Biomedical subjects

M Ohkawa

Publications and source records attributed to M Ohkawa.

At least 127 records · Page 7Linked to original sources

PubMed1995

Refractory haemospermia: any predictive factors?

A total of 56 patients with haemospermia were reviewed. Twenty-four patients suffered from prolonged haemospermia for more than 1 month or recurrent haemospermia (refractory group). In 32 patients haemospermia disappeared within a month (non-refractory group). Patient age in the refractory group was significantly higher than that in the non-refractory group (p < 0.05). Clinical symptoms other than haemospermia, white blood cell counts in the semen, expressed prostatic secretion and urine after prostatic massage, and transrectal ultrasonography findings were studied in both groups, with no significant differences found in any of these parameters. We concluded that, among these clinical findings, only patient age is a predictive factor for refractory haemospermia.

Adolescent↗

PubMed1995

Is CIS of the ureter responsible for skipped lymph node metastasis? A case report.

A case of skipped lesion of lymph node metastasis of left ureteral tumour with concurrent carcinoma in situ in the affected ureter is presented. Postoperatively, lymph node metastasis was de novo detected in the left retrocrural and renal hilar regions on CT scan, although only the obturator lymph node was histologically metastatic among the regional lymph nodes completely dissected. The possible explanations of this rare metastatic mode are discussed.

Carcinoma in Situ↗

PubMed1995

A comparison of intraarterial carboplatin and ACNU for the treatment of gliomas.

BACKGROUND: Intraarterial chemotherapy with carboplatin for malignant gliomas has been tried recently, but its therapeutic efficacy and toxicity have not yet been elucidated. METHODS: We treated patients with malignant glioma by intraarterial chemotherapy using carboplatin, and compared the efficacy as well as the side effects with intraarterial ACNU. RESULTS: Twenty patients were treated with carboplatin (300 mg/m2) and 22 patients were treated with ACNU (80-200 mg/m2). Response (complete remission+partial response) rate for carboplatin was 12.5% compared to 45% for ACNU. Despite higher response rate for ACNU, the difference in the survival curves of the two groups was not significant. Three patients who were treated with high dose (150-200 mg/m2) of ACNU developed hemiparesis and aphasia. Seven patients treated with carboplatin developed 10 incidences of neurotoxicities; two hemiparesis, one aphasia, one blindness, one visual field disturbance, three convulsions, and two developed incidences of disturbances of consciousness. CONCLUSIONS: Intraarterial carboplatin was not superior to intraarterial ACNU in achieving remissions, and showed much greater tendency to produce neurotoxicities.

Adolescent↗

PubMed1995

Enuresis in an adult female with obstructive sleep apnea.

Adult onset enuresis accompanied by obstructive sleep apnea has been reported rarely. A female patient was referred to our clinic with complaints of of a 15-year history of loud snoring and sleep apnea as well as enuresis, which was treated successfully with imipramine and acetazolamide. The mechanism of enuresis and its relationship to upper airway obstruction are reviewed here with reference to the findings of polysomnography and sleep cystometry.

Acetazolamide↗

PubMed1995

Infectious retrovirus is inactivated by serum but not by cerebrospinal fluid or fluid from tumor bed in patients with malignant glioma.

Intravenous gene transfer using recombinant retroviruses tends to suffer from a low infectious viral titer when conducted in vivo. This is, in part, caused by complement-mediated proteolytic inactivation of the retrovirus in human serum. However, if the retroviruses were directly injected into the brain, they might not be inactivated. Supernatant from amphotropic retrovirus-producing cells harboring the BAG vectors was incubated with sera or cerebrospinal fluid (CSF) of patients with gliomas or unrelated disorders. The retroviruses were severely inactivated in sera. However, no such inactivation was noted in CSF or fluid from the tumor bed of glioma patients. These data suggest that gene transfer using recombinant retroviruses could be done into the cavity after removal of the tumor in glioma patients.

3T3 Cells↗

PubMed1995

Metanephric adenoma of the kidney.

