bluuebunny/crossref_metadata_2025 huggingface dataset:
Tertiary geodynamic evolution of the Southern Adria microplate
Authors: Gambini Roberto , Tozzi Mario
Published: July 2007

The southern Adria microplate is the common foreland for the Hellenide and Southern Apennine thrust belts. The Apulian Platform dominates the microplate; outcrop, well and seismic data allow us to trace the carbonate platform edge, whilst structural analysis, geophysical and palaeomagnetic data provide important clues to the geodynamic evolution of the region. The present structural fabric of Apulia is dominated by several E‐W lineaments that divide the region into different blocks (Rospo Plateau, Gargano Promontory, Murge Ridge, Salento Peninsula, Apulian Plateau). One such lineament (the Pescara Dubrovnik ‘Line’, a prominent feature traversing the Adriatic Sea between central Italy and southern Croatia) has been active since the early Mesozoic, when it acted as a major transform fault controlling sedimentation along the northern margin of Southern Adria. During the Cenozoic the Pescara‐Dubrovnik underwent predominantly vertical and oblique movement due to a differential flexural response of the platform and the adjacent pelagic sequences to the thrust belt loading.

In Tertiary time the Southern Adria microplate was partly involved in HeIlenide collision. The Apulian platform can be considered as an area of thicker crust more resistant to underthrusting than the surrounding basins. During the orogenic events it acted as a passive rigid indentor, causing local distortion of the most external Hellenide structures. The dextral transpressive activity recorded along the south‐east margin of this indentor (Kephallinia line) can be interpreted as the result of the oblique collision between the margin of the thick Apulian Platform (in this zone NNE‐SSW striking) and the NW‐SE striking Hellenic thrust belt. Horizontal stress generated during the collision was partly transmitted to the rigid foreland re‐activating palaeo E‐W faults within the south Adria microplate in a dextral strike‐slip sense. The clockwise rotation recorded in the Salento Peninsula can be explained by the rotation of several NW‐SE striking faulted blocks. The rotation was accompanied by the opening of small transtensional basins between blocks. This block rotation was caused by the dextral shear that is expressed along the North and the South Salento Fault Zones.
The importance of goats to a natural environment: a case study from Epirus (Greece) and Southern Albania
Authors: Green Sarah , King Geoffrey
Published: July 2007

In the Epirus region of North‐west Greece, spring flows in villages have reduced dramatically over the last few decades, in some cases with serious economic consequences. We argue here that this has resulted from the major reduction of grazing by mountain goats over the same period together with other associated land‐use changes. Normally such a contention would be impossible to demonstrate because many different causes could be invoked. However, prior to 1946 culturally homogenous Greek‐speaking communities with identical pastoral practices were separated by the closure of the Greek‐Albanian border. Changes of spring flow have not occurred on the Albanian side of the border where heavy grazing has continued. In a region such as Greece where pastoralism has continued for thousands of years, the environment had reached an equilibrium with goat grazing. Apart from the reduction of spring flows, other undesirable ecological consequences are occurring.

It is also interesting to note that long‐term water table changes such as those occurring in Epirus have been attributed to tectonic effects and thought to potentially predict earthquakes. The effect however, may be the result of goats and other livestock ‘leaving’ and not the result of earthquakes ‘coming’.
PHENTOLAMINE TEST FOR OPERATIVE COMPLICATIONS OF PHEOCHROMOCYTOMA: ITS PROGNOSTIC IMPORTANCE
Authors: Nakada Teruhiro , Kubota Yoko , Sasagawa Isoji , Izumiya Ken , Suzuki Hitoshi
Published: July 2007

The purpose of this investigation was to assess whether the phentolamine test is able to predict blood pressure fluctuations during operations on patients with pheochromocytoma. We administered 5 mg phentolamine intravenously to 11 patients with pheochromocytoma and 6 patients with essential hypertension, pretreated with alpha‐adrenoceptor antagonists. Plasma concentrations of epinephrine and norepinephrine were determined before and after phentolamine administration, and blood pressure was measured repeatedly. Subsequently, all patients with pheochromocytoma underwent adrenal operations. Evidence is presented to show that: (1) in patients with pheochromocytoma whose blood pressure remains stable during their operation, phentolamine produces no clear effects on mean blood pressure (MBP), plasma epinephrine and plasma norepinephrine except in one patient with Sipple's syndrome, (2) in patients with pheochromocytoma exhibiting unstable blood pressure changes during surgery, phentolamine lowers MBP and raises plasma norepinephrine and (3) in patients with essential hypertension, MBP and plasma catecholamines remain unchanged following phentolamine administration. Based on these findings, this pharmacological test appears to be useful for predicting hemodynamic stability in patients with pheochromocytoma pretreated with alpha‐adrenoceptor antagonists.
EFFECT OF IMMUNOSUPPRESSION ON THE URINARY EXCRETION OF BK AND JC POLYOMAVIRUSES IN RENAL ALLOGRAFT RECIPIENTS
Authors: Kitamura Tadaichi , Yogo Yoshiaki , Kunitake Tsuyoshi , Suzuki Kazuo , Tajima Atsushi , Kawabe Kazuki
Published: July 2007

Sixty‐five renal allograft recipients on immunosuppressive therapy were examined for BK and JC viruria using Southern blot hybridization. The incidence and degree of BK and JC viruria were compared between this population (group RTR) and, an age‐ and sex‐matched population of non‐immunosuppressed individuals (group CTR). In the results, the incidence of BK viruria was significantly increased in the RTR group compared with the CTR group, while that of JC viruria was similar in the 2 groups. The proportion with a high level of JC viruria, however, was greater in the RTR group compared with the CTR group. Additionally, it was also demonstrated that the incidence of both BK and JC viruria was not affected by the characteristics of renal transplant recipients, such as differences in the donor source (living‐related vs cadaveric), type of immunosuppressive agents used, or the time post‐transplantation.
A NEW TUMOR MARKER FOR BLADDER CANCER
Authors: Koiso Kenkichi , Akaza Hideyuki , Ohtani Mikinobu , Miyanaga Naoto , Aoyagi Kazumasa
Published: July 2007

