bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laparoscopic diagnosis and treatment of nonpalpable testis
Authors: TSUJIHATA MASAO , MIYAKE OSAMU , YOSHIMURA KAZUHIRO , KAKIMOTO KEN‐ICHI , MATSUMIYA KIYOMI , TAKAHARA SHIRO , OKUYAMA AKIHIKO 
Published: March 2003

Abstract Objective: Laparoscopy has become one of the important diagnostic modalities of nonpalpable testis and has been developed and applied in the treatment of this disease. In the present study, we investigated the usefulness of laparoscopy in the diagnosis and treatment of nonpalpable testis.Methods: Laparoscopy was carried out under general anesthesia on 21 patients (23 testes) from October 1991 to October 1999. If the internal spermatic vessels and vas deferens made their way into the internal inguinal ring, the inguinal canal was dissected with an incision in the inguinal region to look for the testis. Patients with intra‐abdominal testis underwent laparoscopic orchiopexy or orchiectomy. If the internal spermatic vessels terminated with a blind end intraperitoneally, making it impossible to identify the testis, the case was judged to be vanishing testis and the operation was finalized without any further examination.Results: In eight of 23 testes (35%), the internal spermatic vessels and vas deferens made their way into the internal inguinal ring. The inguinal region was examined in all the eight testes. Orchiopexy was carried out on two testes and orchiectomy was carried out on six testes. An intra‐abdominal testis was detected in eight of 23 testes (35%). Laparoscopic orchiopexy was carried out on seven testes. One‐stage orchiopexy was carried out on two of the seven testes and two‐stage Fowler‐Stephens orchiopexy was carried out on five of the seven testes. Orchiectomy was carried out on the remaining testis. Blocking or lack of the internal spermatic vessels and vas deferens was seen in seven of the 23 testes (30%) and this condition was diagnosed as vanishing testis.Conclusion: Laparoscopy for nonpalpable testis is considered to be the most effective technique for diagnosing the presence or absence of the testis and the location of the testis.
Annual PSA tests are not necessary for men with a PSA level below 2 ng/mL: Findings of the Imari prostate cancer screening program
Authors: Uozumi Jiro , Tokuda Yuji , Fujiyama Chisato , Takagi Norito , Meiri Hiroyuki , Kuratomi Kazunari , Nakamura Kouji , Ichigi Yasuhisa , Yoshinaga Hidetoshi , Kinoshita Norio , Masaki Zenjiro 
Published: March 2003

AbstractBackground: Annual changes in prostate specific antigen (PSA) levels detected by the Imari prostate cancer screening program were evaluated to establish a more efficient and cost‐saving screening system, especially for men with low PSA levels.Methods: Prostate specific antigen‐based annual mass screenings for prostate cancer were conducted for men aged 60–69 in the Imari district, Saga, Japan. Between 1992 and 2000, 1822 men had their PSA levels tested. A total of 4661 PSA tests were conducted. Changes in PSA levels over the following 1 to 5 years were analyzed in men with PSA levels of 3 ng/mL or less, a range in which the detection rate of prostate cancer would seem to be negligibly low.Results: The overall detection rate of prostate cancer between 1992 and 2000 was 0.73%. The detection rate in men with a PSA level between 3.1 and 3.9 ng/mL, and between 4 and 9.9 ng/mL was 1.6% and 8.3%, respectively. Of 4661 determinations of PSA, 2553 (54.8%) were found to be ≤ 1 ng/mL, 1273 (27.3%) were between 1.1 and 2 ng/mL, and 401 (8.6%) were between 2.1 and 3 ng/mL. Four hundred and thirty‐four men (9.3%) had PSA levels ≥ 3.1 ng/mL, with possible indications for prostate biopsy. Of the men tested, 1.4% with an initial PSA level of ≤ 2 ng/mL and 22.3% with an initial level between 2.1 and 3 ng/mL had a PSA level of ≥ 3.1 ng/mL after 1 year. Almost the same rate of PSA increase was observed between the two PSA tests conducted at 2 to 5‐year intervals. Of the men tested, 2.2% with an initial PSA level of ≤ 2 ng/mL, and 21.9% with an initial level between 2.1 and 3 ng/mL, had a level of ≥ 3.1 ng/mL after 5 years.Conclusion: Levels of PSA in men with an initial level below 2 ng/mL remained stable for up to 5 years. Levels of PSA in 97.8– 98.8% of men remained below 3 ng/mL after 1 to 5 years. In contrast, 18–35.3% of men with an initial PSA level between 2.1 and 3 ng/mL showed PSA progression to 3.1 ng/mL or more within 5 years. Our present data suggest that annual PSA testing is not necessary for men with a PSA level below 2 ng/mL. Prostate specific antigen testing could therefore be conducted at longer intervals in such individuals.
Advanced renal cell carcinoma treated with granulocyte‐macrophage colony‐stimulating factor gene therapy: A clinical course of the first Japanese experience
Authors: Kawai Koji , Tani Kenzaburo , Yamashita Naohide , Tomikawa Shinji , Eriguchi Masazumi , Fujime Makoto , Okumura Ko , Kakizoe Tadao , Clift Shirley , Ando Dale , Mulligan Richard , Yamauchi Atsusi , Noguchi Masayuki , Asano Shigetaka , Akaza Hideyuki 
Published: March 2003

