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T Shimoji

Publications and source records attributed to T Shimoji.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Statistical study of tumors of the renal pelvis and ureter].

We reviewed data from 62 patients with epithelial tumors of the renal pelvis and ureter who were hospitalized and treated at Nagoya University Hospital between July, 1970 and June, 1988. Of the 62 patients, 50 were males and 12 were females, the ratio being 4.2:1. The mean age was 62.1 years, the ages ranging from 41 to 87 years. The peak incidence of tumors was marked in the sixth decade for the males and in the seventh decade for the females. Eighty-two percent of the patients were 50 years of age or older. Smoking habits were noted in 76.0 percent of the males and in 16.7 percent of the females. Asymptomatic macrohematuria, found in 43 patients, was the most frequent symptom. Ninety percent of the 62 tumors were transitional cell carcinoma. Twenty-five patients (40.3%) had concomitant bladder cancer, which was previously diagnosed in 3, simultaneously found in 9, and subsequently developed in 16. Twenty-nine patients had tumors localized in the renal pelvis and eighteen in the ureter; the remaining fifteen had tumors localized in two or three organs, including the renal pelvis, ureter and bladder. Histological grades of ureteral tumors were significantly higher than those of renal pelvic tumors. The sensitivity of urinary cytology was 57.8 percent. High-grade tumors had higher sensitivity than low-grade tumors. Larger tumors (greater than 3 cm in diameter) were significantly associated with high-stage tumors, whereas no apparent correlation was found between tumor size and histological grade. Nonpapillary growth of tumor and vascular invasion were significantly related with high-stage and high-grade tumors; diffuse pattern of tumor infiltration was associated with high-stage tumors.

Adult↗
PubMed1990

[Clinical study of urinary cytology in bladder tumors--analysis of factors related with positivity of urinary cytology].

To clarify the clinical and pathological determinants affecting the sensitivity of urinary cytology, we reviewed cytological findings from 119 patients with bladder cancer who were initially treated between January 1982 and March 1988. Cytological specimens obtained from voided urine were stained by the Giemsa and Papanicolaou techniques, and were classified into three categories of malignant cells: positive, suspicious, and negative. Of 311 specimens examined, 114 (37%) were positive, 81 (26%) were suspicious, and the remaining 116 (37%) were negative. The overall positive rate, or sensitivity, was 50% (60 out of 119 patients). The sensitivities were 7% for patients with grade 1 tumors, 42% for grade 2 tumors, and 97% for grade 3 tumors. Univariate analysis by logistic regression analysis revealed that grade, stage, histological pattern of growth, size and number of tumors, and patient age were significantly related with the positivity of voided urinary cytology. The logistic regression model, as a multivariate analysis, demonstrated that grade was the most important determinant affecting the positive cytologic finding, followed by number of tumors with statistical significance. We conclude that the lower sensitivity in conventional urinary cytology for low-grade tumors necessitates new adjuncts, including immunocytochemistry and flow cytometry, to lower the false-negative rate.

Adult↗
PubMed1989

[An autopsy case of AIDS with disseminated cytomegalovirus infection and neurological disturbance].

We report a case of acquired immunodeficiency syndrome (AIDS) complicated by disseminated CMV infection and neurological disturbance. A 21 years old male with hemophilia A was diagnosed as having AIDS in Feb. 1986 because of interstitial pneumonia and esophageal candidiasis. Since Jan. 1987 he had complained of hypesthesia in the legs. On Mar. 14 he was admitted due to diarrhea. The laboratory data revealed that WBC was 4,000/microliters including 29% of lymphocytes, 1.6% of OKT4+-, 71.6% of OKT8+-lymphocytes, T4/T8 ratio 0.02 and positive HIV antibody and HTLV-1 antibody. After the admission, sensory disturbance exacerbated to complicate paraplegia. He developed acute hepatitis associated with leukopenia, thrombocytopenia, pneumonia and melena, and eventually died on May 29. The autopsy findings disclosed CMV infection in the lungs, colons, and adrenal glands, suggesting that the primary cause of death was adrenal insufficiency. Degeneration of cerebro-spinal nerve cells and peripheral neuritis were thought to result from direct HIV infection to the nervous system.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Adult T-cell leukemia with massive melena due to marked gastrointestinal involvement].

