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Biomedical subjects

H Akaza

Publications and source records attributed to H Akaza.

At least 127 records · Page 7Linked to original sources
PubMed1997

[Development of new drugs for urological cancers].

Urological cancers have a variety of biological characteristics. Thus, anti-cancer agents in this field are often developed focusing on the biological characteristics. For example, LH-RH agonist and anti-androgens have been developed for androgen-sensitive prostate cancer, interferons and IL-2 for renal cell cancer, and BCG for superficial bladder cancer. In this manuscript, new agents which are thought to be promising in the urological field, bropirimine for bladder cancer and liarozole for prostate cancer, are briefly introduced.

Androgen Antagonists↗
PubMed1996

Prognostic value of cadherin-associated molecules (alpha-, beta-, and gamma-catenins and p120cas) in bladder tumors.

Loss of E-cadherin-mediated adhesion is an important step in the progression of many carcinomas. In model systems, it has been shown that cadherin function requires not only proper E-cadherin expression but also its linkage to the cytoskeleton through catenins. Hence, defects in catenins may cause defective E-cadherin function, and catenins as well as E-cadherin might constitute prognostic indicators. Here, we extend our previous study on E-cadherin in bladder cancer (Cancer Res., 53: 3241-3245, 1993). We have evaluated the expression of E-cadherin-associated cytoplasmic molecules (alpha-, beta-, and gamma-catenins and p120cas) to clarify whether or not the pattern of their expression could provide additional prognostic information beyond that from E-cadherin alone. Forty-eight frozen bladder tumor specimens and 9 samples of normal urothelium were studied by immunohistochemistry. A discrepancy between the E-cadherin and catenin expression pattern was seen in 20.8% of cases. Abnormal expression of each molecule is significantly correlated with tumor grade (P < 0.01) and stage (P < 0.01). Reduced expression of all of the molecules correlates with poor survival (P < 0.01 for each variable). Proportional hazard regression analysis showed that beta-catenin, E-cadherin, and alpha-catenin have strong predictive value, whereas plakoglobin and p120cas have a somewhat lower predictive value. Within patients with invasive tumors, those with a normal staining for either E-cadherin, alpha-catenin, or beta-catenin show a trend toward better survival. However, the difference in survival is significant only for E-cadherin (P < 0.05). Thus, beta-catenin, E-cadherin, and alpha-catenin have similar prognostic values. Therefore, from a practical point of view, the expression of any of these proteins can be of prognostic value for patients with bladder cancer.

Adult↗
PubMed1996

Injection of glutaraldehyde cross-linked collagen for urinary incontinence: two-year efficacy by self-assessment.

BACKGROUND: Glutaraldehyde cross-linked (GAX) collagen has recently become available as injection material for treatment of urinary incontinence and should be evaluated for its long-term efficacy. METHODS: The subjects included 78 females with genuine stress incontinence (GSI) and 19 male or female patients with intrinsic sphincter deficiency (ISD: urinary incontinence due to urethral sphincter damage). GAX collagen was injected transperineally or transurethrally through an injection needle under direct endoscopic observation. The efficacy was evaluated by the patients' overall assessment at two years post-treatment. RESULTS: Under local or regional anesthesia, GAX collagen was injected 1.9 times on average (total injection volume: 23.5 mL) in GSI patients and 2.2 times (40.1 mL) in ISD patients. Improvement at two years post-treatment by patients' assessment was observed in 71.7% of GSI patients and 53.3% in ISD patients. Side effects were urinary retention and difficulty in voiding after 48 of the total of 188 injections (25.5%), a large amount of residual urine in four (2.1%) and miscellaneous in 19 (10.1%), for a short period after injection and were not serious. CONCLUSION: Our study indicates that GAX collagen injection is an effective, safe and easy non-medical treatment for urinary incontinent patients.

Aged↗
PubMed1996

Recommended dose of flutamide with LH-RH agonist therapy in patients with advanced prostate cancer.

