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Biomedical subjects

K Miyake

Publications and source records attributed to K Miyake.

At least 199 records · Page 11Linked to original sources
PubMed1996

Endoscopic trigonoplasty in pediatric patients with primary vesicoureteral reflux: preliminary report.

PURPOSE: We investigated the preliminary surgical results of endoscopic trigonoplasty in pediatric patients with primary vesicoureteral reflux. MATERIALS AND METHODS: We performed endoscopic trigonoplasty in 6 pediatric patients (11 refluxing ureters). Reflux was grade II in 4 reno-ureteral units, grade III in 5, grade IV in 1 and grade V in 1 (international classification). Surgery was done using laparoscopic and endoscopic instruments. RESULTS: Vesicoureteral reflux disappeared 3 to 12 months postoperatively. Analgesics were administered postoperatively to 4 patients for 24 hours and to 2 for 48 hours. No bladder irritability or postoperative upper urinary tract dilatation was observed in the early postoperative period. CONCLUSIONS: Minimally invasive endoscopic trigonoplasty can be an effective surgical procedure for pediatric patients with vesicoureteral reflux.

Child↗
PubMed1996

Effects of Ischemia on the function of the isolated rat detrusor muscle.

Ischemia of vital organs causes various degrees of impairment. We studied the in vitro effects of ischemia on the function of the rat bladder. Ischemia was induced by ligation of the bilateral (bilateral ischemia) or right (unilateral ischemia) internal iliac arteries. Bladder weight increased significantly following 1 week of bilateral and unilateral ischemia. Passive tension was significantly higher in ischemic bladders than in control bladders at an increase in length between 6 and 12 mm. In both control and ischemic bladders, active tension was highest at a 16-mm increase in length. Bladders subjected to unilateral or bilateral ischemia for 1 or 2 weeks demonstrated impaired contractile responses to field stimulation, bethanechol, ATP and KCl. There were no differences in contractile strength between muscle specimens obtained from the ipsilateral or contralateral sides of unilateral ischemic bladders. Our findings showed that unilateral and bilateral ischemia inhibited the in vitro contractile strength of the detrusor muscle in response to intramural and pharmacologic stimulation.

Adenosine Triphosphate↗
PubMed1996

Effects of in vivo Ischemia on the infusion cystometry and in vitro whole bladder contractility of the rat.

Ischemia induced by atherosclerosis is a common cause of organ failure in the elderly. We investigated the effects of in vivo ischemia created by ligation of the internal iliac arteries on the parameters of in vivo infusion cystometry under urethane anesthesia and on in vitro whole bladder contractility of the rat. Bladder weight significantly increased after ischemia for 14 days. Infusion cystometry demonstrated that in the ischemic bladders the capacity increased, the voiding pressure decreased, and the volume of residual urine increased, which resulted in deteriorated voiding efficacy. The in vitro whole bladder contractility to field stimulation, bethanechol, ATP, and KCl was reduced by ischemia. The passive pressure increased as the bladder volume enlarged and the bladder compliance once decreased by ischemia on the 7th day, but increased on the 14th day. In an active volume-pressure relationship study the peak response was decreased by ischemia. The volume at which response reached a peak value shifted to a larger volume 14 days after surgery. In conclusion, ischemia impaired in vivo rat detrusor power to empty. Since detrusor contractility in vitro decreased in response to various kinds of stimulation, this deteriorated bladder function was supposed to be caused by muscle degeneration.

Animals↗
PubMed1996

A comparison of transurethral resection of the prostate and medical treatment for the patient with moderate symptoms of benign prostatic hyperplasia.