AbstractA phase I study of granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) gene‐transduced tumor vaccine for patients with metastatic renal cell carcinoma (RCC) was initiated in 1998, as the first cancer gene therapy in Japan. The study is still ongoing, but the first patient is presented here as a case report. The patient was a 60‐year‐old man with Stage IV CRC with multiple lung metastases. After surgical resection of the tumor, autologous tumor cells were transduced and cultured to produce GM‐CSF. The patient received a total of 2.2 × 108 gene‐transduced autologous vaccine cells by subcutaneous injection. During the course of vaccination, growth of the largest metastatic mass slowed to some extent; however, multiple new lesions developed. About 1 month after the start of low‐dose IL‐2 therapy, rapid and remarkable regression in a large lung hilar metastatic mass was noticed. The patient died of progressive disease 7 months after the start of GM‐CSFgene therapy. Careful histological examination by autopsy revealed that the responding mass was infiltrated by CD8 positive dominant T lymphocytes, and did not exhibit vasculitis or any other changes associated with active autoimmune disease.
Laparoscopic nephroureterectomy for dysplastic kidney in children: an initial experience
Authors: Kurokawa Yasushi , Kanayama Hiro‐Omi , Anwar Ahmed , Fukumori Tomoharu , Yamamoto Yasuyo , Takahashi Masayuki , Kagawa Susumu , Murakami Yosihide , Terachi Toshiro 
Published: March 2003

Abstract
Background: Laparoscopic nephroureterectomy for dysplastic kidney is now becoming a widely accepted procedure. We report here our initial experience with laparoscopic nephroureterectomy in four girls.
Methods: Between 1993 and 1999, laparoscopic nephroureterectomy was performed in four girls (mean age 5.3 years). Three patients had an ectopic dysplastic kidney with ectopic ureter, and one patient had hydronephrosis with megaureter due to distal ureteral atresia of the upper moiety in a duplicated dysplastic kidney. The transperitoneal approach was used in all cases.
Results: Mean operative time was 195 min (range 150–266). Blood loss was minimal. All operations were completed successfully and there were no intraoperative or postoperative complications except for subcutaneous emphysema in one patient (case 4). Postoperative analgesia was used in three patients and administered in the form of diclofenac sodium suppositories 12.5 mg (cases 1 and 2) or acetaminophen suppositories 50 mg (case 3) for 1–2 days. One patient did not require any analgesia (case 4). Oral fluid intake was resumed on the first postoperative day and ambulation began within 1–3 days (mean 1.6, cases 1, 2 and 3) and 6 days (case 4). All children returned to normal activity within 3–6 days of surgery. Mean postoperative hospital stay was 7.3 days. All cases had uneventful courses after discharge.
Conclusion: Laparoscopic nephroureterectomy can be performed safely, with minimal postoperative pain, excellent cosmetic results and early ambulation. We advocate the use of laparoscopy for the diagnosis and treatment of dysplastic kidney with ectopic ureter.
Endoscopic management of post‐traumatic prostatic and supraprostatic strictures using Neodymium‐YAG laser
Authors: NABI GHULAM , DOGRA PREM NATH 
Published: March 2003

