bluuebunny/crossref_metadata_2025 huggingface dataset:
ALTERATION OF THE HYPOTHALAMUS‐PITUITARY‐TESTIS AXIS IN OLIGOZOOSPERMIC MEN WITH NORMAL GONADOTROPIN LEVELS
Authors: Fujisawa Masato , Kanzaki Masanori , Hayashi Akijumi , Tanaka Hirokazu , Okada Hiroshi , Arakawa Soichi , Kamidono Sadao
Published: July 2007

Background:

Serum basal hormone levels such as lutenizing hormone (LH), follicle‐stimulating hormone (FSH), and testosterone, which is important to regulate testicular function, do not necessarily indicate the normal integrity of the hypothalamic‐pituitary‐testicular axis and the static measurement is not enough to detect the endocrine disorder. The dynamic measurement of gonadal hormone by GnRH test is considered to be more helpful to understanding the endocrine regulation of spermatogenesis. In this study, we performed GnRH test in oligozoospermic patients with normal levels of LH and FSH to examine the subtle alteration of hypothalamic‐pituitary‐testis axis.

Methods:

GnRH test was performed in 41 patients with oligozoospermia and normal gonadal hormone levels.

Results:

The responses of LH and/or FSH were excessive in most patients in spite of their normal gonadotropin levels. The patients with sperm concentration < 10 ± 106/ml had significantly higher peak levels of both LH and FSH than did those with sperm concentration > 10 ± 106/ml. In the patients with normal peak levels of both LH and FSH, sperm concentration was significantly higher than those with exceeded peak levels of FSH and/or LH after GnRH test. No significant differences were observed in estradiol, testosterone, free testosterone, or prolactin (PRL) levels between patients with normal responses and abnormal responses of LH and/or FSH.

Conclusions:

The feedback control of gonadotropin release from testis was worse in more severely oligozoospermic patients, although the precise mechanism of feed back still remains unknown.
RENOCOLIC FISTULA CAUSED BY XANTHOGRANULOMATOUS PYELONEPHRITIS
Authors: Ono Yoshihiro , Sekihara Tetsuo , Kurokawa Kouhei , Saruki Kazuhisa
Published: July 2007

A 68‐year‐old female was diagnosed with a renocolic fistula, associated with left chronic pyelonephritis due to a ureter stone. Nephrectomy and repair of the fistula were performed. Histopathological examination revealed xanthogranulomatous pyelonephritis.
RENAL ONCOCYTOMA CONTAINING “CHROMOPHOBE” CELLS
Authors: Noguchi Sumio , Nagashima Yoji , Shuin Taro , Kubota Yoshinobu , Kitamura Hitoshi , Yao Masahiro , Hosaka Masahiko
Published: July 2007

We report a rare case of renal oncocytoma containing occasional “chromophobe” cells. This case suggests an intimate relationship between oncocytoma and “chromophobe” renal cell carcinoma.
Reduction of Nitric Oxide with L–/Vc–Monomethyl Arginine in lnterleukin–2 and Anti–CD3 Monoclonal Antibody Combination Therapy
Authors: Nakajima Fumio , Asano Tomohiko , Hayakawa Masamichi , Nakamura Hiroshi
Published: July 2007

We evaluated nitric oxide induction in antitumor therapy consisting of anti–CD3 monoclonal antibody (anti–CD3) and interleukin–2 (IL–2), then determined the effect of nitric oxide reduction with L–NG–monomethyl arginine (LNMA) on the therapeutic methods. Female C57BL/6 mice, MCA102 (a non immunogenic, NK–resistant murine fibrosarcoma cell line), and 145–2C11 (hamster anti–murine–CD3 mAb) were utilized in an experimental hepatic metastasis model developed by injecting a tumor cell suspension into the spleen of mice. A marked increase in serum NO2–+ NO1 was observed at 19 hours after anti–CD3 (10 μ, IV) and additional IL–2 administrations (40times101 U, twice, If) induced a further increase. The NO2, + NO3‐ elevation in spot urine in the combination therapy was not suppressed with LNMA at a dose of 100 μg/h but was significantly lowered at 300 μg/h. The efficacy of the anti–CD3 + IL–2 therapy was not diminished by LNMA administration either at 100 μg/h or at 300 μg/h.
Application of Cytokine Drug Delivery Systems to the Immunotherapy of Renal Cell Carcinoma in Mice
Authors: Marumo Ken , Oya Mototsugu , Murai Masaru , Tazaki Hiroshi
Published: July 2007

We have investigated the antitumor effects of human lymphoblastoid interferon (HLBI) mini–pellets, interleukin–2 (IL–2) entrapped in liposome (IL–2 liposome) and an immune complex of IL–2 and monoclonal antibody against IL–2 (IC–1). The HLBI mini–pellets were administered to nude mice bearing a human renal cancer cell line (KU–2). HLBI levels remained detectable both in the tumor tissue and the serum up to 10 days after peritumor injection. The HLBI mini–pellet significantly suppressed tumor growth by peritumor administration. The antitumor effect of IL–2 liposome on Renca, a murine renal cancer, resulted in the inhibition of tumor growth. An accumulation of Lyt–2– and L3T4 lymphocytes was seen in the tumor tissue which was treated with IL–2 liposomes. The IC–1 was prepared by mixing IL–2 and anti–IL–2 monoclonal antibody at a molar ratio of 2: 1. Plasma IL–2 levels were sustained longer in mice given the IC–1 than in mice given IL–2 alone. The IC–1 complex exerted a more significant antitumor effect by local administration in Renca–bearing mice than the administration of IL–2 alone. We speculated that these effects were a result of sustained tumor IL–2 levels due to the increase in molecular weight. The results we obtained indicate that the cytokine drug delivery system has a long–acting cytotoxicity by administration to the tumor sites through efficient stimulation of the local immune response, and thus provides a useful tool for treatment of renal cell carcinoma.
Exact Documentation of Location and Size of Bladder Tumor with a Three–Dimensional Mapping Device
Authors: Hatano Tadashi , Oda Masami , Ogawa Yoshihide , Osawa Akira
Published: July 2007

Background Cystoscopy is one of the most important devices for diagnosing bladder tumor, but has a crucial shortcoming—the size of observed objects cannot be measured. This paper describes a new method to measure the position and size of a bladder tumor using a three–dimensional mapping device.

