[A case of gastric lipoma prolapsed into the duodenal bulb, which caused ball valve syndrome].
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Aged↗
Biomedical subjects
K Umeda
Publications and source records attributed to K Umeda.
Clinical analysis of 592 patients with microtia.
Clinical and statistical analyses were performed on 592 patients who visited our hospital between April 1968 and March 1995. The preponderance in men (64.7%) and right-side (58.4%) was distinct statistically. The material shows that grade III microtia, peanut-shell type, was the most frequent with 56.8%. It is complicated with congenital stenosis or atresia in most cases (92.0%). The degree of anomalies of the auricle and external auditory meatus was generally interrelated. Ten cases of familial microtia were discovered, and all parent-child cases were father-child. About 27.9% of the patients' mothers had had a cold, threatened abortion, gestosis, anemia, etc during their pregnancy. Except for 6 patients with Treacher-Collin's syndrome and 2 patients whose mothers took thalidomide during pregnancy, we could not demonstrate the cause of the microtia, whether general or environmental.
Ear, External↗
Long-term results of otoplasty for microtia.
We report the results of otoplasty for microtia in 497 ears of 229 patients treated between January 1971 and March 1995. More than 80% of the cases showed satisfactory outcome. Seventy-six ears underwent minor additional surgery. When cartilage exposure occurred because of skin necrosis we used a free skin graft or a pedicled flap or sutured closely.
Adolescent↗
Chemotherapy and granulocyte-colony stimulating factor for non-Hodgkin's lymphoma of the head and neck.
Granulocyte colony-stimulating factor (G-CSF) is believed to be useful for shortening the duration of granulocytopenia and for minimizing the decrease in the granulocyte count caused by chemotherapy for non-Hodgkin's lymphoma. In the present study we investigated the effect of G-CSF on bone marrow suppression caused by chemotherapy for non-Hodgkin's lymphoma of the head and neck. The leukocyte and neutrophil nadirs were significantly higher, while the duration of leukopenia, the time to recovery, and the time to the nadir were significantly shorter when G-CSF was administered prophylactically from 48 h after the completion of chemotherapy than when it was administered after the leukocyte and neutrophil counts had reached nadir. G-CSF had no influence on other blood cell components and caused no severe adverse events.
Aged↗
Diverticular disease of the colon at a regional general hospital in Japan.
PURPOSE: X-ray film registry records were reviewed to better understand the changing nature of diverticular disease (DD) of the colon in Japan. RESULTS: Among 6,849 patients undergoing barium enema examination during a eight-year period from 1985 to 1992, this condition was found in 1,074 patients (15.7 percent), including 702 males (65.4 percent) and 372 females (34.6 percent). During this eight-year period there was an increase in frequency from 10.7 percent in 1985 to 17.8 percent in 1992. The proportion of patients with right-sided, bilateral, and left-sided DD was 69.2 percent, 17.5 percent, and 13.3 percent, respectively. The right-sided DD was more common in the younger age group and was predominant in male patients, whereas the left-sided DD increased with age, especially in female patients. Of the 1,074 patients, 11 (1.0 percent) underwent surgery in the same period. Regarding the right-sided DD, only 2 of 743 patients received surgery (0.3 percent). On the other hand, of the 143 patients with left-sided DD, 9 patients (6.3 percent) received some form of surgery. CONCLUSION: Right-sided diverticular disease of the colon is still common in Japan. It does not appear that this tendency will change in the future. Nearly all patients diagnosed as having diverticula had either no symptoms or only mild symptoms, and only about 1 percent required surgery. Right-sided diverticular disease of the colon seems to have had no serious clinical problems compared with left-sided DD.
Adolescent↗
Collagen remodelling in myocardia of patients with diabetes.
