bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary risks after high‐dose γ‐globulin in children with Kawasaki disease
Authors: Morikawa Yoshiyuki , Ohashi Yasuo , Harada Kensuke , Asai Toshio , Okawa Sumio , Nagashima Masami , Katoh Toshiyuki , Baba Kunizo , Furusho Kenshi , Okuni Masahiko , Osano Mitsuru
Published: March 2003

Abstract Objectives: The goals of the present study were to develop a predictive coronary risk scoring system after intravenous γ‐globulin (IVGG) therapy of any dose for the different preparations currently used in the treatment of children with Kawasaki disease and to determine the predictive value of the system. The previously reported scoring systems were based on treatment with high‐dose IVGG therapy at limited doses and were determined using investigative methods.

Methods
: Four hundred and fifty‐one patients were randomized into one of three groups and received either i.v. polyethylene glycol‐treated human immunoglobulin at a dose of either 200 (n=147) or 400 mg/kg per day (n=152) or freeze‐dried sulfonated human immunoglobulin at 200 mg/kg per day (n=152) for 5 consecutive days. We documented 31 cases of coronary abnormalities (CA). Univariate and multivariate logistic regression was performed using 49 clinical variables and the resulting predictive model was validated.

Results
: The duration of fever (odds (1 day)/odds (≥ 5 days)=0.158; 95% confidence interval (CI) 0.0385–0.648), hemoglobin (odds (Q1=10.3)/odds (Q3=11.6) = 3.97; 95% CI 1.92–8.20), IgG (odds (Q1=1900)/odds (Q3=2658)=2.72, 95% CI 1.18–6.25) and IgA (odds (Q1=72)/odds (Q3=160) =0.415; 95% CI 0.253–0.680) levels after completion of γ‐globulin infusion were independent predictors. The model is quasi‐cross validated and has acceptable sensitivity and selectivity. The estimated risk and observed occurence of CA coincide.

Conclusions
: Determinants of the risk of CA after IVGG therapy are a longer duration of fever, a lower IgG level, a higher IgA level and a lower hemoglobin level after IVGG infusion. This model is applicable for IVGG doses from 1 to 2 g/kg and for at least two different γ‐globulin preparations.
Fiberoptic colonoscopic polypectomy in childhood: Report and review of cases
Authors: Uchiyama Masanori , Iwafuchi Makoto , Yagi Minoru , Iinuma Yasushi , Kanada Satoshi , Ohtaki Masahiro , Okamoto Haruhiko , Hatakeyama Katsuyoshi
Published: March 2003

Abstract
 

Background
: Fiberoptic colonoscopy has been a routine therapeutic modality for colorectal polyps in pediatric patients. Methods of bowel preparation, anesthesia, area of investigation and treatment depending on histopathology are still controversial. In order to clarify the rationale of pediatric colonoscopy the present study was performed.

Methods and Results
: We analyzed the results of colonoscopic examination in 21 patients with colorectal polyps. Mean patient age was 3.7 years, with a range of 1–7 years. Rectal polyps were seen in 10 cases: seven had a solitary polyp (juvenile in six and adenoma in one) and three had multiple polyps (juvenile, lymphoid and Peutz–Jeghers coexisting with hyperplastic polyps). Sigmoid colon polyps were seen in 10 cases: all were solitary juvenile polyps, but one had adenomatous change. Another had multiple Peutz– Jeghers polyps located in the entire colon. Flexible colonoscopic polypectomy was performed in 16 patients and transanal polypectomy was performed in four patients. Autoamputation was seen in two cases of juvenile polyp (resection was ultimately performed in a case having repeated autoamputation). After removing the polyps, all patients have had no recurrence for a period ranging from 6 months to 15 years, except for one case with Peutz–Jeghers syndrome.

Conclusions
: Most polyps are located in the rectum or the sigmoid colon. Although the majority are solitary or juvenile polyps, because histopathologic variety is seen in pediatric colon polyps, histopathologic examination of each polyp is important to detect any dysplastic or adenomatous element with malignant potential and to make a suitable follow‐up schedule. Symptomatic polyps should be removed by fiberoptic colonoscopy or transanal resection with total colon endoscopic examination under general anesthesia. Polypectomy using the electrocautery snare and clip is effective and safe and bowel preparation using polyethylene glycol electrolyte solution is sufficient for the procedure.
Evaluation of DNA damage using the comet assay in children on long‐term benzathine penicillin for secondary prophylaxis of rheumatic fever
Authors: Dündaröz Ruşen , Ulucan Hakan , Denli Metin , Karapi̇nar Kasi̇m , Aydi̇n Halil İbrahim , Baltaci̇ Volkan
Published: March 2003

Abstract

Backround
: Benzathine penicillin is the most widely used antibiotic in the prophylaxis of children with rheumatic fever. The aim of the present study was to evaluate the DNA damage in children receiving one dose of 1.2 million units benzathine penicillin every 4 weeks over a long period to prevent recurrences of rheumatic fever.

Methods
: Thirty‐five children with confirmed rheumatic fever under benzathine penicillin prophylaxis were enrolled in the study and 35 healthy children with similar ages and socioeconomic backgrounds served as controls. To detect any DNA damage, the comet assay was performed on circulating lymphocytes from the study subjects.

Results
: Damaged (limited and extensive migration) cells in children on prophylactic therapy were higher than those in controls (P<0.001).

