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Biomedical subjects

M Moriyama

Publications and source records attributed to M Moriyama.

At least 181 records · Page 10Linked to original sources
PubMed1993

The uretero-ileoceco-proctostomy (ileocecal rectal bladder): early experiences in 18 patients.

With the current practice of continent urinary diversion the patient still has a cutaneous stoma and must perform intermittent catheterization. To circumvent these problems we devised the uretero-ileoceco-proctostomy (ileocecal rectal bladder), in which the intussuscepted ileocecal segment is interposed between the ureters and rectum, the rectal capacity is augmented by side-to-side anastomosis to the cecal limb of the segment and continence is controlled by the anal sphincter. The interposed segment prevents reflux of the urine-fecal mixture to the upper urinary tract and may decrease the risk of carcinoma at the ureteroileal anastomosis. The intussusception is stabilized without opening the recipient bowel (cecal limb), thus simplifying the subsequent ceco-proctostomy with automatic suture technique. Our preliminary experience in 18 patients with this new technique is encouraging with respect to voiding, preservation of renal function and quality of life.

Aged↗
PubMed1993

Detection of precore/core-mutant hepatitis B virus genome in patients with acute or fulminant hepatitis without serological markers for recent HBV infection.

To confirm the possibility that some hepatitis B virus (HBV) variants do not induce HB s antigen (HBsAg), anti-HB core antibody (anti-HBc) and anti-HBc IgM in a transient infection, polymerase chain reaction (PCR) was performed in 20 patients with acute hepatitis and 7 patients with fulminant hepatitis. Patients were diagnosed with non-A, non-B hepatitis by serological markers at admission. PCR successfully amplified the precore/core gene in 5 (25%) of the patients with acute hepatitis and 2 (29%) of the patients with fulminant hepatitis. Subsequent sequencing revealed frequent mutations including precore-defects in the precore/core gene.

Acute Disease↗
PubMed1993

Histological difference between complete responders and non-responders to interferon therapy of the livers of patients with chronic hepatitis C.

Liver histology was compared in patients with chronic hepatitis C to note the differences between responders and non-responders to interferon treatment. Fifty-eight patients were administered interferon in varying doses and over various periods, and were then followed up for 1 year. According to the improvement status of serum alanine aminotransferase (ALT) levels during this period, the patients were classified into complete responders who showed complete normalization of ALT; partial responders who exhibited a significant decrease, but not complete normalization of ALT; and non-responders who did not reveal any significant decrease of ALT. Before application of the interferon treatment, liver biopsies were analyzed in four parameters and given scores from 0 to 5 for three groups in cord with no prior knowledge of the efficacy. The parameters included necroinflammation, fibrosis/lobular distortion, portal lymphocytic reaction and portal (or fibrous septal) outline destruction. Results indicated that there were no significant differences in the score of necroinflammation and portal lymphocytic reaction between the complete responder group and the non-responder group. In contrast, the complete responder group exhibited weaker fibrosis/lobular distortion and less portal outline destruction than the non-responder group. The partial responder group was more akin to the former group in these parameters. Thus, it is safe to conclude that liver histology may predict the efficacy of interferon treatment.

Adult↗
PubMed1993

Correlation of serum antibody titers against hepatitis C virus core protein with clinical features by western blot (immunoblot) analysis using a recombinant vaccinia virus expression system.

In order to study the relationships among the clinical features of hepatitis C patients, the presence of hepatitis C virus (HCV) RNA in their blood, and their serum antibody titers against the core protein of virus and to study the antibody levels in asymptomatic HCV carriers, a recombinant vaccinia virus containing a core protein gene was constructed. The recombinant virus expressed a protein with a molecular mass of 22 kDa in RK-13 cells as determined by Western blot (immunoblot) analysis. By using the cell lysate of virus-infected cells and serially diluted serum samples, core antibody titers in the groups of patients in the chronic hepatitis phase and in the convalescent phase as well as in asymptomatic carriers were determined by enhanced chemiluminescence Western blot analysis. Almost all patients in the chronic phase were shown to have high antibody titers of more than 1:500,000 and with no exception had of HCV RNA in their sera. On the other hand, patients who had recovered naturally and were in the convalescent phase were shown to have significantly lower antibody titers, and the antibody was not detected in the lowest serum dilution of 1:500 in 43% of these patients (three of seven total patients). Antibody levels of patients who showed a good response to interferon treatment decreased to intermediate levels between those of patients in the chronic phase and those of patients in convalescent phase. The antibody titers in asymptomatic carriers varied considerably from 1:500,000 to 1:500, and 41% (11 of 27 total individuals) of these carriers showed a high titer equivalent to that of those in the chronic phase. Core antibody was detected consistently in the individuals in whom HCV RNA was detected. This system for core antibody might be useful for identifying the stage of an apparent HCV infection.

