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Biomedical subjects

K Kumasaka

Publications and source records attributed to K Kumasaka.

At least 73 records · Page 4Linked to original sources

[Clinicobacteriological study of Pasteurella multocida infection as a zoonosis. (2)--Comparisons of P. multocida separated from patients and their pet dogs and cats].

A total of 17 strains of Pasteurella multocida, of which 13 were isolated from patients treated at Nihon University Itabashi Hospital or Nihon University Surugadai Hospital between April, 1984 and March, 1991 and 4 from 1 dog and 3 cats kept by the patients, were evaluated with respect to their biochemical properties, sensitivity to drugs, and serotype. The isolated strains were all considered to be Pasteurella multocida subsp. multocida because of the agreement of their responses to indole, sorbitol and dulcitol with those of this subspecies, except for 1 sorbitol-negative strain of Pasteurella multocida subsp. septica isolated from 1 patient who had been bitten by a cat. All the isolated strains showed high sensitivities to various drugs. The serotype was capsular type A, which is often observed in cats and dogs, in 7 strains, which consisted of 6 of the 7 strains derived from the airway of the patients and 1 of the 6 strains derived from bit or scratch wound. The remaining strains could not be classified. Five morphological types, namely 1, 3, 3.8, 6, and 8 were observed. In 2 patients, Pasteurella multocida subsp. multocida of the same serotype was also isolated from their cats. One of these patients had intimate contact with the cat including kissing. Our findings suggest that: 1) Pasteurella multocida subsp. multocida has been responsible for most conventional cases of Pasteurella multocida infection. 2) Strains isolated from patients differ in the capsular type according to the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Action potential of the intramural ureter in the dog.

In 33 adult mongrel dogs, the function of the intramural ureter was investigated. (A) Bipolar electrodes were placed in both the extravesical ureter and the intramural ureter. Then, an electromyogram (EMG) was recorded from two leads. (B) Cystotomy was performed, needle-type electrodes were inserted into the wall of the ureteral orifice and the extravesical ureter, and the EMG was recorded. (C) A special needle which could record EMG and measure pressure simultaneously was prepared. Then EMG and pressure measurements were recorded from the wall of the intramural ureter. In each experiment, action potentials were recorded from the intramural ureter that were similar to those from the extravesical ureter. The pressure in the wall of the intramural ureter showed variations matching the action potentials. From these results, it was evident that active muscle contraction occurred due to the action potential transmitted from the extravesical ureter even in the intramural ureter.

Action Potentials↗

[The study on the function of the intramural portion of the ureter. The motion of the intramural portion of the ureter in dogs].

UNLABELLED: The present investigation was performed in order to clarify whether the motion of the intramural portion of the ureter is passive or active. In Experiment I, electromyograms of the extravesical and intramural portions of the ureter were recorded using bipolar suspended electrodes and bipolar needle electrodes for 52 ureters in 26 adult mongrel dogs to study the relationship between both portions of the ureters in the nondiuretic and diuretic state. In Experiment II, using 14 ureters in 10 adult mongrel dogs, electromyograms were recorded and the local forces of the ureteral walls of the extravesical and intramural portions were measured with a special needle electrode concurrently. RESULTS: (1) Experiment I demonstrated in the nondiuretic and diuretic state, 1. no significant differences in the ureteral discharge frequency between the extravesical and intramural portion of the ureters, and 2. a 1:1 correspondence in the extravesical and intramural action potentials. (2) Increases were observed in the local forces of the ureteral walls of the intramural portion of the ureters following action potentials. From these experimental results, it was suggested that the intramural portion of the ureter actively moves due to muscular excitation from the upper ureter and participates in urine transport.

Action Potentials↗

[Ureteral function at the ureterovesical junction. Action potentials of the canine intramural ureter during bladder filling or bladder contraction].

