Search PubMed⌕ Search

Biomedical subjects

O Yoshida

Publications and source records attributed to O Yoshida.

At least 487 records · Page 27Linked to original sources

[Treatment of prostatic cancer with intranasal administration of LHRH analog, Buserelin (Hoe 766) study of the optimum dosage of intranasal application].

Patients with pathologically defined prostatic carcinoma (114 cases in 23 institutes) were subcutaneously administered 500 micrograms of Buserelin (Hoe 766) 3 times a day for 7 consecutive days, then randomized to intranasally administered 600 or 900 micrograms/day of Buserelin as maintenance treatment. We examined the clinical efficacy, safety and endocrinological effects of the drug by the intranasal dosage. Size of prostate decreased more than 25% in 21 cases (total 47 cases; measured at the start and 3 months treatment by ultrasonography. Complete response and partial response were observed in 13 cases (16.1%) by NPCP's criteria at 3 months Buserelin treatment. Grobal Improvement Rating (GIR) were respectively 64.3% (600 micrograms group) and 68.0% (900 micrograms group). Grobal Utility Rating (GUR) were respectively 85.7% (600 micrograms group) and 82.0% (900 micrograms group). No significance was observed in these two groups. Adverse reactions were observed in 21 cases (18.9%). Except in 1 case, they were slight and the Buserelin treatment could be continued. Objectively Safety Rating (OSR) was 92.8%. Five cases were treated for more than 2 years with Buserelin and these cases were well controlled. Buserelin was considered as an effective and safe drug to treat prostatic carcinoma.

Administration, Intranasal↗

[Obstructive azoospermia treated by epididymovasostomy following vasovasostomy: a case report].

A case of secondary epididymal obstruction caused by vasal obstruction due to bilateral inguinal herniorrhaphy is reported. A 28-year-old patient, who had undergone right inguinal herniorrhaphy at the age of 3 and bilateral inguinal herniorrhaphy at the age of 25, was diagnosed as having obstructive azoospermia because testicular biopsy disclosed normal spermatogenesis. Vasography revealed bilateral vasal obstruction at the level of the inguinal canal. Bilateral microscopic vasovasostomy was performed but postoperative semen analysis showed azoospermia. At the operation only one sperm was found in the left vasal fluid while no sperm was found in the right. Postoperative vasography showed that the left vasovasostomy was accurate while the right vas was reobstructed. Microscopic epididymovasostomy using Silber's specific tubule technique was performed on the left side. The left epididymis was transected at its tail and numerous normal sperms were found in the epididymal fluid. Four months after the second operation, semen analysis showed normal sperm density of 34 x 10(6)/ml.

Adult↗

[Urinary diversion with Kock pouch: clinical results in 75 cases focusing on late complications].

Internal urinary reservoir type urinary diversions have been getting popularity since Kock reported a continent ileal reservoir in 1982. From November 1984 through October 1987, we performed Kock pouch operation in 75 patients (male 64, female 11; from 24 to 82 years old, mean age 56 years old). The underlined diseases were mostly bladder cancer patients; bladder cancer 70, rectal cancer 2, prostatic sarcoma 1, vesical exstrophy 1 and neurogenic bladder 1 case. The end results for 71 evaluable cases, followed up more than 3 months, were excellent in 49 (69%), good 14 (20%), fair 6 (8.5%) and poor 2 (2.8%), with success rate 89%. The most common complication was the nipple malfunction; prolapse, including intermittent prolapse, in 7 patients, slippage or sliding in 1, and eversion in one patient. Stone formation occurred in 6 patients, mild acidosis in 2 and a entero-pouch fistula in a patient who was re-diverted from a ileal conduit. There were 2 deaths postoperatively. Late complications were prominently decreased due to several important modifications of the operative technique, such as usage of Cavitron Ultrasonic Surgical Aspirator (CUSA) for defatting the mesentery, and fixing the nipple to the pouch. In conclusion, Kock pouch can be a safe and sound operative modality for patients who need urinary bladder replacement.

Adult↗

Staging and differential diagnosis of renal cell carcinoma: a comparison of magnetic resonance imaging (MRI) and computed tomography (CT).

