Search PubMed⌕ Search

Biomedical subjects

J Kawamura

Publications and source records attributed to J Kawamura.

At least 127 records · Page 7Linked to original sources
PubMed1994

[Mass screening for prostate cancer at a local town--five-year results and screening system].

The results of a mass screening examination for prostate cancer conducted from 1989 to 1993 at a local town, Kawagoe-cho, in Mie Prefecture were evaluated. Among the 216 examinees, 4 were found to have prostate cancer. The most accurate examination was the prostate specific antigen (PSA), which was followed by digital examination and transrectal ultrasound. The applicants for the prostate cancer screening accounted for only 8% of the Kawagoe-cho male residents over 40 years old. An educational campaign of prostate disease in the area must be started to increase the number of applicants. We concluded that the most effective modality for the screening program was a combination of PSA and digital examination in the field study, and transrectal ultrasound accompanied by systemic biopsy results in the second tool for screening.

Adult↗
PubMed1994

[Influence of extracorporeal shock wave lithotripsy (ESWL) on renal function assessed by 99mTc-DMSA scintigraphy: comparative analysis between ESWL and percutaneous nephroureterolithotripsy (PNL)].

99mTc-DMSA renal scintigraphy was utilized to investigate the influence of ESWL on renal function in comparison with that of PNL. In the beginning, the reproducibility of renal uptake rate by the scintigraphy was examined in eleven healthy volunteers under both non-diuretic and diuretic states. The renal uptake rate was shown to be sufficiently reproducible in the same person in the two different trials. However, the differences and the standard deviations were shown to be a few percentages, which were not statistically significant. Changes in the repeated renal uptake rate seem to indicate not only changes of renal function with the treatment but also some technical errors. Herein, to investigate changes in renal function of the therapeutic side, the uptake ratio rate (rate of uptake rate in the therapeutic side/uptake rate in the contral lateral side) was utilized instead of uptake rate. Renal scintigraphy was carried out in 48 patients with unilateral renal stones before and after ESWL or PNL monotherapy or the combined ESWL and PNL therapies. Within one week of treatment, the uptake ratio rate significantly decreased in patients with PNL or the combined ESWL and PNL, although DMSA uptake rate in the therapeutic side did not significantly changes. Neither renal uptake rate nor uptake ratio rate significantly changed after ESWL treatment. There was no significant difference in changes of uptake ratio rate between Siemens Lithostars Plus and the improved Dornier HM-3 lithotriptors. This study indicated that ESWL monotherapy did not affect the uptake ratio rate, although PNL monotherapy and the combined ESWL and PNL therapies may affect the uptake ratio rate to some extent.

Adult↗
PubMed1994

[A case of retrovesical hemangiopericytoma].

A case of retrovesical hemangiopericytoma is reported. The patient was a 44-year-old woman with right lumbago. Cystoscopy showed extra-vesical compression in the area from the trigone to right wall of bladder. The histological examination of the specimen obtained with ultrasound-guided transvaginal biopsy revealed hemangiopericytoma. Because of the invasion to the bladder mucosae, total cystectomy and ileal conduit were performed. The patient received postoperative irradiation of 3,060 rad for pelvis. Eight months after operation, computerized tomography showed no evidence of local recurrence of the tumor.

Adult↗
PubMed1994

[Effects of nephrectomy and interferon administration on immunological parameters in patients with renal cell carcinoma].

