bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of prostatic cancer metastasizing to the orbit
Authors: INAGAKI TAKESHI , EBISUNO SHOICHI , MIYAI MASAHIRO , NAKAMURA JUN 
Published: March 2003

Purpose: We report on a case of prostatic cancer with multiple bone metastases, including right orbital involvement.Methods/Results: Hormonal treatment and local irradiation to the right orbit were performed. Subjective symptoms with exophthalmos and pain disappeared.Conclusions: We report on a case of prostatic cancer metastasizing to the right orbital bone.
Hamartoma of the urinary bladder
Authors: Ota Tomonori , Kawai Koji , Hattori Kazunori , Uchida Katsunori , Akaza Hideyuki , Harada Masaoki 
Published: March 2003

Background: Hamartomas of the urinary bladder are extremely rare. We report on a case in a 58‐year‐old female who presented with the chief complaint of pain on urination.Methods/Results: Cystoscopy revealed a solid tumor on the left posterior wall of the bladder. Transurethral resection of the tumor failed to provide a definitive pathological diagnosis of the tumor. Thus, we performed partial cystectomy. The pathological diagnosis was hamartoma arising from the urinary bladder.Conclusion: This is the ninth case diagnosed as urinary bladder hamartoma to be reported in the literature.
Enterocolitis with pathogenic Escherichia coli infection in renal transplant recipients: Case reports
Authors: Watarai Yoshihiko , Takeuchi Ichiro , Usuki Tomoaki , Hirano Tetsuo , Koyanagi Tomohiko 
Published: March 2003

Abstract
Purpose
: We report three cases of enterocolitis associated with pathogenic Escherichia coli infection in renal transplant recipients.
Methods/Results
: Patients presented with abdominal pain and diarrhea at 1, 3 and 7 years after living‐related renal transplantation. Pathogens of enterocolitis were identified by stool culture as verotoxin‐2‐producing O157:H7 E. coli, non‐verotoxin‐producing E. coli 06 and 0125. All patients were basically treated with fluid replacement with additional fosfomycin administration in the patient with O157:H7 E. coli infection. Immunosuppressive drugs were kept at maintenance doses throughout the treatment.
Conclusion
: All patients recovered uneventfully within 10 days after the onset of enterocolitis without severe complications.
Extracorporeal shock wave lithotripsy for a ureteral stone in crossed fused renal ectopia
Authors: Kato Masanori , Ioritani Naomasa , Aizawa Masataka , Inaba Yasuo , Watanabe Ryuji , Orikasa Seiichi 
Published: March 2003

Abstract Background: A 63‐year‐old woman presented with right flank pain and macroscopic hematuria.
Results/Methods
: A plain film showed a calcific shadow on the right iliac bone. On excretory urography, the right kidney was seen in the normal position, but the left kidney was not. Bilateral retrograde pyelogram revealed the S‐shaped kidney and mild obstruction from a 12 × 5 mm calculus in the proximal ureter of the crossed kidney. The patient was successfully treated with in situ extracorporeal shock wave lithotripsy (ESWL) treatment and is stone free at 1 month follow up.
Conclusion
: We believe this is the first case of successful ESWL in a crossed kidney.
Primary malignant melanoma of the male urethra
Authors: Watanabe Jun , Yamamoto Shingo , Souma Takahito , Hida Shuichi , Takasu Kosho 
Published: March 2003

Abstract
Background
: We describe a rare case of malignant melanoma originating from the male urethra.
Methods/Results
: This case, which presented a tan‐colored lesion at the distal urethra on urethroscopy, was considered as transitional cell carcinoma by transurethral biopsy. Pathologic examination of widely resected urethra revealed scattering cells, which included melanin granules in cytoplasm, and then immunohistochemical stains established the diagnosis as amelanotic melanoma. Although partial penectomy and inguinal lymph node dissection were subsequently performed, 7 months later, total cystourethrectomy was required because of multifocal recurrence at the residual urethra.
Conclusions
: In cases of amelanotic melanoma, it should be noted that a lack of melanin granules in tumor cells may lead pathologists and urologists to a misdiagnosis due to the histologic non‐specific appearance. With respect to surgical management, of significance is the fact that malignant melanoma may progress multifocally along the total urethra; therefore, total urethrectomy should be considered as radical surgery for the primary site, even if the tumor is confined to the distal urethra.
Renal masses detected by general health checkup
Authors: Tsuboi Narumi , Horiuchi Kazutaka , Kimura Go , Kondoh Yukihiro , Yoshida Kazuhiro , Nishimura Taiji , Akimoto Masao , Miyashita Tsuguhiro , Subosawa Toshiyuki 
Published: March 2003

