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Biomedical subjects

N Moriyama

Publications and source records attributed to N Moriyama.

At least 235 records · Page 13Linked to original sources

Urethrectomy is harmful for preserving potency after radical cystectomy.

Twenty-three patients who underwent conventional total cystectomy were examined regarding postoperative potency. Two patients who were subjected to simple cystectomy and whose partial prostate and whole seminal vesicles were left showed full erection and normal ejaculation 1-2 months after surgery, thus giving 100% potency after simple cystectomy. In contrast, of 12 patients who underwent radical cystectomy alone, only 3 (25%) regained potency postoperatively, and the strength and duration of erection were not satisfactory for 1 of the 3 patients. Nine patients who received radical cystectomy and urethrectomy did not show signs of potency postoperatively. The sum total postoperative potency rate in the 21 patients subjected to radical cystectomy was 14.3% (3/21). The facts may indicate that urethrectomy is harmful for postoperative potency because damage of the cavernous nerves probably takes place during surgery. To avoid nerve damage, the urethra should be left intact during radical cystectomy employing the nerve-sparing technique developed by Walsh and Donker unless the posterior urethra is invaded by bladder carcinoma. In addition, it was demonstrated that pelvic irradiation might cause impotency as neither pelvic lymph node dissection nor cisplatin administration had any influence on postoperative potency.

Aged↗

[The evaluation of chemotherapy of relapse in prostatic cancer with new response criteria].

Effect of chemotherapy for relapse of prostatic cancer was evaluated with new response criteria, in which four objective parameters including the prostate, bone metastasis, soft tissue metastasis and the serum acid phosphatase level estimated by radioimmunoassay or enzyme immunoassay were judged separately and then summarized to evaluate the response as complete response (CR), partial response (PR), stable and progressive disease (PD). Eighty-two patients were included in the study. Rate of PR and stable were 19% and 27%, respectively, and these two groups showed longer survival than those with PD. Evaluation of prostate and bone showed tendency to be discrepant with total judgement. Evaluation of soft tissues and prostatic acid phosphatase reflected the effect of chemotherapy. Chemotherapy often improved subjective symptoms but the effect did not parallel the total judgement in many cases. Factors influencing response of chemotherapy were mode of pretreatment, performance status, age, number of affected areas and clinical stage, but the grade at initial treatment was not correlated to response. The new criteria used in this study was valid for evaluation of response in prostatic cancer.

Acid Phosphatase↗

[Response criteria for prostatic cancer treated by chemotherapy or antiandrogenic therapy].

The efficacy of cytotoxic agents in the treatment of prostatic cancer is difficult to evaluate because objective, measurable lesions, such as lung, liver, skin, subcutaneous and nodal metastasis are often not found. However, most of the patients with advanced prostatic cancer have bone involvement and elevated serum acid-phosphatase in addition to the primary tumor. Exact clinical trials on such cases, especially phase II studies can not be performed without appropriate evaluations of these three parameters. The criteria of these three parameters offered by various study groups are reviewed and the relevant response criteria are proposed. A stable category was thought to be useful to evaluate the efficacy on the patients with progressing disease. In our proposal, overall assessment of response involves all objective parameters including these three parameters as well as both measurable and unmeasurable disease described in the WHO handbook for reporting results of cancer treatment.

Acid Phosphatase↗

Inverted papillary carcinoma of the urinary bladder.

A 47-year-old man presented with an inverted papillary carcinoma of the urinary bladder. Cystoscopy revealed an approximately 2 cm mass, with a small stalk and smooth surface, which was situated just medial to the right ureteral orifice. Transurethral resection of the tumor was performed on July 25, 1983. Malignant changes were recognized in the epithelial cords in the resected specimen. This is in contrast to the general view that inverted papilloma of the urinary bladder is benign in nature. The authors believe that careful pathologic examination should be done when an inverted type tumor of the urinary tracts is found. No recurrence has been recognized as of September 11, 1987.

Carcinoma, Papillary↗

Clinical and radiologic features of hepatocellular carcinoma originating in the caudate lobe.

Five patients with hepatocellular carcinoma in the caudate lobe were evaluated. Computed tomography (CT) scan and/or angiography clearly demonstrated multiple intrahepatic metastases in four (80%), and tumor thrombi in the portal vein in two (40%), and in the inferior vena cava in one. Even though there was no recognizable lung metastasis, metastases were found in the orbita in one patient, and in the ribs and thoracic vertebrae in two patients. Four patients died after a mean period of 5.5 months from the initial diagnosis. The mechanism for early invasion into the vessels and multiple intrahepatic metastases of hepatocellular carcinoma arising from the caudate lobe is discussed.

Angiography↗

Peripheral low-density area of hepatic tumors: CT-pathologic correlation.

To aid in the distinction between colorectal cancer metastasis to the liver and hepatocellular carcinoma, findings on computed tomographic (CT) scans taken more than 5 minutes after contrast material administration ("late-enhanced CT scans") and pathologic findings were compared. Late-enhanced CT scans of metastatic adenocarcinoma showed a peripheral low-density area (PLDA) that corresponded to viable tumor and a central high-density area that represented fibrous connective tissue. This phenomenon was recognized in 15 of 20 (75%) patients with metastatic adenocarcinoma and in one of 50 (2%) patients with hepatocellular carcinoma. Late-enhanced CT scans may be useful in distinguishing between metastatic nonmucinous colorectal cancer and hepatocellular carcinoma.

