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M Nomi

Publications and source records attributed to M Nomi.

27 records · Page 2Linked to original sources

An assessment of the usefulness of serum prostate-specific antigen level and cancer volume in biopsy specimens to predict the extent of prostate cancer.

OBJECTIVE: To evaluate the usefulness of the combination of serum prostate-specific antigen (PSA) and cancer volume in biopsy specimens as markers to predict the extent of prostate cancer. PATIENTS AND METHODS: Of patients presenting at our hospital with urinary symptoms suggesting prostatic disease, 311 (median age 70 years, range 42-88) with either nodules in the prostate detected by digital rectal examination or with elevated serum PSA levels (> 2.0 ng/mL) underwent systematic biopsy; 69 had prostate cancer. The cancer volume in the biopsy specimens was examined pathologically by measuring the percentage of the biopsy core involved with cancer, the length of cancer tissue per biopsy core and the percentage of cancer in the biopsy specimen. The relationship of serum PSA level, cancer volume in the biopsy specimen and the extent of disease was examined. RESULTS: The volume of cancer in the biopsy specimens increased with increasing serum PSA concentration and the incidence of skeletal metastasis. The number of patients with extraprostatic disease or bony metastasis was significantly higher for these Japanese patients with a serum PSA of < 10 ng/mL. All six patients with a positive bone scan and who had a serum PSA level of < 10 ng/mL had a larger volume of cancer in their biopsy specimens. Among patients who underwent radical prostatectomy and pelvic lymphadenectomy, the incidence of extraprostatic disease increased with the value of each biopsy variable. Among patients with similar serum PSA levels, those showing higher values for the biopsy variables also showed extraprostatic disease. Among those with extraprostatic disease, seminal vesicles were involved by cancer in four of six patients with > 40% positivity in the biopsy cores, > 1.5 mm of cancer per biopsy core or > 20% cancer in the biopsy specimens. Lymph node metastasis was found in four of five patients with serum PSA levels of > 20 ng/mL and a large cancer volume in the biopsy specimen. CONCLUSIONS: These results indicate that a combination of serum PSA level and cancer volume in the biopsy specimen could be useful markers for predicting the extent of prostate cancer.

Adult↗

"Collision phenomenon" of prostate and bladder cancers in lymph node metastases.

We report here the case of a 78-year-old man who, 15 months after orchiectomy for palliation of prostate adenocarcinoma, was diagnosed as having squamous cell carcinoma of the urinary bladder. The bladder cancer was treated surgically, including dissection of pelvic lymph nodes. Some of these nodes were observed at surgery to be swollen, and were found on pathologic examination to exhibit the collision phenomenon: the mixing and mingling of cancer cells representing 2 distinct topographic origins. This case suggests that the possibility of collision phenomenon should be considered whenever any metastasis (but especially one in the lymph nodes) is found in a patient diagnosed with 2 different types of cancer. Moreover, it reminds us that diagnosis of one type of cancer does not rule out the possibility of another.

Adenocarcinoma↗

Relation of abdominal and thigh adipose tissue distribution to serum lipids and glucose metabolism in obese males.

Spin-echo magnetic resonance imaging (MRI) and postprocessing for fat quantification were used to examine the relationship of abdominal and thigh adipose-tissue distribution to serum lipids and glucose metabolism in obesity. Thirteen simple obese male patients and 12 non-obese male volunteers were examined by MRI, blood pressure, and fasting blood sample levels of serum lipids, glucose, immunoreactive insulin, c-peptide, HbA1C and hematocrit. Correlations of thigh visceral and subcutaneous fat areas to serum lipid levels were generally similar, but marked differences were found between relationships of thigh versus abdominal fat areas to serum lipid levels. In addition, diastolic blood pressure was significantly correlated with the fat area, especially with the abdominal visceral fat area (r=0.51, p<0.01), but not with abdominal subcutaneous fat area. The thigh muscle area was highly and inversely correlated with c-peptide (r=-0.72, p<0.01) and systolic blood pressure (r=-0.65). Differences in correlations between visceral and subcutaneous fat areas in the abdomen to metabolic parameters were found between abdominal visceral fat areas and HbA1C and between the abdominal subcutaneous fat areas and HbA1C. These findings suggest that the character of regional fat could be heterogeneous with respect to lipid and glucose metabolism and blood pressure levels in obese males.

