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Biomedical subjects

H Yoshihara

Publications and source records attributed to H Yoshihara.

At least 91 records · Page 5Linked to original sources
PubMed1990

[A clinical study on urethral recurrence observed after cystectomy].

A clinical study was made on 108 male patients who underwent cystectomy. The posterior urethra and partial anterior urethra were removed in 47 cases, half of the perpendicular urethra was removed in 13 cases and the anterior urethra up to the fossa navicularis was removed in 48 cases. Out of 60 cases without urethrectomy, urethral recurrence was observed in 13 cases (21.7%), while no recurrence was observed in the cases treated with urethrectomy. The average period of time from cystectomy to urethral recurrence was 24.7 months (11-39 months). Urethral cancer of such early stages as pIa and pIb were found in 3 and 6 cases, respectively. Stage pT2 was found in 4 cases. Grade 1 cancer was found in 3 cases, grade 2, in 5 cases, and 3 in 5 cases. The proximal end of the perpendicular urethra was found to be the most frequent site for recurrence with 11 cases exhibiting recurrence at this location and 2 cases at the mid-portion of the perpendicular urethra. Many cases exhibited multiple recurrence of tumor of visually grayish, velvety and non-papillary type which was histologically all transitional cell carcinoma. Bladder tumor with higher grade tended to cause urethral cancer recurrence with higher grade. Bladder tumors at multiple locations from the trigone to the lateral and posterior walls tended to cause recurrence in the urethra (p less than 0.05). Of all the cases, 10 cases underwent urethrectomy and 2 cases penectomy. 12 cases received chemotherapy and 5 cases radiation therapy as postoperative adjuvant treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Intravesical instillation chemotherapy of anticancer agents including cylocide: studies of prophylactic effects on the recurrence].

We studied the efficacy of intravesical instillation chemotherapy of anticancer agents including cylocide (CA) in the prevention of recurrence of bladder tumor after surgery. Totally 60 patients with superficial bladder tumor were enrolled into the study. The patients were randomly assigned to either one of three groups: CA 300 mg alone, CA 200 mg + mitomycin C (MMC) 10 mg, and CA 180 mg + adriamycin (ADM) 20 mg. These drugs were initially instilled once a day for one week, and then once a month until 2 years after surgery. Thereafter, the patients were followed up without instillation. The cumulative non-recurrence rates in the CA group was 76.5, 60.0 and 60.0% at 1, 2 and 3 years after the removal of bladder tumor, respectively, while that in the CA + MMC treated group 90.9, 75.3, and 75.3% and that in the CA + ADM treated group, 95.1, 82.9 and 82.9%, respectively. The recurrence rate in the CA, CA + MMC and CA + ADM treated group was 35.3, 27.3 and 19.0%, respectively, the recurrence indices 1.84, 1.07 and 0.74, and the mean times between recurrence 10.8, 16.5 and 18.0 months, respectively. Side effects were noted in 3 of the 17 cases (17.6%) in the CA group, in 3 of the 22 cases (13.6%) in the CA + MMC group and in 3 of the 21 cases (14.3%) in the CA + ADM treated group. These data show that intravesical CA instillation in combination with MMC or ADM is more effective for the prevention of recurrence than that of CA alone.

Actuarial Analysis↗
PubMed1990

[Effect of maternal oxygenation on fetal blood gas status in shiba goat fetuses].

The purpose of this study is to investigate the effect of maternal oxygen administration on the fetal blood gas status. Five Shiba goat fetuses were used whose gestational days were 134 +/- 4 days. Maternal and fetal pH, pO2, pCO2, B.E., and hematocrit were measured every 30 minutes during 4 l/min oxygen administration for 60 minutes. Maternal arterial blood pO2 increased from 95.5 +/- 19.6 mmHg to 262.6 +/- 75.8 mmHg at 30 minutes and to 207.8 +/- 110.1 mmHg at 60 minutes. Fetal arterial blood pO2 increased significantly from 18.4 +/- 3.0 mmHg to 24.4 +/- 5.8 mmHg and 23.6 +/- 6.9 mmHg, respectively. There was a significant positive correlation between maternal pO2 and fetal pO2. The increase in fetal pO2 was small when the control pO2 was less than 17 mmHg. Although maternal pH did not change significantly, fetal pH decreased significantly from 7.29 +/- 0.07 to 7.25 +/- 0.07 at 60 minutes. Also fetal hematocrit decreased significantly from 33.9 +/- 5.2% to 32.8 +/- 5.4% at 60 minutes. Neither maternal nor fetal pCO2 and B.E. changed significantly. Therefore, we concluded that the effect of maternal oxygen administration on fetal pO2 was small when the fetus was already hypoxic. Also 60 minutes' oxygen administration may cause the decrease in fetal pH and hemodilution.