A 60-year-old man born in Okinawa was admitted to our hospital because of epigastralgia. Physical examination revealed general lymphadenopathy, mild hepatomegaly and skin eruption. The peripheral blood leukocyte count was 168,600/microliters, with 93% abnormal lymphocytes showing convoluted or lobulated nuclei. Anti HTLV-1 antibody was positive with titer of 1: 1280 (PA). Leukemic cells had typical ATL cells' surface markers (OKT3; 97.2%, T4; 93.3%, T8; 2.8%, OKIA1; 39.6%, IL-2R; 41.8%) and complete monoclonal HTLV-1 provirus DNA. Endoscopic examination with biopsy revealed massive involvement of ATL cells into gastric mucosa. In the course of the treatment, he had extremely massive melena, and was saved by emergency operation. Multiple ulcers were found in the resected colon. Histological examination showed the marked infiltration of the ATL cells into the mucous or submucous membrane. Thereafter, he was treated well with ALG (Anti Lymphocyte Globulin), until hypercalcemia occurred. He died of acute renal failure after hypercalcemia.

Gastrointestinal Neoplasms↗
PubMed1989

[A case of temporal lobe epidermoid cyst].

A case of temporal lobe epidermoid cyst was reported. More than 5 ml of cerebrospinal fluid was aspirated during the operation. This cerebrospinal fluid among the anatomical interstices of the tumor was considered to be rather responsible for the low density in the CT scan.

Brain Diseases↗
PubMed1988

[A study of postoperative adjuvant chemotherapy of advanced urinary epithelial cancer].

The effect of postoperative adjuvant chemotherapy was studied in 22 cases of advanced urinary epithelial cancer. Vincristine, mitomycin C and bleomycin (VMB) was administered in combination to 9 prophase cases from December, 1980 to March, 1982 and cis-dichlorodiamine platinum, peplomycin and mitomycin C (PPM) in combination to 13 anaphase cases from April, 1982 to November, 1984. The site was renal pelvic cancer in 3 cases, cancer of the ureter in 3 cases, cancer of the bladder in 13 cases, cancer of the pelvis, ureter, and bladder in 1 case, and recurrence of pelvic cancer following bladder cancer in 2 cases. The degree of invasion was pTa in 2 cases, pT1 in 1 case, pT2 in 1 case, pT3 in 11 cases and pT4 in 5 cases. Lymph node metastasis had occurred in 9 cases, no metastasis in 8 cases and it was unclear in the remaining 6 cases. The mean observation period was 16.5 months; 10 patients were alive without any tumors, one patient was alive with a tumor, 11 patients died of cancer, and one patient died intercurrently. The mean postoperative survival period in the mortality cases was 14.5 months. According to the classified type of chemotherapy received, there were 3 out of 9 cases (33.3%) who survived without tumors after receiving VMP and 7 out of 13 cases (53.8%) in the PPM group who survived without tumors. Although a simple comparison cannot be made, it appears that PPM therapy is superior. No severe side-effects were observed.

Aged↗
PubMed1988

[Multivariate evaluation of survival factors and postoperative adjuvant chemotherapy in patients with bladder cancer treated by radical cystectomy].

Multivariate analysis by Cox's proportional hazard model was performed on 71 bladder cancer patients treated by radical cystectomy to clarify factors affecting survival and to evaluate the efficacy of postoperative adjuvant chemotherapy. Clinicopathologic data included in the analysis were age, sex, interval from onset of symptoms to first consultation, prior tumor history, year of operation and tumor characteristics: size, number, growth pattern, stage, grade, mode of infiltration, lymphatic invasion, lymph-node metastasis and lymphocyte infiltration around tumors. Analysis revealed that stage is the most statistically significant factor for survival (p less than 0.0001); followed by year of operation (p less than 0.05) and lymph node metastasis (p less than 0.1). The above three determinants yielded hazard ratios of 16.6 for stage (pT3a-pT4 vs. pTis-pT2), 2.7 for year of operation (1978-1982 vs. 1983-1987) and 2.4 for lymph node metastasis (positive vs. negative). Postoperative adjuvant chemotherapy consisting of cisplatin, peplomycin and mitomycin C (PPM therapy) seemed to improve survival, when the influence of the major prognostic factors were adjusted by the proportional hazards model. The authors conclude that stage and lymph node metastasis should be considered when postoperative adjuvant treatment is selected for patients with bladder cancer treated by radical cystectomy, and that further prospective randomized trials are mandatory to confirm the efficacy of postoperative adjuvant PPM therapy suggested by the present retrospective multivariate analysis.

