Japanese mass screening for neuroblastoma.
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Age Factors↗
Biomedical subjects
Y Arai
Publications and source records attributed to Y Arai.
Combining volume-weighted mean nuclear volume with Gleason score and clinical stage to predict more reliably disease outcome of patients with prostate cancer.
BACKGROUND: Various criteria for patients with prostate cancer have been reported to be of prognostic value, and we have reported that estimates of volume-weighted mean nuclear volume (MNV), developed by Gundersen and Jensen based on a stereological technique, accurately predict the prognosis of prostate cancer. However, all of these studies were conducted on cases in a single institution, and it has remained unclear whether MNV calculations obtained at one institution apply to cases at another institution. In attempting to solve this problem, we made a prognostic index (P.I.) based on data from one hospital, and tested whether these data could be used to predict the prognosis of patients at another hospital. MATERIALS AND METHODS: A retrospective, multivariate prognostic study of 195 patients with prostate cancer, diagnosed at Kyoto University Hospital and treated conservatively, indicated that clinical stage, Gleason score, and MNV were all significantly correlated with the prognosis of patients with prostate cancer. From the relative strengths of these prognostic factors in a multivariate analysis, the following P.I. was constructed: P.I. = Clinical stage x 1.8040 + Gleason score x 1.5245 + MNV x 2.3162 (the constants correspond to the risk ratio estimated by Cox analysis). The P.I. was calculated for 104 patients with prostate cancer diagnosed at Shizuoka City Hospital and treated conservatively for analysis of disease-specific survival. RESULTS: The prognostic index ranged from 3.841-16.142. Using the median value of 12.5 as a cutoff point, a clear separation of cases with poor and favorable prognosis was achieved (P < 0.0001, observation period: 1-167 months). CONCLUSIONS: The results of this study suggest that estimates of MNV can be evaluated at multiple institutions with the use of P.I. calculation. Furthermore, combining estimates of MNV with Gleason score and clinical stage predicts most powerfully disease outcome of patients with prostate cancer.
Aged↗
Intracoronary aspiration thrombectomy for acute myocardial infarction.
To investigate the pathogenesis of acute myocardial infarction (AMI) and values of intracoronary aspiration thrombectomy (ICAT), we applied ICAT to reperfusion therapy using generally available intracoronary catheters to aspirate intracoronary occlusive tissues. We assigned ICAT or primary percutaneous transluminal coronary angioplasty (PTCA) to patients with evolving AMI (Thrombolysis In Myocardial Infarction (TIMI) trial grade 0), and investigated primary histopathologic, clinical, and angiographic outcomes in 43 patients treated with ICAT alone or followed by PTCA, and compared the outcomes with those in 48 patients treated with primary PTCA. No major complications (procedural death, emergent bypass graft surgery) occurred. Reconalization (TIMI grade 3 and 2) was achieved in 25 patients (58%) with ICAT alone and in 39 patients (91%) with ICAT alone or followed by PTCA. Aspirated thrombi were defined as recent thrombi in 21 cases (49%), atheroma in 6 (14%), no thrombi in 13 (30%), and organized thrombi in 1 case. In cases of recent thrombi, ICAT alone provided recanalization more frequently than in those of atheroma or no thrombi (18 of 21 [86%], 3 of 6 [50%], 4 of 13 [31%], respectively; p < 0.05; recent thrombi vs atheroma or no thrombi). There were no significant differences in primary recanalization rate (ICAT alone or followed by PTCA vs primary PTCA; 91% vs 92%) or incidence of complications between the 2 strategies. These results indicate that although the pathogenesis of AMI is heterogeneous in each individual case, intracoronary thrombus contributes little to the pathogenesis of average AMI, and therefore mechanical approaches may be feasible to maximize reperfusion therapies for AMI.
Angioplasty, Balloon, Coronary↗
Dynamic motion study of the whole lumbar spine by videofluoroscopy.
