Biomedical subjects

E Okajima

Publications and source records attributed to E Okajima.

At least 145 records · Page 8Linked to original sources

PubMed1989

[Bilateral ectopic ureteroceles: report of a case].

A case of bilateral ectopic ureteroceles with complete duplicated pelves and ureters occurring in a 9-year-old girl is reported. She complained of cloudy urine and urinary incontinence. IVU revealed bilateral complete duplicated collecting systems and hydronephrosis of upper poles of the kidney. Bilateral ureterovesiconeostomy by modified Politano-Leadbetter method was carried out. Her postoperative course was uneventful and hydronephrosis of upper poles on IVU at 1 year after discharge and urinary incontinence improved. The 11 reported cases with bilateral ectopic ureteroceles including our case are reviewed and some characteristics of this entry are discussed.

Child↗

PubMed1989

[Crossed renal ectopia with ectopic ureter: a case report].

Crossed renal ectopia is a relatively rare congenital anomaly. A case of crossed renal ectopia with fusion (inverted L shaped kidney) associated with ectopic ureter opening to seminal vesicle on the right side, which occurred in a 38-year-old man is reported. He complained of lower abdominal pain, frequency of micturition, and dysuria. Ureterectomy with vesiculeotomy on the right side was carried out. Histological finding is a transitional epithelium inside the duct. This case is the 11th reported case in Japan and some statistical studies were carried out.

Adult↗

PubMed1989

[Infectious cysts of a müllerian duct: a case report].

We report a case of infectious cysts of Müllerian duct. A 48-year-old male patient was referred to our department complaining of terminal miction pain on July 19, 1985. The excretory urogram showed right lateral displacement of bladder and pelvic CT-scan demonstrated a large mass containing multiple cysts. A total of 5 percutaneous punctures was performed, but without success. The cysts were removed completely on November 26, 1985. A large volume of pus subsequently yielded a pure culture of Serratia marcescens and multilobular cysts were observed in the incised tumor. Wound healing was delayed because of severe infection. We discussed the difficulty of the management for infectious cysts of the Müllerian duct.

Cysts↗

PubMed1989

[Changes in the management of urolithiasis: endourologic treatment of calculi in the upper urinary tract].

Three hundred seventy cases with calculi in upper urinary tract were treated by endourology, 210 cases were subjects of percutaneous nephrolithotripsy (PNL) and 160 cases of transurethral ureterolithotripsy (TUL), in Nara Medical University Hospital and 13 affiliated hospitals. Of the PNL cases, PNL was completed in 184 cases (87.6%) and not completed in 16 cases (12.4%). 168 cases (80.0%) had successful results by PNL alone, stone-free or stone fragments less than 5 mm, in spite of the stone location and size. No serious adverse effect was experienced throughout the study. However, changes like a scar formation or fibrosis around the nephrostomy tract were revealed as a late complication by excretory urography, computed tomography and renal scanning. Of the 160 TUL cases, TUL was successful in 132 cases (82.5%) and unsuccessful in 28 cases (17.5%). The results of TUL for the calculi above the upper iliac cresta were not favorable, success rate for stone 6-10 mm in diameter was 70.3% and that for stones larger than 11 mm 37.5%. However, the results of TUL for the calculi below the upper ileac cresta were favorable, the success rate for the 6-10 mm calculi was 91.5% and for the calculi larger than 11 mm 88.4%. Of 28 TUL failures, 7 cases underwent PNL and 21 cases received open surgery. Throughout our endourologic treatments, the most problematic stone was calculi impact in the ureter. The indication of endourology for the calculi in upper urinary tract is discussed with consideration of ESWL which is becoming the main stream of stone treatment.

Adolescent↗

PubMed1989

Viability estimation of preserved dog kidneys based on the LDH activity in the preservation perfusate.

