Biomedical subjects

K Tobisu

Publications and source records attributed to K Tobisu.

At least 55 records · Page 3Linked to original sources

PubMed1993

Hemorrhagic cystitis associated with allogeneic and autologous bone marrow transplantation for malignant neoplasms in adults.

We investigated the occurrence of hemorrhagic cystitis in 30 consecutive adult patients undergoing bone marrow transplantation (BMT) for hematological and non-hematological malignancies. Ten patients with hematological malignancies received allogeneic BMT, and twenty patients, seven with hematological and 13 with non-hematological malignancies, received autologous BMT. All 30 patients received high-dose cyclophosphamide-containing regimens (120 mg/kg in 16, 200 mg/kg in one, 6000 mg/m2 in 13) as preparative therapies. They all received 2-mercaptoethane sulphonate sodium (mesna) combined with hyperhydration 3 liter/day as prophylaxis for hemorrhagic cystitis. Bladder irrigation was not performed. Overall, five patients (16.7%) developed hemorrhagic cystitis; early-onset (within 48 hours of the end of the high dose chemoradiotherapy) hemorrhagic cystitis occurred in one (3.3%; 95% confidence interval, 0.6-16.7%) and late-onset occurred in four (13.3%; 95% confidence interval, 5.3-29.7%). In three of the four late-onset cases, adenovirus was isolated from the urine specimens at the onset of the hemorrhagic cystitis. Among the 13 patients with non-hematological malignancies receiving autologous BMT, one with recurrent breast cancer developed late-onset hemorrhagic cystitis associated with adenovirus type 11. We conclude the prophylactic measure with mesna and hyperhydration to be effective enough to prevent cyclophosphamide-induced hemorrhagic cystitis of early onset. Some BMT recipients, however, even those with non-hematological malignancies undergoing autologous BMT, develop late-onset hemorrhagic cystitis in which adenovirus is considered a principal causative agent.

Adult↗

PubMed1992

Analysis by step sectioning of early invasive bladder cancer with special reference to G3.pT1 disease.

Eighty cases of cystectomized and step-sectioned pT1 transitional cell carcinomas of various grades were analyzed. During the same period, 30 consecutive cases of pT2 carcinomas were also cystectomized and examined for comparison. This is a cross-sectional study of a variety of cases of bladder cancer, designed to delineate the characteristics of G3.pT1 disease. Tumors in this series had a full set of various pathological findings; grades 1 to 3, stages Ta-T1-T2, papillary-papillonodular-nodular tumor configuration, alpha-beta-gamma type of invasion, presence of lymphatic and venous involvement, and presence of associated carcinoma in situ/dysplasia. There is a distinct tendency of stepwise disease progression, such as grade 1-->3, stage T1-->T2, papillary-->nodular configuration, and alpha-->gamma invasion, these factors being mutually related. We noted a similarity between tumor groups containing G3 component, such as G2-3.pT1, G3 > 2.pT1, G3.pT1, G1-3.pT2, and G3.pT2. These tumors are different from groups such as G1-2.pT1, G2.pT1 and G2 > 3.pT1 in terms of tumor configuration and type of invasion. As regards pT1 having G3 components, early cystectomy seems to be the surest treatment. Whenever one adopts a conservative policy in treatment of these tumors, extreme care should be taken to monitor tumor progression.

Adult↗

PubMed1992

[Promotive effects of intravesical instillation of dimethylsulfoxide on bladder carcinogenesis in mice].

The effect of intravesical instillation of dimethylsulfoxide (DMSO) on bladder carcinogenesis was examined in mice. Experiment 1: Fifty-five female C3H/He mice were administered 0.05% N-butyl-N-(4-hydroxy-butyl) nitrosamine (BBN) in their drinking water for 8 weeks. In week 9 they were divided into two groups consisting of 25 mice each. Then, under nembutal anesthesia the first group was given weekly intravesical inatillations of 0.1 ml DMSO (minimum 99.0%) for 10 weeks. The second group received no treatment except anesthesia. All mice were killed 30 weeks after the begining of the experiment and their urinary bladder resected for histological examination. The incidence of bladder carcinoma was 93.7% (15.16) and 27.7% (6/22) in groups 1 and 2, respectively. These incidences differed significantly between the two groups. Experiment 2: One hundred and twenty female C3H/He mice were divided into two groups. The first group was given 0.05% BBN in their drinking water for 5 weeks and then tap water. The second group was not given BBN. In week 6, the first group was divided again into three groups (1, 2 and 3) consisting of 28, 26, and 27 mice, respectively. The second group was divided into groups 4 and 5 consisting of 21 and 18 mice, respectively. Under nembutar anaesthesia groups 1 and 4 received weekly intravesical instillation of 0.05 ml DMSO (minimum 99.0%) from weeks 6 to 13, Group 2 received weekly intravesical instillation of 0.05 ml distilled water from weeks 6 to 13. Groups 3 and 5 received no treatment except anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗

PubMed1992

An ileal neobladder for a female patient after a radical cystectomy to ensure voiding from the urethra: a case report.

An ileal neobladder construction realizing normal micturition was successfully performed after a total cystectomy, with preservation of the urethra, for a 69-year-old female patient with invasive bladder cancer. Approximately 60 cm of terminal ileum was selected, detubularized and re-sutured to create an oval-shaped intestinal pouch to which the bilateral ureters were anastomosed. The bottom of the pouch was anastomosed to the urethral remnant. Three months after surgery, the patient achieved daytime continence, and now enjoys almost the same lifestyle as before. This is the first case of successful neobladder construction to be precisely reported for a female patient. For normal micturition, the ileal neobladder will be one of the possible choices for urinary diversion in not only selected male, but also female, patients.

Aged↗

PubMed1991

Transitional cell carcinoma of the urethra in men following cystectomy for bladder cancer: multivariate analysis for risk factors.

Multicentric development of transitional cell carcinoma in the urinary tract is well recognized. Of 169 male patients who underwent cystectomy for bladder cancer 18 (10.6%) demonstrated urethral cancer (all within 5 years after cystectomy). The risk factors involved in transitional cell carcinoma in regard to the occurrence of urethral cancer after cystectomy were examined by multivariate analysis. Characteristic patterns of bladder cancer in the cystectomy specimens were expressed by the grade, stage, number, size, location and gross pattern of the tumors. Significant risk factors in bladder cancer relating to the development of cancer in the retained urethra were papillary cancer, multiple cancers, and tumors in the bladder neck, prostatic urethra and prostatic gland. Among 19 patients with concomitant carcinoma in situ and/or multiple papillary tumors in the bladder who underwent simultaneous prophylactic urethrectomy with cystectomy in the same observed period 17 (89%) had no lesion in the resected urethra. The results of the multivariate analysis will be useful to avoid unnecessary prophylactic urethrectomy at cystectomy. However, further analysis and consideration of possible mechanisms of the secondary urethral cancer will be necessary to explain the discrepancy posed in the latter study involving 19 patients.

Adult↗

PubMed1991

Development of multiple transitional cell carcinomas in the urinary tract.

The multiplicity of transitional cell carcinomas in the renal pelvis, ureter and bladder was analyzed in terms of (1) tumor configuration, i.e., papillary, nodular cancers, (2) associated mucosal changes such as carcinoma in situ (CIS) and dysplasia and (3) the possible involvement of human papillomavirus (HPV) in the development of multiple papillary cancers in the bladder. The incidences of concurrent or subsequent bladder cancer in renal pelvic cancer and/or ureteral cancer cases were 7/31 (22%) for renal pelvic cancer, 17/28 (60%) for ureteral cancer and 10/15 (67%) for renal pelvic and ureteral cancer. In 33 cases of renal pelvic and/or ureteral cancer occurring since 1978, 67% of the papillary and 13% of the nodular cancers in the upper tract exhibited a simultaneous or later development of bladder cancer. In 211 cases of bladder cancer for which cystectomy was performed, 77% of the papillary cancers arose in multiple form, 57% being associated with CIS and/or dysplasia, whereas 72% of the nodular cancers developed singly, 55% being associated with CIS and/or dysplasia. No positive signals hybridizing to HPV types 1, 5, 6, 11, 16, 17, 18, 20, 33 and 38 were detected in any of 19 papillary bladder cancers and 13 specimens of normal bladder mucosa under conditions of low stringency, suggesting that HPV may not be a factor in multiple bladder tumor development. Definite findings from the present study are: (1) there is multiple development of papillary cancers but they remain superficial, whereas nodular cancers develop singly and are invasive, (2)) there was no steady tendency towards a relation between multiplicity and associated mucosal changes, (3) HPV was not, to our knowledge, involved in the multiple development of papillary cancers in the bladder.

