Biomedical subjects

T Hirai

Publications and source records attributed to T Hirai.

At least 271 records · Page 15Linked to original sources

PubMed1996

[Right traumatic diaphragmatic hernia: a case report].

A periodic examination of chest-X-ray films showed abnormal elevation of the right diaphragm in a 39-year-old man, who had a history of right cordal contusion due to fall from a bridge one and a half years ago. The patient had no clinical symptoms after the accident. Chest and abdominal CT scans and barium examinations of gastro-intestinal tract revealed herniation of the omentum, colon and liver into the right thoracic cavity. Under the diagnosis of diaphragmatic hernia, the patient underwent an operation through a thoracoabdominal approach showing prolapse of the omentum, colon, gall bladder and a part of liver into the thoracic cavity. Prolapse of a gallbladder is rare. Further examinations are necessary with this lesion in mind when physicians find an abnormal shadow of the diaphragm.

Adult↗

PubMed1996

Validity of a random noise oscillation and body box system for the measurement of the respiratory impedance of small animals.

The accuracy and validity of a body box system which was developed for the measurement of airway and chest wall impedance in small animals such as canines was evaluated. Input impedance was calibrated using a resistance tube and the mouth flow sensing system was designed to be as symmetrical as possible such that the minimal common mode rejection ratio (CMRR) from 10 to 40 Hz was greater than 60 dB. The validity of this system using the resistance tube and inertant models indicated that the average error ratio for the input impedance and for the flow transfer function between the mouth and chest flow was within 3 and 0.5%, respectively. The location of the box pressure port near to the oscillatory flow inlet was shown to potentially give rise to errors in the measurement of the flow transfer factor due to the direct effects of the inflow. A distance of 60 cm was adopted in the present system, which proved to be sufficient to avoid this effect. It was concluded that the body box system which is described for small animals in the present study is appropriate for obtaining separate and accurate airway and tissue impedance data.

Airway Resistance↗

PubMed1996

Chest flow during the initial inspiratory phase (V0.1) in pulmonary diseased patients.

We measured the chest flow 0.1 s after the onset of the inspiratory phase (V0.1) in patients with chronic pulmonary emphysema (CPE: n = 5), interstitial pneumonitis (IP: n = 5) and normal subjects (Nor: n = 5). The subjects sat in a body box and breathed air from outside of the body box. V0.1 was measured during rest and during maximal breathing (V0.1-rest, V0.1-max) and then these results were compared with P0.1 (P0.1 rest, P0.1-max) values. V0.1-rest was not significantly different between the three groups (Nor: 0.25 +/- 0.10, CPE: 0.27 +/- 0.06, IP: 0.26 +/- 0.06, l/s), whereas the P0.1-rest in IP patients was significantly greater than in normal subjects (Nor: 1.98 +/- 0.61, CPE: 3.00 +/- 0.80, IP: 3.60 +/- 0.68 hPa; P < 0.05 compared with normal). The V0.1-max in CPE and IP patients was significantly lower than in normal subjects (Nor: 3.66 +/- 1.16, CPE: 0.82 +/- 0.25, IP: 1.02 +/- 0.21 l/s, P < 0.05 compared with normal subjects (Nor: 3.66 +/- 1.16, CPE: 0.82 +/- 0.25, IP: 1.02 +/- 0.21 l/s, P < 0.05 compared with normal), whereas P0.1-max in IP patients was not significantly different with in normal subjects (Nor: 33.2 +/- 10.2, CPE: 9.8 +/- 3.7, IP: 19.5 +/- 3.4 hPa, P < 0.05 compared with normal, P < 0.05 compared with CPE). A simulation of the influence of the mechanical properties of the respiratory system on V0.1 and P0.1 using the Runge-Kutta method suggested that V0.1 was negatively affected by airway resistance but positively affected by chest wall and lung compliance. In contrast, the influence of respiratory mechanics on P0.1 was much less than on the V0.1, except for highly decreased lung compliance. In CPE patients, it was suspected that mechanical disorders might not simply be the determining factors of V0.1-max, but that limitations of the neuro-muscular drive due to chest wall deformity may also play a definitive role in the smaller V0.1-max. In contrast, it may be inferred that IP patients had to exert greater inspiratory effort as compared with the other two groups in order to maintain a similar V0.1-rest because of the increased airway resistance and decreased tissue compliance; thus these abnormal mechanical properties suppress the increase in the V0.1-max. It may be concluded that V0.1 is a good index of chest wall acceleration, which is determined by both the neuro-muscular drive and the mechanics of the respiratory system.

