Early detection of prostate cancer. Results of a prostate specific antigen-based detection program in Japan.

Background: Prostate cancer increasingly is becoming a medical problem in Japan. To maximize the chance for cure, extensive effort is being made to detect prostate cancer while confined to the gland.

Methods: Determination was made of serum prostate specific antigen (PSA) in the early detection of prostate cancer in an Asian male population aged 55 years or older.

High intensity focused ultrasound for benign prostatic hyperplasia.

Background: Transurethral resection of the prostate (TURP) has been the gold standard of treatment for patients with symptomatic benign prostatic hyperplasia (BPH). The present paper discusses the safety and effectiveness of transrectal high intensity focused ultrasound (HIFU) for treating patients with symptomatic BPH.

Methods: HIFU was conducted on 28 patients with BPH.

[Clinicopathological study of nonpalpable and nonvisible (stage T1c) prostate cancer].

Clinical and pathologic characteristics of stage T1c disease (nonpalpable and nonvisible cancer) was studied retrospectively in men who underwent radical prostatectomy in order to better understand this disease entity. Findings in stage T1c disease (16 patients) were directly compared with those in stage T2b disease (11 patients). No significant difference was observed between these groups with regard to age, preoperative serum prostatic acid phosphatase level, prostatic weight, numbers of tumor foci, total tumor volume, volume of index cancer and tumor grade (p > 0.

Does transurethral resection of the prostate pose a risk to life? 22-year outcome.

The clinical outcomes of 717 patients who underwent transurethral resection for benign prostatic hyperplasia between 1971 and 1981, and of 48 who underwent open prostatectomy during the same period were evaluated. All living patients could be followed for a minimum of 12 years postoperatively. The cumulative percentage of patients undergoing a secondary operation was substantially greater after transurethral resection of the prostate than after open prostatectomy.

p53 mutations and prognosis in bladder tumors.

The incidence of loss of heterozygosity on chromosome 17p and p53 gene mutations was assessed in 43 bladder tumor patients. Histological findings, cigarette smoking and prognosis were examined for possible correlation with the presence or absence of loss of heterozygosity on 17p and p53 mutations. Of 20 informative cases 10 (50.

Contigen Bard Collagen implant: the Japanese experience.

This was an open trial to evaluate the efficacy and safety of Contigen Bard Collagen Implant for the treatment of urinary incontinence in patients with either stress incontinence or true incontinence (intrinsic sphincter deficiency). Contigen was injected at two opposing sites in the submucosal tissues of the bladder neck or posterior urethra; this was repeated after 7 days if needed. Patients were evaluated in terms of the frequency and degree of incontinence, the number of pads used, quality of life and the pad weighing test.

Microsatellite instability in prostate cancer.

Assessment of the genetic instability of a microsatellite has indicated a new mechanism in human carcinogenesis. Examination was made to determine whether microsatellite instability is associated with the onset of prostate cancer. Twenty-nine DNA samples from 24 primary prostate cancer, two metastatic lymph-node and three benign prostatic hypertrophy patients were used.

Infrequent involvement of mutations on neurofibromatosis type 1, H-ras, K-ras and N-ras in urothelial tumors.

The neurofibromatosis type 1 (NF1) gene is considered a tumor-suppressor gene whose product acts upstream of ras. The ras gene is an oncogene very commonly detected in human cancers and consists of three families, H-ras, K-ras and N-ras. These genes are converted to active oncogenes by point mutations in codon 12, 13, or 61.

[Comparison of tumor markers versus their relative values to prostatic volume in detecting prostate cancer].

Diagnostic utility of serum markers and their relative values to prostatic volume were evaluated using Receiver Operator Characteristics Analysis (ROC analysis) in 173 patients who underwent ultrasound guided biopsy of the prostate gland. Seventy cases (40.5%) of prostate cancer were detected.

Alterations of microsatellite repeats in bladder-cancer.

Investigation of the genomic instability of microsatellite repeats indicates a new mechanism for human carcinogenesis. This study was conducted to determine whether such alterations in microsatellite repeats are associated with the onset of bladder cancer. Thirty-two primary bladder cancer DNA samples were examined for genomic instability at (CA)n repeats on human chromosomes 5q (D5S107), 17p (D17S261) and 18q (DCC) by polymerase chain reaction (PCR) assay.

Neodymium:YAG laser ablation of the prostate gland--acute perioperative morbidity and short-term outcome.

Twenty-three patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were successfully treated with laser prostatectomy using the Urolase right-angle firing neodymium: Yttrium Aluminum Garnet laser fiber. Most of the patients had health problems of moderate severity. Their conditions were compared preoperatively and 3 mo postoperatively.

[An unusual case of status epilepticus of simple partial seizure with an occipital lobe focus].

A 45-year-old man developed generalized convulsion and consciousness disturbance at age 43. An X-ray CT revealed hemorrhagic infarction in the left fronto-parieto-temporal area. A conventional angiography disclosed complete occlusion of the left cortical vein.

Infratentorial infarction: correlation of MR findings with neurological and angiographical features.

Using magnetic resonance imaging, we reviewed 141 infratentorial infarcts in 81 consecutive cases: 65 infarcts were seen in the paramedian pons, while 18 in the posterior inferior cerebellar artery (PICA) territory and 17 in the watershed area between PICA and superior cerebellar artery. No comparable sign or symptom was observed for 44 (31.2%) infarcts, whereas 66 (46.

[Usefulness and limitation of digital rectal examination and imaging studies in staging prostate cancer].

The diagnostic usefulness of digital rectal examination (DRE), transrectal ultrasonography (TRUS), magnetic resonance imaging (MRI) and computed tomography (CT) was compared in the differentiation of stage B from stage C prostate cancer. Eighteen patients who had undergone radical retropubic prostatectomy were included in this study. Overall, the positive predictive values (PPV) for detecting extraprostatic disease (extracapsular extension, seminal vesicle invasion) were 100% for DRE, 88.

[Clinical feature and quality of life of urinary diversion patients with bladder cancer].

A clinical survey was performed on 95 cases who were treated by total cystectomy with urinary diversion at our hospital between August 1971 and March 1992. Urinary diversions were classified by ureterocutaneostomy (Group I) in 27 patients, ileal or colon conduit (Group II) in 45 and continent urinary reservoir (Group III) in 23. The patients ranged in age from 29 to 76 with an average age of 60.

Effects of fasudil hydrochloride on cerebral blood flow in patients with chronic cerebral infarction.

To evaluate the effect of the novel intracellular calcium antagonist fasudil hydrochloride, cerebral blood flow (CBF) was measured quantitatively with positron emission tomography following the intravenous administration of fasudil in five patients with chronic cerebral infarction. The hemispheric mean CBF increased significantly on both hemispheres 30, 60, and 90 min after the administration of fasudil when the CBF values were corrected according to PaCO2 level, although there was no significant change in raw CBF data. A significant increase of CBF was seen in the cerebellar hemisphere and thalamus at 30 min and in the occipital cortex at 90 min.

[Prophylactic combination therapy after TUR of superficial bladder cancer].

We evaluated 63 patients with superficial bladder cancer (pTa, pTl) who were treated with instillation of bleomycin +/- bacillus Calmette-Guerin (BCG) and administration of uraciltfutraful (UFT) for prophylaxis of tumor recurrence after transurethral resection (TUR). The patients were randomly assigned to groups A and B after transurethral resection by the closed envelope method. Group A (34 cases) was designed as continuous diluted intravesical instillation of bleomycin (120 mg/2,000 ml saline solution/day repeated for 3 days), instillation BCG (40 mg/40 ml saline solution/weekly 6 times) and UFT (400 mg orally/day for 2 years maximum).

[How should we manage chemical substances in living environments].

Recent major advances in science and technology have Introduced a large number of synthetic chemical substances to our societies, resulting in the occasional unfortunate serious pollution of our environment by these chemical substances. A study of the administrative management of these chemical substances has shown inadequacies, as has been revealed in the case of countermeasures against carcinogenic substances in the environment which have not been managed systematically. In view of this situation, the rapid introduction of the risk assessment-risk management process in Japan is proposed, as an administrative countermeasure against carcinogenic substances.

[Reassessment of the sonographic criterion of prostate cancer--nonspecificity of a hypoechoic lesion].

Of 71 patients who underwent ultrasound guided transrectal needle biopsy at the urology clinic in Kitasato University Hospital 19 (26.8%) patients were found to have prostate cancer. The positive predictive value for transrectal ultrasonography (hypoechoic lesion) was disappointing-only 30% (18/60).

[An experience with a continent appendix stoma].

The submucosally embedded in situ appendix guarantees an ideal continence mechanism in patients with ileocecal urinary reservoirs. To date this modification of the Mainz pouch technique was performed successfully in 10 patients between September 1990 and October 1992. Pouch capacity ranged from 350 ml to 900 ml (mean: 565 ml), frequency of intermittent self-catheterization ranged from 3 to 7 times per day (mean: 4.

[Prognosis of incidental (stage A) prostatic cancer].

Incidentally discovered prostatic cancer can pursue a benign clinical course or it can rapidly progress. For the purpose of this study, we summarized pathological and clinical results of 107 (5.3%) stage A prostatic cancer patients in 2008 transurethral resection of the prostate for clinically diagnosed benign prostatic hyperplasia.

[Role of prostate specific antigen, transrectal ultrasonography, and digital rectal examination in the search for clinical prostate cancer].

Two hundred and thirty-four patients who visited the urology clinic in Kitasato University Hospital were evaluated with digital rectal examination (DRE), serum prostate specific antigen (PSA) study and prostate ultrasonography. Of 71 men who underwent ultrasound-guided transrectal biopsy 19 (26.8%) were found to have prostate cancer, accounting for 8.

[Pre-operative, operative and postoperative complications in 2266 cases of transurethral resection of the prostate].

Pre-operative and operative complications in 2266 patients having undergone transurethral resection of prostate (TURP) for the past 20 years at Kitasato University Hospital were analyzed. They consisted of 2008 benign prostatic hyperplasia and 258 prostate cancer patients. Seven hundred and fifty four patients showed some of physical disorders prior to TUR:hypertension in 147 cases, diabetes mallitus in 87, ischemic heart disease in 46, chronic obstructive lung disease in 41 and others.

[Clinical analysis in 2266 cases of transurethral resection of the prostate].

During the past 20 years from August 1971 to July 1991, 3215 cases of transurethral resection were performed at Kitasato University Hospital, and consisted of 2008 benign prostatic hyperplasias, 692 bladder tumors, 258 prostate cancers, 167 bladder neck contractures, 38 urethral strictures, 20 chronic prostatities and 32 various urologic diseases. On 2266 transurethral resections of the prostate including 2008 benign prostatic hyperplasias, and 258 prostate cancers analysis was conducted. Patient age ranged from 44 to 97 (mean, 70.