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Biomedical subjects

Y Kumamoto

Publications and source records attributed to Y Kumamoto.

At least 145 records · Page 8Linked to original sources

Detection of human papillomavirus deoxyribonucleic acid in penile carcinoma by polymerase chain reaction and in situ hybridization.

We investigated the prevalence of human papillomavirus types 16, 18 and 33 deoxyribonucleic acid (DNA) by polymerase chain reaction and the localization of human papillomavirus DNA by in situ hybridization using formalin-fixed, paraffin-embedded tissue specimens of penile carcinoma in Japan. Of 111 untreated penile carcinomas 70 (63.1%) were positive for human papillomavirus DNA by the polymerase chain reaction method. Human papillomavirus type 16 was identified in 68 penile carcinoma cases and type 18 in 2, whereas type 33 could not be detected. Of 12 treated penile carcinomas 2 (16.7%) were positive for human papillomavirus type 16. These data indicate that human papillomavirus type 16 DNA is the type most commonly associated with penile carcinoma. Human papillomavirus type 16 was also detected in lymph node metastasis of penile carcinoma, and that was the same as the human papillomavirus DNA type in the primary carcinoma. The in situ hybridization analysis found the human papillomavirus DNA to be localized in the nuclei of carcinoma cells.

Adult↗

In vitro invasive potential and type IV collagenolytic activity of human renal cell carcinoma cells derived from primary and metastatic lesions.

We investigated in vitro invasiveness and type IV collagenolytic activity of cells from a primary and a metastatic lesion of a patient with renal cell carcinoma. The temporarily cultured cells (SRCC-1P) derived from the primary lesion and those (SRCC-1M) from the metastatic lesion exhibited positive staining for both cytokeratin and vimentin, indicating that they were of renal cell carcinoma origin. An in vitro invasion assay revealed that the cells of SRCC-1M were significantly more invasive than those of SRCC-1P, which showed only marginal invasion. Type IV collagenolytic activity correlated with the in vitro invasiveness, in which SRCC-1M apparently had the higher activity. These results indicate that type IV collagenolytic activity contributes to the invasiveness of the cells in vitro.

Adrenal Gland Neoplasms↗

[Study of local immune response in mice with an impaired chemotaxis of neutrophils--in Pseudomonas aeruginosa induced experimental urinary tract infection].

Experimental ascending urinary tract infection was induced by transurethral instillation of Pseudomonas aeruginosa in mice whose neutrophilic chemotactic activity was suppressed by administration of colchicine, and we investigated the time course fluctuation of local immune response at the infected sites in terms of immune response cells as compared with that in normal mice. In comparison with that in normal mice, a significant suppression was noted in the chemotactic activity of the peritoneal exudating neutrophils when colchicine at a dose of 0.02 mg/mouse was administrated a total of 4 times, namely, 1, 3 and 5 days, and 6 hours before infection (the day of assessment). When experimental ascending urinary tract infection was induced by P. aeruginosa, markedly increased susceptibility to bacterial infection was noted in mice with an impaired chemotaxis of neutrophils (impaired neutrophilic chemotaxis group) as compared with that in normal mice (control group). Apparent infiltration of neutrophils was recognized one day after infection in the control group by the time course observation of the immune response cells at the sites of infection while hardly any infiltration was observed in the impaired neutrophilic chemotaxis group one day after infection. In other words, the cellular infiltration into an infected site was conceivably obstructed when the chemotactic activity was impaired. On the other hand, macrophages in the impaired neutrophilic chemotaxis group demonstrated marked infiltration as compared with that in the control group one day after infection, and such infiltration remained on the same higher level thereafter. As for T and B cells, an increased ratio was noted in helper T cells and early infiltration in IgG positive B cells 3 days after infection and onward when compared with the control group. It was therefore suggested that other immune response cells compensated for the infiltration of neutrophils when their chemotactic activity was obstructed, and that these cells on the whole possibly responded toward the preservation of their protective mechanism against infection.

Animals↗

Assessment of Chlamydia trachomatis-specific IgA and IgG serum antibodies in genitourinary Chlamydia trachomatis infection--comparative study between HITAZYME and IPAzyme.

