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Biomedical subjects

M Koroku

Publications and source records attributed to M Koroku.

At least 19 recordsLinked to original sources

A stone developed within the dilated intravesical ureter following ureteroscopy.

A 58-year-old man presented with a stone within the dilated intravesical ureter, which was probably attributable to a previous ureteroscopy. Transurethral incision of the right intravesical ureter and lithotripsy were carried out without subsequent urinary tract impairment. Although some complications resulting from ureteroscopy, such as ureteral stricture, ureteral perforation and vesicoureteral reflux, have been reported, this complication is considered to be very rare.

Humans↗

[Availability of NMP22 (nuclear matrix protein 22) for the diagnosis of urothelial cancer].

We evaluated the availability of NMP22 for the diagnosis of urothelial cancer. Of 154 patients with gross hematuria or microscopic hematuria, 14 patients with bladder cancer and 4 patients with upper urothelial cancer were detected. Of 73 patients continued to be followed for urothelial cancers, 11 patients with bladder cancer were detected. NMP22 was not available when a large number of RBC was present in urine. Also, NMP22 was significantly higher in patients with urothelial cancers. Interpretation of the ROC curve indicated an optimal cutoff value of 9.2 u/ml. Using 9.2 u/ml as a cutoff, the sensitivity and specificity were, respectively 87.0% and 64.0% in patients with hematuria, and 81.8% and 78.7% in patients with a history of TCC. This indicated that when NMP22 was used for the diagnosis of urothelial cancers, 12.0 u/ml, the value recommended as a cutoff in Japan, might be too high to differentiate patients with urothelial cancers.

Biomarkers, Tumor↗

[Small cell carcinoma of the urinary bladder: a case report].

We report a case of small cell carcinoma of the urinary bladder. A 60-year-old man with microscopic hematuria was referred to our hospital. Cystoscopy revealed a sessile tumor on the left lateral wall of the urinary bladder. The patient underwent transurethral resection of the bladder tumor (TUR-Bt). Because of muscle invasion (pT2), total cystectomy was recommended, but was not performed because the patient would not give consent for the operation. Six months after TUR-Bt, invasive bladder tumor recurred and total cystectomy was performed. Pathological examination of the operative specimen revealed small cell carcinoma. Adjuvant combined therapy of irradiation and chemotherapy (nedaplatin and etoposide) was ineffective. Metastases to retroperitoneal lymph nodes, lung and liver were detected soon after the adjuvant therapy. The patient died 15 months after his first visit to our hospital.

Carcinoma, Small Cell↗

[Silicate calculi: report of two cases].

Two patients, aged 53 and 55, discharged stones spontaneously. Infrared spectrophotometry of the stones demonstrated silicate. They had no history of taking magnesium silicate. Thirty cases of silicate calculi previously reported in the Japanese literature are reviewed.

Aged↗

[A case of transitional cell carcinoma of the bladder in a juvenile patient].

A case of transitional cell carcinoma of the bladder in a 18-year-old female is presented. Cystoscopic examination revealed a papillary tumor on the left lateral wall. Histopathology of the excised tumor showed transitional cell carcinoma, G1 > 2, pT1a. Recurrence has not been observed for about 1 year, after intravesical pirarubicin therapy.

Administration, Intravesical↗

[Clinical statistics at the urological clinic of Sanjukai Hospital--statistics on new outpatients over the last five years].

We herein report the clinical statistics on new outpatients over five years from 1994 at our hospital. The average number of new outpatients per year was 8,534.4 (8,366-8,658) and there was only a slight variation in the number over the last five years. The male to female ratio was 1.61:1. Twenty-one percent of the outpatients were referred to us by other sources. The representative operations on outpatients were circumcision, vasectomy, resection of condylomas and resection of caruncles. A statistical study was made on new outpatients according to the international classification of disease. There were 197.0 (2.3%) malignant urogenital tumors per year. There was a tendency for sexually transmitted diseases to increase over the last five years. In males, the major diseases were upper urinary tract stones (23-27%), benign prostatic hypertrophy (19-26%) and prostatitis (15-24%). In females, they were cystitis (57-59%), upper urinary tract stones (17-18%) and neurogenic bladder (3-4%). We conclude that our hospital plays a major role as a private urological hospital.

