The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
Volume 86 , Issue 2
Showing 1-16 articles out of 16 articles from the selected issue
  • Masao Akimoto
    1995 Volume 86 Issue 2 Pages 241-255
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
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  • Susumu Akimoto, Koichiro Akakura, Takemasa Ohki, Jun Shimazaki, Manabu ...
    1995 Volume 86 Issue 2 Pages 256-262
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Prostate specific antigen (PSA) levels after total prostatectomy or radiation therapy to localized prostate cancer and also during endocrine therapy are within normal range. Therefore, it is necessary to use hyper sensitive PSA assay kits for early detection of relapse. The present study was undertaken to evaluate two hyper sensitive assay kits (Delfia kit, lower limit 0.1ng/ml, Kabi Pharmacia Diagnostics Co. and Markit M kit, 0.5ng/ml, Dainippon Pharmaceutical Co.) and to compare them with conventional PSA kit (Eiken Chemical Co., 1.0ng/ml).
    Total of 291 sera were examined: patients consisted of 10 total prostatectomy+endocrine therapy, 9 radiation therapy+endocrine therapy, 5 radiation therapy alone and 44 endocrine therapy alone. Values of endocrine therapy alone were divided into two groups according to duration after start of treatment; more or less than 5 years.
    The following results were obtained.
    1. In non-relapse patients after total prostatectomy+endocrine therapy and radiation+endocrine therapy, PSA showed under lower limit with hyper sensitive kit. On the contrary, conventional kit indicated more than 1.0ng/ml.
    2. Radiation therapy alone kept PSA in detectable range with hyper sensitive kit in spite of no sign of relapse.
    3. In non-relapsed patients under endocrine therapy alone, long duration (more than 5 years after start of treatment) decreased PSA in non detectable values with hyper sensitive kits. In this case, conventional kit still showed PSA as more than 1ng/ml.
    4. Doubling time at relapse was estimated similar with Delfia kit and Markit M kit, and much longer with conventional kit.
    It is concluded that hyper sensitive kit is more useful to manage patients after therapy than conventional kit.
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  • Yasuaki Ishikawa
    1995 Volume 86 Issue 2 Pages 263-272
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Studies on the pathogenesis of urolithiasis have mainly focused on metabolic disorders. However, metabolic disorders alone are not sufficient to explain the problem. In the present study, morphological and urodynamic differences of the upper urinary tract on both the stone and normal side were examined. There were 35 cases of those who had experienced unilateral, recurrent, and/or multiple stone formation.
    1. Morphologic study. Study of the pelvic-caliceal system (PCS) revealed significant differences in the following parameters on the stone side as compared with the normal side. The findings were: 1) the number of minor calcies (papillaes), Np, was higher; 2) the number of major calices, Nm, was higher; 3) the number of branches, Nb, was higher; 4) the lower calyx radius, 12, was longer; 5) the total calyx area, Ac, was larger; 6) the renal pelvic area, Ar, was larger; 7) and the total area, At, was larger.
    2. Urodynamic study. Additional study of the urodynamic factors revealed significant differences in the following parameters on the stone side as compared with the normal side. These findings include: 1) the peristaltic frequency in the upper third of the ureter was less; 2) the difference in peristaltic interval was longer and the rhythm of the peristaltic discharge was irregular. However, no significant difference in the contraction pressure was found except in the pelviureteral junction. After furosemide had been administered, the contraction pressure decreased while the peristaltic frequency increased on both sides. Futhermore, it was found that on the stone side the peristaltic interval decreased significantly as well as the rhythm of the peristaltic discharge becoming regular.
    The results of the two studies indicate that in the same individual the urine flow in the stone side as compared to the of the normal side is either stangnant or inconstant, thereby creating conditions conductive to the formation and growth of stones which become difficult to discharge owing to these same conditions. Therefore, morphological and urodynamic disorders of the upper urinary tract may be considered as factors contributing to stone formation. It appers that the diuretic action is an effective method for preventing stone recurrence and facilitating stone passage.
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  • Osamu Miyake, Hiroaki Itatani, Hiroshi Itoh, Masao Tsujihata, Seung Sh ...
