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Biomedical subjects

A Terai

Publications and source records attributed to A Terai.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Familial bladder cancer].

Despite little evidence for a hereditary cause of most cases of bladder cancer, two different patterns of genetic involvement have been suggested: an autosomal dominant pattern that accounts for a very small number of cases and a multifactorial, polygenic pattern involving genetic and environmental interaction. Inherited homozygous defect of the glutathione S-transferase M1 gene is a good example of the latter pattern. Molecular genetic analysis has revealed two distinct molecular pathways to bladder tumorigenesis. Papillary noninvasive tumors as well as invasive disease harbor the chromosome 9 allelic loss, while carcinoma in situ contains a p53 gene mutation without an alteration of chromosome 9. The p53 gene mutations are closely associated with high grade, high stage urothelial cancers and immunohistochemical detection of the p53 protein alterations may be promising prognostic marker. Analysis of the p53 gene mutation pattern suggested a monoclonal origin for multicentric occurrence of urothelial cancers.

Family Health↗
PubMed1994

Clinical experience with yolk sac tumors and teratoma in children.

Between 1971 and 1993, 12 children with testicular germ cell tumors were treated at the Department of Urology, Faculty of Medicine, Kyoto University. Seven patients had yolk sac tumors and 5 had mature teratoma. Of the 7 patients with yolk sac tumors 6 had stage I and 1 had stage III tumors. Initial management of the stage I tumors consisted of high orchiectomy in 5 patients and high orchiectomy plus retroperitoneal lymph node dissection in 1 patient. Of these 6 patients, 4 were cured by surgery alone but lung metastases developed in the other 2 patients. One of them was salvaged with thoracotomy and chemotherapy but the other died of tumor. The patient with stage III tumor had bulky tumor spread to lung and retroperitoneum, but seems to have been cured by chemotherapy followed by resection of the residual mass although follow-up is still inadequate (14 months). Six of the 7 patients (85.7%) are alive 13 months to 21 years after diagnosis. Five patients with mature teratoma were treated by high orchiectomy or, more recently, enucleation and all are alive 4 months to 22 years after surgery.

Adolescent↗
PubMed1994

Evolving experience with continent urinary diversion using the Indiana pouch.

The Indiana continent urinary reservoir procedure for urinary diversion was performed in 46 patients. After the first 8 cases several modifications were made to the Indiana pouch. These modifications include complete detubularization of the colonic segment, construction of the pouch augmented with a U-shaped patch of ileum and, more recently, the use of stapled plication. The mean postoperative follow-up period was 46 mo (range 4.5-74.1 mo). There was 1 perioperative death and this case was excluded from the follow-up study. Late complications related to the urinary reservoir occurred in 12 (26.7%) of the 45 patients. Stone formation was observed in 5 patients. Out of 45 patients, 42 achieved complete urinary continence while 2 suffered mild nocturnal incontinence and 1 had significant leakage. Three had unilateral hydronephrosis due to ureteroanastomotic stricture. Reservoirgraphy demonstrated no reflux into the upper urinary tract in all of the follow-up cases. Loopography of the efferent limb showed that a staple-plicated ileum functions better than a suture-plicated one in terms of reliability of the continence mechanism and ease of catheterization. The Indiana pouch should be considered for any patient requiring cutaneous urinary diversion because it is technically easy to perform and it has a low revision and high continence rate.

Adult↗
PubMed1994

Transurethral microwave thermotherapy for benign prostatic hyperplasia: patient characteristics in good and poor responders.