Animals↗
PubMed1990

[Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone].

At Osaka City University Hospital, we performed extracorporeal shock-wave lithotripsy (ESWL) for 1277 patients in a total of 1788 sessions using Dornier kidney lithotripter Model HM III from July, 1985 to the end of December, 1988. Among the patients with a solitary stone, 911 cases were available for the follow-up study and we have compared the results among these cases in respect to the stone location and size. The results obtained were as follows: the ratio of kidney stone to ureter stone was found to be 2.2:1 in male, and 3.8:1 in female patients. This indicates that ureter stones are more frequently found in male than in female patients. In addition, we compared the size of kidney stones found in the patients including 415 male and 243 female patients. Stones larger than 20 mm were more frequently found in female than in male patients. Moreover, a stone composition study of these patients showed that the contents of both phosphate calcium and magnesium ammonium phosphate were higher in female than in male patients. ESWL performed against stones at pelvis and calyces exhibited the best results. The results obtained with the stones less than 20 mm in diameter were especially favorable with a success rate of 100% for the stones less than 10 mm and 83% for the stones 10-20 mm, in diameter, while the results with the stones larger than 20 mm in diameter were rather poor with a success rate of 31%. ESWL performed against ureter stones showed poor results with a success rate of 63% for the stones smaller than 20 mm in diameter.

Calcium Phosphates↗
PubMed1990

[A case of severe tetanus associated with sympathetic overactivity].

A case of severe tetanus showing clinical features compatible with sympathetic overactivity (SOA) is reported. A 64-year-old man was admitted to our hospital 6 days after injury. The clinical signs of SOA developed on the second day in ICU. Through the clinical investigation of this case, we found out and insisted on some new concepts about the clinical features of SOA. 1. Lability of arterial pressure is parallel to that of catecholamine level in serum. 2. Two different types in SOA were found. One is dominantly lable type of Adrenaline and another is of Noradrenaline. 3. Drawing a sharp line between 2 types by assessment of circulatory data from Swan-Ganz catheter is significant for deciding therapeutic lines.

Blood Pressure↗
PubMed1989

Changes in the intracellular calcium ion concentration in the gastric mucosa in a rat ischemia-reperfusion model.

To investigate the role of the intracellular calcium ion in the development of acute gastric mucosal lesions, phosphorylase a activity was measured as an index of the intracellular calcium ion concentration ([Ca2+]i), using Lowry's method, in the rat ischemia-reperfusion model. [Ca2+]i increased significantly at the end of the ischemic state without acute mucosal lesions (AGML). After reinfusion, [Ca2+]i showed a slight increase and AGML developed. Continual intravenous infusion of the calcium channel blocker, diltiazem (1 mg/kg/hr), inhibited the increase in [Ca2+]i in the ischemic state and reduced the development of AGML after reinfusion. These results suggest that the increase in [Ca2+]i in the ischemic state plays an important role in the development of AGML.

Animals↗
PubMed1989

Characterization of hepatic hemodynamics in cirrhotics and non-cirrhotics. Effect of glucagon infusion.

The effect of glucagon on hepatic regional hemodynamics was investigated in patients with chronic liver disease during peritoneoscopy with reflectance spectrophotometry. When glucagon was infused intravenously in patients with a non-cirrhotic liver, the regional hepatic tissue oxygen consumption, as estimated spectrophotometrically, increased significantly, whereas the index of hepatic tissue blood volume did not change appreciably, and consequently, the oxygen saturation of hemoglobin in the hepatic tissue blood decreased. In contrast, the administration of glucagon in patients with liver cirrhosis resulted in a significant increase in the index of hepatic tissue blood volume and produced a minor increase in hepatic tissue oxygen consumption. The oxygen saturation of hepatic blood hemoglobin tended to increase in the cirrhotics. The result suggests the presence of functional vasoconstriction at the presinusoidal and/or sinusoidal vessels in the cirrhotic liver, possibly due to a decreased vasomotor activity and/or an abnormal regulatory function of vasoactive substances, which are released by glucagon.

Adult↗
PubMed1989

[Activity of guanase in serum and liver function tests in HBe antigen-positive chronic hepatitis].

