bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical excision of a metastatic adrenal lesion in a patient with prostatic cancer
Authors: Sakamoto Naotaka , Eto Masatoshi , Ando Sadamu
Published: March 2003

Background: A 64‐year‐old Japanese man with stage D2 prostatic cancer, after having responded dramatically to androgen ablation, demonstrated a solitary adrenal metastasis without disease progression to any other site.

Methods: A surgical excision of the lesion and adjuvant systemic chemotherapy was performed.

Results/Conclusions: The patient has since remained alive without any evidence of recurrence 21 months after surgery.
Bladder dysfunction after proximal urethrolysis in female dogs
Authors: Kato Haruaki , Igawa Yasuhiko , Khaleque Momeen, Abdul , Nishizawa Osamu
Published: March 2003

Background: Functional changes in the bladder after proximal urethrolysis are not recognized, despite the development of neuroanatomical studies of the female urethra or functional studies of the urethra after cystectomy. The aim of the present pilot study is to investigate possible functional changes in the bladder after proximal urethrolysis in female dogs.

Methods: The bilateral nerve branches to the urethra were resected by separating the urethra from the anterior vaginal wall in 10 female dogs. Pre‐ and postoperative cystometrograms were recorded under anesthesia and the bladder capacity, threshold pressure for micturition and bladder stiffness (the inverse of compliance) were compared.

Results: Fourteen days postoperatively, the bladder capacity significantly decreased and the threshold pressure and bladder stiffness significantly increased. Eight weeks after surgery, the threshold pressure and bladder stiffness remained high, but the bladder capacity tended to return to baseline values.

Conclusions: These results indicate that proximal urethrolysis with bilateral sections of the nerve branches to the urethra produces a low‐compliant bladder in the early postoperative period and suggest that afferent stimuli from the urethra may participate in maintaining a compliant bladder during filling.
Urinary nuclear matrix protein 22 as a new marker for the screening of urothelial cancer in patients with microscopic hematuria
Authors: Miyanaga Naoto , Akaza Hideyuki , Tsukamoto Taiji , Ishikawa Satoru , Noguchi Ryosuke , Ohtani Mikinobu , Kawabe Kazuki , Kubota Yoshinobu , Fujita Kimio , Obata Koji , Hirao Yoshihiko , Kotake Toshihiko , Ohmori Hiroyuki , Kumazawa Joichi , Koiso Kenkichi
Published: March 2003

Purpose: The aim of the present study was to determine the clinical usefulness of nuclear matrix protein 22 (NMP22) as a new urinary marker for the screening of urothelial cancer in patients with microscopic hematuria, especially in comparison with that of voided urine cytology.

Methods: Patients with microscopic hematuria detected at a health examination, who were advised by a consulted urologist to have a cystoscopical examination, were asked to enter this study. Urine samples were collected before cystoscopy and divided into two portions for a NMP22 test and voided urine cytology.

Results: Of the 309 patients with microscopic hematuria, 22 cases (7.1%) of urothelial cancer and one case of prostate cancer were detected. For the other cases, 128 (41.4%) were of benign diseases and 158 (51.1%) were designated as having no evidence of disease (NED). The median NMP22 values for urothelial cancer, other diseases and NED were 35.5, 6.7 and 6.0 U/mL, respectively, with 95% confidence intervals of 19.9–228.2, 5.1–9.3 and 5.4–7.2, respectively. The sensitivity of the NMP22 test for urothelial cancer was 90.9% (20/22), whereas the sensitivity of voided urine cytology was only 54.5% (12/22).

Conclusions: The present study indicates that urinary NMP22 is a useful tool for the screening of urothelial cancer in patients with microscopic hematuria.
Influence of 5‐hydroxytryptamine and the effect of a new serotonin receptor antagonist (sarpogrelate) on detrusor smooth muscle of streptozotocin‐induced diabetes mellitus in the rat *
Authors: Kodama Masahito , Takimoto Yukie
Published: March 2003

Background
: We evaluated the changes in the response of detrusor muscle to 5‐hydroxytryptamine (5‐HT; serotonin) and its receptor mechanisms in pathologic bladder of diabetes mellitus rats.

Methods
: Eight‐week‐old male Wistar rats were given an intraperitoneal injection of streptozotocin (STZ, 60 mg/kg) in order to induce diabetes mellitus (4 weeks’ duration). The bladder strips (10 × 2 mm) were subjected to a tension of 1.0 g in organ baths for the measurements of isotonic contractile responses to 5‐HT or relaxation responses to 5‐HT antagonists.

Results
: Bladder strips from STZ‐diabetic rats responded to 5‐HT with greater contractions than did those of control rats, given vehicle alone. However, bladder strip weights gradually increased in the STZ‐diabetic rats as compared with control rats and when the contractile response to 5‐HT was expressed as a percentage of the response to 10–1 mol/L KCl there was no statistically significant difference between the groups. In both control and diabetic rats, the 5‐HT3 selective antagonist did not markedly inhibit the contractile response to 5‐HT. In contrast, the 5‐HT2A selective antagonist inhibited the contractile response to 5‐HT in a dose‐dependent manner.

Conclusions
: These results suggest that the increased contractile response to 5‐HT in diabetic rats’ bladder is related to smooth muscle hypertrophy and/or hyperplasia and indicate that this effect is mediated by activation of 5‐HT2A receptors.
Microsurgical vasoepididymostomy with sperm cryopreservation for future assisted reproduction
Authors: Hibi Hatsuki , Yamada Yoshiaki , Honda Nobuaki , Fukatsu Hidetoshi , Katsuno Satoshi , Ohshima Shinichi , Yamamoto Masanori
Published: March 2003

Abstract Background Although obstructive azoospermia is treatable with microscopic seminal reconstruction, the number of patients who choose to undergo vasoepididymostomy is limited because of recent advances in assisted reproductive technology (ART). We attempted to define the outcome of surgical reconstruction in patients with suspected epididymal obstruction and no previous history of vasectomy.

