Biomedical subjects

Yoshihide Ogawa

Publications and source records attributed to Yoshihide Ogawa.

At least 19 recordsLinked to original sources

PubMed2003

Urinary saturation and risk factors for calcium oxalate stone disease based on spot and 24-hour urine specimens.

In 222 random spot urine specimens, the calcium concentration and calcium oxalate saturation [DG(CaOx)] were significantly higher among stone formers than among non-stone formers, while the citrate and creatinine-corrected citrate concentrations were lower. In 188 24-hour urine specimens, magnesium excretion was lower among stone formers than non-stone formers, while the creatinine-corrected calcium concentration and DG(CaOx) were higher. Among stone formers, there was no gender difference in the urinary concentrations of calcium, oxalate, citrate, magnesium, and DG(CaOx), but the creatinine-corrected calcium, citrate, and magnesium concentrations were higher in women, as well as 24-hour citrate excretion. The levels of calcium and oxalate have a major influence on DG(CaOx), while citrate and magnesium levels have a minor influence. DG(CaOx) was correlated with calcium and oxalate excretion, as well as with the creatinine-corrected calcium and oxalate concentrations. Approximately 5% of 24-hour urine specimens showed critical supersaturation, 80% showed metastable supersaturation, and 15% were unsaturated. Hypercalciuria or hyperoxaluria was fairly common (30% and 40%) in critically supersaturated urine, while it was less common (22.4% and 8.6%) in metastably supersaturated urine and was not detected in unsaturated urine. Hypocitraturia and/or hypomagnesiuria was more common (63.8-80%) at any saturation. The urinary calcium, oxalate, and citrate concentrations, as well as the creatinine-corrected calcium, oxalate, citrate, and magnesium concentrations and DG(CaOx), showed a significant correlation between 57 paired early morning spot urine and 24-hour urine specimens. The creatinine-corrected calcium and citrate concentrations of the early morning urine specimens were significantly correlated with the levels of calcium and citrate excretion in the paired 24-hour urine specimens. In conclusion, no parameter other than urinary saturation gives more than a vague indication of the risk of lithogenesis, so DG(CaOx) in either early morning urine or 24-hour urine specimens appears to be the best predictor of stone risk. Finally, the creatinine-corrected calcium and citrate concentrations in early morning urine can be used as a substitute for measuring 24-hour excretion.

Calcium Oxalate↗

PubMed2003

Milk and calcium prevent gastrointestinal absorption and urinary excretion of oxalate in rats.

Dietary oxalate plays a very important role in the formation of calcium oxalate stones, and dietary intake of calcium may decrease oxalate absorption and its subsequent urinary excretion. The purpose of the present study was to determine the effect on urinary oxalate excretion of an acute oral calcium load, standard milk, or high-calcium low-fat milk followed by a dose of oxalic acid. Male Wistar rats weighing 180-200 g were divided into 7 groups of 6 rats each. All animals were fasted for about 24 hours, anesthetized, and hydrated with normal saline at 3-4 mL/hour. Then the animals were given 1 mL of normal saline [Control], 10 mg (111.1 micromol) of oxalic acid [Ox alone], 2 mL of standard milk (calcium: 1.16 mg or 29 micromol/mL) [NCa milk], 2 mL of high-calcium low-fat milk (calcium: 2.05 mg or 51.3 micromol/mL) [HCa milk], equimolar calcium (4.44 mg or 111 micromol) followed by 10 mg of oxalic acid [Ca + Ox], 2 mL of high-calcium low-fat milk followed by 10 mg of oxalic acid [HCa milk + Ox], or 2 mL of standard milk followed by 10 mg of oxalic acid [NCa milk + Ox]. All treatments were administered via a gastrostomy. Urine samples were collected by bladder puncture just before administration and at hourly intervals up to 5 hours afterwards. Urinary oxalate was measured by capillary electrophoresis, while urinary calcium, magnesium and phosphorus were measured by inductively coupled plasma spectrometry. Urinary oxalate excretion peaked at 1 hour in the Ox alone group, while it peaked at 2 or 3 hours in the Ca + Ox, HCa milk + Ox, and NCa milk + Ox groups. Urinary oxalate excretion decreased significantly when 10 mg of oxalate was administered immediately after the administration of equimolar calcium, high-calcium low-fat milk, or standard milk. The cumulative urinary oxalate excretion over 5 hours was approximately 13.6%, 3.5%, 1.6%, and 2.4% in the Ox alone, Ca + Ox, HCa milk + Ox, and NCa milk + Ox groups, respectively. In conclusions, this study demonstrated that calcium salt, or dairy products containing calcium (especially high-calcium low-fat milk) could decrease the gastrointestinal absorption and subsequent urinary excretion of oxalate.

