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Nakaoka Y, Yanagawa M, Hata A, Yamashita K, Okada N, Yamakido S, Hayashi H, Jayne D. POS0340 VASCULAR IMAGING IN PATIENTS WITH REFRACTORY TAKAYASU ARTERITIS TREATED WITH TOCILIZUMAB: ANALYSIS FROM A RANDOMIZED CONTROLLED TRIAL. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:In the TAKT study, a randomized controlled trial of tocilizumab (TCZ) in patients with refractory Takayasu arteritis (TAK) in Japan, the primary end point of time to relapse after induction of remission with glucocorticoid (GC) treatment showed a trend favoring TCZ over placebo (hazard ratio 0.41 [95.41% confidence interval, 0.15-1.10; p=0.0596]),1 but the double-blind period was too short for imaging evaluation.Objectives:To independently evaluate vascular imaging in a post hoc analysis of radiographs from the TAKT study.Methods:Computed tomography images from patients in the TAKT study were evaluated by three independent radiologists who were not involved in the original trial. Patients who received TCZ and had computed tomography images available (n=28) were included. Assessments were made in 22 arteries for the change from baseline in wall thickness (primary end point), dilatation/aneurysm, stenosis/occlusion, or wall enhancement for at least 96 weeks after the start of tocilizumab treatment. Patient-level assessments were also conducted.Results:Among 28 patients who received at least one dose of TCZ and for whom images were available, 86.7% of 22 arteries had improved/stable (no progression) wall thickness at week 96. The proportions of patients with no progressed, partially progressed, or newly progressed lesions were 57.1%, 10.7%, and 28.6% for wall thickness, and the proportions without progressed lesions were 92.9% for dilatation/aneurysm and 85.7% for stenosis/occlusion (Figure 1). Patients with newly progressed lesions, reflecting more refractory disease, were receiving glucocorticoid doses that could not be reduced below 0.1 mg/kg/day at week 96.Conclusion:Approximately 60% of patients with TAK treated with tocilizumab did not experience progression in wall thickness. Few patients experienced progressive dilatation/aneurysm or stenosis/occlusion. Wall thickness progression likely resulted from refractory TAK. Patients who experience this should be monitored regularly by imaging, and additional glucocorticoid or immunosuppressive treatment should be considered to avoid vascular progression.References:[1]Nakaoka Y et al. Ann Rheum Dis. 2018;77:348-354.Disclosure of Interests:Yoshikazu Nakaoka Consultant of: Roche/Genentech, Grant/research support from: Roche/Genentech, Masahiro Yanagawa Consultant of: Roche/Genentech, Akinori Hata Consultant of: Roche/Genentech, Katsuhisa Yamashita Employee of: Chugai Pharmaceutical Co., Ltd., Norihiro Okada Employee of: Chugai Pharmaceutical Co., Ltd., Shinji Yamakido Employee of: Chugai Pharmaceutical Co., Ltd., Hiromitsu Hayashi Consultant of: Roche/Genentech, David Jayne Consultant of: Roche/Genentech, Grant/research support from: Roche/Genentech
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Tanaka K, Nakamura M, Fukumoto K, Kosuga T, Yanagawa M, Miyai A, Tachiiri S, Otsu S, Kuwabara K. EP-1732: Quantitative estimation of gamma passing rates from characteristics of respiratory motion. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fukatsu K, Yanagawa M, Murakoshi S, Miyakuni T, Ri M, Yasuhara H. SUN-PP012: Enteral Nutrition Via Ileostomy Causes Jejunal Atrophy but Ileal Hypertrophy with Increased Glucagon-Like Peptide-2 (GLP-2) Levels in Ileum. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30163-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fukatsu K, Ogawa E, Yanagawa M, Murakoshi S, Fukushima R, Yasuhara H. PP066-SUN SEVERE GUT ISCHEMIA REPERFUSION CAUSES PROLONGED REDUCTION OF HEPATIC MONONUCLEAR CELL NUMBER IN MICE. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Murakoshi S, Fukatsu K, Moriya T, Yanagawa M, Amenomori S, Yasuhara H. PP045-MON PARENTERAL NUTRITION DECREASES GUT INTERLEUKIN-15 AND 21 LEVELS IN MICE: A POSSIBLE MECHANISM FOR IMPAIRED GUT IMMUNITY DURING LACK OF ENTERAL NUTRITION. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60357-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yanagawa M, Fukatsu K, Mitsui T, Amenomori S, Murakoshi S, Yasuhara H, Nishimura R. PP210-SUN EFFECTS OF A NEW IMMUNE-MODULATING DIET ENRICHED WITH WHEY-HYDROLYZED PEPTIDE, FERMENTED MILK, AND ISOMALTULOSE ON PLASMA AND INTESTINAL CYTOKINE LEVELS IN MICE. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tachiiri S, Tanaka K, Kosuga T, Yanagawa M, Fukushima H, Hayakawa K. EP-1138 ANALYSIS OF TUMRO COVERAGE IN IMAGE-GUIDED POST-OPERATIVE VAGINAL HDR BRACHYTHERAPY OF CERVICAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Honda O, Yanagawa M, Inoue A, Kikuyama A, Yoshida S, Sumikawa H, Tobino K, Koyama M, Tomiyama N. Image quality of multiplanar reconstruction of pulmonary CT scans using adaptive statistical iterative reconstruction. Br J Radiol 2010; 84:335-41. [PMID: 21081572 DOI: 10.1259/bjr/57998586] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We investigated the image quality of multiplanar reconstruction (MPR) using adaptive statistical iterative reconstruction (ASIR). METHODS Inflated and fixed lungs were scanned with a garnet detector CT in high-resolution mode (HR mode) or non-high-resolution (HR) mode, and MPR images were then reconstructed. Observers compared 15 MPR images of ASIR (40%) and ASIR (80%) with those of ASIR (0%), and assessed image quality using a visual five-point scale (1, definitely inferior; 5, definitely superior), with particular emphasis on normal pulmonary structures, artefacts, noise and overall image quality. RESULTS The mean overall image quality scores in HR mode were 3.67 with ASIR (40%) and 4.97 with ASIR (80%). Those in non-HR mode were 3.27 with ASIR (40%) and 3.90 with ASIR (80%). The mean artefact scores in HR mode were 3.13 with ASIR (40%) and 3.63 with ASIR (80%), but those in non-HR mode were 2.87 with ASIR (40%) and 2.53 with ASIR (80%). The mean scores of the other parameters were greater than 3, whereas those in HR mode were higher than those in non-HR mode. There were significant differences between ASIR (40%) and ASIR (80%) in overall image quality (p<0.01). Contrast medium in the injection syringe was scanned to analyse image quality; ASIR did not suppress the severe artefacts of contrast medium. CONCLUSION In general, MPR image quality with ASIR (80%) was superior to that with ASIR (40%). However, there was an increased incidence of artefacts by ASIR when CT images were obtained in non-HR mode.
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Affiliation(s)
- O Honda
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
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Honda O, Kawai M, Gyobu T, Kawata Y, Johkoh T, Sekiguchi J, Tomiyama N, Yoshida S, Sumikawa H, Inoue A, Yanagawa M, Daimon T, Nakamura H. Reproducibility of temporal volume change in CT of lung cancer: comparison of computer software and manual assessment. Br J Radiol 2009; 82:742-7. [PMID: 19332515 DOI: 10.1259/bjr/67746844] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to investigate the reproducibility of volumetric software evaluation and manual evaluation of tumour growth. Three observers manually evaluated whether tumour volume was increasing, if it was unchanged, or if it had decreased in size in 2 serial CT examinations of 45 solid lung cancers. The tumour volumes were calculated 3 times using volumetric software and were evaluated using the same classifications as for manual evaluation. Both data sets were divided into three groups: growth or reduction with consistency among all three evaluations (group A), growth or reduction with consistency between only two evaluations (group B), and others (group C). The volume variation and relative volume variation were calculated from the median volumes measured by volumetric software. Although all 45 tumours were categorised in group A by volumetric software, only 21 tumours were categorised in group A by manual assessment. The relative volume variation of the manual assessment was 88.5 +/- 76.5%, 20.8 +/- 28.3% and 12.9 +/- 12.8% in group A, B and C, respectively. Significant differences were found between groups A and B (p<0.01) and between groups A and C (p<0.001). Inconsistency is often seen in manual assessment; in contrast, evaluation using volumetric software has good reproducibility, even when the relative change in tumour volume is small.
