Biomedical subjects

E Takeuchi

Publications and source records attributed to E Takeuchi.

At least 37 records · Page 2Linked to original sources

PubMed1997

[A case of dyskeratosis congenita with acute interstitial pneumonia].

This is a rare case of Dyskeratosis Congenita (DC) with acute interstitial pneumonia. A 51-year-old man with DC was admitted to our hospital because of cough, sputum and fever. Chest X-ray film showed ground glass opacities in all lung fields for a while steroid's therapy proved effective, but about seven months later the patient's condition became serious. Methylprednisolone, cyclophosphamide and mechanical ventilation therapy were not effective. He died and an autopsy was performed. The lung specimen showed Organizing Diffuse Alveolar Damage, and some parts pointed to bacterial infection. But Pneumocystic carinii pneumonia and Fungal infections were not found. It is therefore necessary to conduct intensive examinations of lung involvement of patients with Dyskeratosis Congenita.

Acute Disease↗

PubMed1997

Ectopic bone formation after total hip arthroplasty.

Two hundred and forty consecutive Japanese patients with 280 primary total hip arthroplasties (THA) were analyzed to clarify the incidence of ectopic bone formation and its predisposing factors and to examine its effect on the clinical results. Ectopic bone formation after THA was found in 61 joints (22%). The predisposing factors were male patients and a hypertrophic type of osteoarthritis. It was revealed that extensive ectopic bone formation, class 3 according to Brooker's classification, restricted flexion and abduction motion of the hip joint.

Adult↗

PubMed1996

Ligation of portal vein branch induces DNA polymerases alpha, delta, and epsilon in nonligated lobes.

Ligation of a portal vein branch supplying 70% of the rat liver causes compensatory hypertrophy of the nonligated hepatic lobes with concomitant atrophy of the ligated lobes. To elucidate the mechanism of this response, the induction of the replication enzymes DNA polymerases alpha, delta, epsilon, as well as proliferating cell nuclear antigen (PCNA), were investigated in nonligated lobes after portal branch ligation. The induction patterns were compared with the well studied liver regeneration after 70% partial hepatectomy. DNA polymerases alpha, delta, and epsilon in the liver were extracted with 5 mM KCl (low-salt extract), then with 600 mM KCl (high-salt extract). DNA polymerases alpha, delta, and epsilon in low-salt extract were partially separated on a hydroxyapatite column and quantified. All enzyme activities in the nonligated lobes started to increase within 24 hr and reached maximum levels by 48 hr after portal branch ligation. These patterns were quite similar to those obtained with the remnant liver after partial hepatectomy. In low-salt extract, DNA polymerase delta and epsilon were prominent, while, in high-salt extract, largely DNA polymerases alpha and some activity of epsilon were recovered. PCNA was also induced after both portal branch ligation and partial hepatectomy, reaching maximum levels at 48 hr. From the similar changes in DNA polymerases and PCNA, our data indicate that portal branch ligation induces hepatocyte proliferation in the nonligated lobes in a way similar to partial hepatectomy.

Animals↗

PubMed1996

Enhanced production of glomerular extracellular matrix in a new mouse strain of high serum IgA ddY mice.