AbstractWe assessed the feasibility, efficacy and long‐term results of endoscopic management using Neodymium‐YAG (Nd‐YAG) laser as a day care procedure in patients with post‐traumatic supraprostatic and prostatic strictures. Three patients with post‐traumatic prostatic and supraprostatic obliterative strictures underwent Nd‐YAG laser core through urethrotomy as a day care procedure. Patient age ranged between 12 and 14 years. Mean duration of injury was 16 months. The length of stricture was assessed by bi‐directional endoscopy prior to the procedure in all cases. Core through procedure was carried out using Nd‐YAG laser under the guidance of a cystoscope placed antegradely. Patients were discharged on the same day with urethral catheter. Foley catheters were removed at 6 weeks. Nd‐YAG laser core through procedure was carried out successfully in all cases with negligible blood loss in a mean time of 48 min. There were no intraoperative or postoperative complications. Patients were discharged on the same day. Follow‐up cystogram was conducted at 6 weeks and urethroscopy at months. At a mean follow‐up of 23 months, patients were asymptomatic and voiding well. Nd‐YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post‐traumatic prostatic and supraprostatic strictures. It can be carried out as a day care procedure in carefully selected patients and has no complications.
Changes in serum and prostatic zinc concentrations in rats after intraprostatic injection of zinc: Comparison of two forms of zinc delivery
Authors: CHO YONG‐HYUN , LEE SEUNG‐JU , LEE JI YOUL , KIM SAE WOONG , KIM JUNG JU , LEE WOO YOUNG , YOON MOON SOO 
Published: March 2003

AbstractBackground: We investigated changes in zinc concentrations in serum and prostatic tissue after an intraprostatic injection of zinc, and compared two forms of zinc delivery: solution and liposome.Methods: Ninety‐six male Wistar rats were used in the study (24 controls, 72 test rats). The test animals were randomly divided into two groups and were injected intraprostatically with 2 mL of 0.04 mol/L zinc sulfate according to the form of zinc delivery. Nine rats in each test group were sacrificed 1 day, 7, 14 and 28 days after injection, and 24 normal rats were injected intraprostatically with 2 mL of distilled water as controls. Serum and prostatic zinc concentrations of each group were measured by inductively coupled plasma atomic emission spectrometry. Blood chemistries, routine urinalysis, urine culture and histopathologic examination were also performed.Results: Serum zinc concentrations did not change significantly after the intraprostatic injection of zinc. Prostatic zinc concentrations were found to be significantly greater (P < 0.05) in zinc‐injected groups than in the control group. The intraprostatic injection of zinc solution and zinc liposome increased zinc levels in both ventral and dorsolateral lobes significantly. Prostatic zinc levels increased progressively following injection, reaching a peak level in 7 days and maintaining a high value throughout the experimental period. The prostatic zinc level of the 1‐day zinc liposome group was higher than that of the 1‐day zinc solution group, while no significant difference was observed between the solution and liposome group in 7, 14, 28 days. No abnormal findings were observed in any of the laboratory and histopathologic examinations; however, an acute inflammatory response was observed in the 1‐day groups.Conclusion: These findings suggest that an intraprostatic injection of zinc in normal rats increases and maintains the prostatic zinc level for at least 4 weeks without causing any systemic or local toxicities. These findings suggest the potentially important clinical applicability of local zinc to the treatment of chronic prostatitis.
Treatment of monosymptomatic nocturnal enuresis by acupuncture: A preliminary study
Authors: HONJO HISASHI , KAWAUCHI AKIHIRO , UKIMURA OSAMU , SOH JINTETSU , MIZUTANI YOICHI , MIKI TSUNEHARU 
Published: March 2003

AbstractObjectives: This study was designed to clarify the clinical usefulness of acupuncture as a treatment option for monosymptomatic nocturnal enuresis, and evaluate the mechanisms of its effect.Methods: Subjects comprised 15 patients (10 males, 5 females) with monosymptomatic nocturnal enuresis who were treated by acupuncture using a disposable stainless steel needle (0.3 mm in diameter, 60 mm in length) inserted into bilateral BL‐33 (Zhongliao) points on the skin of the third posterior sacral foramina and rotated manually for 10 min reciprocally. Bladder capacities and number of wet nights per week were compared before and after treatment. Patients in whom wet nights decreased 50% or more compared with the baseline were considered responders.Results: Nocturnal enuresis improvement rates following acupuncture treatment were 40% (6/15) just after treatment and 47% (7/15) 2 months after. In 6 responders, just after treatment the nocturnal bladder capacity (NBC) increased significantly, from 201 mL to 334 mL (P < 0.05). No side‐effects were recognized throughout the treatment period.Conclusion: Acupuncture may be beneficial in the treatment of nocturnal enuresis by increasing NBC, and provide a promising alternative to conventional therapies for monosymptomatic nocturnal enuresis.
Incidentally discovered pheochromocytoma in long‐term hemodialysis patients
Authors: MORIOKA MASAAKI , YUIHAMA SHINNOSUKE , NAKAJIMA TAKASHI , KOBAYASHI TATSUYA , SONE ATSUSHI , FURUKAWA YOJI , TANAKA HIROYOSHI , SAIKI TOYONORI 
Published: March 2003

