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Biomedical subjects

Y Aso

Publications and source records attributed to Y Aso.

At least 145 records · Page 8Linked to original sources
PubMed1993

[A clinical classification of severity of benign prostatic hyperplasia].

The grading of severity of benign prostatic hyperplasia (BPH) was attempted by scoring clinical manifestations associated with the disease. The total score (0 to 100 points) is the sum total of subjective and objective one, each of which is 50 points at its maximum. Subjective score is composed of symptom score (0 to 25 points) evaluating 5 each obstructive and irritative symptoms and quality of life (QOL) score (0 to 25 points). Objective score consists of functional and anatomical scores. Functional score (0 to 25 points) is calculated by scoring maximum flow rate and residual urine. Anatomical score (0 to 25 points) is calculated by the score of prostatic volume. Seventy-seven BPH patients have been evaluated by this scoring system. The mean values of 4 kinds of scores (symptom, QOL, functional and anatomical scores) were about 8-9 points and thus comparable each other. The total score was 35.4 +/- 12.3 in the average and divided into 6 grades: Grade 0; < 10, Grade 1; > or = 10, Grade 2; > or = 20, Grade 3; > or = 30, Grade 4; > or = 40, Grade 5; > or = 50. The present scoring and grading systems appear to be appropriately formulated to estimate the global severity of BPH patients. Further studies to apply the system to evaluation of therapeutic responses would be mandatory to examine its validity.

Humans↗
PubMed1993

[A survey of postoperative steroid replacement in 40 patients with Cushing's syndrome].

Adrenalectomy for Cushing's syndrome due to adrenocortical adenoma was performed on 40 patients at Tokyo University Hospital between 1960 and 1990. There were 32 women and 8 men aged 2 to 59 (mean 35.7) years. Three different operative approaches to the adrenal gland were employed: lumbar approach in 24 cases, dorsal in 8, and transabdominal in 8 of whom 7 patients were operated before 1970 without definite preoperative localization of the lesions. Postoperative administration of cortisone and hydrocortisone as a steroid replacement has been reduced in duration and dosage in recent 10 years. Average treatment period was 3 years and 1 month in the 1970's, and 9.5 months in the 1980's, respectively. The mean daily dosage of steroid hormone was 517.5 mg (mean) on the operative day and 43.1 mg after three weeks in the 1970's, while 187.5 mg and 18.4 mg in the recent five years, respectively. Nonetheless, even in the recent 6 patients, metabolic alkalosis and hypopotassemia because of steroid excess were observed in a few days after the surgery. These observations indicate that period and dosage of steroid replacement have been reduced in these years and could be further shortened by means of rapid tapering in the early postoperative phase.

Adenoma↗
PubMed1993

A randomized phase II trial of flutamide vs chlormadinone acetate in previously untreated advanced prostatic cancer. The Japan Flutamide Study Group.

We have conducted a double-blind comparative study of flutamide and chlormadinone acetate (CMA) on patients with stage C or D prostatic cancer and with no prior experience of hormone therapy. This is believed to be the first such trial entered in the medical literature, fifty-four patients were randomly selected to undergo flutamide (p.o.) monotherapy at a daily dose of 375 mg, which was determined as the optimal dose in Japan in our previous phase II study. Forty-nine others were randomly selected to undergo CMA (p.o.) monotherapy at a daily dose of 100 mg, which is the most commonly used dosage in Japan for patients with prostatic cancer. Ultimately, 47 patients from the flutamide group and 40 patients from the CMA group were judged eligible, with efficacy being evaluated after 12 weeks of treatment. Similar objective responses were seen in both groups: 48.9% (95% confidence limits 34.1-63.9%) in the flutamide group, 45% (95% confidence limits 29.3-61.5%) in the CMA group. The response at each organ site was also similar between the groups. Serum prostatic specific antigen decreased by more than 50% of the abnormal pretreatment level in 87.5% of the flutamide group and in 85.7% of the CMA group. Serum luteinizing hormone, follicle-stimulating hormone, testosterone and 5 alpha-dihydrotestosterone decreased significantly in the CMA group, but increased significantly in the flutamide group. The serum testosterone level after 12 weeks of treatment was 0.955 +/- 0.13 ng/ml in the CMA group and 6.64 +/- 0.38 ng/ml in the flutamide group. The serum estradiol level also increased significantly in patients in the flutamide group. The serum prolactin level decreased significantly in the flutamide group, but increased significantly in the CMA group. Eight patients on flutamide manifested gynecomastia. Diarrhea and hepatic toxicity were observed in both groups, but only rarely, and were well tolerated. We have thus concluded that flutamide is as effective as CMA in maintaining libido and potency without decreasing testosterone levels.

