Publications (5)2.74 Total impact
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Article: Downsizing a thrombus of advanced renal cell carcinoma in a presurgical setting with sorafenib.
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ABSTRACT: A 53-year-old man presented with fever, 15 kg weight loss, ECOG performance status 0, and 12 × 9.5 cm renal tumor with an associated level II (near level III) tumor thrombus extending into the vena cava. We offered a presurgical targeted therapy to downsize the thrombus and primary tumor, which may reduce the extent of the surgery and operative risk. The patient accepted this approach with administration of sorafenib, resulting in a marked reduction of the primary renal tumor and 43% regression in tumor thrombus. Tumor shrinkage and regression of the thrombus allowed resection of the left kidney. Pathological findings revealed that part of the tumor was necrotic tissue. Two years after initiation of presurgical sorafenib therapy, the patient remains alive without evidence of disease progression.Urologia Internationalis 12/2011; 88(2):235-7. · 0.99 Impact Factor -
Article: Measurement of prostate specific antigen complexed to alpha1-antichymotrypsin to avoid unnecessary biopsy in patients with serum prostate specific antigen levels 4-20 ng/mL.
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ABSTRACT: To investigate whether measuring prostate specific antigen complexed to alpha1-Antichymotrypsin (PSA-ACT) can increase sensitivity and specificity in detecting prostate cancer. In this prospective study, we measured serum total PSA, PSA-ACT, free PSA, prostate volume and transition zone volume on 210 patients with total PSA level of 4-20 ng/mL. From fitted curves between positive predictive values for prostate cancer and age, prostate volume, transition zone volume, total PSA, PSA-ACT or F/T ratio, each function predicting prostate cancer was determined. Relative probabilities for prostate cancer (RPpca) which were defined by combined functions of age, F/T ratio, prostate volume or transition zone volume, and total PSA or PSA-ACT were calculated. Furthermore, using logistic regression, analysis was performed to determine the probability of prostate cancer. Receiver-operating characteristic analysis was performed to clarify the areas under the curve (AUC) for conventional single parameters, RPpca and logistic regression probability. F/T ratio showed the largest AUC among conventional parameters. The AUC of RPpca was larger than those of F/T ratio and logistic regression probability. RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio showed the largest AUC and highest specificity at sensitivity 95% level, however, specificities at sensitivity 90% and 85% were identical to those of RPpca using the functions of age, prostate volume, total PSA and F/T ratio. RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio was the best way to detect prostate cancer, however, the usefulness of PSA-ACT appears limited, considering the cost.International Journal of Urology 09/2005; 12(8):721-7. · 1.75 Impact Factor -
Article: Strain and sex differences in kidney carcinogenesis in rats treated with N-ethyl-N-hydroxyethylnitrosamine and uracil
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ABSTRACT: 各群30匹,8群合計240匹のラットを用いた.第1～第4群が薬剤投与群,第5～第8群が薬剤非投与の対照群とした.薬剤投与群には飲料水中に0.05%EHENを,粉末飼料中に3%ウラシルを混入して,これを3週間同時に投与した.全実験期間は33週間とした.腎腫瘍の発生率は,第1,2,3,4群でそれぞれ100%,95%,71%,60%であり,WistarラットでF344ラットよりも有意に高率に腎腫瘍の発生がみられた.性差による発生率では,雄に高率に発生する傾向があったが,有意差はなかった.対照群には腎腫瘍は発生しなかった.Wistar雄ラットに,EHENとウラシルを同時に投与すれば,短期間に高頻度に腎腫瘍を誘発させうる We earlier demonstrated that simultaneous administration of EHEN and uracil for 3 weeks resulted in enhancement of renal carcinogenesis in F344 female rats. Therefore, to establish a model of renal carcinogenesis in rats that can induce advanced renal carcinoma at a high incidence, differences in the susceptibility to N-ethyl-N-hydroxyethylnitrosamine (EHEN) and uracil of the kidneys in male and female rats of two strains were examined. Group 1 (male Wistar rats), group 2 (female Wistar rats), group 3 (male F344 rats), and group 4 (female F344 rats) received a 3-week simultaneous administration of 0.05% EHEN in the drinking water and 3% uracil in the diet after one week's acclimation. In all the above four groups, the rats were thereafter given a basal diet and water without chemical addition for a 29-week period. Group 5 (male Wistar rats), group 6 (female Wistar rats), group 7 (male F344 rats) and group 8 (female F344 rats) received no chemicals for the entire 33 weeks. At the end of the experiment, renal adenocarcinomas were found in 85, 68, 14 and 0% of the rats in groups 1, 2, 3 and 4, respectively. The incidence of adenomas and adenocarcinomas in Wistar rats were significantly greater than in F344 rats (p < 0.0001). These findings indicate strain and possibly sex differences in kidney carcinogenesis in rats treated with EHEN and uracil, and simultaneous administration of the two agents to male Wistar rats might have an advantage for models to induce advanced renal carcinoma at a high incidence. -
Article: Sarcomatoid carcinoma of the bladder: a case report
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ABSTRACT: 頻尿を訴えた膀胱肉腫様癌の78歳女で,膀胱全摘除術後25ヵ月の現在,再発所見はなく健在である.病理組織学的には大部分が紡錘形の脱分化した腫瘍細胞により構成され,一部に上皮の特徴を有する分化した腫瘍細胞が認められ,後者は免疫組織化学的にepithelial membrane antigenが陽性であった.又,腫瘍の近傍の粘膜には上皮内癌が随伴していた We reported a case of sarcomatoid carcinoma of the bladder in a 78-year-old woman presenting with pollakisuria. She has remained well without any evidence of recurrence for 25 months after radical cystectomy. Microscopic examination revealed a composition almost exclusively of spindle and dedifferentiated cells, accompanied by only a few cells retaining epithelial features of differentiation. The latter cells were immunohistochemically positive for epithelial membrane antigen (EMA). A concomitant carcinoma in situ was present in the adjacent mucosa. Immunohistochemical exploration with EMA proved useful for reinforcing the conventional histological diagnosis. -
Article: Minocycline instillation for lymphorrhea after extraperitoneal pelvic lymphadenectomy. OFF
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ABSTRACT: 腹膜外的骨盤リンパ節郭清後発生したリンパ漏の4症例に対し,ドレーンからミノサイクリンを注入し治療した。4症例のうち2症例は同時に膀胱全摘術を,1症例は前立腺全摘術を施行した。4症例すべてにおいてリンパ漏は著明に改善し,以後のドレーン留置期間を短縮できた。副作用は生じなかった We managed four cases of lymphorrhea after extraperitoneal pelvic lymphadenectomy by means of minocycline instillation into the cavity around the drainage tube. Two patients had concomitantly undergone cystectomy and one prostatectomy via the extraperitoneal approach. In all four cases, the lymphorrhea markedly subsided, which dramatically shortened the duration of drainage. No side effects occurred. These findings indicate that minocycline instillation is an efficacious treatment for lymphorrhea.
