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Biomedical subjects

T Mogami

Publications and source records attributed to T Mogami.

28 records · Page 2Linked to original sources

Administration and dosage of iohexol, a nonionic contrast medium, for dynamic renal computed tomography.

We investigated the optimal method of administering iohexol, which contains 300 mg iodine/ml (Omnipaque 300), a nonionic contrast medium, to maintain adequate renal contrast while reducing artifacts during dynamic CT scanning. In this study, 76 patients with renal disease received 10-50 ml of iohexol as follows: group I (14 patients), 20 ml injected as an intravenous bolus for 5 sec, followed by 30 ml intravenous drip infusion for 5 min; group II (18 patients), bolus of 20 ml injected for 5 sec; group III (13 patients), 20 ml diluted with sterile water (total volume 40 ml), and injected as a bolus for 8 sec; group IV (15 patients), 20 ml injection for 5 sec followed by intravenous drip infusion of 200 ml of Hartmann-Ringer's solution given at maximum speed; and group V (14 patients), 10 ml diluted with sterile water (total volume 20 ml) injected as a bolus for 5 sec. We found that corticomedullary differentiation was most distinct on the images obtained from group IV. We concluded that a lower concentration of iohexol (150 mg iodine/ml) given by intravenous fluid loading can provide superior CT images.

Adult↗

[Monotherapy with extracorporeal shock wave lithotripsy for renal and ureteral stones].

We performed extracorporeal shock wave lithotripsy (ESWL) as a monotherapy using the Medstone STS lithotripter on 288 patients with renal and ureteral stones between June, 1989 and June, 1991. We compared our results with previous reports on ESWL as used in combination therapy. Our cases consisted of 121 patients with renal stones and 167 patients with ureteral stones. A total of 437 sessions of lithotripsy were performed on 288 patients, for an average of 1.52 sessions of lithotripsy per patient. The percentage of stones measuring less than 4.0 mm in diameter that were fragmented was 94.3% for renal stones and 87.6% for ureteral stones. The stone-free rates 3 months after ESWL were 60.3% and 90.4%, respectively. Our results of the monotherapy with ESWL did not differ from those reported on ESWL as used in combination therapy, in terms of the rate of stone destruction and stone-free rates. We studied the other reports carefully and determined that ESWL monotherapy could have been performed in most those cases. We concluded that ESWL monotherapy is an excellent therapeutic method in the light of fewer complications and side effects compared with those from combination therapy, and the fact that the rate of recurrence for renal and ureteral stones is high makes ESWL monotherapy very useful because the procedure can be repeated.

Adolescent↗

A new technique of ureteric catheterization.

Insertion of an indwelling stent catheter or ureteric catheterization using a new guide wire (the Radiofocus guide wire) was carried out in a total of 24 subjects. The subjects comprised 16 patients in whom insertion of a conventional guide wire and ureteric catheter was not possible due to previous use of an indwelling stent catheter for extracorporeal shock-wave lithotripsy (ESWL), 2 cases in whom a conventional guide wire could not be inserted due to post-ESWL formation of a stone street, 4 patients with ureteric stenosis and 2 patients with normal ureters in whom catheterization was impossible by the usual methods. Insertion of a Radifocus guide wire into the renal pelvis was successfully accomplished in all 24 cases and an indwelling catheter could be passed in 21 cases. These results suggest that the Radifocus guide wire should make a useful contribution to ESWL therapy. It can also be applied to retrograde pyelography, ureteric obstruction, and the dilation of ureteric stenosis.

Adult↗

[Current status of the conservative treatment of urinary bladder for invasive bladder cancer].

During the 3 years from 1987 to 1990, we gave hyperthermia to 11 of the patients who visited our department for the treatment of invasive bladder cancer. Results and prognosis are reported. Stage and grade of the cancer before the treatment in 11 cases were T2 in 5 cases, T3 in 3 cases, T4 in 3 cases, transitional cell carcinoma (TCC) grade 2 in 8 cases, TCC grade 3 in 2 cases, and TCC grade 3 + anaplastic carcinoma in 1 case. Complications were observed in 8 of the 11 cases, such as severe heart disease and others. Pretreatment of radiation therapy, transurethral resection or chemotherapy was given in all cases. Hyperthermia was performed combined with hydroxypropyl cellulose-(HPC)-adriamycin, or radiation therapy, and the following results were obtained: complete response (CR) in 4 cases, partial response (PR) in 4 cases, no change (NC) in 2 cases and progressive disease (PD) in 1 case. Among 4 cases of PR, total cystectomy was performed in 3 cases. These 3 cases and the 4 cases of CR are alive now, but the other 4 patients died.

