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Biomedical subjects

A Terao

Publications and source records attributed to A Terao.

At least 73 records · Page 4Linked to original sources

Calcium intake and blood pressure in seven Japanese populations.

The relation between dietary calcium and blood pressure was examined in 1,928 men, ages 40-69 years, from five geographic and two occupational populations in Japan. Dietary calcium intake was estimated using 24-hour dietary recall in systematic samples of participants of population-based cardiovascular surveys from 1983 to 1987. The means of daily calcium intake of the study populations ranged from 449 to 695 mg, approximately 300 mg lower than the recommended US dietary calcium intake. Linear regression analyses were used to examine the relation between dietary calcium and blood pressure within each population, controlling for age, body mass index, alcohol consumption, and sodium intake. Total calcium intake was inversely associated with the systolic blood pressure level in each population, and the pooled estimate of the regression coefficients for millimeters of mercury of blood pressure per 100-mg increase in calcium intake was -0.54 (95% confidence interval -0.89 to -0.19). The inverse association between calcium intake and diastolic blood pressure was less consistent, and the pooled estimate did not reach statistical significance (-0.10, 95% confidence interval -0.34-0.14). Inverse associations existed for both dairy and nondairy food sources of calcium when analyzed separately, and the association was significant only for dairy calcium. Although a causal relation between dietary calcium and blood pressure cannot be established, these results suggest a possible public health implication in Japan of increasing calcium intake for the prevention and control of hypertension, where average dietary calcium intake is low.

Adult↗

[A community-based education program for serum cholesterol reduction in urban hypercholesterolemic persons--comparison of intensive and usual education groups].

A community-based education program was conducted for persons found to be hypercholesterolemic by screening during cardiovascular surveys, in an urban population, to evaluate the feasibility and effect of the program in primary prevention of coronary heart disease. The subjects were men and women aged 40-64 living in the suburbs of Osaka whose serum total cholesterol was between 240 and 299 mg/dl in both the 1988 and the 1989 surveys. Persons with hypothyroidism, those taking medication for hypercholesterolemia or hypertension, and with a history of stroke and coronary heart disease were excluded. Of the 111 persons who were eligible, 104 persons were recruited for the program on March, 1989. The 104 persons were randomly assigned to either an intensive education group (n = 51) or a usual education group (n = 53). For the intensive education group, seven education classes were held from April to November, 1989. Lectures, practice sessions, interviews, and spot cholesterol measurements were conducted in a local community center. The usual education group received a letter with results from the 1989 survey and dietary instruction in April 1989 and an education class in September 1989. Mean serum cholesterol in the intensive education group showed a 10.0 mg/dl greater reduction in September 1989 and a 9.0 mg/dl greater reduction in March 1990 than in the usual education group (p less than 0.05) while mean HDL-cholesterol did not change in either groups. The intensive education group reported a larger decrease in the dietary frequency of chicken egg, poultry skin and small fishes, foods which are rich in saturated fat and cholesterol. The frequency of fatty meat, butter and fish eggs was low in both groups and did not differ between the two groups after the one-year program. These results indicate that a population-based education program is feasible and effective in reducing serum total cholesterol of hypercholesterolemic persons.

Adult↗

[Clinico-pathological comparative study between brainstem encephalitis of Iizuka type and neuro-Behçet's disease].

We experienced one necropsy case of brainstem encephalitis of Iizuka type (BSE) and one necropsy case of the brain-stem syndrome (BSS) of typical neuro-Behçet's disease, and compared them clinically and neuropathologically. Clinically both of these cases showed chronic progressive mental disturbance, pseudobulbar paresis, spastic tetraparesis, cerebrospinal fluid pleocytosis, increased protein, and brainstem atrophy observed by X-CT. Neuropathologically, irregular, boundary-indistinct demyelinating lesions and obsolete softening lesions were sporadically found, associated with perivascular lymphocytic infiltration and gliosis centering on the brainstem. In this way, both cases were similar in many points except for the presence or absence of cutaneo-muco-ocular signs specific for Behçet's disease. Also BSE and BSS reports in the literature showed that both diseases were similar not only in clinical findings consisting of mental disturbance and brainstem signs but also in neuropathological findings with similar topographical distribution of the same histopathological changes, including the variations and diversity of these characteristics. Especially of much interest is their similarity in characteristic mental disturbance. In discriminating BSE from multiple sclerosis and other diseases with exclusive involvement of the brainstem, it is important to understand their clinical characteristics. The characteristic mental disturbance includes damage to memory and sentiment, a change in personality, and lowering in spontaneity, but calculation ability and orientation are comparatively preserved. Of course the similarity in clinical and neuropathological findings does not necessarily mean the identical etiopathogenesis. However, it is possible to consider that neuro-Behçet's disease (syndrome) may form a wide spectrum with BSE and typical neuro-Behçet's disease at the both ends, regarding the time and spatial diversity of the appearance of cutaneo-muco-ocular signs.

