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Biomedical subjects

A Wakatsuki

Publications and source records attributed to A Wakatsuki.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Vesicourethral function study and application of urinary alarm in progressive supranuclear palsy].

We performed a vesicourethral function study on seven patients with progressive supranuclear palsy. In storage phase, 6 patients had decreased urinary sensation and overactive detrusor. Although bladder compliance was normal in all patients, maximum cystometric capacity was decreased in 3 patients. In micturition phase, detrusor contraction was underactive in 4 patients and acontractile in 1 patient. Sphincter electromyogram showed detrusor-sphincter-dyssynergia in 1 patient, no decrease in 3 patients and synergistic decrease in 1 patient. Six patients had urinary incontinence partially due to those neurological abnormality, partially due to dementia and lower activity of daily living. To facilitate the care of such functional incontinence, we devised a urinary alarm. The urinary alarm is a device to detect urine in a diaper. One can know the micturition in a diaper without being informed of micturition by the patient and change diapers as soon as possible. It was also useful to examine their frequency/volume chart.

Activities of Daily Living↗
PubMed1993

[Treatment of staghorn calculi--ESWL monotherapy].

We investigated 41 cases (44 kidneys) of renal staghorn calculi treated in our hospital between November, 1988 and July, 1992. The efficacy of each treatment was 83.3% for extracorporeal shock-wave lithotripsy (ESWL) monotherapy (27 kidneys), 40% for percutaneous nephrolithotomy (PNL) with ESWL (5), 100% for dissolution with ESWL (6), 50% for pyelolithotomy with ESWL (2), 100% for nephrolithotomy with ESWL (1), and 100% for only dissolution (1). In the ESWL monotherapy group except for 3 cases that had complete staghorn calculi with severe caliectasis, the efficacy was between 70% and 100%, and the term of hospitalization was only about 1 month. The complications of ESWL monotherapy were stone street itself and high fever caused by it. However, renal function, could be successfully preserved by the timely drainage with D-J stent or nephrostomy tube. Thus, in most cases of staghorn calculi as well as other urolithiasis, ESWL monotherapy seemed to be more effective and safe than combined therapy of PNL and ESWL.

Aged↗
PubMed1993

[Comparison of the vesicourethral function between progressive supranuclear palsy and Parkinson's disease].

We compared the vesicourethral function between progressive supranuclear palsy (7 cases) and Parkinson's disease (vesicourethral function study in 8 patients with dysuria and questionnaire study in 44 patients). The frequency of urinary incontinence in the 44 patients with Parkinson's disease was 38.7%. Vesicourethral function study showed hypersensitivity, low bladder capacity, detrusor hyperreflexia and normal sphincter EMG. The frequency of urinary incontinence in supranuclear palsy was 85.7%. Vesicourethral function study showed hyposensitivity and detrusor hyperreflexia in 6 cases, and 4 of these 6 cases had residual urine due to impaired detrusor contraction in micturition phase and/or abnormal sphincter EMG. Compliance was normal, but bladder capacity was decreased in progressive cases. Impaired contraction and hyposensitivity made it more difficult to control the urinary incontinence in supranuclear palsy than in Parkinson's disease. Dementia and lower ADL were frequently accompanied with supranuclear palsy (rare in Parkinson's disease). These were other factors that worsen the control of incontinence.

Female↗
PubMed1993

[Argyrosis of the urinary tract after silver nitrate instillation: report of a case].

A 69-year-old woman was referred to our hospital for evaluation of pyuria and renal dysfunction. Twenty days earlier, the patient had undergone silver nitrate retrograde instillations for essential renal bleeding. Routine laboratory findings showed renal dysfunction with a serum creatinine concentration of 7.2 mg/dl and blood urea nitrogen concentration of 68 mg/dl. The urine contained numerous red cells and white cells. The plain X-ray film of the abdomen revealed right renal calcification. Computed tomographic scan confirmed the calcifications in the right renal collecting systems and parenchyma. The most likely diagnosis was argyrosis of the upper urinary tract. The patient underwent a right nephrectomy. Histopathological examination of the specimen showed that the renal pelvis was filled with blood clots. Laboratory evaluation including serum creatinine concentration and urinalysis revealed normal parameters postoperatively. We conclude that this patient developed argyrosis of the urinary tract, and review previously published papers concerning complications of silver nitrate instillation.

