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Yoshihiro Ide

Publications and source records attributed to Yoshihiro Ide.

16 recordsLinked to original sources
PubMed2006

Prostate cancer detection among men with prostate specific antigen levels of 2.5 to 4.0 ng/ml in a Japanese urological referral population.

PURPOSE: Prostate cancer detection at levels of 2.5 to 4.0 ng/ml in a Japanese urological referral population has not been elucidated. The purpose of this study is to investigate the cancer detection rate and clinical relevance of prostate cancer in this PSA range. MATERIALS AND METHODS: All urological patients 70 years or younger tested for prostate cancer were studied. There were 550, 97, 112 and 52 patients with a PSA of less than 2.5, 2.5 to 4.0, 4.1 to 10.0 and more than 10.0 ng/ml, respectively. Transrectal 10-core prostate biopsy was performed in 80 (82%) of the 97 patients with a PSA of 2.5 to 4.0 ng/ml and 102 (91%) of the 112 patients with a PSA of 4.1 to 10.0 ng/ml. RESULTS: Cancer detection rates in patients who underwent biopsy were 26.3% and 34.3% at PSA levels 2.5 to 4.0 and 4.1 to 10.0 ng/ml, respectively. High grade cancers with Gleason score 7 or more were found in 19.0% and 22.9% of patients with cancer with PSA 2.5 to 4.0 and 4.1 to 10.0 ng/ml, respectively. No significant difference was found between the 2 groups in pathological findings on biopsy, including percent positive cores (16.7% vs 20.0%, p = 0.10), maximum cancer length (25.0% vs 30.0%, p = 0.28) and maximum percent cancer length (2.0 vs 3.0 mm, p = 0.17). CONCLUSIONS: Japanese urological referral patients develop prostate cancer quite commonly even if their serum PSA levels are 2.5 to 4.0 ng/ml. Since these cancer cases include high grade, clinically significant cancer, prostate biopsy might be considered at least for selected cases in this PSA range.

Aged↗
PubMed2005

Spontaneous rupture of adrenal pheochromocytoma: review and analysis of prognostic factors.

BACKGROUND AND OBJECTIVES: Because of its rarity, the clinical characteristics of the manifestation of a ruptured pheochromocytoma and factors influencing on treatment outcomes in patients are still unclear. METHODS: A comprehensive MEDLINE review of the literature on pheochromocytomas, rupture and hemorrhage was performed. Based on the review and one additional case of our hospital, statistical analysis was undertaken to analyze the association of clinical outcome with clinical presentation, preoperative diagnosis, and treatment modality. RESULTS: We identified 49 other cases of hemorrhagic pheochromocytoma in the literature. After our case was added, a review of all 50 cases revealed that 17 of 38 that could not undergo adequately prepared (elective) surgery died, while all 12 patients who underwent elective surgery survived (P = 0.004). An accurate preoperative diagnosis of pheochromocytoma was associated with elective surgery (P < 0.0001), and hemodynamic instability (shock status) was a significant factor for a failed diagnosis and inadequate management, resulting in a poor prognosis (P = 0.023). CONCLUSIONS: Although it is a very rare condition, physicians should be aware that a pheochromocytoma can bleed and present acutely in the abdomen with shock; an accurate diagnosis and adequately prepared surgical removal are important for a good postoperative prognosis.

Adolescent↗
PubMed2005

Genetic analysis of JC virus and BK virus from a patient with progressive multifocal leukoencephalopathy with hyper IgM syndrome.

A case of acute progressive multifocal leukoencephalopathy (PML) with hyper IgM syndrome 1 is reported. Viral DNA and VP1 protein of JC virus (JCV) and BK virus (BKV) were detected by immunohistochemistry, in situ hybridization, semi-nested polymerase chain (PCR) and PCR-restriction enzyme analysis. JCV DNA and VP1 protein were found in the nuclei of oligodendrocytes. The non-coding control region (NCCR) and VP1 region of the JCV genome were sequenced; this revealed a novel rearrangement pattern of the NCCR in the brain tissue. The VP1 regions of brain and urine JCV were identical and of genotype type 2A. The BKV in the urine sample was genotype I. No BKV genome was found in the brain. The novel genomic rearrangement of the JCV NCCR in the brain tissue may have altered JCV pathogenesis to induce PML; the impaired immunity from hyper IgM syndrome 1 may have enabled the rearrangement. The JCV NCCR rearrangement in the brain may have originated from the archetypal form in the urine through deletion and duplication.

