The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
Volume 84 , Issue 6
Showing 1-23 articles out of 23 articles from the selected issue
  • Kaoru Shimada
    1993 Volume 84 Issue 6 Pages 991-995
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
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  • Shino Murakami, Tatsuo Igarashi, Masashi Tanaka, Toyofusa Tobe, Kazuo ...
    1993 Volume 84 Issue 6 Pages 996-999
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    In order to investigate long-term effects of indwelling urinary catheters on renal functions, in 46 patients (27 male and 19 female) with ureterostomy or nephrostomy serum creatinine values were measured periodically. Average age of the patients was 60.6 years old. Duration of catheterization was more than 3 years (average 8.1 years). Renal dysfunction was defined as an elevation of serum creatinine more than 2mg/dl. It was found that catheterization used more than 15 years evoked renal insufficiency over 50% of such patients. This period, however, was shorten to 11 years in patients with nephrolithiasis or frequent fever. It was concluded that urolithiasis and symptomatic urinary tract infections were two remarkable risk factors for the deterioration of renal functions, and that these risk factors must be avoided in patients on long-term catheterization in the upper urinary tract.
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  • Atsushi Iwasa
    1993 Volume 84 Issue 6 Pages 1000-1006
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Neuropeptide Y (NPY), consisting of 36 amino acids, has been reported to coexist usually with noradrenaline in peripheral sympathetic neurons.
    For the purpose of clarifying the physiological role of NPY in lower urinary tract, I studied the existence of NPY and its binding sites around human bladder neck. The distribution of NPY in bladder neck was identified by means of immunohistochemistry. Abundant NPY fibers run parallel to muscle fibers, and NPY positive neuron plexus was recognized just beneath the serosa.
    Binding assay and autoradiographic study indicated the abundant NPY specifisites in the epithelial and muscle layers from bladder neck to prostatic urethra.
    Present study revealed that NPY might be a possible neuromodulator in lower urinary tract, cooperating with noradrenaline.
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  • Ken-ichi Suzuki, Seiichi Orikasa, Senji Hoshi, Masaaki Kuwahara, Kazuy ...
    1993 Volume 84 Issue 6 Pages 1007-1012
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Tissue concentration of THP-ADM was analysed after the administration of THP-ADM with or without exposure of high energy underwater shock waves (SW) to rabbit bladder VX2 cancer.
    THP-ADM was administered intra-venously (2mg/kg) or into the urinary bladder (10mg/body). After the administration of THP-ADM, SW was exposed (6, 000-10, 000 shots) to VX2 bladder cancer or normal bladder tissue. One hour later, THP-ADM tissue concentration was measured by high performance liquid chromatography method. In intra-venous group, THP-ADM concentration of cancer tissue was significantly lower (p<0.02) in SW group than that of non-SW group. In bladder instillation group, THP-ADM concentration of normal bladder tissue was significantly higher (p<0.02) in SW group than that of non-SW group and the average concentration of cancer tissue was higher about three times in SW group than that of non-SW group.
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  • Hiroyuki Fujimoto, Ken-ichi Tobisu, Shin-ichi Teshima, Kiyozou Kishi, ...
    1993 Volume 84 Issue 6 Pages 1013-1018
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The clinicopathological findings of 154 patients with initially superficial (stage pTa or pT1) transitional cell carcinoma in the bladder were analyzed to study risk factors for tumor recurrence or progression in grade and/or stage of the low grade tumor. The number, size, grade and stage of tumor at the first presentation were the significant predictors for the first tumor recurrence. However, only the tumor grade and size at the first recurrence were the predictors for the second recurrence. In 19 (33%) of 57 patients with recurrence, low grade superficial tumor progressed in tumor grade and/or muscle invasion. The progression of low grade tumor correlated with short tumor free intervals and tumor size. Grade and/or stage progression was observed in 14% of the tumor of 1cm or less in diameter, whereas in 42% of the tumor more than 1cm in diameter (Chi-square test: p<0.25). These results indicate that tumor grade and size are important predictors for recurrences. Short tumor free intervals and sizes of tumors in the second recurrence are significant predictors for grade and/or stage progression in low grade superficial cancer.
