Hiroshi Yanai

Elevated levels of telomerase activity in malignant pheochromocytoma.

Although malignant pheochromocytoma is a life‐threatening illness, there is no excretory profile that is predictive of malignancy. Reliable prediction of malignant behavior on the basis of histopathology is also notoriously difficult. Although DNA ploidy can be a helpful indicator, aneuploidy per se is not considered to be a specific marker of malignancy. Mutations in p53 have been reported to occur frequently in cases of benign pheochromocytoma. Thus, molecular analysis of this protein is not a useful diagnostic tool. The authors analyzed telomerase activity in benign and malignant pheochromocytomas and assessed its utility as a prognostic marker.

Spontaneous Hemorrhage during Pregnancy Secondary to Renal Angiomyolipoma

We report a case of spontaneous hemorrhage secondary to renal angiomyolipoma treated with percutaneous transcatheter arterial embolization. Fourteen and 18 months after the procedure, the patient showed repeated spontaneous hemorrhage during pregnancy. However, a healthy female infant was delivered at the 39th week of the pregnancy. We discuss the management of renal angiomyolipoma in young married women before pregnancy.

Electropermeabilization in bladder cancer chemotherapy.

Abstract Purpose: Electropermeabilization has been used for the introduction of genes into cells. Using this technique, we introduced the cytotoxic drug bleomycin (BLM) into cells and examined whether the technique might be useful for the treatment of bladder cancer. Materials and methods: For electropermeabilization in vitro, we used YTS-1 cells, a human transitional cell carcinoma line. Aliquots of cell suspension were mixed with a solution of BLM and immediately exposed to electric pulses. A high-power pulse generator was used to supply square-shaped pulses of 1250 V/cm (100 μs, eight pulses). After a 2-h post-shock incubation, cells were washed and incubated for one further hour. Then the concentration of BLM in the cells was measured using a bioassay. For electropermeabilization of tissue, we used normal male Wistar rats. The bladder was exposed and 10 mg/kg BLM was injected into the caudal vein. A series of eight pulses with a time constant of 100 μs at an electric field intensity of 1000 V/cm was applied. The bladder, liver and lungs were extracted 1 h later and prepared for quantification of the BLM concentration using the bioassay. Results: Electrotreated cells contained significantly higher concentrations of BLM than nonelectrotreated cells. The concentration of BLM 1 h after electrotreatment in bladder tissue was 2.7 times higher than that in nonelectrotreated bladder tissue. Conclusion: The electropermeabilization technique has the potential to serve as a new and effective modality for the treatment of bladder cancer.

Surgical repair of anterior hypospadias with fish-mouth meatus and intact prepuce based on anatomical characteristics.

Purpose: A variant form of anterior hypospadias, called a megameatus and intact prepuce (MIP), is thought to be less amenable to conventional distal hypospadias repair. The feasibility of using the standard technique with a parameatal-based foreskin flap is described herein. Materials and Methods: Nine children with the MIP variant underwent repair. A foreskin flap for urethroplasty was harvested from either the ventral (Mathiew) or unilateral site. The glans was split along with the cleft glanular groove to create the glans wings. The flap was laid on the urethral plate to form a neourethra, and glanulomeatoplasty was completed by approximation of the glans wings. Sleeve reapproximation of the penile foreskin was performed for uncircumcised skin closure. Results: The functional and cosmetic results of the procedure were excellent in 8 cases including 1 with temporary postoperative edema of redundant foreskin. The last case underwent excision of the ventral excess foreskin for cosmetic reasons. Conclusions: Although the etiology of the MIP variant remains obscure, the urethral plate distal to the meatus is uniformly pliable and healthy in this variant. Furthermore, the ventral portion just proximal to the meatus is well developed and not atretic so that the parameatal ventral foreskin is safely harvested for onlay urethroplasty.

Histological Evaluation of the Effects of Electropermeabilization after Administration of Bleomycin on Bladder Cancer in the Rat

Objective: The aim of this study was to examine the usefulness of an electropermeabilization method in the administration of a chemotherapeutic agent in bladder cancer in the rat. Materials and Methods: N-Butyl-N-(4-hydroxybutyl)-nitrosamine was used to induce bladder tumors in Wistar rats. Rats in group 1 were given a sham treatment. Rats in group 2 received an injection of bleomycin (BLM). Rats in group 3 received a series of eight 100-µs square-wave pulses at an electric field intensity of 1,000 V/cm (electropermeabilization) applied to the bladder. Rats in group 4 were treated with square-wave pulses after the injection of BLM. Nine days after the various treatments, all the bladders were removed and examined histopathologically. Results: Histopathological examination revealed severe damage to tumors in group 4 exclusively. Conclusion: The cytotoxic effect of BLM on bladder cancer tissue was enhanced by electropermeabilization.

Effects of electropermeabilization after the administration of anticancer drugs on transitional cell carcinoma.

Objective To assess in vitro and in vivo the potential utility of electropermeabilization (EP) as an anticancer drug delivery system for the treatment of transitional cell carcinoma (TCC).

Prostate-specific antigen in patients with relapsed prostate cancer following endocrine treatment

We assessed the relationship between changes in PSA and prognosis, as a possible reflection of tumour growth in patients who relapse following primary endocrine therapy.In 8 patients in whom no therapeutic change was attempted after PSA relapse, the PSA level increased exponentially. Their PSA-DT had a close positive relation-ship to the duration of survival after relapse (r=0.79, p=0.02). In 6 patients who received chemotherapy after relapse, PSA-DT between PSA relapse and initiation of chemotherapy also had a relationship to the duration of survival after relapse (r=0.87, p=0.05).It appears to be reasonable to conclude from these findings that the PSA-DT value is regarded to be a factor associated with prognosis in cases with an exponential increase in PSA after relapse.

The Prognosis of Stage A Patients Treated with the Antiandrogen Chlormadinone Acetate

To determine the efficacy of the antiandrogen chlormadinone acetate as a treatment option for stage A prostate cancer, a retrospective analysis of 111 patients who received chlormadinone acetate was done. Of 55 stage A1 patients, progression was seen in one patient (1.8%) 8 years after the diagnosis. Six out of 56 stage A2 patients (10.7%) showed disease progression at 1–7 years (mean 68 months) after the diagnosis. Progression rates associated with antiandorgen therapy for stage A1 and stage A2 patients were lower than those without treatment reported in the literature. It could be assumed that antiandrogen treatment with chlormadinone acetate inhibited the progression.

Serum concentration of iopamidol after retrograde urethrography in male patients with outlet obstructive symptoms

Serum concentration of iopamidol was measured in 29 male patients with outlet obstructive symptoms after retrograde urethrography. Although no patient showed extravasation, serum iopamidol level was detectable in 4 (14%) patients. Since severe adverse effects are considerably reduced with iopamidol, we prefer to use this contrast medium for retrograde urethrography in male patients with outlet obstructive symptoms.