Biomedical subjects
Publications and source records attributed to K Mitsuhashi.
The case of a 35-year-old Japanese male patient with so-called Mikoshi-Kobu is presented. Because articles about this type of tumor are rare, we report this case with its surgical and histopathological findings.
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Clinical efficacy of combination therapy using Fortimicin (ASTM) and Cefotax (CTX) was studied in 63 patients with complicated urinary tract infections. The patients received 200 mg of ASTM i.m. and 1 g of CTX i.v. twice a day. The overall clinical efficacy of the treatment was evaluated by criteria proposed by the Japanese UTI Committee. The overall clinical efficacy rate was 68.3%. The rate was 67.3% in the patients with single bacterial infection and 72.7% in those with mixed infections. Subjective side effects were observed in one of the patients. Drug related aggravation in laboratory tests was observed in 8 items in 8 patients, but these were mild changes. We concluded that combination therapy with ASTM and CTX was useful for the treatment of complicated urinary tract infections.
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Urinary arylsulfatase A activity expressed as units/mg of urinary creatinine was significantly increased in bladder cancer patients, but not in patients with other genitourinary tract disorders, such as cystitis, urethritis and prostatic cancer, nor in patients with non-urological malignant diseases. The urinary enzyme activity was positively correlated with the stage of the bladder cancer, while post surgical follow-up revealed a marked decrease of the activity. Arylsulfatase A activity was also shown to be higher in malignant than in normal bladder tissue, demonstrating the activity to be a function of the grade of the tumor. Furthermore, the isoelectric point (pI 5.2-5.3) of the tissue enzyme in the bladder tumor coincided with that of the urine enzyme from the same cancer patients; the pI of the enzyme in urine from normal subjects was 4.7. These results suggest that most of the urinary arylsulfatase A in bladder cancer originates from tumor tissue.
Fifty-two cases of renal cell carcinoma (cases with metastatic episode during follow-up period excluded) operated on and whose pathohistological staging had been established at our department clinic during a period of 11 years from January 1973 to December 1983 were studied. Renal arteriography i.e., selective renal arteriography, aortography, was performed on 49 cases, and CT scan and ultrasonic examination were performed on 19 and 15 cases, respectively for analytical comparison of the preoperative staging with the postoperative staging as based on the operative or pathological findings (Robson et al.). Staging was found correct in 33 of the 49 cases (67.3%) by arteriography and 16 of the 19 cases (84.2%) by CT scan. In the current study, ultrasonic assessment was possible only in those cases of venous infiltrations i.e., tumor embolism affecting the renal vein or the vena cava inferior. Most effective in the cases with extracapsular infiltrations or localized lymph node metastases was the CT scan. Correct diagnosis was also possible in 6 of the 8 cases (75%) with venous infiltrations if the arteriograms had been analysed in detail, and both the CT scan and the ultrasonic examination proved effective in this type of cases as well. These findings may suggest that the CT scan alone is sufficient for making a localized staging.
A variant form of urinary arylsulfatase A which was not detected in normal voided urine was demonstrated in the urine obtained directly from the renal-pelvis [Ishibashi, T. et al.: Biochim. Biophys. Acta, 616, 218-227 (1980)]. The variant form was not observed in urine collected directly from the ureter during operations for uretero-cutaneostomy or ileal conduit. However, the urine from intubated uretero-cutaneostomy patients collected near the pelvi-ureteric junction showed the presence of the variant form, further suggesting the origin specificity of the variant. This arylsulfatase was not demonstrated in the voided urine from patients with non-urologic malignant disorders such as uterine endometrial, uterine cervical, rectal, pancreas head and gastric carcinomas, in spite of its appearance in high levels in the urine from patients with advanced bladder cancer.
The prophylactic and chemotherapeutic efficacy of PMPC against infections after TUR-P has been investigated. Bacteriological evaluation: PMPC , 200-300 mg/day for 2-12 weeks, was administered to 49 patients, who had over 10(3)CFU/ml of microorganisms after CET or CEC treatment for 3-7 days. The eradication rate of microorganisms was 40.8% after 2 weeks, 52.2% after 4 weeks, 64.1% after 6 weeks, 65.0% after 8 weeks and 70.6% after 12 weeks. Effectiveness on pyuria : The improvement rate of pyuria against 59 patients who had over 10(5)/hpf of pyuria , was 15.3% after 2 weeks, 16.4% after 4 weeks, 25.4% after 6 weeks, 58.5% after 8 weeks, 72.7% after 10 weeks and 75.0% after 12 weeks. Overall clinical efficacy on PMPC was examined in 26 patients. The results of efficacy were 27.3% after 2 weeks, 48.0% after 4 weeks, 50.0% after 6 weeks, 69.2% after 8 weeks, 75.0% after 10 weeks and 77.0% after 12 weeks. The clinical response was evaluated according to a criterion for clinical evaluation of antimicrobial agent on chronic complicated UTI proposed by UTI committee in Japan. No severe adverse effect including allergic reaction was found. Following administration of PMPC , three patients experienced adverse gastric reactions, and drug administration was discontinued at week 6 or 8. PMPC was effective as a prophylactic chemotherapeutic drug against infections after TUR-P and prostatectomy.
A 48-year-old male, who had been suffering from eosinophilic lymphfolliculosis of the skin (Kimura's disease) for six years, developed the nephrotic syndrome. Renal biopsy revealed immunopathological and electron microscopic changes characteristic of membranous glomerulonephritis. A review of the literature disclosed a high frequency of renal involvement in Kimura's disease. Out of 175 reported cases of the disease, 21 (12%) were found to have proteinuria including 13 who had the nephrotic syndrome. Some of the patients were noticed to have proteinuria before the onset of the skin lesions, suggesting the existence of common etiological factor(s) capable of inducing both skin and kidney lesions.
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10-Methoxy- (10) and 10-hydroxy-3-methyl-2,3,4,5,6,7-hexahydro-1H-3-benzazonine (11) have been synthesized from 7-methoxy-alpha-tetralone (1) via the 1-aminomethyl compound 4, which was converted to the amino acid derivative 7. Hydrogenation and cyclization of 7 afforded the lactam 9, which was reduced with LiAlH4, followed by N-methylation to give 10, from which 11 was obtained. Compounds 10 and 11 have analgetic activity, and the former was found to be comparable to codeine.
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