Biomedical subjects

K Kohri

Publications and source records attributed to K Kohri.

At least 181 records · Page 10Linked to original sources

PubMed1990

Clinical effects of prophylactic dietary treatment on renal stones.

From the investigation of the dietary intake and habits of male Japanese renal stone patients we established several general guidelines. Fluid intake should be increased, especially after dinner. Unbalanced diets should be corrected and avoided (the diet should include different types of food, with vegetables being eaten at every meal and an excessive intake of meat should also be avoided). Three meals a day should be eaten and an excessive intake at dinner should be avoided. The interval from dinner until retiring should be extended. By following these individual dietary guidelines the stone recurrence rate in 199 male calcium stone patients who had received individual dietary instruction decreased remarkably compared to that in male calcium stone patients who had not received individual dietary instruction, not only during the period of outpatient visits but also after outpatient visits were discontinued. From these results we conclude that individual dietary management should be the primary measure for the prophylaxis of renal stone disease in Japan.

Adult↗

PubMed1990

Dietary intake and habits of Japanese renal stone patients.

The daily consumption of various nutrients as well as the daily habits of 241 male stone patients were investigated. Hypercalciuric (300 mg. or more per day) calcium stone patients ingested much more total protein, fats, oils and calcium than normocalciuric calcium stone patients, and uric acid stone patients ingested much more total and animal protein, and carbohydrates than calcium stone patients. However, the amount of ingested calcium by the patients (470 mg.) was similar to that of age-matched healthy male subjects (476 mg.) and did not reach the level of the daily nutritive requirements (600 mg.). The patients ingested large amounts of nutrients, especially animal protein, during the evening meal. From these results it was believed that synthetic dietary management, including not only ingesting various amounts of nutrients but also changing dietary habits, is necessary for the prophylaxis of renal stones.

Adult↗

PubMed1990

Clinicopathological study on end-stage reflux nephropathy in renal-transplanted children.

Five children with end-stage reflux nephropathy underwent kidney transplantation at our clinic. Reflux nephropathy was studied clinically and histologically. All children had proteinuria before starting hemodialysis, and hypertension was present in 2 cases. Three children underwent antireflux operations prior to transplantation. The original kidneys exhibiting reflux were removed during renal transplantation. All original kidneys exhibited atrophy and scarring. Focal and segmental glomerulosclerosis was found in 4 cases. PAS deposition in the interstitium, suggestive of Tamm-Horsfall glycoprotein, was found in all cases. No recurrent signs of focal and segmental glomerulosclerosis have been found in the children who have been followed up from 1 to 6 years after transplantation.

Adolescent↗

PubMed1990

Inhibitory effect of glutamic acid and aspartic acid on calcium oxalate crystal formation.

The effects of Glu and Asp on calcium stone formation was evaluated in three experiments. Studies using mixed suspension, mixed product removal crystallization and scanning electron microscopy showed that Glu and Asp inhibited the nucleation rate, growth rate and suspension density (crystal mass produced) in proportion to the concentration. The main amino acids in calcium oxalate stones and calcium phosphate stones were Glu and Asp. However, the main amino acids in uric acid stones were glycine and urea, and there were no specific amino acids in struvite stones. The activity of urinary GOT and GPT, which convert Asp and alanine, respectively, to Glu in normal subjects was significantly greater than in calcium stone formation.

Aspartic Acid↗

PubMed1990

[Clinical studies on thirty-two cases of childhood urolithiasis].

We evaluated 32 patients with urinary calculi under 16 years of age over the past 14 years since the founding of the Department of Urology, Kinki University School of Medicine. They comprised 0.8% of the total urolithiasis patients. They consisted of 18 boys and 14 girls with a male-to-female ratio of 1.29. The average age was 8.7 years for boys and 10.4 years for girls without any marked peak. The most frequently chief complaint was hematuria which was present in 15 cases (47%). Although pyuria was seen in seven cases (22%), urinary bacterial culture was positive only in 5. The underlying diseases could be diagnosed in 13 cases (41%), of which eight cases (62%) developed metabolic disorder. The sites of calculi were determined in 29 cases (91%), of which 28 had stones in the upper urinary tract. Surgical treatment was performed on 16 cases in 17 sessions. Ureterolithotomy was done in as many as five cases, followed by pyeloplasty in four cases. Nephrectomy was performed in only one case. There was only one case which had been treated with extracorporeal shock-wave lithotripsy (ESWL). The composition of calculi was found in 21 cases (66%), the majority or 13 cases (57%) of which had calcium-containing stones. Nevertheless, there was no case of hypercalciuria. When compared to the previous reports in Japan, it was worthy of note that calculi in the upper urinary tract and calcium-containing stones had higher incidences. It is expected that more patients will be treated with ESWL in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

[Effects and side effects of ureteral stenting during extracorporeal shock wave lithotripsy].

