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Biomedical subjects

T Koyanagi

Publications and source records attributed to T Koyanagi.

At least 19 recordsLinked to original sources
PubMed1992

Prophylactic chemotherapy for primary and recurrent superficial bladder cancer: preliminary results. The Hokkaido University Bladder Cancer Collaborating Group.

A multicenter trial for postoperative prophylaxis of the recurrence of superficial Ta-T1, G1-G2 bladder cancer was performed. Eligible patients with primary or recurrent superficial bladder cancer were randomized into four groups. For the primary cases, intravesical instillation of drugs [group A, 20 mg Adriamycin (ADM) + 200 mg cytosine arabinoside (CA) in 30 ml physiological saline; group B, 10 mg peplomycin (PEP) + 200 mg CA in 30 ml physiological saline; group C, 2 mg neocarzinostatin (NCS) + 200 mg CA in 30 ml physiological saline; and group D, control] was carried out once a week for 2 weeks, once every 2 weeks for 14 weeks, once monthly for 8 months, and, finally, once every 3 months for 1 year. For the recurrent cases, intravesical instillation of 20 mg ADM + 200 mg CA in 30 ml physiological saline as described above and daily oral administration of another drug [group E, 300 mg/day UFT; group F, 200 mg 5-fluorouracil (5-FU)/day; group G, 30 mg ubenimex/day; and group H, no oral drug] was performed. The postoperative follow-up period was 3-36 months. A total of 193 primary cases and 121 recurrent cases of superficial bladder cancer were evaluated. The cumulative 12-month nonrecurrence rates for the primary cases were 86.2% in group A, 78.1% in group B, 82.1% in group C, and 68.4% in group D. The cumulative nonrecurrence rate obtained using ADM+CA (group A) was significantly higher than the control value. On the other hand, no significant difference was found in the cumulative nonrecurrence rates calculated for the recurrent cases, regardless of the oral drug given. Intravesical instillation of ADM+CA for primary superficial bladder cancer was considered to be useful, but the long-term effect of intravesical instillation remains to be elucidated. Further refinement of this regimen is necessary for effective prophylaxis of the recurrence of superficial bladder cancer.

Administration, Intravesical↗
PubMed1992

A case of neurofibromatosis associated with clitoral enlargement and hypertension.

We report a case of clitoral and renovascular involvement of neurofibromatosis resulting in an enlarged phallus with juvenile hypertension. The patient was successfully treated by removal of the clitoral tumor and nephrectomy. This is the first of 15 reported cases with clitoral involvement, that showed concurrent renovascular hypertension.

Child↗
PubMed1992

The temporal relationship between the onset of rapid eye movement period and the first micturition thereafter in the human fetus with advance in gestation.

The objective of this study was to investigate whether micturition occurs, temporally related to the onset of the rapid eye movement (REM) period, in the human fetus. The study was made on 139 fetuses at 33-36 weeks and 153 at 37-41 weeks gestation. The discrepancies between the expected (F(exp)) and observed (F(obs)) frequencies of time lag between the onset of the REM period and the first micturition thereafter were assessed using the goodness-of-fit test. At 33-36 weeks gestation, there was no statistical difference between F(obs) and F(exp) (P greater than 0.05). At 37 weeks onwards, however, significant differences were noted between F(obs) and F(exp) (P less than 0.005). Seventy-two percent of all micturitions occurred within eight minutes after the onset of the REM period. This indicates that there is a temporal relationship between the onset of the REM period and the first micturition thereafter, at term, during 37-41 weeks of gestation.

Embryonic and Fetal Development↗
PubMed1992

Changes in pupillary diameter in relation to eye-movement and no-eye-movement periods in the human fetus at term.

OBJECTIVE: The aim of our study was to reveal whether pupils dilate and constrict in a time sequence in the human fetus and to assess the relationship between changes in pupillary diameter and eye-movement-no-eye-movement periods. STUDY DESIGN: We simultaneously observed pupil and eye movement with real-time ultrasonography in 30 human fetuses at 36 to 41 weeks' gestation. Eighteen were excluded because of data loss. Statistical analysis of pupillary diameter changes were made on the remaining 12 fetuses with the least median of squares regression. RESULTS: Pupillary diameters were found to be differentiated with statistical significance into two groups: 9.7% for the dilated pupil (median 3.0 mm) and 90.3% for the constricted pupil (1.7 mm). The percentage of dilated pupils during the eye-movement period (14.3%) was significantly greater than that during the no-eye-movement period (2.3%; Wilcoxon rank sum test, p < 0.0001). CONCLUSION: These findings indicate a close relation between pupillary dilatation and eye-movement periods in the human term fetus.

