Our previous study demonstrated that endogenous LH was localized mainly in immature Leydig cells and only a few mature Leydig cells of human testis using immunohistochemical techiniqes. However, futher study is necessary to determine the exogenous LH (hCG) binding sites in human testicular tissue. Ten patients were injected with hCG (5000 IU) i. m. before urological surgery, and testicular tissues were obtained at different times during scrotal manipulation. The hCG localization in human testicular tissues was investigated by means of indirect tests of immunofluorescence or immunoperoxidase technique in terms of FITC or HRP labelled IgG, respectively. Positive stained cells appeared in numbers of immature Leydig cells even after hCG injections. Especially 3 hours after injection, there are many positive cells which are composed of immature and mature Leydig cells.
Another finding suggest that hCG could be permeated into seminiferous tubules. However, at 4 hours positive cells in the interstitial tissue decreased in number and positive labelled materials could not be seen in the intratubular space.
All positive labelled materials were localized only in the cytoplasm.

抄録全体を表示

To study the correlation between urinary tryptophan metabolites and etiology of bladder tumor, an excretion of urinary tryptophan metabolites (kynurenine and 3-hydroxy-kynurenine: abbreviated as kyn. comp.) before and after a 3gm load of L-tryptophan was measured among the male patients with spontaneous bladder tumor (28 cases), occupational bladder tumor (12 cases), dyestuff worker (9 cases), and for the control normal healthy subjects (41 cases: 22 males, 17 females).
The results were:
1) In 41 control subjects, pre-loading values were low in both sexes and sexual differences were negligible. However, since the post-loading values among the female subjects were high especially with those who were at the immediate post menstrual stage, only male subjects were used as controls.
2) In those patients who had spontaneous bladder tumor, occupational bladder tumor, and dyestuff workers, both pre- and post-loading values were high compared to the control values. These values were statistically significant by Student t test, though their increased values (post-loading value minus per-loading value) were statistically insignificant.
3) Post-loading plasma tryptophan values of spontaneous bladder tumor patients were slightly lower than that of control subjects. The values of plasma kyn. comp, were so low that exact measurement of this value was impossible in general.
4) Differences in urinary levels of kyn. comp. following the diet containing 3gm of L-tryptophan compared to those following the diet containing 1gm of L-tryptophan were insignificant.

抄録全体を表示

In order to investigate the role of l-tryptophan's promoting factor on tumorgenesis in the urinary bladder, the following experiment was contemplated.
Sixty D-D strain female mice of 7-week-old were fed 0.1% FANFT added CE-2 diet for 4-week duration. Thereafter, these mice were divided into two groups each comprising thirty mice 0.2% l-tryptophan added CE-2 diet for one group (group-1) and CE-2 diet for another (group-2) were fed for those mice in respective groups for another 56 weeks.
Results:
1) There were two cases of bladder tumor among the group-1 mice.
2) Both labeling index and hyperplastic index were statistically significant (t=2.78, p<0.05) in group-1 mice when compared with group-2. From these results L-tryptophan's promoting factor on tumorgenesis in the urinary bladder seemed to be undeniable.

抄録全体を表示

The measurment of urinary flow rate is clearly the most important objective screening test for evaluations of normal or abnormal urodynamics in the lower urinary tract.
The various types of flowmeters have been reported for this purpose. We have used mictiometer 14-F-40 in DISA urological investigation system which has been tested for its accuracy.
In this study 177 normal urinary flow curves in 8 adult males were statistically analysed using 10 parameters in the urinary flow curves.
The results obtained were as follows;
1. Maximum flow rate (MFR) increased propotionally with volumes below 200ml (r=0.8623, p<0.01), so that it is difficult to determine the normal range of MFR in these volumes. Therefore calculation of voided volume/MFR (caluculated minimal time of micturition) were enhanced. This normal range was calculated as less than 10 seconds. MFR were almost constant with volumes over 200ml (27.7±3.8ml/sec, mean±s. d.).
2. Average flow rate (AFR) increased propotionally with volumes below 250ml (r=0.8892, p<0.01) as MFR. With volumes over 250ml, AFR were almost constant. The variation of AFR were less pronounced than that of MFR (18.2±2.7ml/sec).
3. Increasing rate of micturition time was larger with volumes over 400ml than below 400ml. On the contrary time to maximum flow (T max.) was shortened with voided volume over 400ml.
4. Other parameters were less significant.
Cases with quite different urinary flow patterns or urinary flow profiles gave same values of parameters. Therefore, it is possible to give wrong interpretation when only one parameter is chosen for evaluation of micturition status. We emphasized that evaluation of urinary flow patterns itself was as important as measurements of parameters such as MFR, AFR, M. T., T. max. etc. for determination of normal or abnormal micturition.

