RESUMEN
A 78-year-old female suffering from a cerebral infarction and subdural hematoma was referred to us due to a hard mass in the anterior vaginal wall which was disclosed during gynecological examination. An abdominal X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) showed that a large spindle-shaped stone, 60 x 42 mm in size, was impacting the urethra. It was impossible to catheterize the urethra. The stone gradually projected through the external urethral meatus and was removed by grasping and drawing with forceps. Another 83-year-old female with senile dementia was referred to us because of macrohematuria. An abdominal X-ray and CT showed the presence of two oval bladder stones, 32 x 24 mm and 30 x 21 mm in size. During a follow-up, one of the stones projected partially through the external urethral meatus and was removed by drawing with forceps. After a week, the other stone impacted the urethra and was removed in the same way. Both women were frail, bedridden institutionalized elderly with severe dementia, and their urination had been managed with diapers for years. As the proportion of elderly people in Japan rapidly increases, female urethral stones migrating from the urinary bladder, once very rare, may increase in number, to which we must pay attention.
Asunto(s)
Enfermedades Uretrales/etiología , Cálculos Urinarios/etiología , Anciano , Anciano de 80 o más Años , Femenino , HumanosRESUMEN
One of the main objectives of cancer immunotherapy is the activation and increase in number of antitumor effector cells. Recently, genetically modified tumor cell vaccines have been proposed for elicitation of antitumor effector cells. Native alpha antigen (alpha Ag) (also known as MPT59 and antigen 85B) of mycobacteria, which cross-reacts among mycobacteria species, may play an important biological role in host-pathogen interaction because it elicits various helper T-cell type 1 immune responses. To assess the induction of antitumor immune responses by alpha Ag, mouse tumor cell lines transfected with cDNA of alpha Ag from Mycobacterium kansasii were established, and the possibility of producing a tumor cell vaccine for induction of antitumor effects was explored. Transfection of tumor cell lines with an alpha Ag gene lead to primary tumor rejection and the establishment of protective immunity to nontransfected original tumor cell lines in Mycobacterium bovis bacillus Calmette-Gurin (BCG)-primed and unprimed mice. Mice immunized with tumor cell lines transfected with the alpha Ag gene showed delayed-type hypersensitivity responses in vivo and proliferative responses together with induction of interferon-gamma of spleen cells against nontransfected wild-type tumor cell lines in in vitro experiments. Moreover, immunization of mice with alpha Ag-expressing tumor cells elicited tumor-specific and cytotoxic T lymphocyte (CTL) epitope peptide-specific CD8+ CTLs. The results of this study provided evidence of the potential usefulness of alpha Ag in tumor cell vaccines.
Asunto(s)
Antígenos Bacterianos/genética , Vacunas contra el Cáncer , ADN/genética , Terapia Genética/métodos , Neoplasias de la Vejiga Urinaria/inmunología , Neoplasias de la Vejiga Urinaria/terapia , Animales , Interferón gamma/biosíntesis , Ratones , Ratones Endogámicos C3H , Ratones Endogámicos C57BL , Mycobacterium bovis/inmunología , Mycobacterium bovis/metabolismo , Biosíntesis de Péptidos , Bazo/citología , Linfocitos T Citotóxicos/metabolismo , Factores de Tiempo , Transfección , Células Tumorales CultivadasRESUMEN
Generally, major histocompatibility complex (MHC) class I presentation of peptide antigens only occur for proteins' which are actively synthesized and processed intracellularly, so that immunization with a cytotoxic T lymphocyte (CTL) target peptide does not usually elicit effective CTL responses. In the present study, we explored the use of epitope peptides by in vivo electroporation to introduce directly into the cytoplasm for the vaccine elicitation of virus-specific CTLs in a mouse system. BALB/c mice were immunized with human immunodeficiency virus (HIV) env (P18, residues 311-320) or hepatitis C virus (HCV) NS5 (P17, residues 2423-2434) with or without electric pulses. Effector cells against peptide-labeled target cells were elicited in mice immunized with peptides with electric administration but not without electric administration. Moreover, cytolytic activities of CTL against peptide-labeled target cells were enhanced by the addition of plasmid having the immunostimulatory sequence (ISS) or cDNA of the B7-1 molecule in electric administration of peptides. The results of the present study suggest that a peptide vaccine against a virus using electric administration is effective in eliciting virus specific CTLs.