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Affiliation(s)
- O Honda
- Department of radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan.
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Onishi T, Umemura S, Yanagawa M, Matsumura M, Sasaki Y, Ogasawara T, Ooshima T. Remineralization effects of gum arabic on caries-like enamel lesions. Arch Oral Biol 2008; 53:257-60. [DOI: 10.1016/j.archoralbio.2007.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 10/04/2007] [Accepted: 10/12/2007] [Indexed: 10/22/2022]
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Abstract
OBJECTIVES To assess the association of trunk and leg fat mass (FM) and leg lean tissue mass (LTM) with conventional cardiovascular risk factors. DESIGN Cross-sectional study. SETTING AND SUBJECTS We studied 1249 men and 3007 women (age 20-79 years) who attended a research institute for a health checkup between October 1995 and February 2004. MAIN OUTCOME MEASURES Body mass index, waist circumference (WC), hip circumference (HC), systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, triglycerides, glucose and haemoglobin A(1C) were measured. Trunk FM, leg FM and leg LTM were obtained by dual-energy X-ray absorptiometry. We evaluated the associations between the indices for regional body composition and cardiovascular risk factors, which included hypertension, hypercholesterolaemia, hypo-HDL cholesterolaemia, hypertriglyceridaemia, dyslipidaemia and diabetes mellitus. RESULTS Increase in WC and HC respectively showed increase and decrease in odds ratios of cardiovascular risk factors. Increase in trunk FM by 1 kg significantly increased the risk of the cardiovascular risk factors with the odds ratios ranging between 1.11 and 1.45. Increase in leg FM by 1 kg significantly decreased the risk with the odds ratios ranging between 0.52 and 0.90, except for the nonsignificant results for hypercholesterolaemia and hypo-HDL cholesterolaemia in men. Odds ratios of 1 kg increase in leg LTM were only significant for dyslipidaemia in men and hypercholesterolaemia in women (both 0.93). CONCLUSIONS WC and HC showed opposite and independent associations with cardiovascular risk factors. The favourable association of HC was mainly attributable to that of leg FM.
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Affiliation(s)
- Y Sakai
- Fukuoka Health Promotion Foundation, Kyushu Universith Graduate School of Medicine Sciences, Fukuoka, Japan
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Sakata Y, Onishi T, Yamada Y, Arima K, Yanagawa M, Kawamura J. alpha-Fetoprotein producing renal pelvic and ureter tumor. J Urol 2001; 166:1830. [PMID: 11586238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Y Sakata
- Department of Urology, Mie University School of Medicine, Tsu, Mie, Japan
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Ogasawara M, Ito H, Yanagawa M, Fujitani J, Ohto N, Tuzuki M, Hijii C, Ohshima A, Nishioka K, Sakamoto M. [Questionnaire research of the participants in a large scale walking event Fukuoka City analysis of walking habits and related factors]. Nihon Koshu Eisei Zasshi 2001; 48:868-74. [PMID: 11725531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE We examined the walking habits of the participants in the 'AIREF Spring Walk' which was held on March 9, 1997 in the western suburb of Fukuoka City. The aim of this walking event was to motivate the citizens, especially sedentary people, to walk by providing them an opportunity to enjoy walking. METHODS The participants walked one of three distances (5 km, 10 km or 20 km) and answered anonymously a questionnaire immediately after finishing (100% response rare). The questionnaire items covered sex, age, district of residence, the distance of the walking course, the source of information on the event, experience of participating in other walking events in the past, and walking habits. RESULTS The participants of this event (n = 1,039, mean age 49.4 +/- 18.9 [SD] years) were characterized by high rates for females (67%), those aged < 50 years (42%), residents of Fukuoka City (89%), those who chose to walk the shorter courses of 5 or 10 km (74%), and those who took part in a walking event for the first time (61%). Information on the event was obtained through other people (32%) such as friends, acquaintances, members of community walking groups or other family members, leaflets (21%) placed in the Fukuoka Health Promotion Center and seven Fukuoka City public health centers; a newspaper published biweekly by the municipal government (13%); and direct mail (11%). For those attending the 5 km course, more participants learned about the event through other family members compared with the other two courses. Participants who answered that they walked regularly constituted 56% of those aged 20 years or older. The rates for regular walkers significantly increased with the older participants (p < 0.01) and those who chose longer courses (p < 0.001). Compared with the regular walkers, those without a walking habit tended to have acquired information on the event from friends, acquaintances or other family members, or at their work sites (35%). The average amount of time spent was 249 +/- 175 min/week (n = 375). As a whole, only 30% of the participants aged 20 years or older walked longer than the amount of time for aerobic exercise recommended by the Health, Labor and Welfare Ministry (HLWM). The rate for those who reached the HLWM recommendations was increased in older subject (p < 0.001). CONCLUSIONS It is concluded that the aim of the walking event was partly accomplished, which was reflected by the relatively high rates of participation sedentary for people, compared with other large walking events. The sedentary participants tended to choose the relatively short distances and obtain the information about the event through other people. Walking promotion programs should be developed to motivate sedentary citizens to walk. The programs should also support regular walkers, many of whom are 50 years old or older, to maintain walking habits with the HLWM recommendations on aerobic exercise.
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Ito H, Ohshima A, Tsuzuki M, Ohto N, Yanagawa M, Maruyama T, Kaji Y, Kanaya S, Nishioka K. Effects of increased physical activity and mild calorie restriction on heart rate variability in obese women. Jpn Heart J 2001; 42:459-69. [PMID: 11693282 DOI: 10.1536/jhj.42.459] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The effects of exercise and mild calorie restriction on heart rate variability (HRV) were investigated in 12 mildly obese, normotensive Japanese women aged 45.8+/-4.2 (SEM) years with a body mass index (BMI) of 27.3+/-0.4 kg/m2. The subjects participated in a 3-month program aimed at increasing physical activity and modifying eating behavior (intervention group). The control group consisted of 12 women (age 50.1+/-4.8 years, BMI 27.2+/-0.6 kg/m2) who did not attend the program. The frequency domain of HRV was calculated from 5-min Holter recordings while the subjects rested in a supine position. After 3 months, BMI decreased to 25.0+/-0.5 kg/m2 (p<0.001 vs baseline) in the intervention group, which was accompanied by decreases in body fat mass, waist circumference, serum total cholesterol and triglycerides, and improvement in insulin sensitivity. The mean and SD of the RR intervals, total power, and low and high frequency power of HRV significantly increased after the intervention, whereas no significant changes were seen for the controls. The changes in these HRV variables (calculated by subtracting the baseline values from the follow-up values) negatively correlated with the change in waist circumference, with the Pearson correlation coefficients being between -0.50 and -0.62 (p<0.05). A negative correlation was also seen between the changes in high frequency power and insulin resistance estimated by homeostasis model assessment (r=-0.49, p<0.05). The combination of exercise and mild calorie restriction led to changes in HRV indicative of an improvement in parasympathetic modulation.
