Biomedical subjects

T Kotake

Publications and source records attributed to T Kotake.

At least 127 records · Page 7Linked to original sources

PubMed1993

[Assessment of the quality of life of prostate cancer patients].

Assessing the QOL in cancer clinical trials is becoming increasingly important. However, a suitable device of assessment of QOL has not been developed yet for prostate cancer patients in Japan. We tried to assess the QOL of prostate cancer patients using the EORTC questionnaire translated in Japanese, and examined its validity and reliability. Thirty-six patients filled in a questionnaire. The reliability of this device was confirmed by the results of test-retest reproducibility. Good correlation was shown between the results and patients performance status, and between the results and clinical stages, which support the validity of the device. As for the results of assessment of QOL, these patients were severely damaged in sexuality. Those factors of functional status, physical symptoms and fatigue/malaise were closely related to disease activity and clinical stage.

Aged↗

PubMed1993

[Determination of oxalic acid by high performance liquid chromatography].

In order to determine a reliable method for measuring oxalic acid, we carried out a procedure using high performance liquid chromatography. This method proved to be excellent in the case of tea and beer. In the case of urine, however, it had some problem from the aspect of reproducibility, although as far as linearity measurement, dilution test and recovery rate were concerned, accurate results could be obtained. Nevertheless, this method was thought to be unsuitable for routine clinical use, at least at present, for the reasons that it took a long time to perform the measurement, and because of the high cost of the column used in the procedure. The value of the oxalic acid as determined by this method in 24 hr urine from 12 healthy male volunteers was in the range of 17-47 mg/day (average +/- standard deviation: 25.4 +/- 9.0). To correct for their differences of physical constitution, dividing oxalic acid value by body weight rather than by urinary creatinine or body surface area was found to give a more precise value of the norm. From this calculation, it was thought that the normal range of oxalic acid value was 0.6 mg/kg or less.

Beer↗

PubMed1993

[Neoadjuvant therapy for prostatic cancer].

Neoadjuvant therapy for prostatic cancer might be important to increase cure rates of the disease and preservability of the organs. There were 43 cases in a period of 1975-1990 in which total prostatectomy were performed after neoadjuvant therapy. According to the clinical stage, there were 14 cases in B, 23 in C, 4 in D1 and 2 in D2. The median duration of neoadjuvant therapy was 4 months. Clinical response of the prostate in 37 evaluable cases was as follows; 6 cases were PR (16%), 12 cases were MR (32%) and 19 cases were NC (52%). Histopathological effect was as follows; 5 cases were grade 0a (12%), 12 cases were grade 0b (28%), 16 cases were grade 1 (37%), 8 cases were grade 2 (19%) and 2 cases were grade 3 (5%). In 2 cases with histopathological effect of grade 3, lymph node metastases were thought to have obviously disappeared. Histopathological effect seemed related to clinical response. In cases given neoadjuvant therapy for less than 2 months, no adequate clinicopathological effect was obtained. Cases that could achieve downstaging were 8; 1 in grade 0a, 2 in grade 1, 3 in grade 2 and 2 in grade 3. These results suggest that neoadjuvant therapy plays an important role in advanced prostatic cancer.

Aged↗

PubMed1993

[Successful interferon therapy of renal cell carcinoma with tumor thrombus extending into the inferior vena cava--a case report].

It is a fact that there are few effective drugs available except for interferon for that treatment of renal cell carcinoma, and the efficacy rate of interferon is less than 10% even if multiple drug regimens are included. We have experienced a case of renal cell carcinoma in whom interferon therapy was successful in reducing the primary lesion and tumor thrombus extending into the inferior vena cava. A 57-year-old man was admitted to our department with a complaint of macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a right renal tumor and the tumor thrombus. Because of the past history of his myocardial infarction, a radical operation was considered risky. So we started interferon therapy. Four months after the start of interferon therapy, the primary lesion and the tumor thrombus markedly reduced in their size, and the clinical response was evaluated as partial response by response criteria for urological cancer treatment. Therefore, radical nephrectomy and tumor thrombectomy were performed with extracorporeal circulation. Histopathologically, necrosis and lymphocyte infiltration into the cancer cell focus were seen, and these immunologic reactions were considered at the affection of interferon. In some case, interferon therapy is a useful and safe in the treatment of the primary lesion of renal cell carcinoma, and further investigation must be studied.

