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ABSTRACT: The critical factors and etiological role of human papillomavirus (HPV) infection in the development of female bladder tumor were examined. Eighty-four female patients with primary bladder tumor were studied. After DNA extraction from each paraffin-embedded tissue, HPV-DNA and genotype were checked. In cases of all HPV-positive cases and some HPV-negative cases, in situ hybridization (ISH) for high-risk HPV-DNA, and immunohistochemical analysis for p16-INK4a were performed. HPV-DNA was detected in 5 (6.0%) of 84 eligible patients, and HPV16 was detected in 3 patients, and HPV6 and HPV52 was detected in one case, respectively. HPV-DNA was detected frequently in younger patients and in patients with a history of cervical cancer. In four high-risk HPV-positive cases, high-risk HPV-DNA was present in tumor tissues, and p16-INK4a was expressed moderately or strongly. Two cases had a past history of cervical cancer. In these 2 cases, the same HPV type (HPV16) was detected from bladder tumor and cervical cancer. High-risk HPV-DNA ISH signals and p16-INK4A expression were also detected widely in these cervical cancer tissues. HPV infection is likely to play an important role in the development of female bladder tumor at younger cases with a past history of cervical cancer.
Apmis 04/2013; · 1.99 Impact Factor
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ABSTRACT: Liquid-based urine cytology (LB-URC) was evaluated for cytological diagnosis and detection of human papillomavirus (HPV), Mycoplasma, and Ureaplasma. Midstream urine samples were collected from 141 male patients with urethritis and 154 controls without urethritis, and sediment cells were preserved in liquid-based cytology solution. Urethral swabs from urethritis patients were tested for the presence of Neisseria gonorrhoeae and Chlamydia trachomatis. Papanicolaou tests were performed for cytological evaluation. HPV, Mycoplasma, and Ureaplasma genomes were determined by PCR-based methods, and localization of HPV DNA in urothelial cells was examined by in situ hybridization (ISH). The β-globin gene was positive in 97.9% of LB-URC samples from urethritis patients and in 97.4% of control samples, suggesting that high-quality cellular DNA was obtained from the LB-URC samples. HPV DNA was detected in 29 (21.0%) urethritis cases and in five (3.3%) controls (P < 0.05). HPV type 16 (HPV 16) was most commonly found in urethritis patients. Cytological evaluations could be performed for 92.1% of urethritis patients and 64.3% of controls. Morphological changes suggestive of HPV infection were seen in 20.7% of the HPV-positive samples, and ISH demonstrated the presence of HPV DNA in both squamous and urothelial cells in HPV-positive samples. Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum were detected in 14.5%, 10.9%, 6.5%, and 12.3% of urethritis patients, respectively. The prevalence rates of these microorganisms (except Ureaplasma parvum) were significantly higher in urethritis cases than controls (P < 0.05). LB-URC is applicable for detection of HPV, Mycoplasma, and Ureaplasma. HPV infection occurs in urothelial cells, especially in gonococcal urethritis.
Journal of clinical microbiology 11/2011; 50(2):401-6. · 4.16 Impact Factor
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ABSTRACT: The authors elucidated an etiologic role of human papillomavirus (HPV) infection in carcinoma of the bladder.
One hundred seventeen of 224 patients with bladder carcinoma who were treated between 1997 and 2009 were enrolled in this study. The presence of HPV DNA was tested on frozen carcinoma tissues that were obtained by transurethral resection using a polymerases chain reaction-based method. Localization of HPV was observed on archival tissue specimens by in situ hybridization (ISH) for high-risk HPV DNA. Cyclin-dependent kinase (CDK) inhibitor 2A (inhibits CDK4) (p16-INK4a) and minichromosome maintenance protein-7 (mcm-7)-surrogate markers for high-risk HPV-E7 oncoprotein-and HPV-L1 (capsid) protein expression were evaluated by immunohistochemistry.
