PubMed Health⌕ Search

Biomedical subjects

Katsuya Nonomura

Publications and source records attributed to Katsuya Nonomura.

At least 19 recordsLinked to original sources

Reactivation of hepatitis in a bladder cancer patient receiving chemotherapy.

Reactivation of hepatitis is a serious complication of chemotherapy in hepatitis B virus (HBV) carriers. There are many reports of this in lymphoma patients but few in urological cancer patients. A 59-year-old woman with bladder cancer who was an HBV carrier developed severe liver dysfunction after 2 cycles of chemotherapy. The diagnosis was reactivation of hepatitis. She improved with administration of lamivudine with a steroid and is currently well without disease. Care should be taken about the risk of reactivation when performing chemotherapy in HBV carriers and prophylaxis by lamivudine should be considered.

Antineoplastic Agents↗

Survival and prognostic classification of patients with metastatic renal cell carcinoma of bone.

OBJECTIVES: We retrospectively analyzed the survival of renal cell carcinoma patients with bone metastases, and identified prognostic factors and a model predictive for survival in these patients. METHODS: Fifty patients with renal cell carcinoma with osseous metastases were treated at Hokkaido University Hospital between 1980 and 2004. The relationship between several clinical features and survival was examined univariately. The Cox proportional hazards model was then used to form a multivariate model. RESULTS: The median survival time from the diagnosis of bone metastasis was 12 mo, and overall survival at 2 yr was 37%. Clinical features correlated with longer survival in the multivariate analysis were a long interval (24 mo or more) between the diagnosis of kidney cancer and that of osseous metastasis (hazard ratio [HR]: 2.608; 95% confidence interval [CI], 1.031-6.599) and the absence of extraosseous metastases (HR: 2.523; 95%CI, 1.023-6.220). By combining these two favorable factors, renal cell carcinoma patients with osseous metastases could be categorized into two different groups. The median time to death in 20 patients with zero favorable factors (poor prognosis) was 5 mo. On the other hand, 30 patients had one or two favorable factors (good prognosis); the median survival time in this group was 30 mo. There was a significant difference in survival duration between the two groups (p<0.001). CONCLUSIONS: Two prognostic factors predicting survival were identified and used to categorize renal cell carcinoma patients with bone metastasis into two prognostic groups.

Adult↗

[Genital anomaly].

Explore the source record for details and available documents.

Abnormalities, Multiple↗

Salvage chemotherapy with paclitaxel, ifosfamide, and nedaplatin in patients with urothelial cancer who had received prior cisplatin-based therapy.

BACKGROUND AND AIMS: The aim of the present phase II study was to evaluate the efficacy of combination chemotherapy of paclitaxel, ifosfamide, and nedaplatin (PIN regimen) in patients with recurrent urothelial cancer who had been treated with cisplatin-based chemotherapy. PATIENTS/METHODS: Eligible patients were those with histologically confirmed urothelial cancer who had progressed or relapsed after cisplatin-based chemotherapy. The PIN regimen consisted of paclitaxel 175 mg/m(2) on day 1; ifosfamide 4.5 g/m2 divided over days 1, 2, and 3; and nedaplatin 70 mg/m(2) on day 1; PIN was given every 28 days. RESULTS: Among the 32 patients enrolled in the study (median age, 66 years), complete and partial responses were obtained in 5 patients and 19 patients, respectively, with an overall response rate of 75% (95% confidence interval [CI], 59-91%). The median time to progression was 8 months (range, 0-50+ months) and the median survival was 22 months (range, 4-52+ months). The 1- and 2-year overall survival rates were 53.7 and 42.9%, respectively. All patients experienced Grade 3 or 4 neutropenia, while Grade 3 or 4 thrombocytopenia was seen in 8 patients; Grade 3 or 4 anemia was seen in 6 patients; Grade 3 neuropathy was observed in 1 patient, for whom the PIN therapy was discontinued. There were no treatment-related deaths. CONCLUSION: The PIN combination was highly active and tolerable in previously treated patients with urothelial cancer as a second-line treatment.

