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Biomedical subjects

K Okada

Publications and source records attributed to K Okada.

At least 1,063 records · Page 59Linked to original sources
PubMed1991

[A mass screening of the prostatic diseases and serum prostate specific antigen].

We examined the values of prostate specific antigen (PSA) with a RIA kit (Pros Check PSA) and an EIA kit (Market F PA), measuring prostate weights of 125 participants in a mass screening of the prostatic diseases. A mild positive correlation (r = 0.467) between values of PSA (RIA) and prostate weights was found in the participants in whom the prostate cancer was not detected. Since serum PSA levels measured by RIA of 45 normal subjects were 1.8 +/- 1.5 ng/ml (Mean +/- S.D), the upper limit of the normal range was set at 6.3 ng/ml. The participants whose PSA levels exceeded this upper normal range and also whose prostate weights were under 30 g were found in 11 of the 122 subjects (9%). On the contrary, the abnormal values (EIA) were found in only two subjects (one, a prostate cancer and the other, a benign prostate hypertrophy). We, further, examined the PSA values (EIA) in 415 subjects in whom the prostate cancer was detected in 5 (1.2%). The abnormal values were found in 8 (4 prostate cancer, 3 benign prostate hypertrophy and one without prostatic disease). As the false positive rate was very low, the use of PSA is recommended in the first screening of the check up program of the prostatic disease.

Aged↗
PubMed1991

[Antiandrogen therapy of benign prostatic hyperplasia--review of the agents evaluation of the clinical results].

Various non-surgical therapeutic modalities such as balloon dilation of the prostatic urethra, hyperthermia of the prostate and medication with antiandrogens and/or adrenergic blockade have been attempted for the patients with benign prostatic hyperplasia (BPH) especially in an early stage or in a poor operative risk. The observation that androgen deprivation induces shrinkage of the hyperplastic prostate represents the basis for the treatment of BPH with antiandrogen. Although several antiandrogens are now in clinical use in our country, there still remain problems to be solved. We reviewed the mechanism of action and the clinical results of antiandrogens in the treatment of BPH. The improvement following antiandrogen therapy occurred among the patients with symptomatic BPH, in 50-80% subjectively and in 40-50% objectively. The therapy appeared to be more effective in an early stage of the disease. However, the limitation of the duration of the effects and unfavorable side effects should also be noticed. The progestational agents such as gestonorone caproate, chlormadinone acetate and allylestrenol suppress more or less sexual function by interference of the pituitary-gonadal axis. Besides, coincidental prostate cancer must be excluded since antiandrogen therapy might hinder the natural course of the cancer.

Administration, Oral↗
PubMed1991

[Transrectal hyperthermia for benign prostatic hyperplasia].

The PRIMUS system was designed as a dedicated microwave hyperthermia system for treatment of benign prostatic hyperplasia (BPH). Completed cases were 36 patients. Hyperthermia was subjectively effective in 31 patients (86%), but no appreciable changes were noted with regard to the size of the prostate. Side effects occurred in 10 of the evaluable 49 cases (20%). However, no severe side effects were recognized except in one case. The effective ratio revealed 25 of 36 cases (69%). Therefore, transrectal prostatic hyperthermia would be a useful method especially in cases of BPH with severe complications.

Aged↗
PubMed1991

[Clinical studies on endocrine therapy for prostatic carcinoma (4): Initial response to endocrine therapy and prognosis].

We have already pointed out by the use of multivariate analysis that local response of the prostate is one of the important prognostic factors in patients receiving endocrine therapy. Herein, we investigated how the local response to endocrine therapy affects the survival rate or the survival period. We also studied the relationship between the local response and histopathological findings. The local response of prostate was not correlated with the stage progression. Sixty-seven percent of the patents in each stage had an initially favorable local response of the prostate, in which the primary tumor became flattened or reduced by endocrine therapy. By contrast, the local response of the prostate was well correlated with the prognosis in each stage. Patients with a flattened or reduced primary lesion following endocrine therapy showed a higher survival rate or a longer survival period than those with the unchanged lesion. This result has confirmed that the local response of prostate to endocrine therapy is useful in predicting clinical courses of patients. Grade of structural atypism (SAT), one of the pathological findings, had a correlation with local response of the prostate. With an elevation of the SAT grade, the proportion of patients with unchanged primary lesion was increased.

Humans↗
PubMed1991

[Clinical studies on endocrine therapy for prostatic carcinoma (5): Analyses of relapse from endocrine therapy].

