Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 721 records · Page 40Linked to original sources

PubMed1993

Micturitional disturbance in progressive supranuclear palsy.

Detailed micturitional histories were taken from nine patients with progressive supranuclear palsy (PSP), and eight of them (89%) had micturitional symptoms including urinary incontinence in seven. Urodynamic studies were performed in six patients and the results were as follows. Three had residual urine of 100 ml on average. Four had detrusor hyperreflexia and one had a low compliance cystometrogram. One had detrusor-sphincter dyssynergia. Motor unit analysis of external sphincter was performed in four patients and two had neurogenic changes. The results were compared with our previous findings in Parkinson's disease and in striato-nigral degeneration (SND), and we found that a severe degree of micturitional disturbance in PSP seems to be as common as in SND, especially in the urinary storage phase, and more frequent than in Parkinson's disease. Supranuclear types of pelvic and pudendal nerve dysfunctions seemed to be mainly responsible for micturitional disturbance in PSP.

Aged↗

PubMed1993

Regulation of 18-oxocortisol and 18-hydroxycortisol by the renin-angiotensin system and ACTH in man.

Based on urinary excretion studies the secretion of the cortisol derivatives, 18-oxocortisol and 18-hydroxycortisol are believed to be regulated by ACTH and to a lesser degree by the renin-angiotensin system. Plasma concentrations of 18-oxocortisol and 18-hydroxycortisol were measured during the simultaneous activation of the renin-angiotensin system and inhibition of ACTH secretion. Five healthy male subjects consuming a sodium diet ad libitum were studied. Blood was drawn at 0800 h after 1 h in the supine position. In the first set of experiments, the subjects remained in the supine position from 0800 to 1000 h with or without the oral administration of 2 mg dexamethasone at 0800 h. In the second set of experiments the subjects were placed in the upright position after drawing the 0800 h sample. The subjects were studied with and without dexamethasone administered at 0800 h. Blood was drawn again at 1000 h. Plasma levels of 18-oxocortisol, 18-hydroxycortisol, ACTH, plasma renin activity (PRA), cortisol, aldosterone and 18-hydroxycorticosterone were measured by radioimmunoassay. None of these parameters changed during the 2 h in the supine position. 18-Oxocortisol, 18-hydroxycortisol, aldosterone, 18-hydroxycorticosterone and PRA increased, but ACTH and cortisol did not change when the subjects were placed in the upright position. After dexamethasone administration, 18-oxocortisol, 18-hydroxycortisol, cortisol, aldosterone and 18-hydroxycorticosterone decreased in the supine position and no increase occurred in 18-oxocortisol, 18-hydroxycortisol and 18-hydroxycorticosterone in the upright position. PRA and aldosterone increased and ACTH and cortisol decreased in these subjects. 18-Oxocortisol and 18-hydroxycortisol were more dependent on ACTH regulation and less on the renin-angiotensin system than aldosterone.

18-Hydroxycorticosterone↗

PubMed1993

Lower urinary tract dysfunction in the anterior spinal artery syndrome.

Lower urinary tract function was studied in 10 patients with the anterior spinal artery syndrome. In the acute stage all patients had complete urinary retention. Cystometry in 3 patients showed detrusor areflexia. At a neurologically stable stage 9 patients could void and 1 had urinary retention during the preceding 7 years. Cystometric bladder capacities at first and maximum desire to void were decreased in 8 patients and normal in 2. Detrusor hyperreflexia was noted in 8 patients, a normal bladder in 1 and detrusor areflexia in 1. External urethral sphincter electromyography revealed detrusor-sphincter dyssynergia in 4 patients and normal findings in 6. We conclude that the vesicomotor dysfunction in this syndrome is similar to that of traumatic spinal cord injury except that bladder sensation is preserved. The latter finding indicates that at least some of the bladder sensation travels via the posterior columns of the spinal cord.

Electromyography↗

PubMed1993

Staging of pancreatic carcinoma by endoscopic ultrasonography.

