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Biomedical subjects

K Okada

Publications and source records attributed to K Okada.

At least 1,135 records · Page 63Linked to original sources
PubMed1990

[A case of advanced prostatic cancer in a 44-year-old treated effectively with combination chemo-endocrine therapy].

In a 44-year-old man with persistent back-pain for 3 months duration, radiological and echological investigations revealed prostatic mass lesion with multiple osteoblastic involvements. Transrectal biopsy to the prostate demonstrated pathohistologically poorly differentiated adenocarcinoma (Gleason's score 4-4:8). Serum ACP, ALP and IAP were elevated at the initial diagnosis pathologically. The clinical and pathological stage was D2, without metastasis to lung and liver. Combination chemo-endocrine therapy (methotrexate, adriamycin, pepleomycin, Estracyt and tegafur) with bilateral orchiectomies was performed exclusively as initial treatment. These consecutive treatments brought remarkable reduction of the prostatic mass lesion, decrease of tumor markers to normal range, rapid improvement of subjective symptoms and distinct decrease of abnormal activity in bone scintigram. More than 3 years survival was obtained, and normal performance-status was kept. Prostatic cancer in middle-aged adults is reviewed and discussed.

Adenocarcinoma↗
PubMed1990

Immunophenotype, histopathology and clinical stage: their predictive value in the prognosis of non-Hodgkin's lymphomas.

The relationship between immunophenotype, histopathology and clinical stage in influencing prognosis was evaluated in 99 cases of non-Hodgkin's lymphoma (NHL). All cases were histopathologically classified according to the system of the international conference on working formulation (WF), immunologically analysed by flow cytometry with a panel of monoclonal antibodies and clinically staged by the Ann Arbor scheme. Eighty eight percent of T- and 87.7% of B-phenotype NHLs respectively received combination chemotherapies with or without radiotherapy. Early stages I and II showed higher response rates (86% for T- and B-NHL) compared to the advanced ones III and IV (58% for T-NHL and 65% for the B-NHLs), p less than 0.05. Higher overall survival rates were observed in low and intermediate grade NHLs, p less than 0.05. The early stages further showed relatively higher survival rates in T- than in B-phenotype of intermediate grade NHL. Low grade NHL had the highest survival rates in both early and advanced stages, whereas the survival rate was the lowest in high grade NHL irrespective of the clinical stages. Immunophenotype, pathological grade and clinical stage jointly displayed varied predictive values in the prognosis of NHL. Since the present prognostic models are based on histological and staging criteria only, the results suggest that, phenotype should be included in the classification systems or prognostic models for the NHLs, thus facilitating the establishment of effective lineage specific therapies.

Adolescent↗
PubMed1990

The significance of nerve sugar levels for the peripheral nerve impairment of spontaneously diabetic GK (Goto-Kakizaki) rats.

This study was carried out to clarify the relationship between the slowing of motor nerve conduction velocity and nerve levels of sorbitol, fructose, glucose and myoinositol in spontaneously diabetic GK (Goto-Kakizaki) rats. The motor nerve conduction velocity in GK rats was constantly lower than in normal controls at three and nine months of age. This constant decrease in motor nerve conduction velocity in GK rats was closely related to glucose intolerance in GK rats soon after birth. Nerve levels of sorbitol, glucose and fructose in GK rats were significantly increased as compared to normal controls at nine months old, but not (except glucose) at three months old. The increase in nerve concentrations of sugars in GK rats was progressive with age. However, levels of glucose, sorbitol and fructose in normal Wistar rats remain unchanged with age. Although nerve myo-inositol levels in GK rats were lower at three and nine months than those of normal controls, a significant difference in myo-inositol levels was observed only at nine months. On the contrary, nerve myo-inositol level in normal Wistar rats did not show age-related change. These findings suggested that both enhanced polyol pathway activity and myo-inositol depletion play important roles in the reduction of motor nerve conduction velocity.

Aging↗
PubMed1990

[A case of primary signet ring cell carcinoma of the bladder].