Forty-one patients with chronic hepatitis were divided into an HBe antigen-positive group (n = 13) and an HBe antigen-negative group (n = 28) to clarify the relationship between the presence of HBe antigen and liver function. In the HBe antigen-positive group, the activities of serum alanine aminotransferase (p less than 0.01), aspartate aminotransferase (p less than 0.05) and guanase (p less than 0.01) were significantly higher than those in the HBe antigen-negative group. The correlation coefficient between the HBe antigen titer and guanase activity was 0.528, which was higher than the corresponding values for alanine aminotransferase and aspartate aminotransferase. The determination of guanase activity in serum may be useful for evaluating the clinical severity of HBe antigen-positive chronic hepatitis.

Adolescent↗
PubMed1989

[Clinical evaluation of osteocalcin in chronic hemodialysis patients].

Serum level of osteocalcin was measured by radioimmunoassay in 52 patients with chronic renal failure and 92 control subjects. The patients were treated by usual hemodialysis over a 3-month period. The osteocalcin level of the patients was significantly higher than that of the control subjects, but the patients with diabetic nephropathy had a lower osteocalcin level than the patients with non-diabetic nephropathy. There was a significant correlation between serum osteocalcin level and alkaline phosphatase or PTH level. On the other hand, there was no relationship between serum osteocalcin level and various parameters such as bone mineral contents, and bone cortex volume measured by the microdensitometry method. Hemodialysis affected the serum osteocalcin level. The clinical value of osteocalcin as a parameter of bone formation in chronic hemodialysis patients was discussed.

Adult↗
PubMed1989

Hepatotoxicity of menadione predominates in oxygen-rich zones of the liver lobule.

This study was designed to investigate the mechanism of zone-specific hepatotoxicity due to menadione. Infusion of menadione (64-1000 microM) into perfused livers from fasted rats caused a concentration-dependent increase in O2 uptake. During perfusion in the anterograde direction, menadione (1 mM) increased O2 uptake from 115 +/- 11 to 142 +/- 10 mumol/g/hr within 30 min, followed by a decrease to 92 +/- 11 mumol/g/hr over the next 30 min. Trypan blue was taken up by 90% of cells in periportal regions reflecting irreversible cell death, whereas cells in pericentral areas were not damaged. When the hepatic O2 gradient was reversed by perfusing in the retrograde direction, menadione increased O2 uptake initially from 114 +/- 11 to 132 +/- 14 mumol/g/hr, followed by a decline to 51 +/- 12 mumol/g/hr, qualitatively similar to data obtained from perfusions in the natural, anterograde direction. During perfusions in the retrograde direction, however, 95% of cells in pericentral regions were stained with trypan blue whereas those in periportal areas were spared. O2 uptake in specific zones of the liver lobule was then measured with miniature O2 electrodes. When menadione was infused during anterograde perfusions, O2 uptake increased in O2-rich periportal areas from 128 +/- 6 to 156 +/- 12 mumol/g/hr, but was not altered in pericentral regions. Conversely, during perfusions in the retrograde direction, menadione did not affect O2 uptake in periportal areas, but stimulated uptake in O2-rich pericentral regions from 120 +/- 4 to 150 +/- 14 mumol/g/hr.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

[A randomized controlled study to compare bladder instillation therapy of anticancer agents and combination therapy with OK-432 injection in prevention of post-TUR recurrence of bladder cancer].

To evaluate the effects of bladder instillation chemotherapy of anticancer agents with OK-432 intradermal injection (group A) in preventing postoperative recurrence of bladder carcinoma, a randomized controlled study with intravesical instillation chemotherapy of anticancer agents (group B) as the reference standard was performed. As the anticancer agents, pepleomycin (PEP) was usually used at a concentration of 30 mg/30 ml physiological saline. OK-432 injection dose was gradually increased from 0.5 KE to 5.0 KE and maintenance dose was decided by local skin reactions. There were no differences in the patient's background factors between group A (22 cases) and group B (17 cases). The no-recurrence rate of bladder carcinoma was similar in the two groups, but the no-recurrence rate for the virgin tumor or the stage T0 cases was higher in group B. On the other hand, the values for the recurrent cases or the stage T1,2 cases was higher in group A. The SU-PS skin reaction as an immunological response was significantly higher in group A. There were no severe side effects derived from anticancer bladder instillation or OK-432 injection.

Administration, Intravesical↗
PubMed1988

[Clinical and fundamental studies on ceftriaxone (CTRX) against urinary tract infections].