The ability of EUS to diagnose small pancreatic cancer is well known. In this study, we present our experience with EUS in the local staging of 29 patients with pancreatic carcinoma who underwent surgery. EUS was 79, 83 and 79% accurate in determining anterior (including gastric), duodenal and retroperitoneal (vascular) invasion by the tumor. Ultrasonography (48, 39 and 55%, respectively) and CT (38, 33 and 41%, respectively) were less reliable. EUS was equal to angiography in diagnosing vascular involvement. EUS was more effective in detecting splenoportal infiltration (sensitivity 88%, specificity 78%) than arterial involvement (accuracy 50%). EUS was also less reliable in determining the N stage (66%) and in stage grouping (72%). Although EUS is superior to ultrasonography and CT in the local staging of pancreatic carcinoma, further studies must show whether improved staging criteria will lead to better results.

Endoscopy, Digestive System↗

PubMed1993

Endoscopic laser treatment for early gastric cancer.

Endoscopic laser treatment (ELT) has been proposed as one of the curative endoscopic therapies for early gastric cancer. We report our experience with ELT in 111 patients with early gastric cancer limited to the mucosa as diagnosed by endoscopy and/or endoscopic ultrasonography. Twelve patients subsequently underwent laparotomy after ELT and no residual tumor was found in 75% of these cases. Ninety-nine patients had no surgery for various reasons and follow-up information by endoscopy was available for 73 of them for a mean of 2.7 years (range 1 to 7 years). 81% of these patients were found to be tumor free. There was no difference in the success rate of ELT in relation to endoscopic classification, tumor location and histologic type of cancer. Recently, the indications for ELT decreased due to the development of endoscopic mucosal resection (EMR) enabling histological evaluation of a resection specimen. However, the technique of EMR cannot always be performed completely depending on the location and size of the lesions. Therefore, we employed ELT as an additional treatment technique after EMR therapy to achieve complete tumor destruction. Results in 13 patients where both techniques were employed showed complete tumor removal in 11 cases. At present, this combined application may be the most important role of laser irradiation for the treatment of early stage GI tract malignancies.

Aged↗

PubMed1993

Human leukocyte antigen-DR is a differentiation antigen for human granulosa cells.

We raised a murine monoclonal antibody, OG-3, which reacts with human granulosa cells. Immunohistologically, OG-3 antigen was weakly expressed on the granulosa cells of some growing and atretic follicles, but not on those of preovulatory follicles. After ovulation, the antigen expression rapidly increased on granulosa cells during corpus luteum formation. The antigen expression on granulosa/large luteal cells decreased in the mid-luteal phase, but increased again in the late luteal phase. In early pregnancy, OG-3 antigen expression on large luteal cells increased after 7 wk of gestation. The OG-3 antigen distribution in various organs resembled that of human leukocyte antigen (HLA) class II molecules. An HLA-class II-positive human B cell line (AKIBA) and a murine L-cell transfectant expressing HLA-DR antigen were positive for OG-3 antigen, whereas an HLA-class II-negative human T-cell line and L-cell transfectants expressing HLA-DP and DQ antigens were negative. The molecular mass of OG-3 antigen purified from AKIBA cells was 32-35 kDa. The staining profiles in ovaries with anti-HLA-DR or anti-HLA-class II antibodies were similar to that with OG-3. These results indicate that OG-3 antigen is identical to HLA-DR, and that HLA-DR is a differentiation antigen for human granulosa cells.

Adult↗

PubMed1993

Micturitional disturbance in radiation myelopathy.

Detailed micturitional histories and urodynamic studies were performed in five patients with radiation myelopathy. All patients had micturitional symptoms that were irritative in five and obstructive in four, and four had urinary incontinence. Urodynamic studies showed that three patients had residual urine of 158 ml on average. Cystometry showed that four patients had detrusor hyperreflexia and one had low compliance cystometrogram. External sphincter electromyography showed that four patients had detrusor-sphincter dyssynergia. These results indicated that micturitional disturbance seemed to be common and severe in storage as well as evacuation function. The main responsible sites of lesions seemed to be supranuclear parasympathetic and somatic nervous systems regulating the lower urinary tract. Two of three patients who underwent combination of steroid pulse therapy and hyperbaric oxygen therapy experienced improvement of micturitional disturbance and other neurological deficits.

