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Biomedical subjects

K Kihara

Publications and source records attributed to K Kihara.

At least 163 records · Page 9Linked to original sources
PubMed1989

Fatty acid myocardial imaging using 123I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP): comparison of myocardial perfusion and fatty acid utilization in canine myocardial infarction (occlusion and reperfusion model).

To evaluate the relationship between myocardial perfusion and fatty acid metabolism in canine myocardial infarction, 16 dogs were studied using thallium and 123I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP). Eight dogs (group A) had left anterior coronary arterial occlusion (6 h ligation), 6 dogs (group B) had reperfusion (3 h ligation and 1 h reperfusion) and 2 dogs served as the normal control. Myocardial imaging with BMIPP was excellent, owing to its higher uptake and longer retention in myocardium and rapid blood disappearance in addition to diminished liver and lung uptake. The mean half time value which was generated from the BMIPP myocardial washout curve, was significantly larger in the reperfused myocardium. The gamma camera imaging showed uncoupling of BMIPP and thallium (BMIPP uptake greater than thallium uptake) in five dogs in group B. On the other hand, all dogs in group A had a persistent defect in BMIPP and thallium uptake. Our findings indicate that the combination of BMIPP and thallium for myocardial imaging supply different information about the zone of infarction and ischemia, which may be useful for the assessment of myocardial viability.

Animals↗
PubMed1989

Intravesical combination chemotherapy with mitomycin C and doxorubicin for carcinoma in situ of the bladder.

We treated 30 patients with carcinoma in situ of the bladder via intravesical combination chemotherapy. As an induction therapy 20 mg. mitomycin C on day 1 and 40 mg. doxorubicin on day 2 were instilled into the bladder once a week for 5 consecutive weeks. Patients who achieved complete response were assigned a maintenance instillation of mitomycin C alone every 2 to 4 weeks for 1 year. A total of 19 patients achieved complete response following an initial course of induction therapy and 2 partial responders to initial therapy also achieved complete response after repeated induction therapy, resulting in a 70 per cent over-all complete response rate. Toxicity was considerable with moderate to severe bladder irritation occurring in 20 patients but it was tolerable in the majority. Of 21 complete responses 13 remained free of disease for 6 to 43 months (average of 23 months), 5 had recurrent carcinoma in situ and 1 had invasive urethral cancer. In contrast, of 9 nonresponders 2 and 1 had invasive cancer of the bladder and ureter, respectively.

Administration, Intravesical↗
PubMed1989

Sudden death in hypertrophic and dilated cardiomyopathy.

The long-term prognosis for 314 patients with hypertrophic cardiomyopathy (HCM) and 82 with dilated cardiomyopathy (DCM) was investigated in an attempt to elucidate clinical variables predicting sudden death (SD). In the patients with HCM, 68% of cardiac deaths occurred suddenly and unexpectedly. Variables associated with an increased risk to SD were young age (less than 30 years), reduced fractional shortening (less than 35%) and elevated left ventricular end-diastolic pressure (greater than or equal to 20 mmHg). Eight of the 10 patients who died suddenly during or immediately after strenuous exercise were less than 30 years old, and the collapse tended to be associated with exercise-induced ST-depression. In contrast, SD occurring during mild activities, resting or sleep was mainly observed in those aged 30 years or more. Ventricular tachycardia was observed on electrocardiographic monitoring in 24% of those 30 years or more, while it was rare in those under 30 years (5%). On the other hand, no SD was found in patients with apical hypertrophy nor in those 50 years or more. These observations suggest that HCM patients at a young age, with impaired left ventricular systolic and diastolic function, have an increased risk to SD. Since exercise-induced myocardial ischemia rather than ventricular arrhythmias appears to be the more likely mechanism for SD for those under 30 years old, restriction of strenuous exercise should be strongly advised for these patients. For those aged from 30 to 50 years, ventricular tachycardia should be controlled by antiarrhythmic agents for the prevention of SD. In patients with DCM, 24% of all cardiac deaths were attributed to SD. Although no variables reliably predicted SD, it was of note that only one patient out of 26 with SV1 + RV5 greater than or equal to 35 mm died suddenly. Whereas ventricular arrhythmias are known to be a contributing cause for SD, the prognostic significance of ventricular tachycardia on electrocardiographic monitoring in predicting SD has not yet been established. In addition, antiarrhythmic agents often precipitate hemodynamic deterioration. It therefore appears that use of antiarrhythmic agents is not a therapy of first choice and that primary treatment should be focused upon improvement in ventricular function in order to prevent SD in patients with DCM.

