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Biomedical subjects

M Ishigooka

Publications and source records attributed to M Ishigooka.

At least 37 records · Page 2Linked to original sources
PubMed1999

Sacral nerve stimulation and diurnal urine volume.

OBJECTIVES: During a screening trial to determine candidacy for sacral nerve stimulation (SNS), several patients were required to repeat the baseline dietary because of discrepancies in the 24-hour urine output before and after successful stimulation. This raised a question regarding the relationship between urine production and neuromodulation. A more complete diary analysis of patients affected by urgency/frequency and/or urge incontinence was therefore carried out to evaluate the possibility of a direct modulatory influence of SNS on urine production. METHODS: Voiding diaries of 40 patients (37 females and 3 males, average age 39.4 years) who underwent SNS were evaluated. Voiding diaries were obtained at baseline, during and after peripheral nerve evaluation (PNE) and after permanent implantation. RESULTS: There was an increase in the average volume/void during PNE in 39 patients. Twenty-four-hour urine volume during PNE was statistically greater than that at baseline. Volume/void and diurnal volume were also significantly greater in follow-up periods after permanent implantation. CONCLUSION: SNS appears to influence not only bladder function but also urine production. Increase in volume/void is paralleled by an increase in 24-hour urine output. The mechanism is unclear, but it is consistent with an altered release of antidiuretic hormone. This observation reflects the direct refractory involvement of the hypothalamus in micturition.

Adolescent↗
PubMed1999

Intra-arterial infusion chemotherapy for penile carcinoma with deep inguinal lymph node metastasis.

From July 1994 to January 1999, three patients with penile squamous cell carcinoma with deep inguinal lymph node metastases without distant metastases were treated with multimodality treatment including intra-arterial infusion chemotherapy mainly with monthly courses of cisplatin, methotrexate and bleomycin. One patient achieved a complete response and 2 achieved a partial response. It appears to be reasonable to presume that intra-arterial chemotherapy has a beneficial effect in the management of penile cancer with fixed metastatic inguinal lymph nodes, but a larger number of patients and longer follow-up are required to confirm these results.

Aged↗
PubMed1999

Relationship between urodynamic type of obstruction and histological component of the prostate in patients with benign prostatic hyperplasia.

OBJECTIVES: This study was designed to compare urodynamic types of bladder outlet obstruction (BOO) and histological architecture of the prostate in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Twenty-four patients with symptomatic BPH, who underwent transurethral resection of the prostate (TURP), were included in the study. Before surgery, a pressure-flow (P-F) study was performed in all patients. According to the classification by Spanberg et al., they were divided into 5 normal type, 6 low-compliant, 6 compressive and 7 constrictive obstruction. The area density and total area of smooth muscle, fibrous tissue, glandular epithelium and glandular lumen in BPH specimens were estimated using morphometric analysis. RESULTS: In all groups, the stromal component occupied about three fourths of BPH specimens, and fibrous tissue was the most prominent element. However, neither area density nor total volume of each histological component showed a significant difference among the four groups. CONCLUSION: The type of BOO in patients with BPH cannot be explained by histological architecture alone.

Aged↗
PubMed1999

Neurourological insights into the etiology of genitourinary pain in men.

PURPOSE: Pelvic pain remains a challenging urological problem. Because antimicrobial therapy is often unsuccessful for relieving symptoms, it is reasonable to question whether pelvic pain is the result of microbiological versus functional pelvic disease. We analyzed clinical and urodynamic findings to evaluate the role of pelvic floor dysfunction in patients with pelvic pain. MATERIALS AND METHODS: We retrospectively evaluated history, physical examination and urodynamic studies in 103 men with an average age of 47 years who presented with pelvic pain between August 1994 and August 1997. In all patients microbiological tests were negative before study entry. RESULTS: The reported locations of pain were the prostate and/or perineal region in 45.6% of cases, scrotum and/or testis in 38.8%, penis in 5.8%, bladder in 5.8%, and lower abdomen and lower back in 1.9% each. Previous treatment consisted of 1 to 12 courses of antibiotics in the preceding 6 to 36 months. In 88.3% of the patients there was pathological tenderness of the striated muscle with poor to absent pelvic floor function. Urodynamics were performed in 84 cases. Cystometry was normal except for decreased compliance in 5 patients. Abnormal findings were mostly evident in the coordination of voiding and in dynamic sphincter-pelvic floor activity. Average sphincter pressure was increased to 104.9 cm. water in 72.6% of the patients, average peak urine flow was decreased to 9.9 ml. per second in 61.9% and functional urethral length was increased to greater than 35 mm. in 79.8%. Urethral profile pattern was dysfunctional, obstructed, and combined dysfunctional and obstructed in 52.4, 11.9 and 21.4% of the cases, respectively, while in 88.1% urethral sensitivity was minimally or markedly increased. CONCLUSIONS: Since activity is a reflection of neural control, the apparent association of pelvic floor dysfunction with pelvic pain raises the probability of a primary or secondary central nervous system breakdown in the regulation of pelvic floor function. This hypothesis is supported by the improvement in symptoms caused by therapy aimed at modulating the pelvic floor, such as biofeedback, medication and sacral anterior root stimulation.