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  • Kazuo Gohji, Motowo Nakajima, Sadao Kamidono
    1993 Volume 84 Issue 6 Pages 1019-1025
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A new cultured cell line (KG-2) derived from human renal cell carcinoma and a metastatic model in nude mice were studied. KG-2 was cultured from renal cell carcinoma (clear cell carcinoma) of the left kidney. In vitro doubling time of KG-2 was approximately 50 hours. KG-2 cells produced tumors in both the subcutaneous and renal sub-capsular space in nude mice, with tumorigenicity of 75%, showing no difference between the two sites. Histologically, tumors formed in the subcutaneous sites were hypovascular granular cell carcinoma. Moreover, each tumor was encapsulated by a thick fibrous capsule and never produced distant metastasis or invasion into the surrounding tissue. However, tumors formed in the subrenal capsular space were clear cell carcinoma. These tumors were hypervascular, and produced distant metastases. The most common metastatic site was the lung. Immunohistochemical analysis using anti-human collagenase type IV antibody on tumors formed in subcutaneous and subrenal capsular sites demonstrated that the expression of this enzyme in tumors formed in the subrenal capsular space was much higher than that in tumors formed in the subcutaneous site. Additionally, immunohistochemical study using anti-mouse collagen type IV antibody, a major components of the vascular wall, demonstrated many small densely growing vessels in tumors formed in the subrenal capsular space. In contrast, few vessels were produced in tumors formed in subcutaneous sites. These findings suggest that factors relating to the different injection sites may regulate the production of collagenase type IV secreted by KG-2 cells and neovascularity in nude mice. This metastatic model may be useful in the study of the mechanism of cancer metastases.
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  • Tadashi Oeda
    1993 Volume 84 Issue 6 Pages 1026-1035
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    When ethane dimethanesulphonate (EDS) is administered to rats, Leydig cells are destroyed, and damage to the seminiferous tubules is caused due to lack of testosterone (T), but administration of hCG can prevent this damage. In this paper, in order to study in detail this action of hCG, we conducted the following experiment.
    Eleven-week-old male Sprague-Dawley rats were used and we set up a control group, an EDS group and hCG+EDS groups (in addition to EDS, hCG was administered at various concentrations and for various periods). The experimental period was 28 days, and EDS was administered on the 8th day, and the animals were sacrificed on the 28th day. Then we evaluated the degree of testicular damage by determining the diameter of the seminiferous tubules, testicular weight, accessory reproductive organ weight, serum LH and FSH concentrations, and serum and seminiferous tubule T concentrations.
    Our results show that in comparison with the control group in the EDS group the T level in the seminiferous tubule decreased and the seminiferous tubules had atrophied, but in the hCG administration groups the T level in the seminiferous tubules was to some extent maintained, and atrophy of the seminiferous tubules was slight. These phenomena were to a certain extent dependent on the concentration of hCG, and in the groups administered hCG in advance EDS administration, these effects appeared at lower concentrations. In the groups, in which hCG administration started at the same time as EDS, high concentrations of hCG were observed to produce a partial prophylactic action.
    Given the above, in rats by advance administration of hCG it is thought that following EDS administration T is maintained and it is possible to prevent damage to the seminiferous tubules. Also, it is thought that in treating seminiferous tubules already damaged by EDS, administration of high doses of hCG can promote recovery.
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  • Toshihiro Saito, Yoshihiko Tomita, Motohiko Kimura, Tsutomu Nishiyama, ...
