Prevalence of gastroduodenal mucosal injury in asymptomatic patients taking antiplatelet agents in Japan.

PURPOSE: There is little knowledge regarding the prevalence of mucosal injury (MI) in Japanese patients receiving antiplatelet therapy. This study estimated the prevalence of gastroduodenal MI in asymptomatic Japanese patients taking antiplatelet agents and nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: Among patients who underwent an upper gastrointestinal endoscopy at Teikyo University Hospital (Tokyo, Japan), 382 asymptomatic patients taking either low-dose aspirin, ticlopidine, cilostazol, or other NSAIDs and 119 people not taking any of these agents were included. Endoscopic records were evaluated for the presence of MI. RESULTS: Aspirin and NSAIDs users showed a higher prevalence of MI than controls (Aspirin, OR = 2.6 (95% CI = 1.4 - 4.9), NSAIDs, 2.9 (1.4 - 4.4)). Concomitant use of aspirin and NSAIDs increased the prevalence of MI (11.2 (2.8 - 44.8)). Ticlopidine and cilostazol were less likely to cause injury than aspirin and other NSAIDs, the difference remained insignificant due to small sample number (ticlopidine, 0.8 (0.2 - 4.0), cilostazol, 1.3 (0.3 - 4.8)). CONCLUSIONS: In asymptomatic Japanese patients receiving low-dose aspirin, the prevalence of the gastroduodenal MI was the same as that in patients taking NSAIDs and higher than that in controls.

[5'-DFUR chemoprophylaxis in superficial bladder cancer. Kanagawa Urology 5'-DFUR Study Group].

5'-Deoxy-5-fluorouridine (5'-DFUR), an oral fluorinated pyrimidine carbamate, is widely used in patients with gastrointestinal and breast cancers because of its effectiveness. However, in bladder cancer, response rates have only been reported in Phase II clinical trials. Therefore, we conducted a prospective randomized trial to investigate chemoprophylactic effect of 5'-DFUR against recurrence of superficial bladder cancer after transurethral bladder tumor resection (TUR-Bt). The subjects were grouped as follows: 1) 5'-DFUR group (n = 31), received 600 mg/day of 5'-DFUR starting 2-3 weeks after TUR-Bt for 2 years; and 2) control group (n = 31) received no 5'-DFUR. Although there was no significant difference between groups, the cumulative recurrence rates was more favorable in the 5'-DFUR group (p = 0.256) than in the controls. Results according to cancer factors showed that, in patients with G2 based on grading, those in the 5'-DFUR group tended to have a lower recurrence rate than the control group (p = 0.070). There was a 40% incidence of adverse drug reactions (12/30 patients), primarily slight gastrointestinal symptoms which disappeared or improved with drug discontinuation. The results of the present study suggest that 5'-DFUR might be the choice of treatment to prevent recurrence of superficial bladder cancer.

Physical properties of shark gelatin compared with pig gelatin.

Physical properties of shark gelatin were examined during gel formation and postgelation in comparison with pig gelatin. Samples with various concentrations and pH values were evaluated by breaking strength, dynamic viscoelasticity, and dynamic light scattering. Sol-gel and gel-sol transition temperatures for shark gelatin were remarkably lower than those for pig gelatin. Shark gelatin gel shows a narrower pH range to form a stable gel compared with pig gelatin. Melting enthalpy of shark gelatin gel was greater than that of pig gelatin gel, and G' of shark gelatin gel changed more extensively with rising temperature in comparison with pig gelatin gel. It is concluded that shark gelatin has different characteristics from pig gelatin not only for gel characteristics but also for the solution property.

[Study of free to total prostate specific antigen ratio in the detection of patients with prostate cancer].

BACKGROUND: We investigated the clinical usefulness of free to total serum prostate specific antigen (PSA) ratio (F/T ratio) in order to improve the specificity of total PSA measurement for detecting prostate cancer. METHOD: In this study 129 patients with total PSA level 4-20 ng/ml underwent transrectal ultrasound guided sextant biopsy. Serum samples were assessed for total PSA, free PSA and the F/T ratio calculated. All patients were pathologically diagnosed as benign prostatic hyperplasia or prostate cancer. RESULTS: Of 129 patients 21 had prostate carcinoma (PCa) and 108 had benign prostatic hyperplasia (BPH) from the results of prostate biopsies. The mean of total PSA were not significantly different between men with PCa and with BPH. The mean of free PSA for PCa was significantly lower than that for BPH (p = 0.043). Furthermore, the mean of F/T ratio was significantly different between PCa and BPH group (p = 0.0014). The F/T ratio had a higher specificity than total PSA at all levels of sensitivity in detecting prostate cancers. Sensitivity, specificity and accuracy for cancer detection at a cut off 0.12 was 90.4%, 51.8% and 58.1%, respectively. Also, free PSA was as useful as F/T ratio for cancer detection when analyzed in receiver operating characteristic curves analysis. When determined the cut off number of free PSA at 0.78 ng/ml, the sensitivity, specificity and accuracy for cancer detection were 61.9%, 66.7% and 65.9%, respectively. CONCLUSION: This study indicated that the F/T ratio and free PSA could improve the specificity without impairing the sensitivity for detecting PCa in patients with 4-20 ng/ml of total PSA.

[Intermittent hydronephrosis caused by ureteral polyp in childhood: report of a case].

We report a case of ureteral polyp causing intermittent hydronephrosis in a 12-year-old boy. He was often hospitalized with episodes of right flank pain and gross hematuria. An excretory urogram (IVP) revealed mild hydronephrosis, but it showed a markedly dilated right renal pelvis during the attack. An Anderson-Hynes type pyeloplasty was done. At operation we found four ureteral polyps, and performed partial ureterectomy including polyps. Pathological examination showed fibrous ureteral polyps. He has reported no symptoms for 3 months after the operation.

[Serum gamma-seminoprotein on patients suffering from urinary retention due to BPH].

Serum gamma-Seminoprotein (gamma-Sm) of 33 patients suffering from urinary retention due to BPH was evaluated. In acute urinary retention gamma-Sm was 17.1 +/- 54.9 ng/ml (N = 33) and its positive rate was 72.7%. After indwelling urethral catherization for one week gamma-Sm fell to 3.7 +/- 3.6 ng/ml (N = 17) and its positive rate was 42.8%. gamma-Sm measured after one month was negative on all cases. It was showed that gamma-Sm in acute urinary retention increased and after releasing from urinary retention it was rapidly normalized. It is necessary to take into account the above mentioned findings on evaluation of gamma-Sm as a tumormarker of prostatic carcinoma.

[Angiomyolipoma: diagnosed preoperatively as renal cell carcinoma by CT scan].

We report a case of angiomyolipoma diagnosed preoperatively as renal cell carcinoma by computer tomographic scan, ultrasonography and angiography. The method of diagnosis is discussed and the literature reviewed.