bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hematospermia: An investigation of the bleeding site and underlying lesions
Authors: Furuya Seiji , Ogura Hiroshi , Saitoh Nobuhito , Tsukamoto Taiji , Kumamoto Yoshiaki , Tanaka Yoshinori 
Published: March 2003

Background
: The site of hemorrhage and causative lesions in patients with hematospermia were evaluated using the puncture technique for seminal vesicles and/or müllerian duct cysts under ultrasound guidance.
Methods
: Twenty‐one patients aged 26–75 years (mean, 49.8 years) underwent transperineal needle aspiration of the seminal vesicles and/or müllerian duct cysts guided by transrectal ultrasonography (TRUS).
Results
: Dark reddish seminal vesicle fluid was aspirated and the site of bleeding was considered to be the seminal vesicles in 11 patients (52%) (group A). In group A, abnormalities of the seminal vesicles were noted in nine patients (82%). These consisted of dilated seminal vesicles in seven (bilateral in four, unilateral in three), a seminal vesicle cyst in one and seminal vesicle amyloidosis in one. A müllerian duct cyst was confirmed to be the bleeding site in two patients (10%; group B). The bleeding site was estimated to be organs rather than the seminal vesicles in four patients (group C), in all of whom ectopic prostatic tissue was observed in the prostatic urethra. In groups B and C, seminal vesicle abnormalities were not detected by TRUS. In the remaining four patients (group D), failure to aspirate seminal vesicle fluid means that it is unclear whether hemorrhage was from the seminal vesicle or from another source. In group D, ectopic prostatic tissue was demonstrated in the prostatic urethra of three patients and unilateral seminal vesicle dilation was detected by TRUS in one patient.
Conclusion
: Puncture of the seminal vesicles and/or müllerian duct cysts under ultrasonic guidance as well as cystourethroscopy is a useful and minimally invasive examination for determination of the bleeding site responsible for hematospermia.
Hypercalcemia in a patient with renal cell carcinoma producing parathyroid hormone‐related protein and interleukin‐6
Authors: Ueno Munehisa , Ban Shin‐Ichi , Nakanoma Takashi , Tsukamoto Takuji , Nonaka Shoichi , Hirata Risa , Iida Masahiro , Deguchi Nobuhiro 
Published: March 2003

AbstractA patient with renal cell carcinoma who developed humoral hypercalcemia of malignancy is reported. A 52‐year‐old male patient was diagnosed with renal cell carcinoma and multiple lung metastases. A cell line isolated from the surgical specimen exhibited continuous production of parathyroid hormone‐related protein (PTHrP) in vitro. The production of PTHrP from the cancer cells was confirmed by RT‐PCR and immunoradiometric assay. The serum calcium level was not enhanced, whereas the lung lesion was developing and producing interleukin‐6, a possible modulator of osteoclastic resorption. Hypercalcemia was induced when the PTHrP concentration increased up to 3.3 pmol/L.
Treatment outcome by risk group after radical prostatectomy in Japanese men
Authors: Egawa Shin , Suyama Kazuho , Arai Yoichi , Tsukayama Chohtatsu , Matsumoto Kazumasa , Kuwao Sadahito , Baba Shiro 
Published: March 2003

AbstractBackground:North American investigators have suggested the usefulness of risk‐group stratification based on prostate‐specific antigen (PSA), clinical stage and biopsy Gleason score for predicting the biochemical outcome of prostate cancer after radical prostatectomy. There have been no reports of the application of this stratification to early biochemical outcome after radical surgery in Japanese men.Methods:The study population consisted of 178 men treated with radical retropubic prostatectomy and bilateral pelvic lymph node dissection at Kitasato University Hospital (n = 110) and Kurashiki Central Hospital (n = 68) between October 1992 and May 1999. Pathologic and biochemical outcomes after radical prostatectomy were analyzed based on risk‐group stratification. Risk groups were further analyzed according to detailed pathologic findings at biopsy.Results:The median follow‐up period for the 178 patients after radical surgery was 41.5 months (range, 2.0–82.0 months; mean, 40.9 months). Fifty‐eight patients experienced PSA failure at a median of 8.0 months following surgery (range, 0.0–58.0). Risk‐group stratification distinctly defined groups of pathologic findings in the radical prostatectomy specimens. The proportion of patients with PSA failure for low, intermediate and high‐risk groups were 9.5%, 23.9% and 56.9%, respectively (P < 0.0001). Use of the number of cores with cancer and maximum cancer length in biopsy cores failed to improve risk stratification for PSA outcome in all risk groups.Conclusions:Risk‐group stratification based on preoperative variables may significantly improve a physician’s ability to counsel patients about PSA outcome after radical prostatectomy. Further improvement in risk stratification may call for use of variables other than the pathologic information in biopsy cores.
Incidentally discovered giant renal arteriovenous malformation
Authors: Asakuma Junichi , Miyajima Akira , Sawazaki Harutake , Mizuguchi Yasunori , Seguchi Kenji , Ito Keiichi , Asano Tomohiko , Ogata Shou , Tamai Seiichi , Hayakawa Masamichi 
Published: March 2003

