Germ line chimera produced by transfer of cultured chick primordial germ cells

Intrinsic primordial germ cells (PGCs) from stage 27 (5-day-old) chick embryonic germinal ridges were cultured in vitro for a further 5 days, and shown to proliferate on stroma cells derived from the germinal ridge. To determine whether these cultured PGCs could colonize and contribute to the germ-line, PGCs were isolated by gentle pipetting, labeled with PKH26 fluorescent dye and injected into the blood stream of stage 17 (2.5-day-old) chick embryos. The recipient embryos were incubated until they reached stage 28. Thin sections of these embryos were analysed by fluorescent confocal laser microscopy. These analyses showed that the labeled donor PGCs had migrated into the germinal ridges of the recipient embryos, and transplanted PGCs had undergone at least 3-7 divisions. These results suggest that PGCs that had passed far beyond the migration stage in vivo were still able to migrate, colonize and proliferate in recipient chick embryonic gonads.

[A case of male infertility with a chromosomal abnormality of 45, X/46, X + mar]

A 28-year-old man visited our hospital with a complaint of male infertility. His development was normal with body size of 169.5 cm in height and muscular type. His beard and axillary and pubic hairs were male type. The penis and scrotum were also normal, but testes were small (8 ml, bilateral). Semen analysis revealed azoospermia. Serum luteinizing hormone (LH) and testosterone levels are within normal range but follicle stimulating hormone (FSH) was moderately elevated. Testicular biopsy specimen showed severely hyalinized seminiferous tubuli, incarceration of basement membrane and hyperplasia of Leydig cells. Johnsen's score count was two. Chromosomal analysis revealed a mosaic type of 45, X/46, X + mar. We tried to confirm the existence of sex-determining region of the Y chromosome (SRY) by the DNA analysis. It was shown that SRY on genomic DNA fragment. This marker chromosome may be translocated to a fragment of the short arm of Y chromosome.

Arteriovenous malformation associated with a large cyst--case report

A 37-year-old male presented with an arteriovenous malformation in the left temporal lobe associated with a large cyst. The cyst was drained and the nidus completely excised. The histological findings suggest that repeated subclinical hemorrhages from neovascular channels of the cyst membrane was responsible for the growth of the cyst.

[Histochemical expression of proliferating cell nuclear antigen (PCNA) for pre and post chemotherapeutic bladder cancer]

We examined whether the staining of proliferating cell nuclear antigen (PCNA) could be useful as a marker of chemotherapeutic effectiveness in nine patients with invasive bladder cancer treated by bilateral internal iliac artery infusion of cisplatin (CDDP). Two types of monoclonal antibodies PC-10, 19A2 were used for immunohistochemical staining in formalin-fixed, paraffin-embedded tissue sections. There was no difference between positive rates of PC-10 and 19A2. The mean positive rates between pre-chemotherapeutic specimens (15.4 +/- 6.7%) and post-chemotherapeutic specimens (4.2 +/- 3.1%) showed statistically significant difference (p < 001). The immunohistochemical evaluation of PCNA has value for investigation of cell's turnover. Therefore, the changes of PCNA-positive rate could be a historical parameter for the evaluation of chemotherapeutic effects.

[Evaluation of advanced bladder tumor]

Ninety-two cases of advanced bladder tumor treated at the University of Tokyo and branch hospital from January 1977 to December 1992 were analyzed. The advanced bladder tumor was defined as that of higher than pT2 (according to the General Rule for Clinical and Pathological Studies on Bladder Cancer) or that with distant metastases. The following variants were evaluated, the therapeutic methods, the histological type, grade, stage, type of infiltration. The evidence of lymphatic infiltration, vessel infiltration, and lymph node metastases were also reviewed. The survival rate was calculated using Kaplan-Meier's method. In the cases with lymph node metastases, the survival rate was significantly lower than in the cases without metastases (p < 0.01), while no other factors affected the survival rate.

Proliferation of chick primordial germ cells cultured on stroma cells from the germinal ridge

Fluorescent reagent-labelled PGCs isolated from the blood of 2-day-old chick embryos were cultured on stroma cells derived from 5-day-old germinal ridge in Medium 199 supplemented with 10% FBS, human IGF-1, bovine FGF-b, and murine LIF. In 7 experiments, the number of MCs increased by an average of 4.8 fold in 4 days. Intrinsic PGCs in the 5-day embryonic germinal ridge were observed loosely attached to the stroma cells, and they also increased 3.8 fold during culture for 4 days. These results indicate the possibility of applying this culture method to the production of transgenic chickens.

