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Biomedical subjects

K Hara

Publications and source records attributed to K Hara.

At least 379 records · Page 21Linked to original sources
PubMed1996

Concentrations of trichloroethylene and its metabolites in blood and urine after acute poisoning by ingestion.

A 58-year-old man fell into a trichloroethylene reservoir bath head first, during a maintenance degreasing bath and accidentally ingested the solvent. Although he showed deep coma, chemical burns and pneumonia on admission, these symptoms gradually subsided. The concentrations of trichloroethylene (TRI) and its metabolites, trichloroethanol (TCE) and trichloroacetic acid (TCA) in blood and urine were measured during hospitalization. Eight hours after the accident, the concentrations of TRI and its metabolites in serum were 31.4 micrograms/ml TRI, 16.5 micrograms/ml TCE and 79.5 micrograms/ml TCA. The serum TRI concentration decreased to 4.3 micrograms/ml on the following day. Elimination of TCE and TCA from serum occurred biphasically, the estimated half-lives of each metabolites being about 52.6 and 50.4 h in an initial fast phase and 268.3 and 277.2 h in a subsequent slow phase, respectively. Urinary TRI excretion persisted for the first 2 days. The urinary TCE and TCA excretions were longer than that of TRI with a biphasic decrease and the total amount of TCE excreted during the first 2 days was about two times that of TCA. The half-life of urinary TCE excretion (t1/2 25.7 h) was shorter than that of TCA (t1/2 52.1 h) in the fast phase but did no difference during the slow phase, with each half-time being about 166.3 h. The kinetics of TRI metabolites in blood and urine in this case were in slight agreement with the results following inhalation exposure previously reported in the literature.

Accidents, Home↗
PubMed1996

Comparison of aortic valve replacement and percutaneous aortic balloon valvuloplasty for elderly patients with aortic stenosis.

The outcome of aortic balloon valvuloplasty (ABV) was compared with that of aortic valve replacement (AVR) in aortic stenosis (AS) patients more than 60 years old. The indications for ABV included low respiratory and renal function, cancer, the patient's refusal of surgery, and low daily activity. Twenty six patients underwent AVR and 13 underwent ABV. Initially, the AVR group was younger and more symptomatic than the ABV group. Two perioperative deaths occurred in the AVR group, while there were none in the ABV group. Twenty-four AVR patients and 12 ABV patients had a successful outcome, with remarkable pressure gradient reduction in both groups. In the follow-up, only 1 death and no cardiac events were detected in the AVR group (mean follow-up of 27 months), whereas 3 deaths, 6 heart failures, 2 repeated ABV, and 4 AVR were seen in the ABV group (mean follow-up of 10 months). The data showed that ABV was safer than AVR, but a higher rate of restenosis limited its efficacy. In the ABV group, a higher ratio of balloon size to aortic diameter correlated with longer event-free survival. We concluded that for elderly AS patients, ABV should be used only in those with high surgical risk as a palliative therapy or a bridge therapy to AVR, and AVR should be primarily recommended under rigid evaluation of the patient's physical status.

Aged↗
PubMed1996

Long-term outcome of percutaneous transluminal coronary angioplasty and coronary bypass surgery for multivessel coronary artery disease.

We studied the short- and long-term outcomes of 97 patients treated with percutaneous transluminal coronary angioplasty (PTCA) and 72 patients treated with coronary artery bypass graft surgery (CABG) for multivessel coronary artery disease in a single hospital in 1989. Patients treated with CABG had a higher angina class, a higher incidence of diabetes mellitus and a greater extent of the disease. Complete revascularization was achieved in 61 patients (85%) with CABG and in 45 patients (46%) with PTCA (p < 0.001). Initial success of PTCA and CABG was obtained in 95% and 94% of the patients with PTCA and CABG, respectively. Actuarial survival rates at 5 years were similar (96% in the PTCA group; 94% in the CABG group). Fewer patients suffered from cardiac death or myocardial infarction in the CABG group than in the PTCA group, but this difference was not significant. The rate of survival free from death, myocardial infarction, CABG and repeat PTCA, was significantly higher in the CABG group than in the PTCA group (85% vs 48%; p < 0.001). These results suggest that CABG provides a favorable long-term outcome in patients with multivessel coronary artery disease and that PTCA provides a similar outcome in these patients when applied to suitable lesions, although more patients who undergo PTCA require repeat procedures.

Aged↗
PubMed1996

Noninvasive assessment of right heart function by 81mKr equilibrium radionuclide ventriculography in chronic pulmonary diseases.