Adult↗
PubMed2005

Association between body mass index and prostate cancer detection rates in Japanese urologic patients.

OBJECTIVES: To examine whether an association exists between body mass index (BMI) and prostate cancer detection rates or pathologic features of cancer in Japanese urologic patients. METHODS: We studied the age, BMI, and biopsy results of 481 patients who underwent transrectal prostate biopsy. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23.0 (n = 248); overweight, BMI 23.0 to 25.0 (n = 116); and obese, BMI greater than 25.0 (n = 117). We then compared the cancer detection rates and pathologic features among the three groups. Multivariate logistic regression analysis was also performed. RESULTS: No significant differences in the cancer detection rate were found among the three groups (40.2% to 43.1%, P = 0.87) on univariate analysis. Multivariate logistic regression analyses revealed significant associations between the BMI and cancer detection (P = 0.029, 95% confidence interval [CI] 0.85 to 0.99), but no significant associations were observed between BMI and the presence of Gleason components 4 or 5 (P = 0.061, 95% CI 0.79 to 1.01), poor cell differentiation (P = 0.174, 95% CI 0.96 to 1.24), or clinically organ-confined disease (P = 0.45, 95% CI 0.84 to 1.08). CONCLUSIONS: BMI seems to have a significant impact on prostate cancer detection rates, although it seems difficult to apply the BMI directly to the management of patients at risk of prostate cancer in urologic clinics.

Adult↗
PubMed2005

Use of effective core volume obtained from transrectal biopsies for predicting target tumor volume.

OBJECTIVES: To evaluate, in a retrospective review, whether the concept of effective core volume is useful for predicting the volume of a tumor focus identified by transrectal needle biopsy of the prostate gland. METHODS: The tumor volume range was estimated according to the concept of an effective core volume using the numbers of total and positive biopsy cores from the peripheral zone and peripheral zone prostate volume in 32 patients with prostate cancer with one to three cancer-positive cores who only underwent radical prostatectomy after transrectal prostate biopsy. The estimated tumor volume was compared with the actual tumor volume as determined by pathologic examination of whole mount sections of the prostatectomy specimens. RESULTS: In the 32 patients, the actual tumor volume was within the range determined by the effective core volume concept in 24 patients (75.0%), although 4 (12.5%) had a smaller focus and 4 (12.5%) a larger focus than estimated. Overall accuracy improved up to 84.4% (27 of 32) if 5% safety margins were applied to the range determined by the effective core volume concept. In particular, the accuracy was 87.5% (14 of 16) in patients with one positive core after transrectal systemic biopsy. CONCLUSIONS: The effective core volume can be used to predict the volume of prostate cancer with acceptable accuracy. It can provide an assumed maximal tumor volume and valuable information for clinical decision making of the treatment strategy, particularly in cases with one positive core.

Aged↗
PubMed2005

Micropapillary bladder cancer.

A characteristic clinical course of a patient with micropapillary bladder cancer, a rare histological variant with high metastatic potential, is presented. An 80-year-old woman had locally advanced high-grade bladder cancer with a focal micropapillary variant identified which was treated with intra-arterial chemotherapy with radiation therapy. Standard follow-ups involving cystoscopy with cold-cup biopsies and computed tomography could not detail the bladder carcinoma; however, the patient died of carcinomatosis 20 months after treatment. At autopsy, carcinomas proliferated under benign mucosa and infiltrated diffusely in the retro peritoneum. This behavior differs from the normal pattern of invasive transitional cell carcinoma, which usually proliferates forming a mass lesion. Thus, it may be difficult to detect micropapillary bladder cancer by computed tomography which demonstrates only increased tissue density in retroperitoneal fascia; therefore, care should be taken in the follow-up of micropapillary bladder cancer.

