On the afternoon of March 11, 2011, a magnitude 9.0 earthquake followed by catastrophic tsunami hit northeast Japan, causing massive casualties. We are deeply grateful to numerous colleagues throughout the world who sent messages of encouragement to Japan. Although no single member of JUA was lost by this disaster, some pharmaceutical products were affected by damaged lifelines. Amid those drugs, we were running short of testosterone enanthrate (TE) immediately after the earthquake. Testosterone replacement therapy for men with late-onset hypogonadism is nowadays one of the common patients care in urology. Iijima et al. (Kanazawa) reported a male patient of myelodysplastic syndrome who responded to TE. They might have had difficulty of maintaining TRT after the disaster. Fortunately, the pharmaceutical plant in Fukushima resumed to normal production line within a couple of weeks.
In the Editorial, Dr Wong (Singapore) reported her quarter-century history of the Singapore Urological Association (SUA). It is the obligation for urologists especially in Asia to strengthen the relationship between nation member associations, and SUA in the last 10 years contributed to the establishment of the Urological Association of Asia (UAA), and have certainly been one of the most active educational centers in Asia.
In this issue, a series of reviews from experts is included, summarizing the clinical outcomes obtained by the most recent immunotherapy for metastatic renal cell cancer (RCC) using tyrosin kinase inhibitors, antigen-specific immunity with DC- or peptide-based immunotherapy, and those in combination with cytokines. Zhang et al. (Shanghai) reported that erythrocyte sedimentation rate was found to be an important prognostic factor, as well as an informative biomarker, that reflects disease progression and efficacy of sorafenib.
Takagi et al. (Tokyo) studied the probability of developing new onset of chronic kidney dysfunction in RCC patients who underwent nephron-preserving surgery (NSS) or radical nephrectomy. In their retrospective study, the patients who had the preoperative renal function in e-GFR value of less than 45ml/min/1.73m2 receive least benefit of NSS compared with those who had better preoperative e-GFR. Urologists should keep ischemic kidney volume as small as possible, using anatrophic partial arterial clamping in these special subgroup. Further clinical investigation based on larger patient data is warranted.
Eg5 (also known as kinesin spindle protein) plays an important role in maintaining the bipolarity of dividing cells. Ding et al. (Shandong) evaluated the prognostic value of Eg5 immunoreactivity through survival analysis in 163 non-muscle invasive bladder tumor patients, and found that overexpression of Eg5 correlates with higher risk for intravesical recurrence. Shin et al. (Jeonju) confirmed that immediate urine cytology after TURBT for non-muscle invasive cases can be an independent prognostic factor to predict cancer recurrence.
The postoperative evaluation of vesico-urethral anastomosis location in relation to the symphysis pubis after radical prostatectomy is an independent predictor of early recovery of urinary incontinence (Jeong et al. from Seongnam).
Shao et al. (Shanghai) evaluated the clinical outcome of tension-free vaginal tape (TVT) in 24 female patients with intrinsic sphincter deficiency who failed Burch urethropexy. Despite relatively high incidence of bladder injury, the authors found that this situation can be still managed with TVT retropubic sling by elevating urethral closing pressure effectively rather than reducing urethral hypermobility.
Kumon et al. (Okayama) reported that calcifying nanoparticles can be isolated in two thirds of various Japanese urinary stones, cultured in cell culture mediums, and scanning electron microscopy demonstrated two types of nanobacteria-like particles (NPL), rod-shaped NLP growing as a floating form, and spherical NLP with apatite shell growing as an attached form. The clinical significance of this nanoparticles still awaits further investigation.
Hasegawa et al. (Tokyo) reported a very rare case of transverse testicular ectopia with spleno-gonadal fusion in a 2-year-old boy.
Finally, Ishii et al. (Osaka) studied the hemostatic effect of liquid fibrin sealant alone, or in combination with a sheet-type hemostat, such as collagen, gelatin or oxidized-cellulose hemostat, in partial nephrectomy model, and the combined application of fibrin glue with either the collagen or gelatin hemostat was effective to gain reinforced hemostatic effect at the suture site.