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T Ushiyama

Publications and source records attributed to T Ushiyama.

At least 19 recordsLinked to original sources
PubMed1992

[Primary tumor of the ureteral stump following nephrectomy for non-malignant disease. A case report].

Primary tumor in the ureteral stump is rare. A 66-year-old woman visited our hospital because of microscopic hematuria. She had undergone right nephrectomy for the contracted kidney 36 years ago. Intravenous pyelography and cystoscopy showed no positive findings for hematuria. But urine cytology indicated class V. The flexible ureterorenoscopy disclosed a nonpapillary sessile tumor in the ureteral stump. We also did the biopsy of the tumor under the direct vision before open surgery. The specimen showed transitional cell carcinoma, grade 3. The ureteral stump was successfully removed. The flexible ureterorenoscopy was most useful for the diagnosis in this case.

Aged↗
PubMed1992

[Percutaneous nephrostomy versus the placement of double pigtail ureteral stent for the treatment of postrenal failure secondary to malignancies].

From August 1989 through September 1991 we performed percutaneous nephrostomy under ultrasonic guidance in 26 kidneys of 25 patients. We also indwelled double pigtail ureteral stents by endoscopy in 14 kidneys of 13 patients. No patients died because of renal failure. The survival was dependent on progression of primary disease and performance status. Neither significant nor life-threatening complications were encountered. The difference in the improvement of renal function between nephrostomy group and stent group was not statistically significant. Although the indwelling ureteral stent method requires no external drainage bag, this method has certain drawback such as occasional obstruction of stent. Especially in poor risk patients, percutaneous nephrostomy technique seems to be better than placement of double pigtail ureteral stent in the treatment of postrenal failure secondary to malignancies.

Adult↗
PubMed1991

[Cyclosporine induced nephrotoxicity and juxtaglomerular apparatus in mice].

To elucidate the relationship between Cyclosporine (Cs) induced nephrotoxicity and juxtaglomerular (JG) apparatus, we carried out biochemical and morphological experiments using mice. Adult male ICR strain mice weighing about 40 g were used. The mice were divided into 2 groups: the Cs group (Cs 50 mg/kg/day was orally given for 14 consecutive days) and the control group (olive oil for 14 days). Urine was stored for 24 hours on the day 0, 7 and 14 and urine volume and concentrations of urinary creatinine (u-Cr) and urinary potassium (u-K) were measured in each group. All the mice were sacrificed and examined on the 15th day. Concentrations of serum creatinine (s-Cr), serum potassium (s-K), plasma renin activity (PRA), plasma aldosterone (Ald) were noted in each group. The kidneys were also examined histologically with light and electron microscopes. The Cs group showed significant increases of s-K, PRA and Ald and a significant decrease of creatinine clearance compared with the control group. Histologically, the Cs group demonstrated focal vacuolar changes in the proximal tubular cells and an increase in the number of granules in the JG cells. Each granule of the Cs group was larger than that of the control group. Cs certainly stimulates the renin-angiotensin-aldosterone system and causes consequently a secondary aldosteronism.

Animals↗
PubMed1991

[Clinical analysis of urinary incontinence in the institutionalized elderly].

Urinary incontinence among institutionalized elderly were analyzed from clinical and social viewpoints. The patient group included 25 males and 107 females with an average age of 78 years (ranged from 66 to 92). They had neither highly impaired performance status nor severe dementia. Forty-nine of them (37%) underwent urological examination. Urge incontinence was common among male patients, while urge, stress or mixed incontinence were prevalent in female patients. Thirty-six per cent of the patients had to use pads, diapers and others for their incontinence, while other needed no special protection for their incontinence. Incontinence caused limitation of social activity in 30% of the patients. Many causal factors were assumed for incontinence in elderly; weakness of the pelvic muscles, urinary tract infection, cerebrovascular disorders, neurological disorders and prior pelvic surgery. Prostatic carcinoma or urethral stricture caused overflow incontinence in a few patients. Diuretics or tranquilizers appeared to lead incontinence in some patients. Nine of 18 patients undergoing cystometry had overactive detrusor. Majority of the incontinent elderly showed no intention to visit clinics. Therefore, it recommended to keep staffs in elderly institutions as well as elderly themselves informed that incontinence in the elderly should be treated, which in turn improves the quality of life.

