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Biomedical subjects

K Kihara

Publications and source records attributed to K Kihara.

At least 145 records · Page 8Linked to original sources
PubMed1991

Effect of hemodialysis on the concentration of the seven tumor markers carcinoembryonic antigen, alpha-fetoprotein, squamous cell carcinoma-related antigen, neuron-specific enolase, CA 125, CA 19-9 and CA 15-3 in uremic patients.

The incidence of the 7 tumor markers carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), squamous cell carcinoma-related antigen (SCC), neuron-specific enolase (NSE), CA 125, CA 19-9 and CA 15-3 was studied before and after hemodialysis (HD) in 144 uremic patients who had no malignancies. Before HD, of all tumor markers, the mean concentration of SCC only exceeded the normal value. The positive rate was highest in SCC (95.1%), and that of CEA and NSE was 25.7 and 10.6%, respectively. However, AFP was within the normal range in all cases. Among CA antigens, the positive rate of CA 125 was 7.6%, of CA 19-9 was 6.3% and of CA 15-3 was 3.5%. After HD, the incidence as well as the mean concentration of all tumor markers increased. A parallel increment of total protein was observed after HD. The membrane filter used in HD appears to be insufficient to remove tumor marker proteins during HD. It is necessary to consider the clinical interpretation of elevated tumor markers in patients with uremia.

Antigens, Neoplasm↗
PubMed1991

Clinicopathological study of upper urinary tract tumors associated with bladder tumors.

Among 535 cases of urothelial tumors (upper urinary tract and bladder tumors) from 1970 to 1988, 40 had upper urinary tract tumor associated with bladder tumor. Of 40 cases, 18 (45%) were synchronous, 17 (43%) were metachronous with primary upper urinary tract tumor followed by subsequent bladder tumor 18.5 +/- 14.1 (means +/- SD) months later and 5 (12%) were metachronous with primary bladder tumor followed by subsequent upper urinary tract tumor 40.2 +/- 13.6 months later. The incidence (17/52 = 0.32) of bladder tumor occurrence subsequent to primary upper urinary tract tumor was much higher than that (5/465 = 0.01) of upper urinary tract tumor subsequent to primary bladder tumor. The histologic grades of upper urinary tract tumor and associated bladder tumor were consistent in 73%. Except in 1 case, multiple occurrence of upper urinary tract tumor was always observed unilaterally on the side involved. The current results not only support the theory of multicentricity but raise the possibility that tumor cell implantation may play some role at least in the development of bladder tumor subsequent to upper urinary tract tumor.

Carcinoma, Transitional Cell↗
PubMed1991

[Protective effect of urinastatin on ischemic renal injury in rabbits].

Protective effect of urinastatin on ischemic renal injury in rabbits was investigated by urinary enzymes and renal function tests. Ten rabbits were divided into two groups: the control group and urinastatin group administered 50,000 units/kg of urinastatin. The ischemic renal injury model was made by occluding the left renal artery for 60 minutes. Urinary excretions of N-acetyl-beta-D-glucosaminidase (NAG) and gamma-glutamyl transpeptidase (gamma-GTP) (U-NAG and U-gamma-GTP), creatinine clearance (Ccr), free water clearance (CH2O), fractional excretion of sodium (FENa) and urine volume (UV) were measured before occlusion of the left renal artery and after reflow. There were no significant differences in the values before occlusion (baseline values) for U-NAG, U-gamma-GTP, Ccr, CH2O, FENa, and UV between the two groups. U-NAG after reflow was increased in the two groups compared with baseline values, and the increase was significantly lower in the urinastatin group than control group. U-gamma-GTP after reflow was also increased in the two groups compared with baseline values, but the change was not significant between the two groups. Ccr and CH2O after reflow were significantly decreased, and FENa and UV were increased in the two groups compared with baseline values. However, no significant differences were observed between the two groups in these four parameters. These results suggest that urinastatin is effective for the protection of the kidney against ischemic damage, especially of the renal tubular cells.

