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Biomedical subjects

O Yoshida

Publications and source records attributed to O Yoshida.

At least 253 records · Page 14Linked to original sources

Serum antisperm antibodies in men with vas deferens obstruction caused by childhood inguinal herniorrhaphy.

OBJECTIVE: To study the incidence of serum antisperm antibodies in patients with vas deferens obstruction caused by childhood inguinal herniorrhaphy. DESIGN: Retrospective. SETTING: Kansai Medical University and Kyoto University Hospital. PATIENTS: Thirteen patients with vas deferens obstruction caused by childhood inguinal herniorrhaphy. MAIN OUTCOME MEASURES: Indirect immunobead test for serum antisperm antibodies. RESULTS: Of 13 patients, 7 (54%) and 2 (15%) tested positive for immunoglobulin (Ig)G and IgA class antisperm antibodies, respectively; all patients tested negative for IgM class antibodies. The incidence of antisperm antibodies was not different between the patients with possible epididymal obstruction and those without epididymal obstruction. CONCLUSIONS: A significant percentage of patients with vasal obstruction caused by infant inguinal herniorrhaphy have serum antisperm antibodies despite the absence of sperm granulomas.

Adult↗

Long-term followup of the Kock and Indiana pouch procedures.

Between 1984 and 1991, 115 consecutive patients underwent cutaneous continent urinary diversion comprising 76 Kock and 39 Indiana pouch procedures. The 2 different forms of achieving continent urinary diversion were subsequently compared in a long-term followup that evaluated complications, including pouch function and the need for revisions. In the Kock pouch group there were 14 (18.4%) early postoperative complications (3 months), which required 4 subsequent reoperations (5.3%). The Indiana pouch group had a similar incidence of early complications (17.9%) but there were no reservoir related problems. The long-term study group comprised 68 Kock and 37 Indiana pouch patients who were observed for 12 months or longer (mean followup 53 and 34 months, respectively). Of 9 efferent nipple valve malfunctions observed in the Kock pouch group 5 required surgical revision. Of 16 complications related to afferent limb function 15 were caused by the use of polyester fiber fabric for the anchoring collar and 8 of these 15 complications required surgical revision. The first 2 Indiana pouch patients had pouch deformities due to incomplete detubularization of the cecum that required surgical repair. Overall, surgical revisions, including minor repairs, were performed on 15 Kock pouch patients (22.1%) and 4 Indiana pouch patients (10.8%). Both forms of the procedure preserved continence to a satisfactory degree. Urinary tract stones developed in 18 patients (26.5%) from the Kock pouch group, usually on the exposed staples or the eroded, nonabsorbable collar used to construct the nipple valves. Stone formation was rare (5.4%) in the Indiana pouch group. The incidence of ureteral implantation stricture was low in both procedures. There was no significant difference in the incidence of bacteriuria between the 2 methods of urinary diversion. These data demonstrate that the Kock pouch and Indiana pouch procedures can be accomplished with the same early postoperative complication rate. Our 8-year experience showed a high incidence of Kock afferent nipple valve malfunction. However, most of these malfunctions were due to the use of a nonabsorbable collar and can be avoided. When taking this into account, therefore, it can be concluded that the Indiana pouch functions as well as the Kock pouch with roughly the same incidence of late complications and the same reoperation rate but with a lower incidence of stone formation.

Adult↗

A case of a compound heterozygote for adenine phosphoribosyltransferase deficiency (APRT*J/APRT*Q0) leading to 2,8-dihydroxyadenine urolithiasis: review of the reported cases with 2,8-dihydroxyadenine stones in Japan.

We report a case of a compound heterozygote for adenine phosphoribosyltransferase deficiency (APRT*J/APRT*Q0) leading to 2,8-dihydroxyadenine urolithiasis. Polymerase chain reaction-single strand conformation polymorphism analysis demonstrated that APRT*J and APRT*Q0 alleles from the father and mother, respectively, had been transmitted to the patient. We also reviewed the literature regarding Japanese patients with 2,8-dihydroxyadenine urolithiasis. There seemed to be little difference in clinical course between type 2 homozygotes and compound heterozygotes. However, hemolysate APRT activities of compound heterozygotes were lower than those of type 2 homozygotes.

