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Biomedical subjects

T Tsuda

Publications and source records attributed to T Tsuda.

At least 235 records · Page 13Linked to original sources

Comparison of Two Questionnaires on Respiratory Symptoms in a Nicaraguan Population: Value in Diagnosis of Chronic Bronchitis.

Two questionnaires about respiratory symptoms were evaluated for reliability and ability to diagnose chronic bronchitis in a study population of 129 Nicaraguans (110 workers and 19 patients with chronic bronchitis). The first questionnaire (AQ) had symptom questions that were based on British Medical Research Council (MRC) questions, adapted to local Spanish. The second questionnaire (MRCQ) contained MRC symptom questions translated directly into Spanish. The reliability of the questions was measured in a test-retest procedure. The questionnaire-based diagnosis of chronic bronchitis was compared with the diagnosis made by a physician (for workers) or from the hospital records (for patients). The questions concerning symptoms in both questionnaires were of acceptable reliability. For the diagnosis of chronic bronchitis in workers, the AQ showed similar sensitivity, a somewhat higher specificity, and a substantially higher positive predictive value (90%) than the MRCQ (57%). Among the patients, the AQ identified 17 patients as positive (sensitivity 89%), while the MRCQ identified 15 (sensitivity 79%). respiratory questionnaire; reliability; chronic bronchitis; Nicaragua Hanley & Belfus, Inc. Int J Occup Environ Health 1077-3525 2 2 1996 April/June Chronic Exposure to Cigarette Smoke Inhibits the Stimulating Effects of Mineral Fibers on the Production of Tumor Necrosis Factor by Alveolar Macrophages of Rats 95 98 EN Yasuo Morimoto Department of Environmental Health Engineering, University of Occupational and Environmental Health, Japan 1-1, Iseigaoka, Yahatanishiku, Kitakyushu 807, Japan. Ziro Nambu Hajime Hori Tohru Tsuda Hiroshi Yamato Toshiaki Higashi Yasuyuki Yokosaki Masamitsu Kido Isamu Tanaka The objective of this study was to evaluate the chronic combined effects of mineral fibers and cigarette smoke on the production of tumor necrosis factor (TNF) by alveolar macrophages. The authors chronically exposed ten rats to cigarette smoke in vivo and measured the production of TNF by alveolar macrophages in the presence of mineral fibers in vitro. For smoke exposure, rats were divided into two groups. Five rats were exposed daily to a concentration of 10 mg/m(3) of cigarette smoke for six hours a day, five days a week, for four weeks, and five rats (control) were not exposed to smoke. A broncho-alveolar lavage was performed after the smoke exposure, and the recovered alveolar macrophages were incubated with either chrysotile or ceramic fibers on a microplate for 24 hours. TNF activity in the supernatant was determined by the L929 bioassay. When alveolar macrophages were not stimulated by mineral fibers, TNF production tended to be lower in smoke-exposed alveolar macrophages than in unexposed ones, although the difference was not significant statistically. When alveolar macrophages were stimulated in vitro by chrysotile or ceramic fibers, both fibers stimulated TNF production, but TNF production in smoke-exposed alveolar macrophages was lower than that in unexposed macrophages. These results revealed that long-term exposure to cigarette smoke inhibited the stimulating effect of mineral fibers on the production of TNF.

Journal Article↗

A prospective study of the clinical utility of ApoE genotype in the prediction of outcome in patients with memory impairment.

Given the relationship between the presence of ApoE epsilon 4 and Alzheimer's disease (AD), were studied whether knowledge of epsilon 4 status would predict which memory-impaired patients would develop AD over time. One hundred seven patients who presented with memory impairment but not dementia were referred to the study by their family physicians. These patients were followed prospectively over a 2-year period. Twenty-nine patients developed AD, while 78 did not develop dementia. We found that ApoE genotype was a reliable prognostic indicator of who developed AD in this group only when memory test performance was included in the predictive model. These findings indicate that limitations of ApoE genotyping in isolation as a prognostic indicator of AD. Because this study included prospectively selected patients who were followed longitudinally, our findings are likely to have more relevance in the clinical setting than those obtained from currently available retrospective studies.

