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Biomedical subjects

H Hibi

Publications and source records attributed to H Hibi.

86 records · Page 5Linked to original sources

[Clinical study of sparfloxacin, a new quinolone derivative, on urinary tract infection].

Sparfloxacin (SPFX) was evaluated for its clinical efficacy in 22 patients with acute uncomplicated cystitis (AUC) and 51 with chronic complicated urinary tract infection (CC-UTI). SPFX was administered in a single oral daily dose of 100 mg for 3 days to the patients with AUC. According to the UTI criteria, the efficacy rate was 100% (excellent rate was 78.9%). SPFX was also administered in a single oral dose of 200 to 300 mg mostly for 5 days to patients with CC-UTI. The efficacy rate according to the UTI criteria in the evaluable 22 cases was 45.5%. The efficacy rate according to the physicians in charge, evaluated as either excellent or good for the 23 cases treated with SPFX for 7 and 14 days was 65.2%, the overall efficacy rate in 49 cases including the administration for 5 days being 55.1%. In safety profile, subjective side effects were observed in 9 cases (12.3%), in 2 of which the medication was discontinued (2.7%). These side effects, flowever, recovered without any treatment to normal at the completion or discontinuation of the medication. The clinical laboratory values showed a slight elevation of BUN in 2 cases. SPFX was the most potent antimicrobial brug with a long blood elimination half life among the existing current new quinolones (NQs), indicating a possibility of once-a-day treatment regimen. In safety, side effects of SPFX were similar in general to those of other current NQs. Thus, SPFX is regarded as a highly useful antimicrobial drug when the drug is administered with consideration for its unique characteristics.

Adult↗

[Studies on the virulent factor of Escherichia coli isolated from urogenital infection--pilus type and adherence to human exfoliated uroepithelial cells etc].

One hundred and twenty three strains of Escherichia coli isolated from the urine of patients with urogenital infections and 55 strains isolated from the fecal samples of healthy individuals were assayed for 0 antigen and hemolysin production as virulence factors, and for pilus type and in vitro tests of adhesion to human exfoliated uroepithelial cells as colonization factors. The incidence of MS pili in Escherichia coli isolated from patients with acute uncomplicated cystitis, chronic complicated cystitis, acute uncomplicated pyelonephritis and acute prostatitis was 60.9%, 22.7%, 87.5%, 68.2% and 30.9%, respectively. The incidence of P pili was 69.7%, 51.2%, 62.5%, 54.5% and 25.5%, respectively. The strains showing haemolysin production had MS pili and P pili, which show strong virulence. MS pili strains and P pili strains isolated from the patients with acute uncomplicated cystitis and acute uncomplicated pyelonephritis adhered to human exfoliated uroepithelial cells well. Consequently, the pilus type might be the most significant colonization factor in uncomplicated urogenital infection which is shown by the normal defense mechanism in host side.

Bacterial Adhesion↗

[Grand mal like attack by interferon injection in case of renal cell carcinoma].

We performed a radical nephrectomy for renal cell carcinoma on a 60-year-old female. We began to give alpha-interferon (natural type), she had an attack of tonic clonic convulsion (like grand mal attack). There were no abnormal findings in head computed tomography, nor hematologic tests. We ascribed the attack to interferon, and stopped giving it. Because there was an abnormal wave in EEG, she was given an anti-convulsant per os. One month later, the electroencephalogram became normal and she showed no neurological symptoms nor findings.

Carcinoma, Renal Cell↗

[A case of emphysematous pyelonephritis--review of 32 cases in Japanese literature].

A case of emphysematous pyelonephritis is presented. A 66-year-old woman with diabetes mellitus was hospitalized for sudden pyrexia and left abdominal pain on January 13, 1987. She had shown preshock, pre-disseminated intravascular coagulation, hyperglycemia and renal dysfunction. Plain X-ray films of the abdomen and abdominal computer tomographic scanning showed a gas shadow in the left kidney. Retrograde pyelography demonstrated the left complete ureteral obstruction. A diagnosis was made of emphysematous pyelonephritis associated with diabetes mellitus and ureteral obstruction. Left nephrectomy was performed on January 17, 1987, and the pus obtained from the kidney yielded E. coli. After the operation, she has been doing well with diabetes mellitus under good control without insulin therapy. Thirty two cases of emphysematous pyelonephritis in the Japanese literature including our case are reviewed.

Aged↗

[Treatment of chlamydial urethritis--studies on clinical effects of ofloxacin].

