bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative UFT Adjuvant and the Risk Factors for Recurrence in Renal Cell Carcinoma: A Long‐Term Follow‐Up Study
Authors: Naito Seiji , Kumazawa Joichi , Omoto Tetsuo , Iguchi Atsushi , Sagiyama Kazuyuki , Osada Yukio , Hiratsuka Yoshiharu 
Published: July 2007

Background Radical nephrectomy is the standard therapy for low‐stage renal cell carcinoma. However, recurrence sometimes develops even in patients who are considered to have undergone a curative resection of the primary tumor. The purpose of this study was to evaluate the usefulness of UFT (a 1: 4 mixture of tegafur and uracil) adjuvant and the risk factors for recurrence in renal cell carcinoma. Methods A prospective randomized trial was conducted to compare the use of long‐term oral UFT adjuvant with nonadjuvant therapy after a radical nephrectomy for Robson stage I or II renal cell carcinoma. A multivariate analysis was also performed to estimate the risk factors for recurrence. Results A total of 71 patients were entered into this study, and 66 were evaluable (33 for each group). There was no significant difference in patient characteristics between the 2 groups. The nonrecurrence rate at 5 years after a radical nephrectomy was 80.5% and 77.1% in the UFT adjuvant group and the nonadjuvant group, respectively, with a median follow‐up of 112.9 months; the difference was not significant. The toxicity of UFT was generally mild and tolerable. The tumor grade was found to be an important factor influencing recurrence. Conclusion UFT cannot be universally recommended as an adjuvant therapy for radical nephrectomy in all patients with low‐stage renal cell carcinoma.
Surgical Approach to Tumor Thrombus of Renal Cell Carcinoma at the Level between Hepatic Vein and Diaphragm
Authors: Isaka Shigeo , Okano Tatsuya , Shimazaki Jun , Masuda Masahisa , Miyazaki Masaru 
Published: July 2007

BackgroundThe curative resection of tumor thrombus of renal cell carcinoma often provides a good prognosis, but the best surgical method for resection at the level between hepatic vein and diaphragm is still a matter of controversy. MethodsWe performed transabdominal surgery without cardio‐pulmonary bypass on 4 patients with tumor thrombus at the level between hepatic vein and diaphragm. The surgical procedures were as follows: The right lobe of the liver was separated and detached from the retroperitoneum, and then the vena cava was clamped just below the diaphragm simultaneous with clamping the porta hepatis. After complete circulatory isolation of the vena cava, the tumor thrombus was resected. Results: There were no severe complications postoperatively. Two patients died of cancer 18 and 38 months after surgery, and the other 2 are alive without evidence of disease after 62 and 66 months. Conclusion: This anatomically rational approach is thought to be a good alternative to the pull‐through method or cardio‐pulmonary bypass for removing a tumor thrombus at this level.
Epidemiologic Survey of Lower Urinary Tract Symptoms in Asia and Australia Using the International Prostate Symptom Score
Authors: Homma Yukio , Kawabe Kazuki , Tsukamoto Taiji , Yamanaka Hidetoshi , Okada Kiyoki , Okajima Eigoro , Yoshida Osamu , Kumazawa Joichi , Fang‐Liu Gu , Lee Chongwook , Hsu Te‐Chin , Cruz Reynaldo C dela , Tantiwang Anupan , Lim Peter HC , Sheikh Masood A , Bapat Sharad D , Marshall Villis R , Tajima Kazuo , Aso Yoshio 
Published: July 2007

Background The prevalence of lower urinary tract symptoms was determined by survey as an initial step in estimating the significance of benign prostatic hyperplasia (BPH) in Asia and Australia. Methods The symptom index (0 to 35) and quality‐of‐life (QOL) index (0 to 6) of the international prostate symptom score were measured in 7588 men in 9 Asian countries and 146 men in Australia. Results The percentages of Asian men considered to be symptomatic (symptom index ≧ 8) were 18%, 29%, 40%, and 56% in the age groups of 40 to 49, 50 to 59, 60 to 69, and 70 to 79 years, respectively. For Australian men, these figures were 36%, 33%, and 37% in the 50 to 59, 60 to 69, and 70 to 79 year age groups, respectively. Conclusions Our estimates indicate that the prevalences of symptomatic men in Asia and Australia are similar to or greater than those in Europe and America, and suggest BPH is similarly common in these areas.
Complications and Reimplantation of Penile Implants
Authors: Nukui Fumihiko , Okamoto Shigehiro , Nagata Mikio , Kurokawa Jun , Fukui Junnosuke 
Published: July 2007

