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Biomedical subjects

M Moriyama

Publications and source records attributed to M Moriyama.

At least 163 records · Page 9Linked to original sources

Retroperitoneal tumor eleven years after initial treatment of testicular cancer.

Presented is a case report of retroperitoneal tumor eleven years after orchiectomy for testicular cancer. Complete remission was achieved with combined chemotherapy and retroperitoneal lymph node dissection. Histologic examination revealed that primary testicular tumor was pure choriocarcinoma and that the retroperitoneal tumor was likely embryonal cell carcinoma without foci of choriocarcinoma. It is difficult to determine whether the retroperitoneal tumor is a late recurrence of testicular cancer of a primary extragonadal germ cell tumor.

Adolescent↗

Laparoscopy-assisted devascularization of the lower esophagus and upper stomach in the management of gastric varices.

Devascularization of the lower esophagus and the upper stomach is one method of treating patients with clinically significant gastric varices. We describe a new method of laparoscopically-assisted devascularization which has been applied in seven patients with esophagogastric varices. Three of the seven patients had an episode of gastric variceal bleeding, and the remaining four had moderate to large gastric varices with red color signs. The operative procedure was carried out without pneumoperitoneum by using an ordinary forceps and laparoscopic instruments through a small skin incision (3-5 cm); the abdominal wall was elevated with a U-shaped retractor. The operative field was obtained by laparoscopic and direct vision illuminated by laparoscopic light. The procedure time ranged from 100 to 180 minutes with minimal blood loss (70-320 g). No complications were encountered. All patients could be discharged within one week; postoperative pain was minimal and all patients returned to work early. Follow-up (mean 11.4 months) showed no recurrence of gastric varices although, due to an incomplete procedure in two cases, two patients were treated additionally by endoscopic injection of histoacryl.

Esophageal and Gastric Varices↗

Benign prostatic hyperplasia: value of MR imaging for determining histologic type.

PURPOSE: To assess the value of magnetic resonance (MR) imaging for determining the histologic type of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Unenhanced T1- and T2-weighted images and gadolinium-enhanced T1-weighted images were obtained in the transverse plane at 1.5 T in 33 patients with BPH. Hyperphasia was classified as stromal or nonstromal. Nonstromal hyperplasia was diagnosed if (a) the nodules in the inner gland had heterogeneous high signal intensity on T2-weighted images and peripheral enhancement on gadolinium-enhanced images, (b) a surgical capsule was present, or (c) the inner gland volume to total volume ratio was greater than 0.75. RESULTS: A correct diagnosis was made with MR imaging in 23 of 24 patients with nonstromal hyperplasia and eight of nine with stromal hyperplasia (94% accuracy). In nonstromal hyperplasia, nodular lesions were seen in 20 patients and a surgical capsule was seen in 19. Eighteen patients had a transition zone ratio greater than 0.75. CONCLUSION: MR imaging appears to be useful for choosing the type of pharmacotherapy performed because accurate histologic assessment is possible.

Aged↗

Frequent overexpression of vascular endothelial growth factor gene in human renal cell carcinoma.

Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen and an inducer of angiogenesis. Expression of the VEGF gene was investigated in 20 patients with renal cell carcinoma by Northern blot hybridization analysis. Of the 20 tumors, 12 (60%) overexpressed the gene 3.0 times more than in normal renal tissues. No significant correlation was found between overexpression of the VEGF gene and the histopathological data such as grade, cellular and structural subtypes, stage and size of tumor. These results suggest that VEGF is produced by the tumor cells and is responsible for development of this hypervascular tumor.

Adult↗

The development of graphic symbols for medical symptoms to facilitate communication between health care providers and receivers.