Animals↗

PubMed2003

Osteoprotegerin/osteoclastogenesis inhibitory factor decreases human prostate cancer burden in human adult bone implanted into nonobese diabetic/severe combined immunodeficient mice.

Human prostate cancer frequently metastasizes to bone, where it gives rise to osteoblastic bone metastases with an underlying osteoclastic component and subsequent bone pain. However, the importance of osteoclastogenesis in the development of prostate cancer bone lesions in humans is unclear. Osteoprotegerin/osteoclastogenesis inhibitory factor (OCIF) is a member of the tumor necrosis factor receptor family and a novel secreted protein, and it is a negative regulator of osteoclast differentiation, activation, and survival both in vitro and in vivo. In the present study we used a model in which human LNCaP prostate cancer cells that give rise to osteoblastic bone tumors were injected directly into the intramedullary space of human adult bone implanted into nonobese diabetic/severe combined immunodeficient mice to investigate whether the new bone-resorption inhibitor osteoprotegerin/OCIF would inhibit the development of new bone tumors and the progression of established osteoblastic bone tumors. The mice were given consecutive daily s.c. injections of recombinant human OCIF (rhOCIF; 100 micro g/mouse/day) for 2 weeks starting either immediately or 2 weeks after injection of the LNCaP cells. In both protocols, rhOCIF markedly inhibited both the development of bone tumors and the progression of established bone tumor foci quantified by histological examination. Histomorphometrical analysis revealed that rhOCIF markedly reduced the number of osteoclasts and the size of the tumors at the bone sites, but that it had no effect on the local growth of s.c. LNCaP tumors or on LNCaP cell proliferation in culture. These findings demonstrate that osteoclasts play an important role in bone tumor by prostate cancer, and that rhOCIF decreases the LNCaP prostate cancer burden selectively in bone, suppresses the progression of established tumor lesions, and prevents the development of new lesions. These results suggest that inhibition of osteoclastic bone resorption may be an effective therapy for the treatment of prostate cancer that has colonized bone.

Animals↗

PubMed2003

Ascending and descending brainstem neuronal activity during cystometry in decerebrate cats.

AIMS: This study was undertaken to examine the distribution of pontomedullary neurons related to micturition or urine storage, as well as the connections between the pontine micturition center (PMC), medullary neurons, and the spinal cord. METHODS: In decerebrate cats, extracellular recording of the rostral pontine and rostral medullary neurons was performed. Firing of each neuron was quantitated during cystometry. Connections between the PMC, medullary neurons, and the spinal cord (L1) were also examined electrophysiologically. RESULTS: Ninety-four neurons showed an increase or decrease of the firing rate during micturition. Units with an antidromic response to L1 stimulation and an increased firing rate were located in the nucleus locus coeruleus alpha (LCa; n = 8) corresponding to the PMC, and in the medial reticular formation (MRF) of the medulla (n = 14). Units showing a decreased firing rate were located in the nucleus reticularis pontis oralis (PoO; n = 26) and in the MRF (n = 11). The latencies of antidromic and orthodromic responses of the LCa units were longer than those of the PoO units. MRF neurons responded antidromically and/or orthodromically to stimulation of the PMC or L1. CONCLUSIONS: These results suggest that the pathway concerned with urine storage has a faster spinobulbospinal loop than the micturition reflex pathway and that rostral medullary neurons also play an important role in micturition and urine storage. There may be two descending pathways between the PMC and the spinal cord: both a direct pathway and one by means of medullary neurons.

