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F Matsumoto

Publications and source records attributed to F Matsumoto.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Perinatal management of posterior urethral valves detected by prenatal ultrasonography].

PURPOSES: Posterior urethral valves (PUV) are the most common cause of mechanical infravesical obstruction in children. It is emphasized that this disorder has broad spectrum of severity, and patients presenting signs and symptoms in neonates or early infancy are at high risks for renal failure. The clinical pictures changed dramatically with the introduction of prenatal diagnosis by ultrasonography (USG). We report on perinatal management of PUV detected by prenatal USG, especially stressing on the significance of early delivery in risky fetuses. PATIENTS AND METHOD: From 1987 to 1996, we treated 6 patients with PUVs who had been detected by prenatal USG. Fetal hydronephrosis was noticed between 26 to 29 weeks of gestation. Oligohydramnios was apparent at the same weeks of the detection or 2 to 7 weeks later. Fetal conference including obstetrician, neonatologist, anesthesist and urologist was taken place to discuss the date and mode of delivery. Among the patients, 5 were induced early delivery around 30 weeks of gestation. After birth, serum Cr was monitored, and small feeding tube was placed in the urethra. Primary valve ablation was indicated in 4 patients whose Cr returned to near normal after the urethral drainage. One required upper tract diversion because of the continuous elevation of Cr levels. RESULTS: Of the patients, one died of respiratory failure from lung hypoplasia. Ventilation support was needed in 3 patients. The patient who required upper tract division went into ESRF when he was 6 months old. Except for this patient, renal function improved in 4 patients with nadir Cr levels between 0.4 mg/dl to 0.6 mg/dl. Transurethral valve ablation was done on 5 patient between 16th to 40th days after birth with the lowest body weight at operation of 1450 g. Cystometric studies in neonatal periods showed small capacity, and hypertonic bladder in all patients. Valve ablation and administration of anticholinergics improved bladder function. CONCLUSION: Prenatal ultrasonography clearly demonstrate the pathological features of the fetus with PUVs. Because oligohydramnios started in the early 3rd trimester indicates acute renal failure of the fetus, early delivery followed by emergency treatment may salvage the most severe type of this entity.

Female↗
PubMed1998

Neural Network Computer Analysis of Fetal Heart Rate.

> Objective: A nonsubjective evaluation of intrapartum fetal heart rate (FHR) with a neural network (NNW) computer system and its clinical application. Methods: Eight simple FHR data were input into the NNW computer after 16-step normalizations. The computer was composed of 40 units in the input layer, 30 in intermediate layer, and 3 in the output layer, and the probabilities to be normal, suspicious, and pathological were obtained at the output. Before use, the computer was trained 10,000 times by 50-min teacher FHR data of 20 cases with known outcomes. The trained NNW computer was tested by FHRs of another 29 cases. The outcome probabilities in 15 min were calculated every 5 min in another 10 cases, and the bar graphs of the probabilities were displayed in sequence in the trendgrams. Results: The trained NNW computer was 100% accurate in the internal check; in the external check 86% of the results were evaluated correctly with the cardiotocogram, Apgar score, and umbilical arterial pH of the 29 test cases. The FHR scores of our conventional computer FHR analysis were higher in the suspicious and pathological groups than the normal group, and the fetal distress index was high in the pathological group. The trendgrams were simply accurate in typically normal or abnormal cases, transitory abnormal probabilities were shown in intermediate cases, and mixed suspicious and pathological probabilities suggested pathological outcome. Conclusions: The outcome probabilities and their trendgrams in the NNW FHR analysis are promising in objective decision making in the intrapartum stage.

Journal Article↗
PubMed1997

Allopurinol reduced hepatic ischemia-reperfusion injury exacerbated by inhalation of high-concentration oxygen in rats.

Exposure to high-concentration oxygen (O2) increases lipid peroxidation of the cellular membrane, leading to tissue injury which may involve hepatic ischemia-reperfusion (I/R) injury. We examined the effects of inhaling high-concentration O2 on hepatic I/R injury with allopurinol, which is a xanthine oxidase inhibitor. Partial hepatic ischemia was performed in rats with or without allopurinol under 21 or 100% O2 inhalation. Levels of lipid peroxide, serum liver enzymes, and hepatocellular oxidative stress in the 100% O2 group were significantly higher than in the 21% O2. Administration of allopurinol significantly inhibited those changes in the 100% O2 group. Severe degeneration of mitochondria were noted in the 100% O2 group, but appeared to be reduced by allopurinol. Results suggest that inhalation of high-concentration O2 during liver surgery may increase lipid peroxidation and exacerbate hepatic I/R injury, but those changes may be prevented by allopurinol.

