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Biomedical subjects

H Takeuchi

Publications and source records attributed to H Takeuchi.

At least 631 records · Page 35Linked to original sources

[Intrascrotal and seminal vesicular granuloma probably induced by propionibacterium acnes].

A case of right intrascrotal and seminal vesicular granuloma probably induced by Propionibacterium acnes is reported. A 62-year-old man was admitted to our department because of low grade fever and the right intrascrotal and retrovesical masses without tenderness. Ultrasonography computed tomography, magnetic resonance imaging and vesiculography suggested a neoplasm. However, leukocytosis and high erythrocyte sedimentation rate (ESR) and c-reactive protein level (CRP) suggested inflammatory disease. He was treated for 1 week with parenteral cefazolin (CEZ) (4 g/day), and the intrascrotal mass was remarkably reduced in size. To rule out neoplasms, right orchiectomy and needle biopsy of the right seminal vesicle were performed and nonspecific chronic granuloma was identified histologically. On the 5th postoperative day he developed fever (39.2 degrees C) and P. acnes was isolated from blood culture. Gram stain revealed gram-positive rods in the specimen. Further chemotherapy normalized levels of ESR and CRP and white blood cell count and reduced the right seminal vesicle to its normal size. Recently several cases of infection induced by P. acnes have been reported, but this is the first report in the genitourinary tract.

Genital Diseases, Male↗

[Laboratory and clinical studies on cefdinir (10% fine granules) in pediatric field].

Clinical studies on 10% fine granules of cefdinir (CFDN), a new cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows. 1. Half-lives of CFDN in plasma in 3 children when administered on an empty stomach were 1.77 hours (3 mg/kg per os) and 1.47 hours (6 mg/kg per os), respectively. Eight hour urinary excretion rates of CFDN were 21.5% (3 mg/kg per os) and 16.4% (6 mg/kg per os), respectively. 2. CFDN was administered to 11 children with various bacterial infections: 1 patient with scarlet fever, 1 with pharyngotonsillitis, 3 with acute bronchitis, 3 with pneumonia and 3 with urinary tract infections. The overall clinical efficacy rate was 90.9%. 3. Loose stool was noted in 1 patient. No abnormal laboratory test values were encountered.

Administration, Oral↗

[Young-Dees-Leadbetter's posterior urethral lengthening procedure for urinary incontinence: report of three cases].

Urinary incontinence caused by functional or anatomical incompetence of the urethral sphincter is one of the most challenging problems in urological surgery. Posterior urethral lengthening accomplished by tubularization of the trigonum, which was proposed by H. H. Young, J. E. Dees and G. W. Leadbetter, has been shown to improve the outcome in epispadia patients with incontinence. We report our experiences of Young-Dees-Leadbetter's operation in three patients. Case 1 was a 55-year-old woman who had undergone removal of the external genitalia to treat genital Paget's disease, resulting in total incontinence. About one half of the urethra had been removed, resulting in a shortened urethral length of 2.5 cm. Case 2 was a 6-year-old boy with penile epispadia, who had leadage of about a third of the total urine volume. Case 3, an 18 year-old female patient, suffered from total urinary incontinence which had resulted from a defect in the entire urethra and bladder neck following a motor vehicle accident. Posterior urethral lengthening together with ureteral reimplantation was performed on these three patients according to Leadbetter's or Dees' method. Subtotal continence was achieved in cases 1 and 3, and incontinence was completely cured in case 2. Based on our results with these three cases, we feel that Young-Dees-Leadbetter's operation is a useful method for treating sphincteric incontinence, particularly in female patients with an anatomical urethral defect.

Adolescent↗

[Clinical studies on endocrine therapy for prostatic carcinoma (4): Initial response to endocrine therapy and prognosis].

We have already pointed out by the use of multivariate analysis that local response of the prostate is one of the important prognostic factors in patients receiving endocrine therapy. Herein, we investigated how the local response to endocrine therapy affects the survival rate or the survival period. We also studied the relationship between the local response and histopathological findings. The local response of prostate was not correlated with the stage progression. Sixty-seven percent of the patents in each stage had an initially favorable local response of the prostate, in which the primary tumor became flattened or reduced by endocrine therapy. By contrast, the local response of the prostate was well correlated with the prognosis in each stage. Patients with a flattened or reduced primary lesion following endocrine therapy showed a higher survival rate or a longer survival period than those with the unchanged lesion. This result has confirmed that the local response of prostate to endocrine therapy is useful in predicting clinical courses of patients. Grade of structural atypism (SAT), one of the pathological findings, had a correlation with local response of the prostate. With an elevation of the SAT grade, the proportion of patients with unchanged primary lesion was increased.

