Yuzo Kinoshita

Rupture of Renal Artery Aneurysm

Rupture of a renal artery aneurysm, although rare, has been considered to be the most catastrophic urological injury. Three cases of ruptured and 1 case of impending rupture are reported. A review of the cases of ruptured renal artery aneurysm is presented together with emphasis on improved prognosis of this morbidity. Surgical indications are discussed.

Distribution of γ‐Glutamyl Transpeptidase in Male Reproductive System of Rats and its Age‐Related Changes

Summary:  The present study is designed to investigate localization of γ‐glutamyl transpeptidase (γ‐GTP) in male reproductive organs and its age‐related changes using Wistar rats aged 2 to 15 weeks. Histochemically, γ‐GTP activity was detected intensively in epithelial cells of epididymides and seminal vesicles and weakly in those of anterior prostates, but not in testes under the present conditions. Biochemically, the highest γ‐GTP activity was found in epididymal head portions. The order of the activity was epididymides (head > body > tail), seminal vesicles, prostates and testes.

Successful pregnancy with sperm retrieved from the bladder after the introduction of a low-electrolyte solution for retrograde ejaculation.

OBJECTIVE To determine the safety and efficacy of the introduction of a low-electrolyte solution into the bladder before masturbation for sperm recovery in patients with retrograde ejaculation. DESIGN Two case reports. SETTING Assisted reproduction practice at a university hospital. PATIENT(S) Two men with retrograde ejaculation. INTERVENTION(S) A 0.32-mol/L glucose solution or Hams modified F-10 medium (GIBCO, Grand Island, NY) with 10% serum was introduced into the urinary bladder before masturbation. The retrieved sperm were used for IUI. MAIN OUTCOME MEASURE(S) The motility of retrieved sperm, achievement of pregnancy, and outcome of pregnancy. RESULT(S) In patient 1, the motility rate of sperm retrieved from the bladder after the introduction of Hams modified F-10 medium was higher than that after the introduction of a glucose solution. The patients wife did not become pregnant during 10 IUI cycles after treatment with Hams modified F-10 medium. However, she became pregnant during the first IUI cycle after treatment with a glucose solution and was delivered of healthy twin infants. The wife of patient 2 also became pregnant during the first IUI cycle after treatment with a glucose solution and was delivered of a healthy female infant. CONCLUSION(S) The introduction of a glucose solution appears to be a safe and simple method for sperm recovery in patients with retrograde ejaculation.

A Case of Vesical Varices as a Complication of Portal Hypertension and Manifested Gross Hematuria

We report a unique case of vesical varices in a patient who presented with an episode of serious gross hematuria. He also had cirrhosis of the liver and portal hypertension, and had undergone transection of the esophagus 10 years ago. A hemangiomatous mass was discovered on cystoscopic examination, and sonographic examination, computerized tomography and abdominal angiography revealed vesical varices. The genesis of vesical varices and possible treatment in this case are discussed.

Enhanced expression in seminoma of human zinc finger genes located on chromosome 19

Six Krüppel-type zinc finger (ZF) genes were cloned from a seminoma cDNA library. One, ZFS-1, showed high sequence homology to the ZNF91 KRAB (Krüppel-associated box) ZF gene family and also the same chromosomal assignment. Interestingly, Northern blot analyses using ZFS-1 and ZNF91 revealed that multiple ZF genes on chromosome 19 were predominantly expressed in seminomas. In addition, the testis and the seminoma showed specific expression of 2.3 kb transcript. Our results suggest that ZF genes on chromosome 19 may be implicated in the development and/or growth of seminomas.

A new method of the electrolyte-free long-term preservation of human sperm at 4°C

