Shoji Hirano

Mr Imaging of Neurilemoma Arising from the Renal Hilus

The authors present the radiologic findings of a neurilemoma arising from the kidney. Ultrasound, CT, and angiography could not exclude the diagnosis of renal cell carcinoma (RCC). Magnetic resonance (MR) imaging at 1.5 T showed an isointense tumor on T1-weighted images and a high signal intensity on T2-weighted images compared with normal renal parenchyma. The MR findings were helpful in the differentiation from RCC.

Pharmacokinetics of Ceftazidime in Patients with Renal Insufficiency and in Those Undergoing Hemodialysis

The pharmacokinetics of ceftazidime, a new cephalosporin antibiotic, were studied in 7 healthy volunteers and 32 patients with renal insufficiency after a single 500-mg intravenous injection. The mean plasma half-life during beta-phase was 1.67 h in normal subjects and was prolonged to 15.09 h in hemodialysis patients. There were significant correlations between the elimination rate constant and the creatinine clearance, and between the beta-phase rate constant and the creatinine clearance. The mean urinary recovery during 24 h amounted to 89.6% of the dose in normal subjects and decreased with the lowering of renal function. The plasma levels during hemodialysis were lower than those between hemodialyses.

Biochemical and Pharmacodynamic Studies of Simple Renal Cyst Fluids in Relation to Infection

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Elimination Kinetics of Cefotaxime and Desacetyl Cefotaxime in Patients with Renal Insufficiency and during Hemodialysis

The pharmacokinetics of cefotaxime, a new semi-synthetic cephalosporin for injection, was studied in 30 subjects with various degrees of renal function after a single 1-gram intramuscular injection. Serum and urinary concentrations of cefotaxime and desacetyl cefotaxime were determined by high pressure liquid chromatography. The pharmacokinetic parameters of cefotaxime were obtained using a one-compartment open model. The mean serum half-life of the parent compound (cefotaxime), 0.87 h in normal subjects, was prolonged to 2.35 h in hemodialysis patients. There was a significant linear correlation between the elimination rate constant of cefotaxime and creatinine clearance. The mean cumulative urinary recovery of the administered dose in the 24-hour urine was 51.7% as cefotaxime and 25.6% as desacetyl cefotaxime in normal subjects.

Transurethral fulguration for empyema of ectopic ureteral stump

Abstract  A 55‐year‐old woman who had undergone left nephrectomy 7 years prior because of pyonephrosis, suffered from refractory cystitis and was diagnosed with empyema of the left ureteral stump associated with ectopic ureter. Although removal of the stump is a popular treatment for this disease, transurethral fulguration of the stump lumen was performed in the patient described here. The procedure was technically easy and safe, resulting in the disappearance of the dilated stump and cessation of recurring cystitis.

Pharmacokinetics of Cefpiramide in Healthy Volunteers, Patients with Various Degrees of Renal Dysfunction, and Patients on Hemodialysis

The elimination kinetics of cefpiramide, a parenteral semisynthetic cephalosporin derivative, were studied in 6 healthy volunteers and 31 patients with renal dysfunction after a single 500-mg intravenous injection. Cefpiramide concentrations in serum and urine were determined by an agar-well diffusion method. The serum levels in patients with renal impairment were slightly higher than those in volunteers during the period from 30 min to 24 h after the administration. The mean serum half-life during the beta-phase was 4.06 h in the volunteers and was slightly prolonged in the patients. The mean urinary recovery during 24 h amounted to 21.5% in the volunteers and decreased with reduced renal function. Hemodialysis did not enhance the clearance of cefpiramide.