Atrophy↗

[A case of herpes simplex encephalitis with periodic lateralized epileptiform discharges].

A case of a 50-year-old male with herpes simplex encephalitis was reported. An EEG examination revealed periodic lateralized epileptiform discharges (PLEDs) on the right hemisphere on April 17, 1990. Another EEG performed on April 26 showed PLEDs on the left hemisphere, dominantly on the temporal lobe. On and after May 2, PLEDs have not been detected. SPECT showed hyperperfusion in the right temporal and occipital lobe son April 26. T1 weighted MRI examined on April 18 showed low signal intensity and T2 and proton weighted imagings revealed high signal intensity in the greater part of the right temporal lobe and a similar abnormality in a part of the left temporal lobe. Although the origin of PLEDs is still controversial, these findings suggest that, at least in the case of herpes simplex encephalitis, PLEDs appear in the early progressive stage of the inflammatory lesion.

Electroencephalography↗

Hemostatic variables in Japanese and Caucasian men. Tissue plasminogen activator, antithrombin III, and protein C and their relations to coronary risk factors.

Mortality rates of coronary heart disease are much lower in Japan than in the United States. The authors' previous report on coagulation factors showed that population levels of plasma fibrinogen and factor VII activity parallel this mortality difference. To investigate other hemostatic variables, the authors assessed indicators of fibrinolytic activity (tissue plasminogen activator antigen) and coagulation inhibition (antithrombin III activity and protein C) in 136 men aged 34-55 years in four different samples: rural Japanese, urban Japanese, Japanese Americans, and Caucasian Americans. Mean tissue plasminogen activator antigen was higher in Caucasians and Japanese Americans than in rural and urban Japanese (p less than 0.01), while a contrasting trend in mean antithrombin III activity was suggested (p = 0.10). No significant differences were observed in mean levels of protein C. After controlling for known coronary risk factors, mean levels of tissue plasminogen activator antigen remained significantly different across the four samples (p less than 0.01); mean antithrombin III activity was not different (p = 0.23). Population differences in tissue plasminogen activator antigen parallel the coronary heart disease mortality difference between Japan and the United States. Although no definite evidence is available showing that tissue plasminogen activator antigen is a risk factor for coronary heart disease, the present study suggests a positive ecologic association between this hemostatic factor and coronary heart disease mortality.

Adult↗

[A mitochondrial encephalomyopathy due to partial cytochrome c oxidase deficiency with giant evoked potentials--a case report].

A case of mitochondrial encephalomyopathy with a partial cytochrome c oxidase deficiency was reported with special reference to electrophysiological studies. A 56-year-old man was readmitted to Himeji Central Hospital due to mental deterioration and character change. At the age of 44 when he was attacked by his first epileptic seizure, he was admitted to Himeji Central Hospital, where EEG abnormalities and cerebral atrophy were found. Anticonvulsants helped to relieve his generalized convulsions but the EEG abnormalities persisted. At age 46, he had the second generalized seizure, so he quit his job as a crane operator. His family began to notice deterioration of his intellectual function and hyperaggressive behavior. His daily activities, intellectual performance and mental condition gradually deteriorated (WAIS FIQ less than 60). Other clinical and laboratory findings are as follows: bilateral impaired hearing, no optic nerve atrophy, no disturbance of extra ocular muscle movements, mild wasting and weakness of his extremities, normal coordination and sensation, no myoclonus or other involuntary movements, normal laboratory data of serum creatinine kinase, lactate dehydrogenase and aldolase, and increased amount of lactate and pyruvate in serum and cerebrospinal fluid (CSF), no abnormal amino acids in urine. A biopsy specimen of right biceps brachii muscle revealed numerous ragged-red fibers in frozen sections stained by the Gomori trichrome method. These fibers did not react to a cytochrome c oxidase staining. An ATPase staining demonstrated an atrophy of type-2 fibers. An electron micrograph showed many mitochondria in the sarcoplasm but few paracrystalline inclusions. A biochemical analysis of the muscle biopsy also revealed a significant decrease in the cytochrome c oxidase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Diseases↗

Increased accumulation of N-isopropyl-p-(123I)-iodoamphetamine in two cases with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS).

