bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of the Sex-Determining Region of the Y Chromosome in 46,XX True Hermaphroditism
Authors: Kojima Yoshiyuki , Hayashi Yutaro , Asai Nobuaki , Maruyama Tetsuji , Sasaki Shoichi , Kohri Kenjiro
Published: April 2003

Objectives: Two cases of 46,XX true hermaphroditism were analyzed for two Y-DNA sequences, including the recently cloned gene for male testis determination, the sex-determining region of the Y chromosome (SRY). Methods: Polymerase chain reaction was performed to amplify the SRY. DNA was prepared from peripheral blood lymphocytes as well as from gonadal tissue preserved in a paraffin block. Results: One hermaphrodite contained the SRY sequences in peripheral blood lymphocytes and the testicular part of ovotestis tissue preserved in a paraffin block, while in the second patient these sequences were not detected. Conclusions: The SRY positive subject resulted from occult Y mosaicism rather than from X–Y translocation. Testis differentiation in the SRY negative subject may have been caused by mutation of a gene on the X chromosome or, alternatively, on an autosome.
Renal Abscesses in an AIDS Patient Caused by Aspergillus fumigatus
Authors: Kümmerle Sigrid , Wedler Hans
Published: April 2003

Background: Aspergillus abscesses of the kidneys are very rare complications of AIDS which usually have fatal outcome. The 4 patients described in the literature, 2 of whom had bilateral involvement, died due to this opportunistic infection. Methods: Case report of a 33-year-old patient with AIDS in stage C3 and aspergillus abscesses of the kidney. Results: Successful treatment of bilateral aspergillus abscesses of the kidneys with purely conservative antimycotic measures. This was largely due to stabilization of the immune status by supplementing antiretroviral treatment with the proteinase inhibitor indinavir. Conclusions: The options now available for improving immune status in AIDS also improve the treatment chances in renal aspergillosis.
Study on the Origin of Seminal Leucocytes Using Split Ejaculate Technique and the Effect of Leucocytospermia on Sperm Characteristics
Authors: Simbini T. , Umapathy E. , Jacobus E. , Tendaupenyu G. , Mbizvo M.T.
Published: April 2003

The origin of seminal leucocytes and their biological significance were investigated in 76 whole ejaculate samples and 27 split ejaculate samples, obtained from patients attending the Zimbabwe Family Planning Council’s Spilhaus Infertility Clinic at Harare. The leucocytes were more prevalent in fractions 1 and 2 than in fraction 3, implying that the testis, epididymis and prostate are the major sources of seminal leucocytes. The contribution from the seminal vesicles was minimal. An inverse relation is apparent between leucocyte count and sperm count (p < 0.01). The percentage of abnormal sperms was higher (p < 0.05) and the sperm motility poorer in leucocytospermic samples (p < 0.01). Fructose, the seminal vesicular marker, citric acid, the prostatic marker and α-glucosidase, the epididymal marker were not decreased in leucocytospermia. It is concluded that the epididymis and prostate are the major contributors of granulocytes in semen. Leucocytospermia affects sperm morphology and sperm motility but not the accessory sex gland functions. Probably these cytotoxic effects are mediated by hydrogen peroxide due to activation of seminal leucocytes. However, the presence of leucocytospermia in normozoospermic samples is indicative of the possible peaceful coexistence of leucocytes and sperms.
Retroperitoneoscopic Partial Adrenalectomy Using an Endoscopic Stapling Device in Patients with Adrenal Tumor
Authors: Sasagawa Isoji , Suzuki Hitoshi , Tateno Tadashi , Izumi Takuji , Shoji Norifumi , Nakada Teruhiro
Published: April 2003

We performed 15 retroperitoneoscopic partial adrenalectomies using an endoscopic stapling device to divide the normal adrenal tissue and adenoma. The mean operating time and mean blood loss were 162 (129–210) min and 12 (5–67) ml, respectively. In 1 patient (6.7%), a pneumothorax occurred at the end of the procedure due to injury of the medial crus of the diaphragm. However, the procedure was not subsequently converted to open surgery. These facts suggest that posterior retroperitoneoscopic partial adrenalectomy is a valuable addition to adrenal gland surgery.
Successful Closure of Neovesicocutaneous Fistula with Fibrin Glue
Authors: Morita Tatsuo , Tachikawa Nobuyuki , Tokue Akihiko
Published: April 2003

We report a case of neovesicocutaneous fistula following radical cystectomy with urinary diversion via an ileal neobladder. The fistula was closed with fibrin glue. The present case suggests that occlusion therapy with fibrin glue is useful as a treatment option to facilitate the closure of a fistulous tract in the case of prolonged urine leakage from the ileal neobladder.
Ureteroscopic Approach to Early Postoperative Ureteral Obstruction in the Renal Transplant Patient
Authors: Scarpa Roberto Mario , de Lisa Antonello , Porru Daniele , Usai Enzo
Published: April 2003

The ureteroscopic treatment of acute postoperative ureteral obstruction in a kidney transplant patient is presented. This approach was made possible by the use of thin instruments, which do not require predilation, and was chosen in place of antegrade nephrostomy or open surgical access. The concept that the ureteroscope must be adapted to the ureter and its characteristics and not vice versa is stressed. The increasingly widespread availability and use of thin and ultrathin ureteroscopes will ensure that this approach is likely to become the rule rather than the exception in the future.
Properties of Alpha-1-Adrenergic Receptors in the Rat Prostate: Effect of Experimental Diabetes
Authors: Nishi Kazuhiko , Wada Yoshihiro , Saito Motoaki , Foster Jr. Harris E. , Weiss Robert M. , Latifpour Jamshid
Published: April 2003