STUDY DESIGN: Dynamic lumbar flexion-extension motion was assessed by videofluoroscopy. OBJECTIVES: To identify the motion patterns of the whole lumbar spine in normal subjects and in patients with low back pain or spondylolisthesis during actual movement. SUMMARY OF BACKGROUND DATA: Assessment of lumbar instability on terminal radiographs is controversial. Information regarding spinal kinematics during actual movement in vivo is scarce. METHODS: Fluoroscopic lumbar sagittal motion videos were recorded in volunteers (n = 13; mean age, 22.3) and in patients with chronic low back pain (n = 8; mean age, 43.5) and degenerative spondylolisthesis (n = 8; mean age, 63.1) while the subjects bent forward from a standing neutral position (eccentric motion) and then returned to the original position (concentric motion). The videos recorded approximately 8 seconds of motion and were converted to still images at 5 frames per second. Disc angles from the horizontal line were measured to estimate sagittal rotation of each segment. Disc degeneration was evaluated on T2-weighted midsagittal magnetic resonance image. RESULTS: In the volunteer group, six exhibited sequentially spreading motion, four exhibited simultaneous motion, and three showed an altered motion-spreading pattern in the eccentric phase. The first two patterns were considered normal. Six (67%) of the patients with chronic low back pain also showed normal patterns, but seven (88%) of the patients with degenerative spondylolisthesis showed disordered patterns. The order of motion in the concentric phase was also different among the three groups. Prolonged deflection of the slipped segment was observed more frequently in the patients with degenerative spondylolisthesis. Disc degeneration was not always associated with motion-spreading order and the motion patterns. CONCLUSION: Segmental instability influences the whole lumbar motion in patients with degenerative spondylolisthesis. The patients with chronic low back pain did not show a significant difference when compared with the volunteers.
Adult↗
Localization of tumor suppressor activity important in nonsmall cell lung carcinoma on chromosome 11q.
Loss of heterozygosity on chromosome 11q23 is observed at high frequency in human nonsmall cell lung carcinomas (NSCLCs), suggesting the presence of a tumor suppressor gene. Previous analysis of DNA from 79 patients identified a commonly deleted segment of 5 centimorgans. Complementation analysis was used to further localize a putative tumor suppressor gene. Three yeast artificial chromosome (YAC) clones spanning the minimal loss of heterozygosity region were modified, and spheroplast fusion was used to transfer them into human A549 NSCLC or murine Lewis lung carcinoma (LLC) cell lines. The resulting yeast x human hybrid cell lines containing an intact copy of a 1.6-Mb YAC, 939b12, showed reduced growth in vitro. Injection of parental A549 cells into athymic (nu/nu) mice resulted in tumor formation at 27 of 28 injection sites. In contrast, two independent 939b12-containing cell lines formed tumors at only 3 of 20 injection sites. 939b12 also suppressed tumor formation by LLC NSCLC cells in nude mice, but YACs 785e12 and 911f2, which flank 939b12, had no suppressor activity. Further localization of tumor suppression activity on 939b12 was accomplished by introduction of defined fragmentation derivatives into A549 cells and by analysis of YACs that were broken on transfer into LLC cells. This complementation approach localized tumor suppression activity to the central 700 kb of 939b12 and provides a functional assay for positional cloning of this tumor suppressor gene.
Animals↗
Role of nitric oxide and peroxynitrite in the cytokine-induced sustained myocardial dysfunction in dogs in vivo.
Studies in vitro suggested that inflammatory cytokines could cause myocardial dysfunction. However, the detailed mechanism for the cytokine-induced myocardial dysfunction in vivo remains to be examined. We thus examined this point in our new canine model in vivo, in which microspheres with and without IL-1beta were injected into the left main coronary artery. Left ventricular ejection fraction (LVEF) was evaluated by echocardiography for 1 wk. Immediately after the microsphere injection, LVEF decreased to approximately 30% in both groups. While LVEF rapidly normalized in 2 d in the control group, it was markedly impaired in the IL-1beta group even at day 7. Pretreatment with dexamethasone or with aminoguanidine, an inhibitor of inducible nitric oxide synthase, prevented the IL-1beta-induced myocardial dysfunction. Nitrotyrosine concentration, an in vivo marker of the peroxynitrite production by nitric oxide and superoxide anion, was significantly higher in the myocardium of the IL-1beta group than in that of the control group or the group cotreated with dexamethasone or aminoguanidine. There was an inverse linear relationship between myocardial nitrotyrosine concentrations and LVEF. These results indicate that IL-1beta induces sustained myocardial dysfunction in vivo and that nitric oxide produced by inducible nitric oxide synthase and the resultant formation of peroxynitrite are substantially involved in the pathogenesis of the cytokine-induced sustained myocardial dysfunction in vivo.