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Affiliation(s)
- H Ito
- Fukuoka Health Promotion Foundation, Japan
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Ito H, Ohshima A, Tsuzuki M, Ohto N, Takao K, Hijii C, Yanagawa M, Ogasawara M, Nishioka K. Association of serum tumour necrosis factor-alpha with serum low-density lipoprotein-cholesterol and blood pressure in apparently healthy Japanese women. Clin Exp Pharmacol Physiol 2001; 28:188-92. [PMID: 11207674 DOI: 10.1046/j.1440-1681.2001.03429.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
1. The pro-inflammatory cytokine tumour necrosis factor (TNF)-alpha is considered to be involved in the development of atherosclerosis by inducing local inflammatory responses in the vascular wall. Because TNF-alpha is also known to affect lipid and glucose metabolism, the association between the circulating concentration of TNF-alpha and atherogenic risk factors was examined in 82 apparently healthy Japanese women (aged 19-69 years; mean age 48.5 years). 2. The mean (+/-SD) serum TNF-alpha concentration was 2.7+/-0.9 pg/mL (range 1.4-5.9 pg/mL). The TNF-alpha concentration showed significant correlations with age (r = 0.28; P = 0.01), body mass index (r = 0.27; P = 0.01), the waist-hip ratio (r = 0.41; P = 0.0002), percentage body fat (r = 0.30; P = 0.006), systolic (r = 0.32; P = 0.004) and diastolic (r = 0.24; P = 0.03) blood pressure, total cholesterol (r = 0.27; P = 0.02) and low-density lipoprotein-cholesterol (LDL-C; r = 0.36; P = 0.001), while the correlations with high-density lipoprotein-cholesterol (r = -0.20; P = 0.08) and insulin resistance estimated by the homeostasis model assessment (HOMA(IR); r = 0.16; P = 0.15) were not statistically significant. 3. When adjusted for age and menopause, TNF-alpha was significantly associated with systolic blood pressure (r = 0.25; P = 0.02) and LDL-C (r = 0.27; P = 0.02). The association between TNF-alpha and LDL-C remained significant when adjustment was made for age, menopause and the waist-hip ratio (r = 0.24; P = 0.03). 4. Our results indicate that TNF-alpha may play a role in modulating blood pressure and LDL-C.
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Affiliation(s)
- H Ito
- Fukuoka Health Promotion Foundation, Japan.
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Umeda Y, Hayashi N, Ogawa K, Kuromatsu I, Franco OE, Su J, Yamakawa K, Arima K, Yanagawa M, Kawamura J. [Clinical study of prostate cancer: statistical analysis of 107 cases in the past 12 years]. Hinyokika Kiyo 2000; 46:873-8. [PMID: 11211803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
One hundred and seven patients with prostate cancer were treated at Mie University Hospital during the past 12 years between 1988 and 1999. They were between 53 and 83 years old, with an average age of 70.8 years old. The clinical stage was defined as A, B, C and D in 3 (2.8%), 19 (17.8%), 50 (46.7%) and 35 (32.7%) patients, respectively. At initial diagnosis, the tumor was well, moderately and poorly differentiated adenocarcinoma in 26 (24.3%), 47 (43.9%) and 34 (31.8%) patients, respectively. The median follow-up period was 52.3 months. The overall 1, 3 and 5-year survival rates were 98.0%, 86.8% and 75.2%, respectively. The 5-year survival rates for stage A, B, C and D were 100%, 93.8%, 82.1% and 56.9%, respectively. A significant difference (p = 0.017) in 5-year survival rate was noted between stage C and D. The 5-year survival rate was 100% for well differentiated, 78.0% for moderately differentiated, and 53.2% for poorly differentiated adenocarcinoma. A significant difference (p = 0.0016) in the 5-year survival rate was noted between well differentiated and poorly differentiated adenocarcinoma. According to the therapy, the 5-year survival rate in stage C was 86.2% for the radical prostatectomy group and 84.0% for the endocrine therapy group. There was no significant difference between these 2 treatment groups. Endocrine therapies, classified into maximum androgen blockade (MAB) and endocrine therapy other than MAB were performed for stage D as an initial therapy. Although the prognosis in the patients treated with MAB was better than that with other endocrine therapies, there was no significant difference between these 2 endocrine treatment groups.
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Affiliation(s)
- Y Umeda
- Department of Urology, Faculty of Medicine, Mie University
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Okuno T, Coronel OE, Yanagawa M, Takeda K, Kawamura J. Effect of increased intrareservoir pressure on upper urinary tract function in continent urinary diversion patients assessed by radioisotope renography. Urol Int 2000; 64:185-91. [PMID: 10895083 DOI: 10.1159/000030528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
To assess upper urinary tract function and determine an ideal continent reservoir capacity, we investigated the relationship between intrareservoir pressure and functional parameters using radioisotope renography. Forty-three patients for whom ileal reservoir construction was performed by Kock pouch (n = 33) or Hautmann's ileal neobladder (n = 14) approaches between November 1984 and September 1996 were studied. After the reservoir contents were catheterized, (99m)Tc-MAG 3 renoscintigraphy was carried out and time activity curves in the kidney (renogram) and reservoir (reservoirgram) were recorded, while saline solution was poured into the reservoir for monitoring of intrareservoir pressure. Three basic abnormal curves were noted in the excretory phase on renograms: a normal downward curve followed by an upward curve, a continuous upward curve associated with or without a sharp decline after the catheterization of the reservoir contents, and episodes of spike waves. Based on these curves, renograms were classified into five types: normal, high pressure, retention, obstruction, and reflux. Abnormal types were noted with 51 of 65 renal units (78.5%) in the Kock pouch group and 15 of 25 renal units (60.0%) in the neobladder group. This examination method may be useful for evaluating urodynamics in the upper urinary tract of patients with a continent ileal reservoir and provide data on adequate voiding volumes for the individual patient.
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Affiliation(s)
- T Okuno
- Department of Urology, Faculty of Medicine, Mie University, Mie, Japan
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Franco OE, Arima K, Yanagawa M, Kawamura J. The usefulness of power Doppler ultrasonography for diagnosing prostate cancer: histological correlation of each biopsy site. BJU Int 2000; 85:1049-52. [PMID: 10848692 DOI: 10.1046/j.1464-410x.2000.00669.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To correlate the findings of power Doppler ultrasonography (PDUS) of the prostate with those of site-specific transrectal ultrasonography (TRUS)-guided biopsy. PATIENTS AND METHODS The study comprised 28 patients referred to our institution for TRUS-guided prostate biopsy because of an elevated PSA level and/or abnormal digital rectal examination. PDUS findings were graded 0, 1 or 2; grades 0-1 were considered as negative and grade 2 as positive. The blood volume of each biopsy site was also determined using the mean number (MN) value that represents the average vascularity in a 5-mm square sample. PDUS values were correlated with the histological findings of 147 biopsies with 19 focal lesions. RESULTS Grade 2 was assigned to 19 sites, grade 1 to 52 sites, and grade 0 to 76 sites. Fourteen of the 19 PDUS findings of grade 2 sites revealed carcinoma and five were grade 1. Ten of 35 TRUS-positive sites were carcinomas, three benign prostatic hyperplasia (BPH) and 22 normal. The MN value for prostatic carcinoma was 4.33, for BPH 11.7 and for normal tissue 4.7. The overall sensitivity of PDUS was 74%, the specificity 96% and the positive predictive value 74%. CONCLUSIONS Because TRUS alone cannot detect all cancers, PDUS should be used routinely in all patients undergoing TRUS-guided biopsy, to improve the diagnostic yield of prostate cancer.
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Affiliation(s)
- O E Franco
- Department of Urology, Faculty of Medicine, Mie University, Tsu City, Mie, Japan
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Kise H, Shibahara T, Hayashi N, Arima K, Yanagawa M, Kawamura J. Paravesical granuloma after inguinal herniorrhaphy. Case report and review of the literature. Urol Int 2000; 62:220-2. [PMID: 10567887 DOI: 10.1159/000030400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Paravesical granuloma after herniorrhaphy is an unusual complication due to infected suture material and often mimics bladder or urachal malignancy. We present 3 cases of this disease and reviewed 21 previously reported cases. Our patients underwent hernial repair 2-7 years before examination and presented urinary symptoms. They were treated with antibiotics and underwent exploration of the inguinal wound infection but the symptoms did not resolve. En bloc excision and partial cystectomy were performed and resulted in complete resolution of the symptoms. It is important to consider paravesical granuloma in patients who had undergone herniorrhaphy in the differential diagnosis of bladder or urachal tumors.
