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Biomedical subjects

M Yuasa

Publications and source records attributed to M Yuasa.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Postoperative results of ligation of crura penis for impotence with corporal veno-occlusive insufficiency].

We performed ligation of the crura penis for 34 impotents with corporal veno-occlusive insufficiency without arterial insufficiency and neural dysfunction from October 1987 to April 1991. Ages ranged from 24 to 72 (52.6 +/- 12.7) years old and follow up period was from 1 to 41 (17.7 +/- 12.6) months. For six patients ligation of the crura only was performed, for 22 ligation of the crura and deep dorsal vein (DDV) as well was performed at the same time, and for 6 crural ligation was performed after ligation of DDV. These operations required less than one hour and there were no severe complications. The postoperative results at 1 month were as follows: Excellent (sufficient spontaneous erection was recovered); 18, Improved (complete erection with intracavernous papaverine injection was achieved); 13, and Failure; 3. Erectile function was maintained only in 50% of the 18 pts. graded excellent. Ninety percent of the 31 patients graded either excellent or improved could maintain erectile function after 40 months with papaverine injection. Venous surgeries could not be a primary treatment for correcting the outflow abnormalities (of the veins). So it is conceivable that failure or recurrence could occur during a long follow up period. We concluded that crural ligation was acceptable as the first line treatment for erectile dysfunction due to corporal veno-occlusive insufficiency because of its relative non-invasiveness compared to other venous surgeries.

Adult↗
PubMed1992

On-line [11C]methylation using [11C]methyl iodide for the automated preparation of 11C-radiopharmaceuticals.

A novel method for the efficient preparation of 11C-radiopharmaceuticals by on-line [11C]methylation using [11C]methyl iodide has been developed and applied to a rapid, convenient automated system. [11C]Methyl iodide is first trapped in a short column, containing an adsorber and coated substrate, which is connected to an HPLC injector. DMF is then introduced. Alternatively the substrate is added with the DMF. A whole reaction mixture can be easily injected onto an HPLC column for purification by switching the injector valve immediately after the reaction. Thus, radiochemical yields in the preparation of 11C-labeled doxepin, benztropine, cyproheptadine and N-methylspiperone have been improved remarkably and the synthetic procedure simplified.

Benztropine↗
PubMed1992

[Double-blind trial of oral prostaglandin E1 on impotence].

The effect of oral prostaglandin E1 (limaprost) on erectile function was studied in a double-blind placebo controlled trial. Fifty one patients who agreed to participate were examined for their subjective symptoms and nocturnal erection was recorded using an erectometer at the beginning of the study, after an initial 6 week period, and again after a second 6 week period. Patients were randomly assigned to a group which received placebo followed by limaprost or to a group which received limaprost followed by placebo. Ten cases dropped out. In the remaining forty one patients, NPT during the limaprost phase was significantly different from that during the placebo phase. Patients with the history of diabetes mellitus, hypertension, or pelvic surgery showed relatively poor responses to oral prostaglandin E1. Oral prostaglandin E1 achieved 42.9% effectiveness in the psychogenic impotence, and this effectiveness is significantly higher than that of placebo. Oral prostaglandin E1 was suggested as an additional or alternative therapy in the management of psychogenic impotence. Psychogenic impotent who didn't respond to sex therapy and patients with slight organic causes would seem to benefit from oral prostaglandin treatment.

Administration, Oral↗
PubMed1992

[Assessment of autonomic nervous function in impotence using sweat response induced by intradermal injection of acetylcholine].

It is important to evaluate the autonomic nervous function which controls penile erection. One method utilizes intradermal injection of acetylcholine to produce localized sweat response. The sweat response depends on the peripheral autonomic nervous supply. Therefore, the response can be used to detect peripheral autonomic nervous dysfunction. We tried to evaluate the peripheral autonomic dysfunction in 29 impotence using a sweat spots test. We classified the 29 impotence into 6 groups with standard tests such as the papaverine test, nocturnal penile tumescence monitoring, recordings of bulbocavernous reflex, etc. The results were as follows: psychogenic IMP; 8, neurogenic IMP; 8, arterial insufficiency; 5, corporeal veno-occlusive insufficiency; 6 neurogenic with arterial insufficiency; 1, and neurogenic with corporeal veno-occlusive insufficiency; 1. The score of sweat spots test was 25.3 +/- 10.9, being in normal, nineteen severe in 3 and slightly abnormal in 7. Many cases of severe and slightly abnormal patients were DM patients classified into neurogenic IMP. We found 2 cases that were not detected by bulbocavernous reflex but found to be abnormal by sweat spots test. Therefore we conclude that this test effective to detect the autonomic nervous dysfunction in impotence.

