Pyogenic granuloma of the glans penis.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
I Fukui
Publications and source records attributed to I Fukui.
Significance of bladder neck involvement on progression in superficial bladder cancer.
OBJECTIVES: To determine the significance of bladder neck involvement in predicting disease progression in superficial (stage Ta and T1) transitional cell carcinoma (TCC) of the urinary bladder. PATIENTS AND METHODS: A series of 277 patients with newly diagnosed superficial TCCs of the bladder was reviewed, and disease progression (to T2 or worse) was considered. The significance of several risk factors including bladder neck involvement was assessed in univariate and multivariate analysis. RESULTS: Progression occurred in 28 (10.1%) of 277 patients during a median follow-up period of 7.7 years. Nineteen died of bladder cancer. The following variables were found to be statistically significant at the univariate analysis (p < 0.05): irritative symptoms, urine cytology, tumor stage, involvement of the bladder neck, and tumor grade. Indeed, only involvement of the bladder neck, tumor stage, and grade retained their value as independent factors for progression at multivariate analysis. Patients were divided into three groups according to the number of independent risk factors they had. Groups having none, one, and two or three risk factors included 129, 99, and 49 patients with 5-year progression rates of 0.8, 4.6 and 27.5%, and 15-year rates of 4.0, 20.1 and 42.7%, respectively. CONCLUSION: Involvement of the bladder neck is a significant and independent risk factor for progression of superficial TCCs in addition to the histologic grade and stage. The combination of these three risk factors offers better prediction of progression in an individual patient.
Adolescent↗
[Renal hemangiopericytoma: report of a case].
A 34-year-old house wife presented with a right renal mass detected by work-up for epigastralgia. The mass located in the right renal sinus was round and approximately 3 cm in diameter. Although the tumor was well enhanced with contrast medium on CT scan, it was hypovascular on the early arterial phase of renal angiography. Translumbar radical nephrectomy was performed on suspicion of the right renal cell carcinoma. The tumor was solid and hard and, the cut surface of the tumor was homogenously colored pale pink. Microscopically it was hemangiopericytoma arising in the renal sinus, composed of well-developed pericytes and capillaries with so-called staghorn configuration, with invasion of hilar renal vein. Immunohistochemically, the hemangiopericytes were strongly positive for CD34, but negative for factor VIII associated antibodies. To our knowledge, the present patient is the 6th case in the Japanese literature and the first case with incidentally detected renal hemangiopericytoma.
Adult↗
[Successful multidisciplinary treatment for bladder cancer with priapism. A case report].
A 44-year-old man suspected of having transitional cell carcinoma (TCC) of the prostate was referred to our hospital. He had a painful semi-erect penis at his first visit. Then needle biopsy of the corpus cavernosum histologically revealed metastatic TCC. CT of the pelvis showed bilateral ureteral obstruction caused by the advanced tumor but no lymph node swelling was found. Under the diagnosis of prostatic TCC with penile metastasis, bilateral percutaneous nephrostomy followed by two courses of combination chemotherapy (IFEP regimen) was carried out, which resulted in the disappearance of priapism. Radical cystectomy with total penectomy was performed. The final pathological diagnosis was corrected to TCC of the urinary bladder with invasion to the prostate and metastasis of the corpus cavernosum and the right obturator lymph node. Enlargement of the prostate proved to be caused by glandular hyperplasia with atypical hyperplasia of the prostate gland. Three courses of adjvent IFEP chemotherapy was given post-operatively and he has been alive with no evidence of the disease for 10 months.
Adult↗
[Successful management for chemorefractory testicular cancer with brain and lung metastases. A case report].
