bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urachal tuberculosis
Authors: Fujimoto Ken , Samma Shoji , Akiyama Tatsuya , Tanaka Nobumichi , Hirayama Akihide , Nakayama Akifumi 
Published: March 2003

Abstract
Background
: We report on an extremely rare case of urachal tuberculosis that was confirmed using a polymerase chain reaction test of paraffin‐embedded material.
Methods/Results
: A 62‐year‐old man presented with pollakiuria. With a diagnosis of urachal abscess, the patient underwent en bloc resection of the cystic mass. A bacterial culture test of the content showed no organism. The histopathologic findings suggested urachal tuberculosis. The AMPLICOR polymerase chain reaction test by using paraffin‐embedded sections revealed the existence of Mycobacterium tuberculosis in the resected tissue. The only positive finding in systemic screening examinations for tuberculosis was old tuberculosis scars in the upper right lung. It was supposed that hematogeneous spreading from the lung lesion may result in urachal tuberculosis after a long latent period.
Conclusions
: Although urachal tuberculosis is an extremely rare condition, tuberculosis must always be kept in mind when observing any infectious diseases.
Use of bladder mucosal graft for urethral reconstruction
Authors: Özgök Yaşar , Tan M Özgür , Kilciler Mete , Tahmaz Lütfü , Erduran Doğan 
Published: March 2003

Background: The ideal tissue for complex urethral reconstruction has yet to be determined, especially in patients with deficient preputium. The use of bladder mucosa as a free graft could be an alternative in these problem cases.Methods: Bladder mucosa graft urethroplasty was performed on 14 patients with penoscrotal or scrotal hypospadias. The mean age of the patients was 18.7 (range 14–23) years. Ten cases were subjected to primary urethral reconstruction while four cases had previous hypospadias repair.Results: Complete urethral replacement by the bladder mucosa tube was performed in six patients. Meatal problems occurred in two (33.33%) patients and proximal fistula formed in one (16.67%) patient. A bladder mucosa graft was combined with preputial or tunica vaginalis grafts distally in eight cases, and one patient in the tunica vaginalis group developed fistula at the anastomosis of the bladder mucosa and tunica vaginalis grafts. The overall complication rate was 28.6%.Conclusions: Our initial results showed that bladder mucosa grafts can be used successfully for urethral reconstruction especially when combined with preputial or tunica vaginalis grafts distally.
Clinical, urodynamic and endoscopic characteristics of the Stanford pouch ileal neobladder constructed with absorbable staples
Authors: Uygur M Cemil , Tan M Özgür , Altugˇ Ugˇur , Yilmaz Cenk , Erol Demokan 
Published: March 2003

Abstract Purpose The clinical, urodynamic and endoscopic aspects of the Stanford pouch ileal neobladder formed with absorbable staples were investigated.Methods A Stanford pouch ileal neobladder was formed using absorbable staples after radical cystoprostatectomy in 30 male patients with the diagnosis of muscle invasive carcinoma of the bladder between 1995 and 1998. The mean age of the patients was 62 (range 41–70) years. Patients were followed with arterial blood gas, serum biochemistry, pouch cystography, urodynamic tests and endoscopy.Results Five (16.7%) patients had early postoperative complications and three were related to the neobladder. One year postoperatively, low grade (I, II) vesicoureteral reflux was present in five (16.7%) cases. The mean preoperative and 6 months postoperative serum creatinine levels were 1.07 ± 0.3 mg/dL and 1.2 ± 0.4 mg/dL, respectively, but the difference was not statistically significant (P = 0.1). Six months postoperatively the mean serum chloride level was 109 ± 4.5 (range 100–113) mmol/L and the mean arterial blood pH was 7.37 ± 0.2 (range 7.3–7.4). Two (6.7%) patients required oral alkaline supplementation because of high chloride levels. All the patients except one were continent throughout the day after 1 year. However, nocturnal enuresis was present in 25 (83.3%) cases. The pouch capacity was increased gradually up to 12 months postoperatively and the mean pouch capacity 12 months postoperatively was 460 ± 95.8 mL. Micturition occurred spontaneously in most patients while some needed abdominal straining. None of the patients had a residual urine of more than 60 mL. The mean maximum flow rate 6 months postoperatively was 9.8 (range 5.4–15.0) mL/s. After 6 months the stapled edge was noticed as a nodular line. One year postoperatively only a white scar could be observed at the suture line.Conclusion The Stanford pouch ileal neobladder constructed using absorbable staples was able to provide a good capacity–low pressure reservoir with a low rate of complications.
Intravenous digital subtraction angiography and helical computed tomography in evaluation of living renal donors
Authors: Watarai Yoshihiko , Kubo Kozo , Hirano Tetsuo , Togashi Masaki , Ohashi Nobuo , Usuki Tomoaki , Takeuchi Ichiro , Nonomura Katsuya , Koyanagi Tomohiko 
Published: March 2003

