The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
Volume 80 , Issue 12
Showing 1-20 articles out of 20 articles from the selected issue
  • Osamu Yoshida, Yoshiyuki Kakehi
    1989 Volume 80 Issue 12 Pages 1695-1705
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A dramatic improvement in the survival of patients with testicular cancer has been witnessed in the 1970s. These advances are in the areas of diagnosis, staging, and monitoring of patients with this disease. The thrust of improvement includes the finding of sensitive and specific markers, the introduction of CDDP, and utilization of CT. Also, the finding of the efficacy of multidiciplinary treatment consisting of intensive chemotherapy and surgery has played a decisive role in the management of patients.
    This paper is devoted of a discussion of the basic sciences related to testicular cancer and the diagnosis and management of this tumor.
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  • Tamio Yamauchi, Masanori Kokuho, Shuji Yoshino, Yuichi Tachibana, Tsun ...
    1989 Volume 80 Issue 12 Pages 1706-1712
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The parenchymal damage of the liver after estrogen therapy for prostatic cancer, mainly treated with diethylstilbestrol diphosphate (DES-DP), was studied in the six autopsied cases, herein.
    The parenchymal disorder of the liver was “nonalcoholic steatohepatitis”, reported by Ludwig et al., and its degree of disorder was dependent upon the administered dose of estrogen.
    The acceptable total dose of DES-DP was supposed to be about 150g at maximum, according to the various degrees of damage examined histopathologically in the six cases who were administered at total doses of DES-DP from 12, 6g to 619g.
    Comparison of the histopathologic damage to the liver function tests performed within 10 days before death revealed that only the serum levels of cholinesterase (ChE) were abnormally decreased, suggesting its importance to predict the degree of “nonalcoholic steatoheptitis” by monitoring of ChE.
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  • Tamio Yamauchi, Masanori Kokuho, Shuji Yoshino, Yuichi Tachibana, Tsun ...
    1989 Volume 80 Issue 12 Pages 1713-1719
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We have examined the value of cholinesterase (ChE) that indicates the preservation ability of liver function, to assess the liver disorder owing to diethylstilbestrol diphosphate (DES-DP) administration in 25 prostatic cancer patients without castration.
    The correlation between ChE and the other factors such as age, total dose of DES-DP, duration of administration or ratio (total dose/duration), were studied by means of multiple regression analysis (MRA).
    In sixteen patients treated for less than 6 months, ChE was correlated with all factors by MRA with the coefficient of 0.645, and the coefficients of simple correlation between ChE and total dose and between ChE and administered duration, were -0.521 (p<0.05) and -0.596 (p<0.05), respectively.
    In nine patients treated for more than 6 months, ChE was correlated with all factors by MRA with the coefficien of 0.803, and the coefficient of simple correlation between ChE and ratio was -0.707 (p<0.05).
    According to these results and the permissible range of ChE, the total dose of administration for less than 6 months was estimated to be under 50 gram and its duration was within 100 days. The ratio in patients administered for more than 6 months was under 300mg/day.
    Therefore, as far as the long-term hormonal treatment for prostatic cancer and preservation of liver function, we concluded that total dose of DES-DP should be less than 50 gram in less than 100 days for induction therapy and the daily dose of DES-DP should be less than 300mg/day for maintenance therapy.
