Development of a New Polar Organic Chemical Integrative Sampler for 1,4-dioxane Using Silicone Membrane as a Diffusion Barrier.

Efficient monitoring methods must be developed for 1,4-dioxane, which is suspected to be carcinogenic to humans and is highly mobile in aquatic environments. In this regard, polar organic chemical integrative samplers (POCIS) have been utilized extensively as passive samplers for determining time-weighted average concentrations of hydrophilic organic compounds. However, POCIS are difficult to apply to extremely hydrophilic known organic compounds with negative log octanol-water partition coefficient (Kow ) values due to their limited kinetic sampling time. Using an activated carbon-based sorbent with a high adsorption capacity and a bilayer of silicone and polyethersulfone membranes that inhibit mass transfer to the sorbent, we developed a POCIS device to measure 1,4-dioxane (log Kow -0.27) in the present study. Permeation and field calibration tests demonstrated that the use of silicone membranes effectively reduces the water-to-sorbent mass transfer rate. The sampling rate and kinetic sampling period determined by field calibration tests were 1.4 ml day-1 and >14 days, respectively. Finally, the developed POCIS device was applied to a landfill treatment plant to determine the 1,4-dioxane concentrations. Environ Toxicol Chem 2023;42:296-302. © 2022 SETAC.

Case of vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy.

INTRODUCTION: Vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy, although rare, can be a critical complication. However, little has been reported about it by urologists. CASE PRESENTATION: A 79-year-old woman underwent laparoscopic radical cystectomy for invasive bladder carcinoma. Thirteen months postoperatively, she experienced vaginal cuff dehiscence and small bowel evisceration, and underwent emergency surgery. Intraoperatively, we detached the vaginal apex from the surrounding tissue to lengthen it and performed vaginal uterosacral ligament suspension, with no subsequent recurrence. CONCLUSION: Urologists should pay attention to vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy in female patients. In this case, the short vaginal length without vaginal uterosacral ligament suspension might have led to vaginal dehiscence.

Clonal expansion and spread of the ceftriaxone-resistant Neisseria gonorrhoeae strain FC428, identified in Japan in 2015, and closely related isolates.

OBJECTIVES: Ceftriaxone resistance in Neisseria gonorrhoeae is a major public health concern globally because a high-dose (1 g) injection of ceftriaxone is the only remaining option for empirical monotherapy of gonorrhoea. The ceftriaxone-resistant gonococcal strain FC428, cultured in Osaka in 2015, is suspected to have spread nationally and internationally. We describe the complete finished genomes of FC428 and two closely related isolates from Osaka in 2015, and examine the genomic epidemiology of these isolates plus three ceftriaxone-resistant gonococcal isolates from Osaka and Hyogo in 2016-17 and four ceftriaxone-resistant gonococcal isolates cultured in 2017 in Australia, Canada and Denmark. METHODS: During 2015-17, we identified six ceftriaxone-resistant gonococcal isolates through our surveillance systems in Kyoto, Osaka and Hyogo. Antimicrobial susceptibility testing (six antimicrobials) was performed using Etest. Complete whole-genome sequences of the first three isolates (FC428, FC460 and FC498) from 2015 were obtained using PacBio RS II and Illumina MiSeq sequencing. The three complete genome sequences and draft genome sequences of the three additional Japanese (sequenced with Illumina MiSeq) and four international ceftriaxone-resistant isolates were compared. RESULTS: Detailed genomic analysis suggested that the Japanese isolates (FC428, FC460, FC498, KU16054, KM383 and KU17039) and the four international MLST ST1903 isolates from Australia, Canada and Denmark formed four linked subclades. CONCLUSIONS: Using detailed genomic analysis, we describe the clonal expansion of the ceftriaxone-resistant N. gonorrhoeae strain FC428, initially identified in 2015 in Japan, and closely related isolates. FC428 and its close relatives show some genomic diversity, suggesting multiple genetic subclades are already spreading internationally.

Cystoscope-Assisted Laparoscopic Enucleation of a Large Progressive Bladder Leiomyoma.

