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Biomedical subjects

H Komeda

Publications and source records attributed to H Komeda.

At least 37 records · Page 2Linked to original sources
PubMed1993

[A study of methicillin-resistant Staphylococcus aureus (MRSA) infection in urological field].

Out of 110 strains of Staphylococcus aureus isolated from 1985 to 1990, isolation rate of methicillin-resistant S. aureus (MRSA) was investigated. Nineteen strains of 59 S. aureus from outpatients and 20 strains of 51 S. aureus from inpatients were determined as MRSA. Isolation frequency of MRSA from inpatients was increasing in the recent two years. Coagulase type, enterotoxin type and production of toxic shock syndrome toxin-1 (TSST-1) were examined in 22 strains of MRSA. Coagulase type II (86%), enterotoxin type C (68%) and TSST-1 positive strain was most dominant. Susceptibility of MRSA to 4 antimicrobial agents were measured, MRSA were sensitive to vancomycin (VCM), arbekacin (ABK) and minocycline, but resistant to flomoxef. Thirty-four patients from whom MRSA was isolated including 20 patients from urine, 13 from pus and 1 from blood, were analyzed clinically. Pyuria was not recognized in some cases in whom MRSA was isolated from their urine. Concomitant polymicrobial infection was frequently noted in those patients with MRSA in their urinary tract. These facts show that the pathogenic role of MRSA in the urinary tract infection was not significant. On the other hand, when MRSA was isolated from pus or blood, serious infections could be caused by MRSA, especially in compromised host. Regarding the treatment in these cases, administration of VCM or ABK was though to be necessary.

Aminoglycosides↗
PubMed1992

Nitrilase from Rhodococcus rhodochrous J1. Sequencing and overexpression of the gene and identification of an essential cysteine residue.

The amino acid sequences of the NH2 terminus and internal peptide fragments of a Rhodococcus rhodochrous J1 nitrilase were determined to prepare synthetic oligonucleotides as primers for the polymerase chain reaction. A 750-base DNA fragment thus amplified was used as the probe to clone a 5.4-kilobase PstI fragment coding for the whole nitrilase. The nitrilase gene modified in the sequence upstream from the presumed ATG start codon was expressed to approximately 50% of the total soluble protein in Escherichia coli. The predicted amino acid sequence of the nitrilase gene showed similarity to that of the bromoxynil nitrilase from Klebsiella ozaenae. The 5,5'-dithiobis(2-nitrobenzoic acid) modification of the nitrilase from R. rhodochrous J1 resulted in inactivation with the loss of one sulfhydryl group/enzyme subunit. Of 4 cysteine residues in the Rhodococcus nitrilase, only Cys-165 is conserved in the Klebsiella nitrilase. Mutant enzymes containing Ala or Ser instead of Cys-165 did not exhibit nitrilase activity. These findings suggest that Cys-165 plays an essential role in the function of the active site.

Amino Acid Sequence↗
PubMed1992

[Detection of Neisseria gonorrhoeae in first-voided urine sediments from male urethritis patients by polymerase chain reaction].

Neisseria gonorrhoeae was detected from first-voided urine sediments of male patients with urethritis by polymerase chain reaction (PCR). Urine and urinary sediment were treated with proteinase K, and DNA was further purified by phenol extraction. Two oligonucleotides based on sequences within a ribosomal RNA gene from N. gonorrhoeae were used as primers for the PCR. A DNA fragment of 206 bp specific for N. gonorrhoeae was amplified by PCR and detected by agarose gel electrophoresis. In 19 specimens of urine sediments collected from 21 patients in whom N. gonorrhoeae was isolated from urethral swab by culture, 206 bp DNA fragment was amplified by PCR. In all specimens of urine sediments from 24 patients in whom cultures for N. gonorrhoeae were negative, no DNA was amplified by the PCR. The overall coincidence rate between the PCR for detecting N. gonorrhoeae in first-voided urine sediments and culture in urethral swab was 95.6% (43/45). PCR procedure for detection of pathogens from first-voided urine sediments would be noninvasive and would be applied for the diagnosis of gonococcal urethritis and chlamydial urethritis.

