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1.
J Infect Chemother ; 30(4): 277-285, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38242285

RESUMO

The Japanese surveillance committee conducted a third nationwide surveillance of antimicrobial susceptibility of acute uncomplicated cystitis at 55 facilities throughout Japan between April 2020 and September 2021. In this surveillance, we investigated the susceptibility of Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Staphylococcus saprophyticus (S. saprophyticus) for various antimicrobial agents by isolating and culturing bacteria from urine samples. In total, 823 strains were isolated from 848 patients and 569 strains of target bacteria, including E. coli (n = 529, 92.9 %), K. pneumoniae (n = 28, 4.9 %), and S. saprophyticus (n = 12, 2.2 %) were isolated. The minimum inhibitory concentrations of 18 antibacterial agents were determined according to the Clinical and Laboratory Standards Institute manual. In premenopausal patients, there were 31 (10.5 %) and 20 (6.8 %) fluoroquinolone (FQ)-resistant E. coli and extended-spectrum ß-lactamase (ESBL)-producing E. coli, respectively. On the other hand, in postmenopausal patients, there were 75 (32.1 %) and 36 (15.4 %) FQ-resistant E. coli and ESBL-producing E. coli, respectively. The rate of FQ-resistant E. coli and ESBL-producing E. coli in post-menopausal women was higher than that for our previous nationwide surveillance (20.7 % and 32.1 %: p = 0.0004, 10.0 % and 15.4 %; p = 0.0259). For pre-menopausal women, there was no significant difference in the rate of FQ-resistant E. coli and ESBL-producing E. coli between this and previous reports, but the frequency of FQ-resistant E. coli and ESBL-producing E. coli exhibited a gradual increase. For appropriate antimicrobial agent selection and usage, it is essential for clinicians to be aware of the high rate of these antimicrobial-resistant bacteria in acute uncomplicated cystitis in Japan.


Assuntos
Cistite , Escherichia coli , Humanos , Feminino , Klebsiella pneumoniae , Staphylococcus saprophyticus , Japão/epidemiologia , Bactérias , Fluoroquinolonas , Cistite/tratamento farmacológico , Cistite/epidemiologia , Cistite/microbiologia
2.
J Bone Miner Metab ; 37(1): 72-80, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29313098

RESUMO

The aim of this study was to conduct a cross-sectional survey of investigations related to the bone mineral density (BMD) of both non-metastatic prostate cancer (NMPC) patients who have not yet received androgen deprivation therapy (ADT) and patients receiving prolonged ADT in Japan. Japanese male patients with NMPC who received continuous ADT or who were planning to receive ADT were enrolled in this study. Lumbar spine and femoral neck BMD was measured using dual-energy X-ray absorptiometry (DEXA). To assess patient characteristics, we searched medical records and questionnaires to determine whether they had any factors that could possibly affect BMD. A total of 230 patients with a mean age of 76.6 ± 6.4 years were evaluated. Of these, 151 (65.7%) were receiving ADT, and 79 (34.4%) had not yet received ADT. The mean duration of ADT was 37.4 ± 30.7 months. DEXA showed that as the duration of ADT increased, lumbar spine and femoral neck BMD decreased gradually (p = 0.0005 and p = 0.0014, respectively). Stepwise regression analyses revealed that the duration of ADT was a significant variable of both lumbar spine and femoral neck BMD. Moreover, as the duration of ADT increased, the prevalence of osteoporosis increased statistically (p = 0.0002). This study showed that ADT negatively affected lumbar spine and femoral neck BMD. It also showed a progressive increase in the prevalence of osteoporosis in Japanese NMPC patients with ADT.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Povo Asiático , Densidade Óssea/fisiologia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Estudos Transversais , Colo do Fêmur/metabolismo , Colo do Fêmur/patologia , Colo do Fêmur/fisiopatologia , Humanos , Japão , Vértebras Lombares/patologia , Vértebras Lombares/fisiopatologia , Masculino , Metástase Neoplásica , Osteoporose/diagnóstico , Osteoporose/patologia , Osteoporose/fisiopatologia , Neoplasias da Próstata/patologia , Análise de Regressão
3.
Hinyokika Kiyo ; 62(12): 629-632, 2016 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-28103656

