Cytochemical studies of acute tubular necrosis caused by simultaneous administration of dextran and kanamycin

The increased nephrotoxicity of simultaneously administered kanamycin and low molecular weight dextran was studied in rats. The simultaneous administration of the two drugs showed an increase of nephrotoxicity, and caused pronounced vacuolation of the cytoplasm in the proximal tubular cells. The vacuoles were confirmed to be phagolysosomes by electron microscopic, histochemical and cell fractionation methods. The cell fractionation technique indicated that these phagolysosomes contained both kanamycin and dextran. The alteration of membrane was observed in the phagolysosomes, and these lysosomes of damaged renal tissue seemed to be more fragile than normal. The possible role played by lysosomes in the pathogenesis of acute tubular necrosis was discussed.

Mu rhythm suppression during the imagination of observed action

Mu wave suppression is thought to accompany the activation of the mirror neuron system which occurs when a human observes or imitates the behavior of others. Our investigation indicates a possible difference in mirror neuron system activation between passive and more active observation as suggested by mu wave activation levels. Participants were asked to observe four different videos each 80 s in duration. Each video was repeated once after a 30 s interval. The first video was of visual white noise and participants were instructed to passively observe the video. This was identified as the Baseline condition and served as a mu activation level baseline. The second video was of simple bouncing balls and the observer was again asked to passively observe the video (Ball condition). The third video was of a moving hand (Observation condition). The forth video was of the same moving hand and participants also imagined executing the observed hand movement (Imagination condition). As hypothesized, the Imagination condition activated the greatest level of mu suppression, while the Ball condition activated the lowest level of mu wave suppression. The Observation condition produced a slightly larger level of mu wave suppression than the Ball condition. This progressive increase in mu wave suppression supports the hypothesis that the activation of the mirror neuron system increases as the level of active observation increases.

Infectivity of HBV DNA positive donations identified in look-back studies in Hyogo-Prefecture, Japan

AIMS/OBJECTIVES

To clarify transfusion incidence of hepatitis B virus (HBV) infected blood negative for mini pool-nucleic acid amplification testing (MP-NAT).

BACKGROUND

Japanese Red Cross (JRC) blood centres screen donated blood to avoid contamination with HBV. However, a low copy number of HBV may be overlooked.

METHODS/MATERIALS

In Hyogo-Prefecture, JRC blood centres screened 787 695 donations for HBV from April 2005 to March 2009. Of these, 685 844 were donations from the repeat donors. To detect the donors with HBV, serological tests, MP-NAT and/or individual donation (ID)-NAT were performed. To detect the recipients with transfusion-transmitted HBV infection (TTHBI), serological analysis and/or ID-NAT were performed.

RESULTS

In this study, 265 of the 685 844 repeat donations were serologically and/or MP-NAT positive for HBV. Their repository samples from the previous donation were examined in a look-back study; 13 of the 265 repository samples proved ID-NAT positive. Twelve recipients were transfused with HBV-infected blood components derived from 10 of the 13 HBV-infected donors. Only 1 of the 12 recipients was identified as TTHBI case. Seven of the 12 recipients escaped from our follow-up study and 4 recipients were negative for HBV during the observation period.

CONCLUSION

On the basis of the look-back study among the repeat donors in Hyogo-Prefecture, Japan, donations with HBV-infected blood negative for MP-NAT occurred with a frequency of 13 in 685 844 donations (∼1/53 000 donations). However, more than half of the recipients transfused with HBV-infected blood negative for MP-NAT could not be followed up. It is necessary to establish a more cautious follow-up system.

Transgenic rescue from embryonic lethality and renal carcinogenesis in the Nihon rat model by introduction of a wild-type Bhd gene

We recently reported that a germline insertion of a single nucleotide in the rat homologue of the human Birt-Hogg-Dubé gene (BHD) gives rise to dominantly inherited cancer in the Nihon rat model. In this study, we constructed transgenic Nihon rats with introduction of a wild-type Bhd gene to ascertain whether suppression of the Nihon phenotype is possible. Rescue from embryonic lethality of mutant homozygotes (Nihon/Nihon) and suppression of renal carcinogenesis in heterozygotes (Nihon/+) were both observed, defining the germline Bhd mutation in the Nihon rat as an embryonal lethal and tumor predisposing mutation. This transgenic rescue system will be useful to analyse Bhd gene function, its relation to tumorigenesis in vivo, and genetic-environmental interactions in carcinogenesis.

