Biomedical subjects

O Natsume

Publications and source records attributed to O Natsume.

At least 19 recordsLinked to original sources

PubMed1992

[Transurethral resection of the prostate in the urological management for patients with stroke].

We discuss the transurethral resection of the prostate (TUR-P) on 40 patients in the chronic stage of stroke, all of whom were refractory to conservative managements of urinary disturbance. All patients, between 35 and 89 years old (mean: 52.6 years), had only one episode of stroke and were diagnosed as benign prostatic hypertrophy or bladder neck contracture that appeared to cause urinary disturbance in these patients. At six months after TUR-P, all except for one patient, who needed an indwelling catheter due to a reinfarction, were catheter free. Of these cases 36 (92%) obtained independent micturition and did not develop urinary incontinence except transiently postoperatively. Two cases with impaired mobility and one case with progressive senile dementia required helpmates and/or a commode and so forth postoperatively. It is concluded that in chronic stroke patients TUR-P is recommended for those with benign prostatic hypertrophy or bladder neck contracture.

Adult↗

PubMed1991

[Urological management for stroke patients; relation between brain lesions and establishment of micturitional modality].

A total of 154 stroke patients, 96 males and 58 females, were analyzed to establish the micturitional modality according to the type of detrusor function and the level of activities of daily living (ADL). All patients had only one episode of stroke attack and were checked at least one month after the onset. Localization of cerebral lesion in each patient was evaluated by neurological findings and cerebral angiography in addition to computed tomography of the brain. In the patient groups classified according to the type of detrusor function, micturitional modality was established in 50% of the patients with the underactive type, 70% of those with the overactive type and in 88% of those with normal function. This suggests that the overactive and normal type of detrusor function may not affect establishment of micturitional modality. On the other hand, when classified according to the level of ADL, none established micturitional modality in patients with poor ADL. By contrast, in the patients on higher levels of ADL who were able to transfer themselves from or to a wheel-chair without any assistance it was established in 75%, and in those who were able to gait with or without a brace upon discharged from the hospital, in 91%. It is concluded that establishment of micturitional modality in stroke patients is closely related to the level of ADL or function of lower extremities, but not to localization of the brain lesion.

Activities of Daily Living↗

PubMed1991

[A study of relation between patterns of micturitional dysfunction and establishment of micturitional modality in stroke patients].

We managed 246 patients with bladder dysfunction due to the first stroke in our hospital between January, 1983 and December, 1988. Of these 221 were in the chronic stage of stroke. A total of 213 patients were evaluated for types of bladder dysfunction by cystometry. We examined the relation between hemiplegic side and type of dysfunction or micturition activity, but obtained no significant relationship. Establishment of voluntary voiding pattern was considered to depend on the improvement of daily life activities. The catheter-free rate was 89.4%, while 10.6% of the patients, who could not receive sufficient nursing care or had severe medical problems, were obliged to keep an indwelling catheter. We conclude that establishment of a bladder retraining program is necessary not only medically but socially for improvement of quality of life in stroke patients.

Activities of Daily Living↗

PubMed1991

[Clean intermittent catheterization in the management of spina bifida: a review of 113 cases].

One hundred and thirteen cases of spina bifida treated with clean intermittent catheterization (CIC) were reviewed. There were 42 males and 71 females, ranging from 4 months to 50 years. The major reasons for CIC from other voiding methods were vesicoureteral reflux (VUR) (48/113) old, and residual urine (36/113). The most common type of neurogenic bladder was hypoactive detrusor-active sphincter, in 56.6% of patients (64/113). The grade of paralytic disability of lower limb (Sharrard's classification) was low (group IV-VI) in 84 patients and high (group I-III) in 29 patients. Hydroureteronephrosis and VUR improved 52.1% (37/71) and 57.1% (36/63), urinary tract infection and urinary incontinence improved 70.9% (39/55) and 81.7% (72/87). Major complications were pyelonephritis (12 cases) and urethral pain (5 cases). We discussed the choice of voiding method in the management of spina bifida.

Adolescent↗

PubMed1990

[Bladder augmentation in three patients with contracted bladder caused by neurogenic bladder].

