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PubMed1996

Effect of low dietary calcium intake on blood pressure and pressure natriuresis response in rats: a possible role of the renin-angiotensin system.

Dietary Ca is an important modulator of blood pressure in humans and rats. Since the kidney plays a key role in the pathogenesis of hypertension, the effects of a low Ca diet (0.01% Ca) on blood pressure and pressure natriuresis response were studied in normotensive Sprague-Dawley rats. In addition, a possible role of the renin-angiotensin system in the development of hypertension and an altered pressure natriuresis response resulting from low dietary Ca intake was examined. In the low Ca diet group, systolic blood pressure measured by the tail-cuff method was significantly higher than in the normal Ca diet group (1,1% Ca) 1 week after the diet (1 13.0 +/- 7.1 vs. 105.0 +/- 9.5mmHg, p < 0.05). After 4 weeks, the hypertension was more pronounced. Low dietary Ca intake significantly inhibited the water and sodium excretory responses to acute elevation of renal perfusion pressure by tightening an infrarenal aortic constriction. Treatment with an inhibitor of angiotensin-converting enzyme, captopril (30 mg/kg/day), completely abolished the elevation of blood pressure and attenuated the reduced pressure natriuresis response observed in Ca-deficient rats. Although plasma renin activity was not different between the low and normal Ca diet groups after the 2-week dietary regimen, the pressor response to angiotensin II was enhanced by 30% in the low Ca diet group and there was a significant difference in the pressor response between the two groups. These results suggest a possible involvement of the renin-angiotensin system in the development of hypertension and an inhibitory effect on the pressure natriuresis response caused by low dietary Ca intake, via an enhanced sensitivity to angiotensin II.

Analysis of Variance↗
PubMed2005

A novel method for estimating the adaptive ability of guide dogs using salivary sIgA.

Salivary secretory immunoglobulin A (sIgA) concentrations of prospective guide dogs for the blind were determined to clarify whether salivary sIgA is useful in evaluating the potential suitability of guide dogs for the blind. Saliva was collected from 73 prospective guide dogs in the kennel on day 1 (the day of separation from volunteer puppy-raisers), 2, 3, 7 and 14 during the estimation period (at about 1 year old). We selected particularly suitable dogs (superior dogs) and unsuitable dogs (inferior dogs) on the basis of the trainers' estimation. All dogs were divided into two groups, those were acceptable dogs would become the guide dogs and rejected dogs could not become guide dogs. The sIgA concentrations in superior dogs gradually increased from day 1 to 14 and those in inferior dogs remained at low levels. Moreover, the sIgA concentrations on day 14 in the acceptable dogs were significantly higher than those in rejected dogs. The cut-off point of sIgA concentrations on day 14 using an ROC curve was 90 EU/ml, and the specificity of the estimation at this point (70.4%) was higher than that of trainers' estimation (50%). Moreover, parallel testing using both trainers' estimation and sIgA estimation, showed that specificity was further improved (79.5%). The present study showed that sIgA concentration was extremely useful in estimating the adaptive ability for guide dogs for the blind.

Analysis of Variance↗
PubMed1995

Effect of tauroursodeoxycholic acid on bile flow and calcium excretion in ischemia-reperfusion injury of rat livers.

