[Two cases of bladder cancer in patients with chronic renal failure]

We report here two cases of bladder cancer in patients with chronic renal failure who had been treated with hemodialysis. Case 1: A 58-year-old male on hemodialysis for 3 years visited with a complaint of gross hematuria. Transurethral resection of the bladder tumor (TUR-Bt) was performed and histopathological examination showed grade 1, stage pTa transitional cell carcinoma (TCC). The patient was followed for 4 years postoperatively without recurrence. Case 2: A 64-year-old male with hemodialysis for 1 week was referred to our department with a gross hematuria. TUR-Bt was conducted and histopathological findings showed grade 2, stage pT1b TCC. In April, 1992, he revisited our hospital with bladder tamponade due to massive hematuria, and TUR-Bt was performed. Histopathologically, the tumors were grade 2, stage pT2 TCC. He was followed for 1 year without recurrence.

Effect of hydrophilic and lipophilic vehicles on skin permeation of tegafur, alclofenac and ibuprofen with or without permeation enhancers

The effects of an ethanol/panasate 800 (tricaprylin) (40/60) system as a lipophilic vehicle, and an ethanol/water (60/40) system as a hydrophilic vehicle, with or without permeation enhancers for in vitro skin permeation and in vivo skin absorption of tegafur, alclofenac and ibuprofen with different lipophilicity, were evaluated. The in vitro and in vivo skin permeability of tegafur, alclofenac and ibuprofen was enhanced by the use of ethanol/panasate 800 (40/60) or ethanol/water (60/40) binary vehicles as a donor composition. However, the two vehicles showed contrastive properties in relation to the extent of permeation enhancement of the three drugs: tegafur > alclofenac > ibuprofen for the ethanol/panasate 800 (40/60) system, and ibuprofen > or = alclofenac > tegafur for the ethanol/water (60/40) system. When lauric acid, as a permeation enhancer, was added to both of the binary vehicles, the in vitro and in vivo skin permeability of three drugs further increased, and the in vivo absorption rate of the drugs from the ethanol/water (60/40) system was larger than that from the ethanol/panasate 800 (40/60) system. In conclusion, it was suggested that the ethanol/panasate 800 (40/60) lipophilic binary vehicle is useful for hydrophilic drugs, and conversely, the skin absorption of lipophilic drugs can be improved by the use of the ethanol/water (60/40) hydrophilic binary vehicle with or without lauric acid as a permeation enhancer.

Neural regulation of peptide YY secretion

The purpose of these experiments was to investigate the neural control of peptide YY (PYY) secretion. The effects of various pharmacological manipulations and vagotomy on peptide YY (PYY) secretion was examined in dogs. Atropine, hexamethonium and atropine plus hexamethonium treatment blocked food-induced release of PYY significantly. Integrated release of PYY in response to food alone and in combination with atropine, hexamethonium and atropine plus hexamethonium were 8.8 +/- 2.2, -1.1 +/- 2.3, -2.7 +/- 2.2 and -3.2 +/- 3.1 (ng (0-150) min/ml), respectively. beta-Adrenergic blockade with propranolol or depletion of nerve terminal stores of catecholamines with reserpine did not affect food-stimulated release of PYY. Truncal vagotomy resulted in significant elevations of basal and food-induced release of PYY. IV administration of bethanechol, a cholinergic agonist, and electrical stimulation of the vagus nerve resulted in release of PYY. Together, these data suggest that food-stimulated PYY secretion is dependent on ganglionic transmission and an atropine-blockable postganglionic parasympathetic pathway; and that PYY release is inhibited tonically, probably through a vagal cholinergic mechanism. Adrenergic pathways do not participate in food-stimulated PYY release; however, electrical stimulation of the splanchnic nerves increased basal levels of PYY, suggesting that the sympathetic nervous system affects release of PYY.