A case of a rare renal tumor showing characteristic histologic features is presented. The patient was a 54 year old female, whose renal tumor was incidentally detected on abdominal ultrasound (US) examination. Ultrasound, computed tomography and angiography findings were consistent with a diagnosis of renal cell carcinoma of the hypovascular type. Left nephrectomy was performed. The tumor, which measured 2.6 x 2.6 x 2.5 cm, was located in the left renal cortex, and had a uniformly whitish-yellow cut surface and well-defined margin. Histologically, the tumor was characterized by its monomorphous growth pattern and was composed of uniformly small cells arranged in a tubular or rosette-like pattern. The tumor cells had scant cytoplasm and the nuclei were small, round and regular. These histologic features resembled the epithelial elements of a metanephric hamartoma in the nephroblastomatosis complex in infants. However, there was no mitosis and cellular atypia was minimal, suggesting benignity. According to these histologic features, the diagnosis of metanephric adenoma was made. Its clinicopathologic features are discussed.

Adenoma↗

PubMed1995

Analysis of fluorescence spectra from Chinese herbal medicine for male infertility.

To clarify the contribution of Chinese herbal medicine to the treatment of male infertility, fluorescence spectra from Chinese herbal drugs at 500-700 nm with 488 nm excitation were investigated. The fluorescence spectra patterns from Hachimi-jio-gan, Gosha-jinki-gan and Hochuekki-to were similar to those from semen, seminal plasma and spermatozoa. Our previous report revealed that the concentration of spermatozoa correlated with the intensity of the emission peaks from spermatozoa, while sperm motility correlated with the emission peaks from spermatozoa and semen plasma. Thus, it was suggested that the components of these fluorescence productions in Chinese herbal medicine may contribute to clinical effects for male infertility.

Humans↗

PubMed1995

Renal angiomyolipoma composed primarily of smooth muscle element: diagnostic considerations.

A case of renal angiomyolipoma composed primarily of smooth muscle element is presented. It was a solitary small tumor without evidence of tuberous sclerosis. The imaging findings including ultrasonography, computerized tomography, magnetic resonance imaging, and angiography were not characteristic of angiomyolipoma, but suggestive of atypical renal cell carcinoma, and a simple nephrectomy was performed. The diagnostic considerations, particularly imaging features of angiomyolipoma, are discussed.

Aged↗

PubMed1995

Morphological changes in human cerebral arteries after percutaneous transluminal angioplasty for vasospasm caused by subarachnoid hemorrhage.

Light and electron microscopy were used to study morphological changes in cerebral arteries after percutaneous transluminal angioplasty (PTA) for vasospasm in two patients with aneurysmal subarachnoid hemorrhage. One patient died of gastric bleeding 5 days after PTA. Postmortem examination of the inflated middle cerebral arteries revealed heterogeneously extended walls and dilated lumina. Throughout the vessel walls, the extracellular matrix, which was composed of nonmuscle components such as increased collagen, was stretched in conjunction with the medial muscle component. Also, torn and thinned areas of the wall and intramural hemorrhages were caused by overinflation. The second patient died of massive cerebral infarction caused by diffuse vasospasm 5 days after PTA. Prominent stretching of the walls at the atheromatous plaque margin in the dilated vessel was found in addition to the morphological changes observed in the first patient. These observations suggest that characteristic pathological alterations might be present in the vessel wall at the site of angioplasty. The major mechanism of the long-lasting effects of PTA seems to be the stretching and disruption of both the degenerative muscle and the proliferative nonmuscle components, mainly in the media of the vasospastic vessels.

Adult↗

PubMed1995

[Bilateral synchronous renal cell carcinoma: a case report].

A case of bilateral synchronous renal cell carcinoma is reported. The patient was a 55-year-old man. A right renal tumor was pointed out by ultrasound during a health check in July, 1994. Enhanced CT scan and angiography revealed bilateral renal tumors. Right nephrectomy and left partial nephrectomy were performed on November 25, 1994. Both tumors were completely encapsulated. Histological examinations of these tumors revealed renal cell carcinoma, Expansive type, alveolar type, clear cell subtype, G2, INF alpha, pT1, pV0.

Carcinoma, Renal Cell↗

PubMed1995

[Comparison of 99mTc-technegas scintigraphy and high resolution CT in pulmonary emphysema].