Animals↗

PubMed2003

Inhibitory effect of intrathecal glycine on the micturition reflex in normal and spinal cord injury rats.

We examined the influence of lumbosacral glycinergic neurons on the spinobulbospinal and spinal micturition reflexes. Female rats were divided into intact rats, rats with acute injury to the lower thoracic spinal cord (SCI), and rats with chronic SCI. Under urethane anesthesia, isovolumetric cystometry was performed in each group before and after intrathecal (IT) injection of glycine or strychnine into the lumbosacral cord level. The glutamate and glycine levels of the lumbosacral cord were measured after injection of glycine or strychnine in intact and chronic SCI rats. Expression of strychnine-sensitive glycine receptor alpha-1 (GlyR alpha1) mRNA in the lumbosacral cord was also assessed in both rats. In chronic SCI rats, the interval and amplitude of bladder contractions were shorter and smaller when compared with intact rats. IT glycine (0.1-100 microg) prolonged the interval and decreased the amplitude of bladder contractions in both intact rats and chronic SCI rats. IT strychnine (0.01-10 microg) elevated the baseline pressure in intact rats and induced bladder contraction in acute SCI rats. On amino acid analysis, IT glycine (0.01-100 microg) decreased the glutamate level of the lumbosacral cord in intact rats, but not in chronic SCI rats. The glycine level of the lumbosacral cord was 54% lower in chronic SCI rats when compared with intact rats, while the GlyR alpha1 mRNA level did not change after SCI. These results suggest that glycinergic neurons may have an important inhibitory effect on the spinobulbospinal and spinal micturition reflexes at the level of the lumbosacral cord.

Acute Disease↗

PubMed2003

Transabdominal vesical sonography of urethral syndrome and stress incontinence.

BACKGROUND: Transabdominal ultrasonography was used to study the bladder neck morphology in women with urethral syndrome or stress urinary incontinence, in order to determine the ultrasonographic findings of these conditions. METHODS: A total of 210 female patients with a normal bladder, asymptomatic trigonitis, urethral syndrome, and stress incontinence were studied. The mucosal thickness around the bladder neck, the length of the anterior base plate of the bladder, and the anteroposterior vesical wall angle (APVA) at the bladder neck were measured on sagittal transabdominal vesical ultrasonograms with the patient in the supine position. RESULTS: Patients with asymptomatic trigonitis or urethral syndrome had thicker mucosa around the bladder neck than the subjects with a normal bladder, and the subjects with stress incontinence had normal mucosa. The APVA was 158 +/- 17 (mean +/- SD) degrees in the subjects with a normal bladder. It was smaller in symptomatic patients and decreased to 109 +/- 10 degrees in those with conservative therapy-resistant incontinence. The anterior edge of the vesical base plate was visible approximately 2 cm from the bladder neck in subjects without incontinence, while it tended to be absent in patients with incontinence and an APVA of less than 126 degrees. CONCLUSION: A small APVA appears to reflect bladder neck descent, while a small APVA without a visible anterior base plate edge may reflect hypotonia of the vesical base plate. Transabdominal vesical ultrasonography with the patient in the supine position provides useful information and can be carried out as a routine examination in female patients with micturition disorders.

Adult↗

PubMed2003

Urinary oxalic acid excretion differs after oral loading of rats with various oxalate salts.