Background: A bladder leiomyoma is a rare and benign bladder tumor. There are no established guidelines for the surgical treatment of this tumor. A transurethral approach for resection or surgical enucleation of the tumor is difficult, especially in patients with a large-sized leiomyoma. Therefore, a partial cystectomy is often indicated. In this case, we effectively performed a cystoscope-assisted laparoscopic enucleation of an intramural bladder leiomyoma. Case Presentation: A 46-year-old female was incidentally found to have a large tumor on the left wall of her urinary bladder. The MRI and needle biopsy results confirmed that the tumor was a bladder leiomyoma. Despite its benign nature, the tumor was found to progressively increase in size in 6 months. Therefore, we chose to perform a laparoscopic enucleation of the tumor. Simultaneous intraoperative cystoscopy was utilized to observe the operative area from within the bladder, thus enabling us to perform the procedure relatively safely. Although there was a minor inadvertent injury to the bladder mucosa intraoperatively, the left ureteral orifice was preserved. As a result, the tumor was effectively enucleated. The postoperative course was uneventful, and no recurrence was observed at the 4-month follow-up. Conclusion: We effectively accomplished the cystoscope-assisted laparoscopic enucleation of a large-sized leiomyoma of the urinary bladder. Based on our experience, we suggest that this combined technique is better and safer than an independent laparoscopic surgery. In addition, this surgery is now technically feasible and may have other applications in robotic surgery in the future.

Lignans from guaiac resin decrease nitric oxide production in interleukin 1ß-treated hepatocytes.

Guaiac resin, extracted from the heartwood of Guaiacum officinale L. or G. sanctum L., is speculated to have anti-inflammatory effects. Lignans were purified from guaiac resin (also known as gum guaiacum) by monitoring the nitric oxide (NO) production in rat hepatocytes treated with an inflammatory cytokine interleukin-1ß (IL-1ß). Six lignans were purified from guaiac resin and identified as: dehydroguaiaretic acid (1), (+)-trans-1,2-dihydrodehydroguaiaretic acid (2), furoguaiaoxidin (3), meso-dihydroguaiaretic acid (4), furoguaiacin (i.e., α-guaiaconic acid) (5), and nectandrin B (6). To our knowledge, this is the first time that 1 has been isolated from guaiac resin as a non-derivative. Compounds 2 and 6 were first found in guaiac resin. Compound 3 was first isolated from a natural source as a non-derivative. Furthermore, 1-6 significantly suppressed NO production in IL-1ß-treated hepatocytes. Because anti-inflammatory compounds suppress NO production, this system is often used to measure the anti-inflammatory effects of Kampo drugs and herbal constituents. The NO-suppressing activity of the six lignans isolated in this study indicates that guaiac resin has anti-inflammatory effects and that these lignans may be responsible for the anti-inflammatory effects of guaiac resin.

Early efficacy of silodosin in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.

OBJECTIVES: To evaluate the early efficacy of the alpha(1A)-adrenoceptor selective drug, silodosin, for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. METHODS: A total of 68 patients with an International Prostate Symptom Score (IPSS) of >==8 and a Quality of Life (QOL) index of >==2 were included. Changes in the IPSS and QOL index were evaluated before and after 1, 2, 3, 4, 5, 6, 7, 14, and 28 days of twice daily oral administration of 4 mg silodosin. Next, changes in IPSS subscores as well as voiding, storage, and post micturition symptoms were assessed. Changes in total IPSS based on symptom severity were also determined. RESULTS: Total IPSS and QOL index improved significantly from 19.38 +/- 7.46, 4.68 +/- 1.07 at baseline to 15.81 +/- 7.40, 4.22 +/- 1.30 at day 1. The subscores of voiding, storage, and post micturition symptoms were significantly decreased from 8.93 +/- 3.95, 7.97 +/- 3.88, and 2.49 +/- 1.70 at baseline to 7.28 +/- 4.09, 6.52 +/- 3.47, and 2.02 +/- 1.56 at day 1, respectively. This trend continued throughout the study. Regardless of severity, total IPSS were significantly decreased at day 1 and maintained throughout the study. CONCLUSIONS: Silodosin may be considered a promising treatment for benign prostatic hyperplasia/lower urinary tract symptom patients.

[Correlation between re-biopsy one year after endocrine therapy and long-term prognosis in localized prostate cancer].

