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K Arima

Publications and source records attributed to K Arima.

At least 127 records · Page 7Linked to original sources
PubMed1997

Stereologically estimated mean nuclear volume of prostatic cancer is a reliable prognostic parameter.

Although different histological grading systems of prostatic cancer refer to well-described characteristics, results are hard to reproduce. The aim of this study was to obtain morphometric data that would enable objective and reproducible grading of prostatic cancers by stereological estimation of mean nuclear volume (MNV). The clinical records and tissue specimens from 100 patients who were newly diagnosed as having prostatic cancer from 1973 to 1990 and who were followed up for 5 years or longer were retrospectively examined. We analysed the relationship between MNV and clinical stage, Gleason score and histological grading according to the World Health Organization (WHO) classification. To evaluate prognostic predictors, a multivariate analysis of factors associated with cause-specific survival was performed. We found a good correlation between the MNV and clinical stage and between the MNV and histological grading. There was no correlation between MNVs and Gleason scores. Multivariate analysis revealed that the MNV was the only predictor of survival time (coefficient 0.005; P < 0.0001; hazard ratio 1.005). We consider that the MNV is an excellent predictor of the prognosis in patients with prostatic cancer. Moreover, stereological estimation of MNV is a simple, quick, inexpensive and reliable morphometric procedure that enables the quantitative analysis of the histological and biological character of prostatic cancer.

Cell Nucleus↗
PubMed1997

Balloon-occluded arterial infusion as a useful neoadjuvant chemotherapy for bladder cancer.

OBJECTIVE: To evaluate the balloon-occluded arterial infusion (BOAI) of cisplatin and adriamycin as a preoperative adjuvant chemotherapy in patients with bladder cancer of stage > or = T2 or in those with stage T1 and multiple large tumours. PATIENTS AND METHODS: The study comprised 120 patients with bladder cancer who underwent BOAI from November 1984 to December 1995. BOAI chemotherapy (adriamycin and cisplatin) was administered under ischaemia through a 7 F torque-control balloon catheter, both sides of which were inserted into the contralateral internal iliac artery. The regression rate of tumours and any improvement in tumour stage was assessed. RESULTS: The clinical response rate (complete or partial) was 66% and the tumour stage improved in 39% of the patients after BOAI. Of 26 patients with stage T3 a diagnosed before BOAI, 12 were diagnosed as T2 or less after treatment. Of 27 patients who underwent total cystectomy because the tumour was diagnosed as T2 after BOAI, the post-operative histopathological examination showed that 22 (82%) were stage pT1 or below. The features associated with a good response to BOAI in patients with up to pT3a disease were grade 3, non-papillary tumours with a diameter of < 3 cm. CONCLUSION: In patients diagnosed as stage T2 and T3a, or stage T1 with multiple large tumours difficult to be treat by transurethral resection, BOAI should be considered as the first choice to decrease the stage or to confirm the pathological staging.

Aged↗
PubMed1997

Conservative treatment using a methotrexate-lipiodol emulsion containing non-ionic contrast medium for a cervical ectopic pregnancy.

We present a case in which a viable cervical pregnancy was successfully treated with preservation of the uterus. A 26 year old female presented with a 6 week cervical pregnancy with acute moderate bleeding. On the day of admission the patient underwent embolization of the descending uterine artery to decrease the bleeding. The following day, 4 mEq potassium chloride and methotrexate (MTX)(1 mg/kg) dissolved in saline was injected into the amniotic cavity using transvaginal sonographic guidance. The fetal heart beat ceased; however, the urinary beta-human chorionic gonadotrophin (HCG) concentration increased and the gestational sac size also increased. After a second injection of an emulsion of MTX (1 mg/kg) dissolved in a non-ionic contrast medium, iopamidol and lipiodol, the betaHCG concentration in the urine began to decrease. After a third injection with the same emulsion, the cervical mass became necrotic. The betaHCG concentrations in the urine and serum were undetectable and the external cervix returned to normal 44 days after admission. No vaginal bleeding or significant side effects of MTX were observed throughout the treatment. An in-vitro dissolution test revealed that the dissolution rate of MTX was slower from MTX-lipiodol-iopamidol with sonication than without sonication. The present study indicates that use of an MTX emulsion enables slow release of MTX and may be applicable for conservative treatment of ectopic pregnancies, including cervical pregnancy.

