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Biomedical subjects

A Imagawa

Publications and source records attributed to A Imagawa.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Study of recombinant human erythropoietin treatment on the anemia of predialysis patients].

We conducted a multiple-center joint study on the effects of recombinant human erythropoietin (rEPO) for predialysis patients. rEPO was intravenously administered to 42 predialysis patients (13 males and 29 females) with hematocrit (Ht) levels of less than 30%. The subjects were divided into group A (28 cases) in which rEPO was administered twice a week, and group B (14 cases) with rEPO administration once a week. The initial administration dosage was 6000IU/week. The Ht levels were 22.6 +/- 3.3% for group A and 23.2 +/- 2.7% for group B before the administration of rEPO, and increased to 31.0 +/- 4.0% and 27.7 +/- 3.7% respectively twelve weeks after initiating administration. The levels of effective improvement on anemia included 'markedly effective' in 17 cases (80.9%) and 'effective' in 2 cases (9.5%) in group A, and 'markedly effective' in 5 cases (41.7%) and 'effective' in 3 cases (25.0%) in group B. No significant change was seen in serum creatinine (Cr) levels during the study period. In the evaluation of renal function by reciprocal serum creatinine (1/Cr), a consistent tendency was not recognized; thus, suggesting that the rEPO administration had no effect on the renal function. No variation of blood pressure was seen. As far as side effects were concerned, headache and heavy headedness were recognized in four cases. There were, however, no cases in which the severity of the side effects dictated the discontinuation of the rEPO administration. In conclusion, rEPO was judged to be a safe and effective treatment for the anemia of predialysis patients.

Adult↗
PubMed1992

Study of factors related to hypotension in hemodialysis patients.

The factors related to hypotension in hemodialysis patients were evaluated. The subjects consisted of 120 hemodialysis patients (61 males and 59 females), whose ages ranged between 28 and 82 years, and who had undergone hemodialysis treatment for a period ranging between 3 and 201 months. They were divided into three groups: Group A, 53 normotensive patients; Group B, 52 patients with hypotension during hemodialysis; and Group C, 15 patients with constant hypotension. The evaluated factors were age, sex, etiology of renal failure, hemodialysis term, ultrafiltered volume, responsiveness to vasopressor drugs, Cr, Na, Ht, TP, cardiothoracic ratio, presence or absence of heart disease, and microvibration pattern. Statistical analysis was performed using multivariate analysis (Quantification II and IV methods). The results of the Quantification IV method indicated that Groups A and B were similar but Group C was quite different from the other two groups. The results of the Quantification II method indicated that the most important factor which characterized the difference between Group A and Group C was the responsiveness to vasopressor drugs, and the most important factor in the difference between Group B and Group C was the microvibration pattern. Group B was characterized by abnormal microvibration patterns and Group C was characterized by a low responsiveness of the peripheral vessels to vasopressor drugs. We conclude that the hypotension during hemodialysis was caused predominantly by dysfunction of the autonomic nervous system, while the constant hypotension was caused predominantly by a deterioration of constriction of the peripheral vessels.

Adult↗
PubMed1991

[The meanings of the papaverine test].

Intracavernous administration of papaverine is now commonly employed for diagnosis and therapy of impotence. To assess the pharmacokinetics of papaverine, we recorded its concentration in peripheral blood and also in cavernous blood after intravenous and intracavernous injection of 40 mg of papaverine. Peripheral blood was sampled serially after injection. Plasma was immediately extracted and then kept at at -40 degrees C until analysis. High pressure liquid chromatography was used to record the concentration of papaverine. The maximum serum concentration of papaverine measured after intracavernous injection was 7.7 ng/ml, which was considerably lower than the average serum concentration of 24.0 ng/ml after intravenous injection. Peak serum concentration was reached 1 min after intravenous injection and 10 min after intracavernous injection. It is clear that the corpus cavernosum constitutes a separate pharmacokinetic compartment. Therefore there was no significant difference between the papaverine concentration in peripheral blood of patients who showed full erection after intracavernous injection and that of patients who did not achieve erection. The concentration of papaverine in the intracavernous blood of a fully erected penis was only about 1 microgram/ml after 20 min. This concentration is similar to that in cavernous blood of those who showed excessively persistent erection. Our results imply that papaverine administered into the cavernous space relaxes smooth muscle, and is then washed out to general circulation, and the concentration in the cavernous space reaches a low level of about 1 microgram/ml. The low concentration level is maintained for several hours during erection. Therefore, we presume that papaverine acts on both the inflow system and smooth muscle of cavernous tissue in the phase of producing erections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Multivariate analysis of prognostic factors in patients with prostatic cancer].

