Biomedical subjects
Publications and source records attributed to K Shindo.
We report a case of carcinosarcoma of the bladder. Total cystectomy with ileal loop urinary diversion was performed. Histologically, the bulk of the tumor tissue was rhabdomyosarcoma and adenocarcinoma. At distant areas from the bulk tumor transitional cell carcinoma was noted. The literature is reviewed and the clinicopathologic condition of carcinosarcoma of the bladder is discussed.
Patients received pivmecillinam (PMPC) after prophylactic use of various antimicrobial chemotherapeutic agents following prostatectomy, and their clinical responses were assessed for effectiveness in the treatment and prevention of postoperative infection. The data were also analyzed to explore the relationship between bacterial isolates obtained during the postoperative course and the antimicrobial agents administered prophylactically against postoperative infection. Therapeutic effect of PMPC: Treatment of postoperative infections with PMPC was effective in 36 (53.7%) out of 67 patients who had undergone prostatectomy. Prophylactic effect of PMPC: The use of PMPC provided effective prevention of infection in 22 (64.7%) out of 34 patients from whom no bacterial pathogen had been isolated before postoperative antimicrobial chemotherapy. Therapeutic responses to PMPC, compared between different types of operative procedure: There was little or no difference in therapeutic effectiveness of PMPC against postoperative infection when compared between two types of operative procedure, transurethral prostatectomy and subcapsular removal of the prostate. Incidence and types of bacterial isolates following prophylactic chemotherapy with various agents after prostatectomy: Possibly because cephapirin (CEPR) and ticarcillin (TIPC) were mainly administered, alone or in combination, for prophylaxis against postoperative infection, Serratia and Pseudomonas were most frequently isolated. The findings offer suggestions as to the appropriate combination of antimicrobial agents to be used for prophylactic purposes. Effectiveness of PMPC in the presence or absence of a preoperative indwelling urethral catheter: The use of PMPC was more effective both in the treatment and prevention of postoperative infection in cases without preoperative indwelling urethral catheterization than in those with it.
A living related kidney transplant recipient with normal renal functioning and hypertension secondary to renal artery stenosis was treated with captopril and developed reversible granulocytopenia. Complications caused by captopril, an angiotensin converting enzyme inhibitor, have been reported previously in hypertensive patients with systemic lupus erythematosus or with renal artery stenosis after renal transplantation. It is recommended that this drug be used with caution in this setting.
A total of sixty one patients with carcinoma of the rectum accepted radiotherapy of 40 Gy/4W to whole pelvis including the perineum. Randomized study of preoperative radiation to the pelvis showed that patients with advanced carcinoma of the lower rectum and the anus benefited in the prevention of the local recurrence and in the curability of unresectable tumor. Postoperative radiation therapy was indicated in the case of the residual tumor, metastatic lymphnodes, distinct lymphatic permeation and insufficient excision of the rectum. For the pelvic recurrence irradiation of doses more than 36 Gy was effective in the case of slow growing tumor. A radical treatment is expected for patients with inoperable tumor or for patients without indication of major surgery because of age or medical problems by the whole pelvic irradiation plus interstitial irradiation.
A 8-year-old girl was referred with both vesicoureteral reflux and repeated urinary infection since she was 30 months old. At 5 years old, she had had cystoscopy. Her excretory urogram (IVP) was almost normal; her voiding cystogram showed both vesicoureteral reflux of grade III and a maximum bladder capacity of 75 ml. At cystoscopy the ureteral orifices were in normal position of the trigone and the orifices were dilated like a golf-hole. Both ureters were reimplanted without ureter stents by the Cohen cross-trigonal advancement technique. Her IVP and a renograms postoperatively have shown normal kidney function and no urinary retention in either kidney. Her voiding cystograms have shown no vesicoureteral reflux. For 15 months after operation she has had no urinary infection. The Cohen cross-trigonal technique is a simple, safe and more applicable method than other anti-vesicoureteral reflux operations in cases of vesicoureteral reflux with contracted bladder.
