bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continent urinary reservoir formation with transverse colon for patients with pelvic irradiation
Authors: Kato Haruaki , Igawa Yasuhiko , Komiyama Itsuki , Nishizawa Osamu 
Published: March 2003

Abstract
Background: The creation of a continent transverse colon pouch for patients who had previously received radiation therapy for cervical cancer was attempted.
Methods: Three patients underwent construction of a continent urinary reservoir. Approximately 30 cm of a transverse colon segment was isolated for constructing a pouch. A reconfigured colon segment was used in two cases as a continent valve and the appendix was used in one case. Both ureters were implanted submucosally into the pouch in two patients and a reconfigured colon was also used to reconstruct a defect of the ureter in one patient.
Results: All patients could catheterize the pouch easily via the cutaneous stoma without incontinence. No complications were noted.
Conclusions: In the event that a urinary diversion is necessary for a pateint who has previously had radiation therapy, the transverse colon pouch can be a useful method to improve the quality of life. In addition, versatility of the reconfigured colon segment enables the colon pouch to be adapted to adverse clinical stiuations.
Immunological protection induced by bacillus Calmette–Guérin treatment in a murine bladder tumor model
Authors: Iwasaki Akio , Kawai Koji , Hayashi Hitoshi , Ikeda Noriko , Toida Ichiro , Ohtani Mikinobu , Akaza Hideyuki 
Published: March 2003

Abstract
Background: It has been previously reported that MBT‐2 tumor growth is completely inhibited when mice are inoculated with bacillus Calmette–Guérin (BCG). In this study it was examined whether or not vaccination with a mixture of BCG and MBT‐2 cells also induces immunological protection against murine bladder tumors.
Methods: Seven hundred thousand MBT‐2 cells and 1 mg of BCG (Tokyo172 strain) per mouse were injected subcutaneously into female C3H/HeN mice. Four and eight weeks after vaccination with this mixture, animals were reinoculated with MBT‐2 cells alone or MBT‐2 cells cocultured with BCG.
Results: Animals vaccinated with a mixture of BCG and MBT‐2 cells showed MBT‐2 tumor growth but completely rejected the MBT‐2 cells cocultured with BCG. MBT‐2 cells cocultured with BCG developed into tumors when they were inoculated into the control animals. Splenocytes prepared from vaccinated animals showed specific cytocidal activity against MBT‐2 cells precultured with BCG.
Conclusions: The results suggest that a mixture of BCG and MBT‐2 cells induces antitumor immunological protection against BCG‐ or MBT‐2‐associated antigens presented on MBT‐2 cells precultured with BCG.
Electron microscopic study to compare preclinical Cushing’s syndrome with overt Cushing’s syndrome
Authors: Hirano Daisaku , Okada Yasuhiro , Ishida Hajime , Okada Kiyoki 
Published: March 2003

Abstract
Background: No significant differences in gross and light‐ microscopic features have been reported between preclinical and overt Cushing’s adenomas. In this study, the ultrastructural differences between the two syndromes was attempted to be clarified.
Methods: Two preclinical Cushing’s syndrome adenomas and two overt Cushing’s syndrome adenomas obtained from surgical extirpation were examined in an electron microscopic study.
Results: Light microscopically, the adenomas of both syndromes were composed predominantly of clear cells, with few compact cells. Ultrastructurally, the prominent differences were of development in each organelle: the preclinical Cushing’s adenomas had undeveloped mitochondria, which were smaller in size and had sparse cristae, lysosomes and polysomes, whereas the overt Cushing’s adenomas contained well‐developed mitochondria which were larger in size and were filled with abundant cristae, smooth endoplasmic reticulum (SER), lysosomes and polysomes.
Conclusions: Preclinical Cushing’s syndrome adenomas were ultrastructurally characterized by a reduced number of cellular organelles such as mitochondria and SER, which are necessary to synthesize glucocorticoid hormones. However, examination of a greater number of adenomas will be required to be able to draw conclusions on the ultrastructural differences between the two syndromes.
Efficacy of preoperative donation of autologous blood in patients undergoing radical retropubic prostatectomy
Authors: Morioka Masaaki , Yamamoto Tokunori , Furukawa Yoji , Kinugawa Keigo , Sone Atsushi , Jo Yoshimasa , Matsuki Takakazu , Nakajima Takashi , Koide Takao , Tanaka Hiroyoshi 
Published: March 2003