Adolescent↗

PubMed1991

Trial to induce prostatic cancer in ACI/Seg rats treated with a combination of 3,2'-dimethyl-4-aminobiphenyl and ethinyl estradiol.

In an attempt to induce prostatic adenocarcinoma at higher incidence in a shorter period, we administered diet containing 0.75 ppm of ethinyl estradiol (EE) for three weeks to ACI/Seg rats, which are predisposed to develop a high incidence of microscopic adenocarcinoma of the prostate at higher age. Then, feeding was changed to basal diet and a single subcutaneous injection of 50 mg/kg body weight of 3,2'-dimethyl-4-aminobiphenyl (DMAB) was given two days after the change. We repeated this schedule 10 times. The rats were killed in week 60 of the experiment and subjected to routine autopsy. The average body weight of rats in group 1 given EE and DMAB was lower than that of control rats in group 2. The incidence of adenocarcinoma was not significantly different in the two groups, i.e., 6/74 (8.1%) in group 1 and 2/54 (3.7%) in group 2. The lesions were all microscopic. The incidence of atypical hyperplasia was significantly higher in group 1 at 17 of 74 rats (23.0%) whereas in group 2, it was only 2 of 54 rats (3.7%). Simple hyperplasia was also observed in 25 of 74 rats (33.8%) in group 1, which was significantly higher than that in group 2, where six of 54 rats (11.1%) had this lesion. The reduced growth of animals due to treatments with EE and DMAB probably suppressed the development of prostate cancer in this experiment. Further studies are needed to develop an appropriate model to induce prostate carcinoma at higher incidence in a shorter period.

Aminobiphenyl Compounds↗

PubMed1991

A new form of specific targeting cancer immunotherapy using anti-tumor monoclonal antibody-conjugated lymphokine-activated killer cells.

Cross-linking of effector T cells to target cancer cells augments their tumor lytic activities. Here we describe a new method of conjugating lymphokine-activated killer (LAK) cells with cancer-specific monoclonal antibody. The LAK cells were biotinylated, treated with avidin, and conjugated with biotinylated monoclonal antibody. These monoclonal antibody-conjugated LAK cells showed specifically enhanced killing activities against anti-tumor antibody-reactive cancer cells, and cold target cells specifically inhibited their activities.

Antibodies, Monoclonal↗

PubMed1991

Tumor markers in human renal cell carcinoma.

Localization of tumor markers in human renal cell carcinomas (RCC) was studied by an immunohistochemical method using 12 different monoclonal antibodies (MAbs) recognizing carbohydrate antigens, and 2 polyclonal antibodies against S-100 protein and neuron-specific enolase (NSE), respectively. 115D8, DF3 and the MAb to epithelial membrane antigen (EMA) reacted with 9 of 13 (115D8), 6 of 13 (DF3) and 5 of 12 (MAb to EMA) cases of RCC, respectively. S-100 protein was also found in 10 of 13 cases of RCC. Further immunohistochemical studies showed that tumor cells of all 13 RCCs were strongly positive for NSE. Serum NSE levels of patients with RCC were examined by radioimmunoassay. This examination revealed that increased levels of NSE were detected in 11 of 17 sera of patients with RCC. Positive rates for patients in stages II, III and IV were 100% (10/10). On the other hand, increased levels of CA15-3 were detected in only 2 of 17 sera by enzyme immunoassay. Our results indicate that NSE may be a useful marker for human RCC, especially for those tumors that have broken through the renal capsule.

Animals↗

PubMed1991

[A randomized trial of PVB, VAB-6, BVP regimen versus PEB chemotherapy in patients with disseminated testicular tumors].

