Biomedical subjects
Publications and source records attributed to M Ishigooka.
Skene's duct cysts in the adult are uncommon lesions. Complete urologic examinations are necessary because these lesions simulate other clinically important lesions. Herein we report two cases of Skene's duct cyst in adult women. In these cases we could make differential diagnosis by physical, radiological and endoscopic examinations.
Malacoplakia of the prostate is relatively rare in the literature. It occasionally simulates prostatic cancer as regards clinical and histopathological findings. We report a 58-year-old male with this disorder successfully treated with antibiotics. Peculiar histopathologic changes were demonstrated in the prostate with PAS and von Kossa's stains. We recommend caution and suspicion for prostatic malacoplakia to avoid unnecessary surgical intervention.
Hormonal and ultrastructural examinations of the testis were performed in a patient with Down's syndrome. Plasma testosterone was abnormally low, and circulating levels of LH and FSH were higher than the normal range. The administration of HCG resulted in a low response of plasma testosterone. Electron microscopy revealed proliferation of smooth endoplasmic reticulum, an increase in paracrystalline inclusions and the absence of Reinke's crystals in Leydig cells.
Eviprostat has been used as a non-hormonal and non-neuropharmacological treatment for benign prostatic hyperplasia (BPH) in Japan. We evaluated the clinical efficacy of Eviprostat in patients with symptomatic BPH and the anti-inflammatory effect of this drug was investigated by retrospective evaluation of TUR specimens. Clinically, Eviprostat subjectively relieved obstructive symptoms of BPH. Objective improvements were also demonstrated by ultrasonographic evaluation of prostatic volume and urinary flow rates. Histologically, preoperative administration of Eviprostat improved the degree of prostatic inflammation. This drug probably can have a place in the treatment of patients with mild or moderate symptoms of outflow obstruction.
Recurrence of urethral stricture after single internal urethrotomy was investigated in 66 patients with special reference to some factors which would influence restricturing. In the present study, recurrence rate was 16.7% (11 patients). Recurrences occurred within an average of 11.9 months. Factors that had no influence on restricturing were age, aetiology, site of the stricture and duration of indwelling catheterization. On the other hand, stricture length appeared to influence the outcome (chi 2, p < 0.001). Short stricture (< or = 10 mm) showed only 4.4% recurrence rate, while 42.9% in long stricture (> 10 mm). Internal urethrotomy appeared to be effective particularly when the stricture was short, while it seemed difficult to treat long strictures by single internal urethrotomy.
Our followup study of 48 patients with primary aldosteronism concerns the results of 2 different operative methods. After preoperative localization of the unilateral solitary tumor 22 patients underwent unilateral adrenalectomy and 26 underwent enucleation of aldosterone-producing adenoma. Both operative methods improved hypertension, hypokalemia, the low urinary sodium-to-potassium ratio, suppressed plasma renin activity, high plasma aldosterone concentration, high urinary aldosterone excretion and high urinary kallikrein excretion in similar orders of magnitude for 5 years. Levels of plasma cortisol and plasma adrenocorticotropic hormone following respective operations were also identical. Five years postoperatively, ambulation and furosemide administration under low sodium diet stimuli remarkably enhanced plasma renin activity and plasma aldosterone concentration in the aldosterone-producing adenoma enucleation group (p < 0.001), almost similar to that of normal subjects but increment magnitudes were slight (p < 0.05 to < 0.01) in the adrenalectomy group. Preoperatively, angiotensin II infusion failed to increase plasma aldosterone concentration in patients with primary aldosteronism. After respective operations, responses of plasma aldosterone concentration to angiotensin II infusion and of plasma cortisol to adrenocorticotropic hormone administration in the aldosterone-producing adenoma enucleation group were more sensitive than those in the adrenalectomy group. There was no remission of recurrent hyperaldosteronism in either group throughout the study. These results suggest that angiotensin II induces aldosterone release by an activation of tumor uninvolved cortical cells and that the enucleation of aldosterone-producing adenoma is more preferable than unilateral adrenalectomy.
