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Biomedical subjects

Takashi Fukaya

Publications and source records attributed to Takashi Fukaya.

13 recordsLinked to original sources
PubMed2006

Recurrence of occult pneumococcal bacteremia by an identical strain in an apparently healthy child.

This is the first report to describe an apparently healthy girl, who developed recurrent occult bacteremia by the same Streptococcus pneumoniae strain, at 11 and 15 months of age. The two separately isolated organisms were demonstrated to have the identical serotype (type 6B), antibiotic susceptibility (intermediately penicillin-resistant), genotypes of penicillin-binding proteins, and patterns of pulse-field gel electrophoresis. The serum levels of anti-type 6B antibodies showed poor responses after both bacteremic episodes, but other immunological workups did not demonstrate any abnormalities. This case indicates that occult bacteremia may recur due to an identical pneumococcal strain in an immunocompetent infant, and that early introduction of pneumococcal conjugate vaccine is necessary in Japan.

Antibodies, Bacterial↗
PubMed2005

Thrombopoietin in the cerebrospinal fluid of patients with aseptic and bacterial meningitis.

Despite the recent evidence of the localization of thrombopoietin (TPO) and its receptor in the central nervous system (CNS), TPO protein concentrations in the cerebrospinal fluid (CSF) remained to be clarified. We previously reported that serum TPO is increased in children with meningitis. To determine changes in TPO concentrations in the CSF by meningitis and to explore the relationship between serum and CSF TPO concentrations, we measured TPO concentrations in 110 CSF samples and 33 serum/CSF pairs from 11 bacterial meningitis, 49 aseptic meningitis, and 50 nonmeningitis children. In only 12% (13 of 110) of CSF samples (0 bacterial meningitis, 8 aseptic meningitis, and 5 controls), TPO concentrations could be determined (24.1 +/- 29.0 pg/ml). CSF TPO concentrations did not significantly differ among the three groups and did not correlate with age. TPO concentrations in all serum samples were detectable, and mean concentrations in bacterial meningitis (510.6 +/- 237.0 pg/ml) were significantly higher than those in aseptic meningitis (136.6 +/- 71.6, p < 0.01) and controls (181.3 +/- 88.3, p < 0.01). These findings suggest that TPO is not produced in the CNS of patients with meningitis and that TPO did not cross the blood-brain barrier even during meningeal infection.

Adolescent↗
PubMed2005

Extensive endoscopic sinus surgery from the viewpoint of out-patients in a metropolitan area.

Extensive functional endoscopic sinus surgery (FESS) was assessed retrospectively from the viewpoint of out-patients on the basis of their responses to a postal questionnaire, particularly in the Tokyo metropolitan area. Seventeen patients were included in this study (six females and 11 males) with an age range of 22-70 years. All the patients had at least ethmoid sinusitis. Additionally, some patients had maxillary or sphenoid sinusitis or polyps obstructing the nasal cavities. The average operation time and blood loss were 36 minutes and 31 ml, respectively. Four patients had to travel more than one hour to reach home. All of them used the train for travelling to and from the hospital. 'Doctors' advice' was the most common reason for the decision to undergo this ambulatory surgery. Nine (53 per cent) had some unexpected problems post-operatively. The establishment of a care pathway may improve the outcome of extensive FESS on an out-patient basis.

Adult↗
PubMed2004

New marine sesquiterpenoids and diterpenoids from the Okinawan soft coral Clavularia koellikeri.

Six new terpenoids (two maaliane-type sesquiterpenoids, 1 and 2, one aromadendrane-type sesquiterpenoid, 3, one noraromadendrane-type sesquiterpenoid, 4, and two neodolabellane-type diterpenoids, 5 and 6) were isolated from the Okinawan soft coral Clavularia koellikeri. The structures of these compounds were determined on the basis of the results of spectroscopic analysis, chemical conversion, and X-ray crystallographic analysis. Compound 6 exhibited modest growth-inhibition effect in vitro toward tumor cells.

Animals↗
PubMed2004

Immunohistochemical study of apparently intact coronary artery in a child after Kawasaki disease.

BACKGROUND: Coronary arterial lesions (CAL) due to Kawasaki disease (KD) often show progressive intimal hyperplasia even many years after the disease. However, most patients have no CAL after the acute phase, and it is an important issue whether or not coronary arteries without CAL have significant intimal hyperplasia, and whether or not there is the potential for this to progress to stenosis and/or atherosclerosis. METHODS: The authors examined formalin-fixed specimens of the coronary arteries immunohistochemically, using antibodies against vascular growth factors (GFs), the receptors of transforming growth factor-beta (TbetaRs) and inducible nitric oxid synthesis (iNOS) in a KD patient without CAL, and also in four control patients: two with CAL due to KD and two without a history of KD. RESULTS: Vascular endothelial GFs, Platelet-derived growth factor-A (PDGF-A) and TbetaRs were expressed in the vascular smooth muscle cells of all patients. PDGF-A, transforming Gfbeta1 and iNOS were expressed in the intimal smooth muscle cells of the KD but not the normal coronary artery without a history of KD. The number of TbetaR-II-positive cells were fewer than TbetaR-I-positive cells in the intima of CAL due to KD, but the number was of both almost same in the intima of coronary artery without CAL after KD and in the normal coronary. CONCLUSION: The intact coronary artery 13 months after KD still showed the influence of the inflammation of KD. Although the authors speculate that the intimal proliferation will not continue beyond the acute phase, those patients may have a risk factor for atherosclerosis.