Abstract
Background: Radical retropubic prostatectomy (RRP) has resulted in substantial blood loss and the frequent need for homologous blood transfusion. In this study, the efficacy of autologous blood transfusion, from medical and financial perspectives, was evaluated in patients undergoing RRP.
Methods: Between 1994 and 2000, 80 patients with localized prostate cancer underwent RRP in our institute. Based on informed consent, preoperative donation of autologous blood (PDA) was performed in 65 out of 80 patienets. Four or six units were donated during the first 3 years; however, donation units were reduced to a maximum of 4 units since 1997 onwards. The discard rate of donated blood and frequency of homologous transfusion were examined. Changes of hematocrit (Ht) and hemoglobin (Hb) levels through donation and surgery and important factors that may affect postoperative levels of Ht and Hb were evaluated in 56 patients receiving 4‐unit donations.
Results: Overall, 2 or 4 units of donated blood were discarded in four patients and homologous transfusion was required in two patients. In 56 patients receiving 4‐unit donation, the mean Ht level at predonation was 43.3%. Following donation, this decreased to 35.7%. The administration of recombinant human erythropoietin (rHuEpo) relieved declining Ht levels following donation, but changes in Ht levels after surgery were minor. Important factors related to postoperative decline of Ht and Hb levels were operative time and blood loss.
Conclusions: The program of 4‐unit PDA can be performed safely without rHuEpo injection, and it is useful to reduce the risk of requiring homologous transfusion. However, more efficient programs to relieve patient burden and to reduce medical cost are needed.
Combined tumor consisting of non‐functioning adrenocortical adenoma and pheochromocytoma in the same gland
Authors: Sato Hirotaka , Igarashi Hiroshi , Kishimoto Yuichi , Yamaguchi Kenya , Saito Tadanori , Ishida Hajime , Okada Kiyoki , Okano Tadao 
Published: March 2003

AbstractA 59‐year‐old woman was admitted to East Tokyo Metropolitan Hospital for further examination of a left adrenal mass. Catecholamine levels in the plasma and urine were within normal limits. Neither 131I‐metaiodobenzylguanidine (MIBG) nor norcholestenol iodomethyl (131I) had accumulated in the left adrenal gland. A left adrenalectomy was performed through a retroperitoneal endoscope. Sections showed a tumor consisting of two parts. Histologically one part of the tumor was completely encapsulated, with clear cells comprising a honeycomb‐like mass, regarded as adrenocortical adenoma. The other part consisted of rich cytoplasma and these basophilic, hyperchromatic cells included alveolar patterns, resulting in the diagnosis of pheochromocytoma. Thus, an extremely rare case of non‐functioning adrenal incidentaloma consisting of an adrenocortical adenoma and a concomitant pheochromocytoma in the same gland is reported here.
Ureteroscopy and pneumatic lithotripsy, followed by extracorporeal shock wave lithotripsy for the treatment of distal ureteral stones
Authors: Gurbuz Zafer Gökhan , Gonen Murat , Fazlioglu Adem , Akbulut Habib 
Published: March 2003

AbstractBackground: We retrospectively reviewed our experience with retrograde ureteroscopy (URS) and a pneumatic lithotriptor in 160 patients with distal ureteral stones to determine whether prior extracorporeal shock wave lithotripsy (ESWL) is a limiting factor in the ureteroscopic procedure.Methods: From January 1999 to September 2000, we performed URS and pneumatic lithotripsy in 160 patients with distal ureteral stones. Seventy‐four patients were treated with URS primarily (Group 1), while the remaining 86 patients received URS only after ESWL had failed (Group 2). For URS and lithotripsy, we used a 9.5 French rigid instrument and vibrolith (Elmed, Ankara, Turkey).Results: In Group 1, 73 of 74 patients (98.6%) were treated successfully by URS alone, as were 81 of 86 patients (94.4%) in Group 2. Impacted stones were also observed in 17 patients from Group 2. In these patients, endoscopic observation revealed edematous inflammation above and below the calculus. Ureteral perforation occurred in one patient from Group 2, which required surgical repair. There was no significant difference in the stone‐free rates of the two groups t = 1.4 < 1.96t(∞,0.05).Conclusion: Our data demonstrate that when ESWL fails, URS and pneumatic lithotripsy is as safe and effective as primary URS. Pneumatic lithotripsy also seems to be an effective treatment modality for impacted stones.
Prognostic significance of matrix metalloproteinases‐2 activation ratio in renal cell carcinoma
Authors: TAKAHASHI MASAYUKI , OKA NATUO , NARODA TAKUSHI , NISHITANI MASA‐AKI , KANDA KAZUYA , KANAYAMA HIRO‐OMI , KAGAWA SUSUMU 
Published: March 2003