BACKGROUND/AIMS: Tauroursodeoxycholic acid is known to have a hepatoprotective action in cholestatic disorders. We evaluated whether oral pretreatment with tauroursodeoxycholic acid could protect the liver from ischemia-reperfusion injury, with particular regard to its effect on bile flow and biliary calcium excretion. METHODS: A 1-hour in vivo ischemia-reperfusion model of 70% of the lobes of rat liver was used. Animals were divided into six groups (each group; n = 8); a non-ischemia sham group (CS), a control group without bile acids (CON), and 4 bile acid groups; 10 mg/kg and 50 mg/kg (U10, U50), taurocholic acid 10 mg/kg (CA10) and tauroursodeoxycholic acid 10 mg/kg (CD10). Bile acids were given orally for 7 days before operation. RESULTS: Three hours after reperfusion, oral bile acid pretreatment failed to reduce the hepatic ischemia-reperfusion injury biochemically, but histological improvement was observed in the tauroursodeoxycholic acid groups. After reperfusion, tauroursodeoxycholic acid significantly increased bile flow from the ischemic liver, and also significantly increased serum calcium concentration. Although tauroursodeoxycholic acid did not change biliary calcium concentration, it significantly enhanced total biliary calcium output during reperfusion. CONCLUSION: Thus, tauroursodeoxycholic acid inhibited tissue calcium accumulation and enhanced sinusoidal and biliary calcium output during hepatic ischemia-reperfusion. However, it is still unclear if calcium mobilization is part of the protective mechanisms of tauroursodeoxycholic acid in ischemia-reperfusion injury of the liver.

Analysis of Variance↗
PubMed1996

Diagnosis of borderline adenomas of the stomach by endoscopic mucosal resection.

BACKGROUND AND STUDY AIMS: The correct histological diagnosis of gastric borderline adenomas is often difficult, especially in excluding malignancy, since the usual diagnostic methods, such as radiography and histological examination of forceps biopsy specimens, are of limited accuracy. The aim of this study was to retrospectively analyze the value of endoscopic mucosal resection in establishing the correct diagnosis of borderline adenomas. RESULTS: Fourteen borderline adenomas were finally diagnosed as containing early gastric cancer type IIa (well-differentiated tubular adenocarcinoma) after endoscopic mucosal resection, of the remaining 36 tubular adenomas, six represented mild dysplasia, 24 moderate dysplasia, and six severe dysplasia. Most parts of the 14 adenomas containing early gastric cancers had regions of structural atypia, and cellular atypia was moderate in all. Seven of 14 cancers were completely resected, all patients being tumor-free after a follow-up of 33-61 months. CONCLUSIONS: These results suggest that diagnosing borderline adenoma on the basis of radiographic and endoscopic-bioptic findings is generally unreliable, because biopsy specimens may not be representative of the entire lesion. Borderline adenomas of the stomach should be completely resected by endoscopic mucosal resection to obtain a final diagnosis and - depending on the size and type of the lesion - possibly also definitive treatment.

Adenoma↗
PubMed2003

Increased soluble interleukin-6 receptor in vitreous fluid of proliferative vitreoretinopathy.

PURPOSE: To clarify the effect of the interaction between interleukin-6 (IL-6) and its soluble receptor (sIL-6R) on retinal pigment epithelial (RPE) cell proliferation in proliferative vitreoretinopathy (PVR). METHODS: Concentrations of IL-6 and sIL-6R molecules in vitreous fluids were measured in eyes with PVR and idiopathic macular hole (MH), and the localization of IL-6 and IL-6R on the PVR fibrous membrane was studied. Production of IL-6 and sIL-6R by cultured RPE cells and the effect of the IL-6/sIL-6R complex on growth of cultured RPE cells were analyzed. RESULTS: Positive staining of IL-6 and IL-6R was observed in proliferating membranes in all PVR cases. IL-6 and sIL-6R concentrations in vitreous fluid from eyes with PVR were significantly higher than in eyes with MH (p < 0.05). A time-dependent increase in IL-6 molecules was identified in the culture medium of RPE cells, although sIL-6R was not detected. Dose-dependent growth of RPE cells was observed in the three concentrations (50, 100, and 500 ng/ml) of sIL-6R used. CONCLUSION: IL-6 derived from blood during the breakdown of the blood-retinal barrier (BRB) and produced by RPE cells and hematogenous sIL-6R cause RPE proliferation.

Cell Division↗
PubMed2000

In vitro antifungal activity of a novel lipopeptide antifungal agent, FK463, against various fungal pathogens.

