T. Tateno

Dendritic Cell-Based Immunotherapy of Renal Cell Carcinoma

Dendritic cells potently stimulate antigen-specific immune responses and recent data indicate that they are also capable of eliciting antitumor immune responses. We are performing a pilot study which tests the safety and efficacy of antigen-loaded, cultured blood dendritic cells in patients with metastatic renal cell carcinoma. Dendritic cells are simultaneously pulsed with lysate from autologous tumor cells and with the immunogenic protein keyhole limpet hemocyanin. During the pulse, the cells are activated with a combination of tumor necrosis factor-alpha and prostaglandin E2. Patients receive 5-10 X 10(6) dendritic cells per intravenous infusion and up to six infusions at monthly intervals. The first results demonstrate that this treatment modality is very well tolerated and can be associated with strong immunological and clinical responses. The present article discusses the importance of dendritic cell maturation and the role of helper antigens in dendritic cell-based immunotherapy.

Posterior retroperitoneoscopic partial adrenalectomy using ultrasonic scalpel for aldosterone-producing adenoma

BACKGROUND Posterior retroperitoneoscopic adrenalectomy has become a standard procedure, but removal of the entire gland is not necessary in all cases. PATIENTS AND METHODS We performed 10 posterior retroperitoneoscopic partial adrenalectomies for aldosterone-producing adenoma (APA) using an ultrasonic scalpel to divide the normal adrenal gland and the adenoma. RESULTS The mean operation time and blood loss were 154 (110-231) minutes and 11 (5-32) mL, respectively. The mean weight of removed tissue was 5.7 g (2.3-10.2 g). Subcutaneous emphysema occurred in three patients, but there were no serious operative complications. CONCLUSION Posterior retroperitoneoscopic partial adrenalectomy using the ultrasonic scalpel may be a valuable treatment for typical solitary APA.

THE USE OF EBASTINE, A MAST CELL BLOCKER, FOR TREATMENT OF OLIGOZOOSPERMIA

The effect of mast cell blocker (ebastine) on semen quality was evaluated in 15 idiopathic oligozoospermic males. Ten milligrams/day of ebastine was administered orally for 3 months. Nine cases (66.7%) showed definite improvement in the semen quality. The wives of 3 patients (20%) became pregnant within 6 months of the initial treatment. It would appear that mast cell blocker (ebastine) significantly improves semen quality in men with idiopathic oligozoospermia.The effect of mast cell blocker (ebastine) on semen quality was evaluated in 15 idiopathic oligozoospermic males. Ten milligrams/day of ebastine was administered orally for 3 months. Nine cases (66.7%) showed definite improvement in the semen quality. The wives of 3 patients (20%) became pregnant within 6 months of the initial treatment. It would appear that mast cell blocker (ebastine) significantly improves semen quality in men with idiopathic oligozoospermia.

Retroperitoneoscopic Partial Adrenalectomy Using an Endoscopic Stapling Device in Patients with Adrenal Tumor

We performed 15 retroperitoneoscopic partial adrenalectomies using an endoscopic stapling device to divide the normal adrenal tissue and adenoma. The mean operating time and mean blood loss were 162 (129–210) min and 12 (5–67) ml, respectively. In 1 patient (6.7%), a pneumothorax occurred at the end of the procedure due to injury of the medial crus of the diaphragm. However, the procedure was not subsequently converted to open surgery. These facts suggest that posterior retroperitoneoscopic partial adrenalectomy is a valuable addition to adrenal gland surgery.

Microdeletion of the DAZ (deleted in azoospermia) gene or the YRRM (Y chromosome ribonucleic acid recognition motif) gene does not occur in patients with Klinefelter's syndrome with and without spermatogenesis.

OBJECTIVE To evaluate the occurrence of microdeletions of the Y chromosome involving the DAZ and YRRM genes in patients with Klinefelters syndrome with and without spermatogenesis. DESIGN Controlled clinical study. SETTING Yamagata University Hospital, Yamagata, Japan. PATIENT(S) Patients with Klinefelters syndrome with spermatogenesis (n = 1) and without spermatogenesis (n = 20) and a control group of men of proven fertility (n = 10). INTERVENTION(S) Blood and semen sampling and testicular biopsy. MAIN OUTCOME MEASURE(S) Semen analysis, polymerase chain reaction amplification of 32 DNA loci on the long arm of the Y chromosome involving the DAZ (deleted in azoospermia) and YRRM (Y chromosome ribonucleic acid recognition motif) genes, and measurement of plasma FSH, LH, and testosterone levels. RESULT(S) No microdeletions of 32 loci were found in any of the patients with Klinefelters syndrome, either with or without spermatogenesis. Plasma LH and FSH levels were abnormally high and testosterone levels were reduced in all the patients with Klinefelters syndrome. American Society for Reproductive Medicine.) CONCLUSION(S) Severe impairment of spermatogenesis in patients with Klinefelters syndrome is not caused by microdeletions of the Y chromosome involving the DAZ and YRRM genes.

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.

Absence of Y-chromosome microdeletions in patients with isolated hypospadias

Hypospadias is a disorder of male external genital development in which the urethral orifice is located on the ventral surface of the penis rather than at the tip of the glans. It is thought to result from incomplete fusion of the labioscrotal folds during morphogenesis of the external genitalia of the male embryo between 8 and 12 weeks of gestation. It is among the most common of male genital abnormalities, occurring in 0.1%–0.8% of live male births (1).

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.

Expression of plasminogen-related gene B varies among normal tissues and increases in cancer tissues

We previously found that the promoter activity of plasminogen (PLG)‐related gene B (PRGB) was 5‐fold that of PLG. We have since examined the transcript levels of PRGB among various normal human tissues, and compared these findings with those of PLG. Reverse transcription‐PCR analysis revealed that the PRGB expression varied widely among different tissues, while PLG was expressed only in the liver and kidney. RNA samples obtained from cultured cell lines also demonstrated differing PRGB expression. Furthermore, increased PRGB expression was observed in several fresh samples of cancer tissue obtained from cancer patients when compared with surrounding normal tissues.

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.