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ABSTRACT: A 40-year-old male was referred to our hospital for further examination of a left kidney tumor. A left kidney tumor measuring 3 cm in diameter was incidentally found by abdominal ultrasound on physical checkup. Abdominal computed tomography and magnetic resonance imaging confirmed hypovascular tumor of the left kidney. Clinical diagnosis was left renal cell carcinoma and retroperitoneoscopic left nephrectomy was performed. However, pathological diagnosis was carcinoid tumor of the kidney. Primary carcinoid tumors of the kidney are uncommon. We present a case of primary carcioid tumor of the kidney and review the literature.
Hinyokika kiyo. Acta urologica Japonica 11/2011; 57(11):619-22.
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Masayoshi Okumi,
Noritaka Kawada,
Naotsugu Ichimaru,
Harumi Kitamura,
Toyofumi Abe,
Ryoichi Imamura, Yasuyuki Kojima,
Yukito Kokado,
Yoshitaka Isaka,
Hiromi Rakugi,
Norio Nonomura,
Toshiki Moriyama,
Shiro Takahara
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ABSTRACT: The regular dose of an angiotensin II type-1 receptor blocker (ARB) in renal transplant patients for hypertension is shown to be safe and effective; however, information on the appropriate dosing of ARBs in renal transplant patients is limited. We evaluate the efficacy and safety of the maximal dose of candesartan administered to renal transplant patients.
Sixty-nine recipients were enrolled in this study. Patients were divided into three groups based on the basal dose of candesartan: patients not taking candesartan (Group A); patients taking a low to medium dose of candesartan (2-4 mg/day; Group B); and patients taking a high dose of candesartan (8 mg/day; Group C). During the course of the study, the dose of candesartan was gradually increased to a final dose of 12 mg/day. Physiological and biochemical parameters were measured before and after the 12-month study period.
Ninety-one percent of patients succeeded in continuing their administration of candesartan for 1 year and 75% tolerated the administration of the maximal dose of candesartan. Significant differences in proteinuria, albuminuria, serum creatinine, and estimated glomerular filtration rate (eGFR) level among the groups were detected. In Group A, candesartan reduced systolic blood pressure, decreased the levels of proteinuria, albuminuria, eGFR, and hemoglobin and increased plasma potassium, creatinine level, and plasma renin activity.
The gradual increase of an ARB to its maximal dose in renal transplant patients is safe when carefully monitored. We were able to demonstrate the impact of maximal renin-angiotensin system (RAS) blockade on both proteinuria and albuminuria, which indicates the need for future, long-term randomized prospective trials to further establish the impact of maximal RAS blockade on renal and cardiovascular protection in transplant patients.
Clinical and Experimental Nephrology 08/2011; 15(6):907-15. · 1.37 Impact Factor
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ABSTRACT: A 53-year-old female had a history of long-term hemodialysis. Periodic follow-up abdominal ultrasonography revealed a tumor measuring 4 cm in diameter in an area adjacent to the upper pole of the right kidney. Abdominal computed tomography and magnetic resonance imaging confirmed a right adrenal tumor. Furthermore, adrenal scintigraphy after dexamethasone inhibition showed accumulation in the right adrenal gland. An endocrinological test revealed that the plasma renin activity (PRA) was normal, and that the plasma aldosterone (PAC) level was increased to 1,021.8 ng/dl. The PAC-to-PRA ratio (ARR) was 5,109. Under a diagnosis of aldosterone-producing adrenal tumor, laparoscopic right adrenalectomy was performed. After surgery, the PAC level was normalized. Pathological findings showed adrenal cortical adenoma. Primary aldosteronism causes hypertension, hypopotassiumemia, hyporeninemia, and hyperaldosteronemia via excessive secretion of aldosterone in the adrenal glands. However, the patient showed a high serum level of potassium due to anuria, and hypertension was not noted. Thus, some dialysis patients with primary aldosteronism do not show any typical clinical symptoms. A previous study also indicated the presence of hyperaldosteronemia in patients with end-stage renal disease. A diagnosis should be carefully made.