The antifungal activities of FK463 against various pathogenic fungi were tested by standard broth microdilution methods, and compared with the activities of five currently available antifungal agents; viz., fluconazole (FLCZ), itraconazole, miconazole, amphotericin B and flucytosine. Fourteen clinical isolates of Candida albicans categorized as FLCZ susceptible, FLCZ susceptible-dose dependent and FLCZ resistant were similarly susceptible to FK463 with geometric (GM) MIC values of 0.010, 0.011 and 0.015 microg/ml, respectively. All of 17 clinical isolates of Aspergillus fumigatus were inhibited by FK463 at 0.0078 microg/ml or lower concentrations. The antifungal activity of FK463 against a wider range of medically important yeasts and filamentous fungi were studied using stock fungal strains. While Cryptococcus, Trichosporon, Fusarium, Pseudallescheria and Alternaria species or zygomycetes were scarcely or not inhibited by 16 microg/ml of FK463, two Candida species (C. albicans, C. glabrata), as well as all species of Aspergillus, Paecilomyces and Penicillium, were highly susceptible with GM-MICs of < or = 0.008 microg/ml. The other fungal species including several non-albicans Candida were less susceptible with GM-MICs ranging between 0.016 and 2 microg/ml. MICs of the reference drugs were within the range thus previously reported. These results suggest that FK463 be of use in the treatment of serious fungal infections.

Antifungal Agents↗
PubMed2005

Imaging of intraneural edema by using gadolinium-enhanced MR imaging: experimental compression injury.

BACKGROUND AND PURPOSE: Compressive and entrapment neuropathies are diseases frequently observed on routine clinical examination. A definitive diagnosis based on clinical symptoms and neurologic findings alone is difficult in many cases, however, and electrophysiologic measurement is used as a supplementary diagnostic method. In this study, we examined to use protein tracers (Evans blue albumin or horseradish peroxidase) and gadolinium-enhanced MR imaging to determine the changes of blood-nerve barrier permeability in compressive neuropathies. METHODS: In dogs, the median nerve was compressed for 1 hour by using five kinds of clips with various strengths (7.5-90-g force). After clip removal, the combined tracers of Evans blue albumin and gadolinium or horseradish peroxidase was administered intravenously as a tracer. After the animals were euthenized, we compared gadolinium-enhanced MR images with Evans blue albumin distribution in the nerve under fluorescence microscopy. The horseradish peroxidase-injected specimens were observed by transmission electron microscopy. RESULTS: On enhanced MR imaging, intraneural enhancement was caused by 60- and 90-g-force compression after 1 hour. Marked extravasation of protein tracers in the nerve occurred where there was compression by 60- and 90-g-force compression, and capillaries in the nerve showed the opening of tight junction and an increase of vesicular transport under the electron microscopy. This situation indicated breakdown of the blood-nerve barrier, with consequent edema formation and was seen as enhancement on MR imaging. CONCLUSION: Gadolinium-enhanced MR imaging can detect morphologic and functional changes of blood-nerve barrier in the nerve induced by mechanical compression.

Animals↗
PubMed1996

Clonal analysis of nodular parathyroid hyperplasia in renal hyperparathyroidism.

