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Biomedical subjects

O Yoshida

Publications and source records attributed to O Yoshida.

At least 307 records · Page 17Linked to original sources

Evaluation of the usefulness of a novel injectable cephalosporin, E1040, and ceftazidime for management of complicated urinary tract infections caused by Pseudomonas aeruginosa and Proteus mirabilis by using the rat urolithiasis model.

A novel injectable cephalosporin, E1040, significantly eradicated Pseudomonas aeruginosa from the urine, in contrast to ceftazidime, in rats with complicated P. aeruginosa urinary tract infections associated with urinary stones, suggesting that E1040 is a prospective therapeutic agent in the management of refractory Pseudomonas urinary tract infections.

Animals↗

Carcinosarcoma of the prostate.

A very rare case of carcinosarcoma of the prostate is reported. The patient was a 77-year-old man in whom both primary and metastatic tumors presented the pathology of carcinosarcoma of the prostate. The carcinosarcoma was resistant to anti-androgen therapy, and the patient showed low level of serum prostatic acid phosphatase and was free from bony metastases despite multiple metastases to the lung, liver, pancreas, para-aortic lymph nodes, spleen and penis. The sarcomatous component consisted of chondrosarcoma and fibrosarcoma, both of which were positive for vimentin. The carcinomatous component was positive for both keratin and prostatic acid phosphatase.

Acid Phosphatase↗

[Inhibitory effects of Hachimijiogan on micturition reflex via the locus coeruleus].

Pharmacological studies were undertaken to elucidate the role of Hachimijiogan in the micturition reflex via the locus coeruleus, using alpha-chloralose-anesthetized cats. Rhythmic contractions of the urinary bladder induced by continuous infusion of saline into the bladder were dose-dependently inhibited by intravenous injection of Hachimijiogan (10, 30 and 90 mg/kg), as well as flavoxate hydrochloride (1 and 3 mg/kg). In contrast, contraction of the urinary bladder elicited by electrical stimulation of the locus coeruleus was significantly suppressed by intravenous injection of flavoxate, but not affected by that of Hachimijiogan. These results suggest that Hachimijiogan acts on the afferent pathway from the urinary bladder to the locus coeruleus, thereby inhibiting the micturition reflex, while it has no effects on the efferent pathway from the locus coeruleus to the urinary bladder.

Animals↗

[Value of prostate-specific antigen measurements with newly developed enzyme immunoassay (MARKIT-M PA)].

Serum prostate-specific antigen (PSA) levels in patients with prostate cancer and benign prostate hypertrophy (BPH) were investigated with a newly developed enzyme immunoassay (MARKIT-M PA, Dainippon Pharmaceutical Co. Ltd., Osaka, Japan). Sensitivity of the assay system is 0.5 ng/ml and the detection range is 0.5-100 ng/ml. There was a high linear correlation (r = 0.987) between the assay and MARKIT-F PA, and values obtained with the assay were almost equal to those yielded by MARKIT-F PA assay. Using the BPH group as a negative control, the upper cut-off value in BPH patients was determined to be 3.6 ng/ml. Of the 48 patients with untreated prostate cancer, 77% was detectable by means of MARKIT-M PA assay. Using the BPH group as a negative control, specificity and efficiency were 93% and 86%, respectively. In another group of 27 BPH patients whose blood samples were taken immediately after digital prostatic examination, PSA was elevated in 15%. During follow-up of prostate cancer patients, PSA was elevated in 82% at the time of clinically detectable progression. In 15 patients whose disease was clinically well controlled, all levels of PSA were observed to be negative. These findings suggests that detection of serum PSA with this assay is of great use both in the diagnosis and monitoring of prostate cancer patients.

Biomarkers, Tumor↗

[Clinical analysis of urolithiasis in Poh Ai Hospital of I-Lan, Taiwan, R.O.C.--a comparative study with urolithiasis in Japan].

Between August 1987 and December 1990, 546 patients were admitted to the department of Urology at the Poh Ai Hospital of I-Lan, Taiwan, R.O.C. for the treatment of urinary stones. These urinary stone cases accounted for 50 to 60% of all urology patients admitted. The incidence of urolithiasis in I-Lan was estimated at 147/100,000 population in 1990. There were 402 male patients and 144 female patients, The male to female ratio was 2.8: 1. There were 450 upper urinary tract stones (kidney, ureter) in 314 males and 136 females, and 79 lower urinary tract stones (bladder, urethra) in 72 males and 7 females. The ratio of upper to lower urinary tract stones was 6:1. Endourological treatments such as percutaneous nephrolithotripsy and transurethral ureterolithotripsy have increased rapidly in recent years. A summary of the present analysis for composition of 365 stones follows. The most frequent type was calcium-containing stone (92.3%), followed by infection stone (4.7%), then uric acid (UA) stone (3.0%). There were no UA stones found in the female patients. According to urinalysis criteria of more than 10 WBC/HPF (x 400), pyuria was found in 67 cases of 334 metabolic stones (20.1%), and 11 cases of 17 infection stones (67.7%). There were neither pediatric case of stone formation nor cystine stones.

