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Biomedical subjects

K Arai

Publications and source records attributed to K Arai.

At least 361 records · Page 20Linked to original sources
PubMed1996

[Clinico-pathological studies and problems on para-aortic lymph node dissection--D4 dissection].

The advantage or disadvantage of para-aortic lymph node dissection was studied from the viewpoint of clinicopathological findings and their prognosis. No 16 lymph node dissection was performed in 427 cases, and metastasis was observed in 100 (23%). The metastatic rate increased with the depth of cancer. High metastatic rates were seen in type 3 and 4, and in the histologically undifferentiated type. Five year survival rate of patients with No. 16 metastasis (PoHo) was 14%. The n3 (-) group among cases with n4 showed a significantly better outcome than the n3 (+) group. Concerning total gastrectomy with pancreato-splenectomy procedure, blood loss was greater and length of surgery was longer in the D4 group than D2 group. The exudate volume was much higher in D4 and serum albumin significantly decreased in D4 than D2. Almost the same findings were seen in D4 with subtotal gastrectomy. Postoperative complications in D4 group were the same as D2 excluding abscess around pancreatic stump which was higher in D4. In conclusion, D4 dissection does not have an obvious disadvantage for the patients. Randomized clinical trials between D4 and D2 should be done in order to clarify an efficacy of the D4 dissection.

Aorta↗
PubMed1996

[Comparison of the effects of halothane, isoflurane and sevoflurane in the treatment of severe asthmatic attack: a case report].

A 19-year-old woman suffered from a severe asthmatic attack. She did not respond to any of the conventional therapies and eventually lapsed into a state of unconsciousness. We administered isoflurane 1-2% via an endotracheal tube, but, she still required a ventilator. This study was carried out in order to compare the effects of halothane, isoflurane and sevoflurane in the treatment of a severe asthmatic patient. The inhalation of isoflurane, halothane and sevoflurane decreased the airway resistance and systemic vascular resistance in direct relationship to the dosage administered. Because the patient's metabolic rate is low and the occurrence of arrhythmias is rare with isoflurane, we concluded that isoflurane is the best alternative for the patient with asthma.

Adult↗
PubMed1996

[A case of alpha-fetoprotein producing mediastinal germ cell tumor treated with preoperative chemotherapy].

A 20-year-old male was treated with 3 courses of cisplatin combined chemotherapy, with a clinical diagnosis of mediastinal germ cell tumor. Although alpha-fetoprotein (AFP), which alone had been high (893 ng/ml on admission) among tumor markers examined, normalized after chemotherapy, the size of the tumor remained unchanged. The patient underwent total resection of the tumor and has been followed with no evidence of recurrence for 18 months. Pathological examination suggested that the tumor was an immature teratoma with extensive proliferation of fibrous element. Neither other elements of germ cell tumor nor AFP producing cells were found. Preoperative chemotherapy is usually effective in treatment of germ cell tumors. However, it is important to recall that measurements of tumor volume occasionally do not provide information on the tumor's response.

Adult↗
PubMed1996

[The significance of free-type PSA and complex-type PSA in patients with prostatic carcinoma--the characteristics of ACS-PSA method compared with that of Delfia- and Eiken-PSA method].

We studied the clinical significance of free-type prostate specific antigen (PSA) and bound-type PSA in serum of the patients with prostatic carcinoma and benign prostatic hypertrophy. The levels of PSA, gamma-seminoprotein and prostatic acid phosphatase (PAP) in 17 healthy adult males, 20 patients with benign prostatic hypertrophy and 23 patients with prostatic carcinoma were measured by ACS-PSA, Delfia and Eiken-PSA method. The levels of PSA in serum from prostatic carcinoma patients was significantly elevated as compared with that from benign prostatic hypertrophy. Linear regression analysis of the data showed that, although overall correlations were well, different assays gave different PSA concentrations. We have studied the forms of PSA in serum by gel filtration technique and measured PSA levels in each fractions using three methods. Moreover, the characteristics of ACS-PSA method was compared with that of Delfia and Eiken-PSA method. Two peaks of PSA were detected on the elution profiles from three prostatic carcinoma patients sera. Those were estimated complex-type PSA (90kDa) and free-type PSA (30kDa). The complex-type PSA fractions detected by ACS-PSA method were almost identical with that detected by Delfia-PSA method, while free-type PSA fractions detected by ACS-PSA method were greater quantity than those by Delfia and Eiken method. Many factors were contributory to the difference between the assay kits on serum complex-type PSA and free-type PSA levels. The present results suggest that there are some quantitative differences in the immunorecognition of complex-type PSA and free-type PSA between the assay kits.