RESUMO

We investigated the clinical course of patients after cessation of long-term successful hormone monotherapyfor prostate cancer. Studysubjects were ten patients with prostate cancer (localized prostate cancer ; n=8, prostate cancer with bone metastasis ; n=2), who had hormone monotherapyfor over seven years, showed no signs of recurrence, and maintained prostatic-specific antigen (PSA) levels of less than the detection sensitivitylimit (<0.01 ng/ml). The mean duration of hormone therapywas 101.1 months, and the mean duration of follow-up observation from cessation of the therapywas 31.1 months. PSA levels were maintained less than the detection sensitivitylimit in eight patients, and serum testosterone levels were equal to or less than the castration level in seven patients. This studydemonstrated that there were cases that maintained PSA levels of less than the detection sensitivitylimit even after cessation of long-term successful hormone monotherapyfor prostate cancer.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Hormônio Liberador de Gonadotropina/uso terapêutico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Terapia de Reposição Hormonal , Humanos , Masculino , Prognóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/química , Testosterona/sangue , Fatores de Tempo
4.
Hinyokika Kiyo ; 61(11): 433-6, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26699886

RESUMO

A 77-year-old woman was referred to our hospital with complaints of fever and left chest pain. Computed tomography showed left pyothorax and left pyonephrosis with left ureter calculus. After admission, drainage of the left thoracic cavity was performed and she was treated with antibiotics. On the third hospital day, debridement for pyothorax was performed because her condition had not improved. During surgery, we found perforation of the diaphragm, and abscess appeared from the perforated area. We suspected that perforation of the diaphragm from the left pyonephrosis caused left pyothorax, and performed left nephrectomy. After the operation, relapse of the pyothorax and surgical wound infection occurred, but her condition improved and she discharged on the 46 th hospital day. Relapse of the abscess has not occurred.


Assuntos
Empiema Pleural/terapia , Pionefrose/complicações , Pionefrose/cirurgia , Idoso , Antibacterianos/uso terapêutico , Drenagem , Empiema Pleural/etiologia , Feminino , Humanos , Nefrectomia/efeitos adversos , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia
5.
Hinyokika Kiyo ; 61(12): 505-7, 2015 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-26790765

RESUMO

A 14-year old female was referred to our hospital with the chief complaint of microhematuria. A bladder tumor of the right wall was detected by abdominal ultrasonography and cystoscopic examination. Transurethral resection of the bladder tumor was performed. Pathological examination showed urothelial carcinoma, low grade (grade 1>grade 2), pTa. She was free of recurrence at 2 years and 5 months postoperatively.


Assuntos
Hematúria/etiologia , Neoplasias da Bexiga Urinária/diagnóstico , Adolescente , Feminino , Humanos , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/patologia
6.
Hinyokika Kiyo ; 59(3): 149-52, 2013 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-23633628

RESUMO

We performed ultrasound-guided biopsies on 14 patients having tumors that were difficult to distinguish as benign or malignant on computed tomography. The study took place from January 2004 to December 2011. Of the 14 tumors biopsied, 12 were malignant, 1 was benign, and 1 was a sampling error. Of the 12 malignant tumors, 7 were primary kidney carcinomas. Six patients received radical or partial nephrectomies, and all had a good prognosis. Three patients with metastatic kidney cancers died of the primary disease. Eleven patients (85.5%) were diagnosed pathologically by biopsies, allowing us to decide the course of treatment. However, because our tests also revealed one sampling error and one unspecified cancer, we determined that there are limitations to a renal biopsy.


Assuntos
Biópsia por Agulha , Neoplasias Renais/patologia , Rim/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Biópsia Guiada por Imagem , Masculino , Pessoa de Meia-Idade , Nefrectomia , Prognóstico
7.
Hinyokika Kiyo ; 57(7): 363-6, 2011 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-21832870

RESUMO

We retrospectively reviewed the records of 35 patients with penile cancer, who had been treated at Gifu University Hospital and its affiliated hospitals between July 1994 and January 2009. The mean values of follow-up periods, ages, serum squamous cell carcinoma levels and maximum diameters of the tumor were 23.7±28.0 months, 72.3±10.5 year-old, 4.5±4.3 ng/ml, and 4.0±2.6 cm, respectively. Systemic chemotherapy and local radiotherapy were performed in six, and three cases, respectively. Ten patients died of penile cancer. By univariate analyses, maximum tumor diameter (<- 4.3 cmvs >4.3 cm), T factor (<T3 vs >- T3) and N factor (<N2 vs >- N2) were significantly associated with cancer-specific survival. The five-year survival of stage N2 cases (28.6%) were significantly lower than that of stage N0 and N1 cases (68.4%) (p=0.0003). By multivariate analyses N factor (<N2 vs >- N2) was significantly associated with cancer specific survival (p=0.020). We concluded that the development of effective systemic chemotherapy might be crucial to improve the prognosis of patients with metastatic diseases.


