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1.
IJU Case Rep ; 6(6): 454-457, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37928305

RESUMO

Introduction: Urethral hemangioma is an extremely rare occurrence and is not typically considered a common cause of hematuria. Since 2000, only 22 male cases have been reported. Case presentation: A 45-year-old man presented with recurrent painless gross hematuria and the passage of blood clots after ejaculation. The patient underwent a transurethral resection of a 6-mm hemangioma. This isolated sessile lesion was situated between the distal end of the verumontanum and the external sphincter, following an induced erection. The patient remained asymptomatic during the 1-month follow-up visit. Conclusion: This study included the assessment of patient symptoms, diagnoses, and treatments and the literature review of 22 patients. We propose that relaxation of the external urethral sphincter muscle under general anesthesia and artificially inducing an erection can aid in the identification of urethral hemangiomas near the verumontanum during cystourethroscopy.

2.
Asian J Urol ; 10(2): 158-165, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36942115

RESUMO

Objective: We evaluated whether the blood parameters before prostate biopsy can diagnose prostate cancer (PCa) and clinically significant PCa (Gleason score [GS] ≥7) in our hospital. Methods: This study included patients with increased prostate-specific antigen (PSA) up to 20 ng/mL. The associations of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) alone or with PSA with PCa and clinically significant PCa were analyzed. Results: We included 365 patients, of whom 52.9% (193) had PCa including 66.8% (129) with GS of ≥7. PSA density (PSAD) and PSA had better the area under the curve (AUC) of 0.722 and 0.585, respectively with p=0.001 for detecting PCa compared with other blood parameters. PSA combined with PLR (PsPLR) and PSA with NLR (PsNLR) had better AUC of 0.608 and 0.610, respectively with p<0.05, for diagnosing GS≥7 population, compared with PSA, free/total PSA, NLR, PLR, and PsNPLR (PSA combined with NLR and PLR). NLR and PLR did not predict PCa on multivariate analysis. For GS≥7 cancer detection, in the multivariate analysis, separate models with PSA and NLR (Model 1: PsNLR+baseline parameters) or PSA and PLR (Moder 2: PsPLR+baseline parameters) were made. Baseline parameters comprised age, digital rectal exam-positive lesions, PSA density, free/total PSA, and magnetic resonance imaging. Model 2 containing PsPLR was statistically significant (odds ratio: 2.862, 95% confidence interval: 1.174-6.975, p=0.021) in finding aggressive PCa. The predictive accuracy of Model 2 was increased (AUC: 0.734, p<0.001) than that when only baseline parameters were used (AUC: 0.693, p<0.001). Conclusion: NLR or PLR, either alone or combined with PSA, did not detect PCa. However, the combined use of PSA with PLR could find the differences between clinically significant and insignificant PCa in our retrospective study limited by the small number of samples.

