immunohistochemically investigated in the rat SNc. The three distinct subtypes of voltage-gated Ca(2+) channels were tested: the class B N-type alpha 1 subunit (CNB1), the class C L-type alpha 1 subunit (CNC1) and the class D L-type alpha 1 subunit (CND1). A large number of SNc neurons showed intense immunoreactivity against CND1 and they were distributed throughout the entire extent. By contrast, many fewer neurons displayed less intense CNC1 immunoreactivity and many of them were located in the lateral aspect of the SNc. No immunoreactivity against CNB1 was detected in the SNc. Moreover, double immunofluorescence analysis in combination with tyrosine hydroxylase staining revealed that virtually all DA neurons were CND1-immunoreactive whereas many DA neurons especially in the medial SNc exhibited only faint or no immunoreactivity against CNC1. Both CNC1 and CND1 were expressed in cell bodies and proximal dendrites of SNc DA neurons, whilst their distal dendrites that penetrated into the substantia nigra pars reticulata expressed CND1 alone. Thus, the ubiquitously and intensely expressed class D alpha 1 subunit of L-type Ca(2+) channels that is sensitive to both nifedipine and omega-conotoxin may be responsible for the pacemaker activity of SNc DA neurons.

Action Potentials↗
PubMed2001

Gender difference in the relationships among hyperleptinemia, hyperinsulinemia, and hypertension.

Studies reveals that plasma leptin levels (LEP) in females are higher than those in males, and that LEP in hypertensive subjects are higher than those in BMI-matched normotensive subjects. To investigate the relationships among LEP, blood pressure (BP) and insulin sensitivity, we studied these relationships in 133 Japanese males and 263 females. LEP were positively correlated with BP, body mass index, body fat mass (FM) and homeostasis model assessment (HOMA). Regression analysis in which age and FM were adjusted showed LEP were associated with BP and HOMA. Even with adjustment by age, FM and HOMA, LEP were still positively correlated BP in males. LEP in insulin-resistant hypertensives was significantly higher than those in insulin-sensitive hypertensives, in insulin-sensitive normotensives and in insulin-resistant normotensives in males. However, in females, a significantly higher LEP was observed in insulin-resistant subjects than in insulin-sensitive subjects regardless of hypertension. These data suggest that it would be sexual difference in the relationships among hyperleptinemia, hyperinsulinemia and hypertension.

Adult↗
PubMed2001

Differential dosimetry in a neutron-proton mixed field with low-pressure proportional counters.

For a mixed radiation field of neutrons and protons, radiation events were discriminated between photons, neutrons, and protons using a thin plastic scintillator. Distributions of lineal energy were measured with low-pressure proportional counters (LPPCs). To estimate the distribution of lineal energy for ICRU muscle, measurements were carried out using A-150-walled, graphite-walled, ZrO2-walled, and Zr-walled counters. Data were corrected for different atomic compositions between the A-150 plastic and ICRU muscle.

Energy Transfer↗
PubMed2001

An experimental study on radiation streaming through a labyrinth in a proton accelerator facility of intermediate energy.

A radiation streaming experiment has been carried out at the Takasaki Ion Accelerator Facility for Advanced Radiation Application at the Japan Atomic Energy Research Institute in a room housing a Cu target irradiated with 68 MeV protons and in a labyrinth of three-legs having a total length of 29 m. In the experiment, neutron and gamma ray energy spectra, neutron reaction rates, and neutron and gamma ray dose equivalent rates were measured using various counters and dosimeters. The experimental data show the applicability of some empirical formulas for estimating the thermal neutron flux in a room and neutrons streaming in a labyrinth designed for a proton accelerator operating in the intermediate energy region. The data suggest that it is mandatory to estimate the gamma ray dose equivalent rate in a labyrinth, which is dominated by the secondary gamma rays due to the neutron capture reaction.

Academies and Institutes↗
PubMed2001

Concurrent occurrence of gastric adenocarcinoma and duodenal neuroendocrine cell carcinoma: a composite tumour or collision tumours ?

