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C Ohyama

Publications and source records attributed to C Ohyama.

At least 55 records · Page 3Linked to original sources
PubMed1991

Staghorn calculi--long-term results of management.

We have treated 167 patients with staghorn calculi. Conservative therapy was used in 61 patients who have been followed up for 1 to 18 years (average 7.8). Chronic renal failure occurred in 22 of these patients and 7 died from uraemia. The causes of chronic renal failure were bilateral staghorn calculi, staghorn calculi and contralateral urinary calculi, and chronic pyelonephritis of the contralateral kidney. The morbidity and mortality rates following conservative treatment were higher than those following surgical management. The pathological findings in 47 kidneys after nephrectomy showed severe hydronephrosis, renal abscess and xanthogranulomatous pyelonephritis. These results indicated that staghorn calculi destroyed the kidney and early complete removal of these stones is advisable.

Adolescent↗
PubMed1991

[Whole layer needle biopsy for evaluation of neoadjuvant therapy to invasive bladder cancer].

The most important information for treatment of bladder cancer is to know its exact staging. A whole layer needle biopsy technique has been developed for this purpose. Recently, neoadjuvant therapy has been used for invasive bladder cancer. Although down staging of bladder cancer after neoadjuvant therapy are evaluated by CT or ultrasound, these imaging are not reliable. We examined 11 invasive bladder cancer patients by whole layer needle biopsy pre and post neoadjuvant therapy. All cases were pT3-4 by pretreatment biopsy. After neoadjuvant therapy 4 were changed to pT0 by needle biopsy, other cases were no change or minimal change. In 4 changed to pT0, 3 were done total or partial cyctectomy and the results of pathological diagnosis of cystectomized specimens were also pT0. Another one case changed to pT0 is selected as candidate for bladder sparing and the patient is now in close surveillance. All 4 cases changed to pT0 were done combined treatment by chemo (internal iliac artery infusion) and radiotherapy. In remaining 7 cases, pathological staging of surgical or autopsy specimen agreed with that of whole layer needle biopsy. Whole layer needle biopsy showed no severe complication, except minor bleeding from the bladder wall. Tumor seeding into the needle tract was not observed up to present time. In conclusion, this biopsy system is useful for evaluation of the change of stage with chemotherapy and/or radiation therapy. By using this technique we can select the cases for candidate of bladder sparing.

Aged↗
PubMed1991

[Evaluation of bone metastases from renal cell carcinoma].

Twenty-nine cases of bone metastases from renal cell carcinoma were examined. Eight had metastatic bone pain as the initial symptom and were diagnosed that the primary lesion was in a kidney. In eight cases bone metastases appeared after treatment of the primary site. Seven had only bone metastases and another 22 cases had multiple metastases in organs such as the lung and lymph node when the bone metastasis was found. Curable surgical treatment was performed in only 2 cases. The survival curve of these patients were: 1 year; 41 per cent, 2 year; 30 per cent and 3 year; 15 per cent. Bone scan used for detection of bone metastases of carcinoma frequently ends with false positive results. CT scan and angiography are available for differential diagnosis of bone metastasis. We examined 6 cases (9 lesions) of bone metastases from renal cell carcinoma (3 pelvic bones, 2 lumbar bones, 2 femurs and 2 humerus). All lesions were hypervascular by angiography and were easily diagnosed as bone metastases. For early detection of bone metastases from renal cell carcinoma, angiography is useful because hypervascularity and tumor stain are easily detected even in such small lesions as 2 cm. Angiography was also useful for chemoembolization.

Adult↗
PubMed1990

Changes in glycolipid expression in human testicular tumor.

Glycolipids were extracted from testicular tumor tissues of 13 patients, and their pattern of expression compared with that of normal testicular tissue. The most conspicuous and consistent change in the tumor extracts was marked accumulation of CTH (ceramide trihexoside). Structural analysis by enzyme cleavage showed that CTH which accumulated in the tumor tissue was Gb3 (Gal alpha 1-4Gal beta 1-4Glc beta 1-Cer). Immunohistochemistry using anti-Gb3 monoclonal antibody (MAb) (1A4) also indicated massive accumulation of Gb3 in the tumor tissue. Gb3 may be a new marker of testicular tumors, especially seminomas, for which useful markers are so far lacking.