Adult↗
PubMed1997

Adenomyomatous polyp of the uterus in a patient receiving tamoxifen.

We report a case of adenomyomatous polyp that developed during treatment with tamoxifen for breast cancer. A 63-year-old Japanese woman was admitted complaining of atypical genital bleeding. Nine months earlier, she had undergone a modified radical mastectomy for cancer of her right breast, estrogen receptor-positive stage I (T1N0M0). The administration of tamoxifen, 20 mg/day, was started immediately postoperatively. Pelvic examination after tamoxifen administration for 9 months revealed that the uterus was enlarged to the size of a fist. Transvaginal ultrasonography and magnetic resonance imaging revealed a large solid mass with multiple cystic areas in the uterine cavity. The pathological diagnosis of the tumor after total hysterectomy was typical adenomyomatous polyp. It was believed to have developed during tamoxifen administration.

Adenomatous Polyps↗
PubMed1997

Comparison between sporadic cytomegalovirus hepatitis and Epstein-Barr virus hepatitis in previously healthy adults.

In order to determine the factors responsible for the differentiation of cytomegalovirus (CMV) hepatitis and Epstein-Barr virus (EBV) hepatitis, the clinical features and laboratory data of both types of hepatitis were retrospectively analyzed in 20 patients with CMV and 11 patients with EBV. While most signs and symptoms of CMV and EBV hepatitis showed no significant differences, we found that cervical lymph- adenopathy was more common in EBV hepatitis than in CMV hepatitis (p < 0.01). Frequency of epigastralgia was more common in CMV hepatitis than EBV hepatitis (p < 0.05). The percentage of peripheral blood monocytes in the white blood cell count in CMV hepatitis was greater than in EBV hepatitis (p < 0.01). Low CD4 levels and high CD8 levels made CD4/CD8 low in peripheral lymphocytes of both groups of hepatitis. Ten EBV hepatitis patients received antibiotics in the early stage of the disease in which two (25%) developed severe erythematous rashes. Four CMV hepatitis patients received antibiotics and did not develop rashes. Identification of early clinical parameters capable of differentiating CMV hepatitis from EBV hepatitis is important.

Adolescent↗
PubMed1997

Development of a new seminested PCR method for detection of Legionella species and its application to surveillance of legionellae in hospital cooling tower water.

The presence of PCR inhibitors in water samples is well known and contributes to the fact that a practical PCR assay has not been developed for legionella surveillance. In this study, we devised a new seminested PCR assay for detection of Legionella spp. in water samples as a means of overriding the PCR inhibitors without loss of sensitivity. The seminested PCR assay utilized primers to amplify the 16S rRNA gene (LEG primers) of 39 Legionella spp. The assay was specific to legionellae, and the sensitivity was 1 fg of extracted Legionella DNA in laboratory examination. To evaluate the feasibility and sensitivity of the PCR assay in identifying the presence of legionellae, it was used to survey Legionella contamination in the water of 49 cooling towers of 32 hospitals. A commercially available EnviroAmp Legionella kit and a culture method were also used in the survey for comparison with the seminested PCR assay. The detection rates of legionellae in the samples were 91.8% (45 of 49) by the PCR assay and 79.5% (39 of 49) by the culture method. The EnviroAmp kit revealed that 30.6% of the water samples (15 of 49) contained inhibitors of the PCR amplification. However, the seminested PCR assay could produce the Legionella-specific DNA bands in 14 of the 15 samples. Although 8 of the 14 samples were positive in the first-step PCR, 6 of the 14 samples became positive in the second-step PCR. These results suggest that the effect of PCR inhibitors in samples, if any, can be reduced because of the dilution of the sample in the second-step PCR and that sensitivity of detection can be increased by the second-step PCR. Thus, the seminested PCR assay with LEG primers to amplify the 16S rRNA gene of 39 Legionella spp. was a practical and sensitive method to detect Legionella spp. in water samples.

