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61.
Yoko Kubota Teruhiro Nakada Kyoichi Imai Hidetoshi Yamanaka Hideki Sakai Yutaka Saito Yukio Tomaru Koichi Kitamura Osamu Sugano Isoji Sasagawa 《The Prostate》1995,26(1):50-54
There have only been a few studies of chemo-endocrine therapy compared with endocrine therapy alone in newly diagnosed prostate cancer patients. We assessed the effects of these two therapies by comparing long-term survival rates. One hundred and twenty-nine patients were entered in this study between November 1977 and March 1992. Seventy-seven patients were treated with endocrine therapy alone. Other 52 patients received chemo-endocrine therapy, which included orchiectomy and/or diethylstilbestrol diphosphate (DES-DP) plus Cisplatin, with or without other cytotoxic agents. All patients had bone metastasis at the beginning of the study. There was a significant difference in survival between patients who received endocrine therapy and chemo-endocrine therapy (P = 0.0078). That is, survival rate was superior for the chemoendocrine therapy patients throughout the entire follow-up period. These data suggest that early chemo-endocrine therapy containing Cisplatin, with or without maintenance chemotherapy, is a potentially effective treatment for newly diagnosed metastatic prostate cancer and is worth further investigation via a randomized trial. 相似文献
62.
A CASE OF METASTATIC YOLK SAC TUMOR OF TESTIS IN A CHILD 总被引:1,自引:0,他引:1
Akito Terai Satoshi Ishitoya Takayuki Hashimura Hideo Takeuchi Osamu Yoshida 《International journal of urology》1995,2(2):135-138
We report a case of testicular yolk sac tumor in a child aged 3 years and 6 months with multiple bulky metastases to lung and retroperitoneum (stage 11182). After three courses of chemotherapy with a PV 8 regimen (cisplatin, vinblastine and bleomycin). complete and partial responses were obtained for lung and retroperitoneal lymph node metastases, respectively. The patient was followed-up closely. However, on the basis of a re-elevated alpha-letoprotein (AFP) after 4 months' follow-up, he was treated with three courses of salvage chemotherapy with a modified VAB-6 regimen (cyclophosphamide. etoposide. actinomycin D, bleomycin and cisplatin), lollowed by retroperitoneal lymph node dissection. Histologically, only necrotic tissue was found. There is no evidence of recurrence 24 months after lymphadenectomy. There is very little information in the literature on the appropriate management of postchemotherapy residual mass in pediatric testicular tumors. 相似文献
63.
Primary leiomyosarcoma of the thyroid gland 总被引:1,自引:0,他引:1
Osamu Ozaki Kiminori Sugino Takashi Mimura Kunihiko Ito Seiichi Tamai Yasuhiro Hosoda 《Surgery today》1997,27(2):177-180
Primary leiomyosarcoma of the thyroid gland is extremely rare, and to the best of our knowledge only five well-documented
cases have been reported in the world literature. We herein report a 58-year-old female patient with primary leiomyosarcoma
of the thyroid who was successfully treated by total thyroidectomy with a modified neck dissection. Immunohistochemically,
the tumor cells showed positive reactivity to α-smooth muscle actin and vimentin. Radical surgery was thus considered to be
essential in the treatment of this rare but rather aggressive malignancy. 相似文献
64.
Shunya Shindo Kouji Ogata Seiichiro Katahira Keiji Iyori Tadao Ishimoto Masahiro Kobayashi Osamu Suzuki Kihachiro Kamiya Yusuke Tada 《Surgery today》1997,27(1):76-79
Delayed manifestation of aortic stenosis caused by abdominal blunt trauma is rare. We report herein the case of a 67-year-old man who was taken to a nearby hospital after being crushed between a heavy truck and a wall. An emergency laparotomy was performed, revealing only a mesenteric tear which was repaired. He was discharged after an uneventful postoperative course; however, 1 month later he began to experience intermittent claudication, and presented to our hospital in December 1994, 1 year after the first operation. Angiography and enhanced computed tomography (CT) demonstrated infrarenal abdominal aortic dilatation with distal stenosis. Both the dilated and stenotic lesions were resected and bypass surgery was performed. Pathologic examination demonstrated that the intima had been lacerated circumferentially and everted distally, causing the aortic stenosis. To our knowledge, this is the first case of the delayed manifestation of traumatic aortic stenosis to be documented in Japan. The etiology of this rare complication of blunt trauma is described in this report. 相似文献
65.
