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ABSTRACT: An 85-year-old man had planned a laparoscopic right nephrouretectomy for a right lower ureteral cancer, pT1, G3. Two months prior to the surgery, he was re-examined because of continuing macrohematuria. He had a 50 mm tumor in his urinary bladder and tumors from the right upper to lower urinary tract by computed tomographic (CT) examination and cystoscopy. He did not have any metastasis. We diagnosed a cT3N0M0 for the right ureteral cancer and a cT3N0M0 for the bladder cancer. A right nephrouretectomy and cystectomy were then performed. The histopathologic examination revealed an urothelial carcinoma with a choriocarcinoma.
Hinyokika kiyo. Acta urologica Japonica 11/2011; 57(11):633-7.
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ABSTRACT: It is clear that laparoscopic renal surgery has significant advantages over open renal surgery. However, current data on whether these benefits carry over to the elderly are less robust. The objective of this study was to compare the perioperative parameters of laparoscopic nephrectomy and nephroureterectomy in patients aged 70 and over versus those under 70 years of age. The new scoring system, the "E-PASS" (estimation of physiologic ability and surgical stress) was also studied. This scoring system predicts the postsurgical risk by quantifying the patient's reserve and surgical stress. E-PASS comprises the perioperative risk score (PRS), the surgical stess score (SSS), and the comprehensive risk score (CRS) that is determined using the other two scores. Between January 2006 and December 2009, a total of 55 patients who underwent laparoscopic renal surgery met the study inclusion criteria. The perioperative parameters were comparable in the younger patients and the older patients, including SSS, the postoperative complication rate, the operation time and the hospital stay. Laparoscopic renal surgery is feasible and well tolerated in elderly patients, with a low perioperative morbidity and surgical stress. Further examination on the E-PASS scoring system for application to urologic surgery was considered to be necessary. Age alone should not exclude elderly patients from definitive treatment at the outset.
Hinyokika kiyo. Acta urologica Japonica 11/2011; 57(11):603-6.
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ABSTRACT: Although allogeneic bone marrow transplantation (BMT) plus donor lymphocyte infusion (DLI) is performed for solid tumours to enhance graft-versus-tumour (GVT) effects, a graft-versus-host reaction (GVHR) is also elicited. We carried out intra-bone marrow-bone marrow transplantation (IBM-BMT) plus adult thymus transplantation (ATT) from the same donor to supply alloreactive T cells continually. Normal mice treated with IBM-BMT + ATT survived for a long time with high donor-derived thymopoiesis and mild GVHR. The percentage of CD4(+) FoxP3(+) regulatory T cells in the spleen of the mice treated with IBM-BMT + ATT was lower than in normal B6 mice or mice treated with IBM-BMT alone, but higher than in mice treated with IBM-BMT + DLI; the mice treated with IBM-BMT + DLI showed severe GVHR. In tumour-bearing mice, tumour growth was more strongly inhibited by IBM-BMT + ATT than by IBM-BMT alone. Mice treated with IBM-BMT + a high dose of DLI also showed tumour regression comparable to that of mice treated with IBM-BMT + ATT but died early of GVHD. By contrast, mice treated with IBM-BMT + a low dose of DLI showed longer survival but less tumour regression than the mice treated with IBM-BMT + ATT. Histologically, significant numbers of CD8(+) T cells were found to have infiltrated the tumour in the mice treated with IBM-BMT + ATT. The number of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labelling (TUNEL)-positive apoptotic tumour cells also significantly increased in the mice treated with IBM-BMT + ATT. Allogeneic IBM-BMT + ATT thus can induce high thymopoiesis, preserving strong GVT effects without severe GVHR.
Immunology 10/2008; 126(4):552-64. · 3.32 Impact Factor
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Wenhao Cui,
Naoki Hosaka,
Takashi Miyake,
Xiaoli Wang,
Kequan Guo,
Yunze Cui,
Qiang Li,
Changye Song,
Wei Feng,
Qing Li,
Takashi Takaki, Teruhisa Nishida,
Muneo Inaba,
Susumu Ikehara
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ABSTRACT: Although bone marrow transplantation (BMT) has become a valuable strategy for the treatment of various intractable diseases in recent years, success rates remain low in elderly patients because of low thymic function. We have previously shown that fetal thymus transplantation (TT) with BMT is effective for elderly recipients in mice.