Noninvasive multigated equilibrium radionuclide ventriculography with krypton-81m (81mKr) was used to assess right heart relaxation in patients with chronic pulmonary diseases (CPD). The subjects consisted of 30 patients with CPD and 8 patients free of cardiopulmonary diseases admitted to our department. A region of interest (ROI) was selected on both the right atrium (RA) and right ventricle (RV). A time activity curve was obtained for each ROI. As a diastolic index of the right heart performance, the right atrial early emptying rate (RAER) was obtained from the right atrial time activity curve, while the right ventricular rapid filling rate (RVRFR) was obtained from the right ventricular time activity curve. The mean RAER was significantly lower in CPD patients compared with the control (CPD, 9.5 +/- 4.5; control, 16 +/- 3.4%/100 ms). Similarly, the mean RVRFR was significantly lower in CPD patients compared with the control (CPD, 27.3 +/- 9.9; control, 34 +/- 8.5%/100 ms). A strong negative correlation was noted between the mean pulmonary arterial pressure (mPAP) and RAER (r = -0.77; p < 0.001) and between the mPAP and the RVRFR (r = -0.63; p < 0.001). Our results suggest that RAER and RVRFR measured by 81mKr are clinically useful in the noninvasive assessment of right heart relaxation in patients with CPD.

Adult↗
PubMed1996

Impairment of antioxidants in colonic epithelial cells isolated from trinitrobenzene sulphonic acid-induced colitis rats. Protective effect of rebamipide.

BACKGROUND: The functional status of glutathione, its related enzymes, and Cu,Zn-superoxide dismutase in colonocytes isolated from rats with trinitrobenzene sulphonic acid-induced colitis, and the effect of rebamipide (a scavenger) on these antioxidants and on colitis, were studied. METHODS: The rats were treated with rebamipide, killed on day 14, and compared with controls. Glutathione and enzymatic activities were spectrophotometrically estimated. The effect of rebamipide on colitis was also assessed histologically and by myeloperoxidase activity. RESULTS: In controls the concentration of glutathione and the activities of glutathione S-transferase and Cu,Zn-superoxide dismutase were decreased, but that of glutathione peroxidase was increased. Rebamipide prevented the impairment of these enzymes, restored the concentration of glutathione, and attenuated (low damage scores and myeloperoxidase activity) the severity of the colitis. CONCLUSIONS: These features suggest that the impairment of antioxidants is closely related to the development of the inflammatory lesions, and rebamipide has a beneficial effect on experimental colitis.

Alanine↗
PubMed1996

Detection of cytokine mRNA-expressing cells in peripheral blood of patients with IgA nephropathy using non-radioactive in situ hybridization.

IgA nephropathy (IgA-N) is considered to be an immune-mediated disorder and several immunological abnormalities have been observed. In the present study, we optimized non-radioactive in situ hybridization and applied this technique to evaluate the degree of expression of various cytokine mRNAs in peripheral blood mononuclear cells (PBMC) taken from patients with IgA-N on cytospin preparation. Using this method, together with image analysis, we examined the expression of mRNA in cells which secrete cytokines, such as IL-2, interferon-gamma (IFN-gamma), IL-4, IL-5 and IL-6. The expression of these mRNAs was clearly observed in monocytes and lymphocytes at a single-cell level. Compared with healthy adults, the expression of IL-4 mRNA, IL-5 mRNA and IL-6 mRNA, but not IL-2 mRNA or IFN-gamma mRNA, was significantly enhanced. Our results indicate that non-radioactive in situ hybridization method is a powerful technique for analysis of cytokine mRNAs in PBMC at a cellular level. Our results also suggest that mRNA expression of IL-4, IL-5 and IL-6, produced by Th2 cells, is increased in patients with IgA-N. The abnormal regulatory process involved in cytokine expression may play an important immunopathologic role in IgA-N.

Adult↗
PubMed1996

[Three cases of hyperkalemia after reperfusion associated with revascularization for massive acute arterial occlusions].

We encountered three cases of hyperkalemia after the reperfusion of ischemic limbs associated with revascularization surgery for acute arterial occlusions. Two patients died because of uncontrollable hyperkalemia in spite of intravenous insulin and forced diuresis. Careful attention should be paid to hyperkalemia and metabolic acidosis for several hours after the reperfusion in cases of ischemia and/or extensive ischemia of long duration. The aggressive prophylaxis and treatment for MNMS are vital to the anesthetic management of revascularization for acute arterial occlusions.

Acute Disease↗
PubMed1996

Noninvasive evaluation of malignancy of brain tumors with proton MR spectroscopy.

