Hidenori Sumiya

Histochemical examination of expression of ras p21 protein and R 1881-binding protein in human prostatic cancers.

Expression of ras p21 was examined with monoclonal antibody RASK-3 in normal, benign hyperplasic, and cancerous prostates. In patients with stage D2 disease who received endocrine therapy, the relation between ras p21 expression, response to therapy, and prognosis was studied. In these patients, R 1881-binding protein (androgen receptor and progestin-binding protein) was also examined. Non-cancerous cells and most cancer cells from stage A patients did not express ras p21, while expression increased with both higher staging and grading. Staging pelvic lymphadenectomy was done in some stage A2-C cases, and presence of nodal metastasis was correlated with ras p21 expressions in the primary tumours. In stage D2, there was no correlation between ras p21 expression and R 1881-binding protein. Response to therapy and survival did not correlate with expression of ras p21, but was influenced by presence of R 1881-binding protein.

Treatment of hemospermia caused by dilated seminal vesicles by direct drug injection guided by ultrasonography.

Bilateral seminal vesicle puncture and injection of drugs with ultrasound guidance were performed in patients with hemospermia resistant to conservative therapy and with dilated seminal vesicles. Of 7 patients 6 had resolution of hemospermia for 2 to 3 months and then relapse. No side effect was noted.

Nonobstructive Urinary Tract Dilatation in Nephrogenic Diabetes Insipidus

The follow-up study has been performed in 4 male patients with nephrogenic diabetes insipidus lasting for 4 to 15 years. Hydronephrosis or hydroureter appeared to be caused by polyuria with or without urinary tract obstruction. The efficacy of drainage operation is emphasized when polyuria surpasses the transporting ability of urine in the urinary tract.

A case of an infertile man with short-tailed spermatozoa

Summary. Ejaculated spermatozoa from an infertile patient were examined by scanning and transmission electron microscopy. All spermatozoa had abnormalities in the tail region. The abnormalities were divided into three types:

Androphilic protein studied histochemically in stage D2 prostatic cancer.

Androphilic protein in prostatic cancer was histochemically observed with dihydrotestosterone (DHT), R 1881, and mibolerone as ligands. Cancer cells were equally stained with fluorescent R 1881 and mibolerone, and this fluorescence seems to be made up of both the androgen receptor and progestin‐binding protein. The staining with fluorescent DHT was weak. Sixty‐two Stage D2 prostatic cancer patients were examined with histochemical androphilic protein, and they then received endocrine therapy. The presence of fluorescence of R 1881 was not correlated with grade, but a relationship between the presence of fluorescence and the response to endocrine therapy was noticed 6 months after the start of treatment. Moreover, fluorescence‐positive patients showed better survival than fluorescence‐negative patients. An examination with fluorescent DHT revealed a similar tendency to that of R 1881, but the frequency of positive fluorescence was lower, indicating that R 1881 is a suitable ligand in this type of study.

The Effect of Adrenal Surgery on Plasma Atrial Natriuretic Factor and Sodium Escape Phenomenon in Patients with Primary Aldosteronism

Plasma concentrations of atrial natriuretic factor and some vasoactive substances were determined in 8 patients with aldosterone-producing adenoma, 10 with idiopathic adrenal hyperplasia, 10 normotensive subjects and 12 patients with essential hypertension. Plasma atrial natriuretic factor concentration in patients with aldosterone-producing adenoma was the highest among the examined groups. Adrenal surgery reduced plasma concentrations of atrial natriuretic factor and aldosterone concomitant with the elevation in urinary sodium excretion, plasma renin activity and urinary sodium-to-potassium ratio. Withdrawal of trilostane (3 beta-hydroxysteroid dehydrogenase inhibitor) in patients with idiopathic adrenal hyperplasia increased plasma concentrations of atrial natriuretic factor and aldosterone, and decreased the urinary sodium-to-potassium ratio, plasma renin activity and urinary sodium excretion. However, reduced urinary sodium excretion following trilostane treatment returned to the control level successively despite the high levels of plasma atrial natriuretic factor and aldosterone. Acute infusion of saline remarkably increased plasma atrial natriuretic factor concentration in patients with idiopathic adrenal hyperplasia and aldosterone-producing adenoma. These results suggest that a high level of atrial natriuretic factor is a characteristic feature in patients with aldosterone-producing adenoma caused chiefly by the expansion of extracellular fluid volume, and circulating atrial natriuretic factor may contribute to regulation of the sodium escape phenomenon in patients with aldosterone-producing adenoma or idiopathic adrenal hyperplasia.

Histochemical study of R1881-binding protein, prostatic acid phosphatase, prostate-specific antigen, and r-seminoprotein in prostatic cancer.

A histochemical study on R1881-binding protein, prostatic acid phosphatase (PAP), prostate-specific antigen (PA) and r-seminoprotein was conducted. These parameters and histologic grades were compared to each other and with the responsiveness to endocrine therapy. A good correlation was found between histologic grade and presence or absence of R1881-binding protein in the tissue. Presence or absence of R1881-binding protein as well as histologic grade correlated well with responsiveness to endocrine therapy. Positive staining patterns of PAP, PA, and r-seminoprotein in the tissues were similar to each other, particularly between PA and r-seminoprotein. However, no correlation was found between the histologic grade and ratios of PAP, PA or r-seminoprotein-positive cells. Nor was any correlation seen between the ratio of these marker-positive cells and responsiveness to endocrine therapy.

Benign prostatic hypertrophy in a young male.

A 20-year-old male with complaints of dysuria and a sense of residual urine was diagnosed as having benign prostatic hypertrophy. He was treated by suprapubic prostatectomy. Benign prostatic hypertrophy in young men is very rare; this case seems to be the largest (380 g) among juvenile benign prostatic hypertrophy reported in the literature so far.

CHROMOSOME ABNORMALITIES AND RARE FRAGILE SITES DETECTED IN AZOOSPERMIA PATIENTS

SummaryWe have examined constitutional chromosome abnormalities and fragile sites in 40 patients with azoospermia. Chromosome abnormalities were found in four cases. Three cases showed a deletion of the long arm of the Y chromosome 46,X,del(Yq) and the other case had a ring of G group chromosome 46,XY,r(G). In a rare fragile sites test, four fragile site carriers were detected and three rare autosomal fragile sites were identified; fra(8)(q24.1), fra(11)(p15.1), and fra(17)(p12). The expression of these fragile sites were induced specifically by AT-specific DNA ligands, such as distamycin A and Hoechst 33258. In addition, one patient was found to be the case of double ascertainment of fragile sites, fra(8)(q24.1) and fra(17)(p12). The overall frequency of distamycin A-inducible fragile sites in azoospermia patients appeared to be higher than those reported for Japanese healthy subjects and cancer patients. However, no significant relation among fragile sites, clinical and histological findings has been detected so far.

Klinefelter's syndrome with prepenile scrotum

Two cases of Klinefelters syndrome with prepenile scrotum were presented. They underwent the operation for prepenile scrotum according to Glenn and Andersons method. Thereafter urethroplasty was performed in each case. The decrease in response to testosterone in the target organ was noticed in 1 patient, suggesting that some androgen resistance in this case was attributable in part to anomaly of genitalia.