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Biomedical subjects

M Takeda

Publications and source records attributed to M Takeda.

At least 631 records · Page 35Linked to original sources
PubMed1993

[Application of intraurethral catheter for geriatric male patients complaining of urethral obstruction due to malignancy--comparison with benign prostatic hypertrophy].

Intraurethral catheters (IUC) were used for elderly male patients with prostatic urethral obstruction (PUO) due to malignancy (MA) and benign prostatic hypertrophy (BPH). Thirty-three men complaining of urinary retention in spite of medical therapy at the risk for prostatic surgery underwent insertion of IUC (16Fr Puroflex, Angiomed Co., Ltd., Germany). Six of 33 were patients with PUO due to MA (5 prostatic cancer, and 1 urethral invasion of rectal cancer, mean 82.7 years old), and the other 27 were patients with BPH (average 80.1 years old). Follow-up period of the former ranged from 2 to 9 (mean 6.5) months, and that of the latter ranged from 6 to 23 months. Water filling cystometry (CMG) before the insertion of IUC and fluoroscopic voiding cystourethrography (VCU) just after insertion of IUC were performed. We defined normal CMG and normal VCU as normal bladder, overactive CMG and normal VCU as overactive bladder, and normal or poor sensitive CMG and underactive VCU as underactive bladder. Five of 27 BPH patients had previous prostatic operations (TUR-P, and/or balloon dilation), but 6 MA did not. All of MA (3 normal bladder, 2 overactive bladder, and 1 underactive bladder) voided satisfactorily, and average duration of IUC in place was 6.5 months without exchange of IUC. Although sixteen of 27 (59.3%) BPH patients voided satisfactorily, and average duration of IUC in place was 12.1 months without exchange of IUC, in the other 11 of these 27 BPH patients were removed IUC, and average duration of IUC in place was 4.7 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[The effect of desmopressin (DDAVP) in patients complaining of nocturia].

The mechanism of increased nocturnal urine production in adult patients complaining of nocturia has seldom been reported. The objective of this clinical study is to investigate the circadian rhythm of both urine production and plasma arginine-vasopressin (AVP) level, and the efficacy of intranasal instillation of 1-deamino-8-D-arginine-vasopressin (DDAVP) in adult patients complaining of nocturia. Eight patients (seven men, one woman) who ranged in age from 44 to 77 years (mean 64.1 years) were examined. Three of them suffered from Shy-Drager syndrome, and no patient had shown any improvement of symptoms in spite of administration of anti-cholinergic agents and restriction of water intake. Nocturnal urine volume was more than bladder capacity in all patients, and no patient showed normal elevation of nocturnal plasma AVP level. Intranasal administration of DDAVP of 5 or 10 micrograms revealed marked decrease in nocturia, and nocturnal urine volume (p < 0.01). There were mild side effects (headache, nasal obstruction, and hyponatremia) not requiring any treatment. In conclusion, DDAVP is a safe and effective treatment for adult patients complaining of nocturia due to hyperproduction of nocturnal urine and inappropriate nocturnal secretion of AVP.

Administration, Intranasal↗
PubMed1993

[Long-term results and indications of intraurethral stents in elderly patients with prostatic hypertrophy complaining of urinary retention].

Thirty-two elderly male patients with benign prostatic hypertrophy complaining of urinary retention were treated by polyurethane intraurethral stents. All of them were unfit for prostatic surgery due to the presence of several complications, and had been indwelt with a urethral balloon catheter. Cystometry before stent insertion was performed in 23 of the 32 patients. Eleven patients showed overactive bladder, 5 patients normal bladder, and 7 patients underactive bladder. Duration of stent indwelling ranged from 2 days to 22 months (mean 6.7 months), and stent could successfully function for more than 6 months in 20 of the 32 patients (62.5%). Nine of these 20 patients (45%) could keep continence of urine, and urinary tract infections improved in 7 of these 20 patients (35%). The stent failed in 4 of the 5 patients who had had previous operations for prostatic hypertrophy. In a comparison of the findings of urodynamic study prior to insertion of stent with the results of the stent, the results were significantly better in the patients with overactive or normal bladder than in those with underactive bladder (p < 0.05, chi-square test). Bladder stone formation was found in one patient and was the only complication among the 32 patients. In conclusion, stent placement without incontinence or urinary tract infection can be successful for more than 6 months in patients who do not have an underactive bladder and who had not had a previous prostatic operation.