We retrospectively studied the effects and side effects of placing indwelling ureteral stents in 196 cases who underwent extracorporeal shock wave lithotripsy with a ureteral stent. The average period of ureteral stenting was approximately 22 days. Placing ureteral stents was mainly for large renal stones (79.3%), single kidney etc. There were no significant differences between the stunted and non-stunted patients with approximately 2 cm sized single renal stone with respect to the stone free rate, stone free period, and symptoms during stenting, which suggested that ureteral stenting might be unnecessary in those patients. High fever was highest in incidence of the symptoms and complications during stenting (17.2%). It occurred frequently in patients with infected stones or cystine stones. The percentages of pyrexia and stone street in patients using Towers type's stents were higher than those using the others. It was also shown that the bladder portions of the stents in patients using Towers peripheral ureteral stents were densely encased in calculous material and were very brittle. Fortunately the ureteral portions were removed intact. This study suggests that use of an indwelling ureteral stent may not contribute to the higher rate of being free of stones after the treatment of small to medium sized renal calculi, and that stents should be removed or changed early.

Adolescent↗

PubMed1990

[Urolithiasis due to renal tubular acidosis associated with Sjögren's syndrome].

We encountered 4 patients with urolithiasis due to renal tubular acidosis (RTA) associated with Sjögren's syndrome. Laboratory results about RTA in 4 patients with Sjögrenhs syndrome were not significantly different from those in patients who suffered from urolithiasis due to RTA without Sjögren's syndrome. The incidence of urolitiasis in these cases was suspected to be higher than that in RTA patients without Sjögren's syndrome, because all 4 patients in this study had urolithiasis. When we examine patients with bilateral and multiple urolithiasis, particularly in middle-aged women, we should bear in mind that RTA and Sjögren's syndrome may exist in the background.

Acidosis, Renal Tubular↗

PubMed1990

[Calcium urolithiasis and bone change].

Bone mineral contents of calcium urolithiasis patients (105 males and 52 females) were measured by the microdensitometry (MD) method, and the patients were divided into the MD normal group and the MD abnormal group. The patients were also divided into the group (21 males and 3 females) treated with thiazides for 1 year or more and the nontreated group to examine various factors in blood and urine. [Nontreated group] The rate of MD abnormality was higher in younger males. The rate tended to increase with age in females. Alkaline phosphatase values were significantly higher in MD abnormal group males than in MD normal group males. Urinary calcium excretion and PTH values were significantly higher in MD abnormal group females than in MD normal group females. Comparison of hypercalciuria and normocalciuria revealed no significant difference between the MD normal rate and the MD abnormal rate. Comparison of single of stone formers and recurrent stone formers also revealed no significant difference between the MD normal rate and the MD abnormal rate. [Treated group] PTH and alkaline phosphatase values were significantly higher in the treated group than in the nontreated group. Alkaline phosphatase values were significantly higher in the MD abnormal group. From the viewpoint of stone recurrence prevention, the monitoring of bones where the majority of calcium in the body is present is considered important besides behavior of calcium in blood and urine.

Absorptiometry, Photon↗

PubMed1990

[Follow-up study of residual and recurrent stone after extracorporeal shock wave lithotripsy].

The rate of residual stones and that of recurrent lithiasis were investigated in 183 patients who had undergone extracorporeal shock wave lithotripsy (ESWL) between July, 1986 and December, 1988. The investigation was done by questionnaire survey at 22 institutions including our hospital on patients who were followed up after ESWL. The 183 patients included 126 male and 57 female patients between 9 and 77 years old (the mean 43.6 years). The greater part of patients had lithiasis of the lower renal calyx and upper ureter. The rate of residual stones 3 months after ESWL was 33.3% (61 patients) and the success rate was 72.2%. Chemical analysis of stones disclosed calcium oxalate-containing stones in 61% and calcium phosphate-containing ones in 10.8%. Recurrence of lithiasis was observed in 18 of the 131 patients (13.7%) who could be followed up for 6 months or more. These results were compared with those obtained after endoscopic treatment at Kinki University.

