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Biomedical subjects

R Takagi

Publications and source records attributed to R Takagi.

At least 37 records · Page 2Linked to original sources

[5-FU concentration in the serum and the tumor tissue after administration of UFT 200 mg/day to patients over 80 years of age with oral cancer].

UFT was administered orally at a dosage of 200 mg/day, 2 times a day, to patients over 80 years of age with oral cancer. The concentration of 5-FU in the serum and tumor tissue, as well as the side effects, were investigated. The results were as follows: 1. The concentration of 5-FU in the serum peaked (0.017 to 0.066 microgram/ml) 1 or 2 hours after UFT administration. The concentration 8 hours after administration was relatively high (0.016 to 0.041 microgram/ml). 2. The 5-FU concentrations in the tumor tissues in 3 out of 5 cases were greater than 0.05 microgram/g, which is considered to be the effective level. The concentration tended to be higher with increased duration of administration. 3. A minor side effect, bone marrow dysfunction, was observed. No effect on the function of the liver or digestive system was observed.

Aged↗

Role of leptin in women with eating disorders.

OBJECTIVE: This study investigated the role of leptin on eating behavior and reproductive function in eating disorders. METHOD: The subjects included 80 eating-disordered women, having different fat mass, eating behavior, and endocrine abnormalities, and 26 control women. Plasma leptin, insulin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), cortisol, insulin growth factor-1 (IGF-1), free T4 levels, percent body fat, eating behavior score, and menstrual status score were evaluated for each subject. RESULTS: In eating-disordered patients, log of leptin levels were significantly correlated with body fat mass, eating behavior score, menstrual status score, and insulin, LH, and FSH levels. Stepwise regression analysis showed that fat mass and eating behavior score were significant determinants of leptin levels. Furthermore, in patients undergoing recovery, leptin levels were determined by fat mass and/or eating behavior. DISCUSSION: These results suggest that leptin may play some role in counteracting the abnormal eating behavior, reproductive function, and fat mass in these disorders.

Adipose Tissue↗

Immunocytochemical demonstration of laminin in the synovial lining layer of the rat temporomandibular joint.

This immunocytochemical study describes the distribution of laminin in the synovial lining of the rat temporomandibular joint. Laminin immunostaining was present around some synovial lining cells and blood vessels. Ultrastructurally, immunoreactive products for laminin were deposited around cells with a well-developed rough endoplasmic reticulum and secretory granules, suggesting that they were type B synovial lining cells. The localization of laminin immunoreactivity was not uniform around the cell membrane, the most intense immunoreaction being present on the basal aspect membrane as is seen in the basement membrane of epithelia. In contrast, macrophage-like synovial lining type A cells did not show laminin immunoreactivity. This different immunostaining pattern suggests that laminin acts as an adhesion molecule for the type B cells in their epithelial-like arrangement.

Animals↗

Leptin in women with eating disorders.

The aim of the present study was to determine the factors controlling leptin secretion and to clarify the role of leptin in eating disorders. The subjects were 152 eating-disordered women with different fat mass, eating behavior, and endocrine abnormalities and 24 age-matched control subjects. The body fat mass, eating behavior score, and plasma leptin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), triiodothyronine (T3), free thyroxine (T4), insulin, and cortisol levels were evaluated for each subject. In patients with eating disorder, logarithmic values for leptin were significantly correlated with the body fat mass (r = .828, P < .001), eating behavior score (r = .777, P < .001), and LH (r = .465, P < .001), FSH (r = .440, P < .001), T3 (r = .572, P < .001), insulin (r = .410, P < .001), and cortisol (r = -.389, P < .001) levels. After adjusting for fat mass, the partial correlations of log leptin with LH, FSH, insulin, and cortisol were not statistically significant, but log leptin remained correlated with T3 (r = .390, P < .01). Stepwise regression analysis showed that the body fat mass and eating behavior score were significant determinants of leptin levels. These results suggest that eating behavior, as well as the body fat mass, is the control factor for leptin secretion in eating disorders.

Adipose Tissue↗

Plasma concentrations of tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors in patients with anorexia nervosa.

