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Biomedical subjects

J Kumazawa

Publications and source records attributed to J Kumazawa.

At least 163 records · Page 9Linked to original sources
PubMed1992

Bellini duct carcinoma of the kidney.

Human epithelial cells of the kidney present a wide spectrum of cytological and histological variation. The normal epithelium of the kidneys also includes a number of morphologically and functionally different cell types which are arranged along the nephrons and collecting ducts. Although renal carcinoma can involve any type of renal cell, the most common is renal cell carcinoma of the proximal tubuli. Here, we present the case of a 65-year-old Japanese patient with a renal cell carcinoma arising from Bellini duct epithelial cells. State-of-the-art techniques were used to establish the diagnosis and histogenesis of this renal cell carcinoma.

Aged↗
PubMed1992

[Clinical significance of urinary flow pattern--based on combined uroflowmetry and external sphincter electromyography].

We performed combined uroflowmetry and external sphincter electromyography in 108 patients (87 males and 21 females); 16 serving as normal controls, 49 with benign prostatic hyperplasia, 16 with overactive type of neurogenic bladder, 27 with underactive type of neurogenic bladder. Urinary flow pattern was classified into 5 categories. All of urinary flow patterns of normal controls showed pattern A which had the form of a bell. EMG showed complete suppression during micturition followed by a few intermittent increases in amplitude. Urinary flow patterns of BPH patients were distributed widely from pattern A to E. Intermittent increases in EMG amplitude during a late phase of micturition were characteristic in patients with BPH. We must pay attention to sex differences to evaluate urinary flow pattern because it could be influenced by abdominal pressure such as stressing or Créde maneuver in female patients with an underactive type of neurogenic bladder.

Adult↗
PubMed1992

[Recurrence following surgery for primary renal pelvic and ureter cancer--clinicopathologic analysis of distant metastasis].

A retrospective analysis of 59 patients with renal pelvic and ureter cancer (56 transitional cell carcinomas, 2 squamous cell carcinomas, and 1 adenocarcinoma), which were treated surgically, was performed in relation to postoperative recurrence, particularly distant metastasis. Of the 59 cases, postoperative recurrences developed as distant metastasis in 9 cases (15.3%), as bladder cancer in 19 cases (32.2%) and as contralateral renal pelvic and ureter cancer (bilateral metachronous cancer) in 3 cases (5.1%). Three of the 9 cases with the development of distant metastasis were squamous cell carcinoma or adenocarcinoma, and the others transitional cell carcinoma. All the metastases occurred within 2 years. In cases with transitional cell carcinoma, nonpapillary tumor, grade 3, high stage (pT3 and pT4), positive vascular invasion and IFN beta or gamma had a significant influence on the rate of distant metastasis. On the other hand, location, diversity and previous or coexistent bladder cancer did not seem to be related to the frequency of the development of distant metastasis. Thus, tumor aggressiveness was the only predictive valuable of the development of distant metastasis after surgery for renal pelvic and ureter cancer.

Adenocarcinoma↗
PubMed1991

[Role of MRI in diagnosis of adrenal tumors].

The authors evaluated the ability of magnetic resonance imaging (MRI) at 1.5 T to characterize 33 adrenal masses, using visual analysis and the following quantitative variables: signal intensity ratios of tumor/liver, tumor/muscle, and (tumor--muscle)/(fat--muscle) on T2- and T1-weighted images, and the calculated T2 relaxation time of the adrenal masses. All 15 tumors of less than 3 cm in diameter were visually homogeneous on all pulse sequences, whereas the other 18 tumors of over 3 cm appeared to be inhomogeneous. The signal intensity ratios of tumor/liver and tumor/muscle and the calculated T2 relaxation time were not helpful in distinguishing tumors from one another. The ratios of tumor/fat and (tumor--muscle)/(fat--muscle) were useful in distinguishing pheochromocytoma and myelolipoma from other tumors on T2- and T1-weighted images, respectively. However, differentiation among other adrenal tumors appeared to be difficult. The authors concluded that, although MRI might have considerable potential in characterizing adrenal masses, the use of conventional MRI in such analysis is still quite limited.

Adenoma↗
PubMed1991

Significance of urinary endotoxin concentration in patients with urinary tract infection.