Abstract Background A total of 60 604 persons underwent a general health checkup at Toma Hospital, Saitama, Japan, between January 1993 and June 1997, and transabdominal ultrasonography (US) was performed on all persons. We investigated the usefulness of transabdominal US in detecting renal tumors during general health checkups.Methods A definite diagnosis was made in cases where the re‐examination by US revealed calculus with acoustic shadow or a simple cyst. Computed tomography (CT) was conducted in patients suspected of having a renal tumor, and a diagnosis of renal angiomyolipoma (AML) was made if plain CT gave evidence of a fatty component. Patients diagnosed as having a renal cell carcinoma (RCC) with non‐uniform enhancement underwent nephrectomy. If a definite diagnosis could not be made even by contrast CT, the monitoring by US and contrast CT once a year was continued.Results Of 97 (0.16%) patients whose transabdominal US findings indicated a diagnosis of suspected renal tumor, 58 underwent the re‐examination by US; of these, CT was conducted in 47. Detailed US revealed a hyperechoic pattern in 44 patients, a mixed pattern in nine and an iso‐hypoechoic pattern with internal echo in five. By plain CT, 24 patients were diagnosed as having AML, and two as having renal calcification. Contrast CT enabled a diagnosis of renal cyst to be made in two patients and renal tumor in 14. All 14 patients with RCC except one underwent nephrectomy, which provided pathologic evidence supporting the diagnosis. Five patients had a tumor unidentifiable by CT, with continuing periodic follow‐up by US and CT. Eleven patients underwent no CT.Conclusion Of the 60 604 persons who underwent a general health checkup, we found 14 cases of RCC and 24 cases of AML. As a small RCC has a favorable prognosis, patients greatly benefit from early detection; therefore, we should recognize the importance of identifying renal masses by US screening during general health checkups.
Testicular cancers occurring in brothers with cryptorchism
Authors: SUETOMI TAKAHIRO , KAWAI KOJI , SEKIDO NORITOSHI , KIKUCHI KOJI , TAKESHIMA HITOSHI , AKAZA HIDEYUKI 
Published: March 2003

AbstractWe report a case of familial testicular cancer associated with undescended testes in two brothers. The older brother (49 years) presented with a testicular tumor located in the right inguinal canal. The pathologic diagnosis was pure seminoma. Computerized tomography revealed iliac and retroperitoneal lymph node metastases. Four years later, the younger brother (44 years) developed bilateral testicular tumors, one located in the inguinal canal, the other located in the pelvic cavity. The pathologic diagnosis of both tumors was pure seminoma. Radiological examination revealed retroperitoneal lymph node metastases. Both patients received cisplatin‐based combination chemotherapy as the initial treatment. The older brother suffered from repeated recurrences with lymph node metastases in the iliac and inguinal regions, but he was successfully treated with high‐dose chemotherapy. The younger brother achieved long‐term remission after retroperitoneal lymph node dissection following initial chemotherapy. We briefly review the reported cases of familial testicular cancer and discuss the association of the maldescent of the testes and familial testicular cancer cases.
Extracorporeal shock wave treatment for Peyronie’s disease using EDAP LT‐02; preliminary results
Authors: Kiyota Hiroshi , Ohishi Yukihiko , Asano Koji , Hasegawa Norio , Madarame Jun , Miki Kenta , Kato Nobuki , Kimura Takahiro , Ishiyama Takehito , Maeda Shigetaka , Shimomura Tatsuya , Shiono Yutaka , Miki Jun 
Published: March 2003

Abstract
Background
: Peyronie’s disease is an idiopathic fibrosis of the tunica albuginea of the penis, which often causes erectile dysfunction. No effective therapy except surgery has been available for Peyronie’s disease. We investigated the clinical efficacy of extracorporeal shock wave treatment (ESWT) using EDAP LT‐02 as an alternative method of treatment for Peyronie’s disease.
Methods
: Five patients aged 35–65 years were treated by ESWT. All patients had undergone unsuccessful medical treatment before ESWT. Each patient was treated by ESWT (7–40 storages at an energy density of 45–96 MPa) between three and five times at 4‐week intervals. Although no patient needed anesthesia, all were administered diclofenac suppository (50 mg) before ESWT.
Results
: Of the five patients, four were eligible for evaluation. The penile plaque disappeared in one patient (25%). In the other three patients (75%), the penile plaque did not disappear, but softened. Although no improvement of erectile penile curvature was recognized, erectile penile pain disappeared in all patients.
Conclusions
: These results indicate that ESWT is a possible alternative to surgery in the treatment of Peyronie’s disease.
Long‐term effects of transurethral microwave thermotherapy
Authors: OHIGASHI TAKASHI , BABA SHIRO , OHKI TAKAHIRO , NAKASHIMA JUN , MURAI MASARU 
Published: March 2003

