Search PubMed⌕ Search

Biomedical subjects

T Kinukawa

Publications and source records attributed to T Kinukawa.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Urodynamic findings in patients with a urethral Kock pouch after radical cystectomy].

Urodynamic evaluation was performed in 11 male patients, who underwent radical cystectomy with pelvic lymph node dissection for bladder cancer followed by bladder replacement with a urethral Kock pouch, 3 to 21 months after the operation. Frequency of micturition were 4.9 +/- 1.5 times (mean +/- S.D.) during the day-time and 1.5 +/- 1.2 times during the night-time. Tidal volume of micturition ranged from 300 to 550 ml and residual volume from 10 to 30 ml. Urinary continence was completely preserved in all patients (100%) during the day-time and 8 (72.7%) during the night-time. On pouchmetry, maximum capacity of the pouch was 429.2 +/- 82.4 ml, and intra-pouch pressure was 16.2 +/- 5.4 cmH2O at the capacity of 200 ml and 38.7 +/- 11.5 cmH2O at the maximum capacity. Maximum intra-pouch pressure on voiding was 80.0 +/- 19.4 cmH2O. Uroflowmetry demonstrated intermittent voiding curves in all the patients, with maximum flow rate of 15.2 +/- 6.5 ml/sec, voided volume of 405.9 +/- 80.7 ml and residual rate of 4.5 +/- 2.6%. Maximum intra-urethral pressure at the external urethral sphincter was 28.0 +/- 11.3 cmH2O when the pouch was empty and increased in response to pouch filling up to 64.7 +/- 27.0 cmH2O. Maximum urethral closing pressure and total profile length on the urethral pressure profile were 30.2 +/- 12.4 cmH2O and 20.9 +/- 9.0 mm, respectively, with the pouch empty, and 23.2 +/- 14.5 cmH2O and 20.0 +/- 7.6 mm, respectively, with the pouch full.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Endopyeloureterotomy via transpelvic extraureteral approach].

Endopyelotomy has been established as a valuable procedure to relieve the obstruction of ureteropelvic junction or upper ureteral stenosis. However, in a case with a long stenotic segment and in a case with high insertion type of ureteropelvic junction obstruction, we had often poor results by the conventional technique. To resolve these problems, we developed a new technique of endopyeloureterotomy via transpelvic extraureteral approach. We made an auxiliary incision in renal pelvis or dilated ureter involved with stricture to pass a 22 Fr. urethrotome equipped with a cold knife into the retroperitoneal space. Then we incised a stenotic segment by the knife through the urethrotome until the normal caliber of ureteric lumen was found. A 10-16 Fr. stent was left in place in the incised segment for 3 weeks. We treated 38 patients with ureteropelvic junction stenosis or upper ureteral stenosis by this procedure between August 1988 and June 1990. A total of 39 procedures were performed on 39 ureteropelvic junctions or upper ureters. Original disease were congenital anomalies in 23 patients, strictures secondary to urinary calculi in 12 and postoperative strictures in 4. The length of incision was 2 to 6 cm with the average being 3.2 cm. Postoperative follow-up period ranged 4 to 32 months with the average being 19 months. Obstructive changes disappeared or improved in 37 procedures (95%). In two procedures we failed. Thus this new technique of endopyeloureterotomy might be an useful procedure to relieve ureteropelvic junction stenosis or upper ureteral stenosis with a long stenotic segment or high insertion type of ureteropelvic junction stenosis.

Adolescent↗
PubMed1992

[Nephrectomy from cadaveric donor--new procedure alternative to evisceration technique].