Transurethral resection of the prostate is the most common surgical treatment for benign prostatic hyperplasia. We conducted a prospective randomized clinical trial to compare this surgery with medical treatment in men with moderate symptoms of benign prostatic hyperplasia. Of 98 men over the age of 54 years who were screened between June 1993 and June 1995, 53 were studied (25 in the surgery group and 28 in the medication group). Patients' symptoms and the degree to which they were bothered by urinary difficulties were measured with standardized questionnaires and medical evaluations. The men randomly assigned to the surgery group underwent surgery within 2 weeks after the assignment. Surgery was not associated with an impotence or urinary incontinence. The follow-up period was 1 year. Surgery was significantly associated with improvement in residual urinary volume and peak flow rate; and also in the scores for urinary difficulties, sexual performance and interference with activities of daily living (P < 0.001 for all comparisons). We concluded that for patients with moderate symptoms of benign prostatic hyperplasia, surgery is more effective than medication in improving genitourinary symptoms and enhancing the quality of life. Thus, medication as treatment should be reserved for patients who are less bothered by urinary difficulty or who wish to delay surgery.

Chlormadinone Acetate↗
PubMed1996

The incidence of antisperm antibodies in patients with seminal tract obstructions.

Antisperm antibodies are one of the important factors in male infertility caused by vasal obstructions. To investigate the incidence of serum antisperm antibodies in patients with various kinds of seminal tract obstructions, we retrospectively analyzed the sera of 60 patients using the indirect immunobead test (IBT) to find serum antisperm antibodies. Immunoglobulin (Ig)G and IgA class antisperm antibodies were positive in 55% and 18% of those patients with a vasal obstruction caused by inguinal herniorrhaphy and in 60% and 20% of vasectomized patients respectively; whereas these antibodies were positive in 13% and 0% of those patients with an epididymal obstruction of unknown etiology and in 8% and 3% of those patients with congenital bilateral absence of the vas deferens (CBAVD). The incidence of antisperm antibodies was significantly higher in patients with a vasal obstruction than in those with an epididymal obstruction (p < 0.001).

Adult↗
PubMed1996

Does epididymal length in men with congenital bilateral absence of the vas deferens have a correlation with the fertilization rate of epididymal sperm retrieved by micropuncture technique?

To investigate whether the variable length of the epididymis in men with congenital bilateral absence of the vas deferens (CBAVD) might have a correlation with fertilization and pregnancy rates in in vitro fertilization (IVF) treatment, we conducted a retrospective study involving a total of 60 CBAVD patients. All patients in this study had epididymal micropuncture in conjunction with perivascular nerve stimulation as part of the IVF program at the Nagoya University Hospital Reproduction Center. The patients were classified into 3 groups: group I consisted of patients having only a proximal portion of the caput epididymidis with a length of between 0.5 and 1.9 cm, group II consisted of patients with the caput and a portion of the corpus epididymidis with a length of between 2.0 and 4.0 cm, and group III consisted of patients with the caput, corpus and cauda of the epididymis measuring more than 4.0 cm. There were no differences in the sperm count, progression and normal morphology among the 3 groups; however, the motility was progressively higher in patients with a longer epididymis (12% in group 1, 18% in group II and 31% in group III). It was evident that group III showed the highest fertilization and pregnancy rate per patient (23% and 28%, respectively) among the 3 groups. This study shows that epididymal sperm from CBAVD patients with a longer epididymis have a higher IVF rate than CBAVD patients with a shorter epididymis.

Epididymis↗
PubMed1996

[RP105 and B cell apoptosis].

The RP105 is a novel, murine B cell surface molecule that is expressed on mature B cells but not on pre-B or T cells. The RP105 is a 150 kDa type I transmembrane protein, and a member of the leucine-rich repeat protein family. Tandem repeats of a leucine-rich motif in the extracellular domain are thought to be involved in processes such as cell adhesion or receptor-ligand interactions. An antibody against RP105 protects B cells from irradiation- or dexamethasone-induced apoptosis, and drives them to proliferate. B cells activated by RP105-ligation arrest their growth and undergo apoptosis when the antigen receptor is engaged. Thus, RP105 is a signal transduction molecule and seems to have a role in regulation of B cell growth and death.