The relationship between bladder movements and the intramural ureter was studied in the dog by recording electromyograms of the intramural and extravesical ureters recorded during bladder filling and contraction. Bladder filling was achieved by instilling physiological saline at a rate of 10 ml/min to a volume of 5 ml/kg, while bladder contraction was induced by electrical stimulation. For electromyography, an electrode was inserted transperitoneal into both the extravesical ureter and the intramural ureter after it had been separated from the extravesical ureter. A cystostomy for the instillation of water and another cystostomy for the measurement of intravesical pressure were also made in the bladder. During bladder filling at an intravesical pressure of about 10 cmH2O, the frequency of the action potentials in the intramural ureter showed no significant difference to those in the extravesical ureter. In addition, during bladder contraction at a greatly increased intravesical pressure of about 5 times the precontraction level, the frequency of the action potentials in the intramural ureter was not significant by different from those in the extravesical ureter, and also from its own precontraction value. The above findings suggest that action potentials in the intramural ureter are not affected by bladder movements such as filling or contraction, and that the ureter continues to actively transport urine to the bladder during such movements.

Action Potentials↗

[A case of replacement ileocystoplasty for contracted bladder].

The patient was a 49-year-old male. He had a history of asymptomatic hematuria that had occurred 3 years previously. The hematuria and pollakisuria developed again from about March, 1989, and he was hospitalized for bladder tamponade in April. Bilateral percutaneous nephrostomies were performed because a contracted bladder and bilateral hydronephrosis were detected. He was then admitted to our hospital on June 21. The cause of the contracted bladder was not evident, despite extensive examination. A replacement ileocystoplasty constructed by Shishido's method was used to replace the contracted bladder. A U-shape pouch was prepared by detubularization of 25 cm of the ileum and this pouch was anastomosed to the incised end of the bladder neck after subtotal cystectomy. The ureter and ileum were then anastomosed using Coffey's method. The bladder capacity and the maximum urinary flow rate after 1 year were 350 ml and 13 ml/sec, respectively, and residual urine was not noted after urination even following abdominal pressure. Urinary incontinence was not noted either.

Humans↗

[Human respiratory tract infection by Pasteurella multocida subsp. multocida presumably derived from the cat].

Pasteurella multocida is a Gram-negative short rod-shaped bacteria that has been recognized as a pathogen of hemorrhagic septicemia and fowl cholera in the veterinary medicine. Infections by this microorganism as seen in the foreign literature vary widely from local infections due to bites and scratches by animals to general infections such as infections of the respiratory tract, sepsis, and meningitis. In Japan, reported cases of P. multocida infections are predominantly local infections, followed by respiratory infection. Recently, death of diabetic patients due to septicemia by this pathogen has also been reported. In this study, we experienced a case of respiratory tract infection in which the pathogen P. multocida subsp. multocida was suggested to have been transmitted from a pet cat by the agreement of the serotype of the bacterial isolates between the patient and the cat. This case was evaluated from the zoonotic viewpoint. The patient was a 68-year-old male who had been followed up since 1982 with a diagnosis of bronchiectasis. After his referral to our hospital, P. multocida subsp. multocida was isolated from his bloody sputum and, then, from the cat kept by the patient. The tow isolates were identical in terms of the biochemical properties, drug susceptibility profile, and serotype (-:1), and the derivation of P. multocida subsp. multocida infection from cat was established for the first time in this report. The incidence of P. multocida infections is increasing in Japan, and particular attention is considered to be needed about these conditions as zoonoses as indicated in "Preventive Measures against Zoonoses Derived from Pet Animals (Dog, Cat)", an official communication from the Ministry of Health and Welfare to related institutions in 1989. Also, to check whether the patient keeps any pet at the clinical inquiry is a practice of bacteriological importance in all fields of medicine.

Aged↗

[Studies on the giardiasis as the zoonosis].

To obtain basic data on the route of Giardia infection as zoonosis, we examined feces from 80 dogs and 16 cats for Giardia cysts and evaluated the detection rates. In addition, familial infection was studied in 3 family members of the patient with giardiasis. Giardia cysts were detected in 10 of the 80 dogs (12.5%) but none of the cats. Of the 10 dogs from which Giardia cysts were isolated, 6 had been maintained by the breeders. Tow other dogs were for examination in the research institutions. None of the family members of the patient with giardiasis had this infection. Since the detection rates of Giardia cysts in the dogs and cats were low, the possibility that human infection is acquired from dogs or cats seemed to be low. However, some of patients with giardiasis we encountered had never been abroad. This fact together with the presence of Giardia cysts in the dogs despite the low detection rates suggest that attention should be paid to the possible association between human giardiasis and pets since the number of people keeping pets is increasing.

