Search PubMed⌕ Search

Biomedical subjects

H Ihara

Publications and source records attributed to H Ihara.

At least 145 records · Page 8Linked to original sources
PubMed1992

[Percutaneous nephrostomy versus the placement of double pigtail ureteral stent for the treatment of postrenal failure secondary to malignancies].

From August 1989 through September 1991 we performed percutaneous nephrostomy under ultrasonic guidance in 26 kidneys of 25 patients. We also indwelled double pigtail ureteral stents by endoscopy in 14 kidneys of 13 patients. No patients died because of renal failure. The survival was dependent on progression of primary disease and performance status. Neither significant nor life-threatening complications were encountered. The difference in the improvement of renal function between nephrostomy group and stent group was not statistically significant. Although the indwelling ureteral stent method requires no external drainage bag, this method has certain drawback such as occasional obstruction of stent. Especially in poor risk patients, percutaneous nephrostomy technique seems to be better than placement of double pigtail ureteral stent in the treatment of postrenal failure secondary to malignancies.

Adult↗
PubMed1991

Molecular cloning of human platelet thromboxane A synthase.

Complementary DNA coding for thromboxane A synthase was amplified by polymerase chain reaction using primers synthesized according to the partial amino acid sequences of human platelet thromboxane A synthase (Nüsing, R., Schneider-Voss, S., and Ullrich, V. (1990) Arch. Biochem. Biophys. 280, 325-330) and cloned into pBluescript SK II(-). The primary structure of human platelet enzyme was deduced from the nucleotide sequence of the cDNA. The enzyme is composed of 533 amino acids with a molecular weight of 60,487. The primary structure of the enzyme exhibited a 34-36% homology to the amino acid sequences of cytochrome P450s classified in the P450 III gene family. The highly conserved cysteine-containing sequence involved in the heme-binding site of P450 was found near the carboxyl terminus (residues 472-492). The size of the major thromboxane A synthase mRNA from human platelets and human erythroleukemia cells was estimated to be approximately 2.2 kilobases by RNA blot analysis.

Amino Acid Sequence↗
PubMed1991

[Congenital lower urinary tract obstruction and enuresis in children].

We reviewed enuretic children among patients with congenital lower urinary tract obstructions experienced in the Department of Urology, Hyogo College of Medicine during 16 years from 1974 to 1989. Among 612 patients with congenital lower urinary tract obstructions, 139 (22.7%) had enuresis nocturna and/or diurna. The incidence of enuresis was 24.7% with posterior urethral valve (77 cases), 50.0% with anterior urethral valve (6 cases), 23.8% with congenital bulbar urethral stenosis in boys (303 cases) and 19.9% with congenital distal urethral stenosis in girls (226 cases). Diurnal enuresis was more common in enuresis associated with congenital lower urinary tract obstructions than in usual enuresis. In urodynamic examinations, more than half of enuretic children with congenital lower urinary obstructions showed hyperactive detrusor activity. Treatment of congenital lower urinary tract obstructions through operation resulted in cure or amelioration of enuresis in about 80% of the patients. Enuresis associated with lower urinary tract obstruction or neurogenic bladder is sometimes called complicated enuresis and it is an important role of a urologist to differentiate complicated enuresis from simple enuresis.

Adolescent↗
PubMed1991

[Clinical evaluation of intra-arterial infusion of hyperthermo-chemotherapy in gastric cancer].

We performed intra-arterial infusion hyperthermochemotherapy by retaining an intra-arterial reservoir in 17 lesions of 12 patients with non-resectable, metastatic or recurrent gastric cancers. The 12 patients consisted of one with a primary gastric cancer lesion, 6 with a solitary gastric cancer lesion metastasizing to the liver, 4 with gastric cancer accompanied by hepatic metastasis, lymph node metastasis or local recurrence, and one with a gastric cancer lesion metastasizing to Douglas' pouch. A catheter was retained in the hepatic artery of all 6 patients with a solitary gastric cancer lesion metastasizing to the liver, and a catheter was retained in the aorta of the patient with a primary lesion, 3 of the 4 patients with two or more metastatic lesions, and the patient with a lesion metastasizing to Douglas' pouch. The duration of each hyperthermia session was 50 minutes, and one or two sessions were performed within a week. One course consisting of 5 or 6 sessions was repeated. Antineoplastic drugs such as MMC, 5-FU, ADR, epi-ADR, CDDP and VP-16 were injected in bolus form or administered serially through the reservoir. Nine of the 12 patients had polypharmacy. One to 3 courses or 4 to 20 sessions at maximum (average 9.8 sessions) were given. The rate of efficacy of intra-arterial infusion hyperthermochemotherapy was 44% for hepatic metastasis and 25% for lymph node metastasis. The local recurrent lesions, the lesion metastasizing to Douglas' pouch and the primary lesion did not respond to therapy.

