Biomedical subjects

T Ohtake

Publications and source records attributed to T Ohtake.

At least 37 records · Page 2Linked to original sources

PubMed1996

Reduced coronary flow reserve in familial hypercholesterolemia.

UNLABELLED: Familial hypercholesterolemia (FH) presents the highest risk for coronary artery disease (CAD) among patients with hyperlipidemia. Therefore, early detection of coronary arterial atherosclerosis is important for the treatment of FH patients. The aim of this study was to detect early coronary arterial abnormalities that may relate to future atherosclerosis in asymptomatic FH patients by measuring coronary flow reserve (CFR) using PET and 13N-ammonia. METHODS: Twenty-five patients with FH (14 men, 11 women) without a history of myocardial ischemia and 14 control subjects (9 men, 5 women) were studied. Total serum cholesterol (mmole/liter) was 5.33 +/- 0.66 in control subjects and 7.90 +/- 0.77 in FH patients (p < 0.01 versus control subjects). RESULTS: Myocardial blood flow (MBF) at rest and during dipyridamole loading was measured using PET, and CFR was calculated. MBF (ml/min/100 g weight heart) at rest in the FH group (79.0 +/- 20.0) was comparable to that in control subjects (70.0 +/- 17.0). However, MBF during dipyridamole loading was significantly lower in FH patients (163.0 +/- 67.0) than in control subjects (286.0 +/- 120.0, p < 0.01). CFR in FH patients (2.09 +/- 0.62) was also significantly lower than that in control subjects (4.13 +/- 1.38, p < 0.01). CFR showed a gender-specific variance in FH patients (1.85 +/- 0.40 in men versus 2.55 +/- 0.74 in women p < 0.05) but not in control subjects. Significant inverse correlations between CFR and the total plasma cholesterol level as well as plasma LDL cholesterol were observed. CONCLUSION: The CFR was reduced in patients with FH. This abnormality was more prominent in men than in women patients. Noninvasive assessment of CFR by 13N-ammonia PET was useful to detect early abnormalities of the coronary arteries in asymptomatic patients with FH.

Ammonia↗

PubMed1996

Hepatocellular carcinoma associated with alcoholic liver disease: a clinicopathological study and genetic polymorphism of aldehyde dehydrogenase 2.

In this paper, we describe a clinicopathological study of primary hepatocellular carcinoma (HCC) associated with alcoholic liver disease without hepatitis virus infection. In 180 HCC patients who were admitted to Asahikawa Medical College Hospital from 1987 to 1995, 10 patients (6%) had HCC associated with pure alcoholic liver disease (Al-HCC), whereas the HCC in 165 patients was associated with chronic viral liver diseases, in 2 with primary biliary cirrhosis, in 1 each with coexistence of the hepatitis C virus infection and hemochromatosis, and in 2 with cirrhosis of unknown origin. In the Al-HCC group, all patients were male. The diagnosis of HCC was obtained at the age of 54 to 67 years old, and the duration of ethanol intake was 33 to 40 years. Four cases had a history of temperance. As an underlying liver disease, liver fibrosis was found in three cases and liver cirrhosis in seven cases. HCC was diagnosed histologically in all cases. Serum alpha-fetoprotein and PIVKA-II were positive in patients with advanced HCC. In cases with small HCC, the tumor was resected surgically in three cases and percutaneous ethanol injection was performed in two cases. In four cases with small HCC, the patients were alive without tumor recurrence during the observation period. In advanced HCC, transcatheter arterial chemolipiodolization was performed. In the analysis of genetic polymorphism of ALDH 2, all Al-HCC had ALDH 2(1)/2(1).

Aged↗

PubMed1995

Intraductal extension of primary invasive breast carcinoma treated by breast-conservative surgery. Computer graphic three-dimensional reconstruction of the mammary duct-lobular systems.