Animals↗
PubMed1996

Effect of alpha-blockers on epididymal sperm concentration, motility and testicular productivity in the rat.

The present study was undertaken to determine whether alpha-blockers affect epididymal sperm parameters and testicular spermatogenesis. Sprague-Dawley rats were given orally a 1 mg/kg body weight dose of Bunazosin, a selective alpha-adrenoreceptor antagonist, daily for one month as a short-term administration group and three months as a long-term administration group. Using a micropuncture technique, epididymal sperm concentration and sperm motility were measured. Epididymal sperm concentrations were significantly increased in the Bunazosin group, but progressive motility of spermatozoa were not altered. Daily testicular sperm production was also increased after administration of Bunazosin. There were no differences in epididymal sperm concentration and daily sperm production between the one-month group and three-month group. An epididymal wide storage capacity and short transit time after administration of the alpha-blocker could increase the sperm concentration in the cauda epididymidis. Because there were no differences in the epididymal sperm parameters and daily testicular sperm production between the two groups, these changes may occur at 1 month after administration of the alpha-blocker. Moreover, the alpha-blocker might affect testicular function.

Adrenergic alpha-Antagonists↗
PubMed1996

Effects of ethanol on in vivo cystometry and in vitro whole bladder contractility in the rat.

PURPOSE: It is known that acute ethanol intoxication can produce urinary retention in patients with benign prostatic hyperplasia. We evaluated the effects of ethanol on rat bladder function in vivo and in vitro. MATERIALS AND METHODS: Infusion cystometry was performed under urethane anesthesia with or without intravenous injection of ethanol. Voided volume, maximum voiding pressure, residual urine, bladder capacity, the pressure at which micturition was induced and voiding efficacy were compared. Subsequently, the in vitro whole bladder pressure generated by field stimulation, bethanechol, adenosine triphosphate and KCl in the presence of ethanol 0 to 5.0% was investigated. RESULTS: Intravenous administration of ethanol changed the in vivo cystometrogram. Bladder capacity and residual urine volume were significantly increased, and voiding pressure was decreased. Contractility of the isolated whole bladder to various kinds of stimulation in vitro was suppressed by ethanol in a dose-dependent manner. Washing the bladder and incubating it in normal Krebs' solution following exposure to 5% ethanol restored detrusor contractility. CONCLUSION: Ethanol significantly impairs detrusor contractility in the rat in vivo and in vitro.

Animals↗
PubMed1996

[Clinical analysis of 683 prostatic cancer patients in the Tokai Urological Cancer Registry].

Of 815 patients with prostatic carcinoma registered in Tokai Urological Cancer Registry between 1989 and 1991, 683 patients followed up until April to July 1992 were analyzed. The patients were between 48 and 94 years old (mean 73.2). The clinical stage was A in 96 (14.1%), B in 118 (17.3%), C in 117 (17.1%) and D in 352 (51.5%) patients. The histological study well differentiated adenocarcinoma in 150 (22%) patients, moderately differentiated adenocarcinoma in 305 (44.6%), and poorly differentiated adenocarcinoma in 194 (28.4%) patients. There were 12 undifferentiated adenocarcinomas and 22 were not classified. The incidence of patients with poorly differentiated adenocarcinoma increased with the progression of clinical stage. Hormonal therapy was the main treatment (92.8%) and a variety of hormonal therapies with surgery or chemotherapy were attempted through out the clinical stages. Overall survival rate at 5 years was 48.6%. The 5-year survival rage for stage A, B, C and D carcinoma was 84.7, 93.1, 51.8 and 30.3%, respectively. Significant differences in the survival of patients were noted among stage A or B, stage C and stage D (Logrank test: p < 0.0001). The 5-year survival rate was 70.2% for well differentiated, 53.0% for moderately differentiated, and 32.6% for poorly differentiated adenocarcinoma (Logrank test: p < 0.0001). Disease-specific death was observed in 128 patients (66%), and cardio- or cerebrovascular death accounted for 16 (8%) deaths.

