PubMed Health⌕ Search

Biomedical subjects

H Go

Publications and source records attributed to H Go.

At least 37 records · Page 2Linked to original sources

Dissociation of selective renal venous plasma endothelin-1 activity and corresponding plasma renin activity in a patient with hypertension, severe stenosis of unilateral renal artery and ipsilaterally decreased renal function.

Plasma endothelin-1 (ET-1)-like immunoreactivity in selective renal venous blood and peripheral venous blood was measured and compared with plasma renin activity and aldosterone level in a 26-year-old woman with suspected renovascular hypertension due to stenosis of the left renal artery. Although there was no significant step-up in plasma renin activity between the right and the left renal vein, left/right ratio of plasma ET-1 in the renal vein was 2.18. This case suggests that ET-1 may be one of the hypertensive mechanisms of suspected renovascular hypertension in addition to the renin-angiotensin system.

Adult↗

Incidence of pouch stones and risk factors for urolithiasis in patients with continent urinary diversion or neobladder using intestine.

Urinary risk factors and inhibiting factors for urolithiasis, such as oxalate, calcium, phosphate, uric acid, citrate, and magnesium, were examined in 12 patients receiving continent urinary diversion, neobladder, or augmentation cystoplasty using intestine. These data were compared with the incidence of pouch stone formation. Ten (83.3%) of 12 patients had at least one risk factor, and 5 (41.7%) of 12 had two or more risk factors. Pouch stone developed in 4 (80%) of 5 patients with two or more risk factors, and in none of 7 patients with one or zero risk factors. The incidence of pouch stone in the former group was significantly higher than in the latter group. These results suggest that urinary reservoir operations should not be performed in patients with two or more risk factors for urolithiasis.

Female↗

[Laparoscopic management for nonpalpable testis].

In this series, we investigated the efficacy and advantage of laparoscopy for management of nonpalpable testis. Laparoscopic examination was performed in 10 boys, involving one with bilateral nonpalpable testis and 9 with a unilateral nonpalpable testis and a contralateral normal one, between August 1991 and September 1993 in our institution. Three testis were diagnosed as intraabdominal and 8 testis were diagnosed as probably intracanalicular with laparoscopy. Two boys with 3 intracanalicular testis underwent laparoscopic clipping of testicular vessels, and about 6 months later, they underwent the second stage of 2-stage Fowler-Stephens orchiopexy. Eight boys, diagnosed as probably intracanalicular type by laparoscopy, underwent surgical exploration with inguinal incision. Of 8 patients, only 1 boy underwent 1-stage orchiopexy, and the other 7 boys underwent orchiectomy because their gonads were extremely hypoplastic. About 1 year after orchiopexy, 3 testes were normal in both size and location. Laparoscopy seems to be useful for both evaluation and treatment of the nonpalpable testis.

Adolescent↗

[Trans-duodenal-recess laparoscopic nephrectomy and adrenalectomy. Preliminary report].

We report two cases of left nephrectomy and one case of left adrenalectomy with our new laparoscopic procedure. We treated the left renal vein first using trans-duodenal-recess approach. The left renal vein could be detected after an incision into the parietal peritoneum on the left side of the duodenojejunal flexure (duodenal-recess) was performed. When the nephrectomy was performed, the renal artery and vein were transected using endoGIA. When the left adrenalectomy was performed, the adrenal vein was clipped and divide after lysis of the left renal vein. Our new method allowed the renal vein to be treated first, so the remainder of the operation could be performed without the risk of bleeding.

Adrenalectomy↗

Laparoscopic adrenalectomy for primary aldosteronism: report of initial ten cases.

BACKGROUND: Although laparoscopic technique has become popular in the surgical field, the value of laparoscopy in the removal of adrenal gland is unknown. The objective of this study was to examine the feasibility of laparoscopic adrenalectomy. METHODS: Between January 17, 1992, and March 16, 1993, 10 patients (four men, six women; mean, 48.2 years of age) with primary aldosteronism underwent laparoscopic adrenalectomy (seven of left adrenal gland and three of right adrenal gland) with almost the same devices as laparoscopic cholecystectomy. RESULTS: Adrenal tumors were successfully removed with adjacent normal adrenal gland in every patient. The operative time ranged from 165 to 572 minutes (mean, 295 minutes), and the operative bleeding ranged from 50 to 920 ml (mean, 270.5 ml) without requiring blood transfusion. Only one patient required open hemostasis because of uncontrollable bleeding complicated by dislocation of vascular clip in spite of successful laparoscopic removal of adrenal tumor. There was no major complication except for this case. CONCLUSIONS: Laparoscopic adrenalectomy is a relatively safe, alternative operative method for primary aldosteronism, but application of this technique to other types of adrenal lesions remains to be studied.

