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Biomedical subjects

Y Higashi

Publications and source records attributed to Y Higashi.

At least 343 records · Page 19Linked to original sources
PubMed1985

[Changing modality of the treatment in upper urinary tract calculi. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy].

From March, 1984 to April, 1985, 70 cases of upper urinary tract calculi (73 renal units) were treated by percutaneous nephrolithotripsy or transurethro-ureteral lithotripsy, mainly utilizing ultrasonic lithotrite. While in the early period of treatment, two stage procedure of creation of nephrostomy tract and percutaneous nephrolithotripsy was performed for renal and upper or middle part of the ureteral calculi, one stage procedure, nephrostomy tract formation followed by ultrasonic nephrolithotripsy is commonly used in recent cases. During this period, conventional stone surgery was seen in 6 cases of pyelolithotomy and 2 of ureterolithotomy, while 52 cases of stone surgery were performed during the earlier period (from January, 1983 to February, 1984). Renal and upper or middle part of ureteral calculi were successfully removed in 49 out of 58 cases (84.5%). Most of the patients required 1 or 2 trials of percutaneous nephrolithotripsy. Middle or lower part of ureteral calculi were removed in transurethro-ureteral approach in 11 of the 12 cases. Hematuria and fever were most common complications after treatment and 3 patients required blood transfusion after 3 or 4 sessions of nephrolithotripsy. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy are now widely used for treatment of upper urinary tract calculi, replacing the conventional surgical treatment. Moreover, very recently, extracorporeal shock wave lithotripsy is available in Japan. To the patients with renal calculi indicative of this treatment, both percutaneous nephrolithotripsy and extracorporeal shock wave lithotripsy are introduced and either way of treatment can be chosen by the patient himself.

Adult↗
PubMed1985

[Compensatory changes in beta 2-microglobulin handling in the remnant tubules after contralateral nephrectomy. Observations of beta 2-microglobulin excretion into the urine].

Serum and urinary beta 2-microglobulin (S-, U-beta 2MG), and creatinine clearance (C-cr) were examined in 41 nephrectomy cases, and changes in glomerular and tubular handling of beta 2MG such as filtered beta 2MG (Fil-beta 2MG), reabsorption of beta 2MG (Reab-beta 2MG) and fractional excretion of beta 2MG (FE-beta 2MG) were studied. Serum creatinine (S-cr) and S-beta 2MG increased significantly after nephrectomy. C-cr decreased immediately after nephrectomy (80%), but recovered up to 87% in 2 to 4 days postoperatively. Fil-beta 2MG decreased immediately after nephrectomy, but increased up to more than the preoperative level in 2 to 4 days postoperatively. On the other hand, Reab-beta 2MG decreased significantly immediately after nephrectomy, and it took 5 to 8 days until recovery. Consequently, urinary excretion of beta 2MG (Ex-beta 2MG) and FE-beta 2MG increased significantly 0 to 4 days postoperatively. These increases in Ex-beta 2MG and FE-beta 2MG were much higher than those seen in diabetic nephropathy, cadmium nephropathy and Cis-diamminedichloroplatinum (II) (CDDP) intoxication, and were not due to drug intoxication such as general anesthesia or antibiotics, but due to glomerulo-tubular unbalance. Clinical data of renal tubular handling of beta 2-microglobulin in cases of interferon therapy or unilateral nephrectomy revealed many interesting aspects of glomerulo-tubular adaptations, and micropuncture study or isolated tubule perfusion study are awaited.

Adolescent↗
PubMed1985

[Percutaneous nephrostomy--the method and technical problems].

Ultrasound guided percutaneous nephrostomy (PNS) was performed on 72 patients (80 kidneys) including pretreatment for percutaneous nephro-uretero lithotomy (PNL). PNS was performed for post-renal anuria or hydronephrosis in 23 cases (28 kidneys), for urinary leakage in 4 cases (5 kidneys), for vesical bleeding in 1 case (2 kidneys) and as pretreatment of PNL in 44 cases (45 kidneys). Ultrasound guided renal puncture was done percutaneously and a 0.038 inch J-tipped wire guide was inserted into the suitable calyx. Then the nephrostomy tract was dilated with fascia dilators of Malecot nephrostomy set. A 14 Fr or 16 Fr Malecot catheter was used for hydronephrosis or urinary leakage cases. 18 Fr, 24 Fr Malecot catheter or Bardex balloon catheter 18-22 Fr was inserted for PNL cases. In the PNL group, Ht decreased slightly but there was no need of blood transfusion. In the other groups, Ht did not change. Defect of 99m-Tc-DMSA renal uptake in several cases suggested renal injury at nephrostomied cortex. In about 70% of the cases, a fever of more than 37 degrees C was observed, and in 4 cases, more than 39 degrees C was observed. There were no major complications observed. In conclusion, percutaneous nephrostomy using Malecot nephrostomy set is a safe and effective method.