Carcinoma, Renal Cell↗

PubMed1993

A randomized phase II trial of flutamide vs chlormadinone acetate in previously untreated advanced prostatic cancer. The Japan Flutamide Study Group.

We have conducted a double-blind comparative study of flutamide and chlormadinone acetate (CMA) on patients with stage C or D prostatic cancer and with no prior experience of hormone therapy. This is believed to be the first such trial entered in the medical literature, fifty-four patients were randomly selected to undergo flutamide (p.o.) monotherapy at a daily dose of 375 mg, which was determined as the optimal dose in Japan in our previous phase II study. Forty-nine others were randomly selected to undergo CMA (p.o.) monotherapy at a daily dose of 100 mg, which is the most commonly used dosage in Japan for patients with prostatic cancer. Ultimately, 47 patients from the flutamide group and 40 patients from the CMA group were judged eligible, with efficacy being evaluated after 12 weeks of treatment. Similar objective responses were seen in both groups: 48.9% (95% confidence limits 34.1-63.9%) in the flutamide group, 45% (95% confidence limits 29.3-61.5%) in the CMA group. The response at each organ site was also similar between the groups. Serum prostatic specific antigen decreased by more than 50% of the abnormal pretreatment level in 87.5% of the flutamide group and in 85.7% of the CMA group. Serum luteinizing hormone, follicle-stimulating hormone, testosterone and 5 alpha-dihydrotestosterone decreased significantly in the CMA group, but increased significantly in the flutamide group. The serum testosterone level after 12 weeks of treatment was 0.955 +/- 0.13 ng/ml in the CMA group and 6.64 +/- 0.38 ng/ml in the flutamide group. The serum estradiol level also increased significantly in patients in the flutamide group. The serum prolactin level decreased significantly in the flutamide group, but increased significantly in the CMA group. Eight patients on flutamide manifested gynecomastia. Diarrhea and hepatic toxicity were observed in both groups, but only rarely, and were well tolerated. We have thus concluded that flutamide is as effective as CMA in maintaining libido and potency without decreasing testosterone levels.

Aged↗

PubMed1993

[Testicular tumor following orchiopexy. A case report].

A case of testicular tumor occurring after orchiopexy is presented. The patient, a 21-year-old male, who had undergone bilateral orchiopexy 14 years before was admitted to our clinic on February 17 in 1992 because of left testicular tumor. Computed tomography showed left inguinal and paraaortic lymphnode metastases. Left high orchiectomy was performed. The tumor was histologically diagnosed to be mixed tumors of embryonal carcinoma, yolk sac tumor and choriocarcinoma. After two courses of chemotherapy consisting of cisplatin, etoposide and bleomycin (PEB regimen), LDH and tumor markers (HCG, HCG-beta) returned to the normal range. The size of retroperitoneal metastasis was significantly reduced and inguinal metastasis disappeared. Therefore retroperitoneal and left inguinal lymphadenectomy were performed. Pathological examination of the resected retroperitoneal and left inguinal lymphnodes revealed embryonal carcinoma and no residual tumor cells, respectively. Additionally, two courses of chemotherapy were performed after surgery. His postoperative course was uneventful and ten months of follow-up showed no evidence of recurrence.

Adult↗

PubMed1993

[Tuberculosis of the female urethra: a case report].

A 52-year-old female with the chief complaint of miction pain was referred for the examination of a urethral nodule. Physical inspection revealed the meatus to be reddish and swollen. The painless nodule (1 x 1 x 2 cm) was situated between the urethra and vagina on transvaginal examination. Chest X-ray, drip infusion pyelography (DIP) and urethrocystography (UCG) showed no evidence of tuberculosis. Bladder mucosa was normal on cystoscopy. Mycobacterium tuberculosis was not detected from urine or sputum. The nodule was resected along with a portion of the urethra. Histopathological examination revealed tuberculous granuloma of the urethra.

