Search PubMed⌕ Search

Biomedical subjects

N Goya

Publications and source records attributed to N Goya.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Study on urinary levels of interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha in patients with renal cell carcinoma].

We examined the preoperative and postoperative, urinary levels of the cytokines, interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in 14 patients with renal cell carcinoma (RCC), and 9 patients who underwent nephrectomy as donors (controls). Although urinary IL-1 beta was measurable in every subject, both IL-6 and TNF-alpha were undetectable in 12 of the 14 patients. None of the urinary cytokines showed levels significantly different from the controls preoperatively. Urinary levels of IL-1 beta showed no correlation with clinical stage or histological grade. Only urinary IL-1 beta was significantly elevated after nephrectomy, when compared with the controls (P < 0.05). However, urinary IL-1 beta showed no correlation with operative blood loss or postoperative infection. These findings suggest that measurement of urinary cytokines is not useful for diagnosis or monitoring of therapy in RCC patients.

Adult↗
PubMed1997

Long-term outcome of renal transplantation in hepatitis B surface antigen-positive patients in cyclosporin era.

The impact of hepatitis B virus (HBV) infection on the outcome of renal transplantation (Tx) has been controversial. To determine the indication of renal Tx in patients infected by HBV, we investigated the long-term outcome of renal transplant patients with hepatitis B surface antigen (HBsAg). We analyzed 980 patients, including 18 HBsAg carriers, who underwent renal Tx and were immunosuppressed with cyclosporin in our institute. Fourteen out of 18 patients (77.8%) showed hepatic dysfunction after an average period of 17.8 months (range 1-65) after Tx. Four out of 14 patients (28.5%) with hepatic dysfunction died of liver failure due to fulminant hepatitis with functioning grafts between 15 and 71 months after Tx. The remaining 10 patients with hepatic dysfunction are alive up to the time of last follow-up; however, 5 of them lost their grafts because of rejection between 44 and 92 months after Tx. Their liver function improved after withdrawal of cyclosporin. Only 4 patients did not develop chronic liver disease and have had functioning grafts for between 44 and 147 months. One patient died of subarachnoid hemorrhage 22 months after Tx. HBe antigen, antibody and HCV antibody status were not related to the occurrence of liver dysfunction after Tx. Four HBV-DNA-positive patients showed deteriorated liver function. Three patients with chronic active hepatitis confirmed by the biopsy were treated with interferon. Interferon improved liver function in 2 patients, however, 1 patient died of liver failure despite interferon therapy. Our data suggested that the presence of HBsAg is often associated with chronic liver disease leading to liver failure regardless of HBe and HCV status after Tx. The indication of renal Tx in patients with HBsAg should be determined carefully giving consideration to these results.

Adolescent↗
PubMed1997

[A preliminary study on transurethral electrovaporization of the prostate (TVP) using VaporTrode].

BACKGROUND: Surgical therapy for Benign Prostatic Hypertrophy (B.P.H.) has mainly depended upon Transurethral Resection of the Prostate (TUR-P) using a cutting loop electrode. Recently, a new technique TVP was reported using the VaporTrode apparatus. We assessed the safety and efficacy of the VaporTrode in a preliminary study. METHODS: Histological changes of the muscle and liver of pigs were examined after vaporization using the VaporTrode and a cutting loop electrode. First, histological changes were investigated following vaporization after one stroke at a slow hand speed. Next, histological changes were assessed following vaporization at fixed stroke speed in an experimental model. RESULTS: At an electrical output of less than 275 W, the depth of the vaporized layer increased as the stroke speed became slower (4.0 cm/s-2.5 cm/s). When the electrical output was 300 W, the depth of vaporized layer increased even at a faster stroke speed (2.5 cm/s-3.0 cm/s.) The depth of the desiccated layer increased as the stroke speed became slower at any electrical output. However, when the stroke speed was 4.0 cm/s, the depth of this layer was less than 2.0 mm. With the cutting loop electrode, the depth of the desiccated layer increased at a higher electrical power, but the change was very small. CONCLUSION: To achieve deep enough vaporized and desiccated layers safely, the VaporTrode should be used at a stroke speed slower than 3.0 cm/s and a high electrical power of about 275 W.

Animals↗
PubMed1997

[Utility of prostate specific antigen (PSA) density in detecting prostate cancer in men showing gray zone serum PSA levels].