AbstractA case is presented of giant renal arteriovenous malformation (AVM). A 61‐year‐old woman was admitted to the National Defense Medical College Hospital for further evaluation of a renal cyst. Doppler ultrasonography and magnetic resonance imaging revealed a giant renal AVM, although the patient had no history nor clinical sign suggesting an AVM. Under the diagnosis of a right renal AVM, the patient underwent AVM resection.
A case of testicular tunica albuginea cyst with psammoma body
Authors: Rha Koon Ho , Choi Young Deuk , Lee Woong Hee , Lee Joong Shik , Choi Ho Sung , Key Cho Young , Lee Moo Sang 
Published: March 2003

AbstractCystic testicular masses have been considered rare but due to advances in ultrasonographic technologies their incidence has risen. Many testicular cystic masses are benign but there is a chance of malignancy. Psammoma bodies are found in various malignancies that occur in the genital tract of women but rarely in men. We report a case of testicular tunica albuginea cyst with psammoma bodies.
Asynchronous (heterochronic) bilateral renal infarction associated with primary antiphospholipid syndrome
Authors: Kitta Takeya , Takeyama Yoshihiro , Seki Toshimori , Togashi Masaki , Harada Hiroshi 
Published: March 2003

AbstractWe report the rare case of a 51‐year‐old man with asynchronous (heterochronic) bilateral renal infarction associated with primary antiphospholipid syndrome. He was treated for right renal infarction, but 2 months later, while under anticoagulant treatment, he had a recurrence on the other side of the renal infarction. The laboratory work‐up confirmed antiphospholipid syndrome. Six months later the patient has not experienced any new thrombotic episodes and is receiving oral anticoagulants and antiplatelet therapy.
Promoting the effects of intravesical instillation of saline on bladder lesion development in rats pre‐treated with BBN
Authors: ITOH YASUNORI , OKAMURA TAKEHIKO , TOZAWA KEIICHI , YAMADA YASUYUKI , KOHRI KENJIRO 
Published: March 2003

Abstract Background: At present, immunotherapeutic agents such as bacillus Calmette‐Guerin (BCG) and anti‐tumor chemotherapeutic agents in saline are used intravesically in patients with bladder carcinoma. However, of greater significance is the possibility that the saline vehicle may itself promote carcinoma development in the bladder.Methods: The potential promoting effects of intravesical instillation of saline were assessed in female F344 rats. The animals were divided into 3 groups, all of which received 0.05% N‐butyl‐N‐(4‐hydroxybutyl)nitrosamine (BBN) in their drinking water for the first 10 weeks. They were then maintained without further treatment (group 1) or received intravesical instillations of 0.3 mL of saline or distilled water once a week for 6 weeks, 15 weeks after the end of the BBN treatment (groups 2 and 3). At 32 weeks, all the animals were killed and examined immunohistochemically with proliferating cell nuclear antigen (PCNA) antibody, as well as by routine histopathologic examination.Results: Both the incidence and the number of bladder carcinomas were higher in the animals that received instillations of saline than in those who did not receive the instillations. Significant increases in tumor size were also noted for the saline‐treated groups, although this was not linked with the PCNA labeling index.Conclusions: The results indicate that saline is a promoter of urinary bladder carcinogenesis either because of the catheterization or the fluid itself.
Spontaneously ruptured multilocular cystic nephroma
Authors: FUJIMOTO KEN , SAMMA SHOJI , FUKUI YOSHIHISA , YAMAGUCHI AKIRA , HIRAYAMA AKIHIDE , KIKKAWA AKIRA 
Published: March 2003

