Takahiro Koizumi

Effect of vascular endothelial growth factor and its receptor inhibitor on proliferation and invasion in bladder cancer.

Background: Vascular endothelial growth factor (VEGF) and its receptors are major regulators of cancer cell growth and metastases. We investigated the association between serum VEGF levels and clinicopathological parameters in bladder cancer patients. We also evaluated the effects of VEGF and its receptor inhibitor on proliferation and invasion in bladder cancer cell lines. Methods: Serum VEGF levels were measured in 52 patients with bladder cancer and 45 healthy controls. In highly invasive bladder cancer cell lines (T-24, UMUC-3 and J82), we assessed the effect of VEGF on proliferation and invasion of bladder cancer cell lines. The effect of VEGF receptor (VEGFR) tyrosine kinase inhibitor against bladder cancer cell lines was also measured. Results: Serum levels of VEGF were significantly higher in patients with muscular invasive bladder cancer than in patients with superficial bladder cancer (p < 0.005). VEGF increased tumor proliferation in a dose-dependent manner in all cell lines. VEGFR-2 tyrosine kinase inhibitor inhibited proliferation in all three cell lines, and inhibited invasion in T24. Conclusions: In bladder cancer, the serum VEGF level correlates significantly with muscular invasiveness. This study suggests that VEGF promotes tumor proliferation and invasion through VEGFR-2. VEGF-targeted therapy may be effective in treating invasive bladder cancers.

The role of actinin-4 in bladder cancer invasion.

OBJECTIVES To examine actinin-4 expression levels in bladder cancer, in particular its levels during cellular growth and invasion. Actinin-4 is an actin-binding protein that is associated with cell motility and cancer metastasis. METHODS Relative messenger ribonucleic acid (mRNA) and protein expression of actinin-4 in normal bladder and bladder cancer cell lines was determined by quantitative real-time polymerase chain reaction and Western blot analysis. Actinin-4 expression was also localized in bladder cancer cells and tissues using immunohistochemistry. The growth and invasion activity of bladder cancer cells was evaluated using cell growth and in vitro cell invasion assays, and compared with that of bladder cancer cells treated with actinin-4 small interfering ribonucleic acids. RESULTS Actinin-4 mRNA and protein levels were elevated in bladder cancer cells that are known to exhibit increased growth and invasion activity. Protein expression was predominantly observed in the cytoplasm of the invasive bladder cancer cells and tissues. Treatment of bladder cancer cell lines with actinin-4 small interfering ribonucleic acids suppressed the invasive potential of the cells, but did not alter their growth. CONCLUSIONS The current study demonstrates that actinin-4 mRNA and protein levels are elevated in bladder cancer cells lines that exhibit increased growth and invasion activity. In addition, actinin-4 knockdown inhibited invasion of bladder cancer cells, but did not alter their growth. In conclusion, we hypothesize that the accumulation of actinin-4 in the cell cytoplasm is related to an increased susceptibility of tumor invasion and metastasis.

Transperitoneal versus retroperitoneal laparoscopic radical nephrectomy: a comparative study.

Objectives:  To compare perioperative outcome of transperitoneal and retroperitoneal approaches during laparoscopic radical nephrectomy (LRN) and to identify selection criteria for each approach.

Low Transscrotal Orchidopexy Is a Safe and Effective Approach for Undescended Testes Distal to the External Inguinal Ring

Objectives: To review the results of a low transscrotal orchidopexy in patients with palpable undescended testes located distal to the external inguinal ring. Methods: Between July 1998 and June 2005, transscrotal orchidopexy with a single low scrotal incision was performed in 32 patients for 49 undescended testes. The indication was an undescended testis that lay distal to the external ring and could be pulled down manually into the scrotum under general anesthesia. Results: All testes that were treated with the low transscrotal approach were successfully fixed in the middle or lower portion of the scrotum. The mean operative time was significantly shorter for the low transscrotal orchidopexy (45.2 min) than for the inguinal orchidopexy (66.6 min) for 107 undescended testes at similar locations. The median follow-up duration was 39.1 months; all testes except 1 (97.7%) were located in a good position within the scrotum and had a good consistency; 1 testis ascended postoperatively and required inguinal orchidopexy. No inguinal hernias or hydroceles occurred after the surgery. Conclusions: Low transscrotal orchidopexy appears to be an excellent alternative to the standard inguinal orchidopexy for undescended testes located distal to the external inguinal ring.

EVALUATION OF DIFFERENT SUBTYPES OF RENAL TUMORS ON DOUBLE-PHASE HELICAL CT

the 10 year follow-up. The cancer-free survival rate after a single cryoablation procedure was 92.2%, this improved to 96.6% after a secondary cryoablation procedure (n = 8). Median preoperative renal mass size was 2.49 cm (range, 0.7cm-8.4cm). In tumors with T1N0M0 (n = 171) disease-free survival (recurrence and death) and recurrencefree survival were significantly different between pT1a and pT1b when stratified by tumor size, 97.5% of mass size 4cm remained disease free up to 10.5 years compared to 71.4% of those with tumor mass size greater than 4cm (Hazard risk ratio 37.5; 95% confidence interval [CI] 3.4 to 414.1; p = 0.003). Recurrence-free survival showed similar pattern between pT1a and pT1b (p = 0.04). Disease-free survival or recurrence-free survival was not significantly modified by gender, age, tumor position, ECOG status, or treatment approach. CONCLUSIONS: Disease-free survival and recurrence-free survival are significantly better in patients undergoing cryoablation for renal neoplasm mass 4 cm or less compared to those with larger tumors. The current T1N0M0 substratification, based on the 2002 TNM criteria, is an effective predictor of the disease-free survival or recurrence-free survival in patients undergoing cryoablation for renal neoplasm.

[Comparison of digital subtraction angiography, CT angiography, and ultrasonic Doppler examination in the evaluation of penile arterial lesions].

BACKGROUND CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. METHOD Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study, DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E1 into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. RESULTS The CT angiography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visualizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CONCLUSIONS CT angiography has not yet reached the same level as DSA in the evaluation of fine arteries. However, CT angiography can produced images sufficient for the diagnosis of arteriogenic ED with some advantages. We believe that with improvement, CT angiography will become an adequate replacement for DSA in the diagnosis of penile arterisl lesion.