Interlaboratory comparison of low-level organic tritium measurement in environmental samples.
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Biomedical subjects
Publications and source records attributed to K Isogai.
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Registration of renal pelvic and ureteral tumor was done from 1980 through 1986, in the Tokai Urological Tumor Registry. Among the 404 cases of the carcinoma, 384 cases (210 renal pelvis, 174 ureter) were subjected to the present study. A total of 319 cases (83.1%) showed a complete cure, while 20 cases (5.2%) were considered as partial cure, and 45 cases (11.7%) were classified to progressive disease group. Chemotherapy was performed on 151 patients including systemic administration to 141 patients (33.9%) and 11 patients received combined intravesical instillation therapy. Irradiation was performed on 49 patients (12.8%). Degree of histological and morphological differentiation of renal pelvis and ureter tumor were studied in 341 cases of transitional cell carcinoma (88.8%); G0, 0.3%, G1, 12.9%, G2, 49.3%, Gx, 5.2%. Stage of the tumor were T1, 33.6%; T2, 12.5%; T3, 14.6%; T4, 13.3%; Tis, 0.3%; Tx, 24.7%. Five-year relative survival for carcinoma of the renal pelvis was 46.6%, and for the ureter it was 53.1%. Five-year survival according to histological differentiation of transitional cell carcinoma and according to the stage of the tumor were as follows; G1, 91.6%; G2, 58.5%; G3, 27.2%; Ta, 84.6%; T1. 74.2%; T2, 48.5%; T3, 24.1%, T4, 7.3%. The rate of survival was correlated with histological differentiation of the tumor cells. The survival was poor in cases who had the components of squamous cell carcinoma and/or adenocarcinoma. Overall survived case were 177, 122 patients died of cancer, 20 patients died of other causes than cancer, and 1 patient died from immediate surgical effect.(ABSTRACT TRUNCATED AT 250 WORDS)
Endoscopic or fluoroscopic pyeloureterotomy was performed in a total of 32 patients (34 ureters) with ureteropelvic junction obstruction (UPJO) or ureteral stricture from March 1985. Cold incision was performed, using a flexible knife over a guidewire, endoscopically on 23 ureters and fluoroscopically on 11 ureters. The mean operation time was 98.9 +/- 48.3 minutes. Twenty-five (74%) of the 34 ureters showed relief of subjective symptoms, normalized urinalysis and radiographical improvement of hydronephrosis with a mean follow-up period of 11.7 +/- 10.0 months (range: 3-43). The clinical results by etiology were as follows: primary UPJO, 13/16 (81%); secondary UPJO, 4/4 (100%); ureteral stricture, 6/7 (85%); obliteration of ureteral implantation, 2/7 (29%). No major complication was noted with this endourological technique. This endourological technique might be clinically useful for the treatment of UPJO and ureteral strictures.
A 77-year-old male, complaining of epigastralgia, was admitted to hospital. An upper GI series revealed a hemispheric filling defect at the greater curvature of the lower gastric body and two submucosal tumor-like lesions of the antrum. Closer inspection revealed a tumor measuring 60 x 42 mm, with an irregular ulcer, and two submucosal tumor-like lesions with bridging folds, measuring 42 x 28 mm and 20 x 14 mm, respectively. Histologically, the microscopic features in the ulcerated tumor showed a variety of tumor cells with clear PAS-positive cytoplasms and marked atypical nuclei forming glandular structures that predominated. Additionally, a clear cell carcinoma, a papillary adenocarcinoma, a signet-ring cell carcinoma, and a choriocarcinoma were partially seen. Finally, in the submucosal tumor-like lesions, diffuse small tumor cells with scanty PAS-positive cytoplasms without granular structures were seen.
We report a case of metastatic renal tumor from lung cancer. A 53-year-old man presented with gross hematuria 2 years after treatment of the primary lesion. Investigations suggested a metastatic tumor in the right kidney from the lung which was accompanied with regional lymph node metastasis. Surgical treatment was not performed because of his poor condition and the lymph node involvement. Therefore, the combination chemotherapy of 5-fluorouracil, vincristine and doxorubicin, OK-432 was applied. Although this conservative management was effective, he died of progression 6 months later and an autopsy confirmed the diagnosis of metastatic renal tumor.
A 21-year-old man with painless tumor in the right scrotum was seen at our Department. The tumor was resected surgically and histological examination revealed venous hemangioma. This case is 26th case of scrotal hemangioma in Japan.
We reported a case of Paget's disease of the scrotum, a rare disease in urological field. The patient had successful radical resection of the dermal tumor and scrotal plasty. Paget's disease has a low malignancy and its treatment is necessary as the same manner to scrotal cancer. Although most scrotal malignancies are squamous cell carcinoma, urologists should recognize this borderline disorder exactly such as in this case and treat patients with co-operation to the relative fields.
A 32-year-old female consulted our hospital with the complaint of recurrent urinary tract infections, especially acute pyelonephritis. Cystoscopy revealed a wide-based tumor covered with a normal epithelium at internal meatus and right slight opened orifice, the contraction of which was slightly weak. Excretory urography showed almost normal nephrogram, pyelogram and ureterogram, and voiding cystography revealed right vesicoureteral reflux with grade IIb. Under general anesthesia, tumor resection of the bladder and right ureterovesiconeostomy were carried out. Pathologically the tumor was diagnosed leiomyoma. Right vesicoureteral reflux was speculated to have occurred secondarily to leiomyoma of the urinary bladder.
