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Biomedical subjects

J Kawamura

Publications and source records attributed to J Kawamura.

At least 253 records · Page 14Linked to original sources
PubMed1985

[Evaluation of the clinical effect of lisuride hydrogen maleate (SH-1072) on benign prostatic hypertrophy: on the clinical results and mechanism of action].

Lisuride hydrogen maleate (LHM, SH-1072), a dopaminergic agonist and therefore an inhibitor of prolactin (PRL) secretion, were administered to 12 patients with mild to moderate BPH in order to evaluate the clinical effectiveness. LHM was administered 75 or 150 mcg/day, po, for 20 weeks on the average. The status of micturition evaluated by score points and nocturnal frequency of urination was significantly improved, whereas objective responses such as on the amount of residual urine, size of the prostate gland, findings of urethrocystography and the length of prostatic urethra measured on the film were minimal. Serum PRL level have been reduced significantly through the therapy, and testosterone were unchanged. The mechanism of action of the agent on BPH and the surrounding tissue was discussed; reduced androgen effect on the prostate through lowering of PRL and anti-alpha-adrenergic activity or the effect through prostaglandin on the gland, the bladder neck and the posterior urethra would mitigate the symptoms.

Aged↗
PubMed1985

[Percutaneous renal cyst puncture].

Ultrasound-guided renal cyst puncture was performed on 31 cysts which were then 95% ethanol instilled to prevent recurrence of cystic fluid. Ethanol was allowed to remain in place for 20 minutes and removed through the catheter. Morphological improvement was observed on IVP and Tc-99m-DMSA renal scintigram, and DMSA renal uptake rate increased slightly. The cystic wall became thicker, and cystic fluid did not remain any more. The renal tissue near the cyst was intact. One third of the patients had hotflush and/or somewhat drunken sense but these symptoms were only temporary. This method of therapy is a safe and effective way of treating renal cysts.

Adult↗
PubMed1985

[Renal function study by 99mTc-DMSA renal scintigraphy in each treatment of staghorn calculi].

From 1976 through 1984, 94 staghorn calculi of 86 patients were treated in this department. Kidney function was assessed by Tc-DMSA renal scintigraphy consisting of renal cortical imaging and DMSA renal uptake rate, in 84 kidneys preoperatively and 43 kidneys pre- and postoperatively. There was an increase in the postoperative DMSA renal uptake in the operated kidney, in 3 out of 14 kidneys in which pyelolithotomy was performed and in one out of 10 kidneys in which nephrolithotomy was done. It was still impossible to answer the question of which mode of operation should be chosen only from consideration of kidney function study. But it was suggested by the statistical investigation that nephrectomy seemed to be selected in the case of severely decreased renal function. It was reasonable that pyelolithotomy was the best method from the point of predicting the postoperative recovery of renal function. But in the near future, advances in endoscopical stone surgery and extracorporeal procedures, might reduce the damage of the renal function caused by conventional stone surgery.

Humans↗
PubMed1985

[Changing modality of the treatment in upper urinary tract calculi. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy].

From March, 1984 to April, 1985, 70 cases of upper urinary tract calculi (73 renal units) were treated by percutaneous nephrolithotripsy or transurethro-ureteral lithotripsy, mainly utilizing ultrasonic lithotrite. While in the early period of treatment, two stage procedure of creation of nephrostomy tract and percutaneous nephrolithotripsy was performed for renal and upper or middle part of the ureteral calculi, one stage procedure, nephrostomy tract formation followed by ultrasonic nephrolithotripsy is commonly used in recent cases. During this period, conventional stone surgery was seen in 6 cases of pyelolithotomy and 2 of ureterolithotomy, while 52 cases of stone surgery were performed during the earlier period (from January, 1983 to February, 1984). Renal and upper or middle part of ureteral calculi were successfully removed in 49 out of 58 cases (84.5%). Most of the patients required 1 or 2 trials of percutaneous nephrolithotripsy. Middle or lower part of ureteral calculi were removed in transurethro-ureteral approach in 11 of the 12 cases. Hematuria and fever were most common complications after treatment and 3 patients required blood transfusion after 3 or 4 sessions of nephrolithotripsy. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy are now widely used for treatment of upper urinary tract calculi, replacing the conventional surgical treatment. Moreover, very recently, extracorporeal shock wave lithotripsy is available in Japan. To the patients with renal calculi indicative of this treatment, both percutaneous nephrolithotripsy and extracorporeal shock wave lithotripsy are introduced and either way of treatment can be chosen by the patient himself.

Adult↗
PubMed1985

[Compensatory changes in beta 2-microglobulin handling in the remnant tubules after contralateral nephrectomy. Observations of beta 2-microglobulin excretion into the urine].

