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Biomedical subjects

S Takashima

Publications and source records attributed to S Takashima.

At least 19 recordsLinked to original sources

Fulde-Ferrell-Larkin-Ovchinnikov state in a perpendicular field of quasi-two-dimensional CeCoIn5.

A Fulde-Ferrell-Larkin-Ovchinnkov (FFLO) state was previously reported in the quasi-2D heavy fermion CeCoIn5 when a magnetic field was applied parallel to the ab plane. Here, we conduct 115In NMR studies of this material in a perpendicular field, and provide strong evidence for FFLO in this case as well. Although the topology of the phase transition lines in the H-T phase diagram is identical for both configurations, there are several remarkable differences between them. Compared to H parallelab, the FFLO phase for H perpendicularab is confined in a much narrower region at the low-T-high-H corner in the H-T plane, and the critical field separating the FFLO and non-FFLO superconducting states almost ceases to have a temperature dependence. Moreover, directing H perpendicularab results in a notable change in the quasiparticle excitation spectrum within the planar node associated with the FFLO transition.

Journal Article↗

Evaluation of sentinel node identification with isosulfan blue in gastric cancer.

AIMS: The aim of this study was to clarify whether the metastasis of gastric cancer can be detected by identifying the sentinel lymph nodes (SNs) using only lymphatic dye. METHOD: The study was based on 101 patients clinically diagnosed with T1 and T2 gastric cancer. Isosulfan blue was intraoperatively injected within the submucosal layer around the lesion through an endoscope and blue stained nodes (BNs) were identified as SNs and harvested. Standard radical gastrectomy with D2 lymphadenectomy was performed on all patients and SNs and other nodes were evaluated. RESULTS: Out of 101 patients, 21 had lymph-node metastases. The accuracy of SN identification was 97.0% (98/101) and the metastasis detection rate was 85.7% (18/21). With improvement of the manoeuvre in the latter 84 cases, the detection rate was elevated up to 100.0% (18/18), as was the accuracy (84/84). CONCLUSION: The sentinel concept using lymphatic dye is applicable to gastric cancer, but the identification of SNs with lymphatic dye requires some practice. Furthermore, the issue of intraoperative metastasis detection remains to be resolved.

Adult↗

Clinical impact of interstitial pneumonia following surgery for lung cancer.

BACKGROUND: Operative morbidity in patients with lung cancer associated with perioperative interstitial pneumonia (IP) has emerged as a serious problem. PATIENTS AND METHODS: We studied the clinical impact of perioperative related IP in 11 patients (IP group: 7 preoperative known, 4 acute onset) of 473 lung cancer patients who received a pulmonary resection. The IP group was compared to the remaining 462 patients (non-IP group). Demographic data, clinical presentation, and serum KL-6 levels were compared. RESULTS: There were no differences in age, gender, type of surgery, and pulmonary function except for % DLco between the non-IP and IP groups. The IP group showed a higher in-hospital mortality (n=2: 18.3%) than that of the non-IP group (n=3: 0.6%) (P<0.005). Seven patients with underlying IP with high KL-6 levels showed an uneventful recovery. Two patients with postoperative onset of acute IP had a fatal course associated with elevation of serum KL-6 levels. CONCLUSIONS: Postoperative development IP is a serious complication with high mortality, and serial measurement of KL-6 levels is useful to assess the activity of IP.

Adolescent↗

In vivo performance of biodegradable calcium phosphate glass ceramics using the rabbit model: histological and SEM observation.

