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Biomedical subjects

T Akiya

Publications and source records attributed to T Akiya.

At least 37 records · Page 2Linked to original sources
PubMed1987

Liddle's syndrome, an uncommon form of hyporeninemic hypoaldosteronism: functional and histopathological studies.

Liddle's syndrome was diagnosed in a 72-year-old man who presented clinically with hypertension and muscle weakness. This disorder has been characterized by hyporeninemic hypoaldosteronism, hypertension, hypokalemia and enhanced erythrocyte sodium influx. Administration of spironolactone failed to correct the hypertension and electrolyte abnormality, which subsequently improved with triamterene therapy and a low salt diet. However, suppression of the renin-angiotensin-aldosterone system remained unchanged after this treatment. In addition, an atrophic juxtaglomerular apparatus and hypertensive lesions in the arterioles were confirmed by kidney biopsy after triamterene therapy. Therefore, a process of intrinsic hyperactive distal sodium reabsorption, probably affected by aldosterone-independent sodium transport into erythrocytes, appears to be important in the pathogenesis of this syndrome. Triamterene therapy, which usually is performed in patients with this disease, might not be the ultimate therapy in the future even if electrolyte abnormalities were to be improved temporarily.

Aged↗
PubMed1987

Use of indwelling double-curved ureteral stents and problems after stenting.

Indwelling double-curved ureteral stents were placed in 19 patients for 28 months. We used these stents to bypass ureteral obstruction and as adjunct surgery of upper urinary tract troubles. There were 5 cases with stent problems such as stone formation and spontaneous breakage. The duration of stenting with problems was longer than that without problems with statistical significance.

Adult↗
PubMed1986

[Combination chemotherapy of vincristine, ifosfamide and peplomycin in patients with reactivated prostatic cancer].

Ten patients with reactivated stage D prostatic cancer were treated with the combination therapy of vincristine, ifosfamide and peplomycin (VIP therapy). This treatment gave a good relief of bone pain in 4 out of 8 patients (50%) and improvement of dysuria in 2 out of 6 patients (33%), but objective responses of primary and metastatic lesions were poor. The over-all response rate was 20% by Karnofsky's category of response, 10% by the response criteria of Shida et al., 50% by National Prostatic Cancer Project criteria in the United States and 10% by the response criteria of Koyama and Saito's group. The toxicity of VIP therapy was mild to moderate except for hepatic insufficiency shown in one case.

Adenocarcinoma↗
PubMed1985

Renal adenoma incidentally found in removed kidney in a patient with transitional cell carcinoma of the renal pelvis.

Concurrent primary renoparenchymal or renal pelvic neoplasms of different histology in the same kidney appear to be unusual. We herein report on a 75-year-old man in whom a tiny renal adenoma, a transitional cell carcinoma of the renal pelvis, ipsilateral ureter papillomas and transitional carcinoma of the urinary bladder were found. The clinicopathologic findings of this patient as well as the oncogenesis of renal tumours are discussed.

Adenoma↗
PubMed1985

Intravesical instillation of doxorubicin hydrochloride and its incorporation into bladder tumors.

We studied single dose intravesical doxorubicin instillation (50 mg. dissolved in 30 ml. saline) in 29 patients with bladder tumor and 2 with dysplasia of the bladder. The results demonstrated that 1) the levels of doxorubicin hydrochloride in extracts of tumors were significantly higher than those of histologically normal bladder tissues in all regions examined except the dome, 2) the incorporation concentration of the drug into the smallest tumor was 3-fold greater than that of larger tumors, 3) tissue concentration of the drug in histologically normal bladder tissues was 2.4-fold greater in patients with recurrent than with primary bladder tumors, and 4) a high concentration of the agent was noted in unifocal, multifocal and primary tumors classified as papillary noninvasive or invasive transitional cell carcinoma. These findings indicate that intravesical installation of doxorubicin hydrochloride can be incorporated to a high degree by relatively small papillary noninvasive or invasive transitional cell carcinoma located in almost all regions except the bladder dome.

Adult↗
PubMed1985

[A therapeutic experience with alloplastic spermatocele used in obstructive azoospermia].