Asunto(s)
Antígenos Virales/administración & dosificación , Linfocitos T Citotóxicos/inmunología , Proteínas Virales/administración & dosificación , Secuencia de Aminoácidos , Animales , Presentación de Antígeno , Antígenos Virales/genética , Antígeno B7-1/genética , Secuencia de Bases , Electroporación , Antígenos VIH/administración & dosificación , Antígenos VIH/genética , Ratones , Ratones Endogámicos BALB C , Datos de Secuencia Molecular , Plásmidos/administración & dosificación , Plásmidos/genética , Proteínas no Estructurales Virales/administración & dosificación , Proteínas no Estructurales Virales/genética , Proteínas no Estructurales Virales/inmunología , Proteínas Virales/genética , Proteínas Virales/inmunologíaRESUMEN
One hundred and seven patients with prostate cancer were treated at Mie University Hospital during the past 12 years between 1988 and 1999. They were between 53 and 83 years old, with an average age of 70.8 years old. The clinical stage was defined as A, B, C and D in 3 (2.8%), 19 (17.8%), 50 (46.7%) and 35 (32.7%) patients, respectively. At initial diagnosis, the tumor was well, moderately and poorly differentiated adenocarcinoma in 26 (24.3%), 47 (43.9%) and 34 (31.8%) patients, respectively. The median follow-up period was 52.3 months. The overall 1, 3 and 5-year survival rates were 98.0%, 86.8% and 75.2%, respectively. The 5-year survival rates for stage A, B, C and D were 100%, 93.8%, 82.1% and 56.9%, respectively. A significant difference (p = 0.017) in 5-year survival rate was noted between stage C and D. The 5-year survival rate was 100% for well differentiated, 78.0% for moderately differentiated, and 53.2% for poorly differentiated adenocarcinoma. A significant difference (p = 0.0016) in the 5-year survival rate was noted between well differentiated and poorly differentiated adenocarcinoma. According to the therapy, the 5-year survival rate in stage C was 86.2% for the radical prostatectomy group and 84.0% for the endocrine therapy group. There was no significant difference between these 2 treatment groups. Endocrine therapies, classified into maximum androgen blockade (MAB) and endocrine therapy other than MAB were performed for stage D as an initial therapy. Although the prognosis in the patients treated with MAB was better than that with other endocrine therapies, there was no significant difference between these 2 endocrine treatment groups.
Asunto(s)
Adenocarcinoma/epidemiología , Neoplasias de la Próstata/epidemiología , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Anciano , Anciano de 80 o más Años , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Tasa de SupervivenciaRESUMEN
Primary small cell carcinoma of the renal pelvis is rare. We report a case of combined small cell and transitional cell carcinoma of the renal pelvis. The patient was a 78-year-old man with macrohematuria. He was diagnosed with right pelvic tumor by right retrograde pyelography and computerized tomography. A right radical nephroureterectomy was performed. Histological sections of the tumor showed a mixture of small cell and grade 2 transitional cell carcinoma. Positivity for Grimelius was noted in the small cell component. Masson-Fontana, chromogranin A, serotonin, keratin, leucocyte common antigen (LCA), neuron specific enolase (NSE), adrenocorticotropic hormone (ACTH), growth hormone (GH) and somatostatin were negative. Ultrastructurally, the tumor cells were tightly packed and attached together by scattered desmosomes. There were no neurosecretory granules. Seven months after operation, the patient died with peritonitis carcinomatosa. At autopsy, a metastatic tumor was found in the liver and retroperitoneal lymph node. Other organs were not involved. Especially, there were no abnormalities in the lungs.
Asunto(s)
Carcinoma de Células Pequeñas/patología , Carcinoma de Células Transicionales/patología , Neoplasias Renales/patología , Neoplasias Primarias Múltiples/patología , Anciano , Carcinoma de Células Pequeñas/cirugía , Carcinoma de Células Transicionales/cirugía , Humanos , Neoplasias Renales/cirugía , Pelvis Renal , Masculino , NefrectomíaRESUMEN
A case of retrovesical hemangiopericytoma is reported. The patient was a 44-year-old woman with right lumbago. Cystoscopy showed extra-vesical compression in the area from the trigone to right wall of bladder. The histological examination of the specimen obtained with ultrasound-guided transvaginal biopsy revealed hemangiopericytoma. Because of the invasion to the bladder mucosae, total cystectomy and ileal conduit were performed. The patient received postoperative irradiation of 3,060 rad for pelvis. Eight months after operation, computerized tomography showed no evidence of local recurrence of the tumor.
Asunto(s)
Hemangiopericitoma , Neoplasias de la Vejiga Urinaria , Adulto , Cistectomía , Femenino , Hemangiopericitoma/diagnóstico por imagen , Hemangiopericitoma/cirugía , Humanos , Ultrasonografía , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
A 65-year old man, who had had resection of a right ureter tumor two years earlier, was hospitalized with complaints of lower abdominal discomfort and hematuria. Pathological diagnosis of the ureteral tumor was grade 3 transitional cell carcinoma. Computed tomography and magnetic resonance imaging demonstrated a large tumor in the retrovesical space and recurrence of transitional cell carcinoma was suggested. Total pelvic exenteration was performed and pathological diagnosis of the tumor was undifferentiated carcinoma simulating malignant lymphoma. Immunohistochemical examinations revealed no antigens specific for the lymphoid cells or epithelial cells on the specimen. This tumor consisting of undifferentiated carcinoma was considered to be recurrence of transitional cell carcinoma with the diffuse pattern simulating malignant lymphoma proposed by Zukerberg et al.