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Biomedical subjects

T Machida

Publications and source records attributed to T Machida.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Three cases with pelvic dead space infection after total cystectomy caused by methicillin-resistant Staphylococcus aureus (MRSA)--local injection of vancomycin].

We recently had three patients with pelvic dead space infection caused by methicillin-resistant Staphylococcus aureus (MRSA) after total cystectomy for urothelial cancer. All were male and aged from 67 to 74 years old. As for underlying diseases, two of them had bladder cancer and one of them had bladder cancer and right ureteral cancer. Total cystectomy and ileal conduit were performed for two patients with bladder cancer, and total cystectomy, nephroureterectomy and ureterocutaneoustomy were performed for a patient with bladder cancer and ureteral cancer. Pelvic dead space infections caused by MRSA appeared after 15-30 days postoperatively. All patients were cured after we locally administered 0.5 g of vancomycin twice a day for 10-11 days from the drains to the pelvic dead spaces. All patients had preoperative antitumor chemotherapy and the postoperative administrations of beta-lactams in common. From these results, we suggest that local administration of vancomycin is effective for the pelvic dead space infection caused by MRSA after total cystectomy.

Aged↗
PubMed1993

Selective venous sampling directly from cavernous sinus in Cushing's syndrome.

Using superselective catheterization technique, venous sampling directly from the cavernous sinus was performed in seven patients with Cushing's disease and one patient with ectopic ACTH secreting tumor. In Cushing's disease the central/peripheral (c/p) gradients of ACTH in the cavernous sinus (11.9-111.1; mean, 49.6) were much greater than those in the inferior petrosal sinus (1.0-52.0; mean, 14.0). The intercavernous gradients of ACTH provided correct lateralization in all patients but one who had a midline tumor. A patient with ectopic ACTH secreting tumor showed no gradients of ACTH both in the cavernous sinus and in the inferior petrosal sinus. The c/p gradients of PRL were smaller than those of ACTH in the cavernous sinus, inferior petrosal sinus, and jugular vein. The gradients of ACTH and PRL essentially indicated the same laterality in Cushing's disease, whereas the intersinus gradient of PRL provided a false laterality in two patients with a midline tumor. No complications have been observed during and after the sampling procedure. Thus, we conclude that 1) the selective sampling directly from the cavernous sinus offers sufficient c/p gradients (more than 10) for the reliable diagnosis of Cushing's disease, 2) CRH stimulation during the sampling and the simultaneous measurement of PRL are not necessary in this method, 3) the high concentration of pituitary hormones obtained by this sampling may be useful for other clinical investigations.

Adrenocorticotropic Hormone↗
PubMed1993

Cryopreservation of expanded mouse blastocysts by vitrification in ethylene glycol-based solutions.

Experiments were conducted to find optimal conditions for obtaining high survival of expanded mouse blastocysts after vitrification. The vitrification solutions used were designated EFS20, EFS30 and EFS40, and contained 20%, 30% and 40% ethylene glycol, respectively, diluted in PB1 medium containing 30% Ficoll plus 0.5 mol sucrose l-1. In the toxicity test of the solutions and each cryoprotectant, ethylene glycol was found to be toxic to embryos. For vitrification, expanded blastocysts were exposed to the vitrification solutions at 10, 20 or 25 degrees C for various periods; they were then cooled rapidly in liquid nitrogen, after which they were warmed rapidly. When the embryos were directly exposed to EFS40 at 20 degrees C for 2 min before vitrification, 66% of them re-expanded during 48 h of post-warming culture. The re-expansion rates decreased when exposure time was shortened (0.5 min), when exposure temperature was lowered (10 degrees C), or when embryos were vitrified in EFS20 and EFS30, although these conditions should be less toxic. When embryos had been pretreated in a dilute (10-20%) ethylene glycol solution for 5 min, followed by short exposure (0.5 min) to EFS40 at 20 degrees C, post-vitrification survival rate increased to 83-84%; furthermore, the rate reached 94% when the temperature was increased to 25 degrees C. Expanded blastocysts cryopreserved by this two-step method developed into live young as well as control embryos after transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

[Evaluation of prognostic factors in patients with stage 1 renal cell carcinoma].