Biochemical assay and immunohistochemical staining of neutral endopeptidase were performed on bladder cancer cells. In superficial bladder cancer the enzyme activity and immunohistochemical intensity of staining were high, while invasive bladder cancer showed only a low level of activity. This finding suggests that neutral endopeptidase is expressed at a certain stage of cell differentiation, during the neoplastic process in the bladder. Gene expression is assumed to be closely correlated with this mechanism. From the results of this study neutral endopeptidase will serve as a new tumor marker for bladder cancer as well as acute lymphatic leukemia.
CORRELATION OF p53 PROTEIN EXPRESSION IN HUMAN UROTHELIAL TRANSITIONAL CELL CANCERS WITH MALIGNANT POTENTIAL AND PATIENT SURVIVAL
Authors: Watanabe Ryusuke , Tomita Yoshihiko , Nishiyama Tsutomu , Tanikawa Toshiki , Sato Shotaro
Published: July 2007

The p53 gene product has been detected frequently in various human malignancies. We have studied the expression of p53 protein in urothelial transitional cell cancers (TCCs) and examined its correlation with pathologic grade, stage(pT) and patient survival. Specimens from 69 surgically‐resected TCCs (38 cases of urinary bladder cancer, 17 cases of ureteral cancer and 14 cases of renal pelvic cancer) were examined by immunohistochemical staining, using two anti‐p53 monoclonal antibodies, PAb1801 and PAb240, and a polyclonal antibody, CM‐1. Twenty‐six TCCs (37.6%) were positively stained by at least one of the three antibodies. Statistical analysis showed a significant correlation between p53 expression and high pathologic grade (p less than 0.05, p less than 0.001) or progressive pathologic stage (p less than 0.01). In addition, in 51 of the patients who were available for follow‐up (23 cases of urinary bladder cancer, 13 cases of ureteral cancer, and 15 cases of renal pelvic cancer), the correlation between p53 protein expression and prognosis was examined. The survival of patients exhibiting positive p53 protein expression was significantly worse than those with p53‐negative tumors (p less than 0.05). These results suggest that an immunohistochemical test for p53 protein may be a useful method of evaluating the malignant potential of TCCs. Additionally, expression of p53 protein in TCCs is an indicator of a poor prognosis which should be considered in drawing up treatment strategies.
INHIBITORY EFFECTS OF BESTRABUCIL, A CONJUGATE OF CHLORAMBUCIL AND ESTRADIOL, ON THE PRODUCTION OF ANDROGEN‐INDUCED GROWTH FACTOR(S) BY SHIONOGI CARCINOMA 115 CELLS
Authors: Akaza Hideyuki , Imada Seiki , Tsukamoto Sadamu , Koiso Kenkichi
Published: July 2007

It is known that diffusible trophic factors play an important role in both the normal and cancerous growth regulatory processes of hormone‐responsive cells such as are found in the prostate and mammary glands. Consequently, it is important to identify whether the production of such growth factors is affected by administration of therapeutic agents. We examined the effect of bestrabucil, a benzoate of an estradiol‐chlorambucil conjugate, on the production of growth factor(s) by Shionogi carcinoma 115 (SC‐115) cells, an androgen‐responsive cultured cancer cell line. We then investigated whether the inhibitory effect found was specific to bestrabucil, or if it was also produced by a mixture of the 2 compounds, estradiol and chlorambucil. Bioassay employing BALB/3T3 cells demonstrated the presence of two kinds of growth factor in the conditioned medium obtained by culturing SC‐115 cells in medium containing 10‐8 M testosterone; these factors could be separated by heparin‐sepharose column chromatography using 0.5 M NaCI and 1.1 M NaCI. When the SC‐115 cells were cultured in medium containing bestrabucil, at a concentration of 10−5 M, no growth factor activity was detected in the fraction eluted from the heparin‐sepharose column by 1.1 M NaCI. At bestrabucil concentrations of 105‐107 M, concentration‐dependent inhibition of growth factor production by SC‐115 cells could be demonstrated by 3H‐thymidine uptake assay. However, this inhibitory effect could not be demonstrated using only a mixture of estradiol and chlorambucil. The finding that bestrabucil specifically inhibits the production of growth factor(s) may help in the development of a new class of drugs which will be clinically useful in treating hormone‐responsive cancer.
ROLE OF PROSTATE‐SPECIFIC ANTIGEN AND DIGITAL RECTAL EXAMINATION IN THE DETECTION OF PROSTATE CANCER
Authors: Yamamoto Masanori , Hibi Hatsuki , Miyake Koji
Published: July 2007

Prostate‐specific antigen (PSA) is a kallikrein‐like serine protease that is secreted exclusively by the epithelial cells of all types of prostatic tissue, benign and malignant. Its serum concentration is raised in men with prostatic disease including cancer. We have evaluated its usefulness in the diagnosis of prostate cancer by measuring serum PSA concentrations in 260 men aged 50 years or over. All had abnormalities at digital rectal examination (DRE) involving suspected cancer, signs and symptoms of benign prostatic hyperplasia and equivocal findings on DRE, and miscellaneous other conditions, including hematospermia, chronic prostatitis and microscopic hematuria. Transrectal prostatic needle biopsies were performed in the men with abnormal findings on DRE or elevated serum PSA (above 4ng/ml). Serum PSA ranged from 4.0 to 9.9ng/ml in 14 (5%) of the 260 men. Four of the men in this group (31%) who underwent prostatic biopsy had prostate cancer. Serum PSA levels greater than or equal to 10.0 ng/ml were found in 8 (3%) of the 260 men. 5 of these 8 (63%) who underwent prostatic biopsy had cancer. If DRE alone had been used to screen the men having biopsies, 4 of the 10 cancers (40%) would have been missed. If PSA alone had been used to screen these men, only 1 of the 10 cancers would have been missed. Serum PSA measurement was more reliable than DRE for detecting prostate cancer. Since these two methods do not always detect the same malignant tumor, the combined use of DRE and PSA testing affords a more complete evaluation of the prostate gland for malignant involvement.
A PITFALL IN DIAGNOSING A TUMOR THROMBUS BY COMPUTED TOMOGRAPHY
Authors: Egazva Shin , Shimura Satoshi , Soh Shigehiro , Uchida Toyoaki , Koshiba Ken
Published: July 2007

