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Biomedical subjects

Hitoshi Masuda

Publications and source records attributed to Hitoshi Masuda.

At least 19 recordsLinked to original sources

Modulation of intrinsic cavernous tone and nitric oxide production by arginase in rabbit corpus cavernosum.

PURPOSE: Arginase shares the common substrate L-arginine with nitric oxide synthase (NOS). We investigated the roles of NOS and arginase for modulating intrinsic and vasoconstrictor tone in rabbit corpus cavernosum (RCC). MATERIALS AND METHODS: Isolated RCC tissues were used for isometric tension experiments, and NOS and arginase activities. The endothelium lining RCC lacunar spaces was disrupted and/or removed by saponin treatment. RESULTS: Following stretch of approximately 1gm NG-nitro-L-arginine methyl ester (L-NAME) as a NOS inhibitor caused endothelium dependent contraction, while the potent and specific arginase inhibitor N omega-hydroxy-nor-L-arginine (nor-NOHA) caused endothelium dependent relaxation. Relaxation with nor-NOHA was reversed by L-NAME. In the presence of 10 mM L-arginine 0.1 mM nor-NOHA was ineffective. Pretreatment with 0.1 mM L-NAME and 0.1 mM nor-NOHA did not significantly affect the vasoconstrictor response to phenylephrine. The magnitude of contraction with 0.1 mM L-NAME and relaxation with 0.1 mM nor-NOHA during contraction induced by phenylephrine were not significantly different from changes with L-NAME and nor-NOHA under intrinsic basal tone. In the enzymatic study NOS and arginase were detectable in cavernous homogenates. Nor-NOHA inhibited arginase but not NOS activity. CONCLUSIONS: Results indicate that basal nitric oxide production from the endothelium regulates intrinsic cavernous tone and endogenous arginase activity in the endothelium modulates tone by inhibiting nitric oxide production, presumably through competition with constitutive NOS for the common substrate L-arginine.

Animals↗

Prognostic significance of endothelial Per-Arnt-sim domain protein 1/hypoxia-inducible factor-2alpha expression in a subset of tumor associated macrophages in invasive bladder cancer.

PURPOSE: Endothelial Per-Arnt-Sim domain protein 1 (EPAS1) is induced under hypoxia and it transactivates a series of genes involved in angiogenesis and energy metabolism. Recent studies showed that EPAS1 is expressed in tumor associated macrophages (TAMs), which have multifaceted roles in tumor progression. We hypothesized that EPAS1 expressed in TAMs may contribute to bladder cancer progression. MATERIALS AND METHODS: Clinicopathological and followup data on 69 patients undergoing radical cystectomy for T1-4N0-2M0 high grade bladder urothelial carcinoma were reviewed. Quantitative immunohistochemical analysis of TAMs and EPAS1 was performed separately in invasive front and in other superficial parts of carcinoma tissues. TAM counts and EPAS1 positive cell counts were compared with pathological variables and cancer specific survival (CSS). RESULTS: The 5-year CSS rate in the 69 patients was 69% at a median followup of 58 months (range 2 to 196). EPAS1 expression was restricted to a small subset of TAMs. Although TAM counts were not associated with T stage or lymph node metastasis, EPAS1 expressing TAM counts were significantly associated with higher T stage. On univariate and multivariate analyses higher EPAS1 expressing TAM counts in invasive front along with higher T stage and positive lymph node metastasis were significantly associated with shorter CSS, while total TAM counts or EPAS1 expressing TAM counts in other superficial parts did not. CONCLUSIONS: Despite limited prognostic effects of total TAMs EPAS1 expressing TAMs were associated with a poor prognosis of invasive bladder cancer, suggesting that EPAS1 expressed in a subset of TAMs mediates bladder cancer progression.

Adult↗

Control of canine membranous urethra, bulbocavernosus and ischiocavernosus muscles by lumbosacral sympathetic pathways.