The efficacy of prostate specific antigen density (PSAD) in diagnosing prostate cancer was assessed in 98 patients with serum prostate specific antigen (PSA) levels between 2 and 10 ng/ml who had a pathological diagnosis made by prostate biopsy or transurethral resection of the prostate. Of the 98 patients, 22 (22%) had prostate cancer. The PSA (based on a cut-off value of 4.5 ng/ml) had a sensitivity and positive predictive value (PPV) of 82% and 38%, respectively, for diagnosing prostate cancer, while the results for PSAD (based on a cut-off value of 0.13) were 91% and 61%. The PSAD was more efficient than the PSA levels and was also superior to digital rectal examination (DRE) combined with transrectal ultrasonography (TRUS), for which the sensitivity and PPV were 73% and 39%, respectively. Six (11%) out of 57 patients who were normal on DRE and TRUS had prostate cancer. In these 57 patients, the PSA (cut-off value: 4.5 ng/ml) had a sensitivity of 50% and PPV while the values for PSAD (cut-off value: 0.13) were 83% and 36% respectively. The PSAD could effectively detect even impalpable prostate cancer not visible on TRUS.

Aged↗
PubMed1997

[Bladder carcinoma presenting with hypercalcemia: a case report].

A 47-year old woman was referred to our hospital with nausea, vomiting and the loss of body weight. Pelvic computed tomography and magnetic resonance imaging revealed an invasive bladder tumor on the left lateral wall, accompanied with calcification. Laboratory examination revealed marked hypercalcemia (20.6 mg/dl) and elevated serum parathyroid hormone-related protein-intact (29.9 pmol/l), which was apparently produced by the tumor. Treatment with pamidronate and colloid infusion resulted in normocalcemia. Anterior pelvic exenteration was performed. Histopathological diagnosis was transitional cell carcinoma > adenocarcinoma, G3, pT4pN2M0, stage IV. She died of cancer 7 months postoperatively.

Carcinoma, Transitional Cell↗
PubMed1997

[A case of xanthogranuloma of the urinary bladder].

A case of xanthogranuloma of the urinary bladder is reported. A 68-year-old man was referred to our hospital for the evaluation of microscopic hematuria. At that time, he did not have an abdominal tumor and ultrasonography showed no abnormality of the kidneys and the bladder wall. Two months later, he was admitted with the chief complaints of perineal discomfort and non tender fist size mass was palpable in the lower abdomen. Ultrasonography, computed tomographic scan and magnetic resonance imaging MRI demonstrated a supravesical mass which was strongly suspected as urachal tumor. Total cystectomy with urachal resection was performed. The histological diagnosis was xanthogranuloma. The patient has been in good health without recurrence, 4 years after surgery. We discuss xanthogranuloma of the urinary bladder in the literature.

Aged↗
PubMed1995

A case of massive adrenal malignant pheochromocytoma: management of a large pheochromocytoma.

A 69-year-old man was referred to our hospital for a left abdominal tumor measuring about 30 cm in diameter. Laboratory examination revealed an elevation of norepinephrine in plasma and of its metabolites in urine. CT scan disclosed a huge cystic tumor in the retroperitoneal space and an enlarged aortocaval lymph node, suggesting a diagnosis of malignant pheochromocytoma. The hemodynamic studies showed low blood volume and high vascular resistance, and therefore, he was treated with vasodilators and volume expansion. His hemodynamic status normalized and a complete excision was performed. Pathological examination revealed that the patient had a pheochromocytoma with metastasis to a lymph node. The total weight of the tumor was 5,930 g. Since pheochromocytomas can become a large with a risk of malignancy, they should be surgically excised as completely as possible with further treatment after making a definite diagnosis.

Adrenal Gland Neoplasms↗
PubMed1994

A phase II study of prophylactic intravesical chemotherapy with epirubicin in the treatment of superficial bladder cancer. Tokyo Women's Medical College Bladder Cancer Collaborating Group.

Intravesical instillation of epirubicin was carried out to investigate the efficacy of this treatment in preventing postoperative recurrence of superficial bladder cancer. The subjects were 100 patients who had been treated with transurethral resection (TUR) for superficial transitional-cell carcinoma of the bladder (classified as primary or recurrent superficial bladder cancer of pathological stage Tis, Ta, or T1 and histological grade G1, G2, or G3) at Tokyo Women's Medical College Hospital and its affiliated hospitals during the 2-year period ranging from April of 1990 through March of 1992. A solution of epirubicin was prepared by dissolving 20 mg in 30 ml physiological saline, and this was instilled into the bladder a total of 17 times during 1 year: once immediately after TUR, once every 2 weeks for the next 4 months, and then once per month for the following 8 months. Thereafter, the course of each patient was followed by performing urinary cytodiagnosis once each month and cystoscopy once every 3 months. Of the 100 patients, 83 were evaluable. The mean duration of follow-up was 461 +/- 222 days, and the recurrence rate was 30.1% (25/83 cases). The recurrence rate determined for primary cases was 19.7%, whereas that recorded for recurrent cases was 61.9%. Adverse effects occurred in 9.3% (9/97) of the patients, but these side effects were mild in severity and the instillation regimen did not have to be discontinued in any of the patients. Analysis of the risk factors for recurrence revealed significantly higher recurrence in the recurrent-patient group and the multiple-tumor group. On the basis of these findings, the authors surmised that when given in an intravesical instillation regimen, epirubicin causes few adverse effects, and its efficacy in the prophylaxis of recurrence of superficial bladder cancer is equivalent to that thus for reported for other drugs. At present, the authors are carrying out a controlled clinical study on epirubicin that takes into account the risk factors for recurrence of superficial bladder cancer.