We assessed the C. trachomatis antibody assay kit HITAZYME (Hitachi Chemical Co., Ltd.) using clinical specimens. This kit is based on an enzyme immunoassay (EIA) which utilized purified Chlamydia trachomatis outer membrane antigen as the solid phase antigen. Twenty-nine untreated male urethritis patients, 816 pregnant housewives, 188 cervicitis patients, and 76 pelvic inflammatory disease patients were tested. Agreement between the HITAZYME test and antigen detection in infected area was assessed, and a comparison was made with IPAzyme (a commercially available indirect immunoperoxidase assay kit). 1) Summary of HITAZYME and IPAzyme IgA: Agreement between the two assays was relatively good, i.e., 82.6% (916/1109). However, 5.5% (61/1109) were HITAZYME (-), IPAzyme (+), and 11.9% (132/1109) were HITAZYME (+), IPAzyme (-). Thus, in quite a few cases the results did not agree. IgG: Agreement between the two assays was 73.7% (817/1109). Agreement was relatively low, 24.4% (271/1109) were HITAZYME (-), IPAzyme (+). 2) In the cases of disagreement, more specific Western blot analysis was performed to check the reactivity of the anti-C. trachomatis antibody. When IgA was used, agreement between HITAZYME and Western blot analysis was 69.6% (16/23), and agreement between IPAzyme and Western blot analysis was 30.4% (7/23), whereas when IgG was used, agreement between HITAZYME and Western blot analysis was 80.0% (12/15), and agreement between IPAzyme and Western blot analysis was 20.0% (3/15). There was significantly greater agreement with HITAZYME than with IPAzyme. In other words, HITAZYME had greater specificity when reacted with C. trachomatis antigen than IPAzyme. 3) The IgA antibody-positive rate in antigen (+) cases (male urethritis: 72.7%, pregnant housewives: 65.7%, cervicitis: 70.3%, pelvic inflammatory disease: 70.0%) was significantly (p < 0.01) higher than in antigen (-) cases (male urethritis: 16.7%, pregnant housewives: 13.6%, cervicitis: 22.6%, pelvic inflammatory disease: 30.4%). Therefore, IgA antibody can serve as a suitable indicator for active infection. 4) The IgG antibody-positive rate in antigen (-) female cases was 15.5% using HITAZYME and significantly (p < 0.01) lower than with IPAzyme. HITAZYME had greater specificity than IPAzyme. In conclusion, HITAZYME has relatively good sensitivity and specificity. Moreover, since it is an EIA assay, it allows objective evaluation of results. It permits processing of a large number of specimens because it is easy to perform. Thus, HITAZYME is a superior antibody assay for C. trachomatis. It can be used when antigen tests are difficult to perform. It is strongly anticipated that HITAZYME will be able to be used clinically as a screening test.

Chlamydia Infections↗

Leydig cell tumor: a case report with reference to its endocrinological features.

We reported an adult case of Leydig cell tumor, which demonstrated an increase of serum estradiol (E2) and suppression of serum testosterone (T) before orchiectomy. The direct inhibitory action of the elevated E2 on the enzymes involved in steroidogenesis and the negative feedback action on luteinizing hormone (LH) secretion of the E2 possibly caused the suppression of serum T. A human chorionic gonadotropin test before the operation revealed the elevation of T and E2, although the response was poor compared with that in normal subjects. However, the postoperative test showed no elevation of these hormones. This result may indicate that the Leydig cell tumor preserves a response to LH stimulation.

Chorionic Gonadotropin↗

[Staging pelvic lymphadenectomy for prostatic carcinoma].

Forty-two prostatic carcinoma patients with clinical stage A2, B or C underwent pelvic lymphadenectomy (limited node dissection) as a staging operation. The relationships among the presence of lymph node metastasis, tumor marker levels and histological findings of primary lesions were examined in 42 patients. Pelvic lymph node metastasis was noted in 18 (43%) of the 42 patients. The incidence of lymph node metastasis tended to be correlated with differentiation and Gleason's primary lesion sum. The preoperative PSA and PAP levels were significantly elevated in patients with positive lymph nodes for carcinoma than in those with negative lymph node for carcinoma. Patients with higher serum PSA (> or = 20 ng/ml) and PAP (> or = 10 ng/ml) levels were more frequently associated with lymph node metastasis. Thus, when serum PSA and PAP were markedly elevated before treatment in patients with prostatic carcinoma, they should be considered to have a potential of pelvic lymph node metastasis. Pelvic lymph node metastasis was observed in some cases even without high tumor marker levels, particularly those with poorly differentiated carcinoma.

Aged↗

Adenocarcinoma arising in the ileal segment of a defunctionalized ileocystoplasty.

We report a case of adenocarcinoma arising in the ileal segment of an ileocystoplasty which had remained defunctionalized for 22 years, after conversion to the ileal conduit. In our case, inflammation or previous radiation as well as urine exposure are suggested to have participated in the development of the carcinoma in the augmented bladder.

Adenocarcinoma↗

[Clinical long-term studies of the treatment of chronic complicated urinary tract infections. Utility and recurrence after 14-day treatment by cefditoren pivoxil].

