Biomedical subjects

S Wada

Publications and source records attributed to S Wada.

At least 343 records · Page 19Linked to original sources

PubMed1990

[A clinical study on urethral recurrence observed after cystectomy].

A clinical study was made on 108 male patients who underwent cystectomy. The posterior urethra and partial anterior urethra were removed in 47 cases, half of the perpendicular urethra was removed in 13 cases and the anterior urethra up to the fossa navicularis was removed in 48 cases. Out of 60 cases without urethrectomy, urethral recurrence was observed in 13 cases (21.7%), while no recurrence was observed in the cases treated with urethrectomy. The average period of time from cystectomy to urethral recurrence was 24.7 months (11-39 months). Urethral cancer of such early stages as pIa and pIb were found in 3 and 6 cases, respectively. Stage pT2 was found in 4 cases. Grade 1 cancer was found in 3 cases, grade 2, in 5 cases, and 3 in 5 cases. The proximal end of the perpendicular urethra was found to be the most frequent site for recurrence with 11 cases exhibiting recurrence at this location and 2 cases at the mid-portion of the perpendicular urethra. Many cases exhibited multiple recurrence of tumor of visually grayish, velvety and non-papillary type which was histologically all transitional cell carcinoma. Bladder tumor with higher grade tended to cause urethral cancer recurrence with higher grade. Bladder tumors at multiple locations from the trigone to the lateral and posterior walls tended to cause recurrence in the urethra (p less than 0.05). Of all the cases, 10 cases underwent urethrectomy and 2 cases penectomy. 12 cases received chemotherapy and 5 cases radiation therapy as postoperative adjuvant treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

[Clinical study on 32 patients who underwent parathyroidectomy at Osaka City University Hospital].

We retrospectively reviewed 32 patients who underwent parathyroidectomy at our hospital for the last fourteen years. 1) Clinical appearance of primary hyperparathyroidism was in younger age in women. 2) In previous history or at the time of PTX, 9 patients had malignant tumors including 6 thyroid cancers, 36% of the patients with out bone related symptoms had a remarkable decrease in bone mineral content. 3) After PTX, none of patients had recurrent urolithiasis and bone mineral content of all patients was significantly increased in a short time. In addition, upper GI complaints were improved, or hypertension was partially normalized. However, renal insufficiency remained unchanged. 4) In preoperative localization study, Ultrasound sonography (US) demonstrated the best accuracy rate of 88% when only one gland was involved. US was able to detect multiple gland involvement only in 20% of 5 cases. 5) Hypercalciuria was recognized as one of the risk factors of stone formation in patients with primary hyperparathyroidism.

Adenoma↗

PubMed1990

[Experience with extracorporeal shock wave lithotripsy for urinary stone. Factors for requiring more than two ESWL treatments and its result].

Extracorporeal shook wave lithotripsy (ESWL) was performed for the treatment of 1277 urolithiasis patients at Osaka City University Hospital from July, 1985 to December, 1988. A total of 1788 ESWL treatments were carried out using Dornier HM3 kidney lithotripter. 964 patients (75.5%) underwent only one ESWL treatment, while 313 patients (24.5%) more than two ESWL treatments. We retrospectively examined the factors for requiring more than two ESWL treatments. Not only stone number, size and location, but fragility were considered to be the main causes for requiring more than two ESWL treatments. According to component analysis of ureteral stones, which were hard and resistant to shock wave, calcium apatite content of these stones turned out to be high (p less than 0.001). As for fragility, the residual stones created by ESWL were more difficult to be disintegrated that the nontreated stones of the same size (p less than 0.05). "Fragility" of the stones before shock wave and residual stones after ESWL are considered to be a major problem in ESWL treatment of urinary stones to be solved in the years to come.

Adolescent↗

PubMed1990

[Clinical evaluation of Cernilton on benign prostatic hypertrophy--a multiple center double-blind study with Paraprost].

