Biomedical subjects
Publications and source records attributed to M Murai.
In two cases intracranial extension of mucoceles of the paranasal sinus was safely removed by intranasal evacuation and drainage of the lesions located in the paranasal sinus. The diagnosis was ascertained in both cases via intranasal approach. In addition, the volume of the intracranial lesions was reduced. This procedure is both effective and a less invasive diagnostic treatment for the lesion.
The activation of N-methyl-D-aspartate receptors induces the synthesis of nitric oxide, which activates soluble guanylate cyclase and leads to the formation of cyclic GMP in the brain. The inhibition of nitric oxide production, as well as the blockade of N-methyl-D-aspartate receptors, has been reported to prevent the induction of hippocampal long-term potentiation and learning and memory formation in vivo, although the effects of inhibitors of nitric oxide synthase are still controversial. We investigated the putative role of nitric oxide and cyclic GMP in dizocilpine-induced memory impairment in mice. The nitric oxide synthase inhibitors, NG-nitro-L-arginine methyl ester and 7-nitro indazole, as well as dizocilpine, a non-competitive N-methyl-D-aspartate receptor antagonist, dose-dependently impaired spatial working memory in mice, assessed by their spontaneous alternation behavior in a Y-maze. The inhibitory effects of both NG-nitro-L-arginine methyl ester and dizocilpine on their behavior were completely reversed by 8-bromo-cyclic GMP. Cyclic GMP levels in the cerebellum were reduced by treatment with dizocilpine. NG-Nitro-L-arginine methyl ester and 7-nitro indazole reduced cyclic GMP levels in the cerebral cortex/hippocampus and cerebellum, and the suppressive effect of NG-nitro-L-arginine methyl ester on cyclic GMP levels in the cerebral cortex/hippocampus was reversed by co-treatment with L-arginine. Cyclic AMP levels in the brain were not affected by treatment with either dizocilpine, NG-nitro-L-arginine methyl ester, or 7-nitro indazole. Neither NG-nitro-L-arginine methyl ester nor L-arginine had any effect on monoamine and acetylcholine metabolism in the brain. These results suggest that the reduction in nitric oxide/cyclic GMP production in the brain may be responsible for dizocilpine-induced impairment of spontaneous alternation behavior in a Y-maze.
OBJECTIVES: The durability of clinical efficacy of transurethral microwave thermotherapy (TUMT) by Prostatron using a low-energy protocol (maximum power, 50 W) was evaluated on an outpatient basis in patients with symptomatic benign prostatic hyperplasia (BPH). METHODS: One hundred eighteen patients were followed up for longer than 3 months (13.4 +/- 9.5 months; mean +/- SD). All evaluations were made at baseline and then 3, 6, 12, 24, and 36 months after therapy. RESULTS: International Prostate Symptom Score (IPSS) significantly decreased from 18.2 to 10.6 at 6 months (P < 0.01), representing a mean improvement of 41% under the baseline. Peak flow rate increased from the baseline of 8.3 mL/s to 10.3 mL/s at 6 months (P < 0.01). The improvement in terms of mean values of both parameters was sustained up to 24 months. Six of 44 patients (14%) who were followed up for 31 months on average required transurethral resection of the prostate for recurring obstructive symptoms and 10 additional patients (23%) had to be treated with various drug regimens. When the clinical outcome was evaluated in terms of improvement from the baseline according to a response criteria, disease-free rates for IPSS (more than 25% improvement from the baseline) were 76% at 12 months, 77% at 24 months, and 61% at 36 months. Disease-free rate for peak flow rate (more than 2.5 mL/s from the baseline) was sustained in 44% by 12 months and in 48% by 24 months. The overall outcome of the treatment was assessed by adding scores based on both subjective and objective efficacy criteria. At 6 months, 67% of the patients were responders, and 15 of 21 (71%) remained as responders at 24 months. Patients who had estimated prostate volume smaller than 30 cc showed more marked improvement in peak flow rate (P < 0.02), and those with baseline IPSS of 20 or more showed greater reduction of IPSS (P < 0.05) at 24 months compared with each counterpart. CONCLUSIONS: After TUMT with a low-energy protocol, satisfactory results were obtained and the improvement seems to last at least for 24 months. This low-energy protocol may be most beneficial in patients with relatively small size of the prostate.
