Biomedical subjects
Publications and source records attributed to S Yachiku.
We report a case of primary localized amyloidosis of the bladder treated successfully with transurethral resection and intravesical dimethyl sulfoxide instillation. Dimethyl sulfoxide bladder instillation is useful for the treatment of primary localized amyloidosis of the bladder.
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The symptoms of benign prostatic hypertrophy consist of two major groups, obstructive symptoms and irritative symptoms. Uroflowmetry is a safe, easy and accurate method to assess the obstructive symptoms. Furthermore, electromyography of abdominal wall and the monitoring of rectal pressure is helpful to know involvement of abdominal straining. Cystometry provides us objective findings of bladder irritability in bladder outlet obstruction. Detrusor hyperreflexia was revealed in 55%, and uninhibited detrusor contraction was revealed in 22.5% of the patients with benign prostatic hypertrophy. The most sophisticated technique to estimate the volume of prostatic adenoma is transrectal ultrasonotomography. The value, cranio-caudal X left-right X antero-posterior axis length, has been proved to closey correlate to the resected volume of the prostatic adenoma. However there was no correlation between the estimated prostatic volume and the severity of dysuria. The comparison of the uroflow rates before and after loading phentolamine is a helpful method to determine the sympathetic influence to lower urinary tract obstructions. This test differentiates functional obstruction from organic obstruction. Conservative pharmacological therapy on the patients with benign prostatic hypertrophy were also studied. The value of efficacy of prazocine hydrochloride (0.5-6.0 mg/day), Eviprostat (6Tab/day), Prostetin (200-400 mg/day), Hachimi-Jiogan (5 g and 7.5 g/day) on subjective symptoms were 47.8 86.2, 58.5, 52.9 and 66.7% respectively. Ninety-one of the 141 patients with benign prostatic hypertrophy who visited the out-patient clinic in 1983 were given pharmacological treatment initially.
Uroflowmeter has been well documented as an indispensible tool in lower urinary tract diagnosis. In this study 145 normal urinary flow curves in 36 healthy adult males were analysed using the Male Uroflow Diagnostic Interpretation (MUDI) of the DISA urological investigation system. In MUDI, the flow rate pattern is analysed and quantified by previously defined parameters. Then the computed values of these parameters are compared with the values observed in healthy subjects. Finally, the results are conveniently presented on an output sheet. One of the newly defined parameters, (dL/dT) 40, i.e., the bladder contraction velocity at 40 ml before the end of micturition, was situated within the range of 12.5 to 28.3 mm/sec (20.4 +/- 3.9 mm/sec) in healthy males. The variable (dL/dT) 40 did not depend on voided volume and provided excellent discrimination between the control group of healthy males and the group of patients with dysuria. MUDI improves the faults of previous uroflowmetry systems and provides (dL/dT) 40 by which micturition patterns can be discriminated to be good and bad ones. So MUDI seems to be quite versatile in daily urological clinics.
Herein we report two cases of hypogonadism with anosmia or hyposmia (Kallmann's syndrome), a 23-year-old single man (case 1) and a 34-year-old single man. (case 2). Micropenis and small testes were seen in both cases. Central anosima and central hyposmia were found in cases 1 and 2, respectively. Their karyotypes were normal (46, XY). The plasma levels of LH and FSH were low and the reaction to LH-RH test was poor in both cases. After repetitious LH-RH administrations, a good response of plasma LH was recognized in both cases except for a poor response of plasma FSH in case 1, while plasma testosterone remained low in both cases. Their testicular biopsies revealed immature testes without any developed Sertoli and Leydig cells.
Herein we report a case of bladder amyloidosis treated successfully with TUR & DMSO bladder instillation. A diagnosis was made by a biopsy of the bladder epithelium. Amyloid fibrils were confirmed in the biopsy specimen with polarization and electron-microscopy. The patient was treated with TUR. The residual lesion had disappeared with DMSO bladder instillations for 4 months (12X) without side effects after TUR. Thus DMSO bladder instillation with surgical resection seems to be an excellent therapy for bladder amyloidosis.
