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Biomedical subjects

Y Kihara

Publications and source records attributed to Y Kihara.

At least 127 records · Page 7Linked to original sources
PubMed1989

[Restorative effect of muroctasin; MDP-Lys (L18) [DJ-7041] on leukopenia in urogenital cancer patients treated with chemotherapy].

Muroctasin, a derivative of muramyl dipeptide (MDP), increases WBC count through induction of the colony stimulating factor (CSF). This action of muroctasin is useful to treat cancer patients with leukopenia on chemotherapy. Urogenital cancer patients were randomized to either a 50 micrograms or 100 micrograms dose group of muroctasin when the WBC count dropped below 3,000/cmm in the first cycle of chemotherapy. The patients were then subcutaneously treated with muroctasin once daily for 6 consecutive days, and restoration of their WBC count determined. Out of the 32 patients who were enrolled in the study, 25, 24 and 23 patients were assessed for safety, usefulness and efficacy, respectively. The 100 micrograms dose was more effective in restoring the WBC count than the 50 micrograms dose based on the evaluation by the physicians. This result was also confirmed when we used the criteria for evaluation of adverse reactions as recommended by the Japanese guidelines for evaluation of efficacy of chemotherapy on solid tumors. Mild fever and reaction at the injection site were noted in 16% (4/25). In conclusion, muroctasin is useful for leukopenia after chemotherapy.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

[A clinical evaluation of AMS 700 penile prosthesis in the treatment of impotence].

The AMS 700TM & 700 CXTM penile prosthesis was implanted in 34 organic and mixed-type impotent patients between November, 1984 and July, 1988. The patients' ages ranged between 32 and 70, with an average age of 57.2. Twelve weeks after implantation, the prosthesis was evaluated in terms of patient satisfaction with sexual intercourse and postoperative complications. Twenty three patients (67.7%) were highly satisfied, 7 (20.3%) satisfied, 3 (8.8%) dissatisfied and 1 patient worsened (2.9%). Severe complication was found in two cases, both of them being complicated by infection; as a result the prosthesis was removed. Utility of the prosthesis, e.g. effectiveness and safety was; high utility in 26 cases (76.5%), moderate utility in 7 cases (20.6%), and no favorable in one case (2.9%). Thus, overall effectiveness and safety of the AMS 700 penile prosthesis, with its excellent cosmetic appearance upon implantation, were demonstrated by the above findings.

Adult↗
PubMed1989

[Urinary continence in patients undergoing nerve sparing radical prostatectomy].

Recently, the morbidity of radical prostatectomy has been reduced by improvements in surgical techniques and greater understanding of pelvic anatomy. The nerve sparing technique has been considered to be a major contribution to this advance. In our study, urinary control was compared in 33 consecutive patients undergoing a radical retropubic prostatectomy. In 13 patients, a conventional radical prostatectomy was performed and in 20 subsequent patients, a nerve sparing operation was performed. The staff surgeons were the same throughout the study. The age of the patients and pathological stage of the tumor were not significantly different between the groups. The operative time was shorter and intraoperative blood loss was less both significantly in the nerve sparing group. In the conventional operated group, there was one patient with total incontinence and two with significant incontinence requiring absorbable pads. In the nerve sparing group, there were no patients having total incontinence and one had stress incontinence requiring absorbable pads. Urethral pressure profile was measured postoperatively in 17 in the nerve sparing group and in 7 in the conventional group. The maximum urethral pressure in the nerve sparing group was 31.5 cm H2O (SD = 5.4) and in the conventional group 23.2 cm H2O (SD = 5.7) with a significant difference between groups (p less than 0.01). The functional urethral length of the nerve sparing group was 16.7 mm (SD = 5.2) and in the conventional group 13.3 mm (SD = 3.7) with no significant difference between the groups. These results suggest that preservation of neurovascular bundles from the pelvic plexus during radical prostatectomy has no important role in postoperative urinary continence.

Aged↗
PubMed1989

[Prostatic adenocarcinoma: nodal involvement and prognosis of stage D1 patients].