Drug Therapy, Combination↗

PubMed1993

[Advantages in combination chemotherapy using the camptothecin analogue CPT-11 and cisplatinum analogues for human testicular cancer xenografts].

The antitumor effects of combination chemotherapies using CDDP and the camptothecin analogue CPT-11 were compared with those of vinca alkaloids or podophyllotoxins, and those of CPT-11 and cisplatinum analogues were also estimated. Two human testicular cancer xenografts (TTSC -2 and TTSC-3) heterotransplanted in nude mice were used. Combination therapy with CPT-11 and CDDP resulted in significant tumor regression and was much more effective than that of CDDP and vinca alkaloids or podophyllotoxin. The combination of CPT-11 and either CDDP or 254-S was significantly more effective than that of CPT-11 and either carboplatin or DWA2114R. Four evaluable refractory testicular cancers were treated with combination chemotherapy with CPT-11 and CDDP or 254-S as third line chemotherapy. Two patients remain alive and disease free and two patients died of disease. We concluded that the present combination is active in refractory testicular cancer.

Animals↗

PubMed1993

Evaluation and management of dietary habits in Japanese renal stone formers.

To elucidate the relationship between the formation of kidney stones and diet, we carried out a dietary investigation in patients with urinary tract stones. Dietary intakes were estimated for 36 patients (24 men, 12 women) with calcium stones, and compared with the official dietary requirements for the Japanese. Total protein intake, animal protein intake and animal protein ratio were significantly higher for patients with stones in both men and women. Dietary salt intake was significantly higher for male patients and the total group. Dietary calcium and carbohydrate intakes were significantly lower for patients with stones in men and the total group, and tended to be lower for female patients. As a result of dietary guidance, the intakes of total protein, animal protein and salt were markedly reduced. The animal protein ratio was also lowered. Caloric intake and the dietary intakes of carbohydrate, fat and salt were reduced, too. However, the dietary calcium intake did not change. Chemical analysis of 24 hour-urine revealed that the excretion of urea nitrogen was reduced, which reflected the decrease in protein intake produced by the dietary regimen. The excretions of urate and oxalate also tended to decrease.

Adult↗

PubMed1993

Renal tubular hypouricemia and calcium urolithiasis.

The information concerning the relationship of hypouricemia with urinary tract stones is limited. We investigated the incidence and types of hypouricemia, and also studied its relationship to urinary tract stones. Hypouricemia was detected in 3 out of 1520 outpatients (0.20%). The loading tests using pyrazinamide, probenecid and benzbromarone showed that uric acid absorption was impaired before tubular secretion in two cases and incomplete postsecretory reabsorption in one case. Complication of urinary tract stone was found in two cases. The composition of the stones was mixed calcium oxalate and uric acid. Hypouricemia should be recognized as one of the causes of kidney stone formation.

Adult↗

PubMed1993

[Clinical study of acute scrotum].

Acute scrotum is a clinical syndrome which includes various disorders. Differential diagnosis of these disorders is not always easy. We reviewed cases experienced in our hospital, focusing on diagnostic procedures. Final diagnosis in 39 cases were acute epididymitis in 23 cases, torsion of the testis in 13 cases, torsion of appendix epididymis in 2 cases and torsion of appendix testis in 1 case. It became clear ultrasonography was a useful diagnostic procedure; if the torsed portion is delineated, torsion of the testis can be diagnosed. Heterogenous echoes from the interior of the testis indicate the necrosis of the testis. Inspection was also useful; if the blue dot sign is detected, torsion of the appendix testis/epididymis is indicated. However, Doppler ultrasound did not always provide a correct diagnosis of torsion of the testis. If torsion of the spermatic cord cannot be completely ruled out, early surgical intervention and treatment are considered essential.