Animals↗
Transcript levels of aquaporin 1 and carbonic anhydrase IV as predictive indicators for prognosis of renal cell carcinoma patients after nephrectomy.
Since failure of differentiation has been suggested to be involved in the neoplastic process and progression of tumors, we evaluated whether the transcript levels of differentiation markers of proximal renal tubular cells, from which renal cell carcinoma (RCC) arises, could be used as prognostic markers. We used Northern blot analysis to study the expression of aquaporin 1 (aqp1) and carbonic anhydrase IV (ca4) genes in 66 paired samples of primary RCC and non-tumorous kidney tissues. Poor differentiation of tumor cells and non-clear cell-subtype RCC were significantly associated with low levels of aqp1 transcripts. When patients were divided into 2 groups according to level of aqpI transcript in RCC, a low level of aqp1 was significantly associated with unfavorable outcome. Among 18 patients with metastatic RCC and 40 patients with moderately differentiated RCC, those with RCC expressing low levels of aqpl mRNA demonstrated poorer survival than those with RCC expressing relatively high levels of aqp1. Similarly, decreased expression of ca4 mRNA in RCC was associated with poor survival. On multivariate analysis, transcript levels of aqpI and stage of the tumor were the independent factors predicting disease-specific survival. Transcript levels of aqp1 may serve as a new molecular prognostic marker in patients with RCC following nephrectomy.
Aquaporin 1↗
Large granular lymphocyte leukemia with pure red cell aplasia in a renal transplant recipient.
Neoplastic disorders sometimes accompany a renal transplant. Herein, we report a large granular lymphocyte (LGL) leukemia patient with pure red cell aplasia (PRCA) after renal transplantation. A 36-year-old female was presented to our department with anemia in February 1996. She had undergone hemodialysis because of pregnancy in December 1981. She received a renal transplantation from her mother in April 1986. After the transplantation, she received cyclosporin A (CyA) at 2 mg/kg/day, mizoribine at 1 mg/kg/day, and methylprednisolone at 0.1 mg/kg/day for 8 years. In July 1995, her hemoglobin level dropped to 9.3 g/dl, and anemia developed gradually. In January 1996, her hemoglobin was 5.8 g/dl, and she was given a red blood cell transfusion. Laboratory findings were as follows: RBC 1.46 x 10(12)/L; hemoglobin 5.8 g/dl; hematocrit 17.8%; leucocytes 5.2 x 10(9)/L with 62.4% neutrophils, 34.1% lymphocytes, 2.6% monocytes; platelets 50.8 x 10(10)/L; reticulocytes 0.4%. Bone marrow aspirate smears and biopsy sections revealed normal myeloid and megakaryocyte differentiation with few erythroid precursors. The lymphocytes were of medium size with granules in the cytoplasm. More than 90% of lymphocytes were of the LGL type. Surface markers of peripheral blood mononuclear cells demonstrated increases in the CD2+, CD3+, CD4-, and CD8+ populations. A monoclonal rearrangement of T-cell receptor (TCR)-beta chain gene was found by Southern blot analysis of the mononuclear cells in peripheral blood. A diagnosis of LGL leukemia with PRCA was made. During the next 4 months, she received six red blood cell transfusions, a total of 12 U. In March 1996, the patient was treated with cyclophosphamide (1 mg/kg/day). After 1 month of treatment, serum GPT levels increased to 60 IU/l. The dose of cyclophosphamide was reduced to 0.5 mg/kg/day. Two months after initiation of the therapy, the patient developed reticulocytosis and blood transfusion was not needed thereafter. During remission, the number of CD2+, CD3+, CD4-, and CD8+ lymphocytes decreased. Large granular lymphocytes decreased to less than 10% of peripheral blood. The monoclonal rearrangement of the TCR-beta chain gene in peripheral blood disappeared.