[Prophylactic combination therapy after TUR of superficial bladder cancer]

We evaluated 63 patients with superficial bladder cancer (pTa, pTl) who were treated with instillation of bleomycin +/- bacillus Calmette-Guerin (BCG) and administration of uraciltfutraful (UFT) for prophylaxis of tumor recurrence after transurethral resection (TUR). The patients were randomly assigned to groups A and B after transurethral resection by the closed envelope method. Group A (34 cases) was designed as continuous diluted intravesical instillation of bleomycin (120 mg/2,000 ml saline solution/day repeated for 3 days), instillation BCG (40 mg/40 ml saline solution/weekly 6 times) and UFT (400 mg orally/day for 2 years maximum). Group B (29 cases) was designed as the aforementioned minus BCG instillation. Cumulative non-recurrence rates in group A and group B were 80.1% and 72.1% at the time of three years, which revealed no significant difference between the two groups (p = 0.265, generalized Wilcoxon test). The high recurrent incidence of superficial bladder cancer is primarily due to the multifocal nature of the cancer or implantation of tumor cells at the time of the subsequent transurethral resection. The procedure was performed safely with no severe side effects. Our method might be useful to reduce the recurrences of superficial bladder cancer after transurethral resection of bladder (TUR).

Long-term impact of conservative management on localized prostate cancer. A twenty-year experience in Japan

The clinical outcome of 107 patients with localized prostate cancers over the past twenty years was analyzed retrospectively. Immediate endocrine therapy was administered in 55 patients after diagnosis. The other group of 52 patients did not receive any anti-tumor treatment until progression. Overall, 22 patients (21%) died of prostate cancer, while 45 (42%) died of other known causes. During a mean observation period of thirty-seven months, 27 (25%) experienced progression of the disease (local in 9, distant metastasis in 25, and both in 7 patients). The cancer-specific survival rates for these 107 patients were 78 percent at five years and 71 percent at ten years. The timing of endocrine therapy and age at diagnosis did not influence patient's prognosis. Tumor stage failed to demonstrate any prognostic significance after being controlled for other factors including tumor grade. Poorly differentiated histology appeared to be the sole and the strongest predictor for both tumor progression and cancer death. Prostate cancer may not differ significantly among races once it becomes clinically manifest. Expectant management for localized prostate cancer in well and moderately differentiated cancer may be justified because of the higher probability of dying of other intercurrent causes especially in the elderly group of patients. However, definitive forms of therapy should be considered for the group of patients with poorly differentiated tumor who have reasonably long life expectancy.

Skin permeation enhancement of tegafur by ethanol/panasate 800 or ethanol/water binary vehicle and combined effect of fatty acids and fatty alcohols

The effects of vehicle and enhancer on the skin permeation of tegafur across excised hairless mouse skin were investigated. Ethanol, water, panasate 800 (tricaprylin), and their mixtures were used as vehicles, and then a series of fatty acids or fatty alcohols was employed as representative enhancers. The skin permeability of tegafur was dramatically increased by the combination of ethanol and panasate 800, whereas the combination of ethanol and water resulted in only a little increase. The greatest permeation ratio (56.8% of dose at 12 h) was obtained with the ethanol/panasate 800 (40/60) binary vehicle. Furthermore, the skin permeability of tegafur could be enhanced by the addition of fatty acids or fatty alcohols to ethanol/panasate 800 (40/60) and ethanol/water (60/40) binary vehicles. The infinite dose studies suggested that panasate 800 decreased the lag time by increasing the diffusion of tegafur, and ethanol increased the permeation rate by increasing the partition of tegafur into skin. The effects of fatty acids or fatty alcohols added to ethanol as a single vehicle were dramatic, but did not appear in the case of panasate 800 as a single vehicle. In conclusion, panasate 800 was an excellent hydrophobic vehicle in that it minimized time lag and promoted tegafur permeability combined with ethanol. This improvement was further promoted when enhancers were added.

