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Biomedical subjects

A Wakabayashi

Publications and source records attributed to A Wakabayashi.

At least 19 recordsLinked to original sources
PubMed1991

Thoracoscopic carbon dioxide laser treatment of bullous emphysema.

A new technique of thoracoscopic laser ablation of pulmonary bullae suitable for patients with multiple bullae and diffuse emphysema was developed and assessed in 22 patients. 20 of 22 patients survived. Pre-operative and postoperative functional evaluation is available for the 11 patients followed up for more than a month; at 1 to 3 months postoperatively there were increases in FVC (mean 2.0 litres pre-operatively to 2.7 litres postoperatively, p less than 0.001), in FEV1 (0.74 to 1.06 litres, p = 0.01), and in maximum exercise treadmill times (5.4 min to 8.0 min, p less than 0.01). Postoperative air leaks lasted a mean of 13 days and usually resolved spontaneously. Other complications were bleeding (1 patient) and unilateral acute lung injury (1 patient). These results suggest that selected patients with diffuse emphysema and pulmonary bullae may benefit from thoracoscopic carbon dioxide laser ablation.

Cysts↗
PubMed1991

Expanded applications of diagnostic and therapeutic thoracoscopy.

From 1971 to 1990, 315 thoracoscopies were performed. Recent advances in optic/video systems and endoscopic operating instruments have made thoracoscopy easier and more accurate than 20 years ago. The operative mortality rate was low (1%) and the diagnostic accuracy high (99%). Thoracoscopy has been performed at an increasing frequency in recent years because of its expanded applications, especially in the areas of therapeutic or operative procedures such as carbon dioxide laser treatment of spontaneous pneumothorax or diffuse bullous emphysema, neodymium:yttrium-aluminum-garnet laser vaporization of pleural malignant tumors, and thoracoscope/laser-aided pleurectomy, pericardiectomy, or lung resection. Further technologic advancement in thoracoscopy will have a considerable impact on the future of thoracic surgery.

Aged↗
PubMed1990

Clinicopathological study on end-stage reflux nephropathy in renal-transplanted children.

Five children with end-stage reflux nephropathy underwent kidney transplantation at our clinic. Reflux nephropathy was studied clinically and histologically. All children had proteinuria before starting hemodialysis, and hypertension was present in 2 cases. Three children underwent antireflux operations prior to transplantation. The original kidneys exhibiting reflux were removed during renal transplantation. All original kidneys exhibited atrophy and scarring. Focal and segmental glomerulosclerosis was found in 4 cases. PAS deposition in the interstitium, suggestive of Tamm-Horsfall glycoprotein, was found in all cases. No recurrent signs of focal and segmental glomerulosclerosis have been found in the children who have been followed up from 1 to 6 years after transplantation.

Adolescent↗
PubMed1990

Thoracoscopic treatment of spontaneous pneumothorax using carbon dioxide laser.

In an effort to improve the success rate of the previously described thoracoscopic electrocautery ablation technique of spontaneous pneumothorax, the carbon dioxide laser was evaluated in 12 patients. The recurrent (5 patients) or persistent (7 patients) spontaneous pneumothoraces were caused by rupture of (1) blebs in 6 patients, (2) intrapulmonary apical type II bullae in 3 patients, and (3) diffuse bullous emphysema, type III, in 3. The air leaks were successfully sealed in all but 1 patient with ruptured type II bulla. Surgical specimen from this single failure suggested that the entire inner lining of the bullae must be thermocoagulated. This technical modification led to successful outcome in 2 subsequent cases. With the use of carbon dioxide laser, it was possible to treat not only small blebs but all types of bullae causing spontaneous pneumothorax. Laser thoracoscopy is effective and safe in treating spontaneous pneumothorax.

Adolescent↗
PubMed1990

[The therapeutic effect of norfloxacin on chronic prostatitis].

