[Concentration of cis-platinum in portal blood and peripheral blood after intraperitoneal administration].
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Cisplatin↗
Biomedical subjects
S Kawakami
Publications and source records attributed to S Kawakami.
[The correlation of the severity of stress urinary incontinence with static and stress urethral pressure profiles].
The urethral pressure profile (UPP) at rest and under stress was recorded by means of double lumen microtip transducer catheter in 58 females with stress urinary incontinence (SUI). The patients were divided into three groups including mild to moderate SUI patients (n = 29, group 1), severe SUI patients (n = 16, group 2) and very severe SUI patients (n = 13, group 3) according to a one-hour pad test. The functional urethral length (FUL) was divided into four equal lengths and the pressure transmission ratio (PTR) was calculated for each quartile for each female. We examined the correlation of the severity of SUI with urethral pressure parameters: maximum urethral closure pressure (MUCP) at rest and functional urethral length (FUL) at rest and PTR. SUI patients showed a negative association between the severity of SUI and MUCP, but no significant differences in the FUL were seen between the different groups. PTR was shown to be similar in order for all groups of SUI patients showing a linear decrease in the value of the PTR along the FUL. However, we found a negative association between the severity of SUI and PTR (P < 0.05) at the middle part of the FUL (Q3). These findings indicate that there are more defective distal sphincter mechanisms in severe SUI patients than in mild to moderate SUI patients. There was an overlap between the different groups in both MUCP and PTR at the middle urethra (Q3), suggesting that other parameters are related with the severity of SUI.
Adult↗
[A case of cervical spondylitis mimicking motor neuron disease].
The patient was a 65-year-old man who had noted mild weakness of the right hand since summer, 1990. In October, 1990, he had fever and developed apparent weakness of the upper extremities. Neurological examination on admission revealed distal dominant muscle weakness and atrophy of the upper extremities with fasciculation. Deep tendon reflexes were diminished in the upper limbs and exaggerated in the lower ones. No sensory disturbance or cerebellar signs were recognized. Laboratory examination of his blood showed leukocytosis and elevated levels of acute reactants. The needle EMG showed a neurogenic pattern. MRI study of the neck disclosed narrowing of the intervertebral space between C7 and Th1 and a low signal intensity of these vertebral bodies on T1 weighted image. Treatment with antibiotics improved his neurological symptoms and the abnormal MRI findings. The present case was diagnosed as having cervical spondylitis. Neurological symptoms and signs associated with cervical spondylitis have been reported to be paraplegia or quadriplegia. Like the present case, however, cervical spondylitis should also be considered as one of the diseases which could show symptoms and signs very similar to those of motor neuron disease.
Aged↗
Primary malignant tumor of the fallopian tube: appearance at CT and MR imaging.
Primary malignancy of the fallopian tube is a rare entity. To determine the radiologic characteristics of the tumor, 10 patients with pathologically confirmed fallopian tube malignancy (nine with adenocarcinoma and one with mixed müllerian tumor) underwent magnetic resonance (MR) imaging and computed tomography (CT). With both CT and MR imaging, the lesion appeared relatively small, solid, and lobulated when not associated with hydrosalpinx. At CT, the lesion had an attenuation equal to that of other nonspecific soft-tissue masses and enhanced less than myometrium. On T1-weighted MR images the tumor was usually hypointense, and on T2-weighted images the tumor was most often homogeneously hyperintense. Associated CT and MR imaging findings were peritumoral ascites (four cases), intrauterine fluid collection (two cases), and hydrosalpinx (one case). MR findings allowed the lesion to be distinguished from uterine leiomyoma in three cases in which pelvic examination, ultrasound, and CT findings were equivocal.
Adenocarcinoma↗
Anterior pituitary gland in pregnancy: hyperintensity at MR.
The authors obtained midline sagittal T1-weighted magnetic resonance images of the pituitary gland in 30 female patients: five pregnant; two postpartum; and 23 nonpregnant, of childbearing age, and without evidence of pituitary gland disorder. In pregnant and postpartum patients, the relative signal intensity of the anterior lobe compared with the pons was statistically higher than that in the control group (P < .001). In the pregnant patients, positive correlation was noted between the signal intensity ratio of the anterior lobe and the pons and gestational age. The authors believe that the hyperintensity of the anterior pituitary lobe in pregnant and postpartum patients is a physiologic variation. Because the anterior lobe of an infant may also be hyperintense on T1-weighted images and because the anterior lobes of an infant and a pregnant woman are histologically similar, the mechanism responsible for the hyperintensity in each case may be the same. It is important to know that the anterior lobe may be hyperintense in pregnant or postpartum women, especially in cases of probable pituitary gland abnormality accompanying pregnancy, such as pituitary hemorrhage, Sheehan syndrome, or lymphocytic adenohypophysitis.