The usefulness of magnetic resonance imaging (MRI) was compared with that of computed tomography (CT). Twenty-nine patients with renal cell carcinoma, 3 with angiomyolipomas and 1 with renal pelvic cancer, were examined by both MRI and CT. MRI and CT showed similar results in staging cases of renal cell carcinoma. However, MRI may be more sensitive in detecting the venous extension, metastatic adenopathy, and adjacent organ invasion. In predicting the involvement of perinephric fat, however, MRI is only marginally superior to CT. To demonstrate the usefulness of MRI in differentiating renal cell carcinoma from other renal tumors, the density of renal tumor and that of the psoas muscle were determined using a densitiometer, and the percent (%) contrast (the intensity of the renal tumor/the intensity of the psoas muscle X 100) was calculated. In most patients with clear cell type renal carcinoma, the % contrast value in the T1 weighted images was about 100. In the T2 weighted images, the maximum value of the % contrast value was 50 or less in most patients. In one patient with spindle cell type (sarcomatoid type) carcinoma, the % contrast value was 109 in the T1 weighted images, but was 65-85, at most, in the T2 weighted images. In patients with renal angiomyolipomas, the % contrast values were calculated exclusive of the fatty components. The % contrast value of the T1 weighted images was 50 or less in all 3 patients, and that of the T2 weighted images was 50 or more in 2 patients and 21-38 in the others.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

MRI of prostatic cancer: in vivo and in vitro MRI results compared with pathological findings.

Magnetic resonance imaging (MRI) of the prostate was accomplished in 23 patients who had prostatic cancer histologically proved by needle biopsy. Five prostates resected out of 23 patients with prostatic cancer were available for in vitro MRI. The MRI findings of the normal peripheral zone of the prostate had a high signal intensity on T2 weighted image, and the cancer nests in the peripheral zone had lower signal intensity than the normal peripheral zone. A partial or total destruction of the border line between outer zone and inner zone was observed besides than microscopic invasions. MRI also enabled us to differentiate the cancerous foci from the normal tissue at a different signal intensity of imaging in some selected cases in which the resected specimen was examined by in vitro MRI.

Aged↗

[Experience with combination chemotherapy consisting of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) in advanced urothelial cancer].

The M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) regimen was used to treat 6 patients with metastatic transitional cell carcinoma of the urothelial tract. Three patients showed a partial response, all of them were made surgically disease free. Two of them are still alive 1 year and for 6 months after surgery with no evidence of disease and one other died of disease 11 months after surgery. The response in one case was no change and that in two others was a progressive disease. From our experience, we suggest that treatment with M-VAC is effective but that surgery after M-VAC appears essential for the successful management of the patients with metastatic transitional cell carcinoma of the urothelial tract.

Adult↗

[Clinical experience of nerve-sparing radical prostatectomy].

A total of 18 patients underwent nerve-sparing radical prostatectomy for clinical stage B1 or B2 prostatic cancer. An operation was performed according to the modified technique originally described by Walsh and associates. The operative technique involved three steps: 1) accurate ligation of dorsal vein complex, which makes a relatively bloodless field and makes it possible to dissect the lateral pelvic fascia from the prostate; 2) the incision in the lateral pelvic fascia is made anterior to the neurovascular bundle; 3) the lateral pedicle is divided close to the prostate. There were no major intraoperative complications such as rectal perforation or ureteral injury. The mean blood loss was 802 g (340-1600 g) and the average duration of surgery was 173 minutes. Eleven patients had no blood transfusions. Postoperatively, there was a wound infection in one case. Mild bladder neck contracture in one case responded to single dilatation. Sexual function was evaluated in 16 of the patients who have been followed for more than three months and who had not received hormone therapy postoperatively. Of 16 patients 6 (37%) had return of erectile function. Return of erections required 3-15 months (average 9 months). Patients under 70 years old had a higher incidence (80%) of return of erections than those over 70 years old. Four of the 6 patients had tumor involvement confined to the prostate. Initially most patients had significant amounts of stress incontinence. This resolved within the first or second postoperative month. Finally 4 had slight stress urinary incontinence but no patients had total incontinence. The results suggest that nerve-sparing radical prostatectomy is an anatomically safe approach. It can contribute to the quality of life in men at a stage when it is still curable.

Adenocarcinoma↗

[Four cases of upper urinary tract transitional cell carcinoma after radical cystectomy in bladder cancer].