Although it is well known that chronic renal failure induces parathyroid hyperplasia, the pathogenesis and development of this parathyroid lesion in this disease are poorly understood. Histopathologically, there is progression from diffuse to nodular hyperplasia, and each nodule consists of a single cell type with aggressive proliferative potential. Pathophysiologic and clinical investigations have suggested that neoplastic tumors may emerge from nodular hyperplasia. In this study the clonality of parathyroid tissue in nodular and diffuse hyperplasia in renal hyperparathyroidism was analyzed by a method based on restriction fragment length polymorphism of the X chromosome-linked phosphoglycerokinase gene and on random inactivation of the gene by methylation. DNA of peripheral lymphocytes was screened in 43 women undergoing parathyroidectomy for advanced renal hyperparathyroidism, and 10 of these patients appeared to be heterozygous. Fourteen specimens from these patients were available for clonal analysis. The analysis showed that all four specimens of diffuse hyperplasia were polyclonal, whereas all seven specimens from nodules in nodular hyperplasia and all three samples representing parathyroid tissue removed from forearm because of graft-dependent recurrence were revealed to be monoclonal. It is likely that the clonal origin of each nodule is independent. These results suggest that in renal hyperparathyroidism parathyroid glands initially grow diffusely and polyclonally, and then the cells in the nodules are later transformed monoclonally and proliferate aggressively. From the present study it can be concluded that nodular hyperplasia represents monoclonal parathyroid neoplasia, which might explain why patients with nodular hyperplasia in renal hyperparathyroidism are refractory to medical treatment, requiring parathyroidectomy. To prevent recurrences, nodular hyperplastic tissue should not be left at surgery.

Adult↗
PubMed1997

[The relationship between the estimated tumor growth speed and indices of bromodeoxyuridine (BrdU) incorporation and the proliferating cell nuclear antigen (PCNA) expression in superficial bladder cancer].

BACKGROUND: We previously reported that the average tumor growth speed estimated from clinical findings may be useful as a prognostic factor to determine the stage progression in superficial bladder cancer. Here, we examined the relationship between the dynamic estimation based on the average tumor growth speed and the static estimation based on the biological proliferative activity determined from bromodeoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA) indices in superficial bladder cancer. METHODS: The subjects were 11 patients with recurrent superficial bladder cancer. The tumor growth speed was calculated by dividing all tumor volume at a certain recurrence episode by the duration until the recurrence. And then, the average tumor growth speed was determined individually by calculating mean tumor growth speed for all recurrence episodes. BrdU and PCNA indices were investigated by immunohistochemical staining. RESULTS: There was a significant correlation between the average tumor growth speed and indices of PCNA and BrdU were statistically (Spearmen's rank correlation test; between the growth speed and PCNA index: p = 0.85, p < 0.01; between the average tumor growth speed and BrdU index: p = 0.71, p < 0.05; between BrdU index and PCNA index: p = 0.77, p < 0.05). The average tumor growth speed which was calculated based on clinical findings reflected the biological proliferative activities such as BrdU and PCNA indices. Furthermore, the values of all indices were higher in the invasive than in the non-invasive cases. CONCLUSIONS: These findings suggest that the average tumor growth speed as the dynamic estimation is an important prognostic factor to determine stage progression in superficial bladder cancer.

Adult↗
PubMed1987

A method for estimating contact time of red blood cells through lung capillary from O2 and CO2 concentrations in rebreathing air in man.

The gas exchange ratio (R) obtained from O2 and CO2 concentrations measured in rebreathing air usually shows a linear relation to the PCO2. By referring to this relation and the R which equals the Haldane effect coefficient and zero, the true- and oxygenated-venous PCO2 are obtained in addition to the alveolar PCO2. When these PCO2 are evaluated, the R-PCO2 line can also be computed theoretically from a numerical solution on the overall O2 and CO2 diffusions in the red blood cell. By comparing both the experimental and theoretical R-PCO2 lines with each other, we derived a contact time equation. Since the linear approximation of the R-PCO2 relation gave rise to an error in the contact time (tc), first a factor to correct the linearity of the R-PCO2 line was derived. Next, using these parameter values, tc was quantitatively determined from experimental data obtained during rebreathing in 5 normal subjects and it was compared with that estimated from the pulmonary diffusing capacity for CO in the same rebreathing experiment. When the extracellular HCO3- dehydration rate was taken to be 0.1 s in time constant, the tc, being ca. 0.7 and 0.4 s at rest and during exercise, respectively, showed good agreement with those obtained from the diffusing capacity for CO.

Capillaries↗
PubMed1995

Polypoid growth and K-ras codon 12 mutation in colorectal cancer.

