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Biomedical subjects

T Arai

Publications and source records attributed to T Arai.

At least 397 records · Page 22Linked to original sources
PubMed1997

Genetic cholesteryl ester transfer protein deficiency is extremely frequent in the Omagari area of Japan. Marked hyperalphalipoproteinemia caused by CETP gene mutation is not associated with longevity.

Low levels of HDL cholesterol have been clearly demonstrated to be associated with an increased incidence of coronary heart disease, strongly suggesting that HDL particles have an antiatherogenic function. However, little information has been available concerning the atherogenicity of a marked hyperalphalipoproteinemia (HALP). There is no agreement about whether plasma cholesteryl ester transfer protein (CETP) deficiency is associated with an antiatherogenic state or not, although this disorder was reported to be one of the major causes of marked HALP. In the current study, we have found a unique area (Omagari City, Akita Prefecture, Japan) where CETP deficiency caused by a G-to-A mutation at the 5' splice donor site of intron 14 in the CETP gene is extremely frequent. In Omagari City, the mutation was detected more than 20 times more frequently and the prevalence of a marked HALP with plasma HDL cholesterol > or = 2.58 mmol/L (100 mg/dL) was 5 to 10 times higher than in other areas of Japan. This discovery has made it possible to perform a large population-based study concerning the atherogenicity of a marked elevation of HDL cholesterol in a genetically more homogeneous population. There was a statistically significant U-shaped relationship between HDL cholesterol levels and the incidence of ischemic changes in electrocardiograms. In cases of HDL cholesterol < 1.81 mmol/L (70 mg/dL), the incidence increased in proportion to the levels of HDL cholesterol. The frequency of the CETP gene mutation was higher in patients with coronary heart disease than in healthy control subjects. In subjects aged > 80 years, the prevalence of both marked HALP and the intron 14 splicing defect was significantly lower than in the younger generation. The current study indicated for the first time that a marked HALP caused by CETP gene mutation may not represent a longevity syndrome, suggesting the importance of reevaluation of the clinical significance and pathophysiology of a marked HALP.

Aged↗
PubMed1997

The inhibition of motility of demembranated spermatozoa by anti-tubulin antibodies.

The effects of monoclonal anti-tubulin antibodies on the motility of demembranated and reactivated sea urchin spermatozoa were investigated. Two out of ten antibodies examined significantly reduced the motility of spermatozoa, both in motile rate and swimming speed. The binding patterns of the two antibodies YL1/2 and TUB2.1 to the axoneme were studied by immunoblot, immunofluorescence, and immuno-electron microscopy. YL1/2 bound to the axoneme in a specific pattern; signals were very intense in the tail, rich in the proximal portion, and scarce in the middle part of the axoneme. Because the inhibitory effects of the antibody on the motility of spermatozoa with fully long flagella and short flagella were similar, the inhibition was probably due to the binding of the antibody to the proximal portion of the flagellum. TUB2.1 evenly bound to the axoneme by immunofluorescence and immunoelectron microscopy. On the other hand, the eight antibodies which did not affect sperm motility, did not bind to unfixed axonemes, although epitopes for these antibodies were detected abundantly in the axoneme.

Animals↗
PubMed1997

Effects of irradiation of an erbium:YAG laser on root surfaces.