To investigate the relationship between high serum levels of IgA and glomerular lesions, selective mating was performed in high serum IgA ddY mice, a murine model of spontaneously developing mesangioproliferative glomerulonephritis mimicking human IgA nephropathy. The selection and mating of high IgA ddY mice were accomplished when the mice were three to four months old. In the 12th generation of high IgA ddY (HIGA) mice, significantly higher levels of serum IgA from 10 age weeks to 60 weeks (P < 0.0002 to 0.0001) were observed in comparison with BALB/c mice. Relatively high proteinuria was observed at 40 weeks of age, although hematuria was consistently negative. Microscopic observations of renal tissue disclosed a marked glomerular mesangial matrix increase and a reduction of cell proliferation with age by both semiquantitative and morphometric analyses with moderate tubulointerstitial damage. These mesangial matrices were stained markedly by antisera for collagen type IV and by fibronectin, but not by collagen type I. Localization of TGF-beta protein was also detected in the mesangium of the HIGA mice. The positive mesangial IgA deposition was maintained consistently by this mating procedure and became more marked with age. Size analysis of IgA from ten pooled HIGA mice aged 50 to 60 weeks revealed dominant polymeric IgA in sera and dimeric IgA in glomerular eluates. Clonal analysis of serum IgA disclosed heterogeneous spectrotypes in a wide pH range (4.5 to 6.5), in contrast to very limited spectrotypes in the acidic pH range (4.5 to 5.2) of IgA in the glomerular eluates from these mice. The analyses of retroviral gp70 antigen involvement in the HIGA mice disclosed a significant increase of serum levels of gp70 anti-gp70 immune complexes with age, with no relationship to the severity of glomerular gp70 deposition. Northern blot analysis of renal tissue revealed markedly high mRNA expression of collagen type I, IV, fibronectin and TGF-beta even in 10-week-old HIGA mice in comparison with BALB/c mice. The expression became more significant in 60-week-old animals. The genetic background required to induce the expansion of IgA-producing B-cell clones is suggested to be closely related to the increased gene expression of TGF-beta, which induces enhanced glomerular extracellular matrix (especially fibronectin) accumulation in HIGA mice, being possibly mediated by the mesangial deposition of dimeric and highly acidic IgA. This newly established strain may provide a model for investigating the relationship between progressive glomerular sclerotic lesions and the induction of pathogenic IgA in human IgA nephropathy.

Aging↗

PubMed1996

Induction by interleukin-15 of human killer cell activity against lung cancer cell lines and its regulatory mechanisms.

Interleukin (IL)-15 is a novel cytokine with IL-2-like activity. In the present study, we examined IL-15-mediated induction of killer activity of peripheral blood mononuclear cells (MNC) against lung cancer cell lines, and the regulatory mechanisms of this induction by IL-15. Cytotoxic activity was measured by 51Cr release assay. IL-15 at concentrations of more than 10 ng/ml induced significant killer activity of blood MNC against a small cell lung cancer cell line (SBC-3), as well as Daudi cells, and 50 ng/ml was considered its optimal concentration. A time course study revealed that an incubation period of 4-6 days was optimal for induction of killer activity. MNC cultured with IL-15 also exhibited killer activity against other lung cancer cell lines (H-69, N-291 and PC-9 cells). IL-15 and IL-12 had additive effects on induction of killer activity against SBC-3 cells. On the other hand, IL-15 had no synergistic or additive effect on induction of killer activity by IL-2. Fresh human monocytes isolated by centrifugal elutriation augmented the development of killer activity of lymphocytes stimulated by IL-15. As a humoral regulatory factor, IL-4 had a suppressive effect on induction of killer activity by IL-15. IFN-gamma, IL-1beta, TNF-alpha, IL-6 or IL-10 had no effect on induction of killer activity by IL-15 at the optimal concentration. These results suggest that IL-15 has potential for the immunotherapy of lung cancers.

Antibody-Dependent Cell Cytotoxicity↗

PubMed1996

Quantitative EEG analysis as a supplement to the clinical coma scale RLS85.

BACKGROUND: The aim of the study was to investigate the correlation between EEG indicators and clinical scores based on the RLS85 (Reaction Level Scale 85) in comatose patients. The results of a simple visual assessment of the EEG, using an arbitrary scale with typical EEG patterns, were compared with those obtained by quantitative electroencephalography (qEEG). METHOD: The RLS85 scores were examined in 34 patients with impaired consciousness due to brain tumours, vascular lesions or head injuries. The EEG was recorded shortly before or after the clinical examination. The semiquantitative assessment was made by visual inspection of the tracings, using an arbitrary scale where 12 EEG patterns with increasing proportion of slow activity were displayed. Parallel to the visual analysis, the EEGs were processed by means of EEG spectrum analysis and the power/amplitude in slow frequency bands was used as an indicator. The results were based on correlation between various types of EEG variables and the RLS scores which were obtained in the same patients. RESULTS: The correlation between the visual EEG indicators and coma scores ranged between 0.53 and 0.57 (P < 0.01). As regards the computerised EEG analysis, the correlation between the clinical scores and various EEG spectrum values did not exceed 0.45 (P < 0.01). A higher correlation could be obtained by combining eight EEG variables; the multiple correlation coefficient was then 0.68. CONCLUSIONS: The amount of EEG slow activity is significantly correlated to the RLS85 score. This means that the EEG also provides information on the level and not only on the changes of the coma degree. Surprisingly, the indicators based on quantitative EEG, as used in commercially available instruments, did not give better results than the visual assessment. However, the results of the computerised analysis could be improved using multivariate statistical methods. The study also showed a way to improve communication between the neurophysiologist and clinician by presenting the EEG findings in terms similar to those used in the clinical scales. However, the clinician should be aware of the fact that the "EEG score" and the clinical score is not the same: the intention is to supplement rather than to simulate the clinical observation.

