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Biomedical subjects

I Higa

Publications and source records attributed to I Higa.

At least 19 recordsLinked to original sources
PubMed1999

[Fornix of vagina suspension for cystocele].

OBJECTIVE: Bladder neck hypermobility causes cystocele in middle to old elderly women. We developed an easy and useful surgical technique for cystocele. METHODS: Thirteen patients with cystocele (grade 2-4) were operated by fornix of the vagina suspension. Patients were placed on lithotomy position under general or spinal anesthesia. Lower midline or lower abdominal transverse incision was made to open the peritoneum and denuded vesicouterine pouch. Several nylon sutures were placed on the lateral side of exposed fornix of the vagina. These sutures were suspended to anterior layer of the rectus sheath. Fornix of the vagina was fixed to the rectus muscle, so the prolapsed bladder wall was pulled up in normal position. RESULTS: Operating time ranged from 15-110 minutes (average 73 minutes). Ten patients of thirteen were successful up to 2-43 months postoperatively. Cystocele recurred in three patients of thirteen. Two patients was re-operated by the same method, but one of them recurred. Two of three recurrent patients had grade 4 cystocele. CONCLUSION: Fornix of the vagina suspension for cystocele seems useful and promising because of easy procedure without serious morbidity, especially in elderly high-risk patients.

Aged↗
PubMed1996

[Comparative susceptibility of 10 antimicrobials against Pseudomonas aeruginosa isolated from complicated urinary tract infection on 1992 & 1993 vs. 1994 & 1995].

The susceptibility of 10 antimicrobials against P. aeruginosa isolated from complicated UTI during 1992-1995 was determined, and the yearly trend was examined. The drug tested included 3 cephems (ceftazidime [CAZ], cefpirome [CPR], cefclidin [CFCL]), 1 monobactam (aztreonam [AZT]), 2 carbapenem (imipenem/cilastatin [IPM/CS], biapenem [BIPM]), 2 aminoglycosides (netilmicin [NTL], gentamicin [GM]) and 2 new quinolones (ofloxacin [OFLX], ciprofloxacin [CPFX]). A total number of isolates of which MIC were determined was 77 in 1992/1993 and 70 in 1994/1995. MIC50/MIC90(micrograms/ml) on the isolates were as follows (1992/1993 1994/1995); 3.13/ 100 12.5/50 in CAZ, 12.5/100 12.5/100 in CPR, 3.13/25 1.56/25 in CFCL, 6.25/50 12.5/100 in AZT, 6.25/25 3.13/25 in IPM/CS, 1.56/6.25 0.78/50 in BIPM, 12.5/100 6.25/100 in NTL, 6.25/ 50 6.25/100 < in GM, 25.100 < 25/100 < in OFLX, 6.25/100 6.25/100 < in CPFX. When the susceptibility of the yearly trend is compared, no significant changes were detected among the drugs tested expect the decrease of susceptibility on CAZ, AZT and increase of it on IPM/CS. From the data obtained, against complicated UTI infected by P. aerugunosa, CFCL, IPM/CS and BIPM are considered to drugs of first choice in the treatment.

Anti-Bacterial Agents↗
PubMed1996

[Characteristic clinical features of pyelonephritis caused by Enterococcus faecalis].

A clinical study was performed in 13 cases of refractory Enterococcus faecalis pyelonephritis that were detected in the Department of Urology, Hiratsuka Municipal Hospital, from April 1975 to March 1995. The characteristic features were that pyelonephritis was commonly seen in females, and clinical symptoms (low-grade intermittent fever, low back pain, general malaise, etc.) were continuously refractory. Bacteriuria or polymicrobial infections were often found, and bacterial count was often as high as 10(2)-10(4)/ml. Nevertheless we considered that E. faecalis caused of refractory pyelonephritis must not have week adherence and pathogenesis to the kidney, owing to the clinical symptoms and the basic subjects. Furthermore this infection was difficult to cure completely with antimicrobials having activity against E. faecalis, and long-term treatment was needed. Therefore, we recommend that treatment for refractory E. faecalis pyelonephritis be carefully selected according to clinical symptoms and the bacterial density of this strain.

Adolescent↗
PubMed1995

[Study on clinical courses of 7 patients undergone resection of adjacent organs in the treatment of locally extensive renal cell carcinoma].

