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Biomedical subjects

M Gotoh

Publications and source records attributed to M Gotoh.

At least 361 records · Page 20Linked to original sources
PubMed1990

[Transurethral incision of the prostate and bladder neck for the treatment of outflow obstruction caused by a small benign prostate].

Transurethral incision of the prostate and bladder neck (TIPBn) was compared with transurethral resection of the prostate (TURP) followed by bladder neck incision in the treatment of 22 patients with outflow obstruction caused by a small prostate adenoma (below 15 gm). Eleven patients underwent TIPBn and another 11 TURP. An evaluation of the urodynamic findings and subjective symptoms was undertaken before the operation and 3 months afterwards. Urodynamic findings were evaluated, based upon uroflowmetry, i.e., in terms of maximum flow rate, average flow rate, voiding time, initiation time and residual rate. All patients in the TIPBn group revealed an improvement in every urodynamic parameter (MFR: from 6.1 to 10.8 ml/sec, AFR: from 3.1 to 5.8 ml/sec, Voiding time: from 95.5 to 24.2 sec/100 ml, Initiation time: 34.3 to 10.2 sec, Residual rate: 31.6 to 17.8%, in mean value). Ten out of the 11 in the TIPBn group subjectively considered the result to be good. The improvements in the urodynamic parameters in the TIPBn group were statistically comparable to those in the TURP. The improvements in voiding time and initiation time, however, tended to be much better in the TIPBn group. We conclude that TIPBn can be the operation of choice in the treatment of outflow obstruction caused by a small prostate.

Aged↗
PubMed1990

[Effects of alpha-1-blocking agent in the treatment of detrusor sphincter dyssynergia].

Effects of adrenergic alpha-1-blocking agent, prazosin, in the treatment of detrusor external-sphincter dyssynergia (DSD) were evaluated in both experimental and clinical aspects. Experimentally, in the urethral pressure profile in dogs, the maximum urethral closing pressure was depressed after intravenous injection of 1 mg prazosin. When experimental DSD was obtained in dogs by stimulating electrically the unilateral 2nd sacral root, intra-venous injection of 1 mg prazosin inhibited contraction of the external urethral sphincter. Clinically, 74 patients with DSD based on neurogenic bladder from cerebral vascular attack (CVA) (13 cases) and spinal cord injury (61 cases) were retrospectively surveyed in terms of therapeutical effects of prazosin for DSD. Spinal cord injury was subdivided to 4 groups for clinical evaluation; cervical cord injury (C) with complete paralysis, thoracic cord injury (Th) with complete paralysis, lumbar cord injury (L) with complete paralysis and spinal cord injury with incomplete paralysis. Patients with CVA and spinal cord injury with incomplete paralysis showed good response rates in subjective improvement, 69% and 60% respectively. However, those with spinal cord injury with complete paralysis showed a poor response (28% for C, 23% for Th and 14% for L). The amount of residual urine significantly decreased after treatment, in all the groups except that of lumbar cord injury with complete paralysis. In all the groups, however, even after the drug treatment the amount of residual urine ranged from 80 to 170 ml and the rates of needing clean intermittent catheterization unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Pharmacological experiments in aged rat urinary bladder. I. The responses to acetylcholine, norepinephrine and isoproterenol].

To investigate the etiology of unstable bladder in elderly people, we performed pharmacological experiments using the body of the rat urinary bladder. Responses to acetylcholine, norepinephrine and isoproterenol were examined in vitro in aged rats (16 and 24 months old) in comparison with young rats (6 months old). The results of the present study were summarized as follow: 1) The body weight of 16 and 24 months rats was significantly greater than that of the control. 2) There was no significant difference in the response to acetylcholine among three age groups. 3) The contraction strength of 16- and 24-month-old rat urinary bladder induced by norepinephrine was significantly greater than that of the control. 4) The relaxation response of the detrusor strips induced by isoproterenol in 24-month-old rats was significantly smaller than that of the other two groups. It is concluded that responses to alpha-adrenergic agonists were enhanced in the aged rat urinary bladders. In the assumption that a similar change occurs in the human bladders, the age-related increase in the responsiveness to alpha-adrenergic agonists is one of the etiologies or contributing factors for unstable bladder.