Macrophage phagocytic activity has previously been shown to be increased by binding of modified alpha 2-macroglobulin (alpha 2M) with mannose residues at termini of sugar chains to mannose receptors on macrophages, with a subsequent increase in the number of Fc gamma receptors at the cell surface. In the present study, an examination was made of the association of protein tyrosine kinase with the increase in number of Fc gamma receptors following binding of modified alpha 2M to mannose receptors. The phagocytosis of IgG-opsonized sheep red blood cells through the action of the Fc gamma receptor by modified alpha 2M was inhibited by mannose and herbimycin A and slightly so by genistein. The mannose receptor would thus appear to be associated with tyrosine kinase activity. By Western blotting, tyrosine phosphorylated proteins with molecular weights of 32000, 34000, 36000, 65000, 85000 and 110000 appeared or increased upon treating macrophages with modified alpha 2M. The degree of tyrosine phosphorylated proteins was the same for control macrophages following incubation in the presence of mannose and herbimycin A. Genistein treatment affected only tyrosine phosphorylated proteins of 65000 and 110000. The binding of modified alpha 2M to mannose receptors was demonstrated by the inducement of tyrosine kinase activation that was sensitive to herbimycin A, followed by an increase in Fc gamma receptors and consequently greater phagocytosis.
OBJECTIVE: We describe the technique of cosmetic reconstruction after mastoidectomy in the transpetrosal-presigmoid approach for petroclival lesions. TECHNIQUES: This technique involves raising a single temporo-occipital bone flap and cosmetic mastoidectomy, removing the mastoid bone fragments (by means of a rongeur instead of an air drill) for later reconstruction. Replacement of the bone fragments mixed with fibrin glue enables tamponade against the dura to be achieved without a fat graft. RESULTS: Computed tomographic scans and plain cranial films taken a few years later showed successful reconstruction of the mastoid bone with a good appearance of the retromastoid area in seven patients who underwent this procedure. The only complication was infection in one patient from cerebrospinal fluid leakage from the wound. CONCLUSION: We have developed a simple and easy technique of cosmetic reconstruction after the transpetrosal-presigmoid approach.
BACKGROUND: Conventional therapy for renal cell carcinoma (RCC) using systemic administration of interleukin-2 (IL-2) has shown limited anti-tumor action. The purpose of this study was to investigate the anti-tumor effects of a newly developed immune complex of IL-2 (IC) against RCC. METHODS: IC was prepared by mixing IL-2 and an anti-IL-2 monoclonal antibody at a molar ratio of 2:1. The pharmacokinetics and anti-tumor effects of IC were then studied in a murine RCC line, Renca. RESULTS: Serum IL-2 levels were sustained longer in mice given IC than in mice given IL-2 alone after either subcutaneous or intratumoral injections. After an intratumoral injection of IC, the IL-2 concentration in the tumor nodules remained higher compared with mice given IL-2 alone. The anti-tumor effect was most pronounced in mice treated with intratumoral injections of IC. CONCLUSIONS: Results obtained here indicate that an immune complex of IL-2 provides a useful tool for the treatment of RCC by altering the pharmacokinetics of IL-2 in vivo.
