Biomedical subjects

H Takeuchi

Publications and source records attributed to H Takeuchi.

At least 343 records · Page 19Linked to original sources

PubMed1997

Unilateral meningoencephalitis with hemispheric slowing on EEG.

We report a 12-year-old boy with unilateral meningoencephalitis due to non-herpes simplex virus. He experienced secondarily generalized partial seizures of the left extremities with loss of consciousness. In contrast with normal neuroimaging findings, interictal electroencephalograms (EEGs) showed prolonged slowing in the right hemisphere. This laterality agreed with the right brain dysfunction verified on neuropsychological examination. Follow-up EEG is important in such a subtle case with normal neuroimaging.

Child↗

PubMed1997

Experimental and clinical study of detection of glioma at surgery using fluorescent imaging by a surgical microscope after fluorescein administration.

Total resection is the optimal treatment for malignant gliomas. However, an unexpected residual tumor mass is sometimes found on magnetic resonance imaging performed after an operation because of a macroscopically unclear margin of the tumor at surgery. This study was designed to evaluate the effectiveness of fluorescent imaging by a surgical microscope after fluorescein administration for the detection of gliomas at surgery. For this study, we produced two filters for the excitation and emission of fluorescein that can be easily fitted to and removed from a surgical microscope manually during the operation. For the experimental study, Wistar rat brains bearing C6 glioma were removed at appropriate intervals after intravenous administration of 10-20 mg kg-1 body weight of sodium fluorescein, and their surface and coronal section through the tumor were observed using a surgical microscope with the filters. In clinical cases, 1000 mg of sodium fluorescein was intravenously administered to five patients with glioma before tumor resection. In the experimental study, the C6 glioma itself and the edematous brain adjacent to the tumor (within 2-3 mm of the gross surface of the tumor) were well stained a brilliant yellowish green for a few hours. The normal brain was not stained. In clinical cases, the tumors were stained a brilliant yellowish green under fluorescent observation at surgery. The patients had no side effects. At all times the fluorescent observation could be quickly changed to ordinary observation by removing the filters from the surgical microscope. The tumor was also stained a faint yellow under ordinary nonfluorescent observation. Although this contributed to detection of the tumor, the fluorescent staining demarcated the tumor more clearly than nonfluorescent staining. These results suggest that this imaging technique by a surgical microscope with special filters at surgery may be practical and useful for detection of gliomas and warrants further clinical evaluations.

Animals↗

PubMed1997

Transperitoneal laparoscopic adrenalectomy: experience in 100 patients.

Between July 1992 and October 1996, 100 transperitoneal laparoscopic adrenalectomies were performed on 99 patients at our hospital and affiliated hospitals. The clinical diagnoses were primary aldosteronism (41 patients), Cushing's syndrome (15), pre-Cushing's syndrome (6), pheochromocytoma (7; 8 adrenal glands), adrenal cancer (2), nonfunctioning adenoma (22), myelolipoma (3), and complicated adrenal cyst (3). Ninety-seven glands were removed laparoscopically. The mean operative time was 240 +/- 76 (SD) minutes and the mean blood loss 68 +/- 80 mL for the series. The mean blood was 77 +/- 113 mL when the three operations that were converted to open surgery are included. The mean times for the return to a normal diet and unassisted ambulation were 1.3 +/- 0.6 and 1.4 +/- 0.8 days, respectively. The mean duration of the use of analgesics was 1.5 +/- 1.3 days, including the day of surgery. In contrast, in the latest 10 open adrenalectomies done at Kyoto University Hospital, the mean operative time was 186 +/- 53 minutes and the mean blood loss 220 +/- 170 mL. The mean times for return to a normal diet and for unassisted ambulation and the mean duration of the use of analgesics were 1.9 +/- 0.3, 2.9 +/- 1.1, and 2.9 +/- 1.7 days, respectively. Thirty-six operations, excluding one converted to open surgery, performed at Kyoto University Hospital were selected to look at the learning curve for transperitoneal laparoscopic adrenalectomy and evaluated for operative time and blood loss. The mean operative time and mean blood loss in the first 10 procedures performed at Kyoto University Hospital were 256 +/- 63 minutes and 89 +/- 57 mL; however, these values were reduced to 177 +/- 39 minutes and 48 +/- 32 mL in the next 10 procedures at the same hospital. Laparoscopic adrenalectomy via the transperitoneal anterior approach can be equivalent to open adrenalectomy in efficiency with a shorter convalescence.

