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1.
Sci Rep ; 11(1): 17946, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504174

RESUMO

Fluorescence imaging of tumours facilitates rapid intraoperative diagnosis. Thus far, a promising activatable fluorescence probe for hepatocellular carcinoma (HCC) has not been developed. Herein, the utility of the fluorescence imaging of HCC using a ß-galactosidase (ß-Gal)-activatable fluorescence probe SPiDER-ßGal was examined. ß-Gal activity was measured in cryopreserved tissues from 68 patients. Live cell imaging of HCC cell lines and imaging of tumour-bearing model mice were performed using SPiDER-ßGal. Furthermore, fluorescence imaging was performed in 27 freshly resected human HCC specimens. In cryopreserved samples, ß-Gal activity was significantly higher in tumour tissues than in non-tumour tissues. Fluorescence was observed in HCC cell lines. In mouse models, tumours displayed stronger fluorescence than normal liver tissue. In freshly resected specimens, fluorescence intensity in the tumour was significantly higher than that in non-tumour liver specimens as early as 2 min after spraying. Receiver operating characteristic curves were generated to determine the diagnostic value of SPiDER-ßGal 10 min after its spraying; an area under the curve of 0.864, sensitivity of 85.2%, and specificity of 74.1% were observed for SPiDER-ßGal. SPiDER-ßGal is useful for the rapid fluorescence imaging of HCC. Fluorescence imaging guided by SPiDER-ßGal would help surgeons detect tumours rapidly and achieve complete liver resection.

2.
Photodiagnosis Photodyn Ther ; 35: 102420, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34242818

RESUMO

BACKGROUND: Accurate diagnosis of peritoneal metastasis in gastric cancer (GC) is important to determine the appropriate treatment. This study aimed to examine whether matrix metalloprotease-14 (MMP-14) was a candidate enzyme in fluorescence imaging for the diagnosis of peritoneal metastasis in GC. METHODS: GC and normal peritoneal (NP) tissues from 96 and 20 patients, respectively were evaluated for MMP-14 expression. Live cell imaging of GC cell lines (NUGC4, MKN45, MKN74, HGC-27, and Kato-III) was performed using the MMP-14-activatable fluorescence probe; BODIPY-MMP. Furthermore, the overall survival (OS) was calculated in all patients (n = 96). RESULTS: MMP-14 expression was significantly higher in GC tissues (median: 3.57 ng/mg protein; range:0.64-24.4 ng/mg protein) than in NP tissues (median: 1.34 ng/mg protein; median: 0.53-3.09 ng/mg protein) (P < 0.01). Receiver operating characteristic curves showed that the area under the curve, sensitivity, and specificity were 0.907, 84.4%, and 90.0%, respectively. In live cell imaging using the BODIPY-MMP, fluorescence was observed in five GC cell lines. In the analysis of OS, the high expression of the MMP-14 group had a significantly poorer OS rate than the low expression of the MMP-14 group (P = 0.02). In the multivariate analyses, MMP-14 expression was an independent risk factor for OS (hazard ratio: 2.33; 95 % confidence interval: 1.05-5.45; P = 0.04). CONCLUSION: MMP-14 is a promising enzyme in intraoperative fluorescence imaging for peritoneal metastasis in GC, especially in patients with poor prognosis.


Assuntos
Neoplasias Peritoneais , Fotoquimioterapia , Neoplasias Gástricas , Biomarcadores Tumorais , Humanos , Metaloproteinase 14 da Matriz , Neoplasias Peritoneais/diagnóstico por imagem , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Prognóstico , Neoplasias Gástricas/diagnóstico por imagem
3.
Sci Rep ; 11(1): 10664, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-34021168

