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K Takasugi

Publications and source records attributed to K Takasugi.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Sleep apnea syndrome in rheumatoid arthritis (RA) patients complicated with cervical and temporomandibular lesions].

All-night polysomnographic studies were performed on ten patients (all female) with rheumatoid arthritis complicated with temporomandibular joint destruction and cervical lesions. The mean age of these subjects was 67.5 yrs, ranging from 48-81 yr. They all had some morphologic abnormalities of cervical spines and/or temporomandibular joints. Sleep study revealed that all of them had sleep apnea; five of them were of obstructive type (obstructive group) while the remaining showed central type of sleep apnea (central group) predominantly. There were no statistically significant differences of the levels of apnea index, mean-nadir SO2 and the lowest SO2 between the obstructive group and the central group. No detectable differences of cephalographic measurements and MRI findings existed between the two groups either. In one patient, nasal-CPAP converted central apnea to normal breathing dramatically. Our observations indicate that the cause of central apnea in RA patients with temporomandibular lesions is collapse of upper airway, inducing inhibitory inputs from the mechanoreceptors in that region.

Aged↗
PubMed1994

[Amyloidosis in rheumatoid arthritis--clinical study of 124 histologically proven cases].

The diagnosis of secondary amyloidosis due to rheumatoid arthritis (RA) was confirmed by positive tissue staining using Congo-red and antiserum to amyloid A protein. Biopsied specimens were obtained mainly from gastro-intestinal tracts; small salivary glands of the lips as well as abdominal adipose tissues were also studied in a small number. The results were as follows: 1. Gastro-intestinal fiberscopies and biopsies were performed on 789 RA patients for the purpose of routine screening and follow-up for amyloidosis. Seventy-seven cases (10.5%) turned out positive for amyloid. Among the biopsied specimens taken from three different sites, the proportion of amyloid-positivity was 68.9% for gastric antrum, 76.5% for duodenal cap and 88.6% for the second portion of the duodenum, suggesting the higher sensitivity and efficacy of duodenal biopsy in studying secondary amyloidosis in RA. 2. 124 patients of RA complicated with secondary amyloidosis were studied clinically with special reference to its clinical characteristics and prognosis. (1) The mean duration of RA at diagnosis of amyloidosis was 15.4 years and all patients but two were in stage III or IV (Steinbrocker). (2) Gastro-intestinal symptoms were present in 58.1% of the cases, abnormal renal signs in 58.9%, cardiac symptoms in 39.5%, respectively. All of these findings had a significant association with poorer prognosis in secondary amyloidosis due to RA. (3) The 4-year survival rate of all the cases was 57.8%, while the 3-year survival rate for the group without symptoms and signs about amyloidosis was 100%. (4) The causes of death in 36 cases were renal failure (14 cases), infection (13 cases), cerebral bleeding (2 cases), myocardial infarction (1 case), pulmonary infarction (1 case), suicide (1 case) and unknown (4 cases). Patients with intractable diarrhea were mostly susceptible to the ensuing fatal bacterial infection.

Adult↗
PubMed1993

[Two cases of acute progressive interstitial pneumonia associated with dermatomyositis--clinical features and immunological disorders].

