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Biomedical subjects

Y Kihara

Publications and source records attributed to Y Kihara.

At least 145 records · Page 8Linked to original sources
PubMed1987

[Penile implantation surgery for organic impotence due to radical cystectomy or prostatectomy].

Implantation surgery was performed twelve times in eleven patients with organic impotence, mainly due to radical cystectomy and prostatectomy against malignancy, between March, 1982 and April, 1987. A self-contained type prosthesis (AMS Hydroflex(TM] was used in 7 cases, reservoir type inflatable prosthesis (AMS 700TM) in 2, malleable semirigid type (ESKA-Jonas Silicon Silver(TM) Trimming Tip Version) in 2, and nonmalleable semirigid type (Fuji system Finney type) in 1 case. In the last case, the prosthesis was replaced by AMS Hydroflex 4.5 years later at patient's wish. Excellent results and good patients' acceptance were gained with inflatable-type prosthesis (AMS 700 and Hydroflex) in 7 out of 8 cases (88%), whereas concealment problems were produced by semirigid type prosthesis (Finney and Jonas). Experience with AMS Hydroflex penile implantation is reported for the first time in the Japanese literature. Intraoperatively, it was sometimes difficult to implant a pair of Hydroflex rods into both of the corpus cavernosum. Postoperative perineal pain was almost constantly seen and in one patient, penile edema continued for three weeks and subsided spontaneously in two months. In another patient, the length of the prosthesis (15 cm) was short, and exchange to the longer one (17 cm) was necessary. In this patient, the longer Hydroflex caused erosion of the glans to necessitate its removal on one side. From our experience, the diameter (11 mm) of the Hydroflex seems to be too big for the average Japanese patient. The operative procedures and results of each kind of the prostheses are briefly discussed.

Adult↗
PubMed1987

[Optical internal urethrotomy after traumatic disruption of the urethra].

We report 4 cases of complete traumatic disruption of urethra treated by endoscopic management, core-through optical internal urethrotomy. A direct vision urethrotome was used to incise the totally obliterated urethra with transvesical endoscopic guidance and digital rectal or perineal control. Postoperatively, the patients required an average of 1.3 subsequent urethrotomies. The results were satisfactory in three cases and one case was under observation. All patients were continent and three of them were potent. We suggest that the endoscopic approach should be considered as an initial procedure for restoring urethral continuity prior to more extensive surgical repair.

Adult↗
PubMed1986

Dynamic changes in left ventricular regional wall thickness during premature ventricular contraction in conscious dogs.

The contractile pattern of the regional left ventricular wall during premature ventricular contraction was analyzed in conscious dogs instrumented with an ultrasonic dimension gauge across the anterior and posterior left ventricular walls. Aortic flow was measured with an electromagnetic flow probe. A single premature ventricular contraction was induced by stimulating either the anterior or posterior wall with varied coupling intervals from 380 to 650 msec. Stroke volume of premature ventricular contraction was significantly smaller than that of premature atrial contraction with identical coupling intervals. In premature contractions, stroke volume was linearly related to coupling intervals. Though there was no isovolumic wall thickening in premature atrial contraction, the wall started to thicken during isovolumic ventricular systole in premature ventricular contraction. There was a clear inverse correlation between the ratio of the isovolumic wall thickening to the total wall thickening and coupling intervals. In premature ventricular contractions with identical coupling intervals, the deformation of thickening characteristics was more pronounced in regions with closer proximity to the ectopic focus. Thus it is concluded that the pump function is depressed in premature ventricular contraction, in part due to the increased ratio of wall thickening during isovolumic systole before the opening of the aortic valve. Isovolumic wall thickening increases along with the shorter coupling intervals and closer proximity to the ectopic focus. These alterations in left ventricular mechanical function due to ectopic contraction might induce serious sequelae, depending upon the ectopic focus in the presence of already depressed regional function.

Animals↗
PubMed1986

[Staging pelvic lymphadenectomy for carcinoma of the prostate: review of 23 cases].

Between June, 1982 and May, 1985, 37 patients underwent pelvic lymphadenectomy for carcinoma of the prostate, 23 patients as an independent procedure. Of these 23 patients 7 had pelvic node metastasis. Node involvement occurred in 60% with clinical stage C tumors. Correlation with tumor grade revealed nodal metastasis in none of the latients with well differentiated tumors, 33.3% of those with moderately differentiated lesions, and 75% of those with poorly differentiated tumors. Metastatic disease most commonly involved the obturator-hypogastric lymphnodes (85.7%). Of the 23 patients, 14 underwent conventional node dissection, and 9 limited node dissection. Complications of lymphocele, lymphfistula, penoscrotal edema and lower extremity edema occurred mostly in patients with conventional node dissection. Limited staging pelvic node dissection provides information similar to that identified after more extensive dissection and can be accomplished with little morbidity.

