[A pharmacokinetic study of antibiotics in patients with benign prostatic hypertrophy]

Twenty cases intravenously received 1 g of cefotetan before the transurethral prostatectomy. High serum and prostatic concentrations were obtained and half-lives were 298 minutes for serum and 250 minutes for the prostate. The mean value of their creatinine clearance was as low as 46.6 ml/min and it was found to be the reason why the serum half-life time was longer than that reported for normal volunteers.

Receptor-mediated inhibition of adenylate cyclase and stimulation of arachidonic acid release in 3T3 fibroblasts. Selective susceptibility to islet-activating protein, pertussis toxin

Thrombin exhibited diverse effects on mouse 3T3 fibroblasts. It (a) decreased cAMP in the cell suspension, (b) inhibited adenylate cyclase in the Lubrol-permeabilized cell suspension in a GTP-dependent manner, increased releases of (c) arachidonic acid and (d) inositol from the cell monolayer prelabeled with these labeled compounds, (e) increased 45Ca2+ uptake into the cell monolayer, and (f) increased 86Rb+ uptake into the cell monolayer in a ouabain-sensitive manner. Most of the effects were reproduced by bradykinin, platelet-activating factor, and angiotensin II. The receptors for these agonists are thus likely to be linked to three separate effector systems: the adenylate cyclase inhibition, the phosphoinositide breakdown leading to Ca2+ mobilization and phospholipase A2 activation, and the Na,K-ATPase activation. Among the effects of these agonists, (a), (b), (c), and (e) were abolished, but (d) and (f) were not, by prior treatment of the cells with islet-activating protein (IAP), pertussis toxin, which ADP-ribosylates the Mr = 41,000 protein, the alpha-subunit of the inhibitory guanine nucleotide regulatory protein (Ni), thereby abolishing receptor-mediated inhibition of adenylate cyclase. The effects (a), (c), (d), and (e) of thrombin, but not (b), were mimicked by A23187, a calcium ionophore. The effects of A23187, in contrast to those of receptor agonists, were not affected by the treatment of cells with IAP. Thus, the IAP substrate, the alpha-subunit of Ni, or the protein alike, may play an additional role in signal transduction arising from the Ca2+-mobilizing receptors, probably mediating process(es) distal to phosphoinositide breakdown and proximal to Ca2+ gating.

[A case of embryonal rhabdomyosarcoma of the kidney]

A case of embryonal rhabdomyosarcoma of the left kidney is reported. A 16-year-old boy was admitted with the complaint of left abdominal pain and fever on January 6, 1983. Radiological examination showed a tumor of the left kidney; and, nephrectomy was performed. Histopathologically the entire tumor was composed of undifferentiated round cells. Diagnosis of embryonal rhabdomyosarcoma was made on the basis of special stains including immunohistochemical study with nervous tissue specific enolase. Although radiation and chemotherapy were performed postoperatively, the tumor recurred and the patient died on October 22, 1983. The problems of differential diagnosis of embryonal rhabdomyosarcoma from sarcomatous types of nephroblastoma, particularly rhabdoid tumor and other undifferentiated renal tumors were discussed. Fifteen rhabdomyosarcoma of the kidney including our case have been reported in the Japanese literature.

Rupture of renal artery aneurysm

Rupture of a renal artery aneurysm, although rare, has been considered to be the most catastrophic urological injury. Three cases of ruptured and 1 case of impending rupture are reported. A review of the cases of ruptured renal artery aneurysm is presented together with emphasis on improved prognosis of this morbidity. Surgical indications are discussed.

[Effect of etoposide for pulmonary metastases from urogenital tract cancer]

Seven cases with pulmonary metastases from the urogenital tract were treated with VP-16 in either oral doses of 200 mg or intravenous doses of 100 mg for 5 days. Two of 4 cases with transitional cell cancer from the urinary bladder and a case with prostatic adenocarcinoma responded to the treatment. Another 2 cases with adenocarcinoma arising from the kidney showed no response. Leucopenia, thrombocytopenia and alopecia were outstanding side effect.

[Concentration of antibiotics in the prostate: cefmetazole]

Sixteen patients who underwent transurethral resection of prostate preoperatively received intravenous injection of cefmetazole in a doses of 2 gram. Pharmacokinetic study revealed that concentration of cefmetazole in prostatic tissue well correlated to serum concentration with nearly the same half-life times.

[Prophylactic cefmetazole in transurethral prostatectomy]

Patients received 2 gram of cefmetazole, twice on the day of transurethral prostatectomy and the next day, once for the succeeding 2 days. Thirteen out of 34 cases showed significant preoperative bacteriuria. Only 3 of them persisted on the 5th day. Postoperative courses were uneventful in all cases with neither acute epididymitis nor significant fever.

