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Biomedical subjects

H Aoshi

Publications and source records attributed to H Aoshi.

14 recordsLinked to original sources

Schinzel-Giedion syndrome.

A 2-month-old girl was brought to the Department of Pediatrics at Wakayama Rosai Hospital because of poor feeding since 1 month of age. She was the third child of young healthy non-consanguineous parents whose first son was healthy but whose second son had died of 18 trisomy. Physical examination showed midfacial hypoplasia with coarse dysmorphic features, choanal stenosis, remarkable abdominal distention and bilateral talipes equivarus. Abdominal ultrasonography, computed tomography and drip infusion pyelogram showed left severe hydronephrosis and right moderate hydronephrosis. Having diagnosed Schinzel-Giedion syndrome, a left ureteroneocystostomy with tailoring was performed to preserve renal functions and to eliminate the urinary tract infection at the age of 3 months.

Abnormalities, Multiple↗

[A case of retrovesical fibrosarcoma with severe hypoglycemia].

We report a case of retrovesical fibrosarcoma with severe hypoglycemia. A 67-year-old man was admitted to our hospital with second recurrence of the retrovesical tumor with hypoglycemia. The episodes of hypoglycemia were accompanied by the advance of tumor size. Complete tumor resection with total cystectomy was performed on December 21, 1989, and the tumor was diagnosed histopathologically as fibrosarcoma. Soon after removal of the tumor, hypoglycemia disappeared and the patient has been well without local recurrence or distant metastasis for more than 20 months.

Aged↗

[Clinical evaluation of patients with relapsed prostatic carcinoma].

A retrospective clinical study of 41 patients with prostatic carcinoma relapsing after endocrine therapy at Wakayama Medical College from 1972 to 1987 was reported. Patient's age was from 51 to 80, with an average of 69.8 years. Initial clinical stage was A in 2 patients, C in 12, D in 26 patients and unknown in one. Pathological grade at the first visit was well-differentiated cell type in 4 patients, moderately differentiated in 13, poorly differentiated in 23 patients and unknown in one. Of 41 patients, 32 had a local progression and 26 had an appearance or progression of metastasis. Several factors which might be related to the interval between initial endocrine therapy and relapse were analysed. Following factors such as poorly differentiated cell type, stage D, high Gleason score and increase in acid phosphatase level were revealed to be related to the short interval. Chemotherapy consisting of various agents and their combination has not been able to improve the survival of the patients with relapsed prostatic carcinoma. 1-year survival rate of all cases after relapse was 41.3% and none of the patients survived over 3 years.

Aged↗

Nephrectomy in situ: treatment of ureteral fistula due to progressive malignancy.

The authors report 2 patients with recurrent retroperitoneal neoplasms in whom ureteral fistulas were treated successfully by percutaneous transcatheter embolization of the renal artery with absolute ethanol. Angio-occlusive nephrectomy is suggested as an alternative to surgical nephrectomy in seriously ill and high-risk patients to preserve their quality of life.

Aged↗

Urethral remnant tumors following simultaneous partial urethrectomy and cystectomy for bladder carcinoma.

Partial urethrectomy (at least to the bulbous portion) was performed simultaneously in 128 consecutive male patients undergoing radical cystectomy for bladder cancer. Transitional cell carcinoma developed subsequently in the distal urethral remnant in 5 patients (4.0%) followed for 2.6 to 5.7 years (mean 4.1 years) postoperatively. These 5 patients originally had nonpapillary, multifocal and histologically high grade (5) and low stage (4) bladder cancer, 4 with associated carcinoma in situ. Our results suggest that simultaneous total urethrectomy should be considered strongly for patients with high grade nonpapillary multifocal bladder cancer associated with carcinoma in situ. Furthermore, the pattern of distal urethral recurrence in our patients may provide information regarding the appropriate management of the male urethra in potential candidates for continent urinary diversion.

Aged↗

Intravesical Bacillus Calmette-Guérin treatment for superficial bladder tumours.

Intravesical instillations of Tokyo 172 strain BCG were given to 56 patients with superficial bladder cancer during the 24-month period after transurethral tumour resection as a prophylaxis against tumour recurrence. The recurrence rate of tumours was compared with that of historical controls. Results were estimated by the person-years method and there were statistically significant decreases in recurrent tumours following BCG therapy. Our results suggest that the intravesical Tokyo 172 strain BCG is effective and safe as a prophylaxis against the recurrence of superficial bladder tumours.

Administration, Intravesical↗

[Occupational uroepithelial cancer: current status in Wakayama city and clinical study].

According to the records of Wakayama Labor Standard Office, at least 1,085 workers had been exposed to benzidine or beta-naphthylamine in the dyestuff factories in Wakayama City. By October 1988, 101 of them (9.3%) were confirmed to have urinary tract tumors. Including 2 other cases exposed in Osaka, a total of 103 cases of occupational uroepithelial cancer were studied here clinically. Site of tumors was bladder in 91 cases, renal pelvis in 2, ureter in 5 and papillomatosis type in 5. The age at the time of diagnosis ranged from 25 to 87 years with a mean of 53.8 years. The average latent period was 22.7 years, but the older the age of the worker at the start of exposure, the shorter was the latent period. In Wakayama, the proper system of healthy examination for chemical workers using urinary cytology was begun in 1970. Since then, more tumor cases have been discovered in comparison to the patients admitted with subjective symptoms of hematuria. The effectiveness of this group examination was significant in the incidence of total cystectomy in surgical treatment and in survival rate. In the comparative study between the groups of patients with occupational and spontaneous bladder cancer, the average age at diagnosis in the former was about ten years younger. Although the histological grade of tumor was not different between the two groups, the incidence of total cystectomy was lower and the survival rate was significantly higher in the occupational group.