To perform AIH, an artificial spermatocele was inserted into the epididymis for obstructive azoospermia (probably caused by congenital defect of the spermiduct on one side and by accidental vasosection in hernioplasty on the other). The graft used was a cup-shaped alloplastic spermatocele made of silicon-dacron, developed by Wagenknecht et al. The epididymal duct was incised microscopically. The graft was sutured to the epididymal involucrum, punctured through the scrotal skin by an injection needle and aspirated spermatozoa accumulated in the internal cavity, and subjected to AIH. Postoperatively, acceleration of spermatogenesis was attempted by injecting i.m. HCG 2,000 U-HMG 150 U twice a week, but spermatozoa both qualitatively and quantatively sufficient to perform AIH could not be obtained. Spermatozoa were no longer found after two and a half postoperative months. Despite the present failure, we would like to develop a method of grafting of this kind as more precise therapeutic means through further technical improvements in grafting.

Adult↗
PubMed1985

Therapeutic experience of advanced urothelial tract tumors.

Twenty-three patients with locally advanced and/or metastatic urothelial tumors were treated by surgery, chemotherapy or radiation. Radical operation with or without radiation resulted in tumor free conditions in 8 patients. Fifteen patients who had a few dimensionally estimable disease parameters, underwent chemotherapy. Objective responses were obtained in 6 of the 15 patients (1 CR and 5 PR). The objective response of low grade or low stage tumors or cases with high Karnofsky performance ratings was moderate. Combination chemotherapy with cisplatin (CDDP), doxorubicin (ADM) and cyclophosphamide or a CDDP-containing combination appeared to be beneficial for patients with advanced urothelial tract tumors with palliative purpose.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Coexistence of hyperplasia of renomedullary interstitial cells and juxtaglomerular cells after acute occlusion of renal artery.

A left renal artery aneurysm was found in a 45-year-old normotensive man. In an attempt to evade the possible occurrence of aneurysmal rupture, aneurysmectomy in addition to left renal biopsy (first surgery) was performed. This vascular operation led to a virtually complete renal artery stenosis concomitant with the development of hypertension. The renin-angiotensin-aldosterone system and levels of plasma prostaglandins were also increased following this failed surgery. Reconstruction of the affected renal artery was technically so difficult that left nephrectomy was carried out (second surgery). Renal specimens obtained at the first surgery revealed no histological abnormalities. Discriminating histological findings of the kidney obtained at the second surgery were remarkable; hyperplasia of the juxtaglomerular cells producing renin and hyperplasia of the renomedullary interstitial cells which had pecularities similar to cells known to secrete renal prostaglandins. High levels of the renin-angiotensin-aldosterone system and plasma prostaglandins after the first surgery were reduced following the second surgery. It is suggested that acute constriction of the renal artery led to a hyperplastic change of the juxtaglomerular cells and the renomedullary interstitial cells and stimulated an inappropriate release of renin and renal prostaglandins.

Acute Disease↗
PubMed1982

Renal failure caused by retroperitoneal involvement of Hodgkin's disease of the lymphocyte-depletion type.

The paper presents the case of a man with non-functioning unilateral kidney due to retroperitoneal and renal lymph node involvement of Hodgkin's disease, which we interpreted as unilateral renal pelvic tumor. The disease had progressed rapidly to its termination and renal failure in addition to cachexia developed. Nephrostomy on the tumor-uninvolved side had failed to restore renal function and the patient died 3 days after surgery. The study concerns the lack of clinical entity of the nephrotic syndrome even in the absence of glomerulonephropathy often described in the literature dealing with Hodgkin's disease.

Acute Kidney Injury↗
PubMed1982

Enhanced protein synthesis of heart in adrenal-regeneration hypertension and its reduction following antihypertensive treatment.

After unilateral nephrectomy and bilateral adrenal enucleation at 5 weeks of age, salt-loaded rats developed hypertension (ARH) at 6 weeks. Fibrous vascular protein and in vivo incorporation of 3H-lysine into this protein fraction were measured at 15 weeks of age in these animals. This study demonstrates: (1) that incorporation rates of 3H-lysine into cardiac collagen and elastin in ARH rats were greater than in control rats (p less than 0.001, respectively), and (2) that administration of phenoxy-benzamine hydrochloride decreased the incorporation of tritiated lysine into cardiac collagen in ARH rats, concomitant with a reduction in blood pressure. Based on these findings, increased synthesis of cardiac collagen and elastin appears to play an important role in the development of hypertension in ARH.

Adrenal Glands↗