Clinical studies on 61 patients with post-renal acute renal failure caused by ureteral obstruction

The clinical course of 61 patients with post-renal acute renal failure caused by ureteral obstruction seen between January, 1976 and December, 1985, was studied retrospectively. Twenty of the patients were men between 55 and 85 years old, and 41 were women between 35 and 82 years old. In 50 of the 61 patients, uremia was caused by ureteral obstruction secondary to malignant tumors, and in 11, it was secondary to benign diseases. We divided the patients into two groups, those with primary malignant tumors and those with benign diseases. The location of the primary tumors in the malignant group was the genital system in 28 patients, upper gastrointestinal tract in 7, colorectum in 12, the urinary system in 2, and one was unclear. The benign group included 4 with urolithiasis, 3 with pelviureteral junction stenosis, 3 with post-operative ureteral stricture, and 1 with bilateral ureteral ligation due to operation error. Urinary diversion or reconstruction was performed on 56 of the 61 patients; bilateral nephrostomy in 6, unilateral nephrostomy in 16, bilateral ureterocutaneostomy in 8, unilateral ureterocutaneostomy in 11, unilateral nephrostomy with contralateral ureterocutaneostomy in 2, ureterolithotomy in 2, pyeloplasty in 2, ureterovesiconeostomy in 1, and insertion of a ureteral stent in 8. Of the remaining 4 patients 3 were treated by hemodialysis, and the other patient refused treatment. There was no significant difference in recovery of renal function between those patients undergoing only unilateral diversion and those undergoing bilateral diversion.(ABSTRACT TRUNCATED AT 250 WORDS)     

Efficacy of pazufloxacin mesilate in Legionnaires’ disease: a case report and in vitro study of the isolate

We report here a case of culture-proven Legionnaires’ disease successfully treated with intravenous injection of pazufloxacin mesilate (PZFX), a fluoroquinolone newly approved in Japan. The patient was a 51-year-old man hospitalized after a diagnosis of community-acquired pneumonia. Legionella pneumophila SG1 was isolated from the patient’s bronchoalveolar lavage (BAL) fluid, and the soluble antigen of the bacterium was detected in the fluid as well. Subsequently, intravenous PZFX was administered for a week and proved markedly effective. An in vitro study confirmed that PZFX had excellent extracellular and intracellular activity against the isolate from the patient. This case suggests that PZFX is an option for treating Legionnaires’ disease.     

Factors influencing the duration of treatment of acute herpetic pain with sympathetic nerve block: importance of severity of herpes zoster assessed by the maximum antibody titers to varicella-zoster virus in otherwise healthy patients

Antibody responses to varicella-zoster virus (VZV) were serially investigated by the complement-fixation test in 72 Japanese of both sexes, suffering from herpes zoster (HZ), but otherwise healthy. Our objective was to elucidate whether there were mutual relationships among severities of skin lesion, maximum antibody titers to VZV, and duration of treatment for acute herpetic pain (AHP). Patients were divided into 3 groups: mild group (n = 26), moderate group (n = 26) and severe group (n = 20), according to the severity of the skin lesions. The 3 groups did not differ significantly with respect to age (P greater than 0.6). All patients were treated with regional sympathetic nerve blocks (SNBs) until pain relief was achieved. The durations of treatment for AHP became significantly longer as HZ increased in severity; the mean log10 durations of treatment (+/- S.E.) for the mild, moderate, and severe groups were 1.383 +/- 0.037, 1.616 +/- 0.055, and 1.888 +/- 0.069 days, respectively (P less than 0.01 for the mild group vs. the moderate group, and P less than 0.001 for the moderate group vs. the severe group). Irrespective of age, the maximum antibody titers closely paralleled the severities of the skin lesion of HZ; the mean maximum log2 antibody titers (+/- S.E.) for the mild, moderate, and severe groups were 5.12 +/- 0.24, 6.73 +/- 0.20, and 8.00 +/- 0.18, respectively (P less than 0.001 for the mild group vs. the moderate group and for the moderate group vs. the severe group).(ABSTRACT TRUNCATED AT 250 WORDS)     

Natural and Prosthetic Heart Valve Calcification: Morphology and Chemical Composition Characterization

Calcification is the most common cause of damage and subsequent failure of heart valves. Although it is a common phenomenon, little is known about it, and less about the inorganic phase obtained from this type of calcification. This article describes the scanning electron microscopy (SEM)/energy dispersive X‐ray spectroscopy and Ca K‐edge X‐ray absorption near edge structure (XANES) characterization performed in natural and bioprosthetic heart valves calcified in vivo (in comparison to in vitro‐calcified valves). SEM micrographs indicated the presence of deposits of similar morphology, and XANES results indicate, at a molecular level, that the calcification mechanism of both types of valves are probably similar, resulting in formation of poorly crystalline hydroxyapatite deposits, with Ca/P ratios that increase with time, depending on the maturation state. These findings may contribute to the search for long‐term efficient anticalcification treatments.