Aged↗
PubMed1986

[Clinical statistics on inpatients and operations in the Department of Urology, Toyooka Public Hospital (from January 1982 to December 1985)].

Statistical observations on inpatients and operations in our department from 1982 to 1985 were reviewed in comparison with the statistics for the preceeding three years. More elderly persons comprised the inpatients at our hospital than at other facilities. Urogenital tumors and urolithiasis were the predominant disease of the inpatients, as they were in the preceeding three years. Number of prostatic cancer has remarkably increased. Transurethral operations, TUR-P and TUR-Bt, were the most representative. Operations for the malignant disease, especially for prostatic cancer, were more frequent in this period than in the preceeding three years. As to urinary diversion, ileal conduit was the main procedure used during this four years. Kock continent ileal reservoir was adopted in 1985. In July 1985, open operations for urolithiasis were dramatically replaced by percutaneous and transurethral procedures.

Female↗
PubMed1985

Adaptations of the left ventricle to chronic volume overload induced by mitral regurgitation in conscious dogs.

To assess the time-course of adaptive responses of the left ventricle to chronic volume overload, dogs were instrumented with a left ventricular (LV) micromanometer and pairs of ultrasonic crystals for the measurement of LV wall thickness (WTh), LV chamber diameter (D), and longitudinal segment length (L). Following a control study, mitral regurgitation (MR) was created by a transventricular section of the chordae tendineae. Heart rate was controlled during each study by atrial pacing. Plasma norepinephrine levels at rest were determined by high-performance liquid chromatography. Eight days (mean) after the onset of MR, enddiastolic (ED) D had increased by 9% from 34.2 +/- 2.4 mm (SEM) (P less than 0.001), with significant thinning of the wall thickness (from 8.2 to 7.7 mm, P less than 0.001). Consequently the calculated cross-sectional area (CSA) of the left ventricular wall remained the same. Peak wall stress (WSt) and EDWSt increased by 20% and 152%, respectively. During the subsequent 4 weeks, EDD progressively increased, averaging 11% above the control at 4 weeks, while EDWTh returned to the control level. Thus, the development of hypertrophy was clearly evidenced by an increase in CSA (by 8% over the control, P less than 0.001). These changes were accompanied by a consistent reduction in both peak WSt and EDWSt. Mean velocity of circumferential fiber shortening (meanVcf) and percentage shortening were significantly augmented following the onset of MR and remained at the same level thereafter, indicating no further use of the Frank-Starling mechanisms during chronic ventricular dilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1985

EEG changes 24 hours after myelography with metrizamide.

A prospective study of EEG changes following metrizamide myelography was made on 34 patients aged 17-79 years. EEGs were recorded just before and 22-26 hours after myelography. Usually 8-10 ml of metrizamide was injected by either lumbar or lateral cervical puncture. The concentration of metrizamide was relatively high. EEGs were abnormal in 15 out of the 20 patients whose baseline EEGs were normal. EEGs deteriorated in 10 of the 14 patients whose control tracings were abnormal. High voltage delta activity and/or a great deal of theta activity were common abnormalities. Three patients showed triphasic waves. No relationships were found between the EEG changes and clinical variables. But central nervous system involvements by metrizamide tended to be accompanied by a severe EEG slowing.

Adolescent↗
PubMed1985

[Percutaneous nephrostomy--the method and technical problems].

Ultrasound guided percutaneous nephrostomy (PNS) was performed on 72 patients (80 kidneys) including pretreatment for percutaneous nephro-uretero lithotomy (PNL). PNS was performed for post-renal anuria or hydronephrosis in 23 cases (28 kidneys), for urinary leakage in 4 cases (5 kidneys), for vesical bleeding in 1 case (2 kidneys) and as pretreatment of PNL in 44 cases (45 kidneys). Ultrasound guided renal puncture was done percutaneously and a 0.038 inch J-tipped wire guide was inserted into the suitable calyx. Then the nephrostomy tract was dilated with fascia dilators of Malecot nephrostomy set. A 14 Fr or 16 Fr Malecot catheter was used for hydronephrosis or urinary leakage cases. 18 Fr, 24 Fr Malecot catheter or Bardex balloon catheter 18-22 Fr was inserted for PNL cases. In the PNL group, Ht decreased slightly but there was no need of blood transfusion. In the other groups, Ht did not change. Defect of 99m-Tc-DMSA renal uptake in several cases suggested renal injury at nephrostomied cortex. In about 70% of the cases, a fever of more than 37 degrees C was observed, and in 4 cases, more than 39 degrees C was observed. There were no major complications observed. In conclusion, percutaneous nephrostomy using Malecot nephrostomy set is a safe and effective method.

