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Biomedical subjects

O Yoshida

Publications and source records attributed to O Yoshida.

At least 613 records · Page 34Linked to original sources

[Preliminary clinical studies with a new non-ionic contrast medium (Iopamidol) in intravenous pyelography].

The non-ionic and low-osmotic pressure contrast media Iopamilon 370 was used on 20 outpatients who had not been found to have abnormal renal function. The results were compared with those obtained with Urographin (76%), currently used at our department, on 13 of the 20 patients. The nephrograms and renal pelvis obtained using Iopamilon 370 tended to have a clearer contrast than those obtained with Urographin. No side effects were produced.

Adult↗

[Primary hyperparathyroidism: significance of its preoperative localization].

The diagnostic accuracy of locating parathyroid tumors preoperatively was studied by reviewing 27 cases of hyperparathyroidism experienced at our Department between 1965 and 1983. Computed tomography gave the most accurate prediction (69%), followed by venous sampling for PTH (33%), subtraction scintigraphy with 201T1 and 123I (30%), ultrasonography (29%) and palpation (7%). Although the time required for an operation was not changed, significantly fewer parathyroid glands identified were removed during the operation when they had been located accurately before operation. This enabled quick recovery from postoperative hypocalcemia and ensured a safer operation. Scintigraphy and ultrasonography must first be performed in patients suspected of having hyperparathyroidism, but computed tomography is essential before operation. Venous sampling is indicated only when all other tests are negative, or in cases of re-operation.

Adolescent↗

[Bacteriological and architectural studies of infected stones].

The stones associated with urinary tract infection were cultured using a method to distinguish between surface contamination and bacteria within the stone. Twenty three of 30 stones (77%) were infected mainly by Proteus mirabilis or Pseudomonas aeruginosa and most were composed of struvite and/or apatite. Most oxalate and uric acid stones were sterile; occasionally the stones with positive culture had a non-urea-splitting bacteria and these were thought to have been infected secondarily. Some infected stones were studied by light microscopy scanning election microscopy and transmission electron microscopy. We found many rods in the interstices of crystals of struvite and apatite extensively from the nucleus to peripheral layers. These findings are important in the prevention and treatment of infection stones.

Adolescent↗

[Ultrasound-guided renal cyst puncture and 95% ethanol injection. Part 1: Estimation of ethanol levels in the blood and urine following 95% ethanol injection].

Seventeen solitary renal cysts were punctured with the ultrasound-guided procedure and 26-91% of the cyst volume was replaced with 95% ethanol used as a sclerosing agent of the cyst wall. Ethanol was injected through a 7 F pigtail ureteral catheter, allowed to remain in place for 20 minutes and removed through the catheter. Recovery rate of ethanol was 82.4%. The maximum blood level of ethanol was obtained 30 to 60 minutes after injection, while the maximum urinary excretion rate was observed after 60 to 120 minutes. The maximum blood levels of ethanol ranged from 0.015 to 0.339 mg/ml. There was a positive correlation between injected volume of ethanol and the maximum blood level (r = 0.66) or the total amount of urinary excretion during 12 hours (r = 0.72). Residual ethanol concentrations in the body were calculated from injected volume and recovery rate of ethanol. Only 2.3% of the residual ethanol in the body was excreted in the urine during the first 12 hours after injection. However, urine/blood ratio of ethanol 1 hour after injection was tremendously high with a wide variation between 1.6 and 230.5. Therefore, a large part of the ethanol absorbed from the cyst wall seems to be excreted directly from the kidney, not entering general circulation. From the estimation of the blood and urine levels of ethanol, it is concluded that 95% ethanol can be applied to the renal cyst wall as a sclerosing agent through the percutaneous ultrasound-guided procedure in the case of good recovery of ethanol.

Adult↗

[Metastatic penile tumors: report of three cases].

Metastatic tumor of the penis is uncommon in spite of its rich blood supply, abundant vascular space and the proximity of the pelvic organs which have a high incidence of malignant neoplasms. We report three cases of metastatic penile tumors. The primary sites of these cases were the left ureter, the right kidney and the rectum. We review and discuss sixty two cases collected from the Japanese literature, including our cases.

Adenocarcinoma↗

[20 cases of hypercalcemia associated with urogenital malignancies].

Twenty cases (3.3%) of hypercalcemia of more than 11.0 mg/dl associated with urogenital malignancy were observed in 610 inpatients during the past 5 years and 6 months (Jan. 1978-June 1983). Incidences were 10 (16.1%) out of 62 cases of renal cell carcinoma, 6 (1.9%) out of 321 cases of bladder cancer, 3 (6.7%) out of 45 cases of renal pelvic and ureteral cancer, and one (1.1%) out of 95 cases of prostatic cancer. As treatment, surgery (radical nephrectomy) and anti-cancer chemotherapy were effective in 3 cases (2 renal cell carcinomas and one renal pelvic cancer). Conservative therapy with hydration combined with either indomethacin, steroid or eel calcitonin was effective in 11 cases, and s-Ca level was decreased by 3.7 mg/dl on the average. Eighteen patients were in the terminal stage of malignancy when hypercalcemia was observed, and died 5 days to 9 months (mean; 2 months) after the onset of hypercalcemia.