The application of erbium:YAG laser (Er:YAG) irradiation has been investigated for periodontal therapy. The purpose of this study was to evaluate the effects of Er:YAG laser irradiation on root surfaces using a scanning electron microscope (SEM) and to determine the laser's ability to remove lipopolysaccharides (LPS). Infrared spectrophotometry was used to investigate the effects of the laser on LPS applied to root dentin pellets. Premolars extracted for orthodontic reasons were prepared for this study. The crowns were resected below the cemento-enamel junction, longitudinally sectioned, and the contents of the pulp chamber were removed. Then 15 root tips (5 x 5 x 1 mm) were classified into 3 groups of 5 each as follows: group 1, tips without any treatment; group 2, planed tips with the cement layers left untouched; and group 3, planed until the dentin surface was disclosed. The center of each specimen was used as the experimental irradiated area and the peripheral area served as a control. The quantity of vapor delivered by Er:YAG laser was highly increased, and the irradiated areas displayed little morphogenetic changes. The lyophilized sample LPS 0111 B4 from E. coli was then mixed with potassium bromide and pressed into a tablet, which was examined at 4,000-650 Kayser. The lyophilized LPS had a peak at 2.94 microns. LPS on the root dentin pellets was cleared away as much as possible by 150 washings in pyrogen-free water using an ultrasonic cleaner. Five microliters of 24 EU LPS solution was dropped on the root dentin pellets, which were then irradiated by the Er:YAG laser, and washed using the ultrasonic cleaner in pyrogen-free water. The amount of the extracted LPS solution was determined by spectrophotometer at 405 nm. The Er:YAG laser could remove 83.1% of the LPS. This study suggests that Er:YAG laser irradiation might be useful for root conditioning in periodontal therapy. However, clinical testing is necessary to establish what, if any, utility the Er:YAG laser has as a part of periodontal therapy.

Aluminum Silicates↗
PubMed1997

Fatality due to severe Salmonella enteritis associated with acute renal failure and septicemia.

A 66-year-old man was hospitalized for abdominal pain and diarrhea of more than 10 times a day. He had been under regular medication with prednisolone for rheumatoid arthritis. On admission, laboratory data and clinical examination indicated inflammation, dehydration, acute renal failure with a high level of serum musculogenic enzyme (creatine kinase), and ileus. Salmonella enteritidis was isolated from his fecal and blood samples. The patient died within 24 hours after admission, and autopsy showed hemorrhagic necrotic enteritis localized to the ileum. Enterocolitis due to Salmonella enteritidis, which is usually an acute self-limited gastrointestinal illness, may occasionally be a serious and lethal disease.

Acute Kidney Injury↗
PubMed1997

[Autopsy findings of gastric mucosa from elderly people without gastric disease].

Results of pathological studies of surgical specimens have led to widespread acceptance of the belief that with aging the gastric mucosa gradually becomes atrophic and the incidence of intestinal metaplasia increases. To distinguish natural age-related changes in the incidence of fundic gland atrophy and intestinal metaplasia from changes related to disease, we studied stomachs removed at autopsy from 187 people who had had no gastric diseases and were over 60 years old at the time of death (27 were over 100 years old). The autopsies were performed at Tokyo metropolitan geriatric hospital. None of the stomachs had circumscribed gastric lesions, and those found to have cancer or ulcer were excluded. Age at the time of death was not associated with the incidence of fundic gland atrophy or of intestinal metaplasia. Thus, the incidences of fundic gland atrophy and of intestinal metaplasia in elderly people were much lower than those found in studies of surgical specimens. In addition, the incidences of fundic gland atrophy and of intestinal metaplasia did not differ significantly between the sexes, regardless of age.

Aged↗
PubMed1997

[Surgically unsuccessful cases with pulmonary tuberculosis].

Because of the development of effective drugs, surgical treatment for pulmonary tuberculosis has decreased in recent years, but there are some cases which require surgical operation in patients with drug resistant tuberculosis. Between 1979 and 1994, 52 patients with pulmonary tuberculosis underwent surgical operations for the negative conversion of drug resistant bacilli. Pulmonary resection was the principal procedure and when a patient was not tolerant to this procedure, thoracoplasty or cavernostomy was selected. Continuation of bacilli positive sputum after the operation was seen in 12 cases (23.1%). The main causes of the failure were multiple drug resistance and remaining lesions. The unsuccessful rate in the patients with bacilli completely resistant to all of the 5 main drugs (SM, KM, INH, RFP, EB) was extremely high amounting to 57.1%. When 2 or more of the 5 main drugs were effective, the unsuccessful rate was 11.1%. A total of 21 cases had tuberculous lesions remaining in the lung postoperatively, because of bilateral lesions or poor lung function. In such cases, the unsuccessful rate was 42.3%. In the 31 cases that had no remaining lesion, the rate was 9.7%. There was no unsuccessful case in the patients who had 2 or more effective drugs and no remaining lesion. We reoperated on 6 patients and 5 of them got negative conversion. In the 2 of other patients who didn't undergo reoperation, their sputum became negative after long term postoperative chemotherapy, and the other 2 patients had only a few bacilli in ther sputum postoperatively. Nine cases were able to return to normal daily life.