A multiple center double blind study was performed to study the effectiveness of Cernilton (CN) on benign prostatic hypertrophy in comparison to Paraprost (PP). Among a total of 192 patients, overall effect was studied on 159 patients, overall safety rate on 178 patients and rate of effectiveness on 159 patients. There were no differences between the two groups in the selected patients, criteria for exclusion and drop out cases or background data of the patients. Impression of patients and overall effect by committee and physician judgment were slightly higher in the CN group compared to the PP group, but there was no significant difference between the two groups. For the improvement in subjective symptoms, the rate of moderate improvement or more after 4 weeks by committee judgement was higher in the CN group compared to the PP group. The rate of improvement in protracted miction, which is an effective marker of urinary disturbance, was also higher in the CN group compared to the PP group. An analysis of objective symptoms showed a significant improvement in residual urinary volume, average flow rate, maximum flow rate and prostatic weight in the CN group. A significant improvement in the phased change of residual urinary volume was also seen in the CN group. No side effects or abnormalities in clinical test levels were noted in the CN group. By committee judgement, the rate of more than moderate effectiveness was 49.1% in the CN group compared to 41.2% in the PP group, but there was no significant difference between the two groups. By physician's judgment, the rate of more than moderate effectiveness was 49.4% in the CN group compared to 46.3% in the PP group, but there was also no significant difference between the two groups. These results suggested that Cernilton was an effective drug for benign prostatic hypertrophy.

Aged↗

PubMed1990

Detection of endotoxin antibody in long-term dialysis patients.

Endotoxins are often seen in dialysate. They are derived from Gram-negative bacteria especially Pseudomonas, E. coli and Serratia. Endotoxins are large-molecular-weight substances with an average molecular weight of 10(8). These large units can be divided into subunits down to a molecular weight of 10,000 which are thought to pass through dialyzer membranes. To investigate this, endotoxin antibody levels were measured in two groups of patients on chronic regular hemodialysis, a low-flux group using cellulosic membrane dialyzers (cuprophan and cuproammonium rayon (CAR) and a high-flux group using synthetic polymer membrane dialyzers (PMMA, EVAL). Using an ELISA based on standard endotoxin antibodies the percentages of patients in the low flux group with endotoxin antibodies were 26.9% with Cuprophan and 25% with CAR, not significantly different from a normal control group. In the PMMA and EVAL groups, it was 53.6% and 68.4% respectively. Back filtration of dialysate into blood is understood as the main reason for the entry of endotoxin in patients treated with high-flux dialyzers.

Antibodies↗

PubMed1990

[Intravesical instillation chemotherapy of anticancer agents including cylocide: studies of prophylactic effects on the recurrence].

We studied the efficacy of intravesical instillation chemotherapy of anticancer agents including cylocide (CA) in the prevention of recurrence of bladder tumor after surgery. Totally 60 patients with superficial bladder tumor were enrolled into the study. The patients were randomly assigned to either one of three groups: CA 300 mg alone, CA 200 mg + mitomycin C (MMC) 10 mg, and CA 180 mg + adriamycin (ADM) 20 mg. These drugs were initially instilled once a day for one week, and then once a month until 2 years after surgery. Thereafter, the patients were followed up without instillation. The cumulative non-recurrence rates in the CA group was 76.5, 60.0 and 60.0% at 1, 2 and 3 years after the removal of bladder tumor, respectively, while that in the CA + MMC treated group 90.9, 75.3, and 75.3% and that in the CA + ADM treated group, 95.1, 82.9 and 82.9%, respectively. The recurrence rate in the CA, CA + MMC and CA + ADM treated group was 35.3, 27.3 and 19.0%, respectively, the recurrence indices 1.84, 1.07 and 0.74, and the mean times between recurrence 10.8, 16.5 and 18.0 months, respectively. Side effects were noted in 3 of the 17 cases (17.6%) in the CA group, in 3 of the 22 cases (13.6%) in the CA + MMC group and in 3 of the 21 cases (14.3%) in the CA + ADM treated group. These data show that intravesical CA instillation in combination with MMC or ADM is more effective for the prevention of recurrence than that of CA alone.

Actuarial Analysis↗

PubMed1990

Restorative effects of thymosin fraction 5 on reduction in responsiveness of rat thymocytes to allogenic lymphocytes during bladder tumor induction.

One-way MLR was examined by using thymocytes (responder) from Fischer 344/NSIc rats in which urinary bladder cancers were induced by administration of N-butyl-N-(4-hydroxybutyl)nitrosamine [(BBN) CAS: 3817-11-6], and lymph node lymphocytes (stimulator) from WKH/Hkm rats. From the 10th week of the administration, when only hyperplastic change was noticed in the bladder mucosa, progressive decrease of the MLR was detected in the thymus small lymphocyte population (TSLP) and the decrease was the most conspicuous in more dense, namely, intermediate and heavier, small lymphocyte subpopulations. When TSLP was pretreated with TF5 in vitro, the most restorative effects on the decreased MLR were found in hyperplastic stage and the effects were becoming less with the advance of tumor developments. Moreover, in scrutinizing the effects of TF5 on the small lymphocyte subpopulation in hyperplastic stage, the maximal restoration of the responsiveness was found in the heavier subpopulation.

