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Biomedical subjects

R Hattori

Publications and source records attributed to R Hattori.

At least 91 records · Page 5Linked to original sources

[Clinical outcome of radical prostatectomy and pelvic lymph node dissection].

Between September, 1987 and September, 1993, a total of 44 consecutive patients had undergone radical retropubic prostatectomy and pelvic lymphadenectomy for the treatment of prostate cancer. The patients were between 56 and 77 years (mean, 68 years). Eleven patients had clinical state A2 disease, 21 had stage B disease, and 12 had stage C disease. Fourteen of the 44 patients (32%) had positive lymph node metastases. The 5-year survival rate for patients with pT1, pT2 and pT3 was 100%, 71% and 87%, respectively. It was 77% in patients with positive node disease and 90% in patients with negative node disease. The 5-year disease-free survival rate for patients with pT1, pT2 and pT3 was 82%, and 78%, respectively. It was 54% in patients with positive node disease and 88% in patients with negative node disease. In 14 positive node patients, metastases were located in obturater nodes in 8 patients (57%), hypogastric nodes, in 6 patients (43%), external iliac nodes in 6 patients (43%), common iliac nodes in 4 patients (29%) and presacral nodes in 2 patients (14%). We confirmed that radical retropubic prostatectomy is effective treatment for locally confined prostate cancer and removal of obturater, hypogastric lymph nodes and the internal chain of external iliac lymph nodes is important in detecting metastases.

Aged↗

Cloning and structural characterization of the human endothelial nitric-oxide-synthase gene.

Nitric oxide accounts for the activity of endothelium-derived relaxing factor, which seems to have an important role in vasodilation and inhibition of platelet aggregation. In endothelial cells, one isoform of nitric-oxide synthase is constitutively expressed. Analysis of the cDNA encoding the human endothelial nitric-oxide synthase revealed that the mRNA is 4.1 kb in size and that the translated protein consists of 1203 amino acids. We have cloned a genomic DNA encoding the human endothelial nitric-oxide synthase and analyzed the entire nucleotide sequence of the gene. The gene consists of 26 exons with a total size of 21 kb. The 5' flanking region of the gene lacks TATA boxes, but it contains putative Sp1-binding sites in (G+C)-rich regions. Of particular interest is the fact that a shear-stress-responsive element is located at position -985, which probably regulates the nitric-oxide-synthase gene in response to fluid mechanical forces at the transcriptional level in the vascular endothelium. Two minisatellite sequences are detectable in introns 2 and 8; a 32-bp consensus sequence repeats 38 times and a 57-bp consensus sequence repeats ten times. We found polymorphisms of the BamHI fragment containing the former minisatellite sequence in genomic DNA from pedigree family members. Furthermore, five tandem repeats of a 27-bp core consensus sequence and 35 repeats of a dinucleotide (CA) are located in introns 4 and 13, respectively. These repeat sequences will probably provide genetic markers for gene mapping and linkage analysis of inherited diseases including cardiovascular diseases.

Amino Acid Oxidoreductases↗

Three distinct subpopulations of GABAergic neurons in rat frontal agranular cortex.

GABAergic interneurons in the rat frontal cortex were subdivided on the basis of immunoreactivity for calcium binding proteins, neuropeptides and nitric oxide synthase, using double immunofluorescence and mirror image immunohistochemical methods. The results indicate that in this region of the neocortex there are at least three distinct subpopulations of local circuit neurons. The first subgroup consists of parvalbumin-immunoreactive cells. Those do not contain neuropeptide, calretinin or nitric oxide synthase immunoreactivity. A substantial number of parvalbumin-immunoreactive cells in layer II/III were also immunoreactive for calbindin D28k. The second subgroup consists of cells immunoreactive for calretinin. Most were usually immunoreactive for vasoactive intestinal polypeptide as well, but a few cells in layer II/III were immunoreactive for one or the other only. Calretinin-immunoreactive cells do not colocalize parvalbumin, somatostatin or nitric oxide synthase, and only a few colocalize calbindin D28k. The third subgroup consists of cells most of which contain somatostatin, and is entirely separate from the parvalbumin- and calretinin-immunoreactive populations. There was substantial colocalization of somatostatin and calbindin D28k and of somatostatin and neuropeptide Y. Some somatostatin-immunoreactive cells showed nitric oxide synthase immunoreactivity. All of the populations of immunoreactive cells examined in the present study also showed GABA immunoreactivity. About 10% of calbindin D28k-immunoreactive cells and all of those strongly stained for calbindin D28k in layer II/III showed GABA immunoreactivity. Most calbindin D28k-positive cells in deep layers also showed GABA immunoreactivity. These results support that almost all calbindin D28k-immunoreactive non-pyramidal cells are probably GABAergic.

Amino Acid Oxidoreductases↗

Preferential inhibition of inducible nitric oxide synthase by ebselen.

Ebselen, 2-phenyl-1,2-benzisoselenazole-3(2H)-one can preferentially inhibit the activity of inducible nitric oxide (NO) synthase with little inhibition of endothelial constitutive NO synthase within a certain concentration range. This suggests that ebselen deserves further in vivo studies to examine its possible application to the therapy of septic shock where inducible NO synthase is responsible for vasodilation.

