The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
Volume 83 , Issue 10
Showing 1-23 articles out of 23 articles from the selected issue
  • Tadashi Hatano
    1992 Volume 83 Issue 10 Pages 1561-1578
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The present state of computer utilization in urology has been described. Nowadays, use of computer is becoming essential in the urological diagnosis and treatment. Recently computers have been so rapidly developed so that it became much smaller and yet offers higher performance. The methods and problems of utilizing computers have been explained by presenting actual examples.
    An important point that must be recognized in utilizing computers is that the computer is meant to be a part of method in resolving problems and its use itself is not conclusion. In other words, computers are a means of methodology.
    Computers have been used for frequency analysis in urophonograms, diagnosis in a simultaneous pressure-flow study in lower urinary tract, and for supporting the data entry by photoscanner.
    Moreover, computers have been used for digital differentiation to materialize higher performance uroflowmeter. Computers have also been applied to litholytic fluid pressure-flow control system for renal stones, and played important role in long hours's intra pelvic pressure monitoring system in support of the large amount of data accumulation and noise reduction. Recently, in the expert system in the pressure-flow study etc., computer plays an essential role which covers most teritory of the system. Finally, its future applications have also been speculated.
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  • Eiichi Okamoto, Hiroki Shima, Hidenori Yabumoto, Fumihiko Ikoma, Tomoy ...
    1992 Volume 83 Issue 10 Pages 1579-1585
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Radioreceptor assay and thermostability test for the androgen receptor in two cases with complete testicular feminization syndrome were performed in regard to the fibroblasts cultured from genital skin on the basis of dispersed whole cell binding assay (Eil et al., 1980). No [3H]dihydrotestosterone binding to the androgen receptor was observed in case 1 (receptor negative), while maximum binding capacity and dissociation constant of androgen receptor for [3H]dihydrotestosterone in case 2 were 21000 sites per cell and 1.67×10-10M (receptor positive). The specific binding of [3H]dihydrotestosterone to the androgen receptor in case 2 decreased remarkably to 6.6% after high temperature (42°C) incubation in comparison with that at 22°C incubation. The specific binding of [3H]dihydrotestosterone to the androgen receptor in normal controls decreased down to 81.6% at high temperature incubation. Thermostability test was useful to demonstrate qualitative abnormality of androgen receptor in receptor positive testicular feminization syndrome.
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  • Takaichiro Ito, Keiji Fujita, Takeshi Hori, Jiro Kato, Tohru Mogami, Y ...
    1992 Volume 83 Issue 10 Pages 1586-1592
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We performed extracorporeal shock wave lithotripsy (ESWL) as a monotherapy using the Medstone STS lithotripter on 288 patients with renal and ureteral stones between June, 1989 and June, 1991. We compared our results with previous reports on ESWL as used in combination therapy. Our cases consisted of 121 patients with renal stones and 167 patients with ureteral stones. A total of 437 sessions of lithotripsy were performed on 288 patients, for an average of 1.52 sessions of lithotripsy per patient. The percentage of stones measuring less than 4.0mm in diameter that were fragmented was 94.3% for renal stones and 87.6% for ureteral stones. The stone-free rates 3 months after ESWL were 60.3% and 90.4%, respectively.
    Our results of the monotherapy with ESWL did not differ from those reported on ESWL as used in combination therapy, in terms of the rate of stone destruction and stone-free rates. We studied the other reports carefully and determined that ESWL monotherapy could have been performed in most those cases.
    We concluded that ESWL monotherapy is an excellent therapeutic method in the light of fewer complications and side effects compared with those from combination therapy, and the fact that the rate of recurrence for renal and ureteral stones is high makes ESWL monotherapy very useful because the procedure can be repeated.