Akiomi Ogawa Masahiro Takano Kouichi Takagi Osamu Tokunaga Kohji Miyazaki 《Surgery today》1997,27(12):1167-1169
We describe herein a rare case of primary malignant melanoma of the rectum in an 85-year-old woman. The patient presented
with intermittent rectal bleeding, and a colonoscopy revealed an ulcerated polypoid mass in the rectum, located 5 cm from
the anal verge. The lesion was histologically characterized by solid growths of small round cells with scanty cytoplasm and
prominent nucleoli. Although no melanin pigment was found in the tumor cells, they were immunohistochemically positive for
HMB-45, a monoclonal antibody highly specific for malignant melanoma. Thus, HMB-45 proved very useful to establish a diagnosis
of amelanotic malignant melanoma of the rectum. 相似文献
66.
Hajime Kazamatsuri M.D. Tetsuya Hirose M.D. Osamu Kanno M.D. Nobumasa Kato M.D. Hiromoto Yasuda 《Psychiatry and clinical neurosciences》1994,48(4):869-879
Abstract: Two autopsied female sibling cases of sudanophilic leukodystrophy are reported. Case A and case B were the second and third of seven siblings, and a sister and a brother died from severe progressive neurological disease with similar symptoms. Consanguineous marriages were noted in the family of both cases through the past three generations. Case A gradually developed intellectual deterioration and tetraplegia at the age of 29, progressed to akinetic mutism within one year and thereafter survived for 14 years. Neuropathologically, a severe atrophy and degeneration were noted in the white matter of the whole cerebrum, sparing the subcortical U-fibers. Myelin and axons were severely damaged with peripheral astrocytic gliosis. Case B developed similar clinical symptoms at the age of 20 and survived for 7 years in the state of akinetic mutism. Similar postmortem findings as those of case A were found in the white matter of the cerebrum with formation of sudanophilic breakdown products and with thick fibrillary gliosis. The pyramidal tract was completely degenerated. There was no accumulation of abnormal lipid in the brains of both cases. 相似文献
67.
Yoshimi Otani Ichiro Yoshida Satoshi Ohki Motoi Kano Osamu Kawashima Masao Suzuki Yasushi Sato Toru Takahashi Akio Ohtaki Susumu Ishikawa Yasuo Morishita 《Surgery today》1997,27(9):812-815
Pulmonary aspergillosis associated with old tuberculosis is generally resistant to treatment. Thus, if patients are treated
only with conservative therapy, their condition continues to deteriorate due to repetitive hemoptysis, and may even become
critical. Surgical treatment is required for these patients; however, it is extremely difficult to resect the lesion due to
severe adhesions to the chest wall and vascular proliferation surrounding the lesion. We performed preoperative arterial embolization,
achieving good results in three patients with hemoptysis caused by pulmonary aspergillosis. The feeding arteries were embolized
using microcoils and/or gelatin sponges, and a lobectomy was safely carried out in all patients. We concluded that preoperative
arterial embolization is a safe and effective technique to prevent massive hemorrhage occurring at the time of surgery.
This work was presented at the 11th Annual Meeting of the Japanese Association for Chest Surgery, held in Kyoto, Japan, May
13–14, 1994 相似文献
68.
Yasunori Utsunomiya Toshiyuki Imasawa Aya Abe Keita Hirano Tetsuya Kawamura Ryuji Nagasawa Tetsuya Mitarai Naoki Maruyama Osamu Sakai 《Clinical and experimental nephrology》1997,1(2):83-91
Background The purpose of this study was to examine the effects of bacterial suporantigens, which can derange the immune response and
contribute to the renal lesions of immunoglobulin A (lgA) nephropathy.
