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Biomedical subjects

Y Ono

Publications and source records attributed to Y Ono.

At least 469 records · Page 26Linked to original sources

[Diagnostic values and limitations of conventional urodynamic studies (uroflowmetry.residual urine measurement.cystometry) in benign prostatic hypertrophy].

PURPOSE AND METHODS: Diagnostic values and limitation of conventional urodynamic study (UDS) were assessed in 380 patients with benign prostatic hypertrophy (BPH), in terms of uroflowmetry, measurement of postvoid residual urine and cystometry. RESULTS: Maximum and average flow rate on uroflowmetry improved with increasing voided volume. Neither maximum nor average flow rate correlated with size of the prostate, subjective symptom (International Prostate Symptom Score) and bothersomeness for prostatism. Pre-TUR maximum flow rate did not predict outcomes on postoperative flow rate and surgical treatment failures. Uroflowmetry did not differentiate between obstruction and weakness of detrusor contraction. The intraindividual variation of postvoid residual urine was great and the volume of residual urine correlated poorly with subjective symptom, size of the prostate, maximum and average flow rate. On filling cystometry, although uninhibited detrusor contraction was much more frequently observed in patients with urge incontinence as compared with continent patients, there was no significant difference in other parameters between the two groups. Every parameter on cystometry did not correlate with nocturnal frequency. Postoperative persistence of urge incontinence did not correlate with the bladder volume at the first desire to void or at the maximum desire to void, an amplitude of uninhibited detrusor contractions, or bladder compliance. In some cases, evaluation of the intravesical pressure on voiding phase and uroflowmetry was diagnostic of apparent obstruction. CONCLUSIONS: In diagnosis of BPH, conventional UDS has limitation for certain and some caution showed be taken in interpretation of the data. However, since conventional UDS provides important and objective information on obstruction and detrusor function, which are independent of subjective symptom and prostate size, these should be necessary in diagnosis, determination of treatment options and evaluation of treatment outcomes in BPH.

Humans↗

Endoscopic trigonoplasty in pediatric patients with primary vesicoureteral reflux: preliminary report.

PURPOSE: We investigated the preliminary surgical results of endoscopic trigonoplasty in pediatric patients with primary vesicoureteral reflux. MATERIALS AND METHODS: We performed endoscopic trigonoplasty in 6 pediatric patients (11 refluxing ureters). Reflux was grade II in 4 reno-ureteral units, grade III in 5, grade IV in 1 and grade V in 1 (international classification). Surgery was done using laparoscopic and endoscopic instruments. RESULTS: Vesicoureteral reflux disappeared 3 to 12 months postoperatively. Analgesics were administered postoperatively to 4 patients for 24 hours and to 2 for 48 hours. No bladder irritability or postoperative upper urinary tract dilatation was observed in the early postoperative period. CONCLUSIONS: Minimally invasive endoscopic trigonoplasty can be an effective surgical procedure for pediatric patients with vesicoureteral reflux.

Child↗

[Interleukin-3 therapy in patients with aplastic anemia refractory to prior therapies].

A therapeutic trial of interleukin-3 (IL-3) was carried out in four patients with aplastic anemia refractory to the prior therapies. Daily subcutaneous doses of 2.5, 5.0 or 7.5 micrograms/kg was given for 7 or 14 days. In a patient who had co- and immediate boost-administration of granulocyte colony-stimulating factor (G-CSF) and/or erythropoietin (Epo) and another who had sequential administration of G-CSF and Epo two weeks after IL-3, definite hematological response was obtained during the course after IL-3. In one patient, moderate to severe side effects consisting of facial edema, conjunctival bleeding, chills and fever, were observed after two days' administration of IL-3. Co- or sequential administration of other hemopoietic factor(s) may be essential in IL-3 therapy for aplastic anemia.

Adult↗

[The estrogen-induced changes of estrogen receptor in seminal vesicle of immature castrated rat].

