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Biomedical subjects

Y Arai

Publications and source records attributed to Y Arai.

At least 235 records · Page 13Linked to original sources

Development of a compact computed tomographic apparatus for dental use.

OBJECTIVE: To describe a compact computed tomographic apparatus (Ortho-CT) for use in dental practice. METHODS: Ortho-CT is a cone-beam-type of CT apparatus consisting of a multifunctional maxillofacial imaging machine (Scanora, Soredex, Helsinki, Finland) in which the film is replaced with an X-ray imaging intensifier (Hamamatsu Photonics, Hamamatsu, Japan). The region of image reconstruction is a cylinder 32 mm in height and 38 mm in diameter and the voxel is a 0.136-mm cube. Scanning is at 85 kV and 10 mA with a 1 mm Cu filter. The scan time is 17 s comparable with that required for rotational panoramic radiography. A single scan collects 512 sets of projection data through 360 degrees and the image is reconstructed by a personal computer. The time required for image reconstruction is about 10 min. RESULTS: The resolution limit was about 2.0 lp mm-1 and the skin entrance dose 0.62 mGy. Excellent image quality was obtained with a tissue-equivalent skull phantom: roots, periodontal ligament space, lamina dura, and cancellous bone were clearly visualized. CONCLUSION: Ortho-CT provides three-dimensional images of excellent quality for dental use at a low entrance dose.

Humans↗

Depression among caregivers of the disabled elderly in southern Japan.

The present study was conducted in an attempt to investigate factors related to depression of caregivers who looked after the disabled elderly residing in a community in southern Japan. A questionnaire survey was carried out of 45 pairs of caregivers and the disabled elderly who received regular visits from a practice nurse, who was located in Onga County, Fukuoka, in southern Japan. Twenty-four out of 45 caregivers (53.3%) scored above the conventional cut-off of the Center for Epidemiologic Studies Depression Scale (CES-D). The proportion of children-in-law caregivers was significantly smaller (0% vs. 23.8%, P = 0.01) and the proportion of caregivers who had consulted a physician within 1 month prior to the study was greater in the depressed than that in the non-depressed (79.2% vs. 47.6%, P = 0.03). The elderly whose caregivers were depressed (group 1) had more behavioural disturbances than those of the non-depressed caregivers (group 2) (1.92+/-2.38 vs. 0.52+/-0.87, P = 0.01) A multiple logistic regression analysis revealed that only behavioural disturbance was positively related to depression (Odds ratio: 4.29, 95% confidence interval: 1.28-14.37). More behavioural disturbances led the caregivers to depression or the depressed caregivers failed to take care of the elderly, which resulted in an increase in the number of the behavioural disturbances of the elderly.

Activities of Daily Living↗

Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses.

BACKGROUND: A 14-year-old boy was admitted because of lumbago and high fever. METHODS/RESULTS: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case. CONCLUSIONS: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.

Abscess↗

Orthotopic ileal neobladder in male patients: functional outcomes of 66 cases.

BACKGROUND: Orthotopic urinary diversion has become the preferred form of bladder reconstruction after cystectomy. We report on our experience with 66 male patients undergoing this procedure from November 1990 to February 1998. METHODS: A neobladder was constructed using an ileal segment with a Hautmann type bladder. Complications were assessed and subdivided into early and late types. Voiding function was evaluated in terms of voiding pattern and continence. Median follow up was 19.5 (range 3.5-87.7) months. RESULTS: There was one (1.5%) perioperative death. The most frequent pouch-related and unrelated early complications were persistent urine leak (7.6%) and prolonged ileus (16.7%), respectively, the majority of cases of which were managed conservatively. Analysis of late complications revealed 6.2% ureteroileal stenosis and 1.5% urethrointestinal stenosis rates, but no case of bladder stone formation. Of the 61 patients in whom voiding function was evaluable, 95.1% achieved excellent daytime continence, while only 67.2% had night-time continence. With regard to posture at voiding, 23 (37.7%) voided in a sitting position. Three of the patients (4.9%) were unable to void and required regular intermittent catheterization. CONCLUSIONS: An orthotopic neobladder can be constructed with acceptable morbidity and excellent functional results. We believe that orthotopic urinary diversion offers an attractive alternative to a bladder substitute when cystectomy is required.

Adult↗

Changes in resistive index following extracorporeal shock wave lithotripsy.

