[Pediatric vesicoureteral reflux with pathophysiology of clinical interest: report of 2 cases].
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Biomedical subjects
Publications and source records attributed to H Takeuchi.
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In the treatment of prostatic carcinoma, administration of some therapeutic agents, e.g. hormones, continuously as a basal treatment, and other proper treatment, e.g. irradiation or chemotherapy or both, were combined for occasional recurrence of the disease as additional treatment. Effectiveness of 5-fluorouracil in combination with hormones (estrogen or gestagen) in low doses, as a basal treatment, was compared with that of hormones alone in high doses. 5-Fluorouracil at 200 mg/day doses combined with gestagen (allylestrenol or chloromadinone acetate) at 50 mg/day doses was compared with estrogen (hexestrol) at 60 mg/day doses in 30 randomized patients with previously untreated prostatic carcinoma. On the other hand, 5-fluorouracil at 200 mg/day doses combined with hexestrol at 30 mg/day doses was compared with hexestrol at 60 mg/day doses also in 26 randomized patients with carcinoma already well controlled by hexestrol at 60 mg/day doses for more than two years. In patients of the former group treated with 5-fluorouracil and gestagen the rate of recurrence was 20%, mean effective period of therapy was 69 months and 5-year survival rate was 73%, although, in patients treated with high dose estrogen, the rate of recurrence was 60%, mean effective period was 43 months and 5-year survival rate was 55%. At occasional recurrence of the disease, in nearly half the patients in both groups, the disease responded to additional treatments and remission was obtained again. In patients of the latter group with already well controlled disease, no significant difference in prognosis was observed between patients treated with 5-fluorouracil plus low dose estrogen and those treated with high dose estrogen alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Prelymphoma cells (PLC) are defined as cells which give rise to lymphoma cells but are not in themselves autonomous. They are present in the bone marrow of young AKR mice, a strain with a high natural incidence of thymic lymphoma. PLC are identified by transfer of AKR bone marrow into 400-rad-treated F1 recipients, one of the parents being AKR. Normal 1-month-old AKR bone marrow cells result in thymic lymphomas of AKR type in the hybrid recipients after latent periods of 6 to 16 months. In the present study, PLC resulting in lymphoma of AKR type 3 to 4 months after inoculation to irradiated hybrids are described. They are consistently found in the bone marrow of 21- to 28-day-old AKR mice treated at 3 to 5 days of age with a lymphomagenic virus, SL3-3. Long-term culture of these bone marrow cells allows the survival of totipotent hemopoietic stem cells but not of PLC. Thymic stromal remnants prepared from the 21- to 28-day-old virus-treated mice efficiently replicate oncogenic virus; however, they do not contain PLC. This was determined by grafting the remnants to irradiated and nonirradiated hybrid recipients. No AKR type lymphomas developed in the grafted mice. We conclude that the bone marrow of young oncogenic virus-treated AKR mice contains PLC modified by oncogenic virus so that they can produce thymic lymphomas after a shorter latent period than can PLC found in 1-month-old normal AKR mice. The modified PLC are not derived from totipotent marrow stem cells or sequestered in the thymic stroma of virus-treated mice.
A case of rhabdomyosarcoma of the urinary bladder in an 11-month-old boy is presented. The chief complaint was complete urinary retention and histological examination showed embryonal rhabdomyosarcoma of the bladder. Initially, he was treated with vincristine, actinomycin-D and radiation therapy. This therapy was not effective, and he was next treated with vincristine, bleomycin, and cis-DDP. This therapy was significantly effective, and the tumor became non-palpable on physical examination. After six courses he was discharged and maintenance chemotherapy was continued until the tumor relapsed 1 year later. Finally he died of dyspnea due to diffuse pulmonary metastases approximately 2 years after the first diagnosis. We herein discuss several points which affect the prognosis and the usefulness of chemotherapy, especially combination therapy with vincristine, bleomycin, and cis-DDP for recurrent cases.
In the objective judgment of the therapeutic effects and in the comparison of results in institutions and treatment methods, it is essential to introduce the technique of scientific and statistical analysis, in the clinical evaluation. We have tried to clinically evaluate lumbago and sciatica using the technique of multiple regression analysis. Selection of evaluation item and allocation of scores to the item were carried out in 104 patients. Multiple regression analysis was carried out in all patients and the standard regression coefficient showed a correlation with criterion variable (dependent Y) in the order of walking, pain, posture, paralytic symptom in lower limbs and SLR (straight leg raising test). The proportion was 0.69, which seems to be a nearly valid value when other factors are considered.
The stones associated with urinary tract infection were cultured using a method to distinguish between surface contamination and bacteria within the stone. Twenty three of 30 stones (77%) were infected mainly by Proteus mirabilis or Pseudomonas aeruginosa and most were composed of struvite and/or apatite. Most oxalate and uric acid stones were sterile; occasionally the stones with positive culture had a non-urea-splitting bacteria and these were thought to have been infected secondarily. Some infected stones were studied by light microscopy scanning election microscopy and transmission electron microscopy. We found many rods in the interstices of crystals of struvite and apatite extensively from the nucleus to peripheral layers. These findings are important in the prevention and treatment of infection stones.
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We present a case of upper segmental hydronephrosis in the incomplete duplex system due to vascular obstruction of superior ureteropelvic junction. This case appears to be a subtype of Fraley's syndrome in the incomplete duplex system.
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We present three cases of prolapse of ureteral tumor. Prolapse of a ureteral tumor is usually associated with antegrade intussusception of the ureter, and is thought to be a sign of noninvasiveness. In such a case segmental ureterectomy may be justified.
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The composition and structure of nuclei of infection stones were investigated. Twenty seven out of 40 renal stones were found to contain struvite and/or carbonate apatite in the nuclei as well as peripheral layers, and 13 contained calcium oxalate. Some bladder stones also contained different substances in the nuclei. In some infection stones whose architecture was studied in thin section and with scanning electron microscopy, we found large numbers of bacteria in the nuclei composed of struvite and/or apatite. Though we could find no bacteria within the nuclear parts composed of oxalate, we found them in apatite layers outside the nuclei. Urea-splitting bacteria are suggested to participate both in the initial formation of struvite stones and in the diversion of oxalate stones into phosphate stones. Such bacteria may play important roles in stone formation, not only as promotors of crystallization of struvite and apatite but also as a component such as of an organic matrix.
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For the purpose of evaluating the tissue blood flow reducing effect on lower esophagus and cardiac portion of the stomach after transabdominal mucosal transection operation for esophageal varices, 28 adult mongrel dogs were used and divided into (A) 18 as the control (B) 10 caused to have portal hypertension for present study. Closed-couple thermoelectrode flow meter was used to measure the tissue blood flow at lower esophagus and cardiac portion of the stomach following this procedures (1) ligating short gastric vessels, (2) ligating left gastric vessels, (3) transecting only the mucosal tube of the esophagus, (4) completely transecting of the esophagus. The following results were obtained. Effect on lower esophagus: transecting only the mucosal tube of the esophagus reduced 36.0 +/- 11.0% of the tissue blood flow and ligating short gastric vessels or left gastric vessels also reviewed a rather large effect. Effect on cardiac portion of the stomach: ligating the short gastric vessels reduced 2.5 +/- 3.0% of the tissue blood flow, while ligating of the left gastric vessels reduced more effectively 13.6 +/- 6.5%.
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