Methods Twenty-five micrograms of a bacterial superantigen, staphylococcal enterotoxin B (SEB), was injected into IgA nephropathy-prone
ddY mice intrathymically when they reached 6 weeks of age. Evaluation included measurement of albumin excretion in urine,
immunoglobulin concentration, and lymphokine production in vitro, as well as analysis of T-cell receptor expression in splenic
T-cell subsets and examination of renal histology by light and fluorescence microscopy.
Results At 40 weeks of age, the serum level of IgA in these mice was substantially increased and the number of Vβ8+ CD4+splenic T-cells was significantly decreased compared with measurements in untreated controls. Both control and SEB-treated
mice excreted less than 30 μg/mL of urinary albumin. In mice given SEB, the amount of interleukin 2 (IL-2) and tumor necrosis
factor-α (T helper 1 [Th1]-type cytokines) produced by the in vitro-stimulated lymphocytes significantly decreased. whereas
that of interleukin 4 (IL-4) and interleukin 6 (IL-6) (Th2-type cytokines) markedly increased compared with measurements in
control mice. At 40 weeks of age, mice given SEB showed marked glomerular hypercellularity and enhanced glomerular C3 deposition
by renal histology, compared with control mice.
Conclusion These results suggest that bacterial superantigen SEB may modify glomerular lesions through activating Th2 cells, while inducing
deletion of Th1 cells in this experimental model. 相似文献
69.
Toshimichi Hasegawa Yuko Tazuke Yasuhiro Iwasaki Osamu Monta Junichi Sumimura Hiroshi Koyama Toru Dezawa 《Surgery today》1997,27(12):1191-1194
We report herein the case of a premature infant with esophageal atresia (EA) and a tracheoesophageal fistula (TEF) associated
with cardiac anomalies who was successfully treated by an early ligation of the TEF following gastrostomy, and delayed repair
of the esophagus. A 1212-g male was born prematurely at 31 gestational weeks, at which time he was diagnosed as having EA
with TEF and patent ductus arteriosus (PDA), ventricular septal defect (VSD), and atrial septal defect (ASD). A gastrostomy
was initially performed but following extubation he gradually became tachypneic. A chest roentogenogram revealed atelectasis
and ground-glass appearance, and reintubation was required. Ligation of the TEF was performed 53h after his birth. Following
the improvement of his respiratory condition through ventilatory support and the intratracheal administration of pulmonary
surfactant, he underwent repair of the esophagus on the 6th day of life. Postoperatively, he suffered from heart failure,
but was treated with peritoneal dialysis and pharmacological closure of the PDA. Weaning the infant from the ventilator proved
difficult, but it was finally achieved when he had reached a weight of 2268g at 3 months of age by enteral feeding. Our experience
of this case demonstrates that early ligation of TEF should be performed for a premature infant with EA and TEF before respiratory
distress syndrome (RDS) has developed. If a gastrostomy is required to prevent gastric distention, it should be followed by
simultaneous or immediate ligation of the TEF. 相似文献
70.
A patient, an 80-year-old female, had complained of a cough for 20 weeks, and was not cured by cough medicine. Gastroesophageal reflux was considered as the cause of the cough because of her symptoms and gastrointestinal fiberscopy (GIF) and barium meal studies. She made favorable progress on a histamine H2 blocker and cysapurid for 4 weeks. Therefore we diagnosed her cough as caused by gastroesophageal reflux. We also studied the incidence of chronic persistent cough in patients suspected of gastroesophageal reflux because of symptoms and GIF results. Among 676 cases examined by GIF at Niigata-kenritsu Myoko Hospital, we detected 7 cases who complained of heartburn and in whom we observed hiatal hernia and reflux esophagitis by GIF. Only one of them, the present case, complained of a cough. CPC caused by gastroesophageal reflux is not seen frequently, but the possibility of GER as the cause of CPC should be considered. 相似文献