Takaha M

Late recurrence of renal cell carcinoma after nephrectomy.

Late recurrence of renal cell carcinoma is unusual. Of 43 patients who underwent curative nephrectomy more than 10 years before, 2 cases (4.7%) had late recurrence. The 2 cases, both female patients, had late recurrence 12 and 19 years from the date of nephrectomy. The clinical aspects of late recurrence are discussed briefly.

Predictability of renal allograft prognosis during rejection crisis by ultrasonic Doppler flow technique

Using the ultrasonic Doppler technique, renal blood flow was measured in 67 patients who underwent living related renal transplantation from January, 1976 to December, 1979. In 58 of 67 cases, 81 acute and 9 chronic rejection episodes occurred. In the initial stage of acute rejection, there are no particular changes in the pattern of systolic blood flow and by contrast marked changes of diastolic flow. The disappearance of the diastolic phase is indicative of an advanced stage of rejection, the reappearance indicative of recovery from rejection, and persistent loss accompanied by changes of systolic flow indicative of an unfavorable prognosis of rejection. In chronic rejection, there are rapid changes of neither systolic nor diastolic flow though the acceleration time in the systolic phase lengthens gradually. The ultrasonic Doppler flow technique for blood flowmetry of a transplanted kidney is a useful means of knowing the prognosis of rejection and provides an index for corticosteroid bolus therapy.

Hormone Receptor in Renal Cell Carcinoma and Correlation With Clinical Response to Endocrine Therapy

Analyses of hormone receptors in cytosols from 41 renal cell carcinoma specimens were performed by the dextran-coated charcoal technique, using estradiol, synthetic progestin R5020 and synthetic androgen R1881. Binding data were calculated according to the method of Scatchard. Of 41 renal cell carcinomas estradiol receptor was detected in 11, R5020 receptor in 11 and R1881 receptor in 13. No significant correlation between histopathological findings and hormone receptors was observed. Patients were classified into those positive and negative for receptors. The clinical response of endocrine therapy for 17 with advanced residual or metastatic lesions after nephrectomy was studied in regard to the survival rates. Although there was no complete or partial regression in tumor size, the survival rate of patients with 1 or more receptors was significantly higher than that of patients negative for receptors (p less than 0.01). In conclusion, hormonal manipulation in patients with renal cell carcinoma cannot induce an antitumor effect but seems to increase survival in patients with receptors.

Cavernous Hemangioma of Scrotum and Penile Shaft

We report a 13-year-old boy with two independently detected cavernous hemangiomas of the scrotum and the penile shaft. A right scrotal cavernous hemangioma was incidentally found at the age of 6 years by a histological examination of a right scrotal hematoma attributed to contusion. The patient noticed a soft tumor of the penile shaft at the age of 10 and gradual enlargement of the tumor during the next 3 years. He consulted our department at the age of 13. An ultrasonic echogram revealed a heterogeneous tumor, a hemangioma, having dimensions of 3.5 X 2.5 X 1.5 cm and no connection of the corpus cavernosum penis. The tumor was completely removed surgically by means of circumcision on March 30, 1984, and histological examination demonstrated a cavernous hemangioma.

Urinary tract stone disease in modern Japan: stone incidence, composition and possible causes in Osaka district

2,969 stones, obtained from affiliated hospitals as well as the Osaka University Urologic Clinic were analyzed by infrared spectrophotometry. 2,724 of the 2,969 stones were obvious upper urinary tract stones, and the composition of these 2,724 stones is reported. The incidence and possible cause of stones in 750 patients with upper urinary tract calculi, managed in Osaka University Urologic Clinic, are discussed, as well as the recent figures on urinary tract stone disease in Osaka district. These figures are representative of stone disease in Japan.

Role of Magnesium in the Growth of Calcium Oxalate Monohydrate and Calcium Oxalate Dihydrate Crystals

Since about 85% of synthesized calcium oxalate dihydrate (COD) crystals proved not to have changed into calcium oxalate monohydrate (COM) crystals at 30 min of incubation time at 37 degrees C when our evaluation method of the COD-to-COM ratio was being used, we made a comparative study of the inhibitory effects of magnesium, one of the well-known inhibitors of calcium oxalate stone formation, on the growth of seeded COM and COD crystals. The results demonstrated that magnesium in identical concentrations might have stronger inhibitory effects on the growth of COM crystals than on that of COD crystals and suggested that these different effects of magnesium on the growth of COM and COD crystals might arise not only from the difference between the specific surface areas of COM and COD crystals, but also from that between the direct inhibitory effects of magnesium on these two types of calcium oxalate crystal growth.

