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Biomedical subjects

J Sakatoku

Publications and source records attributed to J Sakatoku.

At least 19 recordsLinked to original sources

Predictive factors for the histologic nature of residual tumor mass after chemotherapy in patients with advanced testicular cancer.

OBJECTIVES: To further improve the accuracy of the prediction of histologic findings in the residual mass after chemotherapy in patients with metastatic germ cell tumors, various predictive factors were investigated. METHODS: A total of 23 patients with advanced testicular cancer underwent combination chemotherapy based on cisplatin following surgical removal of residual tumor mass in 20 patients and observation in 3. RESULTS: Complete fibrosis and/or necrosis was found in 6 (30%) operative specimens, teratoma in 3 (15%), and viable malignant tumor in 11 (55%). Three patients had no evidence of disease for a mean follow-up of 45 months. Five of the 6 patients and all of the 11 patients' results could be predicted by a combination of 4 factors, including absence of teratomatous element in the primary tumor, greater than 85% tumor reduction rate after chemotherapy, normal alpha-fetoprotein and beta-subunit of human chorionic gonadotropin levels after chemotherapy, and actual half-life of alpha-fetoprotein less than 7 days. Among these factors the tumor reduction rate and the actual half-life of alpha-fetoprotein were the most important predictions statistically on multivariate analysis. With the use of these criteria, the sensitivity rate, specificity rate, and overall predictive value of diagnosis for existence of viable malignant tumors were 83.3%, 100%, and 94.1%, respectively. CONCLUSIONS: By determining these factors it seems possible to avoid surgical removal of the postchemotherapy residual mass in approximately 30% of patients with advanced metastatic testicular cancer.

Adult↗

[Balloon dilation for ureteral stricture with stone fragments after ESWL].

We treated 5 cases of severe hydronephrosis with balloon dilation. Those hydronephrosis were due to the ureteral stricture with small stone fragments after ESWL (Lithostar). In each case, in situ ESWL had been done on a long-lodged ureteric stone with severe hydronephrosis. And even after the disintegration of stone with ESWL, hydronephrosis remained due to ureteral stricture with small stone fragments. Balloon dilation was done through percutaneous nephrostomy tract in 4 cases and via retrograde transurethral routine in 1 case. Balloon dilation catheter (7 fr. 6 mm diameter 4-10 cm length, Bard Co.) was used. There was no need for stone extraction. After dilation, ureteric stents (8.2/7 fr.) were kept in place for 4-8 weeks. Intravenous urogram was taken on 4-8 weeks after removing ureteric stents. In all of the 5 cases, improvement of hydronephrosis was remarkable. And there was no residual stone fragments in 4 cases. It is concluded that balloon dilation for ureteral stricture with stone fragments after ESWL is very useful. For the valid evaluation of balloon dilation, further experience and longer observation are requisite.

Catheterization↗

Effects of FK506 on rat thymic epithelial cells; immunohistochemical study.

The effects of FK506, a new immunosuppressive agent, on the rat thymus were investigated using the immunoperoxidase technique and flow cytofluorometry using monoclonal antibodies. Flow cytometric analysis of the thymus revealed that the proportion of cells labelled positively with OX7 (Thy-1 antigen), OX8 (CD8, T cytotoxic/suppressor cells) and W3/25 (CD4, T helper cells and macrophages) increased following treatment, with FK506, 1 mg/kg body weight for 14 days. A marked reduction of the thymic medulla following treatment was clearly demonstrated by staining with OX18 (MHC class I) and OX6 (MHC class II). Changes produced by FK506 were also observed in the cortical area of the thymus, being especially marked in the subcapsular area and around the blood vessels by staining with OX6, PKK-1 (alpha-cytokeratin), AB-1040 (type IV collagen), and AB-1220 (laminin). Eventually FK506 treatment resulted in patchy reduction of OX-6, PKK-1, AB-1040 and AB-1220 positive area in the cortex. This evidence suggests that FK506 may impair the thymic microenvironment and subsequently disturb the thymocyte maturation.