BACKGROUND: Neuroendocrine cell (NEC) carcinoma is occasionally accompanied by adenocarcinoma but the relationship between these two morphologically distinct tumours is unclear. Two hypotheses have arisen regarding the mechanism for the association of adenocarcinoma and NEC carcinoma. One is that both are derived from a common multipotential epithelial stem cell. The second hypothesis is that adenocarcinoma and NEC carcinoma arise from a multipotential epithelial stem cell and a primitive NEC, respectively. AIMS: To elucidate the relationship between the two histologically distinct tumours, adenocarcinoma of the stomach and NEC carcinoma of the duodenum. PATIENT/METHODS: We present a case in which the tumour extended across the pyloric ring, the gastric portion of which revealed adenocarcinoma while the duodenal portion showed argyrophil NEC carcinoma. The two histologically distinct lesions of the tumour were examined by immunohistochemistry and genetic analysis of p53. RESULTS: The gastric region was negative for chromogranin A staining but positive for carcinoembryonic antigen (CEA) staining. In contrast, the duodenal region was positive for chromogranin A but negative for CEA. All tumour regions showed a point mutation in p53 gene at exon 7 (GGC (glycine)-->GTC (valine) at codon 245). The distal portion of the duodenal tumour showed an additional point mutation in p53 gene at exon 5 (GCC (alanine)-->GTC (valine) at codon 129). CONCLUSIONS: The two histologically distinct tumours, adenocarcinoma of the stomach and NEC carcinoma of the duodenum, appear to be derived from a common epithelial cell.

Adenocarcinoma↗
PubMed2001

The stereoselective effects of bucolome on the pharmacokinetics and pharmacodynamics of racemic warfarin.

The objective of this study was to investigate the stereoselective influence of bucolome on the pharmacokinetics and pharmacodynamics of warfarin in Japanese inpatients with heart disease. Thirty patients were administered a fixed-maintenance dose of warfarin alone once a day for at least 7 days. The other 25 patients were concomitantly administered warfarin and a 300 mg dose of bucolome once a day, and blood samples were collected on days 1, 4, 7, 14, or 21 after administration of bucolome. Serum concentration of warfarin enantiomers was measured by a chiral reversed-phase HPLC-ultraviolet detection method. The PT-INR was used as a measure of the pharmacodynamic effect of warfarin. Coadministration of bucolome and warfarin had no effect on serum (R)-warfarin concentration and significantly increased serum (S)-warfarin concentration compared with warfarin alone. The PT-INR of warfarin alone was significantly lower with bucolome cotreatment. These results indicate that the augmented anticoagulant effect of warfarin by bucolome is due to inhibition of (S)-warfarin metabolism in vivo. When bucolome is added to a stabilized regimen of warfarin therapy, the dose of warfarin should be reduced by about 30% to 60%, and caution should be exercised during the first 7 days after coadministration of bucolome.

Administration, Oral↗
PubMed2001

Pharmacokinetics of granisetron in adults and children with malignant diseases.

Granisetron (GRN) is widely used for patients with various cancers who suffer from chemotherapy-induced vomiting and nausea. The, pharmacokinetics of GRN has not been fully evaluated in such patients, however, and its dosage regimen is still controversial. In this study, we determined GRN levels in serum and urine from lung cancer patients and children suffering from cancer after intravenous infusion. In lung cancer patients, the interindividual variations in t(1/2beta), area under the concentration-time curve (AUC), and Vd(beta) were relatively smaller than expected from previous reports on healthy subjects, while t(1/2beta) was prolonged more than 5-fold in healthy subjects. Urinary excretion of unchanged GRN in lung cancer patients was ca. 15% of dose, consistent with previous reports, and one individual demonstrated an even higher urinary excretion (ca. 45%). The pharmacokinetic parameters of GRN in child cancer patients varied markedly among individuals, and some child patients had smaller t(1/2beta) than adult patients. In these cases, GRN should be administered at shorter intervals. These results suggested that a pharmacokinetic study of GRN was necessary for planning a dosage regimen and managing chemotherapy-induced vomiting and nausea.