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  • Yasunori Terashima, Tomotaka Hattori, Sachio Kanamori, Masao Akimoto
    1989 Volume 80 Issue 12 Pages 1720-1727
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    One of the major problems with cancer chemotherapy is the development of drug resistance during treatment. Two mechanisms are considered as the cause of drug resistance, natural and acquired. It is now considered that cancers can be composed of multiple clonal subpopulations of cancer cells. In this study, we separated three clones (C1, C3 and C8) from NBT-2 (human bladder cancer cell line) by limiting dilution. We examined the growth rate and the transplantability to nude mice and performed chromosomal analysis of three clones. The doubling time of C1 is 22 hours, and those of C3 and C8 were 25 and 36 hours, respectively. Each clone was transplantable to nude mice, but we could not find out any histological difference among them. The chromosome numbers of C1 was 66, and those of C3 and C8 were 68 and 63, respectively. We could also find out karyotypic difference among them. We could therfore consider that these three clones had different biological features and studied the difference in drug sensitivity among these three clones and the parent cell line. Cells (1×104/well) were incubated in microplates with ten different chemotherapeutic agents for 72hurs. Then 3H-thymidine (1μCi/ml) was added to each. After 24 hours, cells were harvested and the uptake of 3H thymidine was counted with a liquid scintillation counter. According to the reaction pattern, these chemotherapeutic agents were divided into three groups. 1. The radio isotope uptake of three clones and parent cell line was proportionally inhibited by increasing the drug concentration (carboplatin, (glycolato-o, o-) diammine platinum (II), ifosfamide). 2. Clones were inhibited at lower drug concentrations, but parent cell line was first inhibited at higher concentrations of drugs (adriamycine, vinblastine, peplomycin, bleomycin). 3. There was an extensive difference in sensitivity to methotrexate among three clones. Our results demonstrate the presence of clonal heterogeneity of sensitivity to chemotherapeutic agents and it seemes that C1 may be a clone which is naturally resistant to methotrexate.
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  • Ryoji Yasumoto, Masazumi Asakawa, Tatsuo Iseki, Tatsuya Nakatani, Take ...
    1989 Volume 80 Issue 12 Pages 1728-1732
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    To 62 vesical tumor patients, 30ml of a HPC-PEP mixed solution was infused into the urinary bladder. The HPC-PEP solution was prepared by adding 15ml of 2% hydroxypropylcellulosum (HPC) to 15ml of peplomycin (PEP)/physiological saline solution in which 90mg PEP had been dissolved. Accordingly, a total of 30ml of the mixed solution was used. On day 7 after treatment, a clinical evaluation was made through endoscopic observation and urine cytodiagnosis. The results of the evaluation were expressed by assigning appropriate grades for the improvements made. As for the overall clinical effects, 10 patients demonstrated excellent improvement (CR) but 26 patients exhibited no improvement (NC). The overall clinical efficacy for all cases was 58%. When the evaluation was made according to severity (T1, T2, or T3), the results were as follows: of 43 T1 patients, 9 patients were judged CR, and 23 patients were PR; and of 15 T2 patients, 1 patient was CR and 3 patients were PR. However, all T3 patients were NC. The clinical efficacy for the T1 and T2 groups was 74.4% and 26.4%, respectively. A significant difference was observed between the T1 group and the T2 and T3 groups (p<0.05).Evaluation made according to the degree of histopathological differentiation (G1, G2 and G3) demonstrated the following results: of 23 G1 cases, 6 cases were CR, 9 cases were PR; of 32 G2 cases, 4 cases were CR and 16 cases were PR; and of 7 G3 cases, only 1 patient was found to be PR. A statistically significant difference was present between the G2 and G3 groups (p<0.05).According to the evaluatin classified by tumor morphology, 10 cases with CR and 25 cases with PR were observed out of 46 papillary pedunuculated tumor cases, while only one case showed CR out of 16 non-papillary diffuse tumor cases. It is clear that HPC-PEP was more effective in papillary productive tumor cases (p<0.05).When the evaluation was made according to the number of tumors developed, 9 cases were judged as CR and 20 cases as PR out of 53 single-tumor cases; and 1 case with CR and 6 cases with PR our of 9 multiple-tumor cases. A significant difference was noted between the single-tumor and multiple-tumor groups. In addition, the evaluation of efficacy according to the size of the tumor showed a significant difference between the tumors of greater than 1.00cm and those of less than 1.00cm, at the significance level of p<0.05. Judging fom the above results, it is clear that the treatment based on the present study is effective for superficial vesical tumors.
