[Experience of Elcitonin treatment in metastatic bony pain of urological tumors]

Fourteen cases of urogenital tumors (9 prostatic carcinomas, 4 renal cell carcinomas and 1 bladder carcinoma) which had bone metastases were treated with eel-calcitonin, Elcitonin injections for relief of bony pain. Forty mgs. of Elcitonin was injected intramuscularly, 2 to 3 times a week, to out-patients. Forty to 80 mgs. of Elcitonin was injected intramuscularly, daily to hospitalized patients. Relief of the pain was obtained in 71.4% of all patients (71.4% of out-patients and 71.4% of hospitalized patients) and especially in 88.9% of prostatic carcinoma patients. Hypercalcemia was seen in only one patient of renal cell carcinoma. It is considered that Elcitonin treatment is useful for relief of bony pain in the patients with bone metastases, with or without hypercalcemia.

[Study of the prostatic tissue cefbuperazone (CBPZ) level]

The concentration of Cefbuperazone (CBPZ) was determined in the prostatic tissue and serum of 23 patients with benign prostatic hypertrophy. One or 2 of CBPZ was injected intravenously prior to transurethral prostatectomy. The mean CBPZ level in prostatic tissue and tissue/serum ratio at 1 hour was 17.4 +/- 7.2 micrograms/g (28.9 +/- 9.1%) in 10 patients administered 1 g of CBPZ, and 34.7 +/- 1C.2 micrograms/g (35.7 +/- 13.2%) in 13 patients administered 2 g of CBPZ. Serum and prostatic tissue CBPZ levels responded satisfactorily to the dose of CBPZ. Weights of resected prostatic tissue were not correlated to the tissue CBPZ level. Judging from the inhibitory concentration of CBPZ (minimum inhibitory concentration 80), the prostatic tissue CBPZ level was sufficient against pathogenic bacteria, particularly E. coli, K. pneumoiae and P. mirabilis for a relatively long time. For this reason CBPZ is a very useful drug for treatment of bacterial prostatitis and postoperative infection of prostate.

Pathology of ureterorenal units in various ureteral anomalies with particular reference to the genesis of renal dysplasia

Renal morphology of various congenital ureteral anomalies was investigated to gain further insight into the genesis of associated renal dysplasia. Abnormality in the ureteral bud explains the genesis of renal dysplasia as long as the adjoining ureter is cranially ectopic. In caudal ectopy of either single or duplex system, no difference was found in the histologic quality of kidneys with G and H position orifice. In the single system kidneys of H position orifice, however, occurrence of renal dysplasia was not associated with obstruction, suggesting the operation of the "bud theory" even in single system caudal ectopy. In anomalies in which the ureteral orifice was not ectopic, it was suggested that renal parenchymal development was impaired by complete, but not by incomplete obstruction. The association of dysplastic ureter and renal dysplasia was not so frequent as anticipated and the hypodysplastic values of the kidneys with and without dysplastic ureters were similar, suggesting no direct causal relationship between them.

Coexistence of fast and slow myosin isozymes in human external urethral sphincter. A preliminary report

Human external urethral sphincter muscle was isolated for biochemical research. Myosin samples were prepared and pyrophosphate gel electrophoresis and two-dimensional electrophoresis were performed. Assignment in pyrophosphate gel of myosin isozymes of human external urethral sphincter was carried out by making comparisons with those from human rectus abdominis muscle. Myosin light chains in human external urethral sphincter were identified using two-dimensional electrophoresis. Human external urethral sphincter, similar to other voluntary muscles, is composed of fast and slow twitch muscle fibers, since fast and slow myosin components were shown in both pyrophosphate gel and two-dimensional electrophoretograms.

Severe hypertension in infant with unilateral hypoplastic kidney

Unilateral renal hypoplasia unlike Ask-Upmark kidney (segmental renal hypoplasia) seldom causes hypertension. A case of an infant whose hypertension disappeared after removal of a hypoplastic kidney is reported. The removed kidney revealed no sign of Ask-Upmark lesion.