Chlamydia trachomatis↗
PubMed1992

[Comparison of polymerase chain reaction and IDEIA Chlamydia in detection of Chlamydia trachomatis from first-voided urine of male urethritis patients].

We have reported a method for detection of Chlamydia trachomatis by polymerase chain reaction (PCR) with two oligonucleotides based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2. In the previous report, in addition to treatment of the mixture of first-voided urine (FVU) sediment and 1 ml of urine with proteinase K. DNA purification by phenol extraction was necessary for preparation of template DNA for PCR. In this study, FVU sediment was suspended in 1 ml of Chlamydiazyme dilution buffer and a part of the suspension was treated with proteinase K for DNA extraction. The DNA extraction solution could be used as template for PCR without purification of DNA by phenol extraction. One hundred FVU specimens obtained from male urethritis patients were examined with the two methods (PCR and IDEIA) for detection of C. trachomatis. In 33 of 100 specimens, the DNA fragments of C. trachomatis was amplified by the PCR and in 32 of 100, the chlamydial antigen was detected by IDEIA. The positive and negative coincidence rate of the PCR to IDEIA were 93.8% (30.32) and 95.6% (65/68) respectively, resulting in a high overall coincidence rate at 95%. Thus, the improved method with PCR using FVU as a specimen is proved to be a useful, non-invasive diagnostic tool for diagnosis of chlamydial urethritis.

Chlamydia trachomatis↗
PubMed1992

[Detection of Ureaplasma urealyticum by polymerase chain reaction].

A polymerase chain reaction (PCR) procedure for detection of Ureaplasma urealyticum was developed. A set of oligonucreotides based on sequences within the 16S ribosomal RNA gene from U. urealyticum were used as extension primers for the PCR. A DNA fragment of 397 bp was amplified by the PCR, when U. urealyticum DNA was template for the PCR. No amplified product was detected from other bacterial DNA including those of Mycoplasma genus. The amplified DNA fragment of 397 bp was detected on agarose gel electrophoresis, when DNA of > or = 10(2) cells of U. urealyticum per PCR was used as template for the PCR. Thus, the PCR procedure was shown to be a simple, rapid and specific method for detection of U. urealyticum and could be applied to detection of U. urealyticum from clinical specimens.

Base Sequence↗
PubMed1992

[Comparison of polymerase chain reaction and enzyme immunoassay (Chlamydiazyme) in detection of Chlamydia trachomatis from male urethritis].

A method using polymerase chain reaction (PCR) was compared to an enzyme immunoassay (Chlamydiazyme) for detection of Chlamydia trachomatis by testing a reference strain and clinical specimens. Two oligonucleotides based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2 were used as primers for the PCR. A DNA fragment of 242 bp specific for C. trachomatis was amplified by the PCR, when DNA of greater than or equal to 10(2) C. trachomatis was used as template for the PCR. A chlamydial antigen was detected by Chlamydiazyme, when greater than or equal to 2.6 x 10(3) C. trachomatis were applied for the enzyme immunoassay. The PCR method was 26 times more sensitive than Chlamydiazyme in detection of C. trachomatis. The PCR method and Chlamydiazyme were carried out to examine 74 urethral swabs obtained from male patients with urethritis for detection of C. trachomatis. In 45 of 74 specimens, the DNA fragment of C. trachomatis was amplified by the PCR, and in 41 of 74, the chlamydial antigen was detected by Chlamydiazyme. The detection rate of the PCR method (60.8%) was higher than that of Chlamydiazyme (55.4%). The positive coincidence rate of the PCR method to Chlamydiazyme was 100% (41/41) and negative coincidence rate was 87.9% (29/33). The overall coincidence rate between the two methods was high (94.6%). Thus, the PCR method was more sensitive than Chlamydiazyme for detection of C. trachomatis and specific for diagnosis of chlamydial urethritis.

Chlamydia trachomatis↗
PubMed1992

[Detection of Neisseria gonorrhoeae from male patients with urethritis by polymerase chain reaction].