Aged↗
PubMed1993

[Clinical use of an extracorporeal shock wave lithotriptor, Biolithos MARK III, for upper urinary tract stone].

The results of clinical use of an extracorporeal shock wave lithotripter (Biolithos MARK III) are presented. From May 1991 through February 1992, a total of 50 sessions were carried out on 33 patients with upper urinary tract stones. Treatments were performed on an outpatient basis, and none of the patients needed anesthesia or analgesia. One month after the last session, 18 patients (54.5%) were free from stone fragments and 6 (18.2%) had stone fragments equal to or smaller than 4 mm. The over-all successful rate obtained by these categories was 72.7%. After treatment no serious complications were observed. Although gross hematuria appeared in almost all patients, pain was noted in only 5 patients. Laboratory data after treatments showed slight and transient changes. It is concluded that Biolithos MARK III is useful and safe in the management of upper urinary tract stones on an outpatient basis.

Adolescent↗
PubMed1993

[Transurethral resection of papillary tumor in the lower end of the ureter: report of two cases].

Two cases of papillary ureteral end tumors, treated by transurethral resection are presented. Case 1: A 71-year-old female visited us for asymptomatic macroscopic hematuria. Cystoscopy revealed a papillary pedunculated tumor in the bladder protruding from the right ureteral orifice. Under a diagnosis of superficial tumor at the right ureteral end, transurethral resection was performed using a rigid ureteral resectoscope. Pathological examination revealed transitional cell carcinoma, grade 2 without muscular invasion. There is no evidence of recurrence after 25 months of follow up postoperatively. Case 2: On a routine cystoscopy after transurethral resection of bladder tumor in a 68-year-old male, papillary pedunculated tumors protruding from the right ureteral orifice were found. Under a diagnosis of superficial tumor at the right lower ureter, transurethral resection was performed using cold cup forceps and loop electrocoagulation. The tumor was transitional cell carcinoma, grade 1 without invasion. No evidence of recurrence was detected 15 months postoperatively. Transurethral resection of the ureteral tumor at the lower end appeared to be useful for the selected cases. The indications, complications and follow up for this procedure were discussed.

Aged↗
PubMed1993

[Phase I study of flutamide, a nonsteroidal antiandrogen, in patients with prostatic cancer].

A phase I study of orally administered flutamide (a pure anti-androgen) was performed in 26 patients with prostatic cancer. No side effects were observed in 11 patients receiving single doses of either 125, 250, 375 or 500 mg. However, in the daily dosing schedule of 375, 750, 1125 and 1,500 mg/day doses, where medication was taken in three divided doses, discomfort in the stomach, nausea, vomiting and anorexia were experienced in one of the four patients receiving the highest dose of 1,500 mg. Nine patients receiving the other doses did not complain of toxic symptoms. Laboratory values did not change in the three patients receiving the lowest 375 mg/day dose, but elevation of transaminase was observed in five of the nine patients given higher doses. This elevation was observed in all the three patients receiving 1,500 mg/day dose. Among the serum hormone levels, significant increases of luteinizing hormone were observed. As for efficacy, objective responses were observed in two of the three patients in each of the four daily dosing groups. Improvement of pain, voiding obstruction symptoms, and performance status were also observed. Flutamide was found to be absorbed rapidly and to exist as a hydroxylated form (hydroxy-flutamide) in the plasma. The half-life of hydroxy-flutamide was similar in the single and daily administration, but the peak concentration and area under the concentration versus time curve in the daily administration became greater than those in the single administration. In conclusion, flutamide should be examined for efficacy and safety using doses of 375 to 1,125 mg/day in the phase II study.

Administration, Oral↗
PubMed1993

[Clinical evaluation of flutamide, a pure antiandrogen, in prostatic cancer phase II dose-finding study].