Acute Disease↗

PubMed1992

Phase II study of cis-diammine(glycolato)platinum, 254-S, in patients with advanced germ-cell testicular cancer, prostatic cancer, and transitional-cell carcinoma of the urinary tract. 254-S Urological Cancer Study Group.

A multicenter cooperative study was conducted to evaluate the clinical efficacy and safety of cis-diammine(glycolato)platinum (254-S), a second-generation anticancer platinum complex, in the treatment of genitourinary cancers. 254-S was given i.v. at 100 mg/m2 at 4-week intervals. As a result, 2 complete responses (CRs) and 8 partial responses (PRs) were obtained in 35 patients with transitional-cell carcinoma (TCC) of the urinary bladder or pyeloureter, 3 PRs were obtained in 16 subjects with prostatic cancer, and 6 CRs and 6 PRs were obtained in 15 patients with testicular cancer, generating objective response rates of 28.6% [95% confidence interval (CI), 14.6%-46.3%], 18.8% (95% CI, 4.0%-45.6%), and 80.0% (95% CI, 51.9%-95.7%), respectively. Bone marrow suppression was the dose-limiting toxicity, although it was reversible. Although no hydration was performed in approx. 40% of the patients, the incidence of nephrotoxic effects was low and most of those encountered were mild, the exception being one patient who showed severe renal insufficiency after the first treatment. Nausea and vomiting occurred in approx. 70% of the patients, but most gastrointestinal toxicities were controlled without antiemetic treatment. In addition, liver-function impairment was rarely observed. We conclude that 254-S is a promising cisplatin analogue for the treatment of genitourinary cancers and is worthy of further investigation in large-scale, randomized comparative studies with other platinum derivatives in both single-agent and combination regimens.

Adult↗

PubMed1992

The 4th study of prophylactic intravesical chemotherapy with adriamycin in the treatment of superficial bladder cancer: the experience of the Japanese Urological Cancer Research Group for Adriamycin.

A multicentric randomised trial was conducted for the purpose of investigating the efficacy of intravesical chemoprophylaxis of superficial bladder cancers. A total of 443 patients (number of evaluable patients, 284) were registered from July 1987 to December 1989 and randomised into 3 groups. Group A received 21 intravesical instillations of Adriamycin (ADM) at 20 mg/40 ml physiological saline for 2 years after undergoing transurethral resection (TUR); group B was given the same dose as group A but received 6 intravesical instillations for 2 weeks before undergoing TUR; and group C served as a control and underwent TUR only. Better prophylactic effects were obtained in group A. The overall non-recurrence rates calculated for groups A and B differed significantly (P less than 0.05) on day 240, and those determined for groups A and C were also significantly different (P less than 0.01) on day 480. No benefit was obtained using intravesical instillation prior to TUR (group B). The major side effects encountered were pollakisuria and miction pain, which occurred in 32% of the patients in group A and in 52% of those in group B.

Administration, Intravesical↗

PubMed1992

Long-term results of intravesical chemoprophylaxis of superficial bladder cancer: experience of the Japanese Urological Cancer Research Group for Adriamycin.

Long-term results were analyzed in terms of tumor progression and survival in patients with superficial bladder cancer who were enrolled in the second intravesical chemoprophylactic study of the Japanese Urological Cancer Research Group for Adriamycin, which was started in July 1982. This study was a prospective, randomized, controlled trial conducted on primary tumors treated with a long-term instillation regimen that involved control versus intravesical instillations of Adriamycin or mitomycin C given once a week for the first 2 weeks, once every other week for 14 weeks, once a month for 8 months, and once every 3 months for 1 year, for a total of 21 instillations in 2 years. An analysis of the prophylactic effects of such treatment on bladder tumors after TUR has previously been performed, and the results have been published elsewhere. The present study represents a follow-up of the above trial. Of the 671 cases previously analyzed with regard to tumor prophylaxis, 158 cases (23.5%) were eligible to be followed for tumor progression and survival. A detailed comparison of the background factors between these 158 patients and the other 513 cases revealed no statistically significant difference. Thus, the 158 evaluable cases might reasonably be considered to represent all patients enrolled in the second study, and the results were thought to be reasonable enough to reflect the long-term efficacy of the long-term instillation regimen adopted in this study. The median follow-up for these 158 cases was 6.6 years. Tumor progression in terms of the disease stage and/or grade occurred in 43 of 127 patients who received prophylactic instillations and in 12 of 31 control cases. No significant difference in the incidence of tumor progression was found between the treatment and the control groups. In addition, no difference in survival was observed between the treatment group and the control group. Survival was also compared between patients who showed tumor progression and those who did not. All patients whose tumors did not progress survived, whereas the 7-year survival of those exhibiting tumor progression was less than 90%.

