Shiro Onitsuka

Spoke‐wheel‐like enhancement as an important imaging finding of chromophobe cell renal carcinoma: A retrospective analysis on computed tomography and magnetic resonance imaging studies

Aim:  Little information has been reported with regard to the radiological features of chromophobe cell renal carcinomas (CCRC). The aim of the present study was to identify imaging characteristics which lead to the histological diagnosis of CCRC.

Impact of arterial occlusion during partial nephrectomy on residual renal function: an evaluation with (99m)technetium-dimercaptosuccinic acid scintigraphy.

Background: Partial nephrectomy (PNx) has been performed with temporary renal arterial occlusion and in situ renal hypothermia (conventional PNx). However, the impact of temporary renal arterial occlusion on residual renal function has not been well assessed. To address this question, we performed renal scintigraphy with 99mtechnetium‐dimercaptosuccinic acid (DMSA) for the quantitative measurement of postoperative residual renal function after conventional PNx and partial nephrectomy without arterial occlusion (non‐clamping PNx).

Effect of Endocrine Treatment on Prostatic Blood Flow in Patients with Prostatic Adenocarcinoma

Prostatic blood flow in 19 patients with prostatic adenocarcinoma was measured by the hydrogen gas clearance method before and during endocrine treatment. Prostatic volume was reduced to 70 per cent of the pre-treatment volume by 3 months after the beginning of treatment. Prostatic blood flow was remarkably depressed in patients who had never had any treatment of the prostatic carcinoma (22.2 +/- 8.3 ml. per minute per 100 gm.), while prostatic blood flow increased significantly after endocrine treatment (56.3 +/- 21.8 ml. per minute per 100 gm.). It was likely that prostatic blood flow increased as the prostate volume decreased. Final histology of serial prostatic biopsy specimens after endocrine treatment, revealed distinct deterioration of tumor cells and slight stromal hyperplasia compared to the initial pre-treatment biopsy. The stromal-epithelial ratio, which was calculated by computer-assisted image analysis, was markedly increased after endocrine treatment. Our study indicated that endocrine treatment caused a growth-inhibitory effect that was accompanied by increased blood flow in the prostatic carcinoma.

Analysis of prognostic factors related to primary superficial bladder cancer tumor recurrence in prophylactic intravesical epirubicin therapy

Purpose: The aims of the present study were to examine the effects of intravesical instillation of epirubicin on tumor recurrence and to identify tumors that are at a high risk of recurrence.

Retroperitoneoscopic Pyelolithotomy via a Posterior Approach for Large Impacted Renal Pelvic Stone

Retroperitoneal laparoscopic pyelolithotomy via a posterior approach was successful in a patient with a large impacted renal pelvic stone. This procedure is beneficial as an alternative to open surgery for stones that cannot be treated by SWL or intracorporeal lithotripsy. This procedure may also be the initial treatment in selected cases.

A Rat Model of Chemical-Induced Polycystic Kidney Disease with Multistage Tumors

Diphenylthiazole (DPT) induces polycystic kidney disease in the rat which serves as a model of human acquired cystic disease of the kidney. However, DPT administration alone does not produce neoplastic changes in renal cysts. We examined the effect of N-nitrosomorpholine (NNM), a carcinogen, in rats bearing DPT-induced renal cysts. Forty Sprague-Dawley rats were divided into four groups: DPT/NNM, DPT, NNM, and nontreated groups. DPT was administered throughout the experimental period, and NNM was given from weeks 4 to 7 after the start of the experiment. The rats were sampled from weeks 39 to 48, and histopathological examinations of the excised kidneys were performed. Multiple cystic changes were observed in all the DPT-treated rats in both DPT and DPT/NNM groups which were absent in almost all other rats. Solid adenomatous lesions were observed in the NNM-treated rats: in 7 of 9 and in 3 of 10 rats in the DPT/NNM and NNM groups, respectively. Cystic adenomatous lesions were found in 4 of 9 rats in the DPT/NNM group exclusively and not in the other groups. Combined DPT and NNM administration to rats produced an animal model showing neoplastic changes in renal cysts resembling microscopically renal cancer lesions in human acquired cystic disease of the kidney (on hematoxylin and eosin staining).