The lactate dehydrogenase (LDH) activity and LDH isozyme ratio in the perfusate were investigated in perfused dog kidneys, preserved from dogs subjected to warm ischemia of varying duration prior to kidney removal. The length of this warm ischemic time exerted a marked effect on the variations in both the LDH activity and isozyme ratio. Moreover, the variations in LDH activity and isozyme ratio during the preservation were found to correlate well. On this basis, the M-component activity of the LDH isozymes and the activity of the LDH4 and LDH5 isoenzymes are proposed to represent more sensitive parameters for evaluating the tissue hypoxic damage. Our data were also analyzed retrospectively, in relation to the ability of the perfused kidney to function on autotransplantation. It was found that the amount of LDH4 and LDH5 isoenzyme activity was of great value in determining the viability of the kidney. Thus, an analysis of the LDH activity in the wash solution can provide considerable and precise information about the kidney viability as a graft.

Animals↗

PubMed1989

[Penile and urethral metastases from superficial bladder tumor after TUR: a case report].

A case of metastasis to the penis and the urethra from superficial bladder tumor of transitional cell carcinoma (TCC), grade 3 is reported. A 52-year-old male patient was diagnosed to have TCC of the urinary bladder (grade 3, stage pT1a) in May, 1985 and was treated initially with transurethral resection followed by adriamycin (ADR) instillation. In February, 1986, urethroscopy showed a papillary tumor in the cavernosal urethra and a metastatic tumor was noted in the corpus spongiosum penis. Biopsy of urethral tumor revealed TCC, grade 3. Therefore partial urethrectomy with resection of penile tumor was performed. Although the patient underwent combination chemotherapy involving CAP (cisplatin + ADR + cyclophosphamide) and M-VAC (methotrexate + vincristine + ADR + cisplatin) regimens, local lesion and metastatic lesions progressed, and he died in June 1986, 20 days after emasculation. The management of superficial bladder tumor with TCC, grade 3 was reviewed and discussed here.

Carcinoma, Transitional Cell↗

PubMed1989

Testicular tumors occurring in non-twin brothers: a case report.

The present report describes two cases of seminoma that occurred simultaneously in non-twin brothers. These siblings were typed for HLA-A, -B, -C and -DR specificities, and manifested identical haplotypes. Sixty-four sets of affected siblings have been reported prior to the present cases. We examined HLA-DR antigen in brothers with testicular tumors and hereditary roles in the etiology are discussed.

Adult↗

PubMed1988

LH-RH agonist, Zoladex (Goserelin), depot formulation in the treatment of prostatic cancer. Randomized dose-finding trial in Japan.

Ninety patients with advanced prostatic cancer (15 with stage B, 23 with stage C, and 52 with stage D) were randomized to receive 0.9, 1.8, or 3.6 mg, respectively, of Zoladex depot subcutaneous injection every 28 days for 12 weeks. The serum levels of LH, FSH, and testosterone were elevated after the first injection, and followed by a significant decrease. The suppression of testosterone levels in the blood to castrate levels was observed in all patients except two treated with 0.9 mg. Objective response (CR and PR) was seen in 63.6% (0.9 mg), 47.8% (1.8 mg), and 68% (3.6 mg) of patients according to the Japanese Prostatic Group Criteria. Subjective improvement (performance status, analgesic consumption) was also observed in 75-88% of patients but without a statistically significant difference between each dose group. Only minor adverse effects were found during the treatments. The drug was detected dose dependently in the blood by radioimmunoassay. These results suggest that endocrine therapy with Zoladex depot in doses of 3.6 mg subcutaneously every 4 weeks is a useful alternative to surgical castration in patients with prostatic cancer.

Aged↗

PubMed1988

Transcatheter arterial embolization of vesical artery in the treatment of invasive bladder cancer.