Hinyokika kiyo. Acta urologica Japonica 01/2010; 56(1):21-4.
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Yoichi Kakuta,
Masayoshi Okumi,
Naotsugu Ichimaru,
Toyofumi Abe,
Norio Nonomura,
Akihiko Okuyama, Yasuyuki Kojima,
Yoshitaka Isaka,
Shiro Takahara,
Enyu Imai,
Masaru Horio
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ABSTRACT: In Japan, the number of living kidney transplantations has increased each year, and an accurate evaluation of renal function must be conducted before donation to minimize the risk to donors. Recently, the Japanese Society of Nephrology issued a new equation for estimating glomerular filtration rate (eGFR) in Japanese people. This study compared the accuracy of eGFR and creatinine clearance (Ccr) values with that of inulin clearance (Cin) for assessing renal function in kidney donors.
Clinical data were analyzed for 85 potential living kidney donors who had undergone routine measured GFR (mGFR) and Ccr measurements from October 2006 to November 2008 at a single center. Inulin clearance, representing the mGFR, was determined by standard method. The eGFR was calculated as: eGFR = 194 x Scr(-1.094) x Age(-0.287) (for females, x0.739).
Mean mGFR was 96.1 +/- 14.7 (range 67.8-126.8); mean eGFR, 72.6 +/- 12.7 (range 50.1-107.1); and mean Ccr, 117.3 +/- 22.4 (range 35.1-170.1), in units of ml/min/1.73 m(2) for each. Relative to mGFR, the correlation coefficient for Ccr was 0.496, and the mean difference between the two values was 21.1 ml/min/1.73 m(2) (23.2%), with a root-mean square error (RMSE) of 19.6. The correlation coefficient between eGFR and mGFR was 0.502, and the mean difference between the two values was -23.5 (23.7%), with a RMSE of 11.0. Bland-Altman plots showed that Ccr overestimated mGFR in 90.6% of cases, whereas eGFR underestimated mGFR in 95.3% of cases.
Ccr and eGFR values did not accurately estimate mGFR in Japanese living kidney donors.
Clinical and Experimental Nephrology 10/2009; 14(1):63-7. · 1.37 Impact Factor
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ABSTRACT: Understanding the mechanism by which hormone refractory prostate cancer (HRPC) develops remains a major issue. Alterations
in HRPC include androgen receptor (AR) changes. In addition, the AR is activated by cytokines such as interleukin-6 (IL-6).
Atypical protein kinase C (aPKCλ/ι) has been implicated in the progression of several cancers. Herein, we provide evidence
that aPKCλ/ι expression correlates with prostate cancer recurrence. Experiments in vitro and in vivo revealed aPKCλ/ι to be
involved in prostate cancer cell growth through secretion of IL-6. Further, aPKCλ/ι activates transcription of the IL-6 gene
through NFκB and AP-1. We conclude that aPKCλ/ι promotes the growth of hormone independent prostate cancer cells by stimulating
IL-6 production in an autocrine manner. Our findings not only explain the link between aPKCλ/ι and IL-6, implicated in the
progression a variety of cancers, but also establish a molecular change involved in the development of HRPC. Further, aPKCλ/ι
expression might be a biomarker for prostate cancer progression.
Proceedings of the National Academy of Sciences 09/2009; 106(38):16369-16374. · 9.68 Impact Factor
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Ryo Takagawa,
Kazunori Akimoto,
Yasushi Ichikawa,
Hirotoshi Akiyama, Yasuyuki Kojima,
Hitoshi Ishiguro,
Yoshiaki Inayama,
Ichiro Aoki,
Chikara Kunisaki,
Itaru Endo,
Yoji Nagashima,
Shigeo Ohno
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ABSTRACT: The atypical protein kinase C lambda/iota (aPKClambda/iota) is involved in several signal transduction pathways that influence cell growth, apoptosis, and the establishment and maintenance of epithelial cell polarity. Overexpression of aPKClambda/iota has been reported in several cancers and been shown to be associated with oncogenesis. However, the expression and role of aPKClambda/iota in gastric cancer, one of the commonest cancers in Asia, have not so far been investigated. This study aimed to clarify the relationship between aPKClambda/iota expression and the clinicopathological features of gastric cancer.
