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Biomedical subjects

E Okajima

Publications and source records attributed to E Okajima.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Asymptomatic synchronous bilateral granulomatous orchitis--a case report].

A case of asymptomatic synchronous bilateral granulomatous orchitis in a 79-year-old male patient is described. He was diagnosed with asymptomatic microhematuria, and referred to our outpatient clinic. In the physiological examination, there were stone-hard indurations in his bilateral testes. There were multiple hypoechoic areas in the scrotal ultrasonography. Bilateral testicular tumor was suspected. However, histological findings after bilateral orchidectomy revealed granulomatous orchitis. Abdominal computed tomography revealed swelling of the paraaortic lymph nodes postoperatively. However no malignant origin was detected. Differential diagnosis between testicular tumor and granulomatous orchitis is very difficult in any examination except by histological findings. Conservative therapy is usually not effective, and most cases are treated by orchidectomy. Bilateral cases of this entity are relatively rare, but in young cases, it is necessary to distinguish the granulomatous orchitis from the testicular tumor before surgical intervention.

Aged↗
PubMed1994

[Management of advanced urogenital cancer: treatment of metastasis].

In clinical trials in advanced urogenital cancer with metastasis there are cases showing a poor clinical response and poor prognosis. The cure of advanced urogenital cancer still remains a major problem in management. The present paper is a summary of 8 articles presented at the symposium on "Management of advanced urogenital cancer: Treatment of metastasis" in the 43th Annual Meeting of Center Section of Japanese Urological Association in November, 1993. The present status, problems and future conception of treatment modalities for advanced urogenital cancer were discussed.

Humans↗
PubMed1994

[Treatments for advanced transitional cell carcinoma of the urinary tract: chemotherapy and operation].

The current status of treatments for advanced transitional cell carcinoma of the urinary tract with metastasis is reported. A total of 62 patients were treated in Nara Medical University Hospital and its affiliated hospitals between January, 1980 and June, 1993. All patients were divided into two categories; cases in which local recurrence and/or distant metastasis had developed during the followup study (group 1) (n = 32) and fresh cases with distant metastasis (group 2) (n = 30). Most of the metastatic sites were treated with chemotherapy alone or combination therapy including chemotherapy. As for clinical response of each case, CR + PR rate in group 1 (34%) was higher than that in group 2 (13%) (p < 0.1). As for prognosis, the survival rate in group 1 was significantly higher than that in group 2 (p < 0.05). In group 1, the survival of CR was significantly higher than that of the non-responders. No adjuvant therapy for invasive bladder cancer and post-operative adjuvant therapy for renal pelvic and/or ureteral cancer can be recommended to prevent local recurrence or distant metastasis. In addition, supporting therapy and dose intensified chemotherapy would lead to good prognosis in advanced urothelial cancer patients.

Adult↗
PubMed1994

A case report of synchronous triple cancer resected simultaneously.

We report a unique case of a patient with synchronous renal cell carcinoma, hepatocellular carcinoma and squamous cell carcinoma of the oral floor. All three tumors were resected during a single operation. The patient was a 75-year-old man with masses in the liver and right kidney discovered by ultrasound examination during a routine checkup. Further examination also revealed a squamous cell carcinoma of the oral floor. The patient underwent a simultaneous radical nephrectomy, enucleation of the liver tumor and resection of the tumor of the oral floor. The diagnoses were histopathologically confirmed. The number of patients with multiple cancers has recently been increasing. The possibility of a second or third malignant lesion should be considered, not only in patients with a known malignancy but also in those without malignancy. The importance of screening procedures in the early detection of malignancy before the appearance of clinical symptoms should be emphasized.

Aged↗
PubMed1994

[Percutaneous renal cyst puncture with CO2 instillation therapy].

Ultrasound-guided percutaneous puncture of renal cysts replaced by CO2 was performed on 9 renal cysts of 6 patients from May 1993 through September 1993. Puncture and aspiration of cysts was performed using a 5.5 Fr one-step fluid drain kit (pig tail stent) under ultrasonography inspection. Aspirated volume of cyst contents was 15-292ml (mean 115 ml), and the instilled CO2 volume was 15-150 ml (mean 73 ml). All patients were checked by CT scan. In one month, the reduction rate of cyst volume was 46-84% (mean 69%) and lumbago, their chief complaint, was improved in all patients. No complications were observed in patients treated by CO2 instillation. Although long-term followup is needed to draw a definite conclusion, this therapy may be useful for benign renal cystic lesions.

Aged↗
PubMed1994

[Effect of recombinant atrial natriuretic peptide (r-ANP) on ischemic and cyclosporine-induced kidney damage in rats].