Aged↗

[Causal inference in medicine--a historical view in epidemiology].

Changes of causal inference concepts in medicine, especially those having to do with chronic diseases, were reviewed. The review is divided into five sections. First, several articles on the increased academic acceptance of observational research are cited. Second, the definitions of confounder and effect modifier concepts are explained. Third, the debate over the so-called "criteria for causal inference" was discussed. Many articles have pointed out various problems related to the lack of logical bases for standard criteria, however, such criteria continue to be misapplied in Japan. Fourth, the Popperian and verificationist concepts of causal inference are summarized. Lastly, a recent controversy on meta-analysis is explained. Causal inference plays an important role in epidemiologic theory and medicine. However, because this concept has not been well-introduced in Japan, there has been much misuse of the concept, especially when used for conventional criteria.

Causality↗

[The US Health Care and the reform].

Securing access to medical services, controlling costs and improving quality are goals of health care system. Although they are all the same all over the country, each country has its own culture, health care system and health care problems. In the United States, employer-based and individual purchases of private health insurance coverage play a major role, although governmental programs such as Medicaid and Medicare exist for the poor and the elderly. Private health insurance had traditionally secured patients' freedom of choice of health care providers and physicians' professional freedom and had paid providers on a fee-for-service basis. Now, the U.S. has 40 million uninsured persons who do not have access to medical services, although it spends as much as its 14% of GNP on health care. In the early 1990s, this became a major political problem. President Clinton proposed the 'Health Security Act' which would enable any American to have access to comprehensive health care with managed competition to activate the health care market, but it was not enacted. Nevertheless, it is clear that managed care and managed competition will dominate and that traditional fee-for-service plan will be eroded in the health care market. Japan has a universal health care system. We do not have any uninsured or high medical costs. However, it is difficult to improve the quality of health care services within the present system. Japan can learn the system about disclosure of health care information from the managed care in the U.S.

Adolescent↗

Preparation of virus-infection-associated (VIA) antigen of foot-and-mouth disease (FMD) virus from inactivated vaccine.

Virus-infection-associated (VIA) antigen of foot-and-mouth disease (FMD) virus was prepared from an inactivated FMD vaccine. The VIA antigen coupled with an adjuvant of aluminium hydroxide gel supplemented vaccine was efficiently eluted by suspending and stirring in high concentration of phosphate buffer solution (0.3M, pH 7.6). The final elute purified by DEAE-Sephadex A50 from the vaccine was concentrated in 1/500-1/1,000 of the original volume. VIA antigens prepared from two kinds of vaccine (Type O and Asia-1) were antigenically identical to one prepared from a cell culture infected with live virus. Two cattle were infected with FMD virus (Type O) and sera were obtained from each cattle every week. The VIA antigens from the inactivated vaccine were compared with the ones from the cell culture infected with live virus in agar gel diffusion tests using sera from cattle infected with live virus. The antibodies against the VIA antigen were detected between the second week and the 13th or 14th week after infection. The VIA antigen from an inactivated vaccine would be very useful in FMD free countries like Japan to avoid the risk of using live FMD viruses.

Animals↗

Relation between the instrumental activities of daily living and physical fitness tests in elderly women.