3.
BMC Cancer ; 22(1): 1214, 2022 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-36434552

RESUMO

BACKGROUND: The association between the combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR) at the time of adverse events during sunitinib treatment and prognosis is unclear, and prognostic models combining the prognostic factors of sunitinib have not been well studied. Thus, we developed a prognostic model that includes the COP-NLR to predict the prognosis of patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib. METHODS: We performed a retrospective cohort study of 102 patients treated with sunitinib for mRCC between 2008 and 2020 in three hospitals associated with Showa University, Japan. The primary outcome was overall survival (OS). The collected data included baseline patient characteristics, adverse events, laboratory values, and COP-NLR scores within the first 6 weeks of sunitinib treatment. Prognostic factors of OS were analyzed using the Cox proportional hazards model. The integer score was derived from the beta-coefficient (ß) of these factors and was divided into three groups. The survival curves were visualized using the Kaplan-Meier method and estimated using a log-rank test. RESULTS: The median OS was 32.3 months. Multivariable analysis showed that the number of metastatic sites, Memorial Sloan Kettering Cancer Center risk group, number of metastases, non-hypertension, modified Glasgow Prognostic Score, and 6-week COP-NLR were significantly associated with OS. A higher 6-week COP-NLR was significantly associated with a shorter OS (p < 0.001). The ß values of the five factors for OS were scored (non-hypertension, mGPS, and 6-week COP-NLR = 1 point; number of metastatic sites = 2 points; MSKCC risk group = 3 points) and patients divided into three groups (≤ 1, 2-3, and ≥ 4). The low-risk (≤ 1) group had significantly longer OS than the high-risk (≥ 4) group (median OS: 99.0 vs. 6.2 months, p < 0.001). CONCLUSIONS: This study showed that the COP-NLR within the first 6 weeks of sunitinib treatment had a greater impact on OS than the COP-NLR at the start of sunitinib treatment. The developed prognostic model for OS, including the 6-week COP-NLR, will be useful in decision-making to continue sunitinib in the early treatment stage of patients with mRCC.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Carcinoma de Células Renais/patologia , Sunitinibe , Prognóstico , Neutrófilos/patologia , Contagem de Plaquetas , Neoplasias Renais/patologia , Estudos Retrospectivos , Contagem de Linfócitos , Linfócitos/patologia
4.
IJU Case Rep ; 5(2): 92-94, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35252787

RESUMO

INTRODUCTION: Patients with metastatic urothelial carcinoma have poor prognosis and limited treatment options. CASE PRESENTATION: The patient was a 60-year-old male with bladder cancer and multiple lung metastases. He underwent three courses of gemcitabine and cisplatin chemotherapy, despite left femoral bone metastases. Tumor resection and bone replacement surgery was performed. Following the administration of four courses of pembrolizumab, lung metastasis completely resolved. However, after nine courses, right femoral neck bone metastasis was observed; therefore, tumor resection and bone replacement surgery were repeated. Pathologically, PD-L1 expression was low in lung biopsy tissue and bone metastases. Pembrolizumab treatment continued for up to 20 courses; cancer recurrence and adverse events were not observed upon follow-up examination after 1 year. CONCLUSION: Patients responding well to systemic therapy may have resectable metastatic sites, and long-term survival might be achieved with adjunctive metastasectomy. The effect of pembrolizumab was not associated with positive PD-L1 expression.

5.
BMC Urol ; 21(1): 120, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479520

RESUMO

BACKGROUND: We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use. CASE PRESENTATION: A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Testicular tumor markers were negative; syphilis test was positive. Radiological examination suggested aortitis and bilateral testicular malignancy. The patient received ampicillin for the infection and prednisolone for vasculitis. Left orchidectomy was performed to confirm the presence of testicular tumor; histological examinations revealed granulomatous orchitis. The prednisolone doses were adjusted because of relapses and adverse effects of steroid use. Unfortunately, the patient died in the intensive care unit because of uncontrolled blood pressure and pneumonia. CONCLUSIONS: This is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness.


Assuntos
Insuficiência Adrenal/induzido quimicamente , Anti-Inflamatórios/efeitos adversos , Orquite/diagnóstico , Prednisolona/efeitos adversos , Vasculite/diagnóstico , Ampicilina/uso terapêutico , Angiografia , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Edema/diagnóstico por imagem , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Órbita/patologia , Orquite/tratamento farmacológico , Orquite/patologia , Neoplasias Testiculares/diagnóstico , Testículo/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Vasculite/tratamento farmacológico , Vasculite/patologia
6.
ACS Omega ; 6(28): 18135-18156, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34308046