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Affiliation(s)
- H Kise
- Department of Urology, Faculty of Medicine, Mie University, Tsu-city, Mie, Japan.
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Satani H, Yoshimura N, Hayashi N, Arima K, Yanagawa M, Kawamura J. [A case of female paraurethral cyst diagnosed as epithelial inclusion cyst]. Hinyokika Kiyo 2000; 46:205-7. [PMID: 10806582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The patient was a 36-year-old woman with a chief complaint of pain of the urethral meatus. A cyst existed just below the urethral meatus. The paraurethral cyst was removed completely. Histologically, the cyst was lined by stratified squamous epithelium. According to the criteria proposed by Das, paraurethral cysts are classified into 4 groups: epithelial inclusion cysts, Müllarian cysts, Gärtner duct cysts, Skene duct cysts. In this case, the cyst seemed to be an epithelial inclusion cyst. In the Japanese literature, paraurethral cysts have been incompletely classified from an etiological perspective. Differential diagnoses based on the histological findings of the cysts may be important to determine the etiology.
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Affiliation(s)
- H Satani
- Department of Urology, Mie University School of Medicine
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21
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Yoshimura N, Kanda H, Suzuki R, Yamakawa K, Hayashi N, Arima K, Yanagawa M, Kawamura J. [Cyclophosphamide-induced renal pelvic tumor--a case report]. Hinyokika Kiyo 2000; 46:177-80. [PMID: 10806575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We report a case of transitional cell carcinoma in the left renal pelvis, which occurred in a 24-year-old man. He had been treated with cyclophosphamide (CPM) for a period of 27 months for retroperitoneal rhabdomyosarcoma diagnosed at the age of 10. At first 1.2 g CPM had been given twice intravenously for 3 months, followed by oral administration of 41 g CPM for 23 months. Drip infusion pyelography revealed a filling defect in the left renal pelvis. A left renal pelvic tumor was strongly suspected on computerized tomography and magnetic resonance imaging. Left nephroureterectomy was then performed. Histological diagnosis of the left renal pelvic tumor was transitional cell carcinoma, grade 2, pT1N0M0. No recurrence was defected 17 months later. This case seems to be the second case of cyclophosphamide-induced upper urothelial carcinoma reported in Japan.
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Affiliation(s)
- N Yoshimura
- Department of Urology, Mie University Faculty of Medicine
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22
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Kise H, Kanda H, Hayashi N, Arima K, Yanagawa M, Kawamura J. Alpha-fetoprotein producing urachal tumor. J Urol 2000; 163:547. [PMID: 10647679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- H Kise
- Department of Urology, Mie University School of Medicine, Tsu-city, Japan
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23
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Ogura Y, Kameda K, Hayashi N, Arima K, Yanagawa M, Kawamura J. [A case of emphysematous pyelonephritis with emphysematous cystitis]. Hinyokika Kiyo 1999; 45:625-8. [PMID: 10540709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A 74-year-old woman with diabetes mellitus had a high fever, and was treated with antibiotics and insulin in another hospital. She was referred to our department, because CT scan showed the right hydronephrosis and the abnormal gas shadow in the right renal calyces. Ureteral catheterization was performed on the right side and cloudy urine was drained. Urine culture yielded E. coli. Since submucosal emphysematous changes were demonstrated in the bladder mucosa by cystoscopy, she was diagnosed with emphysematous pyelonephritis with emphysematous cystitis associated with diabetes mellitus. Administration of antibiotics and insulin and the ureteral catheter drainage improved her condition immediately. Abnormal gas shadow on CT scan and submucosal emphysema on cystoscopy disappeared. We reviewed 110 cases of emphysematous pyelonephritis and 23 cases of emphysematous cystitis including our case in Japan, and report their clinical characteristics.
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Affiliation(s)
- Y Ogura
- Department of Urology, Faculty of Medicine, Mie University
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24
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Arima K, Hayashi N, Yanagawa M, Kawamura J, Kobayashi S, Takeda K, Sugimura Y. [The progress in diagnostic imaging for staging of bladder and prostate cancer: endorectal magnetic resonance imaging and magnetization transfer contrast]. Hinyokika Kiyo 1999; 45:553-7. [PMID: 10500962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We retrospectively studied the staging accuracy of endorectal magnetic resonance imaging (MRI) in comparison with transrectal ultrasound examination (TRUS) for 71 localized bladder cancers and 19 localized prostate cancers (PC) radically resected. The accuracy of clinical staging for bladder cancer in endorectal MRI and TRUS was 85.9% and 69.2%, respectively. The presence or absence of the continuity of submucosal enhancement on T2-weighted MRI images could be useful for the staging of bladder cancer. The accuracy of the seminal vesicular invasion for prostate cancer in endorectal MRI and TRUS was 95% and 63%, respectively. To determine whether magnetization transfer contrast (MTC) provides additional information in the diagnosis of prostate cancer, the magnetization transfer ratios (MTRs) were calculated in 22 patients with PC, 5 with benign prostatic hyperplasia (BPH) and 4 controls. The mean MTR in the peripheral zone of the normal prostate (8.0% +/- 3.4 [standard deviation]) showed a statistically significant decrease relative to that in the inner zone of the normal prostate (27.4% +/- 3.4, p < 0.01), BPH (25.5% +/- 3.7, p < 0.01), pre-treatment PC (30.6% +/- 5.9, p < 0.01), and PC after hormonal therapy (20.3% +/- 6.3, p < 0.01). The mean MTR in pre-treatment PC was significantly higher than that in BPH, or in PC after hormonal therapy (p < 0.01). MTC was considered to be useful for conspicuity of prostate cancer lesion.
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Affiliation(s)
- K Arima
- Department of Urology, Faculty of Medicine, Mie University
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25
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Kameda K, Hayashi N, Arima K, Yanagawa M, Kawamura J, Yonemura S, Kinbara H. [Abscess of corpus cavernosum: a case report]. Hinyokika Kiyo 1998; 44:893-5. [PMID: 10028438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
A 72-year-old man was admitted to our hospital complaining of a penile mass. The local biopsy indicated an abscess formation in the corpus cavernosum. In spite of antibiotic treatment, the abscess cavity ruptured to the dorsal skin and the urethra. After cystostomy formation, dorso-caverno-urethral fistula was closed by conservative therapies. Although the patient was followed up with antibiotics on an outpatient basis, necrotic changes in the right foot were noticed and he was diagnosed with arteriosclerosis obliterance in the right lower leg. Therefore, he was referred to an orthopedic clinic for amputation of his right lower leg with cystostomy catheter. This is the 7th case reported in Japan.
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Affiliation(s)
- K Kameda
- Department of Urology, Mie University School of Medicine
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26
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Onishi T, Shibahara T, Kise H, Okuno T, Hayashi N, Arima K, Yanagawa M, Kawamura J. [Extracorporeal shock wave lithotripsy in patients with coagulopathies: report of three cases]. Hinyokika Kiyo 1998; 44:657-60. [PMID: 9805672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We describe our experience with extracorporeal shock wave lithotripsy (ESWL) in three patients with coagulation disorders (one case of hemophilia A, and two cases of thromboasthenia). We successfully performed ESWL using factor VIII or transfusion of platelets without any severe hemorrhagic complications, such as perirenal and subcapsural hematomas. We consider that adequate supplement of coagulation factor or platelets may lower the risk of hemorrhagic complications in coagulopathic patients who undergo ESWL.