HPV types 16, 18, 31, 33, 52, and 58, and an unknown HPV type were detected in 18 of 117 samples (15%) from patients with bladder carcinoma. HPV16 was identified in 6 samples, HPV18 was identified in 4 samples, and HPV33 was identified in 3 samples. All were single HPV type infections. HPV was detected in 38% (12 of 28) of histologic grade 1 bladder carcinomas, 8.5% (6 of 71) of grade 2 bladder carcinomas, and in 0% (0 of 18) of grade 3 bladder carcinomas. Multivariate analysis indicated that younger age (<60 years; odds ratio [OR], 10.9; 95% confidence interval [CI], 2.6-45.3) and grade 1 tumors (OR, 4.5; 95% CI, 1.2-17.0) were associated with HPV infection. ISH analysis indicated that high-risk HPV DNA was localized in the nuclei of tumor cells of all HPV-positive samples. p16-INK4a and mcm-7 were expressed in 94% and 89% of HPV-positive carcinoma cells, respectively. HPV-L1 protein expression, which suggested reproductive HPV infection, was not observed in any carcinoma.
The current results indicated that high-risk HPV is likely to be a causative agent of some low-grade bladder carcinomas that develop in younger patients.
Cancer 05/2011; 117(10):2067-76. · 4.77 Impact Factor
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Kazuyoshi Shigehara,
Toshiyuki Sasagawa,
John Doorbar,
Shohei Kawaguchi,
Yoshitomo Kobori, Takao Nakashima,
Masayoshi Shimamura,
Yuji Maeda,
Tohru Miyagi,
Yasuhide Kitagawa,
Yoshifumi Kadono,
Hiroyuki Konaka,
Atsushi Mizokami,
Eitetsu Koh,
Mikio Namiki
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ABSTRACT: The status of human papillomavirus (HPV) infection in urothelial inverted papilloma was examined in the present study. Formalin-fixed and paraffin-embedded tissues from eight cases of inverted papilloma of the bladder were studied. The presence of HPV-DNA was examined by modified GP5/6+PCR using archival tissue sections by microdissection. HPV genotype was determined with a Hybri-Max HPV genotyping kit. Immunohistochemical analysis for p16-INK4a, mcm7, HPV-E4, and L1, and in situ hybridization for the HPV genome were performed. HPV was detected in seven of eight cases (87.5%) of inverted papilloma. Three cases were diagnosed as inverted papilloma with atypia, while the remaining five were typical cases. HPV-18 was detected in two cases, including one inverted papilloma with atypia, and HPV-16 was detected in four cases, including one inverted papilloma with atypia. Multiple HPV type infection was detected in one typical case and one atypical case. High-risk HPV was present in all HPV-positive cases. Cellular proteins, p16-INK4a and mcm7, which are surrogate markers for HPV-E7 expression, were detected in all HPV-positive cases, and their levels were higher in inverted papilloma with atypia than in typical cases. In contrast, HPV-E4 and L1, which are markers for HPV propagation, were observed in some parts of the typical inverted papilloma tissue. High-risk HPV infection may be one of the causes of urothelial inverted papilloma, and inverted papilloma with atypia may have malignant potential.
Journal of Medical Virology 02/2011; 83(2):277-85. · 2.82 Impact Factor
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ABSTRACT: To investigate the prevalence of human papillomavirus (HPV) in the genital and urinary tract of men with urethritis.
Cell samples were collected from the penis, urethra and urine of 142 men with urethritis. A HPV test was performed on the samples using the modified GP5+/6+ polymerase chain reaction method, and the HPV genotype was determined using a HPV GenoArray test.
Out of 142 urethritis patients, HPV was detected in 48% (68 cases), and high-risk HPV was found in 32% (46 cases) of patients, on their penis or in the urinary tract (urethra or urine). HPV was detected in 31% in the penis, 20% in the urethra and 24% in the urine, while high-risk HPV was identified in 23% in the penis, 12% in the urethra and 11% in the urine. Among the HPV-positive men, 66% had HPV infection in the urinary tract where the most common HPV types were HPV6, HPV16, HPV18 and HPV58. Single HPV-type infection was more frequently found in the urinary tract (89%) than in the penis (65%) (P < 0.05).
