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Robot-assisted radical cystectomy (RARC) has gained popularity and proven its efficacy, safety and reproducibility in the last decade. RARC has resulted in less blood loss, enhanced recovery, and shorter hospital stay. RARC has proven to have similar or better postoperative morbidity, mortality and equal oncologic, outcomes. Limiting factors to the acceptance of this surgical approach have included its steep learning curve and the lack of both long-term outcome data. This article systematically reviews the literature comparing the outcomes for RARC (comparisons with open radical cystectomy when performed at the same institution) with a focus on operative, complications, oncologic, functional and survival outcomes.

The approaches to establish a more robust and reproducible baseline process for 30cm × 30 cm-sized CIGS-based thin-film circuits with a Zn(O,S,OH) x buffer layer are reported, which also lead to an achievement of 12.93% efficiency on an aperture area of 864cm 2 . Monitoring the transparency or transmittance (%T) of dip solution as a process control parameter in the chemical bath deposition (CBD)-buffer deposition step and setting the end point of dipping the CIGS-based absorbers in the solution as the %T of 60% remarkably contribute to make our CBD-buffer deposition process more reproducible. By considering carefully the growth process of metal-organic chemical vapor deposition (MOCVD)-ZnO:B window, a thin layer of high-resistivity, intrinsic ZnO is deposited on the Zn(O,S,OH) x buffer layer to simulate the film structure of MOCVD-ZnO:B window in the case of sputtered-5.7 GZO window. Achievement of the reproducibility of 85% for the CIGS-based thin-film circuits with a sputtered-5.7 GZO window confirms that the yield goal of 85% is surely attainable independent of window-layer deposition techniques, such as MOCVD and sputtering. In this study, it is emphasized how important to eliminate unknown factors in the fabrication process for CIGS-based thin-film modules to improve both reproducibility and efficiency.

Describes how the authors have combined speech recognition, dialogue management, and statistical learning procedures to develop Jijo-2; an office robot that can communicate with humans and learn about its environment.

INTRODUCTION AND OBJECTIVES: We herein describe our technique for retroperitoneoscopic pyelo-plasty with concomitant nephropexy in patients with a ureteropelvic junction (UPJ) obstruction in combination with nephroptosis. METHODS: We performed this operation on three female patients with a right UPJ obstruction and nephroptosis diagnosed by intravenous urography, retrograde pyelography, computed tomography and an isotopic renogram. All patients underwent the insertion of a ureteral stent before laparoscopy, and they were placed in the flank position. A four-port, balloon-dissecting, retroperitoneal laparoscopic approach was used. Ge-rota’s fascia was incised and the perirenal fat was completely dissected from the kidney. A UPJ -obstruction was identified and pyeloplasty was performed using Anderson-Hynes dismembered anastomosis. Next, kidney fixation to the abdominal wall was performed by rows of renal capsular 2-0 nylon sutures which were secured to the quadratus lumborum fascia. All procedures were performed retroperitoneoscopically. RESULTS: The median operative time was 350 min with a range from 204 to 414 min. The median -estimated blood loss was 50 ml with a range from 10 to 200 ml. The postoperative hospital stay was 6 days. There were no postoperative complications. The ureteral stent was removed at 6 weeks after surgery. Postoperative urography revealed a complete resolution of hydronephrosis in all cases with one complete resolution and two cases with an improvement of nephroptosis. All patients had a complete resolution of their symptoms. CONCLUSIONS: Retroperitoneoscopic pyeloplasty with concomitant nephropexy seems to be a -feasible, effective and minimally invasive procedure for treating UPJ obstruction in combination with nephroptosis.

This paper deals with the use of the World Wide Web (WWW) as a platform for building robotic systems. We revisit the anatomy of the WWW system together with CORBA, the standard object request broker architecture, and show how to map robotic systems on it. We also review the current status of several meta-computing infrastructures for distributed computing on a wide-area network. Several implementation results are also shown.