Adrenal Gland Diseases↗

PubMed1997

Taste disks are induced in the lingual epithelium of salamanders during metamorphosis.

Morphological changes of oral cavity during metamorphosis with special reference to the taste organ were examined in Ezo salamanders (Hynobius retardatus) and axolotis (Ambystoma mexicanum), and compared with those in bullfrogs (Rana catesbeiana). The non-distensible tongue of salamanders changed the structure progressively during metamorphosis: a small area of the rostrum protruded and developed caudally with recession of the flat area of the tongue. The protrusion that developed on the tongue had numerous papillae, as seen in the frog tongue. The apical region of the papillae occasionally had a cell mass similar to the taste disk of frogs (termed a taste disk-like cell mass). On the flat area of the tongue, the barrel-shaped taste buds of larval salamanders were transformed into taste buds with a wider receptor area. The barrel-shaped taste buds decreased progressively during metamorphosis, while taste disk-like cell masses increased. Neuronal labeling with an antibody to neuron-specific enolase and fluorescent carbocyanine dye showed that the taste disk-like cell masses in metamorphosed salamanders were innervated by the glossopharyngeal nerve (nerve IX). Nerve IX responded to taste stimulation as well as mechanical stimulation applied to the rostral tongue. During metamorphosis the salamanders undergo transformation and rearrangement of taste organs on the tongue possibly as an adaptation to the terrestrial environment.

Animals↗

PubMed1997

Potentiation of the cytotoxicity of carboquone by flavone acetic acid combined with hyperthermia.

Flavone acetic acid (FAA) has shown the effectiveness of vasoactive drugs in the selective reduction of tumor blood flow. A FAA-mediated decrease in tumor blood flow may produce sufficient hypoxic conditions within the tumor. Carboquone (CQ), a naturally occurring prototype bioreductive alkylating agent like mitomycin C (MMC), has been shown to be selectively more cytotoxic toward hypoxic tumor cells. We have reported enhancement of the combined antitumor effects of MMC plus FAA and hyperthermia (HT). In this study, we examined the combined effects of FAA, CQ and HT. In vitro, although HT (43 degrees C, 60 min) reduced the colonogenicity to 0.58 in CQ (0.01 microg/ml) alone, the combined cytotoxicity of CQ and HT was not enhanced with exposure to FAA at a concentration of 100 microg/ml. In vivo, the tumor growth time, calculated as the time required to reach twice the initial tumor volume, for CQ (2 mg/kg) alone, FAA (150 mg/kg) alone, CQ+FAA, CQ+HT (43 degrees C, 15 min), FAA+HT and FAA+CQ+HT was 6.1, 5.1, 7.1, 8.0, 7.6 and 13.4 days, respectively. A significant enhancement of antitumor effects by trimodality therapy with CQ, FAA and HT was observed, when compared to the treatment with CQ and FAA (p < 0.05). The possible mechanisms of an increased antitumor response achieved with the combination of CQ, FAA and HT may be explained in the following way: the FAA-mediated decrease in tumor blood flow produced sufficient hypoxic conditions within the tumor, and these resulted in a significant increase of the antitumor effects of CQ and HT.

Animals↗

PubMed1997

Strip biopsy to treat esophageal granular cell tumor.

Esophageal granular cell tumors are rare neoplasms. We successfully treated a 35-year-old Japanese man with an esophageal granular cell tumor without any complications using strip biopsy. Endoscopic ultrasonography revealed a hypoechoic tumor with a diameter of 8 mm that was confined to the submucosal layer. A strip biopsy done with a two-channel endoscope completely resected the tumor. Six months later, no abnormal findings were recognized in the resected area. Therefore we propose that strip biopsy be considered as a viable alternative treatment for esophageal granular cell tumor, depending on the histologic character, tumor size, and depth of tumor infiltration.

