[Renal damage after extracorporeal shock-wave lithotripsy detected by magnetic resonance imaging].
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Biomedical subjects
Publications and source records attributed to T Machida.
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1) Using two histologically different human renal cell carcinomas heterotransplanted into nude mice, the antitumour effect of UFT was investigated, and an attempt was made to analyze the properties of the tumour strains where a drug efficacy was noted. 2) The two strains used were the JRC 1 strain (tumour doubling time of 9.4 days, clear cell type, papillary histologic pattern, grade 3) and the JRC 11 strain (tumour doubling time of 2.72 days, granular cell type, anaplastic histologic pattern, grade 4). 3) Two dose groups were set up, one receiving 10 mg/kg of tegafur (FT) and 22.4 mg/kg of uracil and the other receiving 20 mg/kg of FT and 44.8 mg/kg of uracil. Each group was further divided into an early administration group (start of administration 3 days after the tumour transplantation) and a late administration group (start of administration at a time when the transplanted tumour proliferated to weight of 100 to 300 mg). 4) Effect as noted in the tumour proliferation inhibition rate was seen only in the group receiving 20 mg/kg of FT and 44.8 mg/kg of uracil in both early and late administration groups of the JRC 1 strain. Among these groups only the early administration groups showed a histological positive effect. 5) The fact that the measured 5-FU intra-tumour concentration in the JRC 1 strain was only 1/4 that of the JRC 11 strain demonstrates more susceptibility of JRC 1 strain to UFT. Moreover, intratumoral concentration of 5-FU differed markedly even with the same administration method and dosage level. This result indicates that intra-tumour concentration will be different if the histological pattern differs.
Efficacy and safety of ofloxacin (OFLX), a new quinolone antibacterial agent, were investigated in cases of sexually transmitted male urethritis and cervicitis. Chlamydial infections occupied a large part of the patients enrolled. This study was conducted in 29 institutions. A total of 1,126 patients with gonococcal, chlamydial or non-gonococcal non-chlamydial infections were enrolled in the study. The general dosing regimen of oral OFLX was 100 mg t.i.d. or 200 mg t.i.d. for 14 consecutive days. Along with the clinical efficacy evaluated by doctors in charge, therapeutic and clinical efficacies were determined according to standardized evaluation criteria. The evaluation of therapeutic efficacy was based on bacterial eradication. On the other hand, clinical efficacy was determined upon the improvement in causative bacteria, WBC counts in smear (or initial urine) specimens and urethra/cervical discharges. Clinical efficacy was determined on 7 and 14 days after starting the medication, except for gonococcal infections for which the efficacy was determined on Day 3 and Day 7. The results obtained are summarized as follows. 1. Efficacy evaluation by standardized criteria Therapeutic efficacy rates in gonococcal infections were 97.9% (93/95) on Day 3 and 100% (119/119) on Day 7. In chlamydial infections, the rates were 77.7% (363/467) on Day 7 and 93.6% (392/419) on Day 14. Chlamydial urethritis rated 94.8% (239/252) and cervicitis 91.6% (153/167) on Day 14. Clinical efficacy rates in gonococcal infections were 63.2% (60/95) on Day 3 and 95.8% (114/119) on Day 7. In chlamydial infections, they were 70.0% (327/467) on Day 7 and 89.7% (376/419) on Day 14. Chlamydial urethritis rated 88.5% (223/252) and cervicitis 91.6% (153/167) on Day 14. Clinical efficacy rates in non-gonococcal non-chlamydial infections were 93.3% (97/104) for male urethritis and 65.9% (27/41) for cervicitis on Day 14. 2. Clinical efficacy determined by doctors in charge A total of 1,028 cases, 752 urethritis and 276 cervicitis cases, was evaluated by doctors in charge. Clinical efficacy rates were 90.3% for urethritis and 92.4% for cervicitis. 3. Safety Safety evaluations was conducted in 1,087 patients. Side effects were observed in 23 patients among them (2.12%). None of them were deemed serious. General laboratory examinations were conducted for 169 patients. Abnormal findings were seen in 11 patients (6.51%) or 13 cases, all of which were minor. The results of this multi-center clinical trial demonstrated that OFLX is effective and well tolerated in the treatment of sexually transmitted disease (STD), both gonococcal and chlamydial infections.