The behavior of some proteinase inhibitors toward the Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme activity in human seminal plasma (HSP) was tested. [(2S, 3R)-3-Amino-2-hydroxy-5-methyl-hexanoyl]L-valyl-L-valyl-L-aspartic acid (Amastatin) and 3-[1-[(2-(hydroxymethyl)- -pyrolidinyl)-2-methylpropyl]-carbamoyl] octanohydroxamic acid (Actinonin) showed strong inhibitory effects. No inhibition of this present enzyme activity was seen with anti-human serum (whole), anti-human leukocyte elastase, phenyl-methyl sulfonyl fluoride, Elastatinal, ethyeneglycol bis(beta-aminoethyl ethyl)N,N,N:N'-tetra acetic acid, and [L-3-trans-ethoxycarbonyl-oxirane-2-carbonyl]1-L-leucine(3-methylbutyl)a mido (E-64). No relation was observed between human pancreatic elastase antigen and the Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme enzyme activity in HSP. Two peaks of Suc-Ala-Ala-Leu-Pro-pNA amidolytic enzyme activity were separated by Cellulofine GCL-2000 gel filtration and these activities were completely abolished by addition of Amastatin. Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme activity in HSP is not an elastase-like metalloproteinase but is rather an acyl amidase-like leucine aminopeptidase.

The amounts of protein measured by absorbance at 280 nm, succinyl-L-alanyl-L-alanyl-L-prolyl-L-leucine-p-nitroanilide (Suc-Ala-Ala-Pro-Leu-pNA), D-valyl-cyclohexyl-alanyl-L-arginine-p-nitroanilide (Val-CHA-Arg-pNA), and glutamyl-L-phenylalanine-p-nitroanilide (Glu-Phe-pNA) amidolytic activities, and prostate-specific antigen (PSA) were measured in human seminal plasma (HSP) samples separated from the semen of 46 cases, including 13 cases of azoospermia and 33 cases of normozoospermia showing either good or poor quality of liquefaction. There was a highly significant correlation between the concentrations of all amidolytic enzyme activities studied and the concentration of PSA in HSP samples (p.01). The HSP sample volume showed a relatively good negative coefficient of correlation to all items measured (p.01) with the exception of protein concentration. The Suc-Ala-Ala-Pro-Leu-pNA, Val-CHA-Arg-pNA, and Glu-Phe-pNA amidolytic activities in azoospermia HSP samples were 2.33. 1.68, and 1.43 times higher, respectively, than those of normozoospermia samples showing good quality liquefaction. After the addition of morphologically purified human sperm to HSP sample of azoospermia cases, the Suc-Ala-Ala-Pro-Leu-pNA amidolytic activity in the HSP sample of azoospermia was not decreased for up to 18 h incubation, while the number of motile human sperm gradually declined, and no motile human sperm were detected after 18 h of incubation. The high Suc-Ala-AlaPro-Leu-pNA amidolytic activity in HSP samples of azoospermia cases did not result from a lack of motility.

Reactivity of CD8+ T lymphocytes against human melanoma has been extensively characterized, but little is known about melanoma Ags recognized by CD4+ lymphocytes. We have identified CD4+ CTL that recognize shared melanoma Ag(s) expressed by autologous melanoma cells and a subset of allogeneic melanomas. The same Ag(s) was shared by autologous and positive allogeneic melanomas by cross-blocking experiments. Cytotoxicity was directed against epitopes presented by HLA-DR on target melanoma cells, and allelic typing revealed that cytotoxicity was restricted through HLA-DR15. These CD4+ T cells released IFN-gamma, IL-4, and TNF-alpha, but not IL-2, in response to HLA-DR15+ target cells. CD4+ T cells did not lyse DR15+ nonmelanoma cell types, including melanocytes or fibroblasts (induced to express HLA-DR by IFN-gamma). Thus, by cytotoxicity assays, shared Ags were only recognized on melanoma cells but not on normal melanocytes. In summary, this analysis shows that melanoma cells share an Ag that is presented by HLA-DR15.

We present a case report of a 25-year-old man with embryonal carcinoma of right atrium and multiple lung metastases featuring SVC syndrome. We resected the cardiac tumor which occupied the right atrium and performed left upper lobectomy. No tumor mass or vestige was detected in the testes. C/s-platinum based combination chemotherapy was performed for residual lung tumors, which leads to the complete remission.

Inhibitors of eicosanoid production had no effect on linoleic acid-induced Schistosoma mansoni cercarial tail loss. In addition, linoleic acid-induced cercarial tail loss was not inhibited by silver nitrate, which binds to putative chemoreceptors for fatty acids in cercariae. There was no correlation between molecular structures of fatty acids and their potencies to induce tail loss. Furthermore, transcompounds of fatty acids which cannot be precursors of eicosanoids elicited tail loss as potently as cis-compounds did. The present results suggest that fatty acid-induced cercarial tail loss is not mediated by eicosanoid production and chemoreceptors, which are involved in cercarial penetration behavior stimulated by fatty acids.