We present adult adrenal ganglioneuroblastoma with giant regional lymph node metastasis. The patient was a 21-year-old male, who had a left adrenal tumor diagnosed by ultrasonography incidentally. He was moderately developed and physical examination was almost normal. Blood pressure was within the normal range. Only the value of the vanilmandelic acid, which was 68.7 mg/day, in the urine was abnormal. Other laboratory data were almost normal. Neither chemical nor physical hormonal disorders were present. We carried out the radical surgical treatment by trans-thoracoabdominal approach under the diagnosis of left adrenal neuroblastoma. Pathological diagnosis was ganglioneuroblastoma. After the operation, the patient received both systemic chemotherapy of vincristine and cyclophosphamide and immunotherapy of OK-432 by subcutaneous administration. Furthermore, 40 Gy of the regional irradiation of 60Co to the operative space after the surgery was performed. At eight months after the operation, he is alive with no evidence of disease. Ganglioneuroblastoma is a neuroblastic tumor including neuroblastoma, which commonly occurs in childhood. The prognosis of the neuroblastic tumors which occur either in the adrenal gland of a young child or in an older child is poor. On the other hand, the biological activity of the adult neuroblastic tumors is different from that of the pediatric neuroblastic tumors. In the adult, the adrenal ganglioneuroblastoma does not always have a poor prognosis. The multimodality treatment which we performed is effective for the neuroblastic tumor. Ultrasonography is both effective and adequate for the screening of the retroperitoneal lesion such as in our case.
A 50-year-old Japanese male hospitalized with the complaint of fever and pyohematuria. An excretory pyelography revealed the right hydronephroureter due to right ureteral stone. When the ureterolithotomy was carried out, a wide-based and rice-sized tumor co-existed at the site of the epithelium of the ureter lithotomized. Resected tumor was pathologically confirmed as poorly differentiated adenocarcinoma with mitosis. Therefore, total nephroureterectomy with bladder cuff resection was done at 10 days after the first operation. However, malignant cells were not found in the surgical specimen or histologically diagnosed localized glandular ureteritis. He is alive without any evidence of recurrence. It was reported that the glandular metaplasia, a relative rare lesion in the ureter, was correlated with carcinogenesis of adenocarcinoma in urothelium. However, when the lesion is small and localized such as in this case it should be treated with ureterectomy and addition of other suitable adjuvant therapies. Furthermore, endourological techniques which have been recently dramatically progressed may become a weapon against this lesion for both treatment and follow-up.
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Five cases of inverted papilloma in the bladder are reported. All cases were males complaining of dysuria or hematuria. Total cystectomy with construction of ileal conduit was carried out in the first case, and transurethral resection in the other cases. Every surgical specimen was histologically diagnosed as inverted papilloma. The inverted papilloma is a distinct lesion characterized by its rarity compared to frequency of the other vesical papillomas. The prognosis is generally benign, but the possibility of recurrence and malignant transformation indicates the necessity of a close periodical follow-up.
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We present a case of ureteral endometriosis in a 48-year-old postmenopausal patient who was hospitalized complaining of right flank pain & microhematuria. She had no bladder irritability. She had a past history of simple hysterectomy and left oophorectomy because of adenomyomatosis. At that time, right ovary and other pelvic organs were normal. Physical examination revealed slight swelling of the liver without tenderness. Laboratory data at admission revealed severe liver dysfunction due to liver cirrhosis. Excretory urography demonstrated right hydronephroureterosis and severe stricture of the right lower ureter. Right ureteral catheterization demonstrated a high degree of stricture at the distal third. Cytology of right pelvic urine was negative. Right nephroureterectomy was done because long segment of right lower ureter adhered to the peritoneum tightly and we could not rule out ureteral cancer. Pathological diagnosis was extrinsic endometriosis of the right ureter. Ureteral endometriosis is rare and postmenopausal endometriosis is also rare. In our case hyperestrogenemia caused by liver cirrhosis might have played a role in the genesis and progression of endometriosis.
A squamous cell carcinoma-related antigen (SCC-Ag), which has been recognized as a tumor marker of cervical cancer of the uterine, was detected in the serum with a radioimmunoassay and its clinical usefulness in penile cancer was evaluated. Seven serum samples of penile cancer, one of Paget's disease and two of condyloma acuminatum were analyzed for the SCC-Ag level. The mean +/- standard deviation of serum SCC-Ag level and positive rate (greater than 2.0 ng/ml) were 1.6 +/- 1.75 ng/ml and 14%. Neither pathological staging nor cell grading of penile cancer showed any relation to the serum SCC-Ag level. When the tumor of the penis has been recognized and a cut-off value of 1.0 ng/ml used, the positive rate of penile cancer was 71.4% and false positive rate of other benign penile tumors was 0%. Serum SCC-Ag values were changed parallel in to the clinical course in three patients. These results suggest that the detection of the serum SCC-Ag value may be of use for detection of penile cancer and monitoring of these patients.
The purpose of this study is to clarify whether cysteine proteinases play an important role in the degradation of myocardial proteins in the infarcted tissue. We studied the effects of a cysteine proteinase inhibitor, Ep459, on degradation of cardiac structural proteins caused by ischemia due to coronary artery ligation for 24 h. Proteolytic effects of purified cysteine proteinases on isolated cardiac tissue were also examined. Using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, degradation of cardiac structural proteins, particularly of myosin heavy chain, alpha-actinin and troponin-I was observed in the infarcted tissue. Treatment with Ep459 significantly reduced protein degradation and total activity of cathepsins B and L in the infarcted tissue, compared with the findings in the untreated group. The electrophoretic pattern of the infarcted myocardium was similar to that of myofibrillar proteins degraded by cathepsins B and L. These results suggest that cysteine proteinases, particularly cathepsins B and L, are involved in degradation of myofibrillar proteins in myocardial infarction.
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