Adult↗
PubMed1999

[Superior vena cava reconstruction combined with resection of mediastinal-pulmonary malignant tumors].

From 1988 to 1997, we experienced 5 cases of the superior vena cava (SVC) replacement with expanded polytetrafluoroethylene (ePTFE) grafts combined with resection of mediastinal or pulmonary malignant tumors. Two patients had lung cancer and three had invasive thymoma. Resection and reconstruction of the superior vena cava (SVC) were performed by application of a bypass graft between the innominate vein and the right atrium in two cases and a temporary bypass using a heparin-coated tube in three cases. Except in one patient who died of acute respiratory failure, no complication or occlusive symptom were observed postoperatively. Two patients remain healthy for 5 years 4 months and 2 years 7 months after operation. Three died 9 years, 5 months, and 110 days after operation respectively. In conclusion, ePTFE graft replacement or patch angioplasty of the SVC should be part of planning and execution of radical excision with curative intent of mediastinal or pulmonary malignant tumors.

Adult↗
PubMed1998

Botox-induced prostatic involution.

BACKGROUND: A simple approach to induced prostatic atrophy was explored. Surgical denervation is known to produce profound atrophy of the rat prostate. Because Botulinum toxin type A (Botox) produces a long-term chemical denervation, the potential to induce atrophy of the rat prostate was explored. METHODS: Thirty rat prostates were injected with varying doses of Botox. Single and serial injections were used, and rats were subsequently sacrificed after either 1 or 4 weeks, respectively. The prostate glands were harvested, weighed, and histologically studied for morphologic and apoptotic changes. RESULTS: The total prostate volume and weight were found to be reduced in all Botox-injected animals. Histologically, a generalized atrophy of the glands was observed with the H&E stain. There was also diffuse glandular apoptosis evident with the Tunel stain. There were no significant complications (e.g., urinary retention, weight loss, or hind/limb weakness). CONCLUSIONS: Botulinum toxin type A injection into the prostate gland induces selective denervation and subsequent atrophy of the prostate. Apoptosis was seen diffusely throughout the gland. It may be possible that in the future, this long-acting neurotoxin could be used for the treatment of common pathologies of the human prostate.

Animals↗
PubMed1998

Renal cell carcinoma with renal artery aneurysm.

We describe a patient who was diagnosed as renal cell carcinoma with renal artery aneurysm in the contralateral kidney. Right aneurysmectomy followed by simple arteriorrhaphy with termino-lateral anastomosis, and then left radical nephrectomy were performed in one session. The patient did well postoperatively. Generally, surgical indication of renal artery aneurysm itself has been yet a matter of debate. In such case like this, however, it seems better to resect any kind of aneurysm of the opposite side, taken into consideration the haemodynamic changes after nephrectomy. Surgical indications are commented on.

Aneurysm↗
PubMed1998

Serum level of carboxyterminal propeptide of type I procollagen in haemodialysis patients.

Serum concentrations of carboxyterminal propeptide of type I procollagen (PICP) and carboxyterminal parathyroid hormone (C-PTH) were measured in 33 haemodialysis patients. Serum levels of PICP and C-PTH in the haemodialysis group were significantly higher than those in the controls. Although there was no correlation between serum C-PTH and creatinine, a positive correlation was found between PICP and creatinine. This indicates that the measurement of PICP in serum is useful for monitoring metabolic bone diseases in haemodialysis patients.

Adult↗
PubMed1998

Endocrinological and pathological entities of the pre-Cushing's syndrome.

The purpose of the study was to clarify the disease entity of pre-Cushing's syndrome. The authors report on the pathological findings and contents of various steroids in the adenomas of three cases of pre-Cushing's syndrome. Oncocytes were found in one adenoma and others were pure clear cell dominant adenomas. All the adenomas contained higher concentrations of precursor steroids than those of five cases of Cushing's syndrome. However, the patterns of increased precursors were quite different among the three cases. Pre-Cushing's syndrome appeared to include several different kinds of disease entities.