Adult↗
PubMed1985

[Long-term administration of ceftriaxone (Ro 13-9904) to complicated urinary tract infections].

The efficacy and safety of ceftriaxone (Ro 13-9904, CTRX) a new broad-spectrum semisynthetic cephalosporin with an outstanding long serum half-life, was evaluated in 22 patients with chronic complicated urinary tract infections. Although the overall clinical efficacy evaluated on day 5 and 10 were similar, the rate of excellent effectiveness was higher on day 10 than on day 5. Eighteen bacterial strains were cultured from freshly voided urine. Eighty percent of the bacteria were eradicated on day 5 and 86.2% were eradicated on day 10. Bacterial replacement had occurred in 3 cases on day 5 and in 6 cases on day 10.

Adult↗
PubMed1985

[Effects of combination chemotherapy with cis-diamminedichloroplatinum (II) (CDDP) on renal function in patients with urogenital malignancies].

The renal function in 23 patients with advanced urogenital cancers (10 testicular, 8 uroepithelial, 3 prostatic cancers and 1 penile cancer) treated with a total of 3 or 4 cycles of combination chemotherapy including CDDP was examined prospectively, by measuring of creatinine clearance (Ccr), fractional excretion of beta 2 microglobulin (FE beta 2 MG) and urinary N-acetyl-beta-glucosaminidase (NAG). Patients with testicular cancers (group 1) who received the cumulative CDDP dose of 360-1966 mg (on average 868 mg), the decrease in Ccr and increase in FE beta 2 MG and NAG were temporary during each chemotherapy cycle. However, in the overall course, after the cumulative dose exceeded 600 mg, higher beta 2 MG excretion persisted and after the cumulative dose exceeded 800 mg, Ccr decreased to 30% of the pretreatment level. This suggests cumulative delayed, irreversible renal damage. The severity of decrease in Ccr paralleled the increase in cumulative CDDP dose. Patients with urogenital cancers other than testicular cancer (group 2) who received the cumulative CDDP dose of 80-480 mg (on average 217 mg), and who had decreased Ccr and tubular damage prior to treatment, even though the cumulative dose was lower than in group 1, changes in Ccr, FE beta 2 MG and NAG were almost in the same magnitude as in group 1. Determination of NAG is useful for detection of the early change in the tubules several days after CDDP administration, while that of beta 2 MG is useful for detection of the chronic damage of renal tubules after several cycles of CDDP chemotherapy. CDDP nephrotoxicity is characterized by dose-dependent tubular damage. Although renal injury may not be evident during the early course of treatment, repeated courses of CDDP may lead to clinically serious chronic renal failure.

Aged↗
PubMed1985

[Percutaneous ultrasonic nepholithotripsy].

Herein we report our experience of percutaneous ultrasonic lithotripsy on 32 renal calculus patients between March and December 1984. Renal calculus removal was successful in over 78.1% of the patients (91.3% for recent 4 months). All patients had bloody urine after tract dilatation and calculus removal, but this usually cleared in 24-48 hours. No patients have required blood transfusion. The major essential contribution responsible for the success of this technique was a nephrostomy placement made accessible to calculi. Percutaneous ultrasonic lithotripsy, when combined with adjuncts such as flexible nephroscopy and radiological stone manipulations using stone grasping forceps and Dormia basket catheter, is an effective treatment for renal calculi, with a success rate of over 90%.

Endoscopy↗
PubMed1985

[Diagnosis of retroperitoneal lymph node swelling by computed tomography in advanced testicular cancer patients, with special reference to retrocrural lymph node swelling].

We tried to divide anatomically the retroperitoneal space into three areas on computed tomography, infrahilar, suprahilar and retrocrural spaces, and investigated the relationship between frequency of lymph node swelling in each space and clinical picture in 15 patients with testicular cancer of stage II or III, particularly focusing on the lymph node swelling in the retrocrural space. Lymph node swelling was found in the infrahilar space in 11 cases (73.3%), in the suprahilar space in 7 cases (46.7%) and in the retrocrural space in 6 cases (40.0%). Retrocrural or suprahilar lymph node swelling was always accompanied by suprahilar or infrahilar lymph node swelling. Most of the patients with retrocrural lymph node swelling had bulky tumors in the infrahilar level and frequently cervical lymph node swelling. Retrocrural lymph node swelling did not necessarily affect the patient's prognosis. The retrocrural lymph node seems to be a sentinel node for retroperitoneal lymph node swelling not only in the case of testicular cancer but also in the cancer of urogenital malignancies.

