bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of ATP and Related Purine Compounds on Urethral Relaxation in Male Rabbits
Authors: Ohnishi Norio , Park Young‐Choi , Kurita Takashi , Kajimoto Noriyoshi
Published: July 2007

Background Non‐adrenergic, non‐cholinergic (NANC) relaxation evoked by electrical field stimulation (EFS) has been observed in the urethra, with nitric oxide (NO) considered the agent most probably mediating this effect. However, Burnstock's purinergic hypothesis suggests that ATP and related purine compounds are neurotransmitters in NANC relaxation, although the physiological and pharmacological effects of ATP and related purine compounds in the urethra have been little studied.

Methods The effects of ATP and related purine compounds, NG‐nitro‐L‐arginine (NOARG; an inhibitor of nitric oxide synthesis from l‐arginine), calcitonin gene‐related peptide (CGRP), substance P and vasoactive intestinal polypeptide (VIP) on relaxation and smooth muscle tension induced by electrical field stimulation (EFS) were studied in isolated male rabbit circular urethral smooth muscle (functional study). In addition, the outflow of ATP elicited by EFS was measured using the luciferase technique (superfusion study). All experiments were performed in the presence of guanethidine (3 times 10‐3 mol/L) and atropine (10‐6 mol/L).

Results In preparations contracted with U46619, a prostaglandin peroxidase inhibitor, ATP had almost no effect on EFS‐induced relaxation; however, suramin, a non‐selective P2)‐purinoceptor antagonist, and NOARG each markedly attenuated this relaxation in a concentration‐dependent manner. ATP and related purine compounds (adenosine, AMP and ADP) each reduced U46619‐induced tonic contraction in a concentration‐dependent manner. The potencies of the relaxant effects of ATP and these purine compounds were almost the same. In preparations contracted with U46619, CGRP and substance P had no effect on tonic contraction, but VIP reduced tonic contraction in a concentration‐dependent manner. In the superfusion study, the outflow of ATP into the superfusate was markedly increased by EFS. When NOARG or prazosin was added to the superfusate, the increase in outflow of ATP was unchanged, but when suramin was added to the superfusate, no increase in outflow of ATP was observed.

Conclusions These findings suggest that P2)‐purinoceptors exist in the male rabbit urethra, and that ATP and related purine compounds may play a role in non‐adrenergic, non‐cholinergic neurotransmission. Consequently, the pathways mediating urethral relaxation by ATP, NO and VIP may be different.
Treatment of Crush Syndrome Patients Following the Great Hanshin Earthquake
Authors: Hara Isao , Nakano Yuzo , Okada Hiroshi , Arakawa Soichi , Kamidono Sadao
Published: July 2007

Five of 8 patients with rhabdomyolysis treated at our hospital following the Great Hanshin Earthquake were diagnosed with crush syndrome. One patient with crush syndrome and 3 patients with rhabdomyolysis and no renal dysfunction recovered with conservative therapy, while 1 crush syndrome patient recovered with peritoneal dialysis (PD). Of the 3 patients who died, 2 had undergone continuous arterio‐venous hemofiltration (CAVH). We examined the laboratory data to identify any factors that may be prognostic for crush syndrome. The serum amylase levels were significantly higher and the levels of aspartate transaminase (AST) and lactic dehydrogenase (LDH) tended to be higher from the patients who died. Examination of the serum amylase, AST and LDH levels may be useful for assessing the prognosis in patients with crush syndrome.
Kidney‐Alone Transplantation in Diabetic Patients with End‐Stage Renal Disease
Authors: Morita Ken , Shindo Junri , Harada Hiroshi , Takeuchi Ichiro , Chikaraishi Tatsuya , Seki Toshimori , Hirano Tetsuo , Nonomura Katsuya , Koyanagi Tomohiko
Published: July 2007

From January 1989 to December 1995, 5 diabetic patients with end‐stage renal disease (1 woman, 4 men) underwent kidney‐alone transplantation. The mean age of the recipients at the time of transplantation was 37.4 years (range, 32 to 43). Graft function and glucose tolerance was evaluated for 5 to 72 months after surgery. Postoperative complications were seen in 2 patients; nonspecific subcutaneous infections and an asymptomatic partial allograft infarction. All renal allografts were functioning 1 year after transplantation, with a mean serum creatinine level of 1.10mg/dL (range, 0.8 to 1.8mg/dL), and a mean urinary protein level of 1 7.8mg/dL (range, 5 to 27mg/dL). The postoperative daily dose of insulin was higher than the preoperative dose, while the level of glycated hemoglobin (HbA1c) increased after surgery and peaked 6 months after transplantation; 1 year after transplantation it had reverted to the preoperative level. As long as the diabetic complications of the renal allograft recipients are not severe, the short‐term survival and the renal function of diabetic patients with end‐stage renal disease improves after kidney‐alone transplantation, which is still the standard method of treatment in Japan.
Three Approaches for Laparoscopic Unroofing of Simple and Complicated Renal Cysts
Authors: Mimata Hiromitsu , Mizoguchi Hiroaki , Ohno Hitoshi , Tasaki Yoshihisa , Hanada Toshikatsu , Nomura Yoshio
Published: July 2007

We report 2 cases of simple renal cysts which were marsupialized with 2 laparoscopic approaches involving either transperitoneal, with reflection of the colon medially or dissection through the mesocolon, and a case of a multilocular renal cyst which was treated by the retroperitoneal approach. Although laparoscopic unroofing of a renal cyst is a safe and effective alternative to open surgical techniques, the transperitoneal approach should only be used for simple renal cysts. The retroperitoneal approach for complicated renal cysts may be indicated if preoperative examinations exclude the possibility of malignancy.
Primary Retroperitoneal Teratoma in an Adult: A Case Report
Authors: Koroku Mikio , Takagi Yoshio , Suzuki Noriyoshi , Wakabayashi Junichi
Published: July 2007

