A permanent established cell line (NRC-12) derived from a human renal cell carcinoma is described. These cells have been maintained for 30 months and over 140 in vitro passages. The growth of these epithelial cells was characterized by the absence of contact inhibition and the doubling time was constant at 48 hours. Electron microscopic study showed the localized nucleus and prominent microvilli resembling the brush border-like structures of the renal cell carcinoma on the opposite side of the nucleus. Histrogical examination of the heterotransplant into the cheek pouches of a golden hamster verified that the nature of the cells was identical to clear cell adenocarcinoma, resembling the original tumor of the patient. Chromosomal analysis revealed the presence of two hypotetraploid stemlines (86 and 88) and a secondary constriction on chromosome A3 of all cells.

抄録全体を表示

Autonomic hyperreflexia is a common complication of the high spinal cord lesion and sometimes may evoke convulsion, intracranial hemorrhage and death. This symptomm is found in acute and in recovery stage of spinal injury and disappeared in chronic stage.
Because of this reason, total spinal block or neurotomia in the lumbar area should not be chosen at first.
The purpose of this study is to find out the trigger mechanism and drug therapy of autonomic hyperreflexia, particularly in the acute and recover phases. The blood pressure, pulse rate, gross sweating, plethysmogram and the vesical pressure were observed while the bladder was filled with normal saline at a rate of 30ml per minute. Effects of phenoxybenzamine, atropine sulfate, bethanechol chloride, diazepam and percamine S were studied.
The following results were obtained:
1) The patients were divided into two groups. The one showed paroxysmall hypertension after increase of bladder pressure and the other showed gross sweatig without paroxysmal hypertension.
2) Among the various stimulation to the patients such as catheterization of the urethra, bladder distension, etc., the most effective trigger of the autonomic hyperreflexia was the vesical contraction.
3) Phenoxybenzamine, diazepam and atropine sulfate are useful in the treatment of autonomic hyperreflexia for mainly reducing the urethral resistance or preventing abnormal contration of the bladder. Administration of bethanechol chloride provoked strong bladder contraction, and this might be due to its inhibitory action on cardiovascular system and this drug did not evoke severe paroxysmal hypertension. Percamine S is effective to autonomic hyperreflexia by its action of blocking both sensory and motor nerves of the bladder.

抄録全体を表示

Ninety-two patients with prostatic carcinoma who were treated at Tokyo Medical and Dental University between 1960 and 1971 were reviewed. Patients except stage A were expected to take estrogen (hexestrol 30-60mg per day) continuously throughout their life. All patients were followed up completely until their death or over 6 years as of December 31, 1977. The results were summarized as follows:
1) The average age of patients was 70 years old (range: 53 to 90). The distribution of patients by stage was: stage A- 6 cases (6%), stage B- 18 cases (20%), stage C- 38 cases (41%) and stage D- 30 cases (33%).
2) In spite of our intention to maintain accurate treatment, the average administration rate (the number of days which a patient exactly took the medicine divided by the number of days while they were observed) was only 49%.
3) The effect of estrogen to prolong the life in patients with prostatic carcinoma was proved in the cases with the administration rate over 70%·Only 37% of all patients filled this condition.
4) Among 15 cases of early carcinoma (stage A and B) treated every year over 40% of the annual administration rate(the amistration rate of each years after the beginning of the treatment), no one died of the carcinoma. On the contrary, 4 (25%) of 16 cases who did not maintain every year the rate of 40% died of carcinoma within 2 years after the treatment was discontinued.
5) Of 50 advanced carcinoma (stage C and D) treated every year at the annual administration rate, over 40%, 10 cases (20%) died within 2 years without any reaction to estrogen, and 5 cases (10%), relapsing after a few years of remission, died of carcinoma in following years. The other 70% of them were thought to be estrogen-sensitive throughout their life, since they did not relapse while they were under the treatemnt.

