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1.
Chest Surg Clin N Am ; 11(2): 407-20, 2001 May.
Article in English | MEDLINE | ID: mdl-11413764

ABSTRACT

The new WHO classification scheme provides a set of simple and easily reproducible morphologic criteria for an accurate and consistent categorization of thymic epithelial tumors. This scheme should facilitate interobserver reproducibility and lead to a more precise assessment of prognosis when used in combination with the staging system.


Subject(s)
Thymoma/classification , Thymoma/pathology , Thymus Neoplasms/classification , Thymus Neoplasms/pathology , Humans , Prognosis , Thymoma/embryology , World Health Organization
2.
Gan To Kagaku Ryoho ; 26(1): 49-53, 1999 Jan.
Article in Japanese | MEDLINE | ID: mdl-9987497

ABSTRACT

The five year survival rate of lung cancer patients is only 10% in Japan. The staging system of c-TNM is more important than p-TNM when deciding treatment modality for lung cancer. Compared to other solid cancers, neoadjuvant therapy in lung cancer treatment has a more important position. A clinical protocol study should be carried out with the idea of "intent to treat" and medical oncology will play a more important role in the treatment of lung cancer.


Subject(s)
Lung Neoplasms/therapy , Chemotherapy, Adjuvant , Combined Modality Therapy , Humans , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Lymph Node Excision , Neoadjuvant Therapy , Neoplasm Staging , Pneumonectomy
3.
Hinyokika Kiyo ; 44(6): 387-90, 1998 Jun.
Article in Japanese | MEDLINE | ID: mdl-9719936

ABSTRACT

We experienced five patients with prostate cancer with disseminated intravascular coagulation syndrome (DIC) at the first presentation at Gunma University Hospital and affiliated institutions between 1991 and 1997. Their average age was 68 years, average DIC score at the first presentation was 10 and prostate specific antigen (PSA) level was more than 700 ng/ml. All of them had multiple bone metastases. The therapy for DIC and hormonal therapy for prostate cancer were simultaneously started at the first presentation before prostate needle biopsy, but all patients died. The average number of days from the start of DIC to death was 685 days. The patients initially showed a good response to therapy, but their conditions soon aggravated. The prognosis was extremely poor, but some proper therapies lead to the prognosis which was equal to that of prostate cancer in Stage D2 without DIC.


Subject(s)
Adenocarcinoma/complications , Disseminated Intravascular Coagulation/etiology , Prostatic Neoplasms/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/secondary , Aged , Aged, 80 and over , Bone Neoplasms/secondary , Humans , Male , Middle Aged , Prognosis , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/pathology
4.
Prostate ; 34(3): 191-4, 1998 Feb 15.
Article in English | MEDLINE | ID: mdl-9492847

ABSTRACT

BACKGROUND: The objective of this study is to determine whether in a dialysis patient with prostate cancer leuprorelin acetate blood levels were abnormally high or low due to kidney failure or because of dialysis. METHODS: Sustained-release leuprorelin acetate 3.75 mg was given every 4 weeks for prostate cancer in a 79-year-old dialysis patient. Changes in serum level of leuprorelin acetate in this patient were measured before and after dialysis. RESULTS: Leuprorelin acetate appeared to have a dialysance close to that of vitamin B12, which has a similar molecular weight. The amount dialyzed did not exceed 8.3% of the amount released per day. Mean blood levels of leuprorelin acetate, as measured in this patient, were higher (0.64 to 1.31 ng/ml) than those in prostate cancer patients with normal kidney function (mean +/- SD, 0.24 +/- 0.12 to 0.50 +/- 0.32 ng/ml). CONCLUSIONS: Sustained-release leuprorelin acetate can be used safely in dialysis patients with prostate cancer.