Cyclosporine A (CYA) a new immunosuppressive drug, has greatly improved the outcome of solid graft transplantation. The nephrotoxicity of CYA, however, is a serious problem, and constitutes the major obstacle limiting the use of CYA as an immunosuppressive agent for renal transplantation. On the other hand, the newly described atrial natriuretic peptide (ANP) hormonal system in both humans and animals appears to play an important role in sodium and water excretion. The present study examined the nephrotoxicity of CYA and the effect of recombinant-ANP (r-ANP) on the damaged kidneys in three groups. Group 1 consisted of rats with 45 minutes warm ischemic left kidney and right nephrectomy [WI rats]; Group 2 consisted of WI rats with oral administration of CYA (100mg/kg/day) for 2 weeks [WI+CYA rats]; Group 3 consisted of WI+CYA rats with intraperitoneal administration of r-ANP (10ng/kg/day) for 2 weeks. Group 2 had lower glomerular filtration rates (GFR) and renal plasma flow (RPF) than Group 1, but Group 3 had significantly higher GFR and RPF than Group 2. Additionally, in order to demonstrate the change in renal viability among the three groups, the adenosine triphosphoric acid level (ATP) and adenylate energy charge ratio (EC) of renal parenchymal tissue were measured by high performance liquid chromatography (HPLC). Group 2 had lower ATP and EC than Group 1, and Group 3 had higher ATP and EC than Group 2. The results of this study suggest that r-ANP is efficacious on rat kidney damage induced by CYA and WIT.

Animals↗
PubMed1993

The binding site for fucose-binding proteins of Lotus tetragonolobus is a prognostic marker for transitional cell carcinoma of the human urinary bladder.

BACKGROUND: Carbohydrate signals are important in tumor metastasis. METHODS: Expression of binding sites for fucose-binding proteins (FBP) of Lotus tetragonolobus were immunohistochemically analyzed in patients with transitional cell carcinoma. RESULTS: The survival of patients with invasive bladder cancer was associated with the degree of expression of FBP binding sites. Overall actuarial 5-year survival and cancer-corrected 5-year survival rates were much worse in patients with strong expression of FBP binding sites than in those with no or weak expression (P < 0.001 and P < 0.05, respectively). Strong expression of FBP binding sites in patients with Stage T3-4 disease or disease beyond Stage T2 with lymphatic permeation also was correlated with increased disease progression. Autopsies revealed that FBP binding sites were strongly expressed in all primary tumors with metastasis and in most of the metastatic tissues. CONCLUSION: The degree of expression of FBP binding sites correlates with the increased metastatic potential of bladder cancer and with poor patient survival times.

Adult↗
PubMed1993

Renal ablation with absolute ethanol for nonfunctioning hydronephrosis.

Six adult patients underwent renal ablation with absolute ethanol for nonfunctioning hydronephrosis due to various ureteral lesions. The procedure of renal ablation consisted of 3 separate sessions: placement of percutaneous nephrostomy; transarterial embolization of the renal artery with absolute ethanol, and sclerotherapy of the renal pelvis and ureter through nephrostomy with absolute ethanol. Marked shrinkage of the treated kidney was observed in all cases without any major adverse effects throughout the observation period. Renal ablation with absolute ethanol for nonfunctioning hydronephrosis constitutes a safe and less invasive alternative to surgical nephrectomy to preserve the quality of life of the patients.

Adult↗
PubMed1993

[A study on markers of bone metabolism in patients with non hypercalciuric calcium stone--measurement of gamma-carboxyglutamic acid and hydroxyproline].

Thirty-one patients (26 male and 5 female patients) of non-hypercalciuric Ca stone formers were studied concerning their bone metabolism. We measured plasma free gamma-carboxyglutamic acid, plasma hydroxyproline, urinary free gamma-carboxyglutamic acid and urinary hydroxyproline as markers of bone metabolism. Plasma free gamma-carboxyglutamic acid level showed significantly higher in stone formers than normal controls (1.01 +/- 0.37 nmol/ml vs 0.39 +/- 0.13 nmol/ml). But no significant difference were observed in plasma hydroxyproline level (1.99 +/- 0.73 micrograms/ml vs 2.27 +/- 0.92 micrograms/ml), urinary free gamma-carboxyglutamic acid (52.0 +/- 17.6 nmol/mg.Cr vs 45.7 +/- 9.8 nmol/mg.Cr), and urinary hydroxyproline (3.87 +/- 2.02 micrograms/mg.Cr vs 3.33 +/- 1.63 micrograms/mg.Cr). In conclusion, these results suggest that abnormality of bone metabolism may be not a primary event in causing stone formation in these patients.

1-Carboxyglutamic Acid↗
PubMed1993

[A questionnaire survey on urinary incontinence in geriatric nursing home patients].

