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Biomedical subjects

K Kawabe

Publications and source records attributed to K Kawabe.

At least 127 records · Page 7Linked to original sources
PubMed1996

The effect of urapidil on neurogenic bladder: a placebo controlled double-blind study.

PURPOSE: We assessed the efficacy and safety of urapidil, a new alpha-blocker, for the treatment of neurogenic bladder dysfunction in a prospective double-blind trial. MATERIALS AND METHODS: A total of 136 patients was randomly assigned to receive placebo (group 1), or treatment with 30 mg. of urapidil for 4 weeks (group 2) or 30 mg. for 2 weeks followed by 60 mg. for 2 weeks (group 3). RESULTS: Urinary frequencies decreased significantly only in group 3. The sum of obstructive symptom scores decreased significantly in all groups. However, a significant difference in subjective symptoms was not noted among the groups. Average and maximum flow rates, and residual urine improved significantly in groups 2 and 3 but not in group 1. Regarding cystometric parameters, no significant changes were noted in any group. In the pressure-flow study, the pressure at maximum flow rate and minimum urethral resistance (pressure at maximum flow rate divided by the square of maximum flow rate) decreased significantly only in group 3. In the urodynamic assessment, significant improvement was noted in groups 3 versus 1. There were no significant differences between the sexes or among underlying diseases with regard to symptomatic and urodynamic improvements. Side effects were noted in 2 patients in group 3 and 1 in group 2, none of which was severe. CONCLUSIONS: Urapidil improved voiding dysfunction in patients with a neurogenic bladder and decreased urethral resistance in a dose related fashion.

Adrenergic alpha-Antagonists↗
PubMed1996

[Laparoscopic adrenalectomy. Experiences with 50 patients].

Fifty patients with adrenal tumors (18 men and 32 women, average age 51.8 years) underwent laparoscopic adrenalectomy from February 1992 to October 1995. Clinical diagnosis included pheochromocytoma in 3 patients, primary aldosteronism (including 1 with a 11-OH-corticosterone-producing tumor) in 15, Cushing's syndrome (including 7 with pre-Cushing's syndrome) in 13, non-functioning tumors in 17, 1 metastatic adrenal carcinoma, and 1 adrenal tuberculosis. Transperitoneal laparoscopic adrenalectomy was performed by the method reported previously. Extraperitoneal laparoscopic adrenalectomy was performed with the patient under general anesthesia in the lateral position. A working space was created by inserting a balloon dissector through a small skin incision. A total of four trocars were inserted. Three of the 50 patients were switched to open surgery, including 1 with metastatic adrenal carcinoma and 1 with adrenal tuberculosis. Laparoscopic tumor removal was successful in the other 47 patients. The average operating time and blood loss were 209 min and 177 ml, respectively. Blood loss was greater in the patients with pheochromocytoma. In patients with Cushing's syndrome, postoperative recovery tended to take longer. Postoperative complications occurred in 40% of the patients in this group, but all complications were minor and successfully treated without any surgical procedures. In the 10 patients undergoing retroperitoneal laparoscopic adrenalectomy, operative courses were excellent, excluding 1 patient with adrenal tuberculosis. Although laparoscopic adrenalectomy is considered to be appropriate for patients with pheochromocytoma and Cushing's syndrome, it appears unsuitable for the removal of malignant and inflammatory lesions.

Adrenal Cortex Hormones↗
PubMed1996

Urodynamic analysis of age-related changes of alpha 1-adrenoceptor responsiveness in female beagle dogs.

PURPOSE: We have evaluated age-related changes of alpha 1-adrenoceptor responsiveness in the lower urinary tract of female beagle dogs by urodynamic analyses. MATERIALS AND METHODS: Six aged parous and 6 young nonparous female beagle dogs were studied. Mean ages (+/- standard error of the mean) of the 2 groups were 68.3 +/- 2.3 and 12.4 +/- 0.08 months. Before and after 4 administrations of alpha 1-adrenoceptor agonist (midodrine hydrochloride 0.03, 0.1, 0.3 and 1.0 mg./kg. intravenously), cystometry, urethral pressure profilometry and external urethral sphincter electromyography were performed. RESULTS: After 0.3 mg./kg. midodrine administration, mean bladder capacity in the aged dogs significantly decreased, compared with that in the young dogs (p < 0.05). After the minimum dose administration (0.03 mg./kg.), the urethral closing pressure in both groups increased significantly (p < 0.05) with no changes in bladder capacity or arterial blood pressure. The proximal urethral closing pressure in the aged dogs increased dose dependently. After administration of 1.0 mg./kg. drug it reached 257% of the initial values (p < 0.01), which was significantly greater than that in the young dogs (p < 0.05). CONCLUSIONS: These findings suggest that 1) age-related increase of alpha 1-adrenoceptor responsiveness occurs in the bladder and in the proximal urethra. The former may be one of the etiologies of detrusor instability in the elderly. 2) A lower dose of midodrine hydrochloride may be useful for the treatment of stress incontinence, independent of age.