Methods We described 40 eligible end‐to‐side vasoepididymostomy procedures performed on 24 azoospermic patients who had either bilateral or unilateral epididymal obstruction.

Results The overall patency rate following surgery was 54% (13/24) and for four patients (17%), natural intercourse resulted in pregnancy. Two pregnancies were initiated with intracytoplasmic sperm injections using frozen sperm collected during vasoepididymostomy.

Conclusions In the era of modern ART, microsurgical vasoepididymostomy with cryopreservation of sperm collected during the operation is recommended for patients with epididymal obstructions.
Metastases to the penis from carcinoma of the prostate
Authors: Kotake Yatsugu , Gohji Kazuo , Suzuki Toshiaki , Watsuji Toshikazu , Kusaka Mamoru , Takahara Kenn , Ubai Takanobu , Noumi Hayahito , Inamoto Teruo , Shibahara Nobuhisa , Ueda Haruhiko , Katsuoka Yoji
Published: March 2003

Abstract A 58‐year‐old man presented with dysuria at the Osaka Medical College Hospital in November 1996. Laboratory examination revealed elevated serum prostate‐specific antigen (PSA) to > 100 ng/mL. Adenocarcinoma of the prostate with metastasis to the bone was diagnosed after a biopsy of the prostate and bone scintigraphy; hormonal therapy was administered. Although bone metastasis was well controlled and the serum PSA level declined to within normal levels (2.0 ng/mL), several painless nodules were found on the penile glans. Biopsy of the nodules showed that the penile tumor was a metastasis from the prostate cancer. The patient underwent partial penectomy for relief from penile pain. The serum PSA level showed no elevation 3 months after the partial penectomy, suggesting that careful observation of prostate cancer patients is necessary, even when oseous metastasis is well controlled and serum PSA levels are kept within normal ranges by hormonal therapy. The case also indicates that urologists should consider the possibility of metastasis to the penis from prostate cancer.
Ureteroarterial fistula in a patient with a single functioning kidney
Authors: Matsui Yoshiyuki , Fujikawa Keita , Oka Hiroya , Fukuzawa Shigeki , Takeuchi Hideo
Published: March 2003

Abstract A rare case is reported of a fistula between the left internal iliac artery and the left ureter in a patient whose left kidney was the only functioning kidney. Internal iliac artery embolization was initially successful in stopping the bleeding, but the fistula recurred when the ureteral stent was removed. Even after embolization, the tissue surrounding a fistula remains very fragile, so the fistula may easily recur as a result of slight injury or inflammation.
Primary signet‐ring cell carcinoma of the urinary bladder inducing renal failure
Authors: Yamamoto Shinya , Ito Takaaki , Akiyama Akihito , Miki Makoto , Tachibana Masaaki , Takase Michio , Matsumoto Tetsuo , Mochizuki Mamoru
Published: March 2003

Abstract A case of primary signet‐ring cell carcinoma of the urinary bladder that was found to have induced renal failure is the second such case reported in the world. Primary signet‐ring cell carcinoma of the urinary bladder is a rare histologic variant of adenocarcinoma. The patient died of distant metastasis 8 months after undergoing total cystectomy. The neoplasm had a high stage at diagnosis, so the prognosis was very poor. To improve the prognosis, earlier diagnosis and establishing a regimen of chemotherapy is necessary.
Candidal infections as a cause of recurrent uretero‐ileal anastomotic dehiscence
Authors: Ather M Hammad , Malik Nadia , Memon Amanullah
Published: March 2003

Abstract Fungal infections are common in immunocompromised patients. The presentation is often subtle and therefore treatment is delayed. Uretero‐ileal anastomotic dehiscence due to candidal infection has never been reported before. This case represents an uncommon but potentially life‐threatening complication in reconstructive surgery; that is, anastomotic dehiscence due to a unique etiology.
Schinzel–Giedion syndrome
Authors: Touge Hiroshi , Fujinaga Takuji , Okuda Masumi , Aoshi Hideo
Published: March 2003

Abstract A 2‐month‐old girl was brought to the Department of Pediatrics at Wakayama Rosai Hospital because of poor feeding since 1 month of age. She was the third child of young healthy non‐consanguineous parents whose first son was healthy but whose second son had died of 18 trisomy. Physical examination showed midfacial hypoplasia with coarse dysmorphic features, choanal stenosis, remarkable abdominal distention and bilateral talipes equivarus. Abdominal ultrasonography, computed tomography and drip infusion pyelogram showed left severe hydronephrosis and right moderate hydronephrosis. Having diagnosed Schinzel–Giedion syndrome, a left ureteroneocystostomy with tailoring was performed to preserve renal functions and to eliminate the urinary tract infection at the age of 3 months.
Limited Wegener’s granulomatosis of the epididymis
Authors: Al‐Arfaj Abdurhman
Published: March 2003

A case is presented of Wegener’s granulomatosis limited to the epididymis in a 32‐year‐old man. Tests for antineutrophils cytoplasmic antibodies were negative throughout. He showed excellent response to treatment with prednisolone, azathioprine and cotrimoxazole, following recurrence of his disease, after local complete excision. He remains free of disease 40 months after the discontinuation of all his treatment.
Glyoxylate determination in rat urine by capillary electrophoresis
Authors: Nishijima Saori , Miyazato Tomonori , Sugaya Kimio , Koyama Yuzo , Hatano Tadashi , Ogawa Yoshihide
Published: March 2003

