Potential risk factors for early acute kidney injury in patients treated with vancomycin

PURPOSE

The acute kidney injury (AKI) onset owing to vancomycin (VCM) is reported that depend on the area under the blood concentration-time curve (AUC) and occur comparison early phase (early AKI). This study aimed to investigate the occurrence of early AKI in patients treated with VCM and new indicators to avoid early AKI.

METHODS

Adult patients who received VCM treatment for more than 4 days and whose trough values measured at least once on or after day 4 and serum creatinine before day 7 from the initiation of VCM administration between August 2021 and September 2022 at the Yamanashi Prefectural Central Hospital were enrolled. Early AKI (defined as AKI occurring within day 7 from VCM administration) and the association between each AUC (0-24, 24-48, 48-72, 0-48, 24-72, 0-72) were investigated. Furthermore, each AUC cut-off value for early AKI was calculated.

RESULT

In total, 164 patients were enrolled; early AKI developed in 21 patients and most frequently occurred on day 4. All stratified AUC were associated with early AKI development. The AUC cut-off values were AUC0-24: 470.8 μg/mL⋅h; AUC24-48: 473.0 μg/mL⋅h; AUC48-72: 489.7 μg/mL⋅h; AUC0-48: 910.2 μg/mL⋅h; AUC24-72: 1039.2 μg/mL⋅h; and AUC0-72: 1544.0 μg/mL⋅h.

CONCLUSION

The possibility of AKI development owing to the AUC accumulation of VCM was observed (accumulation toxicity). Concentration control through early-phase blood concentration measurements and a transition to AUC0-48 <910.2 μg/mL⋅h may reduce the early-phase AKI onset.

Semiconductor Nanostructure Design for Thermoelectric Property Control

We present the methodologies for developing high-performance thermoelectric materials using nanostructured interfaces by reviewing our three studies and giving the new aspect of nanostructuring results. (1) Connected Si nanocrystals exhibited ultrasmall thermal conductivity. The drastic thermal conductivity reduction was brought by phonon confinement and phonon scattering. Here, we present discussion about the new aspect for phonon transport: not only nanocrystal size but also shape can contribute to thermal conductivity reduction. (2) Si films including Ge nanocrystals demonstrated that phonon and carrier conductions were independently controlled in the films, where carriers were easily transported through the interfaces between Si and Ge, while phonons could be effectively scattered at the interfaces. (3) Embedded-ZnO nanowire structure demonstrated the simultaneous realization of power factor increase and thermal conductivity reduction. The [Formula: see text] increase was caused by the interface-dominated carrier transport. The nanowire interfaces also worked as phonon scatterers, resulting in the thermal conductivity reduction.

Immunohistochemical analysis of estramustine binding protein with particular reference to proliferative activity in human prostatic carcinoma

BACKGROUND

The estramustine binding protein (EMBP) specifically binds to estramustine and was first discovered in the rat ventral prostate. However, the physiological property of EMBP in the human prostate still remains to be elucidated. To elucidate whether EMBP is interrelated with cellular proliferation in human prostatic carcinoma (PC), the change in EMBP immunostaining during luteinizing hormone-releasing hormone (LH-RH) analog administration or during Cis-platinum-based chemotherapy, and the difference in EMBP immunostaining between hormone refractory (hr-PC) and untreated PC were analyzed.

METHODS

Forty-six patients with histologically proven untreated PCs (34 were treated with LH-RH analog and 12 were treated with chemotherapy as an initial therapy) and 14 with hr-PC were used in this study. PC tissues were obtained before and 3 months after the initial therapy. The changes in immunostainings for EMBP, proliferating cell nuclear antigen (PCNA), and nm23 protein were compared with the change in serum prostate-specific antigen (PSA) level and the histological response during the treatment.

RESULTS

The increased EMBP expression was observed in tumors with high histological grade and high clinical stage as well as in hr-PC. In untreated PC, EMBP expression weakly correlated with PCNA or nm23 protein immunoreactivity. In PC receiving LH-RH analog, EMBP expression was significantly reduced after treatment, however, no significant changes were observed in PCNA or nm23 protein immunoreactivity. In addition, EMBP expression before the treatment significantly correlated with the serum PSA change, while PCNA expression and nm23 protein immunoreactivity did not. On the other hand, no significant relationship was observed between histological changes induced by the LH-RH analog and immunostainings for EMBP, PCNA, and nm23 protein before treatment. In PC patients receiving chemotherapy, immunostainings for EMBP, PCNA, and nm23 protein were not significantly changed during the treatment. EMBP immunoreactivity was significantly higher in hr-PC than in untreated PC with paralleled change of PCNA expression and nm23 protein immunoreactivity.

CONCLUSIONS

These observations indicate that EMBP is androgen regulated in some PCs. However, EMBP expression is demonstrated even in hr-PC and is interrelated with cellular proliferation especially in hr-PC.

Urethral caruncle with coexistence of intestinal heterotopia. A case report

Urethral caruncle is one of the benign disorders which occurs frequently after the menopause. We describe a case of urethral caruncle with intestinal heterotopia, in which infiltration by lymphocytes, invagination of the urethral transitional epithelium causing nest formation, lumen formation, hypervascularity as well as teleangiectasia were observed, suggesting the occurrence of metaplasia in the transitional epithelium preceding the intestinal heterotopia. The aetiology and clinical significance of urethral caruncle exhibiting intestinal heterotopia are discussed.

Clinical significance of immunohistochemically detectable p53 protein in renal cell carcinoma

OBJECTIVE

To elucidate the clinical significance of p53 protein in renal cell carcinoma (RCC).

MATERIALS AND METHODS

The p53 protein in the paraffin-embedded materials taken from 72 patients with RCCs was evaluated immunohistochemically and was compared with the histological findings, expression of proliferating cell nuclear antigen (PCNA), genetic instability as assessed by 2c deviation index (2cDI) and 5c exceeding rate (5cER) as well as clinical outcome.

RESULTS

The p53 positivity was demonstrated only in a localized and/or focal area of the cancerous tissue. The positive rate of p53 protein was 40.3% in this study. The p53 protein significantly correlated with nuclear grade as well as PCNA expression (p < 0.001 and p < 0.01, respectively). Although there was a wide scatter of 2cDI and 5cER values between p53 positive and negative RCCs, the RCC with positive p53 exhibited significantly higher values in 2cDI as well as 5cER, as compared to that with negative p53 (p < 0.02 and p < 0.005, respectively). However, some of the RCCs with negative p53 showed relatively higher values in 2cDI and 5cER. Using univariate analysis, the prognostic relevance was noted in T, N, M categories, age and p53 positivity, while it was not in 2cDI, 5cER and PCNA expression. Multivariate analysis demonstrated that N category and p53 positivity were independently significant indicators in predicting survival.

CONCLUSIONS

The presence of p53 protein might reflect the genetic instability already occurred. The p53 positivity reflecting a high cellular proliferation could afford an additional but useful information when predicting survival in patients with RCC.

