[Clinical studies of ureteroileal junction stricture in ileal conduit]

Fifty eight patients who underwent ileal conduit formation in our hospital for the past 14 years were reviewed. Out of them, 11 patients developed hydronephrosis which should be treated. It occurred due to urolithiasis, recurrent tumor, contracted ileal loop in one patient respectively, and ureteroileal junction stricture in 8 patients (10 ureteral units). The 8 patients consisted of 6 males and 2 females. All of the males underwent total cystectomy because of bladder tumor (T.C.C.), and the females had anterior pelvic exenteration because of uterine cancer (adenocarcinoma). Out of 10 ureteral units, 7 were corrected by surgical intervention, 1 was dilated with endourological procedure, and 2 had no treatment. Six ureteral units including 1 ureteral unit treated by an endourological method resulted in improvement or disappearance of hydronephrosis. Histological examination of the stricture revealed fibrosis in 7 ureteral units treated surgically. According to our clinical studies, infection in the pelvic space seemed to be one of the causes which brought about ureteroileal junction stricture.

Correlation of serum inhibin concentrations with results in an ovarian hyperstimulation program

In order to appraise follicular development, human serum inhibin was measured daily by radioimmunoassay in 18 women undergoing ovarian hyperstimulation. Serum inhibin in the early follicular phase correlated with the number of follicles greater than or equal to 17 mm in diameter (r = 0.57, n = 18, P less than 0.05), follicles greater than or equal to 14 mm in diameter (r = 0.67, n = 18, P less than 0.01) on the day of human chorionic gonadotropin (hCG) administration and the number of oocytes retrieved (r = 0.67, n = 15, P less than 0.01). The number of oocytes retrieved showed a significant correlation with serum inhibin level on the day of hCG administration (r = 0.84, n = 15, P less than 0.001). These data suggest that: (1) In the early follicular phase, serum inhibin may be a valid index to predict ensuing follicular growth; (2) In the preovulatory phase, serum inhibin may be one of applicable indexes of follicular development during the hyperstimulation cycle.

Human adenylate kinase deficiency associated with hemolytic anemia. A single base substitution affecting solubility and catalytic activity of the cytosolic adenylate kinase

Adenylate kinase deficiency in the erythrocyte is a rare genetic disorder associated with hemolytic anemia. To determine the molecular basis of this disorder, we first cloned the normal gene encoding human cytosolic adenylate kinase (AK1) and determined the structure. The gene was 12 kilobase pairs long and was split into 7 exons. The structures of 5'- and 3'-flanking regions were determined by primer extension and RNA blot analysis. The results showed that two species of mRNA with 0.9 and 2.5 kilobases, which differed at the 3'-end portion, were generated by the AK1 gene. Alu sequences were found in the largest intron (intron 5) and in the noncoding region of exon 7. Next, both alleles of the AK1 gene were cloned from DNA of a patient bearing the adenylate kinase deficiency and their nucleotide sequences determined. A transition (C----T) was found in exon 6 on an allele, which resulted in an Arg to Trp (CGG----TGG) substitution at the 128th residue of AK1. Since chicken AK1 is highly homologous to human AK1 with respect to the amino acid sequence, we introduced an Arg to Trp substitution to chicken AK1 at the same position by oligodeoxynucleotide-directed mutagenesis. The mutant chicken AK1 expressed in Escherichia coli showed a reduced catalytic activity as well as a decreased solubility and a change in affinity to phosphocellulose. Thus it was considered that the observed C----T transition was a cause of the decreased AK1 activity of the patient's erythrocyte. Analysis on phosphocellulose chromatography of erythrocyte AK1 of the patient and parents revealed that the patient's mutant allele was derived from the mother.

Sodium concentration in saliva along the time course of experimental Coriolis sickness

Procedures designed to evaluate the severity of motion sickness have included subjective reporting of changes in salivation. In order to increase objectivity, we studied the sodium concentration of saliva, which is directly related to the flow rate. Healthy adults with normal vestibular function underwent a modified Coriolis Sickness Susceptibility Index (CSSI) test, utilizing a staircase profile. Saliva was collected without interrupting the stimulus by means of cotton placed beneath the subject's tongue for one minute. Samples were obtained 5 min prior to stimulation, 30 and 45 min following stimulus onset, and/or upon reaching the "nausea II" endpoint. Saliva for analysis by atomic absorption spectrophotometry was obtained by centrifugation of the cotton. A significant difference in sodium concentration was found between the baseline and 30-min sample (p less than 0.01). Although the amount of salivation was rather variable, the pattern of changes in sodium concentration was similar in all experimental cases.