    1995 Volume 86 Issue 2 Pages 273-278
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We have operated 25 BPH patients with transurethral Nd-YAG laser ablation for prostate from June of 1993 till December of 1993. We used UltraLine™ fiber for contact laser irradiation of the prostate. This is a lateral firing quartz fiber with high density laser energy output, and so made it possible for us to vaporize prostatic tissue rapidly and deeply. We used 60 Watts of power for all cases. For the prostates larger than 50cm3, limited resection after laser ablation allowed early relief of patinets' symptoms. Two months after the treatment, average flow rate improved from 3.7ml/sec to 7.8ml/sec. Volume of residual urine decreased from 48.4ml to 17.0ml. Twnety-four percent decrease of prostatic volume was also recognized with transrectal sonography. Only 4 patients complained of transient urinary retention, although another 3 or 5 days catheter placement relieved their symptoms. Bleeding was negligible and the other postoperative complications were not recognized at all. Laser-TURP is a new treatment that is effective, less morbid and economical, compared with the ordinary TUR-P. So it will soon become an alternative method to electrocautery TUR-P.
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  • Kazuya Tashiro, Hiroshi Nakajo, Shinaya Iwamuro, Yukihiko Ohishi, Fuji ...
    1995 Volume 86 Issue 2 Pages 279-282
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    A total of 245 patients with renal pelvic and ureteral cancer (transitonal cell carcinoma) were retrospectively analysed for tumor location and prognosis. In 133 renal pelvic cancer patients, 34 patients (25.6%) had tumor in lower calyx, 33 patients (24.8%) in renal pelvis, 31 patient (23.3%) in upper calyx, 21 patients (15.8%) in whole renal pelvis and 7 patients (5.2%) in middle calyx, respectively. In 128 ureteral cancer patients, 60 patients (46.9%) had tumor in lower ureter, 27 patients (21.1%) in distal end of ureter, 26 patients (20.3%) in middle ureter, 12 patients (9.4%) in upper ureter and 3 patients (2.3%) in whole ureter. In combination of tumor location, 101 patients (41.2%) had tumor in only renal pelvis, 94 patients (38.4%) had in only ureter, 14 patients (5.7%) had in renal pelvis and ureter, 19 patients (7.8%) had in renal pelvis and bladder, 12 patients (4.9%) had in ureter and bladder, and 5 patients (2%) had in renal pelvis, ureter and bladder. Five year survival rate of renal pelvic cancer according to tumor location were 55.9% in upper calyx tumor, 60.8% in middle calyx tumor, 63.8% in lower calyx tumor, 60.2% in renal pelvic tumor and 63.8% in PUJ tumor, respectively. There were no significant difference between those 5 groups. Five years survival rate of ureteral cancer according to tumor location, 90% in upper ureteral tumor, 60.8% in middle ureteral tumor, 66.5% in lower ureteral tumor and 52.6% in tumor of disatal end of ureter, respectively. Also in those 4 groups, there were no significant difference. From these results, tumor were found more frequently in renal pelvic and ureteral cancer in upper calyx, lower calyx, lower ureter and distal end of ureter. However, tumor location did not influence prognosis in renal pelvic and ureteral cancer.
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  • Tetsuro Onishi, Yukihiko Ohishi, Norio Iizuka, Hiroshi Shirakawa, Taka ...
    1995 Volume 86 Issue 2 Pages 283-289
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We studied the biological features of cacheixa using renal cell carcinoma heterotransplanted to nude mice (JRC 11) where cachexia was caused after the inoculation of tumour. The results of our study were as follows;
    1) The JRC 11 tumour expressed mRNA of interleukin-6 by the analysis using the polymerase chain reaction method (PCR).
    2) The human IL-6 was detected in the sera of nude mice according to the growth of JRC 11. On the other hand, human IL-1-beta, human tumour necrosis factor (hTNF)-alpha and human interferon (hIFN)-gamma were not detected.
    3) The serial body weight of nude mice excluding tumour weight decreased at the 3rd week after the inoculation of tumour compared with tumour non-inoculated mice (control). Furthermore, the experimental group performed the resection of JRC 11 at the 3rd week after the inoculation of tumour showed a re-increase in the body weight, and reached the same weight as that of the control group at the 6th week after the inoculation of tumour. At the same time, serum hIL-6 was not detected in this group.
