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Biomedical subjects

Y Katayama

Publications and source records attributed to Y Katayama.

At least 433 records · Page 24Linked to original sources
PubMed1994

Chronic motor cortex stimulation for central deafferentation pain: experience with bulbar pain secondary to Wallenberg syndrome.

Six patients with bulbar pain caused by lateral medullary infarct were treated by stimulation therapy. Dysesthesia on the opposite side of the body was subjected to stimulation therapy in these patients. Of the subjects, 4 underwent thalamic stimulation and 3 were treated by motor cortex stimulation; the effects of both thalamic and motor cortex stimulation were investigated in 1 patient. No satisfactory pain control was obtained by thalamic stimulation in any of the patients in this series. In contrast, 2 of the 3 patients treated by motor cortex stimulation reported satisfactory pain control. The pain inhibition usually occurred at intensities below the threshold for the production of muscle contraction (pulse duration, 0.1-0.5 ms; intensity, 3-8 V). This finding was consistent with our previous observations made in a series of patients with thalamic pain, indicating that motor cortex stimulation is significantly more useful than thalamic stimulation for controlling deafferentation pain secondary to central nervous system lesions. We discuss the possibility that better control of deafferentation pain may be provided by stimulation at a level more rostral to the site of deafferentation.

Adult↗
PubMed1994

Changes in urinary excretion of endothelin-1-like immunoreactivity before and after unilateral nephrectomy in humans. Comparison with other urinary parameters and unilateral adrenalectomy.

To assess the value of endothelin-1 (ET-1) as a parameter of renal functional overload and the process of hyperfiltration, urinary excretion of ET-1-like immunoreactivity (U-ET-1) and urinary excretion of other parameters [beta 2-microglobulin (beta 2-MG), N-acetyl-beta-D-glucosaminidase (NAG), albumin (Alb) and 24-hour creatinine clearance (Ccr24)] were measured before, 1, 2 and 7 days after unilateral nephrectomy in 15 patients with unilateral renal lesions (renal cell cancer, renal pelvic cancer, ureteral cancer and renal tuberculosis) and after unilateral adrenalectomy in 5 patients with adrenal lesions. In the nephrectomy group (NX), Ccr24 significantly decreased at 1 and 2 days after the operation, but the other 4 parameters significantly increased after the operation as compared to preoperative values. In the adrenalectomy group (ADX), neither Ccr24 nor ET-1/Cr showed any change after the operation, but the other 3 parameters (beta 2-MG/Cr, NAG/Cr and Alb/Cr) significantly increased. Comparing the NX and ADX groups, both ET-1/Cr and beta 2-MG/Cr in NX were significantly higher than in ADX after the operation. On the other hand, neither NAG/Cr nor Alb/Cr in NX differed from values in ADX. Comparing ET-1/Cr and other parameters, only beta 2-MG showed a positive significant correlation. These results suggest that U-ET-1 may be an indicator of functional overload of the kidney.

Acetylglucosaminidase↗
PubMed1994

Dissociation of selective renal venous plasma endothelin-1 activity and corresponding plasma renin activity in a patient with hypertension, severe stenosis of unilateral renal artery and ipsilaterally decreased renal function.

Plasma endothelin-1 (ET-1)-like immunoreactivity in selective renal venous blood and peripheral venous blood was measured and compared with plasma renin activity and aldosterone level in a 26-year-old woman with suspected renovascular hypertension due to stenosis of the left renal artery. Although there was no significant step-up in plasma renin activity between the right and the left renal vein, left/right ratio of plasma ET-1 in the renal vein was 2.18. This case suggests that ET-1 may be one of the hypertensive mechanisms of suspected renovascular hypertension in addition to the renin-angiotensin system.

Adult↗
PubMed1994

Incidence of pouch stones and risk factors for urolithiasis in patients with continent urinary diversion or neobladder using intestine.