We have already reported that estrogen treatment given to immature castrated rats caused proliferative changes in both collagen and smooth muscle in the seminal vesicles of immature rats detected by light microscopy. Herein, we studied the estrogen-induced changes in estrogen receptor (ER) in the seminal vesicles of immature castrated rats by means of enzyme immunoassay, an immunohistochemical method and RT-PCR, to clarify the mechanism of estrogen induced proliferation of collagen and smooth muscle. Immature rats (3 weeks old) were castrated and left untreated for 3 weeks and then injected subcutaneously with estradiol-17 beta (E2-17 beta, 5 micrograms/day) for 7 days before they were killed. The nuclear ER content per gland, mg tissue and mg protein in the seminal vesicles of castrated rats increased markedly compared with those of non-treated rats. Castration also enhanced ERmRNA expression. The immunohistochemical analysis demonstrated the obvious tissue distribution by which the nuclear ER positive cells were densely distributed in the periglandular stroma. The nuclear ER contents per gland, mg tissue and mg protein in the seminal vesicles of estrogen-treated castrated rats were greater than those in castrated rats. Estrogen treatment further enhanced ERmRNA expression in the castrated rats. The immunohistochemical studies demonstrated that the nuclear ER positive cells appeared among the glandular epithelial cells, basal cells and the peripheral stromal cells, in addition to the periglandular stromal cells. These findings suggest that ER is related to the estrogen induced proliferation of collagen and smooth muscle in the seminal vesicles of immature castrated rats.

Animals↗

Laparoscopic nephrectomy via the retroperitoneal approach.

PURPOSE: We evaluated efficacy of the retroperitoneal approach for laparoscopic nephrectomy of kidneys with benign disease. MATERIALS AND METHODS: Eight men and 12 women (mean age 55 years) with severely damaged kidneys underwent laparoscopic retroperitoneal nephrectomy. One patient had a history of multiple open abdominal and gynecological operations. Kidneys were removed laparoscopically from the working space, which was created by finger and balloon dissection, and maintained by carbon dioxide insufflation in the retroperitoneal cavity. RESULTS: All kidneys were removed successfully via this procedure. Mean operative time was 3.3 hours and mean estimated blood loss was 135 ml. One patient experienced bleeding from the injured capsular artery just after removal of the kidney. CONCLUSIONS: The retroperitoneal approach is recommended for laparoscopic nephrectomy.

Adolescent↗

[A case of advanced gastric cancer remarkably responding to preoperative UFT-E therapy].

We here reported a case of advanced gastric cancer remarkably responding to preoperative short-term UFT-E chemotherapy. UFT-E was orally administered preoperatively for about a month to the patient with type 2 advanced gastric cancer. After the chemotherapy the cancer was found to be remarkably decreased in size and denatured. The amount of residual cancer cells was limited by histopathological examination following the operation and diagnosed as Grade 3 based on the criteria of histological evaluation of chemotherapy for cancer. We continued to administer UFT-E postoperatively and the patient is still alive without symptoms.

Adenocarcinoma↗

Noninvasive evaluation of malignancy of brain tumors with proton MR spectroscopy.

PURPOSE: To test clinical proton MR spectroscopy as a noninvasive method for predicting tumor malignancy. METHODS: Water-suppressed single-voxel point resolved spectroscopy in the frontal white matter of 17 healthy volunteers and 25 patients with brain tumors yielded spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cre), and lactate. These peak intensities were semiquantitated as a ratio to that of the external reference. The validity of the semiquantitation was first evaluated through phantom and volunteer experiments. RESULTS: The variation in measurements of the designated region in the volunteers was less than 10%. Normal ranges of NAA/reference, Cho/reference, and Cre/reference were 3.59 +/- 0.68, 1.96 +/- 0.66, and 1.53 +/- 0.64 (mean +/- SD), respectively. In 17 gliomas, the Cho/reference value in high-grade gliomas was significantly higher than in low-grade gliomas. Levels of NAA/reference were also significantly different in low-grade and high-grade malignancy. In eight meningiomas (four newly diagnosed and four recurrent), the level of Cho/reference was significantly higher in recurrent meningiomas than in normal white matter or in newly diagnosed meningiomas. CONCLUSIONS: Higher grades of brain tumors in this study were associated with higher Cho/reference and lower NAA/reference values. These results suggest that clinical proton MR spectroscopy may help predict tumor malignancy.

Adolescent↗

[Hautmann's ileal neobladder: experience of 37 cases].

