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N Kura

Publications and source records attributed to N Kura.

15 recordsLinked to original sources
PubMed1999

[A case of retroperitoneal hemangiopericytoma].

We report a case of a huge retroperitoneal tumor in a 67-year-old woman. When the patient was taken to another hospital by ambulance, she had lost consciousness because of hypertension and hypoglycemia and abdominal CT revealed a huge retroperitoneal tumor with deviation of the right kidney and inferior vena cava. After further examinations including ultrasonography, MRI and angiography in our hospital, the tumor was extirpated. The tumor, 22 x 17 x 10 cm in size and 2,580 g in weight was diagnosed as hemangiopericytoma histologically. She has remained well with no evidence of recurrence for 9 months since the operation.

Aged↗
PubMed1994

[Electromyographic study on the external urethral sphincter of the male--power spectrum analysis with fast Fourier transformation].

In 23 male patients, the electrical activity of external urethral sphincter muscle was sampled before examination of cystometry (Rest), at first desire to void (FDV), maximum desire to void (MDV) and during urination (Void) by means of electromyography (EMG). Sampling time of each event was 2400 msec. The electrical activity was amplified with a lower limiting frequency of 20 Hz and an upper limiting frequency of 10000 Hz, and recorded on magneto-optical desk. Spectra were obtained using a Hamming window. The action potential of the muscle was quantitatively analyzed and power spectrum of the needle EMGs were analyzed from the magneto-optical disk by a spectrum analyzer using fast Fourier transformation (FFT, Sande-Tukey method). From each power spectrum, mean power frequency (MPF) was obtained from a calculator connected to the spectrum analyzer. Twenty three patients were divided into three groups as follows: 8 patients without any neurological abnormality (normal group), 7 patients with neurogenic bladder showing detrusor-sphincter-dyssynergia (DSD+ group) and 8 patients with neurogenic bladder without detrusor-sphincter-dyssynergia (DSD- group). The results obtained were as follows: 1) The motor unit potentials at Rest had the mean amplitude of 210 +/- 59.4 microV, 329.3 +/- 157.1 microV and 177.6 +/- 132.8 microV in normal group, DSD+ group and DSD- group, respectively. The mean duration were 4.3 +/- 0.2 msec, 5.9 +/- 1.9 msec, and 7.3 +/- 4.5 msec., respectively. The mean phases were 2.8 +/- 0.6, 2.8 +/- 0.5 and 2.5 +/- 0.3, respectively. Statistically there was no difference in amplitude, duration and phase among three groups. 2) In normal group, the power over than -20 dB was distributed from 150 to 220 Hz windows at Rest and FDV. The needle EMGs at MDV showed interference pattern and the power increased over -20 dB in all windows. The power of high frequency area relatively increased. The action potential of the muscle disappeared during urination and the power also disappeared. The average MPF was 103 Hz, 102 Hz, 150 Hz and 98 Hz at Rest, FDV, MDV and Void, respectively. 3) In DSD+ group, the needle EMGs showed interference pattern in MDV and Void, and the power increased only in low frequency area. The average MPF was 104 Hz, 105 Hz, 114 Hz and 120 Hz at Rest, FDV, MDV and Void, respectively. 4) Because of damage to nerves, the action potential of the muscle was difficult to obtain from 3 patients of DSD- group, and the power was not demonstrated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

[Use of ultrasonography in the bladder neck suspension].

