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Biomedical subjects

K Rinsho

Publications and source records attributed to K Rinsho.

35 records · Page 2Linked to original sources

The value of ultrasonography in early detection of renal cell carcinoma.

Renal cell carcinoma is the third most frequent cause of urological cancer death in Japan. The first is bladder cancer and the second is prostatic cancer. However, there has been no clinical trial of mass screening for early detection of renal cell carcinoma. With a view to discovering a method of early detection for renal cell carcinoma, we analyzed the procedures for discovering renal cell carcinoma in 33 patients who were treated at our hospital. In 10 patients, carcinoma had been discovered accidentally without gross hematuria, abdominal mass or flank pain. Seven of these patients were first suspected of having renal cell carcinoma by ultrasonography, two by intravenous pyelography (IVP) and one by computed tomography. Seven out of nine patients operated on were surgically diagnosed as having stage I and two as having stage II. Ultrasonography is far better than IVP from the points of view of noninvasiveness, ease of performance and accuracy. In our study, ultrasonography was the most useful method for early detection of renal cell carcinoma. However, for the mass screening of renal cell cancer by ultrasonography, it is necessary to make its specificity and sensitivity clear and to debate its cost effectiveness.

Adult↗

[A case of lipoma of the spermatic cord].

A case of lipoma of the spermatic cord is presented. The patient is a 68-year-old with the chief complaint of indolent swelling of the left scrotal content which had been noticed about a month ago. A firm elastic and walnut-sized mass with positive transillumination was palpable in the left spermatic cord, but ultrasound sonography demonstrated that it was a solid mass. Though the tumor was punctured with a 18-gauge needle, nothing could be aspirated. The tumor was removed and histologically diagnosed as lipoma originating in the left spermatic cord. Including the present case, 38 Japanese cases of lipoma of the spermatic cord are reviewed.

Aged↗

[A case of retroperitoneal liposarcoma].

A 77 year-old woman presented with the chief complaint of a mass in the right upper quadrant. The examination on admission including IVP, echography, Ga scintigraphy, barium enema, CT scan, and angiography revealed that the right kidney and ascending colon were displaced by the mass. Under the diagnosis of retroperitoneal tumor, operation was carried out. Most of the mass was resected with the right kidney. The pathological diagnosis of the resected tumor revealed well differentiated liposarcoma. Convalescence was uneventful and the patient has been well and free from disease for 14 months. Based on our experience and the review of the pertinent literature in English and Japanese, we emphasize the importance of definite surgery and close follow up, as liposarcoma is frequently recurrent.

Aged↗

[Surgical aspects of open renal biopsy done by urologic residents at Tsukuba University].

The results of the operative aspects of open renal biopsy performed by urologic residents at our University Hospital during the 18 months from July 1982 to December 1983 were analyzed. Open renal biopsy was performed by 1st to 6th year residents for various renal diseases on 19 male and 12 female patients, i.e., 14 patients from Pediatric Department, 16 patients from Nephrologic Department and 1 patient from Urologic Department. All except for 3 operations were done under the guidance of urologic staff. The length of incisional line ranged from 3 to 7 cm (average 5.1 cm) in pediatric patients, and that of nephrologic and urologic patients ranged from 5 to 15 cm (average 8.7 cm). The average operation time was 89.2 minutes for pediatric patients, although it was 81.1 minutes when 1 patient who had concurrently operated on inguinal herniorrhaphy in addition to open renal biopsy was excluded from the analysis. The average operation time was 122.2 minutes for nephrologic and urologic patients, although it was 112.8 minutes when 1 patient who had lost a large amount of blood was excluded. The average blood loss was 28.2 ml for pediatric patients when 2 patients whose blood loss was recorded as "small quantity" was excluded, but it was 24.5 ml when 1 patient who was concurrently operated on for inguinal herniorrhaphy in addition to open renal biopsy was excluded. The average blood loss during operation was 235.1 ml in nephrologic and urologic patients, but it was 149.95 ml when 1 patient who had lost a great deal of blood (1,598 ml) was excluded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Chemotherapy of advanced seminoma].

