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H Nagamatsu

Publications and source records attributed to H Nagamatsu.

At least 19 recordsLinked to original sources
PubMed2001

Risk factors for the development of bladder transitional cell carcinoma following surgery for transitional cell carcinoma of the upper urinary tract.

To determine the risk factors for development of transitional cell carcinoma (TCC) of the bladder (BTCC) following surgery for TCC of the upper urinary tract (UUT-TCC) in patients without history of BTCC, 85 patients surgically treated for UUT-TCC (34 female, 51 male; median age 66, range 42-85 years) were reviewed retrospectively. The Cox proportional hazards model was used to assess the association of relevant clinicopathologic factors with BTCC-free survival in patients without a history of BTCC and TCC-specific survival in all. Median follow-up duration was 35 (range 1-193) months. Six patients (7%) had previous histories of BTCC, and 6 others (7%) had concurrent BTCC at the time of surgery for UUT-TCC. Of 70 patients who had no history of BTCC and underwent follow-up cystoscopy, 24 (34%) developed BTCC during follow-up after surgery. Univariate analysis identified female sex, postoperative systemic chemotherapy, and incomplete distal ureterectomy as significant risk factors for new development of BTCC. After multivariate analysis adjusted for age and pathological (p) T stage in the TNM classification, all three factors remained significant, with respective hazard ratios of 5.56 (95% confidence interval (CI), 1.99-15.6; p = 0.001), 3.19 (95% CI, 1.34-7.62; p = 0.009) and 2.99 (95% CI, 1.08-8.26; p = 0.03). Only pT stage was a significant independent risk factor for TCC-specific death. Female sex and postoperative systemic chemotherapy, as well as incomplete distal ureterectomy, are possible riks factors for development of BTCC following surgery for UUT-TCC.

Adult↗
PubMed2001

Wearing behaviors of a hybrid composite resin for crown and bridge.

The wearing behaviors of a hybrid composite resin for crown and bridge (ES) were examined using a two-body impacting-sliding wear test with a porcelain (PO), Au-Ag-Pd alloy (PD), direct restorative composite resin (CR) and tooth enamel (TO). Although PO was the hardest of all, it showed the largest wear together with ES in the combination of ES-PO, which was probably initiated from the superficial destruction by their impact. The wear in ES-PD was the second largest. It was noted in this combination that the surface of ES was partially contaminated by scraped thin layers of PD to a degree distinguished by the naked eye. The mutual wears of the components were relatively low in the combination of ES with CR, TO or ES itself. It is suggested from these findings that the hybrid composite resin may be useful as an alternative to porcelain for posterior crown and bridge unless it opposes porcelain or alloys.

Analysis of Variance↗
PubMed2001

Total and partial cardiac sympathetic denervation after surgical repair of ascending aortic aneurysm.

UNLABELLED: Sympathetic cardiopulmonary nerves arise from the cervical sympathetic trunks and travel alongside the great arteries to innervate the ventricles. Because of the proximity of the nerve and artery, cardiac sympathetic denervation may occur in patients who have just undergone surgery for the repair of an ascending aortic aneurysm. METHODS: To evaluate the cardiac sympathetic activity in aortic aneurysm, we performed cardiac 123I-metaiodobenzylguanidine (MIBG) imaging on 12 patients (mean age +/- SD, 47 +/- 17 y) before and after the surgical repair of an aneurysm. Seven patients scheduled for coronary artery bypass grafting also underwent 123I-MIBG imaging as controls for open-chest surgery. Planar images were obtained at 15 min (early) and 4 h (delayed) after injection of 111 MBq 123I-MIBG, and the cardiac 123I-MIBG uptake was graded quantitatively and visually. The quantitative evaluation was based on the heart-to-mediastinum ratio (H/M), and visual evaluation was performed by assigning a score of 0-3 (0 = absent, 1 = severely reduced, 2 = reduced, and 3 = normal). Heart rate variability using 24-h Holter electrocardiography was analyzed before and after the operation to generate a time-domain index of heart rate variability as an index of autonomic balance. RESULTS: In patients with aortic aneurysms, both early and delayed H/Ms were significantly decreased after the operation (early H/M: 1.84 +/- 0.16 before vs. 1.40 +/- 0.16 after, P = 0.001; delayed H/M: 1.79 +/- 0.38 before vs. 1.27 +/- 0.18 after, P = 0.004). Visual analysis of 123I-MIBG accumulation in early images showed absence of 123I-MIBG accumulation in 3 of 12 patients, a score of 1 in 7 patients, and a score of 2 in 2 patients. In contrast, no significant difference between H/M before surgery and H/M after surgery was seen in patients who underwent coronary artery bypass grafting. The time-domain index of heart rate variability was significantly lower after the operation than before (135 +/- 40 after vs. 96 +/- 27 before, P < 0.05). CONCLUSION: Cardiac sympathetic nerves are totally or partially denervated after the surgical repair of ascending aortic aneurysm.

