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R Tsugawa

Publications and source records attributed to R Tsugawa.

At least 19 recordsLinked to original sources
PubMed1996

Hypertension and unilateral renal ischemia (Page kidney) due to compression of a retroperitoneal paraganglioma.

We describe a 17-year-old hypertensive man with a left abdominal mass on the computed tomographic scan. Radiologic studies revealed a large tumor near the left renal hilus, resulting in renal compression and displacement toward the posterolateral abdominal cavity. Aortography excluded stenosis of the renal arterial vessels. Plasma and urinary catecholamines were normal and plasma renin activity (PRA) was high. The left renal vein renin was 2.1-fold higher than the right one. After resecting the tumor including the left kidney and adrenal, high blood pressure and elevated PRA returned to normal. Histologically, the tumor was a paraganglioma, and the affected kidney showed hyperplasia of the juxtaglomerular apparatus. Thus, the hypertension in our patient was probably due to renal ischemia extrinsically compressed by a non-functioning retroperitoneal paraganglioma (Page kidney).

Adolescent↗
PubMed1996

[A case of chronic scrotal hematocele].

We report a case of chronic scrotal hematocele. A 94-year-old man complained of urine retention and a painless mass in the right scrotum. He had no history of trauma at the perinium. Tumor markers such as human chorionic gonadotropin, alpha fetoprotein and carcinoembryonic antigen were within normal limits. A transillumination test was negative. A right high orchiectomy was carried out after admission with the diagnosis of suspicion testicular cancer. The extracted mass measured 85 x 60 x 75 mm and contained old brownish black blood. The right testis was located separately from the mass and had a normal appearance. Microscopic examination revealed depositions of cholesterin crystals characteristic of chronic hematocele.

Aged↗
PubMed1995

Backscattered electron imaging of crystal matrix protein on the surface of calcium oxalate crystals using colloidal gold.

In order to clarify the presence and localization of crystal matrix protein (CMP) upon calcium oxalate crystals, scanning electron microscopy (SEM) and backscattered electron imaging (BEI) techniques were used. This protein exhibits a remarkable affinity with calcium oxalate crystals and may be important in stone pathogenesis. In this paper, rabbit anti-human CMP polyclonal antibody was used as first antibody, and for the second antibody, goat anti-rabbit IgG conjugated with 20 nm immunogold was used. Freshly prepared crystals from male urine were fixed in SEM fixative, then blocked and washed with phosphate-buffered saline and bovine serum albumin (PBS/BSA). First and second antibodies were reacted in PBS/BSA. Crystals were then dehydrated and finally coated for SEM study. The SEM technique showed bipyramidal shaped dihydrate calcium oxalate crystals in every sample and even at high magnification, colloidal gold could barely be seen. BEI clearly demonstrated the presence and localization of the gold on the surface of the crystals as well as on the macromolecules eluted from the crystals by dissolving them in ethylenediamminetetraacetic acid solution.

Calcium Oxalate↗
PubMed1995

[Symposium (2). Diagnosis and treatment of renal parenchymal mass. Chairmen's comments].

Although renal cell carcinoma occupies clinically the majority of renal parenchymal mass lesions, indeterminate renal masses among renal cystic lesions and benign renal tumors have been frequently found with recent advances in renal imaging modalities. Renal mass lesions to be differentiated from renal cell carcinoma were focused on in the symposium and the points discussed were divided into four categories. 1. Indeterminate renal cystic masses, especially focused on multilocular cystic lesions and renal malignant lesions associated with acquired cystic disease of the kidney (ACDK) and von Hippel Lindau disease. 2. Angiomyolipoma and oncocytoma, as representative ones among a variety of benign renal tumorous lesions. 3. How to treat small renal masses serendipitously detected by abdominal CT and/or ultrasound, radical nephrectomy or renal parenchyma-preserving operation? 4. Feasibility of percutaneous ultrasound-guided fine needle biopsy for suspicious renal mass lesions. In this symposium, the diagnosis and treatment of various renal mass lesions other than renal cell carcinoma were mainly discussed and the important points to diagnose and treat patients with renal cell carcinoma have been clarified.

Carcinoma, Renal Cell↗
PubMed1995

[Renal cell carcinoma and acquired cystic disease of the kidneys in patients on long-term hemodialysis].

