Evaluation of seminal vesicle characteristics by ultrasonography before and after ejaculation

Twenty males underwent transrectal ultrasonography before and after ejaculation to examine possible alterations that could influence interpretation of seminal vesicle ultrasonography. The preejaculation length of 35 mm was significantly (p < 0.05) decreased to 30 mm after ejaculation. The mean width of the seminal vesicles was 13 mm before and 11 mm after ejaculation. The seminal vesicle volume was significantly diminished after ejaculation (p < 0.05). It therefore seems important to maintain a period of abstinence when evaluating the seminal vesicles by ultrasonography.

Epidermal growth factor in urine from the patients with urothelial tumors

Epidermal growth factor (EGF) concentration in urine was measured with a radioimmunoassay in 40 untreated patients with urothelial tumors and a comparable control group of 25 normals. The concentration of EGF in urine from the patients with bladder, renal pelvic or ureter tumors was lower than normal (p less than 0.05). Patients with T4 tumors had lower concentrations of EGF compared with those of other stages. EGF concentrations after transurethral resection of bladder tumors were significantly elevated compared with the values before operation. These findings suggest that urothelial tumors are related to a low concentration of EGF and that a decrease of EGF is associated with invasion of tumors.

Electrophysiologic findings in optic nerve dysfunction associated with multiple evanescent white-dot syndrome

Electrophysiologic findings in a case of multiple evanescent white-dot syndrome were studied. A 37-year-old woman presented with multiple white dots, granularity of the macula, and optic disc swelling in her left fundus. The electroretinogram and electro-oculogram revealed abnormal findings indicative of changes in the retinal pigment epithelium and photoreceptors. In addition, relative afferent pupillary defect, enlargement of the blind spot, a decrease in the critical fusion frequency, staining of the optic disc on fluorescein angiography and prolonged latency of the P100 component with decreased amplitude in pattern-reversal visual evoked cortical potential strongly suggested dysfunction of the optic nerve in this patient.

[Immunohistochemical study of lung cancer using monoclonal antibody against human pulmonary surfactant apoprotein]

To evaluate the clinical significance of monoclonal antibody against human pulmonary surfactant apoprotein (S-AP), surgically resected lung cancer from 122 patients was studied. Paraffin embedded tissues were used for the immunohistochemical study by the avidin-biotin-peroxidase complex method. The results were as follows. 1. Adenocarcinoma showed highest immunoreactivity for S-AP compared to the other histologic types. Among subtypes of adenocarcinoma, type II alveolar epithelial type, clara cell type and mixed type of these two types were strongly positive (100%, 77.8% and 66.7% respectively). These results indicate that this antibody may be a good marker for the subtyping of adenocarcinoma. 2. There were some positive cases in other histologic types especially in peripheral type of squamous cell carcinoma. These findings suggest that this antibody was useful for the histological differentiation of lung cancer. 3. As to the immunohistochemical reactivity there was a good correlation between tissue and cytological specimens, which indicate cytological studies may be adequate for this kind of histopathological studies. 4. In our study, there were no patients with S-AP positive carcinomas other than patients with lung cancer. These results indicate that this antibody could be used for the differential diagnosis between primary and secondary lung cancer.

[The role of surgery in cases of diagnostic difficulty]

Pulmonary resections for the treatment of pulmonary tuberculosis are decreasing, and nowadays most of them are for the open lung biopsy to make histological diagnosis, because differentiation between tuberculosis, AM and lung cancer is critical. In 1980-1990 forty-three patients, in whom the diagnosis was not established by conventional diagnostic methods, had pulmonary resections for open lung biopsy because of abnormal chest X-ray shadows. Of these, 31 (72%) were non-tuberculous (lung cancer 8, hamartoma 7, lung abscess 5, fungus infection 3, sclerosing hemangioma 2, bronchogenic cyst 2, and others 4, and 12 (28%) were tuberculous or AM. The type of chest film abnormality was solitary pulmonary nodule (coin lesion) in 9 out of 12 patients with tuberculosis or AM, in all eight patients with lung cancer and in 14 out of 23 patients with other diseases. In patients with coin lesions, the incidence of lung cancer was as high as 50% when the diameter was more than 21mm, while it was only 11% when it was 20mm or less. 24 patients with tuberculosis or AM complicated by lung cancer or other diseases were resected. There were 8 smear or culture positive patients with active pulmonary tuberculosis (or AM) (Group 1), of whom 7 had lung cancer and 1 pneumothorax. Of 8 patients who were wrongly diagnosed as active pulmonary tuberculosis (Group 2), there were 5 lung cancers and 3 other diseases. In the remaining 8 patients (Group 3) both old tuberculosis and lung cancer coexisted and in 3 they were found in the same lobe.(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of male infertility: current situation and problems]

We evaluated the results of treatment for male infertility in 883 patients who visited our clinic. The efficacy rate and pregnancy rate after varicocele operation were higher than those after drug therapy. Drug therapy was effective only in patients with a sperm count of 10-40 x 10(6)/ml. The percentage of swollen sperm in hypoosmotic swelling test elevated after operation in varicocele patients. The hypoosmotic swelling test seems to be useful to show the improvement of sperm function by treatment.

