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Biomedical subjects

O Miyake

Publications and source records attributed to O Miyake.

At least 37 records · Page 2Linked to original sources

[Effect of chorei-to and gorei-san on calcium oxalate crystallization in human urine].

The inhibitory effect of two kinds of Kampou medicine, Chorei-to and Gorei-san, on calcium oxalate crystallization in human urine, was examined. Chorei-to or Gorei-san was administered to 15 healthy male volunteers for three consecutive days under normal dietary conditions and 24-hour urine samples were collected before and after the administration. Urinary parameters including calcium, phosphorus, uric acid, oxalate and citrate were measured on each sample obtained. The inhibitory effect on calcium oxalate crystallization was examined using part of the collected 24-hour urine. There was no significant difference in urinary parameters before and after Chorei-to administration. Gorei-san administration significantly increased magnesium excretion in urine. A significant inhibitory effect on calcium oxalate crystallization in human urine was recognized when Gorei-san was administered, whereas Chorei-to had no inhibitory effect on calcium oxalate crystallization in urine.

Adult↗

Bidirectional regulation of telomerase activity in a subline derived from human lung adenocarcinoma.

Telomerase is active in germline cells and tumor cells, but is either not expressed or is repressed in a majority of somatic cells. The regulation mechanism of telomerase activity has lately drawn considerable attention for the possible use of telomerase inhibitors for anti-cancer therapy. We analyzed the regulation mechanism of telomerase activity in the human lung adenocarcinoma cell line A549 and its subline A5DC7 which shows impaired tumor phenotypes. Although A549 and A5DC7 cells have similar growth potentials, when cultured in medium supplemented with 5% fetal bovine serum A5DC7 cells demonstrated a remarkable negative regulation of telomerase activity and telomere shortening. After the long-term culture, A5DC7 cells showed a large senescent cell-like morphology, arrested growth at the 106 population doubling level and entered senescence which was demonstrated by expression of the beta-galactosidase senescence marker. When the serum concentration was raised from 5% to 10% for the senescent A5DC7 cells, telomerase reactivation and telomere lengthening occurred as well as resumption of proliferation. These results demonstrate that the growth arrest seen in senescent A5DC7 cells is reversible and that telomerase activity is also bi-directionally regulated in A5DC7 cells, an event which could not be observed in normal senescent cells. This indicates that stringent telomerase repression and complete growth arrest concomitant with cellular senescence is collapsed in senescent A5DC7 cells in response to exogenous signals. Our study suggests that cellular senescence progresses and/or is regulated at multiple levels.

Adenocarcinoma↗

Characterization of protein components of human urinary crystal surface binding substance.

We previously extracted crystal surface binding substance (CSBS) from human urine and showed that it appeared to constitute a substantial proportion of urinary macromolecular inhibitors of calcium oxalate crystallization. CSBS was isolated from human urine and fractionated by three consecutive chromatography procedures in order to characterize protein inhibitors of calcium oxalate crystallization. Sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and NH2-terminal amino acid sequencing revealed that inhibitory fractions eluted from a final, hydroxyapatite column contained prothrombin and osteopontin. Hydroxyapatite column fractions also contained other, unidentified protein inhibitors of calcium oxalate crystallization. CSBS contained also human serum albumin, alpha 1-acid glycoprotein, alpha 1-microglobulin, alpha 2-HS glycoprotein, retinol-binding protein, transferrin, and Tamm-Horsfall protein, but these proteins seemed to play no direct role in inhibitory activity.

Adult↗

Glycosaminoglycans in crystal-surface binding substances and their role in calcium oxalate crystal growth.