    4) The serial weight of visceral organs including the liver, kidney and spleen began to decrease at the 3rd week after the inoculation of tumour compared with the control group.
    We conclude that serum IL-6 is defined as a promoter of cachexia in renal cell carcinoma relating to paraneoplastic syndrome.
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  • Kiyoshi Nishimura
    1995 Volume 86 Issue 2 Pages 290-295
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    For assessment of the dosimetric and optimal efficacy of Visual Laser Ablation of the Prostate (VLAP), depth, surface area and volume of thermal penetration of the prostate were determined in 14 adult canines. All prostates were irradiated using the right angle laser fiber (Urolase®, Bard, USA) with neodymlum (Nd): YAG laser application.
    In Group 1 animals, treatment was conducted at 40 watts for 60 seconds (2400 jules) and in Group 2, at 60 watts for 60 seconds (3600 jules). Each prostate was dissected out and examined macro and microscopically at 3 days and 1, 2, 4, 8 and 12 weeks after surgery.
    Mean depth of prostatic penetration, surface area and volume of prostatic tissue ablation in each treatment were 4.75±1.25mm, 4.13±1.13cm2, 3.39±1.58cm3 in Group 1 and 5.75±1.25mm, 4.80±1.95cm2, 4.36±1.99cm3 in Group 2, respectively. Histologically, coagulation necrosis and chronic inflammatory changes of the prostatic stroma became evident in 1 to 4 weeks, and reepithelization in the cavity could be observed at 8 to 12 weeks following the treatment. From these result, it would appear that photoirradiation of canine prostate by the right angle laser fiber brings about cavity formation and that more effective dosimetry with maximum penetration in the canine prostate is possible at 60 watts for 60 seconds of pulse duration.
    Based on these findings, Nd: YAG laser therapy should find a broader scope of clinical application in the management of benign prostatic hyperplasia.
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  • Takayoshi Demura, Itaru Ohyama, Masaki Togashi, Nobuo Ohashi, Tatsuya ...
    1995 Volume 86 Issue 2 Pages 296-303
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Prostate specific antigen (PSA) and gamma-seminoprotein (γ-Sm) have been revealed to be the same protein and used as tumor markers for prostate cancer (CaP). However, it seems impossible to detect prostate cancer in the cases with PSA levels of 10.0ng/ml or less. We now report on PSA/γ-Sm ratio in the cases with PSA levels of 10.0ng/ml or less, and on the relation between PSA and γ-Sm in those cases.
    Serum samples were obtained from the patients with no cancer (NC) (n=118) and CaP (n=39). In the cases with PSA ranging from 4.1 to 10.0ng/ml, γ-Sm levels in the patient with CaP were significantly lower than in those with NC (3.744±2.481 (mean±SD, n=27) VS. 7.573±4.182 (n=41), p<0.0001) though PSA levels in both groups were not significantly different, and consequently, PSA/γ-Sm ratio in the patients with CaP were significantly higher than in those with NC (2.181±0.802 VS. 1.095±0.804, p<0.0001). In the cases with PSA levels of 4.0ng/ml or less, γ-Sm levels in the patient with CaP were significantly lower than in those with NC (1.600±0.705 (n=12) VS. 3.243±2.456 (n=77), p=0.0064), while PSA levels in the patients with CaP were not significantly different from those in the patients with NC, and consequently, PSA/γ-Sm ratio in the patients with CaP were significanttly higher than in those with NC (1.762±0.544 VS. 0.808±0.330, p<0.0001).
    Since it is demonstrated that anti-γ-Sm antibody identifies free PSA exclusively, our data indicate that free PSA (=γ-Sm) is lower in the patients with CaP than in those with NC in the cases with PSA levels of 10.0ng/ml or less. The result was that PSA/γ-Sm ratio provides a better method of detecting CaP than PSA alone even in the cases with PSA levels of 10.0ng/ml or less.
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  • Hidetoshi Yoshinaga, Yuji Hirata, Chisato Fujiyama, Yasuhisa Ichigi, A ...
