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Biomedical subjects

K Muranaka

Publications and source records attributed to K Muranaka.

At least 37 records · Page 2Linked to original sources

[Clinical statistics on inpatients and operations during a ten-year period (1983, 10-1993, 12) at Department of Urology, Fukui Medical School].

A clinical statistic survey was carried out on the patients, diseases and operations experienced at the ward of the Department of Urology, Fukui Medical School between 1983 and 1993. The numbers of inpatients and operations have been increasing since 1991. The majority of the inpatients are those with neoplastic disorders, and the number is steadily increasing every year. After the development of new endourological technology and ESWL, the mode of operation has dramatically changed during the 10 years, trending toward minimally invasive surgery and improvement of the patient's quality of life.

Adolescent↗

[Current concept and problems of urinary diversion. 2. Selection of operation: reservoir].

The Kock continent urinary reservoir was constructed in 12 patients from 1988 to 1990 followed by the Indiana continent urinary reservoir in 14 patients thereafter. There were no perioperative death in either group. The period of postoperative follow-up was 11 approximately 70 months, with a mean of 58.9 months. Several modifications of the operative technique were made to the original Kock pouch, but stone formation was observed in 5 patients (42%), resulting from foreign materials permanently in contact with urine. In the Indiana pouch group with a mean postoperative follow-up period of 26.8 months (range 11 approximately 43 months), wound infection occurred in the initial 4 patients and difficulty of catheterization in the other 4 patients. The serum electrolyte values were found to be within the normal limits during the follow-up period in both groups, but, mild acidosis occurred in 2 patients. Patients with urinary diversion demonstrated mild azotemia (P = 0.02) despite similar serum creatinine levels and an increase in urine pH (P = 0.006) postoperatively. Asymptomatic bacteriuria was demonstrated in 22 of the 26 (83%) patients with the reservoir, but only 5 patients had significant pyuria. Our clinical experience suggests that the Indiana pouch is a more reliable method than the Kock pouch to construct a continent urinary reservoir.

Female↗

[Clinical statistics on outpatients during a ten-year period (1983, 10-1993, 12) at Department of Urology, Fukui Medical School].

A clinical statistic survey was carried out on the patients and disease experienced at the outpatient clinic of our Department of Urology, between 1983 and 1993. Although the number of newly diagnosed patients was rather constant, the total number of outpatients gradually increased every year, and the average and median age of newly diagnosed patients became higher. The major disease categories were infectious and neoplastic disorders.

Adolescent↗

[Comparison of the clinical usefulness of the two types of combined spinal epidural needles].

The clinical usefulness of Combined Spinal-Epidural (CSE) needles, Portex Spinal/Epidural set (P needles) and Hakko Disposable Needles set type H (H needles) was compared on 30 patients undergoing elective orthopedic lower limb surgeries. Although the calibers of the epidural needles were a little different, both needles were introduced quite easily in the epidural space. The spinal needles were inserted successfully to the subarachnoid space in 27 out of 30 cases by the P needles and 23 out of 30 cases by the H needles. The average trial times for successful insertion of the spinal needles were 1.3 and 2.6 by the P needles and the H needles, respectively. this was statistically significant (P < 0.05). Adequate spinal anesthesia was established in 26 patients (87%) and 19 patients (63%) by the P needles and the H needles, respectively. One case of the accidental location of the epidural catheter in the subarachnoid space was observed in each group. As the CSE device, the P needles were more sophisticatedly designed for easier insertion to the subarachnoid space than the H needles.

Adolescent↗

[A beneficial effect of glucose-insulin-potassium infusion for intractable ventricular fibrillation--a case of intraoperative myocardial infarction].

A 61-year-old man suffering from compression fracture of the first lumbar vertebra was scheduled for anterior and posterior spinal fusion. Anesthesia was maintained with enflurane, nitrous oxide in oxygen and fentanyl. When his position was changed from right lateral to supine position, ventricular fibrillation (VF) occurred. The operation was discontinued and he was taken into ICU receiving cardiopulmonary resuscitation. Despite ordinary therapies including DC-shock and lidocaine infusion, Vf and defibrillation recurred more than 20 times for the first two hours. Electrocardiogram showed elevation of ST-T segments in II, III, aVF and V1-V3 leads. Because no effective treatment was found, we attempted to use glucose-insulin-potassium mixture, by which Vf stopped. Electrocardiogram taken on the following day showed abnormal Q wave in II, III and aVF leads, and the patient was diagnosed as having had acute myocardial infarction. On the fifth postoperative day, the patient was returned to the ward without neurological deficits. We conclude that glucose-insulin-potassium infusion is a beneficial therapy for Vf, which is resistant to ordinary treatments.