Adult↗

PubMed1997

An inhibitor of poly(adenosine 5'-diphosphoribose) synthetase, 3-aminobenzamide, does not improve cardiovascular depression, bronchospasm, or survival associated with systemic anaphylaxis in rabbits in vivo.

We investigated whether an inhibitor of poly(adenosine 5'-diphosphoribose) synthetase (PARS) is beneficial in anaphylaxis. Twenty-eight rabbits were randomly allocated to three groups: Group I (control) received .9% NaCl solution 10 min before antigen challenge followed by the infusion of the same solution. Group II (3-aminobenzamide 20 mg.kg-1) received 20 mg.kg-1 of 3-aminobenzamide (a PARS inhibitor) 10 min before antigen challenge followed by the continuous infusion of 20 mg.kg-1 of 3-aminobenzamide. Group III received 40 mg.kg-1 10 min before antigen challenge followed by the continuous infusion of 20 mg.kg-1 of 3-aminobenzamide. Survival were similar between three groups. Heart rate, mean arterial pressure (MAP), central various pressure, and pulmonary resistance did not differ between three groups. Dynamic pulmonary compliance did not differ in the early phase after the antigen challenge; however, it was significantly lower in Group III than in Groups I and II 15 min after the initiation of anaphylaxis. 3-aminobenzamide per se did not affect heart rate, MAP, central venous pressure, pulmonary resistance, or dynamic pulmonary compliance in animals without systemic anaphylaxis. In conclusion, this PARS inhibitor did not improve cardiovascular depression or bronchospasm in the early phase of systemic aggregated anaphylaxis in rabbits in vivo, implying that the pathophysiological changes associated with systemic anaphylaxis may not be related to activation of an energy-consuming DNA repair cycle triggered by PARS.

Anaphylaxis↗

PubMed1997

Biphasic synovial sarcoma of the peritoneal cavity with t(X;18) demonstrated by reverse transcriptase polymerase chain reaction.

A case of a biphasic synovial sarcoma, arising on the inner surface of the anterior abdominal wall of a 13-year-old girl, is reported. Although the tumor showed rather typical histological and immunohistochemical features for synovial sarcoma, its unusual clinical presentation and anatomical location caused diagnostic difficulty, especially with regard to differentiation from a malignant mesothelioma. Applying reverse transcriptase polymerase chain reaction (RT-PCR) analysis, the SYT-SSX2 chimeric gene transcripts that result from the translocation, t(X;18)(p11.2;q11.2), found in most synovial sarcomas could be demonstrated. Thus, this RT-PCR approach is a reliable method for confirming the diagnosis of synovial sarcomas in unusual locations.

Adolescent↗

PubMed1997

Urinary reconstruction using appendix as a urinary and catheterizable conduit in 12 patients.

BACKGROUND: The appendix vermiformis can provide an excellent urinary conduit or a catheterizable outlet in continent urinary reservoirs in selected cases. We report our clinical experience using the appendix in urinary reconstruction in adult patients. METHODS: A total of 12 patients underwent urinary reconstruction using the appendix. The indications were pelvic malignancies except for 1 patient with neurogenic bladder and difficulty in self-catheterization via urethra. The appendix was used as a catheterizable conduit in 8 patients, and as a urinary conduit in 4 patients. The in situ submucosally embedded method was used in 6 patients and the Mitrofanoff method was used in 2 patients. Follow-up ranged from 3 to 41 months (mean, 22). RESULTS: Early complications occurred in 3 patients (wound infection, false passage and intestinal anasotomotic leak). Late complications occurred in 3 (slight hydronephrosis, ileus, stomal stenosis). Emergent colostomy and pouchstomy with resection of the appendix was performed in the patient with anastomotic leak. The isoperistaltic Kock nipple valve was reconstructed for continence in this case. Prolonged ileus in 1 patient was treated by open surgery. Other complications were managed conservatively. End results were excellent in 8 patients, good in 3, and poor in 1. CONCLUSIONS: The appendix can be used advantageously as an outlet of continent urinary reservoirs or for a urinary conduit when the ureter is too short to reach the skin. Complete continence and easy catheterization can be obtained, and the appendix construction can be used as a urinary conduit instead of the ileal conduit in poor risk patients.