The membranous urethral muscles, bulbocavernosus muscle (BCM) and ischiocavernosus muscle (ICM) play a significant role on expulsion at ejaculation. Projection of the sympathetic pathways in the retroperitoneum to these muscles was investigated in the dog. Intraluminar pressure of the membranous urethra and contractions of the BCM and ICM to electrical stimulation of the lumbar splanchnic nerve (LSN) or the lumbosacral sympathetic chain (LSC) were examined. Stimulation of the LSN was performed after transection of the unilateral hypogastric nerve (HGN) to clarify its cross-innervation. Stimulation of each of the 2nd to 4th LSNs elicited elevation of the intraluminal pressure of the membranous urethra. In eight dogs whose right HGNs were transected, 15 of the 19 right LSNs, and 12 of the 16 left LSNs examined elicited elevation of the membranous urethral pressure, respectively. In five dogs whose left HGNs were transected, 6 of the 9 right LSNs and 10 of the 12 left LSNs stimulated elicited elevation of the pressure. Stimulation of the HGN caused no detectable contractions of the BCM and ICM in all six dogs examined. Stimulation of the LSC elicited responses of the BCM and ICM in all six dogs examined and the membranous urethra in three of six dogs. The maximum value of the response of the BCM was greater than that of the ICM. After consecutive transection of the ipsilateral pelvic nerve, stimulation of the LSC showed no significant changes in the responses of the BCM and ICM. The above results indicate the following: (1). each of the L2-L4 LSNs sends signals to the membranous urethra via two routes, passing through the ipsilateral or contralateral HGN; (2). the above nerve does not send effective signals to the BCM and ICM; (3). the LSC sends signals to the membranous urethra, BCM and ICM; (4). the signals from the LSC mainly pass through the pudendal nerve to the BCM and ICM; and (5). the signals were dominant to the BCM compared with the ICM.

Animals↗

Successful long-term disease-free survival following multimodal treatments in a patient with a repeatedly recurrent refractory adrenal cortical carcinoma.

A 47-year-old male patient underwent surgery for a 10-cm adrenal cortical carcinoma. A large invasive adrenal mass was surgically removed en bloc with the right kidney and the lower lobe of the liver. Two months postoperatively, a 7-cm recurrent mass developed in the right psoas muscle. After a partial response was achieved by irradiation (40 Gy) and high-dose chemotherapy (carboplatin and etoposide) with peripheral blood stem cell transplantation, the patient underwent surgery with a wide excision of the psoas muscle. Twelve months after the initial surgery, an 8-cm rib metastasis developed and the patient again underwent surgery after a combination of irradiation (50 Gy) and chemotherapy (cisplatin and etoposide). The patient has been doing well without any evidence of recurrence for 5 years. Refractory or metastatic adrenal cortical carcinomas have been thought to be lethal, therefore, the present case provides support for multimodal treatments of refractory adrenocortical cancers.

Adrenocortical Carcinoma↗

Adenocarcinoma arising at the ileoileal anastomotic site of Scheele's ring.

Most tumors arising after augmentation ileocystoplasty have been reported to develop adjacent to the ileovesical anastomosis. Herein, we report a case of adenocarcinoma arising at the ileoileal anastomotic site 33 years after augmentation ileocystoplasty (Scheele's ring plasty) for tuberculous contracted bladder. The present case shows the possibility of late malignancy developing at the ileoileal junction after ileal neobladder.

Adenocarcinoma↗

Favorable outcome of preoperative low dose chemoradiotherapy against muscle-invasive bladder cancer.

