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Biomedical subjects

Y Kawada

Publications and source records attributed to Y Kawada.

At least 145 records · Page 8Linked to original sources
PubMed1992

[Successful management of choriocarcinoma of the testis with brain metastasis: a case report].

A 32-year-old Japanese male consulted a clinic complaining of gynecomastia. Right painless scrotal swelling was also detected. Right high orchiectomy was performed, then the surgical specimen was histopathologically confirmed as choriocarcinoma and mature teratoma. The imaging revealed cerebral, pulmonary, retroperitoneal metastases. After 3 courses of combination chemotherapy with cisplatin, etoposide and peplomycin (PEP therapy), the brain metastasis completely disappeared and the serum titer of the tumor markers such as beta-HCG became normal. The regression rates of lung and retroperitoneal metastases were 68% and 27%, respectively. Therefore, retroperitoneal lymph node dissection was performed. After the 5th course of PEP therapy, lung metastases disappeared completely. Until the present, no evidence of disease has persisted. The PEP therapy, which is a salvage therapy for refractory testicular cancer, was performed as first-line chemotherapy in this case. It was an excellent modality against choriocarcinoma, along with the surgical treatment.

Adult↗
PubMed1992

Comparison of various assay systems for prostate-specific antigen standardization.

To avoid confusion between serum prostate-specific antigen (PSA) values among various assay systems, clinical studies on the possibility of conversion among detection values were performed. The assay kits used for the PSA comparisons were MARKIT-F PA, MARKIT-M PA, EIKEN PA, PA test WAKO, Ball ELSA PSA, E-Test Tosoh II PA, PROS-CHECK PSA, DELFIA PSA and TANDEM-R PSA. Using each kit, the standards attached to each assay system were detected, and 142 sera samples from benign hypertrophies or prostate cancers were assayed for serum PSA values. By detecting the standards for each kit, slopes were obtained which were almost identical to those obtained from original assay system. The coefficients of correlation among the PSA detection systems, using patients' sera, were very high, and linear regression lines were also obtained. The results suggest that almost identical serum PSA values may be detected either by multiplying by a coefficient to bring it to the standard or using the conversion formula.

Adenocarcinoma↗
PubMed1992

[Solitary infected renal cyst: a case report].

A 48-year-old man was admitted to our hospital because of high fever and left flank pain. Laboratory findings revealed a high white blood cell count, high C-reactive protein level, and severe pyuria. Sonographic examination revealed an enlargement of the cyst at the upper pole of the left kidney that had already been detected. Percutaneous drainage was performed for the cyst and 60 ml of purulent fluid was obtained. Bacterial culture of the fluid was positive for Propionibacterium acnes and gamma-Streptococcus. The drainage and administration of povidone-iodine was continued for 7 days. The size of the cyst was reduced with disappearance of symptoms.

C-Reactive Protein↗
PubMed1992

[Cancer of the kidney mimicking renal multilocular cyst].

Two cases of multilocular cystic adenocarcinoma of the kidney are presented. Although ultrasonography (US) and x-ray computed tomography (CT) are generally considered to be excellent diagnostic methods for renal cystic lesions, in the 2 cases reported here they failed to give the correct diagnosis. These unusual cases altered us to the possibility that the capabilities of modern diagnostic imaging techniques can lead to a false sense of security regarding the prognosis. To our knowledge, there are no reliable clinical features which distinguish multilocular cystic adenocarcinoma from multilocular cystic nephroma.

Adenocarcinoma↗
PubMed1992

[Measurement of serum PSA values by DELFIA PSA and its clinical significance on diagnosis and follow-up of prostate cancer patients].