AbstractBackground: Matrix metalloproteinases (MMPs) are a family of zinc‐dependent endopeptidases. MMP‐2 and MMP‐9 have been reported to be closely associated with tumor invasion and metastasis in various human carcinomas.Methods: Tissue samples were obtained from 57 patients with renal cell carcinoma (RCC) who underwent radical nephrectomy in our hospital. We examined the expression of MMPs by gelatin zymography and assessed correlations with clinico‐pathological parameters and clinical outcomes.Results: We detected bands corresponding to MMP‐9, proMMP‐2 and active MMP‐2. The expression of active MMP‐2 and MMP‐2 activation ratio (active MMP‐2/[proMMP‐2 and active MMP‐2]) were higher in T3 tumors than in T1 and T2 tumors. There were no significant differences in the expression of proMMP‐2, active MMP‐2 or MMP‐9 for any of the clinico‐pathological parameters. Patients with high MMP‐2 activation ratio or high MMP‐9 had significantly worse cause‐specific survival. Interestingly, among patients with stage III RCC, those with high MMP‐2 activation ratio or high active MMP‐2 had significantly worse cause‐specific survival. Univariate analysis showed that histological grade (P = 0.0001), histologic type (P = 0.0005), MMP‐2 activation ratio (P = 0.0159), stage (P = 0.0001), MMP‐9 (P = 0.0316), and T (primary tumor) category of TNM (primary tumor, lymph node, metastasis) classification (P = 0.0021) were significant predictors of clinical outcome. Multivariate analysis showed that only histological grade (P = 0.002) and stage (P = 0.0099) were independently significant predictors of clinical outcome.Conclusion: Activation of MMP‐2 appears to play important roles in initiating metastasis, as shown by results obtained with stage III RCC patients. However, further study is needed to confirm this.
Sex difference in urethral response to electrical stimulation of efferent nerves in the pudendal sensory branch of rats
Authors: KONTANI HITOSHI , SHIRAOYA CHISATO 
Published: March 2003

AbstractBackground: We reported sex difference in the urethral pressure (UP) response to electrical stimulation (ES) of the hypogastric nerve in rats. The purpose of the present study was to report on sex difference in the UP response to ES of the pudendal nerves (PN) in rats before and after injection of d‐tubocurarine (d‐tc).Methods: Wistar rats were anesthetized with urethane and α‐chloralose. The L6‐S1 trunk was exposed on the left side and resected. After resection of the motor branch of the PN the peripheral end of the L6‐S1 trunk was stimulated. Fluid was infused into the urethra through a catheter inserted into the bladder neck at a constant rate (0.5 mL/10 min) and the infusion resistance was measured as the UP. When d‐tc was injected, the rats were ventilated with an artificial respirator.Results: Though ES of the L6‐S1 trunk caused fibrillation of the muscles near the tail and steep reduction of the UP, it caused elevation and reduction of UP in male and female rats, respectively, after intravenous injection of d‐tc (0.3 mg/kg). ES of the sensory branch of the PN caused the elevation in male rats and reduction of the UP without injection of d‐tc, and prazosin inhibited the UP elevation but the reduction was not inhibited by Nω‐nitro‐l‐arginine methyl ester.Conclusion: In the sensory branch of the PN, the nerves innervating the smooth muscles in the urethral sphincter were contained. In male rats norepinephrine mediates the UP elevation, but the neurotransmitter that mediates the UP reduction in female rats is not known.
Hydrogen–potassium ATPase inhibitors induce relaxation on rabbit prostatic strips in vitro
Authors: Bagcivan Ihsan , Gökçe Gökhan , Ayan Semih , Yildirim Şahin , Saraç Bülent , Kiliçarslan Hakan , Sarioglu Yusuf 
Published: March 2003