Abstract Objectives: The present study was carried out to evaluate the accuracy of helical computed tomography (CT) and intravenous digital subtraction angiography (IV‐DSA) on anatomical assessment of renal vasculature for living renal donors.Methods: Forty‐two healthy potential renal donors were prospectively evaluated and 35 subsequently underwent donor nephrectomy after helical CT and IV‐DSA evaluation. The vascular and non‐vascular findings were compared between the findings on helical CT, IV‐DSA and surgery.Results: Ten prehilar branches and five accessory renal arteries were found at nephrectomy. Overall, operative findings agreed with the findings by IV‐DSA in 89% and by helical CT in 83%. In delineating accessory arteries, IV‐DSA had a sensitivity of 60% and specificity of 97%, whereas helical CT had a sensitivity of 40% and specificity of 100%. In delineating prehilar branches, IV‐DSA had a sensitivity of 90% and specificity of 100%, whereas helical CT had a sensitivity of 70% and specificity of 100%. Accessory arteries and prehilar branches that were not detected by helical CT or IV‐DSA, were less than 2 mm in diameter and did not require vascular reconstruction. Renal veins were delineated in 63% by IV‐DSA, whereas they were clearly imaged by helical CT in all cases, including a case with a circumaortic renal vein. Non‐vascular findings were obtained in 64% by helical CT, including two renal tumors. None of these findings were obtained by IV‐DSA.Conclusion: Helical CT and IV‐DSA provide comparably sufficient information on renal artery vasculature. However, helical CT provides significantly more information on venous and non‐vascular findings as a single‐imaging modality.
Growth fractions of human renal cell carcinoma defined by monoclonal antibody Ki‐67. Predictive values for prognosis
Authors: Yuba Hiroshi , Okamura Kikuo , Ono Yoshinari , Ohshima Shinichi 
Published: March 2003

AbstractBackground:We used immunohistochemical techniques to elucidate the role of growth fractions of renal cell carcinoma in the clinicopathology of the condition and patient survival.Methods:Fifty‐two fresh‐frozen nephrectomy specimens were immunostained with Ki‐67 monoclonal antibody. Ki‐67 indexes were determined to examine the relationship between tumor size, grade, stage and survival curve. This study included 43 men and nine women with the mean age 58.4 ± 11.7 years, who had been followed up for 39 ± 25 months.Results:The Ki‐67 index ranged from 0.6 to 14.1%, averaging 4.6 ± 5.8%. It was 2.8 ± 2.4% in tumors <5 cm, 4.7 ± 3.6% in tumors ≥5 cm and 7.1 ± 9.0% in tumors ≥10 cm. The Ki‐67 index of grades 1, 2 and 3 tumors was 2.3 ± 1.1%, 3.3 ± 2.7% and 12.0 ± 10.4%, respectively. Grade 3 tumors had a significantly higher Ki‐67 index than grade 1 or grade 2 tumors. There was no correlation between the Ki‐67 index and tumor stage. Patients with a Ki‐67 index < 5.6% had a better prognosis than those with an index > 5.6% (P = 0.029). However, multivariate analysis demonstrated that tumor size (P = 0.034) and grade (P = 0.038) were higher in hazard ratio than the Ki‐67 index.Conclusions:Most renal cell carcinomas had low growth fractions. Although a high Ki‐67 index should indicate a poor prognosis, Ki‐67 did not correlate to metastasis. We believe it is necessary to investigate the factors, other than growth potential, that affect metastasis.
The correlation between penile tumescence measured by the erectometer and penile rigidity by the RigiScan
Authors: Suzuki Kazuhiro , Sato Yoshikazu , Horita Hiroki , Adachi Hideki , Kato Ryuichi , Hisasue Shinichi , Itoh Naoki , Tsukamoto Taiji 
Published: March 2003

