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Biomedical subjects

A Ariyoshi

Publications and source records attributed to A Ariyoshi.

At least 19 recordsLinked to original sources

[Flow cytometry analysis of the DNA content of the prostate cancer--study on the tumor heterogeneity in prostate cancer].

PURPOSE: Clinical significance of DNA ploidy pattern and its DNA heterogeneity is examined in prostate cancer. METHODS: Fresh needle biopsy specimens were analyzed with flow cytometry and were compared with histopathological findings in 42 patients. RESULTS: Seven patients had stage B (1 case of B1, 6 cases of B2), 14 had stage C and 21 had stage D disease respectively. Histopathologically, 18 of the cases were well, 12 were moderately and 12 were poorly differentiated adenocarcinoma. Diploid was observed in 20, aneuploid in 22. Though 22 cases showed no DNA heterogeneity, 14 had type A heterogeneity with aneuploid in association with diploid pattern, and 6 cases had type B heterogeneity in which multiple aneuploid patterns with different D.I. values were observed. The heterogeneity was observed in 28% of well, 58% of moderately and 67% of poorly differentiated adenocarcinoma, respectively, and also in 14% of stage B, 50% of stage C and 57% of stage D patients, respectively. CONCLUSION: We conclude that DNA heterogeneity in prostate cancer is more frequently seen in poorer differentiated ones on histologic grade and in more advanced ones on clinical stage.

Adenocarcinoma

Upper urinary tract involvement after cystectomy and ileal conduit diversion for primary bladder carcinoma.

OBJECTIVES: To design a proper follow-up for cystectomy and ileal conduit urinary diversion for primary bladder transitional carcinoma, we compared the radiographic characteristics of recurrent malignant upper tract lesions with those of benign ureteroileal anastomosis strictures. METHODS: Over a 20-year period, we followed 61 patients who underwent cystectomy and ileal conduit diversion at our hospitals for a minimum period of 3 years. Excretory urography was performed routinely at 1, 3, 6 and 12 months after cystectomy and once yearly thereafter. RESULTS: Five patients (8.2%) developed malignant ureteral obstruction (4 had metachronous upper tract tumors, and 1 patient had retroperitoneal lymph node metastasis which compressed the ureter). Eleven patients (18.0%) developed benign ureteroileal anastomotic stricture. The interval between cystectomy and initial detection of the malignant and benign upper tract lesion ranged between 34 and 118 months (mean 69 months) and between 1 and 20 months (mean 5.1 months), respectively. In all patients with malignant upper tract obstruction, a complete loss of renal function occurred within 10 months after the detection. Conversely, a progressive renal dysfunction was observed in patients with benign ureteroileal anastomotic stricture. All patients were asymptomatic before the detection of lesions on excretory pyelography. CONCLUSIONS: Our results suggest that cancer recurrence can occur even 10 years after cystectomy, typically progressing very rapidly within 1 year. A benign ureteroileal anastomotic stricture, on the other hand, tends to occur within 2 years but advances slowly. Consequently, a proper follow-up necessitates annual excretory urography and/or renal ultrasonography in all patients with ileal conduit urinary diversion after cystectomy.

Adult

Metastatic adrenocortical carcinoma treated by repeated resection: a case report of long-term survival over 18 years.

A case of recurrent and metastatic nonfunctioning adrenocortical carcinoma in a 40-year-old woman is reported. The patient received 4 laparotomies and 1 thoracotomy for recurrent and metastatic disease after removal of the primary adrenal tumor. She has been alive for over 18 years following multiple surgery for diseases after the first adrenalectomy. In selected patients with recurrence and/or metastasis, repeated surgical resection offers the possibility of a cure or extended palliation.

Adrenal Cortex Neoplasms

Prophylactic intravesical chemotherapy with adriamycin plus verapamil for primary superficial bladder cancer: preliminary results. The Kyushu University Urological Oncology Group.