Conclusions
: It has been suggested that differences in the comet scores were induced by the administration of benzathine penicillin over a long period of time and further investigations are needed to confirm this toxic effect.
Prognosis of acute poststreptococcal glomerulonephritis (APSGN) is excellent in children, when adequately diagnosed
Authors: Kasahara Takayuki , Hayakawa Hiroshi , Okubo Soichiro , Okugawa Takayoshi , Kabuki Naoyuki , Tomizawa Shuichi , Uchiyama Makoto
Published: March 2003

Abstract

Background
: Recently, the prognosis of acute poststreptococcal glomerulonephritis (APSGN) has been reported as improved, compared with the results of previous studies. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN.

Methods
: A total of 220 children with acute nephritic syndrome were treated in the affiliated hospitals of our department, between January 1988 and December 1997. Among them, 138 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A beta‐hemolytic streptococcal infection, were studied.

Results
: Serum creatinine and blood urea nitrogen levels at onset were 0.5 ±0.2 mg/dL and 20 ±12 mg/dL, respectively. There were no patients with renal dysfunction (serum creatinine level ≥1.5 mg/dL), but one patient with nephrotic syndrome. Blood pressure was well controlled in all patients and there were no patients with persistent hypertension. Serum complement levels were normalized within 12 weeks (100%), hematuria disappeared within 4 years (100%) and proteinuria disappeared within 3 years (100%) from the onset.

Conclusions
: These data indicate that the prognosis of APSGN during childhood is excellent, when adequately diagnosed and treated.
Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease
Authors: Ishii Masahiro , Ueno Takafumi , Akagi Teiji , Baba Kiyoshi , Harada Kensuke , Hamaoka Kenji , Kato Hitoshi , Tsuda Etsuko , Uemura Shigeru , Saji Tsutomu , Ogawa Shunichi , Echigo Shigeyuki , Yamaguchi Tetsu , Kato Hirohisa ,   Labour and Welfare –‘Study Of Treatment and Long‐Term Management In Kawasaki Disease’ Chairman: Hirohisa Kato)
Published: March 2003

Abstract The Research Committee of Ministry of Health, Labour and Welfare ‘Study of treatment and long‐term management in Kawasaki disease’ reported the guidelines for catheter intervention in coronary artery lesion in Kawasaki disease in this paper. The contents include: (i) background and natural history of coronary artery lesion in Kawasaki disease; (ii) indication of catheter intervention; (iii) types of procedure, and their indication and care; (iv) institute and backup system; (v) the management after procedure, evaluation and follow up; and (vi) prospects, especially in relation to bypass surgery.
Prevalence of breast‐feeding and its correlates in Ho Chi Minh City, Vietnam
Authors: Li Liubai , Thi Phuong lan Doan , Hoa Nguyen‐Thi , Ushijima Hiroshi
Published: March 2003

Background: The health benefits of breast‐feeding are widely acknowledged and breast‐feeding is crucial for the survival of the infants in developing countries. The present study aims to elucidate the prevalence of breast‐feeding and the possible risk factors affecting the breast‐feeding of infants at the age of 3 months in Ho Chi Minh City, Vietnam after the World Health Organization and the United Nations Children’s Fund launched ‘the Baby‐Friendly Hospital’ Initiative in 1989.

Methods: A cross‐sectional study was conducted in the urban areas of Ho Chi Minh City, Vietnam in February, 2000. Two hundred and sixty mother‐infant pairs were conveniently recruited in three child health centers in Ho Chi Minh City. Mothers of infants aged 6–12 months were interviewed and completed a well‐structured questionnaire regarding the feeding types of the infant, the maternal knowledge, attitudes and behaviors related to breast‐feeding.

Results: The results indicated that although about 86.4% newborns in the maternity wards and 88.5% infants at 3 months were at least partially fed with breast milk, the prevalence of breast‐feeding were 57.4 and 53.1%, respectively. About 47.5% newborns were fed with breast milk in the first feeding. The multivariate logistic regression analysis shows that the risk factors for the introduction of breast milk substitutes at 3 months of age were maternal antenatal plan of mixed or artificial feeding (odds ratio (OR) = 6.59, 95% confidence interval (CI): 3.18–13.64,P < 0.001) and the supplement of breast milk substitutes in the maternity ward (OR = 4.30, 95% CI: 2.10–8.77,P < 0.001). Higher maternal education levels were beneficial to the continuation of breast‐feeding. About 18.5% mothers had attended antenatal breast‐feeding education. Most of the mothers (94.1%) and families (95.4%) indicated supportive attitudes to breast‐feeding.

Conclusion: The prevalence of breast‐feeding was relatively low in Ho Chi Minh City, Vietnam. The antenatal education in breast‐feeding needs to be improved and the implementation of the ‘Baby‐Friendly Hospital’ policy needs to be strengthened.
αβ and γδ T cell subsets in chronic renal failure in children on dialysis treatment
Authors: Szczepa´nska Maria , Szprynger Krystyna , Mazur Bogdan , Szczepa´nski Tomasz
Published: March 2003

Background: Impaired immunity, particularly cell‐mediated, is one of the features of chronic renal failure. This also concerns impaired T cell dependent responsiveness.

Methods: The expression of T cell surface antigens (CD3, CD25, TCRαβ, TCRγδ) was evaluated on peripheral blood (PB) mononuclear cells using two‐color flow cytometry in 10 children on continuous ambulatory peritoneal dialysis (CAPD) and in 13 children on maintenance hemodialysis (HD) with polysulfone and cuprophane dialysers.

