bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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

AbstractThe 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

Abstract
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

AbstractA 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

AbstractA 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.
Expression and somatic mutation on androgen receptor gene in prostate cancer
Authors: SEGAWA NAOKI , NAKAMURA MISA , SHAN LIANG , UTSUNOMIYA HIROTOSHI , NAKAMURA YASUSHI , MORI ICHIRO , KATSUOKA YOJI , KAKUDO KENNICHI 
Published: March 2003

AbstractBackground: Lack of androgen receptor (AR) expression or mutation on the AR gene creates the tendency for androgen independence and progression of prostate cancer. However, the association between the progression and AR expression or mutations is still controversial. In this study, we evaluated the prognostic significance of AR expression and mutations in prostate cancers.Methods: Forty‐two prostate adenocarcinomas and three lymph node metastatic lesions sampled prior to hormonal therapy were included in this study; AR expression was analyzed immunohistochemically using an antibody against AR and the result was scored as the percentage of AR‐positive tumor cells in the total tumor cells. Polymerase chain reaction–single‐strand conformational polymorphism (PCR‐SSCP) analysis and DNA sequencing were used to detect AR mutations.Results: Our study revealed the average AR expression in the prostate adenocarcinoma was 52.2 ± 27.1%, which was significantly lower than that in the adjacent non‐tumorous prostate tissue (68.3 ± 18.3% in average) (P < 0.001). A significant correlation was obtained between progression‐free survival and AR expression (P < 0.01). By SSCP analysis, three silent mutations (T649T, E709E and E711E) were detected in three separate prostate carcinomas.Conclusion : We conclude that AR expression is a useful prognostic indicator for tumor progression. Androgen receptor mutation may be an uncommon molecular event in untreated prostate cancer in Japanese men.
Antitumor effect of reduction of 150‐kDa oxygen‐regulated protein expression on human prostate cancer cells
Authors: MIYAGI TOHRU , HORI OSAMU , KOSHIDA KIYOSHI , EGAWA MASAYUKI , KATO HIROAKI , KITAGAWA YASUHIDE , OZAWA KENTARO , OGAWA SATOSHI , NAMIKI MIKIO 
Published: March 2003

AbstractBackground: The 150‐kDa oxygen‐regulated protein ORP150, a new member of the heat shock protein family that functions as a molecular chaperone in the endoplasmic reticulum, was found to increase in infiltrating cancer cells. Since enhancement of ORP150 expression and the presence of vascular endothelial growth factor (VEGF) in human prostate cancer glands were immunohistochemically demonstrated, we examined whether transduced antisense ORP150 cDNA can reduce angiogenicity and tumorigenicity through suppression of VEGF secretion.Methods: Human prostate cancer specimens were immunohistochemically stained with fluorescein isothiocyanate (FITC) for ORP150 or vascular endothelial growth factor (VEGF). An adenovirus vector (Ad) carrying antisense ORP150 cDNA (AdCA‐Antisense ORP150) was constructed and infected to prostate cancer DU145 cells. Expression of ORP150 in the cells was analyzed with western blotting and secretion of VEGF into the supernatant with an enzyme‐linked immunoabsorbent assay (ELISA). Angiogenicity was evaluated by chorioallantoic membrane (CAM) assay. A nude mouse xenograft model was used to examine tumorigenicity.Results: Immunohistochemical study proved that the expression of ORP150 and VEGF was enhanced in the cytoplasm of prostate cancer cells. The Ad showed 100% transduction efficiency and minimum cytotoxicity when the cells were infected at a multiplicity of infection (MOI) of 20 for 24 h. Expression of ORP150 was substantially reduced by the antisense treatment. Secretion of VEGF into the culture supernatant was reduced to 30%. Consequently, the CAM assay showed relatively low angiogenicity, while marked suppression of tumor formation was observed in the xenograft model.Conclusion: Adenoviral‐mediated antisense ORP150 cDNA transfer is well worth considering as an option for prostate cancer gene therapy.
Histologically benign but telomerase positive adrenal pheochromocytoma
Authors: HIRANO YASUHIRO , NOBATA SYUNSUKE , TAKAHASHI HISAYA , KAGEYAMA SHINJI , SUDOKO HIROSHI , USHIYAMA TOMOMI , SUZUKI KAZUO , FUJITA KIMIO 
Published: March 2003