Methods The three–dimensional mapping device, which is connected to an endoscope prior to use, can precisely measure the size and show the position of a bladder tumor. It consists of several arms connected by an angle sensor mounted on the articular site. One end of the device is fixed to the table and the other end is connected to the eye piece of an endoscope. Weight balancers keep each arm in a well balanced position, so urologists can freely manipulate the endoscope. Data from the angle sensor is sent to a personal computer (PC), which computes data such as three–dimensional coordination and diameter of a tumor. The diameter of a tumor is calculated by the PC according to the Pythagorean theorem.

Conclusion The position and size of a bladder tumor can be measured using our three–dimensional mapping device.
Clinical Studies on Advantages and Safety of Visual Laser Ablation for Patients with Benign Prostatic Hyperplasia
Authors: Nasu Yasutomo , Watanabe Toyohiko , Kumon Hiromi , Ohmori Hiroyuki
Published: July 2007

Since 1992, we have been performing VLAP using a right–angle laser delivery system (Urolase) for BPH patients with significant underlying nonurological diseases such as diabetes mellitus, cardiovascular, pulmonary, and maligant diseases. Sufficient clinical results have been obtained without major complications during short–term and long–term observation.

In this study, we discuss the clinical advantages and safety of VLAP, compared with TURP, through analysis of the clinical procedure for VLAP for patients treated with anticoagulant agents such as waríarin.

In our study of 40 patients, 8 patients were treated with anticoagulants for cardiovascular disease. During the procedure and after the operation, no significant complications were encountered except for transient postoperative bleeding.

The 8 patients who received simultaneous anticoagulant therapy also underwent TURP to draw a comparison. The time taken for the procedure and the volume of the blood loss were significantly reduced by VLAP.

The hemostatic nature of YAG laser energy seems to result in a technical improvement over conventional I URP for patients undergoing anticoagulant therapy.
Visual Laser Ablation of the Prostate and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia
Authors: Uchida Toyoaki , Ohori Makoto , Iwamura Masatsugu , Egawa Shin , Ao Teruaki , Yokoyama Eiji , Mashimo Setsuo , Endo Tadao , Koshiba Ken
Published: July 2007

For the past 50 years, transurethral resection of the prostate (TURP) has been the most common treatment for benign prostatic hyperplasia (BPH). The authors have conducted visual laser ablation of the prostate (VLAP) for BPH as a minimum invasive surgery. The results were compared with those of VLAP, VLAP+transurethral incision of the prostate (TUIP), and TURP as other treatments for BPH. In the VLAP group, 50 of 52 (96.2%), 36 of 40 (90.0%) and 31 of 36 (86.1%) were categorized as having more than a Fair Response (FR) at 3, 6 and 12 months, postoperatively. In the VLAP+TUIP group, 24 of 29 (82.8%), 19 of 22 (86.4%) and 9 of 11 (81.8%) were classed as having more than a FR at 3, 6 and 1 2 months, postoperatively. Forty–one of 42 (97.6%), 1 7 of 1 7 (100.0%) and 6 of 6 (100.0%) patients reaction to TURP was more than FR in overall response at 3, 6 and 12 months, postoperatively. The need for a blood transfusion, perforation of the prostate capsule and transit incontinence persisting for more than 1 month occurred in 1 of 45 (2.2%), 1 (2.2%) and 4 (8.9%) patients in the TURP group. Bladder neck contracture was seen in 4 of 52 (7.7%) in the VLAP group. Average postoperative catheter duration was shorter in the VLAP+TUIP (5.7 ± 8.4 days) than in the VLAP group (10.3 ± 10.4 days). Although TURP remains the standard treatment for BPH, VLAP results in less morbidity compared to TURP. VLAP with TUIP appears to lessen the risk of postoperative urinary retention and provide better results in longer follow–up studies.
Experimental Studies of Adhesion and Endocytosis of Calcium Oxalate Crystals in Renal Tubular Cells
Authors: Kohjimoto Yasuo , Ebisuno Shoichi , Tamura Miyako , Ohkawa Tadashi
Published: July 2007

The present investigation was designed to study the interactions between Madin–Darby canine kidney (MDCK) cells and calcium oxalate monohydrate (COM) crystals, the most abundant constituent of urinary crystals, and to clarify the significance of these crystal–cell interactions in stone pathogenesis. COM crystals adhered to the intact surface of MDCK cells by some biological mechanisms (biological adhesion) and, were then internalized into the cell (endocytosis). The microvilli of the cell appeared to play an important role in this process.