Base Sequence↗
PubMed1993

Adaptive changes in zonation for gluconeogenic capacity in liver lobules of cold-exposed rats.

The rate of gluconeogenesis from lactate increased in perfused livers after exposure of rats to cold for 5 days, and it returned to the control rate after 20 days [M. Shiota, T. Tanaka, and T. Sugano. Am. J. Physiol. 249 (Endocrinol. Metab. 12): E281-E286, 1985.]. The relationship between the increased gluconeogenic activity and its zonal distribution in liver lobules was studied in cold-exposed rats that had been starved for 24 h by examination of preparations enriched for periportal hepatocytes (PP-H) and for perivenous hepatocytes (PV-H), which had been isolated by the digitonin-collagenase perfusion technique. In the control group, the rate of gluconeogenesis from lactate or alanine was three times higher in PP-H than in PV-H. The rate of gluconeogenesis from these substrates in PP-H was not changed by exposure of rats to cold. The rates of PV-H increased to the level in PP-H after 5 days of exposure of rats to cold and then returned to the control rates after 20 days. The rate of gluconeogenesis from fructose was not altered in either preparation of cells by cold treatment of rats. The change in gluconeogenic capacity in PV-H caused by exposure of rats to cold was unrelated to changes in the activity of the malate-aspartate shuttle and of pyruvate kinase. The increased capacity in mitochondrial respiration was observed in both preparations of cells by cold treatment of rats for 5 days. The activity of phosphoenolpyruvate carboxykinase was higher in PP-H than in PV-H in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1993

[99mTechnetium-diethylenetriaminepentaacetic acid renoscintigraphy as a measure of renal function and urodynamics after uretero-ileoceco-proctostomy].

Ten patients having a uretero-ileocecoproctostomy (ileocecorectal bladder) were evaluated by 99mtechnetium diethylenetriaminepantaacetic acid renoscintigraphy, which was repeated at an approximately 1 year interval in 7 patients. The computed total glomerular filtration rates at the 1st and 2nd surveys were 100 +/- 23.2 and 92.7 +/- 23.0 ml/min (mean +/- S.D.), respectively indicating a minimal change with no statistically significant difference. The normal or incompletely obstructive renogram patterns were consistent with the pyelographic findings in 27 of 28 renal units, and 5 of 6 renal units with dilated nonobstructive renograms subsequently became normal both on the renograms and pyelograms. Comparing the data in the 1st and 2nd surveys, the frequency of colonic reflux decreases from 8/10 to 3/7 of the patients, the rectal bladder capacity increased from 82 +/- 18.8% to 92 +/- 20.8% of the excreted urine, and the total residual urine rate decreased from 40.4 +/- 12.9% to 28.0 +/- 16.6% (p = 0.1298), respectively. The results indicate that the ileocecorectal bladder, though it has no antireflux mechanism against colonic regurgitation, well functions as an internal continent urinary reservoir. Also, since this comprehensive information is obtained by a single procedure, the radionuclide evaluation can be practiced as a cost-beneficial measure for follow-up of patients with urinary diversions.

Aged↗
PubMed1993

[Transurethral microwave thermotherapy for benign prostatic hyperplasia].

Transurethral microwave thermotherapy (TUMT) of prostate was administered to 10 patients with bladder outlet obstruction due to benign prostatic hyperplasia. The mean age of the patients was 74.4 years (range 63 to 85). The Prostatron device, which provides microwave heating of the prostate and conductive cooling of the urethra was used, and the prostate was heated with a calculated intraprostatic temperature of 45.5 degrees C for 55 minutes. No anesthesia was required for most of the patients. The clinical effects were evaluated at 4-6 weeks and 3 months after treatment. The symptomatic scores improved in the majority of patients. There was no significant change in prostate volume. The maximum flow rate and average flow rate were increased at 6 weeks and 3 months, but there was no significant change. The only side effects were transient hematuria and short-term obstruction secondary to urethral edema. In comparing TUMT with the transurethral resection of prostate (TUR-P), the maximum flow rate after TUMT was lower than that after TUR-P and the improvement of residual urine after TUMT was lower than that after TUR-P.

Aged↗
PubMed1993

[Clinical observations on bladder cancer--difference in clinical features with age].

