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Biomedical subjects

S Yachiku

Publications and source records attributed to S Yachiku.

At least 37 records · Page 2Linked to original sources

[Overexpression of c-erbB-2 and p53 oncoprotein in renal pelvic and ureteral carcinomas with reference to the expression of Ki-67 antigen as a proliferation marker].

PURPOSE: We determine the significance of c-erbB-2 and p53 gene in the progression of renal pelvic and ureteral carcinomas. METHODS: Overexpression of c-erbB-2 and p53 oncoprotein was investigated using immunohistochemical staining with reference to pathological features. The expression of Ki-67 antigen was also studied as a proliferation marker. RESULTS: Forty-seven cases were examined, and the overexpression of c-erbB-2 oncoprotein was revealed in 25 (53%) cases. It was not related both tumor grade (G) and tumor stage (pT). The overexpression of p53 oncoprotein was revealed in 29 (62%) cases. There were 13 p53 positive cases in 27 low grade (G1, G2) tumors, and 16 in 20 high grade (G3) tumors. There were also 8 p53 positive cases in 21 low stage (pTa, pT1) tumors, and 21 in 26 high stage (pT2-4) tumors. Thus, p53 oncoprotein was more frequently overexpressed in high grade tumors (p < 0.05) and in high stage tumors (p < 0.01). Ki-67 labelling index (LI, mean +/- SD) was 10.7 +/- 8.9 in low grade tumors and 26.3 +/- 12.5 in high grade tumors. It was also 9.0 +/- 8.1 in low stage tumors and 24.0 +/- 12.4 in high stage tumors. Thus, Ki-67 LI was higher in high grade tumors (p < 0.01) and in high stage tumors (p < 0.01). The c-erbB-2 status and Ki-67 LI were not correlated, while the LI of p53 positive cases (21. 7 +/- 13.6) was significantly higher (p < 0.01) than it of p53 negative cases (10.3 +/- 8.5). The difference of LI between p53 positive cases and p53 negative cases was significant (p < 0.05) in low grade tumors, but in high grade tumors LI was higher than it of low grade tumors independently of p53 expression. CONCLUSION: p53 but not c-erbB-2 was considered to be associated with rapid tumor progression in renal pelvic and ureteral carcinoma and play an important role in its progression especially in low grade tumors.

Biomarkers, Tumor↗

[Transurethral microwave thermotherapy for benign prostatic hyperplasia].

BACKGROUND: We studied the clinical efficacy of transurethral microwave thermotherapy (TUMT) using Endotherm UMW system (OLYMPUS). METHODS: TUMT was performed in 28 patients with benign prostatic hyperplasia (BPH). Three patients of them were catheterized because of urinary retention. The treatment was performed in a single session for an hour. The urethral surface temperature was set at 39 degrees C, and the coolant flow of the urethral applicator (21 Fr balloon catheter) was set at 30 ml/min, to heat up the broad area of the prostate up to 45 degrees C. The clinical efficacy was evaluated by analyzing subjective responses, using the International Prostate Symptom Score (I-PSS) scale (S) and QOL score (L), and objective responses, using peak urinary flow rate (Qmax), average flow rate (Qave), residual urine volume and prostate volume following the treatment. RESULTS: At 24 weeks after the treatment, significant improvement were observed in S score (41%), L score (37%), Qmax (53%) and Qave (62%). Although there was no significant decrease in residual urine and prostate volume. The three patients, with a catheter indwelled because of urinary retention, were all free of the catheter within 4 weeks after the treatment. During and after the treatment, no severe adverse effects, including transient urinary retention needed for indwelling a catheter, was detected. CONCLUSION: A single session of TUMT by Endotherm UMW considered to be safe and useful for symptomatic BPH patients, even who are not indicated for transurethral resection of the prostate (TUR-P) because of underlying disorders.

Aged↗

[Bellini duct carcinoma of the kidney: a case report].