[Adrenalectomy for nonfunctioning adrenal tumors--comparison between open and laparoscopic surgery, and indication for operation]

Since 1977, we have operated on 18 nonfunctioning adrenal tumors. The pathological diagnosis included seven adrenocortical adenomas, three adrenocortical hypeplasias, three ganglioneuromas two adrenal cysts, two myelolipomas and one metastatic cancer. We successfully performed laparoscopic adrenalectomy in 11 of these patients and open surgery in the other 7 patients. In the patients undergoing laparoscopic adrenalectomy, post-operative recovery (fist oral intake, first ambulation, and total convalescence) was remarkably rapid. The indication of adrenalectomy for nonfunctioning adrenal tumors is controversial, but we can not exclude the possibility of malignancy even in small tumors. Therefore, because of the minimally invasive nature of laparoscopic surgery, the indications for operating on nonfunctioning adrenal tumors will be widened by introducing laparoscopic adrenalectomy.

The effect of lansoprazole treatment on the healing and relapse of peptic ulcer and serum levels of IgG anti-Helicobacter pylori antibody

In the present study, the effects of short-term treatment with lansoprazole on healing and recurrence of peptic ulcer were investigated. Complete healing (change to the S2 stage) after 3 or 4 weeks of treatment with lansoprazole was observed in 9.9% of gastric ulcers and 38.3% of duodenal ulcers. Complete healing was observed after 3 or 4 weeks of treatment with lansoprazole in gastric ulcers and was significantly related to the serum titer of IgG anti-Helicobacter pylori antibodies. This was not the case in duodenal ulcers. Complete healing after 6 or 8 weeks of treatment with lansoprazole was not dependent on serum levels of IgG anti-H. pylori antibodies. Short-term treatment by lansoprazole did not affect serum levels of IgG anti-H. pylori antibodies immediately after the end of lansoprazole treatment, but significantly reduced serum levels of IgG anti-H. pylori antibodies were found 9 months after treatment.

[Two siblings with 2,8-dihydroxyadenine urolithiasis]

We treated two children with 2,8-dihydroxyadenine urolithiasis for over 7 years. The male prepositus was admitted to the hospital because of anuria when he was 10 months old. Bilateral urinary stones had caused the anuria. The stones were 2,8-dihydroxyadenine and his APRT activity was low. He has been treated with about 5.0 mg/kg/day of allopurinol without purine diet restriction. His sister, 3 years old at that time, also was found to have a renal stone. She has been treated with about 3.3 mg/kg/day of allopurinol without restricting purine. The allopurinol therapy without purine-restriction resulted in normal growth of both children with neither the recurrence of stone nor renal impairment.

[Treatment of advanced prostatic cancer--chronological change between 1975 and 1991]

A chronological analysis of the clinical features and treatments of advanced prostatic cancer, stages C and D, was performed in 154 cases treated from 1976 through 1991. These cases were divided into two chronological groups: 61 cases treated between 1976 and 1983, and 93 cases between 1984 and 1991. Concerning demographic features and diagnosis, the number of patients with lymph node metastasis was higher in the latter group. There was also increase in cases who were urologically asymptomatic and detected by checkup digital rectal examination or by the elevation of serum prostatic tumor markers. Histopathological differentiation was consistent between the two groups; more than 70% of cancers were moderately and poorly differentiated adenocarcinoma. As for the treatment, total prostatectomy was performed in eight cases in the latter against none in the earlier, but hormonal therapy remained the main treatment throughout the periods: 74.2% in the earlier and 70.7% in the latter. However the methods of the therapy have clearly changed; estrogens and castration were used less often in the latter period, while LH-RH analogues and antiandrogens replaced them although the therapy was equally effective in 82.3% of the cases in the earlier and in 90.4% in the later period and five-year survival rate and the progression-free survival rate at three years showed no significant difference between the two periods. These results showed 1) refined quality of diagnosis 2) a change in mode of hormonal therapy and 3) no detectable improvement of survival in these 16 years. Development of more effective therapies would be warranted for a better survival.

