bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of androgen‐independent prostate cancer with dexamethasone: A prospective study in stage D2 patients
Authors: Saika Takashi , Kusaka Nobuyuki , Tsushima Tomoyasu , Yamato Toyoko , Ohashi Teruhisa , Suyama Bunzo , Arata Ryoji , Nasu Yasutomo , Kumon Hiromi ,   Okayama Urological Cancer Collaborating Group (OUCCG)
Published: March 2003

AbstractPurpose:In order to evaluate the efficacy of dexamethasone in the treatment of Japanese men with androgen‐independent prostate cancer, a prospective study was conducted using prostate‐specific antigen (PSA) as a primary end‐point.Methods:Nineteen Japanese men with stage D2 androgen‐independent prostate cancer were registered and treatment was started. After ruling out anti‐androgen withdrawal syndrome, they were treated with dexamethasone (1.5 mg daily). Patients were monitored for PSA, symptoms, radiologic response, survival rate, time to disease progression, time to treatment failure and complications.Results:Prostate‐specific antigen levels decreased in nine patients (50.0%); five (27.8%) showed a 50% or greater decrease and two (11.1%) showed an 80% or greater decrease. For the nine patients, the mean duration of PSA response was 7.3 months and the median duration was 2.1 months (range, 1.2–27.5+). Bone pain, which was noted in 13 patients at study entry, improved in seven patients (53.8%). Of nine patients who had serial radiographic examinations with bone scan, three (33%) showed partial response, two (22%) were stable and four (44%) showed disease progression. Treatment was well tolerated, except for one patient who suffered a severe pulmonary infection.Conclusion:Dexamethasone decreased PSA levels and produced subjective symptomatic improvement in the patients with stage D2 androgen‐independent prostate cancer.
Apoptotic cell death and Smad4 expression in transitional cell carcinoma of the renal pelvis and ureter
Authors: Kong Chuize , Zhang Xianghua , Takenaka Ikumasa 
Published: March 2003

Abstract Purpose: To investigate the frequency of apoptosis and the expression of Smad4 protein as well as their roles in transitional cell carcinoma (TCC) of the renal pelvis and ureter.Methods: Apoptosis was detected by using terminal deoxynucleotidyl transferase (TdT)‐mediated dUTP‐biotin nick end labeling (TUNEL) technique in 34 formalin‐fixed and paraffin‐embedded specimens of renal pelvic and ureteral TCC. The expression of Smad4 was immunohistochemically studied.Results: The incidence of apoptosis ranged from 1.10 to 3.75% with a median of 2.50% in TCC of the renal pelvis and ureter. The incidence of apoptosis was noted to be closely related to histologic grade but not to pathologic stage of the cancer. The expression of Smad4 was detected in six of 34 cases (17.6%). Regarding subcellular distribution, Smad4 protein was localized both in cytoplasm and nucleus of the cancer cells. In comparing the incidence of apoptosis with the expression of Smad4, no significant associations were seen between them. The expression of Smad4 was not related to the tumor grade nor stage of the cancer.Conclusions: The present study demonstrated close association of the incidence of apoptosis with the tumor grade of TCC of the renal pelvis and ureter. Significance of Smad4 expression was not noted in the study. It suggests that apoptotic cell death may play an important role in the tumor progression of renal pelvic and ureteral TCC.
Prognostic significance of platelet‐derived endothelial cell growth factor/thymidine phosphorylase expression in stage pT1 G3 bladder cancer
Authors: Li Shengwen , Nomata Koichiro , Sawase Kenji , Noguchi Mitsuru , Kanda Shigeru , Kanetake Hiroshi 
Published: March 2003

Abstract Background: The management of patients with pT1 G3 bladder cancer remains controversial because of the high incidence of recurrence with muscle invasion. Thymidine phosphorylase (dThdPase) is identical to platelet‐derived endothelial cell growth factor (PD‐ECGF) and has angiogenic activity. The aim of this study was to determine whether the expression of PD‐ECGF/dThdPase in bladder cancer tissue was associated with tumor progression and recurrence in patients with pT1 G3 bladder cancer.Methods: Fifteen patients who were pathologically diagnosed as having pT1 G3 transitional cell carcinoma of the bladder were treated with transurethral resection. Sections of paraffin‐embedded bladder tissue were immunohistochemically stained with either mAb654–1, a monoclonal antibody against human PD‐ECGF or anti‐CD34 monoclonal antibody, respectively. When more than 10% of tumor cells were positively stained with mAb654–1, this section was defined as positive in this study.Results: Eight of 15 sections from patients with pT1 G3 bladder cancer (53%) were positive with PD‐ECGF/dThdPase. During follow up, patients in the negative group had no disease progression and only two patients had local recurrence. In contrast, seven of eight positives had recurrence (P < 0.05) and progression was also observed in four recurrent patients. However, there was no statistical relationship between PD‐ECGF and CD34 expression in any of the patients.Conclusion: The expression of PD‐ECGF/dThdPase appears to be an important prognostic factor of pT1 G3 bladder cancer and did not show any significant relationship between PD‐ECGF/dThdPase expression and vascular density.
Urinary transforming growth factor‐β1 levels correlate with bladder outlet obstruction
Authors: Monga Manoj , Gabal‐Shehab Lamia L , Stein Paul 
Published: March 2003