3-Iodobenzylguanidine↗
PubMed1999

Polyarthritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide.

Polyarteritis nodosa is a necrotizing angitis that predominantly affects small and medium-sized arteries. The prognosis of untreated polyarteritis nodosa is very poor. Since symptoms are diverse and no serologic test is specific for polyarteritis nodosa, the diagnosis is difficult and often delayed. We describe a patient with polyarteritis nodosa who had gastrointestinal involvement with multiple aneurysms of the inferior mesenteric artery; only abdominal angiography provided a conclusive diagnosis. Alleviation of symptoms and regression of aneurysms were observed after combination therapy of an immunosuppressive agent, cyclophosphamide, and prednisolone. We emphasize the importance of early diagnosis by angiography and aggressive therapy in patients in whom physical signs indicating definite polyarteritis nodosa are not present.

Aneurysm↗
PubMed1999

Two cases of inflammatory bowel disease with multiple myeloma.

A significant increase has been reported in reticuloendothelial neoplasms in patients with inflammatory bowel diseases. We present two rare cases of multiple myeloma in patients with inflammatory bowel diseases. One was in a 58-year-old woman with ulcerative colitis, and the other was in a 59-year old woman with Crohn's disease. In both patients, multiple myeloma occurred during long-term observation of inflammatory bowel disease and during the inactive stage of intestinal inflammation. The multiple myeloma appeared to have resulted from monoclonal gammopathy of undertermined significance in both patients, and was diagnosed by characteristic serum and bone marrow findings. Our findings suggested that multiple myeloma should be particularly considered in women of middle or advanced age with ulcerative colitis or Crohn's colitis and serum monoclonal gammopathy.

Female↗
PubMed1999

[Long-term efficacy of the Gittes bladder neck suspension with use of ultrasonography for genuine stress urinary incontinence].

Thirty-eight patients with genuine stress incontinence underwent the Gittes procedures of the bladder neck suspension under ultrasonical monitoring. We performed the following two procedures. Original Gittes procedure: the puncture of the needle made twice through the different holes of the rectus fascia for each side and the bilateral helical suture was tied down separately above the rectus fascia. Modified Gittes procedure: the needle was passed through the rectus fascia once for each side and the both end of the helical suture was drawn up to suprapubic area, then the bilateral threads were tied over the rectus fascia. Original Gittes procedure was performed for twenty-nine patients and modified Gittes procedure for nine patients. Tightness of the suspension was decided by monitoring the posterior urethrovesical angle with use of the transrectal ultrasonography during the operation. A long term follow up survey was made up by means of a questionnaire by the phone or the mail. A total of thirty-six patients responded the questionnaire for a 94.7% response rate. The mean follow up was 33.1 months. 83.3% of the patients were cured and 5.6% were significantly improved. None of the patients claimed dysuria. There was no difference between the continent rates of the two procedures. We conclude that the Gittes bladder neck suspension with use of ultrasonography is effective for correction of female stress urinary incontinence.

Aged↗
PubMed1998

Evaluation of clinical indexes to predict fate of pelvic nerve dysfunction.

This study was designed to evaluate posterior urethral sensation and sacral reflex evoked by posterior urethral stimulation to predict fate of pelvic nerve dysfunction. Enrolled were 24 male patients sequentially receiving the following examinations 1-3 months (postoperative) and more then 6 months (follow-up) after surgery for rectal cancer: sensory thresholds of the penile skin (SS) and the posterior urethra (SU), sacral reflex evoked by penile stimulation (BCR) and posterior urethral stimulation (UUR), and urodynamic study. Controls included 25 patients with normal voiding function before pelvic surgery. SS, SU and latencies of BCR and UUR averaged 1.9+/-0.6 mA, 5.6+/-1.8 mA, 33.3+/-4.2 ms and 65.0+/-9.3 ms in controls, respectively, and unchanged postoperatively in 13 patients with normal voiding function. Of 11 patients with voiding dysfunction whose SS and latency of BCR remained unchanged, SU increased in 7, voiding function remained unrecovered in 6 patients during the follow-up period and recovered in the remaining 5. None of four patients with nonevocable UUR recovered voiding function. Thus, unchanged SU and disappearance of UUR were useful to predict recovery and nonrecovery of postoperative voiding dysfunction, respectively.

