Hiromi Nihira

Abnormalities of Renal Venous System and Unexplained Renal Hematuria

Since 1968, 152 patients with unexplained renal hematuria have been treated at our clinic. Renal angiography in 46 patients who did not respond to conservative therapy revealed 21 abnormalities of the vascular system. Of these 21 patients 10 had or were suspected to have renal pelvic and ureteral varices, and 8 had congenital anomalies of either the inferior vean cava or the renal vein. Therefore, it was confirmed that vascular abnormalities were associated with the unexplained renal hematuria in these cases. Since these congenital anomalies might easily induce congestion in the renal venous system they might be the predisposing condition of the renal hematuria. Epinephrine-assisted renal phlebography has been a useful technique to detect anomalies of the venous system.

Treatment of Post-Traumatic Priapism by Intracavernous Injection of Alpha-Stimulant

A 6-year-old boy was seen for post-traumatic priapism which had been present for 4 days. Intracavernous injection of metaraminol was performed to reduce the arterial blood inflow of the penis. Within 30 min after the injection, the penis became flaccid, and the prognosis was good. Recently it was reported that there are two different types of priapism. Type 1 priapism is due to blood stasis. This type is well known and characterized by extremely hard corpora and painful penis. Type 2 is caused by increased arterial blood flow of penis. It differs clinically from type 1 by a more elastic consistency of the penis and the absence of pain. Generally the prognosis of type 2 priapism is favorable. In our case, the penis was relatively elastic and not painful. It was considered to be type 2 priapism.

Treatment of Renal Cancer Patients by Transcatheter Embolization and its Effects on Lymphocyte Proliferative Responses

The effects of transcatheter embolization on lymphocyte proliferation in patients with renal cancer were investigated. Prognosis was good in 12 patients who underwent preoperative transcatheter embolization and 2 of 5 patients with distant metastases survived for 2 years or more. The remaining 9 patients underwent transcatheter embolization as a conservative procedure and 4 of 7 with distant metastases survived more than 1 year. Lymphocyte response to phytohemagglutinin before treatment in the presence of autologous or homologous serum was significantly lower in all patients than in healthy persons (p less than 0.01 and less than 0.05, respectively). The response after transcatheter embolization decreased slightly only in the presence of autologous serum for a short interval but recovered to the pre-treatment level 1 month after embolization. However, only in the presence of autologous serum was the response significantly higher at 2 months after nephrectomy than before treatment in patients who underwent preoperative transcatheter embolization (p less than 0.05). The serum inhibitory factor levels changed in inverse proportion to the post-treatment lymphocyte response. In patients who underwent preoperative transcatheter embolization the serum inhibitory factors essentially disappeared 2 months after nephrectomy.

ABO(H) Blood Group Antigens and Carcinoembryonic Antigens as Indicators of Malignant Potential in Patients with Transitional Cell Carcinoma of the Bladder

Immunoperoxidase methods were used to study ABO(H) blood group antigens and carcinoembryonic antigens in patients with transitional cell carcinoma of the bladder. In our study absence of blood group antigens in cancer tissues was not found to be correlated with histologic grade, stage and survival rate in patients with bladder carcinoma, while it was correlated with subsequent intravesical recurrences. In contrast, the presence of carcinoembryonic antigens in cancer tissues was correlated well with histologic grade, stage and survival rate. Our results suggest that immunoperoxidase detection of blood group antigens could not predict poor survival. In contrast, immunoperoxidase detection of carcinoembryonic antigens is of prognostic value in patients with transitional cell carcinoma of the bladder.