OBJECTIVES: Effect of opioid blockade on regional norepinephrine content of the rabbit urinary bladder was investigated under electrical pelvic floor stimulation. METHODS: Norepinephrine content of the bladder body and base of the rabbit was estimated by high-performance liquid chromatography in the following four subgroups: control group; group 1, treated by electrical stimulation; group 2, treated by naloxone alone; and group 3, treated by electrical stimulation and naloxone. RESULTS: Intravenous administration of naloxone (group 2) caused depletion of norepinephrine content in the bladder body (P < 0.001). Norepinephrine content in the bladder base was also reduced, although this difference was not statistically significant. Electrical stimulation to the pelvic floor musculature (group 1) increased norepinephrine content both in the bladder base and the body (P < 0.01). Such a norepinephrine elevation disappeared in the rabbit treated by electrical stimulation plus naloxone (group 3). Norepinephrine content of this group was almost the same as those treated by naloxone alone. CONCLUSIONS: Opioid blockade appeared to block the hypogastric nerve activation induced by electrical pelvic floor stimulation.
Flow-cytometric analysis of nuclear DNA and measurements of tissue levels of dihydroxyphenylalanine (dopa) and catecholamines were performed using fresh samples of tissue taken from 17 patients with pheochromocytoma. Nine (53%) tumors had a diploid pattern of DNA, and 8 (47%) had an aneuploid pattern. The tissue concentrations of dopa, dopamine, norepinephrine, and epinephrine did not differ significantly between pheochromocytomas with a diploid and those with an anoeuploid pattern. These results suggest that there is no correlation between nuclear DNA ploidy and tissue levels of dopa and catecholamines in pheochromocytomas.
Identification of marker chromosomes by fluorescence in situ hybridization was performed in 2 cases of cryptorchidism. In case 1, the marker chromosome was derived from chromosome 22. In case 2, the origin of the marker was the centromere of chromosome 8. The extent of the congenital anomalies in these cases was milder than that in cases with complete trisomy of an autosome. These findings suggest that an incomplete extra autosome might influence clinical characteristics.
In patients with Down's syndrome, the frequency of leukemia is significantly greater than normally would be expected. However, cancers other than leukemia have been reported to occur rarely. We present a case of Down's syndrome associated with intracranial germinoma and testicular embryonal carcinoma. Currently, no case of double primary carcinomas in Down's syndrome has been reported to the authors' knowledge.
Twenty-one patients with large adrenal tumor on the right side were operated on at Yamagata University Hospital. Bilateral anterior subcostal incision with a vertical midline incision extending from the xiphoid and subsequent use of self-retraction system provided satisfactory exposure of anterior liver and diaphragma area. Successive retraction of the liver exposed the right adrenal tumor and its vascular pedicles. 14 (66.7%) of the 21 patients received right adrenalectomy with liver mobilization, and 7 (33.3%) received right adrenalectomy without mobilizing the liver. Despite the average weight of removed tumors was 152.9% (p < 0.01) greater in the liver mobilized group than in the liver nonmobilized group, the incidence of good exposure of right adrenal central vein including adjacent organs was higher in the former group. In addition, incidence of blood transfusion was identical in both groups. Although postoperative liver function was slightly impaired in the liver mobilized group as compared with the liver nonmobilized group, all examined valuables manifesting liver function in the former group returned to preoperative levels within 3 weeks. The operative procedure described above appears to be useful for the removal of right large adrenal tumors with less risk of serious accident.
PURPOSE: To assess in vivo metabolism of rat testicles in experimental cryptorchidism, we used 31P magnetic resonance (MR) spectroscopy and compared testicular MR spectroscopic parameters with flow cytometric DNA analysis. MATERIALS AND METHODS: In vivo 31P MR spectroscopy and flow cytometric DNA analysis of rat testis were performed before and during 14 days of experimental cryptorchidism. RESULTS: The testicular phosphomonoester (PM)/ATP ratio showed a transient increase when multinuclear giant cells appeared in the seminiferous tubules. However, the ratio returned to the preoperative level when these cells disappeared. The phosphodiester (PD)/ATP ratio gradually decreased and the inorganic phosphate (Pi)/ATP ratio slowly increased. DNA flow cytometry showed a decrease in the percentage of haploid cells and an increase in the percentage of diploid cells from 7 days after cryptorchidism. The percentage of tetraploid cells did not change before and during cryptorchidism. CONCLUSION: This study indicates that in vivo 31P MR spectroscopy in combination with flow cytometric DNA analysis provides useful biochemical and histological information for evaluation of testicular function.