AbstractAdrenalectomy was performed on a 37‐year‐old woman with right adrenal pheochromocytoma. Although the histological diagnosis was benign, telomerase repeat amplification protocol (TRAP) demonstrated positive telomerase activity. Thirty‐five months after adrenalectomy, a recurrent tumor was found. Forty‐seven months after adrenalectomy, bone metastases also appeared. Malignant pheochromocytoma was clinically diagnosed. Our experience suggests that telomerase‐positive tumor cells are highly likely to repeat cell proliferation when they are left in the patient's body, and lead to recurrence. Therefore, telomerase‐positive tumors should be clinically treated as malignant even if they have been histologically diagnosed as benign.
Testicular sperm extraction using microdissection for non‐obstructive azoospermia
Authors: Hibi Hatsuki , Taki Tomohiro , Yamada Yoshiaki , Honda Nobuaki , Fukatsu Hidetoshi , Yamamoto Masanori , Asada Yoshimasa 
Published: March 2003

Background
: Men presenting with non‐obstructive azoospermia (NOA) caused by germinal failure can now be treated in some cases using testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). However, TESE is a blind procedure that does not identify the focal sperm‐producing areas until excision of the testicular tissue. Microdissection TESE, which is the only method available for obtaining excised dilated seminiferous tubules under the operating microscope, improves sperm yield with minimal tissue excision in NOA patients.
Methods and Results
: We performed this procedure on 16 NOA patients. All subjects underwent a microdissection TESE on the right testis, and triple biopsy on the left testis in consecutive fashion in order to compare the efficacy of microdissection TESE with that of a standard biopsy. Although dilated seminiferous tubules were presented in all patients, spermatozoa were retrieved in only a single patient by microdissection TESE. Furthermore, spermatozoa could not be identified by standard biopsies.
Conclusion
: In this series, microdissection TESE did not contribute to spermatozoa recovery in NOA patients. Further study is needed in order to arrive at a reliable assessment of microdissection TESE relative to a standard multiple biopsy in cases of NOA. (Reprod Med Biol 2002; 1: 31–34)
Quadriceps muscle wasting persists 5 months after total hip arthroplasty for osteoarthritis of the hip: a pilot study
Authors: Reardon K. , Galea M. , Dennett X. , Choong P. , Byrne E. 
Published: March 2003

Abstract Aims: To determine whether additional muscle fibre wasting of the ipsilateral vastus lateralis muscle occurs in the early postoperative period after total hip arthroplasty for osteoarthritis of the hip and whether there is an improvement in preoperative measures of quadriceps muscle thickness, strength, pain and function over a 5‐month postoperative period. Methods: Twelve patients had ipsilateral needle quadriceps biopsy for muscle morphology and bilateral quadriceps muscle thickness ultrasound preoperatively, 5 days and 4 weeks postoperatively and a further muscle thickness measurement at 5 months. Seven additional patients and five age‐matched control subjects had bilateral quadriceps muscle ultrasound thickness preoperatively, 6 weeks and 5 months postoperatively, with assessment of quadriceps muscle dynamometry, pain scores and Timed Up and Go (TUG) test. Results: Preoperatively, all 19 patients demonstrated significant atrophy of the ipsilateral compared with the contralateral quadriceps muscle (P = 1.8 × 10–7) on muscle ultrasound, which persisted at 5 months follow up (P = 0.009). Muscle morphology preoperatively showed type 2A and 2B muscle fibre atrophy on needle muscle biopsy, with further atrophy of all three fibre types (P = 0.029) at 5 days postoperatively associated with a fibre type shift from type 1 to 2A fibres (P = 0.0011) at 1 month. There was improvement in hip pain postoperatively and a significant improvement in the TUG test (P = 0.007). However, there was no improvement in muscle strength on dynamometry. Conclusions: There is significant ipsilateral quadriceps atrophy and weakness with 2A and 2B fibre atrophy preoperatively in patients with osteoarthritis of the hip with exacerbation and further atrophy of all three fibre types 5 days postoperatively. Postoperative follow up showed that the reduction in ipsilateral quadriceps muscle thickness persisted at 5 months despite physical rehabilitation. Patients did note significant improvement in pain postoperatively and improvement on functional assessment with the TUG test. Other therapeutic strategies may have to be developed to reverse disuse muscle atrophy. (Intern Med J 2001; 31: 7–14)
Variegate porphyria in Western Australian Aboriginal patients
Authors: Rossi E. , Chin C. Y. B. , Beilby J. P. , Waso H. F. J. , Warnich L. 
Published: March 2003