Acetylglucosaminidase↗
PubMed1991

[BEP (bleomycin, etoposide, cisplatinum) chemotherapy as an induction therapy of advanced extragonadal germ cell tumor].

Five patients with advanced extragonadal germ cell tumor (EGGCT) were treated with cisplatinum + vinblastine + bleomycin (BVP) or cisplatinum + etoposide + bleomycin (BEP) chemotherapy as an induction therapy. All patients had high levels of tumor markers and multiple distant metastasis in poor nutritious conditions. Two patients given BVP therapy died 6 and 9 months after the chemotherapy. By contrast, three patients given BEP therapy achieved complete remission and were surviving longer than one year without any evidences of disease. Granulocytopenic fever was seen soon after the first course of BEP therapy. Prophylactic granulocyte-colony stimulating factor (G-CSF) treatment, enabled two of them to receive full dose chemotherapy without any fever attacks. In conclusion, BEP chemotherapy is effective to EGGCT as well as far advanced testicular tumors and G-CSF treatment is useful for achievement of induction chemotherapy to advanced germ cell tumors.

Adult↗
PubMed1991

[Clinical study of intramuscular imipenem/cilastatin sodium in the field of obstetrics and gynecology].

We evaluated the clinical efficacy and safety of intramuscular (as a new route of administration) imipenem/cilastatin sodium (IPM/CS) in patients with intrauterine infections which are typical in the field of obstetrics and gynecology. The obtained results are summarized as follows. 1. Twenty-seven patients were treated with IPM/CS, 250 mg/250 mg b.i.d. (3 patients), 500 mg/500 mg b.i.d. (22) and other dosages (a change in dosing regimen, 2). The duration of treatment ranged from 3 to 11 days and the total dosage during an entire course of treatment varied from 1.5 to 9.0 g. The drug was suspended in a lidocaine solution and administered in the gluteal muscle of the patients. 2. Clinical efficacies were excellent in 7 patients (26%), good in 19 (70%) and poor in 1 (4%) and the overall efficacy rate was 96.3%. All of the 8 patients who had not previously showed improvements with treatment by other antibiotics responded well to this drug. 3. Bacteriologically, the clinical efficacy rate was 95.8% (23/24) and the eradication rate was 76.2% (16/21). 4. No adverse effects due to the drug were observed. As abnormal laboratory test results, transient elevations of GOT and GPT were noted in one patient.

Adult↗
PubMed1991

[Clinical study of RU 23908 (nilutamide) in prostatic cancer].

To investigate the efficacy and the safety of RU23908 for the treatment of prostatic cancer, an early phase 2 study with the oral administration of 150 or 300 mg daily was performed in 47 patients with stage C or D prostatic cancer at 15 institutions from April 1987 to June 1988. Forty patients were evaluable for efficacy. Concerning the effect on the object lesion, the results of the overall evaluation revealed that complete or partial response (CR + PR) was obtained in 34 of the 40 cases (85.0%). As to the effect classified by site, CR + PR were observed in 35 out of the 40 cases with primary lesion (87.5%), in 10 of the 22 cases with bone metastasis (45.5%), in 5 of the 6 cases with lymph node metastasis (83.3%) and CR was observed in one case with lung metastasis. In the PAP evaluation, 33 out of the 34 cases were judged to be CR + PR (97.1%). The improvement rate of clinical symptoms was 88.9% for bone pain, 83.3% for dysuria and 45.5% for performance status. Adverse reactions were observed in 29 of the 47 cases (61.7%) investigated and 7 cases (14.9%) were withdrawn. During the study period of 12 weeks and the subsequent period of continued administration, 6 cases (12.8%) and 2 possible cases of interstitial pneumonia were diagnosed. From the above results, the treatment of prostatic cancer with RU23908 150 mg/day or 300 mg/day in combination with surgical castration showed an excellent clinical effect compared to conventional endocrine therapy, but has a problem of safety. Therefore, this drug may be expected to be a highly useful therapeutic drug, if safely is improved in the future by reviewing the dose.