Since there are a variety of communication barriers in health care settings in Japan, a study was designed to improve communication by the use of graphic symbols. At the beginning of this study, graphic symbols were developed to correspond to 26 basic symptoms. Seventy-six subjects voluntarily evaluated the comprehensibility of these symbols: nursing students (n = 29), manual sign language interpreters (n = 24), hearing impaired subjects with normal (n = 10), limited (n = 11), and minimal (n = 2) literacy abilities. The comprehension by each respondent of each symbol was compared with that of the authors. On the average, numbers of the matching meanings were 24.9 +/- 1.36 (mean +/- S.D.) for students, 24.5 +/- 1.77 for interpreters, 23.4 +/- 2.22, and 21.5 +/- 3.01 for the first two groups of the hearing impaired. Among the 26 symbols, 10 showed high levels of the matching rates (> 90%) for all groups. These symbols were considered to be effective alternatives to verbal expression. Further refinements of the graphic symbols were suggested to suppress the differences in interpretation of the remainder of the symbols. During this study, colleagues and subjects suggested cognitive strategies to clarify and enhance the meaning of the graphic symbols such as (a) the subtraction of excessive information, (b) the addition of further information, and (c) the simplification of the setting by minimizing social and cultural bias.

Adult↗

[Ask-Upmark kidney: a case report].

A case of Ask-Upmark kidney is presented. An 18-year-old male patient referred to this facility presented with symptoms of hypertension, microscopic hematuria and proteinuria. A hormonal study revealed a high plasma renin activity level. Intravenous pyelography and abdominal computed tomography revealed thinning of the cortex with calyceal dilatation. Arteriography revealed a deep cortical groove in the middle portion of the kidney without renal arterial stenosis. Plasma renin activity of the left renal vein was significantly higher than that of the right renal vein. A left simple nephrectomy was performed under the diagnosis of Ask-Upmark kidney. Postoperatively, plasma renin activity returned to the normal range and a decrease in blood pressure was noted. Recent reports have suggested Ask-Upmark kidney to be a consequence of vesicoureteral reflux rather than a true congenital malformation. Our case indicated no evidence of vesicoureteral reflux and suggests that the lesion was congenital rather than acquired.

Adolescent↗

[Studies on the modified dimethylmethylene-blue (DMB) method for determining glycosaminoglycans (GAG) in urine].

The measurement of glycosaminoglycans (GAG) in urine is very important because GAG is an essential constituent of urinary diseases. Since previously reported methods of determination of GAG are quite complicated, dangerous or not stable, we developed a very simple and rapid method to estimate the content of GAG in urine using a microplate and microplate reader. An aliquot of diluted urine is mixed with a 1,9, dimethylmethylene blue (DMB) dye. The assay is based on the metachromatic shift in absorption maximum which occurs when sulfated glycosaminoglycans are added to the dye. The recovery of GAG is good. Other urinary compounds such as sugar, protein and blood did not influence the measurement of GAG. A good correlation was obtained between the modified DMB method and Blumenkrantz and Asboe-Hansen's method (r = 0.737, p < 0.001). The accuracy of this method makes it useful for screening urinary diseases.

Adult↗

[A study on reservoir function of Kock pouch during a 3-year postoperative period].

Kock continent ileal reservoir has been one of the major options of urinary diversion for the patients with bladder cancer. We performed Kock pouch operation in 16 patients (male 12, female 4; from 41 to 66 years old, mean age 57 years old). Since the reservoir function of Kock pouch after a long postoperative period is not well known, we examined the volume capacity, the compliance and the length of efferent valve of Kock pouch in 8 patients during a 3-year postoperative period. Although the compliance was stable, the volume capacity and the length of the efferent valve showed a decreasing tendency. The shorter efferent valve was not always associated with the case of urinary incontinence. Most of the complications in 15 patients was trouble of efferent valve (prolapse of efferent valve in 7 cases and eversion or fistula formation that required reconstruction surgery in 3 cases). Although some complications were observed, the reservoir function of the pouch was stable. Therefore this method is reliable for permanent urinary diversion.

Adult↗

Laparoscopy-assisted Billroth I gastrectomy.

Laparoscopic distal partial gastrectomy is still technically difficult under conditions of a pneumoperitoneum because of the lack of appropriate techniques and laparoscopic instruments. We describe here a technique of laparoscopy-assisted Billroth I gastrectomy under an abdominal wall-elevating method.

Aged↗