In the kidneys of rats with experimentally induced stones, most COM crystals adhered to the tubular cells and some crystals were engulfed, via endocytosis. Thus, these crystal–cell interactions might be one of the earliest processes in the formation of kidney stones. Further elucidation of the mechanism and the regulatory factors of this process may provide new insight into stone pathogenesis.
Inhibitory Potency of Crystal Matrix Protein on the Crystallization of Calcium Oxalate
Authors: Nakajima Chiaki , Suzuki Koji , Tsugawa Ryuzo
Published: July 2007

The presence of macromolecular substances is among the multiple factors that may influence the complex process of urinary stone formation. The aim of this study was to evaluate the inhibitory potency of crystal matrix protein (CMP). Purification of CMP consisted of calcium oxalate crystal formation, dissolution of crystals, electrodialysis and high–performance liquid chromatography (HPLC). The inhibitory potency of crystal aggregation was examined by the seed crystal method, the undiluted urine method, and the use of scanning electron microscopy (SEM). CMP showed the protein band of 31 kDa in SDS–PAGE. Anti–CMP polyclonal antibody and antihuman prothrombin antibody cross–reacted well with human prothrombin and CMP in Western blotting. CMP and human prothrombin had high inhibitory potency by the seed crystal method and undiluted urine method. Using SEM, we were able to observe the high inhibitory potency of human prothrombin and undiluted CMP on the aggregation of calcium oxalate crystals.
Regulation of the Expression of OPN mRNA in the Rat as an Experimental Model of Renal Stone Disease
Authors: Amasaki Naoya , Yamate Takanori , Umekawa Tohru , Ishikawa Yasuaki , Kajikawa Hiroshi , Kurita Takashi
Published: July 2007

We have sequenced a cDNA of calcium oxalate urinary stone protein extracted with EDTA. cDNA sequences showed complete homology between urinary stone protein and human osteopotine (OPN, bone sialoprotein 1). In this study, we investigated the expression of OPN mRNA in rat kidney serving as experimental models for several conditions that are considered to be risk factors in human renal stone formation. In the renal stone formation model, the expression of OPN mRNA in the distal convoluted tubule of the kidney was enhanced compared with the control which was found sporadically positive by in situ hybridization. By Northern blot analysis, the expression of OPN mRNA was increased in pyelonephritis and hydronephrosis models compared with the control, but no changes were observed in dietary–acid or base–loading models. The expression of OPN mRNA was markedly inhibited in the renal stone formation model by concomitant administration of estradiol and/or progesterone.
Role of rBAT Gene Products in Cystinuria
Authors: Miyamoto Ken–ichi , Katai Kanako , Tatsumi Sawako , Sone Kanako , Segawa Hiroko , Takada Kazumi , Yamamoto Hironori , Taketani Yutaka , Morita Kyoko , Kanayama Hiroomi , Kagawa Susumu , Takeda Eiji
Published: July 2007

To investigate whether rBAT gene products function as a crystine transporter component or as a transport activator, we microinjected several C–terminal deletion mutants of rBAT cRNA into Xenopus oocytes, and measured transport activity for arginine, leucine and cystine in the presence and absence of sodium. Wild type rBAT significantly stimulated the uptake of all 3 amino acids 10–20 fold compared to control mutants. On the other hand, no mutant, except a Δ511–685 mutant, stimulated the uptake of these amino acids. However, the Δ511–685 mutant significantly increased the uptake of arginine. In the presence of sodium, the Δ511–685 mutant also increased the uptake of leucine. The Δ511–685 mutant did not stimulate crystine uptake in the presence and absence of sodium. Furthermore, inhibition of L–arginine uptake by L–homoserine was seen only in the presence of sodium. These results suggest that mutant rBAT stimulates the endogenous amino acid transport system y+ in oocytes. Finally, rBAT gene products, as the primary cause of cystinuria, may function as activators of the amino acid transport system in renal brush border membrane.
Local Toxicity Patterns Associated with lntravesical bacillus Calmette‐Guérin: A Southwest Oncology Group Study
Authors: Berry Donna L. , Blumenstein Brent A. , Magyary Diane L. , Lamm Donald L. , Crawford E. David
Published: July 2007

Background: While the efficacy of bacillus Calmette‐Cuérin (BCG) immunotherapy has been demonstrated, the relative benefit, given a seemingly high incidence and severity of toxicities, remains an issue. Adequate understanding and management of toxicities can maximize the safety of the treatment and enable the administration of required doses of BCC intravesical therapy.

Methods: All week‐to‐week symptoms recorded for the 143 immunotherapy‐naive participants assigned to the BCG arm of SWOG‐8216, BCG vs. Doxorubicin in Superficial Bladder Cancer were analyzed in order to document the pattern of toxicities in the first six week induction course of intravesical BCC treatments. The statistical analysis consisted of fitting logistic regression models to these data for the probability of irritative bladder symptoms (16s).

Results: In the optimal model, the probability of IBS depends only on whether there was IBS associated with the previous treatment, and not on which treatment. The estimated probability of having IBS when there were no 16s associated with the previous instillation is 0.136, whereas the estimated probability of having IBS when there was IBS associated with the previous instillation is 0.689.

Conclusions: Irritative bladder symptoms are unlikely in the week after the first intravesical BCG treatment. Once a patient experiences IBS, he or she is more likely to have IBS with the next and subsequent treatments. Clinicians can use the findings of this analysis when informing their patients about the treatment course and when making decisions about continuing treatments.
Serum Prostate Specific Antigen and Prostate Specific Antigen Density in Patients Receiving Radical Prostatectomy
Authors: Masai Motoyuki , Ito Haruo , Kotake Tadashi , Nagao Koichi
Published: July 2007

Objective: To study the significance of prostate specific antigen (PSA) and prostate specific antigen density (PSAD) for predicting the risk of occult metastatic disease and extra‐prostatic invasion of prostate cancer in patients receiving radical prostatectomy.

Patients and methods: The cases of 41 consecutive patients who underwent radical prostatectomy were reviewed. Relations of PSA and PSAD using Market M PA1M assay for grade, preopvrative clinical stage, postoperative pathological stage, capsular penetration, seminal vesicle invasion, resection margins and lymphnode metastasis are discussed.

