Biomedical subjects

M Ohkawa

Publications and source records attributed to M Ohkawa.

At least 181 records · Page 10Linked to original sources

PubMed1992

[Clinical evaluation of flucytosine in patients with urinary fungal infections].

The clinical effectiveness of flucytosine (5-FC) was evaluated in 52 patients with urinary fungal infections which were diagnosed because of the presence of both funguria (greater than or equal to 10(4) cfu/ml) and pyuria (greater than or equal to 5 WBC/hpf). The patients received oral daily doses of 5-FC ranging 20 to 150 mg/kg, with a mean treatment duration of 11 days. The 57 fungus strains isolated from urine specimens consisted of 51 Candida spp. including 28 Candida albicans, 10 Candida glabrata, 4 Candida tropicalis and 6 Trichosporon beigelii. Forty-seven (92.2%) and 4 (66.7%) of the 51 Candida spp. and 6 T. beigelii strains isolated were eradicated by the treatment, respectively, giving an overall eradication rate of 89.5%. Clinical responses in 32 patients, from whom only fungi were submitted, were excellent in 5, moderate in 22, and poor in 5, thus the overall efficacy rate was 84.4%, based on the criteria of Japanese UTI Committee. Of the 18 strains of Candida spp. tested, 5-FC showed 0.20 micrograms/ml or less of the minimum inhibitory concentrations (MICs) against 16 strains and higher than 100 micrograms/ml against the remaining 2 strains. The MICs of the 5 T. beigelii strains tested were between 3.12 and 6.25 micrograms/ml. As adverse reactions, only 2 patients (3.8%) experienced diarrhea but did not require treatment cessation. These results suggest that flucytosine is an effective drug for urinary fungal infections.

Adult↗

PubMed1991

Monitoring of cortical blood flow during temporary arterial occlusion in aneurysm surgery by the thermal diffusion method.

During aneurysm surgery, regional cortical blood flow (CoBF) was continuously monitored in 12 patients with a thermal diffusion flow probe in an attempt to assess the effects of temporary major arterial occlusion on blood flow and outcome. When the CoBF was above 30 ml/100 g/min, the safe period for temporary clipping applied distal to the perforators was 15 minutes. The occlusion time should be shortened when the CoBF is below 30 ml/100 g/min. Two patients suffered basal infarction, which was not detected by CoBF monitoring. Attention should be paid to the blood flow in the deep structures when a temporary clip is applied at a site proximal to the perforating branches. Direct measurement of CoBF may be of value in estimating the time that temporary occlusion of a major vessel can be tolerated.

Aged↗

PubMed1991

Bacteremia from transurethral prostatic resection under prophylactic use of antibiotics.

We studied the incidence of the postoperative bacteremia developing in 44 patients undergoing transurethral resection of the prostate under prophylactic use of antibiotics. In 15 of the patients, postoperative endotoxinemia was also investigated. Postoperative bacteremia was found in 10 (22.7%) of the patients, in only one of whom septicemia developed. The incidence of bacteremia was not influenced by the kind of antimicrobial agent administered prophylactically, but was significantly higher in the patients with preoperative urinary tract infection or prostatitis on histological examination of resected prostatic tissue (p less than 0.01). Concerning species isolated from the blood, gram-positive cocci were isolated more frequently than gram-negative bacteria, and Staphylococcus epidermidis was the most common species. In 7 (70%) of the bacteremia patients an identical species was isolated from preoperative urine cultures. In the patients with bacteremia, significant increases in white blood cell count and maximal body temperature were found within 3 hours after the procedure as compared to before the procedure. To lower the postoperative bacteremic rate, appropriate and adequate antimicrobial agents must be used preoperatively in patients with infection of the genitourinary tract. As to blood endotoxin, the endotoxin levels in the patients with postoperative fever did not significantly differ from those of the patients without this complication.

Aged↗

PubMed1991

Noninvasive detection and monitoring of renal arteriovenous fistula by color Doppler.

The diagnosis of a renal arteriovenous fistula is usually confirmed by angiography. Described is the utilization of color Doppler ultrasound to monitor a renal arteriovenous fistula before and after treatment by transcatheter steel coil embolization in a 63-year-old woman. Using color Doppler, the arteriovenous fistula with an aneurysmal lesion was clearly visualized. A pulsed-wave Doppler analysis showed increased flow velocity and decreased pulsatility in the supplying artery. After successful transcatheter occlusion of the fistula, these findings disappeared. The Doppler ultrasound technique is likely to be useful to detect and monitor a renal arteriovenous fistula noninvasively, simply, and quickly.