    1993 Volume 84 Issue 6 Pages 1036-1040
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Major histocompatibility complex (MHC) antigens play important roles in immune responses. MHC class II molecules serve as restriction elements for cells presenting antigens to CD4-positive helper T-cells. They also function as histocompatibility antigens responsible for graft rejections by stimulating allogenic reaction. Furthermore, it was reported that the expression of class II antigen on tumor cells increases immunogenicity in mice by a mechanism involving class II molecule positive tumor cells which present tumor associated antigens to host immune cells or induce allogenic reactions against tumor cells. Class II molecules associate with the HLA class II antigen-associated invariant chain (Ii) as soon as class II molecules are produced in the rough endoplasmic reticulum. Ii is considered to block the binding of endogenous peptides to class II molecules, and to be a signal for transporting class II molecules to endsomes. Both functions of Ii are essential for the function of class II molecules. To investigate the association between renal cell cancer (RCC) and the host's immune system, we immunohistochemically examined 60RCCs for the expression of Ii, class II and class I antigens on RCC and the degree of lymphocytic infiltration. We detected Ii to varying degrees on 53 out of 60RCC tissues but none on normal renal tubular cells. Compared with class II antigens, they were detected in the order DR≥Ii≥DP≈DQ. A significant correlation was found between the expression of Ii and the degree of lymphocytic infiltration. These results suggest that the expression of Ii on RCC might increase the immunogenicity of tumor cells and the infiltration of tumor infiltrating lymphocytes (TIL). Since it has been reported that interferon (IFN) increases expression of Ii, IFN which is administered as a cancer treatment, or produced by TIL, might increase the immunogenicity of RCC.
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  • Momokazu Gotoh, Yoko Yoshikawa, Atsuo Kondo, Koji Miyake
    1993 Volume 84 Issue 6 Pages 1041-1045
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Early and longterm results of transurethral incision of the prostate and bladder neck (TIPBn) were compared with those of transurethral resection of the prostate (TURP) in treatment of 36 patients with outflow obstruction caused by small benign prostatic hypertrophy. Seventeen patients underwent TIPBn and 19 TURP. Parameters on uroflowmetry (maximum flow rate, average flow rate, voiding time and residual rate) were significantly improved postoperatively in both groups. There was no significant difference in the improvement on uroflowmetry both at early (3 months) and longterm (TIPBn: 12-48, mean 20.1 months, TURP: 12-48, mean 22.2 months) postoperative periods, between the two groups. Subjective symptom of voiding difficulty was remarkablly improved in all patients of both groups during early postoperative period. However, at longer follow-up, subjective improvement was preserved in 88.2% in the TIPBn group and 73.7% in the TURP group. A re-operation was needed in 4 cases (21.5%) in the TURP group because of recurrence of obstructive symptom due to postoperative baldder neck contracture, while a second operation has not been performed in the TIPBn group.
    We conclude that TIPBn can be the preferred surgical treatment of outflow obstruction caused by small benign prostatic hypertrophy.
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  • Takayoshi Demura, Yoshihiko Watarai, Masaki Togashi, Nobuo Oohashi, Ta ...
    1993 Volume 84 Issue 6 Pages 1046-1053
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Prostate specific antigen (PSA) and γ-seminoprotein (γ-Sm) are used as tumor markers of the prostate cancer. However, the serum concentrations of PSA and γ-Sm are frequently increased in patients with benign prostatic hypertrophy (BPH). We measured the ratio of serum PSA to γ-Sm concentration (P/S ratio), and evaluated its usefulness for diagnosis of prostate cancers. Between April 1988 and July 1992, 162 men underwent prostatic biopsy and/or TUR-P, and were diagnosed pathologically. Of 162 patients, 112 were diagnosed as BPH and 50 were diagnosed as prostate cancer. Of 24 patients with serum PSA level of >20ng/ml, 23 (95.8%) were prostate cancer, while, of 79 patients with serum PSA level of 3.0-20ng/ml, 23 (29.1%) were prostate cancer. The sensitivity and the specificity for PSA were 92.0% and 49.1%, respectively. Of 85 patients with serum γ-Sm level of >4.0ng/ml, 30 (35.3%) were prostate cancer. The sensitivity and the specificity for γ-Sm were 60.0% and 50.9%, respectively.
    A mean±SD of P/S ratio in 112 patients with BPH was 0.954±0.591. While, the mean±SD of P/S ratio was 16.295±58.584 in all prostate cancer patients, and 2.031±0.654 in 27 prostate cancer patients with serum PSA level of ≤20ng/ml. P/S Ratio in prostate cancer patients with serum PSA of ≤20ng/ml as well as in all prostate cancer patients were significantly higher than P/S Ratio of BPH patients (p<0.0001). Of 55 patients with P/S Ratio of ≥1.50, 45 (81.8%) were prostate cancer and 10 (18.2%) were BPH. While, of 107 patients with P/S Ratio of <1.50, 102 (95.3%) were BPH and 5 (4.7%) were prostate cancer. The sensitivity and the specificity for P/S Ratio were 90.0% and 91.1%, respectively. Pathological grade of 5 prostate cancer with P/S Ratio of <1.50 were all well differentiated adenocarcinomas. The higher the grade and the stage of the prostate cancer was, the more P/S Ratio increased. P/S Ratio gradually decreased when the prostate cancer responded to hormone therapy, and increased at recurrence. P/S ratio is more useful means of diagnosis of prostate cancer than PSA or γ-Sm solely.