Background Complications of penile prosthesis implants can be divided into surgical and mechanical failure. We investigated penile prosthesis implants to clarify the surgical and mechanical complications that have arisen in our clinical experience. Methods In the 11 years between 1984 and 1995, 83 penile prostheses were implanted in 74 patients ranging from 37 to 82 years of age. Results Of the 64 malleable and mechanical prostheses, 11 were extracted, including 4 removed because of surgical complications and 2 due to mechanical failure. Of the 19 inflatable prostheses, 6 were removed, including 1 extracted due to surgical complication and 5 extracted due to mechanical failure. Nine reimplantations for 8 patients were performed and all these cases had good results. As a result, 66 out of 74 patients could have coitus after prosthetic surgery. Conclusions Penile prosthetic surgery is an established method of treating organic impotence, however, it should only be considered for selected and well‐informed patients to avoid complications and revision surgery.
Calcium Independent Contraction of Bladder Smooth Muscle
Authors: Yoshimura Yasukuni , Yamaguchi Osamu 
Published: July 2007

Background Recently, it has been suggested that in vascular smooth muscle a Ca2+‐independent mechanism or Ca2+‐sensitization of contractile elements may participate in smooth muscle contraction. In this study, we evaluate this mechanism in detrusor muscle. Methods Strips of smooth muscle from rabbit aorta, rabbit bladder and human bladder were evaluated by in vitro contraction studies. Results The results show that (1) in Ca2+‐free solution containing ethyleneglycol bis (‐aminothylether)‐N,N,‐tetraacetic acid (ECTA), carbachol and phorbol ester produced sustained contractions in detrusor muscle (Ca2+‐free contraction); (2) depletion of Ca2+ stores by caffeine did not affect Ca2+‐free contraction induced by carbachol; and (3) VV‐7 (calmodulin inhibitor) and ML‐9 (myosin light chain kinase [MLCK] inhibitor) did not show inhibitory effects on Ca2+‐free contraction, while H‐7 (protein kinase C [PKC] inhibitor) abolished this contraction. Conclusions These results suggest that neither stored Ca2+ nor the Ca2+‐calmodulin‐MLCK system is involved in the carbachol‐induced Ca2+‐free contraction of detrusor muscle. This Ca2+‐independent contraction seems to be mediated by the activation of PKC coupled with agonist stimulation of the muscarinic receptor.
Correlation of Allelic Loss of the P53 Gene and Tumor Grade, Stage, and Malignant Progression in Bladder Cancer
Authors: Tsutsumi Masakazu , Sugano Kokichi , Yamaguchi Kensei , Kakizoe Tadao , Akaza Hideyuki 
Published: July 2007

Background We examined loss of heterozygosity (LOH) of the P53 gene in bladder cancer, and investigated the role of the P53 gene on malignant progression of papillary tumors. In addition, the clonality of recurrent bladder cancer was examined. Methods LOH of the P53 gene was analyzed in 67 bladder cancers from 47 patients. DNA was extracted from formalin‐fixed, paraffin‐embedded tissues, amplified by the polymerase chain reaction (PCR) at 3 polymorphic loci in the P53 gene, and analyzed with nonradioisotopic single‐strand conformation polymorphism (Non‐RI SSCP) analysis. Results Out of 40 informative samples, LOH was detected in 1 3 samples, containing 4 of 7 in grade 3 (57%), 9 of 23 in grade 2 (39%), and none of 1 0 in grade 1 (0%). Statistical significance was observed between the LOH in grades 1 and 2, and in grades 1 and 3. An analysis of 5 cases showing malignant progression revealed that 3 (60%) showed an LOH in the primary tumor, and 2 showed LOH in recurrent tumors, in contrast to LOH found in 3 cases of 1 9 (1 6%) not showing malignant progression. Four cases with metachronous recurrence exhibited LOH; 2 at recurrent tumors, 1 only at the initial tumor, and 1 at both tumors. Conclusions The alterations of the P53 gene were considered to correlate with tumor grade, and contribute to the malignant progression of bladder cancer. LOH in the P53 gene may serve as a clinical indicator for prognosis in superficial bladder cancer.
Percutaneous Treatment of Transitional Cell Carcinoma of the Upper Urinary Tract
Authors: Okada Hiroshi , Eto Hiroshi , Hara Isao , Fujisawa Masato , Kawabata Gaku , Yamanaka Nozomu , Arakawa Soichi , Kamidono Sadao 
Published: July 2007

