Biomedical subjects

Yuji Yamada

Publications and source records attributed to Yuji Yamada.

At least 55 records · Page 3Linked to original sources

PubMed2004

Clinical outcome of retroperitoneal lymph node dissection after induction chemotherapy for metastatic non-seminomatous germ cell tumors.

BACKGROUND: Retroperitoneal lymph node dissection (RPLND) following induction chemotherapy has been considered a critical component in the comprehensive management of advanced non-seminomatous germ cell tumors (NSGCT). The objectives of the present study were to review the clinical outcome of patients who underwent RPLND and to evaluate the probability of necrosis alone, based on some readily available clinical data for these patients. METHODS: Forty-seven consecutive patients with NSGCT were treated with first-line chemotherapy at our institution between January 1993 and September 2002. Twenty-four of these patients, who underwent RPLND with normal values of tumor markers after induction chemotherapy, were included in the study. The cause-specific survival rate was calculated using the Kaplan-Meier method. Various predictive factors for the histology were analyzed using multivariate analysis. RESULTS: The pathological findings at resection were necrosis alone in 62.5% of cases, teratoma in 25.0%, and viable cancer in 12.5%. The cause-specific 3-year survival rate of patients who underwent complete and incomplete resection was 100% and 50.0%, respectively. Among several clinical factors, prechemotherapy tumor size less than 50 mm was found to be an independent predictor of necrosis alone (hazard ratio = 4.45, P= 0.04). CONCLUSION: Metastatic tumor size before chemotherapy appears to be one of the most important factors for the prediction of necrosis alone in the resected specimens of RPLND. The prognosis of patients might be influenced by the degree to which resection has been completed.

Adult↗

PubMed2004

Extraperitoneal laparoscopic retroperitoneal lymph node dissection in supine position after chemotherapy for advanced testicular carcinoma.

AIM: To evaluate the feasibility and usefulness of extraperitoneal laparoscopic retroperitoneal lymph node dissection (RPLND) in the supine position after chemotherapy for advanced testicular carcinoma. METHODS: Three patients with advanced testicular cancer underwent chemotherapy. Although serum markers were decreased compared with the normal range, residual masses requiring surgical resection were recognized by computed tomography scanning. We applied extraperitoneal laparoscopic RPLND. The patients were placed in the supine position and the first trocar was inserted two finger widths medial to the anterior iliac spine. The retroperitoneal space was dilated using a preperitoneal distention balloon. Two more ports were inserted into the retroperitoneal space and surgery proceeded thereafter. RESULTS: The residual tumors were completely resected by laparoscopy. The procedure required 250-310 min and the bleeding volume was below 50 mL. Although the histopathological findings consisted only of necrosis in all of the patients, one patient recurred at the same place. CONCLUSIONS: Extraperitoneal laparoscopic RPLND in the supine position for residual tumors after chemotherapy is technically feasible and useful in terms of postoperative recovery. With regard to cancer control, further evaluation should be necessary.

Adult↗

PubMed2004

Long-term survival after bilateral adrenalectomy for metachronous adrenocortical cancer.

We report the case of a female patient with bilateral metachronous adrenocortical cancer who survived long-term after adrenalectomy. In 1991, the patient underwent left adrenalectomy to remove a huge adrenal mass (10 x 9 cm) displaying no hormonal abnormality. Histological diagnosis was adrenocortical cancer. A right adrenal mass (7 x 6 cm) was found 4 years after left adrenalectomy. Right adrenalectomy was performed, and histological diagnosis was again adrenocortical cancer. The patient remains alive with no evidence of disease 8 years after last surgery.

Adrenal Cortex Neoplasms↗

PubMed2004

The entering of indium-111 and iron-59 into the hepatocytes from partially hepatectomized rats differ from that of gallium-67.

