Biomedical subjects
Publications and source records attributed to K Okamura.
Serum amylase isozyme was determined in 2 cases with normal urinary amylase but persistantly high serum amylase. Both cases showed dominant S-type amylase associated with tailing findings that was characteristic of macroamylasemia. Moreover, using the immunofixation method, the serum amylase was found to be bound with IgG (K) in case 1 and with IgA (L) in case 2.
Ceftazidime ( CAZ ) was evaluated for its clinical efficacy in a total of 12 cases, namely 3 cases of endometritis, 3 cases of intrapelvic infections, 4 cases of adnexitis and 2 cases of external genital infections. In all the cases, CAZ was administered by intravenous drip infusion, and the duration of the treatment ranged from 3 to 22 days. Daily dose was 2 g in 10 cases, and in the remaining 2 cases, daily doses were changed during the course of treatment in the range from 2 to 4 g. The clinical results of CAZ by disease were as follows; excellent in 1 case and good in 2 cases of endometritis, good in all the 3 cases of intrapelvic infections and the 4 cases of adnexitis, and excellent in 1 case and good in 1 case of external genital infections. The overall efficacy rate was 100%, namely, excellent in 2 cases and good in 10 cases of the total of 12 cases. Neither side effects nor abnormal laboratory findings attributable to CAZ were observed in any of the case. From these results, we may conclude that CAZ is a safe antibiotic with satisfactory clinical effects on gynecological infections.
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Twenty-seven cases in which cancer could not be distinguished from chronic cystitis were reviewed. These cases were divided into those with and those without a past history of bladder tumor. The high frequency of hyperplasia in the group with a history of bladder tumor suggested that hyperplasia may be a precursor of papillary tumor. On the other hand, proliferative lesions such as cystitis cystica and metaplasia were encountered in the group with no history of bladder tumor and 50 percent had symptoms of chronic cystitis. These findings suggested that proliferative lesions in the bladder developed by inflammatory irritation. Urinary cytology was done in 18 cases. Cytology was positive in 2 of the 3 cases of transitional cell carcinoma. Therefore, urinary cytology was useful, but it did not provide distinction in two cases of follicular cystitis and a case of squamous metaplasia was false positive.
A case of retroperitoneal malignant schwannoma is reported. The patient was a 66-years-old man who was referred to our clinic because of an abdominal lump. CT scan and renal arteriography pointed out right renal cyst, but the tumor was separate from the right kidney at operation. Pathological diagnosis of this retroperitoneal tumor was malignant schwannoma. After 10 months he developed local recurrence and had transabdominal excision. He has been doing well 12 months after the second operation. Thirty-one cases of retroperitoneal malignant schwannoma in Japan are reviewed.
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Stimulation of obturator nerve during transurethral electroresection causes violent adductor muscle contraction, and is a major cause of inadvertent bladder perforation. General anesthesia with muscle relaxants is often required when the bladder tumor is in the area where the obturator nerve passes in close proximity to the inferolateral bladder wall. Recently obturator nerve block under spinal anesthesia during transurethral surgery have been reported in several papers, but the blockade is not completely reliable. Obturator nerve block using electrostimulator (neutracer) and insulated electroneedle (pole needle) was performed in 25 patients with bladder tumors during transurethral electroresection from October 1980 to December 1981. We herein describe the technique and results of local obturator nerve blockade. Use of neutracer and pole needle makes the obturator nerve block a completely reliable, safe and easy procedure.
Twenty seven hypothyroid patients with a serum concentration of thyroid stimulating hormone (TSH) of over 40 mU/1 were followed up for three to 20 weeks without replacement therapy. The serum thyroid hormone concentrations increased with a dramatic decrease in serum TSH values in 14 patients (reversible group) but there was no significant change in the other 13 (irreversible group). Fourteen out of 19 patients with goitre but none of the eight patients without goitre belonged to the reversible group. All of the 11 patients with a high uptake of iodide by the thyroid, three of the six with a normal uptake, and none of the 10 with a low uptake belonged to the reversible group. These observations indicate that patients with goitrous hypothyroidism with a preserved thyroid uptake of iodide are likely to become euthyroid spontaneously without replacement therapy.
Although the activity of lysosomal protease in Graves' thyroid is considered to be increased, there has been no quantitative method to estimate the protease activity in the thyroid tissue due to the contamination of thyroglobulin (Tg) which varies in susceptibility to the protease. In the present study, the proteolytic activity (PA) of thyroid lysosomal protease preparation (P25) separated from Tg was assayed using 125I labeled rat Tg. More than 95% of 125I-Tg was hydrolyzed at pH 4.0 without deiodination, and the pattern of liberated iodoamino acids resembled that of pronase digest except for a higher T3/T4 ratio. Thirty-seven Graves' thyroids and 15 paranodular thyroid tissues were assayed. PA, the specific PA (SPA; calculated as PA per mg P25 protein) and PA per DNA content in Graves' thyroids were significantly higher than those in controls. There were good correlations among PA, SPA and PA per DNA content of the thyroid tissue. PA and SPA in the thyroid from 29 patients with Graves' disease treated with propylthiouracil or methimazole did not correlate with serum thyroid hormone level immediately before surgery. In 8 patients treated with KI, PA from 5 patients whose serum thyroid hormone levels had been normalized were significantly lower than those from 3 patients who were still thyrotoxic.(ABSTRACT TRUNCATED AT 250 WORDS)
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Aneurysm of the coronary artery associated with aortitis syndrome is extremely rare. This is a case report of a left coronary artery aneurysm associated with aortitis syndrome. The patient was a 47-year-old woman who complained of palpitation and dizziness on exertion. Aortogram revealed occlusion of the arch vessels, infrarenal aortic stenosis, and a fusiform aneurysm of the left coronary artery. There was neither an intraluminal thrombus nor occlusive changes in the coronary arteries. Severe systolic hypertension nearing 300 mmHg was present in the ascending aorta. Severe hypertension and direct extension of inflammation to the coronary artery seemed to be important factors for the formation of the aneurysm. To resolve the severe hypertension, a bypass operation between the ascending aorta and the abdominal aorta distal to the stenosis was performed. The postoperative course was uneventful and blood pressure was reduced.
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With inoculation of a large amount of tumor cells, the tumor growth of splenectomized mice was depressed compared to sham operated mice. On the contrary, with inoculation of a small amount of tumor cells the occurrence of tumor was lower in sham-operated mice. The effect of splenectomy on tumor growth was bidirectional depending on the dose of the inoculate. The effect was due to the production of the immunosuppressive factor in sera obtained from mice inoculated with a large but not small amount of tumor cells. Studies for the late survivals of 113 patients who had received curative total gastrectomy with or without splenectomy revealed that the non-splenectomized group showed a significantly better late survival rate than the splenectomized group when the splenic hilar lymph nodes were not involved with cancer metastasis.
The following tables show the statistics on the inpatients, diseases and operations at our department during the period from January through December of 1980.