Adenine↗

Should the testicular artery be preserved at varicocelectomy?

A surgical method of varicocelectomy, in which the internal spermatic veins together with the testicular artery are ligated as a whole in the retroperitoneal space, has been proposed as a simple and reliable procedure. We evaluated the effects of ligating the testicular artery at varicocelectomy on fertility. A total of 34 subfertile patients with a left varicocele was randomized into an artery-preserved or artery-ligated group at open varicocelectomy and the change in semen quality was prospectively studied. The artery-preserved group showed improvements in sperm density and total sperm count, while the artery-ligated group showed improvements in sperm density, total sperm count and sperm motility. The results indicated identical improvement in semen quality in both groups of patients. Testicular volume, measured by a punched-out orchidometer, did not change in any of the patients in the ligated group, except for 1 with a grade 3 varicocele, although this decrease could not be detected by sonography. The effects of artery-preserving and artery-ligating varicocelectomy on postoperative pregnancy rates were investigated by examining 116 patients retrospectively. The pregnancy rates of 37.8% and 23.8% in the artery-preserved and artery-ligated groups, respectively, were not significantly different. Despite the theoretical advantage of artery preservation, our study did not show any significant difference between artery-preserving varicocelectomy and the artery-ligating operation when improvements in semen quality and postoperative pregnancy rate were evaluated.

Adult↗

Serum vanadium levels in chronic hemodialysis patients.

Serum vanadium, aluminum, silicon and beta 2-microglobulin levels as well as the red cell count, hemoglobin and systolic blood pressure were simultaneously measured in 80 chronic hemodialysis patients. The serum vanadium level was positively correlated with the serum levels of aluminum, silicon and beta 2-microglobulin as well as the systolic blood pressure, and was inversely correlated with the red cell count and hemoglobin. The mean serum vanadium level was 18.4 +/- 7.6 ng/ml before hemodialysis and decreased to 13.0 +/- 5.30 ng/ml at the completion of dialysis. The dialysate vanadium level increased from 0.4 +/- 0.2 (inflow) to 1.0 +/- 0.4 ng/ml (outflow). It was concluded that vanadium was transferred from blood to dialysate when purified water was used in the preparation of the dialysate.

Aged↗

Effects of erythropoietin on trace elements in patients with chronic renal failure undergoing hemodialysis.

We examined the relationship between recombinant human erythropoietin (rHuEPO) therapy and serum levels of the trace elements aluminum, silicon, zinc, nickel, and manganese in 55 patients undergoing chronic hemodialysis (HD) in whom rHuEPO (for 12 weeks) was effective in reducing anemia, and in 55 patients undergoing HD without rHuEPO treatment. In the rHuEPO group, serum Al level was significantly decreased and Si level showed a tendency to decrease. Zn, Ni, and Mn levels, however, were significantly increased.

Adult↗

Three cases with different types of short-tailed spermatozoa.

Short-tailed spermatozoa were found in 3 men attending our subfertility clinic. Light microscopy revealed basically normal sperm heads, but a short tail was found in 90% or more of the spermatozoa. Scanning and transmission electron-microscopic examinations of the ejaculate revealed several types of short-tailed spermatozoa. In one case, the majority of the spermatozoa had a short, thick tail. In another case, all the spermatozoa were short-tailed, although two different types could be distinguished. As in the first case some spermatozoa were short- and thick-tailed, whereas others possessed an incomplete neck and middle piece, and a short, thick principal piece. In the third case, an elongated middle piece and short principal piece were found in almost all the short-tailed spermatozoa. Our electron-microscopic study revealed that the type of short-tailed spermatozoa was different in each patient.

Adult↗

Effects of shock waves on the male reproductive system.

Although many reports concerning the effects of shock waves on the human body have been published, their effects on the male reproductive system are not well known. This report examines the effects of shock waves on human spermatozoa and rat testes. Semen samples were placed in water at 37 degrees C and 100, 200, 500, and 1,000 shock waves were applied. In proportion to an increasing number of shock waves, sperm motility and the percentage of viable sperm decreased, while the percentage of short-tailed sperm increased. In a second study 500 or 1,000 shock waves were applied to the testes of infant and adult male Wistar rats. Hematomas were observed macroscopically in the testes immediately after shock wave treatment. Light microscopy showed rupture of the basement membrane of the seminiferous tubules and outflow of spermatogenic cells. After 5 weeks, the treated testes appeared atrophic, with the absence of spermatogenic cells in the seminiferous tubules, except for Sertoli cells. Our data indicate that spermatozoa and the testis appear to be structurally damaged by shock waves.

