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Biomedical subjects

S Tokunaka

Publications and source records attributed to S Tokunaka.

At least 37 records · Page 2Linked to original sources

[The therapeutic effect of norfloxacin on chronic prostatitis].

The clinical efficacy of norfloxacin (NFLX) was evaluated on 40 patients. They had subjective symptoms suggestive of prostate inflammations and more than five white blood cells (WBC)/hpf in their prostatic secretions (EPS) or VB3. Of these, gram negative rods were isolated from the EPS in 3 patients and gram positive cocci were obtained in 26 patients. The overall clinical efficacy was determined at the second week. The effectiveness rate of the subjective symptoms was 82.5%. The effectiveness rate of the WBC in the EPS was 47.4%. The effectiveness rate of the bacteria in the EPS was 64.3%. The overall clinical effectiveness rate was 77.8%. A subjective side effect was observed only in one patient who had skin eruption like urticaria. Mild liver dysfunction of blood chemistry analysis was shown only in two patients but they had had long standing chronic hepatitis. We conclude that NFLX is an effective drug for the patients with chronic prostatitis.

Adult↗

Case report: secondary penile carcinoma.

We report a case of secondary penile carcinoma with primary tumor in the pancreas. Immunoperoxidase tissue staining of carbohydrate antigen 19-9, carcinoembryonic antigen and prostate-specific antigen was useful for diagnosis of original tumor.

Adenocarcinoma↗

[Histochemical study of external urethral sphincter in the rabbit. Analysis with construction of histograms].

Male rabbit's external urethral sphincter was examined by histochemical muscle fiber typing (myosin ATP-ase staining), and the analysis with construction of histograms regarding to muscle fiber types were performed. Rabbit's external urethral sphincter was predominantly composed of fast twitch (type 2) fibers (87.3%) as a whole. But the proportion of constituent fiber types varied according to the layers, i.e., the slow twitch (type 1) fibers constituted a relatively high percentage (33.4%) in the inner third layer, while few of the type 1 fibers were found in the outer third layer. The all histograms regarding to fiber type in different layers were normal bell-shaped distribution curves. The mena diameter of type 2 fibers (14.7 microns) was evidently larger than that of type 1 fibers (20.5 microns). All three kinds of muscle fibers equally tended to increase in size toward the outer direction, and in every three layers, the diameter of type 2 was larger than that of type 1 also. The definite differences in the proportion of fiber types and fiber sizes between layers may implicate that the inner and outer layers play different roles, i.e., continuous tonic constriction in the former and sporadic strong constriction of short duration in the latter, under different neural regulations. As far as rabbit's external urethral sphincter is concerned, sporadic strong constriction should be mainly dependent on the muscle fibers of large size composing the outer layer, especially the fast twitch fibers. It is possible that the rabbit is so adapted that it could interrupt urination promptly.

Animals↗

[A case of primary transitional cell carcinoma of the prostate].

A 58-year-old man was admitted to our hospital with the complaint of pollakisuria and micturitional pain. The urine cytology showed malignant cells suggesting the urothelial cancer, but various examinations could not reveal the malignant lesion. The prostate was also normal by the digital examination, endoscopy, roentgenography, ultrasonography and serum markers, and the transperineal prostate biopsy showed no malignancy. Three years after the first admission the prostate showed slight hardness and the transperineal biopsy suggested adenocarcinoma of the prostate. Hormonal therapy was then started and the prostate showed no remarkable change until about two years later, when rapid progression of the prostatic tumor was recognized. The transperineal biopsy of the prostate revealed the transitional cell carcinoma with negative staining of Alcian-Blue, PAS and PSA (prostate specific antigen). The epithelia of the bladder and posterior urethra were normal. The radical cystoprostatectomy was done and the histological diagnosis was the pure type of primary transitional cell carcinoma of the prostate. The literatures were reviewed and the clinical differentiation between transitional cell carcinoma and adenocarcinoma of the prostate was discussed.