A prospective randomized trial was conducted to compare the prophylactic effect of intravesical installation of Adriamycin (ADM) plus verapamil (VR) with that of ADM alone for recurrence of superficial bladder cancer. A total of 226 patients were enrolled and randomized into 2 groups. Group A received intravesical instillation of ADM (30 mg/30 ml physiological saline) on 19 occasions during a 1-year period after transurethral resection, whereas group B received intravesical instillation of ADM (30 mg/24 ml physiological saline) plus VR (15 mg/6 ml saline) according to the same schedule used for group A. Evaluation was possible in 157 of the 226 registered patients (group A, 76; group B, 81). There was no significant difference in the patients' characteristics between the two groups, and there was no significant difference in the overall nonrecurrence rate determined over a 24-month follow-up period. However, group B showed a significantly higher nonrecurrence rate than did group A for tumors measuring less than 1 cm in diameter (P < 0.05) and for histological grade 2 tumors (P < 0.01) in spite of there being no significant difference in the other characteristics of each subgroup of patients. The incidence and severity of side effects were similar in both groups, and VR caused no significant systemic toxicity. Although further follow-up is necessary, these results suggest that intravesical instillation of ADM plus VR is clinically safe and may be more effective than instillation of ADM alone in preventing the postoperative recurrence of superficial bladder cancer (less than 1 cm in diameter, histological grade 2).

Administration, Intravesical

An experimental model for unilateral ischaemic acute renal failure in dog.

We determined the recovery of unilateral ischaemic acute renal failure in both ischaemic and non-ischaemic canine kidneys. Split renal clearance studies were repeated for seven weeks after 90 minutes of left renal artery clamping. Clearance of inulin and para-aminohippuric acid in the ischaemic kidneys dropped significantly for 3 weeks. Significant increase of the fractional excretion of sodium in those kidneys was observed at only 1 week after ischaemia. In the contralateral non-ischaemic kidneys, these indices did not change significantly throughout the experiments. This animal model of acute renal failure would be helpful in testing possible preventive measures and therapy for human acute renal failure.

Acute Kidney Injury

Adjuvant chemotherapy with early intravesical instillation of adriamycin and long-term oral administration of 5-fluorouracil in superficial bladder cancer. The Kyushu University Urological Oncology Group.

A randomized controlled trial was performed to study the efficiency of adjuvant chemotherapy with early intravesical instillation of Adriamycin and long-term oral administration of 5-fluorouracil in 275 patients with superficial bladder cancer. All of the patients were randomized into four groups. Group A received early (immediately and 2 days after transurethral resection) instillation of Adriamycin alone; Group B received early instillation of Adriamycin with oral administration of 5-fluorouracil; Group C received delayed (7 days after transurethral resection) instillation of Adriamycin alone; and group D received delayed instillation of Adriamycin with oral administration of 5-fluorouracil. All patients subsequently received instillations weekly for 2 weeks and then every 2 weeks for a further 14 weeks. After 4 months, they received monthly instillations for 8 months. 5-Fluorouracil (groups B and D) was given daily p.o. for 1 year. Evaluation was possible in 187 patients. The postoperative follow-up period for determination of non-recurrence rates was 36 months, during which no significant difference was detected among the four groups. Moreover, no statistically significant difference was found between the early- and delayed-instillation groups. However, the non-recurrence rates obtained in the groups undergoing early instillation were higher than those determined in the delayed-instillation groups during the 36-month follow-up period, and this difference was especially significant at 4 and 5 months. In addition, the early-instillation groups showed significantly higher non-recurrence rates than did the delayed-instillation groups in terms of primary cases (P less than 0.01), tumor size of less than 1 cm (P less than 0.05), multiple tumors (P less than 0.01), pathological stage pTa (P less than 0.01), and histological grades G1 and G2 (P less than 0.05). Groups B and D, which were treated by intravesical instillation of Adriamycin with oral administration of 5-fluorouracil, showed no significant prophylaxis of recurrence during the 36-month follow-up as compared with groups A and C, which received intravesical instillations alone. The main side effect, which required discontinuation of the treatment, was bladder irritation. However, no significant difference in its incidence was found between the early- and delayed-instillation groups. No severe systemic side effect was encountered in this study. These results suggest that early as well as repeated intravesical instillation of Adriamycin is clinically tolerable and may be effective in preventing the recurrence of superficial bladder cancer.