AbstractBackground:The goal of this study was to evaluate the correlation between increments of penile tumescence and penile rigidity measured by the erectometer and the RigiScan, respectively.Methods:Nocturnal penile tumescence (NPT) was measured in 25 volunteers (mean age, 49.5 years). The erectometer and the RigiScan were used simultaneously for a total of 47 nights. We studied the correlation between maximum penile circumferential changes determined by the erectometer and penile rigidity patterns measured by the RigiScan.Results:Maximum circumferential changes during NPT measured by the erectometer were well correlated to those determined by the RigiScan (correlation coefficient, 0.719). In addition, penile circumferential changes measured by the erectometer corresponded well to the penile rigidity pattern determined by the RigiScan (P = 0.0001). Specifically, maximum penile circumferential changes of more than 30 mm and less than 10 mm had 70% positive predictive value and 100% negative predictive value for predicting the normal rigidity pattern, respectively.Conclusions:Penile circumferential changes measured by the erectometer were well correlated to penile rigidity measured by the RigiScan, particularly when the increments were larger than 30 mm or less than 10 mm. These results suggested that the erectometer was a useful tool to estimate the penile rigidity patterns of the RigiScan.
New semiautomatic suturing device (Maniceps) for precise vesicourethral anastomosis during radical retropubic prostatectomy
Authors: YAMADA YOSHIAKI , HONDA NOBUAKI , NAKAMURA KOGENTA , MITSUI KENJI , HIBI HATSUKI , TAKI TOMOHIRO , KAMIJYOU AYUMI , AOKI SHIGEYUKI , KATO KEITARO , KOKUBO HIROTO , FUKATSU HIDETOSHI 
Published: March 2003

AbstractPerforming vesicourethral anastomosis following retropubic radical prostatectomy may, under some anatomical conditions, be difficult. We describe the use of a new suturing semiautomatic device for deep surgical operations (Maniceps) to facilitate vesicourethral anastomosis. Maniceps is a pair of forceps both jaws of which have a groove at the tip. A 7 mm straight needle is set on the needle‐holder jaw. By closing and reopening the forceps, the needle is moved onto the needle‐receiver jaw. The use of Maniceps in vesicourethral anastomosis ensure the procedure is safe, easy and effective.
Follow‐up of clinical stage I testicular cancer patients: Cost and risk benefit considerations
Authors: KAKEHI YOSHIYUKI , KAMOTO TOSHIYUKI , KAWAKITA MUTSUSHI , OGAWA OSAMU 
Published: March 2003