抄録全体を表示

For detailed evaluation of prostatic gland, various means are under use. However, all of them have their advantages and disadvantages. Recently, computed tomography is available for clinical use. We tried it on the prostatic gland using ACTA scanner which permits study of all body parts, and were able to get clear images of the glands.
A total of 27 cases were studied as of April, 1977. Among these cases, the clinical diagnoses included benign prostatic hyperplasia (BPH) with or withour prostatitis, carcinoma of the prostate (CaP) and bladder neck contracture (BnC). Since we have a small number of cases which were examined with the ACTA scanner, sufficient analyses of these scans could not be performed at this time.
Generally, prostatic regions were clearly delineated by this device. In the cases of BPH without prostatitis, prostatic glands were shown as enlarged, homogeneous masses with smooth margins, and low density areas corresponding to the urethra were located in the center of the glands. However, in CaP and BPH with prostatitis, the margins were shown as irregular and rough. The areas of prostatic glands resected transurethrally were shown clearly in the CT images.
The computed tomography of the prostatic glands may be considered to be useful method for diagnosis of prostatic diseases.

抄録全体を表示

CEA (carcinoembryonic antigen) determinations were performed on 96 patients with urologic dis-ease. The results were compared with 83 patients of disease of another organs which was mainly cancer of digestive tract.
CEA of 211 serum and 37 urine samples were determined by “one step sandwich method” which was radioimmunometric assay for serum CEA.
By this method, the normal range was 0 to 2.5ng of CEA per 1ml of serum, and 0 to 1.5ng of CEA per 1ml of urine.
CEA was elevated in 28 (62%) out of 45 patients, mean value of CEA was 3.2±2.3ng/ml in the patients with urologic active cancer. On the other hand, CEA was elevated in 9 (25%) out of 36 patients with benign urologic disease, mean value of CEA was 1.8±1.0ng/ml in this group.
Value of serum CEA in patients with cancers of the lower digestive tract, lung and others was more elevated than the value of CEA in patients with urologic active cancer.
CEA determination was perfomed before and after the therapy for 5 to 10 weeks on the 12 patients with urologic cancer, as value of CEA was almost paralleled with clinical states.
In 37 patients, both urine and serum CEA levels were determined. Value of CEA in serum was below 2.5ng/ml in 25 patients. Mean value of CEA in urine was 0.8±0.3ng/ml in normal subjects, and 2.2±1.0ng/ml in 4 patients with urologic cancer who had no evidence of urinary tract infection. In cases with urinary tract infection, however, urinary CEA was elevated with an average of 4.4±3.3ng/ml in 12 patients.

抄録全体を表示

With the aim of developing new renal imaging agents for γ-cameras, three types of compounds—cysteine acetazolamide complex, malic acid, and salicyluric acid—were selected and labeled with ^99mTc by e-lectrolysis.
These new renal imaging agents—^99mTc-cysteine acetazolamide complex (TCAC), ^99mTc-malate and ^99mTc-salicylurate—were studied with regard to renal images of rabbits and normal humans. In animal experments using rabbits, renal images obtained with ^99mTc-salicylurate proved better than the other agents, but in experiments with humans ^99mTc-malate gave clearer images than the other. From pharmaceutical discussion it was understood that ^99mTc-malate (pH 5.0) is excellent in labeling yield (99%) and chemical stability and that malic acid is nontoxic metabolite in vivo. The half time of ^99mTc-malate disappearance in human blood was 17 minutes on the average. The excretion rate in urine was 36±6.05% of the dosage at 1 hour, 44±3.41% at 2 hours and 50±5.62% at 3 hours after intravenous injection.
Since the possibility for clinical use of ^99mTc-malate was suggested from the above results, renal imaging was performed on 57 cases with urological renal disorders. In renal imaging, vascular and functional phases were examined; also urinary tract images were discussed. The vascular phase was obtained at 10-20 seconds after intravenous injection (at 10-30 seconds in old patients). The functional phase began to be obtained at 10 minutes after injection, and clearest images were obtained at 60 minutes and thereafter. In the case of obstructive uropathy the urinary tract was observed at 10-30 minutes after intravenous injection. In the case of renal failure when serum creatinine was 4.5 mg/dl or over, hardly any renal images were obtained.
The above-mentioned results show that ^99mTc-malate is useful as renal imaging agent for renal screeing tests.