Aged↗

PubMed1997

Preoperative imaging for parathyroid localization in primary hyperparathyroidism.

BACKGROUND: We retrospectively studied the results of diagnostic imaging using 3 different modalities to determine their usefulness for preoperative localization of the parathyroid, and whether accurate preoperative localization information could be used to modify the surgical approach for parathyroidectomy in patients with primary hyperparathyroidism. METHODS: Images of 37 parathyroid adenomas or hyperplasias in 35 patients with primary hyperparathyroidism were obtained using ultrasonography, computed tomography, and subtraction scintigraphy (using thallium 201 [thallous chloride] and either iodine 123 or technetium 99m pertechnetate [99mTcO4-]). RESULTS: Approximately three fourths of the adenomas or hyperplasias were successfully identified by ultrasound (76.7%) and computed tomography (76.4%), even when the weight of the tumor was less than 500 mg. However, subtraction scintigraphy was of limited use (61.3% successfully identified). A combination of these modalities gave excellent results for detecting adenomas and hyperplasias, leading to an accurate prediction rate of 96.0%. CONCLUSION: We conclude that using the combination of these 3 imaging modalities is very useful for the detection of parathyroid adenomas and hyperplasias, and that with such accurate localization information, the unilateral approach alone, or even simple excision of the parathyroid tumors might be feasible, enabling less invasive surgical treatment.

Adenoma↗

PubMed1997

A study of tubo-ovarian and ovarian abscesses, with a focus on cases with endometrioma.

OBJECTIVE: To determine the incidence and causes of endometrioma-associated tubo-ovarian abscesses (TOAs) and ovarian abscesses. METHODS: The medical records of 6,557 gynecologic inpatients were reviewed, and the data were analyzed using the median test and chi 2 test. RESULTS: The incidence of TOAs was 2.3% (5/218) in patients with endometrioma, and 0.2% (11/6,339) in patients without endometrioma (p = 0.0001). Among the TOA cases (n = 16), no significant differences in age, parity, history of pelvic surgery, or isolated organisms were observed between the subgroups with (n = 5) and without endometrioma (n = 11). There were only 2 cases of ovarian abscess, and both were associated with endometrioma. The causes of the abscesses in the 7 cases with endometrioma were contamination during surgery (1 case), contamination during a transvaginal endometrioma aspiration (1 case), and ascending infection (1 case), and unknown in 4 cases. CONCLUSIONS: The presence of endometrioma is a risk factor for the development of a TOA or an ovarian abscess.

Abdominal Abscess↗

PubMed1997

Effects of fibrin glue on postsurgical adhesions after uterine or ovarian surgery in rabbits.

OBJECTIVE: To evaluate the prophylaxis with fibrin glue on postoperative adhesions following uterine or ovarian surgery in rabbits. STUDY DESIGN: The uterine horns of 10 rabbits were exteriorized and electrocauterized by monopolar coagulation. Fibrin glue was applied to one uterine horn and the other was left untreated as a control (Experiment 1). Multiple ovulation was induced in 12 rabbits with hCG, and wedge resection was performed on both ovaries of each animal. One ovary was treated with fibrin glue and the other was untreated as a control (Experiment 2). Second-look laparotomy was performed to assess adhesion formation 2 weeks after the initial operation. RESULTS: The use of fibrin glue resulted in significant decrease in postoperative adhesions compared with the control side, in the uterine horns and the ovaries (p < 0.02 and p < 0.01, respectively). CONCLUSION: Fibrin glue was useful in preventing postoperative adhesions of the reproductive organs in rabbits.

Animals↗

PubMed1997

A structure-relationship study of the uptake of aliphatic polyamine compounds by rat intestinal brush-border membrane vesicles.