One hundred and eighty-six patients with primary transitional cell carcinoma underwent radical cystectomy between 1965 to December, 1986. Four of them (2.2%) had developed upper urinary tract transitional cell carcinoma. Three of the 4 patients had received various transurethral treatments for the primary bladder lesions before radical cystectomy, but one patient had undergone total cystectomy and ileal conduit as primary treatment. All of the upper urinary tract tumors were invasive. Three patients died and one is alive. We consider the following to be high risk patients for the development of upper tract recurrence. 1) patients with carcinoma-in-situ and multicentric tumors in the bladder, 2) patients with recurrent bladder cancer treated with bladder preserving treatment for a long periods, 3) patients with vesicoureteral reflux, and 4) occupational bladder cancer patients.

Aged↗

[Clinical application of MRI for urological malignancy. 3: A new trial of MRI for bladder cancer and prostatic cancer; surface coil and GD-DTPA].

We performed MRI in several recent cases of bladder cancer and prostatic cancer using a general coil or a 5-inch general purpose surface coil with or without Gd-DTPA. The surface coil improves the spacial resolution, density resolution and signal to noise ratio but reduces the field and the signal detection drops off as the depth from the surface increases. Moreover, additional time is required for patient positioning. In Gd-DTPA enhanced images of bladder cancer, the muscle layer became more distinct, and the images of tumor and bladder mucosa were enhanced, suggesting that facilitates evaluation of the extent of bladder wall invasion of the tumor. In Gd-DTPA enhanced images of prostatic cancer, the area conside to correspond to the tumor was enhanced. MRI using a surface coil and Gd-DTPA is considered to provide detailed information of bladder and prostatic cancer.

Contrast Media↗

[In vitro chemosensitivity test by human tumor colony forming assay].

In vitro chemosensitivity of urological cancers was assessed by a human tumor colony forming assay (HTCA) and a 3H-thymidine incorporation assay. Primary tumor cells from 160 of 253 (63%) urological cancers showed adequate colony growth (greater than 30 colonies per well), and there was a 57% true positive and 100% true negative rate for predicting clinical response of anticancer agents. On the other hand, cells from 37 of 45 (82%) urologic cancers incorporated a sufficient amount of 3H-thymidine (greater than 300 cpm). However, when the positive control drug (chromomycin A3 100 micrograms/ml) was used for the assay quality control, the successful assay rate of the HTCA (38%) was lower than that of the 3H-thymidine incorporation assay (75%), while there was a significant correlation in drug sensitivities between the two assays. Thus, the 3H-thymidine incorporation assay seemed to be more useful than the HTCA for evaluating the chemosensitivity of urologic cancers.

Antineoplastic Agents↗

[Long-term effects of human seminal plasma from whole semen and from different fractions of split ejaculate on motility of human ejaculated spermatozoa].

A number of studies have implied that seminal plasma contains one or more factors that stimulate spermatozoal motility. On the other hand, many authors have shown that continuous, long term exposure to seminal plasma is detrimental to motility and survival of spermatozoa. In this study we examined the long term effects of human seminal plasma not only from whole semen but also from different fractions of split ejaculate on motility of human ejaculated spermatozoa. Washed spermatozoa were incubated in modified BWW medium containing human serum albumin with or without seminal plasma. A considerable percentage of spermatozoa maintained good progressive motility for up to 20 h. when free from seminal plasma. Addition of seminal plasma (20%, v/v) obviously depressed the motility, particularly progressive motility. The most depressive effect occurred in the first (prostatic) fraction of split ejaculate, and the effect of the last (vesicular) fraction was less harmful. These observations suggest that seminal plasma has (a) factor(s) that impair the maintenance of spermatozoal motility which originate possibly from the prostate or epididymis, since both fluids of these accessory organs appear to be secreted mainly into the first portion ejaculate.

Ejaculation↗

[Recent management of renal cell carcinoma].

Our experience of radical nephrectomy was analyzed and recent management of renal cell carcinoma was reviewed. One hundred forty-eight patients with renal cell carcinoma were treated by radical nephrectomy between 1970 and December, 1986. The 5-year survival rate according to pathological T-stage was 100% for 4 patients in pT1, 73% for 85 patients in pT2, 51% for 54 patients in pT3, and 0% for 5 patients in pT4. Four patients in pT1 had no venous involvement, lymph node metastasis, or distant metastasis. Thirty patients had venous involvement, 8 in pT2, 20 in pT3 and 2 in pT4. Seventeen patients had positive lymph nodes, 0 in pT2, 15 in pT3 and 2 in pT4. Thirty-three patients had distant metastasis at the time of nephrectomy, 12 in pT2, 18 in pT3 and 3 in pT4. The 5-year survival rates of 30 patients with venous involvement, 17 with lymph node metastasis and 33 with distant metastasis were 47%, 30% and 37%, respectively. No anti-cancer drugs have been recognized to be effective for renal cell carcinoma. However, recent experiences with interferon and lymphokine-activated killer cell therapy suggest that immunotherapy may have a potential role in the management of metastatic renal cell carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

[A case of paraureteral neurilemmoma causing ureteral obstruction: report of a case].

