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Biomedical subjects

A Demura

Publications and source records attributed to A Demura.

5 recordsLinked to original sources

[A fistula between the common iliac artery and ureter following cutaneous ureterostomy: a case report].

A 72-year-old man underwent total cystectomy with single stoma cutaneous ureterostomy for the treatment of transitional cell carcinoma of the bladder. The patient came to the outpatient clinic every 2 weeks to exchange ureteral catheters. Six months after the operation, he was admitted to our hospital again due to edema of bilateral legs, fever, and loss of appetite. The patient had metastasis of intrapelvic and paraaortic lymph nodes associated with cachexia, and was given intravenous hyperalimentation and treatment to control pain. Suddenly, he complained of left flank pain. When the ureteral catheter was removed, massive bleeding occurred from the stomal orifice. A fistula between the artery and ureter was suspected. Six days later, the patient died due to acute renal failure. After his death, retrograde ureterography was performed to confirm the fistula. A fistula was found between the left common iliac artery and left ureter.

Aged↗

[Hypothyroidism followed by interferon-alpha as adjuvant therapy of renal cell carcinoma: a case report].

A 58-year-old male patient was admitted to the hospital complaining of weight loss. Abdominal computerized tomographic (CT) scan disclosed a mass shadow in the left kidney. From the results of further examination, including drip infusion pyelography (DIP) and angiography, he was preoperatively diagnosed as having a left renal tumor. Left radical nephrectomy was performed on March 15, 1990. The lesion was histologically diagnosed as renal cell carcinoma (clear cell subtype, grade 2) confined by the renal capsule (stage I). No distant metastases were detected. Interferon-alpha was administered every other day as adjuvant chemotherapy. After the patient experienced muscle pain in his thighs and shoulders after exercise on February 11, 1991, the serum creatine phosphokinase (CPK) level progressively increased up to 2,329 U/l. On the basis of the results of various examinations reflecting thyroid gland function, he was diagnosed as having primary hypothyroidism due to Hashimoto's disease. Thyroid function improved after administration of triiodothyronine and thyroxine. Interferon has been reported to influence thyroid function, and, in this case, interferon-alpha therapy may have induced the primary hypothyroidism associated with Hashimoto's disease.

Chemotherapy, Adjuvant↗

[Clinical application of PPC for nonspecific chronic prostatitis].

The clinical effectiveness of PPC, amino acid preparation, on nonspecific chronic prostatitis was evaluated by the double-blind test method. A mixture of two pollen extracts which has been widely employed for the treatment of chronic prostatitis was used as a control. Neither antibiotics nor anti-inflammatory drug was administered during the investigation. A total of 76 cases was reported from six facilities but 14 of them were excluded or dropped out. In 32 cases in the PPC group, subjective symptoms such as discomfort after urination, discomfort in the perineal region, pollakisuria, sense of residual urine and dysuria were improved in 50.0 approximately 61.9% and 70.0 approximately 83.3% after 2- and 4-week administrations, respectively. Similar results regarding each subjective symptom were obtained in 30 cases of the control group and there was no significant difference between the two groups. In the overall clinical effectiveness concerning subjective symptoms, the effective rate including excellently, moderately and slightly effective was 81.3% with PPC and 83.3% with control drug. However when the effective rate was limited to excellently and moderately effective, PPC was slightly superior to the control drug (50.5% versus 36.7%). In regard to prostatic tenderness by the digital examination, both PPC and control drug induced relatively good improvement after 2-week administration. The degree of improvement, however, was not increased in the subsequent 2 weeks. Sclerotic change of the prostate was poorly recovered in both groups even after 4-week treatment. Swelling of the prostate was alleviated in 12.5% of the control group after 2 weeks and in 31.8% after 4 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine↗

[Clinical study on ureterosigmoidostomy].

Clinical studies were made of 60 patients who had undergone ureterosigmoidostomy at our department. The 45 men and 15 women ranged from 35 to 73 years old, with a mean of 59.2 years. Ureterosigmoidanastomosis was performed using the modified Coffey II technique in this series. Bladder tumor was the reason for the operation in 55 cases, uterine cancer in 2, contracted bladder in 1, vesicovaginal fistula in 1 and urethral stricture in 1. In the excretory pyelogram one month after the operation, normal findings and slight hydronephrosis were observed in 37% and 63% of the patients, respectively. However, the pyelogram 6 months after the operation demonstrated normal findings in 61% of the patients, slight hydronephrosis in 34% and moderate hydronephrosis in 5%. None of them showed severe hydronephrosis. Slightly increased BUN level (less than 30 mg/dl) was seen in 15 out of 45 patients (32%) at one year after ureterosigmoidostomy. However, serum creatinine level was not above normal throughout the postoperative course. Although postoperative hyperchloremia was appreciably detected, it was easily managed by the administration of sodium bicarbonate. Serum sodium and potassium levels remained stationary. Of 35 patients observed for more than one year after operation, 11 patients (31%) had developed fever due probably to pyelonephritis, but sigmoidography failed to demonstrate any ureteral reflux. Either urinary or fecal fistula, a complication in the early postoperative period, occurred in 10 patients (17%). One of these patients died. Five patients were cured by conservative treatment. The remaining 4 patients underwent surgical treatment that was ureterocutaneostomy , nephrectomy, or colostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Surveillance colonoscopy after ureterosigmoidostomy].

Twenty-two patients underwent surveillance colonoscopy for 2 to 54 months (average, 22 months) after ureterosigmoidostomy. The distance between site of ureterocolonic anastomosis and anal verge ranged from 13 to 30 cm (average, 18.3 cm) in right side and from 20 to 37 cm (average, 29.5 cm) in left side. The form of implanted site could be classified into 3 types which were flat, sessile and pedunculated types. Endoscopic biopsies performed on eleven polyp-like regions of ureterocolonic anastomosis revealed inflammation in 10 cases (90%) and adenoma without malignancy in one case (10%). The mucosa more than 5 cm away from implanted site showed findings of inflammation without constitutional abnormality in more than 60% of all patients. The periodical surveillance colonoscopy at intervals of approximately one year seemed to be useful for early detection of the tumors of the colon after ureterosigmoidostomy.

Adult↗