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Yoshitomo Sawada

Publications and source records attributed to Yoshitomo Sawada.

7 recordsLinked to original sources

Comparison of two-port and four-port irradiation in the bladder preservation therapy for locally invasive bladder cancer.

AIM: To ascertain therapeutic effectiveness and adverse reactions with radiochemotherapy for locally invasive bladder cancer, comparison was made between two-port and four-port irradiation with intravenous cisplatin administration. METHODS: In 86 patients who were diagnosed with locally invasive bladder cancer on the basis of imaging and biopsy findings, transurethral tumor resection was carried out initially to minimize tumor volume, and then radiochemotherapy was done. From 1985 to 1997, bilateral two-port irradiation was carried out, and after 1998, four-port irradiation was done. In regards to chemotherapy, cisplatin was administered intravenously. Therapeutic effects were assessed 1 month after the end of therapy. RESULTS: Fifty-five patients underwent two-port irradiation; complete response (CR) was achieved in 26 and partial response (PR) in 29 patients. Thirty-one patients underwent four-port irradiation; CR was achieved in 20 patients and PR in 11 patients. The cause-specific 5-year survival rate did not differ significantly between two-port and four-port irradiation (74%vs 79%), but there was a significant difference of survival between CR and PR patients. In the two-port irradiation group, 5-year bladder preservation rate was 89% in CR patients and 52% in PR patients. In the four-port irradiation group, 5-year bladder preservation rate was 90% in CR patients and 46% in PR patients. Of the various adverse reactions, no significant differences in leukopenia, thrombocytopenia or bladder symptoms were observed between two-port and four-port irradiation, but the incidence and severity of loss of appetite, nausea and/or vomiting, diarrhea and dermatitis were significantly greater for two-port irradiation. CONCLUSION: Radiochemotherapy are considered to be modest effective in the bladder preservation therapy for locally invasive bladder cancer. The four-port irradiation shows less adverse reactions than two-port irradiation.

Adult↗

Plasma biopterin levels and tetrahydrobiopterin responsiveness.

Tetrahydrobiopterin (BH4) responsive hyperphenylalaninemia (HPA) with a mutant phenylalanine hydroxylase (PAH) gene was found during neonatal screening for PKU. This study determined blood BH4 and phenylalanine in two patients with hyperphenylalaninemia following oral load with BH4 10 mg/kg. Our patients underwent neonatal screening for PKU, had normal biopterin metabolism and their PAH mutations were determined. Peak plasma biopterin levels in Case 1, which were reached at between 2 and 4h after loading, were 612, 297, and 178 nmol/L at age 30 days, 55 days, and 19 months, respectively, and the maximum phenylalanine decreasing rates, which were found at 24h, were 54, 16, and 4%, respectively. In Case 2, peak plasma biopterin levels were 747 and 327 nmol/L at age 20 and 55 days, respectively, and the maximum phenylalanine decreasing rates were 39 and 32%, respectively. In the BH4 loading test, the peaks of BH4 in both patients lowered ( approximately 50%), on the same dose schedule of BH4, as patients got older.

Biopterins↗

[Sigmoid colovesical fistula associated with cancer of the sigmoid colon].

OBJECTIVES: To report one case of colovesical fistula after the diagnosis of unresponsive urinary tract infection. METHODS: The 76-year-old patient underwent a diagnostic work up including cystography, cystoscopy and barium enema. RESULTS: Cystography revealed an image of the sigmoid colon, and cystoscopy showed a granuloma at the bladder dome. A fistula was identified underneath. A colovesical fistula was diagnosed and several intestinal germs grew on urine cultures. Partial cystectomy and end to end anastomosis of the sigmoid colon were carried out. Pathology report showed a well-differentiated adenocarcinoma which invaded down to the bladder mucosa. CONCLUSIONS: Inflammatory diseases are the main the etiology of colovesical fistula, followed by neoplasias. We reviewed around 170 cases reported in our country. It is important to identify the fistula by means of the gastro-intestinal series and the study of the lower urinary tract when treating patients with urinary tract infection difficult to control. We suggest the best radical therapy is surgery in a single procedure.

Adenocarcinoma↗

[Retroperitoneal fibrosarcoma with myxoid matrix: a case report].

A 54-year-old male visited a local physician with right dorsolumbar pain as the chief complaint. Ultrasonography revealed a tumor mass 13 cm in diameter at the lower part of the liver, and the patient was referred to our hospital. On abdominal computed tomography, uneven contrast-enhanced effects were recognized in the tumor. On magnetic rescmance imaging studies, T1-weighted images showed a hypoechoic pattern from the kidney and a weak hyperechoic pattern from the muscle. T2-weighted images showed uneven hyperecoic patterns. Uneven contrast-enhanced effects were recognized inside and on the margin of the tumor. A diagnosis of retroperitoneal tumor was made, and surgery was performed. Histopathological examination revealed a fascicular alignment of spindle cells in the area in which the myxoid matrix is seen. On the immunological special test, only vimentin was positive, which led to the diagnosis of fibrosarcoma. Fibrosarcoma originating from retroperitoneal tumor is relatively rare.

Biomarkers, Tumor↗

[Phenylketone].

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Humans↗

[Testicular malignant lymphoma: a case report].

We report a case of malignant lymphoma arising from the testicle in a patient who had been on chemotherapy for a long period after orchiectomy. A 54-year-old male presented with indolent swelling in the right scrotum. Diagnosed as having a testicular tumor by ultrasonography and MRI, he underwent orchiectomy. According to the histopathological diagnosis, the tumor was classified as non-Hodgkin's lymphoma, diffuse large cell type, B cell type. Diagnosis of Stage I eA was made by the Arr Arbor classification. Four courses of cycrophosphamide, adriamycin, vincristin and prednisolone (CHOP) therapy were administered. COP (CHOP minus adriamycin) therapy has been given every four months on an out-patient basis. At present, 28 months after the operation, no evident recurrence has been found.

Antineoplastic Combined Chemotherapy Protocols↗

[Clinical investigation of 6 cases of urachal carcinoma].

We have encountered 6 cases of urachal carcinoma in the past 7 years. They consisted of 4 females and 2 males, with the mean age of 48 years old. Of them, 2 cases were identified as gestational complications. Bladder irritating symptoms and extracystic symptoms other than hematuria were not observed as initial symptoms, and urinary cytology was positive in 2 cases. Cystoscopy is essential for diagnosis, but the spread of the tumor was clearly visualized by sagittal section patterns on magnetic resonance imaging. A correlation between the tumor and clinical course was suggested immunohistochemically with, carcinoembronic antigen and carbohydrate antigen 19-9. Cases of gestation concurrent with urachal carcinoma are very rare, but are expected to increase in the future. Thus appropriate medical treatment must be given to the maternal body. For the treatment, appropriateness of advanced surgery more than partial resection of the bladder combined with total urachoumbilical resection was recommended. However, an effective adjuvant chemotherapy after the first surgical resection needs to be established to improve the patient's quality of life.

Adenocarcinoma↗