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Biomedical subjects

K Miyake

Publications and source records attributed to K Miyake.

At least 451 records · Page 25Linked to original sources
PubMed1991

[Analysis of frequency volume chart in elderly people with pollakisuria. Comparison between the elderly and the adult].

Based on the frequency volume chart, 215 patients who complained of pollakisuria were clinically investigated. The subjects were divided into 2 groups: the elderly group was composed of 85 patients more than 65 years of age (mean of 72) and the adult group comprised 130 patients less than 64 years old (mean of 47). The elderly group was characterized by the fact that, during nighttime (after sleep), their urinary volume was larger, each voided volume was smaller and the number of voiding was greater than the other group. Clinical analysis of the causes of pollakisuria enabled us to subdivide them into 6 diagnostic categories. Among the elderly patients polyuria during sleep and unstable bladder were prevalent and among adult patients unstable bladder and over hydration were common. Medication was made in 80 patients (37%), while 108 (50%) needed neither medication nor surgery. It is stressed that the frequency volume chart is one of the important diagnostic tools to evaluate the cause of pollakisuria and to select appropriate treatment.

Adolescent↗
PubMed1991

[Pharmacologic characteristics of human neurogenic bladder: response to KCl, carbachol, ATP and CaCl2].

Pharmacologic characteristics of the human neurogenic bladder to KCl, carbachol, ATP and CaCl2 was investigated in vitro in comparison with the control bladder. Patients with neurogenic bladder underwent augmentation enterocystoplasty because of low bladder compliance or uninhibited contraction which resulted in urinary incontinence and/or vesicoureteral reflux. 1. There was no difference in the contractile strength to KCl between the neurogenic bladder and the control. 2. The contractility (both contractile strength and the value of ED50) to carbachol was than in the control. 3. The contractile strength of the neurogenic bladder to ATP showed greater efficacy than that of the control bladder. 4. The contractility of the neurogenic bladder (contractile strength and the value of ED50) to CaCl2 was significantly greater than that of the control. 5. In the neurogenic bladder there was no correlation between pharmacological responsiveness and the clinical parameters including the data of cystometry. In conclusion, the human neurogenic bladder demonstrated supersensitive responses to carbachol, ATP and CaCl2.

Adenosine Triphosphate↗
PubMed1991

[Extracorporeal shock wave lithotripsy monotherapy in the treatment of staghorn calculi].

From October, 1987 to September, 1989, 53 staghorn calculi of 51 patients underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy by using Dornier HM3 lithotriptor. All patients were treated with double J stenting preoperatively. Mean number of shock waves was 6092 and mean number of sessions was 2.1. In 52 out of 53 kidneys (98%), the stones were disintegrated completely. Complete removal of the stone were observed in 29 kidneys (55%) 3 months after the last ESWL treatment. Complications consisted of fever attack (more than 38 degrees C) (26 patients), ileus (2), subcapsular hematoma (2) and gastrointestinal hemorrhage (1). They could be conservatively treated except one case with percutaneous nephrostomy. Supplementary procedures for the stone street were necessary in 23 patients. They consisted of ESWL (16 patients) and transuretheral lithotripsy (7). The indication of this procedure for the treatment of staghorn calculi was also discussed.

Adult↗
PubMed1991

[The evaluation of cystoscopy in the screening of asymptomatic microhematuria].

As a prospective study on asymptomatic microhematuria, complete urological examinations including cystoscopy, IVP, ultrasound and urinary cytology were performed on 422 patients over 40 years old between January 1987 and December 1988 (group A). The results of group A was compared with that of retrospective study on 266 patients, who had incomplete urological examination between January 1984 and December 1985 (group B). Cystoscopy was performed on 321 patients (87.2%) in group A and on 108 patients (40.6%) in group B. Bladder tumor was found in 10 cases (2.4%) in group A, including 7 cases of male patients (5.7%), but in only 1 case (0.4%) in group B. Since the negative rate of abnormal urinary cytology was 50% and that of abnormal IVP was 90% in 10 cases of bladder tumor in group A, cystoscopy was considered to be an essential examination for the screening of patients with asymptomatic microhematuria over 40 years old patients.