Subject(s)
Antineoplastic Agents, Hormonal/blood , Leuprolide/blood , Prostatic Neoplasms/blood , Renal Dialysis , Renal Insufficiency/blood , Aged , Antineoplastic Agents, Hormonal/administration & dosage , Humans , Leuprolide/administration & dosage , Male , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy , Renal Insufficiency/complications , Renal Insufficiency/therapy
5.
Nihon Jinzo Gakkai Shi ; 38(5): 220-8, 1996 May.
Article in English | MEDLINE | ID: mdl-8699612

ABSTRACT

The aim of this study was to determine the levels of postprandial plasma remnant-like particles-cholesterol (RLP-C) in patients with coronary artery disease (CAD) on chronic maintenance hemodialysis (HD). Forty-two patients on chronic maintenance HD with and without CAD were studied. The subjects took a meal within 1 hr before HD then underwent HD for 4 hr with heparin infusion. The plasma level of RLP-C was monitored before and during HD and its biochemical characteristics were analysed. In the CAD group, the RLP-C level was 5.9 +/- 3.5 mg/dl before HD and 6.9 +/- 4.6 mg/dl after HD. In patients without CAD, RLP-C levels before and after HD were 2.1 +/- 0.8 mg/ dl and 2.7 +/- 1.2 mg/dl respectively (within the normal range). The RLP-C levels between CAD and non-CAD were highly significant (p < 0.001). HPLC analysis of RLP revealed that VLDL remnants were reduced to smaller size, cholesterol rich particles within 1 hr of HD and a marked increase in chylomicron (CM) remnants was observed at the end of HD. These observations suggest that a latent metabolic disorder of chylomicrons and VLDL during HD after a meal can be detected by plasma RLP-C assay. The association between the frequency of latent metabolic lipoprotein disorders and CAD found in HD patients may require appropriate dietary intervention together with drugy therapy for the control of CAD.


Subject(s)
Cholesterol/blood , Coronary Disease/blood , Kidney Failure, Chronic/therapy , Renal Dialysis , Adult , Aged , Coronary Disease/complications , Eating , Female , Humans , Kidney Failure, Chronic/complications , Male , Middle Aged
6.
Biochim Biophys Acta ; 1240(1): 55-64, 1995 Nov 22.
Article in English | MEDLINE | ID: mdl-7495849

ABSTRACT

Membrane-bound Na+/K(+)-ATPase purified from dog kidney outer medulla was solubilized with octaethylene glycol n-dodecyl ether (C12E8) and incubated with [3H]ouabain in the presence of NaCl. ATP and MgCl2 for 10 min at 0 degrees C. The resulting enzyme was separated, by high-performance gel chromatography executed at 0.2 degrees C. Mainly into its (alpha beta)2-diprotomer and alpha beta-protomer, which both bound stoichiometrically to [3H]ouabain. The amounts of ouabain that bound to the tissue itself and its microsomes could be estimated in the same way, as [3H]ouabain was found to bind only to the diprotomer and protomer they possessed. The amounts of ouabain that bound to them in the solubilized state were at least 5-times higher than those that did so when they were non-solubilized, suggesting that the surfactant rendered the enzyme accessible to ouabain. When the solubilized tissue (138 mg ml-1 wet tissue) was reacted with ouabain in the presence of 0.1 M NaCl and 4.8 mM MgCl2 for 10 min at 0 degrees C, maximal ouabain binding was attained in the presence of 18.3 microM [3H]ouabain, 1.2 mM ATP and 3 to 5 mg ml-1 C12E8, which was common to the outer medulla and human colon cancer cells. The present method enabled the pump number in protein and tissue samples in the range 7.2 x 10(-9) (purified pump) to 1.5 x 10(-12) (cancer tissue) mol/mg protein to be estimated within 2 h.


Subject(s)
Chromatography, High Pressure Liquid , Kidney Medulla/metabolism , Ouabain/metabolism , Sodium-Potassium-Exchanging ATPase/metabolism , Animals , Colonic Neoplasms/metabolism , Detergents/pharmacology , Dogs , Humans , Kidney Medulla/enzymology , Membrane Proteins/metabolism , Mice , Microsomes/enzymology , Ouabain/analysis , Polyethylene Glycols/pharmacology , Protein Binding , Salts/pharmacology , Scattering, Radiation , Sodium-Potassium-Exchanging ATPase/analysis , Sodium-Potassium-Exchanging ATPase/isolation & purification , Solubility , Tumor Cells, Cultured
7.
Int J Urol ; 2(4): 277-8, 1995 Sep.
Article in English | MEDLINE | ID: mdl-8564749

ABSTRACT

A 68-year-old female was diagnosed with a renocolic fistula, associated with left chronic pyelonephritis due to a ureter stone. Nephrectomy and repair of the fistula were performed. Histopathological examination revealed xanthogranulomatous pyelonephritis.


