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Volume 75, Issue 4
Displaying 1-17 of 17 articles from this issue
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XI-1 Urodynamic Assessment of Neurogenic Bladder after a Radical HysterectomyShigeo Kaneko1984 Volume 75 Issue 4 Pages 561-569
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSThe disturbance of micturition resulting from radical hysterectomy for cervical cancer is unavoidable and sometimes has a serious effect upon the prognosis. Though the disturbance varies in degree and in symptom, it should be accurately assessed not only to select an appropriate treatment for itself but also to improve operative methods in the future.
Urodynamic features of the disturbance of micturition were studied precisely in ninety-five patients who had radical hysterectomy. The patients consisted of two groups. One was a thirty-eight patient group of radical hysterectomy with preservation of the pelvic plexus (preserved group). The other was a fifty-seven patient group of the operation with transection of the bilateral pelvic plexus (transected group). Urodynamic examination included exteroceptive sensation of the bladder, CO2 gas cystometry with electromyography of external anal sphincter, uroflowmetry and urethral pressure profilometry. The examinations were performed prior to the operation and at 1-3, 4-6, 7-12 months, 2-3 years and more than 3 years after the operation.
The results of the urodynamic examinations became stable in four to six months after the operation. The urethral pressure fell and the compliance of the detrusor went down. These were more remarkable in the transected group and seemed to be direct effects of transection of the pelvic plexus. As the volume and the compliance of the bladder seemed to become smaller and lower in the transected group more than three years after the operation, careful observation must be made for years.View full abstractDownload PDF (1200K) -
XI-2 The Response of Urethral Pressure to Phentolamine and the Damage of the Pelvic Plexus after a Radical HysterectomyShigeo Kaneko1984 Volume 75 Issue 4 Pages 570-579
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSUrodynamic features of the disturbance of micturition were studied precisely in sixty-eight patients who had radical hysterectomy, and an assessment was made about the relation between the degree of impairment of the pelvic plexus and the response of urethral pressure to α-blocker (phentolamine).
The patients consisted of two groups. One was a thirty patient group of radical hysterectomy with preservation of the pelvic plexus (preserved group). The other was a thirty-eight patient group of the operation with transection of the bilateral pelvic plexus (transected group). The performed urodynamic examinations included exteroceptive sensation of the bladder, CO2 gas cystometry with electromyography of external anal sphincter, uroflowmetry and urethral pressure profilometry with and without an intravenous injection of 5mg phentolamine. The examinations were performed prior to the operation and at 1-3, 4-6, 7-12 months, 2-3 years and more than 3 years after the operation.
The maximum urethral closure pressure (cPura) was 77cmH2O and declined by 43 per cent after injection of 5mg phentolamine prior to the operation in both groups. The cPura fell to 69 cmH2O and responded by 31 per cent to phentolamine in the preserved group and to 53cmH2O and by 18 per cent in the transected group more than six months after the operation. The fall of cPura and its poor response to phentolamine were due to damage of the pelvic plexus.
The phentolamine test in the urethral pressure profile is a method which is useful in the diagnosis of the degree of impairment of not only the sympathetic nerves but also the pelvic nerves in the neurogenic bladder of radical hysterectomy, since these nerves were damaged simultaneously by transection of the pelvic plexus.View full abstractDownload PDF (1257K) -
Hiroshi Hashimoto, Kazuhide Kuroda, Shigeo Sakashita1984 Volume 75 Issue 4 Pages 580-590
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSThe changes in the basement membrane were studied in human transitional cell carcinoma of the bladder as well as in carcinoma induced by N-butyl-N-(4-hydroxybutyl)nitrosamine in the rat by ordinary transmission electron microscopy and through histochemical analysis of laminin (a basement membrane specific glycoprotein).
Indirect peroxidase-antibody technique of frozen sections was used in the examination of location patterns of laminin. Electron microscopic study was performed by ordinary methods.
In normal transitional epithelium, the basement membrane is composed of two distinct layers, i. e. an electron lucid layer near the cell surface called the lamina lucida and a denser layer close to the connective tissue called the lamina densa, laminin is located in the lamina lucida in contact with the basal cells. In carcinomas these structures gradually change and this is quite obvious in an invasive one as well as in metastatic lesion of the lymphnodes. However, the location pattern of laminin is constant. In other words, lamina densa changes in various ways such as rupture, detachment from cells, multilayering, and thickening, etc., but laminin is always situated around carcinoma cells and separates them from the surrounding tissue.