Serum prostate specific antigen (PSA) values detected by DELFIA PSA were evaluated for usefulness in the diagnosis and follow-up of patients with prostate cancer. The system is time-resolved fluoroimmunoassay using europium as a tracer, which has a detectable range of 0.10-500 ng/ml with a small sample volume (25 microliters) and reliable quality control data. Furthermore, serum PSA values detected by the assay were equivocal to those detected by Tandem-R PSA. From the mean +3 S.D. of serum PSA values obtained on 227 normal males, 1.98 ng/ml was decided as an upper normal level. Serum PSA values in benign prostatic hyperplasia (BPH) (n = 69) and prostate cancer (n = 86) patients were statistically higher than those in normal males. However, when 1.98 ng/ml was used as a cut-off value, the false positive rate in BPH cases elevated up to 80%. Therefore, in the differential diagnosis of prostate cancer and BPH, we recommend 11.7 ng/ml (mean + S.D. in BPH cases) as a cut-off value, in which sensitivity is 72.1%, 88.4% are true negative in BPH, and efficacy is 79.4%. Serially determined serum PSA values in following up the patients with prostate cancer were confirmed to be highly effective for diagnosing recurrence and evaluating treatment responses. These findings suggest that DELFIA PSA is a useful tool for determination of serum PSA values.

Adult↗
PubMed1992

[A case of Cushing's syndrome due to adrenal black adenoma].

Functional black adenoma of the adrenal gland is rare, and there are few reports. We report a case of functional black adenoma of the adrenal gland associated with Cushing's syndrome. The case was in a 59-year-old female, whose chief complaints were weight gain and general fatigue for 7 years. Clinical and laboratory findings were characteristic to those of Cushing's syndrome. With computed tomography and ultrasonography, a round tumor about 18 x 12 mm was detected at the left suprarenal region. Left adrenalectomy was done and a black tumor, 5.0 g in weight, was obtained. Most of the adenoma cells contained numerous pigmented granules which were considered as lipofuscin. The patient is alive without any symptoms of Cushing's syndrome 8 months after the operation. The Japanese literature of the functional black adenoma was also reviewed.

Adenoma↗
PubMed1992

[Acute relapsing Guillain-Barré syndrome after 5 and 7 years asymptomatic intervals].

A 26-year-old man who recovered from an initial episode of Guillain-Barré syndrome had two relapses after 5 years and then again after 7 years of asymptomatic intervals. The antecedent illnesses, distribution of weakness and clinical courses of each relapse were similar to each other, and each episode reached its peak within 10 days. He received different types of therapy on each time; gammaglobulin and steroid treatment, steroid monotherapy and plasma exchanges. Plasma exchanges were thought to be the most effective. Serum testing by enzyme-linked immunosorbent assay revealed that the patient contained high titer of IgG antibodies against GD1a and GT1b gangliosides and low titer of those against GM1 and GD1b, which were reduced during his clinical improvement.

Adult↗
PubMed1991

Immunological comparison between prostate-specific antigen and gamma-seminoprotein.

Prostate-specific antigen (PA) and gamma-seminoprotein (gamma-Sm) were compared by immunocytochemical, immunodiffusion and immunoblotting methods using rabbit anti-PA antibody and rabbit anti-gamma-Sm antibody. Enzyme immunoassays (EIAs) were developed for measurements of PA and gamma-Sm to determine a correlation between serum PA and gamma-Sm levels in patients with prostate cancer. The patterns of localization and distribution of PA and gamma-Sm were identical in prostate tissue sections, including benign and cancerous human prostates. The immunodiffusion study showed that the antigens with which anti-PA antibody and anti-gamma-Sm antibody reacted in seminal plasma and prostate tissue homogenates were identical to each other. In the immunoblotting study, anti-PA antibody and anti-gamma-Sm antibody recognized a single antigen corresponding to a molecular weight of approximately 33,000 both in seminal plasma and prostate tissue homogenates. The EIAs developed in this study were sensitive, specific, and reproducible, and the correlation between serum PA and gamma-Sm values determined by these EIAs was highly significant (r = 0.99, P less than 0.001). These results indicated that PA and gamma-Sm were immunologically identical and that serum PA and gamma-Sm determined by immunoassays using anti-PA antibody and anti-gamma-Sm antibody should be evaluated as identical tumor markers for serodiagnosis of prostate cancer.

Antigens, Neoplasm↗
PubMed1991

[Detection of Chlamydia trachomatis by polymerase chain reaction].

