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Biomedical subjects

M Takeda

Publications and source records attributed to M Takeda.

At least 505 records · Page 28Linked to original sources

External and interstitial radiotherapy in the treatment of oropharyngeal squamous cell carcinoma.

The records of 165 patients with squamous cell carcinoma of the oropharynx treated at our hospital with external and/or interstitial radiotherapy between 1971 and 1990 were reviewed to evaluate the treatment results, focusing on primary control and complications. All cancers were restaged according to the UICC 1987 TNM staging system. Of these 165 patients, 11% were in Stage I, 55% in Stage II, 24% in Stage III and 8.5% in Stage IV. Local control and complications were analysed in 140 patients. The remaining 25 patients died of intercurrent or metastatic disease during the first 2 years following treatment and were excluded from the analysis. 70 patients were treated by interstitial implant using permanent implant seeds (Rn-222 in eight patients, Au-198 in 62 patients) with or without external radiation. 56 other patients received external irradiation alone and another 14 patients received pre-operative external irradiation plus surgery. 2-year recurrence-free rates were 73% (100% for T1, 76% for T2, 36% for T3 tumours) in the patients who received interstitial implant with or without external radiation and 36% (67% for T1, 48% for T2, 13% for T3 tumours) in the patients treated by external irradiation alone. The incidence of soft-tissue or bone complications requiring long-term treatment was 14%. Based on these findings, it is believed that an interstitial implant using Au-198 grains combined with external beam irradiation is a useful treatment modality for small lesions of the oropharynx.

Adult↗

Adjustments of cardiac function during prolonged exercise relative to lactate threshold.

Alterations in cardiac function during prolonged submaximal exercise relative to lactate threshold (LT) were evaluated on 7 normal healthy males aged 30.3 +/- 5.7 years. Systolic time intervals were analyzed through simultaneous recordings of electrocardiogram, phonocardiogram, and impedance cardiogram at a paper speed of 50 mm/s. Determination of stroke volume (SV) was based upon the method described by Kubicek et al. ANOVA followed by the Scheffe post-hoc comparison revealed that SV and myocardial contractility indices (MSER and PEP/LVET) remained relatively unchanged throughout 40-min cycling exercise, although the changes in heart rate and oxygen uptake were statistically significant. In addition, systolic blood pressure remained almost unchanged during the exercise. These results may be interpreted as evidence of the "contractility reserve", i.e., the ability of maintaining heart muscle contractility during prolonged exercise at LT intensity.

Adult↗

Intravenous reproductive and developmental toxicity studies of cimadronate (YM175), a novel bisphosphonate, in rats and rabbits.

Cimadronate (YM175) is a novel bisphosphonate with potent inhibitory activity on bone resorption under development for the treatment of tumor-induced hypercalcemia, metastatic bone disease and osteoporosis. We conducted intravenous reproductive toxicity and teratology studies (Segment I, II and III) of this compound in rats and teratology study in rabbits. The test compound was dissolved in physiological saline, which was also given as the vehicle control. Rats were administered at a dosage of 0.06, 0.16 and 0.62 mg/kg/day in the male Segment I study. Dose levels in the other studies in rats including the female Segment I were 0.16, 0.31 and 0.62 mg/kg/day. In the Segment I study, no treatment-related abnormalities were observed in reproductive parameters or fetuses. In the Segment II study, slightly retarded fetal ossification was noted at 0.31 mg/kg/day or more, but the incidence of malformation did not increase. In the Segment III study, death of the dams and abnormal tooth growth of offspring were observed at 0.16 mg/kg/day or more. Further Segment III study showed that the no toxic effect level was 0.003 mg/kg/day. In the rabbit teratology study, dose levels were 0.01, 0.025 or 0.05 mg/kg/day. No toxic effects on pregnant females or their litters were observed at up to 0.05 mg/kg/day.

Abnormalities, Drug-Induced↗

Immunoblastic lymphadenopathy-like T-cell lymphoma displaying rearrangement of both IgH and TCR beta genes after 4-year follow-up of idiopathic eosinophilia.

Immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma (IBL-T) occurred in a 60-year-old female after a 4-year follow-up of idiopathic eosinophilia and upper pharyngeal inflammatory tumor with infiltration of mature eosinophils. Gene analysis of tumor cells revealed rearrangement of both IgH and TCR beta genes. The patient died of lymphoma seven months after the onset of the illness, in spite of chemotherapy against lymphoma. The relationship between eosinophilia and the pathogenesis of IBL-T, as well as the significance of the rearrangement of both IgH and TCR beta genes are discussed.

Eosinophilia↗

Squamous cell carcinoma of the oral cavity: MR findings and value of T1-versus T2-weighted fast spin-echo images.

OBJECTIVE: The purposes of this study were to describe the characteristics of squamous cell carcinomas of the oral cavity on unenhanced and contrast-enhanced T1-weighted spin-echo (SE) MR images and unenhanced T2-weighted fast spin-echo (FSE) MR images and to determine which sequences best delineate the margins and extent of the tumors. MATERIALS AND METHODS: Forty-four patients with proved squamous cell carcinoma of the oral cavity (tongue, 24; floor of mouth, seven; buccal mucosa, four; maxillary gingiva, two; and mandibular gingiva, seven) underwent unenhanced axial T2-weighted FSE MR imaging and unenhanced and enhanced axial and coronal T1-weighted SE MR imaging. The appearance, signal characteristics, and extent of the tumors were assessed, and the delineation of tumor margins with each sequence or combination of sequences was evaluated by use of a grading system ranging from 1 (poor) to 3 (excellent). Three patients were excluded because of artifacts on the MR images caused by dental restorations. RESULTS: Tumors in all 41 patients were depicted on unenhanced T1-weighted SE images, but in four patients, tumors were not visible on T2-weighted FSE images. Except for tumors that invaded the maxillary gingiva, the tumors generally had homogeneous, low signal intensity on unenhanced T1-weighted images and nonhomogeneous, high signal intensity on T2-weighted FSE images. All tumors showed enhancement, 76% with a nonhomogeneous appearance. The delineation of tumor margins was excellent (grade 3) in 31 cases and fair (grade 2) in 10 cases. The highest rating was given for unenhanced T1-weighted images in 10 cases, for contrast-enhanced T1-weighted images in 10 cases, for the combination of both unenhanced and contrast-enhanced T1-weighted images in 18 cases, for the combination of unenhanced T1-weighted and T2-weighted FSE images in five cases, and for T2-weighted FSE images in one case. In three cases, the highest rating was given for both combinations of pulse sequences. CONCLUSION: An unenhanced T1-weighted sequence should be used as the basic pulse sequence for MR imaging of tumors of the oral cavity. When tumor margins are not clearly delineated with this sequence, T2-weighted FSE and contrast-enhanced T1-weighted sequences should be added. Although both of these sequences provide supplementary information, the contrast-enhanced T1-weighted sequence is more useful in delineating the margins and extent of tumors than is the T2-weighted FSE sequence.

Adult↗

[Familial Alzheimer's disease in Japanese population].

We ascertained 56 related cases with early onset familial Alzheimer's disease (EOFAD; mean age of onset < 65 years) and 10 related cases with late onset familial Alzheimer's disease (LOFAD; mean age of onset > or = 65 years) through a questionnaire administered to neuro-psychiatric and medical school hospitals in Japan and through a review of cases in Japanese literature. Mean age of onset and death (+/- S.D.) of EOFAD were 43.4 +/- 8.6 years (n = 94) and 51.1 +/- 10.5 years (n = 85), respectively. Distributions of the age-onset were relatively constant within a family but significantly different between families. Our result may suggest that clinical differences between families represent genetic heterogeneity at the molecular level. Six out of 32 related cases of with EOFAD showed the 717 Val-->Ile mutation of beta/A4 amyloid precursor protein (APP) gene. This result suggests that the frequency of this mutation in Japanese population is higher than in Caucasian and allelic the existenced heterogeneity, in Japanese EOFAD.