OBJECTIVE: To clarify the role of glycosaminoglycans (GAGs) in crystal-surface binding substances (CSBS) on the growth of calcium oxalate crystals in urine. MATERIALS AND METHODS: Urine samples (24 h) were collected from healthy men (aged 25-42 years) and CSBS were obtained from the pooled urine samples. The CSBS were digested with heparitinase or proteinase and the inhibition of crystal growth assessed before and after enzyme digestion. Anion-exchange chromatography and high-performance liquid chromatography (HPLC) were used to determine the types of GAGs contained in the CSBS. RESULTS: The inhibitory activity of CSBS on crystal growth decreased with concentration when digested with heparitinase or proteinase. HPLC showed that CSBS contained a small amount of dermatan sulphate and abundant heparan sulphate, both of which inhibited crystal growth. CONCLUSION: Both heparan sulphate and dermatan sulphate may inhibit calcium oxalate crystallization, the former being the predominant GAG in CSBS.

Adult↗

[Inhibitory effect of oral administration of Takusya on calcium oxalate crystallization in human whole urine].

We previously reported that Takusya had the inhibitory effect on in vitro calcium oxalate crystallization and in vivo stone formation in an animal model and it could be a prophylactic agent against calcium oxalate stone formation. We studied the effect of Takusya on calcium oxalate crystallization in human urine. Takusya (500 mg/day and 1,000 mg/day) was administered to 16 healthy men for 3 days and then 24-hour urine samples were collected to measure the urinary excretion of calcium, phosphate, magnesium, uric acid, creatinine, citric acid and oxalic acid. The urine samples before the administration of Takusya was used as a control. The size and distribution of crystals, which were formed in the urine samples by adding calcium chloride and sodium oxalate, were measured using the Coulter counter technique. Urinary magnesium excretion was significantly reduced by 1,000 mg/day of Takusya compared with the control (p < 0.05). The growth of crystals was significantly inhibited by 500 mg/day of Takusya in the large crystal formers whose urine created crystals more than 3.5 microns before the administration of Takusya (p < 0.05). These findings suggested that Takusya inhibited the growth of crystals formed in human urine.

Administration, Oral↗

[Clinical experience of total prostatectomy using DDV-L (deep dorsal venous ligator].

BACKGROUND: We evaluated blood loss in operation and postoperative urinary incontinence to total prostatectomy using the DDV-L. METHODS: We performed total retropubic prostatectomy for 38 patients from May 1979 to May 1995. In 14 patients from October 1994 to May 1995 the DDV-L was used. The DDV-L is used in transurethral approach, disposable device to ligate the deep dorsal vein complex by delivering the needle to lateral of deep dorsal vein complex. RESULTS: We composed the 14 patients which was used the DDV-L with the 14 patients which was from April 1990 to July 1994 was not used that. The mean operating time of 14 patients which was used the DDV-L was 178.5 min, 14 patients which was not used that was 188.0 min. The mean blood loss of 14 patients which was used th DDV-L was 735.7 ml, 14 patients which was not used that was 1250.2 ml. We transfused blood into 2 of 14 patients which was used the DDV-L (14.0%), 10 of 14 patients which was not used that (71.4%). The one of 14 patients which was used the DDV-L (7.5%) and 5 of 14 patients which was not used that (35.7%) had postoperative urinary incontinence needing pad. CONCLUSION: Accordingly the operating results of 14 patients which was used the DDV-L was undoubtedly better that of 14 patients which was as regards blood loss in operation, postoperative urinary incontinence. We can perform easily the management of deep dorsal vein complex by DDV-L, so we can cut of urethra without excess hemostasis and electronic coagulation, and leave enough long membranous urethra. We consider the DDV-L is helpful to total prostatectomy.

Aged↗

[Laser-TURP with a lateral firing fiber for contact irradiation].

We have operated 25 BPH patients with transurethral Nd-YAG laser ablation for prostate from June of 1993 till December of 1993. We used UltraLine fiber for contact laser irradiation of the prostate. This is a lateral firing quartz fiber with high density laser energy output, and so made it possible for us to vaporize prostatic tissue rapidly and deeply. We used 60 Watts of power for all cases. For the prostates larger than 50 cm3, limited resection after laser ablation allowed early relief of patients' symptoms. Two months after the treatment, average flow rate improved from 3.7 ml/sec to 7.8 ml/sec. Volume of residual urine decreased from 48.4 ml to 17.0 ml. Twenty-four percent decrease of prostatic volume was also recognized with transrectal sonography. Only 4 patients complained of transient urinary retention, although another 3 or 5 days catheter placement relieved their symptoms. Bleeding was negligible and the other postoperative complications were not recognized at all. Laser-TURP is a new treatment that is effective, less morbid and economical, compared with the ordinary TUR-P. So it will soon become an alternative method to electrocautery TUR-P.