Preservation of chick primordial germ cells in liquid nitrogen and subsequent production of viable offspring

Conservation of genetic material in chickens was attempted by preserving primordial germ cells in liquid nitrogen. Primordial germ cells collected from the blood of embryos at stage 13-15 of White Leghorn and Barred Plymouth Rock breeds were concentrated by Ficoll density gradient centrifugation. The primordial germ cells were then suspended in a freezing medium containing 10% dimethyl sulfoxide. The temperature of the cell suspension was decreased by 1 degree C min-1 to -80 degrees C; the suspension was then placed in liquid nitrogen (-196 degrees C) and stored for 4-5 months. The cell suspension was thawed by taking it out of liquid nitrogen and placing it in water at 4 degrees C. The viability of the frozen-thawed primordial germ cells was 94.2%. One hundred frozen-thawed cells were injected into the bloodstream of recipient embryos (stage 14-15) from the other breed, from which blood had been drawn before the injection. These embryos were cultured in recipient eggshells until hatching. Viable offspring derived from the frozen-thawed primordial germ cells were obtained by mating male and female germline chimaeras or by mating the chimaeras with Barred Plymouth Rock chickens, and the offspring showed normal reproductive performance. This technique for cryopreservation of primordial germ cells giving rise to viable offspring makes it possible to conserve genetic material in avian species.

Production of germline chimeric chickens, with high transmission rate of donor-derived gametes, produced by transfer of primordial germ cells

Germline chimeric chickens were produced by transfer of primordial germ cells from White Leghorn to Barred Plymouth Rock, and vice versa. Blood was collected from stage 13-15 embryos and primordial germ cells were concentrated by Ficoll density gradient centrifugation. Approximately 200 primordial germ cells were injected into the bloodstream through the dorsal aorta of stage 14-15 recipient embryos from which blood had been drawn via the dorsal aorta prior to the injection. Intact embryos were also prepared as recipients for White Leghorns only. The manipulated embryos were cultured in recipient eggshells until hatching. Germline chimerism of the chickens reaching maturity was examined by mating them with Barred Plymouth Rocks and donor-derived offspring were identified based on their feather color. The efficiency of production of germline chimeras was 95% (19/20). When primordial germ cells were transferred from White Leghorn to Barred Plymouth Rock, the average frequency of donor-derived offspring was 81% for three male chimeras (96% for one female chimera), and it was approximately 3.5 times higher for transfer in the opposite direction (23% for 6 male chimeras). Removing blood from recipient embryos prior to primordial germ cell injection enhanced the frequency of donor-derived offspring by 10% in resulting male chimeras. Male chimeras produced donor-derived offspring more frequently (approximately 3.8 times) than female chimeras. Increases, decreases, or no changes were observed in the frequency of donor-derived offspring from the germline chimeras with increasing age.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of immunosuppression on the urinary excretion of BK and JC polyomaviruses in renal allograft recipients

Sixty-five renal allograft recipients on immunosuppressive therapy were examined for BK and JC viruria using Southern blot hybridization. The incidence and degree of BK and JC viruria were compared between this population (group RTR) and, an age- and sex-matched population of non-immunosuppressed individuals (group CTR). In the results, the incidence of BK viruria was significantly increased in the RTR group compared with the CTR group, while that of JC viruria was similar in the 2 groups. The proportion with a high level of JC viruria, however, was greater in the RTR group compared with the CTR group. Additionally, it was also demonstrated that the incidence of both BK and JC viruria was not affected by the characteristics of renal transplant recipients, such as differences in the donor source (living-related vs cadaveric), type of immunosuppressive agents used, or the time post-transplantation.

[Two-color flow cytometric analysis of lymphocytic subsets in renal cell carcinoma]

The subsets of tumor infiltrating lymphocytes (TILs) in 17 patients with renal cell carcinoma were studied by two-color flow cytometry and immunohistochemistry. In grade 1 tumors, CD4-positive cells were significantly increased compared to grade 2 and 3 tumors (35 +/- 7% vs 25 +/- 10%) (p < 0.05). In 10 of 14 patients, CD8-positive cells were predominant over CD4-positive cells, resulting in less than one in CD4/CD8-ratio. Regarding CD4 cells in all 17 cases, the helper T-cells (CD4-positive and CD45RA-negative) were statistically predominant over the inducer T-cells (CD4-positive and CD45RA-positive) (p < 0.01). When CD8 cells were investigated in 16 out of the 17 cases, the cytotoxic T-cells (CD8-positive and CD11b-negative) were found also significantly predominant over the suppressor T-cells (CD8-positive and CD11b-positive) (p < 0.01). Immunohistochemically, the infiltrating pattern of TILs in the 17 patients was classified into cluster (N = 4), separate (N = 6), and mixed types (N = 7). The tumor in the cluster and mixed type had a tendency to be dominant in low grade tumors, and had the prominent CD8-positive cells (more than 90% were cytotoxic T-cells) over CD4-positive cells. However, no statistical significance was noted in this finding. The advanced tumor tended to show the single type of TIL infiltration. These results suggest that cytotoxic T-cells consisted of most of TILs in cluster and mixed types play an immunoreactive role against renal cell carcinoma.