Administration, Intravesical↗
PubMed1992

Autonomic nervous system regulation of baseline heart rate in the fetal lamb.

OBJECTIVE: We examined 29 chronically instrumented fetal lambs from 125 to 143 days' gestation to investigate the effects of fetal behavioral states and autonomic nervous system maturation on baseline fetal heart rate. STUDY DESIGN: Behavioral states were defined from electrocorticographic analysis as low-voltage fast activity or high-voltage slow activity. Decrease and increase in baseline fetal heart rate subsequent to administration of propranolol and methylatropine represented beta-sympathetic and parasympathetic activity. RESULTS: Baseline fetal heart rate decreased with gestation in both states, with steeper regression in low-voltage fast activity (p less than 0.001). Positive correlation was noted between gestational age and percent decrease baseline fetal heart rate in both states with steeper regression in high-voltage slow activity (p less than 0.001), and between gestational age and percent increase baseline fetal heart rate with steeper regression in low-voltage fast activity (p less than 0.001). Fetal heart rate beta-sympathetic and parasympathetic tones increased with age in both states, with elevation of beta-sympathetic tone in high-voltage slow activity and parasympathetic tone in low-voltage fast activity. CONCLUSION: Sympathetic and parasympathetic systems influence baseline fetal heart rate in these behavioral states and with age.

Animals↗
PubMed1992

Physiologic baroreceptor activity in the fetal lamb.

OBJECTIVE: We investigated the influences of gestational age and behavioral state on fetal baroreceptor activity. STUDY DESIGN: Two protocols were used to analyze low-voltage fast activity and high-voltage slow activity in eight chronically instrumented ovine fetuses at days 127 to 142. In protocol 1 correction of fetal heart rate to mean arterial blood pressure was assessed under physiologic conditions, and the linear regression slope of fetal heart rate on mean arterial pressure was calculated. In protocol 2 an injection of 7.5 micrograms of norepinephrine was given during consecutive behavioral cycles. The ratio of fetal heart rate decrease to mean arterial pressure increase was determined as representing baroreceptor activity. RESULTS: Under protocol 1 the slope was steeper in high-voltage slow activity (2.33 +/- 1.03) than in low-voltage fast activity (0.89 +/- 0.37) (n = 21, p less than 0.001), indicating that fetal heart rate changes are sensitive to blood pressure changes during high-voltage slow activity. Under protocol 2 inverse relationships were found between the ratio of fetal heart rate decrease to mean arterial pressure increase and gestational age in low-voltage fast activity and high-voltage slow activity. CONCLUSION: Fetal baroreceptor activity increased during high-voltage slow activity and decreased with gestational age.

Animals↗
PubMed1991

[Extracorporeal shock wave lithotripsy for renal and ureteral calculi with MPL-9000. Correlation between stone burden and shock wave energy].

Clinical results of ESWL for renal and ureteral stone with MPL-9000 were presented. We also reviewed correlation between stone burden and shock wave energy. We studied 210 cases (295 sessions) of renal stone and 109 cases (154 sessions) of ureteral stone that were treated from November 1988 till January 1989 and from November 1989 till May 1990. Of those sessions, 76 sessions of renal stone cases and 53 of ureteral stone cases were carried out ambulatorily. Successful disintegration (within 4 mm) rate was 86% of renal stones, 84% of ureteral stones, and stone free rate after 6 months was 72% of renal stones and 84% of ureteral stones. As for the complications, brain infarction occurred in one case, subcapsular hematoma of the kidney in one, and arythmia in 5. No other severe side effects were observed. Between shock wave energy (the number of shock wave shots x voltage) and stone burden (long axis x short axis of the stone), a significant correlation was found in renal stone cases, but not in ureteral stone cases. E/B (shock wave energy/stone burden) was 33,100 (kv.shots/cm2) for the renal stone and 56,000 (kv.shots/cm2) for the ureteral stone. These results suggest that there is still another unknown factor, which is not related with renal stone, for successful disintegration of ureteral stone. We also confirmed that more energy is necessary for destruction of ureteral stone than for that of renal stone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Inverted papilloma of the renal pelvis].

