Biomedical subjects
Publications and source records attributed to S Minakata.
[reaction: see text] Five- to seven-membered lactones were prepared from omega-hydroxyalkyl iodides and CO by atom transfer carbonylation without the need for transition metal catalysts. The reaction proceeds via a hybrid radical/ionic mechanism in which the intramolecular alcoholysis of an omega-hydroxyacyl iodide, arising from atom transfer carbonylation, leads to the lactone.
The concentration of urinary ionic calcium was estimated using an ion-selective electrode and ion analyzer for healthy controls and patients with calcium urolithiasis. The following results were obtained: 1) After calculating the ionic strength and calibrating the standard solutions of ionic calcium in each urine, the urinary ionic calcium was estimated using an ion-selective electrode and ion analyzer. The reproducibility and accuracy of the value of urinary ionic calcium were satisfactory. 2) There was a significant correlation between the concentration of urinary ionic calcium and the total calcium excretion. Although the percentage of ionic calcium did not show any correlations among the total calcium, oxalate and urinary pH, it had an inverse relation to urinary citrate and phosphate. 3) In calcium stone formers, the excretion of ionic calcium was higher than in healthy controls significantly. 4) In hypercalciuric calcium stone formers, the concentrations and excretions of total and ionic calcium were significantly higher than in normocalciuric calcium stone formers. However, the percentage of ionic calcium was not different. 5) When the patients were treated with citrate orally, the excretion of urinary citrate was increased, and the excretion of ionic calcium and the percentage for total calcium were decreased significantly. There were significant reductions of ionic calcium in the urine after oral administration of rice-bran. 6) The estimation of urinary ionic calcium might be important to evaluate the urinary risk in recurrent calcium stone, and to estimate the effects of the preventive treatments for its recurrence.
We report two successfully treated cases of ureteral endometriosis. Case 1 is in a 47-year-old female who had a past history of simple hysterectomy and right oophorectomy. Pathological diagnosis was myoma uteri and pelvic endometriosis. Two months later, she visited our clinic for right flank pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. The diagnosis of ureteral endometriosis was made from the past history and clinical features. Danazol therapy started with a daily dose of 400 mg. Sixteen days later, excretory urogram demonstrated complete resolution of the right hydronephrosis. An intravenous pyelography about 1 year after the danazol therapy has indicated no recurrence. Case 2 is in a 35-year-old female who visited our clinic for right lumbar pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. Right ureterocystoneostomy was performed unsuccessfully resulting in endoscopic dilation. Right lower ureter was buried in the dense fibrous tissue approximately 5 cm below the crossing with iliac vessels. The area of obstruction was removed. Histologically, endometriosis was diagnosed. Twenty nine cases of ureteral endometriosis including our two cases were collected from the Japanese literatures and reviewed with respect to the clinical features and treatment.
Explore the source record for details and available documents.
A streptococcal preparation, OK432 was evaluated as the adjuvant immunotherapeutic agent for superficial bladder tumors. Twenty-nine cases were treated with complete transurethral resection and then randomized prospectively into two groups. One group had adjuvant therapy of OK432 intradermal administration and another group had no adjuvant therapy. OK432 administration significantly reduced the recurrence rates as compared to the control group. Although further studies were required for its full significance, in a short-term study, OK432 intradermal administration produced a beneficial effect in reducing the recurrence rates.
Since 1983, eight cases of adrenal incidentaloma were experienced at the Department of Urology, Wakayama Medical College and affiliated hospitals. Six adrenal masses were incidentally detected by computed tomography, and two were first noted by either ultrasonography or intravenous pyelography. Surgical exploration was performed in all cases as the final diagnostic measure. Of them, three had adrenocortical adenomas, three had adrenal cysts, one had adrenal metastasis and one had pheochromocytoma. Preoperative evaluation revealed that all patients except one with pheochromocytoma had no endocrinological abnormality. The management of the adrenal incidentaloma, which will be discovered more frequently accompanied with the increasing use of computed tomography, was discussed with special references to its precise indication of surgical treatment.