Aged↗
PubMed2005

Value of prostate volume measurement using transabdominal ultrasonography for the improvement of prostate-speci fi c antigen-based cancer detection.

PURPOSE: To examine value of prostate-speci fi c antigen (PSA) adjusted by prostate volume measured using transabdominal ultrasonography in prostate cancer detection among men with elevated PSA. METHODS: 238 men aged 79 years or younger with serum PSA levels of 2.0-20.0 ng/mL and normal digital rectal examination fi ndings were studied in terms of total and free PSA, prostate volumes with transrectal (TRUS) and transabdominal (TAUS) ultrasonography and transition zone volumes with TRUS prior to transrectal 10-core biopsy. In addition to sole PSA values and the free-to-total PSA ratio, volume-adjusted PSA values, PSA densities determined by TRUS (PSAD(TRUS)), and TAUS (PSAD(TAUS)), and PSA transition zone densities (PSATzD) were compared using receiver operating characteristic (ROC) analysis. RESULTS: Prostate cancer was diagnosed in 58 (24.4%) of the 238 men who underwent prostate biopsies. Of the areas under ROC curves (AUC) of studied parameters, PSATzD (AUC 0.751) was the best and signi fi cantly superior to PSAD(TAUS) (AUC 0.664, P = 0.007). However, PSAD(TAUS) exceeded PSA (AUC 0.559, P = 0.004) and showed potential capability of a one-fourth reduction in unnecessary biopsies without spoiling sensitivity (90%). Cancer detection rate was only 4.2% in the 48 patients whose prostate volume in TAUS was > 50 mL and PSAD(TAUS) was < 0.075. CONCLUSIONS: Since PSAD(TRUS) and PSATzD were signi fi cantly superior to PSAD(TAUS), TRUS is feasible as the standard fashion to determine prostate volume in the diagnosis of prostate cancers. However, TAUS is also worthwhile as it can improve the prostate cancer detection using sole PSA, and primary use of TAUS has the potential to reduce the substantial number of unnecessary biopsy safely.

Adult↗
PubMed2005

Prostate gland volume is a strong predictor of biopsy results in men 70 years or older with prostate-specific antigen levels of 2.0-10.0 ng/mL.

PURPOSE: The incidence of prostate cancer, benign prostatic enlargement and serum level of prostate-specific antigen (PSA) increase with patient age. Intermediate elevation of PSA in elderly populations is apt to be considered insignificant. We evaluated the impact of PSA and prostate volume on the presence of non-palpable prostate cancer in elderly men with an intermediate level of PSA. MATERIALS AND METHODS: Clinical records of 154 men 70 years or older, with non-cancerous digital rectal examination findings and with serum PSA levels of 2.0-10.0 ng/mL, who underwent initial 6- to 10-core transrectal prostate biopsy, were reviewed for prostate volume, number of biopsy cores, PSA and associated parameters. Stepwise logistic regression and receiver operating characteristic (ROC) models were used to determine the impacts of the parameters on the biopsy results. RESULTS: Overall cancer detection rate was 40/154 or 26.0%. Prostate-specific antigen showed no significant association with the presence of prostate cancer (P = 0.59, Mann-Whitney U-test), while prostate volume did (P < 0.0001). On stepwise logistic regression analysis, prostate volume (P = 0.024, 95% CI 1.008-1.116) and biopsy core density (P = 0.017, 95% CI 4.76-7.12 x 10(6)) were independently associated with a cancer diagnosis, whereas PSA density was not an independent factor for a positive biopsy result. The area under the ROC curve for prostate volume was significantly superior to that of PSA (0.802 vs. 0.529; P = 0.012). CONCLUSIONS: In men 70 years or older with gray zone PSA, prostate cancer patients are equally distributed over any PSA range. Although PSA has less impact on cancer presence than mere prostate volume, prostate cancer would be detected in a substantial proportion of older patients with PSA levels of 2.0-10.0 ng/mL.