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Affiliation(s)
- T Onishi
- Department of Urology, Mie University School of Medicine
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27
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Fumino M, Matsuura H, Hayashi N, Arima K, Yanagawa M, Kawamura J. [A case of renal cell carcinoma with metastasis in clivus presenting as diplopia]. Hinyokika Kiyo 1998; 44:319-21. [PMID: 9656102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We report a rare case of renal cell carcinoma presenting as diplopia which was caused by a metastasis to the clivus. A 58-year-old man was admitted to our hospital with the chief complaint of diplopia. Head magnetic resonance imaging showed a mass in the clivus accompanied by bone destruction. Metastatic tumor to the skull base was suspected. Further examinations for the primary lesion revealed left renal cell carcinoma. He was relieved of diplopia by radiotherapy to the clivus and subsequently underwent left radical nephrectomy.
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Affiliation(s)
- M Fumino
- Department of Urology, Mie University School of Medicine
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28
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Kise H, Shibahara T, Matsuura H, Fumino M, Hayashi N, Arima K, Yanagawa M, Kawamura J. [Laparoscopic fenestration of lymphocele after renal transplantation: report of two cases]. Hinyokika Kiyo 1998; 44:323-5. [PMID: 9656103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Lymphocele after renal transplantation is a complication that often requires surgical treatment. We performed laparoscopic drainage for the postoperative lymphocele in two renal transplantation patients. The patients were suffering from perineal discomfort and urinary frequency due to the lymphocele after the renal transplantation. Percutaneous catheter drainages and injections of tissue sclerosing agents such as povidone-iodine solution and tetracycline were not effective. Then fenestration of the lymphocele by laparoscopic technique was done. This procedure made the lymphatic fluid free from the lymphocele in the retroperitoneal space to the peritoneal cavity following creation of a peritoneal window. There were no apparent complications. The patients were free from symptoms and had no relapse 10 months after the operation. We report the procedure and the results of the laparoscopic fenestration.
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Affiliation(s)
- H Kise
- Department of Urology, Mie University School of Medicine
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29
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Takeda K, Kawaguchi T, Shiraishi T, Kobayashi S, Hayashi N, Yanagawa M, Tochigi H, Sakuma H, Kawamura J, Nakagawa T. Normal bladder wall morphology in Gd-DTPA-enhanced clinical MR imaging using an endorectal surface coil and histological assessment of submucosal linear enhancement using [14C]Gd-DOTA autoradiography in an animal model. Eur J Radiol 1998; 26:290-6. [PMID: 9587759 DOI: 10.1016/s0720-048x(97)01178-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate normal bladder wall morphology in gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced magnetic resonance (MR) imaging using an endorectal surface coil and to perform histological assessment of submucosal linear enhancement with experimental [14C]-gadolinium-tetraazacyclododecane-tetraacetic acid (Gd-DOTA) autoradiography. METHODS AND MATERIAL MR imaging of the bladder was performed using an endorectal coil in 13 consecutive patients with bladder carcinoma and T1-, T2-, and Gd-DTPA-enhanced spin-echo images of the bladder wall were compared. After injection of [14C]Gd-DOTA into a hamster, autoradiograms of the bladder wall were obtained and compared with serial histological sections. RESULTS The normal bladder wall appeared as a homogeneous layer of intermediate intensity on T1-weighted images. After administration of Gd-DTPA, the bladder wall was visualized as three layers: an inner thin layer of low intensity, a middle layer of marked enhancement, and a thick outer layer of intermediate intensity. The autoradiograms demonstrated dense accumulation of [14C]Gd-DOTA in the submucosal layer. Thus, the inner, middle, and outer layers corresponded to the mucosa, submucosa, and muscularis propria, respectively. The thickness of the bladder wall demonstrated on T2-weighted images was almost equal to that of the outer layer on enhanced T1-weighted images. Thus, T2-weighted images revealed only the muscle layer as an intermediate-intensity band. In the preliminary clinical study, MR imaging invariably showed accurate stages of the bladder carcinoma in 13 patients. CONCLUSION In MR imaging of the normal bladder wall, the submucosa was strikingly enhanced after Gd-DTPA administration, separating the bladder wall into three layers. This may have a potential role in the staging of bladder tumors.
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Affiliation(s)
- K Takeda
- Department of Radiology, Mie University School of Medicine, Japan.
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30
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Maeda Y, Arima K, Matsuura H, Hayashi N, Yanagawa M, Kawamura J. [Percutaneous sclerotherapy for chyluria with leg edema: a case report]. Hinyokika Kiyo 1998; 44:25-7. [PMID: 9503204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 45-year-old woman with left leg edema was admitted to our hospital because of chyluria from the previous year. Her left leg edema appeared after Caesarean section for her first delivery and hysterectomy at the age of 31. Because microfilaria was not detected, she was diagnosed with postoperative lymphangiomatosis. The instillation of 0.1-0.5% silver nitrate into the renal pelvis was not effective. We however, after percutaneous sclerotherapy to the left inguinal lymph nodes with doxycycline, the chyluria disappeared and her left leg edema improved. Then, the surplus skin of her left lower leg was resected. We considered percutaneous sclerotherapy to be a good procedure for chyluria due to postoperative lymphangiomatosis.
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Affiliation(s)
- Y Maeda
- Department of Urology, Faculty of Medicine, Mie University
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31
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Yamada Y, Hayashi N, Yonemura S, Arima K, Yanagawa M, Kawamura J. [A case of metastatic ureteral tumor from rectal cancer]. Hinyokika Kiyo 1998; 44:41-3. [PMID: 9503208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 67-year-old man was referred for further examination of left hydronephrosis. He had undergone anterior resection for rectal cancer 2 years previously and also right lobectomy for a solitary hepatic metastasis one year postoperatively. Antegrade pyelography demonstrated a filling defect in middle portion of the left ureter. Cytology of the aspirated urine was class V. Left nephrourete-rectomy was performed. Histologically metastatic adenocarcinoma with intact ureteral mucosa was demonstrated.
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Affiliation(s)
- Y Yamada
- Department of Urology, Mie University School of Medicine
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Abstract
BACKGROUND Urolithiasis is a major health problem in the northeast part of Thailand. In this study, we examined the prevalence of renal stone disease and differences of urinary components between stone formers and healthy control subjects in northeastern rural areas of Thailand. METHODS We selected 3 villages in the rural areas of Khon Kaen province in northeast Thailand. Three hundred and sixty-seven persons were asked questions relating to urolithiasis and were examined by abdominal ultrasound (US). We collected a spot urine sample from stone formers and healthy control subjects from each village. RESULTS Abnormal findings by US were detected in 39 individuals (10.6%), and included 31 individuals with renal calculi (8.4%), 16 with hydronephrosis (4.4%), and 1 individual with a renal cyst (0.3%). This yielded a disease rate of urinary stones in this study of 16.9%. The male/female ratio was 2/1 and the average age of the individuals examined was 40.3 +/- 13.9 years. However, there was no significant difference between the urinary parameters of stone formers and the healthy control subjects. CONCLUSION There was a high incidence of renal stone disease in the northeast part of Thailand, but the tendency for hypocitraturia was only found in stone formers.
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Affiliation(s)
- M Yanagawa
- Department of Urology, Mie University School of Medicine, Tsu, Japan
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33
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Fukatsu T, Kurimoto K, Kanai M, Shibahara T, Fumino M, Yoshimura N, Hayashi N, Arima K, Yanagawa M, Kawamura J, Kinoshita N, Kato H. [A case of bilateral renal infarction]. Hinyokika Kiyo 1997; 43:781-4. [PMID: 9436021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 67-year-old woman was admitted with aching pain in her left flank and nausea. Bilateral renal infarctions were noticed by CT scan and arteriography. Selective intra-arterial thrombolytic therapy was performed. Urokinase (UK) was administered through a balloon catheter embedded into the occlusive segment of the left renal artery selectively. UK (20,000 units/hour) was continuously infused after short-term high dose UK (360,000) infusion. In spite of recanalization of the occluded artery, CT scan and renoscintigraphy image did not suggest recovery of renal function. Conservative intra-arterial thrombolytic therapy is considered to be the most effective treatment for renal infarction.
