Malignant hemangiopericytoma of the head and neck: a report of 3 cases.
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Adult↗
Biomedical subjects
K Tei
Publications and source records attributed to K Tei.
Histopathology of a human allografted kidney with clinically sufficient function.
To clarify the clinico-pathological significance of protocol biopsy and clinically silent rejection in the management of renal graft recipients, we selected a total of 139 (23%) from 604 biopsy specimens according to the following criteria: 1) less than 1.4 mg/dL of serum creatinine and 2) more than 1,500 mL/d of urine volume at time of biopsy. Clinical indications for the biopsy were classified into five categories: i) protocol biopsy (73 specimens), including 69 cases at discharge post-transplantation; ii) slight increase in serum creatinine (32); iii) proteinuria (20); iv) evaluation of pulse-therapy (13); and v) fever elevation (1). Except for the last category, the specimens were histopathologically diagnosed as being normal in 50 (68%), 6 (17%), 1 (5%), and 5 (38%) specimens, respectively. Even borderline changes, and mild acute rejection, as well as drug-induced nephropathy were included, implying the existence of clinically silent rejection or drug-induced nephropathy. Obvious diversity in the histopathological diagnosis was noted in category iii) showing proteinuria, which was mainly caused by chronic rejection, drug-induced nephropathy and glomerulonephritis. The graft survival rate was no different among the four categories, except for category v). These results indicate that biopsies obtained from functionally sufficient renal grafts could provide useful information in the management of the recipients. The clinical significance of protocol biopsy awaits further clarification by the analysis of a large number of cases.
Biopsy↗
[Value of upper gastrointestinal endoscopic examination of head and neck cancer patients].
Between January 1995 and March 1999, we performed the upper gastrointestinal endoscopic examinations on 287 patients with head and neck cancers and detected 23 cases (8%) of esophageal cancer and 8 cases (2.8%) of gastric cancer, showing how frequently esophageal cancer occurs in head and neck cancer. The esophageal cancer involved the oral cavity in 8 cases (9.5%), the oropharynx in 3 cases (8.6%), the hypopharynx in 10 cases (19.6%), and the larynx in 2 cases (2%). Esophageal cancer occurred most frequently in hypopharyngeal cancer, particularly the pyriform sinus type and the postcricoid type. We conclude that upper gastrointestinal endoscopic examination, including Lugol staining, is necessary in head and neck cancer patients.
Adenocarcinoma↗
Role of radiotherapy for mucoepidermoid carcinoma of salivary gland.
This report analyzes 61 patients with mucoepidermoid carcinomas of the salivary gland treated by surgery alone or by surgery plus radiotherapy. Local control for all 61 patients at 5 and 10 years was achieved for 88.8 and 79.7% of the cases. Although the rate of positive surgical margin was higher in patients treated with surgery and radiotherapy (radiotherapy group) than in patients treated by surgery alone (surgery group), the local control rates of the two groups showed no statistically significant differences. There was no local recurrence in seven patients receiving post-operative radiotherapy above 55 Gy while there were three local relapses among 17 patients receiving 55 Gy or lower doses (P < 0.05). The 5- and 10-year actual survival rates were 73.4 and 63.3% respectively. Histopathologic subtype of mucoepidermoid carcinomas correlated with regional lymph node involvement and survival. There were no differences in the local control and survival rates of patients with major salivary gland tumors and patients with minor salivary gland tumors. Radiotherapy using 55 Gy or more combined with operation achieved local control and survival rates comparable with complete resection of tumors even if a positive surgical margin was more frequent in the radiotherapy groups.
Adolescent↗
Thoracoscopic surgery combined with a supraclavicular approach for removing superior mediastinal tumor.
This report introduces our new technique of thoracoscopic surgery combined with a supraclavicular approach for removing superior mediastinal tumor. A 68-year-old woman noticed a tumor palpable in the left supraclavicular fossa. The patient had no pain around the neck and shoulder. A radio-opaque shadow 6 cm in diameter was detected in her left apical lung field on chest roentgenogram. Chest CT and MRI showed that the tumor was located in the superior mediastinum, extending up to the thoracic inlet, and there was no invasion of the surroundings. At first, a thoracoscopic examination was performed to assess the possibility of the excision. After dissecting the tumor from the mediastinal tissue and the first costovertebrae as far as possible by thoracoscopic surgery, a supraclavicular approach was used to enter the thoracic cavity. Complete resection of the tumor was successfully performed by thoracoscopic surgery combined with a supraclavicular approach. The tumor was removed in a plastic bag through the supraclavicular defect. Postoperative histopathology revealed that the tumor was a benign neurogenic one. A satisfactory follow-up of 5 postoperative days was observed without any complications, and the patient was discharged. The procedure was safe, easy, and minimally invasive to perform. Moreover, the supraclavicular approach could be used to add trocar port if needed.
