Takehisa Onishi

Incidence of urolithiasis in northeast Thailand.

Background:

Mitogen-activated protein kinase pathway is involved in α6 integrin gene expression in androgen-independent prostate cancer cells: role of proximal Sp1 consensus sequence

Metastatic diseases of prostate cancer reveal high expression of alpha6 integrin and the activation of mitogen-activated protein kinases (MAP kinase). Therefore, the present study was conducted to examine whether MAP kinase pathway is involved in the alpha6 integrin gene expression in androgen-independent prostate cancer cell lines. alpha6 integrin mRNA expression, the alpha6 integrin promoter-induced luciferase activities and MAP kinase enzyme activities in androgen-independent LNCaP and PC-3 cell lines were higher than those in androgen-dependent LNCaP. Deletion and mutation analysis showed that Sp1 consensus sequence at -48 to -43 bp from the transcription start site was necessary for basal promoter activity. Binding of Sp1 to its consensus sequence in three cell lines was confirmed by electrophoretic mobility shift assays. Sp1 binding to its consensus sequence, as well as promoter activity and mRNA expression, were found to be inhibited by an inhibitor of MAP kinase kinase 1 and 2, U0126, in the androgen-independent cell lines. Our results indicate that the proximal Sp1 is necessary for basal promoter activity of the alpha6 integrin, suggesting that signal transduction from MAP kinases to activation of Sp1 might be involved in alpha6 integrin gene expression in androgen-independent prostate cancer cell lines.

Pheochromocytoma of the urinary bladder without typical symptoms

Pheochromocytoma of the urinary bladder is an unusual tumor that typically presents with hypertensive crises related to micturition. We report, herein, the case of a 62‐year‐old woman with bladder pheochromocytoma. The patient presented with a bladder tumor that was incidentally found by computed tomography (CT) without the triad of sustained hypertension, hematuria and postmicturitional syncope. Cystoscopy revealed a yellowish submucosal tumor in the right lateral wall of the bladder. Treatment consisted of transurethral resection in the initial diagnosis of bladder tumor. A definitive diagnosis was made postoperatively upon pathological examination. The patient has been followed up for 12 months and has shown no recurrence.

Paclitaxel Carboplatin chemotherapy as a second‐line chemotherapy for advanced platinum resistant urothelial cancer in Japanese cases

Objective:  We evaluated the efficacy and toxicity of Paclitaxel Carboplatin (Pca) therapy in patients with advanced urothelial cancer and platinum based chemotherapy failure.

Papillary adenocarcinoma of the renal pelvis and ureter producing carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125

Abstract  We report a case of advanced renal pelvis and ureter adenocarcinoma producing carcinoembryonic antigen (CEA), carbohydrate antigen 19‐9 (CA19‐9) and carbohydrate antigen 125 (CA125). A 72‐year‐old woman was diagnosed with right renal pelvic and ureter tumor with para‐aortic lymph node swelling. Biopsy of the ureteral mass revealed papillary adenocarcinoma. Serum levels of CEA, CA19‐9 and CA125 were extremely elevated. The patient was successfully treated with paclitaxel/carboplatin chemotherapy followed by surgery.

Cutoff value of time to prostate-specific antigen nadir is inversely correlated with disease progression in advanced prostate cancer.

To identify the early predictor of progression to castration-resistant prostate cancer (CRPC) for different stage of advanced PC patients, we focused on time to prostate-specific antigen (PSA) nadir following primary androgen deprivation therapy (PADT). We reviewed 184 advanced (locally advanced and metastatic) PC patients (101 patients with bone metastasis (BM) and 83 patients without BM at presentation) who had received PADT at our institution. We evaluated laboratory data, pathological results, and the influence of PSA kinetics impact on disease progression. The progression rates were analyzed with reference to the nadir PSA level and time to PSA nadir (TTN) following PADT by Kaplan-Meier method. In all, 103 patients (56%) progressed to CRPC. Nadir PSA lower than 0.2 ng/ml (nadir ≤0.2) during PADT was observed in 114 patients (62%). Median TTN was 8.5 months in patients with BM and 11.5 months in patients without BM. Multivariate analysis revealed that nadir ≤0.2 following PADT (P<0.001), longer TTN (>8 months) (P<0.001), extent of disease on bone scan grade (P=0.02), and T stage (P=0.04) in BM group and nadir ≤0.2 following PADT (P<0.001), longer TTN (>11 months) (P<0.001), and T stage (P=0.03) in without BM group were independent prognostic factors for progression. In both groups, longer TTN identified patients with prolonged progression-free survival in both nadir ≤0.2 and >0.2 nadir levels. Longer TTN is strongly associated with a low risk of disease progression, and the cutoff value of TTN could be inversely correlated with disease progression.

