Biomedical subjects
Publications and source records attributed to I Tsuji.
Two cases of ureteral ectopia opening in the vestibule without urinary incontinence are reported. Urinary continence was probably due to the incorporation of the ectopic ureteral ends in the wall of the urethral sphincter.
We report our experience with 17 cases of paraureteral diverticula seen in the last 12 years. These 17 cases represent a particular group of patients with ureteral reflux in that they often had ureteral obstruction too. Early operative intervention is recommended. There is a trend towards renal dysmorphism and dysplasia as the position of the ureteral orifice laterlizes in the diverticulum. A paraureteral diverticulum was considered to be the developmental extravesical expansion of the terminal ureteral end by virtue of the caudally positioned ureteral bud in the wolffian duct.
The incidence and type of congenital anomalies associated with childhood testicular germ cell tumors were studied retrospectively in 25 patients (20 cases of yolk sac tumor and 5 cases of teratoma). Congenital anomalies were observed in 3 patients with yolk sac tumors and in 1 patient who had a mature teratoma. The abnormalities observed included individual cases of retrocaval ureter, diverticulum of the bladder, Down's syndrome and an ipsilateral inguinal hernia. Children with a testicular tumor should be examined closely for congenital abnormalities.
We report 2 cases of primary megaloureter, which might shed an unconventional insight into the etiology of this controversial issue. On histological studies, using light and electron microscopy, the dilated segment was characterized by sparse muscular development with an unrecognized amount of thick myofilaments and interstitial fibrosis, while the distal few centimeters of the narrowed segment maintained relatively normal muscular and interstitial features. The etiological and clinical implication of these findings in the management of primary megaloureter is discussed.
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Twenty-three cases of complete duplication of the collecting system are reviewed. The type of ureteral hiatus was retrospectively studied to assess its relation to various abnormalities of the duplex system. It was stressed that the hiatal concept is quite important in understanding the multifarious problems of the pathophysiology of ureteral dilation, surgical management and faulty embryogenesis of the kidney and ureterovesical junction of the duplex system.
Testing for denervation supersensitivity response of the urethra to alpha-agonist as a means of excluding neurogenic vesical dysfunction prior to planning undiversion is discussed in a case report. The method is specifically applicable to the bladder that has shrunk from disuse or fibrosis and therefore is not amenable to conventional bladder function studies.
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In vitro enzymatic degradation rate of ampicillin (AB-PC) in urine of patients with complicated urinary tract infection and its protective effect of dicloxacillin (MDI-PC) was studied using a specific fluorometric assay for aminobenzylpenicilloic acid (AB-PA), which is converted from AB-PC by bacterial beta-lactamase. The results showed that average degradation rate of AB-PC in the urine of 10 patients were 12.2%, 21.5%, 34.3% and 48.2% at 15, 30, 60 and 120 minutes, respectively. While MDI-PC prevented the enzymatic transformation of AB-PC in such urinary samples and the average degradation rates at 15, 30, 60 and 120 minutes were considerably reduced to 7.7%, 12.2%, 21.6% and 32.8%, respectively. In vivo urinary excretion rate of AB-PA was compared between a total of 5 patients and 4 healthy volunteers after oral administration of 250 mg AB-PC. It was found that the patients excreted 9.1%, 10.7% and 12.7% of total dose at 0 approximately to 2 hours, 2 approximately to 4 hours, 4 approximately to 6 hours, respectively, while the average excretion rates in healthy volunteers were 1.54%, 2.88% and 7.94%, respectively. In 4 patients cross-over administration study, the combined dose of AB-PC and MDI-PC has been proved to clearly decrease the urinary excretion rate of AB-PA in 2 cases, but there was no significant difference in the average rate between the single and the combined dose.
A case of Fraley's syndrome in a Japanese woman was reported. This is believed to be the first case involved in a complete duplex kidney.
Experience with transurethral management of urethral stricture using conventional urethroscope and resectroscope of both infant and adult size is reported and the surgical procedure described. Because incision, dilation, and resection of the stricture are done under direct visual control, it is safe and applicable even in severe strictures hitherto untreatable with other refined closed methods.
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The response of urethral pressure to administration of an alpha-stimulant was compared between a group of eight patients with chronic neurogenic bladders as evidenced by positive denervation supersensitivity to parasympathomimetic bethanechol chloride and a group of ten control patients. A supersensitive response to administration of an alpha-stimulant with a rise of maximum urethral pressure, 10 mm Hg or more above the control urethral pressure, was uniformly observed in the urethra of patients with chronically denervated bladders. Our results appear to add pharmacologic evidence of alpha-adrenergic predominance over the parasympathetic in the urethra which is believed to be innervated dually in the recently envolving new concept.
Pregnant WKA rats were laparotomized on the 12th day of gestation, and all fetuses were removed from the uteri, leaving the fetal membranes attached to placentas in situ, protruding into the peritoneal cavity. After 5 to 6 months, extrauterine tumors were observed in 80% of the operated rats, and elevated serum alpha-fetoprotein levels were detected in 80% of the tumor-bearing rats. The tumors in AFP-positive rats always contained yolk-sac tumor elements. In transplantable tumor lines established in the ascites form, numerous free-floating embryoid bodies were observed. The experiments demonstrate that yolk-sac tumors (endodermal sinus tumors) can be induced by simple fetectomy without infection by exogenous tumor virus.