Adult↗
Dementia care in Japan: insurance for long-term care legislation in Japan.
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Cultural Characteristics↗
Involvement of interleukin-1 in the development of ulcerative colitis induced by dextran sulfate sodium in mice.
Dextran sulfate sodium (DSS)-induced colitis in mice has been recognized as a model for human ulcerative colitis. Using this model, the effects of anti-murine interleukin 1beta (IL-1beta) antibodies (anti-muIL-1beta) and recombinant murine IL-1 receptor type I (rmuIL-1R) on the development of colitis were examined to determine whether IL-1 plays a role in colitis. Furthermore, RT-PCR amplification was used to examine for the presence of mRNAs for IL-1alpha and IL-1beta in the large intestine. In mice with colitis induced by DSS, administration of anti-muIL-1beta (5 mg/kg, once/week, i.p.) significantly suppressed body weight loss and shortening of the large intestine. Administration of rmuIL-1R (0.2 mg/kg or 1.0 mg/kg, once/day, i.v.) significantly suppressed shortening of the large intestine. Expression of mRNAs for IL-1alpha and IL-1beta was observed in the large intestine of mice which received distilled water containing 3% DSS for 5 days. The expression tended to increase in mice which received DSS for 11 days. In contrast, mRNA expression was not observed in mice which received distilled water without DSS. These results clearly demonstrate that IL-1 is involved in the development of DSS-induced colitis in mice and suggest that downregulation of IL-1 might be useful for the treatment of patients with ulcerative colitis.
Animals↗
Cloning of cDNA encoding the common alpha subunit precursor molecule of pituitary glycoprotein hormones in the Australian lungfish, Neoceratodus forsteri.
We have isolated cDNA clones encoding a putative glycoprotein hormone alpha subunit precursor molecule from a pituitary cDNA library of the Australian lungfish (Neoceratodus forsteri) by a two-step plaque hybridization technique initially using cDNA encoding the toad glycoprotein hormone alpha subunit precursor molecule as the hybridization probe. The inserts (799 bp) of two of the isolated cDNA clones contained sequences of 5' and 3' untranslated regions, including a poly(A) stretch, and the entire coding sequence of the alpha subunit precursor molecule. The deduced amino acid sequence showed that its signal peptide consists of 24 residues and its mature protein 97 residues. In the mature protein, there is an insert of one residue (Ala) just after the 9th residue. This insert is unique to the Australian lungfish among vertebrate species studied. The amino acid sequence of the mature protein shares the common, or the same-group, amino acid residues at 9 positions with tetrapod and not actinopterygian vertebrates, while only one residue is common to some teleosts and the lungfish to the exclusion of the tetrapods. The overall sequence of the mature protein of the Australian lungfish also shares more similarity with those of tetrapods (69 to 84%) than it does with teleosts (57 to 74%). These results on the relation of the alpha subunit precursor molecule between the lungfish and other vertebrates are consistent with the recent molecular phylogenetic studies suggesting a closer relationship between lungfish and tetrapods than between lungfish and teleosts. We also found that the primary structure of the lungfish alpha subunit is slightly but significantly more similar to that of homeothermic vertebrates than to that of amphibians. This may be due to specialization of the amphibian alpha subunit molecules.
Amino Acid Sequence↗
Cloning of cDNAs for the pituitary glycoprotein hormone alpha subunit precursor molecules in three amphibian species, Bufo japonicus, Rana catesbeiana, and Cynops pyrrhogaster.
