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Biomedical subjects

M Fujisawa

Publications and source records attributed to M Fujisawa.

At least 91 records · Page 5Linked to original sources
PubMed1999

Diabetic nephropathy accompanied by iodine-induced non-autoimmune primary hypothyroidism: two case reports.

We reported 2 diabetic patients with nephrotic syndrome due to advanced diabetic nephropathy complicated by non-autoimmune primary hypothyroidism. Hypothyroidism developed along with the anasarcous status. Histological examinations of the thyroid gland revealed almost normal thyroid follicles without lymphocytic infiltration. The amounts of thyroid hormone lost into the extravascular space such as in urine and ascites were not sufficient to cause hypothyroidism alone. Serum total iodine levels measured during the hypothyroidal state in both cases were definitely elevated, and the perchlorate discharge test of both cases showed positive discharge (24 and 34%, respectively). The thyroid functions normalized after iodine restriction in the first case and initiating hemodialysis in the second case, in parallel with normalization of serum total iodine levels. These findings suggest that impaired renal handling of iodine resulting in elevation of serum iodine levels, rather than an autoimmune mechanism or extravascular hormone loss, played a principal role in the development of primary hypothyroidism found in these 2 patients, probably through a prolonged Wolff-Chaikoff effect.

Aged↗
PubMed1999

Assisted reproduction technology for patients with congenital bilateral absence of vas deferens.

PURPOSE: We investigate the frequency of cystic fibrosis transmembrane conductance regulator gene mutations in Japanese patients with congenital bilateral absence of the vas deferens, and assess treatment outcomes of assisted reproduction interventions. MATERIALS AND METHODS: In 10 Japanese patients with bilateral congenital absence of the vas deferens genetic analysis was performed for known frequent mutations of the cystic fibrosis transmembrane conductance regulator gene using polymerase chain reaction amplification followed by dot-blot hybridization with the allele-specific oligonucleotide probes and direct sequencing. Intracytoplasmic sperm injection using spermatozoa retrieved from the testes was performed in 7 of the couples. RESULTS: No known mutations of the gene were detected in the patients. However, analysis of the polythymidine tract polymorphism in intron 8 revealed 30% allele frequency of 5T. Pregnancy was achieved in 7 cycles of intracytoplasmic sperm injection using spermatozoa retrieved from the testes. CONCLUSION: The 5T variant in intron 8 polythymidine tract was identified with high allelic frequency in Japanese patients with congenital bilateral absence of the vas deferens, suggesting that the disease in Japan is also partially caused by this particular mutation of the cystic fibrosis transmembrane conductance regulator gene. Modern assisted reproduction technology offers an important option for patients with congenital bilateral absence of the vas deferens.

Adult↗
PubMed1999

[A case of true carcinosarcoma in bladder diverticulum].

We report a case of carcinosarcoma arising from a bladder diverticulum. A 71-year-old male was referred to our hospital for macroscopic hematuria. Two diverticula were identified in the left wall of the urinary bladder, one of which showed a broad-based tumor. The bladder tumor was resected using a transuretheral approach and the tumor was histologically diagnosed as leiomyosarcoma. The patient underwent partial resection of the bladder including the two diverticula and the tumor. Pathological examination revealed that the resected specimen was composed of three elements, transitional cell carcinoma (G3), squamous cell carcinoma, and leiomyosarcoma. Thus, the patient was diagnosed with carcinosarcoma. He died 5 months after surgery to remove the panperitonitis carcinomatosa. This case is the 38th reported case of bladder carcinosarcoma in Japan.

Aged↗
PubMed1999

Pressure pain threshold with and without iontophoretic anesthesia of the masseter muscle in asymptomatic males.

AIMS: The pressure pain threshold (PPT) in the superficial masseter muscle was measured with and without cutaneous anesthesia to determine whether there would be a difference in PPT scores. METHODS: In 14 healthy male subjects, cutaneous tissues in the target areas were anesthetized with lidocaine with the help of an iontophoretic device. As a control, physiologic saline solution was applied iontophoretically to the contralateral masseter site. The subject and the PPT examiner did not know which side contained anesthesia, and the selection of which side to anesthetize was done in a random fashion. Multiple PPT measurements were made in the target sites before and immediately after the iontophoretic anesthesia. RESULTS: The PPT level on the lidocaine side was not statistically different from the PPT level recorded on the control side (339.0 +/- 87.6 kPa and 337.5 +/- 77.7 kPa, respectively). CONCLUSION: Pressure pain sensation in the human masseter is not derived predominantly from the cutaneous tissues, but from the muscle itself.

