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Biomedical subjects

R Shoda

Publications and source records attributed to R Shoda.

34 records · Page 2Linked to original sources
PubMed1988

Plasma famotidine concentration versus intragastric pH in patients with upper gastrointestinal bleeding and in healthy subjects.

To study the concentration-response relationship of famotidine, we serially monitored intragastric pH and measured plasma drug concentrations simultaneously after an intravenous injection of this H2-receptor antagonist (0.1 mg/kg) in eight patients with upper gastrointestinal bleeding and in six healthy subjects. By applying the sigmoidal Emax model the mean (+/- SD) plasma famotidine concentrations associated with an intragastric pH of 4.0 in patients and healthy subjects were estimated to be 17.7 +/- 10.7 and 24.8 +/- 10.3 ng/ml, respectively (not significantly different). No significant differences were observed in the mean pharmacokinetic parameters between the two study groups. Multiple regression analysis revealed that not only a pharmacokinetic factor (i.e., elimination t1/2) but also a pharmacodynamic (or sensitivity) factor (i.e., a drug concentration associated with an intragastric pH of 4.0) contributed significantly (p less than 0.01) to the overall variability in the duration of antisecretory effect in our study subjects, with standardized partial regression coefficients of 0.54 and -0.63, respectively. Based on these data, we predict that around-the-clock control of a fasting intragastric pH above 4.0 can be attained by a continuous infusion of famotidine at rates ranging from 6 to 25 mg/day (mean +/- SD, 11 +/- 7 mg/day) in a 70 kg patient whose pharmacokinetic and pharmacodynamic characteristics are similar to those of our patients.

Adult↗
PubMed1987

[A new treatment of simple renal cyst: percutaneous instillation of minocycline hydrochloride into simple renal cyst].

Minocycline hydrochloride was percutaneously instilled into simple renal cysts to prevent recurrence of renal cysts after the puncture and aspiration of cystic fluid. Fifty-six simple renal cysts in 51 patients were punctured with an 18-gauge needle under ultrasonographic guidance, and the cystic fluid was aspirated under fluoroscopic control. A single 100 mg or 200 mg dose of minocycline hydrochloride dissolved in 5 ml of distilled water was instilled through the needle into the renal cyst. The patients were followed up by computed tomographic (CT) scan and ultrasonography 1, 3, 6 and 12 months after the treatment. Efficacy was evaluated after 3 months or longer. Of 20 renal cysts instilled with 100 mg of minocycline, efficacy was excellent in 10, good in 6 and poor in 4. Of 22 renal cysts instilled with 200 mg of minocycline, efficacy was excellent in 10, good in 9 and poor in 3. No significant difference was noted between the efficacy rate of 100 mg and 200 mg treatments. Complications attributable to treatment were observed in 15 patients: moderate pain in one, slight pain in 6, slight fever in 8 and slight hematuria in one. Neither severe adverse reactions nor infections were observed in any of the patients. These results suggest that the percutaneous instillation of minocycline into simple renal cysts is a new, simple, safe and effective treatment to prevent recurrence of the cyst and additionally to prevent infection following the puncture.

Administration, Cutaneous↗
PubMed1986

[Three cases of primary aldosteronism including one case with postoperative ventricular tachycardia].

Three patients with primary aldosteronism were treated surgically between February and September 1984. All patients had suffered from hypertension with U waves in ECG and laboratory examinations revealed hypokalemia, hyperaldosteronemia and suppressed plasma renin activity. The localization of the adrenal tumor was diagnosed accurately in all 3 patients by adrenal vein sampling and in 2 of the patients by PRP, CT scan, adrenal scanning with 131I-iodo cholesterol and adrenal venography. Adrenal tumors were surgically removed by unilateral adrenalectomy through the flank approach in all cases. Histological examinations of removed specimens showed adrenocortical adenoma. Removal of the adenoma caused a prompt reversal of the laboratory serum abnormalities and hypertension was normalized within 2 weeks postoperatively in all cases. Severe ventricular tachycardia (Torsades de Pointes) was observed suddenly in one of the patients after about 5 hours postoperatively. Therapy including conventional antiarrhythmic drugs, such as lidocaine or procainamide, and potassium administration failed to prevent the arrhythmia. Ventricular tachycardia was successfully treated and disappeared with the use of magnesium sulfate (MgSO4) intravenously. The serum potassium concentration was normal during the episode and the serum magnesium concentration, which was not detected before or just after the operation, was under the limit of normal range (1.4 mEq/l) after the use of magnesium sulfate. Hypomagnesemia which is retrospectively thought to be the result of primary aldosteronism may be responsible for the episode of postoperative ventricular tachycardia.

Adenoma↗
PubMed1985

Pharmacokinetics of ceftazidime in patients with renal insufficiency and in those undergoing hemodialysis.