Clinical effects of ofloxacin (OFLX) in the treatment of the patients with chlamydial urethritis was studied. OFLX was administered at a dose of 200 mg, three times daily (600 mg) for 14 days. In all of the 26 patients with chlamydial urethritis, C. trachomatis was eliminated in 7 to 14 days after the start of administration. The subjective clinical symptoms such as pain on urination and abnormal urethral feeling was disappeared in all cases within 7 days after the administration. The objective clinical symptoms, urethral discharge, polymorphonuclear leukocyte (PMNL) in urethral discharge and PMNL in first urine were improved in 94, 68, 91% respectively on 14 days after the administration. Overall clinical efficacy rate of OFLX on 7 days, 14 days and 21 days after the administration in this study was 63, 82, 91% respectively. Whereas subjective symptoms of side effects were noted in 2 patients (7.6%), any additional medical care was needed in none of them. Because of the marked improvement of clinical symptoms and the safety administration, OFLX could be the first regimen to be chosen for the treatment of the patients with chlamydial urethritis.

Adult↗

[A case of bizarre leiomyoma of the scrotum].

A case report of a bizarre leiomyoma of the scrotum in a 46-year-old male is presented with a review of the literature. The patient was admitted to our hospital with the chief complaint of swelling of the left scrotal content for about 20 years. The tumor was surgically removed easily. Histological findings revealed bizarre leiomyoma. This case is the first report of bizarre leiomyoma of the scrotum in Japan.

Genital Neoplasms, Male↗

[A case of bilateral testicular tumors--a review of 115 cases in Japanese literature].

A case of bilateral testicular tumours of germ cell origin is reported. A 35-year-old man with bilateral testicular swelling visited our clinic. Bilateral high orchiectomy was performed. Histological examination of both resected testis revealed typical seminoma. Postoperative irradiation was performed. The patient is doing well after one year of postoperative follow-up without any sign of metastasis. Besides this case, we found 115 cases of bilateral testicular germ cell tumours in the Japanese literature. There were 39 cases with different and 76 cases with similar histology between the left and right testis. The age distribution, location of testis, time of onset and histological classification of these cases is discussed.

Adolescent↗

The treatment with tranilast, a mast cell blocker, for idiopathic oligozoospermia.

Although many drug treatments have been reported to theoretically improve semen parameters in male infertility, a standard method has not been established. The authors examined whether tranilast, a mast cell blocker, improves fertility and/or semen parameters in severe oligozoospermia. Seventeen patients with a sperm density of less than 10 x 10(6) sperm/mL and their fertile partners were enrolled in this study. Patients were prescribed tranilast 300 mg/day for at least 12 weeks. Semen and blood samples were collected before and after the prescription of tranilast for 12 weeks. Semen parameters, serum gonadotropins, luteinizing hormone, follicle-stimulating hormone, serum testosterone, and testicular size were evaluated. One patient complained of mild drowsiness during treatment. The sperm count was significantly increased after administration of tranilast in 7 patients (41.1%), although sperm motility was not altered. Semen volume and normal morphology were also unaltered. Three pregnancies were achieved. Endocrine profile and testicular size were unchanged. Tranilast, a mast cell blocker, is clinically useful for the treatment of severe idiopathic oligozoospermic men.

Adult↗

Treatment of oligoasthenozoospermia with tranilast, a mast cell blocker, after long-term administration.

The authors retrospectively examined whether long-term administration of tranilast improves semen parameters in severe oligoasthenozoospermia. Fifty-two patients presenting with sperm concentration of less than 10 x 10(6) sperm/mL were enrolled. Subjects were partitioned into 3 groups as follows: patients displaying an atrophic testis with elevated (FSH) (group 1), patients exhibiting normal testicular volume with elevated FSH (group 2), and patients with normal testicular volume and normal FSH levels (group 3). Tranilast (300mg/day) was administered until pregnancy was achieved or for a period of up to 12 months. Sperm concentration was significantly increased at 3 months in 16 subjects (44%) in groups 1 and 3. In group 2, sperm concentration was increased at 12 months (5 of 16 subjects; 31%). Total sperm count was obviously elevated at 3 months in groups 1 and 2, and at 6 months in group 3. Six pregnancies were achieved via natural intercourse. Tranilast, a mast cell blocker, demonstrates a certain clinical benefit in terms of improvement of semen parameters involving severe oligoasthenozoospermia, but it does not appear to afford clinical benefit in long-term administration.

Adult↗

Probability of sperm recovery in non-obstructive azoospermic patients presenting with testes volume less than 10 ml/FSH level exceeding 20 mIU/ml.

We evaluated the sperm recovery rate in non-obstructive azoospermia (NOA) patients presenting with bilateral testicular atrophy characterized by testes volume of less than 10ml and FSH levels exceeding 20 mIU/ml (group NOA-1), and compared the results to those NOA cases displaying unilateral testis volume exceeding 10 ml or FSH levels less than 20 mIU/ml (group NOA-2). Sperm retrieval was conducted in 261 azoospermic patients from April 1995 to December 2002. Forty-six NOA-1 and 37 NOA-2 individuals underwent microdissection TESE or 3-4 standard biopsies. Sperm recovery was achieved in 11 (24%) and 12 (32%) cases in NOA-1 and NOA-2, respectively. All couples received ICSI. Four clinical pregnancies (36.3%) in NOA-1 and two (17%) in NOA-2 resulted. Five subsequent healthy deliveries were obtained. NOA patients presenting with bilateral severe atrophic testes volume and obviously elevated FSH levels exhibited approximately 24% probability of sperm recovery. On the other hand, NOA characterized by testicular atrophy or elevated FSH levels displayed probability of approximately 32%. Differences in sperm recovery were not evident between NOA-1 and NOA-2. No successful pre-operative predictors of sperm recovery were identified.