From 1988 to 1992, 78 patients with genuine stress urinary incontinence underwent bladder neck suspension under ultrasonic monitoring. Tightness of suspension was adjusted by setting posterior urethrovesical angle to approximately 90 degree by transrectal ultrasonography during operation. Urinary continence was achieved in 68 of 78 patients. In the remaining 10 patients, slight incontinence recurred within 6 months after operation. In 60 patients undergoing postoperative chain cystourethrogram, the posterior urethrovesical angles set during operation were about the same as those after operation. In 39 patients undergoing uroflowmetry under the condition that micturition volume was 200 ml or more, urinary flow rate did not decrease after operation. In 20 patients whose posterior urethrovesical angles were measured by transperineal and transabdominal as well as transrectal ultrasonography, angles measured by each ultrasonography were almost identical and neither manipulation could change the configuration of the bladder neck. The posterior urethrovesical angles set during operation were kept postoperatively and provided proper tightness of the suspension suture to achieve urinary continence without any difficulty of urination. Therefore, a posterior urethrovesical angle can be set by transperineal and transabdominal ultrasonography as well as transrectal ultrasonography. While transrectal approach provides the clearest image among the three approaches, transperineal and transabdominal approach carried out with a transabdominal convex or sectorial probe are more convenient than transrectal approach which needed a special probe.

Humans↗
PubMed1993

[Syphilitic orchitis: report of a case].

Syphilitic orchitis ir recently a rare disease in Japan. A 44-year-old man visited our hospital with the complaint of swelling of the right scrotum. He first noticed it about a half year ago, but the swelling mitigated without any therapy. The right testis was about the size of a hen's egg, elastic hard, and slightly rugged when he first visited our hospital. Treponema pallidum hemagglutination assay (TPHA) and rapid plasma reagin (RPR) were positive. We performed high orchiectomy because we could not deny the possibility of testicular tumor. Pathologically, granulomatous inflammation with lympho-plasmacytic infiltration and endoarteritis obliterans of the small arteries were seen in the specimen. It was diagnosed as granulomatous inflammation possibly caused by syphilitic orchitis. Syphilitic orchitis is usually quite difficult to distinguish from other types of granulomatous diseases of the testes, for example tuberculous orchitis. Various types of stains and careful examination of the specimen were thought to be necessary to distinguish these diseases.

Adult↗
PubMed1992

[Dilated cardiomyopathy following alpha interferon therapy of renal tumor with pulmonary metastases: a case report].

We report a case of renal cell carcinoma with pulmonary metastases treated with recombinant alpha interferon and subsequently presenting as congestive heart failure due to a dilated cardiomyopathy. A 66-year-old man presented himself to the department of internal medicine at our hospital with a complaint of persistent cough with sputum on August 27, 1988. Ultrasonogram, computed tomography and angiography showed a right renal cell carcinoma and chest x-ray films disclosed bilateral multiple nodular shadows, probably representing metastases of the renal tumor. After being transferred to our department, the patient underwent the ligation of the right renal artery and vein and the postoperative treatment with recombinant alpha interferon, achieving a complete response for pulmonary metastases and a partial response for the primary region. On February 14, 1990 the patient was admitted to our hospital with a complaint of dyspnea to be diagnosed as congestive heart failure due to dilated cardiomyopathy. The interferon therapy was suspected to have caused the heart disease, and four months after discontinuation of interferon therapy the heart failure symptoms had improved, but hypokinesis of the cardiac wall still persisted. To our knowledge, this may be the first case of alpha interferon-related cardiomyopathy in Japan.

Aged↗
PubMed1991

[A case of malignant melanoma of the penis].

An 83-year-old male presented in October, 1988, with pigmented tumor lesions on the penis. The main tumor mass accompanied with necrotic bleeding, measuring 5 cm in diameter was located on the fore skin and glans penis. On the proximal shaft of the penis, there were three other black tumors, measuring from 0.5 to 3 cm in diameter. The distal urethra of the penis was clinically involved in the tumor mass and bilateral inguinal lymph nodes were palpable. Chest X-ray and liver scan both revealed multiple metastases. Tumor biopsy confirmed malignant melanoma. Phallectomy and bilateral inguinal lymph node biopsies were performed in October, 1988. Pathological findings revealed that a malignant melanoma had developed from the fore skin and glans penis, extended into the penile urethra and metastasized to bilateral inguinal lymph nodes. The patient gradually deteriorated in general condition and died of cancer 28 days later. The prognosis of malignant melanoma of the penis seems to be extremely poor.