Adolescent↗

PubMed1996

Intestinal perforation in temporal arteritis, associated with paroxysmal nocturnal hemoglobinuria.

Temporal arteritis (TA) is an adult-onset, focal granulomatous inflammatory disorder of the small and medium sized arteries. Intestinal perforation is a rare complication of TA. Regarding its etiology, steroid-induced or arteritis-induced ulceration have been proposed. We describe a patient who developed TA in addition to preceding paroxysmal nocturnal hemoglobinuria. During steroid therapy for TA, intestinal perforation manifested, and it was proven to be arteritis induced perforation on histological examinations. The patient may be the 5th reported case of TA complicated with arteritis-induced intestinal perforation. The possibility of polyangitis overlap syndrome of TA and polyarteritis nodosa is discussed.

Anti-Inflammatory Agents↗

PubMed1996

Lung cancer producing interleukin-6.

A patient with complaints of high fever and left shoulder pain was found to have a large mass in the left upper lobe on chest roentgenogram. Laboratory evaluation revealed marked thrombocytosis, hypoalbuminemia, and increased serum concentrations of CRP, fibrinogen and interleukin-6 (IL-6). A transcutaneous biopsy specimen revealed large cell carcinoma. Tumor production of IL-6 was confirmed by immunohistochemical staining with an anti-human IL-6 monoclonal antibody (MH60).

Biopsy↗

PubMed1996

[Asthma-like symptoms due to thoracic aneurysm].

We describe a case of positional dyspnea due to compression of the tracheobronchial tree by an extensive thoracic aneurysm. In a 77-year-old woman with long-standing systemic hypertension, intermittent anterior chest pain gradually developed over several years. She had no history of asthma or thoracic trauma. She was admitted to our hospital because of sudden, severe shortness of breath. The breathlessness was markedly worse when she lay on her back or on her right side. On physical examination, she was in acute respiratory distress with cyanosis, severe hypertension (180/110 mmHg), tachycardia, and inspiratory stridor. A chest X-ray film showed loss of volume and nearly complete radiopacity of the left hemithorax. Arterial blood gas analysis revealed an arterial oxygen partial pressure of 54.8 mmHg, a carbon dioxide partial pressure of 39.8 mmHg, and an oxygen saturation of 84.5 percent on room air. Computed tomographic examination of the thorax showed dilation of the aortic arch and descending aorta, and marked compression of the trachea and the left main bronchus. Examination with a fiberoptic bronchoscope revealed extrinsic compression of the trachea just proximal to the carina. The patient's symptoms stabilized. However, she did not undergo surgery because of her age and because of the size of the aneurysm. She died due to rupture of the aneurysm.

Aged↗

PubMed1996

[Middle lobe syndrome--incidence and relationship to atypical mycobacterial pulmonary disease].

We evaluated the incidence of middle lobe syndrome in the Haibara area, and its relationship to atypical mycobacterial infection. Of the 30,588 persons who underwent annual mini-chest roentgenography in 1992 or 1993 or both, 51 (0.17%) had middle lobe syndrome, diagnosed from posteroanterior and lateral chest X-ray films. The incidence was significantly higher in persons over 50 years old than in persons under 50 years old (0.26% vs 0.02%: p < 0.001), and was higher in femals than in males (0.20% vs 0.11%: p = 0.527). Of 16 patients examined by bronchoscopy and computed tomography, 7 showed evidence of cylindrical bronchiectasis, and four had mycobacterium avium complex pulmonary disease presenting as middle lobe syndrome. All four were women who were 51 years of age or older and none had predisposing pulmonary disorders. Computed tomography showed multiple nodular shadows with or without bronchiectasis located in the middle lobe or the lingula. Cavitary lesions were not seen. These results indicate that middle lobe syndrome is not rare, and that infection with mycobacterium avium complex should be considered when multiple nodular shadows are seen in the middle lobe or the lingula.

