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Biomedical subjects

K Gohji

Publications and source records attributed to K Gohji.

At least 127 records · Page 7Linked to original sources
PubMed1990

Metastatic tumor of the spermatic cord from renal cell carcinoma.

A 56-year-old male visited our hospital with macroscopic hematuria. Physical and X-ray examinations showed he had right renal cell carcinoma with tumor thrombosis in the inferior vena cava and the right spermatic vein. Radical nephrectomy and tumor thrombectomy were performed and he was discharged with no evidence of disease 1 month after the operation. At 5 months after the discharge, he noticed a palpable mass in the scrotum. Right orchiectomy was performed. The tumor was located in the right spermatic cord and histological examination revealed it to be a renal cell carcinoma (clear cell subtype) which was a metastatic lesion from a right renal tumor. In this case, the renal cell carcinoma was considered to have retrogradely metastasized through the spermatic vein. In conclusion, a complete physical examination, including the spermatic cord is recommended during the follow-up period of renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1990

Giant renal angiomyolipoma with an uncommon growth pattern: a case report.

A case of a giant renal angiomyolipoma with uncommon growth pattern in a 66-year-old female is reported. The tumor originated from the upper pole of the left kidney and simultaneously grew posteriorly in a sheet-like fashion while a spheroid mass projected upwards. With magnetic resonance imaging (MRI), the relationship between the tumor and adjacent organs was clear. Tumorectomy employing cavitron ultrasonic surgical aspirator (CUSA) was performed, and proved to be a safe and simple procedure. There has been no recurrence of the growth 2 years post-operatively.

Aged↗
PubMed1990

[Clinical study of extracorporeal shock wave lithotripsy for 1000 patients with renal and ureteral stones].

Using a Dornier HM3 lithotripter, we treated 1,000 patients with renal and ureteral stones from April, 1986 to July, 1989. They consisted of 612 solitary stones (pelvic stones, 152; calyceal stones, 167; ureteral stones, 293), 265 multiple stones and 123 staghorn calculi (complete, 48; partial, 75). The overall rate of the auxiliary procedure was 59.3% (pre-operative, 47.9%; post-operative, 11.4%). Pre-operative procedure included 430 catheterizations, 26 percutaneous nephrostomies (PNSs) and 23 pyelograms . Post-operative procedure included 69 transurethral lithotripsy , 21 PNSs, 26 percutaneous nephrolithotripsy (PNLs), 6 meatotomy , 5 chemolysis and 1 open surgery. 484 (68.3%) in 709 good follow-up cases were stone-free at the time of 3 months since the first extracorporeal shock-wave lithotripsy (ESWL). Complications were pain (34.8%), fever (4.3%), pain & fever (8.5%), subcapsular hematoma (0.1%) and ureteral obstruction (0.1%). Thus, ESWL is considered to be a useful means for renal and ureteral stones and in the case of large stone the combination therapy with PNL is more effective than ESWL-monotherapy.

Adult↗
PubMed1990

[Clinical and pathological evaluations of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) chemotherapy for advanced urothelial cancers].

Fifteen patients with advanced transitional cell carcinoma of the urothelial tract were treated with methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) chemotherapy. Eleven patients were treated to metastatic lesions after surgical resection of primary cancers. One out of 15 patients died of chemotherapy. Of the remaining 14 patients, CR was achieved in one and PR was achieved in seven, clinically. The response rate was 57.1% and the median response duration was 12.6 months. In the patients who had been resected their primary lesions, the response rate was 70% and the duration was 14.1 months. Six patients, including five PRs and one NC, underwent surgical resection and re-staging of the residual tumors after chemotherapy. Clinical response coincided with pathological one in all 6 cases. Three patients were observed the decrease of the lung metastasis, which rate was more than 90%. Two out of 3 who did not show any invasion into the lymph channels in the resected residual tumors, have been free of a recurrence through-out the course of at 47 or at 42 months. However, another patient with lymph channel invasion died of metastasis of the mediastinal and paraaortic lymph nodes. Regarding the frequency of side effects, it seemed to be no significant difference between full and 80% doses administration. In the effectual cases, the residual tumors should be resected surgically and re-staged pathologically.

Adult↗
PubMed1989

[Clinical analysis of renal cell carcinoma with extension into the inferior vena cava].