Interaction of the tail domain of high molecular weight subunits of neurofilaments with the COOH-terminal region of tubulin and its regulation by tau protein kinase II

We previously showed that neurofilaments interact with microtubules (MTs) via their high molecular weight subunits (NF-H) after alkaline phosphatase treatment. Here we studied the effects of phosphorylation of NF-H on this interaction. tau protein kinase II, Ser/Thr protein kinase, phosphorylated NF-H in the tail domain, decreased its electrophoretic mobility to a native level, and also restored its property to be less interactive with MTs. Phosphorylation by cAMP-dependent protein kinase caused no shift of electrophoretic mobility or dissociation from MTs. We conclude that the tail domain of NF-H directly interacts with the MT surface, and the interaction is regulated via phosphorylation of the tail domain of NF-H by Ser/Thr protein kinase like tau protein kinase II. To characterize the binding domain of NF-H on MTs, subtilisin digestion of MTs and competition analysis with the MT binding fragment of tau protein were performed. The dissociation constant of NF-H to subtilisin MTs was higher than that to intact MTs. The maximum binding of NF-H was reduced when tau fragments existed. These results revealed that the COOH-terminal region of tubulin is involved in the binding to NF-H, and the NF-H and microtubule-associated protein binding domains are closely apposed on the surface of MTs.

Comparative effects of neurotensin and neuromedin N on growth of human pancreatic cancer, MIA PaCa-2

Neurotensin (NT), an important regulatory hormone of the gut, stimulates growth of the human pancreatic cancer cell line MIA PaCa-2 in vitro. The purpose of our study was to compare the stimulatory effects of NT and neuromedin N (NMN), a structurally related hexapeptide, on the growth of MIA PaCa-2. In addition, the effects of NT on the growth of MIA PaCa-2 xenografts and normal GI tissues were assessed in athymic nude mice. MIA PaCa-2 cells, plated in serum-free media, were treated with either NT (10(-12)-10(-6) M) or NMN (10(-11)-10(-7) M) and cells were counted. For the in vivo study, MIA PaCa-2 cells were inoculated sc into 30 athymic nude mice and then randomized to two groups to receive either NT (600 micrograms kg-1, sc, tid) or vehicle. At sacrifice (day 35), the xenografted tumours, as well as normal host pancreas, jejunum and ileum were removed, weighed, and assayed for DNA, RNA and protein. Both NT and NMN stimulated the growth of MIA PaCa-2 cells in vitro with maximal (approximately 30%) increases occurring with dosages of 10(-9) M. In vivo, NT had a transient effect on xenografted MIA PaCa-2 tumour area with increases noted on days 21 and 25 of the study. Conversely, NT significantly stimulated the growth of jejunum and ileum, with a more pronounced effect noted in the jejunum. NT and NMN have similar growth-stimulatory effects on MIA PaCa-2 cells in vitro, which suggests an interaction through the same receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

Severe flare-up in a prostate cancer patient treated with luteinizing hormone-releasing hormone analogue depot

A 65-year-old man with advanced prostate cancer was treated with a luteinizing hormone-releasing hormone (LH-RH) analogue. Four days after the initial injection of 3.6 mg of goserelin acetate, severe dyspnea developed due to worsening pleuritis carcinomatosa, which was considered as a flare-up. Chest drainage was required to save his life. Therefore, we emphasize the importance of treatment to prevent tumor flare during LH-RH analogue therapy.

Infrequent involvement of p53 gene mutations in the tumourigenesis of Japanese prostate cancer

A study was made of the incidence of p53 mutations in Japanese males with prostate cancer or benign prostatic hyperplasia. Polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP) was used as a primary screening technique with gene sequencing being carried out in positive cases. Two out of 21 prostate cancers (9.5%) were found to have p53 mutations. These were stage B2 and D2 prostate cancers. No abnormalities were found in the remaining cases or benign prostatic hyperplasia. Mutations of the p53 gene would thus appear infrequent in the tumourigenesis of primary prostate cancer.