Adrenergic alpha-Agonists↗
PubMed1995

Age-related changes in alpha 1-adrenoceptors in rat prostate.

The age-related changes in the density of alpha 1-adrenoceptors in the dorsolateral lobe of the rat prostate were evaluated in Wistar rats at 8, 52, and 104 weeks of age. [3H]YM617, a newly synthesized alpha 1-adrenergic blocker, was used as the ligand. The mean maximum number of binding sites, or alpha 1-adrenoceptor density (Bmax) +/- SE of 104-week-old rats (11.0 +/- 1.2 fmol/mg protein) was significantly lower than that in the 8-week-old rats (37.0 +/- 4.3 fmol/mg protein) and 52-week-old rats (37.2 +/- 3.4 fmol/mg protein) (respectively, P < 0.01). In contrast, mean affinity (Kd) values +/- SE of these groups showed no significant differences (8-week-old rats, 115.8 +/- 9.1; 52-week-old rats, 100.5 +/- 5.8; and 104-week-old rats, 116.4 +/- 9.8 pM). Mean volumes +/- SE of muscle cells of the prostate were 3.7 +/- 1.1 x 10(3) microns3 at 8 weeks, 30.0 +/- 6.2 x 10(3) microns3 at 52 weeks, and 18.6 +/- 8.2 x 10(3) microns3 at 104 weeks. Volumes for 8-week-old rats were significantly smaller than those for 52-week-old (P < 0.01) and 104-week-old rats (P < 0.05). However, the mean area density of the muscle cells showed no difference among the three groups: 20.1 +/- 2.2% at 8 weeks, 27.3 +/- 2.9% at 52 weeks and 20.3 +/- 3.4% at 104 weeks. In conclusion, the density of YM617-binding sites (alpha 1-adrenoceptors) in 104-week-old rats was lower than in 8- and 52-week-old rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗
PubMed1995

Renal aging change of alpha 1-adrenoceptor in Wistar rats.

1. The aging changes of density of the alpha 1-adrenoceptors in the kidney were evaluated with Wistar rats of several ages (8, 52 and 104 weeks old). 2. [3H]prazosin and [3H]YM617 (newly synthesized alpha 1-blocker) were used for the ligand. The Bmax of [3H]prazosin was 74.0 +/- 9.5 fmol/mg/protein in 8 week, 52.1 +/- 7.3 fmol/mg protein in 52 week, and 31.3 +/- 4.2 fmol/mg protein in 104 week rats, and that of [3H]YM617 was 45.0 +/- 6.6 fmol/mg/protein in 8 week, 32.4 +/- 5.7 fmol/mg/protein in 52 week, and 19.3 +/- 5.5 fmol/mg/protein in 104 week rats. 3. The Bmax of both ligands for 104 week rats was significantly decreased compared to 8 week rats, however, 52 week rats showed no decrease of Bmax for both ligands. 4. The Kd values showed no difference in these three age groups for both ligands. 5. Autoradiographic study supported the result above mentioned. Furthermore, the binding sites of alpha 1-adrenoceptors were mainly in the cortex (vascular wall and peritubular area) and that alpha 1-adrenoceptors were chiefly chlorethylclonidine dihydrochloride (CEC) insensitive.

Adrenergic alpha-Antagonists↗
PubMed1995

Effect of bunazosin, alpha 1-adrenoceptor blocker, on multidirectional contractile response and localization of bunazosin binding sites in human hypertrophied prostate.

1. Effects of bunazosin, an alpha 1-adrenoceptor blocker, on the contraction induced by norepinephrine in human hypertrophied prostate were examined in vitro. 2. Prostatic specimens showed maximum contraction at 10(-4) M norepinephrine in longitudinal and circumferential directions to the urethra. 3. Bunazosin (10(-7) M) blocked norepinephrine-induced contraction with a parallel shift of the dose-response curve in both directions (pA2: 8.76 +/- 0.15; pA2: 8.90 +/- 0.08, respectively). 4. Serial sections of prostates were also evaluated by autoradiography. The binding sites were diffusely distributed in the interstitium. 5. We concluded that bunazosin affects multidirectional contraction in prostates.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1995

Increased incidental detection and reduced mortality in renal cancer--recent retrospective analysis at eight institutions.