Androgen receptor in electroresected and cold punch-resected specimens Usefulness of Kaplan cold punch resectoscope

The measurement of androgen receptor and 5 alpha-dihydrotestosterone (DHT) levels in prostatic carcinoma may be of value in predicting responsiveness to anti-androgenic therapy. A sufficient amount of prostatic carcinoma tissue must be removed for measuring androgen receptor and DHT levels. We have studied the usefulness of Kaplan cold punch-resection compared with electroresection for obtaining tissue in 29 cases of enucleated benign prostatic hyperplasia. DHT level in electroresected specimens was similar to controls. However, following low, moderate, and high-power electroresection an average of total R1881 binding sites (Bmax) of electroresected specimens was reduced to 82.2, 71.9, and 52.1 per cent of corresponding controls, respectively. In contrast, the per cent decrease of Bmax of Kaplan cold punch-resected specimens was only 10 per cent of the control. From our data, Kaplan cold punch-resection of the prostate appears to be a useful tool for obtaining tissue suitable for measuring androgen receptor levels.

Immunohistochemical Localization of Testosterone-Estradiol-Binding Globulin in a Clinically Hormone-Independent Prostatic Carcinoma

The localization of the testosterone-estradiol-binding globulin (TeBG) in prostate, liver and metastatic lymph node cells of a patient with hormone-independent prostatic carcinoma was studied by the t

Absorption and excretion of carbenicillin indanyl sodium in patients with reduced kidney function.

On eight volunteers with reduced kidney function, 1 g of carbenicillin indanyl sodium was administered orally for the single dose studies and was given orally in a dose of 1 g every 6 h for 7 days for the multiple dose studies. The patients were divided into two groups according to their kidney functions: group I moderately impaired and group II severely impaired. In the single dose studies, the mean peak level was 12.6 microgram/ml for group I and 26.9 microgram/ml for group II. In the multiple dose studies, the drug tended to accumulate in group II, but the level obtained in group II did not exceed more than 300 microgram/ml. In the single dose studies, the mean peak level in the urine was 1,478.5 microgram/ml for group I and 350.0 microgram/ml for group II. In the multiple dose studies, despite the multiple dose regimen, the level obtained from group II patients only transiently exceeded more than that which will effectively inhibit the growth of Pseudomonas, Klebsiella and Enterobacter. In the single dose studies, the mean cumulative amount excreted in the urine within 24 h was 314.2 mg for group I and 120.1 mg for group II and the difference between both groups was significant (p less than 0.05). For the multiple dose studies, the amount was 278.0 mg for group I and 127.2 mg for group II, respectively. The total amount excreted in the urine within 24 h and the serum level obtained 6 h after ingestion of 1 g of carbenicillin indanyl sodium was correlated to the creatinine clearance and the rate of PSP excreted in the urine within the first 15 min of the test.

A Case of Bilateral Metastatic Renal Tumor Originating in a Cervical Carcinoma

A rare case of metastatic renal tumor originating in a cervical carcinoma in a 59-year-old Japanese woman is presented and the clinical and autopsy features discussed.

Complete Deficiency of Adenine Phosphoribosyl Transferase: Report of a New Family

We report a case of 2,8-dihydroxyadenine urinary lithiasis with complete deficiency of adenine phosphoribosyl transferase. Adenine phosphoribosyl transferase activities in the erythrocytes, lymphocytes and granulocytes of the patients family also were determined. The propositus and her younger brother were homozygotes for adenine phosphoribosyl transferase deficiency and her parents were heterozygotes. This is the third family with this disease to be reported.

Purification of Human Testosterone-Estradiol Binding Globulin (TeBG): A Specific RIA of Human TeBG

The immunological properties of human serum testosterone-estradiol binding globulin (TeBG) which was purified by affinity chromatography and hydroxyapatite column chromatography were investigated and a specific radioimmunoassay (RIA) for human TeBG was established. The purified TeBG here obtained was 86,000 in molecular weight and the antibody prepared against this TeBG slightly cross-reacted with human immunoglobulin G (IgG). The human TeBG labeled with 125I had a high binding activity to the antihuman TeBG antibody, and the sensitivity of the RIA thus obtained was enough to detect the TeBG in 2 μl of the serum.