Enamelins in the newly formed bovine enamel

The possibility of using the antisera raised in rabbits against the porcine 25 kDa amelogenin, 32 and 89 kDa enamelins, and the 13-17 kDa nonamelogenin for the differentiation and identification of the protein components in bovine immature enamel was examined. Although the immunoreactivities of these antisera against bovine enamel proteins were weaker than those against the porcine proteins, it was found that these antisera could differentiate and demonstrate immunohistochemically a characteristic distribution of three different kinds of enamel protein components in the bovine secretory stage enamel similar to those observed in the porcine immature enamel. Of the several high molecular weight proteins being reactive to the anti-porcine 32 and 89 kDa enamelin sera, the 130 kDa protein, having the highest molecular weight, was extracted and purified from the bovine enamel sample which was obtained by peeling approximately 30-microns thickness of the outermost layer of the secretory stage enamel. The amino acid composition of the 130 kDa protein was similar to the known bovine enamelins, and was rich in aspartic acid, glutamic acid, proline, and glycine. The results could suggest that the enamelins of lower molecular weight than this protein, which are found in the bovine secretory stage enamel, are derived from this precursor protein.

Infrequent involvement of p53 mutations and loss of heterozygosity of 17p in the tumorigenesis of renal cell carcinoma

Restriction fragment length polymorphism (RFLP) analysis and the polymerase chain reaction of the single-strand conformation polymorphism (PCR-SSCP) method were conducted to assess the loss of heterozygosity of chromosome 17p and mutations of the p53 gene in 30 surgical specimens of human renal cell carcinoma. Six of 29 tumors (20.6%) showed loss of heterozygosity on chromosome 17p in RFLP analysis, and in none of 21 tumors could a mutation be found on exons 5 to 8 of the p53 gene in PCR-SSCP analysis. We conclude that the p53 gene mutation does not play a role in the development of the majority of cases of renal cell carcinoma and that there may be another tumor suppressor gene on 17p.

[A case of malignant mesothelioma of the tunica vaginalis testis]

A case of malignant mesothelioma of tunica vaginalis testis experienced in an 83-year-old male who presented with a complaint of left intrascrotal pain is reported. The tentative diagnosis was acute epididymitis. Left epididymectomy was performed following the unsuccessful treatment with antibiotics. The histology of the surgical specimen revealed malignant mesothelioma. Radical excision of the left spermatic cord and scrotal content indicated locally advanced disease with positive surgical margin. Metastatic workup, including abdominal and chest computerized tomography scan, magnetic resonance imaging and bone scan demonstrated presence of metastasis to the paraaortic lymph nodes and the lumber spine. The patient is being followed conservatively in consideration of his age and advanced stage of the disease.

Structure-antitumor activity relationship of semi-synthetic spicamycin analogues

Spicamycin, a nucleoside antibiotic containing fatty acids with a variety of chain lengths (C12-C18), showed potent antitumor activity against human gastric cancer SC-9 and human breast cancer MX-1 in a xenograft model. We have made several semi-synthetic spicamycin analogues (SPMs) which differed in the chain length of the fatty acid moiety, and examined their structure-antitumor activity relationship. The cytotoxic activities of SPMs depended on the chain length of the fatty acid moiety, with dodecanoyl, tetradecanoyl, hexadecanoyl and icosanoyl analogues (SPM VIII, SPM X, SPM XII and SPM XVI) exhibiting the most potent cytotoxic activity against P388 murine leukemia cells. SPM VIII showed the most activity against SC-9 in the human tumor xenograft model with the highest therapeutic index among SPMs. The antitumor activity of SPM VIII was superior to that of mitomycin C.