Adult↗
PubMed1989

[Translumbar radical nephrectomy of renal cell carcinoma].

We invented a new surgical approach to the kidney through the flank to perform a radical nephrectomy for renal cell carcinoma. With the patient in usual lateral decubitus position keeping the dorsum vertical to the operating table, a skin incision is made over the XII rib from the posterior axillary line to the lateral edge of the rectus muscle. After the tip of XII rib is resected by about 5 cm, the retroperitoneal space is entered. Blunt dissection of the posterior aspect of Gerota's fascia from fasciae of the quadratus lumborum and psoas muscle is easily carried out with a liver retractor or intestinal spatula. The pulsating renal artery can be identified through Gerota's fascia when the renal hilus is exposed. Following ligation and division of the artery, renal vein is exposed. On the left side, adrenal, gonadal and occasionally lumbar veins are also ligated and severed in addition to the renal vein. Then, the kidney in Gerota's fascia is removed en bloc with perinephric adipose tissue and adrenal gland. Of 21 patients with renal cell carcinoma seen during 1 year and 3 months from June 1987, 11 underwent this operation, and other 10 patients transperitoneal radical nephrectomy because of the possible tumor extension into the renal vein, inferior vena cava or adjacent organ, the severe spinal deformity or metastases and the necessity of additional surgical procedures for concomitant benign intraperitoneal diseases. The blood loss was smaller and operating time was shorter significantly in the translumbar group than the evaluable transperitoneal group. None of those in the translumbar group received blood transfusion. As complications, pneumothorax due to pleural injury during operation and postoperative incisional hernia occurred each in one patient, but no other serious one was found. From the above results, this approach seems to be one of choices for the surgical treatment of renal cell carcinoma, as long as the tumor is not likely to extend to adjacent organs, ipsilateral nodes or the inferior vena cava.

Adult↗
PubMed1989

[A study of intercellular communication of human transitional cell carcinoma cell lines].

Intercellular communication (IC) was investigated by a dye transfer method in 5 human bladder carcinoma cell lines, JTC-29, JTC-30, JTC-32, HUB-41 and T-24 which showed various histological anaplasia when transplanted into nude mice. IC was investigated as follows; 1) IC among cells of each bladder carcinoma cell lines, 2) IC between various combination of different cell lines and 3) IC between cells of bladder carcinoma cell lines and fibroblasts prepared from the human skin or prostate. High IC was observed among JTC-30 cells which showed a differentiated pattern when transplanted into nude mice. JTC-32 and HUB-41, of which transplanted tumors showed poorly differentiated patterns, demonstrated lower IC than JTC-30. Statistical significance was present only between JTC-30 and JTC-32 cells (p less than 0.05). T-24 which formed histologically anaplastic tumor in nude mice demonstrated markedly poor IC. Second, IC between two different cell lines was demonstrated only between JTC-30 and JTC-32. Third, fibroblast from the skin and prostate had high IC but showed apparent IC with none of bladder carcinoma cell lines. These findings indicate that ICs of bladder tumor cells vary with cell lines tested and appear to decrease with progress of malignant anaplasia. Furthermore, the fact that there is sometimes high IC and sometimes lack of IC between differentiated and undifferentiated tumor cells suggests a possible role of IC in prevention of malignant progression. The present study provides no evidence of IC between bladder tumor cells and fibroblasts, which in some reports have been suggested to be an important phenomenon in evaluating the metastatic capacity of cancer cells.

Animals↗
PubMed1989

Changes in release of N-acetyl-beta-D-glucosaminidase, gamma-glutamyl transpeptidase and leucine aminopeptidase from renal tubular cells under anaerobic conditions.

