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Biomedical subjects

M Takayama

Publications and source records attributed to M Takayama.

At least 163 records · Page 9Linked to original sources

Chemical stimulation of the nucleus locus coeruleus: cardiovascular responses and baroreflex modification.

Microinjection of glutamate (Glu, 2.5 nmol) or homocysteic acid (HA, 0.1-0.5 nmol) into the nucleus locus coeruleus (LC) decreased both blood pressure and heart rate. These microinjections also produced a facilitatory or occlusive effect on depressor and bradycardiac responses evoked by electrical stimulation of the aortic depressor nerve (ADN). Destruction of the nucleus tractus solitarius (NTS), which totally eliminated ADN-evoked responses, had no effect on the cardiovascular responses evoked by LC stimulation. These results suggest that the neuronal populations that contribute to the LC-induced cardiovascular responses overlap at least partly with the baroreflex substrate other than the NTS.

Animals↗

Thrombosis-inducing activity--a factor which appears in plasma of patients with allergic asthma during attack.

Thrombosis-inducing activity (TIA) is a factor which was recently identified in plasma from patients with advanced lung cancer and acute respiratory tract infection. In the present study, TIA was measured during periods of attack and nonattack in patients with the allergic and nonallergic type of asthma and pulmonary emphysema with an asthmatic component. In the allergic type of asthma, the attack was accompanied by the appearance of TIA, but when the attack ended it disappeared from plasma. In the nonallergic type of asthma and emphysema with an asthmatic component, TIA remained negative even during the attack. These observations indicate that TIA has some correlations with allergic asthma.

Adult↗

[Endolotherapy of massive bleeding from the small intestinal angiodysplasia in 80-year-old patient].

Angiodysplasia is one cause of chronic gastrointestinal tract bleeding that can not be difficult to detect. In particular, angiodysplasia in the small intestine is very rare and has seldom been reported. An 80-year-old man complained of hematochezia and was admitted to other hospital on October 1991. However, no bleeding sites in the gastrointestinal tract could be revealed by radiographic and endoscopic examinations. After 8 months, he was admitted to our hospital with the same symptom on June 1992. He suffered hemorrhagic shock due to continuous bleeding. Hypotension and anemia progressed in spite of immediate blood transfusion. Emergency angiography revealed extravasation from a peripheral branch of the jejunal artery, in addition tortuous and dilated ileal arteries. Embolization was performed with the catheter inserted superselectively into the nearest arcade of the segmental branch of the vasa recta. After embolization, no complications were occurred. He was discharged and is being followed up as an outpatient.

Aged↗

[Effect of rG-CSF on the morphology and function of neutrophils in ovarian cancer chemotherapy].

The combined use of rG-CSF in ovarian cancer chemotherapy prevents a decrease in the number of neutrophils and promotes their recovery. rG-CSF also protects against infections, enhancing chemotherapeutic effectiveness. It is reported that neutrophils produced by rG-CSF not only increase in number but also in function. Some clinicians, however, doubt whether neutrophils mobilized or produced by rG-CSF have sufficient ability to function practically in clinical cases. We therefore examined, by means of flow cytometry, the neutrophils' phagocytosis and bactericidal ability and we found both normal. No morphological abnormalities were seen in these neutrophils. In our observations, moreover, no effect was exerted on the leukocyte-membrane antigen. It was concluded that (a) rG-CSF was very effective in protecting against the diminution of neutrophils by chemotherapy and (b) in promoting their recovery, and (c) also the function, morphology and leukocyte-membrane antigen of these neutrophils were normal.

Adolescent↗

[A case uterine cervical squamous cell carcinoma successfully treated with preoperative carboplatin-based 5-drug-combined intraarterial infusion chemotherapy].

Preoperative 5-drug-combined intraarterial infusion chemotherapy using carboplatin as a main component was performed in a case of uterine cervical squamous cell carcinoma of Stage IIa. The regimen employed was as follows: carboplatin (100 mg/m2) on Day 4 and 5, vincristine (0.6 mg/m2) on Day 1, peplomycin (5 mg/body) on Day 1, 2, and 3, methotrexate (5 mg/m2) on Day 2 and 3, and doxorubicin (15 mg/m2) on Day 4. These drugs were administered into the right inguinal region through a residual catheter at 3-week intervals prior to operation. After completion of 3 courses, the patient achieved a CR confirmed by pathological analysis and diagnostic imaging followed by extended radical hysterectomy. Side effects observed, especially renal disturbance and myelosuppression, were all tolerable. Intraarterial infusion chemotherapy using carboplatin was thus suggested to be useful against malignant tumors in the gynecological field.