BACKGROUND: To clarify genetic changes in colorectal tumorigenesis, K-ras codon 12 point mutations were examined in 101 ordinary colorectal carcinomas and 6 that complicated ulcerative colitis (UC) with special attention to growth patterns. METHODS: The depths of invasion of ordinary carcinoma were submucosa (SMCa) in 39 cases, muscularis propria (PMCa) in 33, and far-advanced in 29. Growth patterns of SMCa and PMCa were classified into three types: polypoid-growth type without central depression (Type 1), polypoid-growth type with central depression (Type 2), and nonpolypoid-growth type. DNA samples were extracted from formalin fixed paraffin embedded sections, and K-ras codon 12 mutations were examined by two-step polymerase chain reaction-restriction fragment length polymorphism. RESULTS: K-ras mutation frequency was higher in Type 1 SMCa than in nonpolypoid SMCa, 56% (9/16) versus 6% (1/17), respectively, and in PMCa, 78% (7/9) versus 23% (3/13), respectively. In 6 UC carcinomas, a K-ras mutation was detected in only one polypoid carcinoma and none were detected in five nonpolypoid carcinomas. CONCLUSIONS: These results and the authors' previous study suggest that nonpolypoid carcinomas may be derived from flat adenomas, whose K-ras mutation incidence also was low, and this pathway is different from a genetic model based on the ordinary adenoma-carcinoma sequence through polypoid adenomas.

Adenoma↗
PubMed2002

Telomerase activity and human telomerase reverse transcriptase mRNA expression are correlated with clinical aggressiveness in soft tissue tumors.

BACKGROUND: Telomerase is a ribonucleoprotein enzyme that extends telomere specific repeats on the ends of chromosomes. Telomerase activity has been detected frequently in various types of human tumors and has been associated with cell immortality and oncogenesis. Human telomerase reverse transcriptase (hTERT), a telomerase catalytic subunit, reportedly regulates telomerase activity. Little is known about telomerase activity and hTERT mRNA expression in soft tissue tumors. The objective of this study was to clarify the correlation between these two parameters and clinical aggressiveness in soft tissue tumors. METHODS: In 41 surgically resected soft tissue tumors, telomerase activity was measured by the fluorescence-based telomeric repeat-amplification protocol and hTERT mRNA expression was determined by real-time polymerase chain reaction. RESULTS: Telomerase activity was detected in 52% of sarcomas and in none of the benign soft tissue tumors (P < 0.05). Telomerase activity was found in 77% of 13 locally recurrent sarcomas and in 89% of 9 sarcomas with distant metastasis. The frequency of the presence of telomerase activity in those tumors was significantly greater compared with the frequency of telomerase activity in the other sarcomas (P < 0.05 and P < 0.01, respectively). All telomerase positive sarcomas expressed hTERT mRNA. The mean level of hTERT mRNA expression in sarcomas was significantly greater compared with the mean hTERT mRNA expression level in benign tumors (P < 0.05) and in locally recurrent sarcomas compared with primary sarcomas (P < 0.001). CONCLUSIONS: The results of the current study suggest that the detection of telomerase activity and the level of hTERT mRNA expression are useful markers for evaluating the clinical aggressiveness in soft tissue tumors.

Adult↗
PubMed2000

Three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) as an outpatient procedure to assess infertile women: a pilot study.

OBJECTIVES: This study aimed to assess the use of three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) as a routine outpatient procedure for evaluating infertile women. METHODS: In 25 unselected infertile patients, tubal patency and uterine cavity were investigated by 3D-HyCoSy with saline as a contrast medium. The efficacy of the procedure was evaluated with X-ray hysterosalpingography (XHSG) as reference. RESULTS: The positive predictive value, negative predictive value, sensitivity, and specificity of predicting tubal patency by 3D-HyCoSy were 100, 33.3, 84.4, and 100%, respectively. The full contour of the uterine cavity was depicted in 96% of cases by 3D-HyCoSy and 64% by XHSG (P < 0.005). The uterine cavity area measured on 3D-HyCoSy correlated well with the volume of contrast medium required on XHSG (r2 = 0.8166). CONCLUSIONS: 3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women.