Administration, Oral↗
PubMed1991

[Treatment methods as a prognostic factor in eight patients with urachal carcinoma].

Between 1960 and 1982, 8 patients with urachal carcinoma underwent segmental resection of the bladder or en bloc resection, and their five-year survival rate was 50%. One patient each with well, moderate and poorly differentiated adenocarcinoma and one patient with transitional cell carcinoma, died of cancer from 6 months to 2 years and 2 months after operation (mean duration: 1 year and 3 months). The patient with well differentiated adenocarcinoma underwent en bloc resection and was recognized to have peritoneal involvement of the tumor at the operation. The remaining three patients were diagnosed to have tumors confined to their bladder and urachal remnant and were treated with segmental resection of the bladder. Two patients each, with well and moderately differentiated carcinoma confined to their bladder and urachal remnant, were treated with en bloc resection and have been surviving from 8 years and 5 months to 24 years and 10 months (mean duration: 13 years and 7 months) postoperatively as of Dec. 1987. Therefore, patients with well and moderately differentiated adenocarcinomas confined to the bladder and the urachal remnant could be expected to survive longer by en bloc resection.

Adenocarcinoma↗
PubMed1991

[Two cases of urachal cyst].

Case 1: A lower abdominal large painful mass was recognized by palpation, CT scan and ultrasonography in a 64-year-old house wife. Urine cytology was negative. The mass at the dome of bladder was covered with normal epithelium cystoscopically. Aspiration cytology of the lower abdominal mass demonstrated no malignancy and total excision of urachal remnant with a portion of bladder wall was carried out. Histologically, the mass was an urachal cyst with granulomatous change infected with C group beta-streptococcus. Case 2: A 46 year-old male engineer complained of asymptomatic hematuria. Cystoscopic examination revealed a small bleeding lesion at the dome of bladder. Urine cytology was negative. CT scan and ultrasonography revealed a tiny cystic mass lesion with irregular density. Biopsy or aspiration cytology appeared difficult because of the size and localization of the mass. En bloc segmental resection of urachal remnant was carried out. Since intraoperative rapid histological examination of the specimen confirmed no malignancies, dissection of pelvic lymph node was not performed. Urachal cysts presented above were suspicious of malignant degeneration from findings of imaging examination. Either preoperative or intraoperative histological examination in such cases appears to be indispensable to avoid unnecessary extensive operation as well as to perform radical operation required for malignant lesions.

Cytodiagnosis↗
PubMed1990

Decreased coronary vasodilatory capacity in hypertrophic cardiomyopathy determined by split-dose thallium-dipyridamole myocardial scintigraphy.

Split-dose thallium-dipyridamole myocardial scintigraphy was performed in patients with nonobstructive hypertrophic cardiomyopathy (HC) who had angiographically normal coronary arteries. The dipyridamole-induced increases in thallium-201 uptake, calculated to evaluate coronary vasodilatory capacity, were significantly lower in 30 patients with HC than in 13 control subjects (177 +/- 58 vs 281 +/- 46%) and the reductions were observed in both the septal and lateral segments. The reductions of the septal segment in HC patients were significantly greater than those in 10 hypertensive patients with comparable degrees of septal hypertrophy. Of patients with HC, 16 had increases in thallium uptake well below the normal range. Compared with those having normal increases, these patients had significantly lower exercise duration (11 vs 15 minutes), with 33% having ST depression develop at a workload less than or equal to 80 watts. These data indicate that approximately one-half of patients with HC have impaired coronary vasodilatory capacity that could be an important pathophysiologic abnormality of HC resulting in the development of myocardial ischemia and the impairment of cardiac performance during exercise.

Adolescent↗
PubMed1990

Inhibitory effect of testosterone on gap junctional intercellular communication of human transitional cell carcinoma cell lines.