Aged↗
PubMed1991

[A questionnaire survey on micturition problems among institutionalized elderly].

Prevalence of micturition problems among 1,023 institutionalized elderly was surveyed by a questionnaire. The reply was obtained from 821 elderly (80.3%) including 276 males and 545 females with ages averaged 77 years (range 61 to 96 years). They had neither highly impaired performance status nor severe dementia. Micturition problems were complained by 38% of male responders, where micturition difficulty was the most common. On the other hand, 23% of female responders answered having micturition problems and urinary frequency was the most common. One hundred and twenty-four of total responders (15%) replied to have urinary incontinence; 8% in men and 19% in women. Over half of patients with marked objective incontinence denied its presence or refused to answer. Seventy-one per cent of the incontinent elderly had no intention to receive medical care. From the above facts, it seems that many elderly have micturition problems and the incidence of urinary incontinence is latently higher than complained at survey.

Aged↗
PubMed1991

[Cyclosporine induced nephrotoxicity and renal blood flow].

To elucidate the relationship between cyclosporine (Cs) nephrotoxicity and renal blood flow (RBF), we carried our experiments using rats. Adult male Wistar strain rats each weighing about 100 g were used. Rats were divided into 2 groups; the Cs group (Cs 50 mg/kg/day was intraperitoneally given for 10 consecutive days) and the control group (normal saline solution for 10 consecutive days). The renal cortical blood flow was measured in each group by electrolytic hydrogen gas clearance method. We also carried out renal angiography with barium sulfate (BaSO4). Then we measured blood vessel area/renal sagittal section area ratio and the diameter of interlobar arteries. The Cs group showed a significant decrease of renal cortical blood flow compared with the control group. On the other hand there was no significant change in renal angiogram. In conclusion, Cs decreased renal cortical blood flow. We suppose that vascular resistance increased following afferent arteriolopathy caused by Cs administration.

Animals↗
PubMed1990

Interleukin-1 stimulates corticotropin-releasing factor gene expression in rat hypothalamus.

To examine the effect of interleukin-1 (IL-1) on CRF and POMC gene expression, recombinant human IL-1 alpha and -beta were ip injected in rats. The plasma ACTH level showed a dose-related increase at 2 h after the injection of 0.5 and 2 micrograms IL-1 alpha and -beta, and also showed a sustained increase from 1 h until 5 h after the injection of 2 micrograms of IL-1 beta. CRF contents in the medial basal hypothalamus and ACTH contents in the anterior pituitary (AP) decreased at 2 h after the injection of 2 micrograms of IL-1 alpha and -beta, and such decreased levels were maintained until 5 h after the injection of 2 micrograms of IL-1 beta. The levels of CRF mRNA in the hypothalamus and POMC mRNA in AP significantly increased 3 h after the injection of 2 micrograms IL-1 alpha and -beta, and these levels were still higher at 5 h after the injection of 2 micrograms of IL-1 beta compared with those of the control. There was no significant change in the ACTH content and POMC mRNA levels in the intermediate-posterior pituitary or the hypothalamus or in the CRF contents and CRF mRNA levels in the cerebral cortex. These results indicate that acute administration of IL-1 alpha and -beta stimulates gene expression of hypothalamic CRF and CRF release, which causes the stimulation of ACTH release and POMC gene expression in AP.

Adrenocorticotropic Hormone↗
PubMed1990

Glucocorticoids decrease a binding of corticotropin-releasing hormone-binding protein in human plasma.

The binding of CRH-binding protein (CRH-BP) in plasma to labeled human CRH has been examined in patients with hypothalamic-pituitary-adrenal disorders. Compared with that in normal subjects, CRH-BP binding decreased in patients with Cushing's syndrome of pituitary or adrenal origin and in patients who were treated with a high dose of glucocorticoids over a long period of time. On the other hand, CRH-BP binding increased in patients with Addison's disease or hypopituitarism. In patients with Addison's disease, the high level of CRH-BP binding fell to the control level after glucocorticoid replacement. In patients with Cushing's syndrome, CRH-BP binding gradually increased and reached the higher level about 1 yr after surgery. Thereafter, it returned to the control level. There was a good negative correlation between the levels of plasma cortisol and CRH-BP binding in patients with Cushing's syndrome before and after surgery. A Scatchard analysis of CRH-BP binding in patients with Cushing's syndrome and in normal subjects showed that the binding affinity was similar in both groups, but that the number of binding sites was low in patients with Cushing's syndrome. These results suggest that in human plasma, glucocorticoids decrease CRH-BP binding. This seems to be caused by a decrease in the concentration of CRH-BP in the plasma of patients with hypercortisolemia.

