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Biomedical subjects

M Ohkawa

Publications and source records attributed to M Ohkawa.

At least 19 recordsLinked to original sources
PubMed1992

Effectiveness of planar image and single photon emission tomography of thallium-201 compared with gallium-67 in patients with primary lung cancer.

A comparative study of planar images and single photon emission tomography (SPET) of thallium-201 chloride and gallium-67 citrate was performed in 38 patients with proven primary lung cancer to detect the primary lung tumour and to establish the presence of metastasis in the lung hilum and mediastinum. The findings of planar images and SPET were compared with the pathological findings after thoracotomy. It was shown that 201Tl studies were superior to 67Ga studies for evaluation of the primary lesion and lymph node metastases.

Aged↗
PubMed1992

Composition of urinary calculi related to urinary tract infection.

The composition of 3,084 urinary calculi was determined using an infrared spectrophotometer. Mixed calcium oxalate-calcium phosphate stones were most frequently implicated. Of the urinary calculi analyzed 199 were associated with urinary tract infection. Escherichia coli was most frequently isolated (43 strains) and urease-producing organisms, such as Proteus mirabilis, were cultured from 40 patients. The core culture of 20 staghorn calculi yielded 15 isolates from 14 stones. There were 13 identical species isolated from the urine and stone specimens of 13 patients (65%), including 7 strains of P. mirabilis. These results suggest that cultures of urine specimens of urolithiasis patients, especially those with staghorn calculi, may help to elucidate the bacteriology of the stones.

Adolescent↗
PubMed1992

Thiazide treatment for calcium urolithiasis in patients with idiopathic hypercalciuria.

In a randomised trial based on a parallel design to determine the prophylactic effect of thiazide on stone formation, 210 calcium urolithiasis patients with idiopathic hypercalciuria were allocated either to treatment with trichlormethiazide (4 mg/day) or no treatment with only close follow-up; 35 patients were excluded for various reasons, including voluntary withdrawal. The background of the remaining 175 patients (82 in the thiazide group and 93 in the control group), including age and sex, was similar for both groups. In patients treated with thiazide there was a statistically significant fall in urinary calcium output. Statistical analyses also demonstrated that the stone formation rate in the thiazide group was significantly less than that in the control group. Adverse clinical reactions probably due to the drug were observed in 9 patients. These findings indicate that trichlormethiazide has a prophylactic effect on calcium urolithiasis in patients with idiopathic hypercalciuria.

Adult↗
PubMed1992

A clinical study on patients with urinary tract infection due to coagulase-negative staphylococci.

To assess the clinical significance of coagulase-negative staphylococci (CNS) in patients with urinary tract infection (UTI), the clinical characteristics of a total of 117 patients (106 complicated UTI patients, 11 uncomplicated UTI patients) from whom CNS were isolated at urinary colony counts of 10(5) or more per ml were studied. Of the complicated UTI patients, 95 patients (89.6%) suffered from no symptoms while 11 (10.4%) had fever of 38 degrees C or greater, which was strongly suspected to be due to genitourinary tract infections. Six of these patients were managed by indwelling urinary catheters. On the other hand, all of the patients with uncomplicated UTI were young women and had typical symptoms of acute cystitis. These results suggest that CNS, which hitherto have been considered mere contaminants or benign colonization rather than true pathogens, can also cause complicated UTI requiring chemotherapy under certain conditions such as indwelling urinary catheterization and acute cystitis in sexually active women.

Adult↗
PubMed1992

Clinical significance of measurement of serum D-arabinitol levels in candiduria patients.

D-Arabinitol, a major candidal metabolite, is reported to be a useful parameter to diagnose disseminated candidiasis. Conventional determination of serum D-arabinitol levels using gas-liquid chromatography is complicated and time-consuming compared with the enzymatic fluorometric assay, newly available in kits. D-Arabinitol concentrations were determined by both enzymatic fluorometric assay kits and gas-liquid chromatography, and a significant correlation (r = 0.943, p less than 0.01) was found between the two methods in 25 sera from 15 patients with candiduria. D-Arabinitol/creatinine ratios were determined using the enzymatic fluorometric assay in 39 candiduria patients (21 febrile and 18 afebrile) and 22 patients without candiduria as the control. The ratios in the febrile patients were significantly greater than those in the afebrile and the nondocumented candidiasis groups. These results suggest that knowledge of the serum D-arabinitol concentration may help to promptly diagnose invasive candidiasis, particularly Candida pyelonephritis. In addition, enzymatic fluorometric assay kits are considered to be advantageous in that they require little time and are simple to use, as compared with gas-liquid chromatography.

Candidiasis↗
PubMed1992

Candida antigen detection by a latex agglutination test in candiduria patients.