Transcatheter arterial embolization was performed in a total of 70 patients with invasive bladder cancer from October 1980 to December 1987. It was performed as a part of multidisciplinary treatment in patients with invasive bladder cancer. Microencapsulated mitomycin C, gelatin sponge and lipiodol (iodized oil) were used as the embolic material. As a result, reduction of tumor size was noted in 56.7%, but there was no embolic materials-related significant difference. Stage reduction was noted in 72.7% of patients where pathological stages were confirmed by operation. Hemostatic effects were noted in 76.5%. The symptoms of side effects included fever, leukocytosis, urinary frequency and pain, but none of them was severe. The results of the present study indicate that embolization of the vesical artery is useful in the treatment of bladder cancer.

Adult↗

PubMed1988

[Primary signet-ring cell carcinoma of the urinary bladder: report of a case].

A 62-year-old male was admitted to our clinic with the complaints of gross-hematuria and miction pain. Cystoscopic examination revealed non-papillary tumor around the orifice of the left ureter and the left wall. Histopathological findings of the biopsy specimen demonstrated signet-ring cell carcinoma, and the specimen was stained positively by the peroxidase-antiperoxidase technique. No malignant findings in any other organs including gastrointestinal tract and prostate were detected. This patient underwent total cystectomy with ileal conduit and histopathological staging was pT3bNOMO. He was followed with no evidence of local recurrence or metastasis for 29 months after operation. The 45 reported cases with primary signet-ring cell carcinoma of the urinary bladder including our case are reviewed and some characteristics of this entry are discussed.

Acid Phosphatase↗

PubMed1988

[Endocrine therapy of prostatic carcinoma with slow release (depot) formulation of the LH-RH analog ICI 118630 (Zoladex)].

To investigate the clinical efficacy, safety and endocrinology of ICI 118630 (Zoladex) depot formulation at 3 different dose levels (0.9, 1.8 and 3.6 mg), 90 patients were randomized to receive either one of the 3 doses from April, 1985 to March, 1986 in 28 centers. The depot preparation was injected subcutaneously every 4 weeks 3 times (for up to 12 weeks). Clinical efficacy was evaluated in terms of tumor response and overall subjective response. In 70 patients eligible for tumor response evaluation, 14 out of 22 (63.6%) in the 0.9 mg group, 11 out of 23 (47.8%) in the 1.8 mg group, and 17 out of 25 (68.0%) in the 3.6 mg group showed clinical improvement, that is, either complete response or partial response. In 72 eligible patients for overall subjective response evaluation, clinical subjective improvement was observed in 75.0, 81.8 and 88.0% of the patients in the 3 groups, respectively. There was no significant difference between the groups. As for endocrinology, there were 75 eligible patients. Endocrinological effect was observed in 23 out of 25 (92.0%) in the 0.9 mg group, 100% in both 1.8 mg and 3.6 mg groups. There was no significant difference between the groups. Castration was achieved by week 3.5 +/- 1.7 of therapy on average and by week 2 in the earliest case. There was no significant difference in incidence of side effects between the 3 groups: 5 out of 26 (19.2%) in the 0.9 mg group, 8 out of 29 (27.6%) in the 1.8 mg group, and 2 out of 30 (6.7%) in the 3.6 mg group. Flares presented as an increase in bone pain in 2 and as ureteric obstruction in 2 all in the 1.8 mg group but none in the other 2 dose groups. These flares disappeared on further treatment with Zoladex. These patients showed a clinical-response. The blood level of Zoladex was dose dependent, reaching its peak at week 2 of therapy in all 3 dose groups. There was no evidence of accumulation. Since these results demonstrate that 3.6 mg produces medical castration earlier, it may well be considered as an optimal dose in men.

Buserelin↗

PubMed1988

[Clinical efficacy of long-term treatment with LH-RH analogue, ICI 118630 (Zoladex), in prostatic cancer patients. The Zoladex Multicenter Study Group].

