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Biomedical subjects

Y Arai

Publications and source records attributed to Y Arai.

At least 199 records · Page 11Linked to original sources
PubMed2000

Cardiac operations in patients with severe pulmonary impairment.

Many reviews concerning pulmonary complications after cardiac surgical procedures in patients with serious pulmonary disease have been published. However, no strict pulmonary function guidelines were proposed to help the clinician identify the patients at greater risk. We considered whether a low pulmonary function became a risk factor of cardiac operations. We conducted a retrospective analysis of records of 32 patients with severely impaired preoperative pulmonary function who had undergone cardiac operations between July 1988 and March 1999. There was 1 hospital death. The over-all mortality rate was 3.1% (1 of 32). However, this death could not be directly attributed to postoperative pulmonary complications. Postoperative pulmonary complications were seen in 2 patients (6.3%) who required tracheostomy due to atelectasis and pneumonia. No late deaths due to pulmonary complications were observed during the follow-up period. The actual survival rate is 68% at 7 years. A low pulmonary function did not, by itself, become a risk factor of cardiac operations, although a pulmonary function test can be used to alert the clinician to possible postoperative complications, including the requirement of tracheostomy. Especially strict control of postoperative respiration is necessary in patients with forced expiratory volume (FEV) of 1.0 <= 800 ml and/or FEV1.0/BSA <= 600 ml/m2.

Aged↗
PubMed2000

[Continuous intravesical instillation of epirubicin immediately after transurethral resection of superficial bladder cancer: a prospective controlled study].

Between November 1994 and July 1996, 45 patients with superficial bladder tumor were assigned to two groups before transurethral resection of bladder tumor. Twenty-one of the 45 patients were instilled with 20 mg epirubicin before endoscopic resection then continuously irrigated with 40 micrograms/ml epirubicin solution for 20 hours immediately after surgery; 24 of the 45 patients received continuous irrigation with saline in the same manner. The patients were assessed by cystoscopy and urinary cytology every 3 months during the first 2 years and every 6 months thereafter. One year recurrence-free rates in the treated and control groups were 56% and 32%, respectively. The recurrence-free period tended to be longer in the treated group than in the control group, although the difference was not significant (p = 0.17). One year recurrence-free rates in the treated and control groups for the patients with solitary tumor were 88% and 48%, respectively, the difference being marginally significant (p = 0.06). These results suggested that continuous bladder irrigation with epirubicin was effective for patients with a single tumor. Therefore, the long-term prophylactic therapy for a single tumor was an overtreatment. Prophylactic intravesical chemotherapy for superficial bladder cancer was proposed to be stratified by the number of tumors, single or multiple.

Administration, Intravesical↗
PubMed2000

Glucocorticoid-induced apoptotic pathways in eosinophils: comparison with glucocorticoid-sensitive leukemia cells.

Glucocorticoids are known to promote apoptosis of eosinophils, normal and neoplastic lymphoid cells, and blastic cells in some patients with acute myeloid leukemia. We investigated the biochemical signal transduction pathways, in particular, the generation of reactive oxygen species (ROS) and activation of caspases in dexamethasone (DEX)-induced apoptosis of eosinophils, and we compared them with those in DEX-sensitive myeloid and lymphoid leukemia cell lines. The GC-receptor antagonist completely abolished DEX-induced apoptosis of eosinophils and leukemia cells. Among inhibitors related to the ROS system, diphenylene iodonium (DPI), a nicotinamide adenine dinucleotide diphosphate (NADPH) oxidase inhibitor, strongly inhibited both spontaneous and DEX-induced apoptosis of eosinophils at concentrations as low as 0.2 to 2 mumol/L, while promoting apoptosis of leukemia cells in a dose-dependent manner. Apocynin, another NADPH oxidase inhibitor, and antioxidants did not affect the apoptosis of eosinophils or leukemia cells. DEX treatment did not change intracellular production of O2- and H2O2, and it decreased the extracellular release of O2- in both cells. These results suggest little or no involvement of ROS generation in DEX-induced apoptosis of both cells. Although among peptide-based caspase inhibitors, only z-VAD-FMK, a broad caspase inhibitor, partially inhibited the apoptosis of eosinophils and leukemia cells, DEX treatment increased the activities of caspases 2-, 3-, 6-, and 8-like proteases assessed by colorimetry in both cells, suggesting the involvement of a similar caspase activation pathway in DEX-induced apoptosis in both cells. DPI markedly reduced caspase 3-like activity in eosinophils, while augmenting the activity in leukemia cells, indicating that DPI acts upstream of caspase 3 activation opposingly in both cells. Thus, the action of DPI in eosinophils seems peculiar in respect to apoptosis induction, and DPI appears to exert an influence on unknown targets rather than those involved in NADPH oxidase inhibition.

