Suspension technique improves rapid recovery of urinary continence following radical retropubic prostatectomy.

We investigated whether a suspension technique of vesicourethral anastomosis with pubo-prostatic ligaments improved urinary continence following radical retropubic prostatectomy. The suspension of vesicourethral anastomosis was performed in 55 consecutive patients with clinically localized prostate cancer by placement of two stitches, which were anchored to pubo-prostatic ligaments preserving their anterior attachments to the pubic bone. Continence rates, positive rates of surgical margins, and complications in these patients after radical prostatectomy were compared with the results of 30 randomly selected patients in whom a suspension technique was not performed.

Early catheter removal 3 days after radical retropubic prostatectomy.

Aim: We investigated the feasibility and safety of the early removal of urethral catheters 3 days after radical retropubic prostatectomy.

Methods: Seventy consecutive patients underwent radical retropubic prostatectomy with the intent of early catheter removal on postoperative day (POD) 3. Catheter removal was based on postoperative cystograms performed on POD 2.

Immunological monitoring during combination of patient-oriented peptide vaccination and estramustine phosphate in patients with metastatic hormone refractory prostate cancer.

Background: Additive antitumor effects could be achieved by combination of immunotherapy and cytotoxic agents with no or minimum suppression.

Methods: Thirteen patients positive for human leukocyte antigen (HLA)-A24 or -A2 with metastatic hormone refractory prostate cancer (HRPC) who had failed to respond to the prior-peptide vaccination were entered in the combined peptide vaccination and estramustine phosphate. Conducted immune monitoring on those 13 patients were mainly peptide-specific cytotoxic T lymphocyte (CTL) precursor analysis by IFN-gamma productions and peptide-reactive IgG by an enzyme-linked immunosorbent assay (ELISA).

Transurethral electrovaporization for giant prostatic hyperplasia: report of a case.

Although open simple prostatectomy remains the reference standard for the treatment of excessively large or giant prostatic hyperplasia, advances in technology and techniques have facilitated safe transurethral management of select cases. We report a case undergoing removal over 200 g of prostatic adenoma by three transurethral electrovaporization (TVP) sessions and discuss its feasibility in clinical use.

Phase I trial of patient-oriented vaccination in HLA-A2-positive patients with metastatic hormone-refractory prostate cancer.

To evaluate the safety and toxicity of peptide vaccination for patients with metastatic hormone-refractory prostate cancer (HRPC) based on pre-existing peptide-specific cytotoxic T-lymphocyte (CTL) precursors in the circulation, 10 patients positive for human leukocyte antigen (HLA)-A2 with metastatic HRPC were enrolled in a phase I study. Peptide-specific CTL-precursors reactive to 16 kinds of vaccine candidates in the pre-vaccination peripheral blood mononuclear cells (PBMCs) were measured, and patients were followed by vaccination with only positive peptides (up to 4 kinds of peptides). Serum prostate-specific antigen (PSA) levels were monitored regularly.

Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.

Background: The present study was undertaken mainly to investigate whether chemohormonal therapy with estramustine phosphate plus luteinizing hormone-releasing hormone (LHRH) agonist has a more beneficial effect than the hormonal therapy with flutamide plus LHRH agonist for newly diagnosed patients with metastatic prostate cancer.

Methods: A total of 57 patients with metastatic prostate cancer aged 59-80 years (median 74 years) were entered in the study and were randomized to the treatment of estramustine phosphate (560 mg/day) plus LHRH agonist (estramustine group) or flutamide (375 mg/day) plus LHRH agonist (flutamide group) with stratification for the degree of performance status, histological differentiation and bone metastasis.

Results: Both of the treatment regimens were well tolerated with similar incidences of adverse drug reactions.

Induction of cellular and humoral immune responses to tumor cells and peptides in HLA-A24 positive hormone-refractory prostate cancer patients by peptide vaccination.

Background: To assess the safety and immune response of a peptide-based immunotherapy for patients with hormone-refractory prostate cancer, a phase I clinical trial was conducted.

Methods: This study first investigated whether cytotoxic T-lymphocyte (CTL) precursors reacting to peptide with vaccine candidates (14 peptides for HLA-A24 positive patients) were detectable in the pre-vaccination peripheral blood mononuclear cells (PBMCs) of ten patients with hormone-refractory prostate cancer. Patients were then vaccinated subcutaneously with only those peptides to which pre-vaccination PBMCs reacted (CTL precursor-oriented peptide vaccine) for up to four kinds of peptides.

Transurethral endoscopic treatment of upper urinary tract tumors using a holmium:YAG laser.

Background And Objectives: The feasibility of treating upper urinary tract tumors with a holmium:YAG (Ho:YAG) laser in transurethral endoscopy was examined.