Air Conditioning↗
PubMed1997

Relationship between preinfarction angina and time interval to reperfusion with thrombolytic therapy in acute myocardial infarction.

This study was conducted in an attempt to clarify whether preinfarction angina has an ischemic preconditioning effect. The subjects of this study were Killip class I patients who had suffered a first acute myocardial infarction (MI) as a result of total occlusion of the proximal left anterior descending coronary artery without development of collateral vessels and multivessel coronary artery disease. All subjects achieved successful reperfusion [thrombolysis in myocardial infarction (TIMI) flow grade 3] through intracoronary thrombolysis with single-chain urokinase-type plasminogen activator (SCU-PA). Subsequently, they received the same drug therapy and remained free of reocclusion. The patients were divided into those who experienced a new onset of prodromal angina within 24 h before the onset of acute MI [PA(+) group] and those who had a sudden onset of acute MI without the preceding angina [PA(-) group]. They were further divided according to the time interval from the onset of acute MI to reperfusion (within 1 h, 1-2 h, 2-3 h, 3-4 h, and 4-7 h). In addition, the left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and the amount of creatine kinase (CK) released (sigma CK) were compared in these 2 groups at reperfusion time. The results of this study showed that sigma CK was significantly lower in the PA(+) group than in the PA(-) group (1,850 mIU vs 3,583 mIU) when reperfusion was induced within 1 h after the onset of acute MI. When reperfusion was induced 1-2 h after the onset of acute MI, sigma CK tended to be lower in the PA(+) group than in the PA(-) group (3,677 mIU vs 5,261 mIU). Once the time to reperfusion exceeded 2 h, there was no significant difference in sigma CK between these 2 groups. On the other hand, there were no significant differences in LVEF and LVEDVI between these 2 groups at any reperfusion time. In conclusion, preinfarction angina had a preconditioning effect (reduction in sigma CK), but this effect was lost once the time interval from the onset of acute MI to reperfusion exceeded 2 h.

Adult↗
PubMed1997

[A case of papillary cystadenocarcinoma of the prostate].

An 86-year-old was admitted to our hospital with the complaint of urinary retension. Ultrasonography and CT scan revealed a large cystic intrapelvic mass which was palpated on the bilateral inguinal portion. When the needle aspiration was performed, we aspirated serous fluid which a concentration of prostate-specific antigen (PSA) was remarkably elevated to 6200 ng/ml. Following hormonal therapy with diethylstilbestrol diphosphate, maximum androgen blockade with Flutaminde and LH-RH analog was performed. But no reduction in the size of the cyst was observed, he died from dyspnea caused by carcinomatosa 91 days later. Autopsy revealed a papillary cystadenocarcinoma of the prostate. Furthermore, we revealed that the cyst is primary and neoplastic changes supervened in this case. Seven cases of papillary cystadenocarcinoma of the prostate in the Japanese literature are reviewed briefly.

Aged↗
PubMed1997

[Evaluation of renal cystic mass on ultrasonogram and computed tomogram: usefulness of magnetic resonance imaging and renal angiography--category III by Bosniak: report of 5 cases].

Bosniak classification of renal cystic massesis an extremely useful management tool. Of category I-IV by Bosniak, category III lesion is moderately complicated cyst, which cannot be confidently distinguished from malignancy radiologically. Here, we reviewed the clinical course of 5 patients with pathologically proven category III mass by Bosniak in order to evaluate the usefulness of magnetic resonance imaging (MRI) and renal angiography. Two of the 5 lesions were benign (hemorrhagic cyst) and the other were malignant (RCC). On MRI, the results of 5 lesions were true positive in 1 and false negative in 2. On angiography, the results were true positive in 2 and false negative in 1. MRI has an important role in detection of mass. Angiography is necessary for making a definitive diagnosis of the indeterminate renal cystic masses on US and CT as RCC, but cannot increase enough diagnostic confidence in small cystic renal masses. We experienced indeterminate 2 masses (case 1 and 4) on these four imaging techniques, which were RCC and hemorrhagic cyst, respectively. In category III lesions, if malignant finding was detected by MRI or angiography, we believe that surgical exploration should be performed. But, an absolute decision tree for management of the complicated renal cystic mass has not been published, and further investigation should be required.

