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Biomedical subjects

J Ishigami

Publications and source records attributed to J Ishigami.

At least 37 records · Page 2Linked to original sources

[A case of leiomyosarcoma of the kidney].

Leiomyosarcoma of the left kidney seen in a 58-year-old man is reported. On April 10, 1982, he complained of left flank pain. He visited our hospital and left solitary renal cyst was suspected. He had been treated as an outpatient, but left flank pain became exacervated. On May 18, he was admitted to our hospital. On June 7, radical nephrectomy was done under the diagnosis of left renal cell carcinoma. At operation, the tumor invased directory to the psoas muscle and abdominal wall, and could not be completely resected. Pathological diagnosis was renal cell carcinoma with sarcomatoid change. On July 1, he was discharged from the hospital. In December, left flank distention appeared and back pain became exacervated. On February 8, 1983, he was readmitted to our hospital. Low density area was found in left psoas muscle by CT scanning and recurrence of renal cell carcinoma was suspected. alpha-Interferon therapy had been done, but tumor increased remarkably and caused ileus. He died on June 14, 1983. The autopsy revealed a child head-sized cystic tumor in the upper retroperitoneal space, a 5 X 5 X 5 cm metastasis of the left lobe of the liver, a 3 X 3 X 4 cm tumor to the left upper lobe with cavity formation and direct invasion into the spleen, diaphragma and gastric serosa. These metastatic lesions were leiomyosarcoma. Retrospectively, the primary tumor of kidney revealed primary leiomyosarcoma of kidney.

Diagnosis, Differential↗

[Recurrence of acute uncomplicated cystitis--criteria for the evaluation of recurrence after antimicrobial chemotherapy].

UNLABELLED: The recurrence of female acute uncomplicated cystitis was investigated clinically. The criteria for the evaluation of recurrences were proposed, as follows; PATIENTS: Target infection is acute uncomplicated cystitis (AUC) which had satisfied the specifications of AUC Criteria by the UTI Committee of Japan and showed the excellent effects of an antimicrobial agent after a definite period of administration. Treatment period: Seven days; after 3 days' administration to evaluate the drug efficacy, patients shall take an additional 4 days' treatment. Interval of follow up proposed was 7 days. Evaluation of recurrence: Parameters of criteria are pyuria and bacteriuria. Recurrence: Pyuria greater than or equal to 10 WBCs/hpf and bacteriuria greater than or equal to 10(4)/ml. Evaluation of the day of recurrence: Evaluation should be made 14 days after the start of treatment. Urine sampling: After 7 days of treatment, midstream urine is collected and in cases with positive findings, catheterized urine should then be collected. Using these criteria it will be possible to evaluate and compare the ability of various antimicrobial agents to cure acute uncomplicated cystitis.

Acute Disease↗

[Pharmacokinetics of cefixime in patients with impaired renal function].

Cefixime (CFIX) was given orally in a single dose of 100 mg to 7 patients with varying degrees of impaired renal function (Ccr 12.0-56.7 ml/min) and serum concentrations and urinary excretion rates were measured with time for the first 24 hours by the bioassay method to investigate in vivo pharmacokinetics of the drug. The results obtained are summarized as follows. The mean peak serum concentration of CFIX in 3 patients with moderately impaired renal function (group I: Ccr greater than or equal to 30-less than 60 ml/min) was 2.04 micrograms/ml at 6 hours after dosing and gradually declined to 0.10 microgram/ml at 24 hours after dosing. The half-life was 4.15 hours. The mean peak serum concentration of CFIX achieved was 2.27 micrograms/ml at 8 hours after dosing in 4 patients with severely impaired renal function (group II: Ccr greater than or equal to 10-less than 30 ml/min) and the concentration of CFIX was 0.99 microgram/ml even after 24 hours. The half-life was prolonged to 11.05 hours. There was no great difference between groups I and II in the first 24-hour urinary excretion rates. However, the first 4-hour urinary excretion accounted for 2.14% of the administered dose of CFIX in group I but only 0.47% in group II. Urinary concentrations of CFIX peaked at 4-6 hours after dosing in both groups, and thereafter gradually decreased in group I. Whereas, they did not decline much in group II until 24 hours after dosing.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Giant seminoma of undescended testis in Down syndrome.