During 2 years and 7 months from June, 1985 to December, 1987, a randomized multi-center trial of PVB, VAB-6, BVP regimen (group A) without etoposide versus PEB chemotherapy (bleomycin, etoposide and cisplatinum) (group B) was given to patients with disseminated testicular tumors. Of 34 patients registered, 10 patients were with minimal disease in stages IIA, IIIO and IIIA and 24 with extensive disease in IIB, IIIB2 and IIIC. Seminomas were found in 10 patients, while non-seminomatous tumors in 24. Among groups A and B, there was no statistical difference in clinicopathological profiles. A group patients were given either PVB, VAB-6 or BVP according to the physician's discretion. In groups A and B, 35% and 43% of the patients achieved complete response, and 45% and 50% achieved partial response, respectively. The difference in CR rates among both groups was not statistically significant even when calculated according to the stage or histologic grouping. Salvage treatments mainly with surgical resection of residual tumors after the chemotherapy, however, were more successful in group B (88%) than group A (61%). It appears likely that the higher response of induction chemotherapy in patients with extensive disease made the salvage surgery more successful in group B than in group A. The 3 year survival rate was 100% in group B, whereas it was 76% in group A. Although the incidence of myelosuppression and alopecia was significantly higher in group B, neuropathy was significantly more frequent in group A. From the above results, PEB seems to be a better induction chemotherapy than the conventional one for advanced testicular tumors.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1991

[Tumor markers--personal experience. Multidisciplinary treatment of disseminated germ cell tumor in full use of tumor markers].

The ideal course of multidisciplinary treatment of disseminated germ cell tumors was shown with special reference to the role of the tumor markers for 1) diagnosis of pathological elements and risk factors, 2) appropriate selection of the protocol before and during the chemotherapeutic treatment, 3) timely resection of residual tumor and 4) monitoring of the recurrence after treatment. The practical role of tumor markers for evaluation of chemotherapeutic effectiveness, the following reconsideration of the appropriate protocol and timely indication of surgical intervention for residual mass after chemotherapy were emphasized by demonstrating the clinical courses of 2 patients with advanced nonseminomatous testicular germ cell tumors.

Adult↗

PubMed1991

[Tumor markers--personal experience. A case of advanced extragonadal germ-cell tumor showing complete remission by high-dose combination chemotherapy with autologous bone marrow transplantation].

A twenty-four-year-old male patient with stage III advanced extragonadal germ-cell tumor obtained complete remission after comprehensive treatment including high-dose combination chemotherapy with autologous bone marrow transplantation. He had massive tumors in cervical, mediastinal, abdominal and inguinal lymph nodes, bilateral lungs and liver. Ascites, plural effusion and pericardial effusion were also noted. Cancer cells were demonstrated from his bloody sputum, pericardial drainage and an aspirate from supraclavicular tumor. His tumor produced hCG, AFP, placental ALP and LDH, and hCG was the best marker for the diagnosis and monitoring. The initial serum hCG level was high at 460,000 mIU/ml, but fell to 13 mIU/ml after 3 courses of PVP therapy. However, it rose ten-fold in a week. After ultra-high dose combination chemotherapy with autologous BMT, the patient's hCG fell to 1.8 mIU/ml and remained at that level thereafter. He has remained well with no sign of recurrence after 25 months.

Adult↗

PubMed1990

[Discriminant analysis of quantification theory on prognostic factors of chemotherapeutic effects on advanced testicular cancer. East Japan Testicular Tumor Study Group].

Prognostic factors of chemotherapy against advanced testicular cancer were analysed in 33 cases studied by East Japan Testicular Tumor Study Group. In this study a discriminant analysis of quantification theory (a multivariate analysis) was adapted, taking 7 factors as comparative variables. The significant factors for complete tumor response were clinical stage, histology, and tumor markers (HCG-beta, AFP). Prognostic score was calculated in each case by quantification theory, which correctly discriminated the group with CR from that without CR, at a probability of 90.1%. The results of our study indicate that the outcome of chemotherapy on advanced testicular cancer may be predicted with probability, by patients' status and adopted treatment. It may enable one to make an adequate treatment schedule for each patient.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1990

Solitary adrenal metastasis from hepatocellular carcinoma: a case report of simultaneous successful resections.

The case is presented of a 64-year-old male with a left adrenal mass and multiple liver lesions. Preoperative image work-ups included ultrasonography, computed tomography, selective liver and adrenal angiographies, and magnetic resonance imaging. Serial serum alpha-fetoprotein monitoring and the adrenal hormone profile were within the normal ranges. A left adrenalectomy and a right lobectomy of the liver were performed, and the pathology revealed hepatocellular carcinoma with left adrenal metastasis. The clinical significance of the present case, together with the diagnosis and management of the disease is discussed.

Adrenal Gland Neoplasms↗

PubMed1990

Surgical treatment of metastatic renal cell carcinoma.