This paper presents a case of right renal cell carcinoma with a false‐positive finding of tumor thrombus in the inferior vena cava. The intraluminal filling defect revealed by computed tomography appeared to be an artifact due to the inflow of non‐opacified blood into the inferior vena cava. The possibility of such an artifact should be borne in mind to avoid as far as possible any unnecessary diagnostic intervention and delay in instituting proper therapy.
THE AGGRESSIVE TREATMENT OF CHORIOCARCINOMA OF THE TESTIS ASSOCIATED WITH LUNG BONE, AND BRAIN METASTASES
Authors: Satake Ichiro , Tari Kiyonobu , Nakagomi Kazuaki , Ozawa Kazunori , Kishf Kiyozo
Published: July 2007

A case of metastatic choriocarcinoma of the testis involving the retroperitoneum, lung, bone, and brain was successfully treated by surgery, chemotherapy and radiotherapy.
MULLERIAN DUCT CYST WITH 46, XYq‐
Authors: Fujisawa Masato , Okuda Yoshihiro , Okada Hiroshi , Matsumoto Osamu , Kamidono Sadao
Published: July 2007

We report a case of a mullerian duct cyst associated with a 46, XYq‐ chromosome anomaly. Mullerian duct cyst is a consequence of the abnormal regression of paramesonephric derivative. In the past many different manifestations have been associated with the 46, XYq‐, anomaly. We discuss the possibility that a mullerian duct cyst may be one clinical manifestation of 46, XYq‐.
EPIDEMIOLOGY OF UROLOGICAL CANCER DEATHS IN JAPAN
Authors: Nakata Seiji , Yamanaka Hidetoshi
Published: July 2007

We analyzed mortality data (1973‐84) associated with 19 major cancers in Japan. The standardized mortality ratio (SMR) for prostate cancer was high in prefectures clustered in the Kanto‐Chubu and Kyusyu regions, and that for renal cancer was high in prefectures scattered over eastern Japan. On the other hand, the SMR for prostate cancer was low in prefectures in the Kinki and Shikoku regions. In males, the SMR for bladder cancer was low in the Kanto'and Chubu regions, and that for renal cancer was low in the Kanto‐Chubu, Shikoku and Kyusyu regions. The correlation between the prefectural SMR for urological cancers and other cancers was analyzed. Pairs of cancers which were fairly highly correlated (0.5 or higher) were bladder‐lung, kidney‐colon, kidney‐breast, kidney‐ovary, and kidney‐pancreas. For most cancers, the prefectural SMR in males was highly correlated (0.5 or higher) with that in females. However, for cancer of the bone, bladder, skin and larynx, the correlation coefficient was less than 0.5. In 14 of the 19 cancers examined, the slope of the logarithm of the age‐specific mortality rate plotted against the logarithm of age was linear, and the relationship between age and mortality rate could be expressed by the formula

Log M (mortality rate) nLog T (age)

The value of “n” calculated using the formula ranged from 4 to 7 for most cancers, and was highest (9.5) for prostate cancer.
BASEMENT MEMBRANE AND CARCINOGENESIS: ULTRASTRUCTURAL OBSERVATIONS IN THE BASEMENT MEMBRANE OF THE BLADDER EPITHELIUM IN RATS TREATED WITH N‐BUTYL‐N‐(4‐HYDROXYBUTYL)NITROSAMINE (BBN)
Authors: Zhang Xianghua , Matsuoka Noriyoshi , Sugimoto Mikio , Takenaka Ikumasa
Published: July 2007

This study investigated the structural alterations in the basement membrane (BM) of the bladder epithelium in rats treated with N‐butyl‐N‐(4‐hydroxybutyl)nitrosamine (BBN) using transmission electron microscopy. Following administration of BBN, thickening of the BM of the bladder epithelium was observed and remained almost constant from 4 to 20 weeks, although the pathological changes in the rat bladder epithelium induced by BBN altered over the same period of 20 weeks. The reason for this phenomenon can be explained by the increased interfacial area between the basal epithelial cells and the BM of the rat bladder epithelium due to an increase in the number and size of the microvilli on the basal cell surfaces adjacent to the BM. Our results also showed that the frequency of hemidesmosomes increased progressively during the period of carcinogenesis, especially in the lesions of noninvasive transitional cell carcinoma (TCC) in the rat bladder. It is suggested that the neosynthesis of BM components can be carried out both by benign hyperplastic cells and by noninvasive TCC cells of rat bladder. The alterations in the BM thickness may be affected by the changes in the number and size of the microvilli occurring on the basal cell surfaces adjacent to the BM. Both an increased frequency of hemidesmosomes and the neosynthesis of BM are closely related to cell proliferation during carcinogenesis.
OVER‐EXPRESSION OF METALLOTHIONEIN AND DRUG‐RESISTANCE IN BLADDER CANCER
Authors: Saika Takashi , Tsushima Tomoyasu , Och Jyunzo , Akebi Naoki , Nasu Yasutomo , Matsumura Yosuke , Ohmori Hiroyuki
Published: July 2007

