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Biomedical subjects

T Kotake

Publications and source records attributed to T Kotake.

At least 109 records · Page 6Linked to original sources
PubMed1994

p53 gene mutations in human prostate cancers in Japan: different mutation spectra between Japan and western countries.

The involvement of p53 mutations in prostate cancers in Japan was investigated. To evaluate any possible clinicopathological significance, p53 mutations in 40 samples from 36 Japanese prostate cancers of different stages (five cases of latent tumors, three of stage A cancers, 10 of stage B, five of stage C and 13 of stage D), including four lymph node metastases of stage D cases, were examined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis and sequencing. Mutations were detected in five of 40 samples (12.5%); four were in primary cancers and the other in a lymph node metastasis from one of them. All mutation-positive cases were in stage D, and the mutation frequency in stage D cases was 31%. This result indicates that p53 mutations may play a role in the progression of a subgroup of prostate cancers in Japanese, as observed for Americans and Europeans. However, a difference was noted between Japanese and Americans in the p53 mutational spectrum (at CpG site), presumably arising from variation in the underlying etiologic factors.

Aged↗
PubMed1994

Antitumor effect of recombinant human tumor necrosis factor on human testicular tumors heterotransplanted in nude mice.

The antitumor effect of recombinant human tumor necrosis factor (rHu-TNF) on 2 human testicular tumors (embryonal carcinoma, TTSC-1, and teratocarcinoma, TTSC-4) heterotransplanted in nude mice was studied. Therapeutic antitumor effect was observed more evidently in TTSC-1 than TTSC-4 when more than 5 x 10(3) U/mouse of rHu-TNF was administered intratumorally. Complete tumor regression was observed in both TTSC-1 and TTSC-4 after intratumoral administration of rHu-TNF. Histological findings correlated well with the decrease in tumor volume of treated tumors. In contrast to these data, little antitumor effect was observed when the same dose of rHu-TNF was administered intravenously to nude mice bearing these tumors. In conclusion, intratumoral administration of rHu-TNF was a more effective and safe method than intravenous administration against human testicular tumors heterotransplanted in nude mice.

Animals↗
PubMed1994

[Characterization of renal cell carcinoma: current topics].

This article reviewed relatively new findings of renal cancer concerning epidemiology, molecular and cytogenic analysis for carcinogenesis, and immunological analysis. In recent years, increasing numbers of renal cancer have been found incidentally by ultrasonography or computerized tomography. These incidental tumors were detected at earlier stages and the prognosis was improved. The incidence of renal cancers detected incidentally by ultrasonic mass survey in a restricted area (incidental cancer) was 0.06%, which is much higher than the incidence of clinical renal cancers. Moreover, the incidence of renal cancers found in Japanese autopsy specimens (latent cancer) was 0.77%, which was extremely high. Moreover, the frequency of cancer multicentricity in kidneys removed for renal cancers was 0.07% by examining 100 kidneys. To investigate the biological characteristics of incidental and latent cancers including multicentric daughter tumors is a key point in determining the surgical indications. Specific oncogenes participating in the carcinogenesis of renal cancer have not been found so far, but c-myc oncogene was overexpressed in renal cancers. The deletion of 3 p chromosome was very often observed in renal cancers. The suppressor gene for carcinogens of renal cancer may be localized in 3p region. Renal cancer produced a transforming growth factor-alpha (TGF-alpha), which bound to epidermal growth factor receptor (EGFR) and upregulated the expression of EGFR and TGF-alpha. The autocrine loop of TGF-alpha and EGFR may stimulate the growth of renal cancer. Renal cancer patients had immunological reactions to autologous tumor cells in their sera, then renal tumors expressed class 1 (individually unique) antigens or class 2 (cancer shared) antigens. Immunological therapy may be useful for renal cancer. Finally, antiproliferative and antitumor effect of interferon alpha in renal cancer correlated reversely with the expression of F 33 antigen, which is expressed only in renal glomerulus and proximal tubule. We could discriminate the responder from the nonresponder for immunotherapy with interferon alpha. These findings could lead to the development of new modalities for renal cancer.

Carcinoma, Renal Cell↗
PubMed1994

[A case of Rubinstein-Taybi syndrome with bilateral vesicoureteral reflux].