Aged↗
Laparoscopic colpopoiesis using sigmoid colon.
A new technique for colpopoiesis using sigmoid colon autograft by a laparoscopic surgery is introduced for the first time. This technique requires advanced skills perform and may be the choice in respect to naturalness and permanency of the neovagina with minimum invasion.
Adult↗
Laparoscopic reconstruction of vagina using sigmoid autograft.
With the advent of advanced laparoscopic techniques in surgery, new applications have been found, which have expanded the role of laparoscopy in the gynecological field. The aim of this paper is to introduce our laparoscopic technique of taking a sigmoid colon autograft for colpopoiesis in a patient with congenital agenesis of the vagina. This technique is less invasive and is easy to perform, and it may be the best choice of operation in respect to the naturalness and the permanency of the vagina that results. The success of this laparoscopic technique of taking a sigmoid autograft for colpopoiesis suggests diverse possible applications in the future.
Adult↗
Laparoscopic gastrotomy in intragastric surgery for early gastric cancer: a new technique.
Laparoscopic surgery has been widely applied not only in cholecystectomy but also in gastrointestinal operations. In previous reports the authors proposed their original operative technique, laparoscopic intragastric surgery (LIGS),' in which all trocars and surgical instruments are inserted directly into the gastric lumen to perform the resection of mucosal or' submucosal lesions of the stomach. The purpose of this article is to introduce laparoscopic gastrotomy as a new technique for removing early gastric cancer by LIGS.
Journal Article↗
[Transitional cell carcinoma of the renal pelvis with cystic formation: a case report].
A 75-year-old man consulted our hospital complaining of gross hematuria. Retrograde pyelography revealed a filling defect and deformity of the upper calix of the left kidney. Abdominal echography and computed tomography revealed a left renal cystic tumor with irregular wall thickness measuring 7 by 5 cm. As left renal pelvic tumor or left renal cell carcinoma was suspected, left total nephroureterectomy was performed. Macroscopically, the cystic tumor contained a papillary tumor connected to the renal pelvis and histopathological diagnosis was grade 1 transitional cell carcinoma. Cystic formation caused by obstruction of the upper calix was suspected. After adjuvant chemotherapy, he has been well without recurrence or metastasis for 19 months after the operation. This is the 15th case of renal pelvic tumors with cystic formation including tumors in the pyelocaliceal diverticulum reported in Japan.
Aged↗
[A case of soft renal calculi with xanthogranulomatous change].
A case of soft renal calculi with xanthogranulomatous change is reported. A 37-year-old female visited our hospital on February 4, 1992 complaining of frequency of urination and right lower abdominal pain. Under the clinical diagnosis of right renal calculi, extracorporeal shock wave lithotripsy was attempted, but no sign of destruction was observed. Right pyelolithotomy was performed on June 8, 1992. Several soft calculi were removed from the right renal pelvis. Microscopic examination showed that the calculi were surrounded by a cell layer including foam cells and giant cells. In addition, the calculi revealed positive reaction by several stainings (alcian-blue, PAS and muticarmin), which showed that the calculi were mainly composed of mucopolysaccharides. We discussed this disease in terms of symptoms, diagnosis, treatment and mechanism in comparison with previous reports.
Adult↗
[Urinary incontinence following total prostatectomy--evaluation by urodynamics and urethrography].
Urinary incontinence following total prostatectomy was evaluated in 10 patients by urodynamics and lateral urethrography. The pathological stage of the tumors in these patients was pT2 in 5 patients, pT3 in 3 patients and pT4 in 2 patients. Urinary incontinence was present in 8 patients, of whom 7 were stress incontinence and one was urge and stress incontinence. The severity of incontinence of these patients was mild in 5 patients, moderate in 3 and severe in 2. The incontinence was severer in the patients with the tumors of pT3 or pT4 than in the patients with the tumors of pT2. But the severity of incontinence was not related to the pathological grade or resected weight of the tumors. The bladder capacity and bladder compliance were 214.9 ml and 14.3 ml/cmH2O in average, respectively, and was not related to severity of incontinence. The statistical significant differences between continence or mild incontinence patients and moderate or severe incontinence patients were found for the mean functional profile length (2.04 versus 1.37 cm, respectively; p < 0.05) and maximum urethral closure pressure (42.3 versus 17.3 cmH2O, respectively; p < 0.05). But some patients with continence or mild incontinence demonstrated low values in either parameters. No statistical difference was found between continence and mild incontinence patients. On lateral urethrography, the posterior urethrovesical angle was not correlated with the severity of incontinence.
Aged↗
IgM-producing renal plasmacytoma.
