[Transurethral lithotripsy with rigid and flexible ureteroscopy for renal and ureteral stones: results of the first 100 procedures].

We evaluated the clinical outcome of transurethral lithotripsy (TUL) using rigid & flexible ureteroscopy and holmium : yttrium-aluminum-garnet (YAG) laser in our hospital. We retrospectively reviewed 100 consecutive transurethral lithotripsy procedures performed on 82 patients from May 2008 to June 2010 at our hospital. Twenty-five patients (30%) had multiple stones and 10 patients (12%) had bilateral stones.

[Result of treatment for advanced germ cell tumor in the last decade].

Purpose: We retrospectively analyzed our therapeutic results of advanced male germ cell tumors in terms of efficacy and feasibility of our treatment strategy.

Patients And Methods: Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged from 16 to 58 (median 33).

The androgen receptor as putative therapeutic target in hormone-refractory prostate cancer.

The androgen receptor (AR) plays a central role in the initiation and growth of prostate cancer. Androgen deprivation therapy (ADT) has been a gold standard for advanced prostate cancer for decades. Unfortunately, suppressive effects of ADT do not last long and hormone-refractory prostate cancer develops within several years.

Effects of steroidal and non-steroidal antiandrogens on wild-type and mutant androgen receptors.

Background: Molecular basis for secondary antiandrogen therapy in prostate cancer with mutant androgen receptors (ARs) is not fully elucidated.

Materials And Methods: Effects of steroidal and non-steroidal antiandrogens on transcriptional activities of wild-type and mutant (W741C, T877A, and W741C+T877A) ARs were measured. Crystal structure analysis and docking studies were performed using Molecular Operating Environment (MOE) package.

Castleman's disease in the pararenal retroperitoneal space, which is indistinguishable from renal cell carcinoma: a case report.

A 29-year-old woman was hospitalized in our institute with the diagnosis of a right renal mass by ultrasonography on medical checkup. Computerized tomography showed a lower pole solid mass (9 cm in diameter), which was enhanced homogeneously, as well as the renal cortex in the arterial phase. The tumor was excised using radical nephrectomy based on the preoperative diagnosis of renal cell carcinoma, and thus lymph node dissection was also performed.

[Clinical evaluation of postoperative urinary incontinence after laparoscopic radical prostatectomy: "cross sectional study based on the original questionnaire"].

A cross-sectional study for certain symptoms of postoperative incontinence was done for patients who underwent laparoscopic radical prostatectomy (LRP) using our original self-administered questionnaire. A total of 104 patients, who underwent LRP from April 2002 to March 2005 in our institute and related hospitals, participated in our questionnaire study. Mean age and median observation period was 64.

[Sepsis following transrectal prostate biopsy: a report of 2 cases and reviewed similar cases in Japan].

We report two cases of sepsis and disseminated intravascular coagulation (DIC), potentially fatal complications, following transrectal prostate biopsy. We also review similar cases reported in Japan. Case 1: A 63-year-old man received a cathartic and levofloxacin (LVFX) for prophylaxis.

Deferred combined androgen blockade therapy using bicalutamide in patients with hormone-refractory prostate cancer during androgen deprivation monotherapy.

Objective: To assess the effect of adding bicalutamide on serum prostate-specific antigen (PSA) levels in patients with hormone-refractory prostate cancer (HRPC) during androgen deprivation monotherapy (ADMT).

Patients And Methods: Forty-four patients with HRPC were treated with deferred combined androgen blockade (CAB) therapy, administering bicalutamide 80 mg once daily. HRPC was defined biochemically as three consecutive rises in PSA level during ADMT.

Three-dimensional combination of transrectal and transperineal biopsies for efficient detection of stage T1c prostate cancer.

Background: Although an increasing number of men present with stage T1c prostate cancer, the optimal biopsy strategy for detecting stage T1c disease still remains to be defined. The aim of this study was to explore an efficient first-time biopsy scheme for detecting stage T1c and T2 prostate cancer.

