[In situ hybridization study on the detection of HPV DNA in adenocarcinoma and adenosquamous carcinoma of the uterine cervix]

Human papillomavirus (HPV) types 16 and 18 have been found closely associated with squamous cell carcinoma and related lesions of the uterine cervix. In order to investigate the relationship between HPV and adenocarcinoma and adenosquamous carcinoma of the uterine cervix, formalin-fixed, paraffinembedded tissues prepared from 38 cases consisting of 30 cases of adenocarcinoma and 8 cases of adenosquamous carcinoma were examined for the presence of HPV DNA by in situ hybridization with digoxigenin labeled HPV 6/11, 16, 18 DNA probes. HPV DNA was localized on the nuclei of the cancer cells in adenocarcinoma and adenosquamous carcinoma. HPV DNA was detected in 13 cases (43.3%) of adenocarcinoma and 4 cases (50.0%) of adenosquamous carcinoma, and HPV type 18 DNA was detected in 13 cases (34.2%) of adenocarcinoma and adenosquamous carcinoma. These findings suggest an association between HPV, especially HPV type 18, and adenocarcinoma and adenosquamous carcinoma of the uterine cervix.

Estimation of the right ventricular volume overload in children with atrial septal defect by body surface mapping

To investigate the possibility of estimating the right ventricular volume overload in atrial septal defect (ASD) by body surface mapping (BSM), 45 children with ASD were included in the present study. The breakthrough minimum (BTM) appeared later and more leftward in ASD subjects than in the normal controls. Neither the length of the delay in the appearance of the BTM nor the extent of its leftward deviation was significantly correlated with the pulmonary and systemic flow volume ratio (Qp/Qs), obtained by cardiac catheterization. Therefore neither could be used as the parameter of the right ventricular volume overload. sigma R, Rmax (D3 + D4) + magnitude of S max (H4 + H5) and "T dep", the sum of the absolute values of the departure indices (DIs) in the G4, G5, H4 and H5 leads, and the DIs in the J5, J6, K5, and K6 leads in T departure Map, correlated with the Qp/Qs significantly (r = 0.62, 0.68, 0.69, respectively). Accordingly, they might be useful for estimating the right ventricular volume overload. The subjects were divided into 3 groups according to their Qp/Qs. Discriminant analysis between these 3 groups was then performed, using Rmax (D3), magnitude of S max (H4), and T dep as the variables. The accuracy of this discrimination was 82.2%. The results suggest the possibility of estimating the severity of ASD by BSM.

Assessment of the long-term results of ileocecal conduit urinary diversion

We reviewed our 12.5-year experience with ileocecal conduit (ICC) and report the long-term results of 147 cases of ICC compared with those of our 102 cases of ileal conduit (IC). We usually performed ICC following total cystectomy for carcinoma of the bladder, while we chose IC in cases of high stage or recurrent malignancies. The average follow-up period was 41.7 months in the ICC group and 28.8 months in the IC group. The postoperative mortality (6.1%) and the incidence of early complications (21.1%) in the ICC group were comparable with the reported incidences for IC. In the later period, stomal problems were most frequently encountered. Urinary tract complications are important because they affect renal function in the course of a long period of time. Excretory urogram showed a satisfactory result and serum creatinine remained within the normal limits even in patients followed up for a long time in both groups. The incidences of pyelonephritis and urinary stones in the ICC group were 13.6 and 5.4%, respectively. We had expected a much lower incidence of these complications and ICC could not cover all the drawbacks of IC. However, at present, there is no ideal or perfect method of urinary diversion, ICC should be one of the acceptable options which has a satisfactory long-term result.

[Clinical effect of terodiline hydrochloride on pollakisuria and urinary incontinence]

Efficacy and safety of terodiline hydrochloride were studied by treating 38 patients who complained of pollakiuria and incontinence with this drug. Terodiline hydrochloride in a dose of 24 mg once or 12 mg twice a day was administered to these patients for 4 weeks and the conditions of the patients before and after the treatment were evaluated. According to the subjective symptoms, pollakisuria during the daytime and at night, incontinence, anischuria at night and frequency of urination were all reduced significantly. Objective symptoms detected after the treatment a tendency of increase (p less than 0.1) in the bladder volume at the time of maximum micturition. However, no change in the urination volume and the maximum urine flow was observed before and after the administration. A significant decrease (p less than 0.05) in residual urine was noted after the treatment. The results were favorable with overall improvement of 78.4% and efficacy of 75.7%. Side effects were observed in 3 of the 38 cases (7.9%), but all the symptoms were slight.