Aged↗
PubMed2005

Prostate-specific antigen (PSA) complexed to alpha1-antichymotrypsin improves prostate cancer detection using total PSA in Japanese patients with total PSA levels of 2.0-4.0 ng/mL.

OBJECTIVE: To assess the utility of prostate-specific antigen (PSA) complexed to alpha1-antichymotrypsin (PSA-ACT) in prostate cancer screening in Japanese men with a total PSA level of 2.0-4.0 ng/mL, as improving cancer detection in men with these total PSA levels is a challenge for clinical urologists. PATIENTS AND METHODS: Total PSA and PSA-ACT were prospectively assessed and prostate biopsy recommended for patients who met either of two thresholds, i.e. a total PSA of > or = 2.0 ng/mL or a PSA-ACT of > or= 1.5 ng/mL. The diagnostic ability of total PSA and PSA-ACT, and free-to-total PSA ratio and prostate volume-adjusted density were evaluated by receiver operating characteristic (ROC) analysis. RESULTS: Of 1003 men enrolled, 547 met the biopsy criteria and a biopsy was taken in 315 (57.6%) patients. The area under the ROC curve for PSA-ACT (0.679) was significantly greater than that for total PSA (0.601, P = 0.04) and equivalent to that for the free-to-total ratio (0.686, P = 0.911) in 116 men, including 27 with cancer with total PSA levels of 2.0-4.0 ng/mL. PSA-ACT was more specific than the free-to-total ratio at a sensitivity of 95% (36% vs 18%, P < 0.05). The best variable for discriminating between cancer and benign disease in men with PSA levels of 2.0-4.0 ng/mL was PSA-ACT density (area under the curve 0.852) which provided 66% specificity at a sensitivity of 90%. CONCLUSIONS: PSA-ACT is better than total PSA and equivalent to the free-to-total ratio for detecting prostate cancer in men with PSA levels of 2.0-4.0 ng/mL, and is thus useful for reducing the number of unnecessary biopsies.

Adenocarcinoma↗
PubMed2005

Volume-adjusted prostate-specific antigen (PSA) variables in detecting impalpable prostate cancer in men with PSA levels of 2-4 ng/mL: transabdominal measurement makes a significant contribution.

OBJECTIVE: To examine whether prostate-specific antigen (PSA) levels adjusted according to prostate volume improve prostate cancer detection using transrected biopsies in men with PSA levels of 2-4 ng/mL, and benign findings on a digital rectal examination (DRE). PATIENTS AND METHODS: Men aged < or = 79 years and with serum PSA levels of 2-4 ng/mL and normal DRE findings were prospectively enrolled. Eligible patients were recommended for transrectal prostate biopsies after measuring prostate volumes with transrectal (TRUS) and transabdominal (TAUS) ultrasonography, and transition zone volumes with TRUS. In addition to PSA levels and the free-to-total PSA ratio, volume-adjusted PSA levels, PSA densities determined by TRUS (PSAD(TRUS)), and TAUS (PSAD(TAUS)), and PSA transition zone densities (PSATzD) were compared using receiver operating characteristic analysis. RESULTS: Prostate cancer was diagnosed in 31 (22%) of the 139 men who had prostate biopsies. The area under the curve (AUC) of PSAD(TRUS) (0.796) and PSATzD (0.792) was similar and significantly greater than that of PSA (AUC 0.588) and the free-to-total PSA ratio (AUC 0.658). PSAD(TAUS) was a significantly better indicator of prostate cancer than PSA levels alone (P = 0.043). CONCLUSION: As predictors of prostate cancer, there were no significant differences between PSAD(TRUS) and PSATzD. Although PSAD(TAUS) was worse than PSA variables adjusted by total and transition zone prostate volumes determined by TRUS, it was a better predictor than the PSA value alone in men with a low PSA level. These results indicate that TAUS is worthwhile where the routine use of TRUS before biopsy is difficult.

Adult↗
PubMed2004

Detection of prostate cancer in men with prostate-specific antigen levels of 2.0 to 4.0 ng/mL equivalent to that in men with 4.1 to 10.0 ng/mL in a Japanese population.