BACKGROUND: To compare urinary oxalate excretion after the oral administration of oxalic acid, disodium oxalate, or calcium oxalate in rats. METHODS: Male Wistar rats were divided into four groups of six rats each and were intravenously hydrated with normal saline, and then were administered normal saline (control group), 10 mg of oxalic acid, equimolar disodium oxalate, or equimolar calcium oxalate via a gastrostomy. Urine specimens were collected just before administration and at hourly intervals up to 5 h afterwards. The urinary oxalate, calcium, magnesium and phosphorus levels were measured. RESULTS: Urinary oxalate excretion peaked at 1-2 h after administration of oxalic acid or equimolar disodium oxalate, while administration of calcium oxalate only caused a small increase of urinary oxalate excretion. Cumulative urinary oxalate excretion during 5 h was 1.69 +/- 0.10 mg (mean +/- SD; 17%), 1.43 +/- 0.13 mg (13%), and 0.22 +/- 0.03 mg (2%) after the administration of oxalic acid, disodium oxalate, and calcium oxalate, respectively. Urinary calcium excretion showed a decrease in the oxalic acid and disodium oxalate groups, while urinary magnesium or phosphorus excretion did not change significantly. CONCLUSION: The upper gastrointestinal tract seems to be the major site of oxalic acid absorption and only free oxalate is absorbed irrespective of whether it is the sodium salt or not. After binding to calcium in the gut, oxalic acid absorption seems to be inhibited in the presence of calcium and this means that calcium oxalate is poorly absorbed (at least in the upper gastrointestinal tract).

Administration, Oral↗

PubMed2003

Urolithiasis in Okinawa, Japan: a relatively high prevalence of uric acid stones.

AIM: The aim of the present study was to investigate the composition of urinary tract stones in patients from Okinawa, the most southern island group of Japan. METHODS: The study was conducted by 12 hospitals in Okinawa. A total of 1816 urinary tract calculi were obtained from 1816 patients (1323 males; 493 females). The patients had a mean age of 53 +/- 15.3 years (mean +/- SD). The calculi were examined to determine their chemical composition. Stone samples were analyzed by computed infrared spectrophotometer. RESULTS: Pure stones comprised 58.4% of the total, with calcium oxalate stones accounting for 40% (21% monohydrate [whewellite]; 6.6% dihydrate [weddellite]; and 12.4% combined monohydrate and dihydrate stones), uric acid/urate stones for 9.6%, calcium phosphate stones for 5.1%, and struvite stones for 3.7%. The other 41.6% of the stones consisted of calcium oxalate mixed with other components. The male-to-female ratio was 2.7:1. CONCLUSION: In our series, calcium oxalate stones accounted for 81.6% of the urinary tract calculi, while uric acid/urate stones accounted for 15.8%. Uric acid stones, predominantly the anhydrous and/or dihydrate forms, showed a relatively high prevalence. Calcium oxalate stones, predominantly in the form of whewellite, showed a high prevalence among pure calculi; while the predominant combinations among mixed calculi were weddellite + calcium phosphate and whewellite + uric acid/urate.

Adolescent↗

PubMed2003

Device to promote pelvic floor muscle training for stress incontinence.

AIM: Many patients with stress urinary incontinence do not have enough motivation to continue pelvic floor muscle training (PFMT) by themselves. Therefore, a device was created to support PFMT, and its effect was examined. METHODS: Forty-six women with stress urinary incontinence were assigned to a control group or a device group in order of presentation. A pamphlet on PFMT was given to control patients, while the same pamphlet plus the device and instructions on its use were given to patients in the device group. The device had a chime that was set to sound three times a day when exercise sessions were scheduled. PFMT consisted of fast and slow pelvic floor muscle contraction exercises that were performed for 2 min and followed a rhythm set by the device. RESULTS: After 8 weeks, 20 patients from the control group and 21 patients from the device group could be evaluated. In the control group, only the quality of life (QOL) index improved significantly. In the device group, however, the daily number of incontinence episodes, the number of pads used daily, the QOL index, and the pad weight in the pad test improved significantly. Patients in the device group said that they felt obligated to perform PFMT when the chime sounded. Forty-eight percent of patients from the device group were satisfied with the outcome of PFMT, while only 15% were satisfied in the control group. CONCLUSION: This device may be useful to support the management of stress urinary incontinence.

Adult↗

PubMed2003

Control of oxalate formation from L-hydroxyproline in liver mitochondria.