A 41-year-old man visited our clinic with complaints of gross hematuria and pain on urination. Cystoscopic examination revealed papillary and sessile tumor at the retrotrigone of the bladder and the specimen of the transurethral biopsy showed signet ring cell carcinoma. Since there was no primary tumor in any other organs, we diagnosed it as a primary signet ring cell carcinoma of the bladder. Total cystectomy with Kock continent ileal reservoir and post-operative chemotherapy consisting of cisplatinum, adriamycin and 5-FU were performed. The literature on the pathological findings of this disease are reviewed.

Adenocarcinoma, Mucinous↗
PubMed1990

Poxvirus infection in Nile crocodiles (Crocodylus niloticus).

An outbreak was encountered of numerous yellowish cutaneous nodules in one- to two-year-old farmed Nile crocodiles (Crocodylus niloticus) in Kasaba Bay Crocodile Farm at Lake Tanganyika in Zambia during 1988. Out of 4000 crocodiles of different age groups, 300 yearlings were affected and 82 of those affected died. The lesions were prominent on the head, especially around the eyelids, the nostrils, both sides of the mouth, ventral neck, ventral pale belly, limbs and the root of the tail. Histologically, the epidermal lesions revealed large focal areas of marked acanthosis accompanied by hyperkeratosis and parakeratosis. In the prickle cells, there were multiple small neutrophilic granular inclusions and large eosinophilic homogeneous cytoplasmic inclusions. Electron microscopically, there were numerous poxvirus particles and matrices in the cytoplasm of many prickle cells. Dark blue homogeneous cytoplasmic inclusions in toluidine blue sections consisted of an electron opaque matrix with mature viral particles (160 x 200 x 230 nm). Furthermore, there were clumps of granular matrix containing immature viral particles (200 x 399 nm) in the cytoplasm. Various features of viral developing processes were observed.

Alligators and Crocodiles↗
PubMed1990

[A successful case of mediastinal cystic lymphangioma and statistical considerations in the Japanese literature].

A 38-year-old man with large mediastinal cystic lymphangioma was successfully treated. Although he was asymptomatic, mass lesion on chest X-ray, pointed out two years ago, has rapidly increased in its size. The operation was performed through right thoracotomy and the cyst was unilobular and 10 X 8 X 8 cm in size, presented in the right upper anterior mediastinum. It contained about 250 ml of yellowish clear fluid with very thin wall, which was verified as tissue lymph by biochemical examination. Only 27 cases of mediastinal cystic lymphangiomas have been reported in the Japanese literature by 1988. Complete resection of the cyst should be recommended, since almost no evidence of postoperative recurrence would be expected.

Adult↗
PubMed1990

[Clinical studies on endocrine therapy of prostatic carcinoma (1): Multivariate analyses of prognostic factors in patients with prostatic carcinoma given endocrine therapy].

The general trend on the treatment for prostatic carcinoma has been changing from endocrine therapy alone to an alternative type according to stage. We evaluated clinically the favorable and unfavorable outcome of endocrine therapy in Japan, so that others will be appropriately evaluated. In a cooperative study made by members of five universities, 572 patients with clinically or histologically reconfirmed prostatic carcinoma were entered in this retrospective study. We studied the true influence of prognostic factors on the prognosis of 497 patients with prostatic carcinoma who had received endocrine therapy, employing multivariate analyses, such as quantification method II, multiple regression analysis and Cox's proportional hazard model. Twelve factors were considered in the study; "age", "stage", "histological findings (structural atypism = SAT, nuclear anaplasia = NAN, Gleason's primary and secondary pattern)", "pretreatment level of total acid (ACP) and of alkaline phosphatase (ALP)", "castration performed or not performed", "doses of estrogen", "type of response of local prostatic tumor and of ACP to endocrine therapy". Analysis of the "importance" of a prognostic factor by a partial correlation determined by quantification method II, revealed "stage" to have the greatest "importance" on prognosis throughout the entire period. "Response of local prostatic tumor", "response of ACP" and "Gleason's primary pattern" tended to be important factors for prognosis, in particular, in the first half period, and "age" and "Gleason's secondary pattern" were important in the latter half. Multiple regression analysis revealed the "stage", once again to be the most influential factor on the prognosis for the entire observation period. Also "response of local prostatic tumor", "SAT" and "Gleason's primary pattern" affected the patients' prognosis in the first half of the observation period. In the latter half, "age" became more of an influential factor than "histological findings". Analysis with Cox's proportional hazard model revealed that "response of ACP", "stage", "age", "Gleason's primary and secondary pattern", and "response of local prostatic tumor" were definitely the more influential prognostic factors, of which chi-square values (or t values) were statistically significant. Comparison of the significant factors in each multivariate analysis revealed that common influential prognostic factors, such as "age", "stage", "histological findings (mainly Gleason's primary and secondary pattern)", "response of local prostatic tumor" and "response of ACP" were coincident to the clinical impression. The clarification of these factors would be clinically beneficial when treating patients with endocrine therapy.