Adult↗

Brain activation during detrusor overactivity in patients with Parkinson's disease: a positron emission tomography study.

PURPOSE: Patients with Parkinson's disease often have urine storage symptoms, such as urinary urgency, frequency and incontinence, which are induced by detrusor overactivity. However, little is known of the mechanisms inducing detrusor overactivity in this disease. We have previously examined the human brain response to bladder filling in healthy male volunteers using positron emission tomography. We hypothesized that brain activation patterns in response to bladder filling would be different in patients with Parkinson's disease. MATERIALS AND METHODS: Nine male patients with Parkinson's disease were catheterized via the urethra for bladder filling and intravesical pressure monitoring. We performed positron emission tomography, consisting of tasks 1 and 2. For task 1 the bladder was maintained empty via the urethral catheter. For task 2 room temperature water was dripped for bladder filling until the onset of detrusor overactivity. Data acquisition for task 2 was done during detrusor overactivity. Data on each scan were summed on a computer and further analyzed using a statistical parametric mapping procedure. RESULTS: Significant brain activation during detrusor overactivity was found in the periaqueductal gray, supplementary motor area, cerebellar vermis, insula, putamen and thalamus. The most prominent activation was found in the cerebellum. The pons was not activated during detrusor overactivity. CONCLUSIONS: Alteration in brain activation sites in response to bladder filling may be related to the pathophysiology of detrusor overactivity in patients with Parkinson's disease.

Aged↗

Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence.

PURPOSE: Even if performed early in life, hypospadias surgery may have a significant impact on self-esteem and sexual behavior in adolescence. We evaluated the long-term cosmetic and sexual outcomes of hypospadias surgery performed in childhood. MATERIALS AND METHODS: A detailed questionnaire was mailed to 33 patients with hypospadias who were 18 to 26 years old and had undergone the first operation at age 6 years or younger. It was also mailed to 50 age matched controls. RESULTS: A total of 22 patients (66.7%) and 38 controls (76.0%) returned the questionnaire. Mean age in the hypospadias and control groups was 20.6 and 21.0 years, respectively. Eight of the 22 patients had mild hypospadias and 11 had severe hypospadias. Severity was unknown in 3 patients. Age at the first and final operations was 31 to 75 (mean 46) and 35 to 81 months (mean 53). The number of operation was 1 in 10 patients, 2 in 10 and 3 in 2. The rate of dissatisfaction with penile appearance was slightly higher in the hypospadias group than in the control group (40.9% vs 34.2%). The single reason for dissatisfaction in the hypospadias group was inadequate penile size, whereas in the control group penile size, phimosis and curvature were the major reasons for dissatisfaction (69.2%, 46.2% and 23.1%, respectively). Experience with masturbation (100% and 97.4%) and sexual intercourse (52.4% and 55.3%), and mean age at first masturbation (13.4 and 13.0 years) and first sexual intercourse (16.6 and 17.3 years) were similar in the hypospadias and control groups, respectively. CONCLUSIONS: Although patients with hypospadias had a slightly higher rate of dissatisfaction with penile size, their sexual behavior was not different from that in control subjects.

Adolescent↗

Positive pre-transplant flow-panel reactive antibody detected after accelerated acute rejection with negative pre-transplant flow crossmatch.

A 30-yr-old woman underwent kidney transplantation from a flow cytometric lymphocyte crossmatch-negative donor. Immunosuppression consisted of tacrolimus, mycophenolate mofetil, basiliximab and three days of steroid. On day 5 post-transplant, she developed acute rejection and underwent anti-rejection therapy consisting of steroid pulse and deoxyspurgualin. Retrospective analyses of anti-human leukocyte antigen antibody revealed high flow panel reactive antibody (PRA) in the pre-transplant serum without donor specific antibody (DSA) and positive DSA at the time of rejection. Anti-rejection therapy was successful in treating cellular rejection but her graft function further deteriorated after three months post-transplant and graft biopsy revealed chronic allograft nephropathy with positive staining for C4d in peritubular capillary, suggesting the presence of chronic antibody-mediated rejection. Pre-transplant positive flow PRA without DSA may also be a risk for acute and chronic rejection.