We performed clinical analysis of 12 patients with renal cell carcinomas associated with tumor thrombosis in the inferior vena cava. Eleven cases were men, and one was a woman; their ages range from 48 to 76 years old with a mean of 58 years. Nine tumors were observed on the right side, the other 3 tumors were observed on the left side. In five cases, the distant metastases of the disease were noticed at the first visiting to our hospital. Lung metastases were found in five and bone or liver in each one. Chief complaints were macroscopic hematuria in 8 cases (67%), and were weight loss or general fatigue. The symptoms of obstruction of the inferior vena cava, such as venous dilatation of abdominal wall, edema of lower extremities and varicocele of the testes, were seen in 6 cases. The level of the tumor thrombosis was preoperatively determined by CT, echography, cavography or MRI. The level was near the right atrium in one, near the hepatic vein in 8 and near the renal vein in 3, although there was no case extending into the right atrium. Transperitoneal nephrectomy and thrombectomy in the inferior vena cava were performed in 9 cases. Surgery could not be performed in the other 3 patients of their poor general condition or severe heart disease. One patient died because of massive hemorrhage during the operation. The other complications were transient renal failure in 3 cases and postoperative bleeding in one case. In 4 patients without distant metastases or regional lymph nodes metastasis, two died of multiple metastasis of renal cell carcinomas and diabetic coma. The other two cases are alive without disease for 4 and 40 months after operation. For renal cell carcinoma extending into the inferior vena cava without metastasis, nephrectomy and thrombectomy should be performed using the extracorporeal circulation.

Aged↗
PubMed1989

Extragonadal germ cell tumor in the retrovesical region associated with Klinefelter's syndrome: a case report and review of the literature.

We report a case of an extragonadal germ cell tumor from the retrovesical region associated with Klinefelter's syndrome. The patient presented with symptoms of macroscopic hematuria and micturition pain. An x-ray and digital examination were suspicious for prostatic carcinoma. However, needle biopsy of the tumor revealed embryonal cell carcinoma. Serum alpha-fetoprotein was 10,700 ng. per ml. Preoperatively, combined cytotoxic chemotherapy was administered and the antineoplastic effect was excellent. Serum alpha-fetoprotein rapidly returned to the normal range and the tumor volume decreased. Although the preoperative diagnosis was extragonadal germ cell tumor of the prostate, surgery revealed that the tumor originated from the retrovesical region. Orchiectomy and resection were performed. The resected tissue was mostly necrotic with a few viable cells of embryonal cell carcinoma, no metastatic lesions were detected in the lymph nodes and no masses were noted in the testes. Postoperatively, the patient was treated with cytotoxic chemotherapy. His condition has remained good with no clinical evidence of recurrence of the disease.

Adult↗
PubMed1989

[Monoclonal antibody to desmosome associated 34 kD protein and immunohistochemical study in relation to the malignancy of transitional cell carcinomas of urinary bladder].

A mouse monoclonal IgG1 antibody (B-11) that recognized desmosomes in some human tissues was isolated and characterized. By Western blotting, B-11 recognized 34 kD protein only in squamous and transitional epithelium. By avidin-biotin complex (ABC) and immunofluorescence method, B-11 was reactive to squamous and transitional epithelium, but was not reactive to simple columnar epithelium from stomach and colon, simple cuboidal epithelium from urinary tubule and thyroid, and pseudostratified ciliated epithelium from trachea and ductus epididymidis. ABC method of B-11 was performed in 47 patients with transitional cell carcinoma of bladder. The higher positive staining was observed in well differentiated (83% in Grade (G) 1, 73% in G2 and 20% in G3), superficial (76% in non-invasive and 20% in invasive) and expansive growth (68% in Infiltration (INF) alpha, 24% in IFN beta and 18% in IFN gamma) carcinomas. 34 kD protein recognized by a new monoclonal antibody (B-11) is a new cell-type-specific desmosomal component which relates to the histological grade, stage and invasive manner of the transitional cell carcinoma of bladder. The transitional cell carcinoma of bladder obtained by operation or surgical biopsy from 47 patients was stained by ABC method using B-11.

Adult↗
PubMed1989

[Emphysematous pyelonephritis a case report and review of the literature--comparative study with Japan and other countries].