A primary retroperitoneal teratoma is a relatively rare neoplasm in adults. We report 1 such case evaluated by CT and MRI scans. The preoperative MRI was important in that it delineated the precise position of the tumor relative to the surrounding organs.
“Collision Phenomenon” of Prostate and Bladder Cancers in Lymph Node Metastases
Authors: Gohji Kazuo , Nomi Masashi , Kizaki Tomohiko , Maruyama Satoshi , Morisue Koichi , Fujii Akio
Published: July 2007

We report here the case of a 78‐year‐old man who, 15 months after orchiectomy for palliation of prostate adenocarcinoma, was diagnosed as having squamous cell carcinoma of the urinary bladder. The bladder cancer was treated surgically, including dissection of pelvic lymph nodes. Some of these nodes were observed at surgery to be swollen, and were found on pathologic examination to exhibit the collision phenomenon: the mixing and mingling of cancer cells representing 2 distinct topographic origins. This case suggests that the possibility of collision phenomenon should be considered whenever any metastasis (but especially one in the lymph nodes) is found in a patient diagnosed with 2 different types of cancer. Moreover, it reminds us that diagnosis of one type of cancer does not rule out the possibility of another.
Endoscopic Injection of Collagen for the Treatment of Female Urinary Stress Incontinence
Authors: Ang Leonard Pek Kiang , Tay Kah Phuan , Lim Peter Huat Chye , Chng Hong Chee
Published: July 2007

Background The objective of our study was to assess the efficacy and safety of glutaraldehyde cross‐linked collagen injection in the treatment of female urinary stress incontinence.

Methods We conducted a retrospective analysis of the records of 105 women who underwent collagen injection for urinary stress incontinence between March 1991 and April 1995. Preoperative assessment included uroflowmetry, residual urine determination, and urodynamic studies.

Results Of the 105 women in our series, 95 patients (90.5%) had initial successful results at 3 months (61.0% cured, 29.5% significantly improved) while 4 patients (3.8%) had slight improvement and 6 (5.7%) failed surgical correction. One year after the procedure, the success rate dropped to 81.9% (86 patients) with 46.7% cured and 35.2% significantly improved. Nine patients (8.6%) had slight improvement and 10 patients (9.5%) failed surgical correction. Eight patients (7.6%) with initial unsatisfactory results underwent additional sessions of collagen injection and were subsequently either cured or had significant improvement. Twenty‐three patients (21.9%) suffered a relapse. The mean time to relapse was 13.3 months, and 6 of those who relapsed underwent repeated injections with favorable results. Complications were minimal; 6 patients had temporary retention of urine, and 2 patients had urinary tract infections.

Conclusions We conclude that glutaraldehyde cross‐linked collagen injection is a simple and safe method of treatment for urinary stress incontinence. A longer follow‐up period is necessary to assess the long‐term efficacy of this treatment.
Electron Microscopic Study of the Penile Plaques and Adjacent Corpora Cavernosa in Peyronie's Disease
Authors: Hirano Daisaku , Takimoto Yukie , Yamamoto Tadao , Hirakata Hitoshi , Kawata Nozomu
Published: July 2007

Background We conducted ultrastructural studies to clarify the fine structure of penile plaques and adjacent corpora cavernosa, and the causative basis for the process, in Peyronie's disease.

Methods Penile plaques and adjacent corpora cavernosa were obtained during surgical extirpation from 5 patients with Peyronie's disease. Control tissues from the tunica albuginea and adjacent corpora cavernosa were obtained at penile amputation from 2 patients with penile cancer. Prepared tissues were examined by using electron microscopy.

Results Penile plaques were composed of collagen fibrils, amorphous particulate material, and fibroblasts in all patients. In 1 of 5 patients, myofibroblasts were found in the border area between the lesion and underlying structures. Smooth‐muscle cells and endothelial cells resembling myofibroblasts were noted in adjacent corpora cavernosa. In this patient, the plaque progressively enlarged, and was removed within 1 year of onset of the induration.

Conclusions Fibromatosis in Peyronie's disease involves both fibroblasts and myofibroblasts, which undergo sclerosis in some phase. In addition, smooth‐muscle cells and endothelial cells in the adjacent corpora cavernosa may be incorporated in the fibromatosis.
Pharmacokinetic Studies of Mycophenolate Mofetil in Rat Kidney Allograft Recipients
Authors: Inoue Hitoshi , Sugioka Nobuyuki , Hayashida Kazuhisa , Yasumura Tadaki
Published: July 2007

Background A pharmacokinetic estimation of the immunosuppressive activity of mycophenolate mofetil (MPM) was performed in rats with transplanted kidney allografts.

Methods Kidney allografts from Brown Norway rats were transplanted into Lewis rats using a microsurgical technique. MPM, at doses of 5, 10, 15 and 25mg/kg/day, was administered orally every day after transplantation. Pharmacokinetic studies were performed on days 7 and 14, and thereafter every 2 weeks.

Results After the administration of MPM, the plasma concentration of mycophenolic acid (MPA) increased rapidly, peaking at 15 to 30 minutes, and then decreased biexponentially. The peak concentration of MPA and the area under the plasma MPA concentration versus time curves (AUC) significantly correlated with the dosage. MPM administration at 5 and 10mg/kg/day significantly prolonged the graft survival time from 7.1 days to 18.5 days and 85.0 days, respectively. The AUC values on day 7 after transplantation were 32.7,ug‐h/mL and 38.6/ig‐h/mL in rats receiving 5 and 10mg/kg/day, respectively. However, in rats receiving 1 5mg/kg/day of MPM or more, the AUC value at 7 days was 78.8,ug‐h/mL, and almost all of these rats died from gastrointestinal toxicity.