Adenocarcinoma↗
PubMed1996

Early recognition of patients with decreased methotrexate clearance following high-dose methotrexate infusion therapy.

The purpose of this study was to identify the patients with decreased methotrexate (MTX) clearance as early as possible after the start of high-dose methotrexate (HD-MTX) infusion. Fifty-six patients (age: 18 approximately 83 years) received a HD-MTX infusion (dosage: 1.9 approximately 3.8 g/m2) for 6 h. These patients were retrospectively divided into a low-clearance group and a high-clearance group based on the serum MTX concentration at 48 h (1 microM). Six out of the 56 patients showed decreased MTX clearance. The MTX concentrations in the low-clearance group were significantly higher than those in the high-clearance group even in earlier sampling times than at 48 h. The average MTX concentrations were 330 microM at 6 h, 72 microM at 12 h, and 16 microM at 24 h in the low-clearance group, and those in the high-clearance group were 210 microM, 18 microM, and 1.0 microM, respectively. The estimated elimination half-lives (t1/2) at 6 approximately 12 h and 12 approximately 24 h after the start of the infusion were also significantly longer in the low-clearance group (2.8 vs. 1.7 h and 5.0 vs. 2.8 h, respectively). Therefore, we proposed convenient criteria based on the mean + 1 S.D. of the high-clearance group: the concentration > 270 microM at 6 h and > 32 microM at 12 h; the t1/2 value > 2.1 h at 6-12 h. All 6 patients were recognized as belonging to the low-clearance group at an early stage after HD-MTX infusion by using our proposed criteria. These results indicate that patients with decreased MTX clearance could be identified within the first 12 h after the start of HD-MTX infusion. The factors influencing the prolonged elimination of MTX were also investigated. A significant decrease in renal function on day 2 was observed in the low-clearance group. The MTX level at 12 h and the estimated t1/2 values were significantly correlated with BUN, Scr and Clcr on the 2nd day after HD-MTX therapy, suggesting that an alteration in renal function occurs within 12 h of the HD-MTX infusion. The prolonged elimination of MTX could be attributable to this decrease in renal function.

Adult↗
PubMed1996

Two cases of intrascrotal liposarcoma.

Liposarcomas in the scrotum are relatively rare and only 40 cases have previously been reported in Japan. The inside wall of the scrotum is an unusual origin and we report here two cases arising at this site that have been followed for 21 and 40 months, respectively, after surgical resection. Case 1: the patient was a 24-year-old male who noticed a left intrascrotal mass which was histologically demonstrated to be a myxoid type liposarcoma. Case 2: the patient was a 66-year-old male who had the complaint of a left intrascrotal swelling. He underwent radical orchiectomy and histologic examination of the resected tumor revealed a well-differentiated type of liposarcoma. These two cases are the 41st and 42nd intrascrotal liposarcomas reported in Japan.

Adult↗
PubMed1995

Modulation of TCR-mediated signaling pathway by thymic shared antigen-1 (TSA-1)/stem cell antigen-2 (Sca-2).

Thymic shared antigen-1 (TSA-1) is a glycosyl-phosphatidylinositol (GPI)-anchored differentiation Ag expressed on murine lymphocytes, and is identical to stem cell Ag-2 (Sca-2). Using newly established mAb against TSA-1/Sca-2, we have previously shown that surface TSA-1 expression is induced upon activation in T cells, and that anti-TSA-1 inhibits IL-2 production induced by anti-CD3 stimulation in T cell hybridomas. In the present study, we have analyzed the functional role of TSA-1 during T cell activation using normal T cells, T cell hybridomas, and transfected Jurkat cell lines that expressed either GPI-anchored or transmembrane form of TSA-1. Anti-TSA-1 inhibited IL-2 production from normal T cells stimulated with soluble anti-CD3 plus accessory cells. Anti-TSA-1 exhibited the inhibitory effect on T cells, but not on accessory cells, because anti-TSA-1 inhibited IL-2 production in Jurkat cells transfected with TSA-1 cDNA, but not in control transfectant. A transmembrane form of TSA-1 was expressed in Jurkat cells by fusing the extracellular portion of TSA-1 to the transmembrane and cytoplasmic regions of the class 1 Db. The analysis using this transfectant revealed that anti-TSA-1-mediated inhibition of IL-2 production did not require the GPI anchor of TSA-1. Finally, in addition to the inhibition of IL-2 production, tyrosine phosphorylation of CD3 zeta-chains observed following TCR stimulation, one of the important early activation events, was markedly reduced by anti-TSA-1. These results imply that TSA-1/Sca-2 plays an important regulatory role in the TCR signaling pathway of activated T cells in addition to its role in T cell differentiation.