This study was undertaken to assess the usefulness of technetium-99m technegas scintigraphy axial images (technegas) compared with high resolution CT (HRCT) in 12 patients with pulmonary emphysema. All patients were male adult and heavy smokers and their mean age was 65. All patients inhaled 505 MBq technegas in several tidal volume breaths in the supine position without breath holding. SPECT imaging was performed by a Picker model Prism 2000. HRCT was performed after technegas. The technegas images showed different degree of changes from areas of heterogeneity to hot spots or defects. In emphysema, HRCT images showed low attenuation areas varying in size and number. In 4 of 12 patients, the degree of abnormal findings on technegas increased according to the degree of abnormal findings on HRCT. In the remaining 8 patients, however, more detailed findings were shown by technegas than by HRCT. There was no patients in which HRCT showed a greater changes than on technegas. HRCT can demonstrate low attenuation areas, even less than 5 mm in diameter. Moreover previous reports showed that aerosol inhalation would also demonstrate the airway disease. Assessment of the degree of involvement revealed by both methods indicated the superiority of technegas over HRCT. We conclude that technegas can represent the ventilation involvement easily more than HRCT in pulmonary emphysema.

Aged↗

PubMed1995

[Prediction of postoperative pulmonary function using 99mTc-MAA perfusion lung SPECT].

In order to predict postoperative pulmonary function, 99mTc-MAA perfusion lung SPECT and spirometry were performed preoperatively in 52 patients with resectable primary lung cancer; 44 underwent lobectomy, eight pneumonectomy. Local pulmonary function (called local effective volume) was evaluated according to the degree of radionuclide distribution of each voxel in the SPECT images. The total effective volume was defined as the sum of the local effective volume, and the residual effective volume was the total effective volume excluding loss after operation. Predicted pulmonary function (VC and FEV1.0) was calculated by the following formula: Predicted value = preoperative value x percent of the residual effective volume. Postoperative pulmonary function was predicted in the same patients by means of 99mTc-MAA perfusion lung planar scintigraphy and X-ray CT. The patients were reinvestigated with spirometry at one and four months after surgery, and the values were compared with the predicted values. The correlations between the predicted values using SPECT and measured postoperative pulmonary function were highly significant (VC: r = 0.867, FEV1.0: r = 0.864 one month after operation; VC: r = 0.860, FEV1.0: r = 0.907 4 months after operation). The predicted values calculated using SPECT were accurate compared with the predicted values calculated using planar scintigraphy or X-ray CT. The patients with predicted FEV1.0 of less than 0.8 liter required home oxygen therapy. This method is valuable for the prediction of postoperative pulmonary function before the surgical procedure.

Adult↗

PubMed1995

[Differential diagnosis of solitary pulmonary nodules by computerized statistical analysis using CT number].

There have been previous reports on the differentiation of benign pulmonary nodules from malignant ones using CT number. However, most of the nodules were without calcification, and diagnosis could be made only in limited cases. In the present study we established new multiple variables such as relative high density over the 75th percentile, inner gradient number (inner irregular rate), edge gradient number (edge irregular rate) and increased area rate (IAR). They are automatically calculated from CT data by computer. These variables are transformed into relative values, enabling comparisons of nodules without a standard reference phantom. With IAR, pulmonary nodules were classified into three types: type 1 (IAR 1.0-1.4), a high-density solid mass with well-defined margin; type 2 (IAR 1.4-2.0) between type 1 and type 3; and type 3 (IAR > 2.0) a low-density infiltrated mass with ill-defined margin. We studied 52 cases with solitary pulmonary nodules, whose diagnoses were confirmed either histologically or on follow-up. There were 34 benign nodules and 18 primary lung cancers. Using step-wise multiple regression with three variables, 42 of 52 cases were correctly diagnosed. Twenty-four of 28 type 1 cases and all 14 of type 2 cases were correctly diagnosed. This computer analysis is considered to be useful in distinguishing between benign and malignant solitary pulmonary nodules.

Aged↗

PubMed1995

[A case of renal cell carcinoma extending into the inferior vena cava in a long-term hemodialysis patient].

We report a case of left renal cell carcinoma extending into the inferior vena cava associated with the acquired cystic disease of the kidney (ACDK). The patient was a 46-year-old man, who had been treated with hemodialysis for 12 years. In November 1992, ACDK was observed on computed tomography (CT) for routine check up, but no tumorous lesions were detected. He noticed bleeding from the urethra in May 1994. CT and magnetic resonance imaging (MRI) revealed left renal tumor with intrahepatic vena caval tumor thrombus. There were no findings of distant metastasis. Left radical nephrectomy and partial removal of vena cava were performed. Histopathologically, renal cell carcinoma, pT3b, pN0, stage III was diagnosed.