Adult↗

[Clinical analysis on 40 cases of primary aldosteronism--long-term follow-up of blood pressure].

Forty cases of primary aldosteronism after adrenalectomy were observed from 1975 to 1993 at Yokohama City University hospital. All of them had adrenocortical adenoma producing aldosterone. These cases are evaluated retrospectively on localization, surgical approach and long term follow up blood pressure. These patients were from 26 to 65 years old (average 46.6), and consisted of 11 males and 29 females. Fourteen adenomas were located on the right adrenal gland, 25 on left, and one case had adenomas on bilateral adrenal glands. On localization study, 39 cases had been correctly diagnosed by combined diagnostic method of selective adrenal venous sampling, selective adrenal venography, adrenal scintigraphy, X-ray CT, and MRI, with each diagnostic values being 65.8%, 69.0%, 72.5%, 96.9%, 100% respectively. This analysis suggests that, in almost cases, it is enough to diagnose the laterality by adrenal scintigraphy, X-ray CT and MRI. Selective venous catheterization is not always necessary to know the laterality of the tumor. For surgical approach to the adrenal gland, 16 adenomas were removed through anterior subcostal incision (transabdominal approach) from 1975 to 1988, and 24 cases through lumbar oblique incision or dorsal incision (extra peritoneal approach) from 1986 to 1993. This analysis reveals that lumbar oblique and dorsal incision provided us superior surgical approach to the adrenal gland. Thirty-eight cases had been followed after adrenalectomy for more than one year (average 57.6 months). Blood pressure had been normalized in 28 cases, but 10 cases had remained hypertensive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

[Giant schwannoma in the pelvic cavity presenting as renal failure: a case report].

A case of giant schwannoma in the pelvic cavity detected with renal failure is reported. A 50-year-old man was referred to another clinic with chief complaints of general fatigue and edema of the face and dorsa of the feet. On March the 4th 1994, he was hospitalized in the clinic because of renal failure. Bilateral hydronephrosis and a giant pelvic tumor were found by computed tomography (CT) and ultrasonography. Because bilateral percutaneous nephrostomies failed to recover his renal function, he was referred to our clinic for the purpose of hemodialysis and the further examination of the tumor on March 16, 1994. The pelvic angiography showed that the tumor was fed by the vessel from the left internal iliac artery. After the chemo-embolization from the feeding artery, tumor resection was performed on May 9, 1994. The tumor was 16x13x10 cm in size, and 1,110 g in weight. The histological findings of the tumor revealed the mixed type schwannoma of Antoni A and B. Six months after the operation, he has had no tumor recurrence. This is a rare case of pelvic schwannoma which was detected with renal failure. We reviewed and discussed 56 cases of schwannoma in the pelvic cavity, including our case, in the Japanese literature.

Humans↗

[Recurrence of transitional cell carcinoma in bilateral upper urinary tracts and ileal conduit with invasion in the abdominal wall around nephrostomy after total cystectomy: a case report].

A case of recurrence of transitional cell carcinoma in bilateral upper urinary tracts and ileal conduit with invasion in the abdominal wall around nephrostomy after total cystectomy is presented. A 33-year-old man with right nephrostomy, after total cystectomy, construction of ileal conduit, bilateral partial ureterectomy and left nephrectomy for transitional cell carcinoma at another hospital was referred to our hospital because of further recurrence in the right renal pelvis and ileal conduit. He had had left nephrostomy before the left nephrectomy was performed. Right nephrectomy and total extirpation of ileal conduit were performed and hemodialysis was started from the day after the operation. However, several weeks later, transitional cell carcinoma was detected pathologically in the left abdominal wall around the left nephrostomy which had been inserted. The renal pelvis was inferred to have leaked urine around the nephrostomy and invasion arose in this region. After radiation therapy he was discharged but he died from recurrence of carcinoma 9 months after the operation. After total cystectomy, examinations by percutaneous puncture of the renal pelvis are very effective for evidence of recurrence in the upper urinary tract. However, we emphasize that the percutaneous technique carries the risk of tumor invasion through the percutaneous urinary tract.