We recently suggested that the transferrin (Tf)-gallium-67 (67Ga) complex dissociated on the surface of the hepatocytes after partial hepatectomy and free 67Ga bound to heparan sulfate in the extracellular matrix. In the present study, we investigated whether the entering of indium-111 (111In) and iron-59 (59Fe) with high affinity to transferrin differed from the entering of 67Ga by the hepatocytes after partial hepatectomy. 111In was almost taken by the plasma and little taken by the red blood cell. On the other hand, the uptake of 59Fe by the red blood cell was higher than plasma. The uptake of 59Fe by the bone marrow was significantly higher than that of 111In. The uptake of 111In and 59Fe by the liver tissue was reached a maximum 2 d after partial hepatectomy but the uptake ratio of 111In was lower than that of 59Fe. We suspected that the uptake of 59Fe by the liver tissue was the highest because of the high binding affinity of Tf-59Fe to Tf-receptor. The entering of 111In and 59Fe into the hepatocytes was also reached a maximum 2 d after partial hepatectomy but the ratio of 59Fe was slightly lower than that of 111In. These results suggested that the binding affinity to Tf could have played a crucial role in the differences of the entering of 111In, 59Fe and 67Ga into the hepatocytes of partially hepatectomized rats.

Animals↗

PubMed2004

Radon and thoron exposures for cave residents in Shanxi and Shaanxi provinces.

Measurements of natural radiation were carried out in cave dwellings distributed in the Chinese loess plateau. Those dwellings are located in Shanxi and Shaanxi provinces. Radon and thoron gas concentrations were measured using a passive integrating radon-thoron discriminative detector. Concentrations of thoron decay products were estimated from measurements of their deposition rates. A detector was placed at the center of each dwelling for 6 months and replaced with a fresh one for another 6 months. Measurements were conducted in 202 dwellings from August 2001 through August 2002. A short-term measurement was conducted during the observation period. In addition, gamma-ray dose rates were measured both indoors and outdoors with an electronic pocket dosimeter. Radioactivities in soil were determined by gamma-ray spectrometry with a pure germanium detector. Among 193 dwellings, indoor radon concentrations ranged from 19 to 195 Bq m(-3) with a geometric mean (GM) of 57 Bq m(-3), indoor thoron concentrations ranged from 10 to 865 Bq m(-3) with a GM of 153 Bq m(-3), and indoor equilibrium equivalent thoron concentrations ranged from 0.3 to 4.9 Bq m(-3) with a GM of 1.6 Bq m(-3). Arithmetic means of the gamma-ray dose rates were estimated to be 140 nGy h(-1) indoors and 110 nGy h(-1) outdoors. The present study revealed that the presence of thoron is not negligible for accurate radon measurements and thus that special attention should be paid to thoron and its decay products for dose assessment in such an environment. More systematic studies are necessary for a better understanding of thoron and its decay products.

Air Pollutants, Radioactive↗

PubMed2004

Antiagalactosyl IgG antibodies in juvenile idiopathic arthritis, juvenile onset Sjögren's syndrome, and healthy children.

OBJECTIVE: To determine the normal range of antiagalactosyl IgG antibodies in healthy children, and to investigate the utility of determination of antiagalactosyl IgG antibodies in patients with juvenile idiopathic arthritis (JIA) and juvenile onset Sjögren's syndrome (SS). METHODS: Serum concentrations of antiagalactosyl IgG antibodies were measured in 225 healthy children, 68 patients with JIA (systemic arthritis in 21, polyarthritis in 29, oligoarthritis in 18), and 15 patients with juvenile onset SS, using a lectin-enzyme immunoassay employing prepared human agalactosyl IgG as antigen. A comparison was made between the prevalence and utility of antiagalactosyl IgG antibodies in patients and those of conventional rheumatoid factors (RF) determined by laser nephelometry. RESULTS: The average serum concentration of antiagalactosyl IgG antibodies for healthy controls was 2.41 +/- 0.93 arbitrary units (AU)/ml, and the cutoff value of the normal range was set at 4.3 AU/ml (mean + 2 SD). As a result, antiagalactosyl IgG antibodies were positive in 25 (37%) of 68 patients with JIA, and 14 (93%) of 15 patients with juvenile onset SS, in whom values were much higher than the frequencies of RF positivity. The serum concentrations of antiagalactosyl IgG antibodies in patients were closely correlated with those of RF. Thirteen patients with JIA and 6 patients with juvenile onset SS were positive for antiagalactosyl IgG antibodies despite being negative for RF. With regard to prognosis during followup periods of at least 5 years, JIA patients positive for antiagalactosyl IgG antibodies, even if negative for RF, were resistant to treatment. However, positivity for antiagalactosyl IgG antibodies had no relation to joint destruction. CONCLUSION: Our data suggest that antiagalactosyl IgG antibodies, compared with RF, show higher sensitivity to detect immunological disorders in JIA and juvenile onset SS.

