Biomedical subjects

T Tsukamoto

Publications and source records attributed to T Tsukamoto.

At least 361 records · Page 20Linked to original sources

PubMed1995

Preventive effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer in a double-blind trial. The BLP Study Group.

A double-blind trial was conducted in 138 patients with superficial transitional cell carcinoma of the bladder following transurethral resection to evaluate the prophylaxis of recurrence by an oral Lactobacillus casei preparation (BLP). Patients were stratified into the following 3 subgroups: (A) with primary multiple tumors; (B) with recurrent single tumors, and (C) with recurrent multiple tumors. In each group, patients were randomly allocated to receive BLP or placebo. BLP showed a better prophylactic effect in subgroups A and B than placebo, whereas no significant difference was observed in subgroup C. Cox multivariate analysis showed that the outcome with BLP was significantly better than with placebo (p = 0.01). Slight and tolerable adverse reactions occurred in 3 patients receiving BLP and in 3 of the placebo-treated patients. Oral administration of BLP was thus safe and effective for preventing recurrence of superficial bladder cancer.

Administration, Oral↗

PubMed1995

Mass screening for prostate carcinoma: a study in Hokkaido, Japan.

Although there has been controversy about the early detection of prostate carcinoma by mass screening, we carried out an investigational study of such screening, using digital rectal examination (DRE) and serum prostate-specific antigen (PSA) determination in Hokkaido, Japan. We determined the detection rate and some profiles of the carcinoma detected by screening in Japanese men 50 years old and older. The detection rate of carcinoma was 1.10% in 1,639 participants. The rate linearly increased with aging from 0.25% for men in their fifties to 2.29% for those in their seventies. Two thirds of the carcinomas were T1(c) or T2, the frequency of which seemed to be higher than that of patients who visited medical institutions. The simultaneous use of both DRE and serum PSA determination showed a higher positive predictive value than either alone. Our current results indicated that the detection rate of carcinoma was higher than we previously anticipated for Japanese men, and that simultaneous use of DRE and serum PSA determination yielded a higher positive predictive value than either alone.

Aged↗

PubMed1995

Chlormadinone acetate as a possible effective agent for congenital adrenal hyperplasia to suppress elevated ACTH and antagonize masculinization.

We report two cases of congenital adrenal hyperplasia (CAH) in which administration of chlormadinone acetate (CMA), a substituted progestational agent for prostatic disease, suppressed ACTH hypersecretion and lowered plasma testosterone levels. Case 1 was 83-year-old male with advanced prostatic carcinoma and CAH due to 21-hydroxylase deficiency. His plasma testosterone did not decrease in spite of a bilateral orchiectomy. Case 2 was 40-year-old female with CAH due to 21-hydroxylase deficiency suffering from virilization after the cessation of cortisol supplement therapy because of her breast carcinoma. In these two cases, oral administration of CMA at a daily dose of 75-100 mg suppressed ACTH and cortisol to subnormal levels and reduced testosterone levels. With the suppressive effect on ACTH excess and antiandrogenic action, CMA may be suitable for patients with CAH suffering from symptoms due to overproduced ACTH or adrenal androgen.

Administration, Oral↗

PubMed1995

Inflammatory involvement of the hypophysis in Tolosa-Hunt syndrome.

We report a case of painful ophthalmoplegia (Tolosa-Hunt syndrome), which was complicated with diabetes insipidus (DI) and pituitary-adrenal axis hypofunction. A 42-year-old man hospitalized for left orbital pain and impairment of left cranial nerves III, IV, V, VI, developed diabetes insipidus during the corticosteroid treatment. Neuroimaging studies disclosed a thickened, highly contrast-enhanced pituitary stalk, swollen pituitary gland and widened left cavernous sinus up to the superior orbital fissure, which were accompanied by diabetes insipidus and hypofunction of the pituitary-adrenal axis. These were indicative of an extension of granulomatous inflammation of the cavernous sinus to the pituitary portal system and the gland itself.

Adult↗

PubMed1995

Increased peptidylglycine alpha-amidating monooxygenase activity in cerebrospinal fluid of patients with multiple sclerosis.