A 60-year-old man with inverted papilloma of right renal pelvis is presented. On visit to hospital for benign prostatic hyperplasia with prostatic stone, he was found to have microscopic hematuria and intravenous pyelography and retrograde pyelography demonstrated a filling defect with papillary contour. We diagnosed a right renal pelvic tumor, which showed to be low grade because of negative cytology. Therefore, we performed tumor resection with renal preservation. Pathological diagnosis was inverted papilloma. From the Japanese and foreign literature, 16 cases of renal pelvic inverted papilloma were collected. They were reviewed clinically and pathologically, and the therapy was discussed.

Humans↗
PubMed1990

[Renal pelvic tumor in chronic renal failure: report of a case].

A 44-year-old female was admitted because of gross hematuria six years after beginning hemodialysis for chronic renal failure. There was a past history of hematuria one year before admission. Retrograde pyelography, computed tomographic scan and angiography had been performed, and a probable malignant tumor of left renal pelvis had been found in 1986. We recommended surgery at the time, but she refused treatment and was followed up. On June 22, 1987, the patient had a second attack of gross hematuria resulting in bladder tamponade, and hematuria from the left ureteric orifice was confirmed at cystoscopy. Ultrasound showed left obstructive nephropathy. Left nephrectomy was performed because of the presumptive diagnosis of malignant tumor. The histological diagnosis was transitional cell carcinoma of the left renal pelvis. Two courses of M-VAC (methotiexate, vinblastine, adriamycin and cisplatin) chemotherapy were accordingly given postoperatively. The incidence of renal pelvic tumor and its chemotherapy in patients with chronic renal failure are discussed.

Adult↗
PubMed1989

[Clinical evaluation of aztreonam (AZT) in the treatment of complicated urinary tract infections].

Aztreonam (AZT, Azactam) was given to 176 patients with complicated urinary tract infections (UTI), of whom 110 cases satisfied with the "Criteria of UTI Committee for the Evaluation of Drug Efficacy in the UTI (3rd Ed.)", which was modified by adopting the midstream urine data in cases of women. Aztreonam was administered by drip infusion at a daily dose of 1 to 4 grams (mostly 2 grams) for at least five days long. The overall clinical efficacy rate of AZT in the 110 cases with the complicated UTI was 64%, estimated by the criteria cited above. The efficacy rate according to the infection type groupings was 66% for the 38 patients in the 1st group, 33% for the 3 in the 2nd group, 79% for the 19 in the 3rd group, 85% for the 21 in the 4th, 47% for the 19 in the 5th and 42% for the 12 in the 6th group. The disappearance rate of Gram negative bacilli was 87.1%. Especially 15 strains of Pseudomonas aeruginosa were eliminated out of 25 (60%) after AZT administration. Forty-six strains appeared after AZT treatment, 36 (76%) of which were Gram positive cocci. Subjective side effects and abnormal laboratory findings in a total 176 cases were: diarrhea in one, upper abdominal discomfort in one, increases in glutamic pyruvic transaminase in 8, increases in glutamic oxaloacetic transaminase in 5 and eosinophilia in 1. All of these disappeared after termination of the drug. AZT might therefore be a useful and safe antibiotic for the first choice use against complicated UTI.

Adolescent↗
PubMed1988

The organic matrix of urinary uric acid crystals.