Gastric adenocarcinoma samples were obtained from 177 patients who underwent gastrectomy at the Yokohama City University Hospital between 1999 and 2004. Expression of aPKClambda/iota and E: -cadherin was examined immunohistochemically and compared with clinicopathological features of the tumors. Univariate and multivariate analyses were performed for both disease-specific and relapse-free survival.
Overexpression of aPKClambda/iota protein was detected in 126 of the 177 (71.2%) gastric cancers. Immunohistological staining for aPKClambda/iota was stronger in gastric adenocarcinoma of intestinal type than diffuse type (p = 0.036), but was not correlated with E: -cadherin expression. A multivariate analysis suggested that nodal metastasis and aPKClambda/iota overexpression were prognostic factors for disease recurrence.
Our results suggested that aPKClambda/iota overexpression was a strong prognostic factor for gastric adenocarcinoma recurrence. As well as being a new prognostic indicator, aPKClambda/iota is also likely to be a novel therapeutic target for gastric cancer.
Annals of Surgical Oncology 09/2009; 17(1):81-8. · 4.17 Impact Factor
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Kenichi Matsuzu,
Hideyuki Ike,
Haruhiko Cho,
Akio Ashida,
Hirohito Fujikawa,
Beni Saito,
Tsutomu Hayashi,
Keita Fujii, Yasuyuki Kojima,
Kazutaka Narui,
Yoshiro Fujii,
Tatsuo Makino,
Nobuyuki Wada,
Yasushi Rino,
Munetaka Masuda
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ABSTRACT: A 52-year-old woman visited our hospital with epigastralgia. Detailed examination revealed a duodenal cancer of the ascending limbs. Since she refused the resection, the administration of S-1 alone was commenced. After one course of this treatment, oral intake became impossible. Duodenography and endoscopy showed duodenal obstruction, and she underwent surgery. The tumor proved to be unresectable due to direct invasion of the inferior vena cava. Duodenojejunostomy was performed. After surgery, she was treated by S-1 and survived 2 years and 11 months, which resulted in 3 years and 2 months' long survival from her first visit. The intervals of the intake and home stay, after the operation, were 2 years and 8 months and 2 years and 5 months, respectively. The combination of S-1 administration and bypass operation provides a useful alternative for the treatment of unresectable duodenal cancer with stenosis.
Gan to kagaku ryoho. Cancer & chemotherapy 09/2009; 36(9):1573-6.
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ABSTRACT: Understanding the mechanism by which hormone refractory prostate cancer (HRPC) develops remains a major issue. Alterations in HRPC include androgen receptor (AR) changes. In addition, the AR is activated by cytokines such as interleukin-6 (IL-6). Atypical protein kinase C (aPKClambda/iota) has been implicated in the progression of several cancers. Herein, we provide evidence that aPKClambda/iota expression correlates with prostate cancer recurrence. Experiments in vitro and in vivo revealed aPKClambda/iota to be involved in prostate cancer cell growth through secretion of IL-6. Further, aPKClambda/iota activates transcription of the IL-6 gene through NFkappaB and AP-1. We conclude that aPKClambda/iota promotes the growth of hormone independent prostate cancer cells by stimulating IL-6 production in an autocrine manner. Our findings not only explain the link between aPKClambda/iota and IL-6, implicated in the progression a variety of cancers, but also establish a molecular change involved in the development of HRPC. Further, aPKClambda/iota expression might be a biomarker for prostate cancer progression.
