Yoshiaki Iijima

Spinal substance P immunoreactivity is enhanced by acute chemical stimulation of the rat prostate.

OBJECTIVES To investigate the role substance P (SP) plays in prostatic inflammation, we evaluated SP immunoreactivity within the spinal cord after irritation of the prostate. Because alpha-adrenergic blockade attenuates nociceptor-induced pain, the effects of an alpha-adrenergic blocker on SP immunoreactivity were also evaluated. SP is considered a mediator of nociception in the spinal cord. Immunoreactivity of SP is enhanced after acute chemical stimulation of somata. METHODS Rats received chemical irritation of the prostate with or without pretreatment with tamsulosin. They were killed after 1 hour, and immunohistochemical staining for SP was performed. SP immunoreactive areas were quantified in the dorsal spinal cord of the L5 to S2 segments. RESULTS Chemical irritation of the prostate increased SP immunoreactive areas in the L6 to S2 segments. Enhancement was observed in the whole dorsal spinal cord regions. This enhancement was significantly attenuated by tamsulosin in the L6 and S1 segments. CONCLUSIONS SP probably plays a significant role in mediating nociceptive processing from the prostate. Tamsulosin can attenuate nociception-induced SP upregulation within the spinal cord.

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.

Indolent Behaviour of Low-Grade B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Involved in Salivary Glands, Renal Sinus and Prostate

We report a case of MALT lymphoma (malignant lymphoma of mucosa-associated lymphoid tissues) involved in the salivary glands, the renal sinus and the prostate. The masses have been progressing very slowly and the patient has remained alive without any treatment for 5 years from the first symptom of this disease.

Transurethral treatment of bladder diverticula

We performed transurethral fulguration of the diverticular mucosa and incision of the diverticular neck in combination with transurethral prostatectomy or bladder neck resection to treat all aspects of diverticula in 9 patients. Eight cases with bladder outlet obstruction, involving 2 cases of large diverticula, have been successfully treated. A case with neurogenic bladder has failed. We found the transurethral procedure to be equally effective as open operation.

Successful chemotherapy in a patient with recurrent carcinoma of the urachus

Urachal neoplasm generally has a poor prognosis, because of long latency period, extravesical progression and pathological predominant pattern of adenocarcinomas. We report a case of recurrent poorly differentiated carcinoma of urachal remnant, which responded well to combination systemic chemotherapy (methotrexate, vinblastine, doxorubicin and cisplatin: M-VAC). Our case was possibly of transitional cell origin. The patient has been symptom-free even 13 months after the first chemotherapy course.

Malignant lymphoma of the prostate. Report of a case.

A 63-year-old man with primary malignant lymphoma of the prostate is presented. The patient underwent total cystoprostatectomy and ileal conduit construction. The specimen revealed malignant lymphoma, diffuse small cleaved cell of the gland. Three months after the operation, local recurrence and enlarged lymph node development were demonstrated by computed tomography. The patient tolerated well a combination chemotherapy of VP-16, doxorubicin, cyclophosphamide and prednisolone for 5 cycles. Tumor recurrence and lymph node spread could never be recognized following this drug treatment. The patient has been asymptomatic after this chemotherapy for over 3 years.

Retroperitoneal Schwannoma Extending into the Intravertebral Foramen

A 35-year-old Japanese man first visited the hospital for episodes of numbness in the right medial femoral region and loss of muscular strength in the right thigh. A CT scan of the abdomen showed a 10 × 9-cm well-circumscribed in homogeneous multilayered mass, in contact with the lumbar vertebrae. MRI demonstrated a hypodense and hyperdense mixed mass. Tumor extension into the L2/L3 intravertebral foramen was shown. To avoid spinal cord damage, we chose enucleation of the tumor in the intravertebral foramen. A follow-up CT after 1 year showed no evidence of a recurrent mass. In conclusion, we advocate the nerve-sparing operation in cases like that of our patient.

PRIMARY ALDOSTERONISM DUE TO ALDOSTERONE PRODUCING ADENOMA WITHOUT HYPERTENSION

A 2Byear-old woman presented with a &month history of muscular weakness followed by a typical tetany attack. She weighed 43 kg. and was 156 cm. tall. Blood pressure was 132p72 mm. Hg. Physical and neurological examinations revealed no abnormal findings. Laboratory investigations, includmg hemogram, blood chermstry studies and urinalysis, were within normal limits except for decreased serum level of potassium (2.0 mEqJ., normal 3.6 to 5.0). Plasma aldasterune concentration was 774.6 pglml. (normal 35.7 to 240), plasma renin activity less than 0.2 nglml. per hour (normal 0.3 to 2.91, deoxycorticosterune 0.08 nglml. (normal 0.03 to 0.33) and 18hydroxydeoxymticterone 0.03 nglml. (normal 0.01 to 0.07). Urinary excretion of kalliluein was 2.4 units per 1. (normal 0.3 to 7.9). Intravenous administration of 40 mg. furosemide during upright postum showed no inin plasma renin activity. The amount of angiotensin II required to raise the diastolic pressure by 2

Bilateral cryptorchidism associated with 47,XYY karyotype.

We describe an 11-month-old boy with karyotype of 47,XYY who presented with bilateral cryptorchidism, and discuss the hormonal condition of the patient.

Increased vascular collagen and noncollagenous protein synthesis contributes to sustain chronic phase of two-kidney, one-clip renovascular hypertension

PURPOSE Although the enhanced renin-angiotensin (R-A) system responsible for two-kidney, one-clip (2K-1C) hypertension is well known, there may be a shift with time so that this, hemodynamic factor plays a less important role and increased vascular resistance is predominant in sustaining hypertension. While increased vascular protein synthesis has been demonstrated in genetically hypertensive rats, we evaluated the possible relationship between vascular protein synthesis and 2K-1C hypertension with special reference to the R-A system. MATERIALS AND METHODS Two-kidney one-clip rats were treated with splanchnicotomy, beta-aminopropionitrile (collagen inhibitor), or captopril (angiotensin converting enzyme inhibitor) in the acute or chronic hypertensive phase. 3H-proline was injected into rats, and incorporation rates of 3H-proline into vascular collagen, noncollagenous protein and elastin were counted. The plasma level of the R-A system was assayed. RESULTS In the acute phase of 2K-1C hypertensive rats whose R-A system was enhanced, captopril treatment further enhanced plasma renin activity and plasma angiotensin I and suppressed plasma angiotensin II while reducing blood pressure. Synthesis of the vascular proteins was almost identical. In the chronic phase of 2K-1C hypertensive rats whose R-A system was within normal limits, increased incorporation rates of 3H-proline into noncollagenous protein or collagen of mesenteric arteries were decreased by splanchnicotomy or beta-aminopropionitrile and hypertension was lowered. Captopril failed to reduce protein synthesis. CONCLUSIONS An enhanced R-A system participates in the pathogenesis of the acute phase of 2K-1C hypertension while increased noncollagenous protein and collagen syntheses of small arteries appear to play some role in the etiology of the chronic phase of hypertension.