Results: Although serum PSA was correlated with PSAD and PSA was correlated with preoperative prostate volume, PSAO was not influenced by prostate volume. PSA correlated only with the grade, while PSAD was correlated with grade, preoperative clinical Stage, postoperative pathological stage, capsular penetration, seminal vesicle invasion, resection margins and lymphnode metastasis. In addition, sixty‐two percent (8/13) of margin positive patients showed a PSAD value of more than 0.4, while 93% (26/28) of margin negative patients showed less than 0.4. Sixty‐seven percent (6/9) of lymphnode positive patients showed a PSAD of more than 0.4, while 91% (29/32) of lymphnode negative patients showed less than 0.4.

Conclusion: We concluded that PSAD was useful for predicting extraprostatic involvement of prostatic cancer.
Injection of Glutaraldehyde Cross‐Linked Collagen for Urinary Incontinence: Two‐Year Efficacy by Self‐Assessment
Authors: Hornma Yukio , Kawabe Kazuki , Kageyama Shinji , Koiso Kenkichi , Akaza Hideyuki , Kakizoe Tadao , Koshiba Ken , Yokoyama Eiji , Aso Yoshio
Published: July 2007

Background: Glutaraldehyde cross‐linked (GAX) collagen has recently become available ds injection material for treatment of urinary incontinence and should be evaluated for its long‐term efficacy. Methods: The subjects included 78 females with genuine stress incontinence (GSI) and 19 male or female patients with intrinsic sphincter deficiency (ISD: urinary incontinence due to urethrdl sphincter damage). GAX collagen was injected transperineally or trdnsurethrally through an injection needle under direct endoscopic observation. The efficacy was evaluated by the patients' overall assessment at two years post‐treatment.

Results: Under local or regional anesthesia, CAX collagen was injected 1.9 times on average (total injection volume: 23.5 mL) in GSJ patients and 2.2 times (40.1 mL) in ISD patients. Improvement at two years post‐treatment by patients' assessment was observed in 71.7% of GSI patients and 53.3% in ISD patients. Side effects were urinary retention and difficulty in voiding after 48 of the total of 188 injections (15.5%). a large amount of residual urine in four (2.1%) and miscellaneous in 19 (10.1%), for a short period after injection and were not serious.

Conclusion: Our study indicates that GAX collagen injection is an effective, safe and easy non‐medical treatment for urinary incontinent patients.
Phyllodes Type of Atypical Prostatic Hyperplasia
Authors: Fujita Kimio , Matsushima Hisashi , Munaksta Akio
Published: July 2007

This report documents an uncommon prostatic hyperplasia which developed within,1 thick capsule between the bladder and rectum grossly showing a phyllodes type ot growth. It was simply excised, but recurred locally two years later. A total prostatectomy was performed, and microscopic examination of the tissue revealed no malignant transformation.
Prevalence of Urolithiasis in Kaizuka City, Japan—An Epidemiologic Study of Urinary Stones
Authors: Iguchi Masanori , Umekawa Tohru , Katoh Yoshinari , Kohri Kenjiro , Kurita Takashi
Published: July 2007

Background: According to the results of nationwide surveys, the prevalence of urolithiasis has been steadily increasing in Japan. However, these surveys relied on hospital statistics, and there has been no survey of the prevalence of urolithiasis in Japan utilizing postal questionnaires. We surveyed the prevalence of urolithiasis among the inhabitants of Kaizuka City.

Methods: A total of 3,000 inhabitants ranging from 20 to 59 years old were randomly selected from the census register in numbers consistent with the population distribution of each district and sex by municipal computerized system.

Results: A total of 1,975 postal questionnaires were returned, and 1,972 (65.7%) were considered valid. Of the respondents, 137 (6.95%) had a history of stones (men; 9.64%, women; 4.51%). The annual incidence of urolithiasis for Kaizuka citizens aged from 20 to 59 years old in 1991 was 0.97%, and the lifetime prevalence of urolithiasis increased linearly with age, and it was 10.3% for respondents in their 50s. In the total survey population of 7,568, which included the respondents and their family members, 342 (4.52%) had a history of stones. Male administrative workers had a significantly higher prevalence than any other occupational group. The monthly expenditure on food by the families of stone formers was significantly greater than that by the families of non‐stone formers.

Conclusion: Extrapolation of the findings suggests that ≥1 0% of the general population (≥13% of men and >7% of women) can be expected to suffer from urolithiasis at least once in their lifetime.
Intracorporeal Lithotripsy with the Swiss Lithoclast
Authors: Terai Akito , Takeuchi Hideo , Terachi Toshiro , Kawakita Mutsushi , Okada Yusaku , Yoshida Hiroshi , Isokawa Yoshiaki , Taki Yoji , Yoshida Osamu
Published: July 2007

Background: In addition to currently available modalities of intracorporeal lithotripsy (ultrasonic, electrohydraulic, and laser), a new ballistic lithotriptor known as the Swiss Lithoclast has recently gained attention. This study reports our experience with the Swiss Lithoclast in the endoscopic management of urinary calculi.

Methods: A total of 51 patients with urinary calculi were treated with the Swiss Lithoclast; one patient with a renal calculus, 28 with ureteral calculi, and 22 with lower urinary tract (bladder, urethra and Kock pouch) calculi.

Results: The Lithoclast successfully fragmented 94% of the calculi, independent of stone composition. Complete failure of fragmentation was not encountered. In six of the 10 upper ureteral calculi, stone fragments were pushed up into the calyces. Adjunctive extracorporeal shock wave lithotripsy for residual fragments was performed in six cases. The stone‐free rate at one and three months was 84% and 88%, respectively. There were no intraoperative or long‐term complications directly related to the use of this device.