A 36-year-old woman with diabetes mellitus complained of left flank pain and high fever. Drip infusion pyelogram (DIP) did not visualize the left kidney, but revealed crescent-shaped gas formation within the left renal shadow. Abdominal computerized tomography showed a subcapsular shadow in the left kidney. Because her symptoms was aggravated, left nephrectomy was performed under the diagnosis of emphysematous pyelonephritis. There was no manifestation of her prior symptoms after the operation, and she was discharged on the 19th postoperative day. In Japan, 43 cases of emphysematous pyelonephritis have been reported in the literature. These 43 cases were studied clinically and in comparison to the cases reported in Western countries. The male-to-female ratio was approximately 4 to 1, in contrast to the Western ratio of female preponderance. The age of the patients showed its peak at the 50-60's, the mean age being not significantly different from that of Western patients. 37% of the patients had the affected side on the right, 56% on the left, and 7% bilaterally. This was comparable to the results of Western countries. 93% of the subjects suffered from diabetes mellitus as the basal malady, which was comparable to that in Western studies. However, patients afflicted with urinary passage impairment accounted for 14%. This incidence was lower than that reported in Western studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Clinical evaluation of M-VAC chemotherapy (methotrexate, vinblastine, adriamycin and cisplatin) for advanced urothelial cancer].

Combination chemotherapy with methotrexate, vinblastine, adriamycin and cisplatin (M-VAC regimen) was administered to 12 patients with advanced epithelial cancer of the urinary tract in a clinical trial undertaken to assess clinical efficacy of this multiagent therapy. This series comprised 11 males and 1 female ranging in age from 46 to 76 years (mean age: 63), with performance status (PS) being rated 0 in 2, 1 in 5, 2 in 2, 3 in 2 and 4 in 1 of these 12 patients. The site of primary lesion was bladder in 8, renal pelvis in 3 and ureter in 1. Histologically, these tumors were all identified as transitional cell carcinoma (grade 3) with the exception of 1 mixed type (transitional cell carcinoma plus squamous carcinoma). Nine of the patients had already their primary tumor resected surgically while the remaining 3 had undergone only biopsy. The site of metastasis was lung in 7, bone in 4 and lymph nodes in 3. In consideration of the patients' general condition, the dosages of the chemotherapeutic agents were set at 80% of those recommended by Sternberg. Of the 9 patients with primary tumor resected, 1 died of chemotherapy; of the remaining 9 patients, the M-VAC regimen brought about CR in 1 and PR in 4, hence with a response rate of 62.5%. The 4 patients showing PR underwent surgical resection of residual tumor and 2 of them achieved CR and have been free of a recurrence during a 33- or 29-month period of the chemotherapeutic regimen.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Studies on recent clinically isolated Staphylococcus aureus--drug susceptibility and incidence of MRSA in clinical isolates].

Susceptibility of various antimicrobial agents against clinically isolated Staphylococcus aureus was evaluated by Kirby Bauer methods. The incidence of MRSA (Methicillin cephem resistant Staphylococcus aureus) was also investigated. When S. aureus was isolated from urine, the clinical background of the case was further studied. The results are listed below; 1) M1N0 showed the highest susceptibility rate (83.1%) against 537 strains of S. aureus tested, followed by CMZ (63.7%) and CET (63.5%). The susceptibility rate of DMPPC was 41.9%. The incidence of MRSA was 31.3%. 2) In effusion, MRSA was most highly isolated (72.2%). 3) S. aureus isolated from blood and sputa was relatively more resistant to beta-lactams. 4) Strains from urine showed relatively high susceptibility rates. No MRSA was isolated from urine. 5) Thirteen out of twenty-four cases, whose urines were proven to be S. aureus positive, were polymicrobial infection patients.

Adolescent↗
PubMed1989

[Clinical evaluation of serum basic fetoprotein--comparative study of serum immunosuppressive acid protein].

The clinical significance of serum basic fetoprotein (BFP) in renal cell carcinoma was investigated in comparison with serum immunosuppressive acid protein (IAP). Investigated in this study were 46 patients with renal cell carcinoma, 31 males and 15 females ranging in age from 40 to 85 years (mean age: 56 years). According to Robson's system of staging, 10 cases (22%) had a stage I disease, 14 cases (30%) a stage II disease, and 18 (39%) a stage IV disease. The positivity rate for and levels of serum BFP were found higher as disease stage advanced, with 54% of the entire cases and 72% of stage IV cases being positive for serum BFP. On the other hand, 76% of 34 cases for whom assay of serum IAP was feasible and 79% of stage IV cases were positive for serum IAP, thus here again the positivity rate for and serum levels of the marker became increasingly higher with advancing disease stage. Simultaneous assay of serum BFP and IAP demonstrated that 85% of stage IV renal cell carcinoma cases were positive for at least one of the two markers. A study of changes in these tumor markers before and after curative resection of the tumor showed that BFP decreased below the preoperative level within 1 week postoperatively in 92% and even returned to normal in 75% of cases who were positive for the tumor markers preoperatively, while serum IAP reduced below the preoperative level in 82% and returned to normal in 27% of the cases preoperatively.

