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Biomedical subjects

I Takeda

Publications and source records attributed to I Takeda.

At least 19 recordsLinked to original sources
PubMed1995

Transcatheter arterial embolization for massive bleeding from duodenal ulcers not controlled by endoscopic hemostasis.

BACKGROUND AND STUDY AIMS: We evaluated the efficacy of transcatheter arterial embolization (TAE) in patients in whom endoscopic hemostasis of a massively bleeding duodenal ulcer failed. PATIENTS AND METHODS: TAE was performed in 11 patients with endoscopically uncontrollable massively bleeding duodenal ulcers, and the results and long-time outcome were studied. Two additional cases of failed endoscopic hemostasis were treated surgically without TAE. The entire group of 13 patients represented 5% of endoscopically treated duodenal ulcers and 0.6% of all cases with upper gastrointestinal bleeding who underwent emergency endoscopy (n = 2073). All but one of these 13 patients had concomitant disease. RESULTS: Arteriograms performed before TAE revealed extravasation of contrast material around the gastroduodenal artery (GDA), the anterior superior pancreaticoduodenal artery (ASPD), or the posterior superior pancreaticoduodenal artery (PSPD) in six of 11 cases. We failed to stop the bleeding in one patient, in whom only the common hepatic artery side of the GDA bleeding site was embolized; this patient died. TAE was successful in the other ten patients, in whom the long stretch of the GDA, including the ASPD and PSPD, was embolized around the bleeding site. Two surgically treated patients died within a week. CONCLUSIONS: Our findings indicate that TAE may induce hemostasis in 90% of patients with serious concomitant diseases who have endoscopically uncontrollable massive bleeding from duodenal ulcers.

Aged↗
PubMed1995

Serum levels of soluble interleukin-2 receptor in chronic hepatitis C treated with interferon-alpha.

BACKGROUND: Serum levels of soluble interleukin-2 receptor (sIL-2R) seem to serve as a marker for the activation of T lymphocytes. The aim of this study was to evaluate the clinical significance of such levels in patients with chronic hepatitis C (CHC) treated with interferon. METHODS: We measured serum levels of sIL-2R in 37 patients with CHC before and after treatment with recombinant interferon-alpha. Serum receptor levels were then compared with the response of the hepatitis C virus (HCV)-RNA level in serum after interferon. RESULTS: Receptor levels were significantly higher in the patients with chronic persistent hepatitis and chronic active hepatitis than in normal controls (p < 0.01). There was a weak correlation between serum sIL-2R and alanine aminotransferase (ALAT) levels (r = 0.14, p = 0.010). Patients were then classified into three groups on the basis of the effect of interferon treatment on HCV-RNA levels in serum: sustained response (SR; n = 21), non-sustained response (NSR; n = 14), and nonresponse (NR; n = 2). Before and during interferon treatment the serum sIL-2R level remained increased in the SR group and in the combined groups with NSR or NR. However, after interferon was withdrawn, the serum sIL-2R decreased in the SR group but remained significantly increased in the combined response group (p < 0.01-0.05). CONCLUSION: This finding seems to reflect the disappearance of HCV-RNA from the serum of the patients with an SR, and monitoring of sIL-2R levels may therefore be of value as an adjunct to the measurement of serum ALAT and HCV-RNA in evaluating the response to the interferon therapy for CHC.

Adult↗
PubMed1995

[Clinical evaluation of a recurrent mode after treatment in patients with small hepatocellular carcinoma].

A total of 96 patients with small hepatocellular carcinoma (HCC) with a maximal diameter of below 2 cm were analyzed according to recurrent factors and recurrent modes after the first treatment. In this study, recurrences were divided into two groups based on the style of recurrences provisionally: intrahepatic metastases (IM, 35 cases) and multicentric recurrences (MC, 22 cases). In patients with IM, the majority of recurrences were observed within 2 years after the first treatment and the primary HCC lesions had strong relation to the degrees of malignancy. On the other hands, there were no association with recurrent intervals and the degrees of malignancy, although the recurrent rate was high in patients with anti-HCV in MC group. The prognosis after the second treatment in MC group was superior to that in IM group (p < 0.05). These results indicate MC group have a good prognosis if early detection and the second accurate treatment are performed.

Aged↗
PubMed1995

[A case of tricuspid regurgitation due to blunt chest trauma].

