Hinyokika kiyo. Acta urologica Japonica
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A case of renal failure in a patient with severe central nervous system symptoms during oral acyclovir medication is reported. A 68-year-old man maintained on hemodialysis was given oral acyclovir 4,000 mg daily in divided doses because of herpes zoster affecting the left C3/5 dermatomes. He had vomiting and confusion 36 hours after administration. ⋯ The symptoms resolved 4 days after cessation of acyclovir administration and blood purification every day. Because of its high therapeutic index the use of acyclovir is associated with few side effects. In patients with renal failure the half-life of acyclovir is prolonged, this report indicates the importance of adhering to the dosage reductions in patients with renal failure.
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Review Case Reports
[Thromboangiitis obliterans of the spermatic cord: a case report].
A 61-year-old man was admitted to our hospital with a 8-day history of dull pain and swelling in the bilateral scrotum and bilateral inguinal region. Neoplasma of the spermatic cord was suspected, and bilateral orchiectomy was immediately carried out. ⋯ In such a case, surgical exploration is recommended, and a biopsy must be performed for a definitive diagnosis, but orchiectomy should not be readily selected. Our patient is the first reported case in Japan to our knowledge.
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Comparative Study
[Intracavernous injection of lipo prostaglandin E1 for the diagnosis of impotence: a comparative study with prostaglandin E1-CD].
Intracavernous injection of 20 micrograms prostaglandin E1-CD (PGE1-CD, 8 cases), 5 micrograms lipo prostaglandin E1 (Lipo PG-E1, 8 cases) or 10 micrograms Lipo PGE1 (9 cases) was performed in patients with functional impotence in order to comparatively analyze the diagnostic efficacy of these drugs. Full erection was observed in all patients who received intracavernous injection of 20 micrograms PGE1-CD or 10 micrograms Lipo PGE1. However, full erection was observed in 4 out of 8 patients administered 5 micrograms Lipo PGE1. ⋯ With regard to these RigiScan data and duration of erection, there were no significant differences among the 3 groups. There were no severe side effects in any of the patients. These findings indicate that 10 micrograms Lipo PGE1 and 20 micrograms PGE1-CD have similar effects and that Lipo PGE1 may be an effective drug for the diagnosis and treatment of impotence.
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A case of double inferior vena cava associated with congenital hydronephrosis is reported. A 6-year-old girl was referred to our hospital with the chief complaint of severe left flank pain of sudden onset which occurred after she fell down some steps. Abdominal computerized tomographic (CT) scan revealed a huge perinephric urinoma, severe left hydronephrosis with obstructive atrophy and double inferior vena cava. ⋯ The postoperative course was uneventful. Double inferior vena cava is a relatively rare anomaly and most cases in recent years have been incidentally found by ultrasonography and CT scan. Urologists should keep in mind the possibility of this anomaly of the inferior vena cava, especially when reforming left nephrectomy.