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Biomedical subjects

H Ihara

Publications and source records attributed to H Ihara.

At least 127 records · Page 7Linked to original sources
PubMed1993

[Experience of laparoscopic pelvic lymphadenectomy in 10 patients].

From November 1991 through January 1993, we performed laparoscopic lymphadenectomy on 10 patients. These patients were aged 54 to 77 years. All laparoscopic procedures were performed under general anesthesia. We dissected obturator lymph nodes on bilateral side. Total operation time ranged from 127 to 325 minutes. We could excise 3 to 9 lymph nodes on right side and 0 to 10 lymph nodes on left side. Blood loss was 180 ml in one patient, but minimal in the remaining 9 patients. Ureteral injury occurred during laparoscopic procedure in one patient. This injury could be managed with laparoscopic and cystoscopic procedure. Postoperatively complications were observed in 5 procedures, which consisted of subcutaneous emphysema in 2 procedures, fever (over 38 degrees C) in 2, shoulder and arm pain in 1, ileus in 1. The patient with ileus complained of abdominal fullness but he was able to ingest. All patients resumed their preoperative activity by postoperative day 3 to 5. We believe that this procedure was safe and useful for decision making in the management of our patients. We need further study on indications and techniques for this procedure.

Aged↗
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

[Results of combination chemotherapy with etoposide, ifosfamide, peplomycin for advanced prostatic cancer].

Between August, 1986 and August, 1992, 16 combination chemotherapies with etoposide (100 mg/body, day 1-5), ifosfamide (50 mg/kg, day 1, 3, 5), peplomycin (5 mg/body, day 1-5) were performed on 13 patients with endocrine therapy-relapsed advanced prostatic cancer. Seven trials were performed on 5 patients who received DESP (diethylstilbestrol diphosphate) (500 mg/body, day 1-5) with the chemotherapy. In 9 trials performed on 9 patients who did not receive DESP, there was no response case. In 7 trials with DESP, one trial had a partial response (PR) (14%) and 4 remained objectively stable (stable) (57%). As to adverse effects, myelosuppression was observed in all trials but there was no lethal toxicity. The one-year survival rate of these patients treated with the chemotherapy alone and combined DESP were both about 20%. Therefore we should find a more effective treatment for endocrine relapsed prostatic cancer.

Adenocarcinoma↗
PubMed1993

Efficacy and safety of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution.

The efficacy and safety of a quick drying rubbing type disinfectant (HAD Hand Wash) composed of a povidone-iodine (PVP-I) and ethanol were evaluated in the disinfection of transient skin flora on fingers of 30 medical staff of our department. Three millilitres of HAD solution was rubbed onto the hands for three minutes several times a day over a four week period. Bacteriological effects were evaluated twice, on the first day and after four weeks, by the palm stamp method. The rate of colonies sterilized (bacterial reduction rate) after the use of HAD Hand Wash was 86.9 +/- 21.2% (mean +/- SD) on the first measurement, and 91.5% +/- 12.8% at four weeks. Staphylococcus epidermidis was isolated most frequently and this was eradicated in 83.3% of subjects, the bacterial reduction rate 99.7%. Staphylococcus aureus was originally isolated in 14 subjects and was eradicated in 13; the bacterial colony reduction rate was 99.9% showing high antiseptic efficacy. Although the bacterial reduction rate for Bacillus sp. was a rather low, 75.8-100%, this result was not considered problematic from the clinical standpoint. There were no side effects like chapping in spite of an average 104 applications of HAD Hand Wash during the 4-week test period. From these results, HAD Hand Wash was considered highly effective and safe.

Antisepsis↗
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↗
PubMed1992

Induction of thromboxane synthase and prostaglandin endoperoxide synthase mRNAs in human erythroleukemia cells by phorbol ester.

The effects of 12-O-tetradecanoyl-phorbol-13-acetate (TPA) on the mRNA levels of two enzymes, thromboxane synthase (TXS) and prostaglandin endoperoxide synthase (PES), responsible for the synthesis of thromboxane A2 from arachidonic acid, were studied in human erythroleukemia (HEL) cells by RNA blot analysis. TPA induced both TXS and PES mRNAs in HEL cells in a dose-dependent manner at 36 h. The half-maximal and maximal effects for the induction of both mRNAs were at approximately 3 x 10(-9) M and at 10(-8) M, respectively. TXS and PES mRNA levels increased in a time-dependent fashion by TPA, and reached to 7- and 3.5-fold of the control, respectively after 48 h of TPA treatment. These results suggest that expression of TXS and PES genes in HEL cells were simultaneously stimulated by TPA.

Cyclooxygenase Inhibitors↗
PubMed1992

Removal of endotoxin from culture supernatant of Bordetella pertussis with aminated poly(gamma-methyl L-glutamate) spherical beads.

