Production of the phytotoxic metabolite, ferricrocin, by the fungus Colletotrichum gloeosporioides

A siderophore was isolated as a non-specific phytotoxic compound from a culture of Colletotrichum gloeosporioides isolated from infected blackberry. This siderophore was identified as ferricrocin by NMR, IR, MS, and CD spectra. The phytotoxic activities of ferricrocin and deferriferricrocin were compared.

Technical improvements in laparoscopic adrenalectomy

Laparoscopic adrenalectomy has been believed to be the most difficult operation because of the deep location of the adrenals but also because of the lack of standard technology and specific instruments. Herein, we introduce the technique using flexible electron scope (EL2-TF2, Fujinon) and laparoscopic coagulation shears (LCS; Harmonic Scalpel). Use of these two instruments provides a better view on the monitors and faster completion of surgery because of easy dividing procedures of abundant fatty tissues around the adrenal. Our results show shorter operating time compared to the group using conventional instruments. These results reflect an improvement of quality of life of the patients with functional and/or non-functional adenomas in the adrenals.

Regulation of cell growth and the c-myc proto-oncogene expression by phorbol ester 12-0-tetradecanoyl phorbol-13-acetate (TPA) in the androgen-independent human prostatic JCA-1 cells

The proliferation of the human prostatic cancer JCA-1 cells showed a complex response to different concentrations of TPA. Whereas cells exposed for 24 h had growth reduction which was proportional to the concentration of TPA added to the culture media, they showed resistance to low (0.016 and 0.16 nM) but not high (> or = 1.6 nM) doses of TPA after 72 h. Growth-inhibited, treated cells also displayed a distinct cell morphology compared with the controls. Since c-myc expression has previously been shown to be correlated with cellular proliferation, we determined changes in its steady-state level in control and treated cells by Northern analysis. Following a 24h, 48h, and 72h treatment, with 16 nM TPA, c-myc mRNA was suppressed by 91%, 83%, and 78%, respectively, in good agreement with the extent of growth reduction observed. At the low dose of TPA (0.16 nM), however, the c-myc mRNA expression remained inhibited by 85% even though cell growth was only reduced by 10-14%. No difference in the total amount of c-myc protein could be detected between control and treated cells by Western analysis.

Primitive neuroectodermal tumor of the retroperitoneal cavity

We report a case of primitive neuroectodermal tumor (PNET) arising from the retroperitoneal cavity. Because of infiltration, the tumor was excised en bloc with the left kidney. Despite postoperative adjuvant chemotherapy and local radiation therapy, the tumor recurred and the patient died of the disease 3 months postoperatively. Serum levels of neuron-specific enolase (NSE) correlated with those of lactate dehydrogenase (LDH), and it is suggested that monitoring NSE and LDH is useful in evaluating tumor recurrence. The clinical course and the treatment of this aggressive tumor are reviewed.

Flow cytometric bromodeoxyuridine/deoxyribonucleic acid bivariate analysis for predicting tumor invasiveness of upper tract urothelial cancer

We previously reported that flow cytometric bromodeoxyuridine/deoxyribonucleic acid (DNA) bivariate analysis can provide important information on the malignant potential of bladder cancer. Therefore, in the current study we further evaluated upper tract urothelial tumors to clarify whether DNA/bromodeoxyuridine bivariate analysis can provide additional prognostic information on patients with upper tract urothelial tumor. A total of 43 upper tract urothelial tumors that were resected by nephroureterectomy was analyzed. Flow cytometric DNA ploidy and bromodeoxyuridine labeling were determined by an in vitro bromodeoxyuridine labeling method. DNA diploid tumors were associated with an 85.9% 3-year survival rate compared to 36.5% for DNA aneuploid tumors. On the other hand, 11 high bromodeoxyuridine labeled tumors demonstrated a 16.4% 3-year survival rate compared to 82.4% for those with low bromodeoxyuridine labeled tumors. Multivariate survival analysis using the Cox proportional regression model was performed to identify the most informative factors for prognosis, with the single most important factor being histological tumor stage. Nearly as important and the next factor to be chosen was tumor grade, followed by bromodeoxyuridine labeling index status. DNA ploidy status did not influence clinical outcome. Thereafter, when actuarial 3-year survival rates according to the bromodeoxyuridine labeling index status in grade 3 tumors were estimated, 68.4% and 16.7% 3-year survival rates were observed in cases of low and high bromodeoxyuridine labeling index tumors, respectively. These results indicate that flow cytometric bromodeoxyuridine/DNA bivariate analysis may be useful in dividing patients with grade 3 upper tract urothelial carcinoma into 2 different prognosis groups.

