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O Ukimura

Publications and source records attributed to O Ukimura.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Renal angiomyolipoma with marked extrarenal development: a case report].

A 28-year-old female complained of minimal fever elevation. Computed tomography (CT) revealed a left renal tumor of 10 cm in diameter. Ultrasonogram and CT, magnetic resonance imaging and angiography suggested a renal angiomyolipoma (AML) with marked extrarenal development. Partial nephrectomy was performed using a microwave tissue coagulater without clamping of the renal artery. The tumor weight was 800 g and the pathological diagnosis was AML. The management of large AML is reviewed in the literature. Nephron sparing surgery should be performed even in patients who have a larger tumor with extrarenal development.

Adult↗
PubMed1998

Prostate cancer staging: correlation between ultrasound determined tumor contact length and pathologically confirmed extraprostatic extension.

PURPOSE: We determine whether a new parameter, the amount of tumor in contact with the fibromuscular rim (capsule) of the prostate, correlates with extraprostatic extension, and ascertain whether estimating the new parameter using transrectal ultrasonography can predict extraprostatic extension. MATERIALS AND METHODS: We analyzed step sectioned prostatectomy specimens from 189 patients who had had positive peripheral zone biopsies. We measured the contact length, maximum length (mm.) of the portion of the peripheral zone cancer that was in contact with the fibromuscular rim, and determined the contact ratio from the quotient (%) of the contact length divided by the tumor circumference. We evaluated the correlation between the pathological and ultrasound measurements of these parameters, as well as the accuracy of these criteria for predicting microscopic extraprostatic extension. RESULTS: Among the 189 cancers there was a significant difference (p <0.0001) between organ confined tumors and tumors with extraprostatic extension in contact length and contact ratio. There was a positive correlation (r = 0.691) between the contact lengths measured ultrasonically and histologically among 95 patients who had hypoechoic lesions associated with positive biopsies. A receiver operating characteristics curve of the ability of ultrasound estimated contact length to predict extraprostatic extension revealed the best cutoff value to be 23 mm. with 77% accuracy. Logistic regression analysis revealed that pathological contact length correlated better with extraprostatic extension than tumor volume, Gleason score, prostate specific antigen (PSA) level and pathological contact ratio. The best preoperative predictor of extraprostatic extension was the ultrasound contact length, followed by the contact ratio, PSA value, percentage of the biopsy specimen that was cancer and presence of perineural invasion in the biopsy specimen. Multiple logistic regression analysis revealed that the predictability of ultrasound contact length was improved by considering PSA value also. Probability plots for predicting extraprostatic extension were developed by combination of ultrasound contact length with PSA value. CONCLUSIONS: The length of tumor contact with the fibromuscular rim is more significantly related to extraprostatic extension than tumor volume, PSA level and tumor grade. For hypoechoic cancers a new ultrasound staging criterion, contact length, has been defined. For men who are clinically candidates for radical prostatectomy and have peripheral zone hypoechoic cancers the combination of ultrasound contact length and PSA value is the best predictor of extraprostatic extension.

Humans↗
PubMed1998

Intraobserver and interobserver variance in the measurement of ultrasound-estimated bladder weight.

Recently, we reported that ultrasound-estimated bladder weight (UEBW) could be used as a noninvasive tool in evaluating the degree of bladder hypertrophy. This study was designed to test the reproducibility of its measurement. The overall mean UEBW of the initial measurement and that of the second one by one observer in 36 cases was 42.8 +/- 22.6 g and 42.9 +/- 22.6 g, respectively. The paired differences between two measurements ranged from -3.4 to 2.7 g, with a mean difference of only -0.1 g. The interobserver variance was also slight. The paired differences between UEBW measurements derived from the two observers in 32 cases ranged from -6.0 to 7.9 g, with a mean difference of only 0.1 g. The Cochran's test statistic of the measurements of UEBW was 0.142 for one observer and 0.130 for two, which were less than its 5% critical value. Due to these favorable characteristics, UEBW could be reliable tool for the investigation of bladder hypertrophy with a sufficient reproducibility.

Adult↗
PubMed1998

Adrenal hemorrhage diagnosed by ultrasonically-guided biopsy.