Serine:pyruvate/alanine:glyoxylate aminotransferase (SPT/AGT) is largely located in mitochondria in carnivores, whereas it is entirely found within peroxisomes in herbivores and humans. In rat liver, SPT/AGT is found in both of these organelles, and only the mitochondrial enzyme is markedly induced by glucagon. Although SPT/AGT is a bifunctional enzyme involved in the metabolism of both L-serine and glyoxylate, its contribution to L-serine metabolism is independent of mitochondrial or peroxisomal localization (Xue HH et al., J Biol Chem 274: 16028-16033, 1999). Therefore, the species-specific and food habit-dependent organelle distribution might be required for proper metabolism of glyoxylate at the subcellular site of its formation. Glyoxylate formation from glycolate and that from L-hydroxyproline have been shown to occur in peroxisomes and mitochondria, respectively. The present study found that urinary excretion of oxalate was markedly increased when a large dose of L-hydroxyproline or glycolate was administered to rats. Oxalate formation from L-hydroxyproline but not that from glycolate was significantly reduced when mitochondrial SPT/AGT had been induced by glucagon. The hydroxyproline content of collagen is 10 to 13%, and collagen accounts for about 30% of total animal protein; therefore, these results suggest that an important role of mitochondrial SPT/AGT in carnivores is to convert L-hydroxyproline-derived glyoxylate into glycine in situ, preventing undesirable overflow into the production of oxalate.

Animals↗

PubMed2003

Hepatic alanine-glyoxylate aminotransferase activity and oxalate metabolism in vitamin B6 deficient rats.

PURPOSE: Urinary oxalate has an important role in the formation of calcium oxalate stone and approximately 50% to 60% of urinary oxalate is derived from the endogenous metabolism of glyoxylate. Glyoxylate is enzymatically converted to glycine by alanine-glyoxylate aminotransferase in the liver and vitamin B6 has a key role as a coenzyme. Therefore, we evaluated hepatic alanine-glyoxylate aminotransferase activity and oxalate metabolism in vitamin B6 deficient rats. MATERIALS AND METHODS: A total of 12 male Wistar rats were fed a control or a vitamin B6 deficient diet. After 4 weeks creatinine, oxalate, glycolate, glycine and citrate in the urine, and alanine-glyoxylate aminotransferase activity and its mRNA level in the liver were measured. RESULTS: Urinary oxalate-to-creatinine and glycolate-to-creatinine ratios were significantly higher in vitamin B6 deficient rats than in control rats but urinary glycine-to-creatinine and citrate-to-creatinine ratios were significantly lower. Hepatic alanine-glyoxylate aminotransferase activity and its mRNA level were significantly lower in vitamin B6 deficient rats than in control rats. CONCLUSIONS: Vitamin B6 deficiency not only decreased alanine-glyoxylate aminotransferase activity, but also down-regulated alanine-glyoxylate aminotransferase gene expression by hepatocytes and led to hyperoxaluria and hyperglycolic aciduria secondary to impaired metabolism of oxalate precursors. Hyperoxaluria with hypocitruria may also contribute to calcium oxalate stone formation in vitamin B6 deficiency.

Animals↗

PubMed2002

Capillary electrophoresis assay of alanine:glyoxylate aminotransferase activity in rat liver.

We measured hepatic alanine:glyoxylate aminotransferase (AGT) activity using capillary electrophoresis. After rat liver homogenate was incubated in the presence of substrates and pyridoxal 5'-phosphate, the pyruvate and glycine produced by AGT were measured. The AGT activity was 10.02+/-0.31 micro mol pyruvate/h/mg protein and 10.21+/-0.15 micro mol glycine/h/mg protein. This method is relatively simple and shows superior sensitivity, allowing the measurement of enzyme activity in 5 micro g of protein. Therefore, it appears to be suitable for laboratory use and may also have advantages for measuring AGT activity in liver biopsy specimens.

Animals↗

PubMed2002

Effects of intrathecal injection of tamsulosin and naftopidil, alpha-1A and -1D adrenergic receptor antagonists, on bladder activity in rats.