Aged↗

PubMed1996

Obesity.

Obesity is a heterogeneous family of disorders with several overlapping contributory causes. It markedly increases morbidity and mortality from many different diseases, and affected patients are the targets of severe, negative social pressures. Physicians traditionally have been unsuccessful in treating obesity. The usual physician's office approach to obese persons is to conduct a good history and physical examination and then prescribe a 4200-J diet sheet and monthly or biomonthly office visits. This approach usually produces mild and ephemeral weight loss. Some patients quickly become disillusioned and manifest as appointment "no-shows." The doctor often bemoans the lack of will power of his or her ex-patient. Such patients and their physicians would be better served by referral to a professional weight management program, in which a coordinated team approach has proven effective and persistent in body weight control. "He that putteth his trust in the Lord shall be made fat."

Behavior Therapy↗

PubMed1996

[Repair of the gastric tube-right main bronchus fistula after operation for esophageal cancer--treatment by transposition of pedicled pectoralis major muscle flap].

We have experienced a case who showed the gastric tube-right main bronchus fistula. A 51-year-old male complained cough and vomiting suddenly. He underwent esophagectomy and radio-chemotherapy for advanced esophageal cancer 19 months ago. Chest X-ray showed severe pneumonia, and gastroscopy, bronchoscopy and CT scan showed the fistula between the whole stomach esophageal substitute and right main bronchus. After recovery from the pneumonia with the treatment by continuous suction through the naso-gastric tube, operation was performed. The fistula was repaired with transposition of a pedicled pectralis major muscle successfully. After the operation, respiration was performed independently with two ventilators for right and left lung to avoid increasing air way pressure. His postoperative course was uneventful, and he discharged on the 66th postoperative day. The cause of the fistula was considered to be a peptic ulcer due to residual secretion of gastric acid.

Bronchial Fistula↗

PubMed1996

Surgical treatment of Borrmann type IV gastric carcinoma: relevance of lymphadenectomy in improving survival.

BACKGROUND: Borrmann type IV gastric carcinoma carries a poor prognosis, even if curatively resected. The benefit of a lymphadenectomy is unknown. STUDY DESIGN: A retrospective study was designed to evaluate whether improvements have been made in the treatment of type IV gastric carcinoma over the past decade. The 345 patients with type IV carcinoma who underwent laparotomy within a recent 16-year period were split into two groups: one group of patients who underwent laparotomy between 1977 and 1985, and the other between 1986 and 1992. Survival data were compared between these two groups and prognostic factors for type IV gastric carcinoma were assessed by multivariate analysis. RESULTS: A significant difference in survival was observed between the groups, both of which underwent curative resection, despite a lack of difference in background factors. The improvement was more prominent among patients with nodal metastases and insignificant among patients without nodal metastases. Multivariate analysis identified nodal metastasis as a major independent prognostic factor. CONCLUSIONS: An improvement in outcome was presumably achieved through extended lymphadenectomy. However, the survival rate remains unsatisfactory, and further advances in the treatment of this disease are needed.

Adenocarcinoma↗

PubMed1996

[Relationship of hypertension prevalence in companies to business type and scale--from an analysis of health examination results in Fukui prefecture].

The results of health examinations of 89,299 examines from companies in Fukui Prefecture conducted pursuant to the Occupational Safety and Health Act were analyzed to study the relationship between the prevalence in these companies of hypertension, and company size business type. The Mantel-Haenszel method was utilized to adjust for age structure of the examinees according to gender and the type of business of their companies to compare prevalence of hypertension. The results of the analysis indicated that the prevalence of hypertension was significantly higher in small-scale companies for the female examinees working in pulp/paper processing and motor freight transport business than in large-scale companies, but no significant difference was seen for scale of business when the female examinees were grouped without regard to the business type of their companies. In the case of the male examinees, the analysis results revealed that the prevalence of hypertension was significantly higher in small-scale companies for those working in ceramic/earth/rock, motor passenger transport and hotel/restaurant business than in large-scale industry while the prevalence of hypertension was significantly higher in large-scale companies for those working in non-ferrous metal industry, financial and other types of business. Moreover, the analysis results for the male examinees grouped without regard to the type of business of their companies indicated that the prevalence of hypertension remained significantly higher in small-scale companies. The above also suggests the need for measures for health care of workers that considers business type and scale for the purpose of primary prevention of hypertension.