A survey by questionnaires was performed to understand the present conditions of urinary incontinence in the aged. The objects were 748 persons who were residing in eight geriatric nursing homes locating in Nara Prefecture. The answers from 183 males and 565 females ranging from 57 to 101 years old were collected and analyzed. The answers were interpreted as follows: (1) Of these 748 persons 422 (56%) were incontinent, 94 males (51%) and 330 females (58%). (2) The higher age group tends to show the higher rate of incontinence. (3) The rate of incontinence seems to highly correlate with the degree of dementia and impaired mobility. (4) Sixty-nine persons (16%) had consulted a nursing home doctor and/or other medical doctors, only 20 of whom had been medicated for incontinence. (5) An institution where a behavioral therapy program had been employed showed a lower rate of incontinent persons. From these results, it is considered that not only an increase of nursing staff but also aggressive participation of medical specialists including urologists are needed to improve their quality of life.

Activities of Daily Living↗
PubMed1993

[The effects of rhodamine 123 on the cell growth of the cultured cells derived from urogenital carcinoma].

Rhodamine 123 (Rh123) is a red fluorescence dye, which is accumulated more and retained longer in the mitochondria of malignant transformed cells. In this study, the suppressive effects on the growth of cultured urogenital carcinoma cells (PC-3 and LNCaP from prostate carcinoma, T-24 from bladder cancer, and SV-HUC-1 human ureteral transitional cell transformed by SV virus in vitro, ACHN, YCR-1 and RCF213 from renal cell carcinoma) were examined. The cell growth of PC-3, LNCaP, T-24 and SV-HUC-1 was suppressed significantly in a dose dependent manner, but that of cells derived from renal cell carcinoma was not suppressed. The uptake and elimination of Rh123 in PC-3, ACHN and YCR-1 were not significantly different. When administered with verapamil and buthionine sulfoximine, which are reported to be chemical modulators of anticancer agents, Rh123 suppressed the growth of ACHN and YCR-1 significantly. Rh123 seems to have an anticancer effect against the urogenital carcinomas, and the role of Rh123 with hyperthermia, photodynamic therapy and chemotherapy requires further investigation.

Antimetabolites, Antineoplastic↗
PubMed1993

[A case of retroperitoneal extramedullary plasmacytoma].

Extramedullary plasmacytoma (EMP) is a very rare disease and mainly arises in the head and neck area. We herein reported a case of EMP arising in the retroperitoneal space. A 46-year-old man was referred to our outpatient clinic in November 1989 with the complaint of flank pain on the left side. Radiological examinations showed a tumor formation in the retroperitoneal space, which involved the left kidney, spleen and pancreas. Immunoelectrophoresis showed an elevation of serum IgG level and a spike of M-protein was detected in the serum protein electrophoresis. No bone lesions were detected, and bone marrow aspiration showed no abnormal cells. US-guided needle biopsy of the tumor led to the histological diagnosis as plasmacytoma of the IgG-kappa type. Following three cycles of preoperative chemotherapy (a THP-COP regimen), which resulted in a size reduction of the tumor by 40%, extensive resection of the tumor including extirpation of the left kidney, spleen, and tail of pancreas was performed. Because of tumor extension into the posterior wall of the stomach, however, the surgery resulted in incomplete resection. A total of 11 cycles of postoperative chemotherapy (THP-COP) was performed periodically for the residual tumor in the stomach. Rapid tumor spreading in addition to re-elevation of the serum IgG level, however, developed after the 11th postoperative chemotherapy, which extensively involved the stomach and intestines. The patient died of the disease 33 months after the initiation of treatment.

Humans↗
PubMed1993

[Antireflux operation for vesicoureteral reflux in spina bifida patients].

A series of 32 patients with spina bifida, representing 50 renal units with vesicoureteral reflux (VUR), was treated with antireflux operation. All but one patient underwent ureteral reimplantation with Cohen's technique. Another patient was treated with bilateral Politano-Leadbetter's technique. The overall success rates were 92.0% by renal unit and 87.5% by case, with a mean follow-up period of 42.5 months. These results were comparable to those in the recent literature. Failure included recurrence of VUR in 3 patients. Another patient who had undergone unilateral reimplantation developed new occurrence of reflux in the contralateral ureter. Possible masking of contralateral VUR should be taken into consideration in patients with unilateral high grade VUR. We also emphasize the importance of continuing clean intermittent catheterization in a proper manner to be free of VUR postoperatively.

Adolescent↗
PubMed1993

[Unresolved issues concerning the operative indication of augmentation cystoplasty in spina bifida patients: a report of two cases].

