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Biomedical subjects

M Takeda

Publications and source records attributed to M Takeda.

At least 559 records · Page 31Linked to original sources

Dissociation of selective renal venous plasma endothelin-1 activity and corresponding plasma renin activity in a patient with hypertension, severe stenosis of unilateral renal artery and ipsilaterally decreased renal function.

Plasma endothelin-1 (ET-1)-like immunoreactivity in selective renal venous blood and peripheral venous blood was measured and compared with plasma renin activity and aldosterone level in a 26-year-old woman with suspected renovascular hypertension due to stenosis of the left renal artery. Although there was no significant step-up in plasma renin activity between the right and the left renal vein, left/right ratio of plasma ET-1 in the renal vein was 2.18. This case suggests that ET-1 may be one of the hypertensive mechanisms of suspected renovascular hypertension in addition to the renin-angiotensin system.

Adult↗

Incidence of pouch stones and risk factors for urolithiasis in patients with continent urinary diversion or neobladder using intestine.

Urinary risk factors and inhibiting factors for urolithiasis, such as oxalate, calcium, phosphate, uric acid, citrate, and magnesium, were examined in 12 patients receiving continent urinary diversion, neobladder, or augmentation cystoplasty using intestine. These data were compared with the incidence of pouch stone formation. Ten (83.3%) of 12 patients had at least one risk factor, and 5 (41.7%) of 12 had two or more risk factors. Pouch stone developed in 4 (80%) of 5 patients with two or more risk factors, and in none of 7 patients with one or zero risk factors. The incidence of pouch stone in the former group was significantly higher than in the latter group. These results suggest that urinary reservoir operations should not be performed in patients with two or more risk factors for urolithiasis.

Female↗

Simultaneous measurement of cystometry and diuresis renography during full and empty bladder in neurogenic bladder patients: a preliminary report.

In 9 patients (4 male and 5 female; mean 24.7 years old) with neurogenic bladder dysfunction, diuresis renography and water filling cystometry were simultaneously monitored with a full and empty bladder, and findings of diuresis renography with a full bladder were compared with those of diuresis renography with an empty bladder. According to O'Reilly's classification, findings of diuresis renography with a full bladder were significantly worse than those of diuresis renography with an empty bladder, regardless of cystometry patterns and bladder compliances. Although every kidney without hydronephrosis on intravenous pyelogram showed normal diuresis renography with an empty bladder, some kidneys with hydronephrosis showed an obstructive pattern even with an empty bladder. These results suggest that in some patients with neurogenic bladder dysfunction, deterioration of the upper urinary tract occurs more easily with a full than with an empty bladder, regardless of bladder pressure and bladder compliance.

Adult↗

Value of dimercaptosuccinic acid single photon emission computed tomography and magnetic resonance imaging in detecting renal injury in pediatric patients with vesicoureteral reflux. Comparison with dimercaptosuccinic acid planar scintigraphy and intravenous pyelography.

The value of 99mTc-dimercaptosuccinic acid (DMSA) planar renal scintigraphy, DMSA single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) in the assessment of renal injury related to vesicoureteral reflux (VUR) was examined in 60 kidneys of 32 pediatric patients (28 bilateral, 4 unilateral) with primary VUR. The results were: (1) detection of minor renal lesions was best with MRI, then DMSA-planar and DMSA-SPECT, and (2) in comparing the positive rate, DMSA-SPECT (85%) and MRI (83.3%) were superior to intravenous pyelography (55%) and DMSA-planar scintigraphy (65%). These results suggest that DMSA-SPECT or MRI may be more sensitive than DMSA-planar scintigraphy and intravenous pyelography in detecting renal injury related to VUR in pediatric patients.

Child↗

Measurement of urinary endothelin-1-like immunoreactivity and comparison with other urinary parameters in patients with primary vesicoureteral reflux. A preliminary report.