抄録全体を表示

To ascertain anaerobic urinary tract infection, a total of 615 urine specimens from 97 male and 117 female patients were cultured. Most of them have chronic urological disease, such as cancer of the bladder, benign prostatic hypertrophy and urinary calculus. Urinary bacteriological exminations were investigated to serially dilute the urine specimens obtained by two methods. Clean midstream catch technique was applied for the samples of male subjects and sterile catheterization for famele.
112 strains of anaerobes were recovered from 27 per cent of 214 patients (78 of 615 specimens). Peptococcus anaerobius and Peptococcus variabilis were most frequent and isolated 18 times and also 7 strains of Bacteroides fragilis could be found in this study. This result seems similar to that obtained for the anterior urethral flora by other investigators.
Among 30 urine samples with anaerobes of more than 10⁵ viable cells counts per ml., anaerobes were isolated in 5. There is less significnat association between viable cell count and pyuria when anaerobic bacteria were cultured in large quantities of mine sample than when aerobic bacteria were cultured in similar conditions.
The bacterial count and species of yielded anaerobes from urine samples are not the decisive factor for diagnosing anaerobic urinary tract infection. Additional factors, such as clinical findings and predisposing or underlying conditions of the patient, must always be considered. Now criterion for diagnosis of anaerobic urinary tract infection sholud be established.

抄録全体を表示

At present renal transplantation has become an acceptable method for patients with endstage renal disease.
In fact we have experienced with satisfactory outcomes upon patient survival and graft function over 100 cases of renal transplantation from living donors at Osaka University and Hyogo Prefectural Nishinomiya Hospital up to now.
However, these results should be analyzed not only in view of the survival or function but also in aspect of social rehabilitation of the transplant patients as they have to adjust socially.
In this paper, a retrospective analysis was carried out on 81 transplant recipients from living donors performed during past 8 years, Jan. 1, 1970-Dec. 31, 1977, in aspect of social rehabilitation, and contributing factors were focused concerning social rehabilitation.
The following factors were found to be contributing factors:
1) Recipient sex
In females better adjustment was observed significantly than in males.
2) Histocompatibility
The superiority of the well-matched graft at HLA-D locus but not at HLA-A, B locus was recognized.
3) Postoperative complications
Both of liver disease and pulmonary infections were major disturbing factors. Especially, severe liver disease (serum-GOT or GPT levels≥600 K. U.) and opportunistic pulmonary infection were the important factors which disturb excellent social rehabilitation. Diabetes and aseptic necrosis of bone were also troublesome factors. In this point, some of these cases were presented in illustrations of our clinical experiences.
Finally, the somato-social conditions of each person who had lost graft function were compared with pre and postoperative status on chronic hemodialysis. It was gratifying observation that the quality of life in preoperative dialysis periods was essentially unchanged from postoperative ones.
From these experiences, it was discussed how management of renal transplantation should be carried out for excellent social rehabilitation.