Glucose↗

[Renal abscess: complication of transcatheter arterial embolization of renal cell carcinoma].

Transcatheter arterial embolization (TAE) has been widely used in the treatment of tumors as well as other lesions of the kidney. Complications most commonly encountered are post embolization syndrome, such as flank pain, fever, leucocytosis, nausea, vomiting, or ileus. They occur mostly in 24 to 48 hours and its treatment is symptomatic. We experienced a renal abscess developed in a patient of renal tumor with preexisting silent urosepsis. Precise examination of silent infection is recommended as a preprocedure test to avoid such complications.

Abscess↗

[A case of embryonal rhabdomyosarcoma of the spermatic cord].

A case of rhabdomyosarcoma of the spermatic cord in a 6-year-old boy is reported. On February 26, 1986, he visited Nakamura Hospital with the chief complaint of enlargement of the left scrotal content. The contralateral scrotum was normal. The left scrotal content was a hard thumb-head-sized tumor. The left testis and epididymis were not distinguishable from the tumor. On the same day, left high inguinal orchiectomy was performed. The tumor was 3.5 by 2.5 by 2.5 cm in size and was distinguishable from the testis, epididymis and tunica vaginalis. Histopathological findings were embryonal rhabdomyosarcoma and it appeared to have originated from the spermatic cord. Two years after operation, the boy is living without metastasis. Including our experience, 101 cases of the paratesticular rhabdomyosarcoma found in Japanese literature are reviewed and briefly discussed.

Antineoplastic Combined Chemotherapy Protocols↗

The response of Streptococcus faecalis to ciprofloxacin, norfloxacin and enoxacin.

The response to three quinolones of a clinical isolate of Streptococcus faecalis was studied by continuous turbidimetric monitoring, by viable counting, and in an in-vitro model of the treatment of bacterial cystitis. Dense populations (c. 8 x 10(6) cfu/ml) responded to ciprofloxacin, norfloxacin and enoxacin at concentrations below the conventionally determined MIC, but variants, shown to exhibit decreased susceptibility, emerged during overnight incubation. The variants were cross-resistant to each of the three quinolones, but the resistance was lost on subculture in drug-free broth. At a concentration of ten-fold MIC, ciprofloxacin was more bactericidal than norfloxacin or enoxacin. In experiments in the bladder model, doses of ciprofloxacin achieving a peak concentration of 10, 50 or 250 mg/l suppressed bacterial growth for 20 h or more. The doses of norfloxacin or enoxacin required to achieve a comparable effect were higher than those of ciprofloxacin. A reduction in susceptibility, as judged by comparative disc testing, occurred after two cycles of exposure to norfloxacin or enoxacin in experiments in which the peak concentration achieved was 50 mg/l, but not when the peak was 250 mg/l. Reduced susceptibility to ciprofloxacin developed only in experiments in which a lower peak concentration of 10 mg/l was achieved.

Anti-Infective Agents, Urinary↗

[A case of intrascrotal leiomyoma originating from tunica vaginalis].

A case of intrascrotal leiomyoma originating from tunica vaginalis is reported. The patient was a 63-year-old male who complained of painless tumor of the right scrotal contents. The tumor was surgically removed easily. The histological examination of the tumor revealed leiomyoma. Seven cases of intrascrotal leiomyoma reported in Japan were reviewed.

Genital Neoplasms, Male↗

[A case of hamartoma of the retroperitoneal space].

A case of hamartoma of the retroperitoneal space in a 59-year-old woman is reported. Excretory urography, computed tomography and adrenal angiography revealed a tumor with multiple calcification in the left retroperitoneal space. The tumor measuring 6.5 by 3.5 cm, and weighing 30 gm, was removed operatively. Removed specimen consisted of many cysts of various sizes containing mucous fluid and multiple small stones. Microscopically, the tumor was composed of a tubular structure lined by ciliated, epithelium-like tissue of the respiratory system or that of Fallopian tube. These tubules were occasionally dilated cystically. No atypical cells were found. The postoperative course was uneventful.

