Biomedical subjects

M Takaha

Publications and source records attributed to M Takaha.

At least 37 records · Page 2Linked to original sources

PubMed1995

[Clinical studies of chemotherapy for patients with a solitary kidney after nephroureterectomy for advanced upper urothelial transitional cell carcinoma].

Between June, 1987 and December, 1993, ten patients with solitary kidney after total nephroureterectomy for advanced upper urothelial transitional cell carcinoma were treated with chemotherapy (M-VAC or modified M-VAC). This series comprised 6 males and 4 females between 27 and 81 years of age (mean age: 58.5 years). The site of primary lesions was the renal pelvis in one case, ureter in 5 and renal pelvis and ureter in 4. Histologically, these extripated tumors were all identified as transitional cell carcinoma, the stage being pT3 and pT4 in 9 and grade being G3 in 8 of the 10 patients. Among the 13 cases including the 3 cases of recurrence after first line chemotherapy, 7 had lesions suitable for the evaluation. Two of the 7 cases achieved complete response and four achieved partial response, resulting in an 86% response rate. Of the 10 patients, 4 died of metastasis of carcinoma and the others are still alive. The average period after operation among 10 patients was 25 months. Side effects related to this chemotherapy were as follows: general fatigue, nausea or vomiting and alopecia 100%, leucocytepenia (< or = 1,000/mm3) 23%, anemia (RBC < or = 250 x 10(4)/mm3) 62%, thrombocytopenia (< or = 5 x 10(4)/mm3) 46%. However, nephrotoxicity in spite of solitary kidney was not noticed in any patients. From our experience, we suggest that M-VAC or modified M-VAC chemotherapy are safe against patients with a solitary kidney after nephroureterectomy for advanced transitional cell carcinoma of the upper urinary tract.

Adult↗

PubMed1994

Light microscopical immunohistochemical study on parathyroid adenoma in primary hyperparathyroidism.

Fifteen adenomatous parathyroid glands obtained from 15 patients with primary hyperparathyroidism were examined both pathologically and immunohistochemically and connected with the clinical data for each patient. Four consecutive sections of the largest section surface of each resected adenomatous parathyroid gland were utilized for 4 kinds of stains, that is, hematoxylin-eosin, Grimelius and the immunohistochemical stains for parathyroid hormone (PTH) and chromogranin A. The results were as follows: (1) The large adenomatous parathyroid glands showed strong reactions to PTH as well as chromogranin A and Grimelius. On the other hand, the parathyroid adenoma obtained from a 9-year-old boy with hypercalcemic crisis showed almost no stain-positive cells for both PTH and chromogranin A. It is assumed that the former phenomenon reflects a substantial storage of secretory granules, while the latter reflects exhaustion of these granules. (2) The normal parathyroid cells in the neoplastic parathyroid glands generally showed stronger reactions to PTH and chromogranin A than neoplastic parathyroid cells. This suggests that normal cells in the neoplastic parathyroid glands may have their release of PTH rather than its synthesis suppressed, and also might support the hypothesis of some authors that chromogranin A or SP-I might contribute to stabilization of PTH or the secretory vesicle.

Adenoma↗

PubMed1994

[A cooperative study on the incidence of bacteriuria in patients with benign prostatic hypertrophy].

The incidence of bacteriuria in patients with benign prostatic hypertrophy was studied at 8 National Hospitals. Among 1,542 patients, urinary infection was the reason of visit in 63 patients (4.1%). After open and transurethral prostatectomy, one-third of patients developed bacteriuria (30 of 59 subcapsular enucleations, and 252 of 776 transurethral resections). When a catheter is placed without prophylactic antimicrobial, all patients developed bacteriuria within 10 days, and within 30 days even if they received antimicrobials. The incidence of bacteriuria increased with age.

Aged↗

PubMed1994

[Cysts in the cavum tunica vaginalis testis: a case report].

A case of cysts in the cavum tunica vaginalis testis was reported. A 58-year-old man visited our clinic with the chief complaint of urethral bleeding. Urethro-cystogram revealed stricture of bulbous urethra. We palpated several pea-sized painless masses in the left scrotum. On ultrasonogram of the left scrotal contents several cystic lesions were detected at the cranial side of the left testis. At operation, cysts were found in the cavum tunica vaginalis testis, and were resected along with the tunica vaginalis. Fluid of the cysts was serous without sperm. Histopathologically mesothelial cyst was suspected. The incidence of cysts in the cavum tunica vaginalis testis is rare and only 17 cases have been reported in Japan. We reviewed 9 cases of cysts arising from lamina parietalis of tunica vaginalis.

