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Biomedical subjects

K Pak

Publications and source records attributed to K Pak.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Sequential combination chemotherapy consisting of vincristine, peplomycin, methotrexate, cis-diamminedichloroplatinum (II) and adriamycin in urothelial cancer].

The VPM-CisA (vincristine (VCR), peplomycin (PLM), methotrexate (MTX), cisplatin (CDDP) and doxorubicin (ADM), regimen was used to treat 33 patients with urothelial tract tumors. Twenty-two patients had bi-dimensionally measurable disease parameters and 11 patients with locally advanced tumors were given postoperative adjuvant chemotherapy. The protocol consisted of 0.6 mg/m2 VCR on days 1 and 3, 3 mg/m2 PLM on days 1 to 4, 3 mg/m2 MTX on days 2 and 4, 35 mg/m2 CDDP on day 4, and 20 mg/m2 ADM on day 5. These doses were adjusted for each case: the above mentioned dose x [(80/(40+Age]2 +[(Karnofsky's performance status/100)2]. Of these patients, 28 (86 percent) were treated adequately, including 8 (36 per cent) who achieved a complete (2) or partial (6) remission. The mean duration of survival was 65.2 weeks for complete and partial responders, and 48.8 weeks for non-responders, which was not a statistically significant difference. Of 11, who were given post-operative adjuvant chemotherapy (mean observation period: 83.5 weeks) 9 were alive without evidence of disease, 1 had a recurrence 8 months after first chemotherapy, 1 died due to pulmonary and liver metastasis 2 years after the chemotherapy. Toxicity included mild myelosupression, moderate anorexia, vomiting, and severe gastric ulcer, pulmonary fibrosis.

Adenocarcinoma↗
PubMed1989

[Pneumocystis carinii pneumonia in renal transplant recipients treated with cyclosporin].

Four cases of pneumocystis carinii pneumonia occurred among 38 renal transplant recipients. Diagnosis was confirmed by cyst concentration technique in 2 cases. The other 2 cases were clinically, from the rapid improvement of fever, pulmonary infiltrates and hypoxia following a therapeutic trial of high dose sulfamethoxazole-trimethoprim. All patients responded to treatment with high dose sulfamethoxazole-trimethoprim. Three patients survived pneumocystis carinii pneumonia, but i died due to aspergillosis. One patients showed serological evidence of concomitant cytomegalovirus infection.

Adult↗
PubMed1989

[The foreign body granuloma after pyeloplasty: report of a case].

We report a rare case of foreign body granuloma on plain catgut which developed after Anderson-Hynes pyeloplasty for obstruction of the ureteropelvic junction in a 3-year-old boy. We use plain catgut as the suture material on pyeloplasty and seldom experience such a complication. Regarding suture material on pyeloplasty, excessive sutures intended to make anastomosis water-tight to prevent urinary leakage should be avoided in children because they are apt to form foreign body granuloma.

Catgut↗
PubMed1988

Horseshoe kidney in Russell-Silver syndrome.

We describe a case of Russell-Silver syndrome associated with horseshoe kidney in a three-year-eleven-month-old boy. Several urologic anomalies are reported in this syndrome, but to our knowledge, horseshoe kidney has not been reported previously in the English literature.

Child, Preschool↗
PubMed1988

Noncrossed renal ectopia with fusion associated with single ectopic ureterocele.

We report a case of noncrossed renal ectopia with fusion associated with a single ectopic ureterocele. This association is rare, and it is extremely rare that an ectopic ureterocele is not a part of the duplicated urinary collecting system. Some problems about classification of renal fusion and ectopia are presented, and a new classification is introduced.

Adult↗
PubMed1988

Xanthogranuloma of the spermatic cord.

An unusual case of xanthogranuloma of the spermatic cord is described. This benign condition should be included in the differential diagnosis of intrascrotal tumors and simple surgical excision is recommended although we performed high inguinal orchiectomy.

Genital Diseases, Male↗
PubMed1988

[Hydronephrosis presenting as the first sign of malignant lymphoma of the small intestine: report of a case].

A 45-year-old man was admitted to hospital on November 26, 1985 with the chief complaint of left hypochondrial pain. Excretory and retrograde pyelography revealed left hydronephrosis due to extrinsic obstruction of ureter. Computerized tomography and angiography revealed that a tumor of the small intestine was the cause of ureteral obstruction. In addition to the presence of a tumor, a fistula in the small intestine was disclosed on the upper gastrointestinal series. During the operation, a large mass which involved several organs was identified without mobility. The sophisticated operation was composed of wide resection of small intestine including the tumor, left hemicolectomy, left nephroureterectomy, splenectomy, partial pancreatectomy, duodeno-ileostomy and transverse sigmoidostomy was done on December 19, 1985. Pathological diagnosis was malignant lymphoma, diffuse small cell type infiltrating ureter, kidney and perirenal connective tissue. Because of poor postoperative course systemic chemotherapy was not performed and he died of disseminated intravascular coagulation on April 2, 1986.

