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Biomedical subjects

Y Arai

Publications and source records attributed to Y Arai.

At least 127 records · Page 7Linked to original sources
PubMed2001

Association of mild hyperhomocysteinemia with aortic calcification in hypercholesterolemic patients.

Homocysteine is considered to be an independent risk factor for atherosclerosis. Experimental animal models of hyperhomocysteinemia show aortic calcification, suggesting that this disorder is associated with aortic calcification in humans. A total of 28 patients with hyperlipidemia were enrolled into this study. The degree of aortic calcification at the level of the bifurcation and 1 cm proximal to the bifurcation was assessed by computed tomography of the aorta and the association between calcification of the aorta and the plasma level of homocysteine was then analyzed. The mean plasma homocysteine level in 28 patients was 8.7 microM. They were divided into 2 groups, high homocysteine level group (HHL; homocysteine level >8.7 microM) and low homocysteine level group (LHL; homocysteine level < = 8.7 microM). The degree of aortic calcification at the level of the bifurcation differed significantly between the two groups (19.1% vs. 10.5%; p < 0.01). We found that mild hyperhomocysteinemia was associated with aortic calcification, which suggests that interventions to reduce the plasma level of homocysteine may also reduce the severity of aortic calcification.

Aged↗
PubMed2001

Tubeless cutaneous ureterostomy: the Toyoda method revisited.

PURPOSE: Cutaneous ureterostomy is a less invasive method of urinary diversion and an attractive option especially in patients at high risk. We retrospectively examined the long-term outcome of the method introduced by Toyoda. MATERIALS AND METHODS: Since 1983 the Toyoda cutaneous ureterostomy has been performed in 61 patients (103 renal units) with a minimum of 3 months of followup. The ureteral patency rate was reviewed. RESULTS: Of the 92 renal units (89%) that achieved a tubeless condition 53 (51%) had no hydronephrosis, 23 (22%) had mild to moderate hydronephrosis without the need for treatment, 14 (14%) were not evaluated during followup and 2 (2%) were removed due to subsequent renal pelvic and/or ureteral carcinoma. CONCLUSIONS: A high ureteral patency rate was achieved with the Toyoda cutaneous ureterostomy. This procedure is a reasonable alternative to other forms of urinary diversion.

Adult↗
PubMed2001

[Ocular surface changes after dacryocystorhinostomy].

PURPOSE: To observe changes in tear film lipid interference patterns on the ocular surface in patients with nasolacrimal duct (NLD) obstruction before and after dacryocystorhinostomy (DCR). METHODS: The tear film lipid layer on the ocular surface was observed with a specular reflection video recording system in 5 eyes of 4 patients with NLD obstruction before and after DCR. Precorneal tear lipid layer interference patterns at the central cornea, tear meniscus height (TMH), and the Shirmer I test were recorded. Observed patterns were classified into 5 grades. RESULTS: Three of four eyes with TMH values over 0.4 mm before DCR showed decreased TMH postoperatively. One eye with a TMH of 0.2 mm showed no change after DCR. Concerning the tear film lipid layer interference patterns, 4 eyes were classified as grade 1 or 2, and 1 eye was classified as grade 4 before DCR. After DCR, the 5 eyes were classified from grade 3 to grade 4. Epiphora was successfully resolved in all patients after DCR. CONCLUSION: Tear film lipid layers were classified as normal grades before DCR but most cases changed to high grades after DCR. We suggest that the eye after DCR should have a thicker lipid layer than before DCR.

Aged↗
PubMed2001

Expression of transduced HSP70 gene protects chondrocytes from stress.

OBJECTIVE: To investigate the efficacy of adenovirus vector mediated transduction of heat shock protein 70 (HSP70) gene to human chondrocyte-like cell (HCS-2/8) against heat stress. METHODS: Two adenovirus vectors that contain wild-type (AxSHEwt) or mutant-type (AxSHEmt) HSP70 gene, and that are regulated by SRalpha promoter, were constructed. The mutant-type lacks the area that expresses stress durability. One of the 2 adenovirus vectors was added to the cultures of human chondrocyte-like cells (HCS-2/8). Heat stress (48 degrees C) was applied to the transduced cells for 2 h, and the efficacy of adenovirus vector mediated transduction of HSP70 gene against heat stress in the chondrocytes was investigated using alamar blue assay and MTT assay. RESULTS: Absorbance levels at 48 degrees C were 300.3 +/- 51.9 and 1.173 +/- 0.011 in the controls, 278.5 + 33.8 and 1.217 +/- 0.018 in the AxSHEmt transduced cells, and 349 +/- 14.7 and 1.371 +/- 0.033 in the AxSHEwt transduced cells. The level in the AxSHEwt transduced cells was significantly higher than in the other 2 groups (p < 0.05). With 37 degrees C treatment, no significant difference was observed. CONCLUSION: Chondrocytes to which HSP70 gene was transduced had a significantly higher metabolic activity and viability under heat stress.