Peptidylglycine alpha-amidating monooxygenase (PAM) plays a key role in the biosynthesis of many biologically active neuronal and endocrine peptides that possess alpha-amide function at their C-terminus. Using D-Tyr-Val-Gly as the substrate, we measured PAM activity levels in the cerebrospinal fluid (CSF) and serum of patients with a variety of neurological diseases. PAM activity in the CSF was significantly increased in patients with multiple sclerosis (MS), especially during the active stage, compared with that in patients with other neurological diseases (p < 0.05). Levels of CSF PAM activity were not correlated with protein levels in CSF or with level of serum PAM activity. Since PAM is present not only in neurons but also in oligodendroglia, it is possible that the increase in CSF PAM activity in patients with MS may stem from massive demyelination and oligodendroglial destruction.

Adult↗

PubMed1995

[The preventive effect of indeloxazine hydrochloride to the sexual dysfunction caused by anti-androgenergic agent (allylestrenol)].

Anti-androgenergic agents are usually used for patients with benign prostatic hypertrophy (BPH). However steroidal anti-androgenergic agents tend to suppress the sexual function. This side effect is very significant in middle-aged men. Therefore we studied the preventive effect of indeloxazine hydrochloride (INDX), which induces an increase of the dopamine level in the brain, on the sexual dysfunction induced by an anti-androgenergic agent (allylestrenol: ALE). Thirty-six patients with BPH were classified into two groups, one used ALE only, and the other ALE with INDX. For the subjective evaluation of the sexual function, a self assessment questionnaire method was employed before and after administration. We especially studied 3 questions, "morning erection", "erectile capacity" and "frequency of sex". For the objective evaluation of the sexual function, nocturnal penile tumescence (NPT) was measured using an erectometer. NPT occurs in healthy males as a physiological phenomenon and it shows the erectile capacity objectively. The levels of LH, total testosterone and free testosterone were also determined. In the ALE only group, sexual dysfunction was found subjectively and objectively, but in the ALE with INDX group, it was not found. Levels of LH, total testosterone and free testosterone were decreased in the both groups. There was no significant difference between the two groups. We hypothesized that the sexual dysfunction due to ALE is related with not only to the decrease of androgen, but also to suppression of the central nervous system; for example, the suppression of the area of the brain mediating sexual behavior.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1995

[Clinical studies of spermatogenic damage in patients with testicular cancer].

We investigated the spermatogenic function of patients with testicular cancer, and the influences of anti-cancer chemotherapy on testicular function in these patients. Fifty-one patients with testicular cancer were selected for evaluation of their testicular function, including spermatogenesis and endocrinological function, before and after chemotherapy with anti-cancer agents. Before chemotherapy with anti-cancer agents, 22 of 49 patients (44.8%) had a sperm concentration of less than 20 x 10(6)/ml, and 8 patients (16.3%) showed azoospermia. The mean sperm concentration of the patients with testicular cancer was 29.0 x 10(6)/ml before therapeutic chemotherapy with anti-cancer agents, but within 3 months after chemotherapy, it decreased to 3.86 x 10(6)/ml (p < 0.01). Fifteen of 19 patients (73.7%) were revealed to have azoospermia. Damage to spermatogenesis became more severe with the number of chemotherapy treatment. No patients had a detectable sperm count at the completion of 3 or more courses of chemotherapy. But some patients who received 3 courses or more of chemotherapy showed recovered sperm counts after 2 or more years. Thus, a lack of sperm after chemotherapy for cancer did not necessarily indicate inability to recover spermatogenesis over 2 years after chemotherapy. Serum FSH levels of the patients were 5.62 +/- 3.43 mIU/ml before chemotherapy, and 19. 70 +/- 17.06 mIU/ml (p < 0.05) at the time of its completion. Serum FSH levels could reflect damage to spermatogenesis in these cases. Cases in which spermatogenesis did not recover may have higher serum FSH levels than those with recovery of spermatogenesis.

Adolescent↗

PubMed1995

[Clinical efficacy of neoadjuvant M-VAC chemotherapy for invasive bladder cancer].