Changes in serum concentrations of immunoreactive inhibin during the oestrous cycle of the rat

Serum and ovarian concentrations of inhibin during the oestrous cycle of rats were determined by a radioimmunoassay (RIA) based on a porcine inhibin RIA. Serum concentrations of LH, FSH, oestradiol-17 beta, progesterone and testosterone were also determined during the cycle. Serum concentrations of inhibin were high (8.47 +/- 0.58 micrograms/l) during the morning of pro-oestrus and then dropped sharply to the lowest level (3.21 +/- 0.38 micrograms/l) at 24.00 h on the day of pro-oestrus after the preovulatory LH and FSH surge. Inhibin concentrations then recovered rapidly, with a peak (7.94 +/- 0.97 micrograms/l) at 15.00 h on the day of oestrus. Inhibin concentrations in serum dropped again to their second lowest value (4.00 +/- 0.12 micrograms/l) at 24.00 h on the day of oestrus. The largest FSH surge observed from midnight of pro-oestrus to the morning of oestrus (the so-called second FSH surge) was shown to be inversely related to the changes in serum concentrations of inhibin, suggesting a close relationship between the serum FSH and inhibin concentrations in cyclic rats.

[Development of a new therapeutic method in hepatocellular carcinoma using a culture system--the intensifying effect of human epidermal growth factor (hEGF) on the antitumor action of antitumor agents]

The culture system of hepatocellular carcinoma (HCC) has been established and the effect of hepatotrophic factors on these cell lines have been studied. During this study the effect of the human epidermal growth factor intensifying anti-tumor action of anti-tumor agents will be evaluated. HCC cell lines (C-HC-4, C-HC-20) show logarithmic growth in the serum-free medium. These growth curves after administration of 1 x 10(-12- -8) M of hEGF were measured, and the existence of the hEGF receptors was evaluated using the ABC method. The growth curve of HC-4 transplanted into nude mice was measured in 4 groups; the control group, the hEGF group, the gamma Interferon (gamma IFN) group, and the hEGF + gamma IFN group. The hEGF enhanced the cell growth of C-HC-4 and C-HC-20, and EGF receptors were confirmed immunohistologically. In the hEGF+ gamma IFN group, growth inhibition seems to be most important. The hEGF may intensify the anti-tumor action of the anti-tumor agents.

Plasmodium falciparum: characterization of a 33-kDa soluble antigen

A 33-kDa soluble antigen identified in the culture supernatant by patient serum and monoclonal antibodies was present in rings, trophozoites, schizonts, and merozoites of Plasmodium falciparum. The antigen which is released into the culture supernatant by growing parasites was also observed in the host cells of trophozoites and schizonts and could be localized on the host cell surface. Its specificity for the surface of trophozoites and schizonts was observed to decrease with increased duration without subculture. The antigen could then be detected on the surface of noninfected erythrocytes. The antigenicity of the 33-kDa antigen was destroyed by heating at 65 degrees C. Monoclonal and polyclonal specific antibodies weakly inhibited parasite growth in vitro. The antigen was present in both knob positive and knob negative parasites in all the P. falciparum isolates tested.

Effect of physical exercise prelabyrinthectomy on locomotor balance compensation in the squirrel monkey

This study examines the effectiveness of physical exercise, during a prepathology state, on locomotor balance compensation after subsequent unilateral labyrinthectomy in squirrel monkeys. An experimental group underwent 3 hr. of daily running exercise on a treadmill for 3 mo. prior to the surgery, whereas a control group was not exercised. Postoperatively, the locomotor balance function of both groups was tested for 3 mo. There was no significant difference in gait deviation counts in the acute phase of compensation. However, in the chronic compensation maintenance phase, the number of gait deviation counts was fewer in the exercise group, which showed significantly better performance stability.

Inhibin alpha-subunit monomer is present in bovine follicular fluid

The 26 kDa form of the inhibin alpha-subunit monomer was isolated from bovine follicular fluid. Both sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting analysis revealed that the 26 kDa form of the alpha-subunit monomer is composed of 6 kDa and 20 kDa fragments linked together by a disulfide bond(s). The NH2-terminal sequence and amino acid analyses of each fragment showed that those fragments are derived from residues 18 to 60 and 227 to 360, respectively, of the inhibin alpha-subunit precursor (residues 1 to 360) as deduced from the cDNA sequence. Thus, it is concluded that removal of the putative signal peptide (residues 1 to 17) and the middle portion (residues 61 to 226) from the alpha-subunit precursor generates the 26 kDa form of the alpha-subunit. In the in vitro rat pituitary assay, the 26 kDa alpha-subunit exhibited neither inhibin-like nor FSH-release stimulating activity.