To prevent urogenital infections occurring after urethrocystoscopy, we have studied the prevalence of these diseases without the use of antibiotic agents subsequent to urethrocystoscopy to determine the relative importance of aseptic procedures and whether administration of antibiotics is really required for this purpose. Patients enrolled in the present study included those undergoing urethrocystoscopy at four hospitals, totaling 146 patients (93 male and 53 female patients). All of these patients were apparently free of urogenital infections prior to urethrocystoscopy, with less than 5 leucocytes per field in urinary sediment, and a bacteria count of less than 10(4) cells/ml. Each patient was checked between 3 and 14 days after examination for 1) presence of clinical symptoms such as fever, bladder irritation symptoms and urethral secretion, 2) urinalysis and urinary culture, and 3) palpation of epididymis, testis and prostatic gland as required. The endoscope was sterilized for 20 to 30 minutes with 2% glutaraldehyde at 3 clinical institutions and with 0.5% chlorhexidine at the other, in a total of 116 and 30 patients, respectively. Sterilized distilled water was used as perfusate. The external urethral meatus of the subject was disinfected with 0.5% chlorhexidine, followed by local anesthesia with xylocaine jelly. Ten minutes after disinfecting the hands of the examiner, urethroscopy and cystoscopy were performed in this order. Urinary tract infection was detected in one male patient (1.1%) and 2 female patients (3.3%). In these cases, the endoscope was sterilized with glutaraldehyde in 2 cases and with chlorhexidine in the other. None of the subjects demonstrated fever or genital infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Case 1: A 58-year-old man was seen with dull pain over the left flank. The X-ray examination revealed a renal stone in the left kidney. On operation, a globular hard mass was found in the lower portion of the posterior aspect of the kidney from which a biopsy specimen was obtained. A frozen section study showed renal cell carcinoma, and nephrectomy was performed. The patient is well four years after the operation without recurrence or metastasis. Case 2: A 50-year-old man consulted with microhematuria pointed out in a physical examination. At the operation for renal stone, we found the mass in the lower portion of the kidney. A frozen section study of the mass revealed renal cell carcinoma. We performed nephrectomy and lymphadenectomy on the renal pedicle. The patient is well three years after the operation. We reviewed the cases of renal cell carcinoma associated with renal calculi reported in Japan and discussed how the nephrectomy should be performed according to the frozen section study.
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A 44-year-old male was admitted with complaints of gross hematuria and high fever. An excretory urogram and renal angiography revealed a massive lesion in the right kidney. A computed tomographic scan showed bilateral renal tumors with low-density areas. Transperitoneal right radical nephrectomy, regional lymph node dissection and left renal biopsy were performed on September 5, 1984. The tumor was 14.5 X 7 X 6 cm in size and yellowish in cross section. The pathological diagnosis was bilateral angiomyolipomas and the same in the right hilar lymph node and the surrounding tissue. There was no evidence of malignancy.
Magnetic resonance images of a case of superior sagittal sinus thrombosis before and after complete recanalization are presented. The patient was a 61-year-old man with two days history of intermittent right hemiconvulsion followed by post-ictal hemiplegia. Mild erythrocytosis was noted on admission. CT scans revealed left frontal hemorrhagic infarction with empty delta sign in the middle portion of the superior sagittal sinus. Left carotid angiogram showed occlusion of two frontal cortical veins and retrograde filling of these veins into the cavernous sinus. Lack of filling of the middle and anterior part of the superior sagittal sinus was noted. These studies led to the diagnosis of superior sagittal sinus thrombosis associated with hemorrhagic infarction. He was treated with intravenous infusion of low molecular dextran and venesection. Neither heparin, urokinase, hyperosmolar solutions nor steroids were used because of the presence of hemorrhagic infarction and of the lack of signs of increased intracranial pressure. He completely recovered neurologically and recanalization of the superior sagittal sinus was confirmed angiographically eight weeks after the onset. Magnetic resonance images were taken with a Siemens 1.5 T Magnetom scanner using spin-echo pulse sequences. A T 1-weighted mid-sagittal magnetic resonance image ten days after the onset showed hyperintensity in the middle part of the superior sagittal sinus which corresponded to the thrombus. Both T 1 and T 2 weighted coronal images revealed a small area of hypointensity indicating the existence of residual blood flow in the superior sagittal sinus in addition to the thrombus both in the sinus and in the cortical vein.(ABSTRACT TRUNCATED AT 250 WORDS)
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A non-randomized clinical study on systemic combination chemotherapy was conducted by the Japanese Urological Cancer Research Group for Adriamycin to compare the effectiveness of CAP (cyclophosphamide 200-500 mg/m2, adriamycin 30-50 mg/m2 and cisplatin 30-50 mg/m2) and CAF (cyclophosphamide 200-500 mg/m2, adriamycin 30-50 mg/m2 and 5-fluorouracil 250 mg/m2) in 123 patients (104 evaluable) with advanced and/or metastatic cancer of the urinary bladder. Among 96 patients who were non-randomly selected to receive CAP, 4 achieved complete remission, 12 achieved partial remission, 7 achieved minor response, 30 had stable disease, and 43 had disease progression. The response in the 8 patients who received CAF were: partial remission in 1 and progressive disease in 7. The overall response rate to CAP therapy was 17%, as against 13% for CAF therapy. The median duration of survival with CAP was 29 weeks and with CAF, 22 weeks. The differences between the two groups in duration of survival and response rate were not statistically significant. Complete and/or partial remissions were observed in the lymph nodes, lung and liver in 32%, 24%, and 57% of cases, respectively. There was no objective response in bone metastasis. The main side effects of CAP were anorexia (88%), nausea and/or vomiting (81%), alopecia (65%), leukopenia (72%), anemia (48%), and renal dysfunction (17%). No patients died as a result of toxicity of these combination chemotherapy modalities.