Humans↗
PubMed1988

[Effectiveness of FUT-175, protease inhibitor, as an anticoagulant to hemodialysis].

(6-Amidino-2-naphthyl 4-guanidino benzoate) dimethanesulfonate (FUT-175), a protease inhibitor, has been reported to be an effective anticoagulant during hemodialysis without heparin. The anticoagulant activity of FUT-175 is also reported to be short. We applied FUT-175 to 33 patients who were undergoing hemodialysis and susceptible to bleeding, to avoid the use of heparin. The concentration and anticoagulant activity of FUT-175 were relatively stable during hemodialysis. A 20-40 mg/h dose of FUT-175 prolonged coagulation time sufficiently in the instrumental blood of the extracorporeal circuit but not in the systemic blood. Its anticoagulant activity decreased immediately after hemodialysis. Therefore, we could manage all patients without any bleeding trouble during hemodialysis with FUT-175 as an anticoagulant. Although there were side effects of FUT-175, such as nausea, vomiting, itching and eruption, they were not serious, and FUT-175 could be administered without interruption. FUT-175 seems to be useful as an anticoagulant during hemodialysis for patients susceptible to bleeding.

Adult↗
PubMed1988

[Studies on nephrotoxicity of cyclosporin. II. Nephrotoxicity in rats receiving cyclosporin and sulfamethoxazole-trimethoprim].

A cyclosporin (CS) has a serious nephrotoxic effect which is synergistic with sulfamethoxazole-trimethoprim (ST) on renal allograft recipients. The effects of CS and ST on renal function and structure, were examined biochemically and morphologically in rats. Male Wistar rats each weighing 250 g were given various dose regimens (CS 50 mg/kg + ST 600 mg/kg, CS 25 mg/kg + ST 600 mg/kg, CS 10 mg/kg + ST 600 mg/kg) orally for 21 days, and were killed and examined on the 22nd day. Blood urea nitrogen (BUN), serum and urinary creatinine, and urinary N-acetyl-s-D-glucosaminidase (NAG) were measured before administration and on the 7th, 14th and 21st day after administration. The serum levels of CS, sulfamethoxazole (SMX) and trimethoprim (TMP) were measured on the 21st day after administration. Kidneys were examined by light and electron microscopy. All rats that had received 50 mg/kg CS and 600 mg/kg ST died within 9 days after a severe loss in body weight. Rats that had received 25 mg/kg CS and 600 mg/kg ST had lost weight. A high dose CS and ST caused a significant elevation of BUN. The level of serum creatinine was significantly elevated only in rats that had received 25 mg/kg CS and 600 mg/kg ST. Decrease in creatinine clearance was not significant and the urinary NAG activity was not altered significantly during the experimental course. Morphological alterations were confined to the proximal tubuli and they consisted of PAS positive globules, loss of nuclei, tubular cell vacuolation and increased number of lysosomes. However, these alterations were mild and not related to the dose of CS and ST.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

[Ureteral obstruction secondary to iliac artery aneurysm].

A 65-year-old woman was seen in September, 1986, because of general malaise and dull pain in the left flank. Physical examination was unremarkable. Murmur was not heard over the abdomen. An excretory urogram showed left hydronephrosis and a retrograde pyelogram showed extrinsic obstruction at the level of the transverse process of the 5th lumbar spine. Computed tomography (CT) showed a mass with irregular calcification in its center. The mass was assumed to be located in the left iliac artery and as it was enhanced homogeneously, iliac aneurysm was suspected. Angiography revealed an aneurysm of the left iliac artery involving common, external and internal iliac arteries. The patient was treated by ligation of aneurysm, aorto-femoral graft bypass and ureterolysis. Histopathological findings showed aneurysm due to atherosclerosis. A postoperative excretory urogram showed improvement of hydronephrosis. Ureteral obstruction due to iliac aneurysm is unusual but it should be considered when performing differential diagnosis of extrinsic ureteral obstruction. CT is a useful diagnostic tool and aortography should be done to make a final diagnosis. Treatment is based on resection or ligation of aneurysm with ureterolysis.

Aged↗
PubMed1987

[Adrenal myelolipoma: report of a case].