Transurethral microwave thermotherapy (TUMT) has been shown to produce a clinical benefit in patients with symptomatic benign prostatic hyperplasia. In order to identify the features of the ideal candidate, a retrospective analysis was conducted in 32 patients who were followed for 2 mo or more. Good responders (GR) were defined as having their Siroky peak flow rate (PFR) standard deviation (SD) increase by < 0.5 or a decrease in the International Prostatic Symptom Score (I-PSS) of > 10 (22 patients). Poor responders (PR) were defined as having their PFR SD increase by < or = 0.5 and their I-PSS decrease by < or = 10 (10 patients). The prostate volume, pre-TUMT I-PSS and intravesical opening pressure were significantly greater in the GR group, while there were no significant differences between the 2 groups for the other baseline patient characteristics: age, prostate length, PFR, PFR SD, post-voiding residual volume and quality of life. Concerning the operational parameters, significantly more total energy was delivered to the prostate in the GR group (mean 131 kJ) than in the PR group (mean 101 kJ). Moreover, the 7 patients with anti-androgen therapy pre-TUMT received less total energy and 5 of the 7 were poor responders. These results suggest that patients with apparent obstructive symptoms and with moderate enlargement of prostate could benefit more from this less invasive therapy. Clinical response seems to be dose-dependent and patients with a history of recent anti-androgen treatment may have a less favorable response.(ABSTRACT TRUNCATED AT 250 WORDS)

Allylestrenol↗
PubMed1994

Urinary bacteriology of continent urinary reservoirs and calculus formation.

In order to investigate urinary bacteriology in relation to calculus formation in continent urinary reservoirs, a retrospective study was conducted of 19 patients with the Kock pouch and 23 patients with the Indiana pouch. Analysis of a total of 151 urine cultures showed that asymptomatic bacteria (any bacterial count) were present in 92% of urines from the Kock pouch and 74% from the Indiana pouch. The incidence of organisms and total bacterial counts were similar for both pouches. The most prevalent organisms were Escherichia coli, Pseudomonas sp., Klebsiella sp., Proteus sp., Enterobacter sp., and Enterococcus sp. Urinary calculi developed in 42% of the Kock pouch patients and 13% of the Indiana pouch patients. More than half of the patients had multiple stone recurrence. Infectious stones developed in 32% of the Kock pouch patients, usually on the foreign materials, and 9% of the Indiana pouch patients. In general, no clear relationship was established between urinary bacteriology and calculus formation although Proteus sp. or Providencia sp. was determined to be the causative organism in some infectious stones. Furthermore, metabolic stones developed in 32% of the Kock pouch patients and 9% of the Indiana pouch patients. Because calcium phosphate was a constituent of 80% of the metabolic stones, the presence of urinary factors promoting calculus formation was suspected.

Humans↗
PubMed1994

[Endoscopic stone disintegration using the Lithoclast].

We present our experience with a new and unique device for performing intracorporeal lithotripsy known as the Swiss Lithoclast. This simple device uses compressed air to activate a solid probe in a manner of a jackhammer. This device was used to treat 20 patients with stones in the ureter (11), bladder (5) or a Kock pouch (4). The Lithoclast successfully fragmented 90% of the calculi independent of the composition and salvaged 2 failed ESWL treatments. At one month after the procedure, either alone or in combination of with ESWL, 17 of 20 patients became free of stones. There were no complications related to use of the device. We have found the Swiss Lithoclast to be a safe and effective means of performing intracorporeal lithotripsy for urinary calculi.

Adult↗
PubMed1994

[Usefulness of renal dynamic function study with 99mTc-MAG3 (mercaptoacetylglycylglycylglycine)].

The clinical value of a newly developed renography agent 99mTc-mercaptoacetylglycylglycylglycine (99mTc-MAG3) was assessed in comparison with 123I-orthoiodohippurate (123I-OIH). A clear perfusion images were obtained early after 99mTc-MAG3 administration due to physical advantages of the tracer. A close correlation was observed of Tmax and T1/2 values between 99mTc-MAG3 and 123I-OIH. However, T1/2 calculated by 99mTc-MAG3 was significantly longer than that by 123I-OIH. In addition, the effective renal plasma flow (ERPF) value calculated by the clearance rate of the tracer by Tauxe method (radioactivity in plasma at 43 minutes after tracer administration) was smaller than that by 123I-OIH. In conclusion, 99mTc-MAG3 is considered as a useful agent for renography.

Female↗
PubMed1994

[A case of incidental renal leiomyosarcoma].