Although the meaning of these findings is not clear now, it seems that, in the light of its biological activity previously reported, laminin may be produced by carcinoma cells in their proliferation process and may assist the invasion and metastasis of carcinoma cells.View full abstractDownload PDF (8891K) -
Masatoshi Moriyama, Kazumitsu Terashima, Yoshimitsu Fukushima, Yoshika ...1984 Volume 75 Issue 4 Pages 591-593
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSWe surveyed urogenital anomalies in patients with Sotos syndrome. Eight patients were investigated by physical examination, intravenous urography and voiding cystourethrography. Genital anomalies were cryptorchism, migratory testis and hypospadias. Vesicoureteral reflux (VUR) was the commonest urinary tract anomaly. Occasionally observed anomalies were hydronephrosis and contracted kidney. Urogenital anomalies were seen in 7 out of 8 patients (88%). VUR was seen in as many as 6 patients (75%). Not only urogenital survey but also systemic study should be recommended to patients with congenital anomaly syndrome.View full abstractDownload PDF (3155K) -
Shigeo Sakashita, Shyoichiro Nakanishi, Takayoshi Demura, Naoyuki Saka ...1984 Volume 75 Issue 4 Pages 594-599
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSA non-collagenous basement membrane glycoprotein, laminin, was isolated from human renal cell carcinoma as pepsin digested fragments as described by Risteli et al. Immunohistochemical localization of laminin was demonstrated in 32 cases of formalin fixed human renal cell carcinoma using anti human laminin antiserum. The patterns of localization for laminin could be divided into three different types by the homology to normal tubular basement membranes. The clinical features of patients with renal cell carcinoma were closely related to the histochemical patterns of laminin localization.View full abstractDownload PDF (4032K) -
Mitsuo Ohkawa, Masayoshi Shimamura, Shoji Hirano, Haruo Hisazumi, Kazu ...1984 Volume 75 Issue 4 Pages 600-610
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSA total of 355 strains isolated from urine specimens of 196 patients with complicated urinary tract infections were studied for β-lactamase production. β-Lactamase activity was qualitatively determined by a paper strip acidimetric method with benzylpenicillin as substrate and by a chromogenic cephalosporin method with nitrocefin as substrate. The β-lactamase-producing strains which could be detected by at least one of the two methods were found in 44 out of 77 (57.1%) Escherichia coli isolates, 12 out of 59 (20.3%) Pseudomonas aeruginosa isolates, 47 out of 51 (92.2%) Serratia marcescens isolates, 26 out of 32 (81.3%) Klebsiella spp. isolates, 17 out of 17 (100%) Citrobacter freundii isolates, 14 out of 54 (25.9%) of the other gram-negative rods and 1 of 63 (1.5%) of gram-positive cocci. Of 79 β-lactamase-producing strains of the gram-negative rods which could be detected by the chromogenic cephalosporin method, the enzymic activities of 63 strains were inhibited by clavulanic acid, those of 5 strains by cefmetazole and those of 11 strains by the two drugs, in vitro. From these results, the high detection rate of β-lactamases, especially the penicillinases produced by gram-negative rods, might be a clinical problem in the treatment of complicated urinary tract infections.View full abstractDownload PDF (1402K) -
(1) CORRELATION OF DNA-CONTENT WITH HISTOPATHOLOGICAL FINDINGS AND ITS VALUE IN CYTOLOGICAL NEGATIVE CASESShigeru Fujihiro1984 Volume 75 Issue 4 Pages 611-618
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSDNA-content was evaluated as a marker of malignant potentials in bladder carcinoma. This was detected from DNA histogram which was made up by a microphotometric method after staining with Feulgen reaction of tumor cells or urinary exfoliated cells. A total of 62 patients (52 of bladder cancer and 10 of benign urological diseases) were studied. A DNA histogram had a tendency to become low in mode and to shift to the right side as progressing in cell grading or disease staging. This phenomenon as observed in both tumor cells and exfoliated cells. Therefore, at least in the clinical field, urinary exfoliated cells were confirmed to have the same value of tumor cells in detection of DNA-content. On the other hand, patients with carcinoma in situ of the urinary bladder showed low mode and wide distribution in hyperploid region in DNA histogram. This method might be able to be used in detection of carcinoma in situ because of its difficulties in diagnosis excluding urine cytology. Different DNA histograms from those of normal controls were observed in most patients with bladder carcinoma whose urine cytology was negative. In these cases, the detection of DNA-content is thought to be useful in early detection of the cancer.