Biomarkers, Tumor↗
PubMed1990

Management of pyeloureterotomy incision.

We reviewed 122 cases of pyeloureterolithotomy. The pyeloureterotomy incision was closed loosely in 70 cases and not closed in 52 cases. The duration of urinary leakage had no difference statistically between no closure and loose closure (p greater than 0.01). The duration of urinary leakage from the renal pelvis and the upper ureter was shorter than that from the lower ureter in both loose and no closure (p less than 0.05). There was no postoperative stricture. In difficult closures it is not necessary to close the pyeloureterotomy incision.

Adolescent↗
PubMed1990

The effect of high-energy underwater shock waves on implanted urinary bladder cancer in rabbits.

We have examined the effects of high-energy shock waves (HESW) on implanted urinary bladder cancer in rabbits. The bladder cancer was exposed to 2000 to 6000 shots of focused HESW under ultrasound guidance. Although only focal necrosis of the tumor was seen in the one-day HESW exposure (2000 shots), wider and deeper necrosis was observed in the tumors following serial HESW (4000 or 6000 shots; 2 or 3 days). These results indicate that serial HESW exposure has destructive effects on implanted bladder cancer in rabbits.

Animals↗
PubMed1990

Parameatal urethral cysts of the glans penis.

Parameatal urethral cysts are uncommon in the male. We have seen 9 cases and have reviewed these and the 35 cases reported in Japan between 1919 and 1984. The cysts recurred after rupture or aspiration in 3 cases and complete excision is recommended.

Adolescent↗
PubMed1990

Urethral calculi.

We present 56 patients with urethral calculi. In males the commonest location was the posterior urethra; 46 patients complained of dysuria but urinary retention was present in only 7. In 9 patients with penile urethral calculi, 6 had associated urethral disease (urethral stricture in 5 and urethral diverticula in 1). Transurethral litholapaxy or lithotripsy after retrograde manipulation was performed in 33 patients. Endoscopic manipulation was found to be the safest procedure.

Adolescent↗
PubMed1990

[Aspiration biopsy of regional lymph node in bladder cancer].

Percutaneous transabdominal fine needle aspiration biopsy (FNAB) of the pelvic and retroperitoneal lymph nodes was performed in 116 patients with bladder cancer. Metastasis to the regional lymph nodes was determined by this method in 21 patients. FNAB was positive in 10 of 12 patients having unequivocally positive or highly suspicious lymphogram, and in 11 of 104 patients (11%) having normal lymphogram. The results of FNAB were compared to the finding of lymph node dissection (LND) in 51 patients. FNAB and LND were negative in 43 patients and positive in 5. Two patients were FNAB negative but LND positive, and the remaining one case was FNAB positive but LND negative. The correlation between cytological diagnosis of FNAB and histological diagnosis of LND was 94 per cent. The survival rate of the cases of FNAB positive and lymphography negative was significantly higher than that of lymphography positive (p less than 0.01). The metastatic site of 5 cases with bladder cancer who are alive now without disease after more than 3 years was under the common iliac node and the number of the involved nodes was within 3.

Aged↗
PubMed1990

[S-phase cells of human bladder tumors by in vivo bromodeoxyuridine labeling].

At the time of operation, 10 patients with bladder tumors were given an intravenous infusion of bromodeoxyuridine (BrdU, 250 mg) to label the cells in the DNA synthesis phase (S-phase). The removed tumor specimens were stained immunohistologically using anti-BrdU monoclonal antibody. The percentage of BrdU-labeled cells (S-phase cells) were calculated for each specimen, and expressed as Labeling Index (LI). The average LI of G1, G2 and G3 tumors were 0.9%, 2.3% and 11.9%, respectively. LI was almost parallel to pathological grade. In cases of G2 tumor, LI was varied from 0.2 to 6.2%. The higher LI, the more invasive was the tumor. The patient with the highest LI (12.2%) showed lung metastasis postoperatively and died 6 months after operation. S-phase cells were scattered along the basal layer in G1 papillary tumors, and were observed also near the superficial layer in G2 tumors. In cases of non-papillary tumors, S-phase cells were observed irregularly in various layers. This method will give us useful information on evaluation for malignancy and cell kinetics of bladder tumor.