This is a report of successful management for a far advanced, chemorefractory testicular cancer patient. A 29-year-old male was referred to our hospital for the treatment of progressive lung metastases with elevated hCG level, which had recurred after complete remission following 3 courses of BEP chemotherapy and progressed after transient partial regression following 2 courses of intensified EP chemotherapy. In addition, a 3 cm in diameter, solitary brain metastasis was detected on CT. First, we performed wedge resection of bilateral pulmonary lower lobe for chemorefractory pulmonary metastases. Histological examination revealed viable embryonal carcinoma identical to the primary one. Thereafter, whole brain irradiation in combination with VIP chemotherapy (etoposide 100 mg/m2, cisplatin 20 mg/m2 and ifosfamide 1200 mg/m2 daily for 5 consecutive days) was carried out to treat brain metastasis. By 2 cycles of VIP therapy and irradiation (36 Gy), partial tumor regression and normalization of hCG level were achieved, leading to salvage surgery of the brain metastasis which histologically proved to be necrosis. Following an additional cycle of VIP therapy, the patient has been free of recurrence 24 months after completion of the treatment.
Adult↗
[Metastatic renal tumor originating from lung cancer: a case report].
A 45-year-old house-wife, who had undergone surgical treatment for lung adenocarcinoma 2 years previously, presented with a left renal mass detected by follow-up CT. During 7 months of observation, it rapidly enlarged from 1 cm to 3 cm in maximum diameter. Although the short doubling time (40 days) suggested that the tumor was metastatic, abdominal urtrasonography, angiography and CT scan did not exclude primary renal cell carcinoma. Left nephrectomy was performed. Histologically, the tumor proved to be metastasis from the previous lung adenocarcinoma. She has been alive with pulmonary recurrence 13 months after nephrectomy. The doubling time of the tumor may be one of the key factors in differentiating a metastatic renal tumor from a primary carcinoma.
Adenocarcinoma↗
Antibodies to glutamic acid decarboxylase in Japanese diabetic patients with secondary failure of oral hypoglycaemic therapy.
Some patients with non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) are positive for antibodies to glutamic acid decarboxylase (anti-GAD), which have been shown to be a useful marker for the diagnosis and prediction of insulin-dependent (Type 1) diabetes mellitus (IDDM). Anti-GAD positive NIDDM patients tend to develop insulin deficiency. We investigated the prevalence of anti-GAD in 200 NIDDM with secondary failure of oral hypoglycaemic therapy (SF) and 200 NIDDM well controlled by diet and/or sulphonylurea agents (NSF). Twenty-two of 200 (11%, p < 0.05) SF patients and 6 of 200 (3%) NSF patients were anti-GAD positive. The positive. The positive rate for anti-GAD was as high as 23.8% in the non-obese and insulin deficient SF patients. The SF patients with anti-GAD tended to be non-obese and to have an impaired release of endogenous insulin. The internal before development of secondary failure was not associated with the presence of anti-GAD in this study. In conclusion we found that anti-GAD was positive in as many as 11% of the SF patients, suggesting that autoimmune mechanisms may play an important role in the pathogenesis of secondary failure or sulphonylurea therapy.
Analysis of Variance↗
Nisoldipine blocks the increase of intracellular free calcium-ion concentration associated with elevated sodium-lithium countertransport activity in erythrocytes in patients with NIDDM.
To understand the mechanism by which elevated sodium-lithium countertransport activity (SLC) associates with increased intracellular free calcium-ion concentration ([Ca2+]i), we investigated the relationship between SLC and the effects of the extracellular Ca2+ concentration ([Ca2+]o) and a Ca2(+)-channel blocker, nisoldipine, on [Ca2+]i in erythrocytes from 48 patients with non-insulin-dependent (Type 2) diabetes mellitus (NIDDM). There was a significant correlation between SLC and [Ca2+]i. Nisoldipine in the incubation medium significantly decreased [Ca2+]i, and there was a significant positive correlation between SLC and the degree of [Ca2+]i decrease. When the [Ca2+]o was elevated, [Ca2+]i was significantly increased, but nisoldipine almost completely suppressed this increase of [Ca2+]i. There was a significant positive correlation between SLC and the degree of the suppression. These data suggest that elevated SLC correlates with increased [Ca2+]i, and that the increased [Ca2i]i might be due to the increased Ca2+ influx through a dihydropyridine-sensitive Ca2+ pathway.