Eye Movements↗
PubMed1992

Relevance of detrusor hyperreflexia, vesical compliance and urethral pressure to the occurrence of vesicoureteral reflux in myelodysplastic patients.

Bladder pressure in the storage phase is considered to be relevant to the changes in the upper urinary tract. We analyzed retrospectively detrusor hyperreflexia, vesical compliance and maximum urethral closing pressure to determine which is the most significant factor relevant to the incidence of vesicoureteral reflux in 91 myelodysplastic patients. Vesicoureteral reflux was demonstrated in 29 of 91 patients. Cystometry and urethral pressure profilometry were performed in 69 and 27 patients, respectively. Vesicoureteral reflux was observed in 43% of the female patients, which was significantly greater than in the male patients (20%). Detrusor hyperreflexia was noted in 43 patients. Average vesical compliance was 11.3 +/- 8.3 ml./cm. water in 58 evaluable patients. Maximum urethral closing pressure was 56.7 +/- 25.8 cm. water. Vesical compliance in the patients with vesicoureteral reflux was 10.2 +/- 7.5, which was not significantly lower than in those without vesicoureteral reflux (12.2 +/- 8.8). The incidences of vesicoureteral reflux were 38% in the patients with vesical compliance of less than 10, 40% in those with vesical compliance of greater than 10 but less than 20 and 36% in those with vesical compliance of more than 20. The differences were not significant among these patients. Urethral pressure in the patients with vesicoureteral reflux was significantly higher than in those without vesicoureteral reflux (73.8 +/- 23.5 versus 48.2 +/- 23.0, p less than 0.05). The incidence of vesicoureteral reflux was 53% in the patients with urethral pressure of greater than 50, while it was only 8%, significantly less (p less than 0.05), in the lower urethral pressure group. Vesicoureteral reflux was noted in 44% of the patients with detrusor hyperreflexia, which was not significantly greater compared to 31% in the patients without detrusor hyperreflexia. These results suggest that in myelodysplastic patients maximum urethral closing pressure is highly relevant to the incidence of vesicoureteral reflux, while vesical compliance and detrusor hyperreflexia are not. The incidence of vesicoureteral reflux was significantly greater in female patients (43%, p less than 0.05) than in male patients (20%), although urethral pressure values showed no difference between them, indicating that female patients may be another risk factor for vesicoureteral reflux.

Adolescent↗
PubMed1992

Prenatal diagnosis and obstetrical management of May-Hegglin anomaly: a case report.

A case of May-Hegglin anomaly, a rare autosomal dominant thrombocytopenia, is reported. This disorder is characterized by giant platelets, basophilic inclusion bodies within the cytoplasm of granulocytes and an occasional bleeding tendency. This bleeding tendency depends on the platelet count. The fetuses of such patients run the risk of intracranial hemorrhage in utero and during the early neonatal period following vaginal delivery. Prenatal diagnosis of this disorder has not yet been reported. We describe a case of this disorder, diagnosed in pregnancy, which, following prenatal diagnosis of mild thrombocytopenia in the fetus and confirmation by cordocentesis, could successfully undergo a vaginal delivery.

Blood Platelets↗
PubMed1992

Measurement of blood flow in the parameatal foreskin flap for urethroplasty in hypospadias repair.

During the one-stage repair of hypospadias the blood flow of the parameatal-based foreskin flap was measured in 30 patients by using laser Doppler velocimetry. The mean blood flow in the penile foreskin was estimated to be 15 ml/min/100 g and it increased to 150-200% after the induction of anesthesia, and then decreased to 72% at the tip of the created parameatal foreskin flap. Topical application of papaverine hydrochloride restored the flow to the preincision level in half of the cases. The parameatal foreskin flap, both in the form of a manta-wing and in extended circumferential form, appears to have an enough microcirculation suitable for one-stage repair (OUPF II and OUPF IV, respectively) of hypospadias.