Adolescent↗

PubMed1989

Extracorporeal shock wave lithotripsy of staghorn calculi.

A total of 260 patients underwent treatment with extracorporeal shock wave lithotripsy (ESWL). Staghorn calculi were found in 32 cases. In carrying out ESWL for staghorn calculi, double pigtail stent was previously retained in principle. When the ureter was occluded by stone street in case a fever of more than 38 degrees C lasted for 4-5 days after the first treatment with ESWL, percutaneous nephrostomy (PNS) was performed. In ESWL treatment alone a large number of shock waves were required, but double pigtail stent and PNS were used in combination individually, and larger stones were treated by the same waves. When combination therapy was used, hospital stay was short and the rate of remaining stones was low. Our therapeutic conclusions are discussed.

Adult↗

PubMed1989

Amino acids in urine and plasma of urolithiasis patients.

Urine and plasma amino acids in healthy males and patients with calcium stones, were analyzed for thirty-four amino acids. There was no difference in urinary excretion of thirty-two amino acids between the two groups. Plasma values of taurine, aspartic acid, hydroxyproline, glutamic acid, glycine, alanine, cystathionine, ornithine and lysine were significantly higher in controls than in stone formers. Of these amino acids, aspartic acid, glutamic acid, glycine, alanine and lysine are the main amino acids of matrix protein in renal stones. The levels of aspartic acid, glutamic acid, glycine, alanine and lysine in the serum of normal individuals were higher than those in plasma. On the basis of the findings, these amino acids may form soluble complexes with calcium and heparin in stone formers. It is also possible that some amino acids act as promoters or inhibitors in the pathogenesis of calcium oxalate stones.

Amino Acids↗

PubMed1989

Ammonium urate urinary stone: its surface structure and incidence in Japan.

We report on a middle-aged woman with a stone in the right kidney, derived from ammonium urate. Its surface structure was examined by scanning electron microscopy. Ammonium urate is a very rare component of urinary stones in industrialized countries, and they are thought to have an incidence of lower than 0.1% in Japan. The aetiology of ammonium urate-derived stones was investigated from an endemo-epidemiological viewpoint.

Adult↗

PubMed1989

Long-term results and curative mechanisms of vesicoureteral reflux by endoscopic injection of blood.

We describe our new endoscopic procedure for correction of ureterovesical reflux by endoscopic injection of the patient's own heparinized blood behind the ureteral orifice. Before drawing out the needle, small amounts of thrombin and protamine were injected to prevent the injected blood from leaking. Of the 16 ureters treated (13 patients) with international grade I-III reflux, 9 showed complete absence of reflux. The technique is advantageous because it is technically simple and injection can be repeated until the reflux had disappeared. Furthermore, no complications such as distant migration of injected material or escape from the bladder mucosa have been observed. However, the treatment is not consistently successful in cases of high-grade reflux. After the operation, mucosal swelling of ureteral orifice and narrowing of the intramuscular ureter were observed by ultrasonography. The mean pressure of the intramuscular ureter increased 10 cm H2O after the operation. These consequences of the operation may prevent vesicoureteral reflux.

Blood↗

PubMed1989

Magnesium-to-calcium ratio in tap water, and its relationship to geological features and the incidence of calcium-containing urinary stones.

We examined the relationship among magnesium and calcium content in tap water, the geological features and urinary stone incidence in Japan. The magnesium-to-calcium ratio in tap water correlated negatively with the incidence of urolithiasis. There was no correlation between calcium and magnesium concentration in tap water and urinary stone incidence. Geological features in Japan were classified into 5 groups. The magnesium-to-calcium ratio in the basalt areas was higher than in the other areas, while ratio in the granite areas was low. In the sedimentary rock areas calcium and magnesium concentrations were high; the magnesium-to-calcium ratio in these areas was between those of the basalt and granite areas. The limestone areas had a much higher calcium concentration. The incidence of urinary stones in the sedimentary rock and basalt areas was lower than that of the granite areas, while that in the limestone areas was the highest. Thus, the incidence of urinary stone is related to the magnesium-to-calcium ratio in tap water and the geological area.