RESUMO

A distinctive method for synthesizing a variety of multisubstituted α-arylnaphthalenes utilizing novel regiocontrolled ipso-type [4 + 2] benzannulation is presented. Ortho- and para-substituted 1-Ar1-1-Ar2-2,2-dichlorocyclopropylmethanols (AACM) were transformed to the corresponding ipso-type α-arylnaphthalenes. (i) The reaction of ortho-AACM using TiCl4 or SnCl4 (1.0 equiv) proceeded smoothly to afford ipso-type α-arylnaphthalenes (seven examples; 49-69% yield) exclusively, without producing conventional benzannulation isomers. (ii) Para-AACM also underwent the reaction successfully to afford the desired ipso-type α-arylnaphthalenes (14 examples; 39-98% yield) without producing conventional benzannulation isomers. (iii) In contrast, meta-AACM underwent the previously reported conventional benzannulation. (iv) The present method exhibited sufficient substrate generality for application to ortho- and para-substituted AACM substrates bearing Me-, Cl-, and MeO- groups. (v) The six key structures were unambiguously confirmed by X-ray structure analyses. (vi) A plausible reaction mechanism for the present ipso-type reaction is proposed and supported by three careful cross-over and comparable experiments. To demonstrate the utility of the present reaction, we achieved the first total synthesis of chaihunaphthone, a uniquely (highly congested) substituted and less accessible natural lignan lactone with three contiguous trimethoxy substituents (total eight steps, overall 6.4% yield).

7.
J Surg Case Rep ; 2021(4): rjab092, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33854760

RESUMO

We present a case of lung adenocarcinoma metastasizing to the right clear cell renal cell carcinoma diagnosed by computed tomography (CT)-guided renal biopsy and immunohistochemistry. A 72-year-old male patient had right lower abdominal pain for 3 days, followed by right loin pain for 10 days. On CT scan, renal cell cancer was suspected with multiple metastases. Renal cell cancer with metastatic lung adenocarcinoma was diagnosed on CT-guided renal biopsy with positive immunohistochemical markers. The patient, unfortunately, expired after few days of diagnosis. Tumor-to-tumor metastasis is an unusual disease, and its tumors are aggressive. A definite diagnosis of tumor-to-tumor metastasis is a clinical challenge. Immunohistochemistry helped us in the diagnosis without the primary lesion biopsy.

8.
Polymers (Basel) ; 13(5)2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33803487

RESUMO

Achieving multiple physical properties from a single material through three-dimensional (3D) printing is important for manufacturing applications. In addition, industrial-level durability and reliability is necessary for realizing individualized manufacturing of devices using 3D printers. We investigated the properties of architected materials composed of ultraviolet (UV)-cured urethane elastomers for use as insoles. The durability and reliability of microlattice and metafoam architected materials were compared with those composed of various foamed materials currently used in medical insoles. The hardness of the architected materials was able to be continuously adjusted by controlling the design parameters, and the combination of the two materials was effective in controlling rebound resilience. In particular, the features of the architected materials were helpful for customizing the insole properties, such as hardness, propulsive force, and shock absorption, according to the user's needs. Further, using elastomer as a component led to better results in fatigue testing and UV resistance compared with the plastic foam currently used for medical purposes. Specifically, polyethylene and ethylene vinyl acetate were deformed in the fatigue test, and polyurethane was mechanically deteriorated by UV rays. Therefore, these architected materials are expected to be reliable for long-term use in insoles.

9.
Radiol Case Rep ; 16(4): 903-905, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33598063

RESUMO

Segmental testicular infarction is a rare condition. Patients present with clinical features similar to torsion and testicular tumors, with most undergoing surgery. A 55-year-old male patient presented with left scrotal pain. We did a Doppler ultrasonogram and magnetic resonance imaging to diagnose his condition and rule out testicular torsion and tumor. We decided not to operate and asked the patient for follow-up. There was no pain in the left testis, and magnetic resonance imaging showed a reduction in the left testicular lesion after 4 months.

10.
Urol Case Rep ; 34: 101518, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33318940

RESUMO

Castleman's disease (CD) is a unique lymphoproliferative disorder. It commonly occurs in the mediastinum, neck, axilla, and abdomen, and retroperitoneal involvement is rare. Here we report a unique case of CD in the pelvis. Laparotomy was performed and surgery was complicated by adhesions and vascularity. Total surgical duration was Five hours and 45 min with 4.5 L of blood loss. Ten pints of blood was transfused. The mass was histopathologically diagnosed as hyaline-vascular CD. The patient was free of recurrence after 10 years of follow-up.

