Ken Izumiya

Modulation of the urethral pressure by high-frequency block stimulus in dogs

Nerve conduction block by high-frequency stimulus has been used as a method to modulate the contractile force of skeletal muscles. This paper describes the effect of block stimulus on the modulation of urethral closure pressure in dogs. Tetanic stimulus was applied through a pair of electrodes wrapped about the bilateral pudendal nerves and high-frequency stimulus was superimposed through another pair of electrodes wrapped about 1 cm distalward along the nerves. Urethral closure pressure was measured through a transurethral UPP catheter. High-frequency stimulus over 300 Hz reduced elevated urethral closure pressure, which was induced by tetanic stimulus, up to 30-45%.

Successful hyperbaric oxygenation for radiation cystitis due to excessive irradiation to uterus cancer.

Six female patients with radiation cystitis, induced by previous pelvic radiation to uterus cancer, were treated with hyperbaric oxygenation (30-35% of oxygen concentration at 2 atmospheric absolute pressures for 90-120 min daily from 20 to 61 days with the average of 45 +/- 7 days, mean +/- standard error). Except in 1 patient symptoms and cystoscopic findings were improved. No side effects were found. Recurrence of radiation cystitis never occurred during the follow-up period (1.0 +/- 0.1 years). Hyperbaric oxygenation treatment in this pressure environment appears to have a beneficial effect of this disorder.

Hormone Profiles and Contralateral Testicular Histology in Down's Syndrome with Unilateral Testicular Tumor

Hormonal profiles and testicular histology were studied in two patients with Downs syndrome with unilateral testicular tumor. Plasma levels of LH and FSH were elevated above normal ranges in both cases. In case 1, plasma testosterone level was abnormally low, but prolactin level in plasma was within the normal range. Case 2 showed elevated concentration of plasma prolactin and normal level of plasma testosterone. The administration of LH-RH resulted in low response of plasma gonadotropins. The response of plasma testosterone to the administration of HCG was abnormally suppressed in both cases. Testicular histology showed reduction of Johnsen score count and tubular diameter, and an increase in wall thickness. These results indicated that male patients with Downs syndrome have an abnormality in hypothalamo-pituitary-gonadal axis.

Pericentric inversion of chromosome 9 associated with Sertoli-cell-only tubule.

We report a case of pericentric inversion of chromosome 9 associated with Sertoli-cell-only tubule. The literature is reviewed, and the hormonal profile and testicular histology are discussed.

Inhibitors of Collagen Synthesis and Hypophysectomy: Effects on Androgen Induced Growth of Ventral Prostate in Rats

To elucidate the effect of decreased amounts of collagen on prostatic growth, beta-aminopropionitrile, one of the agents that selectively inhibit collagen formation, was administered, with or without exogenous androgen and/or hypophysectomy, to rats of varying ages. The weight of the ventral prostate and the collagen content and the ratio of type III to type I collagen in the ventral prostate were examined. Administration of beta-aminopropionitrile, with or without exogenous androgen, reduced the collagen content in the ventral prostate in any age groups, but increased the weight of the ventral prostate only in young rats. Administration of beta-aminopropionitrile to hypophysectomized rats did not change the weight and collagen content. Administration of beta-aminopropionitrile prevented androgen-induced growth of prostatic collagen, resulting in increased prostatic weight in young rat. The ratio of type III to type I collagen in the rat ventral prostate remained unchanged by administration of beta-aminopropionitrile, exogenous androgen, hypophysectomy, or advancing age. It would appear that in young rats prostatic collagen plays an important role in suppressing prostatic growth. The ratio of type III to type I collagen is stable under various experimental conditions in the ventral prostate.

Changes in serum levels of prostatic acid phosphatase and prostate specific antigen after luteinizing hormone-releasing hormone analogue administration in patients with metastatic prostatic cancer in relation to glandular differentiation

Eighteen previously untreated patients with metastatic carcinoma of the prostate were treated with LHRH analogue. They were divided into 3 groups according to the degree of glandular differentiation. In all groups, a transient rise of PAP and PSA was observed after the LH and testosterone surge. However, relative values of LH, testosterone, PAP and PSA did not differ significantly among the 3 groups. These facts suggest that a transient rise of PAP and PSA is caused by testosterone surge independently from the degree of glandular differentiation after LHRH analogue administration in patients with advanced prostatic cancer.

Cytomegalovirus-associated hepatitis and duodenal ulcer in kidney allograft recipients

We report here on two patients with kidney allografts who had hepatitis and duodenal ulcer caused by cytomegalovirus. In one case, hepatosplenomegaly and jaundice appeared after high fever lasting for ten days. Laboratory examinations showed liver dysfunction and lymphocytosis with atypical forms. Virological studies revealed cytomegalovirus infection and we successfully treated the patient with human interferon-β. In the other case, duodenal bleeding followed by interstitial pneumonia occurred at the 54th day after transplantation. Bleeding from the small duodenal ulcer did not stop in spite of conservative and endoscopic therapies, and gastrectomy was performed. Histologically many epithelial cells with intranuclear inclusions were found around the ulcer. Virological studies showed elevation of antibody titres to cytomegalovirus which was isolated from the urine and oropharyngeal secrete. After gastrectomy and treatment with ganciclovir, the general condition improved and graft function was maintained. Our experience with these cases suggests that aggressive diagnostic investigations for cytomegalovirus infection are essential in patients with organ allografts who present liver and gastrointestinal lesions.

Membranous Lipodystrophy (Nasu’s Disease): A Rare Cause of Neuropathic Urinary Incontinence

A 37-year-old man with membranous lipodystrophy (Nasus disease) was urodynamically studied, to elucidate his urinary incontinence. Although medication failed to improve this unfavorable condition, urodynamic assessment of this patient clearly demonstrated the existence of an uninhibited overactive bladder.

An azoospermic male with reciprocal translocation t(3;4)(p12;q21)

We report a case of autosomal translocation associated with azoospermia. The literature is reviewed, and hormone condition and testicular histology are discussed.

Terodiline in the Treatment of Nocturnal Enuresis in Children

The effect of terodiline was investigated in 17 children with nocturnal enuresis. Twelve of them were evaluated urodynamically before treatment and 6 of these were proved to have detrusor instability with or without provocation. Terodiline in a daily dose of 12.5 mg was administered for 4 weeks. After treatment the number of wet nights per week has significantly decreased. Urodynamically, maximum cystometric capacity has statistically increased and in 2 patients involuntary contraction has disappeared. During these periods no serious side effects were encountered. Terodiline could improve urodynamic parameters in nocturnal enuresis. These changes appear to be favourable in clinical improvement.