Spontaneous regression of pulmonary metastases after nephrectomy for renal cell carcinoma

A case of spontaneous regression of pulmonary metastases from renal cell carcinoma after nephrectomy is presented. In a 57-year-old Japanese male who had already had pulmonary metastases at the time of nephrectomy, the metastatic lesions disappeared without adjuvant therapy 8 years after nephrectomy. He is still surviving without recurrence or any signs indicative of new metastasis at the present. The clinical aspects of this interesting phenomenon are discussed briefly.

Renal Arteriovenous Fistula Associated with a Huge Renal Vein Dilatation

We report a case of an aneurysmal type of renal arteriovenous fistula with a huge spherically dilated renal vein. Although the findings on routine computerized tomography made us strongly suspect renal cell carcinoma associated with a hilar lymph node metastasis, we were able to diagnose the arteriovenous fistula by means of a dynamic computerized tomography scan. On the basis of the roentgenographic findings, partial nephrectomy was performed successfully.

Gonadal findings in cryptorchid boys with Noonan's phenotype.

7 patients with Noonans syndrome, aged 5-16 years, complicated by bilateral cryptorchidism were examined by LH-RH and HCG stimulation tests, long-term HCG stimulation and testicular biopsy. 2 patients showed a good response and there was no effects in the remainder. Histological examination of the tests confirmed interstitial fibrosis in every case and showed abnormalities of the seminiferous tubules in 4 patients while in 1 patient the seminiferous tubules were composed of spermatocytes and spermatids. These hormonal and histological findings show different patterns of disturbance of the pituitary-gonadal system in male patients with Noonans syndrome.

Lysis of autologous tumor cells by peripheral blood lymphocytes treated with interleukin 2 in patients with renal cell carcinoma.

Peripheral blood lymphocytes derived from patients with renal cell carcinoma were stimulated with interleukin 2 and tested in a 4-hour 51chromium-release cytotoxicity assay against autologous cultured tumor and myeloid K562 cells. Of 23 patients autologous tumor lysis of more than 0 per cent was observed in 20 (range 5.3 to 82.8 per cent) and more than 10 per cent lysis was noted in 16. Since no significant correlation between the degree of cytotoxicity and the pathological findings of tumor stage, grade, cell type or lymphocyte infiltration in the tumor was found, it was impossible to predict from the pathological findings which tumor could be lysed by peripheral blood lymphocytes treated with interleukin 2. Comparison of natural killer cell activity against K562 of freshly prepared peripheral blood lymphocytes to that of interleukin 2-treated lymphocytes revealed significant augmentation from 23.6 +/- 9.7 to 65.2 +/- 29.1 per cent. From the kinetics study the lysis of autologous tumor cells was detectable on day 2 of interleukin 2 exposure and the peak activity was observed on day 5. A similar trend was noted in regard to K562 cell lysis. Measurements of peripheral blood lymphocyte subsets with monoclonal antibodies and argon ion laser flow cytometry resulted in a significant decrease of cells positive for OKT 4 (helper/inducer) and a significant increase of cells positive for OKT 8 (suppressor/cytotoxic) and Leu 7 (natural killer) by interleukin 2 treatment. A cold target cell inhibition test was performed in 2 patients with unlabeled autologous tumor and K562 cells as cold inhibitors. In 1 patient unlabeled K562 completely inhibited the tumor lysis but in 1 complete inhibition by autologous tumor and incomplete blockade by K562 were found. From this observation we concluded that peripheral blood lymphocytes treated with interleukin 2 lysed not only autologous tumor cells but also K562. Our results demonstrate that adoptive immunotherapy with peripheral blood lymphocytes activated by interleukin 2 in patients with renal cell carcinoma could be appropriate as a therapeutic procedure.