The clinical efficacy of norfloxacin (NFLX) was evaluated on 40 patients. They had subjective symptoms suggestive of prostate inflammations and more than five white blood cells (WBC)/hpf in their prostatic secretions (EPS) or VB3. Of these, gram negative rods were isolated from the EPS in 3 patients and gram positive cocci were obtained in 26 patients. The overall clinical efficacy was determined at the second week. The effectiveness rate of the subjective symptoms was 82.5%. The effectiveness rate of the WBC in the EPS was 47.4%. The effectiveness rate of the bacteria in the EPS was 64.3%. The overall clinical effectiveness rate was 77.8%. A subjective side effect was observed only in one patient who had skin eruption like urticaria. Mild liver dysfunction of blood chemistry analysis was shown only in two patients but they had had long standing chronic hepatitis. We conclude that NFLX is an effective drug for the patients with chronic prostatitis.

Adult↗
PubMed1989

Thoracoscopic ablation of blebs in the treatment of recurrent or persistent spontaneous pneumothorax.

Recurrent (6 patients) or persistent (4 patients) spontaneous pneumothorax was treated with thoracoscopic ablation of blebs using an electrocautery as an alternative to lung resection. Patients' ages ranged from 17 to 39 years (mean age, 29 years). Ablation was successful in 9 but failed in 1. The mean postoperative hospital stay of the successful cases was 2.1 days. The only failure in this series had an extensive bullalike air cyst involving the apex, and cauterization could not ablate it completely. The follow-up period ranged from 2 to 22 months. During this period, no recurrence was noted.

Adolescent↗
PubMed1989

A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism.

There is a clinical dilemma in the treatment of patients with hypothyroidism and coronary artery disease; excess thyroid hormone administration may exacerbate anginal symptoms, and yet inadequate thyroid replacement may induce congestive heart failure. A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism is described in this paper. A 55 year-old woman with this complication initially received thyroid replacement therapy under strict monitoring. Forty days after the start of the thyroid replacement therapy, serum levels of thyroid hormone had reached the normal range, and then coronary artery bypass grafting was successfully performed. She recovered without any complications, and is now free from chest pain in spite of thyroid replacement therapy.

Angina Pectoris↗
PubMed1989

[A case of traumatic rupture of the testicle].

Traumatic rupture of the testicle is rare because of the protection afforded by surrounding structures. Many clinicians now speculate that this entity is underreported due to misdiagnosis. However, the condition should not be overlooked because of the importance of early treatment for the preservation of testicular function. A more aggressive approach to scrotal hematoma has been advocated. A case of traumatic rupture of testicle in a 21-year-old patient is reported. The testicle was surgically explored 6 days after trauma to the scrotum. The tunica albuginea was repaired and the testicle was preserved. Discussion is made especially on the injury to scrotum.

Adult↗
PubMed1989

[Percutaneous nephro-ureterolithotripsy in patients after urinary diversion or reconstruction using the intestine: report of 5 cases].

Five patients who developed urolithiasis after urinary diversion or reconstruction using the intestine were treated with percutaneous nephro-uretero lithotripsy (PNL). These patients were successfully treated, and we did not experience any severe complications. For the stone removal in this case, PNL seems to be superior to other open surgery methods.

Adult↗
PubMed1988

Angiographic comparison of the internal mammary artery graft and the saphenous vein graft within 2 months and 6 to 12 months after coronary artery bypass surgery.

Angiographic status of the saphenous vein graft (SVG) and the internal mammary artery graft (IMAG) anastomosed to the left anterior descending artery were compared at two different postoperative periods; - within 2 months and at 6 to 12 months after the operation. In 50 SVGs and 35 IMAGs which were studied at the early postoperative period, the rate of intact, stenosed and occluded grafts were almost the same in these two kinds of grafts. However, in 35 SVGs and 25 IMAGs which were studied at the later period, the stenosis of SVG increased significantly while IMAG remained intact. The rate of intact, stenosed and occluded grafts at postoperative 6 to 12 months were 71%, 23% and 6% in SVG, and 88%, 8% and 4% in IMAG, respectively. Considering the better angiographic quality of IMAG, use of IMAG to bypass the most important coronary artery should be considered especially when the patients are younger.

Constriction, Pathologic↗
PubMed1988

[Extracorporeal shock-wave lithotripsy for children].