Adolescent↗

PubMed2004

[A case of ectopic ureterocele in a male adult found during examination of a traumatic injury].

We report a case of ectopic ureterocele in a male adult found during examination of a traumatic injury. A 26-year-old man sustained a blow to his left back during a football game and was admitted to the hospital with a complaint of abdominal pain. The computed tomographic scan showed a huge cystic mass in the retroperitoneum. A cystoscope revealed a large bulge from the left ureteral orifice to the bladder neck and another ureteral orifice distal to the bulge. Retrograde pyelography revealed an ectopic ureterocele showing a complete duplication, a lateral deviation of the left ureter and a bladder deviation to the right. An ectopic ureteral orifice was opening in the posterior urethra. An ureteral catheter inserted into this orifice revealed a dilated left ureter from the upper half of the kidney. Because the function of left upper of kidney was maintained, a transurethral incision was performed. Vesicoureteral reflux remained, but the postoperative course was uneventful. We discuss 11 cases of ectopic ureterocele in male adults including this case.

Adult↗

PubMed2003

High-dose-rate brachytherapy as monotherapy for localized prostate cancer: a retrospective analysis with special focus on tolerance and chronic toxicity.

PURPOSE: To examine retrospectively fractionated high-dose-rate brachytherapy as monotherapy for localized prostate cancer with special focus on tolerance and toxicity, especially chronic toxicity. MATERIALS AND METHODS: Between May 1995 and October 2001, 43 patients with localized prostate cancer were treated with high-dose-rate brachytherapy without external beam irradiation at Osaka University Hospital. The stage was T1, T2, T3, and T4 in 8, 14, 18, and 3 patients, respectively. The adenocarcinoma was well, moderately, or poorly differentiated in 12, 16, and 15 patients, respectively. The median initial prostate-specific antigen level was 19.3 ng/mL (range 3.8-233.0). Thirty-eight patients also received hormonal therapy. Metallic needles were implanted transperineally under real-time ultrasound guidance, followed by a dose optimization program. Patients were irradiated twice daily at intervals of >6 h. A total dose of 54 Gy in nine fractions within 5 days (48 Gy in eight fractions within 5 days for the first 7 cases) was administered in one implant session. The median follow-up was 24 months (range 1-76). RESULTS: Radiation Therapy Oncology Group acute toxicity of Grade 4, 2, and 1 occurred in 1 (2%), 12 (28%), and 8 (19%) patients, respectively. Five patients had late toxicity: one with rectal ulcer (Grade 2) and four with rectal bleeding (Grade 1). The volume receiving 100% of the prescribed dose showed significant correlations with the incidence of acute and chronic toxicities (p = 0.005 and p = 0.014, respectively). The 3-year actuarial overall survival, local control, and biochemical no evidence of disease rate was 94%, 100%, and 55%, respectively. The crude biochemical control rate for low, intermediate, and high-risk patients was 100% (5 of 5), 80% (8 of 10), and 61% (17 of 28), respectively. CONCLUSIONS: High-dose-rate brachytherapy as monotherapy was found to be feasible and well tolerated. It showed a low chronic toxicity rate without any event of Radiation Therapy Oncology Group of Grade 3 or greater.