Adrenal Cortex↗
PubMed1998

The effect of triathlon on urinary excretion of enzymes and proteins.

In order to investigate the effect of triathlon and renal function of normal subjects, we evaluated the excretion of urinary enzymes and proteins before and after triathlon. From 6 subjects samples were obtained 24 hours after the first urine collection. We performed quantification of urinary total protein, beta2-microglobulin (beta2-M), N-acetyl-beta-D-glucosaminidase activity (NAG), and concentration of urinary creatinine from each participant. There was a significant increase in urinary total protein excretion immediately after triathlon (p<0.01). The urinary beta2-M and NAG excretions after triathlon were higher than the initial values. Post-exercise proteinuria in one subject persisted until the next morning, whereas the increased excretion of urinary beta2-M and NAG returned to the pre-exercise level at least 24 hours after triathlon. It appears to be reasonable to presume that glomerular damage may persist in some subjects who do heavy exercise.

Acetylglucosaminidase↗
PubMed1998

Schwannoma of the penis: report of a case and review of the literature.

A case of schwannoma located in the penile shaft in a 65-year-old male is described. Special stain using S-100 immunoperoxidase was useful in establishing the diagnosis in this case. We reviewed the literature on penile schwannoma and focussed on the diagnosis of this rare ailment.

Aged↗
PubMed1998

Pericentric inversion of chromosome 9 in infertile men.

Reproductive condition was studied in 6 infertile men with pericentric inversion of chromosome 9. Semen analyses revealed one azoospermia, one oligozoospermia, three asthenozoospermias and one normozoospermia. Four cases showed normal levels of plasma gonadotropins and testosterone. The response of plasma testosterone to human chorionic gonadotropin was within the normal range in all cases. However, the administration of LH-RH resulted in abnormal response of plasma gonadotropin in all patients. These results indicate that infertile males with pericentric inversion of chromosome 9 have an abnormality in the hypothalamic-pituitary-testicular axis.

Adult↗
PubMed1998

Central autonomic innervation of the lower urinary tract--a neuroanatomy study.

Knowledge about the central innervation of the lower urinary tract is limited. The spinal cord and the pontine micturition center have been investigated most thoroughly, whereas high centers have received little attention. Pseudorabies virus (PRV), a self-amplifying and transneuronal tracer was injected into the bladder trigone of 21 Sprague-Dawley rats. The animals were killed after 72, 96, and 120 h. The whole CNS was sectioned and immunostained for PRV. CNS centers directly connected to the bladder include the intermedio lateral cell column, the central autonomic nucleus, and the nucleus intercalatus at the spinal cord levels T12-L2 and L6-S2. The raphe pallidus et magnus, the A5 nor-adrenergic area, the pontine micturition center, the locus coeruleus, the periaquaductal gray, the nucleus para- et periventricularis of the hypothalamus, the red nucleus, the medial preoptic area, and the cortex are supraspinal centers connected to the bladder. Lower urinary tract function is a complex multilevel and multineuronal interaction. It involves facilitation and inhibition at many levels of the CNS.

Animals↗
PubMed1998

Postoperative chronic pain and bladder dysfunction: windup and neuronal plasticity--do we need a more neurological approach in pelvic surgery?

PURPOSE: Cases of combined symptoms of dysfunctional voiding and associated pelvic discomfort are difficult diagnostic and therapeutic challenges. Surgical solutions not uncommonly fail to relieve those symptoms. We determine why these symptoms persist postoperatively. MATERIALS AND METHODS: Four cases of ureteral injury during gynecological laparoscopic procedures for pelvic/menstrual pain are presented. The cases are reviewed for their severity and similarity in presenting symptoms, complications and long-term consequences. RESULTS: In all cases light pain symptoms and/or dysfunctional voiding problems that existed before the initial surgery escalated severely after corrective pelvic surgery. CONCLUSIONS: There are established neurophysiological mechanisms that would explain the observed increase in pain after surgical manipulation of the pelvis. Windup and changes in neuronal plasticity are direct consequences of wounding and/or neural injury to the central nervous system. These principles are important for surgeons to appreciate due to the impact they can have on the outcomes of surgery. Blocking the sensory input into the spinal cord, inherent to every surgical procedure, through use of local anesthetics, that is preemptive anesthesia, before creation of a wound provides the greatest protection against escalation of symptoms. Thorough evaluation of all patients before pelvic surgery is recommended to identify high risk groups (preexisting pain, voiding syndromes).

Adult↗