Antineoplastic Combined Chemotherapy Protocols↗

[Concomitant intraperitoneal therapy with the antitumor polysaccharide Sizofiran and rG-CSF for ovarian cancer].

The concomitant administration of Sizofiran (a macrophage activator) and rG-CSF (which promotes neutrophil proliferation and activation) caused marked activation of intraperitoneal antitumor immunity. It promoted the induction of IL-2 receptor expression as well as the proliferation and activation of neutrophils, and also caused an increase in LAK and NK activity, which resulted in a clinical antitumor effect. Therefore, this concomitant regimen was found to be useful as maintenance therapy for ovarian cancer.

Drug Administration Schedule↗

[Percutaneous transluminal angioplasty of dialysis access shunts].

Sixteen balloon angioplasties were performed in 10 patients with upper-extremity dialysis access shunts. The initial success rate was 80% (12/15). Of the initial successes, 58% (7/12) were patent at six months and 13% (1/8) at one year. In nine cases, repeat PTA was necessary. The mean interval of patency was about four months. The longest interval was two and a half years. The complication of thrombosis of the loop shunt during PTA was successfully treated by fibrinolytic therapy.

Adult↗

Reduced synthesis of tissue plasminogen activator by vascular endothelium during acute myocardial infarction.

We measured levels of tissue plasminogen activator (t-PA) antigen in 100 patients within six hours of the onset of acute myocardial infarction, in 34 patients with chronic angina but no recent infarction, and in 36 normal subjects. We also assayed von Willebrand factor in the acute patients and in the normal subjects. Measurements were repeated in 40 acute patients at three weeks after myocardial infarction. Although resting levels of t-PA antigen were not significantly different from normal during myocardial infarction, the capacity of the vascular endothelium to release t-PA after five minutes of venous occlusion was impaired (p less than 0.01). The acute phase vessel wall release of von Willebrand factor was increased during acute infarction (p less than 0.01). We conclude that impairment of t-PA production is associated with acute coronary thrombosis, although it is not possible to differentiate between a causative role or a secondary response due to exhaustion of the t-PA producing mechanism.

Adult↗

[Clinical varicella-zoster virus reinfection observed in two advanced-age persons].

We observed two mild varicella cases of an advanced-age man and woman, although varicella in the adult generally presents a more severe course than in the child. The cases had been exposed to his great-grandchild and her grandchild with varicella in their home. They did not experience neuralgia as is typical from herpes zoster. Serological examinations revealed that they had high IgG-antibodies (Ab) against varicella-zoster virus (VZV), but low anti-VZV IgM-Ab. They were also found to have a high level of Ab against VZV soluble antigens (Ag) which are generally low in primary VZV infection. Immunoblotting analysis of anti-VZV IgG-Abs using sera from case 1 or 2 showed that their reaction patterns resembled those of sera children who contracted mild varicella after immunization with varicella vaccine and a herpes zoster-patient rather than those of sera from an immunocompetent adult with varicella. These results of serological examinations and their clinical course indicated that the cases had contracted varicella in the past and were again exposed to VZV resulting in clinically overt but mild varicella.

Aged↗

Two cases of variant form angina pectoris associated with myocardial bridge--a possible relationship among coronary vasospasm, atherosclerosis and myocardial bridge.

Myocardial bridge (MB) is a congenital anomaly of the coronary artery and may occur in 5 to 12% of the human population. However, the mechanism of MB-induced myocardial ischemia is still speculative. We report 2 cases of variant form angina pectoris associated with MB in which myocardial ischemia seemed to be related to the interaction between coronary perfusion and MB. In case 1, electrocardiography during anginal attack at rest showed ST elevation in the inferior leads and MB was observed after percutaneous transluminal coronary angioplasty at the site of the right coronary artery lesion following successful dilatation. In case 2, MB of the left anterior descending coronary was located in the identical portion where coronary vasospasm was induced by intracoronary acetylcholine injection, although ischemia during the spontaneous anginal attack was limited to the inferior area of myocardium. These 2 cases suggest that MB can be, at least in some patients, one of the possible causes of the endothelial damage which seems to be related to coronary vasospasm; this was documented in both cases.

Angina Pectoris, Variant↗

[Clinical usefulness of benzoate tolerance test in patients with liver cirrhosis].