Adult↗
PubMed1988

An outbreak of acute hemorrhagic conjunctivitis due to Coxsackie virus type A24 variant in Japan.

An outbreak of acute conjunctivitis due to Coxsackie virus A24 (CA24) occurred in Okinawa, the southernmost island of Japan, from 1985 to 1986. From conjunctival scrapings of 85 acute hemorrhagic conjunctivitis patients, 39 isolates identified as an antigenic variant of CA24 were obtained and then cultured in HeLa cells. Paired sera taken from these patients with acute conjunctivitis in Okinawa were also tested against enterovirus 70 (EV70) and CA24 and showed rises in neutralizing antibodies to these agents. The subconjunctival hemorrhage among the clinical manifestations caused by the CA24 variant in this recent epidemic was similar to that due to EV70. EV70 conjunctivitis is more commonly known as acute hemorrhagic conjunctivitis (AHC), first named by the Japanese ophthalmologist, Prof. Seiji Sugiura. The present seroepidemiologic survey for the CA24 variant and EV70 in different districts of Japan revealed a low frequency of rise in neutralizing antibody titers against these two pathogens. The differentiation between EV70 and the CA24 variant as the agent causing AHC is very important in epidemiology, especially as there is a high possibility in Japan of outbreaks caused by these two agents.

Adolescent↗
PubMed1987

[Treatment of advanced testicular cancer].

Two patients with stage II, 12 patients with stage III advanced testicular cancer, were treated with a combination of CDDP, vinblastine and bleomycin. Four of the cases (28.6%) achieved a complete response and 6 (42.9%) achieved a partial response. The over all response rate was 71.4%. After CR, 2 cases (50%) showed relapse. Although the treatment confirms some efficacy of the drug regimen, the prognosis is poor in bulky metastasis. Early induction therapy with etoposide is necessary in cases of high volume metastasis.

Adult↗
PubMed1987

[The course of pyuria after transurethral resection of the prostate and factor analysis of its duration].

The course of pyuria and bacteriuria was reviewed in 54 patients undergoing transurethral resection of prostate. Pyuria, which was seen in all cases, lasted for 70.1 +/- 24.7 days and bacteriuria defined as more than 10(4)/ml occurred in 16 patients (30%) postoperatively. To analyze the factors affecting the duration of pyuria, we utilized Hayashi's multidimensional quantification I theory. The factors included age, serum protein, preoperative indwelling catheter, preoperative urinary tract infection, resected weight, postoperative infection, the duration of postoperative indwelling catheter, and the way of antibacterial prophylaxis. The most important factor was resected weight (range 42.8 days), the second was postoperative infection (range 23.9 days) and the third preoperative infection (range 20.9 days). The other factors had no significance. Our analysis showed good correlation between the observed and predicted duration of pyuria (r = 0.82, p less than 0.005).

Aged↗
PubMed1987

[Assessment of obstructive nephropathy using diuretic 99mTc-DTPA renogram and 99mTc-DMSA renoscintigraphy].