Estrogens↗
PubMed1990

[Clinical studies on endocrine therapy of prostatic carcinoma (2): Prognosis of patients with prostatic carcinoma given endocrine therapy, and analyses of causes of death and side effects of endocrine therapy].

Of 572 patients with prostatic carcinoma, 497 received endocrine therapy as the initial treatment. These patients were surveyed in a cooperative research study by members from five universities. Prognosis, causes of death and side effects of estrogen therapy were studied. The prognosis of patients who had received endocrine therapy became worse, as the stage progressed. The prognosis of those who had received a combination of estrogen therapy with castration tended to be better than that of those who had received estrogen therapy alone. Similarly, the prognosis of those who had received a combination of progesterone therapy with castration tended to be better than that of those who had had progesterone therapy alone. No relationship was found between estrogen doses (low, medium and high) and prognosis, although a precise comparison among the three could not be made because of the smaller number of patents with low doses. A high dose of estrogen may not always be the indication, rather a medium dose such as 300 mg diethylstilbestrol diphosphate may be clinically appropriate. The cause of death could be identified in 303 patients who had received endocrine therapy. Cancer-related death was the most frequent (63.7%), and cardio- or cerebrovascular death accounted for only 14.2% of the cases. When this analysis was confined to the patients who had received estrogen therapy, estrogen administration seemed to be the cause of cardio- or cerebrovascular death of 16.1% of the patients. Daily dosing of estrogen was not definitely related to the incidence, or the interval to cardio- or cerebrovascular death. However, among the patients who had died of cardio- or cerebrovascular disease, 50% of the patients who had received a medium or high dose of estrogen tended to die within two years after treatment, while 50% of those who had received a low dose died within three years.

Cause of Death↗
PubMed1990

[Clinical studies on endocrine therapy of prostatic carcinoma (3): Histopathological features of prostatic carcinoma and its prognosis].

We investigated how histopathological features, such as structural atypism (SAT), nuclear anaplasia (NAN) and Gleason's pattern, influence the prognosis of patients receiving endocrine therapy. Patients with SAT 3 or NAN 3 clearly had a lower survival rate and a shorter survival period than those with other grades of SAT or NAN and this tendency was more prominent in the high stage than low stage. Patients with a higher grade of SAT or NAN had a poorer prognosis as well, when only cancer-related death was considered in the calculation of survival and survival period. The results described above suggest that the grade of SAT and NAN is one of most influential factors for prognosis. In the analysis for the prognosis of patients according to grade of mean value of SAT + NAN, there were differences in prognosis among mean value of SAT + NAN 2-4, 5 and 6. This indicated that the combined grading system would provide more information to the prediction of prognosis. Patients with Gleason's primary (or secondary) pattern 1 and 2, or 3 and 4 had a better survival than those with pattern 5 in the analysis when only cancer-related death was considered. This was coincident with the result that the survival rate for each Gleason's sum 2-3, 4-5, 6, 7-8 and 9-10 was different. Consequently, Gleason's pattern influenced the rate of cancer-related deaths, and this pattern may be another important factor for predicting the prognosis.

Estrogens↗
PubMed1990

[Ultrasonographic assessment of intravesical urine volume].

The assessment of intravesical urine volume is very important in the management of the patients with lower urinary tract obstruction or incontinence. As the non-invasive method for measuring residual urine volume, accuracy and usefulness of ultrasonographic measurement was evaluated in a total of 116 occasions in comparison with the conventional catheter technique. The values of the maximum transverse (W), cranio-caudal (H) and antero-posterior distance (D) of the inflated bladder were obtained by trans-abdominal scanning. These parameters were used for the ellipsoid formula (pi/6 x W x H x D). The ultrasonographic measurement of urine volume showed a high coefficiency against the conventional catheterized volume (r = 0.9543). Although a mean standard error was 56.3% of the actual volume, the amount of residual urine at the target of 50 ml and 100 ml could be accurately assessed by ultrasound with an accuracy of 90.5%. The method was also valid in follow-up study to monitor the changes of residual urine volume. The ultrasonographic assessment of intravesical urine volume is, thus, a non-invasive, useful tool in the management of the patients with voiding disturbance.