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  • Shigeyuki Yanagi, Hiroyoshi Suzuki, Tokujuro Namiki
    1993 Volume 84 Issue 6 Pages 1054-1058
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Dynamic infusion cavernosometry and cavernosography (DICC) with intracevernous injection of papaverine was performed in 28 men.
    The change of the corporal body pressure after injection of papaverine and the intracavernous pressure decrease within the first 30 seconds after discontinuation of saline infusion were observed.
    Four different patterns of cavernometric findings can be identified on the basis of the intracavernous pressure behavior in response to injection of papaverine, infusion of saline and discontinuation of infusion: pattern A represents no vasculogenic insufficiency, pattern B represents pure arterial insufficiency, pattern C clearly represents venous leak and pattern D represents venous leak and arterial insufficiency.
    Cavernosography has found out effectively the sites of venous leakage in most our cases.
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  • Ryosuke Nemoto, Katsunori Uchida, Hideyuki Akaza, Kenkichi Koiso, Masa ...
    1993 Volume 84 Issue 6 Pages 1059-1067
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    It has been shown that molecular cytogenetics in iterphase nuclei is applicable to paraffin embedded sections from formarin-fixed materials utilizing in situ hybridization (ISH). This allows precise identification of numerical abnomalities of chromosome in tumor cells without disruption of tumor morphology. Thirteen cases of bladder cancer and twenty six cases of prostate adenocarcinoma were evaluated for numerical aberrations of chromosome 1, 7, 10, 11, 17, 18, X and Y utilizing biotinylated probes specific for the alpha satellite region. In two cases from total prostatectomy, one case from total cystectomy and two cases from TUR-P speciemen, hybridized chromosomes could not be detected in individual tumor cells. With respect to the appearence of the ISH signal, optical concentration and time for the digestion enzyme has to be established essentially. This technique can now be applied on the detection of biological activity in various types of urological cancer.
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  • Takahide Sugiyama, Hisao Matsuda, Norio Oonishi, Hiro Kiwamoto, Atsuno ...
    1993 Volume 84 Issue 6 Pages 1068-1073
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Pharmacotherapy with anticholinergic agents was studied in a total of 80 patients aged 65 years or older with chief complaints of urinary frequency (4 patients) and/or ugency incontinence (76 patients). The subjects were 45 men and 35 women at the age ranging between 65 and 92 (mean 73.7).
    The patients received anticholinergic agents (terodiline hydrochloride 24mg/day, oxybutynin hydrochloride 6mg/day, propantheline bromide 60mg/day separately or in combination) for more than two weeks. Subjective symptoms and objective findings were assessed before and after the administration. In addition, according to the result of Hasegawa's dementia rating scale the patients were divided into dementia group and non-dementia group for further evaluation of the study drugs.
    As a result, cystometrogram revealed significant increase of maximum bladder capacity in either dementia group or non-dementia group. There was no significant difference in rate of objective improvement between both groups. On the other hand, rate of subjective improvemnt was significantly higher in non-dementia group (40%) than in dementia group (15%). As mentioned above, improvement of cystometrogram findings was not associated with improvement of subjective symptoms in the demented patients. This suggests that the major cause of incontinence in demented patients is not the bladder dysfunction but the specific conditions of demented patients such as agnosia and apraxia.
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  • Kohei Kurokawa, Jun Kurihara, Seiji Nakata, Yasusige Matsuo, Kazunori ...
    1993 Volume 84 Issue 6 Pages 1074-1081
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    For the purpose of evaluating the utility of CA19-9 determination in transitional cell cancer (TCC) of the urinary tract, its serum value, tissue level and, immunohistochemical study, and follow up study, with high serum value were examined in 43 cases with TCC and 13 cases of control.