Proceedings of the National Academy of Sciences 09/2009; 106(38):16369-74. · 9.68 Impact Factor
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ABSTRACT: We investigated the clinical efficacy and safety of administration of naftopidil at 75 mg for clinically benign hyperplasia patients who had moderate or severe urinary disturbance according to guidelines for clinical studies regarding urination disorder. Among patients with benign prostatic hyperplasia who were treated with a alpha1-adrenoceptor blocker, we administered naftopidil (75 mg/day) for 12 weeks to 85 patients in whom the global severity was evaluated as moderate or severe. This agent significantly reduced the international prostate symptom score (I-PSS) and residual urine volume, and improved the QOL index and maximum urine flow volume in comparison with the baselines. Concerning the global treatment response, a partial response or better was achieved in 83.8% of the patients. Neither blood pressure nor heart rate were changed in patients who continued to receive this therapy. Side effects included orthostatic hypotension (1 patient: discontinuation), dizziness (2 patients: discontinuation, 1 patient: continuation), and palpitation (1 patient: discontinuation). These results suggest that a once-a-day administration of naftopidil at 75 mg safely relieves urination/accumulated urine symptoms in patients with moderate or severe urination disorder related to prostatic hypertrophy.
Hinyokika kiyo. Acta urologica Japonica 05/2009; 55(4):181-6.
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Noritaka Kawada,
Toshiki Moriyama,
Naotsugu Ichimaru,
Ryoichi Imamura,
Isao Matsui,
Yoshitsugu Takabatake,
Yasuyuki Nagasawa,
Yoshitaka Isaka, Yasuyuki Kojima,
Yukito Kokado,
Hiromi Rakugi,
Enyu Imai,
Shiro Takahara
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ABSTRACT: Anemia is a common complication in posttransplant patients (posttransplant anemia: PTA). We tested the hypothesis that targeting hemoglobin (Hb) over 13.3 g/dl by administration of recombinant human erythropoietin (rHuEPO-ad) has positive impact on quality of life (QOL).
Twenty-four patients, whose initial Hb and estimated glomerular filtration rate (eGFR) were 10.5 +/- 0.2 g/dl and 48.5 +/- 2.7 ml/(min 1.73 m2), respectively, were enrolled in the present study. Physical and mental QOL in these patients before and after rHuEPO-ad were acquired and summarized as physical summary sore (PSC) and mental summary sore (MSC), respectively, by the 36-item Short Form (SF-36), an international questionnaire for analysis of QOL.
Before rHuEPO-ad, posttransplant patients had preserved MSC (54.1 +/- 2.3) but impaired PSC (32.6 +/- 3.2). rHuEPO-ad for 6 months increased their Hb to 13.7 +/- 0.3 g/dl. This was accompanied by improvement of PSC (49.1 +/- 2.1: P < 0.01 versus before rHuEPO-ad). MSC was preserved during rHuEPO-ad (54.4 +/- 1.6: NS versus before rHuEPO-ad). There was inverse correlation between initial PSC or MSC and responses of these parameters to rHuEPO-ad (PSC, P = 0.007; MSC, P = 0.009). Patients whose initial PSC was lower than 39.6 or whose initial MSC was lower than 39.4 were expected to improve their PSC or MSC by more than 10 by rHuEPO-ad.
Anemia in posttransplant patients has negative impacts on their QOL. Scoring mental and physical QOL by SF-36 in posttransplant patients is useful to identify groups of patients whose QOL could be improved by rHuEPO-ad.