A multivariate statistical analysis of 9 potential prognostic factors was made, using data gathered on 107 patients admitted between 1975 and 1987. After each variable was assessed separately for its prognostic importance by means of univariate analysis, a multivariate analysis using Cox's proportional hazards regression model and multivariate logistic model was done. These tests identified Gleason's score as the most important factor for all patients followed by M category and alkaline phosphatase (ALP), while Gleason's score alkaline phosphatase and age at diagnosis were most important for stage D patients. For short-term survival, the significant prognostic factors were Gleason's score and M category while for long term survival they were Gleason's score and age. T. category, stage, acid phosphatase, prostatic acid phosphatase, and treatment were found to be significantly related to survival time when examined individually; they were not found to be significant in the multivariate analysis.

Age Factors↗
PubMed1991

Acute tubulointerstitial nephritis associated with Yersinia pseudotuberculosis infection.

Two siblings infected with Yersinia pseudotuberculosis suffered from acute renal failure about 2 weeks after the onset of the disease. Renal histology in both siblings showed acute tubulointerstitial nephritis. Yersinia pseudotuberculosis type VB was isolated from feces of one of them, antibodies to Yersinia pseudotuberculosis type VB in their sera were elevated. The results of the present study suggest that acute renal failure complicating infections with Yersinia pseudotuberculosis is due to acute tubulointerstitial nephritis.

Acute Kidney Injury↗
PubMed1990

Scleroderma renal crisis in progressive systemic sclerosis: a case report.

We report a case of progressive systemic sclerosis with scleroderma renal crisis 10 years after onset. The patient (female) had progressive renal dysfunction, hypertension which was difficult to control, and massive gastrointestinal bleeding. An angiotensin converting enzyme inhibitor (enalapril) could not control her hypertension. Only intravenous nicardipine had a slight effect on her hypertension. Hemodialysis and plasma exchange, did not reverse the renal crisis, and the patient died. Microscopic examination of her kidney showed thickening of the capillary walls and mild nephrosclerosis.

Acute Kidney Injury↗
PubMed1990

[Ligation of the crura penis: surgical treatment for venous impotence].

Recently it has become clear that venous impotents account for a high percentage of all impotents. In venous impotents a decrease in outflow resistance is seen. We have aggressively performed operations on venous impotents to produce artificial outflow resistance. In this study, we performed ligations of the crura penis in 6 venous impotents. Five patients recovered from erectile dysfunction and 1 patient showed papaverine-induced full erection. There were few severe complications and the duration of operation was very short. This operation is thought to be a simple and effective treatment for venous impotence.

Adult↗
PubMed1989

Effect of moxisylyte hydrochloride on isolated human penile corpus cavernosum tissue.

The effect of moxisylyte hydrochloride on isolated human penile corpus cavernosum tissue was investigated and compared with other a-adrenergic antagonists. Moxisylyte produced a concentration-dependent relaxation of a norepinephrine-induced (1 x 10(-5) M) contraction of the corpus cavernosum tissue. Pretreatment with 1 x 10(-6) M doses of moxisylyte reduced competitively the norepinephrine-induced contraction. The competitive effect of prazosin was strongest among four tested agents, followed by phentolamine, moxisylyte, and then yohimbine. The activity ratio for each antagonist is 2.4 for moxisylyte, as compared with 28.2 for prazosin, 6.7 for phentolamine, and 1.6 for yohimbine respectively. Moxisylyte hydrochloride is an agent with potential clinical and research uses capable of producing erection when injected intra-cavernously.

Adolescent↗
PubMed1989

[Influence of protein intake on phytohemagglutinin skin test in patients undergoing maintenance hemodialysis].

We studied the influence of protein intake on the phytohemagglutinin (PHA) skin test and purified protein derivative (PPD) skin test in 45 patients on maintenance hemodialysis. The patients were 23 males and 22 females, the ages ranging from 19 to 80 years, with an average of 53.6 years. All patients were being maintained on long-term hemodialysis (mean 37.3 months). They were divided into three groups according to protein intake: Group A; less than 1.1 g/kg/day, Group B; 1.1-1.5 g/kg/day, Group C; more than 1.5 g/kg/day. There were no significant differences among the three groups with respect to age, causative disease and the period of maintenance hemodialysis. We measured protein intake, PHA skin test and PPD skin test. Significant differences were found between Group B and Group C with respect to the PHA skin test values and PPD skin test values, the values of Group C being very low compared with those of Group B. The PHA skin test values and PPD skin test values were only slightly lower in Group A than in Group B. The negative reaction rate of PPD in Group A and Group C was much higher than in Group B. The results suggest that excess intake of protein impaired cellular immunity in maintenance hemodialysis patients, and that protein deficiency can also have a detrimental effect on cellular immunity. Therefore, adequate protein intake should be maintained for optimizing cellular immunity.

