T. Sawamura

EFFECTIVE HYPERBARIC OXYGENATION WITH PROSTAGLANDIN E1 FOR RADIATION CYSTITIS AND COLITIS AFTER PELVIC RADIOTHERAPY

Gross haematuria and severe bleeding from the large intestine occurred after pelvic radiotherapy in an 84-year-old woman with cancer of the uterus. Hyperbaric oxygenation treatment at 2 atmospheric absolute pressures for 60 minutes daily over 30 days and infusion of prostaglandin E1 abolished completely haematuria and tarry stool, and reversed the endoscopic findings of radiation cystitis and colitis.

Gonadal Function and Testicular Histology in Noonan's Syndrome with Bilateral Cryptorchidism

Testicular histology and gonadal function were studied in 2 patients with Noonans syndrome accompanied by bilateral cryptorchidism. Plasma FSH level was elevated above the normal range, but plasma levels of LH, prolactin, and testosterone were within normal ranges in both cases. The administration of LH-RH resulted in abnormally high response of plasma gonadotropins in both cases. The response of plasma testosterone to the administration of LH-RH was poor in case 2, but case 1 showed normal response. Testicular histology showed reduction of tubular diameter, Leydig cells per seminiferous tubules, and spermatogonia per tubule in both cases. The results indicate that bilateral cryptorchid patients with Noonans syndrome have an abnormality in the hypothalamo-pituitary-gonadal axis.

Long arm deletion of chromosome 10 in a boy with monorchidism.

We report on a boy with long-arm deletion of chromosome 10 and compare this case to 10 previously reported patients. He had right cryptorchidism and absence of the left testis, but the size of his penis was normal. Cytogenetic analysis of the case showed the deficiency of 10q26.1-26.3 and the presence of 10qter. Four of 10 previously reported patients had an intersex phenotype, and all others had combinations of cryptorchidism, micropenis and hypospadias. These facts indicate that the terminal of chromosome 10q is strongly associated with abnormal male development.

Serum Levels of Total and Free Testosterone in Men Undergoing Hemodialysis

Serum concentrations of total and free testosterone were measured in 102 hemodialysis male patients and 45 healthy men. In hemodialysis patients, serum levels of total and free testosterone were significantly reduced compared to the controls (p < .001). Neither serum total nor free testosterone correlated with age in the controls. In contrast, both total and free testosterone in serum negatively correlated with age in hemodialysis patients (p < .05-.001). It would appear that testicular dysfunction becomes more severe with increasing age in hemodialysis patients.

Chromosomal anomalies in cryptorchidism.

Chromosome analysis was performed in 160 patients with cryptorchidism. Chromosomal anomalies were found in 7 patients (4,4%). The incidence of chromosomal abnormalities was not significantly different between patients with bilateral or unilateral cryptorchidism. Of 7 patients, 1 had sex chromosomal aberration, 2 had marker chromosome and 4 had autosomal anomalies. Additional congenital anomalies were observed in 1 with sex chromosomal aberration, 2 with marker chromosome and 2 with autosomal anomaly. These facts indicate that we had better perform chromosome analysis in all patients with bilateral or unilateral cryptorchidism.

Successful Embolization of a Renal Artery Aneurysm with Preservation of Renal Blood Flow

A 76-year-old man with renal artery aneurysm was successfully treated by transcatheter embolization with complete preservation of renal blood flow. Embolization was performed with detachable platinum coils. Two months later, follow-up angiography showed completely packed aneurysm and preserved blood flow of the branch. It may be reasonable to consider that embolization of the aneurysm is the primary treatment modality for some of the patients with renal artery aneurysm.

Y-autosome translocation associated with azoospermia

Y-autosome translocation is a rare condition. We report here a case of balanced Y-autosome translocation associated with azoospermia. Nineteen cases of a balanced Y-autosome translocation associated with azoospermia are reviewed, and hormone condition and testicular histology are discussed.

