bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Osteoarthritis on Serum Marker Levels of Bone Formation and Resorption in Patients with Benign Prostatic Hypertrophy
Authors: Akimoto Susumu , Furuya Yuzo , Akakura Koichiro , Shimazaki Jun , Ito Haruo
Published: July 2007

Background:

The aim of this study was to investigate the influence of osteoarthritis of lumbar vertebrae on serum bone formation and resorption marker levels of patients with benign prostatic hypertrophy (BPH).

Methods:

Serum levels of carboxyterminal propeptide of type I procollagen (PICP), alkaline phosphatase (ALP), carboxyterminaltelopeptide of type I collagen (ICTP), and prostate‐specific antigen (PSA) were examined in 40 patients with BPH, and the presence of osteoarthritis at the lumbar vertebrae of the patients was evaluated by plain x‐ray‐p.

Results:

Findings of osteoarthritis were observed in 23 of the 40 patients (58%), and 10 of the patients had severe osteoarthritis (involving at least 2 lumbar vertebral bodies). The serum levels of PICP, ALP, ICTP, and PSA of the patients without osteoarthritis findings were not different from those of the patients with osteoarthritis or severe osteoarthritis.

Conclusion:

The influence of osteoarthritis on serum bone formation and resorption marker levels of patients with BPH appears to be rather slight, if there is any influence at all.
Multifactorial Involvement of Multidrug Resistance Protein, DNA Topoisomerase II and Glutathione/Glutathione‐S‐Transferase in NonP‐ Glycoprotein‐Mediated Multidrug Resistance in Human Bladder Cancer Cells
Authors: Kim Wun‐Jae , Kakehi Yoshiyuki , Yoshida Osamu
Published: July 2007

Background:

Multiple mechanisms are important in multidrug resistance in urothelial cancers. We investigated the acquisition of a multidrug resistance phenotype in human bladder cancer cells exposed to doxorubicin.

Methods:

Human bladder cancer cell line 5637 and 2 doxorubicin drug‐resistant sublines (5637/DR5.5 and 5637/DR50) were used. Measurements were made of the steady state mRNA levels of the multidrug resistance gene (mdr1), multidrug resistance‐associated protein (MRP), glutathione‐S‐transferase‐π and DNA topoisomerase II (topo II) genes, P‐glycoprotein (PgP) and MRP expression, glutathione (CSH) and GSH enzyme activity, and topo II catalytic activity. The pharmacokinetics were compared between the parent and the drug‐resistant sublines.

Results:

5637/DR5.5 and 5637/DR50 cells were 7.6‐ and 1 6.2‐fold more resistant to doxorubicin and 16.7‐and 48.3‐fold more resistant to etoposide, respectively, compared with 5637 cells. A dose escalation of doxorubicin increased the MRP expression, CSH levels and glutathione‐S‐transferase (GST) activity, although no PgP expression was observed in any cell line. Resistance was brought about by decreased drug accumulation through drug efflux, although intracellular daunorubicin concentrations were similar between DR5.5 and DR50 cells. Topo II catalytic activity was undetectable in DR50 cells, but maintained in both the parent and DR5.5 cells.

Conclusion:

Reduced drug accumulation in doxorubicin‐resistant cells was mediated by MRP instead of PgP indicating that MRP‐mediated drug efflux functions in a limited manner for drug resistance. An increase in drug efflux via MRP, reduced topo II activity, and increased GSH levels/GSH‐related enzyme activities may play major roles in nonPgP‐mediated multidrug resistance in urothelial cancers treated with anthracyclines.
Muscarinic Receptor Subtypes and Receptor‐Coupled Phosphatidylinositol Hydrolysis in Rat Bladder Smooth Muscle
Authors: Mimata Hiromitsu , Nomura Yoshio , Emoto Akio , Latifpour Jamshid , Wheeler Marcia , Weiss Robert M.
Published: July 2007

Background:

The purpose of this study was to evaluate the muscarinic receptor subtypes expressed in rat bladder smooth muscle and characterize the muscarinic receptor‐coupled phosphatidylinositol (PI) hydrolysis in order to clarify the first step of bladder smooth muscle contraction.

Methods:

Expressions of mRNAs of muscarinic receptor subtypes were examined by Northern blot analysis. Changes in the mass of inositol 1,4,5‐trisphosphate(IP3) and the inhibitory effects of muscarinic subtype specific antagonists on PI hydrolysis were determined after carbachol stimulation.

Results:

mRNAs of m2 and m3 genes, encoding M2 and M3 receptors, were expressed in rat bladder smooth muscle. Carbachol produced a rapid increase of IP3, which returned to the basal level within 30 seconds. 4‐Diphenylacetoxyl‐N‐methylpiperidine methiodide (4‐DAMP; M1 and M3 antagonist) strongly inhibited the PI hydrolysis, but methoctramine (M2 antagonist) partially inhibited it at 10‐4 mol/L The 1C50 value for atropine was 9.5 times 10‐9 mol/L, for pirenzepine 6.4 times 10‐6 mol/L, and for 4‐DAMP 1.5 times 10‐7 mol/L.

Conclusion:

M2 and M3 receptors are expressed in rat urinary bladder. Only M3 receptor was involved in the production of IP3, which might induce the initial phase of contractile response in rat bladder smooth muscle after carbachol stimulation.
Stimulative Effect of Transforming Growth Factor‐β on Collagen Synthesis by Human Prostatic Stromal Cells In Vitro
Authors: Fukabori Yoshitatsu , Nakano Katsuya , Ohyama Atsuko , Yamanaka Hidetoshi
Published: July 2007

Background:

Expression of transforming growth factor‐β (TGF‐β) in the prostate has been reported. The purpose of this study was to evaluate the effect of TGF‐β on collagen synthesis by stromal cells isolated from a patient with benign prostatic hyperplasia (BPH).