Acetylcholine↗
PubMed1990

[Pharmacological experiments in aged rat urinary bladder. II. Responses to ATP, prostaglandin F2 alpha, serotonin, angiotensin II and VIP].

To investigate the possible etiology of unstable bladder in the elderly, we investigated the responses of the aged rat bladder (16 and 24 months old) to 5 non-cholinergic, non-adrenergic neurotransmitters in comparison with the young rat bladder (6 months old). The drugs used were adenosine triphosphate, prostaglandin F2 alpha, serotonin, angiotensin II and vasoactive intestinal polypeptide. 1) The responses of 24-month-old rat bladders to adenosine triphosphate (ATP) were significantly greater than those of 6- and 16-month-old rats. 2) Prostaglandin F2 alpha made no difference in responses among three age groups. 3) The responses to serotonin of 24-month-old rat bladders were greater than those of the other two groups. 4) There was no difference in responses to angiotensin II in three age groups. 5) No response to vasoactive intestinal polypeptide was observed in all age groups. It is probable that the supersensitive responses to ATP and serotonin, observed in the aged rat bladders, may contribute to the development of unstable bladder in elderly people.

Adenosine Triphosphate↗
PubMed1990

[Lower urinary tract function in myelomeningocele. Long-term follow-up data].

We have analyzed long-term follow-up data of the lower urinary tract in 58 myelodysplastic patients. The patients consisted of 16 males and 42 females, whose age varied from 3 months to 16 years old (mean of 7). The follow-up periods ranged from 18 to 100 months (mean of 82). 1. While the bladder compliance of 41 patients conservatively treated with clean intermittent catheterization increased significantly from 5.1 to 11.1 ml/cmH2O, that of 17 patients who underwent anti-reflux surgery failed to do so. 2. A significant correlation was observed between bladder deformity and bladder compliance. A severe deformity was encountered more in the patients surgically treated. 3. Uninhibited contractions decreased in magnitude or disappeared in 26 patients, and increased in strength or developed newly in 8. The remaining 24 cases did not demonstrate them at all. 4. The maximum urethral closure pressure changed +/- 20 percent of the initial value in 27 of 38 patients (71%). The mean value tended to fall at 60 cmH2O.

Adolescent↗
PubMed1990

[Pharmacological experiments in the aged rat urinary bladder. Responses to inorganic ions (Ca2+, K+, Ba2+, Mg2+)].

We studied in vitro the change in muscle contractility and ion permeability of cell membrane of aged rat urinary bladder (16 and 24 months old) and compared with young rat bladder (6 months old). The results are summarized as follows: 1. In aged rat bladder the contractile response to Ca2+ was significantly decreased comparing to young rat bladder. The speed of muscle contractility was also significantly slower in aged rat bladder. 2. There was no significant change in muscle contractility in response to K+ and Ba2+ among the 3 age groups, which indicated that contractile force of aged rat bladder per se was not impaired. 3. Mg2+ relaxed the detrusor muscle in a dose-dependent manner. The magnitude of the response was not different between aged and young rat bladders. It is concluded that the response of aged rat urinary bladder to Ca2+ was decreased in contraction strength and contraction speed. This finding seems to suggest that membrane permeability of Ca2+ has been compromised, which may account for the impaired detrusor contractility frequently observed in elderly persons.

Age Factors↗
PubMed1990

Application of backscattered electron imaging to enzyme histochemistry of lymphatic capillaries.