Animals↗

[Papillary adenocarcinoma of the prostate with good response to antiandrogen therapy and delayed radiotherapy: a case report].

A 76-year-old man complained of initial hematuria and dysuria. Right lobe of the prostate was elastic soft, enlarged and hypoechoic. The serum levels of PA and gamma-Sm were abnormally high. Prostatic biopsy showed papillary adenocarcinoma which was stained by prostatic specific antigen (PA). The cancer was clinically diagnosed as stage C. Antiandrogen therapy was performed. After three months, the prostatic tumor markers decreased to the normal range and the tumor reduced in size without any findings of metastasis on CT scan. Because prostatic biopsy showed viable cancer cells, radiotherapy was added. After six months, the tumor reduced in size without any signs of metastasis on CT scan and prostatic biopsy revealed no viable cancer cells or elevation of the tumor markers. The positive staining for PA and the good response to antiandrogen therapy in our case support the view that papillary adenocarcinoma of the prostate is only a morphologic variant of ordinary prostatic carcinoma (acinous adenocarcinoma).

Adenocarcinoma, Papillary↗

[Herniation of the bladder observed 3 days after herniorrhaphy: a case report].

A 72-year-old man complained of right hemiscrotal swelling and pollakisuria which had appeared 3 days after herniorrhaphy. On physical examination, a large mass in the right scrotum did not transmit light nor shrink upon pressure application. The concentrations of blood urea nitrogen and creatinine in the fluid obtained by puncture from the scrotal mass were high. Cystography demonstrated influx of contrast media into the scrotal mass from the bladder. From these findings, diagnosis was made as herniation of the bladder. An operation was performed through inguinoscrotal incision. The herniated bladder, to which peritoneum was laterally adherent, was incarcerated. The hernia ring, which was located medially to the suture line of previous herniorraphy, had strangulated the herniated bladder. The bladder wall was edematous and the mucosa was dark red. These findings suggested that the blood circulation in the herniated bladder had been disturbed for a relatively long time. Resection of the herniated bladder with the adherent peritoneum was performed in addition to hernia repair. Incomplete herniorrhaphy may be one of the causes of herniation of the bladder in our case.

Aged↗

[Angiographic analysis of intratumoral Pt concentration on intra-arterial infusion therapy for bladder cancer].

Eleven patients with advanced bladder cancers (T2-4) were treated by intra-arterial CDDP infusion therapy and intratumoral Pt concentrations were measured. The following results and suggestions were obtained by comparing the histological effects and intratumoral Pt conc. 1) By calculating cross section areas from diameter of blood vessels, the blood flow distributions of tumor feeding arteries were estimated. Based on this distributions, the distributed CDDP dosage flowed into the tumor feeding arteries was calculated. The distributed CDDP dosage of histologically effective group (N = 5, Grade IIb less than by Shimosato histological evaluation) were significantly higher than that of ineffective group (N = 6, Grade IIa greater than). (p less than 0.02, Student t test). 2) A good correlation was obtained between the revised intratumoral Pt value by distributed CDDP dosages and intervals from intra-arterial infusion therapies to operations. (r = -0.90, p less than 0.001). Intratumoral Pt conc. declined with a half life of 12 weeks. 3) Based on the declined linear line calculated from 2), theoretical intratumoral Pt conc. which was presumed value on day 0 (just after intra-arterial infusion therapy) were calculated. Theoretical Pt conc. of effective group were significantly higher than that of ineffective group (p less than 0.01), although no significant difference was seen between two groups compared by net intratumoral Pt conc. 4) A good correlation was seen between theoretical intratumoral Pt conc. and distributed CDDP dosage (r = 0.89, p less than 0.01). 5) Five of 6 cases with above 5 micrograms/g of theoretical intratumoral Pt conc. were histologically effective, and 5 micrograms/g of theoretical Pt conc. corresponded to 31 mg of distributed CDDP dosage.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Mucinous adenocarcinoma of the prostate with good response to hormonal therapy: a case report].

