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Biomedical subjects

S Kawakami

Publications and source records attributed to S Kawakami.

At least 163 records · Page 9Linked to original sources
PubMed1994

Effects of ursodeoxycholic acid treatment on essential fatty acid deficiency in patients with biliary atresia.

To assess whether ursodeoxycholic acid (UDCA) treatment has any beneficial effect on essential fatty acid (EFA) deficiency in patients who have had a Kasai operation for extrahepatic atresia (EBA), responses of serum fatty acids to UDCA administration (15 mg/kg/d) were investigated in eight jaundice-free patients and in eight patients with jaundice (serum total bilirubin > or = 1.0 mg/dL). All patients were also given taurine supplementation (100 mg/kg/d). Serum fatty acid composition was determined before and 6 months after UDCA treatment. Serum total bile acid concentration and serum total bilirubin value, as a part of conventional liver function tests, were measured before and during UDCA therapy. Before UDCA treatment, the concentrations of linoleic acid and arachidonic acid were significantly lower (P > .05 for the former; P > .01 for the latter) in both the jaundice and jaundice-free groups than in the controls. After 6 months of treatment, the linoleic acid concentration significantly increased (P > .05), to the normal range, in the jaundice-free group, but not in the jaundice group. The arachidonic acid concentration did not increase significantly in either group. The serum total bile acid concentration was lower in six of the eight jaundice-free patients and in four of the eight jaundice patients. The serum total bilirubin value decreased in six of the eight jaundice-free patients and in four of the eight jaundice patients; however, the degree of improvement was not statistically significant in either group. No side effects developed, and there were no changes in blood chemistry values unrelated to liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Arachidonic Acid↗
PubMed1994

Craniofacial cleft with naso-ethmoidal encephalocele--case report.

The anterior skull base of a patient with a craniofacial cleft with naso-ethmoidal encephalocele was reconstructed using temporo-parietal and frontal galea-pericranial flaps and free cranial bone grafts, to prevent meningitis caused by trans-nasal infection. The patient had frequent episodes of meningitis before surgery, however, no episodes of meningitis have been observed up to 1 year postoperatively.

Bone Transplantation↗
PubMed1994

The superficial temporal and retromandibular veins as guides to expose the facial nerve branches.

The superficial temporal vein and retromandibular vein were used as a guide to expose facial nerve branches in the parotid gland, and this procedure was applied to open reduction of mandibular condyle fractures (14 patients) and to superficial parotidectomy (6 patients). The advantages of this method are as follows: It is very easy to identify the superficial temporal vein as a guide, and it produces very little surgical stress because the procedure for exposing the facial nerve branches through the course of the vein is the same as the procedure for exposing the condyle and elevating the superficial lobe of the parotid gland.

Adolescent↗
PubMed1994

Results of circulatory support for postoperative cardiogenic shock.

Over the last 5 years, 15 patients received ventricular assist devices (VADs) (Group 1) and 5 received percutaneous cardiopulmonary support (CPS) (Group 2) while in postoperative cardiogenic shock. Group 1 consisted of 8 men and 7 women ranging in age from 22 to 73 years (average age, 55 years). Nine of these patients underwent surgery for valve replacement, 5 for coronary artery bypass grafting, and 1 for closure of a ventricular septal rupture. The duration of VAD support ranged from 6 h to 9 days (mean, 3.9 days). Group 2 consisted of 4 men and 1 woman ranging in age from 49 to 68 years (average age, 57 years). One of these patients underwent surgery for valve replacement, 1 for coronary artery bypass grafting, 2 for replacement of a thoracic aneurysm, and 1 for left ventricular aneurysmectomy. The duration of CPS ranged from 4 h to 8 days (mean, 2.8 days). In Group 1, 13 patients were weaned from the VADs and 8 survived. Bleeding occurred in 5 patients, renal failure in 4, infection in 3, cardiac failure in 4, cerebral infarction in 1, perioperative myocardial infarction in 1, arrhythmia in 1, and ileus in 1. In Group 2, 4 patients were weaned from the CPS and 3 survived. Bleeding occurred in 3 patients, renal failure in 2, CNS injury in 2, and cardiopulmonary failure in 1. The 8 survivors in Group 1 have been followed for 2 to 56 months (mean, 28.7 months). Five patients were in NYHA class I, 2 were in class II and 1 was in class III.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Ovarian torsion: CT and MR imaging appearances.