Serum and urinary beta 2-microglobulin (S-, U-beta 2MG), and creatinine clearance (C-cr) were examined in 41 nephrectomy cases, and changes in glomerular and tubular handling of beta 2MG such as filtered beta 2MG (Fil-beta 2MG), reabsorption of beta 2MG (Reab-beta 2MG) and fractional excretion of beta 2MG (FE-beta 2MG) were studied. Serum creatinine (S-cr) and S-beta 2MG increased significantly after nephrectomy. C-cr decreased immediately after nephrectomy (80%), but recovered up to 87% in 2 to 4 days postoperatively. Fil-beta 2MG decreased immediately after nephrectomy, but increased up to more than the preoperative level in 2 to 4 days postoperatively. On the other hand, Reab-beta 2MG decreased significantly immediately after nephrectomy, and it took 5 to 8 days until recovery. Consequently, urinary excretion of beta 2MG (Ex-beta 2MG) and FE-beta 2MG increased significantly 0 to 4 days postoperatively. These increases in Ex-beta 2MG and FE-beta 2MG were much higher than those seen in diabetic nephropathy, cadmium nephropathy and Cis-diamminedichloroplatinum (II) (CDDP) intoxication, and were not due to drug intoxication such as general anesthesia or antibiotics, but due to glomerulo-tubular unbalance. Clinical data of renal tubular handling of beta 2-microglobulin in cases of interferon therapy or unilateral nephrectomy revealed many interesting aspects of glomerulo-tubular adaptations, and micropuncture study or isolated tubule perfusion study are awaited.

Adolescent↗
PubMed1985

[Percutaneous nephrostomy--the method and technical problems].

Ultrasound guided percutaneous nephrostomy (PNS) was performed on 72 patients (80 kidneys) including pretreatment for percutaneous nephro-uretero lithotomy (PNL). PNS was performed for post-renal anuria or hydronephrosis in 23 cases (28 kidneys), for urinary leakage in 4 cases (5 kidneys), for vesical bleeding in 1 case (2 kidneys) and as pretreatment of PNL in 44 cases (45 kidneys). Ultrasound guided renal puncture was done percutaneously and a 0.038 inch J-tipped wire guide was inserted into the suitable calyx. Then the nephrostomy tract was dilated with fascia dilators of Malecot nephrostomy set. A 14 Fr or 16 Fr Malecot catheter was used for hydronephrosis or urinary leakage cases. 18 Fr, 24 Fr Malecot catheter or Bardex balloon catheter 18-22 Fr was inserted for PNL cases. In the PNL group, Ht decreased slightly but there was no need of blood transfusion. In the other groups, Ht did not change. Defect of 99m-Tc-DMSA renal uptake in several cases suggested renal injury at nephrostomied cortex. In about 70% of the cases, a fever of more than 37 degrees C was observed, and in 4 cases, more than 39 degrees C was observed. There were no major complications observed. In conclusion, percutaneous nephrostomy using Malecot nephrostomy set is a safe and effective method.

Adult↗
PubMed1985

[Effect of etidronate disodium (EHDP) on calcium oxalate renal stones induced by synthetic 1 alpha(OH) vitamin D3 and ethylene glycol in rats].

Combination of 1 alpha(OH) D3(vit D) and ethylene glycol induced renal or ureteral stones or both consisting of calcium oxalate in male Wistar rats. This study investigates the effect of EHDP on calcium oxalate stone using the rat model. EHDP reduced the frequency of renal stone and calcium content in the kidney, and reduced the size of the stones in the renal pelvis and ureter. EHDP biochemically ameliorated renal injury induced by vit D and ethylene glycol. EHDP suppressed urinary excretion of calcium even though serum calcium slightly increased. EHDP had a phosphaturic action. EHDP elevated urinary excretion of magnesium. However, the severity of hypermagnesuria decreased in the rat which was not given EHDP concomitantly. Although EHDP slightly elevated urinary excretion of oxalate in the control rat, it did not affect the high level of urinary oxalate in the vit D/ethylene glycol rat. EHDP did not produce any histological change in the kidney or femoral bone. These data indicate that EHDP can suppress renal stone formation in the vit D/ethylene glycol rat. It is speculated that firstly, EHDP may physicochemically inhibit stone formation in the process of nidus, aggregation and crystal growth of calcium oxalate, under the supersaturated condition of calcium oxalate in the urine, and secondly, EHDP may endocrinologically inhibit production of 1,25 (OH)2 vit D in the kidney or inhibit 1, 25 (OH)2 vit D-mediated intestinal calcium absorption. It is suggested that in order to prevent stone recurrence, EHDP may be clinically applied not only to calcium phosphate stones but also to calcium oxalate stones and hypercalciuria mediated by an active form of vitamin D.

