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ABSTRACT: The treatment outcome was evaluated in 63 patients with bladder cancer more than 2 years after cystectomy. Cisplatin-based combination chemotherapies were given to 40 patients after the operation as an adjuvant therapy and two patients with T4 or N2 bladder cancer received chemotherapy before the operation as a neoadjuvant therapy. The extent of infiltration of the removed tumors was pTa in 5, pT1 in 18, pT2 in 8, pT3a in 6, pT3b in 17, and pT4 in 9 cases. Regional lymph node metastases were present in 10 cases (16%). Nineteen patients died of tumor recurrences. The 5-year acturial survival rates at each stage were 60% for stage pTa, 78% for stage pT1, 63% for stage pT2, 83% for stage pT3a, 33% for stage pT3b and 38% for stage pT4, respectively. A significant difference (p < 0.05) in survival curve was observed between pT3a and pT3b. The prognosis of patients with tumors extending beyond the bladder muscles is extremely unfavourable, with the exception of bladder cancers infiltrating the neighboring organ (pT4a), the removal of which may result in lasting survival in a part of the cases. Effective adjuvant treatment is required for patients with bladder tumors penetrating the bladder wall.
Hinyokika kiyo. Acta urologica Japonica 08/1997; 43(8):605-10.
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ABSTRACT: 99mTc-MAG3 (mercaptacetyl glycilglycilglycine) is a newly developed radiopharmaceutical for the functional imaging of kidneys. We evaluated the clinical usefulness of 99mTc-MAG3 in 12 cases (7 men and 5 women, aged from 18 to 57 years old) with transplanted kidney, and compared it with 123I-OIH (o-iodohippurate). Immediately after bolus injection of 300 MBq of 99mTc-MAG3, first pass images (1 frame/3 sec for 1 min) and dynamic renal images (1 frame/60 sec for 30 min) were recorded. In 10 of 12 cases, the same examination was carried out using 37 MBq of 123I-OIH within 2 weeks. Because of its larger dose and suitable gamma-ray energy, 99mTc-MAG3 provided much better images than 123I-OIH, particulary among first pass images. Effective renal plasma flow (ERPF) calculated from the clearance of 99mTc-MAG3 was less (about 70%) than that of 123I-OIH, however, a strong correlation (r = 0.98, p < 0.001) was observed between the ERPF values of the two radiotracers. No adverse effects were caused by 99mTc-MAG3. Our data suggested that 99mTc-MAG3 was a promising radiopharmaceutical with which to evaluate regional dynamic renal function.
Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica 06/1995; 55(6):409-13.
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ABSTRACT: One hundred and fifty two cases of genito-urinary tract endometriosis reported in Japan including our 2 cases were reviewed. The incidence and mean patients' age were respectively 0.7% and 22 years old for kidneys, 37.5% and 38.8 years old for ureter and 61.8% and 36.2 years old for bladder. Clinical symptoms in ureteral endometriosis were similar to those in upper urinary tract obstruction and in vesical endometriosis, lower urinary tract symptoms such as pain on urination, irritative bladder symptoms and macrohematuria were frequently observed. Vesical lesions tend to be located on the posterior wall in the retrotrigone or trigone, and ureteral lesions tend to be located in the bilateral lower segments. The incidence of extrinsic type of ureteral endometriosis was 6 times higher than that reported as intrinsic type, and mixed type was reported in only 3.5%. Recent first choice for mild endometriosis is hormonal therapy with Danazole or LH-RH analogue. Surgical treatment is recommended in severe cases or patients in whom hormonal therapy is not effective.
Hinyokika kiyo. Acta urologica Japonica 05/1994; 40(4):349-52.
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ABSTRACT: A male infant with scaphoid megalourethra, which is a rare congenital anomaly, is presented. At birth he exhibited a grossly swollen, malformed penis and cryptorchidism. The corpus spongiosum was not palpable. The infant had congenital renal failure. Retrograde urethrography revealed a crescent-shaped dilatation of the anterior urethra, and the diagnosis of scaphoid megalourethra was made. Subsequent uroradiological examinations showed that there were also severe urogenital anomalies, i.e. renal hypoplasia-dysplasia, hydronephrosis, hydroureter and vesicoureteral reflux. This disorder is frequently associated with other urogenital anomalies. Therefore, once the diagnosis is reached, a careful investigation for other associated abnormalities should be undertaken.