Endotoxin is a component of the outer membrane of gram-negative rods (GNR). Since GNR are responsible for the majority of urinary tract infection (UTI), we measured the concentration of endotoxin in urine using chromogenic endotoxin-specific assay and examined its diagnostic utility in patients with suspected UTI. In all 18 urine samples with an endotoxin concentration exceeding 350 pg/ml and 2 samples with 10-350 pg/ml of endotoxin concentration, GNR were detected at a count of 10(4) cfu/ml. Negative for endotoxin were 3 samples of culture positive for gram-positive cocci (GPC), 2 samples containing various bacterial contaminants and all 37 samples with no growth on culture. Two urine samples collected 5 h after antibiotic dosage showed negative culture for GNR but a significant concentration of endotoxin. In an in vitro experiment, a residual concentration of antibiotic in urine inhibited bacterial growth, leading to a false-negative culture. These results suggest that chromogenic endotoxin assay is a reliable method for diagnosing UTI caused by GNR and detecting false-negative culture of GNR.

Adult↗
PubMed1991

Neutrophil function in hyperosmotic NaCl is preserved by phosphoenol pyruvate.

Hyperosmolarity in the urinary tract inhibits the host defense against bacterial infection. NaCl contributes most to osmolarity in the renal medulla and urine. Therefore, we studied the effect of hyperosmolar NaCl on neutrophil function. When osmolarity was increased by NaCl, polymorphonuclear leukocytes (PMNL) became defective in phagocytosis, intracellular killing of bacteria, chemotactic activity, and superoxide production. This coincided with a decrease in the intracellular adenosine triphosphate (ATP) content of PMNL. Both the inhibition of superoxide production and the reduction in ATP content did not occur at 4 degrees C. By increasing ATP content, phosphoenol pyruvic acid (PEP) protected against the decrease in superoxide production. These results suggest that leukocyte function is inhibited by high concentrations of NaCl due to the activation of the Na(+)-K+ pump. PEP, an ATP precursor, can protect PMNL against osmotic stress by raising the intracellular concentration of ATP.

Adenosine Triphosphate↗
PubMed1991

Role of superoxide in renal scarring following infection by mannose-sensitive piliated bacteria.

The role of superoxide in scar formation following renal infection caused by mannose-sensitive (MS) piliated strains of bacteria was studied in the experimental pyelonephritis model using female Sprague-Dawley rats. The MS piliated strain stimulated renal scarring to a significantly greater extent than either the non-piliated or MR-piliated strain. Modulation of leukocytes by administering cyclophosphamide to induce neutropenia and colchicine to inhibit leukocyte migration was effective in preventing renal scarring. Treatment with superoxide dismutase during the early stage of infection was also effective in preventing scar formation. Finally, the production of superoxide by rat leukocytes was significantly larger following stimulation by MS piliated than either the non-piliated or MR piliated strains. These observations suggest that superoxide released from leukocytes plays a critical role in the development of renal scarring following a bacterial infection, especially by MS piliated strains.

Animals↗
PubMed1991

Chlamydia trachomatis antigen can be detected in the urine sample of men with non-gonococcal urethritis.

We tested the first portion of voided urine (FVU) and urethral swab from 80 patients with non-gonococcal urethritis (NGU) using a novel enzyme-amplified immunoassay (IDEIA) for the detection of Chlamydia trachomatis antigen. Urine specimens were positive in all patients with positive urethral swabs (positive coincidence ratio, 100%) and in 6 of 54 patients with negative swabs (negative coincidence ratio, 88.9%). Our data suggest that FVU is suitable for the detection of Chlamydia trachomatis antigen using the IDEIA test in patients with NGU.

Antigens, Bacterial↗
PubMed1991

Prognostic factors and value of adjunctive nephrectomy in patients with stage IV renal cell carcinoma.

We reviewed 57 cases of Stage IV renal cell carcinoma to clarify the factors influencing prognosis and to evaluate the value of nephrectomy. Cumulative survival from the initial diagnosis was analyzed with respect to the patients' age, sex, side of primary tumor, initial performance status (PS), site of metastasis, and nephrectomy. Overall survival for the patients was 51 percent at one year, 22 percent at three years, and 11 percent at five years. Age, sex, and side of primary tumor had no influence on survival. Improved survival was correlated with good PS, metastases limited to single organ, and removal of the primary tumor. With regard to histopathologic features in nephrectomized patients, low grade and stage were correlated with longer survival. These factors should be considered in the analysis of results of future clinical trials of metastatic renal cell carcinoma.

