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Haruaki Kato

Publications and source records attributed to Haruaki Kato.

At least 19 recordsLinked to original sources
PubMed2006

Radical retropubic prostatectomy through a minimal incision with portless endoscopy: our initial experience.

Twenty-one patients with clinically localized prostate cancer underwent minilaparotomy radical retropubic prostatectomy through a single 5-cm midline or Pfannenstiel incision. A 30 degrees laparoscope was usually positioned around the edge of the incision to facilitate the procedure. The mean operating time was 255 min. The mean blood loss was 859 mL, and no patient required an allogenic blood transfusion. Postoperative pain was noticeably reduced, especially in the Pfannenstiel incision group. Endoscope-assisted minilaparotomy did not involve a learning curve, and could be useful for most urologic surgeons as minimally invasive surgery.

Aged↗
PubMed2006

Churg-Strauss syndrome presenting with eosinophilic prostatitis.

We report a patient with eosinophilic prostatitis associated with Churg-Strauss syndrome. A 74-year-old man, who had been treated for asthma, underwent transurethral resection of the prostate. After the operation he had a high temperature of approximately 40 degrees C. The differential blood count revealed marked eosinophilia of 77.5%. The patient received 20-mg prednisolone and dramatically became afebrile. The pathological diagnosis was eosinophilic prostatitis. These findings strongly indicate Churg-Strauss syndrome.

Aged↗
PubMed2006

Annular rectal constriction due to infiltration by bladder cancer.

Invasive bladder cancers frequently show lymphatic or hematogenous metastasis. Furthermore, aggressive local invasion into adjacent structures is also commonly observed. However, the occurrence of rectal stricture due to infiltration by bladder cancer is relatively rare. Here, we report three patients with aggressive bladder cancer causing rectal obstruction.

Aged↗
PubMed2005

A clinical entity of cystic dilatation of the utricle associated with hemospermia.

PURPOSE: We investigated the mechanism of hemospermia in patients with a midline cyst (MLC) of the prostate, focusing on cystic dilatation of the utricle (CDU) as a possible causative lesion. MATERIALS AND METHODS: Of 138 patients with hemospermia 30 (22%) had an MLC, of whom 19 underwent transperineal needle aspiration of the MLC and bilateral seminal vesicles to determine the site of bleeding. Following MLC aspiration a mixture of dye and contrast medium was injected. The verumontanum was observed endoscopically and pelvic x-ray was done. RESULTS: Seminal vesicle fluid on 1 or 2 sides was hemorrhagic in 13 of the 19 patients (aspiration failed in 6) and fluid from the MLC was nonhemorrhagic in 5 of the 19 (aspiration failed in 7). The MLC communicated with the urethra (CDU) in 15 patients (79%) and with 1 or 2 ejaculatory ducts in 11 (58%). In 5 of 11 patients with communication with the ejaculatory duct hemospermia persisted for more than 1 year. Four of these patients were cured by transurethral unroofing of the CDU. CONCLUSIONS: CDU is a significant underlying lesion for hemospermia. Communication with the ejaculatory ducts was frequent in patients with chronic hemospermia and transurethral unroofing was effective for eliminating hemospermia.

Adult↗
PubMed2005

Female para-urethral adenocarcinoma: histological and immunohistochemical study.

BACKGROUND: Female urethral cancer with a diverticular form is assumed to originate from the para-urethral duct, which is embryologically homologous to the male prostate gland. The purpose of the present paper was to investigate the female para-urethral adenocarcinomas histologically and immunohistochemically. METHODS: Surgical specimens obtained from six female patients with para-urethral adenocarcinomas were examined histologically, and an immunohistochemical study using antibodies against carcinoembryonic antigen (CEA), prostate specific antigen (PSA), and chromogranin A was performed. RESULTS: On histologic examination, the female para-urethral cancers were divided into five cases of mucin-producing-type adenocarcinoma and one case of clear cell-type adenocarcinoma. All five mucin-producing-type adenocarcinomas were positive with anti-CEA, and two of them showed neuroendicrine differentiation. One of them showed a focally positive area with anti-PSA. The clear cell-type adenocarcinoma had no positive reactions to these antibodies. CONCLUSIONS: On the basis of histologic structure, positive CEA staining, and the presence of focal neuroendocrine differentiation, mucin-producing-type adenocarcinomas may arise from the proximal part of the para-urethral duct.

Adenocarcinoma, Clear Cell↗
PubMed2005

Anatomical and histological studies of so-called Müllerian duct cyst.