Urinary risk factors and inhibiting factors for urolithiasis, such as oxalate, calcium, phosphate, uric acid, citrate, and magnesium, were examined in 12 patients receiving continent urinary diversion, neobladder, or augmentation cystoplasty using intestine. These data were compared with the incidence of pouch stone formation. Ten (83.3%) of 12 patients had at least one risk factor, and 5 (41.7%) of 12 had two or more risk factors. Pouch stone developed in 4 (80%) of 5 patients with two or more risk factors, and in none of 7 patients with one or zero risk factors. The incidence of pouch stone in the former group was significantly higher than in the latter group. These results suggest that urinary reservoir operations should not be performed in patients with two or more risk factors for urolithiasis.

Female↗
PubMed1994

Value of dimercaptosuccinic acid single photon emission computed tomography and magnetic resonance imaging in detecting renal injury in pediatric patients with vesicoureteral reflux. Comparison with dimercaptosuccinic acid planar scintigraphy and intravenous pyelography.

The value of 99mTc-dimercaptosuccinic acid (DMSA) planar renal scintigraphy, DMSA single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) in the assessment of renal injury related to vesicoureteral reflux (VUR) was examined in 60 kidneys of 32 pediatric patients (28 bilateral, 4 unilateral) with primary VUR. The results were: (1) detection of minor renal lesions was best with MRI, then DMSA-planar and DMSA-SPECT, and (2) in comparing the positive rate, DMSA-SPECT (85%) and MRI (83.3%) were superior to intravenous pyelography (55%) and DMSA-planar scintigraphy (65%). These results suggest that DMSA-SPECT or MRI may be more sensitive than DMSA-planar scintigraphy and intravenous pyelography in detecting renal injury related to VUR in pediatric patients.

Child↗
PubMed1994

Measurement of urinary endothelin-1-like immunoreactivity and comparison with other urinary parameters in patients with primary vesicoureteral reflux. A preliminary report.

By using a radioimmunoassay specific for endothelin-1 (ET-1), we measured urinary excretion of ET-1-like immunoreactivity in 63 spot urine samples of 48 patients with primary vesicoureteral reflux (VUR). Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG), beta 2-microglobulin (beta 2-MG), microalbumin (Alb), and creatinine (Cr) were also measured. There was no significant correlation in any pairs of ET-1 and NAG, ET-1 and beta 2-MG or ET-1 and Alb. In patients with grade 2, grade 3, and grade 4 VUR, urinary ET-1/Cr was significantly higher than normal (p < 0.05). Comparing the grade of reflux according to the International Classification with urinary ET-1/Cr, the ratio of more than normal urinary ET-1/Cr increased in proportion to the grade of reflux, but it conversely decreased in grade 5. In conclusion, urinary ET-1 may be an indicator of distal renal tubular or collecting duct injury in patients with primary VUR.

Acetylglucosaminidase↗
PubMed1994

A case of 17 alpha-hydroxylase deficiency with retained menstruation.

A patient with 17 alpha-hydroxylase deficiency (17OHD) who continued to menstruate is reported. A 24-year-old woman who presented with hypertension, hypokalemia and irregular menses had increased plasma ACTH and mineralocorticoids without any increase in glucocorticoids or sex steroids, and a bilateral adrenal enlargement on abdominal X-ray CT. ACTH stimulation test revealed hyperresponse of the metabolites of the mineralocorticoid pathway and blunted or absent response of those of the glucocorticoid and androgen pathway. Almost all of the abnormalities disappeared after dexamethasone administration. While 17OHD is usually known to accompany hypergonadotropic hypogonadism, the patient continued to menstruate, though irregularly. Although human chorionic gonadotropin administration failed to induce response, basal plasma levels of ovarian steroid (estradiol) and gonadotropins as well as response to LHRH stimulation test were all normal. Thus, the clinical and biochemical features of this case is compatible with the partial deficiency of both adrenals and ovaries, being less severe in the latter. A further analysis especially at molecular level is needed to elucidate the basis for the heterogeneity of this disorder.

Adrenal Hyperplasia, Congenital↗
PubMed1994

Persistent absence of auditory brainstem responses with preserved hearing and recovery from a prolonged comatose state.