We have demonstrated that urinary uric acid crystals contain an organic matrix within the crystalline boundaries, morphologically similar to that of uric acid stones. Among several glycosaminoglycans in urine, heparan sulfate was almost exclusively identified in this matrix, as in that of uric acid stones. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) showed that several proteins in urine were incorporated in this matrix on a selective basis; two of which were albumin and Tamm-Horsfall mucoprotein. An affinity of uric acid or urate for selective urinary macromolecules in a liquid phase was supposed to be the origin of this matrix. But the proteins in the uric acid stone matrix were not separated by SDS-PAGE. Therefore we could not conclude whether the organic matrix of urinary uric acid crystals is similar to that of uric acid stones.

Crystallization↗
PubMed1986

Crystal-matrix interrelations in brushite and uric acid calculi.

Brushite and uric acid calculi were studied by means of scanning electron microscopy with the partial dissolution method and transmission electron microscopy. Brushite calculi consist of radially oriented columnar crystals which have sheet-like substructure. The organic matrix is identified chiefly at the outside of the crystals but partly included between the substructure. The concentric matrix bands are often dislocated between the neighbouring crystals. Uric acid calculi also consist of radially oriented columnar crystals, and a fine meshwork of the organic matrix is incorporated within the crystals. The concentric matrix layers of different density are angled according to the crystal lattice. These findings indicate that the organic matrix arose from a mucinous surface coat, at least in the radially striated calculi. The crystals continued to grow in this gel-state milieu, either thrusting the matrix aside or incorporating it within the crystals.

Calcium Oxalate↗
PubMed1985

Matrix glycosaminoglycan in urinary stones.

At first, urinary stones were classified according to their inorganic components (apatite, struvite, calcium oxalate monohydrate, calcium oxalate dihydrate and uric acid). Then, matrix glycosaminoglycan was extracted from the stones in each group and was analyzed by 2-dimensional electrophoresis. There were differences in the glycosaminoglycan content of matrices among different groups of urinary stones. The principal matrix glycosaminoglycan content consisted of hyaluronic acid in apatite and struvite stones, heparan sulfate in calcium oxalate monohydrate and uric acid stones, and hyaluronic acid and heparan sulfate in calcium oxalate dihydrate stones. We conclude that hyaluronic acid and/or heparan sulfate has an important role in urinary stone formation.

Electrophoresis↗
PubMed1985

Possible role of hyaluronate in experimental renal stone formation in rabbits.

We produced renal stones in rabbits by modifying Itatani's method, ligation of the right ureter followed by ureteroneocystostomy 1 week later. Renal stones formed in all animals within 2 weeks after ureteroneocystostomy. We measured the components of glycosaminoglycan in the stone matrix, renal tissue and urine by 2-dimensional electrophoresis. Glycosaminoglycan of the stone matrix consisted solely of hyaluronate. Glycosaminoglycan of the control normal urine consisted of only chondroitin sulfate, although hyaluronate was contained in urine in the hydronephrotic and stone forming period. Glycosaminoglycan of the control normal kidney consisted mainly of hyaluronate and chondroitin sulfate, while hyaluronate was the main component of glycosaminoglycan in the stone forming kidney. From these results, it is clear that hyaluronate is the most important component of glycosaminoglycan in the early stone forming period.

Animals↗
PubMed1985

Architecture of calcium oxalate monohydrate urinary calculi.

We have developed a partial dissolution method which enabled us to observe the internal architecture of urinary calculi. Using this method with improved organic matrix fixative, we studied the architecture of small calcium oxalate monohydrate urinary calculi with special attention to crystal-matrix interrelations. Calculi, we have observed, are invariably composed of 3 distinct zones. A core area is composed of randomly aggregated plate-like crystals with tendency of rosette formation. This core area is surrounded by an intermediate layer which shows prominent radial striations. This layer is composed of radially arranged piles of sheet-like crystals which extend beyond many layers of lamination. This layer gradually shifts to a peripheral layer where concentric laminations are prominent and each layer of lamination is composed of minute crystals which have lost radial arrangement. The organic matrix is observed only at the outside of the crystals, and matrix-rich crystal-poor bands separate each layer of concentric lamination. The concentric lamination seems to be a manifestation of the altered density of organic matrix which encrusted on the developing calculi and offered a milieu for crystal growth within.

Calcium Oxalate↗