Animals↗

[A case of adenocarcinoma in the renal pelvis and urinary bladder in a patient with chronic renal failure].

The patient was a 61-year-old male who had undergone right nephrectomy for nephrolithiasis 35 years before. He had been on hemodialysis for 6 years for chronic renal failure caused by left renal staghorn calculus and hydronephrosis. He was admitted to our hospital because of macroscopic hematuria and sense of residual urine which had persisted for 3 months. Cystoscopic examination showed an extensive papillary tumor in the urinary bladder, which histologically was an adenocarcinoma. Giant left hydronephrosis associated with staghorn calculus noted by KUB and CT scan. Total cystectomy, intraoperative radiotherapy, and left nephrostomy were performed under the diagnosis of adenocarcinoma of the urinary bladder and left hydronephrosis. The bladder tumor was found to be a mucinous adenocarcinoma. The patient died from a cerebral hemorrhage on the 17th postoperative day. At autopsy, tumors were found in the pelvis of the left kidney and the middle and lower regions of the ureter, which were adenocarcinoma like the bladder tumor. Adenocarcinoma occurring simultaneously in the renal pelvis and bladder has not been previously reported to our knowledge, in Japan or elsewhere.

Adenocarcinoma, Mucinous↗

[Surgical management in synchronous bilateral renal cell carcinoma].

Six patients with synchronous bilateral renal cell carcinoma were treated surgically over a 7-year period in our department. They were all males and the mean age was 60.3 years. They comprised 7.1% of all patients with renal cell carcinoma encountered during the same period. In four out of the six cases, radical nephrectomy for the larger tumor plus partial nephrectomy for contralateral kidney was performed simultaneously. In the remaining two cases, bilateral partial nephrectomy was performed simultaneously or as separate procedures. Two patients required chronic hemodialysis and died of cardio-pulmonary insufficiency on the 70th and 75th day. One patient, who underwent bilateral partial nephrectomy with incomplete tumor removal, subsequently died of metastatic disease at 27 months. Although one of them required transient hemodialysis, the remaining three patients were alive and disease-free 84, 42, and 17 months after operation, without evidence of tumor. This series suggests that partial nephrectomy is an appropriate option in the management of selected cases of bilateral renal cell carcinoma.

Aged↗

[Inflammatory reaction and laboratory tests: hematologic examination].

The leukocyte count, the differential leukocyte count and the erythrocyte sedimentation rate (ESR) are the more commonly used tests for diagnosing or managing an inflammatory process. Measurements of acute-phase proteins has an advantage over that of the leukocyte count and ESR. Especially microscopic examination of peripheral blood smear can be time consuming, but the simple and inexpensive technique is still clinically useful when a high grade bacteremia is likely to be present. Although the results are examiner dependent, it should be reliable in the proper clinical setting. In the guidelines for the selection of laboratory tests for monitoring the acute phase response, published in 1988, the International Committee for Standardization in hematology (ICSH) considered the biohazzard of ESR. Therefore the ESR should not routinely be performed on blood samples from patients who show a positive test for hepatitis virus or human immunodeficiency virus. The subcommittee for laboratory tests in daily care situations in Japan Society of Clinical Pathology published the "Essential Laboratory Tests" in 1989. We conclude that the differential leukocyte counts and the ESR should be used to follow the activity and response to treatment of certain inflammatory disorders when other objective indicators are not available.

Blood Sedimentation↗

[A case of renal cell carcinoma with polymyositis].

We report a case of renal cell carcinoma with polymyositis. A 62-year-old female with a diagnosis of polymyositis was referred to our department because of the right renal mass discovered by computed tomography. An ultrasonography and renal angiography showed a solid and hypovascular area at the middle pole of the right kidney. A fine needle aspiration biopsy of the mass was performed and the cytology showed a papillary adenocarcinoma. Therefore, the right radical nephrectomy was carried out and her myopathic symptoms were slightly improved postoperatively. The patient has remained well without recurrence or metastasis for two years.