Metallothionein (MT) in tumor cells has been implicated as one of the factors involved in mechanisms of resistance to anti‐cancer drugs, including cis‐diaminedichroloplatinum (CDDP) and adriamycin (ADM). The relationship between the expression of MT and chemotherapy with anti‐cancer drugs was studied in CDDP‐ and ADM‐resistant human bladder cancer cell lines and tissue samples from clinical cases. In drug‐resistant cell lines (T‐24/ADM, CI‐7/CDDP) established in our laboratory, MT expression was studied by immunohistochemistry using the avidin‐biotin peroxidase complex (ABC) method and radioimmunoassay (RIA), using anti‐MT antibody. In addition, other potentfal mechanisms of drug resistance, such as P‐glycoprotein expression were examined and the levels of reduced glutathione (GSH), oxidized glutathione (GSSG) and glutathione‐S‐transferase (GST) determined in these cell lines. The results of these investigations demonstrate that the expression of MT in resistant cell lines increased 2.1‐ and 2.5‐fold when compared with parent cell lines (CI‐7, T‐24). GSH, GSSG and GST levels were unchanged and P‐glycoprotein was not over‐expressed. A total of 120 tissue samples from 35 clinical cases of bladder cancer, before and after chemotherapy, were stained for MT which was detected in 10 of the 35 cases before chemotherapy. The incidence of MT expression was significantly higher (p less than 0.05) in cases with lower pathological tumor grades. By analyzing the MT staining after chemotherapy in the cases whose MT staining was negative before chemotherapy, it was found that cases receiving continuous administration (intravesical chemotherapy or peroral chemotherapy) showed a higher incidence (9/13) of positive staining for MT, than patients receiving intermittent administration (intravenous chemotherapy) (1/8), (p less than 0.05). These results demonstrate that: 1) a correlation exists between MT expression and tumor differentiation and 2) repetitive and continuous administration of anti‐cancer drugs results in increased MT expression in bladder cancer cells. MT expression may therefore be one of the mechanisms by which urothelial tumors acquire resistance to anti‐cancer drugs.
SCHEDULE‐INTENSIFIED M‐VAC CHEMOTHERAPY FOR ADVANCED UROTHELIAL CANCER WITH RECOMBINANT HUMAN GRANULOCYTE COLONY STIMULATING FACTOR (rhG‐CSF)
Authors: Noguchi Sumio , Kubota Yoshinobu , Shuin Taro , Hosaka Masahiko , Miura Takeshi , Kondoh Iichirou
Published: July 2007

M‐VAC (Methotrexate, vinblastine, adriamycin and cisplatin) combination systemic chemotherapy is useful for treating invasive or metastatic transitional cell carcinoma. Granulocytopenia is the major dose‐limiting factor of this chemotherapy and it takes 4 weeks or more to complete a single course of M‐VAC. We have tried to shorten the period of M‐VAC chemotherapy from 4 to 3 weeks by using rhG‐CSF. With this modified M‐VAC regimen, the number of days on which the absolute neutrophil count was less than 10007mm3 was significantly reduced and the period to reach the neutropenia nadir was shortened. No severe side‐effects were observed. In all patients treated with 2 courses of this modified M‐VAC short regimen, the period of hospitalization could be reduced by 2 weeks. We emphasize the possibility of shortening the M‐VAC regimen.
CLINICAL EXPERIENCE OF LOWER URINARY TRACT RECONSTRUCTION USING A URETHRAL KOCK POUCH
Authors: Okada Kiyoki , Aoki Yutaka , Hachiya Takahiko , Yoshida Toshio , Ishida Hajime
Published: July 2007

The operative procedure used in the present series involved a nerve‐sparing radical cystectomy, with anastomosis of the urethra using a pouch made of detubularized ileum. The 36 patients who underwent this operation were all male with an average age of 58. No deaths resulted from the operation. As far as late complications were concerned, malfunction of the antireflux nipple valve was noted in 1 patient and stenosis occurred between the urethra and pouch in 2. One patient was found to have multiple stones in the pouch and reservoir decompensation was recognized in 2. Thus, the late complication rate was 17%. There were no cases of total incontinence, but nocturnal incontinence appeared in 11 out of 31 (35%). A total of 20 out of 25 patients (80%) recovered their erectile function during the postoperative follow‐up period and the disease‐free survival rate at 5 years was 78%. Therefore, the urethral Kock pouch combined with nerve‐sparing cystectomy has proved to be a useful procedure as far as the quality of life is concerned.
NEW INDICATION OF TESTIS BIOPSY FOR AZOOSPERMIA: A CLINICAL STUDY IN JAPANESE PATIENTS
Authors: Matsumiya Kiyomi , Namiki Mikio , Kondoh Nobuyuki , Kiyohara Hisakazu , Okuyama Akihiko
Published: July 2007

Because of the progress made with assisted reproductive techniques, we decided to clarify the indication for testis biopsy in Japanese azoospermic patients. A total of 88 azoospermic patients were recruited with testis histologies obtained by bilateral biopsy. Testicular histology was evaluated using Johnsen's score count. Patients with at least 1 testis containing sperm were assigned to the active spermatogenesis group. Patients whose testes had no sperm were assigned to the hypospermatogenesis group. Differences in terms of the clinical data between the 2 groups were analyzed. Clinical data consisted of past history, physical examination and hormone concentrations. The unpaired t test was generally used to examine the statistical significance of any differences between the 2 groups. 1) There were significant differences between the 2 groups in the levels of serum testosterone and luteinizing hormone. 2) There were markedly significant differences between the 2 groups in terms of testis volume and the concentration of serum follicle‐stimulating hormone (FSH). 3) The smallest testis volume and the highest serum FSH value in the active spermatogenesis group were 7 ml and 32.7 mlU/ml (normal range 2.9‐8.2), respectively. In conclusion, although the presence or absence of active spermatogenesis can be accurately predicted by measuring the testis volume and serum FSH, testis biopsy should be carried out in patients with a testis volume greater than 7 ml or a serum FSH less than 4 times normal when the use of assisted reproductive techniques are planned.
PRIMARY ADENOCARCINOMA OF THE VERMIFORM APPENDIX ASSOCIATED WITH TRANSITIONAL CELL CARCINOMA OF THE BLADDER
Authors: Egawa Masayuki , Koizumi Hisashi , Takashima Tohru , Takeyama Shigeru , Miyagi Tetsusaburo
Published: July 2007