Carcinoma, Renal Cell↗

PubMed1995

[The use of intravesical oxybutynin hydrochloride in patients with neurogenic bladder managed by intermittent catheterization].

Nine patients with persistent urinary incontinence due to neurogenic bladder and intolerable systemic side effects on oral anticholinergic agents were treated with intravesical instillation of oxybutynin hydrochloride. Two tablets (6 mg) dissolved in 10 ml of physiological saline or sterile water were instilled into the bladder two times daily via self intermittent catheterization. The mean bladder capacity increased from 128 to 212 ml 1 month after intravesical instillation of oxybutynin hydrochloride, although this difference was not significant. The bladder was augmented more efficaciously in patients with overactive detrusor than patients with an underactive detrusor. Subjective improvement was recognized in 4 patients. Among 5 patients who discontinued therapy due to ineffective results, maximum urethral closure pressure below 50 cmH2O was seen in 4. Intravesical instillation of oxybutynin hydrochloride was considered to be ineffective clinically in patients with underactive detrusor and low urethral closure pressure. Although no systemic side effects were observed, a decrease of bladder capacity was recognized in 2 patients.

Administration, Intravesical↗

PubMed1995

Colovesical fistula due to sigmoid colon diverticulitis: a case report.

We present a case of colovesical fistula due to sigmoid colon diverticulitis. A 63-year-old woman was referred to our department with the complaints of dysuria, turbid and foul smelling urine. She was treated twice for acute cystitis at the referral hospitals. A diagnosis of colovesical fistula was confirmed on barium enema. She underwent partial resection of sigmoid colon with primary anastomosis and partial cystectomy with repair of bladder wall and covered with omentum. Retrograde cytography taken on the 20th post-operative day revealed no leakage of contrast medium. She was asymptomatic at 3 months of follow-up.

Diverticulitis↗

PubMed1994

[Results of radiotherapy for stage III uterine cervical carcinomas and preliminary study of combined radiotherapy and transarterial infusion chemotherapy].

This is a retrospective analysis of 55 patients with stage III carcinoma of the uterine cervix treated with radiation from November 1984 through December 1991. Eleven of the patients were treated with radiation and transarterial infusion chemotherapy (TAI), using cis-platinum and pepleomycin. The 3- and 5-year cumulative survival rates for all patients were 61% and 58%, respectively, and the 3-year cumulative survival rate for the group with combined radiation and TAI was 47%. According to initial failure site, the locoregional recurrence rate was 36.8%, and that for para-aortic lymph node metastasis and distant metastasis was 31.6%. The failure pattern was similar between the irradiation only group and the group with combined radiation and TAI. The incidence of intestinal complications of grades 1 and 2 was 20%. Irradiation combined with TAI did not increase the incidence of complications.

Adult↗

PubMed1994

[Evaluation of liver function in carbon tetrachloride-damaged rabbits by dynamic SPECT: comparison of 99mTc-GSA and 99mTc-Sn colloid].

Technetium-99m-DTPA-galactosyl human serum albumin (99mTc-GSA) is a new ligand that binds specifically to asialoglycoprotein receptors in hepatocytes. We performed liver dynamic SPECT using 99mTc-GSA and 99mTc-Sn colloid in nine normal control rabbits and 17 chronically CCI4-damaged rabbits (total 29 examinations), and also performed liver function tests (ICGR15, Alb, etc). Using the obtained dynamic SPECT data, we analyzed the liver kinetics of 99mTc-Sn colloid using a one-compartment model (hepatic blood flow [K]) and 99mTc-GSA using a two-compartment model (hepatic blood flow and receptor binding [K1], catabolism [K2]). As the CCl4-treated period increased, K1 decreased most significantly. K1 showed the most significant statistical correlation with the results of liver function tests, ICGR15 (p < 0.0001), Alb, PT, HP, Bil and GPT. Further, only K1 showed a correlation with the hepatic fibrosis of the HAI score. From the present results, liver dynamic SPECT using 99mTc-GSA may be said to provide a novel method for the evaluation of hepatic functional reserve.

Animals↗