Aged↗
PubMed1991

Treatment of complicated urinary tract infections with ofloxacin following an aminoglycoside.

In order to reduce the dosage of aminoglycoside in the treatment of patients with complicated urinary tract infections (UTI) in outpatient clinics and to improve cost benefits, we tried both ofloxacin (OFX) treatment and a combination treatment with OFX and a single dose of aminoglycoside (isepamicin). Both groups showed the same cure rate on day 5, but the bacteriuria elimination rate on day 1 was slightly higher in the isepamicin-OFX group. The recurrence rate on days 7-14 did not differ between the groups. This aminoglycoside-OFX treatment did not show significantly higher effectiveness against complicated UTI but resulted in earlier elimination of bacteriuria. These results suggest that this combination therapy may be cost effective in treating complicated UTI, because of the shorter treatment period required.

Administration, Oral↗
PubMed1991

Incomplete testicular feminization syndrome. A case occurring in a family with frequent hypospadias.

The case of a 16-year-old patient with incomplete testicular feminization syndrome is reported. The patient had phenotypically female genitalia except for clitoromegaly. Hormonal examinations revealed low plasma testosterone levels but a normal concentration of 5 alpha-dihydrotestosterone, and radiological and surgical examinations revealed no development of Müllerian structures including the uterus and the adnexa. This happened in a family with a frequent occurrence of both hypospadias and cryptorchism.

Adolescent↗
PubMed1991

Endopyelotomy for treatment of ureteropelvic junction obstruction.

A total of 14 patients underwent endopyelotomy at our institution for treating ureteropelvic junction (UPJ) obstruction (12 primary and 2 secondary obstructions) between March 1986 and July 1989. Radiographic evaluation of the patients with a minimum follow-up of 6 months demonstrated improvement in 11, while the remaining 3 were stable. These 3 were cases with primary obstruction and 2 of them had had an associated large redundant renal pelvis. No patients exhibited evidence of increased hydronephrosis or decreased renal function. Twelve of the 14 patients had had preoperative symptoms. Complete and partial remission of the symptoms was obtained in 11 and in 1 who was radiographically stable, respectively. Thus, our success rate for endopyelotomy was 75% in primary obstruction. Successful results were obtained in all the 2 cases with secondary obstruction. There was 1 patient with an intraoperative complication (extravasation) and a late complication related to the stent. However, the problems were minor and easily corrected. Our results suggest that careful selection of cases may lead to a high success rate in endopyelotomy for treating primary UPJ obstruction.

Adolescent↗
PubMed1991

Preoperative oral and postoperative parenteral antibiotic prophylaxis of wound infection in total cystectomy with ileal urinary diversion.

We describe an investigation of postoperative abdominal infectious complications and discuss two regimens for preoperative antibiotic bowel preparation in cases who underwent total cystectomy with ileal urinary diversion. Ten cases (28.6%) of 35 who had been operated developed abdominal infectious complications. Six showed abdominal wound infection, 2 showed intrapelvic abscess and 2 showed abdominal wound infection with intrapelvic abscess. Of the 19 strains of organisms isolated from the postoperative infections, 11 (57.9%) were anaerobic bacteria and the most commonly isolated bacteria was Bacteroides. A significantly lower incidence of postoperative infection was found in cases who had received tobramycin and vancomycin (0%) than in those who had received kanamycin alone (41.7%). These results indicate that anaerobic bacteria are the major contributors to postoperative infections following total cystectomy with ileal urinary diversion and that tobramycin-vancomycin prophylaxis greatly reduces the incidence of postoperative infections.

Abdomen↗
PubMed1991

Voiding dysfunction: patients with human T-lymphotropic-virus-type-1-associated myelopathy.

Voiding dysfunction was evaluated in 26 patients (9 males and 17 females) with human T-lymphotropic-virus-type-1-associated myelopathy. Of 26 patients 22 (85%) had difficulty in urination, 15 (58%) had urinary frequency and 9 (35%) had urge incontinence. Cystograms showed trabeculated bladder in 5 patients, vesicoureteral reflux in 3 and bladder neck obstruction in 5. In 25 patients (96%) urodynamic studies showed detrusor hyperreflexia with normal urethral function during storage. Of these patients 17 had detrusor underactivity with detrusor-sphincter dyssynergia during micturition. One patient had normal detrusor function during storage and detrusor areflexia during voiding.

Female↗