Significance of surgical extirpation of a massive tumor involving adjacent viscera is still controversial, because this sort of extensive resection is unusual and its results are poor in terms of a short survival time. Here, we summarize the clinical courses of 7 patients who had been diagnosed as invasive renal cell carcinoma (RCC) and undergone extensive resection of the bowel and/or other adjacent visceras. In addition, a percentage of patients who had direct invasion and/or metastasis to adjacent viscera in routine autopsies was looked up in the Annual Report of the Pathological Autopsy Cases in Japan. Pathological diagnosis indicated that direct invasion was confirmed in 4 out of 7 patients. One patient was relieved from septic shock due to pelvicocolic fistula caused by a direct invasion of RCC. New metastases developed in all patients after the radical operation (2 - 30 mos), and 3 of them further underwent resection of the metastastic lesion(s). Although 5 patients ultimately died of cancer or its related diseases (mean survival time: 14.2 +/- 10.7 mos), other 2 (pT4 and pT3) who underwent resection of lung metastasis have survived for 19 and 72 months. Either an early occurrence of metastasis after local resection or a tumor predominantly composing of spindle cells might indicate a poor prognosis. Surgical extirpation should not be precluded when the patient is having severe symptoms related to extensive involvement of the adjacent visceras. We believe that it is appropriate to individualize in case of choosing patients for such extended radical surgery.

Aged↗
PubMed1994

Cytokine production and cytotoxicity of lymphocytes in patients on maintenance short- or long-term haemodialysis.

The lymphocyte-mediated cytotoxicity and cytokine production of patients under maintenance haemodialysis were studied. The patients were subdivided into two groups; 27 patients receiving haemodialysis treatment for up to 3 years (group 1) and 27 patients for longer than 10 years (group 2). Twenty-six healthy volunteers (group 3) were used as controls. The immunological parameters assayed were NK cell and lymphokine-activated killer (LAK) cell activities, and production of both interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha by either peripheral blood mononuclear cells (PBMC) cultured with IL-2 or LAK cells. In group 1 both NK- and LAK-cell-mediated cytotoxicities were significantly suppressed as compared to those in group 3. The titre of IFN produced by LAK cells was also less than that in group 3. On the contrary there were no significant differences in cytokine production by PBMC in all three groups. Percentage of the cases with suppressed cytokine production seemed higher in group 1 than group 3. In addition there was a close correlation between the value of IFN-gamma and of TNF-alpha produced by PBMC in the patients on haemodialysis. Both the type of dialysis membranes used and the primary diseases did not significantly influence the results in group 1 and group 2. From these results it could be speculated that there are more patients with impaired immune function in group 1 than in group 3. In contrast there was no significant difference in the immune function tested between group 2 and group 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Genetics of food preference in Drosophila sechellia. I. Responses to food attractants.

To reveal the genetic mechanism of host selection in a monophagous fruit fly Drosophila sechellia, olfactory responses and oviposition preferences of this species were compared with those of closely related polyphagous species, D. simulans and D. melanogaster. Adult flies of D. sechellia were strongly attracted to the ripe fruit of Morinda citrifolia which is known to be the sole breeding site of this species. They were also attracted to the odor of n-caproic acid which is contained in the ripe fruit of M. citrifolia and is presumably responsible for the characteristic odor of the fruit. In contrast, D. simulans and D. melanogaster showed a strong repulsion to n-caproic acid. In parallel with the olfactory responses, D. sechellia females laid eggs preferentially on a medium containing n-caproic acid, to which the other two species showed an aversion. Genetic analyses using the hybrid progeny between D. sechellia and D. simulans suggested that the species differences in these behaviors are controlled by gene(s) located on the second chromosome.

Animals↗
PubMed1991

[A case report of eosinophilic cystitis complicated with transient vesicoureteral reflux].

A case of eosinophilic cystitis complicated with transient vesicoureteral reflux in an 11-year-old girl with allergic disorders is reported. She was suffering from pollakisuria, painful urination, vesical irritability, and gross hematuria for about 2 months. Urinalysis showed aseptic pyuria. White blood cell count was 9,700/mm3 with eosinophils of 10%. Eosinophils were also found on urine cytology. Intravenous pyelography revealed bilateral hydronephrosis and apparently contracted bladder. Tumorous lesion and edematous mucosa were observed in the retrotrigonal region on cystoscopy. The multiple bladder biopsy uniformly revealed eosinophilic cystitis. Following antiallergic treatment, practically all symptoms subsided in steps, and normal cystoscopic appearance and histological structure were restored in 3 months. The vesicoureteral reflux markedly diminished in 10 months.

Asthma↗
PubMed1990

[Study on adoptive immunotherapy with tumor-infiltrating lymphocytes (TIL) for renal cell carcinoma--amplification of IL-2-elicited TIL proliferation by OKT3-monoclonal antibody].