Female↗

[Torsion of the undescended testicle: a case report].

A 15-year-old boy was consulted to our hospital with the complaint of swelling of the left inguinal region with tenderness. Under the diagnosis of torsion of the undescended testicle, left orchidopexy was done with the finding of left testicle which had 360 degree counterclockwise intravaginal rotation. This was thought to be the 54th case of the disease in Japan. We have made some discussion on incidence, complication, diagnosis and therapy.

Adolescent↗

[Two cases of emphysematous pyelonephritis--considerations on the choice of treatment].

Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma and perirenal tissues. Two cases of this disease are presented. They were the 16th and 17th case reported in Japan. Case 1 was a 63-year-old woman with diabetes mellitus and liver cirrhosis. She was hospitalized for abdominal pain and anuria. Renal X-rays showed a gas shadow in and around the left kidney, but no evidence of upper urinary tract obstruction. Although hemodialysis was done, she died of heart failure. Case 2 was a 54-year-old man with diabetes mellitus was admitted with the complaint of fever and left abdominal pain. Renal X-rays showed a gas shadow in and around the left kidney but no evidence of upper urinary tract obstruction. He was treated with intensive antibiotic therapy, control of blood sugar, intravenous drips and percutaneous drainage. Clinical features improved, but deteriorated after 40 days of therapy. The gas shadow remained unchanged on CT scanning, and aortography showed the occlusion of the left renal artery. Nephrectomy was done after 50 days. Seventeen cases of emphysematous pyelonephritis in the literature including our cases are reviewed, especially the choice of the treatment is discussed.

Drainage↗

[A case of vesicosigmoidal fistula secondary to diverticulitis of the colon].

A case of vesicosigmoidal fistula secondary to the diverticulitis of colon is reported. A 63-year-old man was admitted to our clinic with the chief complaint of pneumaturia. Cystoscopy revealed an edematous, papillomatous lesion at the left posterior bladder wall. Although multiple diverticulosis of descending and sigmoid colon were demonstrated by barium enema, the presence of a fistula from the intestine to bladder was not confirmed. The presence of fistula was confirmed by detecting the orally administered charcoal in the urine. Resection of sigmoid colon with partial cystectomy was performed. Removed specimen revealed multiple sigmoidal diverticula and a fistula from a sigmoidal diverticulum to bladder through a firm mass. Histological examination of mass demonstrated inflammatory changes. This was the 58th case of vesicosigmoidal fistula due to diverticulitis of colon reported in the Japanese literature.

Diverticulitis, Colonic↗

[Report of a case of a renal arteriovenous malformation presenting an unusual computed tomographic finding].

A fifty-three-year-old woman was admitted for gross hematuria and left lumbago. She was diagnosed as having left renal arteriovenous malformation (AVM) by renal angiography, but contrast enhanced CT of her left kidney demonstrated a low density area of renal parenchyma adjacent to AVM. Because a renal tumor could not be denied completely, we performed translumbar nephrectomy. No renal tumor was found in the removed kidney, and she was diagnosed as having cirsoid type AVM of the left kidney. The low density area in contrast enhanced CT was suspected to be indicating the ischemic renal parenchyma due to the steal phenomenon of renal AVM. This is the first report of a renal AVM with ischemic renal parenchyma demonstrated by CT.

Arteriovenous Malformations↗

[Pyeloureteritis cystica: report of a case].

A 68-year-old female patient was admitted for the examination of duplication of right ureter and right hydronephrosis. Antegrade pyelography showed multiple, small, round defects in the ureter from the upper pole of right kidney. Ureteroureterostomy was performed under the diagnosis of ureteritis. Including our case, 25 cases of pyeloureteritis cystica have been reported in Japan.

Aged↗

[A case of megaureter].

The terminology of megaureters, their histological findings and etiology vary greatly in the literature. We encountered an obstructed megaureter in a 39-year-old man. He complained of epigastral and left flank pain. X-ray examination showed a right marked hydronephroureter which compressed the bladder and left ureter. We performed right nephroureterectomy. Postoperative course was uneventful and his clinical condition improved.

Adult↗