Aged↗
PubMed1990

Remission of filarial chyluria after treatment of coexistent conditions.

Between April 1965 and March 1984, 659 patients (mean age 52.3 years) with chyluria were encountered (probably from filariasis) and 323 were followed for a mean period of 71.9 months (range 1 to 210 months). Of the 323 patients, chyluria was apparently exacerbated by another condition in 132 (40.8%), and often remitted with effective treatment of the coexistent condition. The findings suggest that chyluria is often accompanied by other physiologic or pathologic processes and treatment of these coexistent conditions should be the initial therapeutic approach.

Adolescent↗
PubMed1988

Ultrasound diagnosis of ureteral stones: its usefulness with subsequent excretory urography.

The diagnostic accuracy of ultrasound scanning and excretory urography was compared in 157 patients with ureteral stones. Over-all, the diagnostic accuracy rates were 78.3 per cent for ultrasound scanning and 81.5 per cent for excretory urography. These rates were 83.2 and 85.0 per cent, respectively, in 107 cases of upper ureteral calculi, and 68.0 and 74.0 per cent, respectively, in 50 cases of lower ureteral stones. When the studies were combined the diagnostic accuracy rates increased to 98.1, 94.0 and 96.8 per cent for upper, lower and all stones, respectively. Ultrasound scanning is useful in the diagnosis of ureteral stones, especially in patients with ureteral colic. However, ultrasound combined with subsequent excretory urography is the most reliable method for the diagnosis of ureteral calculi. Bladder filling is a useful diagnostic aid for ultrasound scanning of lower ureteral calculi.

Adult↗
PubMed1987

Reconsiderations of indications for open mitral commissurotomy based on pathologic features of the stenosed mitral valve. A fourteen-year follow-up study in 347 consecutive patients.

From January 1972 to December 1984, 347 consecutive patients underwent open mitral commissurotomy for mitral stenosis. Commissurotomy was performed in 86% of 404 patients undergoing mitral valve operations for stenosis during the same period. These 347 patients had three different types of mitral stenosis: type I, mobile cusps without subvalvular changes (43 patients); type II, thickened cusps with subvalvular changes (210 patients); type III, rigid cusps with severe subvalvular changes (94 patients). Concomitant mild mitral regurgitation was seen in 87 patients (25.1%) and mild to moderate valve calcification in 61 patients (17.6%). There were eight early deaths (2.3%) and 12 late deaths (3.5%), yielding an actuarial survival rate of 94.6% (excluding early deaths) 14 years after operation. There were 17 reoperations (5.0%) The actuarial rates of freedom from reoperation were as follows: 83.8% at 14 years for the entire series; 73.5% for type I stenosis; 88.9% for type II; 84.0% for type III; 91.7% for mitral stenosis with calcification; 82.6% for stenosis without calcification; 90.6% for pure mitral stenosis; and 52.5% for stenosis combined with regurgitation (p less than 0.05). Postoperative effective mitral valve areas calculated according to the hydraulic formula were 2.52 cm2 (mean) at rest and 3.06 cm2 during exercise in six patients with type I stenosis, 2.21 and 2.48 cm2, respectively, in 10 with type II, and 1.85 and 1.87 cm2, respectively, in 14 with type III. Our data clearly demonstrated that open mitral commissurotomy provided excellent long-term results with acceptable valve function and a low incidence of reoperation in patients with pure mitral stenosis not combined with regurgitation, even when associated with severe subvalvular changes with or without mild to moderate valve calcification.

Adolescent↗
PubMed1986

Malakoplakia of prostate.

This represents the twenty-second case of malakoplakia of the prostate reported in the world literature. Eighteen patients (81.8%) had complications which may easily cause urinary tract infection. Treatment of these complications, therefore, is important.