Humans↗

[Clinical studies on endocrine therapy for prostatic carcinoma (5): Analyses of relapse from endocrine therapy].

Prostate carcinomas are well known to be initially responsive to endocrine therapy. However, a significant number of the patients experience a relapse from endocrine therapy during the follow-up period. We clinically analyzed various aspects of the relapse which indicate a limitation in the effectiveness of endocrine therapy for prostate carcinoma. In a total of 372 patients, 117 (31.5%) had some evidence of local relapse such as regrowth of the primary lesion, or a generalized relapse such as re-elevation of total acid phosphatase, reactivation of previously present metastasis or the new appearance of metastasis, during endocrine therapy. Of these, one-fourth had local relapse alone and the remainder showed generalized relapse. The interval from the start of the treatment to the time of relapse tended to become shorter; 45.9 months (mean) in stage B, 36.8 in stage C and 29.3 in stage D, according to the stage progression. As to the non-relapse rate of the primary lesion, no differences were found among the stage, with the rate being approximately 90% at the fifth year in each stage. However, the generalized relapse-rate tended to increase with the stage progression. In the generalized relapse, the patients of stage C or D showed a non-relapse rate of 71.7% or 67.4%, respectively. Most of the generalized relapse appeared within five years following start of endocrine therapy in these advanced stages. The interval from relapse to prostate carcinoma-related death in patients with the generalized relapse was 9 approximately 21 months, and those in stage D tended to show a a poorer prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

[A comparison of the quality of life of prostatic cancer patients under slow releasing LH-RH analogue (TAP-144SR Depot) treatment or synthetic estrogen treatment].

The quality of life (QOL) was studied on 31 prostatic cancer (PC) patients, being followed at our out-patient-clinic during a relapse-free period. Fifteen of them were under treatment with a slow releasing LH-RH analogue (TAP-144 SR Depot) (TAP) and the other 16 prostatic cancer patients with synthetic estrogen (Honvan) (DES). The QOL of 37 benign prostatic hyperplasia (BPH) patients on conservative treatment was also studied. Concerning their general feeling of health, the prostatic cancer patients on TAP treatment felt subjectively better than those on DES. The social life of the patients on TAP or those who had BPH was less affected than that of those on DES. The quality of sexual life was worse for the prostatic cancer patients on both TAP and DES treatment than for the BPH patients.

Aged↗

[Clinical evaluation of intramuscular imipenem/cilastatin sodium in surgical infections].

A multi-center clinical study was carried out at the first Department of Surgery, Okayama University Medical School and its affiliated institutions to evaluate the efficacy and safety profiles of intramuscular imipenem/cilastatin sodium (IPM/CS) in surgical infections, which were mainly biliary tract infections and peritonitis. The following results were obtained: 1. The efficacy rate was 72.0% in a total of 25 evaluable patients and 81.8% in patients with cholecystitis. 2. The efficacy rates in patients with and without underlying diseases were 70.0% and 73.3%, respectively, and they were 71.4% in patients with mild or moderate infections and 75.0% in patients with severe infections. 3. Bacteriologically, the eradication rate was 100% for Gram-positive bacteria and 62.5% for Gram-negative bacteria, with an overall eradication rate of 78.6%. The eradication rate for monomicrobial infections was 71.4% and that for polymicrobial infections was 100%. 4. Out of 25 patients, one developed diarrhea as a drug-related adverse reaction, and laboratory abnormalities attributable to the treatment were observed in 5 patients. None of them was serious, however. 5. The overall usefulness rate was 60.0%, and the usefulness for cholecystitis (72.7%) was superior to that for cholangitis (33.3%).

Adult↗

[Effect of transfusion of blood components on gastric cancer patients--special reference to the incidence of postoperative hepatitis and prognosis].