Apoptosis↗
PubMed2000

[Surgical results of valvular heart disease combined with myocardial revascularization].

Risk factors for hospital death after combined valvular and coronary artery bypass surgery were examined in 131 consecutive cases between October 1988 and December 1999. These accounted for 8.0% of all 1,644 cases of coronary revascularization surgery and 15.3% of all 854 cases of valvular heart disease surgery. 84 men and 43 women underwent combined valvular and coronary artery bypass surgery. The mean age of the patients was 68.9 +/- 3.9 (22-86) years old. Numbers of cases comprised 58 undergoing aortic valve surgery, 63 undergoing mitral valve surgery, and 10 undergoing eight patients died during hospitalization after the operation: four due to cardiac death and four due to non-cardiac death. We studied pre- and perioperative risk factors for hospital death by means of multivariate analysis. As the major factors, ischemic mitral regurgitation, chronic renal failure, and duration of cardiopulmonary bypass were identified as three major predictors of hospital death. Ischemic mitral regurgitation was the strong predictor (p = 0.03) with 5 hospital deaths out of 38 ischemic mitral regurgitation cases (13.1%), whereas only 3 hospital deaths were seen in 93 other cases (3.2%) operated on in the same period. Over all operation results were not unfavorable, indicating that combined operations may be electively performed if severe coronary artery disease was present. The surgical results with ischemic mitral regurgitation are as yet not well documented and will require further study.

Adult↗
PubMed2000

[A case of bladder hemangioma showing bladder tamponade during late pregnancy].

We report a case of bladder hemangioma manifesting bladder tamponade during pregnancy. A 25-year-old woman at 36 weeks of gestation was admitted with a two-week history of gross hematuria and clot retention. Blood hemoglobin concentration was 6.3 g/dl. After blood transfusion and Caesarian section, cystoscopy was performed. Bleeding was noticed from a strawberry-like tumor 5 mm in diameter near the right ureteral orifice, which was easily resected endoscopically. Histopathological diagnosis was cavernous hemangioma of the urinary bladder. This is the first report of a case of bladder hemangioma during pregnancy.

Adult↗
PubMed2000

Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function: a prospective study.