Alanine Transaminase↗
PubMed1997

[Continent urinary reservoir using dilated renal pelvis of non-functioning pelvic kidney in a girl with cloacal exstrophy].

We performed construction of continent urinary reservoir in an 8-year-old girl with cloacal exstrophy who had double stoma of ileostomy and colon conduit. Preoperative evaluation revealed non-functioning right kidney with severely dilated renal pelvis and calyxes in her pelvis. Urinary reservoir was constructed using detubularized colon segment which had been used as the urinary conduit and dilated renal pelvis of non-functioning pelvic kidney. Using Mitrofanoff's principle, continent catheterizable channel was also made of the anterior wall of the renal pelvis. Postoperative course was uneventful. Reservoir capacity increased to 350 ml one and half year postoperatively and she is almost dry with clean intermittent catheterization 5 times a day. Dilated upper urinary tract is one of the ideal material for bladder enlargement that avoids the complication associated with the use of gastrointestinal tract.

Child↗
PubMed1997

[Pathological study of the kidney and the lung in patients with Potter sequence].

PURPOSES: The condition in infants showing the characteristic facial abnormalities, limb deformities, and pulmonary hypoplasia induced by oligohydramnios is termed Potter sequence (PS). In addition to bilateral renal agenesis, Potter sequence could be caused by other urological abnormalities such as cystic dysplasia and obstructive uropathy. Although lethal in most of the patients with PS, some exceptional infants were reported to survive in spite of the antenatal demonstration of oligohydramnios from renal abnormalities. These surviving patients put new questions to us regarding the management of both respiratory and renal failure starting from the newborn periods. The diversity of clinical courses in patients with antenatally detected PS may imply that this entity has a spectrum of severity. Our study of infants autopsied on the diagnosis of PS was undertaken to determine various histological grade of the kidneys and the lungs. MATERIALS AND METHODS: Thirty-two autopsy cases of PS (19 males and 13 females) diagnosed by the presence of the characteristic stigmata, oligohydramnios, and renal or urological abnormalities were studied retrospectively. Patients were divided according to the urological abnormalities into 3 groups; renal hypodysplasia, urinary obstruction, and polycystic kidney disease (PCKD). Renal histology was evaluated by two parameters; renal glomerular count (RGC), and dysplastic grade. Developmental aspects of the lung were judged by lung/body-weight ratio (L/ B ratio) and radial alveolar count (RAC) proposed by Emery. RESULTS: The underlying urological disorders included renal hypodysplasia in 22 patients, obstruction in 7, and polycystic kidney disease in 3. Dysplastic grade of 29 patients with hypodysplasia and obstruction consisted of grade 4 in 12 patient, grade 3 in 9, and grade 2 in 8. In 10 kidneys from 8 patients with grade 2-dysplasia, RGC was significantly fewer than that of normal fetuses for the gestational age. The term patient with PS showed the glomerular count equivalent to normal fetus of around 25 weeks of gestation. L/B ratio indicated definite pulmonary hypoplasia in 25 of 29 patients. The ratio was much smaller than normal in another 4 patients. RAC was calculated in 24 patients; of these only 2 had normal count for gestational age. In another 22, the number of air space stopped to increase at about 20 to 25 weeks of gestation. There was a tendency for L/B ratio to decrease according to dysplastic grade (1.3% for grade 2 vs. 0.9% for grade 3 and 4). CONCLUSION: The primary urological abnormalities leading to PS included bilateral renal hypodysplasia, obstructive uropathy, and PCKD. Histological study of the kidneys indicates that PS is the spectrum disease with various degree of nephron formation. The development of the lung depends, in part, on the grade of renal dysplasia.

Abnormalities, Multiple↗
PubMed1997

["Ghost Hanako's syndrome": report of 2 cases--initial stage of nonneurogenic neurogenic bladder (Hinman syndrome)?].