Effect of various vehicles on ketoprofen permeation across excised hairless mouse skin

The effects of glycerides, short-chain alcohols, and their binary vehicles as donor components on the permeation of ketoprofen (KP) across the excised hairless mouse skin were evaluated with the modified LOVEDAY-type diffusion cell. Among single vehicles, Panasate 800 as tricaprylin appeared to be the most favorable lipophilic vehicle, with no toxicity and with a short lag time (0.9 h), and methanol (MeOH) or ethanol (EtOH) as hydrophilic single vehicles showed the highest KP permeation flux (244.1 and 134.1 micrograms/cm2/h, respectively). Furthermore, KP permeation was enhanced remarkably by the combination of EtOH and Panasate 800 compared with each single vehicle as reflected in the decreased lag time and increased flux. The greatest enhancement was observed in the EtOH/Panasate 800 (40/60) binary vehicle (permeation ratio at 24 h, 40.0%; steady-state flux, 314.0 micrograms/cm2/h; lag time, 3.7 h). Further investigations involving stripping studies and KP accumulation within the skin were performed to explain the mechanism of enhancement caused by the above binary vehicle. It was suggested that the mutual enhancement effect of EtOH/Panasate 800 (40/60) binary vehicle is due to decreasing the barrier ability of the stratum corneum by EtOH and the viable skin by Panasate 800.

Inositol 1,4,5-trisphosphate 3-kinase highest levels in the dendritic spines of cerebellar Purkinje cells and hippocampal CA1 pyramidal cells. A pre- and post-embedding immunoelectron microscopic study

Inositol 1,4,5-trisphosphate 3-kinase (InsP3 3-kinase) plays a crucial role in calcium homeostasis by regulating InsP3 levels. We have reported the highest concentrations of InsP3 3-kinase in the dendrites of cerebellar Purkinje cells and hippocampal pyramidal cells of the CA1 sector of the Ammon's horn. We here investigate its subcellular localization by pre- and post-embedding immunoelectron microscopic study. In both populations of neurons, the major structure expressing a high level of InsP3 3-kinase is the dendritic spines.

Assessment of membrane fusion efficiency and its use for distinguishing epitopes on the fusion (F) protein of Sendai virus (HVJ)

Upon incubation of radioiodinated Sendai virus with Ehrlich ascites tumor cells to induce viral envelope-cell membrane fusion, TCA-soluble radioactivity was found to be rapidly released from the virus into the medium. The amount of the TCA-soluble 125I species released into the medium was correlated with the extent of envelope-membrane fusion. Using a new method based on this phenomenon, we evaluated the fusion-inhibiting activity of monoclonal anti-F protein antibodies and could distinguish epitopes within partially overlapping regions of the F protein by their effects on fusion activity. We concluded this method is a reliable and sensitive one for measuring envelope-membrane fusion.

[Reassessment of the sonographic criterion of prostate cancer--nonspecificity of a hypoechoic lesion]

Of 71 patients who underwent ultrasound guided transrectal needle biopsy at the urology clinic in Kitasato University Hospital 19 (26.8%) patients were found to have prostate cancer. The positive predictive value for transrectal ultrasonography (hypoechoic lesion) was disappointing-only 30% (18/60). While hypoechogenicity has been increasingly accepted as the most sensitive ultrasonographic indicator of malignancy, the specificity of hypoechogenicity is related to benign structures that may also appear hypoechoic. Sonographic detection of prostate cancer is also confounded by the presence of iso- and hyperechoic tumors. Experienced sonographer should be alert to this limitation of the current technology of transrectal ultrasound. The advent of the Biopty gun enabled us to take multiple biopsy cores easily and quickly. Liberal use of random systematic biopsy in addition to directed cores from a hypoechoic lesion should enhance the detection of prostate cancer regardless of the tumor echogenicity.

[An experience with a continent appendix stoma]

The submucosally embedded in situ appendix guarantees an ideal continence mechanism in patients with ileocecal urinary reservoirs. To date this modification of the Mainz pouch technique was performed successfully in 10 patients between September 1990 and October 1992. Pouch capacity ranged from 350 ml to 900 ml (mean: 565 ml), frequency of intermittent self-catheterization ranged from 3 to 7 times per day (mean: 4.4-5.4 times) and complete urinary continence without difficulty of self-catheterization was obtained in eight patients. Two patients with stomal stenosis needed to indwell a catheter. The follow up periods ranged from 3 to 24 months (mean: 14.7 months). The main advantages of appendix stoma technique are shorter operation time, a short ileal segment, no risk of nipple gliding or prolapse, no need for staples, thereby decreasing significantly the risk of stone formation, and facilitating easy catheterization. This method seemed to be valuable for continent urinary reservoir assuring patients of high quality of life.