Summary
Background
: To determine the relaxant effect of omeprazole and lansaprazole, hydrogen–potassium (H+–K+) ATPase inhibitors, on rabbit prostatic tissue in vitro.
Methods
: Male New Zealand white rabbits were sacrificed and their prostatic tissues were removed. The prostatic stromal strips were mounted in organ baths and relaxation responses were obtained in precontracted tissues with phenylephrine, carbachol and potassium chloride (KCl). Relaxation responses were controlled in the presence of various antagonists to explain the mechanism for relaxation exerted by omeprazole and lansaprazole.
Results
: Omeprazole and lansaprazole caused similar relaxation responses in the prostatic strips precontracted with phenylephrine, carbachol and KCl. The addition of prostaglandin synthase inhibitor indomethacin, nitric oxide synthase inhibitor L‐NAME, potassium channel blockers, glibenclamide and tetraethylammonium into the organ baths did not change the relaxations induced by omeprazole and lansaprazole in vitro.
Conclusion
: Omeprazole and lansaprazole cause a relaxation in prostatic stromal tissue precontracted with phenyephrine, carbachol and KC1 in vitro. This relaxant effect is independent of H+–K+ ATPase inhibition. Additionally, cyclooxygenase and nitric oxide pathways do not contribute to this relaxant effect. Further studies are required to determine whether these drugs may have a beneficial effect in the non‐operative treatment of benign prostatic hyperplasia.
Incidence and growth pattern of simple cysts of the kidney in patients with asymptomatic microscopic hematuria
Authors: MARUMO KEN , HORIGUCHI YUTAKA , NAKAGAWA KEN , OYA MOTOTSUGU , OHIGASHI TAKASHI , ASAKURA HIROTAKA , NAKASHIMA JUN , MURAI MASARU 
Published: March 2003

Abstract
Background:
We examined the incidence and natural history of simple renal cysts found by ultrasonography (US) in patients referred for asymptomatic microscopic hematuria.
Methods:
Among the 906 patients aged 18–78 years, 743 patients who had undergone US were included in the present study. The natural history of simple renal cysts was investigated in 55 patients who underwent periodical US examinations for more than 3 years.
Results:
The incidence of simple renal cysts was 4.3% for ages 29 years or younger, 15.3% for ages 30–39, 21.8% for ages 40–49, 23.3% for ages 50–59 and 32.6% for ages 60 years or older; thus the incidence increased in older age groups (P = 0.0005 for men, P = 0.0020 for women). Men tended to have a higher incidence than women. The degree of hematuria did not influence the incidence of renal cysts (P = 0.9044). The annual growth rate of the mean maximum diameter was 4.2% during a 3‐year follow‐up period in 55 patients and 5.1% during a 6‐year follow‐up in 31 patients.
Conclusion:
Since the diameter of a renal cyst may increase by 5% annually, the diameter of the cyst may increase by 1.6 times in 10 years. The scheduling of follow‐up examinations depends on the size at the time of disclosure, the effects on calyceal systems, or the suspicion of a concurrent malignant disease. However, the most simple renal cysts may be followed‐up at an interval of more than 10 years, once a diagnosis has been established.
Evaluation of testicular microlithiasis in varicoceles
Authors: Kobayashi Hideyuki , Nagao Koichi , Nakai Toshiaki , Kudo Takamasa , Yoshida Atsumi , Hara Hiroshi , Miura Kazukiyo , Ishii Nobuhisa , Sawamura Yoshikatsu , Miura Myota 
Published: March 2003

Background:  Testicular microlithiasis is said to be characterized by calcific concretions within the seminiferous tubules. There have been reports suggesting a link between testicular microlithiasis and testicular dysfunction and tumors.Methods:  In this study, we assessed subjects with varicoceles detected by using testicular ultrasound, and evaluated the cases of testicular microlithiasis in terms of age, seminalysis findings, and endocrinological parameters (testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL)). The subjects comprised 224 patients with varicoceles diagnosed by using testicular ultrasound, who attended this institution as outpatients between January 1998 and August 2000.Results:  Testicular microlithiasis was detected in 15 out of 224 subjects (6.7%), bilateral in all cases. No significant differences were seen between the group with testicular microlithiasis and the group without testicular microlithiasis, in terms of age, seminalysis findings, and/or endocrinological parameters (testosterone, FSH, LH, prolactin). The incidence of testicular microlithiasis in outpatients undergoing testicular ultrasound varies between reports, but is of the order of 0.6–2.0%.Conclusion:  In this study, we found a high proportion of testicular microlithiasis at 6.7%, strongly suggesting a link with male infertility. (Reprod Med Biol 2002; 1: 75–79)
Population screening for HFE‐associated haemochromatosis: should we have to pay for our genes?
Authors: Yapp T. R. , Eijkelkamp E. J. , Powell L. W. 
Published: March 2003