The structure of the fluorescent derivative formed in the method of Okayama et al. (Clin Chem 1990; 36:1494-7) for determining delta-aminolevulinic acid (ALA) concentrations was reinvestigated after esterification. The molecular ion peak at m/z 303.1473 corresponded to the molecular formula of C17H21NO4 (calcd 303.1470). The infrared spectrum showed the presence of carbonyl and carboxyl groups. This compound contained two acetyl groups, two methyl groups, and one methoxycarbonylethyl group, as revealed by 1H and 13C nuclear magnetic resonance and 13C-1H shift-correlated spectroscopy. Experiments with correlation spectroscopy via long-range coupling indicated that the main skeleton is 3H-pyrrolizine. The relative arrangement of functional groups was determined by means of nuclear Overhauser effect difference experiments. We were led to the conclusion that the methyl ester of the derivative is 2,6-diacetyl-1,5-dimethyl-7-(2-methoxycarbonylethyl)-3H-pyrrolizine. This structure was unequivocally confirmed by x-ray analysis; therefore, the structure of the derivative itself is 2,6-diacetyl-1,5-dimethyl-7-(2-carboxyethyl)-3H-pyrrolizine.

We propose extension-by-unification method to improve reusability of the dialogue components in the development of communication function of the robot. Compared to previous extension-by-connection method used in behavior-based communication robot developments, the extension-by-unification method has the ability to decompose the script into components. The decomposed components can be recomposed to build a new application easily. In this paper, first we, explain a reformulation we have applied to the conventional state-transition model. Second, we explain a set of algorithms to decompose, recompose, and detect the conflict of each component. Third, we explain a dialogue engine and a script management server we have developed. The script management server has a function to propose reusable components to the developer in real time by implementing the conflict detection algorithm. The dialogue engine SEAT (Speech Event-Action Translator) has flexible adapter mechanism to enable quick integration to robotic systems. We have confirmed that by the application of three robots, development efficiency has improved by 30%.

We have developed an RTDPS (Robotic Technology Distributed Production System) for use as a framework for realizing optimized performance of an integrated robot. The RTDPS is a set of software built onOpenRTM-aist (an implementation ofOMGRT-middleware specification), which consists of a script compiler, node components, and deployment utility. By distributing the application logics among the processing elements, the RTDPS can prevent the centralized control of integrated systems, which causes system bottlenecks. By performing experiments involving two typical applications, we show that the network traffic can be reduced by 73% while balancing the processing load among the processing elements.

An enzyme preparation with affinity to a lysine column was detected from a DEAE-cellulose-adsorbed preparation of human seminal plasma containing plasminogen and plasmin. Two kinds of trypsin-like acidic arginine amidase activity with different affinity to lima bean trypsin inhibitor (LBTI) and aprotinin affinity column were detected from the DEAE-cellulose-adsorbed preparation after treatment of the lysine column. Two kinds of trypsin-like basic arginine amidase activity were also separated by the above-mentioned affinity adsorptions from a CM-cellulose-adsorbed preparation of human seminal plasma. The effect of calcium chloride on these two enzymes was different from human acrosin.

In this paper, we propose an extension-by-unification method to improve reusability and flexibility in the incremental development of state-transition models. The dialogue engine SEAT (Speech Event-Action Translator) has been developed to realize continuous development of statetransition models in order to give robots dialogue capability that can cope with various kinds of speech inputs in various tasks. SEAT has a flexible adaptor mechanism that can connect to many types of robotic interfaces, and the developer can accumulate the scripts by using the script management server, which has a function to propose existing reusable scripts to the developer. We have confirmed that the application of SEAT to the development of three robots has significantly improved development efficiency.

In this paper, we introduce the health exercise robot TAIZO, and the social background of its development. TAIZO can be controlled through both vocal commands and key input. Being roughly humanoid in shape it can demonstrate physical exercises in collaboration with the human demonstrator. Through the experiment, we measure both the usability of keypad and vocal commands, and also their demonstrative effects. Through real demonstration, we confirmed that the robot is effective in drawing in onlookers and encourage them to engage in health exercises.