Calcium↗

PubMed1989

The effect of glycosaminoglycans on the crystallisation of calcium oxalate.

The effect of glycosaminoglycans on urinary stone formation was evaluated using a mixed suspension, mixed product removal (MSMPR) crystallisation system together with scanning electron microscopy (SEM) to examine the resulting crystals. Chondroitin sulphate was found to decrease the nucleation rate and to promote both the growth rate and suspension density. Results obtained with hyaluronic acid, although inconclusive, are similar to those given by chondroitin sulphate. Heparin sodium salt had a powerful inhibitory effect on both the nucleation rate and the suspension density, the effect increasing in proportion to the heparin concentration. SEM examination showed that the octahedral habit of calcium oxalate dihydrate was modified by the addition of heparin sodium salt and confirmed that the average crystal size in the presence of chondroitin sulphate and hyaluronic acid was significantly greater than the control or that found in the presence of heparin sodium salt.

Calcium Oxalate↗

PubMed1989

Parathyroid carcinoma in a case of chronic renal failure on dialysis.

The combination of chronic renal failure plus parathyroid adenocarcinoma is very rare. A 53-year-old female had been on hemodialysis for chronic renal failure for 7 years. For 2 years she has had bilateral knee joint pain, hypercalcemia and an increased parathyroid hormone level. Swelling of parathyroid gland was diagnosed and it was excised. Histological examinations of the excised right lower parathyroid gland revealed adenocarcinoma and the left lower gland showed hyperplasia.

Adenocarcinoma↗

PubMed1989

[The effect of the interval from dinner until retiring on the concentration of lithogenic substances during sleep].

The relationship between the interval from dinner until retiring and the concentration of various substances secreted into the urine during sleep was studied in 69 healthy men who had eaten the same meal. The specific gravity and the concentrations of creatinine, uric acid and magnesium in the morning spot urine were highest in subjects who had retired within 2 hours after dinner. The concentrations of calcium and oxalate in the morning spot urine were highest in those who had retired between 2 and 4 hours. The specific gravity and urinary concentrations of creatinine, uric acid and oxalate were markedly higher in those with the interval less than 4 hours than in those 4 hours or longer. The concentrations of calcium, magnesium and citrate were not significantly different between the two groups. From these results, we recommend that the interval from dinner until retiring be prolonged and fluid be drunk before going to bed to decrease the concentration of lithogenic substances during sleep.

Adult↗

PubMed1989

[Dietary habits of Japanese renal stone formers and clinical effects of prophylactic dietary treatment].

The daily consumption of various nutrients and the daily habits of 241 male stone formers were investigated. The patients (especially uric acid stone formers and hypercalciuric (greater than or equal to 300 mg/day) calcium stone formers) ingested much more total protein and animal protein than healthy Japanese. However, the amount of ingested calcium by the patients (470 mg) was less than that of healthy subjects (553 mg) and did not reach the level of the daily nutritive requirement (600 mg). The amount of ingested nutrients during the evening meal by the patients was about 50% of the daily amount with over 60% of the daily animal protein being ingested at dinner. This tendency was high in subjects who were in their 20's to 40's. The interval from dinner until retiring in the patients was not different from that of healthy males, but it was under 4 hours in over 50% of those in their 30's and 40's in both groups. From these results, we thought that a rapid change in nutritional status and dietary style in the short period after World War II had strongly affected the incidence of renal stone disease in Japan. Therefore, we have established the following general guidelines: 1) increased fluid intake, especially after dinner, 2) correct and avoid unbalanced diet (the diet should include all kinds of food, with vegetables being eaten at every meal and avoidance of an excessive intake of meat), 3) eat three meals a day and avoid an excessive intake at dinner, and 4) extend the interval from dinner until retiring. By following these individual dietary guidelines, the 5-year stone recurrence rate and the stone episode rate decreased remarkably in the period of not only outpatient visits but also in the period when the outpatient visits were discontinued. From these results, we conclude that individual dietary management should be the primary measure for the prophylaxis of renal stone disease in Japan.

Adult↗