PURPOSE: Even in the cases of localized prostate cancer, there are a substantial number of patients who undergo endocrine therapy, and their prognosis is affected by the treatment. We evaluated the histological effect of endocrine therapy and analyzed its correlation with prognosis. METHODS AND SUBJECTS: Seventy-seven cases with localized prostate cancer who underwent maximal androgen blockade (MAB) therapy 1 year or longer were pathologically evaluated using repeat biopsy specimens from November 1994 to October 2001. The relationship between clinical parameters and histological effect in repeat biopsy specimens was examined. Biopsy was conducted mainly by the 6-site systematic method, and the histological effect was judged in accordance with the General Rules for Clinical and Pathological Study of Prostate Cancer (3rd edition). The median re-biopsy and follow-up periods were 13 months and 41 months, respectively. RESULTS: Using this criteria for the histological effects of anti-cancer treatment, the histological effect of endocrine therapy was most frequently observed in class G3b with 61.0%, and correlations with PSA nadir and initial biopsy positive number before endocrine therapy were observed. After biopsy, radical prostatectomy was performed on 9 patients (endocrine therapy was concurrently performed on 4), endocrine therapy on 67 (intermittent administration on 21), and radiation therapy on 1 (MAB was concurrently performed). Outcomes included PSA failure in 14, of whom 2 died of cancer. Three-year and 5-year PSA-failure free survival rates were 91.1% and 76.3%, respectively. Pathological disease stage in radical prostatectomy specimens was examined by dividing it into class G0-2 and class G0-3. This revealed a significant correlation between histological effect and pathological disease stage (pT2-3). PSA-failure free survival was analyzed in 67 of the 77 patients who underwent endocrine therapy. A significantly large number of PSA-failures occurred in class G0-2. Multivariate analysis revealed that the histological effect alone was the influencing factor in PSA-failure. CONCLUSION: A strong histological effect by MAB 1 year or longer after treatment was observed on localized prostate cancer. Evaluation of the histological effect by the present method was considered to be a useful predictor for organ-confined disease after radical prostatectomy and endocrine therapy for PSA-failure.

[Intraurethral condyloma acuminatum: a case report].

A 47-year-old man presented with meatal bleeding. Visual inspection revealed papillary meatal tumors at 5 and 7 o'clock without other genital warts. These lesions were completely resected, and the histological diagnosis was condyloma acuminata. After 2 months, recurrence of warts was not observed macroscopically in the genital area, including the urethral meatus. However, urethroscopy revealed a papillary tumor in the navicular fossa. This lesion was removed and pathological examination revealed that it was also a condyloma acuminatum.

[Retroperitoneal bronchogenic cyst: a case report].

A rare case of retroperitoneal bronchogenic cyst is presented. A 50-year-old man was referred to our hospital for an investigation of a retroperitoneal mass. Computed tomography and magnetic resonance imaging confirmed a retroperitoneal mass, about 4 cm in diameter, adjacent to the left kidney and spleen. On the basis of these imaging modalities, a definitive diagnosis of this mass could not be made. So, resection of the mass was performed. The removed mass was an unilocular cyst and filled with mucinous fluid. Histopathologically, the cyst wall was composed of a fibrovascular connective tissue containing mucus-secreting glands and cartilages and was lined by ciliated pseudostratified columnar epitherium. Thus, a diagnosis of bronchogenic cyst was made. Bronchogenic cysts are rare congenital anomalies of the primitive foregut and usually develop in the mediastinum and lung.

[Phyllodes tumor of the prostate: a case report].

Prostatic phyllodes tumor is an unusual lesion for which there are only occasional reports in the literature. We encountered a phyllodes tumor of the prostate in a 36-year-old man who had complained of urinary frequency and dysuria for one month. In October 1998, he visited our hospital and had a transurethral resection of the prostate (TUR-P) for obstructive symptoms. He experienced recurrent same symptoms in September 1999 and underwent another TUR-P. The pathologic examination at this time revealed phyllodes tumor. In the tumor, despite its regular alternating growth of ducts and stroma, the stromal element appeared histologically malignant, showing marked atypia and rhabdomyosarcoma-like components. Consequently, in December 1999, the patient underwent radical prostatectomy with lymph node dissection. The resection margins and pelvic lymph nodes were free of tumor. The patient remains alive and well after 14 months.