A polymerase chain reaction (PCR) procedure was developed for detection of Neisseria gonorrhoeae. Two oligonucleotides based on sequences within a 16S ribosomal RNA gene from N. gonorrhoeae were used as extension primers for the PCR. A single DNA fragment of 206 bp was amplified, when N. gonorrhoeae DNA was template for the PCR. No amplified product was detected in Chlamydia trachomatis DNA, Ureaplasma urealyticum DNA or other bacterial DNAs. The DNA fragment of 206 bp was detected on agarose gel electrophoresis, when DNA of greater than or equal to 6.5 N. gonorrhoeae per PCR was used as template DNA for the PCR. The culture and the PCR were carried out for detection of N. gonorrhoeae in 67 urethral swabs obtained from male patients with urethritis. In 27 of 28 specimens in which N. gonorrhoeae was isolated and identified by the culture, 206 bp DNA fragment was amplified by the PCR, but in one specimen no DNA fragment was detected. In 2 of 39 culture-negative specimens, 206 pb DNA fragment was detected and in the remaining specimens, PCR was negative for N. gonorrhoeae. The overall detection coincidence rate between the culture and the PCR was 95.5% (64/67). Thus, the PCR procedure developed in this study was sensitive and specific for detection of N. gonorrhoeae and could be applied for diagnosis of gonococcal urethritis.

Gonorrhea↗
PubMed1992

[Detection of Chlamydia trachomatis in first-voided urine sediments from male urethritis by polymerase chain reaction].

Chlamydia trachomatis was detected from first-voided urine sediments of 97 male patients with urethritis by polymerase chain reaction (PCR). Since urine and urinary sediments only treated with proteinase K inhibited DNA amplification by PCR, DNA was further purified by phenol extraction and concentrated. Two oligonucleotides based on sequences within the major outer membrane gene from C. trachomatis serovar L2 were used as primers. A DNA fragment of 242 bp specific for C. trachomatis was amplified by PCR and detected by agarose gel electrophoresis. The DNA fragment was amplified by PCR in all specimens of urine sediments from 50 patients with Chlamydiazyme-positive urethral swab. In 38 specimens of urine sediments from 47 patients with Chlamydiazyme-negative urethral swab, PCR was negative. The overall coincidence rate between the PCR for detecting C. trachomatis in first-voided urine sediments and Clamydiazyme in urethral swab was 90.7% (88/97). Detection of C. trachomatis from first-voided urine sediments by PCR was considered to be noninvasive and useful for the diagnosis of male urethritis due to C. trachomatis.

Chlamydia trachomatis↗
PubMed1992

[Diagnosis of gonococcal urethritis and chlamydial urethritis by polymerase chain reaction].

A polymerase chain reaction (PCR) method was compared to standard methods (cultures for Neisseria gonorrhoeae and Chlamydia trachomatis and an enzyme-immunoassay for C. trachomatis) in diagnosis of gonococcal and chlamydial urethritis in 40 male patients with urethritis. Gonococcal urethritis was diagnosed by detection of a 206 bp DNA fragment amplified by PCR with N. gonorrhoeae-specific primers. Chlamydial urethritis was diagnosed by detection of a 242 bp DNA fragment amplified by PCR with C. trachomatis-specific primers. Gonococcal and chlamydial urethritis, gonococcal and non-chlamydial urethritis, non-gonococcal and chlamydial urethritis, and non-gonococcal and non-chlamydial urethritis were diagnosed in 8, 10, 14 and 8 patients, respectively, by the PCR method. In 9 patients with gonococcal and chlamydial urethritis, 10 with gonococcal and non-chlamydial urethritis, 12 with non-gonococcal and chlamydial urethritis, and 9 with non-gonococcal and non-chlamydial urethritis, diagnosed by the standard methods, the coincidence rates of the PCR to the standard methods were 78% (7/9), 90% (9/10), 100% (12/12), and 89% (8/9), respectively. The overall coincidence rate between the PCR and the standard methods in diagnosis of urethritis were high (90%). In addition, N.gonorrhoeae and C.trachomatis could be simultaneously detected from one urethral sample in approximately 6 hours by means of the PCR. Thus, the PCR method could clinically be applied and would offer several advantages to diagnosis of urethritis, compared to the standard methods.