Abstract Oxalate is important in the study of renal stone formation and is derived from the endogenous metabolism of glyoxylate. The aim of this study was to determine urinary glyoxylate levels by capillary electrophoresis (CE). Urine specimens were obtained from 25 male Wistar rats (16 rats intravenously injected with 10 mg or 20 mg glyoxylate and nine controls) by bladder puncture 1 h after administration of glyoxylate or saline. Urinary glyoxylate was measured by CE using an electrolyte composed of 5 mmol/L pyridinedicarboxylic acid and 0.5 mmol/L cetyltrimethylammonium bromide (pH 5.6 and 11.0). The mean ± SD urinary glyoxylate concentration was 43.1 ± 14.7 μmol/L in control rats, 722.8 ± 165.5 μmol/L in rats given 10 mg of glyoxylate and 1290.0 ± 470.8 μmol/L in rats given 20 mg of glyoxylate. The mean ± SD recovery after spiking 675.7 μmol/L of glyoxylate into 16 urine specimens was 98.82 ± 12.81%. When the reproducibility of urinary glyoxylate determination was assessed, the intra‐assay coefficient of variation (CV) ranged from 1.38 to 2.59% and the inter‐assay CV ranged from 2.94 to 6.69%. Capillary electrophoresis enables sensitive and reproducible determination of urinary glyoxylate levels in rats. This method appears to be suitable for laboratory use and has the advantage of determining glyoxylate and several other urinary anions simultaneously.
Tubularized incised‐plate urethroplasty for secondary hypospadias surgery
Authors: Hayashi Yutaro , Kojima Yoshiyuki , Mizuno Kentaro , Nakane Akihiro , Tozawa Keiichi , Sasaki Shoichi , Kohri Kenjiro
Published: March 2003

Abstract Purpose: Reoperation for failed hypospadias has been considered to be seriously bothersome because abundant penile skin does not tend to remain for urethroplasty or for penile shaft skin coverage. In this study, the tubularization of incised urethral plate was employed for those who had no excessive penile skin after failure of hypospadias repair.

Methods: Five patients with hypospadias underwent tubularized incised‐plate urethroplasty as salvage surgery. The surgical techniques necessary for the performance of the reoperation were not different from those for the primary repair. The urethral plate was incised sufficiently deeply in its midline from the tip of the glans to the regressed meatus. The incised urethral plate was tubularized without tension over a catheter of an appropriate size.

Results: Four of those who underwent secondary tubularized incised‐plate urethroplasty were successfully repaired without complications. A urethrocutaneous fistula occurred at the corona in the remaining patient.

Conclusions: The absence of preputial skin in reoperative cases makes tubularized incised‐plate urethroplasty the ideal option, although the series was small and postoperative duration is still short. In addition, this procedure can give excellent functional and cosmetic results even in patients who require revisional hypospadias surgery.
Laparoscopic diagnosis and treatment of nonpalpable testis
Authors: TSUJIHATA MASAO , MIYAKE OSAMU , YOSHIMURA KAZUHIRO , KAKIMOTO KEN‐ICHI , MATSUMIYA KIYOMI , TAKAHARA SHIRO , OKUYAMA AKIHIKO
Published: March 2003

Abstract Objective: Laparoscopy has become one of the important diagnostic modalities of nonpalpable testis and has been developed and applied in the treatment of this disease. In the present study, we investigated the usefulness of laparoscopy in the diagnosis and treatment of nonpalpable testis.

Methods: Laparoscopy was carried out under general anesthesia on 21 patients (23 testes) from October 1991 to October 1999. If the internal spermatic vessels and vas deferens made their way into the internal inguinal ring, the inguinal canal was dissected with an incision in the inguinal region to look for the testis. Patients with intra‐abdominal testis underwent laparoscopic orchiopexy or orchiectomy. If the internal spermatic vessels terminated with a blind end intraperitoneally, making it impossible to identify the testis, the case was judged to be vanishing testis and the operation was finalized without any further examination.

Results: In eight of 23 testes (35%), the internal spermatic vessels and vas deferens made their way into the internal inguinal ring. The inguinal region was examined in all the eight testes. Orchiopexy was carried out on two testes and orchiectomy was carried out on six testes. An intra‐abdominal testis was detected in eight of 23 testes (35%). Laparoscopic orchiopexy was carried out on seven testes. One‐stage orchiopexy was carried out on two of the seven testes and two‐stage Fowler‐Stephens orchiopexy was carried out on five of the seven testes. Orchiectomy was carried out on the remaining testis. Blocking or lack of the internal spermatic vessels and vas deferens was seen in seven of the 23 testes (30%) and this condition was diagnosed as vanishing testis.

Conclusion: Laparoscopy for nonpalpable testis is considered to be the most effective technique for diagnosing the presence or absence of the testis and the location of the testis.
A stone developed within the dilated intravesical ureter following ureteroscopy
Authors: AKAGASHI KEIGO , TANDA HITOSHI , KATO SHUJI , OHNISHI SHIGEKI , NAKAJIMA HISAO , NANBU AKIHITO , NITTA TOSHIKAZU , KOROKU MIKIO
Published: March 2003

Abstract A 58‐year‐old man presented with a stone within the dilated intravesical ureter, which was probably attributable to a previous ureteroscopy. Transurethral incision of the right intravesical ureter and lithotripsy were carried out without subsequent urinary tract impairment. Although some complications resulting from ureteroscopy, such as ureteral stricture, ureteral perforation and vesicoureteral reflux, have been reported, this complication is considered to be very rare.
Annual PSA tests are not necessary for men with a PSA level below 2 ng/mL: Findings of the Imari prostate cancer screening program
Authors: Uozumi Jiro , Tokuda Yuji , Fujiyama Chisato , Takagi Norito , Meiri Hiroyuki , Kuratomi Kazunari , Nakamura Kouji , Ichigi Yasuhisa , Yoshinaga Hidetoshi , Kinoshita Norio , Masaki Zenjiro
Published: March 2003

Background: Annual changes in prostate specific antigen (PSA) levels detected by the Imari prostate cancer screening program were evaluated to establish a more efficient and cost‐saving screening system, especially for men with low PSA levels.