Subject(s)
Colonic Diseases/etiology , Intestinal Fistula/etiology , Kidney Diseases/etiology , Pyelonephritis, Xanthogranulomatous/complications , Urinary Fistula/etiology , Aged , Female , Humans , Urography
8.
Clin Exp Hypertens ; 16(1): 29-39, 1994 Jan.
Article in English | MEDLINE | ID: mdl-8136773

ABSTRACT

The evidence that some older patients with essential hypertension have low urinary dopamine excretion has brought into question the levels of urinary dopamine and plasma dopa, the major source of urinary dopamine, in young patients with essential hypertension. Twenty-four-hour urine sodium, creatinine, dopamine and noradrenaline and plasma dopa were evaluated in 48 patients with essential hypertension aged 18 to 27 years and 25 normotensive subjects. In comparison with age-matched normotensive subjects, the hypertensive patients had higher urinary dopamine (1920 +/- 80 vs 1520 +/- 130 nmol/day, p < 0.01) and noradrenaline (216 +/- 11 vs 179 +/- 12 nmol/day, p < 0.05) excretion. There was a significant correlation between urinary dopamine and noradrenaline excretion. There was no difference in plasma dopa levels between normotensive and hypertensive subjects. These results suggest that the elevated conversion of dopa to dopamine in the kidney is leading to increased urinary dopamine excretion in young patients with essential hypertension.


Subject(s)
Dopamine/urine , Hypertension/urine , Adult , Age Factors , Dihydroxyphenylalanine/blood , Humans , Male , Norepinephrine/urine
9.
Jpn J Physiol ; 43(5): 697-708, 1993.
Article in English | MEDLINE | ID: mdl-8145406

ABSTRACT

We investigated venous blood drainage from the prostate into the vertebral vein system by cineangiography in five mongrel dogs and measured intraabdominal pressure and venous blood pressure in the dog or human to study the role of intraabdominal pressure in the drainage. The averages of intraabdominal pressure and caudal vena caval pressure in the dog were 32.2 +/- 3.0 and 12.8 +/- 1.3 mmHg, respectively, in the supine position, and 39.2 +/- 3.0 and 23.8 +/- 4.0 mmHg, respectively, in the head-up tilt position, when the radiopaque medium injected into the dorsal penile vein appeared in the vertebral vein system. Intraabdominal pressure in the head-up tilt position was significantly higher than that in the supine position when the venous drainage into the vertebral veins happened. In eight continuous ambulatory peritoneal dialysis patients, intraabdominal pressure showed 8.1 +/- 2.4 mmHg in the supine position, 24.6 +/- 4.3 mmHg in the sitting position, and 30.4 +/- 4.9 mmHg in the standing position at rest. During voluntary contraction of the abdominal muscles, the pressure was increased up to 50.6 +/- 21.6 mmHg in the supine position, 69.3 +/- 19.8 mmHg in the sitting position, and 73.8 +/- 19.8 mmHg in the standing position. These pressure values in the human were significantly higher than those observed at the time when the radiopaque medium appeared in the vertebral veins in both supine and head-up tilt positions in the canine. These results suggest that the increase of intraabdominal pressure causes inflow of prostatic venous blood into the vertebral veins via the inferior vena cava, common iliac vein, or internal iliac vein.