Antineoplastic Combined Chemotherapy Protocols↗

[Image diagnosis of hyperparathyroidism].

Between January, 1983 and January 1988, the diagnosis of hyperparathyroidism was made on 14 patients (8 primary and 6 secondary), and was identified operatively in all. The procedures for image diagnosis were computed tomography (CT), ultrasonography and scintigraphy. Scintigraphy was performed using Tc-99m and Tl-201 by a subtraction technique. For primary hyperparathyroidism, the accuracy of localization was 100% by CT, 87.5% by ultrasonography, 100% by scintigraphy, and 100% by the combination of these three methods. For secondary hyperparathyroidism, it was 68% by CT, 68% by ultrasonography, 36% by scintigraphy and 84% by the combination of these three methods. Ultrasonography and CT were quite useful for imaging of small abnormal parathyroid glands. The accuracy of scintigraphy in secondary hyperparathyroidism was low. Because the swellings of glands do not occur equally in most secondary hyperparathyroidism cases, we consider that large glands absorb the majority of injected radionuclides. Some discussion on merits and demerits of each image procedure was done.

Adult↗

[A clinical study of prostatic carcinoma].

Seventy seven patients with prostatic carcinoma were treated in our clinic between 1977 and 1986. Most of them were treated by a hormonal agent as the first therapy. None of the 9 stage A1 cases showed any reactivation, but 4 of the 5 stage A2 cases relapsed to metastatic disease. The chemotherapy performed in 3 of the 4 reactivated cases had no obvious effect on the disease. Seven of the 8 patients with stage B disease were alive without relapse. Relapse was seen in the other patient who had poorly differentiated carcinoma and chemotherapy in this case resulted in stable disease for the present. Four of the 15 stage C cases including 3 poorly differentiated carcinomas were hormone resistant or reactivated. For these resistant cases radiotherapy and/or the chemotherapy were performed, but a response was seen in only one case. Consequently, the first therapy for stage A2, B and C of poorly differentiated carcinoma must be improved. Of the 40 stage D cases, 4 patients who were treated by an early combination of hormonal therapy and chemotherapy had a better prognosis than the others. These 4 patients had poorly differentiated carcinomas with multiple bone metastases. Two of these 4 patients were alive without relapse for 17 and 72 months, and one of the 2 patients with relapse was also alive for 75 months. We believe that early chemotherapy is the key for better prognosis in stage D cases.

Androgen Antagonists↗

[Study of the prostatic tissue cefbuperazone (CBPZ) level].

The concentration of Cefbuperazone (CBPZ) was determined in the prostatic tissue and serum of 23 patients with benign prostatic hypertrophy. One or 2 of CBPZ was injected intravenously prior to transurethral prostatectomy. The mean CBPZ level in prostatic tissue and tissue/serum ratio at 1 hour was 17.4 +/- 7.2 micrograms/g (28.9 +/- 9.1%) in 10 patients administered 1 g of CBPZ, and 34.7 +/- 1C.2 micrograms/g (35.7 +/- 13.2%) in 13 patients administered 2 g of CBPZ. Serum and prostatic tissue CBPZ levels responded satisfactorily to the dose of CBPZ. Weights of resected prostatic tissue were not correlated to the tissue CBPZ level. Judging from the inhibitory concentration of CBPZ (minimum inhibitory concentration 80), the prostatic tissue CBPZ level was sufficient against pathogenic bacteria, particularly E. coli, K. pneumoiae and P. mirabilis for a relatively long time. For this reason CBPZ is a very useful drug for treatment of bacterial prostatitis and postoperative infection of prostate.

Aged↗

[Experience of Elcitonin treatment in metastatic bony pain of urological tumors].