Adrenal hemorrhage in adults is an uncommon disease and is usually associated with systemic diseases, trauma or anticoagulation. When adrenal hemorrhage is discovered in chronic course without any suggestive clinical settings, it is difficult to distinguish adrenal hemorrhage correctly before surgical resection. We present a case of adrenal hemorrhage which was incidentally detected as an adrenal mass and was successfully treated in a conservative way based upon histopathological findings obtained by ultrasonically guided biopsy.

Adenoma↗
PubMed1998

[A case of pheochromocytoma with a large pseudocyst].

We report a case of pheochromocytoma with a markedly large pseudocyst. A 51-year-old man with the complaint of headache and palpitation was referred to our hospital. Ultrasonography (US) revealed a right adrenal cystic mass. Computerized tomography (CT) and magnetic resonance imaging (MRI) confirmed an adrenal cyst. MRI showed a high intensity mass in both T1 and T2-weighted-images, suggesting an adrenal hemorrhagic cyst. 131I-meta-iodo-benzylguanidine (MIBG) scintigraphy showed a prominent accumulation at the right adrenal lesion. Considering the abnormal elevation of cathecholamines in blood and urine samples, we performed right adrenolectomy with the clinical diagnosis of pheochromocytoma. 131I-MIBG scintigraphy was the most important diagnostic tool in the diagnosis of pheochromocytoma.

3-Iodobenzylguanidine↗
PubMed1998

Noninvasive evaluation of bladder compliance in children using ultrasound estimated bladder weight.

PURPOSE: In healthy children as well as those with urinary disturbance we determined ultrasound estimated bladder weight with the aim of revealing its possible usefulness as a measure of bladder compliance. MATERIALS AND METHODS: We measured ultrasound estimated bladder weight in 71 healthy children with a mean age of 10.3 years, and determined a standard value. A total of 82 patients with a mean age of 9.6 years with urinary disturbance also underwent ultrasound estimated bladder weight measurement as well as conventional urological examinations, including filling cystometry. RESULTS: In healthy children ultrasound estimated bladder weight increased with age, showing a significant linear correlation (r = 0.80, p < 0.0001). Using the formula for linear correlation, 0.86 x patient age + 6.9 gm., we obtained an age matched estimated weight. In 82 patients the percent deviation of the estimate from age matched values was calculated using the formula, (measured ultrasound estimated bladder weight -age matched ultrasound estimated bladder weight)/age matched ultrasound estimated bladder weight x 100, and then correlated with bladder compliance. In 75 of 77 patients (97%) with compliance of 10 ml./cm. water or more the estimate was within 100% deviation. In contrast, 4 of 5 patients (80%) with a low compliant bladder (less than 10 ml./cm. water) had an ultrasound estimated bladder weight greater than 100% deviation. When the estimate was within 100% deviation, all but 1 patient (75 of 76, 98.7%) had compliance of 10 ml./cm. water or more compared to 33.3% (2 of 6) of those with an estimate greater than 100% deviation. As a result, with the use of a cutoff value of 100% deviation ultrasound estimated bladder weight predicted a low compliant bladder with a diagnostic accuracy as high as 96.3% (79 of 82 cases). CONCLUSIONS: Ultrasound estimated bladder weight may be used to evaluate bladder compliance in children. It seems to be a suitable noninvasive urodynamic test in children with suspected urodynamic abnormalities.

Adolescent↗
PubMed1997

Role of PSA and its indices in determining the need for repeat prostate biopsies.

OBJECTIVES: To retrospectively study evaluated prostate-specific antigen (PSA) and four PSA indices as criteria for performing a repeat biopsy when the initial biopsy findings are negative for cancer. METHODS: One, two, or more repeat biopsy sessions were performed on 193, 54, and 14 men, respectively, all of whom had an initially negative biopsy at our institution. We compared the usefulness of PSA, PSA density, age-referenced PSA, volume-referenced PSA, and PSA velocity for predicting the presence of cancer. RESULTS: Overall, 51 men (26%) were found to have cancer on repeat biopsy. Cancer was found in 17% (33 of 193) of the men on the first repeat biopsy and 26% (14 of 54) of the men who had a second repeat biopsy. Of all the indices, PSA and volume-referenced PSA had the highest sensitivity, missing the fewest cancers; however, this was achieved at the expense of saving the least number of biopsies. We evaluated the usefulness of indices among 9 patients who had a normal PSA at the initial biopsy; volume-referenced PSA was the earliest predictive index indicating that a repeat biopsy be performed. Analysis of the area under the receiver-operating characteristic curves revealed no significant advantage for any index over PSA alone in determining who should undergo a repeat biopsy. CONCLUSIONS: In determining the need for repeat biopsies, the established PSA threshold value of 4 ng/mL is equivalent or superior to age-referenced PSA, volume-referenced PSA, PSA density, and PSA velocity. However, volume-referenced PSA has the potential to be the earliest index predicting cancer in men with normal PSA level.