Animals↗

Adenocarcinoma of the urachus associated with stromal osseous metaplasia.

Urachal adenocarcinoma is a rare bladder tumor, occasionally associated with calcification. We report a case of urachal adenocarcinoma with remarkable stromal osseous metaplasia and review the literature on this rare condition. This is the first complete case report in English of this uncommon entity.

Adenocarcinoma, Mucinous↗

High sensitivity to salt in kininogen-deficient brown Norway Katholiek rats.

Brown Norway Katholiek rats, which have very low levels of plasma kininogens, excreted a much smaller amount of kinin in the urine than normal rats of the same strain. The systolic blood pressure of 7-week-old kininogen-deficient rats fed low (0.3%) NaCl diets (131 +/- 4 mm Hg, n = 12) was not different from that in normal rats. Two percent NaCl diets given from 7 weeks of age for 4 weeks caused rapid increases in blood pressure (167 +/- 4 mm Hg, n = 12, 9 weeks old) in deficient rats, although the same diets induced no blood pressure increase in normal rats. Urinary excretion of active kallikrein and prokallikrein remained constant in both rat groups throughout NaCl loading. During this period, the deficient rats secreted less urine (9 weeks old, P < .05) and less urinary sodium (11 weeks old, P < .05). Serum levels of sodium in deficient rats were higher (P < .05) than in normal rats at 9 weeks of age. Intracellular concentrations of sodium in the erythrocytes of deficient rats were higher (P < .05) than in normal rats throughout NaCl loading. Subcutaneous infusion of bovine low molecular weight kininogen with an osmotic pump in NaCl-loaded deficient rats induced a reduction (P < .01) in blood pressure and increases (P < .05) in urine volume and urinary sodium and kinin levels. By contrast, subcutaneous infusion of the bradykinin antagonist Hoe 140 or of aprotinin in NaCl-loaded normal rats induced a hypertensive response. This antagonist treatment reduced urine volume and urinary sodium. These results indicate that the lack of kinin generation observed in the kininogen-deficient rats was related through sodium retention to the hypertensive response to NaCl loading.

Aging↗

[Microsurgical vasovasostomy and epididymovasostomy for seminal tract obstruction: cause of obstruction and operative outcome].

The surgical outcome in 42 patients with seminal tract obstruction who underwent microsurgical vasovasostomy or epididymovasostomy and were followed up for more than 3 months postoperatively is reported. Causes of the obstruction were vasectomy in 7 patients, childhood inguinal herniorrhaphy in 15, epididymitis in 5, Young's syndrome in 3 and others in 12. Twenty-eight patients had bilateral obstruction while 14 had unilateral obstruction. After 51 operations, including 11 reoperation in 9 patients, the anastomosis was patent in 83.3%, semen quality normalized in 21.4% and pregnancy was achieved in 31.0% of the 42 patients. Success rate of vasovasostomy and epididymovasostomy was 57.7% and 78.3%, respectively. Factors detrimentally affecting the operative outcome were obstruction due to Young's syndrome, obstruction for more than 10 years, absence of sperm in vasal fluid during the operation, elevated serum FSH levels and presence of seminal tract anomaly. Presence of serum antisperm antibodies had no effect on pregnancy rate. Microsurgical reanastomosis of the seminal tract resulted in restoration of fertility in many patients with seminal tract obstruction who had normal testicular spermatogenesis.

Adult↗

[Transurethral microwave thermotherapy for benign prostatic hyperplasia: clinical evaluation with International Prostate Symptom Score (I-PSS)].

