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Biomedical subjects

A Araki

Publications and source records attributed to A Araki.

At least 37 records · Page 2Linked to original sources

[Lipoprotein(a) as a risk factor for cardiovascular disease in elderly patients with diabetes].

Lipoprotein(a) (Lp(a)) is an independent risk factor for cardiovascular diseases in non-diabetic people, but few studies have been done in diabetic patients. To investigate whether Lp(a) is a risk factor for cardiovascular disease in elderly people with diabetes, we examined the association of Lp(a) and serum lipid levels (total cholesterol: TC; triglycerides: TG; and high-density lipoprotein cholesterol: HDL-c) with the incidence of coronary artery disease and cerebrovascular disease. We studied 354 outpatients(131 men and 223 women, 60-97 years of age) with non-insulin-dependent diabetes mellitus. The mean concentration of Lp(a) was 21.1 +/- 19.6 mg/dl and the median was 14.0 mg/dl. The Lp(a) concentration did not correlate significantly with age or with sex, but it did correlate significantly with TC (r = 0.152, p < 0.05) and with the level of apoprotein B (r = 0.168, p < 0.05). The incidence of cerebrovascular disease was significantly higher in patients with high concentrations of Lp(a) (> or = 30 mg/ dl) than in those with low concentrations (< 30 mg/ dl). Multivariate logistic regression analysis revealed that male sex, hypertension, a high level of HbA1c, a low level of HDL, and a high level of Lp(a) were independent risk factors for cerebrovascular disease. The incidence of coronary artery disease tended to the higher in those with high concentrations of Lp(a) (> or = 30 mg/dl). However, multivariate logistic regression analysis revealed no significant correlation between Lp(a) concentration and the incidence of coronary artery disease. We conclude that a high concentration of Lp(a) is an independent risk factor for cerebrovascular disease in elderly patients with diabetes.

Aged↗

[Development of comprehensive assessment system for elderly patients in a geriatric hospital].

Studies in the United States and Europe revealed that a comprehensive geriatric assessment is useful in the management and treatment of elderly disabled patients. In Japan, there are few reports of the development of such assessment. We examined the reliability of a scale designed to assess the performance of activities of daily living (ADL), a revised version of Hasegawa's Dementia Scale) HDSR, and a depression scale (GDS-15), using results from 140 patients over 65 years old who were admitted to our hospital from the end of January to early February 1994. The reliabilities of the ADL and HDSR scales were acceptable, but the kappa value of the GDS-15 was very low. The ADL score was low in patients with cerebrovascular diseases, dementia, and bone and joint problems, but the HDSR score was not low in the latter group. These results suggest that each disease has a characteristic pattern of impairments and disabilities. Although psychological assessment is essential and requires validation, a prospective study of outcomes in the evaluated elderly patients might also be fruitful.

Aged↗

Neuroradiological assessment of visuoperceptual disturbance in children with spina bifida and hydrocephalus.

The intellectual status of twelve children with spina bifida and hydrocephalus was evaluated. Seven children were considered to have verbal and non-verbal skill discrepancies. It was considered that the Verbal IQ-Performance IQ score by WISC-R could be used as an index of their visuoperceptual disturbance. The disturbance was closely related to the morphological characteristics of the lateral ventricles on cerebral MRI. The ratio of the areas of the posterior horns to the anterior horns (P:A) showed a negative correlation with visuoperceptual ability. The visual pathway, visual cortex, and the ventral system were thus considered to be the sites of the affected lesions. From P:A changes with time, it was evident that adequate shunting would prevent the perceptual disturbance.

Adolescent↗

[Oxidative stress and diabetes mellitus: a possible role of alpha-dicarbonyl compounds in free radical formation].

Increased oxidative stress in diabetes mellitus has been implicated in the pathogenesis of diabetic complications. Both an increase in reactive oxygen free radical species (ROS) and a decrease in the antioxidant defense mechanism lead to the increase in oxidative stress in diabetes mellitus. During the process of both glucose autoxidation and glycation, including the formation of advanced glycation end-products (AGE), superoxide (O2-), hydrogen peroxide and hydroxylradical (OH.) may be formed. In the present study, alpha-dicarbonyl compounds produced in glucose autoxidation and glycation were measured using a gas chromatography-mass spectrometry method. During glucose autoxidation, glucose and glyoxal were formed as alpha-dicarbonyl compounds, while several alpha-dicarbonyl compounds, including 3-deoxyglucosone (3-DG), were produced from glycated bovine serum albumin. Also, increase in various alpha-dicarbonyl compounds, such as 3-DG, were observed in diabetic rate as compared with control rats. The reaction of alpha-dicarbonyl compounds with amino acids could lead to both ROS and AGE formation, which may contribute to the development and progression of diabetic complications.