We clinically evaluated the efficacy of neoadjuvant M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) therapy followed by radical cystectomy. A total of 21 patients with locally invasive bladder cancer received neoadjuvant M-VAC therapy with an average of 2.4 courses (range 2-4). Of the 21 patients, 4 had stage T2N0M0, 11 had stage T3aN0M0, 5 had stage T3bN0M0 and 1 had stage T4N0M0 at diagnosis. Of the 21 patients, 3 had clinically complete responses (cCR) and 12 had partial responses (cPR), for an overall response rate of 71.4%. The patients who responded to the chemotherapy (cCR + cPR) had a 2-year disease free rate of 80.0% in contrast to 50.0% for the remaining patients who did not respond. A pathological response (pT0, pT1) was achieved in 6 (28.6%) of the 21 patients. The 5 patients in this group remain free of disease for 15 to 79 months (mean 58.8 months). These preliminary results suggest that the patients who achieve either a complete or partial response, in particular those had pathological stage of pT0 or pT1, may have a favorable clinical course.

Adult↗

PubMed1995

[A study on the erectile response with the vacuum constriction device compared with intracavernous injection of a vasoactive drug].

Many types of vacuum constriction devices (VCDs) are used for the treatment of impotence, but the VCDs made in the USA are too large for Japanese males, and air leakage occurs. Therefore, we examined the erectile response of 47 impotent men to a vacuum constriction device that is made in Japan and can be applied suitably for Japanese men, and compared the response to intracavernous injection of prostaglandin E1 (PGE1). When the 47 cases were divided into two groups by nocturnal penile tumescence, twenty of the impotent men were regarded to have fewer organic factor (group A) while 27 were regarded to have more organic factor (group B). All (100%) of the 20 cases of group A achieved a complete erection with the VCD, but only 11 (55%) of them achieved a complete erection with PGE1. Twenty-three (85%) of the 27 cases of group B achieved a complete erection with the VCD, but only nine (33%) achieved a complete erection with PGE1. Two of the four patients who did not achieve a complete erection with the VCD stopped pumping the VCD because of penile pain, and the other two patients had a penile-brachial pressure index (PBPI) of under 0.65. It was suggested that patients with no severe vascular disease can show a good erectile response with the VCD.

Alprostadil↗

PubMed1995

[Uretero-aortic fistula: a case report of a serious complication of indwelling ureteral catheter].

We present a case of a uretero-aortic fistula assumed to be caused by an indwelling ureteral catheter. A 65-year-old male who underwent cystectomy and ureterocutaneostomy with bilateral ureteral stents had been well until gross hematuria from the left catheter developed. In spite of a through radiological examination of the left kidney, no abnormal findings were noted. However, massive hemorrhage was encountered on catheter exchange, prompting us to suspect a formation of a uretero-arterial fistula. CT scan was performed again, demonstrating severe adhesion between the left ureter and the aorta at the crossing point. At exploration, a fistula of about 7 mm between the left ureter and anterior surface of the aorta was recognized. Left nephro-ureterectomy and closure of the aortic fistula with a rectus muscle fascia wrapping was successfully performed. His postoperative course was uneventful. Because the continued increase in the utilization of ureteral catheters could cause frequent occurrence of this condition, urologists should be aware of a uretero-arterial fistula as possible serious complication of indwelling ureteral catheters.

Aged↗

PubMed1995

Cytokines modulate in vitro invasiveness of renal cell carcinoma cells through action on the process of cell attachment to endothelial cells.

Cytokines play important roles in adhesion between various cells and endothelium. Cell-cell adhesion is also a critical step in the invasion of interstitial tissue by cancer cells. Using an in vitro invasion assay modified by cultured human umbilical venule endothelial cells (HUVEC) and an extracellular matrix (Matrigel) membrane system, we studied how cytokines affect the invasiveness of human renal cell carcinoma cells through action on the endothelium. When HUVEC were treated for 6 hours with tumor necrosis factor (TNF, 100 or 1000 U/ml.), interleukin-1 (IL-1, 10 ng./ml.) or IL-6 (1.0 or 10 ng./ml.), the treatment significantly increased in vitro invasiveness of the carcinoma cells. Enhancement of carcinoma cell invasiveness reflected the enhancement by the cytokine treatments of the ability of HUVEC to express vascular cell adhesion molecule-1 (VCAM-1). Application of anti-VCAM-1 monoclonal antibody (mAb) suppressed in vitro invasion of the carcinoma cells when HUVEC were treated with the cytokines at the above concentrations. Moreover, an adherence assay demonstrated that a larger number of carcinoma cells adhered to the endothelium treated by the cytokines than to endothelium not receiving such treatment and that anti-VCAM-1 mAb application inhibited the adhesion. The cytokine treatment of HUVEC did not affect type IV collagenolysis. These results indicated that cytokines can enhance the in vitro invasiveness of carcinoma cells through their action on endothelium (that is, augmentation of VCAM-1 expression) in the in vitro invasion assay modified with HUVEC-Matrigel-reconstituted membrane.