1. There are at least three alpha 1-adrenoceptor subtypes, alpha 1a, alpha 1b and alpha 1d, in human tissues. Using an RNase protection assay, we have now determined the amount of each subtype mRNA in human prostatic tissue, for both benign prostatic hypertrophy (BPH) and non-BPH. In all tissue samples examined, the predominant subtype mRNA was alpha 1a. The total abundance of alpha 1-adrenoceptor mRNA in BPH samples was over six times that in non-BPH samples. This increase was mostly accounted for by alpha 1a, which was almost nine times as abundant in BPH samples as in non-BPH samples. The abundance of alpha 1b was almost the same between BPH and non-BPH samples, and the abundance of alpha 1d in BPH samples was about three times that in non-BPH samples. The ratio of the numbers of the subtype mRNAs, alpha 1a: alpha 1b: alpha 1d, was 85:1:14 in BPH samples and 63:6:31 in non-BPH samples. 2. In situ hybridization studies showed no significant differences in the tissue localization of alpha 1-adrenoceptor subtype mRNAs between BPH and non-BPH samples. alpha 1a and alpha 1d were clearly detected in the interstitium of the prostate, where alpha 1a was stained more intensely than alpha 1d, and the positive sites were primarily smooth muscle cells. In contrast, alpha 1b staining was very faint. 3. This increase in mRNA abundance may be directly related to the contraction of prostatic tissue that leads to obstruction of the urinary tract in BPH patients. Specifically, our data suggest that increased expression of the alpha 1a subtype may be primarily responsible for the contraction of the prostate.
Diffusion routes of common buckwheat were investigated by constructing phylogenetic trees based on variability of RAPD markers among 46 land races and two natural populations of the ancestor. Thirty two primers out of 40 generated reliable RAPD bands, 295 in total. The percentage of polymorphic bands was the highest (45.9%) in southern China, the region in which buckwheat originated, and it declined sharply from southern China to the peripheral range of buckwheat cultivation. Phylogenetic trees for land races were constructed from RAPD variability by the unweighted pair group (UPG) and neighbors joining (NJ) methods. They suggest two major routes of diffusion of buckwheat cultivation; one from southern China-->northern China-->Korea-->Japan, the other from southern China-->Bhutan-->Nepal-->Kashmir-->Karakoram and the Hindukush.
(BACKGROUND). The clinical outcome of laparoscopic surgery performed in 143 patients, including laparoscopic adrenalecotmy, nephrectomy, pelvic lymph node dissection (PLND) and varicocele ligation is reported. (METHODS). In patients who underwent laparoscopic adrenalectomy (32 cases), laparoscopic nephrectomy (7) or PLND (44), the following parameters were evaluated and compared to those obtained in patients undergoing the same surgeries but by conventional open procedure; operation time, hospital stay, pain killer doses and the time necessitated for ambulation. (RESULTS). The operation was successful in 95.8% (137/143). Open laparotomy was necessitated in 4 patients to control bleeding (two in adrenalectomy and two for PLND) and in one nephrectomy case due to massive adhesion with the descending colon. The major complication occurred in 4.2% of the cases, but without mortality. The laparoscopic adrenalectomy, nephrectomy and PLND had an average operating time of 260, 304 and 139 minutes, respectively, while the open surgery for each procedure required 251, 212 and 128 minutes, respectively (p = 0. 24 approximately 0.82). Likewise, the total dose of pain killer was 0.8, 1.8 and 0.9 for the former, whereas it was 3.2, 6.0 and 3.9 for the latter, respectively (p < 0.01). The average hospital stay for laparoscopic surgery was 4.9, 6.4 and 4.7 days in the same order, whereas open adrenalectomy or nephrectomy required about 14 days (p < 0.001). Convalescence was completed within significantly shorter term in patients with laparoscopic surgery. Potential complications of laparoscopic surgery included not only those unique to pneumoperitoneum (8.1%), but also those which may be encountered during any endoscopic operation such as compartment syndrome in the lower extremities. The physiologic changes accompanying increased intra-abdominal pressure affected renal function, characterized by a significant decrease in urinary output (p < 0.02), which, however, resumed to normal range within several hours after the operation without causing permanent renal dysfunction. (CONCLUSION). These results suggest that the laparoscopic surgery in certain area in urology has less morbidity and equal accuracy compared with conventional open surgery.
