Biomedical subjects
Publications and source records attributed to H Takeuchi.
Idiopathic female pseudohermaphroditism associated with a vaginal urethra, prominent clitoris and an accessory phallic urethra is a rare syndrome, with no apparent cause to account for the masculinization of the genitalia and exhibit of similar characteristic features. We report such a case and review the pertinent literature.
Bile alcohols in bile, urine, and feces of a patient with cerebrotendinous xanthomatosis have been analyzed by a combination of capillary gas-liquid chromatography and mass spectrometry after fractionation into groups according to mode of conjugation. The presence of at least 18 bile alcohols, which were excreted mainly as glucurono-conjugates in bile and urine, and as unconjugated forms in feces, was demonstrated. The following bile alcohols were identified with certainty by direct comparison with reference compounds: 5 beta-cholestane-3 alpha,7 alpha,12 alpha-triol; (23R)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,23-tetrol; 5 alpha- and 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24-tetrols; 5 alpha- and 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrols; 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol; (22R)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,22,25-pentol; (23R)- and (23S)-5 beta-cholestane-3 alpha,7 alpha, 12 alpha,23,25-pentols; 3 alpha,12 alpha,25-trihydroxy-5 beta-cholestane-7-one; (24R)- and (24S)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentols; 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25,26-pentol. Although the bile alcohol profile in urine was quite different from those in bile and feces, the determination of urinary bile alcohols as well as of biliary and fecal bile alcohols could be used for diagnosis of cerebrotendinous xanthomatosis.
A 40 year old man who had a systemic inflammatory enthesopathy without spondylarthritis and HLA-B27 is described. The presence of hypergammaglobulinaemia and the effectiveness of glucocorticoid therapy suggested the possibility of its aetiology being 'autoimmune' in nature.
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The survival rate of 19 patients who underwent living-related kidney transplantation after donor-specific blood transfusions (DST) was compared with that of 32 historical controls receiving transplants without DST. The graft survival rate of the DST group was 82% after two and three years. The graft survival rate of the DST group was significantly better than the 53% rate after two years obtained with the 32 historical controls (p less than 0.05). We tested sera from 16 DST-treated recipients to study the beneficial effect of DST on kidney allograft survival using the mixed lymphocyte culture (MLC) serum inhibition test. The results demonstrated that MLC inhibitory factors were induced in the serum of the recipient after completion of DST. This inhibition of MLC was observed by treatment of responder lymphocytes with serum obtained three weeks after DST plus rabbit complement. The inhibitory effect was also specific for responder cells in anti-donor MLC. Regarding the correlation with rejection episodes, these MLC inhibitory factors were often observed in the non-rejection group (p less than 0.05). The data suggest that such factors may be anti-idiotypic antibodies and be associated with prolonged graft survival.
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Between 1983 and 1985, six patients with advanced testicular cancer were treated with 3 cycles of vinblastine, actinomycin D, bleomycin, cyclophosphamide and cisplatinum (VAB-6 combination chemotherapy without maintenance). The histology of the primary tumor was seminoma in one patient and nonseminomatous germ cell testicular tumor (NSGCTT) in 5. Five men with stage III or bulky stage II diseases received no prior chemotherapy but one had received another chemotherapy without cisplatinum. Two patients showed a complete response to chemotherapy. Three were partial responders free of disease after a debulking operation and additional chemotherapy. The other patient who had NSGCTT had recurrence 5 months after the last induction chemotherapy and received additional chemotherapy (PVeBV regimen). Median follow-up was 16 months (range 2 to 28 months) and all patients are alive with no evidence of disease. Severe myelosuppression and serious renal toxicity were not experienced. Marked, but transient elevation of serum transaminase were observed in all patients. These data suggest that this protocol is highly effective and minimally toxic in the treatment of disseminated testicular tumor.
During induction chemotherapy, we experienced the false elevation of the tumor marker alpha-fetoprotein (AFP) in some disseminated testicular cancer patients. We discussed the possibility of the false elevation of the tumor marker AFP and evaluated the relationship between AFP and the markers of liver damage (GOT, GPT, LDH, etc.), the elevation of which were caused by induction chemotherapy of the VAB-6 regimen. We evaluated each variable of the eleven patients with disseminated testicular cancer who had been treated in our hospital between 1979 and 1984. The elevation of each marker of liver damage was induced by the VAB-6 regimen, immediately after the end of each induction chemotherapy but not by other induction chemotherapy regimens. A statistical study confirmed that there was a close correlation between the elevation of AFP and of the markers of liver damage, that is induced frequently by the induction chemotherapy of VAB-6 regimen.