Animals↗
PubMed1995

CD38 ligation induces tyrosine phosphorylation of Bruton tyrosine kinase and enhanced expression of interleukin 5-receptor alpha chain: synergistic effects with interleukin 5.

Mouse CD38 has been implicated in the regulation of both B-cell proliferation and protection of B cells from irradiation-induced apoptosis. CD38 ligation on B cells by CS/2, an anti-mouse CD38 monoclonal antibody, induced proliferation, IgM secretion, and tyrosine phosphorylation of Bruton tyrosine kinase in B cells from wild-type mice. B cells from X chromosome-linked immunodeficient mice did not respond at all to anti-CD38 antibody, although CD38 expression on these B cells was comparable to that on wild-type B cells. We infer from these results that Bruton tyrosine kinase activation is involved in B-cell triggering after cross-linkage of CD38. Analysis of the synergistic effects of various cytokines with CD38 ligation on B-cell activation revealed that interleukin 5 (IL-5) showed the most potent effect on B-cell proliferation, Blimp1 gene expression, and IgM production. These synergistic effects were not seen with B cells from X chromosome-linked immunodeficient mice. Flow cytometry analysis revealed that CD38 ligation increased surface expression of the IL-5-receptor alpha chain on B cells. These data indicate that CD38 ligation increases IL-5 receptor alpha expression and synergizes with IL-5 to enhance Blimp1 expression and IgM synthesis.

ADP-ribosyl Cyclase↗
PubMed1995

Comparison of Modified Radical Mastectomy with Quadrantectomy, Axillary Dissection, and Radiation Therapy in Early Breast Cancer in Japaness Women.

From January 1987 to December 1993, Stage I (T1N0M0) breast cancers were treated by quadrantectomy with axillary lymph node dissection plus radiation therapy (QUART) in 57 cases and by modified radical mastectomy (MRM) in 57 cases. The results for these two treatment groups were compared retrospectively. Booster irradiation of 10 Gy to the tumor bed was given to 1 of 5 cases with a positive resection margin. The remaining 56 cases received 50 Gy lineac X-ray to the ipsilateral breast. Systemic adjuvant therapy, tamoxifen and /or 5-FU derivatives p.o., were given to the majority of cases in both groups. There were no significant differences between the two groups with regard to the patient background; ie, age, tumor size, pathological node status, histology and estrogen receptor status. During the follow-up period of 12 to 89 months (median 55 months) in the QUART group, no local recurrence was observed and only 1 case of bone metastasis occurred. In the MRM group, recurrence occurred in 4 cases during the follow-up period of 12 to 95 months (median 52 months). These consisted of 2 cases of regional lymph node recurrence and 2 cases of lung metastases. The differences in the disease-free survival rate and the overall survival rate between the two groups were not significant. In the QUART group, mild radiation pneumonitis and mild telangiectasia in the breast skin were observed in 2 cases(3.5%) and 1 case, respectively. Mild arm edema was observed in 4 cases (7%) in each group. These results demonstrated that QUART was as effective as MRM in treating T1M0M0 breast carcinoma in Japanese women.

Journal Article↗