Abstract
Background
:To identify the clinical valuables predicting a favorable outcome after transurethral microwave thermotherapy (TUMT) of the prostate with Prostatron.
Methods
:One hundred and two patients with lower urinary symptoms were treated with TUMT using a Prostatron device with the low‐energy protocol (Prostasoft version 2.0 J). The pre‐operative subjective score and objective voiding parameters were collected from the medical record. To test the differences in the risk of the necessity for additional treatments for several subgroups, Kaplan–Meier survival analyses and log‐rank tests were used.
Results
:The Kaplan–Meier analyses showed that 67% of the patients received additional treatment within five years. The median period for receiving additional treatment was 37 months. The patients with a peak flow rate greater than 6.5 mL per second, with a urethral length less than 40 mm, or with an age over 64 years all demonstrated a significantly longer period before receiving additional treatment, when compared with their counterparts. These three factors were also significant in multivariate analysis to predict the long‐term outcome.
Conclusions
:Overall durability of TUMT was limited. Aged patients with a relatively high peak flow rate or with a short prostatic urethral length resulted in lower risk of receiving additional treatments after TUMT.
Primary malignant melanoma of the male urethra
Authors: Kubo Hiroyuki , Miyawaki Itaru , Kawagoe Mari , Kuriwaki Kazumi , Hatanaka Shingo , Tanaka Kazuhiko , Nakagawa Masayuki 
Published: March 2003

AbstractWe report a case of primary malignant melanoma of the male urethra in a patient whose penile shaft was successfully preserved, but who proceeded to acute renal failure (ARF) after interferon (IFN)‐β adjuvant immunotherapy. Primary malignant melanoma of the male urethra is rare and usually shows highly malignant potential. Therefore, urologists must often perform phallectomy, which impacts on the patient both sexually and mentally. A 64‐year‐old man presented at Saiseikai Sendai Hospital with asymptomatic gross hematuria and was diagnosed as distal urethral tumor. We predicted the highly malignant potential of this tumor from the urethroscopic finding and from urinary cytological examination. We did not select trans‐urethral resection (TUR), but selected partial urethrectomy.This patient proceeded to ARF 1 month after natural IFN‐β treatment as an adjuvant immunotherapy. As IFN‐β rarely induces the delayed renal failure, urologists should be aware of renal dysfunction after IFN‐β therapy for the treatment of malignant melanoma.
Tolterodine: As effective but better tolerated than oxybutynin in Asian patients with symptoms of overactive bladder
Authors: Lee Jeong Gu , Hong Jae Yup , Choo Myung‐Soo , Kwon Hun Young , Chung Do Young , Lee Kyu Sung , Lee Ji Youl , Lee Tack 
Published: March 2003

Abstract
Background:
This double‐blind, multicenter study compared the efficacy and tolerability of tolterodine (Pharmacia, Los Angeles, USA) with that of oxybutynin (Alza, Palo Alto, USA) in Asian patients with overactive bladder.
Methods:
Two‐hundred‐and‐twenty‐eight adults with overactive bladder symptoms were randomized to receive tolterodine 2 mg twice daily (bid) (n = 112) or oxybutynin 5 mg bid (n = 116). After 8 weeks’ treatment, changes in micturition diary variables, patients’ perception of treatment benefit, and tolerability endpoints were determined.
Results:
The mean (± SD) number of micturitions/24 h decreased by 2.6 ± 2.9 (−21%) with tolterodine and 1.8 ± 4.2 (−15%) with oxybutynin (both P = 0.0001 vs baseline). The mean number of incontinence episodes/24 h decreased by 2.2 ± 2.3 (−85%) in the tolterodine group and by 1.4 ± 1.8 (−58%) in the oxybutynin group (both P = 0.0001 vs baseline). Patient perception of treatment benefit was over 70% in each treatment group. Adverse events were significantly lower in the tolterodine group compared with oxybutynin‐treated patients (55%

vs 82%; P = 0.001). Dry mouth was reported by significantly fewer patients on tolterodine, compared with oxybutynin (35%

vs 63%; P = 0.001) and withdrawals due to adverse events were lower in the tolterodine group than with those treated with oxybutynin (10%

vs 16%). There were no safety concerns.
Conclusions:
Tolterodine 2 mg bid is equally or more effective than oxybutynin 5 mg bid in the treatment of Asian patients with overactive bladder, and shows significantly better tolerability. This may enhance compliance during long‐term treatment.
Detection and identification of oxalate‐degrading bacteria in human feces
Authors: Kodama Takaomi , Akakura Koichiro , Mikami Kazuo , Ito Haruo 
Published: March 2003