Since the first report in 1977 by Dunnill et al., a substantial number of articles have been written concerning the complications of acquired cystic disease of the kidneys (ACDK) and renal cell carcinoma developing in the native kidneys of patients undergoing long-term hemodialysis. The incidence has been reported to be 35% to 95% of ACDK in patients undergoing long-term hemodialysis. In addition, renal cell carcinoma has been described in 4% to 7% of the ACDK. The etiology of ACDK and renal cell carcinoma in the native kidneys of patients undergoing long-term hemodialysis remains unresolved. Because ACDK and renal cell carcinoma are usually asymptomatic, several reports described the use of imaging studies in the native kidneys of patients undergoing long-term hemodialysis and suggest a variety of management schemes to screen or monitor the status of the native kidneys. Ultrasonography is the most common screening study, but CT scan is more sensitive. Both studies are necessary to diagnose ACDK and renal cell carcinoma in the native kidneys of patients. We review our 10 cases and the Japanese literature with particular attention to the diagnosis and treatment of patients with ACDK and renal cell carcinoma. Our findings were similar to those reported by others. Patients receiving dialysis treatment for more than three years should have a baseline radiologic examination of the kidneys so that subsequent problems can be more easily identified and evaluated. The best surgical treatment for patients with ACDK and renal cell carcinoma is simple nephrectomy by flank incision in order to prevent surgical side effects, for example postoperative bleeding.

Adult↗
PubMed1995

Analysis of glycosaminoglycans induced in newly formed calcium oxalate crystals using an undiluted urine system.

The aim of this study was to examine the effect of sodium pentosan polysulfate (SPP) in an undiluted urine system and to study its relative affinity to calcium oxalate (CaOx) crystals in the presence or absence of heparan sulfate (HS). CaOx crystals were induced with an overload of oxalate above the metastable limit in spun and filtered urine (SF) and ultrafiltered urine (UF). Then, the crystals were dissolved with EDTA (ethylenediaminetetraacetic acid), electrodialysed and lyophilized. The polyanions, HS or SPP were added to the UF prior to the addition of oxalate. Polyanions in crystal matrices were examined by cellulose acetate electrophoresis. Crystal volume and size were suppressed according to the increase of the concentration of SPP when compared with those of the UF. Scanning electron microscopy (SEM) showed marked aggregation of the crystals in the UF and no aggregation in the presence of SPP. HS was the only polyanion found in CaOx crystals formed after overload of oxalate in SF. Crystals formed in UF did not contain any polyanions. When SPP was added to UF, SPP appeared in the crystal matrix in accordance with its concentration. Once HS in physiological concentration was added to the UF containing SPP, HS and SPP obtained from crystals were strongly stained with Alcian blue in electrophoretic study, where SPP is stained stronger than HS. These results suggest that SPP strongly binds to CaOx crystals as well as HS and that HS and SPP competitively bind to the crystal, then, as a result, they are incorporated into the crystals. The fact that SPP suppressed the aggregation of CaOx crystals in undiluted urine showed the possibility that SPP might be one of the useful drugs for preventing CaOx urolithiasis.

Adult↗
PubMed1994

Isolation and partial characterization of crystal matrix protein as a potent inhibitor of calcium oxalate crystal aggregation: evidence of activation peptide of human prothrombin.

In order to clarify the characteristics of crystal matrix protein (CMP), which exhibits a remarkable affinity for calcium oxalate crystals and may be important in stone pathogenesis, we have isolated CMP from macromolecular matrix substances of newly-formed calcium oxalate crystals. Purification of CMP consisted of calcium oxalate crystal formation, dissolution of crystals, electrodialysis, anion exchange chromatography and high-performance liquid chromatography. CMP showed the protein band of 31 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The N-terminal amino acid sequence of CMP was identical to that of human prothrombin. Both anti-CMP polyclonal antibody and anti-human prothrombin antibody cross-reacted well with human prothrombin and CMP in Western blotting. Its amino acid composition and its molecular weight of 31 kDa strongly suggest that CMP is the activation peptide of human prothrombin.

Adult↗
PubMed1994

Influence of RF capacitive heating on the alpha 1-adrenergic receptors of rat prostates.

The aim of this study was to find out the influence of radiofrequency (RF) capacitive heating on the alpha 1-adrenergic receptor of rat prostates. The prostates of 30-week-old Wistar rats were submitted to a 1-hour single session of RF capacitive heating at 45 degrees C. The ventral prostates that were submitted to heating were compared to those of other rats that were not submitted to heating. In order to determine the density of alpha 1-adrenergic receptors in rat ventral prostates, binding assays for alpha 1-adrenergic receptor were performed with [3H]prazosin in membrane preparations. The receptor density in the control group was 27.07 +/- 3.75 fmol/mg protein. The alpha 1-adrenergic receptor density (Bmax) in the thermotherapy group was 17.91 +/- 5.15 fmol/mg protein. A remarkable decrease in the density of alpha 1-adrenergic receptors was observed in the rat prostates of the thermotherapy group. In conclusion, the present results demonstrate that heating the rat prostate by RF capacitive heating damages the alpha 1-adrenergic receptors.

