PubMed Health⌕ Search

Biomedical subjects

S Isaka

Publications and source records attributed to S Isaka.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Prognostic factors for progression of superficial bladder cancer].

To clarify prognostic factors for progression of superficial transitional cell carcinoma of the bladder (Ta, T1 and G1, G2), 159 patients, treated by transurethral resection from 1975 to 1988, were analysed concerning clinical findings, laboratory data, endoscopic findings and histopathological findings of the tumor. Histopathological findings included ABH blood group isoantigen (ABH) and Thomsen-Friedenreich antigen (T-ag) as well as other result. Twenty two cases in the series showed progression; 10 with up-grading and up-staging, 12 with either one of them. Advanced age, positive urinary cytology, multiple or broad base tumor, G2 or T1 tumor, negative ABH and abnormal T-ag were closely associated with progression. By multivariate analysis of these factors, ABH, stage of the tumor, T-ag and form were shown to be important prognostic factors in this order. ABH and T-ag were not correlated with other clinicopathological factors in predicting tumor progression. Therefore we concluded that ABH and T-ag were much important for prediction concerning potential for progression of the superficial bladder cancer.

ABO Blood-Group System↗
PubMed1992

[Incidence of renal cell carcinoma in Chiba Prefecture, Japan; ten years experience].

Many reports about the increase of renal cell carcinoma patients have been published in Japan recently, however, the real fluctuations in the total number of patients in relation to the change of population have not been reported yet. Most of the patients with renal cell carcinoma in the last 10 years were examined in Chiba prefecture, which has a population of about five million and 25 active urological offices. Histologically confirmed cases were investigated by sending questionnaire letters. The items were as follows; sex, age, address, occupation, family history, past history, symptoms, examination methods that first detected the tumor, operation date, tumor diameter and clinical stage. Twenty two offices returned answers and 560 cases who lived in Chiba were found to have renal cell carcinoma from 1980 to 1989. Yearly incidence rates per 100,000 persons demonstrated a significant increase from 0.32 to 2.07. Small, asymptomatic and low stage cancers have been increasing rapidly, however, the rate of metastatic disease has not shown any decrease. The main cause of rapid increase seems to be attributed to progress in diagnostic methods and increase of early detection, but the possibility of an increase in some carcinogenic factors can not be ruled out.

Adult↗
PubMed1992

[A case of pre-Cushing's syndrome].

A 66-year-old female was admitted to Chiba University Hospital for the evaluation of a left adrenal mass which was incidentally discovered by computerized tomography. The patient had no clinical signs of Cushing's syndrome. Although the plasma ACTH level was suppressed, serum cortisol and urinary 17-OHCS levels were normal. Serum cortisol was not suppressed by dexamethasone and loss of diurnal rhythm of cortisol was observed. Uptake of 131I-aldosterone in the left adrenal gland was noted, but no accumulation was observed in the right one. Left adrenalectomy was performed. The tumor resected was 20 x 22 x 26 mm in size. Pathological diagnosis was adreno-cortical adenoma. Whether slight abnormality of adrenocortical function without clinical symptoms observed in the present case would develop into a clinically typical Cushing's syndrome remains to be solved.

Adenoma↗
PubMed1992

[Vesicoenteric fistula complicating Crohn's disease, responded to medical treatment: a case report].

A 20-year-old man was admitted on February 2, 1990 with the chief complaint of pollakisuria, miction pain and macrohematuria. Urinalysis revealed numerous leukocytes and Enterobacter was identified by urine culture. Cystoscopy revealed an edematous region. Contrast film of small intestines demonstrated vesicoileal fistula. Judging from these and the radiographic findings, we made the diagnosis of vesicoileal fistula with Crohn's disease. After medical therapy between February 22 and May 25, urinalysis became normal and we assumed that the fistula had closed. Now, it is about a year since the therapy began, the patient remains well, without urinary and enteric symptoms. Cystoscopy and urinalysis did not reveal recurrence of the fistula. Despite previous reports that vesicoenteric fistulas complicating Crohn's disease require surgical treatment, this case responded to medication, and required no surgical treatment. This case is a reminder of the importance of the principle of therapy.

Adult↗
PubMed1991

Endoscopic re-establishment of membranous urethral disruption.

A total of 17 patients with traumatic membranous urethral disruption underwent urethral reconstruction via a core-through technique. Followup was 1 to 8 years (mean 3.7 years) postoperatively, and included 6 weeks with an indwelling catheter, periodic dilation for 6 months and occasional sounding. Within 1 year postoperatively, 6 patients required additional scar incision, including 3 who underwent scar resection. At 1 to 8 years postoperatively 6 patients had complications: 3 had stricture requiring periodic dilation (including 2 who underwent scar incision), while 2 had mild stress incontinence and 1 had nocturnal enuresis. Traumatic impotence was noted in 7 patients but the operation was not the cause in any. This method of endoscopic management was found to be an acceptable alternative to urethroplasty in cases of membranous urethral disruption.

Adult↗
PubMed1991

Serum immunosuppressive acidic protein as a tumor marker for renal cell carcinoma.