Adult↗
PubMed1996

[Prognosis of hepatic metastasis from colorectal cancer following arterial infusion chemotherapy--assessment from the percentage of tumor involved area and tumor markers].

Prognosis of hepatic metastasis from colorectal cancer following arterial infusion chemotherapy was studied from the percentage of tumor involved area (PTIA) and tumor markers. The PTIA was calculated by the following formula: sigma S'/ sigma S, with S' as the tumor area and S as the liver area on each CT slice. The PTIA was 0.76 to 31.1%, and the average was 6.84%. As for the correlation between the PTIA and the prognosis, a statistically significant reverse correlation was found in the cases of death (r = -0.455, p < 0.05, n = 22). In the tumor regression effect of NC cases, the 50% survival time was 24.4 months in cases showing a decrease in CEA or CA19-9 and 18.7 months in the cases showing an increase. Prognosis of the former cases was significantly better than that of the latter cases (p < 0.05). Therefore, PTIA and the decrease in CEA or CA19-9 in the cases of hepatic arterial infusion chemotherapy for metastasis from colorectal cancer seemed important factors reflecting prognosis.

Antineoplastic Agents↗
PubMed1996

[Arterial infusion chemotherapy for advanced gastric cancer by sequential MTX/5-FU].

Intra-aortic infusion chemotherapy by low-dose sequential MTX/5-FU was performed in 46 advanced or recurrent gastric cancer patients. Partial response was found in 13 cases (28%). The major lesion of 13 responders was inoperable Borrmann Type 4 gastric cancer in 4 cases, peritoneal recurrence with an abdominal wall in 6 cases, recurrence in the abdominal mass in 2 cases and Douglas pouch in one. The mean duration of effectiveness in the responders was 6.7 months and the median survival time was 19 months after the treatment. The side effects were mainly related to the digestive organs, but the symptoms were mild. Leucopenia of grade 3 and 4 was found in 6 (13%) and thrombocytopenia of grade 2 in one patient. Arterial infusion chemotherapy by sequential MTX/5-FU proved to be effective in poorly differentiated and signet ring cell carcinoma, such as Borrmann type 4 gastric cancer.

Adenocarcinoma↗
PubMed1996

[Transition of renal function after repeated intraperitoneal CDDP administration].

The purpose of this study was to clarify the development of renal dysfunction in 20 patients intraperitoneally administered CDDP after gastrectomy and to determine whether this treatment is tolerable for outpatients. The initial dose of CDDP was 100 mg/body and the successive dose was 40-50 mg/body. Subjects received 96 intraperitoneal CDDP administrations in all, and their total doses ranged 90-400 mg (median: 249 mg). As a result, renal dysfunction up to grade 2 developed in 7 patients (35%) with high frequency, while the rate to all administrations was 12% (12/96). Although the creatinine clearance decreased with the increase of cumulative dose, serum creatinine or BUN did not relate to this change. Therefore, we concluded that this treatment for outpatients could not be recommended because there was nothing to indicate renal function easily or sensitively at the present time.

Adult↗
PubMed1996

[Induced hypertensive chemotherapy with angiotensin-II for liver metastases from gastric cancer].

The theoretical purpose of induced hypertensive chemotherapy used together with injection of Angiotensin-II is to increase the delivery of anticancer drug to the target tumor tissue by increasing blood flow in the tumor. Angiotensin-II (0.1 mg) was dissolved in 50 ml of normal saline, and given through a peripheral vein by a microinfusion pump. When systolic pressure rose to about 140 to 150 mmHg, Mitomycin C (10 to 20 mg/body) was given for 10 minutes via implanted port, whose tip was located in hepatic artery, followed by continuous infusion of 5-FU at 250 mg/day for 5 days. Response could be measured in 4 of all cases (66.7%). CR was found in 2 and PR in 2. Bone metastases or systemic lymph node metastases occurred after a few months in one CR case and one NC case. We concluded that this mode of chemotherapy was a useful measure for the treatment of liver metastases from gastric cancer.

Aged↗
PubMed1996

Urinary pyridinoline and deoxypyridinoline as potential markers of bone metastasis in patients with prostate cancer.

