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Biomedical subjects

H Kiwamoto

Publications and source records attributed to H Kiwamoto.

32 records · Page 2Linked to original sources
PubMed1991

[Preparation of a standard diet for out-patients in the study of lithogenesis].

With the development of extracorporeal shock wave lithotripsy treatment, the duration of hospitalization for stone patients fortunately has become shorter. However, a detailed analysis of lithogenesis is not possible during such patients' short hospital stays. We prepared a standard diet to be eaten at home for investigation of lithogenesis at the out-patient clinic. This diet was nutritionally well-balanced and contained the following: energy: 2000 Kcal, total protein: 70-75 g, animal protein: 30-35 g, carbohydrate: 510 g, fat and oil: 50-60 g, calcium: 600-630 mg and magnesium: 320 mg. The urine of 24 male patients with stones on a free diet and the same patients after 3 days on the standard diet was analyzed for urea-nitrogen, uric acid, sodium, calcium, phosphorus, magnesium, citric acid and oxalic acid. The results were compared with those in 17 healthy male subjects who were eating the standard diet (controls). It was found that 66% of hypercalciuria (greater than = 300 mg/day) on a free diet became normocalciuria on the standard diet. The hypercalciuria was therefore thought to be of dietary origin. Moreover, urinary excretion of urea nitrogen, uric acid, sodium and phosphorus by patients remarkably decreased after 3 days on the standard diet, which was not different from that of controls. These results suggest that the standard diet at home is useful in the screening of hypercalciuria and also quite adequate for patients with stones.

Adult↗
PubMed1991

[Management of vesicoureteral reflux in patients with neurogenic bladder dysfunction].

We studied 20 cases of neurogenic bladder with vesico-ureteral reflux retrospectively. Seven patients voided with Valsalva's maneuver and 12 patients were managed with clean intermittent catheterization, but one patient required permanent urinary diversion because of uncontrollable urinary tract infection. The patients were followed by intravenous pyelography, radioisotope renogram, voiding cystourethrography, determination of serum creatinine level and urodynamic study. Anti-reflux surgery was performed in 22 ureters and reflux resolved in 19 ureters. Among 12 ureters not treated by anti-reflux surgery, reflux disappeared in 5 ureters and improved in 2 ureters. Of 5 ureters, reflux resolved after clean intermittent catheterization in 2 ureters, and remained stable without recurrent infection or renal deterioration in the remaining 5 ureters. Regardless whether antireflux surgery was done or not, most of the patients who had high grade reflux and obstructive renal damage on radioisotope examinations had marked low compliance bladders. Our experience suggested the necessity of a suitable treatment to improve bladder compliance before considering anti-reflux surgery.

Adolescent↗
PubMed1991

[AIH in male infertility due to retrograde ejaculation after retroperitoneal lymph node dissection].

A patient with testicular cancer (non-seminoma, stage IIB) who had undergone resection for primary disease and retroperitoneal lymph node dissection as well as chemotherapy and radiotherapy 6 years before developed iatrogenic retrograde ejaculation. The infertility was treated by oral medications, including herbal medicine and injections of a hormone preparation as well as artificial insemination of husband (AIH). After 24 sessions of AIH for 4 years, his spouse gave birth to a healthy baby girl. We believe that for patients with iatrogenic retrograde ejaculation AIH is an effective method of increasing fertility to be employed more often.

Adult↗
PubMed1991

[The effectiveness of prophylactic dietary treatment in renal stones].

By following individual dietary guidelines which were established from analysis of the dietary intake and habits of male renal stone patients, the stone recurrence rate in 75 male calcium stone patients who had only received individual dietary instruction decreased markedly, as compared with that in 114 male calcium stone patients who had not received such instructions. Among 75 patients, recurrence was noted in 6 normocalciuric recurrent stone patients and 1 normocalciuric single stone patient during the period of outpatient visits. Investigation of the daily consumption of various nutrients and urinary excretion revealed no differences among the 6 normocalciuric recurrent stone patients, hypercalciuric recurrent stone patients, hypercalciuric single stone patients and normocalciuric single stone patients. Our findings suggest that the high recurrence rate in the normocalciuric recurrent stone patients is associated with stone lithogenic factors, such as heredity and anatomy, that could not be controlled by the daily treatment in this group.

Adolescent↗
PubMed1991

[Effect of the cerebro-metabolism activator (bifemelane hydrochloride) on urinary incontinence and pollakisuria associated with cerebrovascular dementia].

