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Biomedical subjects

T Koyanagi

Publications and source records attributed to T Koyanagi.

At least 127 records · Page 7Linked to original sources
PubMed1996

Surgical revascularization in children with renovascular hypertension.

Two boys, 11 and 10 years of age, respectively, having renovascular hypertension are reported. Diagnostically, captopril test and renal scintigraphy were useful as pharmacologic probes of the renal arterial stenosis and to determine its laterality, as well for examination of the operative outcome. Both children were rendered normotensive after renal revascularization, one by renal autotransplantation and the other by aortorenal bypass procedure. Renovascular hypertension in children is also discussed.

Aortography↗
PubMed1996

Concentration factors for 137Cs in Japanese coastal fish (1984-1990).

Concentration factors (CFs; Bq kg-1 in wet fish muscle/Bq kg-1 in filtered seawater) for 137Cs were determined in Japanese coastal fish collected from 1984 to 1990. 137Cs/Cs (stable) atom ratios were also examined to clarify the distribution equilibrium of 137Cs between marine fish and seawater. The geometric mean of CF in Japanese coastal fish was 52 +/- 4 (standard error of the mean), with values ranging from 14 to 133. 137Cs/Cs atom ratios both in marine fish and seawater indicate that the distribution of 137Cs was in equilibrium between fish muscle and seawater. Therefore, CF values obtained in the present study can be regarded as equilibrated. Our results show that the CFs for 137Cs in Japanese coastal fish were within the range of Japanese guidelines, but were below the recommended IAEA value.

Animals↗
PubMed1996

[Treatment of advanced testis cancer with a high dose chemotherapy regimen (PVeBV)].

BACKGROUND: The prognosis of patients with testis cancer classified as being in the advanced extent according to the Indiana University staging system is still poor even when treated with cisplatin based chemotherapy. METHODS: Attempting to increase the efficacy of chemotherapy in this high risk group, we have adopted PVeBV chemotherapy (high dose CDDP+VBL+VP-16+BLM) for recent 8 patients with such advanced conditions. In this study, we analized the treatment outcome of those patients retrospectively. RESULTS: Two patients died during the first course of PVeBV chemotherapy due to cancer progression, while 6 patients treated with 3 to 4 cycles of PVeBv were eligible and assessable for response, survival, and toxicity. Five of those 6 achieved pathological CR (pCR) following surgical resection of residual masses after 3 cycles of PVeBV. The other case was saved by salvage chemotherapy with autologous BMT. All 6 patients were long-term disease free survivors in median follow up of 46 months. With the rG-CSF application and vigorous hydration, acute phase toxic effects (myelosuppression, pulmonary fibrosis and nephrotoxicity) were manageable in this intensive regimen. Long term toxic effects such as peripheral neuropathy and ototoxicity were also tolerable and quality of life in such advanced cancer patients was preserved well. CONCLUSION: To improve a cure rate of high risk testis cancer, the dose escalation of induction chemotherapy should be considered.

Adolescent↗
PubMed1996

[Prognostic factors in patients with advanced prostatic cancer (stage D2) initially treated with endocrine therapy].

BACKGROUND: In order to make clear the prognostic factors in patients with advanced prostatic cancer (stage D2) whose initial treatment was hormone therapy, we reviewed 34 men with newly diagnosed advanced prostatic cancer for 6 years from May 1987 at the Hospital of Hokkaido University. METHODS: All patients had histologically proven prostatic adenocarcinoma. The mean age was 67.9 years (range 54 to 86 years). Median follow-up period was 26 months (range 5 to 66 months). The parameters studied were age, performance status, histological grade, extent of disease on bone scan, pretreatment values of PSA, gamma-Sm, PAP and PSA/gamma-Sm ratio, posttreatment values of PSA, gamma-Sm and PAP at 6th month, and the ratio of PSA at 3rd month to PSA at 6th month. RESULTS: Univariate analysis revealed that performance status (PSO vs. PS2, p = 0.006, PS1 vs. PS2, p = 0.016) and extent of disease on bone scan (p = 0.004) in background factors, gamma-Sm (p = 0.005) among pretreatment values of markers, PAP at 6th month (p < 0.001) and the ratio of PSA at 3rd month to PSA at 6th month (p < 0.001) among posttreatment values of markers, significantly related with the cause-specific survival. Based on multivariable analysis, PAP at 6th month and the ratio of PSA at 3rd month to PSA at 6th month were significantly correlated with the cause-specific survival at 24th month and 36th month, respectively. CONCLUSION: We conclude that posttreatment values of markers are more important prognostic factors in patients with advanced prostatic cancer (stage D2) following hormone therapy than pretreatment background factors and values of markers.