BACKGROUND: Intraductal tumor extension is a characteristic feature of primary breast carcinoma, and is an important consideration in patients undergoing breast conservative surgery. However, there have been no reports of studies of intraductal extension within the mammary ductal tree. METHODS: Quadrantectomy specimens from 20 patients with primary invasive breast carcinoma were examined by subgross and stereomicroscopic technique to visualize intraductal tumor extension. Serial 2 mm-thick sections were subjected to two-dimensional (2-D) tumor mapping, measuring the distances and angles of extension, and to three-dimensional (3-D) reconstruction of the mammary duct-lobular systems by means of computer graphics. RESULTS: Intraductal tumor extension was found in 16 of 20 specimens (80.0%), extending continuously from the primary invasive carcinoma through the mammary ductal tree. The distances and angles of extension were larger in tumors with microcalcifications, papillotubular invasive ductal carcinoma, 30% or more of intraductal component, and comedo-type intraductal tumor extension. The 3-D reconstructions demonstrated three types of extension; central (11 cases), peripheral (3 cases), and mixed (2 cases). Further, there were some ductal branches anastomosing with different mammary duct-lobular systems at various sites. In one specimen, intraductal tumor extended widely from the primary invasive carcinoma through a branch connecting adjacent mammary duct-lobular systems. CONCLUSIONS: Three-dimensional reconstruction images of intraductal extension of invasive breast carcinomas are presented for the first time to the authors' knowledge. Examples of ductal anastomoses were observed, and should be considered as a risk factor for possible widespread intraductal extension through multiple mammary duct-lobular systems.

Adult↗

PubMed1995

Endemic occurrence of glomerulonephritis associated with streptococcal impetigo.

We report here a case of type 1 mesangiocapillary glomerulonephritis as well as a case of mesangial proliferative glomerulonephritis associated with streptococcal skin infection superimposed on atopic dermatitis. Both were endemic occurrences of postinfectious glomerulonephritis developed after repeated dirty-skin treatments for atopic dermatitis performed by unauthorized individuals under unsanitary conditions. Of 20 patients who were similarly treated and subsequently admitted to our hospital because of skin infection and fever, 8 (40%) showed urinary abnormalities. Four patients had renal dysfunction with acute nephritic onset. Almost all showed a decrease in CH50 values and an increase in levels of antistreptolysin O and IgE. In the 2 cases presented here, the disease eventually regressed in association with improvement of the skin infection. Although the occurrence of postinfectious glomerulonephritis has recently become uncommon, we must take care to note urinary abnormalities as early as possible in order to prevent the progression of glomerulonephritis.

Adolescent↗

PubMed1995

[Pathological characterization of atypical ductal hyperplasia of the breast].

To clarify the pathological features of atypical ductal hyperplasia (ADH) defined by Page's criteria, histological patterns and the extent of 17 lesions of ADH including clinging carcinoma were examined. The nuclear measurements (mean nuclear area and irregularity of nuclear shape) and the MIB-1 labeling index of ADH were compared with those of noncomedo DCIS with lower grade nuclei, and usual ductal hyperplasia (DH). All ADH were classified into cribriform or micropapillary/clinging types. The extent of ADH was always less than 2.5 mm in the cribriform type (1.4 mm in average), against 5 mm or greater in 6 of 8 lesions of the micropapillary/clinging type (7.1 mm in average). Nuclei of ADH tended to be smaller (< or = 8 microns) than DH and DCIS (p < 0.05), and less irregular in shape than DH (p < 0.01), although indistinguishable from lower grade nuclei of DCIS using these parameters. The MIB-1 labeling index of ADH was very low (0-2.3%) and was the best parameter to distinguish from DCIS (p < 0.01). It was also suggested that the lower level of proliferative activity is one of the most distinctive features of ADH.

Breast↗

PubMed1995

Myocardial glucose metabolism in noninsulin-dependent diabetes mellitus patients evaluated by FDG-PET.

UNLABELLED: Diabetes mellitus (DM) is one of several factors influencing the assessment of myocardial viability using fluorine-18 fluorodeoxyglucose (FDG) PET. METHODS: To compare the myocardial glucose metabolism of normal subjects to patients with DM, we performed a quantitative FDG study during insulin clamp, oral glucose loading and fasting in nine normal volunteers and eight patients with noninsulin-dependent DM (NIDDM). RESULTS: During oral glucose loading, myocardium-to-background (MB) ratio remarkably deteriorated in NIDDM patients compared with normals because of high plasma glucose and low serum insulin. Myocardial glucose utilization (MGU) rates in NIDDM patients were also lower than those in normal volunteers. MB ratio of FDG remarkably improved with insulin clamp in NIDDM patients compared with oral glucose loading. MGU rates during insulin clamp were still slightly lower than in the normal volunteers despite low plasma glucose and adequate plasma insulin. CONCLUSION: The insulin clamp method may be very useful in NIDDM patients for improved myocardial FDG uptake compared to oral glucose loading or fasting, but slight decreases in MGU rates during insulin clamp in NIDDM patients may be because of insulin resistance (GluT4 abnormality).

Adult↗

PubMed1995

Detection of peptidase activity from Treponema denticola, Porphyromonas forsythus, and Bacteroides forsythus as a means of periodontal therapy evaluation.