Antibodies, Monoclonal↗

PubMed1995

Blood coagulation and fibrinolytic activity during femoral neck prosthetic replacement using bone cement.

To assess the blood coagulative and fibrinolytic responses during cemented femoral neck replacement, we measured these parameters in 9 patients, including anti-thrombin III (AT-III), prothrombin time (PT) and activated partial thromboplastin time (APTT) before surgery, just before packing bone cement and after the insertion of the prosthesis. We also measured thrombin-anti-thrombin III complex (TAT), plasmin-alpha 2-plasmin inhibitor complex (PIC), and D-dimer. A significant increase in APTT, and decrease in AT-III and PT were observed before the insertion of bone cement and prosthesis. The value of TAT and D-dimer increased significantly after the insertion of the prosthesis, but there were no significant changes in PIC. The data suggest that blood coagulation is activated after the insertion of bone cement and prosthesis into the femoral shaft, and in addition, the fibrinolysis is also accelerated secondary to the activation of the coagulation. Further investigations are needed to establish whether the activation of the coagulation induced by the cemented replacement exerts a great influence on the appearance of pulmonary thrombosis or circulatory depression.

Adult↗

PubMed1995

[Domestic infection of neurocysticercosis in a Japanese woman, who had not travelled overseas].

A 52-year-old Japanese woman was found to have a single parenchymal cystic lesion in the operculum of the left frontal lobe. Although she had not travelled overseas, neuroradiological and serological studies supported the diagnosis of neurocysticercosis. Three months after a trial with praziquantel, although the cystic lesion decreased in size on MR imagings, she suddenly developed motor dominant aphasia as a manifestation of epileptic attack. This appears to have followed the death of the cysticercus, releasing the cysticercus contents into the surrounding brain and to have stimulated an intense reactive inflammation. Neurocysticercosis, although rare in Japan, may be positively identified by neuroimaging and serological studies and can be treated conservatively with praziquantel.

Animals↗

PubMed1995

[Reconstructive surgery for mitral valve regurgitation in 64 patients: postoperative results of each different type of surgical methods].

Between January 1981 and November 1994, 64 patients underwent reconstructive surgery for mitral valve regurgitation (MR). The ages of the patients ranged from 18 to 71 years (52.8 +/- 8.9). Pathological causes of regurgitation were degenerative in 41 (64%), infective endocarditis in 9 (14%), rheumatic in 8 (13%) and ischemic in 6 (9%). In 27 patients, Kay's and Reed's methods were performed for prolapsed valve and enlarged annuls. In 23 patients who had ruptured chordae of the anterior leaflet in 3, posterior leaflet in 17 and both anterior and posterior in 3, McGoon's method was performed. Ten patients, who had elogated chordae or ruptured papillary muscle, were repaired with GORE-TEX sutures. Cleft repair with sutures and leaflet repair with autopericardium patch was done in 4 patients. There was no hospital death, but one late death. With the follow-up interval from 2 to 155 (mean 63.2) months after surgery, the incidences of freedom from reoperation were 94.8% after McGoon procedure, 89.7% after Kay and Reed, 88.9% after chordaplasty and 75% after cleft and patch repair. The hemodynamics and left ventricular function after McGoon repair in 15 patients revealed with significantly better outcomes than after valve replacement in 15 patients. In conclusion, optimal selection of reconstructive procedures will offer satisfied postoperative long-term results with less freedom of reoperation for MR.

Adolescent↗

PubMed1995

[Acute bacterial meningitis and foramen magnum syndrome as a presentation of odontoid osteomyelitis. A case report].