抄録全体を表示

The effect of glucose, testosterone and FSH on spermatogenesis was studied in organ cultures of 21-day-old rat testes by modification of Trowell's method. The control medium used in all cultures consisted of MEM (Eagles minimum essential medium), supplemented with 10% fetal calf serum, 1mM of sodium pyruvate, 0.1mM each of alanine, aspartic acid, asparagine, glutamic acid, glycine, proline and serine, and 3mM of glutamine and penicillin 100U, per ml. The culture medium was maintained at PH7.1 and explants were incubated at 31°C in a gas atmosphere of 5% CO₂ and 95% air.
The results are summarized as follows.
1) In the control medium, primary spermatocytes showed a marked dimution in number during 4 to 7 days in culture, and gradually disappered in almost all tubules within 14 days in culture, even though spermatogonia were well maintained and mitotic activity continued after 42 days in culture.
2) Sertoli cells in all tubules were well maintained at an almost definite number of 16 to 19 per seminiferous tubules for as long as 42 days.
3) Effects of glucose:
In cultures grown in 2mg/ml concentration of glucose medium, the number of primary spermatocytes was slightly greater than in the control medium containing 1mg/ml of glucose for 7 days in culture. In cultures grown in a 3mg/ml concentration of glucose medium, however, the seminiferous tubules showed moderate diminution in diameter and moderate thickening of the tubular wall with the number of primary spermatocytes being smaller than in the control medium.
4) The osmotic pressure in the culture medium was evaluated to study the toxic effect of a higher concentration of glucose on the maintenance of primary spermtocytes. The osmotic pressure being 330mosm/L in the 2mg/ml concentration of glucose medium and 335mosm/L in the 3mg/ml concentration, the osmotic pressure was proved to be within 330mosm/L in view of the maintenance of primary spermatocytes and the structure of seminiferous tubules.
5) Effect of testosterone:
The concentration of testosterone in culture medium for the best maintenance of primary spermatocytes was 50μg/ml concentration, and 5μg/ml, 100μg/ml, in that order.
6) Effect of NIAMDD-rat FSH, B-1:
Addition of FSH to the control medium resulted in good maintenance in the number of primary spermatocytes. A 200μg/ml concentration of FSH was more effective for the maintenace of primary spermatocytes than 100μg/ml of FSH.
As mentioned above, the most effective culture medium for the maintenance of primary spermatocytes was proved to be 2mg/ml of glucose, 50μg/ml of testosterone and 200μg/ml of FSH.

抄録全体を表示

The effect of glucose, testosterone and FSH on spermatogenesis was studied in organ cultures of 21-day-old rat testis. Since previous experiments on the determinaiton of appropriate experimental conditions for rat testicular culture suggested that the best maintenance of primary spermatocytes was 2mg/ml of glucose, 50μg/ml of testosterone and 200μ/ml of FSH, the present investigation was undertaken to define the actions of these additives in the aforementioned concentrations. Data from 7 days and 14 days of cultures were statistically analyzed by analysis of variance.
As the interpretation of the mode of action of these factors on spermatogenesis is very intricte, data obtained in this series of experiments may be summarized by opinion. The results are summarized as follows.
1) In cultures of 2mg/ml of glucose medium containing a concentration of glucose double that normally present in a control medium, it was demonstrated that differentiation of germ cells was not induced by addition of glucose, while good maintenance of primary spermatocytes was observed for at least 7 days in culture. This suggests that glucose, as the energy source, acts on Sertoli cells to give nutrients to germ cells.
2) In cultures of 50μg/ml concentration of testosterone medium, it was demonstrated that the number of resting, leptotene and zygotene spermatocytes, i. e. early stages of primary spermatocytes, which have been associated with differentiation of spermatogonia increased. A reduction in the number of pachytene spermatocytes, a late stage of primary spermatocytes, and an increase in the number of pyknotic cells were noticiable, since the supplying capacity of Sertoli cells could not be accompanied by an increase in the number of early stages of primary spermatocytes (an explanation is given in subsection 3, concerned with the action of FSH). The primary spermatocytes are suggested to be the source of these pyknotic cells because of the anatomical arrangement of the intratubular cells. Therefore, testosterone may affect the mitotic division of spermatogonia.
Since the duration of spermatogenesis always progresses at a constant speed, resting, leptotene and zygotene spermatocytes observed in preculture must develop into pachytene spermatocytes, the next stage of zygotene primary spermatocytes, in 7 days and 14 days in culture, and resting, leptotene and zygotene spermatocytes ater 7 days in culture must be differentiated from spermatogonia in precultures.
Our interpretation of pyknotic cells is as follows: It has been demonstrated that degenerative processes of germ cells, such as degeneration, pyknosis (necrosis) and disappearance, should be considered as a constant and regular feature of in vivo normal testis, and that the number of spermatozoa produced per spermatogonia should be, in the rat, only 52% of theoretical yield. The pyknotic cells, the degenerated germ cells, are phagocytosed by Sertoli cells. The increase in the number of pyknotic cells and the reduction in the number of primary spermatocytes indicate a decrease in the supplying capacities as well as the phagocytic properties of Sertolic cells. Therefore, the presence of pyknotic cells may reflect the Sertoli cell function.
3) Data from experiments containing 200μg/ml of FSH produced the following two effects.
3)-a) The effect of FSH on the increase in the number of resting, leptotene and zygotene spermatocytes was observed, and was greater than that of testosterone. This indicates that mitotic division of spermatogonia is affected by some action of FSH as well as of testosterone.
3)-b) The other effect of FSH was maintenance of pachytene spermatocytes, and a significant observed increase in the number of primay spermatocytes on the whole. However, no increase in the number of pyknotic cells was observed. The relationship between testosterone and FSH in the number of pyknotic cells of 14-day cultivated explants statistically exhibited