Child↗
PubMed1992

[Flow cytometric analysis of DNA content in adult testicular germ cell tumors].

Flow cytometric DNA analysis was carried out in 54 patients with testicular germ cell tumors (GCTs) experienced at our hospital, to evaluate the clinical relevance of DNA index (DI) and provide some insight into the pathogenesis of testicular GCTs. Histological types with their incidences were seminomas in 31 patients and nonseminomatous germ cell tumors (NSGCTs) in 23 adults. DNA ploidy and DI were analyzed by flow cytometry in 158 paraffin embedded samples; 2.9 samples per case on the average. This study revealed that 52 cases (96%) of evaluable 54 adult GCTs were DNA aneuploid, while DNA diploid tumors were observed in only each one case of NSGCT and seminoma. There was a significant difference (p less than 0.01) between the distribution of DIs in adult NSGCTs (median DI = 1.50) and that in pure seminomas (median DI = 1.85). Although we found no significant correlation between DI and clinical staging of Japanese Urological Association, on the basis of Indiana University staging system, the median DI in NSGCT patients of the advanced extent was lower than those of the other extents. DNA heterogeneity was observed only in 4 of 23 NSGCT patients (17%) and 3 of those 4 patients were assigned to advanced extent. These data suggest that the lower DI and the presence of DNA heterogeneity may have prognostic relevance for NSGCTs.

Adolescent↗
PubMed1992

[Single-dose captopril test and captopril renal scintigraphy in the evaluation of renovascular hypertension].

The effectiveness of single-dose captopril test (CP-T) and captopril renal scintigraphy with 99mTc-DTPA (CP-RG) in the diagnosis of renovascular hypertension (RVH) was evaluated in 27 patients with (Group I, 16 patients) or without (Group II, 11 patients) renal vascular disease. Group I consisted of RVH in 8 patients (bilateral in 3, unilateral in 5), arteriovenous malformation in 3, renal artery aneurysm in 4, including 2 with essential hypertension, and asymptomatic renal artery stenosis in 1. Group II consisted of 6 hypertensive patients (2 with essential hypertension and 4 with renal hypertension) and 5 normotensive patients. Sensitivity of CP-T and CP-RG in the diagnosis of RVH was 29% (2/7) and 86% (6/7), respectively, indicating the latter was more sensitive than the former. In 3 patients with bilateral RVH, positive response in CP-RG was observed only in the unilateral kidney. Specificity of CP-T and CP-RG was 86% (6/7) and 100% (5/5), respectively in Group I, 100% (8/8) and 83% (5/6), respectively in 16 hypertensive patients. CP-T and CP-RG before and after the treatment of RVH were evaluated in 4 patients. The change of positive response in CP-T and CP-RG into negative after percutaneous transluminal renal angioplasty (PTA) or surgery were found in 3, all followed by a fall in blood pressure, which was not observed in the other patient with positive response after PTA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Study of 54 renal allograft recipients in the cyclosporin A era. What influences acute rejection episode and long-term graft survival?].

During the past 5-year period from 1986 to 1991, a total of 54 patients received living-related renal allograft and has been managed with vagaries of cyclosporin A (CYA) immunosuppressive regimen. In order to determine the ideal form of induction regimen, combination drugs with CYA, the initial dosage of CYA and its blood trough level were retrospectively analyzed with particular reference to the possible factors relevant to the occurrence of acute rejection episode in the first three post-transplant months and graft survival. The combination drugs with CYA were prednisolone (PRD) in 10 patients, PRD + azathioprine (AZA) in 19 and PRD+mizoribine (MIZ) in 25. The initial dosage of CYA was 6 mg/kg B.W. in 6 patients, 8 mg/kg in 17, 10 mg/kg in 15 and > or = 12 mg/kg in 16. Blood trough level of CYA measured principally by high performance liquid chromatography was arbitrarily divided into < 100, 100-150, 150-200, > or = 200 mg/kg ranges for the analysis. By arbitrarily dividing the post-transplant period into four (period I: 0-15th day, period II: 16-30th, period III: 31-60th and period IV: 61-90th), the correlation of the incidence of acute rejection episode and aforementioned factors was studied. Relevance of these factors to the graft survival was also studied. The administration of AZA to MIZ to CYA + PRD had no suppressive effect upon the occurrence of acute rejection during the first three months and similarly it had no effect upon graft survival. Rejection episodes, however, occurred more frequently in the recipients with less than 150 ng/ml of CYA trough level in the period I and less than 100 ng/ml in the period III (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Flow cytometric analysis of the DNA content in the urinary bladder cancers treated by radical cystectomy and pre-operative irradiation].