We have previously reported that the Periocheck test offers a rapid, simple periodontal diagnostic tool by detecting peptidase activity specifically attributed to Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus. Relationships between the peptidase activity detected by the Periocheck test and clinical measures were investigated. Fifty-seven Periocheck-positive sites selected from 27 patients with adult periodontitis were subjected to scaling and root planing. Two weeks later, a Periocheck test was undertaken in the test sites. Two groups were then determined, one composed of 40 Periocheck-positive sits, and the other consisting of 17 Periocheck-negative sites. All sites were re-examined at 6, 10, 14 and 18 weeks using both the Periocheck test and clinical measures. On week 18, the negative group displayed a significant decrease in probing pocket depth (PD) and a significant attachment level (AL) gain (2.1 and 1.2 mm, respectively), while the positive group showed a slight decrease in PD and AL gain (0.9 and 0.3 mm, respectively). The differences between negative and positive groups in PD and AL became statistically significant by the tenth week. Improvement of gingival index (GI) and bleeding on probing (BOP) was more apparent in the negative group. The detection of intrapocket microbiological status by the Periocheck test preceded the changes in PD, AL, GI, and BOP after periodontal therapy. In conclusion, the Periocheck test may provide a promising chairside monitoring tool for effectively evaluating therapies associated with scaling and root planing.

Bacterial Proteins↗

PubMed1994

Thymus aplasia in distal trisomy 14q syndrome: an autopsy case with a review of the literature.

The present authors report an autopsy case of a malformed male newborn with de novo duplication of the distal part of the long arm of chromosome 14 (14q24.1 to 14qter) in this paper. The partial trisomy of 14q was due to the unbalanced translocation at the end of the satellite stalk of chromosome 14. This autopsy case also had many kinds of external malformations including odd skull and facies, narrow thorax, and prominent calcaneus as well as retentio testis. The autopsy examination revealed aplasia of the thymus and marked hypoplasia of systemic lymphoid tissues. During an immunohistochemical study of the lymphoid tissues the population of T cells showed only a minority of lymphocytes. While several cases of distal trisomy 14q with cardiac malformations or a developmental abnormality of the thymus and the parathyroids seen in the third and fourth pouch defects have been reported previously, the present case was the first of this syndrome with aplasia of the thymus and systemic lymphoid hypoplasia.

Abnormalities, Multiple↗

PubMed1994

Light chain nephropathy with remarkable accumulation of multinucleated giant cells in the kidney.

A case of light chain deposition disease with multinucleated giant cell accumulation in the kidney is described. A 54-year-old man was admitted to out hospital due to moderate renal failure. Complicated with eosinophilic pneumonia two months after admission, his renal function abruptly deteriorated and hemodialysis was started. Three-day methylprednisolone pulse therapy, however, partially recovered his renal function and hemodialysis was discontinued. His renal biopsy specimen revealed kappa light chain deposition disease with nodular mesangial expansion and subendothelial electron dense deposits. The most characteristic finding in this patient was accumulation of foreign body type multinucleated giant cells around atrophic tubules, small arteries and obsolescent glomeruli, probably associated with light chain deposition. No increase in kappa light chain was detected in his serum or concentrated urine. Such disseminated giant cell reaction, other than intra-luminal infiltration in the tubules, has not been reported in the literature and might be related to the physicochemical or structural properties of the deposited protein.

Giant Cells, Foreign-Body↗

PubMed1994

[Efficacy of intrahepatic arterial chemotherapy to prevent recurrence of residual liver in metastatic liver cancer patients after hepatectomy].

Five-year overall survival rates in 17 cases who underwent the hepatectomy for metastatic liver cancer from digestive tract averaged 43%. Postoperative intrahepatic arterial infusion in combination with Farmorubicin and 5-FU was performed in 9 cases (i.a group). Survival and recurrence rate on cases (i.a group) were compared with that of 8 cases without chemotherapy (control group). The 5-year survival rate was superior in the i.a group to that in the control group. There was no residual liver recurrence in the i.a group, but two cases had recurrence in the residual liver in the control group. These results suggest that the post-hepatectomized intrahepatic arterial infusion of anticancer drugs is useful to prevent recurrence in the residual liver and may prolong the survival time of patients with metastatic liver cancer from GI tract.

Aged↗

PubMed1994

Complete and selective cholinergic denervation of rat neocortex and hippocampus but not amygdala by an immunotoxin against the p75 NGF receptor.