Laparoscopic surgical correction of circumcaval ureter

Laparoscopic transposition and reanastomosis of a circumcaval ureter were performed in a 52-year-old man with right flank pain. A preoperative perfusion pressure study revealed abnormally high intrapelvic pressure. Under laparoscopy, the renal pelvis was divided above the ureteropelvic junction and the ureter was relocated from behind the vena cava. A 5 cm segment of redundant ureter containing the postcaval segment was resected and the ureteral end and renal pelvis were reapproximated with interrupted sutures by intracorporeal knot typing. The postoperative convalescence was uneventful, not necessitating the administration of analgesics. The patient resumed full activities 3 weeks later. The intravenous urogram and renogram obtained 2 months after the operation revealed remarkable improvement in the ureteral obstruction.

[Clinical study on 26 cases of incidental adrenal tumors: a consideration on surgical indication]

At our medical center we have seen 151 patients who have undergone adrenalectomy from 1971 up until June 1992. There has been a recent increase in the number of cases since 99 patients have been seen in the last eight years from 1985. This increase is related to the increase in the number of incidental tumors. Of those 99, 26 have been incidental tumors. Twenty-four of those have been endocrine inactive tumors, and the remaining 2, both active endocrinologically, were pheochromocytoma. We propose that our tentative indications for surgical treatment of incidental tumors are 1) tumors of diameter 3.5 cm or greater, 2) tumors undeniably malignant by imaging diagnosis, 3) tumors that tend to increase in size with every six-month re-examination, even though the original size is less than 3.5 cm in diameter, and 4) tumors endocrinologically active. The main purpose of this study was to make a differential diagnosis of malignant tumors among incidental tumors. Diagnostic modalities included 1) imaging diagnosis such as echography, CT, MRI, and angiography, 2) analysis of DNA ploidy and BrdU uptake utilizing flow cytometry of excised adrenal tumor tissues, and 3) analysis of urinary steroid fraction. It is generally thought that there are currently no methods by which malignant tumors can be differentiated with certainty, even with modern diagnostic technology, and review of the literature, finds approval or disapproval with regard to the methods we selected to evaluate tumors. What has aroused interest in our results is urinary 17KS fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

The anthocyanin responsible for purplish blue flower colour of Aconitum chinense

The anthocyanin in the purplish blue flowers of Aconitum chinense was identified as delphinidin 3-rutinoside-7-O-(6-O-(4-(6-O-(4-hydroxybenzoyl)-beta-D-glucosyl)oxyb enzoyl- beta-D-glucoside), violdelphin by means of chromatography, FAB-MS including MS-MS, 1H and 13C NMR. The anthocyanin is stable in neutral or slightly acidic aqueous solution and the absorption spectra in the pH range of 4.0-6.2 exhibited three characteristic bands at 534, 569 and 620 nm, which are practically identical with those of purplish blue petals of A. chinense. Thus the purplish blue flower colour is manifested by intramolecular co-pigmentation of the anthocyanin.