In this study, cefditoren pivoxil (ME 1207, CDTR-PI), a new oral cephem antibiotic, was given to 72 patients with non-catheterized complicated urinary tract infections (UTI) to evaluate clinical efficacy and safety, and also to investigate the rate of recurrence after completion of treatment. Daily dose of CDTR-PI was 100 mg t.i.d., and CDTR-PI was administered for 14 days. According to the criteria proposed by the Japanese UTI Committee, clinical efficacy of CDTR-PI was evaluated at day 7 and day 14. The rate of recurrence was assessed by bacterial count in urine as the marker. The following results were obtained. 1. Overall clinical efficacy rates were 68.4% on day 7 and 81.6% on day 14. The efficacy rate at day 14 was higher than the rate at day 7. 2. Bacteriologically, eradication rates were 75.5% at day 7 and 79.6% at day 14. 3. As to side effects, abdominal discomfort was observed in 1 case and its incidence was 1.6%. Incidence of abnormalities of laboratory findings was 10.4%, and these abnormalities were slight and transient. 4. Thirty-one patients were assessable to the recurrence of infections, 60% of them were judged as "cured" at 1-2 weeks and 3-7 weeks after completion of treatment. In this study, "relapsed", reappearance of causative organisms, was observed much more frequently than "reinfection". These results suggest that sufficient clinical efficacy and safety of CDTR-PI in non-catheterized complicated UTI were effected by 14 days treatment.

Administration, Oral↗

[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↗

[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↗

[Studies on the production rate of estradiol in the testis in male infertility--studies of the predictive values on therapeutic efficacy in patients with oligozoospermia].

It is surmised that studies on the relationship between the endocrinological milieu and therapeutic efficacy in male infertile patients are essential in elucidating the etiology of this disease and devising effective therapeutic methods. The relation between serum gonadotropin level and therapeutic efficacy has already been reported. In the present study, we investigated the basal levels of two sex steroids, i.e., testosterone and estradiol, and the estradiol:testosterone (E2/T) ratio, and also the increases in these parameters after the administration of hCG to human subjects presenting various degrees of testicular dysfunction, e.g., male infertile patients, aged males, Klinefelter's syndrome and hypogonadotropic hypogonadism. Special attention was given to the characteristics of the reserve capacity for secretion of estradiol in male infertile patients. The hCG test was performed on a total 527 subjects, including 65 normal adult males. The reserve capacity for the secretion of estradiol was investigated on the basis of the increasing rate in the serum E2/T ratio. The increasing rate in the serum E2/T ratio was statistically larger in subfertile males, oligozoospermia and azoospermia in comparison with the normal adult males. On the other hand, the aged males did not show any difference from the normal adult males, whereas the results were significantly lower in the male subjects with Klinefelter's syndrome and hypogonadotropic hypogonadism. It was considered that the increase in the serum E2/T ratio is one characteristic of the gonads of male infertile patients. The results of multiple regression analysis showed that the LH level, the pretreatment sperm concentration and the increasing rate in the serum E2/T ratio were important factors determining the increase in the sperm concentration after treatment. Accordingly, for cases of oligozoospermia characterized by an LH level of 13.7mIU/ml or less and a sperm concentration of 5 x 10(6)/ml or more, the relationship between the increasing rate in the serum E2/T ratio and therapeutic efficacy was investigated. It was found that the increasing rate in the serum E2/T ratio was significantly greater in the therapeutically ineffective cases compared with the therapeutically effective cases. On the basis of this finding, it was surmised that the percentage increase in the serum E2/T ratio is one index reflecting testicular function. In addition, for cases of oligozoospermia characterized by an LH level of 13.7mIU/ml or less, a sperm concentration of 5 x 10(6)/ml or more and the increasing rate in the serum E2/T ratio of 4.01 or less, the relationship between the degree of spermatogenesis and therapeutic efficacy was investigated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[A case of latent Addison's disease with hypogonadotropic hypogonadism and dwarfism].

A case of latent Addison's disease accompanied by hypogonadotropic hypogonadism and dwarfism is described. A 20-year-old man was admitted to our department complaining of short stature and immature development of the external genitalia. Pigmentation was most evident on the fingers and face. Endocrinologically, serum ACTH level was very high, and serum cortisol level was in the lower limit of the normal range. Serum aldosterone and adrenal androgen levels were below their normal ranges. Based on these clinical and laboratory findings, the patient was diagnosed as having latent Addison's disease. Serum LH did not respond to a bolus injection of LH-RH. However, after 3 days administration of LH-RH, the response of serum LH to a bolus injection of LH-RH was enhanced. Serum testosterone level was not increased after the administration of hCG. These findings suggested a hypothalamic cause for the hypogonadism. It was indicated that short stature was apparently caused by GH neurosecretory dysfunction, since nocturnal GH secretion was below that in normal males and the response of GH to the administration of arginine was normal. In regard to the thyroid function, the peak of serum TSH after a bolus injection of TRH was delayed compared with normal subjects, and although serum T4 level was high, the basal metabolic rate was very low. This suggests that there is tissue resistance to the elevated thyroid hormone.