Child, Preschool↗
PubMed2004

Age-dependent changes in the incidence and etiology of childhood thrombocytosis.

To determine the incidence and etiology of childhood thrombocytosis, over 15,000 platelet counts in 7,539 patients performed at a single regional hospital were reviewed. When thrombocytosis was defined as > or =500 x 10(9)/l of platelet counts, the condition could be diagnosed in 6.0% (456 cases) of the patients. All patients were classified as having secondary thrombocytosis. The incidence of thrombocytosis dramatically changed throughout child development; it was 12.5% in neonates, peaked to 35.8% in 1-month-old infants and then returned to 12.9% in 6- to 11-month-old infants. Thereafter, it gradually decreased with age to only 0.6% in 11- to 15-year-old children. Frequent causes of thrombocytosis included infection (67.5%), Kawasaki disease (9.4%), prematurity (7.7%) and iron deficiency anemia (6.4%). Thrombocytosis was an incidental finding in a substantial population of early infants. Thrombocytosis as a reaction to several types of infection and Kawasaki disease was more common in children under 7 years old, while autoimmune disease and tissue damage were major causes in children aged 11-15 years. No child had thromboembolic complications. These findings indicate that childhood thrombocytosis is a benign condition and its incidence and etiology seem to depend on age.

Adolescent↗
PubMed2004

[Surgical treatment of patients with severe obstructive sleep apnea syndrome].

No standard indications currently exist for surgical treatment of severe obstructive sleep apnea syndrome (OSAS). We treated 15 patients with severe OSAS surgically, evaluated surgical indications, and evaluated surgical success. We retrospectively reviewed 15 cases of surgery for OSAS in which polysomnography met 2 or more criteria for the following surgical indications: (1) apnea hypopnea index (AHI) > or = 50, (2) minimum SpO2 below 80%, and (3) enlarged tonsils (grade III, Mackenzie's classification). Among the 15, mean AHI was 85.1. Surgery was done under general anesthesia, with uvulopalatopharyngoplasty (UPPP) in 13 and tonsillectomy alone in 2. Postoperative AHI was measured in 9 patients. According to Nishimura's criteria for assessing surgical success, improvement was "excellent" in 5, "good" in 1, "fair" in 1, and "poor" in 2. When we compared preoperative and postoperative use of continuous positive airway pressure (CPAP) in 7, we found that surgery decreased CPAP requirements. Surgical success was assessed in patients requiring CPAP and improvement was "excellent" in 5, "good" in 1, and "fair" in 1. In conclusion, surgical indications for severe OSAS, including the criterion of enlarged tonsils, were useful. Surgery decreased CPAP requirements and the degree of improvement in this requirement and AHI was valuable in assessing surgical success.

Adult↗
PubMed2004

[A case of pulmonary metastases from laryngeal cancer showing a complete response to chemotherapy with docetaxel].

Docetaxel (TXT) is a new cytotoxic agent against head and neck, (H and N) cancer since the emergence of cisplatin. We herein describe the efficacy of TXT in treating distant metastases from H and N cancer. The patient was a 61-year-old man who had undergone laryngectomy and irradiation for laryngeal cancer (glottic type: T3N0M0). More than 2 years later after the first course of therapy, pulmonary metastases involved in the left lower area were revealed by lung CT. The divided TXT therapy (20 mg, 3 times, and 40 mg, 3 times) was carried out without any sequelae. This consecutive therapy resulted in complete disappearance of the metastases on follow-up CT. It is suggested that divided TXT therapy has potential as a new treatment modality for distant metastases of H and N cancer.

Antineoplastic Agents, Phytogenic↗
PubMed2002

[Critical pathways and computerized multidisciplinary documentation system].

Critical pathways are widely adopted by many large hospitals around the world in order to provide high-quality patient treatment. The development of critical pathways is a lengthy process, and may require the collaboration among physicians, nurses, and staffs in a hospital. The development and implementation of critical pathways at Kanto Medical Center and the transition to a computerized multidisciplinary documentation system took place between 2000 and 2001. The article describes the process of creating the automated documentation system to support the critical pathways. The advantages, pitfalls learned in this integration experience are described.

Critical Pathways↗
PubMedDate not supplied

Acute lymphoblastic leukemia with coexpression of CD56 and CD57: case report.

The authors present the clinical profile of a 6-year-old girl with an unusual immunophenotype of acute lymphoblastic leukemia (ALL). At the initial presentation, massive hepatosplenomegaly developed. The leukemic cells were myeloperoxidase-negative and morphologically lymphoblastic. These cells were positive for B-precursor-cell (CD10, CD19) antigens and natural killer cells (CD56, CD57). Rearrangements of both immunoglobulin heavy chain alleles and monoallelic rearrangement of T-cell receptors (TCRs)-beta and -delta genes, but not that of TCR-gamma gene, were detected, suggesting that these cells being of B-precursor origin. The patient received chemotherapy for extremely high-risk ALL with a good response. To the authors' knowledge, this is the first pediatric case describing coexpression of CD56 and CD57 on B-lineage ALL.

Antigens, CD↗