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Biomedical subjects

M Gakiya

Publications and source records attributed to M Gakiya.

12 recordsLinked to original sources
PubMed2000

[Antireflux surgery in infants with vesicoureteral reflux].

Febrile urinary tract infections (UTI) resulted in the admission of five infants (four boys, one girl) to Okinawa Prefectural Hospital in Miyako. The first febrile episode developed at an average age of 1.3 months. All patients underwent cystoscopy and X-ray studies to role out secondary causes for vesicoureteral reflux (VUR). All patients had high grade reflux and underwent antireflux surgery using a modification of the Amar-Paquin method or the Politano-Leadbetter method. They tolerated the procedures without any complications. No UTI recurred and VUR disappeared in one year following surgery. Early surgical intervention seems beneficial for selected infants with high grade VUR, but the surgical procedure and methods for infants, especially those with severe dilated ureter, are still controversial.

Female↗
PubMed2000

[Spontaneous rupture of infected renal cyst: a case report].

A 68-year-old man who had been followed at 1-year intervals for a left giant renal cyst was referred to our hospital for left flank pain and fever elevation. Abdominal computed tomographic scan revealed a giant cystic lesion of the left kidney suspected to be communicating with the urinary tract. Percutaneous puncture of this lesion was performed and the fluid was drained. The fluid was yellowish and cloudy, and E. coli was detected by its culture. Injection of contrast medium showed communication between the cyst and the urinary tract. The patient underwent drainage for a ruptured renal cyst. Rupture of a renal cyst is uncommon, and this is the 16th case reported in Japan.

Aged↗
PubMed1999

[Rhabdomyolysis following nephrectomy for pyonephrosis: a case report].

A 33-year-old man with chronic alcoholism presented with left flank pain and a low-grade fever. He had a previous history of left renal calculi treated by extracorporeal shockwave lithotripsy 3 months previously at a local hospital. Since a stone was impacted at the ureteropelvic junction resulting in septic hydronephrosis, a D-J catheter was introduced to relieve the condition. He underwent fluid therapy with antibiotics. Elective pyelolithotomy was scheduled on day 10. However, persistent pyonephrosis necessitated the removal of the infected kidney. Hyperthermia over 40 degrees C continued after surgery and dark urine developed on postoperative day 2. Rhabdomyolysis was suspected because of myoglobulinemia with a high creatine phosphokinase level. Systemic cooling and treatment with fluid and diuretics saved his renal function. He survived episodic malignant hyperthermia and was discharged from intensive care unit on postoperative day 5.

Adult↗
PubMed1999

[Transurethral resection of the prostate for patients with dementia].

During the period from July 1995 to June 1996 we performed transurethral resection of the prostate (TURP) on 824 patients with benign prostatic hyperplasia (BPH). Among them, 13 were dementia patients between 74 and 96 years old; they presented with urinary hesitancy in 6, retention in 4, frequency in 2 and incontinence in 1 patient. Past history included stroke in 7, hypertension in 6, pulmonary tuberculosis in 4, diabetes in 3, asthma in 2, angina pectoris in 1, Parkinson's disease in 1, pneumonia in 1, and hepatitis in 1. Careful preoperative examination revealed that they were proper candidates for TURP. They underwent TURP under spinal anesthesia. The mean operative time was 34 min, ranging from 20 to 60 min. The adenoma resected weighed 24 g on the average, ranging from 7.5 to 48 g. During surgery, although hypotension was noted in 2 patients, there was no serious morbidity. Their mental condition was well controlled with ketamine and diazepam during and after surgery. Postoperative complications included acute myocardial infarction in 1, multiple gastric ulcer in 1, and decubitus in 1. None died within 3 months after TURP, 3 died there after, and 10 patients were alive at the mean follow-up period of 26 months. Six patients reported good urination, 3 reported some improvement in urination after surgery, although requiring intermittent catheterization and 1 developed mild incontinence. In conclusion, TURP appears to provide some benefit in selected patients with dementia and should not be considered to be a contraindication for such patients.

Aged↗
PubMed1998

[Endoscopic treatment for urethral stricture and obstruction in pediatric patients. Report of three cases].

Endoscopic surgery has been performed widely for treatment of urethral strictures in adults. However, recent advances in endoscope techniques also allow us to practice endoscopic surgery in pediatric patients. We recently performed endoscopic urethrotomy successfully for the treatment of urethral strictures caused by inflammatory polyp and gonococcal urethritis in a 6-year-old and 12-year-old boy, respectively, and urethral complete interruption after pelvis injury in a 14-year-old boy. We recommend a small caliber endoscope for pediatric urethral strictures and obstructions for endoscopic urethrotomy, which is a safe and effective procedure.

Adolescent↗
PubMed1997

New 3-dimensional mapping device for cystoscopy.