These results indicate that the detection of DNA-content, using urinary exfoliated cells as materials, is of use for estimating stage and grade, in cytological negative cases, for detecting tumor itself in patients with bladder carcinoma.View full abstractDownload PDF (1080K) -
1. Clinical Evaluation of Intrarenal MicrolithShizuichi Kageyama, Masaaki Kuwahara, Seiichi Kurosu, Seiichi Orikasa1984 Volume 75 Issue 4 Pages 619-623
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSTo evaluate extremely small renal calculi (intrarenal microcalculi) which could be observed by computer tomography (CT), but not by ordinary plain roentgenogram, we studied CT in 128 upper urinary calculi patients (249 Kidneys).
The results are follows:
1) In thirty-six out of the 128 cases, intrarenal calculi could not be detected by plain roentgenogram. However, by CT, intrarenal microcalculi were recognized in twenty-three out of the above 36 cases (63.9%).
2) In twenty-seven cases diagnosed as upper urinary calculi by plain roentgenogram, other intrarenal microcalculi were recognized by CT.
3) Within two years, the size of these microcalculi increased enough to be recognized by plain roentgenogram in 20 percents of cases diagnosed as intrarenal microcalculi by CT.View full abstractDownload PDF (2033K) -
IV. Stereographic Urethral Pressure Profile (Stereo-UPP)Takashi Morita, Hiromitsu Noto, Ikuo Miyagawa1984 Volume 75 Issue 4 Pages 624-632
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSA new method of examination whereby urethral pressure profiles are recorded from the anterior, right, posterior and left urethral walls and stereographically expressed by means of a computer system has been devised. The system facilitates three-dimensional delineation of the functional morphology of the urethra, requiring no more time and work than does the conventional urethral pressure profile study, nor causing any pain in the patient. The author would propose this new method to be called “Stereographic Urethral Pressure Profile (Stereo-UPP)”. The new Stereo-UPP consists of the four directional UPP, urethral pressure tomograms and aeroview of urethral pressure distribution. It is advantageous in examining urethral function and morphology.View full abstractDownload PDF (3365K) -
Tatsuo Iizumi, Tsunetada Yazaki, Kenji Rinsho, Shori Kanoh, Kenkichi K ...1984 Volume 75 Issue 4 Pages 633-637
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSDetermination of accurate stage of malignant neoplasm is essential for instituting appropriate therapy. For this purpose percutaneous fine-needle aspiration cytology of retroperitoneal lymph nodes was performed in urogenital malignant tumors including 10 patients with carcinoma of the prostate, 9 patients with carcinoma of the bladder, 3 patients with testicular tumor and 2 patients with carcinoma of the ureter.
Positive cytology was seen in 5 patients (21 per cent), all of whom had positive lymphangiograms. In 16 patients with normal lymphangiograms, aspirated materials were all negative. No significant complications were encountered
This procedure has allowed us to determine the tumor stage more accurately in urogenital malignant tumor. Therefore, percutaneous fine-needle aspiration cytology is best recommended when conventional diagnostic procedures fail to determine the accurate stage in patients with urological malignancy.View full abstractDownload PDF (3855K) -
I-(I) The Clinical and Pathological Observations of the Contracted Bladder Caused by Interstitial Cystitis and TuberculosisTetsuo Yamada, Hirokazu Taguchi1984 Volume 75 Issue 4 Pages 638-645
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSWe reexamined, clinically and histologically, 15 cases which had been treated for tuberculous contracted bladder with different postoperative courses. Three cases that proved to non-tuberculous, and one case that had been complicated by a collagenous disease had such clinical and characteristic features as easiness of hematuria and bladder infection, and had some allergic diseases unlike the other cases of tuberculous contracted bladder.
These four cases also had distinctive histological characters comparing with the other cases. They characteristically displayed prominent granulomatous chronic inflammation, especially in the interstitial tissue, and also displayed muscle degeneration. The inflammatory cell infiltration of these cases consisted of histiocytes, plasma cells and eosinophiles besides many lymphocytes.