RESUMO

Diagnosis of peritoneal metastasis in gastric cancer (GC) is essential for determining appropriate therapeutic strategies and avoiding non-essential laparotomy or gastrectomy. Recently, a variety of activatable fluorescence probes that can detect enzyme activities have been developed for cancer imaging. The aim of this study was to identify the key enzyme involved in peritoneal metastasis in GC. The enzymatic activity of gamma-glutamyl transpeptidase, dipeptidyl peptidase IV, and ß-galactosidase (ß-Gal) was assessed in lysates prepared from preserved human GC (n = 89) and normal peritoneal (NP; n = 20) samples. ß-Gal activity was significantly higher in the human GC samples than in NP samples, whereas no differences were observed in the activities of the other enzymes. Therefore, we used SPiDER-ßGal, a fluorescent probe that can be activated by ß-Gal, for imaging GC cell lines, peritoneal metastasis in a mouse model, and fresh human resected GC samples (n = 13). All cell lines showed fluorescence after applying SPiDER-ßGal, and metastatic nodules in the mice gradually developed high fluorescence that could be visualized with SPiDER-ßGal. The human GC samples showed significantly higher fluorescence than NP samples. ß-Gal is a useful target enzyme for fluorescence imaging of peritoneal metastasis in GC.

4.
Oncol Lett ; 20(4): 82, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32863915

RESUMO

5-Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a minimally invasive therapeutic modality used in the management of various cancers, but to a lesser extent for esophageal cancer (EC). The current study investigated the antitumor effects of ALA-PDT. Human EC cells were treated with ALA, after which ALA-induced fluorescence was examined under a fluorescence microscope. The cytotoxic effects of ALA-PDT were assessed using three types of LEDs (blue, green and red) in vitro and in vivo. Subcutaneous tumor model mice was constructed with KYSE150 cells. ALA-PDT was performed once a week for 4 weeks and tumor weights were measured. A popliteal lymph node (PLN) metastasis murine model was generated using KYSE150 cells. KYSE150 cells were inoculated into the left footpad of nude mice. ALA-PDT was performed on the footpad once a week for 4 weeks. PLNs were then removed 3 weeks after the last treatment. The lymph nodes were evaluated by hematoxylin and eosin staining. Red fluorescence of protoporphyrin IX (PpIX) was observed in all EC cell lines. ALA-PDT using LEDs exerted significant antitumor effects in vitro and in vivo. The antitumor effects of ALA-PDT with blue LED were the strongest, followed by green and red LEDs. The number of metastasized PLNs was significantly smaller in the ALA-PDT group (0%) than in the control group (37.5%). The present results indicated that ALA-PDT is effective for EC.

5.
Anticancer Res ; 40(6): 3163-3167, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487611

RESUMO

BACKGROUND/AIM: Ultrasonically activated surgical devices (USADs) have become indispensable instruments for gastrointestinal surgery. In this study, we investigated the oncological safety of the use of USADs. MATERIALS AND METHODS: We harvested and cultivated the splashes and mist scattered from an USAD when cutting MKN45-derived cancer nodules. Seven days later, we observed viable cancer cells and the total number of cells was counted. The histopathology of the nodules cut by the USAD was also examined. RESULTS: The existence of viable cancer cells was confirmed by ex vivo cell culture. The number of viable cancer cells was reduced by slow grasping of the USAD. The surface of cancerous tissue cut by the USAD was partially heat-denatured, however, there were some parts in which cancerous tissue was exposed on the surface. CONCLUSION: Surgeons should recognize the possibility that cancer cells may be scattered by USAD use.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Terapia por Ultrassom/métodos , Animais , Linhagem Celular Tumoral , Feminino , Humanos , Camundongos , Camundongos Nus , Neoplasias Gástricas/patologia
6.
Gastric Cancer ; 23(4): 725-733, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32048096