Acetylcholine↗
PubMed1992

Study of factors related to hypotension in hemodialysis patients.

The factors related to hypotension in hemodialysis patients were evaluated. The subjects consisted of 120 hemodialysis patients (61 males and 59 females), whose ages ranged between 28 and 82 years, and who had undergone hemodialysis treatment for a period ranging between 3 and 201 months. They were divided into three groups: Group A, 53 normotensive patients; Group B, 52 patients with hypotension during hemodialysis; and Group C, 15 patients with constant hypotension. The evaluated factors were age, sex, etiology of renal failure, hemodialysis term, ultrafiltered volume, responsiveness to vasopressor drugs, Cr, Na, Ht, TP, cardiothoracic ratio, presence or absence of heart disease, and microvibration pattern. Statistical analysis was performed using multivariate analysis (Quantification II and IV methods). The results of the Quantification IV method indicated that Groups A and B were similar but Group C was quite different from the other two groups. The results of the Quantification II method indicated that the most important factor which characterized the difference between Group A and Group C was the responsiveness to vasopressor drugs, and the most important factor in the difference between Group B and Group C was the microvibration pattern. Group B was characterized by abnormal microvibration patterns and Group C was characterized by a low responsiveness of the peripheral vessels to vasopressor drugs. We conclude that the hypotension during hemodialysis was caused predominantly by dysfunction of the autonomic nervous system, while the constant hypotension was caused predominantly by a deterioration of constriction of the peripheral vessels.

Adult↗
PubMed1991

Determination of aluminum in the human serum of a dialysis patient by ion-pair reversed-phase partition high-performance liquid chromatography.

An ion-pair reversed-phase partition high-performance liquid chromatography-spectrophotometric method is described for the determination of aluminum in human serum, based on its complexation with 2,2'-dihydroxyazobenzene. The chelate is separated on C18-bonded silica packing by using an aqueous methanol mobile phase containing tetrabutylammonium bromide and is detected with 0.005 AU full-scale at 510 nm. The proposed system offers a simple, sensitive, and selective method. The detection limits defined as twice the standard deviation of the blank signal, are 0.2 micrograms L-1 in pure solution and 6 micrograms L-1 in serum. The sample solution is prepared from 0.4 mL of serum after protein precipitation with hydrochloric acid and methanol. There was good agreement between the values obtained by this method and graphite furnace atomic absorption spectrophotometry. The aluminum concentrations in 121 patients on hemodialysis were 6-201 micrograms L-1.

Aluminum↗
PubMed1991

[The meanings of the papaverine test].

Intracavernous administration of papaverine is now commonly employed for diagnosis and therapy of impotence. To assess the pharmacokinetics of papaverine, we recorded its concentration in peripheral blood and also in cavernous blood after intravenous and intracavernous injection of 40 mg of papaverine. Peripheral blood was sampled serially after injection. Plasma was immediately extracted and then kept at at -40 degrees C until analysis. High pressure liquid chromatography was used to record the concentration of papaverine. The maximum serum concentration of papaverine measured after intracavernous injection was 7.7 ng/ml, which was considerably lower than the average serum concentration of 24.0 ng/ml after intravenous injection. Peak serum concentration was reached 1 min after intravenous injection and 10 min after intracavernous injection. It is clear that the corpus cavernosum constitutes a separate pharmacokinetic compartment. Therefore there was no significant difference between the papaverine concentration in peripheral blood of patients who showed full erection after intracavernous injection and that of patients who did not achieve erection. The concentration of papaverine in the intracavernous blood of a fully erected penis was only about 1 microgram/ml after 20 min. This concentration is similar to that in cavernous blood of those who showed excessively persistent erection. Our results imply that papaverine administered into the cavernous space relaxes smooth muscle, and is then washed out to general circulation, and the concentration in the cavernous space reaches a low level of about 1 microgram/ml. The low concentration level is maintained for several hours during erection. Therefore, we presume that papaverine acts on both the inflow system and smooth muscle of cavernous tissue in the phase of producing erections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Multivariate analysis of prognostic factors in patients with prostatic cancer].