Background We evaluated the long‐term effect of percutaneous resection in 2 Japanese patients with transitional cell carcinoma of the renal pelvis, and reviewed the medical literature on similar patients, to determine the appropriate indications for percutaneous treatment of transitional cell carcinoma in the upper urinary tract. Results Indications for endoscopic resection in the 2 patients were renal insufficiency and unsuitability for major open surgery. The patients had no recurrence during follow‐up. Seven previous reports described percutaneous resection of upper urinary tract transitional cell carcinoma in 82 patients. Although 72.6% of the patients were successfully treated by percutaneous resection, half of the patients with grade 3 carcinoma developed recurrence. Conclusion These results, together with those of the 7 published reports, suggest that percutaneous resection should be limited to selected patients with low‐grade transitional cell carcinoma.
Testosterone Replacement Therapy for Male Hypogonadism with a Radiation‐Polymerized Testicular Prosthesis
Authors: Imai Kyoichi , Yamanaka Hidetoshi , Mashimo Masamichi , Asano Masaharu , Yoshida Masaru 
Published: July 2007

Background The effect of an artificial testicular prosthesis on sexual disturbance in hypogonadal men was investigated. Methods Twelve hypogonadal men were treated with testosterone replacement therapy delivered via radiation‐polymerized testicular prostheses surgically implanted in their scrotums. Results An average serum testosterone level of over 200ng/dl was maintained for 48 months. Most patients treated with this prosthesis were satisfied with the improvement of their sexual activity. Moreover, the patients were psychologically more satisfied with the enlarged scrotum achieved with the implanted prosthesis. Conclusion We recommend this prosthesis as the first choice among testosterone‐replacement therapies for hypogonadal men.
Biochemical Modulation of 5‐Fluorouracil with Murine Interferon‐α/β Against Murine Renal Cell Carcinoma
Authors: Marumo Ken , Oya Mototsugu , Murai Masaru 
Published: July 2007

Department of Urology, School of Medicine, Keio University, Tokyo, Japan Background Conventional therapy for renal cell carcinoma using interferon (IFN) has shown limited antitumor action. The purpose of our study was to investigate synergistic antitumor effects of IFN and 5‐fluorouracil (5‐FU), and to elucidate the mechanisms of interaction between the 2 agents in mice. Methods Antitumor effects and biochemical modulation of murine IFN‐α/β and 5‐FU were determined against the murine renal cell carcinoma cell line, Renca, in vivo. The activity of thymidylate synthetase and thymidine kinase was measured using cytosolic extracts of the tumors. Results Combination treatment with IFN‐α/β and 5‐FU produced a significant enhancement of growth inhibition against Renca tumor. Treatment with 5‐FU resulted in a 2.7‐fold increase in the total amount of thymidylate synthetase and an 11.6‐fold increase in the thymidylate synthetase inhibition rate, while the administration of IFN‐α/β did not significantly reduce the 5‐FU‐induced increase in thymidylate synthetase. The administration of IFN‐α/β decreased thymidine kinase activity to 65.5% maximally, compared with that in the control mice or the mice treated with 5‐FU. Conclusions The reduction of thymidine kinase caused by treating the mice with IFN‐α/β changes the utilization of exogenous thymidine for DNA synthesis, and may represent the mechanism of the additive antitumor effect of the 2 agents, through the suppression of the salvage pathway for deoxythymidine monophosphate induction.
Screening of H‐ras Gene Point Mutations in 50 Cases of Bladder Carcinoma
Authors: Saito Shiro , Hata Makoto , Fukuyama Ryuichi , Sakai Kosuke , Kudoh Jun , Tazaki Hiroshi , Shimizu Nobuyoshi 
Published: July 2007

Background Mutation converts the H‐ras gene into an activated oncogene in about 10% of human bladder cancers. Codons 12 and 61 are the major “hot spots” for activation. A simple and accurate method to detect point mutations in these codons may be clinically useful for early diagnosis of bladder cancer. Methods Bladder cancer samples from 50 patients, plus 10 samples of normal bladder mucosa, were analyzed for possible point mutation of the H‐ras gene at either codon 12 or codon 61. The H‐ras gene DNA segments that include these 2 codons were amplified by PCR methods, then the possible presence of a point mutation was evaluated at each codon by susceptibility of the respective DNA segments to digestion with the restriction enzyme and by dot blot hybridization assay. A bladder cancer patient who had an H‐ras gene mutation was examined to see whether the mutation was also detectable in the cells released in the urine. Results Definite or possible point mutations were found in 6 (1 2%) out of 50 bladder cancer patients, while no mutation was detected in normal mucosa. A point mutation could also be detected in cells isolated from the patient's urine sample. Conclusion The prevalence of point mutations at codon 1 2 or codon 61 of the H‐ras gene found in this study was similar to that previously estimated for human bladder cancer by DNA transfection assay. The method we have used for detecting point mutations of the H‐ras gene provides a simple and highly accurate way to detect mutated cancer cells even in the urine. It may be clinically usable for early diagnosis of bladder cancer.
Morphological and Pharmacological Characterization of Guinea‐Pig Prostatic Smooth Muscle Cells in Vitro
Authors: Mikuma Naohito , Furuya Seiji , Isomura Hiroshi , Yabu Hideo , Sawada Norimasa , Tsukamoto Taiji 
Published: July 2007