We studied the effects of 8 weeks of streptozotocin (STZ)-induced diabetes on the density and the pharmacological properties of α1-adrenoceptors in the rat prostate using receptor-binding experiments with [125I]iodo-2[β-(4-hydroxyphenyl)-ethylaminomethyl]tetralone [125I]HEAT. Saturation experiments showed the presence of specific [125I]HEAT-binding sites in the control and diabetic rat prostate and that the induction of diabetes significantly decreased the density of [125I]HEAT-binding sites in the rat prostate. [125I]HEAT-binding sites in the prostate of both groups were inhibited by prazosin (nonselective), spiperone (α1B-selective), WB4101 and 5-methylurapidil (α1A-selective) and BMY7378 (α1D-selective) with the following rank order of Ki values: prazosin < WB4101 < 5-methylurapidil < spiperone < BMY7378, indicating a similar pharmacological profile of α1-adrenoceptor in the 2 groups.Comparing the Ki values of the rat prostate with those obtained from the rat submaxillary gland (α1A), rat spleen (α1B), rat vas deferens (α1A + α1B) and those reported for cloned α1D, indicates the predominance of the α1A + α1B or the α1A subtype in the rat prostate. The present study demonstrates that STZ-induced diabetes downregulates the expression of α1-adrenoceptor in the rat prostate, without significantly affecting the receptor subtype specificity.
A 3,500-Gram Leiomyoma of the Bladder: Case Report on a 3-Year Follow-Up after Surgical Enucleation
Authors: Broessner Clemens , Klingler Christoph H. , Bayer Günther , Pycha Armin , Kuber Walter
Published: April 2003

We report on a unique-sized large leiomyoma of the bladder wall in a male patient. After open surgical intervention all symptoms resolved spontaneously and no relapse occurred within a 3-year follow-up period. In conclusion, for symptomatic leiomyoma of the bladder surgical intervention should be considered as an early treatment option since it is associated with low morbidity, a high cure rate for this type of tumor and an immediate relief of urological symptoms.
Scrotal Lymphangioma
Authors: Yasui Takahiro , Akita Hidetoshi , Kobayashi Katsumasa , Kohri Kenjiro
Published: April 2003

We report a case of scrotal lymphangioma. A 6-year-old boy was referred to our hospital due to a right scrotal mass with tenderness. On physical examination the mass was discriminated from the testis and showed transillumination. Total surgical excision of the mass was performed. The lesion was multicystic, and adherent to the skin. Pathological examination revealed lymphangioma. Total surgical excision is considered the treatment of choice for this disease.
Bilateral Cryptorchidism Associated with Terminal Deletion of 10q
Authors: Suzuki Yasuhiro , Sasagawa Isoji , Nakada Teruhiro , Onmura Yoshiki
Published: April 2003

We report on an infant with terminal deletion of 10q (del10q26.11) presenting with bilateral cryptorchidism. Of 9 males previously reported with terminal deletion of 10q, 1 had an intersex phenotype, and the others all had combinations of cryptorchidism, micropenis, and hypospadias. Terminal deletion of 10q appears to include some genes indispensable for normal male genital development.
Kidney Transplantation in a Child with Posterior Urethral Valve from a Hepatitis B Virus-Carrier Mother
Authors: Seki Toshimori , Koyanagi Tomohiko , Nonomura Katsuya , Yamashita Tetsufumi , Chikaraishi Tatsuya , Kanagawa Kouichi
Published: April 2003

The case of a 7-year-old boy with posterior urethral valve (PUV) who underwent successful kidney transplantation for progressive renal failure is reported. He required complex reconstructive surgery for PUV-related disorders, and also specific serological preparation for hepatitis B (HB) as his living donor mother was a proven carrier. By carefully executing the principles of reconstructive surgery and with well-planned seroimmunological preparation, we have demonstrated that successful kidney transplantation can be done from an HB Ag-positive mother to an HB Ag- and HB Ab-negative son, even when his urinary tract is severely dysfunctional due to PUV.
Congenital Cystic Mesoblastic Nephroma
Authors: Campagnola Silvio , Fasoli Lorella , Flessati Paola , Sulpasso Matteo , Balter Rita , Pea Maurizio , Caudana Roberto
Published: April 2003

Congenital mesoblastic nephroma is a relatively rare infantile renal tumor. It comprises 3–6% of renal masses in childhood and 50% during the neonatal period. Most mesoblastic nephroma occur in the newborn period, with 80% of the cases being reported within the first month of life. Macroscopically the tumor is composed of a solid mass of different sizes tending to invade the surrounding structures and renal parenchyma. The authors report a case of cystic mesoblastic nephroma of the cellular subtype, with diffuse areas of hemorrhage and necrosis. The tumor was treated by surgical excision with radical nephrectomy and the child is doing well 4 years after the operation.
Genotypic Evolution in a Quinolone-Resistant Neisseria gonorrhoeae Isolate from a Patient with Clinical Failure of Levofloxacin Treatment
Authors: Tanaka Masatoshi , Sagiyama Kazuyuki , Haraoka Masashi , Saika Takeshi , Kobayashi Intetsu , Naito Seiji
Published: April 2003