The Zoladex (ICI 118,630) multicenter trial included 149 patients with stage B +o D prostatic cancer recruited from 1984 to date. Of them 53 clinical responders on the treatment for 40 weeks or longer were subjected to assessment of antitumour response, overall subjective response, endocrinological response, safety and usefulness. The responders consistently showed a clinical response as evidenced by antitumour response in 32 of 50 patients (64.0%) at week 12 and in 35 of 51 (68.6%) at week 40, and overall subjective response in 42 out of 47 patients (89.4%) at both week 12 and week 40. Endocrinologically, all of the 47 eligible patients maintained a 40-week or longer response. Adverse reactions were observed in 19 out of 73 patients (26.0%), subdivided by the time of occurrence as 15/73 (20.5%) up to week 12, 3/71 (4.6%) between week 12 and week 40, and 5/53 (9.4%) in and after week 40. No patient required the discontinuance of treatment. Usefulness of the drug was observed in 51 out of 52 patients (98.1%). The results indicated that Zoladex in a once monthly regimen may be of great advantage to elderly patients with prostatic cancer, and allow an improved patient compliance: Zoladex may not only produce clinical remission but also improve the quality of life.

Buserelin↗

PubMed1988

[Endocrine therapy for prostatic carcinoma--the clinical trial to compare the efficacy of LH-RH analogue, ICI 118630 (Zoladex) with castration or estrogen].

A multicenter randomized clinical trial was carried out between May, 1986 and May, 1987 involving 82 patients with stage B-D prostatic carcinoma from 29 centers. The clinical efficacy, endocrine effect, safety and usefulness of the luteinizing hormone-releasing hormone (LH-RH) analogue and other endocrine manipulations in the treatment of prostatic carcinoma. Zoladex depot containing 3.6 mg of ICI 118,630, an LH-RH analogue, was administered every four weeks 3 times in total. Patients in the control group received either 300 mg of diethylstilbestrol diphosphate orally daily for 12 weeks or orchidectomy. An antitumor effect (CR + PR) was observed in 21 of the 33 patients (63.6%) in the Zoladex group and in 22 of the 33 (66.7%) in the control group, showing no significant difference between the two groups. There was no significant difference in overall subjective response either; 21 of the 24 (87.5%) in the Zoladex group and 24 of the 30 (80.0%) in the control group. In both groups, 100% endocrine effect was obtained as shown by achievement of castration in all patients. Adverse reactions were observed in 14 of the 39 (35.9%) patients treated with Zoladex as compared with 19 of the 34 (55.9%) control patients, resulting in no significant difference in the incidence between the two groups. These adverse reactions were not so severe as to require withdrawal from the study. In both groups, the treatment was assessed as slightly or more useful in 29 of the 33 (87.9%) patients. From these results, it is concluded that Zoladex, 3.6 mg depot, is a useful drug for treatment of prostatic cancer, having clinical efficacy and endocrine effects comparable to those of the conventional endocrine manipulations, being safe, and causing less physiological and psychological pain.

Aged↗

PubMed1988

[Metastatic penile tumor of extragonadal seminoma: a case report].

Metastatic tumor of the penis is uncommon. A 62-year-old man was admitted with the complaint of diffuse induration of the penile shaft. Biopsy material of the corpora cavernosa and supraclavicular lymphnode showed metastatic seminoma histopathologically, but no abnormal finding of bilateral testes was seen. Chest X-ray showed a mass at the upper anterior mediastinum. We considered the primary site of this malignant disease to be the mediastinum. The patient died of liver cirrhosis but permission of autopsy could not be obtained.

Dysgerminoma↗

PubMed1988

Effect of 1-hexylcarbamoyl-5-fluorouracil on development of rat urinary bladder tumor induced by N-butyl-N-(4-hydroxybutyl)nitrosamine.

The present study was conducted to examine the effect of 1-hexylcarbamoyl-5-fluorouracil (HCFU) on the development of urinary bladder tumors induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in rats. One hundred twenty male Fischer 344 rats were divided into 6 groups. Sixty rats (groups 1, 2 and 3) were given 0.05% BBN in drinking water for the initial 8 weeks of the experiment and another 60 rats (groups 4, 5 and 6) served as controls. HCFU mixed in the powder diet was administered at daily doses of 100 mg per kg of body weight. Group 2 received HCFU throughout and group 3 after BBN administration for 8 weeks. All animals were sacrificed at 20 weeks from the beginning of the experiment and examined histopathologically. In groups 1, 2 and 3, urinary bladder tumors developed in 13 of 18, 0 of 20, and 4 of 19, respectively. Incidences of tumors in the 2 groups treated with HCFU were significantly lower than that of group 1 treated with BBN alone. These results indicated that HCFU was effective in suppressing the incidence of bladder tumor.