Results
: In HD children absolute numbers of leukocytes, lymphocytes, CD3+, αβ, γδ T cells and a percentage of γδ T cells were decreased versus healthy children. Also, we observed a relative increase of CD3+, CD3+/CD25+ and αβ T cells after sessions with cuprophane membranes, and an increase of CD3+/CD25+, αβ T cell percentages after sessions with the polysulfone membranes. Additionally we found a decrease of both relative and absolute numbers of γδ T cells after HD with polysulfone. In CAPD children we found declined absolute numbers of total lymphocytes, CD3+ and αβ T cells and higher relative values of CD3+ and αβ T cells versus controls.

Conclusions
: The T cell depletion in chronic renal failure (CRF) patients primarily results from uremic‐related toxicities, rather than from CAPD or HD‐related incompatibilities. We showed a significant decrease of γδ T cells in CRF patients on HD, that may be partly responsible for impaired T‐dependent responsiveness in that group. The intradialytic changes of γδ Tcells may result from a different degree of biocompatibility during the application of various dialysis membranes.
Accelerated hepatitis B vaccination schedule in childhood
Authors: Bosnak Mehmet , Dikici Bunyamin , Bosnak Vuslat , Haspolat Kenan
Published: March 2003

Abstract
Background
: For children travelling to a hepatitis B virus (HBV) endemic area or before a treatment by blood or blood productions, the conventional HBV vaccination schedule takes too long to be completed. There may be problems in the completion of the whole vaccination schedule in developing countries because of particular problems. In these situations an accelerated schedule may be useful for HBV vaccination.

Methods
: In this study, 40 children were randomly divided into two groups. Groups were vaccinated according to two different schedules; schedule A: one dose at 0, 1, and 6 months and schedule B: one dose at 0, 10, and 21 days (Engerix B,10mcg/0.5ml, GlaxoSmithKline). Follow‐up blood samples were obtained at 1, 6 and 12 months after the first vaccine injection.

Results
: Seroconversion rates were 35 and 80% 1 month after the first vaccine injection, 95 and 80% at 6 months, 95 and 100% at 12 months, in groups A and B respectively. Seroprotection rates were 20 and 65% 1 month after the first vaccine injection, 85 and 70% at 6 months, 95 and 95% at 12 months, in groups A and B respectively. Seroconversion and seroprotection rates was significantly different at day 28 in accelerated vaccination schedule (P < 0.005).

Conclusion
: In conclusion, an accelerated vaccination course against HBV (three doses at 0, 10, and 21 days) elicited protective levels of anti‐HBs antibodies more rapidly than a classic course (three doses at 0, 1, and 6 months) and without a difference in the rate of seroprotection after 1 year. The accelerated 3‐week recombinant HBV vaccination schedule should be recommended for HBV prophylaxis when children, such as hurried travellers, who have to have blood and blood productions, or an estimated irregular vaccination, where they have < 1 month to complete the standard HBV vaccination schedule before travelling to HBV endemic areas.
Relationships among conflict, conflict management, job satisfaction, intent to stay, and turnover of professional nurses in Thailand*
Authors: Kunaviktikul Wipada , Nuntasupawat Raymual , Srisuphan Wichit , Booth Rachel Z.
Published: March 2003

AbstractThis study was conducted to describe level of conflict, conflict management styles, level of job satisfaction, and intent to stay, and to ascertain relationships among conflict, conflict management styles, level of job satisfaction, intent to stay, and turnover of professional nurses in Thailand. The sample was 354 professional nurses employed in four regional hospitals in Thailand. The findings showed that the overall level of conflict was at a moderate level. The majority of subjects used accommodation most frequently to manage conflict. Subjects were dissatisfied with pay but were neither satisfied nor dissatisfied with work, supervision, opportunities for promotion, co‐workers and the job in general facets of job satisfaction. Most subjects had a high intent to stay in their present jobs for 1 year (97.1%) but intent to stay for the next 5 years decreased (78.5%). The result showed some relationships among these variables, but no relationship between intent to stay and turnover of professional nurses.
Social support and end‐of‐life issues for small town Japanese elderly
Authors: Tagaya Akira , Okuno Shigeyo , Tamura Masae , Davis Anne J.
Published: March 2003

Abstract Social support for Japanese elderly people living in small towns is the focus of this paper. Specifically, it explores the relationship between selected aspects of self‐reported social support, religion, end‐of‐life issues, and death anxiety. A total of the 1956 men and women responded to a questionnaire including a scale of social support they received in their home. The major findings showed that an increased level of perceived social support is not a predictor of decreased death anxiety but correlated with image of death and coping style of death anxiety, for which those who reported greater support tend to use more human relationships and fewer religious beliefs. Early in the next century 25% of Japan's population will be 65 years of age or older. Elderly Japanese have benefited from the traditional values of family care giving which historically provided great social support. How do these elderly respond to questions about the end of their lives when their reported social support varies?
Using Internet services to generate a research sampling frame
Authors: Chen Shu‐Li , Effler Judy R. , Roche Aloycha Li de La
Published: March 2003

Abstract The purpose of this paper is to describe how the authors used Internet services to generate a sampling frame for their on‐going pilot study, which evaluates the psychometric properties of Chen's Nursing Home Tool, a community needs assessment instrument for nursing homes. The proposed sampling frame may be used to survey nursing home residents and family members, nursing home providers and community leaders for any selected community in the USA. The availability of a user‐friendly sampling frame can assist health‐care professionals to determine required and desired services and further contribute to the development of a more comprehensive health‐service system.
Evaluation of the Thai–Lao Collaborating Nursing Manpower Development Project using the Context Input Process Product model
Authors: Othaganont Pranom
Published: March 2003