Methods: A transrectal ultrasound-guided systematic three-dimensional 26-core (3D26) biopsy comprising 12 transrectal and 14 transperineal sampling sites was performed in 321 men with median prostate-specific antigen (PSA) level of 6.

[A large amount of distilled water ineffective for prevention of bladder cancer cell implantation at the time of transurethral resection].

A previous study indicated that distilled water could prevent bladder tumor cell implantation in an in vitro assay. We investigated whether a large amount of distilled water irrigation prevented recurrence of superficial bladder cancer in the clinical setting and then we estimated whether cancer cell implantation at the time of transurethral resection is a major mechanism of recurrence. Between May 2000 and January 2002, 22 patients with primary, superficial bladder carcinoma who underwent transurethral resection of bladder tumors (TURBT) were enrolled in this study.

[A case of asymptomatic adrenal hematoma which progressively enlarged during follow-up].

We report a case of asymptomatic adrenal hematoma that enlarged during a 3-year follow-up. A 66-year-old woman exhibited a 4 cm right adrenal mass, incidentally discovered by computed tomography of abdomen, which progressively enlarged to 6 cm in diameter during the 3 years. The patient underwent right adrenalectomy with a diagnosis of a suspected non-functional adrenal tumor.

Portless endoscopic radical nephrectomy via a single minimum incision in 80 patients.

Aim: To assess the feasibility of our portless endoscopic radical nephrectomy via a single minimum incision, which narrowly permitted extraction of the specimen in the initial 80 patients.

Methods: Radical nephrectomy was carried out extraperitoneally in patients with T1-3aN0M0 renal tumors using an endoscope through a single minimum incision without trocar ports and gas. All the instruments used were reusable.

Portless endoscopic adrenalectomy via a single minimal incision using a retroperitoneal approach: experience with initial 30 cases.

Aim: To assess the feasibility of portless endoscopic adrenalectomy via a single minimum incision that narrowly permits extraction of the specimen.

Methods: For 30 cases of adrenal tumor, portless endoscopic surgery through a single flank incision (3-9 cm; mean, 5.6 cm) was performed without gas inflation or trocar port placement.

Reconstruction of the sympathetic pathway projecting to the prostate, by nerve grafting in the dog.

Objectives: To examine the possibility of nerve grafting to repair the sympathetic pathway projecting to the prostate, as contraction of the prostate is known to be controlled by the sympathetic pathway via the hypogastric nerve (HGN), and injuries to the pathway cause significant disturbances in prostatic secretion.

Materials And Methods: In six dogs both of the HGNs were partly removed and immediately repaired with an autologous nerve graft. The left HGN was repaired with a colonic (autonomic) nerve graft and the right with a genitofemoral (somatic) nerve graft.

[A case bilharziasis in a Japanese male].

Bilharziasis is an endemic disease distributed mostly in African countries and the Middle East, and causes severe disturbances of urinary tract secondarily. Although it used to be a very rare disease in Japan, modern human mobility and jet travel have brought this tropical disease into our country far from endemic areas. A 25-year-old Japanese male presented to our hospital with macroscopic hematuria.

Surgical strategy for treating renal cell carcinoma with thrombus extending into the inferior vena cava.

Objective: A surgical strategy for treating malignant renal tumors with thrombus extending into the inferior vena cava (IVC) was assessed.

Methods: We retrospectively reviewed the records for all patients with renal cell carcinoma (RCC; n=30) or Wilms tumor (n=1) with tumor thrombus extending into the IVC who underwent surgical intervention at our institution between January 1980 and December 2001. Tumors were classified preoperatively according to the cephalad extension of thrombus, and intraoperative procedures were selected on the basis of degree of extension.

[Clinical study of surgical site infection following portless endoscopic urological surgery (PLES)].

We investigated the clinical risk factors and bacteriological examination for surgical site infection (SSI) in 144 portless endoscopic surgeries consisting of 66 clean and 78 clean-contaminated surgeries in urological diseases from April 2000 to December 2001. There were no cases of SSI in the clean surgeries. SSI occurred in 5 cases (3.