Clinical profile of Japanese dialysis patients with diabetic nephropathy, diagnosed as having diabetes before the age of thirty

Diabetic nephropathy is the leading cause of death in young diabetic patients. There are a large number of patients with non-insulin-dependent diabetes mellitus (NIDDM) who are diagnosed before the age of 30 in Japan. We investigated 36 patients with young-onset diabetes who started dialysis between 1978 and 1987 in our hospital. Of the 36 patients, 12 (33.3%) were classified as having insulin-dependent diabetes mellitus (IDDM), 22 (61.1%) had NIDDM, and 2 (5.6%) could not be classified clinically. The percentages of the different types of diabetes in our series of dialysis patients were almost identical with those in Nagai's series of 551 diabetic patients diagnosed before the age of 30 at the Diabetes Center of Tokyo Women's Medical College from 1976 to 1981. The present study showed the young-onset NIDDM in Japan was associated with almost the same incidence of end-stage diabetic nephropathy as was IDDM. However, the number of NIDDM patients diagnosed under 30 years of age was almost double that of IDDM patients. Thus, we have to pay greater attention to the development of diabetic nephropathy in young-onset NIDDM patients than has been thought necessary in the past.

[Molecular biologic study on the carcinogenesis of HPV in uterine cervical cancer and related lesions--analysis of HPV types 16, 18 E6/E7 gene mRNA]

Recent molecular biologic studies have shown that some type of human papillomavirus (HPV) is closely associated with uterine cervical cancer. In order to investigate the relationship between HPV DNA and cervical cancer, we studied the carcinogenesis of HPV in cervical cancer and related lesions by dot blot hybridization (D.B.H.), Southern blot hybridization (S.B.H.), in situ hybridization (I.S.H.) and polymerase chain reaction (P.C.R.). We also followed some HPV DNA, mRNA positive or negative cases of cervical dysplasia for more than 16 months prospectively. I. Analysis of HPV DNA HPV DNA were detected in cervical dysplasia and cancer and HPV positive rate increased as the grade of cervical dysplasia became higher by several molecular biologic analysis. Especially, the results of I.S.H. with biotinylated HPV DNA probes revealed that HPV DNA was located in the nuclei of koilocytosis, dysplastic cells and cancer cells. In analysis of HPV type in squamous epithelium, HPV 6/11 was the highest positive rate (21.1%) in mild dysplasia. On the other hand, HPV16 positive rate increased with the grade of dysplasia and 34.9% (15/42) of moderate dysplasia and 51.4% (18/35) of severe dysplasia were positive for HPV 16 DNA, respectively. And N/C ratio in HPV 16 positive cells significantly increased by measurement of micrometer. These findings suggest that HPV 16 is high risk HPV and associated with squamous epithelial neoplasia. About 50% of metaplasia close to cervical neoplasia with HPV DNA was positive for the same type of HPV. In columnar epithelium, several types of HPV DNA were detected in 46.7% (15/32) of cervical adenocarcinoma. Thirty one percent (10/32) of adenocarcinoma, 50% (4/8) of adenosquamous cell carcinoma were positive for HPV 18. This suggests an association between HPV 18 and adenocarcinoma and related lesions. We examined amplified DNA detection of HPV 16 and 18 E7 gene by P.C.R. method. HPV 16 and/or 18 DNA were detected in 25 of 43 cases of cervical scrapes obtained from cervical neoplasia, and we confirmed the P.C.R. is the useful method for the screening and the retrospective investigation of HPV infection. By the immunohistochemical and molecular biologic study, there was no correlation HPV DNA with c-myc product and c-myc gene amplification. II. Analysis of HPV mRNA (E6/E7, L1/L2) The early genes E6/E7 of HPV 16 and 18 were considered as one of the carcinogenic factors of uterine cervix. We investigated the localization of HPV E6/E7 and L1/L2 mRNA in cervical dysplasia and CIS with I.S.H. using antisense and sense biotinylated HPV RNA probes which were made by in vitro transcription.(ABSTRACT TRUNCATED AT 400 WORDS)