Animals↗

Rapid killing of human neutrophils by the potent activator phorbol 12-myristate 13-acetate (PMA) accompanied by changes different from typical apoptosis or necrosis.

To elucidate the relationship between activation of neutrophils and their subsequent death, the effect of phorbol 12-myristate 13-acetate (PMA), a potent activator of neutrophils, was examined. PMA-treated neutrophils showed morphological changes quite different from those of typical apoptosis or necrosis. After fusion of the lobate nucleus, nuclear contents of chromatin uniformly decreased in compactness and soon after the nuclear envelope was broken. Even at this stage, cytoplasmic organelles did not undergo degeneration. Membrane permeability began increasing at 3 h of incubation with PMA, subsequent to nuclear change. Conventional agarose gel electrophoresis and pulsed field gel electrophoresis of DNA from PMA-treated neutrophils revealed no DNA degradation products smaller than 300 kbp. PKC inhibitors, staurosporine and H-7, prevented cytotoxicity by PMA. Furthermore, antioxidants, thiourea, dimethylthiourea, pyrrolidinethiocarbamate, and N-acetyl-L-cysteine, but not superoxide dismutase, were also active in preventing PMA cytotoxicity, suggesting that cell suicide resulting from PMA treatment is due to oxygen radicals, especially the hydroxyl radical. A certain population of neutrophils phagocytosing opsonized zymosan also showed changes similar to those observed in PMA-treated cells.

Antioxidants↗

The neutrophil as an information transmitter in tumor inhibition by a streptococcal biological response modifier, OK-432.

Effective treatment of a rat transplanted ascites tumor by i.p. injection of a streptococcal biological response modifier, OK-432, was abrogated by selective in vivo depletion of neutrophils by a monoclonal antibody, RP-3. The mechanisms by which neutrophils participate in the therapeutic action of OK-432 were studied with Winn's assay using peritoneal exudate cells periodically obtained from rats i.p. injected with this biological response modifier. Intraperitoneal resident macrophages were first activated with OK-432, and within 3 h, tumor-inhibitory activity had moved to the early exuded neutrophils. However, 6 h after injection, exuded macrophages were the only cells involved in tumor inhibition. Considered together with other findings, it is likely that, in this system, neutrophils may transmit information from resident macrophages to exuded inflammatory macrophages in a series of responses induced by i.p. injection of OK-432.

Animals↗

Reduced anti-Pseudomonas aeruginosa activity of a cephalosporin, cefodizime, in rats whose neutrophils were selectively depleted by a monoclonal antibody.

In order to clarify the mechanisms of the in vivo antibacterial activity of a cephalosporin, cefodizime (CDZM), the effect of this antibiotic on Pseudomonas aeruginosa E7 infection was examined in rats whose neutrophils had been selectively depleted by monoclonal antibody RP-3. CDZM was less effective in RP-3-treated rats than in untreated rats. However, treatment of rats with recombinant human granulocyte-colony stimulating factor (rhG-CSF) augmented the in vivo activity of this antibiotic. Furthermore, the in vivo antibacterial activity of two other cephalosporins, cefpimizole (CPIZ) and cefoperazone (CPZ), was bilaterally affected by a rise or fall in the neutrophil number, although to a lesser degree than was the case with CDZM. Taken together, neutrophils play an important role in the in vivo antibacterial activity of certain cephalosporins.

Animals↗

Assessment of visuoperceptual disturbance in children with spastic diplegia using measurements of the lateral ventricles on cerebral MRI.

The authors estimated perceptual disturbance in children with spastic diplegia from the difference between the visual and performance IQ scores (VIQ-PIQ) on the Wechsler Intelligence Scale for Children-Revised (WISC-R), having found a strong negative correlation between this score and the PQ obtained on the Frostig Developmental Test of Visual Perception (DTVP). The ratio of the areas of the posterior horns to the anterior horns (P/A) correlated negatively with visuoperceptual disturbance. This ratio can therefore be used to assess perceptual disturbance at an early age in children with spastic diplegia.

Adolescent↗

[A case of abnormal hemoglobin (HbJ Cape Town) with high serum levels of HbAlc].