Adult↗
PubMed1997

[Clinical statistics of living and cadaveric renal transplantation at the Department of Urology, Mie University School of Medicine].

A statistic survey was made on the clinical results of living and cadaveric renal transplantations performed at our department between October 1980 and June 1996. A total of 38 patients received 6 living and 32 cadaveric renal transplants. The graft and patient survival rates of a living renal transplantation were 83.3% and 100% at 3 years, respectively. The graft survival rate of cadaveric renal transplantation was 66.3% at 3 years and 56.0% at 5 years. In a cadaveric renal transplantation, patients with episodes of acute rejection within 12 months showed a significantly worse graft survival rate. This clinical parameter seems to be a prognostic factor for a long-term graft survival.

Adolescent↗
PubMed1997

[Bladder cancer associated with von Recklinghausen's disease: a case report].

A 53-year-old man was admitted to our hospital with urinary frequency and miction pain. He had von Recklinghausen's disease with multiple café-au-lait spots and neurofibromatosis. Computed tomography scan and magnetic resonance imaging revealed an invasive bladder tumor 10 cm in diameter, and not metastasis. He was diagnosed as having a bladder tumor (T3a N0 M0 with von Recklinghausen's disease. After balloon occluded arterial infusion (BOAI) chemotherapy, total cystectomy was performed. Pathological diagnosis was transitional cell carcinoma, G3, pT3aN0M0. We reviewed and discussed 97 cases of carcinoma associated with von Recklinghausen's disease reported in the Japanese literature. Only 5 cases of bladder cancer have been reported, including the present case.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[A case of xanthogranuloma of the urinary bladder following herniorrhaphy].

We report a case of xanthogranuloma of the bladder following herniorrhaphy. The patient complained of urinary frequency, residual feeling, and presented with a solid mass located on the dome of the bladder. He had undergone previous inguinal herniorrhaphy. Transurethral biopsy revealed an inflammatory change. Partial cystectomy was carried out for en bloc removal of the tumor. The histological diagnosis was xanthogranuloma of the bladder. Postoperatively, the symptoms disappeared. This is the sixth case report of xanthogranuloma of the urinary bladder and the first case following herniorrhaphy in the Japanese literature.

Granuloma↗
PubMed1997

[Selective transcatheter embolization for renal artery aneurysms: report of three cases].

Selective transcatheter embolization using an interlocking detachable coil (IDC) or detachable balloon was performed in three patients with renal artery aneurysms. All aneurysms were of the saccular type, located on segmental branches of the renal artery. After the embolization procedures, the levels of LDH, GOT, WBC and the body temperature were transitionally elevated in all patients. Complete occlusion of the aneurysms were achieved in all cases. Good clinical results were achieved in two of these patients without any renal dysfunction. However, local infarction of ipsilateral renal parenchyma occurred in one patient immediately after the embolization and a Tc-99m-DMSA renal scintigraphy study suggested renal dysfunction after infarction, and the level of serum renin activity was slightly elevated. Selective transcatheter embolization may constitute an acceptable therapeutic approach for renal artery aneurysms because beside avoiding surgery, it has a low risk of complications.

Aged↗
PubMed1997

[A case of bilateral renal infarction].

A 67-year-old woman was admitted with aching pain in her left flank and nausea. Bilateral renal infarctions were noticed by CT scan and arteriography. Selective intra-arterial thrombolytic therapy was performed. Urokinase (UK) was administered through a balloon catheter embedded into the occlusive segment of the left renal artery selectively. UK (20,000 units/hour) was continuously infused after short-term high dose UK (360,000) infusion. In spite of recanalization of the occluded artery, CT scan and renoscintigraphy image did not suggest recovery of renal function. Conservative intra-arterial thrombolytic therapy is considered to be the most effective treatment for renal infarction.