Methods:

Human prostatic stromal cells (HPSC) derived from BPH tissue were cultured in serum‐free medium. After incubation with TGF‐β1, the concentration of procollagen type I C‐peptide (PIP) in the HPSC‐conditioned medium was measured by enzyme immunoassay while the concentration of procollagen type III N‐peptide (PIIIP) was measured by radioimmunoassay. Per‐cell production of each type of collagen was calculated by multiplying the measured concentration by the volume of medium and dividing by the number of harvested cells.

Results:

One ng/mL of TGF‐β1 significantly (P< 0.05) increased collagen production by HPSC, to 220% and 120% of control for types I and III, respectively. Increasing the amount of TGF‐β1 to 10 ng/mL had no further effect. TGF‐β1 did not significantly affect HPSC number at concentrations of either 1 or 10 ng/mL. There was a strong correlation between PIP and PIIIP production (r= 0.929, P< 0.001).

Conclusion:

These findings suggest that TGF‐β stimulates accumulation of extracellular matrix in stromal BPH tissue without affecting proliferation of stromal cells.
Nephron Sparing Surgery for De Novo Renal Cell Carcinoma in an Allograft Kidney: A Case Report
Authors: Park Kyun II , Inoue Hitoshi , Kim Choi Jan , Tomoyoshi Tadao
Published: July 2007

De novo renal cell carcinoma in a renal allograft is rare and has special implications in renal transplant recipients. We describe a patient with a renal allograft who developed a de novo renal cell carcinoma in the functioning renal allograft 258 months after transplantation. The patient underwent enucleation of the tumor because preoperative MRI showed it was well‐encapsulated. A DNA banding study showed that the tumor originated from the donor. Indications for conservative renal surgery in renal cell carcinoma have been increasing. Accordingly, 1 option in the treatment of de novo renal cell carcinoma in a functioning renal allograft is enucleation as a method of nephron sparing surgery.
Abdominal Compartment Syndrome due to Delayed Identification of a Ureteral Perforation Following Abdominoperineal Resection for Rectal Carcinoma
Authors: Katz Ran , Meretyk Shimon , Gimmon Zvi
Published: July 2007

Abdominal compartment syndrome develops whenever the mean intraperitoneal pressure rises above the physiological pressure, leading to renal and mesenteric ischemia and respiratory decompensation due to pressure on the diaphragm. Abdominal compartment syndrome may occur after conditions such as peritonitis, intestinal obstruction, laparoscopic procedures, or abdominal tumors. Leakage from the urinary tract may cause accumulation of urine in the peritoneal cavity which commonly manifests as single or multiple urinomas, or urinary ascites. The case of a patient who had delayed identification of a ureteral perforation following the abdomino‐perineal resection of a rectal carcinoma is presented. Massive urinary leakage into the peritoneal cavity led to the abdominal compartment syndrome. Peritoneal drainage and ureteral stenting improved her condition. A high index of suspicion is necessary in order to diagnose this rare condition.
Sarcomatoid Carcinoma of the Ureter: A Case Report
Authors: Nagayoshi Junichi , Kawakami Takashi , Maruyama Yoshio
Published: July 2007

We report a case of sarcomatoid carcinoma of the ureter in a 60‐year‐old woman who presented at our hospital with right flank pain. She had undergone total ovariectomy and radiation therapy for ovarian cancer at the age of 40 years. A diagnosis of ureteral tumor (cTsNOMO) led to radical right nephroure‐terectomy and partial cystectomy. Microscopic examination showed a tumor that contained areas of both sarcoma and transitional cell carcinoma. The carcinomatous tissues were blended into the sarcomatous areas and there was a transitional zone between the 2 components. Immunohistochemical examination showed that the spindle cells were positive for cytokeratin, so the final diagnosis was sarcomatoid carcinoma of the ureter. The patient has remained well without any evidence of recurrence for 5 months since the operation. There is no effective adjunctive therapy, so constant careful monitoring will be necessary. Sarcomatoid carcinoma of the ureter is a rare tumor and this is only the sixth case reported in Japan.
Cholesteatoma of the Ureter: A Case Report
Authors: Sugamoto Takao , Yokoyama Masayoshi , Nishio Shunji , Takeuchi Masafumi
Published: July 2007

A 72‐year‐old man complained of general fatigue and had low grade fever. Ultrasonography, excretory urography, retrograde urography, and computed tomography revealed left hydronephrosis due to a middle ureteral tumor. A nephroureterectomy was performed. The histological diagnosis was hyperkeratosis with a cholesteatoma.
Adoptive Immunotherapy of Patients with Metastatic Renal Cell Cancer Using Lymphokine‐Activated Killer Cells, lnterleukin‐2 and Cyclophosphamide: Long‐Term Results
Authors: Tomita Yoshihiko , Katagiri Akiyoshi , Saito Kazuhide , Imai Tomoyuki , Saito Toshihiro , Tanikawa Toshiki , Terunuma Masahiro , Nishiyama Tsutomu , Takahashi Kota
Published: July 2007

Background Initial results of adoptive immunotherapy using lymphokine‐activated killer (LAK) cells and interleukin‐2 (IL‐2) appeared to offer promise for treating renal cell cancer (RCC). However, lower response rates were seen in subsequent trials, and the long‐term results of this treatment method have not been fully reported. In this study, we examine long‐term results of adoptive immunotherapy using LAK cells, IL‐2, and cyclophosphamide (LAK/IL‐2/CPM therapy).

Methods We administered 10 courses of therapy to 9 patients with advanced RCC. One patient had liver and para‐aortic lymph node metastases; the others had only lung metastases. The clinical effects were initially evaluated 4 weeks after therapy and follow‐up was continued for periods of 43 to 76 months.