Aged↗

[Multilocular cystic renal cell carcinoma treated with tumor enucleation: a case report].

We report a 65-year-old man with a multilocular cystic renal cell carcinoma which was found incidentally. Computed tomography (CT) demonstrated a 3.0 cm x 3.0 cm multilocular cystic mass at the upper pole of the left kidney. Dynamic MRI demonstrated that the septic wall of the multilocular cystic mass was enhanced. Renal angiography showed a hypovascular tumor. We diagnosed that the tumor was multilocular cystic renal cell carcinoma with a tumor capsule and performed tumor enucleation. The histopathological examination showed that the cystic and septic wall consisted of renal cell carcinoma, clear cell subtype, grade 1. From the review of the literature, the prognosis of multilocular cystic renal cell carcinoma was good, so we selected nephron sparing surgery for this case.

Aged↗

[Primary malignant lymphoma of the urinary bladder].

We report 2 cases of primary malignant lymphoma arising in the urinary bladder. The first case was a 64-year-old woman complaining of gross hematuia during the follow-up period of transitional cell carcinoma (grade 2, stage pTa) of the bladder that was treated with TUR in 1989. Her bladder tumor of this time was broad based, not papillary, and situated on the right side wall with bleeding. The pathological diagnosis of transurethral biopsy specimens was non-Hodgkin lymphoma, diffuse large, B cell type. Four courses of CAP chemotherapy was so effective that she has been free of the disease up to now. The second was a 51-year-old woman presenting with painless gross hematuia. A solid, round and intramural tumor, which was recognized on the left side wall by cystoscopy, was resected endoscopically as much as possible. Three courses of VEPA chemotherapy was done because pathologically it was non-Hodgkin lymphoma, diffuse medium, B cell type, although no evidence of other tumors in any organs was fortunately detected with further examinations. She has been doing well without recurrence for 9 months after discharge from the hospital. Primary malignant lymphoma of the bladder is unusual. About 70 cases have been reported in foreign countries, but only 23 cases in Japan. When malignant lymphoma is confined to the bladder, radiation and chemotherapy can be curative, and yet preserve the function of the bladder.

Antineoplastic Combined Chemotherapy Protocols↗

[Clinical evaluations of tumor enucleation for incidental renal cell carcinoma].

We performed tumor enucleation in 21 patients of renal tumors from Jan. 1980 to Feb. 1993. Of them 19 had renal cell carcinoma. We reviewed the results of clinical experiences. Preoperatively, all patient underwent ultrasound, computerized tomography (CT) and angiography, and evaluated tumor characteristics in terms of its localization, size and pre or absence of pseudocapsule. All cases were shown to be well encapsulated. Of them 17 were asymptomatic and detected incidentally, whereas remaining one case was bilateral renal cell carcinoma clinically characterized by gross hematuria. This case was treated by radical nephrectomy on the right side and enucleation of the tumor on the left side. All cases had localized renal cell carcinoma (stage 1) of low grade (15 cases of grade 1 and 3 of grade 2), and the diameter of the tumor averaged 3.4 cm. Of 18 cases 2 died, one died of causes unrelated to RCC and the other of the metastasis of bilateral RCC after nephrectomy. The 16 cases are presently free of disease for maximal follow up period of 92 months. We consider that tumor enucleation will be indicated for tumors found incidentally, surrounded by pseudocapsule, of small size (less than 3.0 cm in diameter), and of low grade and low stage, and that tumor enucleation for renal cell carcinoma could be curative yet preserve renal function in selected patients.

Adult↗

[Asymptomatic pheochromocytoma: a report of three cases].

