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T Umekawa

Publications and source records attributed to T Umekawa.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Bladder cancer in patients with spinal cord injury: report of two cases].

Two cases of bladder cancer in patients with spinal cord injury are reported. A 57-year-old paraplegic woman who had had an indwelling urethral catheter for 20 years visited our hospital with macroscopic hematuria. A bladder tumor was found endoscopically. A transurethral biopsy revealed a squamous cell carcinoma. She refused operation and received radiation therapy. The second case was in a 69-year-old paraplegic man on clean intermittent catheterization for 2 years presenting with a high grade fever. The diagnosis was a transitional cell carcinoma of the urinary bladder. Bilateral cutaneous ureterostomy was performed because of tumor invasion. He received radiation therapy but died of cancer 18 months after surgery.

Aged↗
PubMed1997

Detection of osteopontin as matrix protein in calcium-containing urinary stones.

Osteopontin (OPN) has been identified as a matrix protein of calcium oxalate urinary stones by sequencing c-DNA for urinary stone protein. OPN, a phosphoprotein, is susceptible to thrombin digestion and specifically stainable with Stains-All. We examined the matrix in 4 kinds of urinary stones, calcium oxalate dihydrate, calcium phosphate, magnesium ammonium phosphate and uric acid; for the presence of OPN by staining thrombin-digestion and undigested matrix with Stains-All. Matrix was extracted with a 0.1 M ethylenediamine tetraacetic acid (EDTA) solution. Furthermore, the amino acid sequence was determined for the NH2-terminal 20 amino acid residues. OPN was identified in calcium oxalate dihydrate and calcium phosphate stones, but was absent in magnesium ammonium phosphate and uric acid stones. Our findings suggest that OPN, which binds tightly to hydroxyapatite and is related to bone formation as bone matrix, also participates in the formation of calcium-containing urinary stones.

Calcium Oxalate↗
PubMed1997

[Two cases of renal cell carcinoma detected by metastasis to another organ].

Two cases of rare metastases from renal cell carcinoma are reported. The first case was in a 44-year-old man presenting with left exophthalmos. Radiological examination revealed left renal tumor with metastases to paraaortic lymph nodes, left orbit, bone and lungs. Radical nephrectomy was performed. Pathological diagnosis was renal cell carcinoma, pT3aN2M1. The patient died of widespread pulmonary metastasis 5 months postoperatively. The second case was in a 59-year-old man with a complaint of tongue tumor. Histopathology of the enucleated tumor was suggestive of metastatic renal cell carcinoma. Computed tomographic scan revealed left renal tumor with regional lymph node metastasis. No other metastasis was found. Radical nephrectomy confirmed the pathological diagnosis of renal cell carcinoma, pT3bN1M1. He has been treated with interferon-alpha and has been free of recurrence for 10 months postoperatively.

Adult↗
PubMed1997

[A case of functioning parathyroid cyst].

A case of functioning parathyroid cyst is reported. A 63-year-old woman consulted our hospital with the chief complaint of neck and joint pain. At that time, laboratory data showed a serum calcium level of 12.8 mg/dl and a phosphorus level of 2.2 mg/dl. Plasma levels of intact PTH were elevated to 278 pg/ml. Computerized tomography, ultrasonography and magnetic resonance imaging suggested parathyroid cyst on the left side of the thyroid gland. We performed left superior parathyroidectomy. The cyst measured 30 x 40 x 30 mm and was chocolate colored. The histopathological diagnosis was a functioning parathyroid cyst. Her postoperative course was uneventful and she was discharged on the 10th postoperative day without symptoms. To our knowledge, only 38 cases of functioning parathyroid cyst have been reported in the Japanese literature.

Cysts↗
PubMed1996

Expression of uncoupling protein in skeletal muscle and white fat of obese mice treated with thermogenic beta 3-adrenergic agonist.