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  • Eiichi Okamoto
    1992 Volume 83 Issue 10 Pages 1593-1599
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The prostatic utricle, a rudimentary structure present in the male prostatic urethra, is currently thought to be of mixed origin, with its cranial portion being derived from müllerian duct and caudal segment from wolffian and müllerian ducts and the urogenital sinus. Enlargement of prostatic utricle has often been demonstrated in patients with hypospadias and its incidence increased according to the severity of hypospadias. It has been suggested that insufficient androgenic stimulation of the urogenital sinus and urethral groove during the critical period of sexual differentiation may cause this entity. Since 5α-dihydrotestosterone (DHT) is a major androgen for the normal development of urogenital sinus, androgen receptor levels in the patients with hypospadias associated with enlarged prostatic utricle may concern this ontogenesis. Fibroblasts derived from penile skin in these patients were assayed for androgen receptor levels using dispersed whole cell binding assay after Eil (1970). Thermostability of androgen receptor in the same fibroblasts was also evaluated by the remaining androgen receptor activity after incubation at 42°C, and expressed as a ratio (percentage) to the androgen receptor activity in the incubation at 22°C. Preputial skin of endocrinologically normal boys in the same range of age (3 to 8 years) was served as controls. There was a significant difference in averages of maximum binding capacities of [3H]DHT to the androgen receptor between those of controls (n=4) and patients with grade II utricle (n=4) (89±5.7 (SE)×102 sites/cell vs. 37±7.1×102sites/cell). Thermostability of androgen receptor in the patients with utricle (n=8) decreased significantly in comparison with that of controls (n=4) (56.0±2.5 (SE)% vs. 74.5±1.8%, respectively). The results suggest that patients with hypospadias associated with enlarged prostatic utricle might have both quantitative and qualitative abnormality of their androgen receptor, and these patients be categorized in the group of partial androgen insensitivity syndrome.
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  • Masaya Tsugawa
    1992 Volume 83 Issue 10 Pages 1600-1608
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The immunobiochemical properties of urinary carcinoembryonic antigen (U-CEA) purified from non-tumor-bearing patients with urinary tract infection were investigated. Moreover, immunohistochemical localization of CEA in the normal urothelium was studied and clinical significance of U-CEA was also analyzed statistically.
    The purified U-CEA showed a molecular weight of approximately 160, 000 by the Western blotting and an antigenicity identical to the purified CEA (Calbiochem Corp.). Amino acids analysis of U-CEA revealed nearly the same values as the purified CEA or the theoretical values of CEA, except for several amino acids susceptible to hydrolysis and sugar chains. Therefore, it was assumed that the U-CEA was a new CEA-related antigen, different from nonspecific cross-reacting antigen (NCA) or even CEA itself. Immunohistochemically, CEA was found mainly at the cytoplasmic membrane in normal urothelial cells.
    The urine samples, collected from patients with various urological disorders, were divided into the inflammation group, showing 5 leukocytes/hpf or more in the urine, and the non-inflammation group, showing less than 5 leukocytes/hpf. The groups were subdivided and U-CEA levels were statistically studied; it was found that the U-CEA levels strongly reflected the presence of inflammation, rather than the presence of urothelial tumors.
    Consequently, it was considered that CEA was present in the normal urothelium and that destruction and regeneration of these cells due to tumor or inflammation might release CEA, not NCA, into the urine.
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  • Akio Fujii, Nobutoshi Oka, Yutaka Murata, Akihiro Higuchi, Noboru Itoh ...
    1992 Volume 83 Issue 10 Pages 1609-1614
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Surgery plus adjuvant chemotherapy using MVP-CAB (Day 1; methotrexate 20mg/m2, vincristine 0.6mg/m2; cyclophosphamide 500mg/m2, adriamycin 20mg/m2, and bleomycin 30mg, Day 2; cisplatinum 50mg/m2) was conducted in 12 patients with epithelial tumors of the upper urinary tract who had unfavorable prognostic factors (progressive disease which was pT2 or more, or transitional cell carcinoma of grade 2 and 3). The MVP-CAB regimen was as follows: A total of 3 cycles were given either before or after surgery. MVP-CAB was given at 3- to 4-week intervals before surgery, or after surgery if the patient had macroscopic residual lesions. For the patients with micrometastases detected after radical surgery, MVP-CAB was given every 1 to 2 months. The median survival period of the 10 patients who underwent radical surgery was 17 months (5-59 months). The three-year survival rate of these 10 patients (Kaplan-Meier method) was 100% in grade 2 (5 patients), 100% in progressive cancer greater than pT3 (6), and 80% in grade 3 (5). In two patients, residual macroscopic lesions after surgery were confirmed. One of them initially responded to MVP-CAB but died of cancer 21 months later, while the other one did not respond and died of cancer 8 months later. Two renal pelvis cancer patients for whom radical surgery was considered impossible due to distant metastases showed remarkable tumor reduction after MVP-CAB administration (one showed CR for liver metastases and the other showed PR for lymph node metastases). As a result, radical surgery became feasible and the patients have now survived 17 and 59 months, respectively. The major adverse reaction to MVP-CAB was bone marrow suppression, which resulted in death in one patient.
