[Clinical studies on 29 cases of testicular tumors]

Clinical studies were performed on 29 cases of testicular tumors over the past 16 years. There were 14 cases of seminoma (S), 4 cases of E+Teratoma (T), 1 case of embryonal carcinoma (E), 1 case of E+STGC, 1 of S+E+T, 1 of S+E+ yolk sac tumor (Y) +choriocarcinoma (C) +STGC, 1 of mature teratoma, 6 of non-germ cell tumor. The stage of the germ cell tumors were stage I in 13 cases and stage II A in one case among 14 cases of seminoma, and stage I in 3 cases, stage II A in 3 cases, stage II B in one case, stage III in one case among 8 cases of non-seminoma. All of the patients underwent high orchiectomy. The seminomas were treated by radiotherapy and non-seminoma cases mainly by chemotherapy after retroperitoneal lymph nodes dissection (RPLND). Twenty one of 23 cases have survived, excluding one death (E+STGC, stage II A) and one unclear case. High orchiectomy and radiotherapy are the established procedures for the treatment of stage I seminoma. The significance of RPLND should decrease because of the high efficacy of current chemotherapy in cases of stage I and II A non-seminoma.

Evolutionary hypervariability in the hinge region of the immunoglobulin alpha gene

The hinge region of the immunoglobulin molecule is responsible for antigen-binding and cross-linking reactions, varying the distance between the two antigen-binding sites. As the amino acid sequence of the hinge region is identical among immunoglobulin molecules of the same (sub)class, it has been regarded as a constant region. By comparison of the nucleotide sequences among primate C alpha genes, it is clear that there is a wide variety of length among the hinge regions of hominoid C alpha genes, which basically consist of tandem repeats of a 15 base-pair sequence. This reiterated structure probably facilitates rapid evolutionary changes in the length of the hinge region. The hinge region of the Old World monkey C alpha gene has a non-reiterated structure whose nucleotide sequence is quite different from those of the hominoid C alpha genes, although its surrounding region is conserved during evolution. This unusual hypervariability reveals that the hinge region has evolved as a semi-variable region in contrast to its constant character from an ontogenic viewpoint.

[Two cases of psittacosis accompanied with rhabdomyolysis]

We experienced two cases of atypical pneumonia accompanied with rhabdomyolysis and diagnosed them as psittacosis based on the results of investigation of paired serum samples. Rhabdomyolysis may be associated with some kinds of viral or bacterial infections, but no report was found in the case of psittacosis as far as we searched and such a description was not found in textbooks. Heretofore, the elevation of GOT and LDH as the laboratory findings in psittacosis was considered as the reflection of liver injury, but that might be brought about by rhabdomyolysis. Although the mechanism(s) of the occurrence of rhabdomyolysis in psittacosis is unknown, when the elevation of muscular origin-enzymes including CPK is recognized in cases of atypical pneumonia, it may be the clue of diagnosis of psittacosis.

Clinical and long-term follow-up study in patients with spontaneous subarachnoid haemorrhage of unknown aetiology

Clinical characteristics and the outcomes of 50 patients with confirmed subarachnoid haemorrhage (SAH) of unknown aetiology were evaluated. Twenty-nine of these patients were interviewed with a mean follow-up of 7.7 years. Seven patients experienced early rebleeding during hospitalization, and one patient experienced late rebleeding during the follow-up period. On admission to the hospital the consciousness level was "clear" in 43 of the patients, "drowsy" in 6, and "semicomatose" in only 1. Of 10 patients who underwent computerized tomography (CT) within 3 days after SAH, 6 showed no abnormal CT findings and 3 had mild subarachnoid blood. Another patient showed severe SAH. Neurological deficit due to symptomatic vasospasm persisted in only 1 case. Two patients died after re-bleeding during hospitalization, and two others died during the follow-up, thereby representing an overall mortality rate of 8%. Of the latter cases, one died of an unrelated disease, and the other died suddenly from an unknown cause. The remaining forty-six patients (92%) had a good outcome. These results confirm previously reported clinical characteristics, namely that the symptoms of the majority of such cases are mild, the incidence of symptomatic vasospasm is rare, the risk of late re-bleeding is very low (less than 1% per year), and the prognosis is good. The CT findings suggest that some of these features resulted from only mild SAH. Thus, SAH of unknown aetiology seems to be a disease entity with a good prognosis.

