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Biomedical subjects

R Takeda

Publications and source records attributed to R Takeda.

At least 235 records · Page 13Linked to original sources
PubMed1990

[Bucillamine-associated membranous nephropathy in a patient with rheumatoid arthritis].

A case of bucillamine-associated membranous nephropathy in a patient with rheumatoid arthritis was reported. A 34 year-old woman was admitted to our hospital because of proteinuria in September, 1988. Rheumatoid arthritis had been diagnosed in April, 1988, and had been treated with bucillamine (disease modifying anti rheumatic drug) and amfenac (nonsteroidal antiinflammatory drug). The renal biopsy specimens showed Stage I membranous nephropathy, on both electron and immunofluorescence microscopy. Proteinuria decreased after the drugs were withdrawn despite continued RA symptoms. These results were consistent with drug induced nephropathy. Since bucillamine has some resemblances in its structure and pharmacologic action to D-penicillamine, which sometimes induces membranous nephropathy, it is thought that the nephropathy in this case was caused by an adverse reaction to bucillamine.

Adult↗
PubMed1990

[A case of renal cell carcinoma associated with rapidly progressive glomerulonephritis].

A 74-year-old man was admitted to our hospital because of a treatment for his right renal tumor. The abdominal CT scanning revealed a mass in the right kidney, and a right selective renal arteriography demonstrated a hypervascular tumor. On admission, urinalysis revealed proteinuria (3-4 g/day) and microscopic hematuria, and serum electrolytes were normal. Serum creatinine and urea nitrogen levels were 1.6 mg/dl and 30 mg/dl, respectively. A percutaneous right renal biopsy specimens showed crescentic glomerulonephritis. Direct immunofluorescence studies showed strong linear staining for IgG and IgA along the glomerular capillary walls. Electron microscopy showed increased mesangial matrix and swollen epithelial cells, but no dense deposits in the para-mesangial area and in the glomerular basement membrane. The patient underwent right radical nephrectomy. Histologic examination of the resected specimen revealed renal cell carcinoma. Postoperatively, he developed rapidly progressive renal failure and the renal function could not be recovered. Using the indirect immunofluorescence technique, we could not confirm the presence of a serum anti-glomerular basement membrane antibody, although the examination could not be carried out until the initiation of hemodialysis therapy. Some cases of glomerulopathies associated with renal cell carcinoma were previously reported, but the case of crescentic glomerulonephritis was very rare.

Aged↗
PubMed1990

[A new reconstructive technique in cases of mitral insufficiency caused by the elongation of the chordae tendineae of the anterior cusp. A case report].

A new technique is proposed for mitral incompetence due to elongated chordae tendineae of the anterior leaflet. It consists in shortening the chordae tendineae of the leaflet level. First, we make a longitudinal orifice in the anterior leaflet just near its free edge and the elongated chordae tendineae. Through the orifice and with the help of a micro nerve hook we pull the elongated chordae the necessary to keep the anterior leaflet in the same level of the posterior leaflet. The orifice is then closed with a polipropilene 5-0 suture. The mitral annuloplasty was performed with a Gregori IMC prosthetic ring. The excellent clinical and laboratorial data suggest that mitral insufficiency due to elongated chordae tendineae can be corrected by this technique.

Adolescent↗
PubMed1989

Microiontophoresis of flurazepam on inspiratory and postinspiratory neurons in the ventrolateral medulla of cats: an intracellular study in vivo.

Effects of flurazepam on the periodic inhibitory postsynaptic potentials (IPSPs) and on the action of locally applied gamma-aminobutyric acid (GABA) were studied in bulbar respiratory neurons of decerebrate cats using concentric multibarrelled electrodes for intracellular recording and extracellular iontophoresis. Iontophoresis of flurazepam augmented spontaneous IPSPs and increased the hyperpolarization induced by GABA. Iontophoretic application of bicuculline suppressed the action of flurazepam. The reversal potential for spontaneous IPSPs was similar to that for the GABA-response. Intracellular Cl- injection shifted both the IPSP wave and the GABA response in a depolarizing direction. Flurazepam enhanced these depolarizing responses. These results suggest that GABA mediates the postsynaptic inhibition in bulbar respiratory neurons.

Animals↗
PubMed1989

[A multicenter clinical trial of SMS 201-995 (octreotide acetate) in acromegaly and gigantism].