Abdomen↗

Inferior vena cava filter used for unresectable renal cell carcinoma with tumor thrombi.

A titanium Greenfield inferior vena cava filter was used for the treatment of 2 patients with unresectable renal cell carcinomas with tumor thrombi to prevent a fatal pulmonary embolism induced by tumor clots released during systemic interferon therapy and embolization of the primary tumor. After treatment, the size of the renal cell carcinomas at the primary site and the tumor thrombi decreased by 50%. There were no fatal pulmonary embolisms or complications related to the filter during the observation period (24 and 25 months) after therapy. This method may be useful in the prevention of a fatal pulmonary embolism induced by embolization and systemic interferon therapy in these patients.

Aged↗

[Clinical studies of newly diagnosed prostate cancer].

BACKGROUND: The objective of this study is to report the outcome of various treatments in patients who were newly diagnosed prostate cancer from May 1984 to December 1994, at a single institution. METHODS: A retrospective study was carried out in the 142 patients. RESULTS: Total retropubic prostatectomy were performed in 52 patients (37%). The 5-year survival rates (Kaplan-Meier) in the patients with total prostatectomy were 89% in stage B (24), 86% in stage C (7), and 87% in stage D1 (17), respectively. Endocrine therapies (33) or endocrine therapies in combination with chemotherapies (37) as a initial therapy for stage D2 were performed. Among these therapies, endocrine therapy in combination with cyclophosphamide (700 mg/m2/4 weeks, i.v.) was superior to any of the other treatments in stage D2. The response rate, median response duration and median survival time in this combination therapy were 83%, 29 months and 49 months. The overall 3, 5, and 10-year survival rate in the 142 patients were 67%, 51% and 26%, respectively. The 5-year survival rates according to grade were 73% in grade 1, 45% in grade 2, 42% in grade 3, respectively. CONCLUSION: The 5-year survival rates in pathological stage C and D1 patients who received adjuvant hormone and radiation therapy after radical prostatectomy were 86% and 87%. The most effective therapy for stage D2 was hormone in combination with cyclophosphamide. The response rate and median response duration were 83% and 29 months.

Aged↗

Imaging techniques for measuring adipose-tissue distribution in the abdomen: a comparison between computed tomography and 1.5-tesla magnetic resonance spin-echo imaging.

Eight subjects were examined both by abdominal X-ray computed transverse axial tomography (CT) and magnetic resonance imaging (MRI) (SE) (TR/TE, 200 ms/15 ms); another eight volunteers were subjected to three MRI scans to test the reliability of repeated measures. Correlations between fat area measures obtained by CT and by MRI for subcutaneous fat, total fat, and visceral vs. subcutaneous-fat ratio were highly significant (r = 0.93, 0.91, and 0.94, respectively; p < 0.01), and the standard errors of estimation were 9.99, 23.87, and 0.0047. The average errors of the method for different fat areas were 2.20 cm2 (intra-examination variance) and 3.75 cm2 (inter-examination variance) for visceral and 0.82 cm2 (intra-examination variance) and 1.29 cm2 (inter-examination variance) for subcutaneous fat areas, respectively. These results suggest that SE MRI is a practical approach to evaluate body fat distribution without the exposure to radiation. The reproducibility of SE MRI for the determination of fat areas is high; variation is small and acceptable. However, it is difficult to determine which estimate of fat area should be accepted when there is a discrepancy between MRI and CT measures.

Adipose Tissue↗