To study the changes in the subsets of peripheral blood lymphocytes before and after nephrectomy and interferon (IFN) therapy, 57 patients with renal cell carcinoma were divided into three groups; one group consisted of 16 patients with metastasis who had been administered IFN-alpha, one group consisted of 16 patients without metastasis who had been administered IFN-alpha, and the other consisted of 25 patients without metastasis who had not been administered IFN-alpha. Immunological parameters such as percentages of NK (Leu-11+ [Leu-7-) cells, percentages of activated CD4 (Leu-3a+ HLA-DR+) positive cells and percentages of activated CD8 (Leu-2a+ HLA-DR+) positive cells were examined by two color flow cytometry and the percentages of CD4 (Leu-3a+) positive cells, percentages of CD8 (Leu-2a+) positive cells values and the ratio of percentages of CD4 positive cells/percentages of CD8 positive cells were evaluated. The percentages of NK cells showed a tendency to decrease after nephrectomy and the administration of IFN-alpha. The percentage of CD4 positive cells showed a significant increase after the administration of IFN-alpha. The percentage of activated CD4 positive cells and the ratio of percentage of CD4 positive cells/percentage of CD8 positive cells showed a tendency to increase slightly. The percentage of CD8 positive cells and percentage of activated CD8 positive cells showed no particular changes. There was a specific correlation between the administration of IFN-alpha and the changes of percentage of CD4-positive cells and this suggests that the administration of IFN-alpha led to the increase of helper T cells.

Carcinoma, Renal Cell↗
PubMed1994

[Local recurrence of ureteral tumor histologically similar to malignant lymphoma: a case report].

A 65-year old man, who had had resection of a right ureter tumor two years earlier, was hospitalized with complaints of lower abdominal discomfort and hematuria. Pathological diagnosis of the ureteral tumor was grade 3 transitional cell carcinoma. Computed tomography and magnetic resonance imaging demonstrated a large tumor in the retrovesical space and recurrence of transitional cell carcinoma was suggested. Total pelvic exenteration was performed and pathological diagnosis of the tumor was undifferentiated carcinoma simulating malignant lymphoma. Immunohistochemical examinations revealed no antigens specific for the lymphoid cells or epithelial cells on the specimen. This tumor consisting of undifferentiated carcinoma was considered to be recurrence of transitional cell carcinoma with the diffuse pattern simulating malignant lymphoma proposed by Zukerberg et al.

Aged↗
PubMed1994

[Study on clinical effects of tosufloxacin (TFLX) and the long-term low dose therapy for the prophylaxis of recurrent urinary tract infection].

Forty five patients with complicated urinary tract infections were treated with tosufloxacin (TFLX) in the initial antibacterial treatment. Excellent and moderate responses were obtained in 39 patients (86.7%). No side effects were seen. Clinical efficacy and safety of long-term preventive administration of TFLX (150mg, a day) were also examined in 39 patients who showed an excellent or a moderate response in the initial treatment. The period of the administration ranged from 28 to 112 days (average; 55 days). The rate of preventing recurrence of urinary tract infection was 92.3% on the last day of treatment. These findings suggested that TFLX was useful not only in treating the patients with complicated urinary tract infections but also in preventing recurrence of urinary tract infection.

Adult↗
PubMed1993

Cognitive recovery correlates with white-matter restitution after head injury.

Longitudinal measurements of local cerebral perfusion (LCBF) and local partition coefficients (L lambda) using xenon-enhanced computed tomography were examined in six patients who had suffered from head injury at a mean age of 30 +/- 9.3 years. They were selected from a larger group with head injury because all were observed longitudinally to make excellent cognitive recovery some years after acute cerebral trauma. Results were compared with similar longitudinal measurements made in six age-matched neurologically normal volunteers. In the index group, cognitive test scores were reduced at the time of the first LCBP measurement but significantly improved to normal at the time of the second. The mean interval between measurements was 2.7 +/- 0.7 years. At the time of the first measurement, all six patients exhibited abnormal volumes of white matter with reduced Hounsfield numbers and LCBF and L lambda values. Abnormalities in volume of white matter and LCBF and L lambda values improved to normal at the time of the second measurement. Perfusion values for frontal cortex, putamen, and thalamus were still slightly reduced but also improved toward normal between measurements. Cognitive recovery correlated best with restoration of white matter integrity, suggesting that following head injury, cognitive impairments may be associated with temporary disconnections of corticothalamic projection systems.

Adult↗
PubMed1993

Correlations of leuko-araiosis with cerebral atrophy and perfusion in elderly normal subjects and demented patients.