The mitochondrial uncoupling protein (UCP) is usually expressed only in brown adipose tissue (BAT) and a key molecule for metabolic thermogenesis. The effects of a highly selective beta 3-adrenergic agonist, CL316,243 (CL), on UCP expression in skeletal muscle and adipose tissues were examined in mice. Daily injection of CL (0.1 mg/kg, sc) to obese yellow KK mice for two weeks caused a significant reduction of body weight, associated with a marked decrease of white fat pad weight and hypertrophy of the interscapular BAT with a sixfold increase in UCP content. Clear signals of UCP protein and mRNA were detected by Western and Northern blot analyses in inguinal, mesenteric and retroperitoneal white fat pads, and also in gastrocnemius and quadriceps muscles, whereas no signal in saline-treated mice. The presence of UCP mRNA in muscle tissues was also confirmed by reverse transcription-PCR analysis. Weaker UCP signals were also detected in control C57BL mice treated with CL, but only in inguinal and retroperitoneal fat pads. Immunohistochemical examinations revealed that UCP stains in the white fat pads were localized on multilocular cells quite similar to typical brown adipocyte, and those in the muscle tissues on myocytes. The mitochondrial localization of UCP in myocytes was confirmed by immunoelectron microscopy. In addition to UCP protein, UCP mRNA was also detected in myocytes by in situ hybridization analysis. Thus, chronic stimulation of the beta 3-adrenergic receptor induces ectopic expression of UCP in adipose tissues conventionally considered as white fat and even in skeletal muscle, which probably contributes to the potent anti-obesity effect of the beta 3-adrenergic agonist.

Adipose Tissue↗
PubMed1996

Effect of CL316,243, a highly specific beta3-adrenoceptor agonist, on sympathetic nervous system activity in mice.

To examine whether long-term administration of a beta3-adrenoceptor agonist influences sympathetic nervous system (SNS) activity, norepinephrine (NE) turnover, a reliable indicator of SNS activity, in the interscapular brown adipose tissue (IBAT), the heart, and the spleen, as well as urinary excretion of NE, were measured using mice treated with CL316,243 (CL), a highly specific beta3-adrenoceptor agonist, at a dose that stimulated thermogenesis and reduced body weight. CL significantly decreased NE turnover in the IBAT, heart, and spleen and decreased urinary excretion of NE without affecting food intake over 1 to 4 weeks of treatment. These findings show that long-term administration of the beta3-adrenoceptor agonist decreases SNS activity and urinary excretion of NE.

Adipose Tissue, Brown↗
PubMed1996

A case of Sheehan's syndrome with delirium.

A 53 year old woman was brought to a psychiatric clinic because of delirium. Upon immediate examination, severe hyponatremia (105 mEq/L) was detected. She was suspected of having internal diseases and referred to our university hospital. When she reached our hospital she was delirious and showed excitement and agitation. Her electroencephalogram showed low voltage theta waves (20 microV) in all leads. She was hospitalized and diagnosed with acute tonsillar abscess and panhypopituitarism based on various endocrine tests. Her past history suggested that Sheehan's syndrome had developed after child-bearing at age 31, resulting in panhypopituitarism. After administration of antibiotics, the fever and tonsillar abscess gradually recovered, and the correction of electrolytes improved the level of consciousness, suggesting that the hyponatremia had been closely related to the clouding of consciousness. As the subsequent administration of cortisol kept the patient's serum sodium levels within the normal range, a decrease in plasma cortisol seemed to be the major cause of the hyponatremia. Psychological symptoms of panhypopituitarism often included abulia, apathy and occasionally coma. However, it is rare for a patient with panhypopituitarism to be misdiagnosed as having a psychiatric disease with delirium. This rare case is presented.

Delirium↗
PubMed1996

Prevalence of urolithiasis in Kaizuka City, Japan--an epidemiologic study of urinary stones.

