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Biomedical subjects

M Takao

Publications and source records attributed to M Takao.

At least 109 records · Page 6Linked to original sources
PubMed1996

Fulminant myasthenia gravis manifested after removal of anterior mediastinal tumor.

Myasthenia gravis developed in a 35-year-old man after removal of an encapsulated anterior mediastinal tumor that was preoperatively diagnosed as a teratoma based on a computed tomographic image. Postoperative pathologic diagnosis of the excised tumor was thymoma. The patient was in crisis after the initiation of immunosuppressive treatment. The therapy was changed to immunoadsorbent perfusion therapy because of concurrent severe pneumonia and an extremely high serum concentration of anti-acetylcholine receptor antibodies. Respiratory support was necessary for 2 months after reoperation.

Adult↗
PubMed1996

Evaluation of the coagulation and fibrinolytic systems in men with intermittent claudication.

The authors evaluated elements of the coagulation and fibrinolytic systems in 18 male patients with intermittent claudication vs 19 men matched for risk factors who served as controls. Prothrombin time and activated partial thromboplastin time did not significantly differ in the patients and the controls. The plasminogen level in the two groups was not significantly different. The level of lipoprotein(a) was significantly higher in the patients than in the controls. The levels of antigen and the activity of protein C did not differ significantly between the two groups. The thrombomodulin level was significantly higher in the patients than in the controls. There were no significant differences between the two groups in the levels of alpha 2-macroglobulin, C1-inactivator, or antithrombin III. The levels of fibrinogen and alpha 1-antitrypsin were significantly higher in the patients vs the controls. Significantly lower levels of alpha 2-plasmin inhibitor and higher levels of alpha 2-plasmin inhibitor/plasmin complex and thrombin/antithrombin III complex were found in the patients vs the controls. These findings suggest that the levels of thrombin/antithrombin III complex, alpha 2-plasmin inhibitor/plasmin complex, and thrombomodulin may perhaps serve as indicators for injury to the peripheral endothelium and that the coagulation and fibrinolytic systems may be activated in patients with intermittent claudication.

Aged↗
PubMed1996

Noninvasive assessment of right heart function by 81mKr equilibrium radionuclide ventriculography in chronic pulmonary diseases.

Noninvasive multigated equilibrium radionuclide ventriculography with krypton-81m (81mKr) was used to assess right heart relaxation in patients with chronic pulmonary diseases (CPD). The subjects consisted of 30 patients with CPD and 8 patients free of cardiopulmonary diseases admitted to our department. A region of interest (ROI) was selected on both the right atrium (RA) and right ventricle (RV). A time activity curve was obtained for each ROI. As a diastolic index of the right heart performance, the right atrial early emptying rate (RAER) was obtained from the right atrial time activity curve, while the right ventricular rapid filling rate (RVRFR) was obtained from the right ventricular time activity curve. The mean RAER was significantly lower in CPD patients compared with the control (CPD, 9.5 +/- 4.5; control, 16 +/- 3.4%/100 ms). Similarly, the mean RVRFR was significantly lower in CPD patients compared with the control (CPD, 27.3 +/- 9.9; control, 34 +/- 8.5%/100 ms). A strong negative correlation was noted between the mean pulmonary arterial pressure (mPAP) and RAER (r = -0.77; p < 0.001) and between the mPAP and the RVRFR (r = -0.63; p < 0.001). Our results suggest that RAER and RVRFR measured by 81mKr are clinically useful in the noninvasive assessment of right heart relaxation in patients with CPD.

Adult↗
PubMed1996

[A case of ureteral malacoplakia in a hemodialysis patient].

A case of ureteral malacoplakia in a hemodialysis patient is reported. A 64-year-old woman suffering from macrohematuria, was diagnosed as having a right ureteral tumor by means of computerized tomography and antegrade pyelography. Right nephroureterectomy with bladder cuff resection was performed. Pathological examination indicated malacoplakia; multiple Michaelis-Gutmann bodies were found. The patient did well postoperatively and was discharged without further complications. This case appears to be the twenty-first report of ureteral malacoplakia in the world.

Female↗
PubMed1996

Iodine-123-metaiodobenzylguanidine myocardial imaging in patients with right ventricular pressure overload.