Addison Disease↗

Clinical study of bone-related relapse in prostate carcinoma.

Prostate carcinoma is usually highly responsive to initial endocrine therapy. However, when relapse occurs, the subsequent clinical course is very poor. In this study, we tried to reveal the clinical aspects of bone-related relapse in 392 patients who received endocrine therapy for prostate carcinoma. In 17 stage B patients who had relapsed, 76% experienced relapse within 4 years following the start of treatment, 76% within 3 years in 27 stage C patients, and 71% within 2.5 years found in 45 stage D patients. Pre-treatment levels of serum enzymes and initial response of the primary lesion and of serum enzymes failed to predict relapse. The Gleason sum tended to be correlated with relapse. In particular, patients with a Gleason sum of 9-10 had a lower non-relapse rate during the follow-up period than patients with lower sums. With the recent use of more sophisticated measurements of PSA and/or PAP, the reduction rate or interval to normalization of the markers must be more relevant to predicting relapse.

Acid Phosphatase↗

Squamous cell carcinoma-associated antigen in uroepithelial carcinoma.

We investigated the clinical significance of squamous cell carcinoma (SCC) antigen determined by radioimmunoassay on patients with uroepithelial carcinoma. Serum SCC antigen levels and the positive rates were significantly higher in uroepithelial carcinoma having an SCC component than in normal controls, benign urologic diseases, other urogenital carcinomas, or in pure transitional cell carcinoma (TCC) of uroepithelial carcinomas. A substantial number of patients with pure TCC showed a positive serum level of SCC antigen. Immunohistochemical staining of SCC antigen on the uroepithelial carcinomas confirmed that some, not all, pure TCC, mostly grade 3, expressed SCC antigen in their cells. These results suggested a biologic characteristic of grade 3 TCC which is closely related to that of SCC. The serum levels of SCC antigen correlated well with the disease extensions in uroepithelial carcinoma containing SCC component. Changes in serum levels of SCC antigen following treatment reflected the clinical courses of patients, particularly in those with elevated pretreatment levels. The results of our study indicated that the determination of SCC antigen would be clinically useful for monitoring clinical courses of patients with uroepithelial carcinomas containing SCC component and of those with pure TCC whose pretreatment level was elevated.

Antigens, Neoplasm↗

Interleukin-6 in renal cell carcinoma.

We studied interleukin-6 production in 4 human renal cell carcinoma cell lines and measured the serum level in 71 patients with renal cell carcinoma, thus, clarifying a relationship between interleukin-6 secretion and an occurrence of the paraneoplastic syndrome in the carcinoma. Interleukin-6 was produced by 3 cell lines and detected in 25% of the patients. The level of interleukin-6 did not directly correlate with tumor volume and the differentiation grade of the carcinoma. However, the positive rate increased with progression of the stage. The serum level affected the 5-year survival of patients without distant metastasis. When serum interleukin-6 was elevated patients had a significantly higher frequency of unexplained fever and an elevation of acute phase proteins. These results suggest that some renal cell carcinomas can produce interleukin-6 and this cytokine is responsible for several paraneoplastic syndromes in the carcinoma.

Carcinoma, Renal Cell↗

Adrenocortical carcinoma in a child with specific pedigree of family associated with cancer aggregation.

We report on a 5-year-old boy with functioning adrenocortical carcinoma as a proband of a specific pedigree with several young family members who had cancer. Most of the members who died of cancer had early onset of osteosarcoma, hepatoblastoma or malignant lymphoma. The finding of cancer aggregation in the family corresponded to the criteria for the cancer family syndrome.

Adrenal Cortex Neoplasms↗

Proposal of a new scheme for the serological typing of Enterococcus faecalis strains.

No systematic study on serotyping of Enterococcus faecalis has been reported since 1964 when M.E. Sharpe conducted serotyping of group D streptococcus in U.K. So, we attempted to re-evaluate serotyping of E. faecalis. For this purpose, we received 42 Sharpe's strains and first examined for their biochemical characteristics as E. faecalis. Only 9 of the 42 strains were identified as E. faecalis. We raised rabbit antisera against a large number of E. faecalis strains, including the 9 Sharpe's strains, 2 strains obtained from CDC in U.S.A. and 36 strains isolated from patients hospitalized in different cities of Japan. From the results of cross-agglutination tests and absorption tests performed on these antisera using a large number of E. faecalis strains, we were able to classify 21 distinct serotype strains and to prepare 21 monospecific typing antisera by absorption of the antisera to the type strains with appropriate cross-agglutinating strains. When 832 E. faecalis strains were serotyped with the 21 typing antisera, 638 strains (76.7%) were typable. Thus, we propose a provisional scheme of 21 distinct serovars in E. faecalis.

Agglutination Tests↗