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Biomedical subjects

K Nishimura

Publications and source records attributed to K Nishimura.

At least 937 records · Page 52Linked to original sources

[A clinical study of testicular tumors].

Fifty-eight of the 44,698 patients seen at our Department, between 1972 and 1984 had a testicular tumor. The incidence rate was 0.13%. The mean age of these 58 cases was 28.6 years and two peak distributions, one in the 0 to 5 year and another in 26 to 30 year age group were observed. Among them, 54 patients (93.1%) had chief complaints of painless testicular swelling at initial examination. The vast majority of them had unilateral tumors; 28 in the right and 29 in the left. Only one patient had bilateral seminomas. Histologically, 30 of them (51.7%) were seminoma, 8 were embryonal carcinoma (13.8%), 2 were teratoma (3.5%) and the remaining 18 had tumors of double or multiple histological type. Most of the seminomas were treated by a combination of high orchiectomy and radiotherapy, and chemotherapy was done mainly for non-seminomatous cases. The 5-year survival rate calculated by the Kaplan-Meier method was 100% for patients with low stage (I, II) seminomas and 62% for those with non-seminomatous tumors.

Adolescent↗

[Transurethral ureterolithotripsy using a rigid ureteroscope].

Eighty patients with ureteral stones underwent transurethral ureterolithotripsy using a rigid ureteroscope. In 68 of the patients (85%), the stones were removed successfully. Most of the 12 failures were removed by a percutaneous approach. The main complications of transurethral ureterolithotripsy were high fever (35%), ureteral injury (10%) and ureteral stricture (1.6%). Ureteroscopic procedures are thought to be useful in stone removal and diagnostic evaluation of abnormality of upper urinary tract.

Adult↗

[Clinical statistics at the Department of Urology, Kitano Hospital (1968-1986)].

A clinical statistic survey was carried out on the patients, diseases and operations experienced at our department between 1968 and 1986. In 1968, the urological department became independent from the dermato-urological department, and in 1981 the urological ward was established. The 19 years are divided in three periods; first period: 1968-1974 (7 years), second period: 1975-1981 (7 years), and third period: 1982-1986 (5 years). The total number of new outpatients during the 19 years was 50,443. They have gradually but steadily increased and have reached recently about 4,000 per year. The total number of inpatients was 3,422 (male: 2,561, female: 861). The proportion of the elderly patients, especially male, has remarkably increased and that of patients more than 60 years old was 44.9% of all inpatients in the third period. Among the major diseases of the inpatients, tumors has got most remarkable increase of its number and proportion. And among tumors, increases of benign prostatic hyperplasia, bladder cancer, prostatic cancer were prominent and at the third period the proportion of those three has reached 81.3% of all tumors. Percutaneous nephrolithotripsy (PNL) and transurethral ureterolithotripsy (TUUL) were introduced in 1985. Recently endoscopical operations such as transurethral resection (TUR), PNL, TUUL and so forth have become a large part of the urological operations.

Adolescent↗

[Heart metastasis of gallbladder cancer--a case report].

A 42-year-old man with gall bladder cancer was given a pancreatoduodenectomy. Chest-roentgenograms revealed a prominence of the left cardiac silhouette 6 months after operation. Two months later, the patient developed exertional dyspnea and chest pain. A diagnosis of heart metastasis of gall bladder cancer was established by aspiration cytology. Intravenous administration of 5-FU and cis-DDDP proved ineffective in controlling the disease. The patient died 14 months after operation. An autopsy revealed metastasis to the left ventricle of the heart. This is the 6th such case of gallbladder cancer in the literature.

Adult↗

[Differential diagnosis and staging of urological tumors by magnetic resonance imaging compared with computed tomography].