The Japanese Urological Cancer Research Group has conducted three randomized clinical studies on intravesical chemoprophylaxis of superficial bladder cancers. This paper presents a comparative analysis of the first and second of these. The protocol used in the first study was a so-called short-term schedule in which drugs (for group A, ADM 30 mg/30 ml; group B, ADM 20 mg/40 ml; group C, MMC 20 mg/40 ml; and group D, control) were administered twice a week for 4 weeks after transurethral resection (TUR), and in the second study a long-term schedule was used, in which drugs (for group E, ADM 30 mg/30 ml; group F, ADM 20 mg/40 ml; group G, MMC 20 mg/40 ml; and group H, control) were administered twice a week for 1 week, every 2 weeks for 7 weeks, monthly for 8 months, and finally once every 3 months for 1 year. In the first study 575 patients were evaluated and followed up for 5 years. The second study started 28 months later, and 607 patients were evaluated. A generally good prophylactic effect was obtained in the second study when the patients' backgrounds were adjusted in combination with the history and number of the tumors. The second study did not reveal any promoting or inhibitory effect on the progression of the recurrent tumors. There were no significant side effects in either study. The indications and the schedule for prophylactic intravesical chemotherapy should be more carefully studied.
This paper reports the results of a radiological population study on the ossification of the posterior longitudinal ligament (OPLL) in both the cervical and the thoracic spine among Japanese. The study was carried out in the Yachiho-mura district in the central part of Japan, where 5074 people were living. X-ray examinations were made of 1058 of the people; there were 440 men and 618 women, 50 or more years of age. The roentgenograms showed 34 cases of OPLL in the cervical spine (3.2%): 19 men (4.3%) and 15 women (2.4%). The condition was most frequently observed at the level of C-4. Radiological classification showed 18 cases of the segmental type, 11 of the continuous type, and five of a mixed type. There were eight cases of OPLL in the thoracic spine (0.8%), four in men (0.9%) and four in women (0.6%). OPLL in the thoracic spine was most frequently observed at the midthoracic levels. All eight cases showed a continuous type of ossification. There were three subjects with OPLL in both the cervical and the thoracic spine. Therefore, the number of subjects with OPLL in either the cervical or the thoracic spine was 39 (3.7%) total.
Enterogenous cysts are relatively rare causes of spinal cord compression. A case of enterogenous cyst causing compression of spinal cord at C2-3 is presented. Radiological findings, including MRI, are discussed.
A testicular choriocarcinoma cell line designated JHTK-1 was established in vitro from a mixed germ cell tumor xenografted into nude mice, and may prove to be the first human choriocarcinoma cell line of testicular origin in long-term culture. The cells have been kept in culture for three years and produce human chorionic gonadotropin persistently. The chromosome number distribution ranged from tetraploidy to septaploidy, and trypsin G-band karyotyping showed that all the chromosomes were of human origin. Dibutyryl cyclic adenosine monophosphate at a concentration of 1 mM caused more than 15-fold stimulation of human chorionic gonadotropin secretion with morphological alteration in JHTK-1 cells. This suggests that dibutyryl cyclic adenosine monophosphate induces the differentiation of cytotrophoblastic cells into syncytiotrophoblastic cells among JHTK-1 cells. When JHTK-1 cells were heterotransplanted into the subcutis of BALB/c nude mice, large cystic tumors were produced with histological characteristics similar to choriocarcinoma.
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