Abdominal Muscles↗

[A case of chronic eosinophilic pneumonia involving IL-5 and GM-CSF].

A 57-year-old woman was admitted because of dry cough and middle-grade fever. Chest rentogenogram showed a diffuse infiltrative shadow in the right middle and lower lung fields. The symptoms disappeared after treatment with minocycline, but a new dense shadow appeared in the right upper and middle lung fields. Eosinophilic pneumonia was diagnosed from the results of bronchoalveolar lavage and transbronchial lung biopsy. The symptoms were alleviated and the infiltrative shadow was effaced after treatment with predonisolone (40 mg/day). The results of a biopsy with human eosinophils suggested that the serum and bronchoalveolar lavage fluid contained IL-5 and GM-CSF.

Bronchoalveolar Lavage Fluid↗

[Intrascrotal fibrous pseudotumor accompanied by pelvic kidney with ectopic ureteral opening: a case report].

A case of intrascrotal fibrous pseudotumor accompanied by pelvic kidney with ectopic ureteral opening is reported. The patient was a 65-year-old man with the complaint of swelling of the right scrotal contents. Ultrasonography showed a heterogeneous mass with acoustic shadow from the right epididymis to right spermatic cord. Intravenous pyelography revealed a non-visualizing right kidney. Endoscopic examination was performed because of the right non-functioning kidney and right epididymectomy was performed. Endoscopic findings showed that the ureteral opening existed at 6 degrees of the bladder neck. Retrograde pyelography demonstrated the right kidney in the pelvic cavity. The tumor was stony hard and 30 x 50 mm in size. Pathological diagnosis of the tumor was a fibrous pseudotumor. We reviewed and discussed 22 cases of fibrous pseudotumor, including our case, in the Japanese literature.

Aged↗

[Studies on distortion of the optic nerve by the internal carotid artery].

The optic nerve (ON) is sometimes distorted by an atherosclerotic internal carotid artery (IC) which we observe during operations. However the distortion seldom causes visual dysfunction. In this paper, 102 nonoperative cases without severe visual disturbance or marked effect on the visual system were studied, using coronal section of MRI and IC angiography, to ascertion ON distortion by IC. The grading of the distortion was determined by coronal section of MRI. Grade (Gr) 0: No distortion of ON, Gr 1: Distortion of ON without chiasmal dislocation, Gr 2: Distortion of ON with chiasmal dislocation. The rate of Gr 0, Gr 1, and Gr 2 were 62.7, 21.6 and 15.7%, respectively. The age of Gr 0, Gr 1 and Gr 2 were 55.4 +/- 19.6, 63.5 +/- 14.7 and 68.9 +/- 5.0 years old, respectively (Gr 2 was different from Gr 0). The occupying rate was calculated by the following formula. The areas were measured by IC angiography of the optic canal: The area of IC in optic canal/The area of optic anal x 100%. The rate of Gr 0, Gr 1 and Gr 2 were 24.2 +/- 19.8, 76.3 +/- 13.2 and 62.0 +/- 28.2%, respectively (Gr 1 and 2 differed from Gr 0). With a rate of more than 70%, the patient had ON distortion by IC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Distribution of free amino acids and related compounds in ocular fluids of rat--I. Aging and inherited cataracts].

The distribution of free amino acids and their related compounds has been determined in the aqueous humors of Wistar strain and Ihara cataract f-strain (ICR) aging rats. Taurine was the most abundant amino acid in aqueous humors except in ICR rats of 16 and 70 weeks. It was supposed that the increase of serine and glutamine, and the decrease of aspartate, proline and glycine in aqueous humors were related to aging. There were interesting changes in amino acids related to opacity of lens, concentration of taurine was lower than that of Wistar rats in ICR rats of 4, 16, and 70 weeks, alanine and citrulline increased in Wistar rats and decreased in ICR rats, and histidine increased in ICR rats with aging. The changes in free amino acids in aqueous humors were the greatest in ICR rats, and these data will provide useful clues for the formation of cataract and the transportation of amino acids.