PURPOSE: Previous studies have shown that factors predictive of tumor recurrence include a history of the disease, multiple tumors at diagnosis, and high tumor grade and stage. Additional biological marker for predicting tumor recurrence could potentially be used in the decision making process and could alter the frequency of clinical cystoscopy. We attempted to clarify whether the tumor proliferative activity estimated by bromodeoxyuridine, which is believed to be a thymidine analogue, and deoxyribonucleic acid (DNA) ploidy status correlates well with tumor recurrence as an objective parameter. MATERIALS AND METHODS: We evaluated 103 patients with superficial grade 2 transitional cell carcinoma of the bladder treated with transurethral resection. Mean followup plus or minus standard deviation was 49.5 +/- 11.3 months (minimum 36). Tumor specimens were obtained by transurethral cold-cup biopsy, with bromodeoxyuridine in vitro pulse labeling then performed under hyperbaric oxygen. The flow cytometric determination of the bromodeoxyuridine labeled cell index and DNA ploidy were estimated. RESULTS: When the tumor was classified according to the bromodeoxyuridine labeled cell index the 5-year no recurrence rates were 82.0 and 27.1% for an index of less than 5.3 and more than 5.3%, respectively. Furthermore, the 5-year no recurrence rates were 75.1% for DNA diploid compared to 29.3% for DNA aneuploid tumors, respectively. Multivariate analysis using Cox's proportional hazards model showed that the most important risk factor for tumor recurrence was a bromodeoxyuridine labeled cell index of more than 5.3% (risk ratio 5.31, p < 0.001), followed by DNA ploidy (risk ratio 2.61, p < 0.05). Tumor stage, initial lesion versus recurrence and single versus multiple tumors did not influence the risk factor for tumor recurrence. CONCLUSIONS: These data indicate that bromodeoxyuridine labeling status can be used as an objective risk factor for bladder cancer recurrence.
The contribution of mannose receptors on the cell surface of mouse peritoneal macrophages to the process of liposome-induced phagocytosis of immunoglobulin G-opsonized sheep red blood cells (SRBCs) through Fc gamma receptor has been investigated. Fc gamma receptor-mediated phagocytosis of opsonized SRBCs was activated by modified alpha 2-macroglobulin, which was produced in the incubation mixture of alpha 2-macroglobulin and liposome-treated splenic B cells. The phagocytosis was specifically inhibited by the addition of D-mannose, and the inhibition was dependent on the D-mannose concentration. The binding of modified alpha 2-macroglobulin to macrophages was also reduced by the addition of D-mannose. The activation effect of modified alpha 2-macroglobulin was not inhibited when in the presence of alpha 2-macroglobulin-trypsin and -methylamine complexes. In the presence of cycloheximide, activated phagocytosis was reduced to the control level. By Scatchard plot analysis of IgG binding studies, the number of Fc gamma receptors of a macrophage had been increased to 4.6-fold that of a control macrophage by treatment with modified alpha 2-macroglobulin. These findings suggest that macrophage mannose receptors are involved in activating the process of Fc gamma receptor-mediated phagocytosis of opsonized SRBCs induced by modified alpha 2-macroglobulin. Lectins may participate in a signal transduction in macrophage activation by liposomes.
The five phenylethanoids, acteoside (1), cistanoside F (2), lavandulifolioside (3), plantamajoside (4) and isoacteoside (5) were isolated from the herb of Plantago lanceolata L. (Plantaginaceae). Compounds 1, the major phenylethanoid in the herb of P. lanceolata L., and 4, the major phenylethanoid in the herb of P. asiatica L., showed inhibitory effects on arachidonic acid-induced mouse ear edema.
Adrenal tumors would be eminently suitable for laparoscopic surgery because of their size and location. We have performed 25 cases of laparoscopic adrenalectomy, and the purpose of this study was to evaluate the clinical results. Since November 1992, 12 men and 13 women with a mean age of 47.3 (range 29-71) years underwent laparoscopic adrenalectomy. Fifteen lesions were on the left side, and ten lesions were on the right side. The clinical diagnosis was primary aldosteronism in eight patients, Cushing's syndrome in seven, and a nonfunctioning adrenal tumor in ten. The mean operating time was 254 +/- 72 minutes (range 155-412 minutes), but the time on the last 10 cases was 216 +/- 40 minutes, which was equal to the mean operating time of the 15 open adrenalectomy cases (190 +/- 66 minutes). There was no difference in the operating time by clinical diagnosis. The time to first oral intake after the operation was shorter in the laparoscopic group, the need for analgesics was less, and the hospital stay and the time until return to preoperative activity were shorter than after open surgery. The laparoscopic cases had no significant complications, and every operation was performed completely. Although there was the learning curve for the performance of laparoscopic adrenalectomy, its operating time was equal to that of open surgery, and the postoperative recovery was significantly faster. Therefore, laparoscopic adrenalectomy would be useful compared with open surgery on the basis of invasiveness and cost.
