Biomedical subjects

Y Arai

Publications and source records attributed to Y Arai.

At least 307 records · Page 17Linked to original sources

PubMed1998

Clinical evaluation of serum prostate-specific antigen-alpha1-antichymotrypsin complex values in diagnosis of prostate cancer: a cooperative study.

BACKGROUND: We studied the clinical significance of serum prostate-specific antigen bound to alpha1-antichymotrypsin (PSA-ACT) values determined with a newly developed enzyme immunoassay. METHODS: Serum PSA-ACT values were determined in a total of 652 sera. Clinical utility for the diagnosis of prostate cancer was compared to that of Tandem-R PSA and gamma-seminoprotein (gamma-Sm). The new enzyme immunoassay is based on the use of the Stanford reference as an international standard for PSA assays. RESULTS: Serum PSA-ACT values ranged from less than 0.10 to 1.4 ng/mL in healthy males (n = 100) while values in patients with benign prostatic hyperplasia (n = 155) averaged 3.4 +/- 3.8 ng/mL (mean +/- SD). In patients with prostate cancer, serum PSA-ACT values increased significantly with progression of the clinical stage and there were statistically significant differences between benign prostatic hyperplasia and each stage of prostate cancer except for stage A. Using BPH levels as controls (4.8 ng/mL for PSA-ACT, 7.2 ng/mL for PSA, 3.8 ng/mL for gamma-Sm, and 2.4 ng/mL for the complexed/free PSA ratio of PSA-ACT/gamma-Sm), specificity was 80%. The sensitivity of prostate cancer detection was 79% for PSA-ACT, 77% for PSA, 57% for gamma-Sm, and 46% for the ratio between PSA-ACT/gamma-Sm. CONCLUSION: Although the determination of serum PSA-ACT showed essentially the same utility as that of PSA for the diagnosis of prostate cancer, PSA-ACT may allow prediction of the clinical stage. The PSA-ACT assay may therefore replace PSA in the detection of prostate cancer.

Disease Progression↗

PubMed1998

Value of the free to total prostate specific antigen ratio and prostate specific antigen density for detecting prostate cancer in Japanese patients.

BACKGROUND: This study evaluated the free to total serum prostate specific antigen (f/t PSA) ratio and prostate specific antigen density (PSAD) in detecting prostate cancer in Japanese males with a PSA level between 2.5 and 20.0 ng/mL in a community-based urology practice. METHODS: Twenty-six patients with clinically localized prostate cancer and 44 patients with histologically-proven benign prostatic hyperplasia (BPH) were studied. The serum levels of free PSA (fPSA) and total (t) PSA were determined using a chemiluminescent enzyme immunoassay. The f/t PSA ratio was calculated by dividing the fPSA value by the total PSA value and was compared with the PSA and PSAD via the receiver operating characteristic (ROC) curves. RESULTS: Patients with prostate cancer had a significantly lower f/t PSA ratio than patients with BPH. The PSAD was a superiordiagnostic tool over PSA (P< 0.01) when analyzed by ROC curves. The f/t PSA ratio was also superior to PSA, but lacked significance (P=0.12), and similarly, the PSAD was superior, but not significant, to the f/t PSA ratio. Using a cut-off value of 0.19, the PSAD had a sensitivity of 81% and a specificity of 82%. With a cut-off value of 14.0%, the f/t PSA ratio had a sensitivity of 81% and a specificity of 66%. CONCLUSION: This study showed that PSAD alone improved cancer detection significantly better than PSA. However, it is still unclear whether the f/t PSA ratio is superior to PSA or PSAD in the discrimination between BPH and prostate cancer in Japanese male patients.

Aged↗

PubMed1998

Preoperative predictors for organ-confined disease in Japanese patients with stage T1c prostate cancer.