We present two cases with mitochondrial encephalopathy with lactic acidosis and strokelike episodes (MELAS), which showed both increased and decreased accumulation of N-isopropyl-p-(123I)-iodoamphetamine (123I-IMP) in single photon emission computed tomography (SPECT). The increased accumulation of the tracer occurred, before low density appeared on conventional computed tomography, suggesting that 123I-IMP SPECT may be useful in pathophysiological study of MELAS.

Acidosis, Lactic↗

Serum fatty acids and fish intake in rural Japanese, urban Japanese, Japanese American and Caucasian American men.

To examine the relationship of fish intake with serum fatty acids cross-culturally, we surveyed a total of 136 men aged 34 to 55 years in four different populations: rural Japanese (RJ), urban Japanese (UJ), Japanese Americans (JA), and Caucasian Americans (CA). Mean levels of estimated total fish intake per day were 124.9 g in RJ, 70.8 g in UJ, 45.7 g in JA, and 32.3 g in CA. The percentage of total serum fatty acids contributed by omega-3 polyunsaturated fatty acids in these populations was 11.8% in RJ, 9.0% in UJ, 3.4% in JA and 2.5% in CA. Means of omega-3 fatty acids and intake of fish were correlated at the population level; this relationship was strongest when intake of dark-meat fish was considered (n = 4, r = 0.979, p = 0.02). Within each population, except for UJ, individual omega-3 fatty acid levels and dark-meat fish intake were significantly associated (p less than 0.05). A 20 g increase in dark-meat fish consumption was associated with an estimated relative increase in omega-3 fatty acid content of serum by 0.76% in RJ, 0.75% in UJ, 0.64% in JA, and 0.22% in CA. The association between fish intake and serum omega-3 fatty acids at the individual level was not explained by other coronary risk factors. Mortality from coronary heart disease is much lower in Japan than in the US. Population differences in fish intake and serum omega-3 fatty acid levels may contribute to the population difference in the risk of coronary heart disease.

Adult↗

Hemostatic variables in Japanese and Caucasian men. Plasma fibrinogen, factor VIIc, factor VIIIc, and von Willebrand factor and their relations to cardiovascular disease risk factors.

Mortality rates of coronary heart disease are much lower and hemorrhagic stroke rates are higher in Japanese than in Caucasians. To investigate whether population differences in plasma concentrations of coagulation factors are consistent with these mortality differences, the authors examined, in 1987, a total of 136 men aged 34-55 years in four different samples: rural Japanese living in Akita, Japan; urban Japanese living in Osaka, Japan; and Japanese Americans and Caucasian Americans living in Minneapolis-St. Paul, Minnesota. The mean plasma fibrinogen level in Caucasians was 290 mg/dl, which was significantly higher than that in each of the Japanese samples (223-250 mg/dl; test for difference: p less than 0.001). The mean coagulation activities of factor VII and factor VIII (factor VIIc and factor VIIIc) were higher in Caucasian and Japanese Americans than in rural and urban Japanese (p less than 0.01 for factor VIIc and p = 0.03 for factor VIIIc). von Willebrand factor did not differ significantly across the populations. The relations of these coagulation factors with other cardiovascular risk factors (age, body mass index (weight (kg)/height (m)2), blood pressure, serum total cholesterol, serum triglyceride, cigarette smoking, and alcohol intake) were also examined. Mean plasma fibrinogen was consistently higher in current smokers than in nonsmokers within each sample. Factor VIIc and factor VIIIc levels were positively associated with serum total cholesterol and serum triglyceride. No consistent associations were seen between von Willebrand factor and cardiovascular risk factors. After the authors controlled for these covariates, mean fibrinogen and factor VIIc levels remained significantly different, but factor VIIIc levels did not. Different levels of coagulation factors across these samples are probably attributable to differences in environmental factors, especially diet, as well as genetic differences between Caucasians and Japanese. Furthermore, the differences in plasma fibrinogen and factor VIIc levels may explain part of the difference in mortality from cardiovascular disease across these populations.