Conclusion MPM monotherapy significantly prolonged rat kidney allograft survival, however, high dosages of MPM caused gastrointestinal toxicity. AUC measurements of the MPA concentration are suitable for the pharmacokinetic monitoring of MPM.
Editorial Comment
Authors: Kawabe Kazuki
Published: July 2007

The authors of this report have provided valuable results based on an experimental study involving allograft transplantation in rats, which is a technically demanding procedure. I regret, however, that the scope of the study did not include more than the rat survival rate. A future study could include a discussion of the renal function involved.
Menkes' Kinky Hair Disease Associated with a Large Bladder Diverticulum: A Case Report
Authors: Kageyama Susumu , Okada Yusaku , Konishi Taira , Koizumi Shuichi , Tomoyoshi Tadao
Published: July 2007

We report a 2 year‐old boy with Menkes' kinky hair disease associated with a solitary huge bladder diverticulum. To our knowledge this is the first reported case treated successfully by surgical excision under general anesthesia, which has been previously considered hazardous due to the poor general condition of the patient.
Six Cases of Prenatal and Neonatal Torsion of the Spermatic Cord
Authors: Giannakopoulos Xenofon , Chambilomatis Panagiotis , Filiadis Loannis , Ntourntoufi Agathi , Andronikou Styliani , Kammenos Alciviadis
Published: July 2007

Torsions of the spermatic cord occurring from the intrauterine period to the end of the first year of life are termed perinatal. These are divided into prenatal and postnatal torsions, depending on their occurrence in the intrauterine or postuterine period. From January 1984 to January 1996, 6 cases were identified at our institution, involving 4 prenatal and 2 postnatal extravaginal torsions of the spermatic cord. These cases are reviewed with regard to optimal therapeutic approaches for the treatment of both the affected gonad as well as the contralateral one, and whether the event occurred prenatally or postnatally. The authors also propose several clinical indications useful for obstetricians, pediatricians, urologists and nurses.
Preoperative Imaging for Parathyroid Localization in Primary Hyperparathyroidism
Authors: Okada Yusaku , Mizutani Youichi , Takeuchi Hideo , Shigeno Chohei , Konishi Junji , Yoshida Osamu
Published: July 2007

Background: We retrospectively studied the results of diagnostic imaging using 3 different modalities to determine their usefulness for preoperative localization of the parathyroid, and whether accurate preoperative localization information could be used to modify the surgical approach for parathyroidectomy in patients with primary hyperparathyroidism.

Methods: Images of 37 parathyroid adenomas or hyperplasias in 35 patients with primary hyperparathyroidism were obtained using ultrasonography, computed tomography, and subtraction scintigraphy (using thallium 201 [thallous chloride] and either iodine 123 or technetium 99m pertechnetate [99mTcO4]).

Results: Approximately three fourths of the adenomas or hyperplasias were successfully identified by ultrasound (76.7%) and computed tomography (76.4%), even when the weight of the tumor was less than 500 mg. However, subtraction scintigraphy was of limited use (61.3% successfully identified). A combination of these modalities gave excellent results for detecting adenomas and hyperplasias, leading to an accurate prediction rate of 96.0%.

Conclusion: We conclude that using the combination of these 3 imaging modalities is very useful for the detection of parathyroid adenomas and hyperplasias, and that with such accurate localization information, the unilateral approach alone, or even simple excision of the parathyroid tumors might be feasible, enabling less invasive surgical treatment.
Inhalation of lnterleukin‐2 Combined with Subcutaneous Administration of Interferon for the Treatment of Pulmonary Metastases from Renal Cell Carcinoma
Authors: Nakamoto Takahisa , Kasaoka Yoshinobu , Mitani Shinji , Usui Tsuguru
Published: July 2007

Background: lnterleukin‐2 is the most promising antitumor agent for advanced renal cell carcinoma, but systemic immunotherapy with interleukin‐2 might be limited because of inadequate efficacy and severe adverse effects. In this study, we treated 7 patients with lung metastases from renal cell carcinoma with topical application of interleukin‐2 by inhalation.

Methods: Patients received 100,000 IU of interleukin‐2 by inhalation 4 times a day and 9,000,000IU of interferon‐alfa‐2a subcutaneously for 5 consecutive days per week. They also received, by oral administration, 800 mg of cimetidine and 50 mg of indomethacin per day. After informed consent was obtained, the treatment started and the absence of any intolerable adverse effects was confirmed in a hospital. Then the treatment continued in an outpatient clinic for at least 3 months.

Results: Of 6 assessable patients, 5 responded to this treatment; 2 patients developed a partial response (33%) and 3 remained stable (67%). Disease progressed in the remaining patient. Therapy was discontinued in 1 patient because of his poor general condition. No severe adverse effects were observed, but pulmonary fibrosis probably associated with this treatment occurred in 1 patient. Conclusion: Although more cases and further evaluation are necessary to assess the significance and the safety of the inhalation of interleukin‐2, this treatment is anticipated to be an option for selected patients with lung metastases from renal cell carcinoma.
Endoscopic Injection of Teflon for Correction of Primary Vesicoureteral Reflux in Children
Authors: Yasui Takahiro , Akita Hidetoshi , Sasaki Shoichi , Hayashi Yutaro , Kohri Kenjiro
Published: July 2007

Background: Treatment of vesicoureteral reflux by endoscopic injection of Teflon paste has recently demonstrated a good success rate. This report describes our experience in treating vesicoureteral reflux in children with particular reference to follow‐up data.