Adult↗
Sustained uterine contractions: a cause of hypointense myometrial bulging.
Fifteen pregnant women were studied with magnetic resonance (MR) imaging. In 14 women, the myometrium exhibited distinct hypointense bulging on T2-weighted images that distorted the gestational sac and decidua but not the outer uterine coutour. In 12 women, an obvious discrepancy was observed between the inner myometrial configuration on T1-weighted images and that on intermediate and T2-weighted images. In three women who underwent serial T2-weighted studies separated by about 30 minutes during one MR examination, hypointense myometrial bulging was observed at a different site on each study. In two women who underwent follow-up MR study within a week after dilation and curettage, the previously distinct hypointense bulging completely disappeared. These findings confirm the transient and mobile nature of this myometrial bulging. This phenomenon can be attributed to sustained uterine contractions, which partially force the blood out of the uterus. The decrease in blood volume results in a decrease in water content, which accounts for the decrease in myometrial signal intensity on T2-weighted images.
Adult↗
[Use of ultrasonography in the bladder neck suspension].
From 1988 to 1992, 78 patients with genuine stress urinary incontinence underwent bladder neck suspension under ultrasonic monitoring. Tightness of suspension was adjusted by setting posterior urethrovesical angle to approximately 90 degree by transrectal ultrasonography during operation. Urinary continence was achieved in 68 of 78 patients. In the remaining 10 patients, slight incontinence recurred within 6 months after operation. In 60 patients undergoing postoperative chain cystourethrogram, the posterior urethrovesical angles set during operation were about the same as those after operation. In 39 patients undergoing uroflowmetry under the condition that micturition volume was 200 ml or more, urinary flow rate did not decrease after operation. In 20 patients whose posterior urethrovesical angles were measured by transperineal and transabdominal as well as transrectal ultrasonography, angles measured by each ultrasonography were almost identical and neither manipulation could change the configuration of the bladder neck. The posterior urethrovesical angles set during operation were kept postoperatively and provided proper tightness of the suspension suture to achieve urinary continence without any difficulty of urination. Therefore, a posterior urethrovesical angle can be set by transperineal and transabdominal ultrasonography as well as transrectal ultrasonography. While transrectal approach provides the clearest image among the three approaches, transperineal and transabdominal approach carried out with a transabdominal convex or sectorial probe are more convenient than transrectal approach which needed a special probe.
Humans↗
[Palliative radiotherapy for local progression of hormone refractory stage D2 prostate cancer].
From 1970 to 1992, 10 patients with hormone refractory stage D2 adenocarcinoma of the prostate presenting themselves with urinary retention and/or gross hematuria were treated by palliative irradiation for local progression at Cancer Institute Hospital. External beam irradiation was delivered to the primary lesion at dose of 38 Gy to one patient and 30 approximately 27 Gy to seven patients. Five of these patients in whom an urethral catheter had been indwelling were able to void without difficulty following the treatment. Of four patients with severe hematuria resulting vesical tamponade, none had hematuria after the treatment. These effect lasted until patients' death or more than 11 months follow-up. In other 2 patients, irradiation had to be discontinued at dose less than 20 Gy because of deteriorated general conditions and no significant effect. Complications of the treatment were minimal. These results indicate that the optimal dose of local palliative irradiation is around 30 Gy. Irradiation is a good choice for palliation of locally progressive hormone refractory prostate cancer in view of its certain and long-lasting effect, low invasiveness and minimal complications. When to institute palliative irradiation is one of the most important question in order to secure a good quality of life for patients. From our experiences, it is our belief that if local progression is symptomatic, palliative irradiation should be initiated as soon as possible.
Adenocarcinoma↗
[Palliative radiotherapy for bone pain in hormone refractory prostate cancer].