PURPOSE: Treatment for benign prostatic hyperplasia (BPH), including minimally invasive therapy, can impair the quality of life. We prospectively determined the impact of 4 different interventional therapies on quality of life and sexual function. MATERIALS AND METHODS: A total of 173 patients were prospectively evaluated between February 1995 and August 1997. Treatment modalities consisted of standard transurethral resection of the prostate in 55 cases, transurethral microwave thermotherapy in 34, interstitial laser coagulation of the prostate in 42 and transurethral needle ablation in 42. Disease specific quality of life was assessed using the International Prostate Symptom Score quality of life assessment index and BPH impact index. In addition, a self-reporting questionnaire was completed before and 3 months after treatment to determine the impact on sexual function. RESULTS: All 4 treatment groups showed significant improvement in the symptom score, International Prostate Symptom Score quality of life assessment score and BPH impact index score. Satisfaction with treatment was highest in patients treated with transurethral resection or laser coagulation. A mild to moderate decrease in erectile function was noted in 26.5%, 18.2%, 18.4% and 20.0% of the transurethral resection, microwave thermotherapy, laser coagulation and needle ablation groups, respectively, but there was no significant difference of mean pretreatment and posttreatment erectile function or libido scores in any group. Ejaculation loss or severe decrease in ejaculate volume was reported by 48.6%, 28.1%, 21.6% and 24.3% of the patients, respectively. Interestingly, 20 of the 44 patients (45. 5%) with loss of ejaculation or severe decrease in ejaculate reported deterioration of the sex life, while only 2 (3.6%) of the 56 without any change in ejaculate volume reported such deterioration. The association of ejaculatory dysfunction with an adverse impact on sexual activity was highly significant (p <0.0001). CONCLUSIONS: Significant improvement in quality of life could be achieved with the present assessed interventional therapies. There was no significant change in sexual desire or erectile function with these therapies. Posttreatment sexual dysfunction appears to be mainly related to impaired ejaculatory function. Urologists should provide proper counseling regarding the possibility of this complication even in patients receiving minimally invasive treatment.

Aged↗
PubMed2000

[A randomized crossover comparison of azasetron alone and azasetron plus dexamethasone for the prevention of nausea and vomiting by chemotherapy including cisplatin].

A randomized crossover study between azasetron alone and azasetron combined with dexamethasone was performed to investigate the prevention of nausea and vomiting due to chemotherapy including cisplatin in patients with advanced head and neck carcinoma. The results indicated that the combination therapy with dexamethasone was more effective than azasetron alone in preventing nausea on days 1 through 5 after the administration of cisplatin and was significantly superior to azasetron alone on days 2 and 3. In addition, complete response (no vomiting) and the antiemetic and antinausea efficacy of combination therapy with dexamethasone on day 2 was significantly superior compared to azasetron alone. No adverse effect from either antiemetic therapy was observed in this study.

Adult↗
PubMed2000

[Pituitary cystic mass with spontaneous disappearance: three cases of equivocal Rathke's cleft cyst].

Three cases with a pituitary cystic mass that spontaneously disappeared were discussed. Common characteristics of these 3 cases were presence of headache, cystic mass, spontaneous disappearance, and no recurrence. Based on clinical course, MRI findings such as cystic mass with ring enhancement, no calcification, and displacement posteriorly of the normal pituitary gland, and previous reports, these 3 cases were diagnosed as an equivocal Rathke's cleft cyst. We suggested that operative indication in an equivocal Rathke's cleft cyst, even though it was symptomatic, should be decided after sufficient follow-up, because there may be a possibility of spontaneous reduction or disappearance like our cases.

Adult↗
PubMed2000

[Hepatic arterial infusion chemotherapy for liver metastases from colorectal cancer].

After randomized studies of hepatic arterial infusion chemotherapy (HAIC) versus systemic chemotherapy for liver metastases from colorectal cancer in the 1980s, the role of HAIC has been unclear and there is still no evidence to support it as the treatment of choice. The high local control, the differences in techniques between Japan and Western countries, the difficulty of detecting pre-treatment extra-hepatic metastases and the fact that HAIC does not control extra-hepatic lesions are the most important points in considering clinical trials of HAIC. Clinical studies on the combination of HAIC using 5-FU and systemic chemotherapy using CPT-11, and then randomized trial of systemic chemotherapy with/without HAIC is required in Japan to reveal the role of HAIC in the management of liver metastases from colorectal cancer. We should understand the importance of our role in this field.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Long-term angiographic evaluation of free internal thoracic artery grafting for myocardial revascularization.