The effects of lipophilicity, ion-diffusion potential and membrane surface potential on the uptake of various aliphatic polyamine compounds by rat intestinal brush-border membrane vesicles (BBMV) have been investigated. A valinomycin-induced potassium-diffusion potential (inside-negative) stimulated the initial uptake of diamine compounds, and good correlation was observed between lipophilicity and the amount of diffusion-potential-dependent transport of the diamines. In contrast, because of their much lower lipophilicity, tri- and tetraamine compounds were not affected by the diffusion potential. Tetracaine, which can make the membrane surface potential more positive, inhibited the transport rate of 1,9-nonanediamine, spermidine and spermine by the BBMV. These data suggest that the transport mechanism of diamines is similar to that of monoamine compounds in respect to its dependence on ion-diffusion potential and on the membrane surface potential. The extent of the effect of ion-diffusion potential on the rate of transport of the diamines was closely related to the lipophilicity of the diamine. In contrast, only the surface potential contributed to the transport mechanism of lower lipophilic tri- and tetraamine compounds.

Anesthetics, Local↗

PubMed1997

Long-term follow-up of a girl with the neonatal form of Bartter's syndrome.

We followed up a girl with the neonatal form of Bartter's syndrome for sixteen years and determined the sensitivity to angiotensin II before and during the indomethacin treatment. A 4-month-old girl was admitted to our hospital, because of severe hypokalemia and growth retardation. Initially we treated her with spironolactone and potassium supplements. This treatment increased plasma potassium levels and her growth. At the age of one year she was diagnosed as having Bartter's syndrome. Since then she has been treated with indomethacin at an initial dose of 3 mg/kg/day combined with spironolactone and potassium. After the start of the indomethacin treatment, her growth increased dramatically, and her final height was normal adult height. Her puberty developed normally and menarche occurred at the age of 12 years. Levels of serum sodium, chloride, plasma aldosterone and urinary prostaglandin E2 were also normalized. Levels of angiotensin I and II were improved but not within the normal range, but plasma potassium levels slightly decreased after plasma aldosterone levels were normalized and did not change during the treatment period. Plasma renin activity remained high until about the age of 8 years, after which it decreased to almost within the normal range. At 5 months after the start of indomethacin (3 mg/kg/day), her vascular sensitivity to angiotensin II had been improved, and after 2 years and 5 months, her vascular sensitivity was further improved. At this time renin activity had decreased after angiotensin II infusion, but plasma aldosterone did not change. At the age of 16 years (dose of indomethacin: 0.5 mg/kg/day), plasma aldosterone increased after angiotensin II infusion. These data suggest that indomethacin and spironolactone are effective treatments for the neonatal form of Bartter's syndrome, especially during childhood.

Angiotensin I↗

PubMed1997

[Measurement of relative plasma volume and plasma refilling rate during ultrafiltration of hemodialysis by measuring apparatus of plasma colloidal osmotic pressure].

BACKGROUND: The objective of this study is the prevention of unexpected hypotension during hemodialysis caused by unsuitable filtration rate. METHODS: The plasma colloidal osmotic pressure (COP) was measured continuously during ultra-filtration, and relative plasma volume (%PV) and plasma refilling rate (PRR) were calculated during 12 ECUMs and one dialysis on twelve patients in early stage of chronic renal failure. Values of %PV and PRR calculated from COP were drawn in graphic curves, and analysed to obtain characteristic pattern. Minimum value of %PV (%PV min), maximum value of PRR (PRRmax) and time for PRR to decrease to 95% (95% PVt) on the curves were documented simultaneously. RESULTS: At the initial stage of %PV curve, obvious fall was observed on 6 of 13 estimation (initial fall of %PV). On the contrary at the initial stage of PRR curve, obvious rise was observed on 5 estimation (initial rise of PRR). A close relationship was indicated between the two phenomenons. In 6 cases with initial fall of %PV and in 5 cases with initial rise of PRR body weight, PRRmax and 95%PVt were lower than another cases without it. The ultra-infiltration velocity was estimated to be relatively high in these groups. In these 8 cases, filtrated water volume was judged as adequate clinically. In 4 of 5 cases without final fall of PRR, it was judged as inadequate and needed to evacuate more 0.9 to 3.0 kg (average of 1.8 +/- 1.07) of water from the patients. CONCLUSIONS: From the above, we concluded that our method is useful for deciding suitable velocity of ultrafiltration and dry weight in hemodialysis therapy.)

Adult↗

PubMed1997

[Treatment results of radical prostatectomy for localized prostate cancer--biochemical failure analyzed from pathological findings at surgery].