Three hundred and ninety-four patients with transitional cell carcinoma of the bladder who initially visited Yokohama City University Hospital were reviewed according to age group. The patients were divided into four groups, group A (less than 49 years old), group B (from 50 to 64 years old), group C (from 65 to 79 years old) and group D (more than 80 years old). The clinical characteristics as follows were obtained by statistical analysis compared with these four groups. No statistical significance was obtained about frequency of macroscopic hematuria as chief complaint. However, the younger age groups (A and B) tended to visit hospital later after the first symptom of hematuria. The older age groups (C and D) had multiple and large tumor at the first cystoscopic examination. The older age groups (C and D) had high stage and high grade tumor at the first roentgenological examination and transurethral biopsy or resection. The 5-year recurrence free rate after transurethral resection of bladder tumor (TUR-BT) of the older age group (D group) was lower than that of the other groups. The 5-year survival rate of older age group was lower than that of the younger age group. However, no statistical significance between the age groups existed concerning high grade or high stage tumor and survival after total cystectomy. We clarified here that the clinical features of elderly patients who have bladder cancer were significantly different from those of younger patients. Otherwise the prognosis of patients who have high grade and/or high stage bladder cancer were demonstrated to be poor regardless of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Experience with extracorporeal shock wave lithotripsy in children].

Extracorporeal shock wave lithotripsy treatment for calculi of the upper urinary tract was performed on 4 children between 6 and 13 years old. The patients were treated under general anesthesia with Lithostar. Good fragmentation was achieved in all cases. No undue side effects or complications were encountered in the cases. We conclude that extracorporeal shock wave lithotripsy is a safe and effective method of treating renal and ureteral calculi in children.

Adolescent↗
PubMed1993

[Isolated hypogastric artery aneurysm ruptured into urinary bladder: a case report].

An 81-year-old man was admitted to our hospital with a complaint of dysuria. He had had a right hypogastric aneurysm repaired three years earlier. Physical examination showed a distended soft abdomen and tender mass about the size of a child's head but no murmur was heard over the mass. An excretory urogram (DIP) showed left hydronephrosis and no excretion from the right kidney. Computerized tomography (CT) showed urinary bladder compressed by the mass on the upper right back side. Cystography showed that the large mass occupied the pelvic region with calcification and communicated with the bladder. After a few days, an operation for the aneurysm was undertaken by the surgical department. Although bilateral ureterolysis was possible, a resection of the aneurysm could not be done. The aneurysm was injected with fibrin adhesive and a bilateral nephrostomy was performed. The renal function has been stable and the size of the aneurysm has remained unchanged for 9 months after the surgery.

Aged↗
PubMed1993

[The inhibitory effects of Takusha on the formation, growth and aggregation of calcium oxalate crystals in vitro].

The inhibitory effects of Takusha on the formation, growth and aggregation of calcium oxalate crystals were estimated by the microplate method and the use of Coulter counter TAII in the diluted urine system and undiluted urine system. In the diluted urine system, the inhibitory effect on aggregation and growth was calculated from the changes in the number and volume of crystals by the seed crystal method. Takusha had a strong inhibitory effect on the aggregation and growth when the concentration was above 10 micrograms/ml. In measuring the metastable limit by the microplate method, Takusha had a mild inhibitory effect on the formation of crystals above the concentration of 1 mg/ml. In the undiluted urine system, after determining the metastable limit, the formation and growth of calcium oxalate crystals which precipitated in response to a load of sodium oxalate were measured. Takusha had a strong inhibitory effect on the formation and growth at the concentration of 0.1-1 mg/ml. Takusha had no glycosaminoglicans in the dimethylmethylene blue assay and had an inhibitory effect on aggregation and growth when its molecular weight was over 10,000. Therefore, Takusha might be useful for preventing stones in recurrent stone formers.

Calcium Oxalate↗
PubMed1993

[Effects of typhoon-caused power failure on medical care facilities].

In the evening of September 27, Typhoon 19 passed Yamaguchi prefecture. The wind velocity exceeded anything that the local meteorological observatory has ever recorded so far in this area. When the typhoon was off shore near Yamaguchi prefecture, the gale brought down many electric-light poles around Hofu city with power failure in Hofu city continuing for more than a week. At the same time the total number of emergency patients in Hofu area was the most in the prefecture. Because the power failure continued for many days, there was more indirect damage attributable to this power failure than the damage related directly to the typhoon. The capacity of the emergency electric power generator equipment installed in the Central prefectural hospital in Hofu city is the largest in Yamaguchi prefecture. Even while electric power failed completely in the Hofu city area, treatment of most of the emergency patients at this hospital was possible. There is no hospital that has as large an electric generator as the Central hospital has. Had this typhoon hit in another area, the ensuring confusion which might have occurred at hospitals in that area would have put many patients in danger with the power failure in many hospitals. Power consumption needs in hospitals have increased over that expected on the time the hospital was built. Therefore, the electric power generators installed in hospitals are of the times very small and unable to cope with massive electrical outage.

Disasters↗
PubMed1992

An immunohistologic evaluation of C-erbB-2 gene product in patients with urinary bladder carcinoma.