A rare case of Bellini duct carcinoma of the kidney is reported. A 44-year-old woman with macroscopic hematuria was referred to our hospital. the clinical diagnosis was a right renal tumor with direct invasion to the liver. Radical nephrectomy and segmental hepatectomy were performed. Histopathological examination revealed papillary growth of atypical cells different from the usual histological pattern of renal cell carcinoma. The histological diagnosis of Bellini duct carcinoma was confirmed by the positive immunohistochemical staining with a collecting duct marker (UEA-1), and distal tubule marker (EMA) and negative staining with a proximal tubule marker (Leu-M1).

Adult↗

[A clinicopathological study on carcinoma of the renal pelvis and ureter].

We investigated the clinicopathological features of 62 patients with transitional cell carcinoma of the renal pelvis and ureter. Four patients had been treated for bladder cancer. Among 58 patients without precedent bladder cancer, 6 had coexistent bladder cancer and bladder cancer subsequently developed in 13. The 5-year cause-specific survival rate was 33% in cases with coexistent bladder cancer, 75% in those with subsequent bladder cancer and 62% in patients without association of bladder cancer. Distant metastases were found in 23 of 62 (37%) cases, the most frequent site being lymph nodes. The site of the primary tumor (renal pelvis and/or ureter) and the pathological findings such as grade, stage, type of infiltration, venous and lymphatic invasion, were significantly correlated to cause-specific survival. Multivariate analysis showed the most influential factors to be the type of infiltration and the site of the primary tumor. Therefore, patients with INF beta or gamma tumors both in the renal pelvis and ureter had a poor prognosis. However, association of bladder cancer was not related to survival.

Adult↗

Clinical applicability of a new tactile sensor for evaluating rigidity of the penis: a comparative study with Rigiscan.

BACKGROUND: A new tactile sensor was developed for detecting hardness of living tissue by Omata et al. in 1992. This paper reports applicability of the sensor for evaluation of penile rigidity. METHODS: Nine patients from a group of 12 patients with penile erectile dysfunction were selected as subjects of this study. All patients agreed to artificial erection and monitoring of penile rigidity by a new tactile sensor and the Rigiscan system. The 9 patients selected all developed more than 1 cm circumferential expansion of the penis after an injection of smooth muscle relaxant into the corpus cavernosum. The sensor equipment consisted of a piezoelectric element that vibrated, and a pickup that detected vibration frequency. When the end of the sensor was pressed against a surface of the penis, the resonance frequency of the sensor changed and indicated rigidity of the organ. Rigidity of the penile shaft was simultaneously monitored with the sensor and the Rigiscan system before and after an injection of 40 mg papaverine or 20 micrograms prostaglandin E1. The sensor's measurements of rigidity were compared with those of Rigiscan. RESULTS: Reproducibility of rigidity measured with the tactile sensor was satisfactory. Statistical analysis was made on 85 simultaneous pairs of rigidity values from the tactile sensor and Rigiscan. The analysis indicated significant correlation between the values. CONCLUSION: The tactile sensor as well as Rigiscan will be of use for evaluating rigidity of the penis.

Adult↗

[Intravesical oxybutynin hydrochloride in the treatment of urge incontinence in the elderly].

PURPOSE: This study was carried out to determine the effectiveness of intravesical oxybutynin hydrochloride on urinary urge incontinence in elderly people. METHODS: The subjects consisted of 13 patients with an average age of 75 years who demonstrated uninhibited detrusor contraction on cystometrogram. The trial protocol consisted of a pretreatment cystometrogram followed by the intravesical administration of 10 ml solution containing 5 mg oxybutynin hydrochloride (pH 5.85). The urodynamic studies were repeated one hour later. RESULTS: The mean bladder capacity before and after one hour of intravesical oxybutynin hydrochloride was 161 +/- 62 ml and 196 +/- 71 ml (mean +/- 1 S.D., n.s.). The rate of improvement was 15.4% (2 cases) in all 13 patients. Four patients out of 13 patients continued intravesical administration of the solution twice daily. Urinary incontinence disappeared in two patients and incontinence was markedly decreased in one. In the remaining patient, urinary incontinence did not change because of increased residual urine. Three patients have continued this therapy over one years and no side effects were observed. In these patients, residual urine volume did not increase. CONCLUSION: It is suggested that intravesical oxybutynin hydrochloride is an effective option of therapy for intractable urge incontinence in elderly people, however, the immediate posttreatment cystometrogram was not predictive of the response to intravesical therapy on overactive bladder in the elderly.