Aged↗
PubMed1997

Correlation of presumed circle area ratio with infravesical obstruction in men with lower urinary tract symptoms.

OBJECTIVES: To examine the predictive value of ultrasonic measurements obtained by transrectal ultrasonography for infravesical obstruction as evaluated by pressure flow studies. METHODS: In 85 men with moderate to severe lower urinary tract symptoms, ultrasonic measurements including prostatic volume, transition zone volume, transition zone index (transition zone volume/prostatic volume), and presumed circle area ratio (PCAR) were compared with urodynamic parameters obtained by pressure flow studies. RESULTS: There were significant interrelationships between these ultrasonic measurements, which were all significantly greater in the obstructed patients than in the unobstructed patients. A simple regression analysis demonstrated that prostatic volume (r = 0.362, P < 0.001), transition zone volume (r = 0.373, P < 0.0005), transition zone index (r = 0.331, P < 0.005), and PCAR (r = 0.487, P < 0.0001) correlated significantly with the Abrams-Griffiths number. More importantly, a multiple regression analysis demonstrated PCAR to be the only independent determinant of the Abrams-Griffiths number. A receiver operator characteristics curve analysis showed that 0.8 was the most suitable cutoff value of PCAR for the prediction of infravesical obstruction with a diagnostic accuracy of 76.5%. CONCLUSIONS: PCAR is useful as a transrectal ultrasonic measurement in assessing the severity of infravesical obstruction in men with lower urinary tract symptoms.

Aged↗
PubMed1997

Preliminary results of power Doppler imaging in benign prostatic hyperplasia.

Power Doppler imaging was performed in 77 patients with lower urinary tract symptoms to characterize Doppler blood-flow signals in benign prostatic hyperplasia (BPH). Pulsatile blood flows were detected in all patients, demonstrating a significant increase of the resistive index (RI) in BPH cases (n = 40, 0.72 +/- 0.05, p < 0.0001), compared to those with a healthy prostate (n = 37, 0.64 +/- 0.04). Of 40 patients with BPH, 28 (70%) had an RI of 0.70 or higher; all but 1 patient with a healthy prostate (1 of 37, 3%) had an RI lower than 0.70 (p < 0.0001). In all 10 patients with BPH, the elevated RI decreased significantly to a normal control level after surgical treatment (0.72 +/- 0.02 vs. 0.64 +/- 0.05, p < 0.001). In conclusion, Doppler RI might be useful as a new urodynamic parameter in BPH.

Aged↗
PubMed1997

Reversible change of bladder hypertrophy due to benign prostatic hyperplasia after surgical relief of obstruction.

PURPOSE: Ultrasound estimated bladder weight was compared before and after surgery for benign prostatic hyperplasia (BPH) to reveal a possible reversible change in bladder hypertrophy. MATERIALS AND METHODS: Ultrasound estimated bladder weight was measured before and after subcapsular (17) or transurethral (16) prostatectomy in 33 male patients with BPH. Sequential changes in the American Urological Association symptom score and urinary flow rate were also examined. RESULTS: Along with a significant improvement in the American Urological Association symptom scores and maximum flow rate, ultrasound estimated bladder weight decreased from 52.9 +/- 22.6 to 31.6 +/- 15.8 gm. in 12 weeks after treatment. In all but 4 patients (29 of 33, or 87.9%) ultrasound estimated bladder weight decreased to less than 35.0 gm. in 12 weeks after treatment. Interestingly, in all patients with an initial ultrasound estimated bladder weight of greater than 80 gm. the bladder weight still remained at an abnormally high level 12 weeks after treatment. CONCLUSIONS: Bladder hypertrophy was completely reversible after the surgical treatment of the obstruction in the majority of patients with BPH. The measurement of ultrasound estimated bladder weight was of value in monitoring therapeutic effects in BPH patients. An extraordinarily high ultrasound estimated bladder weight of 80 gm. or more might suggest degenerative and irreversible pathological changes in the bladder detrusor.