Adult↗
Preliminary ligation of vascular pedicles in male radical cystectomy.
Explore the source record for details and available documents.
Aged↗
Multiple primary malignant neoplasms associated with prostate cancer in 312 consecutive cases.
The relative risk for a second primary cancer after the diagnosis of prostate cancer and the prognostic impact of the association of multiple primary malignant neoplasms (MPMNs) in patients with prostate cancer were analyzed in a retrospective study. The development of MPMNs was examined in 312 consecutive patients who had been diagnosed with prostate cancer between 1966 and 1992. The population-based cancer incidence rates in Japan were utilized to calculate the expected number of MPMNs. Of the 312 patients, 60 fulfilled the diagnosis of MPMNs. In 13 men, prostate cancer and other malignancies were diagnosed simultaneously. In 35 of the 312 patients, prostate cancer was the second or third cancer diagnosis. In the remaining 287 patients, prostate cancer developed initially. Of the 287 patients, 12 developed a second primary malignancy compared with 17 expected (relative risk 0.71, 95% confidence interval 0.45-1.4). No single anatomic site showed a significantly increased risk above that expected either. The overall survival of patients with prostate cancer was not reduced by the association with MPMNs. This may be explained by the fact that the stage of the prostate cancer was lower in patients with MPMNs than in patients without MPMNs.
Adenocarcinoma↗
Prognostic significance of prostate-specific antigen levels two months after hormonal manipulation of metastatic prostate cancer.
OBJECTIVE: To assess the prognostic significance of prostate-specific antigen (PSA) levels before and during therapy in patients with metastatic adenocarcinoma of the prostate receiving hormonal manipulation. METHODS: The PSA levels before and during treatment, together with various clinicopathological parameters, were measured retrospectively in 48 patients with newly diagnosed metastatic prostate cancer. The prognostic importance of these measurements was analyzed by both univariate and multivariate techniques. RESULTS: PSA levels 2 months after treatment were the most useful predictors of progression-free (p = 0.004) or cause-specific survival (p = 0.006) in a multivariate Cox proportional-hazard model including histologic grade, age, performance status and pretreatment hemoglobin. CONCLUSIONS: We have found that a low PSA level 2 months after treatment is prognostically superior to conventional clinicopathological parameters, such as histologic grade, in patients with metastatic prostate cancer undergoing treatment by hormonal manipulation.
Adenocarcinoma↗
Formation of crossline as a fluorescent advanced glycation end product in vitro and in vivo.
Crossline is one of the major advanced glycation end products resulting the reaction mixture of free amino group(s) such as epsilon-one in lysine with D-glucose in vitro. To study crossline formation on proteins in vitro and in vivo, polyclonal antiserum to the crossline hapten was prepared. This antiserum reacted with bovine and human serum albumin that had been modified by prolonged incubation with glucose as well as with crossline itself. Antisera did not react with unmodified serum albumin or the other Maillard-related compounds. Crossline was formed in a time-dependent manner when a mixture of six different proteins was incubated with glucose at pH 7.2 or 9.0. Crossline levels could be measured in rat lens proteins and the levels increased with age. The crossline content of lens proteins in diabetic rats was more than two-fold higher than that of age-matched controls. Results of this study suggest that most proteins containing advanced glycation end products have crossline-like structures. Measurement of crossline-like structures in biological specimens may provide an index of aging and of the development of diabetic complications.
Animals↗
Elevated erythrocyte sodium-lithium countertransport activity correlates with increased intracellular sodium and free calcium-ion concentration in type 2 diabetes.