The immunotoxin 192 IgG-saporin, produced by coupling the ribosome-inactivating protein saporin to the monoclonal 192 IgG antibody against the low-affinity p75 NGF receptor (NGFr), was injected into the cerebral ventricle, septal area, and substantia innominata of adult rats. Injections into the cerebral ventricle induced a complete loss of NGFr-positive basal forebrain neurons and their axons. Extensive loss of cholinergic neurons was found in the septum, diagonal band, and magnocellular preoptic nucleus but not in the nucleus basalis-substantia innominata complex, where many cholinergic, presumably NGFr-negative, neurons remained intact. Cholinergic fibers were completely lost in the neocortex and hippocampus, showed some preservation in allocortical areas, and showed only minor loss in the amygdala. The NGFr-positive cholinergic basal forebrain neurons progressively degenerated during the first 5 d and did not recover after 180 d. The effect of intraventricular 192 IgG-saporin injections on NGFr-positive basal forebrain neurons could be blocked by simultaneous intraventricular injection of colchicine. Intraparenchymal injections into the septal area or substantia innominata damaged cholinergic neurons mainly around the injection sites and reduced their respective cortical and hippocampal projections. Noncholinergic septal neurons containing parvalbumin and noncholinergic neurons containing calbindin-D28k or NADPHd, which were adjacent to cholinergic nucleus basalis-substantia innominata neurons, were not affected by 192 IgG-saporin. The ChAT immunoreactivity in cortical interneurons, habenula, and brainstem was unchanged. Dopaminergic and noradrenergic cortical afferents remained intact. 192 IgG-saporin damaged two neuronal groups outside the basal forebrain that express the p75 NGF receptor: NGFr-positive cerebellar Purkinje cells after intraventricular injection and cholinergic striatal interneurons after injections into the substantia innominata. These results indicate that the immunotoxin 192 IgG-saporin induces a complete and selective lesion of NGFr-positive cholinergic basal forebrain neurons projecting to hippocampus and neocortex.

Acetylcholinesterase↗

PubMed1993

Interstrain differences in murine daunomycin-induced nephrosis.

Examining 8 inbred murine strains [A/J, BALB/c, SM/J, C3H/J, SWR/J, C57BL/6J (B6), DBA-2, B10D2/old (B10D2/o)] for urinary albumin excretion after a single daunomycin (DM) injection (20 mg/kg), we found strain specificity in susceptibility to DM nephrosis. This specificity did not relate to the serum disappearance rate of this drug. A/J and BALB/c were highly susceptible to the nephrosis while C57BL/6J, DBA-2 and B10D2/o were completely resistant to it. Chronological observation revealed that A/J mice had significant proteinuria at 2 weeks after injection, and it persisted for the remaining 4 weeks of this experiment, while C57BL/6J showed no increase over the experimental period. Using segregants obtained from an A/J and B6 backcross, it has been shown that susceptibility is inherited as an autosomal recessive trait and involves approximately three genes. Neither a C5 deficiency, H-2 type nor coat color gene (c-locus) was related to this susceptibility. This strain difference in nephrotoxicity would be a promising way to investigate its subcellular mechanism.

Albuminuria↗

PubMed1993

Biloma during steroid therapy for minimal change nephrotic syndrome.

A 27-year-old man, who had been on steroid therapy for 2 months for his nephrotic syndrome, suddenly developed intra-abdominal bile collection (biloma). He had no previous history of abdominal surgery, trauma, or any disease of the hepatobiliary system. The cause of the biloma formation was due, probably, to cholecystitis in the absence of calculi and a pinhole size perforation in the wall of gall bladder. It was assumed to be closely related to the high-dose steroid therapy over a prolonged period, which would likely suppress the repair process of the locally damaged biliary system.

Abdominal Pain↗

PubMed1993

Spontaneous bacterial peritonitis in an adult patient with nephrotic syndrome.

Most cases of spontaneous bacterial peritonitis (SBP) in association with nephrotic syndrome are children. The complication of SBP in adults with nephrotic syndrome is extremely rare. Herein, we report a 25-year-old man with nephrotic syndrome and chronic renal failure who suffered from SBP. Citrobacter freundii was isolated from ascites. Irreversible deterioration of renal function followed the development of SBP, though the peritonitis was cured with antibiotic treatment. This case suggests that SBP is a rare, but serious complication of adult nephrotic syndrome with ascites.

Adult↗

PubMed1993

[Evaluation of the safety and clinical usefulness of a new myocardial imaging agent, 99mTc-PPN1011--multicenter phase II clinical trial report].