Adrenalectomy↗

Laparoscopic adrenalectomy for primary aldosteronism: a new operative method.

From January 17, 1992 to January 16, 1993, laparoscopic adrenalectomy was performed in 7 patients (3 men, 4 women) with primary aldosteronism ranging in age from 35 to 65 years (mean 48.7 years). Five of the adrenal lesions were on the left side and two were on the right. Five to six trocar-sheath units were used, and adrenal tumors were successfully removed with adjacent normal adrenal glands in all patients. The operative time ranged from 165 to 572 min (mean 302 min), operative blood loss was between 50 and 450 ml (mean 217.2 ml), and there was no major complication. In conclusion, laparoscopic adrenalectomy is a safe alternative operative method for primary aldosteronism, although application of this technique to other types of adrenal lesions remains to be examined.

Adrenal Gland Neoplasms↗

[Application of intraurethral catheter for geriatric male patients complaining of urethral obstruction due to malignancy--comparison with benign prostatic hypertrophy].

Intraurethral catheters (IUC) were used for elderly male patients with prostatic urethral obstruction (PUO) due to malignancy (MA) and benign prostatic hypertrophy (BPH). Thirty-three men complaining of urinary retention in spite of medical therapy at the risk for prostatic surgery underwent insertion of IUC (16Fr Puroflex, Angiomed Co., Ltd., Germany). Six of 33 were patients with PUO due to MA (5 prostatic cancer, and 1 urethral invasion of rectal cancer, mean 82.7 years old), and the other 27 were patients with BPH (average 80.1 years old). Follow-up period of the former ranged from 2 to 9 (mean 6.5) months, and that of the latter ranged from 6 to 23 months. Water filling cystometry (CMG) before the insertion of IUC and fluoroscopic voiding cystourethrography (VCU) just after insertion of IUC were performed. We defined normal CMG and normal VCU as normal bladder, overactive CMG and normal VCU as overactive bladder, and normal or poor sensitive CMG and underactive VCU as underactive bladder. Five of 27 BPH patients had previous prostatic operations (TUR-P, and/or balloon dilation), but 6 MA did not. All of MA (3 normal bladder, 2 overactive bladder, and 1 underactive bladder) voided satisfactorily, and average duration of IUC in place was 6.5 months without exchange of IUC. Although sixteen of 27 (59.3%) BPH patients voided satisfactorily, and average duration of IUC in place was 12.1 months without exchange of IUC, in the other 11 of these 27 BPH patients were removed IUC, and average duration of IUC in place was 4.7 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Laparoscopic adrenalectomy].

Since January, 1992, 8 patients with adrenal disease have been treated by laparoscopic surgery. There were 4 males and 4 females (35-65 years old), seven patients had primary aldosteronism and one non-functioning adrenal tumor. Six trocar-sheath units were placed in the upper abdomen. In case of the lesion being on the right side, the posterior layer of the peritoneum was incised at the point of the hepatic flexure of the colon and on the left side, the dissection was begun by dividing the peritoneal reflection over the lateral aspect of the descending colon, adrenal tumors were removed with normal adrenal gland. In all cases adrenal tumors were removed successfully. The operative time was from 165 to 572 (293 min., average) minutes and there was no major complication.

Adrenal Gland Neoplasms↗

[Long-term results and indications of intraurethral stents in elderly patients with prostatic hypertrophy complaining of urinary retention].

Thirty-two elderly male patients with benign prostatic hypertrophy complaining of urinary retention were treated by polyurethane intraurethral stents. All of them were unfit for prostatic surgery due to the presence of several complications, and had been indwelt with a urethral balloon catheter. Cystometry before stent insertion was performed in 23 of the 32 patients. Eleven patients showed overactive bladder, 5 patients normal bladder, and 7 patients underactive bladder. Duration of stent indwelling ranged from 2 days to 22 months (mean 6.7 months), and stent could successfully function for more than 6 months in 20 of the 32 patients (62.5%). Nine of these 20 patients (45%) could keep continence of urine, and urinary tract infections improved in 7 of these 20 patients (35%). The stent failed in 4 of the 5 patients who had had previous operations for prostatic hypertrophy. In a comparison of the findings of urodynamic study prior to insertion of stent with the results of the stent, the results were significantly better in the patients with overactive or normal bladder than in those with underactive bladder (p < 0.05, chi-square test). Bladder stone formation was found in one patient and was the only complication among the 32 patients. In conclusion, stent placement without incontinence or urinary tract infection can be successful for more than 6 months in patients who do not have an underactive bladder and who had not had a previous prostatic operation.

Aged↗

[Examination of the risk factors for infectious urolithiasis formation in patients receiving urinary diversion or urinary reconstruction using intestine--comparison of reservoir and ileal conduit].