BACKGROUND: We examined so-called Müllerian duct cysts both histologically and immunohistochemically with anatomical observation to investigate the etiology of the 'Müllerian duct cyst'. METHODS: Five cystic lesions located in the prostatic midline were obtained from surgical specimens. A communication between the cystic lesion and the urethra via the utricular orifice was looked for and the specimens were subjected to histological and immunohistochemical testing. RESULTS: A communication between the cyst and the urethra was confirmed in four cases, but not in one case. Histological and immunohistochemical examinations of the epithelium lining indicated that its characteristics were identical to those of the prostatic utricle in all cases. CONCLUSIONS: The so-called Müllerian duct cyst exhibits features comparable to those previously described in the prostatic utricle. There is no evidence that these cystic lesions originate from the Müllerian duct remnant, at least in the epithelial lining. We suggest that they should be termed a prostatic utricular cyst or cystic dilation of the prostatic utricle, depending on whether an outlet to the urethra is absent or present, respectively.

Aged↗
PubMed2005

Müllerian duct remnant involving Wolffian system: a case report and literature review.

A 14-month-old boy with repeated left acute epididymitis was admitted to our department. Ultrasonography detected a midline round cystic mass in a retrovesical region. This was easily opacified by cystourethrography and seen to have a free communication with the posterior urethra. Since urethroscopy revealed a passable orifice in the center of the verumontanum, while a cystic-wall biopsy specimen showed squamous epithelium, we considered this cystic lesion to be an enlarged prostatic utricle. Vasography showed that the bilateral vasa was implanted directly into this cystic lesion, and was the possible cause of his left epididymitis. Ligature of the left vas deferens was performed to prevent left epididymitis. An enlarged prostatic utricle involving the vasa is a rare presentation.

Cysts↗
PubMed2004

Loss of calponin h1 in renal angiomyolipoma correlates with aggressive clinical behavior.

OBJECTIVES: To investigate whether any immunohistochemical differences exist between two types of renal angiomyolipomas (AMLs). Renal AMLs are generally considered to be benign in nature. However, a few of these tumors have been reported to involve other organs. METHODS: Tissue specimens from 3 cases of clinically aggressive and 9 cases of clinically indolent renal AMLs were examined histologically and immunohistochemically using antibodies against calponin h1 and alpha-smooth muscle actin. Immunostaining was evaluated semiqualitatively as no staining to strong staining. RESULTS: The tumor cells in the myomatous component of the aggressive type did not show any reaction to the antibody to calponin h1 protein, but they showed strong immunoreactions with the antibody to the alpha-smooth muscle actin antigen. All cases of the nonaggressive AMLs demonstrated strong immunoreactions with both antibodies used. CONCLUSIONS: Our initial results in a small series of cases suggest a potential molecular difference between the aggressive and nonaggressive type of AMLs. Loss of calponin h1 from the tumor cells of the aggressive type might be related to their pathologically invasive features, and this aggressive type might be categorized into an intermediate type between the benign and malignant types.

Actins↗
PubMed2004

Calponin h1 expression in renal tumor vessels: correlations with multiple pathological factors of renal cell carcinoma.

PURPOSE: We determined whether the architecture of renal tumor vessels is immunohistochemically different from that of normal renal vessels and related to the various pathological factors that affect prognosis of renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 52 cases of primary RCC were selected. Tissues from radical nephrectomy specimens were stained with antibody to alpha-smooth muscle actin (alpha-SMA) and calponin h1. Immunostaining was evaluated semiqualitatively as 0-no staining to 3+-strong staining. Tumor cell proliferation was observed using proliferating marker Ki-67. Data were statistically compared with pathological factors, such as tumor size, histological pattern, growth pattern, cell type, nuclear grade, pathological stage and presence or absence of venous invasion. RESULTS: In normal renal tissues smooth muscle cells of the blood vessels showed strong immunoreactions with antibody to calponin h1 and alpha-SMA. Although alpha-SMA antibody showed similar strong immunoreactions in all types of renal tumor vessels, we observed qualitative alterations in the expression of calponin h1 in different types of RCCs. Strong to moderate immunoreactions with calponin h1 were observed in tumors with expansive growth and an alveolar pattern. Small tumors without venous invasion and chromophobe cell carcinomas also showed strong to moderate expression of calponin h1. Weak or absent expression of calponin h1 was observed significantly in infiltrating tumors, sarcomatous type, large, high grade and high stage tumors associated with significantly higher proliferating indexes. CONCLUSIONS: Our results strongly suggest that the renal tumor vessels are immunohistochemically different from normal renal vessels in respect to calponin h1 expression. We speculate that due to the decrease in or absence of calponin h1 tumor vessels do not develop adequate maturity to maintain vascular integrity. In addition, the distribution of calponin h1 significantly correlated with multiple pathological factors of RCC. Therefore, calponin h1 expression in renal tumor vessels could be a new, important pathological factor in RCC.

Adult↗
PubMed2004

Squamous cell carcinoma in the renal pelvis of a horseshoe kidney.