A 68-year-old man visited his home doctor with the chief complaint of left flank pain. Abdominal ultrasonography revealed left hydronephrosis and space occupying lesion in the right kidney. He was referred to our hospital because of suspected left ureteral stone and for further examination. Drip infusion pyelography revealed a left ureteral stone and retrograde pyelography showed extrinsic compression and deformation of the right pyelogram. A computed tomography showed a heterogeneous solid mass, 7 x 4 cm in size, compressing the pelvicocalyceal system and growing out of the kidney. Right radical nephrectomy was performed under the diagnosis of renal cell carcinoma. The pathological diagnosis was leiomyosarcoma. Seventy-five cases of renal leiomyosarcoma have been reported in the Japanese literature and this is the third case as an incidental tumor. Because of the absence of the characteristic diagnostic signs, this malignant tumor can present diagnostic difficulty. The diagnostic problems and clinical features of renal leiomyosarcoma are discussed.

Aged↗
PubMed1993

[Transurethral microwave thermotherapy for benign prostatic hyperplasia: clinical evaluation with International Prostate Symptom Score (I-PSS)].

Forty patients with symptomatic benign prostatic hyperplasia were treated with a single session of transurethral microwave thermotherapy (TUMT) using a Prostatron. The clinical effectiveness was evaluated by analyzing the subjective and objective responses following the treatment. The International Prostate Symptom Score (I-PSS) and quality of life (QOL) scale were used to evaluate the subjective symptoms. At three months after treatment, significant improvements in I-PSS (p < 0.0001). QOL (P < 0.0001), and peak flow rate (Qmax) (p < 0.05) were observed. Improvement of both I-PSS and Qmax was found in 90% (18/20) of the patients at 2 months. Although 15 patients noted transient urinary retention and 15 patients had mild to moderate macroscopic hematuria immediately after TUMT, no severe adverse effects occurred during the follow-up period. A significant correlation was found between I-PSS improvement and the total thermal dose delivered. However, the thermal dose could not be predicted in each case. The preliminary findings suggest that TUMT by Prostatron is safe and effective as a nonsurgical treatment for benign prostatic hyperplasia. The clinical response seems to be thermal dose dependent. I-PSS is clinically sensitive and is useful in practice.

Aged↗
PubMed1991

Similarity of the tdh gene-bearing plasmids of Vibrio cholerae non-O1 and Vibrio parahaemolyticus.

The gene encoding a hemolysin similar to the thermostable direct hemolysin (TDH) of Vibrio parahaemolyticus was previously cloned from a plasmid of Vibrio cholerae non-O1. The gene (designated as NAG-tdh) was subcloned and its nucleotide sequence was determined and compared with reported sequences of the four tdh gene copies encoding TDH, of which three were cloned from the chromosome and one was cloned from a plasmid of V. parahaemolyticus. In the coding region, the NAG-tdh gene had 100% homology with the plasmid-borne tdh gene (tdh4) whereas the NAG-tdh gene was 96.7-98.6% homologous to the three chromosomal tdh genes. The sequences of the NAG-tdh and tdh4 genes were nearly identical in the further upstream and downstream regions. The entire plasmids carrying the two tdh genes were found to be highly homologous when compared by restriction endonuclease and Southern blot analyses. The results suggest that the tdh gene has been transferred between V. cholerae non-O1 and V. parahaemolyticus by a plasmid, directly or indirectly, and that the nucleotide sequences of the tdh gene-bearing plasmids have undergone minor base changes in the respective genetic backgrounds.

Amino Acid Sequence↗
PubMed1991

Analysis of the tdh gene cloned from a tdh gene- and trh gene-positive strain of Vibrio parahaemolyticus.

A variant of the gene (tdh) encoding thermostable direct hemolysin (TDH) was cloned from the chromosome of Vibrio parahaemolyticus AQ3860, which gave positive results in the hybridization tests with the tdh gene probe and the trh (tdh-related hemolysin) gene probe and showed a low level of reaction in an enzyme-linked immunosorbent assay for TDH. Nucleotide sequence analysis of the cloned gene (tdh5) provided no evidence that tdh5 is evolutionally closer to the trh gene than the other tdh genes. The tdh5 gene was flanked by 40 base-pair sequences constituting perfect inverted repeats, which may suggest association of the tdh5 gene with insertion sequence-like structure. These results suggest that the tdh5 gene and the trh gene were not originally produced by gene duplication in AQ3860 but rather that one of the two genes moved into AQ3860 from an external source.