Assuntos
Neoplasias Penianas/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/patologia , Neoplasias Penianas/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
8.
Hinyokika Kiyo ; 56(6): 331-4, 2010 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-20610927

RESUMO

A 47-year-old man with diabetes visited our hospital complaining of high fever, nausea, and scrotal swelling with pain on 11 April, 2009. He was diagnosed with right epididymitis and given antibiotics. The scrotum ruptured by itself, and the inflammation rapidly spread to the right inguinal area on 19 April. We diagnosed him with Fournier's gangrene. The patient underwent right orchidectomy and debridement of the scrotal contents. Seven days after the operation, he developed a cough. A lung computed tomographic scan (CT) revealed bilateral pleural effusion and multiple nodular lesions. A septic pulmonary embolism (SPE) was diagnosed. We increased the dose of antibiotics and added a new one. After 10 days, a CT showed that the lesions had completely disappeared.


Assuntos
Gangrena de Fournier/complicações , Embolia Pulmonar/complicações , Sepse/complicações , Complicações do Diabetes , Humanos , Masculino , Pessoa de Meia-Idade
9.
Hinyokika Kiyo ; 56(12): 691-5, 2010 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-21273808

RESUMO

A 64-year-old man presented to our emergency room with right back pain on July 10, 2009. At the emergency room, abdominal enhanced computed tomography revealed a cystic lesion in the retroperitoneum. Then he was referred to our department. We performed percutaneous drainage of the retroperitoneal lesion and aspirated white pus. The retroperitoneal cystic lesion proved to be an abscess. Microscopic examination of a Gram stained specimen of the abscess revealed gram-positive bacillary fragments ; therefore, we suspected the pathogen to be Nocardia. He had a history of chronic glomerulonephritis and had received treatment consisting of 20 mg prednisolone, and 75 mg cyclosporine per day. He was regularly visiting the department of cardiovascular for follow-up of chronic heart failure. On the day before his visit to our emergency room, his chest X-ray medicine had revealed a nodular shadow. Then he was referred to the department of respiratory medicine and was scheduled to receive a bronchoscopy later. We suspected the nodule of the lung also to be an abscess of Nocardia. Later, head computed tomography (CT) revealed a brain abscess the pathogen of which was Nocardia. Nocardia is a filamentous, gram-positive, branched bacterium and classified as an aerobic actinobacteria. Nocardia species are difficult to diagnose due to non-specific clinical and histological manifestation. We report this case of disseminated nocardiosis presenting as retroperitoneal abscess. The disseminated nocardiosis was diagnosed without delay by percutaneous drainage and appropriate treatment was provided.


Assuntos
Abscesso Abdominal/etiologia , Abscesso Encefálico , Humanos , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/etiologia , Nocardiose/complicações , Nocardiose/diagnóstico , Espaço Retroperitoneal
10.
Hinyokika Kiyo ; 54(7): 509-11, 2008 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-18697499

RESUMO

Bilateral giant hydrocele in an adult is a rare clinical entity. A 31-year-old man presented with painless bilateral scrotal swelling that had appeared at age 13 years and had increased very slowly since. Computed tomography and ultrasonography revealed collection of fluid on both sides of the scrotum. Giant scrotal hydrocele were diagnosed, and surgical excision was performed. The fluid volume was 1,050 ml in right, 645 ml in left. No inguinal hernia was found. Pathologic examination of the resected portion of the tunica vaginalis testis revealed inflammatory changes, and fluid cytology was negative. Eight months has passed, and there has been no evidence of recurrence.