Adult↗

Establishment and characterization of human urothelial cancer xenografts in severe combined immunodeficient mice.

AIM: To establish and characterize a murine xenograft model of human urothelial cancer in severe combined immunodeficient (SCID) mice for therapeutic simulation. METHODS: Pieces of 30 freshly resected urothelial tumors (24 obtained from bladder and 6 from ureter or pelvis) were implanted subcutaneously into SCID mice, and xenograft tumors were passed in tumorigenic cases. At each passage, histopathology, TP53 mutational status assessed by yeast p53 functional assay, and the Ki-67 labeling index (LI) were examined to evaluate the preservation of original features. A growth delay assay after single-dose irradiation was performed in four representative xenografts. RESULTS: Tumor growth was observed in 18 mice (60%, 18/30). Histologically, 15 of the 18 were epithelial carcinomas similar to the original tumors, whereas the other 3 were Epstein-Barr virus-associated lymphoproliferative disease, resulting in a 50% (15/30) take rate. No correlation was found between the tumor take rate and the clinicopathologic features, TP53 mutational status, or Ki-67 LI of the patients' tumors. Of these 15 xenografts, 11 xenografts were passed from 3 to 10 generations. TP53 mutational status remained stable during the passages, and the Ki-67 LI of eight xenografts was within a range of 50% of the LI of the original tumors, although the other three xenografts increased by over 50%. Specific growth delay after irradiation, independent of the original tumor growth speed and Ki-67 LI, was observed in four xenografts. CONCLUSIONS: SCID mice are useful recipients for investigations of human urothelial cancer with a wide biological range. This easy-to-handle xenograft system can help to develop a better in vivo preclinical evaluation system for therapeutic agents as well as the investigation of tumor pathophysiology.

Animals↗

Laparoscopic removal of a retroperitoneal extralobar pulmonary sequestration in an adult.

A 41-year-old male patient presented with dull left flank pain. A computed tomography (CT) showed a subdiaphragmatic retroperitoneal extra-adrenal mass. A magnetic resonance image demonstrated it was hypointense on T1 weighted and hyperintense on T2. Serum analyses for adrenal hormones revealed no abnormality. [I131]metaiodo-benzylguanidene scintigraphy showed no abnormal uptake. The patient underwent laparoscopic removal to manage the symptoms and to make a pathological diagnosis, which was an extralobar pulmonary sequestration. Another congenital lung malformation was not detected on chest CT scan. The symptom was relieved postoperatively.

Adult↗

Surgery for giant high-flow renal arteriovenous fistula: experience in one institution.

OBJECTIVE: To present five cases of renal arteriovenous fistula (RAVF) seen at our institution, with an emphasis on surgical treatment. PATIENTS AND METHODS: We assessed five patients with giant high-flow RAVF. The affected kidney was evaluated functionally using (99m)Tc-diethylenetriamine pentaacetic acid renal scintigraphy. The size, location, involvement of branched arteries, and renal function dictated the choice of operative method. Four patients were treated with in situ ligation of the feeding artery for extrarenal RAVF, and the remaining patient had a nephrectomy of the nonfunctioning kidney. The clinical outcome was analysed by renal function, blood pressure control, radiographic cardiothoracic ratio (CTR), occlusion of RAVF, and renal artery patency. RESULTS: Of two patients with hypertension, the blood pressure was normalized in one. The renal function of the affected side was preserved in four patients. CTR was normalized or improved in all four patients with preoperative cardiomegaly. There was no recurrence of RAVF in any of the five patients and there was no major morbidity after surgery. CONCLUSIONS: Surgery for giant high-flow RAVF is safe and feasible from the perspective of complications and recurrence, even though transarterial embolization has become the first line of therapy for RAVF.

Aged↗

[Transrectal biopsy of the prostate for the detection of non-palpable prostate cancer: a comparison of 6 versus 12 core biopsy].