We evaluated a latex agglutination test commercially available in kit form for the identification of Candida pyelonephritis in candiduria patients. Tests were performed on sera from 11 patients with fever and candiduria plus other positive candidal sites (group A), 12 patients were fever and candiduria alone (group B), 17 afebrile patients with candiduria alone (group C), and 27 afebrile patients without documented candiduria or bacteriuria (group D). Positive antigenemia with a titer of 1:4 or greater was detected in 9 candiduria patients with fever: 7 (63.6%) in group A and 2 (16.7%) in group B. The incidence of group B, in which Candida pyelonephritis was strongly suspected, was significantly less than that of group A and did not significantly differ from that of groups C and D. These results suggest that this test has little value in the diagnosis of Candida pyelonephritis without disseminated candidiasis.

Aged↗
PubMed1992

Computed tomography and cerebral blood flow correlations of mental changes in chronic subdural hematoma.

To elucidate the pathophysiology of mental disturbances associated with chronic subdural hematoma, we performed quantitative and three-dimensional measurements of cerebral blood flow (CBF) on xenon-enhanced computed tomographic scans in 12 patients who had chronic subdural hematomas and manifested mental disturbances. In 2 patients who had no headache or hemiparesis, minimal mass effect, and severe multiple infarctions on computed tomographic scan, mentation did not improve after surgery. The CBF reduction was severe, and it further deteriorated after surgery. On the other hand, mentation improved to a varied extent in the other 10 patients, who had headache and/or hemiparesis and minimal, moderate, or severe mass effect and minimal or moderate multiple infarctions on computed tomographic scan. The CBF reduction was diffuse on both sides, but was more marked in the thalamus and putamen than it was in the cortex and subcortex. It was restored after surgery, but insufficiently. The restoration rate was statistically significant only in the thalamus, on both sides (with and without hematoma) (P less than 0.05). Dementia scores and CBF values after surgery were correlated on the side with the hematoma in the frontal cortex and thalamus (P less than 0.01) and in the hemisphere and temporoparietal cortex (P less than 0.05). There was no correlation on the side with the hematoma in the occipital cortex, putamen, and frontal and temporoparieto-occipital subcortices or on the side without the hematoma. The thalamus undergoes displacement and distortion by the hematoma, which in turn leads to changes in consciousness. Postoperative residual mental deficits consist primarily of dementia related to preexisting multiple infarctions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Clinical evaluation of flucytosine in patients with urinary fungal infections].

The clinical effectiveness of flucytosine (5-FC) was evaluated in 52 patients with urinary fungal infections which were diagnosed because of the presence of both funguria (greater than or equal to 10(4) cfu/ml) and pyuria (greater than or equal to 5 WBC/hpf). The patients received oral daily doses of 5-FC ranging 20 to 150 mg/kg, with a mean treatment duration of 11 days. The 57 fungus strains isolated from urine specimens consisted of 51 Candida spp. including 28 Candida albicans, 10 Candida glabrata, 4 Candida tropicalis and 6 Trichosporon beigelii. Forty-seven (92.2%) and 4 (66.7%) of the 51 Candida spp. and 6 T. beigelii strains isolated were eradicated by the treatment, respectively, giving an overall eradication rate of 89.5%. Clinical responses in 32 patients, from whom only fungi were submitted, were excellent in 5, moderate in 22, and poor in 5, thus the overall efficacy rate was 84.4%, based on the criteria of Japanese UTI Committee. Of the 18 strains of Candida spp. tested, 5-FC showed 0.20 micrograms/ml or less of the minimum inhibitory concentrations (MICs) against 16 strains and higher than 100 micrograms/ml against the remaining 2 strains. The MICs of the 5 T. beigelii strains tested were between 3.12 and 6.25 micrograms/ml. As adverse reactions, only 2 patients (3.8%) experienced diarrhea but did not require treatment cessation. These results suggest that flucytosine is an effective drug for urinary fungal infections.

Adult↗
PubMed1991

Monitoring of cortical blood flow during temporary arterial occlusion in aneurysm surgery by the thermal diffusion method.

During aneurysm surgery, regional cortical blood flow (CoBF) was continuously monitored in 12 patients with a thermal diffusion flow probe in an attempt to assess the effects of temporary major arterial occlusion on blood flow and outcome. When the CoBF was above 30 ml/100 g/min, the safe period for temporary clipping applied distal to the perforators was 15 minutes. The occlusion time should be shortened when the CoBF is below 30 ml/100 g/min. Two patients suffered basal infarction, which was not detected by CoBF monitoring. Attention should be paid to the blood flow in the deep structures when a temporary clip is applied at a site proximal to the perforating branches. Direct measurement of CoBF may be of value in estimating the time that temporary occlusion of a major vessel can be tolerated.

Aged↗
PubMed1991

Bacteremia from transurethral prostatic resection under prophylactic use of antibiotics.