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  • Kenji Kawamura, Koji Suzuki, Ryuzo Tsugawa
    1989 Volume 80 Issue 12 Pages 1733-1740
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The stone forming urinary environment may be conducive to spontaneous nucleation of calcium oxalate, since it is generally characterized by a reduced metastable limit. This study indicates that the microplate method offers simple and reliable measures for estimating calcium oxalate's propensity for spontaneous nucleation. In measuring the metastable limit by the microplate method, 200μl aliquots of each urine sample were treated with sodium oxalate to give final concentrations of 0-1.5mmol. The urine samples were then incubated at 37°C for 20min and the minimum amount of oxalate necessary to induce nucleation detectable by inverted microscopy was taken to be the measured metastable limit of each urine. The metastable limit by microplate method positively was correlated (p<0.001) with the metastable limit found by the Coulter counter method and inversely correlated (p<0.001) with the concentration product ratio. The metastable limits were significantly lower (p<0.001) in recurrent stone formers than in the control subjects. The metastable limit rose significantly (p<0.01) during treatment with thiazides. Moreover, the metastable limit was inversely correlated (p<0.01) with the stone episode rate. It is concluded that the metastable limits by the microplate method are useful in stone forming potential identification in urine as well as in the assessment of the response to the therapy.
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  • Haruo Ito, Kunio Yamaguchi, Tadashi Kotake, Osamu Matsuzaki
    1989 Volume 80 Issue 12 Pages 1741-1748
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Ovomacroglobulin and LDL fraction of egg yolk were effective to maintain the growth of established human cancer cell lines (Kato III, QG-90, Raji). A serum-free medium (BEM-841) containing 10mM HEPES, 50μg/ml of ovomacroglobulin, 0.1%(V/V) of LDL fraction of egg yolk, 10-8M catalase, 5μg/ml of insulin, 5μg/ml of transferrin, 5ng/ml of selenium, 1mg/ml of BSA, and 0.5% (V/V) of trace elements was developed.
    Primary culture of renal cell carcinoma cells was successful in 3 cases out of 6 by using BEM-841 medium without overgrowth of the fibroblast.
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  • Haruo Ito, Kunio Yamaguchi, Tadashi Kotake, Osamu Matsuzaki
    1989 Volume 80 Issue 12 Pages 1749-1754
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    It was possible to cultivate cells from bladder carcinoma tissues in 4 cases out of 6 without the overgrowth of fibroblast.
    A new human trasitional cell carcinoma cell line (HAMT-1) was established in longterm tissue culture by using serum-free medium (BEM-841) which had been developed by us. The tissue for culture was taken from a 61-year-old Japanese male with grade 3 transitional cell carcinoma of the bladder. The microscopic features of the cell in cultures and of the tumors developed in nude mice resembled closely that of the original tumor. Electron microscopy of the cultured cells and the tumors developed in nude mice revealed characteristics of the epithelial origin of these cells with microvilli, junctional complex and scarce filament formation. Blood TPA level of the nude mouse with the transplanted tumor was equally high as that of the patient from whom the original tumor had been taken. The cells were anchorage independent in the serum-free medium but anchorage dependent in the medium containing 5% FCS. Anchorage dependency could not be restored by the addition of collagen and fibronectin. The doubling time of the cells were 18-20 hours. The chromosome counts of the cell line ranged from 59-78 with a modal count of 74.