A 77-year-old male was hospitalized with a 6-day history of severe posterior cervical pain and headache. An initial lumbar puncture revealed polymorphonuclear pleocytosis indicating pyogenic meningitis. The blood and throat cultures on admission were positive for Staphylococcus aureus. A combination of ceftriaxone and ABPC, both of which were sensitive to the pathogen, were intravenously administered for one month, by which he responded well as to the meningitis. However, he was found to have persistent neck pain, and wasting and weakness of the shoulder girdles, which were associated with polyneuropathy-like sensory loss. Neuroimaging studies disclosed a partial destruction of the odontoid process, subluxation of the atlantoaxial joint, MRI evidence of an inflammatory pseudomass formation dorsal to the odontoid process and an increased uptake of radionuclide on bone scanning, all of which were indicative of osteomyelitic processes at the region of the axis; i.e., the meningitis was thought to be secondary to osteomyelitis of the odontoid process and hence the foramen magnum syndrome characteristic to this particular case was explained by the compression of the cervicomedullary junction due to the pseudomass. To our knowledge, this is the first case of primary odontoid osteomyelitis to be reported in Japan.

Acute Disease↗

PubMed1995

[Sex determination from dental calculus by polymerase chain reaction (PCR)].

We studied sex determination from dental calculus by the PCR method using primers which recognize DYZ3 region of Y-chromosome and DXZ1 of X-chromosome. The amounts of DNA obtained from 1.7-25.0 mg of dental calculus samples ranged 0.6-26.4 micrograms, and the majority of DNA was low molecular weight DNA. After PCR amplification, Y and X products were observed by the method of polyacrylamide gel electrophoresis. Both Y and X amplification products were observed in 26 out of 29 male samples, while, Y products was not detected in two samples and neither Y nor X product was detected in one sample. In 17 out of 20 female samples, only X product was observed, while, Y and X products were observed in three samples. The minimum amount of DNA for sex determination was 3 pg. Sex determination using DNA in dental calculus will be quite useful for forensic application because it can be done without destruction of morphological characteristics of teeth.

DNA↗

PubMed1995

Portography in decision-making about indications for liver resection in hepatolithiasis.

We studied the findings of portograms of patients with hepatolithiasis and the role of portography in decision-making about indications for hepatic resection. The subjects were 20 patients in whom hepatic arteriography including the portal phase or percutaneous transhepatic portography was done. We studied the relationships between the findings of the portograms and cholangiograms and hepatic atrophy or associated cholangiocarcinoma. The portal vein in the involved segment of the liver was obstructed in nine patients, and these patients had hepatic atrophy with or without cholangiocarcinoma. There were 16 patients with hepatic atrophy. Four of five other patients in whom protal shrinking was seen had hepatic atrophy. Bile ducts in the involved segment were obstructed in six patients with hepatic atrophy. In all five patients with cholangiocarcinoma, there was portal obstruction at the branching point in the hepatic hilum, with obstruction of the bile ducts at the same point in two of these patients. Hepatic atrophy and cholangiocarcinoma was more closely associated to changes of the portal vein than obstruction of the bile ducts. Portography is useful to diagnose hepatic atrophy and cholangiocarcinoma and for decision-making about indications for hepatic resection in hepatolithiasis.

Adult↗

PubMed1995

Case of hepatolithiasis diagnosed by magnetic resonance cholangiography.

We report a case of hepatolithiasis in which cholangiography by magnetic resonance (MR) imaging was useful in making a detailed diagnosis. Sonograms showed a high echoic lesion in the liver, and computed tomograms showed dilated intrahepatic bile ducts and atrophic hepatic tissue. By ordinary cholangiography, these findings were not made because of obstruction of the bile ducts by the stones. In MR cholangiograms, intrahepatic stones in dilated bile ducts in the posterior segment were seen, as were dilated bile ducts in the peripheral part of this segment. Posterior segmentectomy was done. The operative specimens had stones in the dilated bile ducts, and hepatic tissue was atrophic. MR cholangiography is useful to diagnose not only hepatolithiasis but also dilatation in the bile ducts. MR cholangiography should be tried if other examinations do not give sufficient information.

Calculi↗