Seminoma is one of the most radiosensitive of the solid tumors. Radiotherapy provides a high cure rate for patients with stage I and II seminoma, but the survival rate of the patients with clinically advanced stage III seminoma is only about 30% in the literature. Our case of advanced metastatic seminoma was treated with cisplatinum, vinblastine and bleomycin. Metastatic tumors in the lung disappeared after chemotherapy but recurred shortly. Then regional radiation was given and the tumors disappeared completely. Subsequent prophylactic chemotherapy was given. In view of the observed chemosensitivity of seminoma, it appears that all patients who present initially with metastatic or bulky retroperitoneal disease should be treated with multiple drug chemotherapy including cis-platinum. Residual tumors can be treated by radiation and surgical resection, which will improve the cure rate of advanced metastatic seminoma.

Adult↗

[Treatment of early urogenital cancer].

Problems in the treatment of early urogenital cancer were discussed. Bladder cancer: Prevention of recurrence of superficial tumor and early diagnosis of microinvasive cancer are important. Renal cancer: Ultrasound study is helpful method for the purpose of early detection of asymptomatic renal cancer. Prostatic cancer: It is necessary to produce the method which detects early prostatic cancer. Testicular cancer: The combination chemotherapy including cis-platinum is very effective.

Adult↗

Long-term intra-arterial infusion chemotherapy with adriamycin for advanced bladder cancer.

Long-term intra-arterial infusion chemotherapy with Adriamycin (ADM) was performed in cases of bladder cancer prior to total cystectomy. This report describes the effects in 13 cases evaluated more than 3 weeks after infusion of 10 mg ADM once or twice weekly. An oblique skin incision approximately 10 cm long was made in the gluteal region to expose the gluteus maximus muscle. A teflon catheter was then inserted into the gluteal artery and fixed; the distal end was brought out from under the skin in the precordial region. A similar procedure was performed on the contralateral side. The catheter was inserted through the superior and inferior gluteal arteries in five and eight cases, respectively. In the former group, partial response was obtained in two cases, minimal response in two and no response in one, so that primary tumor remission was evident in 40% of the cases. In the latter group, all cases but one attained partial response, i.e., remission was seen in 87.5% of cases treated by inferior gluteal infusion. Skin erosion of the gluteal, perineal, and anal regions and sciatica-like pain were observed in some cases; however neither myocardial effect nor bone marrow suppression, which have been reported as side-effects of ADM, were observed in any of the cases. These results suggest that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated.

Aged↗

[Role of lymphangiography in staging carcinoma of the prostate].

Pedal lymphangiography was done on 21 patients with carcinoma of the prostate. The lymphangiograms were positive in 11 cases and negative in 10. Out of 9 patients who underwent lymphadenectomy (5 with positive and 4 with negative findings), operative findings were in agreement with the lymphangiogram in 8 patients (89%). Lymphangiography should be used as the primary procedure in all cases where aggressive therapy is being considered.

Humans↗

[Clinical study of urinary cytology: with special reference to bladder cancer].

During the last 66 months, 482 urinary cytologic examinations were performed on 160 inpatients suspected of having genitourinary cancer at our University Hospital. Cytologic diagnosis was done according to the Papanicolaou's classification. The cytologic findings were compared by size, shape, numbers of the tumor and the histologic findings. The positive rate (classes IV and V) was 56.7% (90 patients) in bladder cancer, 22.2% (18 patients) in prostatic cancer, 13.3% (15 patients) in renal cancer and 62.5% (8 patients) in renal pelvic or ureteral cancer. There was no false positive case for benign disease. The positive rate of cytologic examinations for stage A bladder cancer was statistically lower than that for stage B, C and D cancers. There were no statistically significant differences among the stage B, C and D groups. The positive rate in the low grade (grade I and II) bladder cancer was statistically lower than that of high grade (grade III and IV) cancer. In the small tumor less than thumbtip -sized, cytological diagnosis was positive in 40.0%, while in the large tumor larger than this size, the positive rate was 73.3%. The difference between these two groups was statistically significant. The positive rate in the non-recurrent cases of the bladder cancer was 64.5%, while that in the recurrent cancer cases was 39.3%. The difference between these two groups was statistically significant. The positive rate of urinary cytology did not correspond to the shape or number of tumors. It is desirable to perform cytology more than 3 times on the same patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Postoperative complications and followup in cystectomy].

