bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of prognostic factors related to primary superficial bladder cancer tumor recurrence in prophylactic intravesical epirubicin therapy
Authors: Kondo Tsunenori , Onitsuka Shiro , Ryoji Osamu , Kihara Takeshi , Goto Yukiko , Satoh Toshihiko , Nakazawa Hayakazu , Toma Hiroshi 
Published: March 2003

Purpose: The aims of the present study were to examine the effects of intravesical instillation of epirubicin on tumor recurrence and to identify tumors that are at a high risk of recurrence.Methods: Forty‐five patients with primary superficial bladder cancer were treated with prophylactic intravesical epirubicin following transurethral resection of the bladder tumor (TUR‐BT). Epirubicin (20 mg) was administered intravesically every second week for 4 months and then once a month or every 2 weeks for next 8 months. Patients were analyzed with respect to prognostic factors related to tumor recurrence.Results: The overall recurrence‐free rate, calculated using the Kaplan–Meier method, was 76.1 and 52.3% at 2 and 5 years after operation, respectively. These results were better than those reported for patients treated with TUR‐BT alone. A univariate analysis demonstrated that high‐grade, T1, sessile, large (≥ 2 cm) and multiple tumors were a significantly high risk for recurrence. A multivariate analysis performed by using the Cox proportional hazard model with stepwise selection showed that morphologic features (pedunculated or sessile) were the most prognostic factors for recurrence. This was followed by age and tumor size. The remaining four factors were not found to contribute significantly to recurrence.Conclusions: Epirubicin appears to be effective in preventing the recurrence of superficial bladder cancer. Morphologic features, patient age and size of the tumor were considered independent risk factors. The risk of recurrence for each tumor should be taken into consideration when the intravesical adjuvant therapy protocol is being selected.
Telomerase activity in human renal cell carcinoma
Authors: Fujioka Tomoaki , Hasegawa Michihiko , Suzuki Yasushi , Suzuki Tohru , Sugimura Jun , Tanji Susumu , Koike Hiroyuki 
Published: March 2003

Abstract
Purpose
: Telomerase activity has been detected in a wide variety of human tumors. The present study evaluated telomerase activity in association with the acquisition of renal cell carcinoma (RCC).
Methods
: Telomerase activity was examined in 30 RCC and the adjacent normal kidney tissue, obtained as surgical specimens. The activity was assayed by polymerase chain reaction‐based telomeric repeat amplification protocol assay.
Results
: Among the 30 RCC, 18 (60%) displayed telomerase activity, whereas none of the normal tissue samples exhibited it. Subdivision of the tumors according to telomerase activity did not reveal any obvious difference in distribution with regard to tumor size, stage, histocytological subtype, or DNA‐ploidy. However, a statistically significant relationship was found between the frequency of telomerase‐positive activity and both serum immunosuppressive acidic protein level in the patient and tumor grade (P < 0.05). There was no significant difference in the recurrent‐free survival and the disease‐specific survival between patients with positive telomerase activity and patients with negative activity.
Conclusion
: The present results indicate that telomerase activity might be related to the progression of RCC and thus a marker of malignant potential.
A case of eosinophilic cystitis in a 5‐year‐old boy
Authors: Sano Katsuyuki , Terashima Kazumitsu , Gotoh Kazuko , Ijiri Rieko , Tanaka Yukichi 
Published: March 2003

AbstractEosinophilic cystitis (EC) is rather an uncommon disease in childhood. A case of EC in a 5‐year‐old boy, in which open biopsy was needed for final diagnosis, is reported. After diagnosis, he was treated with pemirolast potassium followed‐up with eosinophil cationic protein (ECP) in serum and urine. Eosinophil cationic protein is an appropriate marker of EC.
Acute renal failure occurring from urinary retention due to a müllerian duct cyst
Authors: Abe Takashige , Shinno Yuichiro , Kawakura Koichi , Moriya Kimihiko 
Published: March 2003

AbstractA patient with a müllerian duct cyst, which caused acute renal failure secondary to urinary retention, is reported. The case was treated successfully by transurethral unroofing of the cyst.
Cystic renal cell carcinoma diagnosed by cystofiberscopy
Authors: Ikegaya H , Kato A , Matsushima H , Takai K , Hosaka Y , Kitamura T 
Published: March 2003