Prostate carcinomas are well known to be initially responsive to endocrine therapy. However, a significant number of the patients experience a relapse from endocrine therapy during the follow-up period. We clinically analyzed various aspects of the relapse which indicate a limitation in the effectiveness of endocrine therapy for prostate carcinoma. In a total of 372 patients, 117 (31.5%) had some evidence of local relapse such as regrowth of the primary lesion, or a generalized relapse such as re-elevation of total acid phosphatase, reactivation of previously present metastasis or the new appearance of metastasis, during endocrine therapy. Of these, one-fourth had local relapse alone and the remainder showed generalized relapse. The interval from the start of the treatment to the time of relapse tended to become shorter; 45.9 months (mean) in stage B, 36.8 in stage C and 29.3 in stage D, according to the stage progression. As to the non-relapse rate of the primary lesion, no differences were found among the stage, with the rate being approximately 90% at the fifth year in each stage. However, the generalized relapse-rate tended to increase with the stage progression. In the generalized relapse, the patients of stage C or D showed a non-relapse rate of 71.7% or 67.4%, respectively. Most of the generalized relapse appeared within five years following start of endocrine therapy in these advanced stages. The interval from relapse to prostate carcinoma-related death in patients with the generalized relapse was 9 approximately 21 months, and those in stage D tended to show a a poorer prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1991

[The effect of dobutamine on hemodynamics, critical cooling, and myocardia excitability during simple deep hypothermia].

The effects of dobutamine (DOB) on hemodynamics, critical cooling, and myocardial excitability were studied in dogs under simple deep hypothermia. Hypothermia was induced by surface cooling after the animals had been anesthetized with ether and triflupromazine (conventional method, group I). Continuous intravenous administration of DOB was combined with conventional method in group II, and surface cooling was performed with thiamylal in group III. The following results were obtained. The mean lowest temperature reached was 15.6 degrees C in group II. MAP, CO and V max of group II were maintained significantly higher than those of group I during cooling. Decrease in BE in group II was mild compared with group I. Catecholamine release during cooling was suppressed completely in group I and II, but increased markedly in group III. Myocardial threshold to artificial pacing in group II was elevated as the temperature fell, and restored during rewarming, while that of group III was unchanged during cooling. Ventricular fibrillation occurred by stimulation of pacemakers in some cases. Our results suggest that even in case of hypothermia, DOB retains a selective inotropic effect with no threat of arrhythmogenicity, and produces stable hemodynamics. These characteristics of DOB allow cooling down to 15 degrees C.

Animals↗
PubMed1991

[An evaluation of the attitudes and productivity of public health nurses in mental health service programs for the elderly].

The relationship between productivity of public health nurses (PHN) employed in mental health programs including home visit service for elderly people with dementia, and their attitudes toward mental health services was studied by surveying PHN at 31 health centers (HC) in Osaka Prefecture. A review of the services provided for 382 clients with dementia visited during a one-year period showed that PHN had provided the following services: home health care education: family education to promote understanding of the disease; management of interpersonal relations in the family; intervention to reduce the burden placed on the family members; medical facility referral; social service resource referral. For each of these PHN-provided services, the service had been provided to more than 60% of the clients. The percentage of clients who had been visited by a PHN accompanying a psychiatrist or a social worker was significantly higher at the 13 HC where PHN attach importance to counseling programs for the elderly, the 8 HC which provide group work services, and the 13 HC which hold case conferences more than six times a year than at other HC. In addition, the service provision rates for many PHN-provided services were significantly higher for these HC than for other HC. Analysis on the basis of whether PHN did or did not attach importance to the counseling program, showed that in either group, clients who had been visited by a PHN accompanying a psychiatrist or a social worker were more likely to have received PHN-provided services than other clients. Furthermore, at HC where PHN actively participated in mental health programs, PHN attitudes toward mental health care were more enthusiastic than at other HC. These results indicate that increased productivity of PHN employed in mental health programs and promotion of a multidisciplinary approach in client services are correlated with each other, and that both factors contribute to improving the quality of home visit services provided by PHN.

Aged↗
PubMed1991

[Clinical studies on prognostic factors in predicting pregnancy].

During the 5-year period from January 1984 to December 1988, 1,025 men were investigated for infertility. The patients were classified according to WHO laboratory manual. Using life-table analysis, WHO's classification of semen analysis was a useful discriminant for infertility prognosis. The Cox's multiple regression model was employed to investigate the relationship between various semen characteristics and future fertility. The duration of infertility, sperm concentration, sperm progressive motility, the presence of female factor were independent and statistically significant factors which influence the cumulative probability of conception.

Adult↗
PubMed1991

[Study of incidental carcinoma of the prostate. II. Nuclear DNA analysis].

The clinical significance of cytofluorometric nuclear DNA analysis, ploidy pattern and DNA content, was investigated in 47 incidental prostatic carcinomas, 24 stage A1 and 23 stage A2 cases, 9 clinically advanced cases and 25 BPHs. The results were compared to clinical stage and histological differentiation. The mean nuclear DNA content of stage A1 cancer, which was similar to BPH, differed from that of stage A2 cases. The latter was almost identical to that of advanced cases. In moderately and poorly differentiated carcinomas it was higher than that of well differentiated ones. A non-diploid pattern was distributed in 33% of stage A1, 78% of stage A2 and 89% of clinically advanced cases. It was detected in 42% of the well-, 77% of the moderately- and 100% of the poorly differentiated adenocarcinomas. The DNA analysis of incidental prostatic cancer thus correlated well to the clinical and pathological parameters. If limited to well differentiated carcinomas, however, 17% of the stage A1 cases showed an aneuploid, and 29% of the stage A2 cases, a diploid pattern. No diploid pattern was detected in clinically advanced cases. Although we have not been able to prove any difference in prognosis in the present cases, these findings suggest that the nuclear DNA analysis is another parameter in defining the prognosis of incidental prostatic carcinoma. Further follow-up of the patients and accumulation of the data are necessary to determine the clinical validity of this method.