We have isolated cDNA clones encoding molecules of putative glycoprotein hormone alpha subunit precursors from their pituitary cDNA libraries for a toad, bullfrog and newt. The insert of the isolated toad cDNA was 562 bp long containing the 5'-untranlated, coding and 3'-untranslated regions of 38, 363 and 161 bp, respectively. The insert of the bullfrog cDNA was 604 bp long containing the 5'-untranslated, coding and 3'-untranslated regions of 70, 366, and 168 bp, respectively. In the newt, a composite cDNA sequence was estimated from four isolated partial clones. It was 694 bp long and contained the 5'-untranslated region of 89 bp, coding region of 366 bp, and 3'-untranslated region of 91 bp or longer. Amino acid sequences deduced from coding regions of the isolated clones showed that the signal peptides consist of 24 residues and the mature proteins of 96 (toad) or 97 residues (bullfrog and newt). In all three species, an insertion of an amino acid residue was found between residues 26 and 27 of the alpha subunit molecule sequence of all other vertebrate species studied. Interestingly, the percentage identities of the entire amino acid sequence between amphibian and mammalian (or avian) alpha subunits are lower than those between lungfish and mammalian (or avian) alpha subunits. This suggests that amino acid substitutions have occurred more frequently during the course of evolution in the alpha subunit molecule of amphibians than in that of other tetrapod vertebrates, although the biological significance of this is not known.
Amino Acid Sequence↗
LHRH neurons migrate into the trigeminal nerve when the developing olfactory nerve fibers are physically interrupted in chick embryos.
Most LHRH neurons actively migrate from the olfactory epithelium to the forebrain during embryonic days (ED) 3.5-8. When a small piece of the membrane filter was placed on the central course of the olfactory nerve in ED 3.5-5 chick embryos, LHRH neurons deviated from their regular migratory course at ED 6.5-7.5 to follow a route along the PSA-NCAM-positive medial and lateral nasal branches of the ophthalmic nerve of the trigeminal nerve. The olfactory nerve fibers which were specifically immunoreactive for somatostatin also deviated into the ophthalmic nerve. Enzymatic removal of PSA using endoneuraminidase did not interfere with the migration of LHRH neurons into the ophthalmic nerve bundle of the trigeminal nerve. The presence of structural supports seems to be primarily of importance in the migration of LHRH neurons along the olfactory and trigeminal nerve bundles. PSA may be less important for the migration of the LHRH neurons along peripheral neural elements.
Animals↗
A clinicocytopathologic study of adenoma malignum of the uterine cervix.
OBJECTIVES: To investigate the nature and the clinical course of adenoma malignum (the so-called minimal deviation adenocarcinoma) of the uterine cervix by conducting a retrospective study of 6 cases consecutively treated in a single institute. METHODS: The pathologic classification of adenoma malignum was performed according to the WHO classification (1994). RESULTS: These tumors accounted for only 1.32% (6/453) of invasive cervical adenocarcinomas. All the cases showed either a watery discharge or atypical genital bleeding, or both, at the time of diagnosis. The preoperative cytologic diagnosis of adenoma malignum was made in 83.3% (5/6) of cases. The preoperative punch biopsy, on the other hand, failed to confirm the diagnosis of adenoma malignum in all cases, although the presence of the disease was suspected in 2 cases (33%). The 5-year survival rate and 5-year disease-free survival rate were 100 and 83.3%, respectively. CONCLUSIONS: This series demonstrates that cytologic examination is a potent screening method to detect this rare disease. When the presence of this disease is suspected by the cytologic examination, a deep biopsy is necessary to make an accurate diagnosis. An ordinary cervical biopsy is usually insufficient to detect deeply positioned tumor glands. The prognosis of the disease may be better than that for ordinary cervical adenocarcinoma.
Adenocarcinoma, Mucinous↗
Misuse of infusion pump during propofol anaesthesia.
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Anesthesia, Intravenous↗
[The propriety of bilateral internal thoracic artery grafting in women].