Therapeutic effects of hyperbaric oxygenation on acute focal cerebral ischemia in rats

The effects of hyperbaric oxygenation on acute focal cerebral ischemia in rats were investigated. All rats suffered 4-hour middle cerebral artery occlusion. Nontreated controls had a 27.9% +/- 5.5% infarct volume, and a left/right hemispheric volume ratio of 109% +/- 3%. Animals treated between 2.5 and 3.5 hours following occlusion had an 18.1% +/- 9.7% infarct volume (p less than 0.01), and a 105% +/- 3% left/right hemispheric volume ratio (p less than 0.001). In conclusion, at least until 4 hours following an ischemic insult, hyperbaric oxygenation reduces ischemic neuronal injury and brain edema following middle cerebral artery occlusion in rats treated between 2.5 and 3.5 hours following occlusion.

Isolation and purification of a low molecular weight protein from bovine urine

A low molecular weight protein was separated from urine samples obtained from a heifer with spontaneous renal disease and from cows with CaNa2EDTA-induced renal dysfunction. The molecular weight and electrophoretic mobility of the separated protein were examined. The low molecular weight protein collected by gel filtration chromatography was further separated into two fractions by ion exchange chromatography using DEAE-cellulose. One of the two fractions, the lowest molecular weight protein showed a single band in SDS-PAGE, and its molecular weight was approximately 12,000. An antiserum against this protein formed a single precipitin line with the urine from cows with experimentally induced renal dysfunction and a heifer with spontaneous renal disease by the double immunodiffusion technique. However, the antiserum did not form any precipitin line with the concentrated urine of healthy cow and human beta 2-microglobulin. In cellulose acetate membrane electrophoresis, this protein migrated in the same position as that of serum gamma-globulin from healthy cow.

Partial purification and characterization of GDP dissociation stimulator (GDS) for the rho proteins from bovine brain cytosol

A novel type of regulatory proteins for the rho proteins (rhoA p21 and rhoB p20), ras p21-like small GTP-binding proteins (G proteins), are partially purified from bovine brain cytosol. These regulatory proteins, named rho GDP dissociation stimulator (GDS) 1 and -2, stimulate the dissociation of GDP from rhoA p21 and rhoB p20. rho GDS1 and -2 are inactive for other ras p21/ras p21-like small G proteins including c-Ha-ras p21, smg p21B, and smg p25A. Since we have previously shown that the rate limiting step for the GDP/GTP exchange reaction of the rho proteins is the dissociation of GDP from these proteins, the present results suggest that rho GDS1 and -2 stimulate the GDP/GTP exchange reaction of the rho proteins. rho GDS1 and -2 are distinct from the GAP- and GDI-types of regulatory proteins for the rho proteins previously purified from bovine brain cytosol. rho GAP stimulates the GTPase activity of the rho proteins and rho GDI inhibits the GDP/GTP exchange reaction of the rho proteins. The present results together with these earlier observations indicate that the rho proteins are regulated by at least three different types of regulatory proteins, GDS, GDI, and GAP.