Addison Disease↗
PubMed1990

[Neurogenic bladder in patients with lumbar vertebral disorders].

Bladder and urethral functions were evaluated urodynamically in 114 patients with lumbar disorders including prolapsed lumbar intervertebral disc (66 patients), lumbar canal stenosis (19 patients), lumbar spondylolysis and/or spondylolisthesis (21 patients), lumbar spondylosis deformans (5 patients) and ossification of the yellow ligament of the lumbar spine (3 patients). The patients consisted of 88 males and 26 females with an average age of 47 years (range 17 to 73 years). Symptomatic organic infravesical obstruction was excluded by physical and radiographic examination. Cystometry revealed preoperative neurogenic bladder in 23 patients (20%); normal detrusor with overactive sphincter in 2 (9%), underactive in 8 (36%), overactive in 5 (23%) and equivocal in 7 (32%). One patient not receiving cystometry revealed abnormal uroflowmetry with 140 ml residual urine. Twenty of them underwent electromyographic examination of the external sphincter and 15 (75%) had an overactive sphincter. Nine (39%) of them complained no urological symptoms. Neurogenic bladder seemed to highly associate in those having abnormal tendon reflex in the lower extremities, decreased bulbocavernosus reflex and sensory disturbance in the perineal area, but there was no statistical significance. Of twenty-three neurogenic bladder patients, eighteen underwent a lumbar vertebral operation and fifteen received postoperative urodynamic evaluation. Uroflowmetry was improved in more than half of the patients within 3 months after the operation and cystometry was normalized in 4 of 7 patients who underwent cystometry over 6 months after the operation. Preoperative overactive detrusor remained unchanged in two of three patients who underwent cystometry over 6 months after the operation.

Adolescent↗
PubMed1990

[Survival rate of bladder tumors--an analysis of 2304 patients with bladder tumors in the Tokai Urological Cancer Registry].

During the 7 years from 1980 to 1986, 2860 cases of bladder tumors were registered in the Tokai Urological Cancer Registry. Among the 2860 cases, 2304 cases were selected from the registered cases for the present study. The 5-year relative (actual) survival rates were 73.8% (61.9%) of all patients; 48.9% (42.4%) in those with malignant neoplasma of urinary bladder excluding transitional cell carcinoma; 48.8% (41/3%) in those with mixed tumor. In patients with transitional cell carcinoma, the 5-year relative (actual survival rates were 93.7% (78.8%) for G1, 87.2% (74.1%) for G2 and 47.3% (38.9%) for G3. As to staging, the 5-year survival rates were 101.9% (88.0%), 87.6% (75.3%), 57.9% (47.8%), 33.7% (28.2%) and 6.1% (5.0%) in patients with stage of Ta, T1, T2, T3 and T4, respectively. The tumors with muscle infiltration and high grade malignancy obviously deteriorated patients' survival. The 5-year relative (actual) survival rate for patients treated with TUR was 98.1% (82.2%). As to grading, the 5-year survival rates were 102.2% (86.6%) for G1, 104.3% (88.3%) for G2 and 56.9% (48.3%) for G3. The 5-year survival rates of those with Ta, T1 and T2 were 103.9% (89.7%), 96.0% (82.6) and 61.1% (49.1%), respectively. The 5-year relative (actual) survival rate for patients undergoing total cystectomy was 62.4% (52.3%). In those patients, the 5-year survival rates were 96.7% (80.9%) for G1, 63.6% (55.7%) for G2 and 55.4% (47.1%) for G3. As to staging, the 5-year survival rates were 102.3% (90.6%), 77.8% (68.2%), 56.3% (47.9%), 41.8% (34.9%) and 15.2% (13.1%) in patients with stage of Ta, T1, T2, T3 and T4, respectively. The 3 and 5-year relative (actual) survival rates in patients with advanced bladder tumors were 5.3% (4.8%) and 0.87% (0.73%), respectively.

Adolescent↗
PubMed1989

Corticotropin-releasing factor-binding protein is a glycoprotein.

