Amano T

Testosterone replacement therapy by testosterone ointment relieves lower urinary tract symptoms in late onset hypogonadism patients.

Introduction. Patients with late onset hypogonadism (LOH) also suffered from lower urinary tract symptoms (LUTS) and LOH symptoms. The objects of this study are to evaluate the efficacy of testosterone replace therapy (TRT) by testosterone ointment (Glowmin: GL) for LUTS in LOH patients. Methods. The Aging Male Symptom (AMS) scale, Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36), International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) were obtained from patients with LOH. A total of 41 patients with LOH have been treated with TRT using 6 mg/day of GL for 3 months. Serum free testosterone levels (FT) and these four scores were compared before and after TRT. Results. Serum FT levels and the scores for the four parameters of AMS, six of eight domains in SF-36, IIEF-5 and total IPSS improved significantly after 3 months TRT. In addition, all IPSS domains also improved significantly, and voiding disturbance seems to have improved more than storage disturbance (P = 0.0280 vs. 0.0483). Conclusion. TRT by administration of GL is considered to be effective in the improvement of not only ED and LOH symptoms, but also LUTS (especially voiding disturbance) of patients with LOH.

Ultraweak biophoton emission imaging of transplanted bladder cancer.

Biophoton emission or spontaneous ultraweak light emission has been observed from almost all living organisms, with intensities ranging from 10-19 to 10-16 W/cm2. The measurement of biophoton emission offers the attractive possibility of noninvasive monitoring of the underlying physiological function of a living system. In the present study, ultraweak biophoton emission from mice with transplanted bladder cancer was detected by a two-dimensional photon-counting system. Photon counts were observed to be 1.51–4.73 times higher from the regions of untreated tumor than from normal regions. Our study suggests that this novel technique may be applicable to the diagnosis of superficial tumors.

Transrectal Ultrasonography of the Prostate and Seminal Vesicles with Hemospermia

Transrectal ultrasonography was performed in 46 patients with hemospermia. Abnormal findings in the prostate and seminal vesicles, including prostatic stones, benign prostatic hyperplasia, prostatitis, and dilatation and calculi of the seminal vesicles, were observed in 34 patients (73.9%). However, no malignant lesions were found in the prostate or seminal vesicles. Transrectal ultrasonography was a useful and noninvasive procedure to investigate the causes of hemospermia. Furthermore, transrectal ultrasonography could demonstrate latent diseases and exclude malignancy of the prostate and seminal vesicle in patients with hemospermia.

Integral Laser Photodynamic Treatment of Refractory Multifocal Bladder Tumors

Integral photodynamic therapy with hematoporphyrin derivative was performed on 35 patients who had resistant transitional cell carcinoma of the bladder, mainly carcinoma in situ. The light source was an argon ion pumped dye laser (wavelength 630 nm.) using rhodamine B. Two types of laser light scattering diffuser developed at our department were used: a motor driven laser light scattering diffuser with computer regulation, and an endoscope modified light scattering diffuser tipped with a small quartz bulb containing a lipid nutritious solution as the scattering medium. The total energy density used was 10 to 30 J./cm.2. Of the 35 patients 24 (68.6%) achieved a complete response and 5 (14.3%) a partial response at 3 months. In 10 of the 24 patients there was no recurrence with an average tumor-free interval of 20.9 +/- 16.7 months, ranging from 5 to 60 months. Bladder capacity was decreased to approximately 150 ml. for 3 months after the integral photodynamic therapy without any evidence of hydronephrosis on excretory urograms, except for 2 patients who had a contracted bladder before photodynamic therapy. Integral photodynamic therapy may prove to be useful for the treatment of carcinoma in situ of the bladder.

A Combined Therapy of Hyperthermia and Tumor Necrosis Factor for Nude Mice Bearing KK-47 Bladder Cancer

A combined therapy of hyperthermia (43.5 C) and tumor necrosis factor (10(3) and 10(4) units) for the treatment of experimental bladder carcinoma KK-47 in athymic mice was studied. Briefly, mice were injected subcutaneously with 10(7) disaggregated cells. When the tumors were 250 mm3 in size, tumor necrosis factor was administered, either intravenously or by intratumor injection. Intravenous injection was 10(3) to 10(4) units tumor necrosis factor in the tail vein and intratumor was 10(3) to 10(4) units injected directly into the center of the tumor. Immediately following injection, the tumor bearing leg was placed in a 43.5 C water bath for 20 minutes. Tumor size was monitored once a week for seven weeks and the animals were divided into control, hyperthermia alone, tumor necrosis factor alone and combined therapy. Results of the study showed no significant difference in 10(3) units of tumor necrosis factor intravenously versus control but a significant regression in hyperthermia alone. Anti-tumor effects significantly increased in hyperthermia plus 10(3) units tumor necrosis factor versus hyperthermia alone. Similar results were seen with 10(4) units tumor necrosis factor intravenously though in the combination group of hyperthermia and tumor necrosis factor, eight mice of eight died one to three days following treatment. In those receiving intratumor injections, there was no difference between tumor necrosis factor or control. Tumor necrosis factor with hyperthermia had the approximate same characteristics as hyperthermia alone and therefore there was no synergistic finding. These results reflect on the suggestion that the combination therapy of hyperthermia and systemic administration of the proper dosage of tumor necrosis factor may produce synergistic anti-cancer effects in bladder cancer patients.

Enuresis in an adult female with obstructive sleep apnea

Adult onset enuresis accompanied by obstructive sleep apnea has been reported rarely. A female patient was referred to our clinic with complaints of of a 15-year history of loud snoring and sleep apnea as well as enuresis, which was treated successfully with imipramine and acetazolamide. The mechanism of enuresis and its relationship to upper airway obstruction are reviewed here with reference to the findings of polysomnography and sleep cystometry.

Effects of Chinese Herbal Medicine on Sperm Motility and Fluorescence Spectra Parameters

Hochu-ekki-to is a Chinese herbal medicine that has been used for unexplained male infertility with some favorable clinical results. However, the detailed mechanisms of the effect of this medicine on male infertility have not been disclosed. This study investigated the effects of Hochu-ekki-to on sperm motility of human semen. Sixteen semen samples were obtained from 14 normal volunteers. Semen samples were incubated with 1, 10, and 100 micrograms/mL of Hochu-ekki-to solution in 5% CO2, 37 degrees C for 1-6 h, and the motility was compared with that of the control groups (the untreated semen and the semen incubated with phosphate-buffered saline). The motility of sperm in 10 and 100 micrograms/mL of Hochu-ekki-to solution for 1-6 h was significantly higher than that of the control groups. One microgram/milliliter of Hochu-ekki-to solution also maintained higher sperm motility after 4-6 h incubation compared with the control groups. Previous reports showed that sperm motility correlated significantly with fluorescence intensity peaks from both spermatozoa and semen plasma. However, the fluorescence intensity at 622 nm excited at 488 nm from spermatozoa fractions in each group was not significantly different. It would appear that the enhanced sperm motility induced by Hochu-ekki-to is mediated by improvement of the circumstances of semen rather than that of spermatozoa-related factors.

Clinical efficacy of Japanese traditional herbal medicine (Kampo) in patients with late-onset hypogonadism.

Introduction. In addition to hormone replacement therapy, non-hormonal therapy, particularly Japanese traditional herbal medicine (Kampo), has been used to alleviate the various symptoms of female menopause. The efficacy and safety of Japanese traditional herbal medicine for male late-onset hypogonadism (LOH) are investigated. Methods. One hundred fifty-one patients with LOH were treated via the administration of Japanese traditional herbal medicine. The most appropriate Japanese traditional herbal medicine was administered to patients according to their pathogenic alteration. After 4 weeks, the clinical efficacy was evaluated based on improvement of LOH symptoms and the score of the simplified menopausal index (SMI). Additionally, predictive factors of efficacy of Japanese traditional herbal medicine were analyzed. Results. Among 151 patients with LOH, 63 (41.8%) achieved both relief from LOH symptoms and normalized SMI score (Excellent response group), whereas 44 (29.1%) achieved either relief from LOH symptoms or normalized SMI score (Fair). However, 44 (29.1%) patients displayed neither relief from LOH symptoms nor normalized SMI score (Poor). Adverse reactions were observed only in four (2.6%) patients. Patients displaying excess conditions and mild LOH symptoms appeared to be superior candidates for Japanese traditional herbal medicine. Conclusion. Japanese traditional herbal medicine is an effective and safe treatment for LOH.

Magnetic resonance imaging of bladder hemangioma

An 18-year-old woman with a bladder hemangioma is described. The tumor had a low signal intensity with multilocular pattern on T1-weighted magnetic resonance (MR) images and high signal intensity on T2-weighted MR images. MR images were useful in evaluating tumor character and its extent.

Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Abstract Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5 mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH. Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients. The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5 mg tadalafil. In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment. Results: The mean age of 81 patients was 66.4 ± 11.4 years old. Their prostate size was 30.2 ± 22.1 ml. Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment. The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point. Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.