Some patients of dermatomyositis (DM) with interstitial pneumonia (IP) have common clinical features. Clinical features of these patients are acute onset, very poor prognosis and that patients have fever, arthritis, typical skin rash, mild myositis and show low ratio of CPK/LDH, low incidence of antinuclear antibody (ANA) appearance, low inflammatory signs. We experienced two cases of this category of DM with IP and examined immunological aspects. Case 1. A 52-year-old woman was admitted in June 1, 1990 with a one-month history of arthralgia and a ten-days history of fever, skin rash, myalgia and dyspnea on exertion. On examination she had Gottron's papules on her fingers, erythema on back, bilateral elbows and legs, proximal muscle weakness and arthritis. Fine crackles were audible in the lower lung fields. Laboratory data included CPK 200 IU/l, ALD 3.2 IU/l, LDH 805 IU/l. Analysis of bronchoalveolar lavage fluid (BALF) revealed increased cellularity with lymphocytosis. She was treated with oral corticosteroid (CS), pulse CS, cyclosporin A. Inspite of these therapies, she died of progressive respiratory insufficiency in July 10, 1990. Case 2. A 23-year-old woman was admitted in April 1, 1991, with a two-month history of arthralgia and a one-month history of fever, skin rash, stomatitis, alopecia. On examination she had Gottron's papules on her fingers, erythema on malar, bilateral elbows and legs, arthritis and stomatitis. Laboratory data included CPK 97 IU/l, ALD 8.5 IU/l, LDH 779 IU/l. She began experiencing dry cough and dyspnea on exertion in May 1991. Analysis of BALF revealed increased cellularity with lymphocytosis. She was treated with oral corticosteroid(CS), pulse CS, pulse cyclophosphamide.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1993

[Bronchoalveolar lavage fluid analysis in rheumatoid arthritis].

In order to clarify the pulmonary involvement in rheumatoid arthritis (RA), bronchoalveolar lavage (BAL) was performed in 52 RA patients, in conjunction with pulmonary function test (PFT) and high-resolution CT (HRCT) of the chest. The results were as follows: 1. Out of nine RA patients with no evidence of lung involvement on HRCT, six (66.7%) showed abnormal differentials of the cells obtained through BAL. 2. RA patients with advanced interstitial lung disease on HRCT had significantly higher BAL fluid (BALF) cellular concentrations, increased percentage of BALF neutrophils and decreased BALF CD 4/CD 8 ratio, as compared with those with no or mild lung involvement. 3. In the non-smoking RA patients who also demonstrated no obstructive patterns on PFT, positive correlations were observed between %VC and the BALF CD4/CD 8 ratio (R = 0.481) as well as the BALF CD4+Leu8- (helper T) cell ratio (R = 0.497). On the other hand, a negative correlation was detected between %VC and the BALF CD8+CD11b- (cytotoxic T) cell ratio (R = -0.533). 4. In those with the increased percentage of BALF eosinophils and/or with increased BALF CD4/CD8 ratio, V25/Ht was depressed significantly, as compared with other patients. Likewise, those with severely depressed value of V25/Ht tended to have significantly elevated BALF CD4/CD8 ratio, as compared with other patients with normal V25/Ht value. Thus, through these detailed studies of BAL cellular differentials and BALF lymphocyte subsets, the diversity of pulmonary involvement was well demonstrated in RA.

Aged↗
PubMed1993

[Clinical study of rheumatoid interstitial lung disease evaluated by high resolution CT].

High resolution computed tomographic (HRCT) scans were obtained in 215 patients with rheumatoid arthritis to assess pulmonary fibrosis (PF). We classified the HRCT appearances as five-point scale (0-4) based on the degrees of PF. The results were as follows: 1. We found 117 cases (54.4%) of PF on HRCT. 2. Patients with PF (grade 1-4) showed significantly increased leucocyte cell counts and significantly worsened pulmonary function test than patients without PF (grade 0). 3. Patients with advanced articular involvement had significantly higher prevalence of PF than others without them. 4. Patients who were previously or currently receiving gold sodium thiomalate (GST) injection or administration of methotrexate had higher prevalence of PF than others. However, patients who were receiving long term GST therapy (1 year long or sigma 1000 mg) had slightly lower prevalence of PF than others. This finding suggests that dose-dependent lung injury is not related to GST therapy. 5. Patients with advanced PF (grade 3, 4) had high prevalence of male sex, smoker, extraarticular manifestation.

Adolescent↗
PubMed1992

[Cricoarytenoid joint involvement in rheumatoid arthritis].