Human corticotropin-releasing factor-binding protein (hCRF-BP), a 38,000 dalton protein, specifically binds hCRF in plasma. CRF-BP-CRF complex adsorbed to concanavalin-A-Sepharose and its Mr decreased after treatment with endoglycosidase H or glycopeptidase A. The binding of CRF-BP to CRF decreased after treatment with endoglycosidase H. These results indicate that the CRF-BP is a glycoprotein that contains asparagine N-linked-type oligosaccharides, and such oligosaccharide chains are important for CRF-BP binding.

Carrier Proteins↗
PubMed1989

Effects of protein kinase-C-related adrenocorticotropin secretagogues and interleukin-1 on proopiomelanocortin gene expression in rat anterior pituitary cells.

To examine the effects of the cAMP-independent protein kinase-C system and interleukin-1 (IL-1) on secretion of ACTH and POMC gene expression in cultured rat anterior pituitary (AP) cells, AP cells were incubated with CRF, 8-bromo-cAMP, arginine vasopressin, angiotensin II, norepinephrine, and phorbol 12-myristate 13-acetate. After 15 h of incubation, CRF and 8-bromo-cAMP increased both ACTH release and the POMC mRNA level. Arginine vasopressin, angiotensin II, norepinephrine, or phorbol 12-myristate 13-acetate stimulated ACTH release but failed to increase basal or CRF-stimulated POMC mRNA levels. Human recombinant IL-1 alpha and -beta increased neither ACTH release nor POMC mRNA levels after 3 h of incubation. After 15 h of incubation, 100 pM to 10 nM IL-1 alpha and -beta increased ACTH release. However, POMC mRNA levels were significantly elevated only by 10 pM IL-1 beta. These results suggest that the CRF-cAMP system plays a major role in both ACTH release and expression of the POMC gene in AP cells, but the cAMP-independent protein kinase-C system contributes only to ACTH release; that acute stimulation of ACTH release from AP with IL-1 administration is not due to direct action of IL-1 at the pituitary level; that chronic exposure of AP cells to IL-1 alpha or -beta can stimulate ACTH release; and that the direct effects of IL-1 alpha and -beta on POMC gene expression, if any, seem to be minimal.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1989

Adrenergic modulation of adrenocorticotropin responses to insulin-induced hypoglycemia and corticotropin-releasing hormone.

To study possible adrenergic modulation of pituitary-adrenal responses to insulin-induced hypoglycemia and CRH we examined the effect of nonselective alpha-blockade (phentolamine) and nonselective beta-blockade (propranolol) on plasma ACTH, cortisol, and vasopressin (AVP) responses to hypoglycemia and CRH in five normal men. Infusion of propranolol or phentolamine did not alter basal plasma ACTH or cortisol levels. The propranolol infusion enhanced the stimulatory effect of hypoglycemia on ACTH, cortisol, and AVP secretion and also enhanced the stimulatory effect of CRH on ACTH and cortisol secretion. Infusion of phentolamine inhibited hypoglycemia-induced ACTH and AVP secretion, but had no effect on the stimulatory effect of CRH on ACTH and cortisol secretion. The increments of plasma ACTH and cortisol induced by an almost maximal dose of CRH (1 microgram/kg) were smaller than those induced by hypoglycemia. The propranolol-induced enhancement of the ACTH response to hypoglycemia was almost the same as the ACTH response to CRH alone. From these results we conclude that propranolol may act at the pituitary level to enhance CRH action, rather than AVP action, and that the ACTH response to hypoglycemia may be mediated by hypothalamic alpha-adrenergic activation.

Adrenocorticotropic Hormone↗
PubMed1989

Responses to corticotropin-releasing hormone and its bound and free forms in pregnant and nonpregnant women.