11.
Psychiatry Res ; 295: 113565, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33221021

RESUMO

Seven years after the Great East Japan Earthquake, we investigated telomeres as a potential biomarker of maternal chronic stress in children according to the timing of exposure to the disaster. The subjects were children aged 5-9 years living in Rikuzentakata, Japan. Relative telomere length (rTL) was measured with PCR in saliva samples. The partial regression coefficient of the rTL was significantly shorter in the group of children conceived after the disaster than in the children who were in utero on the day of the disaster. Telomere length should be investigated as a biomarker for assessing disaster-related trauma in future studies.


Assuntos
Terremotos , Exposição Ambiental/efeitos adversos , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/genética , Estresse Psicológico/genética , Encurtamento do Telômero/genética , Adulto , Biomarcadores , Criança , Pré-Escolar , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Desastres Naturais , Reação em Cadeia da Polimerase , Gravidez , Saliva/química , Estresse Psicológico/metabolismo , Encurtamento do Telômero/efeitos da radiação , Fatores de Tempo
12.
Polymers (Basel) ; 12(11)2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33187211

RESUMO

The critical phenomena of double percolation on polybutadiene (PB)/polyethylene glycol (PEG) blends loaded with poly-3-hexylthiophene (P3HT) nanofibers is investigated. P3HT nanofibers are selectively localized in the PB phase of the PB/PEG blend, as observed by scanning force microscopy (SFM). Moreover, double percolation is observed, i.e., the percolation of the PB phase in PB/PEG blends and that of the P3HT nanofibers in the PB phase. The percolation threshold (φcI) and critical exponent (tI) of the percolation of the PB phase in PB/PEG blends are estimated to be 0.57 and 1.3, respectively, indicating that the percolation exhibits two-dimensional properties. For the percolation of P3HT nanofibers in the PB phase, the percolation threshold (φcII) and critical exponent (tII) are estimated to be 0.02 and 1.7, respectively. In this case, the percolation exhibits properties in between two and three dimensions. In addition, we investigated the dimensionality with respect to the carrier transport in the P3HT nanofiber network. From the temperature dependence of the field-effect mobility estimated by field-effect transistor (FET) measurements, the carrier transport was explained by a three-dimensional variable range hopping (VRH) model.

13.
Turk J Urol ; 46(6): 449-454, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33052831

RESUMO

OBJECTIVE: This study aimed to assess the relationship of the prostate cancer and Gleason scores (GSs) or ISUP Grade system with prostate volume (PV) as assessed by magnetic resonance imaging (MRI) cognitive biopsy and standard biopsy. MATERIAL AND METHODS: Data were collected from 659 patients who underwent MRI cognitive biopsy and standard biopsy from January 2014 to January 2018. The biopsies were performed because of increased prostate-specific antigen (PSA) levels (>4 ng/mL) and/or abnormal digital rectal examination findings. Transrectal ultrasound was used to measure PV. RESULTS: Prostate cancer detection rates in patients with increased PVs of ≤40 cc and >40 cc were 68.8% and 51.6% (p<0.001), respectively. ISUP Grade group ≥2 (Gleason score ≥3+4) detection rates for increased PVs of ≤40 cc and >40 cc were 68% and 73%, and 22.3% and 37.8%, respectively, for those with ISUP Grade group ≥4 (Gleason score ≥8) (p=0.003). Among the patients with PV>40 cc, univariate logistic regression showed a significant relationship between ISUP Grade group ≥2 and PSA, free/total PSA, PSA density, and MRI (p<0.05). On multivariable logistic regression, MRI (p=0.014) and PSA (p=0.039) predicted ISUP Grade group ≥2 in patients with PV>40 cc. CONCLUSION: Although the detection rates of prostate cancer decreased as PV increased, the detection of prostate cancer aggressiveness increased as PV increased. This increase in high ISUP Grade lesions with the rise in PV is due to the use of MRI during prostate biopsy with standard biopsy.