We demonstrated over 100-nm RGB tunable laser operation (479–497, 515–546, 597–650 nm) using a single 9-cm Pr3+-doped ZBLAN fiber pumped by a GaN-LD. The optimized laser cavity at 635 nm realized slope efficiency of 0.69.

The clonal expression of tumor rejection Ag (TRA) was analyzed on nine different clones derived from parental BALB3T3 cells that were transfected with activated H-ras, polyoma middle T (PyMT), c-myc, and v-src oncogenes. It was shown that Bras-h clone, which is an activated H-ras oncogene-induced transformant, expressed TRA as assessed in the transplantation study using syngeneic BALB/c mice. This TRA was not detected on parental BALB3T3 nontransformed cells, suggesting that TRA could be expressed in the BALB3T3 cell transformation. Furthermore, the cross-protection experiments indicated that this TRA was also conferred on other BALB3T3 transformants with high anchorage-independent growth potential such as an activated H-ras transformant Bras-d, and PyMT transformants BMT-f, BnMT-11, BnMT-20, except in the case of one H-ras transformant Bnr-12. In contrast, this TRA was not expressed on the transfectants with little or no anchorage independent growth potential such as a PyMT transfectant BnMT-4, a c-myc transfectant Bmyc-7, and a v-src transfectant Bsrc-7. We developed the mAb BRH19 that could react with TRA+ clones but not with TRA- clones. This mAb makes an immunoprecipitate, which is composed of a 50-kDa single polypeptide chain from Bras-h cell lysate. An injection to mice with this antigen could confer the protection against Bras-h challenge. These data indicate that the 50-kDa putative TRA molecule could be expressed in close association with the cell transformation, irrespective of the introduced oncogenes, and there may exist some regulatory mechanisms rather than individually distinct manners for the expression of TRA.

A method of detecting and tracking moving human speech events by integrating audio and video signals using a particle filter is proposed and evaluated. Using the particle filter, location, on/off status, and human/non-human determination can be estimated simultaneously for multiple sound sources. Experiments demonstrate that the proposed method performs well for the data obtained in an ordinary meeting room using a microphone array and a monocular camera.

A 49-year-old man who had a huge testicular tumor with retroperitoneal lymph node metastasis and bilateral multiple pulmonary metastases was referred to our hospital. Firstly orchiectomy was done obtaining the pathological diagnosis of mixed type germ cell tumor. After cisplatin-based chemotherapy, he underwent resection of the retroperitoneal lymph node involving the abdominal aorta and the inferior vena cava. Both great vessels were resected with the tumor and reconstructed with prosthetic grafts. Two months after the laparotomy, 12 metastatic nodules in the left lung were resected. Seven months later, he furthermore underwent resection of 4 metastatic nodules in the right lung. Microscopically, all resected metastatic tumors were diagnosed to be mature teratoma without viable malignant cells. The patient remains well 30 months after the first operation. Follow-up CT scan demonstrates patency of aortic and vena caval bypass grafts without local recurrence or distant metastasis.

For cooperative work of robots and humans in the real world, a communicative function based on speech is indispensable for robots. To realize such a function in a noisy real environment, it is essential that robots be able to extract target speech spoken by humans from a mixture of sounds by their own resources. We have developed a method of detecting and extracting speech events based on the fusion of audio and video information. In this method, audio information (sound localization using a microphone array) and video information (human tracking using a camera) are fused by a Bayesian network to enable the detection of speech events. The information of detected speech events is then utilized in sound separation using adaptive beam forming. In this paper, some basic investigations for applying the above system to the humanoid robot HRP-2 are reported. Input devices, namely a microphone array and a camera, were mounted on the head of HRP-2, and acoustic characteristics for sound localization/separation performance were investigated. Also, the human tracking system was improved so that it can be used in a dynamic situation. Finally, overall performance of the system was tested via off-line experiments.

An objective of this study is to reduce the efficiency gap of 30 cm/spl times/ 30 cm-sized CIGS-based thin-film modules with MOCVD-ZnO:B or sputtered-5.7GZO (ZnO:5.7wt%Ga) window. Based upon a growth model of MOCVD-ZnO:B window, a thin intrinsic-ZnO layer with the thickness of 50 nm is prepared on a CBD-Zn(O,S,OH)/sub x/ buffer by RIF sputtering in the case of sputtered-5.7GZO window. This approach contributes to maintain the reproducibility of our current baseline process and leads to the achievement of the module efficiency of 12.2 % with this window, which has been measured by NREL. It is emphasized that 1) this gap is reduced up to 1 % by making a module, and 2) low-cost packaging technologies without any J/sub sc/ loss and suitable to CIGS-based thin-film circuits should be developed promptly.