BACKGROUND: Extracorporeal shock wave lithotripsy (ESWL) has replaced most surgical and endourologic forms of therapy for upper urinary tract stone disease. Despite its proved safety and efficacy, its adverse effects on renal function are still to be identified. A newer diagnostic technique, color Doppler ultrasonography, has brought a new insight into renal function. It enables precise evaluation of the renal vascular supply. Changes in intrarenal vascular resistance after ESWL were studied with Doppler ultrasound techniques. METHODS: In 70 consecutive patients the resistive index (RI) was measured at an interlober artery before and 30 min after ESWL in the treated and contralateral kidneys. In 17 patients, a follow-up Doppler study was performed 1 week after ESWL. RESULTS: In the treated kidneys, the RI significantly increased from 0.656+/-0.053 (mean +/- SD) at baseline to 0.682+/-0.053 (P<0.0001). There was no significant correlation of increase in RI with patient age (r = 0.010) or with pre-ESWL blood pressure (r = 0.002). Elderly patients (> or =60 years old, n = 31) had higher RI levels on baseline than younger patients (<60 years old, n = 39). In 18 of the 31 (58.1%) elderly cases the RI were elevated to greater than 0.7, indicating pathologic changes. In younger patients, only 9 (23.1%) experienced increase in RI up to 0.7 or greater. The contralateral untreated kidneys showed significant change in RI before (0.664+/-0.045) and after (0.679+/-0.049) lithotripsy in elderly patients (P<0.005). A follow-up Doppler study showed that the mean RI returned to pretreatment levels after 1 week. CONCLUSIONS: Because of higher RI levels on baseline, elderly patients have a higher risk of post-ESWL renal tissue damage than younger patients. Clinical implication of RI change in the contralateral kidneys in this study remains to be answered. The measurement of changes in RI with Doppler ultrasound techniques after ESWL may provide useful information for clinical diagnosis of renal tissue damage.

Adolescent↗

Urinary undiversion for pelvic actinomycosis: a long-term follow up.

BACKGROUND: A 43-year-old woman who had been using intrauterine contraceptive devices for the past 10 years underwent an emergency operation for bowel and urinary obstruction. METHODS/RESULTS: Frozen section analysis showed undifferentiated adenocarcinoma. Incomplete tumorectomy, ileal resection, partial cystectomy, colostomy and bilateral ureterocutaneostomy were palliatively performed. Postoperatively, periodic acid-Schiff and Grocott-Gomori methenamine tests revealed Actinomyces and the final diagnosis was pelvic actinomycosis. Treatment with penicillin G administered intravenously relieved her symptoms and the lesion was dramatically improved. The patient underwent colostomy closure and urinary undiversion. CONCLUSIONS: Five years after urinary undiversion, the patient's renal function has been maintained and she can void without incontinence and dysuria.

Actinomycosis↗

Patient-reported quality of life after radical prostatectomy for prostate cancer.

BACKGROUND: Increasingly, quality of life (QOL) assessments are receiving greater attention in the management of malignancies, including prostate cancer. We evaluated the impact of radical prostatectomy on patient QOL 12 months or longer after surgery. PATIENTS AND METHODS: We evaluated the impact of radical prostatectomy on QOL in 60 patients with prostate cancer. The patients comprised two groups: the first group (n = 32) was evaluated 12 months or longer after radical prostatectomy; the second group (n = 28) was evaluated while awaiting radical prostatectomy. General health-related QOL was measured with the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire. Sexual function was assessed with the Sapporo Medical University Sexual Function Questionnaire. A newly developed instrument assessing urinary function was prepared only for the postoperative group. RESULTS: No differences between the two groups were seen in comparisons of general health-related QOL subscales. Men who underwent surgery reported significant deterioration in sexual function (decreased quality of erection, decreased sexual activity and decreased satisfaction with sex life) than those awaiting surgery. Of the 32 postoperative patients, 26 (81%) did not use pads at all, five (16%) used one or fewer pads per day due to occasional spotting and only one patient (3%) used two to four pads per day to deal with urine dripping. Twenty-six postoperative patients (81%) stated that, given the choice, they would undergo radical prostatectomy again. CONCLUSIONS: General health-related QOL does not appear to be compromised following radical prostatectomy. Patients are willing to accept some morbidity for a perceived survival benefit. Although minimal urinary dysfunction was reported, most patients were dissatisfied with postoperative sexual function. In preoperative counselling, greater emphasis should be placed on the risk of postoperative impotence.

