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PubMed1997

A posterior lumbar approach for retroperitoneoscopic adrenalectomy: assessment of surgical efficacy.

OBJECTIVES: To compare the efficacy of retroperitoneoscopic adrenalectomy by a posterior lumbar approach (RPA) with that obtained by a transperitoneal anterior approach (TAA) or retroperitoneal lateral flank approach (RLA). METHODS: Fifty-one patients underwent endoscopic adrenalectomy by three approaches, including laparoscopic adrenalectomy by TAA in 33, retroperitoneoscopic adrenalectomy by RLA in 5, and retroperitoneoscopic adrenalectomy by RPA in 13. RESULTS: The average adrenal tumor size was 27 mm (range 8 to 65). The average number of trocars required for RPA was 3.2 which was significantly less than that for TAA and for RLA (4.2 and 4.1, respectively). The conversion rate to open surgery was 9.1% by TAA, 0% by RLA, and 7.7% by RPA. The average operating time for TAA was 252 minutes, which was significantly shortened to 194 minutes by RLA and 142 minutes by RPA (P < 0.02). The average blood loss was 101 mL for TAA and was negligible by RLA and RPA (22 and 32 mL. respectively). CONCLUSIONS: RPA allowed direct access to the main adrenal vascular supply before the gland was greatly manipulated. Endoscopic adrenalectomy by TAA or even by RLA required extra ports for retraction of liver, spleen, vena cava, or adrenal gland, with higher chance of vein avulsion. RPA was technically feasible and most effective for retroperitoneoscopic adrenalectomy in regard to the simplicity of vascular control. The operating time, perioperative morbidity, and cost were reduced with this approach.

Adrenal Gland Neoplasms↗
PubMed1999

Long-term results of treatment of benign central venous obstructions unrelated to dialysis with expandable Z stents.

PURPOSE: To evaluate long-term patency of self-expanding Z stents for treatment of benign central venous obstructions unrelated to dialysis. MATERIALS AND METHODS: Z stents were placed in 19 patients, (ages 26-72 years) with severe symptomatic obstructions of the superior or inferior venae cavae and their large branches and portal vein caused by surgical or catheter injury (n = 8), fibrosis (n = 5), cirrhosis (n = 3), Budd-Chiari syndrome (n = 2), and extrinsic compression (n = 1). Fourteen patients underwent stent placement primarily, five after local urokinase infusion for superimposed thrombosis. Follow-up was performed with ultrasound and venography. RESULTS: Venous congestive symptoms quickly resolved in all patients after stent placement. The follow-up period was from 1 to 94 months. Twelve patients have died during follow-up from 1 to 37 months although all remained asymptomatic until death. Six patients remain alive, asymptomatic, with patent stents, and with follow-up from 24 to 94 months. Primary patency was 83%, and secondary patency was 100%. One patient with a patent stent at 12 months was lost to follow-up. No stent migrations, perforations, infections, or significant complications occurred. CONCLUSION: Benign central venous obstructions are effectively treated by the placement of self-expandable Z stents. Placed percutaneously into obstructive lesions with a minimum risk, these stents offer long-term durability and patency.

Adult↗
PubMed1999

Fecal eosinophil granule-derived proteins reflect disease activity in inflammatory bowel disease.

OBJECTIVES: The aims of this study were: 1) to examine whether the fecal levels of eosinophil granule-derived proteins reflect disease activity in inflammatory bowel disease (IBD); and 2) to examine the extracellular release of these proteins from eosinophils and their stability in feces by an in vitro study. METHODS: We investigated 42 patients with ulcerative colitis (UC), 37 patients with Crohn's disease (CD), and 29 control subjects. The stool samples were collected at 4 degrees C over 48 h and were homogenized. The fecal levels of eosinophil cationic protein (ECP) and eosinophil protein X (EPX) were measured by radioimmunoassay. Fecal Hb (Hb), alpha1-antitrypsin (AT), and lactoferrin (Lf) were also measured by ELISA. RESULTS: Fecal ECP and EPX concentrations were significantly increased in both active UC and active CD compared to inactive UC and inactive CD, respectively. Fecal EPX concentration correlated with the fecal Hb, AT, and Lf concentrations more closely than fecal ECP concentration. Even in the inactive stage, CD patients who relapsed within the following 3 months showed higher fecal ECP and EPX concentrations compared to the patients who did not. EPX was released extracellularly more efficiently than ECP (18.6% vs 6.3%, after incubation for 15 min at 25 degrees C). EPX was more stable in the feces than ECP. CONCLUSIONS: The measurement of eosinophil granule-derived proteins in feces is useful for evaluating disease activity and predicting relapse in patients with IBD. EPX may be more suitable than ECP as a fecal eosinophil marker.