Successful management of inferior vena cava thrombus complicating advanced germ cell testicular tumor with temporary inferior vena cava filter

Abstract  We report a case of right testicular tumor with inferior vena cava (IVC) thrombus. Due to the risk of pulmonary embolization, a temporary IVC filter had been inserted during chemotherapy. There were no complications with the temporary IVC filter during the implantation period. The patient was safely treated with systemic chemotherapy using a temporary IVC filter followed by retroperitoneal lymph node and vena cava dissection.

Glomus tumor of the hypoplastic kidney.

Glomus tumor is a benign mesenchymal neoplasm composed of cells that closely resemble glomus cells, the modified smooth muscle cells of the normal glomus body. They most often occur in the extremities, typically in the subungual region of the fingers, and rarely involve the internal organs. In some cases, an autosomal-dominant mode of inheritance has been suggested, and a gene for inherited glomus tumors is identified on chromosome 1q21-22. Only five cases of glomus tumor arising in the renal parenchyma have been reported to date. A 36-year-old woman with proteinuria was being followed up by her nephrologist. Computed tomography (CT) showed a 12-mm incidental mass in the upper pole of the right congenital hypoplastic kidney. Follow-up CT revealed that the mass was enhanced and the size of the tumor had increased to 17 mm over 2 years (Fig. 1a,b). We diagnosed right renal cell carcinoma (RCC), and retroperitoneoscopic right nephrectomy was performed. Gross appearance showed a well-encapsulated, peripherally located tumor with a dark yellow cut surface and marked mucinous appearance (Fig. 1c). The neoplastic cells were multiform and they had a moderate amount of eosinophilic cytoplasm and indistinct cell border. The nuclei were uniform with open and speckled chromatin. Vessels were dispersed throughout the tumor (Fig. 1d). Immunohistochemical staining showed positivity of tumor cells for smooth muscle actin and vimentin (Fig. 1e,f). The cells were negative for desmin, HMB-45, S100, CD31, CD34, factor VIII, cytokeratin and chromogranin. These results established the diagnosis of glomus tumor arising in hypoplastic kidney. The patient has had an uneventful postoperative course at the 8-month follow up, however proteinuria has continued. Glomus tumors are well circumscribed and composed of varying proportions of glomocytes, blood vessels and smooth muscle. Glomus tumors are divided into three subgroups: glomus tumor proper, glomangioma, and glomangiomyoma. The differential diagnosis of renal glomus tumor includes RCC, angiomyolipoma (AML) when the muscle component predominates, hemangiopericytoma, leiomyomas of the kidney, renal hemangioma, juxtaglomerular cell tumor, and paraganglioma. The radiological features of renal glomus tumor are similar to RCC, therefore it is difficult to

Prostate‐specific antigen half‐life and pretreatment prostate‐specific antigen: Crucial predictors for prostate‐specific antigen trend in delayed‐combined androgen blockade therapy

Purpose:  To elucidate the crucial predictors for prostate‐specific antigen (PSA) trends and determine the usage of anti‐androgen treatment during delayed‐combined androgen blockade (CAB) leading to a PSA level below 0.2 ng/mL.

Renal lymphoma associated with Castleman's disease.

We report the second case in the literature of a renal lymphoma associated with multicentric Castlemans disease.