Jiro Kato

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.

Clinical Studies Of Interstitial Nd-YAG Laser Irradiation For Bladder Cancer Report No.1

Interstitial Nd-YAG laser irradiation has been successfully applied using an endo rod. The rod conected directly to a quartz fiber is made out of new ceramics and is driven into tumor under direct vision. The irradiation effect can be distinguished by a whitish dis-coloration of the cancer. This operation has been performed in 25 cases. In conclusion, it is considered to be a method, comparing conventional transurethral surgery, that the follow-ing advantages can be mentioned: 1. low laser energy is sufficient, 2. it can be applied also to large tumors (more than 3 cm in diameter), 3. damage to the surrounding tissue like an ureteral orifice is very slight, 4. there is no risk of bleeding and perforation, and 5. the technique is simple to practice and easy to manipulate.

Nursing problems in a hemodialysis child with marked growth retardation

成長期にある児童の透析導入および維持透析に至るまてには, 成人とは異なる様々な問題がある. 我々が経験した症例は, 著しい成長遅延を伴った8歳女児の腎不全例て, これは透析方法の工夫と, 透析を通しての患児との交流についての報告てある. 12kgという低体重児て, 体外循環血液量も多くてきないため緩和な透析条件から徐々に効率をあげ, 患児の負担を少なくする透析方法をとった. そして, 患児に見合った暖かい環境づくりに努め, 患児, 母親とともにケーキサレート加クッキーを作製する中て, 望ましい人間関係の構成をめざした. さらに十分患児に説明を行い, 納得した後に治療を行うという看護計画を実施した結果, 患児, 家族より十分な協力を得ることがてきた. 高K血症に対しては, ケーキサレート加クッキーにより良好な結果を得た. 現在は安定した維持透析を行っており, 透析・学校. 日常生活と楽しく円滑に過ごしていることは, 看護側の我々にとって嬉しいことてある.小児腎不全の場合, 腎移植術が望ましいが患児は下部尿路障害を有するため, 適応が困難てある. また患児自ら手術そのものに対しての不安・恐怖心が強く, 「もうこのままて良い」と, 手術を拒んているなど問題点が残されており今後の課題としたい.