Methods: Prostate specific antigen‐based annual mass screenings for prostate cancer were conducted for men aged 60–69 in the Imari district, Saga, Japan. Between 1992 and 2000, 1822 men had their PSA levels tested. A total of 4661 PSA tests were conducted. Changes in PSA levels over the following 1 to 5 years were analyzed in men with PSA levels of 3 ng/mL or less, a range in which the detection rate of prostate cancer would seem to be negligibly low.

Results: The overall detection rate of prostate cancer between 1992 and 2000 was 0.73%. The detection rate in men with a PSA level between 3.1 and 3.9 ng/mL, and between 4 and 9.9 ng/mL was 1.6% and 8.3%, respectively. Of 4661 determinations of PSA, 2553 (54.8%) were found to be ≤ 1 ng/mL, 1273 (27.3%) were between 1.1 and 2 ng/mL, and 401 (8.6%) were between 2.1 and 3 ng/mL. Four hundred and thirty‐four men (9.3%) had PSA levels ≥ 3.1 ng/mL, with possible indications for prostate biopsy. Of the men tested, 1.4% with an initial PSA level of ≤ 2 ng/mL and 22.3% with an initial level between 2.1 and 3 ng/mL had a PSA level of ≥ 3.1 ng/mL after 1 year. Almost the same rate of PSA increase was observed between the two PSA tests conducted at 2 to 5‐year intervals. Of the men tested, 2.2% with an initial PSA level of ≤ 2 ng/mL, and 21.9% with an initial level between 2.1 and 3 ng/mL, had a level of ≥ 3.1 ng/mL after 5 years.

Conclusion: Levels of PSA in men with an initial level below 2 ng/mL remained stable for up to 5 years. Levels of PSA in 97.8– 98.8% of men remained below 3 ng/mL after 1 to 5 years. In contrast, 18–35.3% of men with an initial PSA level between 2.1 and 3 ng/mL showed PSA progression to 3.1 ng/mL or more within 5 years. Our present data suggest that annual PSA testing is not necessary for men with a PSA level below 2 ng/mL. Prostate specific antigen testing could therefore be conducted at longer intervals in such individuals.
Advanced renal cell carcinoma treated with granulocyte‐macrophage colony‐stimulating factor gene therapy: A clinical course of the first Japanese experience
Authors: Kawai Koji , Tani Kenzaburo , Yamashita Naohide , Tomikawa Shinji , Eriguchi Masazumi , Fujime Makoto , Okumura Ko , Kakizoe Tadao , Clift Shirley , Ando Dale , Mulligan Richard , Yamauchi Atsusi , Noguchi Masayuki , Asano Shigetaka , Akaza Hideyuki
Published: March 2003

A phase I study of granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) gene‐transduced tumor vaccine for patients with metastatic renal cell carcinoma (RCC) was initiated in 1998, as the first cancer gene therapy in Japan. The study is still ongoing, but the first patient is presented here as a case report. The patient was a 60‐year‐old man with Stage IV CRC with multiple lung metastases. After surgical resection of the tumor, autologous tumor cells were transduced and cultured to produce GM‐CSF. The patient received a total of 2.2 × 108 gene‐transduced autologous vaccine cells by subcutaneous injection. During the course of vaccination, growth of the largest metastatic mass slowed to some extent; however, multiple new lesions developed. About 1 month after the start of low‐dose IL‐2 therapy, rapid and remarkable regression in a large lung hilar metastatic mass was noticed. The patient died of progressive disease 7 months after the start of GM‐CSFgene therapy. Careful histological examination by autopsy revealed that the responding mass was infiltrated by CD8 positive dominant T lymphocytes, and did not exhibit vasculitis or any other changes associated with active autoimmune disease.
Erosion of a penile prosthesis due to an indwelling urethral catheter as a late complication
Authors: HISASUE SHIN‐ICHI , SATO YOSHIKAZU , HORITA HIROKI , ADACHI HIDEKI , SUZUKI NORIYOSHI , KATO RYUICHI , SUZUKI KAZUHIRO , KOBAYASHI KOU , ITOH NAOKI , TSUKAMOTO TAIJI
Published: March 2003

Abstract A case of erosion of a penile prosthesis caused by indwelling of a catheter in the urethra is reported. A 73‐year‐old man had maintained sexual intercourse with penile prostheses (Jonas prosthesis, 19 cm) for 11 years without any complications until he developed cerebral infarction. One month after starting an indwelling urethral catheter in a neurosurgery clinic, the left‐side penile prosthesis eroded from the area of the fossa navicularis, and was immediately removed. This type of complication is not unusual in patients with a neurogenic bladder. However, it is not well recognized in patients who suddenly develop a neurogenic bladder following a long‐term uneventful period after the implantation of penile prostheses. Therefore, urologists should inform patients who receive this type of treatment that erosion of the prosthesis may develop when they need an indwelling urethral catheter as a late complication.
Laparoscopic nephroureterectomy for dysplastic kidney in children: an initial experience
Authors: Kurokawa Yasushi , Kanayama Hiro‐Omi , Anwar Ahmed , Fukumori Tomoharu , Yamamoto Yasuyo , Takahashi Masayuki , Kagawa Susumu , Murakami Yosihide , Terachi Toshiro
Published: March 2003

Background: Laparoscopic nephroureterectomy for dysplastic kidney is now becoming a widely accepted procedure. We report here our initial experience with laparoscopic nephroureterectomy in four girls.

