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Biomedical subjects

F Masuda

Publications and source records attributed to F Masuda.

At least 37 records · Page 2Linked to original sources

Influence of differences in tumor vascularity upon the effects of hyperthermia.

Utilizing two types of human renal carcinoma heterotransplanted in nude mice, we investigated the variations in hyperthermic effects (42.5 degrees C for 30 min) caused by differences in tumor type with special reference to variations in tumor vascularity. In the hypovascular JRC1 strain, sporadic vascular dilation was observed throughout the tumors after heating. Destruction of tumor cells was observed mainly in the region of dilation. In the hypervascular JRC11 strain, homogenous vascular dilation was observed immediately after heating, mainly at the periphery of tumors. There was a decrease in the viability of cells in the center of the tumor. Therefore, the hypervascular tumors showed greater destruction mainly at the center where blood circulation was reduced. The range of necrosis was also greatly affected by the extent of vascular dilation caused by heating in hypovascular tumors.

Animals

[Study of blood flow in hyperthermia using human renal cell carcinoma heterotransplanted in nude mice--differences in histological tumour pattern upon the effects of hyperthermia].

Utilizing two types of human renal cell carcinoma heterotransplanted in nude mice (JRC 1; papillary, avascular pattern, grade III, JRC 11; anaplastic and alveolar, hypervascular pattern, grade IV), we investigated the influence of tumor blood flow upon the effects of local hyperthermia (42.5 degrees C), induced by 915 MHz microwave. Blood flow was determined from the rate of thermal clearance by use of the bio-heat transfer equation. The rate of thermal clearance was measured at intervals of approximately 10 minutes throughout the treatment session after turning off the microwave for 50 seconds. With both strains it was necessary to increase the microwave power until the constant steady-state temperature of 42.5 degrees C was reached. The JRC 11 strain needed more power for the constant temperature than JRC 1, but it needed a greater decrease in power level during the heating session to maintain a constant steady-state temperature. This was an indication that the tumour blood flow decreased more markedly in the JRC 11 strain. In both tumours, a decrease of blood flow was observed during the heating session. In the case of the JRC 1 strain, it was observed that the mean value of blood flow was 1.87 times higher than that of JRC 11. This indicated a sharp reduction in blood flow in JRC 11 strain. This reduction was confirmed by the thermal clearance measurement at the end of the treatment session. A sharp reduction in blood flow in hypervascular tumour (JRC 11 strain) is caused by a stasis of intra-tumoural blood circulation during the heating.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

[A clinical study of the renal pelvis and ureteral cancer].

During the 13 years from 1976 to 1988, 160 patients with renal pelvic and ureteral cancer were reviewed based on a new general rule for clinical and pathological studies on renal pelvic and ureteral cancer of Japanese Urological Association. There were 71 renal pelvic cancers, 80 ureteral cancers, and 9 cancers in both regions. Patients ranged in age from 35 to 91 years old (average: 63). The involved side was right in 63 and left in 97. The most frequent symptom was hematuria, which was seen in 81.1%. IVP revealed the findings of filling defects, hydronephrosis, and non-visualized kidney in 99.7% of the patients. Total nephroureterectomy with bladder cuff resection was performed in 123 cases, nephroureterectomy in 16 cases, nephrectomy in 5 cases, partial ureterectomy in 10 case, and biopsy in 6 cases. As adjuvant therapies, irradiation was performed in 32 and chemotherapy in 123. Histologically, 156 were with transitional cell carcinoma, one squamous cell carcinoma, one adenocarcinoma and 2 unclear, the over-all survival rate of this study at 1, 3, 5 and 10 years were 86.8%, 73.0%, 65.3% and 45.6%, respectively. No patient with lymph-node metastasis (N+) survived longer than 5 years. All patients with M(1) died within one year. There were no difference of prognosis between renal pelvic cancer and ureteral cancer. Regarding various prognostic factors, our series gave the same results as previous reports. However, it should be stressed that pathological grading was the most important prognostic factor.

Adult

[Study on clinical characteristics in relation to size of renal cell carcinoma].