To evaluate the effect of blood transfusion on incidence of postoperative hepatitis and prognosis of gastric cancer, the data of 493 patients having been operated on curatively in our hospital were divided into two groups: those who received transfusion before the beginning of components transfusion and those who received transfusion after that. The data indicated that the incidences of postoperative hepatitis increased from 3.7% to 5.4% after the beginning of transfusion of blood components, but the 5-year survival rates did not differ significantly. The 5-year survival rates of transfused patients and non-transfused patients were 57%, 84%, respectively (p less than 0.001) and the rates decreased according to the dose of whole blood and/or packed red cells. The same results were obtained when limited to stages I + II, But they were not deteriorated by fresh frozen plasma significantly. The result suggests that it is better to refrain from unnecessary blood transfusion and transfuse whole blood in the case of massive transfusion to decrease the incidence of postoperative hepatitis and more better to transfuse leucocyte-free blood to avoid immunological effect.

Adult↗

[Bacteriological, pharmacokinetic and clinical studies of cefpirome in the field of pediatrics].

Bacteriological, pharmacokinetic and clinical studies on cefpirome (CPR, HR 810), a new cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized below. 1. Antibacterial activities of CPR against clinically isolated strains of Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae and Haemophilus parainfluenzae were superior to those of ceftazidime. 2. Plasma concentrations and urinary excretion rates after intravenous bolus injection of CPR at doses of 10, 20 and 40 mg/kg for 5 minutes in 2 cases each were determined. Mean peak plasma concentrations of CPR at these dose levels were 33.9, 62.9 and 96.0 micrograms/ml at 15 minutes with plasma half-lives of 1.58, 1.69, and 2.13 hours, respectively. Mean cumulative urinary excretion rates in the first 8 hours after administration were 51.2, 78.0 and 74.9%, respectively. 3. Ten patients with bacterial infections (pneumonia 5 cases, urinary tract infection 5 cases) were treated with CPR at a daily dose of 16-79 mg/kg/day. The overall clinical efficacy and bacteriological eradication rates were both 100%. 4. No adverse reactions were observed except in 1 case of mild pain in blood vessels. Abnormal laboratory test results were also mild, slight elevation of GOT, GPT and thrombocytosis in 1 case and eosinophilia in 1 case.

Adolescent↗

[Present status and questions on early prostatic cancer (stage A, B)].

Prostatic adenocarcinoma confined to the prostate gland can be eradicated with radical prostatectomy or radiation therapy. Accurate staging including pelvic lymphadenectomy is needed for defining adequate therapeutic modality. Effort must be made in detecting low stage prostatic cancer. Stage A1 prostatic cancer have to be followed carefully to determine its prognosis and thus most suitable therapy for it.

Adenocarcinoma↗

Effect of cyclosporine on the development of cerebral vasospasm in a primate model.

The authors studied the effect of the immunosuppressive drug cyclosporine (CS) on the development of cerebral vasospasm after subarachnoid hemorrhage (SAH) using a primate model of vasospasm. Eighteen monkeys were randomly divided into three groups: a sham-operated control group, an SAH group, and a CS-treated group. To induce SAH, the right side of the circle of Willis was dissected free of the arachnoid and an autologous blood clot was placed around the arteries. In the CS group, CS (5 mg/kg/day) was administered intramuscularly for 7 days after the induction of SAH. The vessel caliber was evaluated on angiograms before the induction of SAH (Day 0) and 7 days after SAH (Day 7). Histological changes and the deposition of IgG in the arterial wall were studied in the three groups. The combined values of the average reduction of the right cerebral arteries at Day 7 was significant (P less than 0.05) in the SAH group (-43.3%) and in the CS group (-31.3%) as compared with the Sham group (-0.7%); however, there was no significant difference between the values in the SAH and the CS groups. In the CS group, the average reduction in vessel caliber of the right middle and anterior cerebral arteries was significantly (P less than 0.05) less than in the SAH group; this did not prove true for the internal carotid artery, however. Although the deposition of IgG in the media and an inflammatory reaction were observed in the spastic arterial wall in both the SAH and CS groups, there was no definitive difference in these immune/inflammatory reactions between the two groups. It is suggested that CS may be helpful in reducing the severity of vasospasm, but may not have a major therapeutic effect, considering its systemic toxicity.

Animals↗

[Prenatal ultrasound diagnosis of central nervous system anomalies].