A backscattered electron imaging (BEI) in scanning electron microscope (SEM) was applied to the observation of lymphatic capillaries on cryostat-cut tissue blocks of monkey stomachs with enzyme-histochemical method. The differentiation of the lymphatics from blood capillaries was established on cryostat sections using 5'-nucleotidase (5'-Nase)-alkaline phosphatase double-staining method. On the tissue surface, 5'-Nase-positive lymphatic capillary walls were seen as highlights with good contrast and resolution by the BEI. A pair of the backscattered and secondary electron imaging in the same area clearly reveals the correlation between the enzyme activity and surface structure of the tissue. Observation of stereo-pairs of the BEIs increases the information on the three-dimensional architecture of lymphatic capillaries. The present study demonstrates the applicability of the BEI of 5'-Nase reaction to SEM histochemistry of lymphatic capillaries stained with heavy metal.

5'-Nucleotidase↗
PubMed1990

Successful islet isolation from preserved rat pancreas following pancreatic ductal collagenase at the time of harvesting.

In an attempt to develop an improved method for preserving the pancreas prior to islet isolation, the effects of warm and cold ischemia were examined on rat pancreases, from which reproducible high yields of islets can be obtained when fresh. Both warm and cold preservation rapidly decreased islet yield. Use of Hanks' or modified Sacks' solution also led to marked decrease in islet yield. After 6 hrs of preservation, the islet yield was 1/5-1/10 of those of fresh pancreases (374 +/- 74, n = 14), and no islets were obtained after 24 hrs of preservation regardless of the preservation solution. Monitoring of ductal pressure during forced injection of Hanks' solution in 6 hrs-preserved pancreas with HBSS showed a significantly earlier and lower peak of pressure than those of fresh pancreases. On the other hand, simple hypothermic preservation after pancreatic ductal distention with collagenase Hanks' solution at the time of harvesting resulted in a significantly higher islet yield up to 6 hours (171 +/- 58, n = 14, P less than 0.01), as compared with conventional methods. The viability of the islets isolated by this method was confirmed by the ability to restore normoglycemia of STZ-induced diabetic B6 mice on transplantation of 400 islets in the renal subcapsular space. These findings indicated that loss of the integrity of the ductal system against forced collagenase injection during cold preservation led to poor distention and digestion of the pancreas, ductal collagenase injection at the time of pancreas harvesting followed by simple preservation is recommended to obtain viable islets from the preserved pancreas.

Animals↗
PubMed1990

Crucial role of pancreatic ductal collagenase injection for isolation of pancreatic islets.

We have been stressing the advantage of stationary digestion because of its simplicity and reproducible high yields of viable islets. In the present study optimal conditions of stationary in vitro collagenase digestion in mice and rats were examined. We also compared two possible routes for collagenase injection; ductal (PD) and portal venous (PV) based on subsequent islet yield and ability to reverse diabetes in rats. Three parameters which affect the quality of digestion are 1) collagenase concentration, 2) incubation time and 3) digestion temperature. Suitable conditions were easily determined and reproducible high yield of islets could be consistently obtained. The islets from one mouse pancreas (approximately 200 islets) could consistently restore normoglycemia in one STZ-induced diabetic mouse and the islets from one rat pancreas (500-600 islets) can restore normoglycemia in 5-6 STZ-induced diabetic mice within a couple of days. Islet yield in the PD method was greater than that in the PV method, and insulin release from PD islets in response to high glucose was well preserved after 24 hours of culture when compared to PV islets. The ability to restore normoglycemia in STZ-induced diabetic mice was well preserved when transplanting 100 PD islets as compared with the same number of PV islets. The PD islets revealed a well preserved structure with healthy endocrine cells, while the PV islets showed a dilated capillary network and distorted endocrine cell continuity. Histological examination of digested tissue following PD injection showed the complete destruction of pancreatic exocrine tissue, as well as mechanical separation and digestion of interstitial tissue between the islets and exocrine tissue, with the islet being preserved selectively intact.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Roles of CD4+ and CD8+ cells in islet allo- and xeno-graft rejection.