Adult↗
PubMed2000

Retinal ganglion cell death in experimental glaucoma.

AIMS: To determine whether parasol retinal ganglion cells (magnocellular pathway) are selectively lost in the primate model of glaucoma. METHODS: Ocular hypertension was induced in one eye of six Macaca fascicularis monkeys for 6-14 weeks. The retinal ganglion cells in these eyes were labelled retrogradely with the tracer horseradish peroxidase (HRP) implanted into the optic nerve and subsequently examined in retinal whole mount preparations. The degree of retinal ganglion cell loss was estimated from Nissl stained tissue by comparison with the contralateral untreated control eye. RESULTS: In the three glaucomatous retinas with the best labelling 1282 cells could be classified, of which 182 were parasol cells and 1100 were midget cells. Linear regression analysis did not demonstrate a significant reduction in the proportion of parasol to midget cells with increasing cell loss (regression slope 0.023, 95% CI -0.7 to 0.11). Compared with the control eye the cell soma of the remaining retinal ganglion cells in glaucomatous eyes were reduced in size by 20% for parasol cells (p=0.003) and by 16% for midget cells (p <0.001). CONCLUSION: The results of this study do not support the hypothesis that selective loss of parasol retinal ganglion cells occurs in experimental glaucoma. In addition, the change in cell soma size distributions following ocular hypertension suggests that both parasol and midget retinal ganglion cells undergo shrinkage before cell death.

Animals↗
PubMed1995

Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines.

PURPOSE: The purpose of this study was the evaluation of various factors in the formulation of guidelines for treatment of early invasive colorectal cancer, in which malignant cells extend through the muscularis mucosa into the submucosa but do not deeply invade the muscularis propria. METHOD: A total of 182 patients were followed for at least five years or until death, with early invasive cancer diagnosed between 1982 and 1989. Patients were grouped according to the level of invasion, as follows: 64 patients with slight carcinoma invasion of the muscularis mucosa (200-300 microns; sm1), 82 with intermediate invasion (sm2), and 36 with carcinoma invasion extending to the inner surface of the muscularis propria (sm3). RESULT: The configuration, diameter, and histologic grade of adenocarcinoma and lymphovascular invasion were correlated with level of invasion. After endoscopic polypectomy or local resection, 4 patients showed local recurrence and 13 patients showed lymph node metastasis. None of these 17 patients had sm1 disease. The level of invasion, configuration, and location were significant risk factors for development of lymph node metastasis or local recurrence (P < 0.05), but lymphovascular invasion, histologic grade, and diameter were not risk factors. CONCLUSIONS: Preoperative assessment of the level of invasion using this classification, in which the submucosa is divided into three depths, may decrease the incidence of unnecessary surgery for sessile polyps. Assessment according to the level of invasion is useful in the formulation of appropriate guidelines for the treatment of early invasive cancer.

Adenocarcinoma↗
PubMed1999

Three-dimensional reconstruction of the ventral and dorsal pancreas: a new insight into anatomy and embryonic development.

The recent introduction of limited resections of the ventral pancreas for benign disease and for low-grade malignancies calls for a thorough understanding of its anatomy. The two embryonic anlagen were characterized and distinguished through a comprehensive study of their macroscopic, histologic, and immunohistochemical characteristics in 20 autopsy specimens before reconstruction. Sections were histologically stained with hematoxylin-eosin and Grimelius and immunohistochemically stained with antibodies to insulin, glucagon, somatostatin, and pancreatic polypeptide by the avidin biotin complex method. The ventral and dorsal anlagen of the pancreas were reconstructed from eight autopsy specimens, using the "macroserial" method, after serial sectioning and immunohistochemical staining with anti-pancreatic polypeptide antibodies. Compared with the dorsal pancreas, the ventral pancreas was characterized by the presence of smaller and more closely packed lobuli, irregular rather than uniform islets of Langerhans, and rich immunostaining with anti-pancreatic polypeptide. Construction of the two anlagen showed that the dorsal pancreas consisted of the anterior part of the head of the pancreas, and the body and tail of the pancreas, while the ventral pancreas consisted of the posterior part of the head of the gland and the upper two-thirds (62.5%) or all (37.5%) of the uncinate process. The ventral pancreas was related to the right lateral surface of the superior mesenteric vein extending to the back. However, it did not extend across the front surface of the superior mesenteric vein to the left as previously described. The uncinate process was also located posterior to but not anterior to the superior mesenteric vein. The contributions of the ventral and dorsal anlagen to the anatomy of the pancreas gland as demonstrated in this study differ, in some relevant features, from the classical descriptions in the medical literature. The current anatomical findings add essential knowledge for the pancreatic surgeon who contemplates tissue-preserving resections.