Administration, Intravesical↗

[Pharmacokinetics of 99mTc-MAG3 and 131I-OIH: comparative study based on 2 compartment model analysis].

We studied 50 patients with mild to moderate renal dysfunction to compare pharmacokinetics of 99mTc-MAG3 with that of 131I-OIH. After simultaneous bolus injection of both 99mTc-MAG3 and 131I-OIH, 8-point venous blood sampling was performed from 2 to 44 min post injection. Aliquoted plasma samples were counted for radioactivity along with the injected standard to obtain % injected dose/ml plasma for each tracer. Using obtained time-concentration data, classical 2 compartment model analysis was performed for both tracers to obtain various pharmacokinetic parameters, including distribution volumes (Vds), inter-compartmental rate constants, and plasma clearance. In these parameters, Vd of central compartment, Vd at steady state, central to peripheral inter-compartmental rate constant, and plasma clearance were significantly larger for 131I-OIH. In all parameters, significant correlation was found between 99mTc-MAG3 and 131I-OIH. The best correlation was seen in plasma clearance (r = 0.891, p < 0.0001). Plasma clearance ratio (99mTc-MAG3/131I-OIH), however, showed weak but significant negative correlation with serum creatinine, although this correlation was not likely to affect the overall correlation of clearance between 131I-OIH and 99mTc-MAG3. From these results, we confirmed that 99mTc-MAG3 clearance could be used as an alternative to 131I-OIH clearance, although pharmacokinetic behavior of 99mTc-MAG3 was not exactly the same as that of 131I-OIH.

Adult↗

[Clinical early phase II study of bicalutamide (Casodex) in patients with prostatic cancer].

To investigate the efficacy and safety of bicalutamide (Casodex) with its clinically recommended dose, the randomized early phase II study was performed in 124 patients with prostatic cancer (stage C, D). The patients were given 50, 80 or 100 mg of bicalutamide orally once a day in fixed doses for 12 weeks; 122 patients were eligible for evaluation. The overall response rate was 50.0% (20/40), 61.0% (25/41) and 53.7% (22/41) in the 50 mg, 80 mg and 100 mg groups, respectively. The response rate in prostate lesion, bone and lymph node metastases was slightly higher in the 80 mg group than in the 50 mg and 100 mg groups. The proportion of patients showing a response with regard to serum PSA (CR and PR) was 84.2, 92.7 and 97.6% in the 50, 80 and 100 mg groups, respectively. The incidence of adverse reactions was 65.0, 61.0 and 61.0% in the 50, 80 and 100 mg groups, respectively, and there was no significant difference in overall safety rating in the three groups. Frequent adverse reactions were gynecomastia and breast pain. Only one patient in the 80 mg group was withdrawn due to shortness of breath. Serum concentrations of LH, testosterone and estradiol increased significantly after treatment. Bicalutamide was concluded to be effective and well tolerated in patients with prostatic cancer, and its recommended dose was 80 mg once daily.

Administration, Oral↗

[Effects of chronic low-frequency electrical stimulation on the external urethral sphincter of male rabbits--electrophoretic analyses of myosin light and heavy chain isoforms].