Antibody-dependent cell-mediated cytotoxicity against mouse MM2 tumor cell line by macrophages activated with OK-432

The action mechanism of antibody-dependent macrophage-mediated cytotoxicity (ADMC) induced by OK-432 against MM2 carcinoma cells was examined. Adherent peritoneal exudate cells (adherent PEC) harvested from mice 4 days after intraperitoneal injection of OK-432 exhibited potent cytotoxic activity against MM2 cells in the presence of anti-serum obtained from tumor-free mice which had survived over 60 days following treatment with OK-432 and resisted rechallenge with MM2 cells. The cytotoxic activity of the adherent PEC was not abolished by treatment with anti-Thy-1.2 and complement, and there were no differences in ADMC between adherent PEC from BALB/c mice and those from athymic BALB/c (nu/nu) mice. Further, ADMC activity was shown not only against MM2 cells, but also against other allogeneic tumor cells, such as MOPC-11 plasmacytoma cells. On the other hand, the effective factor(s) in anti-serum to MM2 cells was eliminated by passage through a protein A-Sepharose CL-4B affinity column. The action mechanism of ADMC caused by the adherent PEC and anti-serum to MM2 cells is discussed.

[3H]GDP release from rat and hamster adipocyte membranes independently linked to receptors involved in activation or inhibition of adenylate cyclase. Differential susceptibility to two bacterial toxins

When rat adipocyte membranes had been labeled with [3H]GTP in the presence of a beta-adrenergic agonist, the subsequent [3H]GDP release was stimulated by beta-agonists or agonists (e.g. glucagon and secretin) of other "activatory" receptors involved in activation of adenylate cyclase, but was not stimulated by agonists (e.g. prostaglandin E1 and adenosine) of "inhibitory" receptors involved in cyclase inhibition. On the contrary, agonists of inhibitory receptors were effective in stimulating GDP release from hamster adipocyte membranes that had been labeled via inhibitory alpha 2-adrenergic receptors, but an activatory receptor agonist such as isoproterenol was not. Thus, the guanine nucleotide regulatory protein (Ni) involved in adenylate cyclase inhibition is an entity distinct from the regulatory protein (Ns) involved in cyclase activation, and multiple activatory or inhibitory receptors are coupled to a respective common pool of Ns or Ni. Preactivated cholera toxin added together with NAD enhanced GDP release from rat adipocyte membranes prelabeled with isoproterenol but was without effect on the release from hamster adipocyte membranes that had been labeled with an alpha-agonist. In sharp contrast, the active subunit of islet-activating protein, pertussis toxin, failed to alter GDP release from the former membrane but completely abolished inhibitory agonist-induced stimulation of GDP release from the latter membrane preparation in the presence of NAD. Thus, the site of action of cholera toxin is Ns, while that of islet-activating protein is Ni. The function of Ni to communicate between inhibitory receptors and adenylate cyclase was lost when it was ADP-ribosylated by islet-activating protein.

Relationship between postoperative blood pressure change and renal pathophysiology in primary aldosteronism

32 patients with primary aldosteronism due to adrenal adenoma were studied to elucidate the relationship between blood pressure (BP) and renal functions before and after the removal of aldosteronoma. The relationship between either BP or renal functions and the structural changes of the renal biopsy specimens obtained at the operation was also examined. Renal function studies included serum urea nitrogen (BUN), creatinine, creatinine clearance (Ccr), phenolsulfonphthalein (PSP) test, and urine concentration test (max SG). Renal plasma flow (RPF), renal blood flow, and filtration fraction (FF) were measured. Serum sodium was significantly decreased and potassium was increased after the removal of the aldosteronomas. The levels of BUN, Ccr, PSP, and max SG were not significantly correlated to either pre- or postoperative BP levels, and to the improvement of hypertension after the operation. On the other hand, BP was significantly correlated with RPF and FF before surgery. Furthermore, the postoperative improvement of hypertension was correlated with the decrease of FF and the increase of hematocrit after surgery. The influence of duration of preoperative hypertension on BP response after adrenalectomy was not significant in the present study. The higher the BP level, the more marked histological changes were found. But, there was no relationship between renal functions and histological changes of renal biopsy specimens. The results indicate that RPF may participate in the hypertension of primary aldosteronism and that the BP level after surgery may be predicted by examination of the pathological changes present in the kidney.