Adolescent↗
PubMed2005

Midterm follow-up study of high-type imperforate anus after laparoscopically assisted anorectoplasty.

PURPOSE: The aim of this study was to evaluate postoperative anal function of high-type imperforate anus after laparoscopically assisted anorectoplasty (LAARP). METHODS: Between 2000 and 2002, LAARP was performed in 13 patients with high-type imperforate anus. Clinical data of the LAARP group were compared with the posterior sagittal anorectoplasty (PSARP) group (n = 7) operated before 2000. All patients were treated with initial colostomy in the newborn period. After anorectoplasty, daily glycerin enemas were given for postoperative bowel management. Anorectal function of these patients was evaluated using the Kelly score and manometry at the age of 3 to 5 years (LAARP) and 5 to 6 years (PSARP). RESULTS: Age at evaluation in the LAARP group was younger than that in the PSARP group (51 +/- 10 vs 73 +/- 12 months, P < .01). Kelly score was 3.8 +/- 1.3 vs 3.4 +/- 0.8, respectively. Resting pressure of internal sphincter was 31 +/- 11 vs 33 +/- 10 cm H(2)O, respectively. Relaxation reflex of the internal anal sphincter was observed in 62% (8/13) and 29% (2/7), respectively. CONCLUSIONS: Midterm follow-up study revealed that satisfactory fecal continence can be achieved in patients with high-type imperforate anus after LAARP. Laparoscopically assisted anorectoplasty may be a good alternative in this patient population. However, long-term follow-up is necessary to compare the benefits of LAARP against PSARP.

Anal Canal↗
PubMed2001

A method for standardizing jaw displacements in the horizontal plane while recording single motor unit activity in the human lateral pterygoid muscle.

The normal function of the lateral pterygoid muscle is not well understood although this muscle is thought to play an important role in the control of jaw and jaw-joint function and is implicated in temporomandibular disorders (TMD). The lack of a validated method for standardization of jaw movement in studies of lateral pterygoid function has contributed to the lack of understanding of the normal function of this muscle. An improved understanding of normal function will allow valid comparisons to be made with TMD patients in order to identify whether purported differences in activity actually exist. This paper describes a methodology for standardizing command jaw movements in the horizontal plane, together with reliable recordings of single-motor-unit (SMU) activity. In six human participants, jaw movements were standardized by having participants track a linear bank of light-emitting diodes (LEDs) aligned on a monitor displaying the mid-incisor point (MIPT). In all participants, the MIPT target (i.e. an illuminated LED) could be tracked, according to a pre-determined criterion, during single- and multiple-step displacements at different rates (1.3--6.5 mm/s at MIPT) and magnitudes (0.65--12 mm) of movement. SMU activity from the superior (SHLP) or inferior (IHLP) head of the lateral pterygoid muscle could be reliably discriminated during repeated trials of these defined tasks. This methodology establishes a reliable technique for characterizing the firing properties of SMUs within the lateral pterygoid, and has implications for analogous studies in other jaw muscles.

Adult↗
PubMed2004

Longevity-associated mitochondrial DNA 5178 A/C polymorphism is associated with intraocular pressure in Japanese men.

BACKGROUND: Mitochondrial DNA 5178 adenine/cytosine (mt5178 A/C) polymorphism has been reported to be associated with longevity in Japanese individuals, with experimental findings concluding that mt5178 A is an anti-atherogenic genotype. The aim of this study was to determine whether mt5178 A/C polymorphism influences intraocular pressure (IOP), and its relationship with the development of arteriosclerosis. METHODS: Four hundred and forty-nine male volunteers who had visited a general hospital for medical check-up between August 1999 and August 2000 were enrolled. Of these, 386 Japanese men who had not undergone any medical treatment for hypertension, ocular hypertension or glaucoma were selected as subjects of this study. After these subjects were genotyped, a cross-sectional study regarding the relationship between genotype and IOP was conducted. RESULTS: Mean IOP was significantly higher in men with mt5178 C (13.3 mmHg) than in those with mt5178 A (12.7 mmHg) (P = 0.037). This significant difference in mean IOP between the two genotypes remained evident after adjusting for age, body mass index, blood pressure, habitual smoking and habitual drinking. Interactions between mt5178 A/C polymorphism and habitual smoking or daily alcohol consumption with regard to IOP were observed. According to multiple regression analysis, habitual smoking was significantly associated with IOP in men with mt5178 A (P for trend = 0.020), while daily alcohol consumption was significantly associated with IOP in those with mt5178 C (P for trend = 0.021). CONCLUSION: Longevity-associated mitochondrial DNA 5178 A/C polymorphism may be associated with IOP in Japanese men.

