Regulation of sorbitol content in cultured porcine urinary bladder epithelial cells.

Sorbitol content was determined in porcine urinary bladder epithelial cells immediately after death of the animals and after primary culture of the cells at different osmolalities. In both instances, sorbitol content increased with urine and medium osmolality, respectively. For example, at 300 mosmol/kg the cultured cells contained 0.84 +/- 0.02 nmol/mg protein, at 600 mosmol/kg contained 21.7 +/- 0.95 nmol/mg protein, and at 900 mosmol/kg contained 59.5 +/- 2.8 nmol/mg protein. Similarly, aldose reductase activity rose from 0.27 +/- 0.04 mumol.h-1.mg protein-1 at 300 mosmol/kg to 1.81 +/- 0.16 at 600 mosmol/kg and to 3.02 +/- 0.33 at 900 mosmol/kg. These changes were, however, only observed when NaCl but not when urea was used to augment the medium osmolality, since urea equilibrated across the cell membrane. In contrast, sorbitol release from cells cultured at 900 mosmol/kg was slowest into a 900 mosmol/kg medium and fastest into a 300 mosmol/kg medium (63 +/- 16 nmol/10 min compared with 389 +/- 52 nmol/10 min). These studies demonstrate that the sorbitol content of porcine urinary bladder epithelium is regulated by changes both in sorbitol synthesis and sorbitol release. Thus the regulatory mechanisms in the urinary bladder seem to be similar to those present in the embryological related collecting duct.

[Prostatic cancer with cystic formation: a case report].

An 82-year-old man presented with a huge hypogastric tumor. A pelvic computed tomographic scan and magnetic resonance imaging revealed a multiple cystic mass 14 x 10 x 15 cm in diameter. The prostate specific antigen (PSA) value was elevated to 903 ng/ml. Histological examination of the needle biopsy specimens of the prostate revealed moderately differentiated adenocarcinoma. Bone scintigraphy showed a hot area in part of the costa. No other abnormalities were found. The tumor origin was suspected to be the prostate, but the possibility that it was another organ could not be denied completely since the tumor was located in the anterior portion above the bladder. Treatment with luteinizing hormone-releasing hormone agonist and diethylstilbestrol was initiated considering the patient's age. The PSA value returned to normal and the tumor size was reduced markedly after 28 weeks of therapy. Thirty-seven case of prostatic cancer with cystic formation in the Japanese literature are reviewed.

[Hydronephrosis as a complication of appendicitis: a case report].

A case of right hydronephrosis as a complication of appendicitis is reported. The patient was a 63-year-old male, whose chief complaints were pollakisuria and dysuria. Roentgenographic examination revealed right hydronephrosis due to stenosis of right lower ureter and intrapelvic tumor at the right side. Exploration revealed an abscess in the pelvic cavity, and pathologic examination disclosed periappendiceal perforation and an old inflamed appendix. A review of the literature revealed that it is difficult to diagnose the appendicitis without typical symptoms.

[Influence of temperature on the function of the human testes].

The influence of temperature on human Leydig and Sertoli cell functions was investigated in vitro using the organ culture technique. Specific 125I-FSH and 125I-hCG binding sites in testes from patients with prostate cancer cultured for 1, 3, 5 or 7 days at 33 degrees C or 37 degrees C were measured and compared. There were no significant differences in 125I-FSH or 125I-hCG binding sites between the two temperature groups at 1 to 7 days of culture. Testosterone concentration in the medium obtained from testicular organ culture at 33 degrees C did not differ significantly from that at 37 degrees C at 1 to 7 days of culture. In conclusion, a high temperature may not disturb the Leydig and Sertoli cell functions in a short term.

[Down-regulation of rat and human testicular hCG receptors by hCG].

Changes in rat and human testicular human chorionic gonadotropin (hCG) binding sites induced by hCG were estimated in vivo and in vitro. After a single administration of hCG, the specific hCG binding sites were significantly reduced for 7 and 5 days in rat and human testes, respectively. However, hCG binding sites had recovered to pretreatment values by the 14th day after the administration. Occupied hCG binding sites measured in both rat and human testes accounted for about half of the reduced binding sites on the day after administration of hCG, but thereafter the number of sites occupied was not correlated with the reduction of the binding induced a dose-related significant loss of the specific hCG binding sites for 7 and 5 days in rat and human testes, respectively. Thereafter, the number of binding sites gradually increased. These patterns of change in hCG binding sites in vitro were similar to those in vivo. These findings suggest that the reduction in hCG binding sites in rat and human testes by hCG is due not only to occupancy but also down-regulation of the binding sites. In conclusion, the present testicular organ culture method is useful to study hormonal regulation of testicular function, especially in human testes.

[Testicular follicle-stimulating hormone receptors in idiopathic male infertility].

