Biomedical subjects

S Takano

Publications and source records attributed to S Takano.

At least 199 records · Page 11Linked to original sources

PubMed1990

The osmoreceptor complex in the rat: evidence for interactions between the supraoptic and other diencephalic nuclei.

1. Experiments were undertaken to provide evidence for the existence of a circuit of neuronal interconnections between the supraoptic nucleus (SON), the ventral anteroventral third ventricular region (including the organum vasculosum of the lamina terminalis; ventral AV3V) and the median preoptic nucleus (MnPO), and to determine the importance of these connections in the osmotic control of the neuronal activity of the SON. Extracellular recordings were made in the urethane-anaesthetized male rat from neurones in one of these three sites, while the other two sites were electrically stimulated. 2. During recording from the SON, electrical stimulus pulses applied either to the ventral AV3V or to the MnPO were followed by orthodromic excitation (OD+) or initial short-duration inhibition followed by long-duration excitation (OD- +) of most SON neurones (44/48). The latency of OD+ or OD+ component of OD- + response produced by electrical stimulation of the MnPO was significantly (paired t test, P less than 0.01) shorter than that by the stimulation of the ventral AV3V. None of the neurones we recorded in the SON was activated antidromically by stimulation of either the ventral AV3V or the MnPO. Pressure injection of lidocaine (10%, 50 nl) into the MnPO reversibly depressed the OD+ effect after stimulation of the ventral AV3V in all the SON neurones tested (11/11), while injection of lidocaine into the ventral AV3V did not affect the OD+ effect after stimulation of the MnPO in most neurones (7/9). Both types of observation are consistent with the presence of an excitatory input to SON through the MnPO. 3. Pressure injection of lidocaine into both the ventral AV3V and the MnPO reversibly blocked the activation of SON neurones following an I.P. injection of 1.5 M-NaCl (1 ml) (ventral AV3V 11/11; MnPO, 10/10 cells tested). Injection of lidocaine at both sites, however, did not prevent activation of SON neurones by hypovolaemia (2 ml of blood was withdrawn through a cannula in the right atrium: ventral AV3V, 4/5; MnPO, 4/4 cells tested). The integrity of connections in the ventral AV3V and MnPO thus appeared to be essential for osmotic activation of the SON. 4. Of the 119 ventral AV3V neurones which were tested for their response to electrical stimulation of the SON, forty-nine neurones showed orthodromic excitation (OD+; n = 33) or initial inhibition followed by excitation (OD- +; n = 16). Thirty of the forty-nine OD+ or OD- + neurones also showed antidromic excitation (AD) after electrical stimulation of the MnPO.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗

PubMed1990

Neurinoma of the oculomotor nerve--case report.

Only 10 cases of oculomotor nerve neurinoma have been reported previously. The authors report the rarity of a neurinoma originating from Schwann cells of the oculomotor nerve. The diagnosis was based on the initial sign of oculomotor nerve paresis without involvement of other cranial nerves, neuroradiological and surgical findings, and histological features of the specimen obtained at surgery.

Aged↗

PubMed1990

[Long-term treatment for non-A, non-B chronic hepatitis--effects on hepatitis C virus (HCV)].

We have treated 16 patients with chronic non-A, non-B hepatitis with short term (7-13 weeks) and long term (1 year) interferon. Sustained effect (normalization) of treatment was noted in all by long term treatment, where 7 of 8 with short term treatment showed flare-ups of transaminase after the therapy. In addition, negative turn of anti-HCV antibody was noted in 2 of 5 patients with long term treatment, whereas such change was noted in none of 6 anti-HCV antibody positive patients treated with short term treatment. These data suggest that long term interferon therapy may change natural course of chronic non-A, non-B hepatitis caused by HCV.

Adult↗

PubMed1990

[A case of multiple tumors].

A 54-year-old man was admitted to our clinic for a further examination of rectal and liver tumors, after which a rectal cancer, a hepatocellular carcinoma (HCC), a hemangioma of the liver a retroperitoneal cyst, and a submucosal tumor of the stomach (SMT) were diagnosed by means of a colonoscopy, a gastroscopy, and US, CT, and angiography, these tests also revealing elevated CEA and AFP levels. A hepatic subsegmentectomy and a Miles's operation, as well as an enucleation of other liver tumors and an SMT, were performed and a retroperitoneal cyst was removed. The histopathological finding of the rectal cancer was a moderately differentiated adenocarcinoma, while the liver tumors were determined as being an HCC of the trabecular type, adenomatas revealing hyperplasia, a hemangioma, and the SMT showing a benign leiomyoblastoma.