Clinical studies on postoperative complications and prognosis were done on 27 patients who had undergone cystectomy at our hospital. Thirty one postoperative complications were seen in 16 patients. Early complications which developed within 3 months of operation were more frequent (25 cases). They included pyelonephritis (5 cases), wound infection (4 cases), pulmonary complications (2 cases), cardiovascular complications (2 cases), ileus (2 cases) and delayed ambulance (2 cases) in decreasing order of frequency. Complications related to urinary diversion were observed in 4 out of 6 late complications. Reoperation secondary to surgical complications were done in 6 cases. Four of the 6 reoperations were related to gastrointestinal complications, all of which would be fatal if left untreated. Postoperative followup period ranged from 3 weeks to 49 months with a mean period of 12.8 months. The present status of the patients is as follows: 16 patients alive, 10 patients dead and 1 patient lost to followup. So far we cannot draw a definite conclusion regarding the relationship between surgery and the prognosis of the patients because the followup period is too short in many patients. In our experience: 1) The fewest cancer deaths occurred in patients who had undergone radical surgery; 2) the largest percentage of living patients was seen in the group of patients who had undergone radical cystectomy; and, 3) almost all patients with low stage tumors are living more than 6 months after operation.

Adult↗

Renal autotransplantation for localized amyloidosis of the ureter.

Localized amyloidosis of the ureter is a relatively rare disease, causing at times ureteral stenosis with hydronephrosis and renal function impairment to various extent. Although it is not malignant nearly all reported cases have been treated by nephroureterectomy because it is clinically difficult to differentiate this entity from ureteral malignancy. We report a case in which the ipsilateral kidney was salvaged successfully by renal autotransplantation. To the best of our knowledge, this is the first case reported of renal autotransplantation for localized amyloidosis of the ureter in the English literature. We suggest that renal autotransplantation be considered in cases of localized ureteral amyloidosis.

Amyloidosis↗

Xanthogranulomatous pyelonephritis in childhood: case report and review of English and Japanese literature.

Xanthogranulomatous pyelonephritis is an uncommon disease that is usually seen in middle-aged women and is much rarer in children. We report a case of diffuse xanthogranulomatous pyelonephritis in a 3-year-old boy who had a nonfunctioning hydronephrotic right kidney on an excretory urogram. A review of the English and Japanese literature on xanthogranulomatous pyelonephritis in childhood revealed 2 remarkable differences regarding the incidence of sex and radiological findings. The majority of patients were girls in the English literature, whereas the opposite sex was seen in the majority of cases in Japan. The involved kidney was functioning on an excretory urogram in the majority of cases reported in the English literature, however, in all cases from Japan the involved kidney was non functioning. These findings further support the newer concept that xanthogranulomatous pyelonephritis in childhood exists in focal as well as diffuse forms.

Child, Preschool↗

Urinary hydroxyproline excretion as a marker of bone metastasis in prostatic cancer.

In 25 patients with prostatic cancer and 26 patients with benign prostatic hypertrophy, urinary hydroxyproline excretion as estimated by the method described by Cleary and Saunders. The patients were kept on a diet free of gelatin. Urinary creatinine was measured in all patients and serum acid phosphatase, prostatic acid phosphatase, alkaline phosphatase and calcium were measured in patients with prostatic cancer. Urinary hydroxyproline excretion and the hydroxyproline/creatinine ratio were both elevated in patients who had prostate cancer with bone metastasis when compared to values in patients who had benign prostatic hypertrophy or prostatic cancer without bone metastasis. These two were more sensitive indicators of bone metastasis than serum acid phosphatase, prostatic acid phosphatase, alkaline phosphatase and calcium. These results suggest that urinary hydroxyproline is a valuable index of bone metastasis in prostatic cancer.

Bone Neoplasms↗