Although the urinary excretion of NAG and gamma-GTP has been employed as an index of renal injury, the mechanism of release of these enzymes remains unclear. In the case of renal ischemic injury, we recently reported that u-NAG and u-gamma-GTP were not correlated well with the degree of renal damage especially in the late phase of ischemic injury [1]. In order to elucidate the relationship between release of these enzymes and renal ischemic injury, we devised an in vitro model of anoxic injuries to renal tubular cells and measured the time-course release of NAG (a lysosomal enzyme), gamma-GTP and LAP (brush border enzymes) at 37 degrees C under five different aerobic and anaerobic conditions (95% O2, 20% O2, 10% O2, 3% O2 and 0% O2). The ATP and lactate levels in the system were also measured to estimate the metabolic state of the tubular cells. In the 3% O2, 10% O2 and 20% O2 groups, NAG, gamma-GTP and LAP were released into the media at a similar rate to that in the 95% O2 group, and anaerobic damage to the renal tubular cells was not observed. In the 0% O2 group, the NAG in the medium increased from 60 to 180 min at a significantly higher rate than that of the 95% O2 group, and a linear relationship was observed between NAG concentration and incubation time (r = 0.73), although NAG did not increase significantly at 30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗
PubMed1989

[Intrarenal energy metabolism in ischemic renal injury in rabbits].

In order to clarify the cause of the decrease in the urinary excretion of NAG (U-NAG) in severe ischemic renal injury in rabbits, we studied intrarenal energy metabolism in ischemic renal injury. After 5 min of ischemia, energy charge and ATP significantly decreased by 50% and 29% respectively. These parameters, however, did not significantly show the change in more than 5 min of renal ischemia. Energy charge and ATP did not reflect the degree of renal injury produced by ischemia, while it was indicated that the longer the period of ischemia until 120 min of ischemia, the less the rate of intrarenal ATP resynthesis at 30 min after reflow. Intrarenal lactate content increased significantly from the 5 min ischemia group to the 180 min. These results suggest that no improvement in intrarenal energy metabolism with increasing duration of renal ischemia is showed and ischemic renal injury develops progressively. It is probable that the decrease in U-NAG in severe ischemic renal injury is due to the inability of the kidney to wash out NAG into the urine, although NAG may be released from the injured tubular cells in proportion to ischemic renal injury. Therefore, in spite of severe ischemic renal injury, U-NAG may show low values, and may lead to misjudgement that the proximal tubular cells are intact. U-NAG should be measured repeatedly and estimated in association with the other renal function tests, especially creatinine clearance, for the correct evaluation of ischemic renal injury.

Acetylglucosaminidase↗
PubMed1989

[Evaluation of intercellular communication of human prostatic epithelium].

Intercellular communication (IC) among epithelial and/or interstitial cells of human prostate was evaluated. IC was measured by the dye transfer method. In brief, fluorescent lucifer yellow CH was microinjected into an individual cell and communication was measured by scoring the number of surrounding fluorescent cells. Cells used here were outgrowth cells from small tips of tissues of various prostatic diseases and established prostatic carcinoma cell line PC-3. To identify the epithelial cells, keratin staining was done. In prostatitis and benign prostatic hyperplasia, epithelial cells grew in five of six cases cultured and extent of maximum IC was from 18 to 46 cells (mean = 26 cells) at 4 to 6 culture days. Three specimens of separate cases cultured for more than one month had a maximum IC of more than 100 cells. In prostatic carcinoma, epithelial cells grew in 7 of 10 cases cultured and extent of maximum IC was from 6 to 38 cells (mean = 18 cells) at 3 to 6 days. The extent of IC among prostatic carcinoma cells was lower than that of benign prostatic diseases, though not significantly, this indicates the possibility that benign cells were present among the malignant cells in the specimens examined above. Prostatic carcinoma cells cultured from metastatic lesions of bone (PC-3) and lymph nodes had maximum IC of 3 to 5 cells. IC was very limited or absent between benign prostatic epithelium and PC-3 cells. No IC was present between prostatic epithelial and interstitial cells. Interstitial cells prepared from prostatic benign and malignant diseases similarly revealed a high extent of IC.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Communication↗
PubMed1989

[Intravesical bacillus Calmette-Guerin instillation therapy of recurrent superficial bladder carcinomas resistant to intravesical anti-cancer chemotherapy].