Methods: Between 1993 and 1999, laparoscopic nephroureterectomy was performed in four girls (mean age 5.3 years). Three patients had an ectopic dysplastic kidney with ectopic ureter, and one patient had hydronephrosis with megaureter due to distal ureteral atresia of the upper moiety in a duplicated dysplastic kidney. The transperitoneal approach was used in all cases.

Results: Mean operative time was 195 min (range 150–266). Blood loss was minimal. All operations were completed successfully and there were no intraoperative or postoperative complications except for subcutaneous emphysema in one patient (case 4). Postoperative analgesia was used in three patients and administered in the form of diclofenac sodium suppositories 12.5 mg (cases 1 and 2) or acetaminophen suppositories 50 mg (case 3) for 1–2 days. One patient did not require any analgesia (case 4). Oral fluid intake was resumed on the first postoperative day and ambulation began within 1–3 days (mean 1.6, cases 1, 2 and 3) and 6 days (case 4). All children returned to normal activity within 3–6 days of surgery. Mean postoperative hospital stay was 7.3 days. All cases had uneventful courses after discharge.

Conclusion: Laparoscopic nephroureterectomy can be performed safely, with minimal postoperative pain, excellent cosmetic results and early ambulation. We advocate the use of laparoscopy for the diagnosis and treatment of dysplastic kidney with ectopic ureter.
Endoscopic management of post‐traumatic prostatic and supraprostatic strictures using Neodymium‐YAG laser
Authors: NABI GHULAM , DOGRA PREM NATH
Published: March 2003

We assessed the feasibility, efficacy and long‐term results of endoscopic management using Neodymium‐YAG (Nd‐YAG) laser as a day care procedure in patients with post‐traumatic supraprostatic and prostatic strictures. Three patients with post‐traumatic prostatic and supraprostatic obliterative strictures underwent Nd‐YAG laser core through urethrotomy as a day care procedure. Patient age ranged between 12 and 14 years. Mean duration of injury was 16 months. The length of stricture was assessed by bi‐directional endoscopy prior to the procedure in all cases. Core through procedure was carried out using Nd‐YAG laser under the guidance of a cystoscope placed antegradely. Patients were discharged on the same day with urethral catheter. Foley catheters were removed at 6 weeks. Nd‐YAG laser core through procedure was carried out successfully in all cases with negligible blood loss in a mean time of 48 min. There were no intraoperative or postoperative complications. Patients were discharged on the same day. Follow‐up cystogram was conducted at 6 weeks and urethroscopy at months. At a mean follow‐up of 23 months, patients were asymptomatic and voiding well. Nd‐YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post‐traumatic prostatic and supraprostatic strictures. It can be carried out as a day care procedure in carefully selected patients and has no complications.
Changes in serum and prostatic zinc concentrations in rats after intraprostatic injection of zinc: Comparison of two forms of zinc delivery
Authors: CHO YONG‐HYUN , LEE SEUNG‐JU , LEE JI YOUL , KIM SAE WOONG , KIM JUNG JU , LEE WOO YOUNG , YOON MOON SOO
Published: March 2003

Background: We investigated changes in zinc concentrations in serum and prostatic tissue after an intraprostatic injection of zinc, and compared two forms of zinc delivery: solution and liposome.

Methods: Ninety‐six male Wistar rats were used in the study (24 controls, 72 test rats). The test animals were randomly divided into two groups and were injected intraprostatically with 2 mL of 0.04 mol/L zinc sulfate according to the form of zinc delivery. Nine rats in each test group were sacrificed 1 day, 7, 14 and 28 days after injection, and 24 normal rats were injected intraprostatically with 2 mL of distilled water as controls. Serum and prostatic zinc concentrations of each group were measured by inductively coupled plasma atomic emission spectrometry. Blood chemistries, routine urinalysis, urine culture and histopathologic examination were also performed.

Results: Serum zinc concentrations did not change significantly after the intraprostatic injection of zinc. Prostatic zinc concentrations were found to be significantly greater (P < 0.05) in zinc‐injected groups than in the control group. The intraprostatic injection of zinc solution and zinc liposome increased zinc levels in both ventral and dorsolateral lobes significantly. Prostatic zinc levels increased progressively following injection, reaching a peak level in 7 days and maintaining a high value throughout the experimental period. The prostatic zinc level of the 1‐day zinc liposome group was higher than that of the 1‐day zinc solution group, while no significant difference was observed between the solution and liposome group in 7, 14, 28 days. No abnormal findings were observed in any of the laboratory and histopathologic examinations; however, an acute inflammatory response was observed in the 1‐day groups.

Conclusion: These findings suggest that an intraprostatic injection of zinc in normal rats increases and maintains the prostatic zinc level for at least 4 weeks without causing any systemic or local toxicities. These findings suggest the potentially important clinical applicability of local zinc to the treatment of chronic prostatitis.
Treatment of monosymptomatic nocturnal enuresis by acupuncture: A preliminary study
Authors: HONJO HISASHI , KAWAUCHI AKIHIRO , UKIMURA OSAMU , SOH JINTETSU , MIZUTANI YOICHI , MIKI TSUNEHARU
Published: March 2003

Objectives: This study was designed to clarify the clinical usefulness of acupuncture as a treatment option for monosymptomatic nocturnal enuresis, and evaluate the mechanisms of its effect.