Adenocarcinoma↗
PubMed1996

[Tumor size and DNA ploidy changes in renal cell carcinomas--flow cytometric analysis of DNA content in renal cell carcinomas associated with von Hippel-Lindau disease].

BACKGROUND: Renal cell carcinomas (RCCs) develop in 8-63% of von Hippel-Lindau disease (VHL) patients, and loss of 3p segments, chromosome aberrations found in 90% of sporadic RCCs, has also been observed in RCCs associated with VHL. In fact, comparative analysis showed that the chromosome aberrations in RCCs associated with VHL are similar to those found in sporadic RCCs. VHL patients have the whole spectrum of tumors from small early lesions to large ones in the same kidney, providing a unique opportunity to analyze tumors in different stages of development. Subsequently deoxyribonucleic acid (DNA) content in RCCs of VHL patients was examined and correlated to their tumor size to gain some insight in the progression of sporadic RCCs. METHODS: From 1988 to 1991, we have experienced 6 cases of RCCs associated with VHL who underwent partial or radical nephrectomy. A total number of 52 paraffin-embedded samples from 33 RCCs from 6 patients with VHL was analyzed by flow cytometry. RESULTS: The sizes of tumors ranged from 0.2 to 8.2 cm. DNA aneuploid patterns demonstrated in none of 9 tumors less than 1.6 cm, 4 of 14 tumors (29%) as large as 1.6 to 2.5 cm, and 5 of 10 tumors (50%) larger than 2.5 cm (p < 0.05). Twelve tumors less than 1.8 cm showed DNA diploid, so the smallest size of aneuploid tumors was 1.8 cm. CONCLUSION: These data suggest that DNA ploidy change (diploid to aneuploid) in RCCs probably takes place as tumors grow approximately 1.8 cm in size.

Adult↗
PubMed1996

Quantification of renal function with a count-based gamma camera method using technetium-99m-MAG3 in children.

UNLABELLED: To evaluate renal function quantitatively without blood sampling in children, renal uptake by gamma camera renography using 99mTc-MAG3 was compared with plasma clearance by a single blood sample method as the reference. METHODS: Twenty children (15 boys, 5 girls; aged 2-14 yr) with nephrourological diseases were examined prospectively in this study. The patient received an intravenous administration of 5 MBq/kg 99mTc-MAG3 which was prepared using a commercially available kit. Gamma camera renography was performed and the renal uptake per injected dose (%RU) of the 1-min period of postinjection was calculated from a background-corrected renogram curve by computer. The plasma clearance (Clmag) of 99mTc-MAG3 was calculated by the single blood sample method at 35 min postinjection. RESULTS: The %RU of the 1-min period in the 1-3 min postinjection correlated well with Clmag. The best correlation was observed 1-2 min postinjection. The regression equation between total %RU (X) and Clmag (Y) (ml/min/1.73 m2) was Y = -98.509 + 20.373X (r = 0.910, s = 84.19) with standardization by BSA. The best fit regression equation between individual %RU (X) and Clmag (Y) (ml/min/1.73m2) was Y = -43.799 + 19.917X (p = 0.932, s = 43.27). CONCLUSION: The renal uptake method based on separate counts by gamma camera renography using 99mTc-MAG3 does not require a blood sample for quantification of renal function and may be potentially more practical in children.

Adolescent↗
PubMed1996

[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↗
PubMed1996

[Cardiac surgery in patients on chronic hemodialysis].