A 79-year-old man complained of pollakisuria and sense of retention. The prostate was stony hard and heterogeneously enhanced on computed tomographic (CT) scan. The serum levels of prostatic specific antigen, prostatic acid phosphatase and gamma-Seminoprotein were abnormally high. Prostatic biopsy showed mucinous adenocarcinoma which was stained by prostatic specific antigen. Bone scintigraphy revealed multiple metastases. Hormonal therapy was performed. Each prostatic tumor marker decreased to the normal range within 2 months. After 3 months, the prostate was almost normalized on digital examination and CT scan. There were no new metastases, prostatic biopsy revealed that most cancer cells had degenerated to nonviable cells and bone metastases had decreased.

Adenocarcinoma, Mucinous↗

[Clitoral enlargement caused by prepucial hemangioma: a case report].

A 4-year-old girl visited with the chief complaint of clitoral enlargement which was first pointed out when she was one year old. She has received excision of the femoral tumor, which was histologically an arteriovenous hemangioma, at 4 years old. The prepuce was darkly purplish and the clitoral neck was enlarged without enlargement of the clitoral glans. The external genitalia otherwise were normal and there were no virilizing signs. The mass was excised at the preoperative diagnosis of prepucial hemangioma. The mass was enclosed in the prepuce and adherent to its skin and there was no enlargement of the clitoris itself. The histopathological diagnosis was arteriovenous hemangioma.

Child, Preschool↗

[Flow cytometric analysis of DNA ploidy using paraffin-embedded germ cell tumors].

The DNA content of paraffin-embedded materials was determined retrospectively using flow cytometry (FCM) in 36 germ cell tumors, and related to histological type, clinical staging and tumor marker. These histograms were classified from the basis of mode and variance into a diploid and an aneuploid pattern. We could evaluate the DNA histograms in 20 of 36 specimens (56%). Aneuploid patterns were found in 11 of 20 evaluated cases, but there was no correlation between ploidy patterns and histological types. Aneuploid patterns were demonstrated in 2 of 6 stage I cases (33%), and 4 of 5 stage II cases (80%) in seminomas. The difference between stage I and II cases was not statistically significant. There was no correlation between clinical staging and DNA content in non-seminomas. Of the seminomas with elevated human chorionic gonadotropin (HCG) titers, 3 of 4 cases showed aneuploid patterns. These findings indicate that the determination of DNA ploidy in seminomas may prove to be of prognostic value.

Adult↗

[Clinical study of prostate cancer--statistical analysis in the last 10 years].

Fifty one cases of prostate cancer were treated at Yamaguchi University Hospital during 10 years since 1975. Age distribution was between 43 and 90 years old with an average of 70.9 years. Chief complaints were difficulty on micturition (33%), complete urinary retention (19.6%), macroscopic hematuria (15.7%), and frequency (13.7%). Clinical stage was classified as 1 case (2%) with stage A, 7 cases (13.7%) with stage B, 20 cases (39.2%) with stage C and 23 cases (45.1%) with stage D cancer. Histological grade was classified as 9 cases (17.6%) with well differentiated type of adenocarcinoma, 15 cases (29.4%) with moderately differentiated type and 27 cases (52.9%) with poorly differentiated type. The 5-year actual survival rate was 75% for stage A&B, 50% for stage C and 60% for stage D. The 10-year actual survival rate was 20% for stage A&B, 17% for stage C and 20.5% for stage D. There were no statistically significant differences between stage, grade and survival rate. According to specific cause 18 cases (58%) were cancer deaths including 8 cases (15.7%) of refractory disease, and 4 cases (12.9%) of cardiovascular complication. Five of the eight refractory cases could survive over one year by multimodal treatment. Local irradiation to prostate was most effective to control symptoms against locally refractory prostate cancer.

Adenocarcinoma↗

[Transitional cell carcinoma of pelvis in a giant hydronephrotic kidney].