To examine whether orthotopic neobladder replacement using either ileum or colon segments results in increased oxidative stress, by measuring urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), one of the most commonly used markers for evaluating oxidative DNA damage.Urinary levels of 8-OHdG and creatinine, urine analysis, nutritional status, and acid-base and electrolyte balances, were assessed in 22 patients with an ileal neobladder, 28 with a colon neobladder, 37 with an ileal conduit and 22 healthy volunteers. The results from both types of orthotopic neobladder, the ileal conduit and in the healthy controls were compared.The mean (sd) ratios of urinary 8-OHdG to urinary creatinine in patients with an ileal neobladder, colon neobladder, ileal conduit and in controls were 20.4 (7.8), 15.2 (4.3), 15.9 (5.1) and 15.2 (5.4) ng/mg, respectively. The urinary 8-OHdG ratio in the first group was significantly higher than in the other three groups. Among patients with a neobladder, the urinary 8-OHdG ratio was closely associated with the degree of pyuria, but not age, gender, the interval from surgery, body weight, height, serum creatinine or the degree of metabolic acidosis.These findings suggest that creating an ileal neobladder caused significantly greater oxidative stress than a colon neobladder, ileal conduit, or that in healthy controls. Therefore, it is recommended to conduct a careful long-term follow-up considering the possible development of malignant disease after urinary diversion, especially by an ileal neobladder.

In an environment with plural robots, an assembly plan may be changed according to the constraints or abilities of the manipulator which executes the task. For an assembly task composed of subassemblies which can be executed at the same time, the assembly plan depends on the constraints of the manipulator. This paper describes an approach to an assembly planning system using contract net protocols. The contract nets are applied between part agents and robot agents which have a little automatic faculty. An assembly plan is generated based on searching an AND/OR graph for a given product using heuristic estimation.

This paper proposes a multi-agent software architecture for controlling higher level behaviors of a mobile office-conversant robot. In order to keep the whole system comprehensive and extensible, a group structure is introduced into multi-agent architecture. In the architecture, the whole system is divided into several behavior-manager agents and the behavior-manager manages multiple behavior agents, which are dynamically created and destroyed on demands. Several behaviors and behavior-managers are implemented as classes of an object-oriented Lisp. Dialog-based map learning and teleoperation experiments with real mobile robot Jijo-2 are shown for evaluating the architecture.

We propose a method for extracting low-dimensional features from omnidirectional images to be used for robot localization and navigation. Edge detection is combined with thresholding to locate sharp edge pixels, the coordinates of which are fed into a Parzen density estimator (1962) to compute the edge spatial density. The use of the fast Fourier transform makes this density estimate feasible in real-time, while principal component analysis further drops the dimensionality of the resulting feature vector to a manageable number. We show experimental results from a Nomad XR4000 robot in an office environment.

An important key to realize the strong requirement on the electrical yield (i.e. 85 % in the efficiency of over 10 % in 30 cm/spl times/30 cm-sized CIGS-based circuits with an aperture area of over 810 cm/sup 2/) has been indicated to make a robust junction between CIGS-based absorber and Zn(O,S,OH)/sub x/ buffer. In this study, the baseline process for CBD-Zn(O,S,OH)/sub x/ buffer deposition is investigated from the standpoint of reduction of the deviation of FF. By monitoring the transparency or transmittance (%T) of the CBD solution as a new control parameter, the Zn(O,S,OH)/sub x/ buffer deposition process is much stabilized especially on the thickness uniformity measured by LBIC technique. From this approach, it is confirmed that much narrower distribution of FF in the range of over 0.6 can be steadily achieved by improving the thickness uniformity of the buffer and, as a result, the achievement of the above goal is foreseeable.