Animals↗

PubMed1990

[Radiotherapy of aged cancer patients].

Although it is not a categorized modality, cancers of aged patients, generally characterized by a slow growth, histologically high differentiation and low radiosensitivity due to co-existing chronic anemia, should have more individualized treatment because there is a wide spectrum of differences in functional reservoir and tolerance dose of each organs and individuals. In aged cervical cancer of the uterus, we decrease the fractionated and total irradiation dose of a whole pelvic cavity by 10%. For patients more than 80 years old, we principally abandon external beam and singularly chose an intracavitary treatment. In our protocol, there could find no significant difference in 5 year survival between 51-70 y.o. 51.9% (120/231) and 71-80 y.o. 57% (61/107), but in the over 80 y.o. group, it was decreased to 13.6% (3/22) by increased death of other diseases 61.9% (13/21) compared with 18.4% (36/195) in 51-80 y.o. In radiotherapy of advanced lung cancer in aged, we decreased fractionated and total dose by 10 to 20% with minimum irradiation field. In non-small cell carcinoma, a median survival time was 11.5 months in both over and under 70 y.o., although the response rate (CR + PR) was resulted relatively low in aged, 33.3% (N = 45), compared with under 70 y.o., 38.4 (N = 146). The degrees of impairment in respiratory and bone marrow function were similar in both groups. Accordingly, we convinced the efficacy and the necessity of individualized radiotherapy for aged cancer patients.

Aged↗

PubMed1990

[Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone].

At Osaka City University Hospital, we performed extracorporeal shock-wave lithotripsy (ESWL) for 1277 patients in a total of 1788 sessions using Dornier kidney lithotripter Model HM III from July, 1985 to the end of December, 1988. Among the patients with a solitary stone, 911 cases were available for the follow-up study and we have compared the results among these cases in respect to the stone location and size. The results obtained were as follows: the ratio of kidney stone to ureter stone was found to be 2.2:1 in male, and 3.8:1 in female patients. This indicates that ureter stones are more frequently found in male than in female patients. In addition, we compared the size of kidney stones found in the patients including 415 male and 243 female patients. Stones larger than 20 mm were more frequently found in female than in male patients. Moreover, a stone composition study of these patients showed that the contents of both phosphate calcium and magnesium ammonium phosphate were higher in female than in male patients. ESWL performed against stones at pelvis and calyces exhibited the best results. The results obtained with the stones less than 20 mm in diameter were especially favorable with a success rate of 100% for the stones less than 10 mm and 83% for the stones 10-20 mm, in diameter, while the results with the stones larger than 20 mm in diameter were rather poor with a success rate of 31%. ESWL performed against ureter stones showed poor results with a success rate of 63% for the stones smaller than 20 mm in diameter.

Calcium Phosphates↗

PubMed1990

[A case of polymyositis associated with unusual CPK isoenzyme pattern and myocardial imaging].

A case of polymyositis (PM) associated with abnormal creatinine phosphokinase (CPK) isoenzyme pattern and Thallium-201 (Tl-201) myocardial imaging was reported. No such case has ever been reported in Japan. A 44-year-old female was admitted for evaluation of muscular weakness of proximal limbs and polyarthralgia. On laboratory examinations, the serum levels of CPK, aldolase and transaminase were markedly elevated. The electromyograms revealed a typical myogenic pattern. On the pathological findings, the principal changes in muscle tissue consisted of inflammatory cell infiltration. Based on those findings, she was diagnosed as having polymyositis. In our patient, there were three characteristics as following; (1) CPK-MB of CPK isoenzyme showed persistent high levels, (2) macro CPK in Electrophoresis of CPK was observed, (3) Tl-201 myocardial imaging revealed multifocal perfusion defects and localized defect in left ventricular inferior wall. She was started on therapy with prednisolone (30 mg/day). The clinical and laboratory manifestations were improved. Abnormal CPK isoenzyme pattern and myocardial imaging were also improved parallel with disease activity of PM. Thus, this case indicated the relation of the damage of skeletal muscle and cardial involvement in PM to unusual CPK isoenzyme pattern. Then wer reported this case.

Adult↗

PubMed1990

[Clinical study of estramustine phosphate disodium (Estracyt) on prostatic cancer--results of long-term therapy for 38 patients with prostatic cancer].

