[Questionnaire on sexual quality of life in aging couples].

A questionnaire study was conducted on sexual life such as intercourse frequency, libido and erectile function and degree of satisfaction of sexual life in aging couples. Half of them had sexual intercourse and satisfaction of life. According to multivariate analysis using stiffness of penis at erection, erection maintained, and difficulty of maintenance of erection state, there was a significant relationship between satisfaction of sexual life and frequency of erection maintained or difficulty of maintenance of erection state, and also between confidence on erection and difficulty of maintenance of erection state. These values became lower because of aging. We concluded that sexual communication was needed in the life of aging couples, and an urologist should have a role in consulting on aging life.

Antitumor effects of lipoxygenase inhibitors on murine bladder cancer cell line (MBT-2).

Arachidonic acid (AA) metabolites derived from both the lipoxygenase (LOX) and cyclooxygenase (COX) pathways transduce a variety of signals related to cell growth. Selective blockade of the different metabolic pathways of AA (using a general LOX inhibitor NDGA, a 5-LOX inhibitor AA861, a 12-LOX inhibitor baicalein and a general COX inhibitor ibuprofen) revealed that murine bladder cancer cell line (MBT-2) cell proliferation was inhibited by the LOX inhibitors concentration-dependently, but not by the COX inhibitor. Among the LOX inhibitors, baicalein showed the strongest inhibition and induced apoptosis of MBT-2. Proliferation of MBT-2 was also significantly inhibited by 12-LOX antisense oligonucleotides. In an in vivo experiment, the antitumor effects of baicalein administration on C3H/HeN mice implanted with MBT-2 were recognized. These results suggested that LOX inhibition may be significant in the treatment of bladder cancer.

The prognostic role of atrial natriuretic peptides in hemodialysis patients.

BACKGROUND: It is well known that plasma atrial natriuretic peptide (ANP) is an indicator of extracellular fluid volume expansion and that plasma ANP is considered to be a marker for setting the proper dry weight of HD patients. Although the plasma ANP is a prognostic predictor of cardiac death, the prognostic role of ANP in HD patients has yet to be elucidated. In this study, we investigated the prognostic role of ANP in HD patients. METHODS: Plasma ANP concentrations were measured in 105 HD patients after HD. Multiple regression analysis was performed to determine the major factors causing increased plasma ANP concentrations. Cardiac mortality was monitored for 24 months after baseline analysis, and the prognostic role of ANP was examined by Cox proportional hazards regression analysis. RESULTS: Multiple regression analysis showed that cardiovascular disease (CD) and age were independent factors for elevated ANP (R2 = 0.298, p < 0.0001). During a 24-month follow-up period, cardiac death occurred in 11 patients. Kaplan- Meier survival estimates of patients from varying plasma ANP levels (<50 and >50 pg/ml) differed between the two groups (p < 0.0001). The group with the higher ANP level (>50 pg/ml) had the lower survival. When compared with patients with ANP <50, the hazard ratios for cardiac death of patients with ANP of >50 pg/ml were 32.0 (95% confidence interval (CI) 4.1 to 252.4). Univariate Cox proportional hazards model showed that ANP, left ventricular ejection fraction (LVEF), LVMI, age, serum albumin and C-reactive protein (CRP) were significantly associated with the risk of cardiac mortality. By stepwise multivariate Cox proportional hazards analysis, only ANP, LVMI and CRP remained powerful independent predictors of cardiac death. The relative risk ratios were 3.483 (95% CI 1.640-7.397) for ln ANP, 1.023 (1.008-1.038) for LVMI, and 1.379 (1.115-1.705) for CRP. CONCLUSION: High plasma ANP level of post-HD were strongly associated with CD and age. Post-HD ANP level may be a reliable parameter for assessing the risk for cardiac death in HD patients by providing prognostic information independent of other variables previously reported.

Renal cell carcinoma with hemorrhagic cyst formation in a 4-year-old boy.

We report on a case of renal cell carcinoma (RCC) with hemorrhagic cyst formation in a 4-year-old boy. The patient presented with asymptomatic macrohematuria. Abdominal ultrasound, computed tomography and magnetic resonance imaging demonstrated a left renal complicated cyst, 18 mm in diameter. Renal malignancy was suspected, and left radical nephrectomy was performed. Pathological diagnosis was a complicated cyst filled with bloody clots, with a wall composed of RCC. No metastases to the regional lymph nodes or other organs were found. This is an extremely rare occurrence of such a small RCC that developed a hemorrhagic cyst in a boy of this young age. The boy is being followed-up without any additional treatment.

The prognostic role of brain natriuretic peptides in hemodialysis patients.