We report our early experience of laparoscopic radical prostatectomy for clinically localized prostatic cancer.Between April and December 2000, 17 patients with clinical stage T1c to T2b prostatic cancer underwent laparoscopic radical prostatectomy. The median age was 70.9 year old, the median preoperative PSA and the median Gleason score of biopsy specimens was 7.1 ng/ml, 6, respectively. We followed the operation technique from the "Montsouris technique". Briefly, we used five trocars (two 10-mm and three 5-mm trocars) and the operation was performed transperitoneally. Pelvic lymph node dissection was performed in only one patient (case 3). Urethrovesical anastomosis was performed with 6 to 9 interrupted 3-0 absorbable sutures.No conversion to open surgery or reoperation was required in all cases. Median operation time was 450 minutes (range 290 to 750) and median intraoperative bleeding (including urine) was 600 ml (range 100 to 3,135). Only one case (case 3) needed homologous blood transfusion. Median postoperative Foley catheterization period was 9 days (range 5 to 19). Intraoperative complications related to operation procedure were one rectal injury and three vesical injuries, which were treated by absorbable suturing laparoscopically. Major complication was one complete A-V block (case 3) who was required a transient discontinuance of the procedure. Surgical margins were negative in 13 cases. Postoperative pathological evaluation was one pT0, five pT2a, seven pT2b and four pT3a. PSA value decreased less than 0.2 ng/ml after surgery in all patients. Although six months have passed after the surgery in only 4 patients, all of them were fully continent.Although the operation time is still longer than that of conventional open procedures, intraoperative magnified vision allows a more precise and safer dissection, especially for apical dissection. We believe that operative time will decrease with more experience. These results show that laparoscopic radical prostatectomy can be an acceptable treatment option for localized prostatic cancer.

Clusterin expression is highly up-regulated in several normal and malignant tissues undergoing apoptosis. Although recent studies have demonstrated a protective role of clusterin expression against various kinds of apoptotic stimuli, the functional role of clusterin in the acquisition of a therapy-resistant phenotype in bladder cancer remains unknown. The objectives of this study were to determine whether antisense (AS) oligodeoxynucleotide (ODN) targeting the clusterin gene enhances apoptosis induced by cisplatin and to evaluate the usefulness of combined treatment with AS clusterin ODN and cisplatin in the inhibition of KoTCC-1 tumor growth and metastasis in a human bladder cancer KoTCC-1 model. We initially revealed the dose-dependent and sequence-specific inhibition of clusterin expression by AS clusterin ODN treatment in KoTCC-1 cells at both mRNA and protein levels. Clusterin mRNA was increased in a dose-dependent manner by cisplatin treatment at concentrationsor =10 mg/ml, and clusterin mRNA up-regulation induced by 10 mg/ml cisplatin peaked by 48-h post-treatment and began decreasing by 72-h post-treatment. Although there was no significant effect on growth of KoTCC-1 cells, AS clusterin ODN treatment significantly enhanced cisplatin chemosensitivity of KoTCC-1 cells in a dose-dependent manner, reducing the IC(50) by50%. Characteristic apoptotic DNA ladder formation and cleavage of poly(ADP-ribose) polymerase protein were detected after combined treatment with AS clusterin ODN and cisplatin but not either agent alone. In vivo systemic administration of AS clusterin and cisplatin significantly decreased the s.c. KoTCC-1 tumor volume compared with mismatch control ODN plus cisplatin. Furthermore, after the orthotopic implantation of KoTCC-1 cells, combined treatment with AS clusterin and cisplatin significantly inhibited the growth of primary KoTCC-1 tumors, as well as the incidence of lymph node metastasis. Collectively, these findings demonstrated that clusterin helps confer a chemoresistant phenotype through inhibition of apoptosis and that combined AS clusterin ODN may be useful in enhancing the effects of cytotoxic chemotherapy in patients with bladder cancer.