To explore the mechanism by which elevated sodium-lithium countertransport activity (SLC) associates with both predisposition to hypertension and diabetic nephropathy, we investigated the interrelationships among SLC, intracellular sodium concentration ([Na]i), intracellular free calcium-ion concentration ([Ca2+]i), diabetic nephropathy, hypertension, family history of hypertension, and other factors in 48 patients with Type 2 diabetes and 24 healthy controls. There was a significant correlation between SLC and [Na]i (r = 0.36, p < 0.05), [Na]i and [Ca2+]i (r = 0.47, p < 0.01), SLC and [Ca2+]i (r = 0.46, p < 0.01), and between HbA1c and [Ca2+]i (r = 0.38, p < 0.01). Both [Na]i and [Ca2+]i were significantly higher in the patients with elevated SLC than in those with normal SLC (p < 0.01 and p < 0.05, respectively). In stepwise multivariate regresssion analysis, [Na]i, HbA1c, and SLC appeared as independent determinants of [Ca2+]i. These data suggest a significant correlation of elevated SLC with increased [Na]i and [Ca2+]i. This may be a possible mechanism underlying the close association of elevated SLC with both predisposition to hypertension and diabetic nephropathy.
Adult↗
Histological grading of carcinoma in situ of the bladder: its clinical significance in patients who underwent intravesical mitomycin C and doxorubicin sequential therapy.
PURPOSE: The clinical behavior of carcinoma in situ of the bladder seems rather complicated. Although some have advocated the histological grading of carcinoma in situ, to our knowledge no sufficient clinical information has been reported. Therefore, we evaluated the clinical significance of histological grading of carcinoma in situ of the bladder. MATERIALS AND METHODS: From January 1984 to December 1991, 58 patients with carcinoma in situ of the bladder were treated initially with intravesical mitomycin C and doxorubicin sequential therapy. Of the patients 20 had grade 2 and 38 had grade 3 anaplasia according to the modified World Health Organization grading system. Those who failed the initial therapy received another course of mitomycin C and doxorubicin sequential therapy or intravesical bacillus Calmette-Guerin. RESULTS: Following initial therapy, 13 patients (65%) with grade 2 and 28 (74%) with grade 3 disease achieved a complete response. Subsequent intravesical therapy resulted in complete response in 17 patients (85%) with grade 2 and 31 (82%) with grade 3 cancer. The local recurrence rate was higher in the grade 2 than in the grade 3 cases after a median followup of 48 months (range 10 to 84). The recurrent tumor configuration was significantly different between the 2 groups. Papillary cancer recurred only in grade 2 cases, while only nodular cancer recurred in grade 3 cases. The progression-free and survival curves were slightly higher in grade 2 than in grade 3 cases, although the difference was not significant. CONCLUSIONS: There may be some difference in response to initial intravesical chemotherapy and the local recurrence rate between grades 2 and 3 carcinoma in situ, both of which are detrimental to grade 2 lesions. Moreover, it appears likely that grade 2 carcinoma in situ is a precursor of papillary high grade cancer and grade 3 carcinoma in situ is a precursor of nodular cancer. However, patient prognosis in the 2 groups was not significantly different.
Administration, Intravesical↗
Locally-confined signet-ring cell carcinoma of the prostate: a case report of a long-term survivor.
It is generally believed that signet-ring cell carcinoma (SRCC) of the prostate is a high-grade neoplasm with a poor prognosis. We report a case of a long-term survivor diagnosed with localized prostatic SRCC (T3N0M0), who has been alive without any clinical evidence of disease for 100 months after combination therapy which consisted of local irradiation and hormone administration. A posttreatment needle biopsy confirmed the pathological complete response.
Administration, Oral↗
[Mesonephric adenocarcinoma arising in the female urethral diverticulum].