By using a radioimmunoassay specific for endothelin-1 (ET-1), we measured urinary excretion of ET-1-like immunoreactivity in 63 spot urine samples of 48 patients with primary vesicoureteral reflux (VUR). Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG), beta 2-microglobulin (beta 2-MG), microalbumin (Alb), and creatinine (Cr) were also measured. There was no significant correlation in any pairs of ET-1 and NAG, ET-1 and beta 2-MG or ET-1 and Alb. In patients with grade 2, grade 3, and grade 4 VUR, urinary ET-1/Cr was significantly higher than normal (p < 0.05). Comparing the grade of reflux according to the International Classification with urinary ET-1/Cr, the ratio of more than normal urinary ET-1/Cr increased in proportion to the grade of reflux, but it conversely decreased in grade 5. In conclusion, urinary ET-1 may be an indicator of distal renal tubular or collecting duct injury in patients with primary VUR.

Acetylglucosaminidase↗

Inhibition of amiloride-sensitive apical Na+ conductance by acetylcholine in rabbit cortical collecting duct perfused in vitro.

We examined effects of acetylcholine (ACh) on the electrical parameters and intracellular Ca2+ concentration ([Ca2+]i) in the isolated rabbit cortical collecting duct (CCD) perfused in vitro using the conventional microelectrode technique and microscopic fluorescence spectrophotometry. ACh (10(-8) to 10(-5) M) in the bath caused a positive deflection of the transepithelial voltage (VT) and an increase in [Ca2+]i. Carbachol also showed similar but smaller effects. The effects of ACh were antagonized by muscarinic receptor antagonists. ACh at 10(-6) M hyperpolarized the apical membrane voltage and increased the fractional resistance of the apical membrane of the collecting duct cells accompanied by a positive deflection of VT and an increase in transepithelial resistance, whereas it did not affect these parameters in the beta-intercalated cells. In the presence of 10(-5) M amiloride in the lumen, the effects of ACh were almost completely abolished. The ACh-induced increase in [Ca2+]i is accounted for by the release of Ca2+ from intracellular store and Ca2+ entry from the bath. In the absence of Ca2+ in the bath, the ACh-induced changes in electrophysiological parameters were significantly smaller than those observed in the presence of Ca2+. Both phorbol-12-myristate-13-acetate (PMA) and phorbol-12,13-dibutylate (PDBu), activators of protein kinase C (PKC), also inhibited the apical Na+ conductance. In the presence of PMA or PDBu in the bath, ACh did not show further inhibitory effect. 1-(5-Isoquinolinylsulfonyl)-2-methylpiperazine, an inhibitor of PKC, partially attenuated the effect of ACh. These observations indicate that ACh inhibits the apical Na+ conductance partly by both increasing [Ca2+]i and activating PKC. Such an action of ACh may partially explain its natriuretic effect.

Acetylcholine↗

Dephosphorylation of the largest neurofilament subunit protein influences the structure of crossbridges in reassembled neurofilaments.

Phosphorylation-dependent change in electrophoretic mobility is the most unique characteristic of NF-H, the largest molecular mass subunit of the neurofilament. We dephosphorylated NF-H using Escherichia coli alkaline phosphatase, then reassembled it into neurofilaments with NF-M and NF-L, and into NF-H filaments with NF-H alone. We compared these dephosphorylated filaments with control: projections by low-angle rotary-shadow, crossbridges by quick-freeze deep-etch, and core filament packing density by thin-section electron microscopy. Projections in the dephosphorylated filaments were basically similar in structure to those in control, although there was a tendency for them to be wider and less dense, especially in NF-H filaments. Dephosphorylated filaments were still able to form crossbridges between core filaments, but their crossbridges were significantly wider, less dense, more branched and more irregular than crossbridges in control, and core filaments were more densely packed. These structural differences may be brought about by the removal of phosphate groups from NF-H tail and consequent reduction of electrostatic repulsion between adjacent crossbridges extending from the same core filament. The results indicate that phosphorylation of NF-H is necessary for forming well developed crossbridges, straight and at constant intervals, like those of in vivo axonal neurofilaments.

Actin Cytoskeleton↗

Synthesis of the metabolites of clentiazem.