Adenocarcinoma↗

Hepatic lobar atrophy following obstruction of the ipsilateral portal vein from hilar cholangiocarcinoma.

Gross deformity of the liver associated with hilar carcinoma is rare. In 17 patients with hilar cholangiocarcinoma and intrahepatic bile duct dilatation, the relationships between lobar or segmental atrophy, compensatory hypertrophy, and patency of portal vein branches were evaluated with computed tomography (CT) and angiography. All six patients with obstructed or narrowed portal veins (group A) had lobar or segmental atrophy on CT scans and angiograms. Compensatory hypertrophy was observed in the unaffected lobe with a patent portal vein in five. In contrast, neither hepatic atrophy nor hypertrophy was demonstrated in the other 11 patients with patent portal veins. All group A patients had differences in hepatic attenuation on CT scans or dense opacification during the hepatogram phase of angiography. Biliary decompression was optimized when the bile duct selected for percutaneous drainage paralleled a patent portal vein. Knowledge of radiologic findings will assist in determining the primary site along the bile duct from which carcinoma has arisen.

Adenoma, Bile Duct↗

Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features.

Three cases of cavernous hemangioma of the liver having atypical imaging features are described. In the first case, an 11 x 10 cm hypervascular mass with a central hypovascular area supplied by many large tortuous vessels was demonstrated on angiography, CT, and sonography. The mass had a central cavity that contained fluid. In the second case there was a 2-cm isoechoic mass with a peripheral halo, despite the presence of typical features of hemangioma on angiography. The halo was shown histologically to be fibrous tissue surrounding the tumor. In the third case, a 6.5 x 4.3 cm mass exhibited slight peripheral enhancement on CT but was not detectable by angiography. Histologically, the tumor was hyalinized with only scattered small foci of hemangioma within it.

Adult↗

Angiography of small hepatocellular carcinomas: analysis of 105 resected tumors.

One hundred five hepatocellular carcinomas less than 5 cm in diameter were resected in 75 patients. The tumors were studied with respect to their detection rate by angiography and their angiographic features. Angiography identified 86 (82%) of the 105 lesions, missing 19 (18%). The findings included tumor vessels (70%) and tumor staining (76%). Pathologic analysis of the 19 undetected lesions showed that 74% of them were smaller than 2 cm in diameter and that they were well-differentiated carcinomas. Forty percent of 100 lesions were in the anterosuperior subsegment of the right lobe.

Adult↗

[A case of cholangiocarcinoma and dysgerminoma associated with Turner's syndrome].

A rare case of cholangiocarcinoma and dysgerminoma synchronously associated with Turner's syndrome was reported. A 53-year-old woman was admitted to our hospital on July 12, 1984 due to intrahepatic and left inguinal tumors. Physical examination revealed the typical characteristics of Turner's syndrome. The karyotype from myelocyte and fibrocyte culture was interpreted as 45, X. The resected intrahepatic tumor was cholangiocarcinoma that had invaded to the transverse mesocolon and the duodenum, while the inguinal lesion was dysgerminoma derived from a dysgenetic gonad. As far as we have been able to ascertain through our investigations of the literature on malignant disease in Turner's syndrome, the association of cholangiocarcinoma with Turner's syndrome has not been reported previously.

Adenoma, Bile Duct↗

Necrosis of hepatocellular carcinoma as a result of subintimal injury incurred by hepatic angiography: report of two cases.

This report described two patients with hepatocellular carcinoma in whom angiographic procedure caused an inadvertent subintimal injury of the hepatic artery, resulting in tumor necrosis. In the first case of a 38-year-old male, complete obstruction of the common hepatic artery occurred on the initial angiography. It was followed by marked reduction of the tumor vessels on repeat angiography, and necrosis of about half of the tumor as confirmed by computed tomography. In the other 58-year-old female, severe subintimal injury occurred in the proper hepatic artery followed by obstruction of the feeding arteries. Subsequent computed tomography scan disclosed necrosis of the tumor. Both patients presented the postembolization syndrome that consisted of a transient fever and elevation of blood enzymes. When spontaneous regression or reduction of hepatocellular carcinoma is observed, special attention should be paid regarding whether or not hepatic angiography was performed and clinical symptoms followed it.

Adult↗

[The usefulness of CT in the preoperative diagnosis of metastatic lung nodules--a study with resected cases].

The reliability of the preoperative CT diagnosis was studied in patients with pulmonary metastases from osteosarcoma and colorectal cancer as compared with surgical and pathological findings. Seventy-six lesions among 111 surgically proven metastatic nodules were detected preoperatively by CT. But the predictive rate varied greatly depending upon the site and size of the lesions. CT is not so useful in subpleural and apical sites or with nodules of less than 0.2 cm in diameter.

Bone Neoplasms↗