Multistep renal carcinogenesis as gene expression disease in tumor suppressor TSC2 gene mutant model — genotype, phenotype and environment

Cancer is an inheritable disorder of somatic cells. Environment and heredity both operate in the origins of human cancer. These environmental and genetic determinants of cancer can be classified into four groups designated "Oncodemes" [1]. Oncodeme 1 is the irreducible "background" level of cancer due to spontaneous mutagenesis. Oncodeme 2 is "environmentally induced" cancer, whose causative agents are chemical carcinogens, radiation and viruses. Oncodeme 3 is basically "environmentally induced" cancer, but there are genetically determined differences among persons, e.g. the activation or inactivation of carcinogenes. Most human cancers are believed to belong to Oncodemes 2 and/or 3 (about 80%), for which the probability of the occurrence of the initial carcinogenic step(s) is increased, although the number of steps is not decreased. Oncodeme 1 would contain the approximately 20% that would remain if "environmentally induced" cancers (Oncodeme 2 and/or 3) were prevented. Lastly, Oncodeme 4 is "hereditary" cancer. Hereditary cancers could prove valuable in elucidating carcinogenesis, even though only a small proportion of cancers belong to this group. Here, we present a unique animal model of Oncodeme 4 for the study of problems in carcinogenesis; e.g. cell stage and tissue/cell-type-specific tumorigenesis, multistep carcinogenesis, species-specific differences in tumorigenesis, modifier gene(s) in renal carcinogenesis and cancer prevention.

Suppression of cytochrome P450 1A1 and 4A1 gene expression in renal carcinomas of TSC2 gene mutant (Eker) rats

In the kidney, cytochrome P450 (CYP) is involved in arachidonic acid metabolism and the maintenance of homeostasis, but only scarce information is available as to how CYP expression is altered in rodent renal carcinomas (RCs). TSC2 gene mutant (Eker) rat RCs are an example of a Mendelian dominantly inherited predisposition to a specific cancer in an experimental animal. In the present study, the expression of CYP in Eker RCs was studied. In the normal kidney, CYP 1A1 and 4A1 mRNAs were expressed, but this expression was suppressed in spontaneously-induced Eker RCs and in cell line Lk9dL and Lk9dR. In Lk9dL and Lk9dR, Ah receptor nuclear translocator and haemoxygenase-1 mRNAs were expressed, but this expression was inconsistent in spontaneously-induced Eker RCs. The present results showed the suppression of CYP 1A1 and 4A1 mRNA expression in spontaneously-induced Eker RCs and this suppression indicates altered metabolic conditions in Eker RCs.

Distribution of Tsc1 protein detected by immunohistochemistry in various normal rat tissues and the renal carcinomas of Eker rat: detection of limited colocalization with Tsc1 and Tsc2 gene products in vivo

We and others previously demonstrated that hereditary mutation and a subsequent second hit in the rat homolog of tuberous sclerosis gene (Tsc2) are responsible for Eker renal carcinomas (RC). In humans, alteration in the TSC2 gene is known to cause the tuberous sclerosis complex (TSC) that results in hamartomatous lesions in multiple organs, but the function of TSC2 is not fully understood. In recent years, a second gene (TSC1) responsible for human TSC has been cloned, and binding between TSC1 and TSC2 proteins was reported. In this study, to clarify associations between Tsc proteins in vivo, the expression of Tsc1 protein was detected by immunohistochemistry, and compared with Tsc2 expression. Tsc1 protein was expressed in the nervous system and in many endocrine tissues, including pancreatic islets, the parathyroids, testis, and ovary. Tsc1 was also detected in the many epithelial tissues of organs, such as kidney, uterus, small and large intestine, and liver. Our results indicate overlapping, but not identical, organ distributions of Tsc1 and Tsc2 proteins. At the intracellular distribution, double fluorescent immunolabeling allowed the determination that only a partial portion of Tsc1 signals overlapped with Tsc2 in some organs. These results suggest the existence of co-localizing and independent forms of Tsc proteins in endogenous expressions. Additionally, relatively high expression of Tsc1 protein was detected in RC in the Tsc2 mutant (Eker) rat.