During the past thirty-five years, we treated 221 patients with stage 1 renal cell carcinoma. We classified these patients into two groups: 175 patients who did not show recurrence and 45 patients who showed recurrence (excluding one patient who died of other disease). We investigated factors which affect the recurrence after nephrectomy and the survival after recurrence in these two groups. We found two major factors such as tumor diameter and tumor grade which affected the recurrence of renal cell carcinoma. Of these two factors, the grade of malignancy affected the prognosis of the patients with stage 1. Furthermore, as a result of long-term observation, we found that patients with grade I showed good prognosis compared with these with grade II, III and IV. The patients who showed weight loss constituted the majority of recurrent patients. Anaemia, erythrocyte sedimentation rate and positive reaction of C-reactive protein in addition to weight loss were major factors affecting the prognosis of stage 1 patients. In an effort to analysing the features of recurrent patients, there observed that no significant difference of the non-recurrent rate was detected between the patients who showed cancer death after nephrectomy and the patients who were living after nephrectomy. In analysing metastatic lesions and numbers of metastatic foci, we detected relatively long-term survival especially in patients with less than 3 foci of metastases in the lung, compared to those with multiple foci. Furthermore, we found dimension of the metastasis depended on the grade of the primary lesion.

Adult↗
PubMed1993

[Clinical evaluation of a new kit (IMX PA Dainapack) for detection of serum prostate specific antigen].

A study of the clinical utility of the IMx PA Dainapack, a new kit for detection of serum prostate specific antigen (PSA) by a fully automated enzyme immunoassay (EIA) system, was conducted. Results concerning reproducibility, dilution linearity and sensitivity were good. The excellent assay performance of this kit, particularly in terms of its high sensitivity (0.1 ng/ml), was confirmed. The upper limit of normal was determined to be 4.0 ng/ml from the mean +/- 3 S.D. (3.79 ng/ml) in healthy male controls (n = 244). Using 4.0 ng/ml as the upper limit of normal, 6 of 244 healthy male controls (2%) were positive. In various urinary diseases, 173 of 192 prostatic cancer (90%) and 46 of 112 benign prostatic hypertrophy (BPH) (41%) cases were positive. In prostatic cancer, the positive rates increased with the advance in clinical stage and in stage A the positive rate was especially high (8 of 12 (67%) were positive). On the other hand, using the BPH group as a negative control, the maximum accuracy rate for prostatic cancer had a cut-off value of 8.0 ng/ml. Thus, 8.0 ng/ml is an appropriate cut-off value differentiating prostatic cancer from BPH while 4.0 ng/ml is the cut-off value between the normal group and those with prostatic cancer (including stage A) and BPH. In the follow-up patients with prostatic cancer, serum PSA values measured by this kit reflected the effectiveness of treatment. The correlations between values obtained with the IMx PA Dainapack and 6 current kits were good (r = 0.93 to 0.99) but the values differed with the kit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Differential effects of right-sided and left-sided orchidectomy on lateral asymmetry of LHRH cells in the mouse brain.

Luteinizing hormone-releasing hormone (LHRH) immunoreactive cells were found to be more numerous in the right side of the brain than in the left in male mice. Bilateral orchidectomy or removal of the right testis decreased the number of LHRH cells, while removal of the left testis failed to cause any changes in the number of LHRH cells. The results indicated a clear left-right difference in the neuroendocrine regulation of gonadal function in male mice.

Animals↗
PubMed1992

The 4th study of prophylactic intravesical chemotherapy with adriamycin in the treatment of superficial bladder cancer: the experience of the Japanese Urological Cancer Research Group for Adriamycin.

A multicentric randomised trial was conducted for the purpose of investigating the efficacy of intravesical chemoprophylaxis of superficial bladder cancers. A total of 443 patients (number of evaluable patients, 284) were registered from July 1987 to December 1989 and randomised into 3 groups. Group A received 21 intravesical instillations of Adriamycin (ADM) at 20 mg/40 ml physiological saline for 2 years after undergoing transurethral resection (TUR); group B was given the same dose as group A but received 6 intravesical instillations for 2 weeks before undergoing TUR; and group C served as a control and underwent TUR only. Better prophylactic effects were obtained in group A. The overall non-recurrence rates calculated for groups A and B differed significantly (P less than 0.05) on day 240, and those determined for groups A and C were also significantly different (P less than 0.01) on day 480. No benefit was obtained using intravesical instillation prior to TUR (group B). The major side effects encountered were pollakisuria and miction pain, which occurred in 32% of the patients in group A and in 52% of those in group B.