Since there are no reliable tumor markers in renal cell carcinoma, the present study was undertaken to evaluate immunosuppressive acidic protein (IAP) in patients with this tumor. Serum IAP levels were measured in 143 consecutive patients before and/or after nephrectomy by turbidimetric immunoassay. IAP levels had increased according to tumor diameter. Positivity rates of IAP were noticed as 45%, 75%, and 100% for patients with stage I/II, stage III, and stage IV diseases, respectively. Three-year survival rates also correlated with IAP: 96%, 81%, and 44% in preoperative levels below 500, of 501-1,000, and of more than 1,001 micrograms/ml, respectively. Serum IAP levels decreased within 3 months after the operation and increased with recurrence. These results suggest that serum IAP may serve as a tumor marker in patients with renal cell carcinoma.

Adult↗
PubMed1991

[Urinary cytology in patients with urolithiasis].

Urinary cytological examination was performed on 1032 patients of urolithiasis at the Department of Urology, Chiba University Hospital between 1980 and 1990. Seven hundred twenty-four were male and 308 were female, and the mean age was 44 years. The results of cytological examination of I-II and IV-V were classified as negative and positive, respectively. Eleven patients (1.1%) were positive, 2 of whom were found to be with renal pelvic tumor. False-positive findings were noticed in 9 cases (0.9%), and the abnormal cytologic changes in these cases disappeared after the calculi were removed. In negative cytological cases, 2 cases of renal pelvic tumor were found, one at nephrectomy and the other at percutaneous nephrolithotripsy. These cases were with staghorn calculi with hydronephrosis. The significance of cytological examination in management of calculous diseases were discussed.

Aged↗
PubMed1991

[Clinical course of bone metastases by prostatic cancer studies with conventional X-ray].

The clinical courses of bone metastases in 81 cases of prostatic cancer were examined using conventional X-ray. All patients received endocrine therapy as the initial treatment; castration and estrogen were given to 46 cases, castration and antiandrogen to 19, LH-RH analog to 11, flutamide to 5. The response to endocrine therapy was evaluated every 6 months after the start of the treatment according to National Prostatic Cancer Project criteria. The prognosis was calculated by cause-specific survival. The types of untreated bone metastases on X-ray were classified into five: sclerotic in 12 cases (15%), mixed but mainly sclerotic in 25 (31%), mixed but mainly lytic in 14 (17%), lytic in 8 (10%) and undetermined with positive scintigraphy in 22 (27%). Two mixed types showed more spread metastases and tendency of elevated prostatic acid phosphatase when compared with other types. Temporary enlargement of sclerotic area within 6 months after start of the treatment did not correlate with deterioration of disease. Remodeling of metastatic areas occurred 6-36 months after start of the treatment showed curative course and the prognosis of these groups were favorable. Most of lytic areas tended to sclerotic finding following endocrine therapy regardless of effects by endocrine therapy. Sclerotic and two mixed types showed better and worse tendencies, respectively. On viewpoint of remodeling, change of metastatic area and newly appearance of metastases, an evaluation criteria of response to the therapy was proposed, which showed good correlation with prognosis. From these observations, it was concluded that bone metastases tended from lytic to sclerotic changes and that lytic-sclerotic cycles occurred repeatedly along with disease progression regardless of effect to therapy. Remodeling seemed to be curative signs of metastatic area.

Aged↗
PubMed1991

[Regional lymphadenectomy for renal pelvic and ureteral cancers].

Thirty-four patients with renal pelvic and ureteral cancers received regional lymphadenectomy since 1980. The patients consisted of 21 with renal pelvic cancers, 10 with ureteral and 3 with renal pelvic and ipsilateral ureteral. Fifteen patients (44.1%) had metastatic nodes: 13 with renal hilar or para-aortic metastases and 2 with pelvic nodal involvements only. Thirteen of these 15 patients with nodal metastasis had high grade tumors and 14 had high stage tumors. The 5-year survival rate of these 15 patients was 26.3% which was considerably poor when compared with 19 patients without metastasis. Twenty patients with high grade and high stage tumors who received respective operations with regional lymphadenectomy had significantly better prognosis compared with the historical control group (15 patients, from 1961 to 1979). Additional regional lymphadenectomy for renal pelvic and ureteral cancers appears to be a valuable operation for improving prognosis.

Adult↗
PubMed1991

[Removal of renal cell carcinoma extending into the right atrium: report of a case].

A 65-year old man presented with a seven-month history of macrohematuria and left back pain. Abdominal ultrasonography, enhanced computed tomographic (CT) scanning, magnetic resonance imaging (MRI), selective renal angiography and vena cavography revealed a left renal tumor extending into the inferior vena cava and right atrium. Surgery was performed using the cardiopulmonary bypass and the whole tumor was resected grossly except for the tumor invading into the lumbar vein. The patient recovered promptly but died from cancer metastasis six months after operation.

Aged↗
PubMed1991

[Results of radical nephrectomy associated with regional lymphadenectomy for renal cell carcinoma].