The capillaries and lymphatic vessels were filled and extended with blood cells and lymphocytes. The lumen stricture was found at the inflammation with a thickening of the blood vessel wall. Also the infiltration of red blood cells were prominent.
From these histological and clinical findings, the four cases were diagnosed to be interestitial cystitis. Three of them were thought to show the clinical and histological findings of the end stage of interstitial cystitis. The differences in the clinical features between Hunner and our cases were thought to be due to that Hunner had pointed out the characteristic clinical findings only in the early stages of the disease.View full abstractDownload PDF (5285K) -
Norio Miyabe, Katsuya Nonomura, Shoichiro Nakanishi, Toshiaki Goto, Ak ...1984 Volume 75 Issue 4 Pages 646-653
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSClinical experience on eight children with features of growth failure, renal insufficiency and renoureteral dysmorphism was reported.
Discussions as to etiology, pathophysiology and therapeutic modalities were made on this unique syndrome, whereby each feature is thought to be intermingled to affect one another.
A new theory of “hyperfiltration” for the genesis of progressive rena failure was proposed. The importance of total management besides uninary plasty was stressed.View full abstractDownload PDF (4406K) -
Katsuya Nonomura, Kaori Imanaka, Masami Nantani, Tomohiko Koyanagi, Ka ...1984 Volume 75 Issue 4 Pages 654-664
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSFor assessing the drainage of pelvo-ureteral junction (PUJ) and the affected kidney function, diuretic renogram (DR) utilizing furosemide and the determination of relative split renal function (RSRF) were performed with 99mTc-DTPA.
I. In non-diuretic dynamic renal scan, 1 to 2 minute kidney uptake (less background) was counted in 10 studies.
The percentage of each total kidney count and that of each matrix kidney count were expressed for total split renal function (t-SRF) and matrix split renal function (m-SRF). In the relationship to biochemically measured creatinine clearance, the regression line of t-SRF had a correlation coefficient of 0.9663 and that of m-SRF had a less correlation coefficient (γ=0.8396).
II. DR were performed in 30 patients with PUJ stenosis.
In comparison of preoperative excretory urography (IVP), the kidneys of obstructive pattern in DR disclosed more marked dilation of pelvo-caliceal system and a thinning of renal cortex. Postoperatively, eleven of 14 kidneys (78.16%) were assessed to have effective patency in DR, but there was no correlation to the figures of pelvo-caliceal system and cortical thickness.
Although the mean half time of diuretic excretion (D-T 1/2) in the renal pelvis was not comparable with the absolute pressure of pressure flow study, DR were closely correlated with clinical course.
DR study including RSRF has ample clinical usage in deciding the operative application of PUJ stenosis and its postoperative follows.View full abstractDownload PDF (4548K) -
Katsuya Nonomura, Masami Nantani, Kotaro Taniguchi, Tomohiko Koyanagi, ...1984 Volume 75 Issue 4 Pages 665-671
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSFor assessing the drainage through the uretero-vesical junction (UVJ), diuretic renogram (DR) was performed in twenty-five cases of non-refluxing megaloureter and post-ureteral reimplantation.
1) DR analysis of UVJ should be done with the region of interest in the renal pelvis plus the ureter without overlapping the bladder. Although the excretion pattern of the renal pelvis in the cases of marked dilated ureter may disclose no obstruction, that of the renal pelvis plus the ureter will disclose no obstruction, that of the renal pelvis plus the ureter will disclose obstruction by ureteral RI stasis.
2) Compared to excretory urogram and other clinical examination, a poorly functioning kidney tends to show an obstructed pattern (false positive) and six of nine cases of non-refluxing megaloureter had no obstruction in the empty state of the bladder (false negative).
3) Non-refluxing megaloureter which showed non-obstructed pattern with bladder drainage turned out to be obstructed when the bladder is filled with saline.
Thus, the state of bladder filling must be taken into consideration when evaluating the UVJ drainage by DR. It will play a valuable role in further study of UVJ kinetic when combined with other urodynamical examination.View full abstractDownload PDF (3279K) -
Akio Maru, Kimiyoshi Mitsuhashi, Masao Kosugi, Toshimori Seki, Tomohik ...1984 Volume 75 Issue 4 Pages 672-680
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSArylsulfatase A activity was measured in urine from patients with various genitourinary tract disorders.