Administration, Intravesical↗
PubMed1992

Long-term results of intravesical chemoprophylaxis of superficial bladder cancer: experience of the Japanese Urological Cancer Research Group for Adriamycin.

Long-term results were analyzed in terms of tumor progression and survival in patients with superficial bladder cancer who were enrolled in the second intravesical chemoprophylactic study of the Japanese Urological Cancer Research Group for Adriamycin, which was started in July 1982. This study was a prospective, randomized, controlled trial conducted on primary tumors treated with a long-term instillation regimen that involved control versus intravesical instillations of Adriamycin or mitomycin C given once a week for the first 2 weeks, once every other week for 14 weeks, once a month for 8 months, and once every 3 months for 1 year, for a total of 21 instillations in 2 years. An analysis of the prophylactic effects of such treatment on bladder tumors after TUR has previously been performed, and the results have been published elsewhere. The present study represents a follow-up of the above trial. Of the 671 cases previously analyzed with regard to tumor prophylaxis, 158 cases (23.5%) were eligible to be followed for tumor progression and survival. A detailed comparison of the background factors between these 158 patients and the other 513 cases revealed no statistically significant difference. Thus, the 158 evaluable cases might reasonably be considered to represent all patients enrolled in the second study, and the results were thought to be reasonable enough to reflect the long-term efficacy of the long-term instillation regimen adopted in this study. The median follow-up for these 158 cases was 6.6 years. Tumor progression in terms of the disease stage and/or grade occurred in 43 of 127 patients who received prophylactic instillations and in 12 of 31 control cases. No significant difference in the incidence of tumor progression was found between the treatment and the control groups. In addition, no difference in survival was observed between the treatment group and the control group. Survival was also compared between patients who showed tumor progression and those who did not. All patients whose tumors did not progress survived, whereas the 7-year survival of those exhibiting tumor progression was less than 90%.

Actuarial Analysis↗
PubMed1992

Evaluation of systemic chemotherapy with methotrexate, vinblastine, adriamycin, and cisplatin for advanced bladder cancer. The Japanese Urological Cancer Research Group for Adriamycin.

In a cooperative study of the Japanese Urological Cancer Research Group for Adriamycin, the usefulness of chemotherapy with methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC therapy) in treating advanced or recurrent bladder cancer was examined. Evaluation of the clinical responses obtained in 86 evaluable patients revealed 13 complete responses, 29 partial responses, 4 minor responses, 19 cases of no change, and 21 cases of progressive disease. The overall response rate was 48.8% (42/86). The rate of response to M-VAC therapy at each disease site was as low as 21.4% (3/14) in bone lesions but exceeded 40% in the primary lesion, the lymph nodes, the lung, the liver, and other lesions. The clinical response to M-VAC therapy was not significantly influenced by the performance status of the patients, the dose intensity, or previous therapy. The median duration of response for the 42 responders was 22.7 weeks (range, 8.1-134.1 weeks), and the median duration of survival for the 86 evaluable patients was 9.8 months. Side effects were frequently encountered; the patients experienced anorexia, nausea, vomiting, malaise, alopecia, and leukopenia, but all of these symptoms were tolerable.

Adult↗
PubMed1992

Prognostic significance of location of lymph node metastases in colorectal cancer.

The prognostic value of stage of lymph node metastases was evaluated in 357 patients who underwent curative resection for colorectal cancer. Subdivision of Dukes C patients according to the number of positive nodes revealed that the five-year disease-free survival rate (5DFS) was 63 percent in the patients with one to three nodes and 53 percent in those with four or more nodes (not significantly different). Classification according to the location revealed that 5DFS was 70 percent in those who had only local node metastases (n1+), compared with 40 percent in those who had distant node metastases along the major vessels (n2+) (P < 0.001). Twelve of 38 n2+ patients had only one distant node metastasis with no local node involvement (skip metastasis). They had lower 5DFS than the n1+ patients who had three or more positive local nodes (35 percent vs. 57 percent). We conclude that the location, rather than the number, of nodal metastases has a higher impact on prognosis in colorectal cancer patients.