Hypoosmotic swelling test in patients with varicocele

The hypoosmotic swelling test is a simple test for measuring the functional competence of human sperm membrane. Thirty-five patients with varicocele were assessed by hypoosmotic swelling test and the results were compared with those in patients with idiopathic infertility. Percentage of swollen sperm in varicocele tended to be lower than that in idiopathic infertility, especially in sperm concentration between 30 x 10(6)/mL and 40 x 10(6)/mL. Varicocele with sperm motility of 40% or more revealed lower percentage of swollen sperm than idiopathic infertility did. The results indicate that varicocele may particularly injure sperm membrane function because hypoosmotic swelling test is a test for measuring functional ability of human sperm membrane. The percentage of swollen sperm recovered after the operation earlier than did the other sperm parameters such as sperm concentration or motility, which indicates that impaired sperm membrane injury by varicocele is reversible.

Specific amplification of Rickettsia tsutsugamushi DNA from clinical specimens by polymerase chain reaction

Polymerase chain reaction (PCR) was used to detect Rickettsia tsutsugamushi-specific DNA in clinical specimens. The primer pair used for PCR was designed from the nucleotide sequence of the gene encoding the 56-kDa antigen of the Gilliam strain. Theses primers led to a 78-bp fragment by amplifying the genomic DNAs from five serovariants, i.e., the Gilliam, Karp, Kato, Kawasaki, and Kuroki strains of R. tsutsugamushi, and also the DNA from blood clots of patients with scrub typhus, even at the early stage of onset of the disease. This indicates that this method is suitable for the diagnosis of scrub typhus.

Cloning of a Streptococcus sobrinus gtf gene that encodes a glucosyltransferase which produces a high-molecular-weight water-soluble glucan

The gtf gene coding for glucosyltransferase (GTF), which produces a water-soluble glucan, was cloned from Streptococcus sobrinus OMZ176 (serotype d) into plasmid vector pBR322. This gene was expressed in Escherichia coli, and the product was purified to near homogeneity. The antigenicity of recombinant GTF (rGTF) was examined with the antisera raised against purified GTF P1, P2, P3, and P4 obtained from S. sobrinus AHT (serotype g). The rGTF reacted only with anti-GTF P1 serum in a Western blot (immunoblot) analysis. The rGTF closely resembled GTF P1 in its molecular mass, Km value for sucrose, optimal pH, primer dependency, and immunological properties. The high-molecular-weight, water-soluble glucan produced by the rGTF also resembled that of GTF P1, which is the most efficient primer donor for primer-dependent, water-insoluble glucan synthesis. Properties of the rGTF were also compared with those of rGTFS, which was purified from E. coli carrying the gtfS gene isolated from Streptococcus downei (previously S. sobrinus serotype h) MFe28. Both rGTF and rGTFS synthesized water-soluble glucan from sucrose without primer dextran, but their characteristics in Km values for sucrose, optimal pHs, and polymer sizes of the glucan were different. Furthermore, the gtf gene did not hybridize with the gtfS gene in a Southern blot analysis. These results showed that rGTF is similar to S. sobrinus AHT GTF P1 but distinct from rGTFS that has been previously purified from E. coli carrying the gtfS gene.

Facial fibrous dysplasia: report of a case

A case of facial fibrous dysplasia that involved the left frontal, temporal, malar, and mandibular regions is reported. Conservative recontouring was done several times when the patient was 16 to 23 years of age.

Multiple marker evaluation in prostatic cancer with prostatic acid phosphatase, gamma-seminoprotein and prostate-specific antigen

Serum prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm), and prostate-specific antigen (PA) levels were measured in 63 untreated patients with prostatic cancer. The sensitivities of PAP, gamma-Sm, and PA as markers of malignancy were 68%, 83%, and 77%, respectively. The latter two markers were more sensitive than PAP, especially in stage B disease. The specificities of PAP, gamma-Sm, and PA were 95%, 93%, and 93%, respectively. Patients with multiple positive markers were very likely to have prostatic cancer. In reactivation of the disease, positive rates for gamma-Sm and PA were higher than for PAP, indicating that the former two markers are more reliable for monitoring prostatic cancer.