Adult↗
PubMed1991

[Double cancer in small cell lung cancer patients treated with intensive chemotherapy with or without radiation therapy].

Development of double cancer was evaluated in 311 small cell lung cancer patients who had received intensive chemotherapy with or without radiotherapy. Of those, 10 patients (3.2%) developed a second malignancy:stomach cancer in four, non-small cell lung cancer in three, acute myelogenous leukemia in two, and liver cancer in one. The cumulative risk for the development of double cancer was 1.0% at 1-year, 17.0% at 3-years, and 100% at 8.1 years. The relative risk for the development of double cancer calculated by person-year method utilizing age and sex adjusted cancer incidence in Japan was 2.96-fold (p less than 0.01). The risk of non-small cell lung cancer (6.65-fold) and acute myelogenous leukemia (54.9-fold) was particularly high. Of 21 patients who survived disease-free for more than 2 years, 8 patients died; four patients (50%) died of second malignancy, two died of infectious disease, and only two patients died from recurrent small cell lung cancer. These results indicate that a cautious follow-up program for the detection of double cancer is indicated in patients surviving small cell lung cancer.

Adult↗
PubMed1991

[Simultaneous bilateral renal pelvic tumors: a case report].

A case of simultaneous bilateral renal pelvic tumors is reported. A 64-year-old man with the chief complaint of gross hematuria and left flank pain was admitted. Clinical investigations revealed a tumor in the right pelvis and ureter, and another tumor in the left renal pelvis. The right ureteral tumor had invaded the bladder. Right nephroureterectomy, total cystectomy, left partial pyelectomy and ureterocutaneostomy were performed. By pathological examination, right renal pelvic and ureteral tumors were non-papillary transitional cell carcinoma, grade 3, pT4, and the left renal pelvic tumor was papillary transitional cell carcinoma, grade 2, pT1. To our knowledge, this is the 16th case of simultaneous bilateral urothelial tumors of the upper urinary tract in Japan.

Carcinoma, Transitional Cell↗
PubMed1991

[Neurogenic bladder in HAM (HTLV-I associated myelopathy)].

Bladder dysfunction is one of the major symptomatologies characteristic to HAM (HTLV-I associated myelopathy). Four patients, 3 females and 1 male, were diagnosed by neurologists to have HAM with spastic gait disturbance and increased titer of antibody to HTLV-I. They complained of urge incontinence, bed wetting, difficulty in micturition and/or pollakisuria. Urodynamically, in 3 of them severe uninhibited detrusor contractions were observed. On the other hand, in one case detrusor contractility was lost completely at voiding. In all patients, bladder sensation was well preserved. Corticosteroids and interferon could not improve their urological symptoms. Clean intermittent catheterization (CIC) put on 3 patients who had a significant amount of residue relieved them of urinary incontinence. We believe that HAM in patients suffering from severe difficulty in micturition is a good indication for CIC.

Adult↗
PubMed1991

Grade 3 bladder cancer with lamina propria invasion (pT1): characteristics of tumor and clinical course.

To determine the clinical characteristics of grade 3 tumors with lamina propria invasion (pT1), we reviewed the data of 217 patients with superficial bladder cancer who had initially been treated by transurethral resection (193 patients) and fulguration (4), supravesical resection (13) or partial cystectomy (7). We classified the patients into four groups according to histological grade and stage of disease: group 1) grade 0 or 1, pTa tumors (n = 58); group 2) grade 2, pTa tumors (n = 106); group 3) grade 2, pT1 tumors (n = 30); and group 4a) grade 3, pT1 tumors (n = 23). Grade 3, pT1 tumors were significantly related to nonpapillary growth (p = 0.0002), multiple tumors (p = 0.005) and irritative bladder symptoms (p = 0.01). The 5-year progression rates were 0% for group 1, 5% for group 2, 8% for group 3, and 18% for group 4a. The respective 5-year survival rates were 97%, 91%, 83% and 79%. All five patients with grade 3, pT1 tumors who had originally undergone total cystectomy (group 4b) remained alive free of disease for a median follow-up 57 months, establishing a far better survival rate than that for group 4a. These findings show that patients with grade 3, pT1 tumors face a high probability of progression and poor chance of survival. Immediate radical treatment is indicated when tumors recur after initial transurethral resection.

