Yutaka Uchijima

Two different lymph node metastatic patterns of a prostatic cancer

Among 753 autopsy prostatic cancer cases with a metastasis, 476 (63%) had a lymph node metastasis, whereas 277 (37%) did not. Two different lymph node metastatic patterns were observed: Type 1, combined metastasis involving the pelvic and paraaortic lymph nodes; and Type 2, metastasis to the paraaortic lymph nodes, but not to the pelvic lymph nodes. Type 1 metastasis cases showed a significantly more frequent metastasis to the bladder and rectum, and a less frequent metastasis to the lungs and liver. Hydronephrosis occurred more frequently (P < 0.01) in the Type 1. Furthermore, in the Type 1 cases the lymph node metastasis appeared to be continuously invasive, but in the Type 2 cases, metastasis appeared to be the skip type or some metastases may have spread via the vertebral vein bypass route and may have been associated with a hematogenous metastasis.

Prostate mucinous adenocarcinoma with signet ring cell.

Carcinoma exhibiting signet ring cell appearance in the prostatic gland is rare. An example of this rare tumor is presented herein.

Possible metastatic routes via portacavalshunts in renal adenocarcinoma with liver metastasis

Renal adenocarcinoma findings from autopsies on patients with and without liver metastasis (635 and 936 patients, respectively) were investigated concerning the mode of metastasis. The patients with liver metastasis showed a significantly higher frequency of metastases to the lungs, lymph nodes, contralateral kidney, adrenals, pancreas, spleen, peritoneum, and intestines; in the female patients, those with liver metastasis had a higher frequency of metastasis to the ovary and uterus than patients without liver metastasis. Some of the metastases to those organs are explainable by venous spread via portacaval shunts as well as ordinary hematogenous or lymphogenous spread, especially, those to the contralateral kidney, adrenals, spleen, intestines, or ovary.

Purification and properties of gamma-glutamyl transpeptidase from the tissue of human benign prostatic hypertrophy

The enzyme of gamma-glutamyl transpeptidase was purified to homogeneity from the tissue of human benign prostatic hypertrophy and its enzyme properties were studied. The enzyme activity was detected mainly in the luminal border of the epithelium lining ducts by histochemical staining. The enzyme was purified 759-fold that of the crude extract. The specific activity of the purified enzyme was 79,900 mU/mg protein. The following enzyme properties were obtained: Michaelis constant of the enzyme was 0.83 mmol/l. The molecular weight was 72 kDa, consisting of two subunits, 45 kDa and 27 kDa. The isoelectric point of the enzyme was 8.5. The optimum pH ranged from 8.2 to 8.5. By Concanavalin A-sepharose affinity chromatography, more than 60% of the enzyme activity was eluted in the weakly bound fraction, suggesting biantennary complex sugar chain was the major type among the asparagine-linked sugar-chains of the enzyme.

Seminal plasma transferrin concentration in idiopathic oligozoospermia

To investigate whether or not transferrin production is decreased in the testis of idiopathic oligozoospermia, the seminal plasma transferrin concentration was measured and the values were compared in two groups (15 men of pregnancy-proved normozoospermia and 22 patients with idiopathic oligozoospermia). Seminal plasma transferrin concentration in the pregnancy-proved normozoospermic group was 78.5 +/- 37.9 micrograms/mL, and the concentration in the patients with idiopathic oligozoospermia was 44.4 +/- 37.6 micrograms/mL. There was a significant difference between them (P less than 0.01). The patients with idiopathic oligozoospermia could be divided into two subgroups according to seminal plasma transferrin concentration and serum gonadotropin levels. One group had high transferrin levels with elevated serum gonadotropin levels. The results indicate that the determination of seminal plasma transferrin concentration is one of the useful parameters for evaluation of testicular function and also suggest that additional studies may allow for the subdivision of the patients with so-called idiopathic oligozoospermia.

MP02-20 DEFINITIVE MANAGEMENT OF CARCINOGENIC SURGICAL SMOKE DURING TRANSURETHRAL RESECTION OF THE PROSTATE USING A CLOSED IRRIGATION SYSTEM

INTRODUCTION AND OBJECTIVES: Outcomes following prosthetic urethral lift implants (UroLift) (PUL) have been reported in a number of clinical trials. This investigation follows the mid term results in patients of five German centers who were treated in a normal clinical setting outside of study limitations. Previously reported studies rigorously selected subjects with mild to moderate obstruction. We report the prospective outcomes of patients treated by PUL in lieu of TURP after education concerning the less invasive therapy. METHODS: In a multicenter prospective observational study in 212 patients from five German centers were included during the period of 10/2012 through 06/2014. All candidates, submitted for transurethral resection of the prostate (TURP), received information on PUL and were given the choice of procedures. The only exclusion criterion was a prominent median lobe. No patients were excluded because of high post void residual (PVR), prostate volume (PV), history of retention, or oral LUTS therapy. Maximum urinary flow (Qmax), PVR, and the International Prostate Symptom Score (IPSS) with the Quality of Life questionnaire were assessed at baseline and 3, 6, 12, 18 and 24 months after surgery. RESULTS: Of the 212 candidates submitted for TURP, 85 (patient age was 38-85y) chose PUL. A total of 3.8 (2-7) implants were delivered over 57 (35-90 min) under general or local anesthesia. 38% of our more severely obstructed patients would have been denied PUL utilizing previously reported study criteria. 96% reported immediate symptom relief within the first month; mean Qmax, PVR, IPSS, and QoL significantly improved (p<0.001) and was maintained or further improved within the time of follow-up. Sexual function including ejaculation was unchanged or even improved of those who reported sexual activity prior to surgery. Eleven patients (13%) without severe obstruction but related to their high PVR underwent retreatment: two had successful additional PUL and 9 (with PVR values of 90-280ml) underwent TURP, four of which did not significantly improve further and one remained with a suprapubic catheter. CONCLUSIONS: PUL is a new and promising surgical technique which may alleviate symptomatic BPH, even in severely obstructed patients. It is an easy surgical technique and has been efficacious in candidates who would have undergone, until now, TURP or another equivalent therapy. Within the follow-up, these patients demonstrated a similar outcome to those in published studies.