Adult↗

PubMed1996

[Solitary plasmacytoma of sternum--a case report and review of the Japanese literature].

A 39-year-old woman complained of anterior chest pain. A lateral chest X-ray film showed destruction of bone in the body of sternum. CT scan showed a soft tissue density within the sternum. Serum protein electropheresis revealed mild monoclonal gammopathy of IgG-kappa, but the urine contained no Bence-Jones protein. A biopsy specimen showed plasmacytoma with cytoplasmic Ig IgG-kappa. Bone scintigraphy and systemic bone roentgenography revealed only the lesion in the sternum. Sternal subtotal resectin was performed. The defect of the anterior chest wall was reconstructed with double folded marlex mesh and pedicles from the major pectoral muscle. Iliac bone marrow aspiration revealed no evidence of myeloma. There was no serum evidence of monoclonal gammopathy two months after the operation. Therefore, the final diagnosis was solitary plasmacytoma of the sternum. It is now 41 months since surgery, and there have been no signs of fecurrence. Long term follow up is necessary in this case.

Adult↗

PubMed1995

Retrovirally transmitted gene therapy for gastric carcinoma using herpes simplex virus thymidine kinase gene.

BACKGROUND: Herpes simplex thymidine kinase (HTK) is known to phosphorylate ganciclovir (GCV). Phosphorylated GCV is incorporated into genomic DNA, which leads to inhibition of cell growth and cell death in the replicating cells. Recently, much attention has been drawn to the use of retrovirally mediated gene therapy using HTK as a new therapeutic approach for brain tumors. However, little is known about this phenomenon in gastrointestinal carcinomas. METHODS: The authors transfected the HTK gene packaged in retroviral vector into TMK-1 gastric carcinoma cells (TMK-HTK cells). Sensitivity of TMK-HTK cells to GCV was examined in vitro. Moreover, TMK-HTK cells were transduced into nude mice subcutaneously, and the effects of GCV therapy was examined at the concentration of 20 mg/kg daily for 14 days. RESULTS: TMK-HTK cells were sensitive to GCV at the concentration of 0.1 to 100 micrograms/ml in a dose- and time-dependent manner in vitro. Moreover, 12 of 13 TMK-HTK tumors, which were transduced into nude mice subcutaneously, shrunk from the average diameter of 6.5 mm. CONCLUSION: The results indicate that retrovirally transmitted gene therapy with GCV may provide a new therapeutic approach for treatment of gastric carcinomas.

Animals↗

PubMed1995

Incidence, diagnosis and significance of multiple gastric cancer.

Of 2790 patients with gastric cancer undergoing surgery between January 1978 and December 1993, 160 (with 356 neoplastic lesions) had synchronous multiple cancer. Of these lesions 271 (76 percent) were early cancers. Only 85 (53 percent) of the 160 patients were diagnosed before operation as having multiple cancer; 69 further patients (43 percent) were diagnosed during the course of the operation. Small flat (IIb) and depressed (IIc) type lesions had a propensity to be missed before operation. The incidence of multiple cancer was relatively low, indicating that several microscopic lesions might have been overlooked in this series. There has, however, only been one patient (1 percent) with subsequent cancer of the gastric remnant of 126 with multiple cancer and postoperative gastric remnants over the past 16 years. This might be because of co-resection of unrecognized lesions by distal gastrectomy in 68 percent of the patients. Alternatively some microscopic cancers might not invariably be destined to grow into clinically significant lesions over 10 or more years.

Female↗

PubMed1995

Molecular cloning and immunological analysis of goldfish cyclin A during oocyte maturation.

