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Biomedical subjects

Y Kawada

Publications and source records attributed to Y Kawada.

At least 217 records · Page 12Linked to original sources
PubMed1988

[Multimodality treatment of adrenal ganglioneuroblastoma: a case report].

We present adult adrenal ganglioneuroblastoma with giant regional lymph node metastasis. The patient was a 21-year-old male, who had a left adrenal tumor diagnosed by ultrasonography incidentally. He was moderately developed and physical examination was almost normal. Blood pressure was within the normal range. Only the value of the vanilmandelic acid, which was 68.7 mg/day, in the urine was abnormal. Other laboratory data were almost normal. Neither chemical nor physical hormonal disorders were present. We carried out the radical surgical treatment by trans-thoracoabdominal approach under the diagnosis of left adrenal neuroblastoma. Pathological diagnosis was ganglioneuroblastoma. After the operation, the patient received both systemic chemotherapy of vincristine and cyclophosphamide and immunotherapy of OK-432 by subcutaneous administration. Furthermore, 40 Gy of the regional irradiation of 60Co to the operative space after the surgery was performed. At eight months after the operation, he is alive with no evidence of disease. Ganglioneuroblastoma is a neuroblastic tumor including neuroblastoma, which commonly occurs in childhood. The prognosis of the neuroblastic tumors which occur either in the adrenal gland of a young child or in an older child is poor. On the other hand, the biological activity of the adult neuroblastic tumors is different from that of the pediatric neuroblastic tumors. In the adult, the adrenal ganglioneuroblastoma does not always have a poor prognosis. The multimodality treatment which we performed is effective for the neuroblastic tumor. Ultrasonography is both effective and adequate for the screening of the retroperitoneal lesion such as in our case.

Adrenal Gland Neoplasms↗
PubMed1988

[A case of xanthogranulomatous pyelonephritis--an experience of echo-guided aspiration biopsy for the diagnosis].

Xanthogranulomatous pyelonephritis is a rare disease of the kidney. The pre-operative diagnosis of this disease is usually very difficult. Recently, echo-guided aspiration biopsy has been suggested for the differential diagnosis of the renal mass. We experienced a case of xanthogranulomatous pyelonephritis and performed echo-guided aspiration biopsy. A 57-year-old female was admitted to our hospital with complaints of upper abdominal pain and right lumbago. Judging from the findings obtained by intravenous pyelography, computed tomographic scan, ultrasonography and angiography, the lesion was a right renal inflammatory mass but renal tumor could not be denied. Because clear cell carcinoma was suspected from the results of echo-guided aspiration biopsy, right radical nephrectomy was performed. However, the resected kidney was diagnosed to be xanthogranulomatous pyelonephritis. Post-operative course was uneventful.

Adenocarcinoma↗
PubMed1988

[A case of pure choriocarcinoma of the testis with cerebellar metastasis].

We report a case of pure choriocarcinoma of the left testis with multiple pulmonary and cerebellar metastases. A 25-year-old male was referred to our clinic because of painless swelling of the left scrotal content and multiple nodules shown in the chest X-ray. At hospitalization, the examination also revealed cerebellar metastasis. With left high orchiectomy, the lesion was confirmed to be pure choriocarcinoma. In spite of several treatments including surgical removal of metastatic brain tumor and combination chemotherapy, he died on the 79th hospital day. Pure choriocarcinoma of the testis is an uncommon disease. Only 46 cases have been reported in the literature before 1987.

Adult↗
PubMed1988

[In vitro activity of minocycline against Chlamydia trachomatis clinical isolates and clinical efficacy of minocycline to C. trachomatis associated nongonococcal urethritis].

The in vitro activity of minocycline (MINO) against Chlamydia trachomatis and its efficacy in the treatment of C. trachomatis-associated nongonococcal urethritis were investigated. Six isolates of C. trachomatis were inhibited at 0.06 micrograms/ml of MINO and 5 isolates at 0.03 micrograms/ml. All cases received oral MINO twice daily for 7 or more days in doses of 100 mg. In 5 of 31 cases, 2 g of spectinomycin was intramuscularly administrated together with MINO only once. C. trachomatis was eliminated in all cases tested. Excellent results were obtained in 26 cases (84%); urethral discharge and polymorphonuclear cells (PMN) disappeared or decreased to normal levels (3 cells/hpf or less) in these cases. Ureaplasma urealyticum was isolated from 8 cases, 7 of which became free of ureaplasmal infection. MINO seemed to be less effective on the decrease of PMN in the urethral smear in cases infected coincidentally with C. trachomatis and U. urealyticum than in cases infected with C. trachomatis alone. No subjective side effects were observed in any of the 31 cases studied. In conclusion, MINO was a useful antimicrobial agent for the treatment of C. trachomatis- and U. urealyticum-associated nongonococcal urethritis.

Adult↗
PubMed1988

[Ureteritis glandularis: a case report].