Clinical and flow cytometric analyses of renal cell carcinomas with reference to incidental or non-incidental detection

In recent years renal cell carcinomas have been diagnosed as incidental findings. The tumors are usually associated with low stage and good prognosis. To find out if they might have a different malignant potential from suspected tumors, we retrospectively compared 56 cases of incidentally detected tumors with 84 cases of suspected tumors, with regard to tumor stage, nuclear grade, tumor size and DNA ploidy pattern as evaluated by flow cytometry. The incidentally detected tumors were lower in stage (P < 0.01), smaller in size (P < 0.01) and higher in probability of survival (P < 0.02) than the suspected tumors, as other studies have reported. Meanwhile, there was no difference in nuclear grade, DNA ploidy pattern and survival in stage I tumors between the two groups of renal cancers. The results suggest that the better prognosis in incidental renal cancer might be due to early detection rather than lower malignant potential of this specific type of renal cancer.

Alteration in the JC polyomavirus genome is enhanced in immunosuppressed renal transplant patients

JC polyomavirus (JCV) DNAs derived from urine generally contain an archetypal regulatory sequence, whereas regulatory regions of JCVs in the brain with progressive multifocal leukoencephalopathy (PML) have specifically altered regulatory regions. However, JCV DNAs with regulatory regions that deviate from the archetype sometimes occur in the urine of non-PML patients. In this study, we compared the incidence of these rearranged regulatory regions between immunosuppressed (renal transplant recipients) and nonimmunosuppressed patients. We found that the incidence of rearranged JCV regulatory regions was significantly higher in renal transplant patients than that in nonimmunosuppressed patients. This finding suggests that immunosuppression would permit accumulation of JCV with rearranged regulatory regions. On the other hand, from the following observations, we conclude that rearranged regulatory regions unique to PML-type JCVs rarely occur even in renal transplant patients: (1) rearrangements in JCVs from these patients were almost exclusively simple, that is deletions or duplications; (2) duplication of domain A or deletion of domain B, each being a feature common to most PML-type regulatory regions, was rarely detected in JCVs from the patients. The data are consistent with the fact that PML is a rare disease in patients with decreased immune competence and support the hypothesis that changes in the JCV regulatory region may be involved with the etiology of PML.

Laparoscopic adrenalectomy: clinical experience with 12 cases

Laparoscopic adrenalectomy is a new procedure for the treatment of adrenal tumors. The clinical experience with this operation in 12 patients is reported. While adrenal tumors are relatively small and seem to be good candidates for laparoscopic surgery, this procedure is difficult because of the anatomical location. In our study laparoscopic adrenalectomy appeared to be successful, although massive bleeding occurred in 3 patients. These problems should be overcome as the technique is improved and new laparoscopic instruments are introduced.

[Clinical observations of advanced renal cell carcinomas--the chronological change between 1975 and 1991]

An analysis has been undertaken to determine chronological changes that have occurred in the clinical features and treatments of advanced renal cell carcinomas. To accomplish this, 96 renal cell carcinoma cases, handled by the authors' department and at the branch hospital, were divided into two groups: 48 patients treated between 1975 and 1983 (group 1) and 48 patients treated between 1984 and 1991 (group 2). Between the two groups, no differences were seen in the sex ratio, the mean age, and the ratio of those who were found to be advanced cases at the time of diagnosis and those whose cancers had advanced after undergoing a nephrectomy. Concerning treatment, interferon (IFN) and UFT were more frequently used in treating group 2 than group 1, and chemotherapy, radiotherapy, and endocrine therapy less frequently used. No differences were seen in the prognosis between the two groups; however, in those who had advanced after nephrectomy, group 2 cases survived for a significantly longer period than did group 1 cases. Patients who survived for 5 years or longer accounted for two cases in group 1 and 5 cases in group 2 and combination therapies involving surgery, IFN, UFT, or similar medications were used for their treatments. These results suggest that adjuvant therapies, such as surgery, IFN, and UFT, have possibly contributed to prolonging survival, especially for cases that advanced after nephrectomy.