AbstractHaemochromatosis associated with mutations in the HFE gene is the most common inherited disorder in Caucasian populations. Early diagnosis and treatment allows for normal life expectancy, whereas there is considerable morbidity and early mortality in those patients diagnosed late or untreated. Unfortunately, the development of symptoms and signs in haemochromatosis is usually associated with significant iron overload. For this reason, many clinicians and geneticists have advocated population screening. The recent identification of the HFE gene and the availability of a simple DNA‐based diagnostic test have led to international debate as to the most cost‐effective means of population screening for HFE‐associated haemochromatosis. The present paper summarizes the evidence in favour of population screening and analyses the relative advantages of genotypic (DNA test) versus phenotypic (transferrin saturation) testing. (Intern Med J 2001; 31: 48–52)
Retrospective review of febrile neutropenia in the Royal Darwin Hospital, 1994–99
Authors: Healey T. , Selva‐Nayagam S. 
Published: March 2003

Abstract Background: Febrile neutropenia is a life‐threatening complication of cytotoxic chemotherapy. Empirical antibiotic treatment should be based on predominant pathogens and epidemiological characteristics of the treated community. The aim of the present study was to review cases of febrile neutropenia at the Royal Darwin Hospital (RDH) in order to assess the appropriateness of empirical antibiotic therapy. Methods: A retrospective review of cases of febrile neutropenia secondary to malignancy or chemotherapy occurring at the RDH over the period 1994–99. In order to compare infections in this group with those in the wider hospital community, all positive blood cultures in the medical and intensive care units were reviewed for the same time period. Results: Thirty‐six episodes of febrile neutropenia were reviewed. Staphylococcus aureus (predominantly methicillin resistant), Pseudomonas aeruginosa and Escherichia coli were the most common organisms identified. Nine patients died of their infection, four with methicillin‐resistant S. aureus bacteraemia. S. aureus, E. coli, Streptococcus pneumoniae and Burkholderia pseudomallei (melioid) were the most frequently isolated organisms from blood cultures taken in the medical and intensive care units. Conclusions: Gram‐positive organisms are the predominant pathogens in febrile neutropenic episodes at the RDH. Standard empirical therapy with an extended‐spectrum penicillin and an aminoglycoside remains appropriate, with the addition of vancomycin when clinical status fails to improve. When practising in the Top End, particular consideration should be given to skin integrity and scabies and testing for Strongyloides in Aboriginal patients. (Intern Med J 2001; 31: 406–412)
Non‐prescription complementary treatments used by rheumatoid arthritis patients attending a community‐based rheumatology practice
Authors: Buchbinder R. , Gingold M. , Hall S. , Cohen M. 
Published: March 2003

Abstract Background: Over 80% of rheumatoid arthritis (RA) patients have used some type of complementary medicine (CM) at some time. Littleis known about RA patients’ perceptions of the efficacy, hazards and costs associated with CM use relative to physician‐prescribedmedicine. These data may be helpful in better understanding patients’ needs and in improving their care. Aims: To determine the prevalence and features of CM use among RA patients attending a community‐based private rheumatology practice. CM was definedas treatment that was initiated by the patient, excluding treatment that had been prescribed or spec­ifically recommended bytheir doctor. Methods: A telephone‐administered questionnaire was used to survey a stratified random sample of 200 RA patients who had attended the practice withinthe preceding year. The main outcome measures were: (i) CM use in the past year, (ii) patient expenditure onCM, (iii) patients’ perceptions of CM and (iv) characteristics of patientsusing CM. Results: One hundred and six patients responded (response rate 53%) and 101 completed the interview. Seventy‐four patients (73.3%)had used some form of CM in the past year. There were 68 (67.3%) patients who had utilized complementary therapies and 32 patients (31.7%)who had consulted a complementary practitioner for their RA. The most commonly used treatments were dietary (64 instances) and behavioural/cognitivetherapies (45 instances). Prescription medicine was considered more beneficial than either form of CM, and users and non‐users of CMheld a similar perception of the efficacy of ­prescription medicine. The median amount spent on RA treatment per month was $A7(range 0−91) for complementary treatments, $A26 (1−270) for complementary practitioners and $A7(0−80) for pres­cription medicine. Women were more likely to have consulted a CM practitioner (OR = 1.5;95% CI : 1.2−1.9), as were patients who were not receiving a pension (OR = 1.7;95% CI : 1.1−2.6). Conclusions: This study confirmed that CM use is prevalent among RA patients attending a community‐based private rheumatology practice. Despitelesser perceived benefit, patients spent at least as much money on CM as they did on prescription medicine. These findings suggestthat there are other factors motivating the use of alternative treatments. (Intern Med J 2002; 32: 208−214)