Methods: Between December 1993 and November 1994, endoscopic injection of Teflon paste into the submucosa was performed on 18 children (29 ureters) to correct vesicoureteral reflux.

Results: After treatment, reflux was eliminated in 75.9%, decreased in 1 3.8%, and unchanged in 1 0.3% of the ureters. The success rate was lower for high grade reflux cases and ureteral orifices with abnormal shapes.

Conclusion: Long‐term follow‐up for up to 2 years demonstrated that although late recurrence may occur in a small proportion of cases, the procedure is safe, simple and effective for correcting vesicoureteral reflux.
Influence of Prostate Size on Terazosin Efficacy
Authors: Becopoulos Theodosios , Mitropoulos Dionisios , Christofis Loannis
Published: July 2007

Background: While the rationale for the use of α1‐adrenoreceptor antagonists in the treatment of bladder outlet obstruction is well established, not all patients have either objective or subjective improvement. The aim of this study was to evaluate the influence of prostatic size on the changes of peak flow rate, average flow rate and residual urine in symptomatic BPH patients undergoing terazosin treatment.

Methods: Thirty‐five patients with symptomatic BPH received terazosin, 5mg once a day for 3 weeks after a 2‐week dose escalation period. Peak and average flow rates as well as residual urine were assessed before and after treatment. The patients were stratified in 3 groups by prostate size, which was estimated by transabdominal ultrasonography and a digital rectal examination.

Results: The baseline characteristics for age, peak flow rate and average flow rate did not vary between the 3 groups, however, the pretreatment volume of residual urine was greater in patients with large prostate adenomas. Terazosin treatment resulted in significant changes in flow rate and residual urine, however, changes in flow rates were not influenced by prostate size, while a marked decrease in residual urine was found in patients with large prostates.

Conclusion: Patients treated with terazosin obtained similar improvement in peak and average uroflow, independent of the size of the prostate.
Detection of Circulating Tumor Cells in Patients with Prostate Cancer Using Prostate Specific Membrane‐Derived Primers in the Polymerase Chain Reaction
Authors: Noguchi Masanori , Miyajima Jiro , Itoh Kyogo , Noda Shinshi
Published: July 2007

Background: Prostate specific membrane antigen (PSM) is a transmembrane glycoprotein that has been described as human prostate specific. It is possible that PSM could be used as a biomarker for staging prostate cancer.

Methods: Peripheral blood mononuclear cells from 2 groups of patients with prostate cancer were used for the detection of PSM messenger ribonucleic acid (mRNA) using the reverse transcriptase‐polymerase chain reaction (RT PCR) method. Group 1 consisted of 29 untreated patients (1 3 stage B cancer, 5 stage C, and 11 stage D cancers). Group 2 consisted of 40 treated patients (23 responded well and 17 had recurrence after treatment). In addition, blood specimens from 30 patients with benign prostatic hyperplasia, 5 women, and 5 men undergoing cystoprostatectomy for invasive bladder cancer were used as controls. We then correlated patient and disease characteristics with PCR assay results.

Results: Samples of all 40 controls were negative for PSM‐mRNA. Thirteen of 29 patients of group 1 (45%) were positive for PSM‐mRNA. The PCR positive rate did not correlate with clinical stage, pathologic stage, tumor grade, or serum PSA levels. Nine of 40 patients (22%) in group 2 were positive for PSM‐mRNA, and the majority (8 of 9) were derived from the group of patients with recurrent disease.

Conclusions: A nested RT PCR assay for PSM mRNA can detect circulating tumor cells in the peripheral blood of patients with prostatic cancer. These results suggest that the detection of circulating tumor cells could be useful for monitoring disease progression of prostatic cancer.
Urinary Bladder Response to Hypogastric Nerve Stimulation After Bilateral Resection of the Pelvic Nerve or Spinal Cord Injury in Rats
Authors: Kontani Hitoshi , Hayashi Keiichiro
Published: July 2007

Background: We examined the mechanism of urinary bladder motility return after bladder areflexia induced by interruption of the sacral parasympathetic outflow to the urinary bladder following damage to the sacral cord or pelvic nerves in the rat.

Methods: The L6 and SI nerve bundles were resected near the vertebrae, and bilateral pelvic nerve resections (PNR) performed. Spinal cord injury (SCI) was performed by means of a legion generator at the T12 vertebra. Thirty days after PNR and SCI, cystometrograms were recorded under anesthesia.

Results: In all rats subjected to PNR or SCI, overflow incontinence continued, yet some rats subjected to SCI recovered within 2 weeks after the operation. Cystometrograms showed that repetitive bladder contractions appeared in rats subjected to SCI irrespective of hypogastric nerve (HCN) innervation, while bladder contractions did not appear in rats subjected to PNR. Electrical stimulation of the HGN induced higher bladder pressure elevation in rats who underwent PNR than in rats subjected to SCI.

Conclusions: These results suggest that the generation of repetitive bladder contractions induced by bladder distention after bladder areflexia requires the presence of intact pelvic nerves that transmit sacral cord‐originating excitatory information to the bladder. However, the HGN system and functioning pelvic nerve ganglia are not involved in this process. Also, the connection from the preganglionic HGN to the postganglionic parasympathetic nerves in the pelvic plexus did not form after PNR.
Telomere Length and Telomerase Activity in Bladder and Prostate Cancer Cell Lines
Authors: Kageyama Yukio , Kamata Shigeyoshi , Yonese Junji , Oshima Hiroyuki
Published: July 2007

Background: Specific repeats of oligonucleotides at the ends of chromosomes (telomeres) are shortened by cell division in somatic cells and are thought to be related to aging. Immortal cells such as germ‐line cells or cancer cells have demonstrated increased activity of the telomere‐elongating enzyme (telomerase). The length of the telomeres of these cells is stable regardless of cell division. We examined the telomere length and telomerase activity in 3 bladder (JTC30, JTC32, and T24) and 2 prostate cancer (LNCaP and DU145) cell lines.