[A case report of Cushing syndrome due to three distinct adenomas of the right adrenal]

A case is presented of a 40 y.o. female with Cushing's syndrome. Her plasma glucocorticoid values were elevated (11-deoxy-cortisol: 3.46 ng/ml, cortisol: 25.6 micrograms/dl and cortisone: 35.7 ng/ml) with loss of diurnal variation. Urine 17-OHCS value failed to b suppressed by high dose dexamethasone and was unchanged after metyrapone administration. Her plasma mineral corticoids and androgens were within normal limits. There were 3 separate tumors in the right adrenal on CT and the left adrenal had no uptake on 131I-adosterol scintigram. We, therefore, diagnosed her illness as Cushing's syndrome due to unilateral multiple adenomas. Gross and histological examination of the right adrenal revealed one compact cell dominant adenoma and two clear cell dominant adenomas. This is the 4th case of Cushing syndrome due to unilateral multiple adrenal adenomas in Japan.

Ureteral action potential and histological changes in the upper urinary tract receiving the formalin

The present study investigates the ureteral action potential and histological changes of pelvi-ureteral system after injection of the formalin into the obstracted ureters or the renal pelvis. In the first experiment, formalin was injected into the obstructed ureters of 18 dogs for 30 minutes. In the second, formalin was injected into the obstracted renal pelvis of 13 dogs for 30 minutes using ureteral balloon catheters, and then renal pelvis were released from obstraction and catheters were removed. In these experiments, ureteral electromyogram were recorded and histological changes of pelvi-ureteral system were also observed microscopically. Results 1. After injection of formalin into the ureters, ureteral action potential disappeared and had not restored. Histologically, damage was observed in the ureteral smooth muscle as well as in the mucosa. 2. After injection of formalin into the renal pelvis, ureteral action potential disappeared in 46% of the ureters. In 54% of the ureters, action potential had not disappeared, however discharge interval became irregular. Histological changes of the renal pelvis was not related to the presence or absence of ureteral action potential. The results of the present study show that ureteral smooth muscle play part in the conduction of the ureteral excitation, and have an irregular autonomic discharge.

Spinal antinociception: comparison of a dermorphin tetrapeptide analogue, [D-arginine2, sarcosine4]-dermorphin (1-4) and morphine in rats

Intracerebroventricular injections of [D-arginine2, sarcosine4]-dermorphin (1-4) (DAS-DER 1-4) and morphine produced a dose-dependent inhibition of the tail-flick response to thermal stimulation. The ED50 value for each drug was 3.23 (1.35-7.73) nmol/rat and 32.0 (13.3-76.6) nmol/rat, respectively. When injected into the spinal subarachnoid space, the ED50 value was 0.035 (0.015-0.086) nmol/rat for the tetrapeptide and 11.9 (5.7-25.2) nmol/rat for morphine, respectively. Antinociception induced by DAS-DER 1-4 and morphine, through the intracerebroventricular and intrathecal routes, was clearly reduced by pretreatment with a small dose of naloxone. After spinal transection, the antinociceptive potency of systemically-administered morphine was significantly reduced while that of DAS-DER 1-4 was unaltered. The activity of DAS-DER 1-4 and morphine was also reversed by naloxone in spinal animals. It is concluded that DAS-DER 1-4, a dermorphin analogue, has a minor supraspinal action but acts mainly at the level of the spinal cord, in contrast to the action of morphine.

Comparison of the intestinal bacteria in specific pathogen free mice from different breeders

Specific pathogen free BALB/c mice from 3 commercial laboratory animal breeders in Japan were compared on the composition of caecal flora revealed by selective and nonselective cultivation as well as direct microscopical observation on smears, and relative caecal weight. Large differences were detected in viable counts of total bacteria and almost all bacterial groups, while direct microscopical counts which consisted mainly of fusiform bacteria were almost equal, resulting in diverse recovery rates among 3 breeders. Eubacterium and spiral shaped organisms were not detected from all breeders. There also existed variations within breeders, especially those in the number of Enterobacteriaceae. Relative caecal weight also differed among breeders, suggesting the participation of variety of caecal bacteria in determining this parameter. As these variations in bacteriological status of animals can influence experimental results, standardization of intestinal microbial flora is required.

