Masahiro Uno

Ogaki Municipal Hospital, Gihu, Gifu, Japan

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Publications (9)2.13 Total impact

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    ABSTRACT: We performed ultrasound-guided biopsies on 14 patients having tumors that were difficult to distinguish as benign or malignant on computed tomography. The study took place from January 2004 to December 2011. Of the 14 tumors biopsied, 12 were malignant, 1 was benign, and 1 was a sampling error. Of the 12 malignant tumors, 7 were primary kidney carcinomas. Six patients received radical or partial nephrectomies, and all had a good prognosis. Three patients with metastatic kidney cancers died of the primary disease. Eleven patients (85.5%) were diagnosed pathologically by biopsies, allowing us to decide the course of treatment. However, because our tests also revealed one sampling error and one unspecified cancer, we determined that there are limitations to a renal biopsy.
    Hinyokika kiyo. Acta urologica Japonica 03/2013; 59(3):149-52.
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    ABSTRACT: A 64-year-old man presented to our emergency room with right back pain on July 10, 2009. At the emergency room, abdominal enhanced computed tomography revealed a cystic lesion in the retroperitoneum. Then he was referred to our department. We performed percutaneous drainage of the retroperitoneal lesion and aspirated white pus. The retroperitoneal cystic lesion proved to be an abscess. Microscopic examination of a Gram stained specimen of the abscess revealed gram-positive bacillary fragments ; therefore, we suspected the pathogen to be Nocardia. He had a history of chronic glomerulonephritis and had received treatment consisting of 20 mg prednisolone, and 75 mg cyclosporine per day. He was regularly visiting the department of cardiovascular for follow-up of chronic heart failure. On the day before his visit to our emergency room, his chest X-ray medicine had revealed a nodular shadow. Then he was referred to the department of respiratory medicine and was scheduled to receive a bronchoscopy later. We suspected the nodule of the lung also to be an abscess of Nocardia. Later, head computed tomography (CT) revealed a brain abscess the pathogen of which was Nocardia. Nocardia is a filamentous, gram-positive, branched bacterium and classified as an aerobic actinobacteria. Nocardia species are difficult to diagnose due to non-specific clinical and histological manifestation. We report this case of disseminated nocardiosis presenting as retroperitoneal abscess. The disseminated nocardiosis was diagnosed without delay by percutaneous drainage and appropriate treatment was provided.
    Hinyokika kiyo. Acta urologica Japonica 12/2010; 56(12):691-5.
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    ABSTRACT: We report a case of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. A 68-years old female consulted a primary hospital with a chief complaint of back pain. Computed tomography revealed the tumor of the left kidney, so she was referred to our department. The tumor, 45 x 42 mm in length, was slightly enhanced, and that had well-defined margins. We performed radical nephrectomy. Pathological findings suggested MTSCC. MTSCC is a rare type of renal cell carcinoma composed of a combination of low-grade tubular cuboidal cells and spindle cells in a mucinous stroma. The immunohistochemistry is effective in its diagnosis.
    Hinyokika kiyo. Acta urologica Japonica 03/2010; 56(3):159-62.
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    ABSTRACT: A 60-year-old woman underwent detailed examinations for hepatic disorders and pancreatic tumor at the Department of Internal Medicine. A tumor mass in her left renal pelvis and a thickened wall in her left ureter were observed on computed tomography (CT) and magnetic resonance imaging (MRI) images. Retrograde ureteropyelography and drip infusion pyelography images showed a stenosis in 1 vertebral body from the left ureteropelvic junction. Urinary cytology finding was class III-a; however, malignancy could not be disregarded. Since the patient continued to experience severe dorsal pain, a left nephroureterectomy was subsequently performed at the patient's request. Pathological tests showed no malignant findings, and based on the chronic pyelonephritis, we diagnosed her condition as an inflammatory pseudotumor. Not many inflammatory pseudotumors are found in the urinary tract, and even fewer are manifest in the renal pelvis and ureter. Although inflammatory pseudotumors are generally benign, cases of repeated local recurrence exist. Therefore, a meticulous follow-up observation is required.
    Hinyokika kiyo. Acta urologica Japonica 12/2008; 54(11):737-40.
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    ABSTRACT: Prostate cancer is rarely detected from abnormal chest radiographs. We report two cases of prostate cancer detected from pleural effusion. Case 1 is a 76-year-old man who consulted the department of internal medicine of our hospital with dyspnea and abdominal fullness. Pleural effusion and multiple hepatic tumors of unknown origin were pointed out, but he refused any further investigation or treatment for them. Six months later, he consulted a family doctor with urinary frequency and lumbago. Increased serum prostate specific antigen (PSA) level to 864 ng/ml was recognized, then he was referred to our department. Under diagnosis of prostate cancer, T4NOM1c, maximal androgen blockade (MAB) was performed. Serum PSA level was decreased once to 8.1 ng/ml, but then rose gradually and he died 13 months after the beginning of the therapy. Case 2 was a 78-year-old man who was referred to our department to determine the origin of carcinomatous pleuritis detected in a routine general check up of hepatitis C. The serum PSA level was increased to 12,900 ng/ml, and the diagnosis was prostate cancer, T3aNOM1c. Although MAB was performed, the serum PSA level did not decrease markedly. He died 16 month after the beginning of the therapy.