Toxoplasma gondii: antigenic differences between endozoites and cystozoites defined by monoclonal antibodies

The antigenic differences between endozoites and cystozoites of Toxoplasma gondii were analyzed by indirect immunofluorescent assay and Western blotting using monoclonal antibodies. An antigenic determinant of an antigen of 20 kDa mol. wt. that appeared to be localized in the cytoplasm was observed to be specific to cystozoites alone. The 20-kDa antigen was diffused throughout the parasite and was observed in cystozoites produced both in vivo and in vitro.

[A combined treatment of carcinoma of the maxillary sinus--treatment method for T4 cases]

Between 1974 and 1986, 54 cases of squamous cell carcinoma of the maxillary sinus were treated combining surgery, radiotherapy and regional chemotherapy simultaneously. Using UICC (1987) system, these 54 cases were classified into one T1, four T2, thirty-three T3 and sixteen T4. The combined therapy consisted of 1) reduction operation followed by daily cleaning of the necrotic tumor mass; 2) external irradiation with less than 30Gy; 3) intra-arterial infusion of 5-fluorouracil (5-FU) and broxuridine (BUdR); and 4) final tumor resection under general anesthesia. As several modifications were made for the treatment procedure in 1979, the 54 cases were divided into two groups: Group A with 29 cases, which were treated before 1979 and Group B with 25 cases, which were treated after 1979. In this paper, the operative procedure, which we use for T4 cases is described. The first operation is performed after radiotherapy with about 10Gy and in this operation only the necrotic portion of the tumor mass is removed. The maxillary cavity is opened through the sublabial incision. This window is kept open and daily cleaning of the necrotic tumor mass is continued through the window. Three weeks after the simultaneous administration of radiation with 20Gy and 5 intra-arterial infusions of 5-FU and BUdR, the residual tumor is curetted thoroughly under general anesthesia. Surgery is performed through the sublabial window which has been kept open after the reduction surgery. Removal of the residual tumor mass which extends to the pterygomaxillary fossa, nasopharynx, anterior and medial skull base can be performed without difficulty, provided that the tumor mass is removed in pieces.(ABSTRACT TRUNCATED AT 250 WORDS)

[Estimation of regional myocardial sympathetic neuronal function with I-123 metaiodobenzylguanidine (MIBG) myocardial images in patients with cardiomyopathy]

I-123 Metaiodobenzylguanidine (MIBG) is taken up by myocardial sympathetic neuronal endings. Sympathetic neuronal function in 10 patients with cardiomyopathy under stable state were studied by using MIBG and Tl-201 (Tl) SPECT images with 50% cut off level. For myocardial imaging MIBG and Tl were simultaneously injected and collected (dual injection and dual collection mode; Dd mode). Four hours delayed images were also collected. Three types of abnormal findings were noted in MIBG images in combination with Tl images. 1) Enhancement of regional MIBG washout with otherwise normal MIBG and Tl uptake in infero-lateral wall were noted in 5 patients with history of congestive heart failure (Pathophysiologically acceleration of regional sympathetic neuronal function was suspected. Mean washout ratio is 63 +/- 7% vs. 45 +/- 10% in normal region). 2) In 3 patients with dilated cardiomyopathy increase of MIBG/Tl (M/T) ratio was noted in basal septal wall (Sympathetic neuronal function is abnormally accelerated in the region with depressed coronary perfusion. Exaltation of regional sympathetic neuronal function was suspected. Mean M/T ratio is 1.6. Tentative normal range is from 0.8 to 1.20). 3) In 2 patients with dilated cardiomyopathy under severe congestive heart failure defects of MIBG uptake with normal Tl uptake were noted (Sympathetic neuronal function was depleted in spite of normal coronary perfusion. Depletion of myocardial catecolamine was suspected. M/T ratio is 0.75 and 0.7 respectively). Heterogeneous abnormality of sympathetic neuronal function was noted in MIBG images. This findings corresponded to report about heterogeneous myocardial catecholamine concentrations in hearts of recipients of transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrastructural evidence of repair and neuronal survival after labyrinthectomy in the squirrel monkey