Four hundred and thirty-one patients with renal cell carcinoma treated at Jikei University and its related institutions from 1957 to 1988 were studied as to tumour size in relation to clinical characteristics (age, sex ratio, affected side, symptoms), prognostic factor (fever, weight loss, anaemia, elevation of erythrocyte sedimentation rate), pathological staging, pathological grading, and survival. The treated patients were divided into 4 groups on the basis of tumour size (group A; under 3.0 cm, group B; 3.1 to 5.9 cm, group C; 6.0 to 9.9 cm, group D; over 10 cm in diameter). At the time of operation, there were 22 cases (5.1%) in group A, 121 cases (28.1%) in group B, 209 cases (48.5%) in group C, and 79 cases (18.3%) in group D. In studying the clinical factors of age, sex ratio, and affected side, no relationship with size was detected. As for the symptoms, the larger the tumour, the more frequent the symptoms of urinary tract (haematuria, pain, and palpable mass). This tendency was especially marked in the cases of group D (over 10.0 cm in diameter). In addition, no relationships were observed between the rate of haematuria and the symptoms of extraurinary tract in each group. As for the prognostic factors (fever, weight loss, anaemia and the elevation of erythrocyte sedimentation rate), there was an obvious tendency for a positive reaction of these factors in the cases of groups C and D (over 6.0 cm in diameter). As for the distribution of stage and grade in each group, a higher stage and grade were observed with large sized tumours.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Renal Cell

[A clinical and pathological study of small renal cell carcinomas].

Ten cases of a small renal cell carcinoma having a tumor that was 3 cm or less have been studied both clinically and pathologically. In nine of the 10 cases, the tumor had been detected incidentally, and all 9 were asymptomatic. Renal lesion were diagnosed all of the 10 cases by computed tomography and in 9 cases by ultrasonography. The pathological characteristics of small renal cell carcinoma are characterized by an expansive development, an alveolar structure, a clear cell subtype, a low grade nuclear atypism, and a general lack of infiltration. The postoperative follow up period was 20 months on average, and all patients had survived with no appearance of a new lesion.

Adult

[Comparative study of the patients with renal cell carcinoma before and after 1980].

Patients with renal cell carcinoma treated at Jikei University and affiliated institutions were studied with regard to temporal differences. Our study population was divided into two groups: an earlier group comprising 169 patients treated between January 1957 and December 1979, and a later group comprising 165 cases treated between January 1980 and December 1984. The mean age in the earlier group was 56.2 years, while that in the later group was 60.4 years. Therefore, the patients in the earlier group were generally younger than those in the later group. Patients in the earlier group were more likely to present with urinary symptoms at the time of diagnosis. On the other hand, patients in the later group were more likely to present with extra-urinary symptoms or to be asymptomatic. The time period between the onset of symptoms and initial consultation with physician was longer (within one month) in the earlier group. Most patients in the later group underwent nephrectomy using the transperitoneal or thoracoabdominal approach. Few patients in the later group were treated with radiotherapy. As adjuvant chemotherapy, MFC (MMC, 5-FU and Ara-C) or MACV (methotrexate, actinomycin D, cyclophosphamide and vincristine) regimen were most commonly employed in the earlier group. FAV (5-FU, adriamycin and vinblastine) regimen or interferon therapy which was classified as biological response modifiers (BRM) were more commonly employed in the later group. More cases were diagnosed as stage II in the earlier group, and more cases were diagnosed as stage IV in the later group. No significant differences were observed between the earlier and later groups, with regard to 5- and 10-year survival rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[A case of paratesticular rhabdomyosarcoma].

A case of paratesticular rhabdomyosarcoma in an 18-year-old male is reported. The patient was admitted for swelling of the right scrotum and right inguinal pain. Malignant tumor of the right testis was suspected and a high inguinal orchiectomy was performed. The pathological diagnosis was paratesticular rhabdomyosarcoma. Following retroperitoneal lymph node extirpation, chemotherapy, so-called CYVADIC therapy, consisting of cyclophosphamide, vincristine, adriamycin and dacarbazine was employed in 3 regions. The patient is in good health without recurrence 16 months after the surgery.

Adolescent

[Clinical study of undifferentiated renal cell carcinoma in comparison with well differentiated cases].

