Sugao H

Interleukin-6 Activity in Urine and Serum in Patients with Bladder Carcinoma

To investigate the correlation between interleukin-6 and urothelial neoplasms, interleukin-6 activities in blood and urine samples of patients with bladder carcinoma were measured with a proliferation assay using an interleukin-6 dependent murine hybridoma clone, MH60.BSF2. A total of 43 patients and 15 normal volunteers were entered into this study. All of the patients were examined preoperatively and 26 were reexamined more than 6 days postoperatively to eliminate the effect of surgical injury on interleukin-6 secretion. The interleukin-6 titers in urine and serum increased in accordance with the progression of the tumor stage, and tumor removal induced a remarkable decrease in the titer of urinary interleukin-6. Although the interleukin-6-producing site has not been elucidated yet, our study suggests that interleukin-6 activity in bladder carcinoma patients may reflect the immunoreaction against the tumor in local urothelium.

Maximum Electrical Stimulation for Urge Incontinence

Urge incontinence was controlled in 13 (62%) of 21 patients by maximum electrical stimulation which was applied to the anus or the perianal skin. The first session of maximum electrical stimulation was able to determine if this treatment would be successful. This method of patient selection for further stimulation was simple and reliable and achieved clinical success in all of 13 selected patients.

Ejaculatory Duct Cyst: The Case for Effective Use of Transrectal Longitudinal Ultrasonography

We report a case of an ejaculatory duct cyst. Although vasovesiculography showed insufficient differentiation from other cystic lesions, we were able to diagnose the entity by longitudinal transrectal prostatic ultrasonography with electronic linear scanning. On the basis of these findings transurethral unroofing of the cyst was performed successfully.

Transrectal longitudinal ultrasonography of prostatic abscess.

A definite diagnosis of prostatic abscess sometimes is difficult to make. We report 2 cases of prostatic abscess diagnosed with the aid of transrectal longitudinal ultrasonography by electronic linear scanning. Transperineal aspiration of the abscesses was performed easily and correctly with this echographic technique.

INFLAMMATORY PSEUDOTUMOR OF THE URETER

A 54-year-old man presented with a 5-month history of left back pain and no urological problems. Physical examination was unremarkable. The results of laboratory tests were within normal limits, urinalysis was normal and urine cytology was negative. The left kidney was not visualized on excretory urography. Computerized tomography (CT) revealed a heterogeneous 3 em. mass in the upper part of the left ureter and left hydronephrosis with thin parenchyma Diagnosis was ureteral cancer and consequently total left nephroureterectomy was performed. There were no postoperative complications and the patient was discharged from the hospital 23 days after surgery. Followup with excretory urography and CT revealed no recurrence for 7 months. The 4 x 3 x 3 cm. resected mass was rubbery firm with a yellowish-white cut surface and it surrounded the upper part of the left ureter. Macroscopic inspection of the cut surface revealed no obvious lesion on the ureteral mucosa. On microscopy the mass was not encapsulated and it was located

Sclerosing Lipogranuloma of the Penis: Chemical Analysis of Lipid from the Lesional Tissue

The origin of paraffin from penile granuloma tissue was determined first by field desorption mass spectrometry. A case of penile granuloma with histopathological findings of sclerosing lipogranuloma is presented. Chemical composition of the lesional lipid by elemental analysis and infrared absorption spectroscopy revealed paraffin hydrocarbon. Field desorption mass spectrometric analysis showed the paraffin to be a mixture of saturated hydrocarbons containing substantially 24 to 40 carbon atoms. On the basis of the chemical structure of naturally occurring lipids we concluded that this paraffin was exogenous and not endogenous material that was produced in the tissue following lipid degeneration.

Ureteropelvic Junction Obstruction with Renal Pelvic Calcification: A Case Report

Calcification in the wall of the renal pelvis is rare. We report on a 65-year-old man with hydronephrosis secondary to ureteropelvic junction obstruction with renal pelvic calcification. Calcium deposit was found in the wall of the severely dilated renal pelvis. Pathological examination revealed a damaged and hyalinized fibrous renal pelvic wall and serum calcium level was normal. Thus, we speculated that this calcification was dystrophic. Chronic extensive dilatation with intermittent hemorrhage of the renal pelvic wall may have caused this dystrophic renal pelvic calcification.

Comparison of Lumbar Flank Approach and Transperitoneal Approach for Radical Nephrectomy

A retrospective analysis based on Robsons tumor stage classification was performed on 56 patients with renal cell carcinoma who had undergone radical nephrectomy through a lumbar flank approach and 35 who had through a transperitoneal approach. The 5-year survival rates of patients with nephrectomy through the lumbar approach for Robsons stage 1, stage 2 and stage 3 were, respectively, 93.1, 70.4 and 60.0%. In comparison, the respective 5-year survival rates of patients with nephrectomy through the transperitoneal approach for Robsons stage 1, stage 2 and stage 3 were 90.5, 72.2 and 25.0%. As a result, there was no significant difference in survival rates between the two surgical procedures for any of the three Robsons stages. It is further suggested that the lumbar flank approach for radical nephrectomy does not result in poorer prognosis than does the transperitoneal approach, though transperitoneal and thoracoabdominal approaches have been generally recommended.

Renal Leiomyoma Associated with Tuberous Sclerosis

The renal lesions characteristic of tuberous sclerosis are angiomyolipoma and cysts, with the former considered to be more common. Other renal tumors are rarely associated with tuberous sclerosis. Here we present a tuberous sclerosis patient with a renal leiomyoma which was detected incidentally during the investigation of fever of unknown origin.

Neurofibroma of the clitoris. A case report.

We report an unusual case of clitoral hypertrophy due to neurofibromatosis of the external genitalia. Because of no definite skin signs or other nervous or osseous symptoms such as are commonly found in neurofibromatosis, the patient was at first suspected of being a case of hermaphroditism. Finally, the disorder was properly diagnosed after laparotomy followed by clitorectomy. This patient seems to be the 12th case of clitoral neurofibroma reported in the English literature.