BACKGROUND: According to the results of nationwide surveys, the prevalence of urolithiasis has been steadily increasing in Japan. However, these surveys relied on hospital statistics, and there has been no survey of the prevalence of urolithiasis in Japan utilizing postal questionnaires. We surveyed the prevalence of urolithiasis among the inhabitants of Kaizuka City. METHODS: A total of 3,000 inhabitants ranging from 20 to 59 years old were randomly selected from the census register in numbers consistent with the population distribution of each district and sex by municipal computerized system. RESULTS: A total of 1,975 postal questionnaires were returned, and 1,972 (65.7%) were considered valid. Of the respondents, 137 (6.95%) had a history of stones (men; 9.64%, women; 4.51%). The annual incidence of urolithiasis for Kaizuka citizens aged from 20 to 59 years old in 1991 was 0.97%, and the lifetime prevalence of urolithiasis increased linearly with age, and it was 10.3% for respondents in their 50s. In the total survey population of 7,568, which included the respondents and their family members, 342 (4.52%) had a history of stones. Male administrative workers had a significantly higher prevalence than any other occupational group. The monthly expenditure on food by the families of stone formers was significantly greater than that by the families of non-stone formers. CONCLUSION: Extrapolation of the findings suggests that > 10% of the general population (> 13% of men and > 7% of women) can be expected to suffer from urolithiasis at least once in their lifetime.

Adult↗
PubMed1996

Acute hemorrhagic cystitis by adenovirus type 11 with and without type 37 after kidney transplantation.

We report 2 kidney transplant patients with acute hemorrhagic cystitis. Adenovirus type 11 was isolated in the urine of both patients and in 1 patient adenovirus type 37 was also isolated. Each developed macrohematuria with urgency, micturition pain, elevated fever and functional deterioration of the transplanted kidney possibly due to acute rejection. These symptoms and laboratory data suggesting renal impairment persisted for approximately 4 weeks after therapy for acute rejection had been started without any specific additional treatment for adenovirus. Serum creatinine levels returned to slightly higher values than before this episode. Histological findings of biopsy specimens from the transplanted kidney in 1 patient indicated that renal impairment was attributable to acute rejection. According to the clinical results of our cases, there were no remarkable differences between adenovirus type 11 infection with or without type 37 infection. Acute hemorrhagic cystitis caused by the adenovirus is an interesting complication after kidney transplantation, especially with regard to kidney impairment and treatment.

Acute Disease↗
PubMed1996

The effect of osteopontin on the adhesion of calcium oxalate crystals to Madin-Darby canine kidney cells.

OBJECTIVE: We have recently reported that osteopontin protein (OPN) is present in calcium-containing urinary calculi and in rat distal tubular cells and that it is an important substance of the matrix in urinary stone formation. To investigate how OPN participates in urinary stone formation, we assessed the role of OPN in the adhesion of the surfaces of Madin-Darby canine kidney (MDCK) cells, which are distal tubular cells of the dog, to calcium oxalate crystals. METHODS: We cultured MDCK cells with OPN, thrombin, which is an OPN inhibitor, Arg-Gly-Asp peptide and Arg-Gly-Glu peptide as a control for Arg-Gly-Asp peptide, and examined changes in adhesion of calcium oxalate crystals to the cells by scanning electron microscopy and the calcium (45Ca) concentration around the cells. RESULTS: The 45Ca concentration in calcium oxalate crystals adhering to MDCK cells was about 1.4 times higher in MDCK cells incubated with OPN than in an MDCK-cell-negative group, and was about one half that in MDCK cells incubated with thrombin than in the group without MDCK cells. CONCLUSION: OPN is considered to be an accelerator of urinary stone formation because of the increase in adhesion of calcium oxalate crystals to the renal distal tubular epithelium in the presence of OPN. These findings suggest that OPN plays an important role in the formation of calcium-containing urinary stones.

Animals↗
PubMed1996

Nephrogenic diabetes insipidus induced by lobenzarit disodium treatment in patients with rheumatoid arthritis.

Nephrogenic diabetes insipidus (NDI) occurred in a 43-year-old woman who had received lobenzarit disodium for the treatment of rheumatoid arthritis (RA). Her urine output was initially 3 l/day and urine osmolarity was 203 mOsm/l. Based on a sodium chloride loading test and a vasopressin loading test, she was diagnosed as having lobenzarit-induced NDI. Seven days after the cessation of the use of lobenzarit disodium, polydipsia and polyuria disappeared, and the vasopressin test showed a normal response. These findings suggest that lobenzarit induces a reversible form of NDI as a side effect. The reports of lobenzarit-induced NDI in Japan during the past seven years are also reviewed.