Aged↗
PubMed1991

Different mechanisms are involved in 3H-androgen uptake by the rat seminiferous and epididymal tubules in vivo.

Proluminal movement of 3H-androgen from peritubular to intratubular fluids of the adult rat testis and epididymis was investigated by using in vivo microperifusion and subsequent micropuncture of seminiferous tubules and caput, corpus, and cauda epididymal tubules. Tubules were perifused with Minimum Essential Medium containing 3H-testosterone. 14C-polyethyleneglycol was included in the perifusion fluid as a marker for contamination of intraluminal fluid by peritubular fluid. Radioactivity of isotopes in interstitial and intraluminal fluids was determined at 1 and 2 hours after perifusion and the percentage of peritubular isotopes appearing in the intraluminal fluid was determined. Proluminal movement of 3H-androgen across the seminiferous epithelium was significantly restricted. In contrast, intraluminal 3H-androgen concentrations in the caput epididymal fluid were 200-300% of those in the peritubular fluid at both 1 and 2 hours after perifusion. Similar results were found in the corpus epididymis. 3H-androgen concentrations in the cauda epididymal fluid were approximately 125% of the peritubular isotope concentrations. The exact mechanism underlying this uphill transepithelial movement of 3H-androgen in the rat epididymis continues to be elucidated.

Androgens↗
PubMed1991

[Statistical analysis of tumors of the renal pelvis and the ureter--determinants of prognostic significance].

Sixty-two patients with epithelial tumors of the renal pelvis and the ureter were studied with respect to 16 clinicopathological factors and their relationship to the patients survival. The cumulative survival curves are depicted by the Kaplan-Meier method and the statistical difference in the survival rates were detected in 11 factors, age, tumor number, multicentricity, tumor size, histological tumor type, stage, grade, growth pattern, infiltration pattern, lymphatic invasion and venous invasion. Cox's proportional hazard model was applied to evaluate the contribution of these 11 factors to survival. With the univariate analysis, lymphatic invasion showed the greatest hazard ratio followed by growth pattern, stage, venous invasion, age, and grade in this order. Stepwise selection of these factors based on the relative magnitude of their contribution to the survival with Cox's proportional hazard model revealed the most important factor for survival as the lymphatic invasion (hazard ratio 5.29), followed by growth pattern (hazard ratio 2.89). In conclusion, patients with tumor lymphatic invasion and tumor of non-papillary growth pattern showed poor prognosis, and adjuvant chemotherapy should be performed on them to improve their survival.

Adult↗
PubMed1991

[Immunohistochemical localization of proteoglycans in interstitial elements of human bladder cancer].

The immunohistochemical localization of glycosaminoglycan side chains and core protein of proteoglycan was observed, using monoclonal antibodies, on 8 specimens of non-tumor bladder tissues and 26 specimens of bladder tumors obtained from total cystectomy or transurethral resection of bladder tumor (TUR-Bt). In non-tumor tissues of human bladder examined, the surface of urothelial epithelium consisted of heparan sulfate as revealed with antibody HepSS-1, and submucosal interstitial elements consisted mainly of small proteoglycan having chondroitin 4-sulfate side chains as revealed with antibodies 6B6 and 9A2, respectively. On the other hand, in bladder tumors examined, the interstitial fibrous elements, the so-called "specific stroma" in cancer cell nests, consisted mainly of large proteoglycans having chondroitin 4-sulfate or 6-sulfate side chains as revealed with antibodies 2B1, 9A2 and 3B3, respectively. Antibodies 2B1 and 3B3 are considered to be useful to demonstrate the involvement by invasive growth of bladder tumor cells.