RESUMO

BACKGROUND: 5-aminolevulinic acid (5-ALA) has been utilized for cancer diagnosis as a fluorescence probe. We have reported the feasibility of 5-ALA-induced protoporphyrin IX (PpIX) fluorescence for detecting lymph node (LN) metastasis in gastrointestinal malignancies. However, a major barrier to the fluorescence diagnosis has been that the evaluation has been highly dependent on the observers. In this study, we examined the validity of a developed device for automated detection without subjectivity. METHODS: Gastric cancer patients who received oral administration of 5-ALA (20 mg/kg) prior to surgery were enrolled. For a total of 323 LNs obtained from 64 patients, the diagnostic results of the device were compared to those of conventional histopathological examination based on hematoxylin-and-eosin-stained slides. The accuracy with the device was compared to that of stereoscopic detection with conventional fluorescence microscopy for 211 LNs from 42 patients. We used two types of image processing that we previously developed to eliminate autofluorescence of background tissues: differential and ratio methods. RESULTS: For detection of metastasis in 323 LNs, the areas under the receiver operating characteristic curves with the differential method and ratio method were 0.921 and 0.909, respectively. The sensitivity, specificity, and accuracy with the differential method were 78.0%, 96.8%, and 94.4%; while those with the ratio method were 78.0%, 96.1%, and 93.8%, respectively. In 211 LN analysis, the diagnostic accuracy with the device was comparable to that of stereoscopic examination. CONCLUSION: Our device for automated detection of LN metastasis using 5-ALA can be a useful tool for intraoperative diagnosis.


Assuntos
Adenocarcinoma/secundário , Ácido Aminolevulínico/administração & dosagem , Corantes Fluorescentes/química , Linfonodos/patologia , Fármacos Fotossensibilizantes/administração & dosagem , Protoporfirinas/química , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
7.
Sci Rep ; 9(1): 16912, 2019 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-31729459

RESUMO

Deep-UV (DUV) excitation fluorescence microscopy has potential to provide rapid diagnosis with simple technique comparing to conventional histopathology based on hematoxylin and eosin (H&E) staining. We established a fluorescent staining protocol for DUV excitation fluorescence imaging that has enabled clear discrimination of nucleoplasm, nucleolus, and cytoplasm. Fluorescence images of metastasis-positive/-negative lymph nodes of gastric cancer patients were used for patch-based training with a deep neural network (DNN) based on Inception-v3 architecture. The performance on small patches of the fluorescence images was comparable with that of H&E images. Gradient-weighted class activation mapping analysis revealed the areas where the trained model identified metastatic lesions in the images containing cancer cells. We extended the method to large-size image analysis enabling accurate detection of metastatic lesions. We discuss usefulness of DUV excitation fluorescence imaging with the aid of DNN analysis, which is promising for assisting pathologists in assessment of lymph node metastasis.


Assuntos
Linfonodos/patologia , Metástase Linfática/patologia , Microscopia de Fluorescência , Redes Neurais de Computação , Algoritmos , Biópsia , Imunofluorescência , Humanos , Interpretação de Imagem Assistida por Computador , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Aprendizado de Máquina , Software
8.
Sci Rep ; 9(1): 10745, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-31341229

RESUMO

Deep-ultraviolet excitation fluorescence microscopy has enabled molecular imaging having an optical sectioning capability with a wide-field configuration and its usefulness for slide-free pathology has been shown in recent years. Here, we report usefulness of terbium ions as RNA-specific labeling probes for slide-free pathology with deep-ultraviolet excitation fluorescence. On excitation in the wavelength range of 250-300 nm, terbium ions emitted fluorescence after entering cells. Bright fluorescence was observed at nucleoli and cytoplasm while fluorescence became weak after RNA decomposition by ribonuclease prior to staining. It was also found that the fluorescence intensity at nucleoplasm increased with temperature during staining and that this temperature-dependent behavior resembled temperature-dependent hypochromicity of DNA due to melting. These findings indicated that terbium ions stained single-stranded nucleic acid more efficiently than double-stranded nucleic acid. We further combined terbium ions and DNA-specific dyes for dual-color imaging. In the obtained image, nucleolus, nucleoplasm, and cytoplasm were distinguished. We demonstrated the usefulness of dual-color imaging for rapid diagnosis of surgical specimen by showing optical sectioning of unsliced tissues. The present findings can enhance deep-ultraviolet excitation fluorescence microscopy and consequently expand the potential of fluorescence microscopy in life sciences.