CT images of leuko-araiosis in brain slices were quantified according to volumes of reduced Hounsfield units in frontal periventricular white matter in groups of elderly patients with multi-infarct dementia (MID, n = 23) and dementia of the Alzheimer type (DAT, n = 16). Volumes of leuko-araiosis, estimates of atrophic cerebral tissue, and local cerebral perfusion utilising inhalation of xenon gas as the indicator were correlated on the same CT slices. Ratios of frontal leuko-araiosis to total brain tissue volume were similar for patients with MID and DAT (mean 5.7 (SD 2.1)% v 6.5 (3.2%)), and both were significantly greater than ratios in elderly normal volunteers (3.1(1.3)%, 0 < 0.001). Cerebral atrophy (measured as the ratio of volumes of cerebrospinal fluid to total brain area) for DAT patients was 17.0 (6.7)%, which was greater than for MID patients (12.5 (5.4)%; p < 0.05) and both types of patients showed more cerebral atrophy than did age matched, elderly normal subjects. Cerebral perfusion was decreased in all regions measured in patients with MID and DAT compared with elderly normal subjects. Multi variate regression analyses correlated frontal leuko-araiosis with reductions of local cerebral blood flow in subcortical grey matter (p < 0.025) in patients with vascular dementia but not in those with DAT. These quantitative measures implicate decreased perfusion due to atherosclerosis in territories supplied by the deep penetrating cerebral arteries in the pathogenesis of leuko-araiosis in patients with vascular dementia, but suggest a different pathogenesis for leuko-araiosis in Alzheimer's disease.

Aged↗
PubMed1993

Multimodality therapy for advanced clear cell sarcoma of the kidney in a young adult.

We report a clear cell sarcoma of the kidney (CCSK) in a young adult with multiple liver and bone metastases who was treated with surgery, chemotherapy and radiation. Combination chemotherapy consisting of vinblastine, actinomycin D, cyclophosphamide, pepleomycin, cisplatin (modified VAB-6 regimen) and arterial infusion of mitomycin C and doxorubicin into the hepatic artery resulted in the complete disappearance of the liver metastasis. Although systemic and localized combination chemotherapies were very effective against the liver metastasis, the clinical course was that of high-grade malignancy, resulting in death with brain metastasis 32 months after tumor resection. Differing from typical Wilms tumor in children, the treatment of CCSK has been a subject of controversy, particularly in the advanced and adult type. Nevertheless, we consider that the multimodal treatment has an important role in the stabilization of metastatic lesions even at an advanced stage in the adult type of CCSK.

Adolescent↗
PubMed1993

Mean nuclear volume of bladder cancer: stereological estimation and its clinical value.

Mean nuclear volumes (MNVs) of bladder cancer cells from the specimens of 100 patients were estimated by stereological procedure. The value of MNVs of bladder cancer were ranged widely, from 114.6 to 1,041.9 microns3. However, strong correlation was observed between MNV and histopathological grade and stage. Furthermore, the MNV predicts the biological behavior including the malignant potential and prognosis of the patient. Patients with MNV below 315 microns3 had significantly better prognosis than those with MNV above this value (p < 0.01). The 5- and 10-year survival rates for patients with MNV below 315 micron3 were both 97%, while those for patients with MNV above 315 microns3 were 65 and 58%, respectively. MNVs of the recurrent tumors were significantly increased, compared with those of the initial tumors (p < 0.01). MNV of extirpated tumor specimens following chemotherapy consisting of cisplatin and Adriamycin through balloon-occluded arterial infusion (BOAI) was significantly decreased, compared with that before BOAI (p < 0.01). We conclude that the MNV is an excellent predictor for the prognosis of the patient and the tumor recurrence. Furthermore, the stereological estimation of nuclear volume is a simple, quick, inexpensive, and reliable method to assess quantitative analysis of the histological and biological character of bladder cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Automatic suspension device for gait training.