Adult↗
PubMed1996

[Indications of parathyroidectomy for bone disease associated with secondary hyperparathyroidism].

BACKGROUND: The indications and suitable operative time of parathyroidectomy for secondary hyperparathyroidism were discussed. METHODS: From October 1978 to September 1994 parathyroidectomy was performed for 71 patients who had bone and/or joint pain due to secondary hyperparathyroidism. There were 37 men and 34 women (mean age 48.4 years). The duration of dialysis treatment before parathyroidectomy was 0.8 to 19 years, with a mean of 10.9 years. RESULTS: Postoperative subjective improvement was noted in 69% of the patients. No significant difference was observed between the improved and non-improved groups regarding age and the duration of dialysis treatment. But the improvement rate in female patients was significantly lower than that in male patients. CONCLUSION: Patients with high carboxyl-terminal PTH level and generalized fibrous osteitis were good suitable objects for parathyroidectomy. But, those with high serum aluminum level were unsuitable objects for it. Furthermore, 99mTc-Pyrophosphate bone scintigraphy and bone mineral determination using dual photon absorptiometry (DPA) or dual energy X-ray absorptiometry (DEXA) were proved to be valuable for patient selection for parathyroidectomy.

Adult↗
PubMed1996

[Long-term effect after total parathyroidectomy with autotransplantation for secondary hyperparathyroidism].

Although the short-term outcome of total parathyroidectomy combined with autotransplantation in cases of renal osteodystrophy has been reported by many investigators, few studies have been made on the long-term outcome of this surgical technique. We recently examined the long-term outcome of this surgery by following 19 cases for more than one year (range: 12-70 months, mean: 31.7 months). During the follow-up period, changes in subjective symptoms, biochemical parameters and bone mineral density (BMD) were monitored. At the end of the follow-up period, C-parathyroid hormone (C-PTH) and alkaliphosphatase (ALP) were significantly lower than their preoperative levels. Ca, P and %BMD showed no significant change from their preoperative levels, although %BMD tended to be higher than its preoperative level. Depending on the presence or absence of osteoarticular pain at the end of the follow-up period, the patients were divided into the improved group and the non-improved group. Of the 5 patients allocated to the non-improved group, 4 were female and only 1 was male. C-PTH and ALP were significantly higher in the non-improved group. %BMD was higher in the improved group than in the non-improved group, although this difference was not significant. In the non-improved group, 2 patients were suspected of having extra parathyroids, 1 was suspected of having recurrence, and 2 were suspected of having postoperative osteomalacia. Postoperative reduction in BMD was only seen in females, suggesting its relationship to postmenopausal osteoporosis.

Adult↗
PubMed1996

A pediatric case of ureteropelvic junction obstruction treated with retrograde endopyelotomy.

To determine the feasibility of retrograde endopyelotomy in the management of pediatric ureteropelvic junction (UPJ) obstruction, we treated one girl aged 6 years with the Acucise cutting balloon devise for symptomatic UPJ obstruction. The Acucise catheter (7 Fr, flexible) was placed by a cystoscope over a guide wire with fluoroscopic guidance under general anesthesia. After cutting the stenotic area electronically and dilation until 24 Fr for 10 seconds, a 6/10 Fr endopyelotomy ureteral catheter was left in situ for 8 weeks after the operation. Total operating time was 45 minutes and the child was discharged 3 days after the operation. There were no acute complications and short-term, follow-up 8 months after the operative results were satisfactory as determined by intravenous pyelography and diuretic renogram. UPJ obstruction in children may be treated by retrograde endopyelotomy with the Acucise catheter as well as adults. The principal potential advantage of this procedure is reduced morbidity as compared with antegrade endopyelotomy.

Child↗