Chlamydia Infections↗
PubMed1990

[Endoscopic and fluoroscopic pyeloureterotomy for ureteropelvic junction obstruction and ureteral stricture].

Endoscopic or fluoroscopic pyeloureterotomy was performed in a total of 32 patients (34 ureters) with ureteropelvic junction obstruction (UPJO) or ureteral stricture from March 1985. Cold incision was performed, using a flexible knife over a guidewire, endoscopically on 23 ureters and fluoroscopically on 11 ureters. The mean operation time was 98.9 +/- 48.3 minutes. Twenty-five (74%) of the 34 ureters showed relief of subjective symptoms, normalized urinalysis and radiographical improvement of hydronephrosis with a mean follow-up period of 11.7 +/- 10.0 months (range: 3-43). The clinical results by etiology were as follows: primary UPJO, 13/16 (81%); secondary UPJO, 4/4 (100%); ureteral stricture, 6/7 (85%); obliteration of ureteral implantation, 2/7 (29%). No major complication was noted with this endourological technique. This endourological technique might be clinically useful for the treatment of UPJO and ureteral strictures.

Adolescent↗
PubMed1989

[A case report of scrotal hemangioma].

A 21-year-old man with painless tumor in the right scrotum was seen at our Department. The tumor was resected surgically and histological examination revealed venous hemangioma. This case is 26th case of scrotal hemangioma in Japan.

Aged↗
PubMed1989

[A case of renal cell carcinoma with lung metastases successfully treated by interferon-beta].

A case of renal cell carcinoma with multiple lung metastases successfully treated with interferon (IFN) following nephrectomy is reported. A 46-year-old man consulted our institute complaining of left flank pain for 3 months on June 18, 1983. Macroscopic hematuria consisting of blood clot had also been found 1 week before. For a diagnosis of left renal carcinoma with multiple lung metastases, he was admitted. After total nephrectomy, 30 x 10(6) units per day of natural IFN-beta were administered intravenously every other day for 2 months (total dose; 269 x 10(6) units). One of the pulmonary lesions disappeared, but another increased in size and a new lesion was also found. Therefore, this trial was evaluated to be progression. Thereafter, he was treated with 600 mg/day of carmofur (HCFU) and was in a stable condition. As his lung lesions progressed at 11 months after nephrectomy, 9 x 10(6) units/day of recombinant IFN-beta were additionally administered 5 days a week for 4 weeks. When the treatment was completed (total dose; 180 x 10(6) units), the pulmonary lesions disappeared. The complete response lasted for 9 months. However, on May, 1985, bone metastasis to lumbar vertebra was found and he died on November 4, 1985 without any evidence of relapse at lung field.

Antineoplastic Agents↗
PubMed1988

[A case report of non-specific granulomatous prostatitis: successful treatment with chlormadinone acetate].

A case of non-specific granulomatous prostatitis is presented. A 61-year-old male consulted a doctor with the chief complaint of dysuria. For suspicion of prostate cancer, he was referred to our hospital. A digital examination showed stony hard prostate gland which was asymmetrically enlarged to hen's egg size with an irregular surface. Since biopsy specimen from the prostate showed eosinophilic granulation without fibrinoid necrosis, the case was diagnosed as simple nonspecific granulomatous prostatitis. After oral administration of chlormadinone acetate (CMA), he showed a remarkable increase in urinary stream. The findings of urethrogram and prostatic sonogram demonstrated dramatic improvement. He has remained asymptomatic for 29 months without any further treatment. Therefore, CMA could be effective against granulomatous prostatitis.

Administration, Oral↗
PubMed1988

[Paget's disease of the scrotum].

We reported a case of Paget's disease of the scrotum, a rare disease in urological field. The patient had successful radical resection of the dermal tumor and scrotal plasty. Paget's disease has a low malignancy and its treatment is necessary as the same manner to scrotal cancer. Although most scrotal malignancies are squamous cell carcinoma, urologists should recognize this borderline disorder exactly such as in this case and treat patients with co-operation to the relative fields.