    1. Serum values were 19.1U/ml in the control group and 198U/ml in the tumor group. Though those of tumor were higher than those of the control group, there is no statistical difference between both groups. The cases with abnormally high value were observed in 13.7% of the control group, 13.8% of the bladder cancer, and 57.1% of the upper urinary tract cancer.
    2. Tissue levels were 816U/g wet tissue in the control group and 13, 000U/g wet tissue in the tumor group, showing a significantly higher value (p<0.01) in the tumor group, statistically.
    3. Immunohistochemical study were positive in 4.0% of the control group and 88.4% of the tumor group.
    4. There is a significant correlation between serum values and tissue levels (p<0.05, r=0.483).
    5. The serum values did not correlated with the staining property, tumor size, grade, and stage.
    6. The tissue levels correlated with the tumor size, but did not correlate with the staining property, grade, and stage.
    7. In the follow-up study of cases with high value, those, who had not attained postoperative normalization, died of recurrent carcinoma. In cases showing an elevation despite postoperative normalization, too, all showed recurrence. Only those, whose value were normalized and remained at the normal range, are living without metastasis. However, intravesical recurrence could not be estimated from serum values.
    8. Thus, CA19-9 seemed to be a marker which should be once determined for TCC in a big size, particularly transitional cell cancer of the upper urinary tract.
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  • Shoichi Ebisuno, Tadashi Ohkawa, Cheryl Scheid, Mani Menon
    1993 Volume 84 Issue 6 Pages 1082-1087
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    The oxalate uptake was studied in LLC-PK1 cells, an epithelial cell line originated in proximal tubular cells of porcine kidney. It was clear that the cells contain an oxalate exchanger highly sensitive to 4, 4-diisothio-cyanostilbene-2-′ disulfonic acid (DIDS). The uptake was inhibited by the addition of inorganic anions (chloride, sulphate and bicarbonate) to the reaction system, but was unaffected by sodium ion. The data suggest the possibility that it should be consistent with at least two transport systems for oxalate in LLC-PK1 cells, a SO4--/oxalate/HCO3- exchanger and a Cl-/oxalate exchanger.
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  • Masami Machida
    1993 Volume 84 Issue 6 Pages 1088-1094
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Because the affinity of FK506 for red blood cells is strong, plasma FK506 levels vary depending upon the temperature at which plasma is separated from whole blood. This study was undertaken to investigate the effects on plasma FK506 of blood temperature at the time of separation and of its rewarming at 37°C, using A) blood samples from rats administrated with FK506 at 1mg/kg for 7 days, and B) human blood samples added with FK506 at 1.0, 3.2 and 10ng/ml in vitro.
    1) Plasma FK506 levels of samples from rats were not affected by storage time, but samples separated at 20°C were significantly lower in FK506 levels than those separated at 37°C. Plasma FK506 level after rewarming blood at 37°C was not significantly different from that of blood stored at 37°C.
    2) FK506 levels in human plasma, separated at 30°C and 20°C were 51% and 33%, respectively, of the corresponding value for plasma separated at 37°C. But the level of plasma separated at 0°C was 56%, which was higher than that at 20°C.
    3) Rewarming of human blood at 37°C for 5 minutes allowed the plasma FK506 level to return to the initial level.
    FK506 levels of plasma separated without regard to temperature are less reliable and reproducible. The rewarming method appears to be useful for improving the accuracy of measurement of the plasma levels and for reproducing its in vivo levels, because blood samples stored at room temperature will certainly be allowed to recover their initial level by this treatment.
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  • Osamu Kamihira, Yoshinari Ono, Masafumi Sahashi, Shin Yamada, Shinichi ...
    1993 Volume 84 Issue 6 Pages 1095-1098
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Transrectal hyperthermia was performed on 13 patients with chronic non-bacterial prostatitis which failed to respond to the conventional treatments.
    We used “Prostathermer” (Biodan-Medical system, Israel) for heating the prostate gland. The prostate was heated at 42°C-43°C, for 60 minutes in 1 session. Treatment consisted of 6 sessions, and was performed during a period of three weeks on an outpatient basis.
