Mizutani S

Analysis of the Arterial Blood Flow Patterns of Normal and Allografted Kidneys by the Directional Ultrasonic Doppler Technique

AbstractThe arterial blood flow of the allotransplanted kidney was examined 52 times in 40 recipients and that of the normal kidney 6 times in 6 donors by means of the directional ultrasonic Doppler technique.The blood flow patterns showed a rapid forward phase in systole and a slow forward phase in diastole but nothing indicative of a reverse flow was found. A significant correlation was observed between the acceleration time of flow component and graft function, while there were no correlations among diastole/systole ratio, appearance time and graft function. The arterial blood flow patterns of the grafts were classified into 3 groups based on acceleration time: I—excellent, II—intermediate and III—poor graft functions.Additionally, in pursuit of possible relationships between the ultrasonic Doppler flow patterns of the grafts and their morphological features, histopathology and angiography were done for 20 and 15 recipients, respectively. As a result the histologic vascular changes with interstitial da...

Testicular Responsiveness to Long-Term Administration of hCG and hMG in Patients with Hypogonadotrophic Hypogonadism

Steroidogenic responsiveness and amelioration of sperm number and motility following long-term intramuscular hCG and hMG administration were evaluated in 18 males with hypogonadotrophic hypogonadism (HH). The patients consisted of 13 patients with isolated gonadotrophin deficiency (IGD) and 5 patients hypophysectomized at an early or middle pubertal period. Basal serum levels of testosterone and 17 beta-estradiol were within prepubertal range in all patients before the treatment. Serum testosterone levels reached the normal adult male levels within 12-24 months of the treatment in only 2 of 7 younger patients and 1 of 6 older patients with IGD, whereas in all hypophysectomized patients serum levels of both testosterone and 17 beta-estradiol increased to the levels found in normal adult males within 6 months of the treatment. The mean peak levels of serum testosterone and 17 beta-estradiol, respectively, during the treatment were 2.1 +/- 0.8 (SD) ng/ml and 10.8 +/- 4.9 (SD) pg/ml in younger patients with IGD, 1.4 +/- 0.9 ng/ml and 9.7 +/- 5.1 pg/ml in older patients with IGD and 6.0 +/- 1.2 ng/ml and 34.2 +/- 14.8 pg/ml in hypophysectomized patients. Quantitative improvement in both sperm density and sperm motility were found in 4 of 7 younger patients, 1 of 6 older patients with IGD and all hypophysectomized patients, but only 3 of hypophysectomized patients (3 of 18 patients) could become fertile.

A Simple hCG Stimulation Test for Normal and Hypogonadal Males

A simple human chorionic gonadotropin (hCG) test to measure Leydig cell function is described. Plasma testosterone was measured on two occasions, once before intramuscular injection of 10,000 IU of hCG and again four days later. Preliminary tests in 10 adult males showed a maximal increase in plasma testosterone between the third and fifth day that was confirmed in a further 20 normal subjects when measured once on the fourth day. Except for 2 patients with hypospermatogenesis, 24 showed a good response and the mean increase was comparable with that in normal males. Nineteen patients with Klinefelters syndrome usually had lower basal levels and showed a poor response, with the exception of six patients in whom there were moderate but definite increases. Twelve patients with hypogonadotropic hypogonadism had basal testosterone concentrations below 1 ng/ml and eight responded poorly to hCG stimulation. However, four patients showed a moderate but definite response.

Short arm dicentric Y chromosome in a sterile man: a case report.

A short arm dicentric Y chromosome as the predominant cell line in a sterile man is reported. We studied a 33-year-old sterile man whose seminiferous tubules had only Sertoli cells. Chromosomal analysis, using G, Q and C-banding techniques, showed that the predominant cell line had a short arm dicentric Y chromosome. By the deoxyribonucleic acid probe pHY10, the lack of the gene corresponding to the Yq heterochromatic and distal Yq euchromatic region was detected. It is suggested that the gene controlling spermatogenesis is located on the distal euchromatic region on Yq.