Sixty-four patients with active acromegaly and three patients with gigantism were treated with the long acting somatostatin analog SMS 201-995 (50-500 micrograms, sc, every 6-12 h or 150-880 micrograms daily by intermittent sc infusion, for up to 114 weeks). The fasting plasma GH levels were significantly suppressed (less than 50% of the values before treatment) in 49 patients and became normal in 18 patients. Suppression of GH secretion was associated with normalization of plasma somatomedin-C levels (14 out of 30 cases) and significant clinical improvement such as disappearance of headache and decrease of excessive sweating. Shrinkage of pituitary tumors as determined by computed tomography and/or magnetic resonance imaging studies occurred in 11 out of 40 cases. Side effects were minimal and tolerable. SMS 201-995 appears to be an effective agent for the treatment of acromegaly and gigantism.

Acromegaly↗
PubMed1989

Possible association of aldosterone producing adenoma and non-functioning adrenal tumor.

A 37-year-old woman presented with hyperaldosteronism, suppressed renin levels, and a left adrenal mass on CT scanning. Selective adrenal venous sampling indicated a marked rise of the aldosterone level in the right adrenal vein, while the level in the left vein was low. On laparotomy, an aldosterone producing adenoma (APA) of 12x10x5 mm in size was found in the right adrenal gland and was resected, while the left mass was left in situ. The post-operative course showed normalization of both the clinical and biochemical features of primary aldosteronism, with no sign of recurrence or of enlargement of the remaining adrenal mass in 2.5 years of follow up, suggesting the possible coexistence of a "non-functioning" tumor. This case demonstrates the importance of adrenal venous sampling for the localization of APA particularly since the presence of the APA may be masked by a visualized but unrelated adrenal mass.

18-Hydroxycorticosterone↗
PubMed1989

A young type III hyperlipoproteinemic patient associated with apolipoprotein E deficiency.

A 13-year-old female patient had noticed tuberoeruptive xanthomas since 3 years of age. Her serum, VLDL, and IDL cholesterol levels were high (348, 158, and 60 mg/dL, respectively), while LDL and HDL cholesterol levels were 56 and 62 mg/dL, respectively. VLDL-cholesterol/serum triglyceride ratio was extremely high (0.86), suggesting type III hyperlipoproteinemia (HLP). Her apo E was undetectable by the single radial immunodiffusion studies and SDS-polyacrylamide gel electrophoresis. Her parents showed hypertriglyceridemia and her two siblings were normolipidemic, and their apo E levels were normal. Genomic DNA digested with BamHI or EcoRI did not show gross differences in the restriction fragment length between the apo-E-deficient patient and normal controls. Thus, apo E deficiency may be characterized by early appearance of clinical manifestations of type III HLP and higher VLDL-cholesterol/serum triglyceride ratio.

Adolescent↗
PubMed1989

Disopyramide induces insulin secretion and plasma glucose diminution: studies using the in situ canine pancreas.

The mechanism of disopyramide-induced hypoglycemia, a life-threatening complication in the antiarrhythmic drug treatment, is still controversial. To elucidate this, we have evaluated plasma insulin (IRI) and glucagon (IRG) responses in the pancreatic vein (PV) of the in situ pancreas as well as responses of plasma IRI, IRG, and glucose in the femoral artery (FA) to disopyramide phosphate administration in anesthetized dogs. First, infusion of disopyramide at a dose of 50 mg for ten minutes directly into the pancreatic artery, but not the vehicle, increased significantly plasma IRI concentration in the PV (P less than .05 or less), where the IRI response started within three minutes and reached a peak of 2.8-fold preinfusion value at 30 minutes after starting the infusion (n = 7). Plasma IRI concentration in the FA also increased slightly but significantly (P less than .05). Plasma IRG concentration in the PV initially decreased significantly (P less than .05 or less) and in the FA at one point (P less than .05) during the infusion, and then increased significantly after cessation of the infusion, showing a peak of 1.9-fold preinfusion value at 60 minutes in the PV and the FA (P less than .05). Plasma glucose concentration in the FA decreased slowly and significantly after the infusion (P less than .05 or less) and fell by 16% of the baseline value at 60 minutes (P less than .05). Second, serum disopyramide concentration of 13.7 +/- 2.8 micrograms/mL at ten minutes, which corresponds to a twofold to threefold concentration of the human therapeutic level (n = 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Diazepam potentiates postsynaptic inhibition in bulbar respiratory neurons of cats.

