[The value of histochemical detection of prostate specific antigen].
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Biomedical subjects
Publications and source records attributed to S Tokunaka.
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The fiber type of the rabbits' external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoresis of constituent proteins of glycerinated muscle, peptide mapping of myosin heavy chains and non-denaturing pyrophosphate gel electrophoresis of myosin. It was determined as fast type by all three methods. The relative proportions of muscle fibers which were estimated from myosin light chain contents were 88 per cent fast type and 12 per cent slow type. On the basis of the results presented, it was shown to be fast twitch muscle, but not identical to the psoas muscle.
We report a case of primary localized amyloidosis of the bladder treated successfully with transurethral resection and intravesical dimethyl sulfoxide instillation. Dimethyl sulfoxide bladder instillation is useful for the treatment of primary localized amyloidosis of the bladder.
When day 1 cultures of chick myogenic cells were exposed to the mutagenic alkylating agent ethyl methanesulfonate (EMS) for 3 d, 80% of the replicating cells were killed, but postmitotic myoblasts survived. The myoblasts fused to form unusual multinucleated "myosheets": extraordinarily wide, flattened structures that were devoid of myofibrils but displayed extensive, submembranous stress fiber-like structures (SFLS). Immunoblots of the myosheets indicated that the carcinogen blocked the synthesis and accumulation of the myofibrillar myosin isoforms but not that of the cytoplasmic myosin isoform. When removed from EMS, widely spaced nascent myofibrils gradually emerged in the myosheets after 3 d. Striking co-localization of fluorescent reagents that stained SFLS and those that specifically stained myofibrils was observed for the next 2 d. By both immunofluorescence and electron microscopy, individual nascent myofibrils appeared to be part of, or juxtaposed to, preexisting individual SFLS. By day 6, all SFLS had disappeared, and the definitive myofibrils were displaced from their submembranous site into the interior of the myosheet. Immunoblots from recovering myosheets demonstrated a temporal correlation between the appearance of the myofibrillar myosin isoforms and the assembly of thick filaments. The assembly of definitive myofibrils did not appear to involve desmin intermediate filaments, but a striking aggregation of sarcoplasmic reticulum elements was seen at the level of each I-Z-band. Our findings suggest that SFLS in the EMS myosheets function as early, transitory assembly sites for nascent myofibrils.
Uroflowmeter has been well documented as an indispensible tool in lower urinary tract diagnosis. In this study 145 normal urinary flow curves in 36 healthy adult males were analysed using the Male Uroflow Diagnostic Interpretation (MUDI) of the DISA urological investigation system. In MUDI, the flow rate pattern is analysed and quantified by previously defined parameters. Then the computed values of these parameters are compared with the values observed in healthy subjects. Finally, the results are conveniently presented on an output sheet. One of the newly defined parameters, (dL/dT) 40, i.e., the bladder contraction velocity at 40 ml before the end of micturition, was situated within the range of 12.5 to 28.3 mm/sec (20.4 +/- 3.9 mm/sec) in healthy males. The variable (dL/dT) 40 did not depend on voided volume and provided excellent discrimination between the control group of healthy males and the group of patients with dysuria. MUDI improves the faults of previous uroflowmetry systems and provides (dL/dT) 40 by which micturition patterns can be discriminated to be good and bad ones. So MUDI seems to be quite versatile in daily urological clinics.
Herein we report two cases of hypogonadism with anosmia or hyposmia (Kallmann's syndrome), a 23-year-old single man (case 1) and a 34-year-old single man. (case 2). Micropenis and small testes were seen in both cases. Central anosima and central hyposmia were found in cases 1 and 2, respectively. Their karyotypes were normal (46, XY). The plasma levels of LH and FSH were low and the reaction to LH-RH test was poor in both cases. After repetitious LH-RH administrations, a good response of plasma LH was recognized in both cases except for a poor response of plasma FSH in case 1, while plasma testosterone remained low in both cases. Their testicular biopsies revealed immature testes without any developed Sertoli and Leydig cells.
Herein we report a case of bladder amyloidosis treated successfully with TUR & DMSO bladder instillation. A diagnosis was made by a biopsy of the bladder epithelium. Amyloid fibrils were confirmed in the biopsy specimen with polarization and electron-microscopy. The patient was treated with TUR. The residual lesion had disappeared with DMSO bladder instillations for 4 months (12X) without side effects after TUR. Thus DMSO bladder instillation with surgical resection seems to be an excellent therapy for bladder amyloidosis.
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Serum and prostatic tissue levels of Ceftizoxime (CZX) were measured in 37 patients with benign prostatic hypertrophy after intravenous infusion of 0.5 g or 1 g or 2 g of CZX. The prostatic tissue level of CZX was sufficient for the treatment of prostatic infection. Serum and prostatic tissue levels of CZX were maintained satisfactorily by the dose of CZX. Neither the weight of extracted prostatic tissue nor the renal function of the patient was correlated to the tissue level of CZX.