Between 1982 and 1988, 70 patients with proved prostatic adenocarcinoma in stages A2 to C underwent pelvic lymphadenectomy. Median followup has been 30 months. Radial prostatectomy was done in 37 patients, 3 of whom were followed by immediate hormone therapy. Twenty eight patients received radiotherapy alone except one combined with hormone therapy. The remaining 5 patients were treated hormonaly alone. Pelvic lymph node metastases were noted in 21 of the 70 patients (30%). High stage and poor histological differentiation were associated with a significantly higher probability of pelvic lymph node metastases. Poor histological differentiation was more likely to be found in patients with multiple or gross node involvement. Progression of the disease, almost exclusively bony metastases, occurred in 10 of the 21 patients who had positive pelvic nodes and in 7 of the 49 patients with negative nodes (p less than 0.01). According to Kaplan-Meier projections, 1, 3 and 5 year percent disease free survival were, respectively; 73%, 32% and 32% for patients with positive node, and 93%, 82% and 75% for patients with negative nodes. Disease-free survival of stage D1 patients was significantly worse than that of patients with negative nodes (p less than 0.001, Generalized-Wilcoxon test). We divided 21 patients with pelvic nodal metastases into subgroups based upon the volume and extent of nodal disease; 7 patients with a single microscopic nodal involvement and 14 patients with multiple or gross nodal involvement. There was no significant difference in disease free survival between the two groups. 9 of the 21 patients were given hormonal treatment immediately and on the contrary, 12 were followed without hormonal treatment. However, projected disease free survival differed little between the groups. These data suggest that patients with positive nodes appear to have equivalent adverse biologic potential and should be considered candidates for early systemic treatment.

Adenocarcinoma↗
PubMed1989

[Intravesical bacillus Calmette-Guerin therapy for superficial bladder tumor: experience of 13 cases].

We treated 13 patients with superficial bladder cancer via intravesical bacillus Calmette-Guerin (BCG) for 1) prophylaxis of recurrent tumor (prophylaxis group, 8 patients), and 2) therapy of carcinoma in situ (CIS group, 5 patients), with a mean follow up of 13.3 and 14.2 months, respectively. BCG (Tokyo 172 strain) was given intravesically (80 mg in 40 ml, saline) weekly for 8 weeks after transurethral resection or biopsies. In the prophylaxis group, the recurrence rate per 100 patient-months was significantly decreased from 16.1 to 2.83, before and after the BCG therapy (p less than 0.005, chi-square). In 6 patients on whom previous intravesical chemotherapy (MMC and/or ADM) was unsuccessful, the recurrence rate at 100 patient-months was significantly decreased from 15.3 to 2.33, before and after the BCG therapy (p less than 0.005, chi-square). Therefore, we considered that BCG therapy was effective for the patients on whom previous intravesical chemotherapy was unsuccessful. In the CIS group, urine cytology changed to negative in all patients after the BCG therapy. Four of the 5 patients had no recurrence for a mean follow up of 13.8 months. In our cases (12 cases), OKT-4, and OKT-8 proportion of peripheral blood lymphocytes measured from immune reactions had not significantly changed after BCG therapy. This study suggests that BCG is effective not only in therapy of CIS, but in prophylaxis of previously treated cases.

Administration, Intravesical↗
PubMed1988

Acute hemodynamic effects of MDL19205 on conscious dogs with mitral regurgitation.

