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Biomedical subjects

S Takeda

Publications and source records attributed to S Takeda.

At least 541 records · Page 30Linked to original sources
PubMed1992

Successful ultrasonically guided percutaneous ethanol injection for secondary hyperparathyroidism.

Ultrasonically guided percutaneous ethanol injection to all of four enlarged parathyroid glands, which were confirmed by fine-needle aspiration biopsy, was successfully performed in a hemodialysis patient with secondary hyperparathyroidism. In addition to marked reduction of serum parathyroid hormone, the size of parathyroid glands was significantly decreased after the procedure. As an adverse effect, the patient experienced a transient self-limiting dysphonia due to right recurrent nerve palsy after the first injection. This procedure may be an effective alternative to surgical treatment or administration of high-dose 1,25(OH)2 vitamin D3 in uremic patients with sonographically verified multiple enlarged parathyroid glands.

Adult↗
PubMed1992

Coagulopathy in disseminated intravascular coagulation due to abdominal sepsis: determination of prothrombin fragment 1 + 2 and other markers.

To estimate the degree of coagulopathy in abdominal sepsis, we measured the plasma levels of prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III complex (TAT) and plasmin-alpha 2-plasmin inhibitor complex (PIC) by the enzyme-linked immunosorbent assay in 38 patients with disseminated intravascular coagulation (DIC). In 20 patients with DIC due to abdominal sepsis, plasma levels of F1 + 2, TAT and PIC were 2.6 nmol/l, 27.9 micrograms/l and 1.5 micrograms/ml, respectively, with a mean antithrombin III (AT III) activity of 41.7%. F1 + 2, TAT, PIC and AT III levels were 4.7 nmol/l, 75.8 micrograms/l, 8.8 micrograms/ml and 70.9% in 18 patients with DIC as the result of malignancy. Though AT III levels in DIC due to sepsis were lower than those in DIC due to malignancy, the levels of F1 + 2, TAT and PIC in the former were not significantly more increased than those in the latter. The plasma levels of F1 + 2 were positively correlated with TAT and PIC in DIC patients with malignancy; however, there was no correlation between F1 + 2 and TAT or PIC in DIC patients with sepsis. In addition, the levels of serum albumin in the two groups were similar. These results suggest that activation of coagulation and fibrinolytic systems may not be so prominent in cases of DIC due to abdominal sepsis, compared to related events in DIC due to malignancy. It is also suggested that the depletion of AT III in cases of sepsis is not only caused by a consumption related to intravascular coagulation or to an alternate distribution of protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Antifibrinolytic Agents↗
PubMed1992

Antitumor agents. I. DNA topoisomerase II inhibitory activity and the structural relationship of podophyllotoxin derivatives as antitumor agents.

Various podophyllotoxin derivatives from desoxypodophyllotoxin (DPT) were synthesized to examine the structural relationships between the biological significance (cytotoxic effect, effects on DNA topoisomerase II and tubulin polymerization) in vitro and antitumor activity in vivo (L 1210). An intact 6,7-methylenedioxy group of DPT is necessary to inhibit tubulin polymerization and topoisomerase II. 4'-Phenolic hydroxyl group of DPT is essential to inhibit DNA topoisomerase II and the inhibitory effect on DNA topoisomerase II contributes to a high cytotoxicity. The introduction of an aminoalkoxy group at 1-position of DPT enhances the inhibitory activity against DNA topoisomerase II and cytotoxic effect, causing the inhibitory activity against tubulin polymerization to disappear. The results of antitumor test in mice bearing L 1210 on podophyllotoxin derivatives suggest the following: 1) the strong cytotoxic effect itself is not a good indication of antitumor activity in vivo as long as it is associated with inhibition of tubulin polymerization. DNA topoisomerase II inhibitory effect contributes to an antitumor activity in vivo; 2) detailed measurements of cytotoxicity and inhibition on DNA topoisomerase II and tubulin polymerization in vitro are necessary to evaluate podophyllotoxin derivatives.