Tumor necrosis factor-alpha (TNF-alpha) is a cytokine with numerous immunological and metabolic activities. To study the role of TNF-alpha on the pathophysiology of anorexia nervosa and its complications, plasma concentrations of TNF-alpha, 2 soluble TNF receptors (sTNF-RI and sTNF-RII), and leptin were measured in 20 female patients with anorexia nervosa (AN) and 20 age-matched normal women (N). Plasma TNF-alpha concentrations in AN were significantly higher than those in N (4.1 +/- 0.6 pg/mL vs. 1.6 +/- 0.1 pg/mL; P < 0.01). Although no significant difference was observed in plasma sTNF-RI concentrations between the two groups, plasma sTNF-RII concentrations in AN were significantly higher than those in N (2094.0 +/- 138.5 pg/mL vs. 1569.5 +/- 84.0 pg/mL; P < 0.01). Plasma concentrations of TNF-alpha and sTNF-RII after treatment of 8 anorectic patients were not different from those before treatment, although body fat mass and plasma leptin concentrations significantly increased after treatment. Plasma TNF-alpha concentrations were not related to body fat mass in anorectic patients. These results suggest that the adipose tissue may not be the immediate source of TNF-alpha in anorectic patients and that TNF-alpha may contribute to the pathophysiology of immunological and metabolic abnormalities in anorexia nervosa.

Adult↗

Immunocytochemical demonstration of heat shock protein 25 in the rat temporomandibular joint.

The expression of heat shock protein 25 (Hsp 25) was investigated in the rat temporomandibular joint by immunocytochemistry combined with confocal and electron microscopy. Immunostaining with an antibody to Hsp25 was able to demonstrate various cellular elements in the synovial membrane of the joint. Intense immunoreaction for Hsp25 was recognized in certain cells comprising the synovial lining layer. Confocal microscopic observation revealed two characteristic profiles of the Hsp25-positive cells with cytoplasmic processes: one extended thick and long processes towards the articular cavity, and the other prejected horizontally slender processes which covered the synovial membrane. Under the electron microscope, the immunoreactive synovial lining cells were characterized by a well-developed rough endoplasmic reticulum and secretory granules, suggesting that they can be categorized as fibroblastic type B cells. The covering by the cytoplasmic extensions was confirmed by immuno-electron microscopic observations. This cytoplasmic covering presumably performs a barrier function and expedites the effective secretion/resorption of synovial fluids. Since it has been proposed that Hsp 25 is associated with an estrogen receptor, the immunopositive synovial lining cells were considered estrogen-target cells. Immunoreactivity for Hsp25 was also observed in the chondrocytes of the maturative and hypertrophic cell layers as well as in the cells of the articular disk. A suggestion was made that Hsp25 might be involved in the inhibition of apoptosis of those cells.

Animals↗

Three-dimensional computerized tomography angiography in patients with hyperacute intracerebral hemorrhage.

OBJECT: The authors confirm the usefulness of extravasation detected on three-dimensional computerized tomography (3D-CT) angiography in the diagnosis of continued hemorrhage and establishment of its cause in patients with acute intracerebral hemorrhage (ICH). METHODS: Thirty-one patients with acute ICH in whom noncontrast and 3D-CT angiography had been performed within 12 hours of the onset of hemorrhage and in whom conventional cerebral angiographic studies were obtained during the chronic stage were prospectively studied. Noncontrast CT scanning was repeated within 24 hours of the onset of ICH to evaluate hematoma enlargement. Findings indicating extravasation on 3D-CT angiography, including any abnormal area of high density on helical CT scanning, were observed in five patients; three of these demonstrated hematoma enlargement on follow-up CT studies. Thus, specificity was 60% (three correct predictions among five positives) and sensitivity was 100% (19 correct predictions among 19 negatives). Evidence of extravasation on 3D-CT angiography indicates that there is persistent hemorrhage and correlates with enlargement of the hematoma. Regarding the cause of hemorrhage, five cerebral aneurysms were visualized in four patients, and two diagnoses of moyamoya disease and one of unilateral moyamoya phenomenon were made with the aid of 3D-CT angiography. Emergency surgery was performed without conventional angiography in one patient who had an aneurysm, and it was clipped successfully. CONCLUSIONS: Overall, 3D-CT angiography was found to be valuable in the diagnosis of the cause of hemorrhage and in the detection of persistent hemorrhage in patients with acute ICH.

Acute Disease↗

Three-dimensional CT angiographic assessment of vascular diseases using various postprocessing techniques: the voxel transmission and cruising eye view methods and their respective merits.

BACKGROUND: To assess the clinical usefulness of three-dimensional CT angiography (3D-CTA) with newly-developed three-dimensional reconstruction techniques; voxel transmission (VT) and cruising eye view (CEV) methods, for performing minimally invasive diagnostic imaging of vascular diseases. METHODS DESIGN: retrospective comparative study. SETTING: University Hospital, Japan. PATIENTS: fifty-five patients with vascular lesions confirmed by catheter angiography (20 patients with aortic aneurysms, 10 patients with aortic dissection, and 25 patients with peripheral arterial occlusive disease). MAIN OUTCOME MEASURES: minimally invasive, three-dimensional diagnosis of vascular diseases. RESULTS: Angiogram-like images with a diagnostic quality similar to that of catheter angiography were obtained by the three-dimensional CT angiography/voxel transmission (3D-CTA/VT) method. This method is useful for treatment planning and also valuable for assessing the effectiveness of treatment. Three-dimensional endoscopic images of the vessel interior were obtained by the three-dimensional CT angiography cruising eye method (3D-CTA/CEV). This also yielded precise information about the relationship between the vascular lesions and the aortic orifices. CONCLUSIONS: Three-dimensional CTA/VT and three-dimensional-CTA/CEV enable visualisation of vascular lesions from an infinite number of viewing angles, and are useful as minimally invasive diagnostic techniques for imaging the vasculature.