Conclusion: The Swiss Lithoclast is a safe and effective means of intracorporeal lithotripsy. Although suitable for mid and lower ureteral stones, the device has a risk of stone push‐up in patients with upper ureteral stones.
Renal Blood Flow and Serotonin Metabolism in Tacrolimus Treated Rats
Authors: Mugiya Soichi , Fujita Kimio , Malyszko Jolanta , Takada Yumiko , Takada Akikazu
Published: July 2007

Background: Serotonin (5‐HT) is a potent vasoconstrictor and activator of platelets, endothelial cells and vascular smooth muscle cells. The result of activation by serotonin is platelet aggregation and vasoconstriction. The aim of the present study was to evaluate the role of serotonin metabolism as a mediator of tacrolimus (FK 506) nephrotoxicity.

Methods: The whole blood and plasma levels of serotonin and its major metabolite (5‐hydroxyindoleacetic acid: 5‐HIAA) as well as renal cortical blood flow were investigated in rats administered FK 506 at doses of 4, 6 or 8mg/kg b.w. for 14 consecutive days.

Results: Renal cortical blood flow declined in a dose‐dependent manner in the rats given FK 506, whereas serum creatinine remained unaltered following FK 506 administration. Although there was no significant change in serotonin, the whole blood and plasma 5‐HIAA levels increased significantly following FK 506 administration.

Conclusion: FK 506 may cause acute nephrotoxicity by decreasing renal blood flow and the increase of 5‐HIAA suggests some role of serotonin metabolism in the development of FK 506 nephrotoxicity.
An Upregulation of Interleukin‐2 Receptor, Transferrin Receptor Expression and Cytokine Production Mediated by Hemin in Human Peripheral Blood Mononuclear CelIs
Authors: Tsuji Akira , Shinomiya Nariyoshi , Hayakawa Masamichi , Nakamura Hiroshi
Published: July 2007

Background: We previously reported that hemin‐induced mitogenicity in mouse splenocytes was potentiated up to two‐fold by interleukin (IL)‐2, and the combination of hemin and IL‐2 was also effective in inducing cytotoxicity for NK‐resistant target cells. The purpose of this study was to investigate the effects of hemin both on expression of membrane surface receptors and on production of cytokine in human peripheral blood mononuclear cells (PBMC).

Methods: Human PBMC were obtained from 16 healthy volunteers. We analyzed hemin‐mediated surface phenotypes of cells using flow cytometry, and levels of tumor necrosis factor (TNF)‐α and interferon (1FN)‐γ in the culture‐supernatant of cells by ELSA system.

Results: Hemin induced increased expression of both transferring receptor and IL‐2 receptor (CD25) on PBMC in a dose‐dependent manner. When the combination of hemin (30μno//L) and IL‐2 (100U/mL) was added to the culture of PBMC, the population of double positive cells was increased up to 70.4%. These effects of hemin were enhanced by the addition of catalase in the culture. Treatment with hemin plus IL‐2 effectively enhanced the production of TNF‐α and IFN‐γ in PBMC.

Conclusion: Hemin upregulated both IL‐2 receptor and transferrin receptor expression, and stimulated TNF‐α: and IFN‐γ production in PBMC. IL‐2 cooperated with hemin in eliciting these effects.
In Vitro Degradation of Oxalic Acid by Human Feces
Authors: Ito Haruo , Kotake Tadashi , Masai Motoyuki
Published: July 2007

Background: Oxalic acid‐degrading bacteria have been isolated from human feces. Therefore, the possibility exists that oxalic acid in food is degraded in human intestine by such bacteria, and absorption and excretion of oxalic acid is reduced. It may be possible that patients who form idiopathic stones have fewer oxalic acid‐degrading bacteria than healthy controls. The purpose of this study is to examine the possibility that oxalic acid in food is degraded in the human intestine. Methods: Nineteen patients with calcium stones and 13 healthy subjects were included in the study. Samples of feces were diluted with Barber medium containing 1 g/L of oxalic acid dihydrate, and 1%, 0.1% and 0.01% suspensions were prepared. These solutions were incubated under anaerobic conditions at 37°C for seven days. The degradation of oxalic acid was estimated by the decrease of oxalic acid in the medium.

Results: The feces of almost all persons with or without calculi degraded oxalic acid to some degree. Incomplete or no oxalic acid degradation was found in 15 of the 19 stone‐forming patients and in five of the 1 3 stone‐free controls.

Conclusion: Large numbers of oxalic acid‐degrading bacteria were observed less often in the feces of stone‐formers than in the feces of stone‐free controls.
Mechanisms of the Suppression of the Bladder Activity by Flavoxate
Authors: Kimura Yutaka , Sasaki Yasuo , Hamada Kozo , Fukui Hisashi , Ukai Yojiro , Yoshikuni Yoshiaki , Kimura Kiyoshi , Sugaya Kimio , Nishizawa Osamu
Published: July 2007

Background: This study was designed to clarify the primary site of action of flavoxate, clinically used for the treatment of urinary frequency.

Methods: In rats, the effect of flavoxate on contractile responses in isolated detrusor strips, bladder contraction induced by pelvic nerve stimulation, isovolumetric rhythmic bladder contractions, and pelvic nerve activity were examined. In decerebrated cats, flavoxate was microinjected into the nuclei in the pons, and its effect on reflex micturition was observed.

