Erythrocyte aldose reductase correlates with erectile dysfunction in diabetic patients.

Erectile dysfunction (ED) is a common complication of diabetes mellitus. Erythrocyte aldose reductase (AR) has been implicated in a variety of diabetic complications. The subjects were 62 diabetic patients, of whom 25 were treated with hemodialysis (chronic renal failure CRF group) and the remaining 37 did not have chronic renal failure (DM group). The controls were 20 healthy volunteers age-matched to the patients. The level of AR was measured by the quantitative determination kit for AR in all patients and controls. In this study, ED was diagnosed by 5-item version of the International Index of Erectile Function (IIEF-5). The average level of AR in the CRF group was significantly higher than that in the DM group and controls (P<0.001). The average level of AR in the DM group without ED was significantly lower than that in the DM group with ED and controls (P<0.005). These results suggest that the level of AR may be a useful modality for prediction of ED in diabetic patients.

Significant decrease of the International Index of Erectile Function in male renal failure patients treated with hemodialysis.

In order to evaluate the erectile function in male renal failure patients treated with hemodialysis (HD), we investigated the International Index of Erectile Function (IIEF) in patients and healthy controls. The subjects were 174 male patients treated with HD, of whom 43 had diabetes mellitus (DM) and the remaining 131 patients did not have DM. The controls were 1133 healthy males. We evaluated the prevalence of erectile dysfunction (ED) using the erectile function (EF) score, which is one of the five domains of the IIEF, in each age group (upto 39 y old, 40-49 y old, 50-59 y old, 60-69 y old). The severity of ED was classified into five categories using EF in each age group. The univariate logistic regression analysis and multiple variate analysis of IIEF in HD patients were performed. The prevalence of ED in HD patients was significantly higher than that in the controls in each age group. The severity of ED in HD patients was also significantly higher than that in the controls in each age group. In the logistic regression analysis and multiple variate analysis of IIEF in HD patients, DM and age were significant risk factors on sexual dysfunction. ED was more prevalent in male renal failure patients treated with HD than in the controls. In the patient group, ED was more prevalent in older DM patients.

The correlation of TERT expression with c-myc expression in cervical cancer.

Recently putative catalytic telomerase subunit was identified as telomerase reverse transcriptase (TERT). Several reports showed that TERT expression correlated with telomerase activity. It has also been found that c-myc can induce telomerase activation through TERT expression. We examined expression of TERT and c-myc and their correlation in cervical cancers by reverse transcription-polymerase chain reaction (RT-PCR). It was found that TERT and c-myc expression was observed mostly in malignancies and expression of c-myc was concordant for positivity and negativity with TERT. These results support recent studies that c-myc expression is closely associated with TERT and telomerase activity. c-myc up-regulation may play an important role in activation of TERT and telomerase.

Pregnancy complicated with Bartter's syndrome: a case report.

Bartter's syndrome is a rare renal disorder, and since there are few case reports of Bartter's syndrome complicating pregnancy are few, the changes of electrolytes and hormonal metabolism during pregnancy are unknown. We describe and discuss the course of pregnancy complicated with Bartter's syndrome.

Mutation and transcription analyses of the p63 gene in cervical carcinoma.

Genetic mutation of p53, which monitors DNA damage and operates cellular checkpoints, is a major factor in the development of human malignancies. A novel gene p63/p73L/p51, encoding a protein with significant homology to p53 and p73, was recently identified at 3q27-9. To investigate the penetration of p63 in cervical carcinogenesis, mutation and transcription analyses of p63 were performed in cervical carcinoma. A certain isotype of p63 called TAp63gamma encodes the acidic N-terminus and possesses a short C-terminus. Using reverse transcriptase-polymerase chain reaction-single strand conformation polymorphism (RT-PCR-SSCP) analysis for TAp63gamma, one mutation was found in the cervical carcinoma cell line SKG-I. However, no mutations causing amino acid substitutions or frameshifts were found in 54 cases examined for TAp63gamma, which is thought to be a tumor suppressor gene. While cervical carcinomas tended to yield a positive signal in the RT-PCR reaction designed to amplify transcripts encoding the acidic N-terminus, normal cervix and cervical intraepithelial neoplasia (CIN) did not express this transcript. These data suggest that the p63 gene does not play an essential role as a tumor suppressor gene, but expression of TAp63gamma may be speculatively associated with tumor growth in cervical carcinogenesis.

Expression of telomerase subunits and localization of telomerase activation in hydatidiform mole.

Activation of telomerase compensating for the loss of telomeres has been implicated in human cell immortalization and carcinogenesis. Telomeric repeat amplification protocol (TRAP) assay can be used to detect telomerase activity in a variety of malignant tumours, including those of the female reproductive tract which have been found to have high levels of telomerase activity. However, it is unclear whether all the cells or only a subset of cells within a tumour have telomerase activity. To determine the regulation mechanism of telomerase activity in hydatidiform moles, we studied telomerase activity at the single cell level (using an in situ TRAP assay), and expression of TLP1 (telomerase protein 1), TERC (telomerase RNA component) and TERT (telomerase reverse transcriptase component). Expression of TERC and TLP1 was observed in all normal chorionic villi, as well as in trophoblastic diseases, and various cell lines irrespective of telomerase activity. TERT expression was observed in trophoblastic diseases and normal chorionic villi with telomerase activity but not in normal chorionic villi without telomerase activity, except in some cases in the present series, indicating that TERT expression is closely associated with telomerase activity. Upregulation of TERT expression may thus play an important role in telomerase reactivation.

