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Biomedical subjects

H Tamai

Publications and source records attributed to H Tamai.

At least 325 records · Page 18Linked to original sources

[A clinical study of renal tumors].

Seventy one patients with renal tumors treated at our clinic during the 11 years from 1970 to 1980 were clinically examined. The results are summarized as follows. The frequency of patients with renal tumors was 0.22% of the outpatients and 1.72% of the inpatients. Of the 71 renal tumors, 41 were renal adenocarcinoma, and 26 were renal pelvic tumors of which 23 were transitional cell tumors, 2 were squamous cell tumors, and 1 was adenocarcinoma. The other tumors were 1 adenoma, 1 hemangioma, 1 hematoma, and 1 foreign body granuloma. The right and left kidneys were affected at equal frequencies. Male patients were more commonly affected, the sex ratio being 39 to 32. The youngest case was a 29-year-old female, and the eldest was a 84-year-old male. As the initial symptoms and chief complaints, gross hematuria was most frequent (52 cases, 73.2%), followed abdominal tumor mass (32 cases, 45.1%), and fever (26 cases, 36.6%). Only 2 cases showed the classic triad, while 1 case had none of them. The period between onset of symptoms and admission, was within 1 year for all patients except for 2 cases. Metastasis was found in 52 cases. The lung was the most frequent site of metastasis (12 cases, 23.1%), followed by lymphnodes, bones, and liver. The clinical examinations performed and diagnostic techniques used were, renal function (BUN, Serum Cr), Hb, WBC, liver function (T. Bil, GOT, GPT), serum protein fraction, serum LDH, serum Ca, ESR, tumor marker (AFP, CEA), urine cytological examination, blood pressure, IVP (or RP), angiography. As the therapeutic method, nephrectomy was performed in 25 cases (35.2%), combined nephrectomy and irradiation therapy in 12 cases (16.9%), combined nephrectomy and chemotherapy in 11 cases (15.5%), combined nephrectomy and other therapy in 15 cases (21.1%), and conservative therapy in 8 cases (11.3%). For the entire traced series of renal tumors, the 1-, 3-and 5-year survival rates were 72.3, 49.8, and 49.8% respectively. For renal parenchymal tumors (renal adenocarcinoma), the 1-, 3-and 5-year survival rates were 77.8, 53.0, and 53.0%. The most important factor of prognosis was the stage of tumor. Patients with elevated erythrocyte sedimentation rate, and dysproteinemia also had distinctly unfavorable prognosis. In this study of therapy, the highest survival rate was seen for the patients treated by combined nephrectomy and irradiation therapy of both renal parenchymal and pelvic tumors.

Adult↗

[Clinical studies on long acting amoxicillin in the field of urology].

Long acting amoxicillin (L-AMPC) was studied in the treatment of 40 patients with urinary tract infections. The dosage administered was 1,000 mg/day (b.i.d.) consecutively for 3 days in acute simple UTI and 5 days in chronic complicated UTI. Clinical efficacy was assessed according to the criteria established by the UTI Committee in Japan. Accordingly the response to therapy in 27 patients with acute simple cystitis was excellent in 17, moderate in 8 and poor in 2 cases and for chronic complicated UTI was excellent in 2, moderate in 3 and poor in 6 cases. Thus the overall clinical efficacy ratios for acute simple cystitis and chronic complicated UTI were 93% and 45% respectively. The bacteriological elimination ratios were 25 out of 27 of the causative organisms (93%) for acute simple cystitis and 6 out of 11 for chronic complicated UTI (55%). No side effects of significance were observed. The results obtained demonstrated the usefulness of the b.i.d. administration of L-AMPC and were considered, in the light of previous experience to be similar to those obtained with conventional amoxicillin dosage schedules.

Adult↗

Responses to TRH, T3 suppression tests and histological findings by needle biopsy in patients with simple goitre in Japan.

Studies were performed in 120 patients with simple goitre, defined as relatively soft diffuse goitre. All were clinically and biochemically euthyroid and their antithyroid antibodies were negative. The TRH test was performed in 99 after the TRH test, while satisfactory biopsies of the thyroid were obtained in 37. The results showed that 28 of the 115 cases (24%) had an abnormal response to TRH; 8 (7%) were hyporesponders and 20 (17%) were hyperresponders. The T3 suppression test showed that 3 of 99 cases (3%) were non-suppressible. As determined by histological examination of the needle biopsy specimen, 17 of the 37 cases (46%) had normal follicles without lymphocytic infiltration, 10 (27%) had diffuse chronic thyroiditis, 5 (14%) had focal thyroiditis and 4 (11%) had diffuse epithelial hyperplastic change, and 1 (3%) had an adenomatous goitre. It is suggested that simple goitre defined as above includes various thyroid diseases and that the results of TRH tests, antithyroid antibody estimations and histological findings do not correlate in many patients.