[Clinical study concerning upper urinary tract obstruction. 2. Relationship between 99mTc-DMSA uptake in obstructed kidneys and their functions]

To establish a method of detecting divided renal function of the obstructed kidneys noninvasively, comparative studies on 99mTc -DMSA uptake (60 minutes after injection), I 131-hippuran renal uptake (1-2 minutes after injection) and divided creatinine clearance immediately after relief of urinary obstruction were made on 24 cases of obstructive uropathy. A close significant correlation was obtained between 99mTc -DMSA and I 131-hippuran renal uptakes (gamma = 0.8809, P less than 0.001). Also, a significant correlation was noted between 99mTc -DMSA renal uptake and divided creatinine clearance (gamma = 0.7876, P less than 0.001), but the latter constantly gave lower values than the former. These observations led us to conclude that 99mTc -DMSA renal uptake is a reliable indicator of the renal plasma flow in the obstructed kidneys. Quantitative divided renal function of the obstructed kidneys can be estimated by the 99mTc -DMSA uptake method.

Loss of the inhibitory function of the guanine nucleotide regulatory component of adenylate cyclase due to its ADP ribosylation by islet-activating protein, pertussis toxin, in adipocyte membranes

Adenylate cyclase of rat adipocyte membranes exhibited dual responses in a strictly GTP-dependent manner; an activation took place in the presence of certain receptor agonists such as isoproterenol or secretin, whereas an inhibitory phase was observed with other agonists such as prostaglandin E1 or purine-modified adenosine as well as with the stimulatory agonists at higher GTP concentrations. Treatment of membrane donor cells with islet-activating protein (IAP), pertussis toxin, abolished the inhibitory phase while preserving the activatory phase. This unique action of IAP was associated with ADP-ribosylation of a membrane Mr = 41,000 protein. In contrast, the inhibitory phase was preserved in membranes from cholera toxin-treated cells. Monophasic and persistent activation of the cyclase was provoked by guanyl-5'-yl beta,gamma-imidodiphosphate. The time lag normally observed for the guanyl-5'-yl beta,gamma-imidodiphosphate activation was decreased by isoproterenol or cholera toxin but was not altered by IAP treatment. Our conclusion is that the sole site of IAP action is the guanine nucleotide regulatory protein (Ni) that is required for transmission of inhibitory signals from receptors to the catalytic unit of adenylate cyclase; the function of Ni is lost upon IAP-catalyzed ADP ribosylation of the Mr = 41,000 protein which appears to be an active subunit of Ni. A possibility is discussed that rather diverse effects of IAP so far reported with various cell types are accounted for in terms of such interference with the function of Ni.

Guanine nucleotide activation and inhibition of adenylate cyclase as modified by islet-activating protein, pertussis toxin, in mouse 3T3 fibroblasts

Guanine nucleotide regulation of membrane adenylate cyclase activity was uniquely modified after exposure of 3T3 mouse fibroblasts to low concentrations of islet-activating protein (IAP), pertussis toxin. The action of IAP, which occurred after a lag time, was durable and irreversible, and was associated with ADP-ribosylation of a membrane Mr = 41,000 protein. GTP, but not Gpp(NH)p, was more efficient and persistent in activating adenylate cyclase in membranes from IAP-treated cells than membranes from control cells. GTP and Gpp(NH)p caused marked inhibition of adenylate cyclase when the enzyme system was converted to its highly activated state by cholera toxin treatment or fluoride addition, presumably as a result of their interaction with the specific binding protein which is responsible for inhibition of adenylate cyclase. This inhibition was totally abolished by IAP treatment of cells, making it very likely that IAP preferentially modulates GTP inhibitory responses, thereby increasing GTP-dependent activation and negating GTP-mediated inhibition of adenylate cyclase.

Subacute sclerosing panencephalitis: atypical absence attacks as first symptom

Subacute sclerosing panencephalitis was diagnosed in a 10-year-old girl who had suffered from atypical absence attacks for 3 months; diagnosis was made after 5 months of these attacks. Characteristic EEG findings included diffuse spike and wave complexes of about 2.5 Hz associated with desynchronization during the absence attacks, and recruiting rhythm during the tonic seizure. As the lesion responsible for these EEG patterns originated in the brainstem, subcortical structures were probably affected early in the disease. The SSPE complexes may have originated chiefly in the brainstem since, in this case, they were recognized even during the period of absence attacks.

