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Biomedical subjects

E Higashihara

Publications and source records attributed to E Higashihara.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Comparison of Tandem-R PSA and Markit-M PA in the diagnosis of prostate cancer].

The Tandem-R PSA (TR) assay was compared with the Markit-M PA (MM) assay in the diagnosis of the prostate cancer. In patients with a serum prostate specific antigen (PSA) level higher than the cut-off values measured by either the TR assay or the MM assay (4.1 ng/ml and 3.7 ng/ml, respectively), or a suspicious digital rectal examination, sextant biopsy of the prostate was performed. Among 227 patients undergoing biopsy, 64 patients were diagnosed as having prostate cancer. There was a significant difference of serum PSA values between patients with and without prostate cancer in either assay. There was no significant difference between the assays with respect to diagnosing according to prostate cancer using receiver operating characteristic analysis. The correlation between TR and MM in 150 men with a serum Tandem-R PSA below 10 ng/ml was Y = 1.12X + 3.745 (R = 0.68, p < 0.001). The correlation coefficient for the relationship between TR and MM was only 0.68, indicating a poor correlation. Four of the 15 patients with MM values below 4.0 ng/ml calculated by transformation from MM to TR values had prostate cancer. This suggested that conversion of MM values to TR values in the low PSA range presents problems.

Aged↗
PubMed1998

Molecular staging of prostate cancer: comparison of nested reverse transcription polymerase chain reaction assay using prostate specific antigen versus prostate specific membrane antigen as primer.

BACKGROUND: We examined the utility for prostate cancer staging of nested reverse transcription polymerase chain reaction (RT-PCR) using either prostate specific antigen (PSA) or prostate specific membrane antigen (PSM) as primer. METHODS: LNCaP cells were used for the in vitro quantification of RT-PCR. RT-PCR was performed on the peripheral blood of 105 control subjects and 63 patients with prostate cancer (32 who eventually underwent radical prostatectomy and 31 with clinical stage D2 cancer). RESULTS: The nested RT-PCR for the PSA and PSM primers was able to detect 1 LNCaP cell per 10(6) leukemia (K562) cells. None of the control subjects was found positive for the presence of prostate cancer cells by nested RT-PCR. In the 32-patient surgery group, the results of nested RT-PCR were significantly correlated with the pathologic stage of the cancer when using PSM primers (P=2.00 x 10(-3) by Kendall's correlation test) but not when using PSA primers (P=0.06). Extraprostatic extension was significantly more closely correlated with positive PSM nested RT-PCR results (P=0.012 by Fisher's exact probability test) than with positive results of PSA, nested RT-PCR, digital rectal examination, CT imaging, level of serum PSA or Gleason score. In the untreated stage D2 patients, the positive result rate of PSM nested RT-PCR was significantly higher than that of PSA nested RT-PCR (P=0.025 by McNemar test). CONCLUSION: Nested RT-PCR using PSM primers appears to predict the prostate cancer stage more accurately than does nested RT-PCR using PSA primers or conventional clinical staging modalities.

Aged↗
PubMed1998

Prevalence and renal prognosis of diagnosed autosomal dominant polycystic kidney disease in Japan.

UNLABELLED: The prevalence and renal prognosis of diagnosed autosomal dominant polycystic kidney disease (ADPKD) in Japan were estimated. Hospital-based nationwide surveys were conducted in 1995. The number of ADPKD patients who visited hospitals but were not on chronic dialysis was estimated to be 10,000 (95% confidence interval: 8, 200-11,900) and that of ADPKD patients on dialysis was 4,590, yielding a prevalence of ADPKD of 117 per million population at the end of 1994 (95% confidence interval: 102-132). The prevalence increased with age and reached a peak value of 261 per million population at the age group of 55-59 years. The rate of end-stage renal disease among living patients was calculated based on the assumption that the prevalence of ADPKD in the population under the age of 55 years was 261 per million population. The rate of end-stage renal disease increased with the progression of the patients' age, reaching 49% at the age of 65-69 years and declining thereafter. CONCLUSION: The hospital-based prevalence of ADPKD is lower than the autopsy-based prevalence, suggesting that a fairly large number of these patients do not receive medical care in their lifetime. The probability of end-stage renal disease is at most 50% among ADPKD patients who visit a hospital.

Adolescent↗
PubMed1998

Learning curve and conversion to open surgery in cases of laparoscopic adrenalectomy and nephrectomy.