Abstract
Background
: Regardless of the way it is managed, a high cure rate has been achieved for recurrent low‐stage testicular cancer. Achieving a balance between survival and the patient’s inconvenience and expense during follow‐up, has therefore become an important issue.
Methods
:Prognoses and recurrence patterns were investigated in 39 patients with stage I non‐seminomatous germ cell tumor of the testis (NSGCT), and 82 patients with stage I seminomatous germ cell tumor of the testis (SGCT), who underwent high orchiectomy between 1970 and 1997 at our institution. We considered the cost benefits and the risks by reviewing our results together with other reported results.
Results
:Patients with clinical stage I NSGCT under surveillance showed no progression later than 4 years after orchiectomy. The ability to detect progression using chest X‐ray alone appeared very low. There was no infradiaphragmatic recurrence after adjuvant radiotherapy for patients with stage I SGCT. Only two of 204 patients showed progression, which included eight of our patients who underwent two cycles of adjuvant carboplatin therapy.
Conclusions
:Four years of intensive follow‐up is probably sufficient for patients with stage I NSGCT under surveillance, and routine chest X‐rays may be required only during the first year of surveillance. The benefit of using adjuvant radiotherapy for patients with stage I SGCT is that we could remove abdominal and pelvic CT scans from the routine follow‐up protocol. Randomized trials will clarify whether the adjuvant carboplatin therapy is less toxic, provides better prognosis and is more cost‐effective than adjuvant radiotherapy.
Efficacy of 3‐D computed tomographic reconstruction in evaluating anatomical relationships of colovesical fistula
Authors: Shinojima Toshiaki , Nakajima Fumio , Koizumi Jun 
Published: March 2003

AbstractA case of colovesical fistula is reported. The anatomy of the pelvis was determined preoperatively with 3‐D computed tomography (CT), and the fistula, including adjacent structures, could clearly be seen. Compared with conventional axial CT imaging, 3‐D CT provided better and more complete visualization of the anatomical relationships, which facilitated the surgical procedure and provided a good outcome.
Usefulness of prostate‐specific antigen velocity in screening for prostate cancer
Authors: Ito Kazuto , Yamamoto Takumi , Ohi Masaru , Kubota Yutaka , Fukabori Yoshitatsu , Kurokawa Kohei , Suzuki Kazuhiro , Yamanaka Hidetoshi 
Published: March 2003

AbstractBackground: The cut‐off value of prostate‐specific antigen velocity (PSAV) was investigated in relation to the initial prostate‐specific antigen (PSA) value in subjects with initial values of 1.0–4.0 ng/mL, and the usefulness and limitations of PSAV as a screening test for prostate cancer were examined.Methods: In this study, 4883 men who underwent mass screening for prostate cancer two or more times between 1987 and 1998 and had initial PSA levels of 1.0–4.0 ng/mL were investigated. The subjects ranged in age from 42 to 96 years (mean: 68.0 ± 6.6 years). The cut‐off value of PSAV was set at 0.1–1.5 ng/mL per year, and the sensitivity, specificity, efficiency and positive predictive value (PPV) of PSAV for detecting prostate cancer were determined according to the initial PSA value. A similar examination of the average PSAV was carried out in 2888 subjects with three or more visits for mass screening for prostate cancer.Results: The diagnostic efficiency of PSAV was optimal with cut‐off values of 0.3 and 0.75 ng/mL per year in those subjects with initial PSA levels of 1.0–1.9 and 2.0–4.0 ng/mL, respectively, but the PPV was low at 1.8% in subjects with initial PSA levels of 1.0–1.9 ng/mL. When the cutoff value of PSAV was set at 1.2 ng/mL per year in individuals with initial PSA levels of 1.0–1.9 ng/mL, the PPV increased to 7.3% and the sensitivity was 40%. The diagnostic efficiency of the average PSAV was optimal at the cut‐off values of 0.2 and 0.4 ng/mL per year in subjects with initial PSA levels of 1.0–1.9 and 2.0–4.0 ng/mL, respectively, but the PPV was low at 2.2% in the subjects with initial PSA values of 1.0–1.9 ng/mL. When the cut‐off value of PSAV was set at 0.75 ng/mL per year in individuals with initial PSA levels of 1.0–1.9 ng/mL, the PPV was 9.8% and the sensitivity was 46%.Conclusion: It is possible to improve the diagnostic accuracy of prostate cancer screening using the cut‐off value of PSAV and average PSAV in subjects with initial PSA levels of 1.0–4.0 ng/mL. The cut‐off values of PSAV should be set at 1.2 and 0.75 ng/mL per year in individuals with initial PSA levels of 1.0–1.9 and 2.0–4.0 ng/mL, respectively. The cut‐off values of the average PSAV should be set at 0.75 and 0.4 ng/mL per year in individuals with initial PSA levels of 1.0–1.9 and 2.0–4.0 ng/mL, respectively.
Prostatic cystadenoma presenting as a large multilocular mass
Authors: Matsumoto Kazumasa , Egawa Shin , Iwabuchi Keiichi , Baba Shiro 
Published: March 2003