Adenoviridae↗
PubMed2001

[A case of suspected drug-induced ocular pemphigoid].

BACKGROUND: Lacrimal obstruction can occur as a complication of ocular cicatricial pemphigoid. We report a patient who was diagnosed as having drug-induced ocular cicatricial pemphigoid associated with acquired lacrimal canalicular obstruction in spite of relatively mild subconjunctival scar formation. CASE: The patient was a 69-year-old woman. She had been treated for glaucoma, blepharoconjunctivitis, dacryocystitis, and lacrimal canalicular obstruction for two years with topical administration including 0.5% timolol maleate, 0.1% dipivefrine hydrocholoride, 0.1% fluorometholone, and 0.3% ofloxacin. The patient had moderate conjunctival hyperemia without shortening of the inferior conjunctival sac, corneal ulceration, neovascularization, and keratinization. Lacrimal canalicular obstruction progressed further as topical ocular medications were continued. Topical anti-glaucoma medications were stopped after dacryocystorhinostomy. Although the blepharoconjunctivitis was improved, left inferior conjunctival symblepharon, and medical canthal keratinization was progressive despite the use of topical corticosteroids. The conjunctival biopsy specimen showed the lacrimal punctum covered with proliferated conjunctival epithelium. There was a moderate stromal infiltration of small lymphocytes and plasma cells. We diagnosed this patient as having drug-induced ocular cicatricial pemphigoid caused by topical anti-glaucoma medications. CONCLUSION: Lacrimal canalicular obstructions may occur with the topical anti-glaucoma medications even when subconjunctival scarring is mild.

Aged↗
PubMed2001

[Adenocarcinoma of the renal pelvis and transitional cell carcinoma of the ureter occurring 11 years after radical cystectomy for bladder cancer: a case report].

We report a case of upper urinary tract carcinoma which recurred 11 years after total cystectomy. A 52-year-old man presented with complaints of a sense of residual urine and terminal miction pain. Urinary cytology, cystoscopic examination and intravenous pyelography revealed normal findings. Twenty months later, because class V urinary cytologic findings were detected, transurethral biopsy was performed. Carcinoma in situ was diagnosed pathologically. Therefore, total cystectomy and ileal conduit urinary diversion were performed. The pathological diagnosis was transitional cell carcinoma, grade 3, pTis. At 127 months postoperatively, laboratory examination revealed an extremely high serum level of LDH (3,084 U/l). The right kidney was not visualized on IVP and computed tomography revealed a right renal irregular mass. On the suspicion of a renal pelvic tumor, right total nephroureterectomy was done. The pathologic diagnosis was renal pelvic adenocarcinoma and ureteral transitional cell carcinoma. The patient was treated postoperatively with 3 cycles of systemic chemotherapy and radiotherapy. The serum level of LDH returned to normal. However, one year later, the serum level of LDH elevated to 1,118 U/l. He died of retroperitoneal lymph node, left adrenal gland and pulmonary metastases.

Adenocarcinoma↗
PubMed2001

[Effect of combination chemotherapy with nedaplatin and 5-FU for head and neck squamous cell carcinoma].