抄録全体を表示

In order to solve the problems related to the resistance of human being against hypernephroma, in vitro cytotoxicity of the peripheral blood lymphocytes (PBL) from healthy persons was examined using an established cell line (KU-2), which was derived from human renal cell carcinoma, as the target cells.
The original of the KU-2 was a metastatic hypernephroma in the lung, which was capable of producing ervthropoietin, and the KU-2 has been established in our Department as a monolayer cell-line from the tumor successively transplanted in nude mice.
As the effector cells in the cytotoxicity assay, PBL were isolated by Ficoll-Conary method from the blood drawn from 3 healthy male and one healthy female adults. T cells and B cells separated from the PBL after removing macrophages by the carbonyl iron-powder treatment were also used as the effector cells. T cells were obtained as sheep erythrocyte-rosette (ER) forming cells, and B cells as non-ER forming cells. PBL, T cells, and B cells thus obtained were used as the effector cells either as such or after stimulation with phytohemagglutinin (PHA). In vitro cytotoxicity of the effector cells was assayed by % cytotoxicity in the microcytotoxicity assay and also by morphological observation of time lapse cinematographs. Identification of the effector cells responsible for the spontaneous lymphocyte-mediated cytotoxicity (SLMC) was made by scanning electron microscopic observation and by immunofluorescence technique for detection of surface Ig and Fc receptors on the cells.
Cytotoxicity against KU-2 of PBL, T and B cells as such and after stimulaton with PHA showed (1) the highest Cytotoxicity by PHA stimulated PBL and PHA stimulated T cells (PHA induced cytotoxicity), (2) high cytotoxicity by individually isolated non PAH-stimulated B cells (SLMC), absence of cytotoxicity by individually isolated non PHA-stimulated T cells, and (3) discrepancy between the cytotoxic effects demonstrated under time lapse cinematography and % cytotoxicity determined by microcytotoxicity assay with regard to cytotoxicity by individually isolated PHA stimulated B cells. Furthermore, (4) presence of long microvilli on the surface of B cells connected closely with KU-2 cells as target cells was demonstrated under scanning electronmicroscopic observation, and (5) presence of surface Ig and Fc receptor as surface markers on B cells playing major role in SLMC was observed by immunofluorescence technique.
Above mentioned findings indicated strong possibility that cytotoxicity generated by both PHA stimultaed T cells and non PHA-stimulated B cells were responsible for high cytotoxicity generated by PHA-stimulated PBL.