Animals↗
PubMed1992

Effects of angiotensin II on regional brain noradrenaline metabolism in non-stressed and stressed rats.

By measuring levels of noradrenaline (NA) and its major metabolite, 3-methoxy-4-hydroxyphenylethyleneglycol sulfate (MHPG-SO4), in various rat brain regions, the effects of angiotensin II (AT II) injected intracerebroventricularly (ICV) were investigated in non-stressed and stressed rats. Immobilization stress with a wire mesh was employed. Immobilization stress induced significant increases in MHPG-SO4 levels in all brain regions examined, i.e., hypothalamus, amygdala, thalamus, midbrain, hippocampus, cerebral cortex and locus coeruleus (LC) region, which suggests that stress increases NA release in these regions. AT II (1 and 10 micrograms), injected ICV 5 min before exposure to stress for 60 min, attenuated stress-induced increases in MHPG-SO4 levels in the hypothalamus, thalamus and amygdala. AT II, injected ICV in non-stressed rats at 65 min before sacrifice, significantly elevated MHPG-SO4 levels in the midbrain, cerebral cortex, thalamus and LC region. These results indicate that the attenuating effect of AT II on stress-induced increases in brain NA release are, in part, related to the reduction of fear and/or anxiety of the animals exposed to stress.

Angiotensin II↗
PubMed1992

Action of 5-trifluoromethyl-2'-deoxyuridine on DNA synthesis.

The action of 5-trifluoromethyl-2'-deoxyuridine (CF3dUrd) on DNA synthesis was investigated in vitro assay systems with purified DNA polymerases. CF3dUrd was incorporated into the DNA of mammalian cells in culture. We studied the incorporation of CF3dUrd 5'-triphosphate (CF3dUTP) into DNA and effect of CF3dUrd residue on DNA synthesis. Therefore, we synthesized oligonucleotides that allow site specific introduction of a CF3dUrd residue into a synthetic DNA oligonucleotide. After CF3dUTP incorporation, the primer was extended for human DNA polymerase alpha (pol. alpha). When CF3dUrd residue was located at an internucleotide site in the template, however, pol. alpha was exhibited a strong arrest band one nucleotide after the CF3dUrd residue site, and Escherichia coli polymerase I (Klenow fragment) also exhibited a weaker arrest band one nucleotide before the CF3dUrd residue. These results suggested that a mechanism of antitumor activity of CF3dUrd is inhibition of DNA replication.

Base Sequence↗
PubMed1992

[Health status and care of the urban elderly].

In order to investigate the health and care of the urban elderly, self-administered anonymous questionnaires were sent to a sample randomly selected from the elderly 70 to 89 years of age, in 3 different areas (central, residential and suburban) in Wakabayashi-Ward in Sendai. Responses from 1,248 were returned by mail (response rate = 76.4%) and results were compared to the expected values estimated from the results of investigations conducted by the Ministry of Health and Welfare. 1) As for present addresses of the elderly, 94.2% were at home, 3.8% in hospitals, 0.7% in nursing homes, and 1.3% in other facilities. 2) Responses showed that 28.4% were suffering from hypertension, 5.6% from diabetes mellitus, 2.2% from strokes and liver diseases, with all of these percentages similar to the respective expected values. However, 12.7% were suffering from heart disease which was over twice the expected value. 3) Analysis of health habits showed that the percentages of the elderly who had "good sleep and rest", "nutritious meal", and "moderate exercise" were higher than expected. Only 2.3% did not practice good health habits, which was one sixth of the expected value. 4) As for meal habits of the elderly, 88.3% had three meals a day, and 33.7% made efforts to take less salty foods. 5) Dietary habits of the elderly indicated that 83.8% were frequent consumers of meat, fish and soybeans products, 62.3% vegetables, 51.0% sweet confectionery (significantly higher), 49.2% milk (significantly higher), 22.3% fried foods like tempura (significantly higher), and 22.3% salty vegetables (significantly lower).(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1992

[Application of immunohistochemistry to the dead brain].

