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Biomedical subjects

K Okamura

Publications and source records attributed to K Okamura.

At least 433 records · Page 24Linked to original sources

[Squamous cell carcinoma of renal pelvis: a case report and review of the Japanese literature].

Squamous cell carcinoma of renal pelvis is relatively rare and its prognosis is very poor. A 72-year-old man was introduced to our institute because of macroscopic hematuria. He had no history of urolithiasis or urinary tract infection. Excretory urography showed a nonfunctioning right kidney. Cytologic examination of urine was positive for malignant cell from squamous cell carcinoma. Preoperative diagnosis was made as right renal pelvic tumor, but it appeared to be renal tumor on the roentgenogram. Right radical nephrectomy and transurethral ureterectomy was performed. Radiation therapy was done after operation. Pathological diagnosis was squamous cell carcinoma of renal pelvis extensively infiltrating to the renal parenchyma. The patient is alive with no recurrence or metastasis for eight months after operation. Statistical analysis was made on 136 cases of squamous cell carcinoma of renal pelvis reported in the Japanese literature including our case, and this disease is also briefly reviewed.

Aged↗

[Fournier's gangrene: a case report].

Since necrotizing fasciitis of the genitalia was first described by Fournier in 1883, approximately 400 cases have been reported. It has been seldom reported in Japan. Because its mortality rate is still high, the importance of early diagnosis and the subsequent vigorous treatment has been emphasized. A 73-year-old man who had poor controlled diabetes mellitus was admitted to our hospital with painful swelling of scrotum. Chemotherapy using broad spectrum antibiotics and debridement of scrotal skin was performed combined with insulin therapy. As culture of pus and excised tissue from the gangrenous patches yielded the growth of candida, we used 8 g/day of 5-fluorocytosine. Because the gangrene was not healed, we performed bilateral orchiectomy. After the operation, the gangrene was healed and the wound was closed. Diabetes mellitus was controlled well and his general condition was improved.

Aged↗

[Clinical study of ofloxacin (OFLX) on urinary tract infections].

Fifty-three patients with urinary tract infections (UTI) were treated with Ofloxacin, a new oral synthetic antimicrobial agent, and its clinical efficacy was studied. Ofloxacin (600 mg/day) was administered to 35 patients with acute simple cystitis for more than three days, and to 17 patients with complicated UTI for more than five days except a case in which the treatment was interrupted for side effects. Acute simple cystitis: In ten cases meeting the criteria of UTI committee, overall effectiveness rate was 100%. All of the 26 strains isolated from 26 patients disappeared after the treatment. In all of acute simple cystitis cases, 94.3% were evaluated as excellent or as moderate by attending doctors. Complicated UTI: In 11 cases treated during five or seven days, 63.6% of patients showed improvement on pyuria. Seven out of nine strains isolated from seven patients disappeared. However, two strains of P. aeruginosa and P. cepacia persisted after the treatment. In all of the complicated UTI cases, 38.9% of patients were evaluated as excellent or as moderate by attending doctors. Some slight side effects were observed in four out of 53 cases. This study showed that Ofloxacin is effective against urinary tract infections.

Acute Disease↗

[A case of spina bifida with vesicoureteral reflux (VUR) successfully treated by early management].

A case of secondary VUR in neurogenic bladder with meningomyelocele treated successfully with urethral catheterization is reported. A 4-month-old girl was introduced to our clinic for the management of incontinence following the closure of the meningomyelocele (below S1 level). Anal sphincter and bulbocavernous reflex was almost normal. Since the IVP revealed right hydronephrosis, an urethral catheter was indwelt immediately in order to decompress the vesical pressure. Three weeks later, the right hydronephrosis improved, but the cystogram revealed right vesicoureteral reflux. The urethral catheter was left for the conservative management for 20 weeks. VUR had disappeared on the cystogram and right hydronephrosis returned to normal. Thereafter, the treatment was changed from indwelling catheter to clean intermittent catheterization by her mother. No urinary tract infection has occurred. The necessity of early management, especially decompression of the vesical pressure, for patients with neurogenic bladder associated with meningomyelocele is discussed.