Four cases of urachal carcinoma are presented. The first case was a 36-year-old man who was admitted with the chief complaint of macrohematuria with mucinous debris. Cystoscopic examination revealed a single tumor at the dome of the bladder. Partial cystectomy and postoperative radiation therapy were performed. Histological findings showed a well differentiated adenocarcinoma. He has been well for twelve years postoperatively. The second case was a 52-year-old man who was admitted with the chief complaint of macrohematuria with mucinous debris. Cystoscopic examination revealed a single tumor at the dome of the bladder. Partial cystectomy and postoperative radiochemotherapy were performed. Histological findings showed a moderately differentiated adenocarcinoma. He died of a recurrent tumor 30 months after operation. The third case was 70-year-old man who was admitted with the chief complaint of macrohematuria with mucinous debris. Cystoscopic examination revealed multiple tumors at the dome of the bladder, internal urethral orifice and right lateral wall. Total cystectomy, ureterocutaneostomy and postoperative chemotherapy were performed. Histological findings showed a poorly differentiated adenocarcinoma. He died of a recurrent tumor 30 months after operation. The fourth case was a 68-year-old woman who was admitted with the chief complaint of macrohematuria with mucinous debris. Cystoscopic examination revealed a single tumor at the dome of the bladder. CT scan demonstrated a mass with calcification extending from the bladder dome superiorly. Partial cystectomy and postoperative chemotherapy were performed. Histological findings showed a well differentiated adenocarcinoma. She has been well for three months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
The area of the anterior horn of the right lateral ventricle and five ventricular indices: (1) maximum width of the anterior horns, (2) minimum width of the anterior horns, (3) sum of these maximum and minimum widths, (4) ventricular index, and (5) cella media index were measured from the CT scans of 198 cases considered to be "normal". The area of the right anterior horn and indices 1-4 were measured on the slice which most clearly showed Monro's foramina and index 5 was measured on the slice 2 cm above. The size of the ventricular system increased steadily with age. The sum of the maximum and minimum widths of the anterior horns was most highly correlated with the area of the right anterior horn. Using this ventricular index, we graded brain "atrophy" in each age group.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In 37% of 177 cases with colo-rectal cancer, our original staining method succeeded in the detection of cancer cells invaded in the small vein vessels in the primary lesion, 35.4% of which metastasized to the liver. Cancer cells were found histologically in the portal vein in these cases. Serum CEA levels were abnormally high in the cases of vein invasion in 57%. Hematogenic metastases occurred in 90% in the cases of vein invasion with abnormal CEA level. Serum CEA level decreased after the resection of the involved intestine, but increased sharply when hematogenic metastases occurred, while the CEA level increased gradually and slowly in cases of local recurrences or peritoneal disseminations .
Ten patients with sepsis and pneumonia complicated by leukemia or lung cancer were treated with cefoxitin (CFX) at daily dose of 6 g. The following results were obtained. 1. Clinical effects of CFX were good in 5 patients, fair in 2 and poor in 3 with effective rate of 50%. 2. Out of 8 patients with sepsis, 5 showed good response to CFX and effective rate was 62.5%. 3. Bacteriological outcomes were eradicated in 1, unchanged in 1, replaced in 2 and unknown in 6 cases. 4. Diarrhea was observed in 1 patient but this was not considered related to CFX therapy. 5. No abnormal laboratory finding due to CFX was observed. 6. It should be considered that 6 g or more of CFX is given in case of severe infections, such as sepsis or pneumonia complicated by serious underlying diseases.
Chronic renal failure was induced in rats by a five-sixths nephrectomy, after which incisional wounds were made in the abdominal skin, aponeurosis of linea alba, stomach and colon. Bursting strength of the colon and tensile strength of the skin, aponeurosis and stomach were usually lower in the uremics than in the controls, but there was no statistical significance except for colonic wounds on the 7th and 10th postoperative days. Before these results can be extrapolated to clinical cases, pre- and post-surgical treatment must be considered, because immunosuppressants, anticoagulants, and other compounds may influence the retardation of wound healing.
Incisional wounds of the abdominal skin, aponeurosis, stomach and colon were investigated microscopically for a comparison of the findings between uremic and normal rats. The grade of edema and number of inflammatory cells were increased in the rats with uremia and the granulation zone was also larger in the uremics. Hydroxyproline was assayed in the wound tissues by a modification of the technique of Stegemann and Stalder. The hydroxyproline level was lower in the uremics (p less than 0.05) only in the aponeurosis of the 5th postoperative day and in the colon of the 3.5th to 7th day. The correlation coefficient calculated for the blood urea level, biomechanical strength and hydroxyproline level was nil. If these results can validly be extrapolated to patients with chronic renal failure, careful management and avoidance of possible wound infections is of the greatest importance for surgical patients.
Sixty-five cases of anal carcinoma have been treated in the past 20 years - 44 adenocarcinomas, 15 epidermoid carcinomas and 6 others. The sex ratio of male to female was 2:13 among those with epidermoid carcinoma and 27:17 in the adenocarcinoma group. There was no significant difference between the five-year survival associated with both kinds of carcinoma, though adenocarcinomas invaded more deeply and were larger. Lymph node metastases were found in 60% of cases in each group, but inguinal metastases were found in 47% of epidermoid carcinomas and 32% of adenocarcinomas; lung and liver metastases were seen in 13% of the former and 18% of the latter (there was no statistical significance). A new staging is proposed, supported by the five-year survival rate (in parentheses), as follows: stage 1-T1, T2, NO, MO (100%); Stage II - T3, T4, NO, Mo (66.7%) Stage III - any T, N1, MO (31.6%); Stage IV - any T, any N, M1 (0%).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.