Subject(s)
Prostate/blood supply , Abdomen , Adolescent , Adult , Aged , Animals , Dogs , Humans , Male , Middle Aged , Peritoneal Dialysis, Continuous Ambulatory , Posture , Pressure , Veins/physiology , Venous Pressure/physiology
10.
Hinyokika Kiyo ; 39(1): 15-22, 1993 Jan.
Article in Japanese | MEDLINE | ID: mdl-7681620

ABSTRACT

Clinical characteristics of BPH were investigated in the relationship among prostate volume estimated by transrectal sonography, symptoms by questionnaire, residual urine volume, and voiding force evaluated by uroflowmetry. There was no apparent relationship among them, which might be caused by the poor reproducibility of residual urine volume, the difficult enumeration of the symptoms, contamination of other diseases of which voiding disorder is correlated with aging and other unknown factors. Under such a situation, this disease should be treated as a BPH syndrome. Moreover we propose that BPH syndrome should be classified into three types; type 1: symptomatic BPH without enlarged prostate, type 2: asymptomatic BPH with enlarged prostate and type 3: symptomatic BPH with enlarged prostate.


Subject(s)
Prostatic Hyperplasia/diagnosis , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostate/pathology , Prostatic Hyperplasia/physiopathology , Urine , Urodynamics/physiology
11.
Am J Hypertens ; 5(12 Pt 1): 915-8, 1992 Dec.
Article in English | MEDLINE | ID: mdl-1285941

ABSTRACT

To investigate the hypothesis that insulin resistance plays a role in the etiology of hypertension and hyperlipidemia, we measured serum lipid levels, the fasting glucose/insulin ratio, and the insulin response to oral glucose (GTT) in a group of young obese subjects (n = 21) with hypertension and normal glucose tolerance and in normotensive subjects (n = 36) with normal glucose tolerance, matched for age and body mass index. Leisure time physical activity was evaluated by a questionnaire outlining three levels of physical activities during leisure time. Subjects with hypertension had higher fasting serum insulin (19 +/- 2 v 13 +/- 1 microU/mL, P < .01) and lower fasting glucose/insulin ratio (5.3 +/- 0.2 v 7.1 +/- 0.5 mg/dL/microU/mL, P < .01) than normotensive subjects. Subjects with hypertension had higher peak serum insulin and lower plasma glucose area/insulin area ratio in response to glucose (1.8 +/- 0.2 v 2.4 +/- 0.2 mg/dL/microU/mL, P < .05) than normotensive subjects. Serum total cholesterol, low-density cholesterol, and triglycerides were higher in the obese hypertensive subjects than in obese normotensive ones. Blood pressure correlated with either fasting serum insulin, fasting glucose/insulin ratio, or glucose area/insulin area ratio during GTT. The level of leisure time physical activities was lower in obese hypertensive subjects than in obese normotensive ones. There were significant correlations between the levels of physical activity and the fasting plasma glucose/insulin ratio (r = 0.371, P < .01) or the fasting serum insulin concentration (r = -0.282, P < .05). The study provided evidence that a low level of leisure time physical activity is associated with insulin resistance and resultant hyperinsulinemia, which are the key metabolic abnormalities that link hypertension, obesity, and hyperlipidemia in young subjects.


Subject(s)
Exercise/physiology , Hypertension/physiopathology , Insulin Resistance/physiology , Leisure Activities , Obesity/physiopathology , Adolescent , Adult , Aging/blood , Aging/physiology , Blood Glucose/analysis , Body Mass Index , Cholesterol/blood , Cholesterol, LDL/blood , Glucose Tolerance Test , Humans , Hypertension/blood , Hypertension/complications , Insulin/blood , Male , Obesity/blood , Obesity/complications , Triglycerides/blood
12.
Hinyokika Kiyo ; 38(7): 841-3, 1992 Jul.
Article in Japanese | MEDLINE | ID: mdl-1524012

ABSTRACT

A case of shock following intravesical formalin instillation for massive bladder hemorrhage owing to post-radiation cystitis is reported. A 79-year-old woman had been treated with external irradiation for cancer of the uterine body in 1981. She was suffering from massive hematuria after hysterectomy in 1988. No hemostatic procedures were effective. Then we instilled 10% formalin into her bladder. After the instillation she entered a state of allergic shock.