A patient with hypertensive intracerebellar haemorrhage, who recovered from impending tonsillar herniation with emergency haematoma evacuation, showed persistent absence of auditory brainstem responses. The patient demonstrated a preserved stapedius reflex and hearing after recovery, indicating that the auditory brainstem pathway was not completely disrupted. We suggest that the loss of the auditory brainstem response (ABR) could be accounted for by impulse asynchrony along the auditory brainstem pathway. The existence of such a case implies that persistent absence of the ABR is not always indicative of irreversible brainstem damage and a poor outcome following severe brain injury.

Brain Damage, Chronic↗
PubMed1994

Surgical management of cavernous malformations of the third ventricle.

In order to determine adequate therapeutic approaches for cavernous malformations of the third ventricle, the authors reviewed a series of five such malformations managed at their institution and nine others reported in the literature. Four subgroups were identified in terms of the site of origin and could be characterized by different clinical manifestations: visual field defects and endocrine function deficits in patients with malformations in the suprachiasmatic region (six cases); symptoms caused by hydrocephalus in those with malformations in the foramen of Monro region (five cases); and deficits of short-term memory in those with malformations in the lateral wall (two cases) or of the floor of the third ventricle (one case). Unlike cavernous malformations at other locations, malformations of the third ventricle frequently demonstrated rapid growth (43%) and mass effects (71%). The surgical or autopsy findings suggested that the growth was attributable to repeated intralesional hemorrhages. Extralesional hemorrhage was also not uncommon, occurring in 29% of patients. Such tendencies require the adoption of a more aggressive approach to this particular group of cavernous malformations as compared to those in other locations. The risks of regrowth and extralesional hemorrhage appear to be reduced only by complete excision. The surgical approaches adopted should be aimed at providing the best access to the site where the malformation has arisen. The translamina terminalis approach for cavernous malformations in the suprachiasmatic region, the transventricular or transcallosal interfornicial approaches for those in the foramen of Monro region and the transvelum interpositum approach for those in the lateral wall or the floor of the third ventricle appear to be appropriate. In order to select the adequate surgical approach, precise diagnosis of the site of origin is crucial. In addition to neuroimaging techniques, the patient's initial symptoms provide valuable information.

Adult↗
PubMed1994

Continuous monitoring of jugular bulb oxygen saturation as a measure of the shunt flow of cerebral arteriovenous malformations.

Jugular bulb oxygen saturation (SjO2) was monitored during preoperative embolization procedures in a consecutive series of 15 patients with large supratentorial arteriovenous malformations (AVM's) in order to test the hypothesis that changes in the shunt flow ratio can be continuously evaluated from the SjO2. A fiberoptic catheter was placed at the dominant jugular bulb. The SjO2 measured using jugular blood withdrawn before embolization was significantly higher than the SjO2 measured at the end of the final embolization procedure (mean +/- standard deviation 84.1% +/- 12.7% vs. 74.2% +/- 10.9%, p < 0.0001), showing a positive correlation with the AVM volume (r = 0.66, p < 0.001). Continuous monitoring of SjO2 via the fiberoptic catheter revealed a progressive decrease in association with the embolization procedures. Microsurgical resection of the AVM was performed at 1 to 2 weeks after the final embolization. Cases in which postoperative hemispheric deformation was revealed on computerized tomography demonstrated a higher SjO2 at the end of embolization compared to that in the remaining cases (81.6% +/- 8.6% vs. 67.8% +/- 8.4%, p < 0.008). Hemispheric deformation was observed in all cases in which the SjO2 did not decline to a level below 90% following embolization. The risk of severe hyperemic complications appeared to be greatly diminished when the SjO2 fell to below 80%. Assuming that the oxygen saturation of the perfusion flow (SjpO2) ranges from 50% to 75%, the ratio of the shunt flow to total flow at an SjO2 of 90% was estimated to be 0.6 to 0.8 based on the following equation: shunt flow/(perfusion flow + shunt flow) = (SjO2 - SjpO2)/(arterial oxygen saturation - SjpO2). These results suggest that monitoring the SjO2 provides real-time information concerning the progress of embolization and helps to determine whether the embolization has progressed sufficiently to avoid postoperative hyperemic complications.