PURPOSE: We examine how the level of experience acquired by the laparoscopist affects the outcome of laparoscopic adrenalectomy and nephrectomy, and what is necessary to avoid complications in these surgeries. MATERIALS AND METHODS: We retrospectively evaluated the experience levels of 8 urological laparoscopists between 1991 and 1995. In addition, other cases that were converted to open surgery were collected from the institutes with which the 8 laparoscopists were affiliated. RESULTS: The rates of conversion to open surgery were 6.4% in 204 cases of adrenalectomy and 14.3% in 63 of nephrectomy. Conversion rates were related to blood loss volume but not operative time. The major causes of conversion were bleeding in 45% of cases and adhesion in 34%. There were no mortalities. Mean operative time decreased significantly, reaching that of open surgery as the number of procedures increased up to 20 adrenalectomies and 10 nephrectomies. The volume of blood lost remained low from the early experience. Blood transfusion rates were 4.4% for adrenalectomy and 11.1% for nephrectomy. CONCLUSIONS: Operative time of these procedures decreased significantly with surgeon experience and reached that of open surgery. Cases in which adhesion is anticipated should be restricted to avoid conversion. These laparoscopic procedures are acceptable as a standard operative techniques for adrenal and renal diseases.

Adrenal Gland Diseases↗
PubMed1997

Expression of Fas in renal cell carcinoma.

We have investigated whether the Fas-mediated cell death pathway is functional in renal cell carcinoma. The expression of Fas in surgical specimens and cell lines of renal cell carcinoma was examined. Fas expression was positive in six out of 18 tumors measured by flow cytometry and was prominent in advanced tumors. Three out of the six Fas-positive tumors had already metastasized at the time of surgery. A significant correlation was found between the tumor volume and the percentage of Fas-positive cells in a tumor (r = 0.70, P = 0.0007). Fas-positive tumors were larger than Fas-negative tumors [mean tumor volume (ml) +/- SD, Fas(+), 265.6 +/- 136.8; Fas(-), 65.8 +/- 80.9, P = 0.0012]. All human renal carcinoma cell lines tested (ACHN, Caki-1, SMKT-R-2, SMKT-R-3 and SMKT-R-4) expressed Fas abundantly, as Fas-positive cells accounted for > 50% in all cell lines by flow cytometry. Treatment with anti-Fas antibody caused apoptosis in Fas-positive renal cell carcinoma cell lines. However, the effectiveness of apoptosis induction in individual cell lines was not correlated with the level of Fas expressed. These data suggest that Fas targeting may be a therapeutic option for treatment of advanced renal cell carcinoma which is refractory to either chemotherapy or irradiation.

Apoptosis↗
PubMed1996

Significance of free prostate-specific antigen and gamma-seminoprotein in the screening of prostate cancer.

BACKGROUND: Since free prostate-specific antigen (PSA) and gamma-seminoprotein (gamma-SM) recognize similar epitope(s) of PSA, the significance of serum-free PSA and gamma-SM in the early detection of prostate cancer was compared. METHODS: A prospective clinical trial was conducted on 701 male volunteers, age 50 years or older. Free PSA (Tandem-R free PSA, Hybritech) and gamma-SM (gamma-SM, Chugai) levels were determined, and biopsies were performed if the PSA (Tandem-R, Hybritech) level was > 4 ng/ml, or if digital rectal examination (DRE) was suspicious. RESULTS: One hundred and eighty-seven men (27%) had either a PSA level > 4 ng/ml or a suspicious DRE. Of 116 biopsies performed, cancer was detected in 13 (1.9%, 13/701). Receiver-operating characteristic analysis of free PSA to PSA ratio (free PSA ratio, %) and gamma-SM to PSA ratio (gamma-SM ratio), to differentiate normal biopsy findings from cancer, showed that the optimal values were 12% and 0.38, respectively. Positive predictive value for cancer was 24% (12 cancers/50 biopsies) for PSA alone, 42% (8/19) for the combination of PSA and DRE, 45.5% (10/22) for the combination of PSA and gamma-SM ratio, and 50% (10/20) for the combination of PSA and free PSA ratio. Regression analysis showed that gamma-SM highly correlated with free PSA, but that the analytical detection limit of gamma-SM was 1 ng/ml, significantly higher than that of free PSA. CONCLUSIONS: Free PSA determination might effectively eliminate unnecessary biopsies in subjects with PSA > 4 ng/ml, and gamma-SM might provide a complementary index to free PSA, but its validity should be further studied in other settings, such as after radical prostatectomy or during endocrine treatment.

Aged↗
PubMed1996

Significance of serum free prostate specific antigen in the screening of prostate cancer.