Methods: Telomere lengths were evaluated by Southern blot analysis with a oligonucleotide probe, (TTAGGG)S and telomerase activities were detected with a polymerase chain reaction‐based assay method.

Results: Telomerase activity was detected in all of the cell lines. Each cell line had a specific telomere length. In 2 bladder cancer cell lines (JTC30 and JTC32), the telomere length decreased with increased passage of the cells.

Conclusion: The presence of telomerase may be a biological character of bladder and prostate cancers as well as other malignancies, although it does not always compensate telomere shortening.
Incorrect Positioning of an Indwelling Urethral Catheter in the Ureter
Authors: Kato Haruaki
Published: July 2007

An unusual case where a urethral catheter was indwelt in the left ureter is presented. A small contracted bladder and a patulous ureteral orifice appeared to be causative factors of this complication.
Ex Vivo Partial Nephrectomy and Partial Kidney Autotransplantation for Renal Pelvic Carcinoma in a Functionally Solitary Kidney: Case Report
Authors: Nishiyama Tsutomu , Terunuma Masahiro , Tanikawa Toshiki , Takahashi Kota
Published: July 2007

A 46‐year‐old Japanese man was diagnosed with a left renal pelvic carcinoma and a contralateral hypoplastic kidney. The tumor was adjacent to the renal pelvis and was considered too difficult to completely resect in situ. The patient was treated by ex vivo partial nephrectomy of the left kidney followed by autotransplantation of the remaining renal segment. A pathologic evaluation revealed a transitional cell carcinoma, G2, pT3. Graft function recovered satisfactorily postautotransplantation and no significant complications developed during the postoperative period. The patient is alive and doing well 12 months postoperatively with no evidence of tumor recurrence.
Significance of Prostate‐Specific Antigen after Radical Prostatectomy
Authors: Hachiya Takahiko , Endo Makoto , Nogaki Joji , Ishida Hajime , Okada Kiyoki
Published: July 2007

Background:

Serum prostate‐specific antigen (PSA) is expected to be undetectable after radical prostatectomy unless there is residual disease or disease progression. The aim of this study was to confirm the usefulness of serum PSA measurements in monitoring patients after radical prostatectomy.

Methods:

We conducted a study of 50 patients who underwent radical prostatectomy for clinical stage T1 ‐2 or small T3 prostate cancer, analyzed serum PSA levels before and after surgery and compared the pathological findings and clinical outcome.

Results:

Postoperative PSA elevation (PSA failure) was noted in 13% of patients with organ‐confined disease (OCD), 43% with positive surgical margins and/or seminal vesicle involvement (PSM/SVI), and 60% with positive lymph nodes (N+). Postoperative clinical failure was noted in 8 patients, and all were preceded by PSA failures. The 3‐year PSA failure‐free rates were 86.5%, 32.1 %, and 40.7% and the 3‐year clinical failure‐free rates were 100%, 67.5%, and 73.5% in patients with OCD, PSM/SVI and N+, respectively.

Conclusion:

An elevation of serum PSA levels after radical prostatectomy was a sensitive indicator of persistent disease after surgery, and preceded clinical manifestations of disease progression.
Clinicopathological Features of Prostate Cancer Detected by Transrectal Ultrasonography‐Guided Systematic Six‐Sextant Biopsy
Authors: Ito Kazuto , Ichinose Yoshio , Kubota Yutaka , Imai Kyoichi , Yamanaka Hidetoshi
Published: July 2007

Background:

The objectives of this study were to compare the efficacy of 3 modalities (prostate‐specific antigen (PSA) assay, digital rectal examination (DRE), and transrectal ultrasonography (TRUS)) in detecting prostate cancer which was pathologically confirmed by TRUS‐guided systematic six‐sextant biopsy, and to investigate the relationship between the number of positive cores and several clinicopathological parameters.

Methods:

Between 1 992 and 1994, 297 males (155 from a mass screening program and 142 identified as outpatients) with a mean age of 71 years, underwent examinations including PSA determination, DRE, TRUS and systematic six‐sextant biopsy, and/or additional directed biopsy.

Results:

Prostate cancer was detected in 93 men. The sensitivity level of the PSA assay was significantly higher (85%) than that of either DRE or TRUS. Patients with an abnormal DRE or TRUS, elevated PSA levels, and those in the T3‐T4 category or with moderate to poorly‐differentiated adenocarcinomas had more positive biopsy cores (P< 0.05). Also, the relationships of both the number of positive biopsy cores and tumor grade to bone metastasis were significant (P < 0.01). Of 209 hypoechoic areas identified by transrectal ultrasonography, 42% were cancerous, and of 427 isoechoic areas, 1 2% were cancerous. The percentage of positive biopsy cores with hypoechoic areas was 86% in the subjects with a PSA > 10 ng/mL, but low (9%) in subjects with a PSA < 4 ng/mL, and the percentage of negative biopsy cores with a normal TRUS was high (98%) in subjects with a PSA of < 4 ng/mL, but lower (67%) in subjects with a PSA > 10 ng/mL.