A case of primary adenocarcinoma of the vermiform appendix coexisting with transitional cell carcinoma (TCC) of the bladder is presented. The patient was a 74‐year‐old male who underwent radical cystectomy with continent urinary diversion using the Florida pouch. Two different cancers were found, TCC of the bladder and mucinous adenocarcinoma of the appendix. To our knowledge, this is the only such case reported in the medical literature.
A CASE OF TESTICULAR TERATOMA LOCATED IN THE OPPOSITE SIDE OF THE UPPER ABDOMINAL WALL
Authors: Nakamoto Takahisa , Igawa Mikio , Veda Mitsutaka , Yasumoto Hiroaki , Usui Tsuguru
Published: July 2007

We report a case of a testicular teratoma located in the opposite side of the upper abdominal wall. A 2‐year‐old boy presented with a non‐palpable right testis and underwent right inguinal exploration for right cryptorchidism. During surgery, the tumor was found in the opposite side of the upper abdominal wall across the midline. Histological investigation of the tumor revealed a mature teratoma occurring in the intra‐abdominal testis. No such case has been previously reported.
PRIMARY DIFFUSE LARGE CELL LYMPHOMA OF THE PENIS
Authors: Hashine Katsuyoshi , Akiyama Masanori , Sumiyoshi Yoshiteru
Published: July 2007

A 66‐year‐old man presented with malignant lymphoma of the penis. This was of considerable interest because the penis is an extremely uncommon site for primary lymphoma. This patient had no evidence of nodal disease at presentation and so was treated with radiotherapy. He is now cured and both the structure and function of his penis have been preserved.
RECOVERY PERIOD FROM URETERAL OBSTRUCTIONS OF DIFFERENT DURATION AND SEVERITY IN THE RAT KIDNEY
Authors: Yokoyama Masayoshi , Seki Nobumitsu , Oda Takashi , Takeuchi Masafumi , Tanada Shuji
Published: July 2007

The relationship between the period for recovery from hydronephrosis and the characteristics of the obstruction still needs to be clarified. In rat kidney the left ureter was completely obstructed for 3, 7, 14 and 21 d and the renal function was measured by renal scintigraphy using 99mTC‐dimercaptosuccinic acid 3, 7 and 14 d after the obstruction was removed. In addition, recovery from unilateral partial obstruction (PO) of different degrees of severity for 7 d was examined. The kidneys with very mild PO recovered within 3 d and those with a very long period of complete obstruction (CO) did not exhibit any significant recovery. However, most of the kidneys with CO of various durations and those with 7 days' PO of various degrees of severity exhibited maximum recovery 7 d after the release of the obstruction. This study suggests that the period required for maximum recovery from hydronephrosis is usually constant, unless the obstruction is too mild to cause any damage or too long to permit any recovery.
ISOLATION AND PURIFICATION OF A HIGH MOLECULAR WEIGHT SUBSTANCE FROM HUMAN URINE WHICH INHIBITS CALCIUM OXALATE CRYSTAL GROWTH
Authors: Morikawa Mitsuru , Yachiku Sunao , Arima Shigeru
Published: July 2007

A high molecular weight inhibitor of calcium oxalate crystal growth in human urine was investigated. Three inhibitors were isolated by DEAE‐Sephacel ion‐exchange chromatography and, of these, the substance we named Peak 3 protein seemed to be the main inhibitor in human urine. Peak 3 protein was purified by fast protein liquid chromatography and polyacrylamide gel electrophoresis. This substance, with a molecular weight of 30 kDa, did not contain uronic acid and its inhibitory activity decreased after digestion with proteinase. The difference between Peak 3 protein and several inhibitors previously reported was investigated but no clear difference could be found. The fact that it was the protein structure which was responsible for the inhibitory activity and the fact that Peak 3 protein probably possessed many side‐chains which did not contribute to the inhibitory activity influenced the outcome of the investigation.
THE COLONIC NEOBLADDER: A STOMA‐FREE BLADDER SUBSTITUTE AFTER RADICAL CYSTECTOMY ‐ PRELIMINARY RESULTS IN SIX PATIENTS
Authors: Shimizu Toshihiro S. , Jimbo Hiroyuki , Satoh Jin , Fukuda Takahiro , Suzuki Takanori
Published: July 2007

We have used a urethral colonic pouch for total bladder replacement in 6 bladder cancer patients after radical cystectomy. The distal ileum, cecum, ascending colon and the right third of the transverse colon were isolated. The cecum and colon were opened along the tenia and a detubulized pouch was created. The ureters were sutured to the terminal ileum. The maximum pressure wave measured ranged–58 cmH2O, and the amount of residual urine varied between 0 and 58 ml. All patients were completely continent during the day and slight incontinence at night was observed in 3. By amputating the right colonic artery, the pouch is easily moved to the urethral stump and serves as a low pressure neobladder after cystoprostatectomy.
EVOLVING EXPERIENCE WITH CONTINENT URINARY DIVERSION USING THE INDIANA POUCH
Authors: Ami Yoichi , Shichiri Yasumasa , Miyakawa Mieko , Ueda Tomohiro , Terai Akito , Terachi Toshiro , Takeuchi Hideo , Yoshida Osamu
Published: July 2007

The Indiana continent urinary reservoir procedure for urinary diversion was performed in 46 patients. After the first 8 cases several modifications were made to the Indiana pouch. These modifications include complete detubularization of the colonic segment, construction of the pouch augmented with a U‐shaped patch of ileum and, more recently, the use of stapled plication. The mean postoperative follow‐up period was 46 mo (range 4.5‐74.1 mo). There was 1 perioperative death and this case was excluded from the follow‐up study. Late complications related to the urinary reservoir occurred in 12 (26.7%) of the 45 patients. Stone formation was observed in 5 patients. Out of 45 patients, 42 achieved complete urinary continence while 2 suffered mild nocturnal incontinence and 1 had significant leakage. Three had unilateral hydronephrosis due to ureteroanastomotic stricture. Reservoirgraphy demonstrated no reflux into the upper urinary tract in all of the follow‐up cases. Loopography of the efferent limb showed that a staple‐plicated ileum functions better than a suture‐plicated one in terms of reliability of the continence mechanism and ease of catheterization. The Indiana pouch should be considered for any patient requiring cutaneous urinary diversion because it is technically easy to perform and it has a low revision and high continence rate.
NEODYMIUM: YAG LASER ABLATION OF THE PROSTATE GLAND ‐ ACUTE PERIOPERATIVE MORBIDITY AND SHORT‐TERM OUTCOME
Authors: Egawa Shin , Uchida Toyoaki , Kawakami Tatsuhiro , Yokoyama Eiji , Koshiba Ken
Published: July 2007

