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Biomedical subjects

S Yachiku

Publications and source records attributed to S Yachiku.

At least 145 records · Page 8Linked to original sources

[Treatment of organic impotence. Self-administered intracavernous injection of papaverin HCI (a preliminary report)].

Intracavernous injection of 40 mg papaverin HCI caused erection sufficient for intromission in all six cases of organic impotence. The patients were taught to self inject one corpus cavernosum just prior to coitus and reported that they were able to have coitus at home. No complications were encountered. This method should be tried first as an alternative to penile implant for patients with organic erectile failure.

Adult↗

[The use of dimethyl sulfoxide in the treatment of intractable urinary frequency].

Intravesical instillation of dimethyl sulfoxide (DMSO) was used in the treatment of patients with intractable urinary frequency due to chronic prostatitis, chronic cystitis, tuberculous contracted bladder and interstitial cystitis. Before the application of this therapy, all 4 patients were examined carefully to rule out cases of acute infectious diseases of the urinary tract, active urinary tuberculosis, neurogenic bladder and carcinoma in situ of the bladder. Three of the four patients achieved an excellent response both subjectively and objectively. In the United States, intravesical instillation of DMSO had already been established as the specific method in the treatment of interstitial cystitis and no side effects have been reported so far. Therefore, we recommend the use of intravesical instillation of DMSO more commonly in various forms of intractable urinary frequency.

Adult↗

[Synchronous tumors in right renal pelvis and left ureter].

Bilateral synchronous urothelial tumors in the upper urinary tract seem to be rare. To our knowledge, only 34 cases have been reported previously. A 77-year-old-man with the chief complaint of macrohematuria was admitted. Clinical investigations showed left ureteral and right renal pelvic tumors. Resection of the wall of the right renal pelvis and partial ureterectomy and its reanastomosis in the left ureter were done. Pathologic examination revealed that the right renal pelvic tumor was transitional cell carcinoma (G.2, pTlb), and the left ureteral tumor was invasive metaplastic epidermoid carcinoma. The patient is alive with no recurrence or metastasis 1 year after the operation. We reviewed all the reports of bilateral synchronous tumors we could find and discussed the histological findings and treatments reported.

Aged↗

[A case of hydrometrocolpos with left renal agenesis].

Herein we report a case of hydrometrocolpos with left renal agenesis of a four-month-old girl. The hydrometrocolpos due to a transverse septum of the vagina and left renal agenesis were confirmed by laparotomy. The transverse septum was incised and cured successfully by the abdominoperineal approach. We have collected 21 cases of hydrometrocolpos with or without urinary tract malformations including our case in the Japanese literature and discussed its etiology and treatments.

Dilatation, Pathologic↗

[Persistent Müllerian duct syndrome with seminoma: report of a case].

Persistent Müllerian duct syndrome is a male hermaphroditism in which remnants of Müllerian ducts occur from abnormality of Müllerian inhibitory factor and often cause transverse testicular ectopia or hernia uteri inguinalis. A 22-year-old-man was admitted with the chief complaint of painless swelling of the right scrotal content. Preoperative diagnosis was right testicular tumor and left undescended testis. High orchiectomy was done. At operation left transverse testicular ectopia and a remnant Müllerian duct was found incidentally. The right testicular tumor was seminoma pT1. Sixty-seven cases of transverse testicular ectopia have been reported in Japan, 37 of which are reports of a remnant Müllerian duct. Ten of these cases were accompanied by tumors. The pathogenesis and treatment of persistent Müllerian duct syndrome were discussed with review of the literature.

Adult↗

[A case of eosinophilic cystitis with retroperitoneal neurinoma].

A 63-year-old female visited our department, complaining of miction pain. She had several episodes of urinary occult blood. Urinalysis included a small number of red cells, white cells and bacilli. Physical examination revealed a fist-sized mass of her right flank. Cystoscopic examination showed a botryoid tumor with multiple erythematous raised plaques. Biopsy was reported as massive infiltration of eosinophiles in submucosal layer of the bladder, i.e. eosinophilic cystitis. Antibiotics were effective for the improvement of urine findings and symptoms within a week. IVP and CT revealed the abdominal mass as a retroperitoneal tumor with cystic degeneration, and the tumor was resected. Pathological diagnosis was benign neurinoma. Both eosinophilic cystitis and retroperitoneal neurinoma are rare, and the concurrent occurrence of these two diseases has not been reported. Recent studies have suggested that eosinophilic cystitis may occur more frequently than suspected, and may be overlooked clinically and microscopically. This uncommon form of cystitis should be considered in the differential diagnosis especially when the patient has unexplained episodes of bladder symptoms and hematuria.

Cystitis↗

Electrophoretic and ultrastructural analysis of the rabbit's striated external urethral sphincter.

The male rabbit's external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoretic analysis of myosin light chains and electron microscopy. Its pattern of myosin light chains was different from that of the soleus (predominantly slow twitch muscle) but was very similar to that of the psoas (predominantly fast twitch muscle). Ultrastructurally it was shown to be red muscle resembling the soleus. Therefore the fiber type of the rabbit's external urethral sphincter was determined to be the red (fast) type.