Pediatric Nephrology 05/1994; 8(2):218-20. · 2.52 Impact Factor
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ABSTRACT: A Phase 3 clinical study of 99mTc-mercaptoacetyl glycylglycylglycine (99mTc-MAG3) injectable was performed in 506 patients with renal and/or urinary disorders. The scintigraphic findings and renogram patterns of 99mTc-MAG3 were similar to those of 123I-OIH, and Tmax and T1/2 of the 99mTc-MAG3 renogram correlated with those of 123I-OIH (r = 0.62 and r = 0.74, respectively). The clinical efficacy of 99mTc-MAG3, evaluated by the investigators in the same patients, was superior to the efficacy of 123I-OIH and 99mTc-DTPA in 93 of 150 patients (62.0%) and 68 of 151 patients (45%), respectively. The image quality and the reliability of the scintigraphic findings with 99mTc-MAG3 were superior to those with 123I-OIH and 99mTc-DTPA, which reflect the more abundant photons of 99mTc-MAG3 than those of 123I-OIH and higher renal extraction of 99mTc-MAG3 than those of 99mTc-DTPA, respectively. Neither adverse reactions nor abnormal laboratory findings due to 99mTc-MAG3 administration were observed. These results suggest that 99mTc-MAG3 injectable is safe and a useful radiopharmaceutical for diagnosis of renal and urinary disorders.
Kaku igaku. The Japanese journal of nuclear medicine 03/1994; 31(2):183-98.
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ABSTRACT: A phase 2 clinical study of 99mTc-mercapto acetyl glycylglycylglycine (99mTc-MAG3) injectable, a new dynamic renal imaging agent, was performed in 110 patients with renal and/or urinary disorders to evaluate the safety, efficacy and optimal dose of this agent. Neither adverse reactions nor abnormal laboratory findings due to intravenous administration of 99mTc-MAG3 were observed. The investigators evaluated the clinical efficacy of 99mTc-MAG3 was to be effective in 96 of 97 cases. Among the doses of 92.5 MBq, 185 MBq, 370 MBq and 555 MBq, the dose of 92.5 MBq was not large enough to provide adequate-quality blood flow images or reliable information for evaluation of the renal blood flow. It was concluded that the optimal dose range of 99mTc-MAG3 was 185-555 MBq with 370 MBq as the standard dose. Also, we surmise that 555 MBq is especially recommendable when detailed blood flow information is required. These results indicate that 99mTc-MAG3 injectable is useful for the diagnosis of renal and urinary disorders.
Kaku igaku. The Japanese journal of nuclear medicine 12/1993; 30(11):1379-92.
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ABSTRACT: In order to study the effect of high-dose thiazide treatment and low-K diet on citrate uptake by rat renal brush border membrane, we measured citrate uptake by rat renal brush border membrane vesicles (BBMV) and analyzed the acid-base balance of non-treated rats, high-dose thiazide-treated rats and low-K diet rats. Seven-week male Wistar rats (Jcl) were housed in metabolic cages, given 10 mg/Kg BW/day hydrochlorothiazide (HCTZ) by a gastric tube once a day for 3 weeks (high-dose thiazide treated rats) or a low-K diet for 3 weeks (low-K diet rats). Arterial blood was taken from the aorta and BBMV were prepared by the divalent cation precipitation method. Citrate uptake was measured by a Millipore rapid membrane filtration technique. High-dose thiazide treatment for 3 weeks showed a significant metabolic alkalosis and increase of urinary citrate excretion. However, it had no significant effect on citrate uptake by BBMV. On the other hand, low-K diet for 3 weeks showed significant hypokalemia, metabolic alkalosis and decrease in urinary citrate excretion. Moreover, it increased the maximal activity (Vmax) with no difference in citrate affinity (Km). These data suggested that urinary citrate excretion was more affected by the K depletion than by the acid-base balance.