Carcinoma↗

[A combined treatment with 8 MHz radiofrequency hyperthermia, HPC-adriamycin, immunotherapy, radiation, systemic chemotherapy and irradiation for invasive bladder carcinoma].

Hyperthermia was induced for the treatment of invasive bladder carcinoma in order to study its usefulness. The subjects were 12 cases of invasive bladder cancer; including 5 cases of T2, 3 cases of T3, 2 cases of T4, and 2 cases of recurrence after total cystectomy. As previous treatment, 4 patients received radiotherapy and the other received TUR, systemic chemotherapy, and intravesical injection of anticancer drugs. For hyperthermia treatment, a Thermotron RF-8 was used for heating a deep seated tumor. Each case received hyperthermia 2 to 10 times. Combined therapy included injection of HPC-adriamycin into the urinary bladder in 5 cases, immunotherapy in 3 cases, M-VAC therapy in one case, radiotherapy in one case, radiotherapy and intra-arterial injection in one case, and Peplomycin and OK-432 local injection in one case. The treatment results showed a 75% effectiveness; with CR in 4 cases, PR in 5 cases, MR in 2 cases and PD in one case. Three patients died and 9 survived. Of four patients who had received radiotherapy as a previous treatment 3 cases obtained CR and one case MR. Therefore, it was considered that a favorable treatment effect with hyperthermia could be obtained after radiotherapy.

Aged↗

[Clinical experiences of 35 cases with upper urinary tract stones by extracorporeal shock wave lithotripter (MEDSTONE 1000)].

We made clinical trials of the extracorporeal shock wave lithotripter (MEDSTONE-1000) in patients with upper urinary tract stones. Thirty-five cases (total 40 trials) treated during the period of October 1987 through March 1988 were enrolled in this study. The ages of the cases ranged from 22 to 65 (average 43.9) years old, comprising 23 men and 12 women. The site of presence of urinary tract stones was the renal pelvis and calyx in 28 cases and the upper ureter in 7 cases. The size of the stone was smaller than 1 cm in 15 cases, 1 to 2 cm in 12 cases, 2 to 3 cm in 7 cases and larger than 3 cm in 1 case. 13 patients with renal stones were treated with double-J stent catheter and all patients with ureteral stones were treated with the ureteral balloon catheter or flexible-tip ureteral catheter as preoperative manipulation. In 26 cases epidural anesthesia was used and the others were treated under general anesthesia. Stone targetting was determined by two oblique radiographs from separate axes. The intensity of shock waves was mainly 24 KV and the maximum shock wave counts to break up stones were 6800 shots. The size of the broken stone fragments was less than 2 mm in 24 cases (68.5%) and 2 to 5 mm in 10 cases (28.6%), which indicated that the procedure was very effective. However, one case in whom the stone could not be broken was with cystinuria. After three months the fragments completely passed in 22 cases (64.7%) and the residual fragments larger than 5 mm were left in 2 cases (5.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Initial experience of percutaneous renal cryosurgery under the guidance of a horizontal open MRI system.

OBJECTIVE: The aim of this study was to obtain preliminary results of cryoablation of renal tumors by using a percutaneous approach guided by a horizontal open MRI system, and to assess the safety and efficacy of this procedure. MATERIALS AND METHODS: Four patients with renal tumors underwent percutaneous cryosurgery with local anesthesia using a horizontal open MRI system (AIRIS II, Hitachi Medical Corp., Tokyo, Japan). The size of the mass was radiographically documented as 4 cm or less in diameter. A 2- or 3-mm cryoprobe was advanced into the renal mass under real-time MR monitoring. Growth of the iceball during cryoablation was monitored by two-dimensional MR images. Follow-up dynamic CT and physical examination were done after two weeks and six weeks. RESULT: MR imaging demonstrated the iceballs as sharply marginated regions of signal loss that expanded and engulfed the renal mass with clear contrast between the iceball and surrounding tissue. Cryoablated tumors resolved, and there were no serious complications and no clinically significant changes during the procedures and follow-up study. CONCLUSION: In this limited clinical trial of percutaneous renal tumor surgery, cryoablation demonstrated its feasibility with minimal morbidity. Intraprocedual MR-guided cryosurgery can be used as a safe modality, although further studies are necessary to determine the long-term efficacy of this procedure.

Aged↗