Mixed Gonadal Dysgenesis: Case Reports and a Review of 65 Japanese Cases

Four cases of mixed gonadal dysgenesis encountered in our institute are described here, and 65 cases of mixed gonadal dysgenesis in the Japanese literature, including our cases, are reviewed. Of the four cases reported here, three had a chromosomal structure of 46,XY and one of 45,XO/46,XYq-. A chromosomal structure of 45,XO/46,XY accounts for 35% of all cases of mixed gonadal dysgenesis reported in the Japanese literature, 46,XY for 31%, and other types for 24%. Two of our cases (50%) also had a gonadal tumor. The overall incidence of gonadal tumor occurring after onset of puberty and reported in the Japanese literature is 17%.

Urinary retention secondary to ovarian dysgerminoma in a girl

A thirteen-year-old girl sought medical advice because of a markedly weakened urinary stream with severe hesitancy. She was referred to the pediatric clinic because of 3 episodes of acute urinary retention during a previous month. Pelvic examination showed a retrovesical tumor. An excretory urogram revealed bilateral ureterectasis and pyelocalicectasis. Two weeks after left nephrostomy, surgical exploration demonstrated a right ovarian mass causing compression of the left ureter and obstruction of the bladder neck. Excision of the tumor was performed without difficulty, following which the patient resumed normal voiding. The resected tumor weighed 815 Gm and pathologic examination showed dysgerminoma. Postoperatively the following two and one half years were uneventful.

Virilizing adrenal adenoma

Summary o 1. A case of pure virilization caused by an adrenocortical adenoma in a nineteen year old woman is presented. 2. Urinary output of 17-ketosteroids and plasma testosterone concentration increased after dexamethasone suppression and decreased after adrenocorticotropin stimulation. 3. After surgical intervention, urinary 17-ketosteroid values and plasma testosterone concentration fell to normal levels. Four months after surgery she experienced menstrual bleeding. Five months postoperatively, the voice pitch remains deep, but she finds it necessary to shave only every two weeks.

Clinicopathological Study on Upper Urinary Tract Tumors and Associated Bladder Tumors

We reviewed 82 patients with 83 upper urinary tract tumors and investigated those who had associated bladder tumors. Of these patients, 7 (9%) had previous bladder tumors, 14 (17%) had concurrent bladder tumors, and 18 (22%) subsequently developed bladder tumors. As 1 patient subsequently developed a bladder and a upper urinary tract tumor at different times, 38 patients (46%) had associated bladder tumors. The time interval between the occurrence of a previous bladder tumor and the subsequent upper urinary tract tumor was 11 to 144 months (mean: 41 months), while that between an upper urinary tract tumor and the subsequent bladder tumor was 3-31 months (mean: 12 months). Most of the previous bladder tumors were papillary, multiple, and noninvasive (pT1 or less). Multiple upper urinary tract tumors were associated with a high incidence of concurrent bladder tumors, while high-grade (G2, G3) or invasive (pT2 or more) upper urinary tract tumors were associated with a high incidence of concurrent and subsequent bladder tumors. Patients with concurrent bladder tumors had a worse prognosis than those with previous or subsequent bladder tumors due to the increased incidence of high-stage tumors at either the upper tract or bladder site. Our findings suggest that tumor cell implantation is a possible mechanism for the recurrence of bladder tumors and upper urinary tract tumors.

Father-son testicular cancer.

Testicular tumors in closely related family members are rare. We report a case of familial testicular cancer occurring in father-son pairs. The father had teratocarcinoma and his son developed pure seminoma. The association of a genetic factor in the etiology of testicular malignancy is discussed.

Excretion Patterns of Urinary 17-KS and 17-OHCS in Patients with Cushing’s Syndrome

By elution chromatography using ion exchange resin, Amberlite IRC-50, the urinary 17-KS and 17-OHCS were fractionated in 16 adult patients with Cushing’s syndrome, and were compared to those in 17 normal subjects. It was shown in all patients with Cushing’s syndrome that ratios of 5β-H-steroids to 5α-H-steroids, that is, THF to allo-THF and etiocholanolone to androsterone, were above the normal range, in company with increased excretion of total 17-OHCS. Differences of excretion patterns among the three types of Cushing’s syndrome were as follows. In a case of adrenal carcinoma, the highest and markedly elevated amounts of THS, DHA, 17-OHCS and 17-KS were excreted. In 8 of 9 patients with adenoma, ratios of etiocholanolone + androsterone to 11-oxy-17-KS were below the lower limit found in 6 patients with hyperplasia, while the ratios were below the normal range in all patients with adenoma.