Results: Flavoxate suppressed carbachol‐ and calcium ion (Ca2+)‐induced contractions of isolated detrusor strips in a noncompetitive and a competitive manner, respectively. Intravenous flavoxate suppressed both initial phasic, and later tonic, bladder contractions induced by electrical stimulation of the distal end of the pelvic nerve. It abolished isovolumetric rhythmic bladder contractions and the associated efferent pelvic nerve activity, without affecting baseline vesical pressure and afferent pelvic nerve activity. When administered intracerebroventricularly or intrathecally, it abolished isovolumetric rhythmic bladder contractions. Flavoxate microinjected into the nucleus reticularis pontis oralis (PoO; pontine micturition inhibitory region) of decerebrated cats inhibited the reflex micturition, but had no effect when microinjected into the locus coeruleus alpha (pontine micturition center) or locus subcoeruleus (pontine urine storage center).

Conclusions: Flavoxate suppressed the micturition reflex primarily by facilitating the inhibitory action of the PoO on the descending pathways from the pontine micturition center to the sacral arasympathetic intermediolateral nuclei.
Subcapsular Hematoma and Hypertension Following Percutaneous Needle Biopsy of a Transplanted Kidney
Authors: Machida Jiroh , Kitani Kohsuke , Inadome Akito , Wada Yoshihiro , Kawabata Koji , Yoshida Masaki , Ueda Shoichi
Published: July 2007

Percutaneous needle biopsy of a transplanted kidney is indicated as a diagnostic procedure in the evaluation of unexplained deteriorated renal function after renal transplantation. This procedure is not always without complications. We report a case of a subcapsular hematoma and hypertension following a percutaneous needle biopsy of a transplanted kidney. The cause of hypertension in this patient and the management of the subcapsular hematoma are discussed.
Simultaneous Left Renal Pelvic and Bilateral Ureteral Tumors Producing Carbohydrate Antigen 19–9
Authors: Mizutani Youichi , Terachi Toshiro , Yoshida Toru , Kakehi Yoshiyuki , Yoshida Osamu
Published: July 2007

We report a case of a transitional cell carcinoma of the left renal pelvis and both ureters which secreted carbohydrate antigen 19–9. Aggressive surgery was performed including a left nephroureterectomy including the bladder cuff and a right total ureterectomy with an ileal graft replacement. The patient has had good kidney function and no evidence of disease for one year postoperatively.
Leiomyosarcoma of the Ovarian Vein: An Unusual Cause of Severe Abdominal and Flank Pain
Authors: Kawai Koji , Horiguchi Hisashi , Sekido Noritoshi , Akaza Hideyuki , Koiso Kenkichi
Published: July 2007

Leiomyosarcoma arising from the ovarian vein is extremely rare: only one case was found in the literature. We report a case in a sixty‐one‐year‐old woman who had unexplained attacks of pain in her left lower abdomen and flank for two years.
Infected Primary Hydatid Cyst of Retroperitoneum
Authors: Özdemir Enver
Published: July 2007

An infected primary solitary hydatid cyst of the retroperitoneum that displaced the right kidney and liver and elevated the diaphragm is described. It showed pericystic calcification and contained an air‐fluid interface. No other hydatid cyst was demonstrable in any organ. The cyst was treated by surgery together with povidone‐iodine irrigation and albendazole prophylaxis for secondary infestation. In these lesions, increased CT density of the mother cyst and lower densities of the daughter vesicles are pathognomonic. In the present case, secondary bacterial infection further increased the CT density of the mother cyst, while the daughter vesicles remained uninfected and were visible as lower densities.
Intrascrotal Epidermoid Cyst: Report of Two Cases
Authors: Ohyama Chikara , Tochigi Tatsuo , Kuwahara Masaaki , Imai Yoshitada
Published: July 2007

A 70‐year‐old man and a 52‐year‐old man each presented with a painless extratesticular, intrascrotal mass. Magnetic resonance imaging revealed a cystic mass and was the most useful modality for the diagnosis. Complete excisions were performed, and the lesions were histologically diagnosed as epidermoid cysts. Intrascrotal, extratesticular epidermoid cysts are uncommon lesions believed to be teratomas or the result of abnormal embryological closure of the median raphe. However, it is difficult to explain the etiology of some masses by either of these mechanisms.
Recent Concepts in the Management of Male Infertility
Authors: Namiki Mikio
Published: July 2007

This review outlines the current treatment of many causes of male infertility, including idiopathic spermatogenic disorder, varicocele, obstruction of the seminal tract, and emission disorders. Recommendations regarding future treatments are presented.
Analysis of Histological Heterogeneity in Renal Cell Carcinoma: Tumor Size‐Related Histological Change and its Prognostic Significance
Authors: Kanamaru Hiroshi , Muranaka Koji , Mori Hirotaka , Akino Hironobu , Arai Yoichi , Okada Kenichiro
Published: July 2007

Background: It is well recognized that the histology of renal cell carcinoma (RCC) is often heterogenous. It is also believed that the prognosis of patients with large tumors is generally poorer than those with small tumors. However, there has been no detailed study on changes in histological features of RCCs associated with tumor growth. This study was conducted to investigate whether there are any specific histological changes related to tumor size and to study the prognostic value of histological parameters in RCCs.

Methods: The presence or absence of each histological component (3 cell types and 5 histological architectures) was investigated in 110 RCCs. The tumor size‐associated changes in the histological composition of the RCCs were evaluated, and the prognostic significance of the histological parameters was analyzed using univariate and multivariate analysis.

Results: The percentage of RCCs with multiple cell types increased with tumor size, whereas increases in multiplicity were not as prominent in the histological architectures. Several characteristic changes, however, were observed in both cell types and architectures. RCCs with a pure clear cell, pure alveolar pattern or cystic architectural pattern decreased, while those with granular or spindle/pleomorphic cell types, or papillary or solid architectural patterns increased with tumor size. A univariate analysis revealed that a clear cell type and an alveolar or cystic architectural pattern were associated with a better prognosis, while spindle/pleomorphic cells and a solid architecture pattern correlated with a poorer prognosis. Multivariate analysis of cell types and architectures showed, however, that only the presence of spindle/pleomorphic cell types and a solid architecture were independent prognostic variables.