Assuntos
Corantes Fluorescentes , Microscopia de Fluorescência/métodos , RNA/ultraestrutura , Térbio , Fluorescência , Humanos , Células MCF-7/ultraestrutura , RNA/metabolismo , Raios Ultravioleta
9.
Gan To Kagaku Ryoho ; 44(12): 1482-1484, 2017 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-29394675

RESUMO

A 63-year-old man with bloody stools, anal incompetence, and feeling of fatigue was diagnosed as having a RAS mutanttype rectal cancer with abscess and rectovesical fistula. Computed tomography revealed that the tumor had invaded the seminal vesicle, prostate, and bladder and formed an abscess. In addition, his general condition was poor. Thus, we evaluated the lesion as unresectable. His nutritional status improved, and the infection was controlled after colostomy. Then, we performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin(FOLFOX)plus bevacizumab. However, after a single course of chemotherapy, the systemic inflammatory reaction was prolonged. Despite treatment of the infection with antibiotics, it was not fully controlled, making it difficult to continue chemotherapy. A new lesion did not appear, but the primary tumor increased in size. Thus, we performed pelvic exenteration. Pathological examination revealed that the tumor was a well-differentiated adenocarcinoma invading the sigmoid colon and bladder. We resected it curatively and administered adjuvant chemotherapy postoperatively. No recurrence was observed during 10 months' follow-up.


Assuntos
Abscesso/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Neoadjuvante , Fístula Retal/cirurgia , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/cirurgia , Abscesso/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Retal/etiologia , Neoplasias Retais/complicações , Resultado do Tratamento
10.
Gan To Kagaku Ryoho ; 44(12): 2020-2022, 2017 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-29394854

RESUMO

The patient was a 57-year-old man. Upper gastrointestinal endoscopy revealed a 0- II c lesion at the anterior wall of the greater curvature in the lower third of the stomach, and the biopsy of this tumor gave the diagnosis of tubular adenocarcinoma. Abdominal contrast-enhanced computed tomography revealed many enlarged regional and non-regional lymph nodes. Because there was no definite evidence of lymph node metastasis, distal gastrectomy with D2 was performed. Histopathological examinations found the sarcoid reaction(SR)in lymph nodes, but could not demonstrate any cancer cells. SR is the epithelioid cell granuloma in lymph nodes found in patients without systemic sarcoidosis but with cancer. Early gastric cancer with SR is rare, with only 22 reported cases in Japan. SR is considered as one of the differential diagnoses when we find many enlarged lymph nodes in patients with early gastric cancer.


Assuntos
Adenocarcinoma/cirurgia , Sarcoidose/cirurgia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/complicações , Gastrectomia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Sarcoidose/etiologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia , Resultado do Tratamento
11.
Gan To Kagaku Ryoho ; 43(12): 1945-1947, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133184

RESUMO

The prognosis of liver metastasis from gastric cancer, which often exhibits incurable factors, is dismal, and no effective therapy exists. We report a case of giant liver metastasis from gastric cancer after surgery, for which transcatheter arterial embolism and chemotherapy(G-SOX)made it possible to perform hepatic resection. The patient was a 78-year-old woman who underwent distal gastrectomy combined with D2 lymphadenectomy at our department in August 2014. She complained of abdominal distension, and a liver metastasis measuring more than 16 cm in diameter was found on computed tomography in April 2015. Transcatheter arterial embolization was performed followed by chemotherapy(9 courses of G-SOX were administered). These therapies were effective, enabling partial hepatic resection to be performed. The patient remains alive and free from recurrence 4 months after surgery. Although no effective therapy exists for liver metastasis from gastric cancer, intensive therapies may enable curative resection.


