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Biomedical subjects

H Fuse

Publications and source records attributed to H Fuse.

At least 37 records · Page 2Linked to original sources

Experience with a new intraurethral stent for high-risk patients with benign prostatic hypertrophy.

Eight patients with benign prostatic hypertrophy (BPH), considered as a high risk for an operation because of severe accompanying disease, were treated with a self-retaining intraurethral catheter set. Two patients were judged unfit for operation (one because of severe cardiac failure, the other because of severe respiratory failure) and 1 patient rejected an operation. The BPH surgery was postponed in the others because of recent operations for such diseases as gastric cancer or because of severe gastric ulcer. All patients voided freely after stent placement and were continent. The device was left in place for 1 to 16 weeks. The chief complaint was frequency of voiding, with intervals of 1 to 2 hours. Some micturition discomforts such as urgency were recognized in 2 patients, but disappeared within 1 to 2 days. Pyuria observed before treatment disappeared in all but 1 patient. Average residual urine volume calculated on ultrasonograms was 54 ml. Stone formation was demonstrated in 1 patient 9 weeks after placement. We concluded that the intraurethral stent is an effective device for high-risk patients with BPH. However, a longer follow-up study will be needed to exclude late side effects.

Aged

[A case of metastatic urinary bladder tumor from colon carcinoma].

A 62-year-old female patient underwent an operation for a brain tumor. The pathological diagnosis of the resected specimen was metastatic adenocarcinoma with signet-ring cells. The primary lesion was found in the ascending colon. In addition, a non-papillary and pedunculated tumor was found on the right wall of the bladder on cystoscopy. Biopsy of the bladder tumor showed adenocarcinoma with signet-ring cells, which was the same as the histologies of the colon and the brain tumors. Under the diagnosis of metastatic bladder tumor, transurethral resection of the tumor was performed. This is the first case of metastatic bladder carcinoma from the colon reported in Japan.

Brain Neoplasms

Experimental testicular ischaemia: time course of the effect on rat spermatogenesis.

Protection of the spermatogenic cells against anticancer drugs can be performed by temporarily interrupting testicular blood flow during drug administration. In our study we investigated the effect of ischaemia on spermatogenesis, using mature male Sprague-Dawley rats. Eight and 16 weeks after a 1 h period of left testicular ischaemia, left testicular weights significantly decreased compared with the controls (both, p < 0.05). The decreased testicular weights returned to almost normal values at 24 weeks. Sperm counts in the left cauda epididymis were significantly reduced 8, 16 and 24 weeks after ischaemia (p < 0.01, p < 0.01 and p < 0.05, respectively). Sperm motility also decreased 8 and 16 weeks after the procedure (both, p < 0.01). These parameters returned to normal at 48 weeks. The diameter of seminiferous tubules in the left testis was diminished 8 and 16 weeks after testicular ischaemia, and increased tubular wall thickness on the left side was demonstrated 8 weeks after ischaemia (each, p < 0.05). No changes in the parameters at any interval after ischaemia were observed in the right testis. The serum levels of LH, FSH and testosterone showed no alteration throughout the experiment. The present study reveals that testicular damage induced by ischaemia up to 1 h is completely reversible and no contralateral orchiopathy is produced by this procedure.

Animals

[Clinical studies on methicillin-resistant Staphylococcus aureus (MRSA) infections].

We experienced 20 cases of methicillin-resistant Staphylococcus aureus (MRSA) infection from April 1991 to September 1992. Of them, 9 showed substantial morbidity and their clinical courses are herein reported. The clinical presentations of these cases were wound infection and enterocolitis. Although in 8 cases MRSA was eradicated in 14 to 160 days by effective antibiotics administration, one had a fatal outcome. All strains isolated showed similar drug-sensitivity pattern suggesting hospital infection. Sensitivity to vancomycin and arbekacin, however, remained high and these drugs were effective clinically. It should be stressed that treatment strategy of MRSA infection should consist of isolation of patients with MRSA from other patients, use of disposable equipment and products, and serious and continuing concerns of medical personal on communicability of MRSA.

Aged

[Strangulation of the penis by a metallic ring].

An 81-year-old male patient visited our hospital on November 13, 1992 for the treatment of penile edema that had been caused by a metallic ring which he placed for fun 4 days prior to the visit. He had placed the metallic ring on the base of the penis and subsequent penile edema made it impossible to remove the ring. He had no problem with urination. The ring was successfully removed with a metal-cutting tool. But 3 days later, infected penile ulceration occurred at the base of the penis and the necrotic tissue was resected. It took 25 days for the wound to heal. It is stressed that penile strangulation is a serious injury and prompt removal is necessary.

Aged

[Phase I study of flutamide, a nonsteroidal antiandrogen, in patients with prostatic cancer].