We performed fully major histocompatibility complex (MHC)-mismatched fetal TT from B6 (H-2) mice plus allogeneic BMT from C3H/HeN (H-2) mice by intra-bone marrow-BMT (IBM-BMT) using congenitally athymic nude (nu/nu) BALB/c (H-2), or BALB/c adult-thymectomized recipients to obtain triple chimeras. We next carried out the IBM-BMT+TT using senescence-accelerated mouse P1 strain (SAMP1) to examine whether this method would be applicable to aging mice.
Triple chimeric mice survived for a long period with sufficient T-cell functions comparable to the mice treated with BMT plus MHC-matched TT, whereas those without TT survived for a short period with insufficient T-cell reconstitution. Almost all the hematolymphoid cells were derived from donor bone marrow cells. Interestingly, they showed tolerance to all three types of MHC determinants with donor-derived thymic dendritic cells in TT. Triple chimeric SAMP1 also survived for long periods with T-cell functions restored in contrast to non-TT SAMP1 recipients.
These findings suggest that third party combined TT with allogeneic IBM-BMT may be more advantageous for elderly recipients with low thymic function, than IBM-BMT alone (without TT).
Transplantation 05/2008; 85(8):1151-8. · 4.00 Impact Factor
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Kenji Yoshida,
Hidefumi Kinoshita,
Hisanori Taniguti,
Ryusuke Chizaki, Teruhisa Nishida,
Shigenari Kawakita,
Yoshihito Hiura,
Naoki Ooguti,
Gen Kawa,
Kouei Muguruma,
Tadashi Matsuda
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ABSTRACT: A-29-year-old man visited our hospital with the complaint of a continuous rigid and painful erection which began two days before. We diagnosed ischemic type of priapism by aspiration of penile cavernosal blood analysis; an acidotic and hypoxic blood. The leukocyte count was 263,000/p, and chronic myelogenous leukomia (CML) was suspected. After the failure of conservative treatment, glans-cavernosal shunt (Winter procedure) was performed. The postoperative course was uneventful and the intercourse was possible at five months after the operation. CML was treated by administration of imatinib mesylate and no evidence of recurrence was observed.
Hinyokika kiyo. Acta urologica Japonica 06/2007; 53(5):323-5.
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Kenji Yoshida,
Hidefumi Kinoshita,
Hisanori Taniguti,
Ryusuke Chizaki, Teruhisa Nishida,
Yoshihito Hiura,
Naoki Ooguti,
Gen Kawa,
Kouei Muguruma,
Tadashi Matsuda,
Noriko Sakaida,
Yoshiko Uemura
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ABSTRACT: We report a case of Bellini duct carcinoma. A 65-year-old man visited our hospital because of an asymptomatic right renal mass directed by ultrasonography and computed tomography in an other hospital. His urine cytology was negative. The tumor showed a minimal enhancement in computed tomography. Under the preoperative diagnosis of an atypical right renal tumor, laparoscopic right radical nephrectomy was performed. The tumor is 50 mm in diameter and the surface was grayish-white in color. The histopathological diagnosis was low-grade Bellini duct carcinoma. Immunohistostaining revealed positive staining for UA-1 and EMA in the tumor tissue. No evidence of recurrence or metastasis was noted 36 months after surgery without any adjuvant therapy.
Hinyokika kiyo. Acta urologica Japonica 03/2007; 53(2):121-4.
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ABSTRACT: We have previously shown that allogeneic intra-bone marrow–bone marrow transplantation (IBM–BMT) can be used to treat autoimmune diseases in MRL/lpr (H-2K) mice with replacing not only hematolymphoid cells but also stromal cells by normal C57BL/6 (B6: H-2b) mouse cells. In the present study, we examined for existence of donor-derived thymic epithelial cells (TECs) in the host thymus using green fluorescent protein (GFP)-B6 (H-2b) mice. In [GFP-B6→MRL/lpr] chimeric mice, splenocytes and thymocytes were completely replaced by donor-type cells, and levels of serum autoantibodies and proteinuria were significantly – reduced to those levels of normal donors. Interestingly, GFP-expressing TECs – not only medullary TECs, which express mouse thymus stromal (MTS)-10, but also cortical TECs, which express cytokeratin 18 – were found. Also, the number of autoimmune regulator (AIRE) expressing TECs, which regulates tissue-specific antigens to delete autoreactive cells, was reduced in the chimeric mice to that of the donor, whereas the number of forkhead box N1 (FOXN1) expressing TECs, which are crucial in the terminal differentiation of TECs, remained unchanged. These findings suggest that BMCs contain the precursors of functional TECs, and that they can differentiate into TECs, thereby correcting thymic function.
Journal of Autoimmunity.
