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Biomedical subjects

E Higashihara

Publications and source records attributed to E Higashihara.

At least 73 records · Page 4Linked to original sources
PubMed1991

Calcium metabolism in acidotic patients induced by carbonic anhydrase inhibitors: responses to citrate.

Calcium metabolism and its response to citrate were examined in 51 patients with glaucoma receiving carbonic anhydrase inhibitors (acetazolamide or methazolamide). Metabolic acidosis, hypocitraturia and increased incidence of nephrolithiasis were induced by both drugs. However, the acidosis was milder with methazolamide administration. Normocalciuria was observed in 29 patients and was shown to be a result of low filtered calcium. Renal hypercalciuria in 16 patients was associated with elevated parathyroid hormone but nephrogenic cyclic adenosine monophosphate remained within normal limits. Citrate in the form of potassium citrate (4.3 mmol.) and sodium citrate (4.0 mmol.) did not correct the metabolic acidosis or hypocitraturia but consistently decreased fasting and 24-hour urinary calcium excretion in patients with renal hypercalciuria. This event did not occur in patients with normocalciuria or absorptive hypercalciuria. These results suggest that a small amount of citrate could reverse renal hypercalciuria without correcting the metabolic acidosis.

Acetazolamide↗
PubMed1991

Renal cyst formation as a complication of primary distal renal tubular acidosis.

Morphologic studies using renal sonography and CT scanning were performed in 6 patients with primary distal renal tubular acidosis who were followed for 6 to 18 years. Nephrocalcinosis and renal cysts were identified in all patients. Multiple bilateral renal cysts were detected in 3 patients, and unilateral single or several renal cysts were detected in 3 patients. Size and number of the renal cysts in 1 patient did not change over 5 years of alkali therapy. Although the precise mechanism for renal cyst formation has not yet been established, renal cysts may be a common complication of primary distal renal tubular acidosis.

Acidosis, Renal Tubular↗
PubMed1991

[The urodynamic effects of an alpha 1-adrenoceptor agonist on the bladder and urethra of female dogs].

It has been known that alpha 1-adrenoceptors play an important role in urethral contraction. The incompetence of the urethral contraction is a cause of stress incontinence. We studied the urodynamic effects of a selective alpha 1-adrenoceptor agonist (midodrine hydrochloride) on the bladder and urethra of female dogs. Under anesthesia with intravenous chloralose, four doses (0.03, 0.1, 0.3 and 1.0 mg/kg) of midodrine were administered intravenously and urodynamic studies including cystometry, urethral pressure profilometry and electromyography (EMG) of the external urethral sphincter were performed. The administration of midodrine induced a significant increase of the maximum closing pressure in the proximal portion of the urethra (p less than 0.05 at 0.03 mg/kg and p less than 0.01 at 0.1, 0.3, 1.0 mg/kg). There were no significant changes in the functional profile length, the closing pressure at the external sphincters, the maximum bladder pressure, bladder capacity and bladder compliance. The administration of 0.3 mg/kg or more of midodrine produced a significant increase in the mean arterial blood pressure. After midodrine administration, transient increases in the external sphincter EMG activities were recognized. The activities showed the synergistic pattern during the bladder contractions. In conclusion, lower dose administration of a selective alpha 1-adrenoceptor agonist (midodrine) specifically produced an increase of the closing pressure in the proximal portion of the urethra without affecting blood pressure. These results suggest that midodrine is useful for the treatment of stress incontinence in humans.

Animals↗
PubMed1991

[Lymphocytic subsets of tumor tissue, non tumorous kidney, and the peripheral blood in primary renal cell carcinoma].