Similar to the penis, the urinary tract represents a common HPV infection site in men with urethritis.
International Journal of Urology 03/2010; 17(6):563-8. · 1.75 Impact Factor
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ABSTRACT: We report a rare appearance of cystitis glandularis forming a tumorous lesion with blueberry spots in the urinary bladder. A 49-year-old woman was admitted to our hospital with pollakisuria and recurrent gross hematuria. Urine examination showed no pyuria. Computed tomography (CT) scan showed an extravesical invasive mass and cystoscopy revealed a non-papillary tumor with blueberry spots in the bladder. Transurethral resection (TUR) was performed. Histopathological examination revealed cystitis glandularis with cystitis cystica in the part. Postoperative CT scan and cystoscopy showed reduction of the mass in the bladder without any treatments. She is currently well with no evidence of tumor growth three months after TUR.
Indian Journal of Urology 11/2008; 24(4):558-60.
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ABSTRACT: We investigated the incidence and characteristics of acute bacterial prostatitis after transrectal prostate biopsy, based on urine and blood cultures, treatment method, and outcome. Four hundred and fifty-seven patients who underwent transrectal prostate biopsy in our hospital between November 2003 and October 2006 were reviewed. These patients were treated with 200 mg levofloxacin orally twice daily for 4 days, beginning 12 h before biopsy, and with 200 mg isepamicin sulfate given intravenously just before the biopsy. In patients who developed acute prostatitis urine and blood cultures were checked. All organisms isolated in urine or blood cultures were tested for antibiotic susceptibility of the 457 patients, first-biopsy was performed in 371 and re-biopsy was done in 86. Acute bacterial prostatitis developed in 6 patients (1.3%). Acute prostatitis developed after a first-biopsy in 2 patients (0.5%) and after re-biopsy in 4 patients (4.7%), showing a significant difference. All of the urine and blood cultures yielded levofloxacin-resistant Escherichia coli. Immediate intravenous cephalosporin or carbapenem was effective for all of these patients. We concluded that the use of levofloxacin could be a risk factor for acute bacterial prostatitis after transrectal prostate biopsy, due to an increase in fluoroquinolone-resistant E. coli in the rectum. The incidence of prostatitis was higher in re-biopsy patients. We consider that patients should receive levofloxacin for a shorter period before biopsy to avoid generating fluoroquinolone-resistant strains. Treatment with cephalosporin or carbapenem is recommended for patients with acute prostatitis after prostate biopsy.
Journal of Infection and Chemotherapy 03/2008; 14(1):40-3. · 1.80 Impact Factor
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ABSTRACT: We report our second patient treated successfully with a new combined chemotherapy regimen of intra-arterial pirarubicin and nedaplatin plus intravenous methotrexate and vincristine for squamous cell carcinoma (SCC) of the bladder. A 57-year-old man consulted our hospital in September 2005 for treatment of bladder tumors diagnosed in another hospital. Magnetic resonance imaging (MRI) showed an extravesical invasive tumor on the anterior wall of the bladder, and clinical stage T2bN0M0 was diagnosed. Transurethral cold-cup biopsy was performed, and pathological examination revealed SCC. After he received two courses of this new combined intra-arterial chemotherapy regimen using nedaplatin, tumors were detected in MRI and cystoscopy. We performed partial cystectomy in January 2006. Postoperative pathological examination revealed no tumor cells (pathological CR). There were no severe adverse reactions by this chemotherapy regimen. He has been alive without evidence of disease.
Gan to kagaku ryoho. Cancer & chemotherapy 09/2007; 34(8):1319-21.
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ABSTRACT: We performed retrograde percutaneous nephrostomy on a 79-year-old woman admitted to our hospital with recurrent right acute pyelonephritis. Computed tomographic scan showed mild hydronephrosis and some renal stones in the right kidney. Antegrade percutaneous nephrostomy was thought to be impossible because the patient could not be placed in a prone position. Urgent drainage by ureteral catheter placement in the right renal pelvis was performed in the lithotomy position. After pyelonephritis improved, retrograde percutaneous nephrostomy was performed, which provided precise percutaneous access to the desired renal calyx without complications. Renal stones in the right kidney were later removed by percutaneous nephrolithotomy. If a sufficient preoperative evaluation is performed, we consider retrograde percutaneous nephrostomy is a safe and useful method for percutaneous access to the kidney.