Inverted papilloma of the urinary bladder: a case evaluated for malignant potential

We report a case of inverted papilloma in the urinary bladder with special reference to its malignant potential. A 77-year-old male patient complaining of microhaematuria was subjected to cystoscopic examination, which showed a non-papillary pedunculated tumour at the postero-lateral wall, and was treated with transurethral resection. The histological findings of the specimen were compatible with inverted papilloma of the urinary bladder, except for the presence of low grade dysplastic changes in the tumour nuclei. We revealed the malignant potential of this tumour, analyzing and evaluating nuclear DNA content, proliferating cell nuclear antigen (PCNA) as well as p53 expression.

Genomic heterogeneity in bladder cancer as detected by fluorescence in situ hybridization

OBJECTIVE

To investigate the relationship between genomic heterogeneity and tumour grade, stage and DNA content in 30 transitional cell carcinomas (TCCs) of the urinary bladder.

MATERIALS AND METHODS

Tissue specimens from 30 patients (25 men and five women) with newly diagnosed TCC of the urinary bladder were examined for genomic heterogeneity using fluorescence in situ hybridization (FISH) with chromosome-specific DNA probes; the copy number of pericentromeric sequences on chromosomes 7, 9 and 17 was detected within interphase nuclei in contact preparations from the tumour specimens.

RESULTS

The aneusomy of chromosomes 7, 9 and 17 was significantly higher in aneuploid than in diploid tumours (P < 0.001). Tumour grade and stage were strongly associated with aneusomy for chromosome 17 (P < 0.01, P < 0.001, respectively). The aneusomy of chromosomes 7 and 9 were significantly correlated with increasing tumour stage (P < 0.001), but not with tumour grade.

CONCLUSION

These results suggest that the measurement of aneusomy using FISH, especially for chromosome 17, in bladder cancer may offer a new objective and quantitative assay of the biological potential of individual tumours.

Immunohistochemical analysis of proliferating cell nuclear antigen, p53 protein and nm23 protein, and nuclear DNA content in transitional cell carcinoma of the bladder

BACKGROUND

Transitional cell carcinoma (TCC) of the bladder displays an unpredictable biologic behavior and the morphologic methods of grading tumor malignancy are often insufficient to predict the clinical outcome of patients with TCC of the bladder. Thus, the new indicator should reliably reflect prognosis. In this study, the authors determined the prognostic significance of proliferating cell nuclear antigen (PCNA), p53 protein, and nm23 protein, as well as nuclear DNA content in specimens with TCC of the bladder.

METHODS

Paraffin embedded materials taken from 77 patients with nonmetastatic untreated TCC of the bladder (classified as pTa-3b, NO, MO) treated with total cystectomy were employed in this study. PCNA expression, p53 protein and nm23 protein immunoreactivities, and the parameters for nuclear DNA content such as 2c deviation index (2cDI) and 5c exceeding rate (5cER) were evaluated using a computer-assisted image analyzer, and the results were compared with histologic findings and clinical outcome.

RESULTS

PCNA expression positively correlated with p53 protein and nm23 protein immunoreactivities, 2cDI value, and 5cER. In addition, histologic grade positively correlated with all of these five parameters. Similarly, pT category and disease progression positively correlated with all of the five parameters, except for nm23 protein immunoreactivity. In tumors with high genetic instability as judged by 2cDI and 5cER, both PCNA expression and p53 protein immunoreactivity were elevated, whereas nm23 protein immunoreactivity was not. However, the percent coefficient of variation in PCNA expression was smaller than that observed in p53 protein immunoreactivity in each group of genetic instabilities. In univariate analysis, prognostic potential was found with histologic grade, pT category, PCNA expression, p53 protein immunoreactivity, 2cDI value, and 5cER, but was not noted in nm23 protein immunoreactivity. Multivariate analysis indicated that quantity and intensity of PCNA expression (chi 2 = 8; P = 0.0047 for quantity and chi 2 = 8.71; P = 0.0032 for intensity) and 2cDI value (chi 2 = 5.52; P = 0.0019) were independent variables of histologic grade and pT category when predicting survival. However, p53 protein and nm23 protein immunoreactivities and 5cER were not of independent significance.

CONCLUSIONS

The tumor growth fraction as assessed by PCNA immunostaining is an independently significant predictor for survival of patients with TCC of the bladder.

Clinical study on estramustine binding protein (EMBP) in human prostate

To elucidate the characteristics of estramustine binding protein (EMBP) in human prostate, tissue EMBP concentration was examined in 42 benign prostatic hypertrophy (BPH), 34 untreated prostatic carcinoma (PC), 8 hormone refractory PC (hr-PC), as well as 13 control prostate human tissue samples by RIA using rat-EMBP antibody, and the concentration thus obtained was compared with dihydrotestosterone (DHT), prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), and zinc, indices exhibiting androgen dependency in the prostate. EMBP concentration correlated significantly with DHT and PSA levels in the control prostate and BPH, but not in untreated PC. In BPH, EMBP concentration increased significantly after administration of fluoxymesterone (4 mg/day for 2 weeks), whereas it decreased significantly after estramustine phosphate (280 mg/day for 2 weeks). The EMBP/DHT ratio in moderately and poorly differentiated, and the hr-PC was significantly higher than in controls, BPH, and well-differentiated PC. In addition, untreated PC with an EMBP/DHT ratio of more than 40 showed significantly lower progression-free probability as compared with PC with an EMBP/DHT of less than 40. These results suggest that (1) EMBP in BPH and well-differentiated PC preserves androgen dependency, but not in moderately and poorly differentiated, nor in hr-PCs, indicating that EMBP is a protein different from PAP and PSA, and (2) that the tissue EMBP/DHT ratio might be useful as a marker for predicting disease progression.

Bacillus Calmette-Guérin perfusion therapy for carcinoma in situ of the upper urinary tract

OBJECTIVE

To analyse the clinical and therapeutic consequences of bacillus Calmette-Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of the upper urinary tract.

PATIENTS AND METHODS

Eight pyelo-ureteric systems in five patients with cytologically confirmed CIS of the upper urinary tract were treated using perfusion of BCG through a percutaneous nephrostomy tube in five and a retrograde ureteric catheter in three. Follow-up cystoscopy, retrograde pyelography and selective urinary cytology were obtained 4 weeks after the last treatment and every 3 months thereafter.

RESULTS

In three patients (five pyelo-ureteric systems) the cytology remained negative for 10-46 months after the treatment was completed. The remaining two patients (three pyelo-ureteric systems) had persistently positive cytology. Of two patients who received BCG therapy through a ureteric catheter, one developed a ureteric stricture and the other developed renal tuberculosis.

CONCLUSIONS

Although long-term adaptation to a nephrostomy tube disturbs the quality of life of the patient, percutaneous perfusion therapy through a nephrostomy tube seems to be safer than retrograde perfusion through a ureteric catheter.

