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Biomedical subjects

K Kitami

Publications and source records attributed to K Kitami.

17 recordsLinked to original sources
PubMed1991

[Vesicourethral dysfunction of diabetic patients].

In order to evaluate vesicourethral dysfunction in diabetic patients, urodynamic studies, IVP and urinalysis were performed on 173 diabetic patients (male 78, female 95) and 17 nondiabetic control cases. In addition to the classical findings as increased volume at the first desire to void and decreased maximum vesical pressure, diabetic patients showed varieties of vesicourethral dysfunctions such as overactive bladder (14.5%), low compliance bladder (11.0%) and loss of detrusor-external sphincter coordination (31.7%). Vesicourethral function of diabetics was classified in following 5 types by analysing the volume at first desire to void, volume at maximum desire to void, maximum vesical pressure, residual urine volume and bladder compliance. 1. Type 1, normal vesical function, 13 cases. 2. Type 2, vesical dysfunction with minimal residual urine, 49 cases. 3. Type 3, vesical dysfunction with residual urine, 66 cases. 4. Type 4, low compliance bladder, 20 cases. 5. Type 5, overactive bladder, 25 cases. Pyuria was observed in 59.8%, hydronephrosis was found in 10.9% and ectasia of lower ureter was found in 17.8% of diabetic patients. The highest incidence of pyuria and abnormality of the upper urinary tract were noted in Type 4 and followed by Type 3 and by Type 2 in decreasing order. Extent of pyuria and ectasis of the upper urinary tract showed statistically significant correlation with residual urine volume and detrusor-external sphincter coordination. When vesicourethral function was compensated by abdominal strain, the volume of residual urine is not elevated, but when the mechanism of compensation is lost or in the absence of detrusor-external sphincter coordination results in gradual accumulation of residual urine. In cases with long standing chronic urinary tract infection may results in fibrosis of the bladder wall with low compliance bladder. Fibrotic obstruction of uretero-vesical junction can cause hydroureteronephrosis and followed by renal function impairment. As vesical damage become irreversible at this end stage, proper management during early stage is crucial for management of diabetic patients. Cholinergic agent were effective to reduce residual urine volume in Type 3. alpha-blocking agent were effective to reduce residual urine volume in Type 3 and some cases of Type 4. In cases in which medication therapy failed to reduce residual urine, the clean intermittent catheterization was successful in control of urinary tract infection and upper urinary tract ectasis. Transurethral resection of the prostate and the bladder neck is indicated in the male patients with a large amount of residual urine in Type 3 and 4.

Aged↗
PubMed1991

[Persistent primitive proatlantal intersegmental artery (PPPIA) presenting with cerebral infarction].

A case of persistent primitive proatlantal intersegmental artery (PPPIA) is reported. A 65-year-old male with treated hypertension was admitted to our clinic complaining of dysarthria and hemiparesis of sudden onset two days after the ictus. CT revealed spotty low-density lesions in the left corona radiata and bilateral thalami with bilateral watershed infarction. MRI findings were also compatible with cerebral infarction. Left common carotid angiography demonstrated a large anastomosis between the external carotid artery and the vertebral artery at the proatlantal region. Neither of the vertebral arteries were visualized on digital subtraction aortography. All the blood circulation of the vertebro-basilar system was through this anastomotic artery (PPPIA). A flow study revealed hypoperfusion in the territory of the left middle cerebral artery on 133Xe SPECT. Bone window CT of cervical vertebrae revealed hypoplasia of the left transverse foramen in C2, C3, C4, C5, C6 vertebrae. This case is very suggestive of an anaplasia or hypoplasia of the vertebral arteries. The etiology of his left frontal infarction seemed to be a blood-stealing phenomenon of long standing, from the anterior to the posterior circulation through the PPPIA.

Aged↗
PubMed1990

Holoprosencephaly with Dandy-Walker cyst. Rare coexistence of two major malformations.

A case of holoprosencephaly associated with Dandy-Walker cyst is reported. The patient was a male baby whose mother had normal serum titers for toxoplasma, syphilis, rubella and hepatitis B. She had no history of diabetes mellitus, administration of drugs or irradiation during the pregnancy. At the 8th month of gestation, fetal hydrocephalus was diagnosed by ultrasonic imaging. He was delivered by caesarean section at 34 weeks and 4 days, weighing 2,644 g. His head circumference was 42 cm; the anterior fontanel was not distended and its tension was normal. The chromosomal karyotype was a normal 46 XY. X-ray CT showed a large dorsal sac cyst in the supratentorial space and a hypoplastic cerebellum with a large cyst in the posterior fossa. He received a cyst-peritoneal shunt 24 days after birth. After this procedure, his head enlargement was arrested. We discuss the etiology of this rare coexistence of two major malformations.

Abnormalities, Multiple↗
PubMed1990

A case of intraventricular arachnoid cyst. How should it be treated?