Recently, a reduction in the antimicrobial susceptibility of clinical isolates of Neisseria gonorrhoeae to newer fluoroquinolones including levofloxacin in vitro has been recognized in Japan. We examined the quinolone resistance mechanisms in N. gonorrhoeae isolates from a patient with clinical failure of levofloxacin treatment. Man with gonococcal urethritis was treated with oral 100 mg levofloxacin 3 times daily for 7 days. However, clinical failure of the treatment was observed. The minimum inhibitory concentration of levofloxacin for the posttreatment isolate (4.0 μg/ml) was 4-fold higher than that for the pretreatment isolate (1.0 μg/ml). To analyze quinolone resistance mechanisms in the set of isolates, we performed DNA sequencing of the quinolone reisistance-determining regions within the gyrA and parC genes. Moreover, we assayed the intracellular levofloxacin and norfloxacin accumulation level in these isolates. The pretreatment isolate contained three substitutions compared to susceptible wild-type isolate, including serine to phenylalanine at position 91 and aspartic acid to asparagine at position 95 in the GyrA protein, and serine to proline at position 88 in the ParC protein. The posttreatment isolate had four substitutions, including the same three substitutions and an additional glutamic acid to glutamine substitution at position 91 in ParC. There was no significant difference in the level of accumulation of levofloxacin and norfloxacin between the pretreatment and posttreatment isolates. Our results indicate that levofloxacin selects a mutant having an additional alteration within the gene cording for the ParC protein during treatment, which may have enhanced quinolone resistance in the organism.
Quantitative Residual Cortical Activity Measurement: Appropriate Test for Diagnosis of Renal Artery Stenosis?
Authors: Gezici Ayten , Ersay Ahmet , Antevska Elizabetta , Heidental Guido K. , Schreij Gerrit , Demirtas Omer Can
Published: April 2003

Objectives: To evaluate the diagnostic validity of quantitative measurement of residual cortical activity (RCA) in renal artery stenosis (RAS). Methods: In 45 patients with a high clinical likelihood of renovascular hypertension (RVH) and unimpaired renal function, dynamic imaging was performed after an intravenous bolus injection of 148 MBq 99mTc MAG3 for both baseline renoscintigraphy and captopril renography following oral application of 50 mg captopril. RCA was measured according to the Sfakianakis method: RCA = cortical counts at 20 min/counts at peak ×100%. An increase in RCA of ≥5% from baseline was considered indicative of RAS. After renography, all patients underwent selective transfemoral angiography with the digital subtraction technique. A luminal reduction of ≥50% was considered as proof of RAS. Results: The number of kidneys that had a change of ≥5% in RCA values was 12 (27.2%) in normal kidneys, 7 (58.3%) in the patients with bilateral RAS, 14 (82.3%) in the patients with unilateral RAS, and 21 (72.4%) in overall kidneys with RAS. The positive test ratio in pathologic groups was significantly higher than normal (p < 0.05). The sensitivity and specificity of the RCA test were 72.4 and 72.7%, respectively; the positive and negative predictive values were 63.6 and 80%, respectively. Conclusion: Quantitative measurements of RCA can be used as a diagnostic parameter of renal artery stenosis and may contribute of the diagnostic accuracy of visual interpretation and other renographic diagnostic criteria.
Bilateral Symptomatic Adrenal Myelolipoma
Authors: Appetecchia M. , Chilelli M. , Sciarretta F. , Anzà M.
Published: April 2003

Myelolipomas of the adrenal gland were first described in 1905. They are rare cortical, nonfunctioning, benign neoplasms, generally unilateral, usually discovered by accident or at autopsy. Thus they are often classified as ‘incidentaloma’. These tumors are more frequent in males 40–60 years old. Most adrenal myelolipomas are small (diameter < 4 cm) and asymptomatic (70%), but larger tumors may cause local symptoms secondary to mechanical compression. Very large bilateral adrenal myelolipomas are exceedingly rare. They generally require no treatment; however, if symptomatics or if diagnosis is in doubt, surgery is needed. Usually only monolateral adrenalectomy is performed, even in the presence of bilateral tumors, to preserve adrenal function. We present a case of bilateral, symptomatic giant myelolipoma in a young woman, treated with bilateral adrenalectomy.
Epitheloid Sarcoma of the Penis
Authors: Sarica Kemal , Bakir Kemal , Yagci Faruk , Özalpat Özcan , Korkmaz Canan
Published: April 2003

We report a case representing the clinical as well as histopathologic features of epitheloid sarcoma. Both a clinical review and the results of definitive treatment together with the follow-up data are presented.
Unilateral Testicular Torsion: Protective Effect of Verapamil on Contralateral Testicular Histology
Authors: Sarica Kemal , Bakir Kemal , Yagci Faruk , Erbagci Ahmet , Topcu Oǧuzkan , Uysal Okan
Published: April 2003

In this experimental study, it was our aim to reduce the effects of ischemic insults to the contralateral testicle after unilateral testicular torsion. The protective effect of a calcium channel blocking agent (verapamil) on the histology and the tubular diameter of contralateral testicle was evaluated. Following a definite period of unilateral testicular torsion (i.e., 4 h), the protective effect of this specific medication was evaluated both after detorsion and orchiectomy procedures. The results of our study demonstrated the protective effect of verapamil on both parameters, especially in animals undergoing orchiectomy. The majority of the specimens demonstrated normal histologic findings together with preserved tubular structures after a 1-week period under verapamil medication.
Renal Cell Carcinoma
Authors: Miller K.
Published: April 2003

Diagnosis of renal cell carcinoma (RCC) is established using sonography and confirmation by computed tomography (CT). Due to the widespread use of these imaging techniques for numerous indications, small renal tumors are increasingly detected by chance. As the sensitivity of CT is very high, treatment of RCC is routinely initiated without histological confirmation. Standard therapy of locally confined tumors without evidence of lymph node or hematogenic metastases is nephrectomy. However, the results of tumor excision equal those of nephrectomy if tumor size does not exceed 4 cm in diameter. Whereas the prognosis of organ-confined tumors is excellent, no curative treatment for primary metastasized RCC is available to date. Immunotherapy – the only systemic treatment modality with clinically relevant response rates – has so far failed to effect a survival advantage for the patient. Surgery is only potentially curative for asychronous metastases occurring more than 2 years after surgery.
Guidelines for the Diagnosis and Therapy of Testicular Cancer and New Developments
Authors: Weißbach L.
Published: April 2003

