(Background) Matrix metalloproteinases-7 (MMP-7), one of an extracellular matrixdegrading metalloproteinase, play an important role tumor invasion and metastasis. We investigated localization, biochemical characterization and mRNA expression of MMP-7 in prostate tissues.
(Methods) Immunohistochemical method, SDS-polyacrylamide gel electrophoresis and northern blot analysis were performed using tissues of prostatic cancer, BPH and normal prostate.
(Results) A latent proenzyme with Mr28, 000 of MMP-7 was detected in the ductal epithelial cells of BPH and in the cytoplasm of cancer cell of the prostate. The ratio of mRNA expression in MMP-7/β-actin was significantly higher in the tissue of the invasive prostatic cancer than those of normal prostate and BPH in northern blot analysis.
(Conclusions) these results suggest that MMP-7 may participate in the function of exocrine gland of normal prostate by preventing glandular obstruction and may play a role in invasion and metastasis of prostatic cancer.

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(Purpose) We evaluated the alterations of density, localization and subtype specificity of muscarinic receptors in experimentally-induced diabetic rat bladder.
(Methods) Five groups of rats were maintained for sixteen weeks 1) diabetic, 2) diabetic insulin-treated (insulin started 8 weeks after the onset of diabetes), 3) sucrose-fed diuretic, 4) sucrose-removed and 5) age matched controls. We used radioligand binding technique and light microscopic autoradiography to define the density and distribution of muscarinic receptors in the rat urinary bladder.
(Results & Conclusion) Saturation experiments showed an increase in the density of muscarinic receptors in the bladders of diabetic and diuretic rats compared with age matched controls. Insulin treatment partially reversed the up-regulatin of muscarinic receptors in rat urinary baldder. Autoradiographic studies also indicated that muscarinic receptors were located in all layers of the bladder muscularis. The muscularis of the bladder dome contained higher densities of muscarinic receptors than that of the bladder base. Lack of [³H]QNB binding to transitional epithelium, lamina propria, and tunica adventitia suggests an absence of muscarinic receptors in these regions. Inhibition of [³H]QNB binding to the bladder sections by selective muscarinic antagonists indicated existence of the M₂ and M₃ receptor subtypes in the muscularis of the rat bladder.

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(Background) We previously reported that the average tumor growth speed estimated from clinical findings may be useful as a prognostic factor to determine the stage progression in superficial bladder cancer. Here, we examined the relationship between the dynamic estimation based on the average tumor growth speed and the static estimation based on the biological proliferative activity determined from bromodeoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA) indices in superficial bladder cancer.
(Methods) The subjects were 11 patients with recurrent superficial bladder cancer. The tumor growth speed was calculated by dividing all tumor volume at a certain recurrence episode by the duration until the recurrence. And then, the average tumor growth speed was determined individually by calculating mean tumor growth speed for all recurrence episodes. BrdU and PCNA indices were investigated by immunohistochemical staining.
(Results) There was a significant correlation between the average tumor growth speed and indices of PCNA and BrdU were statistically (Spearmen's rank correlation test; between the average tumor growth speed and PCNA index: ρ=0.85, p<0.01; between the average tumor growth speed and BrdU index: ρ=0.71, p<0.05; between BrdU index and PCNA index: ρ=0.77, p<0.05). The average tumor growth speed which was calculated based on clinical findings reflected the biological proliferative activities such as BrdU and PCNA indices. Furthermore, the values of all indices were higher in the invasive than in the non-invasive cases.
(Conclusion) These findings suggest that the average tumor growth speed as the dynamic estimation is an important prognostic factor to determine stage progression in superficial bladder cancer.

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(Background) The influence of rectal contractions on urination was examined using multichannel urodynamic study.
(Methods) We reviewed a total of 246 consecutive urodynamic studies. Each study consisted of a uroflow measurement and multi-channel urodynamic study, evaluating total vesical pressure, abdominal (rectal) pressure, subtracted detrusor pressure and perianal electromyography. Rectal contractions were defined as periodic fluctuations over 5cm H₂O in abdominal pressure detected by a rectal balloon catheter. No relationship of these contractions with cough and breathing was observed.
(Results) Of the 246 patients, 17 (6.9%) had a positive study for rectal contractions. The patients, who had positive rectal contractions, averaged 70-year-old were older than negative subjects averaged 62-year-old. In multichannel urodynamics, the flow rate was significantly decreased, and electromyographic activity was increased at the moment of each rectal contractions.
(Conclusion) The rectal contractions are not artifactual and may be regarded as one of causes responsible for urinary difficulty in the elderly.