Aged↗
PubMed1990

[Suburethral sling procedure for urinary stress incontinence. With special reference to determination of tension of suspension from posturethrovesical angle measured by ultrasonography].

Ten patients with urinary stress incontinence were treated by suburethral sling procedure using a polytetrafluoroethylene tube as the sling. The tension of suspension was determined by the post-urethrovesical angle measured by transrectal ultrasonography in each patient. In nine patients, the post-urethrovesical angle ranged from 90 to 110 degrees, and urinary continence of the patients was completely obtained. The remaining one patient whose post-urethrovesical angle was determined as 120 degrees could not obtain complete continence. None of the patients had subjective post-operative disturbance in urination and the peak flow rate of post-operative uroflowmetry hardly decreased in 7 patients in whom this was performed. Although post-urethrovesical angles reduced as the tension which suspended the bladder neck increased, the tension reforming the post-urethrovesical angle was various in each patient. Since one of the aims of suspension of the bladder neck for patients with stress incontinence is reform of the post-urethrovesical angles, correct and reasonable tension of suspension is to be obtained by measuring the post-urethrovesical angle.

Adult↗
PubMed1989

[Pressure-flow study after percutaneous nephrolithotripsy].

In 46 patients treated with PNL in our hospital, the intervals from PNL to removal of a catheter indwelled in the nephrostomy were studied. The intervals were longer in the cases with ureteral stones than those with renal stones probably because of the different degrees of obstruction. To investigate the degree and the interval of upper urinary tract obstruction after PNL, Pressure-flow Studies were performed every or every other day after PNL in 5 cases with renal stones and 5 cases with ureteral stones, selected from 46 cases. In Pressure-flow Studies, intrapelvic pressures were measured while saline mixed with pigment was being dripping at a rate of 5 ml/min into the renal pelvis through the nephrostomy catheter. Saline initially reached into the urinary bladder at an average of 4.8 days after PNL (range 3 to 7 days) with a mean intrapelvic pressure of 37.6 cmH2O (range 28 to 52 cmH2O) in the cases with renal stones and at an average of 9.2 days (range 7 to 12 days) with a mean intrapelvic pressure of 27.0 cmH2O (range 9 to 43 cmH2O) in the cases with ureteral stones. Pressure-flow Studies were performed again a few days after the initial passage of saline into the urinary bladder in 2 of 10 cases. The intrapelvic pressures, 16 cmH2O and 13 cmH2O, respectively, several days after the initial passage of saline were lower than those, 35 cmH2O and 43 cmH2O, respectively, at the initial passage of saline. Therefore, it was likely that the proper interval of indwelling catheter after PNL was about 7 to 8 days, in the cases with renal stones and about 11 to 12 days in the cases with ureteral stones.

Adolescent↗
PubMed1989

[A study on acute renal damage from percutaneous nephrolithotomy assessed by urinary NAG and gamma-GTP activities].

We performed percutaneous nephrolithotomy (PNL) on 49 patients between May, 1986 and March, 1987. To investigate acute renal damage from PNL, we measured urinary NAG (N-acetyl-beta-D-glucosaminidase) and gamma-GTP (gamma-glutamyl transpeptidase) activities before PNL and for 6 days after PNL in 24 patients. The NAG activities elevated beyond normal level in 23 patients and gamma-GTP activities in 15 patients. NAG activities showed a peak level in the third day after PNL and gamma-GTP activities in the next day of PNL. After the peak both enzyme activities got down gradually. There was no difference in NAG and gamma-GTP activities between nephrostomy and lithotripsy in 2 staged patients. And the intrapelvic pressure during operation was at the normal level in 5 patients. Therefore, we think that the cause of NAG and gamma-GTP activity elevation is a mechanical damage, not an influence of the irrigation fluid. Large stones, long operation time and 2 stage procedure were the factors that produced high enzyme activities, because, we guess, the frequency of mechanical damages to the kidney increase in such cases. Postoperative pyrexia caused a slight increase in enzyme activities but preoperative hydronephrosis exerted no influence on both enzyme activities. We also measured creatinine clearance before and after PNL but no significant change was obtained. PNL causes only slight mechanical damage to the operated kidney which is reversible when assessed by NAG and gamma-GTP activities and the glomerular function is not affected. Therefore, we conclude that PNL is a safe treatment for upper urinary tract stones.