We report a case of adrenal myelolipoma occurring in a 56-year-old man. The patient complained of lumbago and gross hematuria in October, 1981 and consulted a local doctor who pointed out a right ureteral stone and downward deviation of the left kidney. The patient was referred to our hospital for further examination. An echogram showed a high echogenic mass in the left flank which was compressing the spleen and the kidney. A CT scan revealed a large mass with heterogeneous low density contents. The mass was lobulated into several parts and their density suggested fat tissue. An aortogram showed an avascular mass and an adrenal venogram showed multiple veins which radiated to the periphery. Judging from these findings, a tentative diagnosis of adrenal myelolipoma was made and left adrenalectomy was performed. Histological examination revealed that this tumor was composed of adrenal tissues, fatty tissues and myeloid tissues. The postoperative course was uneventful. We discuss the necessity of aortography and selective adrenal venography to evaluate the origin of the tumor. To our knowledge, this is the tenth case report of adrenal myelolipoma in Japan and we have made a brief review of Japanese literature of adrenal myelolipoma.

Adrenal Gland Neoplasms↗
PubMed1987

[Statistical survey of metastasis of bladder tumors--from the annual of pathological autopsy cases in Japan].

We analyzed 1,821 cases of bladder tumors collected from the Annual of the Pathological Autopsy Cases in Japan, 1978-1982, published by the Japanese Pathological Society to determine the frequency of metastasis and metastatic sites. Study of age distribution revealed that the highest incidence was found in the 70-79 age group and that the male to female ratio was 2.95:1. Histologically, the tumors were transitional cell carcinoma in 1,393 cases (80.5%), squamous cell carcinoma in 185 cases (10.7%), adenocarcinoma in 64 cases (3.7%) and anaplastic cell carcinoma in 62 cases (3.6%). Metastasis was found in 1,275 cases (70.0%). The frequency of metastasis according to histological type was transitional cell carcinoma in 960 (69.8%), squamous cell carcinoma in 127 cases (76.5%), adenocarcinoma in 51 cases (86.4%) and anaplastic cell carcinoma in 53 cases (89.8%). Metastasis occurred in order of decreasing frequency in lymph nodes, lungs, liver, bones, peritoneum, kidneys, intestines, prostate, ureters and uterus. These findings were compatible with several previous statistical surveys of autopsy cases of bladder tumor.

Adenocarcinoma↗
PubMed1987

[A case of left inferior vena cava discovered by chance at nephrectomy for renal transplantation].

A case of left inferior vena cava, in a 35-year-old woman, discovered by chance at nephrectomy for renal transplantation is reported. She was admitted to our hospital as a donor of the kidney to her son. She had no remarkable physical signs on chest or abdomen. All laboratory tests were within normal limits. Intravenous pyelogram showed no major abnormality except for the lower position of left kidney than right one. Abdominal aortogram and selective renal arteriogram revealed no abnormality. Bilateral renal arteries were single. Left nephrectomy for transplantation was performed on April 13, 1983. In this operation the left sided inferior vena cava was discovered by chance. Inferior vena cavography was taken postoperatively. It showed the left sided inferior vena cava, type C. Knowledge of the abnormalities of the left renal vein and inferior vena cava is of surgical importance for the urologist when renal transplantation is being considered.

Adult↗
PubMed1987

[An autopsy case of untreated bladder cancer].

A case of untreated bladder cancer with an unusual clinical course in a 48-year-old man is reported. The patient noted painless gross hematuria 10 months prior to the first visit to our department on May 16, 1980. Cystoscopy revealed nonpapillary tumors in the right lateral and posterior wall. The histopathological finding was transitional cell carcinoma, grade II on biopsy. No metastatic lesions were found on clinical evaluation. Therefore, radical cystectomy with ileal conduit was planned. However, the patient refused the operation because he could not tolerate having the stoma on the abdomen. Because the patient had no complaint except for the past gross hematuria, he refused any treatment. The patient revisited our department 6 months after the diagnosis because swelling of the right thigh caused gait disturbance. A chest X-ray revealed pleural effusion, and an excretory urogram disclosed a right non-visualizing kidney and a large filling defect in the bladder. Cervical lymph nodes were swollen and several small nodules under reddish skin on the chest and abdomen were found to be metastatic lesions. Chemotherapy with cis-diamminedichloroplatinum, doxorubicin and 5-fluorouracil was ineffective in regressing the primary tumor although cervical lymph nodes and skin lesions responded at the induction. The patient died 29 months after the initial onset of the gross hematuria and 19 months after the diagnosis. Autopsy findings revealed metastasis in skin, diaphragm, left adrenal gland, stomach, small intestine, pericardium, right epididymis and lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