A multivariate statistical analysis of 9 potential prognostic factors was made, using data gathered on 107 patients admitted between 1975 and 1987. After each variable was assessed separately for its prognostic importance by means of univariate analysis, a multivariate analysis using Cox's proportional hazards regression model and multivariate logistic model was done. These tests identified Gleason's score as the most important factor for all patients followed by M category and alkaline phosphatase (ALP), while Gleason's score alkaline phosphatase and age at diagnosis were most important for stage D patients. For short-term survival, the significant prognostic factors were Gleason's score and M category while for long term survival they were Gleason's score and age. T. category, stage, acid phosphatase, prostatic acid phosphatase, and treatment were found to be significantly related to survival time when examined individually; they were not found to be significant in the multivariate analysis.

Age Factors↗
PubMed1990

Scleroderma renal crisis in progressive systemic sclerosis: a case report.

We report a case of progressive systemic sclerosis with scleroderma renal crisis 10 years after onset. The patient (female) had progressive renal dysfunction, hypertension which was difficult to control, and massive gastrointestinal bleeding. An angiotensin converting enzyme inhibitor (enalapril) could not control her hypertension. Only intravenous nicardipine had a slight effect on her hypertension. Hemodialysis and plasma exchange, did not reverse the renal crisis, and the patient died. Microscopic examination of her kidney showed thickening of the capillary walls and mild nephrosclerosis.

Acute Kidney Injury↗
PubMed1989

[Review of 43 autopsy cases of urogenital malignant tumors].

Autopsy findings were reviewed in 43 patients clinically diagnosed in the last 12 years as having urogenital malignant tumors. Clinical diagnoses were 14 bladder carcinoma, 11 prostatic carcinoma, 6 renal cell carcinoma, 5 renal pelvic carcinoma, and 7 other malignant tumors. Autopsy showed that 31 cases died due to carcinoma and 12 because of other causes. The most common ultimate causes of death were DIC and infection, especially pneumonia and sepsis. Autopsy showed 36 of the 43 cases (83.7%) with metastasis. Clinical diagnosis showed 34 cases of metastasis, but the number of metastasized organs and lymph-nodes was much lower than in subsequent autopsy findings. Autopsy proved 5 cases of clinical misdiagnosis (11.6%) and 4 of undiagnosed malignant tumors (9.3%). In 15 cases (32.6%) the ultimate cause of death as revealed by autopsy had not been clinically diagnosed. Five cases diagnosed as having died due to cancer in fact were found to have died due to other causes. Recent diagnostic techniques are greatly advanced, yet many findings are still revealed for the first time by autopsy. Autopsy continues to be a very important final arbiter of progress and the effect of malignant tumors, and serves to remind us of the ongoing need for constant vigilance and improvement of clinical diagnostic techniques.

Autopsy↗
PubMed1988

[Clinical evaluation of total cystectomy for bladder carcinoma: a ten-year experience].

Fifty-three patients with primary bladder carcinoma underwent total cystectomy during the past 10 years. Ages ranged from 32 to 87 years old, with an average of 68.2 years. Radical total cystectomy, including systemic lymphadenectomy was performed in 22 cases, simple total cystectomy in 8 cases and salvage total cystectomy in 23 cases. An ileal conduit was made for urinary diversion in 23 cases and the other 26 cases underwent cutaneous ureterostomy. Postoperative mortality was 9.4% (5 of 53 cases) and postoperative complications were noted in 17 of the 53 cases (32.1%). The 5-year cumulative survival rate by the life table method for all the cases was 42.6%. The 5-year cumulative survival rate of radical total cystectomy cases was 67.8%, that of simple total cystectomy cases was 50.0% and that of salvage total cystectomy cases was 7.5%. A significant difference was seen between the first 2 groups and the last group. The 5-year cumulative survival rate of the patients with low stage cancer (pTis, pTa, pT1 and pT2) was 56.1% and that of the patients with high stage cancer (pT3, pT4) was 22.7%. A significant difference was observed between the two groups. The 5-year cumulative survival rate of the patients with grades G1, G2 and G3 cancer was 66.7, 45.4 and 26.7% respectively. A significant difference was seen among the three grades.

Adult↗
PubMed1988

[Renal cell carcinoma in the solitary kidney].

We have treated surgically 5 patients with renal cell carcinoma in the solitary kidney. The cause of renal absence was nephrectomy for renal stones, in 2 patients and renal tuberculosis, renal cyst and renal hypoplasia in 1 patient each. Four of the 5 patients died. One of the 4 patients died 5 days after surgery due to gastrointestinal bleeding, 1 due to metastasis, 1 due to gastric cancer and one due to hemodialysis complications. Surgical management of renal cell carcinoma of solitary kidney is discussed.