The effect of high-energy underwater shock waves on implanted urinary bladder cancer in rabbits

We have examined the effects of high-energy shock waves (HESW) on implanted urinary bladder cancer in rabbits. The bladder cancer was exposed to 2000 to 6000 shots of focused HESW under ultrasound guidance. Although only focal necrosis of the tumor was seen in the one-day HESW exposure (2000 shots), wider and deeper necrosis was observed in the tumors following serial HESW (4000 or 6000 shots; 2 or 3 days). These results indicate that serial HESW exposure has destructive effects on implanted bladder cancer in rabbits.

Oriented immobilization of bacterial photosynthetic membrane

We have examined a method for oriented immobilization of photosynthetic membrane fragments on a solid surface by specific avidin-biotin interaction. Photosynthetic membrane fragments from the purple non-sulphur photosynthetic bacterium Rhodopseudomonas viridis, of which the H-subunit of the photosynthetic reaction centre was biotinylated, was immobilized on an avidin-adsorbed plate. Orientation of the immobilized membrane on the plastic plate was checked by an antisera binding assay that could react to the respective sides of the membrane: the H-subunit side was selectively adsorbed on the plate. Light-induced potential and current responses could be measured when the membrane immobilized on the SnO2-coated glass plate was dried and sandwiched with a counter electrode of Hg. The electrical response in the immobilized membrane was much improved in comparison with the control (membranes were simply adsorbed on the plate), supporting the idea that the membranes have an orientation on solid surfaces.

[Preclinical evaluation of several cisplatinum analogs against human esophageal carcinoma by subrenal capsule assay]

The antitumor activities of CDDP analogs (CBD-CA, NK-121, 254-S) were evaluated preclinically by subrenal capsule assay (SRCA) with cyclophosphamide pretreatment. In the fundamental study, the antitumor activities against serially transplanted human esophageal cancer xenograft (IMEs-1) were compared with subcutaneous transplantation assay in nude mice and SRCA. The antitumor activities in SRCA were similar to those of in nude mice assay system (CBDCA greater than CDDP greater than 254-S greater than NK-121). Thus SRCA was considered to be useful for the evaluation of the activities of these agents. The activities were also tested against 10 human esophageal tumors obtained clinically. The sensitivity rate of these agents were 50% in CDDP, 30% in CBDCA, 30% in NK-121, and 30% in 254-S, respectively. These analogs seemed to be less effective than CDDP. However, in two cases, analogs were active though CDDP were inactive. The results suggest that these analogs are useful for the cases in which CDDP can not be given due to the toxicities and also for outpatient use.

[Studies on function of the upper urinary tract. XXIX. Canine ureteral electromyogram isolated from "so-called Pacemaker"]

Many workers have reported that ureteral peristaltic movement is controlled by the "so-called Pacemaker". But, in our recent studies, it was revealed that the existence of pacemaker is not always necessary for the peristaltic movement. In this study, we made isolated and non-isolated prototype models, using 18 mongrel dogs, to explore the influential factors on ureteral peristaltic discharge. Bilateral kidney and ureter were exposed transperitoneally. Unilateral upper urinary tract was prepared to preserve the pacemaker without renal blood supply, and contralateral one was prepared not to preserve the pacemaker by cutting at the proximal portion of the ureter. Vesico-ureteral reflux (VUR) was caused on these two models. A luminal pressure and ureteral electromyogram was recorded. In the result, there is spontaneous peristaltic discharges of the ureter which had the tendency to increase peristaltic frequency according to the increase of the luminal pressure. It was suggested that adequate expanding stimulation is the factor of peristaltic discharge to increase, and the peristaltic discharge under this condition propagates from upper to lower portion of the ureter.