PURPOSE: To test clinical proton MR spectroscopy as a noninvasive method for predicting tumor malignancy. METHODS: Water-suppressed single-voxel point resolved spectroscopy in the frontal white matter of 17 healthy volunteers and 25 patients with brain tumors yielded spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cre), and lactate. These peak intensities were semiquantitated as a ratio to that of the external reference. The validity of the semiquantitation was first evaluated through phantom and volunteer experiments. RESULTS: The variation in measurements of the designated region in the volunteers was less than 10%. Normal ranges of NAA/reference, Cho/reference, and Cre/reference were 3.59 +/- 0.68, 1.96 +/- 0.66, and 1.53 +/- 0.64 (mean +/- SD), respectively. In 17 gliomas, the Cho/reference value in high-grade gliomas was significantly higher than in low-grade gliomas. Levels of NAA/reference were also significantly different in low-grade and high-grade malignancy. In eight meningiomas (four newly diagnosed and four recurrent), the level of Cho/reference was significantly higher in recurrent meningiomas than in normal white matter or in newly diagnosed meningiomas. CONCLUSIONS: Higher grades of brain tumors in this study were associated with higher Cho/reference and lower NAA/reference values. These results suggest that clinical proton MR spectroscopy may help predict tumor malignancy.

Adolescent↗
PubMed1996

[Ten-year follow-up of percutaneous transluminal coronary angioplasty].

The long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA) was evaluated in 124 patients who underwent PTCA between October 1982 and June 1985. Seventy-six patients had their proximal coronary arteries completely revascularized by PTCA (including repeat PTCA) and follow-up angiography showed the vessels were patent 3 to 6 months after the last intervention (group A). The other 48 patients showed incomplete revascularization (group B). The 10-year event-free survival rates from cardiac death and non-fatal myocardial infarction were 89.7% in group A and 93.5% in group B, respectively. Survival rates free from cardiac death, myocardial infarction, coronary bypass surgery, and repeat angioplasty for new lesions were 82.5% and 62.7%, respectively (p < 0.001). Ninety-nine percent of patients in group A and 79.5% of patients in group B were asymptomatic at the follow-up. Coronary angiography was performed in a total of 22 patients (19 patients in group A, 3 in group B). In group A, myocardial infarction occurred in one patient 8 years after PTCA. The infarct-related lesion seemed to be the same as the previous PTCA lesion. Although the other 20 PTCA lesions were all patent without progression, nine significant and new lesions were found on the coronary angiograms. Successfully revascularized vessels remained patent for over 10 years, but new lesions sometimes occur in segments other than the previously treated segment.

Aged↗
PubMed1996

[A clinicopathological study of adenosquamous carcinoma of the lung].

We studied, clinicopathologically, 34 cases of adenosquamous carcinoma (ASC) treated in our institution over the last 30 years. Its incidence was 2.3% of all primary lung cancers. Following findings were characteristics to this type of lung cancer, male dominant, old age, heavy smoker, comparatively large diameter, peripheral location, and normal level of tumor makers. The 5-year survival rates were 35.0% for ASC, 38.1% for squamous cell carcinoma (SCC), and 50.2% for adenocarcinoma (AC). The component of SCC was predominant or equal to that of AC in 27 (79.4%) ASC cases. The degree of cell differentiation was moderate and both SCC and AC components showed the same degree of cell differentiation in most cases. Lymph node metastasis was seen in 15 (48.4%) cases.

Aged↗
PubMed1996

[Clinical significance of serum cholinesterase concentrations determined by enzyme-linked immunosorbent assay (ELISA)].

We developed a sensitive enzyme-linked immunosorbent assay (ELISA) for measurement of the protein mass of serum cholinesterase (CHE). In our ELISA system, a combination of a monoclonal antibody (a capture antibody) and an anti-CHE rabbit antibody (a second antibody) against CHE were used for the specific determination of CHE. The formed antigen-antibody complexes were detected with an alkaline phosphatase-labeled anti-rabbit IgG antibody. Using this ELISA system, we investigated for a possible relationship between the protein mass value and the catalytic activity of serum CHE in three patients groups with different clinical findings: control subjects selected randomly from outpatients (Group A), individuals with a low serum CHE activity including genetic variants (Group B) and patients with sarin poisoning (Group C). The CHE mass value correlated closely with the CHE activity in Group A, as previously reported. In Group B, a less significant correlation than in Group A was observed because both the CHE mass value and the CHE activity were disturbed at relatively lower levels. However, no discrepant cases were observed. On the other hand, in Group C, patients with serious sarin poisoning showed significant discrepancies between the mass value and activity of CHE before medical treatments, indicating that the inhalation of sarin did not affect the protein mass level but did affect the activity of serum CHE. As the patients recovered during the treatments, their CHE activities increased to the levels expected from the regression curve obtained with Group A, whereas the mass values were almost unchanged. In conclusion, protein mass determination of serum CHE provides valuable information concerning the target value of the serum CHE activity for the treatment of patients with organophosphate insecticide poisoning as well as for investigating the specific activity of genetic variants of serum CHE.