Twenty-three cases of primary hyperparathyroidism were experienced at Wakayama Medical College Hospital and affiliated hospitals between January, 1969 and December 1985. Histopathological findings were adenoma in 22 cases, hyperplasia in 1 case. On the clinical diagnosis of this disease, the most sensitive laboratory test was serum calcium level, which was elevated in 21 patients (91%), and in 87.8% of all samples measured. Serum ionized calcium and phosphorus were also sensitive measures. The positive rate of serum PTH was 67% in 18 cases. Tl-chloride scintigraphy identified preoperatively the site of the adenomas in 8 out of 10 cases, and computed tomography in 10 out of 15 cases. Both methods are non-invasive, and are beneficial for the preoperative examination of the localization of parathyroid adenoma. After parathyroidectomy, serum calcium and ionized calcium levels recovered rapidly within the normal limit in 12 hours. On the other hand, serum phosphorus level increased gradually up to the normal limit in about 1 week.
The diurnal variations of urine composition with respect to urinary pH, volume, creatinine, calcium, magnesium, phosphate, uric acid, citrate and oxalate were studied in five healthy men. Generally, there was considerable variations in the excretion of the different urine constituents with meal related peaks except phosphate, which was most pronounced after dinner. The analysis of a 24-hour urine collection cannot account fully for the crystallization properties of urine and a fractionated urinalysis might be of value for therapeutic decisions. However, such procedures probably will not be possible in clinical practice and more reliable methods for evaluation of the crystallization propensity in whole 24-hour urine have to be developed.
Herein we report our experience of percutaneous nephro-ureterolithotomy on 18 renal or upper ureteral calculous patients between December, 1984 and May, 1985. Using an ultrasonic lithotrite and a nephroscope especially developed for the percutaneous disintegration and removal of upper urinary stones via a nephrostomy, 15 of the patients were successfully treated without open surgery.
Urinary excretions of calcium, oxalate and uric acid were estimated in 160 stone-formers (male 118, female 42) and 257 healthy controls (male 207, female 50). Stone-formers were divided into two groups according to their stone analysis: calcium containing stone-formers and non-calcium stone-formers. Calcium stone-formers were divided again into those who had a single stone episode and multiple or recurrent stone episodes. Urinary calcium and oxalate showed significant increases in calcium stone-formers, while urinary uric acid increased only in male calcium stone-formers. Recurrent calcium stone-formers demonstrated significant high levels of urinary calcium excretion especially in males, whereas no difference of urinary oxalate excretion between recurrent and single stone-formers. The frequency distributions on the excretion of three subjects were estimated respectively in patients with calcium stone and in controls. Relative risks, risk curves and stone probabilities were proposed and compared. The higher excretion values of urinary calcium and oxalate closely related to higher risks of forming calcium stones. On the other hand, urinary uric acid did not have such a relation to calcium stone formation. We defined the states which urinary excretions exceeded 95% upper confidence limits of normal controls as hyperexcretions. Hypercalciuria was more than 200 mg/day in male and female, hyperoxaluria was 50 mg/day in male and 45 mg/day in female and hyperuricosuria was 850 mg/day in male and 650 mg/day in female according to our definition. Among male calcium stone-formers, hypercalciuria was found in 45.3%, hyperoxaluria in 26.4% and hyperuricosuria in 15.1%. While in female calcium stone-formers, hypercalciuria in 23.7%, hyperoxaluria in 26.3% and hyperuricosuria in 13.2%. Of the male calcium stone-formers 57.5% showed either or both hypercalciuria and hyperoxaluria, and recurrent stone-formers also demonstrated a higher incidence among them. Excretion products of urinary calcium and oxalate were calculated and compared in each group. Calcium stone-formers showed significant high values especially in male recurrent stone-formers. The estimation by combining some risk factors will provide more useful means of assessing severity of urinary calculous diseases and therapeutic effects of their various treatments.
Explore the source record for details and available documents.
A case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ectopic ureter opening into seminal vesicle was experienced recently in our clinic. The case was a 14-year-old boy with the chief complaint of macrohematuria. Left kidney was not visualized in the excretory urogram and no evidence of left renal artery was seen in the abdominal aortogram. On cystoscopy the left ureteral orifice as well as the left half side of the trigone were not detected and this region appeared elevated, suggesting an extrinsic mass displacing the posterior bladder wall. The right ureteral orifice was normal. CT-scan and echogram showed the mass in the retrovesical region. The seminal vesiculogram demonstrated a seminal vesicle cyst and reflux up the left dilated ureter. After left nephroureterovesiculectomy was performed, renal dysplasia and a seminal vesicle cyst were histopathologically confirmed. The definitions in the literature for seminal vesicle cyst with maldeveloped kidney and ectopic ureter opening into the seminal vesicle with maldeveloped kidney are somewhat confusing, and they should be standardized for proper diagnosis and treatment of such cases.