Adult↗
PubMed1999

[An autopsy case of intracranial T cell type malignant lymphoma with fluctuating neuropsychological symptoms].

A 59-year-old man was admitted to the hospital due to leg edema. He had multiple sclerosis-like episodes of transient diplopia at the age of 36 years and spastic paraplegia at the age of 38. After admission he showed various fluctuating neuropsychological symptoms (disorientation, hallucination, apraxia, aphasia) and cranial nerve palsy. Magnetic resonance imaging revealed abnormal signal intensity in the right thalamus and deep white matter. The patient was diagnosed as having malignant lymphoma and treated with steroid therapy and chemotherapy. Although partial improvement of clinical findings was observed, recurrent cerebral hemorrhage followed. Autopsy findings revealed perivascular infiltration of T cells in the brain, spinal cord and other general organs.

Aphasia↗
PubMed1999

Long-term experience with orthotopic reconstruction of the lower urinary tract in women.

PURPOSE: We investigated the long-term outcome of orthotopic neobladders in women. MATERIALS AND METHODS: At our institutions 8 women have undergone lower urinary tract reconstruction with an orthotopic neobladder and have been followed for more than 4 years. After urethral sparing cystectomy the neobladder was constructed and connected to the native urethra. Late complications were analyzed, and voiding function was evaluated by a pressure flow micturition study and bead-chain cystourethrography. RESULTS: No late complications related to the surgery were noted. Of the 8 patients 7 were completely dry day and night. Four patients with ileal neobladder required clean intermittent catheterization, and hypercontinence might have been caused by downward migration of the neobladder and reduced neobladder pressure at voiding. No recurrence in the native urethra was noted, and all patients were satisfied postoperatively. CONCLUSIONS: These results of orthotopic neobladder in women are encouraging. Overall patient satisfaction was excellent. An international collaborative study is necessary to achieve the number of patients required to determine the ideal orthotopic neobladder for women.

Adult↗
PubMed1998

Twin helical undulator beamline for soft X-ray spectroscopy at SPring-8.

A very high resolution soft X-ray beamline, BL25SU, has been designed and is under construction at SPring-8. Completely right or left circularly polarized light is supplied on a common axis of a newly designed twin helical undulator. A helicity modulation up to 10 Hz can be performed using five kicker magnets. The fundamental radiation covers the region 0.5-3 keV. Higher-order radiation is rather weak on the axis. A monochromator with varied-line-spacing plane gratings is installed to cover the region below 1.5 keV. A very high resolution beyond 10(4) is expected for the whole energy region.

Journal Article↗
PubMed1998

Spectrometer for polarized soft X-ray Raman scattering.

An experimental system for polarized soft X-ray Raman scattering spectroscopy has been constructed. The soft X-ray spectrometer is based on the Rowland circle geometry with a holographic spherical grating. Three types of gratings are used to cover the energy range from 18 eV to 1200 eV. According to a ray-trace simulation, the resolution is expected to be 200 meV at 700 eV by using a 10 micro m slit width. The polarized and depolarized soft X-ray Raman scattering spectra can be measured by rotating the soft X-ray spectrometer around the axis of the incident beam. Preliminary measurements of polarized and depolarized spectra were accomplished at undulator beamline BL-2C of the Photon Factory.

Journal Article↗
PubMed1998

Stem cell factor in human seminal plasma as a marker for spermatogenesis.

OBJECTIVES: To measure the level of stem cell factor (SCF) in human seminal plasma to determine whether SCF may be useful in evaluating the ability to produce sperm and search the role of SCF in the testes. METHODS: We measured the level of SCF in seminal plasma obtained from 108 males, including idiopathic azoospermia due to germ cell aplasia (n = 10), oligospermia (n = 50), asthenospermia (n = 31), and normospermia (n = 1 7). The expression of SCF messenger ribonucleic acid in the human testis was evaluated by reverse transcriptase polymerase chain reaction (RT-PCR). The correlation between its level and clinical findings was also evaluated. RESULTS: RT-PCR showed a larger form that encoded the soluble protein and a smaller form that encoded the membrane-associated form of SCF in the human testis. The similar ratio of the larger form to the smaller one was observed both in the testis of normal and oligospermic men. The level of SCF is significantly correlated with the sperm count (r = 0.214; P < 0.05). CONCLUSIONS: The level of SCF in seminal plasma appeared to predict the ability to produce sperm. Thus, this factor may play an important role in spermatogenesis.