To investigate the feasibility of preoperative low-dose chemoradiotherapy, 50 patients with localized muscle-invasive bladder cancer (T2-T4) were treated with concurrent cisplatin (100 mg/body x 2 courses) and pelvic irradiation (40 Gy). Among 20 patients (40%) who achieved clinical complete regression, 11 with solitary tumor underwent partial cystectomy because of advanced age, poor condition of the patients, or a reluctance to have radical surgery. Radical cystectomy was carried out in the remaining 39 cases (complete regression 9, partial regression 30). Pathologic T0 response (no residual tumor) was achieved in 18 (36%) of all the cases. Median follow-up was 19 months (range 2-59 months). Estimated 3-year disease-free survival was 75% for all patients and 100% for T0 responders. Local recurrence (2 patients) or distant metastasis (6 patients) developed in 8 of 32 patients with pathologic persistent tumor. All of the 11 patients (9 with T0 response and 2 with a small residual tumor nest) who underwent partial cystectomy were recurrence free for observation periods up to 59 months. Low-dose chemoradiotherapy is as effective as other neoadjuvant protocols and is applicable to high-risk patients. The bladder can be preserved by partial cystectomy in selected cases with clinical complete regression.

Aged↗

Roles of accumulated endogenous nitric oxide synthase inhibitors and decreased nitric oxide synthase activity for impaired trigonal relaxation with ischemia.

PURPOSE: We examined whether endogenous nitric oxide (NO) synthase (NOS) inhibitors are involved in the impaired trigonal relaxation with ischemia in rabbits. MATERIALS AND METHODS: Rabbits were divided into control and ischemia groups. Two weeks after partial vessel occlusion strips of trigone and detrusor were processed to determine endogenous methylarginines and L-arginine by automated high performance liquid chromatography. We also compared NOS activity and NO mediated functional responses to electrical field stimulation between 2 groups. RESULTS: Neurogenic and NO but not sodium nitroprusside induced mediated relaxation in the trigone were significantly impaired following ischemia. Ca2+ dependent NOS activity, and baseline and stimulated cyclic guanosine monophosphate production with electrical field stimulation were significantly decreased following ischemia. The contents of L-NMMA (NG-monomethyl-L-arginine) and asymmetrical ADMA (NG, NG-dimethyl-L-arginine) but not L-arginine or symmetrical SDMA (NG, N'G-dimethyl-L-arginine) were increased in the trigone following ischemia. Authentic L-NMMA and ADMA but not SDMA inhibited neurogenic relaxations in a concentration dependent manner without affecting the relaxation produced by sodium nitroprusside in control tissue. Excess L-arginine abolished L-NMMA and ADMA inhibition. CONCLUSIONS: These results suggest that impaired NO mediated trigonal relaxation following ischemia is closely related to decreased NOS activity and the increased accumulation of L-NMMA and ADMA.

Animals↗

[Fibroepithelial polyp of the anterior urethra, found during post-operative follow-up of ureteral cancer].

A 52-year-old man underwent nephroureterectomy against left distal ureteral cancer (transitional cell carcinoma, Grade 2, pTa), and was followed up by surveillance alone. Twenty-two months postoperatively, a pedunculated tumor was found in the anterior urethra by cystourethroscopy. Pathological examination of the tumor resected transurethrally revealed a fibroepithelial polyp. There have been only twelve cases of fibroepithelial polyp of the anterior urethra reported in the literature. Since 4 out of 8 adult cases among them were found during the postoperative follow up period of urothelial cancer, mechanical irritation by repeated transurethral procedures might be responsible for the development of fibroepithelial polyp of the anterior urethra in these cases. If anterior urethral tumor is found during follow-up urothelial carcinoma, benign urethral polyp should be considered in the differential diagnosis.

Carcinoma, Transitional Cell↗

[A case of fibroepithelial ureteral polyp in an adult patient].

A 24-year-old man complaining of asymptomatic gross hematuria was referred to our hospital for treatment of bilateral hydronephroses (left > right) diagnosed at a previous clinic. Radiological examinations demonstrated a filling defect at the left uretero-pelvic junction. Cytological examination of the urine was negative. With the diagnosis of suspected benign ureteral polyp, the patient underwent endoscopic-assisted partial ureterectomy and pyeloplasty through a 5 cm flank incision. Histological examination revealed that the villous tumor in the ureter was a fibroepithelial polyp.

Adult↗

[Cyclophosphamide-induced bladder cancer: three case reports].