AbstractTwo cases of pheochromocytoma incidentally discovered in long‐term hemodialysis patients are reported. Case 1 was a 47‐year‐old‐man who had been receiving hemodialysis for 18 years. Case 2 was a 33‐year‐old woman who had been receiving hemodialysis for 12 years. Both cases were normotensive, and no specific symptoms suggesting pheochromocytoma were seen. Plasma norepinephrine (NE) levels were not elevated in both cases; however, the level of epinephrine (E) was double the normal range in Case 2. After surgery, plasma E level returned to the normal range in Case 2; however, the level of NE remained almost the same as the preoperative value in both cases. Plasma catecolamine levels in long‐term hemodialysis patients with pheochromocytoma are reviewed in the present report, and the efficacy of imaging methods in the diagnosis of pheochromocytoma are discussed.
Current status of positron emission tomography in oncology
Authors: Scott A. M. 
Published: March 2003

AbstractPositron emission tomography (PET) has emerged as a powerful diagnostic tool in oncology patients. There is evidence of the superior utility over conventional imaging methods of the principal PET tracer 18F‐fluoro‐2‐deoxy‐glucose in the staging of a range of cancers and monitoring disease recurrence, as well as changing patient management to more appropriate therapy. The methods for evaluating the evidence for PET remain complex, particularly as the standard evidence‐based approach of randomized controlled trials is not generally applicable to imaging techno‐logies. PET has the potential to dramatically improve our ability to manage patients with cancer and is also making major contributions to the development of new therapies. (Intern Med J 2000; 31: 27–36)
Psychological impact of genetic counselling and testing in women previously diagnosed with breast cancer
Authors: Randall J. , Butow P. , Kirk J. , Tucker K. 
Published: March 2003

Abstract Background: The recent discovery of susceptibility genes relating to breast cancer, BRCA1 and BRCA2, now allows women with breast cancer and a family history of breast/ovarian cancer to undergo genetic testing to identify a causative germ‐line mutation. The present study assessed the psychological status over time of women affected by breast cancer requesting genetic testing (cases; n = 32) compared with matched controls (n = 28). Methods: Subjects were recruited through two Sydney‐based hospitals. Data were collected via questionnaire and telephone interview at baseline, and 2 weeks and 3–6 months following counselling. Results: Genetic test results were not received by the subjects within the study period. Cases showed a greater increase in knowledge of cancer genetics following counselling compared with controls, and this was maintained over time. Psychological symptoms remained stable over the study period and there were no differences between groups. Conclusions: Increased knowledge following genetic counselling was not accompanied by an increase in anxiety or depression. Further assessment will be required in the long term to determine the psychological impact of receiving a genetic test result. (Intern Med J 2001; 31: 397–405)
Outcome of a smoking cessation programme run in a routine hospital setting
Authors: Wood‐Baker R. 
Published: March 2003

Abstract Background: Although tobacco smoking remains the largest preventable cause of mortality in Australia, resources to assist with cessation remain scarce. Research studies have demonstrated improved cessation rates with interventions such as counselling and pharmacotherapy, but there is little information on success in routine clinical practice. Aims: To determine the outcome of a smoking cessation programme run in a routine hospital outpatient setting. Methods: A prospective audit of patients referred to an outpatient smoking cessation programme by hospital specialists or general practitioners. The programme consisted of fortnightly counselling sessions, with nicotine replacement therapy when clinically indicated. Self‐reported abstinence rates were determined by contacting patients by letter or telephone at 3 and 12 months. Abstinence was confirmed, whenever possible, by measuring the expired carbon monoxide (CO) concentration. Results: Over 12 months, 226 new patients were seen through the programme. There was a correlation between the number of cigarettes smoked and the baseline Fagerstrom score (r = 0.49, P < 0.001). Approximately 40% of subjects could not be contacted for follow up. At 3 months the self‐reported abstinence rate was 31%, falling to 19% by 12 months. Measurement of expired CO concentrations proved that self‐reported abstinence was reliable. Conclusions: The abstinence rates achieved by our programme compared well with those previously reported in the literature, demonstrating the effectiveness of a smoking cessation programme run in routine clinical practice. There was an increasing relapse rate during the period of follow up. (Intern Med J 2002; 32: 24–28)
Central nervous system prophylaxis in haematological malignancies
Authors: Wellwood J. , Taylor K. 
Published: March 2003