Urinary risk factors and preventive factors for infectious calcium (Ca) urolithiasis formation, such as citrate, oxalate, Ca, phosphate, magnesium, and uric acid were examined more than 2 months after performing a urinary reservoir in 12 patients (R group) and ileal conduit in 10 patients (C group). There was no difference in the positive rate of risk factors between the two groups and also no difference in the positive rate of more than two risk factors between the two groups. Although four patients with more than two risk factors in the R group suffered from reservoir stones all of which included Ca-urolithiasis, none in the C group did. In the R group, the incidence of stone formation in patients with 2 or more risk factors was significantly higher than those in patients with 1 or no risk factor. In conclusion, the urinary reservoir operation should not be carried out in patients with more than two risk factors for urolithiasis formation, and urinary risk factors should be examined before reservoir operation.

Adult↗

Application of flexible renoureteroscope for antegrade urethroscopy in the treatment of congenital anterior urethral valve.

Antegrade urethroscopy was performed through a cystostomy using a 10.8-fr caliber flexible renoureteroscope in 4 children (aged 2 years and 8 months, 2 months, 14 years and 1 month) with anterior urethral valve. The anatomy of the valves as well as their destruction after transurethral resection (TUR) were well visualized by antegrade urethroscopy. This technique was helpful in performing TUR-valve, after which the findings of voiding cystourethrography in every case and the findings of uroflowmetry in the elder 2 cases showed remarkable improvement. This technique is relatively simple to perform and is thought to be one of the best methods to treat anterior urethral valve. This technique is also applicable to other lower urinary tract lesions in children.

Adolescent↗

[Endoscopic operation of congenital anterior urethral valve. Application of flexible renoureteroscope for antegrade urethroscopy].

4 children with anterior urethral valve were treated by TUR-Valve. Before TUR, valve anatomy could be easily seen by antegrade urethroscopy through cystostomy using a 10.8Fr caliber flexible renoureteroscope and destruction of the valve could be recognized after TUR. Antegrade urethroscopy with a flexible fiberscope was so helpful to TUR-Valve and the findings of voiding cystourethrography and micturition have remarkably improved. This technique is not so difficult to apply and thought to be one of the best methods to recognize valve anatomy and degree of resection. This technique is also applicable to other lower urinary tract lesions in children.

Adolescent↗

[The effect of intra-urethral catheter for prostatic hypertrophy patients who are unfit for operation and suffer from urinary retention].

The effect of double Malecot type polyurethane intraurethral catheter (IUC) was examined in 17 benign prostatic hypertrophy patients who were unfit for operation and suffered from urinary retention. Patients were aged 68 to 90 (mean 80.5) years old and the causes of IUC insertion were cardiac, cerebrovascular, respiratory and gastrointestinal diseases, diabetes mellitus and aging. IUC was selected among three types (55, 60, 65 mm) according to the length of prostatic urethra. Insertion of IUC was carried out easily under fluoroscopic guidance without endoscopy. All patients could void by themselves just after insertion of IUC and the longest indwelling period was 10 months. The length of IUC need not be longer than that of prostatic urethra and patients with normal or hypertonic bladder could void better than those with atonic bladder. Urinary tract infection did not get worse in any patients with indwelling IUC. Double Malecot type polyurethane IUC is a safe and an effective alternative method in place of urethral balloon catheter for inoperable prostatic hypertrophy patients in urinary retention.

Aged↗

Balloon dilatation for entire urethral stricture.

Two patients with entire urethral stricture were treated with balloon dilatation of the whole urethra using a torpedo-type dilatation balloon with satisfactory results. Postdilatation urethrograms revealed that the lumen of the urethra was of satisfactory width in both cases, and the patients are now voiding normally. There has been no complication requiring therapy. These successful results suggest that this technique is a good alternative treatment for entire urethral stricture, and can replace conventional dilatation.

Aged↗

[Bone mineral densitometry by dual photon absorptiometry in patients with urolithiasis--on the possibility of the differential diagnosis of idiopathic hypercalciuria].

Bone mineral density (BMD) of the 3rd lumbar spine was measured by dual photon absorptiometry (DPA) in 8 patients with primary hyperparathyroidism (PHP) and 39 patients with idiopathic urolithiasis (IU). Of the patients, 15 were classified into idiopathic hypercalciuria (IH) which were further classified into 2 types of IH--renal hypercalciuria (RH) and absorptive hypercalciuria (AH)--by Ca restriction and load test. BMD of the IH patients tended to be lower than patients with normocalciuria, but significantly higher than the PHP patients. BMD of the RH patients was significantly lower than the AH patients. In conclusion, DPA may be a simple method for classifying the types of idiopathic hypercalciuria.

Absorptiometry, Photon↗