Endopyelotomy in horseshoe kidneys

Three patients aged 23 to 43 years underwent endopyelotomy to treat stenoses of the ureteropelvic junction (UPJ) in horseshoe kidneys. One patient had failed open primary pyeloplasty and division of the isthmus previously. The other two patients had primary UPJ obstruction and small caliceal calculi associated with horseshoe kidneys. A hook-shaped cold knife was used to incise the ventromedial wall of the stenosis because of malrotation of UPJ in the horseshoe kidney. In two patients, a 14F endopyelotomy stent was left indwelling for 6 weeks. All three patients improved symptomatically, and two patients have shown persistent improvement of renal function radiographically for 52 and 34 months. These results suggest that endopyelotomy can be safely applied to UPJ obstruction in horseshoe kidneys with high efficacy.

A new scoring system based on the histological behavior and proliferative activity of tumor cells for grading the malignant potential of bladder cancers

Urothelial cancer can be considered to consist of a spectrum of diseases with diverse natural histories and the conventional morphological classifications provided by classical histology remain the basis for any decision-making process. The proliferative rate of the tumor cells may be significant since the rate of DNA synthesis is directly related to the rate of tumor growth or tumor involvement. We have previously reported that flow cytometric deoxyribonucleic acid (DNA)/bromodeoxyuridine (BrdU) bivariate analysis can provide important information about the malignant potential of bladder cancer. In the present study, we have formulated a new system based on the histological grade and tumor proliferative activity determined by the BrdU labeling index. An attempt has been made, moreover, to investigate whether this grading system can be used to determine the malignant potential of bladder cancers. A total of 86 patients with bladder tumors, histologically proven to be transitional cell carcinomas, were analyzed. Immediately after removal of tumor specimens, in vitro BrdU labeling was performed. Multivariate survival analysis was conducted using Cox's regression model, followed by estimation of the risk ratio for survival. Based on the risk ratio of the histological grade and the BrdU labeling index, a score ranging from 1 to 52 was assigned to each tumor. Forty-four patients with a score of 1 had a 100% survival rate at 3 years, compared with 42.9% for patients having a score greater than 1. Conversely, 26 patients with the highest score, 52 exhibited a survival rate of only 17.3% at 3 years.(ABSTRACT TRUNCATED AT 250 WORDS)

[Urologic laparoscopic surgery. Present status and prospects for the future]

The present status of urologic laparoscopic surgery in Japan is characterized by expanding indications to adrenalectomies, challenging nephrectomies including malignancies, and developing direct approach to the retro-peritoneal space for urologic disorders. Despite these trends in urologic laparoscopic surgery, few major complications have been reported but the real incidence is conceivable to be similar to the incidence reported from other countries. The surgical risks including operating time and length of hospital stay are not diminished comparing with open surgeries. Particularly, length of hospital stay is not significantly shortened by laparoscopic surgery in Japan comparing to the reports from other countries. This might be mainly caused by the difference of medicare system and customs between Japan and the other countries. In general, urologic laparoscopic surgery in Japan is aggressively extending its indications and technical modifications, and rapidly accumulating the cases; however, discussions on its true merits and basic research on surgical therapeutics seemed to be overlooked. Major tasks for the future are to improve the instruments and technology, and to improve learning curve by establishing efficient educational courses.

[A case of immature teratoma and yolk sac tumor of the testis associated with pulmonary metastases of 2 distinct histological types]

A 24-year-old man presented with right scrotal swelling and was diagnosed as having a testicular cancer. A high inguinal orchiectomy was carried out. Histological examination revealed immature teratoma and yolk sac tumor of the testis. Eight months later, 2 separate metastatic lesions appeared in the lungs, both of which were removed by operation after a course of combination chemotherapy with Etoposide and Cisplatin. The histology showed one to be composed of immature teratoma, and the another of yolk sac tumor.

[Cytokine treatment of renal cell carcinoma]

Cytokine treatment of renal cell carcinoma is described, focusing on interferons (IFN) and interleukin-2 (IL-2). Some cases with excellent responses are being reported, but long term follow-up results are rare. The results of monotherapy by cytokine are not satisfactory, so effective combination therapies with cytokines are awaited in future studies. Effects of the ongoing mono-therapy by cytokines are limited. For further development of the treatment, analyses of the complicated production system of cytokines and interactions are prerequisite.