We present three cases of asymptomatic pheochromocytoma treated at Sumitomo Hospital. They had no hypertensive episode. The tumors of Case 1 and Case 3 were incidentally detected by abdominal ultrasonography at the Health Screening Center of Sumitomo Hospital. The tumor of Case 2 was incidentally detected by abdominal ultrasonography in the health examination of his company. Case 1. A 49-year-old male was hospitalized in Apr. 1992 because of further examination of a right adrenal mass. He underwent right adrenalectomy and its histological examination revealed pheochromocytoma. Case 2. A 45-year-old male was referred to our department for further examination of a left adrenal mass in Aug. 1993. On admission, endocrinological examination was almost normal. He underwent surgical removal of the tumor and its histological examination revealed pheochromocytoma. During the operation, blood pressure and pulse rate were almost unchanged. Case 3. A 51-year-old female was hospitalized in Oct. 1993 because of further examination of a left retroperitoneal mass. She underwent surgical removal of the tumor and its histological examination showed paraganglioma.

Adrenal Gland Neoplasms↗

[Bilateral adrenal myelolipoma: a case report].

A case of bilateral adrenal myelolipoma is presented. The patient was a 40-year-old man in whom a retroperitoneal tumor was unexpectedly found by ultrasonography. Computed tomography revealed bilateral adrenal masses, 14.0 cm in diameter on the right side, and 5.0 cm on the left side, with heterogeneous low density components. Magnetic resonance imaging also revealed a high intensity mass with heterogeneity. Laboratory examination of adrenal function revealed normal results. We confirmed myelolipoma of bilateral adrenal gland, and performed right adrenalectomy, and left tumor enucleation. The right tumor was 14.0 x 12.5 x 10.0 cm in size and 920 g in weight, and the left tumor 5.0 x 4.5 x 4.0 cm in size and 50 g in weight. Pathology disclosed an admixture of mature adipose tissue and hematopoietic elements resembling bone marrow. Histopathological diagnosis was adrenal myelolipoma. This case was the 6th to be reported in the Japanese literature as bilateral adrenal myelolipoma.

Adrenal Gland Neoplasms↗

[Vesicourethral function study and application of urinary alarm in progressive supranuclear palsy].

We performed a vesicourethral function study on seven patients with progressive supranuclear palsy. In storage phase, 6 patients had decreased urinary sensation and overactive detrusor. Although bladder compliance was normal in all patients, maximum cystometric capacity was decreased in 3 patients. In micturition phase, detrusor contraction was underactive in 4 patients and acontractile in 1 patient. Sphincter electromyogram showed detrusor-sphincter-dyssynergia in 1 patient, no decrease in 3 patients and synergistic decrease in 1 patient. Six patients had urinary incontinence partially due to those neurological abnormality, partially due to dementia and lower activity of daily living. To facilitate the care of such functional incontinence, we devised a urinary alarm. The urinary alarm is a device to detect urine in a diaper. One can know the micturition in a diaper without being informed of micturition by the patient and change diapers as soon as possible. It was also useful to examine their frequency/volume chart.

Activities of Daily Living↗

[Treatment of staghorn calculi--ESWL monotherapy].

We investigated 41 cases (44 kidneys) of renal staghorn calculi treated in our hospital between November, 1988 and July, 1992. The efficacy of each treatment was 83.3% for extracorporeal shock-wave lithotripsy (ESWL) monotherapy (27 kidneys), 40% for percutaneous nephrolithotomy (PNL) with ESWL (5), 100% for dissolution with ESWL (6), 50% for pyelolithotomy with ESWL (2), 100% for nephrolithotomy with ESWL (1), and 100% for only dissolution (1). In the ESWL monotherapy group except for 3 cases that had complete staghorn calculi with severe caliectasis, the efficacy was between 70% and 100%, and the term of hospitalization was only about 1 month. The complications of ESWL monotherapy were stone street itself and high fever caused by it. However, renal function, could be successfully preserved by the timely drainage with D-J stent or nephrostomy tube. Thus, in most cases of staghorn calculi as well as other urolithiasis, ESWL monotherapy seemed to be more effective and safe than combined therapy of PNL and ESWL.