Nedaplatin (254-S), which is a cisplatin (CDDP) analog, is an effective agent for head and neck squamous cell carcinoma (HNSCC). 254-S is expected to play an important role in neo-adjuvant chemotherapy (NAC) for HNSCC in place of CDDP. We have been using combination chemotherapy including CDDP, 5-FU, MTX and LV. The response rate and CR rate of this 4-drug combined chemotherapy are 87% and 33%. Thirty-six patients with HNSCC were treated with 5-FU, 800 mg/m2/day for 5 days and 254-S, 100 mg/m2 on day 4. Chemotherapy was discontinued in one patient because of allergic shock. Three patients showed a CR and 10 patients showed a PR. The response rate and CR rate of 254-S plus 5-FU chemotherapy were 37.1% and 8.6%. These were inferior to those with the 4-drug combined chemotherapy. Fourteen percent of patients showed grade 3 leukocytopenia, and 17% showed more than grade 3 thrombocytopenia. The effect of combination chemotherapy of 254-S and 5-FU was inferior to that of the previous chemotherapy including CDDP, 5-FU, MTX and LV. Further study or another combination therapy including 254-S will be essential for improving efficacy against HNSCC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

The new public long-term care insurance system and feeling of burden among caregivers of the frail elderly in rural Japan.

The present study was conducted to investigate the factors related to the feelings of burden (i.e., stress) among caregivers of the frail elderly in rural Japan after the introduction of the new public long-term care insurance system in 2000. Forty-one out of 42 caregivers answered a self-administered questionnaire (i.e., the Japanese version of the Zarit Caregiver Burden Interview (ZBI)) regarding their caregiving situation. Compared with lightly burdened caregivers (n = 20; ZBI > or = 41), those heavily burdened (n = 21; ZBI < or = 40) attended the frail elderly with greater numbers of behavioral disturbances (2.2 +/- 2.6 vs. 0.6 +/- 1.0, p = 0.02) and those with dementia (60.9% vs. 39.1%, p = 0.08). Heavily burdened caregivers spent a longer time with the elderly (17.9 +/- 6.1 hours vs. 11.8 +/- 8.4 hours, p = 0.01) as well as in providing for their physically care (14.0 +/- 7.9 hours vs. 8.6 +/- 8.2 hours, p = 0.04), thus having less time to go out unaccompanied by their patients (1.1 +/- 1.6 hours vs. 2.4 +/- 2.3 hours, p = 0.04). Such caregivers tended to be depressed (70.0% vs. 42.9%, p = 0.08), although they used more social services (5.2 +/- 2.0 vs. 3.7 +/- 2.1, p = 0.03) than the lightly burdened caregivers. In addition, more than half of caregivers (56.1%) in the present study were depressed. This rate was higher than the rates in our studies before the introduction of the new public long-term care insurance system (a rural town: 53.3%, an urban town 46.6%). Furthermore, the number of social services used by caregivers did not seem to increase after the introduction of this insurance system (before: 4.1 +/- 2.0, after: 4.4 +/- 2.1). These findings suggest that the quantity and quality of social services for the frail elderly and their caregivers may not suffice even after the introduction of the new public long-term care insurance system.

Aged↗
PubMed2001

Depression among caregivers of elderly patients on chronic hemodialysis.

The present study was conducted to investigate depression in caregivers of elderly hemodialysis patients. Caregivers answered a self-administered questionnaire about various factors that may affect their depression, and also completed a Center for Epidemiologic Studies Depression Scale evaluation (CESD). The frail elderly who received regular nurse visits were used as controls. Compared with the caregivers of controls, those of hemodialysis patients spent less time on caregiving and had more time to go out unaccompanied by their patients. Males were numerous among hemodialysis patients than in the controls. Compared with the controls, hemodialysis patients were less likely to be older old (80 years old and more), diagnosed as demented or severely limited in activities of daily living (ADL). On the other hand, we did not find any significant difference between the two groups with regard to either the prevalence of depression, the rate of those who experienced any life event such as to cause depression within 6 months (e.g., death of family member), duration of caregiving or time looking after patients. Caregivers of hemodialyis patients may feel a heavy burden because they are obliged to play an important role in supporting patients on dialysis. They seem to need more social support regardless of whether or not their patients suffer from dementia.

Aged↗
PubMed2001

Burden among caregivers of frail elderly in Japan.