    Of 11 patients re-evaluated after 3 months, 6 (55%) achieved improvement of subjective symptoms. Of 9 patients, 4 (44%) showed reduction of the number of white blood cells (≥10 leukocytes count per high-power field) in their expressed prostatic secretion (EPS), which however was not always correlate with improvement of subjective symptoms.
    No complications were encountered in our series.
    Our result indicates that local hyperthermia is safe, and would become new modality in the treatment for chronic prostatitis.
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  • Shinji Kageyama, Hiroyuki Ihara, Yutaka Kurita, Daisuke Ueda, Tomomi U ...
    1993 Volume 84 Issue 6 Pages 1099-1102
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We performed fiber-urethroscopy and cystometry recoring simultaneously in 15 male patients. Fifteen patients were consisted of 12 complaining of micturiton difficulty (such as BPH, NB, BNS) and 3 normal control. Fiberscope, Olympus CYF-1 and BF 3C10, and cystometry were connected the DISA system. Firstly, we insert fiberscope from the urethra to bladder carefull, and then cystometry recording using carbon dioxide gas started under direct vision of fiberscope.
    We compared cystometrical parameters based on our original method to these on conventional one. There were slight statistical significances in the pressure at the first desire to void and the maximum desire to void. But these differences as well as the frequenty and the size of uninhibitted contraction were not induced by the caliber of the urethroscopy.
    In conclusion, cystometric recording and urethroscopic obsernation using fiberscope are simultaneouly carried out safely without reducing their diagnostic accuracy.
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  • Kiyotaka Kawashima, Kyoichi Imai
    1993 Volume 84 Issue 6 Pages 1103-1109
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    To evaluate clinical and pathological factors responsible for tumor recurrence, disease progression and upper urinary tract reoccurrence, we reviewed data from 244 patient with superficial bladder cancer (pTa and pT1) who were initially treated by bladder sparing operation between 1961 and 1990. The factors assessed in the present analysis included sex, age, interval between initial symptoms and first consultation, presence of hematuria, bladder irritability, tumor shape, tumor base configulation size, number, grade, stage, initial treatment, bladder instillation and medication.
    Accumulated recurrence rates were 13% for the first year, 20% for the second year, 23% for the third year and 28% for the fifth year. Tumor base configulation, number and grade demonstrated significant difference among each category. Multivariate analysis by the Cox's proportional hazards model confirmed that tumor number was the most important factor, followed by grade in this order.
    Disease progression developed in 7 patients (3%) and number and grade of tumor demonstrated significant difference. Progression was noted in 60% of multiple, G3 and pT1 tumor.
    Upper urinary tract recurrence developed in 5 patients (2%), however, we can find no risk factor for upper urinary tract recurrence.
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  • Masaoki Harada, Ryosuke Nemoto, Katsunori Uchida, Hideyuki Akaza, Kenk ...
    1993 Volume 84 Issue 6 Pages 1110-1118
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Histopathological comparison of clinical prostatic adenocarcinoma between Japan and the United States (US) has been made with retrospective analyses on 1, 037 and 987 cases, respectively. All cases were histologically evaluated by the same pathologist (M. H.) without previous knowledge of clinical information according to application of the Japanese General Rules for Prostatic Cancer (JGRPC) based on the predominant degree of histological differentiation, the nuclear grading by WHO classification and the Gleason grading systems. The age distribution of the patients was slightly different among both groups. However, this difference appeared not to be essential, because there existed difference of the date on diagnosis between two groups. Even though considering this time difference on registration, much more cases from Japan had stage D disease. The observed incidence of the histological differentiation classified by JGRPC among over-all cases did not show significant difference, however, the incidence among the cases with same stage between two groups differed with some statistical significance. Much more cases from the US fell in well differentiated adenocarcinoma and frequency of moderately differentiated adenocarcinoma was higher in the Japanese even in the cases diagnosed at advanced stages. The observed incidence of nuclear grade 3 was also higher in the Japanese. Gleason primary and secondary grade 5 and score 9-10 appeared more frequently in the cases from Japan. From the results of the patient survival analysed by life table form, the degree of histological differentiation based on JGRPC and WHO nuclear grading revealed significant correlation to the prognosis of the patient in either cases from Japan or the US. However, the Japanese cases with poorly differentiated and/or grade 3 of nuclear grade tended to have much more poor prognosis compared to the cases with the same histological group from the US. The mortality rates of the Japanese cases with 7-10 of Gleason grade-stage categories were much higher than the values of those from the US. However, the cancer mortality rates closely correlated with this grade-stage categories even in the cases from Japan and the curves plotted with mortality rate in each category on both groups revealed quite similarity. These results may suggest that much more clinical prostatic adenocarcinomas from Japan seem to have delay on detecting time and higher histological grade with poorer prognosis, in addition, are supposed to have different characteristics on clinical courses.