Aged↗

Three-dimensional CT angiography of intracranial vasospasm following subarachnoid haemorrhage.

We evaluated the usefulness of three-dimensional CT angiography (3D-CTA) in the diagnosis of intracranial vasospasm following subarachnoid haemorrhage (SAH) in 13 patients suspected of having vasospasm on clinical grounds. The intracranial vessels were clearly shown by 3D-CTA in 12 patients. 3D-CTA revealed spasm in the vessels of nine patients. Catheter angiography performed in seven of these patients immediately after 3D-CTA confirmed vasospasm. A low-attenuation area was seen on CT in the other two patients, representing an ischaemic lesion due to the spasm. In nine patients, a second 3D-CTA was performed using the same technique 1 week after the first, showing no vasospasm. Initial 3D-CTA revealed no vasospasm change in three patients. Following 3D-CTA, one of these had conventional angiography, which also demonstrated no spasm.

Adult↗

Immunocytochemical demonstration of the synovial membrane in experimentally induced arthritis of the rat temporomandibular joint.

The present study is first to report an experimental model of adjuvant-induced arthritis in the rat temporomandibular joint (TMJ). Arthritis was induced by simultaneous intradermal administrations of Freund's complete adjuvant, one at the parietal scalp and the other at the base of the tail. In this model, we demonstrated responses of the synovial membrane by immunocytochemistry using antibodies to OX6 and ED1 which recognize Ia antigen in MHC class II antigen-expressing cells and the macrophage/monocyte lineage, respectively. Three weeks after administration, no remarkable signs of inflammation were macroscopically recognizable in the TMJ, but microscopically the synovial membrane in the TMJ revealed marked changes such as enhanced vascularization and hemostasis in the sublining layer and a thickening in the synovial lining cell layer. Intense OX6-immuno-reactivity was found in the synovial lining cells at lesions in the experimental group but not in the control group. Immunoelectron microscopy revealed that these OX6-immunopositive synovial lining cells developed dense cytoplasmic processes and numerous vacuoles and vesicles, resembling type A cells. Part of the type A cells also showed ED1-immunoreactivity. The expression of OX6 or ED1 immunoreactivity in the synovial lining cells might be involved in the initial immune responses in this arthritis model because the synovial membranes are exposed to the synovial fluids which have been believed to contain antigenic substances.

Animals↗

[Three-dimensional CT angiography for cerebral aneurysm using a multi-angle reconstruction plan method].

The purpose of this study was to evaluate the clinical usefulness of three-dimensional CT angiography (3D-CTA) for the diagnosis of cerebral aneurysm using a new reconstruction method called Multi-Angle Reconstruction Plan (MARP). The threshold values, region of interest and six angles of view were preset for the MARP method on the basis of our experience with cerebral 3D-CTA. Spiral CT angiography was performed in 27 patients with 29 aneurysms. The six images reconstructed with the MARP method were generated from the volumetric CT data. Two radiologists independently reviewed the six 3D-CT images for the presence of aneurysm. It took about five minutes to semiautomatically reconstruct the six 3D-CT images with the MARP method. There were no discrepancies in the evaluation of the 3D-CT images. Twenty-six aneurysms of 24 patients were demonstrated on the six 3D-CT images. Three aneurysms in 3 patients were not depicted on the 3D-CT images by the MARP method. In them, the additional 3D-CT images which were generated after evaluating the 2D-CT images clearly showed the aneurysms. The MARP method is considered to be a useful three-dimensional reconstruction technique for the diagnosis of cerebral aneurysm.

Adult↗

[Clinical usefulness of "optimal threshold setting plan" for reconstruction of three-dimensional CT imaging: preliminary clinical study on hepatic tumors and hepatic parenchymal disease].