The pharmacokinetics of ceftazidime, a new cephalosporin antibiotic, were studied in 7 healthy volunteers and 32 patients with renal insufficiency after a single 500-mg intravenous injection. The mean plasma half-life during beta-phase was 1.67 h in normal subjects and was prolonged to 15.09 h in hemodialysis patients. There were significant correlations between the elimination rate constant and the creatinine clearance, and between the beta-phase rate constant and the creatinine clearance. The mean urinary recovery during 24 h amounted to 89.6% of the dose in normal subjects and decreased with the lowering of renal function. The plasma levels during hemodialysis were lower than those between hemodialyses.

Adult↗
PubMed1985

[A case of bilateral ureteral triplication].

Ureteral triplication is a rare congenital anomaly of the urinary tract, although ureteral duplication is rather common. Bilateral ureteral triplications are even rare anomalies. A five-year-old girl with a history of urinary tract infection and episodes of fever and lower abdominal pain was admitted to our hospital for further examination of microscopic hematuria. An excretory urogram (IVP) revealed bilateral 3 pelves and ureters, and cystoscopic examination showed 2 ureteral orifices on each side. Both sides of bilateral ureteral triplications in our case belonged to type B of Smith's classification. Ureteral triplication was first reported by Wraný in 1870. Since then 84 cases have been reported and among them 3 cases had bilateral ureteral triplications. In this article, the classification and the development of ureteral triplication are reviewed briefly.

Child, Preschool↗
PubMed1985

[A case of retroperitoneal neurinoma].

Retroperitoneal neurinoma is a rare disease, although retroperitoneal tumor is rather common. A 40-year-old man without any clinical symptoms was admitted to our hospital for a medical examination. Ultrasonogram demonstrated a cystic mass over the right kidney. This cystic mass was suggested to be a right adrenal tumor by CT scan and angiogram. All of the laboratory data including endocrinological data were within the normal limits. Under the diagnosis of right non-functioning adrenal tumor, an operation was performed through a right lumbal incision. A round and tennis ball sized tumor with a fibrous capsule was identified and freed from the right kidney and the right adrenal gland, and the tumor was extirpated uneventfully. The surgical specimen was 9.5 X 8.0 X 6.5 cm in size, 260 g in weight, and the histological diagnosis was neurinoma (Antoni-B type).

Adult↗
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

[Computerized tomographic demonstration of a nontraumatic renal subcapsular hematoma].

Nontraumatic renal subcapsular hematoma is an uncommon but not rare clinical entity. If a small renal cell carcinoma is the cause of the hematoma, the carcinoma can hardly be diagnosed on the basis of conventional roentgenographic findings. Computerized tomography provides a noninvasive means of visualizing the hematoma and renal tumor, and of understanding their extent, location and relationship to renal parenchyma. A 42-year-old female, whose complaint was right abdominal pain and vomiting, was admitted to our hospital and a right renal subcapsular hematoma was demonstrated by computerized tomography. She was in good general condition, and renal malignant tumor was not demonstrated by computerized tomography, conventional roentgenographic examinations or ultrasonography. Her clinical course was not eventful . A brief review of clinical diagnosis and management of this disease are made.

Adult↗
PubMed1983

[Renal tuberculosis with a contralateral renal adenocarcinoma: a case report].

A 62-year-old man, who complained of gross hematuria, was admitted because of a space occupying lesion of the right kidney and left non-visualizing kidney on IVP. The right pyelogram was compressed laterally, and the left pyelogram showed a moth-eaten appearance of the middle and lower calyces which was consistent with tuberculosis. Abdominal aortography revealed a hyperneovascularization over the middle and upper portions of the right kidney. CT-scan revealed a low density area of the right kidney and left atrophic kidney. No distant metastases were disclosed by bone scanning, liver scanning, lymphangiographic and chest X-ray studies. Bilateral nephrectomy was performed because the right renal tumor occupied the main renal artery. Hemodialysis was started on the next day. Postoperative course was uneventful. Histological examinations of the surgical specimen revealed a right renal adenocarcinoma and left renal tuberculosis. We discuss the pathogenesis and treatment of the combination of renal tuberculosis and malignant tumor.

Adenocarcinoma↗
PubMed1983

[Spontaneous rupture of the renal pelvis: a case report].

A 63-year-old man who had undergone gastric resection for gastric carcinoma in June 1981, had a dull pain in the right flank and nausea on June 2, 1982. Excretory urograms showed spontaneous rupture of the right pelvis. Metastasis or invasion of the gastric carcinoma to the right ureter was suspected. On June 9, 1982, percutaneous nephrostomy guided by ultrasound was performed. After the nephrostomy, antegrade pyelogram revealed no extravasation of the contrast medium.

Humans↗