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Biomedical subjects

M Osafune

Publications and source records attributed to M Osafune.

At least 19 recordsLinked to original sources

Convenient formation of 4-hydroxyalk-2-en-1-one functionality via A knoevenagel-type carbon chain elongation reaction of aldehyde with 1-arylsulfinylalkan-2-one.

A highly functionalized four-carbon unit, 4-hydroxyalk-2-en-1-one functionality [R2CH(OH)CH=CHCOR1], was conveniently prepared by a reaction of an aldehyde (R2CH2CHO) with a 1-(arylsulfinyl)alkan-2-one [ArS(O)CH2COR1] in the presence of diethylamine (Knoevenagel condition). Other functional groups, such as carbonyl and hydroxy groups, in both of the alkyl chains (R1, R2) did not prevent this reaction. This reaction was used to conveniently prepare (+/-)-(11E)-13-hydroxy-10-oxooctadec-11-enoic acid (14), having cytotoxic activity, and its analogues from undec-10-enoic acid in good yield.

Journal Article↗

[Spontaneous renal rupture resulting from ureteral tumor left untreated for 6 years: a case report].

A 57-year-old man, 6 years after discovery of a left ureteral tumor was admitted to our hospital complaining of severe left abdominal pain. With the diagnosis of acute abdomen, the patient was examined by computed tomography, which showed severe left hydronephrosis with renal rupture. Retrograde and antegrade pyelography showed the hydroureteronephrosis due to the tumor in the lower ureter, so left nephroureterectomy was performed. The ureteral tumor was diagnosed as transitional cell carcinoma, grade 3 and pT2. The present case is the 9th case of spontaneous renal rupture caused by renal pelvic and ureteral tumors in Japan.

Carcinoma, Transitional Cell↗

[A case of functioning parathyroid cyst].

We report a rare case of primary hyperparathyroidism with a functioning parathyroid cyst in a 45-year-old male. He was a recurrent stone former, and consulted our hospital for further examinations of hypercalcemia. Plasma levels of intact parathyroid hormone (PTH) were elevated to 130 pg/ml. Ultrasonography, computed tomography and magnetic resonance imaging revealed a parathyroid cyst on the right lobe of the thyroid gland. We performed right superior parathyroidectomy. Histological examination demonstrated a secondary pseudocyst resulting from cystic degeneration of a parathyroid adenoma. Plasma levels of intact PTH normalized after operation. To our knowledge, only 48 cases of functioning parathyroid cyst were reported in the Japanese literature. We discuss the clinical features and histological evidence of functioning parathyroid cyst.

Cysts↗

[Recurrence of bladder cancer in fossa navicularis 12 years after total cystectomy: a case report].

We report a case of urothelial cancer recurrence in fossa navicularis of urethra 12 years after total cystourethrectomy for bladder cancer. A 73-year-old man had undergone total cystourethrectomy and ureterocutancostomy for multiple bladder cancer on June 13, 1986. Histopathological findings showed transitional cell carcinoma, G3, pT4 with carcinoma in situ. Twelve years after the cystectomy, he was admitted to our hospital complaining of the induration of the glans penis. Magnetic resonance imaging showed a high intensity tumor in T1-WI and low intensity tumor in T2-WI, which had invaded fossa navicularis of urethra to glans penis. Aspiration biopsy of the penile tumor revealed transitional cell carcinoma. Therefore, we performed partial penectomy on July 16, 1998, since computed tomography showed no lymph node swelling in the inguinal region. Five months after the second operation, he was diagnosed with bilateral inguinal lymph node metastasis. Then we performed 2-course M-VAC (methotrexate, vinblastine, doxorubicin cisplatin) therapy, which showed partial response. Thereafter, bilateral inguinal lymphadenectomy with one-course postoperative M-VAC therapy was performed.

Aged↗

[Clinical studies on acute scrotum--focusing on torsion of the spermatic cord].

Surgical exploration was done on 50 patients with acute scrotum between June 1982 and October 1995. Of them, 24 (48%) had torsion of the spermatic cord, 9 (18%) had torsion of the appendage testis, 11 (22%) had intrascrotal hematoma, 4 (8%) had acute epididymitis, and 2 (4%) had bleeding of testicular tumor. The patients who had torsion of the spermatic cord were between 0 and 26 years of age (the mean: 14.6); 9 had torsion on the right side, and 15 on the left side. Infectious manifestations occurred in about 30%, and Prehn's sign developed in 37.5%. Of all cases, orchiopexy was performed in 10 cases and orchiectomy in 14. The testis was saved in 8 (88.9%) of the 9 patients who underwent surgery within 12 hours after onset. On the contrary, the testis was saved in only 2 (13.3%) of the 15 patients who underwent surgery more than 12 hours after onset. We concluded that early consultation, and exploration by a urologist are obligatory in the treatment of torsion of the spermatic cord.