We investigated the requirement for and the roles of CD8+ cells and CD4+ cells for islet graft rejection in allogeneic and xenogeneic combinations by in vivo administration of anti-Lyt2 monoclonal antibody (mAb), anti-L3T4 mAb or both to the recipient mice. In BALB/c to B6 (H-2 and non-H-2 incompatible combination), administration of anti-Lyt-2.2(CD8) or anti-L3T4(CD4) mAb resulted in rejection of most of the grafts, although their survival was prolonged significantly. Administration of both mAbs together completely blocked rejection and all allografts survived over 100 days with mAb administration. In B10.A(5R) to B10.A (H-2K and IA incompatible combination) or B10.AQR to B10.A (H-2K incompatible combination), administration of either mAb alone induced indefinite allograft survival. In bm12 to B6 (IA incompatible combination), allografts were not rejected even in nontreated recipients. In rat-to-mouse combinations, administration of anti-L3T4 mAb produced marked prolongation of graft survival and 3 out of 8 survived over 100 days. Administration of both mAbs also led to prolongation of graft survival which was similar to or better than that of anti-L3T4 mAb alone. The present results indicated that CD4+ and CD8+ cells participate in all types of islet graft rejection studied here and that the absolute requirements of CD4+ or CD8+ T cell subsets for islet rejection depend on genetic as well as species disparity.

Animals↗
PubMed1990

Gamma-irradiation as a tool to reduce immunogenicity of islet allo- and xenografts.

Sensitivity of pancreatic endocrine cells to gamma-irradiation and alteration of islet immunogenicity by irradiation were examined. Syngeneic, allogeneic (DBA/2) and xenogeneic (rat) islets were irradiated and transplanted at varying doses (8, 24, 40, 80 and 160 Gy) into streptozotocin-induced diabetic B6AF1 mice. In an isograft model, late loss of graft function was observed in some animals given 200 24-Gy-irradiated islets. However, larger numbers (400-500) of islets given 40 Gy irradiation did not show reversal of normoglycemia. With higher doses (80 or 160 Gy) significant early as well as late graft loss was observed. In an allograft model, the irradiated islet allografts survived beyond controls. Marked prolongation was achieved with a broad range of irradiation doses between 8 Gy and 120 Gy with 30-90% of recipients maintaining normoglycemia over 50 days. Late loss of graft function was observed between 78 and 180 days with a dose over 24 Gy. Increasing dose resulted in a better allograft survival rate in the early postoperative period, but tended to curtail longterm survival. In an xenograft model, irradiation of islets with 8 to 24 Gy led to prolongation of graft survival. Maximum graft prolongation was achieved with 24 Gy. Higher doses were much less effective and, in some recipients, caused shortening of graft survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[A case of urinary undiversion from ileal loop conduit].

A seventeen-year-old girl, who had had an ileal conduit urinary diversion at 5 years of age, underwent a urinary undiversion 12 years after the initial operation. She has been suffering from recurrent episodes of urinary tract infection with fever. The preoperative evaluation revealed dilatation of the bilateral pelvis and ureters on an excretory urography. Ileal conduitgraphy revealed urinary reflux from the ileal loop to the bilateral upper urinary tracts. Cyclic bladder hydrodilatation through a suprapubic cystostomy was performed and a precise urodynamic study was done on the lower urinary tract. The vesical capacity increased from 40 ml to 300 ml in a month. Cystometry and urethral pressure profile revealed a stable bladder with good detrusor contraction and preserved urethral continence. Voiding status was satisfactory with only a small amount of residue. The undiversion was undertaken as follows. The ureters were once isolated from the ileal loop and their distal ends were everted in length of 5 mm to be nipples in shape. The ureters were reanastomosed to the proximal end of the ileal loop with submucosal tunnels of 2 cm. The ileal loop was then tapered and implanted to the bladder with a submucosal tunnel of 5 cm. Eight months after the undiversion, she enjoys good urination, free from urinary tract infection. Although moderate hydronephrosis remains bilaterally, renal function is stable.

