Shinsuke Hayami

Juxtaglomerular cell tumor without hypertension

Juxtaglomerular cell tumors are rare. This report presents a case of juxtaglomerular cell tumor without hypertension. All previously reported cases showed marked hypertension, whereas this is the first case of juxtaglomerular cell tumor without hypertension. The immunohistochemistry and ultrastructure of this case are discussed.

Relative and total volume of histological components in benign prostatic hyperplasia: Relationships between histological components and clinical findings

To investigate the correlation between histological differences and clinical findings in patients with benign prostatic hyperplasia (BPH), quantitative morphometrical analysis on prostate was performed on 26 specimens obtained by TURP. The relative and total volume of each histological component were obtained. In this series, the proportion of fibrous tissue element showed a weak positive correlation with prostatic volume (r = 0.499, P = 0.0087). The relative volume of the smooth muscle component showed an inverse correlation with prostatic volume (r = −0.488, P = 0.0105). Patient age and symptom score showed no relationship with the relative volume of histological components. The total volume of all histological components increased with prostatic volume. However, an increase in the fibrous tissue element appeared to be predominant in prostatic enlargement (r = 0.970, P < 0.0001). Although the total volume of all histological components increased with prostatic size, fibrous tissue appeared to play a major role in prostatic enlargement in BPH.

Ice Water Test in Patients with Overactive Bladder due to Cerebrovascular Accidents and Bladder Outlet Obstruction

To investigate the factors which influence the results of the ice-water test (IWT) in patients with cerebrovascular accidents or infravesical obstruction, IWT was performed on these patients with urge urinary incontinence. Thirty-two patients with cerebrovascular lesions (group 1) and 16 patients with benign prostatic hyperplasia (group 2) who demonstrated overactive detrusor function on cystometry were evaluated. Ice-chilled sterile saline was infused into the empty bladder through a balloon catheter, and detrusor pressure was simultaneously recorded. Twenty of the 32 patients (62.5%) in group 1 showed positive IWT. In the positive IWT group, threshold volume at involuntary detrusor contraction was significantly lower than that of the negative IWT group (p < 0.05). The incidence of a positive IWT appeared to be higher in patients with pontine lesions than in those with multiple cerebral infarctions. In group 2 IWT was only positive in 1 patient (6.3%). The location of cerebral lesion and the threshold volume at mechanoreceptor-induced involuntary detrusor contraction appeared to influence the results of the IWT.

Pathological Changes of Traumatic Dislocated Testis

We present a 17-year-old patient with a right testicular dislocation. In this case, dislocated testis had been considered as hematoma and therefore remained untreated for 4 months. The patient underwent right orchiopexy 4 months after the injury. Intraoperative testicular biopsy revealed impaired spermatogenesis and existence of many alternative Sertoli cells, but no atrophy of seminiferous tubules. Six months after the operation, semen analysis of the patient revealed the deformity of most sperms. Eight months after the operation, rebiopsy of the right testis disclosed slight improvement in the spermatogenesis of the testis. Damage of the testis appears to be not severe in dislocation and may be recovered by repositioning.

A case of primary giant calculus in female urethra

Urinary calculus is rarely seen in the urethra and is usually encountered in men with urethral stricture or diverticulum. Primary urethral calculi are extremely rare in females. We describe a case of a giant urethral stone impacted in the urethra of a 103-year-old female.

Juxtaglomerular cell tumor of the kidney: Report of a non‐functioning variant

A case of a juxtaglomerular cell tumor (JCT) in a 46‐year‐old man is reported. The tumor, 2.4 cm at its greatest dimension, was incidentally detected by ultrasonography. Although histological, immunohistochemical, and electron microscopic examinations revealed typical features of a JCT, the patient had no history of hypertension or hypokalemia. This is the first report of a non‐functioning JCT in the literature.

Clinical and retrospective evaluation of Eviprostat: a non-hormonal and non-neuropharmacological agent for benign prostatic hyperplasia.

Eviprostat has been used as a non-hormonal and non-neuropharmacological treatment for benign prostatic hyperplasia (BPH) in Japan. We evaluated the clinical efficacy of Eviprostat in patients with symptomatic BPH and the anti-inflammatory effect of this drug was investigated by retrospective evaluation of TUR specimens. Clinically, Eviprostat subjectively relieved obstructive symptoms of BPH. Objective improvements were also demonstrated by ultrasonographic evaluation of prostatic volume and urinary flow rates. Histologically, preoperative administration of Eviprostat improved the degree of prostatic inflammation. This drug probably can have a place in the treatment of patients with mild or moderate symptoms of outflow obstruction.

Electrical pelvic floor stimulation : a possible alternative treatment for reflex urinary incontinence in patients with spinal cord injury

The present study demonstrates the clinical experience of pelvic floor stimulation using percutaneous implantable electrodes and implantable electrical stimulator for the treatment of reflex urinary incontinence in patients with spinal cord injury. Pelvic floor stimulation was carried out on six paraplegic patients who had urinary incontinence from an overactive bladder. After the percutaneous implantation of a pair of electrodes, chronic stimulation was carried out by employing an implanted receiver or an external pulse regulator. Within 4 to 16 weeks of electrical stimulation urinary incontinence was improved in four of the six patients. In two of these six patients, incontinence was completely abolished subjectively. Urodynamic investigations demonstrated an increased volume at the first unstable contraction (P<0.01) in all of the patients. Inhibition of detrusor overactivity was obtained from this procedure. The stimulation effect appeared to be constant during chronic stimulation. This new procedure probably provides a stable and reliable stimulation effect for long term treatment, and may be an alternative treatment for previous external electrical pelvic floor stimulation.

Comparison of the nephrotoxicity between ioversol and iohexol

To evaluate the renal toxicity of intravenous administration of ioversol and iohexol, the urinary N-acetyl-β-glucosaminidase (NAG) to creatinine ratio was measured before and after drip infusion pyelography. Thirty patients received intravenous ioversol and 29 patients received iohexol. The urinary NAG to creatinine ratio tended to increase after respective contrast media: 5% increase in the ioversoltreated, and 8% in the iohexol-treated patients.There were no significant differences in these values; the nephrotoxicity of ioversol appeared to be just as insignificant as that of iohexol.

Thermoreceptor mediated bladder sensation in patients with diabetic cystopathy

Urinary bladder sensation to ice water instillation was evaluated in 32 patients with diabetes mellitus. Sixteen patients were urodynamically normal (group 1) and the remaining 16 were diagnosed as having diabetic cystopathy (group 2). Eleven out of 16 patients in group 2 could be considered as having impairment of sensation to urinate. Two out of 16 (12.5%) subjects in group 1 could not perceive ice water infusion, whereas 25% of patients in group 2 did not feel the ice water sensation. In group 2, patients with impaired urinary sensation showed relatively high incidence of negative ice water test (36.4%), although there were no statistical differences between the other groups. There was no apparent relationship between prevalence of peripheral neuropathy and that of negative ice water test. Impairment of ice water perception was less frequent than that of mechanoreceptor sensation in patients with diabetic cystopathy.