Abstract The purpose of this article was to describe, monitor and evaluate the Thai–Lao Collaborating Nursing Manpower Development Project using Stufflebeam's Context Input Process Product model. The study found that the project had great success in personnel development according to the six activities of the project. It helped develop two nurses with Masters degrees, 24 senior nurses and 283 diploma and auxiliary nurses. There were visible changes in the discipline and in terms of nursing care, nursing process was utilized. The Lao nursing system was developed to the point where white uniforms were used as the symbol of nurses who previously went unrecognized. There was a change in the structure of nursing organization. Moreover, nursing activities moved torwards the goal of health promotion and prevention. The study recommended that a periodic supervisory activity be implemented to enhance the training of trainers. In addition, a 2‐year continuation program for Bachelor degrees in nursing should be developed initially in Laos, then a 4‐year program should be developed. The nursing education program for Masters degrees should initially be obtained through neighboring countries.
Maternal expectations of the child health nurse
Authors: Fägerskiöld Astrid M. , Wahlberg Vivian , Ek Anna‐Christina
Published: March 2003

The main aim of this study was to identify what first‐time mothers in Sweden expected of Child Health Nurses. A further aim was to investigate what help and support was received by the new mothers and whether they felt that anything was missing. Twenty new mothers were interviewed according to grounded theory and the data were analyzed by the constant comparative method. It was found that first‐time mothers expected Child Health Nurses to have faith in a new mother's own strength and to be accessible, approachable and knowledgeable, providing advice and support. New mothers indicated that they had experienced most of these characteristics, especially accessibility and approachability, but some felt that there were deficiencies (e.g. a lack of continued interest in their own bodies and health, as well as a lack of support when they ceased to breast‐feed). The Child Health Service was taken for granted by new mothers. First‐time mothers indicated that they appreciated the service, particularly those mothers who did not have a good social network. However, some of the new mothers expressed negative feelings regarding the Child Health Service provided.
Utilization of research evidence by nurses
Authors: Edwards Helen , Chapman Helen , Davis Leigh M.
Published: March 2003

Abstract This paper challenges the hegemony (the mindset prevailing within education and health‐care environments) that produces and maintains the problems associated with nurses using research evidence in their practise. The challenge is organized around the construct of change. The envisaged changes concern what nurses think and do in relation to nursing research. The position held in the present paper is that the use of research evidence by nurses in their practise will remain a challenge until changes occur to the ways that nurses understand, value and initiate research. It is argued that changing the ways that nurses understand, value and initiate research requires an ideological shift: a re‐education from one set of beliefs, perceptions, values and practises to another. The paper concludes with some suggestions for transforming the hegemonic influences of nurse education systems and the health‐care organizations in which nurses work.
Effect of local application of cold or heat for relief of pricking pain
Authors: Saeki Yuka
Published: March 2003

Abstract The present study was designed to determine the effect of the application of cold or heat on the sensation of pricking pain based on autonomic responses. Electrical stimulation was applied to the antebrachium or brachium of subjects as an artificial pricking pain, and skin blood flow (BF) and skin conductance level (SCL) at the fingertip were measured. Pain sensation was evaluated using the visual analog scale. Pain stimulation produced a significant increase in SCL and a significant decrease in BF at both the antebrachium and brachium. Application of cold to the stimulation site using an ice‐water pack reduced BF and SCL responses and pain sensation. Application of heat using a hot water bottle caused a significant increase in pain sensation and enhancement of BF and SCL responses. These results suggest that application of cold promotes relief of pricking pain sensation and suppression of autonomic responses, and that application of heat has no such effect. It is important that nurses ascertain the type of pain or source of pain and take proper measures for its relief.
The Effect of Foot Massage with Biofeedback: A Pilot Study to Enhance Health Promotion
Authors: Jirayingmongkol Prapasri , Chantein Supatra , Phengchomjan Nuppawan , Bhanggananda Nitaya
Published: March 2003

Proactive health‐care services emphasize health promotion and the prevention of disabling conditions. Currently, in Thai society, the number of elderly with deteriorating health has increased. Therefore, self‐care health promotion activities have become essential in order for the elderly to maintain their well‐being. The purpose of this study was to investigate the effects of foot massage with biofeedback. Foot massage, a Thai primary self‐care custom, has been found to enhance blood circulation, relaxation, and one's own healing power. In addition, touch has been found to stimulate secretion of endorphins and reduce pain and anxiety. It appears therefore that foot massage, or reflexology, promotes a healthy lifestyle for all age groups. An experimental study, utilizing a pilot project in elderly health care, was employed to investigate the effects of biofeedback using foot massage. A pretest/post‐test quasi‐experimental design was used. The sample consisted of four men and 16 women (age range 61–69 years). Four trained researchers massaged the feet of the subjects and measured vital‐sign changes. Biofeedback also was investigated before and after the foot massages. Results showed that the average biofeedback and temperature were lower before than after the foot massage (P < 0.01). The average pulse rate, respiratory rate, and blood pressure, however, were found to be higher before rather than after the foot massage (P < 0.01). It was concluded that the foot massage provided good circulation, relaxation, and comfort. All subjects expressed positive feelings when they received the foot massage (i.e. ‘It is very nice that foot massage can relieve my joint pain, I am happy and comfortable’). These findings appear to indicate that foot massage is beneficial both for physical and mental conditions. Foot massage, however, is just one key to achieving a full range of primary health‐care services. It needs to not only be performed by nurses. Families, also, can provide foot massage for the elderly, anywhere and anytime.
Pattern of progression and survival in hormonally treated metastatic prostate cancer
Authors: Furuya Yuzo , Akakura Koichiro , Akimoto Susumu , Inomiya Hideshi , Ito Haruo
Published: March 2003

Background: Patients with prostate cancer generally respond to androgen ablation therapy, but progression to androgen‐independence is frequently observed. To further evaluate disease progression, the pattern of progression and survival in hormonally treated metastatic prostate cancer was examined.