From 1970 to 1992, 23 patients were treated with irradiation for palliation of pain caused by bone metastases from hormone refractory adenocarcinoma of the prostate at Cancer Institute Hospital. External beam irradiation was delivered to painful bony metastatic sites using linear accelerator. Numbers of irradiated sites were 1, 2, 3 in 6 patients, 4 in 3 patients and 5 or 7 in one patient. To evaluate the pain relief at the irradiated sites, severity and frequency of pain were measured quantitatively before and 1 month after the treatment. Overall efficacy of palliation was evaluated by summing up results of the irradiated sites in each patient. Pain relief was obtained in all the irradiated sites. Minimal relief, partial relief and complete relief of pain were achieved in 10%, 15% and 75% of the 60 irradiated sites, respectively. No significant dose-response relationship was observed. Complete pain relief was attained less frequently at the sites with severe and constant pain that those with moderate and intermittent pain. Minimal, partial and complete palliation of pain was attained in 9%, 17% and 74% of 23 patients, respectively. In patients with highly extensive bone metastases, many irradiated sites, or many irradiated bones, complete palliation was difficult to obtain. Recurrence of pain was observed in one site. In other 59 irradiated sites, pain relief lasted until patient's death or throughout the follow-up period (maximum 51 months, median 9 months). We concluded that external beam irradiation is an effective palliation therapy for pain of bone metastases from hormone refractory prostate cancer and will play a considerable role in the management of advanced disease.
Adenocarcinoma↗
[Surveillance following orchiectomy for stage I testicular tumor].
Thirty-one cases with clinical Stage I testicular tumor were treated by surveillance policy after orchiectomy alone at Cancer Institute Hospital from April in 1985 to October in 1991. Histological types were seminoma in 22 cases and nonseminomatous germ cell tumors (NSGCT) in 9. Relapses were observed in 7 (22.5%) patients between 2.5 and 9.3 months after orchiectomy. Five (22.7%) of 22 seminoma and 2 (22.4%) of 9 NSGCT recurred and received further cis-platin based chemotherapy. In all of 5 seminoma and one of NSGCT cases recurrences developed in the retroperitoneal lymph nodes and in another NSGCT case lung metastasis was observed. All patients have been treated with success and are alive without evidence of disease between 5 and 48 months after salvage therapy. One of the recurrent cases with seminoma had an evident retroperitoneal metastasis misdiagnosed as the small intestine at staging retrospectively. And 2 of 3 seminoma cases and one of 2 NSGCT cases with minimally abnormal findings in the retroperitoneal lymph nodes had recurred. Surveillance policy may not be adequate for patients with these changes. But overall survival rate of stage I testicular tumors were estimated 100%. And relapse were observed in a small number of stage I without "minimally changes". So we regarded that surveillance policy was valid in patients with clinical stage I testicular tumor under careful staging and intensive follow up.
Adult↗
[Sequential hormone and radiation therapy for stage D1 prostate cancer].
From 1980 to 1991, 18 patients with pathologically proven stage D1 prostate cancer were treated with sequential hormone and radiation therapy at Cancer Institute Hospital. The patient mean age was 65.5 year old and mean follow-up period was 3.7 years. Diethylstilbestrol diphosphate or chlormadinone acetate was given prior to radiation therapy and 70 Gy of external radiotherapy using linear accelerator was sequentially delivered to the primary lesion in 35 fractions. Hormone therapy was continued following radiation therapy. Complete flattening of the primary lesion on digital examination was achieved in all cases. Complications of the treatment were minimal and transient. Tumor progression was observed in 4 cases and 2 of them died of cancer. Five-year non-progression rate, 5-year overall survival rate, 5-year disease specific survival rate and cancer death rate were 65%, 68%, 82% and 50% respectively. Prognoses of the patients with poorly differentiated cancer were worse than those with more differentiated cancer. Sequential hormone and radiation therapy for patients with stage D1 prostate cancer improved the patients' survival almost comparable to those of patients with stage C disease.
Adenocarcinoma↗
[A case of stage IIIB2 infantile yolk sac tumor of testis achieved complete remission by "COMPE" chemotherapy].