The guidelines of testicular cancer were elaborated and agreed upon interdisciplinarily. Standard therapy of stage I seminoma is infradiaphragmatic radiotherapy. Possible alternatives are adjuvant carboplatin therapy (still in test procedure) and, in case of lacking risk factors, the watch-and-wait strategy. If small metastases of lymph nodes exist, radiotherapy requires a higher dose and a larger beam field. Standard therapy in clinical stage IIC–III is cisplatin-based multidrug chemotherapy. In regard to nonseminomatous germ cell tumor there are no universal recommendations: retroperitoneal lymphadenectomy (RLA) with protection of ejaculation function, watch-and-wait strategy as well as adjuvant chemotherapy have the same cure rate but differ in relapse rate and morbidity. Knowing the crucial risk factors – depending on the expected relapse rate – it will be possible to recommend adjuvant chemotherapy or wait-and-see strategy in the future. In case of lymph nodes up to 5 cm, three different therapeutic strategies are possible. They reach the same cure rate, but are associated with different morbidity: primary nerve-sparing RLA plus adjuvant chemotherapy, primary nerve-sparing RLA without adjuvant chemotherapy, and primary chemotherapy. Advanced stages are related to three different groups in reference to their prognosis. At present, they are still treated with three or four cycles of PEB. In current protocols, patients with ‘poor prognosis’ receive high-dose therapy afterwards. These results have to be taken in consideration when updating the guidelines. The present guidelines also give notes for the therapy of TIN, residual tumor resection (RTR), management of CNS metastases, and therapy of recurrences.
Factors Determining Analgesic and Sedative Drug Requirements during Extracorporeal Shock Wave Lithotripsy
Authors: Salinas A.S. , Lorenzo-Romero J. , Segura M. , Calero M.R. , Hernández-Millán I. , Martínez-Martín M. , Virseda J.A.
Published: April 2003

Purpose: The aim of this study was to determine what factors influence the analgesic and sedative requirements during extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: A retrospective study was carried out on 2,103 lithotripsy treatments performed over a 7-year period using an electromagnetic lithotriptor. Treatment with analgesics and anxiolytic drugs administered during ESWL was evaluated, and two new variables to determine the analgesic and sedative requirements were defined. A multivariant analysis model was established to determine which variables are related to or could predict the analgesic and/or sedative drug requirements. Results: The most frequently used sedative drug was potassium chlorazepate which was used in 2,059 patients at a mean total dose of 25.6 mg. Pethidine was used in 2,006 patients at a mean total dose of 56.3 mg, and fentanyl in 995 patients at a dose of 93.3 μg. In 52.4% of patients analgesic requirements were low, and in 76.6% sedative requirements were low. In 21.1% of patients analgesic drug requirements were high, and in 1.8% of patients sedative drug requirements were high. The multivariant analysis showed that those requiring most analgesics were, the younger patients (p = 0.003), those who received a higher number of shock waves (p < 0.001) and those who needed more sedation (p < 0.001). Those who received the greatest amount of sedatives were women (p = 0.0026); younger patients (p < 0.001); those treated with higher voltages (p = 0.032), and patients with the highest analgesic requirements (p < 0.001). Conclusions: Predicting the analgesic drug requirements prior to ESWL is very difficult. The present study shows that young age, a greater discharge of shock waves and a high sedative drug requirement are factors clearly related to greater analgesic drug requirements. Higher sedative drug requirements are needed by women, younger patients, those receiving high discharge voltages and those with higher analgesic requirements.
Bilateral Giant Adrenal Myelolipoma and Polycystic Ovarian Disease
Authors: Kalafatis P.
Published: April 2003

We report a case of a nonfunctioning, synchronous, bilateral, very large adrenal myelolipoma in an obese woman. She had diabetes mellitus and oligomenorrhea due to polycystic ovarian disease, and for that, she was taking progesterone medication for over 12 years. The principal clinical findings, the etiology and pathogenesis, the diagnostic-tools including US-guided fine-needle biopsy to preoperative differential diagnosis, are discussed.
Mature Dendritic Cells Induce T-Helper Type-1-Dominant Immune Responses in Patients with Metastatic Renal Cell Carcinoma
Authors: Rieser Claudia , Ramoner Reinhold , Höltl Lorenz , Rogatsch Hermann , Papesh Christine , Stenzl Arnulf , Bartsch Georg , Thurnher Martin
Published: April 2003

We performed a pilot study on a dendritic cell (DC)-based vaccine in 4 patients with advanced renal cell carcinoma. The vaccine consisted of cultured blood DCs loaded with autologous tumor cell lysate plus keyhole limpet hemocyanin (KLH) and matured with a combination of tumor necrosis factor α and prostaglandin E2. We describe the immune response against KLH induced by DC-based immunization in a patient undergoing an objective partial response and compare it with the responses observed in patients with either stable or progressive disease. The patient with the clinical response developed strong delayed-type hypersensitivity (DTH) against KLH after a single vaccination with antigen-loaded DCs, whereas the other patients failed to develop DTH reactivity even after repeated vaccinations. Antigenic stimulation of mononuclear cells (MNCs) induced proliferation and IFN-γ but not IL-4 production as well as expression of the chemokine receptor CXCR3 consistent with a T-helper (Th) type-1 bias. Exogenous IL-12 enhanced and exogenous IL-4 diminished IFN-γ production. In the 2 patients with stable disease two or more vaccinations were required to induce maximal MNC responses. In the patient with progressive disease MNC responses were hardly detectable. Anti-KLH antibodies appeared with different kinetics but could be detected in the serum of all patients. Isotype analysis revealed the presence of IgM, IgG1, IgG2 and IgG3 as well as IgA and complete absence of IgE. The patient with progressive disease also developed IgG4 antibodies indicative of a deviation towards Th2. Cultured blood DCs can be a potent vaccine for the antigen-specific immunization of patients with advanced kidney cancer. KLH serves as a tracer molecule which allows determination of the magnitude, kinetics and Th bias of the cellular and humoral immune response induced by DC-based immunization. The data also suggest that Th type-1-dominant immune responses involving DTH reaction are required for the induction of tumor regression.
New Method of Bladder Biopsy Using Combined Aspiration and Snare
Authors: Abe Hiroyuki , Nishimura Taiji , Osawa Shuichi , Hamasaki Tsutomu , Miura Takafumi , Ikeda Kazunori , Oka Fumiatu , Ohaki Yoshiharu
Published: April 2003