Administration, Intravesical

Intravesical therapy with adriamycin plus verapamil in patients with superficial bladder cancer: a pilot study.

Nineteen patients with histologically proven superficial bladder cancer (Ta, T1) were treated with intravesical instillation of 30 mg of adriamycin (ADM) dissolved in 24 ml physiological saline plus 15 mg of verapamil (VR) (6 ml) every day for 10 days. In spite of the short period of treatment, 6 of the 18 evaluable patients (33.3%) showed complete response (CR) and a further 5 (27.8%) showed partial response (PR). Five of the 6 patients with CR were recurrent cases who had previously received prophylactic intravesical instillation chemotherapy including ADM. Irritative urinary symptoms were observed in 11 of the 19 patients (57.9%). However, these symptoms were mild in the majority of patients and the treatment was completed without interruption in all but 1 patient. There was no significant absorption of ADM and VR into the systemic circulation. No clinical evidence of systemic toxicity was observed. These results suggest that combination of ADM and VR has a possibility to be a useful prophylactic intravesical instillation chemotherapy after endoscopic resection of not only primary but also recurrent chemoresistant bladder cancers.

Administration, Intravesical

[Antiandrogen therapy of benign prostatic hypertrophy: clinical effects of allylestrenol evaluated by transrectal ultrasonographic measurement].

A multicenter trial was carried out on 100 patients with benign prostatic hypertrophy to elucidate the efficacy of anti-androgen therapy with allylestrenol (AE). AE was administered at a daily dose of 50 mg for 16 weeks to the patients and its efficacy was evaluated with subjective symptom scores, residual urine volume and uroflow rates. The effects of AE on prostatic volume and morphology were evaluated using transrectal ultrasound. Of these patients 65 completed the protocol, and only three patients withdrew from the study owing to side effects. Very modest adverse effects on sexual performance were seen in one patient. In this study, significant beneficial effects of AE on symptom scores, residual urine, maximum flow rate, and prostate size were demonstrated. However, volumetric reduction was not associated with urodynamic improvement. Prostatic shape was not changed throughout the study. These findings suggest that allylestrenol can be used as an alternative to prostatectomy in patients who are at high risk for surgery.

Aged

Prognostic factors and value of adjunctive nephrectomy in patients with stage IV renal cell carcinoma.

We reviewed 57 cases of Stage IV renal cell carcinoma to clarify the factors influencing prognosis and to evaluate the value of nephrectomy. Cumulative survival from the initial diagnosis was analyzed with respect to the patients' age, sex, side of primary tumor, initial performance status (PS), site of metastasis, and nephrectomy. Overall survival for the patients was 51 percent at one year, 22 percent at three years, and 11 percent at five years. Age, sex, and side of primary tumor had no influence on survival. Improved survival was correlated with good PS, metastases limited to single organ, and removal of the primary tumor. With regard to histopathologic features in nephrectomized patients, low grade and stage were correlated with longer survival. These factors should be considered in the analysis of results of future clinical trials of metastatic renal cell carcinoma.

Aged

[A 17-year experience with ileal conduit urinary diversion--early and late complications].

