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Biomedical subjects

T Machida

Publications and source records attributed to T Machida.

At least 73 records · Page 4Linked to original sources

Nephrectomy in renal carcinoma with distant metastasis.

A total of 96 cases of renal carcinoma with distant metastasis at the time of diagnosis was studied. The patients were classified into 4 groups: Group O (16) in whom nephrectomy was not performed, Group A (51) who died due to carcinoma within 1 year of nephrectomy, Group B (25) who died due to carcinoma 1 to 3 years after nephrectomy, and Group C (4) who survived for 3 years or more after nephrectomy. Six clinical measurements were evaluated: haemoglobin, ESR, alpha 2 globulin, temperature, weight and C reactive protein. In addition, performance status, the number of organs with metastases, number of metastatic lesions and tumour growth rate were measured. The results showed that in patients surviving for 1 year or more after nephrectomy, there was an abnormality in the results of 3 or less of the 6 clinical measurements, performance was 0 or 1, and the carcinoma had metastasised to only one organ. In addition, it was found that the growth of metastatic lesions in patients who survived for 3 years or more was much slower than in the other patients. Nephrectomy was found to be effective in only 27% of our cases and we consider that careful deliberation should be made pre-operatively as to whether nephrectomy is really necessary in patients with metastasis. The decision should be made on the basis of the results obtained in the 6 clinical measurements given above.

Adult

Neurofibromatosis types 1 and 2: cranial MR findings.

Neurofibromatosis 1 (NF-1) (von Rekhlinghausen disease) and neurofibromatosis 2 (NF-2) (bilateral acoustic neurofibromatosis) have been recently recognized to be distinct disorders through genetic linkages. The authors compared the cranial magnetic resonance (MR) images of 53 patients with NF-1 and 11 with NF-2. In the NF-1 group, MR imaging revealed 19 patients with optic gliomas and eight with parenchymal gliomas. In 32 patients, foci of prolonged T2, similar to those reported previously as hamartomas, were identified in the cerebellar peduncles, globus pallidus, midbrain, and other locations. The frequency of these foci was related to both age and the presence of optic gliomas. In the NF-2 group, MR imaging revealed eight patients with cranial nerve schwannomas and six with meningiomas (in addition to acoustic schwannomas in all 11). These findings demonstrate that NF-1 and NF-2 are different diseases requiring different imaging protocols. NF-1 seems to be associated with tumors of astrocytes and neurons and NF-2 with tumors of meninges and Schwann cells.

Adolescent

[Accuracy of computed tomography in the staging of renal cell carcinoma].

Computed tomography (CT) was performed in a total 124 cases of renal cell carcinoma to determine perinephric invasion, venous invasion and involvement of the regional lymph node. The findings obtained were compared with pathological findings. CT findings for invasion of perinephric fat showed a sensitivity of 82%, specificity of 82 and accuracy of 82%. For adjacent organ invasion CT findings revealed a sensitivity of 90%, specificity of 100% and accuracy of 99%. As to venous invasion CT findings showed a sensitivity of 86%, specificity of 97%, and accuracy of 95%, and for lymph node involvement CT findings revealed a sensitivity of 80%, specificity of 98%, accuracy of 96%. Although the accuracy is not so high in diagnosing invasion of perinephric fat, CT scan was proven to be a valuable diagnostic measure for detection of adjacent organ invasion, venous invasion and lymph node involvement, thus helping to select a suitable surgical approach.

Adult

[Endourology].

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Humans

[Clinical evaluation of serum prostatic acid phosphatase assay based on the immunoenzymatic method (TZR-516)].

The usefulness of a newly developed prostatic acid phosphatase assay based on the immunoenzymatic method (PAP-IEA) was studied. Serum samples were obtained from 22 untreated prostatic carcinoma patients, 34 benign prostatic hyperplasia patients, 32 prostatic disease-free patients and 27 normal volunteers. Mean +/- S.D. of PAP-IEA in prostatic disease-free group and normal volunteer group was 0.46 +/- 0.27 ng/ml. So, the upper limit of PAP-IEA for clinical normal range was set to 1 ng/ml (= Mean + 2S.D.). Thus, the false positive rate of benign prostatic hyperplasia was estimated at 9% and false negative rate of untreated prostatic carcinoma at 27%. Meanwhile, PAP-IEA values measured in this study were correlated well to PAP-RIA values measured in the same samples (r = 0.994).