Tokyo strain bacillus Calmette-Guerin (BCG) was instilled in a dose of 80 mg in 40 ml normal saline to the bladder of 8 patients with recurrent superficial bladder carcinoma (Ta, Tl, Tis) resistant to mitomycin C and/or adriamycin intravesical instillation chemotherapy. Instillation was performed weekly for 6 weeks and 3 to 4 weeks after the last instillation, the response was assessed by cystoscopy and urine cytology. Patients who achieved complete response underwent monthly maintenance instillation for a year and inspection with cystoscopy and urine cytology every 3 months. Of the 7 patients who underwent therapeutic instillation, 3 (43%) achieved complete response, and 2 partial response. Two patients with no response had carcinoma in situ of grade 3 anaplasia. Two of the 3 complete responders were free of disease for 11 and 12 months, but another 1 developed intravesical recurrence 13 months later. One patient underwent prophylactic instillation and remained free of disease for 23 months. Side effects included frequency, urgency and pain on urination which were tolerable with anti-analgesics. Two patients underwent total cystectomy because of tumor progression and had typical lesions of prostatic tuberculosis.

Administration, Intravesical↗
PubMed1989

[Combination chemotherapy with ifosfamide, 5-fluorouracil, cisplatin for stage D2 prostatic cancer].

Twelve patients with stage D2 adenocarcinoma of the prostate were treated with the combination chemotherapy of ifosfamide (2 g/body, i.v., day 1-3), 5-fluorouracil (250 mg/body, i.v., day 1-5) and cisplatin (20-30 mg/body, i.v., day 1-5). The averaged age was 62 years (from 52 to 73 years) with mean performance status of 70% (from 40 to 90%). Six patients were refractory to prior hormone therapy or chemotherapy and the other six had received no prior treatment for prostatic cancer. Based on criteria of National Prostatic Cancer Project, 4 patients achieved partial response (PR) which was maintained from 11 to 23 months with the mean of 17.8 months. Two patients achieved objectively stable stage (NC). Response rate (PR + NC) was 50%. Response rate of patients without prior therapy was 80%, whereas that of hormone-resistant group was 30%. There was a trend toward unfavorable response in patients with prior therapy. Adverse effects were mild to moderate gastric problems and myelosuppression except in one case Adverse effects were mild to moderate gastric problems and myelosuppression except in one case with low performance status under 60%. IFP combination chemotherapy achieved favorable responses and toxicities were tolerable. Therefore, it appears worth while to study whether IFP combination chemotherapy could extend the life of patients with advanced prostatic cancer.

Adenocarcinoma↗
PubMed1989

[A case of spermatocytic seminoma].

In April, 1987, we treated a 33-year-old male patient who presented a painless swelling of the right scrotal content of 6 months duration. After surgery, the resected testis weighed 130 g, and the cut surface showed an edematous, white-yellow, homogenous tumor. A histopathological examination revealed a typical spermatocytic seminoma composed of three types of tumor cells. The small cells had pyknotic nuclei and an eosinophilic cytoplasm while the medium-sized cells and most of the giant cells had nuclei containing granular chromatins. Some of giant cells contained a filamentous, chromatin-like spireme of primary spermatocytes. A chest X-ray, CT scanning and lymphography revealed no metastatic lesions, and the patient is still alive with no evidence of disease 10 months after the orchiectomy.

Adult↗
PubMed1988

Bile acid binding and hypocholesterolemic activity of a new anion exchange resin from 2-methylimidazol and epichlorohydrin.

A new anion exchange resin with an imidazolium salt on a epoxide polymer skeleton was synthesized. This white powder material was odorless and tasteless. The in vitro sodium cholate binding of this resin was much more potent than that of cholestyramine. The hypocholesterolemic activity of this resin in cholesterol-fed rabbits proved to be 4.3 times more potent than that of cholestyramine. These results suggest that effective reduction of plasma cholesterol may be achieved with lower doses of this resin.

Animals↗