[Acute myelomonocytic leukemia with inv (16) (p13 q22) disappeared abnormal karyotype during complete remission]

A 21-year-old man was admitted to our hospital because of anorexia and general malaise in July, 1988. On admission, the white blood cell count of 18,600/microliters with 72% leukemic cells. The bone marrow aspirate showed 76.8% immature monocytes, 10% mature and immature eosinophils. Leukemic cells were 66.6% myeloperoxidase positive cells, and 20.6% naphthylbutyrate esterase positive cells. The lysozyme activity in urine was high. Cytogenetic analysis revealed the presence of 46 XY inv (16) (p13 q22). Under the diagnosis of acute myelomonocytic leukemia with eosinophilia (M4Eo) associated with inv (16) (p13 q22), one course of DCMP induction therapy was performed. After complete remission, the bone marrow aspirate showed disappearance of inv (16) (p13 q22), and associated with decreased residual leukemic cells.

Development of Babesia ovata in the midgut of the tick, Haemaphysalis longicornis

Studies were made on the development of Babesia ovata in the midgut of the nymphal tick vector, Haemaphysalis longicornis. In 12 hr post-repletion, merozoites were observed outside of erythrocytes infected with B. ovata in the contents of the midgut of the tick. After that, these merozoites were transformed into ring-forms which were comparatively large ring 2-3 microns in diameter. Within 48-72 hr post-repletion, ring-form protozoa developed into spherical form 4-5 microns in diameter. Within 3-4 days post-repletion, fission-forms were transformed into fission-bodies 2-3 microns in diameter. Within 4-6 days post-repletion, fission-bodies developed into bizarre-forms 6-7 microns in diameter. At this time, elongated form protozoa which were considered as microgametes, 6-8 microns in length, are also seen. Within 6-8 days post-repletion, round-formed protozoa which were considered as zygotes in 9-10 microns in diameter were observed in the gut. About 10 days after repletion, those round-formed protozoa were transformed into vermicule-formed and round-formed protozoa, 13-15 microns in length, appeared again in the gut epithelial cells.

[A case report of retroperitoneal leiomyoma and review of the Japanese literature]

A 76-year-old woman presented with a history of pain on urination and urinary frequency. The sonogram incidentally demonstrated a mass in the area of the upper right kidney, and CT scan revealed a retroperitoneal tumor. Operation was carried out, and the tumor measured 4 X 4 X 5.5 cm (35 g). The pathology report was consistent with leiomyoma. The patient had undergone surgical excision of a right retroperitoneal tumor before 27 years, and it is suspected to have been an ectopic retroperitoneal tumor judging from operative findings. Retroperitoneal leiomyoma is rare and a review of the Japanese literature is presented.

[A renal biopsy study in pre-eclampsia: clinical-pathological correlations in 20 cases]

Twenty cases of pre-eclamptic toxemia were examined clinicopathologically. Twelve primipara and 6 multipara underwent renal biopsy at 1-24 (3.5 +/- 5.4, mean +/- SD) weeks after delivery. Specimens were examined by light and electron microscopy and immunofluorescence. Their mean blood pressure at delivery was 177.0 +/- 19.4/116.3 +/- 10.2 mmHg, proteinuria was 9.5 +/- 8.4 g/day. Follow-up period was 23.0 +/- 19.3 months after delivery. The severity of double contour of the glomerular basement membrane and mesangial interposition were correlated with the amount of proteinuria at biopsy (r = 0.40, p less than 0.05, r = 0.51, p less than 0.05, respectively). Proteinuria disappeared in all cases after delivery. The length of the hypertensive period after delivery correlated with the severity of glomerular lesions (r = 0.63, p less than 0.05), but did not correlated with the severity of vascular lesions. All patients became normotensive within three months after delivery. No patients showed microhematuria during pregnancy or after delivery.