PURPOSE: To describe the features of twisted ovarian tumors on computed tomographic (CT) scans and magnetic resonance (MR) images. MATERIALS AND METHODS: The CT scans, MR images, clinical records, and histopathologic findings in 10 patients with surgical proof of a twisted adnexal tumor were retrospectively evaluated. RESULTS: The most common findings on MR images were nonspecific: deviation of the uterus to the twisted side (n = 9), engorged blood vessels on the twisted side (n = 6), a small amount of ascites (n = 5), and obliteration of fat (n = 4). The following characteristics were seen only in the five patients with hemorrhagic infarction: (a) a protrusion of the lesion on the twisted side to which the uterus was continuous or engorged blood vessels converged (n = 5); (b) thick, straight blood vessels that draped around the lesion (n = 2); (c) distinct hematoma (n = 2); and (d) complete absence of enhancement (n = 3). CONCLUSION: Three findings (a, b, and d) seem to be diagnostic of the twisted adnexal tumor and may facilitate prompt surgical intervention at examination with MR imaging or CT.

Adolescent↗
PubMed1994

Corticotropin-releasing hormone mediates suppression of pulsatile luteinizing hormone secretion induced by activation of alpha-adrenergic receptors in the paraventricular nucleus in female rats.

The present study examined which subtype of adrenergic receptor in the paraventricular nucleus (PVN) has a role in regulating pulsatile LH secretion and whether CRH mediates the effect of norepinephrine (NE) injection into the PVN on pulsatile LH secretion in ovariectomized (OVX) and ovariectomized estradiol (E2)-treated (OVX + E2) rats. All animals were OVX, and some were sc implanted with Silastic capsules containing E2 dissolved in peanut oil. One week after ovariectomy and E2 implantation, guide cannulae for injection of agent and alpha-helical CRF-(9-41) (alpha-hel CRF), an antagonist of CRH, were stereotaxically implanted into the PVN and third ventricle, respectively. Animals were bled for 3 h at 6-min intervals through an atrial cannula immediately after PVN injection of NE or various adrenergic receptor agonists (phenylephrine, an alpha 1-adrenergic receptor agonist; clonidine, an alpha 2-agonist; and isoproterenol, a beta-agonist). Some of the animals were injected with alpha-hel CRF 5 min before NE injection. NE and both alpha-receptor agonists inhibited pulsatile LH secretion throughout the 3-h sampling period in OVX + E2 rats and significantly reduced the mean plasma LH levels and the LH pulse frequency. On the other hand, LH secretion was inhibited transiently for the first 1-2 h by an injection of NE or an alpha 2-receptor agonist into the PVN in OVX rats, resulting in a significant decrease only in mean plasma LH levels in the NE-injected group. Injection of a beta-agonist did not affect pulsatile LH secretion in either OVX or OVX + E2 animals. Intracerebroventricular injection of alpha-hel CRF before PVN injection of NE completely blocked the NE-induced suppression of pulsatile LH secretion in OVX+E2 rats. These results suggest that 1) the noradrenergic system projecting to the PVN suppresses pulsatile LH secretion via the activation of alpha-adrenergic receptors; 2) this inhibition is mediated by CRH release; and 3) estrogen enhances this suppression.

Animals↗
PubMed1994

Caries-preventive effect of glass ionomer sealant reapplication: study presents three-year results.

The caries-preventive effect of glass-ionomer sealant depends on both retention of sealant and fluoride release. In this study, the retention rate was maintained by sealant reapplication over three years. Caries reduction was 76.1 percent at one year, 69.9 percent at two years and 66.5 percent at three years. Reapplication is an acceptable procedure and seemed to improve caries reduction.

Chi-Square Distribution↗
PubMed1994

[Primary malignant lymphoma of the urinary bladder achieving complete response by COMPA intraarterial chemotherapy: a case report].