2-Naphthylamine↗

[Renal cell carcinoma associated with tuberous sclerosis: a case report].

Renal angiomyolipoma associated with tuberous sclerosis is well known. On the other hand, few cases of renal cell carcinoma in connection with tuberous sclerosis have been reported. We report a patient with tuberous sclerosis whose kidney was involved with renal cell carcinoma. A 18-year-old woman was first admitted in August 1987 for evaluation of left renal tumor. Diagnosis of tuberous sclerosis was made when she was 11 years old on the basis of mental retardation, papules on her face, seizures, white leaf-shaped macules and periventricular calcifications. Computerized tomographic scan demonstrated a large mass arising from the left kidney and small masses in the right kidney. Angiography confirmed bilateral hypervascular renal tumors. On these bases, a clinical diagnosis of bilateral renal angiomyolipomas was made and surgical treatment of the left kidney was recommended because of its large size. However, her parents did not permit treatment until March, 1988. Finally, left nephrectomy of 4,750 g was performed and histological examination revealed renal cell carcinoma with clusters of spindle cells. In the literature available to us, we found twelve reports of malignant renal tumors associated with tuberous sclerosis including five renal cell carcinomas in Japan.

Adolescent↗

[Clinical studies on urinary tissue polypeptide antigen (TPA): problems and improvement in determination].

The reliability of measurement of urinary TPA using a Prolifigen TPA kit (Sangtec, Sweden) was investigated, and an improved method for stabilizing TPA was tested. Samples were filtrated with a cellulose nitrate membrane filter to remove impurities as a possible cause of a high false positive rate which has been a problem in urinary TPA measurement. Serum TPA and Tween 40-treated urinary TPA was not adsorbed by the filter, whereas TPA in the non-treated urine showed a marked affinity to the filter. This shows the instability of TPA in the original urine, and the impropriety of filtration as a measure of purification of urine samples. The dilution test of urine and the standard TPA, and the recovery test of the standard TPA added to 6 different urine samples showed reasonable results only when the samples were treated with Tween 40; otherwise the values were lower than expected. Thirty-four spot urine samples were tested to examine the change in TPA value during the storage for 24 hours. TPA values decreased when urine was stored at room temperature, but this change was prevented by treatment of urine with Tween 40.

Biomarkers, Tumor↗

Occurrence of uroepithelial tumors of the upper urinary tract after the initial diagnosis of bladder cancer.

We treated 519 patients with primary bladder cancer, of whom 12 had upper urothelial tumor during followup. Almost all patients had superficial bladder cancer at diagnosis. All but 1 of 12 patients who underwent total cystectomy with ileal conduit diversion also underwent various transurethral procedures for treatment of the primary bladder lesions. The over-all incidence of bladder cancer patients who subsequently had upper urinary tract tumors was 2.3 per cent. Among the patients with treated bladder tumors a higher incidence (13.2 per cent) was observed in dye workers than in the general population (1.1 per cent). The interval between initial treatment of the bladder cancer and diagnosis of the upper urinary tract tumor ranged from 7 to 170 months (mean 70 months). The frequency of upper urinary tract tumors increased with time. We conclude that the appearance of upper urinary tract tumor after diagnosis of primary bladder cancer may be promoted by nonspecific irritation of the urothelium, which previously was made unstable by urinary chemical carcinogens.

Aged↗

[Foreign body in the kidney: report of a case].

A 49-year-old man was admitted with the suspicion of renal foreign body. A fragment of wire rope was penetrated from his right lumbar region while working. Drip infusion pyelography and computed tomography films revealed a linear metallic object in the region of the right kidney. The foreign body was successfully extracted from the right renal parenchyma. The 38 cases of foreign bodies in the upper urinary tract including 12 in the renal parenchyma found in the literature are reviewed.

Accidents, Occupational↗

[Adrenal incidentaloma: report of eight cases].

Since 1983, eight cases of adrenal incidentaloma were experienced at the Department of Urology, Wakayama Medical College and affiliated hospitals. Six adrenal masses were incidentally detected by computed tomography, and two were first noted by either ultrasonography or intravenous pyelography. Surgical exploration was performed in all cases as the final diagnostic measure. Of them, three had adrenocortical adenomas, three had adrenal cysts, one had adrenal metastasis and one had pheochromocytoma. Preoperative evaluation revealed that all patients except one with pheochromocytoma had no endocrinological abnormality. The management of the adrenal incidentaloma, which will be discovered more frequently accompanied with the increasing use of computed tomography, was discussed with special references to its precise indication of surgical treatment.

Adenoma↗