Methods: Subjects comprised 15 patients (10 males, 5 females) with monosymptomatic nocturnal enuresis who were treated by acupuncture using a disposable stainless steel needle (0.3 mm in diameter, 60 mm in length) inserted into bilateral BL‐33 (Zhongliao) points on the skin of the third posterior sacral foramina and rotated manually for 10 min reciprocally. Bladder capacities and number of wet nights per week were compared before and after treatment. Patients in whom wet nights decreased 50% or more compared with the baseline were considered responders.

Results: Nocturnal enuresis improvement rates following acupuncture treatment were 40% (6/15) just after treatment and 47% (7/15) 2 months after. In 6 responders, just after treatment the nocturnal bladder capacity (NBC) increased significantly, from 201 mL to 334 mL (P < 0.05). No side‐effects were recognized throughout the treatment period.

Conclusion: Acupuncture may be beneficial in the treatment of nocturnal enuresis by increasing NBC, and provide a promising alternative to conventional therapies for monosymptomatic nocturnal enuresis.
Incidentally discovered pheochromocytoma in long‐term hemodialysis patients
Authors: MORIOKA MASAAKI , YUIHAMA SHINNOSUKE , NAKAJIMA TAKASHI , KOBAYASHI TATSUYA , SONE ATSUSHI , FURUKAWA YOJI , TANAKA HIROYOSHI , SAIKI TOYONORI
Published: March 2003

Two cases of pheochromocytoma incidentally discovered in long‐term hemodialysis patients are reported. Case 1 was a 47‐year‐old‐man who had been receiving hemodialysis for 18 years. Case 2 was a 33‐year‐old woman who had been receiving hemodialysis for 12 years. Both cases were normotensive, and no specific symptoms suggesting pheochromocytoma were seen. Plasma norepinephrine (NE) levels were not elevated in both cases; however, the level of epinephrine (E) was double the normal range in Case 2. After surgery, plasma E level returned to the normal range in Case 2; however, the level of NE remained almost the same as the preoperative value in both cases. Plasma catecolamine levels in long‐term hemodialysis patients with pheochromocytoma are reviewed in the present report, and the efficacy of imaging methods in the diagnosis of pheochromocytoma are discussed.
Laparoscopic correction of vesicoureteral reflux using the Lich–Gregoir technique: initial experience and technical aspects
Authors: KAWAUCHI AKIHIRO , FUJITO AKIRA , SOH JINTETSU , UKIMURA OSAMU , MIZUTANI YOICHI , MIKI TSUNEHARU
Published: March 2003

Abstract We report two female cases with vesicoureteral reflux (VUR) who underwent laparoscopic correction of VUR by the Lich–Gregoir technique. One patient was 10 years of age, with international grade III reflux of the left ureter; the other was 27 years of age, with grade II reflux of the right ureter. The respective operating times were 6 h 40 min and 6 h 10 min. There were no complications during surgery. Although post‐surgical ultrasonography revealed mild hydronephrosis in the adult patient, the condition resolved spontaneously 2 months after surgery. The disappearance of reflux was confirmed in both cases by voiding cystography 6 months after surgery.
Current status of positron emission tomography in oncology
Authors: Scott A. M.
Published: March 2003

Positron emission tomography (PET) has emerged as a powerful diagnostic tool in oncology patients. There is evidence of the superior utility over conventional imaging methods of the principal PET tracer 18F‐fluoro‐2‐deoxy‐glucose in the staging of a range of cancers and monitoring disease recurrence, as well as changing patient management to more appropriate therapy. The methods for evaluating the evidence for PET remain complex, particularly as the standard evidence‐based approach of randomized controlled trials is not generally applicable to imaging techno‐logies. PET has the potential to dramatically improve our ability to manage patients with cancer and is also making major contributions to the development of new therapies. (Intern Med J 2000; 31: 27–36)
Psychological impact of genetic counselling and testing in women previously diagnosed with breast cancer
Authors: Randall J. , Butow P. , Kirk J. , Tucker K.
Published: March 2003

Abstract Background: The recent discovery of susceptibility genes relating to breast cancer, BRCA1 and BRCA2, now allows women with breast cancer and a family history of breast/ovarian cancer to undergo genetic testing to identify a causative germ‐line mutation. The present study assessed the psychological status over time of women affected by breast cancer requesting genetic testing (cases; n = 32) compared with matched controls (n = 28).

Methods: Subjects were recruited through two Sydney‐based hospitals. Data were collected via questionnaire and telephone interview at baseline, and 2 weeks and 3–6 months following counselling.

Results: Genetic test results were not received by the subjects within the study period. Cases showed a greater increase in knowledge of cancer genetics following counselling compared with controls, and this was maintained over time. Psychological symptoms remained stable over the study period and there were no differences between groups.

Conclusions: Increased knowledge following genetic counselling was not accompanied by an increase in anxiety or depression. Further assessment will be required in the long term to determine the psychological impact of receiving a genetic test result. (Intern Med J 2001; 31: 397–405)
Outcome of a smoking cessation programme run in a routine hospital setting
Authors: Wood‐Baker R.
Published: March 2003

Abstract

Background: Although tobacco smoking remains the largest preventable cause of mortality in Australia, resources to assist with cessation remain scarce. Research studies have demonstrated improved cessation rates with interventions such as counselling and pharmacotherapy, but there is little information on success in routine clinical practice.

Aims: To determine the outcome of a smoking cessation programme run in a routine hospital outpatient setting.

Methods: A prospective audit of patients referred to an outpatient smoking cessation programme by hospital specialists or general practitioners. The programme consisted of fortnightly counselling sessions, with nicotine replacement therapy when clinically indicated. Self‐reported abstinence rates were determined by contacting patients by letter or telephone at 3 and 12 months. Abstinence was confirmed, whenever possible, by measuring the expired carbon monoxide (CO) concentration.