Immunohistochemistry of p53 protein in transitional-cell carcinoma of the bladder using an image analyzer

The p53 protein is known to be the product of the tumor suppressor gene p53. To elucidate the biological characteristics of p53 protein in transitional-cell carcinoma (TCC) of the bladder, the positive rate (PR) and positive intensity (PI) of p53 immunostaining in 72 TCCs of the bladder were quantified and compared with clinicopathological findings, prognosis and expression of proliferating-cell nuclear antigen (PCNA). The immunoreactivity for p53 and PCNA was evaluated using the CAS 200 Image Analyzer (Cell Analysis System, Elmhurst, Ill., USA). Intense immunoreactivity for p53 protein was observed not only near the basal cell layer but also at the invasive border. Both PR and PI of p53 were significantly correlated with histological grade (p < 0.05 and P < 0.02, respectively), histological stage (p < 0.02 and p < 0.02, respectively). Both PR and PI of p53 were significantly higher in patients who died of bladder cancer and in patients who developed metastatic progression. Using a univariate analysis, the survival was significantly short in subjects with high PR (> 40%) or high PI (> 70%) of p53 (p < 0.01 in both cases). However, using a multivariate analysis, the prognostic value of p53 immunoreactivity was not superior to histological stage. These findings suggested that, although p53 immunoreactivity appears to be related to proliferative activity in TCCs of the bladder, the prognostic relevance of p53 immunoreactivity was rather limited when evaluating the biological attitude of individual TCC of the bladder.

Immunohistochemical analysis of bcl-2 expression in transitional cell carcinoma of the bladder

AIMS

To evaluate the expression of bcl-2 in transitional cell carcinoma (TCC) of the bladder; to compare bcl-2 expression with clinicopathological findings, p53 immunoreactivity, proliferating cell nuclear antigen (PCNA) expression, 2c deviation index (2cDI), 5c exceeding rate (5cER), and the mean nuclear area (MNA).

METHODS

Cystectomy specimens from 77 patients with untreated, non-metastatic TCC of the bladder were studied. Expression of bcl-2, p53 and PCNA was detected immunohistochemically using the following monoclonal antibodies: bcl-2/124, DO-7 and PC10, respectively. Nuclear DNA content was analysed using static cytometry.

RESULTS

Bcl-2 was expressed in 19 (24.7%) of 77 TCCs and in 74 (96.1%) of 77 normal samples of transitional epithelium (taken from normal tissue adjacent to the tumour in each case). In all cases, bcl-2 immunoreactivity was more intense in normal transitional epithelium than in TCC. In normal transitional epitehlium and superficial TCC bcl-2 immunoreactivity was observed at the basal layer, and not at the invasive front. Bcl-2 immunoreactivity was invesely correlated with histological grade and p53 immunoreactivity, and was not correlated with the pT category, disease progression, PCNA expression, 2cDI, 5cER, and the MNA. No significant correlation was found between bcl-2 expression and overall survival.

CONCLUSIONS

Bcl-2 expression in TCC of the bladder seems to be associated with a less aggressive phenotype and does not play an important role in tumour progression.

Intravesical instillation of epirubicin: effect on tumour recurrence in patients with dysplastic epithelium after transurethral resection of superficial bladder tumour

OBJECTIVE

To evaluate whether the intravesical instillation of epirubicin is effective in preventing the recurrence of tumour in the bladder where dysplastic mucosa remains after transurethral resection of tumour.

PATIENTS AND METHODS

Biopsy specimens were taken from apparently normal areas of the bladder mucosa in patients undergoing transurethral resection of the primary tumours. Of the 75 evaluable patients, 18 (24%) had abnormalities in at least one or more specimens. The patients were divided into two groups, 57 with normal and 18 with abnormal biopsy results. Intravesical chemotherapy with epirubicin (20 mg/40 mL saline) was randomized to patients in each group. Tumour recurrence rates were estimated and compared amongst the groups. Factors related to tumour recurrence were evaluated using univariate and multivariate analyses.

RESULTS

The risks of tumour recurrence and progression were evaluated in 18 patients with concomitant mucosal abnormalities. All 10 patients with abnormal biopsy results who were treated with epirubicin had recurrence of tumour within a mean interval of 9 months, whereas six of eight controls had recurrence within a mean of 10.9 months. While there was progression in grade in four of 10 patients with abnormal biopsy results and treated with epirubicin, none of the recurrent tumours in six control patients with mucosal abnormalities progressed in grade. The overall recurrence-free rate of the patients with mucosal abnormalities was higher in controls than in those receiving epirubicin, but the difference was not statistically significant. There were no significant differences in recurrence rate for those treated with epirubicin and controls in the 57 patients with normal biopsy results. Univariate analysis showed that the recurrence-free rates were significantly influenced by tumour multiplicity and the mucosal biopsy results (P < 0.001 and P = 0.02, respectively). In a Cox proportional-hazards model, tumour multiplicity alone had prognostic significance for tumour recurrence (P = 0.002).

CONCLUSIONS

The prophylactic intravesical instillation of epirubicin had no effect in preventing tumour recurrence and, conversely, it may promote tumour progression in bladders with dysplastic mucosal changes.

Preliminary results of concurrent methotrexate, cisplatin and radiation treatment for locally advanced urothelial cancers

Ten patients with invasive bladder cancer and one with locally advanced renal pelvic cancer were treated with concurrent methotrexate, cisplatin and radiotherapy. Methotrexate 30 mg/m2 was administered intravenously on the day of the initiation of radiotherapy and cisplatin 70 mg/m2 on the second day. The number of chemotherapy cycles delivered was 1 in 7 patients and 2 in 4. The median dose of radiation was 50 Gy. Of 11 patients, 7 (64%) achieved a partial response and 4 had no change in disease. The median duration of response was 16 months for patients with a partial response. Six patients with a partial response (55%) are alive for a median of 22.5 months and 2 of 4 with no change are alive for 4 and 15 months, respectively. Leukopenia less than 3000 cell/mm3 was observed in 4 (36%) and thrombocytopenia less than 100,000 cells/mm3 in 3 (27%). Local control could be achieved safely with concurrent methotrexate, cisplatin and radiation therapy in patients with locally advanced urothelial cancer who were unsuitable for surgery.

Limitations of ureteroscopy in diagnosis of invasive upper tract urothelial cancer

The efficacy of ureteroscopic evaluation of upper tract abnormalities was evaluated in 40 patients. Twenty-eight patients presented with a radiologic filling defect, 9 with a filling defect and hematuria and 3 individuals exhibited hematuria alone. Cold cup biopsies revealed transitional cell carcinoma in 7 of 9 patients with papillary tumors and in 2 of 3 with nonpapillary tumors. Four patients without ureteroscopic diagnosis of urothelial cancer were found to have invasive tumors on subsequent nephroureterectomy. Of 15 patients with upper tract urothelial cancer, 12 were treated with total nephroureterectomy. Three individuals with grade 1 neoplasms received conservative ureteroscopic ablative therapy. Ureteroscopy is effective when combined with biopsy in the diagnosis and treatment of papillary lesions, but exhibits a low sensitivity in patients with invasive lesions.

Relationship of genetic instability with immunoreactivities for p53 protein and proliferating cell nuclear antigen in transitional cell carcinoma of the bladder

OBJECTIVE

To elucidate the relationship between genetic instability and tumor development in transitional cell carcinoma (TCC) of the bladder.