Evaluation Studies as Topic↗
PubMed1990

[A case of cystic lymphangioma grown in subcutaneous tissue of the pubis].

A 37-year-old man visited our hospital with the chief complaint of a painless mass in subcutaneous tissue of the pubis. We extirpated the localized cyst 2.5 x 4 cm in size. Histological diagnosis was cystic lymphangioma without malignant findings. We reviewed the literature on lymphangioma, a rare disease seldom seen in urological fields.

Adult↗
PubMed1990

[Behavioral and histochemical observation in rotational rat with adrenal medulla transplantation].

It is widely known that rotation rat is prepared by destroying substantia nigra pars compacta in the rat. Adrenal medulla was transplanted to the rat. The transplantation was judged to be effective in the rat to which adrenal medullary cell was transplanted as the number of rotation decreased evidently in the rat with transplanted adrenal medulla even in the change in the rotating motion after actual transplantation. On the other hand, many transplanted cells transformed into nerve cell which was considered to have produced dopamine were observed in the rat in which transplantation was judged as effective in the histochemical assessment made of the group undergone transplantation of the adrenal medulla. However, in the rat in which no decrease in the number of rotation was observed, only the transplanted cells which were presumed to be the primary adrenal medullary cells were existent. The fact suggests that take of dopamine-producing cells is necessary to see decrease in rotating motion which is found to be the judging criterion for clinical effect.

Adrenal Medulla↗
PubMed1990

[A benzodiazepine antagonist flumazenil in clinical use--a dose finding study].

The effective dose, usefulness and side effects of flumazenil, a specific benzodiazepine antagonist, have been investigated in 72 sleeping patients after the end of the surgical operation who had received flunitrazepam 0.03 mg.kg-1, a long acting benzodiazepine. The patients received intravenous injections of flumazenil 0.1 mg, 0.2 mg, 0.4 mg and 0.8 mg per person as initial doses. Four minutes after the injection of flumazenil, the percentages of the patients who were awake, were 47.4% in 0.1 mg group, 82.4% in 0.2 mg group, 82.4% in 0.4 mg group and 88.2% in 0.8 mg group respectively. There were several side effects observed in all the groups except 0.2 mg group. However, they presented no clinical problems. Therefore, flumazenil 0.2 mg as the initial dose, is considered appropriate.

Adolescent↗
PubMed1990

Administration of calcium carbonate with adequate doses of vitamin D metabolite to patients on hemodialysis improves mild secondary hyperparathyroidism.

The effects of CaCO3 with vitamin D metabolite and without vitamin D metabolite on secondary hyperparathyroidism were investigated in 18 patients undergoing maintenance hemodialysis. 9 patients (Group 1) were treated with 1 microgram/day 1 alpha (OH)D3 and 2 g/day Al(OH)3, and the other 9 patients (Group 2) received 2 g/day Al(OH)3 without vitamin D metabolite. CaCO3 at amounts of 3 g/day was subsequently administered to all patients instead of Al(OH)3. The levels of mid portion-parathyroid hormone (M-PTH) in Group 2 and of 1,25-dihydroxyvitamin D3 in Group 1 during the baseline period were significantly increased as compared to those in the other group, respectively. In Group 1 only, the level of serum ionized calcium was appreciably elevated at the 4th and 12th weeks as compared to the baseline value, and the level of M-PTH was significantly decreased at the 4th and 12th weeks as compared to the baseline value. The levels of serum phosphate, calcitonin, magnesium and bicarbonate in both groups at the 4th and 12th weeks were not appreciably different from the baseline values. The level of serum aluminum in all patients of both groups were reduced at the 12th week as compared to the baseline values. A close correlation was recognized between M-PTH and the level of intact parathyroid hormone. It is concluded that prescription of 3g/day CaCO3, together with adequate doses of vitamin D metabolite, can ameliorate mild secondary hyperparathyroidism.

Adult↗