Two MK5 (45CaO-45P(2)O(5)-5MgO-5K(2)O, in mol%) and MT13 (45CaO-37P(2)O(5)-5MgO-13TiO(2), in mol%) glasses are prepared in the meta- and pyrophosphate regions and crystallized to obtain MK5B and MT13B, respectively. MK5B was obtained by controlled crystallization, and MT13B by powder sintering. As a result of these heat treatment processes, the crystalline phases precipitated in the glassy matrix are KCa(PO(3))(3), beta-Ca(PO(3))(2), beta-Ca(2)P(2)O(7) and Ca(4)P(6)O(19) phases for MK5B and CaTi(4)(PO(4))(6), TiP(2)O(7), alpha- and beta-Ca(2)P(2)O(7) phases for MT13B. To assess the in vivo biological behavior of these glass ceramics, a mixed granulometry in the range 250-355 mum and 355-425 mum with a ratio of 1/1 was implanted for 2, 4, and 12 weeks in the tibiae of Japanese white rabbits. The results showed that the in vivo behavior was strongly affected by their solubility. All implanted materials, MK5B and MT13B, and beta-tricalcium phosphate (beta-TCP) as control material, showed signs of degradation in vivo. However, the levels of degradation were quite different throughout the implantation periods. The highest degradation was observed for MK5B glass ceramic and the lowest for MT13B with beta-TCP in-between. All implanted materials allow for new bone formation in the bone defect area. At the longest implantation period (12 weeks), the MT13B and beta-TCP materials were almost completely surrounded by new bone tissue, whereas MK5B showed some unfilled spaces. This behavior is discussed in terms of the high degradation observed in previous studies.

Absorbable Implants↗

Texture in the superconducting order parameter of CeCoIn5 revealed by nuclear magnetic resonance.

We present a 115In NMR study of the quasi-two-dimensional heavy-fermion superconductor CeCoIn5 believed to host a Fulde-Ferrel-Larkin-Ovchinnikov (FFLO) state. In the vicinity of the upper critical field and with a magnetic field applied parallel to the ab plane, the NMR spectrum exhibits a dramatic change below T*(H) which well coincides with the position of reported anomalies in specific heat and ultrasound velocity. We argue that our results provide the first microscopic evidence for the occurrence of a spatially modulated superconducting order parameter expected in a FFLO state. The NMR spectrum also implies an anomalous electronic structure of vortex cores.

Journal Article↗

Randomized clinical trial comparing level II and level III axillary node dissection in addition to mastectomy for breast cancer.

BACKGROUND: In addition to mastectomy, level II and level III axillary node dissection procedures are performed widely in Japan. A randomized clinical trial was performed to determine which procedure was more effective. METHODS: One group of women had resection of the pectoralis minor muscle and dissection of level I, II and III axillary lymph nodes (level III dissection). In a second group, the pectoralis minor muscle was left intact and level III axillary lymph node dissection was not performed (level II dissection). A total of 1209 women with stage II breast cancer were enrolled in the study and randomly assigned to one of the two groups. RESULTS: The 10-year cumulative survival rate was 86.6 per cent after level II and 85.7 per cent after level III axillary dissection (hazard ratio (HR) 1.02; P = 0.931, log rank test). The 10-year disease-free survival rate was 73.3 and 77.8 per cent respectively (HR 0.94, P = 0.666). Overall survival and disease-free survival rates in the two groups were similar after both procedures. The duration of surgery was significantly shorter (P < 0.001) and blood loss was significantly less (P = 0.001) after level II dissection. In a survey of patients' symptoms on follow-up, no significant differences were found between the two procedures. CONCLUSION: The addition of pectoralis minor muscle resection and level III axillary lymph node dissection to mastectomy for stage II breast cancer did not improve overall or disease-free survival rates.

Adult↗

Intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess.

PURPOSE: To study the efficacy and problems associated with intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess. MATERIAL AND METHODS: The material comprised eight patients with pyogenic hepatic abscess in whom percutaneous drainage could not be performed and intravenous administration of antibiotics was ineffective. An injection catheter was introduced into the common hepatic artery. Almost the same dose of antibiotics as with intravenous administration was infused intra-arterially 2-4 times per day. RESULTS: A therapeutic effect was achieved in six of the eight cases. In these 6 cases, the mean period of intra-arterial infusion was 10.8 days, while the mean period of catheter placement was 14.7 days. Using broad spectrum antibiotics, the therapeutic effect was obtained regardless of the numbers, morphologic characteristics, and differences in location of the abscesses. No significant complications were noted except in one case of splenic infarction. CONCLUSION: Intermittent hepatic artery antibiotic infusion therapy is useful as an alternative therapeutic procedure for pyogenic hepatic abscess in which percutaneous drainage cannot be performed and intravenous administration of antibiotics is ineffective.

