Masayuki Tsugaya

Aromatase mRNA Levels in Benign Prostatic Hyperplasia and Prostate Cancer

Background: Estrogens are suspected to play a role in the pathogenesis of benign prostatic hyperplasia (BPH) and prostate cancer. In this study, the expression of aromatase messenger ribonucleic acid (mRNA) was determined, and these levels were quantitated, in human prostatic tissues to evaluate the role of estrogens in the pathogenesis of BPH and prostate cancer.

Computerized tomography in acute pyelonephritis: the clinical correlations.

Computerized tomography was performed on 19 patients diagnosed as having uncomplicated acute pyelonephritis. The relationship was investigated among the laboratory findings, presence of flank pain, clinical course and severity of the lesions detected by computerized tomography. In patients febrile for less than 2 weeks healing as assessed by computerized tomography took an average of 76 days. However, in patients with repeated febrile episodes occurring for longer than 2 weeks healing was delayed until an average 232 days after onset. Computerized tomography findings generally correlated well with the erythrocyte sedimentation rate, C-reactive protein level, and presence of pyuria and flank pain. However, in patients with a prolonged course computerized tomography proved to be a more reliable indicator of progress than either the results of laboratory tests or the symptoms. In conclusion, computerized tomography was useful in the diagnosis, assessment of severity and evaluation of healing of acute pyelonephritis.

Detection and Monitoring of Simple Renal Cysts with Computed Tomography

We retrospectively investigated the incidence of simple renal cysts in 1,288 healthy subjects, and monitored the growth and formation of such cysts in 39 subjects using abdominal computed tomography (CT). Simple renal cysts were detected in 138 (10.7%) of the 1,288 subjects. The incidence of simple renal cysts increased significantly with the subjects age (p < 0.001). We found that cyst size increased significantly with age and over time on serial CT studies (p < 0.001). Exoparenchymal cysts, comprising greater than 50% of extraparenchymal lesions, were significantly larger than endoparenchymal cysts (p < 0.001), and showed a greater tendency to increase in size over time.

Penile horn: verruca vulgaris.

A case report of penile horn is presented. It is a benign penile wart of uncertain pathogenesis characterized by excessive hypertrophy and cornification of the epithelium. Treatment consists of excision and/or application of bleomycin ointment.

LAPAROSCOPIC GONADECTOMY FOR TESTICULAR FEMINIZATION SYNDROME

Laparoscopic gonadectomy was performed on a patient with complete androgen insensitivity (testicular feminization syndrome). In the case presented here, although the gonads were free, the omentum which was adhering to the right inguinal ring, possibly as a result of previous inguinal hernia repair, obscured the right gonad. The left gonad was located behind the sigmoid colon. We present our laparoscopic experience in managing this case of testicular feminization syndrome.

Transinguinal Laparoscopy for Nonpalpable Testis

Background: About 20% of all undescended testes are nonpalpable. Although surgical exploration was previously the method of choice for management, laparoscopy from the inferior edge of the umbilicus has been established as a useful method of examining a testis that is nonpalpable. However, conventional subumbilical laparoscopy is unnecessary when the testis or its remnant is located below the internal inguinal ring. We evaluated the efficacy of transinguinal laparoscopy after inguinal exploration performed for nonpalpable testis.

A new technique of ureteric catheterization.

Insertion of an indwelling stent catheter or ureteric catheterization using a new guide wire (the Radiofocus guide wire) was carried out in a total of 24 subjects. The subjects comprised 16 patients in whom insertion of a conventional guide wire and ureteric catheter was not possible due to previous use of an indwelling stent catheter for extracorporeal shock-wave lithotripsy (ESWL), 2 cases in whom a conventional guide wire could not be inserted due to post-ESWL formation of a stone street, 4 patients with ureteric stenosis and 2 patients with normal ureters in whom catheterization was impossible by the usual methods. Insertion of a Radifocus guide wire into the renal pelvis was successfully accomplished in all 24 cases and an indwelling catheter could be passed in 21 cases. These results suggest that the Radifocus guide wire should make a useful contribution to ESWL therapy. It can also be applied to retrograde pyelography, ureteric obstruction, and the dilation of ureteric stenosis.

DIETARY SOY ISOFLAVONE REPLACEMENT IMPROVES DETRUSOR OVERACTIVITY OF OVARIECTOMIZED RATS WITH ALTERATION OF CONNEXIN-43 EXPRESSION IN THE URINARY BLADDER

UNLABELLED To evaluate the effects of dietary soy isoflavone on detrusor overactivity (DO) in ovariectomized (Ovx) rats and the association between these effects and expression of the gap junction protein, connexin-43, in the urinary bladder, and to discuss the usefulness of soy isoflavones for overactive bladder (OAB). MATERIALS AND METHODS In all, 24 (8-week-old) virgin female Sprague-Dawley rats were divided equally into four groups: sham operation with control diet (with no dietary soy isoflavones; Sham-CD), bilateral Ovx with CD (Ovx-CD), sham operation with soy isoflavone diet (Sham-ID), bilateral Ovx with soy ID (Ovx-ID). Cystometry was performed after the 4-week CD or ID in each group while awake. Quantitative reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemical and Western blot analyses were also performed to examine the expression of connexin-43 in each group. RESULTS In Ovx-CD rats, there were some significant changes in cystometry variables, including shortening of the intercontraction interval and an increased number of non-voiding contractions compared with Sham-CD rats (P < 0.05). These changes were significantly improved by 4-week soy isoflavone administration (Ovx-ID; P < 0.05). Quantitative RT-PCR, immunohistochemical and Western blot analyses showed that the expression level of connexin-43 mRNA and protein was significantly greater in the urinary bladder of Ovx-CD rats compared with Sham-CD rats. Soy isoflavone administration significantly reduced this increased expression (Ovx-ID). CONCLUSIONS Soy isoflavone replacement improved DO with alteration of the connexin-43 expression pattern in the urinary bladder of Ovx rats. Routine consumption of diet soy isoflavones may be a useful treatment to prevent and improve OAB.

Malignant Mesodermal Mixed Tumor of the Ureter

Malignant mesodermal mixed tumor comprised of epithelial and nonepithelial components is rarely encountered in the urological field. Only 6 cases of malignant mesodermal mixed tumor of the ureter have previously been reported in the literature. We recently encountered a 7th case of malignant mesodermal mixed tumor of the ureter and describe the case in detail. The etiology of malignant mesodermal mixed tumor is also discussed.