To evaluate the usefulness of immunohistochemistry for studies of brain tissues taken from patients with a clinically established diagnosis of brain death, we examined 8 brains that had been removed and fixed in formalin between 13 h and 5 days after diagnosis of brain death (Table). As a control we also examined the brain of a patient who had suffered extensive infarction with a 28-day clinical course and died of pneumonia. Routine examination of each of the brains revealed old to recent tissue necrosis associated with macrophages, capillary proliferation and/or astrocytic gliosis. The streptavidin-biotin immunoperoxidase method was applied to the materials using four monoclonal antibodies: antiglial fibrillary acidic protein (GFAP), anti-vimentin (vimentin), LN-1 and LN-3. GFAP was stained in reactive astrocytes even 5 days after diagnosis of brain death (Fig. 3, 7). Vimentin (Fig. 2, 4) was stained in reactive astrocytes until 3 days after diagnosis of brain death. LN-1 (Fig. 5) produced positive staining in resting microglias until 3 days after diagnosis of brain death. LN-3 (Fig. 1, 6, 8), which detects human leukocyte antigen-DR, stained reactive microglias and macrophages even 5 days after diagnosis of brain death. From our findings, it is considered that immunohistochemical examination is useful even in brains from patients diagnosed as brain-dead.

Aged↗
PubMed1992

Evolutionarily conserved promoter motifs and enhancer organization in the mouse gene encoding the IIB myosin heavy chain isoform expressed in adult fast skeletal muscle.

We have isolated the mouse gene for the MHC isoform expressed in adult type IIB (fast-contracting, glycolytic) skeletal muscle fibers, and determined the DNA sequence of the promoter region. This sequence represents the first example of a promoter for a gene encoding an adult-specific isoform of a mammalian skeletal MHC. The proximal 200 bp of the promoter contains several sequence motifs which are identical or very similar to homologous motifs found in the promoters of a family of chicken skeletal MHC genes. Of these, two novel AT-rich sequences may be important for regulation of the promoter. A second feature of the mouse IIB MHC promoter sequence concerns a number of sequence motifs located at ca. -1,000 bp which are organized in a similar fashion in the IIB MHC promoter and a homologous region of promoter of the mouse muscle creatine kinase gene.

Animals↗
PubMed1992

[Phrenic nerve palsy after open heart surgery--problems in post-operative respiratory management].

We clarified the problems in respiratory management in patients with phrenic nerve palsy (PNP) after open heart surgery. From December 1988 to March 1991, 248 adult patients underwent open heart surgery with topical myocardial cooling. In these patients PNP was diagnosed in 17 patients (6.9%). Age of these patients at operation ranged from 25 to 76 years with a mean age of 57 years. 9 patients were valvular heart disease (7 were reoperation), 7 were coronary artery disease, and one patient was aortic aneurysm. PNP was diagnosed by chest roentgenogram or percutaneous phrenic nerve stimulation test (PNST). Frequency of long-term intubation (> 14 days) was higher in complete PNP patients than incomplete PNP patients. 2 patients, who were observed effort dyspnea at the time of respiratory weaning, were extubated followed by respiratory and circulatory deterioration, and were reintubated. PNP were confirmed after reintubation by PNST. These patients died of pneumonia. Another 2 patients were observed effort dyspnea during respiratory weaning, and were doubted of PNP. PNP were confirmed by PNST before extubation. After hemodynamic stabilization and respiratory physiotherapy, these patients were extubated without any trouble. One patient, who required repeated intubation, was diagnosed PNP by PNST. This patient was extubated after confirmation of improvement of PNP by follow-up PNST. The incidence of PNP was higher in patients with previous open heart surgery than without previous operation. We supposed that the dissection around the heart might be one of major cause of postoperative PNP. So, in recent 4 cases of mitral reoperation, we attempted to reach mitral valve through atrial septum with minimum dissection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Therapeutic value of hepatectomy and transcatheter arterial embolization (TAE) for hepatocellular carcinoma].