Results The 4‐week evaluation revealed 3 complete responses (CR), 3 partial responses (PR), 1 minor response (MR), 1 patient with no change in disease status (NC), and 2 patients whose disease progressed (PD). One CR patient remained apparently free of disease for 43 months. After tumors recurred in the lung of another CR patient further disease progression was suppressed by IL‐2 administration until the patient died from other causes at 46 months. The third CR patient showed tumor recurrence in the lung and was re‐treated with the sameLAK/CPM/IL‐2 therapy. Lung tumors decreased in size (PR), but the patient died due to brain metastasis 2 months after the second round of treatment. The 2 initial PR patients, as well as the MR and NC patients, developed regrowth or new metastatic lesions within 2 to 15 months following therapy. The 2 PD patients died 2 and 9 months after therapy.

Conclusion Long‐term effects ofLAK/IL‐2/CPM therapy were not correlated with the maximal response observed 4 weeks after therapy. AlthoughLAK/IL‐2/CPM therapy appears suitable for use as induction therapy in RCC, our data suggest that long‐term suppression will require surgical removal of remnant tumors or more intensive maintenance therapy.
Hormone/Antihormone Withdrawal and Dexamethasone for Hormone‐Refractory Prostate Cancer
Authors: Nishiyama Tsutomu , Terunuma Masahiro
Published: July 2007

Background Flutamide withdrawal has been reported to benefit patients with hormone‐refractory prostate cancer. Several studies have also demonstrated that a combination of corticosteroids and testicular androgen ablation lowers serum androgen levels and improves clinical response. The purpose of this study was to examine the effect of withdrawal of oral hormonal agents and administration of dexamethasone in stage D3 prostate cancer patients.

Methods Sixteen patients with hormone‐refractory prostate cancer were enrolled in the study. All patients had osseous metastasis and elevated serum prostate‐specific antigen. Nine had been treated with chlormadinone acetate, 4 with estramustine phosphate, and 3 with flutamide as first‐line hormonal therapy. All patients had also been treated either with bilateral orchiectomy (13 cases) or a luteinizing hormone‐releasing hormone (LH‐RH) agonist (3 cases). Seven patients whose disease progressed following hormone withdrawal were treated with oral dexamethasone (initially 1.5mg/day, then tapered to 0.5 mg/day).

Results Eight patients demonstrated a decrease in prostate‐specific antigen of greater than 50% following hormone withdrawal. The time to cancer progression for these 8 patients was 2 to 15 months (mean, 4 months). Among the patients receiving dexamethasone, 4 showed a greater than 90% decrease in prostate‐specific antigen after 3 months' treatment. The time to disease progression for these 4 patients was 3 to 11 months.

Conclusion In treating hormone‐refractory advanced prostate cancer, the first pharmacologic manipulation should be withdrawal of the oral component of combined hormonal therapy. Patients whose disease progresses after hormone withdrawal should then be treated with glucocorticoids such as dexamethasone.
Clinical Evaluation of Serum Prostate‐Specific Antigen‐Alpha1 ‐ Antichymotrypsin Complex Values in Diagnosis of Prostate Cancer: A Cooperative Study
Authors: Kuriyama Manabu , Ueno Kazuya , Uno Hiromi , Kawada Yukimichi , Akimoto Susumu , Noda Masatoshi , Nasu Yasutomo , Tsushima Tomoyasu , Ohmori Hiroyuki , Sakai Hideki , Saito Yasushi , Meguro Norio , Usami Michiyuki , Kotake Toshihiko , Suzuki Yuji , Arai Yoichi , Shimazaki Jun
Published: July 2007

Background We studied the clinical significance of serum prostate‐specific antigen bound to α1‐antichymotrypsin (PSA‐ACT) values determined with a newly developed enzyme immunoassay.

Methods Serum PSA‐ACT values were determined in a total of 652 sera. Clinical utility for the diagnosis of prostate cancer was compared to that of Tandem‐R PSA and y‐seminoprotein (μgm‐ Sm). The new enzyme immunoassay is based on the use of the Stanford reference as an international standard for PSA assays.

Results Serum PSA‐ACT values ranged from less than 0.10 to 1.4ng/mL in healthy males (n = 100) while values in patients with benign prostatic hyperplasia (n = 1 55) averaged 3.4 ± 3.8ng/mL (mean ± SD). In patients with prostate cancer, serum PSA‐ACT values increased significantly with progression of the clinical stage and there were statistically significant differences between benign prostatic hyperplasia and each stage of prostate cancer except for stage A. Using BPH levels as controls (4.8ng/mL for PSA‐ACT, 7.2ng/mL for PSA, 3.8ng/mL for y‐Sm, and 2.4ng/mL for thecomplexed/free PSA ratio of PSA‐ACT/μtgM‐Sm), specificity was 80%. The sensitivity of prostate cancer detection was 79% for PSA‐ACT, 77% for PSA, 57% for γ‐Sm, and 46% for the ratio between PSA‐ACT/γ‐Sm.

Conclusion Although the determination of serum PSA‐ACT showed essentially the same utility as that of PSA for the diagnosis of prostate cancer, PSA‐ACT may allow prediction of the clinical stage. The PSA‐ACT assay may therefore replace PSA in the detection of prostate cancer.
Transurethral Electrovaporization of the Prostate: Preliminary Clinical Results with Pressure‐Flow Analysis
Authors: Okada Takuya , Terai Akito , Terachi Toshiro , Okada Yusaku , Yoshida Osamu
Published: July 2007

Background We evaluated the safety and efficacy of transurethral electrovaporization of the prostate (TVP) as a new alternative treatment for patients with benign prostatic hyperplasia.

Methods A total of 22 patients with symptomatic benign prostatic hyperplasia, including 4 with urinary retention, underwent TVP. If enough of a cavity was not created after 60 minutes of vaporization, transurethral resection of the prostate (TURP) was performed successively. International Prostate Symptom Score (l‐PSS) with quality‐of‐life index, maximum flow rate, and postvoid residual volume were measured at baseline and at 2 weeks, 1, 3, and 6 months. A pressure‐flow study was performed at baseline and at 3 or 6 months after surgery.