BACKGROUND: In order to define the characteristics of patients with clinical stage T1c prostate cancer in Japan, clinicopathologic data obtained from patients treated by radical prostatectomy were reviewed. METHODS: Fifty-four stage T1c cancers were evaluated for tumor volume, Gleason grade, tumor location and pathologic stage from prostatectomy specimens in association with preoperative clinical parameters. RESULTS: The mean tumor volume was 3.94 mL (range, 0.07 to 33.4 mL), and 11 of the 54 tumors had a tumor volume of less than 0.5 mL. Thirty-two tumors (59%) were organ-confined, while 7 (13%) involved the seminal vesicle and/or regional lymph nodes. Multivariate logistic regression analysis of the pretreatment variables, including age, pretreatment PSA level, prostate volume, biopsy grade, and number of cancer-positive cores revealed that the serum PSA level and the number of cancer-positive biopsy cores were independent factors to predict organ-confined tumors (P = 0.036 and 0.044, respectively). For T1c cancer with less than 4 cancer-positive biopsy cores, the sensitivity and specificity for predicting organ-confined tumors were 90% and 70%, with a cut-off value of 17 ng/mL for the serum PSA level. CONCLUSION: The clinicopathologic features of T1c prostate cancer in Japanese patients were similar to those of whites reported elsewhere. Both serum PSA levels and the number of positive biopsy cores may be useful as pretreatment parameters to identify patients with the potential to benefit from radical treatment.

Aged↗

PubMed1998

Incidence of lymph node metastasis and its impact on long-term prognosis in clinically localized prostate cancer.

BACKGROUND: Pelvic lymph node dissection (PLND) is an important staging method for men with clinically localized prostate cancer. We report our experience with staging PLND and the impact of lymph node metastasis on long-term prognosis. METHODS: One hundred forty-eight consecutive patients who underwent staging PLND for clinically localized prostate cancer were retrospectively studied. Patients were evaluated for the presence and number of lymph node metastases, treatment (prostatectomy vs. radiotherapy), and endocrine therapy, and analyzed with respect to disease progression and survival. The mean follow-up period was 52.9 months (range, 2.3 to 165.8 months). RESULTS: Thirty-two patients (21.6%) had pelvic lymph node metastases, the incidence of which markedly decreased from 32.3% in 1982 to 1987 to 6.7% in 1994 to 1997. The intervals to disease progression and cancer death were significantly shorter in patients with positive lymph nodes (P < 0.001). In stage D1 disease, patients who underwent a radical prostatectomy tended to be free of progression longer than those receiving radiotherapy or conservative therapy (P = 0.0546). Other factors, such as early endocrine therapy, the extent of lymph node involvement and the Gleason score of the primary tumor did not predict disease progression or survival. CONCLUSION: These data suggest a decreasing trend in the incidence of lymph node metastasis in the PSA era. Although longer disease-free intervals were observed in radical prostatectomy-treated patients, the impact of an aggressive approach to stage D1 disease awaits further studies.

Adenocarcinoma↗

PubMed1998

Long-term results of definitive treatment in elderly patients with localized prostate cancer.

BACKGROUND: The indication and effectiveness of definitive local treatment for prostate cancer in patients with a limited life expectancy remains to be established. This study is a retrospective analysis of the long-term clinical outcome of elderly patients with localized prostate cancer treated by radiotherapy or a radical prostatectomy. METHODS: From 1982 to 1992, 37 patients with localized prostate cancer, aged 70 years or older, were treated initially by a pelvic lymphadenectomy and then with either external radiotherapy (n = 1 7) or a radical retropubic prostatectomy (n = 20). Lymph node metastasis was negative in all the cases, and no patients received hormonal treatment after the lymphadenectomy. The outcome of all patients was evaluated in June 1997. RESULTS: The 10-year overall and relative survival rates for the radiotherapy group were 27% and 85%, which were not significantly different from the rates of patients in the prostatectomy group (38% and 74%, respectively). The 5-year progression free rates for the radiotherapy group and the prostatectomy group were 63% and 95%, respectively (P= 0.06). CONCLUSION: In elderly patients with localized prostate cancer, the superiority of a radical prostatectomy over radiotherapy was not demonstrated in terms of either overall or relative survival rates, although the progression rate tended to be higher in patients in the radiotherapy group. The indication of definitive treatment in elderly patients should be further studied incorporating a quality of life assessment.

Aged↗

PubMed1998

Ultrasensitive assay of prostate-specific antigen for early detection of residual cancer after radical prostatectomy.