Conclusion:

The serum PSA assay was more useful than either DRE or TRUS in detecting prostate cancer. The percentage of bone metastasis increased concomitant with the number of positive biopsy cores, and the positive biopsy rate of hypoechoic areas positively correlated with the PSA level.
Long‐Term Efficacy of a Self‐Retaining Intraurethral Catheter for the Treatment of Prostatic Obstruction
Authors: Nagai Tatsuya , Kondo Tetsushi , Sakakibara Toshifumi , Yoshikawa Yoko , Gotoh Momokazu , Katoh Takanori , Kobayashi Mineo
Published: July 2007

Background:

Transurethral prostatectomy is a standard treatment modality for intravesical obstruction with benign prostatic hyperplasia. However, some patients cannot undergo this procedure, so alternative devices or surgical procedures have recently been developed.

Methods:

We treated 26 patients with prostatic outflow obstruction by placement of a self‐retaining intraurethral catheter (IUC). All patients had coexisting medical complications which contraindicated transurethral prostatectomy.

Results:

In the short‐term, the treatment was successful in 96.2% of the patients, however, longer follow‐up demonstrated a significant failure rate, and the 3‐year success rate declined to 12.5%. The majority of late failures were associated with urinary tract infections.

Conclusion:

These results showed that although placement of an IUC to treat prostatic obstruction was effective in the short‐term, its long‐term efficacy was highly limited.
Nerve‐Sparing Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer
Authors: Arai Yoichi , Ishitoya Satoshi , Okubo Kazutoshi , Aoki Yoshitaka , Okada Takashi , Maeda Hiroshi , Suzuki Yuji
Published: July 2007

Background:

Nerve‐sparing techniques are used during retroperitoneal lymph node dissection (RPLND) in patients with early stage testicular cancer to preserve postoperative ejaculatory function. Indications for the procedures have been extended to patients with a postchemotherapy retroperitoneal residual mass without compromising the efficacy of surgery. We report 6 cases diagnosed with metastatic testicular cancer who underwent nerve‐sparing RPLND.

Methods:

Between January 1994 and March 1996, 6 patients with metastatic testicular cancer underwent nerve‐sparing RPLND. Five of these patients received primary chemotherapy and had a retroperitoneal residual mass. Four patients underwent complete bilateral RPLND and 2 underwent unilateral template surgery.

Results:

After a mean follow‐up of 18.7 months (range, 8 to 34), there have been no local recurrences and 5 (83%) patients report antegrade ejaculation.

Conclusion:

Nerve‐sparing RPLND is applicable for selected patients with metastatic testicular cancer without increasing the risk of local recurrence. Ejaculatory function is preserved in the majority of patients, contributing to the improvement of the quality of life in men who require such surgery.
Internal Iliac Arterial Infusion Chemotherapy for Rabbit Invasive Bladder Cancer
Authors: Hoshi Senji , Mao Hauping , Takahashi Toshiko , Suzuki Kenichi , Nose Masato , Orikasa Seiichi
Published: July 2007

Background:

Internal iliac arterial infusion (IA) chemotherapy has been used clinically for locally invasive bladder cancer, but there have been no experimental studies to actually demonstrate whether IA is more effective than intravenous infusion (IV) chemotherapy in this setting.

Methods:

We compared the effects of IA and IV using a rabbit invasive bladder cancer model. A 0.2 mL suspension containing 2 times 10/6 VX2 cancer cells was inoculated into the posterior submucosa of the bladder. Two weeks later the rabbits were divided into 3 treatment groups of 8 rabbits each: controls, a group treated with IA consisting of 10 mg/kg carboplatin and 1 mg/kg pirarubicin once a week for 3 weeks (days 14, 21, and 28), and the third treated with the same regimen intravenously.

Results:

All bladder tumors of the rabbits in the IA group decreased in size, and 3 of the tumors totally disappeared (37.5%). There was also no evidence of lung metastasis. All tumors in the rabbits in the IV treatment group increased in size (tumor volume of IA vs. IV, P= 0.008) and 2 rabbits had lung metastases. All tumors of the control group increased in size and all rabbits had lung metastases. The concentrations of platinum and pirarubicin in the bladder tumors were significantly higher in the IA treatment group than those in the IV treatment group at time points from 5 to 10 minutes (P< 0.05) after drug infusion.

Conclusion:

The antitumor effect of IA may be due to higher drug concentrations in the early stage after drug delivery, and the initial circulation of high concentrations of drugs may be the most important factor in suppressing tumor growth.
Cessation of Spermatogenesis in Juvenile Spermatogonia! Depletion (jsd/jsd) Mice
Authors: Kojima Yasuyuki , Kominami Katsuya , Dohmae Kayoko , Nonomura Norio , Miki Tsuneharu , Okuyama Akihiko , Nishimune Yoshitake , Okabe Masaru
Published: July 2007

Background:

Mice homozygousforthe jsd (juvenilespermatogonial depletion) allele are sterile because they become azoospermic. The onset of such azoospermia was investigated by histologic analysis of sections of testes from jsd/jsd mice.

Method:

The testes removed from C57BL/6‐jsd/jsd mice aged 3 to 10 weeks were examined microscopically.

Results:

At 3 weeks of age, spermatocytes were seen in most of the seminiferous tubules of jsd/jsd mice. However, the number of tubules that contained spermatids was significantly smaller than that counted in the wild‐type mice. Since degenerative figures were not abundant in the jsd/jsd testes, the decreased number of spermatids found in the tubules suggested a longer duration of development from spermatocyte to spermatid in jsd/jsd mice. The abnormality extended to the development of type B spermatogonia, and a decrease in their number became apparent after 6 weeks of age in most of the jsd/jsd tubules. However, as early as 3 weeks of age, a few seminiferous tubules in jsd/jsd mice already contained only Sertoli cells and type A spermatogonia.