Arteriovenous Fistula↗

PubMed1991

Biochemical and pharmacodynamic studies of simple renal cyst fluids in relation to infection.

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Adult↗

PubMed1991

[End-stage chronic renal failure in patients treated by antireflux operation].

We report 3 patients progressed to end-stage chronic renal failure after antireflux surgery. Preoperatively, the 3 patients had proteinuria, probably due to reflux nephropathy. Surgical procedures used were Paquin's method in 1 patient and Politano-Leadbetter's method in 2. Rapid deterioration of renal function was observed from puberty in all patients. In addition, renal hypoplasia was suspected in 2 patients. We concluded that both reflux nephropathy and renal hypoplasia played important roles in the progression of renal insufficiency.

Adolescent↗

PubMed1991

[Candida urinary tract infection with special reference to ascending pyelonephritis].

The pathogenesis of Candida urinary tract infection (UTI) has been investigated clinically and experimentally with special reference to ascending pyelonephritis in rats. Among the Candida species, Candida albicans was most frequently isolated from clinical specimens including urine in two medical centers, one in Japan and the other in the United States. The isolates of C. albicans serotype B showed a significantly lower susceptibility to 5-fluorocytosine compared to those of serotype A (p less than 0.01). The distribution pattern of the serum antibody titers against C. albicans in 20 candiduria patients (C. albicans 19 and Candida tropicalis 1) was similar to that in 23 bacterial complicated UTI patients. All patients with candiduria had underlying diseases of the urinary tract, such as neurogenic bladder, bladder cancer or benign prostatic hyperplasia: indwelling urinary catheters were present in 15 patients and all had received antimicrobial agents before the study. Ascending Candida pyelonephritis has been investigated in female rats which were transurethrally inoculated into the bladder with C. albicans ATCC 10259 strain. The incidence of Candida pyelonephritis was approximately 80% in rats treated with cyclophosphamide and more than 70% in rats with partial ureteral obstruction. There was a significant relationship between renal and urinary Candida cell populations (p less than 0.01). Furthermore, a significant relationship was revealed between renal Candida cell populations and histological grades of pyelonephritis (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1991

[Carotid-cavernous fistula successfully treated with embolization and radiation therapy: report of three cases].

Three cases of mixed internal and external carotid-cavernous fistula (CCF) were successfully treated with embolization of feeders from the external carotid artery (ECA) and focal irradiation to the cavernous sinus (CS). Cases 1 and 2 were females, 63 and 69 years old respectively, both with spontaneous left CCF. Case 3 was a 55 year old male with posttraumatic left CCF. Symptoms of case 1 were double vision, left chemosis and exophthalmos; those of case 2 were double vision, left retroobital pain, left forehead dysesthesia and blurred vision; and case 3 complained of double vision, left chemosis, left exophthalmos and pulsatile tinnitus. In all three cases, angiography disclosed left CCF fed by ipsilateral dural branches from the internal maxillary artery (IMA) and the internal carotid artery (ICA). In case 1, small branches from the ascending pharyngeal artery also fed the CS. In cases 2 and 3, feeders from the ECA were arising only from branches of the IMA. In case 3, hypertrophy of the meningohypophyseal trunk was visible. In cases 1 and 2, although the CS was opacified, feeders from the ICA were not clearly visible. Embolizations of branches of the IMA were performed in all cases using Ivalon under selective catheterization. In case 1, symptoms partially improved, but in cases 2 and 3, visual symptoms were transiently aggravated. Focal irradiation to the CS was done with total doses of 30, 30 and 40 Gy each for cases 1, 2, and 3 respectively. In case 1, clinical symptoms gradually improved about one third way through irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

Fifteen years' experience of neuroblastoma: a prognostic evaluation according to the Evans and UICC staging systems.

Our policy of preoperative and postoperative adjuvant therapy of advanced neuroblastoma changed from mild to aggressive chemotherapy in 1978. In order to evaluate the clinical effects of this policy, 39 cases before 1977 and 37 cases after 1978 were retrospectively reviewed using the Evans and the International Union Against Cancer (UICC) staging systems. Both clinical stages (CS) and postsurgical histopathological stages (PS) of the UICC staging system showed an almost 100% cure rate in stages I (CSI, PSI) and II (CSII, PSII). The cure rates of CS III, PS IIIA, and PS IIIB cases were remarkably improved after 1978, but those of CS IV and PS IV cases remained extremely low. However, it was found that a disease-free survival rate of advanced neuroblastoma could be produced by complete resection of the tumor accompanied by adjuvant chemotherapy. In these conditions, we found that for predicting the prognosis of advanced neuroblastoma, the UICC staging system, especially the PS staging system, may be more rational than the Evans staging system.