Adult↗

[Fibroepithelial polyp of the renal pelvis. A case report].

Benign tumors of the renal pelvis are relatively rare, and only a few reports have been published so far. Recently we experienced a case of a 50-year-old woman with a fibroepithelial polyp in the left pelvis. Drip infusion pyelography and abdominal CT revealed a filling defect and tiny renal stones in the left pelvis under the study of her urinary blood occult. A transitional cell carcinoma of the renal pelvis was suspected, so a left total nephroureterectomy was done. The pathological diagnosis of this tumor was fibroepithelial polyp. As it is said that preoperative diagnosis of such a polyp is difficult, preoperative ureteroscopy or perioperative pathological diagnosis by frozen sections should be attempted. But it is difficult to avoid a nephroureterectomy because low incidence of the disease.

Female↗

Primary retroperitoneal teratoma in an adult: a case report.

A primary retroperitoneal teratoma is a relatively rare neoplasm in adults. We report 1 such case evaluated by CT and MRI scans. The preoperative MRI was important in that it delineated the precise position of the tumor relative to the surrounding organs.

Adult↗

Lobar dysmorphism of the kidney.

We report a case of a 38-year-old woman with lobar dysmorphism of the kidney. Lobar dysmorphism is a pathology classified under renal pseudotumor, which has received little attention. It is presumed that these cases will increase in number with advances in imaging diagnosis. Dynamic CT scan is useful for the diagnosis of this disease.

Adult↗

A case of Gartner's duct cyst with a right aplastic kidney.

We report a case of a Gartner's duct cyst with a right aplastic kidney. This was discovered when the right kidney was not identified in an examination for epigastric pain. CT and MRI proved useful in the diagnosis. An MRI showed a tubular structure ascending from the cyst and a complication of a bicornate uterus. As the patient was asymptomatic, the patient was followed without treatment.

Child↗

[A study on the role of Chlamydia trachomatis in chronic prostatitis--analysis of anti-Chlamydia trachomatis specific IgA in expressed prostate secretion by western-blotting method].

Opinion among researchers is divided as to whether Chlamydia trachomatis is the causative organism of chronic prostatitis. In this study, using enzyme immuno assay, we examined the positive rate of anti-C. trachomatis IgA according to the leukocyte count in expressed prostate secretion (EPS), in a total of 169 patients including 92 patients who showed chronic prostatitis-like symptoms. And we confirmed, by western-blotting, the presence or absence of anti-heat shock protein (HSP: 60 KDa) IgA in EPS, and we investigated the role of C. trachomatis in chronic prostatitis. The total positive rate of anti-C. trachomatis IgA in EPS was 26.0% (44/169). According to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 29.0% (20/69), for the group with 5-9 WBC/hpf was 37.9% (11/29), for the group with less than 5 WBC/hpf was 18.3% (13/71). Accordingly the positive rate of anti-C. trachomatis IgA in EPS was not higher in direct correlation to the severity of the inflammation at the infected site (p = 0.09). But the positive rate for the group with more than 5 WBC/hpf was higher than for the group with less than 5 WBC/hpf. On the other hand, the total positive rate of anti-HSP IgA in EPS was 17.6% (6/34), and according to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 38.5% (5/13), for the group with 5-9 WBC/hpf was 0% (0/12). Accordingly the positive rate of anti-HSP IgA in EPS was higher in direct correlation to the severity of the inflammation at the infected site (p = 0.13). From this results, it was suggested that C. trachomatis was concerned with 29.0% (20/69) of chronic prostatitis with more than 10 WBC/hpf, and also C. trachomatis is the causative organism of chronic prostatis.

Antibody Specificity↗

[Investigation of Chlamydia trachomatis-specific IgA, IgG antibody with EIA method].