A cerebral metabolic activator was administered to patients with cerebrovascular dementia to treat urinary incontinence or pollakisuria. The results are of interest as discussed in this paper. This study was carried out on 35 patients (15 males and 20 females) with cerebrovascular dementia with the chief complaint of incontinence or pollakisuria averaging in age 78.1 years with a range of 65 to 92. The underlying disease was cerebral hemorrhage in 4 cases, cerebral embolism in 21 cases and sequelae of cerebral apoplexy in 10 cases. ADL was assessed in all cases by cerebral CT or MRI and Hasegawa's test, a simple test for dementia. Bladder function was evaluated by determining urodynamic tests (CMG, UFM, UPP) before and after medical treatment. Test drug was bifemelane hydrochloride, a cerebrovascular metabolic activator. It was administered at a dose of 150 mg/day for periods of 2 months or more. As a result, bladder symptoms improved in 16/35 patients (45.7%), and mental symptoms in 21/35 (60%). Urine voiding and holding as bladder functions determined by urodynamics tests were not affected at all. The effect of this drug on bladder symptoms is secondary to improvement of mental symptoms, and its most pronounced clinical effect was on dementia.

Aged↗
PubMed1990

[Review of a 14-year experience of augmentation enterocystoplasty. Observations on bowel dynamics].

Fifteen patients with low compliance bladder of varying etiologies (neurogenic bladder, radiation induced contracted bladder after radical hysterectomy, bladder tuberculosis and interstitial cystitis) underwent augmentation enterocystoplasty. The ileocecal tubular segment was used in 12 patients, ileal-patch in 2 and ileal-cup patch in 1. In all patients in whom partial reconstruction was done, the functional bladder capacity satisfactorily increased and the maximum detrusor pressure was low. The upper urinary tract did not deteriorate in 12 patients. Three died from recurrence of uterine or bladder cancer. Five neurogenic patients were managed by intermittent self-catheterization postoperatively. Another 10 patients was dry without voiding difficulty. Of 18 ureteral reimplantations in ileocecal cystoplasty, 13 had reflux without resultant progressive hydronephrosis. In 3 patients ureteral reimplantation was not required without reflux after ileal-patch and ileal-cup patch cystoplasty.

Adult↗
PubMed1990

[Clinical effect of terodiline hydrochloride on pollakisuria and urinary incontinence].

Efficacy and safety of terodiline hydrochloride were studied by treating 38 patients who complained of pollakiuria and incontinence with this drug. Terodiline hydrochloride in a dose of 24 mg once or 12 mg twice a day was administered to these patients for 4 weeks and the conditions of the patients before and after the treatment were evaluated. According to the subjective symptoms, pollakisuria during the daytime and at night, incontinence, anischuria at night and frequency of urination were all reduced significantly. Objective symptoms detected after the treatment a tendency of increase (p less than 0.1) in the bladder volume at the time of maximum micturition. However, no change in the urination volume and the maximum urine flow was observed before and after the administration. A significant decrease (p less than 0.05) in residual urine was noted after the treatment. The results were favorable with overall improvement of 78.4% and efficacy of 75.7%. Side effects were observed in 3 of the 38 cases (7.9%), but all the symptoms were slight.

Adult↗
PubMed1989

[Experimental studies on sympathetic innervation of lower urinary tract. Quantitation of nerve terminals and urethral pressure response after hypogastric denervation].

On 6 female mongrel dogs (denervated group), bilateral hypogastric nerves were cut distally to the inferior mesenteric ganglion. Five dogs were kept intact as a control group. After 2-5 months, urethral pressure response to continuous noradrenaline infusion (0.1 microgram/kg/min) was monitored. The urethral pressure rose significantly after noradrenaline loading in each group, however there was no significant difference in the degree of the response between the denervated group and control group. Subsequently, the bladder and the urethra were extirpated to determine the intrinsic noradrenaline content. The tissue noradrenaline concentration was highest in the posterior urethra, intermediate in the bladder base and lowest in the bladder dome. Although these values tended to be lower in the denervated group than in the control group, no significant difference was obtained between the groups in each portion. These results suggest that the majority of sympathetic components which consists in the hypogastric nerve may involve short adrenergic neurons. Thus, chronic hypogastric denervation alone does not induce sympathetic denervation supersensitivity. Simultaneous decentralization of the pelvic nerve may be necessary for inducing sympathetic denervation supersensitivity.

Animals↗
PubMed1989

[Neurogenic bladder dysfunction due to tethered spinal cord syndrome in adults: report of two cases].