To ascertain whether abnormalities in testicular binding of follicle-stimulating hormone (FSH) are related with spermatogenic impairment found in idiopathic male infertility, we measured FSH receptors in testicular tissues obtained by biopsy from 48 infertile men. The 48 infertile men were divided into 3 groups by histological grading using Johnsen's score count, and testicular FSH receptors among these groups were compared. Although 9 of the 18 infertile men with low Johnsen's score count and 5 of the 15 men with middle score count had no obvious FSH binding sites with high affinity, all 15 men with a high score count had high affinity FSH binding sites. In connection with high affinity binding sites for FSH, maximum binding number (Bmax) decreased significantly with the degree of spermatogenic impairment, but the association constant (Ka) was similar among the 3 groups. The present findings demonstrate that the decrease in testicular high affinity binding sites for FSH is related with the degree of spermatogenic impairment found in idiopathic male infertility.

[Testicular follicle-stimulating hormone receptors and effectiveness of human menopausal gonadotropin-human chorionic gonadotropin treatment in idiopathic male infertility].

To investigate the relationship between testicular follicle stimulating hormone (FSH) receptors and the effectiveness of human menopausal gonadotropin (hMG-hCG) treatment in idiopathic male infertility, 48 infertile men were examined. Most of the 14 patients without detectable testicular high affinity FSH receptors did not show any increase in sperm count after the hMG-hCG treatment, whereas 23 of the 34 patients with FSH receptors responded to the treatment. In patients with FSH receptors, patients with a middle or high Johnsen's score count responded more than those with a low score count did. From the above results, it seems that both the presence or absence of testicular FSH receptors and the histological appearance of spermatogenesis predict responsiveness to hMG-hCG treatment in infertile men.

[Clinical evaluation of long-term administration of terodiline hydrochloride for the treatment of patients with pollakisuria and incontinence].

We evaluated the effectiveness and side effects of long-term administration of terodiline hydrochloride in patients with chief complaints of pollakisuria or incontinence or both due to unstable bladder or neurogenic bladder associated with uninhibited contraction. The dose was 24 mg once daily. The symptoms such as pollakisuria and incontinence improved in 31 out of 41 patients (76%). Mild side effects were observed in 12 out of 47 patients (26%), which were thirst, dizziness, dysuria, urticaria and gastrointestinal symptoms. An increasing tendency of both maximum desire to void and compliance (p less than 0.10), and significant difference in maximum static pressure (p less than 0.05) were observed on urodynamic examinations before and after administration of this medicine. The results obtained from this study suggest that terodiline hydrochloride may be greatly recommended for patients with such symptoms as pollakisuria and incontinence.

Surgical repair of varicocele: effective treatment for subfertile men in a controlled study.

We performed a comparative study to evaluate the efficacy of surgical repair of varicoceles in improving fertility. A group of 224 subfertile men with varicoceles was divided into 141 patients who had their varicoceles surgically corrected and 83 who had not. A significant improvement in sperm density and percentage of progressive motile sperm was noted in the corrected group (p less than 0.01, p less than 0.05). Pregnancy rate was also higher in the corrected group (p less than 0.05). From this controlled study we conclude that the repair of a varicocele increases the chance of fertilization.

Preoperative parameters related to the improvement of semen characteristics after surgical repair of varicocele in subfertile men.

To know the parameter related to improvement of each semen characteristic (sperm density and percentage of progressive motile sperm) after high ligation of the left internal spermatic vein, 119 men from infertile couples were investigated. In each individual, the semen characteristic was considered to be different from the postoperative mean value if it was over or below 2 SD of the preoperative mean. Although no relationship was detected with the age of the patient, the duration of infertility or the preoperative semen characteristics, a definite relationship was found between the degree of varicocele and the improvement in each semen characteristic. For improvement of the sperm density, each of the volume and the score count by Johnsen's scale of the affected and unaffected testes and the serum hormone values (LH, FSH and testosterone) showed correlations. Meanwhile, for the improvement of the percentage of progressive motile sperm, correlations were found only with each of the testicular volume on the unaffected side and the serum testosterone level.

[Extracorporeal shock wave lithotripsy--difficulties in ESWL].

At Kanbara Hospital, 187 patients with urolithiasis have been treated by extracorporeal shock-wave lithotripsy (ESWL) since the first ESWL treatment in December, 1986. Some cases in which ESWL could not be performed easily were experienced. These difficulties were analyzed retrospectively and some problems in the ESWL treatment are discussed.

[A case of fracture of the penis].

A case of fracture of the penis was presented. A 44-year-old man in the state of morning erection, suddenly heard an abnormal cracking sound while he rolled over in bed. He immediately felt pain of the swelling penis. Surgery was carried out soon after he was admitted. Postoperative course was uneventful, except for slight pain on erection. The Japanese literature was reviewed, and the clinical statistics on 208 patients were summarized.