AbstractA 64‐year‐old man suffered from hypertensive syncope and was admitted to Branch Hospital, Faculty of Medicine, The University of Tokyo. On admission he had no symptoms; however, two renal cysts of about 5 cm in diameter were found in his left kidney. Cystofiberscopy with a thin optical fiberscope was performed in addition to puncture and cystography. Cytology revealed class I, but the wall surface of the lower cyst was uneven, fluid‐filled, colloid‐like and white‐gray compared with that seen in the upper cyst. It was diagnosed as renal cell carcinoma (RCC) and left nephrectomy was performed (5 cm in diameter, RCC, papillary tubular, common, clear cell subtype, G2 > G1, INF beta, pT2, pMx, pV0, ew(–)).
Telomerase activity in urine after transurethral resection of superficial bladder cancer and early recurrence
Authors: Wu Xiu‐Xian , Kakehi Yoshiyuki , Takahashi Takeshi , Habuchi Tomonori , Ogawa Osamu 
Published: March 2003

Abstract
Background
: To explore the relationship between telomerase activity in urine after transurethral resection (TUR) of superficial bladder cancer and early intravesical recurrence.
Methods
: Urine samples were obtained from 42 patients with superficial bladder cancers prior to TUR and on the postoperative day 1 and day 6. These patients were followed‐up prospectively by cystoscopy at 3 and 6 months after TUR in combination with urinary cytology and telomerase activity. Telomerase activity in the urine was assessed by the telomeric repeat amplification protocol assay.
Results
: Urinary telomerase activity prior to TUR was positive in 24 (57%) of the 42 patients. On the postoperative day 1 and day 6, positive urinary telomerase activity was seen in 13 (31%) and nine (21%) patients, respectively. Postoperative urinary telomerase activity on either day 1 or day 6 was significantly associated with pre‐operative urinary telomerase activity status (P = 0.0024). Fifteen patients showed intravesical tumor recurrence at 3 months cystoscopic check‐up and an additional nine had recurred at the 6 months check‐up. Recurrence rate within 6 months in patients with pre‐operative positive urinary telomerase activity was similar to that in those with negative activity (58.3 vs 58.8%). However, recurrence rate at 3 months for patients with positive activity was higher than that of those with negative activity (50 vs 17.7%), in 23 patients treated only by TUR.
Conclusions
: Presence of cells positive for telomerase activity in urine after TUR of superficial bladder cancer indicates persistently existing cancer cells in the urine. It is, however, not a sole predictor of the early intravesical recurrence.
Trends and characteristics in prostate cancer mortality in Japan
Authors: Nakata Seiji , Takahashi Hirotomo , Ohtake Nobuaki , Takei Tomoyuki , Yamanaka Hidetoshi 
Published: March 2003

Abstract
Background
: In North America, the incidence and mortality of prostate cancer has been declining since the early 1990s. We calculated the age‐adjusted death rates, age‐specific death rates and standardized mortality ratio (SMR) for prostate cancer in Japan and analyzed their features.
Methods
: Yearly age‐adjusted death rates for prostate cancer were calculated by dividing the number of events by the population at risk, with direct standardization to the world population. Age‐specific death rates were calculated for the 1970s, 1980s and 1990s and which age group showed the highest rate of increase was examined. The SMR in each prefecture was also calculated for each period.
Results
: The respective number of deaths and the age‐adjusted death rate was 1107 and 2.29 in 1973 and 6251 and 5.15 in 1997. The age‐specific death rates showed an exponential increase with age in all three periods and the rate of increase was higher in older age groups. The distribution of SMR showed the same tendency in all three periods. The prefectures with significantly high or low SMR were distributed in clusters.
Conclusions
: The prostate cancer death rate is increasing rapidly in Japan. However, the age‐adjusted death rate has remained stable from 1996 to 1997. How this figure will change and whether the prostate cancer death rate in Japan will begin to decline, like in North America, is of interest. The prefectures with significantly high or low SMR showed a characteristic clustered distribution pattern.
Prediction of organ‐confined disease by prostate‐specific antigen nadir after neoadjuvant therapy
Authors: Hachiya Takahiko , Minei Sadatsugu , Kobayashi Ken‐Ichirou , Ishida Hajime , Okada Kiyoki 
Published: March 2003