OBJECTIVES: Perhaps the greatest value of PSA determination in the treatment of prostate cancer is in determining persistent disease after a radical prostatectomy. We investigated the ability of an ultrasensitive PSA assay to detect residual prostate cancer in men at risk for recurrence after a radical prostatectomy. METHODS: Using the Immulite third-generation PSA assay (detection limit, less than 0.003 ng/mL), and the standard IMx PSA assay, we determined PSA levels in 205 serum samples serially obtained from 34 men after a radical prostatectomy. The average days from surgery to serum sampling was 430 (range, 63 to 1296). Patients were classified as having nonaggressive or aggressive cancers, based on clinicopathologic findings. A biochemical relapse was arbitrarily defined. RESULTS: All 17 patients with nonaggressive cancers had PSA values of less than 0.02 ng/mL throughout the sampling period. Two of these patients (12%) had 2 or more consecutive PSA increases and were considered as a biochemical relapse. In contrast, 14 (82%) of 17 patients with aggressive cancers fit criteria of a biochemical relapse. All of the relapses were identified within 2 years after surgery. The IMx assay detected only 7 biochemical relapses during the same sampling period. CONCLUSIONS: Using the Immulite PSA assay, relapse detection times may be shortened allowing for most serological recurrences to be detected within 2 years after a radical prostatectomy. Patients with aggressive cancers may require frequent postoperative PSA determinations with a highly sensitive PSA assay which would allow early intervention when treatments for relapse are effective.

Aged↗

PubMed1998

Hydrostatic pressure induces expression of interleukin 6 and tumour necrosis factor alpha mRNAs in a chondrocyte-like cell line.

OBJECTIVES: To clarify the effect of pressure on the expressions of proteoglycan core protein and metabolism related cytokines in a chondrocyte-like cell line, HCS-2/8. METHODS: HCS-2/8 cells were exposed to 1, 5, 10, or 50 MPa of hydrostatic pressure (HP) for two hours, and mRNA expressions of interleukin 6 (IL6) and tumour necrosis factor alpha (TNFalpha) were examined by using reverse transcription-polymerase chain reaction (RT-PCR) method with specific primer sets; and mRNA of proteoglycan core protein, stromelysin, and tissue inhibitor of metalloproteinase 1 (TIMP1) were measured with northern blotting. RESULTS: HP exposure caused temporal morphological changes of the cells, but did not affect cellular viability, IL6 and TNFalpha mRNA expressions were not observed in the control cells under the atmospheric pressure, whereas in the cells treated with HP, pressure dependent enhancement of IL6 mRNA expression was observed between 30 minutes and four hours after HP release. TNFalpha mRNA expression also increased 30 minutes after the exposure to 50 MPa of HP and disappeared four hours later. Proteoglycan core protein mRNA levels increased between 30 minutes and four hours after the exposure to 1 or 5 MPa of HP, whereas the levels decreased after 10 or 50 MPa of HP. Stromelysin and TIMP1 mRNA signals did not respond to HP. CONCLUSION: HP at excessively high levels induced IL6 and TNFalpha expression and reduced the expression of proteoglycan core protein, while physiological levels of HP increased the expression of proteoglycan core protein. These findings are important when considering the pathology of osteoarthritis.

Aggrecans↗

PubMed1998

Extrahepatic arterial supply to the liver: observation with a unified CT and angiography system during temporary balloon occlusion of the proper hepatic artery.

PURPOSE: To evaluate routes of potential extrahepatic arterial supply to the liver. MATERIALS AND METHODS: Twenty-three patients with liver tumors underwent computed tomographic (CT) arteriography of extrahepatic arteries before and after temporary balloon occlusion of the proper hepatic artery. The right inferior phrenic artery (RIPA), left inferior phrenic artery (LIPA), superior mesenteric artery (SMA), celiac axis, and left gastric artery (LGA) were evaluated. RESULTS: During temporary balloon occlusion of the proper hepatic artery, extrahepatic arterial supply was immediately evident in 22 of 23 patients (96%). The liver was supplied by the RIPA in 17 of 20 patients (85%), by the LIPA in five of six (83%), by the SMA in eight of 16 (50%), by the celiac axis in two of 10 (20%), and by the LGA in one of six (17%). There was no apparent relationship between the enhanced zones supplied by extrahepatic arteries and the presence or absence of nearby tumors. CONCLUSION: Extrahepatic arterial supply to the liver was readily evident in a large proportion of patients during temporary balloon occlusion of the proper hepatic artery. This finding suggests a need for consideration of extrahepatic arterial supply when angiographic intervention for liver tumors is contemplated.