UNLABELLED: Iodine-123-metaiodobenzylguanidine ([123I]MIBG) has been used to evaluate the cardiac sympathetic nervous system, particularly that of the left heart. To clarify whether the right ventricular (RV) sympathetic neuronal function could be evaluated by [123I]MIBG myocardial imaging, we applied the technique in patients with pulmonary hypertension that was associated with either chronic pulmonary diseases or pulmonary vascular diseases. METHODS: All patients underwent right heart catheterization, and right heart hemodynamics were determined during a clinically stable state. SPECT was performed in the resting state 15 min (early imaging) and 4 hr (delayed imaging) postadministration of [123I]MIBG. Seven regions of interest (ROI) were selected on the delayed short-axis images on the RV free wall, left ventricular (LV) free wall and interventricular septum (IVS). We calculated the IVS-to-LV uptake ratio from the scintillation counts of the ROI. Thallium-201 myocardial imaging was also performed within 1 wk after [123I]MIBG imaging. RESULTS: Images obtained with these techniques were analyzed for the RV-to-LV uptake ratio. The IVS-to-LV ratio on [123I]MIBG correlated negatively and significantly with the mean pulmonary arterial pressure (PAm). The RV-to-LV uptake ratio on 201Tl images correlated significantly with PAm. CONCLUSION: Our results suggest that the uptake ratio of [123I]MIBG in the IVS is a useful index for evaluating the severity of pulmonary hypertension, and that chronic RV pressure overload contributes to disturbances of the cardiac sympathetic nervous system.

3-Iodobenzylguanidine↗
PubMed1996

[Left ventricular rupture following aortic and mitral valve replacement in a patient with osteogenesis imperfecta: a case report].

Intraoperative left ventricular rupture (type I) occurred following aortic and mitral valve replacement in 62-year-old man with osteogenesis imperfecta. Re-replacement of the mitral valve and the repair of left ventricular rupture were successfully performed. However, the patient died suddenly 3 days after the operation. Retroperitoneal bleeding due to the insertion of a continuous hemofiltration catheter via the femoral vein was detected at autopsy. Seven patients who underwent double valve replacements for aortic and mitral disease with osteogenesis imperfecta were reported with poor surgical results. We report our patient and discuss the relationship between osteogenesis imperfecta and left ventricular rupture.

Aortic Valve↗
PubMed1995

A eukaryotic gene encoding an endonuclease that specifically repairs DNA damaged by ultraviolet light.

Many eukaryotic organisms, including humans, remove ultraviolet (UV) damage from their genomes by the nucleotide excision repair pathway, which requires more than 10 separate protein factors. However, no nucleotide excision repair pathway has been found in the filamentous fungus Neurospora crassa. We have isolated a new eukaryotic DNA repair gene from N.crassa by its ability to complement UV-sensitive Escherichia coli cells. The gene is altered in a N.crassa mus-18 mutant and responsible for the exclusive sensitivity to UV of the mutant. Introduction of the wild-type mus-18 gene complements not only the mus-18 DNA repair defect of N.crassa, but also confers UV-resistance on various DNA repair-deficient mutants of Saccharomyces cerevisiae and a human xeroderma pigmentosum cell line. The cDNA encodes a protein of 74 kDa with no sequence similarity to other known repair enzymes. Recombinant mus-18 protein was purified from E.coli and found to be an endonuclease for UV-irradiated DNA. Both cyclobutane pyrimidine dimers and (6-4)photoproducts are cleaved at the sites immediately 5' to the damaged dipyrimidines in a magnesium-dependent, ATP-independent reaction. This mechanism, requiring a single polypeptide designated UV-induced dimer endonuclease for incision, is a substitute for the role of nucleotide excision repair of UV damage in N.crassa.

Amino Acid Sequence↗
PubMed1995

Exhaled nitric oxide in isolated pig lungs.