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  • Tetsuo Osawa, Sho Nakamura, Tomoyuki Imai
    1992 Volume 83 Issue 10 Pages 1615-1621
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Blood collected from the irrigation fluid used during TURP was retransfused in 17 patients. Of the 17 patients, 8 cases were also transfused preoperatively reserved blood. The weight of resected adenoma (g), resection time (minutes), the volume of salvaged blood (ml) of 9 cases who were transfused only salvaged autologous blood were 30.6g, 63min. and 355ml, respectively, and those of 8 patients who were given both salvaged and preoperatively reserved autologous blood were 46.1g, 78min. and 703ml, respectively. No patient was transfused homologous blood. Preoperative urine cultures showed contamination of bacteria in 12 cases (70.6%), and the blood concentrated from irrigated fluid was positive for bacteria in 2 cases (11.8%). Blood count (RBC, Hb, Ht) just after TURP, after blood retransfusion, at the next and the 7th day after the operation were compared to those of just before TURP (Blood Count Ratio). The ratio of the 9 cases who received only salvaged blood were 83.5%, 96.8%, 90.9%, 85.2% each and the ratio of the 8 cases who were transfused both salvaged and preserved blood were 86.9%, 102.6%, 101.4%, 97.5% each. There were no adverse effects due to the autologous blood retransfusion.
    Conclusion: Retransfusion of salvaged autologous blood from the irrigating fluid of TURP was clinically safe and effective. No homologous blood was transfused in TURP when salvaged autologous blood with or without preserved blood was retransfused to the patient.
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  • Takanori Kato, Masahiko Saito, Soichiro Hasegawa, Atsuo Kondo, Koji Mi ...
    1992 Volume 83 Issue 10 Pages 1622-1627
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Effects of magnesium (Mg) ions on the contraction of the rat detrusor muscle induced by intramural nerve stimulation were investigated in vitro.
    1. Frequency-response curve demonstrated that contractile responses increased in magnesiumfree Krebs' solution and decreased in high magnesium solution (MgCl2 5mM) in comparison with those in normal Krebs' solution.
    2. When MgCl2 was added into an organ bath with cumulative way, the magnitude of detrusor contraction decreased dose-dependently. The contractile response was completely abolished by 30mM MgCl2.
    3. Mg ions suppressed the detrusor contraction induced by a high KCl concentration.
    4. The effect of Mg ions on the detrusor contraction was enhanced by verapamil but was inhibited by Bay-K8644.
    5. Procaine agonized the effect of Mg ions on the detrusor contraction. On the other hand, caffeine did not modify the effect of Mg ions.
    These results suggest that Mg ions seem to play an inhibitory role on 2 types of Ca-channels existing on the cell membrane and to inhibit release of Ca ions from the intracellular deposit.
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  • Akira Tohda, Shozo Hosokawa, Kenji Shimada
    1992 Volume 83 Issue 10 Pages 1628-1632
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We analized 17 cases of multicystic dysplastic kidney (MCDK) to document the natural history of MCDK and its management. One patient was nephrectomied for respiratory failure associated with MCDK. Follow-up studies of 14 kidneys revealed that 5 kidneys (36%) did not change in size, 7 kidneys (50%) decreased in size. Two kidneys (14%) increased in size during the follow up periods and were nephrectomied. Hypertension and malignancy was not observed in our cases.
    Evaluations for the contralateral kidney and urinary tract system were performed in 15 patients and 5 (33%) revealed anormalies—two patients with VUR, 1 with PUJ stenosis, 1 with ureteral stricture and 1 with ectopic ureterocele.
    In our hospital, the management for MCDK is conservative in most cases. Nephrectomy is indicated when there are complications resulting from the size of MCDK, or when the kidney continues to increase in size after the second year of life.
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  • Iwao Fukui, Shuichi Gotoh, Kazunori Kihara, Hiroyuki Oshima, Koichi Ok ...