Adenocarcinoma↗

PubMed2003

Experimental proof of contamination of blood components by (1-->3)-beta-D-glucan caused by filtration with cellulose filters in the manufacturing process.

The level of (1-->3)-beta-D-glucan in blood is a diagnostic index of fungal infection because it is released from the fungal cell wall. However, high levels of plasma (1-->3)-beta-D-glucan in patients administered blood components may give false positive results. High levels of (1-->3)-beta-D-glucan have been detected in blood components. We suspected that (1-->3)-beta-D-glucan from cellulose filters had been eluted into blood components by filtration in the manufacturing process. To investigate the contamination of blood components by (1-->3)-beta-D-glucan from cellulose filters, in vitro experiments were performed by using six cellulose filters and a nylon filter. Human serum albumin (HSA) solution (100 ml) was flowed through each filter after rinsing with 100 ml of distilled water, and (1-->3)-beta-D-glucan in each fraction was determined by Fungitec G test MK. The concentration of (1-->3)-beta-D-glucan eluted from cellulose filters in 100-ml distilled water fractions ranged from 6 to 207 pg/ml, and that of HSA fractions ranged from 33 to 20,784 pg/ml. These data showed that remarkably higher (1-->3)-beta-D-glucan levels were detected in HSA fractions flowed through cellulose filters in spite of advance rinsing with 100 ml of distilled water. In the case of a nylon filter, (1-->3)-beta-D-glucan was not eluted in either fraction. These results indicate that (1-->3)-beta-D-glucan contamination in blood components is caused by filtration with cellulose filters in the manufacturing process.

Blood Chemical Analysis↗

PubMed2003

Reactivity of agalactosyl IgG with rheumatoid factor.

BACKGROUND: The difference in the reactivity of rheumatoid factor (RF) with agalactosyl IgG and galactosyl or intact IgG is controversial. METHODS: ELISAs for IgM-RF, using agalactosyl IgG and galactosyl IgG as a coated antigen, were developed. The sera of patients with RA, systemic lupus erythematosus (SLE), chronic liver diseases (CLD) and healthy subjects were measured for IgM-RF. An absorption test was performed using these IgGs with or without heat-pretreatment to determine any differences in the antigenicity between agalactosyl IgG and intact IgG. RESULTS: IgM-RF titers were higher against agalactosyl IgG than those against both heated-intact and intact IgG in three of nine RA patients' sera. Three other serum samples showed similar titers against all three forms of IgG and the remaining three serum samples showed varied results. IgM-RF titers were higher in sera of RA patients than those of SLE, CLD and healthy subjects. Absorptions of RA sera showed that RF was completely absorbed by 5x of absorptions with agalactosyl IgG as well as intact IgG. CONCLUSIONS: The reactivity of IgM-RF is higher with agalactosyl IgG than with heated-intact or intact IgG. The antigenic epitopes of agalactosyl and intact IgG were shown to be closely similar by the absorption test.

Absorption↗

PubMed2003

Prospective study of HDR (192Ir) versus MDR (137Cs) intracavitary brachytherapy for carcinoma of the uterine cervix.