A case of metastatic infantile yolk sac tumor of testis is reported herein. The patient was 23 months old with a painless swelling of the right scrotal contents. Histological examination revealed yolk sac tumor. Six months later, the serum alpha-fetoprotein (AFP) was re-elevated and solitary lung metastasis had developed. After 4 courses of chemotherapy with cisplatin (CDDP), vincristine (VCR), methotrexate (MTX), peplomycin (PEP) and Etoposide (COMPE), serum AFP was normalized and lung metastasis disappeared. He has shown no evidence of disease for 5 years with normal physical growth. Aggressive chemotherapy including CDDP might be used for Stage III infantile testicular cancer.
Antineoplastic Combined Chemotherapy Protocols↗
[A case of testicular choriocarcinoma achieving pathological complete response by "COMPE" chemotherapy, consisting of cisplatin, vincristine, methotrexate, peplomycin, and etoposide].
We report a case of pure choriocarcinoma of the left testis in a 27-year-old male. He consulted a physician with left back pain in August, 1990. Intravenous pyelography (IVP) revealed left hydronephrosis. Abnormal computerized tomography (CT) revealed para-aortic lymph node swelling. The chest X-ray revealed bilateral multiple coin lesions. The genital examination revealed a left testicular nodule 8 mm in diameter. Left high inguinal orchiectomy was performed. Histopathological diagnosis was pure choriocarcinoma. After 4 courses of the PVB (cisplatin, vinblastine, bleomycin) therapy, tumor regression rate of the pulmonary metastases was 41.9%. He was transferred to our hospital on December 3, 1990 and was admitted 3 days later. "COMPE" chemotherapy, consisting of cisplatin, vincristine, methotrexate, peplomycin, and etoposide, was administered. After seven courses of "COMPE" chemotherapy, he achieved a partial response (the regression rate of the pulmonary metastases and the retroperitoneal lymph node metastasis were 78.8% and 69.1%, respectively) and the residual masses in the lungs and the retroperitoneum were removed. Necrosis and xanthogranulomatous fibrosis were found in the resected material. The patient showed no evidence of disease one year after thoracotomy.
Adult↗
[Rectal involvement by prostate carcinoma: a report of three cases].
We reported 3 cases of rectal involvement by locally invasive prostate carcinoma which caused an urethrorectal fistula in case 1 and a rectal stenosis in case 2 and 3. Discriminating between primary rectal carcinoma and prostate carcinoma locally invasive to the rectum is very important because of distinct differences in treatment and prognosis. To confirm the tumor origin, tumor markers, proctosigmoidscopy, computerized tomography and biopsy with immunohistochemical staining for prostate specific antigen were useful.
Adenocarcinoma↗
[Recent progress in the diagnosis and treatment of diabetes insipidus].
Recent progress in the diagnosis and treatment of diabetes insipidus (DI) is reviewed. Response of plasma vasopressin (AVP) to 5% hypertonic saline can be a new indicator of the capacity of AVP response to osmotic stimuli. Marked progress in the imaging analysis by computed tomography and magnetic resonance imaging (MRI) has made it possible to evaluate hypothalamic-pituitary lesions in detail. Especially, signal intensity on T1-weighted MR image of neurohypophysis is suggested to reflect its function. Sequencing analysis of genes encoding AVP-neurophysin precursor or AVP receptor is expected to be a most useful method for the diagnosis of inherited DI. Intranasal administration of DDAVP (1-deamino-8-D-AVP) is recommended as a standard therapy for DI.
Administration, Intranasal↗
[Renal cell carcinoma in a horseshoe kidney: report of two cases].
We report 2 patients with renal cell carcinoma in a horseshoe kidney. A renal tumor was diagnosed during evaluation of right humeral metastatic cancer of unknown origin in case 1 (64-year-old male) and gross hematuria in case 2 (54-year-old male). Both patients underwent radical nephrectomy with division of isthmus and retroperitoneal lymph node dissection. The tumors were staged pathologically as pT2bpN0pV0pM1(oss) and pT3pN0pV1bM0, respectively. Only 27 cases of renal cell carcinoma developed in a horseshoe kidney, including the present two cases, have been reported in the Japanese literature. The blood supply to the horseshoe kidney and its evaluation by preoperative angiography were discussed.
Carcinoma, Renal Cell↗
[A case of carcinoma of the uterine cervix accompanied with paraneoplastic cerebellar degeneration].
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Aged↗
Prediction of outcome in fulminant hepatic failure by serum human hepatocyte growth factor.
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Growth Substances↗