To assess the effects of MDL19205, a combined inotropic-vasodilating agent, or an inodilator, on the left ventricle with subacute volume overload due to mitral regurgitation (MR), seven dogs were instrumented with a left ventricular (LV) micromanometer and a pair of ultrasonic crystals for the measurement of LV circumferential segment length. After examining the effects of this drug in the normal hearts, its effects were observed in the same dogs in which MR was produced by sectioning chordae tendineae. Mitral regurgitation caused increases in LV peak dP/dt (2,384 +/- 256 to 3,090 +/- 622 mmHg/sec; p less than 0.05), mean circumferential shortening velocity (Vcf; 1.41 +/- 0.25 to 1.85 +/- 0.20 sec-1; p less than 0.05), LV end-diastolic pressure (LVEDP; 8.2 +/- 1.6 to 15.8 +/- 3.7 mmHg; p less than 0.001), and LV end-diastolic length (LVEDL; 10 to 10.6 +/- 0.2mm; p less than 0.01). The dogs were intravenously administered MDL19205 7 to 14 days after they had completely recovered from the first and second operations. With 3 mg/kg of MDL19205, peak changes of hemodynamic indices occurred within 5 minutes in the hearts with MR LV dP/dt and mean Vcf significantly rose (from 3,090 +/- 622 to 5,356 +/- 811 mmHg/sec; p less than 0.001, 1.85 +/- 0.20 to 2.65 +/- 0.36 sec-1, p less than 0.001). LVEDP and LVEDL were returned to the control values obtained in the normal hearts (15.8 +/- 3.7 to 6.4 +/- 2.4 mmHg; p less than 0.001, 10.6 +/- 0.2 to 10 +/- 0.4; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Role of the left atrium in adaptation of the heart to chronic mitral regurgitation in conscious dogs.

The manner in which the left atrium adapts to chronic mitral regurgitation and the role of the adapted left atrium as a modulator of excessive central blood volume were analyzed in seven conscious dogs, instrumented with high-fidelity pressure transducers and ultrasonic dimension gauges for measurement of left atrial and left ventricular pressure and cavity size. After obtaining data in a control situation, mitral regurgitation was produced by transventricular chordal sectioning. Heart rate was matched by right atrial pacing. In the "early" stage (7-14 days), left ventricular end-diastolic and mean left atrial pressures increased from 6 to 16 mm Hg and from 4 to 12 mm Hg, respectively. Both left ventricular end-diastolic segment length and left atrial diameter prior to atrial contraction increased by 7%. In the "late" stage (20-35 days), despite significant decreases in left ventricular filling pressure (11 mm Hg) and left atrial pressure (8 mm Hg), there was a continuous increase in left ventricular end-diastolic dimension (10%) and atrial end-diastolic diameter (10%). After the onset of mitral regurgitation, the left atrium performed greater work with a more enlarged cavity. Left atrial chamber stiffness was progressively decreased. These changes were associated with progressive increase in the left atrial diameter at zero stress, and there was a significant increase in the diameter of the left atrial myocyte. These results indicate that during chronic mitral regurgitation, the left atrium enlarges in size and mass, with a more potent booster action. The left atrial chamber becomes more compliant. Thus, the enlarged left atrium appears to exert an important compensatory mechanism in the case of excessive central blood volume by buffering pressure rise in the atrium and by providing an adequate ventricular filling volume.

Adaptation, Physiological↗
PubMed1988

[Clinical experience of nerve-sparing radical prostatectomy].

A total of 18 patients underwent nerve-sparing radical prostatectomy for clinical stage B1 or B2 prostatic cancer. An operation was performed according to the modified technique originally described by Walsh and associates. The operative technique involved three steps: 1) accurate ligation of dorsal vein complex, which makes a relatively bloodless field and makes it possible to dissect the lateral pelvic fascia from the prostate; 2) the incision in the lateral pelvic fascia is made anterior to the neurovascular bundle; 3) the lateral pedicle is divided close to the prostate. There were no major intraoperative complications such as rectal perforation or ureteral injury. The mean blood loss was 802 g (340-1600 g) and the average duration of surgery was 173 minutes. Eleven patients had no blood transfusions. Postoperatively, there was a wound infection in one case. Mild bladder neck contracture in one case responded to single dilatation. Sexual function was evaluated in 16 of the patients who have been followed for more than three months and who had not received hormone therapy postoperatively. Of 16 patients 6 (37%) had return of erectile function. Return of erections required 3-15 months (average 9 months). Patients under 70 years old had a higher incidence (80%) of return of erections than those over 70 years old. Four of the 6 patients had tumor involvement confined to the prostate. Initially most patients had significant amounts of stress incontinence. This resolved within the first or second postoperative month. Finally 4 had slight stress urinary incontinence but no patients had total incontinence. The results suggest that nerve-sparing radical prostatectomy is an anatomically safe approach. It can contribute to the quality of life in men at a stage when it is still curable.