Adult↗

Comparison of artery-ligating and artery-preserving varicocelectomy: effect on post-operative spermatogenesis.

To evaluate the effects of ligature of the internal spermatic artery at varicocelectomy on fertility, we conducted a prospective randomized study for comparison of two surgical methods (artery-ligated and artery-preserved). A total of 66 infertile patients with palpable varicocele was randomly assigned to an artery-ligated or artery-preserved group at varicocelectomy and the change in seminal characteristics and testis volume was prospectively investigated. Sperm density and motility improved significantly in the artery-ligated group. There was significant improvement in sperm density in the artery-preserved group, but motility did not reach the level of statistical significance in this group. The significant change in testis volume was not observed in both groups. Seven (23.3%) of 30 patients in the artery-ligated group and 5 (13.9%) of 36 men in the artery-preserved group managed to impregnate their partners. The difference was not statistically significant. In spite of the advocative advantage of artery preservation, our present study did not show any significant difference between artery-ligating and artery-preserving varicocelectomy when improvements in semen quality and pregnancy rate were assessed. Thus, artery-ligated varicocelectomy is warranted with regard to post-operative fertility in the patients with clinical varicocele.

Adult↗

Human chorionic gonadotropin adjuvant therapy for patients with Leydig cell dysfunction after varicocelectomy.

The authors treated 135 men who underwent varicocelectomy, but had sustained Leydig cell dysfunction disclosed by LHRH test with human chorionic gonadotropin (hCG). hCG was administered for 10 weeks: 50,000 units were given in 10 divided doses intramuscularly. Semen analysis and measurement of serum hormone level were obtained 8 weeks after the completion of treatment, and every 3 months after that. All patients were followed up for 2 years to confirm pregnancy. Fifty-five percent of patients achieved pregnancy and they showed significant increase in sperm density, percentage of sperm motility, normal form sperm, and serum testosterone level. It is recommended that hCG be administered to patients who undergo varicocelectomy but have persistent subtle Leydig cell dysfunction disclosed by LHRH test to stimulate the intratesticular testosterone production.

Chorionic Gonadotropin↗

Microsurgical epididymal sperm aspiration versus epididymal micropuncture with perivascular nerve stimulation for intracytoplasmic sperm injection to treat unreconstructable obstructive azoospermia.

A novel sperm collection method by epididymal micropuncture combined with perivascular nerve stimulation has been developed to obtain as many clean sperm as possible for IVF for patients with surgically irreparable vasal obstruction. To assess whether the new technique could improve the fertilization and pregnancy rates obtained when attempting microsurgical epididymal sperm aspiration (MESA) to retrieve epididymal sperm from such patients, a prospective randomized comparative study was conducted. Twenty-nine cycles of conventional MESA with ICSI were performed on 25 couples with congenital bilateral absence of the vas deferens (CBAVD) and four failed vasovasostomy cases (group 1). Thirty cycles of epididymal micropuncture with nerve stimulation with ICSI were performed on 28 couples with CBAVD and two failed epididymovasostomy cases (group 2). The mean volume of epididymal fluid and sperm motility in group 2 was significantly higher than that in group 1 (p < .001). Both fertilization and pregnancy rates in group 2 were significantly higher than those in group 1 (p < .001 and p < .03). This novel epididymal sperm collection method for ICSI can provide significantly higher fertilization and pregnancy rates than conventional MESA for ICSI.

Cytoplasm↗

Holmium laser incision technique for ureteral stricture using a small-caliber ureteroscope.

BACKGROUND AND OBJECTIVES: The holmium laser has a short absorption depth in tissue and possesses excellent properties both in ablation and hemostasis. We have performed endoscopic incision for ureteral stricture using the holmium laser through a small-caliber ureteroscope. METHODS: This method was used on five patients and seven ureters. The etiology of the stricture was stone scar in two patients, ureteroenteroanastomosis of Indiana urinary pouch in two, and primary in one. We used an 8F semi-rigid or 6.9F flexible ureteroscope. No prior procedures, such as balloon dilation, were necessary in any of the cases. The stricture was incised with the holmium laser using a 365-microm fiber through the working channel of the ureteroscope. The holmium laser operated at a wavelength of 2100 nm, with an output of 1.0 J/pulse at a rate of 10 Hz. After completion of the incision, a 12F Double-J catheter was left in for six weeks. RESULTS: The mean operative time was 89 minutes. The stricture resolved completely in all cases at an average follow-up of 8.6 months. CONCLUSIONS: The holmium laser incision for ureteral stricture using a small-caliber ureteroscope is an easy-to-perform, safe and effective procedure.

Aged↗