Aged↗
PubMed1993

[Early lesion of choroidal neovascularization. 2. Early lesion of choroidal neovascularization in pathological myopia].

We describe early features of choroidal neovascularization in 50 pathologically myopic eyes. The eyes were classified into three categories on the basis of degree of myopic chorioretinal degeneration in the posterior pole: mild diffuse atrophy, severe diffuse atrophy and focal atrophy. Choroidal neovascular membranes (CNMs) were grouped into a minimally leaking type and a markedly leaking type in fluorescein angiographic patterns. CNMs were more frequently associated with the mild diffuse atrophy than with the other atrophies. Of the markedly leaking CNMs, 83% were seen in eyes with mild myopic chorioretinal degeneration and 78.5% of the minimal leaking CNMs were found in eyes with severe myopic chorioretinal degeneration. In association with CNMs, lacquer crack and the granular hypofluorescein lesions were observed in 72% and 40%, respectively. The visual acuity deteriorated in all of the 14 eyes which could be followed up more than 1 year.

Adult↗
PubMed1993

[NEO-MACOP-B chemotherapy for the treatment of advanced-stage aggressive non-Hodgkin's lymphoma].

We conducted a new chemotherapy, NEO-MAC OP-B (addition of etoposide and mitoxantrone to MACOP-B with half dose of methotrexate and half administration of doxorubicin), to reduce severe mucositis, which is a major toxic effect of MACOP-B, and to increase its effect with etoposide and mitoxantrone as new non-cross resistant drugs. Between Jan. 1989 and Mar. 1993, 12 patients with previously untreated advanced aggressive non-Hodgkin's lymphoma (NHL), 2 patients with adult T cell lymphoma, and 3 patients with relapsed NHL, were treated with NEO-MACOP-B. After termination of NEO-MACOP-B therapy, 83.3% of 12 patients with previously untreated NHL were in complete remission (CR). After median follow-up of 22 months, Kaplan-Meier estimates showed that overall survival of 12 previously untreated patients was 71.4%, and relapse-free survival of complete responder was 83.3%. Toxic effects on all 17 patients were moderate with a lower incidence of severe mucositis (only one patient with relatively severe stomatitis, WHO Grade 3). No treatment related deaths were observed. Thus, NEO-MACOP-B is an effective and safe treatment for advanced stage aggressive NHL.

Adult↗
PubMed1993

[Elution of lead and cadmium from imported gold-decorated glassware].

Lead and cadmium were known to be eluted from some imported gold-decorated glassware, which was bonded at a quarantine station. Elution of lead and cadmium was confirmed to be occurred from the gold-decorated portion, but not from glass itself. No elution of these heavy metals was observed from gold-decorated glassware in the market.

Cadmium↗
PubMed1993

Biphasic disease of central nervous system induced in DBA/2 mice by the D variant of encephalomyocarditis virus (EMC-D).

DBA/2 mice infected with the D variant of encephalomyocarditis virus (EMC-D) (10(1) PFU/head) developed biphasic hind limb paralysis. At 12 days post inoculation (12 DPI), 60% of the infected mice developed hind limb paralysis and two-thirds of them showed recovery by 33 DPI. Thereafter, about 30% of the mice which once showed paralysis developed hind limb paralysis again by 56 DPI. Histopathologically, the spinal cord lesion of paralysed mice was characterized by demyelination associated with infiltration of macrophages in the funiculus lateralis and by degeneration of neurons in the cornu ventrale. Virus antigens were detected in the cytoplasm of degenerated neurons and oligodendrocytes in the demyelinated lesions from 3 to 14 DPI. At 28 DPI, demyelinated lesions reduced in size due to prominent remyelination. At 56 DPI, infiltration of mononuclear cells mainly composed of anti-L3T4-positive (CD4+) T cells were observed in the cornu ventrale of the mice showing recurrence of hind limb paralysis. These results suggested that the early paralysis was mainly due to demyelination in funiculus lateralis caused by EMC-D and macrophages and that the late paralysis was due to degeneration of motor neurons, probably brought about by CD4+ T cells.