A new myocardial perfusion imaging agent, 99mTc-1,2-bis[bis(2-ethoxyethyl phosphino]ethane (99mTc-PPN1011) was administered to 52 patients with various heart diseases each at rest and peak exercise on different days (Method A) and on the same day (Method B). The safety, optimal dosage, imaging procedures and the clinical usefulness were evaluated. No drug related adverse reactions were found. Image quality was considered adequate for diagnosis with as little as 185 MBq per injection, though the optimal dose range was 370-740 MBq. SPECT images were obtainable as early as 10 min, also until 3 hours after injection. There were no significant differences in clinical efficacy between method A and B, as well as sequential tests at rest and exercise. 99mTc-PPN1011 and 201T1 images in the same patient were compared segment by segment. Image quality of 99mTc-PPN1011 was significantly superior to that of 201T1. Analysis of images indicated that both agent were similar in diagnostic efficacy. It was concluded that 99mTc-PPN1011 is useful for myocardial perfusion imaging.

Adult↗

PubMed1993

[Evaluation of the clinical usefulness of a new myocardial imaging agent, 99mTc-Tetrofosmin (PPN1011)--a report of multicenter phase III clinical trials].

The clinical usefulness of a new myocardial perfusion imaging agent, 99mTc-1,2-bis[bis(2-ethoxyethyl)phosphino]ethane (99mTc-Tetrofosmin, (PPN1011) was evaluated in 355 patients with various heart diseases. Both 1 and 2 day protocols resulted in images that were significantly clearer than those of 201Tl. The absence of significant drug related adverse reaction supported the safety of the agent for clinical use. Regional abnormalities detected by CAG agreed with 99mTc-Tetrofosmin SPECT findings in 74% and with 201Tl SPECT in 78% of this study. Eighty-four percent of an abnormalities were detected with 99mTc-Tetrofosmin SPECT, as compared with those detected with 201Tl SPECT (88.4%). The complete concordance ratio between 99mTc-Tetrofosmin and 201Tl images in segmental analysis was 87-89% at rest and stress. Since 99mTc-Tetrofosmin SPECT was judged clinically useful in 93.2% (331/355) of the patients studied, it is concluded that 99mTc-Tetrofosmin is a promising agent for myocardial perfusion imaging. The simple labeling procedure without heating and cooling is suitable for emergency administration. Reconditioning of myocardial perfusion could be evaluated with 99mTc-Tetrofosmin injection before and after interventional therapy. These are additional features of the agent for clinical use.

Adult↗

PubMed1993

[The recent studies of myocardial blood flow and metabolism by using positron emission computed tomography].

Since the application of positron emission computed tomography (PET) for myocardium, the evaluation of myocardial blood flow, glucose metabolism, fatty acid metabolism, oxygen consumption and etc. has been performed. Especially, it has been regarded very important clinically to evaluate myocardial viability from the mismatch of myocardial glucose metabolism and blood flow. Many early myocardial PET studies were qualitative, while recently noninvasive quantitation method without arterial blood sampling has become possible in quantitating myocardial glucose metabolism or myocardial blood flow reserve. We quantitated regional myocardial glucose utilization rates (rMGU) in 114 cases during fasting, oral glucose loading, or insulin clamp to study the relation between rMGU and plasma insulin value or FFA value, the normal rMGU value during each condition and the difference of rMGU among each part of myocardium. And as to the question in which condition of FDG study was appropriate to evaluate myocardial viability, we introduced the opinion of Schelbert for oral glucose loading or insulin injection method and presented our opinion for fasting or mild insulin clamp.

Adult↗

PubMed1992

Surface electromyographic study of idiopathic cranial dystonia focused on the orbicularis oculi muscles.

We studied 115 Japanese patients with idiopathic cranial dystonia (Meige disease), using surface electromyography (EMG) focused on the orbicularis oculi muscles to classify the findings of the abnormal involuntary movements of this disease and to evaluate the pathophysiology of blepharospasm (BS). Surface EMGs at rest and at voluntary eyelid opening after eyelid closing were investigated. We found 62 (53.9%) patients exhibiting the overblinking type, 37 (32.2%) the tonic BS type, and 16 (13.9%) the normal type of behavior, considering the frequency of spontaneous blinking and presence of spasms. The present results suggest that BS is not a summation of blinking but a spatial and temporal extension of the orbicularis oculi muscle activity engaging in blinking, and the classification of the present study can support the investigation of the temporal characteristics of patients with this disease.

Blepharospasm↗