Adult↗

PubMed1996

[Pneumothorax from a nasogastric feeding tube].

An 83-year-old woman was admitted to our hospital because of fever and disturbance of consciousness. Pneumonia and multiple organ failure were diagnosed from symptoms, a chest X-ray film, and laboratory findings. With the administration of antibiotics and an antiprotease inhibitor, the pneumonia and multiple organ failure began to resolve, but consciousness remained disturbed. A nasogastric feeding tube was inserted to provide parenteral nutrition. Neither abnormal resistance nor reflex coughing were noted during insertion. Bubbling rales were not heard on auscultation, and a chest X-ray film revealed that the tube had traversed the right bronchial tree, perforated the lung, coiled up in the right pleural vavity, and caused a right pneumothorax. The tube was immediately removed. The pneumothorax was treated with an intercostal drainage tube for 1 day and resolved without further problems. This case shows one of the dangers involved in inserting nasogastric feeding tubes. The medical community should be aware that pulmonary complications may develop after such tubes are inserted in patients with risk factors.

Aged↗

PubMed1996

[Characteristics and management of patients with lung cancer and idiopathic interstitial pneumonia].

Among 102 patients with idiopathic interstitial pneumonia (IIP), 22 with lung cancer who were treated from 1981 to 1994 were studied retrospectively. As controls, 248 patients with lung cancer only who were treated from 1991 to 1992 were also studied. Lung cancer developed in 6 of 85 patients after IIP was diagnosed (7.1%). The time from the onset of IIP to the onset of lung cancer was 7.7 years. In 17 patients both IIP and lung cancer were present on admission. In general, patients with IIP and lung cancer were heavy smokers. In patients with IIP and lung cancer, %VC was higher than in those with IIP alone, and 20 cancers (90.0%) were in peripheral lung fields. Seventeen patients received anticancer chemotherapy, irradiation, or both. Five patients (29.4%) died of respiratory failure due to progression of pneumonitis after the therapy. The prognosis for patients with IIP and lung cancer was very poor.

Aged↗

PubMed1996

[Swyer-James syndrome with unilateral pulmonary edema].

A 64-year-old man with ischemic heart disease was admitted to our hospital because of dyspnea. A chest X-ray film showed a butterfly shadow in the right lung. A chest X-ray film obtained before the patient had respiratory symptoms showed hyperlucency of the left lung. CT scans obtained at maximal inspiration and expiration revealed air trapping. Pulmonary arteriography showed that the left pulmonary artery and its branches were very small. Cardiac catheterization showed poor cardiac function. Swyer-James syndrome should be included in the differential diagnosis of patients with unilateral pulmonary edema.

Bronchial Diseases↗

PubMed1996

[Thy-1 induction and its tissue-specific regulation in the rat--studies on acute rejection and granulomatous inflammation].

Thy-1 is a surface molecule known to be involved in cellular adhesion and signal transduction, and it has been found that Thy-1 induced on endothelial cells regulates vascular permeability both in vitro and in vivo at sites of inflammation. To further investigate regulation of Thy-1 expression at inflammatory sites, we made two in vivo models using LEJ/Hkm, rat strain. One is allogenic transplantation model and another is granulomatous inflammation model induced by Freund's complete adjuvant. Thy-1 mRNA was detected in the normal brain, thymus, heart, lung, liver, kidney, skin and lymph node but not in peripheral blood mononuclear cells by reverse transcription and polymerase chain reaction method. In the skin transplantation and dermal inflammation, Thy-1 expression was up-regulated on endothelial cells. On the other hand, Thy-1 was induced on rat renal tubular epithelial cells in acute cellular rejection. No obvious Thy-1 upregulation was observed in the granulomatous inflammation in the kidney. Moreover, no induction of Thy-1 expression was seen in either acute cellular rejection or granulomatous inflammation in the lung. These observations suggested that there is a tissue-specific regulation on Thy-1 expression and that Thy-1 induction appears to be one of important factors that modulates acute cellular rejection of skin allografts through its function on vascular permeability regulation.