Three patients with contracted bladder caused by neurogenic bladder underwent ileocystoplasty. The primary diagnosis was meningomyelocele for all of them. The operative procedure adopted was Goodwin's Cup-patch method. All cases have obtained increased bladder capacity with improvement of bladder compliance and have been free from urinary incontinence. They were followed up by using clean intermittent self catheterization. Ileocystoplasty combined with clean intermittent self catheterization offers a successful method in patients with contracted bladder caused by neurogenic bladder.

Adult↗

PubMed1990

[Management of female neurogenic bladders caused by cervical spinal cord injuries--cutaneous vesicostomy].

Cutaneous vesicostomy according to Paquin's modification was performed on 5 female patients with neurogenic bladder caused by cervical spinal cord injury and long-term follow-up is now available. All patients are free from risk of autonomic dysreflexia and catheter trouble. There was one significant complication, stomal stricture, but it did not result in severe urinary infections or secondary changes in the upper urinary tract. Cutaneous vesicostomy proved to be valuable to improve the quality of life in female patients with neurogenic bladder caused by cervical spinal cord injury.

Adult↗

PubMed1989

Testicular tumors occurring in non-twin brothers: a case report.

The present report describes two cases of seminoma that occurred simultaneously in non-twin brothers. These siblings were typed for HLA-A, -B, -C and -DR specificities, and manifested identical haplotypes. Sixty-four sets of affected siblings have been reported prior to the present cases. We examined HLA-DR antigen in brothers with testicular tumors and hereditary roles in the etiology are discussed.

Adult↗

PubMed1988

[Percutaneous management of perinatal spontaneous rupture of a calyceal diverticulum].

We report a case of spontaneous rupture of a calyceal diverticulum in a perinatal woman who was treated with percutaneous procedure. A 28-year-old woman, who delivered a full-term healthy male infant 13 days prior to hospitalization, was admitted complaining of left progressive severe flank pain. Kidney-urethra-bladder X-ray showed a space-occupying lesion in the lower pole of the left kidney. Drip intravenous pyelography revealed the left renal pelvis and calyx to be pushed up. Renal computed tomographic scan demonstrated a cystic lesion in the lower pole of the left kidney with a perirenal hematoma. After percutaneous puncture followed by indwelling of 8 Fr. balloon catheter within the cystic lesion for drainage, the patient recovered dramatically. Retrograde and antegrade pyelography showed the cystic lesion communicating with an adjacent calyx in the lower pole of the left kidney. The physiological relationship to pregnancy is discussed as a possible etiological factor in the unique occurrence of this rare rupture, and the literature is reviewed.

Adult↗

PubMed1988

[The management of vesicoureteral reflux with neurogenic bladder due to spina bifida].

Thirteen cases (20 ureters) of vesicoureteral reflux (VUR) associated with neurogenic bladder, treated with anti-reflux operation are reviewed. Twelve of the 13 cases had meningomyelocele and 1 had spina bifida occulta as an underlying disease. The type of neurogenic bladder was hypoactive detrusor-active sphincter in 11 patients and hypoactive detrusor-hypoactive sphincter in 2 patients. They were treated with an anti-reflux operation, 2 ureters by Politano-Leadbetter method and 18 ureters by Cohen method. The results were successful (success rate 85.0%). Therefore, we concluded that in neurogenic bladder patients especially with the hypoactive detrusor-active sphincter, the cause of their renal deterioration is mostly VUR. Thus we should examine such patients for VUR. On the other hand, when the renal deterioration of VUR patients cannot be improved by conservative treatment for example clean intermittent catheterization or indwelling catheter, we should perform an anti-reflux operation.

Adolescent↗

PubMed1988

[Transurethral electroresection of the external urethral sphincter in the urological management of male tetraplegics].

