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Biomedical subjects

I Motoi

Publications and source records attributed to I Motoi.

12 recordsLinked to original sources
PubMed1996

Clinical evaluation of extracorporeal shock wave lithotripsy for salivary stones.

The treatment of sialolithiasis is discussed in this report. Generally, stones within the distal salivary duct are easily removed by transoral ductotomy, although proximal stones are usually treated by excision of the salivary gland and its duct. Since 1980, extracorporeal shock wave lithotripsy (ESWL) has been in clinical use for the treatment of renal and gallbladder stones. We used this technique as a treatment for sialolithiasis. We undertook ESWL on 14 submandibular gland stone patients and 1 parotid gland stone patient, clinical symptoms such as pain and swelling disappeared without excision of the affected salivary gland. Stones larger than 10 mm seem to have a tendency to form Steinstrassen. Although computed tomography findings correlate with success in breaking up gallstones, they did not predict success for salivary stones. We conclude that sialolithiasis is treated successfully without adverse effects by ESWL in selected patients.

Adolescent↗
PubMed1992

[ESWL treatment of urinary stones at an outpatient clinic].

A total of 107 patients (age: mean 51.6, range 17-85, sex: male 71, female 36) with urinary stones in 112 renoureteral units were subjected to extracorporeal shockwave lithotripsy (ESWL) in situ using an EDAP LT-01 at an outpatient clinic between June 1990 and July 1991. All patients were given an analgesic suppository before ESWL. One ESWL session required 20-60 minutes with a repetition rate of 1.25 Hz, 2.5 Hz or 5 Hz. The effectiveness of the treatment was evaluated in 94 cases consisting of 50 renal units (R1 2, R2 46, R3 2) and 44 ureteral units (U1 16, U2 1, U3 27) three months after the final session according to the criteria reported by Sonoda. Of the 94 cases, 80 cases (85.1%) were stone free and 12 cases (12.8%) had residual fragments of less than 4 mm in diameter. Macroscopic hematuria was seen in all cases. Fever or colicky pain occurred in 3 cases. Outpatient ESWL using the EDAP LT-01 is considered to be safe and efficient for the initial treatment of urinary stones.

Adolescent↗
PubMed1991

Biochemical and pharmacodynamic studies of simple renal cyst fluids in relation to infection.

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Adult↗
PubMed1991

[Giant hydrocele: two case reports].

Two cases of giant hydrocele, having more than 1,000 ml of contents, are presented. The first patient was a 77-year-old man with the complaint of urination difficulty and a very swollen left scrotum of three years duration. Mild prostatic hypertrophy, mild renal dysfunction and hypertension were seen during hospitalization. A scrotal puncture gave 2,100 ml of serous fluid. Radical hydrocelectomy and plastic operation for surplus scrotal skin were done, and difficult urination improved markedly. The second patient was a 77-year-old man with the complaint of right scrotal swelling of fifteen years duration. He had developed pollakisuria and urination difficulty three years previously. When he was transferred our hospital on emergency due to engorgement, the diagnosis of giant hydrocele was made. Right orchidectomy was performed because of marked testicular atrophy and old hemorrhagic fluid of 1,200 ml. Urination difficulty and pollakisuria disappeared postoperatively.

Aged↗
PubMed1990

[Clinical evaluation of ofloxacin in the treatment of chronic complicated urinary tract infection].

Ofloxacin was administered orally at a daily dosage of 300 mg and 600 mg in three divided doses for 14 days to 24 and 60 patients with chronic complicated urinary infections, respectively, in order to evaluate the therapeutic efficacy. The clinical efficacy was evaluated according to the criterion proposed by the UTI Committee in Japan and its efficacy was evaluated in 84 cases. In the group of 24 patients receiving a daily dosage of 300 mg, the clinical effectiveness after a 5-day treatment was excellent in 13 cases and moderate in 7 cases. The overall clinical efficacy was 83.8%. In the group of 60 patients receiving a daily dosage of 600 mg, the rate of overall clinical efficacy after a 5-day treatment was 83.3%, being excellent in 23 cases and moderate in 27 cases. The eradication rate was 85.3% and 92.5% by 300 mg and 600 mg dosages of ofloxacin, respectively. As adverse reactions, anorexia and nausea occurred in 2 cases. Laboratory anomalies consisted of 1 case of slight and transient elevation of transaminase, and 1 case of elevated serum creatinine.

