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Biomedical subjects

S Sagawa

Publications and source records attributed to S Sagawa.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Indication and result of renal autotransplantation for renovascular hypertension].

Twenty patients with renovascular disease in 22 kidneys were treated surgically by the method of renal autotransplantation at our department during the 13 years from 1970 to 1982. Etiological disorders included 11 cases of fibromuscular dysplasia, 3 cases of atherosclerosis, 3 cases of aortitis syndrome, two cases of renal artery aneurysm and one case of renal artery thrombosis. Age distribution ranged from 13 to 64 years old (average 28.9 years), and male to female ratio was 1 to 3. Ex vivo surgery was carried out in 11 of these 20 cases. Angioplasty in 9 cases, endarterectomy and partial nephrectomy in one case each were performed extracorporeally. Reconstruction of the urinary tract was needed for 14 kidneys in 13 patients, 12 kidneys were treated by UCN, and PU anastomosis was performed in 2 kidneys in 2 patients. Outcome of renal autotransplantation was "cured" in 17 cases and "improved" in 3 cases during follow-up period from 8 months to 13 years. Revision was successful for the postoperative complication such as urine leakage, bladder tamponade, perirenal fluid collection and ileus.

Adolescent↗
PubMed1984

[A case of bilateral testicular germ cell tumors of different cell types with maturation in the metastatic region].

A case of bilateral testicular germ cell tumors of different cell types and maturation in the metastatic region is described. A 42-year-old man with bilateral testicular swelling visited our clinic. Bilateral high orchiectomy was performed. Subsequent histological examination revealed seminoma and embryonal carcinoma in the right testis and seminoma and mature teratoma in the left. Then bilateral retroperitoneal lymphadenectomy was performed and 7 metastatic regions were found in the para-aortic lymph nodes. One of these revealed histopathologically a mature teratoma containing cartilage constituents. After the operation, multiple drug treatment with Cis-DDP, vinblastine and pepleomycin was started. The patient has been in complete remission for about 1.5 year. In addition, we reviewed the literature about bilateral testicular germ cell tumors and maturation in the metastatic region.

Adult↗
PubMed1984

Hyperbaric diuresis at a thermoneutral 31 ATA He-O2 environment.

The basic pattern of body water exchange was studied in four Japanese male divers during exposure to a thermoneutral 31 ATA (He-O2) environment for 3 d (Seadragon V). The hyperbaric chamber temperature was raised from 25 degrees C +/- 0.5 degrees C at 1 ATA (air) predive to 31.5 degrees C +/- 0.3 degrees C at 31 ATA. Both rectal and mean skin temperatures were measured every hour (including during sleep) and were maintained at the same level at both pressures. The exposure to 31 ATA induced an increase in the daily urine flow and a corresponding reduction in the insensible (and evaporative) water loss without changing the total daily water output. However, the daily fluid intake decreased by 600 ml at 31 ATA, and hence the divers developed a state of negative fluid balance, as reflected by a reduction in body weight and an increase in hematocrit. All changes in the pattern of body water exchange observed at 31 ATA were gradually reversed during subsequent decompression. As observed in a previous dive to 31 ATA (Seadragon IV) in which there was a subtle cold stress (as indicated by the 1 degree C reduction in mean skin temperature at 31 ATA), the increase in daily urine flow at pressure was almost entirely due to the increase in overnight urine flow. However, the hyperbaric nocturia observed in the present dive was a water diuresis in nature whereas that in the previous dive was an osmotic diuresis. These results indicate that the hyperbaric diuresis at 31 ATA is due to an increase in overnight urine flow and that the hyperbaric nocturia is not in any way related to the subtle cold stress attendant in many hyperbaric environments.

Adult↗
PubMed1984

[Combination chemotherapy of advanced transitional cell carcinoma with cis-platinum, cyclophosphamide, adriamycin and 5-fluorouracil (CISCAF)].

Ten patients with advanced transitional cell carcinoma were treated with the combination chemotherapy (CISCAF) consisting of cis-platinum (CDDP), cyclophosphamide (CPM), adriamycin (ADM) and 5-fluorouracil (5-FU). There were 8 males and 2 females with a median age of 57 years (range 33-76). Prior to this chemotherapy, all primary lesions were resected surgically; one patient received irradiation, one interferon. CDDP (15 mg/m2) with mannitol diuresis and ADM (7 mg/m2) were given daily for 5 days. CPM (200-300 mg/m2) was given on day one, and 5-FU (200-300 mg/m2) on day 2. Courses were repeated every 3-4 weeks for 3 courses and later every 2 months. All patients were evaluable for toxicity and 9 for response. There were 3 (33%) partial and 2 minor responses. Survival difference between responders (PR + MR) vs non-responders (NC + PD) was significant during the 30-120 days of observation, but not significant throughout the whole period (generalized Wilcoxon test). The overall toxicity due to chemotherapy was generally mild, except for one irreversible nephrotoxicity and one gastric hemorrhage treated surgically.