BACKGROUND: In a recent study by the Casodex Combination Study Group, USA, patients in a flutamide (750 mg/day) plus LH-RH agonist group showed a high treatment failure rate, mainly due to flutamide-induced diarrhea and hepatotoxicity. Our current study was conducted to determine the optimal dose of flutamide for use in this type of combination therapy. METHODS: In a randomized, multicenter study, 30 patients (hormone untreated; stage C or D) were divided into 2 groups: flutamide 250 mg (125 mg x 2; 14 patients) and flutamide 375 mg (125 mg x 3; 16 patients, and each dose combined with either goserelin acetate (3.6 mg every 4 weeks) or leuprolide acetate (3.75 mg every 4 weeks). Goserelin and leuprolide were administered to patients in a 1:1 ratio. Flutamide monotherapy at a daily dose of 375 mg was determined to be the optimal dose in Japan in our previous phase II study. The endpoints of this pilot study were the objective response and adverse events during the 12-week treatment. RESULTS: The objective response rate was 83.3% in the flutamide 250 mg group and 85.7% in the flutamide 175 mg group according to the Japanese response criteria for prostate cancer. Elevated PSA levels fell to within the normal range in 83.3% of the patients in the former group and in 93.3% of the patients in the latter group. One patient administered 250 mg of flutamide experienced diarrhea, while the serum GOT and/or GPT were elevated in 3 patients administered 250 mg of flutamide and 4 patients administered 375 mg of flutamide. CONCLUSIONS: Based on the findings of this pilot study of maximal androgen-depletion therapy for advanced prostate cancer, 375 mg/day of flutamide is recommended in combination with an LH-RH agonist. Assessment of the effects of our recommended regimen on longer term survival, quality of life and antiandrogen withdrawal syndrome of patients treated requires additional patients and time for follow-up.

Aged↗
PubMed1996

Acute thrombosis in a contralateral kidney after radical nephrectomy: successful treatment by thrombolytic therapy using a tissue-type plasminogen activator.

A 67-year-old male became anuric immediately after a right radical nephrectomy for renal cell carcinoma. The patient was diagnosed with an acute arterial thrombosis of the remaining kidney within 4 hours after surgery by both CT scan and angiography. Thrombolytic therapy was started by a transcatheteral infusion of tissue-type plasminogen activator (TPA) resulting in a complete recanalization. Hydration and systemic administration of heparin followed, and renal function recovered within 3 weeks. This is the first report of acute thrombosis in a contralateral renal artery immediately after a radical nephrectomy which was successfully treated with TPA. It is probable that compression of the contralateral renal artery by the retractor for an extended period of time during surgery led to this unfavorable condition.

Aged↗
PubMed1996

Adrenal myelolipoma associated with hereditary spherocytosis.

Myelolipomas are benign tumors composed of mature fat and bone marrow elements. We report a case of adrenal myelolipoma associated with hereditary spherocytosis which was treated with splenectomy seventeen years ago. The hematopoietic stimulus of the hereditary spherocytosis might have been associated with the development of adrenal myelolipoma in the present case.

Adrenal Gland Neoplasms↗
PubMed1996

A case of angiomyolipoma diagnosed by thin slice non-enhanced CT and needle biopsy.

We report a case of a 52-year-old female with two intrarenal tumors in the left kidney and a contralateral non-functioning kidney. Two renal cell carcinomas were suspected on 10mm and 5mm thick slices of computed tomography (CT), while angiography could not exclude a diagnosis of angiomyolipoma. Thin section (2 mm thick) non-enhanced CT detected negative attenuation values (indicative of fat) within both tumors, but these values were higher than the value for normal fat tissue. Negative attenuation values within the tumor using non-enhanced thin sections are thought to be essential for a CT diagnosis of angiomyoplipoma, especially when angiomyolipoma is difficult to distinguish from renal cell carcinoma. We performed an ultrasonography-guided needle biopsy of the tumor and pathological examination confirmed the diagnosis of angiomyolipoma, consisting of rich angiomyomatous element and small amount of mature adipose tissue.

Adipose Tissue↗
PubMed1996

Pharmacokinetics of tamsulosin hydrochloride in patients with renal impairment: effects of alpha 1-acid glycoprotein.

The pharmacokinetics of tamsulosin hydrochloride in patients with renal impairment were compared with those in healthy volunteers, and the factors that influenced plasma levels of tamsulosin were elucidated. A single oral dose of 0.2 mg of tamsulosin was given and blood and urine samples were obtained for 36 hours after administration. Unbound plasma concentration of tamsulosin was measured by a combination of equilibrium dialysis and liquid chromatography tandem mass spectrometry methods to examine the effect of protein binding on the pharmacokinetics of tamsulosin. Mean values for maximum concentration (Cmax) and area under the concentration-time curve (AUC) of total drug (Cmax,t and AUC1) in patients with renal impairment were 73% and 211% greater, respectively, than those in healthy volunteers. Mean Cmax and AUC of unbound drug (Cmax,u and AUCu), however, were almost the same in the two groups. A high correlation was found between alpha 1-acid glycoprotein (alpha 1-AGP) concentration and AUCt, but no correlation was found between alpha 1-AGP concentration and AUCu,0-36) or between creatinine clearance (ClCR) and AUCu,0-36). These results show that in patients with renal impairment, the pharmacokinetics of tamsulosin are affected by the change in protein binding that is associated with alteration of plasma alpha 1-AGP concentration, but are not largely affected by the decrease in the renal excretion. Although total tamsulosin levels increased as plasma protein binding increased, unbound tamsulosin levels (which are directly associated with the pharmacologic effects) remained unchanged in these patients.