Animals↗
PubMed1993

[Application of lactate threshold in the exercise program for patients with coronary heart disease].

This study was conducted 1) to measure the exercise intensity corresponding to lactate threshold (LT) and 2) to clarify the method of prescribing LT level for patients with coronary heart disease (CHD) on the assumption that LT level indicates an optimal exercise intensity for those patients. Three males and 9 females with CHD, aged 57.6 +/- 7.7, participated in this study. Oxygen uptake (VO2), heart rate (HR), and ratings of perceived exertion (RPE) at LT and at maximal exercise were measured before (pre), 4 months (mid) and 8 months (post) after exercise conditioning. The intensity of most exercises was maintained at the level of LT. A significant increase was found in VO2LT from pre- to mid-test, and further increase was found from mid- to post-test after matching exercise intensity to the improvement in VO2LT. It is suggested that matching the progression of the absolute exercise intensity with the training-induced improvements of aerobic capacity i.e., maintaining the exercise intensity at LT for a sustained period of time, is a valid procedure for further improvement in aerobic capacity of CHD patients.

Aged↗
PubMed1993

[A case of renal cell carcinoma effectively treated by interferon-alpha and embolization of the renal artery].

A case of renal cell carcinoma effectively treated by interferon-alpha and the embolization of the left renal artery is reported. A 69-year-old man was referred to us because of a left renal mass. We made a diagnosis of a left renal tumor with tumor thrombus in the renal vein and inferior vena cava, and multiple lung metastases by imaging examinations. At first the embolization of the left renal artery was selected and interferon-alpha treatment was performed for 3 months. At 3 months after the embolization, the metastatic lung tumors had completely disappeared and the left renal tumor and the tumor thrombus were reduced in size, so that left radical nephrectomy was performed. Pathological examination revealed that a small part of the tumor was viable renal cell carcinoma. After the operation, interferon-alpha treatment has been continued for 15 months and recurrence and metastasis have not been detected.

Aged↗
PubMed1993

[Idiopathic normal pressure hydrocephalus in elderly patients: its pathophysiology and diagnosis].

We described 10 cases of idiopathic normal pressure hydrocephalus (NPH) in elderly patients who had good results after shunting. Retrospective analysis of our cases offers the following results which indicate the pathogenesis and surgical selection of idiopathic NPH. 1) Most of the patients had risk factors of ischemic cerebrovascular disease and had multiple small ischemic lesions such as lacunae. 2) Cerebrospinal fluid (CSF) pressure is below 20mmHg in all cases and its response to acetazolamide loading was suppressed or almost lost in most of cases. 3) The volume of the lateral ventricle was slightly reduced after the effective operation. 4) Some of the patients showed clinical improvement even if they had symptoms for more than 2 years before treatment. Two primary theories exist concerning the cause of NPH. One is extraventricular obstruction to CSF flow at the level of the arachnoid villi or the basal cistern. The other is periventricular white matter ischemic damage which decreases the tensile strength of the ventricular walls and leads to ventricular dilatation. Tangential periventricular shearing force due to ventricular dilatation produces the symptom of NPH. Our results support these descriptions as the causes of idiopathic NPH in elderly patients. We noticed, firstly, involvement of the ischemic risk factor. Other findings implied decreased elasticity or compliance of the brain and the loss of the autoregulatory properties of cerebral circulation which accelerate the ischemic damage to the periventricular white matter. In understanding the etiology, it is important to know the fragility of the aged brain and the mechanical and hemodynamic stress to which it is subjected.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Examination of the risk factors for infectious urolithiasis formation in patients receiving urinary diversion or urinary reconstruction using intestine--comparison of reservoir and ileal conduit].

Urinary risk factors and preventive factors for infectious calcium (Ca) urolithiasis formation, such as citrate, oxalate, Ca, phosphate, magnesium, and uric acid were examined more than 2 months after performing a urinary reservoir in 12 patients (R group) and ileal conduit in 10 patients (C group). There was no difference in the positive rate of risk factors between the two groups and also no difference in the positive rate of more than two risk factors between the two groups. Although four patients with more than two risk factors in the R group suffered from reservoir stones all of which included Ca-urolithiasis, none in the C group did. In the R group, the incidence of stone formation in patients with 2 or more risk factors was significantly higher than those in patients with 1 or no risk factor. In conclusion, the urinary reservoir operation should not be carried out in patients with more than two risk factors for urolithiasis formation, and urinary risk factors should be examined before reservoir operation.