In Japan, it has not accepted that kidneys were harvested from a heart beating cadaveric donor. We usually removed kidneys from a donor after a donor was in cardiac arrest. To minimize warm ischemia, we employed in situ perfusion of kidneys and new procedure alternate to evisceration technique in nephrectomy from a cadaveric donor. Our procedures for the harvest of the kidneys from the cadaveric donor were presented and the clinical result of our series were reported. The kidneys was promptly perfused with chilled Ringer's lactate solution through double balloon catheter placed into the aorta, just after cardiac function ceased. Bilateral nephrectomy was performed through a long midline incision from just beneath the xyphoid bone to the pubic bone. Upon entering the abdomen, the small bowel and mesentery were retracted to the right and the posterior parietal peritoneum was incised over the great vessels and through the ligament of Treitz. The peritoneal incision was extended around the right colon so the bowel can be retracted upward and the right kidney was exposed. Then, the peritoneal incision was performed around the left colon to explore the left kidney. Both ureters were transsected as far down toward the bladder as possible. The in situ perfusion was stopped. Thereafter, the superior mesenteric artery was transsected and the duodenum and the pancreas were retracted upward. The proximal vena cava and aorta were transsected at a 2-3 cm above the level of the left renal vein, and the distal vena cava and aorta at a 5-6 cm an below the level of the left renal vein. The kidneys and the great vessels were removed in en block.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[The evaluation of the effects of bunazosin hydrochloride in the treatment of prostatic hyperplasia].

Thirty-five patients with prostatic hyperplasia were entered into a randomized controlled study using bunazosin hydrochloride(alpha 1-adrenergic blocker). Eighteen patients were allocated to be treated with an initial dose of 1.5 mg/day (group 1) and 17 patients received an initial dose of 3.0 mg/day (group 2). Subjective symptoms and parameters of urodynamic studies were evaluated after 4 weeks and 12 weeks. There were 5 withdrawals or exclusions within 4 weeks and 6 within 12 weeks. Therefore, 15 patients in group 1 and 15 patients in group 2 were eligible for evaluation at 4 weeks, 12 patients in group 1 and 11 patients in group 2 were eligible for evaluation at 12 weeks. The rates of the improvement in subjective symptoms such as retarded urination, protracted urination, weakened urinary stream, abdominal straining on voiding, and sense of residual urine were 40%, 25% in group 1 and 46.7%, 36.4% in group 2, at 4 weeks and at 12 weeks, respectively. The rate of improvement in objective parameters of the urodynamic study such as voiding volume, residual volume, maximum flow rate and average flow rate were 26.7%, 16.7% in group 1 and 26.7%, 20.0% in group 2, at 4 weeks and at 12 weeks, respectively. Thus, these improvements were not correlated with the dosage of drug. Adverse effects such as diarrhea, mild headache, palpitation and gastric disturbance were observed in 2 patients in group 1, and 3 patients in group 2. In the 24 patients treated with the drug over 12 weeks, there were no specific adverse effects due to prolonged administration. These findings showed that bunazosin hydrochloride is beneficial for the treatment of prostatic hyperplasia, and could be safety administered for a prolonged period of time up to 12 weeks.

Adrenergic alpha-Antagonists↗
PubMed1992

[Clinical evaluation of usefulness of cefixime (200 mg administered once daily) in the treatment of acute uncomplicated cystitis].

A comparative study of cefixime (CFIX), a new oral cephem antibiotic, was carried out at the Department of Urology, Nagoya University Hospital and its four affiliated hospitals to evaluate the clinical efficacy and safety of two dosage regimens of CFIX, given either in twice daily doses (BID group) or once daily dose (UID group), in the treatment of acute uncomplicated cystitis. Forty six female patients (BID group) were administered the daily dose of 200 mg in two divided doses for 3 days, 30 female patients (UID group) were administered 200 mg once daily for 3 days. The clinical efficacy was evaluated in 33 cases from the BID group and in 22 cases from the UID group, respectively, according to the criteria recommended by the Japan UTI Committee. In the BID group, the clinical efficacy was evaluated as excellent in 18 cases, moderate in 13 and poor in 2, with an overall clinical effectiveness rate of 94%. In the UID group, it was evaluated as excellent in 9 cases, moderate in 12 and poor in 1, with an overall clinical effectiveness rate of 96%. Safety was monitored in 71 patients, and only one case of stomatitis was seen in the UID group. This findings suggest that 200 mg once daily dosing regimen of cefixime is as effective as 100 mg twice daily dosing regimen in treatment of acute uncomplicated cystitis, and is well tolerated in terms of safety.

Acute Disease↗
PubMed1992

[A case of ureteral complication following endopyelotomy].