The survivals of 174 patients who underwent nephrectomy for renal cell carcinoma were analyzed to evaluate the influence of the surgical treatment of metastases on their prognosis. For 34 of the 174 patients, surgical resections of the metastases were performed concurrently with nephrectomy. For 38 patients, 44 surgical resections of metastases were performed in the follow-up period after nephrectomy. Apparently curative resections of metastases, at the time of nephrectomy or after nephrectomy, were significantly correlated with good survivals after surgery, irrespective of the number of metastatic foci. Aggressive surgical treatment was beneficial in patients with a longer tumor-free period after nephrectomy or with stable disease for about six months after surgical treatment, although this might simply be a reflection of a longer natural disease course in this specific group of patients.

Adult↗

PubMed1989

[Stage IV renal cell carcinoma producing alpha-fetoprotein treated with multimodal treatment. A case report].

A 63 year old man, having right renal cell carcinoma which was found after initial symptoms of left supraclavicular tumor and gross hematuria, is presented. The points to note with this case are; (1) An unusual production of alpha-fetoprotein (AFP), (2) Being discovered at a very advanced stage and that the disease progressed rapidly (at initial presentation the patient had lymph nodes metastases from the paraaorta, mediastinum to the left supraclavicular region. Later the patient had a recurrent tumor in the left supraclavicular area and multiple cutaneous metastases), (3) Various modalities of treatment were given (right nephrectomy, abdominal lymph nodes dissection, resection of the supraclavicular and mediastinal lymph nodes metastases, hyperthermia combined with irradiation for the recurrent tumor in the supraclavicular region and systemically adoptive immunotherapy with tumor infiltrating lymphocytes). During this treatment course, the drift of serum AFP showed a good correlation. The possibility of AFP as a tumor marker of renal cell carcinoma in selected cases was presented and the suitability of the treatments performed to this patient was discussed.

Carcinoma, Renal Cell↗

PubMed1989

[A case of proliferative chronic cystitis, progressing to obstructive nephropathy, treated by total cystectomy and enterocystoplasty].

A 52 year-old man, being pointed out as with microscopic hematuria and suspected of carcinoma of the urinary bladder at another institution, visited this hospital for further examination. DIP demonstrated an irregular right lateral wall of the urinary bladder. CT of the pelvic cavity revealed a protrusive mass lesion inside the urinary bladder. Cystoscopy proved a circular, edematous and irregular mass lesion around the urinary bladder neck. The pathological examination of TUR specimens showed a proliferative chronic cystitis. However, after about half a year, there was a recurrence of mass lesions in the urinary bladder. Moreover, right non-functional kidney and left hydronephrosis were observed. For preserving renal function, total cystoprostatectomy was performed. Nerve sparing technique for sexual function, and total bladder replacement using a detubularized sigmoid colon to obviate the need for a stoma were adopted. Postoperative course was uneventful and the function of both kidneys was recovered. Normal urination from the urethra and sexual function are both preserved. Pathological examination of the cystectomized specimen confirmed only proliferative cystitis with extensive deep ulceration and thick connective tissues. A rare case in which obstructive nephropathy was caused by proliferative cystitis is reported and discussed.

Chronic Disease↗

PubMed1989

[Analysis of renal cell carcinoma with tumorous legion in the liver].

We presented 3 cases of renal cell carcinoma with hepatic lesion, for which it was difficult to make a diagnosis preoperatively. The hepatic lesion was cavernous hemangioma of the liver, liver metastasis of renal cell carcinoma or hepatocellular carcinoma. To discuss the strategy of treatment for liver metastasis of renal cell carcinoma at the time of nephrectomy, or in the follow-up period after nephrectomy, we reviewed the 188 cases of renal cell carcinoma which were nephrectomized from December, 1962 to June, 1988. At the time of nephrectomy, there was only 1 case that had concurrent liver metastasis. In 4 cases, liver metastasis was found at autopsy, and in 15 cases, in the follow-up period after nephrectomy. We analysed these 15 cases and classified them into 2 groups. One was "early metastasis group", i.e., liver metastasis was found within 18 months after nephrectomy, and the other was "late metastasis group", i.e., liver metastasis detected more than 6 years after nephrectomy. In the "early metastasis group", 2 lived 10 months or 57 months, but 5 died within 1 month after the appearance of liver metastasis. In the "late metastasis group", 4 of 7 lived more than 2 years after the appearance of liver metastasis and the median survival was 21 months. In both groups, when liver metastasis was found, there were metastases in multiple organs and the hepatic lesions were multiple.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