Aged↗

PubMed1998

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging.

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging. J. Neurophysiol. 80: 3077-3099, 1998. Horizontal and roll components of the angular vestibulo-ocular reflex (aVOR) were elicited by sinusoidal rotation at frequencies from 0.2 Hz (60 degrees/s) to 4.0 Hz ( approximately 6 degrees/s) in cynomolgus monkeys. Animals had both lateral canals plugged (VC, vertical canals intact), both lateral canals and one pair of the vertical canals plugged (RALP, right anterior and left posterior canals intact; LARP, left anterior and right posterior canal intact), or all six semicircular canal plugged (NC, no canals). In normal animals, horizontal and roll eye velocity was in phase with head velocity and peak horizontal and roll gains were approximately 0.8 and 0.6 in upright and 90 degrees pitch, respectively. NC animals had small aVOR gains at 0.2 Hz, and the temporal phases were shifted approximately 90 degrees toward acceleration. As the frequency increased to 4 Hz, aVOR temporal gains and phases tended to normalize. Findings were similar for the LARP, RALP, and VC animals when they were rotated in the planes of the plugged canals. That is, they tended to normalize at higher frequencies. A model was developed incorporating the geometric organization of the canals and first order canal-endolymph dynamics. Canal plugging was modeled as an alteration in the low frequency 3-db roll-off and corresponding dominant time constant. The shift in the low-frequency 3-dB roll-off was seen in the temporal responses as a phase lead of the aVOR toward acceleration at higher frequencies. The phase shifted toward stimulus velocity as the frequency increased toward 4.0 Hz. By incorporating a dynamic model of the canals into the three-dimensional canal system, the spatial responses were predicted at all frequencies. Animals were also stimulated with steps of velocity in planes parallel to the plugged lateral canals. This induced a response with a short time constant and low peak velocity in each monkey. Gains were normalized for step rotation with respect to time constant as (steady state eye velocity)/(stimulus acceleration x time constant). Using this procedure, the gains were the same in canal plugged as in normal animals and corresponded to gains obtained in the frequency analysis. The study suggests that canal plugging does not block the afferent response to rotation, it merely shifts the dynamic response to higher frequencies.

Algorithms↗

PubMed1998

Subjective evaluation of chewing ability and self-rated general health status in elderly residents of Japan.

The purpose of the present study was to statistically analyse the relationship between subjective evaluation of chewing ability and self-rated general health status in elderly Japanese residents. Interviews were conducted with 1,544 respondents over 65 years of age in Yamanashi Prefecture, Japan. The interviews included questions concerning age, sex, health status, capacity to understand conversation, chewing ability, and ADL status. First, the age-adjusted odds ratio between subjective evaluation of chewing ability and self-rated health status was 2.242 (p < or = 0.01). Second, the age-adjusted odds ratio between respondentive evaluation of chewing ability and ADL status was 2.572 (p < or = 0.01). Third, the age-adjusted odds ratio between self-assessment of chewing ability and the degree of understanding conversations was 5.290 (p < or = 0.01). These results suggest that chewing ability is related to self-rated general health, ADL status, and the degree of understanding conversation among the elderly.

Activities of Daily Living↗

PubMed1998

The correlation between coronary stenosis index and flow-mediated dilation of the brachial artery.