A case of ureteral complication observed after endopyelotomy is reported. A 19-year-old female patient suffering from right hydronephrosis due to uretero pelvic junction stenosis was treated with endopyelotomy. The stenotic ureter was incised by cold knife for a distance of 5 cm through full thickness. The cut ureteral segment was intubated with a ureteral stent catheter of 10 Fr calibre. The top of the catheter was advanced 1 cm from the edge of the incised ureter. To prevent protrusion of the catheter tip, a flexible guide wire 0.038 inches in diameter was inserted into the catheter and the tip of the guide wire was advanced to the bladder. Antegrade pyelography performed 3 weeks after the operation revealed a lesion resembling a pseudo-ureter. It was made by the catheter that had slipped out of the incised ureter. The lumen of the true ureter was also preserved without stenosis. After removal of the stent catheter and safety guide wire, the true ureter was intubated with a double J catheter of 10 Fr calibre. One week later the pseudo-ureter was not demonstrated by excretory urography performed. Finally, hydronephrosis due to uretero pelvic junction stenosis was treated successfully.

Adult↗
PubMed1991

[The evaluation of cystoscopy in the screening of asymptomatic microhematuria].

As a prospective study on asymptomatic microhematuria, complete urological examinations including cystoscopy, IVP, ultrasound and urinary cytology were performed on 422 patients over 40 years old between January 1987 and December 1988 (group A). The results of group A was compared with that of retrospective study on 266 patients, who had incomplete urological examination between January 1984 and December 1985 (group B). Cystoscopy was performed on 321 patients (87.2%) in group A and on 108 patients (40.6%) in group B. Bladder tumor was found in 10 cases (2.4%) in group A, including 7 cases of male patients (5.7%), but in only 1 case (0.4%) in group B. Since the negative rate of abnormal urinary cytology was 50% and that of abnormal IVP was 90% in 10 cases of bladder tumor in group A, cystoscopy was considered to be an essential examination for the screening of patients with asymptomatic microhematuria over 40 years old patients.

Adult↗
PubMed1991

[Treatment with percutaneous nephrolithotripsy and dissolution for bilateral renal cystine calculi in an infant].

A 20-month-old child was admitted to our hospital due to obstructive renal failure caused by cystine calculi. After recovering from the renal failure by bilateral percutaneous nephrostomy, pelvic irrigation with N-acetylcysteine was performed using a 12Fr. flexible double lumen catheter. In 2 weeks the calculus was reduced by 39% in size, then residual calculi were successfully removed by percutaneous nephrolithotripsy using 11.5Fr. rigid ureteroscope and postoperative irrigation with N-acetylcysteine.

Acetylcysteine↗
PubMed1990

An outlet obstruction caused by V-shaped bar at the bladder neck in a woman.

A case of outlet obstruction caused by a V-shaped bar at the bladder neck in a woman was treated successfully by transurethral resection of the bar. The poor urinary flow in our patient was believed to be due to impedance during voiding caused by retraction of the bladder neck in the anteroposterior direction by the bar. Our case is different from previously reported cases.

Cystoscopy↗
PubMed1990

Primary malignant lymphoma of the urinary bladder. A case report.

A patient with primary malignant lymphoma of the urinary bladder is presented. Grossly, the bladder showed multiple submucosal masses. Histologically and immunohistochemically, diffuse B-cell lymphoma of the medium-sized cell type was revealed. On the basis of clinicopathological features, the present case resembled previously recorded cases of bladder lymphoma. The pathogenesis of this primary bladder lymphoma was presumably associated with follicular or chronic cystitis. Primary lymphoma of the bladder is a condition that is very rarely included in series of extranodal lymphomas, and there is a curious sex difference in its occurrence rates between Japan and Western countries. Primary lymphoma of the bladder may be considered a lymphoma that originates fro mucosa-associated lymphoid tissue.

Antibodies, Monoclonal↗
PubMed1990

[Thoracic duct drainage pretreatment in living related kidney transplantation--long-term results of low dose steroid and azathioprine immunosuppression].

