Biomedical subjects

Hiroichi Kishi

Publications and source records attributed to Hiroichi Kishi.

6 recordsLinked to original sources

PubMed2006

Acute pericarditis as a result of unusual metastasis of the visceral pleura in a patient with testicular seminoma.

A 30-year-old man with a left testicular swelling was referred to our hospital. We performed a left high orchiectomy based on a diagnosis of clinical stage II testicular cancer. Pathological specimens of the left testis showed seminoma. The patient underwent three courses of combined chemotherapy. The retroperitoneal lymph nodes were dissected and there were no viable cancer cells. Twelve years later a right testicular tumor was discovered. The patient underwent a right high orchiectomy. Pathological specimens of the testis showed seminoma, and the patient was treated with prophylactic irradiation. One year after discharge a metastasis was found at a left supraclavicular fossa. The patient was treated with combined chemotherapy and irradiation. Six months after the treatment he complained of dyspnea. We diagnosed the condition as pleuritis carcimatosa. Two days after irradiation to the left thorax the patient suffered a sudden and fatal cardiac arrest. Autopsy survey revealed pericarditis as a result of a direct invasion of visceral pleural metastasis.

Adult↗

PubMed2006

[Clinical significance of pelvic lymph-node dissection for the patients with locally invasive bladder cancer--correlation between the number of retrieved lymph nodes and prognosis].

The objective of this study was to know the effects of pelvic lymph node dissection on the survival of the patients who received radical cystectomy without neoadjuvant chemotherapy or radiotherapy. Between 1984 and 2000, 104 patients underwent operation at our institution for tumors clinically diagnosed as locally invasive bladder cancer (T2-4NxM0). Survival rates and 8 prognostic factors (age, sex, size, multiplicity, type, pT, N, pv) were analyzed by uni- and multivariate analysis. The significant factors were size, type, pT, N, pv by univariate analysis. Of these 5 factors, N factor was the most significant by multivariate analysis. Patients (N-) who had more than 20 lymph nodes retrieved showed better survival than the others.

Aged↗

PubMed2005

Hemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral re fl ux.

A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral reflux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral reflux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection.

Humans↗

PubMed2003

Computed tomography-guided percutaneous acetic acid injection therapy for functioning adrenocortical adenoma.

We reported the outcomes of computed tomography (CT)-guided percutaneous acetic acid injection therapy for functioning adrenocortical adenomas. With the patient in a prone position, the puncture needle was inserted vertically downward into the adenoma with frequent CT scanning. After confirmation by pilot injection with contrast medium, a small aliquot of 40-50% acetic acid was injected and repeated. Between 1997 and 2002, 18 sessions of CT-guided injection therapy, including one session of ethanol injection, were performed on 10 patients (five patients with primary aldosteronism and five patients with Cushing's or subclinical Cushing's syndrome) without any complications except transient upper abdominal pain during the acetic acid injection. The follow-up period ranged from 5-69 months. The treatment resulted in almost an extirpation of the adrenocortical hyperfunction in seven patients after one or two sessions. CT-guided percutaneous acetic acid injection might be a simple, cost-effective, and far less invasive treatment for small functioning adrenocortical adenomas.

Acetic Acid↗

PubMed2002

Development of (18)F-fluoroethylcholine for cancer imaging with PET: synthesis, biochemistry, and prostate cancer imaging.

UNLABELLED: The effectiveness of (11)C-choline PET in detecting various cancers, including prostate cancer, is well established. This study was aimed at developing an (18)F-substituted choline analog, (18)F-fluoroethylcholine (FECh), as a tracer of cancer detection. METHODS: No-carrier-added (18)F-FECh was synthesized by 2-step reactions: First, tetrabutylammonium (TBA) (18)F-fluoride was reacted with 1,2-bis(tosyloxy)ethane to yield 2-(18)F-fluoroethyl tosylate; and second, 2-(18)F-fluoroethyl tosylate was reacted with N,N-dimethylethanolamine to yield (18)F-FECh, which was then purified by chromatography. An automated apparatus was constructed for preparation of the (18)F-FECh injection solution. In vitro experiments were performed to examine the uptake of (18)F-FECh in Ehrlich ascites tumor cells, and the metabolites were analyzed by solvent extraction followed by various kinds of chromatography. Clinical studies of (18)F-FECh PET were performed on patients with untreated primary prostate cancer as follows: A dynamic (18)F-FECh PET study was performed on 1 patient and static PET studies were performed on 16 patients, and the data were compared with those of (11)C-choline PET on the same patients. RESULTS: (18)F-FECh was prepared in high yield and purity. The performance of the automated apparatus was excellent. The in vitro experiment revealed that (18)F-FECh was incorporated into tumor cells by active transport, then phosphorylated (yielding phosphoryl-(18)F-FECh) in the cells, and finally integrated into phospholipids. The clinical PET studies showed marked uptake of (18)F-FECh in prostate cancer. A dynamic PET study on 1 patient revealed that the blood level of (18)F-FECh decreased rapidly (in 1 min), the prostate cancer level became almost maximal in a short period (1.5 min) and it remained constant for a long time (60 min), and the urinary radioactivity became prominent after a short time lag (5 min). Static PET studies conducted under bladder irrigation showed no difference between (18)F-FECh uptake and (11)C-choline uptake in prostate cancer. However, (18)F-FECh gave a slightly higher spatial resolution of the image, which was attributed to the shorter positron range of (18)F. CONCLUSION: The synthesis of (18)F-FECh was easy and reliable. (18)F-FECh PET was very effective in detecting prostate cancer in patients. The chemical trap, consisting of active transport of (18)F-FECh and formation of phosphoryl-(18)F-FECh, seemed to be involved in the uptake mechanism of (18)F-FECh in tumors.

Adenosine Triphosphate↗

PubMedDate not supplied

Treatment of patients with superficial bladder cancer by intravesical instillation of anticancer drugs plus oral chemotherapy following TUR-Bt: a randomized controlled trial.

We conducted a randomized controlled trial to compare local recurrence rate after transurethral resection of superficial bladder cancer treated by either intravesical instillation of an anticancer drug alone (method A) and the intravesical instillation plus oral chemotherapy (doxifluridine, 5'-DFUR, an intermediate metabolite of capecitabine) (method B). Results between groups showed no difference in recurrence-free survival curves in 196 patients subjected to primary analysis. However, patients subjected to secondary analysis (method B, over 3 months administration of 5'-DFUR) showed a significantly better prognosis than method A (p=0.0244, Wilcoxon). Regarding correlation between thymidine phosphorylase (TP, an enzyme to convert 5'-DFUR to 5-fluorouracil) level and prognosis, method A patients showed poorer prognosis in higher TP level cases than in lower TP levels. However, there was no significant difference in prognosis between those with higher and lower TP levels. In method B patients, there was no difference in prognosis between those with higher and lower TP levels. Method A patients tended to show a slightly better prognosis than those with lower TP levels, while method B patients tended to have a slightly better prognosis with higher TP levels, but no significant difference was observed. These findings suggested 5'-DFUR showed a mild efficacy in patients with higher TP levels and that patients with higher TP levels resulted in poorer prognosis.

Administration, Intravesical↗