We studied the incidence of the postoperative bacteremia developing in 44 patients undergoing transurethral resection of the prostate under prophylactic use of antibiotics. In 15 of the patients, postoperative endotoxinemia was also investigated. Postoperative bacteremia was found in 10 (22.7%) of the patients, in only one of whom septicemia developed. The incidence of bacteremia was not influenced by the kind of antimicrobial agent administered prophylactically, but was significantly higher in the patients with preoperative urinary tract infection or prostatitis on histological examination of resected prostatic tissue (p less than 0.01). Concerning species isolated from the blood, gram-positive cocci were isolated more frequently than gram-negative bacteria, and Staphylococcus epidermidis was the most common species. In 7 (70%) of the bacteremia patients an identical species was isolated from preoperative urine cultures. In the patients with bacteremia, significant increases in white blood cell count and maximal body temperature were found within 3 hours after the procedure as compared to before the procedure. To lower the postoperative bacteremic rate, appropriate and adequate antimicrobial agents must be used preoperatively in patients with infection of the genitourinary tract. As to blood endotoxin, the endotoxin levels in the patients with postoperative fever did not significantly differ from those of the patients without this complication.

Aged↗
PubMed1991

Noninvasive detection and monitoring of renal arteriovenous fistula by color Doppler.

The diagnosis of a renal arteriovenous fistula is usually confirmed by angiography. Described is the utilization of color Doppler ultrasound to monitor a renal arteriovenous fistula before and after treatment by transcatheter steel coil embolization in a 63-year-old woman. Using color Doppler, the arteriovenous fistula with an aneurysmal lesion was clearly visualized. A pulsed-wave Doppler analysis showed increased flow velocity and decreased pulsatility in the supplying artery. After successful transcatheter occlusion of the fistula, these findings disappeared. The Doppler ultrasound technique is likely to be useful to detect and monitor a renal arteriovenous fistula noninvasively, simply, and quickly.

Arteriovenous Fistula↗
PubMed1991

Biochemical and pharmacodynamic studies of simple renal cyst fluids in relation to infection.

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Adult↗
PubMed1991

[End-stage chronic renal failure in patients treated by antireflux operation].

We report 3 patients progressed to end-stage chronic renal failure after antireflux surgery. Preoperatively, the 3 patients had proteinuria, probably due to reflux nephropathy. Surgical procedures used were Paquin's method in 1 patient and Politano-Leadbetter's method in 2. Rapid deterioration of renal function was observed from puberty in all patients. In addition, renal hypoplasia was suspected in 2 patients. We concluded that both reflux nephropathy and renal hypoplasia played important roles in the progression of renal insufficiency.

Adolescent↗
PubMed1991

[Candida urinary tract infection with special reference to ascending pyelonephritis].

The pathogenesis of Candida urinary tract infection (UTI) has been investigated clinically and experimentally with special reference to ascending pyelonephritis in rats. Among the Candida species, Candida albicans was most frequently isolated from clinical specimens including urine in two medical centers, one in Japan and the other in the United States. The isolates of C. albicans serotype B showed a significantly lower susceptibility to 5-fluorocytosine compared to those of serotype A (p less than 0.01). The distribution pattern of the serum antibody titers against C. albicans in 20 candiduria patients (C. albicans 19 and Candida tropicalis 1) was similar to that in 23 bacterial complicated UTI patients. All patients with candiduria had underlying diseases of the urinary tract, such as neurogenic bladder, bladder cancer or benign prostatic hyperplasia: indwelling urinary catheters were present in 15 patients and all had received antimicrobial agents before the study. Ascending Candida pyelonephritis has been investigated in female rats which were transurethrally inoculated into the bladder with C. albicans ATCC 10259 strain. The incidence of Candida pyelonephritis was approximately 80% in rats treated with cyclophosphamide and more than 70% in rats with partial ureteral obstruction. There was a significant relationship between renal and urinary Candida cell populations (p less than 0.01). Furthermore, a significant relationship was revealed between renal Candida cell populations and histological grades of pyelonephritis (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Carotid-cavernous fistula successfully treated with embolization and radiation therapy: report of three cases].

Three cases of mixed internal and external carotid-cavernous fistula (CCF) were successfully treated with embolization of feeders from the external carotid artery (ECA) and focal irradiation to the cavernous sinus (CS). Cases 1 and 2 were females, 63 and 69 years old respectively, both with spontaneous left CCF. Case 3 was a 55 year old male with posttraumatic left CCF. Symptoms of case 1 were double vision, left chemosis and exophthalmos; those of case 2 were double vision, left retroobital pain, left forehead dysesthesia and blurred vision; and case 3 complained of double vision, left chemosis, left exophthalmos and pulsatile tinnitus. In all three cases, angiography disclosed left CCF fed by ipsilateral dural branches from the internal maxillary artery (IMA) and the internal carotid artery (ICA). In case 1, small branches from the ascending pharyngeal artery also fed the CS. In cases 2 and 3, feeders from the ECA were arising only from branches of the IMA. In case 3, hypertrophy of the meningohypophyseal trunk was visible. In cases 1 and 2, although the CS was opacified, feeders from the ICA were not clearly visible. Embolizations of branches of the IMA were performed in all cases using Ivalon under selective catheterization. In case 1, symptoms partially improved, but in cases 2 and 3, visual symptoms were transiently aggravated. Focal irradiation to the CS was done with total doses of 30, 30 and 40 Gy each for cases 1, 2, and 3 respectively. In case 1, clinical symptoms gradually improved about one third way through irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