Acute Disease↗

Heparin sulfate in the stone matrix and its inhibitory effect on calcium oxalate crystallization.

The nature of the soluble stone matrix and its possible role in urinary stone formation was studied. For this purpose we performed two-dimensional cellulose acetate membrane electrophoresis of the glycosaminoglycans (GAGs) which were contained in the soluble stone matrix, substances adsorbed onto calcium oxalate crystals in vitro (crystal surface binding substances, CSBS) and urinary macromolecules (UMMs). The main GAG in the soluble stone matrix and CSBS was found to be heparan sulfate, whereas the UMMs contained various GAGs usually seen in urine. An inhibition assay showed the soluble stone matrix to have the strongest inhibitory activity among these macromolecular substances when inhibitory activity was expressed in terms of uronic acid concentration. It is suggested that the main GAG in the soluble stone matrix consists of heparan sulfate, which has a strong inhibitory activity on calcium oxalate crystal growth and aggregation and constitutes part of the CSBS.

Adult↗

Extramedullary plasmacytoma (EMP) of urinary bladder.

An extramedullary plasmacytoma (EMP) is presented with an isolated lesion in the urinary bladder accompanying an IgG-K paraproteinemia. After a short-term oral melphalan administration, the tumor soon regressed together with the paraprotein, and has never recurred during the two-year follow-up. This is the fourth case of primary EMP of the urinary bladder reported in the literature.

Aged↗

[A case of renal schwannoma].

A case of renal schwannoma is presented. A 51-year-old female was admitted to our hospital because of a left renal mass on April, 16, 1987. A drip infusion pyelogram showed encasement of the lower and medial calyx. An abdominal CT-scan showed a 2.5 cm mass with irregular density. Selective left renal arteriography showed the hypovascular tumor of the left kidney. Transperitoneal radical nephrectomy was performed on May, 1, 1987. Histological diagnosis was renal schwannoma arising from renal pelvis. The patient was well without recurrence 20 months after operation. Our present case is the 12th case of renal schwannoma reported in the English and Japanese literature.

Female↗

[Intermittent intravenous high-dose cyclophosphamide therapy for advanced prostatic cancer with distant metastasis].

Twelve patients with advanced carcinoma of the prostate were treated with intravenous high-dose cyclophosphamide. All were hormone-resistant cases. At an interval of 3-4 weeks, cyclophosphamide was administered intravenously. The standard dosage of cyclophosphamide was 1,000 mg/m2 and a 10% lower dose was administered to patients with liver dysfunction, anemia and elderly patients. The results of 10 patients were evaluable. One case showed objective partial response, 1 case was stable and 8 patients showed objective progression according to the NPCP efficacy evaluation standard. The overall response rate was 20%, which we did not consider satisfactory. As to toxicity of cyclophosphamide, one patient died of severe acute hepatic failure, but in others, complications were mild to tolerable.

Adenocarcinoma↗

[Primary hyperparathyroidism in a child with parathyroid crisis--review of 24 cases reported in Japan].

A 9-year-old boy, who had been admitted to the Pediatric Department for the examination of IgA nephropathy, was transferred to our urological clinic on Aug. 6, 1985, because of parathyroid crisis. Before urological consultation, he had been complaining of bilateral knee and calcaneal pain, anorexia and abdominal pain, which had persisted for several days. Laboratory data indicated serum Ca of 17.6 mg/dl, iP of 2.3 mg/dl and iPTH of 0.77 ng/ml. Roentgenographic examination such as chest, extremities and neck computed tomography showed no abnormal findings. The final diagnosis was parathyroid crisis caused by primary hyperparathyroidism and neck exploration was carried out on August. 10. Left upper parathyroid gland, which was 1 cm in diameter, was surgically removed. The other three glands were normal in size. Histological examination of the resected parathyroid gland revealed chief cell adenoma. In the post-operative course, serum Ca level was soon reduced to the normal range and bone pain disappeared rapidly. During the follow up period of 2.5 years, the patient was clinically free of recurrence. Only 23 cases of primary hyperparathyroidism in children have been reported in the Japanese literature. The clinical characteristics of these specific cases are that primary hyperparathyroidism in children shows a low incidence of renal lesion, but the complicated bone disease is of higher incidence compared with the adult cases. Histopathologically, parathyroid adenoma was frequently observed (14/19), and the other 5 cases were parathyroid hyperplasia.