The phase II study of flutamide, a pure anti-androgen, was performed to estimate the clinical doses on 165 hormone untreated or treated patients with prostatic cancer. The hormone-untreated patients were given orally flutamide of 90, 375, 750 or 1,125 mg/day in three divided doses daily for 12 weeks. Responses were not observed at the 90 mg/day dose except for improvement of clinical symptoms. However, an objective response rate of 48.8-46.7% was obtained at 375-1,125 mg/day doses. In hormone-treated patients including cases refractory to the previous hormonal treatment, the objective response rates were 13.3 and 8.3% in 375 and 750 mg/day flutamide groups, respectively. Side effects such as gynecomastia, nausea, vomiting, diarrhea, and abnormal laboratory findings such as the elevation of hepatic transaminases were observed. The incidence increased dose-dependently. Determinations of serum hormone levels revealed an increase in testosterone levels by the use of flutamide. In conclusion 375 mg/day of flutamide is the optimal dose in monotherapy for hormone-untreated patients with prostatic cancer, where the quality of life can be maintained compared with therapies involving testosterone suppression. This dose is also expected to show some efficacy in cases refractory to hormone treatment.

Administration, Oral↗
PubMed1992

Enhancement of chemotherapeutic effects by recombinant human granulocyte colony-stimulating factor on implanted mouse bladder cancer cells (MBT-2).

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) was administered intraperitoneally in combination with multidrug chemotherapy using methotrexate (M), vinblastine (V), doxorubicin (A), and cisplatin (C, or for the combination, MVAC) to C3H/He mice (5-week-old females) after experimental carcinoma, MBT-2, a transplantable transitional cell carcinoma of the urinary bladder had been implanted. The effects of therapy were studied. The animal groups consisted of: (1) control (no drug administration), (2) rhG-CSF (100 micrograms/kg/d, from days 8 through 42 after MBT-2 implantation, except for the days when MVAC was administered), (3) high-dose MVAC (2 mg/kg of M, 0.2 mg/kg of V, 2 mg/kg of A, and 4 mg/kg of C once a week for 3 weeks), (4) low-dose MVAC (one-quarter of the high dose), (5) high-dose MVAC with rhG-CSF, and (6) low-dose MVAC with rhG-CSF. In an in vitro system, rhG-CSF did not show any effect on the proliferation of MBT-2 cells or exert any influences on A's tumor proliferation-suppressing action on MBT-2. However, in an in vivo system, concomitant administration of rhG-CSF significantly enhanced the tumor-suppressing effect of the MVAC therapy, as did rhG-CSF alone. The greatest effect was observed in the group receiving high-dose MVAC plus rhG-CSF. These result suggested that rhG-CSF-stimulated granulocytes may exert antitumor activity on tumor cells severely damaged by chemotherapeutic agents at a relatively high concentration. The survival rate was improved to some degree even by administration of rhG-CSF alone. Although further study is required to elucidate the action mechanism of rhG-CSF, these results suggest that rhG-CSF may be useful clinically to enhance the activity of antitumor agents and not only through its ability to alleviate granulocytopenia or prevent its development.

Agranulocytosis↗
PubMed1992

Phase II study of cis-diammine(glycolato)platinum, 254-S, in patients with advanced germ-cell testicular cancer, prostatic cancer, and transitional-cell carcinoma of the urinary tract. 254-S Urological Cancer Study Group.

A multicenter cooperative study was conducted to evaluate the clinical efficacy and safety of cis-diammine(glycolato)platinum (254-S), a second-generation anticancer platinum complex, in the treatment of genitourinary cancers. 254-S was given i.v. at 100 mg/m2 at 4-week intervals. As a result, 2 complete responses (CRs) and 8 partial responses (PRs) were obtained in 35 patients with transitional-cell carcinoma (TCC) of the urinary bladder or pyeloureter, 3 PRs were obtained in 16 subjects with prostatic cancer, and 6 CRs and 6 PRs were obtained in 15 patients with testicular cancer, generating objective response rates of 28.6% [95% confidence interval (CI), 14.6%-46.3%], 18.8% (95% CI, 4.0%-45.6%), and 80.0% (95% CI, 51.9%-95.7%), respectively. Bone marrow suppression was the dose-limiting toxicity, although it was reversible. Although no hydration was performed in approx. 40% of the patients, the incidence of nephrotoxic effects was low and most of those encountered were mild, the exception being one patient who showed severe renal insufficiency after the first treatment. Nausea and vomiting occurred in approx. 70% of the patients, but most gastrointestinal toxicities were controlled without antiemetic treatment. In addition, liver-function impairment was rarely observed. We conclude that 254-S is a promising cisplatin analogue for the treatment of genitourinary cancers and is worthy of further investigation in large-scale, randomized comparative studies with other platinum derivatives in both single-agent and combination regimens.