AbstractBackground : Oxalate is detoxified (catabolized) via the action of two enzymatic proteins, formyl coenzyme A transferase (encoded by the frc gene) and oxalyl coenzyme A decarboxylase (encoded by the oxc gene), contained in the cytosol of Oxalobacter formigenes that colonizes the human intestinal tract. It is speculated that oxalate‐degrading bacteria decrease oxalate absorption from the intestines and their absence in the gastrointestinal tract correlates with the formation of calcium‐oxalate urolithiasis.Methods : Two methods of detection and identification of this bacterial strain were studied in human fecal samples collected from Japanese subjects. Genomic DNA was isolated from bacterial culture, and specific 16S rDNA was amplified by polymerase chain reaction (PCR) followed by sequencing. The oxc gene was amplified directly from human feces by PCR using the specific primers.Results : Oxalate‐degrading bacteria were identified by comparing the sequences of 16S rDNA. The oxc gene was directly detected from human feces by PCR. It was ascertained that a combined PCR detection method using both 16S rDNA and the oxc gene allows for identification of O. formigenes in human fecal samples.Conclusion : This detection and identification method of oxalate‐degrading bacteria using 16S rDNA and oxc gene should be applied in examination of clinical samples.
Role of Doppler ultrasound and resistive index in benign prostatic hypertrophy
Authors: Tsuru Nobuo , Kurita Yutaka , Masuda Hiroaki , Suzuki Kazuo , Fujita Kimio 
Published: March 2003

AbstractBackground: The aim of the present study was to assess the resistive index in patients with benign prostatic hypertrophy (BPH) and the role of power Doppler ultrasonography.Methods: From April 1996 to December 1997, a total of 214 men aged 48–86 years with symptoms of BPH were prospectively enrolled to participate in our study. All patients presented to our clinic with lower urinary tract symptoms. Transrectal ultrasonography was used to calculate the total prostate volume (TPV), transition zone (TZ) volume, transition zone index (TZI = TZ volume/TPV) and presumed circle area ratio (PCAR). Power Doppler imaging was used to identify the capsular and urethral arteries of the prostate and measure its resistive index (RI) value.Results: The RI of capsular arteries significantly correlated with theTPV, TZ volume, TZI
(r = 0.470; P < 0.0001) and PCAR
(r = 0.334; P < 0.0001). Correlations were found
between the RI of capsular arteries and the International Prostatic Symptom Score (IPSS)
(r = 0.389; P < 0.0001), peak flow rate of
uroflowmetry (r = ‐0.393; P < 0.0001).Conclusion: We demonstrated that an increase of the RI of capsular arteries correlated with increases in the TZI and PCAR in BPH. The lower IPSS and peak flow rate correlated with the high RI of capsular arteries; however, no correlation between the RI of urethral arteries and prostatic parameters was found. The findings suggested that the RI of capsular arteries may become the index for measuring lower urinary obstruction in the future.
Prospective randomised trial comparing diethylstilboestrol and flutamide in the treatment of hormone relapsed prostate cancer
Authors: Burns‐Cox Nick , Basketter Vanessa , Higgins Bernard , Holmes Simon 
Published: March 2003

AbstractBackground: Patients with hormone relapsed prostate cancer (HRPC) are often treated with flutamide or diethylstilboestrol. However, which of these two options is the best treatment for HRPC remains unclear.Methods: We carried out a prospective study to determine and compare the prostate‐specific antigen (PSA) response and survival in patients with hormone relapsed prostate cancer (HRPC), all of whom had previously shown a good response to medical or surgical castration. The patients were randomised to treatment with diethylstilboestrol (DES) and aspirin, or the antiandrogen flutamide. In addition, quality of life was determined by interview and questionnaire.Results: Twenty‐eight patients were randomised for treatment options.There was a significantly greater fall in the PSA (65% vs 35%; P = 0.034) after treatment with diethylstilboestrol compared to treatment with flutamide. Median survival also rose after treatment with diethylstilboestrol (18 months) compared to flutamide (11 months), but this difference did not reach statistical significance. There was no difference in the quality of life parameters between the two groups. There were no cardiovascular complications in the stilboestrol group.Conclusions: In HRPC, treatment with stilboestrol is associated with a greater PSA fall and an increase in median survival when compared to flutamide treatment.
d‐Xylose absorption after urinary orthotopic bladder replacement: colon neobladder compared with ileal neobladder
Authors: Hara Shoji , Miyake Hideaki , Okada Hiroshi , Arakawa Soichi , Kamidono Sadao , Hara Isao 
Published: March 2003