Hinyokika kiyo. Acta urologica Japonica 06/2007; 53(5):297-9.
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ABSTRACT: We report a case of squamous cell carcinoma (SCC) of the bladder treated successfully with intraarterial chemotherapy using nedaplatin. A 75-year-old woman was admitted to our hospital in March 2004 with gross hematuria. Cystoscopic examination showed tumors on the anterior bladder wall. Computed tomography (CT) scans and magnetic resonance imaging (MRI) revealed extravesical invasion of the tumors, and a clinical diagnosis of T3bN0M0 was made. Transurethral biopsy was performed, and histopathological examination revealed SCC, grade 2-3, invasive. The patient received a new combined chemotherapy, intraarterial nedaplatin and pirarubicin plus intravenous methotrexate and vincristine. After two courses of the chemotherapy, CT scans and MRI demonstrated no tumor in the bladder. Transurethral bladder-wall biopsy was performed in November 2004, and histopathological examination of the specimen revealed no definite tumors. The patient is alive without evidence of disease more than 1 year after the chemotherapy.
International Journal of Clinical Oncology 09/2006; 11(4):329-31. · 1.41 Impact Factor
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ABSTRACT: Emphysematous cystitis is a rare form of acute cystitis presenting with gas collection in the bladder wall and lumen. We report three cases of emphysematous cystitis. The first patient was a 71-year-old woman with gross hematuria. Intravenous pyelography and cystoscopy revealed a characteristic gas collection in the bladder. The second patient was a 59-year-old man with abdominal fullness who was hospitalized for treatment of a cerebral infarction. Abdominal radiography and computed tomographic (CT) scan demonstrated emphysematous cystitis. The third patient was a 67-year-old man with diarrhea and abdominal pain after operation for rectal cancer. CT scan accidentally showed gas bubbles in the bladder wall and lumen. All of the cases, the symptoms were improved after treatment with antibiotics.
Hinyokika kiyo. Acta urologica Japonica 06/2006; 52(5):371-4.
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Kazuyoshi Shigehara,
Toshiyuki Sasagawa,
John Doorbar,
Shohei Kawaguchi,
Yoshitomo Kobori, Takao Nakashima,
Masayoshi Shimamura,
Yuji Maeda,
Tohru Miyagi,
Yasuhide Kitagawa,
Yoshifumi Kadono,
Hiroyuki Konaka,
Atsushi Mizokami,
Eitetsu Koh,
Mikio Namiki
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ABSTRACT: Purpose. We performed a randomised controlled study regarding the effects of androgen replacement therapy (ART) on lower urinary tract symptoms (LUTS) in hypogonadal men with benign prostate hypertrophy (BPH). Methods. Fifty-two patients with hypogonadism and BPH were randomly assigned to receive testosterone (ART group) as 250 mg of testosterone enanthate every 4 weeks or to the untreated control group. We compared International Prostate Symptom Score (IPSS), uroflowmetry data, post-voiding residual volume (PVR) and systemic muscle volume at baseline and 12 months after treatment. Results. Forty-six patients (ART group, n=23; control, n=23) were included in the analysis. At the 12-month visit, IPSS showed a significant decrease compared with baseline in the ART group (15.7±8.7 vs. 12.5 ± 9.5; p < 0.05). No significant changes were observed in the control group. The ART group also showed improvement in maximum flow rate and voided volume (p < 0.05), whereas no significant improvements were observed in the controls. PVR showed no significant changes in either group. In addition, the ART group showed significant enhancement of mean muscle volume (p < 0.05), whereas no significant changes were seen in the controls. Conclusion. ART improved LUTS in hypogonadal men with mild BPH. © 2010 Informa UK, Ltd.