Adult↗
PubMed1989

[Review of 43 autopsy cases of urogenital malignant tumors].

Autopsy findings were reviewed in 43 patients clinically diagnosed in the last 12 years as having urogenital malignant tumors. Clinical diagnoses were 14 bladder carcinoma, 11 prostatic carcinoma, 6 renal cell carcinoma, 5 renal pelvic carcinoma, and 7 other malignant tumors. Autopsy showed that 31 cases died due to carcinoma and 12 because of other causes. The most common ultimate causes of death were DIC and infection, especially pneumonia and sepsis. Autopsy showed 36 of the 43 cases (83.7%) with metastasis. Clinical diagnosis showed 34 cases of metastasis, but the number of metastasized organs and lymph-nodes was much lower than in subsequent autopsy findings. Autopsy proved 5 cases of clinical misdiagnosis (11.6%) and 4 of undiagnosed malignant tumors (9.3%). In 15 cases (32.6%) the ultimate cause of death as revealed by autopsy had not been clinically diagnosed. Five cases diagnosed as having died due to cancer in fact were found to have died due to other causes. Recent diagnostic techniques are greatly advanced, yet many findings are still revealed for the first time by autopsy. Autopsy continues to be a very important final arbiter of progress and the effect of malignant tumors, and serves to remind us of the ongoing need for constant vigilance and improvement of clinical diagnostic techniques.

Autopsy↗
PubMed1989

Intracavernous injection therapy in recovery of spontaneous erection (not for self-injection)--its mechanism and indications.

Ten impotents underwent intracavernous injection therapy for recovery of spontaneous erection using papeverine hydrochloride alone or in combination with phentolamine. Six out of ten patients recovered spontaneous erection. Almost all respondents tended to have low initial penile-brachial-index values and their penile-brachial-index values rose after treatment. We concluded that periodic erections after using a vasoactive drug may have the effect of stimulating and activating the lethargic blood flow system and finally revitalizing the erectile organ.

Adult↗
PubMed1988

Can an intracavernous papaverine injection be used to diagnose arteriogenic impotence?

We injected papaverine into the corpus cavernosum of 93 patients with impotence, and compared the results with findings from nocturnal penile tumescence monitoring, psychogenic erection monitoring after sexual stimulation, penile-brachial indexes, and dynamic cavernosography. There was a significant correlation between the findings from papaverine injection and dynamic cavernosography, but there was no correlation between the papaverine findings and other tests including the penile-brachial index. We conclude that we can disregard the possibility of venous abnormality in those who respond to papaverine injection, but we cannot disregard the possibility of arteriogenic abnormality. We proved that papaverine injection cannot diagnose arteriogenic abnormality.

Adult↗
PubMed1988

[Clinical evaluation of total cystectomy for bladder carcinoma: a ten-year experience].

Fifty-three patients with primary bladder carcinoma underwent total cystectomy during the past 10 years. Ages ranged from 32 to 87 years old, with an average of 68.2 years. Radical total cystectomy, including systemic lymphadenectomy was performed in 22 cases, simple total cystectomy in 8 cases and salvage total cystectomy in 23 cases. An ileal conduit was made for urinary diversion in 23 cases and the other 26 cases underwent cutaneous ureterostomy. Postoperative mortality was 9.4% (5 of 53 cases) and postoperative complications were noted in 17 of the 53 cases (32.1%). The 5-year cumulative survival rate by the life table method for all the cases was 42.6%. The 5-year cumulative survival rate of radical total cystectomy cases was 67.8%, that of simple total cystectomy cases was 50.0% and that of salvage total cystectomy cases was 7.5%. A significant difference was seen between the first 2 groups and the last group. The 5-year cumulative survival rate of the patients with low stage cancer (pTis, pTa, pT1 and pT2) was 56.1% and that of the patients with high stage cancer (pT3, pT4) was 22.7%. A significant difference was observed between the two groups. The 5-year cumulative survival rate of the patients with grades G1, G2 and G3 cancer was 66.7, 45.4 and 26.7% respectively. A significant difference was seen among the three grades.

Adult↗
PubMed1988

[Renal cell carcinoma in the solitary kidney].

We have treated surgically 5 patients with renal cell carcinoma in the solitary kidney. The cause of renal absence was nephrectomy for renal stones, in 2 patients and renal tuberculosis, renal cyst and renal hypoplasia in 1 patient each. Four of the 5 patients died. One of the 4 patients died 5 days after surgery due to gastrointestinal bleeding, 1 due to metastasis, 1 due to gastric cancer and one due to hemodialysis complications. Surgical management of renal cell carcinoma of solitary kidney is discussed.

Aged↗