Hisao Komeda

Mycoplasma genitalium in the cervices of Japanese women

Background: Mycoplasma genitalium is considered a cause of nongonococcal urethritis in men. This organism also is a cause of genital infections in women, and has been detected in women attending sexually transmitted disease clinics in the United Kingdom and Denmark, although its prevalence is unknown in Japanese women. Goals: To determine the prevalence of M. genitalium in the cervices of women with cervicitis or adnexitis as well as in asymptomatic pregnant women in Japan. Study Design: Two hundred women who attended obstetric and gynecologic clinics were recruited. Sixty‐four women had cervicitis, 53 had adnexitis, and 3 had both. Eighty pregnant women were asymptomatic for infection. Cervical swab specimens were examined for M. genitalium using a polymerase chain reaction‐based assay. Results: Five (7.8%) of 64 women with cervicitis and 3 (5.7%) of 53 women with adnexitis were positive for M. genitalium. After exclusion of Chlamydia‐positive women, 5 (8.8%) of 57 women with cervicitis, and 2 (4.1%) of 49 women with adnexitis were positive for M. genitalium. In none of 80 asymptomatic pregnant women, including a Chlamydia‐positive woman, was M. genitalium detected. Overall, 7 (6.6%) of 106 women with Chlamydia‐negative genital infections were positive for the M. genitalium. This prevalence was significantly greater than that in asymptomatic pregnant women (P < 0.05). Conclusions: A significantly greater prevalence of M. genitalium was demonstrated in Japanese women with Chlamydia‐negative cervicitis or adnexitis, compared with that in asymptomatic pregnant women. This study suggests that M. genitalium may play a pathogenic role in a portion of cases with Chlamydia‐negative genital infections.

Bacillus Calmette-Guérin instillation treatment for carcinoma in situ of the upper urinary tract.

Objective To analyse the efficacy and safety of bacillus Calmette–Guérin (BCG) perfusion treatment forcarcinoma in situ (CIS) of the upper urinary tract.

Mycoplasma genitalium in non-gonococcal urethritis.

Sir: The report of Tayal and Pattman (International Journal SrD & AIDS 1994;5:359-61) highlights a phenomenon that is probably occurring in GU clinics throughout the UK. They noted a very high level of HSV-1 infection (63-79%) in their female patients since 1986. Previous reports had indicated a much lower level than this. Reviewing our last 100 culture positive patients (back to January 1993) we also note a high prevalence of type I virus in females (Table 1). Herpes simplex type I was found

Prevalence of Mycoplasma genitalium in men with gonococcal urethritis

A significant association of Mycoplasma genitalium with non-gonococcal urethritis has been reported, but the prevalence of this mycoplasma in men with gonococcal urethritis has not been so well studied. In this study, we examined urethral swab specimens from 45 Japanese male patients with gonococcal urethritis for the presence of M. genitalium by using a polymerase chain reaction-based assay. We also sought Chlamydia trachomatis by an enzyme immunoassay Chlamydiazyme . Of the 45 specimens, 2 4.4 were positive for the mycoplasma and 12 26.7 were positive for C. trachomatis. The findings suggest that M. genitalium may be a cause not only of non-gonococcal urethritis but also of postgonococcal urethritis.

Prevalence of Mycoplasma genitalium in asymptomatic men in Japan

We aim to clarify the prevalence of Mycoplasma genitalium in asymptomatic men in Japan. First-catch urine specimens were obtained from 187 asymptomatic Japanese men and examined for the presence of M. genitalium using a polymerase chain reaction (PCR)-based assay. Two (1.1%) of 187 first-catch urine specimens were positive for M. genitalium. The prevalence of M. genitalium in urine specimens of asymptomatic men in Japan is lower than that in asymptomatic men in the UK (6%) and Denmark (9%).

Initial experience of using an iron-containing fiducial marker for radiotherapy of prostate cancer: Advantages in the visualization of markers in Computed Tomography and Magnetic Resonance Imaging

Abstract Visualization of markers is critical for imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). However, the size of the marker varies according to the imaging technique. While a large-sized marker is more useful for visualization in MRI, it results in artifacts on CT and causes substantial pain on administration. In contrast, a small-sized marker reduces the artifacts on CT but hampers MRI detection. Herein, we report a new ironcontaining marker and compare its utility with that of non-iron-containing markers. Five patients underwent CT/MRI fusion-based intensity-modulated radiotherapy, and the markers were placed by urologists. A Gold Anchor™ (GA; diameter, 0.28 mm; length, 10 mm) was placed using a 22G needle on the right side of the prostate. A VISICOIL™ (VIS; diameter, 0.35 mm; length, 10 mm) was placed using a 19G needle on the left side. MRI was performed using T2*-weighted imaging. Three observers evaluated and scored the visual qualities of the acquired images. The mean score of visualization was almost identical between the GA and VIS in radiography and cone-beam CT (Novalis Tx). The artifacts in planning CT were slightly larger using the GA than using the VIS. The visualization of the marker on MRI using the GA was superior to that using the VIS. In conclusion, the visualization quality of radiography, conebeam CT, and planning CT was roughly equal between the GA and VIS. However, the GA was more strongly visualized than was the VIS on MRI due to iron containing.