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(Background) We have studied on the patient who showed a primary lung carcinoma and microscopic metastasis from renal cell carcinoma simultaneously after nephrectomy for renal cell carcinoma.
(Patient) A 57-year-old man who had an incidentally discovered right renal cell carcinoma at the time of the examination of different disease, and received nephrectomy. Two years and four months after nephrectomy, a solitary primary lung carcinoma was found. Therefore, he received lobectomy. Histopathological examination revealed that the lung tumour was a poorly differentiated adenocarcinoma, and peripheral lesions of the lung tumour, it was also disocovered small clear-cell carcinoma simultaneously. At that time, we could not diagnose this carcinoma as a metastatic renal cell carcinoma. Nine months after lobectomy, new coin lesions were appeared in the lung. Therefore, we diagnosed a minimum clear lesion which was found nine months ago was metastatic renal cell carcinoma clinically. At present, the patient receives interferon-α therapy.
(Results) As a result, we diagnosed primary lung carcinoma and small metastatic renal cell carcinoma simultaneously. However, the latter diagnosis could be obtained throught the progression of the disease.
(Conclusion) We conclude that we must give heed to the patients with new cancerous lesions histologically when the patients treated of cancer previously.

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(Background) We report basic animal experimental study which we evaluated the thermocoagulation effects of two different type of Nd: YAG laser (pulse and continuous wave (CW) laser).
(Methods) The Rotalase internally reflecting fiber delivery system coupled to the pulse and CW Nd: YAG laser was used to create lesions in Seminoma tissue implanted Scid mice with the fiber tip 2mm away from the target tissue under the water. Laser power output used was 20, 40 and 60-watt for varying times (30-180sec) of irradiation. Stationary lesions, where a single spot of target was irradiated, were created. On the other hand, we measured tissue temperatures at 7, 10 and 14mm from tissue surface. The seminoma tissues removed from Scid mice were photographed after bisection, the fixed in 10% formalin and examined histologically.
(Results) For the purpose of these experiments, ablated tissue is defined as the volume of tissue that has been destroyed by both coagulation and vaporization. Estimates of the volume of ablated tissue were made by macroscopic examintion of the bisected lesion, measuring the depth and width of the lesion as seen from the edges of the coagulated area around vaporized zone. The mean depth and width penetration, volume ablation and rising of the tissue temperature at pulsed 60-watt, 60 seconds was greater than that observed at other groups. Irradiated spot lesions were characterized by an initial 10-20 second period of tissue blanching followed by an audible “popcorn phenomenon” which meant more than 100°C in tissue temperature, then formation of small surface bubbles as tissue began to evaporate and char.
(Conclusion) This study suggests the potential usefulness of the pulse Nd: YAG laser for Visual Laser Ablation of the Prostate (VLAP).

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(Background) To evaluate how much mass screening for prostatic cancer (PC) would benefit the nation economically, cost-effectiveness of PC screening was analyzed.
(Methods) The cost per life-year saved (cost-effectiveness ratio; CER) was compared between PC screening and other 5 already established cancer screenings in Japan by an analytical simulation model to estimate cost and effectivenss of various screening programs, which was proposed recently by Hisamichi and Kamae.
(Results) Although CER in PC screening amounted 204×10³yen for males aged from 55 to 59 years of age, among males more than 60 years of age, CER became negative, which meant a positive balance might be obtained economically by the adoption of screening. CER of PC screening was similar to that of colorectal cancer screening, while was 2 to 14 times lower than that of the remaining 4 established cancer screenings. According to the sensitivity analysis, the rate of the prevalence of PC, as well as the rate of the examinees for the secondary study influenced remarkedly the cost-effectiveness of PC screening.
(Conclusion) The morbidity and mortality of PC has seriously increased in the past years in Japan and the number of PC patients in 2015 is anticipated to show a 5.19-fold increase of that in 1990. According to such considerable increase of PC patients in the near future, PC screening is thought to be an economically well-balanced public activity.

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We experienced a case of MEN type 2a with bilateral and large pheochromocytomas. A 39-year-old man was admitted to the previous hospital with complaints of paroxysmal headache, hypertension and diabetes mellitus. Radiographic imagings showed thyroid tumors in both lobes and bilateral adrenal tumors. Thyroid tumors were histologically proved to be medullary thyroid carcinoma by needle biopsy and systemic investigations revealed an excessive secretion of plasma and urinary cathecholamines which suggested the presence of pheochromocytoma. The patient was diagnosed as MEN type 2a. He was admitted to our hospital for the treatment of bilateral adrenal tumors for which we performed one-stage bilateral adrenalectomy by thoracoabdominal approach. Both adrenal tumors were histologically confirmed as pheochromocytoma. The patient's postoperative course was uneventful. He underwent uneventful total thyroidectomy approximately 2 months after bilateral adrenalectomy.
Even in bilateral and large pheochromocytomas, one-stage bilateral adrenarectomy enables safe postoperative managements. We concluded that the thoracoabdominal approach is feasible in the patients with huge and cranially spreading adrenal tumor, which gives us a wide operative field for easy vascular control.

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