Clinical and Experimental Nephrology 04/2009; 13(4):355-60. · 1.37 Impact Factor
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Yasuyuki Kojima,
Kazunori Akimoto,
Yoji Nagashima,
Hitoshi Ishiguro,
Sumiko Shirai,
Takashi Chishima,
Yasushi Ichikawa,
Takashi Ishikawa,
Takeshi Sasaki,
Yoshinobu Kubota,
Yoshiaki Inayama,
Ichiro Aoki,
Shigeo Ohno,
Hiroshi Shimada
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ABSTRACT: Breast cancer is one of the common malignant diseases among women in Japan as well as in western countries, and its incidence continues to increase. Normal mammary duct epithelial cells exhibit a well-organized apicobasal polarity, which forms the basis for their specific structure and function. Although the loss of epithelial cell polarity is one of the major changes that occur during the progression of tumor cells, including breast cancer, the underlying molecular mechanisms for this, as well as their relationship to other changes such as increased proliferation and metastasis, remain to be elucidated. The atypical protein kinase C lambda/iota (aPKC lambda/iota) is involved in several signal transduction pathways, including the establishment of epithelial cell polarity. In this study we evaluated the expression and localization of aPKC lambda/iota in breast cancer by immunohistochemistry and compared our findings with the clinicopathologic factors associated with the tumor specimens. We detected aPK Clambda/iota protein overexpression in 88 of the 110 breast cancer cases (80.0%) under study, expect for decreased expression in a few cases. The immunoreactivity of aPK Clambda/iota was generally weak in ductal carcinoma in situ, but strong in invasive ductal carcinoma (IDC; P = .022). The correlation between apical or cytoplasmic aPKC lambda/iota localization and tumor pathologic type (ie, atypical ductal hyperplasia, ductal carcinoma in situ. or IDC) was also demonstrated (P < .001). These results thus indicate that the normal apicobasal polarity is lost upon the progression of a breast lesion to IDC. This is also the first evidence to show aPKC lambda/iota overexpression in breast cancer and demonstrates that its localization is associated with the trend of pathologic type of the tumor.
Human pathology 07/2008; 39(6):824-31. · 3.03 Impact Factor
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Ken Kato,
Munehide Matsuhisa,
Naotsugu Ichimaru,
Shiro Takahara, Yasuyuki Kojima,
Kaoru Yamamoto,
Toshihiko Shiraiwa,
Akio Kuroda,
Naoto Katakami,
Ken'ya Sakamoto,
Taka-aki Matsuoka,
Hideaki Kaneto,
Yoshimitsu Yamasaki,
Masatsugu Hori
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ABSTRACT: New-onset diabetes after renal transplantation (NODAT) is known to be a potent risk factor for cardiovascular events. We therefore investigated the incidence and risk factors for NODAT, and evaluated surrogate endpoints of atherosclerosis in Japanese patients with stable renal function after renal transplantation. Seventy-nine patients were enrolled in the study, and a 75 g oral glucose tolerance test (OGTT) was performed in subjects excluding patients with known NODAT. We evaluated the risk factors for NODAT and the degree of atherosclerosis, determined by brachial-ankle pulse wave velocity (baPWV), ankle-brachial blood pressure index (ABPI) and intima-media thickness (IMT) of the carotid artery. Eleven patients diagnosed as NODAT had significantly higher fasting plasma glucose before transplantation, blood pressure, and incidence of hepatitis C virus (HCV) infection than patients without NODAT. Multivariate regression analysis revealed that the independent determinant of NODAT was fasting plasma glucose pre-transplantation, HCV infection and systolic blood pressure. The baPWV in patients with NODAT was significantly higher compared to that in patients without NODAT. In addition, the independent determinant of baPWV evaluated by multivariate regression analysis was an increase in systolic blood pressure and age, and a decrease of adiponectin levels. In conclusion, we found that high fasting plasma glucose prior to transplantation, HCV infection and high blood pressure are risk factors for NODAT in Japanese patients after renal transplantation. Since NODAT patients have advanced arterial stiffness probably due to high blood pressure, strict control of blood pressure will be important for preventing the development of cardiovascular disease in NODAT.
Endocrine Journal 07/2008; 55(4):677-83. · 2.03 Impact Factor
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Hitoshi Inoue,
Norio Nonomura, Yasuyuki Kojima,
Masahiro Shiba,
Daizo Oka,
Yasuyuki Arai,
Masashi Nakayama,
Hitoshi Takayama,
Kazuo Nishimura,
Hiroshi Mori,
Akihiko Okuyama
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ABSTRACT: Renal cell carcinoma (RCC) frequently occurs in patients with long-term dialysis. Long-term dialysis causes distinctive pathological changes in the kidney, which is known as acquired cystic disease of the kidney (ACDK). It is of great interest to know whether RCCs occurring in the dialytic kidneys harbour the same or similar mutations of the von Hippel-Lindau (VHL) gene as conventional dialysis-unrelated clear cell RCCs so often do.