Lymphocyte subsets were examined in renal cell carcinoma (TILs), adjacent non-tumor renal tissue and peripheral blood (PBLs) by flow cytometry and histochemistry in eighteen patients with renal cell carcinoma. CD5-positive cells were predominant in the TILs in 14 patients. In the renal cell carcinoma tissue, CD8-positive cells were predominant over CD4-positive cells, resulting in a less than unity ratio of CD4/CF8-positive cells. The lymphocyte number was significantly in adjacent normal renal tissue than in renal cell carcinoma. However, lymphocyte subsets ratios were not significantly different between these two tissues. PBLs showed the same proportions (CD4/CD8 mean 1.9 +/- 0.8) as the previously published healthy controlled data. The proportions of CD8-positive cells were significantly increased (p less than 0.05) and those of CD4-positive cells were also significantly decreased (p less than 0.01) in the TILs. The infiltrating pattern of TILs in 17 patients was divided histochemically into cluster (N = 7), single (N = 4), and mixed types (N = 6). The cluster and mixed types were significantly more common in grade 1 tumors and the single type was more common in the grade 2 tumors (p less than 0.05). The pT3 tumors showed the single type of TIL infiltration pattern, but showed no significant difference. In the cluster pattern of TILs, CD8-positive cells were surrounded by CD4-positive cells. Non-tumorous kidneys showed no infiltration of lymphocytes, except in 2 patients of pyelonephritis. These results suggest that cytotoxic T-cells stained as CD8 play an immunoreactive role against renal cell carcinoma.

CD4-CD8 Ratio↗
PubMed1991

[Lectins expression of parathyroid glands with primary hyperparathyroidism].

The binding sites of lectins in parathyroid glands were determined by an immunohistochemical method in normal parathyroid gland, hyperplasia, adenoma and carcinoma, the used lectins were commercially available Glycine max (SBA), Concanavalin enciformis (Con A), Triticum vulgaris (WGA), Richinus communis (RCA), Banderiaea simplicifolia II (BSA II) and Arachis hypogaea (PNA). For normal parathyroid glands (2 cases) and hyperplasia (2 cases), WGA and BSA II were stained in cytoplasma and cell membrane. For carcinoma (1 cases), all lectins but BSA II were positively stained. In particular, SBA revealed more stronger stain than any other hystological types. From the staining patterns of lectins, it was suggested that adenomas (22 cases) be divided into one group similar to carcinoma and the others to normal parathyroid gland and hyperplasia. But there was no difference in clinical data of patients between the two groups.

Adenoma↗
PubMed1991

[Vesicoureteral reflux and renal scarring. Report of cooperative study of "Progressive renal disease" of Ministry of Health and Welfare].

196 cases with vesicoureteral reflux (VUR) from multiple centers were analysed to examine the relationship between VUR and reflux nephropathy. The high correlation (p less than 0.01) was observed between reflux and renal scarring. Even in cases in whom VUR was not demonstrated at the time of testing, renal scarring of various degrees was recognized, suggesting either co-existed hypoplastic kidney or pre-existed infection. The renal scarring, but not VUR, had a significant correlation with proteinuria and hypertension. Retrospective analysis shows that the surgical treatment was closely related to the degree of renal scarring but not to the degree of reflux. Renal scarring progressed even when reflux did not become worse, which is probably accounted for by the presence of pyelonephritis. Although frequency of pyelonephritis decreased significantly (p less than 0.01) from 0.60 +/- 0.89 to 0.084 +/- 0.305 times/patient. year after anti-reflux surgery, renal scarring progressed in 13 kidneys (5.8%). Seven of the 13 kidneys became worse due to the surgical failure. The scar progression was recognized in the remaining six kidneys (three patients) including adult cases despite the successful surgical correction of reflux. Our study points to the urged need for a prospective clinical trial designed for the study of the pathological and clinical background of progressive renal failure in VUR.

Adult↗
PubMed1991

[Hyperthermic treatment of benign prostatic hyperplasia by a prostathermer].

Prostate thermotherapy consisting of 6 sessions of intrarectal 60 min irradiation of 915 MHz microwave generated by a prostathermer (Blodan, Isreal) was performed once or twice a week on 30 patients with benign prostatic hyperplasia. Excluding 2 cases who refused further therapy at the first session because of rectal discomfort, 28 cases were evaluated for the efficacy of the treatment. Good or fair improvement in subjective symptoms was observed in 24 (85.7%) of the cases. Nocturia was significantly relieved from 2.9 to 2.0 a night. Among the objective responses, no improvement was achieved as to residual urine or prostate size, while a significant increase of maximum or average flow rate on uroflowmetry was observed. Adverse effects were minor or moderate, including 2 cases of urethral bleeding and rectal discomfort, 2 cases of lower urinary tract infection and 1 case of hypotension, which occurred at the 5th session. The scoring criteria taking into account of both subjective and objective responses showed that the efficacy is good in 10 cases (33.3%) and fair or good in 20 cases (66.7%). These results indicated the usefulness of the prostathermer as one of non-surgical therapies for benign prostatic hyperplasia.