Aged↗

[Comparison of the vesicourethral function between progressive supranuclear palsy and Parkinson's disease].

We compared the vesicourethral function between progressive supranuclear palsy (7 cases) and Parkinson's disease (vesicourethral function study in 8 patients with dysuria and questionnaire study in 44 patients). The frequency of urinary incontinence in the 44 patients with Parkinson's disease was 38.7%. Vesicourethral function study showed hypersensitivity, low bladder capacity, detrusor hyperreflexia and normal sphincter EMG. The frequency of urinary incontinence in supranuclear palsy was 85.7%. Vesicourethral function study showed hyposensitivity and detrusor hyperreflexia in 6 cases, and 4 of these 6 cases had residual urine due to impaired detrusor contraction in micturition phase and/or abnormal sphincter EMG. Compliance was normal, but bladder capacity was decreased in progressive cases. Impaired contraction and hyposensitivity made it more difficult to control the urinary incontinence in supranuclear palsy than in Parkinson's disease. Dementia and lower ADL were frequently accompanied with supranuclear palsy (rare in Parkinson's disease). These were other factors that worsen the control of incontinence.

Female↗

[Renal arteriovenous fistula detected 25 years after nephrolithotomy: a case report].

We report a case of intrarenal arteriovenous fistula (AVF) with macroscopic hematuria detected after nephrolithotomy performed 25 years previously. The present case, successfully treated by transcatheter embolization with steel coils, is the eighth case of postnephrolithotomy AVF reported in English and Japanese literatures. The necessity of renal arteriography in patients with postoperative massive hematuria is stressed.

Arteriovenous Fistula↗

[Adrenal myelolipoma associated with Cushing's syndrome: a case report].

A 42-year-old woman was referred to our hospital for evaluation of severe hypertension. A right adrenal tumor was revealed by CT scan, and the elevation of cortisol and u-17OHCS was found. We made a diagnosis of adrenal adenoma with Cushing's syndrome and performed right adrenalectomy. However, a small myelolipoma (1.5 mm in diameter) was found beside the cortical adenoma by histopathological examination. Adrenal myelolipoma is not a rare disease now, because it is easily-detected as an incidental by CT scan. The present case of adrenal myelolipoma, however, is interesting and uncommon in its connection with functioning cortical adenoma. Only 3 cases have been previously reported so far in English and Japanese publications. We discuss the etiology of adrenal myelolipoma, and suggest that myelolipoma would develop in the course of regressive or necrotic degeneration of cortical cells by hormonal disorders, stress, circulatory disturbance or other unknown factors.

Adenoma↗

[Extracorporeal shock wave lithotripsy for renal and ureteral calculi with MPL-9000. Correlation between stone burden and shock wave energy].

Clinical results of ESWL for renal and ureteral stone with MPL-9000 were presented. We also reviewed correlation between stone burden and shock wave energy. We studied 210 cases (295 sessions) of renal stone and 109 cases (154 sessions) of ureteral stone that were treated from November 1988 till January 1989 and from November 1989 till May 1990. Of those sessions, 76 sessions of renal stone cases and 53 of ureteral stone cases were carried out ambulatorily. Successful disintegration (within 4 mm) rate was 86% of renal stones, 84% of ureteral stones, and stone free rate after 6 months was 72% of renal stones and 84% of ureteral stones. As for the complications, brain infarction occurred in one case, subcapsular hematoma of the kidney in one, and arythmia in 5. No other severe side effects were observed. Between shock wave energy (the number of shock wave shots x voltage) and stone burden (long axis x short axis of the stone), a significant correlation was found in renal stone cases, but not in ureteral stone cases. E/B (shock wave energy/stone burden) was 33,100 (kv.shots/cm2) for the renal stone and 56,000 (kv.shots/cm2) for the ureteral stone. These results suggest that there is still another unknown factor, which is not related with renal stone, for successful disintegration of ureteral stone. We also confirmed that more energy is necessary for destruction of ureteral stone than for that of renal stone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