We examined the relationship between flow-mediated dilation (FMD) of the brachial artery and the extent and severity of coronary artery disease (CAD). Using high-resolution ultrasonography, we measured FMD and nitroglycerin-induced brachial artery dilation. We studied 121 patients (77 men, 44 women; mean age 64+/-11 years, range 25-79 years) who underwent coronary arteriography. The extent and severity of CAD were assessed by the coronary stenosis index (CSI). The adjusted FMD correlated inversely with CSI (rs=-0.63, p<0.0001). Multivariate analysis demonstrated that the adjusted FMD was an independent predictor of CSI. The adjusted FMD was 10.2+/-4.8% in patients without CAD (n=32), 7.7+/-6.0% in patients with single-vessel disease (n=31), 5.2+/-5.5% in patients with double-vessel disease (n=29), and 2.0+/-3.9% in patients with triple-vessel disease (n=29). The adjusted FMD was significantly lower in the double- (p<0.01) and triple-vessel (p<0.0001) disease groups than in patients without CAD. The adjusted FMD was significantly lower in the triple-vessel disease group than in the single-vessel disease group (p<0.001). Based on our results, as coronary atherosclerosis becomes more severe, the adjusted brachial artery FMD becomes more severely impaired.

Adult↗

PubMed1998

[Effect of lafutidine, a novel antiulcer agent, on healing and relapse of acetic acid-induced gastric ulcer in rats].

Effect of lafutidine ((+/-)-2-(furfurylsulfinyl)-N-[4-[4-(piperidinomethyl)-2-pyr idyl] oxy-(Z)-2-butenyl] acetamide, FRG-8813), a novel antiulcer agent, on the healing and relapse in acetic acid-induced gastric ulcer in rats was investigated. Lafutidine at 1, 3 or 10 mg/kg, twice daily for 10 days reduced the ulcer area in a dose-dependent manner, and the effect by 10 mg/kg of lafutidine was significant. The effect of famotidine at 1 mg/kg and cimetidine at 30 mg/kg, which have almost equal antisecretory activity to lafutidine at 10 mg/kg, on the ulcer area was not significant. Effect on the healing and relapse was assessed by endoscopy for 25 weeks after the induction of gastric ulcer. Drugs were administered twice daily for 11 weeks. Lafutidine at 3 mg/kg and famotidine at 1 mg/kg accelerated the healing, but cimetidine at 30 mg/kg did not. Cumulative relapse rate and inflammatory cell infiltration were significantly reduced in rats initially treated with lafutidine. Famotidine and cimetidine had no effect. In conclusion, lafutidine accelerated ulcer healing and prevented ulcer relapse in rats.

Acetamides↗

PubMed1998

Focal fatty change in segment IV of the liver occurring after gastrectomy.

In some cases, focal fatty change of the liver parenchyma has been attributed to local systemic venous inflow replacing the portal venous supply. However, no reports of focal fatty change in the dorsal portion of segment IV of the liver caused by direct inflow of an aberrant pancreaticoduodenal vein (APDV) through the parabiliary venous system (PVS) are available. We report a 60-year-old woman with focal fatty change in segment IV of the liver which occurred after gastrectomy with APDV shown on CT performed during selective gastroduodenal arteriography.

Fatty Liver↗

PubMed1998

Japanese intake of flavonoids and isoflavonoids from foods.

The intake of flavonoids and isoflavonoids was estimated based upon a preliminary database of 40 food items, covering at least 80% of total food consumption. Fifty volunteer women in "I-City" recorded the weight of all dietary intake for 3 days in September 1996, and received a health check-up, as well as laboratory examination. The data was analyzed in relation to the various food factors. Average daily intake per capita of flavonoids was as follows: 4.9 mg kaempferol, 8.3 mg quercetin, 1.5 mg rutin, 0.6 mg myricetin, 0.3 mg luteolin, 0.01 mg myricitrin, 0.4 mg fisetin, and 0.3 mg eriodictyol. Total intake from vegetables and fruits was less than 10 mg 16.2 mg (range: 3.18-35.61 mg) and 23.27 mg (4.62-52.12 mg) of isoflavones, such as daidzein and genistein, respectively, were taken per day, and total isoflavone intake was 39.46 mg (7.80-87.73 mg). Chief component analysis on ingested vitamins, flavonoids and isoflavonoids was carried out. Factor 1 was mainly composed of flavonoids and antioxidant vitamins. Factor 1 was positively associated with age and the level of HDL cholesterol and negatively related to the level of triglycerides. Factor 2, which was mainly composed of isoflavonoids, was positively associated with creatinine and uric acid levels. So far, these factors did not show a significant association with bone density and other health indices, such as BMI and blood pressure.