OBJECTIVES: To analyze prospectively whether prostate cancer (CaP) incidence differs between Japanese men with a prostate-specific antigen (PSA) level of 2.0 to 4.0 ng/mL and those with a PSA level of 4.1 to 10.0 ng/mL. METHODS: Men 79 years old or younger who were referred to our clinic were screened for CaP. Individuals with PSA levels of 2.0 ng/mL or greater were recommended for transrectal prostate biopsy. The prebiopsy clinical characteristics, cancer detection rate, and pathologic findings from the needle biopsy and prostatectomy specimen were compared between the low (2.0 to 4.0 ng/mL) and intermediate (4.1 to 10.0 ng/mL) PSA groups. RESULTS: Of 858 patients screened for CaP, 440 with benign findings on digital rectal examination met the criteria, and 274 (62.3%) underwent biopsy. Of those undergoing biopsy, 110 and 123 patients had a low or an intermediate PSA level, respectively. Men in the low PSA group had a higher free/total PSA ratio, smaller prostate volume, and lower PSA density compared with those in the intermediate PSA group. CaP was diagnosed in 26 (23.6%) of 110 in the low and 29 (23.6%) of 123 in the intermediate PSA group. No statistically significant difference was found between the two groups in the pathologic findings of needle biopsy, including Gleason score, number of cores per biopsy, percentage of positive cores, and cancer length in the positive cores. CONCLUSIONS: No statistically significant difference was found in the incidence of CaP (23.6%) between men with low and intermediate PSA levels in a Japanese population. The diagnostic yield was comparable to that reported for both white and black men.

Aged↗
PubMed2004

Clinically isolated cerebellar metastasis of renal pelvic urothelial cancer.

A 70-year-old man who had undergone radical surgery for renal pelvic transitional cell carcinoma 9 months previously developed solitary cerebellar metastasis. Despite neurosurgical removal, the patient died and post-mortem pathological examination revealed microscopic metastatic lesions within microvessels of the lung. No other lesion, including local residual cancer, was detected.

Aged↗
PubMed2004

Effects of sextant transrectal prostate biopsy plus additional far lateral cores in improving cancer detection rates in men with large prostate glands.

PURPOSE: To determine whether additional, far lateral cores improve the diagnostic performance of transrectal sextant biopsy in men with large prostate glands. METHODS: Men with prostate volumes of 50 mL or greater in transrectal ultrasonography who were suspected of prostatic adenocarcinoma were prospectively enrolled. Biopsy criteria were defined as 2.0 ng/mL or greater of serum total prostate-specific antigen and/or abnormal findings on digital rectal examination. Four cores of far lateral biopsies were added to the standard sextant technique. RESULTS: Of 104 patients enrolled in the present study and undergoing biopsy, 14 (13.5%) were diagnosed as having prostate cancer and 27 (26.0%) were diagnosed as having prostatic intraepithelial neoplasia (PIN) or an atypical gland. There were no cases where cancer was only detected in the additional cores, whereas PIN/atypical gland was uniquely detected from the additional, far lateral sites in eight of the 27 patients who were diagnosed with this condition. CONCLUSIONS: Although the number of patients diagnosed as having PIN/atypical gland might increase with the addition of far lateral cores, this additional sampling does not improve cancer detection rates in men with large prostate glands.

Adenocarcinoma↗
PubMedDate not supplied

Ovarian tumor with functioning stroma.

The authors reported two cases with ovarian tumors with functioning stroma. One was an ovarian carcinoid with testosterone-producing stroma and another was an ovarian mucinous cystadenoma with elevated serum level of estrogen. They appeared as multilocular cystic masses with varying signal on MR. This imaging feature was mimicking both those of Sertoli-Leydig tumors with heterologous elements and granulosa cell tumors, which are well known as functioning tumors. It had been reported in pathological literatures that any type of ovarian tumors can show hormonal activity due to functional stroma, although, it is the first report in the radiological literatures.

Aged↗