Role of stress fiber-like structures in assembling nascent myofibrils in myosheets recovering from exposure to ethyl methanesulfonate

When day 1 cultures of chick myogenic cells were exposed to the mutagenic alkylating agent ethyl methanesulfonate (EMS) for 3 d, 80% of the replicating cells were killed, but postmitotic myoblasts survived. The myoblasts fused to form unusual multinucleated "myosheets": extraordinarily wide, flattened structures that were devoid of myofibrils but displayed extensive, submembranous stress fiber-like structures (SFLS). Immunoblots of the myosheets indicated that the carcinogen blocked the synthesis and accumulation of the myofibrillar myosin isoforms but not that of the cytoplasmic myosin isoform. When removed from EMS, widely spaced nascent myofibrils gradually emerged in the myosheets after 3 d. Striking co-localization of fluorescent reagents that stained SFLS and those that specifically stained myofibrils was observed for the next 2 d. By both immunofluorescence and electron microscopy, individual nascent myofibrils appeared to be part of, or juxtaposed to, preexisting individual SFLS. By day 6, all SFLS had disappeared, and the definitive myofibrils were displaced from their submembranous site into the interior of the myosheet. Immunoblots from recovering myosheets demonstrated a temporal correlation between the appearance of the myofibrillar myosin isoforms and the assembly of thick filaments. The assembly of definitive myofibrils did not appear to involve desmin intermediate filaments, but a striking aggregation of sarcoplasmic reticulum elements was seen at the level of each I-Z-band. Our findings suggest that SFLS in the EMS myosheets function as early, transitory assembly sites for nascent myofibrils.

[Uroflow metrical analysis of normal adults by male uroflow diagnostic interpretation]

Uroflowmeter has been well documented as an indispensible tool in lower urinary tract diagnosis. In this study 145 normal urinary flow curves in 36 healthy adult males were analysed using the Male Uroflow Diagnostic Interpretation (MUDI) of the DISA urological investigation system. In MUDI, the flow rate pattern is analysed and quantified by previously defined parameters. Then the computed values of these parameters are compared with the values observed in healthy subjects. Finally, the results are conveniently presented on an output sheet. One of the newly defined parameters, (dL/dT) 40, i.e., the bladder contraction velocity at 40 ml before the end of micturition, was situated within the range of 12.5 to 28.3 mm/sec (20.4 +/- 3.9 mm/sec) in healthy males. The variable (dL/dT) 40 did not depend on voided volume and provided excellent discrimination between the control group of healthy males and the group of patients with dysuria. MUDI improves the faults of previous uroflowmetry systems and provides (dL/dT) 40 by which micturition patterns can be discriminated to be good and bad ones. So MUDI seems to be quite versatile in daily urological clinics.

Experience with dimethyl sulfoxide treatment for primary localized amyloidosis of the bladder

We report a case of primary localized amyloidosis of the bladder treated successfully with transurethral resection and intravesical dimethyl sulfoxide instillation. Dimethyl sulfoxide bladder instillation is useful for the treatment of primary localized amyloidosis of the bladder.

The fiber type of the rabbits' striated external urethral sphincter: electrophoretic analysis of myosin

The fiber type of the rabbits' external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoresis of constituent proteins of glycerinated muscle, peptide mapping of myosin heavy chains and non-denaturing pyrophosphate gel electrophoresis of myosin. It was determined as fast type by all three methods. The relative proportions of muscle fibers which were estimated from myosin light chain contents were 88 per cent fast type and 12 per cent slow type. On the basis of the results presented, it was shown to be fast twitch muscle, but not identical to the psoas muscle.

[A case of bladder amyloidosis]

Herein we report a case of bladder amyloidosis treated successfully with TUR & DMSO bladder instillation. A diagnosis was made by a biopsy of the bladder epithelium. Amyloid fibrils were confirmed in the biopsy specimen with polarization and electron-microscopy. The patient was treated with TUR. The residual lesion had disappeared with DMSO bladder instillations for 4 months (12X) without side effects after TUR. Thus DMSO bladder instillation with surgical resection seems to be an excellent therapy for bladder amyloidosis.

[Two cases of Kallmann's syndrome]

Herein we report two cases of hypogonadism with anosmia or hyposmia (Kallmann's syndrome), a 23-year-old single man (case 1) and a 34-year-old single man. (case 2). Micropenis and small testes were seen in both cases. Central anosima and central hyposmia were found in cases 1 and 2, respectively. Their karyotypes were normal (46, XY). The plasma levels of LH and FSH were low and the reaction to LH-RH test was poor in both cases. After repetitious LH-RH administrations, a good response of plasma LH was recognized in both cases except for a poor response of plasma FSH in case 1, while plasma testosterone remained low in both cases. Their testicular biopsies revealed immature testes without any developed Sertoli and Leydig cells.

[Transfer of ceftizoxime into serum and prostatic tissue]

Serum and prostatic tissue levels of Ceftizoxime (CZX) were measured in 37 patients with benign prostatic hypertrophy after intravenous infusion of 0.5 g or 1 g or 2 g of CZX. The prostatic tissue level of CZX was sufficient for the treatment of prostatic infection. Serum and prostatic tissue levels of CZX were maintained satisfactorily by the dose of CZX. Neither the weight of extracted prostatic tissue nor the renal function of the patient was correlated to the tissue level of CZX.