AbstractMultilocular cystic nephroma is a relatively rare benign tumor of the kidney. An adult case of spontaneously ruptured multilocular cystic nephroma was reported. A 33‐year‐old woman who presented with a right flank colic attack. The preoperative diagnosis was spontaneously ruptured renal tumor. A right nephrectomy was performed. A multilocular cystic lesion, 10 cm in diameter, was found in the removed specimen, which had a hematoma inside and direct tumor extension into the renal pelvis. On microscopic examination, the surface of loculi was covered by a layer of hobnail epithelium, and septa were composed of fibrous tissue with dilated vessels, lacking in normal renal components. There were no signs of malignancy. The lesion extending into the renal pelvis showed the same microscopic findings. The final diagnosis was multilocular cystic nephroma. Two respects, spontaneous rupture and tumor extension into the renal pelvis, were unique to the present case. There has been no report of spontaneously ruptured mutilocular cystic nephroma. The tumor extension into the renal pelvis, however, has been found in several reports. This growth pattern might be one of the characteristics of this benign renal tumor.
Holmium laser enucleation for large (greater than 100 mL) prostate glands
Authors: Hettiarachchi Janaka A , Samadi Albert A , Konno Sensuke , Das Akhil K 
Published: March 2003

Abstract
Background:
To evaluate the holmium laser enucleation of the prostate (HoLEP) using the transurethral soft tissue morcellator (TUSTM), as a primary surgical treatment for symptomatic benign prostatic hyperplasia (BPH) with prostate glands > 100 mL.
Methods:
Eighteen patients with preoperative prostate volumes > 100 mL underwent the HoLEP procedure. The criteria for surgery were determined by a preoperative International Prostate Symptom Score (IPSS), a prior failure of medical therapy, and urinary retention.
Results:
The mean preoperative IPSS and prostate gland size were 13.8 and 142.3 mL, respectively. The total energy used by the laser was 288.4 kJ. The mean catheter time was 23.8 h and, perioperatively, no patients had electrolyte abnormalities or required blood transfusions. The 3‐week postoperative IPSS was 2.8, with minimum long‐term complications.
Conclusions:
Holmium laser enucleation of the prostate with TUSTM is a safe and effective alternative to open prostatic surgery for glands > 100 mL.
Sarcomatoid carcinoma and carcinosarcoma of the urinary bladder
Authors: Ogishima Tatsuya , Kawachi Yoshio , Saito Akira , Suzuki Fujihiko , Ishi Kazuhisa , Tanaka Toru 
Published: March 2003

AbstractTwo cases, sarcomatoid carcinoma and carcinosarcoma, of the urinary bladder are reported. A 68‐year‐old man with sarcomatoid carcinoma underwent total cystectomy and was alive and had had no recurrence after 21 months. A 78‐year‐old woman with carcinosarcoma underwent total cystectomy, but she died from increasing multiple lung metastases 4 months after surgery. The histopathological characteristics of both neoplasms are reported and discussed.
Effect of administration mode (patient vs physician) and patient's educational level on the Turkish version of the International Prostate Symptom Score
Authors: Bozlu Murat , Doruk Erdal , Akbay Erdem , Ulusoy Ercüment , Çayan Selahíttín , Acar Deníz , Kanik Emíne Arzu 
Published: March 2003

AbstractObjectives: To compare the effectiveness of the International Prostate Symptom Score (IPSS) when administered by the physician to when self‐administered by the patient. The effect of the patient's educational level on the IPSS was also evaluated.Methods: One hundred and seven previously untreated patients with symptomatic benign prostatic hyperplasia (BPH) completed the Turkish version of the International Prostate Symptom Score (Turkish I‐PSS) and quality of life (QOL) questionnaires during a single office visit, first on their own and then with an interviewing physician. The patients were categorized into three groups according to their educational levels. Paired t‐tests were performed to compare the total IPSS (tIPSS) and QOL results between the two testing modes. IPSS and QOL scores resulting from both modes were compared using a kappa test. Differences between the physician‐assisted and self‐administered scores among the different educational groups were further compared using a one‐way anova test and Post Hoc Multiple Comparisons. To compare the objective effectiveness of tIPSS and QOL between the two testing modes, we selected the positive actual state, which was maximum urine flow (Qmax) of 15 mL/s or less and constructed receiver operating characteristics (ROC) curves for all patients. This estimation was constructed for each educational level.Results: There were no statistical differences in IPSS and QOL values obtained by the patients or physicians (P > 0.05). The ROC areas for tIPSS were 0.94 and 0.93, and the ROC areas for QOL scores were 0.97 and 0.91 for information obtained by physicians and patients, respectively. When IPSS answers and QOL scores were evaluated separately, consistency was found across both modes of administration. However, there were lower levels of consistency in answers to IPSS questions 2, 5 and 6 (P = 0.59;0.42; 0.52, respectively). There was no significant difference among the aforementioned data in the educational groups.Conclusion: Although the total IPSS and QOL scores were not affected by the different modes of administration, we recommend that the physicians should evaluate answers to questions 2, 5 and 6 carefully. The present study demonstrates that the educational level did not affect the IPSS and QOL when administered either by the physician or the patient.
Ureteroenteric fistula after retrograde balloon dilatation of ureteral stricture
Authors: OH SEUNG‐JUNE , JEONG BYONG‐CHANG , KIM HYEON HOE 
Published: March 2003