A 50-year-old Japanese male hospitalized with the complaint of fever and pyohematuria. An excretory pyelography revealed the right hydronephroureter due to right ureteral stone. When the ureterolithotomy was carried out, a wide-based and rice-sized tumor co-existed at the site of the epithelium of the ureter lithotomized. Resected tumor was pathologically confirmed as poorly differentiated adenocarcinoma with mitosis. Therefore, total nephroureterectomy with bladder cuff resection was done at 10 days after the first operation. However, malignant cells were not found in the surgical specimen or histologically diagnosed localized glandular ureteritis. He is alive without any evidence of recurrence. It was reported that the glandular metaplasia, a relative rare lesion in the ureter, was correlated with carcinogenesis of adenocarcinoma in urothelium. However, when the lesion is small and localized such as in this case it should be treated with ureterectomy and addition of other suitable adjuvant therapies. Furthermore, endourological techniques which have been recently dramatically progressed may become a weapon against this lesion for both treatment and follow-up.

Humans↗
PubMed1988

[Ultrasound-guided puncture for renal cyst and instillation of povidone iodine].

Percutaneous puncture followed by instillation with 10% povidone iodine was performed on 23 patients with benign renal cysts. All patients showed remarkable reduction (mean: 86.6%) in size of renal cyst on sonography or computed tomography within a short time (mean: 143 days). Twelve (85.7%) of the 14 symptomatic patients due to the disease were relieved of subjective symptoms such as lumbago after instillation. In a 71 year-old man, microscopic hematuria disappeared after this treatment. There were no complications with this treatment except in one patient who suffered from perinephritis due to a technical problem. This treatment seems to be a safe and effective way to prevent recurrence of cystic fluid.

Adult↗
PubMed1988

[Two cases of acute renal failure associated with non-typhoid Salmonella infection].

Two cases of acute renal failure associated with non-typhoid Salmonella infection are reported. Case 1: A 49-year-old man was admitted with the complaint of severe watery diarrhea and oliguria. Stool culture revealed Salmonella typhimurium. Laboratory data showed hyponatremia and acute renal failure. Hemodialysis was performed 3 times and renal failure was improved. Case 2: A 63-year-old woman was admitted with complaint of severe watery diarrhea, nausea, and fever. Stool culture revealed Salmonella E group. Septic shock appeared after admission, and anti-shock therapy was immediately carried out. Acute renal failure was cured without hemodialysis, even though multiple organ failure had occurred concomitantly. We discussed the management of patients with Salmonella infection, especially those with acute renal failure.

Acute Kidney Injury↗
PubMed1988

[A case of hamartoma of the retroperitoneal space].

A case of hamartoma of the retroperitoneal space in a 59-year-old woman is reported. Excretory urography, computed tomography and adrenal angiography revealed a tumor with multiple calcification in the left retroperitoneal space. The tumor measuring 6.5 by 3.5 cm, and weighing 30 gm, was removed operatively. Removed specimen consisted of many cysts of various sizes containing mucous fluid and multiple small stones. Microscopically, the tumor was composed of a tubular structure lined by ciliated, epithelium-like tissue of the respiratory system or that of Fallopian tube. These tubules were occasionally dilated cystically. No atypical cells were found. The postoperative course was uneventful.

Female↗
PubMed1987

Intractable diarrhea in infancy--whether infection, zinc deficiency, cholestasis and hemorrhage are causes or results?

Although there has been a marked decrease in the number of infants with intractable diarrhea in Japan, the difficulty in treating it still remains unchanged. Here we report two infants who suffered presumably from "chronic nonspecific enterocolitis" with resistance to the usual treatment. Besides prolonged diarrhea and weight loss, they showed manifestations such as infection, zinc deficiency, cholestasis, abnormal blood coagulation, etc. In this paper, we discuss whether they are causes, effects, results, or coincidences. In spite of the reduction of diarrhea after 3 months of age, both babies are even now being followed up by us because of their still poor weight gain.

Bacterial Infections↗
PubMed1987

A new diet-exercise therapy in our obese-child clinic.

Because a large percentage of childhood obesity may persist into adulthood and cause a hotbed of so-called seijin-byoh (adult diseases), its treatment should also be considered from the viewpoint of seijin-byoh prophylaxis. Most obese children, however, are awkward in their movements, in spite of binge eating or bulimia, and unable to carry out any severe exercise-diet therapy. For such subjects, we have designed a new practicable procedure, and obtained excellent results for the last five years. The main principle of our procedure is that the control of caloric intake is relaxed as much as possible after due consideration of a child's growth in height: no restriction for mild, 10-15% of the requirement for moderate, and 20-25% for severe obese children, respectively. The ratio of protein/energy is established at a higher level than usual, while that of fat/energy at a lower level. For exercise, walking is the most easy and important exercise and the proper speeds for individuals are converted from the same amount of movement determined at the 1st increase point of serum lactate values, where the proportion of movement-energy originating from body fat reaches the highest percentage at about 75%. Our new procedure is supported also by the fact that the reduction in body weight combines with the improvement in measurement values of fatty metabolites without any change in values of proteins.