[Detection of myocardial lesions by dipyridamole thallium-201 scintigraphy in patients with rheumatoid arthritis]

Dipyridamole Thallium-201 (T1) scintigraphic studies to evaluate microcirculation of the heart were performed in 54 patients with rheumatoid arthritis (RA) who had neither cardiac complaints nor myocardial damages on ECG. Twenty seven of 54 RA patients showed some perfusion defects in this study. The values of ESR, CRP and rheumatoid factors of IgM and IgG classes were significantly higher in these patients with perfusion defect comparing with those in the rest of RA patients with normal perfusion. The scintigraphic perfusion defects improved relating with the reduction of inflammatory activities of RA. The histological specimens of heart in 12 RA autopsy cases were reviewed to study the etiology of these perfusion defects. In 7 of 12 cases, microvasculitis and microthrombosis were observed without any macroscopic findings compatible with myocardial infarction. Our results suggest that RA patients have frequently microcirculatory disturbances in the heart due to microvasculitis without any clinical symptoms of ECG changes.

A rare portosystemic shunt detected by MRI and diagnosed by dynamic liver scintigraphy with Tc-99m phytate

Although various types of portosystemic shunts with portal hypertension have been widely reported, a collateral circulation near the pancreas head is rare. The authors report a case of a rare portosystemic shunt surrounding the pancreatic head, which was diagnosed by dynamic liver scintigraphy using Ikoma's scintigraphic criteria for the presence of portosystemic shunts. According to these criteria, abnormal accumulation of radioactivity at various abdominal sites (not identified on static images after the dynamic study) on 6 or more continuous frames of 5-second intervals (i.e., for 30 seconds or more after the arterial phase) indicates the presence of a portosystemic shunt. If liver scintigraphy is performed on a patient with portal hypertension, the dynamic study is valuable in the detection and diagnosis of a portosystemic shunt.

[Comparative double-blind study of cefroxadine and cephalexin in the treatment of complicated urinary tract infection]

To evaluate the efficacy, safety, and utility of cefroxadine (CXD) for the treatment of complicated urinary tract infections, a double blind study comparing CXD with cephalexin (CEX) was carried out. Patient received either 1,500 mg/day of CXD 3 times a day, or 2,000 mg/day of CEX 4 times a day for 5 days by oral route, and the following results were obtained. Of the 305 patients, clinical efficacies were evaluated in 220 cases (CXD 105 cases, CEX 115 cases) except that excluded or dropped out. Side effect was evaluated in 301 cases (CXD 150 cases, CEX 151 cases). There was no statistically significant difference in the back ground characteristics between the 2 groups. Overall clinical assessment by the committee according to the "Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on Urinary Tract Infection" patients evaluated as better than "good" were 64 of 105 (61.0%) for CXD and 75 of 115 (65.2%) for CEX. The difference between the 2 groups was not statistically significant. In effect on pyuria, patients evaluated as better than "decreased" were 58 of 105 (55.2%) for CXD and 69 of 115 (60.0%) for CEX. The difference between the 2 groups was not statistically significant. In effect of bacteriuria, patients evaluated as better than "decreased" were 57 of 105 (54.3%) for CXD and 69 of 115 (60.0%) for CEX. The difference between the 2 groups was not statistically significant. Analyses were stratified according to classification by the type of infection, diagnosis, degree of pyuria before treatment, and bacterial count before treatment. There were no statistically significant differences between the 2 treatment groups as to any item. In evaluation by attending physician, patients evaluated as better than "good" were 81 of 140 (57.9%) for CXD, and 85 of 141 (60.3%) for CEX. Statistically significant difference was not observed between the 2 groups. In drug usefulness by attending physician, patients evaluated as better than "usefulness" were 106 of 140 (75.7%) for CXD, and 109 of 141 (77.3%) for CEX. The difference between the 2 groups was not statistically significant. In evaluation of the infections with sensitive species to both CXD and CEX by the committee according to "Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on Urinary Tract Infections, overall clinical efficacies were evaluated in 102 (CXD 48 cases, CEX 54 cases) which were infected with sensitive species. There was no statistically significant difference in the back ground characteristics between the 2 treatment groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Renal autotransplantation--results of 15 years follow-up