The present study investigates the effects of chronic low-frequency electrical stimulation on the external urethral sphincter (EUS) of rabbits through the biochemical analysis of the isoforms of myosin light and heavy chains. Twenty-eight adult male rabbits were used in the test. Of these, the EUS of 14 rabbits were continuously stimulated directly at 1.8 Hz, 0.8 msec, 5.0 V with an implantable electrical cardiac pacemaker for more than 10 weeks. The other 14 rabbits were used as the control group and were nurtured under the same conditions as the stimulated group but without the electrical stimulation. Upon conclusion of the stimulation program, the urethra was removed from all 28 rabbits. The portion of the urethra containing the EUS (from the middle of the prostate to the pelvic diaphragm) was cut transversely into thin serial sections and glycerinated. The glycerinated muscle fibers were then isolated under a stereomicroscope and samples for electrophoretic analysis were prepared. Two-dimensional electrophoresis according to the procedure of O'Farrell for myosin light chains and SDS-PAGE containing 40% glycerol for myosin heavy chains were carried out. The molar ratio of myosin subunits was determined by quantification through the dye elution process. The average percentages of slow myosin light chain molecules in 8 unstimulated and 8 stimulated EUS were 33.4 +/- 8.9% (mean +/- SD) and 70.1 +/- 12.8%, respectively. The average percentages of slow myosin heavy chain molecules in 6 unstimulated and 6 stimulated EUS were 17.6 +/- 5.7% and 40.2 +/- 7.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[A case of psychological non-neuropathic bladder successfully diagnosed by continuous monitoring of detrusor pressure].

We report a case of psychological non-neuropathic bladder difficult to diagnose and treat. A 44-year-old woman was admitted to the Department of Urology of the Asahikawa Medical College Hospital with complaints of difficulty in micturition and urinary incontinence. Urodynamic studies revealed underactive function of the detrusor and incompetent urethra. She was instructed in self intermittent catheterization for difficulty in micturition. Drug therapy, electrical stimulation and vesicourethral suspension were not effective to control urinary incontinence. Since uninhibited detrusor contraction was elicited by psychogenic stress during continuous monitoring of the detrusor function, she was diagnosed as psychological non-neuropathic bladder closely related to psychogenic factor. She had a careful counselling and medical treatment designed by her psychiatrist, urinary incontinence was remitted in about one year and a half.

Adult↗

Intravesical instillation of oxybutynin hydrochloride therapy for patients with a neuropathic bladder.

Intravesical oxybutynin hydrochloride was administered to 17 patients with a neuropathic bladder (myelomeningocele in 15 and spinal cord tumour in two) and urinary incontinence refractory to intermittent catheterisation. Therapy consisted of instillation of a 10 ml solution containing 5 mg oxybutynin hydrochloride twice daily. The cystometric bladder capacity before and after 1 hour of intravesical oxybutynin hydrochloride was 132 +/- 45 ml and 193 +/- 71 ml (mean +/- 1 standard deviation, p < 0.01) in all 17 patients. In 13 patients with low compliant bladders, the mean bladder compliance before and after 1 hour of instillation was 4.2 +/- 2.4 ml/cmH2O and 8.5 +/- 6.4 ml/cmH2O respectively (p < 0.01). The period of the intravesical oxybutynin hydrochloride treatment ranged from 2 to 16 months (mean 11.1 months). The improvement rate of 'moderately improved' and better response was 76.5% in all 17 patients. One patient complained of slight lower abdominal pain, which receded as treatment continued. Since the pH value of the solution appeared to be so low as to irritate the vesical mucosa, the value was adjusted to 5.85. No local or systemic side effects were observed thereafter. These encouraging results suggest that intravesical instillation of oxybutynin hydrochloride is an attractive alternative in patients with a neuropathic bladder, who are either unresponsive to or have intolerable side effects from oral medications.

Adolescent↗

Isolation and purification of a high molecular weight substance from human urine which inhibits calcium oxalate crystal growth.