[Study on the localization of human papillomavirus DNA in the vulvar disease by means of in situ hybridization]

We investigated human papillomavirus (HPV) DNA of vulvar diseases obtained from 18 cases of condyloma acuminatum, 3 cases of hyperplastic dystrophy without atypia, 4 cases of lichen sclerosus, 4 cases of Bowenoid papulosis, one case of Bowen disease and 8 cases of squamous cell cancer by in situ hybridization with biotinylated HPV 6, 11, 16 and 18 DNA probes. The results of in situ hybridization analysis showed that HPV 6/11 was positive in 94.4% (17/18) of condyloma acuminatum. In 17 cases of HPV 6/11 positive condyloma acuminatum, 3 cases were positive for HPV 16 and one for HPV 18, respectively. HPV 16 was positive in 75.0% (3/4) of Bowenoid papulosis and one case of Bowen disease was positive for HPV 18. In two cases of Bowenoid papulosis which were positive for HPV 16, cervical carcinoma in situ containing HPV 16 DNA sequences was also found during the follow up period. In 8 cases of squamous cell cancer, 2 cases were positive for HPV 18, one for HPV 16 and one for HPV 6/11. All cases of hyperplastic dystrophy without atypia and lichen sclerosus were negative for HPV DNA. Our results suggested HPV is closely associated with vulvar neoplasia.

[A case of metastatic ureteral tumor]

We report a case of metastatic ureteral tumor resulting from gastric cancer in a 56-year-old female. She had undergone distal gastrectomy for gastric cancer in our hospital 3 years earlier, on the histological diagnosis of poorly differentiated adenocarcinoma with absolute curative resection. In March, 1987, she visited our hospital complaining of microscopic hematuria and lumbago. Intravenous pyelography and left retrograde pyelography revealed the stenotic change of the left ureter and hydronephrosis. Endoscopic ureteral biopsy was performed, and the histological diagnosis was an inflammatory change of the ureter. But the hydronephrosis increased, so partial ureterectomy was performed. The histological examination confirmed adenocarcinoma in the left ureter resulting from gastric cancer. From the 340th postoperative day, she complained of general fatigue and vomiting, and gastroscopy revealed recurrent gastric cancer.

[Three cases of vulvar bowenoid papulosis: the localization of HPV DNA by in situ hybridization]

Cytological, histological, and molecular biological studies were conducted in 3 cases of vulvar Bowenoid papulosis, using biotinylated HPV DNA probes by in situ hybridization. 1) Cytological findings showed dyskaryotic cells that revealed hyperchromatism with a coarse granular pattern, and a high N/C ratio was observed among the dyskeratotic cells. 2) In 2 cases of Bowenoid papulosis lesions, HPV 16 DNA was detected in the nucleus of the dysplastic cells. 3) In one case of Bowenoid papulosis, a complicated carcinoma in situ of the uterine cervix was observed, and the HPV 16 DNA was found to be positive in both the vulva and cervix.

Crystallographic properties of a series of synthetic hydroxyapatites

The crystallographic properties of hydroxyapatites synthesized at temperatures of 200 degrees C, 500 degrees C, 900 degrees C and 1250 degrees C, designated HAP200, HAP500, HAP900 and HAP1250, respectively, were studied using X-ray powder diffraction. Values of a-axis length for the hydroxyapatites ranged from 9.406 A to 9.416 A, which were smaller than the corresponding value for stoichimetric hydroxyapatite, a = 9.418 A. Generally, the a-axis length decreased with the synthesis temperature, except for HAP500 which showed the smallest value. Crystallinity of the hydroxyapatites, measured by X-ray diffraction peak broadening as full width at the half-maximum value (FWHM), increased with the synthesis temperature, although HAP500 showed a decrease. These results suggest that the synthetic hydroxyapatites contained some carbonate ions, probably at the A-site of the apatite structure, and that the structure was depleted of carbonate ions at about 500 degrees C.