PURPOSE: The crucial shortcoming of cystoscopy is that it does not measure the size of observed objects, and so we developed a new device that adds measurement capability to the cystoscope. MATERIALS AND METHODS: The device consists of 5 arms linked to each other by freely bending joints. Before use 1 end of the arm is fixed to the examination table and the other end is linked to the eyepiece of the cystoscope. While linked to the arms, the cystoscope can move freely in any direction. Each joint carries an accurate sensor to measure its angle. The angle measurements are calculated collectively to obtain the 3-dimensional coordinates at the tip of the cystoscope. The tip of the cystoscope can be moved to the other side of the objects to be measured, which provides a pair of 3-dimensional coordinates, because the distance between them can be calculated. RESULTS: We could calculate the distance between the bladder neck and each ureteral orifice, and the angle of the bladder neck formed with the left and right orifices in clinical cases. By continuous measurement of the location of the bladder neck and the ureteral orifice, it was clearly demonstrated that the distance between them increased as the bladder filled. CONCLUSIONS: Our computer assisted, 3-dimensional mapping device can replace unreliable cystoscopic assessment with more reliable numerical values. New diagnostic criteria based on the exact numerical values can be established with the use of this device.

Cystoscopes↗
PubMed1995

[Double uterus and double vagina with unilateral imperforate vagina associated with ipsilateral renal agenesis: an infant case report].

Duplicated uterus associated with unilateral imperforate vagina and ipsilateral renal agenesis is a very rare anomaly. We report a case of a 10-month-old female infant presenting with pus discharge from vagina, and discussed the embryologic and clinical features relevant to this interesting disease complex with a review of the past literature. Echographic and CT examinations demonstrated a right-sided cystic pelvic mass. IVP revealed a left slight hydronephrosis and non-visualizing right kidney. No right ureteral orifice was found at cystoscopy. Under anesthesia the mass and pus was aspirated. Under the diagnosis of Gartner's cystic duct and a right renal agenesis or dysplasia with or without ectopic ureter, we subsequently performed laparotomy. Surgical exploration revealed a duplicated uterus with a normal ovary, and the mass was an imperforate right-sided vagina which communicated through the uterus. The diagnosis was changed to a double uterus with right-sided imperforate vagina, then the vaginal septum was excised. The post-operative course was uneventful, and pus discharge and the left hydronephrosis have disappeared.

Female↗
PubMed1994

Treatment of advanced renal cell carcinoma using regional arterial administration of lymphokine-activated killer cells in combination with low doses of rIL-2.

We investigated the usefullness and problems of arterial administration of lymphokine activated killer (LAK) cells in combination with systemic IL-2 in the treatment of metastatic renal cell carcinoma (RCC). Ten nephrectomized patients with extrapulmonary and/or nonresectable metastases were treated with arterial infusions of LAK cells and systemic rIL-2 (5 x 10(5) IU twice a day) for 1-12 weeks. Leukapheresis was carried out once or twice a week, and two LAK cell populations generated from two gravity subtypes of peripheral blood lymphocytes were administered separately. Five of 15 metastases treated showed appreciable regression of metastatic sites including bone, muscle and lymph nodes. Two of 15 showed a minor response. Local pain due to metastasis was relieved or disappeared in 6 patients. There was no correlation between the response of the patients and the number of LAK cells used. The 24- and 56-month survival rate was 50 and 25%, respectively. No serious side effects were experienced during treatment. We conclude that regional arterial administration of LAK cells in combination with a low dose of IL-2 is worthwhile as an alternative treatment modality to conventional therapy for a selected group of patients with advanced RCC.

Adult↗
PubMed1994

[Scrotal calcification associated with hydrocele testis in a child: a case report].

Scrotal calcification is a rare complication of childhood hydrocele testis. Herein, a 12-year-old boy who suffered from left hydrocele testis with intrascrotal calcification is reported. The boy had experienced scrotal pain about 6 months prior to the first visit to our hospital, and gradually noted scrotal swelling. Physical examination revealed left scrotal enlargement with transillumination. Sonographic examination revealed a left hydrocele testis, and a 1.5 cm discrete focus of calcification was found immediate cranio-lateral to the left testis, contour, size and consistency of which were palpated normally. In left hydrocelectomy, no appendix epididymidis was found. A smooth, white, spherical, firm body connecting to the head of the epididymidis was removed. A microscopic examination revealed multiple layers of collagenous tissue with the necrotic tissue in the core. We concluded that this case presented with hydrocele testis secondary to a growing calcification reacting to the infarction due to the repeated torsion of the appendix epididymidis.

Calcinosis↗
PubMed1991

[A case report of eosinophilic cystitis complicated with transient vesicoureteral reflux].

A case of eosinophilic cystitis complicated with transient vesicoureteral reflux in an 11-year-old girl with allergic disorders is reported. She was suffering from pollakisuria, painful urination, vesical irritability, and gross hematuria for about 2 months. Urinalysis showed aseptic pyuria. White blood cell count was 9,700/mm3 with eosinophils of 10%. Eosinophils were also found on urine cytology. Intravenous pyelography revealed bilateral hydronephrosis and apparently contracted bladder. Tumorous lesion and edematous mucosa were observed in the retrotrigonal region on cystoscopy. The multiple bladder biopsy uniformly revealed eosinophilic cystitis. Following antiallergic treatment, practically all symptoms subsided in steps, and normal cystoscopic appearance and histological structure were restored in 3 months. The vesicoureteral reflux markedly diminished in 10 months.

Asthma↗