Two girls aged 6 and 7 years old with established urination habit complained of daytime incontinence and deterioration of nocturia after they started school life. They were quite afraid of the lavatory and sometimes skipped urination during school time completely. Voiding cystography revealed bladder trabeculation and vesicoureteral reflux. On cystometry, bladder compliance was preserved with no uninhibited contraction. Ghost tales about labatories, such as "the tale of Ghost Hanako," prevail in almost every elementary school in Japan. In some children, especially schoolgirls, lavatory phobia results in dysfunctional voiding. Such "Ghost Hanako's syndrome" may be an early phase of non-neurogenic neurogenic bladder (the Hinman syndrome). Detailed information regarding school life and urination habit is important for the treatment of this entity.

Child↗
PubMed1997

[A clinical study of intermittent hydronephrosis].

A clinical study was conducted on the intermittent hydronephrosis in children. Of 78 children with hydronephrosis due to ureteropelvic junction obstruction operated between 1991 and 1995, 5 had intermittent hydronephrosis. All 5 patients were boys between 6 months and 6 years of age. Presenting symptoms were intermittent flank pain and vomiting. Ultrasonography performed during pain attack demonstrated dilation of the renal pelvis in all patients. Diuretic renography demonstrated obstruction in 4 of the 5 children and deterioration of renal function on the affected side in 2. The cause of ureteropelvic junction obstruction was aberrant vessels in 2 cases, fibrous band in 1, ureteral kinking within adventitia in 1 and a ureteral polyp in 1. Postoperatively, all patients have been relieved from the pain. In summary, ultrasonography at the time of symptom attack as well as diuretic renography are useful for the diagnosis and observation of intermittent hydronephrosis.

Abdomen, Acute↗
PubMed1997

[Bladder hemangioma in a child: a case report].

We report a case of bladder hemangioma in a child. An 8-year-old girl was referred to our hospital for the evaluation of painless hematuria. Neither pyuria nor bacteriuria was detected. She had no dysuria. Intravenous pyelography showed deformity of the bladder without dilation of the upper urinary tract. Voiding cystourethrography revealed a filling defect of the bladder. Reddish blue masses were seen cystoscopically at the right wall and the dome of the bladder. Partial cystectomy was performed. From the histological findings, the diagnosis was cavernous hemangioma of the urinary bladder. Her postoperative course was uneventful and no recurrence was seen at the cystoscopical examination 3 months postoperatively. This is the 15th case of bladder hemangioma in children reported in Japan.

Child↗
PubMed1997

[Expression of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) in joint tissues of rapidly destructive coxarthropathy (RDC), analyzed by immunohistochemical study].

OBJECTIVE: Rapidly destructive coxarthropathy (RDC) is characterized by rapid destruction of hip joints, but its pathogenetic mechanism is still obscure. Matrix metalloproteinases (MMPs) are possibly one of the candidates concerning with this mechanism. We attempted histochemical investigation to demonstrate MMPs and tissue inhibitor of metalloproteinases (TIMPs) in joint tissues obtained from RDC patients to clarify their roles in the destruction mechanism. MATERIALS AND METHODS: Joint tissues including synovia and cartilage-bone tissues were obtained from RDC patients at total hip replacement (THR). After fixation with 4% paraformaldehyde, cartilage-bone tissues were partly decalcified. We performed histochemical study for paraffin sections of these tissues by using avidin-biotin method. Antibodies used in this study were monoclonal antibodies to MMP-1, MMP-2, MMP-7, MMP-8, MMP-9, TIMP-1, TIMP-2 and polyclonal antibody to MMP-3. RESULTS: Histological feature of RDC was severe destruction of cartilage and bone by invasion of non-specific granulation tissues composed of many small vessels, macrophages and fibroblastic cells. At the same time, RDC showed apparently fewer lymphocytic cells in these granulation tissues compare with rheumatoid arthritis. MMP-2 and MMP-9 were expressed most demonstrably in synovia and destructive regions of femoral heads, especially in osteoclasts, macrophages, and fibroblastic cells, while MMP-1, MMP-3, were slightly expressed only in the superficial layer of synovia in limited cases. MMP-8, usually contained in neutrophils, was not present in RDC. On the other hand TIMP-1 and TIMP-2 were presented throughout the synovia and destructive regions of femoral heads including fibroblastic cells, macrophages, osteoblasts and osteocytes. CONCLUSION: Immunohistochemical study revealed obvious presence of MMP-2 and MMP-9 in synovia and destructive regions of femoral heads in RDC. Those evidence suggest that MMP-2 and MMP-9 share very important role in the destructive mechanism of RDC, possibly under imbalance between TIMPs.