The case was in a 7-month-old boy. Rubinstein-Taybi syndrome was diagnosed from the broad halluces and the characteristic physiognomy noticed since birth. He was brought to us at 7 months of age with fever as the chief complaint. Voiding cystourethrogram showed bilateral vesicoureteral reflux. The testis was palpable in the inguinal canal on either side, but could not be brought to the scrotum. No abnormalities were detected in the penis. From the above findings, he was diagnosed to have bilateral 4th degree vesicoureteral reflux and undescended testes as complicating Rubinstein-Taybi syndrome. The condition was treated by bilateral anti-reflux repair and bilateral orchidopexy at 8 months of age. There has been no recurrence of vesicoureteral reflux for 3 years. A brief discussion was made about the urological complications of Rubinstein-Taybi syndrome.

Cryptorchidism↗
PubMed1994

[Neoadjuvant and adjuvant chemotherapy of bladder cancer].

Conventional treatments such as surgery and radiotherapy for deeply invasive, clinically non-metastatic bladder cancer are associated with cure in less than 30% of cases. This has led to the search for new approaches to therapy. Based on the excellent results with combination chemotherapy such as M-VAC in patients with advanced disease, neoadjuvant or adjuvant chemotherapy has been advocated to improve survival. Twenty patients with primary invasive bladder cancer who underwent radical cystectomy received postoperative adjuvant chemotherapy using a CAP (cyclophosphamide, doxorubicin and cisplatin) or modified M-VAC (methotrexate, vinblastine, pirarubicin and cisplatin) regimen. Sixteen of the patients were treated with CAP and four with the modified M-VAC. Of the 20 patients, 17 had transitional cell carcinoma with or without non-transitional cell elements. All of the patients had tumors with a histological grade of G2 (six cases) or G3 (14 cases). As for lymph node metastasis, there were 10 N0 cases, three N1 cases, six N2 cases, and one N3 case. The five-year survival rate of these 20 patients was 65.9%, while that of 49 patients not administered any adjuvant chemotherapy was 29.9%. Regarding toxicity, both adjuvant chemotherapy regimens in this study were generally well tolerated. The most common toxic effects were gastrointestinal symptoms, alopecia and myelosuppression. Twenty other patients with invasive transitional cell carcinoma of the bladder received two or three cycles of neoadjuvant chemotherapy using the modified M-VAC or MEC (methotrexate, epirubicin and cisplatin) regimen prior to radical cystectomy or partial cystectomy. Of 19 evaluable patients who received neoadjuvant chemotherapy, a complete response was observed in two (10%), a partial response in 11 (55%), and no change in six (30%). The overall response rate was 65%. The five-year survival rate of 20 patients who received neoadjuvant chemotherapy was 74.2%. Regarding toxicity, one patient died of a bowel complication after surgery, and the complication was suggested to be drug-induced.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[Management of advanced urogenital cancer: treatment of metastasis].

In clinical trials in advanced urogenital cancer with metastasis there are cases showing a poor clinical response and poor prognosis. The cure of advanced urogenital cancer still remains a major problem in management. The present paper is a summary of 8 articles presented at the symposium on "Management of advanced urogenital cancer: Treatment of metastasis" in the 43th Annual Meeting of Center Section of Japanese Urological Association in November, 1993. The present status, problems and future conception of treatment modalities for advanced urogenital cancer were discussed.

Humans↗
PubMed1994

[Management of advanced renal cell carcinoma: surgical treatment of metastasis].

The prognosis of advanced renal cell carcinoma, especially with metastatic lesions was very poor. We described the outcome of surgical treatment of advanced renal cell carcinoma with metastasis. From 1964 to 1992, 279 cases of renal cancer were treated in the Department of Urology, the Center for Adult Diseases, Osaka. Sixty four cases were with distant metastasis (M1 case) and 55 cases were recurrent after radical nephrectomy (M0-M1 case). Among these 119 cases with distant metastasis, 50 cases were treated by surgical resection. Indication of surgical resection was first to obtain surgical complete regression (sCR), second to improve quality of life (QOL). Lung metastases from 14 patients (M1, 5 cases; M0-M1, 9 cases) were resected. The survival of patients with unilateral lung metastases was significantly better than that of patients with bilateral lung metastases. Bone metastases from 18 patients (7 cases to obtain sCR, 11 cases to improve QOL) were resected. The prognosis of patients with bone metastasis was very poor, and more than a 3-year survival was seen in only patients histopathologically with grade 1. QOL improvement was observed in 9 of 11 patients (82%). Solitary adrenal metastasis showed a relatively good prognosis. Surgical resection of brain metastasis was performed only to improve QOL, because all patients had other metastases. Lymph node metastasis showed in general poor prognosis. Six cases with tumor thrombus extending into inferior vena cava nephrectomized under extracorporeal circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Gland Neoplasms↗
PubMed1994

[The role of salvage surgery following chemotherapy in advanced testicular cancer].