Aged↗
PubMed1988

[Multimodality treatment of adrenal ganglioneuroblastoma: a case report].

We present adult adrenal ganglioneuroblastoma with giant regional lymph node metastasis. The patient was a 21-year-old male, who had a left adrenal tumor diagnosed by ultrasonography incidentally. He was moderately developed and physical examination was almost normal. Blood pressure was within the normal range. Only the value of the vanilmandelic acid, which was 68.7 mg/day, in the urine was abnormal. Other laboratory data were almost normal. Neither chemical nor physical hormonal disorders were present. We carried out the radical surgical treatment by trans-thoracoabdominal approach under the diagnosis of left adrenal neuroblastoma. Pathological diagnosis was ganglioneuroblastoma. After the operation, the patient received both systemic chemotherapy of vincristine and cyclophosphamide and immunotherapy of OK-432 by subcutaneous administration. Furthermore, 40 Gy of the regional irradiation of 60Co to the operative space after the surgery was performed. At eight months after the operation, he is alive with no evidence of disease. Ganglioneuroblastoma is a neuroblastic tumor including neuroblastoma, which commonly occurs in childhood. The prognosis of the neuroblastic tumors which occur either in the adrenal gland of a young child or in an older child is poor. On the other hand, the biological activity of the adult neuroblastic tumors is different from that of the pediatric neuroblastic tumors. In the adult, the adrenal ganglioneuroblastoma does not always have a poor prognosis. The multimodality treatment which we performed is effective for the neuroblastic tumor. Ultrasonography is both effective and adequate for the screening of the retroperitoneal lesion such as in our case.

Adrenal Gland Neoplasms↗
PubMed1988

[Ureteritis glandularis: a case report].

A 50-year-old Japanese male hospitalized with the complaint of fever and pyohematuria. An excretory pyelography revealed the right hydronephroureter due to right ureteral stone. When the ureterolithotomy was carried out, a wide-based and rice-sized tumor co-existed at the site of the epithelium of the ureter lithotomized. Resected tumor was pathologically confirmed as poorly differentiated adenocarcinoma with mitosis. Therefore, total nephroureterectomy with bladder cuff resection was done at 10 days after the first operation. However, malignant cells were not found in the surgical specimen or histologically diagnosed localized glandular ureteritis. He is alive without any evidence of recurrence. It was reported that the glandular metaplasia, a relative rare lesion in the ureter, was correlated with carcinogenesis of adenocarcinoma in urothelium. However, when the lesion is small and localized such as in this case it should be treated with ureterectomy and addition of other suitable adjuvant therapies. Furthermore, endourological techniques which have been recently dramatically progressed may become a weapon against this lesion for both treatment and follow-up.

Humans↗
PubMed1987

[New combination chemotherapy in refractory rhabdomyosarcoma of the prostate: a case report and review of the literature].

A rare case of prostatic rhabdomyosarcoma in a 3-year-old child is presented. He received a multimodal treatment of chemotherapy including vincristine, cyclophosphamide, actinomycin-D plus adriamycin, and linac irradiation followed by total prostatectomy with segmental resection of bladder. Despite no viable sarcoma cells in the surgical specimen, he showed relapse 4 months later. By the combination of cisplatin, vinblastine and peplomycin (PVP therapy), the bulky mass in the pelvis rapidly reduced by 95%. Furthermore, cisplatin, etoposide and peplomycin (PEP therapy), instead of PVP therapy, were administered to the refractory disease. Although the residual tumor was salvaged after 7 courses of PEP therapy, abdominal dissemination and liver metastasis occurred 2 months postoperatively. The combined modality of vincristine, peplomycin, ifosfamide, methotrexate, adriamycin, melphalan plus nimustine, and irradiation of microtron were effective for the abdominal dissemination, but he died of cerebral hemorrhage 31 months after the start of treatment. We emphasize that more aggressive chemotherapy including cisplatin, etoposide and so on is required to manage the advanced, relapsed, or resistant cases compared to the usual modality of rhabdomyosarcoma.

Antineoplastic Combined Chemotherapy Protocols↗