The DNA ploidy of bladder cancers treated by radical cystectomy following pre-operative irradiation was analyzed by flow cytometry using paraffin embedded samples. The DNA ploidy and its changes by irradiation were studied. We used flow cytometry in 30 patients with transitional cell carcinoma of the bladder who received pre-operative irradiation (40 Gy in 24 patients, 20 Gy in 5 patients and 60 Gy in one) with follow-up for at least 3 years. Total 140 paraffin embedded samples (4.6 samples per one patient) were available. The effects of therapy were related to the DNA patterns before irradiation and to the DNA ploidy changes after irradiation. 1. Eight DNA diploid tumors and twenty-two DNA aneuploid ones were detected before irradiation. Although diploid group didn't change its DNA ploidy after irradiation, of 22 aneuploid tumors 18 were changed to DNA diploid and 4 were not changed in their ploidy. 2. The tumor eradicating effect of irradiation was shown to be higher (p < 0.05) in the diploid group (5 of 8, 63%) than in the aneuploid group (5 of 22, 23%). 3. Overall survival rates were discussed in 3 groups (A, B and C), the group A was 10 of tumor free and 3 diploid tumors after irradiation, the group B was 13 of aneuploid tumors which changed to diploid ones and the group C was 4 of persistent aneuploid tumors. Each of 5 year survival rate was 100% (A), 58% (B) and 0% (C). Overall survival for C group was significantly shorter than for other groups (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Localization of androgen receptor in male sex organ, accessory sex organs and external genital skin].

Previously, we established an anti-androgen receptor (AR) monoclonal antibody. Using the antibody, we investigated immunohistological AR localization in human testes, epididymides, seminal vesicles and scrotal skins. The testes, epididymides and scrotal skins were obtained from a prostate cancer patient without pre-hormonal therapy undergoing bilateral orchiectomy. The seminal vesicles were obtained from a bladder cancer patient undergoing radical cystectomy. The tissues were immediately frozen in liquid nitrogen and kept at -80 degrees C until used. Cryostat-frozen sections were cut at 5 microns and stained by an indirect method. We obtained the following results. 1) In the testes, nuclei of Leydig cells were stained though Sertoli cells were not stained. AR localization in Leydig cells which produce testosterone suggests autocrine or intracrine mechanism in the testis. 2) In the epididymides, nuclei of epithelial cells of epididymal ducts were stained, while muscles and connective tissues were not stained. In the seminal vesicles, nuclei of glandular epithelial cells were stained. 3) In the scrotal skins, the cells of squamous cell layer have positive stainings. The cells in the upper portion of squamous cell layer were stained more intensely than the cells in the lower portion. The basal layer was not stained. The cells of the outer root sheath of hair follicles in the scrotal skins were also stained. 4) In androgen target organs, AR-positive cells and AR-negative cells were mixed in the epithelium of a glandular duct, which suggests heterogeneity of AR localization in the androgen target organs.

Animals↗
PubMed1992

[Undiversion in a patient with ileal conduit using cecoileal urinary reservoir, a case report].

A case of urinary undiversion in a 19 year old man with high ileal loop, who at the age of 1 year was inadvertently cystectomized for probable acute urinary retention masquerading as acute abdomen, is reported. The ileo-ceco-colonic segment was isolated and the colon was partially detubularized. After ileocecal intussusception and stabilization to the cecal wall (Hendren), a segment of ileal patch was applied to form an Indiana type pouch. The ileal loop was free from the abdominal wall and its distal end was anastomosed to the terminal ileum of the pouch. Undiversion was completed by connecting the pouch at its dependent portion with the remnant prostatic urethra. At 4 months postoperatively the pouch functions quite satisfactorily as a low pressure and good volume reservoir that empties well without reflux. His erectile and ejaculatory function have also been maintained.