Abstract
Background: To evaluate the digestive and absorptive status using the d‐xylose test in patients who underwent radical cystectomy and orthotopic bladder replacement either by colon or ileal segment.
Methods: d‐Xylose serum levels after an oral load, nutritional status, plasma vitamin B12 levels, and acid–base and electrolyte balances were studied in 18 patients with colon neobladder and 12 patients with ileal neobladder. Mean follow‐up period was 51 months. Results of both types of bladder replacement and a healthy control group were compared.
Results: Although no significant difference in the changes of plasma levels of d‐xylose after oral load was observed between patients with colon neobladder and healthy controls, plasma levels of d‐xylose 90 min after oral load in patients with ileal neobladder were significantly lower than those with colon neobladder. In contrast, there was no significant difference in nutritional status, plasma levels of vitamin B12, and acid–base and electrolyte balances between patients with colon and ileal neobladders.
Conclusion: Despite acceptable nutritional status, intestinal malabsorption might be present in patients with ileal neobladder, as indicated by the plasma levels of d‐xylose, while the colon neobladder group showed no significant differences compared with normal controls. Therefore, absorptive and metabolic status should be carefully monitored after ileal neobladder creation.
α‐Interferon 2a and 13‐cis‐retinoic acid for the treatment of metastatic renal cell carcinoma
Authors: Wong M. , Goldstein D. , Woo H. , Testa G. , Gurney H. 
Published: March 2003

Abstract Background: It is suggested that immunotherapy may have a better role than cytotoxic chemotherapy in the treatment of metastatic renal cell carcinoma. Aims: A phase II study of α‐interferon 2a (IFN2a) and 13‐cis‐retinoic acid (CRA) in the treatment of metastatic renal cell carcinoma. Methods: Twenty‐two patients with no previous systemic therapy were treated with IFN2a daily at 3 million units (MU) and escalated to 6 and 9 MU if tolerated, together with CRA given orally at 1 mg/kg per day in two divided doses. Changes in quality of life were also assessed. Results: Twenty patients were available for assessment. Three patients (14%) achieved a partial response and five patients (23%) had stable disease. No patient achieved a complete response. A durable response was observed in partial responders with median length of response of 44 weeks (range 32−59 weeks). Therapy was stopped in seven (35%) patients due to treatment‐related toxicities, and quality of life was worsened in the majority of patients. Conclusion: IFN2a and CRA has a low response rate and significant toxicity, and the combination as standard treatment of metastatic renal cell carcinoma is not recommended, despite the suggestion that CRA may lengthen the response to IFN2a. (Intern Med J 2002; 32: 158−162)
Retrospective survey of unselected hospital patients with and without cancer comparing outcomes following venous thromboembolism
Authors: Cook N. , Thomas D. M. 
Published: March 2003

AbstractBackground:  Cancer patients are at risk of venous thromboembolism (VTE). Currently, management of these patients is based on studies performed in the general population.Aims:  To determine whether the natural history of VTE in cancer patients differs sufficiently from patients in general such that a specific management approach is required.Methods:  A retrospective survey was conducted using case records from three tertiary referral hospitals (1993−2001). One hundred and forty‐seven VTE patients with cancer and 82 control patients matched for age and gender were followed for a median of 24 months (0−104 months).Results:  The overall prevalence of cancer among patients with VTE was 19.3% (vs 4% in patients with arterial thromboembolic events). In the follow‐up groups, cancer conferred a significantly worse functional status, although other risk factors for VTE were similar. Proximal sites of VTE were twice as common in cancer as in non‐cancer patients. The majority of patients in both groups were treated with oral anti­coagulants. Complications were more common in cancer patients (40%vs 23%) and occurred more frequently despite apparently adequate anticoagulation. Following VTE, cancer patient survival (median 4.1 months, 127 deaths) was markedly worse than non‐cancer patients (median not reached, eight deaths). Thirty‐five cancer deaths occurred within 5 weeks of VTE. Eleven deaths in cancer patients were directly related to VTE compared to three in patients without cancer.Conclusions: Cancer patients with VTE fare extremely poorly compared to the general hospital population. Prospective treatment studies, specifically in cancer patients with VTE, are needed. (Intern Med J 2002; 32: 437−444)