Adult↗
PubMed1998

The correction of type 2 stress incontinence with a polytetrafluoroethylene patch sling: 5-year mean followup.

PURPOSE: The durability of pubovaginal sling procedure for type 2 stress urinary incontinence was evaluated by a questionnaire survey. MATERIALS AND METHODS: From 1989 to 1996, 48 patients with type 2 stress urinary incontinence were treated with a polytetrafluoroethylene patch sling. Tightness of the sling was adjusted by setting the posterior urethrovesical angle at about 90 degrees under ultrasound monitoring. Study inclusion criteria were no urine leakage for at least 24 months confirmed by questionnaire and no recurrent urinary incontinence during followup. RESULTS: We received answers from 39 patients (81.3%), of whom 1 was excluded from study due to less than 24-month followup (18 months) without urine leakage. Of the 38 patients 32 (84.2%) reported no leakage of urine, 4 (10.5%) were subjectively improved, 2 (5.3%) were the same and none was worse, for an overall cure or improved rate of 94.7%. Followup of the 32 patients maintaining urinary continence averaged 65.9 +/- 29.4 months. Of the patients 6 (15.8%) had slight pelvic pain, 4 (10.5%) always and 10 (26.3%) sometimes had to strain to void, and 14 (36.8%) complained pollakisuria. Urge incontinence coexisted in 5 of 6 patients reporting improved or the same status. Of all patients 31 (81.6%) were satisfied with the decision to undergo the operation. CONCLUSIONS: Durability and safety of our procedure for stress urinary incontinence were confirmed by the survey questionnaire. Most of the patients complained of no or little difficulty voiding.

Adult↗
PubMed1997

[Study of directional differences on static and stress urethral pressure profiles of female urethra].

PURPOSE: We investigated the female continence mechanisms by comparing directional differences of static and stress urethral pressure profiles (UPP) in urinary continent females with those in stress incontinent females. Also, the mechanisms of bladder neck suspension were investigated by comparing directional differences of UPP pre- and post-operatively. METHODS: UPP at rest and under stress were recorded by means of double lumens microtip transducer catheter in 21 females without urinary incontinence (normal group) and 38 females with stress urinary incontinence (SUI group). And UPP were recorded pre- and postoperatively in 19-females of SUI group who had surgical cure of SUI (ope group). These measurements were performed on the urethral directions (anterior-direction of symphysis pubis, lateral and posterior) to which the pressure sensor in the catheter were pointed. Pressure transmission ratios (PTR) were calculated in each quartile dividing functional urethral length (FUL) into four equal lengths. We compared the parameters (the maximum urethral closure pressure = MUCP, FUL and PTR) when the sensor lies at the anterior, lateral and posterior direction in each group. The parameters in normal group were compared with those in SUI group in each direction and those in ope group were, compared pre- and postoperatively. RESULTS: In all groups, MUCP is always highest in the anterior direction but FUL shows no differences in the three directions. In all directions, MUCP and FUI are higher in the normal group than in the SUI group and there is no significant change in MUCP and FUL following successful bladder neck suspension. In the normal group, PTR of anterior, lateral and posterior urethra were approximately equal, but SUI group patients demonstrated significantly decreased PTR in the lateral and posterior urethra in comparison with PTR observed in the anterior urethra. Also, PTR of the anterior urethra in the SUI group approximates that in the normal group but PTR of the lateral and posterior urethra are lower in the SUI group than in the normal group. In the ope group, in the proximal three-quarters of the FUL, PTR in the lateral and posterior urethra approximated to those in the anterior urethra postoperatively. CONCLUSION: These findings suggest that urethral support is destructed in the SUI group as mentioned in DeLancey's hammock hypothesis and lateral and posterior weakness were corrected by bladder neck suspension. Bladder neck suspension restored the continence by constructing posterior support of urethra as the substitution for destructed urethral support.

Aged↗
PubMed1996

[En bloc cystourethrectomy with preservation of potency].