抄録全体を表示

Adenosine 3′, 5′-cyclic monophosphate (cyclic AMP), discovered by Sutherland et al. in 1958, is now considered to be the secondary messenger of various β-adrenergic actions, such as cardiac inotropic action, glycogenolysis, lipolysis and relaxation of several smooth muscles. (1) Many investigators have already detected the presence of inhibitory β-adrenergic receptors in the vas deferens of some mammals. (2) Phosphodiesterase inhibitors (i. e. aminophylline, theophylline and papaverine) can reduce or abolish contractions of the vas deferens or rabbits, guineapigs and rats. (3) Externally applied dibutyryl cyclic AMP, a derivative of cyclic AMP, can reduce or abolish contractions of the vas deferens of guinea-pigs, rats and humans.
From the above-mentioned previous reports by many authors, it may be suggested that cyclic AMP is the intracellular mediator of inhibitory β-adrenergic action of the vas deferens smooth muscle.
In this paper, changes in tissue cyclic AMP levels of the rat vas deferens following administration of catecholamines, adrenergic blocking agents and aminophylline have been observed.
The methods were as follows:
1) 9 weeks old male Wistar rats (216±21g), anesthetized with sodium pentobarbital 50mg/kg i. p., underwent lapalotomy.
2) A drug or drugs were injected into the vena cava inferior.
3) 3, 8, 15, 30 or 60 minutes after the injection, the total length of both vas deferens was excised.
4) Immediately cyclic AMP levels of each tissue were estimated, using the cyclic AMP Assay Kit (Radiochemical Centre, Amersham, England).
The saline-injected group and drug-administered group were compared statistically.
The results obtained were as follows:
1) 20μg/kg of epinephrine or isoproterenol could elevate tissue cyclic AMP levels maximamly 8 minutes after the injection of these drugs.
2) The elevation of tissue cyclic AMP levels induced by the injection of epinephrine or isoproterenol was dose-dependent.
3) Preinjection of propranolol 1.0mg/kg abolished the elevation of tissue cyclic AMP levels induced by the injection of epinephrine 20μg/kg or isoproterenol 20μg/kg. But, preinjection of phenoxybenzamine 1.0mg/kg caused no effects.
4) Aminophylline 50mg/kg neither changed the basal tissue cyclic AMP level nor acted synergistically when combined with epinephrine or isoproterenol.
5) Propranolol 1.0mg/kg, phenoxybenzamine 1.0mg/kg or norepinephrine 0.2-200μg/kg did not change the basal tissue cyclic AMP level.
My results may add some proof to the hypothesis that cyclic AMP is the intracellular mediator of inhibitory β-adrenergic action of vas deferens smooth muscle.

抄録全体を表示

Cases of hypogonadotropic hypogonadism associated with anosmia (Kallmann's syndrome) were reported in seven adult males.
All of them exhibited eunuchoid habitus with small testicles, and bilateral testicles had not descended in three cases.
No or small responses of plasma LH and FSH against LH-RH were showed in all but one case, but after daily administration of LH-RH (100μg) for five days, good responses of plasma LH against LH-RH were detected in three cases.
Plasma testosterones were very low and increments against HCG were small, if present, in all cases. Literatures were reviewed brieflly.

抄録全体を表示

There are two types of multiple and simple sac in acquired ureteral diveticula. The later is extremely rare. Only eight cases of simple sac type have been described in previous papers in the world and two cases in Japan. Acquired ureteral diverticulum after renal transplantation was not reported yet. A case of renal transplant recipient with acquired ureteal diverticulum from kidney allograft is presented herein. The diverticulum opened into the ureter approximately one centimeter proximal from the vesico-ureteral junction. It contained about 500ml of urine, the internal surface was covered with transitional epithelium but its wall did not contain muscular layer in histopathology. The etiology of this case was considered that ureteral stenosis of the vesico-ureteral junction was seen in the first operation and some weakness of the ureter was acquired because of transplantation. We performed the diverticulectomy and the uretero-ureteroneostomy twice, which failed. Then the third operation of the uretero-pyerostomy using the opposite inherent ureter successfully cured the disturbance.

抄録全体を表示

A 54-year-old woman was hospitalized for the management of diabetes mellitus. A solid mass was felt in the left upper quadrant at an abdominal examination. An abdominal scout film and excretory urography showed a grape-fruit sized mass unrelated to the urinary tract. The tumor removed was 7×6×8.5cm in size, and 240g in weight. The content of the tumor was gray necrotic material. The histology revealed a fibrous capsule and degenerative material containing cholesterin cyrstals. To our knowledge this kind of retroperitoneal pseudocyst has never been reported before.

抄録全体を表示