Adrenal Cortex Hormones↗

PubMed1993

Elevated plasma 19-hydroxyandrostenedione levels in Cushing's disease: stimulation with ACTH and inhibition with metyrapone.

OBJECTIVE: The regulation of 19-hydroxyandrostenedione secretion has been suggested to be under the control of both the ACTH-adrenal axis and renin-angiotensin system. We undertook the present study to evaluate the effect of the chronic excess of ACTH, or the short-term excess of ACTH due to metyrapone, on 19-hydroxyandrostenedione secretion in patients with Cushing's disease. DESIGN AND PATIENTS: We measured plasma 19-hydroxyandrostenedione levels simultaneously with plasma delta 4-androstenedione, corticosterone, 11-deoxycorticosterone, aldosterone and cortisol levels after HPLC separation in 13 patients with Cushing's disease under basal conditions and during a dexamethasone suppression test or metyrapone test. Seven patients with Cushing's syndrome due to adrenal adenoma were used for comparison. RESULTS: The basal levels of 19-hydroxyandrostenedione in Cushing's disease were elevated (mean +/- SD; 323 +/- 193 pmol/l, n = 13), while those in Cushing's syndrome due to adrenal adenoma were low (92 +/- 24 pmol/l, n = 7), compared to those in normal subjects (117 +/- 33 pmol/l, n = 54). The basal levels of delta 4-androstenedione were mildly elevated in Cushing's disease (9.0 +/- 6.5 vs 3.6 +/- 2.6 nmol/l of normal subjects) but not in Cushing's syndrome due to adrenal adenoma (3.1 +/- 3.0 nmol/l). In the overnight 8 mg dexamethasone suppression test in Cushing's disease (n = 12), plasma levels of 19-hydroxyandrostenedione and delta 4-androstenedione decreased from 277 +/- 172 to 156 +/- 99 pmol/l and from 9.2 +/- 6.8 to 4.7 +/- 3.4 nmol/l, respectively, whereas the overnight 1 mg dexamethasone suppression test did not induce significant changes. Metyrapone administration in Cushing's disease (n = 9) increased plasma delta 4-androstenedione level from 9.5 +/- 6.7 to 47.2 +/- 28.1 nmol/l, but decreased plasma 19-hydroxyandrostenedione level from 301 +/- 196 to 196 +/- 105 pmol/l. CONCLUSIONS: These data indicate that plasma levels of 19-hydroxyandrostenedione in patients with Cushing's disease are elevated due to chronic ACTH excess, and that metyrapone can inhibit 19-hydroxylation in humans.

Adrenal Cortex Hormones↗

PubMed1993

Micturitional disturbance in multiple system atrophy.

Detailed micturitional histories and urodynamic studies were conducted to investigate the micturitional disturbance in multiple system atrophy (MSA). Eighty-six patients with MSA comprised of 14 with striatonigral degeneration (SND), 42 with olivopontocerebellar atrophy (OPCA) and 30 with Shy-Drager syndrome (SDS). The results were as follows. Micturitional symptoms were noted in over 90% of patients with each type of MSA. Dominant symptoms were irritative ones in SND and OPCA, and a combination of irritative and obstructive ones in SDS. Micturitional symptoms in SDS appeared earlier than those in SND or OPCA. The degree of micturitional disturbance was severer in SDS than in SND or OPCA. Micturitional disturbance tended to become worse as the disease progressed. The responsible sites of lesions of micturitional disturbance seemed to be supra- as well as infranuclear lesions of the pelvic and pudendal nerves in MSA. Infranuclear lesions were more prominent in SDS than in SND or OPCA. Follow-up studies of some of the patients with SDS and OPCA suggested that the responsible sites of pelvic nerve lesions changed from supra- to infranuclear lesions during the course of disease.