Conclusion: The histological composition of RCCs varied according to the size of the tumor. Sarcoma‐tous components increased with tumor size and were independently associated with a poor prognosis. Further study is warranted to correlate specific genetic alterations with tumor growth‐related histo‐logical changes in RCCs.
Transinguinal Laparoscopy for Nonpalpable Testis
Authors: Layashi Yutaro , Mogami Tohru , Sasaki Shoichi , Maruyama Tetsushi , Tatsura Hiroyuki , Tsugaya Masayuki , Kohri Kenjiro
Published: July 2007

Background: About 20% of all undescended testes are nonpalpable. Although surgical exploration was previously the method of choice for management, laparoscopy from the inferior edge of the umbilicus has been established as a useful method of examining a testis that is nonpalpable. However, conventional subumbilical laparoscopy is unnecessary when the testis or its remnant is located below the internal inguinal ring. We evaluated the efficacy of transinguinal laparoscopy after inguinal exploration performed for nonpalpable testis.

Methods: Twelve children with 14 nonpalpable testes (2 children had bilateral nonpalpable testes) were considered for a novel method of laparoscopy. We performed laparoscopy through the internal inguinal ring after opening the inguinal canal.

Results: Inguinal exploration revealed the testis or its remnant in 5 patients, and thus prevented unnecessary laparoscopy in these individuals. Transinguinal laparoscopy identified the anatomy in 7 patients. Four of the latter were found to have blind‐ending vas deferens and spermatic vessels, while in 3 patients, the testes were located in the peritoneal cavity.

Conclusion: Transinguinal laparoscopy may become the accepted method for managing nonpalpable testes, as inguinal exploration can eliminate the need for laparoscopy in some cases, and the visualization achieved with transinguinal laparoscopy is just as good as that with conventional laparoscopy.
Laparoscopic Bladder‐Neck Suspension for Urinary Stress Incontinence in Women: Our First Twenty Patients
Authors: Tay Kah Phuan , Lim Peter Huat Chye , Ravintharan T.
Published: July 2007

Background: Laparoscopic bladder‐neck suspension for women with urinary stress incontinence avoids the problems associated with a large abdominal incision. This study reviews the short‐term outcome of this minimally invasive operation.

Methods: Between September 1993 and February 1995, 20 female patients with type II urinary stress incontinence underwent laparoscopic bladder‐neck suspension at our institution (mean age, 46.6 years; mean weight, 59.5 kg; mean duration of symptoms, 3.75 years; mean follow‐up, 7 months). The extraperitoneal space was created with a preperitoneal distention balloon system; dissection of the bladder and bladder neck was done via 3 working ports. In 16 patients, the paraurethral vagina on either side of the bladder neck was hitched up to the iliopectineal ligament by 2–0 sutures. In the remaining 4 patients, the bladder‐neck suspension was performed using hernia mesh and staples. Four patients had intraperitoneal suspension.

Results: The operative time ranged from 75 to 205 minutes, with a mean of 111.5 minutes. The period of urethral catheterization ranged from 2 to 7 days, with a mean of 3.1 days. The hospitalization stay ranged from 5 to 15 days, with a mean of 6.35 days. Thirteen patients (65%) had complete resolution of symptoms, 5 patients (25%) reported significant improvement, and 2 patients (10%) did not benefit from the operation.

Conclusion: Long‐term follow‐up is necessary to determine the efficacy of this laparoscopic technique. The success rate for any incontinence procedure is usually inversely proportional to the duration of follow‐up.
Characteristics of Androgen‐Independent Growth of Androgen‐Responsive Shionogi Carcinoma 115 Cells
Authors: Tomioka Susumu , Ichikawa Tomohiko , Watabe Yoshio , Suzuki Hiroyoshi , Shimazaki Jun
Published: July 2007

Background: The effects of castration on the biological features of an androgen‐responsive carcinoma were examined in order to clarify the mechanism responsible for the relapse of an androgen‐responsive carcinoma after androgen ablation therapy.

Methods: A well‐characterized androgen‐responsive mammary carcinoma, Shionogi carcinoma 115 (SC115), was used for these experiments. Male mice were examined for the effects of castration on the growth rate of the tumor, the number of androgen receptor‐positive cells, and the karyotype of the SC115 tumors. Castration was performed 1 week prior to tumor transplantation, or 2 or 3 weeks after tumor transplantation.

Results: SC115 tumors did not develop when transplanted into castrated male mice. When castration was performed 2 weeks after transplantation, the tumor showed androgen‐independent growth with temporary regression of growth rate. However, when castration was performed more than 3 weeks after transplantation, the tumor showed androgen‐independent growth not associated with any temporal regression of growth rate. There were no significant differences in histological features or the number of androgen receptor‐positive cells between SC115 tumors in untreated or castrated mice. To test whether SC115 tumors growing under androgen‐deprived conditions became fully androgen‐independent, SC115 tumors were transplanted in both male and female mice. A transplanted tumor piece grew progressively only in male mice. This indicates that the SC115 tumor maintains its androgen response in the next generation, even though growth of the tumor resumed after temporary suppression due to castration. Chromosomal analyses revealed no apparent cytogenetic changes in the SC115 tumors that resumed growth under androgen‐deprived conditions.