Methods: One hundred and ninety‐three patients with untreated metastatic prostate cancer (TxNxM1) who received endocrine therapy between 1986 and 1995 were included in the present study. The pattern of progression was evaluated in these patients.

Results: One hundred and eighteen of the 193 patients (61.1%) had disease progression: 33 had local progression, 73 had distant progression and 12 had distant with local progression. Patients with only local progression had a longer interval to disease progression and longer survival than those with distant progression. The interval from disease progression to death in patients with local progression was longer than in those with distant progression. The patients whose prostate‐specific antigen (PSA) had not been normalized 3 months after the start of endocrine therapy had a tendency to progression either into the prostate or into distant sites. Patients with extent of disease (EOD) scores of 3 and 4 progress, especially to distant sites, after endocrine treatment.

Conclusions: In untreated metastatic prostate cancer, patients with a poor response of PSA levels and patients with a high volume of bone metastasis (i.e. EOD 3, 4) were in the high‐risk group for progression, especially to distant sites. Progression into distant sites was a poor prognostic factor for patients with recurrence to endocrine therapy.
Intrarenal pelvic papillary Wilms’ tumor associated with aniridia: A case report
Authors: Natsume Osamu , Hirao Yoshihiko , Matsuda Mieko , Okuda Tadami
Published: March 2003

Background: Intrarenal pelvic Wilms’ tumor in a papillary growth is rare in children. A case of a two‐year‐old infant with Wilms’ tumor associated with congenital aniridia is reported.

Results: A chromosomal abnormality (11p13 deletion) was found in this patient. The tumor was well evaluated by ultrasonography, computed tomography and magnetic resonance imaging.

Discussion: Previous case reports are briefly reviewed and the clinical characteristics disclosed.
Changes in renal blood flow in response to sympathomimetics in the rat transplanted and denervated kidney
Authors: Morita Ken , Seki Toshimori , Nonomura Katsuya , Koyanagi Tomohiko , Yoshioka Mitsuhiro , Saito Hideya
Published: March 2003

Background: Renal denervation and re‐innervation may affect vascular responses to sympathomimetics, which may play a role in the maintainance of renal blood flow (RBF) following renal transplantation. The purpose of the present study was to elucidate pharmacological alteration of the renal sympathetic response following kidney transplantation. Using the rat kidney transplantation model, we focused on responses to various sympathomimetics in order to investigate the effects of sympathetic denervation and functional re‐modulation mechanisms in the transplanted kidney.

Methods: Male isogenic rats underwent unilateral kidney denervation or kidney transplantation accompanied by unilateral native nephrectomy. Renal blood flow was evaluated using a laser Doppler flow meter following bolus injection of 50 μg/kg dopamine and continuous infusion of 60 μg/min phenylephrine (PE) at 0, 30, 60, 90 and 240 days after transplantation as well as at 30 days after denervation.

Results: Bolus injection of dopamine (50 μg/kg) induced an initial reduction in RBF (that of α‐adrenoceptors) followed by a long‐lasting increase in RBF (that of β‐adrenoceptors) in the native kidney. In grafted or denervated kidneys, the dopamine‐induced decrease in RBF mediated by α‐adrenoceptors was markedly enhanced, while the increase in RBF mediated by an action of dopamine on β‐adrenoceptors was blunted. The effects of the post‐transplant period on vascular responses to dopamine were significant, but not completely synchronized with the native kidney, even at 240 days. Continuous infusion of PE (60 μg/min) produced a gradual increase in RBF in the native kidney, whereas a sudden reduction (i.e. breakthrough in autoregulation) was observed in the denervated and transplanted kidney.

Conclusions: The responses to sympathomimetics in the grafted kidney were shifted towards flow reduction (i.e. enhanced vasoconstriction via stimulation of α‐adrenoceptors and blunted vasodilatation via stimulation of β‐adrenoceptors. This functional impairment was recovered in a time‐dependent manner. In addition, the hemodynamic autoregulation system in the kidney deteriorated following transplantation or denervation.
Human papillomavirus associated with bladder carcinoma? Analysis by polymerase chain reaction
Authors: Tekin Mehmet, ĮLTERIŞ , Tuncer Serdar , Aki Fazil, TUNCAY , Bilen Cenk, YÜCEL , AygÜn Cem , Özen Haluk
Published: March 2003

Background: The aim of the present study was to assess the possible etiologic role of human papillomaviruses (HPV) in bladder tumors.

Methods: Forty‐two fresh biopsy specimens from different grades and stages of bladder tumor cases and 10 normal bladder mucosa biopsies were studied. Specimens were analyzed by polymerase chain reaction (PCR) with HPV‐specific general primer set for the detection of viral DNA. Polymerase chain reaction‐positive samples were also tested with HPV 16‐ and 18‐specific primers by the same method.

Results: We found two samples (4.8%) containing HPV DNA among the TaG1 bladder tumors. All other specimens, including the control group, were found to be negative by PCR. Neither of the two HPV‐positive patients had immune deficiency and/or genital warts. Human papillomavirus 16 was detected by type‐specific primers in one sample, but the other HPV‐positive sample could not be typed.