Adult↗

A new syndrome: angiotensin-converting enzyme dysfunction syndrome: differential diagnosis and pathogenesis--case reports.

The authors previously reported a new syndrome, angiotensin-converting enzyme dysfunction syndrome (ACEDS), which is clinically characterized by mild systemic hypertension, a hypokalemic alkalosis, and hyperreninism with a high concentration of angiotensin-I (ANG-I), a normal angiotensin-II (ANG-II) value, and a normal aldosterone level. In the present study, they investigated the diagnosis and differentiation of diseases concomitant with hyperreninism, such as ACEDS, Bartter's syndrome, familial periodic paralysis, and renovascular hypertension treated with captopril for two months, and discussed the pathogenesis of ACEDS.

Adolescent↗

The trend of coronary heart disease and its risk factors based on epidemiological investigations.

Changes in the incidence of coronary heart disease (CHD) in the past 20 years have been observed in workers in the city and residents in rural areas and the risk factors of CHD studied. Findings show that the incidence of CHD in the residents in rural areas has hardly changed, and remains still low. However, the incidence of CHD in workers in the city has recently shown a tendency to increase. Furthermore, a study of CHD risk factors shows that in the rural areas residents hypertension has a strong influence on the incidence of CHD, while the role of serum total cholesterol is weak. In the city workers a high serum total cholesterol has become a risk factor. Therefore, it appears that the incidence of CHD caused by hypertension and by hypercholesterolemia are mixed in Japan. At present it appears that the influence of hypertension is becoming weaker, while the influence of hypercholesterolemia is becoming stronger. The resulting balance between them may be expressed as a rise and fall of CHD in Japan at present.

Adult↗

Electrophysiological and pathological studies on Creutzfeldt-Jakob disease with retinal involvement.

In a case of Creutzfeldt-Jakob disease in a 59-year-old female, multifocal degeneration from the cerebral cortex through the visual pathway to the retina was detected clinically, electrophysiologically, and pathologically. Visual evoked cortical potentials (VECPs) showed a peculiar huge negative wave in the early stage but the amplitude reduced gradually. The a- and b-waves of the ERG were detectable in the final stage. Dynamic topography of VECPs revealed a delay of excitation in the visual cortex in the early stage, but a complete defect of the cortical potential and diminished reactivity of the brain stem were apparent in the later stage. Pathological findings were the spongy degeneration of the cerebral cortex, demyelination of the white matter and the optic pathway, and the degeneration of the nerve fiber layer and ganglion cell layer of the retina.

Brain↗

Oral zinc therapy normalizes serum uric acid level in Wilson's disease patients.

The authors investigated changes in the serum uric acid (s-UrA) level seen in a Wilson's disease patient who had to undergo oral zinc therapy because of the occurrence of D-penicillamine-induced acute sensitivity reactions, including neutrophilic agranulocytosis, thrombocytopenia, and skin eruptions. Although s-UrA levels were low before oral zinc therapy (mean +/- SD, 1.60 +/- 0.20), they increased (mean +/- SD, 2.63 +/- 0.32) to within normal range (2.8-8.0 mg/dl) after therapy. There were no significant changes in the renal tubular reabsorption of UrA during oral zinc therapy. This therapy also produced an improvement of the decreased cholinesterase (ChE) values usually seen in Wilson's disease. These results suggest that oral zinc therapy can normalize UrA metabolism in Wilson's disease by improving liver dysfunction and increasing UrA synthesis.

Administration, Oral↗

Angiotensin I level and sporadic hypokalemic periodic paralysis.

A patient with secondary (sporadic type) hypokalemic periodic paralysis with relative hypertension had reninism with a high concentration of plasma angiotensin I (ANG-I) but no hyperaldosteronism or high angiotensin II value. Angiotensin-converting enzyme (ACE) activity was usually normal. Results of other hormonal analyses were also normal. However, the glomerular filtration rate and filtration fraction of the kidneys were greatly elevated. Despite severe hypokalemia, the patient's potassium clearance was high. No evidence of distinct hyperplasia of the juxtaglomerular cells was obtained. These results suggest that decreased affinity of ACE to the substrate ANG-I (so-called ACE dysfunction syndrome) produced the reninism and high concentration of plasma ANG-I, and that the latter induced an increase in the glomerular filtration rate of the kidneys with sequential occurrence of secondary hypokalemic periodic paralysis.

Adolescent↗