A dye transfer method was applied to investigate the effect of testosterone on gap junctional intercellular communication (IC) of two kinds of human transitional cell carcinoma cell lines, JTC-30 and JTC-32. When JTC-30 cells were cultured with testosterone at nontoxic concentrations (17-69 microM), a dose and time dependent inhibition of dye transfer was observed. More than 90% inhibition occurred after exposure to 69 microM testosterone for 96 h. The inhibition was reversed rapidly after testosterone deprivation. Similar results were obtained with JTC-32 cells. 17 beta-Estradiol showed no inhibitory effect on IC of both transitional cell carcinoma cell lines even at toxic levels. Testosterone exhibited no inhibitory effect on IC of human fibroblasts. The inhibitory effect of 5 alpha-dihydrotestosterone was almost similar to that of testosterone. At concentrations examined, cyproterone acetate influenced neither dye transfer nor the inhibitory effect of testosterone, suggesting a mechanism of testosterone action different from that of the known receptor system. Since blockage of IC has been indicated as one reliable evidence for tumor promotion, current results suggest that testosterone is a possible endogenous promoter of the bladder carcinoma and may therefore possibly play a role on the sexually different incidence of bladder carcinoma.

Carcinoma, Transitional Cell↗
PubMed1990

[Relation of tumor number to clinical course of superficial papillary bladder tumors].

Clinical courses of 293 patients with superficial papillary bladder tumors were analysed on the basis of tumor number at the first presentation. The follow-up period ranged from 6 to 266 months with a median of 59 months. 171 patients (58%) had a single tumor, while 122 (42%) had multiple tumors. Those older than 60 years occupied 68% in the latter group and 51% in the former (p less than 0.01). High grade tumors were more frequent in the latter than the former (p less than 0.05). The five-year recurrence rate was 68% for the latter and 39% for the former single tumor group (p less than 0.01). Malignant progression was observed in 3.6% of patients with a single tumor and 13.4% of those with multiple tumors (p less than 0.01). The results would offer a theoretical background to the finding of a poor ten-year actuarial survival rate of 54% for multiple tumor group compared with 76% for the single tumor group (p less than 0.05). However, the rate of primary cancer death was similar in both groups.

Adult↗
PubMed1990

[A study of cytokeratin in human normal bladder epithelium and bladder carcinoma cell lines].

Normal epithelial and carcinoma cells of human bladder were investigated for the cytokeratin which is one of the intermediate filaments and comprises cytoskeleton using the immunofluorescence method. Carcinoma cell lines used were JTC-30, JTC-32, HUB-41 and T-24. In normal urothelium, keratin fibers were fine and straight with unchanged diameter and distributed regularly in the cytoplasm. By contrast, keratin fibers in bladder carcinoma cells were kinked and changed in diameter and were distributed irregularly in the cytoplasm. The above findings were most obvious in T-24 which formed undifferentiated carcinoma when transplanted to nude mice, and keratin fibers were dominantly located in the perinuclear area. The changes of keratin fibers appeared to be parallel to the grade of histological anaplasia of the tumor formed by implantation of bladder carcinoma cell line cells to nude mice. These observations suggest that the morphology of cytokeratin is a useful indicator for evaluating the grade of malignancy in transitional cell carcinoma.

Animals↗
PubMed1990

[Exercise capacity in coronary artery disease evaluated by continuous wave Doppler flowmetry].