Adolescent↗

[Clinical significance of stereological estimation of mean nuclear volume in human bladder carcinoma--further analysis of nuclear morphometric variables].

Recently, nuclear morphometry methods have been used to quantitatively analyze the malignant potential of cancer cells. We have previously shown that the malignant potential of human bladder carcinoma can be analyzed quantitatively through mean nuclear volume measurements. In the present study, we examined other measurements obtained from nuclear morphometry and evaluated their usefulness as indicators of the outcome of bladder carcinoma. Our subject group consisted of 161 patients with untreated bladder carcinoma. Four nuclear morphometric values were measured on each subject: the mean nuclear volume (MNV), the mean nuclear area (MNA), the nuclear roundness factor (NRF) and the variation of nuclear area (VNA). MNV, MNA and VNA values increased as the tumors progressed to a more advanced stage and grade of malignancy. Patients were then divided into two subgroups based on each morphometric value: small MNV (< 186.9 microns3) and large MNV (> or = 186.9 microns3); small MNA (< 33.6 microns2) and large MNA (> or = 33.6 microns2); low NRF (< 81.1) and high NRF (> or = 81.1); and low VNA (< 33.0) and high VNA (> or = 33.0). Survival rates were significantly higher among patients with a small MNV, a small MNA and a low NRF (5-year survival rate; 93.0, 84.9 and 84.6%), compared to patients exhibiting high values (5-year survival rate; 59.7, 61.3 and 61.9%). For patients with grade 2 tumors, those with a small MNV had a high survival rate (5-year survival rate; 95.2%), similar to that of patients with grade 1 tumors (5-year survival rate; 95.2%)(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Prophylactic effect of UFT in combination with intravesical chemotherapy on the recurrence of superficial bladder tumor].

The influence of N1-(2-tetrahydrofuryl)-5-fluorouracil plus uracil (UFT) on the recurrence of superficial bladder tumors was evaluated in a randomized clinical study. Group A (n = 196) underwent transurethral resection (TUR) and the intravesical chemoprophylaxis, while group B (n = 193) received 400 mg per a day of UFT orally for 6 months in addition to the instillation therapy. These adjuvant therapy was started one week after TUR. Consequently, 30 patients in group B showed UFT-related toxicity and administration of UFT was discontinued in 10 of them. In addition, 87 patients in group B did not complete the 6-month course of UFT administration. Comparison of 2-year actuarial non-recurrence curves revealed no significant difference between groups A and B. However, UFT seemed to have a favorable prophylactic effect when recurrence rates were compared among those patients with recurrent tumors (generalized Wilcoxon: p = 0.1277), and those with recurrent multiple tumors (p = 0.0847).

Administration, Intravesical↗

[Clinical application of Dornier Lithotripter Compact for upper urinary tract stones].

The results of clinical application of a Dornier Lithotripter Compact (Dornier Medical Systems Co., Ltd.) on upper urinary tract stones are presented. Between October 1991 and June 1992, 30 patients with upper urinary tract stones were treated with ESWL in the Department of Urology, Kyoto University. Although 49 sessions for 32 stones in total were carried out without anesthesia, analgesics such as indomethacin and/or pentazocine were required in 37 sessions (76%). Stone-free rate 3 months after the last session was 12/30 cases (40%) and the success rate, the ratio of the patients without residual stone or with residual stones less than 4 mm to total 30 patients, was 18/30 (60%) at the point. Macrohematuria was seen after the treatment in 42/49 (86%) sessions, but it disappeared within 3 days in all instances. Pain necessitating analgesics after the treatment was seen in 16/49 (33%) sessions. Subcutaneous bleeding and fever-up of less than 38 degrees C were seen in 15/49 (31%) and 8/49 (16%) sessions, respectively, but bacteremia after the treatment was not detected in any case. No serious adverse effects were observed in blood chemistry. The Dornier Lithotripter Compact is considered to be useful in the treatment of renal and upper third ureteral stones.

Adolescent↗

Intraarterial lymphocyte-injection therapy for lymphedema of the leg: an examination using indium-111 oxine labeled autologous lymphocytes.