Actuarial Analysis↗

PubMed1992

Evaluation of systemic chemotherapy with methotrexate, vinblastine, adriamycin, and cisplatin for advanced bladder cancer. The Japanese Urological Cancer Research Group for Adriamycin.

In a cooperative study of the Japanese Urological Cancer Research Group for Adriamycin, the usefulness of chemotherapy with methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC therapy) in treating advanced or recurrent bladder cancer was examined. Evaluation of the clinical responses obtained in 86 evaluable patients revealed 13 complete responses, 29 partial responses, 4 minor responses, 19 cases of no change, and 21 cases of progressive disease. The overall response rate was 48.8% (42/86). The rate of response to M-VAC therapy at each disease site was as low as 21.4% (3/14) in bone lesions but exceeded 40% in the primary lesion, the lymph nodes, the lung, the liver, and other lesions. The clinical response to M-VAC therapy was not significantly influenced by the performance status of the patients, the dose intensity, or previous therapy. The median duration of response for the 42 responders was 22.7 weeks (range, 8.1-134.1 weeks), and the median duration of survival for the 86 evaluable patients was 9.8 months. Side effects were frequently encountered; the patients experienced anorexia, nausea, vomiting, malaise, alopecia, and leukopenia, but all of these symptoms were tolerable.

Adult↗

PubMed1992

Modified method of radical retropubic prostatectomy for localized prostatic cancer.

A modified method of retropubic radical prostatectomy was devised. The root of the penis was compressed and the bilateral internal iliac arteries were clamped before the dissection of the prostate. The urethra was divided at the junction of the prostate and bladder so that the bladder stump thus created has the size of the tip of the middle finger. Vesicourethral anastomosis was done by Vest procedure. By this method 24 patients were operated. All patients except one were alive without recurrence after the mean follow-up of 32 months. This method seems to be good enough to recommend.

Acid Phosphatase↗

PubMed1992

Transurethral treatment of bladder diverticulum.

Transurethral resection of the bladder diverticular neck and fulguration of the diverticular mucosa were performed in 31 diverticula. Cystograms showed that 26 of the 31 diverticula had disappeared completely after 1 month. Follow-up cystograms have shown no recurrence, and no further surgical procedures were required. Therefore, we conclude that resection of the diverticular neck from 4 to 8 o'clock to even the gap between the bladder mucosa and diverticular wall in conjunction with transurethral treatment of the prostate, if required, is a safe, fast and effective method.

Aged↗

PubMed1992

[Percutaneous renal cyst puncture and ethanol instillation].

Under ultrasound guidance 79 simple renal cysts in 65 patients were punctured and aspirated with our contrivance, a 5 Fr single J catheter on a 19 gauge needle. Forty-eight renal cysts were successfully punctured, that is, they had no bloody fluid and did not have any leakage of contrast medium. These cysts were instilled with absolute ethanol for 5 minutes. To follow up the patients, consecutive observation was done by sonography or CT every three months. Ethanol-instilled renal cysts were more markedly reduced (reduction rate: 93 +/- 17%) than not-instilled cysts (reduction rate: 32 +/- 28%). Thus, ethanol-instillation was useful in the reduction of renal cysts. After the puncture of cysts, hematuria disappeared in most patients.

Aged↗