A polymerase chain reaction (PCR) procedure was developed for detection of Chlamydia trachomatis. Two oligonucleotide primers based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2 were used. A single DNA fragment was amplified, when C. trachomatis DNA was template for the PCR. No amplified product was detected in Chlamydia psittaci DNA, Chlamydia pneumoniae DNA or other bacterial DNAs. The amplified DNA fragment was detected, when DNA of greater than or equal to 10(2) C. trachomatis per reaction was used as template for the PCR. Thus, the PCR was shown to be specific for C. trachomatis and more sensitive than the enzyme immunoassays for detection of chlamydial antigen and the chlamydial rRNA:DNA probe hybridization method.

Chlamydia trachomatis↗
PubMed1991

[Detection of Chlamydia trachomatis from urethral swab in male urethritis by polymerase chain reaction].

A polymerase chain reaction (PCR) with Chlamydia trachomatis-specific primers was applied for detection of C. trachomatis from urethral swab in male urethritis. The results were compared with those of culture method for detection of C. trachomatis. Of 18 clinical specimens tested in this study, inclusion bodies of C. trachomatis were detected in 11 specimens by the culture method. For PCR, sample DNA was prepared from transport medium in which urethral smear was suspended and two oligonucleotides based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2 were used as extension primers. In 12 of the 18 specimens, 242bp DNA fragment was amplified by PCR and demonstrated to be the DNA fragment of C. trachomatis by Southern blot hybridization. No DNA of 242bp was amplified by PCR from five specimens in which any inclusion bodies of C. trachomatis were observed or from a specimen in which one inclusion body per cover slip was detected by culture method. C. trachomatis DNA of 242bp was amplified from all specimens in which 14 and more inclusion bodies per cover slip were detected by culture method. In two specimens concluded s negative by culture method, amplified C. trachomatis DNA were detected by PCR. Thus, the PCR would be a more simple and sensitive method for detection of C. trachomatis, compared with the culture method.

Bacteriological Techniques↗
PubMed1991

[Endourological re-establishment by transluminal puncture for a complete obliteration of traumatic urethral disruption].

We performed transluminal re-canalization by needle puncture under fluoro-endoscopic control on a total of ten patients (membranous urethra, 8; bulbous urethra, 2) with complete obliteration after traumatic urethral disruption. The re-canalized tract was created by balloon dilation, internal urethrotomy or endoscopic resection of the scar tissue. The patient age ranged from 10 to 57 years (mean age; 37.9 +/- 15.3 years). A transluminal puncture was attempted in three patients by transperineal-transurethral approach and in seven by transurethral approach. In one of them, who sustained a complete membranous disruption 5 weeks ago, transluminal puncture failed because of the movable proximal urethra. The remaining nine patients voided without difficulty for the mean follow-up period of 18.1 +/- 14.3 months (range: 2-46). Three patients had mild stress urinary incontinence. A transluminal puncture is less invasive, safe and reliable for re-establishment of the true proximal part of the disrupted urethra. It can be recommended as a useful technique for endo-urological re-establishment for a completely obliterated urethra. Although this endoscopic re-establishment requires urethral sounding or internal urethrotomy for 6 months postoperatively, it may be an alternative to conventional surgical repair.

Adolescent↗
PubMed1991

[Secondary tumor of the prostate: a case report].

We report a case of a 62-year-old man with secondary prostatic tumor, which manifested postrenal renal failure. Although pathological examination of the transurethral biopsy specimen and rectal biopsy specimen revealed no malignancy, transperineal prostatic biopsy specimen demonstrated signet ring adenocarcinoma. Post-mortem examination suggested that cancer cells had transferred from the stomach or the gallbladder to the prostate and other organs.

Adenocarcinoma, Mucinous↗
PubMed1991

[A case report of relapsed stage D2 prostate cancer successfully treated with intraarterial chemotherapy].