Administration, Intravesical↗
PubMed1994

[Flow cytometric DNA analysis on renal cell carcinoma--a study of 116 cases on fresh surgical specimens].

DNA ploidy was investigated using flow cytometry on fresh surgical specimens from 116 cases with renal cell carcinoma. DNA diploid tumor was observed in 39 cases (33.6%) and aneuploid in 77 cases (66.4%). DNA aneuploid group was further classified into 3 subgroups by DNA index (D.I.); near-diploid group (D.I.: 0.8-1.2, 21.6%), near-tetraploid group (D.I.: 1.8-2.2, 12.9%) and other aneuploid group (31.9%). DNA ploidy pattern correlated with clinical stages and histological grading, indicating significantly a higher incidence of DNA diploid in cases in stage I and grade 1. DNA clonal heterogeneity was observed in 48.1%, and homogeneously diploid was in 28.6% of 77 cases who were analyzed more than 2 specimens. Incidences of DNA heterogeneity and homogeneous diploid correlated with the number of analyzed specimens and our results showed that more than 4 specimens were necessary to diagnose the DNA ploidy patterns. The near-tetraploid group was shown to have an extremely poor prognosis compared with the diploid group and the other aneuploid group. There were no significant difference between the diploid group and the aneuploid group in terms of the early prognosis, however, the incidence of disease recurrence was significantly higher in the aneuploid group. Our results demonstrated that DNA ploidy was an useful prognostic factor in the evaluation of patients with renal cell carcinoma.

Adult↗
PubMed1994

[Adenovirus-induced kidney graft pyelonephritis following renal transplantation].

A 16-year-old female received a kidney transplantation from her mother 13 months before she suddenly noticed gross hematuria and painful micturition, and developed high fever with chills. The serum creatinine (S-Cr) level rose from 1.5 to 2.6 mg/dl, but there was no clinical sign of acute rejection. Despite the treatment with antibiotics and gamma-globulin, the the high fever and hematuria did not improve. The adenovirus antibody titer elevated from x8 to x1,024, while adenovirus was not isolated from the urine. On the 15th day of the disease, hematuria disappeared spontaneously and on the 19th day she became afebrile. The S-Cr level also was normalized spontaneously. Histological examination of the graft biopsy on the 14th day, showed severe tubulointerstitial nephritis localized in the renal medulla and full type intranuclear inclusions were revealed in tubular epithelial cells. From these findings, we diagnosed this case as adenovirus-induced kidney graft pyelonephritis associated with acute hemorrhagic cystitis.

Adenovirus Infections, Human↗
PubMed1994

[Present situation in self-injection therapy with interferon-alpha for patients with renal cell carcinoma].

Interferon-alpha (IFN alpha) is often used for the treatment of renal cell carcinomas. The injections are frequently self-administered at home. To assess how this therapy was accepted by the patient we sent out a questionnaire. For the past 2 years until March 1993, this therapy was performed in our department on 52 patients, of whom 45 were selected for the study. All patients were informed of their disease and consented to the necessity of this treatment. Thirty-eight patients answered this questionnaire. Almost all patients injected this agent mainly by themselves. These findings suggested that they regarded this therapy as a strategy to be executed by themselves for the treatment of carcinoma. The main toxic symptoms in this therapy were asthenia, fever and loss of appetite. Leukocytopenia occurred in about half of the patients, of whom 1 patient required medication because of a rapid decrease in the white blood cell count shortly after inception of this therapy. The treatment was discontinued in 50% of the patients because of these adverse effects. Systemic toxicity disappeared after cessation of IFN alpha administration. Additionally, over 80% of the patients expressed concern about effectiveness, the duration and high cost of this therapy. The patients had to be repeatedly instructed about the method of disposing used needles and syringes. This study revealed that self injection of IFN alpha, which required strict management particularly at the initiation, can be performed at home. However, countermeasures must be taken against the side actions and an optimum regimen of IFN alpha should be established as soon as possible.

Adult↗
PubMed1993

[The surgical management of renal cell carcinoma involving the right atrium].