UNLABELLED: During the past 28 years, 397 patients with renal cell carcinoma were treated at The Jikei University Hospital and its related institutions. Of these, 44 cases with undifferentiated renal cell carcinoma (grade IV) were compared with well differentiated cases (grade I), with regard to following 5 clinicopathological items: 1) general clinical features such as distribution of patient ages, sex ratio, affected side, the relationship of age and the volume of nephrectomized kidney, 2) angiographic appearance, 3) distribution of stages, 4) distribution of metastatic organs, 5) survival rates of each grade and each stage. THE RESULTS: 1) There was no specific trend in the distribution of affected ages, sex ratio and affected side of the tumour, but the volume of nephrectomized kidney in grade IV cases was much larger than that of the kidneys in grade 1 cases. Furthermore, in grade IV cases, the older the patient, the much lighter was the nephrectomized kidney. 2) No specific trends were observed in the angiographic pattern in the two groups. 3) Regarding stages, 75% of patients with the grade IV had stage IV carcinoma. But, 69% of patients with grade I had stage I. 4) Grade IV patients had a high incidence of lung and liver metastasis compared with grade I, which had a high incidence of bone metastasis. 5) Patients in grade IV and in grade I with stages I-III carcinomas lived longer than any grade with stage IV. So the undifferentiated renal cell carcinoma should be treated with adjuvant therapy even in low stage.

Adult

Hyperthermia with simultaneous administration of interferon using established human renal carcinoma heterotransplanted in nude mice.

Using human renal carcinoma heterotransplanted in nude mice, the effects of the combined use of hyperthermia and interferon (natural human interferon-alpha; IFN-alpha, and recombinant interferon-gamma; IFN-gamma) were examined. The hyperthermic device used was the Clini-Therm, Mark VII, 915 MHz, microwave. The administration of interferon was started immediately before hyperthermia and carried out on consecutive days. The combined use of hyperthermia and IFN was compared with hyperthermia and with IFN alone. The combined use of hyperthermia and IFN-alpha was shown to have significant anti-tumour effects compared with the former or latter alone. Of 10 nude mice (10 implanted tumours) used for the experiment, 5 showed complete disappearance of the implanted tumours and the others showed prolongation of survival. Combined treatment with IFN-gamma and hyperthermia showed no significant effect when compared with other treatment groups. Combined treatment with local hyperthermia and IFN-alpha may have some application to the clinical management of renal carcinoma.

Animals

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

[Partial nephrectomy for renal tumors].

We performed partial nephrectomy in 5 patients with renal tumors. In 1 patient with synchronous bilateral renal cell carcinoma, radical nephrectomy was conducted simultaneously for the contralateral kidney. The second patient had a transitional cell carcinoma of the renal pelvis of the contralateral side, for which the pelvis was resected simultaneously. In the remaining 3 patients the contralateral kidney was normal. In these patients the tumor was less than 3.0 cm in size and localized in either the upper pole or peripheral region, for which partial nephrectomy was performed. The weight of the resected kidney ranged 6 to 35 g with a mean of 18.2 g. The tumor size was 1.8 to 4.0 cm, the mean being 2.4 cm. Tumor grading was renal cell carcinoma grade 1 in 2 patients, grade 2 in 2 patients and oncocytoma in one patient. In all patients the tumor was encapsulated with a pseudocapsule with no involvement of the perinephric fat, venous or regional lymph nodes, and the tumor was diagnosed as pT2V0N0M0, stage I. In none of the patients intraoperative or postoperative complications developed with renal function of the operated kidney normal. The follow up interval after the operation was 5 years in 1 patients and 6 months to 1 year and 2 months in the remaining 4 patients. All patients have survived without metastasis or local recurrence in the operated kidney. We believe that partial nephrectomy is worth performing in selected patients with renal cell carcinoma not only in those having lesion in solitary kidney or bilateral kidneys but also in those whose function of the contralateral kidney is normal.

Adenoma

[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

[A partial nephrectomy in renal cell carcinoma].

Two patients with a renal cell carcinoma under went a partial nephrectomy. In both these cases the renal cell carcinoma had been detected incidentally and the lesion was a localized small tumor. Therefore, a partial nephrectomy was performed similarly, the tumor size was 1.8 x 1.7 cm in both cases, but the histologic grading was grade 1 in one case and grade 2 in the other though the stage was pT2VoNoMo, stage 1 in both. We thus consider it recommendable that a partial nephrectomy be performed not only in cases of a solitary or bilateral renal cell carcinoma but also in selected cases of a renal cell carcinoma with normal contralateral kidney.

Carcinoma, Renal Cell

[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