Animals↗
PubMed1994

[Studies on the modified dimethylmethylene-blue (DMB) method for determining glycosaminoglycans (GAG) in urine].

The measurement of glycosaminoglycans (GAG) in urine is very important because GAG is an essential constituent of urinary diseases. Since previously reported methods of determination of GAG are quite complicated, dangerous or not stable, we developed a very simple and rapid method to estimate the content of GAG in urine using a microplate and microplate reader. An aliquot of diluted urine is mixed with a 1,9, dimethylmethylene blue (DMB) dye. The assay is based on the metachromatic shift in absorption maximum which occurs when sulfated glycosaminoglycans are added to the dye. The recovery of GAG is good. Other urinary compounds such as sugar, protein and blood did not influence the measurement of GAG. A good correlation was obtained between the modified DMB method and Blumenkrantz and Asboe-Hansen's method (r = 0.737, p < 0.001). The accuracy of this method makes it useful for screening urinary diseases.

Adult↗
PubMed1993

[Treatment of staghorn calculi: combined therapy and stone recurrence].

Between April 1986 and September 1992, 29 extensive staghorn calculi were treated in 24 patients. Treatment was with extracorporeal shock-wave lithotripsy (ESWL) monotherapy in 11, initial ESWL followed by percutaneous nephrolithotomy (PNL) in 7 and initial PNL followed by ESWL in 11. A comparison based on treatment demonstrated that initial PNL followed by ESWL resulted in a lower rate and shorter duration of the "stone street" while stone-free rate at 1 year after the last treatment, recurrence rate, residual stone-growth rate and other complication rates were similar. Initial PNL followed by ESWL should be considered the efficacious treatment option, especially for patients with extensive traghorn calculi.

Aged↗
PubMed1993

[Isolated hypogastric artery aneurysm ruptured into urinary bladder: a case report].

An 81-year-old man was admitted to our hospital with a complaint of dysuria. He had had a right hypogastric aneurysm repaired three years earlier. Physical examination showed a distended soft abdomen and tender mass about the size of a child's head but no murmur was heard over the mass. An excretory urogram (DIP) showed left hydronephrosis and no excretion from the right kidney. Computerized tomography (CT) showed urinary bladder compressed by the mass on the upper right back side. Cystography showed that the large mass occupied the pelvic region with calcification and communicated with the bladder. After a few days, an operation for the aneurysm was undertaken by the surgical department. Although bilateral ureterolysis was possible, a resection of the aneurysm could not be done. The aneurysm was injected with fibrin adhesive and a bilateral nephrostomy was performed. The renal function has been stable and the size of the aneurysm has remained unchanged for 9 months after the surgery.

Aged↗
PubMed1993

[The inhibitory effects of Takusha on the formation, growth and aggregation of calcium oxalate crystals in vitro].

The inhibitory effects of Takusha on the formation, growth and aggregation of calcium oxalate crystals were estimated by the microplate method and the use of Coulter counter TAII in the diluted urine system and undiluted urine system. In the diluted urine system, the inhibitory effect on aggregation and growth was calculated from the changes in the number and volume of crystals by the seed crystal method. Takusha had a strong inhibitory effect on the aggregation and growth when the concentration was above 10 micrograms/ml. In measuring the metastable limit by the microplate method, Takusha had a mild inhibitory effect on the formation of crystals above the concentration of 1 mg/ml. In the undiluted urine system, after determining the metastable limit, the formation and growth of calcium oxalate crystals which precipitated in response to a load of sodium oxalate were measured. Takusha had a strong inhibitory effect on the formation and growth at the concentration of 0.1-1 mg/ml. Takusha had no glycosaminoglicans in the dimethylmethylene blue assay and had an inhibitory effect on aggregation and growth when its molecular weight was over 10,000. Therefore, Takusha might be useful for preventing stones in recurrent stone formers.

Calcium Oxalate↗
PubMed1993

[Renal cell carcinoma with contralateral adrenal metastasis: a case report].

