Hiroaki Osanai

Experience with Dimethyl Sulfoxide Treatment for Primary Localized Amyloidosis of the Bladder

We report a case of primary localized amyloidosis of the bladder treated successfully with transurethral resection and intravesical dimethyl sulfoxide instillation. Dimethyl sulfoxide bladder instillation is useful for the treatment of primary localized amyloidosis of the bladder.

Effect of Imidafenacin on Nocturia and Sleep Disorder in Patients with Overactive Bladder

Objective: To evaluate the efficacy of imidafenacin on nocturia and sleep disorder in patients with overactive bladder (OAB). Patients and Methods: A prospective multicenter study of imidafenacin 0.1 mg twice daily for patients with OAB and nocturia was conducted. At baseline and at week 4 and 8, patients were assessed using the overactive bladder symptom score (OABSS), frequency volume charts (FVC) and the Pittsburgh Sleep Quality Index (PSQI). Results: Treatment with imidafenacin significantly improved OAB symptoms. Imidafenacin also improved PSQI, especially subjective sleep quality, sleep latency and daytime dysfunction. In FVC, the number of daytime voids and nighttime voids significantly decreased and average voided volume significantly increased after imidafenacin. Subanalysis of FVC based on the patients’ age revealed that nocturnal polyuria was more often found in patients aged 75 years or over than in those aged under 75 years (79 vs. 55%, p < 0.05). Treatment with imidafenacin significantly reduced the nocturnal polyuria index only in patients aged 75 years or over. Conclusions: Imidafenacin can improve nocturia and sleep disorder in patients with OAB. The efficacy of imidafenacin on nocturia is attributable to an increase in bladder capacity and a decrease in nocturnal urine volume. We conclude that imidafenacin is an effective and safe drug for nocturia in patients with OAB.

Severe hypertension in infant with unilateral hypoplastic kidney

Unilateral renal hypoplasia unlike Ask-Upmark kidney (segmental renal hypoplasia) seldom causes hypertension. A case of an infant whose hypertension disappeared after removal of a hypoplastic kidney is reported. The removed kidney revealed no sign of Ask-Upmark lesion.

Cryptococcus arboriformis Sp. Nov., a novel anamorphic basidiomycetous yeast species isolated from a patient's urine.

A basidiomycetous yeast strain isolated from the urine of a 73‐year‐old Japanese patient with chronic renal failure was revealed to be a novel species by sequencing the D1/D2 26S rDNA and ITS regions of the rRNA gene. The name Cryptococcus arboriformis sp. nov. is proposed for the isolate, with IFM 54862T (=CBS 10441T =JCM 14201T) as the type strain. A phylogenetic analysis positioned Cryptococcus arboriformis in the Trichosporonales lineage and showed that it is closely related to C. haglerorum.

Localization of small renal tumor by dynamic computerized tomogarphy

Herein we report on 4 cases of renal tumor whose diameter was less than 3 cm. A mass lesion was suggested by renal echography in mass screening program. Renal dynamic computerized tomography (CT) with bolus injection can delineate a mass lesion clearer than ordinary plain and enhanced CT, and renal angiography. In renal dynamic CT, tumor lesion is well depicted because of the difference between the time density curve in the tumor lesion and that in the surrounding renal parenchyma. Renal dynamic CT is considered to be an especially versatile modality to diagnose small tumors which are hardly delineated by ordinary enhanced CT.

Fournier gangrene associated with hyper IgE syndrome (Job syndrome).

Abstract:  We report a case of a 32‐year‐old man with hyper IgE syndrome (Job syndrome) who developed Fournier gangrene due to infectious multiple atheromas of the scrotal skin that progressed to the right groin and thigh. The patient required surgical debridement and subsequent skin grafting. This is a rare case of Fournier gangrene associated with hyper IgE syndrome (Job syndrome). When a patient without diabetes mellitus has repeated infections and atopic‐like dermatitis, Job syndrome should be considered.

[Renomedullary interstitial cell tumor: a case report].

Renomedullary interstitial tumor is a common tumor in the renal medulla, present in 26-41% of consecutive autopsy specimens. However clinically evident case is infrequent because this lesion is usually small (less than 3 mm). We report a case of renomedullary interstitial tumor in a 76-year-old woman. Ultrasonogram incidentally revealed a mass in the left kidney while she visited to the hospital for hypertension and unstable angina. A CT scan showed a 2 cm mass that was not clearly enhanced. MR images showed low signal intensity in both T1 and T2 images. Arteriography demonstrated no neo-vascularity. Those findings showed that this lesion was benign one or hypovascular carcinoma. So Left nephrectomy was performed and histological examination revealed a renomedullary interstitial tumor.