Three patients with renovascular hypertension who underwent renal autotransplantation were followed for over 15 years. These patients were all normotensive and renal functions were satisfactory, during the follow-up period.

Postoperative prophylactic intravesical instillation of cytosine arabinoside and mitomycin C in superficial bladder tumor. A follow-up study

A follow-up study was made on 225 Japanese patients with superficial bladder tumors who were treated postoperatively with intravesical instillation of cytosine arabinoside and mitomycin C nineteen times during one year. Cumulative recurrence rates of the tumor were 16.7 and 41.9 per cent during the first 1 and 3.5 years after surgery, respectively. These results are superior to the previous findings in cases in which instillation therapy was not given. Histologically, there was no definite difference in recurrence among the groups with low-grade and high-grade tumors. The recurrence rate of multiple tumors was higher than that of a solitary tumor. Earlier postoperative instillation appeared to be more effective during the initial one year after surgery.

Human renal cell carcinoma: establishment and characterization of two new cell lines

Characterization studies have been carried out on 2 cell lines (KPK 1 and KPK 13) established from human renal adenocarcinoma. KPK 1 and KPK 13 have been passaged 178 times in vitro for about 6 years and 7 months and 78 times for about 3 years an 2 months, respectively. Although morphologic differences exist between the 2 lines, each has an epithelial morphology and exhibits multilayering. Doubling time of KPK 1 and KPK 13 cells was 29 hours and 51 hours, respectively. Both KPK 1 and KPK 13 induced tumors at the site of subcutaneous injection, closely resembling the original tumor from which they were derived. Chromosome number of both cell lines was 100 per cent aneuploid and the presence of Y chromosomes was confirmed by G banding in KPK 13 cells. KPK 1 was found to have high thromboplastic and high fibrinolytic activities, whereas KPK 13 was shown to have comparatively low thromboplastic and no detectable fibrinolytic activities. These activities were detected in the serum free supernatant fraction from KPK 1 cells but were not detected in that from KPK 13 cells.

Bilateral renal artery stenosis and renovascular hypertension in rabbits

In 21 rabbits bilateral renal artery stenosis was produced by constriction of the right renal artery with 1 of 3 different clips in size followed by left renal artery constriction with the smallest clip. Five to 6 weeks after left renal artery constriction, 5 ml. of the blood samples for the measurement of plasma renin activity (PRA) was taken from both renal veins and the distal vena cava, and the left nephrectomy was performed. In 17 out of 21 rabbits, PRA was determined in 3 different blood veins: L, left renal vein PRA; R, right renal vein PRA; and P, distal vena cava vein PRA. Three PRA patterns, L greater than P greater than or equal to R (A type), L, R greater than P (B type) and R greater than L not equal to P (C type), were observed. Removal of the left kidney caused a significant decrease in the average blood pressure persisting for 5 weeks in the rabbits with the type A pattern of PRA (p less than 0.05). In all 4 animals with the type B or C pattern of PRA hypertension persisted even after removal of the left kidney. Comparison of the PRA values between the venous blood in 3 different vascular trees seems very useful to predict the depressor response that follows nephrectomy of the severer constricted side.