Results TURP was required in 10 of 22 patients. At 6 months, mean l‐PSS decreased from 20.0 to 5.2, quality‐of‐life index decreased from 4.6 to 1.1, mean maximum flow rate increased from 6.9 to 16.7 mL/s, and postvoid residual volume decreased from 152 to 32 mL. Detrusor pressure at maximum flow decreased from 108 to 39 cm H20, with a significant relief of bladder outlet obstruction in 93% of the patients. Mean decrease in hematocrit was 4.4%, and in serum sodium, 4.8 mEq/L. None of the patients required transfusions or had TUR syndrome. A urethral stricture and a severe stress incontinence developed in 1 patient.

Conclusion TVP seems to be a safe and effective alternative to a standard TURP associated with fewer intraoperative complications. Although preliminary clinical results have been promising, further study is necessary to establish long‐term efficacy and safety of this procedure.
Predictability of Conventional Tests for the Assessment of Bladder Outlet Obstruction in Benign Prostatic Hyperplasia
Authors: Homma Yukio , Gotoh Momokazu , Takei Mineo , Kawabe Kazuki , Yamaguchi Takuhiro
Published: July 2007

Background The degree of bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH) is most accurately quantified by pressure flow studies (PFS), although these studies are more invasive and complicated than conventional tests. We examined how precisely conventional tests predicted the PFS‐assessed degree of BOO.

Methods The study population consisted of 232 BPH patients who had undergone routine conventional tests and PFS. Correlation of the conventional test results with the degree of BOO assessed by PFS was examined by Spearman's correlation coefficients. Regression and subgroup analyses were performed to predict the degree of BOO using the conventional test results as the explanatory variables.

Results The degree of BOO correlated with prostate volume, the degree of endoscopic obstruction, and to a lesser extent, with the maximum flow rate (Qmax) and age. The predictability of conventional tests alone, or in combination, for BOO, was approximately 60% to 70%, which is not acceptable for investigational use. However, almost all patients with a prostate volume larger than 30 mL, or with severe obstruction on urethroscopic findings, had an obstructed bladder outlet.

Conclusion PFS is mandatory when the precise evaluation of the degree of BOO is required, and patients are highly likely to have an outlet obstruction when they have a prostate larger than 30 mL, or severely obstructed posterior urethra on endoscopy.
Treatment for Advanced Testicular Cancer with High‐Dose Chemotherapy and Autologous Blood Stem Cell Transplantation
Authors: Takahashi Atsushi , Miyao Noriomi , Masumori Naoya , Takeda Kouichi , Shigyo Masanori , Sasamura Hiroto , Sakamaki Sumio , Niitsu Yoshiro , Tsukamoto Taiji
Published: July 2007

Background This study was carried out to investigate the efficacy and safety of high‐dose chemotherapy (HDC) for the treatment of patients with advanced testicular cancer.

Methods Seven patients were treated with high‐dose carboplatin, etoposide, and ifosfamide followed by autologous blood stem cell transplantation. One patient received 1 cycle, 4 patients received 2 cycles, and 2 patients received 3 cycles of HDC. We performed a total of 15 autologous blood stem cell transplantations: 8 with autologous bone marrow; 6 with peripheral blood stem cells; and 1 with peripheral blood stem cells in addition to autologous bone marrow.

Results Four of the 7 patients achieved a pathologic complete response via early use of HDC and additional salvage surgery. All 4 patients are still alive without evidence of disease at 12, 30, 33, and 54 months, respectively. One patient is alive with active disease at 35 months. Two patients refractory to conventional chemotherapy died of progressive disease at 5 and 27 months, respectively. The hematologic recovery after HDC was rapid, and peripheral blood stem cells tended to have shorter hematologic recovery compared with those from autologous bone marrow, although the difference was not significant. Nonhematologic toxicity was usually mild and manageable.

Conclusion High‐dose chemotherapy, followed by autologous blood stem cell transplantation, may be safe and effective for patients with advanced testicular cancer, particularly when early use of HDC is conducted for chemotherapy‐sensitive patients. A further large, long‐term, follow‐up study will be needed to define the role of HDC.
Lack of Selectin‐Dependent Adhesion in Prostate Cancer Cells Expressing Sialyl Lex
Authors: Satoh Makoto , Numahata Kenji , Kawamura Sadafumi , Saito Seiichi , Orikasa Seiichi
Published: July 2007

Background Recently, it has been reported that upregulation of the oligosaccharide sialyl Lex (SLex) in prostate cancer is associated with hormone‐resistant, aggressive disease. However, it is not clear that SLex expressed on prostate cancer cells has a biological function related to metastatic potential.

Methods The expression levels of SLex, sialyl Lea (SLea), disialosyl galactosylgloboside (DSGG), monosialosyl galactosylgloboside (MSGC) and various fucosyltransferases in 3 prostate cancer cell lines were determined. The function of SLex expressed on prostate cancer cell lines was determined by a selectin‐dependent adhesion assay.

Results No prostate cancer cell lines expressed SLea, DSGG, or MSGG, but all prostate cancer cells moderately expressed SLex. Fucosyltransferase expression did not correlate with the expression of SLex, and all prostate cancer cells failed to bind immobilized selectin.