Aged↗
PubMed1996

[Basic and clinical studies of pazufloxacin on infectious enteritis research group of T-3761 on infectious enteritis].

A clinical study was carried out on pazufloxacin (PZFX) in 137 patients including shigellosis, Salmonella enteritis, enteropathogenic Esherichia coli enteritis and cholera, and carriers of these pathogens. Antibacterial activity of PZFX against clinical isolates, fecal concentration of PZFX and effects of PZFX on fecal microflora were also investigated. The overall clinical efficacy rate was 97.2%. The bacteriological efficacy rates were 98.2% against Shigella spp., 81.8% against Salmonella spp., 50% against Vibrio cholerae O1, and 100% against E. coli, V. parahaemolyticus, Aeronomas spp., Plesionomas shigelloides and V. cholerae non-O1, respectively. Side effect (epigastralgia) was observed in 1 of 130 cases (0.8%). The rate of abnormal laboratory findings was 11.2% (11/98). These were mainly elevation of GOT and/or GPT and increased eosinophils. The clinical usefulness rate was 95.2%. The MIC90 values of PZFX against Shigella spp., Salmonella spp. and E. coli were 0.025, 0.025 and 0.025 micrograms/ml, respectively. The results of fecal drug concentration and the effects on fecal microflora in one patient were compatible with those obtained in healthy volunteers.

4-Quinolones↗
PubMed1996

[A case of bilateral testicular torsion in a neonate].

A case of testicular torsion in the newborn is presented. A 8-day-old infant with bilateral intrascrotal swelling since birth was referred to us. Bilateral testicular torsion was suspected and operation was carried out at the same day. We operatively found extravaginal torsion of the bilateral spermatic cord. The bilateral testis appeared extensively necrotic, but we repaired the torsion and performed bilateral orchiopexy because of bilateral torsion. We could not palpate well the bilateral testis in one year, probably due to an atrophy. Sixty-nine cases of testicular torsion in the newborn including our case from Japanese literatures were reviewed and discussed. Especially forty-seven cases were presented at birth.

Atrophy↗
PubMed1996

[Results of antireflux surgery in infants with vesicoureteral reflux].

BACKGROUND: Due to the advancement of prenatal and postnatal ultrasound screening in addition to better understanding by pediatricians, more infants have been detected to have vesicoureteal reflux. There are still debates, however, about their management whether to take conservative or surgical treatment. METHODS: We analysed clinical courses of 51 children with primary reflux undergoing antireflux surgery when they were under 1 year. RESULTS: A total of 41 infants (80%) presented with febrile urinary tract infections. The first UTI was seen as early as 7th day after birth, with the average age of 2 months. Seven infants had hydronephrosis detected by prenatal ultrasound, and 2 were identified by neonatal screening ultrasonography. Sixty-eight of 86 reflux ureters (79%) showed high grade reflux (grade IV approximately V). All the other 18 ureters with mild to moderate grade of reflux except one accompanied with contralateral high grade reflux. One ureter with grade II reflux was associated with contralateral obstructed meganreter. Renal parenchymal abnormalities, either with scarring and/or small kidney, were identified in 64 kidneys (74%) at or before the reimplantation. The operation was done as early as 1 month-old with the average age of 5.6 months. Among the children, 24 (47%) underwent anti-reflux surgery before 6 month-old. Smallest infant weighted 2500 gr at the time of operation. Reimplantation was done by the Cohen transverse advancement technique in 75 ureters (87%). The modified Politano-Leadbetter method in 6 with Hutche's diverticulum, and the Glenn-anderson advancement method in 5 with moderate to mild reflux. Two dilated ureters were treated with folding of the intravesical segment. Follow-up voiding cystourethrogram of 49 children at 6 months revealed no evidences of persistent reflux. There were no patients with obstruction of reimplantation except one with slight upper-tract dilatation. One infant revealed new low grade contralateral reflux, and he is being observed. Two children presented pyelonephritis after the operation. CONCLUSION: Our success rate of 100% in antireflux surgery enables us to continue our policy to perform early operative interventions in infants with high grade reflux. In addition to the meticulous and careful technique, the conditions for successful results include; 1) A through checkup of the lower tracts by VCG and endoscopy. 2) Find the better operative instruments for the small bladder. 3) Do not hesitate to perform the ureteral tapering. 4) Make good use of operative loupe.