    1992 Volume 83 Issue 10 Pages 1633-1639
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    During 2 years and 10 months from November 1985 to September 1988, 50 patients with invasive bladder cancer (pT2-4, pN0-2, M0) were treated with total cystectomy followed by adjuvant combination chemotherapy including cis-platinum. In addition, so-called immunopotentiator (OK-432) and Kanpo (Juzentaihoto: TJ-48) were given to the patients in a random fashion to evaluate whether or not these agents had any significant effect on patients' prognosis. The 3- and 5-year survival rates for 48 evaluable patients were 71% and 67%, respectively. Histologic grade of primary tumors and number of cycles of adjuvant chemotherapy administered had a significant correlation to patients' survival: patients with grade 2 anaplasia had a better 3- and 5-year survival rates than those with grade 3 anaplasia, and patients receiving 3 or more cycles of chemotherapy had a better 3-year survival rate than those with 2 or less cycles. pT and pN categories also affected patients' survival, though not statistically significant. Administration of OK-432 or TJ-48 and pre-operative treatment such as irradiation and intra-arterial chemotherapy had no favourable effects on the survival. Side effects of the adjuvant chemotherapy were minimal to moderate and more than 70% of the patients tolerated at least 3 cycles of chemotherapy. It is likely that adjuvant chemotherapy, when given in a post-operative setting, should be repeated at least 3 cycles or more.
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  • Susumu Tsujino, Tamio Yamauchi, Masanori Kokuho, Tsuyoshi Kobayashi, Y ...
    1992 Volume 83 Issue 10 Pages 1640-1646
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We presented 12 patients with invasive bladder cancer treated by the subselective intra-arterial COMPA chemotherapy. COMPA was administered up to an average of 3.3 courses (ranged from 2 to 6 courses) every 2 or 3 weeks, consisting of cisplatin: 15mg/M2 on days 4 and 5; vincristine .(oncovin®): 0.6mg/M2 on days 1 and 2; methotrexate: 5mg/M2 on days 2 and 3; peplomycin: 5mg/body on days 1, 2 and 3; and adriamycin: 10mg/M2 on day 4. These were injected through a teflon catheter the tip of which was placed just proximal to the aortic bifurcation, and another tip was led through a subcutaneous tunnel from the inguinally punctured area to the anterior chest wall.
    The 12 patients, 7 men and 5 women, ranged in age from 53 to 73 (mean: 67) years. Histopathologically 11 had transitional cell carcinoma and one had adenocarcinoma. Malignant gradings were grade 2 in 8 patients, and grade 3 in 4. The stagings were T2 in 3 patients, T3 in 5, T4 in 4 and only one had bony metastasis.
    Of the 12 patients, 10 were alive at the last follow-up with a mean duration of 36 months (range: 16 to 49). Six patients achieved a complete remission, four achieved a partial remission and two were stable. One died of ileus after 16 months and another of progression after 36 months.
    All the patients received post-chemotherapeutic adjunctive therapies, which were transurethral resection, partial cystectomy, radiation and/or intravesical instillation.
    The toxicities were not severe, but anorexia, nausea, vomiting, hairloss, numbness of fingers and/or toes, subileus, and leukopenia were noticed.
    Intra-arterial COMPA chemotherapy is effective as the neoadjuvant treatment of invasive bladder cancer and useful for the bladder-preserving treatment.
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  • Makoto Fujisawa, Shigeru Arima, Sunao Yachiku
    1992 Volume 83 Issue 10 Pages 1647-1654
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Chondroitin polysulfate (CPS) have inhibitory activity on stone formation of calcium oxalate. This study compared the inhibitory effect of three CPS (CPS S-I, CPS S-II, CPS S-III) with sodium pentosan polysulfate (SPP) and chondroitin sulfate (CS). Crystal growth inhibition was measured in a seeded crystal growth system with 14C-oxalate, and CPS S-I and CPS S-II were the most active substances inhibiting crystal growth.
    Since CPS S-II and CPS S-III had remarkable hemorrhagic adverse effect, these two substances were excluded from the following study. The study of administration of the rest of the substances (CPS S-I, SPP, CS) to rats revealed that CPS S-I highly inhibited formation of stone in kidney. About 65 percent of CPS S-I administered subcutaneously was excreted in 24 hours urine.
    Therefore it may be of value to study clinical usefulness of CPS S-I for treatment of patient with urolithiasis.
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  • Yasuo Kawanishi, Kazunori Kimura, Hirohide Iriguchi, Tadayuki Miyamoto ...
    1992 Volume 83 Issue 10 Pages 1655-1661
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The effect of oral prostaglandin E1 (limaprost) on erectile function was studied in a double-blind placebo controlled trial. Fifty one patients who agreed to participate were examined for their subjective symptoms and nocturnal erection was recorded using an erectometer at the beginning of the study, after an initial 6 week period, and again after a second 6 week period. Patients were randomly assigned to a group which received placebo followed by limaprost or to a group which received limaprost followed by placebo.