From March 1993 to February 1993, 36 patients with chronic renal failure underwent cardiac surgery with intraoperative hemodialysis (HD). We examined and compared the medium term results of those patients cased upon the time periods of operation and types of heart disease. With respect to the time periods of operation, the 1st term (n = 12) was between March 1985 and February 1989, and the 2nd term (n = 24) was between March 1989 and February 1993. Concerning types of disease, Group A was comprised of 24 patients with ischemic heart disease, and Group B was comprised of 12 patients with valvular or congenital heart disease. Only one early death was observed in the 1st term (8.3%: LOS). As for late death, 5 cases were observed in the 1st term (45.3%), and 2 cases were observed in the 2nd term (8.3%). The actuarial survival rate (post 3 years) was 72.7% in the 1st term and 91.3% in the 2nd term. In each case, the survival rate of the 2nd term was significantly better than the that of the 1st term (p < 0.025). When compared cased upon the types of disease, the actuarial survival rate (post 6 years) was 84.6% in Group A, and 45.5% in Group B, respectively. This difference was statistically significant (p < 0.05). Causes of late death were cerebral hemorrhage in 5 cases, sudden and unknown in one and DIC in the remaining one patient. There were many postoperative complications in this series in addition to the above stated fatal ones. The majority of them, however, were successfully treated, if early diagnosis of them was obtained. During the perioperative period through the long-term period, incidents of fatal hemorrhage among patients on chronic dialysis were reduced by 1) strict management of hypertension; 2) HD without use of Heparin; and 3) with respect to patients who required Warfarin after valve replacement, through the careful anti-coagulant therapy which maintained the thrombo-test (TT) value at precise levels.

Adult↗
PubMed1996

[Effective administration of recombinant granulocyte colony-stimulating factor to prevent granulocytopenia due to combination chemotherapy for testicular germ cell tumors].

A prospective randomized study on the administration of recombinant granulocyte colony stimulating factor (rG-CSF) was conducted on 15 patients with testicular germ cell tumors. The clinical stagings of all patients except one were minimal to moderate extent according to the Indiana University staging system. Combination chemotherapy using bleomycin, etoposide and cisplatinum (BEP) was performed as the initial treatment on the eligible patients. rG-CSF was administered by two different methods; 1) routine administration on the 6th day after BEP chemotherapy (group A), and 2) the same method, but after granulocytopenia of 1,500/mm3 had developed (group B). The administration of rG-CSF in group A significantly reduced the severity of leucocytopenia and also the incidence of stomatitis compared with group B. Although rG-CSF produced no significant side effects, the thrombocytopenia was prominent in the group A patients (not significant). BEP chemotherapy itself is an easily-tolerable and well established method for treating young adult patients. The method used in group B seems to be suitable in situations where thrombocytopenia and cost effectiveness.

Adult↗
PubMed1995

Gelsolin: a candidate for suppressor of human bladder cancer.

Human transitional cell carcinomas of the bladder frequently reveal chromosomal abnormalities that span a range between chromosome 9p12 and 9qter, even at early stages of bladder carcinogenesis. Because the gene that encodes an actin-regulatory protein, gelsolin, is localized in chromosome 9q33, we examined the expression of gelsolin in a number of human bladder cancer cell lines and tissues. In all 6 cell lines and in 14 of the 18 tumor tissues (77.8%), gelsolin expression was undetectable or extremely low in comparison with its expression in normal bladder epithelial cells. Furthermore, upon the introduction of the exogenous human or mouse authentic gelsolin cDNA into a human bladder cancer cell line, UMUC-2, gelsolin transfectants of UMUC-2 greatly reduced the colony-forming ability and the tumorigenicity in vivo. These results suggest that gelsolin plays a key role as a tumor suppressor in human urinary bladder carcinogenesis.

Base Sequence↗
PubMed1995

A myosin missense mutation, not a null allele, causes familial hypertrophic cardiomyopathy.

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is characterized by myocardial hypertrophy of unknown etiology. Missense mutations of the cardiac beta-myosin-heavy-chain (beta-MHC) gene that may be responsible for cardiac hypertrophy have been detected in patients with HCM. On the other hand, gross structural abnormalities in the cardiac beta-MHC gene, ie, an alpha/beta hybrid gene and partial deletion of the gene, have also been reported. The direct correlation between gross abnormalities and development of HCM is not well understood. METHODS AND RESULTS: We analyzed the structure of the cardiac beta-MHC gene from patients with HCM by using polymerase chain reaction-DNA conformation polymorphism analysis and found two sequence variations in exons 3 and 22 in one patient. These sequence variations at codon 54 (exon 3; nonsense mutation) and codon 870 (exon 22; Arg-to-His mutation) were identified by direct sequencing and dot-blot hybridization with allele-specific oligonucleotide probes. Relatives of this patient were examined for the mutations. It was revealed that the missense mutation was inherited from the affected father and the nonsense mutation from the unaffected grandmother through the unaffected mother. In addition, the missense mutation was also found in seven other patients from two other unrelated multiplex HCM families. CONCLUSIONS: The Arg870His mutation was suggested to cause HCM. In contrast, the gene with the nonsense mutation would encode for a cardiac beta-MHC protein of only 53 amino acid residues, which may be too short to be incorporated into the thick filament assembly of cardiac myosin chains and showed no dominant phenotype of heart disease. This is the first report of a nonsense mutation in the human cardiac beta-MHC gene.