Adenocarcinoma↗

PubMed1990

[Stereotactic aspiration using coordinate software for hypertensive intracerebral hematomas].

Stereotactic aspiration for intracerebral hematoma has become widely used due to improvements in computed tomography (CT). CT-guided stereotactic aspiration for hypertensive intracranial hematomas was performed in 46 cases. Stereotactic aspiration with coordinate software was carried out among 16 cases. We compared the clinical results of conventional stereotactic aspiration with results of the new method using coordinate software. Using coordinate software, we can examine the route for the target point, as well as the target point of the hematoma before surgery. Therefore we can avoid obstacles such as ventricles and internal capsules. Further, we can aspirate hematoma by using only this one procedure. Mean hematoma aspiration percentage has risen from 44.9 to 87.2% by using coordinate software. Rate of drainage tube insertion after operation has decreased from 90 to 50%. The period of placement of the drainage tube and the frequency of infection due to the drainage tube has become lower, too. Therefore we can say that the outcome of treatment of hypertensive intracranial hematomas is improved by using coordinate software.

Cerebral Hemorrhage↗

PubMed1990

[Instrumentation surgery for tumor of the spine].

Spinal instrumentation surgery has come into wide use recently, especially for tumor of the spine. It is very effective for fixing the spine for relieving the patient from pain. But the decision about the indication of instrumentation surgery for tumor of the spine must be made carefully. In cases of double malignant tumors including spinal tumor, it is hard to decide how to treat tumor of the spine. We report a case of 78-year-old male with multiple myeloma of the cervical spine and cancer of the prostate. The patient had been in good health until one year previously, when he started to complain of nuchal pain. He became bedridden with loss of voluntary control of the right upper extremity for the last two months. Then he was admitted to our hospital and radiological examination was carried out. It revealed tumor of the cervical spine and it seemed to be bone metastasis. Further examination revealed that the patient was suffering from multiple myeloma and cancer of the prostate. The tumor of the spine was diagnosed as either multiple myeloma or metastasis of cancer of the prostate. Spinal instrumentation surgery using Luque-rod was carried out as one of the comprehensive treatment plans for double malignant tumors. The instrumentation surgery was effective for fixing the spine and improving the patient's quality of life. In operative procedures, intraoperative spinal cord monitoring was carried out. Intraoperative spinal cord monitoring was indispensable for preventing spinal cord injury. The tumor of the spine was diagnosed as multiple myeloma by pathological examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

[Experience in the use of Kyosera Injection Port as a kind of implantable reservoir (the second report)].

A total of 30 pieces of Kyosera Injection Port, as a kind of implantable reservoir, was used in 29 cases of liver tumor for an intermittent repeated chemotherapy. Of these 27 cases were actually used between Aug. 1st, 1986 and Aug. 31st, 1989. In this paper we studied the safety of the reservoir. The observation period averaged 259.4 days, with the highest of 760 days and the lowest of 29 days. The injection times averaged 12.7 times, with the maximum of 40 times and the minimum of one. The reservoir was placed under the laparotomy, and the cases which underwent cholecystectomy were 93.1%. 16 cases were treated with intraarterial infusion, and 14 with intraportal infusion. We investigated the complication of Kyosera Injection Port in 27 cases. As a result, there were no complication such as catheter occlusion and infection via catheter. But of 27 cases, 8 cases were recognized a complication, and the rate was 29.6%. Lumbago was noted during infusion chemotherapy in three cases, and on the other hand, there were steatolysis and necrosis of the tissue surrounding the implantation site, a movement of port, a catheter out of vessel, a leakage of the drug, and intraabdominal bleeding after taking off the catheter. But of 8 complication cases, only two cases were not able to inject drug. As a result, the rate of complication was 70.4% in over all. On the other hand, of 27 cases, there were 5 cases which recognized the complication caused by reservoir in itself. The safety rate was 81.5%. In such a circumstance this reservoir was very safe and seemed suitable to the implantable reservoir.

Adult↗

PubMed1990

[Non-ketotic hyperosmolar diabetic coma in neurosurgical cases; review of 7 cases].