Aged↗

Gastroprotective mechanism of lafutidine, a novel anti-ulcer drug with histamine H2-receptor antagonistic activity.

Lafutidine (CAS 118288-08-7, FRG-8813) is a novel histamine H2-receptor antagonist with gastroprotective activity. The aim of this study was to investigate the property of the gastro-protective activity of lafutidine by examining the effect on ammonia-induced change in transmucosal potential difference (PD), basal gastric mucosal blood flow (GMBF) and noxious agent-induced cell damage. Intragastrical application of lafutidine accelerated the recovery of the PD reduction after exposure of the mucosa to 0.25% ammonia solution and the accelerating effect was abolished by chemical deafferentation, but not with indometacin, a cyclooxygenase inhibitor. The application of capsaicin, as a reference compound, significantly promoted the recovery of the ammonia-induced PD reduction and this effect was not altered with indometacin. Lafutidine given intragastrically caused a sustained increase in GMBF in a dose-dependent fashion, which was also completely inhibited in the deafferentated rats. In vitro studies revealed that, in contrast to 16,16-dimethyl prostaglandin E2, lafutidine did not protect isolated gastric superficial epithelial cells from ethanol- or ammonia-induced damage. In conclusion, the gastroprotection of lafutidine is induced by promoting the restitution of the damaged mucosa after a noxious agent, not by directly protecting the epithelial cells and this effect may be caused through the mechanism of capsaicin-sensitive afferent nerves.

16,16-Dimethylprostaglandin E2↗

Long-term treatment results of elderly patients with prostate cancer in Japan: an analysis of prognostic factors.

BACKGROUND: The management of elderly patients with prostate cancer is an important issue because the incidence of prostate cancer is high in old men, and people are also living longer today. The present retrospective study was therefore conducted to evaluate the long-term clinical outcome of elderly patients with prostate cancer and to analyze the prognostic factors. METHODS: Between 1980 and 1992, 151 patients aged 75 to 89 years old were diagnosed as having prostate cancer. The patients were initially managed by hormonal therapy in 117, radical prostatectomy in 11, external radiotherapy in 20, chemotherapy in 1 and no treatment in 2 cases. The clinical outcome of the patients was analyzed in relation to clinical stage, histological grade and treatment methods received. RESULTS: By univariate analysis, the stage and treatment methods were significant variables for overall and cause-specific survival rates, and grade was a significant variable for cause-specific survival rate of the patients. However, multivariate analysis revealed that stage was the only independent prognostic factor for overall as well as cause-specific survival of the patients. Among the patients with stage A2-B disease, a comparison between those treated definitively and non-definitively revealed no difference in terms of overall and relative survival rates. CONCLUSIONS: The presence of advanced prostate cancer disease had the greatest impact on the survival of the elderly patients. On the other hand, localized prostate cancer was satisfactorily managed with non-definitive almost as well as with definitive treatment.

Aged↗

A patient with genetic deletion of glutathione-S-transferase T1 and M1 who developed non-small-cell lung cancer and myelodysplastic syndromes.

Glutathione S-transferase (GST) M1 polymorphism is a marker for susceptibility to smoking-related neoplasms, such as lung and bladder cancer. Recently, a genetic deletion of GSTT1, an isoenzyme of GST, has been reported to be associated with myelodysplastic syndromes (MDS). A 59-year-old man with a long-term smoking habit was treated successfully for non-small-cell lung cancer. Four years after the surgical removal of his lung cancer, he developed MDS and died. Using a polymerase chain reaction-based genotyping method, he was found to have a deletion of both the GSTM1 and GSTT1 genes. Screening for the deletion of the GSTM1 and GSTT1 genes may be useful for assessing individual genetic susceptibility to smoking-related lung cancer and MDS.

Asian People↗

Computed tomography under endoscopic retrograde pancreatography (ERP-CT) to investigate the drainage area of the pancreatic head.