Forty patients with symptomatic benign prostatic hyperplasia were treated with a single session of transurethral microwave thermotherapy (TUMT) using a Prostatron. The clinical effectiveness was evaluated by analyzing the subjective and objective responses following the treatment. The International Prostate Symptom Score (I-PSS) and quality of life (QOL) scale were used to evaluate the subjective symptoms. At three months after treatment, significant improvements in I-PSS (p < 0.0001). QOL (P < 0.0001), and peak flow rate (Qmax) (p < 0.05) were observed. Improvement of both I-PSS and Qmax was found in 90% (18/20) of the patients at 2 months. Although 15 patients noted transient urinary retention and 15 patients had mild to moderate macroscopic hematuria immediately after TUMT, no severe adverse effects occurred during the follow-up period. A significant correlation was found between I-PSS improvement and the total thermal dose delivered. However, the thermal dose could not be predicted in each case. The preliminary findings suggest that TUMT by Prostatron is safe and effective as a nonsurgical treatment for benign prostatic hyperplasia. The clinical response seems to be thermal dose dependent. I-PSS is clinically sensitive and is useful in practice.

Aged↗

[Human prostatic tissue specific antigens: a model for the research of monoclonal antibodies against unknown antigens].

Mouse monoclonal antibodies were prepared using a cell mixture containing prostatic secretory, basal cells and stromal cells as an immunogen, and by the immunofluorescence method with cryosections of prostate tissue. An immunohistochemical screening process was used in the expectation that it would help identify not only the antibodies reacting with the secretory cells predominant in the prostate but also those reacting with relatively rare cells in the prostate tissue. Two cell clones have been established which produce antibodies (IgG1) that react well with prostatic secretory cells: a clone producing antibodies specific to prostatic acid phosphatase (PAP) and one producing antibodies specific to prostate-specific antigen (PSA). These antibodies could recognize the native antigens in the seminal plasma, respectively. These findings indicate that antibodies recognizing only one substance can be prepared, even when a mixture of prostatic tissue including many proteases is used as an immunogen. Production of antibodies against prostate-specific antigens other than PAP and PSA by this method should provide a useful means for analyzing unknown antigens in the prostate.

Acid Phosphatase↗

Use of a new hypersensitive assay for the detection of prostate specific antigen in prostate cancer.

We have developed a new hypersensitive enzyme immunoassay for prostate specific antigen (PSA) based on the (MARKIT-M PA) assay but employing a two-hour incubation of the primary monoclonal antibody. The analytical sensitivity has been determined at 0.2 ng/ml, calculated as the mean+three standard deviations of the zero calibrator. Serum PSA was measured at least one month after radical prostatectomy (nine patients) or cystoprostatectomy (six patients). Based on the PSA levels of these patients, the recommended PSA cut-off level indicative of residual disease after radical prostatectomy was 0.4 ng/ml. Increasing (> 0.4 ng/ml) PSA levels preceded recurrence by eight months in a patient who developed bone metastasis after radical prostatectomy. In two patients treated with endocrine therapy, increasing PSA levels also preceded clinical evidence of progression by between eight and nine months. The study suggests that the newly developed sensitive PSA assay allows for the identification of patients with disease progression and the early commencement of adjuvant treatment.

Humans↗

[Preventive chemotherapy after transurethral prostatectomy: a randomized study].

The usefulness of preventive chemotherapy was studied in transurethrally prostatectomized patients with no prior urinary tract infections. They were divided into two groups (A and B) randomized by the envelope method. A was administered intravenously piperacillin (PIPC) 2 g once after surgery, and twice on the following day. B was similarly administered PIPC intravenously, followed by oral administration of tosufloxacin tosilate (TFLX) 300 mg twice daily from the second to the fifth day. Of the total of 135 cases, 104, 45 in A and 59 in B, conformed to the patient standards established for analysis. Efficacy was assessed by the primary physician and also according to a unified standard in which the onset of a post-surgical infection and a bacteriuria of 10(4) or greater CFU/ml observed ten days after surgery were regarded as ineffective. An intergroup statistically significant difference was not observed in the efficacy rate assessed by the primary physician. However, according to the unified standard assessment, B showed a significantly higher efficacy rate (88.1%) than A (62.2%). The administration of TFLX following PIPC was useful. With an indwelling catheter, B exhibited a significantly greater efficacy rate when the retention period was four days or longer. The efficacy was greater in both groups if lavage was not performed, and this effect was greater in A. Consequently, the administration of TFLX was considered more useful for long-term indwelling catheter cases. Neither serious side effects, nor clinical test abnormalities were observed in this study.

Aged↗