[Persistent Müllerian duct syndrome with seminoma: report of a case]

Persistent Müllerian duct syndrome is a male hermaphroditism in which remnants of Müllerian ducts occur from abnormality of Müllerian inhibitory factor and often cause transverse testicular ectopia or hernia uteri inguinalis. A 22-year-old-man was admitted with the chief complaint of painless swelling of the right scrotal content. Preoperative diagnosis was right testicular tumor and left undescended testis. High orchiectomy was done. At operation left transverse testicular ectopia and a remnant Müllerian duct was found incidentally. The right testicular tumor was seminoma pT1. Sixty-seven cases of transverse testicular ectopia have been reported in Japan, 37 of which are reports of a remnant Müllerian duct. Ten of these cases were accompanied by tumors. The pathogenesis and treatment of persistent Müllerian duct syndrome were discussed with review of the literature.

[A case of hydrometrocolpos with left renal agenesis]

Herein we report a case of hydrometrocolpos with left renal agenesis of a four-month-old girl. The hydrometrocolpos due to a transverse septum of the vagina and left renal agenesis were confirmed by laparotomy. The transverse septum was incised and cured successfully by the abdominoperineal approach. We have collected 21 cases of hydrometrocolpos with or without urinary tract malformations including our case in the Japanese literature and discussed its etiology and treatments.

[Synchronous tumors in right renal pelvis and left ureter]

Bilateral synchronous urothelial tumors in the upper urinary tract seem to be rare. To our knowledge, only 34 cases have been reported previously. A 77-year-old-man with the chief complaint of macrohematuria was admitted. Clinical investigations showed left ureteral and right renal pelvic tumors. Resection of the wall of the right renal pelvis and partial ureterectomy and its reanastomosis in the left ureter were done. Pathologic examination revealed that the right renal pelvic tumor was transitional cell carcinoma (G.2, pTlb), and the left ureteral tumor was invasive metaplastic epidermoid carcinoma. The patient is alive with no recurrence or metastasis 1 year after the operation. We reviewed all the reports of bilateral synchronous tumors we could find and discussed the histological findings and treatments reported.

[The use of dimethyl sulfoxide in the treatment of intractable urinary frequency]

Intravesical instillation of dimethyl sulfoxide (DMSO) was used in the treatment of patients with intractable urinary frequency due to chronic prostatitis, chronic cystitis, tuberculous contracted bladder and interstitial cystitis. Before the application of this therapy, all 4 patients were examined carefully to rule out cases of acute infectious diseases of the urinary tract, active urinary tuberculosis, neurogenic bladder and carcinoma in situ of the bladder. Three of the four patients achieved an excellent response both subjectively and objectively. In the United States, intravesical instillation of DMSO had already been established as the specific method in the treatment of interstitial cystitis and no side effects have been reported so far. Therefore, we recommend the use of intravesical instillation of DMSO more commonly in various forms of intractable urinary frequency.

Electrophoretic and ultrastructural analysis of the rabbit's striated external urethral sphincter

The male rabbit's external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoretic analysis of myosin light chains and electron microscopy. Its pattern of myosin light chains was different from that of the soleus (predominantly slow twitch muscle) but was very similar to that of the psoas (predominantly fast twitch muscle). Ultrastructurally it was shown to be red muscle resembling the soleus. Therefore the fiber type of the rabbit's external urethral sphincter was determined to be the red (fast) type.

Muscular development in the urinary tract

The structures of the ureter, ureterovesical junction, bladder and sphincteric urethra were investigated histologically in 17 human fetuses (from 3rd to 21st weeks) and 2 neonates, with particular emphasis on their muscular development. The differentiation of ureteral muscle begins from the upper part of the ureter at the 12th week and muscle bundles run spirally. The purely longitudinal intramural ureteral muscle differentiates much later than the upper ureteral muscle and begins to form muscle bundles at the 17th week. The deep periureteral sheath and the trigonal muscle differentiate at an almost similar pace to the intramural ureteral muscle. The detrusor muscle begins to differentiate from the apical dome of the bladder at the 7th week. Distinct superficial periureteral sheath is also seen around the 12th week. The urethral striated muscle is recognized at the 8th week. It starts to develop in the anterior wall of the urethra as a dense cellular accumulation which eventually extends caudolaterally to form a U-shaped figure. The urethral smooth muscle starts its differentiation between the 9th and 11th weeks inside the urethral striated muscle.