Endothelium-derived nitric oxide (NO) is an important regulator of vascular resistance. Low concentrations of NO have been recorded in the exhaled breath of spontaneously breathing animals and humans. To determine whether NO synthesis in the lung contributes to the NO measured in the breath, we measured the concentration of NO in the exhaled air of isolated perfused and ventilated porcine lungs by using a chemiluminescence method. With NO-free normoxic ventilation (21% O2-5% CO2-74% N2) of eight porcine lungs perfused with a Krebs-dextran and albumin perfusate, baseline exhaled NO was 5.8 +/- 1.8 parts per billion (ppb) and pulmonary vascular resistance (PVR) was 8.9 +/- 1.8 mmHg.l-1.min. Hypoxic ventilation (5% O2-5% CO2-90% N2) caused a fall in NO to 3.6 +/- 1.8 ppb and a rise in PVR to 13.6 +/- 3.6 mmHg.l-1.min. Vasoconstriction with the thromboxane analogue U-46619 (10(-9) M) raised PVR to 31.7 +/- 6.8 mmHg.l-1.min but did not decrease NO levels from baseline. Subsequent addition of acetylcholine (10(-6)M) lowered PVR to 22.1 +/- 4.5 mmHg.l-1.min and increased exhaled NO to 7.0 +/- 2.0 ppb. Addition of a NO synthase inhibitor, NG-nitro-L-arginine methyl ester (10(-5) M), to four lungs caused a rise in PVR to 43.0 +/- 7.0 mmHg.l-1.min and a decrease in NO to 1.5 +/- 1.0 ppb. Addition of autologous blood to the perfusate of four lungs caused no change in PVR from baseline but decreased exhaled NO to 2.7 +/- 0.5 ppb.(ABSTRACT TRUNCATED AT 250 WORDS)

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1995

Relationship of cigarette smoking to the severity of coronary and thoracic aortic atherosclerosis.

We studied the relationship of cigarette smoking to the severity of coronary and thoracic aortic atherosclerosis in 116 men who received coronary angiography and transesophageal echocardiography. Severity of coronary atherosclerosis was assessed in terms of Gensini's score (GS), and that of thoracic aortic atherosclerosis was assessed by the average sclerotic length (ASL) and average sclerotic area (ASA). The plasma fibrinogen levels were significantly positively correlated with smoking, and fasting blood sugar levels tended to be positively associated with smoking. GS was inversely associated with serum levels of high density lipoprotein (HDL) cholesterol. ASL and ASA were positively associated with age, fasting blood sugar levels and plasma fibrinogen levels, and these associations were statistically significant. Analysis of covariance was used to examine the net association between cigarette smoking and GS, ASL or ASA controlling for age, total cholesterol, HDL cholesterol, fasting blood sugar and plasma fibrinogen. We found that GS, ASL, and ASA were all significantly increased with increasing number of cigarette years. Additional adjustment for other risk factors (triglyceride, uric acid, body mass index, alcohol use and hypertension) also showed a strong independent contribution of smoking to GS, ASL and ASA. We concluded that the cumulative exposure to cigarette smoking was an independent indicator of the severity of coronary atherosclerosis as well as thoracic aortic atherosclerosis.

Adult↗
PubMed1995

[Erythroblastic transformation of chronic myelogenous leukemia associated with an additional chromosome abnormality translocation (6;9].

A 57-year-old female was diagnosed being in the blastic phase of chronic myelogenous leukemia (CML) on her second admission in May 1993. The patient was previously treated with vincristine and prednisolone in the accelerated phase of CML in December 1991 without improvement. Other chemotherapeutic agents such as BHAC-DMP (enocitabine, daunorubicin, mercaptopurine, prednisolone), interferon, mercaptopurine and ranimustine were also administered. After the second chronic phase was achieved, she was treated with busulfan as an outpatient. On her second admission, the diagnosis of erythroblastic transformation was made, and cytogenetic study revealed t(9;22) (q34;q11) with the additional chromosomal abnormalities, t(6;9) (p23;q34). This karyotype rearrangement has been reported neither in Ph-positive CML nor in blastic crisis.

Blast Crisis↗
PubMed1994

A new class of DNA photolyases present in various organisms including aplacental mammals.