The aim of this study was to evaluate the drainage area of the pancreatic head with computed tomography under endoscopic retrograde pancreatography (ERP-CT). ERP-CT was performed in 26 patients without lesions of the pancreatic head. By comparing ERP-CT images with ERP images, we evaluated the drainage area of the inferior branch of the pancreatic head. In 77% of these cases, the drainage function of Santorini's duct system (including the accessory papilla) was impaired. In 13 cases with the normal duct pattern, all inferior branches from Santorini's duct drained the anterior inferior area and all inferior branches from Wirsung's duct drained the posterior inferior area. In six cases with an ansa-type duct pattern, all inferior branches from Wirsung's duct drained the posterior inferior area, and inferior branches from Santorini's duct were divided into branches draining the anterior inferior area and branches draining the posterior inferior area. ERP-CT is a useful method for evaluating the three-dimensional anatomic variations of the pancreatic duct.

Aged↗

Expression of platelet-derived endothelial cell growth factor/thymidine phosphorylase in human bladder cancer.

We investigated the expression of platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) in primary bladder cancer, its association with clinicopathologic findings, and their prognostic value. mRNA was extracted from 20 bladder cancer specimens and 6 normal bladder mucosal tissues. Relative amounts of PD-ECGF/TP mRNA were evaluated by reverse transcriptase-polymerase chain reaction (RT-PCR) and compared with the level of glyceraldehyde-3-phosphate dehydrogenase mRNA (used as an internal standard). PD-ECGF/TP expression was examined by immunohistochemistry in 85 patients who underwent cystectomy for bladder cancer. Serum PD-ECGF/TP levels were measured in 23 patients using a sandwich-type enzyme-linked immunosorbent assay. By RT-PCR analysis, expression of PD-ECGF/TP was found to be 7-fold higher in invasive tumors than in superficial tumors (P<0.01) and 9-fold higher than in normal bladder (P<0.01). Out of 85 transitional cell carcinoma tissue samples, 69 (81%) were evaluated as PD-ECGF/TP-positive by immunohistochemical staining. PD-ECGF/TP expression correlated significantly with tumor grade (P = 0.001), depth of invasion (P = 0.012), and lymphatic invasion (P = 0.01). No correlation was found between expression of PD-ECGF/TP and the number of tumors, tumor configuration, lymph node involvement, venous invasion, c-erbB-2 expression, or overall survival. We could not detect a significant serum level of PD-ECGF/TP in any patient. The results suggest that PD-ECGF/TP might give valuable information for bladder cancer management, though it may not be a good new tumor marker for bladder cancer.

Adult↗

Optical mapping of neural network activity in chick spinal cord at an intermediate stage of embryonic development.

We have applied multiple-site optical recording of transmembrane potential changes to recording of neuronal pathway/network activity from embryonic chick spinal cord slice preparations. Spinal cord preparations were dissected from 8-day-old chick embryos at Hamburger-Hamilton stage 33, and transverse slice preparations were prepared with the 13th cervical spinal nerve or with the 2nd or 5th lumbosacral spinal nerve intact. The slice preparations were stained with a voltage-sensitive merocyanine-rhodanine dye (NK2761). Transmembrane voltage-related optical (dye-absorbance) changes evoked by spinal nerve stimulation with positive square-current pulses using a suction electrode were recorded simultaneously from many loci in the preparation, using a 128- or 1,020-element photodiode array. Optical responses were detected from dorsal and ventral regions corresponding to the posterior (dorsal) and anterior (ventral) gray horns. The optical signals were composed of two components, fast spike-like and slow signals. In the dorsal region, the fast spike-like signal was identified as the presynaptic action potential in the sensory nerve and the slow signal as the postsynaptic potential. In the ventral region, the fast spike-like signal reflects the antidromic action potential in motoneurons, and the slow signal is related to the postsynaptic potential evoked in the motoneuron. In preparations in which the ventral root was cut microsurgically, the antidromic action potential-related optical signals were eliminated. The areas of the maximal amplitude of the evoked signals in the dorsal and ventral regions were located near the dorsal root entry zone and the ventral root outlet zone, respectively. Quasiconcentric contour-line maps were obtained in the dorsal and ventral regions, suggesting the functional arrangement of the dorsal and ventral synaptic connections. Synaptic fatigue induced by repetitive stimuli in the ventral synapses was more rapid than in the dorsal synapses. The distribution patterns of the signals were essentially similar among C13, LS2, and LS5 preparations, suggesting that there is no difference in the spatiotemporal pattern of the neural responses along the rostrocaudal axis of the spinal cord at this developmental stage. In the ventral root-cut preparations, comparing the delay times between the ventral slow optical signals, we have been able to demonstrate that neural network-related synaptic connections are generated functionally in the embryonic spinal cord at Hamburger-Hamilton stage 33.