A cross-sectional study was conducted to quantitatively evaluate the relationship between the instrumental activities of daily living (IADL) and various physical fitness tests in elderly women living at home. The study focused on the total population of those women aged 65 years and over living in Y Town, Hyogo Prefecture, Japan, who visited a nursing home for day services. A total of 128 subjects were divided into two groups: dependent in IADL group (n = 49) and independent in IADL group (n = 79). The magnitude of the relation was evaluated by the odds ratio (OR). The following tests showed a significant decrease in IADL: knee-raising test [age-adjusted OR = 4.23, 95% confidence interval (CI) 1.81-9.87], height (age-adjusted OR = 4.09, 95% CI 1.75-9.56), grip strength (age-adjusted OR = 3.68, 95% CI 1.57-8.60), sit-and-reach test (age-adjusted OR = 2.76, 95% CI 1.20-6.34), and standing on one leg with closed eyes (age-adjusted OR = 2.56, 95% CI 1.09-5.97). Multivariate analysis using Hayashi's quantification method I indicated that knee-raising was the test most highly correlated with decreased IADL. These results suggest that measurement of knee-raising ability, muscle strength of the lower extremities and flexibility of hip joint could be the most useful factors to assess the level of instrumental self-support ability.

Activities of Daily Living↗

Sarcoidosis presenting as bilateral hydronephrosis.

We report an unusual case of sarcoidosis associated with bilateral hydronephrosis. The patient was a 53-year-old Japanese woman who presented with dysuria and urinary incontinence. Computed tomography of the abdomen showed bilateral hydronephrosis caused by a retroperitoneal mass, surrounded by enlarged retroperitoneal lymph nodes. Histological examination of the mass demonstrated noncaseating epithelioid cell granulomas involving the retroperitoneal lymph nodes. Corticosteroid therapy led to complete resolution of the retroperitoneal mass and hydronephrosis. This case emphasizes that sarcoidosis should be included in the differential diagnosis of a retroperitoneal mass.

Diagnosis, Differential↗

A rare case of severe acute pancreatitis complicated with pancreatic pseudocysts, obstructive jaundice and intraperitoneal hemorrhage.

A 58-year-old man visited our hospital because of back pain. Blood examinations revealed the presence of acute inflammation and an increase of pancreatic enzymes. Abdominal computed tomography indicated pseudocysts in the pancreas. The patient was diagnosed as having acute pancreatitis with pseudocysts formation. During the course of the disease, a newly formed pseudocyst in the pancreatic head compressed the common bile duct, leading to the obstructive jaundice. In addition, the rupture of a pseudocyst in the pancreatic tail caused intraperitoneal hemorrhage. This is an interesting case of acute pancreatitis with pseudocysts in which two rare complications developed.

Acute Disease↗

[A case of diaphragmatic paralysis following herpes zoster].

We report a case of diaphragmatic paralysis after herpes zoster. A 82-year-old woman developed shortness of breath on effort after about two months of a typical herpes zoster eruptions affecting the C4 and C5 dermatomic areas on the right side. A chest x-ray showed an elevated right diaphragm. The diaphragmatic evoked potential by stimulation of the right phrenic nerve at the posterior border of the sternocleidomastoid muscle was not elicited. Chest CT and cervical MRI were normal. The viral antibody titers of herpes zoster were elevated in the serum. Cervical herpes zoster should be considered as a possible cause of hemidiaphragmatic paralysis.

Aged↗

[Pollen dispersion of Cryptomeria japonica in autumn].

To clarify the significance of pollen dispersion of Cryptomeria japonica in autumn, the distribution pattern of pollen dispersion using specimens collected from 1987 to 1995 by Durhum collector was examined. After the dispersion period in the spring, the pollen count was suddenly decreased. The total pollen count from October to December showed no relation to the total pollen count for that of in spring of the same year; but it was closely correlated (r = 0.877) with the total pollen count during the dispersion period in the spring of the next year. In particular, accurate correlation between the total pollen count during November and that in January to May of the following year was observed with the correlation index of r = 0.909. Patients with a pollinosis probably for Cryptomeria japonica were also observed in the autumn. These results suggest that we can forecast the degree of pollen dispersion of Cryptomeria japonica in the coming year from the total pollen count during November of the year before.

Forecasting↗

[Pulmonary and endobronchial tuberculosis with subclavian artery-pulmonary artery shunts].