Amino Acid Oxidoreductases↗

Nitric oxide synthase immunoreactivity colocalized with NADPH-diaphorase histochemistry in monkey cerebral cortex.

The distributions of reduced nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) and nitric oxide synthase (NOS) containing neurons and the extent of NADPH-d and NOS colocalization have been analyzed by histochemical and immunocytochemical techniques in the neocortex of Macaca fuscata monkeys. NADPH-d positive cells were consistently also NOS positive and presented a relatively uniform distribution from area to area, but area-specific differences were observed in the pattern of distribution of fiber plexuses.

Amino Acid Oxidoreductases↗

Structure and function of nitric oxide synthases.

Nitric oxide (NO), which accounts for the biological activity of endothelium-derived relaxing factor, is now thought to play a variety of roles in the nervous system and in immunologic reactions. NO is synthesized from L-arginine by nitric oxide synthase (NOS). There are three isoforms of NOS; type I (neuronal), type II (inducible), and type III (endothelial). The fundamental structure of the three isoforms, which contain calmodulin-, FMN-, FAD-, and NADPH-binding domains, is the same. Calmodulin is already bound to inducible NOS without requiring Ca2+, while the others are Ca2+/calmodulin-dependent. Endothelial NOS is bound to membranes by N-myristoylation, while the other isoforms are soluble. The human endothelial NOS gene has been cloned. It has several highly repetitive regions which could provide potential sites for DNA polymorphism. It might be of interest to examine the relationship between such polymorphism and cardiovascular disorders.

Amino Acid Oxidoreductases↗

Laparoscopic radical nephrectomy for renal cell carcinoma: early experience.

We developed a laparoscopic radical nephrectomy for malignant disease of the kidney and successfully performed the operation in six patients between July 1992 and October 1993. This procedure is basically derived from that of Clayman and associates. A CO2 pneumoperitoneum is induced, and five trocars are introduced into the abdominal cavity through the lateral abdominal wall. The kidney is removed en bloc together with the adrenal gland, perirenal fatty tissue, and Gerota's fascia. The free kidney is put into a laparoscopy sack, and the sack is pulled out through a 5- to 6-cm incision in the abdominal wall without morcellation to allow complete pathologic examination. By this procedure, right nephrectomy was performed in four patients and left nephrectomy in two patients. The mean operative time was 6 hours and 13 minutes, and the mean blood loss was 430 mL. There were no severe complications. The average hospital stay was 11 days, and the average time to full convalescence was 21 days. Pathologic examination revealed renal cell carcinoma in five patients and nephroblastoma in one. Of the patients with renal cell carcinoma, the stage was pT1pN0pM0 in three patients and pT2pN0pM0 in two. There has been no recurrent disease in these six patients with a mean follow-up period of 9.5 months.

Adult↗

[Laparoscopic pelvic lymphadenectomy in prostate cancer].

We described the clinical results and efficacy of laparoscopic pelvic lymphadenectomy for localized prostate cancer. This procedure was followed by radical prostatectomy, if metastasis was not found in frozen section. In the presence of positive nodes, optional treatment, such as TUR or castration, other than radical prostatectomy was performed. We performed laparoscopic lymphadenectomy on twenty seven patients between April 1992 and September 1993. They range from 52 to 78 years in age and consist of 4 patients with stage A2, 17 with stage B, and 6 with stage C. We dissected the obturator lymph nodes on bilateral sides. The average operating time was 162 minutes (range 86 to 320 minutes). The average number of nodes removed from the right side was 7.1 +/- 5.9 and 6.1 +/- 4.5 from the left side, which was comparable to the number of lymph nodes obtained by open dissection. Colon injury occurred in one patient, which was managed by laparotomy procedure. Nodal metastases were found in 6 patients by frozen section, and in 10 patients by permanent section. This discrepancy suggested that two-staged operation might be preferable for the localized prostate cancer. Six patients were given suitable therapies besides radical prostatectomy. Laparoscopic pelvic lymphadenectomy is a safe and useful procedure for prostate cancer, especially for the patients who are likely to have nodal metastasis.

Aged↗

[A case of recurrent yolk sac tumor of testis in a 3-year-old child successfully treated by VAC (vincristine, actinomycin-D, cyclophosphamide) therapy].

A case of recurrent yolk sac tumor in a three-year-and five-month old child is reported. Left high orchiectomy was performed two years earlier at which time no evidence of metastatic disease was demonstrated. Twenty-four months postoperatively, serum alpha-fetoprotein (alpha-FP) was elevated and recurrent mass appeared in the left para aortic region. Treatment by VAC regimen consisting of vincristine, actinomycin D and cyclophosphamide was performed. Complete response was obtained after two courses of this therapy, which was confirmed by retroperitoneal lymphadenectomy. We believe that this chemotherapy is effective and safe for the treatment of yolk sac tumor of infantile testis.

Antineoplastic Combined Chemotherapy Protocols↗

Emergency coronary angioplasty for acute myocardial infarction: predictors of early occlusion of the infarct-related artery after balloon inflation.