Augmentation cystoplasty is evolving into a common method of surgical treatment for a low capacity and/or low compliance neurogenic bladder. Although an increasing number of successful results have been recently reported, the operative indication of augmentation cystoplasty is yet to be established. Herein, we report two cases of neurogenic bladder due to spina bifida which required abandonment of augmentation cystoplasty. The first case was in a 23-year-old female with a severely deformed bladder and right vesicoureteral reflux (VUR). She refused to undergo ileocystoplasty because we could not assure her of postoperative conception which she eagerly anticipated. The second case was in a 19-year-old male with a severely deformed bladder and right VUR. He experienced recurrent episodes of ventriculoperitoneal shunt (V-P shunt) difficulty which required exchanging the shunt tube each time, and each exchange proved to be very difficult or nearly impossible. Based on lengthy neurosurgical consultation, we came to the conclusion that ileocystoplasty was not a preferable treatment of choice for the correction of his disease due to the possibility of V-P shunt infection, which could be fatal. Alternatively, both cases were treated with Cohen's ureteral reimplantation, which resulted in the recurrence of VUR. These cases presented still unresolved issues concerning the operative indication of augmentation cystoplasty in spina bifida patients.

Adult↗
PubMed1993

[A study on plasma allantoin in patients undergoing maintenance hemodialysis].

Current studies have reported that free radical molecules had anticipated intimately with the pathogenesis of some complications specific for a long term hemodialysis. Among substances generated by free radical reaction, methylguanidine (MG) had been well known as most popular parameter in hemodialyzed patient, but allantoin (Alt) had been reported to be generated from uric acid by hydroxyradical, too. In this study, we measured serum level of Alt in long term hemodialyzed patient and analysed in the comparison with serum level of sialic acid, MG, and MG/Cr value. Serum level of Alt in patients group varied from 2.6 to 105.9 nmol/ml, which was significantly higher as compared with exclusively undetectable level in normal volunteers (n = 15). Serum level of Alt in each patient showed a significant correlation with serum level of a sialic acid (r = 0.400 p < 0.02). Furthermore, although serum level of Alt failed to show a significant correlation with serum level of MG, but showed a significant correlation with MG/Cr value. (r = 0.485 p < 0.01). In addition, higher level could be found in patient group having higher serum level of MG or MG/Cr value. Based upon those results, we proposed that a measurement of serum level of Alt could be of value in detection of free radical reaction in long term hemodialyzed patient.

Adolescent↗
PubMed1993

Primary malignant melanoma of the female urethra: a case report.

A case of primary malignant melanoma of the female urethra is presented. A 65-year-old Japanese woman was referred with dysuria and urethral bleeding. A hemorrhagic blue-black tumor, 3 cm in diameter, was diagnosed as a malignant melanoma by urinary cytology and biopsy. In spite of radical surgery followed by adjuvant immunochemotherapy with beta interferon, dacarbazine, nimustine and vincristine (IFN beta-DAV), the patient died of the disease one year after surgery because of lung metastasis which developed six months after diagnosis. The regional lymph nodes were not involved. In the present paper, we have briefly discussed the diagnostic value of cytological examination for this condition, as well as biopsy, with regard to the risk of hematogeneous tumor spread.

Aged↗
PubMed1992

Frequent association of p53 gene mutation in invasive bladder cancer.

Structural alterations of the p53 gene were investigated to elucidate the molecular biological difference between superficial and invasive bladder cancer by polymerase chain reaction single-strand conformation polymorphism analysis. In 25 bladder cancers obtained from 23 patients, p53 gene mutations were investigated in exon regions 4 to 11. Twenty-four were transitional cell carcinomas, and the remaining one was a squamous cell carcinoma. Only one of 13 superficial bladder cancers, including pTis, pTa, and pT1, was found to have p53 gene mutation. However, of 12 invasive bladder cancers with pT2, pT3, and pT4, six primary carcinomas, including a squamous cell carcinoma and one metastatic carcinoma, were found to have p53 gene mutations. The number of cancers examined in Grades 1, 2, and 3 was three, seven, and 15, respectively. p53 gene mutation was not found in any of the ten cancers with Grades 1 and 2, while eight of 15 bladder cancers with Grade 3 were found to have p53 gene mutation. The results indicated that the incidence of p53 gene mutations appeared to be much higher in invasive-type and high-grade bladder cancers than in superficial and low-grade ones. Our results are compatible with the recently published results by Sidransky et al. [Science (Washington DC), 252: 706-709, 1991] showing that p53 gene mutations were frequently found in invasive bladder cancers by sequence analysis on polymerase chain reaction amplified products corresponding to exons 5 to 9. Our results are also compatible with previously reported results by Olumi et al. (Cancer Res., 50: 7081-7083, 1990) showing that the loss of chromosome 17p, revealed by analysis with restriction fragment length polymorphism, was frequent in high-grade bladder cancers. In this study, p53 gene mutations were often found in exon 4 as well as in other exons. Therefore, this region should also be examined for screening of mutations of this gene in bladder cancer. There appeared to be no consistent mutation sites in exons 4 to 11 of the p53 gene and no specific patterns of the mutation in bladder cancer.

Base Sequence↗