Cyclin A belongs to a family of proteins involved in the regulation of the eukaryotic cell cycle. Although cyclin A is thought to be involved in the regulation of both S and M phase, its exact role in the cell cycle, especially in the meiotic cycle (oocyte maturation), is uncertain. We isolated cyclin A cDNA clones from a goldfish oocyte cDNA library. Monoclonal antibody raised against bacterially produced goldfish cyclin A recognized a 47-kDa protein that disappeared after egg activation. Unlike goldfish cyclin B, which is absent in immature oocytes, cyclin A was already present in immature oocytes and its protein level did not change remarkably during oocyte maturation. These results differ from the finding in Xenopus, in which cyclin A is absent, but cyclin B is present, in immature oocytes. Goldfish cyclin A was associated with cdc2 kinase in mature oocytes, but not with cdk2. Recombinant cyclin A bound to and activated cdc2 in a cell-free system, but cyclin A and cdk2 binding was not observed. The kinase activity of cyclin A-cdc2 was undetectable in immature oocytes and first appeared at about the time of germinal vesicle breakdown (GVBD). In contrast to the cyclin B-cdc2 activity that corresponded to the occurrence of GVBD, cyclin A-cdc2 activity increased only slightly until GVBD was completed and increased drastically after the completion of the first meiotic division. Furthermore, microinjection of cyclin A mRNA into immature oocytes did not cause GVBD; however, microinjection of cyclin B mRNA did. These results suggest that cyclin A-cdc2 kinase and cyclin B-cdc2 kinase play different roles in controlling oocyte maturation. The roles of cyclin A in the rapid activation of cyclin B-cdc2 kinase at meiosis I and II transition and in the maintenance of high maturation-promoting factor activity in mature unfertilized eggs are discussed.

Amino Acid Sequence↗

PubMed1995

Subsite-specific risk factors for colorectal cancer: a hospital-based case-control study in Japan.

To investigate the subsite-specific risk factors for colorectal cancer, we conducted a case-control study, using a common questionnaire which inquired about general lifestyles over the past five years (1988-92), at the Aichi Cancer Center Hospital, Nagoya, Japan. This study compared 432 patients with histopathologically diagnosed colorectal cancer (94 proximal colon [cecum, ascending colon, transverse colon]; 137 distal colon [descending colon, sigmoid colon]; 201 rectum [rectosigmoid, rectum]); and 31,782 first-visit outpatient controls who were free from cancer. In both genders, habitual smoking selectively increased the risk for rectum cancer. Soft or loose feces increased the risk for all subsites of colorectal cancer, particularly in female rectum cancer (odds ratio [OR] = 4.5). Among female dietary habits, Japanese-style foods decreased the risk for distal colon cancer, but increased the risk for proximal colon cancer. These results suggested that the risk factors for colorectal cancer differ by subsite among such a low-risk population as the Japanese. It is suggested also that 'irritable bowel' (soft or loose feces) might be associated with distal subsites of colorectal cancer, independently or combined with habitual smoking.

Adult↗

PubMed1995

Preservation of the lower esophageal sphincter during total gastrectomy for gastric cancer to prevent postoperative reflux esophagitis.

The lower esophageal sphincter (LES) is usually removed during total gastrectomy to successfully perform a curative operation. In this study, the preservation of the LES in curative total gastrectomy was attempted to reduce the reflux. An experimental study using dogs has revealed that the high-pressure zone of the LES can be preserved by making a resection at the gastroesophageal junction, which thus helps to protect the reflux. A previous clinicopathological study revealed that the LES can be preserved without any fear of recurrence at the resection site, if the tumor is located more than 2.0 cm and 3.0 cm from the gastroesophageal junction to the oral margin in node-negative and -positive cases, respectively. Clinically, 8 patients underwent an LES-preserving total gastrectomy [LES(+) gastrectomy] while 19 had an LES(-) gastrectomy in the same period. Of the five LES(+) cases examined, all showed a high pressure zone, whereas none of the four LES(-) cases examined showed such a high-pressure zone after the operation. Endoscopic examination showed that only one of the seven LES(+) cases but six of nine LES(-) cases revealed esophagitis.

Anastomosis, Surgical↗

PubMed1995

Clinical usefulness of an ATP heat sensitivity test using endoscopic biopsy materials from esophageal cancer patients.

The usefulness of a heat sensitivity test which involved performing an ATP assay on endoscopic biopsy materials for predicting the clinical response to hyperthermia was investigated in esophageal cancer patients. Following in vitro heat treatment of FM3A tumor cells, the heat sensitivity detected by ATPA was significantly correlated with that in the colony-forming assay, and the percent inhibition of the ATP level in the tumor cells was correlated with in vivo tumor growth. The heat sensitivity of the biopsy materials evaluated by ATPA correlated well with that of the resected specimens in 18 esophageal cancer patients, while the clinical response to thermal therapy was well predicted by the heat sensitivity of the biopsy materials evaluated by ATPA in seven of the patients. These results indicate that the heat sensitivity test conducted by performing an ATPA on endoscopic biopsy materials could be a useful indicator for predicting the clinical response to thermal therapy.

