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Biomedical subjects

S Sakurai

Publications and source records attributed to S Sakurai.

At least 145 records · Page 8Linked to original sources
PubMed1996

[Video-assisted bedside pleuroscopy under local anesthesia: use of a rigid cystoureteroscope in patients with undiagnosed pleural effusion].

Up to 20% of pleural effusions remain undiagnosed despite history-taking, physical examination, thoracentesis, and percutaneous closed pleural biopsy. The next diagnostic procedure used is often thoracoscopy under general anesthesia in an operating room. We report a technique for beside pleuroscopy and pleural biopsy that can be done without assistance of surgeons. We performed video-assisted pleuroscopy with a rigid cysto-ureteroscope in seven patients with pleural effusion that remained undiagnosed despite extensive clinical evaluation. A sterile 19.8 Fr. rigid cysto-ureteroscope was placed into the pleural space under local anesthesia. Pneumothorax was induced to enhance visualization of the surfaces. Forceps-biopsy specimens were taken of suspicious lesions on the parietal pleural. In three patients the pleural surface appeared smooth and in two the parietal pleural surface was studded. A localized coin-like lesion was seen in one patient, and extensive fibrinogenic adhesions and diffuse opacity of the parietal pleura was seen in another. Using this bedside procedure, we diagnosed pleural tuberculosis in three patients and pleural metastases of adenocarcinoma in one. When done under local anesthesia with a rigid cyst-ureteroscopy, video-assisted pleuroscopy can be a safe and useful diagnostic aid in patients with undiagnosed pleural effusion.

Anesthesia, Local↗
PubMed1995

Gastric adenoma-carcinoma sequence with special reference to p53 and Ki-ras gene alterations.

With the aim of detecting the timing of p53 and Ki-ras gene alterations in the gastric adenoma-carcinoma sequence, 19 early gastric adenocarcinomas arising from adenomas were studied. Immunohistochemically, 5 adenocarcinomas were positive for p53; 3 focally and 2 diffusely. The p53 point mutations were detected in a focal area with p53 immunoreactivity in 2 of the 5 p53-positive adenocarcinomas. This indicated that p53 point mutations may play a less crucial part in malignant conversion of adenoma to adenocarcinoma in the stomach than in the colon. No Ki-ras gene mutations at codons 12 and 13 were detected in any lesion. These results suggest that the adenoma-carcinoma sequence in the stomach has a different mechanism from that in the colon.

Adenocarcinoma↗
PubMed1995

Association of a restriction fragment length polymorphism in the alcohol dehydrogenase 2 gene with Japanese alcoholic liver cirrhosis.

BACKGROUND/AIMS: The association of ADH2 polymorphisms with alcoholic liver cirrhosis has not been clearly demonstrated. METHODS: We investigated the association of two alleles in the ADH2 gene marked by restriction fragment length polymorphisms in patients with alcoholic liver cirrhosis. The ADH2 restriction fragment polymorphisms with Mae III were determined using the polymerase chain reaction on lymphocytes from 76 male Japanese alcoholics (non-cirrhotic patients; 34 cases, cirrhotic patients; 42 cases) and 60 healthy male subjects. RESULTS: The frequency of the ADH2(1)/ADH2(1) genotype was significantly higher in the alcoholics than in the healthy subjects p < 0.001). In the alcoholics, the genotype ADH2(2)/ADH2(2) was significantly more prevalent in the cirrhotic group than in the non-cirrhotic group (p < 0.05). CONCLUSIONS: These results suggest that the Mae III polymorphisms of the ADH2 gene may be associated not only with susceptibility to alcoholic liver cirrhosis, but also with the development of alcoholism in Japanese patients.

Adult↗
PubMed1995

Kinematic and kinetic comparison of downhill and level walking.

Kinematic and kinetic data were collected from 12 healthy subjects whilst they performed both downhill and level walking at a controlled cadence. A ramp of 6 m length and a gradient of -19% was used for downhill walking and this incorporated the same force platform that was used for level walking. Planar net joint moments and mechanical power at the ankle, knee, and hip joints were calculated for the sagittal view using force platform and video records based on standard inverse dynamics procedures. On the basis of differences in ankle, knee, and hip joint kinematics the ankle joint was seen to compensate for the gradient at push off and during the swing, the knee joint from early stance through until early swing phase, and the hip joint from early swing through until the early stance phase. The major differences in joint moments and muscle mechanical power were seen in the knee and ankle joint. Whereas peak moments and muscle power were much higher for downhill walking in the knee joint, these measures were significantly smaller at the ankle joint. Hip joint moments and muscle power estimates were only slightly larger for downhill walking. These data explain well the problems that patients with patellofemoral pathology and anterior cruciate ligament (ACL) deficiency encounter with downhill walking, and the muscle soreness experienced by mountain trekkers. RELEVANCE: Biomechanical estimates of musculoskeletal loadings in gait are invariably derived from laboratory studies of walking over a level surface. In this study comparisons were made between downhill and level walking in order to appreciate more fully the increased loadings on the lower extremity under more stressful but not atypical conditions. The data so derived provide the necessary basis for the prediction of loadings on specific muscle/joint structures and can serve as a foundation for exercise prescription with patients recovering from injury or orthopaedic surgery.