Aged↗
PubMed1990

Long-term consequence of nephrectomy.

Renal function and blood pressure were assessed in 139 patients after unilateral nephrectomy. Followup ranged from 1 to 57 years, with a mean of 13.0 +/- 1.1 (standard error). Serum creatinine, creatinine clearance, beta 2-microglobulin clearance and blood pressure remained stable during followup. No significant effect of years after unilateral nephrectomy, blood pressure or cause of nephrectomy was observed on creatinine clearance. However, urine excretion of protein (correlation coefficient 0.475, p less than 0.01) and N-acetyl-beta-D-glucosaminidase (correlation coefficient 0.464, p less than 0.01) increased as a function of years after unilateral nephrectomy. Creatinine clearance tended to be low in elderly patients or patients who underwent nephrectomy at an advanced age. Our studies show that despite the late development of proteinuria and tubular injury, unilateral nephrectomy is not associated with deterioration in kidney function or elevation of blood pressure during long-term followup.

Acetylglucosaminidase↗
PubMed1990

Laser ureterolithotripsy with combined rigid and flexible ureterorenoscopy.

Because the pulsed dye laser can be transmitted through a thin, flexible quartz fiber a small caliber ureteroscope and flexible ureterorenoscope are applicable. Therefore, the use of a rigid or flexible ureterorenoscope was combined with laser lithotripsy to treat upper urinary tract calculi. All 14 ureteral stones below the pelvic brim were removed successfully with a rigid 7.2F (outer diameter) ureteroscope and 14 of 16 stones above the pelvic brim were removed with a flexible ureterorenoscope. Laser monotherapy was effective in 24 cases and the complementary use of forceps or electrohydraulic lithotripsy was required in 4. Two stones were lost from the visual field during endoscopic manipulation. There was no complication requiring surgical correction. The combined use of these instruments is highly successful and safe for the treatment of upper urinary tract calculi.

Adult↗
PubMed1990

[In situ hybridization study of human papillomavirus from the penile cancer].

The histochemical detection of human papillomavirus (HPV) was performed using the technique of in situ hybridization from the formalin fixed paraffin embedded specimens of penile carcinoma and condylomata+ acuminata . One of 19 penile cancer cases (5.3%) revealed the positive staining on the nuclei of the tumors for HPV type 16/18. However, the positive nuclei were scattered and localized in small part of the tumor which showed no koilocytosis. On the contrary, 11 of 12 condyloma acuminata cases (91.7%) showed positive staining on the nuclei of the tumors for HPV type 6/11, also 5 of the 11 cases (45.5%) revealed cross reaction for other type of HPV. The HPV types 6/11, 16/18 and 31/33/35 may be unrelated to the pathogenesis of the Japanese penile carcinoma. However, further study is necessary to evaluate that the number of HPV-DNA copy in our cases is too small, or the other type of HPV is responsibility.

Adult↗
PubMed1990

[Four cases of bladder replacement by enterocystoplasty after radical cystectomy for bladder cancer].

Four male patients with invasive bladder cancer, 44 to 68 years old in age, underwent bladder replacement with ileum after radical cystectomy. In three patients an ileal segment alone was isolated for construction of neobladder, and in the fourth patient, the terminal portion of the ileum, the cecum and the proximal part of the ascending colon were isolated for the bladder replacement. In all the cases isolated segments were detubularized for obtaining a low pressure reservoir. All the patients, except one who had a past history of cerebro-vascular disease and was performing intermittent self-catheterization because of a kind of detrusor-sphincter dyssynergia of the ileal-neobladder, are now enjoying almost the same voluntary urination as before the operation. Serum creatinine, BUN and electrolytes are all normal during the postoperative observation period, although a very slight metabolic acidosis was observed in 3 patients. Ten to 16 months have passed without any complications and all the patients are alive without any sign of tumor recurrence or metastatic involvement.

