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Biomedical subjects

J Kawamura

Publications and source records attributed to J Kawamura.

At least 235 records · Page 13Linked to original sources
PubMed1987

[A case of Werner's syndrome associated with bladder cancer].

A 41-year-old woman was diagnosed as having Werner's syndrome associated with bladder cancer. The patient noticed sudden, total gross hematuria in September, 1985. Cystoscopy revealed a papillary tumor with a stalk that was accompanied by a daughter tumor and concealed the left ureteral orifice. The tumors were 25 X 20 X 10 mm and 15 X 10 X 5 mm. Double contrast cystograms, computed tomography and transurethral echo showed no invasion of muscle layer. Intravesical instillation of mitomycin (10 mg), cylocide (300 mg) and adriacin (30 mg) was carried out 3 times per week for 4 weeks. Tumor size was reduced, and then TUR was performed. High power section of the removed bladder tumor showed pathologically PNT, TCC, grade II, INF alpha, pTla, lyo and v(-). The patient had such clinical manifestations as short stature with low body weight, thin limbs and stocky trunk, senile face, early graying hair, highpitched voice, bilateral cataracts, osteoporosis, sclerodermia-like signs, flat feet, tendency toward diabetes mellitus and parental consanguinity. Hyaluronic acid was not detected in the urine. To the best of our knowledge, this seems to be the 30th report describing the association of malignancy with Werner's syndrome in Japan; besides, only one other case of bladder cancer in Werner's syndrome has been reported to date in the world.

Adult↗
PubMed1987

[Prostatic development, cytodifferentiation and growth: epithelial-mesenchymal interaction and heterogeneity of prostatic cellular activity].

Prostatic growth and hormonal effects on the prostate play a basic role in the pathogenesis of abnormal proliferative diseases (i.e. benign prostatic hyperplasia and prostatic carcinoma). During the embryonic period, the prostate is organized through the budding and branching of the epithelial cords into the urogenital sinus mesenchyme. The urogenital sinus mesenchyme has an inductive potential for the prostatic epithelial development and cytodifferentiation under the influence of androgen and an epithelial-mesenchymal interaction. In this interaction, mesenchymal cells are considered as a mediator of hormonal action on epithelial cells. Postnatal prostatic growth is obtained further ductal branching morphogenesis and regulated by the epithelial-mesenchymal interaction, androgen, and epithelial/mesenchymal ratio. Castration-induced degeneration, and androgen-induced regeneration of the glandular architecture of the mouse prostate were investigated by microdissection techniques that permitted precise quantitation of the numbers of the terminal ductal tips and ductal branch-points. During the first 15 days after birth, active branching morphogenesis occurred as a result of focally high levels of DNA synthesis confined almost exclusively to the distal tips of the branching ducts. Following castration about 35% of the ductal tips and branch-points were lost in distal regions (usually near the capsule). By contrast, in more proximal regions of the prostate the ducts survived in an atrophic condition. The lost distal ductal morphology completely regenerated following administration of testosterone propionate (TP) to the castrated males. Whole-mount autoradiography demonstrated that labelling intensity reached a maximum on the third day of TP treatment in distal ductal areas. Recognition of the mesenchymal-epithelial interaction and heterogeneities in the morphogenesis, androgen dependency, and DNA synthetic activity within the prostatic architecture is fundamental to understanding the mechanism of androgenic regulation of normal or abnormal prostatic growth and development.

Androgens↗
PubMed1986

[Prognostic characteristics of gallium-positive accumulation in the kidney with renal cell carcinoma by the tomographic whole-body Ga-67-citrate scan].

A frontal tomographic whole-body Ga-67-citrate scan was performed on 67 patients with renal cell carcinoma to clarify the characteristics of gallium uptake by the kidney in relation to the tumor stage and grade, clinical laboratory data and prognosis. Positive gallium uptake by the kidney in 32 patients correlated well with the clinicopathologically higher stage and grade of the tumor and with abnormal values in prognostic indexes in the blood such as erythrocyte sedimentation rate, CRP alpha 2 globulin, ferritin and copper. Gallium accumulation in pulmonary metastatic lesions was found in 13 of 21 patients and all cases with positive uptake by the pulmonary metastatic lesions belonged to the gallium-positive group in the kidney. Kaplan-Meier estimation of survival rate clearly demonstrated bad prognosis in this group. Since the sensitivity of the Ga-67 scan is low but the specificity is high, positive gallium uptake is indicative of an ominous clinical course and shorter survival in patients with renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1986

[A study on the cause of urolithiasis of the upper urinary tract--clinical study of risk factors in the formation of stones in the upper urinary tract].

Various risk factors and inhibitors of the stone formation of the upper urinary tract have been pointed out in urine. We examined the amount of daily excretion of several important risk factors (calcium, phosphorus, urate and oxalate) and inhibitors (magnesium and citrate) in the urine of 21 healthy males, 13 male single stone formeks and recurrent and/or multiple stone formers before and after taking the regular diet which contains 500 mg of calcium and 1,000 mg of phosphorus a day. The daily excretion of calcium, phosphorus and magnesium indicated no significant differences among the 3 groups. The excretion of oxalate in urine for 24 hours was significantly decreased in the stone formers after taking the regular diet. The urinary excretion of the urate per body surface area in the stone formers was significantly higher than that in the healthy control. The amount of the excretion of the citrate in urine in the recurrent and/or multiple stone formers was significantly lower than that in the other 2 groups. Many patients of the recurrent and/or multiple urinary stones had more than two abnormal values of above-mentioned risk factors and inhibitors. These results suggest that the causes of the formation of the upper urinary stone were not single but multiple and that the dietary advice to these patients was important against the recurrence of the urolithiasis.