Cysts↗

PubMed1994

[A case report of condyloma acuminatum in female urethra].

A case of condyloma acuminatum in female urethra is reported. A 53-year-old woman was referred to our clinic because of urethral bleeding. A tumor was noted around the external urethral meatus and the size of the tumor was 20 mm in diameter. Excision was performed on the tumor including the external urethral meatus. Pathological examination revealed condyloma acuminatum. Condyloma acuminatum in female urethra is very rare. We reviewed and discussed 6 cases of condyloma acuminatum in female urethra, including our case, in the Japanese literature.

Condylomata Acuminata↗

PubMed1994

[A case of bilateral epididymal leiomyomas].

A case of bilateral epididymal leiomyomas is reported. A 62-year-old man was referred to our hospital under the suspicion of left testicular tumor. A small hen-egg sized painless mass was palpated in the left scrotum and a little-finger-tip-sized mass in the right scrotum. At the operation, bilateral epididymal tumors were revealed, left high orchiectomy and right epididymectomy were performed. Gross evaluation revealed elastic hard tumors at the tail of bilateral epididymis. The left tumor was 40mm in diameter and the right was 10mm. On the cut surface, the tumors were yellowish and solid. Histopathologically they were diagnosed as epididymal leiomyoma. We reviewed 75 cases of epididymal leiomyoma reported in the Japanese literature. Bilateral cases accounted for 21% of the 75 cases.

Epididymis↗

PubMed1994

[Leiomyoma of the kidney: a case report].

A case of leiomyoma of the kidney is reported. A 57-year-old man with the chief complaint of right back pain was consulted to our hospital. Abdominal computed tomography (CT) demonstrated a right renal tumor. Right renal angiography revealed a hypovascular lesion. Under the diagnosis of right renal tumor, right radical nephrectomy was performed. Gross evaluation revealed a well encapsulated solid mass. The tumor was 48 x 43 x 42 mm in diameter and a hemorrhagic region was present. Microscopically, the tumor was composed of interlacing bundles of spindle cells. Diagnosis was leiomyoma of the kidney. We reviewed 42 cases of renal leiomyoma reported in Japanese literature.

Humans↗

PubMed1993

Ureteropelvic junction obstruction with renal pelvic calcification: a case report.

Calcification in the wall of the renal pelvis is rare. We report on a 65-year-old man with hydronephrosis secondary to ureteropelvic junction obstruction with renal pelvic calcification. Calcium deposit was found in the wall of the severely dilated renal pelvis. Pathological examination revealed a damaged and hyalinized fibrous renal pelvic wall and serum calcium level was normal. Thus, we speculated that this calcification was dystrophic. Chronic extensive dilatation with intermittent hemorrhage of the renal pelvic wall may have caused this dystrophic renal pelvic calcification.

Aged↗

PubMed1993

MR angiography of renal cell carcinoma.

Seventeen patients with renal cell carcinoma were studied to evaluate the usefulness of gradient echo (fast low-angle shot), time-of-flight magnetic resonance (MR) angiography under breath-holding. By reconstruction of the data of consecutive coronal scans of the abdomen, in all 17 patients with renal cell carcinoma, MR angiography can delineate the abdominal aorta, inferior vena cava and renal arteries and veins simultaneously without any contrast materials. Our present study suggested that MR angiography is a useful imaging method for preoperatively assessing spacial vascular structures of the abdomen of patients with renal cell carcinoma.

Adult↗

PubMed1993

[Clinical studies on the need of prophylactic antibiotics during extracorporeal shock wave lithotripsy].