THE FACTORS RESPONSIBLE FOR EARLY OCCLUSION OF THE INFARCT VESSEL AFTER emergency percutaneous transluminal coronary angioplasty (PTCA) were retrospectively examined in 191 patients with acute myocardial infarction. During the 24-hour period after the initial balloon inflation, 47 patients (25%) had occlusion of the vessel (occlusion group), whereas 144 did not (nonocclusion group). The former patients immediately underwent repeat PTCA, which was successful in 37. Univariate correlates of early occlusion were a shorter time interval between the onset of symptoms and PTCA (3.5 +/- 2.2 vs 4.5 +/- 2.9 hours, p = 0.025), right coronary artery involvement (53% vs 30%, p = 0.015), prior thrombolytic therapy (49% vs 32%, p = 0.035), and undersized inflation (43% vs 17%, p < 0.001). With multivariate analysis the three independent predictors were undersized inflation (p < 0.001), right coronary artery involvement (p = 0.004), and a shorter time interval until PTCA (p = 0.011). Thus patients undergoing early PTCA and having right coronary artery involvement appear to be at greater risk of having early occlusion. Thrombolytic agents and undersized inflation may also play an important role in its development.

Aged↗

Magnetic resonance images of hematospermia.

Seminal vesicles and their adjacent structures were studied using magnetic resonance imaging (MRI) in 7 normal volunteers and 15 patients with hematospermia. Normal seminal vesicles are depicted on T2-weighted images either as a mixture of high- and low-signal granules or as a convolution of tubules with a diameter of less than 0.5 cm. Fourteen of the 15 patients with hematospermia exhibited abnormalities on MRI. Dilatation or cyst formation in the seminal vesicle was observed in 13 patients, and a dilatation of the midline structure was seen in 3 patients. Abnormal signal intensity of the seminal vesicles was seen in 11 patients and was thought to be due to subacute hemorrhage.

Adult↗

Stabilization of inducible nitric oxide synthase by monoclonal antibodies.

We have produced 14 monoclonal antibodies to inducible nitric oxide synthase purified from rat peritoneal cytotoxic activated macrophages. None of the antibodies showed neutralizing activity, but some of them enhanced the enzyme activity through stabilization of the enzyme.

Amino Acid Oxidoreductases↗

A stable L-arginine-dependent relaxing factor released from cytotoxic-activated macrophages.

It has been known that cytotoxic-activated macrophages release an unstable vasorelaxing substance, nitric oxide. We have found that a more stable relaxing factor is released from those cells. This factor seems to be synthesized from L-arginine. It acts through the activation of soluble guanylate cyclase without affecting membrane potential. It has little charge at nearly neutral pH, and its molecular weight is < 500.

Animals↗

Antithrombotic effect and reperfusion by low molecular weight heparin in a canine model of coronary artery thrombosis.

The lability of an intracoronary thrombus, which is common in the case of unstable angina, indicates the presence of endogenous fibrinolysis. To prove our hypothesis that suppression of coagulation facilitates the thrombolytic process, low molecular weight heparin (LMWH) was given intravenously to dogs with intracoronary thrombi induced by copper coils. LMWH caused reperfusion in this model and suppressed the formation of intracoronary thrombi, thus supporting our hypothesis.

Animals↗

[The effects of the treatment for acute rejection with OKT3 monoclonal antibody treatment on the long-term results of cadaveric kidney transplantation].

Although the efficacy of OKT3 monoclonal antibody (OKT3) upon the steroid resistant rejection is well known, its beneficial effect on long-term result of kidney transplantation has not yet been well examined in Japan. A retrospective group study was performed to analyze the effect of OKT3 on the cadaver kidney allograft. Between September 1987 and October 1990, a total of 77 patients from four different hospitals were classified into 2 groups. Thirty-four patients from 2 hospitals were entered OKT3 therapy group and 43 patients from the other hospitals were entered steroid therapy group. Initial immunosuppression comprised low-dose cyclosporine (6 mg/kg), steroid and antilymphocyte globulin in both groups. In OKT3 therapy group, acute rejection episodes those were considered steroid resistant were observed in 7 patients. They were treated with OKT3 monoclonal antibody. Of the seven patients, six recovered normal renal function. The mild rejection in OKT3 therapy group was treated with high-dose steroid. Minimal follow-up was 2 years. The 2-year graft survival was 82.4% in OKT3 therapy group and 74.4% in steroid therapy group. Although the improvement on the 2 year graft survival with OKT3 treatment was 8%, the difference between two groups was not statistically significant.

Adolescent↗

The significance of cystoscopy for the diagnosis of urothelial tumour.

Authors have studied the aetiology of asymptomatic microhaematuria on the basis of complete urologic examinations including cystoscopy, excretory urography, ultrasound, urinalysis and urinary cytology. In 10 out of 422 patients transitional cell carcinomas of the urinary bladder were found. Bladder cancer was the most common malignancy among the lesions found by our evaluation of patients with microhaematuria. We conclude that cystoscopy should be an essential part in the aetiological evaluation of microscopic haematuria.

Adult↗