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Affiliation(s)
- T Fukatsu
- Department of Urology, Mie University School of Medicine
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34
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Kise H, Shibahaha T, Yoshimura N, Uchida K, Arima K, Yanagawa M, Kawamura J. [Selective transcatheter embolization for renal artery aneurysms: report of three cases]. Nihon Jinzo Gakkai Shi 1997; 39:771-5. [PMID: 9396247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Selective transcatheter embolization using an interlocking detachable coil (IDC) or detachable balloon was performed in three patients with renal artery aneurysms. All aneurysms were of the saccular type, located on segmental branches of the renal artery. After the embolization procedures, the levels of LDH, GOT, WBC and the body temperature were transitionally elevated in all patients. Complete occlusion of the aneurysms were achieved in all cases. Good clinical results were achieved in two of these patients without any renal dysfunction. However, local infarction of ipsilateral renal parenchyma occurred in one patient immediately after the embolization and a Tc-99m-DMSA renal scintigraphy study suggested renal dysfunction after infarction, and the level of serum renin activity was slightly elevated. Selective transcatheter embolization may constitute an acceptable therapeutic approach for renal artery aneurysms because beside avoiding surgery, it has a low risk of complications.
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Affiliation(s)
- H Kise
- Department of Urology, Mie University School of Medicine, Japan
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35
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Matsuura H, Hayashi N, Arima K, Yanagawa M, Kawamura J, Takeda H. [Evaluation of renal cystic mass on ultrasonogram and computed tomogram: usefulness of magnetic resonance imaging and renal angiography--category III by Bosniak: report of 5 cases]. Nihon Hinyokika Gakkai Zasshi 1997; 88:826-9. [PMID: 9364850 DOI: 10.5980/jpnjurol1989.88.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bosniak classification of renal cystic massesis an extremely useful management tool. Of category I-IV by Bosniak, category III lesion is moderately complicated cyst, which cannot be confidently distinguished from malignancy radiologically. Here, we reviewed the clinical course of 5 patients with pathologically proven category III mass by Bosniak in order to evaluate the usefulness of magnetic resonance imaging (MRI) and renal angiography. Two of the 5 lesions were benign (hemorrhagic cyst) and the other were malignant (RCC). On MRI, the results of 5 lesions were true positive in 1 and false negative in 2. On angiography, the results were true positive in 2 and false negative in 1. MRI has an important role in detection of mass. Angiography is necessary for making a definitive diagnosis of the indeterminate renal cystic masses on US and CT as RCC, but cannot increase enough diagnostic confidence in small cystic renal masses. We experienced indeterminate 2 masses (case 1 and 4) on these four imaging techniques, which were RCC and hemorrhagic cyst, respectively. In category III lesions, if malignant finding was detected by MRI or angiography, we believe that surgical exploration should be performed. But, an absolute decision tree for management of the complicated renal cystic mass has not been published, and further investigation should be required.
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Affiliation(s)
- H Matsuura
- Department of Urology, Faculty of Medicine, Mie University
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36
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Shibahara T, Kise H, Kanai M, Fukatsu T, Fumino M, Hayashi N, Arima K, Yanagawa M, Kawamura J. [A case of xanthogranuloma of the urinary bladder following herniorrhaphy]. Hinyokika Kiyo 1997; 43:679-82. [PMID: 9365851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a case of xanthogranuloma of the bladder following herniorrhaphy. The patient complained of urinary frequency, residual feeling, and presented with a solid mass located on the dome of the bladder. He had undergone previous inguinal herniorrhaphy. Transurethral biopsy revealed an inflammatory change. Partial cystectomy was carried out for en bloc removal of the tumor. The histological diagnosis was xanthogranuloma of the bladder. Postoperatively, the symptoms disappeared. This is the sixth case report of xanthogranuloma of the urinary bladder and the first case following herniorrhaphy in the Japanese literature.
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Affiliation(s)
- T Shibahara
- Department of Urology, Mie University School of Medicine
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37
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Yonemura S, Okuno T, Yamada Y, Uchida K, Arima K, Yanagawa M, Kawamura J. [Bladder cancer associated with von Recklinghausen's disease: a case report]. Hinyokika Kiyo 1997; 43:585-8. [PMID: 9310783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 53-year-old man was admitted to our hospital with urinary frequency and miction pain. He had von Recklinghausen's disease with multiple café-au-lait spots and neurofibromatosis. Computed tomography scan and magnetic resonance imaging revealed an invasive bladder tumor 10 cm in diameter, and not metastasis. He was diagnosed as having a bladder tumor (T3a N0 M0 with von Recklinghausen's disease. After balloon occluded arterial infusion (BOAI) chemotherapy, total cystectomy was performed. Pathological diagnosis was transitional cell carcinoma, G3, pT3aN0M0. We reviewed and discussed 97 cases of carcinoma associated with von Recklinghausen's disease reported in the Japanese literature. Only 5 cases of bladder cancer have been reported, including the present case.
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Affiliation(s)
- S Yonemura
- Department of Urology, Faculty of Medicine, Mie University
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38
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Kameda K, Kanai M, Yonemura S, Matsuura H, Okuno T, Hayashi N, Arima K, Yanagawa M, Kawamura J, Tochigi H. [Clinical statistics of living and cadaveric renal transplantation at the Department of Urology, Mie University School of Medicine]. Hinyokika Kiyo 1997; 43:437-41. [PMID: 9250496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A statistic survey was made on the clinical results of living and cadaveric renal transplantations performed at our department between October 1980 and June 1996. A total of 38 patients received 6 living and 32 cadaveric renal transplants. The graft and patient survival rates of a living renal transplantation were 83.3% and 100% at 3 years, respectively. The graft survival rate of cadaveric renal transplantation was 66.3% at 3 years and 56.0% at 5 years. In a cadaveric renal transplantation, patients with episodes of acute rejection within 12 months showed a significantly worse graft survival rate. This clinical parameter seems to be a prognostic factor for a long-term graft survival.
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Affiliation(s)
- K Kameda
- Department of Urology, Mie University School of Medicine
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39
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Kise H, Kobayashi K, Arima K, Yanagawa M, Tochigi H, Kawamura J, Hioki T, Sugiura Y. [Effect of pamidronate and interferon-alpha on bone and lung metastases and hypercalcemia in a patient with renal cell carcinoma]. Hinyokika Kiyo 1996; 42:879-81. [PMID: 8973939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pamidronate is a second generation bisphosphonate used for treating tumor-induced hypercalcemia and for preventing the development of new bone metastasis. A 47-year-old man with renal cell carcinoma was admitted in our institution because of hypercalcemia with multiple metastasis in bone, lung and lymph nodes. After embolization of the right renal artery, the patient was treated with pamidronate and interferon-alpha. Intravenous pamidronate significantly reduced bone pain and normalized the serum calcium level. The pulmonary metastasis responded to interferon therapy after 2 months of therapy. Radical nephrectomy was then carried out. Paraaortic lymph nodes were found to be necrosed completely. Ossification of osteolytic lesions was observed after two months of therapy and metastatic lesions in the lung showed complete remission (CR) after six months of therapy.
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Affiliation(s)
- H Kise
- Department of Urology, Mie University School of Medicine
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40
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Uchida K, Satani H, Okuno T, Yanagawa M, Tochigi H, Kawamura J. [Two cases of giant condyloma of the penis treated with penis-sparing methods]. Hinyokika Kiyo 1996; 42:605-8. [PMID: 8889572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Herein, we report two cases of giant condyloma of the penis treated with penis-sparing methods. In the first case, the papillomatous tumor disappeared with topical use of fluorouracil ointment. In the second case, the tumor was treated with topical use of fluorouracil or bleomycin hydrochloride, followed by the resection of tumor. Giant condylomas reported in the recent 13 years are reviewed and methods of treatment discussed.