[Clinical experience of simultaneous fiber-urethrocystoscopy and cystometry recording]

We performed fiber-urethroscopy and cystometry recording simultaneously in 15 male patients. Fifteen patients were consisted of 12 complaining of micturition difficulty (such as BPH, NB, BNS) and 3 normal control. Fiberscope, Olympus CYF-1 and BF3C10, and cystometry were connected the DISA system. Firstly, we insert fiberscope from the urethra to bladder careful, and then cystometry recording using carbon dioxide gas started under direct vision of fiberscope. We compared cystometrical parameters based on our original method to these on conventional one. There were slight statistical significances in the pressure at the first desire to void and the maximum desire to void. But these differences as well as the frequently and the size of uninhibited contraction were not induced by the caliber of the urethroscopy. In conclusion, cystometric recording and urethroscopic observation using fiberscope are simultaneously carried out safely without reducing their diagnostic accuracy.

[Clinical use of an extracorporeal shock wave lithotriptor, Biolithos MARK III, for upper urinary tract stone]

The results of clinical use of an extracorporeal shock wave lithotripter (Biolithos MARK III) are presented. From May 1991 through February 1992, a total of 50 sessions were carried out on 33 patients with upper urinary tract stones. Treatments were performed on an outpatient basis, and none of the patients needed anesthesia or analgesia. One month after the last session, 18 patients (54.5%) were free from stone fragments and 6 (18.2%) had stone fragments equal to or smaller than 4 mm. The over-all successful rate obtained by these categories was 72.7%. After treatment no serious complications were observed. Although gross hematuria appeared in almost all patients, pain was noted in only 5 patients. Laboratory data after treatments showed slight and transient changes. It is concluded that Biolithos MARK III is useful and safe in the management of upper urinary tract stones on an outpatient basis.

Complete recovery from monocular blindness caused by aneurysmal compression to optic nerve--report of two cases

Two patients with complete absence of light perception due to optic nerve compression were treated by decompressive procedures. Visual function progressively improved to the level of useful vision. A 42-year-old female with a partially thrombosed aneurysm in the right A1 of the anterior cerebral artery presented with right visual loss without light perception. The aneurysm was trapped and the intraluminal organized blood clot removed without dissecting the dome from the optic nerve. Her vision recovered to 20/20 1 week later. A 29-year-old male with a partially thrombosed saccular aneurysm of the anterior communicating artery presented with left monocular blindness. The aneurysm was clipped and the intraluminal clot removed without dissecting the aneurysmal wall from the optic nerve. His visual acuity gradually recovered to 10/20 12 days later. Visual recovery after decompressive procedures following prolonged absence of light perception due to optic nerve compression by aneurysms is rare. The pathophysiological mechanism of prompt visual recovery is unknown, but surgical treatment should be considered for any such patients.

Smaller local brain volumes and cerebral atrophy in spontaneously hypertensive rats

Spontaneously hypertensive rats (SHR) have enlarged cerebral ventricles from 8 weeks of age onward and smaller brains than age-matched, normotensive Wistar-Kyoto (WKY) rats (controls). At 6-7 months of age local cerebral glucose utilization is apparently lower in many brain areas of SHR relative to WKY rats. These observations led to the hypothesis that there are morphological differences between these two strains of rats in many, if not all, brain areas. This hypothesis was tested in 6-7-month-old SHR and WKY rats by quantitating 1) the volumes of the ventricular system, whole brain, six gray matter structures, and two white matter areas; 2) the thickness of two regions of the cerebral cortex; and 3) the frequency of neuronal nuclei (neuronal frequency) in nine brain areas. Ventricular volume was twofold greater in SHR than in control rats. The volumes of the entire brain and all six gray matter structures plus the thickness of the two cortical regions were 11-25% less in SHR. Neuronal frequency was, however, similar in the two rat strains. The latter finding coupled with the smaller regional tissue volumes indicates appreciably fewer neurons per brain structure in young adult SHR than in controls. These results indicate significant cerebral structural differences between young adult SHR and WKY rats and suggest that structure as well as metabolism are abnormal in the SHR brain.

Differences and similarities in albumin and red blood cell flows through cerebral microvessels

Pages H1515–H1524: A. Tajima, H. Nakata, S.-Z. Lin, V. Acuff, and J. Fenstermacher. “Differences and similarities in albumin and red blood cell flows through cerebral microvessels.” Page H1521: right column, second paragraph, the first four lines read as follows:

If the cycling period is <10 s for the system, then all of the capillaries will be perfused and labeled within 10 s of the first appearance of RISA and radiotagged RBCs in cerebral capillaries. The time from intravenous injection to radiotracer appearance in cerebral capillaries is ap7 s in the awake rat.