Biomedical subjects
Publications and source records attributed to T Machida.
Acquired spinal epidermoid tumours are rare, and probably caused by skin fragments that have been transplanted by trauma or lumbar puncture. They almost always occur in the region of the cauda equina. We present an acquired spinal epidermoid tumour at the T 10 level, with pathological confirmation. A skin fragment had migrated to a site where it developed into a tumour.
Mouse oocytes and embryos at various developmental stages were exposed directly to an ethylene glycol-based vitrification solution (EFS) for 2 or 5 minutes at 20 degrees C. They were then vitrified at -196 degrees C and were warmed rapidly. At the germinal vesicle stage, the proportion of morphologically normal oocytes was 36 to 39% if they had cumulus cells, whereas in cumulus-removed immature oocytes and in ovulated oocytes it was only 2 to 4%. This low survival was attributed to the harmful action of ethylene glycol. After fertilization, on the other hand, the post-warming survival rate of 1-cell zygotes, as assessed by cleavage to the 2-cell stage, increased markedly (62%). As the developmental stage proceeded, higher proportions of vitrified embryos developed to expanded blastocysts; the rates increased up to 77 and 80% in 2-cell and 4-cell embryos, respectively. For embryos at the 8-cell, morula and early blastocyst stages, the proportion of embryos developed after vitrification (90 to 95%) was not significantly different from that of the untreated embryos (95 to 100%) when the period of exposure to EFS solution was 2 minutes. As the blastocoel began to enlarge, however, survival began to decrease again, with rates of 79 and 57% in blastocysts and expanded blastocysts, respectively. After the cryopreserved 2-cell, 4-cell and 8-cell embryos as well as morulae and blastocysts were transferred to recipients, 43 to 57% of the recipients became pregnant, and 48 to 60% of these various stage embryos developed into live young.
Three new glycosides, neohancosides B, C, and D, have been isolated as polyacetates 2, 3, and 4 from Cynanchum hancockianum along with neohancoside A hexaacetate [1]. The new compounds were established as 9-hydroxylinalool-3-O-beta-D-xylopyranosyl-(1-->6)-beta-D-glucopyr anoside heptaacetate [2], 2-hydroxyacetophenone-2-O-beta-D-xylopyranosyl-(1-->6)-beta-D-gluc opyranoside hexaacetate [3], and 6'-O-sinapoylsucrose octaacetate [4] by means of spectroscopic and chemical tools.
We investigated the infection rate of Chlamydia trachomatis in sexual partners who had pregnant wives with C. trachomatis diagnosed by means of serum-antibody test (Ipazyme) or antigen test (Chlamydiazyme, IDEIA-chlamydia). Antibody-positive rate was 60.4% (90/149 cases), and antigen-positive rate was 7.4% 11/149 cases). All cases with Chlamydial antigen had anti-Chlamydial antibody. Eleven cases with Chlamydial antigen had no symptom of urethritis. Among these cases, eight cases had abnormal laboratory findings. However, the other three cases who had no abnormal finding were careers of C. trachomatis. In this study, sexual partners who had Chlamydial antigen were few, however, those who had anti-chlamydial antibody were many. Therefore, C. trachomatis will disseminate among many families as a latent infection.
We compared the antimicrobial activities of penems in human urine with those in Mueller-Hinton broth in order to clarify the usefulness of penems for urinary tract infections. Furthermore, we also investigated the influence of urine components, such as pH, magnesium concentration and calcium concentration, on the antimicrobial activities of penems. Three penems, i.e., imipenem, panipenem and meropenem were employed. And two bacterial strains, i.e., Escherichia coli NIHJ JC-2 and Pseudomonas aeruginosa 18s, were tested. There was no significant difference in MBCs between human urine and Mueller-Hinton broth against E. coli. However, MBCs of penems in human urine was lower than those in Mueller-Hinton broth against P. aeruginosa. On the other hand, MBCs of penems against these two strains were low when urine pH was high or urine calcium concentration was low. No influence of urine magnesium concentration on MBCs of penems was seen. From these results, it was suggested that we should measure the antimicrobial activities of penems not only in Mueller-Hinton broth, but also in human urine, when we administer penems to patients with urinary tract infections. And we should foresee the clinical effects of penems against urinary tract infections paying attention to urine pH of the patients.