A 73-year-old man complained of macroscopic hematuria. Preoperative diagnosis was left giant hydronephrosis due to UPJ stenosis. Resected kidney unsuspectedly contained multiple papillary tumors. Ureterectomy and partial cystectomy was additionally performed. Histological examination showed transitional cell carcinoma. Urinary stasis in the dilated pelvis may have been one of the causes of carcinomatous changes in the epithelium in our case.

Aged↗

[Ureteroplasty for megaureter by ureteral plication: report of two cases].

We performed ureteroplasty for megaureter by ureteral plication with ease in two cases with unilateral megaureter due to uretero-vesical stenosis and obtained good results in each case. Because ureteral plication theoretically preserves lower ureteral blood supply and eliminates suture line leakage, this technique is thought to be superior to excisional tapering techniques in ureteroplasty for a megaureter.

Child↗

[Congenital absence of the vas deferens associated with retrocaval ureter: a case report].

Unilateral absence of the vas deferens is frequently associated with ipsilateral anomalies of the urinary tract. A case of congenital absence of the vas deferens on the right side was associated with retrocaval ureter in a 30-year-old male. He was married and sterile for two years. On scrotal exploration, both testicles were normal but the vas deferens and the body and the tail of the epididymis on the right side were absent. The tail of epididymis on the left side was obstructed. Therefore, we performed a vaso-epididymostomy on the left side and anastomosed an artificial spermatocele on the body of the right-sided epididymis. The diagnosis of retrocaval ureter was confirmed by the intravenous pyelography and the retrograde pyelography.

Adult↗

Testicular development following unilateral orchiopexy measured by a new orchiometer.

Of 170 patients having undergone orchiopexy for unilateral cryptorchid testes, 90 responded to our inquiry. Testicular size was measured in 55 patients using an accurate and practical orchiometer (punched-out orchiometer) developed in our department. In boys under ten years of age (prepubertal), testicular development was minimal, and the operated on and contralateral testes were not significantly different. With the onset of puberty, both testes enlarged, and no significant differences were observed. However, by age fourteen the side operated on was significantly (p less than 0.05) less well developed than the contralateral testis. No difference was detected clinically between the operated on and contralateral testes when the contralateral testis was less than 10 mL in volume. When the contralateral testis was greater than 15 mL, however, a significant difference was detected both statistically (p less than 0.05) and clinically. The findings suggest limited prospects for the development of testes that are operated on at puberty.

Child↗

Effects of FK506 on rat thymus: time-course analysis by immunoperoxidase technique and flow cytofluorometry.

The effect of administration of FK506 at 1 mg/kg body weight for 14 days on rat lymphoid tissues, especially the thymus, and recovery after discontinuation of treatment, were investigated by the immunoperoxidase technique and flow cytofluorometry using monoclonal antibodies OX6, OX7, OX8, OX18 and W3/25, reactive with rat lymphocytes. Marked reduction of the thymic medulla upon treatment was clearly demonstrated by staining with OX18 and OX6. Changes produced by FK506 were also observed in the cortical area of the thymus, and were especially marked in the subcapsular area and around blood vessels. Eventually, the thymic cortex appeared patchy, this change being maximal 14 days after the start of administration. Obvious restitution of the thymic medulla was evident about 14 days after withdrawal of FK506. Flow cytometric analysis of the thymus showed that the percentages of cells labelled positively with OX7, OX8 and W3/25 were increased with FK506 treatment, and recovered to the normal level soon after withdrawal. Furthermore, the peak of fluorescence intensity of OX7+, OX8+ and W3/25+ cells showed a temporary shift to the right during FK506 treatment; however, the peak of fluorescence intensity of OX18+ cells showed a temporary shift to the left. Treatment with FK506 also produced a significant change in 3H-thymidine uptake by thymocyte. These results suggest that FK506 may inhibit the proliferation, maturation and differentiation of thymocytes. However, thymocytes prepared from FK506-treated rats and labelled with FITC behaved similarly to rat thymocytes in normal recipient rats. This suggests that during FK506 treatment thymocytes may retain their potential for peripheral mobilization.

Animals↗