A high molecular weight inhibitor of calcium oxalate crystal growth in human urine was investigated. Three inhibitors were isolated by DEAE-Sephacel ion-exchange chromatography and, of these, the substance we named "Peak 3 protein" seemed to be the main inhibitor in human urine. Peak 3 protein and several was purified by fast protein liquid chromatography and polyacrylamide gel electrophoresis. This substance, with a molecular weight of 30 kDa, did not contain uronic acid and its inhibitory activity decreased after digestion with proteinase. The difference between Peak 3 protein and several inhibitors previously reported was investigated but no clear difference could be found. The fact that it was the protein structure which was responsible for the inhibitory activity and the fact that Peak 3 protein probably possessed many side-chains which did not contribute to the inhibitory activity influenced the outcome of the investigation.

Calcium Oxalate↗

[Studies on enhancement of drug absorption through the bladder mucosa].

We examined the effects of dimethyl sulfoxide (DMSO), hyaluronidase and saponin on drug absorption through the bladder mucosa. Female Wistar rats underwent intravesical instillation of each agent prior to the administration of lanthanum solution or anticancer drug; 4'-O-tetrahydropyranyldoxorubicin (THP). The absorption of lanthanum was recognized as dense grain in bladder tissue under electron microscope. The concentration of THP in bladder tissue and plasma was measured by high performance liquid chromatography. The ultrastructural change caused by instillation of DMSO, hyaluronidase and saponin was also investigated by transmission and scanning electron microscopy. The electron microscopic study of the bladder treated with DMSO revealed the exfoliation of superficial cells, and the electron-dense grains of lanthanum were observed in submucosal layer. The concentration of THP was twice as high as that of untreated animals in both bladder tissue and plasma. The treatment with hyaluronidase caused no severe histological change of bladder mucosa, and lanthanum was observed only in the cytoplasma of superficial cells. The increased concentration of THP was slightly exhibited in plasma but not in bladder tissue. The treatment with saponin caused vacuolization and swelling of superficial cells, and many grains of lanthanum were observed between superficial cells and intermediate cells. The concentration of THP in bladder tissue was significantly higher than that of untreated animals, but in plasma no difference was revealed. These findings indicate that each three agent caused an unique effect on drug absorption of bladder mucosa and such characteristic of each agent must be considered for clinical application. Saponin is thought to be useful on intravesical chemotherapy because of increased concentration of anticancer drug (THP) in bladder tissue without that in plasma.

Animals↗

[Biochemical analysis of the external striated urethral sphincter of male rabbits. Difference in the proportions of muscle fiber types in the male rabbit external urethral sphincter by axial subdivisional study].

We studied the difference in the proportion of fast and slow myosin subunits in axially subdivided external urethral sphincter of male rabbit using myosin light chain and heavy chain analyses. The whole urethras from 6 adult male Japanese White rabbits were sagittally bisected and one halves from all animals were processed for myosin light chain analysis and another halves from all animals for myosin heavy chain analysis. Each half urethra containing the external urethral sphincter was subdivided into 4 parts, namely prostatic (P), prostatic apical (PA), infraprostatic (IP) and bullbourethral glandular (BUG) portions, from cranial to caudal direction. The electrophoretic samples from 4 different parts were separately processed. The external urethral sphincter muscle in each part from all animals were processed together for a sample because of the minute amount of the muscle. Two-dimensional electrophoresis according to the procedure of O'Farrell for myosin light chains and SDS-polyacrylamide gel electrophoresis containing 40% glycerol for myosin heavy chains were carried out. Molar ratio of myosin subunits were estimated by the dye elution procedure. The relative proportions of slow myosin molecules in respective parts were 33.4% (P), 26.3% (PA), 18.5% (IP) and 11.0% (BUG) from myosin light chain analysis and 20.3% (P), 16.1% (PA), 7.2% (IP) and 5.0% (BUG) from myosin heavy chain analysis. The urethral striated musculature in male rabbit was predominantly composed of fast myosin subunits as a whole. But the proportion of slow myosin subunits occupied a relatively high percentage in the proximal region and tended to decrease toward the distal end.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Clinical study of TZP-4238 on patients with benign prostatic hypertrophy--with special reference to urodynamics].

