Hinyokika kiyo. Acta urologica Japonica
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The effect of a single day treatment with 600 mg norfloxacin 600 mg ofloxacin or 1,920 mg trimethoprim-sulfamethoxazol was determined on 114 patients with acute cystitis. The overall clinical efficacy was excellent in 101 patients (89%), moderate in 9 patients (8%) and poor in 4 patients (3%). Recurrence was observed in 8 cases (8%) within 6 weeks after the treatment. The effectiveness rate and the recurrence rate were inferior in those caused by S. epidermidis compared with those caused by E. coli.
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The clinical course of a case of vesicosigmoidal fistula is presented. The patient, a 76-year-old woman, became aware of terminal micturition pain and pollakisuria in February, 1985. She was first treated under the diagnosis of cystitis to be relieved of her subjective symptoms, although there was no improvement of pyuria. ⋯ Because of considerably extensive inflammatory changes over the mucosal membrane of the bladder, the hole of fistula on the vesical wall was simply closed from outside of the bladder without performing partial cystectomy. Histological examination only demonstrated non-specific inflammatory changes without evidence of malignancy. She had a favorable progress postoperatively.
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Two cases of acute renal failure associated with non-typhoid Salmonella infection are reported. Case 1: A 49-year-old man was admitted with the complaint of severe watery diarrhea and oliguria. Stool culture revealed Salmonella typhimurium. ⋯ Septic shock appeared after admission, and anti-shock therapy was immediately carried out. Acute renal failure was cured without hemodialysis, even though multiple organ failure had occurred concomitantly. We discussed the management of patients with Salmonella infection, especially those with acute renal failure.
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Persistent pruritus is one of the most common symptoms in hemodialysis patients. The cause of pruritus is not known, and conventional treatment for pruritus is rarely helpful. Some authors thought that release of histamine from increased mast cells in uremic patients was the cause of pruritus. ⋯ Oral zinc sulfate, 445 mg daily for two months, relieved pruritus subjectively in 53% of the patients. After treatment, serum histamine levels decreased significantly, as well as serum zinc levels increased significantly. These findings suggest that zinc deficiency participates in increased histamine levels in dialysis patients, and subsequently in the development of uremic pruritus.
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Review Case Reports
[Emphysematous pyelonephritis complicated by liver cirrhosis and diabetes mellitus: a case report and a review of the literature].
A case of emphysematous pyelonephritis is presented and a review of literatures is made. A 67-years-old woman with diabetes mellitus, complained of severe left flank pain and high fever and was referred from the department of gastroenterology. A computed tomography film demonstrated gas in the left renal parenchyma and a diagnosis of emphysematous pyelonephritis was made. ⋯ Emphysematous pyelonephritis is a rare, life-threatening disorder and 85 cases in the world have been reported to date. Our case is the 18th one in Japan. Its etiology, symptomatology, treatment and prognosis are discussed.