Yoshio Kawachi

Naftopidil monotherapy vs naftopidil and an anticholinergic agent combined therapy for storage symptoms associated with benign prostatic hyperplasia: A prospective randomized controlled study.

Aim: The aim of this study was to compare the efficacy and safety of α1‐adrenoceptor (α1‐AR) antagonist monotherapy with combination therapy using α1‐AR antagonist and anticholinergic agent for benign prostatic hyperplasia (BPH) with storage symptoms as the chief complaint.

Factors Associated with Variation in Utility Scores among Patients with Prostate Cancer

OBJECTIVE We aimed to assess the effects of age, comorbidity, and disease-specific functions on utility scores derived from three methods on prostate cancer. METHODS A total of 330 Japanese prostate cancer patients were asked to answer self-administered questionnaires. Community-weighted utility scores were derived from the EuroQoL-5D (EQ-5D) and the Short Form-36 (SF-36), while the patients directly elicited utility score was derived from time trade-off technique. Univariate and multivariate analyses were performed to examine the relation between covariates and utility scores. We assigned age, the Index of Co-existent Disease, and disease-specific functions including sexual, urinary, bowel, and hormonal function as covariates. RESULTS Bowel and hormonal function were related to utility scores, while age and sexual function were not. Comorbidities were more closely related to utility scores derived from EQ-5D and SF-36. CONCLUSIONS These results contribute to an understanding of which factor has an impact on utility scores in patients with prostate cancer.

Long-term treatment and prognostic factors of α1-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Abstract Objective. This study evaluated the 5-year failure rate of naftopidil (NAF) or tamsulosin hydrochloride (TAM) in lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH/LUTS) and compared the prognostic factor of two α1-blockers. Material and methods. A total of 131 patients with International Prostate Symptom Score (IPSS) ≥ 8 or IPSS quality of life (IPSS-QOL) ≥ 3 with BPH/LUTS receiving treatment with α1-blockers had been administered NAF or TAM, and failure rates were calculated for 5 years. Age, prostate volume (PV), acute urinary retention (AUR), overactive bladder (OAB), IPSS, IPSS-QOL and postvoiding residual volume (PVR) were evaluated as prognostic factors. Results. No significant differences in failure rate were observed between the drugs. The failure rate was significantly high for patients with a PV ≥ 35 ml, PVR ≥ 30 ml, a history of AUR or complications of OAB symptoms. The failure rate for patients with a history of AUR was significantly higher than in those without AUR in the NAF group. By contrast, in the TAM group, it was significantly higher in patients who had OAB symptoms than in those without OAB. Conclusions. No significant differences were observed between the drugs for the failure rate. Each treatment had a unique factor for prognosis, such as history of AUR for NAF and complications of OAB for TAM. Therefore, it will be necessary to use the two α1-blockers properly, considering the patients background.

Small cell carcinoma of the prostate with hypercalcemia

Abstract We present a case of small cell prostate carcinoma with hypercalcemia in a 75‐year‐old man. He was diagnosed as having stage T3bN1M0 adenocarcinoma of the prostate. His serum prostate‐specific antigen level was reduced to below the normal range after a combination treatment of a luteinizing hormone‐releasing hormone agonist and flutamide for prostate carcinoma. He subsequently experienced increasing fatigue, poor appetite, short time loss of consciousness and pain in his lower abdomen. His serum calcium level and carcinoembryonic antigen were increased. He died 5 months from the start of treatment. The autopsy revealed small cell carcinoma of the prostate and multiple metastasis of the lung, liver, pancreas, lymph nodes and spine.

Sarcomatoid carcinoma and carcinosarcoma of the urinary bladder

Two cases, sarcomatoid carcinoma and carcinosarcoma, of the urinary bladder are reported. A 68‐year‐old man with sarcomatoid carcinoma underwent total cystectomy and was alive and had had no recurrence after 21 months. A 78‐year‐old woman with carcinosarcoma underwent total cystectomy, but she died from increasing multiple lung metastases 4 months after surgery. The histopathological characteristics of both neoplasms are reported and discussed.

Inverted Transitional Cell Carcinoma of the Ureter

An inverted urothelial tumor (transitional cell carcinoma, inverted type, grade 1), consisting of a large (3.5 ± 1.2 ± 1.2 cm) tumor with stalk (0.3 cm in diameter) and surrounding broad base polypoid foci (0.5 ± 0.6 ± 0.5 cm altogether), was found in the lower segment of the left ureter of a 59‐year‐old man. He has taken oral anticancer drugs and kanpo medicine as a follow‐up for 61 months, and is now free of disease. Differential diagnosis, inverted urothelial papilloma and carcinoma, and adequate treatment are discussed.

A CASE OF ARTERIAL PRIAPISM TREATED BY EMBOLIZATION

An 18‐year‐old unmarried man, who had shown arterial priapism caused by mild perineal trauma sustained during skate‐boarding, has been successfully treated by autologous clot embolization at the common penile artery. He was able to have a normal erection and ejaculate 5 d after embolization.

Hypoxia-Inducible Protein 2 (HIG2), a Novel Diagnostic Marker for Renal Cell Carcinoma and Potential Target for Molecular Therapy

To identify molecules to serve as diagnostic markers for renal cell carcinoma (RCC) and as targets for novel therapeutic drugs, we investigated genome-wide expression profiles of RCCs using a cDNA microarray. We subsequently confirmed that hypoxia-inducible protein-2 (HIG2) was expressed exclusively in RCCs and fetal kidney. Induction of HIG2 cDNA into COS7 cells led to secretion of the gene product into culture medium and resulted in enhancement of cell growth. Small interfering RNA effectively inhibited expression of HIG2 in human RCC cells that endogenously expressed high levels of the protein and significantly suppressed cell growth. Moreover, addition of polyclonal anti-HIG2 antibody into culture medium induced apoptosis in RCC-derived cell lines. By binding to an extracellular domain of frizzled homologue 10 (FZD10), HIG2 protein enhanced oncogenic Wnt signaling and its own transcription, suggesting that this product is likely to function as an autocrine growth factor. ELISA analysis of clinical samples identified secretion of HIG2 protein into the plasma of RCC patients even at an early stage of tumor development, whereas it was detected at significantly lower levels in healthy volunteers or patients with chronic glomerulonephritis. The combined evidence suggests that this molecule represents a promising candidate for development of molecular-targeting therapy and could serve as a prominent diagnostic tumor marker for patients with renal carcinomas.

Effect of tamsulosin on urodynamics in benign prostatic hypertrophy

Abstract Tamsulosin 0.2 mg was administered orally once daily for 4 weeks to 20 patients with bladder outlet obstruction associated with benign prostatic hypertrophy. Urinary flow rate and versical capacity at first desire to void increased significantly, and prostatic pressure decreased significantly, and prostatic urethral length decreased although not significantly. Tamsulosin showed no tendency to accumulate, and no drug-related adverse events were observed. Thus tamsulosin appears to be a safe and effective drug for the treatment of patients with bladder outlet obstruction associated with benign prostatic hypertrophy