Journal Article↗
PubMed1995

Effects of systolic anterior motion of the mitral valve on haemodynamics. Evaluation by a direct method.

We evaluated the effects of systolic anterior motion systolic anterior motion of the mitral valve on cardiac haemodynamics. Seven adult mongrel dogs in which systolic anterior motion-septal contact was observed after dobutamine administration were used. To exclude the effects of left ventricular function and morphology, a stone removal basket catheter was placed in the left ventricular outflow tract, and haemodynamics were compared with the basket closed and opened. The basket was opened five times in three dogs not showing systolic anterior motion-septal contact, but the basket itself did not effect the haemodynamics. In the seven dogs that showed systolic anterior motion-septal contact without left ventricular hypertrophy, the basket was opened a total of 33 times in the presence of various degrees of systolic anterior motion-septal contact. After opening the basket, systolic anterior motion was reduced echocardiographically, and significant (P<0.01) changes were observed in the left ventricle-aorta pressure gradient (from 68 +/- 22 to 25 +/- 15 mm Hg), the systolic ejection period (from 146 +/- 19 to 135 +/- 16 ms), and the stroke volume (SV; from 9.4 +/- 2.9 to 10.1 +/- 3.3 ml). After basket inflation, aortic pressure and aortic flow waveforms changed but the peak pressure and flow velocity did not. The temporal distribution of left ventricular ejection also definitely changed after the basket was opened. No changes were observed in the peak dp/dt, peak negative dp/dt, time constant, left ventricular end-diastolic pressure, or left atrial pressure. These observations in this animal model of systolic anterior motion without left ventricular hypertrophy suggest that: (1) there is no potential for generation of an intra-cavity gradient in the absence of systolic anterior motion of the mitral valve, so that (2) systolic anterior motion narrowed the left ventricular outflow tract and, consequently, produced the systolic ejection period, and affected the left ventricular ejection dynamics, and that (3) the basket catheter is useful because it allows these assessments in the same heart with a nearly fixed left ventricular contractility, at least in our animal model.

Animals↗
PubMed1995

Superantigenic exotoxin production by isolates of Staphylococcus aureus from the Kawasaki syndrome patients and age-matched control children.

Nineteen strains of Staphylococcus aureus were isolated from the throat or the tooth surfaces of 19 cases amongst 127 patients with Kawasaki syndrome (KS) during the acute phases and 11 S. aureus isolates were obtained from five of 17 diseased controls and six healthy controls. The production of exotoxins, particularly superantigenic toxic shock syndrome toxin-1 (TSST-1), coagulase serotype, pigment production, haemolytic activity and tryptophan auxotrophy of these isolates were compared. Among 10 KS S. aureus strains isolated in 1990-1991, five (50%) secreted TSST-1, a higher frequency than two (18%) of 11 control isolates. In contrast, none of the nine KS strains collected in 1984 produced TSST-1. Four of five TSST-1-secreting KS strains produced white or white to golden pigmentation, whereas the two control strains capable of TSST-1 production formed golden colonies. There were no noticeable differences between S. aureus strains from KS patients and control children in the production of staphylococcal exotoxins A-E, coagulase serotype, haemolysis of sheep erythrocytes and tryptophan auxotrophy. The pathological or aetiological role of a new TSST-1-secreting S. aureus clone in patients with KS was not confirmed.

Bacterial Toxins↗
PubMed1995

Rapid identification by polymerase chain reaction of staphylococcal exfoliative toxin serotype A and B genes.