Abstract Background: Urinary transforming growth factor‐β1 (TGF‐β1) levels have been shown to correlate with elevated intrapelvic pressure associated with ureteropelvic junction obstruction. Other studies have evaluated urinary TGF‐β1 levels in prostate cancer. This study tests the hypothesis that urinary TGF‐β1 levels might correlate with objective measures of bladder outlet obstruction (BOO).Methods: Twenty‐three men (age: 46–85 years) with lower urinary tract symptoms underwent urodynamic studies consisting of non‐invasive uroflowmetry, cystometrogram and voiding pressure flow studies. Patients were classified as obstructed (n = 17) or not obstructed (n = 6) based on Abrams‐Griffith nomograms. Urinary TGF‐β1 was extracted from an aliquot of urine obtained at the time of bladder catheterization for urodynamic studies. Urinary TGF‐β1 levels were then determined by enzyme‐linked immunosorbent assay (ELISA).Results: There was a strong correlation between urinary TGF‐β1 levels and the presence of obstruction by Abrams‐Griffith nomogram criteria (P = 0.025). Urinary TGF‐β1 levels were significantly higher in men with obstruction (0.039 ± 0.011 pg/mL) than in men without obstruction (0.029 ± 0.009 pg/mL; P = 0.036).Conclusion: Urinary TGF‐β1 levels correlate with objective measures of BOO. Further study is needed to test the utility of urinary TGF‐β1 as a non‐invasive diagnostic tool for BOO.
Identification of muscarinic receptor subtypes of cultured smooth muscle cells and tissue of human bladder body
Authors: Kiwamoto Hiro , Ma Fu‐Hai , Higashira Hanae , Park Yung‐Chol , Kurita Takashi 
Published: March 2003

Abstract Background: Muscarinic receptor subtypes of cultured smooth muscle cells from the human bladder body were investigated by the receptor binding assay method. The result was compared with that obtained from the human bladder body tissue to confirm whether the receptor subtypes of the cells are not changed after several passages of cell culture.Methods: Inhibitory effects of various muscarinic antagonists on the binding of [3H]‐N‐methylscopolamine ([3H]‐NMS) to membrane preparations obtained from cultured smooth muscle cells from the fourth subculture of the human bladder body were compared with those prepared from the human bladder body tissue and cells expressing human muscarinic receptor subtypes.Results: Binding‐inhibition constants (pKi) for atropine, pirenzepine, methoctramine, 4‐diphenylacetoxy‐N‐methylpiperidine methiodide (4‐DAMP), oxybutynin and propiverine obtained from membrane preparations of cultured smooth muscle cells were 8.91, 6.35, 8.24, 8.53, 7.29 and 5.61, respectively. pKi values of these muscarinic receptor antagonists against the membrane preparation of human bladder body tissue were 9.08, 6.66, 8.05, 8.79, 7.53 and 6.04, respectively. pKi values of cultured smooth muscle cells and tissue from human bladder body were correlated closely with those of insect cells expressing the cloned human M2 receptor subtype.Conclusion: The binding affinities for various muscarinic receptor antagonists of cultured human smooth muscle cells were maintained through the fourth subculture and it was suggested that the M2 receptor subtype is predominantly expressed in cultured smooth muscle cells of human bladder body as well as in tissue of the human bladder body.
Neurofibromatosis involving the urinary bladder
Authors: Chakravarti Aniruddha , Jones Malcolm Anthony , Simon Jayanthi 
Published: March 2003