Autonomic Nervous System↗

PubMed1993

Current topics in childhood lupus nephritis.

Lupus nephritis is a major predictor of the prognosis of systemic lupus erythematosus (SLE). The present paper discusses lupus nephritis from clinical and immunopathological points of view. Although recent advances in diagnosis and treatment improve the prognosis of children with SLE, there remain many unsolved clinical problems. One of the current topics in the treatment for SLE is intermittent intravenous cyclophosphamide therapy which is effective even for the steroid-resistant patients with severe lupus nephritis, at least for short-term observation. Immunopathologically, the following issues are discussed: (i) The C5b-9 terminal complement complex plays an important role in the pathogenesis of lupus nephritis. The possible interaction of vitronectin and SP-40,40 is also mentioned; (ii) A semi-quantitative analysis of the charge barrier of the glomerular basement membrane reveals that the charge barrier dysfunction plays an important role in the pathogenesis of proteinuria in lupus nephritis. This study also demonstrates that the charge of immune deposits is important for the initiation of glomerular injury in lupus nephritis; (iii) It is demonstrated that the histopathological diversity of lupus nephritis is based on biological properties of nephritogenic auto-antibodies in murine lupus models.

Adolescent↗

PubMed1993

Effects of stress shielding on the mechanical properties of rabbit patellar tendon.

Mechanical properties of the stress-shielded patellar tendon were studied in the rabbit knee. Stress shielding was accomplished by stretching a stainless-steel wire installed between the patella and tibial tubercle and thus, releasing the tension in the patellar tendon completely. Tensile tests were carried out on the specimens obtained from the patellar tendons which were exposed to the stress shielding for 1 to 6 weeks. The stress shielding changed the mechanical properties of the patellar tendon significantly: it decreased the tangent modulus and tensile strength to 9 percent of the control values after 3 weeks. There was a 131 percent increase in the cross-sectional area and a 15 percent decrease in the tendinous length. Remarkable changes were also observed in the structural properties: for example, the maximum load of the bone-tendon complex decreased to 20 percent of the control value after 3 weeks. Histological studies showed that the stress shielding increased the number of fibroblasts and decreased the longitudinally aligned collagen bundles. These results imply that if no stress is applied to the autograft in the case of augmentative reconstruction of the knee ligament, the graft strength decreases remarkably.

Animals↗

PubMed1993

Pepsinogen C gene polymorphisms associated with gastric body ulcer.

This study was aimed to investigate the association of restriction fragment length polymorphisms (RFLPs) for pepsinogen genes with peptic ulcer disease. Eighty unrelated controls, 61 patients with gastric ulcer, and 57 patients with duodenal ulcer were studied. No genetic polymorphisms for pepsinogen A were detected by EcoRI digestion in Japanese subjects but a 100 base pairs insertion-deletion RFLP for the pepsinogen C gene was observed. The allele frequencies of the large (3.6 kilobase EcoRI fragment) and the small fragment (3.5 kilobase EcoRI fragment) were 80.6% and 19.4% respectively in controls, 55.4% and 44.6% in patients with gastric body ulcer, 79.4% and 20.6% in patients with gastric angular ulcer, 71.4% and 28.6% in patients with gastric antral ulcer, and 75.4% and 24.6% in patients with duodenal ulcer. The allele frequency of the small fragment was significantly higher in patients with gastric body ulcer than in controls and in patients with gastric angular or antral ulcer. The genotypes which possessed the small fragment were significantly more frequent in patients with gastric body ulcer (78.4%) than in controls (33.8%) and in patients with gastric angular or antral ulcer (37.5%). These results suggest that there is a significant association between the genetic polymorphism at the pepsinogen C gene locus and gastric body ulcer, and that the pepsinogen C RFLP is a useful marker of the genetic predisposition to this disorder. These results also indicate genetic heterogeneity of gastric ulcer disease, and suggest that the pepsinogen C RFLP may be a useful subclinical marker to explain the differences in genetic aetiologies of gastric body ulcer and gastric angular or antral ulcer.