BACKGROUND: Amplification or overexpression of the c-erbB-2 gene have been reported to correlate with poor patient prognosis in human breast, gastric, and ovarian cancer. Recently, the c-erbB-2 gene product was found to be expressed frequently in the urinary bladder carcinoma. In the current study, the presence of the c-erbB-2 gene product in urinary bladder carcinomas was compared with patient outcome to evaluate whether c-erbB-2 gene product could identify a subset of patients who are destined to have a poor prognosis. METHODS: Immunohistologic study of the c-erbB-2 gene product was done in formaldehyde-fixed paraffin-embedded tissue specimens obtained from 88 transitional cell carcinomas of the human urinary bladder. Eighty-three patients who underwent complete tumor resection by total cystoprostatectomy (30 patients) or by bladder-preserving operations such as transurethral surgery (50 patients) or partial cystectomy (3 patients) entered a follow-up study. The other five patients did not enter the follow-up study because of lost follow-up (2 patients) or distant metastasis at the time of surgery. RESULTS: The c-erbB-2 gene product was expressed in 23 of 88 patients (26%), showing an increase in the expression rate corresponding to the advancement of tumor grade (P < 0.05) and tumor stage (P < 0.2). The 5-year disease-free survival rate was 48.5% for patients with c-erbB-2 negative tumors versus 9.7% for those with c-erbB-2 positive tumors (P < 0.01). The 5-year actuarial survival rate was 65.5% for patients with c-erbB-2 negative tumors versus 41.8% for those with c-erbB-2 positive tumors (P < 0.05). Multivariate analysis using Cox regression model showed that the c-erbB-2 gene product tissue status was a significant prognostic factor independent of grade and stage of the tumor. CONCLUSIONS: The results suggest that the c-erbB-2 gene product could be a tumor marker to identify a malignant subgroup in bladder carcinomas.

Adult↗
PubMed1992

Vascularized tendon grafting in the rabbit.

Using a conventional free tendon graft, adhesion formation, with a consequent loss of gliding ability, occurs if the surrounding soft tissue is heavily scarred. An animal experiment was conducted, to evaluate whether a free vascularized tendon graft provides a better gliding surface, with minimal adhesion formation. In order to scar the gliding floor, the lateral aspect of the legs of 40 adult rabbits, including the peroneus tendon and its surrounding soft tissue, was exposed to liquid nitrogen. Two weeks after this induction of frostbite, all the rabbits were randomly divided into two groups: a vascularized tendon graft group and a free tendon graft group. Histologic examination revealed less adhesion of the tendon to the surrounding soft tissues in the vascularized tendon graft group. The tendon pull-out test demonstrated that less pull-out weight was required for vascularized tendons. A microangiographic study disclosed better circulation through the tendon graft and the surrounding soft tissues in the vascularized tendons. These results suggest that, even if scarring is heavy, the free vascularized tendon graft is less likely to adhere to the surrounding soft tissue than the conventional free tendon graft and, consequently, it provides a better gliding surface.

Animals↗
PubMed1992

Interferon and natural killer cell activity in patients with exanthem subitum.

Early immune response was studied by assessing interferon (IFN) and natural killer cell activity in 13 patients with exanthem subitum associated with human herpesvirus 6 infection during the acute and convalescent phases. Only IFN-alpha showed a significant increase in the plasma of patients during the acute febrile phase compared with the convalescent period. The inhibitory effect of IFN-alpha and IFN-beta on human herpesvirus 6 replication was demonstrated in vitro with cord blood mononuclear cells. Natural killer cell activity was also significantly augmented in the acute phase, especially in the exanthem period, rather than in the convalescent phase (P less than 0.01). These results suggest that the enhanced IFN-alpha response and natural killer cell activity in the acute early phase of the disease may play pivotal roles in the recovery from exanthem subitum.

Cytotoxicity, Immunologic↗
PubMed1992

Mechanism of augmentation of endotoxin fever by beta interferon in rabbits: possible participation of tumor necrosis factor (cachectin).

We analyzed the mechanism of the augmentation of endotoxin fever by human beta interferon (IFN) cross-reacting to rabbit cells in rabbits by using a purified rabbit tumor necrosis factor (RaTNF) and a monoclonal anti-RaTNF. The late peak of fever evoked by the injection with both endotoxin and HuIFN was suppressed when the animals were injected previously with anti-RaTNF. IFN also augmented the pyrogenicity of RaTNF in a synergistic manner in rabbits. The blood collected 2 h after the injection of RaTNF plus IFN contained a significant endogenous TNF activity, and the serum was shown to be pyrogenic. The endogenous pyrogen activity in the 2-h blood was heat stable (70 degrees C, 30 min) and was reduced by the in vitro treatment with anti-RaTNF. These results suggest that IFN augments the febrile response of rabbits to endotoxin by stimulating endogenous TNF-mediated TNF production to induce the late peak of fever.

Animals↗