Twenty-seven patients with advanced testicular cancer underwent cisplatin-based combination chemotherapy and followed by salvage surgery. Complete necrosis and/or fibrosis (necrosis) was found in 12 (44%) operative specimens, mature teratoma in 5 (19%) and residual cancer in 10 (37%) patients. Ten of the 12 (83%) patients with necrosis and all 5 with mature teratoma were rendered disease-free (NED). Only 6 of the 10 (60%) patients with residual cancer were continuously NED. These findings suggest that if carcinoma is found in the resected specimen, further salvage chemotherapy is required. Salvage surgery should be avoided in patients with elevated serum tumor marker levels.

Adolescent↗
PubMed1994

[Cyst of the tunica albuginea testis: a case report].

The patient is a 75-year-old male presenting with a chief complaint of a left painless intrascrotal mass. The left testis was tense to palpation with induration inside. Ultrasonography demonstrated a 3.0 x 1.5 cm cystic space along the margin of the left testis. Left high orchiectomy was performed. Histopathological diagnosis was tunica albuginea cyst. Important differential diagnosis includes a simple testicular cyst and epidermoid cyst of the testis.

Aged↗
PubMed1994

A prospective randomized trial for treating stages B2 and C prostate cancer: radical surgery or irradiation with neoadjuvant endocrine therapy.

A randomized clinical trial of neoadjuvant endocrine therapy followed by either surgery or irradiation and a resumption of endocrine therapy for stages B2 and C prostate cancer has been in progress since 1989. A hundred patients entered the trial between 1989 and 1993, and 95 cases were evaluated. Forty-six patients received surgery and 49 were treated with irradiation. Neoadjuvant endocrine therapy for two months resulted in prostate shrinkage and prostate specific antigen lowering. Except for two patients, one dying of a progression of disease and the other of another concurrent cancer, all are alive with an average follow-up term of 25 (range 3-53) months. The good prognostic results obtained from both treatment groups at present seem to be due in part to the neoadjuvant endocrine therapy; but in order to reach a final conclusion further comparisons need to be made.

Aged↗
PubMed1993

Prognostic significance of bone metastases in patients with metastatic prostate cancer.

BACKGROUND: The distribution of bone metastases on a bone scan has not been duly considered when assessing the prognosis of metastatic prostate cancer. METHODS: The medical records of 76 patients with newly diagnosed, untreated metastatic prostate cancer were reviewed. According to the distribution of bone metastases on the initial bone scan, we divided the patients into three groups: Group I (having bone metastases exclusively within the pelvis and the lumbar spine), Group II (having bone metastases exclusively outside these bones), and Group III (having bone metastases in both areas). RESULTS: Among the responders to androgen deprivation, those in Group I survived significantly longer than did those in Groups II or III. Because the extent of the disease and the distribution of histologic differentiation in Groups I and II were similar, the results indicate that the presence of bone metastases outside the pelvis and the lumbar spine is predictive of short survival time. This prediction was not possible when the extent of disease (EOD) grading system was used. CONCLUSION: The distribution of bone metastases on the initial bone scan should be considered as a variable for the prognostic stratification of patients with metastatic prostate cancer.

Adenocarcinoma↗
PubMed1993

An analysis of sit-to-stand movements.

We analyzed the movements involved in rising from a knee-high chair in 12 healthy men weighing within +/- 10% of standard body weight. A regular series of transition points was observed in the angles of the hip, knee, and ankle joints throughout the sit-to-stand movement, which was classified into six stages. As the duration of sit-to-stand movements increased, the duration of Stage 2 decreased, whereas Stage 3 grew longer. The durations of stages 4 and 5 remained constant. We also calculated the minimum unilateral hip and knee extension torque per weight in kilograms required for natural sit-to-stand movements, or N-Stand (1.7-2.3 seconds), and found that minimum hip extension torque was 0.7Nm and minimum knee extension torque was 0.9Nm. The minimum hip and knee extension torque required for N-Stand corresponds to a mean 27% and 30%, respectively, of the actual maximum hip and knee extension torque.