Relationship between hypoosmotic swelling test, semen analysis, and zona-free hamster ovum test

The hypoosmotic swelling test is a simple test for measuring the functional competence of the human sperm membrane. Fifty-four patients with idiopathic infertility were assessed by hypoosmotic swelling test and the results were compared with those of routine semen analysis and zona-free hamster ovum human sperm penetration test (ZSPT). Semen samples with abnormal semen parameters had lower percentage of swollen sperm in comparison with those with normal semen parameters. A positive correlation was observed between sperm concentration and sperm swelling (r = .50, p less than .05). A strong positive correlation was observed between the percentage of sperm motility and the percentage of swollen sperm (r = 0.60, p less than .01), and between motile sperm concentration and sperm swelling (r = .62, p less than .01). On the other hand, sperm swelling correlated only weakly with the percentage of sperm penetration. The results indicate that the hypoosmotic swelling test appears to evaluate different functional qualities of sperm than ZSPT.

[The surgical treatment of chronic empyema--from the stand point of preservation and improvement of pulmonary function]

During the period of 1978 to 1990, 247 patients with chronic empyema were operated. The cure rate was 88.3%. The operation was not successful in 29 patients (11.7%), of whom 19 were operative death and 10 were those whose condition never improved to the level of discharge. The pulmonary function improved post-operatively in those patients who underwent decortication and air-plombage, but not in those who underwent pleuropneumonectomy and thoracoplasty (modification of Grow's method). Most remarkable changes of pulmonary function were seen in patients who underwent thoracoplasty. Air-plombage was found effective in controlling empyema and for the preservation and improvement of post-operative pulmonary functions.

[Radiotherapy of prostatic carcinoma]

Forty-one patients with adenocarcinoma of the prostate localized in the pelvis (stage A2, NX; 3, A2, pN0; 5, B, NX; 5, B, pN0; 1, C, NX; 13, C, pN0; 7, C, pN1; 7) underwent curative external radiotherapy. Thirty-two cases were treated by fast neutron combined with or without Liniac X-ray and 9 cases were treated by Liniac X-ray. Twenty-six cases were well controlled by radiotherapy, but 15 cases recurred and were followed by endocrine therapy. The types of recurrence were local growth in 3, distant metastases in 11, and both in 1. These recurrences occurred in the cases of large prostatic carcinoma, small radiation field in NX cases or low radiation dose. The five-year disease-free survival rates of stage A2, B, C were 86, 66, and 47%, respectively and the five-year overall survival rates were 100, 100, and 53%, respectively. The cases with well differentiated carcinoma had better prognosis than those with poorly differentiated carcinoma (p less than 0.05). As 58% of the cases which were given concomitant endocrine therapy were controlled for over 2 years, endocrine therapy seems to be effective in the cases of failure after radiotherapy. Most of the complications were slight and only one case with complication of sacral decubitus needed surgical treatment. It was concluded that external radiotherapy was a good modality for prostatic carcinoma localized in the pelvis.

Angiogenic factor of a rat mammary tumor cell line (RMT-1) (I). Secretion of two distinct angiogenic factors into serum-free conditioned medium by RMT-1 cells

Serum-free conditioned medium of a rat mammary tumor cell line RMT-1, established from a rat mammary carcinoma induced by 7,12-dimethylbenz[a]anthracene (DMBA), produced the complete angiogenic response in both rabbit cornea and chick embryo chorioallantoic membrane assays. The angiogenic activity in the RMT-1 conditioned medium was separated into two fractions on a column of heparin-Sepharose; one was eluted with 0.1 M NaCl and the other with 0.5 M NaCl, which are referred to hereafter as rAF-1 and rAF-2, respectively. These two angiogenic factors were further purified separately by FPLC on a Superose 12 column. The partially purified rAF-2 had an apparent Mr of 30,000-50,000 and seemed to exhibit mitogenic activity toward Balb/c 3T3 cells, while the partially purified rAF-1, with an apparent Mr of 10,000-30,000 did not have a mitogenic effect on these cells. Both rAF-1 and rAF-2 were resistant to heat and acid treatment, and exhibited trypsin sensitivity, suggesting that they are heat and acid stable peptides. The two angiogenic factors did not stimulate the proliferation of cultured vascular endothelial cells. These results suggest that RMT-1 secretes two distinct angiogenic factors into the medium and that these two secretable angiogenic factors participate cooperatively in the induction of the angiogenic response produced by a DMBA-induced rat mammary tumor in vivo.