Three cases of cyclophosphamide (CPM)-induced transitional cell carcinoma (TCC) of the bladder are reported. A 36-year-old female (case 1) and a 63-year-old male (case 2) received CPM at total doses of 104 g and 100 g, respectively, for the therapy of Wegener's granulomatosis. A 50-year-old female (case 3) received CPM at a dose of 57 g for the therapy of recurrent breast cancer. They visited our institute with the chief complaint of macrohematuria. In all cases, cystoscopy revealed bladder tumor with hemorrhagic cystitis. They underwent transurethral resection of bladder tumor. Histological examination revealed grade 2 TCC in cases 1 and 2 and grade 3 TCC in case 3. All patients underwent intravesical instillation of Mitomycin C with or without hyperthermia. Including our 3 cases, 17 cases of CPM-induced bladder tumor have been reported in the Japanese literature.

Administration, Intravesical↗

Different distribution of nitric oxide synthase and soluble guanylyl cyclase activities in the detrusor and proximal urethra of the rabbit.

PURPOSE: We investigated the different distributions of nitric oxide synthase (NOS) and soluble guanylate cyclase activities in the detrusor and proximal urethra in the rabbit. MATERIALS AND METHODS: The detrusor and proximal urethra were excised, the mucosa and muscularis were separated and each layer was homogenized to measure the activities of NOS as well as baseline and sodium nitroprusside (SNP) activated soluble guanylate cyclase. Isometric tension experiments were performed in detrusor and urethral strips with and without mucosa. RESULTS: In the detrusor NOS and sodium nitroprusside activated soluble guanylate cyclase activities in the mucosa were much higher than in the muscularis. While in the proximal urethra NOS activity in the 2 layers was similar, SNP activated soluble guanylate cyclase activity in the muscularis was 2.8 times higher than in the mucosa. Removing the mucosa reduced nitric oxide (NO) mediated neurogenic relaxation in the proximal urethra, while no relaxation responses could be elicited by electrical field stimulation with or without mucosa in the detrusor. On the other hand, removing the mucosa did not affect SNP or 8-bromo-cyclic guanosine monophosphate induced relaxation in the detrusor and proximal urethra. CONCLUSIONS: In the detrusor NOS and soluble guanylate cyclase activities were mainly detected in the mucosa, while in the urethra these activities were distributed throughout the mucosa and muscularis. Also, the mucosa in the urethra but not in the detrusor contributed to electrical field stimulation induced, NO mediated relaxation. These findings confirm previous studies demonstrating that NO has a different role in the detrusor than in the proximal urethra.

Animals↗

Intracavitary administration of OK-432 with subcutaneous priming for malignant ascites in a case of advanced renal cell carcinoma.

The intracavitary injection of OK-432 (a streptococcal preparation) with subcutaneous priming has been shown to be an effective immunotherapy for patients with malignant effusion. We applied this treatment in a case of advanced renal cell carcinoma with massive ascites. The patient received 0.2 Klinishe Einheit (KE) OK-432 in the subcutaneous injection twice (day 1 and day 7) followed by 10KE OK-432 intra-abdominal administration (day 9). The treatment was performed safely without major side-effects except for transient pyrexia. A significant reduction of ascites was noted 1 month after the treatment without subsequent re-accumulation. Intracavitary injection of OK-432 with subcutaneous priming seems to be a simple, safe and effective treatment for ascites in advanced renal cell carcinoma.

Antineoplastic Agents↗

Endoscopic minilaparotomy radical nephrectomy for chronic dialysis patients.