Evaluation Studies as Topic↗

PubMed1990

Bacterial and crystal adherence to the surfaces of indwelling urethral catheters.

Bacterial and crystal adherence to the surfaces of indwelling urethral catheters was investigated by scanning electron microscopy and immunofluorescence method in relation to microbiological examination. Gram-negative bacteria were isolated more frequently than gram-positive bacteria in urine and catheter cultures. Microorganisms and crystals frequently were associated with fibrillar material, some of which was considered to be fibrin. On the surfaces of catheters indwelling for more than 1 week bacteria often were embedded in an amorphous matrix. It was believed that the thick coherent matrix adherent to the catheter served as a protected reservoir of microorganisms that persisted despite antimicrobial chemotherapy. Additionally, urease-producing bacteria attached to the catheter could have an important role in the development of calculous incrustation.

Adolescent↗

PubMed1990

Clinical significance of the antibody-coated bacteria test in patients with candiduria.

The clinical significance of the antibody-coated bacteria (ACB) test was evaluated with urine from 20 patients with candiduria. The relationship between the in vitro antibody-coating test for Candida albicans, urinary immunoglobulin (Ig) levels and serum antibody titres was evaluated in 40 patients without candiduria, 23 of whom had bacterial urinary tract infection (UTI). Urine specimens from 19 of the 20 patients with candiduria gave a positive result regardless of clinical symptoms; 12/23 specimens of urine from patients with bacterial UTI were positive for antibody-coated C. albicans cells, but there were no positive samples in the patients without UTI. All of the coating-positive patients had serum antibody titres greater than or equal to 1:160, the class of antibody being dependent on the urinary Ig levels. The ACB test for candiduria is of little clinical value in indicating invasive Candida UTI as the Candida cells appear to adhere to antibodies in urine contaminated with circulating fluids.

Aged↗

PubMed1990

[A clinical study of bacteremia in urology].

We investigated 32 patients with bacteremia that occurred in the Department of Urology, School of Medicine, Kanazawa University between April, 1983 and March, 1989. This incidence represented 1.9% of the total number of inpatients. The study group comprised 29 males and 3 females, and their age varied from 25 to 82 years with a mean age of 61.7 years. Twenty-two (75%) of the 32 patients had urologic malignancies. The majority of patients were compromised hosts who had one or more (average, 3.8) factors that promoted bacteremia. Urinary tract infections existed in 26 (86.0%) patients before the bacteremic episode and urine cultures revealed a species identical to that simultaneously isolated from the blood in 19 (73.1%) of the 26 patients. Out of the 26 patients, there were 22 (84.6%) with complicated pyelonephritis and 22 (84.6%) with an indwelling urinary tract catheter. In blood cultures, the most common isolate was Staphylococcus epidermidis and gram-positive cocci were cultured at a rate of 43.9% which was higher than that (39.0%) of gram-negative rods. In contrast, in urine cultures, gram-negative rods were isolated predominantly. S. epidermidis and Corynebacterium spp. isolated less frequently in blood than in urine, indicated contaminants. However, Enterococcus spp. and Candida albicans were recognized as causative organisms of bacteremia via the urinary tract, because the urine culture demonstrated a species identical to that obtained from blood in these bacteremic patients. Antibiotic sensitivity tests demonstrated that isolates from blood tended to show tolerance to beta-lactam antibiotics, but had good sensitivity to aminoglycosides.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

In vitro susceptibility testing of Candida isolates from clinical specimens to four antifungal agents.

A total of 231 isolates of Candida species including 163 of Candida albicans (132 of serotype A and 31 of serotype B), 42 of Candida tropicalis, 17 of Candida glabrata, 7 of Candida parapsilosis and 2 of Candida krusei were collected from clinical specimens in two medical centers, one in Japan and the other in the United States. The in vitro antifungal activities of amphotericin B, 5-fluorocytosine, miconazole and fluconazole were evaluated for the above isolates by means of a photo-read broth microdilution method for determination of the 30% inhibitory concentration (IC30). The results showed that IC30 values of fluconazole were generally great compared with those of the other drugs, regardless of Candida species. The isolates of C. albicans serotype B showed a significantly lessened susceptibility to 5-fluorocytosine compared with those of serotype A (p less than 0.01). This method has the advantage of objective measurement, thus minimizing observer variability as compared with the agar dilution test.

