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Biomedical subjects

M Takaya

Publications and source records attributed to M Takaya.

At least 55 records · Page 3Linked to original sources
PubMed1989

Anticardiolipin antibodies by an enzyme-linked immunosorbent assay: fundamental studies on the conditions for antigen-application and specificity of the assay.

We have established an enzyme-linked immunosorbent assay (ELISA) for anticardiolipin antibodies (aCL) using standard sera obtained from the Rayne Institute, St. Thomas' Hospital (London, U.K.). In this study, we compared several fundamental requirements for the assay with the standard assay as a reference, such as conditions for antigen application and test samples using our patients' samples. In addition, the specificity of our assay and cross-reactivities of aCL were also evaluated. In the standard assay, the concentration of antigen was optimal in the range of 30-100 micrograms/ml. The antigen-coating temperature was optimal at 4 degrees C for 16 hours. The method based on rapid evaporation of CL-ethanol solution can be used instead of the standard method. On the other hand, there was no significant difference in the results between physical conditions of the antigen (CL-ethanol solution vs. CL-micelles), between washing solutions (saline vs. PBS containing 0.05% Tween-20) and between test samples (sera vs. plasma). The aCL activity in our patients' samples was almost completely inhibited by pre-incubation of sera with either CL or phospholipid reagent for activated partial thromboplastin time (APTT). Interestingly, the aCL activity of the lupus anticoagulant was negative, but aCL-positive samples were also absorbed by the reagent for APTT. No inhibition of the aCL activity, however, was observed when patients' sera were preincubated with ss-DNA.

Autoantibodies↗
PubMed1988

Abnormalities of pulmonary blood flow during cold exposure in systemic lupus erythematosus.

The aim is to determine whether pulmonary blood flow is altered during cold exposure of the hands in individuals with systemic lupus erythematosus (SLE). Cold exposure was induced by immersion of the hands, one at a time, in 10 degrees C water in nine SLE patients in whom pulmonary fibrosis had been ruled out by a routine examination. Lung perfusion was measured by continuous venous infusion of krypton 81 m. Cold exposure to at least one of the hands caused an 8 to 22% decrease of pulmonary blood flow in five of the nine patients. A 10 to 33% increase in flow developed in three of the nine patients during cold exposure of the hands. We conclude that these abnormalities in pulmonary blood flow during cold exposure were revealed in SLE patients with scarcely any clinical symptoms.

Adult↗
PubMed1988

Clinical trial of ambroxol (Mucosolvan) in Sjögren's syndrome.

A clinical trial is described in which twelve patients with Sjögren's Syndrome (SS) were given a dose of 135 mg ambroxol (Mucosolvan) daily for eight weeks. Nine of the patients completed the trial. Three patients dropped out because they developed side effects (generalized rashes in two patients and stomatitis in one). The side effects, however, were mild and cleared off after cessation of treatment. Ambroxol improved sicca symptoms, especially ocular symptoms, in the SS patients, although lacrimal and salivary gland functions measured by Schirmer test or gum test were not changed. Furthermore, the treatment did not alter any chemical findings determined in the stimulated tear and saliva. Our results suggest that ambroxol is useful for the management of sicca symptoms in some patients with SS.

Adult↗
PubMed1988

[Experimental study of the usefulness of evoked potentials in predicting the reversibility of the brainstem function following infratentorial epidural balloon compression].

With few warnings signs, posterior fossa mass lesions can affect life-supporting brainstem systems directly and cause a precipitous failure of vital functions. Consequently, a technique, by which brainstem dysfunction could be detected at its reversible stage, would have clinical value. Recently manly reports have suggested that the evoked potentials might be advantageous in assessing a developing brainstem dysfunction and might be a more sensitive or reliable detector of deteriorating neurological function than the physical or neurological signs. To explore this possibility, we recorded somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) serially during inflation and deflation of balloons placed in the suboccipital epidural space of cats, as a model of an acutely expanding posterior fossa lesion. The results were correlated simultaneously recorded cardiovascular and pupillary function and with supratentorial and infratentorial epidural pressure. In this study, N1 of cortical SEP (CSEP), wave IV of BAEP, and wave III of short latency SEP (SSEP) were found to be useful parameters in predicting the electrophysiological reversibility. Experimental results were as follows: 1) As the infratentorial epidural balloon was expanded, CSEP, wave IV of BAEP and wave III of SSEP showed remarkable changes both in latency and in amplitude. Decrease in blood pressure and pulse rate preceded or developed at the same time as the apparent change in CSEP. Futher expansion of the balloon resulted in Cushing phenomenon and lability of blood pressure.2) As long as wave IV of BAEP remained, and decompression was started within 15 minutes after N1 of CSEP were completely suppressed, changes in SEP. BAEP and cardiovascular function were all reversible.2+ decompression. (ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Prospective studies on the progress of sicca symptoms in Sjögren's syndrome: subclinical disease develops into the clinical syndrome.