When the enzyme activity was expressed on the basis of volume or protein amount of urine, no significant difference was found between normal and affected urine. However, the arylsulfatase A in affected urine was significantly heat labile as compared with control urine enzyme, although the heat stability test at 62.5°C the for 10min could not differentiate the urinary tract disorders each other.
Upon isoelectric focusing, the pI (5.2-5.3) for the arylsulfatase A of nephrostomic urine, which showed remarkably lower activity and lower heat stability than that of normal voided urine in patients with congenital obstruction of the pelvi-ureteric junction and voided urine in a half of patients with advanced bladder cancer or renal cell carcinoma was clearly different from the pI (4.6-4.7) of the enzymes in healthy and the other urogenital disorders. Furthermore, the nephrostomic and voided urine enzyme were found to have different immunological characteristics. These results suggest that the arylsulfatase A from nephrostomic and voided urine is an enzyme of a different type.View full abstractDownload PDF (3170K) -
Tetsuro Onishi, Toyohei Machida, Fujio Masuda, Yoshikazu Arai, Jojiro ...1984 Volume 75 Issue 4 Pages 681-687
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSRenal cell carcinoma is one of the most malignant neoplasms in the urological field. Most of them die as a result of metastases in clinical course. And this has been true in our experience, both for patients receiving chemotherapy and for those treated by nephrectomy. We present here the difference between cases without metastases over five years (28 cases, group I) and cases with metastase (33 cases, group II), with special reference to the clinical and pathological characteristics of patients with metastases secondary to nephrectomy.
There was no relationship between group I and group II concerning with site, mean age, period from the onset of symptoms and the first symptoms. The rapidity of metastasis seemed to vary with the site of metastasis: The median interval to first lung metastases after nephrectomy was one year and a month, hepatic metastases one year and two months, osseous metastases one year and three months, brain metastases one year and two months and lymph node metastases three years and five months.
The mean weight of nephrected tumor for group I was 396gm and that for group II was 571gm. The mean diameter of the tumor for group I was 5.9cm and that for group II was 7.4cm, but there was no significant difference between group I and group II.
There was no significant relationship between group I and group II concerning with preoperative laboratory findings, i. e., LDH, GOT, GPT, γ-GTP, Al-P, Ca, α2-globulin, E. S. R. and CRP.
A large percentage of group I patients were diagnosed low stage clinically, and low grade pathologically, compared with group II patients. And even in the low staged patients, most of group II patients were high graded. Therefore, histological grade was a critical factor of metastases concerning with postoperative renal cell carcinoma.View full abstractDownload PDF (951K) -
Toshiaki Gotoh, Tetsuo Hirano, Masanori Arakawa, Tomohiko Koyanagi1984 Volume 75 Issue 4 Pages 688-696
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSOf two hundred and eighty-three patients with primary VUR, clinicopathological study was carried out in the subgroup of patients who demonstrated features suggestive of reflux nephropathy.
1) Proteinuria and/or hematuria was found in 25 patients. It was more commonly found among adult men and often associated with latent renal insuffieiency. Lack of urinary tract infection and late referral may partly be responsible for the latter.
2) The incidence of renal scarring was not influenced by the sex or age difference. When the kidney was severely contracted, it was often associated with renal dysplasia and azotemia in children, and with hypertension in women.
3) Hypertension in the absence of renal insufficiency was observed predominantly in female and a high PRA level was proved in 30%. Half of the patients had no history of urinary tract infection.
4) Renal insufficiency was found in 15 patients. In 9 children this was observed predominantly in male and their chief sign were low stature and proteinuria. High stage renal insufficiency was observed from their first consultation. In 6 adult patients there was no sexual preponderance and their chief complaints were hypertension and proteinuria. End-stage renal disease was observed in 4; one from the first consultation and the others within 5 years of examination.
5) HLA typing did not show any particular trend among 9 familial VUR.
6) Renal pathology was evaluated in 11 specimens. All but one showed typical pyelonephritic change. Renal dysplasia was found in 4. Focal glomerulosclerosis was observed in 6. Of these, Ig M and C3 deposition was observed in 3 by immunofluorescent studies. In one of them, Ig A deposition in non-sclerotic glomeruli was also observed. Proliferative glomerulonephritis with Ig M deposition was observed in another one.
It was concluded that proteinuria, renal insufficiency and focal glomerulosclerosis were closely correlated. Pathogenesis of focal sclerosis was reviewed with special reference to the hyperfiltration theory.View full abstractDownload PDF (2761K)
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