Abstract Background It is not clear whether or not serum prostate‐specific antigen (PSA) levels after androgen deprivation prior to radical prostatectomy (neoadjuvant therapy) have any value in the prediction of the final pathologic stage.Methods We conducted a study on 49 patients who underwent retropubic radical prostatectomy following neoadjuvant therapy for clinical stage T1c, T2, and T3a prostate cancer. We evaluated progression‐free survival based on the PSA failure rate and the predictive value of the PSA nadir after neoadjuvant therapy and other clinical factors to determine the most important predictor of organ confinement.Results Of the 49 patients, 30 had organ‐confined disease. Of 31 patients without adjuvant therapy after surgery, the PSA failure‐free rates at 2 years were 81.6 and 34.3% in the subset of organ‐confined disease and non‐organ‐confined disease, respectively (P = 0.0031). Of the 18 patients with adjuvant androgen deprivation therapy after surgery, the PSA failure‐free rate at 2 years was 100% and 59.7% in patients with organ‐confined disease and non‐organ‐confined disease, respectively. Baseline PSA (P = 0.037), PSA nadir (P < 0.0001) and PSA density (P = 0.003) significantly correlated with organ confinement. Multivariate logistic regression analysis revealed that the PSA nadir was the only independent predictor of organ confinement (P = 0.044).Conclusions There was a trend that the patients with non organ‐confined disease had a higher probability of PSA failure than did the patients with organ‐confined disease. The PSA nadir after neoadjuvant therapy was the strongest predictor of organ confinement. The predictive value of the serum PSA nadir should be validated in well‐designed larger population‐based studies.
Secondary amyloidosis of the bladder causing macroscopic hematuria
Authors: Oka Natsuo , Fukumori Tomoharu , Takahashi Masayuki , Kanayama Hiro‐Omi , Kagawa Susumu 
Published: March 2003

AbstractBladder involvement in amyloidosis is unusual. The case of an 80‐year‐old man with macroscopic hematuria caused by secondary amyloidosis of the bladder is described. Cystoscopic examination revealed only a diffuse edematous area and bleeding. No tumor‐like lesions were identified. Transurethral biopsy revealed amyloid deposits. Macroscopic hematuria disappeared spontaneously after cystoscopy and bladder biopsy. The patient has been followed up without treatment and is currently free of symptoms.
Retroperitoneal cystic metastasis from a small clear cell renal carcinoma
Authors: Ishii Nobuyuki , Yonese Junji , Tsukamoto Tetsurou , Maezawa Takuya , Ishikawa Yuuichi , Fukui Iwao 
Published: March 2003

AbstractA 39‐year‐old housewife was referred to our hospital for the treatment of a small renal tumor. A 25 × 35 mm cystic mass that had been detected by computerized tomography scan just caudal to the renal hilus proved to be a metastasis from the renal carcinoma of clear cell type. The pathogenesis may have been due to tumor cells obstructing a lymphatic vessel draining the kidney. Cystic metastasis from renal cell carcinoma is very rare and this appears to be the second published case in the world.
Post‐traumatic high flow priapism: Demonstrable findings of penile enhanced computed tomography
Authors: Suzuki Kazumi , Nishizawa Shuji , Muraishi Osamu , Fujita Akifumi , Hyodoh Hideki , Tokue Akihiko 
Published: March 2003

AbstractPost‐traumatic high flow priapism is a rare disease. A review of English published reports revealed 63 cases. Enhanced computed tomography (CT) of the penis has not previously been used as a diagnostic method for post‐traumatic high flow priapism. We present a case of post‐traumatic high flow priapism diagnosed with enhanced CT of the penis. Additionally, diagnostic modalities for post‐traumatic high flow priapism are discussed with review of published work.
Extracorporeal shock wave lithotripsy produces a lower stone‐free rate in patients with stones and renal cysts
Authors: DELIVELIOTIS CHARALAMBOS , ARGIROPOULOS VASILIOS , VARKARAKIS JOHN , ALBANIS STEFANOS , SKOLARIKOS ANDREAS 
Published: March 2003

Abstract Background: Renal cysts have a space‐occupying effect and therefore can distort the pelvicalyceal anatomy. This distortion often produces abnormalities in normal urinary drainage. In the same way, it may effect the ability of the kidneys to become stone free after extracorporeal shock wave lithotripsy (ESWL). The purpose of the current study is to evaluate the effect of renal cysts on the outcome of ESWL.Methods: We studied 15 patients who had renal stones and coexistent renal cysts. Four patients had polycystic disease, five patients had multiple cysts and six patients has solitary ones. All cysts produced a distortion to the calyceal system of the kidneys, a fact confirmed by intravenous urography (IVU) and computed tomography (CT). All patients underwent ESWL and their stone‐free status was evaluated 1 month later by ultrasound and plain kidney ureter bladder (KUB) X‐ray.Results: We had a total 60% (9/15) stone‐free patients in our study group and a stone fragmentation rate of 100%. Patients with more cysts had lower stone‐free rates. Patients with polycystic kidneys had a 25% (1/4) stone‐free rate, while patients with multiple cysts and solitary cysts had, 60% (3/5) and 83.3% (5/6), respectively. These results are lower than the rates reported in patients without renal cysts.Conclusions: We believe that renal cysts may interfere with the passage of stone fragments, due to the impediment of drainage and urinary stasis from the stretching and distortion of the calyceal system by the renal cysts.
Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behçet's syndrome
Authors: Evereklioglu Cem , Özbek Emin , Er Hamdi , Çekmen Mustafa , Yürekli Muhittin 
Published: March 2003

