ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We analyzed mortality data (1973‐84) associated with 19 major cancers in Japan. The standardized mortality ratio (SMR) for prostate cancer was high in prefectures clustered in the Kanto‐Chubu and Kyusyu regions, and that for renal cancer was high in prefectures scattered over eastern Japan. On the other hand, the SMR for prostate cancer was low in prefectures in the Kinki and Shikoku regions. In males, the SMR for bladder cancer was low in the Kanto'and Chubu regions, and that for renal cancer was low in the Kanto‐Chubu, Shikoku and Kyusyu regions. The correlation between the prefectural SMR for urological cancers and other cancers was analyzed. Pairs of cancers which were fairly highly correlated (0.5 or higher) were bladder‐lung, kidney‐colon, kidney‐breast, kidney‐ovary, and kidney‐pancreas. For most cancers, the prefectural SMR in males was highly correlated (0.5 or higher) with that in females. However, for cancer of the bone, bladder, skin and larynx, the correlation coefficient was less than 0.5. In 14 of the 19 cancers examined, the slope of the logarithm of the age‐specific mortality rate plotted against the logarithm of age was linear, and the relationship between age and mortality rate could be expressed by the formulaLogM(mortality rate) nLogT(age)The value of “n” calculated using the formula ranged from 4 to 7 for most cancers, and was highest (9.5

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

From March 1989 to December 1992, we encountered 25 kidneys in 21 patients with a suspicious ureteropelvic junction (UPJ) obstruction detected only on prenatal ultrasound. In all these patients other urological abnormalities were excluded by voiding cystourethrography and other radiological findings. Diuretic renography (DR) was initially performed at an age ranging from 15 days to 32 months in all patients and repeated a total of 39 times. Both the split renal function (SRF) and diuretic drainage half‐time clearance (DT1/2) of radioagent were within their normal ranges in the case of 15 (60%) of the kidneys on initial DR. In these kidneys, there were no aggravated signs on repeated DR. Decreased SRF was found in 3 kidneys (12%) on initial DR. Of these, the renal function spontaneously reverted to normal in 2 cases with bilateral hydronephrosis. Another 1 kidney revealed significant UPJ obstruction assessed by pressure flow study and continuous nephrostomy drainage had brought relief from the obstruction 1 year later. Prolonged DT1/2 with normal SRF was found in 7 (28%) kidneys. The renal function did not deteriorate and the diuretic response improved on repeat DR except for 1 kidney, whose function deteriorated and on which ultimately, pyelo‐plasty was performed at 7 months of age. Prenatally diagnosed hydronephrosis is usually asymptomatic and clinically significant UPJ obstruction should be always verified. Although even today there is still no examination which can detect a definite obstruction, we can identify one as significant by careful repeat examinations and thus avoid unnecessary surgery without causing any renal deteriorat

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study investigated the structural alterations in the basement membrane (BM) of the bladder epithelium in rats treated with N‐butyl‐N‐(4‐hydroxybutyl)nitrosamine (BBN) using transmission electron microscopy. Following administration of BBN, thickening of the BM of the bladder epithelium was observed and remained almost constant from 4 to 20 weeks, although the pathological changes in the rat bladder epithelium induced by BBN altered over the same period of 20 weeks. The reason for this phenomenon can be explained by the increased interfacial area between the basal epithelial cells and the BM of the rat bladder epithelium due to an increase in the number and size of the microvilli on the basal cell surfaces adjacent to the BM. Our results also showed that the frequency of hemidesmosomes increased progressively during the period of carcinogenesis, especially in the lesions of noninvasive transitional cell carcinoma (TCC) in the rat bladder. It is suggested that the neosynthesis of BM components can be carried out both by benign hyperplastic cells and by noninvasive TCC cells of rat bladder. The alterations in the BM thickness may be affected by the changes in the number and size of the microvilli occurring on the basal cell surfaces adjacent to the BM. Both an increased frequency of hemidesmosomes and the neosynthesis of BM are closely related to cell proliferation during carcino

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Metallothionein (MT) in tumor cells has been implicated as one of the factors involved in mechanisms of resistance to anti‐cancer drugs, including cis‐diaminedichroloplatinum (CDDP) and adriamycin (ADM). The relationship between the expression of MT and chemotherapy with anti‐cancer drugs was studied in CDDP‐ and ADM‐resistant human bladder cancer cell lines and tissue samples from clinical cases. In drug‐resistant cell lines (T‐24/ADM, CI‐7/CDDP) established in our laboratory, MT expression was studied by immunohistochemistry using the avidin‐biotin peroxidase complex (ABC) method and radioimmunoassay (RIA), using anti‐MT antibody. In addition, other potentfal mechanisms of drug resistance, such as P‐glycoprotein expression were examined and the levels of reduced glutathione (GSH), oxidized glutathione (GSSG) and glutathione‐S‐transferase (GST) determined in these cell lines. The results of these investigations demonstrate that the expression of MT in resistant cell lines increased 2.1‐ and 2.5‐fold when compared with parent cell lines (CI‐7, T‐24). GSH, GSSG and GST levels were unchanged and P‐glycoprotein was not over‐expressed. A total of 120 tissue samples from 35 clinical cases of bladder cancer, before and after chemotherapy, were stained for MT which was detected in 10 of the 35 cases before chemotherapy. The incidence of MT expression was significantly higher (p less than 0.05) in cases with lower pathological tumor grades. By analyzing the MT staining after chemotherapy in the cases whose MT staining was negative before chemotherapy, it was found that cases receiving continuous administration (intravesical chemotherapy or peroral chemotherapy) showed a higher incidence (9/13) of positive staining for MT, than patients receiving intermittent administration (intravenous chemotherapy) (1/8), (p less than 0.05). These results demonstrate that: 1) a correlation exists between MT expression and tumor differentiation and 2) repetitive and continuous administration of anti‐cancer drugs results in increased MT expression in bladder cancer cells. MT expression may therefore be one of the mechanisms by which urothelial tumors