A retrospective survey of renal cell carcinoma between 1975 and 1993 at eight collaborating institutions was conducted with special reference to the incidental detection and mortality of renal cancer. The analysis demonstrated a recent dramatic increase in the frequency of incidental renal cancer, which now comprises two-thirds of all renal cancers, and a simultaneous recession in non-incidental or suspected renal cancer. Incidental renal cancer has remained unchanged during the last decade as far as patient demographics, occasion and method of detection, and the degree of tumor extension are concerned. On the other hand, the annual number of deaths from renal cancer has significantly decreased, and kidney-sparing surgery has been more frequently performed. These results indicate that incidental renal cancers are now in the majority, and earlier detection may contribute to improving the mortality and morbidity from the disease as a whole.

Aged↗
PubMed1995

Treatment of benign prostatic hyperplasia with high intensity focused ultrasound: an initial clinical trial in Japan with magnetic resonance imaging of the treated area.

BACKGROUND: High intensity focused ultrasound (HIFU) is a method of delivering acoustic energy to a focal point and is expected to induce tissue thermal ablation. Transrectal HIFU was applied to symptomatic benign prostatic hyperplasia (BPH) for relief of intravesical obstruction without injury to surrounding tissue. The clinical effectiveness and safety of transrectal HIFU were investigated. METHODS: Thirty-seven Japanese men with symptomatic BPH were treated with HIFU. The treatment was minimally invasive; operating time was less than 40 minutes, and a posttreatment indwelling catheter was left in place for 3-4 days. RESULTS: The maximum urinary flow rate (ml. per second) increased from 7.6 +/- 0.6 to 9.3 +/- 0.6 at three months in 37 patients (P < 0.05). During the same period the International Prostatic Symptom Score and Quality of Life score (points) decreased from 23.6 +/- 1.4 to 10.5 +/- 0.3, 5.2 +/- 0.3 to 2.6 +/- 0.1 (P < 0.001), respectively. Overall response estimated by these three individual parameters were as follows; excellent 18.9%, good 48.6%, fair 10.8% and poor 21.6% at three months. Magnetic resonance imaging using an endorectal coil showed coagulative necrosis defined in the therapy zone at one month after treatment. Side effects were transient urinary retention in six patients (16.2%), gross hematuria in four patients (10.8%) and hematospermia in four patients (10.8%). There was almost no intraoperative blood loss. CONCLUSIONS: Transrectal HIFU treatment of symptomatic BPH is safe, reduces symptoms significantly, and leads to a slight increase in uroflow.

Aged↗
PubMed1995

Accuracy of prostatic volume calculation in transrectal ultrasonography.

BACKGROUND: Estimation of the prostatic volume by transrectal ultrasonography is now widely used to evaluate the effect of conservative treatment and to improve the specificity of prostate specific antigen. Accurate measurement of prostatic volume is necessary for the calculation of prostate specific antigen density (PSA/prostatic volume ratio). METHODS: Three dimensional models of the prostatic contour were constructed from transrectal ultrasonotomograms taken at 5 mm intervals in 20 cases. Using these models, the accuracy of ellipsoid volume calculation and prolate ellipse volume calculation were examined. For prolate ellipse volume calculation, prostatic length was measured in two ways; length (Lv) vertical to the transverse section, and length (Lp) parallel to the prostatic urethra. RESULTS: Ellipsoid volume calculation showed errors of about 20%. Moreover, ellipsoid volume calculation fluctuated markedly (up to 50%) in accordance with the change of the scanning angle of the transverse section. The error of prolate ellipse volume calculation using Lp for length increased by an average of 25% as the angle moved away from the perpendicular. The prolate ellipse volume calculation using Lv for length was the most reliable method. The degree of error was least dependent on the angle between the plane and the axis. CONCLUSION: Although prolate ellipse volume calculation was more accurate than ellipsoid volume calculation, it is essential to have the three axes cross at right angles to obtain an accurate value by the prolate ellipse volume calculation.

Humans↗
PubMed1995

Response criteria for the therapeutic efficacy of treatment for benign prostatic hyperplasia.