AbstractWe present two interesting cases of a 24‐year‐old man and a 14‐year‐old boy, uncle and nephew, with lower urinary tract symptoms, café au lait patches and subcutaneous nodules. Ultrasonography and computed tomography scans showed a large, irregular lobulated soft tissue mass between the bladder and sacrum. Cystoscopy, laparotomy and biopsies revealed neurofibromatosis involving the urinary bladder. No enlargement of the tumor or upper urinary tract obstruction has occurred during the long‐term follow up. We recommend meticulous follow up of patients with giant intrapelvic neurofibromatosis.
Does transurethral resection of the prostate facilitate detection of clinically significant prostate cancer that is missed with systematic sextant and transition zone biopsies?
Authors: Kitamura Hiroshi , Masumori Naoya , Tanuma Yasushi , Yanase Masahiro , Itoh Naoki , Takahashi Atsushi , Tsukamoto Taiji , Adachi Hideki , Hotta Hiroshi 
Published: March 2003

Abstract
Background
: A prospective study was conducted to determine whether transurethral resection of the prostate (TURP) facilitates detection of prostate cancer that is missed with systematic sextant biopsies associated with transition zone (TZ) biopsies.
Methods
: A total of 139 consecutive patients underwent transperineal TZ biopsies of each lobe in addition to a transrectal systematic sextant peripheral zone (PZ) biopsy. Patients whose biopsies were negative for cancer received TURP for relief of lower urinary tract obstruction when indicated.
Results
: Cancer was detected in biopsy specimens of 40 patients. Of these cancers, 18 originated in the PZ alone and 22 were located both in the TZ and the PZ. No cancers were detected in the TZ alone. Of 99 patients who were proven not to have cancer by the biopsies, 18 were indicated for TURP. Five of these patients (28%) had cancer in the resected tissues. All cancers were clinically organ confined and their Gleason sum scores were 2–5. Cancer‐positive chips accounted for less than 10% of all resected specimens. Of the 66 patients with negative biopsies and without indication for TURP, four (6%) were revealed to have an elevation of the serum PSA level during follow up. They were later proven to have cancer by a second biopsy.
Conclusion
: Routine use of TZ biopsy is not warranted for detection of cancer. Transurethral resection of the prostate can detect cancers in patients with negative PZ and TZ biopsies. However, cancers detected by TURP may not always be clinically significant and only four of 66 patients who were not indicated for TURP and received a close follow up were later found to have cancer, although their follow‐up period was short. Thus, it still remains to be elucidated whether TURP is necessary for all patients with negative biopsies of the prostate.
Long‐term results of percutaneous balloon dilation for ureterointestinal anastomotic strictures
Authors: Yagi Shizuo , Goto Toshihiro , Kawamoto Ken , Hayami Hiroshi , Matsushita Shinji , Nakagawa Masayuki 
Published: March 2003

Abstract
Background:
We determined the long‐term result of our percutaneous antegrade balloon dilation technique performed for adult patients with ureterointestinal anastomotic stricture between 1992 and 1997.
Methods:
Balloon dilation was performed on 13 ureterointestinal anastomotic strictures in 10 patients. After a nephrostomy was performed, a guide wire was introduced into the intestinal loop through the stenotic portion under direct observation using a ureterorenoscope. Dilation was performed using the Olbert balloon dilator (30‐Fr) inserted along a guide wire into the stenotic portion. A 20‐Fr or 22‐Fr multihole catheter was left for approximately 6 weeks. No major complications were encountered during or after these procedures. After removal of the indwelling catheters, the progress of each patient was followed for at least 14 months.
Results:
Additional dilation was necessary in three of 10 patients for the recurrent stricture. The balloon dilation was ineffective in two patients with a long stenosis of the ureter or a previous history of radiation therapy for uterine cancer. Eight of 10 patients showed satisfactory outcomes during the mean follow‐up period of 47.1 months.
Conclusions:
Based on these results, we believe that the balloon dilation could be the first line of treatment for strictures of uro‐digestive anastomosis, except for some patients with a long stenosis or a previous history of intrapelvic radiation.
Involvement of adrenomedullin induced by hypoxia in angiogenesis in human renal cell carcinoma
Authors: Fujita Yoshitsugu , Mimata Hiromitsu , Nasu Nobuyoshi , Nomura Takeo , Nomura Yoshio , Nakagawa Masayuki 
Published: March 2003