Adult↗
PubMed1992

[Successful intrauterine digoxin therapy for fetal complete atrioventricular block with endocardial cushion defect: a case report].

We report herein a case of fetal complete atrioventricular block accompanied with endocardial cushion defect, successfully diagnosed and treated, in utero, with transplacental digitalization. A 23-year-old Japanese woman, at 20 weeks of gestation, was referred to the Maternity and Perinatal Care Unit of Kyushu University Hospital because of fetal continuous bradycardia. B-mode scanning and dual M-mode echocardiography revealed that the fetus had complete atrioventricular block with endocardial cushion defect with a ventricular rate of 60 beats per minute. At 23 weeks of gestation, it was found that the fractional shortenings (FSs) in both ventricles and the ventricular rate had decreased, with an increase in pericardial effusion. Thus, we diagnosed the fetus as having cardiac failure. Transplacental digoxin treatment was started and continued for 10 weeks, after which fetal pericardial effusion, as well as FSs ameliorated. The pregnancy was interrupted by cesarean section at 33 weeks of gestation due to a decrease in FSs with an accumulation of fetal ascites. A 1780g female infant was delivered and a pacemaker was implanted surgically, immediately after birth. She is alive and well at the time of writing.

Adult↗
PubMed1992

How blood viscosity influences changes in circulation during pregnancy?

The changes of whole blood viscosity and plasma viscosity were studied in 15 normal non-pregnant women, and 120 normal pregnant women ranging from 8 to 39 weeks of gestation. The values of whole blood viscosity during normal pregnancy were significantly lower from 20 to 31 weeks of gestation than those in the other periods of gestation, and there was a positive correlation between whole blood viscosity and hematocrit. Plasma viscosity, however, did not change significantly during pregnancy. There was no correlation between whole blood viscosity and plasma viscosity, and there was also no correlation between plasma viscosity and plasma fibrinogen concentration. These findings suggest that decreases in whole blood viscosity, resulting from the change of packed-cell volume, may strongly contribute hemorheologically to the decrease in peripheral resistance during the second trimester.

Blood Circulation↗
PubMed1992

[Long-term results in 1,400 patients with coronary artery bypass grafting: saphenous vein vs arterial grafts].

To analyze and compare the effects of saphenous vein grafts (SVG) and arterial grafts (AG) on the long-term results of the coronary artery bypass grafting (CABG), retrospective nonrandomized studies were performed in 1,400 consecutive patients with CABG in terms of reoperation, postoperative transluminal coronary angioplasty (PTCA) to the grafts, actuarial survival rate, and cumulative event free rate. AG was used frequently in recent cases in which more diffuse and multiple vessel disease were encountered. No statistically significant differences were noted in any of the reoperation free rate, actuarial survival rate, success rate of the PTCA, and cumulative event free rate between SVG and AG, because the long-term results of the SVG was apparently better than reported Caucasian's long-term results, while those of the AG were as good as Caucasian's. Reoperation and PTCA for the AG were performed less than one year after the CABG in most cases and restenosis after the PTCA was rare. In contrast, those for the SVG were mainly done late postoperative period, and the incidence of the restenosis after the PTCA was very high. These results indicated that the main cause of the graft failure in the AG was technic-related, and that of the SVG was graft's atherosclerosis. We conclude from this study that AG should be indicated more extensively than SVG, but proper indication and application of the AG in various situations and technical improvement to avoid stenosis at anastomosis are important to improve the long-term results of the CABG.

Adolescent↗
PubMed1992

[Sequential coronary artery bypass using gastroepiploic artery].

We carried out sequential coronary bypass grafting using the gastroepiploic artery (GEA) as an in situ graft in seven patients. Four patients had sequential graft from the right coronary to the circumflex. Three patients were anastomosed to two or three peripheral branches of the right coronary artery. There were no early deaths. Postoperative angiograms revealed that the patency rate was 92.3% (12/13 anastomoses). Sequential GEA grafting is available to anastomose the peripheral branches of the right coronary and the circumflex where the in situ internal thoracic artery is difficult to access. Therefore, this procedure will be indicated for multiple coronary artery bypass grafting.

Aged↗