    Hinyokika kiyo. Acta urologica Japonica 09/2008; 54(8):565-8.
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    ABSTRACT: A 51-year-old man with left renal tumor and multiple lung metastases was admitted to our hospital for treatment. Left nephrectomy was performed, and pathological diagnosis was renal cell carcinoma (clear cell carcinoma, G2, pT3a). Initially, Interferon-alpha (IFN-alpha) therapy was started for lung metastases. About 40 days after surgery, head magnetic resonance imaging revealed brain metastases, and therefore gamma knife radiosurgery(GKS) was performed. Since chest computed tomography showed no change in lung metastases, we tried a combination of interleukin-2 (IL-2) and IFN-alpha therapy to elininate those metastases. As a result, neither lung nor brain metastases could be detected at the 4th month follow-up examination. At 5 months after the IL-2 and IFN-alpha therapy, the patient attempted suicide. Therefore, the IL-2 and IFN-alpha therapy was stopped and an antidepressant was prescribed. Now 11 months after withdrawal of the IL-2 and IFN-alpha, the patient's mental condition remains stable. No recurrence of the cancer has been detected by CT.
    Hinyokika kiyo. Acta urologica Japonica 07/2005; 51(6):381-4.
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    ABSTRACT: We report a case of renal hemangiopericytoma which was incidentally discovered by ultrasonography at a health screening. A 58-year-old man was admitted to our hospital for close examination of the renal tumor. Computed tomography revealed the left renal tumor, 60 x 50 mm in size, which was well enhanced with contrast medium. Magnetic resonance imaging revealed an isointensity mass (T1-weighted) and high-intensity mass (T2-weighted) at the left kidney. Radical nephrectomy was performed on suspicion of left renal cell carcinoma. Histopathological examination revealed renal hemangiopericytoma. The present case is the 7th in the Japanese literature.
    Hinyokika kiyo. Acta urologica Japonica 02/2005; 51(1):17-20.
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    ABSTRACT: We studied 181 patients diagnosed with male urethritis at Oogaki Municipal Hospital from April 2002 to March 2004. Twenty-two out of 92 patients diagnosed with gonococcal urethritis (GU) and 52 out of 89 patients diagnosed with non-gonococcal urethritis (NGU) were positive for Chlamidia trichomatis by polymerase chain reaction (PCR). Most patients of male urethritis were in their twenties. Of GU patients, 39 (67%) were infected from commercial sex workers (CSWs). Of NGU patients, 12 (30%) were infected from CSWs, 24 (40%) from girl friends and 4 (10%) from their Twenty-eight (48%) out of GU patients were infected through oral sex. spouse. Eighty-three GU patients were treated with SPCM (2 g, one shot). Fifty-five patients could be evaluated for the efficacy of treatment. Elimination rate of Neisseria gonorrhoeae was 100% and 14 out of 18 patients with persisting urethritis had C. trichomatis. Eighty-two NGU patients were treated with minocycline, tosufloxacin, levofloxacin, gatiflixacin or clarithromycine. Sixty-six patients could be evaluated for the efficacy of treatment. Forty-one patients were diagnosed with non-gonococcal chlamydial urethritis (NGCU) and 25 patients were diagnosed with non-gonococcal, non-chlamydial urethritis (NGNCU). The clinical curative rate of NGCU and NGNCU was 93% (38/41) and 80% (20/25), respectively.
    Hinyokika kiyo. Acta urologica Japonica 02/2005; 51(1):57-60.
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    ABSTRACT: Even with curative surgery, renal cell carcinoma occasionally recurs in other organs, with fatal results. In this study, we identified independent prognostic factors for survival in patients with renal cell carcinoma after curative surgery. The records of 482 patients (mean age, 61.0 years; range, 17-90 years) who underwent curative surgery for renal cell carcinoma at Gifu University Hospital and its affiliated hospitals between 1991 and 2000 were reviewed. The average follow-up period was 42 months (range, 10-140 months). Clinical characteristics of the 482 patients were divided into three categories: patient factors (sex, age, performance status, and mode of tumor discovery), tumor factors (T classification, N classification, mode of infiltration, histological grade, and venous invasion), and treatment factor (whether or not adjuvant therapy with interferon-alpha was used). Stepwise multivariate Cox proportional hazards regression modeling was performed to identify independent determinants of survival. Of the patient factors, performance status and mode of tumor discovery were independent factors predicting survival. Of the tumor factors, venous invasion and mode of infiltration were independent factors predicting survival. Use or non-use of adjuvant therapy was not significantly associated with survival. Overall, performance status, venous invasion, mode of infiltration, and histological grade were shown to be independent prognostic factors, in descending order of importance. Performance status, venous invasion, mode of infiltration, and histological grade, in descending order, were the most important factors predicting survival after curative surgery for renal cell carcinoma.
    International Journal of Clinical Oncology 01/2005; 9(6):510-4. DOI:10.1007/s10147-004-0441-1 · 2.13 Impact Factor