A 58-year-old female patient with lymphedema of the left leg was treated by repeated intraarterial lymphocyte-injection therapy. To elucidate whether the injected lymphocytes act at the affected site of the leg, we examined the distribution of the In-111 oxine labeled lymphocytes injected into the proximal artery to the affected leg in comparison with the distribution in the other, healthy, leg. The radioactivity of the affected leg was almost two times higher than that of the healthy leg during the first 30 min after injection, and it remained higher even after 24 hours. The circumference of the affected leg of the patient decreased steadily during her hospital stay. These results, together with the clinical findings, suggest that some of the intraarterially-injected lymphocytes remained in the affected leg at least 24 hours and might play some role in reducing the volume of lymphedematous fluid.

Blood Component Transfusion↗

[Long-term outcome of cryptorchism after orchiopexy].

The long-term outcome of cryptorchism (undescended testis) was studied in 43 patients who underwent orchidopexy at pre-puberty ages and who were over 15 years of age at the time of this study. The follow-up period after operation was 11 approximately 23 years. Cryptorchism was unilateral in 39 patients and bilateral in 4 patients. The sperm concentration and motility were examined, using a cut-off level of 20 x 10(6)/ml for sperm concentration and 50% for sperm motility. In the unilateral cryptorchism group, 16 patients (61.5%) had normal semen quality, 8 patients (30.8%) oligozoospermia, 1 (3.8%) asthenozoospermia and 1 (3.8%) azoospermia. In the bilateral cryptorchism group, 3 patients (75.0%) were normal and 1 (25.0%) had azoospermia. Eight patients with unilateral cryptorchism were married and 7 of them (87.5%) had children. The sperm concentration had no inverse correlation with the age at operation. In patients with unilateral cryptorchism, the testicular volume on the healthy side was significantly higher than that on the affected side. The sperm concentration tended to correlate with the testicular volume on the healthy side rather than that on the affected side. These findings suggest that the sperm profiles in patients with unilateral cryptorchism are chiefly associated with the testicular function on the healthy side.

Adolescent↗

[Experience with laparoscopic nephrectomy].

Laparoscopic procedures are promising techniques which allow less invasive surgery not only for intra-abdominal organs but also for retroperitoneal organs. Laparoscopic nephrectomy was first described by Clayman et al. We removed the left kidney of a 36-year-old male patient using laparoscopic procedures according to Clayman's technique. The kidney had developed hydronephrosis due to congenital ureteropelvic junction stenosis. In the peritoneal cavity the freed kidney was pushed into a Lapsac, minced using scissors and forceps, and removed without elongation of the wound. During the operation, pneumoperitoneum with CO2 gas induced increases in PaCO2, central venous pressure, pulmonary artery wedge pressure and cardiac output, all of which the patient tolerated well. The patient was discharged from the hospital on the 9th postoperative day. Laparoscopic nephrectomy is a useful alternative to the conventional open surgery in selected cases, when surgical techniques and instruments are improved appropriately.

Adult↗

[Laparoscopic pelvic lymphadenectomy in patients with localized prostate cancer].

Laparoscopic pelvic lymphadenectomy is a newly developed technique of lymph node dissection in patients with malignancy of the pelvic organs. Three patients with localized prostatic cancer underwent laparoscopic pelvic lymphadenectomy. The patients were 77 years old with stage C disease, 73 with stage B1, and 65 with stage A2. Five to ten lymph nodes were removed from each patient after laparoscopic procedures lasting 220 to 270 minutes. There were no complications during the procedures and their convalescence was uneventful. All lymph nodes were negative by pathological examination and a radical retropubic prostatectomy was done 2 weeks after the lymphadenectomy in two patients. The other patient was treated with external radiotherapy and bilateral orchiectomy. Patients with stage C cancer, a high serum level of prostate specific antigen or a high grade tumor are the best candidates for this less invasive staging procedure. The disadvantage of this procedure is long operation time and complications due to CO2 pneumoperitoneum.

Aged↗

[Treatment of endocrine-resistant stage D carcinoma of the prostate with a cisplatin derivative (DWA2114R): a pilot study].

DWA2114R (DWA) is a new derivative of platin compounds. Eleven patients with rapidly progressive, endocrine-resistant stage D carcinoma of the prostate were treated with infusion of DWA (800-1,000 mg/m2) every 3 to 4 weeks. A partial objective response was observed in 3 of 11 patients (27%). This response lasted from 5 to 11 months with an average of 7.7 months. Six patients (55%) had a significant decrease or disappearance of bone pain and five became ambulatory and asymptomatic. Four patients (36%) showed no change, and four patients (36%) did not respond to the treatment and showed progression of their disease. There were no patients with severe leukopenia (less than 1,000/mm3). No significant renal toxicity was observed in any of the patients and gastrointestinal toxicity was tolerable. DWA appears to be an effective drug available for the treatment of endocrine-resistant advanced carcinoma of the prostate.