Adult↗
PubMed2002

Effect of YM471, an orally active non-peptide arginine vasopressin receptor antagonist, on human vascular smooth muscle cells.

OBJECTIVE: To investigate the effects of YM471, a non-peptide arginine vasopressin (AVP) V1A and V2 receptor antagonist, on the AVP-induced growth responses in human vascular smooth muscle cells (VSMCs). METHODS: Binding of YM471 to V1A receptors on VSMCs was measured using [3H]AVP. Intracellular free Ca2+ concentration was measured by fura 2 fluorescence. Mitogen-activated protein (MAP) kinase activity was determined using the p42/p44 MAP kinase specific peptide and [gamma- 32P]ATP as substrates. The effect of AVP on hyperplasia and hypertrophy of VSMCs was determined by cell number and protein content measurements. RESULTS: YM471 potently and concentration-dependently inhibited the specific binding of [ 3H]AVP to V1A receptors on VSMCs, exhibiting an inhibition constant (Ki ) of 0.35 nmol/l. YM471 inhibited the AVP-induced increase in intracellular free Ca concentration with an 50% inhibition concentration (IC50 ) of 2.01 nmol/l and inhibited the activation of MAP kinase with an IC50 of 6.11 nmol/l. In addition, AVP concentration-dependently induced hyperplasia and hypertrophy in VSMCs, but YM471 prevented these AVP-induced growth effects, exhibiting IC50 values of 2.31 and 0.23 nmol/l, respectively. CONCLUSIONS: These results indicate that YM471 has high affinity for V receptors on, and potently inhibits AVP-induced physiologic responses of, human VSMCs.

Antidiuretic Hormone Receptor Antagonists↗
PubMed2000

Comparison of tests for fecal lactoferrin and fecal occult blood for colorectal diseases: a prospective pilot study.

OBJECTIVE: This prospective pilot study was conducted to compare the usefulness of measuring fecal lactoferrin (Lf) to that of fecal occult blood (FOB) test for detection of colorectal diseases. PATIENTS AND METHODS: The subjects were 351 patients who underwent colonoscopy. A fecal sample was obtained on the day before colonoscopy. Fecal Lf was measured by enzyme-linked immunosorbent assay. The FOB test was performed by combined assay (latex agglutination) of hemoglobin and transferrin. RESULTS: The specificities of the fecal Lf and FOB tests were the same (88.7%). For patients with colorectal cancer (13), colorectal polyp (69), ulcerative colitis (18), Crohn's disease (13), non-specific colitis (8), internal hemorrhoids (60), colon diverticulum (27), and miscellaneous diseases of the colon (10), the rates of positivity for fecal Lf were 7/13, 14/69, 12/18, 7/13, 4/8, 22/60, 8/27, and 6/10, respectively. The corresponding rates for FOB were 8/13, 12/69, 11/18, 4/13, 4/8, 9/60, 2/27, and 1/10. For patients with internal hemorrhoids, the rate of positivity for fecal Lf was significantly higher than that for FOB. In other disease groups, there was no significant difference in the rate of positivity between fecal Lf and FOB. CONCLUSION: These findings suggest that measurement of fecal Lf is as useful as FOB in detecting colorectal diseases.

Colonic Diseases↗
PubMed1991

Circadian rhythm of blood pressure in normotensive NIDDM subjects. Its relationship to microvascular complications.