PURPOSE: The aim of this study was to compare the results of high-dose rate (HDR) and medium-dose rate (MDR) intracavitary brachytherapy for carcinoma of the uterine cervix on the basis of a prospective study and to determine the dose rate conversion factor (DRCF) from low-dose rate (LDR) to MDR via HDR, because a DRCF of 0.54 from LDR to HDR has been widely accepted. MATERIALS AND METHODS: Between August 1991 and July 1999, 104 patients were entered into this trial to compare results between HDR (n=54) and MDR (n=50). Three patients were excluded from this study, leaving 54 HDR patients and 47 MDR patients eligible. Method and dose of external beam radiotherapy were the same for both groups. For HDR intracavitary brachytherapy, point A dose was adjusted to 32 Gy/4 fractions for stages I and II, to 30 Gy/4 fractions for stage III, and to 22.5 Gy/3 fractions for stage IV. The corresponding values for MDR were 35.6 Gy/4 fractions, 34 Gy/4 fractions, and 25.5 Gy/3 fractions. The average dose rate at point A was 30 Gy/hour (9.0-65.2) for HDR and 1.7 Gy/hour (1.3-2.2) for MDR. We assumed a DRCF of 0.9 from MDR to HDR. RESULTS: The 3-year cause-specific survival rates for HDR were 85%, 83%, 75%, and 0% for stages I, II, III, and IV, respectively. The corresponding figures for MDR were 100%, 82%, 58%, and 40%. Six of the HDR patients (11%) and 2 of the MDR patients (4%) developed Kottmeier's grade 2 or 3 late complications. A DRCF of 0.6 from LDR to MDR could be derived from a DRCF of 0.9 from MDR to HDR and one of 0.54 from LDR to HDR. CONCLUSIONS: There were no statistically significant differences in cause-specific survival and incidence of late complications between HDR and MDR. A DRCF of 0.6 from LDR to MDR could be determined. However, because the results of this trial were preliminary, a further study is needed.

Adult↗

PubMed2003

The significance of prostate-specific antigen alpha-1-antichymotrypsin complex and its indices for the detection of prostate cancer.

We examined the usefulness of prostate specific antigen alph-1-antichymotrypsin complex (PSA-ACT) and its indices for the detection of prostate cancer in patients with a prostate specific antigen (PSA) level between 2.1 and 10.0 ng/ml. Between July 1999 and October 2001, 151 patients with a PSA level between 2.1 and 10.0 ng/ml underwent a systematic biopsy under transrectal ultrasound (TRUS) guidance. The clinical values of total PSA, PSA-ACT, PSA density (PSAD), PSA-ACT density (PSA-ACTD), PSA transition zone density (PSATZD) and PSA-ACT transition zone density (PSA-ACTTZD) for the detection of prostate cancer were compared by using receiver operating characteristic (ROC) curve analysis. Of the 151 patients, 36 (23.8%) were histologically confirmed as having prostate cancer. The differences between patients with prostate cancer and benign prostatic disease were significant with respect to the PSA and PSA-ACT related parameters examined in this study. According to ROC curve analysis, the area under the curve (AUC) of PSA-ACTTZD was the greatest of all the parameters. The differences was significant between the AUC of PSA-ACTTZD and total PSA (p < 0.05). The cutoff value of PSA-ACTTZD with 0.20 ng/ml2 showed the highest sum of sensivitity (90%) and specificity (55%). Also, in 86 patients with a PSA level between 2.1 and 6.0 ng/ml, the AUC of PSA-ACTTZD was the greatest of all the parameters. Measuring the level of PSA-ACT and its indices may provide a better differentiation of prostate cancer and benign prostatic disease than total PSA alone in patients with intermediate PSA levels. PSA-ACTTZD is the most useful indicator among PSA-ACT and its volume indices.

Aged↗

PubMed2002

Expression of UDP-N-acetyl-alpha-D-galactosamine-polypeptide galNAc N-acetylgalactosaminyl transferase-3 in relation to differentiation and prognosis in patients with colorectal carcinoma.

BACKGROUND: Tumor development usually is accompanied by alterations of O-glycosylation. Initial glycosylation of mucin-type, O-linked proteins is catalyzed by one of the UDP-GalNAc-polypeptide N-acetyl-galactosaminyl transferases, such as GalNAc-T3, which is expressed in adenocarcinoma cells. The authors investigated whether such expression influenced tumor differentiation or prognosis in patients with colorectal carcinoma. METHODS: The expression of GalNAc-T3 was evaluated immunohistochemically in 106 paraffin embedded samples from surgically resected colorectal carcinomas and was related to patient and tumor characteristics. Western blot analysis was performed on seven samples of frozen tissue. RESULTS: Strong tumor expression of GalNAc-T3 predicted 5-year survival in patients with colorectal carcinoma (67.2% vs. 43.6% for weak expression; P = 0.017). GalNAc-T3 expression was not associated with age, gender, tumor size, tumor location, or disease stage but was related to histologic differentiation (P = 0.049) and depth of invasion (P = 0.031). Univariate analysis showed that strong GalNAc-T3 expression significantly enhanced the likelihood of survival. Multivariate Cox survival analysis identified enzyme expression as an independent prognostic factor that was second only to TNM stage. CONCLUSIONS: GalNAc-T3 expression is a novel and useful indicator of tumor differentiation, disease aggressiveness, and prognosis in patients with colorectal carcinoma.