[Congenital ureteral valves: report of 2 cases]

Congenital ureteral valves have not been a well recognized condition for the cause of ureteral obstruction. In our first case a 21-year-old male presented with left flank pain. Intravenous urography showed left mild hydronephrosis due to upper ureteral obstruction. Partial ureteral resection and re-anastomosis was performed. Histology demonstrated mucosal folds with smooth muscle. In our second case a 12-year-old boy presented with left flank pain. Retrograde pyelogram showed a fold-like filing defect which suggested ureteral valve. Endoscopical valve resection through nephrostomy was performed. Optimal management and diagnostic difficulties were discussed.

Pulsed dye laser lithotripsy for ureteral stone fragmentation

The efficacy of the second generation dye-laser lithotriptor (Pulsolith) with high power output was studied in 35 patients with ureteral stones. Ninety per cent of the calcium oxalate monohydrate stones were fragmented, although it required more total energy as compared to that delivered to calcium oxalate dihydrate or phosphate stones. Cystine stones remain resistant to dye-laser lithotripsy. The calculi including cystine stone were immersed in rifampicin or tetracycline solutions and the effect of optical coupling on fragmentation efficacy was measured in vitro. The optical coupling seemed to improve photo-acoustic effect, but the fragmentation rate for cystine stones remained only 10 per cent of that for calcium oxalate.

[Percutaneous resection of renal pelvic carcinoma: a case report]

A 72-year-old male patient underwent antegrade percutaneous resection of a solitary and papillary tumor in the lower calyx of left kidney. He had undergone right nephroureterectomy one month previously due to right nonfunctioning kidney caused by right ureteral carcinoma. Percutaneous electroresection of the tumor was performed after puncture of a lower calyx. Pathological findings revealed a grade 2 transitional cell carcinoma. Second look biopsy was done on the 11th postoperative day, which showed no residual tumor pathologically. Continuous instillation of mitomycin-C 50 mg/50 ml saline with 40 cm H2O pressure for one hour was done through the nephrostomy catheter once a day, totally 7 days as an adjuvant therapy. No side effect was noticed. Cytological, radiographic studies were negative 24 months after the treatment. We discuss the indication and technical aspect of percutaneous approach to renal pelvic carcinoma.

[Long-term results and risk factors of tumor recurrence in patients with superficial bladder cancer who were treated by intravesical bacillus Calmette-Guerin (BCG) instillation]

An evaluation was made of the long-term results and risk factors of tumor recurrence in patients with superficial bladder cancer who were treated with intravesical bacillus Calmette-Guerin (BCG) and who had a mean follow-up period of 57 months. Eligible for the study were a total of 102 patients who were treated by transurethral resection of tumors and were considered to be free from tumor from 1984 to 1989. A suspension containing 80 mg Tokyo 172 strain BCG in 50 ml normal saline was given intravesically to 50 patients once a week for six weeks without further maintenance instillation. To the other 52 patients was additionally given monthly intravesical BCG instillation for 12 months. The actuarial nonrecurrent rates according to sex, different BCG treatment protocol, tumor grade, tumor status including primary or recurrent tumors, and solitary or multiple tumors were estimated by Kaplan-Meier method. The estimated three-, five- and seven-year actuarial nonrecurrent rates in all 102 cases were 77.3%, 68.5% and 60.6%, respectively. When nonrecurrent rates were compared to tumor characteristics, no statistically significant differences were observed between primary and recurrent tumors or between solitary and multiple tumors estimated by generalized Wilcoxon method. On the other hand, when nonrecurrent rates were compared with tumor grades, grade 3 tumor showed a 40.0% three-year nonrecurrent rate. The differences between grade 3 and grade 1 and between grade 3 and grade 2 were statistically significant (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical evaluation of flutamide, a pure antiandrogen, in prostatic cancer phase II dose-finding study]