A case of contralateral adrenal metastasis of renal cell carcinoma is reported. The patient was a 54-year-old male, who underwent a right radical transperitoneal nephrectomy for renal cell carcinoma, and had been administered interferon alpha intramuscularly. Nine months after the operation computerized tomography revealed the presence of an adrenal mass on the left side, undetected at nephrectomy, which suggested that the renal cell carcinoma had metastasized. A left adrenalectomy was performed. Histologically, the mass was identical to metastasis of renal cell carcinoma. The patient was administered supplementary hydrocortisone and was well 3 months after the adrenalectomy with no evidence of recurrence or other metastasis. This is the 24th case of contralateral adrenal metastasis of renal cell carcinoma in the Japanese literature.

Adrenal Gland Neoplasms↗
PubMed1991

Inhibition by sodium-potassium citrate (CG-120) of calcium oxalate crystal growth on to kidney stone fragments obtained from extracorporeal shock wave lithotripsy.

Retention of fragments within the kidney after extracorporeal shock wave lithotripsy (ESWL) continues to be a major shortcoming of this form of stone treatment. The aim of this study was to evaluate the ability of sodium-potassium citrate to inhibit calcium oxalate crystal nucleation and growth on to stone fragments remaining after ESWL. The continuous flow crystallisation technique was adapted to induce calcium oxalate crystal nucleation and growth on to the surface of fragmented kidney stones and the inhibitory effect of sodium-potassium citrate was assessed by scanning electron microscopy and by determining the relative increase in crystalline mass at final concentrations of 0, 2, 4, 6, 8, 10 mmol/l. Sodium-potassium citrate significantly inhibited the deposition of new crystalline calcium oxalate in a dose-dependent manner above 2 mmol/l; these findings were confirmed by scanning electron microscopy. It was concluded that sodium-potassium citrate may provide an effective means of preventing the formation of new kidney stones by the deposition of calcium oxalate on to residual stone fragments resulting from ESWL and that the technique used is an efficient means of testing the efficacy of therapeutic agents to prevent stone recurrence in patients treated with ESWL.

Calcium Oxalate↗
PubMed1991

[Echocardiographic assessment of the etiology of aortic regurgitation in the elderly].

We performed echocardiographic studies in 189 elderly subjects aged over 65. Aortic regurgitation (AR) was detected by real time 2-D Doppler system. 189 patients were classified into 5 groups based on the severity of AR (AR-: 81 pts, AR1+: 32 pts, AR2+: 44 pts, AR3+: 27 pts, AR4+: 5 pts). The diameter of the aortic root, the angle (theta) between the aortic wall and interventricular septum and echo intensity of aortic valve were measured by 2-D echocardiography. There was no relation between the severity of AR and angle theta. Diameters of aortic root were significantly increased in AR3+ cases as compared with AR- and AR2+. Systolic blood pressure was significantly increased in AR4+ cases as compared with AR-, AR1+, and AR2+. Diastolic blood pressure was also decreased in AR3+ cases as compared with AR-. Echo intensity of aortic valve was increased in patients with AR. It was thought that increased diameters of the aortic root in patients with severe AR were induced from the long-standing AR, and that increased systolic blood pressure and decreased diastolic blood pressure in severe AR were caused by hemodynamic changes due to AR. Therefore, we concluded that AR in the elderly was caused by degeneration and/or deformity of the aortic valve.

Aged↗
PubMed1991

[Renal carcinoma in hemodialysis patients. Specially concerned with acquired cyst].

Acquired cystic disease of the kidney (ACDK) with carcinoma in the original kidney is one sensational complication of long-term hemodialysis patients. The rate of incidence is about forty times higher than that in the general population and especially high in the young male group. From Dec. 1978 to Nov. 1990, we identified 8 patients of ACDK by computerized tomography (CT) scan, sonographic examination and angiography. Most patients had no clinical symptoms. The mean term of hemodialysis of the patients was 8 yrs. And one patient was diagnosed as having ACDK and tumor 8 yrs after kidney transplantation and then the kidney was removed. Their mean age was about 32 y.o. and the tumor size 1-3 cm in diameter. All tumors were inside the renal capsule. (Robson-1) Pathohistologically, the tumor area consisted of mainly clear cell carcinoma and the epithelium of the cyst wall showed multi-layered or papillary hyperplasia. In the 1st and 7th cases, simple nephrectomy was performed by transperitoneal approach. In the other cases it was performed by flank incision. All cases have had no recurrence and no metastasis of renal carcinoma. The etiology of ACDK and carcinoma occurrence has not been clarified yet, but it is suggested that uremic metabolite and deficiency of immuno-surveillance may cause the pathological changes in kidney tissue.

Adenocarcinoma↗