    1995 Volume 86 Issue 2 Pages 304-307
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    In comparison with megaureters in children, their reports in adult are not common. We had an opportunity to treat seven adults with megaureters during the last six years. They were all female and ages ranged from 46 to 67 years. Five patients with grade II and one with grade III (Pfister-Hendren's classification) were treated by reconstructive surgery, excision of the narrow segment, taparing of the dilated lower ureter and reimplantation through a submucosal tunnel. The outcome of all the grade II patients was excellent and the case with grade III showed mild improvement. The results suggested that surgical reconstruction could be equally effective for megaureters in adults compared to those in children.
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  • Taizo Kazama
    1995 Volume 86 Issue 2 Pages 308-315
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    In order to study endocrinological disorders in varicocele, serum hormone (LH, FSH and testosterone) levels, intratesticular temperature, and testicular histology were evaluated in the rats with experimental left varicocele. Testosterone production and its responsiveness to human chorionic gonadotropin (hCG) in isolated Leydig cells were also determined in the model. The varicocele was created by partial ligation of the left renal vein. The mean difference between intratesticular and intraperitoneal temperature and the levels of serum hormones were similar in varicocele-induced and sham-operated rats at either 2 or 4 weeks after surgery. Histological examination using the Johnsen score count method showed defective spermatogenesis at 2 and 4 weeks. In Leydig cell incubation, testosterone levels in the media without hCG were similar in the left testes of varicocele-induced rats (LV), the right testes of varicocele-induced rats (RV), and the testes of sham-operated rats (S) at 2 and 4 weeks. Although the presence of various concentrations of hCG made no difference in testosterone production between LV, RV, and S at 2 weeks, there were significantly decreased elevations in the production at 100mIU/ml and 1, 000mIU/ml of hCG in LV and RV as compared with that of S at 4 weeks. The bindings of [125I] hCG to Leydig cells from LV and RV were significantly lower than S at 4 weeks. Furthermore, testosterone responsiveness to dibutyryl c-AMP in Leydig cells was similar between LV, RV, and S.
    These data indicate that experimental left varicocele in rats impairs the responsiveness of Leydig cells to hCG through a reduction in the number of hCG receptors, and this change does not seem to be caused by a rise in intratesticular temparature. Besides, it is suggested that defective spermatogenesis observed in this model is not subsequent to the endocrinopathy.
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  • Toru Shimazui, Mitsuro Tomobe, Katunori Uchida, Kazunori Hattori, Hide ...
    1995 Volume 86 Issue 2 Pages 316-320
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We examined nucleolar organizer region (NOR) indices on 13 bladder tumors on both squash-prepared specimens and paraffin embedded specimens stained by silver-colloid method. It was noted that; 1. The nuclear size was enlarged by squashing, 2. Aggregated NOR dots were dispersed, 3. Uniformity of microscopic phase of the dots was obtained, 4. Squash specimens had more precise countabilities than the paraffin embedded sections for avoidance of nuclear resection.
    NOR indices (mean±S. D.) of those bladder tumors on squash-preparation and paraffin section were 8.64±4.32 and 6.13±1.58, respectively, and the former showed good correlation with the tumor stage. When we prepare the squashed specimen from the surgically resected ladder tumor tissue, embedding and sectioning processes which are inevitable for preparation of paraffin embedded section, could be eliminated. Thus, squash-smear technique was considered to be better than the method using paraffin embedded section on the point of shorter duration of examination and accurate countability of the NOR dots.
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  • Hideki Wada, Yoshikazu Sato, Nobukazu Suzuki, Hiroki Horita, Akihiko S ...
    1995 Volume 86 Issue 2 Pages 321-324
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Many types of vacuum constriction devices (VCDs) are used for the treatment of impotence, but the VCDs made in the USA are too large for Japanese males, and air leakage occurs. Therefore, we examined the erectile response of 47 impotent men to a vacuum constriction device that is made in Japan and can be applied suitably for Japanese men, and compared the response to intracavernous injection of prostaglandin E1 (PGE1). When the 47 cases were divided into two groups by nocturnal penile tumescence, twenty of the impotent men were regarded to have fewer organic factor (group A) while 27 were regarded to have more organic factor (group B). All (100%) of the 20 cases of group A achieved a complete erection with the VCD, but only 11 (55%) of them achieved a complete erection with PGE1. Twenty-three (85%) of the 27 cases of group B achieved a complete erection with the VCD, but only nine (33%) achieved a complete erection with PGE1. Two of the four patients who did not achieve a complete erection with the VCD stopped pumping the VCD because of penile pain, and the other two patients had a penile-brachial pressure index (PBPI) of under 0.65. It was suggested that patients with no severe vascular disease can show a good erectile response with the VCD.