Background Prostatic smooth muscle is thought to play a major role in the pathogenesis of bladder outlet obstruction in patients with benign prostatic hypertrophy. However, the physiology of prostatic smooth muscle cells remains largely unknown, in part due to the lack of a suitable model system. We therefore sought to establish an in vitro culture of guinea pig prostatic smooth muscle cells. Methods: Immature guinea pig prostate was treated by enzymatic digestion and the cells obtained were used to initiate the primary culture. After 3 to 4 passages, cultured smooth muscle cells were examined morphologically by immunocytochemistry and electron microscopy. The contractile properties of cultured smooth muscle cells were also examined. Results The cultured prostatic cells demonstrated hill and valley morphology, which is a hallmark of smooth muscle cells in vitro, and stained positively for desmin. In addition, electron microscopic examination of ultrastructural morphology revealed myofilaments. Confluent cultures of prostatic smooth muscle cells showed a clear, dose‐dependent contractile response to phenylephrine. Furthermore, contraction of the prostatic smooth muscle cells by 10‐6 mol/L phenylephrine was completely inhibited by pretreatment with 10‐6 mol/L terazosin. Conclusions An in vitro culture of prostatic smooth muscle cells was established. This culture is likely to provide a powerful tool for elucidating the physiology and pathophysiology of prostatic smooth muscle.
Role of ATP and Related Purine Compounds on Urethral Relaxation in Male Rabbits
Authors: Ohnishi Norio , Park Young‐Choi , Kurita Takashi , Kajimoto Noriyoshi 
Published: July 2007

Background Non‐adrenergic, non‐cholinergic (NANC) relaxation evoked by electrical field stimulation (EFS) has been observed in the urethra, with nitric oxide (NO) considered the agent most probably mediating this effect. However, Burnstock's purinergic hypothesis suggests that ATP and related purine compounds are neurotransmitters in NANC relaxation, although the physiological and pharmacological effects of ATP and related purine compounds in the urethra have been little studied. Methods The effects of ATP and related purine compounds, NG‐nitro‐L‐arginine (NOARG; an inhibitor of nitric oxide synthesis from l‐arginine), calcitonin gene‐related peptide (CGRP), substance P and vasoactive intestinal polypeptide (VIP) on relaxation and smooth muscle tension induced by electrical field stimulation (EFS) were studied in isolated male rabbit circular urethral smooth muscle (functional study). In addition, the outflow of ATP elicited by EFS was measured using the luciferase technique (superfusion study). All experiments were performed in the presence of guanethidine (3 times 10‐3 mol/L) and atropine (10‐6 mol/L). Results In preparations contracted with U46619, a prostaglandin peroxidase inhibitor, ATP had almost no effect on EFS‐induced relaxation; however, suramin, a non‐selective P2)‐purinoceptor antagonist, and NOARG each markedly attenuated this relaxation in a concentration‐dependent manner. ATP and related purine compounds (adenosine, AMP and ADP) each reduced U46619‐induced tonic contraction in a concentration‐dependent manner. The potencies of the relaxant effects of ATP and these purine compounds were almost the same. In preparations contracted with U46619, CGRP and substance P had no effect on tonic contraction, but VIP reduced tonic contraction in a concentration‐dependent manner. In the superfusion study, the outflow of ATP into the superfusate was markedly increased by EFS. When NOARG or prazosin was added to the superfusate, the increase in outflow of ATP was unchanged, but when suramin was added to the superfusate, no increase in outflow of ATP was observed. Conclusions These findings suggest that P2)‐purinoceptors exist in the male rabbit urethra, and that ATP and related purine compounds may play a role in non‐adrenergic, non‐cholinergic neurotransmission. Consequently, the pathways mediating urethral relaxation by ATP, NO and VIP may be different.
Endoscopic Injection of Collagen for the Treatment of Female Urinary Stress Incontinence
Authors: Ang Leonard Pek Kiang , Tay Kah Phuan , Lim Peter Huat Chye , Chng Hong Chee 
Published: July 2007