Adult↗
PubMed1997

[Breakage of a Seldinger spring guide wire during percutaneous catheterization of a subclavian vein].

Spring guide wires have been widely used for the central venous catheterization with the popularity of the Seldinger technique. We report here an accidental breakage of a spring guide wire during percutaneous catheterization of a subclavian vein. The venipuncture by a plastic catheter over an introducer needle and the insertion of a spring guide wire through the catheter were easily achieved. However, the insertion of an indwelling catheter over the guide wire was difficult to perform, and the pulling out of the guide wire from the catheter was more difficult, which brought the uncoiling of the spring part of the guide wire from the mandrel. The tip of the guide wire was not cut off, and there were no sequelae in the patient. A plastic catheter over an introducer needle for a subclavian venipuncture is so flexible that it is occasionally bent between the clavicle and the first rib after pulling out of the inside needle. Probably, that is the reason of the difficulties of the insertion of an indwelling catheter and the pulling out of a guide wire. The use of a rigid metal needle for the venipuncture is an alternative way to avoid these troubles.

Catheterization, Central Venous↗
PubMed1997

No evidence for direct incorporation of esterified palmitic acid from plasma into brain lipids of awake adult rat.

Awake adult rats were given a solution of [9,10-3H]palmitate ([3H]PAM) by gavage. The appearance of radiolabel in plasma lipid fractions was monitored by thin-layer chromatography at fixed intervals thereafter. At 2 h, the rats were killed by microwave irradiation and radioactivity in whole brain and individual brain phospholipids was determined. In plasma, esterified [3H]PAM was mainly associated with triglyceride, phospholipid, and cholesterol ester. Radioactivity appeared to a larger extent in triglyceride than in unesterified fatty acid, suggesting that unesterified [3H]PAM in plasma was largely due to release from esterified [3H]PAM by lipoprotein lipase hydrolysis. Brain radioactivity could be accounted for entirely by incorporation of unesterified plasma [3H]PAM. Esterified [3H]PAM in chylomicrons or lipoproteins was calculated to make no measurable contribution using a published value for the incorporation coefficient of [3H]PAM into brain in the evaluation. These results suggest that ingested palmitic acid (PAM) in adult rats enters blood as esterified triglyceride within chylomicrons and lipoproteins and, in part, eventually is converted to circulating unesterified PAM. It is the circulating unesterified PAM that is incorporated into brain from blood, whereas esterified PAM within plasma chlomicrons and lipoproteins makes no measurable direct contribution.

Administration, Oral↗
PubMed1997

[Tuberculous pleuro-peritonitis showing increased levels of CA125].

A 53-year-old woman was admitted because of dyspnea and coughing of about 8 months duration. On examination she had left pleural effusion and ascites. The serum CA125 level was high (1150 U/ml) but gynecological examinations were negative. Radiological and ultrasonic studies revealed bilateral pleural effusions and ascites. Cytological and bacteriological studies of the pleural effusions and ascites were all negative. The pleural fluid was exudate with high lymphocyte counts and elevated ADA (87.4 IU/l) and CA125 (1800 U/ml). Tuberculous pleuritis was diagnosed based on the findings of sputum culture and of pleural biopsy. The latter revealed epithelioid cell granulomas and giant cells. Cells in both pleural effusion and ascites were stained with antibodies to CA125. Antituberculous chemotherapy was started and the patient responded well. Both pleural effusions and ascites decreased; the level of CA125 also decreased to the normal range in about two months.