Animals↗
PubMed1985

[The treatment of renal cell carcinoma with recombinant human leukocyte interferon].

Recombinant human leukocyte (alpha) interferon was administered i.m. at the initial dose of 3 X 10(6) U/day to 27 patients with measurable metastatic renal cell carcinoma during the past 2 years. The results of 22 of these patients were evaluable. Three patients (13.6%) showed partial response; 3 patients (13.6%), minor response; 7 patients (31.8%), no change; and 9 patients (40.9%), progressive disease. Major toxicity consisted of fever (55.5%), anorexia (44.4%), malaise (22.2%), elevation of GOT/GPT (48.1%), leukopenia (44.4%) and thrombocytopenia (29.6%). When the 3 patients who showed stabilization (S) and the 2 patients who showed mixed effects (ME) among the 7 patients who showed no change are classified into the responded group, half the patients had some response to interferon. Characteristics of these responders (PR + MR + ME + S) were good performance status, relatively longer disease-free interval, metastases limited to the lungs or metastasis to lungs and one other organ excluding the liver, and frequency of interferon-induced thrombocytopenia. Interferon administration is still being continued to 4 patients on an outpatient basis, 5 patients are hospitalized and 13 patients have died. In conclusion, patients with pulmonary metastases seem to be the best responding group for interferon treatment in renal cell carcinoma and further trials, especially combined regimens with chemotherapy and/or other kinds of interferon should be tested.

Aged↗
PubMed1985

[The determination of oxalate in the urine by a new enzymatic method using oxalate oxidase].

Oxalate is one of the most important constituents in urine of urinary stone. But the determination of oxalate in urine has not been performed as a routine laboratory examination because of difficulty or inaccuracy in measuring oxalate in urine. We tried to measure oxalate in urine by the newly developed enzymic method with oxalate oxidase. This method is not only simple but also accurate enough. The reproducibility S.D./mean was 2.3-9.0%, the recovery rate was 95.2 +/- 4.0% (mean +/- S.D.) With this method, the normal range of urine oxalate in 24 hours was determined to be 11.8 mg-39.4 mg, the upper limit was 40 mg. By taking the regular diet which contains 500 mg of calcium and 1,000 mg of phosphorus a day, the excretion of oxalate in urine was significantly decreased in the stone formers. This suggests that the influence of the diet upon the excretion of oxalate in urine for 24 hours is important especially in stone formers.

Diet↗
PubMed1985

[Renal cell carcinoma, primary lesion which was not easily identified: report of two cases].

We report two cases of renal cell carcinoma, primary lesions of which were not diagnosed at an early stage. The first case was a 58-year-old woman, who had nephrectomy due to staghorn calculus of left kidney. Fifteen months later, she died of metastatic cancer whose origin was unknown until the left kidney was re-examined. It was sarcomatoid renal cell carcinoma. The second case was 43-year-old woman, who had amputation of right index finger due to metastatic tumor. Renal cell carcinoma was highly suspected, but no tumor could be found in her kidneys although various urological examinations were performed. Two years later, abdominal CT scan showed a space-occupying lesion (SOL) of left kidney. She had left nephrectomy, and the origin was finally identified.

Adult↗
PubMed1985

[Experimental and clinical studies on calcium urolithiasis: (I) Animal model for calcium oxalate urolithiasis using ethylene glycol and 1-alpha (OH) D3].

As calcium oxalate stones are the most important component in urolithiasis, an experimental model has to be designed to clarify the pathogenesis and aid in their prevention. Hyperoxaluria as well as hypercalciuria were produced in rats by administering ethylene glycol (0.5%, in drinking water administered ad libitum) and 1-alpha (OH) D3 (0.5 micrograms/rat given every other day), respectively, for three to four weeks. Neither drug alone produced stones efficiently as did the combination regimen of these two compounds. The occurrence of stones was 77.3%, and with only a moderate degree of renal functional impairment. Biochemical and histological data were obtained using this model.

Animals↗
PubMed1985

[Effects of combination chemotherapy with cis-diamminedichloroplatinum (II) (CDDP) on renal function in patients with urogenital malignancies].