Between April 1993 and August 1995, a Hautmann's ileal neobladder was created in 37 men after total cystectomy for bladder cancer. Ureteroileostomy was performed using a submucosal tunnel instead of the Le-Duc Camey procedure. There was no operative mortality and only a few early complications. The mean postoperative follow-up time was 16 months, with a range of 3 to 31 months. Hydronephrosis occurred in 3 patients, being caused by stenosis at the uretero-ileo anastomosis in 2 and by proximal stenosis in 1. Neobladder-ureteral reflux did not occur in any of the patients. Postoperative ileus developed in 3 patients, and one required laparotomy. Stenosis of the urethro-ileal anastomosis developed in 3 patients, who were successfully treated by transurethral incision. Thirty five patients achieved daytime continence, while 2 patients had slight incontinence. Twenty nine patients achieved nighttime continence, and most of the patients awoke 1-4 times to prevent overflow incontinence. The mean maximum flow rate, average flow rate and post-voiding residual urine volume were respectively 15.3 ml/sec, 5.5 ml/sec and 81 ml at 6 months postoperatively, and 14.9 ml/sec, 5.4 ml/sec and 76 ml at 12 months. Four patients with more than 100 ml of residual urine required sterile intermittent catheterization 2-4 times a day. Urethral recurrence was detected in 2 patients. One was treated with transurethral resection and cisplatinum-based systemic chemotherapy, and the other required urethrectomy and urinary diversion using a new continent efferent limb.

Aged↗

Long-term stone recurrence rate after extracorporeal shock wave lithotripsy.

PURPOSE: We followed patients who were stone-free after extracorporeal shock wave lithotripsy (ESWL) to investigate the factors that contributed to recurrent calculi. MATERIALS AND METHODS: For longer than 5 years 903 patients without residual fragments 3 months after ESWL were enrolled in this study. Plain abdominal films and/or excretory urograms were evaluated every 6 months for recurrent stones on the side of ESWL. Patients who presented with colic pain or other complaints and who were suspected of having recurrent stones were also examined. Stone recurrence rates were calculated with the Kaplan-Meier method. We assessed the influence of patient age; size, location, composition and configuration of the original stones, and pyuria after ESWL on stone recurrence. RESULTS: Mean followup was 25 months and stones recurred in 183 of 903 renal units (20.3%). Kaplan-Meier recurrence rates were 6.7, 28.0 and 41.8% after 1, 3 and 5 years, respectively. There was a significant correlation between stone recurrence and multiple stones on one hand, and pyuria after ESWL on the other hand. Stones recurred most frequently in the lower calix. Recurrent stones were passed without intervention in 33 cases, while ESWL was repeated in 53. CONCLUSIONS: These data demonstrate the importance of long-term followup and the search for an effective prophylactic therapy to prevent recurrence.

Adolescent↗

[Emergency surgical salvage for a type A early thrombosed aortic dissection complicated cardiac tamponade in a 80-year-old-patient].

A 80-year-old woman underwent emergency operation for a type A early thrombosed aortic dissection associated with cardiac tamponade. Her preoperative chest CT (not enhanced) showed high density area in the false lumen that indicated early thrombosis and the projection of true lumen at antero-left-lateral portion of ascending aorta that means "ulcer-like projection" called on aortogram. After the relief of the cardiac tamponade by pericardiocenthesis, we emergently performed the graft replacement of the ascending aorta under the extracorporeal circulation combined with selective cerebral perfusion. Her postoperative course was uneventful and satisfactory.

Acute Disease↗

Malignant astrocytomas with homozygous CDKN2/p16 gene deletions have higher Ki-67 proliferation indices.

p16 is involved in a cell-cycle regulatory cascade that includes cyclin-dependent kinase 4 (cdk4), cyclin D1 and pRb. Alterations of each of these components have been described in primary human glioblastoma multiforme (GBM) or GBM cell lines, and alterations of the individual components of this pathway appear inversely correlated with one another. While this suggests that disruption of any individual component has similar oncogenic effects, homozygous deletions of the CDKN2/p16 gene are the most common genetic alteration. We investigated the relationship between homozygous CDKN2/ p16 deletions and cellular proliferation in 50 primary astrocytomas (2 WHO grade I pilocytic astrocytoma, 15 grade II astrocytomas, 20 grade III anaplastic astrocytomas and 13 grade IV GBMs). Using a comparative multiplex PCR assay, homozygous deletions of the CDKN2/p16 gene were detected in 5 anaplastic astrocytomas (25%) and 6 GBMs (46%), but in none of the lower-grade tumors. Ki-67 immunohistochemistry was used to assess the number of proliferating cells in the same samples used for molecular genetic analysis. In both anaplastic astrocytomas and GBMs, Ki-67 proliferation indices were significantly higher in tumors with CDKN2/p16 deletions (20%) than in those without deletions (10%; p = 0.0001). These results suggest that homozygous CDKN2/p16 deletions in high-grade astrocytomas may have a more deleterious effect on cell cycle control than the other aberrations in the p16-cdk4-cyclin D1-pRb pathway, and may provide one explanation for why homozygous CDKN2/p16 deletions are more common genetic events in high-grade astrocytomas than RB mutations or CDK4 amplification.