OBJECTIVE: To investigate the relationship between circadian rhythm of mean blood pressure (MBP) and microvascular complications in non-insulin-dependent diabetes mellitus (NIDDM) subjects. RESEARCH DESIGN AND METHODS: Seventy-six normotensive NIDDM subjects without azotemia were studied under ordinary hospital conditions with a noninvasive ambulatory blood pressure monitoring device. Time series data were analyzed by the cosinor method. RESULTS: Fifty-four subjects had a circadian MBP rhythm similar to that of 34 age-matched nondiabetic control subjects, with a peak value in the afternoon (group 1). In contrast, 22 had a reversed circadian MBP rhythm, with a peak value during the night (group 2). Obvious complications were found in 65% of group 1 and in all of group 2. The prevalence of retinopathy and somatic neuropathy and the degree of retinopathy were similar in the two groups. The prevalence and degree of autonomic neuropathy (postural hypotension and reduced beat-to-beat heart-rate variation) and nephropathy were greater in group 2 than group 1. Linear discriminant analysis revealed a correlation between the reversed circadian MBP rhythm and postural hypotension (F = 32.2, P less than 0.001) and overt nephropathy (F = 5.1, P less than 0.05) but not with beat-to-beat heart-rate variation (F = 0.17, NS). CONCLUSIONS: These results suggest that in the hospitalized normotensive NIDDM subjects, there are normal and reversed circadian MBP rhythms and that the reversal of normal circadian MBP rhythm may be related to the degree of postural hypotension and/or nephropathy.

Blood Glucose↗
PubMed1984

[Changes in grading at bladder tumor recurrence].

Today, transurethral resection to superficial bladder tumors is an important method, although frequent recurrence is a problem. We examined whether the degree of progressiveness could be determined at the time of recurrence and therapeutic manner decided from only the grading. Forty four cases which had recurred over twice and in which grading was changed during recurrence were examined. Recurrence occurred twice in 19 cases, and 3 times in 13 cases. Two patients had the largest number of recurrences, i.e., seven. The patients were divided in 3 groups. The 1st group consisted of 25 cases not worsening in grade from initial and recent transurethral resection-bladder tumor (TUR-Bt). The 2nd group consisted of 9 cases who had progressing grading. The 3rd group consisted of 10 cases who died of carcinoma. In the first group, grading decreased in 17 cases. Eight cases in the 3rd group were grade 4. We found that recurrent cases of bladder tumor did not always progressive, grading, being rather decreased than progressing in group 1. However, most of the grade 4 cases died of carcinoma. In conclusion, recurrent TUR-Bt in low grade bladder tumor patients may not be progressive, but grade 4 cases at recurrence require radical operation.

Adult↗
PubMed1997

Impaired endothelial function in epicardial coronary arteries after Kawasaki disease.

BACKGROUND: Intimal lesions observed in the coronary arteries (CAs) of patients who have suffered episodes of Kawasaki disease (KD) raise concern about the premature development of arteriosclerosis. Accordingly, we investigated endothelial function in the epicardial and resistance CAs after KD during long-term observation. METHODS AND RESULTS: We assessed the responses of left epicardial and resistance CAs to serial intracoronary infusions of acetylcholine (final concentrations, 0.1 and 1 micromol/L) and nitroglycerin in subjects by using quantitative angiography and a Doppler flow wire system. Three age-matched groups were evaluated: 8 control subjects (group 1), 10 KD patients with normal left CA from the onset (group 2), and 8 KD patients with a persistent or regressed aneurysm in the left anterior descending CA (LAD) (group 3). Acetylcholine (1 micromol/L) changed the LAD area to 114.0+/-2.6%, 72.7+/-3.9% (P<.05 versus group 1), and 88.9+/-4.3% (P<.05 versus groups 1 and 2) of baseline in groups 1, 2, and 3, respectively, with a similar degree of increased coronary blood flow in each group. Nitroglycerin increased the LAD area to 143.5+/-7.7%, 132.3+/-1.9%, and 120.8+/-5.6% (P<.05 versus group 1), respectively. CONCLUSIONS: Results demonstrate a persistent endothelial dysfunction in the epicardial but not resistance CAs in patients after KD and enhanced stiffness of persistent or regressed aneurysms. The concern over early arteriosclerosis warrants the surveillance of KD patients from childhood to adulthood.

Acetylcholine↗