抄録全体を表示

A system was described for studying an adoptive immunity to retrograde Proteus mirabilis (Pm) pyelonephritis in the rat. Cyclophosphamide-treated (100mg/kg) rats were challenged with Pm retrogradely, immediately after receiving intravenously 1.5-2.0×10⁸ cells of the following sources: Immune spleen cells from retrograde Pm pyelonephritic rats and thymus and spleen cells from normal rats respectively. Protective immunity was measured by the presence or absence of renal abscesses and their frequency.
The demonstration of the protective immunity was dependent upon the Pm dose challenged. When challenged with 10⁵Pm, the development of renal abscesses in the former 2 groups receiving either immune cells or normal thymus cells was inhibited significantly compared to the latter group. The inhibition was not significant in the case challenged with 10⁸Pm.
Since a small amount of serum antibody was found only in the immune cell recipient, the immunity was considered to be conferred by the transferred cells. It was also suggested that the observed adoptive immunity might be due to the T-cells in the transferred cell populations since a protection was also observed in the normal thymus cell recipient. The fact that the simultaneous administration of immune serum did not affect the result suggests that the resistance developed in the recipient was dependent upon the cell-mediated immunity in this system.

抄録全体を表示

The present paper concerns with our review on the clinical results of a total of 23 patients with tumor of the renal pelvis, who were seen at Jikei University Hospital in the 22 years' period from 1953 to 1974. Out of these 23 cases, 21 had transitional cell carcinoma and the remaining 2 had squamous cell carcinoma.
The affected side was left for 15 cases and right for 8 cases. The incidence was 6.7 times higher for male patients than for female patients. The average age of patients was 59 years.
The most frequent initial symptom was gross hematuria in 20 cases (87%), followed by pain in 3 cases (13%). The main symptoms were gross hematuria in 22 cases (96%), pain in 8 cases (35%) and palpable mass in 4 cases (17%), in the decreasing order. Two of the 4 cases in which a palpable mass was present had squamous cell carcinoma and the remaining 2 cases had advanced hydronephrosis which resulted from associated ureteral tumor. Thus, in these 4 cases no patient was included who were with palpable mass in the presence of uncomplicated transitional cell carcinoma of the renal pelvis. Nonurologic symptoms such as gastrointestinal distrubances were seen in 8 cases (35%).
Laboratory tests revealed anemia in 7 cases (30%) and accelerated ESR in 10 cases (43%). In addition, in 6 cases (38%) an increase in α₂-globulin was noted. However, in no case hepatic dysfunction or hypercalcemia was observed. Urinary cytologies carried out in 8 cases were positive for tumor cells in 3 cases (38%).
Plain film of the kidney indicated association of renal stones in 3 cases (13%), and soft tissue masses in 4 cases (17%). From the findings of excretory urography, filling defect was detected in the pelvic area in 19 cases (83%) and in 4 cases (17%) there was no visualization. Out of 11 cases in which renal angiographic studies were carried out, in 6 cases (55%) an encasement of renal artery was shown, while in 3 cases (27%) an enlargement of pelviureteric artery was observed. Besides these findings, neovascularity was observed in 5 cases (45%).
In 8 (38%) out of 21 cases of transitional cell carcinoma of the renal pelvis, association of bladder and/or ureteral tumor was demonstrated. In 5 of these 8 cases, complications were found at the same time when tumor of the renal pelvis was seen, but in 2 other cases, complications occurred 8 months and one year and 11 months after operation of pelvic tumor, respectively. In the remaining one case, pelvic tumor was detected 5 years and 2 months after total cystectomy for tumor of the bladder.
Seventeen cases (74%) out of 23 cases underwent nephrouretectomy and in 13 of these cases the intramural ureter was removed with cuff of bladder. In the remaining 6 cases, comprised of cases in early years and those of squamous cell carcinoma of the renal pelvis, only nephrectomy was done.
The 5-year survival rate in 21 cases of transitional cell carcinama was 60%, showing close correlation of prognosis with the histological grade and stage. All the 3 cases, in which palpable mass was observed or no visualization was noted by the excretory urography, died within 5 years. These 3 cases, though classified as low grade, presented hydronephrosis resulted from ureteral tumor which complicated concurrently. From these data it seems that the prognosis of transitional cell carcinoma of the renal pelvis associated with ureteral tumor is poor.
In this series, both of 2 cases of squamous cell carcinoma died within one year.

抄録全体を表示

A case of retrocaval ureter with a periureteric venous ring was reported. A 24 year-old man visited our clinic with asymptomatic gross hematuria. DIP and RP revealed right hydronephrosis and small “S” deformity of the right ureter. In surgery, it was found that the right ureter passed through the periureteric venous ring (type AB). Excision of the ventral vena cava and intubated ureterotomy were performed. The post operative course was uneventful and satisfactroy result was obtained. Prior to our report, only 4 cases of type AB had been mentioned by Rotter (1935), LePage (1972), Matsumura (1972) and Irikura (1973). Anomaly of post renal vena cava, especially type AB, was reviewed.

抄録全体を表示