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  • Kazunori Kobashi
    1989 Volume 80 Issue 12 Pages 1755-1762
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A subrenal capsule assay (SRCA) was performed on 34 fresh surgical specimens from 31 urinary tansitional cell carcinoma (TCC) patients. On day 6, 97.7% of explants were detected macroscopically and tumor cells were present in 45.6% of all explants microscopically. In control groups, there was a negative correlation between the change in explant size (ΔTS) and the percentage of the area of interstitial tissue. And in the several explants on day 6, the pseudocysts made up of cancer cells were seen. These support that urinary TCCs from fresh surgical specimens grow under the renal capsule. An evaluable assay rate of 97% was given. Susceptibility to cisplatin (CDDP), adriamycin (ADM), methotrexate and cyclophosphamide (CPM) was seen in 33%, 41%, 32% and 29%, respectivity, of tumors using the ΔTS method. In interstitial tissue rich tumors, a higher rate of susceptibility to anticancer drugs was given using the ΔTS method than using the tumor growth inhibition rate (TGIR) method. There was a positive correlation between the rate of S-phase cells of the tumor and the susceptibility using the ΔTS method. But, there was no correlation between this and the susceptibility using the TGIR method. These findings suggest that the ΔTS method is more practical than the TGIR method. In addition, the growth of explants was better in immunosuppressed mice with 180mg/kg of CPM than in normal mice. And the effectiveness of a combination of CDDP and ADM was seen as an anti-tumor effect or a reduction of side effects.
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  • Taketoshi Kishimoto, Kazunobu Sugimura, Tatsuya Nakatani, Keisuke Yama ...
    1989 Volume 80 Issue 12 Pages 1763-1768
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    During the 39 months since the introduction of transurethral lithotripsy (TUL) for the treatment of ureteral stones at our hospital in August 1985, TUL was performed a total of 200 times in 178 patients with ureteral stones. Among them, 111 patients had left ureteral stones and 65 had right ureteral stones, while 2 patients had ureteral stones in both sides. The stones were divided into upper ureteral stone (84 patients) and lower ureteral stone (94 patients) at above and below the iliac brim. 89% of the stones were less than 2cm in diameter. Most of the patients were given lumbar anesthesia, and a guide wire was inserted into the ureter. The ureter was dilated with a ureteral bougie, and a 13F or 14F Storz ureteroscope was inserted. The stones were disintegrated by an ultrasound lithotripto and removed using forceps and a basket catheter. After the TUL procedure, a double J catheter was indwelled and removed within 5 days. The results were evaluated by DIP which was done 2 to 3 months after TUL. The success rate included residual stones less than 4mm in diameter, as they could be spontaneously discharged. As a result, the success rate for upper ureteral stones was 53%, and it was higher for smaller stones. On the other hand, the success rate for lower ureteral stones was 85% and significantly higher. The main reasons for failure were the upper migration of the stones (60%) and inability to insert the ureteroscope up to the stone due to ureterostenosis and ureteral perforation (39%). As for complications, ureteral perforation (13 cases), complete ureteral upture (one case), bladder perforation (one case) and subcapsular hematoma (one case) were observed. In the early stage, fever of over 38°C was seen in 16% of the patients, and in the latter stage, grade 1 VUR and ureterostenosis were seen in 3 patients each. These results suggest that although ESWL is more effective for upper ureteral stones, TUL is recommended for lower ureteral stones.
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  • Atushi Takenaka, Sohei Kitazawa, Takashi Koyama, Takahiro Fujimori, Ak ...
    1989 Volume 80 Issue 12 Pages 1769-1775
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A mouse monoclonal IgG1 antibody (B-11) that recognizes desmosomes in some human tissues was isolated and characterized. By Western blotting, B-11 recognized 34kD protein only in squamous and transitional epithelium. By avidin-biotin complex (ABC) and immunofluorescence method, B-11 was reactive to squamous and transitional epithelium, but was not reactive to simple columnar epithelium from stomach and colon, simple cuboidal epithelium from urinary tubule and thyroid, and pseudostratified ciliated epithelium from trachea and ductus epididymidis.
    ABC method of B-11 was performed in 47 patients with transitional cell carcinoma of bladder. The higher positive staining was observed in well differentiated (83% in Grade (G) 1, 73% in G2 and 20% in G3), superficial (76% in non-invasive and 20% in invasive) and expansive growth (68% in Infiltration (INF) α, 24% in IFNβ and 18% in IFNγ) carcinomas.
    34kD protein recognized by a new monoclonal antibody (B-11) is a new cell-type-specific desmosomal component which relates to the histological grade, stage and invasive manner of the transitional cell carcinoma of bladder.
