[Compared studies of antimicrobial agents against E. coli, Klebsiella, Citrobacter and Proteus isolated from urinary tract infections]

In vitro activities of antibacterial agents against E. coli, Klebsiella, Citrobacter and Proteus which were isolated from patients urinary tract infections at 8 hospitals in Japan, were investigated by agar dilution method from July to October in 1979. The summarized results are as follows. 1. Among oral antibacterial agents, MPC and PPA have showed potent antibacterial activities against E. coli and Klebsiella. Among parenteral antibiotics, CTM was the most active against E. coli and Klebsiella. However, ABPC-resistant E. coli and Klebsiella have appeared to occupy about 40% and 96% of bacteria isolated from urinary tract infections, respectively. 2. In vitro activities of antibacterial agents against Proteus and Citrobacter showed not so potent. 3. Causative organisms in female patients with simple urinary tract infections were mainly E. coli and Klebsiella. 4. Among oral antibacterial agents, PPA have shown similar antimicrobial activities against E. coli isolated from simple and complicated urinary tract infections. ABPC and MPC have been influenced in some degree by these factors. However, parenteral antibiotics are not influenced by these factors. On the other hand, in vitro activities of antibacterial agents against Klebsiella isolated from simple and complicated urinary tract infections were similar.

Multimodal treatment of advanced adult Wilms tumor

We report 2 cases of advanced adult Wilms tumor that were treated with surgery, radiation and chemotherapy. The first patient had relapse of a Wilms tumor in the liver 2 years after nephrectomy. Combination chemotherapy, consisting of actinomycin D and vincristine, radiation therapy and final resection of the liver metastasis were successful and the patient has been free of disease for 4 years. The second patient had undergone transcatheter embolization of the renal artery elsewhere with the tentative diagnosis of an inoperable renal cell carcinoma metastatic to both lungs. A left renal tumor, weighing 4,500 gm., and a tumor thrombus in the vena cava extending to the right atrium were removed, and histologically diagnosed as a Wilms tumor. Subsequent chemotherapy and radiotherapy resulted in complete disappearance of the lung metastases. We conclude that multimodal treatment, namely a well timed combination of surgery, chemotherapy and radiotherapy, could potentially eradicate the disease even at an advanced stage.

Periodic urine cytology surveillance of bladder tumor incidence in dyestuff workers

The validity of urine cytology surveillance of occupational bladder tumor incidence was evaluated by reviewing the clinical history of nine bladder tumor cases found in dyestuff plant workers. A bladder tumor surveillance system has been organized for workers (179) active and 65 retired) who had been exposed to benzidine or beta-naphthylamine in the plant. The system consists of two-stage tests: periodic urine cytology as the first-stage screening test, followed by, in suspicious cases, urological examinations as second-stage tests. The urine cytology surveillance was found to be useful for two reasons: first, it detected tumors in five out of six cases surveyed by athe system, and second, four cases screened by cytology had tumors curable by transurethral operation, while other cases underwent cystectomy. Calculated average latent periods from the first and last exposure was 26.4 years (SD = 6.0) and 14.0 years (SD = 6.2), respectively. This time period indicates that the surveillance system should continue to be used for the exposed group even after workers have ceased being exposed.

Myelolipoma of the adrenal gland

A case is reported of an adrenal myelolipoma producing a retroperitoneal hematoma. A right suprarenal mass with fatty density was detected by a computerized tomography scan. The mass had irregular vessels on the arteriogram. This is the youngest patient reported among those with surgically removed myelolipoma. There was no endocrine activity.

Spironolactone bodies in aldosteronomas and in the attached adrenals. Enzyme histochemical study of 19 cases of primary aldosteronism and a case of aldosteronism due to bilateral diffuse hyperplasia of the zona glomerulosa

The formation of spironolactone (S) bodies, eosinophilic laminated cytoplasmic inclusions, is induced in the aldosterone-producing cells of the human adrenal cortex after the administration of spironolactone. The aim of this study was to define the enzyme histochemical characteristics of S bodies, S-body-containing cells, and the apparently hyperplastic zona glomerulosa (zG) of adrenal tissues attached to aldosteronomas. S bodies were found in 14 of 19 aldosteronomas, in 10 of 19 adrenal tissues attached to aldosteronomas, and in the adrenal tissues in a patient with aldosteronism due to bilateral diffuse zG hyperplasia. The S bodies themselves exhibited most intense 3 beta-hydroxysteroid dehydrogenase (3 beta HSD) activity but did not exhibit glucose-6-phosphate dehydrogenase (G6PD), NADP-dependent isocitrate dehydrogenase (NADP-ICDH), or succinate dehydrogenase (SDH) activity, confirming histochemically the origin of S bodies in the smooth endoplasmic reticulum. In two adenomas, S bodies were found to be surrounded by reaction products of acid hydrolase but were not found in the other adenomas and the remaining adrenal tissues. S-body-containing cells, irrespective of being neoplastic or not, showed enhanced 3 beta HSD, G6PD, and NADP-ICDH activity and weak SDH activity (Type I pattern of enzyme activity). Though zG was hyperplastic in most of the adrenal tissues attached to the adenomas, zG cells that did not contain S bodies showed the opposite pattern (Type II pattern) of enzyme activity (ie, weak 3 beta HSD, G6PD, and NADP-ICDH activity and intense SDH activity), in contrast to those in the adrenal tissues in a patient with aldosteronism due to bilateral diffuse zG hyperplasia (which showed the Type I pattern). The results are consistent with the view that hyperplastic zG cells, except S-body-containing cells, in the case of aldosteronoma are not hyperfunctioning. The latter cells may have enhanced but possibly abortive steroidogenic activity.

Antiandrogenic effects of spironolactone: hormonal and ultrastructural studies in dogs and men

A decrease in the level of plasma testosterone and an increase in the level of plasma progesterone were noted after spironolactone had been administered for 20 days in 5 patients with prostatic carcinoma, as well as in 8 male dogs. Electron microscopic observation disclosed myelin-like bodies in the cytoplasm of Leydig and adrenocortical cells in dogs, contributing to a resolution of the mode of antiandrogenic action of spironolactone.

Transplantation of human renal cell carcinoma to the nude mice: as an intermediate of in vivo and in vitro studies

Five human renal cell carcinomas were transplanted successfully to nude mice fed and grown under a specific pathogen-free condition. The histology of the transplanted tumor tissue was a close reproduction of the original human cancer tissue in situ. The transplanted tumor tissue possessed an abundant supply of blood vessels, which was considered to be of host animal origin. All transplanted tumor cells grew easily when transferred to an in vitro cell culture system from the nude mice. In this latter cell culture system tumor cells demonstrated a growth pattern characteristic of epithelial cells. The electron microscopy of these cells showed some characteristic morphological features that indicated their cytological origin.