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Biomedical subjects

F Ikoma

Publications and source records attributed to F Ikoma.

At least 37 records · Page 2Linked to original sources
PubMed1994

[A case of capillary hemangioma of the testis in a child].

Testicular tumors derived from connective tissue, blood vessels and musculature are uncommon and intratesticular tumors of vascular origin are extremely rare. A rare case of capillary hemangioma of the testis in a child is reported. An 11-year-old boy was admitted with the chief complaint of painless mass in the right scrotum. He was diagnosed with a right testicular tumor by physical examination and ultrasonography, preoperatively. Right high orchiectomy was done on December 10, 1990. The testis measured 2.5 x 2.3 x 1.5 cm. Pathologically, the tumor was diagnosed as a capillary hemangioma of the testis.

Child↗
PubMed1993

Vesicoureteral reflux in infants under one year old. Follow-up study and consideration on development of renal scarring.

In an attempt to clarify reflux nephropathy (RN), 67 infants aged under one year with vesicoureteral reflux (VUR) were retrospectively classified into two groups, non-surgical and surgical. They were evaluated on VUR grading, VUR spontaneous cessation rate, and incidence of scarring. As a whole, spontaneous cessation rate was 61 percent. The cessation rate was higher for infants with lower VUR grading. The average age at cessation was 2.5 years. Some patients showed no scarring at presentation despite severe VUR. However, most cases of renal scarrings at the time of presentation belonged to grade IV or V. Scarring advanced in 3 kidneys of the non-surgical group and in 13 kidneys of the surgical group. Of these 16 kidneys, 7 were rated as grade IV and 9 as grade V. An association between development of scarring and recurrent urinary tract infections was suggested.

Cicatrix↗
PubMed1993

[Liver impairment in kidney transplant recipients. 1. Prevalence and clinical significance of hepatitis C].

The prevalence and the clinical significance of hepatitis C (HCV) infection in recipients of kidney transplantation was assessed using second generation anti-HCV antibody (anti-HCV-2). Out of 88 patients whose preoperative sera were available for anti-HCV-2 determination, 27 patients (30.7%) were positive. Transfusion units were significantly larger and the duration of hemodialysis was significantly longer in the patients with anti-HCV-2 than those without. In 10 patients whose preoperative sera were negative for anti-HCV-2, seroconversion was documented after the operation, so that the postoperative positive rate of anti-HCV-2 increased to 42.9% (39/91). Seroconversion from positive to negative was observed in only one patient. Out of 91 patients who were followed-up at least 3 months after operation, 66 patients (72.5%) developed liver dysfunction. According to the criteria of non-A, non-B post-transfusion hepatitis established by the Japanese Society of Digestive Disease, 31 of 66 patients (34.1%) were diagnosed as "definite", 21 patients (23.1%) as "suspicious". The anti-HCV-2 positive rate was 90.3% in the "definite" group, which was significantly higher than the other groups. Liver dysfunction in the patients with anti-HCV-2 had a tendency for a chronic or prolonged course. Out of 20 patients in whom liver dysfunction continued for more than 1 year, 18 patients were positive for anti-HCV-2. It is concluded from this study that the prevalence of hepatitis C is very high in kidney transplant recipients with HCV as the main and most important etiologic factor of liver dysfunction, especially in chronic liver impairment.

Adolescent↗
PubMed1993

Predeposit autologous blood transfusion in elderly patients undergoing transurethral resection of the prostate.

In order to reduce the rate of homologous blood transfusion, predeposit autologous blood transfusion has been introduced in 134 out of 266 patients undergoing transurethral resection of the prostate since February 1988. Nine (6.7%) out of 134 patients who deposited their own blood were also transfused with homologous blood. In contrast, the rate of homologous blood transfusion was 22.7% in 132 patients who did not deposit autologous blood. Overall homologous blood transfusion rate (14.7%) in the past 4.5 years has been much lower than in the previous 4 years (22.2% in 203 patients). In 6 patients in whom blood donation was performed concurrently with administration of recombinant human erythropoietin, decrease of haemoglobin level was significantly less than in those without rHuEPO. Predeposit autologous blood transfusion can reduce homologous blood transfusion rate. It is safe and easily performed, and more effective when combined with rHuEPO administration even in elderly patients undergoing TURP.

Aged↗
PubMed1993

[Cholesterin granuloma in a hemodialysis patient with polycystic kidney disease].

We report a case of cholesterin granuloma of the kidney masquerading as a renal tumor. A 59-year-old man with polycystic kidney disease had been on hemodialysis for 5 years when he developed asymptomatic gross hematuria. Ultrasonography and CT scanning showed a solid mass in the right kidney and nephrectomy was performed. The resected specimen was a 2.0 x 2.0 cm yellowish solid mass. Histological examination showed a granuloma containing numerous cholesterin crystals. A renal mass containing cholesterin crystals is very rare and only one case has been reported previously in Japan.

