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K Nishimura

Publications and source records attributed to K Nishimura.

At least 865 records · Page 48Linked to original sources

[Obstructive azoospermia treated by epididymovasostomy following vasovasostomy: a case report].

A case of secondary epididymal obstruction caused by vasal obstruction due to bilateral inguinal herniorrhaphy is reported. A 28-year-old patient, who had undergone right inguinal herniorrhaphy at the age of 3 and bilateral inguinal herniorrhaphy at the age of 25, was diagnosed as having obstructive azoospermia because testicular biopsy disclosed normal spermatogenesis. Vasography revealed bilateral vasal obstruction at the level of the inguinal canal. Bilateral microscopic vasovasostomy was performed but postoperative semen analysis showed azoospermia. At the operation only one sperm was found in the left vasal fluid while no sperm was found in the right. Postoperative vasography showed that the left vasovasostomy was accurate while the right vas was reobstructed. Microscopic epididymovasostomy using Silber's specific tubule technique was performed on the left side. The left epididymis was transected at its tail and numerous normal sperms were found in the epididymal fluid. Four months after the second operation, semen analysis showed normal sperm density of 34 x 10(6)/ml.

Adult↗

Staging and differential diagnosis of renal cell carcinoma: a comparison of magnetic resonance imaging (MRI) and computed tomography (CT).

The usefulness of magnetic resonance imaging (MRI) was compared with that of computed tomography (CT). Twenty-nine patients with renal cell carcinoma, 3 with angiomyolipomas and 1 with renal pelvic cancer, were examined by both MRI and CT. MRI and CT showed similar results in staging cases of renal cell carcinoma. However, MRI may be more sensitive in detecting the venous extension, metastatic adenopathy, and adjacent organ invasion. In predicting the involvement of perinephric fat, however, MRI is only marginally superior to CT. To demonstrate the usefulness of MRI in differentiating renal cell carcinoma from other renal tumors, the density of renal tumor and that of the psoas muscle were determined using a densitiometer, and the percent (%) contrast (the intensity of the renal tumor/the intensity of the psoas muscle X 100) was calculated. In most patients with clear cell type renal carcinoma, the % contrast value in the T1 weighted images was about 100. In the T2 weighted images, the maximum value of the % contrast value was 50 or less in most patients. In one patient with spindle cell type (sarcomatoid type) carcinoma, the % contrast value was 109 in the T1 weighted images, but was 65-85, at most, in the T2 weighted images. In patients with renal angiomyolipomas, the % contrast values were calculated exclusive of the fatty components. The % contrast value of the T1 weighted images was 50 or less in all 3 patients, and that of the T2 weighted images was 50 or more in 2 patients and 21-38 in the others.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

MRI of prostatic cancer: in vivo and in vitro MRI results compared with pathological findings.

Magnetic resonance imaging (MRI) of the prostate was accomplished in 23 patients who had prostatic cancer histologically proved by needle biopsy. Five prostates resected out of 23 patients with prostatic cancer were available for in vitro MRI. The MRI findings of the normal peripheral zone of the prostate had a high signal intensity on T2 weighted image, and the cancer nests in the peripheral zone had lower signal intensity than the normal peripheral zone. A partial or total destruction of the border line between outer zone and inner zone was observed besides than microscopic invasions. MRI also enabled us to differentiate the cancerous foci from the normal tissue at a different signal intensity of imaging in some selected cases in which the resected specimen was examined by in vitro MRI.

Aged↗

[Experience with combination chemotherapy consisting of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) in advanced urothelial cancer].

The M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) regimen was used to treat 6 patients with metastatic transitional cell carcinoma of the urothelial tract. Three patients showed a partial response, all of them were made surgically disease free. Two of them are still alive 1 year and for 6 months after surgery with no evidence of disease and one other died of disease 11 months after surgery. The response in one case was no change and that in two others was a progressive disease. From our experience, we suggest that treatment with M-VAC is effective but that surgery after M-VAC appears essential for the successful management of the patients with metastatic transitional cell carcinoma of the urothelial tract.

Adult↗

[Clinical application of MRI for urological malignancy. 3: A new trial of MRI for bladder cancer and prostatic cancer; surface coil and GD-DTPA].

We performed MRI in several recent cases of bladder cancer and prostatic cancer using a general coil or a 5-inch general purpose surface coil with or without Gd-DTPA. The surface coil improves the spacial resolution, density resolution and signal to noise ratio but reduces the field and the signal detection drops off as the depth from the surface increases. Moreover, additional time is required for patient positioning. In Gd-DTPA enhanced images of bladder cancer, the muscle layer became more distinct, and the images of tumor and bladder mucosa were enhanced, suggesting that facilitates evaluation of the extent of bladder wall invasion of the tumor. In Gd-DTPA enhanced images of prostatic cancer, the area conside to correspond to the tumor was enhanced. MRI using a surface coil and Gd-DTPA is considered to provide detailed information of bladder and prostatic cancer.

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