Renal cancer tissues (eight clear cell, two papillary, one Bellini duct and three of the so-called dialysis-specific renal carcinomas) from 13 patients undergoing long-term dialysis were examined for somatic mutations of the VHL disease gene. By means of laser capture microdissection, cancerous and surrounding non-cancerous renal tissues from dialytic patients were subjected to PCR-based direct sequencing of the VHL gene.
Direct forward and reverse sequencing showed that three tumours possessed VHL gene mutations (713delG, 500-504del5-bp and 709A>G). These three mutations were identified in clear cell carcinomas occurring in association with end-stage renal disease undergoing dialysis for 194, 147 and 125 months. None of the non-tumour tissues or other carcinoma tissues analysed, including dialysis-specific carcinoma, possessed VHL gene mutations.
These results indicate that VHL tumour-suppressor gene mutation is involved in clear cell carcinoma in association with long-term dialysis. Mutation of the VHL gene was not found in any of the dialysis-specific RCCs studied herein.
Nephrology Dialysis Transplantation 07/2007; 22(7):2052-5. · 3.40 Impact Factor
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ABSTRACT: Background:Mice homozygousforthe jsd (juvenilespermatogonial depletion) allele are sterile because they become azoospermic. The onset of such azoospermia was investigated by histologic analysis of sections of testes from jsd/jsd mice.Method:The testes removed from C57BL/6-jsd/jsd mice aged 3 to 10 weeks were examined microscopically.Results:At 3 weeks of age, spermatocytes were seen in most of the seminiferous tubules of jsd/jsd mice. However, the number of tubules that contained spermatids was significantly smaller than that counted in the wild-type mice. Since degenerative figures were not abundant in the jsd/jsd testes, the decreased number of spermatids found in the tubules suggested a longer duration of development from spermatocyte to spermatid in jsd/jsd mice. The abnormality extended to the development of type B spermatogonia, and a decrease in their number became apparent after 6 weeks of age in most of the jsd/jsd tubules. However, as early as 3 weeks of age, a few seminiferous tubules in jsd/jsd mice already contained only Sertoli cells and type A spermatogonia.Conclusion:It is assumed that the decrease in type B spermatogonia occurred at various ages and locations. The defect of spermatogenesis in jsd/jsd mice was attributable to aberrations in multiple steps of spermatogenesis.
International Journal of Urology 06/2007; 4(5):500 - 507. · 1.75 Impact Factor
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Yasuyuki Kojima,
Masatoshi Mogaki,
Ryo Takagawa,
Ikuko Ota,
Mitsutaka Sugita,
Shiho Natori,
Yohei Hamaguchi,
Haruki Kurosawa,
Tadao Fukushima,
Hidenobu Masui,
Shingo Fukazawa,
Shoji Yamanaka,
Yukio Tsuura,
Kaoru Nagahori
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ABSTRACT: Follow-up colonoscopy of a 25-year-old Japanese man with ulcerative colitis (UC) who had undergone endoscopic mucosal resection twice for early colon cancers revealed the presence of a new 1.5-cm-diameter tumor in the sigmoid colon. It was diagnosed by preoperative biopsy as a poorly differentiated adenocarcinoma. Sigmoidectomy was performed, and the pathological findings revealed lymphoepithelioma-like carcinoma (LEC). In situ hybridization to detect Epstein-Barr virus (EBV)-encoded small RNAs showed positive signals in stromal lymphocytes, but weak signals in the tumor cells. The association between EBV and LEC was obscure in this case. Unlike typical UC-mediated colon cancers, the lesion was poorly differentiated, and negative for p53 signals immunohistochemically. These findings may hint at a novel mechanism of carcinogenesis in UC-mediated colorectal cancer.
Journal of Gastroenterology 03/2007; 42(2):181-5. · 4.16 Impact Factor
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ABSTRACT: Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis.
In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation.
RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5 +/- 11.1 years. Dialysis duration before RCC diagnosis was 11.2 +/- 7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9 +/- 1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5(11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P = 0.01) and smaller tumors (P = 0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer.
Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients.