Estramustine phosphate disodium (Estracyt) was used in the treatment of 38 patients with prostatic carcinoma for at least 1 year. Of these patients 37 patients were treated with Estracyt as primary treatment and 1 patient had been treated with another antiandrogenic therapy before the Estracyt treatment. Estracyt was given orally in a dose of 560 mg/day in divided oral doses. The clinical evaluation was done for the change of PAP, the relapse rate, the survival rate and the side effect. Among 22 cases which had shown abnormally high PAP values before the treatment started, the values decreased or normalized in 21 cases (95.5%) in the first year of administration of Estracyt. In 6 cases, however, the values increased again in the second year or later. Relapse was observed in 10 (26.3%) out of 38 cases. Relapse rate was 2.6%, 51.7%, and 51.7%, at the first, third, and fifth year, respectively. Survival rate was 97.4% at the first year, 88.5% at the third year, and 68.8% at the fifth year for the follow-up study. Side effects were observed in 14 (36.8%) out of 38 cases. The main side effect was gynecomastia. Gastro-intestinal disturbance and edema were also observed. However, there were only 2 cases (5.2%) in which administration of Estracyt had to be discontinued.

Adenocarcinoma↗

PubMed1990

[A case of hyperplastic polypoid lesion in the common bile duct hard to differentiate from early bile duct carcinoma].

In a 72-year-old male carcinoma of the bile duct was suspected because of an abnormality on laboratory examination. Ultrasound showed the dilatation of extrabiliary duct. Endoscopic ultrasound revealed localized wall thickening of the common bile duct. ERCP demonstrated the dilatation of the CBD. Within the dilated duct a filling defect was present. Histology of the resected specimen disclosed hyperplasia of the epithelium in the CBD.

Aged↗

PubMed1989

Effects of hyperbaric environment on human auditory middle latency response (MLR) and short latency somatosensory evoked potential (SSEP).

Hyperbaric chamber dives at 19 ATA with helium-oxygen were performed at the Japan Marine Science Technology Center from November 15 to December 3 in 1988 and from January 25 to February 4 in 1989. During simulated underwater experiments, auditory middle latency responses (MLRs) and short latency somatosensory evoked potentials (SSEPs) were recorded in 3 professional divers (2 divers in each dive) for assessment of brain function. During the saturation dive (180 m below sea level) component Pa on MLR was lost, while component Po remarkably increased in amplitude. These MLR changes rapidly recovered between the beginning of decompression and at about 90 m below sea level. On the other hand, N9-N20 interpeak latency on SSEP slightly or moderately increased in the both divers, but N9-N14 interpeak latency was not affected by the 19 ATA saturation dive. These results suggest that the hyperbaric environment corresponding to 180 m below sea level cause some cerebral dysfunctions, probably between the brainstem and the cortex, but these dysfunctions are only transient.

Adult↗

PubMed1989

Correlation of tumor necrosis factor and prostaglandin E2 production of monocytes in bladder cancer patients.

Patients with advanced malignant neoplasms have a variety of abnormal monocyte and lymphocyte functions. The authors examined tumor necrosis factor (TNF) and prostaglandin E2 (PGE2) production of monocytes in 48 patients with bladder cancer and 16 control subjects. Monocytes were isolated from peripheral blood mononuclear cells by adherence to plastic tissue. They were cultured with lipopolysaccharide for 24 hours, and the culture supernatant was obtained. The TNF was measured by enzyme immunoassay using anti-recombinant human TNF antibody, and PGE2 was measured by radioimmunoassay. As a result, in high-stage bladder cancer patients, there was a significant inverse correlation between TNF and PGE2 production of monocytes. However, there was no significant correlation in control subjects and low stage patients. Accordingly, some patients with high-stage bladder cancer had higher TNF production but lower PGE2 production of monocytes, and vice versa.

Carcinoma, Transitional Cell↗

PubMed1989

Anatomical bases of binaural interaction in auditory brain-stem responses from guinea pig.