AbstractAdvances in endourology have made transluminal balloon dilatation a safe and effective procedure for the treatment of ureteral strictures. Bilateral ureteral stricture was treated with retrograde balloon dilatation and ureteral stenting in a 59‐year‐old‐woman. The patient had previously undergone abdominoperineal resection and adjuvant radiotherapy due to rectosigmoid adenocarcinoma. Subsequently, unilateral ureteroenteric fistula was detected on follow‐up retrograde ureteropyelography. To our knowledge, this is the first case of ureteroenteric fistula after balloon dilatation for ureteral stricture in a patient with predisposing factors for compromised vascularity of the ureter.
Cell proliferation, apoptosis, angiogenesis and growth rate of incidentally found renal cell carcinoma
Authors: ODA TOSHIRO , TAKAHASHI ATSUSHI , MIYAO NORIOMI , YANASE MASAHIRO , MASUMORI NAOYA , ITOH NAOKI , SATO MASA‐AKI , KON SHIN‐ICHIRO , TSUKAMOTO TAIJI 
Published: March 2003

AbstractBackground: Our previous study showed that the growth rate of incidentally found renal cell carcinoma (RCC) varied, and that the initial clinical and pathological features did not predict subsequent growth of the carcinoma. The objective of this study was to determine the relationships between cell proliferation, apoptosis, angiogenesis and the growth rates of these RCC.Methods: We examined cell proliferation, apoptosis, and angiogenesis in 16 incidentally found cases of RCC. Cell proliferation was assessed by immunohistochemical staining with a Ki‐67 antibody. Apoptosis was assessed by the terminal deoxynucleotidyl transferase (TdT) mediated deoxy‐UTP biotin nick end labeling (TUNEL) technique. The Ki‐67 labeling index (KI) and the apoptotic index (AI) were determined as the ratio of immunohistochemically positive cells per 1000 cancer cells. The KI/AI ratio was also determined. Angiogenesis was evaluated by CD34 immunostaining. Finally, we investigated the correlation between these parameters and the growth rate of primary lesions of incidentally found RCC.Results: The KI ranged from 7 to 73 (median, 20), AI ranged from 6 to 171 (median, 26), and microvessel density (MVD) ranged from 21 to 673 (median, 265) for incidentally found RCC. Ki‐67 labeling index, AI and MVD were not closely correlated to each other. Furthermore, these parameters were not associated with growth rates of incidentally found RCC. Only the KI/AI ratio was strongly correlated to the growth rate of incidentally found RCC (r = 0.709; P = 0.0083).Conclusion : Our results suggest that the balance between cell proliferation and apoptosis partly determines the growth rate of primary lesions of incidentally found RCC.
Antegrade extraperitoneal approach to radical cystectomy and ileal neobladder
Authors: SEREL TEKIN AHMET , SEVI˙N GüüVEN , PERK HAKKI˙˙ , KOŞAR ALIM , SOYUPEK SEDAT 
Published: March 2003