AIMS: To investigate collagen remodelling in the interstitium of the heart in patients with diabetes. METHODS: Immunohistochemical study of the biopsied myocardium using type specific anticollagen antibodies (I, III, IV, V, VI) was performed in 12 patients with non-insulin dependent diabetes mellitus and six non-diabetic patients. There was no history of hypertension or coronary artery stenosis in any of the patients. RESULTS: Noticeable accumulations of collagen types I, III, and VI in the myocardial interstitium were recognised in both groups, but little accumulation of types IV or V was found. Types I and III mainly stained in the perimysium and perivascular region, while type VI predominantly stained in the endomysium. There was no disease specific accumulation of collagen in diabetes mellitus. The percentage of total interstitial fibrosis in the myocardium was significantly higher in the diabetic group than in the control group (p < 0.05). Although the percentages of collagen types I and VI did not differ between the two groups, the percentage type of III was significantly higher in the diabetic group than in the controls (p < 0.01). CONCLUSIONS: Collagen remodelling mainly as a result of an increase in collagen type III in the perimysium and perivascular region, occurs in the hearts of patients with diabetes.
Adult↗
[A study on the mass screening system for prostatic diseases].
Between 1984 and 1990, a mass screening for prostatic diseases was carried out on men over 55 years old in cities, towns and villages in Toyama Prefecture, Japan. The total number of subjects examined in the primary study was 1,232, which was 17.7% of the males over 55 years old in these areas. The primary study consisted of inquiry concerning urination, digital examination of the prostate, transabdominal ultrasonography, and determination of tumor markers. A secondary study was indicated for 100 subjects (8.9%) suspected to have prostatic cancer and 169 (15%) suspected to have benign prostatic hypertrophy, but only 92 (35%) of them were actually examined. Prostatic cancer was histologically diagnosed in 3 subjects (0.3%), and benign prostatic hypertrophy was established in 56 subjects (4.5%), who were referred to urologists. Though a high percentage of the population was covered by the primary study the percentage of subjects who received the secondary study among those in whom it was indicated was low. This probably was a reason for the low detection rate of prostatic cancer. An improved system is considered to be needed to increase the efficiency of mass screening for prostatic diseases.
Humans↗
Typing of recent infectious bronchitis virus isolates causing nephritis in chicken.
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Animals↗
Multiple marker evaluation in prostatic cancer with prostatic acid phosphatase, gamma-seminoprotein and prostate-specific antigen.
Serum prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm), and prostate-specific antigen (PA) levels were measured in 63 untreated patients with prostatic cancer. The sensitivities of PAP, gamma-Sm, and PA as markers of malignancy were 68%, 83%, and 77%, respectively. The latter two markers were more sensitive than PAP, especially in stage B disease. The specificities of PAP, gamma-Sm, and PA were 95%, 93%, and 93%, respectively. Patients with multiple positive markers were very likely to have prostatic cancer. In reactivation of the disease, positive rates for gamma-Sm and PA were higher than for PAP, indicating that the former two markers are more reliable for monitoring prostatic cancer.
Acid Phosphatase↗
[Relationship between reactivation and tumor markers in prostatic cancer].
Twenty-seven cases of reactivated prostatic cancer between 1979 and 1990 were investigated. Reactivation took place in the form of local aggravation in 3 cases, occurrence or aggravation of metastasis to bones in 8 cases, and in both forms in 16 cases. The elevation of tumor markers preceded the clinical findings in 11 cases (41%). In 75% of the cases with occurrence or aggravation of metastasis, the elevation of tumor markers preceded the clinical findings. This showed that tumor markers were useful in most cases for early detection of reactivation. However, in 3 cases with local aggravation, the clinical findings preceded the elevation of tumor marks. Therefore, it is also important to check the clinical findings at the follow-up. At the time of reactivation, positive rates of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostatic specific antigen (PA) were 78%, 83% and 80%, respectively. Thus gamma-Sm and PA appeared to be more reliable than PAP for monitoring of prostatic cancer.
Acid Phosphatase↗
[Clinical results and problems of anti-androgen therapy of benign prostatic hypertrophy].
We evaluated the effect of anti-androgen therapy for benign prostatic hypertrophy. Patients showed a significant reduction in the prostatic weight measured by means of transrectal ultrasonography after 3 to 4 months of treatment. However, there were no patients who showed any symptomatic improvement despite a reduction in the prostatic weight. They had prostatic stones more frequently than the group who showed symptomatic improvement properly. We summarized some problems of anti-androgen therapy for benign prostatic hypertrophy.