Animals↗
PubMed1991

Evidence for insertion sequence-mediated spread of the thermostable direct hemolysin gene among Vibrio species.

The tdh gene of Vibrio parahaemolyticus which encodes the thermostable direct hemolysin has been found in some strains of other Vibrio species. Analysis of seven tdh genes cloned from V. parahaemolyticus, Vibrio mimicus, and non-O1 Vibrio cholerae revealed that all tdh genes were flanked by insertion sequence-like elements (collectively named ISVs) or related sequences derived from genetic rearrangement of ISVs. The ISVs possessed 18-bp terminal inverted repeats highly homologous to those of IS903 (2- to 4-bp mismatch) and were 881 to 1,058 bp long with less than 33.6% sequence divergence. These features and nucleotide sequence similarities among ISVs and IS903 (overall homologies between ISVs and IS903, ca. 50%) strongly suggest that they were derived from a common ancestral sequence. A family of ISVs were widely distributed in Vibrio species, often regardless of the possession of the tdh genes, and one to several copies of the ISVs per organism were detected. A strain of V. mimicus possessed two copies of the ISVs flanking the tdh gene and three copies unrelated to the tdh gene. However, the transposition activity of the ISVs could not be demonstrated, probably because they had suffered from base changes and insertions and deletions within the transposase gene. The possible mode of ISV-mediated spread of the tdh gene is discussed from an evolutionary standpoint.

Bacterial Toxins↗
PubMed1990

Nucleotide sequence of the thermostable direct hemolysin gene (tdh gene) of Vibrio mimicus and its evolutionary relationship with the tdh genes of Vibrio parahaemolyticus.

The gene encoding a hemolysin similar to the thermostable direct hemolysin (TDH) of Vibrio parahaemolyticus was previously cloned from the chromosome of Vibrio mimicus. The nucleotide sequence of the hemolysin gene was determined in this study. The gene proved to be a variant of the thermostable direct hemolysin gene (tdh gene) and was designated as Vm-tdh because the sequence divergences between the Vm-tdh gene and four tdh genes of V. parahaemolyticus were 2.1-3.0%, while the sequence divergences among the four tdh genes of V. parahaemolyticus ranged between 1.4 and 3.3%. Analysis of these five tdh genes revealed that they evolved from a common ancestor in discrete and understandable order by sporadic base substitutions.

Base Sequence↗
PubMed1990

Cloning and nucleotide sequencing of Vero toxin 2 variant genes from Escherichia coli O91:H21 isolated from a patient with the hemolytic uremic syndrome.

Cellular DNA extracted from Escherichia coli strain B2F1 (O91:H21) was found to contain two separate DNA sequences that hybridized with a Vero toxin 2 (VT2)-specific gene probe under stringent conditions. These two sequences were cloned and both were shown to encode a variant of Vero toxin 2 (VT2vh). The nucleotide sequences of the operons encoding VT2vh, designated as vtx2ha and vtx2hb, were determined. The two operons were nearly identical (99% overall DNA homology) and both encoded A subunits of 319 amino acid residues and B subunits of 89 amino acid residues, the A and B subunit genes being separated by a stretch of 14 bp. The A and B subunit genes of the vtx2ha operon exhibited 98.6% and 95.5% DNA homology, respectively, with those of the slt-II operon encoding Shiga-like toxin II (or VT2) cloned from a strain from a patient with hemorrhagic colitis, while the A and B subunit genes of the vtx2ha operon showed 94.5% and 82.8% DNA homology, respectively, with those of the slt-IIv operon encoding a SLT-II variant cloned from a strain isolated from a pig with edema disease. The nucleotide sequences of the presumed promoters and presumptive ribosome binding sites in the vtx2ha, vtx2hb, and slt-II, and slt-IIv operons were identical. These results indicate that nucleotide sequences encoding a family of VT2-related toxins are present in various strains of E. coli and that the sequences of the genes for A subunits are better conserved than those of the B subunit genes.

Amino Acid Sequence↗