PURPOSE: The significance of serum free prostate specific antigen (PSA) in the screening of prostate cancer was examined. MATERIALS AND METHODS: A prospective clinical trial was conducted on 701 male volunteers 50 years old or older. Serum free PSA was determined and biopsies were performed if PSA was greater than 4 ng./ml. or if digital rectal examination was suspicious for cancer. RESULTS: Of the men 187 (27%) had a PSA of greater than 4 ng./ml. (11%) and/or a suspicious digital rectal examination (19%). Of 116 biopsies performed in the 701 men cancer was detected in 13 (1.9%). PSA detected more tumors (12 of 13, 92%) than digital rectal examination (9, 69%). Receiver operating characteristic analysis showed that the optimal free PSA-to-PSA ratio (free PSA ratio) was 12%. The positive predictive value for cancer according to PSA with free PSA ratio (50%, 10 cancers in 20 biopsies) was significantly greater (p = 0.0473) than that according to PSA alone (24%, 12 cancers in 50 biopsies), which indicated that 30 of 50 biopsies were avoided with only 2 cancers missed when PSA and free PSA were used for biopsy indication. CONCLUSIONS: Free PSA determination might eliminate unnecessary biopsies in men with a PSA of more than 4 ng./ml. with minimal missed cancers.

Aged↗
PubMed1995

[Evaluation of advanced bladder tumor].

Ninety-two cases of advanced bladder tumor treated at the University of Tokyo and branch hospital from January 1977 to December 1992 were analyzed. The advanced bladder tumor was defined as that of higher than pT2 (according to the General Rule for Clinical and Pathological Studies on Bladder Cancer) or that with distant metastases. The following variants were evaluated, the therapeutic methods, the histological type, grade, stage, type of infiltration. The evidence of lymphatic infiltration, vessel infiltration, and lymph node metastases were also reviewed. The survival rate was calculated using Kaplan-Meier's method. In the cases with lymph node metastases, the survival rate was significantly lower than in the cases without metastases (p < 0.01), while no other factors affected the survival rate.

Combined Modality Therapy↗
PubMed1995

[Histochemical expression of proliferating cell nuclear antigen (PCNA) for pre and post chemotherapeutic bladder cancer].

We examined whether the staining of proliferating cell nuclear antigen (PCNA) could be useful as a marker of chemotherapeutic effectiveness in nine patients with invasive bladder cancer treated by bilateral internal iliac artery infusion of cisplatin (CDDP). Two types of monoclonal antibodies PC-10, 19A2 were used for immunohistochemical staining in formalin-fixed, paraffin-embedded tissue sections. There was no difference between positive rates of PC-10 and 19A2. The mean positive rates between pre-chemotherapeutic specimens (15.4 +/- 6.7%) and post-chemotherapeutic specimens (4.2 +/- 3.1%) showed statistically significant difference (p < 001). The immunohistochemical evaluation of PCNA has value for investigation of cell's turnover. Therefore, the changes of PCNA-positive rate could be a historical parameter for the evaluation of chemotherapeutic effects.

Aged↗
PubMed1995

[Association of malignant neoplasms of other organs in patients with primary hyperparathyroidism].

There are several reports of an increased occurrence of nonparathyroid cancer in patients with primary hyperparathyroidism. Whether there is a cause and effect relationship has not been established. Especially, the coexistence of the parathyroid and thyroid tumors appears significantly high. Recently PRAD 1 was determined the one of the oncogenes of parathyroid adenoma. Interest in PRAD 1's role with respect to oncogenesis has been intensified by its incrimination in other, nonparathyroid, human tumors. If properly conducted surveillance programs do indicate a higher likelihood of cancer in patients with primary hyperparathyroidism, the current philosophy that the patient with mild and asymptomatic hyperparathyroidism does not need the surgery must be reevaluated.

Adenoma↗
PubMed1994

Mediation of renal cyst formation by hepatocyte growth factor.

Hepatocyte growth factor (HGF) is a potent mitogen for renal tubular cells, and HGF and its receptor (c-met proto-oncogene product, Met) can induce lumen formation in epithelial cells. We measured the concentration of HGF in cyst fluids from patients with renal cystic diseases. The concentration of HGF was high in proximal cyst fluid (mean 2.45 vs 0.42 ng/mL in distal cysts). Cyclic AMP concentration was higher in distal than in proximal cysts (663 vs 6.0 pmol/L). mRNA of HGF and Met were co-expressed in cyst walls from cases with polycystic kidney disease. These findings suggest that HGF is a growth factor that may mediate human renal cyst genesis.