Fourteen cases of urogenital tumors (9 prostatic carcinomas, 4 renal cell carcinomas and 1 bladder carcinoma) which had bone metastases were treated with eel-calcitonin, Elcitonin injections for relief of bony pain. Forty mgs. of Elcitonin was injected intramuscularly, 2 to 3 times a week, to out-patients. Forty to 80 mgs. of Elcitonin was injected intramuscularly, daily to hospitalized patients. Relief of the pain was obtained in 71.4% of all patients (71.4% of out-patients and 71.4% of hospitalized patients) and especially in 88.9% of prostatic carcinoma patients. Hypercalcemia was seen in only one patient of renal cell carcinoma. It is considered that Elcitonin treatment is useful for relief of bony pain in the patients with bone metastases, with or without hypercalcemia.

Aged↗

[A clinical study of 33 cases of renal pelvic and ureteral tumors].

Thirty-three cases of primary renal pelvic and/or ureteral tumors, i.e., 14 renal pelvic tumors, 14 ureteral tumors and 5 renal pelvic and ureteral tumors, treated at our hospital between November, 1976 and August, 1987 are reviewed retrospectively. Tumor occurred on the right side in 18 cases, left side in 14 cases and bilateral in one case. The patients ranged in age from 33 to 77 years (average 65.7 years), the sex ratio was 4.5:1 with male predominance over female. The most frequent symptoms were gross hematuria in 22 cases (67%). Interval from onset of initial symptoms to first visit within one month for 23 cases (70%). The major findings of excretory urograms were non-visualizing kidney in 18 cases (55%) and filling defect in 12 cases (36%). Positive urinary cytology was obtained in 18 cases (55%). Operative therapy was performed in all cases, namely, total nephroureterectomy with partial cystectomy in 21 cases (64%) and nephrectomy with transurethral ureterectomy in 7 cases (21%). Histopathologically, all cases but one case of squamous cell carcinoma were transitional cell carcinoma. Subsequent bladder tumors were found in 10 cases (30%). The overall survival rate at 1, 3 and 5 years were 84%, 68% and 61%, respectively by Kaplan-Meier method. In this series, grade and stage of tumor were the most influential factors for prognosis.

Adult↗

Pathology of ureterorenal units in various ureteral anomalies with particular reference to the genesis of renal dysplasia.

Renal morphology of various congenital ureteral anomalies was investigated to gain further insight into the genesis of associated renal dysplasia. Abnormality in the ureteral bud explains the genesis of renal dysplasia as long as the adjoining ureter is cranially ectopic. In caudal ectopy of either single or duplex system, no difference was found in the histologic quality of kidneys with G and H position orifice. In the single system kidneys of H position orifice, however, occurrence of renal dysplasia was not associated with obstruction, suggesting the operation of the "bud theory" even in single system caudal ectopy. In anomalies in which the ureteral orifice was not ectopic, it was suggested that renal parenchymal development was impaired by complete, but not by incomplete obstruction. The association of dysplastic ureter and renal dysplasia was not so frequent as anticipated and the hypodysplastic values of the kidneys with and without dysplastic ureters were similar, suggesting no direct causal relationship between them.

Adolescent↗

Severe hypertension in infant with unilateral hypoplastic kidney.

Unilateral renal hypoplasia unlike Ask-Upmark kidney (segmental renal hypoplasia) seldom causes hypertension. A case of an infant whose hypertension disappeared after removal of a hypoplastic kidney is reported. The removed kidney revealed no sign of Ask-Upmark lesion.

Humans↗

Coexistence of fast and slow myosin isozymes in human external urethral sphincter. A preliminary report.

Human external urethral sphincter muscle was isolated for biochemical research. Myosin samples were prepared and pyrophosphate gel electrophoresis and two-dimensional electrophoresis were performed. Assignment in pyrophosphate gel of myosin isozymes of human external urethral sphincter was carried out by making comparisons with those from human rectus abdominis muscle. Myosin light chains in human external urethral sphincter were identified using two-dimensional electrophoresis. Human external urethral sphincter, similar to other voluntary muscles, is composed of fast and slow twitch muscle fibers, since fast and slow myosin components were shown in both pyrophosphate gel and two-dimensional electrophoretograms.

Electrophoresis↗