Adenocarcinoma↗
PubMed1991

Assessment of daily physical activity levels of severely disabled persons using heart rate series.

Daily physical activity levels of severely disabled persons were assessed by means of a statistical analysis of their heart rate during a 24-h period. A non-Gaussian probability density function of the heart rate was calculated and separated into two levels of heart rate distributions, i.e. a relatively lower heart rate for basic daily activity and a relatively higher heart rate relating to vigorous activity. Disabled persons with low ambulatory ability showed daily activity levels similar to normal subjects in the length of time and the level of the heart rate. Their daily activity satisfied their needs for maintaining good health. However, more prolonged vigorous activity in daily living was necessary to improve cardiovascular fitness. For severely disabled persons without ambulatory ability, almost all of the heart rates during daily activity were categorized into the lower heart rate distribution. Their low level of physical activity may lead to a serious decrease in cardiovascular function with its attendant risk of cardiopulmonary disease.

Activities of Daily Living↗
PubMed1991

[A case of renal artery aneurysm with calcification].

We report a case of left renal artery aneurysm with ring-like calcification in a 57-year-old man. The selective renal arteriography showed a 30 x 28 mm saccular type aneurysm arising from the periphery of the bifurcation of posterior segment artery. There were no clinical symptoms, such as hypertension and loin pain, but we performed aneurysmectomy for fear of rupture. Histopathological findings showed atherosclerotic changes with marked calcification of wall lacking natural collagen fibers. Renal artery aneurysm with calcification seldom ruptures because of its generally hard wall. However, as cases of rupture through weakness of calcification have been reported, we recommend positive surgical treatment.

Aneurysm↗
PubMed1991

[The mite-free room (MFR) for the management of atopic dermatitis: living in the MFR improved first the itch and then the dermatitis].

While there are increasing data supporting the view that mite allergen sensitivity is one of the major causes of atopic dermatitis (AD) as well as asthma, it is practically difficult to avoid house dust allergens as part of the management of AD. Therefore, we served a conditioned room in which mites were eliminated to the level less than 3 mites/m2, named mite free room (MFR) for experimental treatment of AD to evaluate the possible therapeutic effect of the mite-free condition. Thirteen relatively severe patients with high-IgE RAST score to the mite allergens were treated with night time admission to the MFR without disturbing their social activities in the day time. Our MFR treatment gave eleven of the thirteen patients relief from itch and dermatitis within 2 to 3 weeks, yet they stayed average only 11 hours a day in the MFR. These results may provide a possible candidate in the treatment of AD instead of topical and/or systemic medicines of which prolonged usage is sometimes associated with adverse side effects.

Adolescent↗
PubMed1991

A case of primary systemic amyloidosis with AA protein.

We present here a case of young adult-onset primary systemic amyloidosis with AA protein. A 29-year-old male presenting with macrohematuria was transferred to our hospital because of aggravation of renal function. Amyloid protein was detected in the bladder, stomach and thyroid. The amyloid protein proved to be AA type by potassium permanganate histochemical analysis. Since secondary amyloidosis was excluded by the laboratory data and there was no family history of amyloidosis, a diagnosis of primary systemic amyloidosis with AA protein was reached. Although the patient was prescribed dimethyl sulphoxide, his renal function worsened with gastrocolic symptoms and a bleeding tendency. Hemodialysis (HD) was then initiated. After starting the HD, the patient's general condition recovered and subsequently the patient on treatment with maintenance HD was discharged.

Adult↗
PubMed1991

Pharmacokinetics and optimum dose of disopyramide in patients with chronic renal failure.

The pharmacokinetics and optimum dose for maintenance of disopyramide (DP) which is effective against arrhythmia were studied in patients with chronic renal failure (CRF, n = 10), who had a creatinine clearance (Ccr) less than 30 ml/min. The plasma concentrations (PC) of DP and mono-isopropyl-disopyramide (MDP) an active metabolite of DP, were measured by high performance liquid chromatography. Samples from patients and controls were obtained at 0, 1, 2, 3, 4, 6, 8, 12, 24, 33, and 48 hr after oral administration (OA) of 100 mg DP. The pharmacokinetic parameters were calculated using a two-compartment model. In CRF, the plasma half life (T 1/2) of DP was 5.25 to 22.42 hr (average is 12.45 hr) and that of MDP was 5.09 to 131.66 hr (average is 16.9 hr). In normal controls, the T 1/2 of DP was 6.05 hr, but that of MDP could not be determined the available sensitivity of measurement. T max was 3.11 hr at the total PC of DP and MDP, and C max was 2.48 g/ml on average. In conclusion, the present study revealed that: (1) the PC of a mixture of DP and MDP should rise following OA of DP every 8 or 12 hr in CRF; (2) it is necessary therefore to monitor the accumulation of MDP after rolling OA of DP; and (3) OA of DP every 24 hr can maintain an effective PC.

Administration, Oral↗