Nephron-sparing tumorectomy for a large benign renal mass : A case of massive bilateral renal angiomyolipomas associated with tuberous sclerosis

Abstract A case of massive bilateral angiomyolipomas (AML) associated with tuberous sclerosis in a 33‐year‐old woman is reported. She was hospitalized because she had been experiencing abdominal fullness and epigastralgia. Several imaging studies revealed massive bilateral renal tumors and she was diagnosed as having renal AML associated with tuberous sclerosis. Left nephrectomy was carried out after renal arterial embolization for intratumor hemorrhage. Two years after left nephrectomy, nephron‐sparing surgery (tumorectomy) for right AML was done because of an increase in the size of the right renal AML and she hoped for a future pregnancy. The left kidney with AML weighed 5700 g and the right AML weighed 1700 g. Postoperative serous creatinine did not differ from that before operation and an increase in the size of the residual tumor was not observed 8 months after operation. We consider that tumorectomy is an effective therapy in patients with a very large tumor involving a solitary kidney.

Electrovaporization using a rollerball electrode for flat or small papillary tumors of the bladder: basic study in dogs.

PURPOSE We investigated electrovaporization of flat bladder tumors with a rollerball electrode 3 mm in diameter as a substitute for conventional transurethral resection with a cutting loop. MATERIALS AND METHODS A basic study of the action of electrovaporization was performed in dogs. The bladder was exposed under general anesthesia in three mongrel dogs. The rollerball electrode was attached to the resectoscope and inserted into the bladder via a cystostomy. Then electrovaporization was performed with a low or high pressure on the electrode tip and a speed of about 1 cm/sec using a Force 40 generator. The cutting mode power was set at 100 W or 200 W. The effects of the rollerball and cutting loop electrodes were also examined in the coagulation mode (45 W) as a control. RESULTS A deeper vaporization zone was obtained by using a power of 200 W in the cutting mode than with a power of 100 W, and a desiccation zone was found below the vaporization zone (VZ). The VZ was thicker with a high contact pressure than with a low contact pressure. This VZ was deeper than the tissue defect and heat-affected zone obtained using a rollerball electrode or cutting loop electrode in the 45 W coagulation mode. CONCLUSION Although caution is required because the VZ can become too deep with excessive pressure, the rollerball electrode seems to be safer and more useful than the cutting loop electrode for resection of flat or small papillary bladder tumors.

Effects of direct injection of dehydrated ethanol on PC3 human prostate cancer cells in nude mice: Preliminary study

Objectives:  The effect of direct local injection of dehydrated ethanol on hormone‐independent prostatic carcinoma cells (PC3 cells) implanted in nude mice was investigated.

[Clinico-pathological investigation of upper urinary tract tumors in patients with normal renal function and in patients with end stage renal disease].

AIMS To clinically investigate upper urinary tract tumors in end stage renal disease (ESRD) patients. PATIENTS AND METHODS Between 1988 and 2003, a study was made of 153 patients who underwent surgical treatment for upper urinary tract tumors in the Department of Urology, Tokyo Womens Medical University. Of these, 10 had ESRD while 143 had normal renal function. Comparisons were made of the following variables between the two groups: patients background, clinical findings, surgical procedures, pathological findings, prognosis, depth of tumor cell invasion, tumor grades, postoperative survival rates, cancer-specific survival rates, and complications. RESULTS Ten ESRD patients with upper urinary tract tumors were comprised of 5 males and 5 females with a median age of 59 (40-71) years and an average hemodialysis period of 71 (0-279) months. Macroscopic hematuria appeared in seven cases (70%) at the onset, and tumors occurred at the renal pelvis in nine cases (90%). As to the T stage, seven cases (70%) were pT2 or more and all 10 cases (100%) exhibited grade 2 or higher in ESRD patients, yielding no significant differences with the cases of normal renal function. In addition, there was no significant difference in both groups with respect to postoperative survival rates and cancer-specific survival rates in cases with curative resection. CONCLUSION Although upper urinary tract tumors had been considered to exhibit higher grades and stages of malignancy in ESRD cases than in those with normal renal function, the present results showed that the clinico-pathological features are similar in both patients groups. Given that there was no significant difference in postoperative survival rates and cancer-specific survival rates, radical surgery should be also indicated, if possible, for the ESRD patients with upper urinary tract tumors as well as the patients with normal renal function.