Clinical application of three-dimensional CT (3D-CT) angiography using the volumetric acquisition capabilities inherent in spiral CT has provided 3D-CT images of vascular structures as well as visceral organs. However, the standard method for deciding the threshold, which is an important process for defining regions of interest, has not yet been established. The setting of an inappropriate threshold may result in reconstruction of a 3D-CT image, leading to misdiagnosis. To simplify the determination of the optimal threshold in a way consistent with the purpose of reconstructing a 3D-CT image, we developed an Optimal Threshold Setting Plan (OPT Plan). With this method, an optimal 3D-CT image could be selected from among those multiple 3D-CT images that were reconstructed on the basis of the multiple thresholds input in advance by referring to attenuation values in both the hepatic lesion and its background on two-dimensional CT images. Clinical usefulness of the OPT Plan for the reconstruction of 3D-CT images was evaluated in 10 patients with hepatic tumors and hepatic parenchymal disease. We obtained 13 3D-CT images (on average) with threshold changes every 5 Hounsfield units, with a mean reconstruction time of 2 minutes 49 seconds, and easily selected an adequate 3D-CT image. Based upon this preliminary experience, the OPT Plan may resolve the difficulty encountered in the setting of thresholds for achieving 3D-CT images, and is considered to be useful for three-dimensional qualitative evaluation of hepatic lesions and hepatic parenchymal disease.

Adult↗

Reduction of hyponatremia in a schizophrenic with polydipsia-hyponatremia syndrome by surgical intervention.

In a chronic schizophrenic with polydipsia-hyponatremia syndrome, we observed physiological data consecutively before and after a successful LAPIDES vesicostomy for his bladder retention. Although his polydipsia was unchanged, frequency of hyponatremia was significantly reduced after the operation. We found that bladder retention might be one of the factors relevant to the prediction of hyponatremia from diurnal weight gain.

Adult↗

[Evaluation of three-dimensional CT angiography (3D-CTA) for the diagnosis of cerebral vasospasm].

We evaluated the usefulness of three-dimensional CT angiography (3D-CTA) for the diagnosis of cerebral vasospasm following subarachnoid hemorrhage (SAH). Eleven patients with SAH who were suspected of having cerebral vasospasm on the basis of their clinical symptoms were examined by 3D-CTA with a spiral CT scanner after an intravenous bolus administration of contrast medium. 3D-CTA revealed vasospastic changes of the cerebral vessels in eight patients. Conventional angiography was performed in six patients immediately after the 3D-CTA examination, and demonstrated the cerebral vasospasm. In eight patients, a second 3D-CTA was performed with the same technique one week after the first 3D-CTA examination. The second 3D-CTA showed the cerebral vessels without vasospastic change. In conclusion, 3D-CTA is a promising, minimally invasive strategy for the assessment of cerebral vasospasm.

Cerebral Angiography↗

[Postoperative three-dimensional CT angiography (3D-CTA) in evaluation of proximal clipping for ruptured vertebral aneurysms].

At present, intra-arterial angiography remains the gold standard for most cerebrovascular problems. Recently, three-dimensional computed tomographic angiography (3D-CTA) has been reported as a screening method for the diagnosis of cerebrovascular disease. This imaging modality uses the information obtained on a contrast-enhanced CT scan to generate three-dimensional images of the cerebrovascular system. We performed 3D-CTA in the preoperative and postoperative evaluation of patients undergoing proximal clipping of ruptured vertebral artery aneurysms in addition to conventional cerebral angiography. In this study, the value of 3D-CTA after proximal clipping of ruptured vertebral artery aneurysm was evaluated retrospectively. Six patients were examined with a spinal CT (HITACHI CT-W 3000) after intravenous bolus injection of 100 ml contrast material (Iohexhol 300 mgI/ml) at the rate of 2 ml/s with a 25 second pre-scanning delay. The images of 3D-CTA were reconstructed using a new 3D-volume-render (Voxel Transmission) technique. The ages of the six patients ranged from 33 to 61 years and five cases were males and one case was female. Only one patient had a saccular aneurysm and the other five had fusiform aneurysms. Two patients underwent emergency operations within 4 days, and the other four had delayed operations. The outcome was good recovery in five cases and severe disability in one case. Postoperative conventional cerebral angiography demonstrated no delineation of the aneurysms in five cases. These results correspond well to postoperative 3D-CTA. Postoperative conventional cerebral angiography could not be performed in only one patient, but the aneurysm was visualized on the third postoperative 3D-CTA. Proximal clipping is still one of the therapeutic options for ruptured vertebral aneurysms, but some reports emphasized the possibility of rebleeding after proximal clipping of vertebral artery aneurysms. The rebleeding occurred within 1 week after proximal clipping in 6 of 9 cases (66.7%), and the prognoses were extremely poor. Therefore, in patients selected for proximal clipping, it is necessary to undertake postoperative evaluation of the aneurysm within one week after proximal clipping. 3D-CTA is minimally invasive and can be easily performed repeatedly, even if the patients are in a poor condition. In conclusion, 3D-CTA is very useful especially for evaluation of ruptured vertebral artery aneurysms following proximal clipping.

Adult↗