Prognostic significance of endothelial Per-Arnt-sim domain protein 1/hypoxia-inducible factor-2alpha expression in a subset of tumor associated macrophages in invasive bladder cancer.

Purpose: Endothelial Per-Arnt-Sim domain protein 1 (EPAS1) is induced under hypoxia and it transactivates a series of genes involved in angiogenesis and energy metabolism. Recent studies showed that EPAS1 is expressed in tumor associated macrophages (TAMs), which have multifaceted roles in tumor progression. We hypothesized that EPAS1 expressed in TAMs may contribute to bladder cancer progression.

Favorable outcome of preoperative low dose chemoradiotherapy against muscle-invasive bladder cancer.

To investigate the feasibility of preoperative low-dose chemoradiotherapy, 50 patients with localized muscle-invasive bladder cancer (T2-T4) were treated with concurrent cisplatin (100 mg/body x 2 courses) and pelvic irradiation (40 Gy). Among 20 patients (40%) who achieved clinical complete regression, 11 with solitary tumor underwent partial cystectomy because of advanced age, poor condition of the patients, or a reluctance to have radical surgery. Radical cystectomy was carried out in the remaining 39 cases (complete regression 9, partial regression 30).

[Cyclophosphamide-induced bladder cancer: three case reports].

Three cases of cyclophosphamide (CPM)-induced transitional cell carcinoma (TCC) of the bladder are reported. A 36-year-old female (case 1) and a 63-year-old male (case 2) received CPM at total doses of 104 g and 100 g, respectively, for the therapy of Wegener's granulomatosis. A 50-year-old female (case 3) received CPM at a dose of 57 g for the therapy of recurrent breast cancer.

Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm.

Background: For small, incidentally discovered renal cell carcinoma, partial nephrectomy is becoming more widely accepted as an alternative to radical nephrectomy and the need for minimally invasive approach is increasing.

Methods: We carried out endoscopic minilaparotomy partial nephrectomy in seven cases of solitary renal cell carcinoma smaller than 4 cm. Five of them were without renal pedicle clamping.

Endoscope-assisted minilaparotomy (endoscopic minilaparotomy) for retroperitoneal Schwannoma: experience with three cases.

We have been applying endoscope-assisted minilaparotomy (endoscopic minilaparotomy) to retroperitoneal operations with favorable outcomes. Here, endoscopic minilaparotomy through a single flank incision (4-7 cm) was performed in three cases of incidentally discovered retroperitoneal Schwannoma. Resection of the tumor was successfully completed.

Endoscopic minilaparotomy radical nephrectomy for chronic dialysis patients.

Background: To assess the feasibility of laparoscope-guided minilaparotomy (endoscopic minilaparotomy) for renal cell carcinoma in patients on chronic dialysis.

Methods: Endoscopic retroperitoneal minilaparotomy using a 30 degrees telescope was carried out through single skin incision (5-8 cm) in eight patients with renal cell carcinoma who were on chronic dialysis. Outcomes of the operations were compared to those in eight patients on chronic dialysis with renal cell carcinoma who underwent standard translumbar radical nephrectomy.

Positive expression of HIF-2alpha/EPAS1 in invasive bladder cancer.

Objectives: To investigate the expression of hypoxia-inducible factor (HIF)-2alpha/endothelial PAS domain protein 1 (EPAS1) in bladder cancer.

Methods: Two bladder cancer cell lines (T24, EJ-1) were examined for the expression of HIF-2alpha/EPAS1 mRNA by reverse transcriptase-polymerase chain reaction and HIF-2alpha/EPAS1 protein by Western blot analysis, respectively. Expression of HIF-2alpha/EPAS1 protein was also investigated immunohistochemically on paraffin-embedded sections from 24 patients with bladder cancer.

Intracavitary administration of OK-432 with subcutaneous priming for malignant ascites in a case of advanced renal cell carcinoma.

The intracavitary injection of OK-432 (a streptococcal preparation) with subcutaneous priming has been shown to be an effective immunotherapy for patients with malignant effusion. We applied this treatment in a case of advanced renal cell carcinoma with massive ascites. The patient received 0.