Conclusion: These results suggest that no gross changes in the number of androgen receptor‐positive cells or karyotype are necessary for androgen‐independent growth in this system once the size of tumor increased.
Aromatase mRNA Levels in Benign Prostatic Hyperplasia and Prostate Cancer
Authors: Tsugaya Masayuki , Harada Nobuhiro , Tozawa Keiichi , Yamada Yasuyuki , Hayashi Yutaro , Tanaka Shin , Maruyarna Kohji , Kohri Kenjiro
Published: July 2007

Background: Estrogens are suspected to play a role in the pathogenesis of benign prostatic hyperplasia (BPH) and prostate cancer. In this study, the expression of aromatase messenger ribonucleic acid (mRNA) was determined, and these levels were quantitated, in human prostatic tissues to evaluate the role of estrogens in the pathogenesis of BPH and prostate cancer.

Methods: Prostatic tissues were obtained either by retropubic prostatectomy, radical prostatectomy, or radical cystectomy from patients with BPH, prostate cancer, and bladder cancer. The expression of aromatase mRNA in the prostatic tissues was studied by Southern blot analysis of the reverse transcription and polymerase chain reaction technique (RT‐PCR) products. Aromatase mRNA levels were measured in human prostatic tissues by the RT‐PCR using a fluorescent primer.

Results: Aromatase mRNA was identified in all specimens by Southern blot analysis of the RT‐PCR products. The concentrations of aromatase mRNA (mean ± SD) which were measured by fluorometric quantitation in 16 of 19 patients with BPH and in 3 of 4 patients with prostate cancer, were 1.81 ± 3.02, and 0.84 ± 0.27, ± 10‐‐3 attomoles/μg of total RNA, respectively.

Conclusions: These results demonstrate local formation of estrogen in the prostates of patients with BPH and prostate cancer. Controlled studies will be necessary to determine whether this may be a faclor in the development of BPH and prostate cancer.
Infected Renal Cystic Mass Associated with Bacterial Meningitis: A Case Report
Authors: Fuse Haruki , Ohkawa Mitsuo , Asamoto Teruo
Published: July 2007

We report a case of an infected renal cystic mass associated with bacterial meningitis in a 70‐year‐old woman who had had poorly‐controlled diabetes mellitus for approximately 30 years. She suffered from bacterial meningitis due to Klebsiella pneumoniae, which was successfully treated with antimicrobial chemotherapy for 1 month. Approximately 2 weeks later she developed left flank pain and a high fever. A CT scan and an ultrasonogram revealed a left renal cystic mass, which was considered to be an infected renal cyst. Turbid and thick fluid was obtained by percutaneous aspiration which contained numerous white blood cells. Culture of this fluid yielded K. pneumoniae. The bacterial meningitis was considered to be a secondary infection of the septicemia which resulted from the infected renal cystic mass.
Laparoscopic Retroperitoneal Nephrectomy for Atrophic Kidney Associated with Ectopic Ureter in a 2‐Year‐Old Girl
Authors: Nishiyama Tsutomu , Terunuma Masahiro
Published: July 2007

A 2‐year‐old Japanese girl underwent laparoscopic retroperitoneal surgery for removal of an atrophic left kidney located in the left retroperitoneal space that was associated with an ectopic ureter. No serious complications developed during the operation or postoperatively.
A Case of Renal Cell Carcinoma Associated with Synchronous Contralateral
Authors: Cancer Renal Pelvic , Tumor Bladder , Ando Masao , Arisawa Chizuru , Okano Tadao
Published: July 2007

We report a case of renal cell Carcinoma associated with synchronous contralateral renal pelvic cancer and bladder tumor. The patient underwent total nephroureterectomy for the left renal pelvic cancer with transurethral resection of the bladder tumor. After 2 courses of combination chemotherapy, we performed surgical enucleation of the right renal cell carcinoma. Although transurethral resection of the recurrent bladder tumors was undergone 17 months after the last operation, the patient retains normal renal function.
High‐Dose Chemotherapy with Peripheral Blood Stem‐Cell Transplantation for Hormone‐Refractory Advanced Carcinoma of the Prostate: Experience of Two Cases
Authors: Nishiyama Tsutomu , Kishi Kenji , Deg˜chi Takashi , Mukaiyama Taketo , Terunuma Masahiro
Published: July 2007

Two patients with hormone‐refractory advanced prostate cancer were treated with high‐dose chemotherapy and peripheral blood stem‐cell transplantation. A satisfactory number of stem cells were collected by appropriately timed leukapheresis in these patients. The stem‐cell samples collected from the first patient were positive for prostate‐specific antigen messenger ribonucleic acid expression; such expression was not detected in the samples from the second patient. The first patient has remained in complete remission as of December 1995. The second patient died of the disease.
Total Incontinence Secondary to Sphincter Destruction after Prostate Cryotherapy for Recurrent Prostatic Carcinoma
Authors: Watanabe Toyohiko , Rivas David A. , Miettinen Markku , Gomella Leonard , Chancellor Michael B.
Published: July 2007

We report a case of total urinary incontinence secondary to sphincter destruction after prostate cryotherapy for recurrent prostatic carcinoma in a 64‐year‐old man. Periurethral collagen injection was impossible due to inadequate penetration of the injection needle, because of severe scarring and fibrotic changes of the urethra after cryotherapy.
Opitz Syndrome in a Japanese Male
Authors: Nishiyama Tsutomu , Gunji Tetsuki , Terunuma Masahiro , Matsui Toshiharu
Published: July 2007

There have been only a few reports on Opitz syndrome in Japan. We report here a case of a Japanese male with canthal hypertelorism, bilateral cleft lip and palate, scrotal hypospadias with scrotal transposition, and cryptorchidism, findings that met the criteria for this syndrome. After repair of the cleft lip and palate, urethroplasty was performed at age 2, and bilateral orchiopexy was performed at age 3. At age 5, the child is of normal weight for his age, voids urine smoothly on standing, and has slight mental retardation.