Base Sequence↗
PubMed1994

[Treatment of advanced prostatic cancer--chronological change between 1975 and 1991].

A chronological analysis of the clinical features and treatments of advanced prostatic cancer, stages C and D, was performed in 154 cases treated from 1976 through 1991. These cases were divided into two chronological groups: 61 cases treated between 1976 and 1983, and 93 cases between 1984 and 1991. Concerning demographic features and diagnosis, the number of patients with lymph node metastasis was higher in the latter group. There was also increase in cases who were urologically asymptomatic and detected by checkup digital rectal examination or by the elevation of serum prostatic tumor markers. Histopathological differentiation was consistent between the two groups; more than 70% of cancers were moderately and poorly differentiated adenocarcinoma. As for the treatment, total prostatectomy was performed in eight cases in the latter against none in the earlier, but hormonal therapy remained the main treatment throughout the periods: 74.2% in the earlier and 70.7% in the latter. However the methods of the therapy have clearly changed; estrogens and castration were used less often in the latter period, while LH-RH analogues and antiandrogens replaced them although the therapy was equally effective in 82.3% of the cases in the earlier and in 90.4% in the later period and five-year survival rate and the progression-free survival rate at three years showed no significant difference between the two periods. These results showed 1) refined quality of diagnosis 2) a change in mode of hormonal therapy and 3) no detectable improvement of survival in these 16 years. Development of more effective therapies would be warranted for a better survival.

Aged↗
PubMed1994

[Two-color flow cytometric analysis of lymphocytic subsets in renal cell carcinoma].

The subsets of tumor infiltrating lymphocytes (TILs) in 17 patients with renal cell carcinoma were studied by two-color flow cytometry and immunohistochemistry. In grade 1 tumors, CD4-positive cells were significantly increased compared to grade 2 and 3 tumors (35 +/- 7% vs 25 +/- 10%) (p < 0.05). In 10 of 14 patients, CD8-positive cells were predominant over CD4-positive cells, resulting in less than one in CD4/CD8-ratio. Regarding CD4 cells in all 17 cases, the helper T-cells (CD4-positive and CD45RA-negative) were statistically predominant over the inducer T-cells (CD4-positive and CD45RA-positive) (p < 0.01). When CD8 cells were investigated in 16 out of the 17 cases, the cytotoxic T-cells (CD8-positive and CD11b-negative) were found also significantly predominant over the suppressor T-cells (CD8-positive and CD11b-positive) (p < 0.01). Immunohistochemically, the infiltrating pattern of TILs in the 17 patients was classified into cluster (N = 4), separate (N = 6), and mixed types (N = 7). The tumor in the cluster and mixed type had a tendency to be dominant in low grade tumors, and had the prominent CD8-positive cells (more than 90% were cytotoxic T-cells) over CD4-positive cells. However, no statistical significance was noted in this finding. The advanced tumor tended to show the single type of TIL infiltration. These results suggest that cytotoxic T-cells consisted of most of TILs in cluster and mixed types play an immunoreactive role against renal cell carcinoma.

Adult↗
PubMed1994

[Objective and subjective response in stage D2 prostate cancer patients with cancer pain].

Fourty-eight patients with stage D2 prostate cancer, initially treated with endocrine therapy at the University of Tokyo between 1981 and 1990, were followed up and analysed. For the assessment of a subjective response, pain score, narcotic score, and performance stages (PS) were used. Of the fourty-eight patients, twenty-one suffered from cancer pain due to bone metastases. These patients showed significantly (p < 0.01) more lesions of bone metastases and higher PS, compared with patients without cancer pain. The progression free survival of these patients was significantly (p < 0.01) lower than that of patients without cancer pain, although the actuarial survival was not significant. In twenty-one patients with cancer pain, the objective and subjective response rates to endocrine therapy were 75% and 86%, respectively. The duration of pain relief was 1.25-54 (median 19) months. Those rates to anti-cancer chemotherapy in refractory patients (8 patients) previously treated with endocrine therapy were both 25% and those to additional administration of flutamide (FUL) or diethylstilbestrol (DES) in refractory patients (6 patients) were 33% and 100%, respectively. Although the duration of pain relief was 0.78-8 (median 2) months, the additional administration of DES or FLU led to pain relief and improved quality of life (QOL) in all 6 patients. Endocrine therapy such as LH-RH agonist and non-steroidal pure anti-androgen, which has no severe side effects, would be of great usefulness in stage D2 prostatic cancer patients with pain on the basis of efficacy and safety.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