Adolescent↗

Gonadotropin response to luteinizing hormone releasing hormone in hyperthyroid patients with menstrual disturbances.

This study was designed to investigate the gonadotropin response to luteinizing hormone releasing hormone (LHRH) in patients with hyperthyroidism, as related to the presence or absence of menstrual disorders. Forty-one Japanese women with hyperthyroidism were separated into groups on the basis of the presence of a regular menstrual cycle, hypomenorrhea, or amenorrhea and further subdivided into the phase of the menstrual cycle at the time of testing. The findings in these groups were compared with those in normal subjects with respect to thyroid function, basal serum LH and FSH levels and serum LH and FSH responses to LHRH, and basal estradiol levels. Serum LH responses to LHRH were increased over normal subjects in those with hyperthyroidism regardless of the phase of the menstrual cycle and regardless of the presence or absence of menstrual disturbances. However, these augmented LH responses to LHRH were less marked in those with menstrual disorders than in those with regular menstruation. Both basal serum FSH and peak serum FSH response to LHRH were also increased in the follicular phase but not in the luteal phase of the cycle in hyperthyroid patients, regardless of menstrual function. These results suggest that high levels of circulating thyroid hormones augment the gonadotropin response to LHRH, and that increased LH and FSH secretion probably maintains the normal cyclic pituitary gonadal axis function in patients with hyperthyroidism.

Adult↗

Changes in thyroid function in euthyroid subjects with a family history of Graves' disease: a follow-up study of 69 patients.

TRH tests were performed in 206 clinically and biochemically euthyroid relatives of patients with Graves' disease. In 117 of the 206, T3 suppression tests were performed. Results revealed that 56 of the 206 (27.1%) showed abnormal responses to TRH. Twenty-nine of these (14.1%) revealed absent or decreased responses, and 27 (13.1%) revealed augmented responses to TRH. Eight of the 117 (6.8%) were T3 nonsuppressible. These eight subjects consisted of 4 subjects out of 17 hyperesponders and 4 subjects out of 90 normal responders. The majority of suppressible subjects (86 among 109) demonstrated normal responses to TRH. Sixty-nine of the 206 subjects were followed for 6 months to 5 yr to observe changes in their thyroid functions. Among all 69 subjects 3 became clinically thyrotoxic 12, 12, and 18 months after their initial visit, respectively, and 2 became clinically hypothyroid 2 yr after their initial visit. Since 69 subjects were clinically and biochemically euthyroid and had no goiter or exophthalmos at their initial visit, the incidence of thyrotoxicosis or hypothyroidism in these subjects could be considered to be remarkably high. It is of interest that the 3 thyrotoxic patients were TRH hyporesponders at their first visit. One patient was T3 suppressible; T3 suppression tests were not performed in the other 2 patients at their initial visit. There was no abnormality in the first TRH test in 2 relatives who became hypothyroid. It is suggested that 1) among euthyroid relatives with a family history of Graves' disease, there are many with abnormalities in TRH responsiveness and T3 suppressibility, 2) nonsuppressible subjects are more likely to be TRH hyporesponders and vice versa, 3) hyperthyroidism or hypothyroidism occurs frequently in euthyroid relatives with a family history of Graves' disease, and 4) thyrotoxicosis occurs frequently in TRH-hyporesponders, and hypothyroidism occurs in the others.

Adolescent↗

Clinical and pathological significance of sibling Graves' disease.

The clinical picture and serum antithyroid antibodies in 16 pairs of siblings with Graves' disease were compared with an age and sex matched group of 32 patients with Graves' disease who did not have a family history of any thyroid disease (control patients). There was a significant difference in frequency and mean titres of antibodies to thyroglobulin between sibling patients. (positive 76.0%) and control patients (positive 40.0 %), but not in microsomal antibodies (sibling; positive 92.0%, control; 92.0%). There were no significant differences in the mean values of 24 h 131I-thyroidal uptake, serum T3U, serum T4 and T3 concentrations before treatment between the two groups. Lymphoid follicles and degeneration of the epithelia were more often found in the thyroid glands of sibling patients than in those of the control patients, when 32 (16 sibling, 16 control) thyroid glands from the same groups in the clinical study, including antibody series, were examined pathologically after subtotal thyroidectomy for Graves' disease. Moreover, there was a strong tendency to increased lymphocyte and plasma cell infiltration in the thyroid glands of sibling patients with Grave's disease. The findings might indicate that Graves' disease is closely related to Hashimoto's thyroiditis, especially in sibling patients with Graves' disease.

Adult↗