Aged↗
PubMed1997

[Clinical evaluation of scintigraphy and tumor biopsy for incidentally detected adrenal masses].

PURPOSE: A decision tree in diagnosis of incidentally detected adrenal masses (incidentaloma) was made on the basis of these results. METHODS: The clinical usefulness of adrenal scintigraphy with 131I-adosterol and ultrasonically guided tumor biopsy was investigated in 44 patients. RESULTS: Adrenal scintigraphy was performed in 32 patients, of whom 21 were found to have an increased uptake in the tumor, including 19 cases of cortical adenoma and 2 of hematoma. No abnormal uptake was found in the remaining 11 patients, including 2 of cortical adenoma, 1 of adrenocortical oncocytoma and 8 of non-cortical tumors. Adrenal scintigraphy was thus thought to be useful in the differentiation of cortical tumor from non-cortical tumor, showing the sensitivity of 86%, the specificity of 80% and the diagnostic accuracy of 84%. Cytological or histological study on specimens obtained by percutaneous adrenal tumor biopsy was performed in 19 patients, of whom 18 (95%) were correctly diagnosed in terms of the malignancy of incidentaloma. CONCLUSIONS: Taken together, the differential diagnosis and the surgical indication of adrenal incidentaloma could be made successfully based on adrenal scintigraphy and tumor biopsy.

Adenoma↗
PubMed1997

Noninvasive quantitative estimation of infravesical obstruction using ultrasonic measurement of bladder weight.

PURPOSE: Ultrasound estimated bladder weight was compared to pressure-flow studies to test the ability of ultrasound estimated bladder weight to predict infravesical obstruction. MATERIALS AND METHODS: A total of 65 men with urinary symptoms underwent ultrasonic measurement of bladder weight and pressure-flow studies. Assuming the bladder is a sphere, ultrasound estimated bladder weight was calculated from bladder wall thickness measured ultrasonically and intravesical volume. RESULTS: Ultrasound estimated bladder weight correlated significantly (p < 0.0001) with the Abrams-Griffiths number, urethral resistance factor and the Schäfer grade of obstruction. A cutoff value of 35 gm. for ultrasound estimated bladder weight revealed a diagnostic accuracy of 86.2% (56 of 65 cases) for infravesical obstruction with 12.1 (4 of 33) and 15.6% (5 of 32) false-positive and false-negative rates, respectively. CONCLUSIONS: Ultrasound estimated bladder weight can be measured noninvasively at the bedside and it is promising as a reliable predictor of infravesical obstruction.

Aged↗
PubMed1997

The American Urological Association symptom index for benign prostatic hyperplasia as a function of age, volume and ultrasonic appearance of the prostate.

PURPOSE: Our study was conducted to reveal quantitatively the relative effects of age and ultrasonic appearance of benign prostatic hyperplasia (BPH) on urinary symptoms as evaluated by the American Urological Association (AUA) symptom index score. MATERIALS AND METHODS: In 929 examinees (732 with a normal prostate and 197 with BPH) on a mass screening program for prostatic diseases using transrectal ultrasonography in Japan, the AUA symptom score was compared to age, prostatic volume and presumed circle area ratio using simple and multiple regression analyses. RESULTS: Simple regression analysis demonstrated the symptom score to correlate significantly with age (R = 0.162, p < 0.0001), prostatic volume (R = 0.072, p = 0.0281) and presumed circle area ratio (R = 0.150, p < 0.0001). However, multiple regression analysis demonstrated that age and presumed circle area ratio were significant independent determinants of the total symptom score. Among 7 symptoms included in the AUA symptom index weak stream and hesitancy scores were not influenced by age, prostatic volume or presumed circle area ratio. CONCLUSIONS: As a parameter representing the degree of BPH in terms of the severity of urinary symptoms, presumed circle area ratio was preferable to prostatic volume. Regression analyses confirmed again that the AUA symptom index was influenced considerably by age and was not specific to BPH.