A new system was designed to detect staphylococcal exfoliative toxin A (ETA) and B (ETB) genes by the polymerase chain reaction (PCR). The primer pairs for the ETA gene (eta) were 20 and 20-mer, and its PCR product was a 741-bp eta fragment, while the primer pairs for the ETB gene (etb) were also 20 and 20-mer, and its PCR product was a 629-bp etb fragment. When these primers were simultaneously used in the PCR, the two types of ET were clearly detected as two bands in an ETA and ETB double-producer using only one colony within 3 hr. We examined 66 strains of Staphylococcus aureus isolated from patients with staphylococcal scalded skin syndrome (SSSS) and compared the results obtained by ELISA and PCR. The same results were obtained for 56 of the strains, i.e., 30 strains were ETA producers, 20 strains were ETB producers, and 6 strains were double-producers. However, positive results were obtained for 5 of the 10 non-ET-producing strains. Two of these strains were judged by PCR as ETA producers and three as ETB producers. Thus, PCR is very sensitive and rapid in detecting ETA and ETB gene fragments in colonies isolated from patients with SSSS.

Base Sequence↗
PubMed1995

Prognosis of epilepsy withdrawn from antiepileptic drugs.

Antiepileptic drugs (AED) were discontinued in 55 epileptics who had been free from seizures treated with AED, in accordance with the following criteria and procedures. (i) A reduction in AED commences when patients have been free from seizures for at least 2 years and epileptic discharges have also disappeared in repeated electroencephalogram (EEG) recordings during that period. (ii) AED are gradually reduced if no relapse is seen in clinical seizures and epileptic discharges in EEG. (iii) As a rule at least 2 years are required as the interval from the onset of a reduction to the withdrawal of AED. Forty-three patients were followed up by a questionnaire and/or by telephone and the follow-up period from the withdrawal of AED to the survey ranged from 0.9 to 8.8 years; in 38 patients (88.4%) the period was longer than 2 years. No relapse of seizures was found in any of the 43 patients. The severity of epilepsy judged by the total number of frequency of seizures, the presence of neuropsychiatric complications, the combination of different types of seizures, and the duration of epilepsy from the seizure onset to the last seizure appeared not to be risk factors for the recurrence of seizure. Normal EEG was, however, considered to be an important prerequisite for a good prognosis.

Adolescent↗
PubMed1995

Clinicopathological and molecular biological studies of gastric adenomas with special reference to p53 abnormality.

To determine the role and timing of p53 alteration in gastric adenomas, sequentially biopsied gastric adenomas were immunohistochemically studied for p53 overexpression. From a total of 29 cases, 32 adenomas were endoscopically followed up more than 1 year and used in this study. Immunohistochemically, p53 positivity with diffuse or focal staining was observed in 12 of 32 adenomas. During the follow-up period, only four adenomas transformed to adenocarcinoma, of which three showed p53 positivity by immunohistochemistry. The mutation of the p53 gene in exon 5 through 8 was examined in 18 gastric adenomas including four adenomas with malignant transformation. The PCR-SSCP analysis and DNA sequencing revealed four missense mutations and one silent mutation in five adenomas. The missense mutation was present in three adenomas with diffuse p53 staining and in one adenoma with focal p53 staining. The predominant type of mutation was the G:C to A:T transition. In addition to the p53 gene analysis, Ki-ras gene was also investigated, but no mutation in codon 12 and 13 was found in the adenomas investigated. This study indicated that gastric adenomas might be one of the precursor lesions of gastric cancer but somewhat different from colon adenomas in regard to growth potential, p53 staining pattern and the rate of Ki-ras gene mutation.

Adenocarcinoma↗
PubMed1995

Primary malignant lymphoma of the intestine: clinicopathologic and immunohistochemical studies of 39 cases.

Clinicopathologic and immunohistochemical features in 39 cases of primary intestinal non-Hodgkin's lymphoma (NHL) in Japanese patients were studied. Only resection materials in state IE and IIE-1 were included in this study because of the certainty that the intestine was the primary site of the lymphoma. The updated Kiel classification was used to classify NHL. Histologically, only two cases (5.1%) were follicular lymphomas, and the others were diffuse lymphomas. Twenty-eight patients (71.8%) had high-grade NHL and 11 (28.2%) had low-grade NHL. Twenty (71.4%) of the 28 high-grade NHL were centroblastic lymphomas, and 14 (70.0%) of these 20 cases of centroblastic lymphoma were the polymorphic variant. Ten (90.9%) of the 11 low-grade NHL were low-grade mucosa-associated lymphoid tissue (MALT) lymphomas. Macroscopically, 18 patients had polypoid masses, 17 ulcerative tumors and four had diffusely infiltrating NHL. Seven of the 10 low-grade MALT lymphomas were polypoid masses. Immunohistochemically, 35 lesions (89.7%) were of the B cell phenotype and three (7.7%) were of the T cell phenotype. In the remaining case, the cell lineage could not be determined. No lesions were considered to be of histiocytic origin. The 5 year survival rate for high-grade B cell lymphomas was poorer than for low-grade B cell lymphomas, and the present study indicated that the histological grade of the intestinal B cell lymphomas was a prognostically significant factor.