Adolescent↗
PubMed1994

[Trans-duodenal-recess laparoscopic nephrectomy and adrenalectomy. Preliminary report].

We report two cases of left nephrectomy and one case of left adrenalectomy with our new laparoscopic procedure. We treated the left renal vein first using trans-duodenal-recess approach. The left renal vein could be detected after an incision into the parietal peritoneum on the left side of the duodenojejunal flexure (duodenal-recess) was performed. When the nephrectomy was performed, the renal artery and vein were transected using endoGIA. When the left adrenalectomy was performed, the adrenal vein was clipped and divide after lysis of the left renal vein. Our new method allowed the renal vein to be treated first, so the remainder of the operation could be performed without the risk of bleeding.

Adrenalectomy↗
PubMed1994

[The clinical significance of interleukin-6 as an inflammatory marker (the studies in patients with open heart surgery)].

We analyzed serum levels of interleukin-6 (IL-6) and seven acute phase proteins in CRP positive samples and in patients with open heart surgery. The concentrations of serum IL-6 were not correlated with other acute phase proteins in CRP positive samples. However, IL-6 were in inverse correlation with CRP, AAG, AAT and CER in patients with open heart surgery. These discrepancies were due to the differences in response time of each acute phase protein after the start of inflammation. Responses of acute phase proteins after open heart surgery were investigated from hour to hour. IL-6 increased rather rapidly than other acute phase proteins, and increases of CRP, TRF, AAT, AAG, CER, HAP and AMG followed. The time reached the peak were IL-6, CRP, TRF, AAT, AMG, AAG, HAP reached the peak in that order. IL-6 constantly increased seven hours earlier, and reached at maximum values forty three hours earlier than CRP in each case. The measurement of serum concentration of IL-6 may be useful for early detection of acute inflammation.

Acute Disease↗
PubMed1994

[Clinical statistics on patients operated at the Department of Urology, Kaizuka Municipal Hospital during ten years (from 1983 to 1993)].

A statistic survey was made on the patients undergoing operations between July, 1983 and June, 1993. The total number of patients was 1780, comprising 1469 males and 311 females. The most frequent organ was the prostate with 526 cases (29.6%), followed by 415 (23.3%) penile and scrotum cases, and 290 (16.3%) bladder cases. Major operations were transurethral resection of prostate (418 cases) and bladder tumor (191 cases).

Adult↗
PubMed1994

[Patterns of mediastinal and supraclavicular metastases in apical invasive lung cancer--importance of supraclavicular lymph node dissection].

Thirty-one patients with apical invasive lung cancer, who underwent surgical therapy were analyzed. In the patients with palpable nodal metastases in the supraclavicular region, the lymph nodes were dissected through a collar incision in supine position after thoracotomy. In the patients without palpable nodes, the supraclavicular nodes were dissected through the same wound and in the same position after the tumor was resected by the hook or anterior approach. N factor was N0 in eighteen patients, N1 in two patients, N2 in seven patients, and N3 in four patients. The ratio of supraclavicular metastasis was 33.3%. Patterns of mediastinal and supraclavicular metastases were classified into three types. Type I (supraclavicular type): metastasized directly to the supraclavicular nodes via the chest wall, Type II (mediastinal type): metastasized via a common route from hilum to mediastinum, Type III (mixed type): combination of Type I and Type II. Of the nine patients who had N2 or N3 disease uncovered by supraclavicular lymph node dissection, one patient was Type I, six were Type II, and two were Type III. Of the four patients with supraclavicular node metastasis, two had palpable nodes and two histological metastasis. The nodes were metastasized via the chest wall in three patients. Two patients with N3 disease are still alive without recurrence, one patient for eighty-six months and another for twenty months after the operation. Since supraclavicular lymph nodes are local and very near from involved structures of apical invasive lung cancer, dissection of these nodes will provide improved prognosis.

Adenocarcinoma↗