Aging↗

Laparoscopic adrenalectomy for Cushing's syndrome: comparison with primary aldosteronism.

BACKGROUND: Removal of adrenal adenoma of Cushing's syndrome is believed to be more troublesome than primary aldosteronism because of large amount of retroperitoneal adipose tissue and bleeding from the fat. The objective of the present study was to evaluate the feasibility of laparoscopic adrenalectomy for Cushing's syndrome and comparison of the results of laparoscopic adrenalectomy between primary aldosteronism and Cushing's syndrome. METHODS: From January 17, 1992, to July 31, 1993, laparoscopic adrenalectomies for functioning adrenal lesions were performed in 14 patients (five men, nine women), three of whom had Cushing's syndrome and 11 of whom had primary aldosteronism. RESULTS: Operative times (mean +/- SD) for primary aldosteronism and Cushing's syndrome were 269.0 +/- 100.9 minutes and 253.7 +/- 57.9 minutes, respectively. No difference was noted in operative time, operative bleeding, and postoperative recovery between them. However, the weight of removed tissue from patients with Cushing's syndrome (20.00 +/- 8.17 gm) was greater than that from those with primary aldosteronism (6.64 +/- 2.01 gm). No operative complications occurred in patients with Cushing's syndrome. Ultrasonic aspiration and argon-beam coagulation were useful for laparoscopic adrenalectomy in patients with Cushing's syndrome. CONCLUSIONS: Cushing's syndrome may be a good indication for laparoscopic operation.

Adenoma↗

Expression of bone matrix protein messenger ribonucleic acids in human breast cancers. Possible involvement of osteopontin in development of calcifying foci.

BACKGROUND: Development of calcifying foci is a fairly common finding in human breast cancers, and the deposition of calcium phosphate is observed in such foci. The calcium phosphate is a physiologic component of bones and teeth. Since the expression of messenger (m) RNAs of osteopontin (OPN), osteocalcin (OC), osteonectin (ON), and matrix gla protein (MGP) has been described in bones and teeth, we examined the mRNA expression of OPN, OC, ON, or MGP in the calcifying foci that were observed in human breast cancers. EXPERIMENTAL DESIGN: Cell types expressing mRNAs of OPN, ON or MGP were identified with combination of in situ hybridization and immunohistochemistry. RESULTS: The OPN mRNA-expressing cells clustered around the necrotic foci within cancer cell nests, and the examination with anti-OPN antibody revealed that OPN protein was localized in such necrotic foci where calcium phosphate deposited. The OPN mRNA-expressing cells were identified as macrophages by staining the adjacent section with the anti-CD68 PG-M1 monoclonal antibody which specifically recognizes macrophages. Neither ON mRNA-expressing cells nor MGP mRNA-expressing cells appeared to correlate with the deposition of calcium phosphate. CONCLUSIONS: The OPN protein produced by macrophages appeared to play a significant role for development of calcifying foci within necrotic area of breast cancers.

Antibodies, Monoclonal↗

[A case of cutaneous malignant melanoma metastatic to the choroid].

A case of metastasis of cutaneous malignant melanoma to the choroid was reported. The patient, a 61-year-old man, had undergone an amputation of his right first finger 3 years ago due to cutaneous malignant melanoma. Ophthalmoscopic examination revealed a whitish yellow elevated choroidal lesion and serous retinal detachment in the left eye. Fluorescein angiography demonstrated multiple pinpoint leaks in the early phase and progressive pooling of dye into the subretinal space in the late phase. In magnetic resonance imaging, the tumor showed a hyperintense image in both T1 and T2-weighted images. Autopsy was performed and histopathological examination of the eye showed that the tumor cells were polygonal in shape, and had round or oval nuclei, but the cytoplasms had little melanin pigment. Immunohistochemistry for S-100 and HMB-45 antibody showed positive staining in choroidal tumor and other metastatic lesions, indicating that they were metastatic tumors from cutaneous malignant melanoma (amelanotic melanoma cells).

Choroid Neoplasms↗