The long term results of 28 HLA 1-haploidentical donor kidney transplant recipients receiving preoperative lymphocyte deletion through thoracic duct drainage and low dose of steroid and azathioprine immunosuppressive treatment were presented. The number of removed lymphocytes was 129.9 +/- 38.1 x 10(9) (mean +/- SD) and the duration of thoracic duct drainage pretreatment was 35 +/- 4 days. Graft survival was 96% at 3 months through 2 years, 89% at 3 years and 84% at 5 years. Patient survival was 100% at 3 months through 2 years and 96% at 3 years through 5 years. Fifteen acute rejection crises were observed in 13 patients within the first 3 months postoperatively. There was no irreversible rejection in the first 3 months. Four chronic rejections were observed in 4 patients. Life-threatening infectious disease was observed in 5 patients, diabetes mellitus in 2 and cataract in 4. These results indicated that the reduction of the dose of steroid in post transplant period might have beneficial effects on the long term graft survival of HLA 1-haploidentical kidney transplant patients receiving TDD pretreatment and the conventional immunosuppressive treatment.

Adolescent↗
PubMed1990

[Thoracic duct drainage pretreatment and low dose cyclosporine and low dose steroid immunosuppressive treatment in living related kidney transplantation].

The results of 20 HLA 1-haploidentical donor kidney transplant patients treated with preoperative lymphocyte deletion through thoracic duct drainage and low dose of cyclosporine and steroid immunosuppressive therapy, were presented. The number of removed lymphocytes was 114 +/- 36 X 10(9) (mean +/- SD) and the duration of thoracic duct drainage was 35 +/- 7 days. Graft survival was 100% at 3-9 months and 89% at 1-2 years after transplantation. Patient survival was 100% at 3-9 months and 89% at 1-2 years. A patient died from lung cancer (adenocarcinoma) in the 9th posttransplant month. Acute rejection was not seen in 20 patients during the first 3 months. Life-threatening infectious disease was never seen either. Diabetes mellitus was observed in 1 patient. No other complications were observed. These results indicated that thoracic duct drainage and low dose cyclosporine and steroid postoperative immunosuppressive treatment might yield complete success in HLA 1-haploidentical kidney transplant patients.

Cyclosporins↗
PubMed1990

[Clinical importance of microhematuria as an initial sign of bladder tumor].

To investigate the role of microhematuria for the diagnosis of bladder tumor, the retrospective study of 156 patients with bladder tumor was done. Among the 156 cases, asymptomatic microhematuria was observed in 15 cases (9.6%) as an initial sign of the disease. According to the process to the final diagnosis, these 15 cases were classified into 4 groups; the Group 1 comprised 4 patients who consulted the urologist just after health examination; the Group 2 comprised 6 patients who consulted the urologist by the introduction of the general practitioner; the Group 3 comprised 2 patients who disregarded the sign and consulted the urologist after the appearance of symptoms; the Group 4 comprised 3 patients whose general practitioner overlooked the sign and who consulted the urologist after the appearance of the symptoms. The mean duration between the initial sign and the final diagnosis of each group was 2, 2, 8 and 62 months, respectively. Three of the 5 patients (60%) in groups 3 and 4 were treated by total cystectomy, while only 2 of the 10 patients (20%) in groups 1 and 2 totally cystectomized. High grade tumor was observed more frequently in groups 3 and 4 than in groups 1 and 2. Since the negative rate of urinary cytologic examinations of these 15 cases was 33.3%, cystoscopic examination was necessary for screening of bladder tumor.

Adult↗
PubMed1990

[Treatment of condyloma acuminata using human lymphoblastoid interferon].

Eighteen cases of condyloma acuminata were treated by human lymphoblastoid interferon (HLBI). Seventeen were male and one was female. Five cases were recurrent cases. Except one patient, all the patients were administered HLBI by intralesional injection. Five patients were treated by single injection. Others were given 2 to 8 injections during one to 5 weeks. Total dose varied from 3 x 10(6) to 24 x 10(6) U. Of the eighteen patients, 6 showed a complete response and 3 a partial response (greater than 50% reduction in size of the lesion). In 5 of the 11 patients (45%) who were treated with a total dosage of more than 12 x 10(6) U, the lesion was completely cleared. Six patients who showed a complete response did not experience recurrent disease during the 6-month follow-up period. In conclusion, intralesional administration of HLBI for condyloma acuminata proved to be effective.

Adolescent↗
PubMed1989

Long-term results of transurethral lithotripsy with the rigid ureteroscope: injury of intramural ureter.