AbstractBackground: The objective was to measure urinary adrenomedullin (AM) levels in patients with active or inactive Behçet's syndrome and compare them to levels in healthy control subjects.Methods: Forty‐five consecutive patients with Behçet's syndrome (20 men and 25 women with a mean age of 37.7 ± 10.8 years) and 20 age‐ and sex‐matched healthy hospital staff volunteers as control subjects (nine men and 11 women with a mean age of 36.2 ± 10.4 years) were studied. Urinary and plasma AM concentrations were measured by high‐performance liquid chromatography. We also investigated whether disease activity correlates with urinary and plasma AM levels. The Mann–Whitney U‐test was used in statistical analysis and the values were expressed as mean ± SD.Results: Urinary excretion of AM (pmol per mg urinary creatinine) in patients with Behçet's syndrome (81.3 ± 35.1) was significantly higher (P < 0.001) than in control subjects (31.2 ± 16.1). Plasma AM levels (pmol/L) in patients with Behçet's syndrome and controls were 69.1 ± 19.2 and 20.7 ± 11.8, respectively; the difference was significant (P < 0.001). Although active Behçet's syndrome patients (n = 22) had higher urinary AM levels (92.1 ± 41.1) compared to inactive (n = 23; 70.8 ± 32.2), the difference was not significant (P > 0.05). Plasma AM levels in active Behçet's syndrome patients (77.5 ± 21.2) were also higher than in inactive (61.6 ± 17.3), but the difference was not significant (P > 0.05).Conclusion: Urinary AM levels were higher in Behçet's patients than in control subjects. Urinary AM levels were correlated with plasma AM levels. The results suggest that the higher AM levels found in the urine may be produced by the kidney as a result of the stimulation of inflammation during the course of Behçet's syndrome, or may come from plasma, as plasma AM levels were increased. However, the exact sites of AM synthesis by the kidney (e.g. glomeruli, blood vessels and/or tubular cells) could not be determined in this study. Further studies in this respect are necessary.
Neoadjuvant androgen withdrawal prior to external radiotherapy for locally advanced adenocarcinoma of the prostate
Authors: Hara Isao , Miyake Hideaki , Yamada Yuji , Takechi Yoshizumi , Hara Shoji , Gotoh Akinobu , Fujisawa Masato , Okada Hiroshi , Arakawa Soichi , Soejima Toshinori , Sugimura Kazuro , Kamidono Sadao 
Published: March 2003

AbstractBackground: It is unclear whether positive interactions between radiation and androgen withdrawal for patients with locally advanced prostate cancer is synergistic or additive. The present study aimed to clarify the significance of neoadjuvant androgen ablation prior to external radiotherapy in a human prostate LNCaP tumor model and in patients with locally advanced prostate cancer.Methods: Comparisons were made between the effect of castration prior to radiation on the growth of subcutaneous LNCaP tumors implanted into male nude mice and their serum prostate‐specific antigen (PSA) levels, and the results of castration or radiation alone. Twenty‐nine patients with histologically proven and locally advanced adenocarcinoma of the prostate were treated with luteinizing hormone‐releasing hormone analog at least 3 months before, during, and after external radiation therapy with a total dose of 70 Gy. The toxicity and response to this therapy were evaluated.Results: Treatment combining castration and radiation resulted in synergistic inhibition of LNCaP tumor growth and a significant delay in the emergence of androgen‐independent recurrence as opposed to either treatment alone. The external radiotherapy was completed in 28 patients (96.6%), resulting in a reduction of serum PSA levels in all 28 patients to below 1.0 ng/mL. All patients were alive after a mean follow‐up period of 34 months (range 11–53) with a 3‐year PSA relapse‐free survival rate of 83.7%. Among several factors examined, only the Gleason score was significantly associated with PSA relapse‐free survival in univariate analysis, but not in multivariate analysis. Thirteen of 28 patients (46%) and 7 of 28 (25%) also showed at least one form of gastrointestinal or genitourinary toxicity, respectively. Of these patients, 8 with gastrointestinal toxicities, and 1 with genitourinary toxicity, experienced acute complications higher than grade 3.Conclusion: The experimental findings objectively suggested the use of neoadjuvant androgen withdrawal prior to radiation therapy. Although our clinical experience is preliminary, combined androgen ablation and radiation therapy may also be effective in controlling locally advanced prostate cancer, with tolerable side‐effects.
Factors associated with failure of extracorporeal shock‐wave lithotripsy for ureteral stones using Dornier lithotripter U/50
Authors: Shiroyanagi Yoshiyuki , Yagisawa Takashi , Nanri Masayuki , Kobayashi Chika , Toma Hiroshi 
Published: March 2003