Cholesterol↗
PubMed1993

[Mainz pouch urinary diversion with appendix stoma].

The modified Mainz pouch urinary diversion was performed on 5 patients with bladder cancer using the submucosally embedded in situ appendix as a continence mechanism. It proved to be successful on 4 patients showing the complete urinary continence without difficulty in self catheterization. One patient became incontinent and a balloon catheter was retained. Advantages of the appendix stoma in the Mainz pouch are the reduction of the ileal segment to be isolated for creation of the pouch, relative simplicity of the operative technique, and the avoidance of use of foreign bodies such as metal staples or Marlex meshes.

Adult↗
PubMed1993

Primary vesicoureteral reflux in children under one year of age: the case for conservative management?

The natural course of reflux nephropathy was evaluated in children who have been diagnosed for primary vesicoureteral reflux already during the first year of life. The retrospective study in 103 patients (163 refluxive renal units) revealed that 80% of all children in this age group were boys. Scarring at the time of diagnosis was evident in 29% of the cases, compared to a rate of 20% in our whole reflux population. New scarring occurred in 17 patients (18%): 63% of the children had high grade refluxes (IV and V). The rate of spontaneous resolutions was 61% and even grade V refluxes showed a spontaneous cessation in 40% of the cases. These data indicate a high overall spontaneous cure rate in young children, but underline the importance of selecting those patients with already scarred kidneys and recurrent urinary tract infections for an early operation since they are not likely to show a spontaneous resolution of reflux.

Adolescent↗
PubMed1992

Pituitary and gonadal functions in patients with chordee without hypospadias.

Pituitary and gonadal functions in 16 prepubertal boys with chordee without hypospadias by stimulation of gonadotropin releasing hormone or human chorionic gonadotropin were compared to those of age-matched normal boys. The patients with chordee without hypospadias had poor follicular stimulating hormone response but pituitary luteinizing hormone reserve function was normal. Testosterone response by stimulation of human chorionic gonadotropin was not impaired in patients with chordee without hypospadias. The results suggested that chordee without hypospadias may also be categorized into hypospadias from the aspect of its pituitary and gonadal functions in addition to the embryogenesis of chordee.

Child, Preschool↗
PubMed1992

Testicular function in patients with hypospadias associated with enlarged prostatic utricle.

Of 485 patients with hypospadias who underwent urethrography, enlarged prostatic utricles were found in 173 (35.7%). Utricles with a higher grade of enlargement were seen mainly in patients with a severe degree of hypospadias. Serum testosterone levels before and after 3 days' treatment with human chorionic gonadotrophin were determined by radioimmunoassay in 97 prepubertal boys with hypospadias and enlarged prostatic utricles. Lower levels of serum testosterone were found after hormonal stimulation in 22 patients with high grade utricular enlargement when compared with 5 controls and 75 patients with low grade enlargement; the difference was statistically significant. This finding supports the hypothesis that utricular enlargement may be due to androgenic insufficiency during the critical period of organogenesis.

Chorionic Gonadotropin↗
PubMed1992

[Complete testicular feminization syndrome associated with thermolabile androgen receptor].

Radioreceptor assay and thermostability test for the androgen receptor in two cases with complete testicular feminization syndrome were performed in regard to the fibroblasts cultured from genital skin on the basis of dispersed whole cell binding assay (Eil et al., 1980). No [3H]dihydrotestosterone binding to the androgen receptor was observed in case 1 (receptor negative), while maximum binding capacity and dissociation constant of androgen receptor for [3H]dihydrotestosterone in case 2 were 21000 sites per cell and 1.67 x 10(-10) M (receptor positive). The specific binding of [3H]dihydrotestosterone to the androgen receptor in case 2 decreased remarkably to 6.6% after high temperature (42 degrees C) incubation in comparison with that at 22 degrees C incubation. The specific binding of [3H]dihydrotestosterone to the androgen receptor in normal controls decreased down to 81.6% at high temperature incubation. Thermostability test was useful to demonstrate qualitative abnormality of androgen receptor in receptor positive testicular feminization syndrome.

Adult↗
PubMed1992

[Mainz pouch with umbilical stoma].

Between March 1986 and May 1991 the Mainz pouch urinary diversion was performed in 23 patients with bladder cancer. In 12 of these 23 patients, stoma was constructed in the umbilicus. As the efferent stomal limb, the ileum was used in 10 cases and the appendix was used in 2 cases. The skin at the bottom of the umbilicus and the abdominal fascia under the umbilicus were excised round. The stomal limb was pulled through the fascial hole and the stomal margin was sutured to the skin. The cosmetic results of the umbilical stoma were satisfactory in these 12 patients. Pouch capacity ranged from 330 ml to 560 ml and good urinary continence without difficulty of self-catheterization was obtained in 11 patients. In 1 patient difficulty in catheterization occurred due to a pocket-formation in the stomal limb and the operative revision was performed. Stomal stenosis occurred in 1 patient. Acute renal failure followed by intestinal bleeding occurred in 1 patient who was cured with intensive care including hemodialysis. The results of our study show the superiority of the umbilical stoma in the Mainz pouch in regard to good cosmetic appearance, no need to use a Marlex collar, little bending of catheterization route and low incidence of complications such as parastomal hernia or nipple valve prolapse.