Results: Over 12 months, 226 new patients were seen through the programme. There was a correlation between the number of cigarettes smoked and the baseline Fagerstrom score (r = 0.49, P < 0.001). Approximately 40% of subjects could not be contacted for follow up. At 3 months the self‐reported abstinence rate was 31%, falling to 19% by 12 months. Measurement of expired CO concentrations proved that self‐reported abstinence was reliable.

Conclusions: The abstinence rates achieved by our programme compared well with those previously reported in the literature, demonstrating the effectiveness of a smoking cessation programme run in routine clinical practice. There was an increasing relapse rate during the period of follow up. (Intern Med J 2002; 32: 24–28)
Central nervous system prophylaxis in haematological malignancies
Authors: Wellwood J. , Taylor K.
Published: March 2003

Given the poor prognosis of central nervous system (CNS) involvement in haematological malignancies, management is directed towards prevention. CNS prophylaxis may take the form of intrathecal therapy, cranial irradiation, systemic therapy or some combin­ation of these. The toxicity of these methods is an important consideration. A risk‐orientated approach to the delivery of CNS prophylaxis in each disorder is required. (Intern Med J 2002; 32: 252−258)
Asthma management: how effective is it in the community?
Authors: Matheson M. , Wicking J. , Raven J. , Woods R. , Thien F. , Abramson M. , Walters E. H.
Published: March 2003

Abstract

Background:  The National Asthma Campaign (NAC) was launched in Australia in 1989 with the major objective of improving asthma management through the implementation of a six‐step asthma management plan.

Aim:  The objective of the present study was to analyse the management of asthma in a cohort of adults with self‐reported asthma 10 years after the commencement of the NAC.

Methods:  The subjects were participants in the laboratory phase of a cross‐sectional epidemiological study conducted in Melbourne in 1999−2000. Participants completed the detailed European Community Respiratory Health Survey, which included specific questions about their asthma management. Participants were included in this analysis if they had a positive response to the question ‘Have you ever had asthma?’. This resulted in a total of 435 subjects.

Results:  Of the subjects with self‐reported asthma, over half of the participants reported that a doctor had ever measured their breathing (52.9%). However, only 10.1% of participants reported that they owned a peakflow meter (PFM) and only 13.3% reported that they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (P < 0.0001), as has PFM ownership (P < 0.0001) and, importantly, possession of a written action plan (P = 0.0004).

Conclusions:  Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required. (Intern Med J 2002; 32: 451−456)
Is magnetic resonance angiography useful in renovascular disease?
Authors: Prasad S. , Bannister K. , Taylor J.
Published: March 2003

Abstract

Background:  Magnetic resonance angiography (MRA) of renal vessels correlates well with conventional angiography (CA) and enables non‐invasive assessment of renal vessels without nephrotoxic contrast.

Aims: We aimed to identify the referral source and nature of the patient group undergoing renal MRA, and the impact of this test on their management.

Methods: All renal MRA scans performed at the Royal Adelaide Hospital from 1 November 1997 to 31 Dec­ember 2000 were reviewed (n = 121). Clinical data were obtained by case‐note review or from treating physicians. MRA scans were with gadolinium enhancement, using a Siemens Vision 1.5 Tesla machine (Siemens, New York), with Visual Basic 33 software and 3D reconstruction.

Results: Nephrologists ordered the majority of renal MRA studies (64.5%). Indications for MRA included: (i) hypertension (91.3%), (ii) abnormal renal function (78.3%), (iii) other imaging suggesting renovascular disease (64.3%) and (iv) renal impairment with angiotensin‐converting enzyme inhibition (18.3%). Eighty‐seven MRA studies revealed renovascular abnormalities (‘positive’). Over 50% of patients had three or more risk factors associated with vascular disease, with MRA positive in 76%. Localized renal artery stenosis was identified in 65 cases. In 40 of these, CA and further intervention was not undertaken, mainly due to presence of features of irreversible renal damage, low‐grade stenosis or stable clinical parameters. CA was performed in 25 patients, all of whom had moderate‐ to high‐grade (>60%)­­stenosis on MRA. Revascularization was attempted in 21 of the 25 patients, with technical success in 17. In 22 patients, MRA identified non‐localized abnormal­ities, most commonly diffuse arterial disease. None went on to angiography.

Conclusions: Selective use of renal MRA in high‐risk patients (identified by vascular risk factors or with standard renal imaging) can assist in avoidance of invasive, potentially nephrotoxic conventional angiography in up to 80% of cases. Those with lesions warranting treatment can then be selected for further intervention. (Intern Med J 2003; 33: 84−90)
Herbicide‐resistant genetically‐modified crop: its risks with an emphasis on gene flow
Authors: Kwon Yong Woong , Kim Do‐Soon
Published: March 2003

Herbicide‐resistant genetically‐modified (GM) crops are the most widely cultivated worldwide, representing 78% of GM crops in 1999, followed by insect‐resistant GM crops with Bt gene. Gene flow is the most touching risk arising from GM crops, and is categorized as three types: within species, between species and between GM crop and other organisms. This review shows that gene flow is a reality in the plant kingdom with evolutionary change. Herbicide resistance evolves naturally and spreads dynamically in weeds. One of the most concerning crop in relation to gene flow is Brassica napus, which has a high outcrossing rate and many relative species. In contrast, frequency of gene flow via outcrossing is relatively low in inbreeding cereal crops such as rice, wheat and barley, but published reports have shown that substantial gene flow is possible. Another possible and immediate risk is herbicide‐resistant GM crops becoming volunteer weeds. Dry direct‐seeded rice is one of the most likely crops in this respect. Stacking different resistance genes in a crop would accelerate multiple resistance evolution in weeds. Multiple resistance to three major herbicides has already been observed in oilseed rape cultivation. More efforts must be made for long‐term risk assessment on GM crops in the natural ecosystem. More studies on weed biology and ecology, particularly reproductive processes in weeds, are essential for better understanding of gene flow and systematic management strategy. We hope that this review motivates researchers to analyze data available now, to collect fundamental information on crops and weeds in agro‐ecosystem, and to lead to better risk assessment and management.
Comparison of physiological effects of fluazifop‐butyl and sethoxydim on oat (Avena sativa L.)
Authors: Luo Xiaoyong , Matsumoto Hiroshi , Usui Kenji
Published: March 2003