Child, Preschool↗

[Quantitative nitroblue tetrazolium reduction test of peripheral blood polymorphonuclear leukocytes in women in pregnancy and labor].

We performed the quantitative nitroblue tetrazolium (NBT) test for normal peripheral blood polymorphonuclear leukocytes (PMNs) to investigate the functions of PMNs during pregnancy and labor. The results were as follows. With regard to the spontaneous NBT test, the ability of PMNs to reduce NBT in pregnant and parturient women was significantly greater than to reduce NBT in non-pregnant women. The greatest ability was observed in PMNs in parturient women. With regard to the PMA-stimulated NBT test, the ability of PMNs to reduce NBT in pregnant and parturient women was significantly greater than to reduce NBT in non-pregnant women. Stimulation of NBT reduction was observed when PMNs were exposed to kallikrein. These results suggest that PMNs are so much affected by pregnancy that their functions are accelerated in pregnancy and labor, and that PMNs may have favorable effects on pregnancy and labor not only in the aspect of defense mechanisms but also in the aspect of the ripening of the uterine cervix, and that PMNs may be affected by kallikrein during labor.

Female↗

[Urological treatment of patients with spinal cord injury in the chronic stage].

One hundred eighty patients with spinal cord injury were admitted to our hospital between January, 1980 and June, 1983. Eighty-five of them had cervical lesions, 54 had thoracic lesions and 41 had lumbar lesions. Most of the neurogenic bladders due to spinal cord injury treated in our clinic, could be classified into 3 major patterns: hypoactive detrusor-hypoactive sphincter, hypoactive detrusor-active sphincter, and hyperactive detrusor-hyperactive sphincter. To control the hyperactivity of the detrusor and the sphincter, we employed pharmacotherapy first and then we performed transurethral resection of the bladder neck and prostatectomy (TUR-Bn.P) and nerve block (sacral nerve block, pudendal nerve block, obturator nerve block and lumbar nerve block). In the case of a hypoactive detrusor, we employed TUR-Bn.P, open ileal flap fixation to the bladder and voiding training. Using these procedures, we could make 157 patients catheter-free.

Catheters, Indwelling↗

[Risk factors influencing the prognosis of severe aortic valve disease following aortic valve replacement].

As a result of improvement in intraoperative and postoperative management, severe aortic valve disease can be cured by operation, however, late cardiogenic sudden death after aortic valve replacement (AVR) has been existed as one of the important unsolved problem. This report is aimed to predict the risk factors influencing the postoperative prognosis of severe aortic valve disease. Twenty-three cases with aortic regurgitation (AR) and 20 cases with aortic stenosis (AS) were selected by postoperative period over 12 months. In 18 AR cases with normal coronary artery substantiated by selective coronary angiography, cross sectional area index of left ventricular wall (CSAI) and ST depression in left chest leads of electrocardiogram correlated well as the CSAI increased, so decreased the ST segment. This shows the increment of CSAI leads left ventricular endocardial ischemia. By means of introduction of this indicator, 23 AR and 20 AS patients were divided into two groups as group C-I having CSAI over 20 cm2/m2 and group C-II under 20 cm2/m2. Left ventricular ejection fraction (EF) was selected as an predictive indicator of left ventricular function. As same as CSAI, AVR cases were divided into two groups as group E-I having EF under 50% and E-II over 50%. Each group was compared concerning with the complication rate of postoperative low cardiac output syndrome (LOS) and late cardiogenic sudden death. In C-I group of AR, 55% cases accompanied with LOS, 18% died due to LOS and 18% died suddenly from late cardiogenic cause, however, none of cases in C-II group had these complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Clinical evaluation of schizophyllan combined with irradiation in patients with cervical cancer. A randomized controlled study.

To evaluate the clinical effects of the anti-tumor polysaccharide Schizophyllan (SPG), a randomized study was done on 220 patients with Stage II or Stage III cervical cancer who had been given irradiation, concomitantly. The tumor-reducing effect of SPG was significant in patients in either stage. The time to recurrence was longer in SPG-dosed patients with Stage II cancer, compared with findings in the control group. There was no significant difference in the time to recurrence in patients with Stage III cancer between the SPG and control groups. When comparing the 48-month survival curve, the survival time of patients with Stage II cancer in the SPG group was significantly longer than in the control group. However, there was no significant difference in the survival rate of patients with Stage III cancer between the SPG-dosed and control groups.