[The effect of interleukin-1 on ocular inflammation in rabbit ocular tissue]

IL-1 (Interleukin-1) has attracted attention not only as a mediator of the immunological response but as a substance involved in acute and chronic inflammatory responses. The author induced endophthalmitis by intravitreous injection of IL-1 into rabbit eyes. The inflammation model was characterized by the indicators of aqueous humor protein and PGE2 levels, and IL-1 and PAF were investigated as possible mediators of inflammation in IL-1 induced endophthalmitis. A prostaglandin (PG) synthetase inhibitor suppressed both the protein level and PGE2 level, while a PAF antagonist acted to inhibit the increase in the protein level in aqueous humor but did not inhibit the rise in PGE2. Combined administration of the PAF antagonist and the PG synthetase inhibitor further reduced both the protein and PGE2 levels. These findings suggest that PAF may be a mediator of endophthalmitis due to IL-1, and that IL-1 induced endophthalmitis is also modified by other factors in addition to PAF.

[Concentration of thrombin antithrombin III complex and plasmin alpha 2-plasmin inhibitor complex in nephrotic syndrome]

Plasma concentration of fibrinogen (Fbg), plasminogen (PLG), antithrombin III (AT III), alpha 2-plasmin inhibitor (alpha 2-PI), thrombin antithrombin III complex (TAT) and plasmin alpha 2-plasmin inhibitor complex (PIC) were evaluated in 23 nephrotic patients with proteinuria more than 3.5 g/day, including 4 cases with clinical evidence of thromboembolism. Among patients without thromboembolism, concentration of PLG and AT III was in the normal range but that of Fbg and alpha 2-PI was significantly elevated (p less than 0.01 for Fbg and p less than 0.001 for alpha 2-PI respectively). Also there was a positive relationship between AT III and serum albumin (p less than 0.05). Two fifth of these patients had an had an increased level of TAT, and also had a higher level of PIC compared with normal control (p less than 0.01). There was a positive relationship between TAT and PIC, TAT and Fbg (p less than 0.05), PIC and Fbg (p less than 0.01). TAT and PIC levels were markedly elevated in the patients with thromboembolism. From aforementioned data, it was suggested that patients with nephrotic syndrome would be in the prethrombotic state and the increased level of Fbg is one of the major risk factors of thromboembolic complications in these patients. Furthermore measurement of TAT and PIC are the useful means for the diagnosis of these complications.

[Effects of cyclosporin A on male reproduction in rats]

Effects of cyclosporin (Cs) on male reproduction in rats were examined. A dose-dependent decrease of the sperm counts in the cauda epididymis was observed 6 weeks after Cs was administered. A significant decrease of sperm motility was also observed in the each Cs-treated group in any observational period after Cs injection, which suggested an injury to epididymis by Cs. A slight damage of the seminiferous tubules was demonstrated 6 weeks after administration of 40 or 60 mg/kg of Cs. No change in serum levels of luteinizing hormone and testosterone was demonstrated throughout the experiment. But serum levels of follicle-stimulating hormone were significant high in any observational period except 6 weeks after Cs injection. It was concluded that Cs gave injuries to both spermatogonia and epididymal function in rat.

[Primary testicular carcinoid tumor with teratoma: a case report]

We report a case of primary testicular carcinoid with teratoma and review the literature. A 68-year-old man was hospitalized with an asymptomatic left testicular mass. Left radical orchiectomy was performed under a diagnosis of testicular tumor. Histologically, the tumor showed a typical appearance of teratoma with carcinoid components. Barium studies, computed tomographic scan could not demonstrate any other tumor anywhere else. He is now being followed at our clinic without any evidence of recurrence.

Serodiagnosis of hepatitis C virus (HCV) infection with an HCV core protein molecularly expressed by a recombinant baculovirus

An enzyme-linked immunosorbent assay (ELISA) was developed for serological diagnosis of hepatitis C virus (HCV) infection, using HCV core protein (p22) synthesized by a recombinant baculovirus. Among 58 clinically well-defined chronic non-A, non-B hepatitis (NANBH) patients, 49 (84.5%) were positive for p22 antibody (anti-p22), whereas 42 (72.4%) were positive for C100-3 antibody (anti-C100-3), as measured by the present assay using the HCV nonstructural protein as antigen. Thirty-nine patients (67.2%) had both antibodies. No significant level of anti-p22 was detected in sera of chronic hepatitis B patients or normal blood donors. In typical post-transfusion NANBH patients, anti-p22 could be detected at, or even before, the first alanine aminotransferase peak. Anti-p22 was also detected in blood donors who were previously shown to be involved in transmitting HCV but in whose serum anti-C100-3 was not detectable. The ELISA detecting antibody to the HCV core protein expressed and properly processed in animal cells will be useful for mass screening of donor blood as well as for early diagnosis of hepatitis C.