Adenocarcinoma↗

PubMed2002

Neoadjuvant androgen withdrawal prior to external radiotherapy for locally advanced adenocarcinoma of the prostate.

BACKGROUND: It is unclear whether positive interactions between radiation and androgen withdrawal for patients with locally advanced prostate cancer is synergistic or additive. The present study aimed to clarify the significance of neoadjuvant androgen ablation prior to external radiotherapy in a human prostate LNCaP tumor model and in patients with locally advanced prostate cancer. METHODS: Comparisons were made between the effect of castration prior to radiation on the growth of subcutaneous LNCaP tumors implanted into male nude mice and their serum prostate-specific antigen (PSA) levels, and the results of castration or radiation alone. Twenty-nine patients with histologically proven and locally advanced adenocarcinoma of the prostate were treated with luteinizing hormone-releasing hormone analog at least 3 months before, during, and after external radiation therapy with a total dose of 70 Gy. The toxicity and response to this therapy were evaluated. RESULTS: Treatment combining castration and radiation resulted in synergistic inhibition of LNCaP tumor growth and a significant delay in the emergence of androgen-independent recurrence as opposed to either treatment alone. The external radiotherapy was completed in 28 patients (96.6%), resulting in a reduction of serum PSA levels in all 28 patients to below 1.0 ng/mL. All patients were alive after a mean follow-up period of 34 months (range 11-53) with a 3-year PSA relapse-free survival rate of 83.7%. Among several factors examined, only the Gleason score was significantly associated with PSA relapse-free survival in univariate analysis, but not in multivariate analysis. Thirteen of 28 patients (46%) and 7 of 28 (25%) also showed at least one form of gastrointestinal or genitourinary toxicity, respectively. Of these patients, 8 with gastrointestinal toxicities, and 1 with genitourinary toxicity, experienced acute complications higher than grade 3. CONCLUSION: The experimental findings objectively suggested the use of neoadjuvant androgen withdrawal prior to radiation therapy. Although our clinical experience is preliminary, combined androgen ablation and radiation therapy may also be effective in controlling locally advanced prostate cancer, with tolerable side-effects.

Adenocarcinoma↗

PubMed2002

Targeted deletion of both thymidine phosphorylase and uridine phosphorylase and consequent disorders in mice.

Thymidine phosphorylase (TP) regulates intracellular and plasma thymidine levels. TP deficiency is hypothesized to (i) increase levels of thymidine in plasma, (ii) lead to mitochondrial DNA alterations, and (iii) cause mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). In order to elucidate the physiological roles of TP, we generated mice deficient in the TP gene. Although TP activity in the liver was inhibited in these mice, it was fully maintained in the small intestine. Murine uridine phosphorylase (UP), unlike human UP, cleaves thymidine, as well as uridine. We therefore generated TP-UP double-knockout (TP(-/-) UP(-/-)) mice. TP activities were inhibited in TP(-/-) UP(-/-) mice, and the level of thymidine in the plasma of TP(-/-) UP(-/-) mice was higher than for TP(-/-) mice. Unexpectedly, we could not observe alterations of mitochondrial DNA or pathological changes in the muscles of the TP(-/-) UP(-/-) mice, even when these mice were fed thymidine for 7 months. However, we did find hyperintense lesions on magnetic resonance T(2) maps in the brain and axonal edema by electron microscopic study of the brain in TP(-/-) UP(-/-) mice. These findings suggested that the inhibition of TP activity caused the elevation of pyrimidine levels in plasma and consequent axonal swelling in the brains of mice. Since lesions in the brain do not appear to be due to mitochondrial alterations and pathological changes in the muscle were not found, this model will provide further insights into the causes of MNGIE.