Adult↗
PubMed1983

Factors influencing the determination of colloid osmotic pressure of plasma.

The present experiment was performed to examine the influence of pH and temperature of plasma samples on the determination of colloid osmotic pressure (COP). A linear increase in COP was observed when pH of the plasma increased. A significant linear correlation was also observed between COP and the temperature of the samples. The latter relation was explainable by van't Hoff's thermodynamic law, but the former could not always be interpreted by the Donnan's membrane equilibrium. These results suggested the importance of a correction for pH and temperature of the sample when the measurement was made in a condition different from pH 7.4 and 37 degrees C. An equation to predict COP was derived empirically from samples with a wide range of the plasma protein concentration (C) obtained by diluting a pooled rat plasma without altering the albumin-to-globulin ratio (A/G). A possible error in calculating COP was tested in samples with various levels of A/G. There existed a discrepancy of COP by approximately 10% between the measured value and the calculated one even if A/G was identical to the level from which the equation was derived. The difference of the two values became larger when the difference between the A/G for the equation and that of the test sample was higher. From the above experiment we can conclude that a reliable value of COP can be obtained only by a direct measurement of COP.

Animals↗
PubMed1983

Fragility of red blood cells under 31 atmosphere absolute for 14 days.

The present investigation was undertaken during the course of a 14-day dry saturation dive at 31 ATA to study hematologic changes and osmotic fragility of red blood cells in relation to lipid contents of the plasma and red cells. Increase in the hematocrit and blood cell count was observed in the early phase at 31 ATA, which was attributed to the hemoconcentration caused by the hyperbaric diuresis. Osmotic fragility of red blood cells fluctuated during the course of the experiment, but the change was not related to the atmospheric pressure. Cholesterol and phospholipid contents in red blood cells and the plasma also fluctuated but the change was not caused by the pressure. However, an overall correlation between the osmotic fragility and the phosphatidyl choline of red cells and the correlation between the osmotic fragility and the total cholesterol level in the plasma were observed at both 1 and 31 ATA. These correlations revealed an intimate relation between the red cell fragility and lipid composition of the cell membrane and the plasma within intra- and interindividual variations during the course of the dive. The present result did not indicate any significant alteration of red blood cell function due to prolonged exposure to 31 ATA He-O2 environment.

Adult↗
PubMed1983

Properties of red blood cell after multiday exposure to 31 ATA.

Hematologic changes, osmotic fragility of red cells, and lipid contents of plasma and red blood cells were determined during the course of a 14-day dry saturation dive at 31 ATA (SEADRAGON IV). Increases in hematocrit and red blood cell count were observed during the early period at 31 ATA, which was attributed to hemoconcentration resulting from a diuresis. The osmotic fragility of red blood cells decreased slightly during the course of the experiment, but the changes were not related to the atmospheric pressure. Cholesterol and phospholipid content of the red blood cell and the plasma showed slight, insignificant daily variations independent of pressure. However, the same overall correlation was observed between the osmotic fragility and the phosphatidylcholine content of red blood cells and between the osmotic fragility and the total cholesterol level in the plasma, at both 1 ATA and 31 ATA. These correlations revealed an intimate relationship between the cell fragility and lipid composition of the cell membrane and the plasma within intra- and interindividual variations during the course of the experiment, but did not indicate any significant alteration of red blood cell function by the prolonged exposure to 31 ATA helium-oxygen environment. These results indicate that the exposure of human divers to 31 ATA for 14 days does not seem to induce any irreversible chemical changes in the red blood cell.

Adult↗
PubMed1983

[A case of vesical endometriosis].

Endometriosis of the bladder is an uncommon disease, but is common in gynecology. A 34-year-old woman visited us to be explored for the cause of microscopic hematuria and proteinuria, but gross hematuria had never been observed. Cystoscopic examination revealed a great number of pea size, hemispheric cysts on the trigone and the posterior wall of the bladder. Histopathological examination of the specimen taken by TU-biopsy showed vesical endometriosis. Danazol (17 alpha-Pregna-2, 4-dien-20-yno[2,3-d] isoxazol-17-ol) was given to induce menostasia and thereafter endoscopic findings and subjective symptoms were improved. Seventy-five cases of vesical endometriosis in the Japanese were reviewed.

Adult↗
PubMed1982

Predictability of renal allograft prognosis during rejection crisis by ultrasonic Doppler flow technique.

Using the ultrasonic Doppler technique, renal blood flow was measured in 67 patients who underwent living related renal transplantation from January, 1976 to December, 1979. In 58 of 67 cases, 81 acute and 9 chronic rejection episodes occurred. In the initial stage of acute rejection, there are no particular changes in the pattern of systolic blood flow and by contrast marked changes of diastolic flow. The disappearance of the diastolic phase is indicative of an advanced stage of rejection, the reappearance indicative of recovery from rejection, and persistent loss accompanied by changes of systolic flow indicative of an unfavorable prognosis of rejection. In chronic rejection, there are rapid changes of neither systolic nor diastolic flow though the acceleration time in the systolic phase lengthens gradually. The ultrasonic Doppler flow technique for blood flowmetry of a transplanted kidney is a useful means of knowing the prognosis of rejection and provides an index for corticosteroid bolus therapy.