    Ten cases dropped out. In the remaining forty one patients, NPT during the limaprost phase was significantly different from that during the placebo phase. Patients with the history of diabetes mellitus, hypertension, or pelvic surgery showed relatively poor responses to oral prostaglandin E1. Oral prostaglandin E1 achieved 42.9% effectiveness in the psychogenic impotence, and this effectiveness is significantly higher than that of placebo. Oral prostaglandin E1 was suggested as an additional or alternative therapy in the management of psychogenic impotence. Psychogenic impotents who didn't respond to sex therapy and patients with slight organic causes would seem to benefit from oral prostaglandin treatment.
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  • Shigeo Isaka, Tatsuya Okano, Jun Shimazaki, Shino Murakami, Toru Hara, ...
    1992 Volume 83 Issue 10 Pages 1662-1667
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Many reports about the increase of renal cell carcinoma patients have been published in Japan recently, however, the real fluctuations in the total number of patients in relation to the change of population have not been reported yet. Most of the patients with renal cell carcinoma in the last 10 years were examined in Chiba prefecture, which has a population of about five million and 25 active urological offices.
    Histologically confirmed cases were investigated by sending questionaire letters. The items were as follows; sex, age, address, occupation, family history, past history, symptoms, examination methods that first detected the tumor, operation date, tumor diameter and clinical stage. Twenty two offices returned answers and 560 cases who lived in Chiba were found to have renal cell carcinoma from 1980 to 1989. Yearly incidence rates per 100, 000 persons demonstrated a significant increase from 0.32 to 2.07. Small, asymptomatic and low stage cancers have been increasing rapidly, however, the rate of metastatic disease has not shown any decrease. The main cause of rapid increase seems to be attributed to progress in diagnostic methods and increase of early detection, but the possibility of an increase in some carcinogenic factors can not be ruled out.
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  • Hidehiro Kakizaki, Masaki Togashi, Koji Kurisu, Tomohiko Koyanagi, Kaz ...
    1992 Volume 83 Issue 10 Pages 1668-1676
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The effectiveness of single-dose captopril test (CP-T) and captopril renal scintigraphy with 99mTc-DTPA (CP-RG) in the diagnosis of renovascular hypertension (RVH) was evaluated in 27 patients with (Group I, 16 patients) or without (Group II, 11 patients) renal vascular disease. Group I consisted of RVH in 8 patients (bilateral in 3, unilateral in 5), arteriovenous malformation in 3, renal artery aneurysm in 4, including 2 with essential hypertension, and asymptomatic renal artery stenosis in 1. Group II consisted of 6 hypertensive patients (2 with essential hypertension and 4 with renal hypertension) and 5 normotensive patients. Sensitivity of CP-T and CP-RG in the diagnosis of RVH was 29% (2/7) and 86% (6/7), respectively, indicating the latter was more sensitive than the former. In 3 patients with bilateral RVH, positive response in CP-RG was observed only in the unilateral kidney. Specificity of CP-T and CP-RG was 86% (6/7) and 100% (5/5), respectively in Group I, 100% (8/8) and 83% (5/6), respectively in 16 hypertensive patients. CP-T and CP-RG before and after the treatment of RVH were evaluated in 4 patients. The change of positive response in CP-T and CP-RG into negative after percutaneous transluminal renal angioplasty (PTA) or surgery were found in 3, all followed by a fall in blood pressure, which was not observed in the other patient with positive response after PTA. This suggests that the change of positive response in CP-T and CP-RG into negative after the treatment of RVH correlates well with an improvement of hypertension. In Group II, 4 of 8 patients with various renal parenchymal disease showed positive response in CP-T. All these 4 patients were normotensive and had unilateral vesicoureteral reflux with ipsilateral renal scar or small kidney. Long-term follow-up should clarify that these results are only false-positive or have some implications such as future development of hypertension in these patients.
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  • Yoshinari Ono, Tsuneo Kinukawa, Shinichi Ohshima
    1992 Volume 83 Issue 10 Pages 1677-1680
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Endopyelotomy has been established as a valuable procedure to relieve the obstruction of ureteropelvic junction or upper ureteral stenosis. However, in a case with a long stenotic segment and in a case with high insertion type of ureteropelvic junction obstruction, we had often poor results by the conventional technique. To resolve these problems, we developed a new technique of endopyeloureterotomy via transpelvic extraureteral approach.
