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Biomedical subjects

M Kanematsu

Publications and source records attributed to M Kanematsu.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Xanthogranulomatous pyelonephritis coexisting with fistula between ureter and sigmoid colon: a case report].

A 63-year-old woman with the complaints of left renal stone and fistula between left ureter and colon was transferred to our clinic by a local doctor. Anemia, gamma-globulinemia, and acceleration of ESR were detected by hematology on admission. Kidney-ureter-bladder X-ray and intravenous pyelography showed left non-functioning kidney with coral stone, and RP revealed a fistula between left ureter and sigmoid colon. She was operated by nephroureterectomy and fistulectomy. The resected kidney appeared pale and parenchyma was almost replaced by yellowish tissue and pus. Histologically, the lesion was confirmed to be xanthogranulomatous pyelonephritis. Meanwhile, the cause of the fistula was considered to be due to extending ureteritis and pelvic infection from the pyelonephritis. Postoperative course was satisfactory.

Female↗
PubMed1988

Laboratory assessment of lomefloxacin (SC-47111) in comparison with norfloxacin.

The activity of lomefloxacin and norfloxacin against 681 bacterial strains, including 520 strains isolated from infected urine was assessed in vitro. All strains were tested in two inocula and the susceptibility of urinary isolates was evaluated at three pH levels. Lomefloxacin displayed a broad spectrum of antibacterial activity which was similar to that of norfloxacin and which was independent of inoculum size. Good activity was shown for lomefloxacin against all Gram-negative urinary pathogens: strains of Pseudomonas spp and nalidixic acid-resistant enterobacteria were the least susceptible, indicating a degree of cross resistance between newer quinolones and nalidixic acid. Lomefloxacin generally showed more modest activity against Gram-positive cocci and bacteroides than against enterobacteria. Under the acidic conditions that commonly prevail in urine the activity of both compounds against Gram-negative urinary pathogens was markedly reduced, whereas strains of Gram-positive cocci were only minimally affected.

Anti-Bacterial Agents↗
PubMed1988

[A case of renal cell carcinoma suspected of multilocular cystic nephroma].

A 52-year-old, healthy looking woman was referred for further evaluation of left renal mass, She had had a history of hematuria for ten years. Admission laboratory studies were within normal limits except for slight elevation of white blood cell count, c-reactive protein, blood sedimentation rate and immunosuppressive acidic protein. Retrograde pyelography demonstrated a large mass with ringed calcification in the middle lobe of the left kidney. The multiloculated mass was also confirmed by computed tomography and ultrasonography. Selective left renal arteriography showed stretched arteries and irregularity and tortuosity of the smaller vessels. Under a presumptive diagnosis of multilocular cystic nephroma or renal cell carcinoma, left radical nephrectomy was performed. In surgical specimen, many lobules were filled with serous fluid and clotted blood. Microscopic examination revealed that the lining of the cyst wall consisted of renal cell carcinoma cell. At present, 5 months after the operation, she is well without any signs or symptoms of recurrence.

Carcinoma, Renal Cell↗
PubMed1988

[A case of xanthogranulomatous pyelonephritis--an experience of echo-guided aspiration biopsy for the diagnosis].

Xanthogranulomatous pyelonephritis is a rare disease of the kidney. The pre-operative diagnosis of this disease is usually very difficult. Recently, echo-guided aspiration biopsy has been suggested for the differential diagnosis of the renal mass. We experienced a case of xanthogranulomatous pyelonephritis and performed echo-guided aspiration biopsy. A 57-year-old female was admitted to our hospital with complaints of upper abdominal pain and right lumbago. Judging from the findings obtained by intravenous pyelography, computed tomographic scan, ultrasonography and angiography, the lesion was a right renal inflammatory mass but renal tumor could not be denied. Because clear cell carcinoma was suspected from the results of echo-guided aspiration biopsy, right radical nephrectomy was performed. However, the resected kidney was diagnosed to be xanthogranulomatous pyelonephritis. Post-operative course was uneventful.

Adenocarcinoma↗
PubMed1988

[A case of female urethral diverticulum calculi].