A 77-year-old woman with a productive cough and fever was admitted to the hospital. Pulmonary and endobronchial tuberculosis, pneumonia of the left upper lobe, and stenosis of the left main bronchus were diagnosed. She was given the antimycobacterial drugs isoniazid, rifampin, and streptomycin, and her condition improved. Two months later, bronchoscopy revealed semilunar-shaped stenosis of the left main bronchus, and auscultation revealed wheezing in the middle-end expiratory phase. A continuous flow murmur (Levine III) was also heard at the left anterior chest wall. Cardiac catheterization with subclavian arteriography revealed two left subclavian-pulmonary shunts. In a case of systemic-pulmonary shunt such as this, the bronchial stenosis could be surgically repaired, but the result would be an increase in dead space. If left untreated, the pulmonary hypertension would progress and symptoms of pulmonary disease would become more severe. Subclavian-pulmonary artery shunt is a very rare complication of pulmonary tuberculosis. Surgical treatment should consist of open bronchoplasty along with lobectomy and removal of the shunt, rather than embolization of the shunt and endoscopic bronchoplasty.

Aged↗

[Mucin gene--regulation of the expression of MUC2 and MUC3 mucin gene in the airway].

Mucus hypersecretion is a characteristic feature of several human airway diseases, including chronic bronchitis, cystic fibrosis and asthma. Analysis of rat disease models has suggested that mucin synthesis is up-regulated as part of the disease process. To understand the primary structure of secretory mucins, several cDNAs encoding airway mucin have been isolated. In most cases, full-length sequences have not been obtained. In this review, we focused on the MUC2 and MUC3 mucin gene. MUC2 mucin has been reported to be expressed in the human lung with airway disease and in the rat lung with infection and exposure to irritant such as SO2. MUC3 is also expressed in the bronchus. Less is known about the structure and the expression pattern of the MUC3 mucin gene. Recent findings show that the expression pattern of the MUC2 and MUC3 mucin genes differ strikingly, suggesting that they play distinct functional roles in the airway and intestine. Functional analysis of mucin gene promoter will provide better understanding of the regulation of its expression in the airway under both normal and pathological conditions.

Amino Acid Sequence↗

[Swyer-James syndrome with pneumomediastinum and subcutaneous emphysema due to bronchial asthma].

A 24-year-old woman was admitted to our hospital due to moderate asthmatic attacks. Dyspnea and hypoxemia progressed gradually despite medication. A chest roentgenogram revealed left unilateraly hyperlucency with pneumomediastiumn and subcutaneous emphysema. Swyer-James syndrome was diagnosed. Several cases of Swyer-James syndrome with bronchial asthma airway hyperresponsiveness have been reported, but we know of no reports of Swyer-James syndrome with pneumomediastinum and subcutaneous emphysema due to prolonged asthmatic attacks. Pneumomediastinum and subcutaneous emphysema may be caused by abnormally high pressures in the bronchial lumen and alveolar space during asthmatic attacks, because the emphysematous lesion may be structurally weak.

Adult↗

Pre beta 1-high-density lipoprotein increases in coronary artery disease.

Pre beta 1-HDL promotes cholesterol efflux from cell membranes. Its plasma concentration is regulated by lecithin: cholesterol acyltransferase (LCAT). To clarify whether the concentration of pre beta 1-HDL changes in coronary artery disease (CAD), we determined the distribution of apolipoprotein A-I (apoA-I) among HDL subfractions in 20 CAD patients and 20 healthy controls, using nondenaturing two-dimensional gel electrophoresis. We found that CAD patients had significantly higher concentrations of pre beta 1-HDL than the controls [7.6% +/- 3.4% vs 4.6% +/- 2.3% of apoA-I (P < 0.01)]. Even after correcting for apoA-I concentrations, this increase remained significant [87 +/- 37 vs 63 +/- 28 mg/L apoA-I (P < 0.05)]. The mean LCAT concentration was significantly lower (P < 0.05) in CAD patients than in controls. These findings, that pre beta 1-HDL concentrations increase in CAD, strongly suggest that the process of reverse cholesterol transport could be altered in CAD.