Study Design/materials And Methods: Thirty-three treatments were performed on 30 patients with renal pelvic and ureteral carcinomas. After vaporization and coagulation eliminated the tumors, the surrounding mucosa was fully coagulated.

Serum levels of bone turnover markers parallel the results of bone scintigraphy in monitoring bone activity of prostate cancer.

Objectives: To investigate the usefulness of bone turnover markers as a modality for monitoring bone metastasis in patients with prostate cancer with bone metastasis.

Methods: Serial measurements of pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), carboxyterminal pro-peptide of type I procollagen (PICP), prostate-specific antigen (PSA), and the percentage of the positive area on the bone scan were prospectively performed before and after hormonal therapy in 84 patients with prostate cancer with bone metastasis for median follow-up of 29 months.

Results: Serial ICTP and PICP levels in 48 patients without progression of bone metastasis demonstrated a downward trend during treatment and were almost within the normal range by the end of follow-up.

Protective role of heparin/heparan sulfate on oxalate-induced changes in cell morphology and intracellular Ca2+.

Alterations in intracellular Ca2+ ([Ca2+]i) are generally associated with cellular distress. Oxalate-induced cell injury of the renal epithelium plays an important role in promoting CaOx nephrolithiasis. However, the degree of change in intracellular free calcium ions in renal epithelial cells during oxalate exposure remains unclear.

Role of heparan sulfate proteoglycan (syndecan-1) on the renal epithelial cells during calcium oxalate monohydrate crystal attachment.

We have reported that heparan sulfate (HS)/heparan sulfate proteoglycan (HSPG, syndecan-1) expression significantly increased in the rat kidney during calcium oxalate (CaOx) nephrolithiasis. Although the exact role of syndecan still remains unclear, HS/syndecan-1 is thought to have some important role in the CaOx crystal formation. Mardin-Darby canine kidney (MDCK) cells are most commonly used in kidney stone research.

Calcium nephrolithiasis and distal tubular acidosis in type 1 glycogen storage disease.

A 36-year-old man was admitted to hospital due to right flank pain as a result of ureteral stones. He had been followed up for type 1 glycogen storage disease since the age of 11 years. He had four episodes of spontaneous stone birth during the previous 2 years, and each stone was composed mainly of calcium oxalate.

Endoscopic antegrade laser incision in the treatment of urethral stricture.

Objectives: To examine the possibility of antegrade incisions at varying stricture lengths. We have developed a new method of using a ureteroscope and holmium:yttrium-aluminum-garnet (YAG) laser to make an antegrade incision without using a guidewire. Endoscopic internal urethrotomy involves the use of a guidewire or ureteral catheter that is passed through the stricture as an indicator for retrograde incision.

Heparan sulfate (HS)/heparan sulfate proteoglycan (HSPG) and bikunin are up-regulated during calcium oxalate nephrolithiasis in rat kidney.

We reported that expression of both HSPG and of bikunin are increased in calcium oxalate (CaOx) nephrolithic rat kidneys (lida et al., J. Am.

Confocal laser microscopy of chondrocytes that received gene transfer using in vitro electroporation.

To develop a gene therapy for osteopathies, this study was conducted to establish a method of transferring the BMP gene, a bone formation factor, to cells and administering the cells with BMP expression to patients with osteopathies. Although virus vectors are frequently used for gene transfer, there has been reported a death case of gene therapy using the adenovirus vector. Therefore, various efforts have been made to prevent such complications.

No residual tumor in a radical prostatectomy specimen after neoadjuvant hormonal therapy for localized prostate cancer.

The role of neoadjuvant hormonal therapy (NHT) before radical prostatectomy for localized prostate cancer remains controversial because many argue that apparent downstaging results in difficulties with the pathological evaluation of the neoadjuvant treated prostatectomy specimen. Furthermore, the downstaging to pT0 (no residual tumor), as reported by several institutions, remains questionable and is not yet confirmed by clinical or experimental evidence. To examine this issue and to assess the influence of NHT on downstaging, we investigated the stage pT0 status in radical prostatectomy specimens after NHT.

[Anti-emetic effects of ondansetron hydrochloride throughout courses of cytotoxic chemotherapy].

Since the emesis induced by cytotoxic drugs is intractable, and is a possible determinant of a patient's QOL during chemotherapy, the control of this adverse event is essential to complete a course of cancer chemotherapy. The anti-emetic effects of a 5-HT3 antagonist, ondansetron hydrochloride (OND), was evaluated during a course of CDDP-containing chemotherapy. Forty-eight patients with gynecologic carcinoma, respiratory malignancy, or urological cancer were followed throughout their treatment courses.