Transurethral electroresection of external urethral sphincter (TUR-sph) was performed in sixteen male tetraplegics to obtain good voiding efficiency and to prevent autonomic dysreflexia due to detrusor sphincter dyssynergia. Ratio of residual urine as a parameter of voiding efficiency and blood pressure and plasma noradrenaline level during voiding as parameters of the significance of autonomic dysreflexia were evaluated before and after TUR-sph, and all these parameters had significantly improved after TUR-sph. After discharge from the hospital, all patients urinated comfortably with the maneuver of suprapubic percussion by themselves and/or their helpmates, and no patients complained of any inconvenience due to urinary incontinence. Moreover, no patients had the episode of autonomic dysreflexia in daily life except for one patient who had it once with urinary tract infection. TUR-sph brings not only the improvement of voiding efficiency but also the effect as a safety valve against autonomic dysreflexia by means of preventing the occurrence of autonomic dysreflexia due to detrusor sphincter dyssynergia.

Adolescent↗

PubMed1987

[Usefulness of computed tomography and ultrasonography for the early detection of renal cell carcinoma].

Eighty-three cases of renal cell carcinomas admitted to Nara Medical University and its related hospitals from August, 1962 through July, 1984 were reviewed. We have been using computed tomography (CT) and ultrasonography (US) for early detection of renal cell carcinomas since 1980. Thereafter the number of patients with low stage renal cell carcinoma was significantly increased. Furthermore 6 carcinomas were incidentally detected by CT and/or US examination for checkup of other diseases. We believe that CT and US may be valuable as a screening modality for early detection of renal cell carcinoma.

Adult↗

PubMed1987

[Intracavernous injection of papaverine hydrochloride for impotence in patients with spinal cord injury].

Twenty-one intracavernous injections of 40 or 60 mg papaverine hydrochloride were given to ten male paraplegics. Erection sufficient for coitus was achieved within a few minutes after 15 of the injections (71.4%). Tumescence of the penis lasted from 18 minutes to 48 hours and the penile tumescence of the patients who had reflective erection usually lasted longer than that of the patients who did not. The trial that lasted for 48 hours resulted in the fracture of the penis that was presumed to have occurred during coitus and it was treated operatively. Intracavernous injection of papaverine hydrochloride is available for the impotence of male paralegics, but both doctor and patient must be careful about the sensory disturbance of the penis to avoid penile injury during erection. Further studies are needed to establish safety and long-term efficacy, as well as to determine if histological change of cavernous body occurs by repeated injection.

Adult↗

PubMed1987

[Urological treatment of patients with spinal cord injury in the chronic stage].

One hundred eighty patients with spinal cord injury were admitted to our hospital between January, 1980 and June, 1983. Eighty-five of them had cervical lesions, 54 had thoracic lesions and 41 had lumbar lesions. Most of the neurogenic bladders due to spinal cord injury treated in our clinic, could be classified into 3 major patterns: hypoactive detrusor-hypoactive sphincter, hypoactive detrusor-active sphincter, and hyperactive detrusor-hyperactive sphincter. To control the hyperactivity of the detrusor and the sphincter, we employed pharmacotherapy first and then we performed transurethral resection of the bladder neck and prostatectomy (TUR-Bn.P) and nerve block (sacral nerve block, pudendal nerve block, obturator nerve block and lumbar nerve block). In the case of a hypoactive detrusor, we employed TUR-Bn.P, open ileal flap fixation to the bladder and voiding training. Using these procedures, we could make 157 patients catheter-free.

Catheters, Indwelling↗

PubMed1986

[Complete remission obtained in advanced testicular cancer treated by etoposide (NK-171)].

A 38-year-old man was admitted to Nara Medical University Hospital on Feb.7,1983, because of swelling of the scrotal contents on the right side and elevated serum AFP, beta-HCG and LDH suggestive of testicular tumor. Right orchiectomy was carried out and a pathological diagnosis of embryonal cell carcinoma of the right testis (pT3N0M1) was made. The patient, upon evidence of multiple pulmonary metastases, was treated with a combination chemotherapy of cis-Diamminedichloroplatinum, vincristine and peplomycin. After three courses of combination chemotherapy, pulmonary metastases were decreased, but their foci persisted. The patient was then treated with Etoposide 62 mg/m2 daily for 5 days every three weeks, and after this course, complete remission of pulmonary metastases was obtained. The patient recieved 3 courses of Etoposide and retroperitoneal lymph node dissection, and has since shown no evidence of disease for 2 years and 4 months after surgery.

Adult↗

PubMed1967