A seventy-six-year-old woman with plasmacytoma presenting as a renal mass died three months after diagnosis. Bone surveys disclosed no lytic lesions. Gallium-67 scan showed an avid uptake of the radionuclide in the renal mass. Histologic and immunofluorescence studies of resected specimens demonstrated that the renal parenchyma was destroyed by sheets of immature plasma cells producing IgM-lambda and by massive deposits of amorphous, eosinophilic substance stained with anti-mu and anti-lambda antisera. The literature is reviewed. We believe this case is the first one of well-documented IgM-producing renal plasmacytoma.
Aged↗
[A case report of left upper lobectomy for lung cancer performed on an aged man of 90 year old].
A 90-year-old man was admitted to our hospital because of the dyspnea on exertion and an abnormal shadow of the chest. The examinations revealed pulmonary adenocarcinoma (bronchioloalveolar cell type) of the left S3 with clinical classification of stage I. Spirometry showed severe obstructive lung dysfunction (VC 2.05 l, % VC 75.2%, FEV1.0 0.72 l, FEV1.0% 39.3%). Walking exercise in the ward and the stairs as well as instrumental physiotherapy (Triflow) partially improved his respiratory function. Left upper lobectomy and lymphnode dissection were performed. On the 3rd postoperative day the patient developed mild delirium which disappeared in a few days. He was discharged from the hospital 62 days after the operation.
Adenocarcinoma, Bronchiolo-Alveolar↗
Continuous subcutaneous injection of ketamine for cancer pain.
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Humans↗
[In vitro activity of minocycline against Chlamydia trachomatis clinical isolates and clinical efficacy of minocycline to C. trachomatis associated nongonococcal urethritis].
The in vitro activity of minocycline (MINO) against Chlamydia trachomatis and its efficacy in the treatment of C. trachomatis-associated nongonococcal urethritis were investigated. Six isolates of C. trachomatis were inhibited at 0.06 micrograms/ml of MINO and 5 isolates at 0.03 micrograms/ml. All cases received oral MINO twice daily for 7 or more days in doses of 100 mg. In 5 of 31 cases, 2 g of spectinomycin was intramuscularly administrated together with MINO only once. C. trachomatis was eliminated in all cases tested. Excellent results were obtained in 26 cases (84%); urethral discharge and polymorphonuclear cells (PMN) disappeared or decreased to normal levels (3 cells/hpf or less) in these cases. Ureaplasma urealyticum was isolated from 8 cases, 7 of which became free of ureaplasmal infection. MINO seemed to be less effective on the decrease of PMN in the urethral smear in cases infected coincidentally with C. trachomatis and U. urealyticum than in cases infected with C. trachomatis alone. No subjective side effects were observed in any of the 31 cases studied. In conclusion, MINO was a useful antimicrobial agent for the treatment of C. trachomatis- and U. urealyticum-associated nongonococcal urethritis.
Adult↗
[Detection of polyamines by an enzymatic assay. (6). Fundamental and clinical studies of a simple enzymatic method for determining total polyamines in blood].
A simple enzymatic method for determining total polyamines in human blood was established. Polyamines in trichloroacetic acid extract from 1 ml of blood were isolated on an anion-exchange column and measured spectrophotometrically by the end point assay using polyamine oxidase and putrescine oxidase. The recovery was as high as 98.4% and within-run precision (coefficient of variance: 1.82%), and the values obtained by this method were in fair agreement with those obtained by high performance liquid chromatography and the enzymatic differential assay methods previously reported. The polyamine levels were not changed when the blood was stored at -20 degrees C. Blood polyamine levels were measured in 108 patients with genitourinary cancers, 29 patients with benign prostatic hypertrophy, 18 patients with benign urological diseases and 25 normal subjects. Although polyamines were not significantly elevated in the low stage of cancer, elevation was observed at a high stage of malignancy. These results indicate that the determination of total polyamines may be useful to determine biochemically the malignancy of cancers.
Biomarkers, Tumor↗
Clinical reevaluation of the effect of oxybutynin chloride on uninhibited neurogenic and reflex neurogenic bladder.
Oxybutynin chloride has been clinically used for the relief of symptoms associated with voiding in patients with uninhibited neurogenic and reflex neurogenic bladder in the USA. The present clinical and urodynamic studies were the first meticulously in patients with uninhibited neurogenic and reflex neurogenic bladder in Japan. A single oral dose of oxybutynin chloride (3 or 6 mg) did not induce any change either in subjective symptoms or in urodynamic studies; however, in the continual administration study, 7 of 9 patients showed an improvement in the symptoms associated with voiding. The drug reduced urinary frequency, urgency and incontinence, and significantly increased the volumes at the first desire to void (FDV) and maximum desire to void (MDV) in cystometry. Furthermore, no serious adverse reactions were observed, and hence the drug seems to be of clinical significance.
Aged↗
[Detection of chlamydial antigen with an EIA in patients with sexually transmitted disease].
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Antigens, Bacterial↗