METHODS

The genetic instability as assessed by 2c deviation index (2cDI) and 5c exceeding rate (5cER) was compared with immunoreactivities for p53 protein and proliferating cell nuclear antigen (PCNA) in specimens obtained from 65 patients with primary untreated TCCs.

RESULTS

Both p53 and PCNA immunoreactivities significantly correlated with histological grade as well as stage. The immunoreactivity of p53 significantly correlated with that of PCNA, while a dissociation of the positive correlation between p53 immunoreactivity and PCNA expression was noted in the TCCs with high 2cDI value (> or = 2.0) and/or high 5cER (> or = 10%). In addition, PCNA expression became higher as the genetic instability increased, however, the p53 immunoreactivity was not parallel with the change of genetic instability. Moreover, some TCCs with high genetic instability (2cDI > or = 2.0 and 5cER > or = 10%) showed concomitant expression of high PCNA and low p53 protein, whose clinical outcome was poor in general.

CONCLUSIONS

The inactivation of p53 may represent a rather early event in the development of TCC of the bladder. However, the proliferative activity in itself rather than the effect due to a specific alteration in p53 plays an important role in the development and progression in TCC of the bladder.

Immunohistochemical evaluation of proliferating cell nuclear antigen, prostate-specific antigen and alpha 1-antichymotrypsin in human prostate cancer

OBJECTIVE

To determine the relationship between growth fractions defined by proliferating cell nuclear antigen (PCNA), prostate-specific antigen (PSA) and alpha 1-antichymotrypsin (ACT) staining in prostate cancer.

MATERIALS AND METHODS

A total of 96 lesions, including 71 from prostate cancers and 25 from benign prostatic hyperplasia (BPH) were evaluated in microscopic sections of the prostatic tissues from 34 patients with prostate cancer. Immunohistochemical staining was performed with an avidin-biotin system using monoclonal anti-PCNA antibodies, polyclonal anti-PSA and anti-ACT antibodies.

RESULTS

There was a significant difference in the mean PCNA labelling index between tissue from prostate cancer (4.2 +/- 7.1) and BPH (0.5 +/- 1.1) (P = 0.002). The mean labelling index of PCNA tended to increase with increasing Gleason score. The proportion of cells positive for PSA was significantly higher in tissue from BPH than from prostate cancer (P = 0.005). While the proportion of cells immunostaining for ACT was significantly higher in tissue from BPH compared to that from prostate cancer (P = 0.02), there was no significant difference in the proportion of ACT-positive cells among prostate cancers of differing Gleason score. The mean labelling index of PCNA decreased significantly with the increase in the proportion of PSA-positive cells (P = 0.013). There was a significant relationship between the proportion of ACT- and PSA-positive cells (P = 0.001).

CONCLUSION

These results indicate a reciprocal relationship between cell growth and tumour differentiation in prostate cancer. Although the significance of ACT deserves further study, there was evidence for the complexing of PSA with ACT from the immunohistochemical studies.

Estramustine-binding protein to dihydrotestosterone ratio in human prostatic carcinoma: a new marker for predicting disease progression

OBJECTIVE

To elucidate the clinical significance of estramustine-binding protein (EMBP) in human prostatic carcinoma (PC) as an indicator for predicting disease progression.

PATIENTS AND METHODS

EMBP concentrations in prostate tissue samples taken from 35 patients with benign prostatic hyperplasia (BPH), 33 patients with prostatic carcinoma (PC) taken before treatment, and from nine patients with hormone-refractory PC (hr-PC) were measured by radioimmunoassay using an antibody raised against rat EMBP. The dihydrotestosterone (DHT), prostatic acid phosphatase (PAP), prostate-specific antigen (PSA) and zinc levels in the tissue were also measured.

RESULTS

The EMBP concentration in well differentiated PC (W-PC) samples was no higher than in samples of BPH tissue, whereas concentrations in moderately differentiated PC (M-PC) and poorly differentiated PC (P-PC) were significantly higher (P < 0.01 and P < 0.005, respectively); the highest levels were those in tissue from hr-PC (P < 0.001). Levels of PAP, PSA and zinc were significantly lower in tissue from PC than from BPH, while the differences in levels between W-PC, M-PC and P-PC were not significant. The EMBP to DHT ratio in the tissue increased significantly from W-PC through M-PC to P-PC and was greatest in hr-PC tissue. Conversely, the PAP:DHT, PSA:DHT and zinc:DHT ratios did not correlate with the progress of histological grade. In addition, the pre-treatment EMBP:DHT and zinc:DHT ratios in 14 patients who developed hr-PC within 3 years after the administration of estramustine phosphate were significantly higher when compared with the remaining 19 patients (P < 0.001 and P = 0.0184, respectively), whereas the PAP:DHT and PSA:DHT ratios showed no significant difference between the groups. Moreover, patients with a high EMBP:DHT ratio (> or = 82) had a low progression-free probability compared to those with a lower ratio.

CONCLUSION

The androgen-dependent property of EMBP tends to decline with the transformation of prostatic tissue into biologically more malignant disease. The tissue EMBP:DHT ratio before treatment may be a good indicator of the individual malignant potential of PCs.

Association of nm23 protein levels in human prostates with proliferating cell nuclear antigen expression at autopsy

OBJECTIVE

To investigate nm23-H1 gene expression in the human prostate.

METHODS

The nm23-H1 protein levels of normal prostatic tissues, latent cancers of the prostate and primary and metastatic sites of clinical prostate cancers from autopsied men were evaluated using immunohistochemical analysis. Cell proliferation in serial sections using proliferating cell nuclear antigen immunoreactivity was also estimated.

RESULTS

Intense nm23-H1 staining was observed in metastatic sites of clinical prostate cancers. The incidence of intense nm23-H1 staining cells in primary sites of clinical prostate cancers was significantly higher than that found in latent cancers and normal prostates (p < 0.01). The staining pattern of nm23-H1 was heterogeneous in latent cancers of the prostate. A significant relationship was observed between nm23-H1 staining and positive proliferating cell nuclear antigen staining (p < 0.01).

CONCLUSIONS

These results seem to indicate that the nm23-H1 gene expression is related to cell proliferation and tumor metastatic potential, and appear to show the existence of a biologically different population of cells within the latent cancer.

Comparison of ureteropelvic transitional cell carcinoma with bladder transitional cell carcinoma using an image analyzer

To elucidate whether a significant difference in malignant potential between ureteropelvic transitional cell carcinoma (TCC) and bladder TCC is present, the argyrophilic nucleolar organizer region (AgNOR), nuclear DNA content and mean nuclear area (MNA) were evaluated in 32 ureteropelvic TCCs and 60 bladder TCCs, and were also compared with histological grade and stage. The parameters used were the mean AgNOR count (C-AgNOR), the percentage of cells exhibiting more than 3 AgNOR dots within nuclei (P-AgNOR), 2c deviation index (2cDI), 5c exceeding rate (5cER) and MNA. No significant difference in these 5 parameters was found between ureteropelvic and bladder TCCs. In addition, within each histological grade of tumor, no significant difference in each parameter between ureteropelvic and bladder TCCs was noted. Similarly, within pTa or pT1 TCCs, there was no significant difference in the parameters between ureteropelvic and bladder TCCs. On the other hand, invasive TCCs (pT2 and higher), the C-AgNOR and P-AgNOR were significantly higher in ureteropelvic than in bladder TCC (p < 0.05), while no significant difference in 2cDI, 5cFR and MNA was noted. These findings suggest that: (i) as a whole, the difference in malignant potential between ureteropelvic and bladder TCCs appears to be less significant, and (ii) factors other than the malignant potential of a tumor might contribute to the unfavorable clinical outcome in patients with ureteropelvic TCC.