Nippon Jinzo Gakkai shi 11/1993; 35(10):1115-21.
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ABSTRACT: In order to study the effect of thiazide on urinary citrate excretion, we measured sodium dependent citrate uptake by rat renal cortical brush border membrane vesicles (BBMVs) and analyzed acid-base balance with or without thiazide treatment. 5-weeks male Wistar rats (Jcl) were housed in metabolic cages, given 0.1 mg/100 g BW/day hydrochlorothiazide (HCTZ) by a gastric tube once a day for 3 weeks (thiazide treated rats). Arterial blood was taken from aorta and BBMVs were prepared with divalent cation precipitation method. Citrate uptake was measured by a Millipore rapid membrane filtration technique. Oral treatment of HCTZ for 3 weeks showed a significant increase of urinary citrate excretion in both concentration and daily excretion. The sodium dependent citrate transport was observed in rat renal brush border membrane (BBM). But no significant effect of oral HCTZ was observed on acid base balance and sodium dependent citrate uptake in rat renal BBM. These data suggested that the stimulative effect of thiazide on citrate excretion was not via sodium dependent citrate transport in rat renal BBM.
Nippon Jinzo Gakkai shi 07/1993; 35(6):679-86.
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ABSTRACT: A case of pheochromocytoma discovered at pregnancy is reported. The patient was a 27-year-old woman who had no symptoms before pregnancy. A sudden hypertensive attack occurred during vaginal examination at the 36th week of pregnancy. Magnetic resonance imaging (MRI) and ultrasonography showed a right adrenal mass. The level of catecholamine in blood and urine was beyond the normal limit. This patient was diagnosed as pheochromocytoma with pregnancy. Cesarean section was immediately done to avoid hypertensive crisis caused by spontaneous delivery. Blood pressure and blood volume were controlled by an alpha-blocker for one month after delivery, and, then the tumor was removed surgically. Pheochromocytoma with pregnancy is life-threatening for the mother and the fetus because of difficult diagnosis and complex clinical features. Early diagnosis and appropriate treatment are mandatory. Pathophysiological characteristics and the treatment of such specified statics are mainly discussed through our successful achievement.
Hinyokika kiyo. Acta urologica Japonica 12/1992; 38(11):1243-7.
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ABSTRACT: We report a case of renal cell carcinoma within a simple renal cyst in the upper pole of the right kidney. The renal cyst was found incidentally by ultrasonography. During the 3 years of follow-up, the cyst size was increasing and a small solid mass was arising from the cyst wall. Angiography revealed a hypervascular tumor stain in the renal cyst. At operation a 15 mm tumor arose from the wall of the cyst. Histopathological examination showed clear cell type renal cell carcinoma and "cyst" with sheets of carcinoma within the cyst wall. The coexistence of renal cyst and tumor is considerably rare. Fifty two cases were collected from the Japanese literature including this, and they are reviewed briefly.
Hinyokika kiyo. Acta urologica Japonica 03/1992; 38(2):181-4.
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ABSTRACT: The case is presented of a four year old boy with a large left abdominal mass. The patient was diagnosed as having a left giant hydroureteronephrosis due to a primary obstructed megaureter, based on the findings of ultrasonography, micturating cystourethrography, excretion urography, computed tomography and percutaneous antegrade pyeloureterography. Diuretic renography showed that the obstruction was partial. Since a static renal scintigram indicated that renal function on the affected side was moderately well preserved, ureteroplasty is planned.
Acta paediatrica Japonica; Overseas edition 01/1992; 33(6):723-8.
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ABSTRACT: A 41-year-old man visited our clinic with complaints of gross hematuria and pain on urination. Cystoscopic examination revealed papillary and sessile tumor at the retrotrigone of the bladder and the specimen of the transurethral biopsy showed signet ring cell carcinoma. Since there was no primary tumor in any other organs, we diagnosed it as a primary signet ring cell carcinoma of the bladder. Total cystectomy with Kock continent ileal reservoir and post-operative chemotherapy consisting of cisplatinum, adriamycin and 5-FU were performed. The literature on the pathological findings of this disease are reviewed.