Blood Pressure↗
PubMed2004

The damaging effect of UV-C irradiation on lens alpha-crystallin.

PURPOSE: To evaluate the effect of UV-C irradiation on the structural properties of alpha-crystallin and its chaperone activity. METHODS: alpha- and betaL-crystallins were isolated from bovine lenses using gel chromatography. The purified alpha-crystallin was subjected to UV-C irradiation (254 nm; 1, 2, 5, 10, 20, 50 J/cm2). We measured the tryptophan fluorescence, circular dichroism (CD) spectroscopy in the far UV, and the chaperone activity of both irradiated and non-irradiated alpha-crystallin. RESULTS: The tryptophan fluorescence of alpha-crystallin decreased, whereas the N-formylkynurenine fluorescence increased markedly with increasing doses of UV-C irradiation. Both the oxidation of Met1 and the racemization of Asp151 of alphaA-crystallin increased at a dose of 1-2 J/cm2 and then gradually decreased. The CD spectrum showed that the secondary structure of alpha-crystallin altered with increasing radiation dose, and almost all of the beta-sheet structure was lost at doses above 50 J/cm2. The chaperone activity of alpha-crystallin irradiated with doses under 5 J/cm2 remained intact. However, it was reduced to only 40% after irradiation at 10 J/cm2. CONCLUSIONS: Our study suggests that photo-oxidation of tryptophan residues in alpha-crystallin may be one of the events that affects the three-dimensional packing array and chaperone activity of this lens protein.

Animals↗
PubMed1993

A study on cerebral nicotine receptor distribution, blood flow, oxygen consumption, and other metabolic activities--a study on the effects of smoking on carotid and cerebral artery blood flow.

We investigated middle cerebral artery flow velocity (MCA-FV) by a noninvasive method to determine whether or not smoking causes an increase in cerebral blood flow (CBF). Furthermore we determined sequentially the changes in CBF caused by smoking in order to evaluate changes in responses at different times in daily activities and the effect from meals. The subjects were 25 healthy individuals ranging in age from 20 to 36 yr. MCA-FV was measured by a transcranial Doppler system. They smoked a filtered cigarette for 5 min at 1 P.M., 3 P.M., 6 P.M., 8 P.M., 10 P.M., 8 A.M., and 11 A.M. Results (1) Smoking caused increases in both common carotid artery flow volume and MCA-FV, and the percentage increase of these parameters showed a good correlation (r = 0.809). (2) MCA-FV increased significantly during the first (by 6.6%) and second halves (by 5.4%) of the smoking period. (3) The change in MCA-FV after meals was slight. (4) Smoking tended to increase MCA-FV during each smoking session but the changes were not significant. The pulsatility index reduced significantly during almost every smoking session. These results lead to the conclusion that smoking reduces vascular resistance in cerebral arteries and increases CBF.

Adult↗
PubMed1996

[Dynamic study of the liver with helical scanning: determination of hepatic contrast enhancement in routine studies].

Helical CT makes possible imaging of the entire liver in as few as 20 seconds during a single breath hold. This method is thus superior to conventional dynamic CT. In this study, optimal late scanning time and optimal volume of contrast medium in the liver were determined with helical CT in routine studies. (1) Optimal late scanning time In 50 cases, CT images of the liver were obtained at various times following the administrations of contrast medium (1.4 ml/kg). Scanning was started at 60,90,120,150 and 180 seconds after injection. Enhancement of the liver and detection of hepatic and portal veins were best at 60 seconds, followed at 90 seconds. However, a scanning delay of 60 seconds still had an effect on the arterial phase. The optimal late scanning time was thus concluded to be at 90 seconds. (2) Optimal volume of contrast medium In 40 cases, CT images of the liver were obtained following the administration of various amounts of contrast medium (1.0 ml, 1.2 ml, 1.4 ml, 1.6 ml/kg) to determine the optimal volume. No significant difference was found between 1.6 ml/kg compared and 1.4 ml/kg of administered contrast medium. It is evident from the present data that a scanning delay of 90 seconds appears to be optimal and a contrast medium volume of 1.4 ml/kg (body weight) is best for conducting helical dynamic CT on the liver.