PURPOSE: The levels of probable markers of bony metastatic disease were measured to evaluate their efficacy as predictors of disease and therapeutic outcome. MATERIALS AND METHODS: Urinary pyridinoline, urinary deoxypyridinoline, serum alkaline phosphatase and serum osteocalcin were measured in patients with benign prostatic hyperplasia, clinically localized prostate cancer and prostate cancer with bone metastases. Also, urinary pyridinoline and deoxypyridinoline were compared in 2 groups of patients with metastatic prostate cancer of the bone who demonstrated progression or positive response to treatment. Urinary pyridinoline and deoxypyridinoline were determined by high performance liquid chromatography and were normalized to urinary creatinine. RESULTS: Levels of pyridinoline and deoxypyridinoline in urine, and the level of alkaline phosphatase in serum from patients with bone metastatic prostate cancer were significantly greater than levels in patients with benign prostatic hyperplasia or localized prostate cancer. Serum osteocalcin levels failed to separate the 3 groups. Serial measurement of urinary pyridinoline and deoxypyridinoline was correlated with a positive response to treatment (decreased) and with clinical progression of disease (increased) before detection of new bone lesions by bone scintigraphy. CONCLUSIONS: Measurement of urinary pyridinoline and deoxypyridinoline may provide a useful marker of prostate cancer metastatic to bone and may be useful in monitoring the response to treatment.

Aged↗
PubMed1996

[Changes in gastric intramucosal pH and hepato-splanchnic oxygen extraction ratio after heart surgery].

The Do2/VO2 balance of splanchnic organs after heart surgery was evaluated using two different methods; the measurement of hepato-splanchnic oxygen extraction ratio (OERspl) and gastric intramucosal pH (pHi) employing a hepatic venous catheter and a gastric tonometric catheter. Systemic oxygen extraction ratio was within normal ranges during the 24 hours of the experiment, but pHi decreased and OERspl increased significantly at 6 hours after admission to the ICU. Both pHi and OERspl returned gradually to normal levels after 24 hours. We conclude that a period of 24 hours is required to restore sufficient blood flow in the visceral organs to meet oxygen demand and that the pHi reflects the splanchnic DO2/VO2 balance as well as OERspl.

Adult↗
PubMed1996

[Pseudohypoaldosteronism].

Mineralocorticoid resistance results from inability of aldosterone to exert its effect on its target tissues. The syndrome is associated with salt loss, hypotension and hyperkalemic acidosis. We have cloned and sequenced the cDNA of the mineralocorticoid receptor of five sporadic cases with this syndrome but have found no mutations of pathophysiological significance, which would explain the resistance of these patients to aldosterone. In all of these patients, we also examined 0.9 kb of the 5' regulatory region and the first untranslated exon of the mineralocorticoid receptor gene, without detecting any abnormalities. We are now studying the subunits of the amiloride-sensitive sodium channel (ENaC), which are in the postreceptor pathway of aldosterone action, in this disease.

Aldosterone↗
PubMed1996

[Studies on changes in the ratio of free to total PSA after endocrine treatment of prostate carcinoma].

The post-diagnostic changes in the free to total PSA ratio in the serum of patients with prostate carcinoma, after the initiation of endocrine treatment were examined. Two-week pretreatment with either chlormadinone acetate (100 mg/day) or flutamide (375 ng/day) was administered orally to 14 patients with newly diagnosed advanced prostate carcinoma (clinical stage was C in 2, Dl in 1 and D2 in 11). Then the LH-RH analogue was injected. Total and free PSA in the serum of these patients were measured every 4 weeks by the Ab bead PSA (Eiken) and the recently developed assay for free PSA by Eiken, respectively. The follow-up period ranged from 3 to 9 months with a median of 6 months. Levels of both total and free PSAs decreased significantly following the endocrine treatment, while free to total PSA ratio at 4 to 16 weeks after the start of LH-RH analogue was increased significantly compared to the pretreatment level (p < 0.05). These findings suggest that the rate of decrease of complex PSA during the first 4 months after the beginning of treatment may exceed that of free PSA in the serum of patients with advanced prostate carcinoma initially treated with endocrine therapy.

Aged↗
PubMed1996

[Eosinophilic pneumonia presenting as a mass shadow].

A 35-year-old man underwent routine chest roentgenography and a mass shadow was seen in the left lung field. Examination of a transbronchial lung biopsy specimen revealed that many eosinophils had infiltrated under the bronchial mucosa and into the alveolar septum. The total serum IgE concentration was high, and skin tests with Aspergillus antigen and serum precipitating antibodies against Aspergillus were positive. The mass lesion disappeared without any therapy, and a cystic lesion remained. Mediators released from eosinophils were thought to have damaged the lung tissue. We should have administrated corticosteroids as soon as possible.