Aged↗
PubMed1990

[A clinical study of 124 cases of renal cell carcinoma].

One hundred twenty-four cases of renal cell carcinoma treated at Department of Urology, The University of Tokyo were analyzed for their clinical characteristics and prognosis. To be noted were the recent increase of incidentally detected cases, kidney-sparing technique in curative surgery and adjuvant therapy using biological response modifiers. Prognosis was more favorable in cases with incidental detection, normal ESR or cystic pattern in pathological architecture, whereas that of cases with metastatic lesions or Grade 3 tumors was ominous. Tumor stage as TUMV or Robson stage was useful to predict the prognosis, although one stage contained cases of considerably different survival periods. These results suggested that the efforts to improve prognosis in the present practice should include early detection of renal cancer by promoting health check-up and development of preventive measure of postoperative recurrence. A more proper staging system might also be needed to analyze clinical studies.

Carcinoma, Renal Cell↗
PubMed1989

Renal hypercalciuria and acidification defect in kidney stone patients.

Calcium metabolism and renal acidification ability were examined in renal stone patients. On a random diet 33 of 52 patients excreted more than 4 mg. per kg. body weight per day of urinary calcium and were entered into a second study on a 300 mg. calcium diet. Absorptive and renal hypercalciuria was differentiated by fasting urinary calcium (mg. per 100 ml. glomerular filtration). Every absorptive hypercalciuria patient tested and 5 renal hypercalciuria patients had a normal renal acidification ability, and the serum parathyroid hormone and urinary cyclic adenosine monophosphate levels were normal. By calcium restriction urinary calcium decreased more in absorptive hypercalciuria than in renal hypercalciuria (2.48 +/- 0.14 versus 3.34 +/- 0.27 mg. per kg. body weight per day, p less than 0.05). However, urinary calcium remained high in 76 per cent of the patients with absorptive hypercalciuria. Nine patients had a defect in renal tubular acidification and the calcium metabolism was similar to those with renal hypercalciuria. Present studies show that renal hypercalciuria and renal tubular acidification defect cannot be differentiated without an ammonium chloride test.

Acidosis, Renal Tubular↗
PubMed1989

Congenital anterior urethral diverticulum and recurrent urinary tract infection.

A patient with congenital anterior urethral diverticulum is described. He showed recurrent lower urinary tract infection, but he did not have severe upper urinary tract abnormalities. One-stage resection and urethroplasty were successfully performed before the upper urinary tract change developed. Anterior urethral diverticulum should be considered as a cause of recurrent lower urinary tract infection in young children.

Diverticulum↗
PubMed1989

[Extracorporeal shock wave lithotripsy for upper urinary tract stone using piezoelectric lithotripter (Piezolith 2200)].

The results of clinical trial using the second generation extracorporeal shock wave lithotripter (Piezolith 2200, Wolf, West Germany) were presented. The treatments were performed between December 1987 and March 1988 at the University of Tokyo. In total 59 ESWL sessions were carried out on 32 patients with 48 upper urinary tract stones. The treatment could be performed without anesthesia or analgesic agent in every case. A double-J ureteral stent was indwelling in 6 patients with ureteral stones or large stones before ESWL treatment, and transurethral lithotripsy (TUL) was performed in two patients after the treatment. On the X-ray film obtained three weeks after the final ESWL treatment, 13 cases (40.6%) were completely free from stone fragments, while 9 cases (28.2%) had stone fragments less than or equal to 5 mm. Others had fragments greater than 5 mm. ESWL using this device was clinically useful in 71.9% in the three weeks follow-up period. No serious complication was observed after treatment except macroscopic hematuria for a few days in all cases, pyrexia in 4 cases (12.5%) and flank pain in 7 cases (21.9%). There were slight and transient changes in the laboratory data after the treatment, but these changes were milder than those with spark gap lithotripters. It is concluded that Piezolith 2200 is useful in the management of patients with upper urinary tract stones, and it is applicable more safely than the first generation lithotripters.

Adult↗