Conclusion The expression of SLex on these prostate cancer cells does not correlate with selectin‐dependent adhesion.
Chromophobe Cell Renal Carcinoma in Childhood
Authors: Fujii Yasuhisa , Kihara Kazunori , Tsujii Toshihiko , Kawakami Satoru , Nemoto Tetsuo , Washizuka Makoto , Oshima Hiroyuki
Published: July 2007

We report the first case of chromophobe cell renal carcinoma in childhood. A 12‐year‐old boy presented gross hematuria following minor trauma. He was diagnosed as having a left renal tumor 45‐mm in diameter. Radical nephrectomy was performed. One year later the boy was well.
Renal Vein Thrombosis Misdiagnosed as a Renal Cell Carcinoma with a Tumor Thrombus in the Inferior Vena Cava
Authors: Takayama Hitoshi , Kinouchi Toshiaki , Meguro Norio , Maeda Osamu , Saiki Shigeru , Kuroda Masao , Usami Michiyuki , Kotake Toshihiko
Published: July 2007

A 69‐year‐old man was diagnosed with a right renal carcinoma with a tumor thrombus in the inferior vena cava, and underwent a radical nephrectomy. The entire specimen was examined by step‐wise sectioning and found to be a thrombus with extensive hemosiderin deposits and recánalization which contained no malignant cells.
Urodynamic Changes after Endoscopic Correction of Vesicoureteral Reflux
Authors: Ozawa Hideo , Kumon Hiromi , Ichikawa Takaharu , Nagai Atsushi , Ohmori Hiroyuki
Published: July 2007

Massive bilateral vesicoureteral reflux (VUR) in a 7‐year‐old girl with spinal scoliosis was successfully treated by endoscopic correction. She was admitted due to a febrile urinary tract infection and urinary incontinence. A cystometrogram demonstrated normal detrusor function during storage. The endoscopic subureteric injection of polytetrafluoroethylene (TeflonTM) was performed, resulting in the disappearance of the VUR. A postoperative cystometrogram demonstrated overactive detrusor function during storage, necessitating anticholinergic medication. She has been free of febrile urinary tract infections and incontinence for 2 years postoperatively, although self‐catheterization is necessary. In a case of neurogenic vesical dysfunction with massive reflux, endoscopic subureteric injection is not only a therapeutic tool, but also a useful diagnostic option for detecting occult detrusor overactivity during storage prior to open surgery.
Testicular Metastases from Carcinoma of the Bile Duct: A Case Report
Authors: Tozawa Keiichi , Akita Hidetoshi , Kusada Shuji , Hayashi Yutaro , Sasaki Shoichi , Ueda Kosuke , Kohri Kenjiro
Published: July 2007

A 41 ‐year‐old man was admitted to our hospital with chief complaints of painless tumor in the left scrotal contents and loss of body weight. As the tumor was suspected of being a neoplastic lesion, left radical inguinal orchiectomy was carried out. Histopathological examination showed metastatic adenocarcinoma of the bile duct. Metastatic carcinoma to the testicle, epididymis, and their tunics is unusual and testicular metastases from adenocarcinoma of the bile duct is extremely rare. A case of testicular metastases from carcinoma of the bile duct is reported and the literature reviewed.
Left Acute Scrotum Associated with Appendicitis
Authors: Yasumoto Ryoji , Kawano Manabu , Kawanishi Hironobu , Shindow Kiyo , Hiura Akihito , Kim Eui‐chol , Ikehara Teruyuki
Published: July 2007

A 10‐year‐old boy, who had a mild inguinal hernia in his left scrotum, was referred to our clinic because of redness of the scrotal skin and tenderness of the left scrotal contents. Scrotal echography showed a hypoechoic lesion around the normal testis and epididymis. Because torsion of either the testis or testicular appendage was suspected, the scrotum was opened and 1.5 mLof purulent fluid was observed in the tunica vaginalis with inflammatory tissue around the testis and epididymis. On the first postoperative day, a low grade fever and abdominal tenderness persisted, however, the abdomen was flat and soft. There was no marked tenderness over McBurney's point, butthere was moderate tenderness over Lanz's point on deep palpation. Abdominal sonography and magnetic resonance imaging revealed abscess formation between the bladder and the sacrum. With a diagnosis of perforation of the appendix, a laparotomy was performed. The inguinal hernia sac could not be observed on inspection, and it was not possible to palpate the left side because of severe adhesion due to infection. Also, the neck of the right inguinal sac could not be seen. The appendix specimen was gangrenous. On the second postsurgical day, all symptoms and signs disappeared. We present this rare condition and discuss the difficulty in establishing a diagnosis.
Pathophysiology of Clinical Varicoceles in Infertile Men
Authors: Cockett Abraham T. K. , Takihara Hiroshi , Iwamura Masatsugu , Koshiba Ken
Published: July 2007

In infertile men, clinical varicoceles most often occur bilaterally. In our experience with these patients, both testicles are smaller than normal. We find more than 25% to 35% immature and tapered sperm in in the ejaculum of these men, and the motility of the sperm is usually low. We have found serotonin in the plasma of the varicoceles, and believe this biogenic amine is responsible for the poor sperm motility. We now agree that a subset of neuroendocrine cells in the prostate secrete serotonin. Bilateral varicocele surgery can improve the patient's fertility potential, and we advocate surgical treatment.
Preliminary Report of a Modified Continent Appendix Stoma in a Sigmoid Urinary Reservoir Pouch
Authors: Arakawa Soichi , Gohji Kazuo , Hara Isao , Fujisawa Masato , Okada Hiroshi , Kamidono Sadao
Published: July 2007

Background:

The application of an appendix stoma in a Mainz urinary reservoir pouch is an established procedure and assures good continence. We modified this method for use with a sigmoid pouch.

Methods:

In each of 3 men with bladder carcinoma, an appendix with a blood supply was prepared and anastomosed to the detubularized sigmoid pouch with a 3‐cm submucosal tunnel.

Results:

In all 3 patients, this procedure was performed successfully, and the pouch was completely continent. Self‐catheterization could be performed without difficulty by 2 patients, and with slight resistance in the remaining patient. The patients are satisfied with their quality of life.

Conclusions:

We conclude, based on our findings and these preliminary observations, that this procedure is a potentially good alternative for the placement of continent stoma in continent urinary reservoir surgery.
Clinical Study of Renal Cell Carcinoma with Brain Metastasis
Authors: Yamanaka Kazuki , Gohji Kazuo , Hara Isao , Gotoh Akinobu , Takechi Yoshizumi , Yamada Yuji , Taguchi Isao , Tamada Hiroshi , Okada Hiroshi , Arakawa Soichi , Kamidono Sadao
Published: July 2007

Background:

The clinical outcome of patients with renal cell carcinoma with brain metastasis was analyzed.