Female↗
PubMed2000

Sonographic features of acute colonic diverticulitis: the "dome sign".

PURPOSE: This study was performed to clarify the sonographic features of acute colonic diverticulitis to enable its differentiation from appendicitis. METHODS: Of 119 patients who were referred to our hospitals for lower abdominal pain between June 1997 and December 1998 and underwent sonography, 12 patients had a definitive diagnosis of acute colonic diverticulitis and 4 patients a tentative diagnosis. Seventy-eight patients were diagnosed as having acute appendicitis, confirmed by appendectomy. In the 16 patients with diagnoses of diverticulitis, the sonographic and clinical features of acute colonic diverticulitis were studied. RESULTS: Among the 12 patients with definitive diagnoses of acute colonic diverticulitis, sonographic findings included localized thickening of the colonic wall (100%) and a hemispheric mass (the "dome sign") protruding at the thickened colonic wall (100%) and consisting of a hypoechoic wall (100%) and a central echogenic area (66%). The presence of diverticula was confirmed by barium-enema x-ray study in all 12 patients. The 4 patients with tentative diagnoses of acute colonic diverticulitis all had colonic wall thickening but no dome sign. Colonoscopy revealed colitis in 3 of these patients. All 16 patients recovered with conservative treatment, without laparotomy. CONCLUSIONS: Sonography was useful for differentiating acute colonic diverticulitis from appendicitis. The sonographic finding of the dome sign seems to be specific for acute colonic diverticulitis.

Abdominal Pain↗
PubMed1992

Three cell lines showing androgen-dependent, -independent, and -suppressed phenotypes, established from a single tumor of androgen-dependent Shionogi carcinoma 115.

We investigated the heterogeneity of cells in terms of androgen responsiveness within a single tumor mass of Shionogi carcinoma SC-115 showing androgen-dependent growth. After cloning of the tumor by the limiting dilution method in the presence of androgen, we isolated 40 clones at random. Twenty-two clones required androgen for growth (androgen-dependent phenotype), 16 did not (androgen-independent phenotype), and the remaining two clones showed growth inhibition when androgen was added (androgen-suppressed phenotype). In addition, 22 androgen-dependent clones showed heterogeneity in growth factor sensitivity in the absence of androgen. All clones were sensitive to both acidic and basic fibroblast growth factor (FGF), 7 of 22 clones were sensitive to epidermal growth factor (EGF) and transforming growth factor (TGF)-alpha, and 2 of 22 clones were sensitive to TGF-beta. This preexisting heterogeneity may be partly responsible for the growth of androgen-dependent tumor under hormone-deprived circumstances. Three typical clones, SC2G, SC1G, and SC4A, were selected from androgen-dependent, -independent, and -suppressed phenotypic groups, respectively. These clones, as well as original solid tumors, were found to produce heparin-binding growth factors of heterogeneous elution positions. The molecular nature of these growth factors is not yet known. Neither anti-basic FGF antibody nor anti-EGF antibody inhibited the cell growth when added in cell culture, suggesting the factors were distinct from basic-FGF and EGF.

Androgens↗
PubMedDate not supplied

Current status of angiography and interventional radiology in Japan: survey results.

PURPOSE: Because the practice of interventional radiology in Japan seems very different from that in western countries, a survey was conducted to define practice patterns and the current position of radiologists in the field of vascular and interventional radiology in Japan. MATERIALS AND METHODS: During the spring of 1992, a questionnaire was mailed to all institutions to which members of the Japanese Society of Angiography and Interventional Radiology belong. RESULTS: For abdominal, thoracic, and peripheral angiography, more than 50% of procedures were controlled by radiologists. The majority of abdominal embolotherapy (87%) and peripheral angioplasty (70%) procedures were performed by interventional radiologists. On the other hand, 64.3% of neurointerventions, 74% of abscess drainage, and 98% of coronary angioplasty procedures were performed by other specialists. In most institutions, embolotherapy for liver neoplasms was commonly performed by radiologists (97%). Peripheral and renal angioplasty and thrombolysis were performed by 74% of respondents, although less than 10 cases per year were encountered at 81% of institutions. Abscess drainage and biopsy were performed by radiologists in more than 50% of institutions. In other nonvascular interventional procedures, especially lithotripsy, the practice by and experiences of radiologists were very limited. Fifty-seven percent of radiology departments have beds allocated and radiologists serve as attending physicians for interventional purposes. CONCLUSION: The practice pattern of interventional radiology in Japan is quite different from that in other countries because of differences in patients' diseases, historical backgrounds, number of interventional radiologists, and department organization.

