Sadanori Kamikawa

Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments.

Abstract:  We treated two cases of interstitial cystitis (IC) that were resistant to some conventional therapies with hyperbaric oxygen (HBO). Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 60 min/day × 5 days/week for 4 weeks) in a hyperbaric chamber. The period of follow up was 12 months for case 1 and 9 months for case 2. After a course of HBO, the bladder mucosal ulcer (Hunners ulcer) disappeared, and changes from baseline in pain and urinary frequency was constitutively inhibited. There were no adverse events during the 20 treatment sessions. One woman (case 1) had mild Eustachian tube dysfunction, resulting in a transient hearing impairment. HBO seems to be an option for treatment of IC resistant to conventional therapies.

Extraperitoneal laparoscopic Lich–Gregoir antireflux plasty for primary vesicoureteral reflux

Abstract We performed laparoscopic Lich–Gregoir antireflux plasty on 4 patients with primary vesicoureteral reflux. All procedures were conducted using the extraperitoneal approach. The average surgical time was 230 min. There were no complications. After surgery, voiding cysturethrograms showed no reflux in all patients.

Combination of a liquid fibrin sealant with sheet-type hemostatic agents: Experimental evaluation in partial nephrectomy animal model

Liquid fibrin sealants, together with sheet‐type hemostatic agents, have been used during partial nephrectomies to secure effective hemostasis at the suture site. Using animal kidneys, we investigated which hemostatic agent might adhere most effectively to the renal tissue and serve best as a bolster. Liquid fibrin sealant alone, or in combination with a sheet‐type hemostat, such as collagen, gelatin or oxidized‐cellulose hemostat, was applied to the cut surface of the kidney of anesthetized rabbits, and the differences in the degree of adherence to the kidney and resultant hemostatic efficacy were evaluated. Histological analyses were also carried out to compare the degree of adherence of each of the aforementioned hemostats to the kidney tissue. Fibrin sealant plus the collagen or gelatin hemostat was found to have a stronger hemostatic effect than fibrin sealant applied alone or fibrin sealant plus oxidized‐cellulose hemostat. The histological investigation showed that the fibrin sealant adhered well to kidney tissue when it was applied with the collagen or gelatin hemostat, showing the advantage of combining these two materials for achieving effective hemostasis. Fibrin sealant used in combination with the collagen or gelatin hemostat was the most suitable for obtaining a reinforced hemostatic effect at the suture site in a partial nephrectomy animal model.

Pharmacokinetic study of interleukin-2 following intravenous injection in hemodialysis patients with renal cell carcinoma.

Abstract:  The purpose of the present study is to determine the change in blood concentration of interleukin‐2 (IL‐2) after intravenous injection in hemodialysis patients and to assess its safety. Four hemodialysis patients who underwent nephrectomy due to renal cell carcinoma were treated with IL‐2 at a dose of 350 000–700 000 JRU by intravenous injection. Pharmacokinetic parameters were analyzed from the serum IL‐2 concentration, which reached its peak just after the end of infusion, followed by biphasic elimination, and was below the detection limit in all patients at 24 h postinfusion. In comparison with patients with normal renal function, the volume of distribution in the serum compartment was almost comparable (3820 ± 2020 mL). Clearance (50.47 ± 11.50 mL/min) decreased to 40%, and the half‐life of the distribution phase (0.45 ± 0.19 h) and that of the terminal phase (1.72 ± 0.20 h) were distinctly longer. The area under the blood concentration–time curve was about two‐fold higher than that of non‐hemodialysis patients. In all patients, there were no serious adverse reactions. The results of the present study suggest that intravenous IL‐2 therapy can be safely performed in hemodialysis patients.

Concentration gradient of oxalate from cortex to papilla in rat kidney

Abstract Background: The kidney eliminates the major fraction of plasma oxalate. It is well known that oxalate is freely filtered by glomeruli and secreted by the proximal tubules. However, the renal handling of oxalate in distal nephrons, which is considered as playing an important role in stone formation, remains obscure.

ROLE OF THE TRANSITION ZONE FOR ELEVATING SERUM PROSTATE-SPECIFIC ANTIGEN IN BENIGN PROSTATIC HYPERPLASIA

Background:

Macro and Micro Autoradiographic Studies on Oxalate in Normal and Hyperoxaluric Rats

It is known that the deposition of calcium oxalate crystals in the kidney is the first stage of stone formation. However, the exact location of this deposition in the kidney has not been determined. Hautmann and Oswald1 pointed out that there was a concentration gradient of oxalate and calcium from cortex to medulla of the kidney, and that oxalate and calcium contents in the papilla were hundred times higher than those in urine. These findings indicated that the renal papilla, especially the interstitium of papilla might be the site of the calcium oxalate crystalluric deposition. In the present study, we performed autoradiographic studies on oxalate in hyperoxaluric rats using 14C-oxalate, in order to elucidate the distribution of oxalate in renal tissue and the site of the deposition of calcium oxalate crystals along the nephron.

Chemical analysis of diet-induced milky ascites in CAPD patients.

CAPD療法施行時の排液混濁は, 腹膜炎以外の原因による場合は稀である. 我々は食事性に排液混濁をきたしたと考えられたCAPD患者を経験し, 排液成分の検討から以下の結果を得た. 1. 排液中の細胞成分は腹膜炎合併例と比べて少なく, 細菌は検出されなかった. 2. 食事性排液混濁時, 排液中の総蛋白, アルブミン, 総脂質, β-リポ蛋白, コレステロール濃度はCAPD患者の腹膜炎合併例と同程度に高値であり, 中性脂肪の濃度は腹膜炎合併例より有意に高値であった. 3. 食事性排液混濁例では, 排液が肉眼的に透明な平常時でも総脂質, リン脂質, コレステロール濃度は正常CAPD患者の排液中より高濃度であった. 4. 食事性排液混濁例では脂肪乳剤の静脈内投与では排液混濁はみられなかった. 以上から, 食事性排液混濁例では, 食事摂取によるリンパの増流に伴って腹腔内へ蛋白や脂質が漏出し排液混濁をきたしたと考えられた. これらの症例では排液の混濁は一過性で栄養状態に大きな変化はみられず, 特に治療は必要としなかった.