Neurosurgical patients with non-ketotic hyperosmolar diabetic coma (NHC) in our institution were analysed retrospectively. Seven cases were diagnosed as NHC being 0.47% of the number of inpatients in the last 5 years. The age ranged from 60 to 72 years old (mean 65) and there were 6 males and 1 female. Only 2 patients (29%) had a clear past history of diabetes mellitus. Prior to the NHC, systemic infection was present in 2 cases. Intravenous hyperalimentation (IVH) was performed in 5 cases, glycerol osmotherapy in 3 cases, diphenylhydantion therapy in 3 cases and tube feeding in 2 cases. The overall mortality rate in our series was 71% (5 cases), of which 2 cases died within 2 days due to cardiopulmonary failure, and 3 cases in the chronic stage died due to disseminated intravascular coagulopathy (DIC), or due to renal failure. The prognosis of NHC in neurosurgical patients is generally bad because of the presence of consciousness disturbance prior to the onset of NHC, which may mask the symptoms occurring from the NHC. Other predisposing factors could be systemic infection, IVH or tube feeding, and osmotic agents which are frequently used in neurosurgical patients. There was a tendency for NHC to occur predominantly in the chronic stage after the blood sugar had returned to normal range from the hyperglycemic state in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1989

Histological changes of the liver by treatment of chronic non-A, non-B hepatitis with recombinant leukocyte interferon alpha. Comparison with histological changes in chronic hepatitis B.

We have treated 17 patients with non-A, non-B chronic hepatitis by recombinant interferon alpha (0.3-9 megaunits for 4-28 weeks). In six patients, serum aminotransferase levels fell to normal or near-normal range during treatment. The mean levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in 17 patients fell from 156 +/- 80 (mean +/- SD) and 213 +/- 135 at the beginning of treatment to 94 +/- 49 and 112 +/- 71, respectively, at the end of treatment. In 12 patients, liver biopsies were performed before and after (or during) the treatment, and histological activity indices (HAI) were blindly examined by two independent observers. For comparison, we examined histological changes of pre- and posttreatment liver biopsies of 19 patients who were treated by recombinant interferon for chronic hepatitis B. Mean HAI scores improved from 10.0 to 5.4 after treatment in non-A, non-B chronic hepatitis. The most marked reduction was noted in scores of portal inflammation and hepatocellular degeneration and/or necrosis. No such reduction was observed in B-viral chronic hepatitis. These data indicated that rapid biochemical resolution by the treatment was related to histological improvement of the liver in our patients with non-A, non-B hepatitis.

Adult↗

PubMed1989

Postoperative results of distal partial gastrectomy, selective vagotomy plus antrectomy, and selective proximal vagotomy for duodenal ulcers.

We investigated the postoperative results of distal partial gastrectomy, selective vagotomy plus antrectomy, and selective proximal vagotomy, to evaluate their effectiveness in the treatment of duodenal ulcers. The operative mortality of selective vagotomy plus antrectomy and selective proximal vagotomy seemed to be lower when compared to distal partial gastrectomy, although each procedure showed a sufficiently low mortality. The acid reduction rate was significantly lower after selective proximal vagotomy than after the other procedures (p less than 0.01). However, the rate of ulcer recurrence following selective proximal vagotomy tended to be higher compared with the other procedures. All three procedures showed good results according to Visick's grading and postoperative symptoms occurred in about 50 per cent of all patients, no matter what the procedure. The regaining of physical ability was significantly greater following selective proximal vagotomy than following distal partial gastrectomy (p less than 0.05) and the capacity to work was also better after vagotomy, particularly selective vagotomy plus antrectomy (p less than 0.05). Thus, although distal partial gastrectomy and selective vagotomy plus antrectomy proved superior regarding the low ulcer recurrence rate and acid reduction, while selective proximal vagotomy proved superior for improving the quality of life, on the whole, the three operations promise almost equivalent results.

Adult↗

PubMed1989

[Cloverleaf skull syndrome with occipital bone cristae. Report of two cases].

Two cases of cloverleaf skull syndrome are reported. The patients were born with trilobed deformity of the skull associated with synostosis of the lambdoidal, coronal, and sagittal sutures in Case 1 and of the lambdoidal suture in Case 2. Both patients had hydrocephalus, low-set ears, and ocular hypertelorism. Ventriculoperitoneal shunting had been performed for hydrocephalus in both cases in early infancy. Thereafter, the skull anomaly caused mental and physical retardation and elevated intracranial pressure. In both cases, surgery was successful in terms of cosmetic and neurological improvement. Both cases involved prominent midline crista formation of the skull over the posterior fossa, which steadily progressed during the first year of life and produced hydrocephalus, apparently by compressing or obstructing the aqueduct and/or the ostia of the fourth ventricle. Twenty-four cases of surgery for cloverleaf skull syndrome have been reported to date. Only Partington's types II and III were treated surgically, and patients with type III had more favorable outcomes than those with type II. However, these reports provide no clear-cut data that surgery significantly influences the outcome. The experience with the two cases reported here suggests the benefits of early shunting followed later by radical surgery.