Colorectal Neoplasms↗
PubMed1992

High survival of rabbit morulae after vitrification in an ethylene glycol-based solution by a simple method.

Rabbit morulae were exposed to a vitrification solution-modified PBS [PB1] medium containing 40% ethylene glycol + 18% Ficoll + 0.3 M sucrose (EFS) for 2, 5, or 10 min at 20 degrees C and were vitrified in liquid nitrogen. When morulae were rapidly warmed, 96% had an intact zona pellucida. When embryos were cultured after removal of the mucin coat, high proportions of them formed blastocoel (79-100%), but the percentage of embryos developed to fully expanded blastocysts decreased with increased exposure time 87%, 40%, and 17%). The survival rate of morulae vitrified after removal of the mucin coat was lower than that of mucin-intact embryos. To assess the development potential in vivo, 131 embryos were vitrified after 2 min of exposure to EFS solution; all the embryos were recovered and 120 were transferred to recipients without removal of the mucin coat, resulting in 78 (65%) full-term fetuses or young. This simple method, which yields high survival both in vitro and in vivo, will be of practical use for vitrifying rabbit embryos.

Animals↗
PubMed1992

Survival of mouse morulae vitrified in an ethylene glycol-based solution after exposure to the solution at various temperatures.

Mouse morulae were exposed in one step to a vitrification solution (EFS, a modified PBS containing 40% ethylene glycol, 18% Ficoll, and 0.3-M sucrose) at various temperatures, then cooled rapidly in liquid nitrogen, and then warmed rapidly. All of the embryos exposed to the EFS solution for 0.5 min at 25 degrees C before vitrification developed in culture. However, survival rates were lower if the duration of exposure was prolonged to 2, 5, or 10 min. At lower ambient temperatures (20, 10, and 5 degrees C), high survival rates were associated with longer exposure to the EFS solution. The toxicity of the EFS solution was also lower at lower temperatures. The toxic injury of morulae was manifested as decompaction of the blastomeres. Among the three additives in the EFS solution, ethylene glycol, which can cross cell membranes, was responsible for the toxicity. The results show that the optimum time for exposure of the embryos to the EFS solution before rapid cooling varies with the ambient temperature, i.e., 0.5 min at 25 degrees C, 0.5-5 min at 20 degrees C, 2-5 min at 10 degrees C, and 2-10 min at 5 degrees C. If they are exposed for an optimum period, almost all mouse morulae can survive vitrification (94-100%).

Animals↗
PubMed1992

Effects of amiloride on distal renal tubule sodium and calcium absorption: dependence on luminal pH.

The goal of our study was to examine the effects of amiloride on distal renal tubule calcium and sodium absorption at low and high luminal pH. In vivo microperfusion of distal convoluted tubules were performed on rats. Total Ca and Na concentrations in perfusion and collected fluids were measured by atomic absorption spectrometry. When tubules were perfused with low pH perfusate (pH = 5.6), net calcium absorption (JCa) averaged 5.4 pmol/min. With high pH perfusate (pH = 7.1), JCa was significantly higher averaging 8.9 pmol/min. (P less than 0.01). In contrast, net sodium absorption (JNa) was not affected by luminal pH (231 pmol/min. versus 237 pmol/min.). At low luminal pH, 10(-4) M amiloride analogue (5-N-methyl-N-isobutyl amiloride) (MIA) inhibited sodium absorption but stimulated calcium absorption. At high luminal pH MIA still inhibited Na absorption but it had no effect on calcium absorption. Thus, the natriuretic effect of amiloride appears to be independent of luminal pH, while the amiloride-stimulated distal calcium absorption is observed at low but not at high luminal pH.

Absorption↗
PubMed1992

[Single-dose treatment of tosufloxacin (TFLX) for acute uncomplicated cystitis].

The effectiveness of a single 300-mg dose of tosufloxacin and of 3-day treatment with tosufloxacin (300 mg daily) were compared in a prospective trial in order to clarify the cost-effectiveness of tosufloxacin for acute uncomplicated cystitis. Fifty female patients (25 patients of each group) with acute uncomplicated cystitis received one of these treatment regimens, and the clinical data and follow-up culture results were analyzed. The effectiveness rates of single-dose treatment and 3-day treatment after 3 days were 100% and 96%, respectively. The recurrence rates of single-dose treatment and 3-day treatment after 14 or 28 days were 0% (0/13 patients) and 15% (2/13 patients), respectively. There was no significant difference in the effectiveness rate and the recurrence rate between these two groups, statistically. All isolated strains were eliminated in both regimens. From these results, it is suggested that single-dose treatment of tosufloxacin is effective enough for acute uncomplicated cystitis.