Biological characteristics of inverted papilloma of the urinary bladder

OBJECTIVES

To elucidate the biological characteristics of inverted papilloma (IP) of the bladder.

MATERIALS AND METHODS

The immunoreactivity of p53, nuclear DNA content (assessed by ploidy and 2c deviation index [2cDI]) and the expression of proliferating cell nuclear antigen (PCNA) in 17 IPs were evaluated using a computer-assisted image analyser and compared with those in 12 superficial transitional cell carcinomas (TCCs), 29 invasive TCCs and one inverted papillary TCC of the bladder.

RESULTS

Positive staining for p53 and PCNA and intense staining with Feulgen were observed predominantly in the basal layer of the bladder mucosa. All IPs and most superficial TCCs were diploid, while most invasive TCCs were aneuploid. Although the 2cDI and the immunoreactivities for PCNA and p53 were significantly lower in IPs than in invasive TCCs, there was no significant difference in these three variables between IPs and superficial TCCs. However, some IPs were more immunoreactive for p53 than were the superficial TCCs.

CONCLUSIONS

The distribution of cells with p53 and PCNA immunoreactivity, and with intense Feulgen staining, indicated that IP of the bladder might have high proliferative activity and that those IPs with a high immunoreactivity for p53 may be susceptible to malignant transformation.

Estramustine-binding protein in carcinoma and benign hyperplasia of the human prostate

For the purpose of elucidating whether the biological characteristics of estramustine-binding protein (EMBP) are different in benign prostatic hypertrophy (BPH) and prostatic carcinoma (PC) and also to determine the clinical value of EMBP in the tissue, the EMBP concentration in 19 patients with BPH and 26 with untreated PC was measured by means of radioimmunoassay (RIA) using an antibody raised against EMBP obtained from the rat ventral prostate and compared simultaneously with the dihydrotestosterone (DHT) level in the same tissue. The level of serum prostate-specific antigen (PSA) was also measured in these patients. The EMBP concentration was significantly correlated with the tissue DHT level in BPH and well-differentiated PC (r = 0.745, p < 0.0001), whereas it did not correlate in moderately and poorly differentiated PC (r = -0.159, p = 0.542). By comparing well-differentiated PC with moderately and poorly differentiated PC, the EMBP concentration was significantly lower in the former than in the latter two conditions (p < 0.005) in spite of the highest tissue DHT level in well-differentiated PC. The ratio of the EMBP concentration to the DHT level in moderately and poorly differentiated PC was significantly higher when compared with that observed in either BPH or well-differentiated PC (p < 0.005, respectively). However, the level of serum PSA did not reflect the histological differentiation of PC. These results suggest that: (i) the correlation of the EMBP concentration to the DHT level changed with the progression of the histological grade, and (ii) the ratio of the EMBP concentration to the DHT level in the tissue is clinically valuable in elucidating the biological potential of individual tumors.

Secondary plasmacytoma of the testis: report of a case

We report a case of secondary plasmacytoma of the testis. The patient previously had had plasmacytoma of the nasal cavity, and then recurrences occurred in the right ethmoid sinus, sphenoid sinus, nasopharynx and clavicle before testicular plasmacytoma has developed. This is the 49th case of testicular plasmacytoma reported in the world literature.

Evaluation of the argyrophilic nucleolar organizer region, nuclear DNA content and mean nuclear area in transitional cell carcinoma of bladder using a quantitative image analyzer

To search for reliable parameters that reflect the biological potential of bladder cancer, the argyrophilic nucleolar organizer region (AgNOR), nuclear DNA content and mean nuclear area (MNA) were studied in paraffin-embedded materials of 75 primary transitional cell carcinomas (TCCs) using a quantitative image analyzer, and were also compared with histological findings and prognosis. The AgNOR parameters studied were the mean AgNOR count (C-AgNOR) and the percentage of cells exhibiting more than 4 AgNOR dots within nuclei (P-AgNOR), whereas the DNA parameters were the 2c deviation index (2cDI) and 5c exceeding rate (5cER). These 5 parameters significantly correlated with the histological grade (p < 0.0001, respectively). Similarly, these 5 parameters correlated with the histological stage, but the correlation was higher in 2cDI and 5cER (p < 0.0001, respectively) in comparison with the AgNOR parameters and MNA. Using univariate analysis, the prognostic relevance was noted in all but P-AgNOR. The 5cER value could discriminate histological grade-II tumors in relation to prognosis, whereas the remaining parameters could not. In addition, the significant difference between noninvasive and invasive tumors was noted in 2cDI and 5cER (p < 0.05, respectively), but not in C-AgNOR, P-AgNOR and MNA. These results suggest that (i) 2cDI and 5cER exhibit superiority over the AgNOR parameters and MNA in predicting survival, and (ii) in histological grade-II tumors, evaluation of the 5cER value is most important when predicting survival as well as judging the necessity for further aggressive treatment in patients with TCCs of the bladder.

A mapping of histology and cell proliferation in human bladder cancer: an immunohistochemical study

Transitional cell carcinoma of the urinary bladder is a multifocal disease and the whole bladder mucosa is more or less involved in the neoplastic process. A mapping study of 5 cystectomy specimens was performed, and cell proliferation was evaluated immunohistochemically using anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody. A correlation between the pathological findings and the rates of PCNA-positive cells was observed in both the tumor and the surrounding mucosa in 4 of the 5 cases. The rates of PCNA-positive cells increased in areas with normal mucosa adjacent to those with dysplasia or transitional cell carcinoma, and in areas with normal mucosa or dysplasia adjacent to those with carcinoma in situ or transitional cell carcinoma in 2 cases. These features may indicate that a field change observed in the mapping study of a bladder with cancer is a manifestation of a stepwise progression of the mucosal disease.

Immunohistochemical analysis of nm23 protein in transitional cell carcinoma of the bladder

OBJECTIVES

To elucidate the clinical significance of the nm23 gene product in transitional cell carcinoma (TCC) of the bladder.

PATIENTS AND METHODS

The immunoreactivity of nm23 protein and proliferating cell nuclear antigen (PCNA) were evaluated in paraffin-embedded tumour samples obtained from 74 patients with TCC of the bladder who underwent total cystectomy between 1981 and 1993 and compared with the histological findings and clinical outcome.