A 70-year-old Japanese male was first diagnosed as poorly differentiated adenocarcinoma of the prostate with bone metastasis in 1983. He received chemoendocrine therapy with both DESD and HCFU following subcapsular orchiectomy since 1983. As a result of the treatment, the prostate cancer was stabilized. At the end of 1988, the serum levels of PA were elevated. Diagnostic imaging revealed a local recurrence in the prostate. The pathological analysis of the prostate revealed undifferentiated adenocarcinoma. Intraarterial chemotherapy with a reservoir system was carried out. Doses of CDDP, ADM and MTX were 75 mg, 30 mg and 50 mg, respectively. Eight weeks after intraarterial chemotherapy, the regression rate was 60%, and serum PA titer improved to within normal limits. In this case, as the initial clue for suspecting recurrence, periodic detection of PA was useful, and the intraarterial chemotherapy was considered useful for the control of the locally recurrent prostate carcinoma.

Adenocarcinoma↗
PubMed1991

[Clinical study of urinary fungal infection: survey of patient background and fungal strains from the urine].

Clinical features of urinary fungal infections were analyzed in 152 patients in whom fungi were cultured from urine and mycologically identified between February, 1989 and June, 1990. The average age was 66 years old, and approximately 70% of the patients were 60 years old or older. Systemic and urinary tract underlying diseases were observed in 145 patients (95.4%) and 70 patients (46.1%) had urinary indwelling catheters. Previous use of antimicrobial agents before isolation of urinary fungi was recorded in 103 patients (67.8%), the 2nd and 3rd generation cephems and new quinolones being most frequent. A mixture of fungi and bacteria was observed in 68 patients (44.7%). Gram-positive cocci were isolated from 50% of them. Of 173 strains of fungi, C. glabrata was the most frequent (31.2%), followed by C. albicans (27.8%), C. tropicalis (17.3%) and T. beigelii (15.0%). All strains of C. glabrata, C. albicans, C. tropicalis and T. beigelii were highly sensitive to flucytosine (5-FC), miconazole (MCZ) and amphotericin B (AMPH), except for 3 strains which were resistant to 5-FC. The consecutiveness was confirmed by repeated culture in 59.4% of the patients. Fungi in the urine, however, spontaneously disappeared in the other patients.

Aged↗
PubMed1991

[Urinary tract infections after kidney transplantation].

Clinical significance of urinary tract infections (UTI) after kidney transplantation was studied in 57 cases. Of these patients, the UTI occurred in 63% of cases during follow-up after transplantation. Although the bacteriuria were observed more frequently in living-related donor (LD) group at pre-operation, cadaveric donor (CD) group showed significantly higher frequency in bacteriuria and UTI after transplantation. The initial UTI occurred within 4 weeks after transplantation in 86% of cases. The significant risk factors in the occurrence of UTI were presence of bacteriuria in post-operation, CD group, mismatch numbers in HLA, amount of steroid, and ages of donor and recipient. Of the bacteria isolated, about half were pathogens in UTI, which was a 2 times higher risk compared with the time of chronic hemodialysis. Gram negative rods were found to be major pathogen in UTI cases. The effect of UTI on graft survival was not obvious. However, of the patients who have bacteriuria at operation, 52% were found to have bacteriuria due to the same strain during follow-up. Therefore, bacteriological examination of urine at transplantation must be done carefully.

Adult↗
PubMed1991

[Fundamental study on the collection of prostatic fluid using catheter].

The catheter for expressed prostatic secretions (EPS) collection was newly developed for the purpose of protecting EPS from the contamination of the urethral bacteria. This catheter is blind-ended, and has several lateral windows and a balloon between the end and the windows. The procedure of EPS collection using this catheter is as follows; first the catheter is inserted into the urethra, then a balloon is blown up. The catheter is extracted during massage of the prostate and finally EPS is aspirated through the internal lumen of the catheter. In 23 male patients who had neither urinary tract infection nor genital infection, this catheter method was carried out. Before inserting the catheter, the urethral swab was obtained, then culture of the swab and the EPS was done. The catheter method protected against contamination with bacteria in 56%, with Ureaplasma urealyticum in 40%, and all contaminations in 44% of all cases.

Adolescent↗