Conclusions: The low prevalence of HPV in this and many previous studies does not support an etiologic role of HPV in bladder carcinogenesis. We detected the virus in two early stage tumors, but none was detected in the high‐grade samples. However, to clarify the positivity of HPV in these occasional cases, future studies must be designed by using in situ PCR techniques, including samples from tumors and normal bladder mucosa from the same patient.
Direct and indirect effects of electrical stimulation on the motility of human sperm
Authors: Saito Kazuo , Kinoshita Yuzo , Hosaka Masahiko
Published: March 2003

Background: Electroejaculation is a technique that is becoming more frequently available for obtaining sperm from men with spinal cord injury or psychogenic anejaculation. However, the effect of electrical stimulation on the movement of human sperm has not been clarified.

Methods: Electrical stimulation was applied to ejaculated semen or washed sperm via a pair of electrodes in the sperm‐counting chamber while sperm motility was recorded using a computer‐assisted semen analyzer.

Results: When monopolar pulse stimulation was applied to sperm, the motility rate and velocity of sperm near both electrodes decreased according to the number of pulses and current despite low electrical voltages. However, motility of sperm in the center between electrodes did not change. When extremely high‐voltage electrical stimulation with more than 80 V/2 mm (distance between electrodes) was applied to sperm, sperm stopped moving regardless of their location between the electrodes, despite a low electrical current and low energy. Replicating clinical rectal probe electroejaculation, continuous sinusoidal alternating current at 50 V/10 mm was applied to a untreated ejaculated semen. The motility of sperm, except for those adjacent to both electrodes, did not change after stimulation for 60 s, despite a high electrical energy.

Conclusions: The motility of sperm near electrodes was decreased when high electric current flowed, despite low electrical voltages. In addition, sperm lost their motility when extremely high‐voltage electrical stimulation was applied. However, electrical stimulation during clinical rectal probe electroejaculation seems to have no effect on sperm motility.
Histopathologic analysis of angiogenic factors in localized renal cell carcinoma: The influence of neoadjuvant treatment
Authors: Kawata Nozomu , Yagasaki Hiroki , Yuge Humikazu , Nakanoya Yuji , Fujimura Kei , Sugimoto Shuji , Hirakata Hitoshi , Takimoto Yukie
Published: March 2003

Background:

This study was conducted in order to clarify whether histopathologic analysis of factor thymidine phosphorylase (TP) and Factor VIII could be a useful predictor of postoperative recurrence in localized renal cell carcinoma. Therefore, the relationship between tumor infiltrated lymphocytes (TIL) and both TP and Factor VIII was studied.

Method:

Of the 71 patients who underwent surgery, 54 patients had no neoadjuvant therapy (group 1), 10 patients were preoperatively administered IFN‐γ (group 2), and the remaining seven patients preoperatively received IFN‐γ and transarterial embolization (group 3). Both TP and Factor VIII immunostaining were performed on formalin‐fixed, paraffin‐embedded archival tissue from 71 renal cell carcinoma specimens, while TIL immunostaining was performed on frozen sections. Positive immunostaining was quantitatively scored by a computer‐assisted digital image analysis. For TIL, positive results were semiquantitatively scored.

Results:

A significant difference in the recurrence‐free rate was recognized for Groups 1, 2 and 3 (P < 0.05). Therefore, the median TP‐positive rate (PR), VIII‐PR, number of microvessels and positive mean vascular area levels were investigated, between the recurrence cases (n = 6) and the recurrence‐free cases (n = 11). Only the TP‐PR levels showed a significant difference among them (P = 0.044). In regards to the neoadjuvant cases, a significant correlation was observed between both VIII‐PR and CD4 (r = 0.815) as well as between VIII‐PR and CD11b (r = 0.756).

Conclusion:

There was no clear evidence that the neoadjuvant treatment would increase the recurrence‐free survival in patients with localized renal cell carcinoma. TP‐PR might be a predictor of postoperative recurrence in patients with localized renal cell carcinoma.
Transperineal 12‐core systematic biopsy in the detection of prostate cancer
Authors: Kojima Munekado , Hayakawa Takahiro , Saito Toshihiko , Mitsuya Hideo , Hayase Yosimasa
Published: March 2003

Background:

The present study was designed to determine the clinical value of transperineal 12‐core systematic prostate biopsy guided by transrectal ultrasonography (TRUS) in the detection of prostate cancer.

Methods:

A total of 679 consecutive patients underwent systematic prostate biopsies because of abnormal results on digital rectal examination and/or TRUS and/or an elevated serum prostate‐specific antigen level. Systematic six‐ and 12‐core biopsies were taken in 138 patients between April 1994 and February 1995 and in the remaining 541 between March 1995 and February 2000, respectively. Twelve‐core biopsy included two samples from the lateral portion of the peripheral zone and four from the anterior portion of the transition zone in addition to the conventional six‐core biopsy.

Results:

In the series overall, systematic biopsy revealed 156 cases of prostate cancer (23.0%). The detection rate increased by 5.2%, although this was statistically not significant, from 18.8% (26/138) by six‐core biopsy to 24.0% (130/541) by 12‐core biopsy. Out of 130 patients in whom prostate cancer was detected by 12‐core biopsy, it was supposed that conventional six‐core biopsy would have missed 18 cases (13.8%).

Conclusions:

Systematic 12‐core biopsy might improve the detection rate for prostate cancer. However, further studies are needed to determine its clinical value in the diagnosis of the disease.
One‐stage urethroplasty for strictures: Nigerian experience
Authors: Aghaji Aloy E , Odoemene Charles A
Published: March 2003

Abstract Purpose: To analyze the effects on voiding and complications of one‐stage urethroplasty for urethral stricture.