Role of Dopamine in the Striatum, Renin-Angiotensin System and Renal Sympathetic Nerve on the Development of Two-Kidney, One-Clip Goldblatt Hypertension

PURPOSE The possible role of the striatum and renin-angiotensin (R-A) system for the development of two kidney-one clip (2K-1C) Goldblatt hypertension is examined. MATERIALS AND METHODS Monoamine contents of the striatum were determined by brain dialysis techniques, and plasma and kidney levels of the R-A system were measured by radioimmunoassay in sham-operated rats (experiment 1), 2K-1C hypertension (experiment 2), left renal denervation only (experiment 3), renal denervation of left clipped-kidney (experiment 4) and left renal artery clipping with renal denervation of right nonclipped kidney (experiment 5) in the acute phase. RESULTS Plasma angiotensin I (ANG I) and plasma angiotensin II (ANG II) were initially increased between the first day and the first week, were suppressed at the second week, then increased again at the third week. Renal denervation of clipped or nonclipped kidneys did not influence the plasma R-A system in 2K-1C rats. The levels of striatum dopamine (DA), dihidroxyphenylacetic acid (Dopac) and homovanillic acid (HVA) in hypertensive 2K-1C rats were higher than those in normotensive sham-operated rats. There were significant positive relationships between these monoamines and systolic blood pressure. Renal levels of ANG I, II and angiotensin I converting enzyme activity (ACE) in the clipped-kidney were significantly higher than in sham-operated and nonclipped kidneys of 2K-1C rats. CONCLUSION The enhanced R-A system in clipped-kidney and high levels of monoamines described above in the striatum appear to participate in the development of 2K-1C hypertensive rats.

Change in haemoglobin concentration, haematocrit and vasoactive hormones in haemodialysis patients with erythropoietin-associated hypertension

The changes in haemoglobin concentration, haematocrit, plasma renin, activity (PRA) and atrial natriuretic peptide (ANP) were studied in 10 haemodialysis patients with erythropoietin-associated hypertension. All patients received intravenously 1500 IU of recombinant human erythropoietin (rHuEPO) thrice weekly for 24 weeks. Treatment with rHuEPO induced significant rises in haemoglobin concentration (p<0.001) and haematocrit (p<0.01)., However, the difference between post- and pretreatment levels of haemoglobin (ΔHb) was not correlated with that between post-and pre-treatment mean blood pressure (ΔMBP). No correlation was found between ΔHt (difference between post- and pre-treatment values of haematocrit) and ΔMBP. These results indicate that elevation of the haematocrit and haemoglobin concentration of haemodialysis patients does not necessarily lead to an increase in blood pressure. In these patients, no significant differences were observed in PRA and ANP, comparing pre-treatment values with those measured 4, 8, 12 or 24 weeks after commencing rHuEPO. This suggests that neither PRA nor ANP play a central role in the pathogenesis of rHuEPO-induced hypertension.

Hormone Profiles and Testicular Histology in Azoospermic Men with Sex Chromosome Aberrations, Autosomal Anomalies and Normal Karyotype

Hormone profiles and testicular histology were studied in azoospermic men with sex chromosome aberrations, autosomal anomalies, and normal karyotype. In patients with sex chromosome aberrations, levels of plasma gonadotropins were significantly higher than those with autosomal anomalies and normal karyotype. The testosterone level in plasma was considerably lower in those with sex chromosome aberrations than in other groups. The prolactin level in plasma was not significantly different among the three groups. The administration of LH-RH resulted in a remarkably lower response of plasma gonadotropins in sex chromosome anomalies than in other groups. The response of plasma testosterone to the administration of hCG was also significantly decreased in those with sex chromosome aberrations compared with other groups. Johnsen score count and diameter of the seminiferous tubules were considerably reduced in those with sex chromosome anomalies compared with other groups, while wall thickness and Leydig cells per seminiferous tubule were significantly increased. It would appear that hormone disturbances and testicular alterations are less marked in azoospermic men with autosomal anomalies than in those with sex chromosome aberrations.