The effects of intrathecal injection of tamsulosin (an alpha-1A adrenergic receptor antagonist) and naftopidil (an alpha-1D adrenergic receptor antagonist) on isovolumetric bladder contraction were investigated in rats under urethane anesthesia. Intrathecal injection of tamsulosin (10-30 microg) or naftopidil (0.1-30 microg) transiently abolished isovolumetric rhythmic bladder contraction. Following the recovery of bladder contraction, the interval between contractions was the same as the control value before the injection. The amplitude of bladder contraction was decreased by intrathecal injection of naftopidil (3-30 microg), but not by tamsulosin. Therefore, in addition to the antagonistic action of these agents on the alpha-1 adrenergic receptors of prostatic smooth muscle, both agents (especially naftopidil) may also act on the lumbosacral cord, and thus may improve collecting disorders in patients with benign prostatic hyperplasia.

Adrenergic alpha-1 Receptor Antagonists↗

PubMed2002

Biochemical and morphological effects of bladder pumping on the urinary bladder in rats.

AIMS: To study the influence of bladder pumping on the urinary bladder in 44 female rats. METHODS: Under halothane anesthesia, a urethral catheter was inserted into the bladder of 27 rats, and air (0.4-0.8 mL) was pumped in and out of the bladder at 0.5 cycles/second for a period of 5 minutes. Twenty-four hours after pumping, the bladder was harvested for measurement of the tissue levels of myosin, actin, and nerve growth factor, as well as for electron microscopy. In nine of the 27 rats, cystometry was performed without anesthesia before and 1, 7, 30, and 90 days after bladder pumping. The remaining 17 rats that did not undergo pumping were anesthetized and their bladders were harvested as a control. RESULTS: Bladder pumping increased the bladder capacity and decreased the maximum bladder contraction pressure, but did not increase the residual volume. Bladder pumping also increased the tissue level of nerve growth factor and decreased the levels of myosin and actin. Electron microscopy showed degeneration of bladder smooth muscle cells and nerve fibers after bladder pumping, as well as derangement and disruption of collagen fiber bundles in the bladder wall. These functional and morphological effects of pumping disappeared within 90 days. CONCLUSIONS: Bladder pumping therapy appears to have various effects on the bladder wall collagen fiber bundles, smooth muscle cells, and nerves.

Actins↗

PubMed2002

Molecular analysis of adrenergic receptor genes and interleukin-4/interleukin-4 receptor genes in patients with interstitial cystitis.

PURPOSE: Interstitial cystitis is a chronic and sterile inflammatory disease of the bladder. Clinically many patients with interstitial cystitis also have allergic or autoimmune diseases. Recent studies have suggested that allelic variations in the adrenergic receptor beta2 gene, the interleukin (IL)-4 gene and its receptor gene are closely associated with immune diseases. Therefore, we studied adrenergic receptor genes alpha1d (ADRA1d), beta2 (ADRB2) and beta3 (ADRB3), and IL-4/IL-4 receptor genes in patients with interstitial cystitis. MATERIALS AND METHODS: We studied 55 patients with interstitial cystitis and 228 controls. Genomic DNA was extracted from a whole blood sample collected from each subject. We analyzed 5 gene polymorphisms (G404781T, Arg16Gly, Trp64Arg, C589T and Ile50Val) per gene (ADRA1d, ADRB2, ADRB3, IL-4 and IL-4 receptor, respectively) and their relationship to interstitial cystitis. RESULTS: The frequency of the Arg/Arg genotype of the ADRB2 gene and the TT genotype of the IL-4 gene were significantly higher in patients with interstitial cystitis than in controls. A significant difference of ADRA1d genotype prevalence was also observed. However, there were no remarkable differences of IL-4 receptor or ADRB3 genotype prevalences. CONCLUSIONS: Variants of the ADRB2, ADRA1d and IL-4 genes may be related to a predisposition to interstitial cystitis.

Cystitis, Interstitial↗

PubMed2002

Ultrasonographic changes of the female bladder neck during development.

