[A case of colonic adenocarcinoma incidentally occurring in an Indiana pouch].

We present a rare case of colonic adenocarcinoma occurring in an Indiana pouch. A 68-year-old man underwent radical cystectomy with Indiana pouch urinary diversion for the treatment of bladder cancer 16 years ago. He was referred to our hospital for the treatment of a right staghorn stone, left renal stone, and pouch stones. Cystoscopic findings showed a 10×10 mm tumor distal to ureter anastomosis. Under the diagnosis of colonic adenocarcinoma in an Indiana pouch, tumor and stones were successfully removed. Adenocarcinoma occurrence after ureterosigmoidostomy is well-known. However, diagnosis of adenocarcinoma in an Indiana pouch is extremely rare.

[A case of inverted urothelial carcinoma of bladder].

We present a case of inverted urothelial carcinoma of the bladder. A 60-year-old male was referred to our hospital for bilateral ureteral stones. When transurethral ureterolithotripsy was performed to treat these stones, a tumor at the trigone of bladder was incidentally diagnosed. This tumor was pedunculated and its surface was not uniformly round. After the operation, this tumor was diagnosed as inverted urothelial carcinoma through the histopathologic examination. The patient was subsequently followed up for 6 months and there was no evidence of recurrence. Although this is a rare case, it is worth considering there is an urothelial carcinoma with inverted proliferation.

[Successful gemcitabine-nedaplatin therapy in a hemodialysis patient with ureteral carcinoma after bilateral nephroureterectomy].

A 79-year-old male, who received hemodialysis due to bilateral nephroureterectomy and cysto-prostateurethrectomy. Five months later, an enlarged lymph node was found in the left of inguinal area. Abdominal computed tomography revealed a low density mass from the para-aortic lymph node to the left of inguinal area, suggesting lymph node metastasis of ureteral carcinoma. After 3 cycles of gemcitabinenedaplatin therapy, the size of lymph node metastasis decreased. This is a report of successful treatment of ureteral carcinoma with hemodialysis.

[A case report: Bilharzial schistosomiasis in the urinary bladder presented with gross hematuria].

A 31-year-old Japanese man who had been in Africa for two years presented with gross hematuria. He had been swimming in Lake Malawi during this period. Urinary specimen consisted of hematuria and pyuria. Cystoscopy showed tumors resembling Bilharzial tubercles located in the trigone, left lateral and posterior wall and dome. Further urine examination demonstrated eggs of schistosome haematobium. The patient was highly suspected of having Bilharzial schistosomiasis in the urinary bladder. Transurethral resection of bladder tumors was performed for diagnosis. Pathological examination revealed granuloma with many eggs of schistosome haematobium. He was diagnosed with Bilharzial schistosomiasis and was treated with 3,600 mg of praziquantel daily for two days. There have been no signs of recurrence during the one-year follow up except for excretion of degenerated eggs of schistosome haematobium in the urine specimens.

Thorium-232 exposure during tungsten inert gas arc welding and electrode sharpening.

To assess the exposure of welders to thorium-232 (232Th) during tungsten inert gas arc (TIG) welding, airborne concentrations of 232Th in the breathing zone of the welder and background levels were measured. The radioactive concentrations were 1.11 x 10(-2) Bq/m3 during TIG welding of aluminum (TIG/Al), 1.78 x 10(-4) Bq/m3 during TIG welding of stainless steel (TIG/SS), and 1.93 x 10(-1) Bq/m3 during electrode sharpening, with 5.82 x 10(-5) Bq/m3 background concentration. Although the annual intake of 232Th estimated using these values did not exceed the annual limit intake (ALI, 1.6 x 10(2) Bq), we recommend reducing 232Th exposure by substituting thoriated electrodes with a thorium-free electrodes, setting up local ventilation systems, and by using respiratory protective equipment. It is also necessary to inform workers that thoriated tungsten electrodes contain radioactive material.

Determination of multielements in a typical Japanese diet certified reference material by instrumental neutron activation analysis.

Multielements in a typical Japanese diet certified reference material prepared at the National Institute for Environmental Studies (NIES) of Japan, in collaboration with the National Institute of Radiological Sciences (NIRS) of Japan were determined by instrumental neutron activation analysis (INAA). Five samples (ca. 510-1000 mg) and comparative standards were irradiated for a short time (10 s) at a thermal neutron flux of 1.5 x 10(12) n cm(-2) s(-1) (pneumatic transfer) and for a long time (6 h) at a thermal neutron flux of 3.7 x 10(12) n cm(-2) s(-1) (central thimble) in the Rikkyo University Research Reactor (TRIGA Mark-II, 100 kW). The irradiated samples were measured by conventional gama-ray spectrometry using a coaxial Ge detector, and by anti-coincidence and coincidence gamma-ray spectrometry with a coaxial Ge detector and a well-type NaI(Tl) detector. The concentrations of 38 elements were determined by these methods.

[Prognostic value of serum immunosuppressive acidic protein in renal cell carcinoma].

BACKGROUND: To determine whether the immunosuppressive acidic protein (IAP) could be a useful marker for renal cell carcinoma (RCC), serum IAP levels were compared with clinicopathological features in RCC patients. Furthermore, IAP cutoff level to predict the recurrence was determined using receiver operating characteristics (ROC) curve analysis. PATIENTS AND METHODS: Between January 1994 and December 1998, pretreatment serum IAP was measured in 123 consecutive patients with PCC at Kitasato University Hospital. Ninety-eight patients were received radical surgery and 86 patients were performed as clinically curable renal cell carcinoma (pT1-pT3N0M0). ROC curve analysis was utilized to set the cutoff value of IAP for prediction of cancer recurrence. Significance of prognostic factors in RCC recurrence was analyzed by Cox proportional hazard model. RESULTS: The mean age of the 123 patients was 58.6 years (range 33 to 90, median 59). The mean follow-up period was 24.8 months (range 1 to 78, median 26). The median IAP levels were 447 ug/ml in stage I, 629 ug/ml in stage II, 588 ug/ml in stage III and 1,150 ug/ml in stage IV (p < 0.05). Tumor size and venous involvement were significantly associated with IAP concentrations (p < 0.05). However, tumor grade did not correlate with IAP level. Of 86 patients with clinically curable tumor, 79 patients were disease-free after median follow-up of 27 months. Using ROC curve analysis, IAP cutoff level for prediction of cancer recurrence was set at 620 ug/ml. Disease-free survival rate in patients with preoperative IAP levels of 620 ug/ml or lower was 98.5% (67/68) at 27 months postoperatively, whereas that in patients with IAP greater than 620 ug/ml was 75.0% (12/18). This difference was statistically significant (p < 0.05). Results of multivariate analysis revealed that preoperative IAP and pT stage were statistically significant factors for tumor recurrence after radical surgery (p < 0.05). CONCLUSIONS: The present study indicates that preoperative IAP level is a useful prognostic marker in patients with RCC. In particular, patients with clinically curable tumors (pT1-3N0M0), whose preoperative IAP levels greater then 620 ug/ml may have high risk for recurrence after radical nephrectomy.