We recently had three patients with pelvic dead space infection caused by methicillin-resistant Staphylococcus aureus (MRSA) after total cystectomy for urothelial cancer. All were male and aged from 67 to 74 years old. As for underlying diseases, two of them had bladder cancer and one of them had bladder cancer and right ureteral cancer. Total cystectomy and ileal conduit were performed for two patients with bladder cancer, and total cystectomy, nephroureterectomy and ureterocutaneoustomy were performed for a patient with bladder cancer and ureteral cancer. Pelvic dead space infections caused by MRSA appeared after 15-30 days postoperatively. All patients were cured after we locally administered 0.5 g of vancomycin twice a day for 10-11 days from the drains to the pelvic dead spaces. All patients had preoperative antitumor chemotherapy and the postoperative administrations of beta-lactams in common. From these results, we suggest that local administration of vancomycin is effective for the pelvic dead space infection caused by MRSA after total cystectomy.
Using superselective catheterization technique, venous sampling directly from the cavernous sinus was performed in seven patients with Cushing's disease and one patient with ectopic ACTH secreting tumor. In Cushing's disease the central/peripheral (c/p) gradients of ACTH in the cavernous sinus (11.9-111.1; mean, 49.6) were much greater than those in the inferior petrosal sinus (1.0-52.0; mean, 14.0). The intercavernous gradients of ACTH provided correct lateralization in all patients but one who had a midline tumor. A patient with ectopic ACTH secreting tumor showed no gradients of ACTH both in the cavernous sinus and in the inferior petrosal sinus. The c/p gradients of PRL were smaller than those of ACTH in the cavernous sinus, inferior petrosal sinus, and jugular vein. The gradients of ACTH and PRL essentially indicated the same laterality in Cushing's disease, whereas the intersinus gradient of PRL provided a false laterality in two patients with a midline tumor. No complications have been observed during and after the sampling procedure. Thus, we conclude that 1) the selective sampling directly from the cavernous sinus offers sufficient c/p gradients (more than 10) for the reliable diagnosis of Cushing's disease, 2) CRH stimulation during the sampling and the simultaneous measurement of PRL are not necessary in this method, 3) the high concentration of pituitary hormones obtained by this sampling may be useful for other clinical investigations.
Experiments were conducted to find optimal conditions for obtaining high survival of expanded mouse blastocysts after vitrification. The vitrification solutions used were designated EFS20, EFS30 and EFS40, and contained 20%, 30% and 40% ethylene glycol, respectively, diluted in PB1 medium containing 30% Ficoll plus 0.5 mol sucrose l-1. In the toxicity test of the solutions and each cryoprotectant, ethylene glycol was found to be toxic to embryos. For vitrification, expanded blastocysts were exposed to the vitrification solutions at 10, 20 or 25 degrees C for various periods; they were then cooled rapidly in liquid nitrogen, after which they were warmed rapidly. When the embryos were directly exposed to EFS40 at 20 degrees C for 2 min before vitrification, 66% of them re-expanded during 48 h of post-warming culture. The re-expansion rates decreased when exposure time was shortened (0.5 min), when exposure temperature was lowered (10 degrees C), or when embryos were vitrified in EFS20 and EFS30, although these conditions should be less toxic. When embryos had been pretreated in a dilute (10-20%) ethylene glycol solution for 5 min, followed by short exposure (0.5 min) to EFS40 at 20 degrees C, post-vitrification survival rate increased to 83-84%; furthermore, the rate reached 94% when the temperature was increased to 25 degrees C. Expanded blastocysts cryopreserved by this two-step method developed into live young as well as control embryos after transfer.(ABSTRACT TRUNCATED AT 250 WORDS)
During the past thirty-five years, we treated 221 patients with stage 1 renal cell carcinoma. We classified these patients into two groups: 175 patients who did not show recurrence and 45 patients who showed recurrence (excluding one patient who died of other disease). We investigated factors which affect the recurrence after nephrectomy and the survival after recurrence in these two groups. We found two major factors such as tumor diameter and tumor grade which affected the recurrence of renal cell carcinoma. Of these two factors, the grade of malignancy affected the prognosis of the patients with stage 1. Furthermore, as a result of long-term observation, we found that patients with grade I showed good prognosis compared with these with grade II, III and IV. The patients who showed weight loss constituted the majority of recurrent patients. Anaemia, erythrocyte sedimentation rate and positive reaction of C-reactive protein in addition to weight loss were major factors affecting the prognosis of stage 1 patients. In an effort to analysing the features of recurrent patients, there observed that no significant difference of the non-recurrent rate was detected between the patients who showed cancer death after nephrectomy and the patients who were living after nephrectomy. In analysing metastatic lesions and numbers of metastatic foci, we detected relatively long-term survival especially in patients with less than 3 foci of metastases in the lung, compared to those with multiple foci. Furthermore, we found dimension of the metastasis depended on the grade of the primary lesion.