PURPOSE: Several studies suggest that extended transrectal prostate biopsy more than 6 core may improve the cancer detection rate. We compared 6 and 12 core biopsies to determine the impact on cancer detection and complication rate. PATIENTS AND METHODS: We retrospectively evaluated 150 patients who underwent transrectal ultrasound guided prostate biopsy between January 1999 and December 2003. Patients who were suspected to have prostate cancer on digital rectal examination and/or who had a history of previous prostate biopsy were excluded. Sextant biopsy was performed in 52 patients (6 core group) and 12 core biopsy was performed in 98 patients (12 core group). The cancer detection rate and post-biopsy complication rate were estimated. RESULTS: There was no significant difference in the overall cancer detection rate between 6 and 12 core groups (17 of 52 men or 32.7% versus 35 of 98 men or 35.7%). In addition, even if calculated the cancer detection rate stratified according to a PSA of 0 to 4.0, 4.1 to 10.0 and greater than 10.0 ng/ml, there was no significant difference between both groups. There was also insignificant difference of complication rate between both groups. CONCLUSIONS: The results of our study showed that there was no significant difference in cancer detection and complication rate between both groups.

Aged↗

Parental and neonatal risk factors for cryptorchidism.

BACKGROUND: Cryptorchidism is one of the most common congenital malformations in males. As male sexual differentiation is critically dependent on normal androgen concentrations, increased exposure to environmental factors affecting androgen homeostasis during fetal life may cause cryptorchidism. We investigated the relation between cryptorchidism and lifestyle, occupational exposure and the characteristics of parents and/or the perinatal and delivery characteristics. MATERIAL/METHODS: Case-control study conducted among the eligible 96 cases underwent orchiopexy between 1990 and 2003 and 116 controls were enrolled among boy outpatients born in between 1985 and 2001 and who were determined by pediatricians not to have genitourinary malformation. All the cases and controls were surveyed between 1999 and 2003 in Japan. RESULTS: We found significant positive associations between cryptorchidism and cesarean section (OR=2.19, 95% CI=1.09-4.40), paternal smoking before and during pregnancy (OR=1.87, 95% CI=1.03-3.37 and OR=1.94, 95% CI=1.08-3.50, respectively) and paternal exposure to diesel exhaust before and during pregnancy (OR=2.42, 95% CI=1.06-5.55 and OR=2.35, 95% CI=0.99-5.59, respectively). CONCLUSIONS: We found associations of cryptorchidism with unusual delivery and paternal smoking during pregnancy. These findings suggested that cryptorchidism might be associated with not only genetic factors but also increased parental exposure to environmental factors. In the future, prospective study is needed to do risk assessment accurately in the hormone-dependent stages of pregnancy critical for testicular descent.

Abortion, Spontaneous↗

Negative feedback regulation of T helper type 1 (Th1)/Th2 cytokine balance via dendritic cell and natural killer T cell interactions.

The ability of extracellular stimuli to modulate dendritic cell (DC) activation of natural killer T (NKT) cells was not well understood. We investigated the effects of the T helper type 1 (Th1)/Th2-cytokine environment on DC induction of NKT cell-mediated cytokine production in mice. Pretreatment of myeloid DCs with Th1 or Th2 cytokines, interleukin (IL)-4 or interferon (IFN)-gamma, led to the enhanced production of reciprocal cytokines by NKT cells (eg, IL-4 pretreatment led to the enhanced production of Th1 cytokines) in vitro and in vivo. Thus, the recognition of Th1 or Th2 cytokines by DCs acts as a negative feedback loop to maintain Th1/Th2-cytokine balance via NKT cell functions. Using these data, we manipulated cytokine levels and innate cytolytic activity in vivo to increase an antitumor response. This is the first description of a novel regulation system governing Th1/Th2 cytokine balance involving DCs and NKT cells.

Animals↗

Recent trends of genitourinary endoscopy in children.