Therapeutic value of hepatectomy and TAE was evaluated retrospectively in 150 hepatectomized and 117 non-hepatectomized patients of hepatocellular carcinoma (HCC). Operative death was seen in 5 patients. Cumulative 5 years survival rate and disease free cumulative 5 years survival rate of the 145 hepatectomized patients were 35.4 per cent and 23.6 per cent respectively. These survival rates were significantly affected by tumor size, intrahepatic metastasis (IM) and vascular invasion (Vp). But the influences of tumor margin (TW) and curative resection (relative curative or relative non-curative) were slight. Ninety-two patients (69:dead, 23:alive) had tumor recurrences. TAE was performed in 56 out of 92 patients effectively and 2 years survival rate was 31.5 per cent. Overall cumulative 5 years survival rate of non-hepatectomized patients was 6.6 per cent, but this group showed a more reduced hepatic reserve and more advanced tumor stage. Six patients treated by TAE survived more than 4 years. Hepatectomy is a first option for the treatment of HCC since complete cure may be estimated. However, because of operative risk and higher recurrence rate, use of current multidisciplinary treatment including TAE is necessary for the prognostic improvement of HCC with or without hepatectomy.

Aged↗
PubMed1992

[The results and problems of surgical treatment of cancer of the duodenal papilla of Vater].

Twenty six of 28 cases (92.9%) of cancer of duodenal papilla of Vater were resected from 1981 to 1990. Twenty five pancreatoduodenectomy and one total pancreatectomy were performed. Operative death and hospital death were not observed. Three year and five year cumulative survival rates of resected cases were 58% and 52% respectively. There was relatively good correlation between pathological cancer extension and postoperative prognosis. Postoperative prognosis of the cases which had cancer extension to the pancreas was extremely poor. But the prognosis of the cases of cancer within Oddi muscle was extremely good. Immunohistochemical staining using anti CEA, anti CA19-9 and anti DUPAN 2 was studied and Grade III staining pattern was observed only in the cases which had cancer invasion to the pancreas. Preoperative diagnosis of cancer extension using endoscopic ultrasonography and appropriate choice of the operative procedure are important. Extended operation and effective adjuvant therapy are necessary for advanced cases of cancer of the duodenal papilla.

Adult↗
PubMed1992

[Herpes zoster of the right cervical region associated with right facial nerve palsy and hoarseness].

A 69-year-old man was suffering from herpes zoster on his 2nd and 3rd right cervical spinal segments and 3rd branch of the trigeminal nerve. He came to our hospital on his 10th illness day and was treated with continuous cervical epidural block, intravenous infusion of acyclovir for five days, and oral paramethasone and Vitamin B12. Oh his 18th illness day, right facial nerve palsy and hoarseness became clear. His cerebrospinal fluid showed no abnormality except cell count 23 x 3 mm-2. No clear paralysis of vocal cords was detected on laryngoscopy. He was also treated with right stellate ganglion block starting on his 21st illness day. His pain and facial nerve palsy recovered completely by his 68th illness day, but hoarseness continued about two months. The hoarseness might be a result of spread of the disease 1) by cerebrospinal fluid, 2) by contact with the 3rd cervical nerve and vagal nerve via accessory nerve, and 3) direct effect on the vocal cords and the muscles controlling them. Herpes zoster on the head and neck region shows various complications and we should follow its course cautiously.

Aged↗
PubMed1992

[A case of hyperalphalipoproteinemia with complete deficiency of cholesteryl ester transfer activity].