AbstractA case is reported here of a patient with a giant multilocular prostatic cystadenoma who presented with gross hematuria and underwent extensive surgical resection. A 35‐year‐old man presented with asymptomatic gross hematuria. Magnetic resonance imaging of the pelvis demonstrated a multilocular mass replacing the prostatic gland. At exploration the urinary bladder was found to be displaced anterolaterally and severely adherent to the large tumor. The pathological features were consistent with multilocular prostatic cystadenoma. There have been no signs of tumor recurrence during 24 months’ follow‐up after surgery. Although the natural history of prostatic cystadenoma remains unknown, complete surgical excision may not always be necessary. Physicians should at least be aware of the possibility of this disease entity before making treatment decisions.
Annual changes of the incidence and clinical characteristics of magnesium ammonium phosphate urinary stones
Authors: OGATA TAKAHIDE , AKAKURA KOICHIRO , MIZOGUCHI KEN‐ICHI , MIKAMI KAZUO , NOZUMI KUNIYOSHI , ITO HARUO 
Published: March 2003

AbstractBackground: Magnesium ammonium phosphate (MAP) urinary stones account for the majority of staghorn stones and frequently cause a non‐functioning kidney. In the present study, we examined the annual changes of the number and clinical characteristics of MAP stones.Methods: The annual incidence of MAP stones was investigated in 2619 patients with urinary stones in whom composition of the stone was analysed at Chiba University Hospital between 1964 and 1999. In addition, the annual number of patients with MAP stones was examined at Funabashi Clinic. In a total of 644 patients with MAP stones, age and sex of the patients, location and size of the MAP stones, urinary cultures and etiological factors were analysed.Results: The number of MAP stones in the lower urinary tract was relatively constant. In contrast, MAP stones in the upper urinary tract had dramatically decreased since 1989, resulting in an increase in the rate of MAP stones in the lower urinary tract. Age distribution of the MAP stone patients ranged from 10 years to > 80 years, with the majority aged 30–60 years. The proportion of larger MAP stones in the upper urinary tract increased. There was no significant difference in prevalence of urine cultures. Among etiological factors for MAP stones, difficulty on urination tended to be common in recent years.Conclusion: The number of MAP stones, especially in upper urinary tract, has been decreasing during the last decade. At present, treatment of urinary tract obstruction seems important for the management of MAP stones in lower urinary tract.
Calcium nephrolithiasis and distal tubular acidosis in type 1 glycogen storage disease
Authors: IIDA SHIZUKA , MATSUOKA KEI , INOUE MICHIRO , TOMIYASU KATSURO , NODA SHINSHI 
Published: March 2003

AbstractA 36‐year‐old man was admitted to hospital due to right flank pain as a result of ureteral stones. He had been followed up for type 1 glycogen storage disease since the age of 11 years. He had four episodes of spontaneous stone birth during the previous 2 years, and each stone was composed mainly of calcium oxalate. Intravenous pyelography showed right hydronephrosis due to ureteral stones and bilateral multiple renal stones. We carried out transurethral ureterolithotripsy (TUL) on the right ureteral stones. The composition was a mixture of calcium oxalate and calcium phosphate. Laboratory evaluation demonstrated the association of distal renal tubular acidosis (RTA). These observations suggest that hypocitraturia and distal RTA are strongly correlated to recurrence of calcium nephrolithiasis. The patient's serum uric acid and urinary citrate excretion levels normalized after allopurinol and potassium citrate administration.
Concentration gradient of oxalate from cortex to papilla in rat kidney
Authors: NAKATANI TATSUYA , ISHII KEIICHI , SUGIMOTO TOSHIKADO , KAMIKAWA SADANORI , YAMAMOTO KEISUKE , YONEDA YUKIO , KANAZAWA TOSHINAO , KISHIMOTO TAKETOSHI 
Published: March 2003