99mTc-DMSA and diuretic 99mTc-DTPA renoscintigraphy were performed on 51 kidneys suspected of obstructive nephropathy based on excretory urography to evaluate the residual renal function and the degree of urinary flow impairment respectively. We classified the response to diuretics into 6 patterns: I. normal, IIa. severely damaged renal function, IIb. slow RI excretion without urinary tract visualization (pattern II had no response to furosemide), IIIa. rapid elimination of tracer from the obstructed upper tract, IIIb. slow elimination, and IV. gradual tracer accumulation in the pelvicalyceal system with fairly well preserved renal function but no response. Hydronephrosis varied according to pattern type, in the ascending order of I, IIIa, IIIb and IV (p less than 0.05). Degree of hydronephrosis was inversely related to 99mTc-DMSA uptake, but without statistical significance. 99mTc-DMSA uptake was lower for pattern III as a whole (IIIa + (IIIb) than for pattern I (p less than 0.005), but there was no difference between IIIa and IIIb. Pattern IIa exhibited a significantly lower uptake than any of the other groups. (p less than 0.005) In contrast to previous views, we believe that pattern IIIa indicates a mild obstruction of urinary flow and impaired renal function. Consequently, assessment of obstructive nephropathy should not be based only on urodynamic study but also on differential renal function test.

Humans↗
PubMed1987

[A case of giant vesical diverticulum with malignant neoplasm].

We experienced a case of giant vesical diverticulum with a malignant neoplasm in which the preoperative diagnosis was difficult. It simultaneously occurred with a vesical tumor. The patient, a 68-year-old man, visited our hospital complaining of pollakisuria, nycturia and microscopic hematuria. He had urinary retention and his vesical urine volume was 1,450 ml. X-ray examination and ultrasound examination revealed a giant vesical diverticulum and moderate hypertrophy of the prostate. A vesical tumor was suspected. Cystometrogram revealed a flaccid pattern with vesical capacity over 900 ml. Diverticulectomy and resection for a vesical tumor were performed. A malignant neoplasm in the vesical diverticulum was found during the operation. Transurethral resection of the prostate was performed after two months. There has been no evidence of recurrence for 3 years postoperatively.

Aged↗
PubMed1987

[Recurrence of transitional cell carcinoma in the left pelvis and ureter, and ileal conduit after total cystectomy: a case report].

A 63-year-old male with transitional cell carcinoma of the bladder underwent total cystectomy. Five years later sequential excretory urography and urinary cytologic examination revealed tumor recurrence in the left pelvis and ureter; left nephroureterectomy was performed in July, 1984. In December, 1985, he complained of macrohematuria and urinary cytology was positive. Ileal conduitgraphy showed filling defects at the bilateral uretero-ileal anastomosis, where two papillary lesions were disclosed by endoscopic examination. In January, 1986, total extirpation of the ileal conduit and reconstruction of a new ileal conduit was performed. Macroscopically the two lesions were found to be a papillary tumor at left uretero-ileal anastomosis and a polypoid tumor distal to right uretero-ileal anastomosis. Histological examination revealed both tumors to be grade II transitional cell carcinoma. This rare case is discussed and the literature is reviewed.

Anastomosis, Surgical↗
PubMed1987

[Fournier's gangrene: a case report].

Since necrotizing fasciitis of the genitalia was first described by Fournier in 1883, approximately 400 cases have been reported. It has been seldom reported in Japan. Because its mortality rate is still high, the importance of early diagnosis and the subsequent vigorous treatment has been emphasized. A 73-year-old man who had poor controlled diabetes mellitus was admitted to our hospital with painful swelling of scrotum. Chemotherapy using broad spectrum antibiotics and debridement of scrotal skin was performed combined with insulin therapy. As culture of pus and excised tissue from the gangrenous patches yielded the growth of candida, we used 8 g/day of 5-fluorocytosine. Because the gangrene was not healed, we performed bilateral orchiectomy. After the operation, the gangrene was healed and the wound was closed. Diabetes mellitus was controlled well and his general condition was improved.

Aged↗
PubMed1986

Peritumoral oedema and lipid content.

The authors analyzed the water and lipid contents of oedematous tissues of white matter obtained during the operation, comparing with the absorption value in the CT scan. As the absorption value lowered its level, the water content increased, while the lipid decreased. However, after subtracting these two components, the content of protein also showed a significant decrement parallel to the absorption value despite the existence of extravasated protein. The decrement of lipid content was considered to be due to a dilution effect by an expanded volume of extravasated oedema fluid, as well as the decrease in protein, rather than the actual loss of tissue component; that is demyelination. It is the relative decrease in protein content which contributes to the low absorption value of oedematous tissue.

Adult↗