The present study was conducted in order to investigate the factors related to the feelings of psychological stress, called heavy burden, in caregivers who took care of frail elderly in the eastern part of Fukuoka Prefecture, Kyushu, Japan. Fifty-eight caregivers answered a self-administered questionnaire, involving the Japanese version of the Zarit Caregiver Burden Interview (ZBI) and thus described their own caregiving situation. Compared to caregivers with a light burden, heavily burdened caregivers were less likely to have time to go out without patients, but were more likely to consult physicians. Heavily burdened caregivers spent a longer time on looking after the elderly as well as on physical caregiving, and also used more social services than lightly burdened caregivers. However, the physical disabilities of the patients did not differ between the two groups. Even after controlling for confounding factors, the time spent on looking after frail elderly was found to be a significant factor related to the caregivers' heavy burden (10-24 hrs vs. 0-9 hrs; odds ratio: 5.35, 95% confidence interval: 1.17-25.58). These findings suggest that looking after frail elderly for a long time seems to be an important factor related to caregivers' developing psychological feelings of heavy burden.

Aged↗
PubMed2001

Magnetic resonance imaging observation of the conus medullaris.

We examined the anatomical height and shape of the conus medullaris in 602 cases using magnetic resonance imaging. The peak of the distribution of the conus height was at the middle one-third of L1. The comparison of the conus level had no significant relationships with age or sex, but the juvenile group had more a caudal distribution of the conus level. The shape of the conus medullaris was classified into three types, and the type B was most frequently observed.

Adolescent↗
PubMed2000

Apoptosis induced by cadmium in human lymphoma U937 cells through Ca2+-calpain and caspase-mitochondria- dependent pathways.

Apoptosis induced by cadmium has been shown in many tissues in vivo and in cultured cells in vitro. However, its molecular mechanism is not fully understood. When the human histiocytic lymphoma cell line U937 was treated with cadmium for 12 h, evidence of apoptotic features, including change in nuclear morphology, DNA fragmentation, formation of DNA ladder in agarose gel electrophoresis, and phosphatidylserine externalization, were obtained. Moreover, loss of the mitochondrial membrane potential (Deltapsi(m)) was observed in the cadmium-treated cells and was inhibited by a broad caspase inhibitor (Z-VAD-FMK). Caspase inhibitors suppressed the DNA fragmentation in the order of Z-VAD-FMK > caspase-8 inhibitor > caspase-3 inhibitor. Expression of Bcl-x(L) and Bid decreased significantly in the cadmium-treated cells, although no apparent change in Bcl-2 and Bax expression was found. Tetrakis-(2-pyridylmethyl) ethylendiamine, a cell-permeable heavy metal chelator, partially reversed the increase of fluorescence of Fura-2 in the cadmium-treated cells. In addition, verapamil (70 microm), a voltage-dependent Ca(2+) channel blocker, inhibited the DNA fragmentation induced by cadmium less than 100 microm and decreased the fluorescence of Fura-2. Cadmium up-regulated the expression of type 1 inositol 1,4,5-trisphosphate receptor (IP(3)R) but not type 2 or type 3 IP(3)R. Calpain inhibitors I and II partially prevented DNA fragmentation. No effects of Z-VAD-FMK on the expression of type 1 IP(3)R or of calpain inhibitors on the loss of Deltapsi(m) were observed. These results suggest that cadmium possibly induced apoptosis in U937 cells through two independent pathways, the Ca(2+)-calpain-dependent pathway and the caspase-mitochondria-dependent pathway.

Amino Acid Chloromethyl Ketones↗
PubMed2000

Prevalence and contamination levels of Listeria monocytogenes in retail foods in Japan.

Retail foods in Japan were surveyed for the presence and contamination levels of L. monocytogenes. It was isolated from 12.2, 20.6, 37.0 and 25.0% of 41 minced beef, 34 minced pork, 46 minced chicken and 16 minced pork-beef mixture samples, respectively. MPN values were higher than 100/g in five (10.9%) minced chicken samples, but lower than 100/g in all minced beef, pork and pork-beef mixture samples. The organism was also isolated from 5.4% of the 92 smoked salmon samples at MPN values lower than 10/g, and from 3.3% of 213 ready-to-eat raw seafood samples at MPN values from lower than 0.3 to higher than 100/g. None of the 285 vegetable samples were contaminated with L. monocytogenes. These findings indicate that ready-to-eat raw seafoods are relatively high risk among the foods surveyed in this study.

Animals↗
PubMed2000

Enzymatic removal of polysialic acid from neural cell adhesion molecule perturbs the migration route of luteinizing hormone-releasing hormone neurons in the developing chick forebrain.

