Biomedical subjects
Publications and source records attributed to Y Baba.
We performed ureteroplasty for megaureter by ureteral plication with ease in two cases with unilateral megaureter due to uretero-vesical stenosis and obtained good results in each case. Because ureteral plication theoretically preserves lower ureteral blood supply and eliminates suture line leakage, this technique is thought to be superior to excisional tapering techniques in ureteroplasty for a megaureter.
Unilateral absence of the vas deferens is frequently associated with ipsilateral anomalies of the urinary tract. A case of congenital absence of the vas deferens on the right side was associated with retrocaval ureter in a 30-year-old male. He was married and sterile for two years. On scrotal exploration, both testicles were normal but the vas deferens and the body and the tail of the epididymis on the right side were absent. The tail of epididymis on the left side was obstructed. Therefore, we performed a vaso-epididymostomy on the left side and anastomosed an artificial spermatocele on the body of the right-sided epididymis. The diagnosis of retrocaval ureter was confirmed by the intravenous pyelography and the retrograde pyelography.
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To estimate a reasonable and convenient method for the assessment of daily energy expenditure in workers, the validity of a calorie counter combined with an accelerometer (Kenz Calorie Counter) was tested during treadmill exercise. Ten male and female students each volunteered for exercise on a treadmill at different running speeds: 9 speeds at 2 to 10 km/h each for male subjects: 8 speeds at 2 to 9 km/h each for female subjects. Energy expenditure measured with respiratory gas analysis was compared with that estimated by the calorie counter outfitted on the waist of the subjects. For running speed slower than 9 km/h, the work intensity reading on the calorie counter increased in direct proportion to the speed of the treadmill. The correlation between running speed and the work intensity reading of the calorie counter was linear up to 8 km/h (y = 0.95 x -0.2, r = 0.96, P less than 0.001). A linear relationship during treadmill exercise (at a speed of less than 9 km/h) was also established between energy consumption measured by respiratory gas analysis and that estimated from the calorie counter (y = 1.00 x + 11.7, r = 0.94, P less than 0.001). Thus, we validated the usefulness of the calorie counter for the assessment of energy expenditure during daily physical activities.
Of 170 patients having undergone orchiopexy for unilateral cryptorchid testes, 90 responded to our inquiry. Testicular size was measured in 55 patients using an accurate and practical orchiometer (punched-out orchiometer) developed in our department. In boys under ten years of age (prepubertal), testicular development was minimal, and the operated on and contralateral testes were not significantly different. With the onset of puberty, both testes enlarged, and no significant differences were observed. However, by age fourteen the side operated on was significantly (p less than 0.05) less well developed than the contralateral testis. No difference was detected clinically between the operated on and contralateral testes when the contralateral testis was less than 10 mL in volume. When the contralateral testis was greater than 15 mL, however, a significant difference was detected both statistically (p less than 0.05) and clinically. The findings suggest limited prospects for the development of testes that are operated on at puberty.
Between 1978 and 1987, 30 cases of invasive thymomas were treated with radiotherapy after surgery. Surgical therapy consisted of total resection in 15 patients, subtotal resection in 1 patient, and biopsy in 14 patients. Myasthenia gravis (MG) was associated in nine patients (MG(+) group), but in 21 patients there was no evidence of myasthenia gravis (MG(-) group). Irradiation in the dose range of 30 to 58.7 Gy was delivered. The total average 5-year survival rate was 71.8%; it was 39.2% in MG(+) group and 78.3% in MG(-) group, though there was no significant statistical difference. Myasthenia gravis was well controlled by the tumorectomy and associated radiotherapy in 7 of the 9 patients. However, in 3 of 7 patients (42.9%) myasthenia gravis recurred at 2 years, 2 years and 7 months, and 5 years and 8 months after initial therapy. Total body irradiation of 2 Gy with 0.1 Gy fractions was administered for uncontrollable myasthenia gravis in one patient with marked improvement. Radiation therapy is an important therapeutic modality for unresectable malignant thymoma as well as for postoperative combined therapy. Total body irradiation may be an effective method to treat patients with otherwise resistant myasthenia gravis.