BACKGROUND: To assess the feasibility of laparoscope-guided minilaparotomy (endoscopic minilaparotomy) for renal cell carcinoma in patients on chronic dialysis. METHODS: Endoscopic retroperitoneal minilaparotomy using a 30 degrees telescope was carried out through single skin incision (5-8 cm) in eight patients with renal cell carcinoma who were on chronic dialysis. Outcomes of the operations were compared to those in eight patients on chronic dialysis with renal cell carcinoma who underwent standard translumbar radical nephrectomy. RESULTS: Resection of the tumor was successfully completed without complication and the postoperative course was uneventful in both of the treatment groups. No significant difference in mean operative time or mean blood loss was observed between the treatment groups. Wound pain was minimal and analgesics were generally not required in the minilaparotomy group. The endoscopic laparotomy group resumed full diet and began walking earlier than the group that underwent standard radical nephrectomy. CONCLUSIONS: Endoscopic minilaparotomy seems to be a valuable alternative treatment for renal cell carcinoma in patients on chronic dialysis.

Aged↗

Endoscope-assisted minilaparotomy (endoscopic minilaparotomy) for retroperitoneal Schwannoma: experience with three cases.

We have been applying endoscope-assisted minilaparotomy (endoscopic minilaparotomy) to retroperitoneal operations with favorable outcomes. Here, endoscopic minilaparotomy through a single flank incision (4-7 cm) was performed in three cases of incidentally discovered retroperitoneal Schwannoma. Resection of the tumor was successfully completed. The postoperative course was uneventful. Wound pain was mild and full oral feeding and walk were resumed the day following operation. It is concluded that endoscopic minilaparotomy is applicable to retroperitoneal Schwannoma with excellent postoperative recovery.

Aged↗

Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm.

BACKGROUND: For small, incidentally discovered renal cell carcinoma, partial nephrectomy is becoming more widely accepted as an alternative to radical nephrectomy and the need for minimally invasive approach is increasing. METHODS: We carried out endoscopic minilaparotomy partial nephrectomy in seven cases of solitary renal cell carcinoma smaller than 4 cm. Five of them were without renal pedicle clamping. All procedures were done through single skin incision (5-8 cm) using a 30 degrees telescope. Hemostasis was achieved with a harmonic scalpel, a microwave tissue coagulator, an argon beam coagulator and autologous fibrin glue. RESULTS: There were no perioperative complications. All patients had negative surgical margins. The operating time was 157-275 min (average 209 min). The blood loss was 20-1200 ml (average 525 ml). Postoperatively, renal function as assessed by serum creatinine was within normal limits. Neither local recurrences nor metastases were observed during a follow-up of 6-15 months. The postoperative course was markedly improved over that expected from standard open surgery. CONCLUSIONS: With minimal morbidity and complications, endoscopic minilaparotomy partial nephrectomy is feasible for small renal cell carcinoma.

Aged↗

Accumulated endogenous NOS inhibitors, decreased NOS activity, and impaired cavernosal relaxation with ischemia.

We examined whether endogenous inhibitors of nitric oxide (NO) synthesis are involved in the impaired cavernosal relaxation with ischemia in rabbits. Two weeks after cavernosal ischemia caused by partial vessel occlusion, endothelium-dependent and electrical field stimulation (EFS)-induced neurogenic NO-mediated relaxations, but not sodium nitroprusside (SNP)-induced relaxation, were significantly impaired in the isolated corpus cavernosum. The Ca(2+)-dependent NO synthase (NOS) activity and the basal and stimulated cGMP productions with carbachol or EFS were significantly decreased after ischemia. Supplementation of excess L-arginine partially recovered both of the impaired relaxations. The contents of N(G)-monomethyl-L-arginine (L-NMMA) and asymmetric N(G), N(G)-dimethyl-L-arginine (ADMA) but not L-arginine and symmetric N(G),N'(G)-dimethyl-L-arginine (SDMA) were increased in the cavernosal tissues after ischemia. Authentic L-NMMA and ADMA but not SDMA concentration dependently inhibited both relaxations without affecting the relaxation produced by SNP in the control. Excess L-arginine abolished the inhibition with L-NMMA and ADMA. These results suggest that the impaired NO-mediated cavernosal relaxations after ischemia are closely related to the decreased NOS activity and the increased accumulation of L-NMMA and ADMA.

Animals↗