A method of multiple random biopsy combined with bladder wall aspiration and snare in bladder cancer is presented. Our method was used on 23 patients with clinically superficial bladder cancer and was found to have advantages in obtaining an adequate amount of tissue with minimal thermal degeneration.
Standardization and Potential Use of HPLC for Detection of Cellular Placental Alkaline Phosphatase Using Established Tumour Cell Lines and Fresh Tumour Biopsies
Authors: Torabi-Pour N. , Nouri A.M.E. , Chineguwndo F. , Oliver R.T.D.
Published: April 2003

Placental alkaline phosphatase (PLAP) is one of the cellular phosphatases (ALP) expressed in patients with testis cancers, particularly in seminomas. Using various techniques including Western blot and high-performance liquid chromatography (HPLC) systems and ATC2, a newly developed specific anti-PLAP monoclonal antibody (Mab), the presence of active form of PLAP in lysates prepared from testis tumour fragment and tumour cell lines, was studied. This was carried out following isolation of PLAP from biological samples using CNBr Sepharose-conjugated ATC2 beads. The results showed that: (1) The target for the newly developed Mab ATC2 was PLAP. (2) The ATC2-conjugated bead system was an efficient method for isolating pure PLAP. (3) Diethylamine (DEA), in contrast to urea and glycine, was the most efficient for separation of PLAP from ATC2-conjugated beads, as the isolated molecule did not lose any phosphatase activity and there was very little uncoupling of the ATC2 Mab from the beads. (4) ATC2-conjugated CNBr beads could pick up PLAP from a solution containing standard PLAP and lysates prepared from tumour cell lines or testis tissue fragments positive for the PLAP. (5) HPLC profile of testis tumour lines and testis tumours showed two distinct peaks with ALP activity, one at retention time 7– 8 min (corresponding to 95 kDa molecule) and one at 12–13 min corresponding to 70 kDa molecule). These data demonstrated the potential use of various biochemical methods in combination with HPLC for isolation of the fully functional molecules with ALP activity from different samples including lysates prepared from patients with testis cancer. The nature of ALP activity at 95 kDa is being investigated as no such molecule has been reported previously. These techniques might have an important implication for an early detection of germ cell tumours, particularly in patients with equivocal ultrasound.
Effect of Transrectal Ultrasonography of the Prostate on Serum Prostate-Specific Antigen Levels and Free/Total Prostate-Specific Antigen Ratio
Authors: Serel T. Ahmet , Çetin Meltem , Delibaş Namık , Çelik Ercan , Tahoğlu Mehmet
Published: April 2003

To study the effect of transrectal ultrasonography (TRUS) on serum total prostate-specific antigen (PSA), free PSA and free/total (f/t) PSA ratio and to determine the reliability of serum total and free PSA levels and f/t PSA ratio after such interventions, serum free and total PSA levels and f/t PSA ratios were determined before, immediately after and 24 h after TRUS in 44 patients who were referred to our department by their general practitioner for prostate screening. The duration of TRUS procedure and prostate volume and age were evaluated to determine whether the serum PSA levels following TRUS had changed. The total PSA and free PSA levels and f/t PSA ratio did not show any significant rise immediately after DRE and TRUS. The duration of the TRUS procedure did not appear to affect the PSA values. Age and prostate volume were not correlated with the PSA levels. Our findings revealed no significant changes in f/t PSA ratio and serum free and total PSA level, suggesting that serum free and total PSA levels and f/t PSA ratio may be more reliable parameters in the early period after TRUS.
Experimental Study Showing a Diminished Cytosolic Antioxidative Capacity in Kidneys of Aged Rats
Authors: Akçetin Ziya , Erdemli Gurur , Brömme Hans-Jürgen
Published: April 2003

In response to the rising demand for renal transplantations, more and more marginal (e.g. older) organs are being transplanted with the result of decreasing graft survival rates. Ischemia-reperfusion injury via oxidative stress is thought to be the main pathogenetic factor for this phenomenon. The cytosolic antioxidative capacity (CAC; expressed as superoxide anion radical scavenging capacity and quantified as the amount of cytosol (=ID50), which scavenges 50% of superoxide anions generated by a defined xanthine oxidase activity in vitro) and the catalase activity were therefore quantified in renal tissues of young (10 weeks) and older (40 and 60 weeks) Wistar rats and compared to each other. CAC with an ID50 of 0.064 μl in 10-week-old rats was significantly higher than in older rats (0.152 μl in 40- and 0.100 μl in 60-week-old rats; p < 0.01). The catalase activity in 10-week-old rats was 18,200 ± 3,500 U/g w/w and 18,900 ± 850 U/g w/w in 40-week-old rats. In 60-week-old rats, however, catalase activity was found to be significantly less (7,500 ± 175 U/g w/w; p < 0.01). In conclusion, the aforementioned significant decrease of the cytosolic antioxidative capacity of kidneys in older rats should be the rationale for extensive cytoprotective, antioxidative treatment trials especially after renal transplantation from aged donors.
Significance of Carbohydrate Antigen Sialyl-Lewis X, Sialyl-Lewis A, and Possible Unknown Ligands to Adhesion of Human Urothelial Cancer Cells to Activated Endothelium
Authors: Fujii Yasuhisa , Yoshida Masayuki , Chien Lee-Jung , Kihara Kazunori , Kageyama Yukio , Yasukochi Yukio , Oshima Hiroyuki
Published: April 2003