Adult↗
PubMed1995

Receptors for melanocortin peptides in the hypothalamic-pituitary-adrenal axis and skin.

The syndromes of hereditary IGD and triple A syndrome are potentially life threatening and severely disabling diseases. Clinical awareness of these syndromes is of considerable prognostic and therapeutic importance. The defects in the ACTH receptor causing IGD help illuminate the mechanisms of ligand binding and signal transduction by this receptor. Identification of the molecular defect(s) responsible for IGD cases with a normal ACTH receptor structural gene and for the triple A syndrome remains a challenge, which will hopefully eventually provide further insight into the mechanisms of adrenocortical function. The cloning of the melanocortin receptors has been a giant step towards a better insight into the physiological role of the POMC-derived peptides. It is now becoming apparent that the differential processing of POMC in the brain, the pituitary, and peripheral tissues, yielding a number of different biologically active melanocortin peptides, combined with the distinct tissue distribution and pharmacological profile of the melanocortin receptors will help elucidate the molecular basis of these functions.

Adrenal Cortex Neoplasms↗
PubMed1995

A precursor form of human kidney gamma-glutamyl transferase in normal and cancerous tissues, and its possible post-translational modification.

We have found three molecular forms of human gamma-glutamyl transferase (GGT) in normal and renal cell carcinomatous tissues, and also have reported the marked differences in the sugar chains of GGTs between normal and cancerous tissues by serial lectin affinity chromatographies. In this study, the peptide maps of three purified GGTs (79 kDa, 50 kDa and 25 kDa) obtained by lysylendopeptidase digestion, the subcellular localization of GGTs, and the sugar chains of GGTs were compared between normal and cancerous tissues. According to the results, the total peptide bands of the digested 79 kDa component represented the sum of those of the digested 50 and 25 kDa components on 12.5% SDS-PAGE. In addition, C-terminal and N-terminal amino-acid sequences of the 79 kDa protein were the same as the sequences of light and heavy subunits, respectively, suggesting that the 79 kDa component is of the precursor form of the 50 kDa mature heavy and 25 kDa light subunits, respectively. On the other hand, the GGT activity in renal cell carcinomatous tissues was significantly increased in the microsomal fraction and decreased in the soluble fraction compared with that of normal tissues. Meanwhile, the sugar moiety of GGTs in the respective subcellular fractions was obviously different between normal and cancerous tissues. In particular, a reduced multiantennary complex type sugar chain and an elevated high-mannose or hybrid-type sugar chain in the microsomal fraction were observed in the GGT in cancerous tissues.

Amino Acid Sequence↗
PubMed1995

Long-term production of human monoclonal antibodies by human-mouse heterohybridomas.

Production of monoclonal antibodies (mAbs) by fused somatic cells was first developed by Köhler and Milstein two decades ago, but its utilization for the production of human mAbs, particularly those bearing kappa chains, has been difficult because heterohybridomas formed with mouse myeloma cells are unstable and tend to lose certain of their human chromosomes. We have stabilized two such heterohybridomas over one year period and induced the production of kappa-bearing and lambda-bearing human mAb, respectively. Increased productivity was achieved by adding the Na+K(+)-ATPase inhibitor, ouabain and a cell mitosis inhibitor, cytochalasin B, to the cell culture media.

Animals↗
PubMed1995

Serial lectin affinity chromatography demonstrates altered asparagine-linked sugar chain structures of gamma-glutamyltransferase in human renal cell carcinoma.

Differences between human renal cortex and human renal cell carcinoma (RCC) in asparagine (Asn)-linked sugar chain structures of gamma-glutamyltransferase (GGT) were investigated by using a serial lectin affinity chromatographic technique. The relative amounts of GGT which passed through the concanavalin A (Con A) column but bound to the phytohaemagglutinin E column, were significantly decreased in RCC, but there were significant increases in the relative amounts of GGT which bound weakly to the Con A column and passed through the pea lectin (PSA) column, and bound strongly to the Con A column and bound to the wheat germ agglutinin column in RCC compared with those of the normal renal cortex. A significant correlation was observed in RCC between nuclear grade and relative amount of GGT which bound weakly to the Con A column and passed through the PSA column. The findings indicate that Asn-linked sugar chain structures are altered in RCC and suggest that studies of qualitative differences of sugar chain structures of GGT might lead to a useful diagnostic tool for human RCC.

Adult↗