Acid Phosphatase

[Chemosensitivity test utilizing in vivo-like growing of renal cell carcinoma].

Utilizing two different types of renal cell carcinoma (JRC 1; papillary pattern, grade III, JRC 11; anaplastic and alveolar pattern, grade IV) heterotransplanted in nude mice, studied: 1) chemosensitivity tests using an in vivo-like growing culture method (collagen gel-supported culture system) with 3H-thymidine up-take assay; 2) using H and E staining, serial change of each tumour in this culture system was examined during 7 days after culture start-up. The chemo-agent tested was natural human interferon-alpha (HLBI), and the doses were 10, 100, 1,000 I.U./ml. In JRC 1, significant responses to IFN (10, 100, 1,000 I.U.) were noted, but no dose dependency was observed. In contrast, in JRC 11, compared with control, a decrease of 3H-thymidine up take in each dose of IFN was observed, but no significant differences were observed between the tested groups and control. In the 3-day culture of JRC 1, the central portion contained fewer viable cells. In the 7-day, the majority of the viable cells were replaced throughout the tumour. In contrast, in the 3-day culture of JRC 11, a decrease of viability in the central portion was observed, and this tendency progressed during the period of culture. In the 7-day only two to three thin viable cell layers were observed around the cultured tumour. Consequently differences of growth features in this culture system can be seen between the different types of tumours. Thus, a more detailed examination is needed for the clinical application of this culture system.

Animals

[MR imaging of the inner ear; findings of Ménière's syndrome].

Symptoms in Ménière's disease are explained by hydrops of endolymphatic system with recurrent ruptures of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of endolymph which may be due to an obstruction of the endolymphatic duct and sac, located in the vestibular aqueduct. Non-visualization or narrowing of the vestibular aqueduct of the paper have been demonstrated by conventional tomography and high resolution computed tomography (HR-CT). But the endolymphatic duct and sac can not be obtained by HR-CT and conventional tomography. Whereas, on MRI, these are identified. By MRI, we prospectively tried to demonstrate morphological alterations in 10 patients with Ménière's disease and in 4 patients with vestibular neuronitis. These were compared with a group of 20 normal men. Visualization of the endolymphatic duct and sac (vestibular aqueduct) on MRI was assessed. There was a distinctly decreased visualization of the vestibular aqueduct in the Ménière group and vestibular neuronitis group. We were able to confirm a statistically proven usefulness of the MRI technique in identifying an anatomical abnormality which is directly in correlation with the side of the lesion in cases of unilateral Ménière's disease.

Adult

[Pancreatic secretory trypsin inhibitor in urothelial cancer].

Pancreatic secretory trypsin inhibitor (PSTI) levels are known to increase in some kinds of cancer. We determined the PSTI levels in patients with urothelial cancer to evaluate its usefulness as a tumor marker. The subjects were 101 patients who had bladder cancer (n = 81) or renal pelvis and ureter cancer (n = 20). Twenty-six healthy volunteers were used as controls. PSTI was measured by an RI kit using the double antibody method, and levels above 20 ng/ml were taken as positive. Serum tissue polypeptide antigen (TPA) levels were also measured in 32 cases. None of the controls, 65% of the patients with renal pelvis and ureter cancer, and 30.9% of bladder cancer had positive levels of PSTI. The positive rate for each stage was 22.3% for Tis, Taand T1, 38.5% for T2, 73.3% for T3 and 100% for T4. The rate tended to increase with the progress of tumor infiltration. All subjects with positive readings above 30 ng/ml had progressive cancer. The usefulness of PSTI as a tumor marker was similar to that of TPA. PSTI is not a specific marker of urothelial cancer, but it showed an association with the progression of cancer. Therefore, it is considered to be a useful marker to determine postoperative metastasis, recurrence, and disease progression.

Adult

[Experimental evaluation of cisplatin analogous in urogenital cancer].