Establishment of a human renal pelvic cancer cell line producing tissue thromboplastin and plasminogen activator

A new epithelial cell line derived from undifferentiated carcinoma of human renal pelvis, designated KP 1, was established in vitro. The cell line has been passaged 190 times in vitro for 5 years and 9 months. The predominant cell in KP 1 was a tear-drop-shaped cell. Doubling time of the cell line was 35 h. The malignant epithelial character of this line was verified by carcinogenicity in the subcuticular layer of nude mice and by karyotypic analysis which revealed the cells to be completely aneuploid with a model chromosome number in the hypertriploid range. KP 1 cells were shown to produce both tissue thromboplastin and plasminogen activator which was immunologically identical to urokinase, the plasminogen activator in urine.

Heterotransplantation of human urinary bladder cancers in nude mice

Thirty-one human urinary bladder cancers were transplanted subcutaneously into congenitally athymic nude mice. Subcutaneous growth was obtained in eight at the initial transplantation. Only one of these eight successful transplants, which was derived from squamous cell carcinoma, has been serially transplanted successfully and was characterized by high thromboplastic and low fibrinolytic activities which were virtually constant throughout the serial passages. This strain will provide a useful model system for studying anticancer therapies.

Heterotransplantation of human upper urinary tract tumors in nude mice

Eight human upper urinary tract tumors were transplanted subcutaneously into congenitally athymic nude mice. Subcutaneous growth was obtained in three (NKPP 1, NKPP 2, and NKPU 1) at initial transplantation and they were all serially passaged up to 29, 28, and 5 passages, respectively. Their histologic appearances were similar to those of the originals. These established strains with high transplantability and differing degrees of thromboplastic and fibrinolytic activities will provide a useful model system for studying anticancer therapies and biological characteristics of upper urinary tract tumors.

[Clinical significance of urinary CEA measurement as a screening test of bladder cancer (author's transl)]

Non-infected urine samples of twenty six preoperative bladder cancers were examined by urinary CEA radioimmunoassay and exfoliative cytology. There were 65% of urinary CEA positivity and 58% of cytological positivity (class III, IV, V). CEA measurements were positive in 8 of 11 negative cytology cases (class I and II). Exfoliative cytological examination failed to detect most of well differentiated transitional cell carcinomas, while urinary CEA study detected 4 of 6 such cases. Combination of both urinary CEA measurement and cytology resulted in 85% of positivity. Therefore we recommend routine use of this combination as a screening system of bladder cancer.

Surgical treatment of renovascular hypertension associated with bilateral renal artery stenosis

We report on 15 patients operated upon for renovascular hypertension associated with bilateral renal artery stenosis. Followup has been for 1 to 12 years. Four of 5 patients with positive split renal function studies and 3 of 5 patients with positive renal vein renin assays underwent unilateral operations on the positive side. All of these patients were cured or improved. The guide for unilateral operations in hypertensive patients with bilateral renal artery stenosis by angiography was the physiological information obtained from the preoperative screening tests, especially the plasma renin activity ratios of the 3 different veins and the split renal function studies.

Urinary carcinoembryonic like antigen levels in patients with urinary tract reconstruction using bowels

Urine CEA levels of sixty six cystectomy patients with urinary tract reconstruction using the small or large bowel was evaluated. Most of them had abnormally high CEA levels regardless of bladder tumor recurrence. Ileal conduit cases showed higher CEA levels than those of colocystoplasty cases. We think this is probably due to difference of mucosal surface areas rather than of original location of the resected specimens, for the small bowel contains much wider mucosal surface in a length unit.

Followup study after conservative and surgical treatment of vesicoureteral reflux

Our series of 94 cases (145 ureters) of vesicoureteral reflux is reviewed. The occasional disappearance of reflux during conservative treatment should not be mistaken for cure because of its variable nature. To avoid such a mistake voiding cystography under fluoroscopic monitoring is repeated indefinitely. Those patients who were treated surgically were followed for at least 2 to 3 years before cure was established. Transient ureteral dilatation after reimplantation was eradicated within 3 months. Postoperative urinary infection was observed at various intervals, ranging from 1 week to 5 months, and the erythrocyte sedimentation rate was likely to be influenced by infection. Postoperative chemotherapy was continued until the erythrocyte sedimentation rate was normal and there was no infection and/or dilatation of the upper tract.