We describe a case of hemoglobinopathy detected on admission for examination for high blood glucose levels and abnormal liver function. In 1991, it was pointed out that he had postprandial hyperglycemia. In 1994, at age 60, he had lassitude and anorexia. He was admitted to our hospital on the suspicion of diabetes mellitus and liver disease. Glycosylated hemoglobin levels was very high, but the 75 gram oral glucose tolerance test result was within the normal range. After abstinence from alcohol, his glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and gamma glutamyl traspeptidase became normal. Diabetes was excluded and abnormal hemoglobinopathy had been suspected. We analyzed his abnormal hemoglobin. In isoelectro-phoresis a fast moving variant was detected suggesting the presence of abnormal hemoglobin at the cathode. We fractionated hemolytic globin by CM-chromatography and detected an abnormal peak before the alpha chain band. Subsequently, we sequenced isolated abnormal alpha chain and detected the substitution of Ariginine for Glutamamine at position 92 (Hb J Cape Town). So far he has not demonstrated any symptoms or signs of HbJ Cape Town. Hemoglobinopathy is not uncommon in aged people.

Amino Acids↗

Prediction of relapses after interferon-alpha therapy by hepatitis C virus RNA in peripheral blood mononuclear cells.

To investigate the predictive value of hepatitis C virus (HCV)-RNA in peripheral blood mononuclear cells in the response to interferon therapy in patients with chronic hepatitis C, 15 patients with histologically proven chronic active hepatitis and who were positive for serum HCV-RNA were treated with interferon-alpha (6 million units; i.m.) every day for two weeks and then three times a week for 22 weeks. Ten of the 15 patients were responders whose alanine aminotransferase levels decreased to the normal range at the end of interferon therapy. In four of the 10 responders, HCV-RNA was not detected by reverse transcription-polymerase chain reaction in peripheral blood mononuclear cells nor in serum at the end of treatment. These four patients were complete responders, with alanine aminotransferase levels remaining normal for the next 24 weeks. In five of the 10 responders, HCV-RNA was detected in peripheral blood mononuclear cells but not in serum at the end of treatment. All of these relapsed within the next 24 weeks. In the remaining responder, HCV-RNA was detected both in peripheral blood mononuclear cells and in serum at the end of treatment. This responder also had a relapse within the next 24 weeks. Five of the 15 patients were non-responders, in whom HCV-RNA was detected both in peripheral blood mononuclear cells and in serum. Thus, detection of HCV-RNA in peripheral blood mononuclear cells may be a good clinical marker to predict relapse after interferon treatment.

Adult↗

Restricted V beta gene usage of tumour-infiltrating T lymphocytes in primary gastric malignant B-cell lymphoma.

Ten cases of primary gastric malignant lymphoma (PGL) were investigated by immunohistochemical and molecular genetic analysis. These cases were diagnosed histopathologically as follicular small cleaved cell type (1 case), diffuse small cleaved cell type (3 cases) and diffuse large cell type (6 cases) based on the WF (Working Formulation) classification. Seven cases classified as small cleaved or diffuse large cell type belong to low (4 cases) or high (3 cases) grade MALT lymphoma according to Isaacson's classification. All PGL belonged to B lineage cells according to immunohistochemical study and immunoglobulin rearrangements. Rearrangements of TCR beta chain genes were observed in four of the ten cases. The possibility that the TCR beta rearrangements were caused by tumour-infiltrating T-cells (TILs) was supported by the following observations: the tumours did not show T- and B-cell biphenotype, TCR beta exhibited functional VDJ rearrangement and V beta usage pattern was not a neoplastic type. Analysis of the repertoire of the TCR beta chain in TILs revealed a common usage of V beta 2 in the above four cases, and furthermore, predominant usage of a particular beta chain composed of V beta 2-D beta 2.1-J beta 2.3 was observed in one of the four cases. These results indicate that the TILs of PGL have a restricted TCR repertoire.

Adult↗

When do brain abnormalities in cerebral palsy occur? An MRI study.

The authors used MRI to analyse retrospectively the brain images of patients with cerebral palsy (CP) to evaluate its the role in the assessment of brain abnormalities and injury, and the relationship of pre-, peri- and postnatal events to CP. 70 patients with CP aged two to 16 years who underwent MRI were divided into four groups: group 1 (26 patients) comprised subjects whose CP was considered to have been caused by neuronal migration disorders in the embryonal stage; group 2 (30 patients) contained subjects whose cause was vascular disorders; in group 3 patients (five) the cause was intra-uterine infection; and CP clearly attributable to birth asphyxia (group 4) was noted in only nine patients. The results indicate that CP of term infants is often the result of prenatal factors, and their MRI findings indicated migration and cerebral infarction. Brain MRI is an essential examination in identifying the factors causing brain damage in CP.