Human autologous peripheral blood lymphocytes (PBL) and lymphocytes infiltrating renal cell carcinoma (TIL) were cultured with medium containing 1000 IU/ml of human interleukin 2 (IL-2). A high cytotoxic activity against fresh autologous as well as cultured allogenic tumor cells was developed. By culturing these lymphocytes with OKT3 monoclonal antibody during the initial 2 days of long-term culture, in terms of T cell activation signal, IL-2-driven lymphocyte proliferation was remarkably accelerated with maintenance of appreciable level of cytotoxic activity. The same culture method also induced an increase in OKT3 and IL-2 receptor positive lymphocyte population in LAK cells and TIL. This method may enable us to gain more autologous TIL in vitro for adoptive immunotherapy of renal cell carcinoma than the usual culture method with IL-2 alone. Five patients with metastatic renal cell carcinoma were treated with adoptive immunotherapy with TIL, LAK and IL-2. One patient with pulmonary metastasis has had a minor response which has lasted for 3 months so far. We have not experienced any serious side effects during the treatment.

Antibodies, Monoclonal↗
PubMed1990

[Immunological study on chyluria].

Immunological studies were performed in 87 patients with chyluria referred to our clinic from January 1982 to December 1988. White blood cell count in 78 patients was 5210.3 +/- 1440.9/mm3. The fraction and the number of lymphocyte were 18.7 +/- 9.5% and 934.1 +/- 521.6/mm3, respectively: they were lower than normal limit. The percentages of T and B lymphocytes studied in 46 patients were 79.3% +/- 11.2% (normal range: 76-86) and 10.4 +/- 7.9% (normal range: 8-16), respectively: both lymphocytes tended to decrease in percentage. Lymphocyte blast formation stimulated with phytohemagglutinin (PHA) was carried out in 20 patients. The mean of the blast formation was 17410.0 +/- 10275.1 c.p.m. (normal range: 377700-62400), and much lower than normal value. Of 22 patients who had PPD skin test, only 9 (40.9%) were positive. These findings signified that cellular immunity was suppressed in patients with chyluria. On the other hand, the value of immunoglobulin was within normal range (IgG: 1325.3 +/- 475.6 mg/dl, IgA: 242.0 +/- 98.3 mg/dl, IgM 130.4 +/- 95.9 mg/dl). Study on the values of laboratory examinations showed statistically positive correlation between total lymphocyte population and T cell number, and between total lymphocyte population and lymphocyte blast formation. In patients with chyluria, serious sequelae have not been reported. However, care should be taken for possible opportunistic infection and, particularly, malignant tumors because suppression of cellular immunity may be one of the promoting factors of malignant tumors.

Adult↗
PubMed1990

[Early clinical result of modified M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) for advanced transitional cell carcinoma of renal pelvis and ureter].

From March, 1986 through June, 1988, the reduced M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) regimen was used to treat 6 patients with metastatic or locally invasive transitional cell carcinoma of renal pelvis and ureter. Out of 5 evaluable patients with advanced stages (N+ and/or M+) pathological complete remission and partial remission were observed in one patient each and minor remission in two patients inspite of our reduced regimen according to performance status of the patients. Toxicity was rather mild except in one patient who showed severe myelosuppression. This regimen seems to give favorable antitumor activity against transitional cell carcinoma of upper urothelium.

Aged↗
PubMed1989

Immature renal tissue in inguinal canal.

A 3-year-old boy underwent an operation for a right undescended testis. A small, elastic, hard mass attached loosely to the spermatic cord was noted in the inguinal canal away from the testis and epididymis. Pathological examination of this mass revealed mesonephric remnant tissue.

Abdominal Neoplasms↗
PubMed1989

[Clinical studies of ureteroileal junction stricture in ileal conduit].

Fifty eight patients who underwent ileal conduit formation in our hospital for the past 14 years were reviewed. Out of them, 11 patients developed hydronephrosis which should be treated. It occurred due to urolithiasis, recurrent tumor, contracted ileal loop in one patient respectively, and ureteroileal junction stricture in 8 patients (10 ureteral units). The 8 patients consisted of 6 males and 2 females. All of the males underwent total cystectomy because of bladder tumor (T.C.C.), and the females had anterior pelvic exenteration because of uterine cancer (adenocarcinoma). Out of 10 ureteral units, 7 were corrected by surgical intervention, 1 was dilated with endourological procedure, and 2 had no treatment. Six ureteral units including 1 ureteral unit treated by an endourological method resulted in improvement or disappearance of hydronephrosis. Histological examination of the stricture revealed fibrosis in 7 ureteral units treated surgically. According to our clinical studies, infection in the pelvic space seemed to be one of the causes which brought about ureteroileal junction stricture.

Adult↗
PubMed1989

[Regional transarterial infusion of autologous lymphokine-activated killer (LAK) cells for advanced renal cell carcinoma and its preliminary clinical result].