To establish an easy and convenient method for assessing the daily physical activity of workers, validity of a calorie counter combined with an accelerometer (KENZ Calorie Counter) was tested and compared with the method of daily survey and Stanford's interview method for energy consumption of daily physical activity. The subjects of this study were 92 volunteers. Energy expenditure of daily physical activity during 3-4 d was measured in 20 volunteers by means of a calorie counter, and the daily energy consumption was calculated from relative metabolic rates of physical activity. In the remaining 72 volunteers the energy consumption over 4-7 d was measured by means of a calorie counter and calculated from the Stanford's interview method. Correlation of the energy expenditure of daily physical activity measured by calorie counter (y) and that calculated from daily survey (x) was y = 0.74 x + 473 (r = 0.91, n = 56). Correlation of the calorie expenditure over 4-7 d measured by the calorie counter (y) and that predicted by Stanford's interview method (x) was high (y = 0.65 x + 3513, r = 0.86, n = 72). Relationship between the energy expenditure measured by the calorie counter (y) and that calculated by both daily survey and Stanford's interview method (x) showed a high correlation (y = 0.84 x + 518, r = 0.98, n = 128). These results suggest that a calorie counter combined with an accelerometer is valid for assessing the daily physical activity of workers.
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Neuro-psychiatric complications of primary Sjögren's syndrome (SjS) were studied on their frequency and characteristics of clinical signs in 150 patients of our clinic. Clinical symptoms and laboratory examinations were compared in the patients group complicated with neuro-psychiatric symptoms and the non-complicated group. Neuro-psychiatric symptoms (neuro SjS) were complicated with 63 patients (42.0%). Central nervous system (CNS) involvement were occurred in 47 patients (31.3%). In this group (CNS SjS), psychiatric complications were observed in 43 patients (28.7%), consisted with 29 cases of neurosis, 7 cases of depression, 6 cases of presenile dementia, and others. Nine patients (6.0%) in this group had neurologic involvement that were 3 cases of aseptic meningitis, 3 cases of neurogenic bladder, and each case of multiple infarction, multiple sclerosis, and others. These 9 patients showed more frequently positive results for rheumatoid factor, anti-SSA antibody, leucopenia, and lymphopenia, so this subgroup might be consisted of a small group which was resemble to systemic lupus erythematosus. Cranial nerve involvement, mainly injured in trigeminal nerve, and peripheral nerve involvement were complicated with 5 patients (3.3%) and 24 patients (16.0%), respectively. In neuro-psychiatric complicated group, mean age was older and dry mouth were more frequent (p less than 0.05) than non-complicated group. In psychiatric complicated group, mean age was older (p less than 0.01) and dry mouth were more frequent (p less than 0.05). In any groups of neuro-psychiatric complications, the frequency of any autoantibodies was not statistically different from non-complicated group. But, in the group of cranial nerve involvement, anti-RNP antibody was 60.0% positive (in non-complicated group, 17.2%: p less than 0.05). In CNS SjS group, magnetic resonance imaging (MRI) abnormalities were occurred in 8 of 13 patients. High intensity lesions in white matter on the T2-weighted examinations was characteristic, which showed lacnar infarctions or demyelinated lesions in MRI abnormalities. In CNS SjS, corticosteroid or immunosuppressant was not always necessary, because this complication was self-limited or enough controlled by minor-tranquilizer or anti-depressant. The character of onset in neuro SjS was chronic and neuro SjS was insidiously developing disease. And more studies including treatment on neuro SjS were needed.