A phase I study of orally administered flutamide (a pure anti-androgen) was performed in 26 patients with prostatic cancer. No side effects were observed in 11 patients receiving single doses of either 125, 250, 375 or 500 mg. However, in the daily dosing schedule of 375, 750, 1125 and 1,500 mg/day doses, where medication was taken in three divided doses, discomfort in the stomach, nausea, vomiting and anorexia were experienced in one of the four patients receiving the highest dose of 1,500 mg. Nine patients receiving the other doses did not complain of toxic symptoms. Laboratory values did not change in the three patients receiving the lowest 375 mg/day dose, but elevation of transaminase was observed in five of the nine patients given higher doses. This elevation was observed in all the three patients receiving 1,500 mg/day dose. Among the serum hormone levels, significant increases of luteinizing hormone were observed. As for efficacy, objective responses were observed in two of the three patients in each of the four daily dosing groups. Improvement of pain, voiding obstruction symptoms, and performance status were also observed. Flutamide was found to be absorbed rapidly and to exist as a hydroxylated form (hydroxy-flutamide) in the plasma. The half-life of hydroxy-flutamide was similar in the single and daily administration, but the peak concentration and area under the concentration versus time curve in the daily administration became greater than those in the single administration. In conclusion, flutamide should be examined for efficacy and safety using doses of 375 to 1,125 mg/day in the phase II study.

Administration, Oral

DNA analyses of XX and XX-hypospadiac males.

Fourteen 46,XX "males" were analyzed by Southern blot hybridization with seventeen different Y chromosome-derived DNA probes and by the polymerase chain reaction for an additional two sites on the short arm of Y. Eight 46,XX males possessed various segments of the short arm of the Y chromosome, including the sex determining region. The detected segments ranged from the two most distal loci to nearly the entire length of the short arm, viz., 10 out of 11 loci. None of the eight patients had hypospadia. Five out of the six remaining cases had hypospadia and no Y sequence was detected, suggesting the presence of a causative difference between hypospadiac and non-hypospadiac groups.

Adolescent

Recurrence of superficial bladder tumours after transurethral resection.

From 1979 to January 1990, 48 patients with newly diagnosed superficial bladder tumours were treated by transurethral resection (TUR) at Toyama Medical and Pharmaceutical University Hospital. The relationship between tumour recurrence and the stage, grade, number, or size of the tumours was investigated. The 1-, 2-, 3-, 4- and 5-year non-recurrence rates were 72%, 63%, 47%, 40%, and 40%, respectively. Non-recurrence rate for pTa tumours was significantly higher than that for pT1 tumours (p < 0.05). There was no relationship between tumour grade and recurrence. The rate of recurrence of multiple tumours was higher than that of single ones. There was no difference in non-recurrence rate between tumours smaller than 1 cm and those of 1 cm or larger. Non-recurrence rate in the instillation therapy group was significantly higher than in the non-instillation group (p < 0.05). It was concluded that patients with multiple or high-stage tumours have the risk of a high rate of recurrence and that intravesical chemotherapy is effective in preventing local recurrence in some patients.

Administration, Intravesical

Klinefelter's syndrome with prepenile scrotum.

Two cases of Klinefelter's syndrome with prepenile scrotum were presented. They underwent the operation for prepenile scrotum according to Glenn and Anderson's method. Thereafter urethroplasty was performed in each case. The decrease in response to testosterone in the target organ was noticed in 1 patient, suggesting that some androgen resistance in this case was attributable in part to anomaly of genitalia.

Child, Preschool

Epidermal growth factor in urine from the patients with urothelial tumors.

Epidermal growth factor (EGF) concentration in urine was measured with a radioimmunoassay in 40 untreated patients with urothelial tumors and a comparable control group of 25 normals. The concentration of EGF in urine from the patients with bladder, renal pelvic or ureter tumors was lower than normal (p less than 0.05). Patients with T4 tumors had lower concentrations of EGF compared with those of other stages. EGF concentrations after transurethral resection of bladder tumors were significantly elevated compared with the values before operation. These findings suggest that urothelial tumors are related to a low concentration of EGF and that a decrease of EGF is associated with invasion of tumors.

Carcinoma, Transitional Cell

Evaluation of seminal vesicle characteristics by ultrasonography before and after ejaculation.

Twenty males underwent transrectal ultrasonography before and after ejaculation to examine possible alterations that could influence interpretation of seminal vesicle ultrasonography. The preejaculation length of 35 mm was significantly (p < 0.05) decreased to 30 mm after ejaculation. The mean width of the seminal vesicles was 13 mm before and 11 mm after ejaculation. The seminal vesicle volume was significantly diminished after ejaculation (p < 0.05). It therefore seems important to maintain a period of abstinence when evaluating the seminal vesicles by ultrasonography.

Adult

Seminal plasma transferrin concentration: relationship with seminal parameters and plasma hormone levels.

Seminal plasma transferrin concentrations were determined in 155 infertile male patients and in 15 pregnancy-proven fertile males (control group); then the relationship between these concentrations and seminal parameters and plasma hormone levels was investigated. The concentrations of seminal plasma transferrin in patients with a sperm concentration below 20 x 10(6)/ml were significantly lower than those in the control group (p < 0.01). There was no significant difference in seminal plasma transferrin concentration between patients with a sperm concentration of 40 x 10(6)/ml or more and the control patients. A positive correlation was observed between sperm concentration and seminal transferrin content (r = 0.56; p < 0.05). However, correlations between seminal transferrin concentration and sperm motility and between seminal plasma transferrin content and sperm morphology did not show any significance, nor did the seminal transferrin content correlate with plasma LH, FSH, prolactin or testosterone levels. It, therefore, seems that while transferrin is indicative of certain physiopathological conditions in the germ cells, this protein is not a distinctive marker of the fertility potential of an individual.