There is a non-linear interaction of binaural stimulation on auditory brain-stem potentials in both human and animals. The interaction takes the form of the binaurally evoked ABR being of smaller amplitude than the sum of the monaurally evoked ABRs. In the guinea pig this interaction occurs at the time of components P4, N4 and P5. In order to investigate the generator sites of binaural interaction in the ABR, various lesions were made in the brain-stem auditory system in 29 guinea pigs. The effects of those lesions on binaural interaction were as follows: (1) unilateral lesion of lateral lemniscus or bilateral lesions of the inferior colliculi had no significant effect on binaural interaction; (2) transection of the lateral lemnisci bilaterally was associated with a loss of the component of binaural interaction associated in time with N4; (3) a lesion just lateral to the lateral superior olivary complex resulted in an attenuation of the component of binaural interaction associated in time with P4; (4) complete section of the decussating fibers of the trapezoid body or a complete unilateral lesion of the superior olivary complex led to a loss of all components of binaural interaction. These results suggest that binaural interaction in the guinea pig ABR requires the integrity of several distinct portions of the brain-stem auditory pathway, i.e., both lateral lemnisci are required for the interaction occurring at the time of N4; the brain-stem just lateral to the lateral superior olive participates in the interaction at the time of P4. The trapezoid body and superior olivary nucleus are required for binaural interaction at P4, N4 and P5.

Animals↗

PubMed1989

Effect of age on the modification of brain polyunsaturated fatty acids and enzyme activities by fish oil diet in rats.

To determine the effect of age on the modification of brain lipids and functions by fish oil and lard diets, the polyunsaturated fatty acids, phospholipid states and enzyme activities of intracellular organelles in young and aged rats fed these diets were analyzed. The concentration of arachidonic acid (20:4) and docosahexaenoic acid (22:6) tended to decrease with increasing age. The UV absorption of phosphatidylethanolamine (PE) and phosphatidylcholine (PC) also decreased. An increasing effect of the sardine oil diet on brain 22:6 concentration in aged rats was slightly greater than that in young rats. However, the modification of 20:4 concentration in aged rats was similar to that in young rats. Significant increases in the UV absorption of PE and PC of aged rats fed the fish oil diet were observed. The lactate dehydrogenase (LDH) activities of aged rats fed the sardine oil diet increased significantly, whereas the activities of aged rats fed the lard diet decreased. These results suggest that fish oil may be able to regulate the brain lipid composition and LDH activity in aged rats.

Acid Phosphatase↗

PubMed1989

Pancreatic acinar cell tumors in rats induced by 3,2'-dimethyl-4-aminobiphenyl.

Pancreatic acinar cell lesions, including foci, nodules, adenomas and in situ carcinomas, were found in male F344 rats given s.c. injections of 3,2'-dimethyl-4-aminobiphenyl (DMAB) at doses ranging from 50 to 167 mg/kg body weight in two 60-week experiments. The pancreatic lesions induced by DMAB were essentially the same as those reported in rats treated with 4-hydroxyaminoquinoline-1-oxide and azaserine. DMAB at high doses induced pancreas acinar cell as well as fat necrosis, and tumorigenicity for the pancreas was most effective at high necrogenic levels of carcinogen exposure. Mean labeling indices in basophilic foci, acidophilic foci, nodules and adenomas assessed by bromodeoxyuridine incorporation were elevated to approximately 0.69, approximately 2.17, approximately 1.43 and approximately 0.96% respectively, in contrast to the value of 0.39% observed for the surrounding normal acinar cells. The increase was significant in the acidophilic foci and nodules and the fact that these lesions had very high labeling indices suggests that they may have potential for progression to tumors.

Adenoma↗

PubMed1989

Two years clinical experiences with extracorporeal shock-wave lithotripsy and transurethral ureterolithotripsy for ureteral stones at Osaka City University Hospital.

From July 1985 to June 1987, 303 patients with ureteral stones were treated by either extracorporeal shock-wave lithotripsy (ESWL) or transurethral ureterolithotripsy (TUL). The ureteral stones were classified into two groups, upper and lower ureteral stones. The upper ureteral stone was defined as a stone located above the pelvic brim in radiological examinations. ESWL was performed using a Dornier lithotriptor HM-3. For TUL, following the insertion of a guide wire and dilatation of the intramural ureter by ureteral bougie, a ureteroscope was introduced into the ureter. The success rate included both patients who became stone free and patients whose stones were disintegrated into less than 4 mm. The success rate of ESWL for upper ureteral stones was 90%, and 8.5% were treated subsequently by TUL. The success rate of TUL for upper ureteral stones was 42%, and the remaining required another session of TUL or another procedure, mainly ESWL. On the other hand, the success rate of TUL for lower ureteral stones was 71%, and the remainder also required another session of TUL or another procedure, mainly ESWL. The efficacy of TUL for stone street was comparably low by the evaluation done at 5 days after the procedure. However, almost all patients with stone street, which had developed after ESWL treatment, became stone free several weeks after TUL and insertion of a stent catheter. Major complications or side effects for ESWL were fever of more than 37.5 degrees C (7.5%) and pain attacks (8.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