A case of primary malignant lymphoma of the bladder is reported. A 70-year-old woman was admitted to our clinic with the chief complaint of intermittent gross hematuria on March 31, 1992. Examination of cystoscopy, IVP, ultrasonography and CT scan suggested a non-papillary invasive bladder tumor. Pathological examination of transurethral biopsy revealed malignant lymphoma, B cell type. After 5 courses of intraarterial COMPA (CDDP, VCR, MTX, PEP, ADR) chemotherapy, she have been in complete remission. Intraarterial COMPA chemotherapy might be effective and useful for primary malignant lymphoma of the urinary bladder.

Aged↗
PubMed1994

[Significance of transrectal ultrasonography in surgery for stress urinary incontinence and cystocele. Assessment of the bladder neck suspension by measuring posterior urethrovesical angle and angle of inclination of the upper urethra].

We treated 42 females (26 with genuine stress urinary incontinence, 13 with incontinence and cystocele, and 3 with cystocele) with bladder neck suspension using transrectal ultrasonography during operation. The optimum tightness of suspension was decided by adjusting the posterior urethrovesical angle to about 90 degrees in 26 patients with genuine stress urinary incontinence accompanied with flattened posterior urethrovesical angles and by adjusting the angle of inclination of the upper urethra to about 10 degrees in 16 patients with cystocele accompanied with rotationally descended urethra. Urinary continence was achieved in 35 of 39 patients presenting with urinary incontinence. Three patients with cystocele without urinary incontinence remained dry after the operation. The average of maximum urinary flow rate significantly increased after operation. The angles of inclination of the upper urethra measured on the ultrasonogram during operation corresponded well with those measured on the post-operative lateral urethrocystogram. In 26 patients without cystocele, the angles of inclination of the upper urethra and the posterior urethrovesical angles were correlated significantly on the pre-operative urethrocystograms. Roentgenographic changes in pre- and post-operative urethrocystograms showed concomitant restoration in the angles of inclination of the upper urethra and in the posterior urethrovesical angles as well as significant elevation of the bladder neck. Present results indicate that the angles of inclination of the upper urethra measured by transrectal ultrasonography during operation as well as the posterior urethrovesical angles are useful and reliable to decide the optimum tightness of bladder neck suspension for the patients with stress urinary incontinence accompanied with rotationally descended urethra.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Experience of ileal neobladder for bladder cancer by Hautmann procedure].

Operative results of ileal neobladder by the Hautmann procedure were studied in the patients with bladder cancer. From 1990 to 1993, 23 patients underwent total cystoprostatectomy for transitional cell carcinomas of the bladder. In 12 of these patients, an ileal neobladder was constructed for total bladder replacement under the following criteria; patients 1) with cancer confined in the bladder (T3b, M0, N0 or less), 20 without carcinoma in situ extending to more than half of urothelium of the bladder, 3) without cancerous lesion in the bladder neck or the prostatic urethra, 4) with performance status of 0 and the age of 75 or less. Pathologically, the disease was grade 2 in 3 patients, grade 3 in 9, stage pT1b in 3, stage pT2 in 4, stage pT3a in 1 and stage pT3b in 4. Two of 3 patients with the disease of stage pT1b had multiple papillary tumors. The remaining one patient had microinvasive cancer that carcinoma in situ infiltrated into submucosal area. Radical cystoprostatectomy and total bladder replacement by Hautmann procedure was performed in all patients. The maximum neobladder capacity was 349.5 +/- 58.1 ml (mean +/- SD). The intravesical pressure at maximum capacity was 30.6 +/- 6.2 cmH2O. At half maximum capacity, the intravesical pressure was 17.1 +/- 6.8 cmH2O. the maximum urethral closure pressure and the functional urethral length were 89.2 +/- 38.1 cmH2O and 25.5 +/- 7.0 mm, respectively. One patient had stress urinary incontinence. Slight nocturnal incontinence was found in 2 patients and nocturia was 1.86 +/- 0.55 times.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Voiding dysfunction after abdominal radical hysterectomy. Comparison between patients with and without adjuvant irradiation therapy].