Adult↗

PubMed1993

Effect on urapidil on benign prostatic hypertrophy: a multicenter, double-blind study.

In a prospective multicentric double-blind trial, urapidil, an alpha 1-adrenergic antagonist, was investigated for its efficacy in benign prostatic hypertrophy (BPH). After 1 week of baseline on placebo, 214 patients with BPH were randomly assigned to 4 groups; group P was given placebo, group L, 15 mg of urapidil b.i.d. for 3 weeks, group M, 15 mg b.i.d. for 1 week followed by 30 mg b.i.d. for 2 weeks, and group H, 15 mg b.i.d. for 1 week followed by 45 mg b.i.d. for 2 weeks. In all groups, day and night urinary frequency improved significantly (p < 0.01 or p < 0.05) compared to baseline, but the differences were not significant between groups. The residual urine rate was significantly (p < 0.05 vs. group P) decreased in group H. Average and maximum flow rate improved significantly (p < 0.01 or p < 0.05) in group M and group H, but intergroup differences were not noted. Overall impression evaluated by investigators improved significantly (p < 0.01 vs. group P) in group M and group H. More patients in group H (7/55) and group M (4/51) had side effects than in group P (2/54). None of them were severe. In summary, a daily dosage of 60 mg urapidil proved to be the most beneficial in the treatment of patients with BPH.

Adrenergic alpha-Antagonists↗

PubMed1993

A bronchofibroscopic analysis of the bronchial mucosa using a dye-scattering method for the detection of bronchial lesions.

A study was undertaken to evaluate the usefulness of a dye-scattering method for the analysis of bronchial lesions. After methylene blue was introduced through a cannula, the bronchial staining intensities seen by bronchofibroscopy were later compared with the histologic findings in 74 biopsied specimens of lesions taken from 20 patients with lung cancer and from 6 patients with bronchiectasis, 2 with a rheumatoid lung, and 2 with sarcoidosis. It was found that 86% (25 of 29) of the specimens that stained positively were malignant. Further, 4 specimens that manifested a false positive response to staining were either too small to be inspected histologically or showed necrosis. Of 27 specimens that were negative to staining, 89% (24 of 27) were revealed to be nonmalignant lesions. In this latter group the response of 3 specimens was false negative on histologic inspection, 2 showing cancer cells without surface infiltration. We thus conclude that this dye-scattering method is of great use in enabling the differentiation of nonmalignant mucosa from neoplastic lesions and the preoperative determination of the stage of a tumor.

Bronchi↗

PubMed1993

Monoclonal antibodies to the Golgi apparatus of serous exocrine cells.

We demonstrated that a common antigen (Golgi-associated antigen, GAA 108) is present in the Golgi apparatus of serous exocrine cells, using an immunohistochemical method with monoclonal antibodies (MAb) 108 (IgG1) and 18 (IgM), raised to the microsomal fractions of rat parotid gland. The MAb reacted with polypeptides of molecular weights in the 58-170 KD range in parotid gland on Western blot analysis. The Golgi apparatus of the following cells was immunostained with these MAb: acinar cells of parotid gland, pancreas, and exorbital lacrimal gland, serous cells of sublingual gland, chief cells of stomach, and epithelial cells of rat prostate. However, positive reaction occurred throughout the entire cytoplasm of submandibular gland acinar cells. Immunoelectron microscopy (IM) revealed antigen (GAA 108) localization in the medial and trans-Golgi cisternae and trans-Golgi network (TGN), including condensing vacuoles, in parotid, exorbital lacrimal, and pancreatic acinar cells, and serous acinar cells of sublingual gland. Lysosomes and apical cell membranes also stained positively in some cells. In the submandibular gland reactions were observed in the medial and trans-Golgi cisternae, condensing vacuoles, secretory granule contents, cell membrane, and in some duct lumens. These results suggest that although GAA 108 is found in the Golgi apparatus of most serous exocrine cells, it is secreted by a regulated pathway in the acinar cells of submandibular gland.