The phase II study of flutamide, a pure anti-androgen, was performed to estimate the clinical doses on 165 hormone untreated or treated patients with prostatic cancer. The hormone-untreated patients were given orally flutamide of 90, 375, 750 or 1,125 mg/day in three divided doses daily for 12 weeks. Responses were not observed at the 90 mg/day dose except for improvement of clinical symptoms. However, an objective response rate of 48.8-46.7% was obtained at 375-1,125 mg/day doses. In hormone-treated patients including cases refractory to the previous hormonal treatment, the objective response rates were 13.3 and 8.3% in 375 and 750 mg/day flutamide groups, respectively. Side effects such as gynecomastia, nausea, vomiting, diarrhea, and abnormal laboratory findings such as the elevation of hepatic transaminases were observed. The incidence increased dose-dependently. Determinations of serum hormone levels revealed an increase in testosterone levels by the use of flutamide. In conclusion 375 mg/day of flutamide is the optimal dose in monotherapy for hormone-untreated patients with prostatic cancer, where the quality of life can be maintained compared with therapies involving testosterone suppression. This dose is also expected to show some efficacy in cases refractory to hormone treatment.

Prognostic significance of bromodeoxyuridine high labeled bladder cancer measured by flow cytometry: does flow cytometric determination predict the prognosis of patients with transitional cell carcinoma of the bladder

We studied whether flow cytometric determination of proliferative cell activity estimated by the bromodeoxyuridine in vitro labeling technique provides significant prognosticators beyond the classical histological evaluation in the patient with bladder cancer. We evaluated 81 patients with transitional cell carcinoma of the bladder using fresh bladder specimens. Clinical followup of at least more than 24 months was requested, with the mean followup being 37.9 +/- 10.5 months. Tumor grade and stage were the histological prognostic parameters. Flow cytometric bivariate measurements of deoxyribonucleic acid (DNA) ploidy and bromodeoxyuridine labeled cell index were evaluated. Tumors with a bromodeoxyuridine labeled cell index of more than 10.7%, which was the value of the mean plus 2 times the standard deviation obtained in grade 1 bladder tumors, were designated as high bromodeoxyuridine labeled cell index tumors. A total of 51 patients with low bromodeoxyuridine labeled cell index tumors demonstrated a 98.0% 3-year actuarial survival rate estimated by the Kaplan-Meier method, compared to 42.9% for those with high index tumors. Multivariate survival analysis was performed with Cox's proportional regression model to study statistical individual prognostic values of histological and flow cytometric parameters. Histological tumor grade was the single most important prognostic factor (risk ratio 13.2, p < 0.05), with tumor stage being the second most important (risk ratio 9.2, p < 0.05), followed by bromodeoxyuridine labeled cell index status (risk ratio 6.9, p < 0.05). DNA ploidy status did not influence the clinical outcome. When grade 3 tumors were classified as low and/or high bromodeoxyuridine labeled cell index tumors, 3-year actuarial survival rates were 85.7% and 27.3%, respectively. These results indicate that DNA/bromodeoxyuridine bivariate analysis can be used as an effective adjunct to histological examination for prognostication and decision-making in treatment of bladder cancer patients.

[Increase in erythropoietin secretion mediated by adenosine A2 receptors]

The present study was undertaken to assess the adenosine receptor regulation of erythropoietin (Ep) secretion in hepatocellular carcinoma cells (Hep3B) in response to hypoxia. In vitro cultures of Hep3B cells with N6-cyclohexyladenosine (CHA) at a concentration of 10(-5)M produced significant increases in cyclic AMP accumulation (142.43 +/- 13.31 pmole/10(6) cells) after 1 hr and Ep secretion (29.83 +/- 1.69 mU/ml) after 20 hr when compared with their respective hypoxia controls (cAMP: 3.05 +/- 0.26 pmole/10(6) cells, Ep: 19.41 +/- 1.41 mU/ml). The stimulatory effects of CHA on both Ep secretion and cyclic AMP accumulation were significantly inhibited by 8-phenyltheophylline (8-PT) at a concentration of 5 x 10(-7). No significant change in cell growth was observed at the CHA and 8-PT concentrations used in these experiments employing a spectrophotometric method. Incubation with 8-bromo cyclic AMP (10(-4)M) in response to hypoxia also produced a significant enhancement of Ep secretion (30.74 +/- 0.50 mU/ml) when compared with hypoxia controls (22.69 +/- 0.23 mU/ml), whereas no significant increase occurred in a normoxic atmosphere. CHA inhibited specific binding of [3H]5'-N-ethylcarboxamideadenosine (100 nM) to Hep3B cell membrane preparations in a dose-dependent manner in the displacement experiments and IC50 was 7.72 x 10(-6)M. These results indicate that Ep secretion is stimulated by adenosine membrane A2 receptors which are linked to adenylyl cyclase activation.

[Anchored cell analysis and sorting (ACAS) system]

Advanced biology and recent technology have provided sophisticated and objective method for analyzing biological characteristics on cells. Following that, many new instruments have developed. Diagnostic immunocytochemistry has become an accepted diagnostic tool in cell biology. In recent years, remarkable advances in technology provide a method for quantitative and objective analyses of cell characteristics. The newly developed computer assisted laser cytometer (ACAS 570) can be applied in clinical basis as well as in research laboratory. Fluorescent intensities of ancharage-dependent cells can be automatically analyzed and make it possible to separate a subpopulation of cells. This computer controlled system principally consists of argon ion laser, phase contrast microscope. Quantitative fluorescence measurements and computer graphic images can be obtained. The present paper demonstrates multiple applications of laser cytometer for evaluation of cell biology.

Bladder tumor staging: comparison of conventional and gadolinium-enhanced dynamic MR imaging and CT

With computed tomography (CT) and unenhanced magnetic resonance (MR) imaging, stage pT3b extravesical extension and beyond can be diagnosed, but tumors confined to the bladder wall (stages pT1-pT3a) are poorly delineated. To determine whether visualization of such tumors could be improved with gadolinium-enhanced MR imaging, dynamic breath-hold T1-weighted MR images were obtained after intravenous infusion of 0.1 mmol/kg gadopentetate dimeglumine in 79 patients (86 tumors). Conventional MR images, CT scans, and histologic correlation were available in all cases. With dynamic gadolinium-enhanced MR imaging, the mucosa could be distinguished from the muscular layers of the bladder wall. Staging accuracy with this technique was 85% (73 of 86), which was significantly better than with CT (55%; 47 of 86) (P < .005) or conventional MR imaging (58%; 50 of 86) (P < .05). The accuracy of staging the intramural extent (pT1-pT3a) of bladder tumors was thus improved with gadolinium-enhanced dynamic MR imaging.

Immunohistological analysis of tumour infiltrating lymphocytes in seminoma using monoclonal antibodies

Immunological characterization of tumour infiltrating lymphocytes (TIL) by immunohistological techniques was carried out in 20 cases of stage I seminoma. Routine pathological examination of these surgical specimens showed typical seminoma in 20 cases. Eighteen cases showed obvious TIL and immunohistological staining on frozen specimens was performed in 12. TIL in seminomas were predominantly T-cells but B-cells were also identified. T-cells were distributed diffusely with predominance of the CD8+ phenotype judged semiquantitatively. In contrast to the distribution of T-cells, B-cells tended to accumulate and occasionally formed lymphoid follicles. In such follicles the phenotypic pattern of B-cell antigens was comparable with secondary lymphoid follicles in lymphoid organs. There is an immunologically complex response to seminoma by the host with a predominant infiltration of cytotoxic/suppressor T-cells and functional maturation of B-cells.