We evaluated 59 patients with voiding dysfunction after abdominal radical hysterectomy for uterine cancer. Of 59 patients, 45 underwent the surgery alone, and the other 14 underwent surgery and postoperative radiotherapy. Irradiation (mean dose, 60 Gy) was performed in bilateral commoni iliac regions excluding the bladder. In principle, the indwelling urethral catheter was removed 4 days after operation. All patients were followed up at the gynecological department until the onset of the voiding dysfunction. The mean interval between operation and the onset of voiding dysfunction was significantly longer (P < 0.01) in the group treated by surgery alone (7.9 years) than in the group treated by surgery in combination with radiotherapy (3.8 years). Voiding dysfunction developed earlier as the age at the time of operation was higher. No differences were observed in the volume of residual urine, the detrusor function, or the incidence of urinary tract infection between the two groups. These results suggest that aged patients develop voiding dysfunction earlier after radical hysterectomy than young patients, and postoperative radiotherapy shortens the interval between operation and the onset of postoperative voiding dysfunction.

Age Factors↗
PubMed1994

[Lung residuals following chemotherapy in patients with stage III nonseminomatous testicular cancer. Report of 4 cases].

Since 1989, 4 patients with Stage III nonseminomatous germ cell tumor of the testis underwent thoracotomy for persistent radiographic masses after systemic chemotherapy. They were treated with multi-drug regimen including cisplatin, vincristine, methotrexate, peplomycin, and etoposide until normalization of tumor markers was obtained. Residual masses of the 4 patients consisted of viable cancer cells in 1 patient, immature teratoma in 1, mature teratoma in 1 and necrosis in 1. Of the 4 patients 3 achieved complete remission and are doing well with no evidence of disease, while the other case with residual viable cancer cells died of renal failure. The key to successful treatment of advanced testicular cancer was considered to be a favorable response to chemotherapy and complete resection of any residual tumors.

Adult↗
PubMed1994

[Analysis of continence mechanisms by stress urethral pressure profiles].

The urethral pressure profiles (UPP) at rest and under stress, using double lumens microtip transducer catheter, in 17 females without urinary incontinence (normal group) were compared with those in 39 females with stress urinary incontinence (SUI group). And UPP were compared pre- and postoperatively in 21 females of SUI group who had surgical cure of SUI by bladder neck suspension (operative group). Pressure transmission ratios (PTR) were calculated in each quartile dividing functional urethral length (FUL) into four equal lengths. Maximum urethral closure pressure (MUCP) and Functional urethral length (FUL) in normal group were significantly higher than those in SUI group. In normal group, although bladder neck opening under stress (bladder neck incompetence) existed in 41% of them, the PTR in the distal three-quarters of the FUL were significantly larger than those in SUI group and urinary continence was remained in all of them. On the contrary, in SUI group, there was an almost linear decrease in the value of the PTR along the FUL. Therefore, it was suggested that SUI patients might lose distal urethral compensatory mechanisms. The results, obtained from the resting UPP, show that there is no significant change in MUCP or FUL following bladder neck suspension. In contrast, the stress UPP shows that successful operation generated a magnification of the PTR in the proximal three-quarters of the FUL. Only 1 case of post operative group showed bladder neck incompetence. Therefore suspending the bladder neck in a high position might produce the ability to occlude proximal three-quarters of the FUL.

Adult↗
PubMed1994

[Low dose COMPE. Cisplatin, vincristine, methotrexate, peplomycin, etoposide chemotherapy for advanced testicular cancer].