Administration, Oral↗
[Evaluation of anti-androgen therapy for benign prostatic hypertrophy by using transrectal prostatic ultrasonography].
We evaluated the effect of anti-androgen therapy for benign prostatic hypertrophy on 33 patients who had undergone transrectal prostatic ultrasonography both before and after administration of anti-androgenic drugs in our clinic. Patients treated with chlormadinone acetate (CMA) orally, or TSAA-291 intramuscularly showed a significant reduction in the prostatic weight. However, this reduction was not correlated with the degree of symptomatic improvement. In addition, patients who showed no symptomatic improvement despite a reduction in the prostatic weight often had prostatic stones or small inflammatory cell infiltrations in their prostatic tissue. Therefore, the coexistence of prostatitis or bladder neck obstruction with prostatic hypertrophy may contribute to the lack of symptomatic improvement in such patients.
Administration, Oral↗
[Washout rate in patients with hypertrophic cardiomyopathy and hypertensive cardiac hypertrophy].
The present study was performed to clinically clarify the pathogenesis of hypertensive cardiac hypertrophy (HT) and hypertrophic cardiomyopathy (HCM). Exercise thallium-201 (Tl-201) myocardial scintigraphy using a bicycle ergometer was performed for controls, HT and HCM. The scintigrams were evaluated by the circumferential profile analysis. Furthermore, the changes in Tl-201 dynamics in exercise Tl-201 scintigraphy with verapamil injections were examined in these three groups. Analysis of exercise Tl-201 scintigraphy without verapamil injections showed that the initial uptake did not differ among the three groups, but the washout rate three hours after the Tl-201 injections (WR3) did differ among the three groups. Although the WR3 of HT did not differ from that of the controls, the WR3 of HCM was lower than that of the controls. The WR3 with and without verapamil were compared. Although the WR with verapamil injections equalled that without verapamil injections in the controls and HT, the WR3 with verapamil injections decreased more than did that without verapamil injections in HCM. As an index of great and rapid changes in circulation, the washout rate one hour after the Tl-201 injection (WR1) was calculated. The WR1 without verapamil did not differ among the three groups and did not differ from that with verapamil injections in each group. These results suggest that Tl-201 dynamics of HT differ from those of HCM and lowering of the WR3 in HCM may not be caused by disturbance in the microcirculation, but rather by disturbance of Tl-clearance through the cell membrane and its cytoplasm.
Cardiomegaly↗
[Pain relief by high-dose medroxyprogesterone acetate in advanced prostatic cancer].
The effect of high-dose medroxyprogesterone acetate was studied in 7 patients with advanced prostatic cancer. Results in 7 patients were no change (NC) in 5 (71%) and progressive disease (PD) in 2 patients (29%). However, pain relief was obtained in 6 of the 7 patients (86%). As side effects, 2 patients (29%) showed moon-face and 2 patients weight gain (29%). These results indicate that treatment of high-dose medroxyprogesterone acetate is useful for pain relief in patients with advanced prostatic cancer.
Adenocarcinoma↗
[A case of bilateral coronary artery to pulmonary artery fistulas associated with hepatic arteriovenous fistula].
A 55-year-old man, previously treated for primary hypothyroidism, was admitted for evaluation of atypical chest pain. On physical examination, the pulse rate was 60 and blood pressure was 132/84 mmHg. Heart sounds were normal and no murmur was heard. Abdominal palpation showed no abnormal finding, and bruit was not heard. The electrocardiogram was normal and stress-induced ischemia was not found. The chest X-ray showed no sign of pulmonary hyperaemia or mass lesion, and central shadow was normal (CTR = 44%). During right heart catheterization, the pressures were normal in the cardiac chambers, pulmonary artery, and wedge position. A significant increase in oxygen saturation was disclosed at pulmonary artery level (10%) and the upper site of the inferior vena cava (22%). Coronary arteriography found coronary artery fistulas from the left main trunk, the left anterior descending artery, the left circumflex, and the right coronary artery to the pulmonary trunk. The left and right ventriculograms were normal. The digital subtraction angiography of celiac artery showed hepatic arteriovenous fistula. Ultrasonography and computed tomography found no mass lesion of the liver. Since combination of the bilateral coronary artery with pulmonary artery fistula, and hepatic arteriovenous fistula is very rare, the present case is worth noting for the investigation of the pathogenesis of congenital arteriovenous fistulas.