Adult↗

[Inappropriate preservation of myocardium by topical cooling with iced slush].

Topical cooling with iced slush has been applied as a conventional myocardial preservation in open heart surgery. However, there might be several disadvantages due to topical cooling with iced slush which melted to be liquid, because of membrane integrity decreased during ischemia. To understand more detailed mechanism of deterioration for myocardium by immersion in some liquid during ischemia, we subjected isolated crystalloid perfused rabbit hearts to a 30 minute of ischemia with immersion in Krebs-Henseleit (K-H) solution (I), K-H+hexamethlyamiloride which was Na+/H+ channel blocker (II) and histidine containing cardioplegia (HBS) designed to accelerate anaerobic glycolysis by a proton buffering (III), followed by a 30 minute of reperfusion. These groups were compared to the hearts hanging in air during ischemia (control). Phosphocreatine (PCr), ATP and intracellular pH were measured by 31 PNMR in group I, II, III. Developed pressure (Dev P) and diastolic pressure (EDP) with a intracavitary balloon were also evaluated with monitoring of 2 mmHg diastolic contracture during ischemia. Dev P declined to 46%, 54% of preischemic value in group I and group II, respectively, although % recovery of control heart was 74% after ischemia-reperfusion process. Diastolic function was severely deteriorated in group I and II, as compared to control heart. ATP and intracellular pH showed a similar decline as PCr in group I and II which was not seen in group III during ischemia. HBS prevented the deterioration of PCr, ATP and intracellular pH during ischemia along with excellent recovery of myocardial function. We therefore conclude that 1) significant deterioration of myocardium occurs with ischemia if the heart preserved in Krebs-Heseleit solution and the mechanism of injury by immersion in liquid on the heart appears to be due to proton accumulation caused by intracellular acidification and loss of high energy phosphate.

Animals↗

[Usefulness of the preoperative MRI for diagnosis and operative method in a case of cor triatriatum].

A case was 6-year-old female diagnosed as the cor triatriatum. The magnetic resonance imaging synchronized at R wave on the electrocardiogram was performed in order to see the abnormal septum in the left atrium. In the horizontal view, the abnormal septum that divides the left atrium into the accessory left atrial chamber and the true left atrium, was well visualized. This septum lied on the vertical portion. Operation was carried out with the approach through the accessory chamber and the fibromuscular membrane were excised. Preoperative imaging of the MRI was useful and helpful for us to reach to a decision of the surgical approach in this patient.

Cardiac Surgical Procedures↗

[A case report of a distal posterior cerebral artery (P3) aneurysm, not accessible through a subtemporal approach].

A case of a ruptured aneurysm located in the P3 portion of the posterior cerebral artery (PCA), which was not accessible through a subtemporal approach, was reported. In addition to the case presented here, alternative operative approaches to the distal P3 portion or higher ambient cistern were reviewed and discussed. A 64-year-old man was admitted because of sudden onset of headache. CT scan disclosed SAH which was recognized mainly in the left ambient cistern with intraventricular bleeding (Fisher Group 4, Hunt and Kosnik Grade 2). A left vertebral angiogram disclosed a small saccular aneurysm in the distal P3 portion of the left PCA, which was located as highly as the plexal point of the anterior choroidal artery. On day 4, neck clipping was tried via the left subtemporal approach. The distal P3 aneurysm, however, could not be reached by this approach, in spite of aspiration of the parahypocampal gyrus. On day 7, the patient died of massive bleeding from a Cushing ulcer. It was considered that an occipital interhemispheric approach might have been more suitable in the present case.

Aneurysm, Ruptured↗