Animals↗

Relation between parathyroid hormone and adrenocorticotropic hormone in primary hyperparathyroidism.

Parathyroid hormone is concerned with urolithiasis, and regulated by serum ionized calcium concentration. We thought that parathyroid hormone might also be regulated by a hormone. 1 mg of ACTH injection was given intramuscularly to 6 patients with primary hyperparathyroidism, 6 patients with urolithiasis, and 5 control subjects. Serum calcium significantly increased 2 h after ACTH injection in primary hyperparathyroidism. However in the other two groups, an increase of serum calcium was not observed. Parathyroid hormone increased after ACTH injection in most subjects of all three groups. Calcium concentration in a culture medium of parathyroidectomy increased in 4 cases, and the parathyroid hormone concentration in the culture medium increased in 3 cases after ACTH addition. From these data, we believe that ACTH directly influences the parathyroid glands, and that calcium is released from the parathyroid cells. Therefore, the decrease in calcium concentration in the parathyroid cells activates the excretion of parathyroid hormone. The fact that serum parathyroid hormone increases in most subjects in all groups supports our hypothesis, namely that ACTH acts directly on the parathyroid gland.

Adenoma↗

Nutritional risk factors in calcium stone disease in Japan.

The purpose of this study is to examine the nutritional environment affecting calcium stone disease in Japan. The following results were obtained. Renal stone disease in the late 1970s increased by about three times than that of the 1940s . Fats and oils, animal protein and calcium intake increased remarkably after the second World War and milk plus milk products, meat and animal products were increased surprisingly compared with 1950. The most ingested nutrients of calcium stone formers were not much different from the results of the National Nutritive Survey in Japan. But the ingested amount of calcium was unexpectedly small and did not reach the level of the daily nutritional requirement in Japanese (15 mmol). The ingested amount of total protein correlated with urinary calcium excretion and had the highest coefficient of determination to the urinary calcium excretion by multiple regression analysis. We have finished our research of individual dietary habits and suggest that the following individual dietary guidance is the primary treatment for the prophylaxis of renal stone disease.

Adult↗

[Surgical resection in pulmonary metastases of genitourinary cancers].

Four patients (2 with renal cell carcinoma, 1 with testicular embryonal carcinoma, 1 with testicular seminoma) underwent surgical resection for pulmonary metastases. Three patients except one with renal cell carcinoma are still alive without disease at 1, 2.3 and 2.3 years, respectively. Surgical resection of metastatic pulmonary sarcoma or carcinoma is now the accepted method of treatment. As chemo- and radio-therapy are often ineffective for metastatic genitourinary cancers, our current policy is to employ surgical treatment provided that the operability is assessed carefully.

Adult↗

Oral calcium tolerance test and serum calcitonin in calcium stone formers.

Ninety-seven male patients with idiopathic calcium urolithiasis and 17 normal male subjects were studied to evaluate the mechanism of idiopathic hypercalciuria with an oral calcium tolerance test, which has been useful in differentiating hypercalciuria. The changes in parathyroid function, such as parathormone and urinary cyclic AMP, and calcium after calcium load differed between absorptive hypercalciuria and renal hypercalciuria. We have confirmed that the change in serum calcitonin after calcium load was also different in these two hypercalciurias. The increase in serum calcium was sufficient to reduce parathyroid function but serum calcitonin was unchanged after calcium load in the control group, in patients with normocalciuria, and those with renal hypercalciuria. Although serum and urinary calcium were more elevated in absorptive hypercalciuria than in the other three groups, parathyroid function was not significantly reduced after loading in absorptive hypercalciuria. In this group only, the serum calcitonin was significantly elevated after calcium load. It is reasonable to suggest that, in this group, because parathyroid function is usually suppressed by intestinal hyperabsorption of calcium, parathyroid function may not be further suppressed by even calcium load. Possibly the significant stimulation of calcitonin may compensate for the lack of suppression of parathyroid function and maintain normal serum calcium levels in absorptive hypercalciuria. These results suggest that the change in serum calcitonin is also useful to differentiate abnormalities of calcium metabolism in patients with hypercalciuria.

Adult↗

Changes in cyclic AMP and electrolytes after parathyroidectomy in primary hyperparathyroidism.

Changes in the excretion of urinary cyclic AMP, calcium and phosphate, and serum calcium, ionized calcium, and magnesium were studied after parathyroidectomy for primary hyperparathyroidism. Urinary cyclic AMP decreased rapidly and 8 of 11 patients had a significant reduction 1 h postoperatively, but changes in serum calcium and ionized calcium were delayed. Serum calcium concentrations closely parallelled those of serum ionized calcium and phosphate excretion returned to normal almost 7 h later than that of cyclic AMP. Excretion of urinary calcium rose rapidly at 4 h after surgery because calcium clearance improved after the reduction in circulating parathyroid hormone. The fall in urinary calcium at about 24 h was due to the subsequent reduction in serum calcium.

Calcium↗