Subject(s)
Formaldehyde/adverse effects , Hemorrhage/drug therapy , Shock/chemically induced , Urinary Bladder Diseases/drug therapy , Administration, Intravesical , Aged , Cystitis/complications , Female , Humans , Radiation Injuries/complications
13.
Nihon Jinzo Gakkai Shi ; 34(7): 853-8, 1992 Jul.
Article in Japanese | MEDLINE | ID: mdl-1479727

ABSTRACT

A 35-year old female with an autoimmune disease complaining of recurrent hemoptysis and macrohematuria had received a renal transplantation from her mother. After transplantation, recurrence of pulmonary hemorrhage occurred twice. First recurrence followed the peritonitis with ileal perforation. Steroid pulse therapy had no effect on this recurrence, while double filtration plasmapheresis was effective. During this treatment, renal function was not failed. Second recurrence followed acute rejection that was cured with the OKT3-rescue therapy. DFPP therapy was effective on this episode. Pulmonary hemorrhage was caused by auto immune reaction and acute rejection caused by transplant immune reaction were recognized independently, and they needed different treatment. According to this clinical course, we consider the relation between auto immune reaction and transplant immune reaction was as follows. T cell activation caused by primary transplant immune reaction may have no direct influence on auto immune reaction. Peritonitis and rejection may induce auto immune reaction. We suppose that this auto immune reaction was caused by humoral factor, because auto immune reaction was controlled by DFPP.


Subject(s)
Autoimmune Diseases/therapy , Hemorrhage/therapy , Kidney Transplantation , Lung Diseases/therapy , Plasmapheresis/methods , Adult , Female , Graft Rejection , Humans , Recurrence , Transplantation Immunology
16.
Angiology ; 42(9): 691-5, 1991 Sep.
Article in English | MEDLINE | ID: mdl-1928809

ABSTRACT

The effects of L-dopa on blood pressure, heart rate, plasma renin activity, norepinephrine, epinephrine and prolactin were studied in a randomized single-blind trial in 36 patients with essential hypertension. In response to L-dopa, 250 mg administered orally, the blood pressure decreased significantly as compared with the results of placebo treatment. The heart rate and plasma norepinephrine and epinephrine were unchanged. The plasma renin activity and prolactin decreased as a result of L-dopa administration. The administration of a peripheral DA2 dopamine receptor blocker, domperidone (20 mg, orally) prevented the L-dopa-induced reduction in plasma prolactin but failed to block the fall in blood pressure and plasma renin activity. These results suggest that the blood pressure-lowering effect of L-dopa may be mediated through multiple sites involving D1 dopamine receptors, the central nervous system, and the renin-angiotensin system.


Subject(s)
Hypertension/drug therapy , Levodopa/therapeutic use , Adult , Blood Pressure/drug effects , Epinephrine/blood , Heart Rate/drug effects , Humans , Male , Norepinephrine/blood , Renin/blood , Renin-Angiotensin System/drug effects , Single-Blind Method
17.
Hinyokika Kiyo ; 37(5): 557-61, 1991 May.
Article in Japanese | MEDLINE | ID: mdl-1858595

ABSTRACT

A 69-year-old woman suffered from bilateral renal stones. Laboratory examinations showed primary hyperparathyroidism. Neck exploration including left hemithyroidectomy and partial thymectomy failed to reveal the abnormal parathyroid gland. Localization studies were done for an ectopic parathyroid adenoma. Repeated selective arteriography with digital subtraction technique revealed an ectopic parathyroid adenoma in the upper mediastinum. Computed tomography, ultrasonotomography and selective venous sampling also confirmed this finding. Subsequently, mediastinal exploration with partial sternotomy was performed and the ectopic parathyroid adenoma was removed. We discuss the preoperative localization studies for ectopic parathyroid adenoma.