Response criteria for the therapeutic efficacy of treatments for benign prostatic hyperplasia (BPH) were proposed following the International Consultation on BPH held in 1993. In the present study, we validated the criteria and proposed a simplified form, which consists of the responses of three parameters: symptom score and quality of life assessed by the international prostate symptom score and the maximum flow rate. Each of the three individual parameters is evaluated as one of four response grades: excellent, good, fair or poor, and the number of response grade of the three parameters determines the overall response. Excellent and Good responses are regarded as effective, and fair and poor are regarded as not effective. The validity of the response criteria was assessed by comparing the responses determined by these criteria with those made by physicians in charge using a group of 225 patients receiving various treatments. The agreement rates on effectiveness of overall responses between the response criteria and physicians were 77% for a multicenter trial of medical treatment (n = 94), 100% for TURP (n = 23), 92% for laser treatment (n = 47), 80% for thermal treatment (n = 26) and 78% for alpha-blockers (n = 35), respectively. Altogether, 88% (198 of 225 cases) were evaluated accurately regarding effectiveness. Addition of prostate volume to the battery of response parameters made little contribution to diagnostic accuracy. Deletion of any of the other three parameters, however, significantly compromised the quality of assessment. These results suggest that the proposed criteria may be useful as the standard method for the assessment of the clinical efficacy of BPH treatment.

Aged↗
PubMed1995

Parent-to-child transmission is relatively common in the spread of the human polyomavirus JC virus.

JC polyomavirus (JCV), the causative agent of progressive multifocal leukoencephalopathy, is ubiquitous in the human population, infecting children asymptomatically and then persisting in renal tissue. In most adults, renal JCV replicates and the progeny are excreted in urine. We used this urinary JCV to elucidate the routes of JCV transmission. A 610-bp JCV DNA region (IG region) encompassing the 3'-terminal sequences of both T-antigen and VP1 (major capsid protein) genes was amplified by means of PCR from urine specimens collected from all members of seven families. JCV strains were then unequivocally identified by the nucleotide sequences of the amplified IG regions. We could identify 18 distinctive JCV strains from 27 individuals. Different JCV strains were detected from all unrelated persons. However, the same viral strain was detected from one (four families), two (one family), or three offspring (one family) as well as from the fathers (three families) or from the mothers (three families). In total, the JCV strains detected in half of the JCV-positive children were identified in their parents. Since most humans are infected during childhood, these findings indicated that JCV is transmitted frequently from parents to children. We roughly estimated that 50% of JCV transmission occurs by this route and that the other 50% occurs outside the family.

Adult↗
PubMed1995

[Histochemical study of biotinylated lectins in prostatic cancer].

We examined the staining pattern of various lectins in the malignant and benign prostatic tissues to clarify the difference of sugar residues of mucosubstances between them. The binding of different lectins (Concanavalia ensiformis [Con A], Triticum vulgaris [WAG], Ricinus communis [RCA-I], Arachis hypogaea [PNA], Ulex europaeus [UEA-I], Glycine max [SBA], and Gliffonia simplicifolia II [GSA-II]) to cells of benign prostatic tissues (17 cases) and adenocarcinoma (54 cases) was evaluated immunohistochemically. SBA which was negative in benign epithelial cells, showed tendency to the binding to prostatic carcinoma (42.6%). UEA-I was significantly bound to the adenocarcinoma (68.5%) compared to the benign prostatic tissue (35.3%). We also examined histochemically 25 pairs of tissues obtained from prostatic adenocarcinoma before and after the various therapies with various lectins. The histological responsiveness on the post-therapeutic specimens showed a significant correlation to the clinical responsiveness to therapy. But the staining pattern of these 7 lectins on the pre-therapeutic specimens did not show a significant correlation to the clinical responsiveness to therapy. In summary, the staining pattern of some lectins in the prostatic cancers is different from that in the benign prostatic tissues.

Adenocarcinoma↗
PubMed1995

[A case of male infertility with a chromosomal abnormality of 45, X/46, X + mar].

A 28-year-old man visited our hospital with a complaint of male infertility. His development was normal with body size of 169.5 cm in height and muscular type. His beard and axillary and pubic hairs were male type. The penis and scrotum were also normal, but testes were small (8 ml, bilateral). Semen analysis revealed azoospermia. Serum luteinizing hormone (LH) and testosterone levels are within normal range but follicle stimulating hormone (FSH) was moderately elevated. Testicular biopsy specimen showed severely hyalinized seminiferous tubuli, incarceration of basement membrane and hyperplasia of Leydig cells. Johnsen's score count was two. Chromosomal analysis revealed a mosaic type of 45, X/46, X + mar. We tried to confirm the existence of sex-determining region of the Y chromosome (SRY) by the DNA analysis. It was shown that SRY on genomic DNA fragment. This marker chromosome may be translocated to a fragment of the short arm of Y chromosome.

Adult↗
PubMed1995

[Transrectal ultrasound guided biopsies in 266 patients].