Administration, Oral↗
PubMed1987

[Wilms' tumor in an adult patient: a case report].

A case of Wilms' tumor in an adult patient is presented. The tumor in adults is rather rare and has an unfavorable prognosis. A 39-year-old man bruised his left flank while skiing in February, 1983. He noticed severe left flank pain. The pain subsided after a week of rest. However, he complained of left abdominal mass and dull pain again, and consulted our outpatient clinic on May 21, 1983. Left transperitoneal nephrectomy was performed under a diagnosis of left injured renal tumor. Histological diagnosis was nephroblastoma. A combined chemotherapy of actinomycin D (ACD) and vincristine (VCR) was started after operation. A total of 10 mg of ACD and 14 mg of VCR was administered by the end of 1983. In March 1984, however, a local recurrence and pulmonary metastases of the tumor were detected by CT and chest films. Local RF-hyperthermia combined with irradiation, alpha-interferon or chemotherapy using cisplatin and adriamycin was given. The patient died of profound cachexia in December, 1984 after gradual deterioration of general conditions.

Adult↗
PubMed1987

[Bilateral ureteral tumors associated with chronic renal failure: a case report].

A 66-year-old female with bilateral ureteral tumors associated with chronic renal failure is presented. She received pan-hysterectomy due to uterine cancer in 1957. She was first referred to our clinic to make internal shunt under a diagnosis of chronic renal failure. In 1979, the diagnosis of neurogenic bladder and bilateral vesicoureteral reflux (rt; grade 3, lt; grade 1) was made. She was admitted to our clinic with complaints of macroscopic hematuria and a temperature of 39 degrees C on April 28, 1983. Cystoscopically, pyuria from the right ureteral orifice was found. Right retrograde pyelography revealed severe dilatation of the right ureter and renal pelvis with some filling defects. For drainage of pus retaining in the right renal pelvis, right percutaneous nephrostomy was made under the guidance of ultrasonography. After her general condition improved, right nephroureterectomy was performed under the diagnosis of right pyonephrosis on June 8, 1983. Right pyelonephritis and right ureteral tumor, grade 3, were pathologically demonstrated. After the operation, an invasive bladder tumor was detected on cystoscopy and ultrasonography, subsequently a total of 3,900 rad irradiation was given to the bladder tumor. She died of pulmonary edema 7 months later. Autopsy demonstrated a transitional carcinoma, grade 3, of the left ureter. Bilateral urothelial tumors of the upper urinary tract is rare, and to our knowledge only 29 cases have been reported in Japan.

Aged↗
PubMed1983

Pharmacokinetics of cefotetan in normal subjects and patients with impaired renal function.

The elimination kinetics of cefotetan (YM09330), a new parenteral semisynthetic cephamycin derivative, were studied in eight healthy volunteers and 41 patients with renal insufficiency after the administration of a single 500-mg dose intravenously. Concentrations of cefotetan in serum and urine were determined by both bioassay and high-pressure liquid chromatography. The pharmacokinetic parameters for cefotetan were calculated on the basis of a two-compartment open model. Serum concentrations of cefotetan immediately after administration were approximately 180 micrograms/ml in all subjects regardless of function; however, serum concentrations during the beta-phase increased directly with the degree of renal impairment. The mean serum half-life during the beta-phase was 3.0 h in normal subjects as compared with 13.1 h in hemodialysis patients. There was a linear correlation (P less than 0.0001) between the elimination rate constant of cefotetan and creatinine clearance. The mean cumulative urinary recovery of cefotetan in the 24-h urine was 83.3% of the administered dose in normal subjects and decreased with reduced renal function.