The purpose of this study was to assess the effect of benzodiazepine on inhibitory postsynaptic potentials (IPSPs) of medullary respiratory neurons in decerebrate, paralyzed cats. Diazepam (0.05 and 0.1 mg/kg i.v.) reversibly increased the IPSP waves occurring during the inactive phase of the respiratory cycle in all inspiratory and postinspiratory neurons examined. Input resistances of these neurons were reduced at that phase. The reversal potential for the IPSP wave was unaltered. Intracellular injection of chloride ions reversed the IPSP to depolarization, and diazepam produced a purely depolarizing effect. The drug effects observed during the active phase of each neuron include a decrease in the firing rate and a shortening of the burst activity. The firing threshold and shape of these spikes, however, remained unaltered. These results suggest that diazepam depresses the bulbar respiratory neuronal activities specifically by potentiating the periodic postsynaptic inhibition.

Animals↗
PubMed1989

Indium-111 transferrin imaging for the diagnosis of protein-losing enteropathy.

For assessment of gastrointestinal protein loss, seven patients suspected of having protein-losing enteropathy were studied by gamma camera imaging using in-111 transferrin. Four patients with a value equal to or more than 20 ml/day on the alpha-antitrypsin clearance test or a high protein content on the gastric juice showed definite intestinal activity on an early image, demonstrating protein loss. The loss site could be determined by observing the movement of radiotracer within the bowel lumen on the subsequent images. The three patients with a value of less than 20 ml/day in the test showed no obvious intestinal activity throughout the study. Therefore, in-111 transferrin abdominal imaging appears to be useful for determining the loss site as well as for establishing the rapid diagnosis of protein-losing enteropathy.

Adult↗
PubMed1989

The influence of halothane and thiopental on respiratory-related nerve activities in decerebrate cats.

The effects of halothane and thiopental on the respiratory efferent activities in the phrenic, recurrent laryngeal and hypoglossal nerves were studied in decerebrate, paralyzed and artificially ventilated cats. Inhalation of halothane (2%, 90 s) and intravenous injection of thiopental (2-3 mg/kg) produced a similar change in the breathing pattern, characterized by an increase in respiratory frequency and a decrease in the respiratory burst discharge in the three nerves studied. Depression of the respiratory activity was greatest in the hypoglossal nerve, intermediate in the recurrent laryngeal nerve, and least in the phrenic nerve. Both drugs diminished the whole power spectral densities of the three nerves. Thiopental selectively attenuated the high frequency peaks of these spectra and shifted the peak frequencies to lower values. Bilateral section of the vagus and carotid sinus nerves had no effect on the action of thiopental on the respiratory neural activities, whereas it decreased, but did not eliminate, the action of halothane. The present results demonstrate that both halothane and thiopental produce a selective depression of the upper airway motor activities, with stronger effects on the hypoglossal nerve. Effects on the peripheral receptors and the central respiratory drives differ between the two drugs.

Administration, Inhalation↗
PubMed1989

Biochemical characterization of a digitalis-like substance in human urine, partially purified by high pressure liquid chromatography.

We have partially purified a digitalis-like extract from human urine by means of high pressure liquid chromatography (HPLC). Four fractions, giving positive activity for the cross-reaction in the digoxin radioimmunoassay, Na-K-ATPase inhibition or competition with ouabain binding to its receptor, were detected on HPLC. Among these fractions, the first (F-1) was shown to contain the principle fraction, sharing all the activities, and to exhibit quite similar characteristics to ouabain in the modes of Na-K-ATPase inhibition, ouabain displacement activity and positive inotropic action.

Animals↗
PubMed1989

Development of coronary heart disease in familial hypercholesterolemia.

We studied the development of coronary artery disease in 10 homozygous and 692 heterozygous patients with familial hypercholesterolemia. Seventy-five (22%) male heterozygotes and 35 (10%) female heterozygotes were affected by myocardial infarction, which was first noted in men in the 3rd decade of life and in women in the 4th decade of life. Thirty-eight (70%) out of the deceased 54 heterozygous patients died of coronary heart disease. The mean age at death was significantly less in male heterozygotes (54 years) than in female heterozygotes (69 years). Five homozygous and 105 male and 56 female heterozygous patients received coronary angiographic evaluation. The regression equations between age (X) and coronary stenosis index (Y) obtained by assigning score (0 to 5) to each of 15 coronary artery segments were Y = 1.57X - 20.43 (r = 0.956, p less than 0.05) in the homozygotes, Y = 0.52X - 9.11 (r = 0.438, p less than 0.001) in the male heterozygotes, and Y = 0.47X - 12.54 (r = 0.343, p less than 0.01) in the female heterozygotes. From these data, we can assume that coronary artery stenosis detectable by angiography will occur after 17 and 25 years of age in male and female heterozygotes, respectively, and the treatment of heterozygotes with lipid-lowering drugs can be delayed until late adolescence.