We studied the efficiency and toxicity of three types of recently developed cisplatin analogous agents-carboplatin, 254-S and DW2114, in animal experiments and clinical examinations. In animal experiments, these three agents were injected into SD rats intraperitoneally to determine their effects on rat functions. The antitumor effect of these agents was about the same as that of CDDP, but the renal toxicity of 254-S and DW2114 was lower than that of CDDP. However, more serious myelopathy was observed with these agents than with CDDP. Although slight damage to the testis was seen in the 254-S group, damage to the testis by the other agents was negligible. It was suggested that the damaged region in the testis was spermatogonia. In clinical examinations, we administered the three analogous agents separately for testicular tumors, prostatic cancer and bladder tumors, but a complete response (5M) was recognized in only one case given 245-S, and we found these three agents less effective than CDDP. At present, CDDP is extensively used clinically as one of the combination therapy agents. However, in the first place, we should develop a new CDDP analogous agent that has an anti-tumor effect greater than that of CDDP.

Adult

[A case of squamous cell carcinoma of the renal pelvis accompanying an ectopic opening with vesicoureteral reflux of complete duplication of uretero pelvis].

Squamous cell carcinoma of the renal pelvis is a relatively rare disease. Recently, we observed a case of squamous cell carcinoma of the renal pelvis with vesicoureteral reflux in a 49-year-old female patient. Her main symptom was abdominal pain on the left side. The complete duplications of uretero-pelvis on both sides, and vesicoureteral reflux in the upper left part of the kidney were recognized by means of various examinations. During the operation, a tumor was found in the upper left renal pelvis, and in the ureter belonging to the upper left renal pelvis. Pathologically, it was diagnosed as a squamous cell carcinoma. After the extraction of the left uretero-pelvis, 50 Gy of radiotherapy was administered to the patient. However, she died four months after the operation.

Carcinoma, Squamous Cell

[Role of MRI in the pediatric central nervous system disorders].

Recent rapid development of the MRI system has enabled us to diagnose precisely the disorders of the central nervous system (CNS) also in neonates and young children. Because of a long studying time, the use of oral chloral hydrate or other alternative drugs for sedation, such as secobarbital and meperidine, is necessary for young children under 6 years of age. The advantages of MRI are the optional plane imaging, a high contrast resolution, and the artifact-free imaging from the surrounding bones and air. MRI can detect myelination disorders and the lesions in the posterior fossa, the middle fossa, and the spinal canal. These abnormalities are difficult to depict with conventional X-ray CT scanning. MRI is useful also for the survey of various congenital anomalies of the brain and the spine. Furthermore, it is sensitive enough to detect the CNS blood flow and the cerebrospinal fluid (CSF) flow. Arteriovenous malformation, moyamoya disease, and sinus thrombosis are diagnosed by MRI without using contrast media, CSF flow void phenomena in the aqueduct and the Monro's foramina are indexes of the CSF pathway obstruction and of normal pressure hydrocephalus.

Adolescent

[A case of bullous cystitis].

A case of bullous cystitis with a right ureter stone seen in a 25-year-old male is described. Inflammatory tumorous cystitis was performed. One month after transurethral resection, there was inflammatory tumorous cystitis at the same position. Therefore, right ureterolithotomy and right ureterovesical neostomy were done. The patient is currently in good health 1 year and 5 months after the surgery.

Adult

[Clinical study of renal cell carcinoma with bony metastasis: comparative study with lung metastasis].

For the purpose of clinical analysis of renal cell carcinoma with bony metastasis (59 cases) the cases with lung metastasis (146 cases) were selected for comparison. The analyzed items were the distribution of bony metastatic portions, the results of radiotherapy for bony metastasis, comparative study with lung metastasis on clinical background, comparative study with lung and bony metastasis on the survival rate, comparative study with solitary bony and lung metastasis on the survival rate, comparative study with bony and lung metastasis on the grade of primary lesion. The most frequent metastatic portion was lower extremities, spine, upper extremities and pelvic bone in this order. The survival rate of the cases with bony metastasis was better than that of lung, especially with solitary metastatic cases. The effects of radiotherapy for bony metastasis were not so good for prolonging the survival. The grade of kidney malignancy did not influence the survival of patients with bony metastasis, on the contrary, in patients with lung metastasis, there was a good prognostic factor for survival.

Adult