Adenocarcinoma↗
PubMed1988

[Clinical experience with the Kock continent ileal urinary reservoir].

From May 1985 through July 1987, 22 patients underwent Kock continent ileal reservoir for urinary diversion. There were 19 males and 3 females, between 38 and 82 years old (mean age 63.1 years). A one-stage radical cystectomy and Kock pouch construction were performed in 21 patients. One patients was converted from standard ileal conduit to this new reservoir. The keys to success of the Kock pouch are creation and maintenance of the nipple valve to prevent reflux and to ensure continence. Mesenteric fat is removed with CUSA for 8 cm along the afferent-efferent limbs of the pouch and exclusion of mesentery is limited for only 3-4 cm. This important modification will ensure adequate ileal intussusception and vascular supply to the valves. To prevent eversion and prolapse, the nipple valve is anchored to the wall of reservoir. A strip of sauvage filamentous Dacron serves as a collar to fix the afferent-efferent limbs to the pouch. There were 2 postoperative deaths and two major early complication: 1 acute renal failure and 1 intestinal fistula, both of which were treated conservatively. Late complications occurred in 6 patients. Of these 6 patients, 1 required reoperation and revision of the continence valve mechanism and 1 required hospitalization for entero-pouch fistula. Serum electrolytes and vitamin B12 remained normal in all patients. Patients perform self-catheterization every 4-6 hours during the day and once at night for volumes ranging up to 1,000 ml. The end result in 19 of 20 patients was excellent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Unilateral disc-shaped cataract with coloboma of lens.

A case of unilateral disc-shaped cataract with coloboma of the lens is reported. The patient, a 17-year-old girl, had best corrected visual acuity of 0.01 (+ 9 D) in the right eye and 1.2 in the left eye. Exotropia of 10 Hirschberg degrees was found in her right eye. The visual disturbance of that eye was thought to be due to amblyopia. The pupillary center of the lens was very thin and membranous, with no nucleus. A ring-like hypertrophic cataract was observed from the lens equator to the periphery of the pupillary area. A bow-shaped coloboma of the lens was found from 3 to 5 o'clock, where the Zinn's zonule was coarse. Some dozen bright white spots were dispersed temporally from the periphery of the macular ring. This combination of disc-shaped cataract with the coloboma of lens is the first such case reported.

Adolescent↗
PubMed1987

Psychotropic effects of adrenergic beta-blockers on agonistic behavior between resident and intruder mice.

The present study was conducted to investigate the effect of adrenergic beta-blockers on agonistic behavior in male mice, using quantitative ethological methods. Agonistic behavior was evoked using a resident-intruder paradigm. The following drugs were administered orally at four dose levels (vehicle, 5, 10 and 20 mg/kg) to either resident or intruder mice: dl-propranolol, practolol, d-propranolol, and l-propranolol. When the resident was treated with either dl-propranolol or l-propranolol, aggressive episodes (offensive sideways posture, attack bite, tail rattle) were suppressed significantly in a dose-dependent manner, whereas practolol and d-propranolol were ineffective. All treatments except the high dose of l-propranolol failed to affect the resident's solitary behavior (locomotion). When the intruder was treated with beta-blockers, agonistic behavior was not altered. Since practolol does not cross the blood-brain barrier, the differential suppression of agonistic behavior is due to the central action of beta-blockers. d-Propranolol does cross the blood-brain barrier but is devoid of beta-receptor blocking property; hence l-propranolol suppression of agonistic behavior implies inactivation of brain adrenergic beta-receptors. The findings seem to indicate that beta-blockers such as dl-propranolol and l-propranolol have a psychotropic action.