14.
Polymers (Basel) ; 12(9)2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32957555

RESUMO

We investigated the electrical properties of a composite film loaded with semi-conductive poly(3-hexylthiophene) (P3HT) nanofibers dispersed in poly(styrene-b-butadiene-b-styrene) (SBS). This structure can be regarded as the hybrid of SBS matrix with elastic mechanical properties and P3HT nanofibers with semiconducting properties. The P3HT nanofibers were embedded in the fingerprint pattern of microphase-separated SBS, as observed by scanning force microscopy. Furthermore, the electrical conductivity and field-effect mobility of the composite films were evaluated. The field-effect mobility was estimated to be 6.96 × 10-3 cm2 V-1 s-1, which is consistent with the results of previous studies on P3HT nanofibers dispersed in an amorphous polymer matrix including poly(methyl methacrylate) and polystyrene, and we found that the P3HT nanofiber network was connected in the SBS bulk matrix. The film was stretchable; however, at elongation by two times, the nanofiber network could not follow the elongation of the SBS matrix, and the conductivity decreased drastically. The field-effect transistor of this film was operated by bending deformation with a radius of curvature of 1.75 cm, though we could not obtain an off-state and the device operated in a normally-on state.

15.
Int J Implant Dent ; 6(1): 31, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32607761

RESUMO

BACKGROUND: Excessive loading from the occlusion is known as a major pathological factor in implant failure. The force applied to the implant varies depending on the positional relationship to an opposing tooth in clinical cases. However, no studies have clarified the relationship between the discrepancy and mechanical complications. MATERIALS AND METHODS: The study enrolled patients whose mandibular first molar was missing and was opposed by a natural maxillary first molar. The horizontal and vertical distance between the residual ridge and the occlusal surface of the maxillary first molar were measured from computerized tomograms. Subsequently, four finite element models were constructed in combinations of horizontal and vertical discrepancies. Additionally, the effect of inclined implantation and angled abutments were examined in a large clearance model. Maximum von Mises stress values generated in abutments under 90° or 60° loading vectors were compared with a three-dimensional finite element method. RESULTS: Data from 123 subjects (39 males and 84 females, average age 55.2 ± 11.4 (SD) years) were collected for the analyses. Under all conditions, the stress on the load side (the buccal side) was concentrated on the platform, and the stress on the opposite side (the lingual side) was concentrated on the top of the abutment tube inserted into the implant. In comparison to 90° loading vectors, the maximum von Mises stresses of each model were 1.20 to 2.67 times under 60° loading vectors. For inclined implantation, the maximum stress was 8.4% less at a 90° load and 9.7% less at a 60° load compared with vertical implantation. With angled abutments, the maximum stress was 15.7% less at a 90° load and 30.0% less at a 60° load compared with vertical implantation. CONCLUSION: In cases of progressive alveolar resorption with a large clearance between the implant and the opposing teeth, a higher stress concentration was observed at the joint between the implant and the abutment. Our findings also showed that stress concentration around this area can be reduced by the use of inclined implantation and angled abutments under the condition of a horizontal offset between the implant and opposing teeth.