We examined whether prophylactic antibiotics are necessary or not during the ESWL treatment for patients with urolithiasis. Twenty-eight patients with unilateral renal or ureteral stones composed of calcium oxalate, calcium phosphate or the mixed stones were treated with MPL 9000 between May 12 and September 30, 1992. Although 17 patients (60.7%) had complications of pyuria before treatment, none of the 28 patients had taken any prophylactic antibiotics during the treatment. To evaluate the clinical signs of infection, we examined the white blood cell count, in blood and urine sediment and serum C-reactive protein (CRP) value at the time of 1, 3 and 7 days after ESWL treatment, and body temperature and urine culture at the time immediately after the treatment in addition to the above-mentioned days, compared with the pre-treatment data. White blood cell count at one day after ESWL treatment was significantly elevated both in the patients with and without pyuria, while body temperature at the time immediately after the treatment was significantly elevated only in the patients with pyuria. Six of the 23 patients (26.1%) with preoperative sterile urine and who had urine culture immediately after ESWL, had bacteriuria. However, none of the 28 patients had any clinically significant infectious complications during ESWL treatment without any antibiotics therapy. We concluded that it is important to examine urine culture immediately after ESWL treatment for early protection from complication of urinary tract infection and that administration of prophylactic antibiotics is not necessary during ESWL treatment for patients with non-infection stones even concomitantly with pyuria.

Adult↗

PubMed1993

[A case of renal cell carcinoma effectively treated by interferon-alpha and embolization of the renal artery].

A case of renal cell carcinoma effectively treated by interferon-alpha and the embolization of the left renal artery is reported. A 69-year-old man was referred to us because of a left renal mass. We made a diagnosis of a left renal tumor with tumor thrombus in the renal vein and inferior vena cava, and multiple lung metastases by imaging examinations. At first the embolization of the left renal artery was selected and interferon-alpha treatment was performed for 3 months. At 3 months after the embolization, the metastatic lung tumors had completely disappeared and the left renal tumor and the tumor thrombus were reduced in size, so that left radical nephrectomy was performed. Pathological examination revealed that a small part of the tumor was viable renal cell carcinoma. After the operation, interferon-alpha treatment has been continued for 15 months and recurrence and metastasis have not been detected.

Aged↗

PubMed1993

A case of primary localized amyloidosis of urethra.

Amyloidosis of the urethra is a rare disease. The clinical appearance resembles carcinoma of the urethra, so that biopsy is required to make the appropriate diagnosis. Once primary localized amyloidosis of the urethra has been diagnosed, selection of the appropriate treatment for each case becomes important. We report a case of primary localized amyloidosis in the male anterior urethra. This case was treated successfully with urethral dilatation.

Amyloidosis↗

PubMed1993

[Clinical experience of percutaneous renal cyst puncture in recent six years].

Ultrasound-guided renal cyst puncture of 69 renal cysts was performed in our department, between April, 1986 and March, 1992. The indications for this procedure consisted of cysts over 4 cm in diameter and those of less than 4 cm in diameter with caliceal or pelvic distortion and compression. Fifty-four cysts were instilled with dehydrated ethanol, 10 cysts with minocycline, one cyst with 50% dextrose as a sclerosing agent, and four cysts underwent only aspiration of the cyst fluid. We instilled dehydrated ethanol when the aspirated fluid was not bloody and there existed no extravasation of the contrast medium or communication between the cyst cavity and the urinary tract. The instilled volume of dehydrated ethanol ranged from 8 to 400 ml (average: 72.8 ml), equivalent to 35.0-100% (average: 62.1%) of the aspirated volume. Retention time was 20 minutes, the follow-up period was 2-67 months (mean follow-up period: 13.7 months), and the reduction rate of the cyst volume was 60.0-100% (average: 96.2%). There were no major complications due to puncture or dehydrated ethanol instillation. Ultrasound-guided renal cyst puncture was shown to be a safe non-surgical approach and a useful method of treating renal cysts.

Adolescent↗

PubMed1993

[A case of virilizing adrenocortical carcinoma in adult].

A case of virilizing adrenocortical carcinoma is reported. A 35-year-old woman was referred to our clinic because of left adrenal mass detected incidentally by ultrasonography. At the time of admission, facial acne, systemic hirsutism, hypertrophied clitoris and amenorrhea for two months were observed. Serum testosterone showed obviously high level and urinary 17-KS and 17-OHCS showed slightly high level. A computed tomography revealed a heterogeneous mass with calcification in the left adrenal region. Selective angiography revealed hypervascularity. Under the preoperative diagnosis of virilizing left adrenal tumor, left adrenalectomy was performed. The tumor measured 8 x 6 x 7 cm, and weighed 194 g. A diagnosis of adrenocortical carcinoma was made by pathological examination. Virilizing adrenocortical carcinoma is very rare in adults. We reviewed and discussed 10 cases of virilizing adrenocortical carcinoma in adults, including our case, in the Japanese literature.

Adrenal Cortex Neoplasms↗

PubMed1992

[Usefulness of MR angiography in renal tumor].