Assuntos
Hidrocele Testicular/cirurgia , Adulto , Diagnóstico por Imagem , Humanos , Masculino , Escroto/lesões , Hidrocele Testicular/diagnóstico , Hidrocele Testicular/etiologia , Hidrocele Testicular/patologia , Resultado do Tratamento , Procedimentos Cirúrgicos Urogenitais
11.
Hinyokika Kiyo ; 53(2): 133-5, 2007 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-17352166

RESUMO

An 87-year-old man visited our hospital, complaining of abdominal distention and inability to urinate. Computed tomography (CT) and magnetic resonance imaging revealed a giant prostate tumor. The patient underwent percutaneous tumor biopsies. The histologic diagnosis was moderately differentiated adenocarcinoma of prostate. The clinical stage according to the TNM classification system was T4N0M0, stage IV. Combined androgen blockade therapy was performed. Four months later, CT showed that the tumor had decreased markedly in size, and the serum prostate specific antigen level was within normal range. Hormone refractory prostate cancer was not found 1 year after the start of treatment.


Assuntos
Adenocarcinoma/tratamento farmacológico , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Acetato de Clormadinona/uso terapêutico , Gosserrelina/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Antagonistas Adrenérgicos alfa/administração & dosagem , Idoso de 80 Anos ou mais , Anilidas/uso terapêutico , Esquema de Medicação , Quimioterapia Combinada , Humanos , Imageamento por Ressonância Magnética , Masculino , Naftalenos/administração & dosagem , Nitrilas , Piperazinas/administração & dosagem , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Compostos de Tosil/uso terapêutico
12.
Hinyokika Kiyo ; 51(11): 741-5, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16363706

RESUMO

We report the results of renal transcatheter arterial embolization (renal-TAE) in two patients with autosomal dominant polycystic kidney disease (ADPKD) treated with hemodialysis (HD). A 73-year-old man and a 65-year-old woman on HD visited our department complaining of abdominal fullness, abdominal pain and appetite loss. Abdominal computerized tomography (CT) revealed polycystic kidneys. Both patients underwent renal-TAE. Approximately 1 month later, the symptoms had improved and CT showed decreased cyst volume. These results suggest that renal-TAE is a useful therapy for patients with ADPKD.


Assuntos
Embolização Terapêutica , Rim Policístico Autossômico Dominante/terapia , Idoso , Feminino , Humanos , Masculino , Artéria Renal , Diálise Renal
13.
Hinyokika Kiyo ; 49(7): 393-6, 2003 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-12968480

RESUMO

We report a case of urinary retention complicated with acute transverse myelitis caused by Mycoplasma pneumoniae. A 16-year-old man visited a clinic because of urinary retention, fever, muscle weakness and sensory disturbance of lower extremities. He was referred to our hospital for further examination. He was diagnosed with acute transverse myelitis due to M. pneumoniae infection based on cerebrospinal fluid examination, serum titer of antibody to M. pneumoniae and magnetic resonance imaging. He was treated with corticosteroids for acute myelitis. A urethral catheter was indwellt for urinary retention. His muscle strength and sensory of lower extremities improved after 2 months of treatment, and he was discharged from our hospital. However, since urinary frequency, urge incontinence and weak urinary stream persisted, he was referred to us for further examination. A pressure-flow study examination showed a decreased maximum urinary flow rate and the findings of detrusor sphincter dyssnergia. We diagnosed him with uninhibited bladder and detrusor sphincter dyssnergia. We administered propiverine hydrochloride and imipramine hydrochloride, and his symptoms subsided significantly. Now, (8 months) after this medication, he still has incontinence at night.


Assuntos
Mielite Transversa/complicações , Pneumonia por Mycoplasma/complicações , Retenção Urinária/etiologia , Adolescente , Humanos , Imageamento por Ressonância Magnética , Masculino , Mielite Transversa/diagnóstico , Pneumonia por Mycoplasma/diagnóstico
14.
Nihon Hinyokika Gakkai Zasshi ; 93(4): 588-91, 2002 May.
Artigo em Japonês | MEDLINE | ID: mdl-12056047

RESUMO

A 28-year-old man visited our hospital complaining of the ulcerous lower extremity. An angiography showed the stenosis of the dorsal digital artery. The clinical diagnosis was Buerger's disease. The administration of prostaglandin I2 (PG I2) and antithrombotic drug were done. The ulcerous lower extremity improved. But a computerized tomographic scan of the abdomen showed the bilateral hydronephrosis incidentally. A retrograde pyelography (RP) revealed the bilateral ureteral strictures. We suspected the etiology was the retroperitoneal fibrosis associated with Buerger's disease.