Recently, two new kits, HITAZYME (Hitachi Chemical Co., Ltd.) and SERO IPALISA (Savyon Diagnostics, Ltd.), for the assay of anti-C. trachomatis antibodies by the enzyme immunoassay (EIA) method have been developed and put into clinical application. In the study reported here, the authors investigated the clinical usefulness of these assay kits, together with the IPAzyme and micro-IF test, in the diagnosis of cases of urogenital tract C. trachomatis infections. 1. The positive rates for IgA antibodies, which are considered to be an indicator of active infection, obtained with the HITAZYME and SERO IPALISA kits in the 82 antigen-positive cases were significantly (p < 0.005) higher than the rates obtained with the IPAzyme and micro-IF test. These results showed the usefulness of the HITAZYME and SERO IPALISA kits for detecting C. trachomatis infections. 2. A comparison was made of the assay results obtained with the HITAZYME and SERO IPALISA kits, and it was found that there was a large number of cases (142) that tested negative for IgA antibodies with the HITAZYME but positive with the SERO IPALISA kit. We carried out a confirmatory test on the specimens of cases for which the results obtained with the HITAZYME and SERO IPALISA kits were not in agreement. This test employed the Western blotting method using COMC (the antigen extracted from EB of C. trachomatis strain L2 and used in the HITAZYME kit) and whole EB of C. trachomatis strain L2 (the antigen used in the SERO IPALISA kit). The results showed a significantly higher degree of agreement between the HITAZYME kit data and the Western blotting data than between the SERO IPALISA kit data and the Western blotting data. 3. In addition, with the objective of investigating the existence of cross reactivity with anti-C. pneumoniae antibodies, we performed Western blotting using as the antigen crude whole EB of C. pneumoniae strain TW-183. The results showed that anti-C. pneumoniae antibodies were detected in 25 of 35 (71.4%) cases that were negative with C. trachomatis antigen and the HITAZYME kit and positive with the SERO IPALISA kit. These findings indicate a strong possibility that these cases positive with the SERO IPALISA kit are due to a cross reaction with anti-C. pneumoniae antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Bacterial↗

[Changes in the voiding condition with aging in elderly males--results of a field survey for prostatic diseases].

We investigated changes in the voiding condition with aging in 1476 males 50 years and older, who participated in a field survey for prostatic diseases conducted from 1982 to 1991 in Hokkaido. Voiding conditions were evaluated subjectively with a symptom index (weak stream, intermittency, nocturia, urge incontinence), and objectively with maximum flow rate. Digital rectal examination (DRE) revealed 10.3% (572 participants) of total evaluable participants to have moderate or marked enlargement of the prostate. The incidence of enlargement of the prostate apparently increased with aging. Subjective urinary symptoms, both obstructive and irritative, increased in the incidence and degree with aging. The maximum flow rate and maximum flow rate-nomogram also became worse with aging the incidences participants having urinary symptoms or decreased maximum flow rate increased in parallel with the size of the prostate on DRE. For each size of the prostate on DRE, the incidence of participants having urinary symptoms increased with aging. The maximum flow rate showed a similar tendency, decreasing with aging, irrespective of the size of the prostate. These results indicate that aging as well as the size of the prostate may affect the voiding condition in males aged 50 years and older.

Aged↗

[Clinical study on female patients with bladder irritability--comparison between cystitis and urethral syndrome].

We analysed the clinical background of female who had no underlying disease but consulted out urology outpatient clinic with a chief complaint of symptoms of bladder irritation. Overally, 50.1% (102/200 cases) of the cases had urethral syndrome, without pyria or bacteriuria. Plotting of the age distribution of the urethral syndrome cases showed a bell-shaped curve, with the peak at the 40-49 year-old age bracket. The age distribution for the cystitis cases showed two peaks: at 20-29 years of age and 60-69 years of age. These results indicate that the cases of urethral syndrome involve multiple factors with increasing age. Examination of the external genitalia revealed the urethral smear specimens to be positive for leukocytes in 48.9% (88/180 cases) of the total urethral syndrome cases and in 72.7% (16/22 cases) of the urethral syndrome cases positive for urethral bacteria. Accordingly, it was surmised that there is considered to be a precursor of cystitis-as a cause of urethral syndrome cases. In addition, the rates of detection of chlamydia trachomatis from the vagina and urethra of the urethral syndrome cases in the reproductive age range of (2/34 cases) for the urethra. However, these rates were about the same as those determined for healthy volunteers. Nevertheless, it was surmised that urethritis or vaginitis caused by C. trachomatis was one of the causes of the symptoms of bladder irritation in some of the cases. Accordingly, it was concluded that infection due to C. trachomatis cannot be ignored as a possible cause of urethral syndrome.