Animals↗

PubMed1993

Distribution of gamma-glutamyl transpeptidase in human salivary glands: immunohistochemical study using a monoclonal antibody.

We studied in detail the distribution pattern of gamma-glutamyl transpeptidase (gamma-GT) in human salivary glands using a monoclonal antibody (MAb) to human kidney gamma-GT. In the sublingual gland, a strong reactivity of the enzyme was recognized along the luminal and lateral membranes of serous cells. Weak but positive reactivity was noted on the luminal membrane of mucous cells. The intercellular canaliculi in the demilune and luminal surfaces of excretory duct cells were also immunoreactive. In the submandibular gland, a weak reaction was observed on the luminal membrane of intercalated duct cells and striated duct cells. Faint reactivity was seen on the luminal membrane of striated duct cells of the parotid gland. No reaction was observed in serous cells of the parotid gland. The immunoreaction in the sublingual gland was stronger than that in submandibular or parotid glands.

Antibodies, Monoclonal↗

PubMed1993

Production and secretion of parathyroid hormone-related protein in pheochromocytoma: participation of an alpha-adrenergic mechanism.

We studied the relation between calcium metabolism and serum PTH-related protein (PTHrP)-like immunoreactivity (PRP-LI) in 12 patients with benign pheochromocytoma, 10 of whom had not received any medication before admission. Basal serum PRP-LI levels were elevated in 7 of these 10 untreated patients. After tumor resection, serum PRP-LI became undetectable in all 10 patients examined. Serum calcium decreased (P < 0.01), and serum phosphorus increased significantly (P < 0.05) after tumor resection. Serum PTH increased in 5 of 7 patients postoperatively. alpha-Adrenoceptor-blocking agents given as preoperative treatment (n = 6) decreased elevated PRP-LI levels in 5 patients, had no effect in the remaining patient with undetectable levels, and tended to decrease serum calcium levels that were normal in 5 of 6 patients and elevated in 1, while serum phosphorus levels showed reciprocal changes. In the remaining 2 patients who had received alpha-adrenoceptor-blocking agents before admission, serum PRP-LI was undetectable. Tissue PRP-LI concentrations were high in all resected tumors (n = 8). Western blot analysis of tumor extracts showed multiple bands at about 14, 16, 21, 27, and 34 kilodaltons, which differed among tumors. Northern blot analysis of PTHrP mRNA (n = 5) and immunohistochemistry (n = 5) showed positive findings. These findings suggest that PTHrP is synthesized in pheochromocytoma and released into the general circulation, probably via an alpha-adrenergic mechanism, and that changes in serum PRP-LI levels are fairly positively associated with those in serum calcium levels in patients with pheochromocytoma.

Adolescent↗

PubMed1993

A differentiation-related molecule on the cell surface of human granulosa cells.

We raised a monoclonal antibody (OG-1) specifically reactive to human ovarian granulosa cells. Indirect immunofluorescence staining of freshly isolated granulosa cells from preovulatory follicles showed the OG-1 antigen on the cell surface of granulosa cells. The antigen was purified from granulosa cells by immunoaffinity chromatography. Under reducing or nonreducing conditions, the sodium dodecyl sulfate-polyacrylamide gel electrophoresis profile of the purified antigen showed two specific protein bands, corresponding to mol wt of 125 and 145 kilodaltons. Immunohistologically, the OG-1 antigen on granulosa cells of primary follicles seemed to increase during follicular development. After ovulation, the antigen was detected on granulosa cells during corpus luteum formation. The antigen expression began to decrease on corpus luteum days 10-12 and disappeared on corpus luteum days 13-14. Luteal cells of pregnancy did not express the OG-1 antigen. Granulosa cells in atretic follicles expressed the OG-1 antigen. On the contrary, thecal or small luteal cells did not express it throughout the menstrual cycle. These results indicate that OG-1 antigen is a differentiation-related surface antigen of human granulosa cells.

Adult↗