Magnetic resonance imaging (MRI) was performed on 49 urological tumors (11 renal cell carcinomas, 3 renal pelvic cancers, 2 renal angiomyolipomas, 1 renal leiomyosarcoma, 1 large renal cyst, 4 adrenal tumors, 11 bladder cancers, 2 bone metastasis from bladder cancer, 10 prostatic cancers, 1 prostatic sarcoma, 1 urethral cancer, 1 penile cancer and 1 perivesical granuloma) since October 1985 to September 1986. MRI was performed using a Signa (G.E.) with a 1.5T superconductive magnet and 3 images, including T1 weighted image, T2 weighted image, and proton density image, were obtained. In conclusion MRI is a noninvasive examination and gives more information than computed tomography despite its high cost. In renal cell carcinoma, the chemical shift in MRI and clear visualization of tumor thrombus enable accurate staging. Differential diagnosis from other renal mass lesions may be possible by the T2 weighted image. In adrenal disease, most of the adrenal masses can be differentiated, but in some cases it is impossible. In bladder cancer, wall invasion of tumor may be evaluated in T2 weighted image, and MRI is suitable for staging of locally advanced tumor. In prostatic cancer, visualization of periprostatic plexus and differentiation between internal and external gland may enable local staging and identification of low stage tumors.

Diagnosis, Differential↗

[A case of primary intracranial malignant lymphoma associated with gastric carcinoma].

A case of synchronous multiple primary neoplasms, an intracranial malignant lymphoma and a gastric carcinoma, is presented. A 63-year-old man was admitted to our hospital with complaints of dizziness and a floating sensation on gait. A CT scan after admission, revealed a well-defined, nodular high density area in the left frontal lobe, which was markedly enhanced by the contrast medium. In order to rule out a metastatic brain tumor, examinations were performed as a consequence, and, the gastric carcinoma was found. A partial removal of the brain tumor and a gastrectomy were performed in two stages. Pathologically, the diagnosis of the brain tumor indicated a malignant lymphoma of large cell type, and that of the gastric carcinoma was an adenocarcinoma. The patient received postoperative irradiation and chemotherapy and was discharged in a good condition. He died of pneumonia 21 months after the operation. Necropsy revealed a marked atrophy of the brain without recurrence of the malignant lymphoma and no recurrence of a gastric cancer.

Adenocarcinoma↗

[Results of radical nephrectomy for renal cell carcinoma. Report 1. Analysis according to the TNM staging system of the general rule for clinical and pathological studies on renal cell carcinoma].

One hundred and six patients with renal cell carcinoma were treated with radical nephrectomy at our Department between 1970 to December, 1985. A retrospective analysis was performed with TNM staging system of The General Rule for Clinical and Pathological Studies on Renal Cell Carcinoma, which was established by the Japanese Urological Association in 1983. The 5-year survival rate according to pathological T-stage was 100% for 2 patients in pT1, 67.5% for 58 patients in pT2, 49.5% for 42 patients in pT3, 0% for 4 patients in pT4. Two patients in stage of pT1 had no venous involvement, lymph node metastasis, or distant metastasis. Twenty two patients had positive venous involvement (21%), 4 (7%) in stage of pT2, 16 (38%) in pT3, 2 (50%) in pT4. Twelve patients had positive lymph nodes (11%), 0 (0%) in stage of pT2, 10 (24%) in pT3, 2 (50%) in pT4. Twenty five patients, (24%) had distant metastasis at the time of nephrectomy, 8 (14%) in stage of pT2, 15 (38%) in pT3, 2 (50%) in pT4. The 5-year survival of 22 patients with venous involvement, 12 patients with lymph nodes metastasis, 25 patients with distant metastasis were 47%, 30%, 39% respectively. No significant difference of 5-year survival between 69% of 48 patients in T1 & 2VoNoMo (Robson-I) and 76% of 12 patients in T3VoNoMo (Robson-II) were considered to need the establishment of new classification for early stage of renal cell carcinoma. TNM staging system was thought to be better than Robson's Classification for analyzing the unique biological potential of renal cell carcinoma.

Adult↗

[A case of congenital penile curvature].

A case of congenital penile curvature is reported. A 19-year-old male with ventral curvature of the penis since adolescence was surgically repaired by Nesbit's technique. Marked curvature during erection and coital dysfunction was completely corrected by the operation. The definition of the clinical entity and the methods of surgical repair, emphasizing the superiority of Nesbit technique, was briefly summarized.

Adult↗