In this study the effects of exercise on peak aortic flow velocity (PFV), and the relationship between the maximum change in PFV and the extent of ischemia or infarction were examined. In 16 normal controls (NC) and 83 patients (pts) with documented coronary artery disease, continuous wave Doppler echocardiography and thallium-201 scintigraphy were performed simultaneously during supine bicycle exercise. The patients were grouped according to their results of thallium perfusion imaging: Group (G) 1 (10 pts) = normal; G-2 (30 pts) = ischemia without old infarction, G-3 (23 pts) = old infarction without angina, and G-4 (20 pts) = angina with old infarction. Three different PFV responses to exercise were observed. In NC, PFV increased progressively with exercise. In 28 pts (G-1 = 10, G-2 = 2, G-3 = 11, G-4 = 5), PFV increased as in NC (Type I). In 43 pts (G-2 = 24, G-3 = 9, G-4 = 10), PFV increased at the initial stage but was unchanged or decreased at the final stage (Type II). In 12 pts (G-2 = 4, G-3 = 3, G-4 = 5), PFV decreased progressively with exercise (Type III). The incidence of acute ischemia was 25% (7/28) in Type I, 79% (34/43) in Type II and 75% (9/12) in Type III. Furthermore, Doppler and scintigraphic studies were repeated during exercise in 16 pts (Type II = 14, Type III = 2) who underwent percutaneous transluminal coronary angioplasty (PTCA). After PTCA, in 11 of the 16 pts, the images of acute ischemia nearly resolved and profile of the PFV changed from Type II or III to Type I. In the remaining five patients, the results of both studies were unchanged. Finally, the maximum change of PFV showed good correlation with the extent of ischemia and/or prior infarction (in G-2, r = -0.50, p less than 0.01; in G-3 except for 11 pts of Type I, r = -0.76, p less than 0.01; in G-4, r = -0.80, p less than 0.001). The extents of ischemia and infarction in each group were considered to be far greater in Type III than those in the other Types. These results show that changing of PFV during exercise are related with the presence and extent of acute ischemia and/or infarction.

Adult↗
PubMed1990

[Alpha 2-plasmin inhibitor plasmin complex in patients undergone surgery in femoral neck fracture].

The alpha 2-plasmin inhibitor-plasmin complex (alpha 2-PI-PM), alpha 2-plasmin inhibitor (alpha 2-PI) and some functions of coagulation and hemostasis were assayed on aged patients who were operated for femoral neck fracture. After the surgery, APTT, PT, fibrinogen, AT-III and platelet counts were in normal range or slightly deviated, which did not match with the DIC diagnostic standard. FDP levels in the operation group (337 +/- 303 ng/ml) were significantly increased compared to the level of the normal aged persons (64 +/- 9.9 ng/ml). The alpha 2-PI-PM in the operation group was 2.92 +/- 3.56 micrograms/ml, which was significantly higher than the alpha 2-PI-PM level (0.76 +/- 0.45 micrograms/ml) in the normal aged persons. Moreover, 3 in 7 operation cases, showed the increase of alpha 2-PI-PM levels over 5 micrograms/ml. The alpha 2-PI-PM in DIC group was 5.29 +/- 5.17 micrograms/ml. These data suggest that the patients are in the pre DIC state after surgery. In titers of FDP and alpha 2-PI, there were no differences between patients treated with and without heparin. alpha 2-PI-PM levels were improved in 5 out of 7 cases with the heparin treatment. On the other hand only one in 6 cases who did not receive heparin therapy showed the improvement of alpha 2-PI-PM level. In some cases without heparin treatment, the alpha 2-PI-PM level increased in the course of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Therapeutic effects of oral dipyridamole on myocardial perfusion and left ventricular function in patients with hypertrophic cardiomyopathy].

As myocardial ischemia possibly due to small vessel coronary disease has been reported in hypertrophic cardiomyopathy (HCM), we investigated therapeutic efficacy of oral dipyridamole (DP) in 20 patients. DP of 150 mg/day for 2 weeks significantly increased septal washout rate (39 +/- 14 to 45 +/- 11%) in exercise Tl-201 myocardial imaging, improving reversible defects in 6 patients. The result further supported that small vessel coronary disease could induce myocardial ischemia in HCM. In RI angiography. DP increased ejection fraction (50 +/- 9 to 53 +/- 7%) and peak filling rate (1.9 +/- 0.6 to 2.0 +/- 0.5 sec-1) at rest. DP also improved subjective symptoms, cardiac size and atrial premature beats in Holter monitoring. In exercise test, maximal work load was increased from 7.6 +/- 2.0 to 8.3 +/- 1.4 METS. These observations indicate that oral DP is an useful drug for treatment of HCM, in improving subjective symptoms, left ventricular function, exercise tolerance and arrhythmias, possibly due to beneficial effects on myocardial perfusion and afterload reduction.

Administration, Oral↗