Methods:

Nine patients (median age, 60 years) with primary renal cell carcinoma and distant metastasis, including brain metastasis, were treated. The median time to the development of brain metastasis was 15 months after the initial visit. Patients with poor performance status or progressive disease were treated with interferon or conservative therapy alone. Patients with good performance status and other well‐controlled metastatic foci were treated either with radiotherapy, or by tumorectomy of brain metastasis, or both. The median follow‐up was 26 months after the initial visit.

Results: The 1‐year, cause‐specific survival rate was 17%. Of the 5 patients treated with α‐interferon alone, all died of disease after the treatments, without improvement of performance status, 1 to 4 months after the diagnosis of brain metastasis. Two of 4 patients who underwent radiotherapy were treated with a combination of γ‐knife and tumorectomy of brain metastasis. They remained alive 10 and 22 months after diagnosis of brain metastasis. The 2 patients who underwent the combination treatment of γ‐knife and tumorectomy showed improvement of their performance status after these treatments for brain metastasis.

Conclusion:

Brain metastasis is an unfavorable prognostic factor in renal cell carcinoma. Although a larger number of patients would be necessary to demonstrate the definitive effects of γ‐knife treatment, our results suggest that the combination of γ‐knife and tumorectomy of brain metastases may be recommended for selected patients with good performance status and other well‐controlled metastatic foci.
Smoking and Obesity in Relation to the Etiology and Disease Progression of Prostate Cancer in Japan
Authors: Furuya Yuzo , Akimoto Susumu , Akakura Koichiro , Ito Haruo
Published: July 2007

Background:

Various risk factors have been investigated concerning the etiology of prostate carcinoma, but many questions about the significance of the risk factors remain unanswered. To evaluate the relationship between smoking and obesity in prostate cancer, a case‐control study was performed.

Methods:

Between 1986 and 1995, 329 patients with untreated prostate cancer and 188 patients with benign prostate hyperplasia (control patients) were evaluated according to their smoking habits and the degree of obesity. Also, the progression of prostate cancer in relationship to smoking and obesity was examined.

Results:

Smoking and obesity were not risk factors for the development of prostate cancer (odds ratio, 0.986, 0.836; 95% confidence interval, 0.69‐1.41, 0.57‐1.24, respectively). Nor were smoking or obesity a risk factor for survival in stage D2 patients, however, in stage B1‐D1 patients, obese men had a tendency for disease progression.

Conclusion:

This study demonstrated that neither smoking nor obesity increase the risk of developing prostate cancer, or the risk of disease progression in prostate cancer patients. However, obese men have a tendency for progression of stage B1‐D1 prostate cancer although further studies are necessary to confirm this finding.
Holmium: YAG Laser Resection of the Prostate Versus Visual Laser Ablation of the Prostate and Transurethral Ultrasound‐Guided Laser Induced Prostatectomy: A Retrospective Comparative Study
Authors: Kitagawa Motoaki , Furuse Hiroshi , Fukuta Ken , Aso Yoshio
Published: July 2007

Background:

Transurethral resection of the prostate (TUR‐P) is the gold standard for treating symptomatic benign prostatic hyperplasia (BPH) despite some perioperative morbidity. As a minimally‐invasive alternative to TUR‐P, a neodymium:YAG laser, and more recently a holmium:YAG laser, have been used in transurethral surgery for BPH. In order to assess the safety and efficacy of various BPH treatments, the outcome in patients treated with transurethral ultrasound‐guided laser induced prostatectomy (TULIP), visual laser ablation of the prostate (VLAP) and holmium:YAG laser resection of the prostate (HoLRP) were retrospectively compared.

Methods:

From May 1995 to August 1996, 60 patients with symptomatic BPH underwent TULIP (n=20), VLAP (n=20), and HoLRP (n=20). All patients were evaluated preoperatively and at 1 and 3 months postoperatively by the International Prostate Symptom Score (IPSS), the IPSS quality‐of‐life score (QOL), maximum flow rate (MFR), prostate volume, and residual urine volume.

Results:

The preoperative mean IPSS was 18.5, 19.3, and 19.6 and the mean MFR was 6.3, 6.9, and 6.1mL/sec in the TULIP, VLAP, and HoLRP groups, respectively. At 1 month after surgery, the mean IPSS was 10.2, 9.5, and 4.7 and the mean MFR was 9.6, 1 3.4, and 1 8.7mL/sec while at 3 months the mean IPSS was 6.2, 6.1, and 3.6 and the mean MFR was 14.1, 1 6.0, and 21.5 mL/sec in patients treated with TULIP, VLAP, and HoLRP, respectively. No serious complication occurred in any patient.

Conclusion: Although HoLRP requires expertise, it appears to be a promising treatment modality for BPH.
Transrectal Microwave Hyperthermia for Patients with Benign Prostatic Hyperplasia
Authors: Barbalias George A. , Liatsikos Evangelos N.
Published: July 2007

Background:

A randomized study evaluated the efficacy of treatment with transrectal microwave hyperthermia (TMH) treatment in patients with benign prostatic hyperplasia (BPH).

Methods:

Eighty BPH patients received TMH therapy and 20 patients were given a sham treatment. TMH was achieved using a prostathermer which includes a microwave transrectal heat generator, a cooling system and a transurethral sensor probe. Patients that received TMH had 5 to 6 sessions of 1 hour each where the prostate was heated to 42°C to 43.5°C. The sham treatment consisted of a single session where the temperature was maintained at 37°. All patients were evaluated at 3 and 12 months after treatment.