Assuntos
Hidronefrose/etiologia , Hidronefrose/terapia , Stents , Tromboangiite Obliterante/complicações , Adulto , Anti-Inflamatórios/administração & dosagem , Humanos , Masculino , Prednisolona/administração & dosagem , Fibrose Retroperitoneal/etiologia , Tromboangiite Obliterante/tratamento farmacológico
15.
Int J Urol ; 14(1): 39-42, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17199858

RESUMO

OBJECTIVE: Urethritis is not always caused by a single pathogen, and isolation of more than two pathogens from one patient is not uncommon. We developed a method to simultaneously detect 16 pathogens related to urethritis. METHODS: We designed specific primers used for amplification of urethritis pathogens in our 16-well microplate assay. Sixteen microliters of each reaction mixture containing template DNA was added to each well to amplify 16 pathogens simultaneously. RESULTS: After we evaluated the specificity and sensitivity of this microplate polymerase chain reaction method, we used it to detect pathogens in clinical samples. Of 163 clinical samples, 49.7% (81/163) were positive for specific pathogens, and 6.7% (11/163) showed mixed infection. A specific pathogen was not identified in 43.6% (71/163) of cases. CONCLUSIONS: We developed a 16-well microplate assay with 16 specific primers to identify pathogens associated with urethritis.


Assuntos
Uretrite/microbiologia , Humanos , Infecções/complicações , Infecções/microbiologia , Técnicas Microbiológicas/métodos , Reação em Cadeia da Polimerase
16.
Int J Urol ; 14(1): 75-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17199865

RESUMO

We report a case in which lung metastases disappeared spontaneously after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis. A 58-year-old man presented with gross hematuria. Computed tomography (CT) revealed a left renal tumor and multiple lung metastases. Intravenous pyelography revealed a filling defect in the upper renal calyx. Urine cytology was positive. Left renal pelvic cancer was diagnosed and nephroureterectomy performed. The resected specimen was diagnosed pathologically as sarcomatoid carcinoma of the renal pelvis. Approximately 5 months later, CT revealed that the lung metastases had disappeared. There has been no evidence of disease for 46 months postoperatively.


Assuntos
Carcinoma/secundário , Carcinoma/cirurgia , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Pelve Renal , Neoplasias Pulmonares/secundário , Regressão Neoplásica Espontânea , Nefrectomia , Ureter/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
17.
Int J Urol ; 12(12): 1045-9, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16409608

RESUMO

PURPOSE: The purpose of this retrospective study was to clarify the character of incidental prostate cancer, stages T1a and T1b. METHODS: We analysed 101 cases of incidental prostate cancer. Incidental prostate cancer was diagnosed on the basis of normal digital rectal examination findings, a serum prostate-specific antigen (PSA) level of less than 4.0 ng/mL, and no abnormal computed tomography or ultrasonography findings. All patients were treated at Gifu University Hospital or an affiliated hospital during the period January 1992 through December 2001. RESULTS: There were 64 stage T1a cancers and 37 stage T1b cancers. The mean age of patients was 71.3 years (range 51-87 years). The mean serum PSA level was 1.63 ng/mL (range 0.2-4.0 ng/mL). Thirty-five stage T1a patients (56.5%) and thirty-two stage T1b patients (86.5%) underwent some type of treatment. Total prostatectomy was performed in eight stage T1a cases and fifteen stage T1b cases. Pathological diagnoses were as follows: pTx (n = 1), pT0 (n = 5) and pT2 (n = 2) for stage T1a cancers, and pT0 (n = 6), pT2 (n = 8) and pT3 (n = 1) for stage T1b cancers. Only one stage T1b cancer recurred. CONCLUSION: The outcome of patients with incidental prostate cancer was satisfactory; disease recurred in only one case of stage T1b cancer and there were no cases of PSA failure, although the pathological diagnosis in nine of the fifteen stage T1b cases (60.0%) treated with total prostatectomy was pT2 or pT3. Careful monitoring was indicated for stage T1a cancer, and some treatment was necessary for stage T1b cancer.


Assuntos
Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Próstata/terapia , Estudos Retrospectivos
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