BACKGROUND: The objective of this study is to evaluate efficacy of en bloc cystourethrectomy with preservation of potency in patients with bladder carcinoma. METHODS: A total of nine patients underwent this procedure in 1991 and 1994. Following 2 cases of 1991 who were confirmed to recover potency and had no recurrence in the pelvis during 2-year follow up as a preliminary study, 7 cases underwent the same procedure in 1994. Erectile function was measured by the snap gauge band. RESULTS: Six of the 9 patients recovered erection adequate for sexual activity and 4 of them have practiced sexual intercourse. The remaining 3 patients experienced mild erection but inadequate. One of them failed to accomplish adequate erection because of perineal pain at erection. Three to eighteen months after surgery, the first erection was experienced. Surgical margins were pathologically negative in each of the 9 specimens. By the present, all of the 9 patients survive with no evidence of disease. CONCLUSION: The potency-sparing en bloc cystourethrectomy appears to preserve potency on the level comparable to the two-stage potency-sparing cystourethrectomy combined with delayed urethrectomy.

Adult↗
PubMed1996

[Relationship between pretreatment serum levels of prostate specific antigen and bone metastasis in prostate cancer].

We retrospectively reviewed pretreatment levels of serum prostate specific antigen (PSA) in 138 newly diagnosed, untreated patients with prostate adenocarcinoma to evaluate the usefulness of serum PSA levels to predict results of radionuclide bone scans. All of the 24 patients with serum PSA levels above 200 ng/ml showed positive bone scans whereas those with serum PSA levels below 10 ng/ml included only three cases (3/51, 5.1%) positive for bone metastasis. All of the three had poorly differentiated adenocarcinoma of the prostate. In conclusion, bone scans may not be necessary in the cases with serum PSA levels less than 10 ng/ml except for those with poorly differentiated adenocarcinoma.

Adenocarcinoma↗
PubMed1996

[Results of transurethral resection of prostate plus incision (TUR-P+I) for benign prostatic hypertrophy].

The results of 14 patients treated by TUR-P+I and 15 patients by TUR-P between September 1991 and August 1993 were reviewed to evaluate the effects of TUR-P+I. Tur-P+I is a combined technique of channelling TUR-P and transurethral incision of the bladder neck and the prostate. After receiving modest TUR of the adenoma, the bladder neck and anatomical capsule of the prostate was incised by electroresectoscope at 6 o'clock position from the bladder neck toward to verumontanum. Before operation, the maximum floor rate, average flow rate, and residual urine volume were measured, which were respectively 9.9 +/- 5.6 ml/s (M+SEM), 4.4 +/- 2.3 ml/s, and 130 +/- 80 ml in TUR-p+I group, and 11.6 +/- 2.9 ml/s, 4.3 +/- 1.8 ml/s, and 60 +/- 60 ml (p < 0.01) in TUR-P group. The operation time and resected tissue weights were similar in both groups; 68 +/- 16 min and 11 +/- 5.2 g in TUR-P+I group, and 72 +/- 25 min and 11 +/- 6.5 g in TUR-P group. The post-operative maximum flow rate, average flow rate and residual urine volume were respectively improved to 19.0 +/- 5.7 ml/s, 9.3 +/- 3.7 ml/s, and 20 +/- 20 ml in TUR-P+I group, and 14.6 +/- 6.1 ml/s (p = 0.057), 6.6 +/- 2.6 ml/s (p < 0.05), and 30 +/- 30 ml (not significant) in the TUR-P group. Neither significant blood loss nor complications were experienced in either procedure. It is suggested that TUR-P+I could be a safe and effective alternative of TUR-P. Longer follow-up and the prospective study are required to establish the value of the current combined technique.

Aged↗
PubMed1995

Effects of clenbuterol on rabbit vesicourethral muscle contractility.