Among fetal anomalies, the rate of the central nervous system (CNS) abnormality is high, and almost all cases are wanted to diagnose prenatally for the improvement of their prognosis. For instance, anencephaly should be detected for its lethal prognosis. Hydrocephalus has a certain possibility for intrauterine treatment. Spina bifida should be found in utero for the immediate operation after birth. At present, most of these major anomalies of CNS can be successfully screened or diagnosed by using ultrasonography. Brain anomalies such as hydrocephalus, Dandy-Walker anomaly and holoprosencephaly show characteristic dilatation of ventricles, which can be easily found in the routine screening ultrasonography from the beginning of the second trimester of gestation. Ultrasonographic detection of neural tube defects such as anencephaly and spina bifida is not difficult in utero. Thus it is possible to diagnose the most of CNS anomalies by using prenatal ultrasound in the early stage of gestation now. Recent advances of ultrasonography, particularly the development of transvaginal technique have contributed to the earlier diagnosis of CNS anomaly even in the first trimester of gestation.

Anencephaly↗

[Comparison of transvaginal sonographic appearance and endometrial histology].

Transvaginal sonograms were performed randomly in 51 patients in order to study the changes that occur in the normal endometrium. A total of 68 sonograms were performed. The accuracy of sonographic estimates of the endometrium was evaluated in 51 patients who underwent endometrial biopsy. Sonographic patterns were classified into six types. In the menstrual phase, the endometrial pattern showed hyper-echogenicity and an irregular border, then the pattern became thin and linear. The pattern assumed a leaf shape with hypo-echogenicity in the mid proliferative phase and hyper-echogenicity in the late phase. The enhancement of endometrial hyper-echogenicity and the disappearance of the midline were observed in the early secretory phase. A hyperechoic lumpy pattern was seen by the next menstruation. In all of the individuals studied, sonography was able to depict changes in the endometrium which corresponded to various phases of its histology.

Adult↗

Tissue reaction to collagen-coated porous hydroxyapatite.

To give tenacity to high porosity (80%-90%) hydroxyapatite (HA) and to make a stronger bone substitute, a collagen-coated porous HA (C-HA) was prepared, and its compressive strength was examined. By implanting C-HA into the femoral condyle of adult rabbits, the capacity for new bone formation and foreign-body reactivity were quantitatively compared with those of HA alone. The compressive strength of C-HA was 4.3 times greater than HA. At four weeks after implantation, the mean areal ratio of the newly formed bone in the C-HA block in each rabbit was 9.9%, which was somewhat less than the 13.7% in the HA block; the mean number of multinucleated giant cells (MGC) per visual field at x25 in the C-HA-implanted specimens in each rabbit was 14.4, significantly larger than the 6.1 in the HA specimens. However, 12 weeks after C-HA implantation, the areal ratio of new bone increased to 32.7%, the number of MGC decreased to 9.4, and the differences compared to the values in HA cases, 31.5% and 6.8, disappeared. These results showed that C-HA is mechanically stronger than HA and that there is no difference between HA and C-HA in capacity for new bone formation or foreign-body reaction.

Animals↗

[Clinical and pathological studies of the urothelial tumors with inverted proliferation].

We reported a case of inverted papilloma of the bladder, and six cases (two of ureteral cancer and four of bladder cancer) of transitional cell carcinoma with inverted proliferation. These tumors were superficial and pedunculated as well as transitional papilloma or ordinary papillary transitional cell carcinoma though they showed a non-papillary and polyp-like configuration. Moreover, these urothelial cancers with inverted proliferation were thought to be similar to papillary cancer with regard to grading, multiplicity, invasiveness and recurrence. Therefore, transurethral resection or segmental ureterectomy may be recommended for the tumor of low grade malignancy and radical treatment including systemic chemotherapy may be recommended for the tumor of high grade malignancy.

Adult↗

[Transcatheter embolization of huge renal arteriovenous aneurysm: a case report--review of 270 cases of renal arteriovenous fistula reported in Japan].

We report a case of huge renal arteriovenous aneurysm, which was successfully treated with transcatheter arterial embolization (TAE). A 72-year-old woman was admitted with the clinical symptom of dyspnea on effort. She felt a tremor in the left abdomen. Computerized tomographic scan showed a large enhanced mass (8x7x7 cm) on the left kidney. Selective renal arteriography revealed a renal arteriovenous aneurysm. Transcatheter arterial embolization with a steel coil was performed with minimal loss of renal parenchyma. A total of 270 cases of arteriovenous fistula have been reported in Japan and were statistically analyzed. The number of reports on TAE has dramatically increased since 1978, TAE can be first indicated for treatment of renal arteriovenous fistula in view of less invasiveness and preservation of renal function.

Adolescent↗