Adult↗
PubMed1999

Health-related quality of life among renal-transplant recipients in Japan.

BACKGROUND: This study had four goals: (1) to evaluate an index of health-related quality of life (HQOL) among renal-transplant recipients in Japan, (2) to compare HQOL of renal-transplant recipients with that of the Japanese population as a whole, and (3,4) to study associations of HQOL with renal function and with the time since transplantation. METHODS: Questionnaires were distributed to 570 subjects. All were outpatients, were 16 years old or older, and were studied at least 1 year after they had received their latest renal transplant. HQOL was assessed with the Short Form 36-item health survey. Subjects' physicians provided data on renal function. Associations of HQOL with serum creatinine concentration and with the time since transplantation were evaluated by logistic regression. RESULTS: The response rate was 83%. Data from patients with diabetes and from those who had had at least two renal transplants were excluded; data from 395 recipients were analyzed. On the physical functioning, general health perception, vitality, and social functioning scales, the patients' scores were significantly lower than the Japanese national-norm scores. General health perception was particularly low. Serum creatinine concentrations were associated with general health perception, vitality, and social functioning. Longer times since transplantation were associated with better social functioning. CONCLUSIONS: Although social and physical functioning may improve after transplant surgery, a low self-rating of general health seemed to remain. The rarity of renal transplantation in Japan and other psychosocial factors may explain the low self-rating of general health in Japanese renal-transplant recipients.

Adolescent↗
PubMed2003

Salivary secretory IgA concentrations in beagle dogs.

The normal concentrations of salivary secretory IgA (sIgA) were examined, and the response of sIgA to acute stress was evaluated in dogs. Ten clinically healthy beagle dogs familiarized with the method of saliva sampling were used. During the non-stress period, saliva samples were collected between 0800 hr and 1700 hr at 1-hr intervals for 7 consecutive days and analyzed for sIgA concentration. After a 1-day control period, a noise stressor was presented for 15 min between 0845 hr and 0900 hr on 2 consecutive days. Saliva was collected at pre-stress, immediately after, 30 min after and 60 min after the stress. The average sIgA concentration over the 2-day period was compared with the control value. Environmental stimuli were restricted. During the non-stress period, significant variations were observed during the diurnal pattern, in which sIgA increased in the morning and then decreased; and the day-to-day variations were significant except at 0800 hr and 0900 hr. During the stress experiments, the sIgA concentration decreased significantly, immediately after and 30 min after the noise stress, and then increased to the same level as the control value by 60 min after the stress. When estimating the effectiveness of salivary sIgA as a marker of stress in dogs, the appropriate time for saliva sampling appears to be in the morning. Salivary sIgA was deemed potentially useful as a marker of stress in dogs.

Animals↗
PubMed1989

[Studies on the urophonography (3)--Clinical investigation on prostatic cancer].

Recently we have developed an entirely new method of sonic detection of lower urinary tract disorders during micturition. This procedure was designated as "urophonography" and its recording as "urophonogram". Sixteen patients with prostatic cancer before and three months after anti-androgenic therapy and ten healthy male volunteers underwent urophonography. The urophonograms were classified into four types. Type 1 was characterized by its diamond shape, while Type 2 was characterized by its random sound spikes. Type 3 was a mixture of Types 1 and 2. Type 4 had few sound spikes. Analysis of these urophonograms also revealed that the frequencies of these urethral sounds belonged to the range from 0.4 to 1.5 KHz. The amplitude (power) of the sounds was in the range of 40-60 dB. Healthy volunteers belonged to Type 4. Prostatic cancer patients belonged to Types 1, 2 and 3 at 18.8, 68.8, nad 12.4%, respectively. After the treatment the percentages of Types 1, 2, 3, and 4 changed to 18.8, 50.0, 0, and 31.2%, respectively. Comparison of uroflowmetric parameters with urophonograms showed that Type 2 patients showed a lesser degree of micturition disturbances, evidenced by these parameters. It was considered that urophonograms were useful as urodynamic investigation.

Aged↗