Adult↗
PubMed1989

Serial electrocardiographic and angiographic changes of patients with hypertrophic cardiomyopathy.

The characteristics of ECG findings as they relate to myocardial changes during long-term course of hypertrophic cardiomyopathy (HCM) were studied. Serial changes in ECG were compared with changes left ventriculogram and bi-ventriculogram in 15 patients with HCM without intraventricular conduction disturbance. Serial changes in ECG findings, with special reference to the negative T wave, were categorized in three groups; 1) 5 patients with increase or appearance of the negative T wave (A-1 group). 2) 4 patients with decrease or disappearance of the negative T wave (A-2 group). 3) 6 patients without significant changes in the T wave (B-group). A-1 group presented a marked increase in SV1 + RV5, and of the thickness of anterior and apical wall, and a decrease of the peak dV/dt/EDV (end diastolic volume-normalized peak filling rate), serially. End diastolic volume (EDV) and ejection fraction (EF) did not change significantly. The configuration of left ventriculogram changed from a round form to a spade-like form. A-2 group presented a marked decrease in SV1 + RV5, the thickness of anterior and apical wall, peak dV/dt/EDV and peak dV/dt/V (left ventricular volume of the time of peak filling-normalized peak filling rote). EF decreased serially, 2 cases of A-2 group presented the clinical picture of dilated cardiomyopathy in the end stage. In B group, SV1 + RV5, the wall thickness and left ventricular function did not change, serially. In conclusion, serial observations of ECG are useful for assessing alterations in wall thickness, LV-form and LV-function.

Adult↗
PubMed1989

The possible role of endogenous digitalis-like substance in the regulation of circadian changes in urinary electrolyte excretion in man.

The urinary volume (U.V.), Na excretion (UNaV) and K excretion (UKV) have been reported to show a circadian rhythm in man, but the mechanism of this rhythm has not been made clear. To investigate how atrial natriuretic peptide (ANP) and endogenous digitalis-like substance (DLS) participate in the circadian change in urinary electrolyte, the circadian changes in ANP and DLS (digoxin-like immunoactivity: DLI, Na-K-ATPase inhibitor: ATPI, ouabain binding inhibitor to Na-K-ATPase: OBI) were evaluated in 5 normal man. ANP, DLI and OBI showed no significant correlation with urinary electrolyte excretion, but there was a significant positive correlation between plasma ATPI and urinary Na excretion. From these results it is suggested that circulating Na-K-ATPase inhibitor (plasma ATPI) may be involved in the regulation of the circadian rhythm of urinary Na excretion.

Adult↗
PubMed1989

[Monitoring of somatosensory evoked potentials during extracranial revascularization].

Intraoperative somatosensory evoked potentials (SEPs) were measured in 17 patients during 21 extracranial revascularization and related procedures. The operations included 13 carotid endarterectomies (CEAs), two cervical internal carotid ligations, one vertebral artery (VA) clipping, one VA-common carotid artery (CCA) transposition, and four temporary balloon occlusion tests (TBOTs). Three of the 13 CEAs (23%) showed reduced amplitude and delayed latency of primary cortical SEPs during clamping of the carotid artery, followed by their recovery after emplacement of the internal shunt. Flattening of SEPs during clamping of the CCA was observed in the case of VA-CCA transposition; however, SEPs returned to normal immediately after insertion of a balloon indwelling shunt into the CCA. One of the four TBOTs showed alteration of SEPs during balloon occlusion of the subclavian artery proximal to the origin of the VA. In the others, SEPs remained stable during the entire procedure. Only one transient intraoperative ischemic complication was encountered among the cases of CEA. It was detected through flattening of SEPs, which led to the discovery of an internal shunt obstruction. Carotid stump pressure was also measured in 12 CEAs and two TBOTs, and seven of these 14 had pressure less than or equal to 50 mmHg. Four of the seven had carotid stump pressure less than or equal to 30 mmHg, and three of these four also showed altered SEPs. SEPs remained stable if the collateral flow was sufficient during vascular occlusion and showed obvious alteration when the blood flow was reduced to below the threshold. The authors conclude that monitoring of SEPs during extracranial revascularization is very useful.

Adult↗