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00022.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

M‐VAC (Methotrexate, vinblastine, adriamycin and cisplatin) combination systemic chemotherapy is useful for treating invasive or metastatic transitional cell carcinoma. Granulocytopenia is the major dose‐limiting factor of this chemotherapy and it takes 4 weeks or more to complete a single course of M‐VAC. We have tried to shorten the period of M‐VAC chemotherapy from 4 to 3 weeks by using rhG‐CSF. With this modified M‐VAC regimen, the number of days on which the absolute neutrophil count was less than 10007mm3was significantly reduced and the period to reach the neutropenia nadir was shortened. No severe side‐effects were observed. In all patients treated with 2 courses of this modified M‐VAC short regimen, the period of hospitalization could be reduced by 2 weeks. We emphasize the possibility of shortening th

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00023.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

lleocystoplasty was performed in rats and the morphological and cell‐kinetic changes occurring in the ileal grafts were determined at intervals up to 18 months postoperatively. The intestinal mucosa underwent no progressive changes but included villous and avillous regions associated with crypts of various sizes at all time intervals. Newly appearing and densely packed epithelial cells, shaped like petals, were always present in the lower parts of the villi associated with crypts showing no elongation, but seldom present in those with elongated crypts in the villous mucosa. Bromodeoxyuridine studies showed that the petal‐shaped cells interfered with cell migration. No petal‐shaped cells were observed in avillous mucosa in which the rate of cell turnover depended on crypt size. Fine‐structural changes in absorptive epithelial cells in both types of mucosa included features of prematurity or hypermaturity in the cytoplasm and close adherence to the basal portions of adjacent cells and to the basal lamina. These changes may possibly contribute to the prevention of reabsorption of urine. However, some of the mechanisms responsible for adherence of the basal parts might incidentally interfere with the normal cell kinetics of the intestinal epithelium, resulting in dense packing of cells and the formation of multiple types of mucosa in ileal

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The operative procedure used in the present series involved a nerve‐sparing radical cystectomy, with anastomosis of the urethra using a pouch made of detubularized ileum. The 36 patients who underwent this operation were all male with an average age of 58. No deaths resulted from the operation. As far as late complications were concerned, malfunction of the antireflux nipple valve was noted in 1 patient and stenosis occurred between the urethra and pouch in 2. One patient was found to have multiple stones in the pouch and reservoir decompensation was recognized in 2. Thus, the late complication rate was 17%. There were no cases of total incontinence, but nocturnal incontinence appeared in 11 out of 31 (35%). A total of 20 out of 25 patients (80%) recovered their erectile function during the postoperative follow‐up period and the disease‐free survival rate at 5 years was 78%. Therefore, the urethral Kock pouch combined with nerve‐sparing cystectomy has proved to be a useful procedure as far as the quality of life is co

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Technetium 99m diethylenetriaminepentaacetic acid renoscintigraphy was applied to 14 patients to obtain comprehensive information on the kidney and urinary tract 12.6 8.8 months (mean SD) after uretero‐ileoceco‐proctostomy (ileocecal rectal bladder) diversion. The total glomerular filtration rate (GFR) was within the normal range in all patients, and the diuretic renogram was normal in 19 of 28 kidneys, dilated‐nonobstructive in 7 and obstructive‐intermediate in 2. The mean colonic reflux was 16.6 18.4% of total excretion and the mean total residual in the colon and rectum was 38.815.5%. In the second study, performed 12.4 3.5 months later in 9 patients, the GFR of bilateral and individual kidneys remained stable, 17 of 18 kidneys were normal as judged by both renography and pyelography, and the occurrence and degree of colonic reflux decreased. There was a tendency for the rectal capacity to increase, while the total residual tended to decrease solely due to the decrease in colonic residual. These results indicate that the ileocecal rectal bladder functions well as an internal continent reservoir and that radionuclide investigation is a valuable and cost‐beneficial means for the follow‐up of urinary

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00026.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Fourteen dogs were studied to determine the level of thermal damage to the normal or benign hyperplastic prostate. Prostates were heated transurethrally by a balloon laser probe (Nd: YAG laser) at various temperatures for 20 min. Coagulative necrosis was observed in the prostate when it was heated above 45.4C for 20 min. Tissue damage in the bladder neck occurred above 49.4C, damage to the urethral mucosa occurred above 46.5C, and damage to the urethral sphincter occurred above 43.2C. It was calculated that there was a 50% probability of necrosis of the prostate gland occurring when prostatic tissue was treated at 45.0C for 20 min. Striated muscle cells in the urethral sphincter were more heat‐sensitive than smooth muscle cells of the bladder neck or transitional cells of the urethral mucosa. This basic information is essential for the safe application of Nd: YAG laser hyperthermia to the prostate glan

ISSN:0919-8172    

DOI:10.1111/j.1442-2042.1994.tb00027.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY