Identification and characterization of a novel aac(6')-Iag associated with the blaIMP-1-integron in a multidrug-resistant Pseudomonas aeruginosa.

In a continuing study from Dec 2006 to Apr 2008, we characterized nine multi-drug resistant Pseudomonas aeruginosa strains isolated from four patients in a ward at the Hiroshima University Hospital, Japan. Pulsed-field gel electrophoresis of SpeI-digested genomic DNAs from the isolates suggested the clonal expansion of a single strain; however, only one strain, NK0009, was found to produce metallo-β-lactamase. PCR and subsequent sequencing analysis indicated NK0009 possessed a novel class 1 integron, designated as In124, that carries an array of four gene cassettes: a novel aminoglycoside (AG) resistance gene, aac(6')-Iag, blaIMP-1, a truncated form of blaIMP-1, and a truncated form of aac(6')-Iag.

Increased prevalence and clonal dissemination of multidrug-resistant Pseudomonas aeruginosa with the blaIMP-1 gene cassette in Hiroshima.

Objectives: The aim of this study was to evaluate the dissemination of metallo-beta-lactamase (MBL)-encoding genes among multidrug-resistant (MDR) Pseudomonas aeruginosa isolates recovered from major hospitals in the Hiroshima region.

Methods: During July to December from 2004 to 2006, a surveillance of eight major hospitals in the Hiroshima region identified 387 non-duplicate isolates resistant to imipenem (MIC >or= 16 mg/L). They were screened for resistance to amikacin (MIC >or= 64 mg/L) and ciprofloxacin (MIC >or= 4 mg/L) and MBL-encoding genes.

Five-year longitudinal effect of radical perineal prostatectomy on health-related quality of life in Japanese men, using general and disease-specific measures.

Objective: To investigate the longitudinal alteration of health-related quality of life (HRQL) up to 5 years after radical perineal prostatectomy (RPP) among Japanese patients with localized prostate cancer.

Patients And Methods: In all, 194 patients who had RPP were included in this longitudinal survey. The validated RAND 36-Item Health Survey (SF-36) and the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) were used to evaluate the HRQL.

Decrease of renal function due to warm ischemia after laparoscopic partial nephrectomy: evaluation using 99mTc-DMSA renal scintigraphy.

Introduction: The purpose of this study is, using technetium-99m-dimercaptosuccinic acid ((99m)Tc-DMSA), to evaluate the decrease of renal function caused by warm ischemia.

Patients And Methods: The (99m)Tc-DMSA scan was performed before and 1, 3 and 6 months after the operation for 19 consecutive patients. The patients were divided into three groups by warm ischemic time (group A: 40 min intersection 60 min).

Development of the human retroperitoneal fasciae.

Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification.

Materials And Methods: Horizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9-12 (3 fetuses, crown-rump length, CRL 40-65 mm) and 20-25 weeks of gestation (9 fetuses, CRL 152-220 mm)] were compared.

Results: In the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF).

Prevalence of painful bladder syndrome (PBS) symptoms in adult women in the general population in Japan.

Aims: The aim of this study was to clarify the prevalence of painful bladder syndrome (PBS) symptoms in adult women in the general population in Japan.

Methods: Web-based survey through an internet-based market research company that enrolled 561,631 men and women in Japan was conducted from January 9 to January 11, 2007. After the women allocated to four age groups; 20s, 30s, 40s, and 50s or older, a total of 80,367 women, comprising an almost equal number from each age group, were then randomly invited to participate.

Immunohistochemical analysis of Reg IV in urogenital organs: Frequent expression of Reg IV in prostate cancer and potential utility as serum tumor marker.

Regenerating islet-derived family, member 4 (Reg IV) is a candidate marker for cancer and inflammatory bowel disease and is associated with neuroendocrine and intestinal differentiation. We have reported that 14% of prostate cancer (PCa) cases are positive for Reg IV by immunohistochemistry. In the present study, we performed immunohistochemical analysis of Reg IV in other major urological cancers, including 101 renal cell carcinoma (RCC), and 95 urothelial carcinoma (UC) of urinary bladder by immunohistochemistry.

Lack of information underlies women's perceptions of erectile dysfunction (ED) drugs in Japan.

Introduction: Some Japanese women are known to have negative attitudes toward erectile dysfunction (ED) drugs, but the environment underlying these perceptions is unclear.

Aim: To reveal the underlying environment that shapes women's perceptions of ED drugs in Japan.

Methods: A web-based questionnaire was conducted through an Internet-based market research company.

Reg IV is an independent prognostic factor for relapse in patients with clinically localized prostate cancer.

Regenerating islet-derived family, member 4 (REG4, which encodes Reg IV) is a candidate marker for cancer and inflammatory bowel disease. We investigated the potential prognostic role of Reg IV immunostaining in clinically localized prostate cancer (PCa) after radical prostatectomy. Immunohistochemical staining of Reg IV was performed in 98 clinically localized PCa tumors obtained during curative radical prostatectomy.

Restoration of FGF receptor type 2 enhances radiosensitivity of hormone-refractory human prostate carcinoma PC-3 cells.

Background: This study was undertaken to investigate the radiosensitizing effects of fibroblast growth factor receptor 2IIIb (FGFR2IIIb) in androgen-independent human prostate carcinoma PC-3 cells devoid of normally resident epithelial cell FGFR2IIIb.

Materials And Methods: A clonal line of PC-3 cells expressing FGFR2IIIb was established by stable transfection. Clonogenic cell survival, apoptosis and cell cycle distribution with and without gamma-irradiation were then compared between FGFR2IIIb-expressing PC-3 cells and control cells mock-transfected with vector alone.

Female perineal membrane: a study using pelvic floor semiserial sections from elderly nulliparous and multiparous women.

To describe the architecture and topohistology of the female perineal structures, especially the perineal membrane (PM), we examined frontal sections (one side) and horizontal or transverse sections (another side) of 15 bisectioned pelvic floors. The PM, notably comprising elastic fibers, extended mediolaterally or transversely on the immediately inferior side of the rhabdosphincter area. More posteriorly, the elastic fibers more tilted along the long axis of the vagina and became lining the lateral vaginal wall as a fibrous skeleton.

Alternative nonsteroidal antiandrogen therapy for advanced prostate cancer that relapsed after initial maximum androgen blockade.

Purpose: Large meta-analyses have documented that maximum androgen blockade with nonsteroidal antiandrogens for advanced prostate cancer confers survival benefits, although it remains controversial. Also, we and others have reported the effectiveness of second line hormonal therapy for prostate cancer that relapses after initial hormone therapy. However, there is little clinical evidence of the effectiveness of the latter treatment strategy.

Deep hypothermic circulatory arrest for resection of renal tumor in the inferior vena cava: beneficial or deleterious?

Background: The use of deep hypothermic circulatory arrest (CA) during resection of renal tumors with caval extension is limited in many institutes because of possible adverse effects on immune or platelet function. The present study examined whether routine use of CA implied a negative impact on prognosis.

Methods And Results: Thirty-six cases of renal tumor with caval extension were retrospectively reviewed (age range, 40-82 years; follow-up, 5 months to 23 years).

Overactive bladder in children should be strictly differentiated from monosymptomatic nocturnal enuresis.

Introduction: To elucidate the prevalence of concomitant overactive bladder in children with a chief compliant of primary enuresis, and to evaluate the pathogenetic difference between monosymptomatic and non-monosymptomatic enuresis.

Materials And Methods: All patients had evidence of primary enuresis. Neurogenic bladder was excluded.

Inguinal hernia after radical perineal prostatectomy: comparison with the retropubic approach.

Objectives: To clarify the characteristics of inguinal hernia (IH) after radical perineal prostatectomy (RPP) compared with that after radical retropubic prostatectomy (RRP).

Methods: We retrospectively reviewed 285 and 311 men who underwent RPP and RRP, respectively, for clinically localized prostate cancer between August 2000 and June 2006, using medical records and a telephone survey.

Results: The incidence of postoperative IH after RPP was 1.

First isolation of blaIMP-7 in a Pseudomonas aeruginosa in Japan.

We report here the first isolation in Japan of a carbapenem-resistant Pseudomonas aeruginosa strain that carries the metallo-beta-lactamase gene bla(IMP-7). This isolate revealed high-level resistance to all of the tested antibiotics except for piperacillin, showing a multidrug-resistant phenotype.

Lower urinary tract symptoms after radical perineal prostatectomy.

Objective: To clarify the impact of radical perineal prostatectomy (RPP) on lower urinary tract symptoms (LUTS) in patients with clinically localized prostate cancer.

Methods: A total of 117 patients with a median age of 69 years who underwent RPP alone between August 2002 and August 2005 were included in the study. We measured LUTS on the basis of the International Prostate Symptom Score (IPSS) and IPSS quality of life (QOL) questionnaire before, and 3, 6 and 12 months after surgery.

Risk factors for intravesical recurrence following urothelial carcinoma of the upper urinary tract: no relationship to the mode of surgery.

Objective: The aim of this study was to clarify whether intravesical recurrence of upper urinary tract cancer after treatment is related to the mode of surgery or other oncological factors.

Methods: We evaluated 106 patients (mean age 70.4 years; mean follow-up 24.

Anterior urethral valves in children: a possible association between anterior urethral valves and Cowper's duct cyst.

To elucidate the pathophysiology of congenital obstruction of the anterior urethra and to investigate the association between anterior urethral valves and syringocele. Three boys with congenital obstruction of the anterior urethra diagnosed at our department between 1997 and 2004 were analyzed retrospectively. All three boys had congenital obstruction in the bulbar urethra.

Nonfunctional pituitary macroadenoma manifested as muscular symptoms.

A 75-year-old man with a large pituitary adenoma presented with general muscular weakness, including difficulty in rising in the morning and forceless defecation and urination, and muscular pain, numbness and atrophy in the shoulder, neck and thigh. Testosterone replacement and subsequent resection of the pituitary tumor resulted in resolution of the symptoms. The value of pituitary imaging tests for men with hypogonadotropic hypogonadism is discussed.

DNA methylation of the RIZ1 gene is associated with nuclear accumulation of p53 in prostate cancer.

The retinoblastoma protein-interacting zinc finger gene, RIZ1, is thought to be a tumor suppressor gene. RIZ1 is inactivated by mutation, deletion and DNA methylation in several human cancers. In the present study, the relationship between DNA methylation of RIZ1 and mutation of p53 was investigated in prostate cancer (PCa).

Women's perception of male erectile dysfunction drugs in the general population.

Objective: The aim of this study is to investigate trends in women's perception of male erectile dysfunction (ED) drugs in the general population.

Methods: We designed an online questionnaire survey and randomly invited an initial total of 2370 women to respond to it from a database population that included 450,000 men and women recruited through an Internet-based market research company. The 17 items of the questionnaire comprised 9 items related to socio-cultural background and 8 items related to the perception of ED drugs, ED itself, and sexual relations.

Transurethral ethanol injection for prostatic obstruction: an excellent treatment strategy for persistent urinary retention.

Objectives: To evaluate the efficacy of transurethral ethanol injection into the prostate (TUEIP) for patients with persistent urinary retention resulting from benign prostatic hyperplasia or advanced prostate cancer.

Methods: Twenty-one Japanese men (elderly or at high risk anesthesiologically) who had developed persistent urinary retention because of benign prostatic hyperplasia or advanced prostate cancer were treated with TUEIP from January 2001 to January 2005. Patient age and preoperative prostate volume was 64 to 92 years (median 84) and 24.

Lower urinary tract symptoms and risk of prostate cancer in Japanese men.

Our aim was to investigate whether or not men with lower urinary tract symptoms are at increased risk of prostate cancer. A total of 3511 men aged 50-79 years who underwent mass screening for prostate cancer between 2002 and 2004 for the first time, and completed the International Prostate Symptom Score (IPSS) questionnaire at the time of the prostate specific antigen (PSA) test, were enrolled in the present study. All men with PSA values greater than 4.