We experienced a case of a 44 year old man who had ingested potassium bromate solution for suicide attempt. Soon after the ingestion, nausea, vomiting, abdominal pain and diarrhea developed in him. Several hours later, he began to complain of auditory disturbance and, in addition, anuric acute renal failure occurred. Direct hemoperfusion and hemodialysis was performed on the patient for the treatment purpose. Five weeks later, he was released from hemodialysis procedure. Gradually, on the other hand, progressing anemia was observed until 90th hospital day, which slowly improved thereafter. Further, pruritus, lower leg pain, headache, tinnitus and loss of sense of taste, etc. were observed in the clinical course. Renal biopsy was performed on the 119th hospital day and the specimen showed the regenerative stage of acute tubular necrosis. In our case, acute renal failure was reversible and, many other clinical manifestations were observed. However slight anemia and irreversible severe auditory disturbance remained unimproved.
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Healthy worker effect (HWE), which can be described as a lower death rate within a work force when compared to the general population, has been observed in many epidemiological mortality studies on industrial work populations free of significant life-shortening hazards. The purpose of this report is to evaluate this effect on the active work populations engaged in large scale manufacturing companies in Japan, and to appreciate the possible attributable factors to this phenomenon. Standardized mortality ratios (SMRs) were calculated for workers in the member companies of The Japan Iron and Steel Federation (JISF) and The Japan Chemical Fibers and Textile Association (JCFTA), where mortality surveillance systems have been established. SMRs for all causes of death from 1969 to 1981 were within the range of 50 to 81 in JISF, and 34 to 41 in JCFTA. These results point to the existence of strong HWE, equal to or even lower than the reported values in some industrial populations in the United States. An evident HWE for cancer was also observed in the study populations, but it was reported to be of little significance, if at all, in the United States. HWE can be considered as a composite result of factors such as: (1) selection of healthier work force, (2) risk reduction due to life style modification during employment, and (3) methodological characteristics of the SMR, which are dependent on the percentage of active workers.(ABSTRACT TRUNCATED AT 250 WORDS)
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We studied the airway responsiveness of asthmatic and normal children to ultrasonic nebulized distilled water (UNDW inhalation test). It was found that this stimulus induced a fall in FEV1 (forced expiratory volume in 1 s) in asthmatic children, but little fall in normal children. This airway response was shown to be reproducible at about 2-week intervals. The more severe the asthma, the higher the percentage of the responders to the UNDW inhalation test, and the greater the fall in FEV1. The results of the UNDW inhalation test did not correlate with that of acetylcholine inhalation test or of exercise-induced asthma (EIA). UNDW-induced bronchoconstriction was inhibited by premedication with disodium cromoglycate (DSCG) (20 mg) or inhaled ipratropium bromide (40 micrograms). Jet-nebulized distilled water induced little fall in FEV1 in asthmatic children. These data suggest that UNDW-induced bronchoconstriction may involve the release of chemical mediators from the mast cells and cholinergic pathways. We conclude that UNDW inhalation test is a safe, less burdensome, and rather convenient method to evaluate clinically nonspecific airway hyperresponsiveness in asthmatic children.
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We report here a patient with acute lymphoblastic leukemia (ALL) in whom hypofibrinogenemia developed during chemotherapy. The patient was a 65-year-old female who was diagnosed as having common ALL, and she was treated with BHAC-DMPV (enocitabine: 160 mg, daunorubicin : 40 mg, 6-MP: 35 mg, prednisolone (PSL): 60 mg, and vincristine: 2 mg). Hypofibrinogenemia appeared promptly each chemotherapy, including PSL was given. To ascertain a correlation between hypofibrinogenemia and the drugs given in this patient, a trial administration of PSL was attempted during a complete remission state. The level of fibrinogen, in terms of the amount of antigen or coagulability, decreased during PSL treatment, although the levels of AT III, plasminogen, alpha 2PI.Plm complex, and FDP did not change. Thus, it is difficult to speculate that PSL induced destruction of leukemia cells and release of protease from the cells resulting in fibrinolysis and hypofibrinogenemia in this case. These findings also suggest that the administration of only PSL could induce hypofibrinogenemia.
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