Animals↗

PubMed2002

Predicting the extent of prostate cancer using a combination of serum prostate-specific antigen-alpha(1)-antichymotrypsin complex and systematic biopsy.

OBJECTIVE: The objective of the present study was to evaluate the usefulness of the combined systematic biopsy with serum prostate-specific antigen-alpha(1)-antichymotrypsin complex (PSA-ACT) level to predict the extent of prostate cancer. MATERIALS AND METHODS: Sixty-two patients with clinically organ-confined disease who underwent radical prostatectomy were evaluated for serum PSA and PSA-ACT levels, systematic biopsy, and the pathological stage. RESULTS: The incidence of extraprostatic disease in patients with more than half the biopsy cores positive or > or = 8 ng/ml PSA-ACT was significantly higher than those with less than half positive or <8 ng/ml PSA-ACT, respectively, whereas cancer in bilateral lobes or > or = 10 ng/ml PSA could not be used as a predictor of extraprostatic disease. Furthermore, in those with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or those with more than half the biopsy cores positive and > or = 10 ng/ml PSA, extraprostatic disease was significantly more common than in those with less than half positive and <8 ng/ml PSA-ACT or those with less than half positive and <10 ng/ml PSA, respectively. However, the incidence of extraprostatic disease predicted by these three variables was not significantly better than those by the two variables (percentage positive biopsy cores plus serum PSA-ACT or PSA). CONCLUSIONS: The combined systematic biopsy with serum PSA-ACT or PSA could be used as a useful predictor for the extent of prostate cancer. Patients with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or > or = 10 ng/ml PSA could avoid a prostatectomy because there is a high probability that they have extraprostatic disease.

Aged↗

PubMed2002

Detection of beta-human chorionic gonadotropin expressing cells by nested reverse transcriptase-polymerase chain reaction in the peripheral blood stem cells of patients with advanced germ cell tumor.

PURPOSE: We investigated whether peripheral blood stem cells (PBSCs) were contaminated by tumor cells. MATERIALS AND METHODS: A total of 13 patients with advanced testicular cancer underwent PBSC transplantation at our institute. Nested reverse transcriptase-polymerase chain reaction using primers specific for beta-human chorionic gonadotropin (beta-HCG) or alpha-fetoprotein (AFP) detected 1 beta-HCG or AFP producing cell in 1 x 10(6) PBSCs. RESULTS: Although AFP messenger (m) RNA was not identified in any of the 13 patients, beta-HCG mRNA was detected in 7. All patients with beta-HCG mRNA in PBSCs had elevated serum beta-HCG before treatment. Three patients with a normal beta-HCG range before treatment did not have beta-HCG mRNA in the PBSCs. The serum beta-HCG level in the patients whose PBSCs were contaminated with tumor cells was significantly higher than in patients whose PBSCs contained no tumor cells. Four of the 7 patients with beta-HCG mRNA in PBSCs eventually died of cancer, whereas those whose PBSCs were not contaminated with tumor cells survived without disease. CONCLUSIONS: Patients with elevated serum beta-HCG levels are likely to have PBSCs contaminated by tumor cells. Moreover, the prognosis of patients with tumor cells in the PBSCs is poor.

Adolescent↗

PubMed2002

Nephrostomy tract tumor seeding following percutaneous manipulation of a renal pelvic carcinoma.

We report a case of nephrostomy tract tumor seeding following percutaneous pyeloscopic manipulation of a renal pelvic carcinoma. To our knowledge, this is the second reported case of such a lesion surrounding the nephrostomy tract. Percutaneous pyeloscopic treatment carries a potential risk of local tumor spillage and implantation in the nephrostomy tract.

Carcinoma, Transitional Cell↗