Germinoma originating in the basal ganglia. Report of a case showing unusual appearance on MRI

A case of germinoma originating in the basal ganglia is presented. Preoperative MRI showed an area of a reticulated core of mixed signal intensity with a surrounding rim of low signal intensity in the right basal ganglia on T2-weighted image. This finding was reported to be characteristic of cavernous angioma, but the tumor was histopathologically identified to be a germinoma with old hemorrhage. The pitfall of MRI in diagnosing brain tumors is discussed.

Antibody-dependent cellular cytotoxicity and natural killer activity against HTLV-1 infected cells

Antibody-dependent cellular cytotoxicity (ADCC) and natural killer (NK) activity were examined using MT-2 cells persistently infected by HTLV-1 as target cells, and mononuclear cells as effector cells, from healthy one-week-old newborn babies, infants, children and adults. More than 10% of ADCC was observed in 17 newborn babies out of 22 (77.3%) and in all 67 healthy one-month-old babies to adults, by adding serum from anti-HTLV-1 positive carriers. When anti-HTLV-1 negative serum was added, less than 10% of ADCC was observed. If infants without anti-HTLV-1 antibodies were breast-fed they had the possibility of HTLV-1 vertical transmission. There was no significant decrease in NK activity between 90 healthy newborn babies, infants, children, or adults. These results suggest that ADCC and NK activity protect against the transmission of HTLV-1 from mother to child.

New ultraviolet labelling agents for high-performance liquid chromatographic determination of monocarboxylic acids

New UV-labelling agents have been synthesized, which are designed to convert monocarboxylic acids into their highly UV-absorbing derivatives for enhancement of the sensitivities of UV detection in high-performance liquid chromatography. The reagents are p-nitrobenzyl, 3,5-dinitrobenzyl and 2-(phthalimino)ethyl p-toluenesulphonates. Each has been prepared by reaction of p-toluenesulphonyl chloride with p-nitrobenzyl alcohol, 3,5-dinitrobenzyl alcohol or N-(hydroxyethyl)phtalimide, respectively, in the presence of sodium hydroxide, and they are stable in the solid state for at least 6 months. Monocarboxylic acids were derivatized to their p-nitrobenzyl, 3,5-dinitrobenzyl or 2-(phthalimino)ethyl esters with each of the above reagents, respectively, then determined by high-performance liquid chromatography with UV detection. In the UV-labelling with each reagent, 18-crown-6 was used as the catalyst. The effects of the reaction solvent, reaction temperature and time and the concentrations of each reagent and the catalyst were also examined.

[Cutaneous metastases from transitional cell carcinoma of the bladder]

Two cases of transitional cell carcinoma of the bladder with cutaneous metastases are reported. In one patient, multiple nodular metastatic lesions appeared simultaneously with urethral recurrence after total cystectomy. In another patient, diffuse inflammatory metastatic lesion was generated after radiotherapy for pelvic lymph nodes. The pathways of metastatic dissemination from the transitional cell carcinoma of the bladder are discussed.

Tissue polypeptide antigen expression in human prostate tumors

Thirty-seven specimens of benign and malignant prostatic tumors were studied for the localization of tissue polypeptide antigen (TPA) by an avidin-biotin-peroxidase complex technique. In addition, 23 metastases of prostatic carcinoma in other organs and 12 nonepithelial tumors of prostate also were studied. All benign and malignant tumors of epithelial origin, including their metastasis, stained positively. Nonepithelial tumors were uniformly negative. In the metastatic lesions, small foci of tumor cells and even single tumor cells could be identified by TPA staining. Immunohistochemical localization of TPA appeared to be a useful tool for assessing the micrometastases of prostatic carcinoma in other organs, especially lymph nodes, or elucidating the epithelial origin of an otherwise undifferentiated prostatic cancer.