Child, Preschool↗

PubMed1989

[Availability of intermittent chemotherapy by reservoir in liver metastasis of colo-rectal cancer].

From August 1986 to May 1989, in 18 cases of liver metastasis from colo-rectal cancer, intermittent chemotherapy was undergone by implantation reservoir in the subcutaneous. Intra-arterial infusion chemotherapy was under taken in 6 cases, and intra-portal vein chemotherapy in 12 cases. 5-FU 500 mg + MMC 10-6 mg was infused through implantable reservoir once every two weeks. CDDP and ADM were also infused in one case. Infusions averaged 12.4 times, and the most was 24 times in the group of intra-arterial infusion chemotherapy. In the group of intra-portal vein infusion chemotherapy, infusion averaged 12.4 times, with the highest at 35 times. In liver metastasis (H3), there is no significant difference between intra-arterial infusion chemotherapy and intra-portal vein infusion chemotherapy, revealing the cumulative survival rate. And the reservoir group compares with the 14 cases of hepatectomy and the 9 cases of systemic chemotherapy in cumulative survival rate. As a result, there was no significant difference between the group with the reservoir and the systemic chemotherapy group in H1 cases and H2 cases, revealing a median survival rate in these treatment groups. The median survival of reservoir group was 8.3 months, and that of the hepatectomy group was 20.6 months in H2 cases. In the H3 cases, the median survival of the reservoir group was 9.6 months, and that of the systemic chemotherapy group was 10.3 months. Reservoir was implanted in three cases to prevent recurrence after hepatectomy. As a result, two of three cases have survived for 20 months and 10 months, respectively.

Adult↗

PubMed1989

[The influence of dose of transfusion and component of blood on the incidence of post-transfusion hepatitis].

Two thousand five hundred ninety-six consecutive patients who received blood transfusion for the first time within one week and had no liver dysfunction before transfusion had been selected from 8637 patients who received blood transfusion at the hospital between 1982 and 1987. The influence of dose, components of transfused blood and sex, age of recipients on the incidence of post-transfusion hepatitis was investigated. The rate of development of hepatitis depended on the dose of transfusion, not on sex and age of recipients. The rate of development of hepatitis raised as number of transfused blood increased without limiting point to 100%. The carrier rate of healthy population of non-A, non-B hepatitis virus was estimated 1.39%. Stored blood, concentrated red blood cell and fresh blood are high risk components and fresh frozen plasma was low risk component.

Hepatitis↗

PubMed1989

[Clinical study on two cases of progressive systemic sclerosis with anti Wa antibody].

It is well known that patients with progressive systemic sclerosis (PSS), as well as other autoimmune disease, have various kinds of autoantibodies. We presented two PSS patients with anti Wa antibody, which had recently been reported as a new anti cytoplasmic antibody in only one case with PSS. Our first case, 49 years old female had clinical features of arthralgia, Raynaud's phenomenon, sclerodactyly, transient myalgia and sicca complex. Her laboratory findings showed hypergammaglobulinemia (1.9 g/dl), positive RAHA (1: 640) anti Wa antibody (1: 256), and anti SS-A antibody (1: 256). Second case, 64 years old female had also clinical features of Raynaud's phenomenon, sclerodactyly, dysphagia, dyspnea on exertion and dry mouth. Furthermore lung fibrosis and dysmobility of upper GI tract were observed. FANA (1: 20) was detected as nucleolar pattern, and the titer of anti Wa antibody was 1: 64. Clinical findings of myositis were not seen in both cases. This study suggested that anti Wa antibody might be one of the diagnostic marker on PSS.

Autoantibodies↗

PubMed1989

[Evaluation of disease activity by hand X-ray findings in rheumatoid arthritis].

It would appear to us that the patients with rheumatoid arthritis (RA), in whom articular bone lesions were confined to the wrist and/or carpal joints in X-ray films, may follow a milder disease activity than do the patients with the hand and finger joint lesions. To clarify it, the present study was performed retrospectively. RA patients showing stage II or more lesions in the wrists and/or carpal joints but no lesions over stage II in any hand and finger joint (MCP, IP and PIP) radiologically after 5 years or more duration were regarded as the carpal type (C type). The clinical and laboratory data were compared between 44 patients of the C type RA and 44 patients of other type RA, matched in the sex, age and disease duration. Significant differences were observed in the following parameters between the 2 groups; the functional class, Lansbury's activity index, number of the affected joints, ESR, CRP and hemoglobin values, and ADL scores. That is, Hb values and ADL scores were higher, but the others were lower, in the C type RA group than in other type RA group. The positive percentage and titer of rheumatoid factor were not significantly different between the 2 groups. It was concluded that C type RA patients are milder in the activity and fewer in the number of affected joints than other type RA patients. Furthermore it was suggested that C type RA patients may have milder clinical course and better prognosis than other type RA patients.