Tau protein kinase II has a similar characteristic to cdc2 kinase for phosphorylating neurofilament proteins

Tau protein kinase II purified from a bovine brain tau protein fraction (Ishiguro, K., Takamatsu, M., Tomizawa, K., Omori, A., Takahashi, M., Arioka, M., Uchida, T., and Imahori, K. (1992) J. Biol. Chem. 267, 10897-10901) was shown to have a similar substrate specificity to cdc2 kinase in that both phosphorylate neurofilament (NF) proteins. Tau protein kinase II recognized the dephosphorylated form of the heavy subunit of NF (NF-H) as a predominant substrate. The substrate was phosphorylated to the same extent with tau protein kinase II as with cdc2 kinase. Upon phosphorylation, the electrophoretic mobility of the NF-H on SDS-polyacrylamide gel electrophoresis changed to the position of the phosphorylated form. A synthetic peptide containing a KSPXK sequence was by far a better substrate for tau protein kinase II than that containing a KSPXX sequence, as was also observed with cdc2 kinase. NF-H lost its microtubule-associating ability upon phosphorylation with tau protein kinase II as well as with cdc2 kinase. Although anti-PSTAIR antibody (PSTAIR is an amino acid sequence commonly found in cdc2 and several cdc2-related kinases) failed to react with tau protein kinase II, tau protein kinase II bound to p13suc1-Sepharose beads (p13suc1 is a yeast protein known to bind to cdc2 kinase).

Glycogen synthase kinase 3 beta is identical to tau protein kinase I generating several epitopes of paired helical filaments

We previously reported that tau protein kinase I (TPKI) induced normal tau protein into a state of paired helical filaments (PHF); this is further confirmed here by immunoblot analysis using several antibodies. We also present the amino acid sequence of TPKI, which is identical to glycogen synthase kinase 3 beta (GSK3 beta). Moreover, we found that TPKI activity was inseparable from GSK3 activity throughout the purification procedure. These results indicate that TPKI is identical to GSK3 beta.

[Role of prostate specific antigen, transrectal ultrasonography, and digital rectal examination in the search for clinical prostate cancer]

Two hundred and thirty-four patients who visited the urology clinic in Kitasato University Hospital were evaluated with digital rectal examination (DRE), serum prostate specific antigen (PSA) study and prostate ultrasonography. Of 71 men who underwent ultrasound-guided transrectal biopsy 19 (26.8%) were found to have prostate cancer, accounting for 8.1% (19/234) of the whole population. When PSA levels were arbitrarily divided into 0 to 2, 2.1 to 10 and greater than 10 ng/ml, the positive DRE was associated with cancer detection rate of 3.3%, 77.8% and 100%, respectively, with an overall detection rate of 32.6%. However, a normal DRE (benign-feeling gland) is associated with much less cancer detection rate of 5.9%, 28.6% and 100%, respectively, with an overall rate of only 16.0%. The positive biopsy rate was 30% (18/60) in the presence of hypoechoic lesions on sonography, but 9.1% (1/11) if absent. The positive predictive value of DRE (32.6%, 15/46) increased to 36.6% (15/41) if a hypoechoic lesion was identified sonographically and to 87.5% (14/16) if PSA levels were abnormal. One patient was found to have a microfocus of well differentiated adenocarcinoma in one of the 6 biopsy cores. Radical retropubic prostatectomy was performed in 9 of the 19 patients with clinically localized prostate cancer. On pathologic examination of the prostatectomy specimens 5 of them were upstaged to positive seminal vesicle or lymph node metastasis. The spectrum of prostate cancer detected by these modern techniques is broad and extends from tiny clinically insignificant cancer to advanced disease in its incurable stage.(ABSTRACT TRUNCATED AT 250 WORDS)