Animals↗
PubMed1996

[Adult pneumococcal meningitis complicated by cerebral infarction: a case report].

We describe a 36-year-old man with pneumococcal meningitis who suddenly showed a left central type facial palsy and left hemiparesis. Magnetic resonance imaging (MRI) revealed a low intensity area in the posterior limb and genu of the right internal capsule to caudate nucleus in T1-weighted images and a high intensity area in T2-weighted images. We surmised vasculitis as the cause of cerebral infarction, because steroid treatment was effective.

Adult↗
PubMed1996

[Clinical evaluation of sulbactam/cefoperazone for lower respiratory tract infections. Correlation between the efficacy of sulbactam/cefoperazone and beta-lactamase].

The efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) were evaluated in 42 patients with respiratory tract infections, including pneumonia (29 patients) and lower respiratory tract infections (5 patients). Overall clinical efficacy rates (excellent + good) were 79% in pneumonia and 80% in respiratory tract infections in 34 patients evaluated for clinical efficacy. It was excellent that the clinical efficacy rate was 92% in mild and moderate pneumonia. Pathogens isolated from sputa were 31 strains, including 8 strains of Pseudomonas aeruginosa, 7 of Streptococcus pneumoniae, 3 of Staphylococcus aureus and 3 of Haemophilus influenzae. Since the isolates were eradicated in 18 strains, replaced in 3, unchanged in 2 and unknown in 8, the overall eradication rate was 91%. The eradication rates were 89% in beta-lactamase producing strains and 100% in beta-lactamase positive sputum, and excellent or good in 19 (83%) of 23 patients with beta-lactamase negative sputum. The eradication rate was 88% in 5 patients with beta-lactamase positive sputum. One patient experienced a moderate rash. Abnormal laboratory test values were observed in 10 patients (26.3%), but these abnormalities were mild and transient. These results suggested that SBT/CPZ was effective and safe for the treatment of respiratory tract infections caused by beta-lactamase producing as well as beta-lactamase non-producing bacteria.

Aged↗
PubMed1996

Relationship between peptidase activity from Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus and attachment loss.

As a diagnostic test, "Periocheck" can detect the N-carbobenzoxyglycyl-glycy-arginyl peptidase that is produced by Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus. The aim of this study was to clarify the relationship between peptidase activity and attachment loss. After Phase 1 and surgical therapy, a total of 111 sites from 47 adult periodontitis patients were divided into four groups according to peptidase activity (trypsin unit, TU): A, < 0.1 TU; B, 0.1-0.2 TU; C and D > or = 0.2 TU. All sites in groups A, B, and C were untreated, whereas both subgingival 3% hydrogen peroxide irrigation and 2% minocycline application were undertaken every 45 days throughout the experiment in group D. All subjects were recalled at 3-month intervals. Peptidase activity and clinical assessments were measured for the 18-month period. Significant attachment loss associated with high values of the peptidase activity was found through the experimental period in groups B and C. In contrast, no obvious change of attachment loss was found in groups A and D following low peptidase activity at 6, 12, and 18 months. The mean attachment loss throughout the 18-month period was 0.22 mm in group A, 1.04 mm in group B, 1.53 mm in group C, and -0.35 mm in group D. Probing depth and percentages of bleeding on probing significantly increased in group C, whereas they decreased in group D. This peptidase test displayed a 77.8% sensitivity and 68.6% specificity regarding the detection of > or = 1 mm attachment loss with a cut-off value of 0.1 TU. Multiple linear regression analysis showed a close relationship between peptidase activity and predictable attachment loss within a 12-month period. These findings suggest that this peptidase test is useful in identifying the risk sites for predictable attachment loss.

Bacterial Proteins↗
PubMed1996

The evaluation of mammographic microcalcification as biological malignancy in breast cancer.

The biological significance of mammographic microcalcification (MM) was investigated in breast cancer. 119 (39.8%) had evidence of microcalcification, while 170 were negative. Fifty-three (44.5%) of those with MM had nodal metastases. There is no significant correlation between MM and nodal metastases. Five-year survival of patients with MM was significantly shorter than that without. This suggests that MM may be of biological significance in breast cancer, and thereby attention should to be paid to assessing breast cancer patients with mammographic microcalcification.

Adult↗