We herein report the preliminary but appreciable results of regional transarterial infusion of 2 gravity subtypes of autologous lymphokine-activated killer (LAK) cells into the metastatic sites in combination with systemic recombinant interleukin-2 (rIL-2) administration in 3 patients with advanced renal cell carcinoma. Leukapheresis was performed once a week and peripheral blood lymphocytes were separated into 2 different subtypes by Percoll gradient centrifugation. These lymphocytes were incubated with rIL-2 for a few days to induce LAK cells. LAK cells were transferred to the metastatic lesions through cannula twice a week. A large iliac bone metastasis disappeared 3 months after the initial LAK cell therapy via a superior gluteal artery. A case of complete disappearance of psoas muscle and para-aortic lymphnode metastasis as well as partial regression of a lumbar bone metastasis was seen after lumbar arterial infusion treatment. Another case with brain metastasis showed a rapid exacerbation of brain edema after one week's LAK therapy. Our treatment modality seems to be worthwhile and promising for treatment of the advanced renal cell carcinoma.

Adult↗
PubMed1988

[Clinical evaluation of total cystectomy for bladder carcinoma: a ten-year experience].

Fifty-three patients with primary bladder carcinoma underwent total cystectomy during the past 10 years. Ages ranged from 32 to 87 years old, with an average of 68.2 years. Radical total cystectomy, including systemic lymphadenectomy was performed in 22 cases, simple total cystectomy in 8 cases and salvage total cystectomy in 23 cases. An ileal conduit was made for urinary diversion in 23 cases and the other 26 cases underwent cutaneous ureterostomy. Postoperative mortality was 9.4% (5 of 53 cases) and postoperative complications were noted in 17 of the 53 cases (32.1%). The 5-year cumulative survival rate by the life table method for all the cases was 42.6%. The 5-year cumulative survival rate of radical total cystectomy cases was 67.8%, that of simple total cystectomy cases was 50.0% and that of salvage total cystectomy cases was 7.5%. A significant difference was seen between the first 2 groups and the last group. The 5-year cumulative survival rate of the patients with low stage cancer (pTis, pTa, pT1 and pT2) was 56.1% and that of the patients with high stage cancer (pT3, pT4) was 22.7%. A significant difference was observed between the two groups. The 5-year cumulative survival rate of the patients with grades G1, G2 and G3 cancer was 66.7, 45.4 and 26.7% respectively. A significant difference was seen among the three grades.

Adult↗
PubMed1987

The role of preoperative intra-arterial doxorubicin chemotherapy in combination with low-dose irradiation for bladder cancer.

Twenty patients with bladder cancer (T1, 3 patients; T2, 6 patients; T3, 8 patients; T4a, 3 patients) were preoperatively treated with intra-arterial doxorubicin chemotherapy in combination with low-dose irradiation. The originally scheduled operations were as follows: total cystectomy in 16 patients (T1 + cis, 1 patients; T2, 5 patients; T3, 7 patients; T4a, 3 patients), segmental cystectomy in 2 patients, and transurethral resection in 2 patients. The total dose of doxorubicin ranged from 120 to 540 mg (251.5 +/- 100.2 mg), and that of irradiation was from 4 to 36 Gy (24.4 +/- 7.3 Gy). Clinical and pathological effects were evaluated in all of the cases. Clinically, complete remission (CR) was observed in 14 cases (70.0%), partial remission (PR) was seen in 3 cases, a minor response (MR) occurred in 2 cases, and no response (NR) was seen in 1 patient; non patient showed progressive disease (PD). The pathological effects (according to the criteria of Shimosato et al.) were as follows: grade IV was seen in 10 cases, grade III in 3 cases, and less than grade II in 7 cases; however, viable tumor cell were not seen in 13 (65.0%) of the 20 cases. The bladder was preserved in 13 (81.3%) of the 16 cases for which total cystectomy had been recommended. All of the patients were followed up for periods ranging from 3 to 54 months (26.3 +/- 16.5 months), during which time 6 patients (30.0%) died (3 with cancer, 1 without cancer, and 2 unknown causes). The actual survival rate according to the stage of disease was 100.0% at 50 months in T1-T2 and 40.9% at 54 months in T3-T4a. In T3-T4a, the actual survival rate in pathologically complete responders was 60% (relative rate 68.8%) at 54 months, and the actual survival rate in incomplete responders was 25.0% (relative rate 27.1%) at 36 months. The results of our study are encouraging, especially in T1-T2 and T3-T4a cases, who showed a complete response. It is concluded that doxorubicin intra-arterial chemotherapy combined with low-dose irradiation could be the first treatment of choice for locally invasive bladder cancer.

Aged↗