[Work-physiological assessment of eye-tracking task]

Mental work-load has increased with technical innovation, while manual work-load has decreased. As a result, eye fatigue has become one of the complaints in the modern working environment. Heretofore, the evaluation of visual work-load was based mainly on observation of the refractive power and accommodative function of the eyes. The purpose of this study is to assess, through observation of eye movement, the work-load created by eye-tracking tasks. The subjects were required to track, only by eye movement, a target oscillating between a distance of 35 cm in the horizontal or vertical direction for seven minutes. Mispursuit of the target, blinking and heart rate were recorded during the period of the experiment. The subjects were given eye-tracking tasks under nine conditions comprising angles 20 degrees, 40 degrees and 60 degrees in the respective moving widths and 0.1 Hz, 0.3 Hz and 0.5 Hz in the moving frequency of the target. Four healthy male volunteers participated in the eye-tracking experiments involving the horizontally moving target and five healthy male volunteers participated in those involving the vertically moving target. The task load condition of visual angle of 20 degrees with target frequency of 0.1 Hz was employed as standard. The relative velocity of the target and the velocity of eye movement were obtained using various combinations of visual angles and target frequencies. The following results were obtained: 1) The frequency of mispursuits increased significantly with the increase of relative target velocity. The degree of increase of mispursuit was especially remarkable at relative target velocities exceeding 1.0 Hz or at eye movement velocities exceeding 40 degrees/s.(ABSTRACT TRUNCATED AT 250 WORDS)

[Renal artery thrombosis following surgical treatment of chyluria]

A case of segmental renal arterial thrombosis occurring after bilateral surgical stripping and interruption of renal pedicle lymphatics for chyluria is presented. This case showed elevation of serum creatinine (6.6 mg/dl) and lactate dehydrogenase (1131 IU/L) on the 4th day after operation, and on the 14th day, renal scintigraphy with 99 m-Tc diethylenetriamine penta acid acetic showed bilateral marked decrease of glomerular filtration rate. Aortography and selective left renal angiography demonstrated left segmental renal thrombosis, but right renal arteries were intact on the 20th day after operation. Systemic anticoagulation therapy was performed, but left renal function was destroyed completely. Excessive and prolonged retraction of the renal artery with vascular tape may have resulted in this unfortunate complication.

[Metastatic tumor of the spermatic cord from gastric cancer]

A 70-year-old male who had undergone gastrectomy due to gastric cancer 6 years previously visited our department complaining of perineal and bilateral scrotal mass. Biopsy specimen of the perineal mass showed well-differentiated adenocarcinoma. The spermatic cords were resected en bloc with the entire scrotal content, penis and perineal skin. Histological examination of the spermatic cord, epididymis and perineal subcutaneous tissue revealed well differentiated adenocarcinoma similar to that of the lesion resected from the stomach 6 years earlier. The patient was followed for 2 years with no evidence of recurrence. Metastatic tumors of the spermatic cord and epididymis resulting from gastric cancer are rare and 31 cases previously reported in the Japanese literature are reviewed.

[Renal cell carcinoma in the solitary kidney]

We have treated surgically 5 patients with renal cell carcinoma in the solitary kidney. The cause of renal absence was nephrectomy for renal stones, in 2 patients and renal tuberculosis, renal cyst and renal hypoplasia in 1 patient each. Four of the 5 patients died. One of the 4 patients died 5 days after surgery due to gastrointestinal bleeding, 1 due to metastasis, 1 due to gastric cancer and one due to hemodialysis complications. Surgical management of renal cell carcinoma of solitary kidney is discussed.

[Effects of estrogen and endocrine therapeutic agents on the estrogen receptor, progesterone receptor and DNA synthesis in MCF-7 human breast cancer cells using the whole cell uptake method]