Methods: All patients who underwent one‐stage urethroplasty for stricture in two health institutions in Enugu, Nigeria, between January 1989 and December 1998, were included. The age of the patient, duration of symptoms and the cause of the stricture were noted. Retrograde urethrogram and, when necessary, micturating cystourethogram was done. Urethroplasty was either by substitution using pedicled penile skin flap or by end‐to‐end anastomosis. Patients were followed up monthly for 1 year during which the patient's ability to urinate satisfactorily was assessed and any complications were noted. One hundred and forty‐four (144) men, aged between 11 and 76 years (mean 36.3 ± 11.2 years), were studied. These included 121 cases who had rapidly recurring strictures after internal urethrotomy or dilatation and 23 cases of complete stricture. Etiology of the stricture included external trauma (43.8%), postinflammatory (36.1%) and iatrogenic (post‐catheterization; 20.1%). Ninety‐one (63.2%) strictures were in the anterior urethra, 47 (32.6%) in the posterior urethra and six (4.2%) bulbomembranous. The mean length of the strictures was 3.1 ± 1.4 cm.

Results: Anastomotic urethroplasty was performed in 98 (68.1%) patients and substitution in 46 (31.9%). Hospital stay was between 12 and 14 days, except in those who developed complications. Normal voiding was achieved in 124 (86.1%) patients. Urethral fistula was encountered in five (3.5%) patients and recurrent stricture in 15 (10.4%). There was no mortality.

Conclusions: One‐stage urethroplasty affords an excellent cost‐effective means of reconstruction of the urethra in patients with stricture of various etiologies. In our environment in particular, it avoids the fulminating infection often encountered after the first stage of a two‐staged operation.
Multiple endocrine neoplasia type 2B
Authors: Nakata Seiji , Okugi Hironobu , Saitoh Yoshitaka , Takahashi Hirotomo , Shimizu Kazuhiko
Published: March 2003

Abstract We report a case of multiple endocrine neoplasia type 2B (MEN 2B) in a 30‐year‐old woman. There was no family history of MEN 2B in her family. DNA testing was carried out and a point mutation was found in exon 16, codon 918 (ATG to ACG) in the RET proto‐oncogene. The woman died of medullary thyroid carcinoma, 13 years after a total thyroidectomy.
Prostate adenocarcinoma producing syndrome of inappropriate secretion of antidiuretic hormone
Authors: Yamazaki Takako , Suzuki Hiroyoshi , Tobe Toyofusa , Sekita Nobuyuki , Kito Hiroki , Ichikawa Tomohiko , Akakura Koichiro , Igarashi Tatsuo , Ito Haruo
Published: March 2003

Abstract The syndrome of inappropriate secretion of antidiuretic hormone (ADH) was recognized in a 68‐year‐old man with a poorly differentiated metastatic adenocarcinoma of the prostate. Elevated levels of ADH were found in the tissues of the primary tumor and lymph node metastasis. The patient's clinical course is detailed and the pathophysiology of this syndrome is discussed. To our knowledge, this case is the ninth reported case of syndrome of inappropriate secretion of ADH with adenocarcinoma of the prostate. Antidiuretic hormone activity was proven in only three cases including this case.
Intracavitary administration of OK‐432 with subcutaneous priming for malignant ascites in a case of advanced renal cell carcinoma
Authors: KAGEYAMA YUKIO , SAKAI YASUYUKI , ARAI GAKU , HYOCHI NOBUHIKO , SUZUKI MASAHITO , MASUDA HITOSHI , KAWAKAMI SATORU , HAYASHI TETSUO , OKUNO TETSUO , KOBAYASHI TSUYOSHI , KIHARA KAZUNORI
Published: March 2003

The intracavitary injection of OK‐432 (a streptococcal preparation) with subcutaneous priming has been shown to be an effective immunotherapy for patients with malignant effusion. We applied this treatment in a case of advanced renal cell carcinoma with massive ascites. The patient received 0.2 Klinishe Einheit (KE) OK‐432 in the subcutaneous injection twice (day 1 and day 7) followed by 10KE OK‐432 intra‐abdominal administration (day 9). The treatment was performed safely without major side‐effects except for transient pyrexia. A significant reduction of ascites was noted 1 month after the treatment without subsequent re‐accumulation. Intracavitary injection of OK‐432 with subcutaneous priming seems to be a simple, safe and effective treatment for ascites in advanced renal cell carcinoma.
Endoscopic minilaparotomy radical nephrectomy for chronic dialysis patients
Authors: Kageyama Yukio , Kihara Kazunori , Ishizaka Kazuhiro , Okuno Tetsuo , Hayashi Tetsuo , Kawakami Satoru , Masuda Hitoshi , Suzuki Masahito , Hyochi Nobuhiko , Arai Gaku
Published: March 2003

Abstract
Background
: To assess the feasibility of laparoscope‐guided minilaparotomy (endoscopic minilaparotomy) for renal cell carcinoma in patients on chronic dialysis.

Methods
: Endoscopic retroperitoneal minilaparotomy using a 30° telescope was carried out through single skin incision (5–8 cm) in eight patients with renal cell carcinoma who were on chronic dialysis. Outcomes of the operations were compared to those in eight patients on chronic dialysis with renal cell carcinoma who underwent standard translumbar radical nephrectomy.