Twenty four cases of benign hypertrophy with bladder outlet obstruction were treated with 17 alpha-acetoxy-6-chloro-2-oxa-4,6-pregnadiene-3,20-dione (TZP-4238), and the effects on urodynamic parameters, clinical efficacy, safety, and usefulness were evaluated. Improvement rate of subjective rate of subjective symptoms was 52.9%. Obstructive symptoms improved more prominently than irritation symptoms. A significant improvement in flow rate of nomograms for maximum flow rate (MFR) and average flow rate (AFR) accompanied with the decrease in the prostatic weight were observed. However, no changes were observed on the urethral sphincter electromyography and the urethral pressure profile. A significant decrease of maximum cystometric capacity was observed, although the effective cystometric capacity was not changed. The overall improvement rate for urodynamic parameters was 43.7%. A significant decrease in weight and diameter of the prostate was observed. The prostatic weight decreased in 57.1%, and the average reduction rate was 15.4%. The overall improvement rate concerning clinical efficacy evaluating both subjective symptoms and objective parameters was 58.8%. Adverse reactions were observed in 5 cases. They were judged as not clinically problematic. Taking into account clinical safety and clinical efficacy, the clinical usefulness was 50.0%. TZP-4238 was considered to be an appropriate agent for treating patients with benign prostatic hypertrophy with bladder outlet obstruction.

Aged↗

[A clinical study of total cystectomy for patients with bladder cancer].

We assessed the treatment outcome of total cystectomy for 67 patients with bladder cancer treated at Asahikawa Medical College Hospital between 1977 and 1991. The analyses of cause-specific 5-year survival rates by pathological stage (pT) and grade revealed a lower survival rate for higher stage, higher grade and non-transitional cell carcinomas. The condition of lymph node metastases (pN) was also correlated to the survival rate. Significant differences were observed between the survival rates of the patients with pT < or = 2 and pT > or = 3, and the patients with pNO and pN > or = 2. The cancer deaths were mainly caused by distant metastases. Preoperative irradiation showed prognostic advantage in the patients who had acquired down-staging by this treatment, and postoperative systemic chemotherapy also improved the prognosis in the patients with pT > or = 3.

Adult↗

[Postoperative intravesical installation of tetrahydropyranyl-adriamycin (THP) and cytosine arabinoside (CA) for superficial bladder cancer: clinical results of prophylactic effects on recurrence].

Intravesical instillation of tetrahydropyranyl-adriamycin (THP) and cytosine arabinoside (CA) was performed on 42 patients with superficial bladder cancer after transurethral resection (TUR) for the purpose of prophylaxis of recurrence. The instillation was carried out with 30 mg of THP dissolved in 30 ml of distilled water and 200 mg of CA (total 40 ml). These drugs were instilled 7 times for the initial 2 weeks after TUR, and then 7 times every two weeks, 8 times every month, and 4 times every three months. Cases eligible for evaluation of efficacy were 38 out of 42 patients. The cumulative non-recurrence rate at one, two and three years were 94%, 84% and 75%, respectively. These high non-recurrence rates were demonstrated regardless of the size, number and pathological grade of the tumors. Severe bladder irritability was demonstrated in 8 (19%) of 42 patients, but generalized side effects were not seen in any case. The reformed regimen with 20 mg of THP in 30 ml of physiological saline solution was then performed on trial in several patients and there were no severe symptoms. THP combined with CA seems to be remarkably effective for the prophylaxis of recurrence, while a high concentration of THP in distilled water may lead to severe bladder irritability.

Administration, Intravesical↗