Aged↗

Serial diffusion-weighted imaging in a patient with MELAS and presumed cytotoxic oedema.

A patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was studied with serial diffusion-weighted MRI (DWI) after stroke-like episodes and the apparent diffusion coefficient (ADC) was measured in an infarct-like lesion. In the acute and subacute stages, the affected area gave high signal on DWI and its ADC was much lower than that in a normal control region. In the chronic stage, the ADC became higher than that in normal brain. We therefore suggest that the stroke-like episodes did not cause vasogenic oedema but were related to energy failure and cytotoxic oedema.

Brain Edema↗

Comparison of high-resolution contrast-enhanced 3D MRA with digital subtraction angiography in the evaluation of hepatic arterial anatomy.

AIM: To evaluate the validity of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography (MRA) in defining hepatic arterial anatomy and to compare this with digital subtraction angiography (DSA). MATERIALS AND METHODS: MRA and DSA were performed in 30 patients. MRA was performed with breath-hold, gadolinium-enhanced, three-dimensional, fast low-angle shot sequence with a 512 pixel matrix. MRA was compared with DSA in terms of image quality and depiction of hepatic arterial anatomy. The agreement in image quality between MRA and DSA was determined with the kappa statistic. RESULTS: With respect to image quality, there was excellent or good correlation between MRA and DSA for the common hepatic artery (kappa=0.85), proper hepatic artery (kappa=0.72), gastroduodenal artery (kappa=0.70), left hepatic artery (kappa=0.49), left gastric artery (kappa=0.50), splenic artery (kappa=0.84), and superior mesenteric artery (kappa=0.88). Poor correlation was found for the right hepatic artery (kappa=0.18) and right gastric artery (kappa=0.38). With regard to hepatic arterial anatomy, MRA correlated correctly with DSA in 28 of the 29 cases, i.e. 97% of patients. CONCLUSION: MRA is a useful technique for the evaluation of the hepatic artery, and for the vast majority of patients, MRA can replace intra-arterial DSA.

Aged↗

Developmental neurotransmitter pathology in the brainstem of sudden infant death syndrome: a review and sleep position.

Developmental studies on neurotransmitters and their receptors in sudden infant death syndrome (SIDS) infants and controls are reviewed, including comparison between the prone and supine positions at death. In SIDS infants, there are an increase of glial fibrillary acidic protein (GFAP)-positive astrocytes in the brainstem, an increase of substance P (SP) in the medulla and pons, a decrease of tyrosine hydroxylase (TH)-positive catecholaminergic neurons in the ventrolateral medulla (VLM), and vagal nuclei in the medulla oblongata and basal ganglia, a decrease of tryptophan hydroxylase (TrH)-positive serotonergic neurons in the periaqueductal gray matter (PAG), and decreases of 5-hydroxytryptamine 1A (5-HT1A) and 5-HT2A receptor immunoreactivities in the VLM and vagal nuclei in the medulla oblongata. These findings may be the result of chronic or repeated hypoxia and at the same time suggest hypofunction or immaturity of cardiorespiratory regulation. In contrast, 5-HT1A and 5-HT2A receptor immunoreactivities are increased in the PAG of SIDS infants. These increased immunoreactivities may reflect delayed neuronal maturation or a developmental abnormality of the nocicetive reaction of cardiorespiratory and arousal control in SIDS. Also, there are no differences of brainstem gliosis and catecholaminergic neuron changes between the prone and supine positions. Therefore, these changes may be predisposing factors for SIDS.

Astrocytes↗

Molecular biology in cerebral cortex of sudden infant death syndrome.

Full-scale investigations of sudden infant death syndrome (SIDS) by methods of molecular pathology have been carried out. This paper reports the basic preliminary data of SIDS cerebral cortex analyzed by restriction landmark genomic scanning (RLGS) method, which is the second dimension electrophoresis of DNA recently developed in Japan. The RLGS method was carried out separately using the cerebral cortex of a 4-month-old infant with SIDS and using the cerebral cortex of a 3-month-old infant as a control to investigate SIDS-specific spots. As a result, the coincidence rate of spots between the infant with SIDS and the infant without SIDS was 98.12%. The average coincidence rate of spots in humans is usually 99.07%. Therefore, it was confirmed that the coincidence rate of spots by RLGS between the infant with SIDS and the infant without SIDS was lower than that in humans. In addition, the incidence of SIDS-specific spots was 1.19% and the incidence of non-SIDS-specific spots was 0.6%.