Results
: Resection of the tumor was successfully completed without complication and the postoperative course was uneventful in both of the treatment groups. No significant difference in mean operative time or mean blood loss was observed between the treatment groups. Wound pain was minimal and analgesics were generally not required in the minilaparotomy group. The endoscopic laparotomy group resumed full diet and began walking earlier than the group that underwent standard radical nephrectomy.

Conclusions
: Endoscopic minilaparotomy seems to be a valuable alternative treatment for renal cell carcinoma in patients on chronic dialysis.
Usefulness of PSA screening in outpatients with bladder cancer: Preliminary results
Authors: Kurokawa Kohei , Suzuki Kazuhiro , Okazaki Hiroshi , Ito Kazuto , Shiono Akihiko , Fukabori Yoshitastu , Yamanaka Hidetoshi
Published: March 2003

Background:
We performed prostate‐specific antigen (PSA) screening and evaluated its usefulness in outpatients with bladder cancer who may have an elevated risk for prostate cancer.

Methods:
Sixty‐one new or followed‐up outpatients with bladder cancer were examined between September 1999 and December 2000 in the Department of Urology, Gunma University Hospital, Japan. PSA was measured after informed consent was obtained, and patients in whom the PSA level was 4.1 ng/mL or higher were selected for thorough examination. In the examination, one examiner performed DRE (digital rectal examination) and, based on DRE and TRUS (transrectal ultrasonography) findings, determined whether prostate biopsy was indicated.

Results:
The average age of the 61 cases was 69.1 ± 8.6 years, and the average PSA level was 3.5 ± 5.8 ng/mL. The PSA level was 4.1 ng/mL or higher in 11 (18.0%) patients, nine of whom underwent six‐sextant biopsy under TRUS guidance. Of these nine cases, four (6.6%) were diagnosed as having prostate cancer. The Gleason score was 7 in three cases and 9 in one case. The clinical stage was T2N0M0 in three cases and T3N0M0 in one case.

Conclusions:
On PSA screening in patients with bladder cancer and patients with a history of transurethral resection of the bladder tumor (TUR‐BT), prostate cancer was found in 6.6%. This rate is higher than in the general population. These cancers were classified into intermediate to high‐risk groups, and the prognosis of prostate cancers could be more important than those of the bladder cancers in two cases (50%). We conclude that PSA screening for inpatients with bladder cancer may be useful.
Metastatic urothelial cancer showing an efficacy by low‐dose cisplatin
Authors: Matsuyama Hideyasu , Yamakawa Gen‐Ichiro , Hirata Hiroshi
Published: March 2003

A 69‐year‐old man who had developed multiple distant metastases on retrocaval lymph nodes after four courses of Methotraxate, Vinblastine, Adriamycin, Cisplatin (MVAC) chemotherapy was successfully treated by intravenous infusion of low‐dose cisplatin (CDDP) (10 mg/time, once per week) and oral administration of 600 mg/day 5′‐deoxy‐5‐fluorouridine (5′‐DFUR), a pro‐drug of 5‐FU, in an outpatient setting. A partial response (62% reduction rate) was confirmed by abdominal computed tomography (CT) scan after 7 months. Although the CDDP dosage had been reduced to 5 mg/week 1 year previously, the tumor was still reducing in size in November 2000. Combination therapy of 5′‐DFUR with low‐dose CDDP could become an option for advanced bladder cancer that compromises the patient’s quality of life, especially when used in an outpatient setting.
Multiple endocrine neoplasia type 1 with pyonephrosis
Authors: Satoh Akinori , Iigaya Tomohiko
Published: March 2003

A case of multiple endocrine neoplasia type 1 (MEN 1) with a clinical manifestation of pyonephrosis is reported. A 47‐year‐old woman with a 14‐year history of renal stones was initially seen with pyonephrosis. The patient was found to have elevated serum levels of parathyroid hormone and growth hormone. Radiologic examinations demonstrated an ectopic parathyroid tumor and a pituitary tumor. She was diagnosed as having MEN 1.
Angiogenesis in renal cell carcinoma: Evaluation of microvessel density, vascular endothelial growth factor and matrix metalloproteinases
Authors: ZHANG XIANGHUA , YAMASHITA MOTOKI , UETSUKI HIROTSUGU , KAKEHI YOSHIYUKI
Published: March 2003

Abstract Background: Angiogenesis, the growth of new blood vessels, has a critical role in tumor growth and metastasis. The purpose of this study was to investigate the involvement of angiogenesis and angiogenic factors in the pathogenesis of renal cell carcinoma (RCC).

Methods: Formalin‐fixed and paraffin‐embedded tissue blocks from 70 patients with RCC were studied. The situations of tumor angiogenesis were evaluated by assessing microvessel density (MVD) through CD31 immunostaining. The expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase‐2 (MMP‐2) and metalloproteinase‐9 (MMP‐9) was detected immunohistochemically.

Results: The value of MVD ranged from 12.0 to 93.0 with a median of 39.91 in RCC. Of the 70 RCCs, the expression of VEGF was detected in 52 (74.3%), MMP‐2 in 29 (41.4%) and MMP‐9 in 19 (27.1%) cases. Statistical analysis revealed significant associations of the tumor stage with MVD, and the expression of VEGF and MMP‐2 in RCC. Additionally, MVD was closely related to the expression of VEGF but was not related to the expression of MMP‐2 and MMP‐9 in RCC.

Conclusion: The degree of angiogenesis may be closely related to the tumor progression of RCC. The expression of VEGF may be responsible for angiogenesis in RCC, and both VEGF and MMP‐2 expression may function as tumor associated angiogenic factors in RCC.