A case of tricuspid regurgitation due to blunt chest trauma is presented. A 35-year-old man was in good health until he sustained blunt chest trauma in a traffic accident 17 years ago (in 1972). After that easy fatiguability developed. In 1977, slight tricuspid regurgitation was detected, but he was clinically well and no treatment seemed necessary. In October 1989, he was admitted due to right heart failure. The chest X-ray film showed marked cardiomegaly and ECG revealed atrial fibrillation and complete right bundle branch block. Two-dimensional echocardiogram showed a flail anterior leaflet of the tricuspid valve and severe tricuspid regurgitation. In December 1989, he underwent tricuspid valve replacement with Carpentier-Edwards bioprosthesis. The chordae tendineae to the anterior leaflet of the tricuspid valve were ruptured. Furthermore, an artificial cardiac pacemaker was implanted because of slow atrial fibrillation. His postoperative course was uneventful.

Accidents, Traffic↗
PubMed1995

[Mass-screenings for osteoporosis using computed X-ray densitometry (CXD): in a mobile unit].

The early diagnosis and treatment of osteoporosis is considered to be important for the prevention of fractures which often cause elderly to become bed-ridden. Computed X-ray densitometry (CXD), a method to measure bone mineral content in the metacarpus II utilizing a simple X-ray image, has been used for mass-screening of osteoporosis, because of its utility and reliability. However, due to its requiring adequate X-ray equipment, this method is often unsuitable for use in small facilities in a remote mountain areas. The use of CXD for osteoporosis screening, was attempted in a mobile unit for tuberculosis screening, by our public health center. The results showed that it is possible to use CXD in combination with a mobile unit, correcting the obtained values according to the radiographic conditions. With this set-up, CXD was used for mass-screening of osteoporosis in a total of 1150 subjects living in mountainous areas of Yoshino-gun, Nara prefecture, and CXD was found to be convenient and effective for mass-screening. The use of CXD in a mobile chest X-ray unit can be expected to be useful for mass-screening of osteoporosis especially in remote mountainous areas having inadequate X-ray equipment.

Absorptiometry, Photon↗
PubMed1994

Soluble P-selectin in the plasma of patients with connective tissue diseases.

We measured the soluble P-selectin (sP-selectin) in plasma of 54 patients with connective tissue diseases and 12 normal controls by a 2-step sandwich enzyme immunoassay. Our purpose was 2-fold: to determine (1) whether the level of sP-selectin of such patients is higher than normal, and (2), if it is, whether it correlates with any of the laboratory data currently available. The mean levels in patients with systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD) and rheumatoid arthritis (RA) were 306, 1,048 and 844 ng/ml, respectively, compared with 220 ng/ml for controls. The mean levels in patients with SLE and nephropathy, MCTD and either nephropathy or thrombosis, and malignant RA were 351, 1,116 and 1,721 ng/ml, respectively. No correlation was found between the levels of sP-selectin and other laboratory data (WBC, CRP, ESR, antinuclear antibody, RF, aCL) except the number of platelets (y = 0.057, r = 0.37). In the clinical course of patients with lupus nephritis and MCTD with nephropathy, sP-selectin became a sensitive parameter. Thus, the level of sP-selectin is higher than normal in patients with connective tissue diseases, especially when complications exist, and it does not correlate with any of the laboratory data currently available except the number of platelets. Measurement of sP-selectin levels should be included in the laboratory tests of patients with connective tissue diseases, especially when complicated by nephropathy or thrombosis.

Adolescent↗
PubMed1994

Retreatment of chronic hepatitis C with interferon.

OBJECTIVE: We analyzed the retreatment of chronic hepatitis C with interferon to get the standpoint for the selection of patients to receive it. METHODS: A complete response was defined as continuous normalization of the serum alanine aminotransferase (ALT) level and continuous disappearance of serum hepatitis C virus RNA (HCV-RNA) during interferon administration and more than 6 months after. Patients without complete response were classified as noncomplete responders. From August 1990 to May 1993, we retreated 23 noncomplete responders on initial treatment with interferon and studied the factors that alter the effectiveness. RESULTS: Complete response was achieved in eight (34.8%) patients; the other 15 patients did not achieve this degree of response. Three patients were of genotype II and five were of genotype III in these eight complete responders. All complete responders were patients with relapse who had had normalized serum ALT levels during the initial administration and undetectable HCV-RNA at the end of the period. No patient who failed to achieve normalization of the serum ALT level on initial treatment achieved a complete response on retreatment. HCV-RNA concentrations before retreatment were significantly less than before initial treatment in the eight complete responders. CONCLUSION: Interferon retreatment of patients who do not achieve a complete response may be effective in relapsed cases with undetectable HCV-RNA at the end of initial treatment. Selection of patients to receive interferon retreatment requires careful review and consideration of genotype, HCV-RNA concentration, and the clinical response on initial treatment.