Adolescent↗
PubMed1989

Vagally mediated insulin secretion by stimulation of brain cholinergic neurons with neostigmine in bilateral adrenalectomized rats.

This study investigated the relationship between central cholinergic neurons and insulin secretion in bilateral adrenalectomized fed rats. Neostigmine (a cholinesterase inhibitor, 5 x 10(-8) mol) administered into the third cerebral ventricle produced significant increases in hepatic venous plasma insulin and glucose concentrations, whereas i.v. injection of the same dose of neostigmine did not. Prior acute subdiaphragmatic vagotomy or i.p. pre-injection with methylatropine (10(-8) mol) completely prevented the neostigmine-induced rise in plasma insulin concentration. Intraperitoneal pretreatment with hexamethonium (5 x 10(-8) mol) also significantly reduced the plasma insulin response. These peripheral pretreatments did not change the plasma glucose response to neostigmine. Intraventricular co-administration of 10(-9) mol methylatropine, a dose that was ineffective when pre-injected i.p., eliminated the plasma insulin and glucose responses to neostigmine, whereas hexamethonium (5 x 10(-8) mol) had no influence on either response to neostigmine. These observations suggest that stimulation of central cholinergic-muscarinic neurons with third cerebral ventricular injection of neostigmine results in vagally mediated insulin secretion in bilateral adrenalectomized fed rats.

Adrenalectomy↗
PubMed1989

Loss of heterozygosity on the short arm of chromosome 3 in carcinoma of the uterine cervix.

Loss of genes at specific chromosomal loci is a common genetic alteration in human tumors and is thought to be critical for unmasking the recessive genetic changes for tumorigenesis. To learn whether such recessive mutations are involved in the development of carcinoma of the uterine cervix, 18 fresh tumors were analyzed by Southern blot hybridization using 34 polymorphic DNA markers covering 19 different chromosomes. We found loss of heterozygosity at the D3S2 locus on chromosome 3p in all nine patients who could be evaluated. Human papillomavirus type 16 and type 18 were present in seven and three of 18 tumors, respectively, while no amplification of 13 oncogenes, including c-myc and H-ras, was detected in these tumors. These results suggest that recessive genetic changes on chromosome 3p are one of the important genetic alterations for the development of carcinoma of the uterine cervix. Since this locus is also lost commonly in lung cancer and in renal cell carcinoma, it is possible that these three different types of adult tumors result from mutations of the same recessive gene on chromosome 3p.

Blotting, Southern↗
PubMed1989

Significance of transcatheter chemoembolization combined with surgical resection for hepatocellular carcinomas.

In order to improve the survival rate after liver resection for hepatocellular carcinoma (HCC), 71 HCC patients were treated with transcatheter chemoembolization (TCE). In the present study, we analyzed the effects of TCE on the patients' survival rates, as well as on the liver specimens resected in a histopathological study, comparing those not treated with TCE (n = 21). The overall survival rates, including hospital mortality, for 1 year, 3 years and 5 years were 81%, 72% and 54% respectively. However, no differences were observed in the survival rates between the TCE and the non-TCE groups. A histopathological study demonstrated that TCE was quite effective on the main tumor but not on intrahepatic metastasis or on tumor thrombus in the portal vein. However, we found that most of the intrahepatic metastatic lesions were necrotized in 8 of the 30 cases with these lesions. The histopathological study proved that these particular cases had some abnormalities in the portal blood supply. All but one of them are currently alive 3-48 months after resection, although the prognosis of the patients who had intrahepatic metastasis or a tumor thrombus in the portal vein was extremely poor. Preoperative TCE may, therefore, be thought of as a useful modality when it is effective in killing intrahepatic metastases. To control the lesions, portal vein embolization may be a promising technique in the future.

Aged↗