Age of Onset↗
PubMed1996

[Femoral testis: report of three cases].

Three patients were referred to our clinic with the chief complaint of emptiness of the right scrotal contents. Every physical examination in these patients revealed a little-finger-tip sized mass corresponding to the normal testis at the right side of the femoral region. Right orchiopexy by the dartos-pouch technique was successfully performed. On every surgical exploration of these patients, the gubernaculum was fixed to the femoral skin and the testis was found to be normal in size. Our cases are the 2nd, 3rd and 4th cases of femoral testis, reported in the Japanese literature.

Child, Preschool↗
PubMed1996

[Accessory scrotum with lipoma: a case report].

A newborn male infant was referred to our clinic because of anomalies of external genitalia. The infant was born at term after a normal pregnancy and delivery, and was appropriate for gestational age. A tumor mass covered with scrotum-like skin on its tip was noticed in the right side of perineum between the scrotum and anus. The raphe, which ran along the midline at the penis and the normal scrotum, circumscribed the right side of this structure. Both testes had descended into the scrotum. The condition was associated with incomplete penoscrotal transposition. There was no other urological anomaly including lower urinary tract. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion was diagnosed as an accessory scrotum. Thirty-one report cases of the accessory scrotum including our own were reviewed and discussed.

Genital Neoplasms, Male↗
PubMed1996

[Responses of cytokines, acute phase proteins, and polymorphonuclear cell elastase to surgical stress in the patients with esophageal cancer].

The serum levels of cytokines (interleukin-1 beta; IL-1 beta, interleukin-6; IL-6, tumor necrosis factor alpha; TNF alpha), and acute phase proteins (CRP, alpha 1-antitrypsin; alpha 1-AT, alpha 1-acid glycoprotein; alpha 1-AG, fibrinogen; FBG, pancreatic secretory trypsin inhibitor; PSTI), and the plasma concentration of polymorphonuclear cell elastase; PMN-E and white blood cell counts were measured in 18 patients with esophageal cancer who underwent radical esophagectomy through right thoracotomy and reconstruction with gastric tube. Peripheral venous blood samples were obtained before and just after operation, and on the 1st, 2nd, 3rd, 7th and 14th post-operative day. The serum concentrations of IL-6 just after operation were significantly correlated with volume of blood loss during operation and duration of thoracotomy. Plasma PMN-E levels just after operation seemed to be correlated with those factors, but its correlation was not statistically significant. Serum IL-6 levels began to increase markedly just after operation, and reached the maximum by the 1st post-operative day. This elevation preceded that of acute phase proteins, indicating that IL-6 may induce the production of acute phase proteins in vivo. Furthermore, peak serum values of IL-6 after operation were correlated with volume of blood loss and duration of thoracotomy. These results suggest that elevation of IL-6 and PMN-E levels may reflect the degree of surgical stress, and the measurement of IL-6 and PMN-E is useful for the early detection of an inflammatory response.

Acute-Phase Proteins↗
PubMed1996

[Ectopic ureter opening in the vestibulum without urinary incontinence: a case report].

A case of ectopic ureter without urinary incontinence despite its ureteral orifice in the vestibulum is reported. A 2-year-and-9-month-old female was referred to our hospital with the pain of external genitalia, pollakisuria and macroscopic hematuria. Examination revealed a complete double system of the left upper tract with vestibular opening from the upper moiety. She did not show any signs of ureteric incontinence after the establishment of voiding habits. Because radioisotope (RI) scintigram showed apparent uptake in the upper half of the left kidney we performed left ureterocystoneostomy with psoas hitch procedure. We postulate that the incontinence mechanism is maintained when the running course of the ectopic ureter is through some portion of the urethral sphincter musculature. This is the 10th case reported in Japan.

Child, Preschool↗