Retroperitoneal neurilemmomas are rare tumors. They are usually asymptomatic, and often become quite large before they are discovered. A case is reported of a 75-year-old man with complaints of general malaise and left lumbar pain. Intravenous pyelography showed left renal nonfunctional and retrograde pyelography revealed the stenosis of the left ureter. The ultrasonogram demonstrated a cystic mass, and it was diagnosed as a retroperitoneal tumor with central necrosis by computerized tomography and magnetic resonance imaging. The tumor was removed with the left nonfunctioning kidney and ureter. The tumor was 3 x 3 x 4 cm, and the histological diagnosis was neurilemmoma (Antoni A + B type). There was a tight fibrous adhesion between the tumor and the left ureter, and the tumor was concluded to have originated from the adventitia of ureter. To date, 120 benign cases have been reported in Japan. They are reviewed and discussed.

Aged↗

[Assessment of the response of human bladder cancer cell lines to radiation using colony formation assay and [3H] thymidine incorporation assay].

The effect of radiation on the human bladder cancer cell lines, KK47 and J82, was studied using colony formation assay and [3H] thymidine incorporation assay. The response to radiation was dose-related for both assays, but the curve for the colony formation assay was steeper than that for [3H] thymidine incorporation assay. However, the steepness of the curve for [3H] thymidine incorporation assay increased to be approximately the same as that for the colony formation assay as the incubation period increased. [3H] Thymidine incorporation assay can provide a rapid assessment of radiation sensitivity comparable to that obtained by the colony formation assay to select a radiosensitive bladder cancer patient for definitive or adjunctive radiotherapy.

Cell Line↗

[Clinical studies on renal function and trace elements].

The serum trace elements aluminum (Al), zinc (Zn), nickel (Ni), and manganese (Mn), and creatinine clearance (Ccr) were measured in twenty normal volunteers and 40 patients; 5 patients had mild renal dysfunction, 10 patients had chronic renal failure 5 patients had uremia and 20 patients had been undergoing chronic hemodialysis. Serum Al, Cu, Zn, Ni and Mn were measured with a flameless atomic absorption spectrophotometer. Serum Al levels increased with decrement of the Ccr value. The serum Al level was abnormally high in chronic hemodialysis patients. The serum Cu level in the patients was similar to that in the healthy subjects. Serum Zn, Ni and Mn levels decreased with the decrement of the creatinine clearance level. These results suggest that measurement of serum Al, Zn, Ni and Mn levels can be used as an indication of renal function clinically. In conclusion, serum Al, Zn, Ni and Mn levels are clinical indicators of renal function.

Aluminum↗

[Clinical experience with the Kock continent ileal urinary reservoir].

From May 1985 through July 1987, 22 patients underwent Kock continent ileal reservoir for urinary diversion. There were 19 males and 3 females, between 38 and 82 years old (mean age 63.1 years). A one-stage radical cystectomy and Kock pouch construction were performed in 21 patients. One patients was converted from standard ileal conduit to this new reservoir. The keys to success of the Kock pouch are creation and maintenance of the nipple valve to prevent reflux and to ensure continence. Mesenteric fat is removed with CUSA for 8 cm along the afferent-efferent limbs of the pouch and exclusion of mesentery is limited for only 3-4 cm. This important modification will ensure adequate ileal intussusception and vascular supply to the valves. To prevent eversion and prolapse, the nipple valve is anchored to the wall of reservoir. A strip of sauvage filamentous Dacron serves as a collar to fix the afferent-efferent limbs to the pouch. There were 2 postoperative deaths and two major early complication: 1 acute renal failure and 1 intestinal fistula, both of which were treated conservatively. Late complications occurred in 6 patients. Of these 6 patients, 1 required reoperation and revision of the continence valve mechanism and 1 required hospitalization for entero-pouch fistula. Serum electrolytes and vitamin B12 remained normal in all patients. Patients perform self-catheterization every 4-6 hours during the day and once at night for volumes ranging up to 1,000 ml. The end result in 19 of 20 patients was excellent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