A rare case of arachnoid cyst in the trigone of a lateral ventricle is reported. The patient was an 8-year-old boy who had had four episodes of convulsions prior to admission. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a cystic lesion containing fluid resembling cerebrospinal fluid. Although he received a cyst-peritoneal shunt, the lesion did not decrease in size. Direct removal of the cyst was then scheduled. The entire cyst was finally removed, although it was firmly attached to the choroid plexus. The enlarged trigone gradually decreased in postoperative CT. The effectiveness of a cyst-peritoneal shunt is not always satisfactory. We recommend total resection of the cyst without use of a shunt system.

Arachnoid Cysts↗
PubMed1990

New method of MVD using a vascular tape for neurovascular compression involving the vertebrobasilar artery--report of two cases.

In the treatment of hemifacial spasm and trigeminal neuralgia by microvascular decompression (MVD), lack of improvement or recurrence may occur because of the difficulties in positioning prostheses and the involvement of the large vertebrobasilar arteries, even with use of fenestrated aneurysm clips or adhesives. We have developed a new method of MVD, in which a vascular tape is anchored to the dura mater to transpose the responsible large artery. This method achieved successful results in our two patients with nerve compression involving the vertebrobasilar arteries.

Aged↗
PubMed1990

[Paratesticular rhabdomyosarcoma: a case report].

A thirteen-year-old boy noted a swelling in his right scrotum one year prior to admission. On August 7, right high orchiectomy was performed. The tumor mass measured 10 x 6 x 7 cm. Microscopic examination revealed alveolar type rhabdomyosarcoma. Lymphangiography and computed tomography revealed retroperitoneal lymph node metastasis. He was treated with VAC therapy (vincristine, actinomycin D, cyclophosphamide) and VAD therapy (vincristine, adriamycin). This drug combination was effective, and he has been followed for two years with no evidence of recurrence.

Adolescent↗
PubMed1990

[A case of 2,8-dihydroxyadenine stone with a partial deficiency of adenine phosphoribosyltransferase].

A 37-year old female was admitted with a complaint of gross hematuria. Intravenous pyelography and retrograde pyelography showed right non-functioning kidney with a radiolucent stone in the ureter. Computerized tomographic scan revealed right hydronephrosis and ureteral stone. Ureterolithotomy was performed. Infrared spectrometric analysis of the stone revealed a 2,8-dihydroxyadenine calculus. The adenine phosphoribosyltransferase activity in red blood cells was partially deficient. After the operation the patient has been given 100 mg/day of allopurinol and is on a low purine diet. There have been no signs of recurrence.

Adenine↗
PubMed1989

[Multiple ureteral diverticula: a case report].

A 73-year-old male was admitted to our hospital with the complaint of difficulty and frequency of urination. Needle biopsy of the prostate was done and microscopic examination revealed adenocarcinoma. Bone scintigram showed multiple bone metastasis and he was diagnosed as having prostatic carcinoma stage D2. Intravenous pyelography revealed multiple out-pouching lesion of mid left ureter and left mild hydronephrosis. Fosfestrol was given for prostatic carcinoma and no treatment was given for multiple ureteral diverticula. Sixteen cases of multiple ureteral diverticula from Japan were collected and discussed.

Adenocarcinoma↗
PubMed1987

[Carcinoma of the urachus with variable pathological findings: report of a case and review of literature].

A 71-year-old man was admitted with the chief complaint of gross hematuria. Cystoscopic examination showed a broadbased papillary tumor at the apex of the bladder. There was edema of the mucous membrane around the tumor. CT-scan demonstrated a mass extending from the bladder dome superiorly. Partial resection of the bladder was done. Pathological examination revealed grade 3 transitional cell carcinoma, with scattered adenocarcinoma and squamous cell carcinoma foci. Chemotherapy with bleomycin (BLM) and cis-dichlorodiamine platinum (CDDP) was done postoperatively. Ten months after the operation, he was readmitted because of recurrence in retroperitoneal lymph nodes. Chemotherapy with BLM and CDDP was done, but he died of pulmonary complications. Autopsy revealed retroperitoneal lymph node metastasis of transitional cell carcinoma. There was no metastasis to any other organ. We briefly discuss 275 cases of the carcinoma of the urachus collected from the Japanese literature.

Adenocarcinoma↗
PubMedDate not supplied

Findings of magnetic resonance imaging in cerebral venous occlusion: difference from hemorrhagic infarction.

A case of cerebral venous occlusion is reported. X-ray computed tomography showed a high-density lesion mimicking an intracerebral hemorrhage. In contrast, magnetic resonance images taken at the early clinical stage revealed a high-intensity lesion in both T1- and T2-weighted images. Follow-up magnetic resonance images at the chronic phase revealed that the intensity of this lesion had changed to low in the T1-weighted image, while still being high in the T2-weighted image. These findings suggest that the lesion might be due to venous congestion produced by cerebral venous occlusion rather than hemorrhage into the cerebral parenchyma.

Cerebral Hemorrhage↗