A 53-year-old nulliparous woman complained of terminal pain on urination and bended micturition. Previously, she had been treated unsuccessfully with antibiotics for chronic cystitis. On examination, a mass of approximately a thumb's head-size, was palpated at the left portion of urethral meatus. Plain film of the pelvis revealed stones under the margin of symphysis pubis. Positive pressure urethrography revealed a diverticulum slightly larger than the stones. Transvestibular diverticulectomy and urethrolithotomy were performed without any postoperative complications. In Japan, 38 cases of diverticulum calculi of the female urethra have been reported.

Diverticulum↗
PubMed1988

[In vitro activity of minocycline against Chlamydia trachomatis clinical isolates and clinical efficacy of minocycline to C. trachomatis associated nongonococcal urethritis].

The in vitro activity of minocycline (MINO) against Chlamydia trachomatis and its efficacy in the treatment of C. trachomatis-associated nongonococcal urethritis were investigated. Six isolates of C. trachomatis were inhibited at 0.06 micrograms/ml of MINO and 5 isolates at 0.03 micrograms/ml. All cases received oral MINO twice daily for 7 or more days in doses of 100 mg. In 5 of 31 cases, 2 g of spectinomycin was intramuscularly administrated together with MINO only once. C. trachomatis was eliminated in all cases tested. Excellent results were obtained in 26 cases (84%); urethral discharge and polymorphonuclear cells (PMN) disappeared or decreased to normal levels (3 cells/hpf or less) in these cases. Ureaplasma urealyticum was isolated from 8 cases, 7 of which became free of ureaplasmal infection. MINO seemed to be less effective on the decrease of PMN in the urethral smear in cases infected coincidentally with C. trachomatis and U. urealyticum than in cases infected with C. trachomatis alone. No subjective side effects were observed in any of the 31 cases studied. In conclusion, MINO was a useful antimicrobial agent for the treatment of C. trachomatis- and U. urealyticum-associated nongonococcal urethritis.

Adult↗
PubMed1988

[Ultrasound-guided puncture for renal cyst and instillation of povidone iodine].

Percutaneous puncture followed by instillation with 10% povidone iodine was performed on 23 patients with benign renal cysts. All patients showed remarkable reduction (mean: 86.6%) in size of renal cyst on sonography or computed tomography within a short time (mean: 143 days). Twelve (85.7%) of the 14 symptomatic patients due to the disease were relieved of subjective symptoms such as lumbago after instillation. In a 71 year-old man, microscopic hematuria disappeared after this treatment. There were no complications with this treatment except in one patient who suffered from perinephritis due to a technical problem. This treatment seems to be a safe and effective way to prevent recurrence of cystic fluid.

Adult↗
PubMed1988

[A case of superselective transcatheter embolization for injured renal segmental artery associated with percutaneous nephroureterolithotomy (PNL)].

A case in which the renal segmental artery was injured due to percutaneous nephroureterolithotomy (PNL) and treated by superselective transcatheter embolization is reported. The patient was a 30-year-old man with left ureteral and bilateral renal calculi. The left renal and ureteral calculi were successfully removed by PNL and a 24Fr. nephrostomy catheter was placed for 8 days after PNL. A few minutes after removal of the nephrostomy catheter, arterial bleeding, which seemed to occur due to injury of renal segmental artery associated with PNL, began. The bleeding was stopped by replacement of a 24Fr. nephrostomy catheter and the patient received 5 units of packed red blood cells. Six days after hemorrhage, superselective transcatheter embolization was performed. No further bleeding occurred and the nephrostomy catheter was removed 2 days later without any incident. This interventional technique is safe and useful to control bleeding from renal segmental artery injured by PNL.

Adult↗
PubMed1987

[New combination chemotherapy in refractory rhabdomyosarcoma of the prostate: a case report and review of the literature].

A rare case of prostatic rhabdomyosarcoma in a 3-year-old child is presented. He received a multimodal treatment of chemotherapy including vincristine, cyclophosphamide, actinomycin-D plus adriamycin, and linac irradiation followed by total prostatectomy with segmental resection of bladder. Despite no viable sarcoma cells in the surgical specimen, he showed relapse 4 months later. By the combination of cisplatin, vinblastine and peplomycin (PVP therapy), the bulky mass in the pelvis rapidly reduced by 95%. Furthermore, cisplatin, etoposide and peplomycin (PEP therapy), instead of PVP therapy, were administered to the refractory disease. Although the residual tumor was salvaged after 7 courses of PEP therapy, abdominal dissemination and liver metastasis occurred 2 months postoperatively. The combined modality of vincristine, peplomycin, ifosfamide, methotrexate, adriamycin, melphalan plus nimustine, and irradiation of microtron were effective for the abdominal dissemination, but he died of cerebral hemorrhage 31 months after the start of treatment. We emphasize that more aggressive chemotherapy including cisplatin, etoposide and so on is required to manage the advanced, relapsed, or resistant cases compared to the usual modality of rhabdomyosarcoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[A case of primary psoas abscess with paravesical extension].