Intratumoral growth of Staphylococcus aureus was compared with the intrarenal growth, to examine the usefulness of the method as a marker of its pathogenicity. When 5 x 10(7) CFU/mouse of three derivatives from S. aureus Cowan I with different intrarenal growth were intravenously injected into Ehrlich tumor-bearing mice, they lodged in the tumor tissue at approximately 10(3) CFU/0.1 g by 30 min after infection, and grew in the range of 10(6) CFU/0.1 g to 10(8) CFU/0.1 g by day 4, regardless of their intrarenal growth capacity. In contrast, S. saprophyticus lodged in both tissues to the same degree as S. aureus, but did not grow at all. The time course of the staphylococcal growth was different between tumor tissue and kidney, suggesting differences in the local responses against S. aureus.
A supportive method for clonal identification of Staphylococcus aureus strains was devised. Culture supernatant obtained by cellophane surface culture was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) without performing any concentration procedure prior to electrophoresis. The combined use of cellophane surface culture and SDS-PAGE was convenient for determining whether the strains belonged to the same clone or not when conducted in conjunction with other tests for bacteriological characterization.
Intratumoral growth of Staphylococcus aureus Cowan I-derived AP332 was examined by subcutaneous inoculation of cocci in doses ranging from 18 to 1.8 x 10(5) CFU with Ehrlich ascites tumor cells. Inoculation of 18 CFU AP332 resulted in staphylococcal growth in one of five mice, and the proportion of mice established intratumoral infection increased with the initial inocula. Six other strains of S. aureus also grew in the tumor tissue, and none of the three strains of coagulase-negative staphylococci grew at all. Ethanol-killed tumor cells did not promote staphylococcal growth as vigorously as the live tumor cells, especially when the initial inoculum of AP332 was smaller than 10(4) CFU.
Determined were long-term results of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) adjuvant chemotherapy following radical surgery for locally invasive urothelial cancers. All cases at least histologically exhibited one of the following findings, a stage beyond pT3b (bladder cancer) or pT3 (upper tract urothelial cancer), lymph duct tumor involvement (ly +), venous involvement (V +), and/or regional lymph node involvement (N1) without any evidence of distant metastasis and/or residual tumors. Two cycles of M-VAC chemotherapy were given after radical surgery for each case. A total of 33 cases comprising 21 bladder cancers and 12 upper tract urothelial cancers following cystectomy and/or nephroureterectomy with partial cystectomy who had a mean follow-up period of 56.7 +/- 9.2 months could be analyzed. Overall actuarial survival rates of three- and five-years estimated by Kaplan-Meier method were respectively 41.9% and 31.6%. These results indicate that the postoperative outcome was extremely poor in patients with locally advanced urothelial cancer even after extensive adjuvant chemotherapy. Therefore, more effective modalities including optimal dose and scheduling of chemotherapy are needed to assure therapeutic improvement of locally invasive urothelial cancers.
To observe the upper urinary tract more clearly with a thin flexible endoscope, we developed a novel real-time processing system. This system enhances the parts of the dark cladding around the core by individual strong brightness of each image fiber. The upper urinary tract in eight patients was examined using a thin flexible endoscope with this system at retrograde pyelography or at urological operation. Six patients had hydronephrosis and 2 had filling defects in the renal pelvis or calyx. The endoscope was 0.75 mm in diameter and had 300 pixels of image fiber. The objective portion could be assessed successfully in seven of eight. Significantly finer and colorful image could be obtained with this system compared with the conventional method and the epithelium could be clearly observed. We conclude that this real-time processing system remarkably improves the quality of image obtained with the thin flexible ureteroscope and makes it a more promising modality in the diagnosis and treatment of the upper urinary tract.