Adult↗

PubMed1998

Self-reported exercise frequency and personality: a population-based study in Japan.

This study of relationships between personality and exercise frequency was based on 22,448 residents (40 to 64 years old) in Miyagi, Japan. They completed the self-administered questionnaires on their exercise frequency and the Japanese version of the short form Eysenck Personality Questionnaire-Revised. Higher scores on Extraversion were positively related to exercising and higher scores on Neuroticism and Psychoticism were positively related to "not exercising" in a general population for both sexes. These observed relationships were consistent even when an analysis of covariance was conducted with controlling for possible confounding factors of age, marital status, and education.

Adult↗

PubMed1998

[Nutritional intake by the oldest elderly Japanese. Tokyo Centenarian Study 6].

Rapid demographic aging has made caring for the elderly an increasingly important social issue in Japan. To study current conditions of the oldest elderly citizens, we investigated the dietary practices of centenarians in the Tokyo metropolitan area. First, we compared the food intake of centenarians with that of octogenarians. Next, to identify dietary trends, we investigated whether food intake by centenarians had changed significantly between 1981 and 1995. Nutritional intake by the centenarians and octogenarians in 1995 was about 60% and 75% that of the control, respectively. However, the nutritional intake of well nourished centenarians was similar to that of the octogenarians. Cognitive function and daily activity have an influence on nutritional intake. The centenarians were similar to the control subjects in their consumption of dairy products, sweets, and fruit. However, their intake of cereals, meat, fish, and fatty oils was loss than 60% that of the control, which indicates their preference for soft and sugary foods. The pattern of dietary practices of centenarians in 1981 was similar. Although the total food intake of centenarians amounted to 60% of the control in 1995 energy intake per kilogram of body weight averaged over 30 kcal. As to dietary trends, centenarians in 1981 are more cereals, eggs, algae products, and legumes than did their 1995 counterparts. This finding seems to reflect a generational difference in dietary habits.

Activities of Daily Living↗

PubMed1998

[A case of pyelitis cystica diagnosed with utilization of ureterofiberscope].

We herein report a case of pyelitis cystica in 65-year-old woman. She was referred to our hospital in order to have a treatment for a stone in the ureter on left side. Excretory urogram showed hydronephrosis on left, and multiple, small, smooth and round filling defects in the renal pelvis on right side. ESWL was performed to the ureteral stone, and the stone was discharged completely in 4 days. Then further examinations were made for the filling defects of right renal pelvis. Nonopaque calculi were ruled out on retrograde pyelogram and CT scan. Urinary cytology from the renal pelvis was class I. Our impression was pyelitis cystica of right kidney. Under spinal anesthesia, ureterofiberscopy was performed. Multiple small cysts were observed in the pelvis and calyx, as well as cystitis cystica. Cold cup biopsy was also done and histopathological finding ws pyelitis cystica, without malignancy. We compared endoscopic findings with radiographic findings in 18 cases of pyloureteritis cystica from the Japanese literature. The radiographic findings were multiple small, in a uniform size, and round filling defects with regular contour, and the endoscopic findings were multiple white or ocher colored, half sphere or sphere shaped, and small cyst with smooth surface in 15 of 18 cases. We thought these findings were characteristic ones in pyloureteritis cystica. Endoscopy and biopsy are mandatory for diagnosis of pyeloureteritis cystica.

Aged↗

PubMed1998

[Diagnoses and treatments for recurrent colon cancer].

The incidence of recurrence after curative resection in colon cancer is approximately 20%, and liver metastasis is the most common. Diagnostic modalities including recent techniques for recurrent colon cancer for example also in the liver, are not complete to point out minimal lesions. Thus, it is very hard to evaluate that recurrent lesions are localized or not. On the other hand, only regional treatments such as surgical resection and hepatic infusion chemotherapy are effective for this cancer, and the effect of systemic chemotherapy including 5-FU-LV and new agents are still now limited. From these points of view, for better management of patients with recurrent colon cancer, deeply understandings of incompleteness of imaging diagnoses and well application of local treatments are required.

Colonic Neoplasms↗