Expression of processed core protein of hepatitis C virus in mammalian cells

A structural protein of hepatitis C virus (HCV) was expressed in monkey COS cells under the control of an exogenous promoter, and a protein of 22 kDa was identified by immunoblot analysis. This protein (p22), which was produced by processing in COS cells, reacted specifically to sera of chronic hepatitis C patients, and its coding region was mapped at the most amino-terminal part of the HCV polyprotein. These results suggested that the p22 protein is the nucleocapsid (core) protein of HCV. Moreover, the assay detecting antibody to p22 was found to be useful for early diagnosis of HCV infection.

[Measurement of urinary epidermal growth factor by radioimmunoassay and its application]

Epidermal growth factor (EGF), a polypeptide hormone originally discovered in the mouse submaxillary gland, stimulates growth in a variety of tissues in several species. This hormone has recently been identified in human urine. Herein, radioimmunoassay (RIA) for human EGF (hEGF) has been developed, using human recombinant EGF as reference standard and radioiodinated tracer and antibodies raised against hEGF. Its sensitivity was somewhat higher than that of RIAs reported formerly. This method had no cross reactivity with high molecular weight EGF. Urinary concentrations of hEGF in normal males and females were 30.2 +/- 13.0 ng/mg creatinine and 46.4 +/- 17.4 ng/mg creatinine, respectively. Urinary concentration of hEGF in patients with renal cancer was somewhat low. The patients with bladder cancer had lower urinary excretion of hEGF than normal adults (p less than 0.05). However, the role of hEGF in health and disease remains to be determined.

Rat plasma fibronectin contains two distinct chemotactic domains for fibroblastic cells

Mechanism of fibronectin (FN)-induced chemotaxis of fibroblastic cells has not been fully understood. The present study was performed to establish a molecular nature of the chemotactic region of rat plasma FN. The chemotactic dose-response pattern of intact FN for mouse embryo fibroblastic cells, NIH-L13 cells, which was represented as a "bell-shape" curve with a maximum activity at around 50 nM, changed to a "biphasic" mode through a proteolysis with thermolysin. Two distinct chemotactic components were isolated from the thermolytic fragments. One component, a fragment with a molecular mass of 110-150 kDa, was estimated to contain the central cell-binding domain and the carboxyl-terminal heparin-binding domain of the intact FN molecule. Cell migration stimulated by the 110-150-kDa fragment increased successively in a dose-dependent manner, and the capability to promote the migration was much higher than that of the intact FN (over 2-fold). The second chemotactic component, a fragment with a molecular mass of 21 kDa, was shown to reside in the carboxyl-terminal fibrin-binding domain. The 21-kDa fragment produced a bell-shape dose-response pattern, being consistent with the intact FN, whereas a maximum response occurred at a 100-fold lower concentration (0.5 nM) than that of the intact FN molecule. At higher concentrations, this fragment revealed an inhibitory activity for the cell migration in response to the 110-150-kDa fragment. No significant molecular interaction between these two active components was observed by polyacrylamide gel electrophoresis under nondenaturing conditions, suggesting that the 21-kDa fragment may act directly on the cell to inhibit the cell migration. These results suggest that rat plasma FN contains at least two chemotactically active components that regulate cooperatively chemotactic migration of fibroblastic cells.

Effects of activin A on anterior pituitary cells fractionated by centrifugal elutriation

We have shown previously that activin A increases the number of immunoreactive follicle-stimulating hormone (FSH) cells. To further investigate the action of activin A, we examined its effects on anterior pituitary cells fractionated by centrifugal elutriation. Before activin A treatment, FSH cells were widely distributed among various fractions; a higher proportion of FSH cells was found in larger cell fractions (fractions 5-9), and a lower proportion in smaller cell fractions (fractions 2-4). After culture of the cells in each fraction with activin A (10 ng/ml) for 72 h, the number of FSH cells in fraction 4 only was significantly (P less than 0.05) higher by 225% than that in cells cultured without activin A. The amount of FSH secreted into the medium was minimal or undetectable in fractions 1-4. However, FSH secretion tended to be, or was significantly (P less than 0.01 in fraction 9), stimulated by activin A in fractions 5-9, in which the numbers of FSH cells were not significantly affected. These results suggest a dual mode of action of activin A on FSH: activin A increases the number of FSH cells in a specific type(s) of middle-sized cell fraction, and stimulates FSH secretion at least from larger cells without affecting the number of FSH cells.