Objective: To assess the contribution of the carbohydrate antigens, sialyl-Lewis X (sLex) and sialyl-Lewis A (sLea), which are known to be ligands for E-selectin, to the adhesion between human urothelial cancer cells and cytokine-activated human endothelial cells. Materials and Methods: We studied the expression of sLex and sLea antigens of three bladder cancer cell lines (JTC 30, JTC 32, and T24) by flow cytometry and the adherence to interleukin 1β-activated human umbilical vein endothelial cells (HUVEC). Results: JTC 30 and JTC 32 cells expressed both sLex and sLea antigens, and showed adhesion to activated HUVEC, which was completely abolished by anti-E-selectin antibody. T24 cells expressed neither sLex nor sLea antigen, and did not adhere to activated HUVEC. Each of anti-sLea or anti-sLex antibody partially blocked the attachment of JTC 30 cells to activated HUVEC, and combination of these antibodies almost completely blocked the adhesion. The combination of antibodies did not significantly influence the adhesion of JTC 32 cells. Conclusion: These results indicate that both sLea and sLex carbohydrate antigens are involved in E-selectin-mediated adhesion of some urothelial cancers, and that there might be unknown ligands for E-selectin on urothelial cancer cells.
Effect of N-(Biphenylyl-Methyl)Imidazole, a Type 1 Angiotensin II Receptor Inhibitor,on the Co ntractile Function of the Rat Corpus cavernosum
Authors: Tong Yat-Ching , Wang Chia-Jane , Chan Paul , Cheng Juei-Tang
Published: April 2003

The effect of N-(biphenylyl-methyl)imidazole, losartan potassium, a newly developed antihypertensive type 1 angiotensin II receptor antagonist on the rat erectile function, was studied. Sexually active 9-week-old male spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats were given losartan 60 mg/kg intraperitoneal injections. Mean blood pressure (MBP) dropped significantly in both SHR and WKY rats (for SHR: from 140 ± 8 to 114 ± 5 mm Hg, p < 0.05, n = 8; for WKY: from 113 ± 7 to 79 ± 9 mm Hg, p < 0.05, n = 8). On the contrary, the intracavernous pressure (ICP) of SHR and WKY rats did not differ significantly from that of the corresponding controls receiving saline injections (p > 0.05, n = 8 for each group). For the chronic study, the rats were fed with losartan 30 mg/kg/day for 30 days. MBP decreased significantly in SHR but not in WKY rats (for SHR: from 137 ± 7 to 113 ± 5 mm Hg, p < 0.05, n = 8; for WKY: from 110 ± 6 to 107 ± 5 mm Hg, p > 0.05, n = 8). The ICP of the losartan-treated rats was not significantly different from that of control rats (p > 0.05, n = 8 for each group). In contrast, WKY rats receiving guanethidine 1 mg/kg/day for 30 days showed significantly decreased ICP. Angiotensin II (10–9–10–5 M) and losartan (10–9– 10–5 M) did not induce significant contractile responses of the cavernosal strip when tested in vitro. On the other hand, methoxamine 10–4 M induced good contractile responses. In conclusion, the present study demonstrated that angiotensin II did not cause significant change in the contractile status of rat corpus cavernosum. Correspondingly, the type 1 angiotensin II inhibitor effectively lowered blood pressure but did not affect cavernosal contractile function, thus is useful clinically in the treatment of hypertensive disorders without significant detrimental effects on male sexual function.
Ureterointestinal Anastomosis in Orthotopic Neobladders
Authors: Porena Massimo , Mearini Luigi , Zucchi Alessandro , Mearini Ettore
Published: April 2003

Objective: This study reports our experience with a ureteroileal reimplantation technique based on the Leadbetter-Clarke method, which is used for orthotopic neo-bladders, constructed preferably with the Camey II technique. Methods: We carried out 114 ureteroileal reimplantations using this technique in 58 patients undergoing radical cystectomy and orthotopic neobladder reconstruction. The incidence of neobladder-ureteral stenosis and reflux were analyzed during the follow-up. Results: During the mean follow-up of 31 months, the incidence of stenosis was 2.6% (3 ureteroileal implants, including 1 case of neoplastic stenosis). The incidence of slight-to-moderate reflux was 9.6% but did not cause any deterioration in renal function or an increased incidence of reflux-related pyelonephritis. Conclusion: This technique provided good functional results and a low incidence of complications, and may be recommended as a valid alternative to standard methods of creating ureterovesical anastomosis.
Effect of Increased Intrareservoir Pressure on Upper Urinary Tract Function in Continent Urinary Diversion PatientsAssessed by Radioisotope Renography
Authors: Okuno Toshiyuki , Coronel Omar Enrique Franco , Yanagawa Makoto , Takeda Kan , Kawamura Juichi
Published: April 2003