The cricoarytenoid (CA) joint, which controls the vocal cords, is diarthrodial; it is composed of two cartilages with a ligamentous capsule lined by synovial membrane. It has been known that inflammation of CA joint occurs sometimes in patients with rheumatoid arthritis (RA). Yet, so far, no detailed full-report on this subject has ever been made in this country. Here we report four RA cases with CA joint ankylosis or abduction disturbance due to progression of CA arthritis. Episodes of inspiratory dyspnea were observed in all cases and tracheostomy was performed in case 1 and case 2. Further surgical intervention i.e., tracheoplasty was necessary in case 2. Case 3 and case 4 have been followed conservatively thus far. Clinical surgical interventions were necessitated mainly with joint replacement, 3) there exists severe destruction of cervical spines as well as temporomandibular joints. Rheumatologist must be fully aware of how urgent this clinical entity is and not miss-diagnose+ these patients.

Arthritis, Rheumatoid↗
PubMed1991

[A case of rheumatoid arthritis complicated with auranofin-induced acute interstitial pneumonitis].

A case of auranofin(AF)-induced acute interstitial pneumonitis in a patient with rheumatoid arthritis (RA) is reported and possible mechanism of the incidence is discussed. A 57 year-old woman with a history of RA starting in early April 1989, had been prescribed AF for seven days prior to her referral to this hospital. Because of the severity of her polyarthritis, AF was discontinued; therapy with gold sodium thiomalate (GST) instead was started on 23 June 1989. The patient responded quite favorably. At a total cumulative dose of 160mg of GST, however, she developed generalized exfoliative dermatitis and the drug was discontinued. On 29 Sept. 1989 when her skin lesions cleared up completely, she was put on AF again. Six days after resumption of AF therapy, she developed fever. Nonproductive cough and dyspnea on exertion was observed within the following three days. The chest X-ray film revealed diffuse reticular-linear infiltrates more prominently in both upper lobes. Arterial blood gas studies showed hypoxemia and a restrictive ventilatory defect was demonstrated by pulmonary function studies. AF was stopped. High dose pulse iv corticosteroid(CS) therapy combined with oral CS was instituted. Immediate improvement of both subjective and objective findings was observed. By using the patient's peripheral blood lymphocytes, delayed lymphocyte stimulation test(DLST) against the probable causative agents was performed before the bolus CS therapy. Stimulation Index(shown in percentage) was markedly elevated in AF(724%) as compared with GST(163%). The fiberoptic bronchoscopy with bronchoalveolar lavage(BAL) was performed. Analysis of BAL fluid revealed increased cellularity (9 x 10(5)/ml) with marked lymphocytosis of 79%.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Rheumatoid↗
PubMed1990

"Alternative self-diploidization" or "ASD" homothallism in Saccharomyces cerevisiae: isolation of a mutant, nuclear-cytoplasmic interaction and endomitotic diploidization.

A mutant of Saccharomyces cerevisiae representing a novel life cycle, named "alternative self-diploidization" or "ASD" homothallism, was obtained fortuitously. In this life cycle, MAT alpha (or MATa) haplophase and MAT alpha/MAT alpha (or MATa/MATa) diplophase alternate. Germinated cells are haploid and mating. They soon become nonmating and sporogenous as they vegetatively grow. They sooner or later diploidize presumably via endomitosis. The diploid cells haploidize via normal meiosis. A single recessive nuclear mutation, named asd 1-1, is responsible for "ASD" homothallism. In the rho 0 cytoplasm, asd 1-1 cells mate even if at a low efficiency and fail to diploidize. Since pet mutations do not have such effects, we conclude that a certain mitochondrial function other than respiration is required for manifestation of "ASD" homothallism. That is, "ASD" homothallism is the result of some sort of nuclear-cytoplasmic interaction.

Cell Nucleus↗
PubMed1990

[Two cases of rheumatoid arthritis complicated with vasculitis-induced ischemic enterocolitis].