Aged↗
PubMed1987

[Clinical study on adenocarcinoma of the prostate].

In 92 patients with prostatic carcinoma who were treated at the Takamatsu Red Cross Hospital from January 1976 to December 1985, we analyzed the age, chief complaint, degree of advancement, grade of tumor, way of therapy and prognosis. The age of the patients was between 51 and 87 years (mean: 74.8 years). The most frequent chief complaint was dysuria. In terms of the degree of advancement, 14 cases were assessed as Stage A, 23 cases as Stage B, 16 as Stage C and 39 as Stage D. Analysis of the grade of tumor disclosed that 38 cases (41.3%) had well differentiated adenocarcinoma, 20 cases (21.7%) had moderately differentiated adenocarcinoma and 29 cases (31.5%) poorly differentiated adenocarcinoma. Forty-four of the subjects have already died. The 5-year survival rate was 41.2% when calculated pursuant to life table method. The 5-year survival rate was 85.7% for Stage A, 36.1% for Stage B, 53.4% for Stage C and 24.3% for Stage D. The 5-year survival rate was 54.7% for well differentiated adenocarcinoma, 61.7% for moderately differentiated adenocarcinoma and 12.7% for poorly differentiated adenocarcinoma. Comparison of the 3-year survival rate among the 4 ways of therapy revealed only a small intergroup difference; namely, the rate was 58.5% for hormone therapy, 51.6% for intraarterial neocarzinostatin therapy, 77.1% for total prostatectomy and 57.1% for radiation therapy. These results indicate that our way of chemotherapy, which chiefly employs intraarterial administration of neocarzinostatin as an induction therapy, is at least comparable or superior to hormone therapy in terms of efficacy.

Adenocarcinoma↗
PubMed1986

[Use of arterial infusion of neocarzinostatin with or without combination chemotherapy as a treatment of carcinoma of the prostate].

Prostate cancer patients were treated with a basic therapy of intra-arterial injection of neocarzinostatin (NCS). This therapy was divided into three types of regimen: NCS intra-arterial injection alone, NCS intra-arterial injection + diethylstilbestrol (DES), and NCS intra-arterial injection + aclacinomycin A (ACR) + peplomycin (PEP). A comparative study was carried out on the clinical efficacies of these three regimens, and at the same time an investigation was made of the prognosis in the cases receiving NCS intra-arterial injection alone and NCS + DES. The clinical efficacy was found to be high in each of the three treatment groups in terms of subjective symptoms and laboratory findings, except for ALP. In the evaluation of efficacy on the basis of histological findings, the rates were 60.0% for NCS intra-arterial injection alone, 71.4% for NCS + DES, and 88.2% for NCS + ACR + PEP. Thus, all three of these treatment regimens gave good efficacy rates, but it is especially noteworthy that the combined chemotherapy regimen yielded the highest efficacy rate. On the other hand, the incidence of adverse reactions was much higher in the case of the combined chemotherapy regimen than in the other two regimens. In the patient group administered the NCS intra-arterial injection alone, the one-year survival rate was 75.0% and the 4-year survival rate was 25.0%, while in the NCS + DES treatment group the one-year survival rate was 87.5% and the 4-year survival rate was 37.5%. For individual patients, the correlation between the clinical efficacy and the prognosis was not strong. However, it was concluded that all three of the chemotherapy regimens are useful as forms of remission induction therapy.

Aclarubicin↗
PubMed1986

[Oral administration of 5-fluorouracil (5-FU) with intravesical chemotherapy as prophylaxis against recurrence of superficial bladder tumors].

The oral administration of 5-FU together with the intravesical instillation of carboquone and cytosine arabinoside was attempted in cases of superficial bladder tumor for the purpose of prophylaxis against postoperative recurrence. The recurrence rate in 25 patients treated by this intravesical chemotherapy and oral 5-FU administration was 9.1% after one year, 14.0% after two years and 27.8% at three to five years. The recurrence rate in 13 patients with intravesical chemotherapy alone was 8.7% after one year, 31.5% after two years and 58.9% at three to four years. The recurrence rate in six patients with oral 5-FU administration alone was 18.2% after one year, 41.6% after two years and 100% after three years. These results suggest that oral administration of 5-FU in combination with intravesical chemotherapy is useful as prophylaxis against recurrence of superficial bladder tumors.

Administration, Intravesical↗