Adenocarcinoma, Mucinous↗
PubMed1991

[Treatment of 300 patients with bladder cancer].

From September 1973 to September 1989, 300 patients with bladder cancer were treated at the Department of Urology, Hyogo College of Medicine. They were 231 males and 69 females with an average age of 65.3 years old. The overall 5-year survival rate (Kaplan-Meier's method) was 64.7%. The 5-year survival rates were not different between male patients and female patients, or between patients with single tumor and patients with multiple tumors. Patients with vesical irritation symptoms had more unfavorable prognosis than patients with painless hematuria. Size and configuration of the tumors also affected the prognosis. Histological diagnosis was transitional cell carcinoma in 291 patients, squamous cell carcinoma in 7 patients, adenocarcinoma in one patient and undifferentiated carcinoma in one patient. In patients with transitional cell carcinoma, the 5-year survival rates according to histological grades were 93.5% for G1, 77.8% for G2 and 31.6% for G3. The 5-year survival rate according to clinical stage was 94.4% for Ta, 79.7% for T1, 66.7% for Tis, 46.1% for T2, 38.5% for T3 and 26.6% for T4. Transurethral resection of bladder tumor (TUR-b.t.) was performed in 208 patients as an initial operation and the 5-year survival rate in these patients was 78.6%. The 5-year survival rates for total cystectomy (52 patients), partial cystectomy (6 patients) and simple tumor resection (4 patients) were 51.9%, 25.0% and 37.5%, respectively. These findings suggest that superficial tumors (Ta, T1) can be controlled with TUR-b.t. but infiltrating tumors (T2, T3, T4) should be treated more vigorously with multidisciplinary approaches.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effects of serum-isolated vs synthetic bilirubin-albumin complexes on dye-binding methods for estimating serum albumin.

Bush and Reed reported (Clin Chem 1987;33:821-3) that the reaction of albumin with bromcresol purple but not with bromcresol green underestimated the concentration of albumin in synthetically obtained bilirubin-albumin (Bd) by 29%. Their unproven assumption was that chemically synthesized Bd behaved in a manner indistinguishable from the natural Bd in icteric serum. Here we verify that Bd, whether synthetically obtained or isolated from serum, causes an underestimation of albumin in the bromcresol purple but not in the bromcresol green method. The molar ratio of Bd from either source to underestimated albumin approximates 1.0, suggesting that one molecule of Bd would react equivalently to a molecule of albumin in the bromcresol purple method. This underestimation might falsely suggest hypoalbuminemia in patients with increased serum Bd.

Adult↗
PubMed1991

Double-contrast CT arthrography of the cruciate ligaments.

The value of computed tomography (CT) in evaluating the cruciate ligaments was assessed by studying an amputated knee in order to find the most suitable position for detecting minimal defects of the ligaments. The ACL or PCL, or both, of 60 patients (61 knees) were then examined by CT and the findings were compared with those of arthroscopy. Defects 3mm in length were shown by CT. A sufficient quantity of air and an adequate amount of positive contrast medium were required to obtain an accurate picture of the ligaments. For the ACL, the sensitivity of CT was 96.6%, specificity was 95.5%, and accuracy was 96.1%. For the PCL, sensitivity was 78.6%, specificity was 91.7%, and accuracy was 84.6%. Ruptures of the cruciate ligaments shown by CT were classified into four types. Their CT images coincided significantly with their arthroscopic findings. This study shows double-contrast CT arthrography to be a valuable method for evaluating the cruciate ligaments, and especially the ACL.

Adolescent↗
PubMed1990

Selective inhibition of expression of the substance P receptor mRNA in pancreatic acinar AR42J cells by glucocorticoids.