Plasma CRH levels are considerably higher in women during the third trimester of pregnancy than in non-pregnant women. Most of plasma CRH in pregnant women is bound to CRH-binding protein (CRH-BP). To gain further insight into CRH physiology during pregnancy, we measured the responses of plasma ACTH and cortisol and the changes in bound and free forms of CRH in plasma after human CRH administration (2 micrograms/kg) in five pregnant (39-40 weeks of pregnancy) and five nonpregnant women. The mean basal plasma ACTH and cortisol levels in the pregnant women were higher than those in the nonpregnant women. However, the maximum increments in plasma ACTH and cortisol levels and the integrated ACTH and cortisol responses, after subtraction of the basal levels after CRH administration, were similar in the two groups. The plasma CRH half-time in the pregnant group was similar to that in the nonpregnant group. The mean basal plasma CRH level in the nonpregnant women was 1.5 +/- 0.2 (+/- SE) pmol/L, and that in the pregnant women was 360 +/- 35 pmol/L. On gel filtration chromatography, almost all of the CRH in the plasma was protein bound (320 +/- 30 pmol/L) in the pregnant women; no CRH peaks were detected in nonpregnant women because of the low plasma CRH levels. After CRH administration, the level of the bound form of plasma CRH was highest at 5 min, and then declined to a plateau at 15 min and 30 min in the pregnant women. In the nonpregnant women, protein-bound CRH also was highest at 5 min, but it progressively declined thereafter. The disappearance rate of the bound CRH in plasma from the nonpregnant women was similar to that of the second compartment of the plasma decay curves of the free CRH from both groups. We conclude that the plasma ACTH and cortisol responses to exogenous CRH are similar in pregnant and nonpregnant women, the effect of CRH-BP on the disappearance of plasma CRH is minimal, and plasma CRH-BP in pregnant women has the capacity to bind additional CRH.

Adrenocorticotropic Hormone↗
PubMed1989

[Results of the treatment of prostatic cancer].

Two hundred and twenty patients with prostatic cancer were treated in our clinic during the past ten years between April, 1977 and March, 1987. The age distribution was from 45 to 91 years old and more than half of patients were in seventies. Stages A, B, C and D were 3.5%, 19.7%, 21.2% and 55.6%, respectively. Hormonal therapy was given in 175 cases (79.5%) as an initial treatment. The first therapy showed effectiveness in 181 (83.8%) of 216 cases; in 153 (87.4%) of 175 cases treated by hormonal therapy. Reactivation after the initial treatment was observed in 59 (32.6%) of 181 cases; in 48 (31.4%) of 153 cases treated by hormonal therapy. The interval between the start of treatment and reactivation for the stage D was significantly shorter than that for the other stages. Elevation of serum alkaline-phosphatase levels, accelerated erythrocyte sedimentation rate and hydronephrosis were significant risk factors for reactivation. Of the 220 cases, 51 (23.2%) died of advanced cancer. The overall 5-year survival rate was 41.2%. High grade and high stage were significantly related to the poor prognosis. In our studies, as hormonal therapy, maintenance on 100 mg of diethylstilbestrol diphosphate daily was found effective for the treatment of prostatic cancer.

Adenocarcinoma↗
PubMed1989

[Pressure-flow study after percutaneous nephrolithotripsy].

In 46 patients treated with PNL in our hospital, the intervals from PNL to removal of a catheter indwelled in the nephrostomy were studied. The intervals were longer in the cases with ureteral stones than those with renal stones probably because of the different degrees of obstruction. To investigate the degree and the interval of upper urinary tract obstruction after PNL, Pressure-flow Studies were performed every or every other day after PNL in 5 cases with renal stones and 5 cases with ureteral stones, selected from 46 cases. In Pressure-flow Studies, intrapelvic pressures were measured while saline mixed with pigment was being dripping at a rate of 5 ml/min into the renal pelvis through the nephrostomy catheter. Saline initially reached into the urinary bladder at an average of 4.8 days after PNL (range 3 to 7 days) with a mean intrapelvic pressure of 37.6 cmH2O (range 28 to 52 cmH2O) in the cases with renal stones and at an average of 9.2 days (range 7 to 12 days) with a mean intrapelvic pressure of 27.0 cmH2O (range 9 to 43 cmH2O) in the cases with ureteral stones. Pressure-flow Studies were performed again a few days after the initial passage of saline into the urinary bladder in 2 of 10 cases. The intrapelvic pressures, 16 cmH2O and 13 cmH2O, respectively, several days after the initial passage of saline were lower than those, 35 cmH2O and 43 cmH2O, respectively, at the initial passage of saline. Therefore, it was likely that the proper interval of indwelling catheter after PNL was about 7 to 8 days, in the cases with renal stones and about 11 to 12 days in the cases with ureteral stones.

Adolescent↗