BACKGROUND: Our previous study showed that the anteroposterior vesical wall angle (APVA) at the bladder neck on transabdominal ultrasonography varied widely between women. The present study examines whether the APVA changes during development in girls with a normal bladder. METHODS: Seventy-four females aged 0-29 years with normal bladders were examined by transabdominal ultrasonography. They were divided into six age groups and their APVA was measured in the supine position by sagittal ultrasonography. Intravenous urography was conducted to examine bladder neck descent and bladder neck opening. RESULTS: The APVA ranged from 85 to 200 degrees. The mean APVA in girls aged 0-4 years was 129 +/- 30 degrees (+/-SD) and the mean APVA in girls aged 5-9 years was 135 +/- 25 degrees. The mean APVA at ages 10-14 years was 161 +/- 26 degrees; at 15-19 years, 164 +/- 33 degrees; at 20-24 years, 164 +/- 18 degrees; and at 25-29 years, 163 +/- 16 degrees. The APVA values of these four groups were significantly larger (P < 0.05) than those of the two younger groups. No bladder abnormalities were found on intravenous urography. CONCLUSION: The APVA was small in some girls under 10 years of age, but the APVA of girls aged over 10 years was similar to that in young adults. The APVA may reflect bladder base plate tone and be partially related to hormonal changes in females during development.

Adolescent↗

PubMed2002

Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971-2000).

BACKGROUND: The clinical demographics of chronic dialysis patients are changing worldwide. However, long-term data from regional dialysis registries have not yet been analyzed and reported. METHODS: The Okinawa Dialysis Study (OKIDS) registry included all chronic dialysis patients treated in Okinawa, Japan, since 1971. Data for the years 1971 to 1990 were analyzed to predict trends for 1991 to 2000. The predicted values were then compared to the actual values and analyzed statistically, with particular attention being paid to relative risk of death. Multivariate Cox proportional hazards analysis was done to analyze the time factors of relative risk of death. RESULTS: A total of 5246 patients (2981 men and 2265 women) were registered and the total duration of observation was 28,431 patient-years. The prevalence and incidence of dialysis patients expressed per million population were 2320 and 297, respectively, in 2000, values that were significantly higher (P < 0.02 for both) than the predicted values. The gross mortality rate per 1000 patient-years was 118.4 for 1971 to 1980, 63.3 for 1981 to 1990, and 77.7 for 1991 to 2000. The adjusted hazards ratio (95% confidence interval) for mortality was 0.743 (0.650 to 0.862) for 1981-1990 and 0.721 (0.659 to 0.790) for 1991 to 2000 in comparison to the risk of mortality in 1971 to 1980. The decrease in mortality rate was largely due to the drop in cardiac deaths from 71.0 for 1971 to 1980 to 17.2 for 1991 to 2000. CONCLUSIONS: The incidence and prevalence of chronic dialysis patients increased more than expected over the past decade in Okinawa, Japan. Despite the rapid change in patient demographics, the survival rate did not decrease significantly.

Adolescent↗

PubMed2002

[Risk factors for duration of urinary incontinence after radical prostatectomy].

PURPOSE: In this study, we examined risk factors for duration of incontinence after radical prostatectomy at our hospital. MATERIALS AND METHODS: From April 1988 to March 2000, 45 patients with prostate cancer underwent retropubic radical prostatectomy at our hospital. Thirty-eight of 45 patients could be followed up. The patients' age, height, weight, body mass index (BMI), preoperative prostatic specific antigen level, clinical stage, nerve-sparing surgery or none, operation time, bleeding volume, resected prostate weight, cancer positive or negative at surgical margins, postoperative stage, radiation therapy or none, anti-androgen therapy or none, duration of postoperative incontinence, and follow-up period were examined. RESULTS: All patients had postoperative stress incontinence, and no one had urge incontinence. Medians of duration of postoperative incontinence and follow-up period were 5.5 and 12 months, respectively. When the patients were divided into 2 groups by the value of each parameter, postoperative anti-androgen therapy (chi 2 test, p = 0.0429) and high BMI (> or = 25.0 kg/m2, p = 0.0206) were related to the long duration (> or = 5.5 months) of postoperative incontinence. CONCLUSION: These results suggest that common factors are involved in the etiology of prolonged incontinence after radical prostatectomy and genuine stress incontinence in women. Therefore, both body weight control and pelvic floor muscle exercise might be also important for the treatment of incontinence after radical prostatectomy.

Aged↗