Twenty‐three patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were successfully treated with laser prostatectomy using the Urolase right‐angle firing neodymium: Yttrium Aluminum Garnet laser fiber. Most of the patients had health problems of moderate severity. Their conditions were compared preoperatively and 3 mo postoperatively. Symptom scores decreased from an average of 23.9 to 7.0. Symptomatic relief was achieved in 95.7% of patients. Peak urinary flow rates increased from an average of 6.4 to 17.0 ml/s. The residual urine decreased from an average of 45.2 to 22.9 ml. The volume of the prostate gland measured by sonography decreased from an average of 32.8 to 25.7 ml. Virtually no blood loss was noted intraoperatively. Acute urinary retention occurred immediately following removal of the catheter in 3 out of 17 (17.6%) patients without a percutaneous cystostomy tube. Acute epididymitis developed in 5 out of 20 (25.0%) patients without bilateral vasectomy. Based on these results, laser prostatectomy may be concluded to be a safe and effective alternative to standard transurethral resection of the prostate gland, particularly in the case of high‐risk patients.
TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATIC HYPERPLASIA: PATIENT CHARACTERISTICS IN GOOD AND POOR RESPONDERS
Authors: Ami Yoichi , Terai Akito , Onishi Hiroyuki , Oishi Kenji , Takeuchi Hideo , Yoshida Osamu
Published: July 2007

Transurethral microwave thermotherapy (TUMT) has be'en shown to produce a clinical benefit in patients with symptomatic benign prostatic hyperplasia. In order to identify the features of the ideal candidate, a retrospective analysis was conducted in 32 patients who were followed for 2 mo or more. Good responders (GR) were defined as having their Siroky peak flow rate (PFR) standard deviation (SD) increase by 0.5 or a decrease in the International Prostatic Symptom Score (l‐PSS) of 10 (22 patients). Poor responders (PR) were defined as having their PFR SD increase by 0.5 and their l‐PSS decrease by10 (10 patients). The prostate volume, pre‐TUMT l‐PSS and intravesical opening pressure were significantly greater in the GR group, while there were no significant differences between the 2 groups for the other baseline patient characteristics: age, prostate length, PFR, PFR SD, post‐voiding residual volume and quality of life. Concerning the operational parameters, significantly more total energy was delivered to the prostate in the GR group (mean 131 kJ) than in the PR group (mean 101 kJ). Moreover, the 7 patients with anti‐androgen therapy pre‐TUMT received less total energy and 5 of the 7 were poor responders. These results suggest that patients with apparent obstructive symptoms and with moderate enlargement of prostate could benefit more from this less invasive therapy. Clinical response seems to be dose‐dependent and patients with a history of recent anti‐androgen treatment may have a less favorable response. The histological composition of the prostatic tissue may play an important role as far as microwave thermal interactions and treatment outcome are concerned.
RADIATION THERAPY FOR PROSTATE CANCER CONFINED TO PELVIS
Authors: Akakura Koichiro , Akimoto Susumii , Ohki Takemasa , Igarashi Tatsuo , Murakami Shino , ShimazakV Jun
Published: July 2007

To evaluate the usefulness of external beam radiotherapy for patients with prostate cancer confined to the pelvis, long‐term results and prognostic factors were analyzed. During the period–1989, 44 cases were treated with staging pelvic lymphadenectomy followed by monotherapy using external beam irradiation by Linac X‐ray and/or fast neutrons and observed without any treatment until relapse was evident. All patients were followed until death or for a mean of 78.6 mo (range:–113 mo) for patients still alive. Four cases died of prostate cancer at 26, 28, 54, and 83 mo from the start of radiation. Eleven cases died of other causes (10‐72 mo, mean 36.4 mo). Fourteen cases (31.8%) manifested clinical relapse of cancer; 4 had local relapse, 7 developed bone metastases, and 3 relapsed at lymph nodes. After relapse, endocrine therapy was effective in most cases. The five‐year disease‐free survival rates of pNO (32 cases) and pN1 (8 cases) patients were 79.8% and 52.5%, respectively, but that of pN2 (4 cases) was worse. Cause‐specific survival was similar between patients with pNO and pN1 disease, the rate at 5 yr being 92.5% in the former and 100% in the latter. Those with high levels of serum prostate specific antigen (PSA) before treatment and advanced local disease (clinical stage C) showed unfavorable prognoses. The number of argyrophilic nucleolar organizer regions (AgNORs) might be a predictive factor in patients treated with irradiation. In conclusion, prostate cancer patients with stage A2‐C, diagnosed as pN0‐1 by staging pelvic lymphadenectomy, were successfully treated with external beam radiotherapy. The selection of candidates using prognostic factors such as N category, clinical stage, PSA, and AgNORs seems to be important for monotherapy with radiation.
RETROPERITONEAL MALIGNANT MESENCHYMOMA: A CASE REPORT
Authors: Satake Ichiro , Tari Kiyonobu , Nakagomi Kazuaki , Ishii Masaru , Kishi Kiyozo
Published: July 2007

A case of a 37‐year‐old woman with a retroperitoneal tumor is reported. Angiography revealed that the tumor was partially supplied via an intercostal artery, suggesting that the cause of the tumor might be located in the rib. Histologically the tumor was diagnosed as a malignant mesenchymoma composed of chondrosarcoma and myxoid liposarcoma in addition to fibrosarcoma. The chondro‐sarcomatous element was predominant, a phenomenon which is extremely rare. Pulmonary metastases developed 8 mo after surgical removal of the tumor and the patient died of the disease 2 yr postoperatively.
MALIGNANT LYMPHOMA IN THE FEMALE URETHRA
Authors: Kakizaki Hiroshi , Nakada Teruhiro , Sugano Osamu , Kato Hiroaki , Yamakawa Mitsunori
Published: July 2007