In our institution, the exclusion criteria of the bilateral internal thoracic artery (BITA) grafting include age over 70 years old, obesity, severe diabetes, renal dysfunction and poor preoperative physical activity. The objective of this study is to evaluate propriety of the use of bilateral internal thoracic artery for coronary artery bypass grafting (CABG) in women. Clinical outcome of female patients who underwent BITA grafting (group B-F; n = 50) was compared with that of female patients who underwent single internal thoracic artery grafting (group S; n = 50). In addition, clinical outcome of the male patients who underwent BITA grafting (group B-M; n = 50) was compared with that of group B-F. Between group B-F and S, the age, prevalence of obesity and that of renal dysfunction were significantly different, which was predictable because of the group selection according to the criteria. However, the prevalence of previous myocardial infarction and that of left ventricular dysfunction and the extent of coronary artery disease were not significantly different. Whereas, between group B-F and B-M, preoperative factors were not significantly different except the body size. Intraoperative technical factors, such no of grafts, aortic cross clamp time, cardiopulmonary bypass time, rate of complete revascularization, were not significantly different. In comparison of group B-F with group B-M, the site of anastomosis with arterial grafts were not significantly different. Patency rate of arterial and venous grafts two week after operation was not significantly different. Either postoperative complications, such as reoperation for bleeding, wound complication, low output syndrome, renal dysfunction etc, were not significantly different. One patient (2%) in group B-F and 1 patient (2%) in group B-M died in the hospital (p > 0.05). In summary, BITA can be a viable conduit of choice for CABG in female patients as well as that in male patients. Criteria of the use of BITA is recommended to exclude preoperative risk factors above-mentioned.
Aged↗
[Mitral valve regurgitation with anterior mitral leaflet chordal rupture or elongation--repair using the flip-over technique].
Repair of prolapsed anterior mitral leaflet has remained technically difficult. The purpose of this study was to assess the clinical results after using the flip-over technique for patients with anterior mitral leaflet prolapse due to dhordal rupture or elongation. Between January 1993 and September 1997, fifteen adult patients with pure mitral valve regurgitation (MR) due to prolapse of the anterior mitral leaflet underwent repair using the flip-over technique. The indication for this procedure were; 1) all mitral structures except the prolapsed area must appear to be intact, and 2) the corresponding chordae attached to the posterior leaflet should be sufficiently strong to be transferred to the anterior leaflet. The prognoses following this technique were retrospectively studied to assess the early and mid-term clinical outcome of this procedure. Follow up was complete in all patients and ranged from 2 to 56 months (with a mean of 25 +/- 17.9 months). There was no hospital death, None required reoperation. One patient died because of acute recurrent MR during follow-up. No other complication was experienced. Doppler echocardiographic studies at the final follow-up showed less than mild regurgitation in 11 (78.6%) of the 14 surviving patients. We believe that this procedure was effective for that the obtained repair of a prolapsed anterior mitral valve and early and mid-term clinical outcome from this procedure has been satisfactory.
Adult↗
[An evaluation of cases carried out by both root reconstruction using Carrel patch method and concomitant procedure].
During the past 7 years from January 1991 to November 1997, we experienced 31 cases of aortic root reconstruction utilizing Carrel patch method. Concomitant procedure were performed in 9 cases of them due to another cardiovascular disease. Complicated cardiovascular disease included 3 cases of ischemic heart disease, 3 cases mitral regurgitation and one case of Aortic arch aneurysm. Several concomitant procedures were performed; 5 cases of CABG, 2 cases of mitral annuloplasty, one case of CABG with mitral valve replacement and one case of aortic arch replacement. The mean extra corporeal circulation time was 190.6 +/- 39.3 minutes and aortic clamp time was 147.8 +/- 34.2 minutes in these 9 cases. There were no significant differences of operative results between the simple root reconstruction group and the concomitant procedure group. We concluded that the aortic root reconstruction using the Carrel patch method has few complications. Although further long-term follow-up is required, our experiences suggest that the aortic root reconstruction with the concomitant procedure can be carry out safely with the aid of appropriate assistance method.
Adult↗