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Affiliation(s)
- K Uchida
- Department of Urology, Mie University School of Medicine
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Okuno T, Tochigi H, Yanagawa M, Arima K, Kawamura J. [A clinical study of renal cell carcinoma with extension into the inferior vena cava]. Hinyokika Kiyo 1996; 42:487-91. [PMID: 8809555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nineteen patients with renal cell carcinoma with tumor extension into the inferior vena cava (IVC) were investigated between January, 1973 and March, 1994. The patients were between 50 and 78 years old with a mean of 65.9 years. The male to female ratio was 1.7 to 1. Thirteen tumors were on the right side and 6 on the left side. In 12 patients, both nephrectomy and removal of the tumor thrombus were performed. The survival rate in the operated group was 60% at 5 years. Histologically, 7 cases were diagnosed as clear cell subtype and 5 cases as granular cell subtype. From this study, an extended operative intervention such as radical nephrectomy combined with tumor thrombectomy of the IVC with or without cavectomy was suggested in the case of renal cell carcinoma without any other metastatic lesions and histopathologically of the clear cell subtype.
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Affiliation(s)
- T Okuno
- Department of Urology, Mie University School of Medicine
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42
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Arima K, Nakagawa M, Yanagawa M, Sugimura Y, Tochigi H, Kawamura J. Prognostic factors of peripheral blood lymphocyte subsets in patients with renal cell carcinoma. Urol Int 1996; 57:5-10. [PMID: 8840483 DOI: 10.1159/000282868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In 76 patients with renal cell carcinoma (RCC) we assessed the therapeutic effects of interferon-alpha (IFN-alpha) and the outcome of curative resection by analyzing changes in peripheral blood lymphocyte subsets to try to find prognostic indices. The percentage of activated CD8-positive cells present in blood samples before IFN-alpha therapy was significantly higher in progressive disease (PD) patients who died within 8 months than in PD patients who survived for more than 18 months. The high percentage of activated CD8-positive cells present in postoperative blood samples was the most remarkable characteristic in patients in which RCC recurred. Multivariate analysis showed that the percentage of activated CD8-positive cells in postoperative blood samples was the only predictor of recurrence (hazard ratio 1.29, p value 0.02). Thus, the high percentage of activated CD8-positive cells in postoperative blood samples is, therefore, a useful indicator of poor prognosis.
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Affiliation(s)
- K Arima
- Department of Urology, Mie University School of Medicine, Japan
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43
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Arima K, Kise H, Yamashita A, Yanagawa M, Tochigi H, Kawamura J, Horiuchi E, Sugimura Y. [Renal angiomyolipoma: diagnosis and treatment]. Hinyokika Kiyo 1995; 41:737-43. [PMID: 7484542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In 10 years the diagnosis of renal angiomyolipoma (RAML) was made in 14 patients (male-to female ratio 1:3.7) at our institution; 1 case was associated with tuberous sclerosis (TS) and 1 case had regional lymph node involvement. A statistical study was done on data taken from 739 cases of RAML in the Japanese literature, including our cases. The male to female ratio was 1 to 3. Twenty eight percent of the cases were associated with TS. The ratio of bilateral cases to the unilateral one was 1 to 3. The main clinical signs were flank pain, abdominal mass, hematuria and fever elevation. Recently the ratio of nephrectomy has decreased to 30%. The percentage of detecting the fat component by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging were 88.1%, 86.5% and 80.8% respectively. The percentages of visualizing hypervascularity, aneurysms, absence of arterio-venous shunt and onion peel appearance by selective renal angiography were 77.3%, 71.4%, 48.1% and 4.9% respectively. Small (less than 3 cm), asymptomatic, simple lesions with adipose component may be observed annually by CT and US until more experiences is gained with surveillance of these patients. Embolization was useful for emergency cases or pre-treatment of nephron sparing surgery, but insufficient by itself. As there still remain problems in the diagnosis of RAML, especially in the case of very small tumors, in the case with almost no adipose component and in the case associated with renal cell carcinoma, the diagnosis of RAML should be made synthetically including angiography.
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Affiliation(s)
- K Arima
- Department of Urology, Mie University School of Medicine
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Yamashita A, Hayashi N, Sugimura Y, Yanagawa M, Arima K, Nakano S, Kimbara H, Tochigi H, Kawamura J. [Clinical study of prostatic cancer--statistical analysis of 184 cases in the latest 21 years]. Hinyokika Kiyo 1995; 41:447-53. [PMID: 7645452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
One hundred and eighty-four patients with prostatic cancer were treated at Mie University Hospital from 1973 to 1993. They were between 47 and 90 years old, with an average age of 71.8 years old. One hundred and fifty-eight patients (85.8%) were in either stage C or D. Of the 146 cases histologically examined, 17.8% were well differentiated adenocarcinoma, and 47.9% and 34.2% were moderately and poorly differentiated adenocarcinomas, respectively. The overall 3-year, 5-year and 10-year survival rate were 64.2%, 44.9% and 24.2%, respectively. The patients with high stage and/or poorly differentiated adenocarcinomas revealed worse prognosis. Although the prognosis in the patients treated with estrogen and orchiectomy was better than that with estrogen alone, there was no significant difference between the 2 treatment groups. The prognosis of patients with prostatic cancer has been improved since 1988. A possible explanation is that prostate specific antigen has been introduced as a tumor marker, which might contribute to an accurate diagnosis in prostatic cancer and improve the prognosis of the disease. In conclusion, the diagnosis in lower stage and radical prostatectomy might bring favorable prognosis. In future, safer and more effective chemotherapy and endocrine therapy including LH-RH analogue are awaited, to obtain a better prognosis in the patients with advanced prostatic cancer.
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Affiliation(s)
- A Yamashita
- Department of Urology, Mie University School of Medicine
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45
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Kuromatsu I, Hayashi N, Yanagawa M, Tochigi H, Kawamura J. [Combined small cell and transitional cell carcinoma of renal pelvis: a case report]. Hinyokika Kiyo 1995; 41:47-50. [PMID: 7900568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Primary small cell carcinoma of the renal pelvis is rare. We report a case of combined small cell and transitional cell carcinoma of the renal pelvis. The patient was a 78-year-old man with macrohematuria. He was diagnosed with right pelvic tumor by right retrograde pyelography and computerized tomography. A right radical nephroureterectomy was performed. Histological sections of the tumor showed a mixture of small cell and grade 2 transitional cell carcinoma. Positivity for Grimelius was noted in the small cell component. Masson-Fontana, chromogranin A, serotonin, keratin, leucocyte common antigen (LCA), neuron specific enolase (NSE), adrenocorticotropic hormone (ACTH), growth hormone (GH) and somatostatin were negative. Ultrastructurally, the tumor cells were tightly packed and attached together by scattered desmosomes. There were no neurosecretory granules. Seven months after operation, the patient died with peritonitis carcinomatosa. At autopsy, a metastatic tumor was found in the liver and retroperitoneal lymph node. Other organs were not involved. Especially, there were no abnormalities in the lungs.
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Affiliation(s)
- I Kuromatsu
- Department of Urology, Mie University School of Medicine
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46
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Matsuura H, Hioki T, Sakurai M, Arima K, Yanagawa M, Sugimura Y, Tochigi H, Kawamura J, Kinoshita N, Katoh H. [Influence of extracorporeal shock wave lithotripsy (ESWL) on renal function assessed by 99mTc-DMSA scintigraphy: comparative analysis between ESWL and percutaneous nephroureterolithotripsy (PNL)]. Hinyokika Kiyo 1994; 40:1061-7. [PMID: 7863857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
99mTc-DMSA renal scintigraphy was utilized to investigate the influence of ESWL on renal function in comparison with that of PNL. In the beginning, the reproducibility of renal uptake rate by the scintigraphy was examined in eleven healthy volunteers under both non-diuretic and diuretic states. The renal uptake rate was shown to be sufficiently reproducible in the same person in the two different trials. However, the differences and the standard deviations were shown to be a few percentages, which were not statistically significant. Changes in the repeated renal uptake rate seem to indicate not only changes of renal function with the treatment but also some technical errors. Herein, to investigate changes in renal function of the therapeutic side, the uptake ratio rate (rate of uptake rate in the therapeutic side/uptake rate in the contral lateral side) was utilized instead of uptake rate. Renal scintigraphy was carried out in 48 patients with unilateral renal stones before and after ESWL or PNL monotherapy or the combined ESWL and PNL therapies. Within one week of treatment, the uptake ratio rate significantly decreased in patients with PNL or the combined ESWL and PNL, although DMSA uptake rate in the therapeutic side did not significantly changes. Neither renal uptake rate nor uptake ratio rate significantly changed after ESWL treatment. There was no significant difference in changes of uptake ratio rate between Siemens Lithostars Plus and the improved Dornier HM-3 lithotriptors. This study indicated that ESWL monotherapy did not affect the uptake ratio rate, although PNL monotherapy and the combined ESWL and PNL therapies may affect the uptake ratio rate to some extent.