The metabolites of clentiazem in the urine or bile of rats and dogs were investigated. Fifteen basic, 6 acidic, 2 neutral and 4 conjugated metabolites were isolated. In the present paper, fourteen reference compounds as shown in Charts 1, 2 and 3 were synthesized to identify the structures of the metabolites in procedures fundamentally similar to those employed in the synthesis of the corresponding metabolites of diltiazem.

Animals↗

Antithrombotic effects of KW-3635, a thromboxane A2-receptor antagonist, in guinea pigs.

Antithrombotic effects of KW-3635, a newly synthesized thromboxane (TX) A2-receptor antagonist, were studied in guinea pigs. In the extracorporeal circulation thrombosis model, the shunt was filled with thrombi, and reduction of platelet count and increase in plasma TXA2 concentration were observed. KW-3635 (30 and 100 mg/kg, p.o.) inhibited the thrombus formation in the shunt and prevented the decrease in platelet count in the circulating blood without affecting the red blood cell count. BM13,505 (30, 100 mg/kg, p.o.), another TXA2-receptor antagonist, and ticlopidine (300 mg/kg, p.o.), an antiplatelet drug, also inhibited the thrombus formation, while aspirin (10, 300 mg/kg, p.o.) did not. Peripheral arterial occlusive disease was induced by injection of sodium laurate into the femoral artery in guinea pigs. Daily oral administration of KW-3635 (3-30 mg/kg) significantly prevented the progression of vascular lesions. BM13,505 (3-30 mg/kg, p.o.) and ticlopidine (100 mg/kg, p.o.) also ameliorated the vascular lesions, whereas aspirin (10, 100 mg/kg, p.o.) did not. KW-3635 at concentrations up to 10(-4) M did not affect coagulation parameters in vitro. These results suggest that TXA2 is involved in the pathogenesis of arterial thrombotic and ischemic disorders. KW-3635 may be useful for the treatment of thrombotic disease and peripheral arterial occlusive diseases.

Animals↗

Encephalomyocarditis (EMC) virus-induced testicular lesion in BALB/c mice.

Characteristics of encephalomyocarditis (EMC) virus-induced testicular lesions were investigated in 4- and 8-week-old BALB/c male mice after intraperitoneal (i.p.) and intratesticular (left) (i.t.) inoculation of the D variant of EMC virus (EMC-D). Apart from variation in severity and incidence, the histopathological nature of the resultant testicular lesion was similar in all infected mice, and was characterized by degeneration and necrosis of germinal cells and spermatogonia with inflammatory infiltration. Almost all the inoculated left testes of the i.t. group developed marked lesions. In general, the virus titre in the testis and incidence of testicular lesions were higher in 4-week-old mice than in 8-week-old mice. In addition, testicular lesions developed earlier and with a higher incidence in the PBS-inoculated right testis of the i.t. group than in either testis of the i.p. group of the same age.

Animals↗

[Laparoscopic management for nonpalpable testis].

In this series, we investigated the efficacy and advantage of laparoscopy for management of nonpalpable testis. Laparoscopic examination was performed in 10 boys, involving one with bilateral nonpalpable testis and 9 with a unilateral nonpalpable testis and a contralateral normal one, between August 1991 and September 1993 in our institution. Three testis were diagnosed as intraabdominal and 8 testis were diagnosed as probably intracanalicular with laparoscopy. Two boys with 3 intracanalicular testis underwent laparoscopic clipping of testicular vessels, and about 6 months later, they underwent the second stage of 2-stage Fowler-Stephens orchiopexy. Eight boys, diagnosed as probably intracanalicular type by laparoscopy, underwent surgical exploration with inguinal incision. Of 8 patients, only 1 boy underwent 1-stage orchiopexy, and the other 7 boys underwent orchiectomy because their gonads were extremely hypoplastic. About 1 year after orchiopexy, 3 testes were normal in both size and location. Laparoscopy seems to be useful for both evaluation and treatment of the nonpalpable testis.

Adolescent↗

[A case with clinical features of progressive supranuclear palsy with apraxia--corticobasal degeneration?].