Laboratory experiments were conducted to compare the physiological effects of two herbicides: fluazifop‐butyl {butyl (RS)‐2‐[4‐(5‐trifluoromethyl‐2‐pyridyloxy)phenoxy]‐propionate} and sethoxydim {(±)‐2‐[1‐(ethoxyimino)butyl]‐5‐[2‐(ethylthio)propyl]‐3‐hydroxy‐2‐cyclohexen‐1‐one} on oat (Avena sativa L. cv. Zenshin). The herbicides strongly inhibited growth of oat and induced chlorosis at the basal part of shoots and ethylene production from the seedlings. The phytotoxicity of these herbicides in oat seedlings was alleviated by 2,4‐D (2,4‐dichlorophenoxyacetic acid), but not by IAA (indole‐3‐acetic acid). Coleoptile elongation induced by 2,4‐D or IAA was inhibited by fluazifop‐butyl and sethoxydim, suggesting both herbicides possess the activity to inhibit this auxin action. Fluazifop (free acid) and sethoxydim inhibited proton excretion from oat roots but fluazifop‐butyl did not. This proton excretion was not restored by 2,4‐D or IAA. Furthermore, cellular electrolyte leakage in oat shoots was increased by both herbicides, indicating that the membrane permeability was increased. We conclude that fluazifop‐butyl and sethoxydim may have the same mechanism of action which leads to disruption of membrane integrity, although fluazifop‐butyl acts as a free acid after hydrolysis (fluazifop).
Evaluation of the allelopathic potential of Kava (Piper methysticum L.) for weed control in rice
Authors: HONG NGUYEN HUU , XUAN TRAN DANG , EIJI TSUZUKI , MATSUO MITSUHIRO , YUICHI OGUSHI
Published: March 2003

Kava is a perennial pepper plant from the Oceanic region, which is commonly used as a drink by natives and for pharmacological purposes. Results of this study concluded that Kava has allelopathic potential and suppressed germination and growth of lettuce (Lactuca sativa L), barnyardgrass (E. crus‐galli Beauv var. formosensis Ohwi.), and duck‐tongue weed (M. vaginalis Presl var. plantaginea Solms‐Laub.) Moreover, Kava inhibited emergence of weeds in paddy soils. The inhibition of Kava became stronger as the applied concentration increased. In a greenhouse experiment, Kava had the greatest inhibition on emergence and weed growth in paddy soils when a dose of 1 ton ha−1 of Kava was divided and applied at 3, 16, and 23 days after watering. Inhibition by Kava varied among weed species. Results from this study suggest that Kava might be useful for weed control in rice or reduce dependence on herbicide.
Restoration of tuber production by exposure to unshaded daylight in Eleocharis kuroguwai Ohwi shaded during the early tuber formation period
Authors: INAMURA TATSUYA
Published: March 2003

The loss of final tuber weight of Eleocharis kuroguwai Ohwi by shading during the early tuber formation period (TFP) is overcome by exposure to unshaded daylight thereafter (late TFP). In the present study, the growth parameters that contribute to the dry matter increase (DMI) per day of tubers in the late TFP were examined. DMI of the tuber during the late TFP was determined by that of the whole plant and the ratio of the DMI of the tuber to that of the whole plant during this period. The ratio of the DMI of the tuber to that of the whole plant during the late TFP was significantly correlated with the DMI of the whole plant during the first 14 days of the late TFP. During the late TFP after the exposure to unshaded daylight, DMI of the whole plant correlated with the surface area of the stem (SAS) and net assimilation ratio (NAR), and the SAS correlated with the stem dry weight (DW) and specific stem‐surface area (SSA). SSA negatively influenced NAR, but NAR was increased by unshading. During the late TFP after shading, the effect of the decrease of the stem DW due to shading on the DMI of the whole plant was mitigated by the large SAS and high NAR. These results indicate that the growth parameters that contribute to the DMI of tuber during the late TFP after exposure to unshaded daylight are SAS and NAR just after unshading, and SSA during this period.
Glufosinate tolerance in hybrid corn varieties based on decreasing ammonia accumulation†
Authors: PORNPROM TOSAPON , CHOMPOO JAMNIAN , GRACE BELINDA
Published: March 2003

Field tolerance to glufosinate in hybrid corn varieties (non‐GMOs) was evaluated at physiological and biochemical levels. The present experiment was conducted to provide information for the development of a glufosinate‐tolerant corn variety through a conventional breeding program. The effect of glufosinate on the physiological response to crop injury, plant height, and fresh and dry weight was examined in 15 locally adapted corn varieties to this herbicide. The highest degree of tolerance was observed in the varieties Pacific 626 and Pacific 983, while the most susceptible variety was CP 989. CP 989 tended to accumulate ammonia more than Pacific 626 and 983; and the concentration of glufosinate resulting in a 50% increase in ammonia concentration in CP 989 was half that required for Pacific 626 and 983. These results indicate that the degree of ammonia accumulation might be related to the sensitivity of these corn varieties to glufosinate.