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  • Katsunori Uchida, Toru Shimazui, Mikinobu Ohtani, Hideyuki Akaza, Kenk ...
    1993 Volume 84 Issue 6 Pages 1119-1126
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Histopathological characteristics of stage A prostatic adenocarcinoma from Japan (137 cases) and the United States (51 cases) were comparatively evaluated by retrospective analysis. All cases were examined by one referee pathologist (MH) using classification based on Japanese General Rules for Prostatic Cancer (JGRPC), nuclear grading by Mostofi-WHO system and Gleason grading. The incidences of the cases with well differentiated, low nuclear anaplasia and Gleason grade 1 or 2 on primary and secondary grades as well as histologic score 2-4 were much more higher in the cases from Japan as compared with those from the US. In the cases from the US proportion of the cases with moderately differentiated adenocarcinoma and grade 2 nuclear anaplasia exceeded those with well differentiated and grade 1 anaplasia. Adenocarcinomas with Gleason grade 3 in primary and secondary grade and 6-8 of histologic score wee also more frequently observed in the cases from the US. No different distribution of each histologic grade could be obtained among the Japanese cases classified stage A2 and entire cases from the US. These results suggest that much more stage A adenocarcinoma in the US might fall into A2 if strict criteria was applied for subcalssification of stage A, which may reflected in the remarkable difference in the incidence of clinical prostatic carcinoma.
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  • Fumihiro Kimura, Yoshinori Taoka, Tomohiko Asano, Masaru Murai, Hirosh ...
    1993 Volume 84 Issue 6 Pages 1127-1129
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We describe herein a renal transplant recipient who developed cutaneous sequamous cell carcinoma 15 years after the first transplantation.
    A 41-year-old Japanese man received a renal transplant from his mother for end-stage glomerulonephritis in December 1975 when he was 25 years old. Unfortunately, he suffered irreversible chronic rejection and returned to hemodialysis in March 1986. In December 1986 he received the second renal transplant from his father. In November 1990, the patient developed a nodule just lateral to his right lateral eye angle. He was treated with cryosurgery by a nearby dermatologist four times. However, the lesion did not improve, and he came to our hospital. Cutaneous biopsy specimen showed squamous cell carcinoma. The nodule was resected without decreasing the dose of cyclosporine and azathioprine. He has remained asymptomatic with out evidence of recurrent cutaneous lesions for two years of follow-up. This patient seems to represent the 3rd case of cutaneous cancer after renal transplantation in Japan.
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  • Masahiro Uno, Shin-ichiro Yamada, Shigehiko Ozeki, Manabu Okano, Takas ...
    1993 Volume 84 Issue 6 Pages 1130-1133
    Published: June 20, 1993
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We reported a case of juxtaglomerular cell tumor, which excessively produced renin, resulting in secondary hypertension. A 25-year-old woman complained of headache and nausea. Hypertension and elevation of plasm renin activity were found by physical and laboratory examination. US and CT showed a space occupying lesion at upper pole of the right kidney. Angiography showed a hypovascular area at the corresponding area of the right kidney. Renin-secreting renal tumor of the right kindey was diagnosed and right nephrectomy was performed. Postoperativelly, blood pressure and plasma renin activity became normalized and symptoms ameliorated. The juxtaglomerular cell tumor was pathologically confirmed and localization renin in the tumor cells was shown by immunohistochemical study. Forty one cases of juxtaglomerular cell tumor have been reported, since Robertson reported the first case. We discussed the clinical and pathological charactaristics of the disease in this report.
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