Between January, 1975 and December, 1989, 86 patients with renal cell carcinoma received radical nephrectomy associated with lymphadenectomy at our institutions. Pathological examination revealed lymph node metastasis in 15 patients (17.4%). The incidence of lymph node metastasis increased in accordance with the aggravation of tumor stage (p less than 0.01) and grade (p less than 0.05). Patients with a rapidly growing tumor showed higher incidence of lymph node metastasis than patients with a slow growing tumor (p less than 0.01). Regional lymph node metastases were found in 3 of the 41 patients with a slow growing tumor. Since these 3 patients are surviving with no evidence of disease for 38.7 months on average, the regional lymphadenectomy was considered to have been effective for their survival. Nine of the 25 patients with a rapid growing tumor had progressive lymph node metastasis. Four of them had apparent tumor thrombi as well as lymph node metastasis, and 2 of them had distant metastasis. These patients showed poor prognosis even after operation. Lymphadenectomy was of no value to the patients with apparent tumor thrombi and/or distant metastasis.

Adult↗
PubMed1990

Plasma concentration of atrial natriuretic factor in idiopathic oedema.

Low level of plasma atrial natriuretic factor (ANF) under altered dietary sodium and its elevation during bigeminy were found in a 40-year-old woman with idiopathic oedema. The natriuretic effect of this peptide and the role of renin-angiotensin-aldosterone system in oedema formation in this disorder are discussed.

Adult↗
PubMed1990

[High dose chemotherapy and autologous bone marrow transplantation for advanced germ cell tumor].

Six patients, with advanced germ cell tumor refractory to prior chemotherapy including cis-platinum and etoposide, were treated by high dose chemotherapy and autologous bone marrow transplantation. Etoposide (1200-1800 mg/m2), cyclophosphamide (120 mg/kg) and cis-platinum (60-120 mg/m2) were given and the autologous bone marrow was infused 72 hours after the last dose of chemotherapy. Two patients were treated by high dose chemotherapy three times. The regimen of the third high dose chemotherapy was etoposide (1800 mg/m2), cyclophosphamide (120 mg/kg), adriamycin (80 mg/m2), ACNU (200 mg/m2) and 254S (100 mg/m2). One patient died of cerebral hemorrhage 7 days after ABMT. Of the 5 patients evaluable for response, 4 responded: one patient obtained a complete response and 3 a partial response.

Adolescent↗
PubMed1990

[Histological effects of endocrine therapy on prostatic cancer].

Histological effects of endocrine therapy were evaluated in one hundred and four prostatic cancer patients by new criteria presented by the committee of "General Rule for Clinical and Pathological Studies on Prostatic Cancer". Route and time of biopsy, clinical stage and histological grade were related to histological effects. Biopsy specimens taken within three months from the start of the therapy tended to score rather low marks and this tendency is especially apparent with low grade cancers. Histological effects evaluated by the present method correlated well with prognosis in localized stages (stage B, C and D1). In metastatic cases, however, local effects were not related to the prognosis.

Aged↗
PubMed1990

[A clinico-pathological study of small renal cell carcinoma].

Between 1960 and 1989, 50 patients with small renal cell carcinoma measuring below 3 cm in diameter were examined. Among them, 31 patients were nephrectomized, but in 19 patients, the renal cell carcinoma was found first at autopsy. The average tumor diameter of the unrecognized ones was smaller than that of nephrectomized patients with the minimum of 0.4 cm. Forty-one patients had clear cell carcinoma, 9 granular cell carcinoma, 40 grade 1 tumor, and 10 grade 2 tumor. The grade 3 tumor was not found in our study. Three out of the 50 patients had distant metastasis at the time of operation or autopsy. Six patients had microscopic tumor thrombi just close to the tumor pseudo-capsule. Two patients had apparent tumor thrombi in the main renal vein. The smallest tumor that showed microscopic tumor thrombi measured 1.5 cm in diameter. The incidence of tumor thrombi was correlated with tumor diameter. The step sections by 4 mm thick of nephrectomized specimens were examined on 16 patients. The daughter tumor was found in two patients. The tumor thrombi had close relationships with the presence of distant metastasis (p less than 0.001) and/or the daughter tumor (p less than 0.01). In conclusion, small renal carcinoma measuring less than 1.5 cm in diameter was considered to be treated by conservative surgery.

Adult↗
PubMed1990

Investigating the response of prostatic cancer to endocrine therapy.

The presence of androphilic protein identified histochemically with R 1881-CMO-BSA-FITC correlated with response to endocrine therapy and prognosis. Ras P21 was not a useful indicator of the subsequent course of the disease. Conventional X ray assessment of boney metastases still seems of use in monitoring overall progress of the disease.

Bone Neoplasms↗
PubMed1990

[Factors influencing prognosis of stage D2 prostatic cancer following endocrine therapy: comparison between short-term cancer death and long-term survival group].

To clarify factors affecting prognosis following endocrine therapy, stage D2 patients who died from prostatic cancer within 3 years and those under well-controlled state longer than 5 years were compared with respect to background factors and response to endocrine therapy. Thirty-five and 18 cases, respectively, were studied. Differences between the two groups were bone pain, anemia, tumor grade, number of bone metastasis, and response to endocrine therapy. Performance status in long-term survival groups tended to be better than that in short-term cancer death groups.

Adenocarcinoma↗