A study of the clinical utility of the IMx PA Dainapack, a new kit for detection of serum prostate specific antigen (PSA) by a fully automated enzyme immunoassay (EIA) system, was conducted. Results concerning reproducibility, dilution linearity and sensitivity were good. The excellent assay performance of this kit, particularly in terms of its high sensitivity (0.1 ng/ml), was confirmed. The upper limit of normal was determined to be 4.0 ng/ml from the mean +/- 3 S.D. (3.79 ng/ml) in healthy male controls (n = 244). Using 4.0 ng/ml as the upper limit of normal, 6 of 244 healthy male controls (2%) were positive. In various urinary diseases, 173 of 192 prostatic cancer (90%) and 46 of 112 benign prostatic hypertrophy (BPH) (41%) cases were positive. In prostatic cancer, the positive rates increased with the advance in clinical stage and in stage A the positive rate was especially high (8 of 12 (67%) were positive). On the other hand, using the BPH group as a negative control, the maximum accuracy rate for prostatic cancer had a cut-off value of 8.0 ng/ml. Thus, 8.0 ng/ml is an appropriate cut-off value differentiating prostatic cancer from BPH while 4.0 ng/ml is the cut-off value between the normal group and those with prostatic cancer (including stage A) and BPH. In the follow-up patients with prostatic cancer, serum PSA values measured by this kit reflected the effectiveness of treatment. The correlations between values obtained with the IMx PA Dainapack and 6 current kits were good (r = 0.93 to 0.99) but the values differed with the kit.(ABSTRACT TRUNCATED AT 250 WORDS)
Luteinizing hormone-releasing hormone (LHRH) immunoreactive cells were found to be more numerous in the right side of the brain than in the left in male mice. Bilateral orchidectomy or removal of the right testis decreased the number of LHRH cells, while removal of the left testis failed to cause any changes in the number of LHRH cells. The results indicated a clear left-right difference in the neuroendocrine regulation of gonadal function in male mice.
A multicentric randomised trial was conducted for the purpose of investigating the efficacy of intravesical chemoprophylaxis of superficial bladder cancers. A total of 443 patients (number of evaluable patients, 284) were registered from July 1987 to December 1989 and randomised into 3 groups. Group A received 21 intravesical instillations of Adriamycin (ADM) at 20 mg/40 ml physiological saline for 2 years after undergoing transurethral resection (TUR); group B was given the same dose as group A but received 6 intravesical instillations for 2 weeks before undergoing TUR; and group C served as a control and underwent TUR only. Better prophylactic effects were obtained in group A. The overall non-recurrence rates calculated for groups A and B differed significantly (P less than 0.05) on day 240, and those determined for groups A and C were also significantly different (P less than 0.01) on day 480. No benefit was obtained using intravesical instillation prior to TUR (group B). The major side effects encountered were pollakisuria and miction pain, which occurred in 32% of the patients in group A and in 52% of those in group B.
Long-term results were analyzed in terms of tumor progression and survival in patients with superficial bladder cancer who were enrolled in the second intravesical chemoprophylactic study of the Japanese Urological Cancer Research Group for Adriamycin, which was started in July 1982. This study was a prospective, randomized, controlled trial conducted on primary tumors treated with a long-term instillation regimen that involved control versus intravesical instillations of Adriamycin or mitomycin C given once a week for the first 2 weeks, once every other week for 14 weeks, once a month for 8 months, and once every 3 months for 1 year, for a total of 21 instillations in 2 years. An analysis of the prophylactic effects of such treatment on bladder tumors after TUR has previously been performed, and the results have been published elsewhere. The present study represents a follow-up of the above trial. Of the 671 cases previously analyzed with regard to tumor prophylaxis, 158 cases (23.5%) were eligible to be followed for tumor progression and survival. A detailed comparison of the background factors between these 158 patients and the other 513 cases revealed no statistically significant difference. Thus, the 158 evaluable cases might reasonably be considered to represent all patients enrolled in the second study, and the results were thought to be reasonable enough to reflect the long-term efficacy of the long-term instillation regimen adopted in this study. The median follow-up for these 158 cases was 6.6 years. Tumor progression in terms of the disease stage and/or grade occurred in 43 of 127 patients who received prophylactic instillations and in 12 of 31 control cases. No significant difference in the incidence of tumor progression was found between the treatment and the control groups. In addition, no difference in survival was observed between the treatment group and the control group. Survival was also compared between patients who showed tumor progression and those who did not. All patients whose tumors did not progress survived, whereas the 7-year survival of those exhibiting tumor progression was less than 90%.