Adult↗
PubMed1992

Persistence of archetypal JC virus DNA in normal renal tissue derived from tumor-bearing patients.

JC virus DNAs derived from the urine of nonimmunosuppressed individuals generally contain an archetypal regulatory region which may have generated various regulatory regions of JC virus from from the brain with progressive multifocal leukoencephalopathy (PML). In this study, we examined whether JC virus persisting in normal human kidney tissue contains the archetypal regulatory region. Renal medulla, cortex, and tumor from 32 patients bearing renal tumors were screened for JC virus DNA by blot hybridization. Viral DNA was detected in the medulla in 13 cases (41%), in the cortex in 2 cases (6%), but not at all from the tumor. A number of viral DNA-positive specimens (8 from the medulla and 2 from the cortex) were used to amplify and sequence viral regulatory regions by polymerase chain reaction. Structures of the regulatory regions from all the specimens were, with a few nucleotide variations, identical with that of the archetypal region which was previously detected in the JC virus DNA from urine. This finding supports the hypothesis that the JC virus associated with PML evolved from the archetypal JC virus during persistence in human hosts. Furthermore, we present evidence that renal JCV is replicating and that progeny virions are excreted into the urine.

Adult↗
PubMed1992

Clinical aspects of polycystic kidney disease.

A total of 316 patients (167 men and 149 women) with autosomal dominant polycystic kidney disease was studied retrospectively by a multi-institute group. With advancing patient age renal function decreased, and blood pressure, prevalence of liver cysts and probability of end stage renal failure increased. The probability of end stage renal failure was 39% in the patients in their sixties. Regression analysis indicated that polycystic kidney disease patients could expect to lose 1.1 ml. per minute of creatinine clearance per year, reaching a level of 10 ml. per minute, a point of end stage renal failure, by the age of 72.7 years. The better prognosis in our study than that reported previously in white patients might be due to the inclusion of more asymptomatic persons and/or milder genotypic expression of polycystic kidney disease in Japan. There was no sex difference in the prevalence of liver cysts (54.6%), pancreatic cysts (7.1%), intracranial aneurysms (8.0%) and hypertension (63.6%). The occurrence of pancreatic cysts was significantly associated with liver cysts. Our study clarifies several clinical characteristics of polycystic kidney disease in Japan.

Adult↗
PubMed1992

A survey on incidental renal cell carcinoma in Japan.

A survey of renal cell carcinoma detected incidentally (incidental renal cancer) in 116 collaborating institutions was conducted nationwide in Japan between 1980 and 1988. The analysis of 1,428 cases demonstrated a dramatic increase in the frequency of incidental renal cancer from 20 cases in 1980 to 338 cases in 1988. Detection occurred at routine health examinations in 32.8% of the cases and during examinations for unrelated diseases in the remainder. The chief method of detection was ultrasonography (68.2%), followed by computerized tomography (21.8%) and excretory urography (6.4%). Tumor extension was within the renal capsule in 76.5% of the cases and the mean tumor diameter was 5.4 cm. The 5-year survival rate was 76.5% but it was better in cases detected by ultrasonography compared with other methods. These results were compatible with previous reports and suggest that incidental renal cancer detection may improve the prognosis of renal cancer as a whole.

Carcinoma, Renal Cell↗
PubMed1992

Effect of recombinant human granulocyte colony-stimulating factor in patients receiving chemotherapy for urogenital cancer. Urological rhG-CSF Study Group.