Alanine Transaminase↗
PubMed1992

Treatment of small hepatocellular carcinoma.

Of the 692 patients with hepatocellular carcinoma (HCC) who were admitted to our hospital between 1976 and 1990, 60 (8.8%) had small HCC with a maximal diameter of below 2 cm. The outcome of these 60 cases was analyzed after they had been divided into 4 groups based on the therapeutic method used: operation group (17 cases), percutaneous ethanol injection therapy (PEIT) group (20 cases), transcatheter arterial embolization (TAE) group (13 cases), and oral anticancer drug therapy (per os) group (10 cases). The 1-, 2-, 3-, 4-, and 5-year survival values obtained for the operation group (100%, 87.5%, 87.5%, 87.5%, and 87.5%, respectively) were significantly higher than those found for the per os group (P < 0.01). The best therapeutic results were achieved in the operation group. Although the follow-up period for the PEIT group was short, the 2-year survival of this group was nearly equal to that of the operation group. Whereas the duration of survival tended to increase in inverse proportion to the severity of the underlying liver cirrhosis, the survival values did not differ between solitary and multiple tumors or among the different histological grades of HCC. In this series, 20 patients died; 9 deaths (45.0%) were due to progressive disease and 3 deaths (15.0%) were attributed to hepatic failure. Because the operation group included many patients who displayed relatively good liver function, we cannot rule out the possibility that their excellent outcome may have been associated with this background factor. Therefore, further prospective investigation is necessary to compare the efficacy of various therapies in patient groups with a homogeneous background.

Aged↗
PubMed1992

[Clinical decision analysis and ROC curve].

This workshop was planned to teach the importance of clinical decision analysis and the ROC curve in clinical medicine. A pre-workshop test and post-workshop test were given before and after the workshop. In the clinical decision analysis a heart disease case was shown, a decision tree was made, and the chance node and expected value were calculated. The ROC curve was prepared from the results of urine analysis of patients with renal and urinary tract infections, and the cut-off points were changed variously. There were 27 participants. Twelve of them took both the pre-workshop test and post-workshop test, and about half of them answered that they understood how to perform the analysis. There tended to be more participants who understood how to make the clinical decision analysis than the ROC curve.

Decision Support Techniques↗
PubMed1991

Network system: the integrated picture archiving and communication system with the hospital information system.

We describe the outline of Hokkaido University picture archiving and communication system (HU-PACS) and its network functions. HU-PACS processes 0.5 Gbytes of images daily through 10 acquisition devices. Functional integration of hospital information system (HIS) and PACS has been implemented. The HU-PACS can access common data base with HIS. Multi-image data-base systems provide fast throughput of image retrieval. The system is composed of 4 modules: (1) 2 image data-base systems (IDS), (2) 1 image management system (IMS), (3) image display terminals (IDT), and (4) 8 image acquisition nodes interfaced to 10 modalities and 1 film scanner. These 4 modules are connected by branch and loop type local area networks (LAN). HU-PACS has functions other than basic PACS functions. Images in optical disk library (ODL) are loaded onto magnetic disks (MD) in advance according to patient booking information, the images expected to be viewed are transferred to the local storage automatically, and the desired images can be pre-downloaded into local storage by instruction through HIS terminals.

Computer Communication Networks↗
PubMed1991

Acute mesenteric lymphadenitis due to Yersinia pseudotuberculosis lacking a virulence plasmid.

A serotype 4a strain of Yersinia pseudotuberculosis lacking the virulence plasmid pYV (pYV- strain) was isolated from the mesenteric lymph nodes but not from the stool or the appendix of a 10-year-old girl with a diagnosis of acute mesenteric lymphadenitis. Microscopically, reticulocytic abscess and lymphadenitis were persent in the enlarged mesenteric lymph nodes. Antibody against the isolate was detected in the serum. The isolate was negative for the presence of plasmid pYV and plasmid pYV-mediated properties, including autoagglutination and calcium dependency, but was positive for chromosome-mediated properties, including invasion into HeLa cells and tissues of mice and the Serény test. Mice were orally infected with this pYV- strain, and rapid elimination from the intestine occurred 14 days later. Hence, the potential to inhibit the phagocytosis encoded by plasmid pYV was lacking. As the pYV- strain was recovered from the mesenteric lymph nodes and the spleen, the invasiveness was encoded by chromosomal genes. The count of the pYV- strain in the mesenteric lymph nodes increased to 10(4.6) cells per g within 4 days. These findings suggest that pYV- Y. pseudotuberculosis was the causative agent of acute mesenteric lymphadenitis in the absence of gastroenteritis.