Base Sequence↗
PubMed1995

Penile tumescence in the human fetus at term--a preliminary report.

The aim of this study is to reveal whether the penis per se actually becomes tumescent and flaccid, in time sequence, in the human fetus at term. We observed the fetal penis with real-time ultrasonography in 50 male human fetuses at 36-39 weeks' gestation and measured the penile length once at a given time per 1-min epoch for each case during the 60-min window of examination. Thirty-eight were excluded due to a lack of continuous ultrasound visualization of the penis. Penile length changes were statistically analyzed for the remaining 12 fetuses using the 'least median of squares regression'. Penile length was seen to be significantly stratified into two groups: 22.5% at tumescence (group median = 20.8 mm) and 77.5% at flaccidity (group median = 16.0 mm). Penile tumescence was found to occur at the following frequency during the given observation period: once in 41.7%, twice in 50.0% and three times in 8.3% with durations ranging from 5 to 17 min. These findings indicate penile tumescence exists in the term fetus. The frequency and duration of penile tumescence are in good correlation with neonates.

Fetus↗
PubMed1995

Three-dimensional ultrasound image of the fetal stomach: congenital duodenal obstruction in utero.

To quantitatively characterize the stereographic stomach configuration in utero, 11 fetuses (subject-group) with congenital duodenal obstruction, diagnosed antenatally, between 29 and 37 weeks' gestation were studied. Also included were 879 uncomplicated fetuses between 20 and 40 weeks' gestation as a control-group. Applying the algorithm which we devised: "Modeling a three-dimensional shape from a silhouette by detecting symmetry", we reconstructed the three-dimensional stomach configuration from a two-dimensional ultrasound image for each case. The statistical differences in two parameters, stomach volume and sphericity, between subject- and control-group fetuses, were analyzed using the Grubbs-Smirnoff's test at corresponding gestational ages. From 29 to 37 weeks' gestation, the stomach volume in the subject-group fetuses was found to increase greatly with advancing gestation, having significantly higher values than the control-group fetuses, whereas the stomach sphericity remained unchanged with no significant differences from the control-group fetuses. These findings indicate that the fetal stomach with duodenal obstruction maintains almost the same three-dimensional portrayal in utero as that seen in uncomplicated fetuses, although the stomach becomes extremely enlarged.

Duodenal Diseases↗
PubMed1995

Is there a critical gestational age in neutrophil superoxide production activity?

We studied superoxide (O2-) production in neutrophils from 78 normal pregnant women at 7 to 39 weeks' gestation to determine whether there is a critical gestational age in O2- production activity of maternal neutrophils. The O2- production was measured by determining the rate of superoxide dismutase-inhibitable reduction of ferricytochrome c at 550 to 540 nm. A scattergram of neutrophil O2- production value versus gestational age was analyzed using the least median of squares regression, leading to a statistical stratification in which the median values of O2- production for outlying and nonoutlying points were 6.60 nmol/10(6) cells and 2.72 nmol/10(6) cells, respectively. All of the outlying points were concentrated at 19 to 22 gestational weeks. There was the significant difference in FMLP-induced O2- production in neutrophils of nonpregnant subjects when incubated with the sera from 10 cases (selected among 60 cases with nonoutlying points) (3.86 +/- 0.77 nmol/10(6) cells) compared with 5 cases with outlying points (5.62 +/- 1.19 nmol/10(6) cells) (P < .05) These results suggest that during the normal course of pregnancy, the production of O2- from the function of circulating neutrophils can be dissociated from such neutrophil functions as adherence, chemotaxis, and phagocytosis.

Adult↗