AbstractBackground : In the present series of 170 patients who underwent extracorporeal shock‐wave lithotripsy (SWL) treatment for ureteral stones, the authors determine which patients with ureteral stones had an unsuccessful outcome.Methods: The records of 170 patients with ureteral stones who were treated with SWL using the Dornier lithotriptor U/50 (EMSE 140) between January 1998 and December 1999 were retrospectively investigated. One hundred and thirty‐one patients were treated with SWL alone (single session, n = 98; multiple session, n = 33) and 39 patients required auxiliary treatment due to failure of SWL (33 with transurethral ureterolithotripsy (TUL), one with open lithotomy, and five with residual fragments who were followed up). These two groups were compared using multivariate logistic regression analysis.Results : Lower ureteral stones and stones more than 12 mm in diameter were associated with a poor outcome of SWL. There were no significant differences in age, gender, number of stones, JJ stent placement, and degree of ureteral obstruction due to the stone between the two groups. The odds ratios of lower ureteral stones and stones ≥ 12 mm were 4.18 and 2.57, respectively.Conclusion : Patients with distal ureteral stones and/or stones more than 12 mm in diameter were difficult to treat successfully with SWL. Alternatives such as TUL should possibly be considered as a first‐line therapy for these stones.
Surgical reconstruction of exstrophy–epispadias complex: Analysis of 13 patients
Authors: Sujijantararat Phichaya , Chotivichit Areesak 
Published: March 2003

AbstractBackground : Because exstrophy–epispadias complex is uncommon and satisfactory surgical reconstruction outcomes are difficult to achieve, the surgical repairs by one surgeon (PS) were analysed over a 14‐year period.Methods : Retrospective analysis was performed on 13 patients with the complex who underwent surgery between January 1986 to August 2000. Cosmesis and continence were evaluated. Complications including wound dehiscence and urethrocutaneous fistula were reported.Results : Of six patients with classical exstroply who underwent functional bladder closure, all had good cosmesis except one who had partial dehiscence. Four patients with isolated epispadias had satisfactory cosmesis. Urethrocutaneous fistula was found in one boy in the classical exstrophy group. Continence was achieved in three out of four patients who had bladder neck reconstruction. One girl whose bladder neck was severely obstructed after functional bladder closure, had continent catheterizable stoma.Conclusion : Functional bladder closure yielded satisfactory cosmetic outcome. Bladder neck reconstruction made the patient dry in 75% of cases.
Massive hematuria after cystoscopy in a patient with an internal iliac artery aneurysm
Authors: Honma Ichiya , Takagi Yoshio , Shigyo Masanori , Sunaoshi Kenichi , Inaoka Masami , Miyao Noriomi 
Published: March 2003

AbstractAn unusual case is reported here of a patient with internal iliac artery aneurysm who developed massive hematuria after cystoscopic examination. A 75‐year‐old man presented with asymptomatic gross hematuria. Cystoscopic examination revealed that the bladder neck was congested and that the right‐side wall was being pressed on by an extrinsic mass. Computed tomography showed a right internal iliac artery aneurysm and tortuous perivesical vessels. Three days after the cystoscopic examination the patient suffered massive hematuria. Hemorrhage due to an arteriovesical or arterio‐ureteral fistula secondary to rupture of the internal iliac artery aneurysm was suspected, and an emergency operation was performed. At operation the aneurysm had not ruptured but overswelling perivesical vessels were found to have developed, and these fed a high blood flow to the bladder neck. In the present case cystoscopic examination injured the mucosa and led to massive hemorrhage from the bladder neck.