Case-Control Studies↗

Quantification of trace elements in the brain of SIDS victims.

In this report, the quantification and analysis of trace elements in the frontal lobes of the brains of sudden infant death syndrome (SIDS) cases were carried out. In all materials, V, Cr, Sn and Sb were not observed and Mg, Na, K, Fe, Zn and Br were observed. As for all of these trace elements, there was no significant difference between SIDS and non-SIDS. Only Ca was not observed in SIDS and observed only in non-SIDS. It is well known that Ca moves from outside of cells to inside of cells and induces cell damage by membrane disturbance in a hypoxic situation. The result in this report suggests that the deaths in SIDS cases are so sudden and are not sufficient for the kinetics of Ca into brain cells in the hypoxic situation.

Calcium↗

Concentric structure of thalamic lesions in acute necrotizing encephalopathy.

Acute necrotizing encephalopathy of childhood (ANE) is characterized by multiple, symmetrical brain lesions affecting the bilateral thalami, putamina and cerebral white matter, which often show a concentric structure on CT and MRI. To reveal the pathological substrate of this finding, comparison was made between CT and necropsy findings of three fatal cases of ANE. Cranial CT demonstrated a concentric structure of the thalamocerebral lesions in one patient who died 3.5 days after the onset of encephalopathy, but not in the other two patients who died within 30 h. Neuropathological examination of postmortem brains revealed laminar changes of vascular and parenchymal pathology in all the cases. Excessive permeability of blood vessels and resultant vasogenic edema became more prominent with increasing depth from the cerebral surface. The deep portion of the lesions showed severe perivascular hemorrhage, accounting for the central high density on the CT images of one patient.

Child Welfare↗

Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcome.

Perineal rectosigmoidectomy (Altemeier's procedure), as used for the surgical treatment of full-thickness rectal prolapse, has a long history. The physiological derangement in patients with rectal prolapse is complex, frequently showing impairment of the rectoanal inhibitory reflex, intermittent high-pressure rectal motor activity, disturbances in anorectal sampling and attendant pudendal neuropathy. There are currently few defined preoperative factors in patients presenting with rectal prolapse and fecal leakage which predict for the restoration of continence after surgery. This review describes our technique of Altemeier's procedure and analyzes the reported results of this operation, presenting those studies which assessed postoperative continence and prolapse recurrence in particular. The lack of prospective randomized data regarding this perineal approach makes clinical interpretation difficult at the present time.

Aged↗

Age related expression of Werner's syndrome protein in selected tissues and coexpression of transcription factors.

AIMS: Werner's syndrome (WS) is an uncommon autosomal recessive disease resulting from mutational inactivation of human WRN helicase, Werner's syndrome protein (WRNp). Patients with WS progressively develop a variety of aging characteristics after puberty. The aim of this study was to determine the distribution of WRNp and the expression of the transcription factors regulating WRN gene expression in a variety of human organs in an attempt to understand the WS phenotype. METHODS: Tissue specimens were obtained from 16 controls aged from 27 gestational weeks to 70 years of age and a 56 year old female patient with WS. The distribution of WRNp and the expression of the transcription factors regulating WRN gene expression-SP1, AP2, and retinoblastoma protein (Rb)- were studied in the various human organs by immunohistochemical and immunoblot analyses. RESULTS: In the healthy controls after puberty, high expression of WRNp was detected in seminiferous epithelial cells and Leydig cells in the testis, glandular acini in the pancreas, and the zona fasciculata and zona reticularis in the adrenal cortex. In addition, the SP1 and AP2 transcription factors, which regulate WRNp gene expression, appeared in an age dependent manner in those regions where WRNp was expressed. In controls after puberty, SP1 was expressed in the testis and adrenal gland, whereas AP2 was expressed in the pancreas. CONCLUSIONS: These findings suggest that the age specific onset of WS may be related to age dependent expression of WRNp in specific organs.

Adolescent↗