Subject(s)
Adenoma/diagnosis , Choristoma/diagnosis , Mediastinal Neoplasms/diagnosis , Parathyroid Glands , Adenoma/diagnostic imaging , Aged , Choristoma/diagnostic imaging , Female , Humans , Mediastinal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Ultrasonography
18.
Kokyu To Junkan ; 38(12): 1241-5, 1990 Dec.
Article in Japanese | MEDLINE | ID: mdl-2287820

ABSTRACT

To determine whether depressed left ventricular (LV) contractile function can occur after exhaustive exercise, echocardiographic studies were performed in eleven athletes before, at the finish (9 minutes) and during recovery (15 hour) after the Biwa Lake Ironman Triathlon (3.2 km Swim, 161 km Bike, 32 km Run). Before racing and during recovery, the studies were performed both at rest and after brief exercise (10-15 minutes). Heart rates after brief exercise were comparable to those attained after racing. Digitized M mode echocardiographic data as to wall thickness, cavity dimension, fractional shortening (FS) and peak circumferential shortening (maxVcf) were obtained. When we compared race finish to pre-race brief exercise, the LV end-diastolic dimension (EDD) was reduced (46 +/- 7 vs 47 +/- 6 mm, less than 0.05) and FS declined (33 +/- 5 vs 39 +/- 6%, p less than 0.05). In spite of reduced wall stress, maxVcf decreased. Individual percent reductions in FS were not correlated with decrease in EDD, but correlated with increases in EDS. Although a persistent reduction in cavity size was observed during recovery, FS and maxVcf returned toward the baseline. The results suggest that prolonged strenuous exercise may result in impaired LV function in part because of a reversible depression in the contractile state.


Subject(s)
Exercise/physiology , Ventricular Function, Left/physiology , Adult , Blood Pressure , Echocardiography , Female , Heart Rate , Hematologic Tests , Humans , Male , Middle Aged
19.
Hinyokika Kiyo ; 36(9): 1069-72, 1990 Sep.
Article in Japanese | MEDLINE | ID: mdl-2239614

ABSTRACT

A 35-year-old female patient was hospitalized for a headache. She was referred to our department for the evaluation of right hydronephrosis noted on the excretory urogram which was performed as part of a hypertensive diagnostic study. Endocrine examination revealed renal hypertension. Excretory urogram and antegrade pyelography showed obstruction of the lower part of the right ureter. On surgical exploration, the lower part of the right ureter was surrounded by brown tissue. Complete hysterectomy and ureterovesiconeostomy were performed. Histologically, the brown tissue around the ureter was diagnosed as endometriosis. One year after the operation, excretory urogram showed normal urinary tract and the blood pressure was 130/80 mmHg. Endometriosis is a common gynecological disease but ureteral endometriosis is relatively rare. Review of the Japanese literature disclosed 16 previous cases of ureteral endometriosis and we report the 17th case with a review of the literature.


Subject(s)
Endometriosis/complications , Hydronephrosis/complications , Hypertension, Renal/etiology , Ureteral Neoplasms/complications , Adult , Endometriosis/pathology , Female , Humans , Ureteral Neoplasms/pathology
20.
Hinyokika Kiyo ; 36(8): 945-8, 1990 Aug.
Article in Japanese | MEDLINE | ID: mdl-2239598

ABSTRACT

The patient was a 75-year-old man who complained of macrohematuria which had set in from April 12, 1988. Under the clinical diagnosis of bladder tumor, total cystectomy with ureterosigmoidostomy was performed on June 25. During his surgery, we discovered a polypoid lesion of the right ureter close to the common iliac artery. The tumor was peanut-sized and had a stalk suggesting benign nature, so we resected it. Postoperative pathological examination revealed the tumor was transitional cell carcinoma (grade 2) with an inverted growth pattern. Though we could find no signs of tumor recurrence, the presence of tumor's residuum could not be ruled out. We performed nephroureterectomy of the right side on December 19. Follow-up on July 1, 1989 this patient revealed no tumor recurrence.


Subject(s)
Carcinoma, Transitional Cell/pathology , Kidney Neoplasms/pathology , Neoplasms, Multiple Primary , Ureteral Neoplasms/pathology , Aged , Carcinoma, Transitional Cell/surgery , Follow-Up Studies , Humans , Kidney Neoplasms/surgery , Male , Ureteral Neoplasms/surgery
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