International Journal of Urology 09/2006; 13(8):1045-8. · 1.75 Impact Factor
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ABSTRACT: We report a rare case of multiple endocrine neoplasia (MEN) type 1 with thymoma. A 57-year-old woman with a chronic duodenal ulcer and hypoglycemia had been seen at a nearby clinic. Abdominal echogram revealed two nodules in the pancreas and she was referred to our hospital for evaluation. Her diagnosis was MEN type 1, gastrinoma and hyperparathyroidism with anterior mediastinal tumor. There were high calcium levels in the blood and urine. Gastrin was quite high. A chest X-ray revealed a retrosternal tumor. Computed tomography revealed an anterior mediastinal tumor without sign of invasion to the surrounding organs, and two small masses in the pancreas. Cervical echogram revealed a few masses in both sides behind the thyroid. From these findings, her preoperative diagnosis was MEN type 1 with thymic carcinoid or thymoma. We performed thymectomy and parathyroidectomy concomitantly. The mediastinal tumor was diagnosed as invasive thymoma.
The Japanese Journal of Thoracic and Cardiovascular Surgery 05/2006; 54(4):171-3.
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ABSTRACT: We report a case of thymic cancer with pericardial tamponade in a 70-year-old woman. The patient complained of chest pain and was carried to our hospital. CT scan showed a mediastinal mass and massive pericardial effusion. The effusion was serous fluid, not bloody, and no malignant cells were found. The patient underwent a tumor resection, and the final pathological diagnosis was squamous cell carcinoma of the thymus. In a review of 14 cases of thymic tumor with pericardial tamponade as initial manifestations in the Japanese literature,there were only three cases of thymic cancer. The prognosis was reported to be extremely poor.Some reports showed the effectiveness of chemotherapy and irradiation therapy. We should keep looking for the best treatment for this disease.
Gan to kagaku ryoho. Cancer & chemotherapy 02/2006; 33(1):79-82.
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ABSTRACT: A 60-year-old male, who had been maintained on hemodialysis for 4 years, visited our hospital to receive living renal transplantation. He complained of macrohematuria, and preoperative examination showed elevation of psostate specific antigen (PSA). Cystoscopy revealed papillary tumors on the right lateral bladder wall. Transurethral resection of bladder tumor (TUR-Bt) was performed and histopathological examination showed transitional cell carcinoma, G2, pTa. The histologic diagnosis of the transrectal needle prostate biopsy specimen was moderately differentiated adenocarcinoma. Combined androgen blockade as a neoadjuvant therapy and radical prostatectomy were performed. A case of synchronous double primary cancers, comprised of adenocarcinoma of the prostate and transitional cell carcinoma of the urinary blader in a hemodialysis patient has never been previously reported in the Japanese literature.
Hinyokika kiyo. Acta urologica Japonica 11/2005; 51(10):689-93.
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Atsuhiro Matsumoto,
Yukiomi Namba,
Koji Yazawa,
Naotsugu Ichimaru,
Yasushi Miyagawa,
Shiro Takahara,
Akihiko Okuyama,
Mariko Kim, Yasuyuki Kojima,
Yukito Kokado,
Masahiro Kyo
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ABSTRACT: We present a case of 29-year-old female who underwent an ABO-incompatible living kidney transplantation from her father. The serum creatinine (s-Cr) level of this patient was stabilized about 1.1-1.2 mg/dl during the first 3 months after the transplantation. Thereafter, the function of allograft was deteriorated gradually. A biopsy performed on post-transplant day (PTD) 520 to evaluate a rise in creatinine revealed an interstitial nephritis and chronic renal allograft nephropathy. The renal function worsened persistently, although we increased the dosage of immunosuppressant subsequently. The following biopsy performed on PTD 630 showed a suspicion of BK virus nephropathy, with a mass of tubular epithelial nuclear inclusions and an interstitial nephritis. The diagnosis of BK virus nephropathy was confirmed on the immunohistochemistry staining using anti-SV40 antibody and PCR analysis. Despite reducing the immunosuppressants, the function of the allograft worsened progressively and was lost on PTD 912.
Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 12/2003; 94(7):685-8.