Age Factors↗
PubMed1996

Possible use of ultrasonically-estimated bladder weight in patients with neurogenic bladder dysfunction.

In 25 patients with detrusor areflexia, ultrasonically-estimated bladder weight (UEBW) was compared with bladder capacity and compliance obtained by cystometry, and UEBW was also compared with grade of bladder deformity as evaluated by cystography. UEBW correlated significantly with compliance (P < 0.01) and degree of bladder deformity (P < 0.01). Taking a cutoff value of 40 g, UEBW revealed diagnostic accuracy as high as 96% and 80% for low-compliance (< 10 ml/cm H2O) and high-grade deformity (grade II/III), respectively. UEBW could be a new urodynamic parameter capable of evaluating functional as well as morphological changes of the bladder.

Adult↗
PubMed1996

Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: a preliminary report.

The aim of the present study was to evaluate the usefulness of ultrasonic estimation of bladder weight as a measure of bladder hypertrophy using transabdominal ultrasonography in men with infravesical obstruction. Ultrasonically estimated bladder weight (UEBW) was calculated from the thickness of the bladder wall measured ultrasonically and the intravesical volume at the ultrasonic measurement, assuming a spheric bladder. There was a statistically significant correlation (r = 0.970, P <0.001) between the actual bladder weight of cadaver bladders and the UEBW. The UEBW did not change with bladder filling. The UEBW in the obstructed group (group O, 49.7 +/- 19.5 g, mean +/- SD) was significantly greater than that in the normal control group (group NC, 25.6 +/- 5.7 g; P <0.001) or the nonobstructed group (group NO, 28.4 +/- 4.2 g; P <0.001). The greatest UEBW was 34.8 g in group NC and 35.2 g in group NO, whereas 94% (45 of 48) of group O had a UEBW greater than 35.0 g. In all 5 patients with benign prostatic hyperplasia (BPH), the increased UEBW decreased to a normal control level at 3 months after treatment of BPH. This new noninvasive method may be useful in investigation of bladder hypertrophy.

Adult↗
PubMed1996

A statistical study of the American Urological Association symptom index for benign prostatic hyperplasia in participants of mass screening program for prostatic diseases using transrectal sonography.

PURPOSE: A study was done on the prevalence of urinary symptoms in community based populations in Japan regarding the influences of aging and benign prostatic hyperplasia (BPH) as evaluated by transrectal sonography. MATERIALS AND METHODS: In 961 Japanese men 55 to 87 years old who underwent mass screening for prostatic diseases the American Urological Association symptom index scores were compared with age and ultrasonic diagnosis of the prostate. RESULTS: Moderate to severe symptoms (symptom score 8 or more) were found in 265 of our 961 samples (27.6%), while BPH was also recognized ultrasonically in 197 (20.5%). Frequencies of urinary symptoms and BPH increased significantly with age. BPH related increase in total symptom scores occurred only in select men when adjusted by age. CONCLUSIONS: The ability of the American Urological Association symptom index to characterize BPH in an individual was limited because of the lack of specificity to the disease along with the considerable influence of aging on the symptom score. Currently, transrectal sonography is the most reliable method for the definitive diagnosis of BPH.

Age Distribution↗
PubMed1995

[Effect of acupuncture on the overactive bladder].

BACKGROUND: We examined the effect of acupuncture for the overactive bladder. METHODS: Eleven patients (9 males and 2 females) with the overactive bladder were treated with acupuncture. The age of the patients ranged from 51 to 82 years (mean 71 years). Nine patients complained of urge incontinence and 2 patients of urgency. Uninhibited contraction was observed in all patients before the acupuncture. A disposable needle (0.3 mm in diameter, 60 mm in length) was inserted into bilateral BL-33 points at the depth of 50 to 60 mm and was rotated for 10 minutes manually. The treatment was performed 4 to 12 (average 7 times). RESULTS: Urge incontinence was controlled completely in 5 and partially in 2 of 9 patients. In 2 patients who complained urgency complete response was obtained after the treatment. Uninhibited contraction disappeared in 6 patients after the treatment. Acupuncture induced an increase of maximum bladder capacity and bladder compliance with statistical significance (p < 0.01 and p < 0.05), respectively. CONCLUSION: Acupuncture at the BL-33 point was effective for controlling the overactive bladder.

Acupuncture Therapy↗