Between January 1985 and November 1992, 12 patients with renal cell carcinoma involving the inferior vena cava were evaluated and treated at this hospital. In 4 of the 12 patients (33%), the tumors extended into the right atrium. These 4 patients underwent radical nephrectomy with tumor thrombus extraction. Of the 4 patients one had metastases to regional lymph nodes, but no patient had distant metastases. We used a cardiopulmonary bypass and a right atriotomy in all patients for the removal of thrombus under direct vision. We also performed in the intra-operative transesophageal ultrasonography for monitoring of intra-atrial thrombus. The average blood loss during operation was 10,430 ml. One of these patients died in the postoperative period and the other patient died from inferior vena caval emboli without long term sequelae. However, the remaining 2 patients of this group are free of disease, with a mean follow-up of 21 months. Although the numbers are small, these results suggest that patients with intra-atrial tumor thrombus had a worse prognosis than those with other types of vena cava tumor thrombus. One reason for this poor prognosis is due to the complicated surgical management and we believe that a complete removal of tumor thrombus and a complete vascular control are key points of this operation.

Aged↗
PubMed1992

High HTLV-I proviral DNA level associated with abnormal lymphocytes in peripheral blood from asymptomatic carriers.

The level of proviral DNA in peripheral blood mononuclear cells from a representative group of asymptomatic HTLV-I carriers in Miyazaki district, an HTLV-I endemic area in Japan, was determined by a single-cycle polymerase chain reaction method (PCR). Of 217 subjects, 26% had a high level of proviral DNA, 43% a medium level, 18% a low level, and 13% an undetectable level. In the high-DNA group, 60% had at least 0.6% abnormal lymphocytes on peripheral blood smears, significantly higher than in those with low DNA levels (19%). This association was present for men of all ages and for women under 55. Men were more than twice as likely to have abnormal lymphocytes as well as high levels of proviral DNA. These differences may reflect different host responses to the virus by sex or by the time or route of infection. This study supports the utility of PCR for molecular screening in epidemiologic studies of the natural history of HTLV-I, and may lead to the identification of those carriers who are at greatest risk of developing HTLV-I-induced malignancy.

Age Factors↗
PubMed1992

[Optimal dose of cyclosporin in living related kidney transplantation].

We performed in total 528 kidney transplantations from Feb. 1983 to Dec. 1988 in Kidney Center of Tokyo Women's Medical College. Of the 528 kidney transplantations, 450 were living related kidney transplantations. The living related renal transplant recipients treated with CYA were divided into 3 groups: high dose CYA double drug therapy group (group 1), high dose CYA triple drug therapy group (group 2) and low dose CYA triple drug therapy group (group 3). Group 1 (n = 263) was treated with CYA (initial dose 12 mg/kg) and methylprednisolone (MP). Group 2 (n = 106) was treated with CYA (initial dose 10 mg/kg), MP and azathioprine (AZ) (1 mg/kg). Immunosuppression of group 3 (n = 81) consisted of CYA (initial dose 6 mg/kg), MP and AZ (2 mg/kg) (or mizoribine (MZ) (3-5 mg/kg). CYA serum trough level (polyclonal) was lowered according to the initial dose of CYA, and in particular trough level in group 3 was controlled at a low level (50-150 ng/ml in induction phase) to reduce CYA nephrotoxicity. However, even if strict control of serum trough level was accomplished, we could not get improvement of renal function in Group 3. Group 3 had more frequent and severe accelerated acute rejections (AAR) than the other groups. These data showed that inadequate immunosuppression in group 3 caused more frequent and severe rejection episodes. Also, renal biopsy revealed CYA nephrotoxicity even in group 3 and this nephrotoxicity may have been caused by ischemic damage by severe rejections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Autologous blood transfusion aided with erythropoietin in transurethral resection of the prostate].

Erythropoietin (EPO) with an established clinical efficacy in renal anemia has in recent years become applied as an aid to autologous blood transfusion in surgical patients. This report describes our experience with autotransfusion along with the use of EPO in transurethral resection of the prostate (TUR-P), indicating its usefulness. Ten patients with benign prostatic hypertrophy aged 60 to 74 years received 3000 units of EPO, with an iron preparation, nine times beginning 3 weeks prior to operation. Autologous blood of 300 ml was collected from the patient each at 2 and 1 week before operation and was used at TUR-P. Five other patients who underwent TUR-P with the same volume of autotransfusion accompanied by preparative medication with the iron alone served as controls. In the EPO treated group (mean age, 68.3 years) the mean value for hemoglobin concentration (Hb) was 14.0 +/- 1.6 g/dl on the day of operation, which showed a recovery rate of 94.9 +/- 5.4% (Hb recovery rate) as against the pre-EPO treatment value (mean: 14.8 +/- 1.3 g/dl). This Hb recovery rate was significantly greater (p less than 0.001) when compared to 82.2 +/- 2.5% in the control group (mean age, 68.2 years). Of the EPO treated patients, those in their sixties (n = 6; mean age, 66.3 years) exhibited a significantly higher Hb recovery rate (98.3 +/- 3.5%) than the rate (89.9 +/- 3.0%) for patients in their seventies (N = 4; mean age, 71.3 years) (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Transfusion, Autologous↗