Adolescent↗
PubMed1987

[Chemolysis of cystine calculi incarcerated in the ureter by the alkaline organic amine, tromethamine-E].

We dissolved the cystine calculi incarcerated in the ureter by irrigation with tromethamine-E via percutaneous nephrostomy. Case 1: A 25-year-old man with a past history of cystinuria and staghorn calculi in the right kidney, suffered from obstructive renal failure caused by the incarceration of a stone (18 x 15 mm) in the left middle ureter. After recovering promptly from renal failure by left percutaneous nephrostomy, he received continuous irrigation with tromethamine-E through an angiographic catheter percutaneously placed in the ureter. The ureteral calculus was reduced by 70% in size after the irrigation for 35 days, and then extracted percutaneously. Case 2: A 3-year-old child had multiple cystine calculi in the right renal pelvis and ureter. Although a calculus in the renal pelvis was extracted by the percutaneous ultrasound lithotripsy, two calculi incarcerated in the middle ureter were impossible to remove by a percutaneous approach. The irrigation with tromethamine-E was initiated through the catheter placed percutaneously in the right ureter. Both calculi completely dissolved 47 days later. The chemolysis by irrigation with tromethamine-E was greatly valuable in the treatment of cystine calculi. This dissolution could be an alternative to surgery especially in the treatment of ureteral cystine calculi, which might be difficult to be extracted by the percutaneous or transurethral approach.

Adult↗
PubMed1987

[A case of vesicosigmoidal fistula secondary to diverticulitis of the colon].

A case of vesicosigmoidal fistula secondary to the diverticulitis of colon is reported. A 63-year-old man was admitted to our clinic with the chief complaint of pneumaturia. Cystoscopy revealed an edematous, papillomatous lesion at the left posterior bladder wall. Although multiple diverticulosis of descending and sigmoid colon were demonstrated by barium enema, the presence of a fistula from the intestine to bladder was not confirmed. The presence of fistula was confirmed by detecting the orally administered charcoal in the urine. Resection of sigmoid colon with partial cystectomy was performed. Removed specimen revealed multiple sigmoidal diverticula and a fistula from a sigmoidal diverticulum to bladder through a firm mass. Histological examination of mass demonstrated inflammatory changes. This was the 58th case of vesicosigmoidal fistula due to diverticulitis of colon reported in the Japanese literature.

Diverticulitis, Colonic↗
PubMed1986

Cortisol responsiveness to insulin-induced hypoglycemia in Cushing's syndrome with huge nodular adrenocortical hyperplasia.

A 51-yr-old male patient with a 3 yr history of Cushing's syndrome is described. The baseline plasma cortisol level was elevated, while the plasma ACTH levels remained at an undetectable level. Dynamic testing of pituitary-adrenal function revealed no suppression after 8 mg of dexamethasone, and there was no response to metyrapone or CRF, while plasma cortisol showed a hyperresponse to synthetic ACTH. Plasma cortisol responded to insulin-induced hypoglycemia without an obvious ACTH response. These and the computerized tomography data suggested a "huge" bilateral nodular adrenocortical hyperplasia which was later confirmed by surgery. The left and right adrenal glands weighed 55 and 76 g, respectively. In vitro experiments, using the adrenal tissue, showed that there was an adrenal cortisol response to 1-39 ACTH but not to regular insulin, arginine vasopressin, angiotensin II, norepinephrine or epinephrine. These results indicate that plasma cortisol responded to a slight hypoglycemia-induced plasma ACTH change which was not detected in the ACTH radioimmunoassay or to factors other than ACTH which might be induced by hypoglycemia.

Adrenal Cortex↗
PubMed1986

Corticotropin-releasing factor (CRF) and vasopressin concentration in major brain regions after adrenalectomy and their involvement in adrenalectomy-induced ACTH elevation.

CRF and vasopressin concentrations in major brain regions after bilateral adrenalectomy and their involvement in adrenalectomy-induced ACTH secretion were investigated. At 5, 14 and 28 days after bilateral adrenalectomy, the plasma ACTH level was greatly elevated, whereas hypothalamic CRF content was reduced at 5 days and was not changed at 14 and 28 days after adrenalectomy. The CRF concentration in the medulla oblongata was reduced at 2-4 weeks after adrenalectomy. On the other hand, the arginine vasopressin (AVP) concentration was significantly elevated 2-4 weeks after adrenalectomy. An intrajugular administration of anti-ovine or anti-rat CRF serum significantly suppressed the elevated plasma ACTH level in adrenalectomized, freely moving rats, whereas anti-AVP serum or antipressor AVP antagonist, dpTyr(Me)AVP did not suppress the ACTH level. These results indicate that CRF played an important role in the adrenalectomy-induced ACTH elevation but that vasopressin was not involved.

Adrenalectomy↗