[In situ hybridization study on the localization of HPV DNA in the precancerous lesions of uterine cervix]

Human papillomavirus (HPV) types 16 and 18 have been found closely associated with cervical cancer. In order to investigate the relationship between HPV DNA and cervical precancerous lesions, we examined the formalin fixed specimens obtained from 22 cases of mild dysplasia, 33 cases of moderate dysplasia and 31 cases of severe dysplasia of the uterine cervix for the presence of HPV 6/11, 16 and 18 DNAs by in situ hybridization using the biotinylated HPV DNA probes. We also followed some HPV DNA positive cases of cervical dysplasia for more than 6 months prospectively. The results of in situ hybridization analysis revealed that HPV DNA was detected in the nuclei of koilocytosis, dysplastic cells and metaplastic cells. HPV 6/11 was positive in 27.3% (6/22) of mild dysplasia and 21.2% (7/33) of moderate dysplasia. On the other hand, HPV 16 positive rate increased with the grade of dysplasia and 36.4% (12/33) of moderate dysplasia, 61.3% (19/31) of severe dysplasia were positive for HPV 16 DNA. Some of the follow-up cases which were positive for HPV 16 DNA were later found to have carcinoma in situ. Our results suggest that HPV type 16 might play an important role in cervical carcinogenesis.

[A scirrhous carcinoma of the nipple suspected of being Paget's disease]

Discussed is a 38-year-old woman, whose chief complaints were an eczema-like lesion and itching of the nipple in the left breast. Thus, Paget's disease was suspected, and touch cytology and a cytological biopsy of an aspirated specimen were done. The results indicated a class II and class V status, respectively. A radical mastectomy, therefore, was performed immediately. Macroscopic findings of the resected tissue showed no tumor in the nipple or in the mammary gland. A histological examination led to the determination of a scirrhous carcinoma of the nipple. Seventeen months after the operation, the patient has had no recurrence.

[Detection of human papillomavirus types 16 and 18 DNA sequences in the screening of the cells related with carcinoma in situ of the uterine cervix--application of in situ hybridization for cytologic diagnosis]

In order to investigate the relationship between the presence of human papillomavirus (HPV) DNA and cervical carcinoma, we examined the cervical screening cells as well as the biopsy specimens obtained from 3 cases of severe dysplasia, 13 cases of carcinoma in situ (CIS) and 2 cases of microinvasive carcinoma for the presence of HPV types 6, 11, 16 and 18 DNA by DNA-DNA in situ hybridization using the biotinylated HPV DNA probes. The results of in situ hybridization analysis revealed that HPV 16 DNA sequences were detected in the nuclei of koilocytosis of severe dysplasia and CIS cases. The nuclei of atypical cells obtained from cervical screening cells were positive for HPV 16 or 18 DNA sequences. Two CIS cases were positive for the presence of HPV 16 and 18 DNA sequences. None of them contained HPV 6/11 DNA sequences. Eighteen cervical screening cases were examined and 10 contained HPV 16 DNA sequences and 6 contained HPV 18 DNA sequences. We suggest that the identification of HPV DNA types in cervical screening cells by in situ hybridization might be of diagnostic and prognostic value in early cervical neoplasia.

[Clinical studies on enoxacin in urinary tract infection]

Enoxacin was administered orally to 49 out-patients with urinary tract infections (UTI) at the doses of 600 mg/day and clinical effects were evaluated. Out of 13 patients with simple acute UTI evaluated by the UTI criteria, the results were excellent in 8 cases and good in 5 cases. Overall effectiveness rate was 100%. Out of 10 patients with simple acute UTI evaluated on over 5-day administration, the results were excellent in 9 cases and good in 1 case. Overall effectiveness rate was 100%. Out of 14 patients with simple acute UTI evaluated by our own criteria because their bacteriological response is unknown, the results were excellent in 7 cases and good in 7 cases. Overall effectiveness rate was 100%. Out of 12 patients with chronic complicated UTI evaluated by the UTI criteria, the results were excellent in 6 cases, good in 3 cases and poor in 3 cases. Overall effectiveness rate was 75.0%. Poor effective cases were mainly found in ones with mixed infection. Sensitivity test using discs did not always correspond to the bacteriological effect in cases with chronic complicated UTI. An adverse reaction was noted in 3 patients (6.1%). Two cases had gastrointestinal symptoms and 1 case had skin eruption. All symptoms were readily improved after discontinuing administration. From the above results, Enoxacin was considered to be a useful agent for urinary tract infection.