    The transitional cell carcinoma of bladder obtained by operation or surgical biopsy from 47 patients was stained by ABC method using B-11.
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  • Yasuo Kitamura
    1989 Volume 80 Issue 12 Pages 1776-1782
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Clinical data of 31 patients (34 renal units) with severe congenital hydronephrosis who had received preliminary nephrostomy were reviewed to survey functional recovery of the kidneys and the significance of preliminary nephrostomy.
    The results were as follows:
    1. In most cases, the renal function based on Ccr and 99mTc-DMSA renal scintigraphy after nephrostomy could not improve beyond preoperative one.
    2. A close linear correction was found between the thickness of renal parenchyma before preliminary nephrostomy and the renal function after the nephrostomy.
    3. Preliminary nephrostomy is indicated for severe hydronephrosis in neonates and infants, obstruction of the lower ureter, and serious general condition, which need accurate split renal function, and for patients without accurate diagnosis.
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  • Masaki Togashi, Tatsuya Mori, Satoshi Nagamori, Bunshiro Saitoh, Hajim ...
    1989 Volume 80 Issue 12 Pages 1783-1789
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The result of renal conserving procedures for the surgical management of renal cell carcinoma experienced in 10 patients was repored. All except two were afflicted with tumor involvement in both kidneys (four cases) or in the solitary functioning kidney (four cases). The tumor stage was I in 8 and IV in 2 patients. One of the stage IV patients died of metastatic disease 8 months postoperatively. Of the 9 patients, 8 remained free of cancer in the follow-up period, while one who received an enucleative surgery and whose pseudocapsule of the tumor was missing had a local recurrence. Four of the 5 tumors having no pseudocapsule or having an invasion in the pseudocapsule were grade 2 or 3. The renal conserving surgery is believed to yield an excellent control in low grade and low stage tumors. Partial nephrectomy, rather than simple enucleation, remains to be a preferred surgical treatment in parenchyma-sparing operation, although the enucleative surgery may have a good indication for multiple and central encapsulated tumors.
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  • Shigeo Isaka, Tatsuya Okano, Jun Shimazaki, Ryosuke Nemoto, Kenkichi K ...
    1989 Volume 80 Issue 12 Pages 1790-1794
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    In the last ten years 19 patients with urotherial cancer of the upper urinary tract underwent excision of the tumor with preservasion of the ipsilateral kidney. Renal function was preserved well in all cases in 31 months of the mean follow up term. In the presence of a normal contralateral kidney, local tumor excision was done electively in 12 patients (5 lower portion of ureter, 5 low grade lesions, 2 high age), local recurrence developed 6-63 months after operation in 2 patiens, and they underwent nephroureterectomy. 11 cases are alive with no evidence of disease and one is alive with contralateral renal pelvic cancer.
    Absolute indications for conservative surgery were solitary kidneys/non functioning contralateral kidney in 3 patients and bilatral tumor in 4 patients. Most tumors were high grade or high stage (6: grade 2, 4: PT2).No one had local recurrence, but one had a metastasis to a lung, 4 were suffering from bladder cancer post-operatively. Three patients were died from cancer 20-30 months after operation.
    Local excision of urotherial cancer should be considered not only for cases of contralaterel damaged kidneys but also for low grade, low stage localized tumors. Precise preoperative evaluation of tumors using a ureterorenoscope should be made for the indication of the renal preservative operation.