Adenoma↗

[Foreign body in the kidney: a case report and a review of the Japanese literature].

A 50-year-old female was admitted to our hospital with the chief complaint of right lumbago. She had undergone acupuncture for right lumbago several years earlier. Radiography revealed a linear metallic shadow in the right kidney. Computed tomographic scan revealed it to be located in the right renal parenchyma. The foreign body was extracted operatively. Including our case, 43 cases of foreign bodies in the upper urinary tract found in the Japanese literature so far are reviewed.

Acupuncture Therapy↗

[Four cases of sperm invasion].

Four cases of spermatic invasion of epididymis are presented. All four cases were fertile. The etiology, histological findings, and role of sperm invasion in male infertility are discussed.

Adult↗

LH-RH agonist, Zoladex (Goserelin), depot formulation in the treatment of prostatic cancer. Randomized dose-finding trial in Japan.

Ninety patients with advanced prostatic cancer (15 with stage B, 23 with stage C, and 52 with stage D) were randomized to receive 0.9, 1.8, or 3.6 mg, respectively, of Zoladex depot subcutaneous injection every 28 days for 12 weeks. The serum levels of LH, FSH, and testosterone were elevated after the first injection, and followed by a significant decrease. The suppression of testosterone levels in the blood to castrate levels was observed in all patients except two treated with 0.9 mg. Objective response (CR and PR) was seen in 63.6% (0.9 mg), 47.8% (1.8 mg), and 68% (3.6 mg) of patients according to the Japanese Prostatic Group Criteria. Subjective improvement (performance status, analgesic consumption) was also observed in 75-88% of patients but without a statistically significant difference between each dose group. Only minor adverse effects were found during the treatments. The drug was detected dose dependently in the blood by radioimmunoassay. These results suggest that endocrine therapy with Zoladex depot in doses of 3.6 mg subcutaneously every 4 weeks is a useful alternative to surgical castration in patients with prostatic cancer.

Aged↗

[Instillation chemotherapy with peplomycin in superficial bladder cancer: clinical study on the effects of the direct antitumor activity and of the prophylaxis of recurrence].

Two kinds of clinical studies for intravesical instillation chemotherapy of peplomycin (PEP) were carried out, one to evaluate the direct antitumor activity in superficial bladder cancer (study I), and the other to evaluate the prophylactic effect on recurrence of bladder cancer after transurethral resection (study II). In study I, 22 patients with low stage bladder cancer were entered, and 16 of them were eligible for evaluation of efficacy. Twelve patients were treated twice a week with intravesical instillation of 20 mg of PEP/20 ml of saline for 4 weeks. Four patients were treated in the same way with 40 mg of PEP/20 ml of saline. Among the patients treated with 20 mg of PEP, two showed complete remission and one showed partial remission. Of the patients treated with 40 mg of PEP, one showed partial remission. Thus, the overall response rate was 25%. The tumors of the two complete responders were so tiny that they might have been damaged mechanically by the biopsy forceps. Therefore, we considered that the instillation chemotherapy of PEP at a dose of 20 or 40 mg/20 ml of saline had little effect on superficial bladder cancer. In study II, we performed a randomized trial designed to compare the recurrence rate after transurethral resection (TUR) alone with that after TUR followed by prophylactic instillation of PEP. Ninety-four patients newly diagnosed as having low stage bladder cancer were entered in the study. They were divided into three groups after TUR. Group A consisted of 38 patients who were treated with weekly instillation of 20 mg of PEP/20 ml of saline for 8 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗

[Endocrine therapy of prostatic carcinoma with slow release (depot) formulation of the LH-RH analog ICI 118630 (Zoladex)].