The objective of this study was to evaluate the long-term biochemical and pathological effects induced by neoadjuvant hormonal therapy (NHT) in patients with clinically localized disease. Between March 1993 and May 1997, 24 patients with clinically localized prostate cancer received NHT for 3 to 11 months (median: 5 months) using luteinizing hormone-releasing hormone analogue prior to radical prostatectomy and pelvic lymphadenectomy. The clinical stage was T1 in 1 patient, T2 in 17 and T3 in 6, the pretreatment serum prostate-specific antigen (PSA) value wasor = 10 ng/ml in 5 patients, 10 to 20 ng/ml in 4 and20 ng/ml in 15 (mean: 34.7 micrograms/l), and the Gleason score wasor = 4 in 9 patients, 5 to 7 in 11 and8 in 3. The mean prostate specific antigen (PSA) value 3 months after NHT had reduced below 2 ng/ml in 18 of the 24 patients (67%), and finally decreased by an average of 95% (i.e., 1.9 ng/ml) prior to surgery. The pathological stage was pT0 in 2 patients, pT2 in 10 and pT3 in 12. The incidence of organ-confined disease (OCD) was significantly higher in patients with clinical stage T1 or T2a than with T2b or T3, with pretreatment PSA valuesor = 10 ng/ml than with PSA values10 ng/ml, and with PSA valuesor = 2 than with PSA values2 at 3 months after NHT; in contrast, the Gleason score had no significant impact on the rate of OCD. After a median follow-up of 49 months (range 34 to 85 months), 6 patients (25%) had a recurrence evidenced by rising PSA, and the 3-year recurrence-free survival rate was 79%. These results suggest that NHT appears not to be of significant additional benefit to patients who have a higher clinical T stage, higher pretreatment PSA values and/or in patients whose PSA values do not normalize early in the treatment process.

To determine whether serum levels of the prostate-specific antigen-alpha1-antichymotrypsin complex (PSA-ACT) and its density (ACTD) in patients scheduled to undergo radical prostatectomy for clinically localized prostate cancer can predict organ-confined vs extraprostatic disease.Serum samples were obtained from 62 patients with clinically localized prostate cancer before they underwent radical prostatectomy. PSA and PSA-ACT were measured using immunofluorometric techniques with different monoclonal antibodies against PSA and ACT, respectively. Furthermore, the PSA and PSA-ACT densities of the whole prostate (PSAD and ACTD, respectively) were calculated. The relationships of serum PSA, PSA-ACT, PSAD, ACTD and the pathological stage of the prostatectomy specimens were analysed.The disease was organ-confined or extraprostatic in 30 and 32 men, respectively. In men with organ-confined cancer, the mean PSA and PSA-ACT levels were significantly lower than in those with extraprostatic disease. Furthermore, there were significantly higher mean PSAD and ACTD levels in men with extraprostatic than with organ-confined disease. There were also significant differences in PSA, PSA-ACT, PSAD and ACTD levels at each pathological stage, whereas there was no significant association between these variables and the Gleason score. Receiver-operating characteristic curve analysis for detecting organ-confined disease showed that PSA-ACT and ACTD had a larger area under the curve than PSA and PSAD, respectively, but these differences were not significant. Furthermore, PSA-ACT and ACTD provided significantly better sensitivity for detecting organ-confined disease than PSA and PSAD, respectively.Measuring PSA-ACT and ACTD may improve the preoperative evaluation of patients scheduled to undergo radical prostatectomy, because these factors better differentiate extraprostatic from organ-confined disease than PSA and PSAD.

To compare, in a dog model, the properties of a reconstructed bladder (peristalsis, histological changes and absorption) using an autotransplanted ileal segment with standard enterocystoplasty.Female beagle dogs were divided into two groups. In group 1 (autotransplantation, six dogs), a Heineke-Mikulicz-type pouch was constructed using autotransplanted terminal ileum. The artery and vein of the terminal ileum were anastomosed to the iliac artery and vein, respectively. The pouch was anastomosed to the bladder remnant immediately above the vesical triangle. In group 2 (control, five dogs) the same type of bladder reconstruction using terminal ileum was undertaken but with no vessel anastomosis. Bladder function in these two groups was then compared for peristalsis (by monitoring intravesical pressure), histological changes (by microscopy) and glucose reabsorption (by measuring the amount of glucose remaining in the reconstructed bladder). The mean (range) follow-up was 11 (7-18) months for group 1 and 9.2 (7-12) months for group 2; the recovery time before examination was 4.6 (2-7) months for group 1 and 4.0 (2-6) months for group 2.In group 1, there were no major complications in five dogs after the procedure and they survived for7 months; the autotransplant became necrotic in one dog where the arterial diameter was1 mm. In the control group, all five dogs survived foror = 7 months after surgery. Intestinal peristalsis was inhibited in group 1 but not in group 2. The bladder was oval/spherical in group 1 and elongated in group 2, with a thinner epithelium and fewer goblet cells in the latter. Glucose reabsorption was greater in group 2 than in group 1.Bladder reconstruction using autotransplanted terminal ileum in dogs is technically feasible. For bowel peristalsis and reabsorption of glucose, autotransplanted ileum may have functional advantages over a standard enterocystoplasty.