Animals↗

Phase II study of combined administration of 5-fluorouracil, epirubicin and mitomycin-C by hepatic artery infusion in patients with liver metastases of gastric cancer.

This multicenter phase II study evaluated the efficacy of the FEM regimen (5-fluorouracil 333 mg/m(2) each week, epirubicin 30 mg/m(2) once every 4 weeks and mitomycin-C 2.7 mg/m(2) once every 2 weeks) administered by hepatic artery infusion (HAI) for unresectable hepatic metastases of gastric cancer. The response rates were 55.6% (complete response: 3, partial response: 32, no change: 21, progressive disease: 7/63) and the mean 50% survival was 10.5 months. Most responders died due to the progression of extrahepatic lesions. HAI of the FEM regimen induced a high response rate in patients with hepatic metastases of gastric cancer, and the prognosis-determining factor was the existence of extrahepatic lesions in many patients.

Aged↗

Anti-carcinogenic activity of Taraxacum plant. I.

An extract of the roots of Taraxacum japonicum (Compositae) exhibited strong anti-tumor-promoting activities on the two-stage carcinogenesis of mouse skin tumor induced by dimethylbenz[a] anthracene (DMBA) as an initiator and 12-O-tetradecanoylphorbol-13-acetate (TPA) as a promoter, as well as on that induced by DMBA and fumonisin B1. Further, the extract exhibited anti-tumor-initiating activity on the two-stage carcinogenesis of mouse skin tumor induced by (+/-)-(E)-methyl-2-[(E)-hydroxyimino]-5-nitro-6-methoxy-3-hexen amide (NOR-1) as an initiator and TPA as a promoter. These results suggested that an extract of the roots of the Taraxacum plant could be a valuable chemopreventive agent against chemical carcinogenesis.

9,10-Dimethyl-1,2-benzanthracene↗

Anti-carcinogenic activity of Taraxacum plant. II.

Eleven triterpenoids (1-11) from the roots of Taraxacum japonicum (Compositae) were examined for their inhibitory effects on Epstein-Barr virus early antigen (EBV-EA) induced by the tumor promoter, 12-O-tetrade-canoylphorbol-13-acetate (TPA), in Raji cells as a primary screening test for anti-tumor-promoters (cancer chemopreventive agents). Of these triterpenoids, taraxasterol (1) and taraxerol (7) exhibited significant inhibitory effects on EBV-EA induction, but the inhibitory effects of their acetates 2 and 8 were weaker than those of 1 and 7. Furthermore, 1 and 7 exhibited potent anti-tumor-promoting activity in the two-stage carcinogenesis tests of mouse skin using 7,12-dimethylbenz[a]anthracene (DMBA) as an initiator and TPA as a promoter, and 1 showed a remarkable inhibitory effect on mouse spontaneous mammary tumors using C3H/OuJ mouse. These results strongly suggested that taraxasterol (1) could be a valuable chemopreventive agent.

Animals↗

Plasma endothelin-1 elevation associated with alcohol-induced variant angina.

Vasospastic angina as a result of alcohol ingestion has been reported, but the mechanism of alcohol-induced coronary artery spasm is presently unknown. This report presents 2 cases of alcohol-induced variant angina (VA) with elevated levels of plasma endothelin-1 after alcohol ingestion. In case 1, the plasma endothelin-1 concentration was 3.15 pg/ml before drinking (normal <2.30 pg/ml) and increased to 4.09 pg/ml when measured 5 h after alcohol ingestion. After 2 months of abstinence, the plasma endothelin-1 concentration was 2.88 pg/ml and 6 months after abstinence, it decreased to 2.03 pg/ml (normal range). In case 2, the plasma endothelin-1 concentration was 2.44 pg/ml before drinking and increased to 4.36 pg/ml when measured 5 h after alcohol ingestion. After 2 months of abstinence, the plasma endothelin-1 concentration was 3.04 pg/ml and 6 months after abstinence, it decreased to 2.09 pg/ml (normal range). These 2 cases suggest that a relationship may exist between alcohol-induced VA and elevation in the plasma endothelin-1 concentration after alcohol ingestion.

Aged↗