In order to investigate the mechanisms of the endocrine therapeutic agents and the applicability of combined endocrine therapies for breast cancers, we studied the effects of estrogen and the endocrine therapeutic agents on estrogen receptor (ER), progesterone receptor (PgR), and DNA synthesis in MCF-7 human breast cancer cells, which is known to be sensitive to estrogen. ER and PgR of MCF-7 cells were determined by whole cell uptake method. In brief, intact MCF-7 cells cultured in the multi-well plates were incubated with various concentrations of tritiated estradiol (E2) or promegestone (R5020) at 37 degrees C for 1 hour. The characteristics of the hormone binding were analyzed by Scatchard plots. MCF-7 cells had single class of ER (Kd: 2.1 +/- 0.2 X 10(-10) M, MBC: 9.0 +/- 1.5 X 10(3) sites/cell) and PgR (Kd: 7.2 +/- 1.1 X 10(-10) M, MBC: 3.1 +/- 0.5 X 10(4) sites/cell). When cultured in the presence of 10(-8) M or 10(-6) M of E2, tamoxifen (TAM), R5020 or medroxyprogesterone acetate (MPA) for 48 hrs, the numbers of binding sites of ER and PgR altered, but the affinities of either of them did not change. E2(10(-8) or 10(-6) M) increased about twice the number of PgR. Although treatment of 10(-8) M TAM, a non-steroidal antiestrogen, slightly increased the number of PgR, 10(-6) M TAM significantly decreased the number of PgR. Both of R5020 (10(-8) or 10(-6) M) and MPA (10(-8) or 10(-6) M), synthetic progestins, decreased the number of ER dose-dependently. On the other hand, E2 (10(-8) and 10(-6) M) and R5020 (10(-8) M) enhanced DNA synthesis, but 10(-6) M TAM or MPA inhibited DNA synthesis. The effects of single, sequential and coincidental treatment of these agents were compared. The sequential treatment of 10(-8) M E2 for 36 hrs and followed 10(-6) M MPA for 36 hrs ("10(-8) M E2----10(-6) M MPA") and "10(-6) M TAM----10(-6) M MPA" inhibited DNA synthesis of MCF-7 cells more efficiently than 10(-6) M TAM alone or 10(-6) M MPA alone for 72 hrs. However, "10(-6) M MPA----10(-6) M TAM" inhibited DNA synthesis less than "10(-6) M TAM----10(-6) M MPA".(ABSTRACT TRUNCATED AT 400 WORDS)

[Inverted papilloma of the ureter]

Two cases of ureteral inverted papilloma are reported. Case 1: A 48-year-old male had asymptomatic gross hematuria and filling defect of left middle ureter on intravenous pyelography. Segmental resection of ureter was performed. The specimen was a 1 cm polypoid lesion with histologic features resembling "multifocal bud-like proliferation", which was reported as the initial stage of the inverted urothelial tumor by Kunze et al. Case 2: A 64-year-old female with asymptomatic gross hematuria and complete obstruction of left middle ureter on ante- and retrograde pyelograms. Total nephroureterectomy was performed. A 4 cm lobulated and pedunculated lesion with histologic features of typical inverted urothelial papilloma was resected. Twenty-one cases of ureteral inverted papilloma in the literature, including our cases, are analyzed.

[Mesh-graft urethroplasty: a case report]

We used a meshed free-foreskin transplant in a two-stage procedure for reconstruction of the extended stricture of urethra after direct vision urethrotomy. The results were excellent. Mesh-graft urethroplasty is a useful method for patients with extended strictures of the urethra or recurrent strictures after several operations.

[One-stage operation of ureteropelvic junction and ureterovesical junction stricture]

One-stage surgical management for ureteropelvic (UP) and ureterovesical (UV) strictures is reported. A 3-year-old boy with UP and UV strictures on left side, underwent nephrostomy at 4 months old. The plastic operations which were Anderson-Hynes method for UP stricture and submucosal tunnel method with tailoring of dilated ureter for UV stricture were performed at the same time. The post-operative intravesical pyelogram and renal scintigraphy showed the improvement of hydronephrosis. Many authors have described two-stage operations for such cases. Our findings revealed that one-stage operation, carefully preserving the blood supply to the ureter, would be an alternative surgical management for UP and UV strictures.

[A case of fibrosarcoma of the kidney extending into the inferior vena cava]

A case of fibrosarcoma of the kidney extending into the inferior vena cava with intraoperative development of massive neoplastic pulmonary emboli is reported. A 38-year-old man was admitted to our hospital because of right renal tumor with gross hematuria, right flank pain and abdominal tumor. Inferior venacavograms and computerized tomography demonstrated almost total occlusion of the abdominal part of the vena cava by tumor thrombi. No signs of inferior vena caval involvement were present. Intraoperative pulmonary neoplastic emboli suddenly occurred after right nephrectomy was performed. Immediately, pulmonary thrombectomy was performed with extra-corporeal circulation. Postoperatively, pulse, blood pressure and ventilation were stable, but the patient remained unconscious and neurologic signs gradually deteriorated. Computerized tomography of the brain showed diffuse brain edema and infarctions. The patient died of cardiopulmonary insufficiency with multiple pulmonary metastasis 8 months postoperatively. We emphasize the risk of fragmentation and migration of the tumor thrombi during surgical treatment of neoplasm of the kidney invading the inferior vena cava.