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  • Momokazu Gotoh, Masahiko Saito, Kumiko Kato, Atsuo Kondo
    1989 Volume 80 Issue 12 Pages 1795-1801
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A new operative technique for continent urinary diversion was designed as a continent vesicocutaneostomy and preliminary experiments were performed on 7 dogs. A-Ushaped flap of anterior bladder wall (30×20×30mm) was created, which was then rolled and sutured to an efferent duct. One-half to two-thirds in length of the efferent duct was placed between the muscular layer and mucosa of the bladder, and the distal end of the efferent duct was anastomosed to the cutaneous stoma made at the suprapubic area. In this urinary diversion, excretion of urine from the bladder was done by intermittent catheterization from the stoma through the efferent duct. The operation was successful on all of the experimented dogs, continence of the stoma was preserved and catheterization through the stoma was achieved easily. Urodynamic assessment of the efferent duct was performed, being focused on the mechanism of continence, at 3 and 6 months after the operation. The length of continence zone and maximum closing pressure through the entire efferent duct were 23.2±4.5mm and 41.2±14.7cmH2O respectively with empty bladder (intravesical pressure=0). When the bladder was full (intravesical pressure=20-40cmH2O), these parameters were 21.4±4.7mm and 36.0±7.0cmH2O respectively. The length of continence zone and maximum closing pressure of only the submucosal part of the efferent duct were 12.8±4.3mm and 18.5±5.2cmH2O with empty bladder, 13.3±2.9mm and 22.0±9.9cmH2O with full bladder. Furthermore, in 6 out of 7 cases, continence was completely preserved in the presence of only the submucosal efferent duct, when the intravesical pressure was increased up to 50-90cmH2O. The present preliminary experiments revealed that this new operation would be suitable for clinical application, in patients with preserved resevoir function of the bladder who need urinary diversion.
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  • Ken Sato, Kouji Kawai, Yukiko Nishijima, Akira Sasaki, Isao Kiriyama, ...
    1989 Volume 80 Issue 12 Pages 1802-1808
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A clinico-statistical study was made on 92 patients with renal cell carcinoma who visited us from January 1978 to November 1988. The results were as follows:
    1. Seventy-eight patients were treated by radical nephrectomy, two patients by partial nephrectomy, and three patients were treaed at other hospitals initially. Nine patients were underwent only conservative therapy.
    2. Overall 1, 3, 5, and 10-year survival rates by Kaplan-Meier method were 81.8%, 58.0%, 55.3%, and 50.2%, respectively.
    3. The 3-year survival rates according to clinical T-stage were 71.3% for 56 patients in T2, 66.8% for 16 patients in T3a, and 24.1% for 16 patients in T3b.
    A significant difference existed between patients in T3a and patients in T3b. It appears that the new TNM classification system is more accurate for prognosis of patients in stage T3 than that currently in use.
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  • Noriaki Tokuda, Darwich E. Bejany, Manuel A. Penalver, George M. Suare ...
    1989 Volume 80 Issue 12 Pages 1809-1815
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Construction of continent colonic urinary reservoir was performed in 44 patients afer exenteration for invasive bladder carcinoma or various gynecologic tumors. The distal ileum was tapered over a 14 French red rubber catheter. The ileocecal valve was reinforced with three circumferential silk sutures in a purse-string fashion. Full continence was obtained in all patients (100%).
    A non-tunneled, non-refluxing ureterocolonic anastomosis was performed in all 88 ureters. No obstruction or reflux was observed in 84 ureters (95%).
    There were 7 early postoperative complications and 3 of them required reoperation (pelvic abscess 1, urinary leak from ureterocolonic anastomosis 1, pouch-vaginal fistula 1). Moreover, there were 7 late complications and 3 of them required reoperation (stomal stenosis 1, parastomal hernia 2).
    These results suggest that this method is a safe, simple and useful one for permanent urinary diversion.
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  • Seiichi Toyota, Yasuo Fukushi, Shinnosuke Katoh, Seiichi Orikasa, Yasu ...
    1989 Volume 80 Issue 12 Pages 1816-1823
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Bacterial adherence to mucosa is thought to be an initial and important stage to cause urinary tract infection. Among some mechanisms of bacterial adherence, the role of fimbriae and its receptor is worthy of notice.
    In particular, type 1 fimbriae, for which mannose is assumed as a receptor, is reported as the most common type and called “common fimbriae”. Therefore if a certain amount of mannose is present in urine, it will cover the fimbriae of bacteria and competitively block the bacterial adherence to bladder mucosa.