Two cases of neurogenic bladder dysfunction due to tethered spinal cord syndrome in adults were experienced. They visited our hospital with the complaint of dysuria. The excretory urogram were almost normal. Urodynamic examinations revealed normoactive detrusor-overactive sphincter in case 1, and overactive detrusor-overactive sphincter in case 2. Cystometry-electromyogram demonstrated detrusor-external urethral sphincter dyssynergia in either cases. They were diagnosed as neurogenic bladder due to intraspinal tumor with spina bifida by myelography, computed tomography, and urodynamic examination. Laminectomy, subtotal extirpation of tumor and neurectomy of filum terminale were performed by orthopedists in both cases. The tumor was pathologically diagnosed as lipomas. Postoperatively they showed satisfactory recovery in micturition.

Adult↗
PubMed1989

[Clinical study of terodiline hydrochloride on nervous pollakisuria].

TD-758 (12 mg tablets) was given in two tablets daily to 19 patients with nervous pollakisuria. The changes in frequency of daily micturition and in subjective symptoms were studied referring to the diary kept by each patient, along with the occurrence of side effects. Before the medication, urodynamic studies were made on each patient and all the cases were thus confirmed being free from detrusor instability or uninhibited contraction. The wash-out period of other drugs and control observation period, each one week, were set before the medication period which lasted for four weeks. The frequency of micturition per day showed a significant decrease from the first week of the medication period (p less than 0.05), and at the fourth week there was noted a significant reduction by twice per day on the average (p less than 0.001). Subjective efficacy was noted as follows: excellent in 3 cases (15.8%), good in 9 cases (47.7%), unchanged in 7 cases (36.8%), and thus 12 cases (63.2%) showed an efficacy of the rating of good or higher. In four cases dry mouth and in two cases sense of abdominal distention were noted out of the total of 19 cases, but no side effects of severe degree to stop the medication were noted during the medication period. In conclusion TD-758 is a clinically useful remedy for treatment of nervous pollakisuria.

Adult↗
PubMed1988

[A case of renal malignant lymphoma].

Malignant lymphoma affects any organ of the body, but is rarely found in a urological organ. We found a case of renal malignant lymphoma. A 45-year-old male, who had been operated on for primary hepatic malignant lymphoma 9 months previously, was admitted to our clinic, complaining of high fever. X-ray and ultrasonographic examinations suggested a metastatic tumor in the right kidney. Right nephrectomy was performed, and pathohistological examination revealed primary hepatic malignant lymphoma in the right kidney.

Humans↗
PubMed1988

[Measurement of nerve conduction velocity of the dorsal nerve of the penis].

Tests for evaluating the function of the nervous system in patients with erectile impotence have been performed indirectly with the measurement of nerve conduction velocity in the extremities and other neurological procedures, since it has been technically difficult to measure the nerve conduction velocity of the dorsal nerve of the penis. Calculation of the nerve conduction velocity of the dorsal nerve of penis from values of the bulbocavernosus reflex latency was not reliable and the development of a technique to measure accurately the nerve conduction velocity of the dorsal nerve of penis has been awaited. Ten impotent men were studied, and a precise description was made about the procedure of measuring the orthodromic nerve conduction velocity of the dorsal nerve of the penis. The dorsal nerve of the penis was stretched optimally with a weight of 300 g, and its conduction velocity reached the maximal value. This new methodology is of use in the evaluation of erectile impotence.

Adult↗
PubMed1987

[Clinical evaluation of a prostate-specific antigen as a serum marker of prostatic cancer].

Combined measurement of serum prostate-specific antigen (PA) and prostatic acid phosphatase (PAP) was performed in 235 patients with various urologic diseases including 55 patients with prostatic cancer. A PA level of over 24.7 ng/ml and a PAP level of over 3.1 ng/ml were considered to be positive. The positive rate of PA was 57% in the patients with untreated prostatic cancer and 3% in the patients without prostatic cancer. The positive rate of PAP was 52% in the patients with untreated prostatic cancer and 1% in the patients without prostatic cancer. PA and PAP were considered to be equally sensitive and specific serum markers of prostatic cancer. However, the positive rate increased to 65% without increasing the false positive rate when the PA and PAP were both measured simultaneously. The combined assay of PA and PAP is recommended for screening prostatic cancer. The cross-over titer of PA and gamma-Sm using standard samples in each kit revealed linearity, which suggested that PA and gamma-Sm possess the same antigenicity.

Acid Phosphatase↗