Primary malignant lymphomas in the female urethra are extremely rare. We report a 63‐year‐old woman who presented with a localized tumor of the urethral meatus. The tumor was classified as a non‐Hodgkin's malignant lymphoma, a diffuse, small cleaved cell type according to the Working Formulation classification. Immunohistochemistry confirmed that the tumor was derived from B cells. The patient underwent chemotherapy and remains free from evidence of the disease 3yr after excision. To our knowledge she is the seventh case of malignant lymphoma in the female urethra reported in the English literature.
IN VIVO EFFECT OF A SELECTIVE ENDOTHELIN RECEPTOR ANTAGONIST, BQ‐123, ON RENAL FUNCTION IN CYCLOSPORIN A‐TREATED RATS
Authors: Tanda Katsutoshi , Seki Toshimori , Kobayashi Shinya , Kanagawa Kouichi , Chikaraishi Tatsuya , Togashi Masaki , Nonomura Katsuya , Koyanagi Tomohiko
Published: July 2007

To inveslgate the possible involvement of endogenous endothelin (ET) in cyclosporin A (CsA) nephrotoxicity, we examined the renal effects of the selective [125I]ET‐1 binding to porcine aortic membrane (ETA) receptor antagonist, BQ‐123 (BQ), on CsA‐treated rats. An osmotic minipump filled with BQ or its vehicle (saline), was subcutaneously implanted and animals were treated with CsA (50mg/kg/d, i.p.) for 4 d. In both BQ‐and its vehicle‐treated rats, the 24‐hour urine volume, urinary N‐acetyl‐D‐glucosaminidase (NAG) excretion, urinaryCa/creatinine (Cr) and urinaryNAG/Cr ratios were significantly increased compared with those before administration of CsA. In contrast, after administration of CsA, urinary Cr excretion was significantly decreased in both rat groups. Although urinary NAG excretion and the NAG/Cr ratio in the rats treated with BQ were significantly increased compared with those treated with saline, the serum Cr levels in BQ‐treated rats were significantly lower than those in saline‐treated rats. Urinary immunoreactive ET‐1 (irET‐1) excretion in all animals was significantly increased after administration of CsA. There were no significant differences in urinary irET‐1 excretion in both BQ‐treated and saline‐treated rats with and without CsA. Expression of irET‐1 was seen in the cytoplasm of renal tubules, but the degree of expression was similar in the BQ‐treated and saline‐treated rats on CsA. In the BQ‐treated rats, small round areas with high grain densities over the glomeruli in the cortex and vesa recta bundles in the outer medulla were masked by the antagonist action of BQ. On microscopic examination of autoradiograms, the numbers of autoradiographic grains were clearly decreased in the glomeruli and vessels, which confirmed the presence of ETA. It was concluded that: (1) BQ had no effect on the products and release of ET‐1; (2) BQ could not entirely prevent CsA nephrotoxicity in rats; (3) BQ increased the tubular damage caused by CsA.
EPIDERMAL GROWTH FACTOR BINDING BY MEMBRANES OF HUMAN RENAL CELL CARCINOMAS: ESTABLISHMENT OF AN EPIDERMAL GROWTH FACTOR RECEPTOR ASSAY FOR CLINICAL USE
Authors: Yoshida Ken‐ichiro , Tosaka Akira
Published: July 2007

In order to quantitate epidermal growth factor receptors (EGFR) in human renal cell carcinoma (RCC) tissues, the binding of isotope‐labeled epidermal growth factor (125I‐EGF) to pooled membrane samples from human RCC was studied. Specific EGF binding to membranes at 4C reached a plateau after 2 h of incubation and remained constant up to 8 h; specific binding at 25C reached a plateau after 30 min of incubation, then decreased gradually. 125I‐EGF binding to the membrane was displaced by both EGF and transforming growth factor‐aL, but not by insulin and basic fibroblast growth factor. Scatchard analysis of the specific EGF binding generated a straight line, indicating a single class of binding sites for EGF, with a dissociation constant (Kd) of 21.1 times1010M and a maximum number of binding sites of 57.2fmol/mg membrane protein. When the protein concentration in the incubation medium was adjusted from 0.71mg/ml to 2.84 mg/ml, Scatchard analysis revealed identical Kd values, and the maximum number of binding sites was proportional to the protein concentration. These results demonstrate the presence of EGFR on RCC membranes and indicate that these receptors can be studied quantitatively.
ANALYSIS OF nm23 GENE EXPRESSIONS IN HUMAN BLADDER AND RENAL CANCERS
Authors: Kanayama Hiro‐omi , Takigazva Hiroshi , Kagazva Susumii
Published: July 2007

We measured nm23‐H1 and nm23‐H2 mRNA levels in tissues from 22 human bladder cancers and 16 renal cell carcinomas, and in 7 bladder cancer and 6 renal cancer cell lines by Northern blot and slot blot hybridization analyses. Differences in mRNA levels were evaluated in primary tumor tissues and in paired normal tissues and cell lines. Moreover, nrh23 gene expression in primary tumor tissues was compared with clinicopathological features. High nm23‐H1 and nm23‐H2 expression was observed in cancerous areas of human bladder tissue (nm23‐H1: p = 0.001, nm23‐H2: p = 0.001) and bladder cancer cell lines (nm23‐H1: p = 0.001, nm23‐H2: p< 0.001) compared with that in normal bladder mucosa. However, mRNA levels of both nm23 genes were not associated with histological grade, pathological stage, tumor metastasis or prognosis. On the other hand, in human renal cell carcinomas, levels of both nm23 mRNAs in tumor tissues were similar to those in paired normal kidneys, but elevated in cultured cell lines (nm23‐H1: p= 0.002, nm23‐H2: p = 0.014). Moreover, there was a tendency towards high nm23 gene expression in grade 2 tumors compared with grade 1 (grade 1 vs grade 2, nm23‐H1: p = 0.107, nm23‐H2: p = 0.008; no grade 3 tumors in this study) and in high stage renal cancers (stage II vs stage III, nm23‐H1: p = 0.023, nm23‐H2: p = 0.005). From these results, we suggest that reduced nm23 mRNA levels are not associated with metastasis of either bladder or renal cancers and there may be some tissue‐specific differences in the expression patterns of nm23‐H1 and nm23‐H2 in human cancers.
URINARY BACTERIOLOGY OF CONTINENT URINARY RESERVOIRS AND CALCULUS FORMATION
Authors: Terai Akito , Arai Yoichi , Okada Yusaku , Yoshida Osamu
Published: July 2007