Background The objective of our study was to assess the efficacy and safety of glutaraldehyde cross‐linked collagen injection in the treatment of female urinary stress incontinence. Methods We conducted a retrospective analysis of the records of 105 women who underwent collagen injection for urinary stress incontinence between March 1991 and April 1995. Preoperative assessment included uroflowmetry, residual urine determination, and urodynamic studies. Results Of the 105 women in our series, 95 patients (90.5%) had initial successful results at 3 months (61.0% cured, 29.5% significantly improved) while 4 patients (3.8%) had slight improvement and 6 (5.7%) failed surgical correction. One year after the procedure, the success rate dropped to 81.9% (86 patients) with 46.7% cured and 35.2% significantly improved. Nine patients (8.6%) had slight improvement and 10 patients (9.5%) failed surgical correction. Eight patients (7.6%) with initial unsatisfactory results underwent additional sessions of collagen injection and were subsequently either cured or had significant improvement. Twenty‐three patients (21.9%) suffered a relapse. The mean time to relapse was 13.3 months, and 6 of those who relapsed underwent repeated injections with favorable results. Complications were minimal; 6 patients had temporary retention of urine, and 2 patients had urinary tract infections. Conclusions We conclude that glutaraldehyde cross‐linked collagen injection is a simple and safe method of treatment for urinary stress incontinence. A longer follow‐up period is necessary to assess the long‐term efficacy of this treatment.
Electron Microscopic Study of the Penile Plaques and Adjacent Corpora Cavernosa in Peyronie's Disease
Authors: Hirano Daisaku , Takimoto Yukie , Yamamoto Tadao , Hirakata Hitoshi , Kawata Nozomu 
Published: July 2007

Background We conducted ultrastructural studies to clarify the fine structure of penile plaques and adjacent corpora cavernosa, and the causative basis for the process, in Peyronie's disease. Methods Penile plaques and adjacent corpora cavernosa were obtained during surgical extirpation from 5 patients with Peyronie's disease. Control tissues from the tunica albuginea and adjacent corpora cavernosa were obtained at penile amputation from 2 patients with penile cancer. Prepared tissues were examined by using electron microscopy. Results Penile plaques were composed of collagen fibrils, amorphous particulate material, and fibroblasts in all patients. In 1 of 5 patients, myofibroblasts were found in the border area between the lesion and underlying structures. Smooth‐muscle cells and endothelial cells resembling myofibroblasts were noted in adjacent corpora cavernosa. In this patient, the plaque progressively enlarged, and was removed within 1 year of onset of the induration. Conclusions Fibromatosis in Peyronie's disease involves both fibroblasts and myofibroblasts, which undergo sclerosis in some phase. In addition, smooth‐muscle cells and endothelial cells in the adjacent corpora cavernosa may be incorporated in the fibromatosis.
Pharmacokinetic Studies of Mycophenolate Mofetil in Rat Kidney Allograft Recipients
Authors: Inoue Hitoshi , Sugioka Nobuyuki , Hayashida Kazuhisa , Yasumura Tadaki 
Published: July 2007

Background A pharmacokinetic estimation of the immunosuppressive activity of mycophenolate mofetil (MPM) was performed in rats with transplanted kidney allografts. Methods Kidney allografts from Brown Norway rats were transplanted into Lewis rats using a microsurgical technique. MPM, at doses of 5, 10, 15 and 25mg/kg/day, was administered orally every day after transplantation. Pharmacokinetic studies were performed on days 7 and 14, and thereafter every 2 weeks. Results After the administration of MPM, the plasma concentration of mycophenolic acid (MPA) increased rapidly, peaking at 15 to 30 minutes, and then decreased biexponentially. The peak concentration of MPA and the area under the plasma MPA concentration versus time curves (AUC) significantly correlated with the dosage. MPM administration at 5 and 10mg/kg/day significantly prolonged the graft survival time from 7.1 days to 18.5 days and 85.0 days, respectively. The AUC values on day 7 after transplantation were 32.7,ug‐h/mL and 38.6/ig‐h/mL in rats receiving 5 and 10mg/kg/day, respectively. However, in rats receiving 1 5mg/kg/day of MPM or more, the AUC value at 7 days was 78.8,ug‐h/mL, and almost all of these rats died from gastrointestinal toxicity. Conclusion MPM monotherapy significantly prolonged rat kidney allograft survival, however, high dosages of MPM caused gastrointestinal toxicity. AUC measurements of the MPA concentration are suitable for the pharmacokinetic monitoring of MPM.