Adolescent↗
PubMed1995

Unsuccessful effort to detect human papillomavirus DNA in urinary bladder cancers by the polymerase chain reaction and in situ hybridization.

The association of human papillomavirus (HPV) with urinary bladder carcinogenesis is now a controversial issue. In order to certify the presence of HPV DNA in urinary bladder cancers, the polymerase chain reaction (PCR) using five primer sets for detecting various HPV types was used in this study as well as in situ hybridization (ISH) for HPV 16 and 18 detection. In the PCR study of 93 DNA samples extracted from formalin-fixed and paraffin-embedded urinary bladder cancers, no HPV DNA was detected in these tumor samples. The ISH study was also performed on the same tumor samples, but failed to demonstrate any HPV 16- or 18-positive signals in all except one of the tumor samples. However, the PCR failed to demonstrate HPV 16 DNA even in the bladder cancer positive for HPV 16 DNA by the ISH. This ISH technique was able to demonstrate HPV 16 and 18 DNA in eight of 13 paraffin-embedded cervical cancers, in which HPV 16 or 18 DNA had already been detected by the PCR. Our HPV study using PCR and ISH revealed that the HPV status of urinary bladder carcinomas was far different from that of cervical cancers.

DNA Probes, HPV↗
PubMed1995

Alcohol-metabolizing enzyme polymorphisms and alcoholism in Japan.

The liver enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which are responsible for the oxidative metabolism of ethanol, are polymorphic in humans. Cytochrome P450IIE1, an ethanol-inducible isozyme of liver microsomal P450, is also important in ethanol metabolism. Genetic polymorphisms in the 5'-flanking region of the human cytochrome P450IIE1 gene have recently been reported. We hypothesized that the polymorphisms of ADH, ALDH, and P450IIE1 modify the susceptibility to development of alcoholism. We determined the genotypes of the ADH2, ALDH2, and P450IIE1 loci of 96 Japanese alcoholics and 60 healthy male subjects, using leukocyte DNA by the restriction fragment-length polymorphism by polymerase chain reaction. The alcoholics had significantly higher frequencies of the ADH2(1) and ALDH2(1) alleles than did the healthy subjects. No significant difference in the frequency of the P450IIE1 genotype was observed between the alcoholics and the healthy subjects. In conclusion, genetic polymorphisms of the ADH and ALDH genes, but not of the P450IIE1 gene, influence the risk of developing alcoholism in Japanese.

Adult↗
PubMed1995

[Relationship of perfectionism to depression and hopelessness in college students].

The purpose of this study was to construct a Japanese version of Hewitt and Flett's (1991b) Multidimensional Perfectionism Scale (MPS), and examine the relationship of perfectionism to depression and hopelessness in college students. In Study 1, a translated version of MPS was administered to 414 college students. Sixty-seven of them also completed seven personality scales in order to examine validity of the new scale. The self-oriented, other-oriented, and socially-prescribed perfectionism subscales have high reliability and validity. In Study 2, 163 college students completed a questionnaire of stressor, depression, and hopelessness scales, in addition to the Japanese MPS. Self-oriented perfectionism was negatively correlated with hopelessness, and socially-prescribed perfectionism positively with depression and hopelessness regardless of the degree of stressor. These results were different from those of Hewitt and Flett (1991b), and it was found that part of the self-oriented subscale correlated positively with hopelessness, and other part negatively. In the present study, the negative part appeared to have been dominant.

Adult↗
PubMed1995

[Squamous cell carcinoma of the ureter as a late complication of ureterocutaneostomy--a case report].

A case of squamous cell carcinoma of the ureter was reported. A 62-year-old woman, who underwent left nephrectomy and right ureterocutaneostomy at the age of thirty-one because of tuberculosis of the urinary tract, visits our hospital periodically for an ureteral catheter change. An urgent nephrostomy was performed because of ureteral stricture on March 8, 1994. Three months later tenderness and induration appeared at the former ureteral stoma. The resected specimen was histologically diagnosed as squamous cell carcinoma. Right palliative ureterectomy did not produce the desired effects due to the invasion of the tumor into the surrounding organs. In this rare case, it is suggested that chronic infection and irritation of the indwelling catheter might be causative of squamous cell carcinoma of the ureter.

Carcinoma, Squamous Cell↗