Adult↗
PubMed1993

[Internal decompression with hippocampectomy for massive cerebral infarction].

Massive cerebral infarction due to the occlusion of a main cerebral artery is often unresponsive to medical treatment. Internal decompression with hippocampectomy was tried for two patients and satisfactory results were obtained without advancing cerebral edema. External decompression was also performed on 12 patients, but it was accompanied by intensified edema postoperatively. Satisfactory results were obtained in four cases, but three patients remained in vegetative states, and five patients died. The internal decompression with immediate hippocampectomy resolves compression to the brain stem without aggravating cerebral edema and may be more effective in preserving life than external decompression.

Aged↗
PubMed1993

Phosphorylated neurofilament accumulation in neuronal perikarya by cyclosporin A injection in rat brain.

Cyclosporin A, a calcineurin inhibitor, was administered into the rat hippocampus. Seven days after drug administration the effects of phosphatase activity suppression in the brain to changes in neuronal cytoskeletal proteins were studied. Rat brain homogenates injected with cyclosporin A showed 16-38% suppression of Ca/calmodulin-dependent phosphatase activity measured by 32P released from 32P-labeled histone, indicating that cyclosporin A acts as an inhibitor of calcineurin after binding with cyclophilin in the brain. Hematoxylin-eosin staining revealed many basophilic neurons in the pyramidal layer of hippocampus, cerebellum, thalamus and cerebral cortex. Immunohistochemical study with anti-phosphorylated neurofilament 200kDa antibody showed positive staining of neuronal perikarya of these basophilic neurons. The number of immunopositive neurons with anti-phosphorylated neurofilament 200KDa increased with the concentration of cyclosporin A injected into the brain, indicating a dose-dependent effect of the compound. Staining with anti-dephosphorylated neurofilament 200KDa (SMI-32) was decreased in neuronal perikarya of cyclosporin A injected brains compared with that of control brains injected with dimethyl sulfoxide alone, suggesting an increased phosphorylation of neurofilament 200KDa subunit protein. The perikarya of these basophilic neurons were not stained with anti-PHF (paired helical filaments) or anti-tau antibodies. Immunostaining with anti-ubiquitin was not increased in these cells. Immunostaining with anti-calcineurin A and anti-calcineurin B showed positive staining of neurons in hippocampus, cerebellum and caudate nucleus both in experimental and control brains. Calcineurin B immunoreactivity was more intense in pyramidal cells in hippocampus injected with cyclosporin A than in controls. Western blot study with antibody against calcineurin A revealed significantly more degradation products of calcineurin A in cyclosporin A injected brains. The present data suggest that cyclosporin A inhibits calcineurin activity in the brain, which results in increased phosphorylation of perikaryal neurofilaments. Since abnormal phosphorylation is speculated in the pathological process of Alzheimer's disease, the results will help elucidate the participation of phosphatase in the pathology of cytoskeletal proteins in Alzheimer's disease.

Animals↗
PubMed1993

[HTLV-I associated myelopathy with macular degeneration].

The authors report a case of macular involvement in a patient with HTLV-I associated myelopathy (HAM). The patient was a 10-year-old girl who noticed sudden decreased vision in her right eye in November 1987. The corrected visual acuity was 0.01 in the right eye and 1.0 in the left eye. Fundus examination of the right eye disclosed mild optic disc pallor. The macula appeared to have pigmentary mottling with superficial irregular retinal reflex that was three disc diameters in size. Fluorescein angiography revealed a discoid hypofluorescent area in the macula, surrounded by mottled hyperfluorescent areas. She had no contributory family history of ocular disease, but had a history of blood transfusion during an operation for patent ductus arteriosus and ventricular septal defect at the age of 8 months. In November 1990, she developed gait disturbance due to spastic paraparesis and was admitted to our hospital. Antibodies to HTLV-I were markedly elevated in serum (titer, 1:8192) and in cerebrospinal fluid (titer, 1: 1024). She was diagnosed as HAM. Two months later, she developed encephalopathy and bilateral optic disc atrophy.