Adenocarcinoma↗

[An experience with augmentation sigmoid cystoplasty for urinary incontinence caused by sacral agenesis: a case report].

Sacral agenesis is an uncommon disease. About 50 cases have been reported in Japan since 1929. Neurogenic bladder is often accompanied with the disease. The patient was a 26-year-old man who had suffered from persistent urinary incontinence since his childhood. Kidney-ureter-bladder (KUB) revealed Type IV sacral agenesis according to the classification by Renshaw. The upper urinary tract remained normal. Urodynamics study showed a low compliance bladder with low urethral pressure. Pharmacotherapy failed to improve his continence. Augmentation sigmoid-cystoplasty was undertaken to enlarge vesical capacity and it has successfully overcome his urinary incontinence. Clinical aspects of sacral agenesis are discussed focusing on urological problems.

Adult↗

[Nerve-sparing retroperitoneal lymph node dissection for stage IIA testicular embryonal carcinoma: a case report].

A 32-year-old man who had left testicular embryonal carcinoma with low volume left para-aortic lymph node swelling was treated initially with 3 courses of cisplatin-based combination chemotherapy. Pathological findings of the primary lesion revealed no yolk sac element and no elevation of serum alpha fetoprotein (alpha-FP) and beta-human chorionic gonadotropin (beta-HCG) levels even before the left orchiectomy. Therefore, the retroperitoneal lymph node dissection (RPLND) was performed despite marked shrinkage of the enlarged nodes. The L1-3 lumber splanchnic nerves from the right sympathetic truncus were detected in the intra-aortocaval region to prevent impairment of ejaculatory function and the lymph nodes in the area were removed one by one between the preserved neurofibers. On the other hand, the left para-aortic lymphatic tissue which included enlarged nodes was dissected in en bloc manner. The pre-aortic lymphatic tissue caudally to the inferior mesenteric artery was preserved not to be touched. The patient ejaculated normally 3 weeks after the RPLND. Treatment of stage IIA disease with chemotherapy first might be helpful in performing RPLND, if necessary, with keeping both ejaculatory function and radicality.

Adult↗

[Pseudosarcomatous fibromyxoid tumor of the urinary bladder: a case report].

A 41-year-old man was referred to our clinic for gross hematuria. Cystoscopy revealed a 6 x 5 x 5 cm wide-based tumor located at the dome of the bladder. Pathological diagnosis of the biopsy was pseudosarcomatous fibromyxoid tumor. Microscopically this tumor was composed of spindle cells and myxoid stroma, and immunohistochemical and ultrastructural studies showed benign characteristics of this tumor. Therefore partial cystectomy was performed. It is important to recognize the histological characteristics of this essentially benign condition so that total cystectomy can be avoided.

Adult↗

[Circumvention of the intrinsic multidrug-resistance in renal cell carcinoma].

Most of renal cell carcinomas (RCCs) are refractory at the start of chemotherapy. We have demonstrated that the frequently elevated expression of the multidrug resistance gene (MDR) in RCCs is associated with the intrinsic vinca alkaloids and anthracyclines resistance. The preliminary clinical trials using verapamil or amiodarone in combination with vinblastine or doxorubicin to overcome multidrug-resistant (MDR) tumors could not achieve satisfactory results owing to severe cardiovascular toxicities of such reversing agents. In the present study, we studied the sensitizing ability of bis-benzyl-isoquinoline (cepharanthine) and SDB-ethylenediamine (N-1379) in natural MDR kidney cancer cells. Cepharanthine remarkably sensitized vinblastine and doxorubicin sensitivities in those cells with high MDR RNA levels. From a clinical point of view, cepharanthine seems to be a potent and less toxic agent to treat natural MDR kidney cancers.

Alkaloids↗

[Anti-interleukin-6 (IL-6) therapy of IL-6-producing renal cell carcinoma].

Interleukin-6 (IL-6) has been demonstrated to be an autocrine growth factor of renal cell carcinoma in vitro and released IL-6 has been thought to elicit the acute phase response in vivo. We investigated the possibility of anti-IL-6 therapy of IL-6-producing renal cell carcinoma. There was a dose-dependent decrease in the number of colonies formed in vitro of NC65 renal cell carcinoma cell line in the presence of dexamethasone which is known to inhibit the induction of IL-6 messenger RNA. IL-6 receptor antisense oligonucleotide and anti-IL-6 receptor antibody also showed growth inhibition of NC65 cells. IL-6 antisense oligonucleotide and anti-IL-6 antibody did not alter the proliferation of NC65 cells. These findings suggest that inhibitors of IL-6 production or IL-6 function may be useful for some renal call carcinoma patients.

Carcinoma, Renal Cell↗