RESULTS

The immunoreactivity of nm23 protein was positive near basement membrane in normal transitional epithelium and superficial TCCs; it could also be positive at the invasive front of TCCs. The immunoreactivity of nm23 protein in TCCs was significantly higher than that in normal transitional epithelium and correlated significantly with the expression of PCNA and with histological grade. Similarly, immunoreactivity was significantly higher in invasive TCCs than in superficial TCCs; however, there was no significant difference between superficial TCCs and normal transitional epithelium. Immunoreactivity of nm23 protein was not associated with the early development of metastasis after radical surgery or with a favorable clinical outcome.

CONCLUSION

Immunoreactivity of nm23 protein appeared to be associated with the proliferation and progression of TCC of the bladder. The potential role of nm23 as a suppressor of the metastatic activity of tumours was less prominent, partly because of mutations of nm23 in TCCs of the bladder.

Factors related to the outcome of M-VAC in 101 patients with advanced urothelial cancer

The objective of this study is to identify factors related to the results of intravenous methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) for 101 patients with advanced urothelial cancer. The effects of various factors on response and survival were evaluated using univariate and multivariate analyses. The factors included in the analyses were sex, age, performance status (PS), primary site, histological type, grade, T category, N category, M category, prior chemotherapy, prior radiotherapy, and dose of chemotherapeutic drugs. Univariate analysis revealed that M category and prior chemotherapy had a significant correlation with the response, and that factors significantly related to survival were PS, primary site, N category, M category, prior chemotherapy and prior radiotherapy. A multiple logistic regression model showed that N category, M category and prior chemotherapy were related to response. The response rates of patients with N1-4 or M1 or prior chemotherapy were lower than those with N0 or M0 or without prior chemotherapy. A Cox regression model demonstrated that PS and M category independently contributed to survival. Patients with high grade PS or distant metastases showed a lower survival rate than those with low grade PS or localized diseases. M category was the most important factor related to response and survival. These results seem to indicate the low effectiveness of M-VAC for distant metastases, and the inability of this regimen to improve the outcome of patients with advanced urothelial cancer.

Long-term results with M-VAC for advanced urothelial cancer: high relapse rate and low survival in patients with a complete response

OBJECTIVE

To describe the long-term results of treating patients with advanced urothelial cancer using a combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC).

PATIENTS AND METHODS

Fifty-one patients (37 men and 14 women, median age 66 years, range 41-82) with inoperable or metastatic carcinoma of the bladder, ureter or renal pelvis were treated with M-VAC and their responses evaluated for up to 7 years. Relative dose intensity (RDI) was calculated by dividing the actual dose intensity by the projected total dose intensity and related to outcome. Overall survival was assessed from the date of initiation of treatment with M-VAC, using the Kaplan-Meier method.

RESULTS

Of the 51 patients. 10 (20%) had a complete and 18 (35%) had a partial response, giving an overall response rate of 55% (95% CI, 41-68%). There was no significant difference in the median values of RDIs with response to the M-VAC regimen. The median duration of response was 11.9 months for the 10 patients with a complete response and of these, eight relapsed at a median of 10 months after treatment and died at a median of 8.5 months from the time of disease recurrence. Survival of patients with a complete response differed significantly from those with no response at 1 year after the start of treatment, but not subsequently.

CONCLUSION

Long-term follow-up revealed a high relapse rate and poor prognosis in patients with a complete response who received the M-VAC as induction therapy. Therefore, new adjunctive therapies are needed for patients with locally unresectable or metastatic urothelial cancer.

Absorption of nitrogen dioxide and nitric oxide by soda lime

Inhaled nitric oxide (NO) is used for the treatment of pulmonary hypertension as a selective pulmonary vasodilator. However, NO is oxidized rapidly to the more toxic nitrogen dioxide (NO2). Elimination of NO2 from inspired gas is essential for safe clinical use NO. We therefore investigated the efficacy of soda lime in absorbing NO2 from NO2-containing gases. Commercially available soda limes (Soda sorb and Wako lime-A), were exposed to the following six gas mixtures containing NO and NO2 in a hypoxic carrier gas for 20 min: No. 1: NO 40 ppm; No. 2: NO 35 ppm and NO2 5 ppm; No. 3: NO 30 ppm and NO2 10 ppm; No. 4: NO 20 ppm and NO2 20 ppm; No. 5: NO 10 ppm and NO2 30 ppm; and No. 6: NO2 40 ppm. Both types of soda lime completely absorbed the NO2 in all samples when it was present (Nos 2-6). NO concentration in these gas mixtures was reduced by an amount equal to the NO2 absorbed by soda lime. NO was absorbed minimally when NO2 was not present in the mixture. Nitrite was detected from the Wako lime-A granules exposed to the test gas by the chemical analysis. These findings suggest that soda lime completely absorbs NO2 by chemical neutralization, but NO is absorbed as simultaneously absorbed NO2 only where NO and NO2 coexist. Therefore, we conclude that soda lime is useful for NO2 absorption during NO inhalation therapy but NO monitoring from a point distal to the soda lime is required for precise control of inspired NO concentration.

[Acid phosphatase (ACP)]

The acid phosphatases are a group of enzymes capable of hydrolyzing esters of orthophosphoric acid in an acid medium. Acid phosphatase activity is widely distributed in human tissues and acid phosphatases represent a heterogeneous group of enzymes containing many isoenzymes, each specific for one type of tissue. The human prostate is particularly rich in this enzyme (PAP) and serum enzyme levels have been used as a tumor marker of prostate cancer. While PAP was markedly increased in patients with bone metastases of prostate cancer, it is unable to detect earlier stage tumors reliably. The sensitivity and specificity of serum acid phosphatases and PAP are low in diagnosing, staging and following patients with prostate cancer. Presently, prostate-specific antigen (PSA) is superior to PAP for diagnosis, screening, and monitoring prostate cancer. PAP may have an adjuvant value in the management of prostate cancer because a combination of PSA and PAP testing has revealed a high sensitivity and specificity in detecting prostate cancer.

Clinical value of argyrophilic organizer region in bladder transitional cell carcinoma

For the purpose of elucidating whether or not argyrophilic organizer regions (AgNORs) predict the biological behaviors of bladder tumors, the AgNOR was analyzed in 80 primary bladder transitional cell carcinomas (TCCs), using the computer-assisted image analyzer. The AgNOR parameters used were the mean AgNOR count (C-AgNOR) and the percentage of cells exhibiting more than 3 AgNOR dots or 4 AgNOR dots within nuclei (3P-AgNOR and 4P-AgNOR, respectively). The correlation of C-AgNOR with 3P-AgNOR and 4P-AgNOR reached a high statistical significance (p < 0.0001, respectively). All of these three AgNOR parameters correlated with histological grade, whereas the difference between grade I and II proved to be higher in 3P-AgNOR and in 4P-AgNOR (p < 0.01, respectively) as compared with that in C-AgNOR (p < 0.05). Similarly, these three parameters correlated with histological stage, whereas the statistical significance of the correlation was less prominent in C-AgNOR. Moreover, the prognostic relevance was noted in C-AgNOR (p = 0.041), whereas it was indicative in 3P-AgNOR as well as in 4P-AgNOR (p = 0.090 and p = 0.061, respectively). These results suggest that 3P-AgNOR and 4P-AgNOR reflect the difference in the proliferative activity of individual TCCs more precisely than C-AgNOR. Since the biological behaviors of individual TCCs cannot be predicted by the proliferative activity alone, the AgNOR in TCCs has a rather limited value regarding the prediction of survival.