4-Quinolones↗
PubMed1992

Alterations of gluconeogenesis by ischemic renal injury in rats.

This study was designed to determine changes in one metabolic function, gluconeogenesis (GLG), after ischemic renal injury. Tubule suspensions were prepared by collagenase treatment of SD rat kidneys on 1, 3, and 7 days after left renal artery and vein occlusion for 0-90 min and incubated in Krebs-Henseleit buffer with or without 2 mM pyruvate or malate aerobically. Glucose contents were assayed photometrically. On days 1 and 3 after ischemia for longer than 60 min, serum creatinine levels rose significantly. The tendency of increase of GLG was observed on days 1 and 3 after 10-60 min of ischemia. GLG increased significantly on day 1 after 30-min ischemia. On the other hand, GLG decreased significantly on day 1 after 90-min treatment. Morphologic damage was limited to the corticomedullary region on days 1 and 3 after ischemic times of 30 and 60 min. These results suggest that renal GLG is stimulated to supply energy for ATP decrease by ischemia and for further regeneration in extraproximal segments along the nephron.

Acute Kidney Injury↗
PubMed1992

[Analysis of tumor volume in latent prostatic carcinoma].

An assessment has been made of the histopathological characteristics of latent prostatic carcinoma and the tumor volume in 500 male Japanese patients who underwent dissection at The Jikei University since 1983. A microscopic observation was made of the prostatic glands extirpated totally at the necropsy, fixed with formalin and prepared as a step-section in a thickness of 3 mm. In the cases of latent carcinoma, after photographing the lesion in the same magnification and measuring the area of the carcinoma lesion with a digitizer, the volume was calculated by multiplying the thickness of 3 mm, and carcinoma volume was determined by integrating the value of each slice and adjusted by a conversion formula. The incidence of latent carcinoma was 104 cases out of 500 (22%). The incidence increased as the age layer becomes higher, and latent carcinoma was observed in 44% of the patients aged 80 and above. Complication of latent carcinoma with prostatic hyperplasia was presumed to be an independent phenomenon in so far as it is seen from the statistical aspect. The patients were classified histopathologically into well-differentiated type (64%), mixed type (27%) and poorly-differentiated type (9%), showing high incidence in the low-aged layer of well-differentiated lesions and in the high-aged layer of mixed type lesions and in the high-aged layer of mixed type lesions. The average tumor volume of latent carcinoma was so small as 231 mm3, but many of the lesions in the cases of well-differentiated type were small, being on average 103.9 mm3, but many of the lesions in the cases of poorly-differentiated type were large, being on average 642.2 mm3. Statistically, with a tumor size of 200 mm3 as the boundary, a difference was observed in the distribution of histological constitution between the group with smaller lesions and the group with larger lesions. As an application of this result to the clinical carcinoma of stage A, the value of volume of 200 mm3 was considered to be important as a diagnostic criterion in deciding the necessity of treatment.

Adenocarcinoma↗
PubMed1992

[Small cell carcinoma of urinary bladder. A case report].

A 57-year-old male patient was admitted because of a severe lumbar pain and gross hematuria. The rectal examination revealed a fist-sized soft tissue mass in the small pelvic space. A huge non-papillary tumor, which occupied the intravesical space, was found on cystoscopic examination. CEA IAP, TPA, CA19-9 and NSE were abnormally elevated in the serum. The pelvic CT scan shown an enormous polypoid tumor arising from the anterior vesical wall, while no abnormal lesion was found in the head, neck, chest and abdominal CT scans. The bone scintigraphy revealed multiple abnormal accumulations. The transurethral biopsy of the tumor was carried out. The pathological examination revealed homogeneous and small tumor cells arranged in sheet and solid patterns, which were positive for the anti-NSE stain and anti-NF stain, but negative for Grimelius stain. The final diagnosis was small cell undifferentiated carcinoma of the urinary bladder. The patient died of cancer five months after diagnosis.

Carcinoma, Small Cell↗