Non-obstructive vesicoureteral reflux in adults: value of conservative treatment

Chronic or recurrent non-obstructive urinary tract infection was investigated in 158 adult patients, 39 of whom had vesicoureteral reflux. Conservative, long-term chemotherapy did not eradicate the reflux in these patients. The characteristics of reflux in adults were studied with cystograms, excretory urograms, cystoscopic findings of the ureteral orifices or trigones and the clinical histories of the patients. These data were evaluated and compared to data obtained from adults with chronic or recurrent uncomplicated urinary tract infection and from children with vesicoureteral reflux who were referred to us during the same period. Non-obstructive vesicoureteral reflux in adults may be considered to be congenital in most cases, since the proportion of trigonal anomalies in adults with reflux is equal to that in children and the frequency of abnormalities at the ureteral orifice and trigonal region is significantly more than the frequency noted in control patients with uncomplicated pyelonephritis. Characteristically, excretory urography revealed caliceal scarring in adults with reflux in contrast to children, in whom a normal or dilated pattern of the upper tract was prominent. Recurring renal infection, for which this congenital defect of the ureterovesical valve must be responsible, produces progressive renal damage. Prolonged conservative treatment is of little use and is often destructive in adults with reflux.

Significance of anaerobic bacteria isolated from the urinary tract. II. Experimental studies

An attempt to cause retrograde urinary tract infection with Bacteroides fragilis (a strain subcultured in artificial media) failed to produce any significant renal infection in rats. Intravenous inoculation with Fusobacterium (a strain subcultured in artificial media) also did not cause demonstrable renal infection in rats. Nor could the anaerobic organism be demonstrated in the kidneys of these animals. Animals receiving Bacteroides (a strain subcultured in artificial media) inoculated directly into the renal medulla developed no renal infection. The anaerobic organism however, continued to be demonstrable in the kidneys of 78 per cent of these animals even on the 3rd day after inoculation. Rabbits receiving Bacteroides (a fresh clinical isolate) which was injected into the subcutaneously fixed kidney with ureteral obstruction all developed overt renal infection. There was also evidence of marked proliferation of the injected anaerobic bacteria and pyuria in these cases.

An evaluation of average flow rate in traumatic neurogenic bladder dysfunction

The average flow rate of 60 male patients with spinal cord injuries was studied in a simplified method with a urine cup and a stopwatch. Results were based on the level of the lesion, course of injury, sensation of micturition, cystometric type and cystographic change. The average flow rate of 60 patients with traumatic spinal cord injury was 10.62 plus or minus 5.37 ml. per second, while that of 10 normal adult male patients was 15.70 plus or minus 3.10 ml. per second. The average flow rate was better in patients who had normal or nearly normal proprioceptive sensation than in those without this sensation. Bladder deterioration was not noted on the cystograms of patients who had normal proprioceptive sensations. Therefore, patients with traumatic cord bladders with normal urinary sensation may have a good prognosis, while those with disturbed proprioceptive sensation may require some urological manipulation to reduce urethral resistance.

Divided renal and peripheral venous renin as a means of predicting operative curability of renal hypertension

1. Eighteen patients with unilateral arterial stenosis or renal parenchymal lesion underwent corrective surgery for hypertension. Operative curability of hypertension was compared with pre-operative plasma renin activity (PRA) determined in three different veins; affected side renal (A), contralateral renal (C), and peripheral veins (P).

2. Those with renal arterial stenosis in whom the PRA in the affected side renal vein was significantly higher (more than 14 ng/ml) than that in both the contra-lateral side and peripheral veins, i.e. those with PRA values showing a pattern of A > C=P were found surgically curable without exception.

3. Patients with unilateral renoparenchymal lesions showed either A, C > P or A = C=P pattern and these were all found not curable. A similar pattern was found in four controls.