A giant seminoma of undescended testis in a forty-one-year-old Japanese male with Down syndrome is reported as is a review of the literature. The relationship between Down syndrome and testicular cancer are discussed. To our knowledge this is the largest seminoma of undescended testis (weight 3,500 Gm) so far recorded.

Adult↗

Urinary diversion: anastomosis of the ureters into a sigmoid pouch and end-to-side sigmoidorectostomy.

From 1978 to 1982 bilateral ureterorectostomy and end-to-side sigmoidorectostomy were done following cystectomy for carcinoma of the bladder in 7 patients. No patient had recurrent pyelonephritis or ureterointestinal obstruction. Rectography showed the absence of rectoureteral reflux of contrast medium but rectosigmoid reflux appeared after injection of more than 150 ml. opaque solution. Adequate alkali therapy was performed in 2 patients with hyperchloremic acidosis. While there were some problems concerning the quality of urinary and fecal control achieved in our patients they were no worse than those of ordinary ureterosigmoidostomy. This operation might be recommended for patients in whom a collection appliance is unacceptable. However, before this surgical procedure can be performed the fact that the end result in terms of fecal urinary continence is unpredictable must be explained thoroughly to the patient.

Adult↗

[Comparative study of chemosensitivity tests of human urogenital tumors between a clonogenic assay and a novel dye exclusion test].

There is a need for chemosensitivity tests of human tumors to become simpler and to have a better correspondence with their therapeutical record. We examined and compared two chemosensitivity tests in vitro. One was a clonogenic assay performed using a double agar system and the other was a novel dye exclusion method that was a modification of the traditional dye exclusion method of Weisenthal. Cultured cells and surgical speciners of urogenital tumors were used for the present experiments. Comparison of chemosensitivity between the clonogenic assay and the novel dye exclusion test resulted in a similar dose response for each, and both tests were suitable not only for cultured cells but also surgical speciners. Among surgical speciners, 17 of 25 cases (68%) tested by clonogenic assay and 8 of 11 cases (73%) tested by novel dye exclusion test were successful in detecting drug sensitivity. Renal cell carcinomas had higher plating efficiency and showed a higher success rate in the clonogenic assay than any other urogenital tumors. On the other hand, the novel dye exclusion method depended on tumor cell growth in suspension culture. Among 11 cases on which both the clonogenic assay and the novel dye exclusion method were performed, only in one case was there failure to estimate drug sensitivity. Therefore, more successful results in examining the chemosensitivity of urogenital tumors might be expected by using both the clonogenic assay and the novel dye exclusion method.

Antineoplastic Agents↗

[Comparative studies of the efficacy, safety and usefulness of S6472, cefaclor and cephalexin on complicated urinary tract infection by the double-blind method].

To objectively evaluated the usefulness of the standard formulation of cefaclor (CCL) and the long-acting formulation of cefaclor (S6472) in noncatheterized complicated urinary tract infection (UTI), a double-blind comparison study was carried out using cephalexin (CEX) as a control. Patients were orally treated with either 500 mg of CCL 3 times/day, 750 mg of S6472 2 times/day, or 500 mg of CEX 4 times/day for 14 days. Overall clinical effect was evaluated on days 5 and 14 in accordance with the UTI therapeutic evaluation standard, with check for recurrence on day 21. There was no demographic difference between the groups. There was no difference in the effective rate on day 5 among the 3 treatment groups: 58.1% in S6472 group, 66.0% in CCL group and 61.9% in CEX group. Nor on day 14, was there any significant difference in the effective rate among the 3 groups: 70.8% in S6472 group, 63.4% in CCL group and 61.8% in CEX group. Stratification analyses (by UTI group, infection site, in- or out-patient, time of starting treatment, pretreatment severity of pyuria, total number of bacteria before treatment) revealed no significant difference among the 3 groups. Therapeutic effect evaluated by physicians in charge was not significantly different among the 3 groups on day 5 or day 14. In terms of overall therapeutic effect, all 3 products were very effective in patients infected with sensitive bacteria: On day 5, 85.4% in S6472 group, 84.4% in CCL group, and 83.7% in CEX group. There was no significant difference among the 3 groups on either day. The incidence of side effects was not significantly different among the 3 groups: 4 out of 129 patients treated with S6472 (3.1%), 2 of 131 treated with CCL (1.5%) and 2 of 128 with CEX (1.6%). Clinical laboratory tests revealed 4 abnormal findings in 4 patients treated with S6472, 6 findings in 4 treated with CCL, and 4 findings in 2 treated with CEX, showing no significant difference in incidence among the 3 groups. Both side effects and abnormal clinical laboratory findings were mild and reversible. Physicians in charge judged the usefulness of the 3 drugs on days 5 and 14, taking efficacy and safety into consideration. Significant difference was not observed. The presence of recurrence was examined 7 days after drug withdrawal in patients regarded as remarkable responders to 14-day treatment by overall therapeutic effect evaluation.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗

[Fundamental and clinical studies on S6472 (a new prolonged acting preparation of cefaclor) in the urological field].

Fundamental and clinical studies on S6472, a new prolonged acting preparation of cefaclor, were performed and the following results were obtained. Serum level and urinary excretion. 750 mg of S6472, 500 mg of cefaclor (CCL) and 500 mg of cephalexin (CEX) were orally administered in 6 healthy adult volunteers by the cross over method to measure serum level and urinary excretion. The serum level-time curve of S6472 showed 2 peaks at 1 and 6 hours after administration. The peak serum level of S6472 was 4.2 micrograms/ml and 2.9 micrograms/ml, respectively, 1 and 6 hours after administration. The peak serum level of CCL and CEX was 5.8 micrograms/ml and 12.1 micrograms/ml, respectively, 2 hours after administration. The urine level-time curve of S6472 also showed 2 peaks at 0-2 and 4-6 hours after administration and the peak urine level was 1,320 micrograms/ml and 994 micrograms/ml, respectively, 0-2 and 4-6 hours after administration. The peak urine level of CCL was 1,337 micrograms/ml, 0-2 hours after administration and that of CEX was 2,079 micrograms/ml, 2-4 hours. The mean urinary excretion of S6472, CCL and CEX was 56%, 69% and 94% of dose at 12 hours after administration. Clinical evaluation. S6472 was tried in 200 cases of various urinary tract infections. For one group of 85 cases with acute uncomplicated cystitis, clinical effects were evaluated as excellent in 40 cases, moderate in 42 cases and poor in 3 cases, and the overall clinical effectiveness rate was 96.5%. For another group of 68 cases with complicated urinary tract infection, clinical effects were evaluated as excellent in 9 cases, moderate in 27 cases and poor in 32 cases, and the overall clinical effectiveness rate was 52.9%. Side effects. Side effects were observed in 7 cases with diarrhea, epigastralgia, stomatitis, eruption and facial swelling. Administration of S6472 was discontinued in 2 cases, but in 7 cases all symptoms were transient.

Adult↗

[In vitro antibacterial activity of various cephems against clinical isolates from complicated urinary tract infections].

In vitro antibacterial activity of several cephems (CEZ as the first generation (group A); CTM and CMZ as the second generation (group B); CMX, CPZ, LMOX, CTX and CZX as the third generation (group C)) against 8 species, each of 54 strains, of Gram-negative clinical isolates from complicated urinary tract infection was compared by determination of the MICs. The following results were obtained: The most sensitive drugs against each species in MIC80; CTX (MIC80 0.20 microgram/ml) against E. coli, CMX (1.56 microgram/ml) against K. pneumoniae, LMOX (0.39 microgram/ml) against P. mirabilis, LMOX (0.78 microgram/ml) against Indole (+) Proteus, CMX and CPZ (50 micrograms/ml) against E. cloacae, CMX and LMOX (50 micrograms/ml) against C. freundii, CMX (3.13 micrograms/ml) against S. marcescens and CPZ (25 micrograms/ml) against P. aeruginosa The most sensitive drugs against each species in MICS100; CMX (MIC100 3.13 micrograms/ml) against E. coli, CMX (6.25 micrograms/ml) against K. pneumoniae, CTX (0.78 microgram/ml) against P. mirabilis, LMOX (1.56 microgram/ml) against Indole (+) Proteus, CPZ (100 micrograms/ml) against E. cloacae, CMX (100 micrograms/ml) against C. freundii, CMX (12.5 microgram/ml) against S. marcescens and CPZ (50 micrograms/ml) against P. aeruginosa. In each species, the group C were most sensitive followed by those of the group B. Many isolates were highly resistant to the group A (especially in C. freundii, S. marcescens and P. aeruginosa).