Adenocarcinoma↗

[Dynamic urinary flow images in patients with ileal loop diversion assessed by I-123-hippuran scintigraphy. Detection of ileoureteral reflux].

To evaluate upper urinary tract and ileal loop functions, dynamic urinary flow studies using I-123 hippuran were performed in 52 kidneys of 27 patients with ileal loop urinary diversion. Analysis of regional renograms enabled easy assessment of the cortical, pelvic and loop functions. Normal pattern was found in 33 cortices (63.5%), 22 pelvis (45.8%) and 14 loops (51.9%). Most of the abnormal findings in the upper urinary tract were delayed excretion and/or retention of the pelvic and ureteral urines. Diagnosis of ileoureteral reflux under normal physiological circumstances was made to compare the pelvic and loop curves. Small peaks and/or irregular spike waves observed in the down slope of the pelvic curve concurrently with the increased activity of the loop curve indicate a production of the ileoureteral reflux associated with ileal movement. This reflux was noted in 22 of the 27 cases (81.5%). Bilateral reflux was evident in 3 cases, and unilateral reflux in 19 cases. Ileoureteral reflux was noticed in 14 of the 15 cases (90%) in which retrograde loopography was performed. Although bilateral reflux was found in 8 cases, the hippuran study revealed bilateral in only one case, unilateral in 5 and no reflux in 2. Thus, I-123 hippuran scintigraphy consisting of sequential renal images, loopograms and regional renograms enables the diagnosis of ileoureteral reflux and obstructive uropathies and is a useful tool to detect functional complications of the upper urinary tract in patients with ileal loop diversion.

Adult↗

Clonogenic assay for urologic malignancies.

An in vitro double soft agar technique was used to culture 91 human urologic tumors including 37 renal cell, 40 uroepithelial, 7 prostatic and 7 testicular cancers. Cells from 31 of 37 renal, 32 of 40 uroepithelial, 3 of 7 prostatic and 4 of 7 testicular cancer specimens grew to the extent that they could be used in chemosensitivity testing in soft agar (greater than or equal to 30 colonies per control plate). With this assay system, a very high growth rate (70/91; 77%) was obtained. The in vitro response rates of greater than or equal to 10% were noted with mitomycin C, 5-fluorouracil, cisplatin, bleomycin and vincristine in renal cell cancers, and with vincristine and cisplatin in uroepithelial cancers. Drug sensitivity studies showed that the rates of in vitro sensitivity of uroepithelial cancers were close to those obtained in general clinical experience, while the rates of the vitro sensitivity of renal cell cancers were considerably higher than the rates found clinically. It is concluded from this study that in vitro chemosensitivity testing by clonogenic assay is likely to be a useful tool in the treatment of urologic cancers, but that a simple definition of sensitivity cannot be applied for all types of tumors.

Antineoplastic Agents↗

Transitional cell carcinoma in a pelvic kidney associated with recurrent lung cancer.

We report a case of transitional cell carcinoma of the renal pelvis arising in a pelvic kidney two years after resection of bronchogenic carcinoma. Primary cancer in a pelvic kidney has been rarely described and this is the second reported case of transitional cell carcinoma originating in a pelvic kidney and the first associated with recurrent lung cancer.

Aged↗

[A bacteriological study on urinary calculi associated with infections].

There are difficult problems in the management of urinary calculi associated with infections. Stones associated with infections are not only infection stones such as struvite stones, but also other kinds of stones such as calcium oxalate. Therefore, from practical view points, bacteriological studies should be carried out on urinary calculi associated with infections as a whole. We investigated 120 cases of urinary calculi associated with infections with special reference to bacteria on the stone surface, within the stone, compositions of the stone and permeation of an antibiotic into the stone. Proteus was isolated most frequently from the urine, followed by E. coli and Pseudomonas. These bacteria were isolated from the stone surface, although the incidence of Proteus mirabilis was higher than that in the urine. Bacteria were isolated in 25 of the 33 specimens of the inside parts and in 12 of the 12 stones of MAP and MAP plus other components. Proteus mirabilis was found in 7 of the 12 stones. Bacteria were isolated from the inside of 9 of the 16 stones of CaP and CaP plus other components and Proteus mirabilis was found in 6 of these 9 cases. Pseudomonas was isolated in 2 out of the 7 stones of CaP plus CaOX and its growth was seen in 5 specimens. The incorporation of an antibiotic, Cefmetazole, into the stone differed greatly with each stone. There were some cases in which the concentration of Cefmetazole in the inside was less than 5% of that in the outside. Stones may function as a sanctuary for organisms and may protect these organisms.