Results:

There was an improvement of subjective obstructive symptoms in 54 patients (75%) after TMH. An evaluation of urodynamic parameters revealed an increase in the maximum flow rate and a decrease of the detrusor opening pressure as well as the detrusor pressure at maximum flow in patients treated with TMH. A significant improvement in the amount of residual urine was seen in all TMH‐treated patients (P<0.0001).

Conclusion:

Although TMH cannot be considered a superior alternative to open surgical or transurethral excision of the prostate, it is a valid option for patients who have indwelling urethral catheters and for those at high surgical risk.
Role of the Transition Zone for Elevating Serum Prostate‐Specific Antigen in Benign Prostatic Hyperplasia
Authors: Sakamoto Wataru , Iwata Hironori , Kamikawa Sadanori , Tsurusaki Kiyoshi , Sugimoto Toshikado , Nakatani Tatsuya , Sugimura Kazunobu , Yamamoto Keisuke , Kishimoto Taketoshi
Published: July 2007

Background:

Patients with benign prostatic hyperplasia (BPH) have a wide range of concentrations of PSA. However, it is not known what factors influence the concentration of serum PSA other than the prostate volume. BPH is composed of an enlarged transition zone (TZ) and other zones (nonTZ). The TZ is thought to play a more important role than the non TZ in determining the concentration of serum PSA in BPH patients.

Methods:

We investigated the individual glandular zone volume, the amount of PSA produced by each zone and the PSA density in each zone in 23 patients with histologically‐confirmed BPH. The PSA density in the TZ was calculated by dividing the difference between the serum PSA before and after surgical resection by the specimen weight. We examined the influence of these parameters on the concentration of serum PSA in BPH patients.

Results:

The serum PSA concentration correlated with the amount of PSA produced by the TZ (r= 0.90, P< 0.01), but not the nonTZ (r= 0.25, P= 0.29). The concentration of serum PSA also showed a significant correlation with the TZ volume (r= 0.67, P<0.01) and the PSA density in the TZ (r= 0.51, P<0.05), but not with the PSA density in the nonTZ (r=‐0.06, P= 0.81). Also, age was inversely correlated with the PSA density in the TZ (r=‐0.69, P<0.01).

Conclusion:

The hypertrophic prostate cell volume (TZ volume) and activity (PSA density in the TZ) significantly correlated with the concentration of serum PSA in BPH patients, and the TZ cell activity decreased inversely with age in these BPH patients.
Results of Closure of Urethrocutaneous Fistulas after Hypospadias Repair
Authors: Hayashi Yutaro , Mogami Mihoko , Kojima Yoshiyuki , Mogami Tohru , Sasaki Shoichi , Azemoto Masataka , Maruyama Tetsuji , Tatsura Hiroyuki , Tsugaya Masayuki , Kohri Kenjiro
Published: July 2007

Background:

Urethrocutaneous fistulas are one of the major causes of morbidity after hypospadias repair.

Methods:

During the last 2.5 years, 26 patients underwent repair of 41 urethrocutaneous fistulas. These fistulas were repaired by a 3‐layered closure method, by using meticulous surgical techniques aided by optical magnification. In large fistulas, a dermal subcutaneous flap was created and brought over the surgically repaired urethral fistula.

Results:

Twenty‐four of the 26 patients with urethrocutaneous fistulas after hypospadias repair had fistula closure, with a 92% success rate.

Conclusion:

A high success rate was obtained with a multilayered closure using meticulous techniques to repair urethrocutaneous fistulas.
Nonfunctioning Adrenal Cortical Cancer and Analysis of the Steroidogenic Activity of the Tumor: A Case Report
Authors: Morioka Masaaki , Tanaka Hiroyoshi , Ohashi Yozo , Jin Tie‐Xiong , Watanabe Hironobu , Furihata Mutsuo
Published: July 2007

An adrenocortical cancer was detected by a CT scan in a 37‐year‐old woman, which did not have an excessive secretion of steroids or catecholamines. The tumor was enhanced inhomogeneously by the bolus injection of contrast medium, and magnetic resonance imaging (MRI) showed that the tumor was hypointense compared to the liver on a T1‐weighted image and was diffusely hyperintense on a T2‐weighted image. Histologically, the tumor consisted predominantly of compact cells with marked cellular and nuclear pleomorphism, but no capsular or vascular invasion were observed. An analysis of the steroidogenic activity of the tumor revealed that the activity of mitochondrial P450c11j8 was extremely reduced in the tumor.
Right Paranephric Abscess as a Rare Late Complication of Laparoscopic Cholecystectomy
Authors: Nishiyama Tsutomu , Terunuma Masahiro , Sasaki Koichi , Hanyu Shugo
Published: July 2007

A laparoscopic cholecystectomy on a 63‐year‐old woman was uneventful. Twenty‐one months after the operation she complained of dull right flank pain, loss of appetite, weight loss, and cough. CT of the abdomen showed an 8.5 cm mass adjacent to the posterior aspect of the upper pole of the right kidney. CT also demonstrated a small calcification (5 mm diameter) posterior to the upper pole of the right kidney. The patient underwent exploratory laparotomy 2 months after the presentation with flank pain. Examination of the mass showed a thick abscess wall and 250 mL of pus. The patient's symptoms improved after the abscess was drained.
Successful Treatment with Polymyxin B Immobilized Fiber of Septic Shock Complicated by Renal Stone
Authors: Soda Takeshi , Ogura Keiji , Kondo Morihiro , Yagisawa Mareki
Published: July 2007

We describe a patient with septic shock that was spontaneously complicated by calyceal diverticular calculus. The patient recovered from shock with in a few days with treatment by extracorporeal elimination of endotoxin using a blood purification cartridge consisting of polymyxin B immobilized fiber. Standard open nephrolithotomy was performed, and the patient was discharged from the hospital 2 months after admission.
Laparoscopic Nephrectomy in Children: Two Case Reports
Authors: Ushiyama Tomomi , Kageyama Shinji , Mugiya Soichi , Suzuki Kazuo , Fujita Kimio
Published: July 2007