Animals↗

PubMed1988

[Experimental model of urinary bladder tumor in rats for evaluation of chemotherapeutic agents].

The chemotherapeutic agents were evaluated using the experimental urinary bladder tumor rat model induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN). Nine hundred and fourteen male rats received 0.05% BBN in drinking water for 8 weeks, and were divided into 35 groups to follow the regimens of chemotherapeutic agents. Thirty one groups received the agents after BBN treatment, and 4 groups were given the oral agents starting simultaneously with BBN treatment. All rats were killed at 20 weeks and incidence of the urinary bladder was examined histopathologically. The following 13 agents were evaluated; adriamycin (ADM), mitomycin-C (MMC), cyclophosphamide (CPM), 5-fluoro-uracil (5-Fu), N-(2-tetrahydrofuryl)-5-fluorouracil (FT-207), neocarcinostatine (NCS), carbazil quinone (CQ), bleomycin (BLM), vincristine (VCR) and cis-diammine-dichloroplatinum (CDDP) were dosed intraperitoneally, and N-(2-tetrahydrofuryl)-5-fluorouracil (FT-207), 1: 4 mixture of FT-207 and uracil (UFT) and 1-Hexylcarbamoyl-5-fluorouracil (HCFU) were dosed orally. Among these agents, 5-Fu, FT-207, CQ, VCR, CDDP, UFT and HCFU were effective in inhibiting the incidence of urinary bladder tumor induced by BBN. In conclusion, the experimental bladder tumor rat model induced by BBN seems to be useful in evaluating the effective chemotherapeutic agents for a superficial bladder cancer. The importance of the experimental animal model for the evaluation of chemotherapeutic agents is discussed.

Animals↗

PubMed1987

Scanning electron microscopy of changes in the urinary bladder in dogs treated with N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN).

The fine structures of the bladder mucosa during BBN carcinogenesis and of bladder tumors induced by BBN in dogs were examined by scanning electron microscopy. Normal dog bladder mucosa was covered with polygonal superficial cells with peaked microridges, but no microvilli. Microridges and uniform microvilli were observed in hyperplastic mucosa. In low grade papillary tumors induced by low doses of BBN, pleomorphic microvilli predominated. In dogs which received high doses of BBN, bizarre pleomorphic microvilli and blebs were observed in papillary lesions, whereas bumpy surfaces with thick short microvilli were observed in non-papillary lesions. These sequential changes which were observed in dog bladder mucosa during BBN carcinogenesis parallelled the changes that occurred in the process of chemical carcinogenesis in rodents, and dog bladder tumors were similar to those of rodents and of human bladder cancers.

Animals↗

PubMed1987

Prophylactic treatment for superficial bladder cancer following transurethral resection.

A total of 130 primary cases with superficial bladder cancer were entered in the prospective randomized group study. The prophylactic treatments compared consisted in intravesical instillation of adriamycin (20 mg/-40 ml or 30 mg/30 ml), mitomycin C (20 mg/40 ml) or thio-TEPA (30 mg/30 ml), and noninstillation treatments with etretinate or tegafur; control patients were also studied. All agents were administered for 2 years. Recurrences were significantly suppressed in the instillation groups compared with control and non-instillation groups. Significant suppression of recurrence was observed in stage 1 or grade 2 disease treated with prophylactic instillation administered over the first 24 months of a 48-month observation period. These results may indicate the clinical usefulness of prophylactic instillation, but the long-term effect of intravesical instillation is still uncertain. A long-term follow-up study is therefore necessary.

Administration, Intravesical↗