The effect of glucocorticoids on the regulation of the substance P receptor (SPR) mRNA was studied in rat pancreatic acinar AR42J cells by Northern blot analysis with the cloned cDNA. After a lag period of about 1 h, dexamethasone rapidly decreased steady-state SPR mRNA to almost negligible levels by 2 h. This decrease occurred in a dose-dependent manner by dexamethasone and was caused by various steroids in accordance with their relative potencies as glucocorticoids. These results indicate that the expression of the SPR mRNA is selectively and negatively regulated by glucocorticoids through interaction with the glucocorticoid receptor. The mechanisms of reduction of SPR mRNA levels were studied by treatment of AR42J cells with actinomycin D or cycloheximide. The SPR mRNA half-life was approximately 30 min, and this rate remained unchanged by dexamethasone treatment. Furthermore, the rapid turnover of the SPR mRNA required ongoing protein synthesis. On the basis of the result of actinomycin D treatment, together with kinetics of dexamethasone-induced changes in SPR mRNA levels, we discuss the mechanism in which glucocorticoids act at transcription initiation to reduce SPR mRNA levels.

Animals↗
PubMed1990

Combined cisplatin and radiation therapy in patients with invasive bladder cancer.

Thirty-five patients with T2-T4 invasive bladder cancer were treated with combined cisplatin and radiation therapy. In 18 patients radical cystectomy was performed after the combined therapy. In the other 17 patients radical cystectomy could not be performed for various reasons. Pathological examination of the cystectomy specimens showed down-staging in 66.7% and no residual tumour in 33.3%. These results suggest a synergistic action of cisplatin and radiation. Side effects were not severe and were well tolerated. This combined therapy of cisplatin and radiation is very effective for invasive bladder cancer.

Adult↗
PubMed1990

[Autotransfusion in urological surgery--experience with transurethral resection].

With the purpose to avoid the risk of homologous transfusion, autologous blood transfusion was performed in 26 patients who underwent transurethral resection of the prostate (TUR-P). Autologous blood (200-400 ml/time, 1-3 times, total 200-800 ml, mean 381 ml) was predeposited 4 days to 3 weeks prior to elected TUR-P and was transfused during or just after the operation. Since the start of this program in February 1988, homologous transfusion rate was decreased to 13.1%, whereas it has been 22.3% in 203 cases between January 1984 and January 1988. The mean hemoglobin level fell to 81.6% of the predeposition level. However, the hemoglobin level recovered to 90.1% one month after operation. The circulatory condition of the patients with autologous transfusions was stabler than that of the patients with homologous transfusion or no transfusion. No clinical hemostatic problems occurred. In cases with mild to moderate volume resection of the prostate, this autologous blood transfusion is recommended.

Aged↗
PubMed1990

[A case of spontaneous disappearance of pulmonary metastasis of renal cell carcinoma following nephrectomy].

A 76-year-old man was admitted to our hospital on October 3, 1988 complaining of general fatigue and left flank pain. A large movable mass was palpable in his left flank. Intravenous pyelography and computerized tomography confirmed left renal tumor. Chest X-ray showed a coin lesion in the left lung. Left nephrectomy was performed on October 14, 1988. Histopathological diagnosis was adenocarcinoma of clear cell type. Chest X-rays, on the postoperative eleventh day, showed disappearance of the pulmonary coin lesion which was seen preoperatively. Recurrence of pulmonary metastasis has not been seen for 14 months after operation.

Aged↗
PubMed1990

[Consideration on transfusion in urologic surgery--a retrospective study on homologous and autologous transfusions].

To obtain data for promoting autologous transfusion in urologic surgery, the cases of perioperative homologous transfusions in the past 5 years are reviewed. Although the mean perioperative homologous blood transfusion rate was not so high (10.2%), the rate in common urological surgery was comparatively high (eg. radical nephrectomy 39.4%, simple or palliative nephrectomy 21.6%, total nephroureterectomy 33.3%, renal allotransplantation 82.8%, total cystectomy 96.2%). Mean homologous transfusion volume in these surveys was 982 ml. Two successful cases of autologous blood transfusion by the predeposit method or intraoperative collecting method are presented. Transfusion-associated adverse effects, especially viral infection and immunosuppression, were discussed and the value of autotransfusion was stressed.

Blood Transfusion↗