BACKGROUND: Although plasma concentrations of brain natriuretic peptides (BNP) increase in hemodialysis (HD) patients as well as patients with cardiovascular diseases (CD), the clinical significance of BNP in HD patients has yet to be elucidated. In this study, we investigated the pathophysiological significance of BNP in HD patients. METHODS: Plasma BNP concentrations were measured in 164 HD patients after HD and 14 healthy volunteers. In 12 patients without CD, BNP was also measured before HD. Multiple regression analysis was performed to determine the important factors causing increased plasma BNP concentrations. Cardiac mortality was monitored for 36 months after baseline analysis, and the prognostic role of BNP was examined by Cox proportional hazards regression analysis. RESULTS: Plasma BNP concentrations of HD patients without CD decreased significantly during HD session (124.5 +/- 90.7 vs. 91.4 +/- 67.6 pg/ml, mean +/- SD, p = 0.004), but were still significantly higher than those of the healthy subjects (9.7 +/- 9.2 pg/ml, p = 0.0002). Plasma BNP concentrations of patients with CD were significantly higher than of those without CD (579.6 +/- 564.3 vs. 204.0 +/- 241.5 pg/ml, p < 0.0001). Plasma BNP concentrations were also significantly higher in diabetes mellitus (DM) patients than in non-DM patients (514.1 +/- 585.4 vs. 296.0 +/- 347.0 pg/ml, p = 0.0031). Multiple regression analysis showed that left ventricular mass index (LVMI), CD and DM were independent factors for the elevated BNP (R(2) = 0.303, p < 0.0001). During a 36-month follow-up period, cardiac death occurred in 13 patients. Kaplan-Meier survival estimates of patients from varying plasma BNP quartiles (<200, 200-450, 450-700 and >700 pg/ml) differed between the four groups (p < 0.0001). The group with the highest BNP level (>700 pg/ml) had the lowest survival. When compared with patients with BNP <200, the hazard ratios for cardiac death of patients with BNP of 200-450, 450-700 and >700 pg/ml were 2.3 [95% confidence interval (CI) 0.14-36.7], 18.7 (1.9-183.4) and 51.9 (6.5-416.3), respectively. The univariate Cox proportional hazards model showed that BNP, left ventricular ejection fraction, LVMI, age, DM, serum albumin and C-reactive protein (CRP) were significantly associated with the risk of cardiac mortality. By stepwise multivariate Cox proportional hazards analysis, only BNP, LVMI and CRP remained powerful independent predictors of cardiac death. The relative risk ratios were 1.002 (95% CI 1.001-1.002) for BNP, 2.192 (1.532-3.135) for CRP and 1.027 (1.013-1.042) for LVMI. CONCLUSION: High plasma BNP concentrations in HD patients were associated with volume overload, left ventricular hypertrophy, CD and DM. Plasma BNP concentration may be a useful parameter for assessing the risk of cardiac death in HD patients by providing prognostic information independently of other variables previously reported.

Significance of brain natriuretic peptides in patients on continuous ambulatory peritoneal dialysis.

It is well known that plasma brain natriuretic peptide (BNP) concentration is elevated in cardiovascular diseases such as congestive heart failure. However, although it has been reported to increase in hemodialysis (HD) patients, little is known about plasma BNP in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Plasma BNP concentrations were measured and compared among CAPD patients (n=32), HD patients (n=63) and healthy volunteers (n=14) as well as those patients without cardiovascular disease. In addition, the correlation between plasma BNP concentration and parameters of echocardiography was examined. Plasma BNP concentration was significantly higher in CAPD patients without cardiovascular disease (n=23) than in healthy volunteers (n=14) (62.1+/-60.6 pg/ml versus 9.7+/-9.7 pg/ml, mean +/- SD, P<0.0001). Furthermore, it had a positive correlation with LVMI (CAPD: r=0.37, P=0.0354; HD: r=0.49, P<0.0001) but a negative correlation with LVEF (CAPD: r=-0.39, P=0.0277; HD: r=-0.40, P=0.0010) in both CAPD and HD patients. When all patients were compared, plasma BNP concentration was significantly lower in CAPD patients (n=32) than in HD patients (n=63) (114.8+/-142.7 pg/ml versus 296.8+/-430.4 pg/ml, P<0.0001). When those patients without cardiovascular disease was compared, it was also significantly lower in CAPD patients (n=23) than in HD patients (n=40) (62.1+/-60.6 pg/ml versus 151.8+/-102.2 pg/ml, P<0.0001). In conclusion, plasma BNP concentration was elevated in CAPD patients and correlated with LVMI and LVEF, suggesting that plasma BNP in CAPD patients may be associated with left ventricular hypertrophy (LVH) and left ventricular systolic dysfunction. In addition, plasma BNP concentration was significantly lower in CAPD patients than in HD patients, suggesting that cardiac load in CAPD patients may be lower than that of HD patients.