Adolescent↗

Changes in bacterial phagocytosis of macrophages in experimental ulcerative colitis.

We previously reported that numerous macrophages which phagocytosed dextran sulfate sodium were observed to have accumulated in the mucosal lesions and in the spleen in experimental ulcerative colitis induced in mice with dextran sulfate sodium. In this paper, we investigated the bacterial phagocytic ability of macrophages which were isolated from spleens of mice treated with 3% dextran sulfate sodium for 6 months. In this model, the number of phagocytosed bacteria (Listeria monocytogenes) and the phagocytic index were significantly decreased. The phagocytic ability of splenic macrophages obtained from nontreated mice was also evaluated by incubating with dextran sulfate sodium in vitro, and adding bacteria. The number of phagocytosed bacteria and the phagocytic index were also significantly decreased. These observations suggest that the decrease in bacterial phagocytosis in this model by macrophages that phagocytosed dextran sulfate sodium indicates a decline of the mucosal defense system to bacteria.

Animals↗

[Bone mineral density in postmenopausal elderly women with type 2 diabetes].

We measured lumbar bone mineral density (L2-4 MBMD) in the postmenopausal elderly diabetic women and made comparisons with age-matched controls in terms of the age, body mass index (BMI) and % BMD of age-matched. In addition we evaluated the correlation between BMD and menarche age, menopause age, HbA1c, serum calcium, serum phosphate, serum alkaline phosphatase (S-Alp) and the ratio of urine calcium to urine creatinine (UCa/Cr). Moreover we divided non-insulin dependent diabetic patients (NIDDM) into two groups; the high BMD group and the low BMD group. Serum Alp and the ratio of UCa/Cr were compared in these two groups. The relationships between regimen of therapy and BMD were also analyzed in female NIDDM. There were no significant differences of BMD and background factors between controls and NIDDM. The ratio of UCa/Cr in the high BMD group were significantly less than that in low BMD group (p < 0.05). BMD in NIDDM with retinopathy was lower, but not significantly, than that in NIDDM without retinopathy. The methods of therapy for NIDDM such as diet alone, an oral hypoglycemic agent and insulin did not influence BMD in elderly postmenopausal diabetics. These results indicated that BMD in elderly postmenopausal diabetics are dependent on UCa/Cr and retinopathy.

Aged↗

[Development of Elderly Diabetes Impact Scales (EDIS) in elderly patients with diabetes mellitus].

To assess the quality of life (QOL) in elderly diabetic patients, 452 elderly outpatients aged over 60 years old who lived in 4 districts near our hospital were visited at home and of them were asked to follow 83 questionnaires concerning QOL by professional interviewers. Using the 37 questions about the impact of diabetes on elderly diabetic patients, we have developed the Elderly Diabetes Impact Scales (EDIS). The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry). Responses to questions were estimated with a 4-point multiple-choice assessment. The impact was rated from 1 (no impact, never worried, or very satisfied) to 4 (very burdened, always worried, or very dissatisfied) for each question and total EDIS scores were calculated by summing up the scores of the 37 questions. The internal consistency of the EDIS and its six subscales were of a satisfactory magnitude (0.66-0.88). There was also a significant correlation between the EDIS and PGC morale scales (r = -0.48, p < 0.001) and between the EDIS subscales and 3 moral components suggesting a convergent validity of the EDIS. The EDIS may be useful in evaluating the quality of life in elderly patients with diabetes mellitus.

Activities of Daily Living↗

[Factors associated with increased diabetes burden in elderly diabetic patients].

To define the factors that determine the increased burden of diabetes in elderly diabetic patients, we examined the relationship between the Elderly Diabetes Impact Scales (EDIS) and physical or social factors in 383 elderly outpatients aged over 60 years old who answered QOL questionnaires by professional interviewers. The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry) and total EDIS scores were calculated by summing up the 4-point scores of 37 questions. The EDIS scores were highest in patients who received insulin therapy. In univariate analysis, high EDIS scores were significantly associated with high HbA1c, low Roken ADL score, and the presence of retinopathy or neuropathy. Among social factors, leisure activities, housework or jobs, social network, and positive social support were significantly associated with low EDIS scores, while negative social support was associated with high EDIS scores in elderly diabetic patients. Multiple linear regression analysis revealed that age (younger), sex (women), low ADL (or diabetic complications), insulin therapy, low positive social support, high negative social support, economical dissatisfaction, and the low adaptative feeling of diabetes were significant and independent determinants of a high burden in diabetic patients indicated by EDIS scores in Japanese elderly diabetic patients.

Activities of Daily Living↗