We treated 208 patients with ureteral calculi via transurethral lithotripsy using the rigid ureteroscope between March 1985 and April 1988. A total of 220 ureteroscopic procedures was performed in 217 ureters. Complete removal was achieved after 180 procedures (81.8%) and incomplete removal was achieved after 9 (4.1%). In 31 cases (14.1%) the stone could not be removed because of various reasons. Ureteral disruption was observed in 1 case (0.5%), which was treated successfully with reconstruction. Ureteral perforation occurred in 15 cases (6.8%) and was treated successfully except for 1 patient (0.5%) in whom ureteral stricture was observed requiring reconstruction. From long-term followup of sequential excretory urography and voiding cystography, mild stricture at the vesical end of the ureter was noted in 3 of 86 ureters (3.5%) and vesicoureteral reflux was noted in 7 of 73 (9.6%). These results indicate that the injury to the intramural ureter might arise from the passage of the ureteroscope resulting in stricture and vesicoureteral reflux.

Adolescent↗
PubMed1989

[Reconstructive surgery of obstructive disease of the upper urinary tract].

Efficacy of reconstructive surgery for the obstructive disease of the upper urinary tract was evaluated. Reconstructive surgery was performed in 75 units of the urinary drainage system of 72 patients between July, 1977 and December, 1987. 44 patients were male and 28 were female. The patients ranged in age 1 to 71, mean +/- S.D. being 43 +/- 14 years old. Original diseases were postoperative scar, scar due to the calculi, injury, retroperitoneal fibrosis, ureteritis, tuberculosis, amyloidosis and multiple ureteral diverticulum. The surgery consisted of ureterocalicostomy, renal descensus, descent of right renal vein, uretero-ureterostomy, ureteroneocystostomy (to the dome of the bladder), psoas bladder hitch and renal autotransplantation. Renal autotransplantation was chosen instead of ileal substitution to preserve the continuity of the urinary drainage system, when the upper urinary tract was extensively damaged. The obstructive change of the upper urinary tract improved or disappeared in 66 of 75 units. However, it persisted in 9 units, which were treated with ureterocalicostomy (wrong technics; in 4 units), ureteroureterostomy (wrong choice of the procedure; in 4 units) and autotransplantation (cessation of anti tbc drugs; in 1 unit). In 3 of these 9 units, additional reconstructive surgery was necessary. One patient who was treated with autotransplantation, died of massive bleeding from rupture of arterial anastomosis on 14th postoperative day. No other life-threatening complications were observed. Deterioration of the renal function was observed in two severely damaged kidneys which were performed autotransplantation, although the obstructive change of their urinary tract completely disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Renal autotransplantation and extra-corporeal surgery].

Renal autotransplantation with/without extra-corporeal surgery was performed in 53 patients between September, 1975 and december, 1987. Original disease was obstructive disease of the upper urinary tract in 25 patients, renovascular hypertension and renal vascular disease in 13, renal calculous disease in 12 and renal cell carcinoma in 3. Ten of the 53 patients had solitary kidneys. Three patients died on 14, 21 and 49 postoperative days of massive bleeding with disseminated intravascular coagulopathy caused by the rupture of transplant arterial anastomosis (1 patient with urinary obstructive disease) and sepsis caused by wound infection (2 patients with renal calculous disease). Two kidneys were removed on operative day and 8 postoperative days due to arterial thrombosis in 2 patients with aneurysm of intrarenal artery. The deterioration of renal function was observed in previously damaged kidneys of two patients with extensively damaged ureter. No other severe complications were observed. In 23 of 24 patients with the obstructive disease of the upper urinary tract, disappearance or improvement of the obstructive change was observed after surgery. All 5 patients with renovascular hypertension showed normo-tension without administration of antihypertensive drugs after surgery. In 3 of 5 patients with an aneurysm of the intrarenal artery, the aneurysm was removed and reconstruction of the artery was performed successfully. Two patients with arterio-venous fistula and one patient with nut cracker syndrome had no severe hematuria with bladder tamponade after surgery. Ten of 12 patients with renal calculous disease were treated successfully without residual calculi by this procedure. Three patients who had solitary kidney with renal cell carcinoma were treated successfully by this procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