Assuntos
Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Embolização Terapêutica , Feminino , Gastrectomia , Hepatectomia , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Neoplasias Gástricas/terapia , Resultado do Tratamento
12.
Int J Cardiol Heart Vasc ; 9: 15-21, 2015 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-28785700

RESUMO

BACKGROUND: Sex specific temporal trends in the incidence and prevalence of hospitalization for heart failure (HF), particularly in conjunction with reduced and preserved left ventricular ejection fraction (EF) remain unclear, especially in Asian general populations. METHODS: We conducted a community based HF registration study over a 10 year period in an aging cohort of the Japanese general population. RESULTS: A total of 2598 cases of hospitalized HF were registered during the survey period. Of these 1413 cases (55%) were initial admissions for HF (incident case). The study period was divided into five 2-year terms (T1, 2003-2004; T2, 2005-2006; T3, 2007-2008; T4, 2009-2010; T5, 2011-2012), and data were compared among the terms. Age adjusted incidence of HF (per 105 person-year) remained stable in men, but decreased significantly by 25% in women (from 104 at T1 to 79 at T5; p for trend < 0.05). Among incident cases who underwent echocardiography (≈ 90%), the proportion of HF with preserved EF increased in men (from 32% at T1 to 43% at T5; p for trend < 0.05), and was relatively high and remained stable throughout the study period in women (from 52% at T1 to 58% at T5; p for trend; NS). CONCLUSION: Although the incidence of HF has declined especially in women between 2003 and 2012 in the study population, the proportion of HF with preserved EF has increased over time. These trends suggest a future prevalence of HF with preserved EF rather than HF with reduced EF in aging Asian populations.

13.
Eur Heart J Acute Cardiovasc Care ; 3(3): 195-203, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24920759

RESUMO

AIMS: The aims of this study were to evaluate reperfusion rate, therapeutic time course and in-hospital mortality pre- and post-Japan earthquake disaster, comparing patients with ST-elevation myocardial infarction (STEMI) treated in the inland area or the Tsunami-stricken area of Iwate prefecture. METHOD AND RESULTS: Subjects were 386 consecutive STEMI patients admitted to the four percutaneous coronary intervention (PCI) centers in Iwate prefecture in 2010 and 2011. Patients were divided into two groups: those treated in the inland or Tsunami-stricken area. We compared clinical characteristics, time course and in-hospital mortality in both years in the two groups. PCI was performed in 310 patients (80.3%). Door-to-balloon (D2B) time in the Tsunami-stricken area in 2011 was significantly shorter than in 2010 in patients treated with PCI. However, the rate of PCI performed in the Tsunami-stricken area in March-April 2011 was significantly lower than that in March-April 2010 (41.2% vs 85.7%; p=0.03). In-hospital mortality increased three-fold from 7.1% in March-April 2010 to 23.5% in March-April 2011 in the Tsunami-stricken area. Standardized mortality ratio (SMR) in March-April 2011 in the Tsunami-stricken area was significantly higher than the control SMR (SMR 4.72: 95% confidence interval (CI): 1.77-12.6: p=0.007). CONCLUSIONS: The rate of PCI decreased and in-hospital mortality increased immediately after the Japan earthquake disaster in the Tsunami-stricken area. Disorder in hospitals and in the distribution systems after the disaster impacted the clinical care and outcome of STEMI patients.


Assuntos
Desastres/estatística & dados numéricos , Terremotos/mortalidade , Infarto do Miocárdio/mortalidade , Tsunamis/estatística & dados numéricos , Idoso , Tratamento de Emergência/mortalidade , Tratamento de Emergência/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Japão/epidemiologia , Masculino , Reperfusão Miocárdica/mortalidade , Reperfusão Miocárdica/estatística & dados numéricos , Intervenção Coronária Percutânea , Características de Residência/estatística & dados numéricos , Estudos Retrospectivos , Tempo para o Tratamento/estatística & dados numéricos
14.
J Am Heart Assoc ; 3(3): e000798, 2014 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-24811614