To assess upper urinary tract function and determine an ideal continent reservoir capacity, we investigated the relationship between intrareservoir pressure and functional parameters using radioisotope renography. Forty-three patients for whom ileal reservoir construction was performed by Kock pouch (n = 33) or Hautmann’s ileal neobladder (n = 14) approaches between November 1984 and September 1996 were studied. After the reservoir contents were catheterized, 99mTc-MAG 3 renoscintigraphy was carried out and time activity curves in the kidney (renogram) and reservoir (reservoirgram) were recorded, while saline solution was poured into the reservoir for monitoring of intrareservoir pressure. Three basic abnormal curves were noted in the excretory phase on renograms: a normal downward curve followed by an upward curve, a continuous upward curve associated with or without a sharp decline after the catheterization of the reservoir contents, and episodes of spike waves. Based on these curves, renograms were classified into five types: normal, high pressure, retention, obstruction, and reflux. Abnormal types were noted with 51 of 65 renal units (78.5%) in the Kock pouch group and 15 of 25 renal units (60.0%) in the neobladder group. This examination method may be useful for evaluating urodynamics in the upper urinary tract of patients with a continent ileal reservoir and provide data on adequate voiding volumes for the individual patient.
How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?
Authors: Schlichter Andreas , Schubert Roberto , Werner Wolfram , Zermann Dirk-Hendrik , Schubert Jörg
Published: April 2003

Background: The indication for elective nephron-sparing surgery (NSS) in renal cell carcinoma (RCC) is under discussion in the urological literature. The main problem of NSS is the multifocality of RCC. The presented study was performed to asses the accuracy of pre- and intraoperative ultrasound (US), and computerized tomography (CT) in determination of tumor size and detection of multifocal lesions. Materials and Methods: Tumor size was measured by preoperative US and CT and compared with the tumor diameters in gross sections of the neoplastic kidneys. Multifocality was determined by 3-mm step sectioning of the nephrectomy specimen, and the results were correlated with preoperative US and CT on the one hand, and the ex situ sonography of the nephrectomized kidney on the other hand. Results: US and CT show similar results in the determination of the tumor size. In only 22.9%, preoperative US and CT were able to detect multifocal tumors. Ex situ sonography had a sensitivity of 40.0% and a specificity of 87.2% in this regard. Conclusions: In preparation for nephron-sparing surgery of renal cell carcinoma, neither preoperative routine imaging, nor intraoperative ultrasound can safely predict multifocal lesions of renal cell carcinoma.
Long-Term Administration of Oral Low-Dose Topoisomerase II Inhibitors, MST-16 and VP-16, for Refractory or Relapsed Non-Hodgkin’s Lymphoma
Authors: Okamoto Takahiro , Nishimura Yasuo , Yamada Shinji , Yamada Shu , Itoh Tohru , Mori Ako , Saheki Kaname , Okada Masaya , Takatsuka Hiroyuki , Wada Hiroshi , Tamura Amane , Fujimori Yoshihiro , Kakishita Eizo
Published: April 2003

It is known that the topoisomerase II inhibitors, MST-16 (sobuzoxane) and VP-16 (etoposide), are effective for the treatment of lymphoma. Five patients with refractory or relapsed non-Hodgkin’s lymphoma (NHL) were treated with a combination of oral MST-16 and VP-16 over a long period. Two patients had severely refractory NHL. The remaining 3 patients could not be treated with intensive chemotherapy because of severe organ dysfunction or a poor hematopoietic reserve. All 5 are alive and well after MST-16 and VP-16 treatment. MST-16 and VP-16 are effective for NHL when intensive chemotherapy is ineffective or contraindicated.
Scleroderma Associated with Anemia and Thrombocytopenia that Responded Well to Cyclosporin
Authors: Kamada Kazuhiro , Kobayashi Yutaka , Katada Kazuhiro , Takahashi Yufuko , Chikayama Satoshi , Ikeda Motomi , Kondo Motoharu
Published: April 2003

A 55-year-old woman came to our hospital because of cutaneous sclerosis of the limbs in September 1996, and was diagnosed with scleroderma based on a skin biopsy. In August 1997, the cutaneous sclerosis became progressive (hemoglobin level, 4.3 g/dl; platelet count, 7 × 109/l). The laboratory results were positive for the direct Coombs test, bone marrow aspiration showed a dry tap, and the bone marrow biopsy showed marked fatty marrow. Indium-111 bone marrow scintigraphy showed a markedly decreasing uptake. These findings indicated bone marrow hypoplasia associated with hemolytic anemia. After prednisolone therapy (60 mg) was initiated, the direct Coombs test became negative but the blood cell count did not increase. Then, 300 mg of cyclosporin was initiated and anemia and thrombocytopenia improved. The cyclosporin dosage was gradually decreased and the patient’s hematological condition was good, although the cutaneous sclerosis changed only a little. This is a rare and interesting case of a patient with scleroderma associated with bone marrow insufficiency and hemolysis who responded well to cyclosporin.
Relationship between Soluble Transferrin Receptors in Serum and Membrane-Bound Transferrin Receptors
Authors: Kuiper-Kramer Ellen P.A. , Coenen Jules L.L.M. , Huisman Carla M.S. , Abbes André , van Raan Jan , van Elsacker Henk G.
Published: April 2003

The expression of transferrin receptors on the cell membrane of erythroblasts was analysed with flow cytometry in patients with different forms of anaemia. At the same time the concentration of soluble transferrin receptors (sTfRs) was analysed in serum. It was shown that only in iron deficiency a high concentration of sTfRs in serum could be explained with an increased expression of transferrin receptors on the erythroblastic membrane. In anaemia of chronic disease and myelodysplasia a discrepancy between a low expression on the cell membrane and normal or elevated serum values was seen. From this study we conclude that the concentration of sTfRs in serum does not only depend on the expression of transferrin receptors on the erythroblasts but also on the erythroid activity.
Use of Fiberoptic Bronchoscopy in Bone Marrow Transplant Recipients
Authors: Glazer M. , Breuer R. , Berkman N. , Lossos I.S. , Kapelushnik J. , Nagler A. , Naparstek E. , Kramer M.R. , Lafair J. , Engelhard D. , Or R.
Published: April 2003