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Affiliation(s)
- H Matsuura
- Department of Urology, Mie University School of Medicine
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47
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Arima K, Yanagawa M, Sugimura Y, Tochigi H, Kawamura J, Saitoh K, Yamazaki Y, Mori O, Oomoto Y, Nakagawa M. [Effects of nephrectomy and interferon administration on immunological parameters in patients with renal cell carcinoma]. Hinyokika Kiyo 1994; 40:469-74. [PMID: 8073952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To study the changes in the subsets of peripheral blood lymphocytes before and after nephrectomy and interferon (IFN) therapy, 57 patients with renal cell carcinoma were divided into three groups; one group consisted of 16 patients with metastasis who had been administered IFN-alpha, one group consisted of 16 patients without metastasis who had been administered IFN-alpha, and the other consisted of 25 patients without metastasis who had not been administered IFN-alpha. Immunological parameters such as percentages of NK (Leu-11+ [Leu-7-) cells, percentages of activated CD4 (Leu-3a+ HLA-DR+) positive cells and percentages of activated CD8 (Leu-2a+ HLA-DR+) positive cells were examined by two color flow cytometry and the percentages of CD4 (Leu-3a+) positive cells, percentages of CD8 (Leu-2a+) positive cells values and the ratio of percentages of CD4 positive cells/percentages of CD8 positive cells were evaluated. The percentages of NK cells showed a tendency to decrease after nephrectomy and the administration of IFN-alpha. The percentage of CD4 positive cells showed a significant increase after the administration of IFN-alpha. The percentage of activated CD4 positive cells and the ratio of percentage of CD4 positive cells/percentage of CD8 positive cells showed a tendency to increase slightly. The percentage of CD8 positive cells and percentage of activated CD8 positive cells showed no particular changes. There was a specific correlation between the administration of IFN-alpha and the changes of percentage of CD4-positive cells and this suggests that the administration of IFN-alpha led to the increase of helper T cells.
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Affiliation(s)
- K Arima
- Department of Urology, Mie University School of Medicine
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48
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Koul H, Ebisuno S, Renzulli L, Yanagawa M, Menon M, Scheid C. Polarized distribution of oxalate transport systems in LLC-PK1 cells, a line of renal epithelial cells. Am J Physiol 1994; 266:F266-74. [PMID: 8141327 DOI: 10.1152/ajprenal.1994.266.2.f266] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although oxalate is a major component of kidney stones, the factors affecting renal oxalate handling are poorly understood. This uncertainty stems in part from complexities inherent to available preparations; thus the present studies examined oxalate handling in a simpler model system, LLC-PK1 cells, an epithelial cell line of porcine origin. Initial studies on monolayers in dishes demonstrated that these cells accumulate oxalate via a process or processes sensitive to the anion transport inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS). Subsequent studies using LLC-PK1 monolayers on membrane filters examined the characteristics and distribution of these transporter(s). At the apical surface, DIDS-sensitive uptake was sensitive to [Cl-] but not [SO4(2-)] or [HCO3-] and was unaffected by alterations in pH or membrane potential. At the basolateral surface, oxalate uptake was [Cl-] insensitive but markedly affected by variation in pH, [SO4(2-)], or [HCO3-]. Uptake at the two membrane surfaces was also differentially affected by transport inhibitors and organic acids. Thus LLC-PK1 cells appear to express unique transporters at each membrane surface: oxalate/Cl- exchange at the apical surface and oxalate/SO4(2-) (or HCO3-) exchange at the basolateral surface.
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Affiliation(s)
- H Koul
- Division of Urology and Transplantation Surgery, University of Massachusetts Medical School, Worcester 01655
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Tsubota N, Yanagawa M, Yoshimura M, Murotani A, Hatta T. The superiority of exercise testing over spirometry in the evaluation of postoperative lung function for patients with pulmonary disease. Surg Today 1994; 24:103-5. [PMID: 8054786 DOI: 10.1007/bf02473389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Thoracic surgeons have often been embarrassed by the discrepancy between an improvement in symptoms and the unchanged or even worse results of spirometry in postoperative patients with either bullae or inflammatory lung disease. Forty-four patients with lung diseases, who underwent a total of 47 operations, were categorized as follows: 12 cases of empyema, 16 cases of giant bulla (undergoing surgery a total of 19 times), 4 cases of bronchiectasis, and 12 cases of other miscellaneous diseases. All patients were tested preoperatively and again 4-6 months after surgery on both the spirometer and treadmill exercise tests. The forced vital capacity (FVC) and forced expiratory volume (FEV1.0) results were as follows: the empyema group 1.82 +/- 0.52 liters preoperatively to 1.93 +/- 0.69 liters postoperatively and 1.47 +/- 0.44 liters to 1.56 +/- 0.53 liters, respectively; and the giant bulla group, 3.49 +/- 0.96 liters to 3.35 +/- 0.77 liters and 2.35 +/- 0.96 liters to 2.48 +/- 0.69 liters, respectively. However, the exercise time was prolonged in the empyema group from 6.00 +/- 3.77 min to 8.33 +/- 3.80 min (P < 0.01) and in the giant bulla group from 11.83 +/- 3.71 min to 12.92 +/- 2.84 min (P < 0.05). It was thus concluded that exercise testing should be chosen for the postoperative evaluation of patients with inflammatory pulmonary disease and giant bullae, especially if any discrepancies are seen between spirometry and performance status, because on the basis of our results, it appears that the benefits obtained by surgery are best measured by the dynamic values of exercise testing and not by the static values of spirometry at rest.
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50
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Onishi T, Nakano S, Yanagawa M, Sugimura Y, Tochigi H, Kawamura J. [Initial chemotherapy followed by orchiectomy and retroperitoneal lymphadenectomy--a case of seminoma with a testicular tumor and enlarged regional lymph nodes]. Hinyokika Kiyo 1994; 40:151-4. [PMID: 7510450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A 43-year-old male visited our hospital with complaints of right scrotal swelling and lower abdominal mass. Computed tomographic (CT) scan showed the right testicular tumor and regional enlarged lymph nodes. However, there were no metastasis in lung, brain, liver, and bone. First, we performed chemotherapy of modified PVB regimen (cisplatinum, vinblastine, peplomycin) prior to the right orchiectomy, because a tumor lump was palpable from the right testis to the lower abdominal mass. After three courses of modified PVB chemotherapy, beta-HCG, HCG and LDH values became within normal limits and all tumors were necrotic on the CT scan. Then, we performed the right orchiectomy and retroperitoneal lymphadenectomy simultaneously. After operation, two courses of VIP chemotherapy (etoposide, ifosfamide, cisplatinum) were performed since viable cells in one of the obturator lymph nodes were pathologically noticed. The patient has been free of recurrence of the tumor for 15 months after the treatment. In the particular case, in which the primary testicular tumor was not extirpated en bloc, the initial chemotherapy followed by orchiectomy was found to be feasible.
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Affiliation(s)
- T Onishi
- Department of Urology, Mie University School of Medicine
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