RESUMO

BACKGROUND: The aim of this study was to evaluate the temporal impact of the 2011 Japan earthquake and tsunami on the incidence of sudden cardiac and unexpected death (SCUD). METHODS AND RESULTS: We surveyed the impact of the disaster on the incidence and clinical characteristics of SCUD in Iwate. To perform complete identification of SCUD for 8 weeks before and 40 weeks after the disaster, medical records and death certificates relevant to SCUD were surveyed in the study area. Compared with the previous year's rate, the incidence (per 10 000 person-year) of SCUD for the initial 4 weeks after the disaster (acute phase) was double (33.5 vs 18.9), and thereafter the rate returned to the previous level. Significant relationships were found between weekly numbers of SCUD and seismic activity (intensity, r=0.43; P<0.005: frequency, r=0.46; P<0.002). The standardized incidence ratio (SIR) of SCUD in the acute phase was significantly increased compared with that of previous years (1.71, 95% CI 1.33 to 2.16). Increased SIRs were predominantly found in female subjects (1.73, 95% CI 1.22 to 2.37), the elderly (1.73, 95% CI 1.29 to 2.27), and residents living in the tsunami-stricken area (1.83, 95% CI 1.33 to 2.46). In addition, SIRs for weekdays (1.71, 95% CI 1.28 to 2.24) and nights-mornings (2.09, 95% CI 1.48 to 2.86) were amplified. CONCLUSIONS: The present results suggest that the magnitude of a disaster, related stress, and population aging may cause a temporary increase in the incidence of SCUD with amplification of ordinary weekly and circadian variations.


Assuntos
Morte Súbita Cardíaca/epidemiologia , Morte Súbita/epidemiologia , Desastres , Terremotos/mortalidade , Tsunamis , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Morte Súbita/etiologia , Morte Súbita Cardíaca/etiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Fatores Sexuais
15.
Hinyokika Kiyo ; 56(9): 499-503, 2010 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-20940524

RESUMO

A 67-year-old man received left radical nephrectomy for left renal cell carcinoma (RCC) (clear cell carcinoma, G2, pT3bN0M0). After 9 months, he presented with an acute onset of left extremity edema. A computed tomographic (CT) scan and magnetic resonance imaging reveal recurrent renal cell carcinoma in the inferior vena cava (IVC) and the left renal fossa, thrombus in the left external vein and acute pulmonary embolism. We performed treatment with sunitinib for 5 months after anticoagulant therapy for 3 weeks. A new CT scan showed disappearance of RCC in the IVC and reduction in the size of RCC in the renal fossa. Only 11 cases are reported as recurrent RCC in the IVC. We report the first case of recurrent intracaval RCC in which sunitinib treatment was effective.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/patologia , Indóis/uso terapêutico , Neoplasias Renais/patologia , Pirróis/uso terapêutico , Neoplasias Vasculares/tratamento farmacológico , Veia Cava Inferior , Idoso , Antineoplásicos/administração & dosagem , Carcinoma de Células Renais/cirurgia , Humanos , Indóis/administração & dosagem , Neoplasias Renais/cirurgia , Masculino , Nefrectomia , Pirróis/administração & dosagem , Sunitinibe
16.
Hinyokika Kiyo ; 56(7): 385-7, 2010 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-20724813

RESUMO

We report a case of prolapse of a simple ureterocele presenting as perineural tumor. A 60-year-old woman presented with perineum pain and bleeding. A physical examination revealed a hard mass, 30 mm in diameter protruding from the external meatus. The computerized tomography, magnetic resonance imaging and cystography showed an uncharacterized tumor. Endoscopic examination was performed. However, just before resection the mass collapsed spontaneously and turned out to be a prolapse of ureterocele. No transurethral incision was performed. Eleven months postoperatively, the patient has not developed vesicoureteral reflux or urinary tract infection. Physicians should consider prolapse of a simple ureterocele in the differential diagnosis of the female meatal tumor.


Assuntos
Ureterocele/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Prolapso , Tomografia Computadorizada por Raios X , Ureterocele/diagnóstico
17.
Hinyokika Kiyo ; 56(6): 335-8, 2010 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-20610928

RESUMO

We report a case of verrucous carcinoma of the penis. A 62-year-old man, who presented with penile swelling and pain, was referred to our hospital. Although, penile tumor biopsy revealed no evidence of malignancy, the patient presented with penile swelling and discharge. The penis was surgically resected and urinary diversion was performed. The pathological examination of the resected glans revealed verrucous carcinoma of penis. Furthermore, in situ hybridization revealed human papilloma virus (HPV) infection. This clearly showed that the verrucous carcinoma of the penis resulted from the HPV infection. The patient has survived for 14 months after surgery without local recurrence or metastasis.