A 68-year-old male patient with benign hypertension shows high levels of high density lipoprotein cholesterol (HDL-C) of 171 mg/dl. The serum total cholesterol was 240 mg/dl. An abnormal slow alpha band and polydisperse low density lipoprotein (LDL) bands were detected by agarose gel and polyacrylamide gel electrophoresis. The slow alpha band was considered as an apo E-rich HDL. A peak of large HDL particle and a peak of abnormal high-molecular-LDL particle were observed in the patient's serum by gel permeation high performance liquid chromatography. Cholesteryl ester transfer activity (CETA) of the patient's serum was completely deficient (0.0%/10 microliters/18 hr). From these results, it is strongly suggested that patient's hyper-HDL-cholesterolemia caused by a complete deficiency of CETA.

Aged↗
PubMed1992

[The effect of epidural anesthesia on prostaglandin synthesis during alveolar hypoxia].

The effect of epidural anesthesia on prostaglandin synthesis during alveolar hypoxia was investigated in 20 patients. Group I received intravenous anesthesia and group II received epidural and intravenous anesthesia. Patients in both groups were intubated with a double-lumen end tracheal tube, allowing separate ventilation of the right lung with 5% CO2, 6% O2 and 89% N2 as a hypoxic challenge and the left lung with 100% O2. In both groups, adequate systemic oxygenation was maintained. Pulmonary artery pressure and pulmonary vascular resistance increased significantly in both groups. Cardiac index decreased significantly in group II. Both 6-keto PGF1 alpha and thromboxane B2 increased in group I, but only 6-keto PGF1 alpha increased in group II. Hypoxic pulmonary vasoconstriction (HPV) stimulated prostaglandin synthesis. 6-keto PGF1 alpha is the major arachidonic acid metabolite released during HPV. The results suggest that epidural anesthesia does not inhibit HPV, but exerts some effects on thromboxane B2 synthesis during alveolar hypoxia.

Aged↗
PubMed1992

[A prospective study of psychosomatic reaction to hysterectomy].

Psychosomatic reaction to hysterectomy was prospectively studied by means of psychological tests and a questionnaire. One hundred and twenty patients who had simple hysterectomy were examined before and as long as one year after operation. The mean score for A-state, a state anxiety scale, was high before operation and rapidly declined postoperatively. SRQ-D and CMI, which represent depressive and neurotic states, respectively, showed rather high scores before and 2 weeks after operation. Mean scores in these psychological tests declined to a plateau within 6 months after operation, and there were less psychological and physiological symptoms and there was improved physical activity, showing that most patients can over come psychosomatic problems caused by hysterectomy. A close correlation was observed between the results of psychological tests and the number of psychological symptoms. Forty patients with a high SRQ-D score showed abnormality in other scales. Psychosomatic disorders associated with hysterectomy are characterized by various symptoms but mainly by a depressive state. High SRQ-D patients were divided into three subgroups: A) the SRQ-D score is constantly high, B) the SRQ-D is high for the first several weeks, and C) the score increased after discharge. Patients in each subgroup showed signs of a characteristic personality. These results show the presence of a different psychosomatic approach to the patients personally.

Anxiety↗
PubMed1992

[Methicillin-resistant Staphylococcus aureus (MRSA) isolated in hospitals in Fukuoka City area].

Bacteriological and clinical studies were carried out on 280 strains of Staphylococcus aureus isolated in hospitals in Fukuoka city area from September 1990 to March 1991. Of all S. aureus strains studied 116 (41.4%) were methicillin-resistant. The proportion of MRSA in S. aureus isolates from outpatients was 10% (11/109), 69.2% (90/130) in those from inpatients. The average age of patients with isolated MRSA was 70.5 +/- 16.9 years and that of patients with isolated MSSA, 44.2 +/- 29.3. MRSA strains were recovered mainly from sputum and pus. The isolation rate did not vary significantly with hospitals of different size (number of beds). Of all MRSA strains 48 (41.3%) produced coagulase type VII. As for drug susceptibility, MRSA strains with coagulase type VII were more sensitive to clindamycin and more resistant to minocyclin compared to MRSA with other coagulase types.

Age Factors↗