The renal function in 23 patients with advanced urogenital cancers (10 testicular, 8 uroepithelial, 3 prostatic cancers and 1 penile cancer) treated with a total of 3 or 4 cycles of combination chemotherapy including CDDP was examined prospectively, by measuring of creatinine clearance (Ccr), fractional excretion of beta 2 microglobulin (FE beta 2 MG) and urinary N-acetyl-beta-glucosaminidase (NAG). Patients with testicular cancers (group 1) who received the cumulative CDDP dose of 360-1966 mg (on average 868 mg), the decrease in Ccr and increase in FE beta 2 MG and NAG were temporary during each chemotherapy cycle. However, in the overall course, after the cumulative dose exceeded 600 mg, higher beta 2 MG excretion persisted and after the cumulative dose exceeded 800 mg, Ccr decreased to 30% of the pretreatment level. This suggests cumulative delayed, irreversible renal damage. The severity of decrease in Ccr paralleled the increase in cumulative CDDP dose. Patients with urogenital cancers other than testicular cancer (group 2) who received the cumulative CDDP dose of 80-480 mg (on average 217 mg), and who had decreased Ccr and tubular damage prior to treatment, even though the cumulative dose was lower than in group 1, changes in Ccr, FE beta 2 MG and NAG were almost in the same magnitude as in group 1. Determination of NAG is useful for detection of the early change in the tubules several days after CDDP administration, while that of beta 2 MG is useful for detection of the chronic damage of renal tubules after several cycles of CDDP chemotherapy. CDDP nephrotoxicity is characterized by dose-dependent tubular damage. Although renal injury may not be evident during the early course of treatment, repeated courses of CDDP may lead to clinically serious chronic renal failure.

Aged↗
PubMed1985

[Percutaneous ultrasonic nepholithotripsy].

Herein we report our experience of percutaneous ultrasonic lithotripsy on 32 renal calculus patients between March and December 1984. Renal calculus removal was successful in over 78.1% of the patients (91.3% for recent 4 months). All patients had bloody urine after tract dilatation and calculus removal, but this usually cleared in 24-48 hours. No patients have required blood transfusion. The major essential contribution responsible for the success of this technique was a nephrostomy placement made accessible to calculi. Percutaneous ultrasonic lithotripsy, when combined with adjuncts such as flexible nephroscopy and radiological stone manipulations using stone grasping forceps and Dormia basket catheter, is an effective treatment for renal calculi, with a success rate of over 90%.

Endoscopy↗
PubMed1985

[Diagnosis of retroperitoneal lymph node swelling by computed tomography in advanced testicular cancer patients, with special reference to retrocrural lymph node swelling].

We tried to divide anatomically the retroperitoneal space into three areas on computed tomography, infrahilar, suprahilar and retrocrural spaces, and investigated the relationship between frequency of lymph node swelling in each space and clinical picture in 15 patients with testicular cancer of stage II or III, particularly focusing on the lymph node swelling in the retrocrural space. Lymph node swelling was found in the infrahilar space in 11 cases (73.3%), in the suprahilar space in 7 cases (46.7%) and in the retrocrural space in 6 cases (40.0%). Retrocrural or suprahilar lymph node swelling was always accompanied by suprahilar or infrahilar lymph node swelling. Most of the patients with retrocrural lymph node swelling had bulky tumors in the infrahilar level and frequently cervical lymph node swelling. Retrocrural lymph node swelling did not necessarily affect the patient's prognosis. The retrocrural lymph node seems to be a sentinel node for retroperitoneal lymph node swelling not only in the case of testicular cancer but also in the cancer of urogenital malignancies.

Adult↗
PubMed1985

[Histopathologic evaluation of anti-tumor activity of alpha-interferon for renal cell carcinoma, especially in autoptic cases].

The anti-tumor activity of alpha-interferon (gamma-IFN-alpha A) was assessed histopathologically in 14 patients with metastasized renal cell carcinoma. Ten of the patients had undergone radical nephrectomy, two patients embolization alone, one patient no prior treatment and one patient nephrectomy in IFN therapy. IFN was given daily intramuscularly starting at the dose of 3 X 10(6) U and increased every 3 days to the maximum of 5 X 10(7) U. This treatment could be tolerated. The clinical response was evaluated according to the criteria of Koyama and Saitou. Two of the patients showed partial response, one patient minor response, five patients no change and six patients progressive disease. The clinical responders also had histopathologically detected improvement. Renal cell carcinoma of a higher grade (sarcomatoid type) or lower grade (grade II greater than or equal to), was seen frequently, and the papillary or tubular type was resistant to IFN. The clear cell type and grade III tumor was more responsive to IFN. Histopathologically, no lymphocyte infiltration into the cancer cell focus was seen and the immunologic reaction was not considered to be affected by IFN, because of the myelosuppression due to the IFN therapy and because more responders used the steroid hormone like predonizolone to prevent side effects. Fever, anorexia and general malaise were observed in all cases. Myelosuppression like leukocytopenia and/or thrombocytopenia was also observed but easily improved after cessation of IFN medication or decrease of IFN dose. Liver dysfunction was observed but spontaneous recovery without discontinuation of IFN therapy or decrease of IFN dose was seen in two cases. The disturbance of the central nervous system similar to the occurrence of abnormal EEG waves or psychosis, was a dose-limiting factor. Further studies especially to develop an appropriate method of administration and the combination with other anti-cancer agents must be studied.

Aged↗