Intravesical instillation of dimethyl sulfoxide (DMSO) was used in the treatment of patients with intractable urinary frequency due to chronic prostatitis, chronic cystitis, tuberculous contracted bladder and interstitial cystitis. Before the application of this therapy, all 4 patients were examined carefully to rule out cases of acute infectious diseases of the urinary tract, active urinary tuberculosis, neurogenic bladder and carcinoma in situ of the bladder. Three of the four patients achieved an excellent response both subjectively and objectively. In the United States, intravesical instillation of DMSO had already been established as the specific method in the treatment of interstitial cystitis and no side effects have been reported so far. Therefore, we recommend the use of intravesical instillation of DMSO more commonly in various forms of intractable urinary frequency.
Bilateral synchronous urothelial tumors in the upper urinary tract seem to be rare. To our knowledge, only 34 cases have been reported previously. A 77-year-old-man with the chief complaint of macrohematuria was admitted. Clinical investigations showed left ureteral and right renal pelvic tumors. Resection of the wall of the right renal pelvis and partial ureterectomy and its reanastomosis in the left ureter were done. Pathologic examination revealed that the right renal pelvic tumor was transitional cell carcinoma (G.2, pTlb), and the left ureteral tumor was invasive metaplastic epidermoid carcinoma. The patient is alive with no recurrence or metastasis 1 year after the operation. We reviewed all the reports of bilateral synchronous tumors we could find and discussed the histological findings and treatments reported.
Herein we report a case of hydrometrocolpos with left renal agenesis of a four-month-old girl. The hydrometrocolpos due to a transverse septum of the vagina and left renal agenesis were confirmed by laparotomy. The transverse septum was incised and cured successfully by the abdominoperineal approach. We have collected 21 cases of hydrometrocolpos with or without urinary tract malformations including our case in the Japanese literature and discussed its etiology and treatments.
Persistent Müllerian duct syndrome is a male hermaphroditism in which remnants of Müllerian ducts occur from abnormality of Müllerian inhibitory factor and often cause transverse testicular ectopia or hernia uteri inguinalis. A 22-year-old-man was admitted with the chief complaint of painless swelling of the right scrotal content. Preoperative diagnosis was right testicular tumor and left undescended testis. High orchiectomy was done. At operation left transverse testicular ectopia and a remnant Müllerian duct was found incidentally. The right testicular tumor was seminoma pT1. Sixty-seven cases of transverse testicular ectopia have been reported in Japan, 37 of which are reports of a remnant Müllerian duct. Ten of these cases were accompanied by tumors. The pathogenesis and treatment of persistent Müllerian duct syndrome were discussed with review of the literature.
The structures of the ureter, ureterovesical junction, bladder and sphincteric urethra were investigated histologically in 17 human fetuses (from 3rd to 21st weeks) and 2 neonates, with particular emphasis on their muscular development. The differentiation of ureteral muscle begins from the upper part of the ureter at the 12th week and muscle bundles run spirally. The purely longitudinal intramural ureteral muscle differentiates much later than the upper ureteral muscle and begins to form muscle bundles at the 17th week. The deep periureteral sheath and the trigonal muscle differentiate at an almost similar pace to the intramural ureteral muscle. The detrusor muscle begins to differentiate from the apical dome of the bladder at the 7th week. Distinct superficial periureteral sheath is also seen around the 12th week. The urethral striated muscle is recognized at the 8th week. It starts to develop in the anterior wall of the urethra as a dense cellular accumulation which eventually extends caudolaterally to form a U-shaped figure. The urethral smooth muscle starts its differentiation between the 9th and 11th weeks inside the urethral striated muscle.
The male rabbit's external urethral sphincter was investigated with O'Farrell's 2-dimensional electrophoretic analysis of myosin light chains and electron microscopy. Its pattern of myosin light chains was different from that of the soleus (predominantly slow twitch muscle) but was very similar to that of the psoas (predominantly fast twitch muscle). Ultrastructurally it was shown to be red muscle resembling the soleus. Therefore the fiber type of the rabbit's external urethral sphincter was determined to be the red (fast) type.
We have previously reported the relevance of muscle dysplasia to the nonreflux megaureter. On electron microscopy, muscle cells which are scattered in large amounts of connective tissue without any bundle formation are found to be deficient in myosin filaments, which, with actin filaments, are believed to be an essential contractile unit of smooth muscle. Investigations of these dysplastic features of the ureter were extended to various other congenital disorders of the ureter experienced in our institution from 1963 to 1981. Muscle dysplasia was found in 8 of 34 cases of nonreflux megaureter, in 1 of 22 cases of reflux megaureter, in 4 of 23 cases of ectopic ureter of single system, in 4 of 9 cases of ectopic ureter of duplex system, 0 of 4 cases of the ureter of ureterocele of single system and in 1 of 13 cases of the ureter of ureterocele of duplex system. When muscle dysplasia was extensive, involving the whole length of the dilated ureter, incidence of associated renal dysmorphism was high in that 12 of 17 ureteral units as such demonstrated either severe renal dysplasia (9) or hypoplasia (3). Similar muscle dysplasia was also found in most of the dome of ureterocele (in 5 of 6 and 12 of 13 ureteroceles of single and duplex systems respectively). Muscle dysplasia is discussed as to its genesis, relevance to various congenital ureteral disorders and clinical implications.
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