Assuntos
Carcinoma Verrucoso/etiologia , Infecções por Papillomavirus/complicações , Neoplasias Penianas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade
18.
Hinyokika Kiyo ; 56(5): 261-4, 2010 May.
Artigo em Japonês | MEDLINE | ID: mdl-20519923

RESUMO

A 39-year-old woman, who was followed because of a 4 cm asymptomatic angiomyolipoma (AML) in the left kidney, presented with an acute onset of lower left back pain in the 38th week of her first pregnancy. An ultrasound revealed an 8 cm mass suggestive of AML rupture and retroperitoneal hemorrhage. An emergency caesarean delivery was performed. A post-delivery computed tomographic scan confirmed the AML rupture and selective embolization was performed. This was a case in which the AML grew rapidly during the pregnancy ; therefore, we discuss the relationship between AML and pregnancy.


Assuntos
Angiomiolipoma/fisiopatologia , Neoplasias Renais/fisiopatologia , Complicações na Gravidez/fisiopatologia , Adulto , Angiomiolipoma/complicações , Angiomiolipoma/terapia , Cesárea , Embolização Terapêutica , Feminino , Hemorragia/etiologia , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/terapia , Gravidez , Complicações na Gravidez/terapia , Espaço Retroperitoneal , Ruptura Espontânea
19.
Hinyokika Kiyo ; 56(4): 203-7, 2010 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-20448443

RESUMO

The objective of this study was to evaluate the efficacy and safety of low-dose docetaxel, estramustine and dexamethasone combination chemotherapy in patients with hormone-refractory prostate cancer (HRPC). Sixty-nine patients with HRPC were enrolled. Docetaxel was given at a dose of 25 mg/m(2) on days 1 and 8 every 3 weeks, oral estramustine 280 mg twice daily on days 1 to 3 and 8 to 10, and oral dexamethasone 1 mg daily throughout the course. Cycles were repeated every 21 days. Treatment was continued until disease progression or excessive toxicity. Patients were evaluated for response and toxicity. Patients received a median of eleven cycles (range : 1-25). Prostatic-specific antigen (PSA) was decreased greater than 50% in 53 (77%) out of 69 patients and median duration of PSA response was 10.2 months. Median time to progression and overall survival 10.2 and 24 months, respectively. Grade 1-2 fatigue was the most common toxicity observed in 10 (15%) patients. Grade 3-4 toxicities were observed in five (7%) patients (2 thrombosis, 2 bilirubin elevation, and 1 aspartate transaminase/alanine transaminase elevation). Low-dose docetaxel, estramustine and dexamethasone combination chemotherapy is an effective and well tolerated treatment for Japanese HRPC patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Biomarcadores Tumorais/sangue , Dexametasona/administração & dosagem , Dexametasona/efeitos adversos , Docetaxel , Esquema de Medicação , Estramustina/administração & dosagem , Estramustina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/mortalidade , Taxa de Sobrevida , Taxoides/administração & dosagem , Taxoides/efeitos adversos
20.
Hinyokika Kiyo ; 55(6): 353-5, 2009 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-19588870

RESUMO

A 19-year-old woman was admitted to our hospital with a complaint of residual feeling, frequency and pain on urination. Laboratory analysis revealed an elevated eosinophilia count in peripheral blood and white blood cell count in urine. Lymphocyte stimulation test of Chinese herb named "Seijoh-bohhuh-toh" showed a positive reaction. Bladder symptoms were improved after ceasing this Chinese herb. From these points, we considered that the Chinese herb might have caused eosinophilic cystitis. We report this rare case with a review of the literature.


Assuntos
Cistite/induzido quimicamente , Medicina Tradicional Chinesa/efeitos adversos , Eosinofilia/induzido quimicamente , Feminino , Humanos , Adulto Jovem
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