Bacteria↗

[Studies on antibiotics distribution in the post-operative cavity].

In 17 post-operative patients, serum and operation cavity exudate levels after 2 g administration of various cephems (CZX, LMOX, CTX, and CPZ) by one hour drip infusion were evaluated. Drug concentration in exudate (actual levels) was corrected by using an equation for the purpose of excluding blood contamination. After 2 hours from the start of infusion, theoretical levels generally were similar to actual levels. CZX: Peak exudate level was 38.9 micrograms/ml at 4 hours. Maximum exudate level/maximum serum level (E/S) was 0.31. LMOX: Peak in exudate was 41.4 micrograms/ml at 4 hours. E/S was 0.59. CTX: Exudate peak level was 30.8 micrograms/ml at 2 hours, and E/S was 0.53. CPZ: Peak level in exudate was 74.0 micrograms/ml at 4 hours. E/S was 0.36. Generally, peaks occurred at 4 hours (3 hours later than serum peaks), and their range was between 30 and 80 micrograms/ml. At 8 hours, drug levels in exudate were 10 approximately 60 micrograms/ml, and they were higher than the corresponding serum level at that time.

Adult↗

[Two cases of spontaneous fistula between urinary tract and gastrointestinal tract].

This is a report of two cases of a fistula between the urinary and gastrointestinal tracts. One case was a 56-year-old female patient with a right pyeloduodenal fistula, and the other was a 38-year-old female with a left ureterodescending colon fistula. The chief complaint was right lumbago in the first case, and fever and left lumbago in the second case. Both cases were diagnosed by retrograde pyelography. In both cases, the ailing kidney appeared to be non-functioning, and the former was operated by nephrectomy, fistulectomy, and duodenectomy in the cuneate form, while the latter was operated by nephrectomy and fistulectomy. The cause of the formation of the fistula was considered to be chronic pyelonephritis accompanied by renal stones in the first case, and rupture of the colon diverticulitis in the second case. Postoperative prognosis was satisfactory in both cases.

Adult↗

[A case of ectopia testis transversa].

A case of ectopia testis transversa was reported. A patient, 35-year-old male, was admitted to our hospital with swelling of left scrotal contents. At operation, two testes were situated in the left scrotal half, but the right half was empty. Including our case, 66 cases of ectopia testis transversa have been reported in Japan.

Adult↗

[Male infertility with chromosomal abnormalities. I. XYY syndrome].

Chromosomal abnormalities are found in a considerably high percentage of cases of male infertility, in particular azoospermia. We report a case of the XYY syndrome and review the literature. A 36-year-old man, a factory hand, presented with infertility. He was safely delivered at term as a fourth child when his father was 41 years old and his mother 38. He had no delinquent or criminal record. His height was 179 cm, weight 75 kg and distance of extended hands 184 cm. No gynecomastia was noticed. Both testes were 8ml in size and growth of pubic hair and penis were normal. Severe oligozoospermia was identified in semen analysis. Seminal vesiculography showed pathological dilatation of the seminal vas end. The testicular biopsy specimens revealed spermatogenic arrest for the most part. Chromosomal analysis showed 47, XYY karyotype; and, two Y-chromatin was revealed in cultured lymphocytes. Though plasma gonadotropin levels were high, testosterone, estradiol, prolactin, TSH, GH, T3 and T4 levels were within normal limits. Pituitary reserve function for secreting gonadotropins and Leydig cell reserve function to secrete testosterone have been found to be almost normal.

Adult↗

A rare case of adenocarcinoma of bladder following augmentation enterocystoplasty.

This is a report of a case of poorly differentiated adenocarcinoma found 20 years after bladder augmentation ileoplasty. The origin of this tumor was proved to be the ileal part of bladder augmentation. Autopsy revealed metastatic lesions in the stoma (sigmoid conduit), lungs, liver, left femur, adrenal glands and lymph nodes. A review of the literature revealed only one other such case. This is a rare case of adenocarcinoma in the ileal part of bladder augmentation.

Adenocarcinoma↗