Acetylglucosaminidase↗
PubMed1989

[A case of lipoma of the spermatic cord].

A rare case of lipoma of the spermatic cord is reported. A 53-year-old man was admitted with painless mass in the left scrotum during the preceding one year. Since an elastic soft, tenderless, smooth surface, fist-sized and low echoic solid pattern mass in the left scrotum was suspected of tumor of the spermatic cord, resection of the mass with left orchiectomy was performed. Histological finding showed lipoma of the spermatic cord. Including the present case, 61 cases of intrascrotal lipoma in the Japanese literature are reviewed.

Genital Neoplasms, Male↗
PubMed1989

[Condyloma acuminata in teenage patients].

From 1978 to 1987, 93 new patients with condyloma acuminata visited urological clinic of our hospital. Among them, 16 patients (17%) were teenagers. The number of teenage patients increased gradually year after year as the total number of patients increased. The proportion of females in teenagers was slightly higher than that in adults. Condyloma in male teenage patients frequently occurred around the cornal sulcus. The site of condyloma in female teenage patients were labia minora and anus. None of other sexually transmitted diseases except for urethritis accompanied condyloma. All patients underwent electrocautery. None of teenage patients showed recurrence of condyloma in contrast with relative high recurrence rate (19%) in adult patients.

Adolescent↗
PubMed1988

Actinomycosis of urachal remnants.

We report a case of urachal actinomycosis. The patient presented with complaints of micturition pain and a lower abdominal mass. Computerized tomography and an echogram showed the mass extending from the dome of the bladder to just beneath the rectus muscle. Exploration revealed a hard mass in the urachal cord, which was near the dome of the bladder and extended to the umbilicus. The mass and urachal cord were resected, and histopathological examination revealed actinomycosis of the urachal remnants.

Actinomycosis↗
PubMed1988

[Clinical efficacy of aztreonam in patients with complicated urinary tract infections].

Aztreonam (AZT) (2 g daily) was intravenously administered for 5 to 7 days to 65 patients with complicated urinary tract infections (UTI). Ninety one organisms were isolated from these patients' urine. Among them 66 organisms were eliminated following AZT administration. The elimination rate for Gram negative organisms was 94.7% and that for Gram positive organisms was 33.3%. Thirty one organisms appeared newly by the replacement of organisms. Among them, 12 organisms were E. faecalis. The efficacy rate of AZT in single infection and in mixed infection was 55.8% and 13.7%, respectively. The overall clinical efficacy rate of AZT in the present study was 41.5%. As side effects, skin rash and itching were observed in 3 patients and slight elevations in blood chemistry were observed in 10 patients. The results indicate that AZT is an effective drug for the treatment of patients with complicated UTI, especially those caused by Gram negative organisms.

Adult↗
PubMed1988

[Postoperative hydrocele testis as a complication of high ligation of internal spermatic vein].

We reviewed 785 patients with varicocele testis who underwent high ligation of internal spermatic vein at Kasukabe City Hospital between 1969 and 1985, and found only 3 patients suffering from postoperative hydrocele testis. Analysis of the hydrocele content in one case revealed a high protein level, which suggested that the etiology of the hydrocele after high ligation is of lymphatic origin, so that it is important to preserve the lymphatics of spermatic cord in order to prevent postoperative hydrocele.

Adult↗