The capacity of the liver to metabolize intravenously loaded benzoic acid to hippuric acid was examined in 7 healthy adults and 18 patients with liver cirrhosis. Blood samples were withdrawn at 5 to 120 min after infusion of benzoic acid (15 mg/Kg), and then serum was obtained to determine the contents of the fatty acids by HPLC as well as to examine several pharmacokinetic parameters under a two-compartment model program. The urinary samples were collected at 60 min after the infusion. In the serum of the patient group, the maximum concentration (Cmax) and area under the concentration curve from zero time to the infinity (AUC) for benzoic acid remained in the normal range, but the mean transit time(MRT) and half-life time(T1/2) were significantly delayed. In serum of the patient group, the AUC for hippuric acid was hardly reduced but the Cmax was significantly reduced. Moreover, MRT, T1/2 and time to reach Cmax(Tmax) were significantly delayed. In urine at 60 min after the loading, benzoic acid was below the limit of detection and was recovered as hippuric acid with a recovery rate of 70% in the healthy adult group and 40% in the patient group.

Adult↗

[Immunohistochemical study on keratin of squamous cell carcinoma of the uterine cervix].

An immunohistochemical study of squamous metaplasia (n = 10), dysplasia (n = 18), squamous cell carcinoma (n = 48) and 3 cases of adenosquamous carcinoma of the uterine cervix with anti-56KD keratin and 68KD keratin antibodies was performed. In the cases of squamous metaplasia, there were two types of staining of which one type had 56KD positive and 68KD negative and another type had both positive. In the cases of dysplasia, there were two types of staining the same as in squamous metaplasia. But in the cases of carcinoma in situ (CIS) (n = 25), there were three types of staining of which the first type had both 56KD and 68KD negative (n = 7), the second type had 56KD positive and 68KD negative (n = 15), and the third type had both 56KD and 68KD positive (n = 3). In invasive carcinoma (n = 23), there were two types of staining the same as in dysplasia of which one type had 56KD positive and 68KD negative (n = 17) and another type had both positive (n = 6). The keratin negative cases in CIS showed morphologically atypical reserve cell hyperplasia composed of atypical small cells with round nuclei and had a small lesion compared with other types. This result suggested that keratin negative CIS was an early form of CIS which was keratin positive. The results indicating that all dysplasia had 56KD keratin positive and CIS had not always 56KD keratin positive suggested that dysplasia was not always a precursor lesion of CIS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Clinical significance of benzoate-metabolizing capacity in patients with chronic liver disease: pharmacokinetic analysis.

Benzoate-metabolizing capacity was studied in control subjects and in liver disease patients after intra-venous loading of 15 mg benzoate per kg of body weight. In the 7 control subjects, the mean level (+/- SEM) of Cmax for serum benzoate was 104.1 +/- 6.8 micrograms/ml, AUC was 2.57 +/- 0.32 mg.min/ml, MRT was 21.5 +/- 1.5 min and T1/2 was 15.5 +/- 1.3 min. For serum hippurate, on the other hand, Tmax was 27.9 +/- 6.0 min, Cmax was 33.4 +/- 2.1 micrograms/ml, AUC was 1.96 +/- 0.13 mg.min/ml, MRT was 39.6 +/- 2.9 min and T1/2 was 30.7 +/- 2.4 min. In 12 patients with chronic hepatitis, Cmax, AUC, MRT and T1/2 for benzoate and Tmax, MRT and T1/2 for hippurate remained at control levels, but Cmax and AUC for hippurate were slightly decreased compared to controls. However, in 18 patients with liver cirrhosis, Cmax and AUC for benzoate were in the control range but MRT and T1/2 were significantly delayed (p less than 0.01 for both). Moreover, the MRT value was increased in proportion to the severity of liver disease (p less than 0.01). AUC for hippurate was not changed to any extent, and Tmax, MRT and T1/2 were slightly delayed, while Cmax was significantly reduced. AUC, MRT and T1/2 for benzoate and Tmax, MRT and T1/2 for hippurate showed significant correlation with serum albumin levels, prothrombin time and indocyanine green clearance rate. These results suggest that benzoate-metabolizing capacity, especially as indicated by the MRT value for serum benzoate, appears to be a better index than the indocyanine green clearance rate for determining hepatic functional reserve in chronic liver disease.

Adult↗

[Fracture of percutaneously inserted IVC filters--two cases of Günther's filter].

During the period from 1988 to 1990, percutaneous insertion of Günther vena caval filters were performed in ten patients in our institution. In two of them, fracture and partial migration of anchoring limbs were observed. Günthter's filter is an attractive device for interventional radiologist because of its technical ease of percutaneous placement and relative stability within the vein. However, our experience suggests that this device is not entirely safe and reliable. The patients should be carefully followed up with a possibility of distal migration in mind. Further structural improvement seems necessary.

Adult↗