16.
Diagnostics (Basel) ; 10(3)2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32168745

RESUMO

BACKGROUND: The AR-V7 splice variant is a cause of castration-resistant prostate cancer (CRPC). However, testing for the presence of AR-V7 by real-time polymerase chain reaction (RT-PCR) shows AR-V7 positivity in healthy individuals. We hypothesized that the positivity reflects contamination by hematopoietic cells. We tried a novel circulating tumor cell (CTC) enrichment instrument, using Celsee, to clear hematopoietic cells. METHODS: We tested whole blood or Celsee-enriched samples for AR-V7 by RT-PCR, and included samples from 41 CRPC patients undergoing sequential therapy. We evaluated the associations between AR-V7 status and clinical factors. We evaluated factors affecting AR-V7 positivity. RESULTS: AR-V7 positivity was lower in Celsee-enriched than in whole blood specimens. AR-V7 and clinical factors did not predict the therapy effectiveness. We found no significant differences in the effectiveness of enzalutamide/abiraterone (Enz/Abi) upon AR-V7 evaluation. All AR-V7 positive patients had resistance to Enz/Abi. Docetaxel (DTX), cabazitaxel (CBZ), and Radium223 treatment showed no significant difference in the treatment effectiveness, regardless of AR-V7 presence. AR-V7 was more frequently positive than Extent of disease (EOD) 2 in cases with bone metastases. CONCLUSION: Celsee CTC enrichment suppresses AR-V7 false positivity. All AR-V7 positive patients presented resistance to Enz/Abi. DTX, CBZ, and Radium223 were effective and remain treatment options. AR-V7 positivity should progressively appear in patients with advanced bone metastases.

17.
Diagnostics (Basel) ; 9(3)2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31416266

RESUMO

PURPOSE: Liquid biopsy is becoming increasingly important as a guide for selecting new drugs and determining their efficacy. In urological cancer, serum markers for renal cell and urothelial cancers has made the development of liquid biopsy for these cancers strongly desirable. Liquid biopsy is less invasive than conventional tissue biopsy is, enabling frequent biopsies and, therefore, is considered effective for monitoring the treatment course. Circulating tumor cells (CTCs) are a representative liquid biopsy specimen. In the present study, we focused on developing our novel technology for capturing renal cell cancer (RCC)-CTCs using an anti-G250 antibody combined with new devices. Basic experiments of our technology showed that it was possible to detect RCC-CTC with a fairly high accuracy of about 95%. Also, RCC-CTC was identified in the peripheral blood of actual RCC patients. Additionally, during the treatment course of the RCC patient, change in the number of RCC-CTC was confirmed in one case. We believe that the technology we developed will be useful for determining the treatment efficacy and drug selection for the treatment of renal cell cancer (RCC). In order to solve issues such as thresholds setting of this technology, large-scale clinical trials are expected.

18.
Cancer Treat Res Commun ; 17: 23-30, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30326420

RESUMO

BACKGROUND: Upper urinary tract neuroendocrine carcinoma (UUT-NEC) is extremely rare and has a poor prognosis. Although a few cases of successful treatment have been reported, no treatment has shown established efficacy. PATIENTS AND METHODS: We analyzed 70 UUT-NEC patients, including 68 with small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC) reported between 1985 and 2017 and 2 treated at our hospital. RESULTS: Median patient age was 66 years, 58.6% were men, and 60% were of Asian descent. Most UUT-NECs were SCNEC (68; 95.7%), whereas LCNEC was very rare (2; 2.9%). More than half of the patients had accompanying other histological components, the most common being urothelial carcinoma (51.5%), whereas 41.4% had NEC alone. Of the 70 patients, 27 underwent additional therapy (e.g., chemotherapy and radiotherapy) along with surgery. Median survival was 15 months. In univariate analysis, stages T1-2 disease showed better prognosis than stages T3-4 (P < 0.001). Additional treatment (e.g., chemotherapy and radiotherapy) significantly improved prognosis (P = 0.014). Moreover, platinum-based chemotherapy also was associated with improved prognosis (P = 0.017). For platinum-based chemotherapy, multicollinearity with additional treatments was strong, and, thus, these data were not included in the analysis. Multivariate analysis revealed pathological stage (T1-2 vs. T3-4; P = 0.003) and additional treatment (P = 0.028) to be independent predictors of improved prognosis. CONCLUSION: Although UUT-NEC has a poor prognosis, additional treatment along with surgery and therapeutic intervention and stage T1-2 disease are independent factors to improve prognosis.