Between 1990 and 1998, 41 patients underwent free internal thoracic artery grafting for coronary artery bypass. To investigate usefulness of free internal thoracic artery grafting, we compared the postoperative graft patency of free internal thoracic artery grafts with that of in situ internal thoracic artery grafts, and compared the long-term results such as actual survival and cardiac-event free rate in patients receiving free internal thoracic artery grafts with those results in patients receiving in situ internal thoracic artery grafts. Postoperative changes in luminal diameter of free internal thoracic artery grafts were calculated as the difference between the first and secondary angiographic evaluation in 17 patients who were followed-up for more than 5 years. The early postoperative graft patency rate of free internal thoracic artery was 95.2%. All these early patent grafts remained patent at the time of the late study. At 9 years post-surgery, patients who received free internal thoracic artery grafts had a survival rate of 100% and a cardiac event-free rate of 77.5%; the luminal diameter enlargement was 0.57 mm, and the mean matching rate increased 27.8%. We conclude that the free internal thoracic artery provides long-term results comparable with those of in situ internal thoracic artery.

Aged↗
PubMed2000

[A study on parameters to predict tumor volume for stage T1c prostate cancers of Gleason score 6 or less].

The number of cases of stage T1c prostate cancer has dramatically been increasing since the introduction of PSA as a screening test. The patients with T1c prostate cancer are usually treated by radical prostatectomy. In this group, however, some cancers are of small tumor volume and with a Gleason score of less than 7. These cancers are considered to be good candidates for watchful waiting management. We have investigated 40 patients with T1c prostate cancer treated by radical prostatectomy between 1996 and 1998. All 9 patients harboring tumors of Gleason score 7 or greater had tumors larger than 0.5 cm3. We have investigated PSA-related parameters including total PSA (PSA), PSA density (PSAD), free PSA, and % free PSA in 31 patients with T1c cancers of Gleason score 6 or less in order to clarify good preoperative predictors of tumor volume. We compared the distribution of PSA, PSAD, free PSA, and % PSA between the larger and smaller tumor groups. There was no significant difference in PSA, PSAD, or free PSA value. The small tumor group had a greater mean % free PSA than the larger tumor group (23.27 versus 11.88, p = 0.007). Areas under receiver operating characteristic curves were 0.715, 0.794, 0.636, and 0.842 for PSA, PSAD, free PSA and % free PSA. In stage T1c prostate cancer of Gleason score 6 or less, % free PSA may be the most useful preoperative predictor for tumor volume of 0.5 cm3 or greater.

Aged↗
PubMed2000

[Immunoadsorption therapy with TR-350 (tryptophan column) for Guillain-Barré syndrome: investigation including serum antiganglioside antibody assay].

Immunoadsorption therapy (IAT) using TR-350 was performed for 14 patients with Guillain-Barré syndrome (GBS). Presence of serum antiganglioside antibodies (AGA) was investigated in all the patients in the acute phase. In 14 patients studied, 6 men and 8 women, ages from 24 to 74 years(mean, 42.5 years), 7 patients had suffered from common cold and 3 from diarrhea before neurological onset. Ophthalmoplegia was seen in 6 patients, facial palsy in 6, bulbar palsy in 3 and cerebellar sign in 2. Functional grade scores (FGS) by Hughes et al. of the patients were from 5 to 1 (mean, 3.3). In 4 patients, whose FGS were 1 or 2, IAT were performed, because of worsting of bulbar palsy, bilateral facial palsy and limb weakness. Relapse occurred in one patient. IAT was started from 2 to 18 days (mean, 8.4) after neurological onset and performed 3 to 14 times (mean, 7.5) for each patient. Mean FGS improved from 3.3 to 2.1 after IAT. The mean time to improve 1 grade was 10.3 days and mean time to improve 2 grades was 39.0 days. The mean FGS after 1 month was 1.4 and that after 3 months was 0.4. Some of 14 patients had elevated titers of AGA in sera in the acute phase. Four patients had anti-GQ1b IgG antibody and showed external ophthalmoplegia. One patient with anti-GD1b IgG antibody had cerebellar signs as well as peripheral neuropathy. Those AGAs decreased after IAT in parallel with improvement. IAT is an effective treatment in acute phase of GBS.

Acute-Phase Reaction↗
PubMed1999

A 2-Mb sequence-ready contig map and a novel immunoglobulin superfamily gene IGSF4 in the LOH region of chromosome 11q23.2.