Visible spectra of erythroid cells stained with Wright's method were studied microphotometrically. Most mature cells of vertebrates have the main peak at 520 nm (A 520) and accessory peaks at 410 nm and 600 nm (A 410 and A 600), respectively. To compare the absorption at 520 nm against 410 nm and 600 nm, the relative absorption spectra were determined and effectively shown as percentage ratios (RAs) to the main peak of A 520. The A 520 shifted to the shorter side of the wavelengths in birds and lower vertebrates. When the RA values of 410 and 600 nm were compared, it was observed that RA 410 of immature cells was less than that of mature cells (15%), and that immature cells of the lower RA 410 type were present in peripheral blood, as well as in bone marrow of vertebrates. Thus, photometric analysis of erythroid cells at RA 410 and RA 600 against A 520 seems to provide useful parameters for comparative studies on vertebrate erythroid cells. Six spectral types can be observed in vertebrate erythroid cells by these parameters.
Morphological and pharmacological investigations were made of two giant neurons, RPeNLN (right pedal nerve large neuron) and LPeNLN (left pedal nerve large neuron), situated symmetrically on the anterior surface of the pedal ganglia of an African giant snail (Achatina fulica Férussac). The two neurons (about 250-300 microns in diameter) were the largest ones identified in the ganglia of the snail species. The axonal pathways of the two neurons were symmetrical; of their four main axonal branches, the three main branches innervated the ipsilateral pedal nerves, whereas the last main branch projected to the contralateral pedal nerves. The pharmacological features of the two neurons were very similar. Both were inhibited markedly by dopamine [minimum effective concentrations (MECs): 3 X 10(-6)-10(-5) M], DL-octopamine (MECs: 2 X 10(-6)-2 X 10(-5) M), 5-hydroxytryptamine (MEC: 3 X 10(-6) M), GABA (MEC: 3 X 10(-4) M), L-homocysteic acid (MECs: 3 X 10(-5)-10(-4) M) and erythro-beta-hydroxy-L-glutamic acid (MEC: 3 X 10(-5) M). Acetylcholine showed varied effects, either excitatory or inhibitory, on the two neurons examined. No substances were found to have any marked excitatory effects on the neurons.
An aenurysm of a diverticulum of the ductus arteriosus in a 33-year-old man was presented. The chest radiography revealed a mass obscurring the aortic window above the hilus of the left lung. His blood pressure was 130/70 mmHg, and there was no difference in pressures between the upper and lower or between the right and left extremities. A CT scan of the chest showed 30 X 34 mm angioma adjacent to the descending aorta and pulmonary artery. Aortography and contrast radiography of the right ventricle revealed a cystic pedunculated aneurysm at the superior portion of the descending aorta. The base of the left pulmonary artery was slightly displaced. There was no communication between the aorta and pulmonary artery, nor was any significant difference in pressure between the ascending and descending aorta. This case was diagnosed as an aneurysm of the diverticulum of the ductus arteriosus, and then it was resected. The abnormality was confirmed by the localization of the aneurysm and histopathologic findings, but the presence of the ligamentum arteriosum was not confirmed. This is the 23rd case of the aneurysm of the diverticulum of the ductus arteriosus in adults, and the first case in Japan in which the diagnosis was made in a living patient, followed by successful surgery.
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Two-dimensional (2D) echocardiographic and clinical characteristics of patients with mitral regurgitation (MR) due to abnormal reinsertion of chordae tendineae (looping) in the middle scallop of the posterior leaflet were described and compared with those of patients with chordal rupture of the posterior leaflet. Twenty-five patients with posterior mitral valve prolapse who underwent mitral valve replacement were studied. They were categorized in three groups; 14 patients with MR due to ruptured chordae tendineae (RCT) of the posterior leaflet (RCT group); three patients with looping of the chordae tendineae in the middle scallop of the posterior leaflet (looping group); and eight patients with both RCT and looping (looping + RCT group). It was difficult to distinguish the looping group from the other two groups by their 2D echocardiographic findings, which were characteristic of those of RCT. However, the following findings were more frequently encountered in the patients with looping than in those without: 1) aberrant or absent systolic coaptation with salient arc of the posterior leaflet, observed in six of the RCT group (43%), two in the looping group (67%) and seven in the looping + RCT group (88%); 2) with thickened edges of the posterior leaflet, shown in three of the RCT group (21%), two of the looping group (67%) and five of the looping + RCT group (63%) in the long-axis view, and also noticed in four of the RCT group (29%), two of the looping group (67%) and six of the looping + RCT group (75%) in the short-axis view. In the clinical history, the onset of a heart murmur, congestive heart failure and surgical treatment occurred at significantly younger ages in the looping group than in the RCT group. As for hemodynamic parameters, pulmonary hypertension was significantly milder in the looping group than in the RCT group. In conclusion, although 2D echocardiographic findings of patients with looping were similar to those of patients with RCT, it seemed possible to differentiate the looping group from the RCT group by the 2D finding of a prolapsed posterior mitral valve with a salient arc and a thickened edge. It was also suggested that the looping of chordae tendineae in the middle scallop of the posterior leaflet was congenital in origin.