We evaluated prospectively twenty-two subjective sicca features in seventeen patients with Sjögren's syndrome (SS) including six patients with primary SS twice at a six-year interval. In the second evaluation in 1986, the frequency of sicca symptoms was increased for most items, and the mean number of positive symptoms was also increased in the patients compared with the results in 1980. In the first evaluation, three patients lacked any sicca symptoms, and were considered as subclinical SS. Sicca symptoms developed in all three of these patients later. A positive correlation between the number of sicca symptoms and the patients' age was also reconfirmed by the present study. Changes in sicca symptoms between the two evaluations were not correlated with objective findings of exocrine gland involvement determined at the time of diagnosis of SS. The lacrimal or salivary secretion and sialographic findings determined serially were relatively stable during whole observation period, except in some patients. The results indicate that both the symptoms and objective findings of glandular involvement progress very slowly in SS, although patients with subclinical disease eventually develop clinical SS.

Adult↗
PubMed1987

[Experimental study of evoked potentials in predicting the reversibility of brain function following tentorial herniation].

Brainstem auditory evoked potentials (BAEP), somatosensory evoked potentials (SEP) and EEG were recorded sequentially in cat with mass-induced intracranial hypertension in correlation with mass volume, intracranial pressure (ICP), systemic blood pressure (BP) and size of the pupils. 1) As the intracranial pressure was raised by expansion of a supratentorial epidural balloon, suppression of cortical SEP (CSEP) and pupillary abnormality appeared first, EEG, waves IV and III of BAEP and wave III of short latency SEP (SSEP) were suppressed in this order. 2) As far as wave IV of BAEP remained and decompression was started within 30 minutes after peaks of CSEP completely suppressed, changes in P1 and N1 of CSEP were reversible. 3) Further raising of ICP was followed by loss of waves IV and III of BAEP and wave III of SSEP in this order. Simultaneously with loss of wave III in SSEP, systemic blood pressure dropped rapidly. By immediate balloon deflation after disappearance of wave III of SSEP, animals recovered from hypotension, but hardly from suppression in EEG, CSEP and BAEP. 4) Preservation of wave IV of BAEP indicated good improvement of pupillary abnormality even after removal of compression. These results suggest that for the patient with disturbed consciousness caused by supratentorial mass lesion, decompressive procedure should be started before wave V of BAEP and brainstem components of SEP disappear. EP monitor seems to be useful clinical method for preventing irreversible change of the brain in patients with coma caused by supratentorial mass lesions.

Animals↗
PubMed1986

Association between HLA and Sjögren's syndrome in Japanese patients.

Japanese patients with primary Sjögren's syndrome (SS), patients with SS and rheumatoid arthritis (SS-RA), and patients with SS and connective tissue disease without RA (nonrheumatoid connective tissue disease [SS-CTD]) were typed for HLA antigens. Patients with primary SS and those with SS-RA had higher frequencies of DRw53 than did those who had SS-CTD; however, the group with SS-CTD showed a negative correlation with DRw52. These data indicate that Japanese and white patients with SS have different HLA specificities, and that genetic factors involved in the development of SS-CTD might be different from those in primary SS and SS-RA.

Arthritis, Rheumatoid↗
PubMed1986

[Technical problems in intraoperative monitoring of sensory evoked potentials].

Recent advances in both the equipment and the recording technique of sensory evoked potentials (EP) have brought high levels of versatility and reliability of objective measurement to the assessment of nervous system function. They have also allowed the use of intraoperative evoked potentials. The operating room, however, is usually considered a hostile environment, where various kinds of artifacts from surgical manipulation and generated by electrical armamentaria disturb electrophysiological recordings. Although several authors have reported on intraoperative EP monitoring, they have described few of the practical details of recording techniques. Having developed an intraoperative recording technique for evoked potentials over the past 3 years, we present the technical measures taken to overcome interference and obtain sufficiently stable and reliable EP recordings for intraoperative monitoring. All electrical equipment used in the operating rooms must, of course, be grounded securely. Even after grounding in the usual manner, however, artifacts appeared intermittently. The source was found to be a Mayfield-Kees three-pin head rest and a self-retaining retractor, both of which seemed to pick up electromagnetic radiation originating from electrocauteries and others. These artifacts could be minimized by grounding the head pins all each point of insertion into the patient's head and by use of a silicon-coated spatula rather than a metal one. In addition automatic artifact rejection by voltage overload sensing seems to be indispensable to eliminate the effect of extraneous mechanical and electrical interference which occur inevitably in surgical procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1986

[Technical details for recording trigeminal evoked potentials in the cat].