Child↗
PubMed1993

[Myocardial revascularization with bovine internal thoracic artery graft (BIOFLOW): a case report].

Bovine internal thoracic artery graft (BIOFLOW) was used for coronary artery bypass grafting (CABG). A 64-year-old woman who had undergone triple CABG with saphenous vein five years ago was referred to our hospital again with anginal attack. Coronary angiogram showed the obstruction of the graft for LAD and new stenosis at right coronary artery (RCA). Gastroepiploic artery was not available because the patient had a history of gastric ulcer several times, and saphenous vein had harvested initial operation. We planned re-CABG for LAD with left internal thoracic artery and RCA with BIOFLOW. But at the operation, LAD was not graftable because of severe calcification. So that we performed single CABG to RCA with BIOFLOW. The BIOFLOW was patent at the 28 th postoperative day. From our experience, BIOFLOW can be expected as a graft for CABG when saphenous vein, internal thoracic artery and gastroepiploic artery are not available.

Aged↗
PubMed1993

[Right ventricular visualization by Tl-201 myocardial scintigraphy in chronic obstructive pulmonary disease].

Tl-201 myocardial scintigraphy was performed in 130 patients with chronic obstructive pulmonary disease (COPD) to evaluate right ventricular hypertrophy, and the clinical significance of this method was studied. Tl-201 uptake ratio of the right ventricle, which represents the ratio of total counts of the right ventricle to counts of the administered dose of Tl-201, was higher in COPD, especially in pulmonary emphysema and B type COPD by Burrows classification than in controls. The grade of visualization of the right ventricle by visual assessment (RVV) was marked (+3) in only a few cases and moderate (+2) in many cases (more than 80%) in all diseases except bronchial asthma. The incidences of right ventricular hypertrophy by electrocardiogram, right-sided heart failure and marked dyspnea (Hugh-Jones 4.5) were very low in cases with RVV grade +2 and very high in cases with +3. The grade of RVV was related to the severity of pulmonary perfusion impairment, although in diffuse panbronchiolitis the RVV was relatively slight compared with the impairment of perfusion. May parameters of pulmonary function such as %VC, FEV1.0%, RV/TLC, V25, %DLCO, Raw, delta N2 and PaO2 showed abnormal values in patients with RVV grade of (+2) or (+3) in all diseases except bronchial asthma. In COPD, Tl-201 myocardial scintigraphy seems to be useful for assessment of right ventricular overloading, and for follow-up observation and differentiation between cor pulmonale and right ventricular hypertrophy secondary to cardiac diseases by observing Tl-201 uptake of the lung and left ventricle.

Humans↗
PubMed1992

Assembly regulatory domain of glial fibrillary acidic protein. A single phosphorylation diminishes its assembly-accelerating property.

Phosphorylation of glial fibrillary acidic protein (GFAP) induces disassembly of the filaments. An amino-terminal fragment of bovine GFAP (G-Hf) was produced by lysylendopeptidase digestion. G-Hf formed ribbon-like filaments in the presence of GFAP even in low ionic strength, whereas the fragment itself did not form any structures. Only one (PK3) of the five V8 protease fragments of G-Hf accelerated GFAP assembly to the same degree as G-Hf did, whereas the other fragments did not. When PK3 was cleaved into two fragments, it lost the assembly-accelerating property. The sequence of PK3 was determined as RRRVTSATRRSYVSSSE, which corresponded to residues 3-19 of porcine GFAP. It was concluded that PK3 contains a sequence indispensable for GFAP assembly and that neither PK1 (RRRVTS) nor PK2 (ATRRSYVSSSE) included all of the sequence. A single phosphorylation of PK3 by cyclic AMP-dependent protein kinase diminished its assembly-accelerating property. The phosphorylation site was determined as Ser-12 of porcine GFAP. It was shown that single phosphorylation of the amino-terminal head domain, which contains an indispensable sequence for GFAP assembly, might be sufficient for GFAP disassembly.

Amino Acid Sequence↗