Humans↗
PubMed1998

Antibodies to glutamic acid decarboxylase (GAD) in non-obese Japanese diabetics without insulin therapy: a comparison of two commercial RIA kits based on recombinant and pig brain GAD.

To compare the clinical usefulness of commercial radioimmunoassay (RIA) kits based on recombinant and pig brain GAD, we measured glutamic acid decarboxylase autoantibody (GADAb) titers in 125 non-obese (body mass index < 24) Japanese diabetics without insulin therapy using two commercial RIA kits based on recombinant human (rh) GAD65 (GADAb Cosmic) and purified pig brain native GAD (RIP Anti-GAD Hoechst). The frequencies of GADAb positivity using these two RIA kits (normal ranges; < 1.3 and < 4.0 U/ml, respectively) were about 4.8 (6/125) and 3.2% (4/125), respectively. The six patients found to be positive with RIA using GADAb Cosmic demonstrated significantly higher prevalence of NIDDM in their parents (P = 0.04), lower beta-cell function estimated by intravenous glucagon loading tests (P = 0.03) and higher prevalence of progression to insulin therapy (P = 0.0001). Five of these six patients slowly progressed to insulin-requiring status within 34 +/- 11 months of follow-up evaluation, and one of these five patients progressed to a completely insulin-dependent status within 30 months from the onset of diabetes. Of these six patients, two demonstrated chronic pancreatitis, three had chronic thyroiditis, and five showed HLA DR4. Interestingly, two of the six patients demonstrated very low GADAb titers (2.3 and 2.9 U/ml), while RIP Anti-GAD Hoechst showed no positivity with the same sera. Based on the binding study after pre-incubation of unlabeled GADs, these low titrated GADAb were elucidated to be true specific reactions to rh GAD65 alone. Moreover, one of the two patients with chronic thyroiditis and HLA DR4 slowly progressed to insulin-requiring status over a period of 45 months. These findings suggest that the measurement of GADAb using a commercial assay kit with rh GAD65 may be more useful to detect non-insulin-dependent type I diabetics among non-obese patients than using a commercial kit with purified pig brain native GAD, especially among those with low GADAb titers.

Adult↗
PubMed1998

Telomerase activity in the testis of infertile patients with selected causes.

In human testes, stem cells such as spermatogonia need to produce progeny cells continually. Telomere length is maintained throughout spermatogenesis, i.e. from spermatogonia to spermatozoon, and telomerase is reported to be present in the testes. In this study, we measured the activity of telomerase in the human testes of 16 cases of idiopathic azoospermia, 10 of obstructive azoospermia, and 17 of oligozoospermia in order to understand the role of telomerase in spermatogenesis. Telomerase activity in the testes with Sertoli cell-only and in testes with maturation arrest were 0.08 +/- 0.05 optical density (OD) (mean +/- SD) and 1.96 +/- 0.98 OD, respectively (P < 0.05). Classifying those testes with maturation arrest into two groups, the telomerase activity of those with early maturation arrest (arrest at spermatocyte) and of those with late maturation arrest (arrest at round spermatid) was 1.82 +/- 0.82 OD and 2.10 +/- 1.14 OD respectively. There was no significant difference between the two groups. The telomerase activity in the testes showing hypospermatogenesis in obstructive azoospermia and in those of oligozoospermia with hypospermatogenesis was 1.89 +/- 1.06 OD and 1.92 +/- 1.02 OD respectively. No difference in telomerase activity existed between the testes with maturation arrest and those with hypospermatogenesis in obstructive azoospermia or oligozoospermia. Sertoli cell-only testes without germ cells showed no telomerase activity. The source of the telomerase activity was likely to be germ cells. The telomerase activity in the testes (n = 63) was related to the histology of the testes. The activity of telomerase showed no significant correlation with the sperm concentration in each patient. Only serum oestradiol level significantly correlated with telomerase activity (P < 0.05). The concentrations of follicle stimulating hormone, luteinizing hormone, or testosterone had no significant relationship with the telomerase activity. Therefore similar levels of telomerase activity were detected in the testes of infertile men with azoospermia and oligozoospermia and in testes showing maturation arrest.

Adult↗
PubMed1998

Expression pattern of phospholipid hydroperoxide glutathione peroxidase messenger ribonucleic acid in mouse testis.