There are almost no special histopathological characteristics or criteria that exactly define a malignant pheochromocytoma. Tissue concentrations of catecholamine metabolites and superoxide dismutase activity have been proposed as possible candidates for discriminating between benign and malignant pheochromocytomas. Tissue concentrations of dihydroxyphenylalanine, metanephrine, normetanephrine, vanillylmandelic acid, and 3-methoxy-4-hydroxyphenylethylglycol were determined in 29 normal adrenal medullas, 13 benign pheochromocytomas and 6 malignant pheochromocytomas, respectively. The copper-zinc superoxide dismutase and manganese superoxide dismutase activities in remnants of these tissues were determined by interruption of nitric formation from hydroxylamines. Catecholamine metabolites and copper-zinc superoxide dismutase activity in benign and malignant pheochromocytomas were identical. Manganese superoxide dismutase activity in malignant pheochromocytoma was the lowest among the groups examined. These data suggest that the assay of catecholamine metabolites in removed specimens is not a reliable method for making a differential diagnosis of benign or malignant pheochromocytoma. However, a low level of manganese superoxide dismutase activity in malignant pheochromocytoma may be a marker for malignancy of this neoplasm.
The present study was designed to obtain evidence of reflex activation of the hypogastric nerves during electrical pelvic floor stimulation. Rabbits were treated with yohimbine (900 micrograms./kg./min.) with and without electrical stimulation under general anesthesia. Norepinephrine (NE) content of the rabbit bladder body and base were estimated by high performance liquid chromatography. Administration of yohimbine alone reduced the NE content of the bladder base (p < 0.05). The combination of yohimbine and electrical pelvic floor stimulation decreased NE content in the bladder base to a greater extent (p < 0.001); NE content in the bladder body decreased slightly (p < 0.001). Here we present evidence that the hypogastric nerves are reflexively activated by stimulation of the pelvic floor structures.
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We report a case of pericentric inversion of chromosome 9 associated with Sertoli-cell-only tubule. The literature is reviewed, and the hormonal profile and testicular histology are discussed.
Histopathological studies were performed in 18 dialysis patients with renal cell carcinoma. All patients were classified as stage I according to the criteria in the protocol of Robson. The 2 main cell types in these patients were granular (50%) and clear (44%) cell tumors. Thirty-nine percent of the carcinomas exhibited a predominantly acinar growth pattern, 27% had a papillary, and 17% exhibited a cystic growth pattern. In 28 nondialysis patients, the commonest cell type was clear cell carcinoma (67%) and acinar growth pattern was the predominant one (67%). The incidence of papillary renal cell tumors in dialysis patients was significantly higher than in nondialysis patients (p < 0.05). Patients with papillary renal cell tumors had received longer duration of dialysis therapy than those with nonpapillary renal cell carcinomas (p < 0.05). Seven (39%) showed grade 1 carcinoma and 11 (61%) showed grade 2, but grade 3 carcinoma was not observed. In these patients, 8 had associated acquired cystic disease of the kidney (ACDK). The duration of dialysis in the patients with ACDK was significantly longer (p < 0.001). The most frequent cell type was granular-cell carcinoma (63%) in the patients with ACDK. Six patients without ACDK (60%) showed clear-cell carcinoma and 4 (40%) had granular cell tumors. Seventy-four percent of carcinomas exhibited a predominantly either papillary or cystic growth pattern in the patients with ACDK. However, renal cell carcinomas in dialysis patients with or without ACDK did not show significant differences in growth pattern.(ABSTRACT TRUNCATED AT 250 WORDS)
We report a case of pericentric inversion of chromosome 9 associated with chordee without hypospadia. Plasma levels of LH and testosterone were within normal ranges, but the plasma FSH level was slightly elevated. The LH response to LH-RH stimulation and the response of plasma testosterone to HCG were normal. However, the administration of LH-RH induced an abnormally low response of plasma FSH.