The automatic suspension device (REHABOT) suspends the patient's body in a standing position allowing the patient to walk around the circular handrail without forward propulsion. Reduction of body weight is accurately maintained automatically while safely supporting the patient. The device was used for 23 patients with orthopaedic disorders or central nervous system disorders who were chosen because of their initial difficulties with gait training in parallel bars. Its advantages are that (1) it may be used for patients with open wounds or cardiac problems, or patients using prostheses or orthoses, (2) preparation and walking practice are simpler both for patients and staff than the therapeutic pool and walking trolley, (3) running costs are lower than the therapeutic pool. Its drawbacks are that the initial cost is relatively high, only one patient can be trained at a time, and the effect of warm water is missing. The automatic suspension device will become one of the new and fundamental pieces of equipment for gait training, especially for hospitals where there are many elderly patients and also severely and multiple disabled persons.

Adolescent↗
PubMed1993

[Herpes zoster and malignancy].

A retrospective survey was conducted regarding the relationship between hospitalized patients with herpes zoster and malignancy based on clinical records. A total of 220 patient were hospitalized for treatment of herpes zoster during the past 15 years, and 23 of them had involvement with malignant tumors. Malignancy was found during hospitalization in 4 cases (1.8%). This was significantly higher than 0.27, the predicted number of malignancy cases. Three of the 4 cases were gastric cancer. The discovery rate of gastric cancer through screening at admittance was 2.4%, which was higher than 0.14%, the discovery rate in gastric cancer checkups in Hokkaido. Examination for malignant tumors should be required for all patients with herpes zoster who need to be hospitalized.

Adolescent↗
PubMed1993

[Treatment of patients with staghorn calculi by means of extracorporeal shock wave lithotripsy (ESWL)].

Between August, 1987 and December, 1991, 84 patients with 87 staghorn calculi were treated mainly with extracorporeal shockwave lithotripsy (ESWL) using a Dornier HM-3 improved lithotriptor. Patients were 38 men (38 renal units, mean age 54.9 years) and 46 women (49 renal units, mean age 54.3 years). Staghorn calculi were divided into 2 types; 54 units of complete type (mean stone area 9.2 cm2) and 34 units of incomplete type (mean stone area 5.5 cm2). Patients with complete type were treated with 3.6 sessions and 7,779 shock waves on average and 31.6 days for hospitalization was required, while patients with incomplete type were treated with 2.4 sessions and 5,288 shock waves on average and 15.7 days for hospitalization was required. After treatment, the excellent rate was 47.2% for the complete type and 44.1% for the incomplete type. After the monotherapy of ESWL the excellent rate was 46.9% and after the combined therapy with percutaneous nephrolithotripsy (PNL) and/or percutaneous nephrostomy (PCN) it was 43.5%. We considered that the ESWL monotherapy for staghorn calculi was not feasible in patients with a large stone volume, with severe hydrocalices, with cystine stones and with so-called "complex staghorn calculi".

Adolescent↗
PubMed1993

[Dietary control for out-patients in urinary stone clinic].

We studied the dietary habits of 113 upper urinary tract stone formers and 24-h urine specimens before and after dietary control. Protein intake was decreased in male patients after dietary control but urinary risk factors were not changed significantly. The excretion of urinary risk factors (calcium, uric acid and oxalate) was decreased in the patients who had calcium excretion of more than 250 mg per day or uric acid excretion more than 650 mg per day or oxalate excretion more than 45 mg per day before the control. The daily protein intake was significantly correlated to urinary uric acid, calcium, and phosphate excretion and the daily vitamin C intake to urinary citrate excretion. There was a negative correlation between the daily calcium intake and urinary oxalate. The mean stone episode rate of these patients was significantly decreased from 0.174 to 0.059 stones per year by dietary control (p < 0.005).

Adult↗
PubMed1993

[Development of an anesthesia ledger using relational database].

An anesthesia ledger was developed using relational database KIRI Ver3. This anesthesia database includes 33 items for input, for example patient's name, patient's I.D. number, data of operation, diagnosis, operative procedure, name of surgeon, name of anesthesiologists and so on. One can select data from displayed menu cards only by rolling down or rolling up the cursor at 19 items and can input numbers by keyboard at twelve items. Even a computer beginner can easily operate it after a minimal training. Only patient's name must be input by text style. We can construct this anesthesia database only by use of functions of KIRI Ver3 without programming. One can use this anesthesia ledger at any operative facilities by changing a part of database and a file of doctor's name.

Anesthesia↗