During development in the chick embryo, luteinizing hormone-releasing hormone (LHRH) neurons migrate along the olfactory nerve from the olfactory epithelium to the forebrain. At embryonic day 5.5 (E5.5) to E6.0, the majority of LHRH neurons begin to enter the medial forebrain and then course dorsocaudally along the forebrain substance just beneath the pia matter in association with the somatostatin (SST)-positive fibers, which branch medially from the SST-positive olfactory nerve. By E6.5, the neurons and SST-positive medial branch of the olfactory nerve have proceeded toward the septal area. Intense immunoreactivity for the polysialylated form of neural cell adhesion molecule (PSA-NCAM) on both the LHRH neurons and the SST-positive fibers during this period suggests that this less adhesive form of NCAM is involved in the migratory process. This possibility was examined by using a polysialic acid (PSA)-specific endoneuraminidase. PSA removal did not alter the behavior or appearance of the SST-positive olfactory fibers within the migration pathway. However, it induced a significant deviation of migrating LHRH neurons from the regular path in the forebrain. The effect of PSA removal is more likely to involve changes in the interaction of the migrating neurons with a subset of the SST-positive olfactory fibers and/or other elements in the forebrain rather than an alteration in the pattern of their axonal substrate. On the basis of these results, it is suggested that PSA contributes to the specific pattern of LHRH neuronal migration in the forebrain by limiting interaction of these LHRH neurons with their surrounding environment.

Animals↗
PubMed2000

Analysis by early angiography of right internal thoracic artery grafting via the transverse sinus : predictors of graft failure.

BACKGROUND: There has been debate regarding whether technically demanding right internal thoracic artery (RITA) grafting via the transverse sinus can be extensively applied to patients in high-risk groups, such as patients with a small body size, elderly patients, and woman with relatively smaller coronary artery and internal thoracic artery (ITA) diameters. METHODS AND RESULTS: Of the 1456 patients who underwent isolated coronary artery bypass grafting between January 1989 and December 1998 at Kumamoto Central Hospital, 393 patients (mean age, 62.4+/-9.0 years) with the RITA anastomosed to the major branches of the circumflex artery were studied. Left ITA grafting was performed in 384 patients, and in 369, the in situ left ITA was anastomosed to the left anterior descending coronary artery using standard methods. Early postoperative angiography was performed in 381 patients. The RITA was occluded in 4 patients, and string-like artery and significant stenosis were present in 11 and 7 patients, respectively; RITA graft patency was thus 94.1%. Of the preoperative variables and angiographic data, simple and multiple logistic regression analyses identified decreased severity of native stenosis, diffuse sclerosis of native vessels, and residual side branches of the ITA as independent predictors of nonfunctional grafts. The method of ITA grafting did not influence the patency of the graft. CONCLUSIONS: The excellent patency rate demonstrated by this study, the largest angiographic study to date of RITA grafting via the transverse sinus, indicates that this technique can provide reliable revascularization of the left ventricle and that it has the potential to be applied to a wide variety of patients with diseased circumflex arteries.

Adolescent↗
PubMed2000

Histological distribution of class III alcohol dehydrogenase in human brain.

The distributions of class III alcohol dehydrogenase (ADH), a glutathione-dependent formaldehyde dehydrogenase, and class I ADH in the human brain were examined immunohistochemically. The most intense immunostaining of class III ADH was observed in the dendrites and cytoplasm of cerebellar Purkinje cells. Scattered cerebral cortical neurons in layers IV and V, and some hippocampal pyramidal neurons were also immunopositive. The neuronal distribution of class III ADH resembled that of the vulnerable neurons in patients with hypoxic encephalopathy, which in view of the intense staining in the Purkinje cells, raises the possibility that this enzyme contributes to the hypoxia and cerebellar degeneration suffered by chronic alcoholics. Perivascular and subependymal astrocytes, which contribute to the maintenance of the cerebral cellular milieu and isolate the brain from the systemic circulation and cerebrospinal fluid, were also class III ADH positive. As the substrates of this enzyme include intrinsic toxic formaldehyde, inflammatory intermediate of 20-hydroxy-leukoteiene B4, and possibly ethanol, the distribution of class III ADH immunostaining indicates this enzyme contributes to the defence of the brain against degenerative processes. The finding that, unlike ependymal cells, subependymal astrocytes were class III ADH positive, suggests this enzyme may be useful for differentiating astrocytes and ependymal cells.

Aged↗