Hinyokika kiyo. Acta urologica Japonica 05/1990; 36(4):457-60.
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ABSTRACT: In order to study the characteristics of oxalate transport across the brush border membrane, we studied oxalate uptake and efflux by rat renal cortical brush border membrane vesicles (BBMV). The vesicles were prepared with MgCl2 precipitation method and oxalate uptake was measured by a modification of the rapid millipore filtration technique. In order to analyze efflux of oxalate from BBMV, the vesicles were pre-equilibrated with 100 microM [14-C]-oxalate for 10 min, at 30 degrees C. Temperature dependent and independent oxalate uptake were observed under the conditions of salt and anion free medium. Temperature dependent oxalate accumulation showed "over shoot", indicating carrier mediated oxalate flux. The stimulating effect of an inside alkaline pH gradient on oxalate uptake failed to show at intravesicular pH 8.5. The efflux of oxalate from pre-loaded BBMV showed three steps decreasing curve. Initial rapid efflux was inhibited by extravesicular 5 mM para-aminohippurate (PAH) and low temperature (5 degrees C). Extravesicular 100 microM PAH had no effect on oxalate efflux. These data suggested a carrier mediated oxalate transport system across the barrier from intracellular to luminal site. An outwardly directed chloride (Cl) gradient stimulated oxalate uptake in BBMV, DIDS, anion exchange inhibitor, inhibited this Cl-stimulated oxalate uptake completely. Harmaline, a Na-coupled cotransport inhibitor, had no effect and Probenecid, an organic anion transport inhibitor, caused 45% inhibitory effect on Cl-gradient stimulated oxalate transport system via anion exchange in the rat kidney BBMV.
Nippon Jinzo Gakkai shi 02/1989; 31(1):57-65.
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ABSTRACT: MRI of bladder cancer was accomplished in 28 patients. All of the 28 patients were simultaneously studied by CT, and 22 were also studied by transurethral US before operation. MRI is not as useful as US for local staging of bladder cancer. However, MRI is more useful for diagnosing extravesical extension and covers the deficit of the overdiagnosing tendency of US.
Hinyokika kiyo. Acta urologica Japonica 01/1989; 34(12):2091-6.
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ABSTRACT: The magnetic resonance imaging (MRI) of bladder cancer was accomplished in 26 patients who had histologically proven transitional cell carcinoma through transurethral resection. All 26 patients were simultaneously studied by computed tomography (CT) and 21 were also studied by transurethral ultrasonography (US) before surgery or preoperative irradiation. The evaluations of the MRI and CT were carried out by the same radiologist and urologist postoperatively; the evaluation of the US was carried out by several urologists preoperatively, and their results compared with the postoperative pathological findings. The staging accuracy for pT2 tumors and above for each imaging modality was as follows. MRI: sensitivity 83.3%, specificity 71.4%, accuracy 76.9%; CT: sensitivity 58.3%, specificity 42.8%, accuracy 50%; US: sensitivity 100%, specificity 70%, accuracy 85.7%. The results of the staging with regard to extravesical extensions were as follows. MRI: sensitivity 60%, specificity 85.7%, accuracy 80.8%; CT: sensitivity 60%, specificity 81%, accuracy 76.9%. On the other hand, the sensitivity of US was 25%, specificity 94.1% and accuracy was 81%. The higher the pathological staging, the more the diagnostic accuracy was likely to be increased with MRI and CT, but diminished for US. There were three cases of pT1 tumors being over-diagnosed by US, but two of them were accurately staged by MRI. The other 11 cases, diagnosed as T2 or above by US, were only minimally overstaged or understaged by MRI. MRI seemed able to overcome the disadvantage of US which tended to over-diagnose pT1 tumors and which was not suitable for use in diagnosing infiltrative tumors correctly. CT seemed useless for local staging.
Japanese Journal of Clinical Oncology 10/1988; 18(3):217-26. · 1.78 Impact Factor
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Nippon Jinzo Gakkai shi 12/1987; 29(11):1347-54.