We performed extracorporeal shock wave lithotripsy (ESWL) on a 5-year-old and 8-year-old. Ureteral calculi in both patients were disintegrated, and all fragments were passable spontaneously. The 5-year-old girl was the youngest of the cases of ESWL reported in Japan. As this patient was 107 cm in height, we put a styrofoam layer on the back of this patient. This protected her lung from the shock wave, and the height limit was released from the ESWL treatment. These cases and the peculiarities and devices for ESWL in the pediatric field are discussed.

Child↗
PubMed1988

[Pathological study on reflux nephropathy].

Four hundred patients with primary vesicoureteral reflux were followed clinically in our department between 1975 and 1984. Histopathological studies including immunofluorescent study were carried out on 13 of them. Their renal function was followed by intravenous pyelography, and from serum creatinine values, proteinuria and radioisotope renograms. Renal deterioration was found in 4 patients. Proteinuria was observed since the first consultation in three of them. Microscopically, mesangial proliferation was observed in all patients but none of them showed focal glomerulosclerosis. An immunofluorescent study was carried out on 7 patients. IgM deposition was found in 3 patients (43%), C8 deposition in only 2 of 3 patients (29%), IgG deposition in 1 of them (14%), and IgA deposition in 1 patient (14%). Proteinuria, renal disorders and mesangial proliferation were correlated with reflux nephropathy. Especially, intrarenal reflux could cause reflux nephropathy but it is impossible to deny immunological factors.

Adolescent↗
PubMed1987

[A study of cyclothymic personality in personality type theory: a structural interpretation of syntonic and immodithymic personalities in the cyclothymic personality type].

This study was undertaken to explore various fundamental characteristics of the cyclothymic personality type. The subjects were 474 students who were classified into three basic personality types -cyclothymic, schizothymic and collathymic- on the basis of their performance on the VERAC Personality Inventory (VPI). Analyses of two questionnaires (TSPS and Self-Differential) completed by the subjects indicated that students classified as cyclothymic had a stronger tendency to recognize their own personality type and to adjust images which could or might be recognized by others. To explore the cyclothymic personality in greater detail, this group was classified into two sub-types -hypomanic and immodithymic types- and two additional tests (EPPS and EFT) were administered to these subjects. Analysis of the responses to these tests revealed that (a) the differences between the two sub-types in EPPS coincided to some degree with earlier reports in the clinical literature, (b) there was no difference between the sub-types in terms of reaction time or number of errors in EFT, and (c) the differences obtained between EPPS and EFT were not so clear as those obtained among the three basic personality types. Overall, these results supported the contention that cyclothymic personality type is a viable sub-category in personality type theory.

Adolescent↗
PubMed1987

[Extracorporeal shock wave lithotripsy of urolithiasis].

A total of 159 patients underwent 194 treatments with extracorporeal shock-wave lithotripsy for upper urinary tract calculi between August 4 and November 30, 1986. A single treatment was performed in 76% of the patients with renal stones and 90% of the patients with ureteral stones. Treatment was successful in 153 patients (93%). Seventy percent of the patients with renal stones and 95% of those with ureteral stones were stone-free over the one-month follow-up, while about 15% had small and asymptomatic fragments believed to be passable spontaneously. Only one patient required surgical removal of the calculi due to severe ureteral edema. Adjunctive urological management is required in about 9% of the patients preoperatively or postoperatively. The period of hospitalization averaged about 11 days after treatment and patients usually returned to work within a few days after their discharge. Extracorporeal shock-wave lithotripsy is the preferred form of management for symptomatic ureteral and renal calculi.

Adolescent↗
PubMed1987

[Extracorporeal shock wave lithotripsy--difficulties in ESWL].

At Kanbara Hospital, 187 patients with urolithiasis have been treated by extracorporeal shock-wave lithotripsy (ESWL) since the first ESWL treatment in December, 1986. Some cases in which ESWL could not be performed easily were experienced. These difficulties were analyzed retrospectively and some problems in the ESWL treatment are discussed.

Female↗