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  • Kazuhiro Takai, Hiroyuki Kojima, Masaya Oshi, Kazuki Kawabe
    1995 Volume 86 Issue 2 Pages 325-332
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    Auxotypes, serovars and minimum inhibitory concentration (MIC) of various antibiotics are investigated on 85 gonococcal strains isolated from the patient with gonorrhea from 1984 to 1986 in Japanese Red Cross Medical Center. As to the auxotypes 33 strains were identifed to be Proto, 33 to be Pro, 10 to be Arg and 9 to be PAU. No AHU strain was identified. Serovars were divided into 1A and 1B. MIC of 22 kinds of antibiotics including penicillins, cephems, spectinomycin, tetracycline and new quinolones were determined. Cumulative MIC curves were found to be shifted to the right according to the order of auxotypes Arg, PAU, Proto, Pro in the most antibiotics. Serovar 1A was found to have lower MIC as compared to 1B, though only 5 strain of 1A were in the study.
    Seventy-eight % of isolates were Proto or Pro, so-called Asian auxotype which were revealed to have higher MIC not only of penicillin but also of the other antibiotics. Nine strains were identified as PAU which was lately identified in Canada. This might suggest that gonococcal strains are spreading over the world in spite of the local predominance of auxotype distribution.
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  • Morimasa Kuwahara, Nobuta Fujisaki, Kouji Nakamura, Kazumichi Ohta, Ma ...
    1995 Volume 86 Issue 2 Pages 333-336
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We reported a case of 45-year-old patient with high flow priapism secondary to arteriovenous fistula produced by perineal trauma. Diagnosis was based on the results of gasometry in cavernous blood, cavernography and pudendal arteriography. Although conservative treatment had been tried, complete resolution of priapism was not obtained. We could successfully treat the priapsim by percutaneous temporary embolization of the right internal pudendal artery with Gelatin. Erection and sexual function, after 2 months of treatment, was normal. The rationale for the use of this embolization in the treatment of high flow priapism and its etiology was discussed.
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  • Mitsuhiro Mizunaga, Mitsuru Morikawa, Masanobu Miyata, Shigeo Kaneko, ...
    1995 Volume 86 Issue 2 Pages 337-340
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    We report a case of psychological non-neuropathic bladder difficult to diagnose and treat. A 44-year-old woman was admitted to the Department of Urology of the Asahikawa Medical College Hospital with complaints of difficulty in micturition and urinary incontinence. Urodynamic studies revealed underactive function of the detrusor and incompetent urethra. She was instructed in self intermittent catheterization for difficulty in micturition. Drug therapy, electrical stimulation and vesicourethral suspension were not effective to control urinary incontinence. Since uninhibited detrusor contraction was elicited by psychogenic stress during continuous monitoring of the detrusor function, she was diagnosed as psychological non-neuropathic bladder closely related to psychogenic factor. She had a careful counselling and medical treatment designed by her psychiatrist, urinary incontinence was remitted in about one year and a half.
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  • Yoshio Ohno, Tamio Yamauchi, Tomohiro Ueda, Satoru Kawakami, Tsuneo Ka ...
    1995 Volume 86 Issue 2 Pages 341-344
    Published: February 20, 1995
    Released: July 23, 2010
    JOURNALS FREE ACCESS
    This is a case report of a 51-year-old male in the late stage of malignant lymphoma who presented with pathological fracture renal cell carcinoma recondary to metastatic. He underwent right nephrectomy followed by immunotherapy consisting of interferon alpha and some cytokines. According to his condition and extension of the disease, OK-432, interleukin-2 and interferon gamma were combined. He was also given irradiation to the bone metastases. He died of progressive disease 8 years and 6 months after the initiation of interferon alpha therapy. The autopsy revealed evidence of pancreatic involvement with renal cell carcinoma and malignant lymphoma as well. Malignant lymphoma also infiltrated into the mesentery and left femur.
    We reviewed other reports regarding multiple malignant tumors associated with renal cell carcinoma and discussed the occurrence of malignant lymphoma in renal cell carcinoma patients.
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