Aged↗
PubMed1997

[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy--report of an autopsied Japanese case].

We report a 75-year old Japanese man with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). His family had no consanguinous marriage and his grandfather had migraine attacks. His father showed uncontrollable emotion at the age of 59 followed by gait disturbance, disorientation, pseudobulbar palsy and died at the age of 63. The patient had migraine attacks with aura since 10 year-old and showed uncontrolableness of his emotion and gait disturbance at the age of 63 followed by disorientation, urinary incontinence and pseudobulbar palsy, and died from aspiration pneumonia at the age of 75. The postmortem examination revealed an arteriopathy in the cerebral white matter and meningeal vessels and multiple infarctions in the cerebral white matter corpus callosum, basal ganglia, middle cerebellar peduncle and pontine tegmentum. The affected arterial walls showed eosinophilic and periodic acid Schiff (PAS)-positive granules in the media, which were composed of numerous electron dense small granules in varying sizes on electron microscopic examinations. These granules showed complements (Clq, C3, C4)-like immunoreactivity but did not have IgG-, IgM-, IgA-, kappa and lambda chain-, or beta-amyloid-like immunoreactivities. The clinicopathological features in this patient were compatible with those reported as CADASIL in the European countries and this is the first case report of CADASIL in Japanese race.

Aged↗
PubMed1996

[Legionella infection in occupational and environmental health].

Air condition systems are indispensable for amenity in the work environment. It is known that Legionella species are widely distributed in the water of cooling towers, and that the bacteria are responsible for community-acquired pneumonia (Legionnaires' disease) and for influenza-like symptoms (Pontiac fever). Furthermore, Legionella species are associated with building-related illness. In Japan, however, prevention and countermeasures are inadequate against legionellosis compared to those of Europe and the USA. This is because occupational and environmental medicine in Japan has not been based on a microbiological point of view, and that workplace inspections have not covered cooling towers. Therefore, Legionella species in the water of coolig towers have not been routinely monitored in the work environment. This review describes the microbiological characteristics of Legionella species, their habits in the environment, the source and route of infection, the pathogenesis, the symptoms and treatment of legionellosis, outbreaks of this disease throughout the world, and how to deal with this organism in the work environment to prevent legionellosis.

Environmental Health↗
PubMed1996

Enhanced expression of the protein kinase substrate annexin in human hepatocellular carcinoma.

Annexin (AX) constitutes a new family of Ca2+-dependent membrane-binding proteins; 13 of them have been described. Among these, annexin-1 (AX-I) has displayed many biological functions in vitro. Its actual role in vivo, however, remains unknown. We already reported that AX-I was expressed in proliferating (regenerating) hepatocytes at both protein and messenger RNA (mRNA) levels. The role of AX-I in human hepatocellular carcinoma (HCC) remains obscure. In this study, the amounts of AX-I at protein and mRNA levels, as well as its localization, have been determined in the normal human liver, chronic hepatitis liver, and nontumorous and tumorous portions of HCC. AX-I was rarely found in normal and chronic liver tissues, whereas it is overexpressed at both the transcriptional and translational levels in tumorous and nontumorous regions of HCC. In addition, more AX-I was expressed in the tumorous portion than the nontumorous portion of HCC. AX-I was present in the hepatocytes and HCC cells, localized mainly in the cytoplasm. AX-I was expressed in poorly differentiated cancer cells. Furthermore, AX-I was tyrosine-phosphorylated in HCC. We also found that some of the AX-I- positive hepatocytes in the nontumorous tissues were derived from a particular subset of parenchymal cells (stem or oval cells). These results indicate that AX-I plays an important role in the malignant transformation process leading to HCC and that it is closely related to the histological grade of HCC. HCC would offer a novel tool with which to study the function of AX-I in malignant transformation.

Annexin A1↗