Abstract
Background:
The kidney eliminates the major fraction of plasma oxalate. It is well known that oxalate is freely filtered by glomeruli and secreted by the proximal tubules. However, the renal handling of oxalate in distal nephrons, which is considered as playing an important role in stone formation, remains obscure.
Methods:
At 15–180 min after intravenous injection of 14C‐oxalate to rats, the intrarenal localization of radioactivity was quantitatively measured by the radioluminographic method using a bioimaging analyzer. Tissue radioactivity was compared with plasma, and urinary radioactivities were measured by a liquid scintillation counter. The control study was conducted with 14C‐inulin.
Results:
The radioactivity of 14C‐oxalate in the papilla was 10 times greater than in the cortex and eight times greater than in the medulla 180 min after injection when almost no radioactivity was present in the urine. In contrast, the radioactivity of 14C‐inulin was nine times less in the papilla than in the cortex at the same time.
Conclusion:
Oxalate remains in the renal papilla for an extended period. This accumulation of oxalate may be attributed to calcium oxalate crystal fixation along the deep nephron which is considered to be the first step of stone formation.
Establishment and application of criteria for the elective transfer of two good‐quality embryos to reduce high‐order multiple pregnancies
Authors: Shibahara Hiroaki , Suzuki Tatsuya , Tanaka Yasuko , Hirano Yuki , Taneichi Akiyo , Obara Hiromi , Fujiwara Hiroyuki , Takamizawa Satoru , Sato Ikuo 
Published: March 2003

Aim
: This study was carried out to establish criteria for the elective transfer of two good‐quality embryos to reduce high‐order multiple pregnancy rates. The pregnancy and multiple pregnancy rates per transfer were retrospectively analyzed in 128 in vitro fertilization and embryo transfer (IVF‐ET) cycles.
Results
: The analysis revealed that the pregnancy and multiple pregnancy rates were 26.6% (34 of 128) and 23.5% (eight of 34), respectively. Five twin and three triplet pregnancies were included. The pregnancy rates in women 29 years old and younger, 30–34 years, 35–39 years, and 40 years and older were 21.2 (seven of 33), 37.0 (17 of 46), 25.8 (eight of 31), and 11.1% (two of 18), respectively. There was a significant difference of the pregnancy rates between 30 and 34‐year‐old and 40‐year‐old and older women (P < 0.05). The multiple‐pregnancy rate in women 40 years and older was 0%. Three triplet pregnancies were established only in the first attempt of IVF‐ET. The pregnancy rates in women, to whom good‐quality embryos (0–4) were transferred, were 0% (none of 12) for 0, 17.2% (five of 29) for one, 41.2% (seven of 17) for two, 30.8% (12 of 39) for three, and 32.3% (10 of 31) for four and more embryos, respectively. The multiple pregnancy rates in women who had good‐quality embryos of one, two, three, and four and more transferred were 0% (none of five), 23.5% (four of seven), 16.7% (two of 12), and 20.0% (two of 10), respectively.
Conclusion
: The criteria for the elective transfer of two good‐quality embryos were established as follows: age < 40 years, a first treatment cycle, and more than three good‐quality embryos available for transfer. After the application of the established criteria, the overall pregnancy and multiple pregnancy rates were 30.4% (14 of 46) and 14.3% (two of 14), respectively, which was satisfactory as compared with those in the 128 IVF‐ET cycles before application of the criteria. An elective transfer of two good‐quality embryos can be highly recommended to avoid high‐order multiple pregnancies in subjects with the established criteria. (Reprod Med Biol 2002; 1: 23–29)