We report a 65-year-old female who have suffered from progressive gait disturbance for 3 years, followed by disorientation and forgetfulness. Neurological examination revealed dementia, constructional disability, limb kinetic apraxia, supranuclear gaze palsy, especially on downward gaze, symmetrical muscle rigidity and bradykinesia. Involuntary movements were undetectable. Brain MRI showed significant brain atrophy in the left fronto-parietal lobe. The three-dimensional surface display with 131I-IMP demonstrated decreased cerebral blood flow in the left frontoparietal cortex. The diagnosis of this case is discussed with regard to either progressive supranuclear palsy or corticobasal degeneration or both.

Aged↗

[An adult case of lumbar intradural lipoma].

A 42-year-old female with intradural lipoma at the level of L1 is reported. She was admitted with a history of 32 months of lumbago, 25 months of pain of the left leg, and 12 months of motor weakness in the left leg. Neurologically, sensory impairment below the L1 dermatome of the left leg, and motor weakness of bilateral legs were noted on admission. CT demonstrated a low density mass with no contrast enhanced effect at the level of L1. MRI showed a mass with high signal intensity on the T1-weighted image, and low signal intensity on the T2. L1 laminectomy, and additional Th12 and L2 partial laminectomy were performed and the tumor was partially removed. The tumor was completely in the intradural space. Pathologically, the tumor consisted of mature adipose cells with normal vessels. Postoperatively, the epidural effusion at the operative area caused sensory impairment and motor weakness of the right leg. Finally, the patient came to be neurologically free of defects except for slight sensory diminution of the L4 dermatome of the left leg. In this case, total removal of the tumor was difficult because of adhesion between the tumor, the cauda equina and the conus medullaris. Postoperatively, neurological findings showed a marked improvement. The preoperative neurological deterioration in this case seemed to be associated with simple compression exerted on the nerves.

Adult↗

[Cysts in the cavum tunica vaginalis testis: a case report].

A case of cysts in the cavum tunica vaginalis testis was reported. A 58-year-old man visited our clinic with the chief complaint of urethral bleeding. Urethro-cystogram revealed stricture of bulbous urethra. We palpated several pea-sized painless masses in the left scrotum. On ultrasonogram of the left scrotal contents several cystic lesions were detected at the cranial side of the left testis. At operation, cysts were found in the cavum tunica vaginalis testis, and were resected along with the tunica vaginalis. Fluid of the cysts was serous without sperm. Histopathologically mesothelial cyst was suspected. The incidence of cysts in the cavum tunica vaginalis testis is rare and only 17 cases have been reported in Japan. We reviewed 9 cases of cysts arising from lamina parietalis of tunica vaginalis.

Cysts↗

[A case report of condyloma acuminatum in female urethra].

A case of condyloma acuminatum in female urethra is reported. A 53-year-old woman was referred to our clinic because of urethral bleeding. A tumor was noted around the external urethral meatus and the size of the tumor was 20 mm in diameter. Excision was performed on the tumor including the external urethral meatus. Pathological examination revealed condyloma acuminatum. Condyloma acuminatum in female urethra is very rare. We reviewed and discussed 6 cases of condyloma acuminatum in female urethra, including our case, in the Japanese literature.

Condylomata Acuminata↗

[A case of bilateral epididymal leiomyomas].

A case of bilateral epididymal leiomyomas is reported. A 62-year-old man was referred to our hospital under the suspicion of left testicular tumor. A small hen-egg sized painless mass was palpated in the left scrotum and a little-finger-tip-sized mass in the right scrotum. At the operation, bilateral epididymal tumors were revealed, left high orchiectomy and right epididymectomy were performed. Gross evaluation revealed elastic hard tumors at the tail of bilateral epididymis. The left tumor was 40mm in diameter and the right was 10mm. On the cut surface, the tumors were yellowish and solid. Histopathologically they were diagnosed as epididymal leiomyoma. We reviewed 75 cases of epididymal leiomyoma reported in the Japanese literature. Bilateral cases accounted for 21% of the 75 cases.

Epididymis↗