    We made an auxiliary incision in renal pelvis or dilated ureter involved with stricture to pass a 22Fr. urethrotome equipped with a cold knife into the retroperitoneal space. Then we incised a stenotic segment by the knife through the urethrotome until the normal caliber of ureteric lumen was found. A 10-16Fr. stent was left in place in the incised segment for 3 weeks.
    We treated 38 patients with ureteropelvic junction stenosis or upper ureteral stenosis by this procedure between August 1988 and June 1990. A total of 39 procedures were performed on 39 ureteropelvic junctions or upper ureters. Original disease were congenital anomalies in 23 patients, stricutres secondary to urinary calculi in 12 and postoperative strictures in 4. The length of incision was 2 to 6cm with the average being 3.2cm. Postoperative follow-up period ranged 4 to 32 months with the average being 19 months. Obstructive changes disappeared or improved in 37 procedures (95%). In two procedures we failed.
    Thus this new technique of endopyeloureterotomy might be an useful procedure to relieve ureteropelvic junction stenosis or upper ureteral stenosis with a long stenotic segment or high insertion type of ureteropelvic junction stenosis.
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  • Kunio Ono, Seiichi Orikasa, Senji Hoshi, Kazuyuki Yoshikawa, Tatsuo To ...
    1992 Volume 83 Issue 10 Pages 1681-1688
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Accurate staging is one of the most important determinants necessary in planning an effective treatment for bladder cancer, but at the present time, staging by the conventional clinical methods are not completely reliable. Accordingly, we have newly developed a percutaneous transabdominal core needle biopsy technique capable of obtaining good cylindrical specimens of the entire layer.
    In order to obtain the core specimen of the bladder wall, which is a vesico-elastic material, the biopsy needle must penetrate the bladder wall at an extremely high speed. We have developed an original automatic biopsy instrument and modified the head of needle for this purpose. With this method, we could obtain good core specimens for pathological staging in about 90% cases. The correlation between the pathological stagings of core specimens and those of cystectomy specimens were in good agreement.
    This technique is accurate not only for preoperative pathological staging, but also monitoring histopathologically the responsiveness of multi-disciplinary treatment for invasive bladder cancer. This method allows us to determine the optimal therapeutic modality for managing individual patient with invasive bladder cancer.
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  • Toru Suzuki, Etsuji Takasaki, Mikihiko Honda, Katsumi Kaneko, Kiyohiko ...
    1992 Volume 83 Issue 10 Pages 1689-1695
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    It was retrospectively analyzed whether intravesical instillation of bacillus Calmette-Guerin (BCG) or anti-cancer agents had prophylactic effect or not after removal of superficial bladder tumors. The results over a follow-up period ranging from 6 to 40 months showed 23.8 per cent recurrence in group 1 patients treated with BCG (21 patients), 46.7 per cent recurrence in group 2 treated with anti-cancer agents (45 patients) and 52.3 per cent recurrence in the group 3 (127 patients) which were not received any intravesical drugs. Long-term results among the 3 groups calculated with Kaplan-Meier method demonstrated that the instillation of BCG or of anti-cancer agents was more useful for prophylaxis, compared with the acturial non-recurrence rates of group 3. The instillation of BCG showed good prophylactic effects especially in recurrent, grade 2 and pTa bladder tumors. The instillation of anti-cancer agents showed to provide prolonged protection from recurrence, but the instillation of BCG did not.
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  • Akira Sasaki, Mikinobu Ohtani, Naoto Miyanaga, Zhongtao He, Hideyuki A ...
    1992 Volume 83 Issue 10 Pages 1696-1702
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The antitumor effect of tumor necrosis factor (TNF) in combination with Cis-diamminedichloroplatinum (II) (Cisplatin) upon implanted bladder carcinoma (MBT-2) in mice was analysed together with the toxicity. Mice were implanted into the bladder wall with about 104 cells MBT-2 viable cells. TNF was the purified human natural tumor necrosis factor. The antitumor effects were evaluated by the volume of the tumor thus implanted and the drug-toxity by the body weight of mice and microscopic as well as macroscopic findings of the main organs.
    As a result,
    1) The toxity of TNF to mice was not enhanced in a dose-dependant fashion when combined with Cisplatin.
    2) The antitumor effect by combination of TNF and Cisplatin was significantly increased compared to control group.