Assuntos
Carcinoma de Células Grandes/tratamento farmacológico , Carcinoma Neuroendócrino/tratamento farmacológico , Carcinoma de Células Pequenas/tratamento farmacológico , Neoplasias Renais/tratamento farmacológico , Neoplasias Ureterais/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Grandes/mortalidade , Carcinoma Neuroendócrino/mortalidade , Carcinoma de Células Pequenas/mortalidade , Evolução Fatal , Feminino , Humanos , Neoplasias Renais/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Ureterais/mortalidade
19.
Intern Med ; 56(13): 1733-1737, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28674368

RESUMO

We report a case of a 72-year-old woman who initially presented with symptoms of bulbar myasthenia and was positive for anti-acetylcholine receptor antibodies. She subsequently developed painful muscle spasms, myoclonus, and stiffness. Thymoma was detected, and both anti-glycine receptor and anti-glutamic acid decarboxylase antibodies were found. She was diagnosed with thymoma-associated progressive encephalomyelitis with rigidity and myoclonus (PERM). She experienced marked improvement after thymectomy followed by plasma exchange and intravenous immunoglobulin and prednisolone. This case suggests that thymectomy followed by sufficient immunosuppression may be useful in the treatment of thymoma-associated PERM. Myasthenia gravis may develop in thymoma-associated PERM patients.


Assuntos
Encefalomielite/complicações , Encefalomielite/diagnóstico , Rigidez Muscular/complicações , Rigidez Muscular/diagnóstico , Timoma/complicações , Timoma/diagnóstico , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico , Idoso , Autoanticorpos , Diagnóstico Diferencial , Encefalomielite/terapia , Feminino , Glutamato Descarboxilase/imunologia , Humanos , Rigidez Muscular/terapia , Miastenia Gravis/complicações , Receptores de Glicina , Timectomia , Timoma/terapia , Neoplasias do Timo/terapia
20.
BioDrugs ; 30(1): 17-25, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26691837

RESUMO

BACKGROUND: DMB-3111 is a biosimilar trastuzumab drug being jointly developed by Meiji Seika Pharma (Japan) and Dong-A Socio Holdings (Korea). We investigated the bioequivalence of DMB-3111 relative to trastuzumab. OBJECTIVES: The aim of this study was to investigate the bioequivalence between DMB-3111 and trastuzumab and the pharmacokinetic, safety, and immunogenicity of both drugs in healthy Japanese adult males. METHODS: Seventy healthy Japanese adult males were randomized 1:1 to receive either DMB-3111 or trastuzumab as a single intravenous infusion (6 mg/kg) over 90 min. Bioequivalence was assessed in terms of the pharmacokinetic parameters of both drugs. Adverse events (AEs) were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Immunogenicity was tested using anti-drug antibody (ADA) assays. RESULTS: The 90% confidence intervals of the treatment differences (DMB-3111 versus trastuzumab) in the mean log-transformed maximum concentration, the area under the concentration-time curves (from 0 min to the last measured value or from 0 min to infinity), mean residence time, and the terminal half-life were within the accepted range for bioequivalence [log(0.80) to log(1.25)]. The frequencies of AEs and adverse drug reactions were similar with both drugs. No ADA reactivity to DMB-3111 or trastuzumab was observed in any subject. CONCLUSIONS: DMB-3111, a trastuzumab biosimilar, was bioequivalent to trastuzumab in terms of its pharmacokinetics and showed similar safety after a single intravenous infusion at 6 mg/kg over 90 min in healthy Japanese adult males. DMB-3111 is likely to show similar efficacy and safety profiles to trastuzumab in cancer patients (ClinicalTrials.gov #NCT02100917).


Assuntos
Antineoplásicos/administração & dosagem , Medicamentos Biossimilares/administração & dosagem , Trastuzumab/administração & dosagem , Adulto , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacocinética , Área Sob a Curva , Povo Asiático , Medicamentos Biossimilares/efeitos adversos , Medicamentos Biossimilares/farmacocinética , Método Duplo-Cego , Seguimentos , Meia-Vida , Humanos , Infusões Intravenosas , Masculino , Equivalência Terapêutica , Trastuzumab/efeitos adversos , Trastuzumab/metabolismo , Adulto Jovem
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