Adult↗

Pyogenic psoas muscle abscess: report of three cases.

We report three cases of primary psoas muscle abscess. Two of these cases were treated by open drainage through a lumbar incision and the other was by ultrasonography (USG)-guided percutaneous aspiration of the abscess. Antibiotic therapy was also instituted in all cases. Post-operatively, the patients recovered well with no sign of recurrence. USG-guided percutaneous drainage combined with appropriate antibiotic therapy appears to be the first choice procedure for treatment of the primary psoas abscess if correct diagnosis is promptly made and the procedure can be performed.

Adult↗

Leydig cell tumor: a case report with reference to its endocrinological features.

We reported an adult case of Leydig cell tumor, which demonstrated an increase of serum estradiol (E2) and suppression of serum testosterone (T) before orchiectomy. The direct inhibitory action of the elevated E2 on the enzymes involved in steroidogenesis and the negative feedback action on luteinizing hormone (LH) secretion of the E2 possibly caused the suppression of serum T. A human chorionic gonadotropin test before the operation revealed the elevation of T and E2, although the response was poor compared with that in normal subjects. However, the postoperative test showed no elevation of these hormones. This result may indicate that the Leydig cell tumor preserves a response to LH stimulation.

Chorionic Gonadotropin↗

[Epidemiological and bacteriological study on gonococcal infections].

Epidemiological and bacteriological studies on Neisseria gonorrhoeae isolated in Sapporo, Japan, in 1980 and 1991 performed and the following results were obtained. 1. The range of age in the patients infected with Neisseria gonorrhoeae tended to be younger than those in the whole country. 2. Male patients in the early 20s or younger with gonococcal urethritis were often infected by bon-professional females but those in their late 20s or older were often infected from professional females, for example prostitutes and hostesses. 3. The rate of professional females who were positive to gonococci reached 17.4% and young females in their teens with cervicitis had the highest morbidity rate of gonococci than those in the older females. 4. The latent period in gonococcal infections tended to become longer gradually. 5. The isolation rate of penicillinase producing Neisseria gonorrhoeae (PPNG) showed a peak of 23.9% (61/255) in 1985, but gradually declined thereafter and it was 3.7% (1/27) in 1991. 6. An investigation on auxotype showed a decline of proto and Pro-strains and an increase of AHU-strains in non-PPNG. And most of the PPNG belonged to proto or Pro-strains. 7. With the relationship between auxotype and sensitivity to AMPC, AHU-strains were more sensitive than proto or Pro-strains.

Adolescent↗

[Methicillin-resistant Staphylococcus aureus (MRSA) infection in urological field--clinical backgrounds and clinical course].

The Staphylococcus aureus in this study were isolated from 33 outpatients and 38 inpatients of the Department of Urology from August 1989 to April 1991. Twenty one patients (29.5%), three outpatients, had the MRSA type. Significant correlations were found between the incidence of MRSA infection and such factors as diabetes mellitus and the isolation of MRSA within 7 days of the administration of antibiotic agents. Out of 14 MRSA which were investigated for coagulase type, 9 were type VII. This indicates an outbreak of MRSA in the urological ward. Seven cases of MRSA and 5 cases of MRSA had high grade fever (over 38 degrees C), but all patients experienced much relief by using susceptible antibiotic agents. Our study shows that the isolation frequency of MRSA has increased in urological field. Therefore, we think it is important to treat patients with MRSA infection adequately, especially when there are compromised hosts in the same room.

Adult↗