Adenocarcinoma, Papillary↗

[Studies on transient hyperphosphatasemia].

We found 39 cases of transient hyperphosphatasemia (TH) from 8 primary medical care institutions over a 2.5 year period, beginning in 1986, and 36 cases were available for this analysis. The maximum activity of serum alkaline phosphatase (ALP) was 318 K.A unit, and 16 cases showed 100 K.A unit or more. Ages of the TH cases were ranged from 8 to 92 months and average of 25.4 months. There were no seasonal fluctuation of the incidence. Although high fever was noticed in 21 cases (58%), and diarrhea and upper respiratory infections were observed in 9 cases (25%) each, no common characteristic features in underlying diseases or laboratory abnormalities were noticed. All of those clinical signs were returned to normal within one month, except for 3 cases in which we could not make follow up study. ALP levels were re-examined within one week in 14 cases (39%) but re-examination was not requested in another 14 cases. ALP levels were returned to normal within one month but characteristic isoenzyme patterns for TH were detectable for up to 3 months from the onset. According to the investigation over 1.5 year period at Kumagaya pediatric hospital, 28 out of 7,287 samples (0.38%) were found to have TH. The mechanism to develop TH is not known, but sugar chain aberrations of ALP are more likely the cause, since viral infections were seen only a few occasions.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaline Phosphatase↗

[Studies on growth of Pasteurella multocida on BTB agar].

It has been reported that the Pasteurella multocida does not grow on the BTB agar. Therefore, this medium has been used as selective and differential medium for Pasteurella multocida. However, we have experienced that some of the Pasteurella multocida from the patient's materials grew on the BTB agar. Here, we will report on the studies of the growth of the Pasteurella multocida strain on the BTB agar. Ten strains of Pasteurella multocida from humans and animals were used as the test strains. Those were adjusted to McFarland No. 5 by the sterilized physiological saline and inoculated on the agars. We compared commercially prepared BTB agars from 3 companies and BTB agars prepared by our-self from dehydrated culture medium. Blood, Chocolate, Nutrient and MacConkey agar were also used in this study. As for the growth of the Pasteurella multocida, we checked the pH of each agar and the temperature during the cultivation. The results are as follows: 1) Pasteurella multocida was confirmed to grow on all of the BTB agar. 2) Pasteurella multocida grew most heavily at 37 degrees C and pH of 7.4 to 8.2. 3) The difference of the growth on each agar was considered to be the difference of the pH and nutritional condition of the agar.

Agar↗

[A case of hyper-HDL-cholesterolemia presenting peculiar lipoprotein patterns in agarose gel electrophoresis].

Lipoprotein metabolism was analyzed in a patient with marked hyper-HDL-cholesterolemia. A 50 year old male with no symptom of ischemic heart disease or xanthoma had a serum cholesterol level between 293 and 410 mg/dl, and a markedly elevated, HDL-cholesterol level (160-190 mg/dl). The cholesterol content of ultracentrifugally separated HDL2 was exclusively increased, while it was normal in the HDL3 fraction. Analytical ultracentrifugation and HPLC revealed that HDL particles became remarkably larger than the control and, on the contrary, LDL particles became smaller. LPL and LCAT activities were higher in this case, but H-TGL activity was normal. Agarose gel electrophoresis of lipoproteins showed an abnormal broad band which was located between alpha and pre beta band. Serum levels of apolipoprotein A-I, A-II, C-II, C-III and E were higher, while apolipoprotein B level was slightly lower than the control. Cholesteryl ester transfer protein (CETP) activity was demonstrated to be completely deficient in this case, as determined in 10 microliters serum using [3H] CE-labeled HDL3 as donor and VLDL + LDL fraction as acceptor. Since CETP was considered to catalyze the cholesteryl ester transport from HDL to VLDL and LDL, the deficiency of this activity might be the cause of the marked hyper-HDL-cholesterolemia in this patient.

Adolescent↗