Acute Disease↗

PubMed1996

[Successful surgical repair of acute DeBakey type I aortic dissection complicated by acute occlusion of the suprarenal abdominal aorta].

We reported a case of acute DeBakey type I aortic dissection presented with occlusion of the suprarenal abdominal aorta, who was successfully treated by simultaneous graft replacement of the ascending aorta and total aortic arch. The patient was a 68-year-old man who complained of chest pain and symptoms of acute arterial occlusion of bilateral lower extremities, and who had consciousness disturbance due to stroke caused by aortic dissection. He underwent simultaneous graft replacement of the ascending aorta and total aortic arch under selective cerebral perfusion during an emergent operation. For reconstruction of the arch vessels, we used three separate grafts that were connected to the aortic prosthesis before use. Although postoperative course was complicated by myonephropathic metabolic syndrome, the patient subsequently recovered and was discharged on foot. Early vascular reconstruction and appropriate management of reperfusion injury are extremely important in the setting of malperfusion phenomena complicating acute aortic dissection.

Aged↗

PubMed1996

[Bronchiolitis obliterans preceding rheumatoid arthritis: effect of clarithromycin].

A 62-year-old man was referred to our department because of exertional dyspnea and a 6-year history of coughing and sputum production. He had never smoked, and had had an operation for chronic paranasal sinusitis. Coarse crackles and rhonchi were audible over both lower lung fields. The cold hemagglutinin titers were high. pulmonary function tests showed airflow obstruction, and a sputum culture revealed Hemophilus influenzae A chest X-ray film and a CT scan showed diffuse micronodular shadows in the centrilobular regions, mild ectasis of bronchioles mainly in the lower lung fields, and mild hyperinflation. A specimen of lung tissue was obtained by thoracoscopic biopsy, and histologic examination showed bronchiolitis obliterans, with bronchiolar narrowing or obliteration due to submucosal fibrosis and inflammation. Rheumatoid arthritis was diagnosed 14 months after the operation. The patient was treated with clarithromycin for 3 years. Respiratory symptoms were relieved and pulmonary function gradually improved.

Anti-Bacterial Agents↗

PubMed1996

[Fulminant interstitial pneumonia associated with polyarteritis nodosa].

A 54-year-old man was referred to our hospital because of fever, abdominal pain, hematemesis, and dyspnea on exertion. Laboratory examination on admission revealed elevations of WBC count and CRP. a low serum complement level, hypoxemia, and microhematuria. A chest X-ray film and a CT scan showed bilateral interstitial pneumonia and cardiomegaly. Angiography showed microaneurysms in peripheral branches of the superior mesenteric artery, the hepatic artery, and the right renal artery. Examination of a specimen of the right quadriceps muscle revealed arteritis with fibrinoid necrosis in a small artery, which was consistent with polyarteritis nodosa (PN). A specimen obtained by transbronchial lung biopsy before treatment showed interstitial mononuclear cell infiltration and edema. PN with interstitial pneumonia was diagnosed and the patient was treated with 1 g of methylprednisolone for 3 days, followed by 60 mg of prednisolone and 100 mg of cyclophosphamide daily. The interstitial pneumonia progressed. Despite a second trial of steroid pulse therapy in addition to mechanical ventilation and various kinds of antibiotics, the patient died of respiratory failure on the 35th hospital day. A specimen obtained by transbronchial lung biopsy 3 days before death revealed proliferation of fibroblasts, mononuclear cell infiltration in the interstitium, and hyaline membrane formation in air spaces. No evidence of infection was found. Interstitial pneumonia associated with PN had been considered to be quite rare, but recently some cases resembling the present case have been reported. We believe that interstitial pneumonia associated with PN might not be rare, and the present case shows that it can be fulminant.

Humans↗

PubMed1996

[Pseudoaneurysm].

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Aneurysm, False↗