Animals↗
PubMed1991

Antiplatelet glycoprotein Ib monoclonal antibody (OP-F1) totally abolishes ristocetin-induced von Willebrand factor binding, but has minimal effect on the botrocetin-induced binding.

We describe here a new antiplatelet glycoprotein (GP) Ib monoclonal antibody (MoAb) designated OP-F1 (IgG1 kappa). Both OP-F1 and a well-characterized anti-GPIb MoAb, AP-1, totally abolished ristocetin-induced von Willebrand factor (vWF) binding to platelets and desialylated vWF binding to platelets at an IgG concentration of 2-8 micrograms/ml. AP-1 also blocked snake venom botrocetin-induced vWF binding at a similar IgG concentration, whereas OP-F1 had a minimal effect on botrocetin-induced binding. At a higher IgG concentration (150 micrograms/ml), OP-F1 inhibited botrocetin-induced binding by 50%. AP-1 (IgG) did not interfere with binding of [125I]OP-F1 (IgG) to platelets. Thus, the epitope involved in the binding of OP-F1 or AP-1 appears to be quite different. These results suggest that the vWF binding site(s) on the GPIb molecule generated by these inducers is in close proximity but not completely identical.

Antibodies, Monoclonal↗
PubMed1990

[Changes in ketone body ratio and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma after transcatheter arterial embolization].

The ketone body ratio (acetoacetate/3-hydroxybutyrate:KBR) and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma (HCC) were examined. KBRs and levels of pyruvate and lactate in patients with HCC were similar to those in patients without liver diseases (1.57 +/- 0.88, 0.84 +/- 0.32, 11.4 +/- 4.5 vs 1.80 +/- 0.9, 0.89 +/- 0.48, 10.8 +/- 6.2). However, pyruvate to lactate ratios were significantly lower in HCC patients (7.45 +/- 1.57 vs 8.62 +/- 2.15, p less than 0.05). Among the HCC patients the levels of pyruvate and lactate were significantly higher in patients with liver cirrhosis (LC) than those in patients without LC. The sequential changes of KBRs and levels of pyruvate and lactate were examined before and after transcatheter arterial embolization (TAE). Although KBRs were transiently decreased immediately after TAE, they were at higher levels from the 3rd to 21st day in comparison with those before TAE. The levels of pyruvate and lactate showed no significant changes immediately after TAE. However, they followed a course similar to that of KBRs after TAE. Lower KBRs and higher levels of pyruvate and lactate tended to be observed in HCC patients with LC after TAE than in those without LC. This suggests a decrease of intrahepatic blood flow probably due to histological reconstruction. These results suggest that the presence of LC is one of the most important factors influencing the functional reserve of liver in HCC patients. In HCC patients without LC, the recovery from the overload of TAE may operate at mitochondrial levels at least the 3rd day after TAE.

Carcinoma, Hepatocellular↗
PubMed1990

[A basal cell carcinoma of the esophagus--a case report].

Reported is the case of a 58-year-old male who visited our hospital with the chief complaint of anorexia. Diagnosed as having an esophageal cancer, a subtotal esophagectomy was performed including the dissection of the tumor. According to the surgical findings, the tumor was not exposed to the tunica externa and no lymph node metastasis or infiltration to the pleura or a metastasis to the lung or liver was note. On histopathological examination a basal cell carcinoma of esophagus was determined but no squamous epithelium was seen. The carcinoma was the muscular propria, and neither infiltration into the epithelium nor invasion into the vessels was noted. The postoperative progress appeared good, however seven months later the patient died from multiple hepatic metastasis.

Basal Cell Carcinoma↗
PubMed1990

[Ultramicroassay of red cell group using Terasaki-plate].

In order to simplify the testing-method of blood groups (ABO, Rh, MN, Ss, P, I, Lewis, Duffy, Kidd and Diego) and the assay of glycosyl transferases activity, we have developed a new method using Terasaki plate (T-plate method), and examined its usefulness in the routine examination. As results followings were obtained: 1) The sensitivity of T-plate method was equal or superior than that of the common method using test-tube. 2) Samples used for T-plate method were smaller in volume compared with those for the common tube test method. 3) The percent of coincidence between T-plate method and tube test method was 100% for ABO, Rh, MN, Ss, P, I, Duffy, Kidd and Diego grouping. They were 98% for Lewis(a) and 96% for Lewis(b) grouping, respectively. These results indicate the superiority of T-plate method than the common method using test-tubes in respects of smaller volume of samples, lower price and handling of a large amount of samples.

Blood Grouping and Crossmatching↗