OBJECTIVE: Recurrence is not rare after radical prostatectomy for localized prostate cancer. The treatment results of radical prostatectomy for localized prostate cancer was evaluated in this retrospective study. METHODS: A total of 36 patients with localized prostate cancer (clinical stage: A, B) were treated with radical prostatectomy. Kaplan-Meier product limit method analyzed from biochemical failure was used to study the treatment results of radical prostatectomy, and Cox's proportional hazards model was used to analyze the influence of pathological findings at surgery on biochemical failure. RESULTS: Of all 36 patients, 24 (67%) had pT3 (N0-2) disease, and these patients received adjuvant hormonal therapy after surgery. Overall freedom from biochemical failure at 5 years after surgery was 53% (pT1-2N0; 83%, pT3N0-2; 40%). No significant difference was seen in the freedom from biochemical failure between patients grouped by pathological classification (p = 0.106), tumor grade (p = 0.476), proximal and distal margin involvement (p = 0.095) and regional lymph node metastasis (p = 0.482), but a significant difference was seen between patients grouped by capsule involvement (freedom from biochemical failure at 5 years in cases with positive capsule: 30%, p = 0.023) and seminal vesicle involvement (freedom from biochemical failure at 5 years in cases with positive seminal vesicles: 26%, p = 0.014). Cox's proportional hazards model, on the other hand, showed only that seminal vesicle involvement significantly influenced on biochemical failure (p = 0.031). CONCLUSION: We confirmed a high likelihood of biochemical failure and presumably less favorable prognosis in patients with seminal vesicle involvement. These results indicated that candidates for surgery should be selected pathologically by excluding those with seminal vesicle involvement in the preoperative evaluation.

Aged↗

PubMed1997

[Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia in a patient who died of progressive peripheral polyneuritis and cerebral dysfunction].

We reported a 59-year-old woman who received a diagnosis of psoriasis vulgaris at the age of 35 and had been under medical treatment. She was admitted to our department on August 16, 1993 because of lymphadenopathy, arthralgia and neuralgia. We observed cervical and axillar lymphadenopathy 1-3 cm in diameter, anemia and leukothrombocytosis. Elevated levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immunoglobulin G (IgG), but not M-protein were observed by immunological analysis of the serum. Bone marrow aspiration biopsy revealed hypercellularity with myeloid hyperplasia and slight increase in plasma cells. Elevated levels of serum interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF) were detected; IL-6 was 62.1 pg/ml and G-CSF was 66 pg/ml, but IL-1 alpha, IL-1 beta and TNF-alpha were within the normal range. Idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia was diagnosed by lymph-node biopsy and the patient received following treatment with prednisolone and hydroxyurea. Leukocytes, platelets and skin eruptions increased again when the steroid dose was tapered, so we changed treatments to MP (melphalan, prednisolone) therapy. In addition, various neurological abnormalities such as convulsions, loss of consciousness and peripheral polyneuritis were observed. Despite treatment her condition deteriorated and she finally died. Very few reports show these neurological abnormalities in IPL or Castleman's disease therefore we think this is a very rare case.

Brain Diseases↗

PubMed1997

[An experimental study of infection stone formation by Corynebacterium species].

The relationship between infection stone and Corynebacterium species was investigated in vitro and in vivo. Urease activity of urease-splitting Corynebacterium species was evaluated by 2 methods; an increase in pH of human urine after inoculation of Corynebacterium species and direct measurement of urease activity of 10(7) CFU organisms from amounts of ammonia by indophenol method. Formation of infection bladder stone was induced in male Wistar rats by implanting a zinc disc and inoculating 10(6) CFU organisms surgically into the bladder. Urine was alkalinized by the inoculation of Corynebacterium renale, C. pilosum and group D2 Corynebacterium. C. renale and C. pilosum had strong urease activity, and group D2 Corynebacterium had moderate activity. C. pseudodiphtheriticum did not produce the elevation of urinary pH and had little urease activity. Infection stones were formed in 100% of rats by inoculation of C. renale and C. pilosum and 88% of rats by group D2. Urinary pH was elevated in all inoculated rats. In conclusion, C. renale, C. pilosum and group D2 Corynebacterium may play a role in formation of infection stones.

Animals↗