AbstractBackground: Adrenomedullin (AM) has pluripotent activities and is involved in the regulation of vasomotor tone, cell differentiation and embryogenesis. However, the expression and pathophysiological role of AM has not been determined in human renal cell carcinoma (RCC).Methods: Twenty‐six RCC specimens and three cultured human RCC cell lines (A498, SN12C and KPK‐13) were analyzed. Expression of AM was determined by immunohistochemistry and reverse transcription–polymerase chain reaction (RT‐PCR) analysis. The correlation between AM expression and microvessel count (MVC) in RCC specimens was examined to determine if AM plays a role in tumor angiogenesis. The correlation between the expression of AM and vascular endothelial growth factor (VEGF) was also investigated. Lastly, the effect of hypoxia upon the mRNA expression of AM, VEGF and hypoxia inducible factor‐1 (HIF‐1) by RCC cell lines was determined.Results: Immunohistochemistry indicated that AM and VEGF were primarily localized in the cytosol of RCC cells. AM and VEGF mRNA were detected in all RCC specimens and cultured RCC cell lines analyzed by RT‐PCR. There was a positive correlation between AM mRNA expression and MVC (r = 0.516, P = 0.0062), and between VEGF mRNA expression and MVC (r = 0.485, P = 0.0111). We also observed a positive correlation between AM mRNA expression and VEGF mRNA expression (r = 0.552, P = 0.0029). Hypoxia significantly induced AM and VEGF mRNA expression, although the increase of the AM mRNA level (10.6–26.7 fold) was markedly greater than that of the VEGF mRNA level (1.5–1.9 fold).Conclusion: These results suggest that hypoxia‐induced AM plays a part in tumor angiogenesis in conjunction with VEGF and facilitates human RCC growth under hypoxic conditions.
Comparison of parameters to determine the cause of urinary disturbance in men with prostate volume less than 20 milliliters
Authors: HIRAYAMA AKIHIDE , SAMMA SHOJI , FUJIMOTO KEN , YAMAGUCHI AKIRA , AKIYAMA TATSUYA , FUKUI YOSHIHISA 
Published: March 2003

AbstractBackground: A pressure‐flow study, although a slightly invasive procedure, can evaluate bladder outlet obstruction and detrusor contractility. This study was conducted in men with a non‐enlarged prostate to determine the cause of urinary disturbance by less invasive examinations that might eventually replace pressure‐flow study.Methods: Thirty‐six men with lower urinary tract symptoms were enrolled. Their prostate volume, estimated by transrectal ultrasonography, was less than 20 mL. All patients were examined using pressure‐flow study, free‐flowmetry, transrectal ultrasonography, prostate specific antigen and an interview using the International Prostate Symptom Score and Quality of Life Index. With determination of the cause for urinary disturbance, parameters that correlated with outflow obstruction or impaired detrusor contractility were sought.Results: Twenty‐one (60%) of the 36 men were judged as having outflow obstruction, and 16 of these 21 men had normal detrusor function. Impaired detrusor contractility was observed in 17 men. Only three of these 17 men had no outflow obstruction. Four patients had an unstable bladder. All these four had normal detrusor contractility, but had outflow obstruction. Among the parameters examined, only the maximum flow rate in a flow metrogram (Qmax) correlated significantly with the degree of outflow obstruction (P = 0.04). The positive predictive value of Qmax for outflow obstruction was 65% at a flow rate of less than 10 mL/s, and 100% at that of less than 5 mL/s. No parameter correlated with detrusor contractility.Conclusion: The only parameter that was a clear indicator of outflow obstruction was Qmax. Other indicators of detrusor contractility should be sought.
Extracorporeal shock wave lithotripsy treatment in paraplegic patients with bladder stones
Authors: Ki˙lci˙ler Mete , Sümer Fahri , Bedi˙r Selahattin , Özgök Yaşar , Erduran Doǧan 
Published: March 2003

Abstract
Background: Spinal cord injury patients are at increased risk of developing urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy (ESWL).
Methods: We examined 20 consecutive spinal cord injury patients (all male) undergoing ESWL for the treatment of bladder stones between April 1992 and May 2000. The mean number of shock waves administered in these 20 patients was 3600 and the shock power was 19 kW/s. All patients were treated without anesthesia. After ESWL, the bladder was irrigated with povidone iodine solution and stone fragments were evacuated through a 22F endoscopic sheath.
Results: All patients became stone‐free after ESWL. Stone fragments were observed in the urethra of 3 patients, which were removed by urethroscopy. No major complication was observed; however, 5 patients had minor hematuria (which subsided within 24 h) and subfebrile fever (37.2–37.5°C).
Conclusion: ESWL and transurethral bladder irrigation is a safe, effective and simple modality for the treatment of bladder stones in spinal cord injury patients.
Muscarinic M2 receptors inhibit Ca2+‐activated K+ channels in rat bladder smooth muscle
Authors: NAKAMURA TAKAYUKI , KIMURA JUNKO , YAMAGUCHI OSAMU 
Published: March 2003