Adult↗

Therapeutic effect of a retinoid (Ro 10-9359) on rats with bladder tumours induced by N-butyl-N-(4-hydroxybutyl)-nitrosamine upon administration alone or in combination with mitomycin C.

The therapeutic effect of an aromatic retinoic acid analogue (Ro 10-9359) and mitomycin C (MMC) on rats with bladder tumours induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) was examined. Eight-week-old female Wistar rats were given 0.05% BBN in drinking water for 8 weeks. Therapy was started at week 26 and all rats were killed at week 30. MMC at a dose of 0.3 mg/kg twice a week ip for 3 weeks significantly reduced the incidence and the mean number of tumours. With oral Ro 10-9359 at a dose of 100 mg/kg once weekly for 4 weeks, no significant effect was observed. The combination of MMC and Ro 10-9359 significantly reduced the mean number, but not the incidence, of tumours. The difference between the effect of MMC alone and that of MMC given in combination with Ro 10-9359 was not statistically significant. Thus no favorable effect of the retinoid could be demonstrated either alone or in combination with MMC.

Animals↗

Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by 99mtechnetium-dimercaptosuccinic acid renal scintigraphy.

99mTechnetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

Adult↗

Congenital renal anomaly: evaluation with 99mTc-dimercaptosuccinic acid renal scintigraphy.

Technetium 99m-2,3, dimercaptosuccinic acid (99mTc-DMSA) preferentially accumulates in the renal cortex, demonstrating functioning cortical mass. We used 99mTc-DMSA renal scintigraphy in ten patients with horseshoe kidneys and five patients with unilateral fused kidneys. The results show that 99mTc-DMSA renal scintigraphy reliably establishes the diagnosis of horseshoe kidney and clearly shows the isthmus, which is very essential for proper management. The technique also aids in the definitive assessment of separate kidney function and of total radionuclide uptake is possible using 99mTc-DMSA scintigraphy.

Adolescent↗

[Study of combination chemotherapy with cytosine arabinoside in the intravesical treatment of superficial bladder tumors].

The effect of instillation therapy using CA alone or in combination with MMC, NCS or CQ was examined in 111 patients (92 males and 19 females, aged 32-87 years old with an average age of 66 years) with multiple superficial bladder tumors. The response rate of 29 patients given CA 400 mg alone was 48.3%, that of 25 patients given combination therapy of CA 200 mg and MMC 20 mg was 84.0%, that of 28 patients given combination therapy of CA 200 mg and NCS 4,000 U was 71.4%, that of 22 patients given combination therapy of CA 200 mg and NCS 6,000 U was 95.5% and that of 7 patients given combination therapy of CA 200 mg and CQ 10 mg was 100%. The response rates of the patients given any of the combination therapies were higher than that of the patients given CA alone. But because MMC, NCS and CQ were not administered singly, combination therapy cannot be concluded to be superior to single therapy. There was little difference between the response rate of primary cases and that of follow up cases. The side effects were all symptoms of local irritation, and were not indicative of systemic damage. Side effects were seen in 3.4%, 71.4%, 40.0% and 3.6% of the patients given CA alone, CA + CQ combination therapy, CA + MMC combination therapy and CA + NCS (4,000) therapy, respectively, combination therapy of CA and CQ producing the highest percentage of side effects.

Adult↗

[Surgical treatment of renovascular hypertension with special reference to the indications for reconstructive surgery].

Based on the retrospective analysis of 38 cases of renovascular hypertension treated by surgical intervention, the following indications are proposed for arterial reconstructive surgery: younger age of patient, short duration of hypertension, renin-mediated hypertension and extent and functional significance of the obstructing arterial lesion, favorable level of renal function in the affected side, and renal function threatened by advanced progressive vascular disease, surgically correctable lesion, and focal, unilateral renal arterial atherosclerosis without generalized atherosclerosis, good surgical risk, and hypertension not responding to medical treatment. Although the clinical use of the angiotensin I converting enzyme inhibitor and induction of percutaneous transluminal angioplasty can provide a new approach to non-surgical treatment for renovascular hypertension, the long-term use of antihypertensive drugs induces gradual decrease in renal function. Surgical treatment is best reserved for the patient on whom the available data meet the above criteria for vascular surgery.

Adult↗

[Prevention of infected urinary stones by urease inhibitor. IV. Treatment of infection stones in rats by a new hydroxamic acid and cefalexin].

We investigated the combined effectiveness of a new urease inhibitor, N-( pivaroyl ) glycinohydroxamic acid, with Cefalexin in the treatment of infection stones in rats. Combination therapy with the hydroxamic acid and Cefalexin inhibited bladder stone formation, and dissolved the stone dose dependently, while separate therapy was not significantly effective against stone formation or bacterial growth. This compound may become a useful medicine for the treatment of infection stones.

Animals↗