BACKGROUND: The objective of this study is to evaluate the diagnostic utility of digital rectal examination (DRE), prostate specific antigen (PSA) and transrectal ultrasonography (TRUS) for prostate cancer. METHODS: On 266 patients ultrasonography guided transrectal biopsies were performed using the automatic biopsy gun fitted with an 18 gauge biopsy needle. RESULTS: There was no major complication. Cancers were found in 52 patients (19.5%), and 16 of them were not identified by echography. Among 67 hypoechoic areas detected by echography, 36 (53.7%) were found to be cancer. The positive predictive value of DRE was 52.1% and that of PSA and TRUS were 24.4% and 53.7%, especially the rate increased to 93.7% by combining of these three techniques. CONCLUSION: These results suggest that the use of DRE, PSA in conjunction with TRUS enhances early detection of prostate cancer.

Aged↗
PubMed1995

[Evaluation of reliability of IPSS by 24-hour uroflowmetry].

BACKGROUND: Although the international prostate symptom score (IPSS) is now often used to assess the symptoms of BPH, whether or not patients answer the questions correctly has not been validated objectively. METHODS: Reliability of IPSS was evaluated by 24-hour uroflowmetry in 20 hospitalized male patients. Six of them had prostatic hypertrophy or cancer, and the evaluation was performed before and after TURP or hormonal therapy in these six patients. The objective scores for frequency and nocturia were obtained from the time recorded on IC card. The objective score for intermittency was calculated from the uroflow curves. RESULTS: The answer about frequency was not correct compared with the objective scores for frequency. The answers about nocturia and intermittency were almost the same as the corresponding objective scores. The answer for weak stream correlated with the average of peak flow rate. However, the threshold of peak flow rate for "weak stream" fluctuated markedly before and after the treatment in the same individuals. The answer for hesitancy had no correlation with the hesitation time. Patients seemed to understand the question translated in Japanese as "have you need force to urinate?" CONCLUSION: Before wider use of IPSS in Japan, the correct translation of the questions and verification of the usefulness of the questions in large number of Japanese patients seem necessary.

Humans↗
PubMed1995

[Comparative study on minimum inhibitory concentration of gonococcal strains according to their auxogroups and serovars].

Auxotypes, serovars and minimum inhibitory concentration (MIC) of various antibiotics are investigated on 85 gonococcal strains isolated from the patient with gonorrhea from 1984 to 1986 in Japanese Red Cross Medical Center. As to the auxotypes 33 strains were identified to be Proto, 33 to be Pro, 10 to be Arg and 9 to be PAU. No AHU strain was identified. Serovars were divided into 1A and 1B. MIC of 22 kinds of antibiotics including penicillins, cephems, spectinomycin, tetracycline and new quinolones were determined. Cumulative MIC curves were found to be shifted to the right according to the order of auxotypes Arg, PAU, Proto, Pro in the most antibiotics. Serovar 1A was found to have lower MIC as compared to 1B, though only 5 strain of 1A were in the study. Seventy-eight % of isolates were Proto or Pro, so-called Asian auxotype which were revealed to have higher MIC not only of penicillin but also of the other antibiotics. Nine strains were identified as PAU which was lately identified in Canada. This might suggest that gonococcal strains are spreading over the world in spite of the local predominance of auxotype distribution.

Adult↗
PubMed1995

[Deoxycorticosterone-producing adrenocortical carcinoma--a case report].

A 39-year-old male presented with gross hematuria and left lower abdominal discomfort. Excretory urography showed a left ureteral stone and hydronephrosis. CT scans and magnetic resonance imaging showed a solid mass at the upper pole of the left kidney. Angiography revealed a hypervascular lesion at this area. The laboratory data showed a slightly decreased serum potassium level. In the endocrinological study, the serum deoxycorticosterone (DOC) level was markedly elevated. There was, however, no evidence of hypertension. The operation was performed on November 13, 1992. The tumor was almost separated from the left kidney, but an aberrant artery which divided from the renal artery and penetrated the renal parenchyma was found. Therefore, we had to carry out en bloc removal of the tumor together with the left kidney and the ureter which contained the ureteral stone. Pathological diagnosis was adrenocortical carcinoma. After the operation, hypokalemia and the serum concentration of DOC returned to normal range. Therefore, the tumor was diagnosed as DOC producing adrenocortical carcinoma. The patient was discharged 30 days after the operation with uneventful postoperative course. He received 2.5 g of op'-DDD a day. There was no evidence of distant metastasis or local recurrence 12 months after the operation. Nineteen cases of DOC producing adrenocortical tumor have been reported in the world literature. A case and a review of the literature are herein reported.

Adrenal Cortex Neoplasms↗