Biomedical subjects
Publications and source records attributed to J Shimazaki.
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Five cases of testicular tumor which originated from cryptorchid testis are presented. One of these cases showed complete remission for 3 years by multidisciplinary therapy including lobectomy. In Japanese literature, we found 182 cases of testicular tumor originating from cryptorchid testis and 29 cases whose testicular tumor occurred after orchidopexy.
Tumor marker for tumors in urology has been widely used to testicular and prostatic tumors. A part of testicular tumor produces alpha-fetoprotein (AFP) and HCG, thus these markers can not be used for early detection of disease. However, they are very useful in typing testicular tumor, and in monitoring a course of disease which produces them. beta-HCG seems to be more specific than HCG. In case of prostatic cancer, prostatic acid phosphatase (PAP) assayed immunochemically is sensitive and specific marker. Prostate antigen seems to be another excellent marker for this tumor, and this is well correlated with PAP. In reactivated case, tissue polypeptide antigen was elevated, suggesting use of this marker.
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Rat prostatic tumor (Dunning R 3327 tumor) is a well-differentiated adenocarcinoma of Copenhagen strain rat; its growth is extremely slow and androgen-dependent. Two new sublines (Chiba University A and B; CUA, CUB) were obtained during passages; CUA, squamous cell carcinoma, grew at moderate speed, and CUB grew rapidly, being composed of spindle-shaped cells and large bizarre polygonal cells. Growth of CUA was slightly androgen-dependent, while that of CUB was independent of sex hormones. Activities of acid phosphatase were increased in both CUA and CUB as compared with the original R 3327, so the less differentiated sublines of CUA and CUB showed unusual progression. In contrast, activities of alkaline phosphatase in CUA and CUB were diminished as compared with that of the original tumor. Both androgen and estrogen receptors were detected in the cytosol from R 3327, but there was no detectable amount of androgen and estrogen receptors in CUA. CUB did not show any androgen binding but estrogen binding was observed in the cytosol, though estrogen did not have any detectable effect on the growth of this tumor.
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We performed circle tube nephrostomy in 17 patients using a newly designed catheter. The catheter which we called 'Chiba Nephrostomy Circle tube' consisted of a silicon tube which has three holes in the middle portion, and a metal connector. The renal function recovered to normal in 12 of the 17 patients (recovery rate 71%), improved in 4 (24%), and remained unchanged in only one patient. Although temporal urinary leakage occurred in 5 patients (29%), there were no serious complications with this newly designed tube. Furthermore, pyelonephritis, renal bleeding and urolithiasis, which occasionally occur by single nephrostomy, did not occur with this method. Thus, we proved the clinical usefulness of the newly designed circle tube.
The patient was a two years and seven months old, who was legally a female. She visited our University Hospital with the chief complaint of ambiguous genitalia. The hypertrophied clitoris was 13 mm in length and 11 mm in diameter. The external urethral orifice and vagina were observed separately. The testis-like mass was palpable in the right labium. She had a karyotype of 46XX . The Urinary excretion of 17 KS and pregnanetriol and serum 17 alpha-hydroxyprogesterone were within the normal range. Vaginography showed the vagina, uterus and left fallopian tube. At exploratory laparotomy, we found the uterus and left fallopian tube; the left and right gonads were in the intraperitoneal cavity and the inguinal canal, respectively. To build female characteristics, clitoroplasty was performed, the right gonad was removed the testis-like portion of the left gonad was resected, and the ovary-like portion in the left gonad was biopsied. Both gonads were confirmed to be ovotestis histologically.
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A 65-year-old male visited the Sawara Hospital with the chief complaint of right intrascrotal mass. The mass without tenderness, in which right testis and spermatic cord appeared to be involved, reached the right inguinal region. Right high orchiectomy was performed under the diagnosis of a testicular tumor. Histological diagnosis was malignant lymphoma. Intravenous pyelogram revealed right hydronephrosis and 67Ga-scintigram showed an abnormal accumulation of radioisotopes in the pelvic and paraaortic region. Chemotherapy with vincristine, cyclophosphamide, 6-mercaptopurine and prednisolone was performed under the diagnosis of stage IV lymphoma. Two months after chemotherapy, right hydronephrosis disappeared and no abnormal accumulation in 67Ga-scintigram was found. He has been doing well three months after treatment.
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