Adult↗
PubMed1983

Elimination kinetics of cefotaxime and desacetyl cefotaxime in patients with renal insufficiency and during hemodialysis.

The pharmacokinetics of cefotaxime, a new semi-synthetic cephalosporin for injection, was studied in 30 subjects with various degrees of renal function after a single 1-gram intramuscular injection. Serum and urinary concentrations of cefotaxime and desacetyl cefotaxime were determined by high pressure liquid chromatography. The pharmacokinetic parameters of cefotaxime were obtained using a one-compartment open model. The mean serum half-life of the parent compound (cefotaxime), 0.87 h in normal subjects, was prolonged to 2.35 h in hemodialysis patients. There was a significant linear correlation between the elimination rate constant of cefotaxime and creatinine clearance. The mean cumulative urinary recovery of the administered dose in the 24-hour urine was 51.7% as cefotaxime and 25.6% as desacetyl cefotaxime in normal subjects.

Adult↗
PubMed1983

[A double blind clinical trial of cefamandole and cefmetazole in complicated urinary tract infections].

We conducted a randomized double blind comparison of cefamandole (CMD) and cefmetazole (CMZ) in the treatment of 193 patients with complicated urinary tract infections. The patients received 1 gram of CMD or CMZ twice a day intravenously by drip infusion over 1 hour for 5 days. Pretreatment urinary leukocyte counts and urinary bacterial counts were at least 5 cells/hpf and 10(4) bacteria/ml, respectively. Each patient was randomly allocated either to CMD or CMZ group. There were 93 patients in CMD group and 100 patients in CMZ group. Clinical efficacy was evaluated based on the effect of treatment on bacteriuria and pyuria according to the criteria set by the UTI Committee, Japan. The response to CMD treatment was excellent in 18 cases (19.4%), moderate in 38 cases (40.9%) and poor in 37 cases (39.8%) with an overall effectiveness of 60.2%, whereas the response to CMZ was excellent in 19 cases (19.0%), moderate in 40 cases (40.0%) and poor in 41 cases (41.0%) with an overall effectiveness of 59.0%. No statistical significant difference was found between 2 treatment groups. Comparison of the bacteriological response between 2 groups showed that the eradication rate for strains of Gram-positive cocci were significantly higher in those patients treated with CMD. Gram-negative rods were eradicated from 68.4% of cases treated with CMD, and 78.0% of those with CMZ, but the difference was not significant. Adverse reactions were observed in 3 patients receiving CMD 1 case each of diarrhea, eruption and epigastric pain. Abnormality in laboratory tests was found in 6 patients in each treatment group. The results indicate that CMD is effective, safe and useful in the treatment of patients with complicated urinary tract infections, and its efficacy, safety and usefulness are comparable with those of CMZ.

Adolescent↗
PubMed1983

[Two cases of renal angiomyolipoma].

Two cases of renal angiomyolipoma without tuberous sclerosis are presented. The 1st case was a 33-year-old woman who had left flank pain and macroscopic hematuria on August 26, 1980. Physical examinations revealed a large left renal tumor, and selective renal angiograms showed the presence of a hypovascular mass located in the central to median lower part of the left kidney. Ultrasonography showed a high echogenic mass accompanied by a round low echogenic area in the left kidney. Computed tomography revealed a fatty density in the renal mass. The 2nd case was a 60-year-old woman who was incidentally diagnosed as having a right renal tumor by ultrasonography on February 18, 1982. The echogram showed a high echogenic mass in the right kidney, and the fatty density in the renal mass was determined by computed tomography. These patients underwent nephrectomy and the histological diagnosis was angiomyolipoma. The usefulness of ultrasonography and computed tomography in the preoperative diagnosis of this clinical entity and the possibility of association with renal cell carcinoma are discussed.

Adult↗