Adolescent↗
PubMed1982

[The acquisition of language through finger spelling in a child with auditory agnosia (author's transl)].

A child with auditory agnosia for verbal and nonverbal sounds was reported. He was born without difficulty and his early development was normal. At the age of 14 months, he suffered from herpes simplex encephalitis and fell in a trance. Soon after he recovered from the illness, he found not to pay any attention to sounds and not to speak any words. He was referred to Teikyo University hospital at 2.5 years of age for the hearing measurement. The average threshold of conditioned orientation reflex audiometry at 500, 1000 and 2000 Hz were 85 dB, while the threshold of auditory brain stem response was 15 dB which is normal. CT scan demonstrated bilateral lesions of superior temporal gyrus. Neurological examination revealed nothing particular except the troubles with hearing and speech. He was made a diagnosis of auditory agnosia. The speech therapy was started at two years old. During the first three years, he was taught how to communicate with gestures and lip reading. However, it was difficult for him to understand the meaning of gestures and lip reading. During these years he could acquire lip reading of simple words. As to environmental sounds, he could respond the telephone-bell and the organ at three years and seven months old, but could not discriminate other sounds. At five years old, finger spelling for his language education was introduced. He appeared to have learned finger spelling more easily and could read and write several letters through finger spelling within a month. One year after introduction of finger spelling, he acquired about 60 words (54 nouns and 6 verbs) and could read words and two-words sentences. However, the speed of his acquisition of language was very slow for his age. Now, he can understand mother's simple instructions and communicate with his mother and his speech therapist through finger spelling, but his responses toward environmental sounds are not stable yet. The course of this patient suggests that language acquisition of children with auditory agnosia might be different from that of deaf children. The prognosis of auditory agnosia in children is controversial. In this patient, the development of language is not good as well as in most previous reports, perhaps because of extensive lesions of language area. The patients with auditory agnosia is frequently mistaken for deaf or mentally retarded children. We emphasize that the early diagnosis and early speech therapy with visual communication are needed for these children.

Agnosia↗
PubMed1982

Body heat balance and urine excretion during a 4-day saturation dive at 4 ATA.

Five male volunteers were exposed for 4 days to a 4-ATA helium-oxygen saturation dive. Partitional calorimetry was performed during 2-h test periods at various ambient temperatures (Ta). Heat production during the period at 4 ATA in helium-oxygen was identical to that at 1 ATA in air. The nonevaporative heat loss (convective and radiant heat losses) was increased with a concomitant decrease in evaporative heat loss. The mean skin and mean body temperatures fell significantly at 4 ATA, and a slight reduction was observed in the rectal temperature. The conductive heat transfer coefficient from the core to skin (hk) was reduced, probably due to vasoconstriction at 4 ATA. Subjective thermal neutrality at rest at 4 ATA was obtained around Ta = 32 degrees C. A diuresis was observed at 4 ATA, but it disappeared with an increase in chamber temperature. An inverse relationship of urine flow to mean skin temperature was observed. An increase in urine flow at 4 ATA might be attributed to cold stress due to lower skin temperature that was caused by the increased nonevaporative heat loss.

Adult↗
PubMed1981

A case of normoreninemic, normotensive primary aldosteronism associated with essential hypertension and nephrocalcinosis.

A 36-year-old female case of normotensive normoreninemic primary aldosteronism with persistent hypokalemia and nephrocalcinosis is reported. She was referred to us for episodes of sudden muscle weakness during 8 years prior to admission. On the first day of admission, her blood pressure was 174/104 mmHg. On the second day of admission blood pressure normalized to 120/80 mmHg. Both of her parents were hypertensive. Arterial blood gas analysis showed metabolic alkalosis. Except an impaired urine concentration ability, renal functions were normal. Intravenous pyelogram showed numerous granular calcifications. Basal plasma renin activity was 1.0 approximately 1.5 ng/ml/hr and increased by sodium depletion. Plasma aldosterone concentration was 70 approximately 80 ng/dl and did not respond to various stimulations. Blood pressure was dependent on sodium balance. It fell on salt restriction and rose on salt loading. Blood pressure responses to vasoactive hormones were normal. Circulating plasma volume was within normal range. After removal of an adrenal adenoma, there was mild fall of blood pressure, serum potassium returned to normal level and plasma renin activity increased slightly. Histologically, there was renal tubular calcifications, and juxtaglomerular apparatus was normal. Blood pressure was elevated to 160/100 mmHg when patient was followed at out-patient clinic after discharge. We concluded that she had essential hypertension associated with primary aldosteronism. Although sodium loss and an increase in urinary kallikrein were found, they did not seem to be the cause of normoreninemic normotensive state of this patient, and the pathogenesis remains to be elucidated.

Adrenal Gland Neoplasms↗