Episodes of catastrophic entero-colitis associated with mesenteric vascular insufficiency in patients with rheumatoid arthritis(RA) have rarely been recorded thus far. We herein report two cases of RA complicated with severe attacks of entero-colitis presumably due to mesenteric vasculitis. Surgical intervention was necessary in the first case, while the second patient recovered well only through conservative therapy. Case 1: A 74-year-old man with history of RA since 1985 started to complain of abdominal discomfort and nausea early in February, 1989. On February 12, Episodes of tarry stool developed. Rapid down-hill clinical course prompted laparotomy under the clinical diagnosis of peritonitis. Ischemic changes were observed at the ileum end, the entire length of which was 120 cm orally from the cecum. The site was resected. Multiple linear and aphthoid ulcer lesions were discovered throughout the entire lumen. Histopathologically, evidence of necrotizing vasculitis such as fibrinoid necrosis and mural thrombi was demonstrated in small arteries of the submucosal layer underlying the ulcer lesion. Case 2: A 63-year-old woman who had been suffering from RA since 1980 noticed the onset of nausea, abdominal pain and bloody diarrhea in July, 1989. Colonoscopy examination revealed multiple linear and aphthoid ulcers in the sigmoid colon which was presumed to be due to ischemia. Laboratory evaluation at that time demonstrated hypocomplementemia, positive circulating immune complex and high titer of anti-DNA antibody. Corticosteroid therapy with moderate dose was successful in alleviation of all the abnormal findings and the patient fully recovered three months after her initial GI episode.

Aged↗
PubMed1986

[Lyme disease].

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Erythromycin↗
PubMed1985

A simple method for efficiently establishing 8-azaguanine-resistant mutant human leukemia and myeloma cell lines.

A simple and convenient method for efficiently establishing 8-azaguanine-resistant mutant leukemia and myeloma cell lines (for example, the T cell lines Jurkat and CCRF-CEM, human myeloid/macrophage-like cell lines HL60 and U937, Burkitt lymphoma line Raji and the human myeloma line RPMI 8226), is described. The method relies on culturing the cell lines in RPMI 1640 medium containing 8-azaguanine and supplemented with 15% heat-inactivated fetal calf serum and large amounts of amino acids and vitamins, and removes the necessity for pretreatment with mutagenic reagents such as ethyl methylsulfonate or X-irradiation. The possibility of obtaining mutant cell lines using the method described here is about 15 times greater than using media without high levels of amino acids and vitamins. Hybridomas produced between mitogen-activated human peripheral blood lymphocytes and an 8-azaguanine-resistant Jurkat mutant cell line (established by this method) were shown to produce soluble T cell-derived macrophage activating factor (MAF)-like material.

Antigens, Surface↗
PubMed1980

[Surgical treatment of congenital muscular torticollis--long term follow-up study of total resection procedure (Mikulicz) and histological examination of resected sternomastoid muscles (author's transl].

Total resection procedure (Mikulicz) was performed in 27 patients under 10 years of age with typical congenital muscular torticollis. Postoperative clinical assessment was carried out in 20 of these 27 patients. Resected sternomastoid muscles were studied histologically in 14 other patients. The operative procedures and histological findings were compared in a discussion of the relative values of conservative and operative treatment. Neck contracture due to torticollis improved immediately after operation and no recidivations followed. Skeletal deformity of the face and spinal column completely subsided within two or three years after the operation. Plagiocephaly remained and seemed not to be directly related to the torticollis. There were no patients with scar formation such as disfiguration or keratosis. Subcutaneous adhesion probably of the platysma with the deeper layer was palpable in three patients, but did not affect the clinical course. Accessory nerve injury during operation occurred in one patients, causing slight weakness of the trapezius muscle. On the other hand, disappearance of the sternomastoid muscle relief was cosmetically acceptable subjectively and objectively. The resected sternomastoid muscle in 14 patients with typical congenital muscular torticollis were studied histologically in specimens sectioned longitudinally. Hematoxylin-eosin, Masson's and van Gieson's stains were used and the distribution of the fibrosis throughout the muscles was examined. Fibrous changes were detected in almost the whole length and breadth. The changes were similar in all operated patients, although the ages were different. The findings by naked eye examination were usually less than those by histological examination. This follow-up study confirmed that total resection procedure gives good clinical results of congenital muscular torticollis. Histological studies suggested the need for removal of the fibrous changes involving the whole muscular tissue, as such changes can lead to recidivations.

Child↗