Aged↗
PubMed1984

Long-term results of open mitral commissurotomy for mitral stenosis with severe subvalvular changes: a ten-year evaluation.

Out of 212 patients undergoing open mitral commissurotomy for mitral stenosis from January, 1972, to December, 1981, 53 patients had extremely severe subvalvular changes. In this study, we evaluated postoperative results in these 53 patients. There were 2 operative deaths (3.8%) and 1 late death (1.9%). Of the 50 surviving patients, 34 (68%) were in New York Heart Association Class I and 13 patients (26%) were in Class II, postoperatively. Three patients (6%) required reoperations an average of 5 years 5 months because of the progression of residual mitral regurgitation. The actuarial rate of freedom from mortality and reoperation was 78.6% at 10 years after operation. When anticoagulant therapy was not given, no patient had thromboembolic complications. Postoperative hemodynamic studies demonstrated that mean diastolic gradients across the mitral valve were 5.30 +/- 1.25 mm Hg (standard deviation) at rest and 9.50 +/- 5.13 mm Hg during exercise. Calculated mitral valve areas were 1.86 +/- 0.48 cm2 at rest and 1.88 +/- 0.51 cm2 during exercise. There was no evidence of any adverse effects of mild to moderate valve calcification. It is concluded that for a follow-up period as long as 10 years, the stenosed mitral valve with greatly advanced subvalvular deformities can be salvaged with low mortality, low incidence of reoperation, and acceptable valve function even when such deformities are associated with mild to moderate calcification.

Blood Pressure↗
PubMed1984

Re-evaluation of the indications for cardiac valve replacement.

We re-evaluated the indications for mitral valve replacement and reconstruction, and attempted to determine the optimal time for aortic valve replacement. (1) The actuarial event-free survival rate in patients undergoing open mitral commissurotomy for mitral stenosis with far-advanced subvalvular deformities was 78 per cent at 11 years after surgery and similar in patients undergoing mitral valve replacement for mitral stenosis. Postoperative clinical improvements compared favorably with those in patients undergoing mitral valve replacement. If quality of postoperative life in patients not requiring anticoagulants is borne in mind, open mitral commissurotomy should be given strong consideration as the procedure of choice for the majority of patients with mitral stenosis. (2) The long-term results of reconstructive procedures for mitral regurgitation largely depend upon the pathological anatomies contributing to the development of mitral regurgitation. The results were less satisfactory in patients with fibrotic changes of valvular and subvalvular tissue than in patients undergoing mitral valve replacement for mitral regurgitation. (3) In aortic valve replacement, the postoperative prognosis was poor in patients with a preoperative left ventricular end-systolic volume index exceeding 200 ml/m2 and left ventricular ejection fraction less than 0.35. Operative management of patients with aortic valve disease should be considered, before severe left ventricular systolic dysfunction is evident.

Aortic Valve↗
PubMed1982

Reconstructive surgery for acquired valve disease.

There has been a continuing controversy between reconstructive valve surgery and replacement. In this paper, an analysis of clinical and hemodynamic late results of the patients undergoing open mitral commissurotomy (OMC, 135 patients), repair of mitral regurgitation (MAP, 32 patients), and combined valvuloplasty (62 patients) was presented. 1) OMC: The 10-year actuarial survival rate was 86.5% postoperatively. None of the patients required reoperation in this series. Clinical and hemodynamic improvements mainly depended upon the anatomical severity of a stenosed mitral valve. 2) MAP: The 10-year actuarial survival rate was 94% postoperatively. Especially, good to excellent results were obtained in the patients with mitral regurgitation due to ruptured chordae or dilated annulus. 3) Combined valvuloplasty: The 10-year actuarial survival rates postoperatively were 90% in OMC + tricuspid annuloplasty group (31 patients), 100% in MAP + tricuspid annuloplasty group (7 patients), and 87.2% in OMC + aortic commissurotomy group (24 patients). The reconstructive valve surgery provides very small operative risk, very low late mortality and morbidity. Therefore, it should be the treatment of choice for most of the patients with symptomatic valve disease.

Aortic Valve↗