[Renal transport and nephrotoxicity of cephaloridine (author's transl)]

Large doses of cephaloridine (CER) cause acute necrosis of the proximal renal tubule in various species, as well as gentamicin (GM). However, administration of the two drugs simultaneously resulted in a protective effect of CER against GM related nephrotoxicity in rats. The present studies were designed to examine the mechanism of CER transport system into renal cells in vitro, using the rat kidney slices and 3H-CER, effects of transport system of CER by GM or cephalexin, and effects on CO2 production in rat kidney slices of CER and GM. The results were as follows: 1. CER was transported into cells actively and intracellular concentration of CER became to be equal to extracellular concentration on around 100 mcg/ml of extracellular concentration of CER. 2. GM and CEX inhibited intracellular active transport of CER. 3. CER had inhibitory effect on CO2 production in rat kidney slices and its effect was dose dependent. GM had no effect on CO2 production. The author concluded that intracellular transport system of CER, GM and CEX is the same, and competition may be present, if each drugs are administrated simultaneously. Different attitude on CO2 production of CER and GM does not explain the difference of the mechanism of renal toxicity of each drugs directly. However, it may explain that the mechanism of renal toxicity of CER is not the same as of GM in parts.

Non-IgM monoclonal gammopathy in patients with Sjögren's syndrome

Two Japanese patients with Sjögren's syndrome with non-immunoglobulin M(IgM) class monoclonal gammopathy are described. The monoclonal IgA lambda detected in the serum and saliva was confirmed to possess rheumatoid factor activity in the first patient with a hypergammaglobulinemic purpura and hyperviscosity syndrome. Idiotype specificity was present on the surface membrane of peripheral blood lymphocytes as well as in the cytoplasm of infiltrating cells in the salivary glands. Common idiotypic specificity was found in four of 60 other patients who had rheumatoid factors. In the serum and saliva of the other patient, a monoclonal immunoglobulin G, kappa type (IgG kappa), was detected. Kappa type IgG was found in most of the infiltrating cells in the salivary glands and also in the saline extract from a resected submandibular gland. Our findings indicate that non-IgM class monoclonal gammopathy is also one of the complications of Sjögren's syndrome.

Stimulation of dehydrogenase synthesis by cadmium in a cadmium-resistant strain of Saccharomyces cerevisiae

The activity of dehydrogenase in Saccharomyces cerevisiae was estimated by reduction of 2,3,5-triphenyltetrazolium chloride. By the adaptation of yeast to cadmium, the high activity of dehydrogenase was observed. Furthermore, the activity of dehydrogenase in Cd-resistant cells was increased by growing in medium containing CdSO4. However, the activity of dehydrogenase was inhibited by the addition of CdSO4 to the reaction mixture. The activity of dehydrogenase in Cd-sensitive cells was increased slightly by incubation with low concentrations of CdSO4. High activity of dehydrogenase in Cd-resistant cells was completely negated by the addition of cycloheximide to the incubation medium. The increase of dehydrogenase activity is due partly to de novo synthesis of protein.

Effects of acute and chronic ethanol administration on amino acid metabolism in rabbit brain and blood

Acute administration of ethanol increased the cerebrocortical amino acids derived through the tricarboxylic acid cycle except for GABA and decreased the plasma alanine, valine, isoleucine, leucine, and phenylalanine whereas chronic administration of ethanol caused no significant changes in the cerebrocortical amino acids and increased the plasma glutamic acid, glutamine, glycine, and ornithine, with decreases in taurine and phenylalanine. Result of this experiment suggests that the CNS-depressant effect of ethanol is related to changes in the GABA system and increased uptake by the brain of the branched-chain amino acids while the development of tolerance to ethanol is associated with cellular adaptation in the CNS.

Effect of OK-432 on immunization with mitomycin-C-treated L1210 cells

The pretreatment of B6D2F1 mice with OK-432 alone was not so effective to retard the growth of L1210 leukemia, and the leukemic cell was poorly immunogenic in the mice. However, when OK-432 was given by ip injection in combination with mitomycin-C-treated L1210 cells, the growth of L1210 leukemia was significantly retarded and some mice did not "take" the leukemia. Meanwhile, BCG was also effective in this respect. Differences in properties as an immunopotentiator between OK-432 and BCG were suggested by the experiments of in vitro cytotoxicity test of spleen cells.

Mesonephric adenocarcinoma of the urethra in a woman: report of a case

A case of urethral carcinoma in a 42-year-old woman is reported. The histologic examination of the urethral tumor disclosed mesonephric adenocarcinoma, which is rare in female subjects. The pathology is discussed and the literature is reviewed briefly.

A case of parathyroid carcinoma concurred with hyperplasia: an electron microscopic study

A case of parathyroid carcinoma is reported. The histology of the parathyroid glands disclosed carcinoma in 1 gland and chief cell hyperplasia in another. Therefore, we recommend careful exploration of all parathyroid glands. An electron microscopic feature of parathyroid carcinoma is presented.