Adult↗
PubMed1985

[Percutaneous ultrasonic nepholithotripsy].

Herein we report our experience of percutaneous ultrasonic lithotripsy on 32 renal calculus patients between March and December 1984. Renal calculus removal was successful in over 78.1% of the patients (91.3% for recent 4 months). All patients had bloody urine after tract dilatation and calculus removal, but this usually cleared in 24-48 hours. No patients have required blood transfusion. The major essential contribution responsible for the success of this technique was a nephrostomy placement made accessible to calculi. Percutaneous ultrasonic lithotripsy, when combined with adjuncts such as flexible nephroscopy and radiological stone manipulations using stone grasping forceps and Dormia basket catheter, is an effective treatment for renal calculi, with a success rate of over 90%.

Endoscopy↗
PubMed1985

[Determination of left ventricular center of contractile motion by two-dimensional echocardiography].

To quantify left ventricular (LV) regional wall motion using two-dimensional echocardiography, reference points such as the center of left ventricular gravity or an intersecting point of radial grids were conventionally used, assuming that they were near or at the center of LV contractile motion. However, since the LV does not contract homogeneously, their positions might be quite different. Endocardial high density spots in two-dimensional echocardiograms were used as markers for LV regional wall motion, and we determined the center of LV contractile motion (C) at papillary muscle level in the parasternal short-axis view for 10 normal subjects (control group) and eight patients with aortic regurgitation (left ventricular volume overload; LVVO group). In one subject, each of six endocardial high density spots extracted from different LV regions, and were traced frame by frame throughout one cardiac cycle using a video motion analyzer, and their systolic movements were shown by six vectors. Using the method of least squares, the point of convergence of vectors (C) was determined from the point toward which the six vectors were directed. The LV centers of gravity at end-diastole (Ged) and at end-systole (Ges) were also determined by tracing the endocardial surface on video frames. The distributions of C, Ges, and Ged were compared. In the control group, point C was at the point 35% distant from Ged toward the middle of the interventricular septum (IVS). Ges deviated from Ged in the same direction as point C, but the distance was one third of C(11%). In the LVVO group, the distribution of Ges referred to Ged was similar to that of the control group, however, point C was closer to Ged, since its deviation was 16% of the radius. These results suggest that point C, which is determined by the directions of regional wall motion, reflects the contractile pattern of the whole LV. This might be termed the center of LV contraction. Using it as a reference, we were able to obtain more accurate quantitative data about LV regional wall motion.

Aortic Valve Insufficiency↗
PubMed1984

Effect of ICI 118,587 on left ventricular function during graded treadmill exercise in conscious dogs.

Effect of ICI 118,587 (corwin, ICI), a new cardioselective beta-partial agonist, on left ventricular (LV) function was studied and compared with that of isoproterenol and propranolol in 10 conscious normal dogs, instrumented with a micromanometer and pairs of ultrasonic crystals for analysis of LV wall motion. Heart rate, LV dP/dt and mean circumferential shortening velocity were measured at rest and during 3 levels of treadmill exercise (Ex). Before drug administration (control), the heart rate, dP/dt, percent shortening and mean circumferential shortening velocity were enhanced linearly along with the graded Ex. The Ex response curve shifted upward during isoproterenol infusion and downward after the administration of propranolol. With ICI, hemodynamic and contractile indexes were enhanced at rest as with isoproterenol, while these indexes were depressed during maximal Ex as after propranolol. The Ex response curve after ICI crossed the control response curve at a moderate level of Ex. Thus ICI exerts positive inotropic and chronotropic effects at rest when basal sympathetic tone is low, whereas it exerts negative inotropic and chronotropic properties at maximal Ex when sympathetic tone is high. The inherent dual action of this drug is expected to open a new field of treatment for ischemic heart disease with or without heart failure.

Adrenergic beta-Agonists↗