Conclusion:

It is assumed that the decrease in type B spermatogonia occurred at various ages and locations. The defect of spermatogenesis in jsd/jsd mice was attributable to aberrations in multiple steps of spermatogenesis.
Distal Ureteral Atresia Associated with Crossed Renal Ectopia with Fusion: Recovery of Renal Function after Release of a 10‐Year Ureteral Obstruction
Authors: Morozumi Makoto , Ogawa Yoshihide , Fujime Makoto , Kitagawa Ryuichi
Published: July 2007

We report on a 10‐year‐old boy with distal ureteral atresia associated with crossed renal ectopia with fusion. He was admitted with a high fever associated with a urinary tract infection. The diagnosis was established by antegrade and retrograde pyelography. The upper hydronephrotic portion of the kidney, obstructed for 10 years, recovered its function after nephrostomy placement. To our knowledge, this is the first patient whose renal function has recovered despite an ureteral obstruction of 10‐years' duration. Therefore, we recommend a transient nephrostomy placement even for far advanced pediatric hydronephrosis, to test for the possibility of functional recovery.
Brain Metastasis from Prostate Cancer: A Case Report
Authors: Zhang Xianghua , Tsukuda Fumio , Yamamoto Norihito , Takenaka Ikumasa
Published: July 2007

Brain metastases from prostate cancer are rare in postmortem examinations, and even rarer in clinical series. We report an unusual case of brain metastasis from prostate cancer confirmed by antemortem diagnosis in a 72‐year‐old man. The metastatic brain tumor was surgically resected and the patient was kept stable for more than 19 months after diagnosis of the brain metastasis.
Primary Signet Ring Cell Adenocarcinoma of the Prostate Treated by Radical Prostatectomy after Preoperative Androgen Deprivation
Authors: Kanematsu Akihiro , Hiura Masaru
Published: July 2007

We report a case of primary signet ring cell adenocarcinoma of the prostate gland in a 76‐year‐old man. Radical prostatectomy was performed 4 months after bilateral orchiectomy, which proved to be a successful preoperative androgen deprivation therapy. To date, 3 years have passed with no clinical or serologic evidence of recurrent disease. Immunohistochemical testing showed the cancer tissue to be positive for prostate specific antigen and negative for carcinoembryonic antigen. This is the first reported case of primary prostate signet ring cell adenocarcinoma treated by radical prostatectomy, andthismode of therapy should be considered as a treatment of choice for the disease.
Hemangioma of the Prostatic Urethra: Hematospermia and Massive Postejaculation Hematuria with Clot Retention
Authors: Furuya Seiji , Ogura Hiroshi , Tanaka Yoshinori , Tsukamoto Taiji , Isomura Hiroshi
Published: July 2007

The case of a 53‐year‐old man with hematospermia and massive postejaculation hematuria that caused urinary retention is described. This is the sixth case in the English and Japanese language literature. Cystourethroscopic examination revealed that a solitary raised tumor was present just distal to the vermontanum, and that bleeding was from its apex. Histologic examination of an excisional biopsy sample showed features compatible with hemangioma.
Sonographically‐Detected Impalpable Testicular Cancer with Retroperitoneal Bulky Metastases: A Case Report
Authors: Sakai Naoki , Yamada Tetsuo , Asao Takeshi , Murayama Tetsuo
Published: July 2007

We report a case of a sonographically‐detected impalpable embryonal cell carcinoma with bulky retroperitoneal metastases. A 34‐year‐old man, who presented with left flank pain, was presumed to have an extragonadal retroperitoneal germ cell tumor. Scrotal sonography revealed a hypoechoic lesion, 7 mm in diameter, which was histologically diagnosed as a primary embryonal cell carcinoma. Evidence suggested that the primary tumor had grown slowly, as the tumor was well encapsulated. This case suggests that some extragonadal germ cell tumors arise from a primary testicular cancers, and that successful treatment of these tumors should include consideration that they may have arisen as a primary testicular mass.
Incidence of Urolithiasis in Northeast Thailand
Authors: Yanagawa Makoto , Kawamura Juichi , Onishi Takehisa , Soga Norihito , Kameda Koji , Sriboonlue Pote , Prasongwattana Vitoon , Borwornpadungkitti Sombat
Published: July 2007

Background:

Urolithiasis is a major health problem in the northeast part of Thailand. In this study, we examined the prevalence of renal stone disease and differences of urinary components between stone formers and healthy control subjects in northeastern rural areas of Thailand.

Methods:

We selected 3 villages in the rural areas of Khon Kaen province in northeast Thailand. Three hundred and sixty‐seven persons were asked questions relating to urolithiasis and were examined by abdominal ultrasound (US). We collected a spot urine sample from stone formers and healthy control subjects from each village.

Results:

Abnormal findings by US were detected in 39 individuals (10.6%), and included 31 individuals with renal calculi (8.4%), 16 with hydronephrosis (4.4%), and 1 individual with a renal cyst (0.3%). This yielded a disease rate of urinary stones in this study of 16.9%. The male/female ratio was 2/1 and the average age of the individuals examined was 40.3 + 13.9 years. However, there was no significant difference between the urinary parameters of stone formers and the healthy control subjects. Conclusion: There was a high incidence of renal stone disease in the northeast part of Thailand, but the tendency for hypocitraturia was only found in stone formers.
Endoscopic Correction of Vesicoureteral Reflux by Subureteric Teflon (Polytetrafluoroethylene) Injection: Review of 6‐Year Experience
Authors: Kumon Hiromi , Tsugawa Masaya , Ozawa Hideo , Monden Koichi , Ohmori Hiroyuki
Published: July 2007

Background:

Endoscopic correction of vesicoureteral reflux (VUR) was first proposed in 1981 and the first series of patients treated by subureteric polytetrafluoroethylene paste injection (STING) was reported in 1984. Although many successful studies, primarily European, have been undertaken since then, this technique has recently been rejected in the United States. In this paper, we report our 6‐year experience and discuss indications for this technique.