AbstractBackground:  Survivors of shipwrecks along the Western Australian coast may have introduced a mutation for variegate porphyria into the Aboriginal population prior to first settlement.Aims:  To assess the mutations responsible for variegate porphyria in Western Australian Aboriginal patients, particularly the R59W mutation, which is the most common cause of variegate porphyria in South Africa.Methods:  New cases of porphyria were diagnosed by biochemical separation of porphyrin subtypes. Single‐stranded conformation polymorphism analysis and DNA sequencing of the protoporphyrinogen oxidase gene was performed on Aboriginal patients to define possible causative mutation sites.Results:  Of the 296 new cases of porphyria diagnosed in Western Australia from 1978 to 1998, six had biochemically proven variegate porphyria. Three of those cases occurred in Aboriginal patients. Evidence for a possible fourth Aboriginal case of variegate porphyria is described. The R59W founder mutation respons­ible for over 90% of variegate porphyria in South Africa was excluded. Two new mutations that predicted amino acid substitutions with significant effects on enzyme function were detected in conserved regions of the protoporphyrinogen oxidase gene in one Aboriginal variegate porphyria patient and the possible fourth case.Conclusion:  Results suggest that the mutations causing variegate porphyria in the Western Australian Aboriginal population occur sporadically and were not inherited from shipwrecked sailors. (Intern Med J 2002; 32: 445−450)
Guillain−Barré syndrome and hyponatraemia
Authors: Colls B. M. 
Published: March 2003

Abstract Background : Hyponatraemia is a recognized association of the Guillain−Barré syndrome (GBS) and is also known to occur after the administration of intravenous infusion of gamma globulin (IVIG), a treatment often used in management of GBS.Aims : To document serum sodium concentration in GBS patients before, during and after management procedures (including IVIG) positive pressure ventilation (PPV) and the use of medications capable of causing a low serum sodium. To consider whether pseudohyponatraemia might be a contributory factor. To assess whether hyponatraemia is a predictor of poor outcome.Methods : Clinical record audit of 84 patients with GBS admitted to Christchurch Hospital, New Zealand, over a 10‐year period.Results : Serum sodium concentration was significantly low (<133 mmol/L) in 26 of 84 (31%) patients. In 12 of these cases the hyponatraemia developed during or after IVIG, suggesting that pseudo­hyponatraemia was a contributing factor. Six (7%) significantly hyponatraemic patients died, but no eunatraemic or slightly hyponatraemic patient died (P = 0.001). Six of 38 patients aged ≥50 years died, whereas none of the 46 patients aged <50 years died (P = 0.007). Five of 19 ventilated patients died but only one of 65 non‐ventilated died (P = 0.002).Conclusions : Significant hyponatraemia occurred in 26 (31%) of the patients, but in 12 of these it appeared likely that pseudohyponatraemia caused by IVIG was a contributing factor. Hyponatraemic patients have a poorer prognosis than eunatraemic patients, however it is difficult to separate this factor from other poor prognostic factors (older age and PPV). (Intern Med J 2003; 33: 5−9)
Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery
Authors: Goodarzi Mashallah 
Published: March 2003

SummaryThe safety and side‐effects profile of epidural administration of a hydrophilic (morphine), highly lipophilic (fentanyl) and a drug with intermediate hydrophilic and lipophilic activity (hydromorphone) were compared in 90 children undergoing orthopaedic procedures. Ninety patients were randomly assigned (30 in each group) to receive epidural morphine, hydromorphone, or fentanyl for postoperative analgesia. Respiratory effects, nausea, somnolence, urinary retention, pruritus and visual pain scales were evaluated and compared during a 30‐h period following surgery. In the morphine group, 25% showed respiratory depression with oxygen saturation below 90% but there was no incidence of respiratory depression in the fentanyl or hydromorphone groups. Somnolence was prominent in some of the patients in all the groups, but was more prolonged in the morphine group. Statistically, there was no significant difference in nausea between the groups, but pruritus was more severe and frequent in the morphine group. The incidence of urinary retention in the morphine group was higher compared with the fentanyl and hydromorphone groups. In conclusion, epidural hydromorphone, demonstrating less side‐effects, is preferable to morphine and fentanyl for epidural analgesia in children.