Humans↗
PubMed1992

[BEP (bleomycin, etoposide, cisplatin) therapy for testicular tumors].

We describe our experience with BEP (bleomycin, etoposide, cisplatin) therapy as chemotherapy for testicular tumors in 11 patients. Eight were non-seminomatous testicular cancer patients and 3 were seminoma patients. Three of 8 non-seminomatous testicular cancer patients had no evident metastasis and BEP therapy was performed for prophylaxis of recurrence. Other 5 non-seminomatous testicular cancer patients and 3 seminoma patients had metastatic lesions and BEP therapy was performed to cure these metastatic lesions. Ten of our 11 patients are living and disease-free. One non-seminomatous testicular cancer patient who had brain, lung, eye and bladder metastases and had an extremely elevated human chorionic gonadotropin (hCG) level responded only partially and died later due to disease progression. Side effects in most patients were nausea, vomiting, alopecia and leucopenia and all these side effects were reversible. Neuromuscular toxicity such as paresthesia or abdominal cramp that is sometimes encountered in PVB (cisplatin, vinblastine, bleomycin) therapy was not seen in our patients. Our results support the concept that BEP therapy is better than PVB therapy as an initial chemotherapy for testicular tumors.

Adolescent↗
PubMed1992

[Prader-Willi syndrome associated with chromosomal aberration: report of a case].

A male case of Prader-Willi syndrome (2.8 years in age) with an interstitial deletion of a chromosome affecting 15q 11-12 region is reported. The chief complaints were hypoplastic scrotum and defect of bilateral scrotal content. The clinical features were short stature, obesity, delayed mental development, bilateral cryptorchidism, hypogenitalism, hypopigmentation, and bilateral moderate vesicoureteral reflux with a history of muscular hypotonia. Bilateral orchidopexy was done. Endocrinologically both base values of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were normal although LH reserve function was impaired on gonadotropin releasing hormone (GnRH) test. Testosterone response was normal by the stimulation of human chorionic gonadotropin. An interstitial deletion of proximal 15q, and pituitary-gonadal axis in Prader-Willi syndrome are discussed in relation to the clinical features and therapy.

Child, Preschool↗
PubMed1992

[Ectopic ureter opening to vestibule without urinary incontinence: a case report].

A case of a 2-year-old female with right ectopic ureter opening in vestibule vaginae and without urinary incontinence is reported. Excretory urogram showed mild dilatation of the upper right segment with bilateral complete duplication. Right ectopic ureter some functioning upper segment of the kidney was reimplanted into the bladder to avoid surgical intervention for heminephrectomy. According to the retrograde ureterogram of ectopic ureter the running courses and shapes of the dilated distal portions of ureters were compared between two groups, ectopic ureter with incontinence and that without incontinence. We suppose the continence mechanism of ectopic ureter is kept when the running course of the ureter through some portion of the urethral sphincter musculature.

Anastomosis, Surgical↗
PubMed1992

[Chromosome abnormalities in hypospadias? An analysis of 131 patients].

We performed chromosome studies in 131 patients presenting with hypospadias, with the aim of detecting any causal connections between chromosomal abnormalities and the induction of hypospadias. Autosomal abnormalities were revealed in 6 and sex chromosomal abnormalities in 10 patients. Although a significant causal relationship between the occurrence of hypospadias and chromosomal abnormalities was seen in this study in only two cases of mixed gonadal dysgenesis (45,X/46,XY and streak gonad), the high incidence of chromosomal abnormalities observed (12.2%) seems noteworthy compared with the incidence of only 0.61% in the normal male population.

Adolescent↗
PubMed1992

[Prognostic parameters of scar progression, new scar formation and maturation in primary vesico-ureteral-renal reflux].

We analysed the data recorded for 901 children (1357 kidneys) treated for primary vesicoureteral reflux between 1973 and 1988 at our institution. The retrospective study showed a rate of 7.3% for new renal scarring and progression; analysis by reflux grade revealed progression and new scarring in reflux, 10.9% of cases with grade IV and 16.5% of cases with grade V whereas low grades (I and II) were followed by no scarring at all. A close correlation of new scarring with urinary tract infection and bladder function was demonstrated. Spontaneous resolution of reflux was observed in 33.6% of all patients and in only 2.6% of patients with grade V reflux, as against a 85.5% resolution rate in patients with grade I or II reflux. A different sex distribution was revealed in the age group under 1 year, in which 80% of the patients were boys and the resolution rate was higher than in any other age group.

Adolescent↗