In order to investigate urinary bacteriology in relation to calculus formation in continent urinary reservoirs, a retrospective study was conducted of 19 patients with the Kock pouch and 23 patients with the Indiana pouch. Analysis of a total of 151 urine‐cultures showed that asymptomatic bacteria (any bacterial count) were present in 92% of urines from the Kock pouch and 74% from the Indiana pouch. The incidence of organisms and total bacterial counts were similar for both pouches. The most prevalent organisms were Escherichia coli, Pseudomonas sp., Klebsiella sp., Proteus sp., Enterobactersp., and Enterococcus sp. Urinary calculi developed in 42% of the Kock pouch patients and 13% of the Indiana pouch patients. More than half of the patients had multiple stone recurrence. Infectious stones developed in 32% of the Kock pouch patients, usually on the foreign materials, and 9% of the Indiana pouch patients. In general, no clear relationship was established between urinary bacteriology and calculus formation although Proteus sp. or Providencia sp. was determined to be the causative organism in some infectious stones. Furthermore, metabolic stones developed in 32% of the Kock pouch patients and 9% of the Indiana pouch patients. Because calcium phosphate was a constituent of 80% of the metabolic stones, the presence of urinary factors promoting calculus formation was suspected.
URINARY INCONTINENCE IN SENILE DEMENTIA OF THE ALZHEIMER TYPE (SDAT)
Authors: Sugiyama Takahide , Hashimoto Kiyoshi , Kiwamoto Hiro , Ohnishi Norio , Esa Atsunobu , Park Young‐Choi , Kurita Takashi
Published: July 2007

Twenty patients (1 male and 19 females) with senile dementia of the Alzheimer type were studied using cystometry in combination with sphincter electromyography, brain computed tomography (CT) and evaluating the activities of daily life (ADL), with special reference to urinary incontinence. Seven of the patients were continent and the remainder were incontinent. Cystometry revealed uninhibited detrusor contraction in 8 out of the 13 incontinent patients, while no uninhibited contraction was found in 7 continent patients. There was a significant correlation between uninhibited detrusor contraction and urinary incontinence (p 0.05). Brain CT showed that the degree of brain atrophy was more severe in those with uninhibited contraction than those without (p 0.05). There was no clear relationship between sphincter coordination and the occurrence of incontinence. The ADL score tended to be lower in incontinent patients, although no significant difference was apparent (0.05 p 0.1). Uninhibited detrusor contraction and poor ADL functioning caused by brain atrophy are thought to be major causes of urinary incontinence in patients with senile dementia of Alzheimer type.
METALLOTHIONEIN IN HUMAN SEMINAL PLASMA
Authors: Suzuki Takanori , Suzuki Kazuhiro , Nakajima Katsuyuki , Otaki Noriko , Yamanaka Hidetoshi
Published: July 2007

Metallothionein (MT) concentrations were measured in the seminal plasma of 4 fertile and 35 infertile mbn and in the hydrocele and spermatocele fluids. The relationship between MT content and sperm density, total number of sperm per ejaculate, sperm motility and abnormal form rates, leukocyte count and zinc levels in seminal plasma, as well as the relationship between MT and serum follicle‐stimulating hormone, luteinizing hormone, testosterone, and prolactin were examined. MT was not detected in the hydrocele and spermatocele fluids. MT levels were related to zinc levels and to the leukocyte count in seminal plasma, but there was no correlation between MT and the other factors examined. This study supported previous findings that MT was secreted predominantly from the prostate and induced by inflammation of the prostate gland or seminal vesicles; the findings suggest that MT binds mainly to zinc and is one of the zinc‐binding proteins in seminal plasma.
INTRA‐ARTERIAL INFUSION CHEMOTHERAPY IN COMBINATION WITH A BISCOCLAURINE ALKALOID, CEPHARANTHIN, TO TREAT BONE METASTASIS ARISING FROM RENAL CELL CARCINOMA
Authors: Shichiri Yasumasa , Kanba Tomomi , Yoshida Shuzo , Arai Yoichi , Kakehi Yoshiyuki , Yoshida Osamu
Published: July 2007

A 64‐year‐old man with iliac bone metastasis from left renal cell carcinoma was treated by intraarterial infusion chemotherapy using vinblastine and epirubicine in combination with a biscoclaurine alkaloid, Cepharanthin. A good response was confirmed by computed tomography scan and the symptoms related to the metastatic lesion were much improved. Partial resection of the left iliac bone was performed when no viable cancer cells were found in the metastatic lesion.
INFANTILE GRANULOMATOUS URACHAL ABSCESS WITH ACUTE LOCALIZED PERITONITIS AND APPENDICITIS
Authors: Yoshimura Kazuhiro , Toki Kiyohide , Koide Takuo , Ashino Nobuhiko , Maki Ichiro
Published: July 2007

Infected urachal remnants in early childhood are occasionally seen. However, intraperitoneal penetration of an infected urachal remnant, resulting in acute peritonitis, is rare. We report a case of infantile granulomatous urachal abscess extending into the peritoneum and appendix. The diagnosis and treatment of urachal abscess in childhood are discussed.