Downsizing and refinement of the pediatric endoscope in video-monitoring systems have facilitated genitourinary endoscopy even in small children without any traumatic instrumentation. Indications for endoscopy in children with hematuria or tractable urinary tract infection have been tailored for the rareness of genitourinary malignancy or secondary vesicoureteral reflux (VUR) as a result of infravesical obstruction. Most mechanical outlet obstructions can be relieved endoscopically irrespective of sex and age. Endoscopic decompression by puncture or incision of both intravesical and ectopic ureteroceles can be an initial treatment similar to open surgery for an affected upper moiety. Endoscopy is necessary following urodynamic study to exclude minor infravesical obstruction only in children with unexplained dysfunctional voiding. Genitourinary endoscopy is helpful for structural abnormalities before and at the time of repairing congenital urogenital anomalies. Endoscopic injection therapy of VUR has been established as a less invasive surgical treatment. Pediatric endoscopy will play a greater role in the armamentarium for most pediatric urological diseases through the analysis of visual data and discussion on the indications for endoscopy throughout the world.

Child↗

Advanced renal pelvic carcinoma associated with dermatomyositis.

Dermatomyositis is an uncommon in flammatory myopathy with characteristic cutaneous manifestations which is frequently linked to several cancers. A 42-year-old man presented with left flank pain with typical symptoms of dermatomyositis. Computed tomography showed a solid mass in the pelvis of the left kidney and lymphadenopathy in the retroperitoneum. Since the general condition of the patient rapidly deteriorated because of marked muscle weakness of the respiratory muscles, the patient initially underwent medical treatment with prednisolone. After the improvement of respiratory function, the patient underwent radical nephroureterectomy and retroperitoneal lymphadenectomy. The pathological specimen showed moderately differentiated adenocarcinoma, stage pT3N2. After surgery, the patient showed a marked improvement of clinical symptoms related to dermatomyositis. Twenty-two months later, multiple organ metastases occurred and the patient died of cancer. We should point out the significance of surgical and medical treatment for these patients.

Adenocarcinoma↗

Mesenchymal cells infiltrating a bladder acellular matrix gradually lose smooth muscle characteristics in intraperitoneally regenerated urothelial lining tissue in rats.

OBJECTIVE: To characterize serial long-term histological changes in mesenchymal cells infiltrating a collagen-based matrix, as in a hollow organ with differentiated urothelial lining created intraperitoneally by grafting cultured urothelial cells, mesenchymal cells with smooth-muscle immunohistochemical characteristics infiltrated into the scaffold, despite no mesenchymal cells being seeded into the scaffold before grafting. MATERIALS AND METHODS: To regenerate a urothelial lining tissue intraperitoneally, rat urothelial cells were cultured and seeded with the feeder-layer technique onto bladder acellular matrix (BAM). After 7 days of cultivation to attach urothelial cells on the BAM, the matrix was folded with the urothelial cells inside and grafted onto the mesentery of the previously partially cystectomized rat. RESULTS: The grafted urothelial cells on the BAM, which formed a monolayer before grafting, stratified into three to four layers as early as 4 days after grafting. Although the regenerated urothelium became thinner with time, there was urothelial stratification and a peculiar angular appearance on the apical surface of the regenerated urothelium even after 56 days. The mesenchymal cells infiltrating the BAM showed positive immunohistochemical staining to alpha-smooth muscle actin or desmin at 7 days. Subsequently, the number of actin- or desmin-positive cells gradually decreased with time. On transmission electron microscopy, the infiltrating mesenchymal cells were characterized as myofibroblasts at 7 days. Smooth muscle-like cells were identified at 14 and 28 days, and fibrocytes were the main population at 56 days. CONCLUSIONS: Although epithelial-mesenchymal interactions have been assumed to be one of the most critical factors in smooth-muscle development, mesenchymal cells infiltrating the scaffold in this intraperitoneal regeneration model gradually lost smooth muscle characteristics with time. These results suggest that interactions between cultured urothelial cells and infiltrating mesenchymal cells alone could not maintain the smooth muscle character of infiltrating mesenchymal cells.

Animals↗