DNA photolyase specifically repairs UV light-induced cyclobutane-type pyrimidine dimers in DNA through a light-dependent reaction mechanism. We have obtained photolyase genes from Drosophila melanogaster (fruit fly), Oryzias latipes (killifish) and the marsupial Potorous tridactylis (rat kangaroo), the first photolyase gene cloned from a mammalian species. The deduced amino acid sequences of these higher eukaryote genes show only limited homology with microbial photolyase genes. Together with the previously cloned Carassius auratus (goldfish) gene they form a separate group of photolyase genes. A new classification for photolyases comprising two distantly related groups is proposed. For functional analysis P.tridactylis photolyase was expressed and purified as glutathione S-transferase fusion protein from Escherichia coli cells. The biologically active protein contained FAD as light-absorbing cofactor, a property in common with the microbial class photolyases. Furthermore, we found in the archaebacterium Methanobacterium thermoautotrophicum a gene similar to the higher eukaryote photolyase genes, but we could not obtain evidence for the presence of a homologous gene in the human genome. Our results suggest a divergence of photolyase genes in early evolution.

Amino Acid Sequence↗
PubMed1994

The pulmonary vascular response to acute hypoxia in chronic pulmonary disease: morphological assessment with magnified pulmonary wedge angiography.

To detect hypoxic pulmonary vasoconstriction (HPV) morphologically, we investigated the pulmonary vascular response to acute hypoxia in 27 patients with chronic pulmonary disease (CPD) and 8 healthy subjects. Pulmonary hemodynamic measurements and magnified pulmonary wedge angiography (MPWA) were carried out before and after inhalation of 13% oxygen in nitrogen for 15 min. The diameters of central arteries (A) and muscular arteries (B) were measured using a densitometric method. Vasoconstriction was detected in the muscular arteries than in the central arteries by MPWA. There was a significant correlation between delta P (changes of mean PA pressure) and delta B/A (changes in diameters of B/A) in the CPD group. A significant correlation was found between delta SvO2 and delta B/A in the control group. We conclude that MPWA was a very useful method for the simple detection of HPV in patients with CPDs and we detected one site of HPV on the ninth generation of the pulmonary arterial tree by MPWA.

Adult↗
PubMed1994

Descending necrotizing mediastinitis secondary to a retropharyngeal abscess.

A rare case of descending necrotizing mediastinitis (DNM) secondary to a nontraumatic retropharyngeal abscess is reported. Even in the era of antibiotics, the mortality of DNM is still around 40%. In spite of drainage of a localized neck abscess, and the administration of systemic antibiotics, the retropharyngeal abscess extended to the pericardial and pleural cavities. Several drainage procedures and thoracotomies were performed to treat the bilateral empyemas and purulent pericarditis. The patient was discharged on hospital day 52. Computed tomography was used to follow the progression of disease, and assess the efficacy of treatment. DNM is a very aggressive form of mediastinitis. The importance of proper mediastinal drainage, as well as the systemic administration of antibiotics, must be emphasized.

Candidiasis↗
PubMed1994

[HTLV-1 associated myelopathy (HAM) with severe orthostatic hypotension--a case report].

We present a case of HAM with severe orthostatic hypotension. A 62-year-old woman was admitted to Mito Red Cross Hospital because of orthostatic dizziness and severe gait disturbance. Physical examination revealed a severe orthostatic hypotension (142/90 mmHg (supine) vs. 84/70 mmHg (standing)). Neurological examination revealed weakness and hyperreflexia in the lower extremities, as well as extensor plantar response and spastic gait. In tests of autonomic nervous system, there was no reflex bradycardia in Aschner eye ball pressure test and carotial sinus reflex, no overshoot in Valsalva test, and electrocardiogram revealed a low value in CVR-R. The imprint techniques under 1% pilocarpine subcutaneous administration revealed a marked disturbance of sudomotor function. Blood cell counts, blood chemistry and urinalysis were unremarkable. The serological examination revealed a high titer value of anti-HTLV-1 antibody. Anti-HTLV-1 antibody and oligoclonal IgG band were detected in the cerebrospinal fluid. Magnetic resonance imaging (MRI) of the cerebrum demonstrated multiple small high intensity areas in the white matter, but these lesions showed no gadolinium enhancement. Since the test of the autonomic nervous system revealed both sympathetic and parasympathetic disturbance, it is important to investigate the autonomic disturbance including orthostatic hypotension in cases of HAM.

Female↗