Primary malignant melanoma of the female urethra: a rare case of cytological observation

We herein report a rare case of primary malignant urethral melanoma developed in an elderly Japanese patient with hypertension, diabetes and hyperlipidemia. An 80-year-old female presented at our hospital with a history of urodynia and perineal pain lasting for several months. Cystoscopy revealed cystitis and urethritis with erosion. At that time, urinary cytology was negative for malignancy, although melanophages were observed. Four months later, lower abdominal computed tomography and magnetic resonance imaging indicated urethral tumors. Urinary cytology subsequently detected malignant melanoma, and a biopsy of the urethra confirmed malignancy. Although inguinal lymph node metastasis was found 16 months postoperatively, the patient has remained free of disease for more than six years after surgery and chemotherapy.

Development and Clinical Application of a Polymerase Chain Reaction-Based Assay for Detecting Bacteroides ureolyticus

We developed a polymerase chain reaction (PCR)-based assay for detectingBacteroides ureolyticus. No DNA fragments hybridizing the internal probe specific forB. ureolyticus were amplified from the DNAs of other bacterial species tested. This assay can detect the amount of DNA corresponding to 18 cells ofB. ureolyticus. Using this assay, we examined urethral swab specimens from men with nongonococcal urethritis (NGU) and asymptomatic men for the presence ofB. ureolyticus. WhileB. ureolyticus was detected in 6 (12.0%) of 50 asymptomatic men, this was not significantly different from the detection rate of 19.3% (22 of 114 specimens) in men with NGU. This study demonstrates that the PCR-based assay can be applied for detectingB. ureolyticus in clinical specimens and suggests that this assay might develop into a useful tool for analyzing the pathogenicity of this organism in various organs.

Polymerase chain reaction法を用いた初尿沈渣からの淋菌の検出

hybridisation. The P acnes genome was less frequently and less abundantly detected in tuberculosis specimens. 5 Thus, an aetiological relationship between P acnes and sarcoidosis has been advocated. We report here the first case of a patient with NSG in whose lung specimens were found abundant P acnes genome. A 65-year-old female non-smoker with no history of dust exposure or pet ownership was referred to our hospital with bloody sputum. The patient’s superficial lymph nodes were not palpable. No abnormal findings were revealed by ophthalmological or otolaryngological examinations. Serum levels of C-reactive protein and lysozyme were raised to 2.62 mg/dl and 10.8 mg/ml, respectively. Antinuclear antibody, rheumatoid factor and antineutrophil cytoplasmic antibody were negative. The ACE level was within the normal range. A skin test with purified protein derivative was negative. Small mediastinal and hilar lymph nodes were detected on CT scanning. Multiple irregularly marginated consolidations with air bronchograms were distributed predominantly in peribronchovascular or subpleural lesions of both lungs on a high-resolution CT scan. Total cell count of bronchoalveolar lavage fluid was 9.7610/ml with a cell population of 88% macrophages, 5% neutrophils, 5% lymphocytes and 2% eosinophils; the CD4+/CD8+ ratio was 11.1. Pathological findings of open lung biopsy specimens were consistent with NSG (fig 1A and B) and no pathogenic organisms (including mycobacteria and fungi) were detected in culture of the biopsy specimens. The patient was diagnosed with NSG. P acnes DNA was detected in abundant amounts in the granulomas by in situ hybridisation (fig 1C). This is the first report of NSG with P acnes DNA found in the granulomas of lung specimens. This may indicate an aetiological link between NSG and P acnes, and it also suggests that NSG is an atypical sarcoidosis with a common aetiology. The clinical and pathological differences between these diseases could be explained by variability in the host response to P acnes or the histological location of P acnes, although further study would be necessary to arrive at more definite conclusions.

Influence of gold marker for magnetic resonance imaging during prostate radiotherapy

Abstract Gold markers (GM) are increasingly used for CT and MRI registration during in intensity-modulated radiation therapy for prostate cancer. Additionally, diffusion-weighted imaging has been adopted to measure the effects of radiotherapy for prostate cancer, similar to tests of blood prostate-specific antigen levels. As diffusion-weighted imaging (DWI) is often affected by a magnetic component, we evaluated the influence of GM on the Diffusion weighted images in three cases. We found that the size range of signal void of GM in MRI was 2–5 mm. We conclude that a GM would not affect the quality of DWI in daily practice.