CA-125 Antigen↗
PubMed1997

[A randomized comparative study of surgical adjuvant chemotherapy using 5-fluorouracil and dl-leucovorin with CDDP 5-FU and dl-leucovorin for colorectal cancer].

A randomized comparative study of surgical adjuvant chemotherapy using dl-leucovorin (dl-LV) and 5-fluorouracil (5-FU) (FL-therapy) with CDDP, 5-FU, and dl-LV (PFL-therapy) was conducted. The following were the administration schedules: Arm A was 13 mg/m2 of CDDP, 300 mg/m2 of 5-FU, and 30 mg/body of dl-LV for 5 consecutive days and arm B was 300 mg/m2 of 5-FU and 30 mg/body of dl-LV for 5 consecutive days. Both regimens were followed by biweekly administration of the same dose of dl-LV and 5-FU in outpatients. Arm A was started at the 26th postoperative day and arm B at the 21st day on average. Some 26 cases composed of 11 cases of arm A and 15 cases of arm B completed the administration schedules. Only one case in arm A was complicated by local recurrence around 35 months after operation. Major toxicities were anorexia and neutropenia. Both toxicities were seen more in arm A than in arm B, showing complete recovery in all cases. These data suggest that PFL-therapy and FL-therapy seem to be possible and promising surgical adjuvant therapies for advanced colorectal carcinoma.

Adenocarcinoma↗
PubMed1997

[Application of measuring 99mTc-MAG3 plasma clearance based on one-compartment model (MPC method) to pediatric patients].

Measurement of 99mTc-MAG3 plasma clearance based on 1-compartment model (MPC method) were applied to 12 pediatric patients and evaluated for the factors which might affect the calculated results. Depth correction is a critical factor for the measurement of renal uptake. Three different equations for estimating renal depth were compared with the real depth measured by ultrasonography. The equation proposed by K. Itoh was suitable though the equations by T. Ito and Raynaud were insufficient. Estimation of distribution volume, which is regarded as circulating plasma volume (CPV), is also critical for the calculation of MAG3 clearance by MPC method. Precisely, hematocrit measured by venous sampling and circulating blood volume (CBV) calculated as 7.5% of body weight are used for estimation of CPV. However, assumed CPV as 5% of body weight was acceptable if the hematocrit was not severely deviated from the normal value. Simplified MPC method utilizing two factors mentioned above gave a positive correlation with Russell's one point sampling method. In conclusion, MPC method is applicable for pediatric patients.

Adolescent↗
PubMed1997

[Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

Arteriovenous Fistula↗
PubMed1997

[Esophagobronchial fistula and empyema resulting from esophageal carcinoma].

A 59-year-old woman was admitted to the hospital with a one-month history of hemoptysis, generalized fatigue, and a high fever. A chest X-ray film obtained on admission showed a massive right-sided pleural effusion. Examination of an aspirate showed a high level of amylase, and bacteria that were the same as oral bacteria. Closed drainage yielded ichorous pus and food residues, which led us to the diagnosis of empyema caused by esophageal perforation. Esophagography and fiberoptic esophagoscopy revealed that an esophagobronchial fistula related to an advanced esophageal carcinoma had caused the empyema. Surgical resection was done, and the patient was alive at the time of this writing, 7 months after she was first treated. Esophageal carcinoma is sometimes accompanied by esophagobronchial fistula. Patients with this condition usually have severe respiratory symptoms; those presenting with empyema are rare. Esophageal carcinoma must be carefully ruled out as the cause of empyema.

Bronchial Fistula↗
PubMed1997

[Severe acute cardiac failure caused by the combination of the aortic stenosis and sudden onset of the mitral chordae rupture].

The patient, who had an aortic stenosis, suddenly complicated with severe acute cardiac failure. The rupture of the mitral chordae tendineae was detected by the echocardiogram. Double replacements (aortic and mitral) were done immediately after the onset of chordae rupture. This condition, combination of aortic stenosis and sudden onset of chordae rupture, always results in severe heart failure which is explained by the combination of pressure and volume loading. Finally the emergent operation is believed to be an only solution for this situation.

Acute Disease↗