We report a rare case of squamous cell carcinoma in the renal pelvis of a horseshoe kidney. An 80-year-old woman was referred to the National Nagano Hospital for the examination of occult blood in her urine. Microscopic hematuria was found, but pyuria was not seen. Computed tomography and magnetic resonance imaging showed a mass in the left renal pelvis of the horseshoe kidney. No renal stone or hydronephrosis was found. Cytopathological examination in the voided urine specimen was positive. Left nephroureterectomy with the splitting of the isthmus of the horseshoe kidney was performed without renal pedicle clamping using a microwave tissue coagulator. No bleeding was encountered after separating the isthmus. A final pathological diagnosis of squamous cell carcinoma with a tumor thrombus was made. Lymph node metastasis had developed and rapidly progressed and the patient died of disseminated malignancy 4 months after the operation. We reviewed 24 cases of renal pelvic tumor in horseshoe kidneys previously reported in Japan. Seven cases (30%) included components of squamous cell carcinoma. The incidence is higher than that of renal pelvic tumors in the general population.

Aged↗
PubMed2004

Anatomical reconsideration to renal area: lessons learned from radical nephrectomy or adrenalectomy through a minimal incision over the 12th rib.

BACKGROUND: To perform radical nephrectomy or adrenalectomy through a minimal incision over the 12th rib and to compare this with the traditional supracostal or transcostal approach. We review and clarify the related surgical anatomy through close observation. METHODS: We performed radical nephrectomy in six patients with upper urinary tract carcinoma through a minimal incision over the 12th rib and in five patients with renal cell carcinoma through a medium-sized incision, and adrenalectomy in five patients (bilaterally in one) again through a minimal incision over the 12th rib. During surgery, special points were noted to find out the differences between the new minimal-incision approach and the conventional approach. RESULTS: The procedures were accomplished smoothly with no complications through either a minimal or medium-sized incision. From our observation, it is clear that most of the procedures involved in the minimal-incision approach were and should be carried out within the space created in the retroperitoneum beneath the lateroconal fascia. CONCLUSION: Entering the correct anatomical planes posteriorly and anteriorly in the renal fasciae is a prerequisite for full mobilization of the kidney, together with the perinephric fat. To perform this, recognition of the lateroconal fascia and incising it along the correct lines are of the utmost importance for minimal-incision radical nephrectomy and adrenalectomy. Furthermore, this anatomical approach is also important for the conventional open approach and laparoscopic approach.

Adrenalectomy↗
PubMed2004

Angiomyolipoma of kidney involving the inferior vena cava.

We successfully treated a case of angiomyolipoma of the right kidney involving the inferior vena cava. Tissue sections of the tumor were immunostained and immunohistochemically tested with the smooth muscle related antibodies, namely, calponin h1, h-caldesmon and alpha-smooth muscle actin, and were then compared with the five cases of common type of angiomyolipoma. Furthermore, we reviewed and analyzed 25 case reports of invasive renal angiomyolipomas.

Adult↗
PubMed2004

The same-pedicle concept for continent urinary diversion using a Yang-Monti reconfigured tube.

OBJECTIVE: To facilitate the anastomosis of a continent valve to the umbilicus or a suitable skin area, we used a reconfigured tube made from the same segment of the intestinal reservoir as that used to construct the urinary pouch. MATERIALS AND METHODS: Seven patients underwent continent ileal-pouch formation using a reconfigured ileal tube following cystectomy for bladder cancer. Two irradiated patients and 1 patient with neurogenic bladder underwent continent colon-pouch construction with a reconfigured colon tube. RESULTS: The average length of the reconfigured ileal tube was 5 cm, while the colon tube was maximally 10 cm long. All procedures were technically straightforward. All the continent pouches functioned well, without catheterization difficulties. CONCLUSIONS: Since the Yang-Monti tube and the pouch are easily mobilized, being based on the same vascular pedicle, and can therefore bridge the gap, making the umbilical anastomosis was greatly facilitated. Sufficient support for the tube is provided by the pouch.

Adult↗
PubMed2004

Renal pelvic urothelial carcinoma in horseshoe kidney.

A 40-year-old man with asymptomatic gross hematuria visited our hospital. He had been followed up on the horseshoe kidney and left ureteral stone. Cystoscopy revealed a flow of gross hematuria from the left orifice. Drip infusion pyelography, retrograde pyelography, abdominal computerized tomography, magnetic resonance imaging revealed a renal pelvic mass in the upper pole of left kidney. Left nephroureterectomy and isthmusectomy and partial cystectomy were done. A microwave tissue coagulator (Microtaze AZM-520, AZWELL) was used to divide the isthmus. There was very little bleeding and leakage of urine from the divided isthmus. The postoperative course was favorable.

Adult↗