Adrenergic beta-Antagonists↗
PubMed1987

Quantitative analysis of contraction band and coagulation necrosis after ischemia and reperfusion in the porcine heart.

To assess the importance of contraction band necrosis (CBN) in reperfusion, CBN, coagulation necrosis (CN), and infarct size, expressed as CBN + CN, were quantitatively analyzed in 25 porcine hearts without collateral circulation. The left anterior descending coronary artery was ligated for 20, 30, 60, and 120 min and then reperfused for 8 hr (groups 1 to 4, respectively). Five hearts were not reperfused (group 5). The areas of CBN and CN were traced at a magnification of X 100 under an inverted microscope and quantified with use of an image analyzer. There was no change in hemodynamics with either occlusion or reperfusion. Regional myocardial blood flow, measured by the generated hydrogen gas clearance method, decreased to almost zero after occlusion but recovered during reperfusion. Percent of risk area infarcted in groups 1 to 4 was 0 +/- 0%, 11 +/- 7%, 80 +/- 9%, and 96 +/- 2%, respectively, and the percent of risk area infarcted in group 4 was the same as that in hearts subjected to permanent occlusion (95 +/- 3%). The percent area of CBN was 100 +/- 0% in group 2, 68 +/- 11% in group 3, 2 +/- 1% in group 4, and 2 +/- 2% in group 5. In group 3, the inner third of the ischemic left ventricular wall showed CN and the middle and outer third CBN. These findings show that in pig hearts without collateral circulation, the transmural infarct, two-thirds of which is occupied by CBN, is evident even when reperfusion is achieved after 1 hr occlusion. Therefore, protection against CBN might reduce infarct size after reperfusion.

Animals↗
PubMed1987

Effects of pacing-induced ischemia on early left ventricular filling and regional myocardial dynamics and their modification by nifedipine.

The effect of pacing-induced ischemia on early left ventricular filling and regional myocardial lengthening was studied in 11 patients with coronary artery disease (CAD) and six control patients with normal coronary arteriograms. All of the 11 patients with CAD developed typical anginal pain during pacing tachycardia, and in the postpacing beat, the left ventricular end-diastolic pressure (LVEDP) rose from 13 +/- 4 to 26 +/- 4 mm Hg (mean +/- SD, p less than .01), the relaxation time constant increased from 43 +/- 9 to 59 +/- 7 msec (p less than .01), and the ejection fraction diminished from 62.1 +/- 6.7 to 51.6 +/- 10.6% (p less than .01). However, the peak rate of early left ventricular filling (LVPF) obtained from frame-by-frame analysis of left ventriculograms and the LVPF normalized for the stroke volume and for the end-diastolic volume did not change significantly. In the ischemic segment, the peak rate of lengthening (PL) decreased by 45% with ischemia, and the PL normalized for the end-diastolic segment length decreased by 42%. However, the PL normalized for the extent of systolic shortening did not change. In the control segment there was a tendency for these three variables to increase, but the changes were not statistically significant. The time difference from the PL to the LVPF increased significantly in the ischemic segment (31 +/- 28 vs 75 +/- 48 msec, p less than .05). Although the LVEDP rose slightly but significantly from 9 +/- 3 to 12 +/- 5 mm Hg (p less than .05) in the control patients in the postpacing beat, the other global hemodynamic variables and the variables of regional myocardial dynamics did not change. The administration of nifedipine in six patients with CAD resulted in the disappearance or diminution of anginal pain even with the same duration and rate of pacing and was associated with restoration of global systolic function and regional myocardial shortening and lengthening in the ischemic segment. In the control segment, the three variables of segmental lengthening increased with administration of nifedipine. Thus, the segmental myocardial lengthening rate decreased with ischemia due to a decrease in segmental shortening and impairment of myocardial distensibility. The LVPF did not decrease with ischemia despite impairment in isovolumetric relaxation, accentuation of asynchrony in left ventricular filling, and a decrease in the PL in the ischemic segment because of an increase in the PL in the nonischemic segment secondary to an increase in left ventricular filling pressure.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