Arterio-Arterial Fistula↗
[Diastolic dysfunction and its relation to myocardial fibrosis in essential hypertension].
This study elucidated diastolic left ventricular dysfunction and whether myocardial interstitial fibrosis correlates with diastolic dysfunction in mild to moderate systemic hypertension (HT). Six normotensive subjects, 18 hypertensive patients without left ventricular hypertrophy (LVH) and 10 hypertensive patients with significant LVH were evaluated. M-mode echocardiography was used to determine fractional shortening (FS), isovolumic relaxation time (IRT), and left ventricular filling volume during rapid and slow filling periods and the atrial contraction period (RFV, SFV, ACV). The quotients of the left ventricular filling volume and the end-diastolic volume and stroke volume were also calculated. Simultaneous biventriculography was used to determine the end-diastolic thickness of the interventricular septum and posterior wall. Right ventricular endomyocardial biopsies were performed to calculate the percentages of fibrosis. The FS was normal in all groups. The percentages of fibrosis in the two HT groups were significantly greater than those in the normals. The IRT of the HT groups was significantly greater, and the RFV, RFV/EDV and RFV/SV were significantly less than those of the normals. Multiple regression analysis showed that the wall thickness and the percentages of fibrosis correlated significantly with IRT, RFV, RFV/EDV and RFV/SV. The standard coefficients of correlation of wall thickness and the percentages of fibrosis were 0.333 and 0.239 in respect to IRT, and -0.304 and -0.473 in respect to RFV. There were significant correlations between the percentages of fibrosis and RFV (r = -0.675), RFV/EDV (r = -0.664) and RFV/SV (r = -0.602) in the normals and in cases of HT without LVH.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiac Catheterization↗
[Renal cyst puncture under ultrasound guidance: complications of ethanol injection].
Under ultrasound guidance, we treated 25 cases of renal cyst with 99% ethanol instillation to prevent the recurrence of this disease from January 1985 to June 1987. Patients' age was from 17 to 85 years old with the average age of 63 years. Twelve cases were men, and 13 cases were women. Among the 25 cases, eleven were asymptomatic and 14 showed clinical features of lumbago, microhematuria, hypertension or proteinuria. The aspirated site was the right side in 9, left side in 14 and bilateral kidneys in 2 cases. Subsequently, cyst puncture was carried out 27 times. We encountered 12 complications following puncture. These complications were derived from the puncture itself or caused by the ethanol instillation. Flank pain caused by the injection of ethanol, nausea, causalgia or a feeling of drunkenness appeared immediately after the inoculation procedure. However, no serious complications such as pneumothorax, perirenal hematoma or infection were recognized. Some complications arose in 7 cases of 9 examples (77.8%) following more than 50 ml of ethanol injection, but the complications were observed in only 5 cases of 18 examples (22.8%) following less than 50 ml of administration. Based on these findings, ethanol injection in renal cysts appears to be useful for the treatment of this disease. In case of huge cysts when more than 50 ml of ethanol, is instilled the case should be followed up carefully after the instillation procedure.
Adolescent↗
Clinical analysis of ureteral tumours with or without renal pelvic neoplasms.
Twelve patients with ureteral tumours with or without ipsilateral renal pelvic neoplasms were retrospectively analysed. Haematuria was the most common symptom. Location of all tumours was preoperatively detected by conventional diagnostic methods, such as intravenous or retrograde pyelography, washing cytology of the upper urinary tract, computed tomography, echogram and abdominal aortography. Cumulative proportion survivals of 1, 3 and 5 years were 81.9%, 68.2% and 45.5%, respectively. Patients with high Karnovsky rating survived longer (p less than 0.05) than those with low rating. Patients with low-stage tumours (T1, T2) showed longer survival rate (p less than 0.001) than those with high-stage tumours (T3, T4). Vascular invasion of tumour cells was present in removed specimens in 4 out of 7 patients who died or are alive with cancer, but none in those who survived without disease. Good therapeutic response could not be achieved unless surgery was performed.
Aged↗