A series of 185 patients, 133 males and 52 females, were treated by ileal conduit urinary diversion in the past 17 years. The patients ranged in age from 7 months to 81 years with an average of 59 years. Diversions were performed for malignant diseases in 174 patients, 85% of whom underwent a simultaneous radical surgery. The follow-up covered the postoperative period from 4 months to 16 years 8 months with an average of 4 years 8 months. Six patients (3%) died within 1 month of operation, and 43 of a total of 58 mortal cases died of cancer thereafter. The survival rates of 143 patients with bladder cancer were 84% for 1 year, 72% for 3 years, 67% for 5 years, 62% for 10 years and 54% for 15 years. Early complications were noticed in 38% of the patients. Delayed wound healing due to local infection (20%) and intestinal obstruction (10%) were the two major complications in this period. Late complications were encountered in 51% of the patients. Mild peristomal dermatitis (22%) and gradually developing renal complications (22%) are two major problems in the standard ileal conduit urinary diversion. The latter was significantly more frequent in patients who underwent the operation between 1973 and 1981 than in those who had the surgery between 1982 and 1989. Postoperative hydronephrosis was observed in 15 (13%) of 117 patients who showed normal urograms preoperatively. Ileoureteral reflux was observed in 50% of the cases with nonobstructing conduits, while it increased up to 70% along with obstruction of the conduit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Surgical treatment of renal cell carcinoma associated with pulmonary metastasis].

Fifty-nine nephrectomies have been performed in patients with renal cell carcinoma during a 15-year-period from 1973 to 1987 in Fukuoka University Hospital. Of whom 13 had pulmonary metastasis and 10 had other organ metastasis. The 1, 3, 5-year survival rates in patients with metastasis were significantly worse than those without metastasis. No significant difference was observed between the survival rates in patients with pulmonary metastasis and other organ metastasis. Only 1-year-survival rate was better in patients with delayed metastasis after nephrectomy than that of patients with synchronous lung metastasis to the primary tumor. Resection of pulmonary metastasis was performed in 6 patients. Four of them, however, underwent another resection for recurrence in the lung. The average survival periods of the patients with and without surgical removal of pulmonary metastasis were almost same in the alive cases, but in the dead cases there was observed a 26-month-longer survival period in patients undergoing resection of metastatic lesion than those without resection. In conclusion, resection of pulmonary metastasis may not bring eradication of the disease in the majority of cases. However, aggressive surgery for pulmonary metastasis should be accepted because no effective adjuvant therapy is practically available in the treatment of renal cell carcinoma. Additionally, a case was reported of spontaneous regression of a pulmonary metastasis seen in a 61-year-old male with renal carcinoma. The lesion showed an apparent regression after radical nephrectomy on chest films and completely disappeared at 8 months postoperatively. After 9 months disease-free period, heterotopic recurrence developed in the same lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Renal Cell

Barium granuloma involving urinary bladder.

The first case of barium granuloma involving urinary bladder is reported. Surgical removal was the treatment of choice. Histological diagnosis was foreign body granuloma with xanthomatous inflammation. The foreign body was identified as barium by analytical electron microscopy.

Aged

Early intravesical instillation of adriamycin with oral administration of 5-fluorouracil after transurethral resection for superficial bladder cancer: preliminary results.

In all, 199 patients were entered in this study by 21 collaborating hospitals. Patients with superficial transitional cell carcinoma of the bladder were randomized postoperatively into four groups. Group A received early (immediately and 2 days after transurethral resection) instillation of adriamycin (30 mg/30 mg); group B received early instillation of adriamycin with oral administration of 5-fluorouracil (200 mg/day); group C received delayed (7 days after transurethral resection) instillation of adriamycin (30 mg/30 ml); and group D received delayed instillation of adriamycin with oral administration of 5-fluorouracil (200 mg/day). All patients subsequently received instillations weekly for 2 more weeks, and then every 2 weeks for a further 14 weeks. After 4 months, they received one instillation per month for 8 months. 5-Fluorouracil was administered p.o. for 1 year. The postoperative follow-up period was 12 months. After 3 and 6 months there were significant differences in the non-recurrence rates between groups B and C. After 12 months the overall non-recurrence rates were 87.9% in group A, 83.5% in group B, 89.2% in group C, and 82.8% in group D, and there were no significant differences among the four groups. The number of patients entered and the follow-up period are not adequate for firm conclusions, and further studies are necessary. The main side effect was bladder irritation, which was observed in 38.8% of patients in the early instillation groups and in 26.3% of those in the delayed instillation groups. No severe systemic side effects were observed in this study.

Administration, Intravesical