    As the first step, we tried to detect mannose in urine by high performance liquid chromatography (HPLC). Sugar can be measured by detecting the fluorescence which is produced by a sugar separated by ion exchange, reacting with arginine at high temperature. The results using standard sugar samples should have highly stable retention time and concentration curve with the minimum detectable mannose concentration of 0.02μg. We investigated mannose in urine from 186 cases. Since the mannose peak was often masked by near unidentified peaks, the peak of mannose could be detected only in 80 cases and its concentration could be measured only in 24 cases. Mannose concentration in the urine of the 24 cases was between 2.6 and 108.7μg/ml and in most of cases it was lower than 20μg/ml.
    Secondaly, we examined the possibility of a mannose in urine to prevent bacterial adherence to mucosa by the hemagglutination test using guinea pig erythrocytes and type 1 fimbriated E. coli. The minimum bacterial concentration to agglutinate 2% guinea pig erythrocytes was studied on 11 strains retaining type 1 fimbriae derived from 26 strains caused acute cystitis. Using the minimum bacterial concentration of 11 strains agglutinating 2% guinea pig erythrocytes, the minimum mannose concentratioin to inhibit agglutination was between 0.6 and 156μg/ml and, in 7 of 11 strains, it was lower than 20μg/ml.
    These results indicate that free mannose in urine can prevent the type 1 fimbriae mediating bacterial adherence to mucosa, and a small amount of mannose is considered as one of the antibacterial factors existing in urine.
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  • Hideki Watanabe, Takeshi Hori, Shoichi Sasaki, Yukihiro Noguchi, Hirot ...
    1989 Volume 80 Issue 12 Pages 1824-1827
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A case of cecoureterocele in a 22-month-old girl is reported. She was admitted because of recurrent urinary tract infection associated with fever and dysuria.
    Excretory urogram showed a left duplex kidney with hydroureteronephrosis of the upper and lower moieties. Although the left upper moiety was hypofunctioned, some excretion of contrast medium was noted. Voiding cystourethrography demonstrated reflux into the left upper moiety, and a prominent dilation of the bladder neck and the urethra. Bladder sonography demonstrated an ectopic ureterocele at the bladder neck, and it was diagnosed as a cecoureterocele by endoscopic examination.
    Left pyelopyelostomy, total ureterectomy from the left upper half kidney and open resection of the ureterocele were performed together with reimplantation of the left lower ureter using Cohen technique in 1 stage. At the operation, the left lower ureter was confirmed as a typical obstructive megaureter.
    Convalescence was uneventful, and postoperative excretory urogram revealed an improvement of the left pyeloureterogram. But the postoperative voiding cystourethrography showed a remnant of cecoureterocele in the urethra causing bladder outlet obstruction. Endoscopic incision of the remnant cele wall in the urethra resulted in marked improvement in voiding and complete resolution of urinary tract infection.
    A brief review of cecoureterocele was given.
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  • Akihiko Gotoh, Ken-ichi Matsuura, Sadao Yoshimura, Yasuo Takano
    1989 Volume 80 Issue 12 Pages 1828-1831
    Published: December 20, 1989
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Bilateral breast mass was found in a 71-year-old male who had been placed on estrogen therapy for stage D2 prostatic adenocarcinoma. Microscopically the mass contained adenocarcinoma morphologically similar to that of the prostate, but the differential diagnosis was impossible between metastatic prostatic carcinoma and primary breast carcinoma. Formalin-paraffin sections of both tumors were stained positively by PSA (prostatic specific antigen) and PAP (prostatic acid phosphatase) using B-SA (biotin-streptavidin) system technique and prostatic origin of the breast mass was confirmed. Prostatic origin for metastatic carcinoma in the breast is are with only 30 reported cases in the literature including 5 Japanese cases. In most of them the diagnosis of the breast lesion as prostatic carcinoma has been made on morphologic and clinical grounds only. Accurate diagnosis is important for the prognosis of the patient, and immunohistochemical method is useful for he diagnosis of breast carcinoma metastasized from prostatic origin.
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