AbstractGiven the poor prognosis of central nervous system (CNS) involvement in haematological malignancies, management is directed towards prevention. CNS prophylaxis may take the form of intrathecal therapy, cranial irradiation, systemic therapy or some combin­ation of these. The toxicity of these methods is an important consideration. A risk‐orientated approach to the delivery of CNS prophylaxis in each disorder is required. (Intern Med J 2002; 32: 252−258)
Asthma management: how effective is it in the community?
Authors: Matheson M. , Wicking J. , Raven J. , Woods R. , Thien F. , Abramson M. , Walters E. H. 
Published: March 2003

Abstract Background:  The National Asthma Campaign (NAC) was launched in Australia in 1989 with the major objective of improving asthma management through the implementation of a six‐step asthma management plan.Aim:  The objective of the present study was to analyse the management of asthma in a cohort of adults with self‐reported asthma 10 years after the commencement of the NAC.Methods:  The subjects were participants in the laboratory phase of a cross‐sectional epidemiological study conducted in Melbourne in 1999−2000. Participants completed the detailed European Community Respiratory Health Survey, which included specific questions about their asthma management. Participants were included in this analysis if they had a positive response to the question ‘Have you ever had asthma?’. This resulted in a total of 435 subjects.Results:  Of the subjects with self‐reported asthma, over half of the participants reported that a doctor had ever measured their breathing (52.9%). However, only 10.1% of participants reported that they owned a peakflow meter (PFM) and only 13.3% reported that they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (P < 0.0001), as has PFM ownership (P < 0.0001) and, importantly, possession of a written action plan (P = 0.0004).Conclusions:  Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required. (Intern Med J 2002; 32: 451−456)
Is magnetic resonance angiography useful in renovascular disease?
Authors: Prasad S. , Bannister K. , Taylor J. 
Published: March 2003

Abstract Background:  Magnetic resonance angiography (MRA) of renal vessels correlates well with conventional angiography (CA) and enables non‐invasive assessment of renal vessels without nephrotoxic contrast.Aims: We aimed to identify the referral source and nature of the patient group undergoing renal MRA, and the impact of this test on their management.Methods: All renal MRA scans performed at the Royal Adelaide Hospital from 1 November 1997 to 31 Dec­ember 2000 were reviewed (n = 121). Clinical data were obtained by case‐note review or from treating physicians. MRA scans were with gadolinium enhancement, using a Siemens Vision 1.5 Tesla machine (Siemens, New York), with Visual Basic 33 software and 3D reconstruction.Results: Nephrologists ordered the majority of renal MRA studies (64.5%). Indications for MRA included: (i) hypertension (91.3%), (ii) abnormal renal function (78.3%), (iii) other imaging suggesting renovascular disease (64.3%) and (iv) renal impairment with angiotensin‐converting enzyme inhibition (18.3%). Eighty‐seven MRA studies revealed renovascular abnormalities (‘positive’). Over 50% of patients had three or more risk factors associated with vascular disease, with MRA positive in 76%. Localized renal artery stenosis was identified in 65 cases. In 40 of these, CA and further intervention was not undertaken, mainly due to presence of features of irreversible renal damage, low‐grade stenosis or stable clinical parameters. CA was performed in 25 patients, all of whom had moderate‐ to high‐grade (>60%)­­stenosis on MRA. Revascularization was attempted in 21 of the 25 patients, with technical success in 17. In 22 patients, MRA identified non‐localized abnormal­ities, most commonly diffuse arterial disease. None went on to angiography.Conclusions: Selective use of renal MRA in high‐risk patients (identified by vascular risk factors or with standard renal imaging) can assist in avoidance of invasive, potentially nephrotoxic conventional angiography in up to 80% of cases. Those with lesions warranting treatment can then be selected for further intervention. (Intern Med J 2003; 33: 84−90)