AbstractPurpose: To clarify the functional relationship between M2 muscarinic receptor and Ca2+‐activated K+ channel, we investigated the effect of carbachol (CCh) on the membrane current of rat bladder smooth muscle cells.Methods: Rat bladder single smooth muscle cells were patch clamped with whole‐cell configuration.Results: CCh (10 µmol/L) transiently induced an outward current in the presence of K+ in the pipette solution. A high Ca2+ concentration in the pipette solution persistently induced an outward current, which was inhibited by CCh. In the presence of M2 inhibitor, AFDX‐384, CCh induced the outward current persistently, indicating that M2 was involved in the current inhibition. In pertussis toxin pretreated cells, CCh did not apparently inhibit the outward current. The CCh‐induced outward current was inhibited by iberiotoxin, a selective inhibitor of large‐conductance Ca2+‐activated K+ channels (BKCa).Conclusion: CCh induces BKCa, which is inhibited by M2‐ and Gi‐mediated signal transduction pathway. This M2‐mediated pathway may enhance contraction which is initiated by M3‐stimulation in rat bladder smooth muscle.
Role of transient hyperprolactinemia in the late follicular phase of the gonadotropin‐stimulated cycle
Authors: Takiguchi Shuji , Nakamura Yasuhiko , Yamagata Yoshiaki , Takayama Hisako , Harada Ayako , Sugino Norihiro , Kato Hiroshi 
Published: March 2003

Background: Serum prolactin (PRL) concentration is known to transiently increase in rats; however, its change is obscure and the role of it is also unclear in women. We studied the relationship between estradiol (E2) and PRL production and the role of transient hyperprolactinemia in the late follicular phase of the gonadotropin‐stimulated cycle.Methods: (1) Serum E2 and PRL concentrations were measured on an early follicular day and immediately before a human chorionic gonadotropin (hCG) injection in 60 patients with normoprolactinemia. Twelve of the 60 patients also received a gonadotropin injection with bromocriptine, and serum hormone levels were compared with those without bromocriptine. (2) Preovulatory serum E2 and PRL concentrations were compared between the natural and clomiphene treatment cycles in 14 hormonally normal women. (3) Changes of serum PRL concentrations were measured before and after E2 loading in five premature ovarian failure (POF) patients. (4) The E2 production by granulosa cells in the presence of PRL was measured.Results and Conclusion: Serum E2 and PRL concentrations were significantly increased by the gonadotropin injection. Bromocriptine treatment completely inhibited the PRL increase, but further increased serum E2 concentration on the late follicular day. The E2 loading increased serum PRL levels in POF patients. The clomiphene treatment increased serum E2 but decreased PRL concentrations. Prolactin significantly decreased E2 production by granulosa cells. A feedback loop may exist between E2 and PRL to control the excess E2 production induced by gonadotropin injection. (Reprod Med Biol 2002; 1: 69–74)
Is there another chapter in the Helicobacter pylori/peptic ulcer disease story?
Authors: Clancy R. L. , Pang G. 
Published: March 2003

Abstract The role of Helicobacter pylori in the production of mucosal damage has largely been considered within a simple infection paradigm, because to date eradication has appeared to be a predictable outcome of antibiotic therapy. Changes in the epidemiology and management of peptic ulcer disease, however, require a more comprehensive framework to understand these shifting clinical patterns. The present review examines mucosal damage as an outcome of a complicated host–parasite relationship, with alterations in both parasite physiology and host defence mechanisms being keys to understanding disease patterns. (Intern Med J 2001; 31: 181–183)
Australian Medical Council: a view from the inside
Authors: Breen K. , Frank I. , Walters T. 
Published: March 2003

AbstractAlthough it has an important role in maintaining medical standards, little is known about the work of the Australian Medical Council (AMC) by members of the medical profession. A non‐statutory standards authority, the AMC accredits medical schools in Australia and New Zealand, examines overseas‐trained doctors for registration purposes and advises Medical Boards and Health Ministers on registration issues. The AMC, in consultation with Specialist Medical Colleges and others, is currently working on a number of initiatives to ensure standards of medical training and practice, including procedures to recognize new specialties and to accredit externally specialist education and training courses. (Intern Med J 2001; 31: 243–248)