Actuarial Analysis↗

Two-dimensional echocardiographic evaluation of the severity of mitral stenosis with reference to the prediction for mitral valve commissurotomy or replacement.

Thirty patients with mitral stenosis were classified into three grades of severity reflected by anterior mitral leaflet and subvalvular apparatus using two-dimensional echocardiography in order to study the possibility of predicting the type of surgery indicated, and were evaluated pre- and postoperatively for systolic and diastolic volumes; left heart function using left ventricular posterior wall movement (LVPWVSmax, LVPWVdmax) and posterior wall excursion (PWE) and newly devised left atrial empty volume ratio (LAEVR). The LVPWVSmax was increased from 57 +/- 7 to 74 +/- 7 mm/s (p less than 0.001) in grade I, from 48 +/- 13 to 63 +/- 9 mm/s (p less than 0.02) in grade II, and from 44 +/- 6 to 64 +/- 7 mm/s (p less than 0.001) in grade III. The LVPWVdmax showed an increase from 68 +/- 15 to 91 +/- 15 mm/s (p less than 0.001) in grade I, from 57 +/- 17 to 86 +/- 18 mm/s (p less than 0.01) in grade II, and from 55 +/- 11 to 83 +/- 6 mm/s (p less than 0.01) in grade III. In the PWE, there was an improvement from 12.4 +/- 1.6 to 15.5 +/- 2.1 mm (p less than 0.01) in grade I; from 10.5 +/- 2.0 to 12.5 +/- 1.5 mm (p less than 0.02) in grade II; and from 9.4 +/- 1.5 to 14.4 +/- 1.5 mm (p less than 0.001) in grade III. In the LAEVR, there was also an improvement from 65 +/- 12 to 39 +/- 21% (p less than 0.01) in grade I.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The fiber type of the rabbits' striated external urethral sphincter: electrophoretic analysis of myosin.

The fiber type of the rabbits' external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoresis of constituent proteins of glycerinated muscle, peptide mapping of myosin heavy chains and non-denaturing pyrophosphate gel electrophoresis of myosin. It was determined as fast type by all three methods. The relative proportions of muscle fibers which were estimated from myosin light chain contents were 88 per cent fast type and 12 per cent slow type. On the basis of the results presented, it was shown to be fast twitch muscle, but not identical to the psoas muscle.

Animals↗

Photophosphorylation and oxidative phosphorylation in intact cells and chromatophores of an aerobic photosynthetic bacterium, Erythrobacter sp. strain OCh114.

Light-induced ATP synthesis was studied in intact cells and chromatophores of Erythrobacter sp. strain OCh114. ATP synthesis was measured by both the pH method and the luciferin-luciferase luminescence method. The rate of ATP synthesis was moderate (a typical value of 0.65 mol of ATP per mol of bacteriochlorophyll per min), and synthesis was inhibited by antimycin A. ATP was synthesized under illumination only under aerobic conditions and not under anaerobic conditions. This characteristic was similar to that of other light-induced energy transduction processes in this bacterial species, such as oxidation of reaction center, oxidation of cytochrome c551, and translocation of H+, which were not observed under anaerobic conditions. This phenomenon was reconciled with the fact that the Erythrobacter sp. could not grow anaerobically even in the light. The characteristics of oxidative phosphorylation and ATP hydrolysis were also investigated. The respiratory ratio of chromatophores was 2.3. Typical rates of oxidative phosphorylation by NADH and by succinate were 2.9 mol of ATP per mol of bacteriochlorophyll per min (P/O = 0.22) and 1.1 mol of ATP per mol of bacteriochlorophyll per min (P/O = 0.19), respectively. A typical rate of ATP hydrolysis was 0.25 mol of ATP per mol of bacteriochlorophyll per min in chromatophores. ATPase and adenylate kinase are also involved in the metabolism of adenine nucleotides in this bacterium.

Adenosine Triphosphate↗