Neoadjuvant chemotherapy for locally advanced urothelial cancer of the upper urinary tract

Cisplatin-based multiple-drug chemotherapy is currently considered the most effective treatment for advanced and metastatic urothelial cancers. We treated 15 patients with locally advanced urothelial cancers of the upper urinary tract using the cisplatin-based multiple-drug regimen in a neoadjuvant setting. The regimens administered were: M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin); MEC (methotrexate, etoposide and cisplatin), or M-VEC (methotrexate, vinblastine, epirubicin and cisplatin). Total nephroureterectomy was performed in all patients and response was evaluated pathologically Of 15 patients 2 (13%) achieved a pathological complete response, 6 (40%) a pathological partial response, for an overall response rate of 53% (95% confidence limits 29-77%). The median durations of response were 54 months for patients with a pathological complete response and 15.5 months for patients with a pathological partial response. One of six patients with a pathological partial response and 4 of 7 with no remission died of cancer. While a positive relationship between the pathological response and prognosis was observed, adequate follow-up is needed to assess the ability of neoadjuvant chemotherapy to improve the prognosis of patients with locally advanced urothelial cancer of the upper urinary tract.

Study of estramustine binding protein: its relationship to androgen dependency and histological differentiation in human prostatic carcinoma tissue

For the purpose of elucidating the clinical significance of estramustine binding protein (EMBP), EMBP concentration in human prostatic carcinoma (PC) tissue was measured by radioimmunoassay (RIA) using an antibody raised against rat EMBP and was compared with dihydrotestosterone (DHT) level and histological differentiation in the same tissue. The mean concentrations of EMBP in 20 untreated and 6 hormonally refractory PC were 112.6 +/- 120.7 and 218.0 +/- 102.3 ng/g tissue, respectively. In the 20 untreated PC, the EMBP concentration was not significantly different between the high and low tissue DHT groups. On the other hand, the EMBP concentration was significantly higher in moderately and poorly differentiated PCs as compared with well-differentiated PC, whereas the DHT level was highest in well-differentiated and lowest in poorly differentiated PC. Furthermore, in the 6 hormonally refractory PC, the EMBP concentration was higher in spite of a lower tissue DHT level in comparison with untreated PC. These results suggest that the EMBP concentration does not reflect androgen status in PC tissue but might reflect the malignant potential of the tumor.

[M-VAC therapy in a patient with ureteral carcinoma accompanied by chronic renal failure]

A 63-year-old man with recurrence of ureteral cancer accompanied by chronic renal failure was given M-VAC therapy. Twenty mg of methotrexate was infused on the first day, and 30 mg of cisplatin was infused for one hour at two hours before dialysis on the second day. The total-CDDP level declined in two exponential curves. The half-life of the first phase was 75 minutes and that of the second phase was very long. The free-CDDP level was decreased rapidly and near the level for quantitative analysis after dialysis. Three mg of CDDP was eliminated by dialysis. Seventy-two hours after administration, the MTX level was 0.27 microM, which was at the high-risk level of high-dose therapy. In conclusion, it is considered that CDDP and MTX can be given to a patient with chronic renal failure. However, it is necessary to determine the MTX serum level, even after very low dosages, and to adjust the leucovorin rescue therapy accordingly.

Beta adrenergic receptor inhibitory factor in serum of patients with nasal allergy

Sera obtained from patients with perennial mite nasal allergy and Japanese cedar pollinosis were examined to identify "beta receptor inhibitory factor". This was done by evaluating the inhibition of 3H-dihydroalprenolol binding to guinea pig cerebral membrane. beta receptor binding was inhibited by preincubation with sera from 8 of 44 (18.1%) perennial allergy patients, whereas sera from 2 of 41 (4.9%) controls showed this inhibition. Sera from 6 of 41 pollenosis patients (14.6%) showed this inhibitory effect in the pollen season but not in other seasons. Serum from one such patient (2.4%) demonstrated this effect both in and out of the pollen season. Sera from 2 pollenosis patients inhibited the beta receptor function not in the pollen season, but in the off season. This inhibitory effect was eliminated by immunodepletion from the positive-inhibition serum. These findings identified circulating beta receptor inhibitory factor in a limited population of patients with nasal allergy indicating the possible pathogenetic role of this factor in the disturbance of the sympathetic nerve function. This beta receptor inhibitory effect may correspond to the anti beta receptor autoantibody which Venter postulated in 1980.

Vesicourethral function after surgery for uterine cancer: predictive value of postoperative maximum urethral closure pressure on residual urine

Using a urodynamic technique, vesicourethral function was evaluated in 30 patients who had undergone surgery for uterine cancer. In all 28 patients treated with radical hysterectomy, detrusor function was damaged irrespective of the use of the Cavitron ultrasonic surgical aspirator (CUSA), whereas, in 2 patients treated with semiradical hysterectomy, the function was preserved. Vesicourethral functions 3 weeks after the operation in all 28 patients treated with radical hysterectomy showed underactive detrusor function with low compliance. In 10 out of these 28 patients, postoperative maximum urethral closure pressure (MUCP) did not decrease, without relation to the use of CUSA nor to the presence of detrusor sphincter dyssynergia, and more than 5 weeks were required to reduce residual urine to less than 50 ml. On the other hand, in the remaining 18 patients, postoperative MUCP decreased, and residual urine decreased to less than 50 ml by 5 weeks after the operation. From the results obtained here, we can conclude that the evaluation of MUCP at an early phase after the operation is a useful tool to predict complications caused by residual urine, such as urinary tract infection, irreversible alteration of detrusor function or deterioration in renal function.

[Short-term incubation study on inhibitory effect of chemohyperthermia against hormone-independent human prostatic carcinoma cell line (PC-3)]

The sensitivity of a hormone-independent human prostatic carcinoma cell line (PC-3) to chemohyperthermia was evaluated in vitro. The anticancer drugs used here were vincristine sulfate (VCR), peplomycin sulfate (PLM) and cis-diamminedichloroplatinum (CDDP). To evaluate cytotoxicity in short-term treatment, an inhibitory test on cell survival was more useful than a test on cell proliferation. With the inhibitory test on cell survival, the relationship of the administration method was examined to obtain better cell cytotoxicity, i.e., the cells were exposed to 1) the drug and heat at 43 degrees C simultaneously, 2) the drug followed by heat, or 3) heat followed by the drug. The combined treatment with drug and heat simultaneously produced more pronounced cytotoxicity than the treatment with heat followed by drug administration. The combined effect did not result from exposure to the drug followed by heat. Of the three drugs, the action of VCR and CDDP was potentiated with heat, but PLM was not.