Antibodies, Monoclonal↗
PubMed1991

[Clinical study on long-term treatment of chronic hepatitis C with interferon].

We treated 41 chronic hepatitis C patients with recombinant interferon alpha 2a, 6 X 10(6) IU/day, for three weeks daily followed by intermittent therapy, 3 X 10(6) IU/day, three times weekly for 6 months and more. After 6 months of intermittent therapy, serum aminotransferases (AST, ALT) decreased to normal or nearly normal levels in 29 of 41 patients (70.7%) with histological improvement. The HCV (C100-3) antibody disappeared during and after IFN therapy in 7 of 34 HCV antibody positive patients (20.6%). Serum aminotransferases levels of all such patients were normalized or nearly normalized. The IFN antibody was detected in 8 of 41 patients (19.5%) including one whose IFN antibody was already present before starting IFN therapy. IFN treatment was discontinued in 22 of 41 patients (53.7%) because they responded completely or nearly completely to IFN therapy. All of the 22 patients have been maintaining normal aminotransferase levels for 1 to 24 months (mean, 12 months) after the treatment period. We conclude that long-term IFN therapy is greatly beneficial in controlling hepatic inflammatory changes in chronic hepatitis C.

Adolescent↗
PubMed1991

[Bladder replacement by entero-cystoplasty after radical cystectomy for bladder cancer--the urethral Kock pouch].

From September 1989 to March 1990, 6 male patients with invasive bladder cancer, 49 to 70 years old in age, underwent bladder replacement with the ileum (the urethral Kock pouch) after radical cystectomy. Follow up ranged between 3 and 9 months. Urodynamic evaluation showed the ileal bladder to be a low pressure reservoir with a capacity that increased to more than 250 ml. The ileal bladder was emptied by straining without significant residual urine in all patients except one who was performing intermittent self-catheterization. All patients were continent in the daytime. However, all patients required pads at night because of occasional loss of a little urine. Excretory urograms revealed excellent upper tract function. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.

Adenocarcinoma↗
PubMed1991

[Study of growth fraction on fine needle aspirated prostatic tissue smear using monoclonal antibody Ki-67].

Immunohistochemical staining using monoclonal antibody Ki-67 was performed in 30 patients with benign prostatic hypertrophy (BPH), one with prostatic tuberculosis (TB), 22 with prostatic adenocarcinoma, one with prostatic transitional cell carcinoma and one with prostatic invasion from a bladder cancer. Specimens were aspirated from the prostate transrectally and a cytological smear were made. This antibody is specific for a proliferation-associated nuclear antigen. Alkaline phosphatase anti-alkaline phosphatase stained immunopositive nuclei red making positive or negative specimens easy to recognize. In BPH and TB smears, no immunopositive cell was reactive with Ki-67. In prostatic malignancy were found many immunopositive cells ranging from 2.5 to 10.2% (mean 5.9%) in prostatic adenocarcinoma (n = 22), and from 11.9 to 24.3% (mean 18.1%) in prostatic transitional cell carcinoma. Transitional cell carcinoma may have a much greater growth fraction than adenocarcinoma in prostatic tissue. Poorly differentiated adenocarcinoma showed a higher growth fraction (from 4.2 to 10.2%, mean 6.9%) than well differentiated (from 3.1 to 8.9%, mean 5.8%) and moderately differentiated adenocarcinoma (from 2.5 to 10.1%, mean 5.6%), but this difference was not significant. There was no correlation with age, clinical stage, bone metastasis or Böcking's cytological grade. In conclusion, immunohistochemical staining using Ki-67 on aspirated prostatic smear is visualizes the growth fraction of prostatic disease well and is useful to diagnose prostate cancer.

Adenocarcinoma↗