Although the vestibular and cochlear branches of the VIIIth cranial nerve originate embryologically from the same primordia, results of the present investigation confirm previous findings indicating that the vestibular branch may be more plastic with respect to recovery after surgical insult than the cochlear division. In this report we show ultrastructural details of changes undergone by the vestibular nerve after surgery. Dendrites peripheral to the vestibular nerve ganglion (VNG) were severed by surgically removing the vestibular end organs; the squirrel monkeys were then allowed to recuperate, and tested for their vestibulospinal and vestibulo-oculomotor functions behaviorally. However, behavior deficits resulting from the injury are reported separately. The vestibular nerves excised from the internal acoustic meatus and the temporal bones were examined histologically for changes of VNG and fibers from day 1 to 1,247 days after labyrinthectomy. Light- and electron-microscopic examinations indicated that some perikarya and some fibers of the VNG remained in the ganglionic matrix for up to 1,247 days, the longest period studied, after the operation. Fibers extended toward the remodeled inner ear space in the absence of appropriate sensory cell targets. The surviving neurons and fibers exhibited various degrees of wallerian-like degeneration at first, but many of them retained ultracellular organelles and integrity even after 1,247 days. Since vestibular perikarya are bipolar, the unsevered fibers that project to the brainstem could retain functional synaptic connections, a possibility that is now under investigation. Schwann cells in the ganglionic matrix may also have contributed to vestibular neuron survival by providing the proper nourishment. Morphometric measurements determined that neurons remaining in the ganglion had significantly smaller cross-sectional areas than normal neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

Second-phase optokinetic after-nystagmus and vestibular compensation

To evaluate the direction-specific effect of optokinetic storage function on balance compensation after unilateral labyrinthectomy, squirrel monkeys (n = 12) were exposed to a prolonged (30 min) daily optokinetic stimulus (horizontal, constant speed-90 degrees/sec) for 14 days; either in the ipsilateral direction to the slow phase of spontaneous nystagmus, or in the contralateral direction, or without any optokinetic stimulus. The effect of optokinetic stimulus in ipsilateral direction (slow phase of OKAN-II in the opposite direction) was significantly more (p less than 0.001) in the vestibulo-oculomotor balance (static) regainment than the other two groups, but this group showed the severest gait deviation in the vestibulospinal balance function (p less than 0.05).

Cerebrovascular complications in children with nephrotic syndrome

Although the nephrotic syndrome is known to be a hypercoagulable state, cerebral arterial thrombosis associated with the nephrotic syndrome is an uncommon yet treatable cause of stroke syndrome in children. We report 2 children, 1 with congenital nephrotic syndrome and the other with minimal change nephrotic syndrome, who developed cerebral arterial thrombosis. The complication was fatal in 1 patient.

Induction of follicle stimulating hormone receptor by erythroid differentiation factor on rat granulosa cell

Erythroid differentiation factor (EDF), inhibin beta A-homodimer, induced expression of follicle stimulating hormone receptors on rat granulosa cells prepared from diethylstilbestrol primed immature female rats. After 3 day incubation with EDF, the number of FSH receptors on the granulosa cells was increased to about 3.5 times of the control value in a dose dependent manner with an ED50 value of 61 ng/ml. On the other hand, EDF related peptides, i.e., bovine 32K Da inhibin A and TGF beta, had no effect on the FSH receptor induction. The present observation suggests that EDF may play a role in the initiation of the cytodifferentiation of ovarian granulosa cells.

Identification of a specific receptor for erythroid differentiation factor on follicular granulosa cell

A cellular receptor for erythroid differentiation factor (EDF) was demonstrated by incubation of 125I-labeled EDF with rat follicular granulosa cell cultures. The specific binding of labeled EDF to the cells showed saturation; Scatchard analysis of binding data indicated a single class of receptors having Kd = 3.4 x 10(-10) M. A large excess of unlabeled EDF reduced labeled EDF binding almost completely, whereas similar doses of inhibin and transforming growth factor type beta, which are quite similar to EDF in protein structure and subunit organization, had no effect; EDF did not share receptors with those factors. EDF receptor (activin A receptor) expression was enhanced in granulosa cells cultured in the presence of follicle-stimulating hormone; follicle-stimulating hormone raised the number of EDF binding sites/cell from 13,000 to 96,000 without altering the binding affinity.