A forty four-year-old house-wife presented with gross hematuria and difficulty on urination of a year and 3 months duration. Transvaginal examination showed a hen egg-sized soft mass on the anterior vaginal wall. Urine cytology revealed many clusters of malignant cells suggestive of adenocarcinoma. Cystourethrography revealed two urethral diverticula, whose orifices were cystoscopically located at the proximal and distal side of urethral sphincter, respectively. By vaginal digital pressing, a soy-bean sized papillary tumor came out of the proximal diverticulum. Histopathological examination of the biopsied tumor suggested poorly differentiated transitional cell carcinoma with inverted growth. Under the diagnosis of carcinoma arising in the urethral diverticulum, anterior pelvic exenteration with formation of Indiana pouch was carried out. The tumor in the proximal diverticulum was histologically composed of a variety of adenocarcinomatous pattern, such as tubular, papillary and cystic structure with a distinctive pattern of tubules lined by a superficial layer of hobnail cells, leading to the diagnosis of mesonephric adenocarcinoma of urethral diverticulum. Postoperative radiation therapy was given because the diverticulum was adherent to the pubic bone, though lymph node metastasis was negative. She has been well with no evidence of the disease for 1 year and 4 months after the operation. Although the histogenesis of female urethral mesonephric adenocarcinoma was still controversial, this case seems to be the forty fourth case in the world literature.
Adult↗
5-fluorouracil and allopurinol combined with recombinant interferon-alpha 2b in the treatment of patients with advanced prostate cancer: a phase I/II study.
PURPOSE: We determined the toxicity and preliminary response rate of escalating doses of 5-fluorouracil (670 to 1,500 mg./m.2 per day) combined with a fixed dose of interferon-alpha 2b (5 million units) and allopurinol (300 mg. every 8 hours) in cohorts of patients with metastatic prostate cancer. MATERIALS AND METHODS: The trial included 11 men with metastatic prostate cancer. Cohorts of patients received a 5-day constant infusion of 5-fluorouracil combined with subcutaneous interferon-alpha 2b 3 times weekly and allopurinol for 1 week during 5-fluorouracil infusion. Treatment was repeat every 3 weeks. RESULTS: Of 10 patients evaluable for treatment response and toxicity 3 had a partial response as judged by significant decreases in prostate specific antigen measurements (mean followup 13.5 months). Significant dose limiting toxicities encountered included mucositis, diarrhea and leukoneutropenia. CONCLUSIONS: Further evaluation of this treatment to determine overall response rates and benefit should take into consideration the significant toxicity experienced.
Aged↗
[Results of transurethral resection of prostate plus incision (TUR-P+I) for benign prostatic hypertrophy].
The results of 14 patients treated by TUR-P+I and 15 patients by TUR-P between September 1991 and August 1993 were reviewed to evaluate the effects of TUR-P+I. Tur-P+I is a combined technique of channelling TUR-P and transurethral incision of the bladder neck and the prostate. After receiving modest TUR of the adenoma, the bladder neck and anatomical capsule of the prostate was incised by electroresectoscope at 6 o'clock position from the bladder neck toward to verumontanum. Before operation, the maximum floor rate, average flow rate, and residual urine volume were measured, which were respectively 9.9 +/- 5.6 ml/s (M+SEM), 4.4 +/- 2.3 ml/s, and 130 +/- 80 ml in TUR-p+I group, and 11.6 +/- 2.9 ml/s, 4.3 +/- 1.8 ml/s, and 60 +/- 60 ml (p < 0.01) in TUR-P group. The operation time and resected tissue weights were similar in both groups; 68 +/- 16 min and 11 +/- 5.2 g in TUR-P+I group, and 72 +/- 25 min and 11 +/- 6.5 g in TUR-P group. The post-operative maximum flow rate, average flow rate and residual urine volume were respectively improved to 19.0 +/- 5.7 ml/s, 9.3 +/- 3.7 ml/s, and 20 +/- 20 ml in TUR-P+I group, and 14.6 +/- 6.1 ml/s (p = 0.057), 6.6 +/- 2.6 ml/s (p < 0.05), and 30 +/- 30 ml (not significant) in the TUR-P group. Neither significant blood loss nor complications were experienced in either procedure. It is suggested that TUR-P+I could be a safe and effective alternative of TUR-P. Longer follow-up and the prospective study are required to establish the value of the current combined technique.
Aged↗