Experiments were undertaken to establish technical standards for recording of trigeminal evoked potentials (TEP) as a tool for assessment of the effectiveness of various therapeutic procedures for trigeminal neuralgia. Serial changes in the action potentials of the maxillary nerve and TEP were studied when parameters of electrical stimulation, namely, intensity and frequency, and position of electrodes were altered. The effects of use of muscle relaxants and change of body temperature of animals on TEP were also studied. On the basis of these experimental results, the technical details most suitable for TEP recording in cat were explored. The most distinct TEP was recorded under the following animal conditions and parameters: keeping rectal temperature between 37.5 degrees C and 38.5 degrees C, slackening with muscle relaxants, stimulating the infraorbital nerve with 10 volts of square-pulse electricity 5 times per second in short latency TEP and 2 times per second in long latency TEP, placing the active electrode on the vertex for short latency TEP and on the primary sensory area for long latency TEP. Eight positive peaks and three negative peaks were recorded under these conditions. The average and standard deviations of peak latency of potential from 10 cats were as follows: P 1, 0.67 +/- 0.04 msec; N 1, 0.89 +/- 0.07 msec; P 2, 1.35 +/- 0.10 msec; P 3, 1.89 +/- 0.08 msec; P 4, 2.43 +/- 0.26 msec; P 5, 3.17 +/- 0.15 msec; P 6, 3.36 +/- 0.21 msec; P 7, 5.02 +/- 0.39 msec; P 8, 6.07 +/- 0.35 msec; N 2, 10.4 +/- 1.15 msec; N 3, 18.5 +/- 1.74 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Effects of thiopental on sensory evoked potentials in the cat].

Noninvasive electrophysiological evaluation with sensory evoked potentials would be of clear diagnostic and prognostic value in evaluating comatose patients with stroke or severe head injury. In order to protect the brain from such kinds of insults, barbiturate coma therapy has been employed and its effectiveness has been already established. However, in the barbiturate coma therapy, it is occasionally difficult to distinguish the pharmacological effect of barbiturate from the preexisting brain dysfunction caused by the underlying process of the disease. In adult cats, authors studied changes of sensory evoked potentials following cumulative intravenous administration of thiopental which is used clinically for barbiturate coma therapy. P1 and N1 of cortical SEP showed tendency of gradual decrease in amplitude. However, no significant changes occurred in latency by stepwise increment of thiopental dose. Changes in amplitude of P1 and N1 of cortical SEP preceded to the flattening on electroencephalogram. Around at the level of the concentration where EEG changes began, I-II interpeak latency of BAEP and latency of wave I of short latency SEP started to increase. BAEP and early components of SEP (I.II.III.IV) persisted even in by far the higher level of serum concentration of thiopental than that of clinical use. Furthermore, most of these parameters showed no statistically significant change neither in amplitude nor in latency. These experimental results suggest that sensory evoked potentials will provide us with useful information in the assessment of the brainstem function in patients under thiopental induced deep coma.

Animals↗
PubMed1986

[Implantable continuous epidural morphine infusion system for relief of chronic cancer pain].

Chronic cancer pain remains intractable by standard treatment in many patients and interferes with their mobility and independence. Epidural morphine infusion therapy is adopted for providing adequate analgesia in patients who are generally morphine independent and have intractable pain. A totally implantable pump system, Infusaid, has allowed continuous epidural morphine infusion without wound care or frequent percutaneous injections and with a potentially lowered risk of adverse reactions including respiratory suppression. Since December 1984, the authors have used this totally implantable drug delivery system for continuous epidural morphine infusion in two patients who had been suffering from chronic pain caused by pelvic cancer associated with metastatic and/or invasive lesions: Case 1: a 61-year-old man with rectum cancer; and Case 2: a 44-year-old man with colon cancer. Before system implantation, a therapeutic response to epidural morphine was confirmed by a one-shot test injection. Pain relief was evaluated by use of Visual Pain Analogue Scale Scores (VPASS). In spite of the presence of an artificial anus on the left abdomen in both patients and of pus discharge from a sacral infectious fistula on admission in Case 2, no infectious complication occurred in either case. Urinary retention developed after the implantation in Case 2, but this improved following the reduction of morphine concentration. No other adverse reaction was observed. In Case 1, the system was effective for 6 months until his death from advancing malignancy, and the patient was able to return to work three months after discharge.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Experimental study on the origins of far-field SEP to median nerve stimulation in the cat].

Results of various experimental and clinical studies on the origins of somatosensory evoked potentials (SEP) suggested that the far-field and early near-field potentials are generated primarily from sources within the dorsal column-medial lemniscal system. However, there are a few studies where direct depth recordings of SEP were performed and they were compared with surface-recorded SEP components. The purpose of this investigation is to determine the origins of somatosensory far-field and early near-field evoked potentials in cat by the analysis of distribution mode of surface-recorded SEPs, the comparison of depth recorded with surface-recorded SEPs and by the study of SEP changes caused by serial destruction of the structures relating to sensory pathway. A complex patterns of evoked potentials were recorded from cerebral epidural surface in cat by forelimb median nerve stimulation. The largest positive to negative slope was recorded from the epidural electrode on the sensory cortex contralateral to the stimulation. Five small positive potentials could be identified on the positive slope. We labeled these potentials as I, II, IIIA, IIIB, IV according to the report by Iragui-Madoz. The largest positive potential recorded from the VPL was coincident with the surface-recorded IIIB in latency at different interstimulus intervals. After transection of the midbrain-pons junction, IIIA remained unchanged, and the following waves disappeared. However, IIIA decreased in latency and markedly decreased in amplitude after transection of the pons at its rostral level. IIIA seems to be generated from the medial lemniscus at the level of osseous cerebellar tentorium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