To determine the expression pattern of phospholipid hydroperoxide glutathione peroxidase (PHGPx) mRNA in testes, Northern (3-, 8-, 40-, and 80-wk-old mice) and in situ (8-wk-old mice) hybridization analyses using digoxigenin-labeled RNA probes for PHGPx were performed in the testes of ICR mice. PHGPx mRNA in the mouse testes was first expressed at 3 wk of age, greatly increased at 8 wk, and persisted at the high level until 80 wk. According to in situ analysis, the PHGPx mRNA was expressed stage-specifically during spermatogenesis. It first appeared in pachytene spermatocytes of stage X, gradually increased in round spermatids during early spermiogenesis, and reached a peak in step 10-11 elongating spermatids. After step 12, PHGPx mRNA began to show a progressive decline in the spermatids and was weakly detected in step 16 spermatids. However, the signal was not detected in spermatogonia or early spermatocytes. On the other hand, according to in situ and reverse transcription-polymerase chain reaction analyses, PHGPx mRNA was also expressed in Leydig cells. These findings suggest that PHGPx in testes may be closely involved in spermatogenesis as well as having a general antioxidant function.

Aging↗
PubMed1998

The guttural pouch is not present in the white rhinoceros (Ceratotherium simum); morphology of the eustachian tube and nasopharynx.

The nasopharynx and eustachian tube (auditory tube) were morphologically examined in the white rhinoceros. The narrow nasopharynx cavity was enlarged dorsoventrally. The most lateral part of both sides sharply rises in a dorsal direction and the volume is estimated at 173 cc. The eustachian tube is 145 mm in length from the auditory bulla to the nasopharynx. The hyaline cartilage is well-developed in the middle region of the eustachian tube wall. The results demonstrated that the white rhinoceros does not have a guttural pouch. We suggest that the occurrence of the guttural pouch may not be dependent on the phylogenetic status of perissodactyls such as horse, donkey and tapir.

Animals↗
PubMed1998

Construction and voiding functions of three types of orthotopic neobladders using colonic segments: the Kobe University experience.

BACKGROUND: At Kobe University Hospital we have created orthotopic neobladders since 1988 by using several colonic segments. Various types of neobladders were compared and a detailed description of these procedures and the voiding function outcome is presented. METHODS: Thirty-two men with invasive bladder carcinoma or recurrent carcinoma in situ underwent a radical cystectomy followed by orthotopic neobladder replacement using a right colonic, ileocolic or sigmoid colonic segment. The functional capacity, percentage of residual urine volume, configuration of the neobladder, and location in the pelvis were evaluated 1 year after surgery. Voiding function was evaluated using a questionnaire which included questions on diurnal and nocturnal continence, and by uroflowmetric analysis. RESULTS: Operative time, blood loss, and functional neobladder capacity did not differ for the 3 types of neobladders. The configuration of the right colonic and ileocolic neobladders resembled the shape of a rugby ball. The configuration of the sigmoid neobladder was oval. The right colonic and ileocolic neobladders tended to be located along the right side wall of the pelvis. The sigmoid neobladder was located in the center of the pelvis. Daytime and nocturnal continence was not affected by either the type of neobladder or its configuration or position. Neobladders located in the center of the pelvis exhibited a better maximum flow rate than those located along the right wall of the pelvis. CONCLUSION: The technical difficulty in constructing the 3 types of neobladders was approximately the same. For better voiding a neobladder should be located in the center of the pelvis.

Aged↗
PubMed1998

Preliminary report of a modified continent appendix stoma in a sigmoid urinary reservoir pouch.

BACKGROUND: The application of an appendix stoma in a Mainz urinary reservoir pouch is an established procedure and assures good continence. We modified this method for use with a sigmoid pouch. METHODS: In each of 3 men with bladder carcinoma, an appendix with a blood supply was prepared and anastomosed to the detubularized sigmoid pouch with a 3-cm submucosal tunnel. RESULTS: In all 3 patients, this procedure was performed successfully, and the pouch was completely continent. Self-catheterization could be performed without difficulty by 2 patients, and with slight resistance in the remaining patient. The patients are satisfied with their quality of life. CONCLUSIONS: We conclude, based on our findings and these preliminary observations, that this procedure is a potentially good alternative for the placement of continent stoma in continent urinary reservoir surgery.

Aged↗
PubMed1998

Squamous cell carcinoma in an ileal conduit.

We report a patient with squamous cell carcinoma that developed at the ureteroileal anastomosis and extended into the ileal conduit 11 years after a radical cystectomy for transitional cell carcinoma of the bladder. To our knowledge, this is the first report to document the development of a squamous cell carcinoma in an ileal conduit after a radical procedure for bladder cancer.

Aged↗