To investigate the clinical efficacy, safety and endocrinology of ICI 118630 (Zoladex) depot formulation at 3 different dose levels (0.9, 1.8 and 3.6 mg), 90 patients were randomized to receive either one of the 3 doses from April, 1985 to March, 1986 in 28 centers. The depot preparation was injected subcutaneously every 4 weeks 3 times (for up to 12 weeks). Clinical efficacy was evaluated in terms of tumor response and overall subjective response. In 70 patients eligible for tumor response evaluation, 14 out of 22 (63.6%) in the 0.9 mg group, 11 out of 23 (47.8%) in the 1.8 mg group, and 17 out of 25 (68.0%) in the 3.6 mg group showed clinical improvement, that is, either complete response or partial response. In 72 eligible patients for overall subjective response evaluation, clinical subjective improvement was observed in 75.0, 81.8 and 88.0% of the patients in the 3 groups, respectively. There was no significant difference between the groups. As for endocrinology, there were 75 eligible patients. Endocrinological effect was observed in 23 out of 25 (92.0%) in the 0.9 mg group, 100% in both 1.8 mg and 3.6 mg groups. There was no significant difference between the groups. Castration was achieved by week 3.5 +/- 1.7 of therapy on average and by week 2 in the earliest case. There was no significant difference in incidence of side effects between the 3 groups: 5 out of 26 (19.2%) in the 0.9 mg group, 8 out of 29 (27.6%) in the 1.8 mg group, and 2 out of 30 (6.7%) in the 3.6 mg group. Flares presented as an increase in bone pain in 2 and as ureteric obstruction in 2 all in the 1.8 mg group but none in the other 2 dose groups. These flares disappeared on further treatment with Zoladex. These patients showed a clinical-response. The blood level of Zoladex was dose dependent, reaching its peak at week 2 of therapy in all 3 dose groups. There was no evidence of accumulation. Since these results demonstrate that 3.6 mg produces medical castration earlier, it may well be considered as an optimal dose in men.

Buserelin↗

[Clinical efficacy of long-term treatment with LH-RH analogue, ICI 118630 (Zoladex), in prostatic cancer patients. The Zoladex Multicenter Study Group].

The Zoladex (ICI 118,630) multicenter trial included 149 patients with stage B +o D prostatic cancer recruited from 1984 to date. Of them 53 clinical responders on the treatment for 40 weeks or longer were subjected to assessment of antitumour response, overall subjective response, endocrinological response, safety and usefulness. The responders consistently showed a clinical response as evidenced by antitumour response in 32 of 50 patients (64.0%) at week 12 and in 35 of 51 (68.6%) at week 40, and overall subjective response in 42 out of 47 patients (89.4%) at both week 12 and week 40. Endocrinologically, all of the 47 eligible patients maintained a 40-week or longer response. Adverse reactions were observed in 19 out of 73 patients (26.0%), subdivided by the time of occurrence as 15/73 (20.5%) up to week 12, 3/71 (4.6%) between week 12 and week 40, and 5/53 (9.4%) in and after week 40. No patient required the discontinuance of treatment. Usefulness of the drug was observed in 51 out of 52 patients (98.1%). The results indicated that Zoladex in a once monthly regimen may be of great advantage to elderly patients with prostatic cancer, and allow an improved patient compliance: Zoladex may not only produce clinical remission but also improve the quality of life.

Buserelin↗

[Endocrine therapy for prostatic carcinoma--the clinical trial to compare the efficacy of LH-RH analogue, ICI 118630 (Zoladex) with castration or estrogen].

A multicenter randomized clinical trial was carried out between May, 1986 and May, 1987 involving 82 patients with stage B-D prostatic carcinoma from 29 centers. The clinical efficacy, endocrine effect, safety and usefulness of the luteinizing hormone-releasing hormone (LH-RH) analogue and other endocrine manipulations in the treatment of prostatic carcinoma. Zoladex depot containing 3.6 mg of ICI 118,630, an LH-RH analogue, was administered every four weeks 3 times in total. Patients in the control group received either 300 mg of diethylstilbestrol diphosphate orally daily for 12 weeks or orchidectomy. An antitumor effect (CR + PR) was observed in 21 of the 33 patients (63.6%) in the Zoladex group and in 22 of the 33 (66.7%) in the control group, showing no significant difference between the two groups. There was no significant difference in overall subjective response either; 21 of the 24 (87.5%) in the Zoladex group and 24 of the 30 (80.0%) in the control group. In both groups, 100% endocrine effect was obtained as shown by achievement of castration in all patients. Adverse reactions were observed in 14 of the 39 (35.9%) patients treated with Zoladex as compared with 19 of the 34 (55.9%) control patients, resulting in no significant difference in the incidence between the two groups. These adverse reactions were not so severe as to require withdrawal from the study. In both groups, the treatment was assessed as slightly or more useful in 29 of the 33 (87.9%) patients. From these results, it is concluded that Zoladex, 3.6 mg depot, is a useful drug for treatment of prostatic cancer, having clinical efficacy and endocrine effects comparable to those of the conventional endocrine manipulations, being safe, and causing less physiological and psychological pain.

Aged↗