Clenbuterol (10(-10)-10(-7) M), a selective beta 2-adrenoceptor agonist, reduced spontaneous contractile force of isolated rabbit bladder dome, bladder base and proximal urethra. Clenbuterol inhibited both acetylcholine (Ach)-and electrical field stimulation (EFS)-induced contractions of rabbit bladder dome, but was more potent in inhibiting EFS-than Ach-induced contractions. Acetylcholine-but not EFS-induced contractions in the bladder dome were completely inhibited by pretreatment with 10(-6) M atropine. The atropine resistant component of the EFS-induced contractions was completely inhibited by tetrodotoxin, 10(-6) M. Clenbuterol and a non-selective beta-adrenoceptor agonist, isoproterenol, potentiated the EFS-induced contractions of isolated striated muscle preparations from the external urethral sphincter and from the extensor digitorum longus in the rabbit. Clenbuterol was more potent than isoproterenol in increasing EFS-induced contractile force in the external urethral sphincter, whereas isoproterenol was more potent than clenbuterol in increasing EFS-induced contractile force in the extensor digitorum longus. These data suggest that clenbuterol may have a role in the treatment of urinary incontinence by inhibiting the detrusor contraction and fascilitating the external urethral sphincter selectively.

Acetylcholine↗
PubMed1995

[The experimental evaluation of the difference in closing dynamics of internal urethral ostium on the urinary continence and on the ejaculation induced by an administration of phenylephrine].

BACKGROUND: The internal urethral ostium is usually closed both on the ejaculation and on the urine collection, although the difference of the closing characteristics have not been known. METHODS: The difference in closing style of bladder neck (internal urethral ostium) between on the phenylephrine administration corresponding state to the ejaculation and on the filling of urinary bladder corresponding state to the urinary continence was evaluated by Stereo-UPP method using mongrel dogs. RESULTS: On phenylephrine administration, the length between verumontanum and bladder neck was lengthened, and a remarkable pressure increase was observed in the area. On the urinary continence filling physiological saline in the bladder, the length of the urethra on the UPP curve of the anterior wall of urethra was lengthened (10%) and the base of bladder was gradually become flat. The pressure in the bladder neck was not relatively increased. CONCLUSIONS: The internal urethral ostium was closed both on the phenylephrine administration and on the urine collection, although the closing characteristics of each was very different. It was demonstrated that on the phenylephrine administration the area between the verumontanum and the bladder neck was lengthened, together with the rise of pressure in the area, whereas on the urine collection bladder neck was closed in low pressure by flattening the base of bladder.

Adrenergic alpha-Agonists↗
PubMed1995

[Post-TUR-P stress urinary incontinence successfully treated by periurethral injection of autologous fat to the prostate: a case report].

A 77-year-old man had been suffering from stress urinary incontinence for 2 years since he had received transurethral resection of prostate (TUR-P) for benign prostatic hypertrophy. A 60-min pad test yielded 3 g of urine. Prostatic urethra was widely open and the external sphincteric injury was suggested because of the short membraneous urethra on the urethrogram. Urethral pressure profile indicated his maximal urethral closing pressure (MUCP) of 24 cmH2O and functional urethral length of 1.6 cm and cystometry demonstrated an underactive bladder, indicating that his incontinence was caused by sphincteric injury. Autologous fat injection therapy was performed in the lithotomy position under spinal anesthesia. Fifteen ml of subcutaneous fat was obtained from his lower abdomen by liposuction through a 15G needle, and 10 ml was injected submucosally from the perineum at 6 o'clock area of the prostatic apex under the guidance of transrectal echography using a 15G needle. The patient became completely dry after the procedure. MUCP and FUL increased to 35 cmH2O and 1.9 cm, respectively, although longer follow up is necessary. The advantage of autologous fat injection to the prostate for post-TUR-P SUI patients is briefly discussed.

Adipose Tissue↗
PubMed1995

[Assessment of disturbance of urinary bladder function after an operation for rectal cancer].

Disturbance of urinary bladder function occurs frequently after operations on rectal cancer. Clinical studies of 15 male patients with resected rectal cancers revealed a close relationship between the disturbance of urinary bladder function and the extent to which the autonomic nerves in the pelvis were disturbed. Clinically, transection of the hypogastric nerve did not affect urinary function. Branches to the urinary bladder in the pelvic plexus controlled bladder function bilaterally. Transection of one side of the pelvic splanchnic nerve (PSN) did not affect bladder function. Partial transection of the bilateral PSN strongly affected bladder function, but in these cases, compensation by the non-disturbed PSN improved urinary bladder function 3 months after the operation. It seems possible that the lower-grade branches to the urinary bladder in the PSN may control bladder function. Uroflowmetry, amount of residual urine, cystometry, and urinary bladder compliance were all useful in assessing disturbance of branches to the urinary bladder in the PSN. To assess the grade of severe Clinical cases, it proved the most convenient to examine the uroflowmetry and amount of residual urine.

Adult↗