Adult↗
PubMed1993

Bladder tumors: staging with gadolinium-enhanced oblique MR imaging.

To clarify the importance of imaging plane in evaluation of invasion by tumor into muscle, 50 patients with bladder tumors underwent examination with magnetic resonance (MR) imaging performed with an oblique plane and the early phase of contrast enhancement. After the ideal oblique plane was selected, an oblique T2-weighted image was obtained. Gadopentetate dimeglumine was then administered, and an oblique T1-weighted image was obtained. The staging based on oblique T2-weighted and oblique contrast material-enhanced T1-weighted MR images was then correlated with histopathologic staging. The respective accuracies of oblique contrast-enhanced T1-weighted and oblique T2-weighted images were 78% and 60% for overall staging (P < .05), 90% and 74% for differentiation between (a) stage T1 and lower-stage tumors and (b) stage T2 and higher-stage tumors (P < .05), and 92% and 88% for differentiation between (a) stage T2 and lower-stage tumors and (b) stage T3a and higher-stage tumors (P > .05). Oblique MR imaging performed in conjunction with the early phase of contrast enhancement showed significantly high staging accuracy, especially in differentiation between superficial tumors and tumors with superficial muscle invasion.

Adult↗
PubMed1993

Bladder wall morphology: in vitro MR imaging-histopathologic correlation.

To study the morphology of the normal and inflamed bladder wall, the findings of magnetic resonance imaging and histopathologic examination of 13 in vitro specimens were correlated. Normal bladder wall appeared as a band of intermediate signal intensity on T1-weighted images and as bands of low (inner) and intermediate (outer) signal intensity on T2-weighted images. Inflamed bladder walls demonstrated two additional inner bands of intermediate (inner) and high (innermost) signal intensity on T1-weighted images and high (inner) and low (innermost) signal intensity on T2-weighted images. The mean histopathologic percentages of muscle bundles in inner and outer bands that appeared on T2-weighted images were 92.5% +/- 4.9 and 78.3% +/- 8.2, respectively. The authors conclude that the total thickness of the two bands of differing intensity that appeared on the T2-weighted images of the normal bladder wall correlated well morphometrically with the muscle layers in the histopathologic specimens, and that the different signal intensities in the muscle layer represent a compact inner and looser outer arrangement of smooth muscle bundles.

Aged↗
PubMed1993

Incidence and clinical features of renal tubular acidosis-1 in urolithiasis.

To elucidate the frequency and clinical picture of renal tubular acidosis-1 (RTA-1) in nephrolithiasis, the acid-loading test was performed in 474 patients with calcium-containing stones. RTA-1 was detected in a total of 11 patients (6 men and 5 women, 2.3%). The incidence of RTA-1 in female patients tended to be higher than in male patients (3.2 vs. 1.9%). One male patient had the complete form, the others had incomplete form. There was a tendency that RTA-1 patients were younger than non-RTA-1 patients in men, and the former were older than the latter in women. The percentages of positive family history and positive past history were 27 and 45%, respectively. Stones were single in 7 cases and multiple in 4 cases. They were unilateral in 10 cases, and bilateral in 1 case. Hypercalciuria was detected in 2 of the 11 cases, hyperuricosuria was present in none of the 11 cases, and hyperoxaluria in 2 of 8 cases examined. Stones were composed of calcium oxalate in 2 cases, calcium phosphate in 2, and calcium oxalate mixed with calcium phosphate in 3.

Acidosis, Renal Tubular↗
PubMed1993

Results obtained from microsurgical therapy of varicocele.

The microsurgical method of varicocelectomy was performed in 56 patients. In 25 cases the procedure was done because of scrotal symptoms and in 31 cases as a treatment for infertility. Complete regression of varicosities was observed in all the cases including 2 recurrent ones. The conception rate was 56% in the infertility patients excluding azoospermic and severe oligozoospermic ones. This microsurgical method has a good success rate and is also quite satisfactory in terms of its pregnancy rate.

Adult↗