Attempts were made to prepare adsorbents having a high affinity for endotoxin in the culture supernatant of Bordetella pertussis. When poly(gamma-methyl L-glutamate) (PMLG) was used as a matrix and amino groups as the ligand, the highest affinity for endotoxin was attained even at a high ionic strength (mu = 0.2-0.4). PMLG beads containing amino groups of about 3.2 meq/g selectively removed endotoxin from the culture supernatant of B. pertussis without affecting the protective antigens. It was demonstrated that 1 ml of the wet adsorbent adsorbed 4.5 mg of endotoxin. The beads of PMLG derivatives, therefore, are considered to be a useful adsorbent for the removal of endotoxin from the pertussis vaccine, affecting neither filamentous hemagglutinin nor pertussis toxin.

Adsorption↗
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

[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

Effects of serum bilirubin on determination of uric acid by the uricase-peroxidase coupled reaction.

We examined the possible effect of different bilirubin species, including unconjugated (Bu), sugar-conjugated (Bc), and authentic delta bilirubin (Bd) isolated from serum, on the direct enzymatic measurement of uric acid by using the uricase (EC 1.7.3.3) and peroxidase (EC 1.11.1.7) coupled reaction. Bc, isolated from human bile, produced the most interference with uric acid determination. Although the presence of human serum albumin reduced interference by Bu and Bc, albumin-bound Bc complex still produced greater interference than Bu. Interference with the peroxidase reaction by Bc covalently bound to serum albumin (Bd) was less than that by Bu. We examined this phenomenon by using serum-isolated Bd obtained by ammonium sulfate precipitation and ultrafiltration and by using commercially available ditaurobilirubin (DTB) and chemically synthesized Bd (via Woodward's reagent, WBd) as surrogates for bile-isolated Bc and natural Bd, respectively. DTB produced the same amount of interference as natural Bc, but the interference produced by DTB in the presence of serum albumin was not the same as that produced by natural Bc with albumin. Our synthetic Bd appears to be a reliable surrogate for natural Bd in testing for bilirubin interference.

Bilirubin↗
PubMed1992

In vitro effects of light on serum bilirubin subfractions measured by high-performance liquid chromatography: comparison with four routine methods.

The effects of light on serum bilirubin subfractions in vitro were investigated by HPLC and four routine methods for bilirubin analysis. By HPLC, the rate of photodegradation of unconjugated bilirubin (Bu) was nearly twice that of monoconjugated bilirubin (mBc) and threefold that of diconjugated bilirubin (dBc); delta bilirubin (Bd) was most stable against photoirradiation. In the diazo method, the rate of photodegradation of direct bilirubin was almost the same as that of the sum of mBc, dBc, and Bd determined by the HPLC method. However, the rate of photodegradation of indirect bilirubin was significantly lower (P < 0.001) than that obtained by HPLC, because approximately 30% of the bilirubin photoproducts reacted with the diazo reagent as indirect bilirubin. The rate of photodegradation of total bilirubin determined by the direct spectrometric method was lower than that determined by the diazo method, but equal to that of the total peak areas of HPLC. In the Ektachem method, bilirubin photoproducts affected total bilirubin negligibly, and Bc and Bu positively, so that the value of Bd decreased. In the bilirubin oxidase method, bilirubin photoproducts were oxidized enzymatically by both the total and direct bilirubin reagents. We re-emphasize the importance of shielding serum from light to avoid generating bilirubin photoproducts that interfere with the accurate determination of serum bilirubin subfractions. We also recommend HPLC analysis as a standard method for bilirubin measurement.

Adult↗
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

[Clinical statistics on inpatients admitted to the Department of Urology, Hyogo Prefectural Hospital Nishinomiya during 20 years from 1972 to 1991].

A statistic analysis was carried out on the 4,956 inpatients admitted to our Department of Urology from April 1972 to December 1991. The patients included 3,399 males and 1,557 females. A total of 4,105 operations including 255 renal allotransplantations were performed on 3,590 patients. Open surgery for upper urinary tract stones has been replaced by extracorporeal shock-wave lithotripsy (ESWL) in the last three years.

Adult↗
PubMed1992

Chondromalacic changes of the patella in rabbits.

Malalignments of the patellofemoral joints were artificially made in eleven rabbits using four different methods in order to generate chondromalacia of the patella. Chondromalacic changes and the location similar to the chondromalacia of the human body were generated in one joint of the patching group. According to the results of our investigation, the most reasonable etiological factor of the chondromalacia is thought to be the expansion of the medial retinaculum and capsule of the knee joint, and chondromalacia patellae may not be a precursor of osteoarthritic changes.

Animals↗