We evaluated the efficacy and safety of recombinant human granulocyte colony-stimulating factor (G-CSF) in patients with leukopenia after chemotherapy for urogenital cancers. Recombinant human G-CSF was administered at 100 micrograms./m.2 intravenously in 36 patients and at 75 micrograms. per body weight subcutaneously in 37 for 8 days after methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) therapy or for 14 days after other chemotherapies. Cycle 1 of chemotherapy was given without recombinant human G-CSF, while at cycle 2, recombinant human G-CSF was given additionally. Therefore, cycle 1 of the regimen served as a control to cycle 2 in each patient. An elevation in the median white blood cell nadir was noted: 1,500 versus 3,200 (intravenous) and 2,100 versus 3,200 (subcutaneous) on M-VAC therapy, and 1,800 versus 2,100 (intravenous) and 1,700 versus 2,500 (subcutaneous) on other chemotherapeutic regimens. A shortening of the leukopenic period was observed in cycle 2. There were no significant adverse side effects attributed to the use of recombinant human G-CSF. The results indicate that recombinant human G-CSF may be safely and effectively used against leukopenia after chemotherapy for urogenital cancer. This remedy will become useful for completion of the schedule and dose intensification of chemotherapy in the future. Subcutaneous administration is considered to be the more preferable route.

Adult↗
PubMed1992

Advantage of a smaller caliber fiberscope and learning curve on transurethral lithotripsy.

Transurethral lithotripsy was performed in 63 patients with ureteral calculi between September 1987 and March 1991. Three types of flexible nephroureteroscopes with diameters of 12.8F, 10.5F and 9.3F were used in groups 1, 2 and 3, respectively. The rate of successful stone disintegration and the stone-free rate 3 months after lithotripsy were 73% (11 of 15 patients) and 67% (10 of 15), respectively, in group 1, 93% (26 of 28) and 82% (23 of 28), respectively, in group 2, and 95% (19 of 20) and 85% (17 of 20), respectively, in group 3. Four complications were encountered in the patients treated with the 12.8F device (group 1). Our results clearly show that use of a slimmer fiberscope and the effect of learning to perform techniques with the flexible nephroureteroscope improved the success rate and decreased the complication rate in transurethral lithotripsy.

Adult↗
PubMed1992

A survey on incidental adrenal tumors in Japan.

A nationwide Japanese survey of 210 cases from 116 collaborating institutions demonstrated a dramatic increase in incidentally detected adrenal tumor from 4 cases in 1980 to 54 in 1988. The most common diagnosis was nonfunctioning cortical adenoma (69 cases), followed by pheochromocytoma (49). A total of 14 malignant tumors (6.7%) and 16 functioning benign cortical lesions was also found. Histological study revealed that functioning tumors were small and found in relatively young female patients, nonfunctioning cortical adenomas were of similar size but found in older patients, and all malignant tumors were larger than 6.5 cm. in diameter and occurred in patients 58 years or younger. These results indicate an increase in the occurrence of incidental adrenal tumor and the complexity of pathology.

Adrenal Gland Neoplasms↗
PubMed1992

Percutaneous reduction of cyst volume of polycystic kidney disease: effects on renal function.

Percutaneous reduction of cyst volume was performed in 10 patients with autosomal dominant polycystic kidney disease and its effects on renal function were studied. Although creatinine clearance, urinary excretion of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase, and renal uptake of 99mtechnetium-dimercaptosuccinic acid did not change significantly, a transient increase in urinary protein and a decrease in inulin clearance were observed. Complications, such as hematuria, fever and decreases in hematocrit, were slight and transient in most patients. This procedure holds little promise for altering the course of polycystic kidney disease.

Adult↗
PubMed1992

Effect of water mobility on drug hydrolysis rates in gelatin gels.

The stability of drugs incorporated in gelatin gels was studied, with a focus on the water mobility in the gels. Trichlormethiazide hydrolysis and kanamycin-catalyzed flomoxef hydrolysis in gelatin gels were chosen as models for apparent first-order and second-order hydrolysis, respectively. The mobility of water in gelatin gels was determined by NMR, ESR, and dielectric relaxation spectroscopies. The amount of bound water in the gels was determined from dielectric relaxation spectra. Spin-lattice relaxation time of water determined by 17O NMR and rotational correlation time of an ESR probe determined by an ESR probing method were useful in determining the microviscosity of the gels. The hydrolysis rate of trichlormethiazide in the gels was found to depend on the amount of free water available for the reaction, while that of flomoxef depended on the microviscosity of the gels, which reflected the mobility of water molecules. Thus the dependence of hydrolysis rates on the water mobility was influenced by the hydrolysis mechanism.

Cephalosporins↗