Twenty-three patients who previously demonstrated no detrusor contraction during cystometry were evaluated using a combined uroflowmetry and abdominal wall electromyography. Ten patients voided without abdominal straining (normal detrusor reflexia), 11 could not void without abdominal straining (detrusor areflexia, detrusor weakness, or bladder outlet obstruction), and 2 had equivocal findings with the method.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Tsumura Hachimijiogan, 7.5 g a day, was administered to 30 patients with benign prostatic hypertrophy (BPH). Clinical effects were estimated based on subjective symptoms and objective findings obtained by uroflowmetry. Twenty patients (66.7%) showed improvement of subjective symptoms and 14 patients (46.7%) showed good response in uroflowmetry. An improvement of overall clinical efficacy was observed in 21 patients (70%). These results were better than those obtained with 5.0 g a day doses of Tsumura Hachimijiogan. No significant relation between the "Sho" in Chinese medicine and the clinical effects of Hachimijiogan was detected. No side effects or abnormal laboratory data were found in any of these 30 patients.
Serum and prostatic tissue levels of Ceftizoxime (CZX) were measured in 37 patients with benign prostatic hypertrophy after intravenous infusion of 0.5 g or 1 g or 2 g of CZX. The prostatic tissue level of CZX was sufficient for the treatment of prostatic infection. Serum and prostatic tissue levels of CZX were maintained satisfactorily by the dose of CZX. Neither the weight of extracted prostatic tissue nor the renal function of the patient was correlated to the tissue level of CZX.
We found that a few patients with urolithiasis had normal parathyroid hormone levels but high cyclic AMP excretion. The purpose of this paper was to study the endocrinological mechanism. Male rats were given intraperitoneally dibutyryl cyclic AMP (DBcAMP), a derivative of cyclic AMP, per 100 gm of body weight for 50 days. Feed and water were supplied ad libitum. Crystal formation or calcification in mainly the dystal tubules and collecting system were found in 3 out of 10 rats, and renal calcium stones in 2 rats. The cyclic AMP of the renal parenchyma, especially the renal medulla, was elevated by more than 100 times after DBcAMP administration. Serum calcium levels, urinary calcium and phosphate excretion, and the adrenaline levels of the renal parenchyma were significantly increased. Serum parathyroid hormone was slightly enhanced, but vitamin D and the noradrenaline levels of the renal parenchyma were not changed. Based on these findings, it is suspected that stone formation in rats injected DBcAMP occurs through the action of DBcAMP on the renal tubules to increase urinary calcium excretion and to make renal stones as a form of primary hyperparathyroidism.
Parathyroid hormone (PTH) is strongly concerned with the pathogenesis of urinary stones. PTH is mainly regulated by the serum calcium concentration and not by other hormones, as is usually the case. We studied whether PTH is also regulated by adrenocorticotrophic hormone (ACTH) or not. ACTH (0.25 mg) was injected intravenously to 17 patients with primary hyperparathyroidism PHP, 7 patients with urolithiasis, 7 patients with malignant hypercalcemia, and 6 control subjects. Serum calcium was significantly increased in only PHP. The serum calcium increase rate showed a significant positive correlation with serum alkaline phosphatase, and a negative correlation with the preinjected serum calcium. PTH was slightly increased in all four groups. Serum cortisol and ACTH concentrations were not significantly different among the groups. PTH concentration in a culture medium of parathyroid tissues increased after ACTH addition. Serum calcium was significantly increased after ACTH injection in an adrenalectomized rat, and decreased in a parathyroidectomized rat. From our data and those of others, it appears that ACTH acts on the adrenal glands to decrease the serum calcium concentration, and might act directly on the parathyroid gland or bones to increase it.
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