Organisms in the prostate and antibiotics in the treatment of postoperative infections

On 24 benign prostatic hyperplasia patients with preoperatively sterile urine, who also had no history of urinary tract infection, the organisms in the prostate obtained through transurethral resection as well as in the anterior urethra were isolated. In 17 patients out of 24, organisms obtained in the prostate were identical to those in the anterior urethra; therefore, it can be concluded that another 7 patients had organisms in the prostate itself before the operation. These results would suggest that sterile urine did not indicate sterile prostate and that organisms in the prostate did not always ascend from the urethra. In the patients who preoperatively received transurethral catheterizations, Streptococcus faecalis was the most predominantly isolated organism in the prostate, which was highly sensitive to ABPC and minocycline and lower to cephems. On the other hand, in the patients with no history of catheterizations, Staphylococcus epidermidis was the most commonly isolated one, which was highly sensitive to ABPC and minocycline as well as cephems. So, in the treatment of the cases with infectious symptoms after transurethral resection of the prostate, ABPC or minocycline should be selected as first-choice drugs rather than cephems.

A fact database for toxicological data at the National Institute of Hygienic Sciences, Japan

The computerized fact database for the toxicity data of chemicals was constructed at the National Institute of Hygienic Sciences, Tokyo, Japan (biological database, BL-DB). The BL-DB stores data on mutagenicity, teratogenicity, carcinogenicity, and other toxicological tests of chemicals that appeared in the scientific literature. The BL-DB includes information about chemical identification, test system, results of the assays, and a bibliography. The system consists of five modules: data collection, data maintenance, data search, data downloading, and backup. ADABAS is used as a core database management system. Many kinds of test data are stored with the same formats; therefore, users can retrieve data of different toxicological data by the same manner. A user of the BL-DB can use about 50 kinds of commands to interact with the system, and the majority of fields are defined as search fields, thereby facilitating retrieval of target data through many ways. Currently, there are mainly data for the mutagenicity, especially on the Salmonella/microsome assay and the rodent micronucleus assay. These data can be retrieved and used for structure-activity relationship studies.

Unstable chromosome aberrations in bladder and renal cell carcinoma

Structural chromosome aberrations were investigated in 18 bladder carcinoma and 14 renal cell carcinoma patients. Unstable chromosome aberrations, such as breaks, gaps, minutes, and fragments, appeared in varying proportion. Double minutes (dmin) were also observed. In bladder carcinoma, 10 kinds of aberration were observed in 38.8% of the metaphase analyzed, and, in renal cell carcinoma, 7 kinds of aberrations were observed in 15.0%. The frequency of chromosome aberrations observed, and the occurrence of dmin and of aneuploidy, were correlated positively with histopathological grade and stage. From the results obtained here, we conclude that study of chromosome aberrations should be added as one of investigations for evaluating the malignant potential of the tumors.

Immunoreactive protein to rat estramustine binding protein in human seminal plasma: its relationship to prostatic acid phosphatase and zinc

Immunoreactive estramustine binding protein in human seminal plasma obtained from 34 infertile men was measured by means of radioimmunoassay (RIA) using the antibody raised against EMBP obtained from ventral prostate of rat. The mean concentration of IR-EMBP in human seminal plasma measured by this RIA was 1.092 ng/ml, ranging 258 to 1.859 ng/ml. Both concentrations of prostatic acid phosphatase and zinc in human seminal plasma concurrently measured were statistically significantly negatively correlated with that of IR-EMBP. These results here obtained might reveal that IR-EMBP in human seminal plasma signify androgen status in low possibility.

Relationship of thyroid to estramustine binding protein (EMBP) concentration in rat prostate

Alternations of estramustine binding protein (EMBP) concentration in rat prostate in relation to androgen status under hypo- and hyperthyroid conditions was estimated by means of radioimmunoassay (RIA). In hyperthyroid rats, EMBP concentration in dorsal as well as in lateral prostate was not significantly changed, but significantly reduced in ventral prostate (P less than 0.01). Ventral tissue concentration of testosterone(T) + dihydrotestosterone (DHT), DHT and T, and the ventral tissue ratio of DHT to T + DHT were not significantly changed in hypo- and hyper-thyroid conditions compared with that of the control. In hyperthyroid rats, serum T level and EMBP concentration in ventral prostate were significantly reduced in comparison to ones of the control (P less than 0.05 and P less than 0.01, respectively), however, the ratio of ventral tissue (T + DHT) to serum T was significantly increased (P less than 0.05). Moreover, in contrast to the control, EMBP concentration expressed as microgram/microgram ventral DNA was significantly reduced in hyperthyroid rats (P less than 0.05). On the other hand, in hypothyroid rats, change of EMBP concentration in ventral prostate in relation to androgen status was not significant in comparison to the control. The results here obtained revealed that EMBP concentration in ventral prostate under hyperthyroid condition would be affected by (a) a modulation of endogenous androgen-dependency in EMBP synthesis or by (b) a reduction of cell numbers responsible for EMBP synthesis.

Flow cytometric DNA analysis of stage D2 prostatic carcinoma

Flow cytometric DNA analysis was performed on 34 samples of prostatic carcinoma patients with stage D2 disease to study the relationship between DNA ploidy pattern, Gleason sum score, and prognosis. Nuclei were extracted from paraffin-embedded needle biopsy specimens. The DNA ploidy pattern was diploid in 53% of the tumors, tetraploid in 38%, and aneuploid in 9%. A significant correlation between DNA ploidy pattern, Gleason sum score, and prognosis was not proved. It was considered that DNA ploidy pattern and Gleason sum score of limited primary lesion did not allow a prognosis of the patients with stage D2 prostatic carcinoma to be made.

Estramustine binding protein in human benign prostatic hypertrophy

Using a highly sensitive radioimmunoassay (RIA) of estramustine binding protein (EMBP) with the antibody raised against rat-EMBP, the concentration of EMBP in human benign prostatic hypertrophy (BPH) tissue was evaluated. Using mechanical separation procedure, EMBP was found significantly higher in the epithelium (10.7 ng/mg protein) than in the stroma (2.9 ng/mg protein). When human BPH was classified into glandular, fibromuscular and mixed type, the concentration of EMBP was the highest in glandular type (15.7 ng/mg protein) and the lowest in fibromuscular type (10.8 ng/mg protein).

Bilaterally dilated upper urinary tract and bladder induced by diabetes insipidus

A case of hypothalamic diabetes insipidus accompanied by nonobstructive dilatation of the bladder and upper urinary tract is reported. Treatment with dDAVP resulted in decrease of the urine volume and improvement of dilatation of the urinary tract.

Effects of prazosin HCl on the urethral pressure profile in patients with benign prostatic hyperplasia

The effects of prazosin HCl on the urethral pressure profile (UPP) were studied in 14 patients with benign prostatic hyperplasia. Urethral pressure profilometry was performed 1 h after oral administration of 1 or 2 mg prazosin HCl. Functional profile and continence zone lengths were significantly reduced following administration of 1 or 2 mg prazosin HCl, as compared with the pretreatment lengths. The administration of 2 mg prazosin HCl resulted in a significant decrease in prostatic peak pressure, whereas the maximum urethral closure pressure exhibited an insignificant decrease. The results suggest that the effects of prazosin HCl on UPP were dose dependent within the range from 1 to 2 mg.