Bone marrow transplantation (BMT) has become the therapy of choice for a number of malignant and nonmalignant hematologic and nonhematologic disorders. A frequent complication after BMT is pulmonary disease which is associated with a high mortality rate. We examined the results of 79 bronchoscopies performed between May 1991 and May 1995 in 62 patients for the evaluation of pulmonary complications after BMT. In all cases bronchoalveolar lavage (BAL) was performed, in 10% transbronchial biopsy (TBB) was also carried out and in 13% bronchoscopy was followed by open lung biopsy. Positive results were found in 67% of bronchoscopies. Fungal infection (Candida and Aspergillus species) was the most common finding (18%), bacterial infection was found in 13%, mixed (fungal and bacterial) infection in 6%, cytomegalovirus in 11% and Pneumocystis carinii pneumonia in 4%. Diffuse alveolar hemorrhage was detected in 11% of cases. Idiopathic pneumonia syndrome (IPS) was diagnosed by TBB in 3% of procedures. We conclude that BAL is a safe and accurate procedure for the evaluation of pulmonary complications after BMT. TBB should be considered in the absence of thrombocytopenia for the diagnosis of IPS. If bronchoscopy findings are negative, open lung biopsy should be considered.
Evaluation of Erythropoietic Activity on the Basis of the Red Cell and Reticulocyte Distribution Widths during Epoetin Beta Therapy in Patients Undergoing Cardiac Surgery
Authors: Sowade Olaf , Sowade Birgit , Gross Johann , Brilla Kay , Ziemer Sabine , Franke Werner , Stephan Peter , Scigalla Paul , Warnke Harry
Published: April 2003

The changes in the red cell and reticulocyte distribution widths during preoperative treatment with recombinant human erythropoietin (rhEPO) were evaluated in a double-blind, placebo-controlled trial in cardiac surgery patients. The increases in the reticulocyte count, in the hemoglobin and in all distribution widths are the expression of the marked preoperative stimulation of erythropoiesis in the patients treated with rhEPO. Only placebo patients with a hemoglobin ≤7.5 mmol/l or a transferrin >4.0 g/l at baseline showed an increase in the red cell distribution width or in the reticulocyte hemoglobin distribution width on oral iron therapy alone. While the reticulocyte count and the distribution widths of red cells in the rhEPO patients decreased postoperatively, only the increases in the distribution widths of reticulocytes after the second postoperative day indicate that stimulation of erythropoiesis had taken place. In patients with a low hemoglobin or a high transferrin the rhEPO therapy should be preceded by iron therapy in order to raise the hemoglobin level and reduce the cost of treatment.
Effects of Oxygen and Carbon Dioxide on Mean Cell Volume
Authors: Kojima Noriko , Tatsumi Noriyuki , Kojima Kazuhide , Kirihigashi Kikuo
Published: April 2003

Changes in mean cell volume (MCV) following addition of CO2, O2 or both to venous blood treated with ethylenediaminetetraacetic acid were studied in an attempt to evaluate the effects of saturation with these gases. The MCV before the addition was taken to be 100%. When CO2 was mixed with each of 353 samples, the mean increase (±SD) was 6.10 ± 1.72%. When O2 was added to 335 specimens, the mean decrease was 1.42 ± 0.96%. When first CO2 and then O2 was added to 266 samples, the mean change (the sum for each sample of the absolute value of the increase plus that of the decrease) was 7.39 ± 1.90%. Results of samples of venous and arterial blood from 15 subjects were compared to check these observations in vivo. The MCV of venous blood was always larger than that of arterial blood.
Six New Gaucher Disease Mutations
Authors: Demina Anna , Beutler Ernest
Published: April 2003

Six previously undescribed mutations were identified in 6 unrelated Gaucher disease patients: 437C→T (107Ser→Leu), 593C→T (159Pro→Leu), 604C→T (163Arg→Stop), 1138G→A (341Ala→Thr), 1214G→A (366Ser→Asn), 1294T→A (393Trp→Arg). Five patients were compound heterozygotes and 1 patient was a 593T/593T homozygote. Four patients had type I Gaucher disease with mild clinical phenotypes. Two other patients manifested central nervous system involvement (type II and type III).
Recurrent Breast Relapses in a Patient with Acute Lymphoblastic Leukaemia following Allogeneic Bone Marrow Transplantation
Authors: Savaşan Süreyya , Abella Esteban , Karanes Chatchada , Ravindranath Yaddanapudi
Published: April 2003

Isolated extramedullary relapse is very rare after allogeneic bone marrow transplantation (BMT) in acute lymphoblastic leukaemia (ALL) and continues to be a therapeutic problem. We report recurrent breast relapses in a patient with ALL after allogeneic BMT. On both occasions, bone marrow cells were shown to be of donor origin and masses disappeared after systemic chemotherapy. Treatment of the isolated extramedullary relapse after allogeneic BMT is discussed.
Atypical Spontaneous Factor VIII Inhibitor: Specific Diagnostics and Therapy of Acute Bleeding
Authors: Steinbrueckner B. , Steigerwald U. , Keller F. , Ordung R. , Neuenroth L. , Reuther J. , Klinker H. , Schwender S.
Published: April 2003

Differentiation of rapidly binding coagulation factor inhibitors from antiphospholipid antibodies is a challenge for the hemostaseologic laboratory, especially with respect to the different therapeutic consequences. Several immunological and functional assays for the diagnosis of these disorders have been proposed. Here we report the clinical and laboratory findings of a 65-year-old man who developed severe bleeding after a tooth extraction. The process leading to the diagnosis of a spontaneous atypical factor VIII inhibitor and the value of different laboratory tests are discussed.