We successfully performed a laparoscopic nephrectomy on 2 young girls in March 1994 and August 1994. The first patient was a 9‐year‐old girl with a hypoplastic kidney associated with an ectopic ureterocele, and the other was a 3‐year‐old girl with a nonfunctioning hydronephrotic kidney caused by stricture of the pyeloureteral junction. The operating times were 153 and 183 minutes, respectively. No complications occurred intraoperatively or postoperatively in either patient. The 9‐year‐old girl resumed normal daily activities by postoperative day 2, and the 3‐year‐old girl by postoperative day 3. Both girls were discharged on day 4.
Nephrogenic Adenoma in a Patient with Transitional Cell Carcinoma of the Bladder Receiving Intravesical Bacillus Calmette‐Guérin
Authors: Oyama Nobuyuki , Tanase Kazuya , Akino Hironobu , Mori Hirotaka , Kanamaru Hiroshi , Okada Kenichiro
Published: July 2007

A 76‐year‐old‐man was admitted to our hospital for a recurrent bladder tumor. He had received intravesical bacillus Calmette‐Guérin (BCG) treatment for a transitional cell carcinoma of the bladder. A follow‐up cystoscopy revealed a solitary papillary tumor in the left bladder wall. A transurethral cold cup biopsy revealed a nephrogenic adenoma without any evidence of malignant cells. We discuss the pathogenesis of nephrogenic adenoma and suggest that prolonged cystitis caused by intravesical BCG may play an etiological role.
Congenital Megalourethra: A Case Report
Authors: Seki Narihito , Senoh Kohei , Kubo Shuta , Tsunoda Toshiyuki
Published: July 2007

We describe a case of a male infant with a scaphoid megalourethra. A physical examination showed a large, flabby phallus with bilateral undescended testes. The corpus spongiosum was absent with normal corpora cavernosa. Urethrography showed a crescent‐shaped dilatation of the anterior urethra. Further examination revealed an association with concomitant urogenital anomalies, right renal hypoplasiadysplasia, bilateral vesicoureteral reflux and the prune‐belly syndrome. A urethroplasty with resection of the excess urethral tissue and reconstruction of the urethra was performed. There was a satisfactory surgical result and the patient now voids without difficulty.
The anatomy of trade union benefits in the 1960's
Authors: Marsh Arthur , Cope Peter
Published: July 2007

Pre‐1914, average union expenditure per head on benefits almost equalled the average wage; today it is only one‐twentieth of average earnings. In analysing the trends in benefit patterns, the authors discuss such factors as the low level of expenditure on unemployment benefit, the rising trend of dispute benefit in the 1960's, the run down of superannuation benefits, and the increase in expenditure on sickness and accident, and the increase in contributions to educational programmes. They also consider probable future developments.
The use of working parties in industrial relations
Authors: Philp A. J.
Published: July 2007

Problems encountered in introducing a new pay scheme led one company to experiment with the use of joint working parties as a means of implementing major changes. Their experiences proved that, if properly handled, working parties can make an invaluable contribution to joint problem‐solving over a wide area.
The economic evaluation of operator training
Authors: Johnson P. S.
Published: July 2007

Companies tend to make changes in their training methods in an economic vacuum: little attention is paid to evaluating the benefits to be derived from a change in relation to the costs involved. In this article operator training is treated as an investment, and the cost of the investment and the returns on the investment are analysed to demonstrate how individual firms can approach the question of evaluating the benefits of training. There may even be cases, the author points out, where the ‘sitting next to Nellie’ approach is the best economic proposition.
Herzberg's two‐factor theory of job attitudes: a critical evaluation and some fresh evidence
Authors: Wall Toby D. , Stephenson Geoffrey M.
Published: July 2007

This evaluation of Herzberg's theory of motivation discusses its ambiguities and the influence of the tendency for people to give “socially desirable” answers. Evidence from the authors' experiments suggests that the theory is untenable as a description of the structure of job attitudes and the determinants of job satisfaction and dissatisfaction. The authors acknowledge that a policy of job enrichment derived from the application of the theory would be likely to promote satisfaction and allay dissatisfaction. A concise summary of their analysis and conclusions is given at the end of the article.
Productivity bargaining: a reassessment
Authors: Hawkins Kevin
Published: July 2007

While governments tend to regard productivity bargaining as a long term anti‐inflationary weapon, the author's research points out its weaknesses in this direction, and indicates that productivity bargaining may ultimately have far more important effects on the structural and behavioural development of collective bargaining at plant level.
The aims and methods of the education and training of shop stewards: a case study
Authors: Warren Alexandra
Published: July 2007

The author's research indicates that management's objectives in releasing shop stewards for courses and the shop stewards' objectives may be quite different. Views on how far courses should be “education” and how far “training”, and the best structure for courses, also emerged from this study.
Wages Councils, retail distribution and the concept of the “cut‐off”
Authors: Armstrong Dr. E. G. A.
Published: July 2007

If proposed amendments to the Industrial Relations Bill remove protection afforded to some groups of workers by the Wages Councils system, an alternative will have to be found. In retail distribution a case can be made out for operating a bipartite system with voluntary negotiation above, and statutory wage protection below, a “cut‐off” point determined on the basis of turnover.
“What does the word ‘inflation’ mean to you?” and “What is the connexion between wage claims and rices?” Findings from two national sample surveys in 1966 and 19711
Authors: Behrend Hilde
Published: July 2007

Even in 1971 it is evident that a large proportion of Britain's population does not understandthe process of inflation and sees no connexion between wage claims and prices.
Work‐group composition as a factor in productivity and satisfaction
Authors: Cross Denys , Warr Peter
Published: July 2007

Work teams on production lines are usually made up at random; but the authors' research indicates that where teams are constituted on the basis of skills, higher productivity and increased job satisfaction may result.