MR angiography using a gradient-echo, pulse sequence FLASH (fast, low-angle shot) method during breath-hold with a "MAGNETOM H-15" scanner (1.5 Tesla; Siemens Medical System) was performed on 27 patients with renal tumor at our clinic between February 20, 1990 and September 30, 1991 and we studied to evaluate its usefulness. Of these 27 patients, 22 patients including one patient under hemodialysis treatment had renal cell carcinoma and one patient had oncocytoma pathologically proven from the excised specimens. The remaining four patients including two patients associated with inferior vena caval tumor thrombus were clinically diagnosed as renal cell carcinoma based on the result of imaging examinations such as excretory urography, ultrasonography, computed tomography and conventional angiography. However, they could not be operated on because their tumors were too advanced. By reconstruction of the data of consecutive coronal scans of the abdomen with Maximum Intensity Projection (MIP), the MR angiography could in all cases delineate abdominal blood vessels such as the abdominal aorta, inferior vena cava and renal arteries and veins simultaneously without any intravenous contract materials. Our present study revealed that MR angiography has some advantages, especially with regard to preoperative angiographic information about the abdomen of patients with renal tumor. That is, MR angiography can delineate many kinds of arteries and veins of the abdomen simultaneously and in a broader range, as well as it can be performed on the patients with hypersensitivity to iodinated contrast materials or renal insufficiency in a usual fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

PubMed1992

[Transitional cell carcinoma of the ureter with inverted proliferation: a case report].

A case of transitional cell carcinoma of the ureter with inverted proliferation is presented. A 74-year-old man with the chief complaint of asymptomatic macrohematuria was referred for a suspicion of a ureteral tumor. Excretory urography demonstrated a filling defect with a round smooth contour in the right lower ureter. Urine cytology was negative for malignant cells. No bladder tumor was noted by cystoscopic examination. Under the clinical diagnosis of a right ureteral tumor, right total nephroureterectomy was performed. The gross specimen contained a 2.0 x 1.0 cm, polypoid, pedunculated and smooth-surfaced tumor. The pathological diagnosis was transitional cell carcinoma with inverted proliferation G2 much greater than G1. Malignant tumor with inverted proliferation in the ureter is very rare. In Japan, 8 cases of transitional cell carcinoma with inverted proliferation in the ureter, including our case, are reviewed.

Aged↗

PubMed1992

[A case of retroperitoneal venous aneurysm].

A case of retroperitoneal venous aneurysm is reported. A 73-year-old woman was referred to us with the chief complaint of left abdominal mass. A giant abdominal mass was palpable and diagnostic imaging examination including ultrasound tomography, excretory pyelography, computed tomography, magnetic resonance imaging and angiography revealed a giant cystic mass encircled by calcification in the left retroperitoneal space. Operation for this cystic mass was performed under the preoperative diagnosis of a giant left renal cyst. During operation the mass was located between the left kidney and the left adrenal gland. Because it was difficult to separate the mass from the left kidney the mass was removed with the left kidney. The extirpated tumor measured 15.5 x 15.0 x 9.5 cm and contained old blood clots and red-yellow colored fluid. A histological examination revealed that the tumor wall was composed of smooth muscle and elastic fibers. Therefore, pathological diagnosis was retroperitoneal venous aneurysm. Retroperitoneal venous aneurysm is very rare. To our knowledge, this is the 8th case of retroperitoneal venous aneurysm reported in Japan.

Aged↗

PubMed1992

[Influences of bacteria within stones on ESWL treatment].

On 26 patients with upper urinary stones treated by extracorporeal shock wave lithotripsy (ESWL), the influences of the bacteria within the stones on the inflammatory complications, especially on urinary tract infection, after the ESWL treatment, were studied. The constituents of the stones obtained from these 26 patients consisted of the mixed stone of calcium oxalate and calcium phosphate (10 patients), calcium oxalate alone (2 patients), calcium phosphate alone (1 patient) and uric acid (1 patient). Of these 26 stones including no infection stones such as struvite and carbonate apatite, 5 stones (19.2%) had bacteria within the stone. Although no patients had severe inflammatory complications after ESWL treatments, the fact that the patient group having bacteria within the stones had a significantly elevated body temperature at one day after ESWL treatment compared to that on the preoperative day (P < 0.01) suggests that we should take into consideration the bacteria within non-infection stones as one of the risk factors of inflammatory complications after ESWL treatment.

Adult↗