Objectives To develop a new method for the long-term preservation of human sperm. Setting Andrology laboratory of our hospital. Patients Thirty-one normal and 19 asthenozoospermie semen samples obtained from patients attending our infertility clinic. The average sperm motility was 70.2% and 36.0% in the normal and asthenozoospermie groups, respectively. Interventions Ejaculated sperm were centrifuged and washed using the electrolyte-free Percoll gradient and then were preserved at 4°C. Main Outcome Measures The motility of the preserved sperm was analyzed using computer-assisted semen analyzer after the addition of Hams modified F-10 (GIBCO, Grand Island, NY). Results In the normal group, motility rate after the addition of Hams F-10 for 1, 2, and 4 weeks of preservation was 65.4%, 40.4%, and 5.5%, respectively. In the asthenozoospermie group, motility rate after 1 and 2 weeks of preservation was 31.3% and 18.1%, respectively. Preservation solutions containing sodium or potassium decreased motility after preservation. Restoration of preserved sperm was not achieved by incubation alone; however, reinitiation was induced by incubation together with Hams F-10. Conclusions Human sperm in the electrolyte-free solution survived for a long period of time at 4°C and reinitiation of sperm motility after preservation required the addition of Hams F-10.

The role of potassium ion and extracellular alkalization in reinitiation of human spermatozoa preserved in electrolyte-free solution at 4°C

OBJECTIVE To elucidate reinitiation factors in human spermatozoa preserved in the electrolyte-free solution at 4 degrees C. SETTING Andrology laboratory of our hospital. PATIENTS Semen samples were obtained from patients attending our infertility clinic. INTERVENTIONS Ejaculated sperm were centrifuged and washed using the electrolyte-free Percoll gradient and then were preserved for 1 week at 4 degrees C. MAIN OUTCOME MEASURES The motility of preserved sperm was incubated and analyzed after the addition of electrolyte solutions. RESULTS The motility rate was 9.6% when the preserved sperm were incubated directly. The motility increased to 35.1% after alkalization (pH 7.8) and further increased to 40.7% when 0.1 mM KCl was added. The motility decreased to 1.4% in a weak acidic solution (pH 6.8), however, the addition of a > or = 10 mM concentration of NaCl or > or = 0.1 mM concentration of KCl increased in motility. The motility rate in 40 mM NaCl and 40 mM KCl (pH 6.8) was 19.8% and 31.5%, respectively. The restoration of motility by NaCl was inhibited by 1 mM amiloride. The motility also rose to 54.1% and 32.3% in 0.04% NH3 and 80 mM NH4Cl solution, respectively. CONCLUSIONS The reinitiation of preserved spermatozoa was induced by potassium ion and extracellular alkalization.

Direct and indirect effects of electrical stimulation on the motility of human sperm

Background: Electroejaculation is a technique that is becoming more frequently available for obtaining sperm from men with spinal cord injury or psychogenic anejaculation. However, the effect of electrical stimulation on the movement of human sperm has not been clarified.

Viability and function of human sperm in electrolyte-free cold preservation

OBJECTIVE To assess the viability and function of human sperm in electrolyte-free cold preservation. DESIGN Prospective comparative study. SETTING Andrology laboratory of our hospital. PATIENT(S) Ten semen samples obtained from patients attending our infertility clinic. INTERVENTION(S) Ejaculated sperm were washed using the electrolyte-free Percoll gradient and were then preserved in 0.33 M glucose solution, 0.16 M NaCl solution, 0.16 M KCl solution at 4 degrees C for 4 weeks. As a control, TEST (TES and Tris) yolk buffer (TYB) was added to the ejaculated semen and preserved at 4 degrees C. MAIN OUTCOME MEASURE(S) Sperm tail morphology, motility, viability (eosin-Y stain), and the concentration of adenosine triphosphate (ATP) were analyzed. RESULT(S) The number of sperm with normal tail form and the motility of sperm preserved in glucose solution (electrolyte-free cold preservation) were significantly (P < 0.01) higher for 4 weeks than those of sperm preserved in the other three media. The sperm viability in glucose solution was 75.5%, 65.4%, and 51.3%, after 1, 2, and 4 weeks, respectively. The ATP concentration after 1, 2, and 4 weeks remained 64.2%, 53.0%, and 4.3% of the prestorage value, respectively, in the sperm stored in glucose solution. CONCLUSION(S) The morphology, motility, viability, and ATP concentration of sperm in electrolyte-free cold preservation were substantially better than those in NaCl solution, KCl solution, or TYB for 2 weeks.

Clinical Significance of Interruption of Therapy with Allylestrenol in Patients with Benign Prostatic Hypertrophy

Background: A multicenter, clinical trial investigated the effects of an interruption of antiandrogen therapy on subjective and objective clinical parameters in patients with benign prostatic hypertrophy (BPH).