In a cooperative study of the Japanese Urological Cancer Research Group for Adriamycin, the usefulness of chemotherapy with methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC therapy) in treating advanced or recurrent bladder cancer was examined. Evaluation of the clinical responses obtained in 86 evaluable patients revealed 13 complete responses, 29 partial responses, 4 minor responses, 19 cases of no change, and 21 cases of progressive disease. The overall response rate was 48.8% (42/86). The rate of response to M-VAC therapy at each disease site was as low as 21.4% (3/14) in bone lesions but exceeded 40% in the primary lesion, the lymph nodes, the lung, the liver, and other lesions. The clinical response to M-VAC therapy was not significantly influenced by the performance status of the patients, the dose intensity, or previous therapy. The median duration of response for the 42 responders was 22.7 weeks (range, 8.1-134.1 weeks), and the median duration of survival for the 86 evaluable patients was 9.8 months. Side effects were frequently encountered; the patients experienced anorexia, nausea, vomiting, malaise, alopecia, and leukopenia, but all of these symptoms were tolerable.
The prognostic value of stage of lymph node metastases was evaluated in 357 patients who underwent curative resection for colorectal cancer. Subdivision of Dukes C patients according to the number of positive nodes revealed that the five-year disease-free survival rate (5DFS) was 63 percent in the patients with one to three nodes and 53 percent in those with four or more nodes (not significantly different). Classification according to the location revealed that 5DFS was 70 percent in those who had only local node metastases (n1+), compared with 40 percent in those who had distant node metastases along the major vessels (n2+) (P < 0.001). Twelve of 38 n2+ patients had only one distant node metastasis with no local node involvement (skip metastasis). They had lower 5DFS than the n1+ patients who had three or more positive local nodes (35 percent vs. 57 percent). We conclude that the location, rather than the number, of nodal metastases has a higher impact on prognosis in colorectal cancer patients.
Rabbit morulae were exposed to a vitrification solution-modified PBS [PB1] medium containing 40% ethylene glycol + 18% Ficoll + 0.3 M sucrose (EFS) for 2, 5, or 10 min at 20 degrees C and were vitrified in liquid nitrogen. When morulae were rapidly warmed, 96% had an intact zona pellucida. When embryos were cultured after removal of the mucin coat, high proportions of them formed blastocoel (79-100%), but the percentage of embryos developed to fully expanded blastocysts decreased with increased exposure time 87%, 40%, and 17%). The survival rate of morulae vitrified after removal of the mucin coat was lower than that of mucin-intact embryos. To assess the development potential in vivo, 131 embryos were vitrified after 2 min of exposure to EFS solution; all the embryos were recovered and 120 were transferred to recipients without removal of the mucin coat, resulting in 78 (65%) full-term fetuses or young. This simple method, which yields high survival both in vitro and in vivo, will be of practical use for vitrifying rabbit embryos.
Mouse morulae were exposed in one step to a vitrification solution (EFS, a modified PBS containing 40% ethylene glycol, 18% Ficoll, and 0.3-M sucrose) at various temperatures, then cooled rapidly in liquid nitrogen, and then warmed rapidly. All of the embryos exposed to the EFS solution for 0.5 min at 25 degrees C before vitrification developed in culture. However, survival rates were lower if the duration of exposure was prolonged to 2, 5, or 10 min. At lower ambient temperatures (20, 10, and 5 degrees C), high survival rates were associated with longer exposure to the EFS solution. The toxicity of the EFS solution was also lower at lower temperatures. The toxic injury of morulae was manifested as decompaction of the blastomeres. Among the three additives in the EFS solution, ethylene glycol, which can cross cell membranes, was responsible for the toxicity. The results show that the optimum time for exposure of the embryos to the EFS solution before rapid cooling varies with the ambient temperature, i.e., 0.5 min at 25 degrees C, 0.5-5 min at 20 degrees C, 2-5 min at 10 degrees C, and 2-10 min at 5 degrees C. If they are exposed for an optimum period, almost all mouse morulae can survive vitrification (94-100%).
The goal of our study was to examine the effects of amiloride on distal renal tubule calcium and sodium absorption at low and high luminal pH. In vivo microperfusion of distal convoluted tubules were performed on rats. Total Ca and Na concentrations in perfusion and collected fluids were measured by atomic absorption spectrometry. When tubules were perfused with low pH perfusate (pH = 5.6), net calcium absorption (JCa) averaged 5.4 pmol/min. With high pH perfusate (pH = 7.1), JCa was significantly higher averaging 8.9 pmol/min. (P less than 0.01). In contrast, net sodium absorption (JNa) was not affected by luminal pH (231 pmol/min. versus 237 pmol/min.). At low luminal pH, 10(-4) M amiloride analogue (5-N-methyl-N-isobutyl amiloride) (MIA) inhibited sodium absorption but stimulated calcium absorption. At high luminal pH MIA still inhibited Na absorption but it had no effect on calcium absorption. Thus, the natriuretic effect of amiloride appears to be independent of luminal pH, while the amiloride-stimulated distal calcium absorption is observed at low but not at high luminal pH.