Adrenergic alpha-Antagonists↗
PubMed1996

[A study of the relation between clinical prognostic factors and the estimated tumor growth speed in superficial bladder cancer].

(BACKGROUND). We studied the dynamic estimation of biological activity to evaluate stage progression using clinical findings of the superficial bladder cancer. (METHODS). From 1983 to 1993, 111 patients who underwent transurethral resection initially. 54 (48.6%) cases showed tumor recurrences at least once were estimated the tumor growth speed, dividing the total amount of tumor volume of summing all tumors at a certain recurrence with the duration between recurrences, and which was compared with various prognostic factors of the superficial bladder cancer. The Prognostic factors included age, sex, frequency of recurrences, tumor's number, tumor's size, stage, histological grade, shape, intravesical treatment and duration to recurrence from the last transurethral resection. (RESULTS). Seven (13%) cases showed disease progression in the sense of tumor stage (T2 < ) out of 54 recurrent patients. The tumor growth speed during one episode of recurrence was not statistical different between any factors. However, the average of tumor growth speed, which was calculated based on all episodes of recurrences, was statistically different (the cases with stage progression versus without : P < 0.05) between the cases with and without stage progression. (CONCLUSION). The results suggested that the dynamic estimation of biological activity of the superficial bladder cancer has a potential to be an important prognostic factor to determine the stage progression of the disease.

Adult↗
PubMed1996

[Bronchial arterial infusion therapy for lung metastases of urogenital tumors].

Three patients with lung metastases of urogenital tumors were treated by bronchial arterial infusion therapy. Case 1: A 52-year-old man who had multiple lung metastases of right renal cell carcinoma fell into a dyspnea at 5 months after right radical nephrectomy. Though the effects of resection or laser coagulation with bronchoscopy were temporary, two sessions of BAI therapy with radiation improved the symptom of dyspnea for at least 3 months. Case 2: A 53-year-old man who had multiple lung metastases of right renal cell carcinoma was treated with systemic chemotherapy after right radical nephrectomy. Because the systemic chemotherapy showed only minor response, two sessions of BAI therapy were performed. No lung metastasis was detected in radiographs for 2 years after BAI therapy. Case 3: A 69-year-old man who had multiple lung metastases of left ureteral tumor was treated with 3 sessions of systemic chemotherapy. Though the systemic chemotherapy was effective, 2 sessions of BAI therapy with radiation showed a more suppressive effect, and the regrowth was not detected for 7 months after the therapy was performed. We concluded that BAI therapy was an effective therapeutic method not only for cases with no operative indication, but also for cases in which systemic chemotherapy was not effective.

Aged↗
PubMed1996

[Comparison of clinical effects between granisetron alone and combination of granisetron and methylprednisolone against the nausea and vomiting induced by CDDP chemotherapy--comparative study by the cross-over trial. University of Tsukuba Antiemetics Study Group].

A cross-over clinical trial was carried out to compare the antiemetic effect and safety between granisetron alone (40 micrograms/kg) and the combination of granisetron and methylprednisolone (MP: 10 mg/kg) in urological cancer patients treated with cisplatin. Forty-eight courses were given with granisetron alone and 47 courses with both granisetron and MP. The antiemetic effect of nausea and vomiting was evaluated in the acute emetic phase. during the 24 hours following the CDDP administration, and in the delayed emetic phase, 2 to 7 days after the administration. Combination therapy of granisetron and MP demonstrated a greater antiemetic effect during the 72 hours following the CDDP administration than by granisetron alone. But there was no significant difference in antiemetic effect between combination therapy and granisetron alone after the 3rd day. Combination therapy also demonstrated more efficacy in complete antiemetic effect, with no emesis and less than moderate nausea, than by granisetron alone. Both treatments showed no side effects and were safe.

Aged↗
PubMed1996

[An overview of clinical trials in endocrine therapy for cancer].

To obtain information for published clinical trials in endocrine therapy for cancer in Japan, a computerized literature search of MEDLINE, EMBASE and IGAKU-CHUO-ZASSHI (CD-ROM) was done. We found four articles on randomized trials for prostate cancer and two for breast cancer. In order to obtain information for ongoing randomized phase III trials in endocrine therapy for cancer in the United States and Europe, a search of PDQ (Physician's Data Query) was done. In PDQ, 13 active trials started after January 1990 in endocrine therapy for breast cancer and six active trials started after January 1990 in endocrine therapy for prostate cancer were registered. Out of 13 trials for breast cancer, projected sample sizes were over 1,000 in eight trials, and QOL was selected as an end point in six trials. Out of six trials for prostate cancer, projected sample sizes were over 500 in three trials, and QOL or sexual function was selected as an end point in three trials.

Antineoplastic Agents, Hormonal↗