Regulation of cGMP levels by guanylate cyclase in truncated frog rod outer segments

Cyclic GMP is the second messenger in phototransduction and regulates the photoreceptor current. In the present work, we tried to understand the regulation mechanism of cytoplasmic cGMP levels in frog photoreceptors by measuring the photoreceptor current using a truncated rod outer segment (tROS) preparation. Since exogenously applied substance diffuses into tROS from the truncated end, we could examine the biochemical reactions relating to the cGMP metabolism by manipulating the cytoplasmic chemical condition. In tROS, exogenously applied GTP produced a dark current whose amplitude was half-maximal at approximately 0.4 mM GTP. The conductance for this current was suppressed by light in a fashion similar to when it is activated by cGMP. In addition, no current was produced in the absence of Mg2+, which is known to be necessary for the guanylate cyclase activity. These results indicate that guanylate cyclase was present in tROS and synthesized cGMP from exogenously applied GTP. The enzyme activity was distributed throughout the rod outer segment. The amount of synthesized cGMP increased as the cytoplasmic Ca2+ concentration of tROS decreased, which indicated the activation of guanylate cyclase at low Ca2+ concentrations. Half-maximal effect of Ca2+ was observed at approximately 100 nM. tROS contained the proteins involved in the phototransduction mechanism and therefore, we could examine the regulation of the light response waveform by Ca2+. At low Ca2+ concentrations, the time course of the light response was speeded up probably because cGMP recovery was facilitated by activation of the cyclase. Then, if the cytoplasmic Ca2+ concentration of a photoreceptor decreases during light stimulation, the Ca2+ decrease may explain the acceleration of the light response during light adaptation. In tROS, however, we did observe an acceleration during repetitive light flashes when the cytoplasmic Ca2+ concentration increased during the stimulation. This result suggests the presence of an additional light-dependent mechanism that is responsible for the acceleration of the light response during light adaptation.

The faecal flora of the giant panda (Ailuropoda melanoleuca)

The faecal floras of two adult (male and female) and one infant (male) giant panda kept at the Ueno Zoo, Tokyo, Japan were examined and shown to be quite different from those of other animals. The predominant bacteria in the adults were Streptococcus (including Enterococcus) and Enterobacteriaceae, while obligate anaerobes had minor populations. Fastidious anaerobes were not detected. The predominant bacteria in the suckling infant were Lactobacillus and Streptococcus, followed by Bifidobacterium. After the infant began to eat bamboo leaves the number of Lactobacillus decreased and Bifidobacterium became undetectable, whereas Enterobacteriaceae became one of the most predominant flora. The most dominant streptococcus isolated from the female panda was identified as Streptococcus bovis, but those from the male adult and the weaned infant were not identified as any known species.

Somatic mosaicism for DNA repair capacity in fibroblasts derived from a group A xeroderma pigmentosum patient

A female Japanese xeroderma pigmentosum (XP) patient with severe skin lesions and various neurologic abnormalities was assigned to complementation group A by conventional cell fusion studies. Ultraviolet (UV)-irradiated skin fibroblasts showed a biphasic survival curve, as measured by colony-forming ability. The surviving fraction decreased rapidly up to 2 J/m2 of UV, with a steep slope of D(O) (mean lethal dose) = 0.95 J/m2. At much higher doses it decreased more slowly, with D(O) = 3.5 J/m2. To èlucidate the cause of this unique survival response, we isolated a large number of independent clones from single colonies and measured their responses to UV. Of 81 clones analyzed, ten showed a marked resistance to killing by UV, which was only slightly more sensitive than normal cells, and these clones had a rate of unscheduled DNA synthesis (UDS) that was about 45% of normal cells. By contrast, the remaining 71 clones were extremely sensitive to UV, typical of XP group A strains, and had a UDS level 1%-3% of normals. Analysis of restriction fragment length polymorphism using seven polymorphic DNA probes indicated that the UV-resistant clones were derived from the same individual as the UV-sensitive clones. These results clearly demonstrate that this patient's fibroblast cells consist of two types with differing responses to UV, and provide direct evidence of somatic mosaicism for DNA repair capacity in an XP patient.