Adult↗
PubMed1984

Heterogeneity of protein kinase NII from rat liver nuclei.

Protein kinase NII from rat liver nuclei was resolved into two fractions, NIIa and NIIb, by DEAE-Sephadex column chromatography. NIIa was eluted at 151 mM (NH4)2SO4 and NIIb at 175 mM. They had an identical molecular size (125,000 daltons, 7.0S) and subunit composition (alpha alpha' beta 2). However, they showed significantly different Km values and turnover numbers for casein substrate. Furthermore, NIIa was found predominantly as a form bound to the chromatin, while NIIb was in the nucleoplasmic-soluble fraction in addition to the chromatin-bound fraction. These observations suggest that NII consists of a heterogeneous population of at least two molecular species, differing in the activity and functional states in the cell nucleus.

Animals↗
PubMed1984

Effects of pressure on the phase transition of bilayers in liposomes. Influence of cholesterol and alpha-tocopherol.

The effects of pressure on the gel-to-liquid crystalline phase transition temperature of dimyristoylphosphatidylcholine (DMPC) bilayers containing cholesterol, alpha-tocopherol, and alpha-tocopheryl acetate were studied by fluorescence depolarization. The transition temperature of cholesterol mixtures (greater than 7.5 mol%) was lower than that of 100% DMPC at atmospheric pressure, but it became higher than the latter on increase in pressure. The thermodynamic parameters of the transition (delta V, delta S, delta H) were estimated and the functions of cholesterol and alpha-tocopherols in the bilayers are discussed.

Cholesterol↗
PubMed1984

[Bleomycin, vinca alkaloid and cis-diamminedichloroplatinum combination chemotherapy for advanced testicular tumors].

Thirteen patients with advanced testicular tumors (seminoma 2, non-seminoma 11) were treated with combination chemotherapy involving BLM, vinca alkaloid and CDDP (BVP) as induction therapy and followed with CPM, VCR and CDDP as maintenance therapy. BVP and COP administration was repeated every 3 and 4 to 8 weeks for 1 year, if there were no serious side effects. The overall response rate (CR + PR) was 92% with a 69% CR rate. At a mean follow-up of 30 months (7-52 month range), 54% of the patients were alive with no evidence of disease. Bulky metastases, failure to respond to prior chemotherapy and teratomatous metastases were considered to be poor prognostic factors. The toxicity of BVP was similar to that reported for CDDP, except that allergic reaction occurred in 3 patients after several courses of treatment. Two of the 3 went into anaphylactic shock.

Adult↗
PubMed1984

[Allergic reaction to CDDP: report of 4 cases].

Four cases of CDDP allergic reaction (CDDP reaction) are reported. CDDP was given intravenously with vinka-alkaloid and bleomycin or cyclophosphamide (CDDP combination therapy). Case 1 was a 59-year-old man with left ureteral squamous cell carcinoma. The tumor was so large and infiltrated into the retroperitoneal space, that he had conservatively undergone only left nephrectomy and tumor biopsy. Post-operative CDDP combination therapy was performed. Soon after the beginning of the 6th CDDP drip-infusion, a reaction to CDDP occurred. Case 2 was a 22-year-old man diagnosed to have left testicular embryonal carcinoma with multiple pulmonary metastases. After radical orchiectomy and retroperitoneal lymphadenectomy, CDDP combination therapy was performed. At the beginning of the 8th CDDP drip-infusion, a reaction to CDDP occurred. Case 3 was a 49-year-old man diagnosed to have non-papillary bladder carcinoma. Although his bladder was tumor free by TUR-Bt, distant lymph node metastases occurred. CDDP combination therapy was performed. At the beginning of the 6th CDDP drip-infusion, a reaction to CDDP occurred. Case 4 was a 64 year-old-man diagnosed to have bladder carcinoma which was recurrent from right renal pelvic tumor. After total cystectomy and ileal conduit, CDDP combination therapy was performed for diffuse retroperitoneal lymph nodes metastases. At the beginning of the 8th CDDP drip-infusion, a reaction to CDDP occurred. Reaction to CDDP developed at the 6th to 8th course of combination chemotherapy with CDDP, i.e., 450 to 700 mg of CDDP in total doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