Adult

[A study on the mass screening system for prostatic diseases].

Between 1984 and 1990, a mass screening for prostatic diseases was carried out on men over 55 years old in cities, towns and villages in Toyama Prefecture, Japan. The total number of subjects examined in the primary study was 1,232, which was 17.7% of the males over 55 years old in these areas. The primary study consisted of inquiry concerning urination, digital examination of the prostate, transabdominal ultrasonography, and determination of tumor markers. A secondary study was indicated for 100 subjects (8.9%) suspected to have prostatic cancer and 169 (15%) suspected to have benign prostatic hypertrophy, but only 92 (35%) of them were actually examined. Prostatic cancer was histologically diagnosed in 3 subjects (0.3%), and benign prostatic hypertrophy was established in 56 subjects (4.5%), who were referred to urologists. Though a high percentage of the population was covered by the primary study the percentage of subjects who received the secondary study among those in whom it was indicated was low. This probably was a reason for the low detection rate of prostatic cancer. An improved system is considered to be needed to increase the efficiency of mass screening for prostatic diseases.

Humans

[Clinical study on primary aldosteronism--localization of adrenal tumors].

Seven cases of primary aldosteronism were experienced during the 12 years in the Toyama Medical and Pharmaceutical University Hospital. The majority of cases were between 32 and 64 years old with a mean of 51 years. Two cases were male and 5 were female. Hypertension was observed in 6 cases, but one case had normal blood pressure. Hypokalemia was recognized in 6 cases. The plasma level of aldosterone was high in all cases and all the cases showed low levels of plasma renin activity. Concerning the localization of the lesions, CT scan, magnetic resonance imaging and adrenal scintigraphy revealed an accuracy rate of 100%, each. Therefore, these imaging techniques are very useful tools for identifying the locality of the adenoma. On the other hand, the accuracy rates of adrenal venous aldosterone assay and ultrasonography were 83 and 60%, respectively. The cases with rather short duration of hypertension before surgery returned to normal in blood pressure earlier after the operation than the other cases.

Adenoma

[Measurement of urinary epidermal growth factor by radioimmunoassay and its application].

Epidermal growth factor (EGF), a polypeptide hormone originally discovered in the mouse submaxillary gland, stimulates growth in a variety of tissues in several species. This hormone has recently been identified in human urine. Herein, radioimmunoassay (RIA) for human EGF (hEGF) has been developed, using human recombinant EGF as reference standard and radioiodinated tracer and antibodies raised against hEGF. Its sensitivity was somewhat higher than that of RIAs reported formerly. This method had no cross reactivity with high molecular weight EGF. Urinary concentrations of hEGF in normal males and females were 30.2 +/- 13.0 ng/mg creatinine and 46.4 +/- 17.4 ng/mg creatinine, respectively. Urinary concentration of hEGF in patients with renal cancer was somewhat low. The patients with bladder cancer had lower urinary excretion of hEGF than normal adults (p less than 0.05). However, the role of hEGF in health and disease remains to be determined.

Adult

Multiple marker evaluation in prostatic cancer with prostatic acid phosphatase, gamma-seminoprotein and prostate-specific antigen.

Serum prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm), and prostate-specific antigen (PA) levels were measured in 63 untreated patients with prostatic cancer. The sensitivities of PAP, gamma-Sm, and PA as markers of malignancy were 68%, 83%, and 77%, respectively. The latter two markers were more sensitive than PAP, especially in stage B disease. The specificities of PAP, gamma-Sm, and PA were 95%, 93%, and 93%, respectively. Patients with multiple positive markers were very likely to have prostatic cancer. In reactivation of the disease, positive rates for gamma-Sm and PA were higher than for PAP, indicating that the former two markers are more reliable for monitoring prostatic cancer.

Acid Phosphatase

Molecular cloning and mapping of 10 new probes on the human Y chromosome.

We have developed a novel positive cloning vector whose use precludes the cloning of any fragments less than 0.8 kb as well as 3.4-kb EcoRI fragments of DYZ1, the largest repeating-DNA family on the long arm of the human Y chromosome. Using this vector, we subcloned inserts of a Y-chromosome-specific phage library constructed from EcoRI-digested flow-sorted Y-chromosome DNA. Ten novel Y-specific fragments were obtained. Their localization on the Y chromosome was determined by deletion mapping using clinical samples with structurally abnormal Y chromosomes. The long arm of the Y chromosome was divided into 12 segments by the novel probes in combination with established probes. The amelogenin-like sequence, mapped on the long arm in Human Gene Mapping 10, has been mapped on the short arm.

Amelogenin