AbstractBackground: We describe a new operative technique for the surgical treatment of bladder cancer.Methods: Male patients with invasive bladder cancer were managed by radical cystoprostatectomy using a technically different approach than the conventional method. The main feature of this method includes a small vertical incision between pubis and umbilicus, keeping the abdominal peritoneum closed during the surgery. Reperitonealization is done at completion to isolate the urinary anastomoses from the bowel anastomoses.Results: Seventy‐six consecutive patients with bladder cancer underwent this operation. The mean operation time was 4 h 30 min and the mean hospital stay was 11 days. No mortality was seen in the early postoperative period. Only one patient developed serious bowel distension. Two patients developed pneumonia. Wound infection was seen in two patients. Two patients experienced hydronephrosis in the late period of follow‐up. Four patients developed pelvic lymphocele. There was no evidence of postoperative electrolyte loss in any of the patients. Three patients developed abdominal hernia and this was corrected with surgical treatment. Urodynamic evaluation of 15 patients showed a low capacity reservoir. All patients were continent during the daytime.Conclusion: This technique keeps the abdominal peritoneum closed during radical cystoprostatectomy, preventing the patients from complications, such as infection, water and electrolyte imbalances. The technique also decreases the recovery time.
Predictors of prostate cancer on repeat transrectal ultrasound‐guided systematic prostate biopsy
Authors: PARK SOO‐JEON , MIYAKE HIDEAKI , HARA ISAO , ETO HIROSHI 
Published: March 2003

Abstract
Background:
We analyzed the outcome of repeated transrectal ultrasound (TRUS)‐guided systematic prostate biopsy in Japanese men whose clinical findings were suspected of prostate cancer after previous negative biopsies.
Methods:
Between January 1993 and March 2002, 1045 patients underwent TRUS‐guided prostate biopsy. Among them, 104 patients underwent repeat biopsy due to indications of persistent elevated serum prostate‐specific antigen (PSA), abnormal digital rectal examination (DRE) or TRUS, increased PSA velocity, and/or previous suspicious biopsy findings. Several clinicopathological factors were evaluated for their ability to predict the detection of prostate cancer on repeat biopsy.
Results:
Prostate cancer was detected in 22 of 104 patients (21.2%) who underwent repeat biopsies. PSA concentration and PSA density at both the initial and repeat biopsies, and PSA velocity in men with positive repeat biopsy were significantly greater than those in men with negative repeat biopsy. The incidence of abnormal findings in DRE and TRUS at initial biopsy in men with positive repeat biopsy was also significantly higher than that in men with negative repeat biopsy. However, neither the presence of prostatic intraepithelial neoplasia nor number of biopsy cores at initial biopsy had a significant association with the results of the repeat biopsy. Furthermore, multivariate analysis revealed that PSA and PSA density at both the initial and repeat biopsies, PSA velocity, and DRE and TRUS findings at initial biopsy were independent predictors of malignant disease on repeat biopsy.
Conclusion:
Despite an initial negative biopsy, repeat TRUS‐guided biopsy should be carried out to exclude prostate cancer in cases of suspicious clinical findings, such as elevated PSA or PSA‐related parameters, or abnormal findings of DRE or TRUS.
Acute renal failure following ingestion of wild mushrooms
Authors: Mount P. , Harris G. , Sinclair R. , Finlay M. , Becker G. J. 
Published: March 2003

AbstractWe describe three cases of acute renal failure in young men who ingested wild mushrooms with the intent of producing hallucinations. Two cases remained dialysis dependent and, in these cases, renal biopsy revealed tubulointerstitial nephritis and ­fibrosis. Similar cases have been reported in other countries, but not in Australia. The most recognized mushroom nephrotoxin is orellanine, however the causative mushroom species and the actual toxin involved in these cases are unknown. (Intern Med J 2002; 32: 187−190)
Bilateral tubal pregnancies after the termination of intrauterine pregnancy following gamete intrafallopian transfer
Authors: Shibahara Hiroaki , Suzuki Tatsuya , Wada Tomoaki , Ohno Takashi , Yamauchi Ariko , Tsunoda Tetsuo , Takamizawa Satoru , Sato Ikuo , Shiraishi Satoshi 
Published: March 2003

It is well known that the prevalence of heterotopic pregnancies following assisted reproductive technology (ART) is much higher than among spontaneous pregnancies. Here, we illustrate a very rare case of bilateral simultaneous tubal pregnancies combined with intrauterine pregnancy (incomplete abortion) following gamete intrafallopian transfer (GIFT). In this case, unsuspected bilateral tubal pregnancies were diagnosed when laparotomy was performed 10 days after the termination of an intrauterine pregnancy. We conclude that a careful monitoring after the termination of an intrauterine pregnancy should be performed when the patient has prolonged genital bleeding, which might be a warning signal of heterotopic pregnancy existence even in patients without any risk factors of ectopic pregnancy. (Reprod Med Biol 2002; 1: 65–67)