    3) The effects of TNF was enhanced in a dose-dependant fashion when combined with Cisplatin.
    4) The antitumor effects was confirmed by pathological findings.
    These results suggest that the combined use of n-TNF and Cisplatin is promising as a clinically effective treatment against bladder cancer in human.
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  • Akio Fujii, Nobutoshi Oka, Yutaka Murata, Akihiro Higuchi, Ichiro Naka ...
    1992 Volume 83 Issue 10 Pages 1703-1708
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Eight patients with total cysto-urethrectomy underwent an augmented and valved rectum (Kock), a type of continent urinary diversion. A satisfactory outcome was obtained in 6 patients. These 6 patients urinated 6 to 8 times a day (1-2 times during the night). The volume each time was 350-450ml. Urinary incontinence occurred only 1-2 times a month when deeply asleep, and there were no patients whose daily life was restricted. However, there were 3 patients with urinary tract complications. In 2 of them, urinary diversion was required, and unilateral total ureteral obstruction was observed in the remaining patient. The reason for the complications appeared to be that stapling of the intussusception of the sigmoid colon was performed in 5 placements as described in the original method. Following the 4th patient, we were able to prevent any complication in the urinary tract by stapling of the intussusception in 3 places (at 12, 5 and 7 o'clock), and by suturing mucosa to mucosa of the rectum and intussusception in 6 places with polyglycolic acid suture, and further suturing serosa to serosa of the sigmoid colon and rectum in 4 places with silk suture.
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  • Takashi Kawasaki, Masayuki Takeda, Yasushi Katayama, Hideto Go, Takesh ...
    1992 Volume 83 Issue 10 Pages 1709-1712
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    4 children with anterior urethral valve were treated by TUR-Valve. Before TUR, valve anatomy could be easily seen by antegrade urethroscopy through cystostomy using a 10.8Fr caliber flexible renoureteroscope and destruction of the valve could be recognized after TUR. Antegrade urethroscopy with a flexible fiberscope was so helpful to TUR-Valve and the findings of voiding cystourethrography and micturition have remarkably improved. This technique is not so difficult to apply and thought to be one of the best methods to recognize valve anatomy and degree of resection. This technique is also applicable to other lower urinary tract lesions in children.
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  • Hiroyoshi Suzuki, Shigeyuki Yanagi, Tokujuro Namiki, Manabu Takano
    1992 Volume 83 Issue 10 Pages 1713-1716
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A 29 year-old male with the complaints of two steps urination and sense of residual urine was admitted. At cystoscopy, a ureterocele was found between the normal left ureteric orifice and the bladder neck. Excretory urography demonstrated a radiolucent area in the bladder and a left lower hydroureter. Retrograde pyelography revealed that the left ureter was divided into two branches. Operative exploration demonstrated that the left ureter was an inverted Y ureteral duplication with an ectopic ureterocele; one opened into the ureterocele and the other into the trigone. We resected the ureterocele wall. Four months later, a voiding cystogram did not show vesicoureteric reflux. Now, he has no symptoms and the results of examination are normal.
    An inverted Y ureteral duplication is the rarest of all anomalies of the ureter. A review of the literature revealed 36 cases reported previously. Clinical analysis was obtained by reviewing 26 of these cases and adding our own (male 10: female 17, average age: 23 years). Complication included 6 cases of ectopic ureteral opening, 6 with blind-ending branch and 5 with ureterocele. The symptoms of this disease depended on the complicating anomalies. The present case was the 5th one of an inverted Y ureteral duplication with a ureterocele in the world literature.
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  • Toshihiro Saito, Masahiro Terunuma, Takako Koizumi, Tsutomu Nishiyama, ...
    1992 Volume 83 Issue 10 Pages 1717-1720
    Published: October 20, 1992
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A 54-year-old woman who had undergone radical nephrectomy for renal cell cancer nine months before was admitted to our hospital because of difficulty in breathing. X-ray films of the chest showed massive pleural effusion on the left side and cytological examination of the effusion revealed malignant cells which may have originated from renal cell cancer. Intrapleural installations of interleukin-2 and of tumor infiltrating lymphocytes isolated from the pleural effusion were performed. After the initiation of the treatment, the pleural effusion decreased and malignant cells disappeared from the pleural fluid. Partial response defined by the criteria provided by the Japan Lung Cancer Society was achieved. No serious side effects were observed. This would be a useful treatment for pleuritis carcinomatosa by renal cell cancer.
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