Patients and Methods:

Since February 1990, we have used the STING technique to endoscopically correct VUR. In this analysis, 38 ureters in 24 patients (mean age, 47.3 years; range, 7 to 79 years), with at least 1 year of follow‐up were included.

Results:

The first injection resulted in disappearance of VUR in 34 ureters (89.5%). A second injection was done for 2 failed and 3 recurrent ureters during follow‐up, resulting in disappearance of VUR in the 3 recurrent ureters. The final success rates were 1 00% for both primary VUR and secondary VUR due to neurogenic bladder, but only 55.6% (5/9) for secondary VUR following transurethral resection of bladder tumors. No postoperative early or delayed complications were noted in any case. Conclusion: The procedure is simple and effective for the treatment of all grades of VUR. However, the procedure should be performed after careful consideration of the indications, since theoretically the risk of distant migration of the paste cannot be ignored.
Prognostic Markers of Intravesical Bacillus Calmette‐Guérin Therapy for Multiple, High‐Grade, Stage T1 Bladder Cancers
Authors: Lee Eunsik , Park Inae , Lee Chongwook
Published: July 2007

Background:

Prediction of a response to intravesical bacillus Calmette‐Guérin (BCG) therapy for bladder cancer is clinically important. We determined whether several molecular markers have prognostic value in intravesical BCG therapy for multiple, high‐grade, stage T1 bladder cancers. Methods: The expressions of p53 (clone D07), bcl‐2 (100‐D5), cathepsin‐D (C5), c‐myc(9E11), c‐erbB‐2 (CB11) and Ki‐67 (MM1) were determined by immunohistochemistry in paraffin‐embedded tissues from 32 multiple, T1, grade II–III bladder cancer patients (1 5 BCG responders, 1 7 nonresponders) who had undergone a single course of BCG therapy (Pasteur strain, 5 × 108 CFU weekly for 6 weeks) after complete removal of the tumors. The association between the expression of these markers and the response to BCG was assessed by univariate and multivariate analyses.

Results:

There was no difference in patient and tumor characteristics between the 2 groups. Using multivariate analysis, the only useful marker was p53, with the overexpression of the p53 protein inversely related to the response to BCG therapy (P = 0.0182).

Conclusion:

Our results suggest that the status of p53 expression offers significant clinical information and may be a useful tool in the selection of suitable candidates for BCG therapy in multiple, high‐grade stage T1 bladder cancer patients.
Correlation of Nuclear Morphometry and Immunostaining for p53 and Proliferating Cell Nuclear Antigen in Transitional Cell Carcinoma of the Bladder
Authors: Ogura Keiji , Fukuzawa Shigeki , Habuchi Tomonori , Ogawa Osamu , Yoshida Osamu
Published: July 2007

Background:

In an attempt to determine the biological significance of nuclear morphometric findings, measurements of mean nuclear volume (MNV) and nuclear roundness factor (NRF) were compared to the immunoreactivityof p53 expression and proliferating cell nuclear antigen (PCNA) in human bladder cancer.

Methods:

MNV and NRF were measured using stereological methods. Expression of p53 and PCNA were determined by immunohistochemical staining. Specimens from 111 patients with previously untreated bladder cancer were analyzed.

Results:

The mean MNV was 235.8 ± 1 33.6 μm3 for the 81 patients with p53‐labeling index (LI) less than 10% and 337.2 ± 141.0 μn3 for the 30 patients with p53 LI greater than 10% (P = 0.008). There was Resign if icant correlation between NRF and expression of p53. The mean MNV was 220.1 ± 1 20.5 μm3 for the 67 patients with PCNA LI less than 28% (the mean value of PCNA LI) and 328.9 ± 149.2 μm3 in 44 patients with PCNA LI greater than 28% (P= 0.0001). The mean NRF was 80.7 ± 4.2 for the 67 patients with PCNA LI less than 28%, and 82.3 ± 3.4 for the 44 patients with PCNA LI more than 28% (P= 0.04). Conclusion: Nuclear morphometric findings may reflect the proliferative potential of cancer eel Is of the bladder, as indicated by findings of immunostaining for p53 and PCNA.
Transurethral Visual Laser Ablation of the Prostate for Benign Prostatic Hyperplasia Using a KTP/YAG Laser
Authors: Miki Tsuneharu , Kojima Yasuyuki , Nonomura Norio , Matsumiya Kiyomi , Kokado Yukito , Yoshioka Toshiaki , Takahara Shirou , Okuyama Akihiko
Published: July 2007

Background:

Transurethral visual laser ablation of the prostate (VLAP) has been established as an alternative method for the treatment of benign prostatic hyperplasia (BPH). However, most VLAP procedures utilize only a neodymium:yttrium‐aluminum‐gamet (Nd:YAC) laser. Since a potassiumtitenyl‐phosphate (KTP) laser offers limited tissue penetration, KTP can be safely utilized to excise part of the obstructing prostatic tissue. This study assessed the interaction between KTP vaporization and YAG coagulative ablation to determine the safety and efficacy of VLAP utilizing a combined KTP/YAG treatment.

Methods:

Forty patients with bladder outlet obstruction secondary to BPH were treated with VLAP using a KTP/YAG laser. The laser light was delivered by an angle delivery device.

Results:

Most cases demonstrated a significant improvement in routine subjective and objective parameters (AUA symptom score, peak flow rate, average flow rate, and amount of residual urine). No significant complications relating to this procedure were reported, however, 4 patients experienced postoperative acute urinary retention.

Conclusion:

KTP/YAG laser ablation of the prostate is safe and effective for the treatment of BPH.