Adult↗

PubMed1989

[Clinical significance of intracranial hemorrhage caused by cerebral arteriovenous malformations: with special reference to intraventricular hemorrhage].

Forty-two cases with intracranial hemorrhage caused by cerebral arteriovenous malformation (AVM), which was diagnosed by CT scan, were reviewed with regard to the clinical significance of intracranial hemorrhage, especially intraventricular hemorrhage (IVH). Twenty-one patients were defined as poor risk cases whose level of consciousness at admission was 100 to 300 according to the Japan Coma Scale, whereas the remaining 21 patients were defined as good risk cases. Surgical excision of AVM was undertaken in 35 out of the 42 cases. Urgent surgical removal of intracerebral hematoma and AVM within 24 hours following onset was undertaken in 11 cases. In 14 patients, urgent continuous ventricular drainage was carried out. The effects of the following factors on the level of consciousness at admission, and on the result of AVM treatment were investigated to clarify the clinical significance of intracranial hemorrhage; 1) cast formation of 3rd and/or 4th ventricle, 2) volume of intraventricular hematoma, 3) accompanying intracerebral hematoma and 4) acute hydrocephalus. It was confirmed that all these factors significantly contributed to the development of serious disturbance of consciousness in the acute stage following intracranial hemorrhage. For good risk cases, the rate of patients who showed a good recovery or only moderate disability according to the Glasgow Outcome Scale reached 91%, whereas for poor risk cases, it was only 43%. The presence of large intracerebral hematomas of more than 4 cm in diameter accompanied with IVH was significantly correlated with the result of AVM treatment. The presence or absence of cast formation of 3rd and/or 4th ventricle, volume of intraventricular hematoma and acute hydrocephalus were not significantly related to the result of AVM treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1988

Zinc clearance correlates with clinical severity of Crohn's disease. A kinetic study.

After peroral and intravenous loading of zinc in 10 patients with Crohn's disease, a kinetic analysis of serum zinc was carried out. The patients were divided into two groups depending on the clinical activity indices (group A:five with active form and group B:five with inactive form). The mean level of serum zinc was significantly reduced in group A patients, but not in group B, when compared to findings in control subjects. A significant reduction in AUCpo (area under the concentration vs time curve by peroral administration), accompanied by increased zinc clearance (ClZn) was also found in group A but not in group B. The ClZn significantly correlated with clinical activity indices. Absorption efficiency, the ratio of AUCpo/AUCiv (area under the concentration vs time curve by intravenous administration), was similar in group A, group B, and the control. Therefore, the absorption of zinc in patients with the disease seems to be intact, regardless of whether they have the active or inactive form of Crohn's disease. The hypozincemia seen in patients with Crohn's disease is presumably related to an accelerated turnover rather than to a malabsorption of zinc.

Adolescent↗

PubMed1988

Reduced oxytocin response to osmotic stimulus and immobilization stress in lactating rats.

The release of oxytocin in response to an osmotic stimulus and immobilization stress was compared in lactating rats 8-12 days after delivery and in non-lactating rats. Intravenous injection of hypertonic saline or immobilization stress induced an increase in blood oxytocin levels in both lactating and non-lactating rats, but the increment in the former was significantly lower than that in the latter. The lower responsiveness of oxytocin release to stress in lactating rats was not altered by ovariectomy 2 days after parturition. Oxytocin release induced by electrical stimulation of the anteroventral third ventricle (an osmoreceptive area), paraventricular nucleus and neurohypophysis was significantly lower, to a similar extent, in lactating rats compared with non-lactating rats. These findings indicate that the structural reorganization reported in the hypothalamo-neurohypophysial system may not function to facilitate release of oxytocin in response to stress and osmotic stimulus in lactating rats. The reduced responsiveness of the release of oxytocin is independent of the influence of ovarian hormones, and may be due to the low ability of the oxytocin neurone itself to release oxytocin, and/or due to the activated inhibitory influence on the oxytocin neurone in the lactating rat.

Animals↗