Human chromosome 11q23.2 has been proposed to contain a tumor suppressor gene(s) whose deletion has been associated with cancer of the lung and breast and with neuroblastoma. To analyze the genomic structure and to isolate a candidate tumor suppressor gene from this region, we constructed a 2-Mb sequence-ready contig map using bacteriophage P1 (P1), bacterial artificial chromosome (BAC), and P1-derived artificial chromosome (PAC). The map comprises a contig of 24 overlapping P1, BAC, and PAC clones. To isolate gene fragments from the region, we performed direct cDNA library screening, exon trapping, EST mapping, and genomic sequencing using the P1, BAC, and PAC clones. Sequence analysis of 5 clones, which spans 23% (458,738 bp) of the region, and extensive gene scanning along the entire region revealed that the region is extraordinarily scarce in genes, but we identified one ubiquitously expressed novel gene and one testis-specific gene fragment. The novel gene, which we call IGSF4 (immunoglobulin superfamily 4), is transcribed into a 1.6- or 4.4-kb RNA encoding a 442-amino-acid protein. It shares strong homology with mouse IGSF-B12 and cell adhesion molecules NCAM1 and NCAM2 within their Ig-like C2-type domains. The IGSF4 gene, a novel gene that is shown to be located in the common loss of heterozygosity region, possesses a number of interesting features and may be good candidate for a tumor suppressor gene.

Amino Acid Sequence↗
PubMed1999

Evaluation of voltage-sensitive dyes for long-term recording of neural activity in the hippocampus.

We searched for an optimal voltage-sensitive dye for optical measurements of neural activity in the hippocampal slice by evaluating several merocyanine-rhodanine and oxonol dyes. The wavelength dependence (action spectra), pharmacological effects of staining, signal size, signal-to-noise ratio, and the utility of the dyes for long-term continuous recording were examined for four merocyanine-rhodanine dyes (NK2761, NK2776, NK3224 and NK3225), which had been reported to be optimal in embryonic nervous systems, and for two oxonol dyes (NK3630 (RH482) and NK3041 (RH155)), which have been among the most popular potentiometric probes for the hippocampal slice preparation. NK2761, NK3224 and NK3225 provided large signal-to-noise ratios, and proved to be useful for optical recordings lasting several hours. NK3630 was most suitable for long-term recording, although the signal-to-noise ratio was slightly inferior to that of the merocyanine-rhodanines. Using NK3630 (RH482) on the hippocampal slice preparation, we demonstrate here that long-term potentiation can be monitored stably for more than 8 hr.

Animals↗
PubMed1999

Temporal and spacial relationships between PSA-NCAM-expressing, newly generated granule cells, and radial glia-like cells in the adult dentate gyrus.

The granule cell layer of the adult dentate gyrus possesses two characteristics of an immature nervous system. The first is that granule cells continue to be generated in the innermost region of the granule cell layer, and newly generated and developing granule cells in the adult express highly polysialylated neural cell adhesion molecule (PSA-NCAM). PSA-NCAM-expressing apical dendrites have dynamically unstable processes such as irregular shafts and many stick-like or fan-shaped fine processes. The second is that radial glia-like cells expressing glial fibrillary acidic protein (GFAP) remain in a similar region of the granular layer. The numbers of PSA-NCAM-expressing granule cells and GFAP-expressing radial glia-like cells show a parallel age-dependent decrease during aging. Moreover, by using confocal laser scanning microscopy and immunoelectron microscopy, we demonstrated that PSA-NCAM-expressing dendrites and GFAP-expressing radial processes are partly in contact with each other, and occasionally the radial glial processes envelop the PSA-NCAM-positive dendritic processes. The temporal and spatial relationship between the two immature elements suggests that the processes of the radial glia-like cells are closely associated with the dendritic growth of the newly generated granule cells in the adult dentate gyrus and that these two immature features of neurons and glia in the dentate gyrus diminish with age.

Aging↗