Adult↗
PubMed1989

[A case of primary right ureteral squamous cell carcinoma with intraperitoneal invasion].

A case of primary right ureteral squamous cell carcinoma with intraperitoneal invasion was studied. The patient was a 38-year-old male with chief complaints of right lumbago and gross hematuria. He was admitted to our clinic suspected of having calculi. However, the radiogram was negative. As the patient was suffering from severe hypogastric pain, indicating acute abdomen, an investigative celiotomy was performed. The tumor that was subsequently revealed formed a mass engulfing the furcation of the right internal and external iliac arteries, ureter, ileum and sigmoid colon. As a radical resection was considered impossible, as much of the tumor as possible was excised and a colostomy was performed. After the operation, a regimen of polypharmacy, including bleomycin, was administered against the residual tumor. This therapy has proved to be remarkably effective. At present, the patient is under regular medical observation, and the postoperative course has been favorable.

Adult↗
PubMed1989

[Two autopsy cases of prune belly syndrome in stillborn and its pathogenesis].

Two autopsy cases of prune belly syndrome are reported. In Japan, 111 cases have been reported. Abdominal muscle deficiency or hypoplasia, urinary tract abnormalities and cryptorchidism are usually recognized. Case 1 was a female stillborn at 33 weeks' gestation and case 2 was a male stillborn at 21 weeks' gestation. Both cases had anomalies of genitourinary and digestive system. There was anatomic obstruction of external urethral orifice in case 1 and overriding urethra in case 2 which meant functional obstruction. In relation to the pathogenesis, we propose the important role of the urethral obstruction, whatever anatomic or functional. Further examination of the lower urinary tract including serial section analysis might be necessary to identify the pathogenesis of prune belly syndrome.

Female↗
PubMed1989

[A case of leiomyoma of urinary bladder with relapse from the external urethral orifice--clinical analysis of leiomyoma of urinary bladder in Japan].

A 22-year-old female visited our hospital with complaints of pollakisuria and dysuria on July 3, 1987. Cystoscopy revealed a tumorous lesion in the urinary bladder. On July 8, 1987, she had urinary retention because of relapse of the tumor from the external urethral orifice. Under the diagnosis of urinary bladder tumor, tumorectomy was performed. The resected tumor had a steel, smooth surface, was elastic soft, red-purple and 7 g in weight. Pathological examination demonstrated the tumor to be composed of spindle-like cells, which showed no mitotic figures. Therefore, the tumor was diagnosed as leiomyoma of urinary bladder. In the literature, 67 cases of leiomyoma of the urinary bladder have been reported so far in Japan. The patients ages ranged from the 2nd to 8th decade, the peak age being the 4th decade. The sex ratio was 5 to 2, females being predominant. Chief complaints were hematuria, pollakisuria and dysuria, but prolapse of the tumor from the external urethral orifice was rare, only 3 cases including our case being reported thus far. Tumorectomy (34 cases, 27%) or partial cystectomy (16 cases, 27%) was performed in many cases, because it was benign. The prognosis was good, and there have been no reports stating that it become malignant.

Adult↗
PubMed1988

Ureteral stenosis secondary to common iliac aneurysm: a case report and review of the literature in Japan.

A case of right ureteral obstruction secondary to right common iliac aneurysm presenting as right hydronephrosis is reported and the literature is reviewed. A 66-year-old man was admitted to our hospital with lower abdominal pain and was treated by bypass operation with artificial vessel and uretero-ureterostomy of right ureter under the diagnosis of right ureteral stenosis secondary to right iliac aneurysm. Histological examination showed arteriosclerotic aneurysm and a fibrillary inflammatory change in peri-ureteral tissue without any hemosiderin-laden macrophages. Intravenous pyelography showed improvement of right hydronephrosis 45 days after operation. To date 11 cases including our case have been reported in Japan, 10 in males and the other in a female. Initial symptoms were either lumbago or an abdominal mass with palpitation in many cases. The treatment was by resection of aneurysm with bypass grafting or ureterolysis.

Aged↗