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Biomedical subjects

F Ikoma

Publications and source records attributed to F Ikoma.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Consideration on transfusion in urologic surgery--a retrospective study on homologous and autologous transfusions].

To obtain data for promoting autologous transfusion in urologic surgery, the cases of perioperative homologous transfusions in the past 5 years are reviewed. Although the mean perioperative homologous blood transfusion rate was not so high (10.2%), the rate in common urological surgery was comparatively high (eg. radical nephrectomy 39.4%, simple or palliative nephrectomy 21.6%, total nephroureterectomy 33.3%, renal allotransplantation 82.8%, total cystectomy 96.2%). Mean homologous transfusion volume in these surveys was 982 ml. Two successful cases of autologous blood transfusion by the predeposit method or intraoperative collecting method are presented. Transfusion-associated adverse effects, especially viral infection and immunosuppression, were discussed and the value of autotransfusion was stressed.

Blood Transfusion↗
PubMed1990

[Clinical statistics on outpatients, inpatients and operations in 1988].

Statistical studies were made on 1,766 outpatients, 657 inpatients and 687 operative procedures at our department in 1988. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were congenital urethral stenosis, hypospadias, vesicoureteral reflux, benign prostatic hypertrophy and bladder tumor. A total of 687 operations were performed. The five major operations were optic internal urethrotomy, hypospadias repair, transurethral resection of prostate, ureterocystoneostomy and transurethral resection of bladder tumor.

Adolescent↗
PubMed1989

New development and progression of renal scarring in children with primary VUR.

To study the development of new scars and progression of previous scarring, we analysed 711 children with primary VUR. New scar or progression of previous scarring was observed in 7.3% of the kidneys with reflux. Factors which promote the formation of new scars are high-grade VUR, recurrent UTIs and high-pressure bladder which results in high-pressure reflux. The average age of new scarring was from 7 to 9 years. We emphasize the importance of the follow-up study until the age of 15 years, even after reflux has stopped following surgery.

Adolescent↗
PubMed1989

Polyorchidism: preoperative diagnosis by ultrasonography.

Polyorchidism is an unusual abnormality of the genital tract in which supernumerary testicles are present, usually within the scrotum. We report a recently encountered case with no remarkable symptoms. Preoperative ultrasonographic evaluation differentiates this rare benign entity from more ominous abnormalities such as neoplastic involvement of the scrotal contents.

Child↗
PubMed1989

[Renal dysfunction in children with vesicoureteral reflux].

It is well recognized that reflux nephropathy is one of the commonest causes of end-stage renal failure (ESRF) in children. We made a retrospective study of 28 children with vesicoureteral reflux (VUR) who showed impaired renal function, as defined by either the serum creatinine of more than 1.0 mg/dl or BUN of more than 20 mg/dl. There were 20 boys and 8 girls, and the incidence of both sexes was 4.8% and 1.9% respectively. Of patients, proteinuria was detected in 22, and hypertension in 7. Five patients progressed to ESRF during his or her clinical course. About half of the patients in this series presented proteinuria or growth retardation which had led to urological check-up. Bilateral reflux was demonstrated in 24 patients, and all of the remaining 4 with unilateral reflux had hypoplastic or dysplastic contralateral kidney. Micturition cystourethrography revealed moderate or severe reflux in 86% of the ureters either at the first examination or during the follow-up periods. Urographic findings which suggested renal dysfunction included bilateral small kidney, unilateral small kidney with contralateral renal scarring, and bilateral generalized renal scarring. According to the pattern of the progression of renal dysfunction, patients were subdivided into 3 groups. Group I; patients showed bilateral renal hypoplasia on urography, and renal dysfunction progressed to ESRF before the age of 10 years despite surgical treatment. In patients of group II, gradual decrease of renal function led to ESRF at the age of puberty, although SCr was around 1.2-1.5 mg/dl when they were about 10 years old. In group III, renal function was stable at about 1.0 mg/dl of SCr during childhood. Temporary improvement of renal function was observed in only 3 of 21 children who were followed for more than 1 year after antireflux surgery. Deterioration of renal function was caused within 6 months to one year. Antireflux surgery had only little influence on the improvement of renal function in this series. We emphasize the need for early detection and management of reflux to prevent progression of renal dysfunction.

Adolescent↗
PubMed1989

[Reflux nephropathy and reflux glomerulopathy].

The several problems of reflux nephropathy and reflux glomerulopathy are reviewed and discussed. From my own experience of primary vesicoureteral reflux (VUR) in 901 children and secondary VUR in 195 children I would like to stress my cherished opinion that for the treatment of VUR all clinical and subclinical infravesical obstruction should first be ruled out.

Adolescent↗
PubMed1989

Destruction of renal parenchyma at percutaneous nephrolithotripsy; experimental study.

The destruction of renal parenchyma caused by excess deflection of the sheath was examined to determine at what level of force the renal parenchyma was ruptured during PNL. The kidney obtained from right nephroureterectomy due to renal pelvic cancer (stage T2N0M0) of a 54-year-old female patient was punctured at the posterolateral portion with a puncture needle. The tract was dilated up to 26 Fr. in size with an Amplatz renal dilation set. The 26 Fr. sheath was left in the tract and fixed to the metal bar attached to Gig Boring Machine (Hydroptic-6) which could sense the change of pressure added to the renal parenchyma in the parallel movement of the metal bar. The critical angle in regard to the deflection of the renal parenchyma in order not to cause the rupture of renal parenchyma on PNL was calculated from both the resultant force and the shape of the wound of renal parenchyma at rupture. The safety angle against horizontal plane of the tract ranged from 18 to 37 degree.

Biomechanical Phenomena↗
PubMed1989

[Clinical statistics on outpatients, inpatients and operations in 1987].

Statistical studies were made on 1,859 outpatients, 587 inpatients and 601 operative procedures at our department in 1987. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, congenital urethral stenosis, benign prostatic hypertrophy and bladder tumor. A total of 601 operations were performed. The five major operations were hypospadias repair, optic internal urethrotomy, transurethral resection of prostate, ureterocystoneostomy and transurethral resection of bladder tumor.

Hospital Departments↗
PubMed1988

Clinical analysis of the small kidney associated with VUR.

Analysis was performed on the clinical features of children with VUR who had one or two kidneys that were at least -2 SD smaller than normal for age of its renal ratio. The prevalence of the small kidney was 15.6% (97/623 children). Of 107 small kidneys, 87 (82%) were associated with moderate (grade IV) to severe (grade V) reflux and renal scarring was evident on 95 kidneys (88%). About half of the kidneys were diagnosed as scarred atrophy and 40% as congenital hypoplasia. The renal growth after antireflux surgery was evaluated by the change of the renal ratio and it was found that about three-fourths remained small during the pre- and postoperative periods. Accelerated growth was only exceptional.

Adolescent↗
PubMed1988

Renal growth and progression of reflux nephropathy in children with vesicoureteral reflux.

We analyzed renal growth and development of renal scars in 754 children with primary and 169 with secondary vesicoureteral reflux. The incidence of a small kidney was 15.5 per cent in the primary and 24.1 per cent in the secondary groups. About three-fourths of the small kidneys remained small from the first examination through followup. Catch-up renal growth was only exceptional. New scars or progression of previous scarring was observed in 7.4 and 30 per cent of the primary and secondary groups, respectively. Factors that promote formation of new scars are high grade vesicoureteral reflux, recurrent urinary tract infections and abnormal bladder function that results in high pressure reflux. We emphasized the importance of precise examination of the lower urinary tract. An early antireflux operation should be performed on children with severe reflux or recurrent urinary tract infections.

Child↗