Adult↗
PubMed1986

[Staging pelvic lymphadenectomy for carcinoma of the prostate: review of 23 cases].

Between June, 1982 and May, 1985, 37 patients underwent pelvic lymphadenectomy for carcinoma of the prostate, 23 patients as an independent procedure. Of these 23 patients 7 had pelvic node metastasis. Node involvement occurred in 60% with clinical stage C tumors. Correlation with tumor grade revealed nodal metastasis in none of the latients with well differentiated tumors, 33.3% of those with moderately differentiated lesions, and 75% of those with poorly differentiated tumors. Metastatic disease most commonly involved the obturator-hypogastric lymphnodes (85.7%). Of the 23 patients, 14 underwent conventional node dissection, and 9 limited node dissection. Complications of lymphocele, lymphfistula, penoscrotal edema and lower extremity edema occurred mostly in patients with conventional node dissection. Limited staging pelvic node dissection provides information similar to that identified after more extensive dissection and can be accomplished with little morbidity.

Aged↗
PubMed1986

[Clinical statistics on inpatients and operations in the Department of Urology, Toyooka Public Hospital (from January 1982 to December 1985)].

Statistical observations on inpatients and operations in our department from 1982 to 1985 were reviewed in comparison with the statistics for the preceeding three years. More elderly persons comprised the inpatients at our hospital than at other facilities. Urogenital tumors and urolithiasis were the predominant disease of the inpatients, as they were in the preceeding three years. Number of prostatic cancer has remarkably increased. Transurethral operations, TUR-P and TUR-Bt, were the most representative. Operations for the malignant disease, especially for prostatic cancer, were more frequent in this period than in the preceeding three years. As to urinary diversion, ileal conduit was the main procedure used during this four years. Kock continent ileal reservoir was adopted in 1985. In July 1985, open operations for urolithiasis were dramatically replaced by percutaneous and transurethral procedures.

Female↗
PubMed1986

[Epidemiological study on urolithiasis in Mie Prefecture. 1. Present status in 1985].

To determine the present status of urolithiasis in Mie Prefecture, we analyzed the 1,314 patients of urolithiasis at 17 Departments of Urology and 2 Departments of Medicine in 1985. The ratio of male patients to female patients was 2.6 to 1. The most frequent incidence of urolithiasis was observed in Iinan county. The incidence of urolithiasis in the urban area was the same as that in the country. Most of the stones (96.9%) were in the upper urinary tract. The incidence of lower urinary tract calculi tended to be high in southern Mie Prefecture. The ratio of upper urinary tract calculi to lower urinary tract calculi in the urban area was the same as that in the country. The peak incidence in males was in the forties, while that in females was in the fifties. The average age was 44.5 years old. Ureterolithotomy was the most frequent (37.5%) surgical therapy, percutaneous nephrolithotomy and shock wave lithotomy done in 8.0% and 6.3%, respectively. The most frequent component of the urinary tract calculi was calcium oxalate and/or calcium phosphate (84.0%). The incidence increased in summer (April through September).

Adult↗
PubMed1986

[Experimental and clinical studies on calcium lithiasis. II. Prevention of recurrent calcium stones with thiazides and allopurinol].

We evaluated 113 patients with recurrent or multiple calcium urolithiasis at our outpatient stone clinic between 1980 and 1983. Diagnostic categories included hypercalciuria (36 patients), hyperoxaluria (35 patients), and hyperuricosuria (31 patients). Thiazides and/or allopurinol were administered to the hypercalciurics and hyperuricosurics, respectively for prevention of stone recurrence. Patients followed up for more than one year were 23 (male 16, female 7) in the thiazide group, and 15 (male 12, female 3) in the allopurinol group. The mean treatment interval was 2.49 years in the former, and 2.35 years in the latter. The remission rate (percentage of patients without formation of any new stones) was 82.6% in the thiazide group, and 73.3% in the allopurinol group. The group stone formation rate was reduced from 0.85 to 0.35/pt-yr in the thiazide group, and from 0.74 to 0.27/pt-yr in the allopurinol group. Efficacy of these two drugs for the prevention of calcium stone recurrence was observed in this selective therapy, but a careful double blind study should be carried out to draw a definite conclusion.

Allopurinol↗
PubMed1985

Temporary above-knee prostheses and training programme during chemotherapy.

A temporary prosthesis has been developed for above-knee amputees who receive long-term post-amputation chemotherapy. The temporary prosthesis has an adjustable laminated quadrilateral socket, the size of which is adjusted by metal screws. Fifteen patients were fitted with the temporary prosthesis. Initial fittings were carried out after a period averaging 46 days from amputation. All of the patients were able to walk with one crutch after about one month from initial fitting. Although patients often had to discontinue their prosthetic training owing to chemotherapy, they could resume wearing their prostheses simply by adjusting the socket. One patient, who was fitted with a cosmetic ultra-light prosthesis initially due to her poor general condition, was later fitted with the temporary prosthesis. She regained the ability to walk 60 days later and still wears it. Early fitting of temporary prostheses for these patients is not only of practical convenience but also improves their mental state.

Adolescent↗