[Treatment in male infertile clinic of Kaizuka Municipal Hospital]

The results of treatment of 68 idiopathic male infertile cases are reported. The follow up period was 3 years and 8 months from the time the Department of Urology, Kaizuka Municipal Hospital had opened. The main treatments were human mammary gonadotropin-human chorionic gonadotropin (HMG-HCG) therapy and high ligation of left testicular vein in the cases accompanied with varicocele. Adjuvant therapy was administration of vitamin B12, herb medicine and antibiotic agents for prostatovesiculitis. Some cases were administered clomiphene citrate. The results in 43 cases at over 10 weeks after treatment was followed. Mean sperm count and mean sperm activity rate in 11 cases accompanied with no varicocele and whose sperm count was 2 approximately 45 x 10(6)/ml were raised from 11.0 +/- 8.0 SD x 10(6)/ml and 19.1 +/- 11.4 SD% to 22.7 +/- 16.8 SD x 10(6)/ml and 26.9 +/- 18.5 SD%, respectively after 20 weeks of HMG-HCG therapy. Efficacy was 7 out of 11 (63.6%) in sperm count and 6 out of 11 (54.5%) in sperm activity rate. Pregnancy was obtained in 3 cases. Effect of HMG-HCG therapy was not observed in 8 cases accompanied with varicocele and whose sperm count was 2 approximately 45 x 10(6)/ml. High ligation of left testicular vein was effective in all of the 4 cases accompanied with varicocele and whose sperm count was 2 approximately 45 x 10(6)/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of urinary retention due to a female paraurethral leiomyoma]

A case of urinary retention due to a female paraurethral leiomyoma is reported. The patient was a 67-year-old female who visited our clinic complaining of urinary retention. Urinary sediment and infravenous pyelography revealed no abnormal findings. An oval-shaped mass was palpated at the anterior vaginal wall. The tumor was 7 X 6 cm in size, elastic hard in consistency, irregular surfaced and well movable. Computed tomography revealed a calcified tumor in the urethrovaginal septum extending over all the urethral length from the bladder neck to the urethral meatus. Cystourethroscopic examination revealed a bladder neck elevation. Transvaginal needle biopsy was performed and the pathological diagnosis was benign leiomyoma. Transvaginal removal of the tumor was performed under the diagnosis of female paraurethral leiomyoma. The tumor was easily dissected from the vaginal wall but was adhered rather firmly to the urethra. The origin of the tumor could not be identified. Postoperatively, urination was improved. Female paraurethral leiomyoma is rare but must be considered as a cause of urinary retention.

Detection of papillomavirus nucleic acids in genital precancers with the in situ hybridization technique

Recent advances in in situ hybridization technology have made it possible to analyze the distribution of human papillomavirus (HPV) type 16 nucleic acid sequences in genital neoplasms. This review addresses the methodology of in situ hybridization as it relates to the detection of HPV sequences in precancerous lesions and explores the potential value of this technique for both detecting HPV sequences in tissue sections and analyzing HPV gene functions that may be important in the genesis of squamous neoplasia.

[A case report of ovarian squamous cell carcinoma developing into a dermoid cyst with malignant transformation--immunohistochemical study]

A histopathological and immunohistochemical study has been made on a case of an ovarian cancer that developed into a dermoid cyst with a malignant transformation. The case involved a 64-year-old married woman and her clinical grading was determined as being in Stage Ia (i). The ovarian tumor, weighing 1550 g, consisted of large cystic and small solid parts, and a well-differentiated squamous cell carcinoma (large cell, keratinized type) was observed in the solid part. By using an immunoperoxidase technique (the ABC method), the SCC was found to be positive in many cancer cells and the TPA also was positive in some cancer cells, though both the CEA and AFP were found to be negative.