We report a case of primary psoas abscess with paravesical extension. A 16-year-old man who had suffered from remittent fever for two months was admitted to our clinic. He had no urological symptoms or walking disturbances, but ultrasonography showed a well-defined echoic mass at the right paravesical space. Computed tomography confirmed this finding, and right psoas muscle appeared to be enlarged with irregular low density areas. Percutaneous drainage for right paravesical abscess was performed, and 15 ml of pus was obtained. The bacterial and fungal culture of the specimen resulted in no growth of any organisms. Six days after percutaneous drainage, he received en bloc resection of right paravesical abscess with segmental resection of bladder wall and peritoneum adherent to it. Furthermore, the affected region of the right psoas muscle was salvaged as highly upward as possible. Surgical specimen disclosed, pathologically, a non-specific granuloma with stellate necrosis. This finding suggested a feature of cat-scratch disease, tularemia, lymphogranuloma venereum and Yersinia infection. We reviewed the related literature on diagnostic images such as CT, ultrasonography and 67Ga scintigraphy. Moreover, bacterial causes and therapy of primary psoas abscess are discussed.

Abscess↗
PubMed1987

[Chemolysis of cystine calculi incarcerated in the ureter by the alkaline organic amine, tromethamine-E].

We dissolved the cystine calculi incarcerated in the ureter by irrigation with tromethamine-E via percutaneous nephrostomy. Case 1: A 25-year-old man with a past history of cystinuria and staghorn calculi in the right kidney, suffered from obstructive renal failure caused by the incarceration of a stone (18 x 15 mm) in the left middle ureter. After recovering promptly from renal failure by left percutaneous nephrostomy, he received continuous irrigation with tromethamine-E through an angiographic catheter percutaneously placed in the ureter. The ureteral calculus was reduced by 70% in size after the irrigation for 35 days, and then extracted percutaneously. Case 2: A 3-year-old child had multiple cystine calculi in the right renal pelvis and ureter. Although a calculus in the renal pelvis was extracted by the percutaneous ultrasound lithotripsy, two calculi incarcerated in the middle ureter were impossible to remove by a percutaneous approach. The irrigation with tromethamine-E was initiated through the catheter placed percutaneously in the right ureter. Both calculi completely dissolved 47 days later. The chemolysis by irrigation with tromethamine-E was greatly valuable in the treatment of cystine calculi. This dissolution could be an alternative to surgery especially in the treatment of ureteral cystine calculi, which might be difficult to be extracted by the percutaneous or transurethral approach.

Adult↗
PubMed1987

[Clinical observation of bacterial isolates from urine specimens of outpatients].

Changes of bacterial isolates from urine specimens of outpatients with urinary tract infections (UTI) from 1977 through 1984 were studied. Organisms which were isolated from patients with bacteriuria of over 10(3) bacteria per ml of urine regardless of grade of pyuria were studied. The incidence of UTI, especially that of acute cystitis was decreased during the recent 8 years. E. coli was the most predominant isolate in acute UTI with an isolation frequency of over 70% every year, followed by S. epidermidis nearly every year. Citrobacter spp., Klebsiella spp., P. mirabilis and S. aureus were also isolated steadily every year. Bacterial isolates in acute UTI were generally composed of these six species of bacteria. Although many kinds of bacteria were isolated in chronic UTI, E. coli was the most frequent species with an isolation frequency of 17-37%, followed by E. faecalis except in 1981 and 1982. The tendency of gram-negative rods to increase in acute and chronic UTI was observed except in 1981 and 1982. A slight decrease in sensitivity of E. coli and P. mirabilis against ampicillin (ABPC) and sulbenicillin (SBPC) was observed in acute UTI. In chronic UTI, the tendency of the sensitivity of E. coli against ABPC, SBPC and nalidixic acid to recover and the tendency of the sensitivity of P. aeruginosa against dibekacin to decrease were observed. E. faecalis was estimated to be sensitive to gentamicin, cefazolin, minocycline and fosfomycin. However, unlike those species mentioned above, many strains of E. faecalis showed a positive disc sensitivity to these drugs.

