[Nephrotoxicity in rats receiving cyclosporine--biochemical and morphological study].
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Biomedical subjects
Publications and source records attributed to Y Aso.
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In order to study the effect of Bestatin on superficial bladder cancer, the drug was used in combination with hyperthermia and Peplomycin therapy. The study was made using the following 2 groups. Group 1; Hyperthermic treatment with Peplomycin was used in 6 cases of bladder cancer. Group 2; Bestatin was given in combination with hyperthermia and Peplomycin in 15 cases of bladder cancer. As a result, complete or partial regression was obtained in 1 and 5 cases in Groups 1 and 2 respectively. Therefore, the combined use of Peplomycin and Bestatin in hyperthermic treatment for superficial bladder cancer appeared to be effective. Degeneration of tumor cells, irregularity of tumor structure, interstitial edema, fibrosis and cell infiltration were observed in the surgical specimens taken from effective cases, although the mechanism of action of Bestatin on tumors was clearly demonstrated upon histological examination.
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Ultrasonically guided puncture of the prostate was carried out in 10 patients with prostatic disease. Biopsy of the aiming portion of the prostate was performed with more certainty and safety by this method than the conventional blind procedure. In the 15 cases having the suspicion of seminal vesicle disorder, the seminal vesicle was punctured under ultrasound control. By this procedure, the seminal vesicle fluid was safely and accurately obtained.
Each of 5 patients with renal cell carcinoma and urinary bladder tumor who were operated on at the department of urology, Hamamatsu University School of Medicine and its affiliated hospitals, received 20 mg of 4'-O-tetrahydropyranyladriamycin (THP) intravenously at the beginning of surgery. Heparinized peripheral blood samples were collected at regular intervals and separated in plasma and blood cell fractions by centrifugation for the estimation of THP. The THP concentration of the surgical specimen was also studied. In renal cell carcinoma, the surgical specimen was divided into cytoplasm and nuclear fractions, and the THP concentration in each fraction was measured. The THP concentration gradually decreased in the plasma and blood cell fractions with passage of time after the administration in both renal cell carcinoma and urinary bladder tumor. In renal cell carcinoma, although the tumor revealed a lower concentration of THP compared with the normal renal cortex and medulla, the nuclear fraction of the tumor showed a higher concentration than those of the normal renal cortex and medulla. In contrast to renal cell carcinoma, the THP concentration of the urinary bladder tumor was found to be higher than those of the normal urinary bladder mucosa and muscle.
Residual stone and stone recurrence following operation for renal staghorn calculus were investigated in 58 kidneys of 55 patients. Residual stones were found in 12 kidneys (20.7%), but cases who underwent intraoperative radiogram using Kodak X-O mat KS film or extracorporeal renal surgery showed no residual stones. True recurrence was observed in 9 kidneys (19.6%). The rates of true recurrence after partial nephrectomy, nephrolithotomy, extended pyelolithotomy and autotransplantation with extracorporeal renal surgery were 29.2%, 8.3%, 33.3% and 0% respectively. Morphological study of renal tissue removed intraoperatively from patients with staghorn calculus suggested that calcium deposits in pelvic mucosa or collecting tube might play an important role in stone recurrence. However, despite the calcium deposits in removed specimens, no recurrences have been observed in patients who underwent extracorporeal surgery for complicated staghorn calculus. Therefore, this procedure might be useful to prevent stone recurrence.
Bredinin, a new nucleoside antibiotic isolated from Eupenicillium brefeldianum, and steroids were used as immunosuppressive agents in 31 renal transplant patients; 17 of them received grafts from living-related donors and 14 from cadavers. The one-year graft survival rates were 100% in renal recipients from living donors and 69.2% in cadaver kidney recipients. There was no serious complication from the use of these immunosuppressive agents.
Fiberscopes for the observation of the upper urinary tract (pyeloureteroscopes) have improved markedly in terms of resolution and durability. With these improved pyeloureteroscopes, transurethral observation of upper urinary tract lesions was performed 42 times in 40 cases from April 1979 to May 1983. The guide tube method (J. Urol. 112: 176-178, 1974) was used for insertion of the fiberscope into the ureter. At present, our transurethrally passed pyeloureteroscope is useful in the diagnosis of some upper urinary tract lesions which are not visualized or confirmed by other current image diagnostic procedures. However, it should be noted that it does not visualize all parts of the upper urinary tract - especially the lower calyx. Insertion to the target is also sometimes difficult and we must be careful in the interpretation of findings because of inevitable image distortion and the similarity between inflammation and urothelial tumor.
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Renal autotransplantation has been a treatment of choice for renovascular hypertension, renal artery aneurysm, complicated staghorn calculi, ureteral disorders and others. The paper reports 5 cases of extensively damaged ureter and discusses the indication and the results of operation. There were three cases of postoperative extensive ureteral stricture. One patient had postoperative ureteral injury with retroperitoneal abscess. The last one showed renal foreign body calculi with recurrent pyelonephritis after ureterocutaneostomy. The postoperative course of four patients had been uneventful revealing well functioning autotransplanted kidneys without hydronephrosis and infection during the follow-up period of 22 to 42 months. However, the patient with the ureteral injury and retroperitoneal abscess died of bleeding from renal vein anastomosis on the 15th postoperative day, since the renal pedicle showed marked inflammatory change including renal vein wall. Subsequently, autotransplantation is contraindicated in the cases with marked inflammation in the renal pedicle. In cases of various other ureteral lesions including long distance ureteral stricture, this procedure is recommended when neither the end to side ureteral anastomosis, Boari's bladder flap operation nor bladder hitch operation is feasible.
During the 5-year period from October, 1978 to September, 1983, primary hyperparathyroidism has been found at our clinic in 16 out of 395 cases of urinary stones (4.1%) and in 12.6% of the recurrent or multiple stone-forming patients. Plasma-ionized calcium level and rapid rapid calcium load test were most valuable in the diagnosis of primary hyperparathyroidism. It has been proved that neck surgery for primary hyperparathyroidism prevents recurrence of urinary tract stones.
The possibility of many persons viewing the same field together has been long desired in urological endoscopy, not only for objective diagnosis and proper treatment but also as an aid in teaching. Since 1978, the authors have been using the video-system consisting of an MK- 309C as a video-camera with a television monitor, the connecting scope between the endoscope and the video-camera, and a CLX as a light source. This system has been used in cystourethroscopy, TUR and fiberscopy of the upper urinary tract by our pyeloureteroscope . The features of this system are to use the connecting scope which allows television monitoring of the findings without disturbing the handling of the endoscope by the operator, the three-tube video-camera which transmits the pictures in quite natural color and good resolution to the television monitor and the very bright light source which gives clear views of the lesions. The endoscopic field that could be viewed simultaneously by many persons using this system proved to be satisfactory.
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