Clinical efficacy of ceftriaxone (CTRX) against complicated urinary tract infections in 20 patients was examined, and the serum CTRX level was also measured in the patients with chronic renal failure (CRF). CTRX was administered at a dose of 1.0 g once a day for 5 to 10 days. The overall clinical efficacy was rated excellent in 4 cases (20%), moderate in 13 cases (65%) and poor in 3 cases (15%) with a total efficacy of 85%. Seventeen out of 27 strains (62.8%) isolated were eradicated after CTRX administration. In the patients with CRF, serum levels were very high and showed a plateau 4 hours after the injection. Furthermore, CTRX may not be removed by usual hemodialysis treatment. There were no severe side effects due to CTRX in these patients.

Adult↗
PubMed1988

[Evaluation of Candida HA titer in patients with urinary tract infections].

The serum candida antibody (HA titer) was measured by means of indirect hemagglutination test in 28 patients with complicated urinary tract infections (UTI) and 11 control subjects. The peripheral lymphocytes subsets (OKT-3,4,8 and 4/8 ratio) were also examined in same patients. The 17 UTI patients who had Candida species in their urine had a higher HA titer than the other UTI patients without Candida or control subjects, but elderly UTI patients (over 71 years old) did not show higher HA titer. A positive correlation was seen between HA titer and OKT-3,4 or 4/8 ratio. On the other hand, HA titer and OKT-8 showed a negative relationship. Therefore, the ability to produce the candida antibody might be closely related to the host cellular immune responsiveness.

Age Factors↗
PubMed1988

[Effect of nutritional treatment of esophageal cancer patients on pre and post-operative hemodynamic changes and postoperative lung complications].

In 35 patients with esophageal cancer, preoperative nutritional state and hemodynamic changes on exercise test using Swan-Ganz catheter were studied. Thirty-five patients were divided into two groups. Group 1; preoperative daily calorie intake was less than 1.75 X BEE (basal energy expenditure), Group 2; preoperative daily calorie intake was more than 1.75 X BEE. There were significant differences between Group 1 and Group 2 in preoperative daily calorie intake, serum transferrin, retinal binding protein, pre-albumin and total lymphocyte count. From this result, Group 1 was thought to be malnutritional state, but nutritional state of Group 2 was thought to be improved. From the analysis of the hemodynamic changes on exercise test using Swan-ganz catheter, the cardiac function was better in Group 2 than in Group 1. The difference of the cardiac function was thought to be brought by the difference of nutritional state. In postoperative hemodynamic changes, Group 2 was better than Group 1 and in the occurrence of lung complications, Group 2 was much less than Group 1. These results was thought to be due to the difference of cardiac function brought by differences of nutritional state.

Adult↗
PubMed1988

[Clinical and fundamental study of guanabenz in hypertensive patients with renal failure].

Clinical and fundamental study of Guanabenz were performed in 20 hypertensive patients with renal failure, who were treated by maintenance hemodialysis treatment. The patients received 2 mg of Guanabenz orally, twice a day for 3 months or more. The clinical efficacy of good control was attained in 65%, and of fair control in 90%. On the other hand, the objective and subjective effects of Guanabenz were compared between short term (within one year long) hemodialysis patients and long term (over one year) patients. The overall clinical efficacy was higher in short term patients. The serum level of Guanabenz in hemodialysis patients showed a maximum value at 2-4 hours after administration. As Guanabenz might not be removed so much by hemodialysis, the administration schedule and daily dosage were discussed. There were no severe side effects arising from administration of Guanabenz.

Adult↗
PubMed1988

[The effects of ninzin-to with daiokanso-to in patients with chronic renal failure].

The clinical effects of ninzin-to with daiokanso-to were studied on 15 patients with chronic renal failure. The level of urea nitrogen and creatinine in sera was slightly decreased in early days of treatment (about 3 months long), but thereafter these levels were gradually increased in many patients and 2 patients needed hemodialysis treatment. The effects of these drugs against subjective symptoms were found in bowel habits, general malasia and anorexia. The overall effective rate was 80% in early term and 60% in late term. There were no severe adverse reactions.

Adult↗
PubMed1988

[Experience with extracorporeal shock-wave lithotripsy of upper urinary tract stones].

The first 121 cases of upper urinary tract stone treated by extracorporeal shock wave lithotripsy (ESWL) at our clinic were analyzed. Three months after ESWL, 78% of the patients became stone free, and 17% of the patients had residual stone fragments which were less than 5 mm in diameter and considered passable. The success rate was therefore about 94.6%. No severe side effects were observed, although temporary elevations in serum creatinine phosphokinase, lactate dehydrogenase, glutamic-oxaloacetic transaminase, aldolase and total bilirubin occurred. These results indicated that ESWL was a safe and effective procedure for upper urinary tract stones.

Female↗