We presented 15 patients with advanced testicular cancer treated with to 7 courses (mean: 3.2 courses) of COMPE chemotherapy. The low dose COMPE, given 14 patients, consisted of the chemotherapeutic agents as follows: cisplatin, 5 mg/m2 by intravenous push infusion and thereafter 25 mg/m2 by continuous 24-hour-infusion on day 3 and 30 mg/m2 by continuous 24-hour-infusion on day 4; vincristine, 0.6 mg/m2 by drip intravenous infusion (div) on days 1 and 2; methotrexate, 10 mg/m2 by div on day 1; peplomycin, 10 mg/m2/day, divided to three times by intramuscular injection on days 1 to 3; etoposide, 100 mg/m2, by div on days 3 to 5. The regular dose COMPE (given one patient) had CDDP dosage up to 50 mg/m2/day on days 3 and 4. the regimens were given every 3 or 4 weeks in admission. Patients were adequately hydrated but no diuretics were used. The patients were diagnosed as 5 seminomas with 4IIA and one IIB and as 10 non-seminomas with 2IIA, one IIB, one IIIB 1,4 IIIB2, and 2 IIIC stagings, respectively. Of the 15 patients, 12 patients are alive with no evidence of disease at 13-86 months (mean: 39.5 months) of follow-up duration. Six patients achieved complete remission. Of 8 patients achieved partial remission with chemotherapy alone, 6 patients achieved complete remission by following resection of residual masses or irradiation but another 2 patients (IIB2:1, IIIC:1) failed to achieve complete remission had relapse and died after 19 and 25 months, respectively. One patient (IIIC) showed no change had progression and died after 5 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[A case of completely responding stage D2 prostatic cancer with no evidence of disease 14 years after diagnosis].

A 58-year-old male complaining of pollakisuria, miction pain and back pain visited us Dec. 26, 1979. Rectal examination revealed the prostate enlarged by 5 digital width, stony hard and irregular. Transrectal needle biopsy revealed moderately differentiated adenocarcinoma of the prostate. Bladder neck invasion, pelvic and mediastinal lymph node metastases and multiple bone metastases were found. The case was diagnosed with prostatic adenocarcinoma T3N2M1 (OSS, LYM) stage D2. Three courses of chemotherapy using ifosfamide applied from Feb. 2, 1980 showed no marked effect except for partial pain relief. Hormonal treatment with diethylstilbestrol diphosphate was started from May 28 and arterial infusion chemotherapy using CDDP and 5-FU was performed 2 months later, resulting in size reduction of the prostate and pelvic lymph node metastases and disappearance of mediastinal lymph node metastases. Needle biopsy of the prostate was negative for cancer cells. After 8 months, Tegafur was started, and 12 months later radiotherapy was added to the prostate and pelvic lymph nodes. The abnormal accumulation in bone scan began to decrease after 14 months and achieved complete remission 28 months after the initial therapy. We discontinued the hormonal therapy 31 months later because of his complaint of chest discomfort and palpitation. At the present time, 14 years after the initial therapy, the prostate was 35 x 29 x 19 mm in size on transrectal ultrasonography with undetectable serum PSA level and no tumor cells but only mass fibrosis has been seen by pathological examinations. We considered this patient to be with no evidence of disease.

Adenocarcinoma↗
PubMed1994

Expression of hepatocyte growth factor in normal and carbon tetrachloride-treated monkeys.

We examined hepatocyte growth factor-producing organs in normal and carbon tetrachloride-treated Japanese monkeys, a species more related to human beings than rats, by measuring hepatocyte growth factor protein and hepatocyte growth factor mRNA in various tissues. Hepatocyte growth factor protein and hepatocyte growth factor mRNA levels were determined by use of an enzyme-linked immunosorbent assay for human hepatocyte growth factor and Northern-blot analysis using human hepatocyte growth factor cDNA as a probe, respectively. Although very slight amounts of hepatocyte growth factor protein were found in various organs of normal monkeys, the hepatocyte growth factor protein levels were remarkably increased only in the livers and spleens of carbon tetrachloride-treated monkeys. Hepatocyte growth factor mRNA was distinctly detected in the livers, spleens, lungs, intestinal tracts, adrenal glands and aortas of normal monkeys. After the administration of carbon tetrachloride, the hepatocyte growth factor mRNA levels in the liver, spleen and gastrointestinal tract were markedly increased; the level in the lung was unchanged, differing from the findings in rats; and the levels in adrenal gland and aorta were unaltered. These results indicate that the liver is an important hepatocyte growth factor-producing organ in monkeys during liver regeneration and that hepatocyte growth factor induced in the liver may stimulate hepatocyte proliferation by way of a paracrine mode.

Animals↗