Adolescent↗
PubMed2001

[Polyphenol constituents from Salacia species: quantitative analysis of mangiferin with alpha-glucosidase and aldose reductase inhibitory activities].

Mangiferin, three catechins, and two catechin dimers were isolated from the roots of Salacia reticulata (SRE), and examined their inhibitory activities against several carbohydrate metabolize enzymes (sucrase, maltase, isomaltase, alpha-amylase, and aldose reductase). Among them, mangiferin was found to inhibit sucrase, isomaltase, and aldose reductase from rat with IC50 values of 87, 216 and 1.4 micrograms/ml, respectively. The inhibitory activities of mangiferin are competitive for sucrase and isomaltase with inhibitor constant (Ki) 55 micrograms/ml and 70 micrograms/ml, respectively. In order to determine the mangiferin contents in the water extracts from the roots of S. reticulata, a quantitative analytical method by means of HPLC was developed and the mangiferin contents in SRE were determined to be in the range of 0.9-2.3% by the application of this method. A high linear correlation (r = 0.934) was observed between the mangiferin contents and the sucrase inhibitory activity. In addition, this analytical procedure of mangiferin was found to be applicable for other Salacia species (S. oblonga, S. chinensis, and S. prinoides). Thus, the quantitative HPLC analysis of mangiferin was supposed to be suitable for the quality control of Salacia species and its products.

Aldehyde Reductase↗
PubMed2001

Effects of cilnidipine on muscle fiber composition, capillary density and muscle blood flow in fructose-fed rats.

The aim of this study was to examine the roles of muscle fiber composition, capillary density and muscle blood flow in insulin resistance (IR) and the effect of cilnidipine, a calcium channel blocker in fructose-fed rats (FFR). Six-week-old male Sprague-Dawley rats were fed either normal rat chow or fructose-rich chow for 6 weeks. For the last 2 weeks, the rats were treated by gavage with a vehicle (Control and FFR groups) or with cilnidipine (FFR+Cil group). Blood pressure (BP) and insulin sensitivity were assessed in the sixth week. Muscle fiber composition, capillary density and blood flow in the soleus muscle were evaluated. BP of FFR was significantly higher than that of the controls. Cilnidipine significantly lowered BP in FFR. Insulin sensitivity was significantly lower in FFR than in the controls. Cilnidipine significantly improved IR in FFR. The composite ratio of type I fibers in the soleus muscle was significantly lower in FFR than in the controls, but that of type II fibers was significantly higher in FFR. Treatment with cilnidipine resulted in recovery of this ratio to that of the controls. Insulin sensitivity was found to be significantly correlated with the composite ratio of either type I fibers or type II fibers. There were no intergroup differences in capillary density. Muscle blood flow in the FFR+Cil group was higher than that in the Control or FFR groups. These results suggest that muscle fiber composition is linked to IR and that cilnidipine may improve IR in FFR either by modulating muscle fiber composition or by increasing muscle blood flow.

Animals↗
PubMed2001

Concurrent versus sequential radiotherapy for small cell lung cancer.

Two meta-analyses have shown that thoracic radiotherapy plus chemotherapy is superior to chemotherapy alone in the treatment of limited-stage small cell lung cancer. To minimize the likelihood of emergence of chemotherapy resistance, the optimal schedule for integration of the two modalities might be to introduce radiotherapy early in the course of treatment. The Cancer and Leukemia Group B trial performed from 1981 to 1984 failed to show an advantage for early concurrent chemoradiation. However, three recent controlled trials of thoracic irradiation timing (the National Cancer Institute of Canada trial, the Yugoslavian trial, and the Japan Clinical Oncology Group trial) showed that early radiotherapy is superior to delayed radiotherapy. These three trials used the combination of cisplatin/etoposide and showed that a long-term survival rate greater than 20% is achievable using early integrated chemoradiation. For the present, early concurrent administration of thoracic radiotherapy with a cisplatin/etoposide-based regimen should be standard therapy. Semin Oncol 28 (suppl 4):23-26.

Antineoplastic Combined Chemotherapy Protocols↗