Adenosine Triphosphate↗

PubMed1995

Intravascular ultrasonography of supra-aortic arteries as an adjunct to percutaneous transluminal angioplasty.

We report the intravascular ultrasonographic appearances of three supra-aortic atherosclerotic lesions in two patients before and after percutaneous transluminal angioplasty. Atherosclerotic plaques with calcification and dissection of the arterial wall after percutaneous transluminal angioplasty were demonstrated to better advantage, although they were difficult to see on conventional angiograms.

Aortic Dissection↗

PubMed1995

Differential diagnosis of extra-axial intracranial tumours by dynamic spin-echo MRI.

Dynamic MRI was performed on 22 patients with extra-axial intracranial tumours. Serial images were obtained every 30 s for 3 min using a spin-echo sequence (TR 200, TE 15 ms) after rapid injection of Gd-DTPA, 0.1 mmol/kg body weight. The contrast medium enhancement ratio (CER) was correlated with the histology of the tumours. Meningiomas and extra-axial metastases showed a sharp rise, then a gradual decline. Although both had a definite early peak of CER, metastases showed a more rapid decline. Neuromas and extra-axial lymphoma showed a slow, steady increase with no peak within 180 s. This study indicates that the CER is helpful in the differentiation of extra-axial tumours.

Adult↗

PubMed1995

Metabolic inter-organ relations by exercise of fed rat: carbohydrates, ketone body, and nitrogen compounds in splanchnic vessels.

Fed rats were exercised until exhaustion by almost 65% VO2max on a treadmill. In 2.5 min after the exercise, blood was collected from various vessels of the splanchnic bed. Metabolites, glucose, lactate, ketone body, and nitrogencompounds in the plasma, were measured. Glucose excretion from the liver was increased by exercise, but was not significant. The absorption by the kidney decreased to 30% by exercise. Lactate was highly absorbed by the kidney, lower limbs, and digestive tract by exercise. Exercise caused a 200-300% increase of the plasma beta-hydroxybutyrate, but the absorption by the kidney and the lower limbs was decreased. These data suggest that glucose is a good carbon source for the recovery, and that lactate is more useful than glucose, but ketone body is less effective at a very early recovery phase under fed condition. Amino acid balances in each organ except digestive tract were positive showing anabolic conditions of these organs even after exhaustive exercise at fed condition. Most amino acid concentrations in the plasma tended to decrease to 60-90% by exercise. Amino acids were excreted from the digestive tract, and were eventually absorbed by the liver in both rested and exercised rat. The digestive tract, therefore, seems to be a primary amino acids pool to supply them to the liver during the inter meal. Urea excretion from the liver was more than the absorbed ammonia showing that active deamination from amino acids was carrying on. The resulted carbon skeletons of the amino acids might be used for the gluconeogenesis in the liver.

Amino Acids↗

PubMed1995

Age-related changes in the static and dynamic mechanical properties of mouse lungs.

To investigate the effects of aging on pulmonary mechanical properties in mice, we devised a new experimental apparatus to measure the respiratory impedance of excised lungs in mice and examined age-related changes in both static and dynamic properties. In an accelerated senescence-resistant strain of mice, SAMR1 (Takeda, T., Y. Fukuchi, Y. Uejima, K. Teramoto, T. Oka and H. Orino, J. Am. Geriatr. Soc. 39: 911-919, 1991), ranging from 3 to 24 months of age, static compliance (Cst) as well as total lung capacity increased significantly with age, whereas specific compliance and the K value, as determined by exponential analysis, showed no significant change. In the dynamic study, dynamic compliance (Cdyn) increased significantly with age, whereas the frequency dependence of Cdyn (Cdyn/Cst) did not vary with age. From these results we concluded that lung elasticity, normalized to lung volume, remained constant with age and that the effects of aging on pulmonary mechanics might be solely derived from increases in lung volume in the SAMR1 strain of mice.

Age Factors↗