Amphotericin B↗

PubMed1990

[A case of pseudoinfarct of the liver (Zahn's infarct)].

We reported a case of pseudoinfarct (Zahn's infarct) of the liver caused by the inflammatory pseudotumor. A dense segmental staining in the area of Zahn's infarct, which was thought to be characteristic finding, was found on the hepatic angiography. This finding was supposed to be consistent with sinusoidal hyperemia according to the pathological finding.

Adult↗

PubMed1990

[Pulmonary lesion of paraquat poisoning on high resolution CT].

It is well known that paraquat causes severe organ-toxicity and pulmonary damage. We observed the progress of a patient who survived paraquat poisoning, and we recorded the changes in the lung by high resolution CT. The patient was a 35-year-old man who attempted suicide by paraquat (Guramoxone 100 ml) ingestion. At the time of hospitalization, there was no respiratory involvement. Five days after ingestion, an X-ray examination showed only indistinct vascularity of both lung fields, but high resolution CT showed increased density in the central part of both lung fields. According to the clinical progress after ingestion, mediastinal and subcutaneous emphysema were noted by chest X-ray examination. On the other hand, severe interstitial pneumonia progression of severe lung fibrosis with a decrease in lung volume and interstitial pulmonary emphysema in addition to mediastinal, subcutaneous emphysema were seen by high resolution CT. High resolution CT is useful for detecting morphologic change and diagnosing clinical stages. Observing the course of changes by high resolution CT is useful for deciding the course of clinical therapy, and we have no hesitation in affirming that it should be used in such cases.

Adult↗

PubMed1990

Karyotypic changes from initial diagnosis to relapse in childhood acute leukemia.

Cytogenetic study was performed at both diagnosis and relapse in 31 children with acute leukemia who had initially abnormal karyotypes, 21 with acute lymphocytic leukemia (ALL) and 10 with acute nonlymphocytic leukemia (ANLL). Seventy percent of the patients showed karyotypic changes between diagnosis and relapse. The ALL patients showed karyotypic changes more often than the ANLL patients (76 vs. 40%)(chi-square test, p less than 0.05). All the initially abnormal patients with karyotypic changes exhibited structural changes, most frequently chromosome 1 abnormalities, especially in ANLL, and 6q-, 7p-, 9p- in ALL. Half of the patients, with structural karyotypic change had two or more clonally related cell lines at relapse. On the other hand, only 20% of the patients with karyotypic changes showed numerical changes. All but one of the initially abnormal patients showed karyotypic changes involving the original cytogenetically abnormal clone. Our study demonstrated that sequential cytogenetic studies may provide a better understanding of the nature of leukemia relapse.

Acute Disease↗

PubMed1989

Clinical values for an index predicting postoperative residual liver function by pre-operative liver-scintigraphy in patients with liver disease.

Hepatic resection is essential in treating hepatocellular carcinoma. However, before an operation, it is difficult to predict the functional reserve in the remnant following massive resection. We devised an original method by which effective liver volume was measured by liver scintigraphy. In order to predict the residual liver function before hepatic resection in a preoperative radiocolloid study, we obtained a predictive index by combining the K values with effective liver volumes which seemed to have the estimated residual liver function. Twenty-one patients with liver or biliary tract disease were selected at random for the present study. We divided them into 3 groups in accordance with prognosis after hepatic resection. There were statistically significant difference between the deceased group who died from hepatic failure and the group who died from causes other than hepatic failure; and between the deceased group who died from hepatic failure and the living group in the preictive index (p less than 0.01). Our data suggest that if the predictive index is above 0.45, the probability of hepatic failure after hepatic resection is low. We concluded that our predictive index is useful to use in preoperative prediction of post-hepatectomic residual liver function.

Aged↗

PubMed1989

Calcified chronic subdural hematoma with intracerebral rupture forming a subcortical hematoma. A case report.

We report a calcified chronic subdural hematoma which ruptured intracerebrally forming an acute subcortical hematoma in the frontal lobe in a 59-year-old woman with long-standing liver cirrhosis. Both hematoma cavities communicated each other through a small defect within the inner membrane of the subdural hematoma. The content of both hematomas was identical and was of a clay-like clot. The inner membrane around this communication consisted of thick, very vascular granulation tissue with many hemosiderin deposits and was tightly adherent to the cortex. We speculated that a fresh bleeding into the granulation tissue resulted in formation of a subcortical hematoma through a rupture of the inner membrane. Disseminated intravascular coagulation likely played an important role in this unusual condition.

Brain Diseases↗