Acute Disease↗
PubMed1987

[A case of prostate cancer with multiple pulmonary metastases].

A 65-year-old man was hospitalized with bloody sputum. His chest X-ray showed multiple nodules in both lung fields. Transbronchial lung biopsy demonstrated a poorly differentiated adenocarcinoma, which suggested that respiratory abnormalities might be metastatic cancer. Because he had noticed pollakisuria and dysuria, urologic consultation was sought. The findings of digital examination, urethrography, and ultrasonotomography suggested that he had an advanced prostate cancer. In addition, tumor markers of prostatic acid phosphatase (PAP), acid phosphatase (ACP), and prostate antigen (PA) showed abnormal titers; 120 ng/dl, 166 IU/l, and 15.4 ng/ml, respectively. The prostate tissue obtained by transperineal biopsy revealed histopathologically adenocarcinoma and positive findings in immunohistochemical staining for PAP and PA as well as the specimens from the lung. Bilateral orchiectomy and medication of 250 mg of DESD daily as an antiandrogen therapy improved respiratory symptoms. One week after the operation, the multiple shadows on the chest X-ray diminished dramatically. Moreover, serum values of PAP and PA also decreased to the normal range. He is alive in a stable condition 6 months after the operation.

Adenocarcinoma↗
PubMed1987

Nonsurgical management of ureteral fistulas.

The combined procedure by antegrade introduction of the guidewire and retrograde placement of ureteral stents was successfully performed for the conservative management of postoperative ureteral fistulas in two patients. Superselector guidewire and ureteral bougie catheter are of use to facilitate difficult stent placement for severe narrowing accompanied with the dehiscent ureter.

Adult↗
PubMed1986

[Clinical studies on doxycycline in the treatment of nongonococcal urethritis by Chlamydia trachomatis].

Twenty-one nongonococcal urethritis patients by Chlamydia trachomatis infection were treated with doxycycline (DOXY, Vibramycin) 200 mg/day orally for 2 weeks. The age of these patients were ranged from 17 to 52. C. trachomatis was eradicated 8(89%) of 9 cases on 3rd day and never reisolated on 7th day after treatment. Ten (83%) of 12 patients on 7th day and any patients on 14th day were not suffered from symptoms after treatment. Urethral discharge was not seen macroscopically, 11 (92%) of 12 patients on 7th day and any patients on 14th day. According to the criteria for urethritis requiring at least 4 WBC per high power field in urethral smear and/or first voided urine, the overall clinical efficacy rate was 44% (4/9) on 3rd day, 83% (10/12) on 7th day and 100% (9/9) on 14th day. No side effects were recognized in any cases. In conclusion, DOXY was thought to be useful and safe drug in the treatment of nongonococcal urethritis by C. trachomatis.

Adolescent↗
PubMed1986

[Evaluation of urinary cytology for upper urinary tract disease].

One hundred and seventy-two patients with upper urinary tract disease were examined by cytological study of ureteral urine which was taken by ureteral catheterization. Of 139 patients with benign disease or ureteral stricture due to non-urological cancer, only one case with renal cyst revealed positive findings (false positive rate: 0.7%). Two positive cases, which were a renal hemorrhage without followup and a uterine cervical cancer with squamous cancer cells in the ureteral urine, were excluded. Although 6 of 17 (35%) uroepithelial cancers in the upper urinary tract were registered as positive, this examination was little use for detecting stage pTa, grade 1 or papillary non-invasive tumors. However, 2 out of 12 (17%) renal pelvic or ureteral cancer patients with negative results of voided urine were cytologically detected by ureteral urine. Five out of 6 cases of these cancers demonstrated malignant cells in the renal pelvic urine sampled from surgical specimen. We have recently experienced aspiration cytology for upper urinary tract disease, using the percutaneous puncture method, and five of 7 upper urinary tract patients were cytologically diagnosed. This procedure could be valuable for detecting even patients with associated bladder cancer or failure of ureteral catheterization.

Aged↗