Aged↗

Failure to detect missense mutations in the S182 gene in a series of late-onset Alzheimer's disease cases.

The possibility of an interaction of multiple genes has been speculated in pathogenesis of Alzheimer's disease (AD). Because we have recently cloned a novel gene S182 bearing five different missense mutations which segregate with early-onset familial AD, we sought the frequency of these mutations in familial and sporadic late-onset AD to clarify the incidence of these mutations in the disease. The current study showed lack of these mutations in 118 independent subjects affected with late-onset Alzheimer's disease.

Aged↗

Hypoglycemia associated with localized fibrous mesothelioma of the pleura.

Hypoglycemia is known to be a rare consequence of non-islet cell tumors. A patient having severe, episodic hypoglycemia was found to have a large mass occupying the right hemithorax. The hypoglycemia resolved immediately after surgical removal of the tumor. Histologic examination of the tumor revealed localized fibrous mesothelioma.

Female↗

Familial Alzheimer's disease in kindreds with missense mutations in a gene on chromosome 1 related to the Alzheimer's disease type 3 gene.

We report the cloning of a novel gene (E5-1) encoded on chromosome 1 which has substantial nucleotide and amino-acid sequence similarity to the S182 gene on chromosome 14q24.3. Mutations, including three new missense mutations in the S182 gene, are associated with the AD3 subtype of early-onset familial Alzheimer's disease (AD). Both the E5-1 and the S182 proteins are predicted to be integral membrane proteins with seven membrane-spanning domains, and a large exposed loop between the sixth and seventh transmembrane domains. Analysis of the nucleotide sequence of the open reading frame (ORF) of the E5-1 gene led to the discovery of two missense substitutions at conserved amino-acid residues in affected members of pedigrees with a form of familial AD that has a later age of onset than the AD3 subtype (50-70 years versus 30-60 years for AD3). These observations imply that the E5-1 gene on chromosome 1 and the S182 gene on chromosome 14q24.3 are members of a family of genes (presenilins) with related functions, and indicates that mutations in conserved residues of E5-1 could also play a role in the genesis of AD. Our results also indicate that still other AD susceptibility genes exist.

Alzheimer Disease↗

The Ras suppressor RSU-1 localizes to 10p13 and its expression in the U251 glioblastoma cell line correlates with a decrease in growth rate and tumorigenic potential.

Rsu-1, which was isolated based on its ability to suppress transformation by v-Ras, is a highly conserved gene which shares homology with yeast adenylyl cyclase in the region required for activation by Ras. Genomic DNA clones of human RSU-1 have been isolated and used as a probe for fluorescence in situ hybridization (FISH) to assign RSU-1 to 10p13, confirming the previous results of somatic cell hybrid mapping localizing RSU-1 to chromosome 10. Screening of more than 20 human tumor cell lines for RSU-1 expression revealed that most cell lines contained abundant RSU-1 RNA and protein. However, the p33 RSU-1 protein was undetectable in the U251 glioblastoma cell line and transfection of a rsu-1 expression vector into U251 cells yielded a cell line in which rsu-1 was under the control of a regulatable metallothionein promoter. Addition of Cd2+ to the U251-Rsu-1 transfectant resulted in transcription of rsu-1 RNA and the accumulation of p33 Rsu-1 protein. Appearance of the Rsu-1 protein correlated with a reduction in growth rate of the U251-Rsu-1 transfectant. In addition, reduction in anchorage independent growth and phenotypic alteration in U251-Rsu-1 transfectant agar colonies was observed. Two U251-Rsu-1 transfectant cell lines were non tumorigenic when injected subcutaneously into athymic nude mice. These results, in conjunction with the frequent deletions observed in chromosome 10 in glioblastomas, suggest that RSU-1 loss of function may play a role in the progression of this disease.

Animals↗