[2,8-dihydroxyadenine urolithiasis due to partial deficiency of adenine phosphoribosyltransferase: a case report].

A 35-year-old female was referred to our clinic with a complaint of left flank pain in 1993. Drip infusion pyelography showed a filling defect of 25 x 24 mm in size in the left ureteropelvic junction. Computed tomography and ultrasonography revealed it as the renal stone. Percutaneous nephroureterolithotomy and extracorporeal shock-were lithotomy were performed. The stone was composed of 2,8-dihydroxyadenine (DHA). The patient was diagnosed as having a partial deficiency of adenine phosphoribosyltransferase (APRT) from the low APRT activity and a genotype of a compound heterozygote APRT*J/APRT*Q0 by T-cell analysis. The urinary excretion of 2,8-DHA crystals disappeared by the postoperative treatment with allopurinol. Cases of 2,8-DHA urolithiasis reported in the Japanese literature are discussed.

[Two cases of functioning parathyroid cysts].

Two cases of functioning cysts are reported. The first patient was a 48-year-old man who underwent percutaneous cyst puncture for a palpable mass in the neck at another hospital. Hypercalcemic crisis brought the patient to Koga General Hospital. The second patient was a 69-year-old woman with the complaint of discomfort in the right neck of several years duration and with a palpable mass identified on physical examination at a local hospital. Both patients had high serum calcium and parathyroid hormone (PTH) levels and were diagnosed as having functioning parathyroid cysts by imaging studies including ultrasonography, computed tomographic scan, magnetic resonance imaging and scintigraphy. After parathyroidectomy, their serum calcium and PTH levels became normal, but calcium supplement was necessary in the first patient. To our knowledge, these are the 40th and 41st cases reported in the Japanese literature.

[Endoscopic adrenalectomy by retroperitoneal approach for primary aldosteronism].

Endoscopic adrenalectomy by a retroperitoneal approach through the skin incision less than 5 cm has been performed in 6 patients (3 males and 3 females; 4 right and 2 left side) with primary aldosteronism from December 1992 to June 1993. The treatment was successful in all the cases. As for complications, pneumothorax occurred in one case. The required operation time was from 120 to 330 min (mean: 196 min) and the blood loss was from 20 to 279 ml (mean: 94 ml), which were similar to those in open adrenalectomy. The retroperitoneal approach was thought to be more advantageous than widely adopted laparoscopic adrenalectomy in the following points: (1) No complications such as pulmonary embolism or pneumomediastinum. (2) No injuries to the intraabdominal organs. (3) Two operators using one video system is sufficient.

[Recovery process of injured ureters in dogs].

This paper is the 13th report in a series of studies on the application of microexplosion to medicine and biology. The recovery process of injured ureters was investigated in the day. The 60 ureters of 42 mongrel dogs were used. The ureter was injured with a nail, punch or surgical knife. The "pierced injury" was passed through the ureter with a nail of 1 mm or 2 mm in diameter, the "punch injury" was punched out in the ureter by a puncher of 1 mm or 2 mm in diameter and the "cut injury" was cut in the ureter 5 mm or 10 mm in size with a surgical knife. The recovery process of the injured ureter was observed in each of the two ureters 3 days, 1 week, 3 weeks, 6 weeks and 12 weeks after the injury by means of IVP, for macroscopic and microscopic findings. The results were as follows: 1) In IVP, it was observed that the 1 mm pierced injury resulted in no urine leakage after 3 days, that the 2 mm pierced injury and 1 mm punch injury in no urine leakage after almost 1 week and that the 2 mm punch injury and 5 mm cut injury and 10 mm cut injury in no urine leakage after almost 3 weeks. Hydroureter due to tissue edema was observed only in one ureter with a 10 mm cut injury after 1 week. No ureteral stricture, hydronephrosis or hydroureter was observed in the other ureters.(ABSTRACT TRUNCATED AT 250 WORDS)

Microexplosion cystolithotripsy in 105 cases.

We treated 105 consecutive patients with bladder calculi by microexplosion lithotripsy, with a success rate of 100 per cent. The weight of the removed calculi averaged 18 gm., with a range of 2 to 305 gm. For the procedure spinal anesthesia was used in 78 patients, while general anesthesia was used in 24. Minor extraperitoneal bladder perforation occurred only once and it resolved spontaneously several days later. Presently, we consider microexplosion lithotripsy to be the treatment of first choice for bladder calculi.

[A case of recurrent stones in the urinary bladder after extensive panhysterectomy].

A 71-year-old female suffered from recurrent stones in the urinary bladder, caused by bladder injury due to extensive panhysterectomy. The stones were crushed successfully by micro-explosion lithotripsy (MEL). This newly established treatment is recommended for such recurrent stones in the urinary bladder.

Development and application of confined blasting for bladder and kidney stones.

Microexplosion lithotripsy (MEL) was clinically developed for the destruction of urinary stones in our clinic in 1981. In MEL two kinds of blasting are available: external charge blasting and confined blasting. The detonation power of the latter is 3 times larger than that of the former. Up to July, 1986, microexplosion cystolithotripsy has been successfully performed on 100 cases. In the early stages only external charge blasting was used. It was, however, not easy to crush a big bladder stone over 5 cm in diameter. For that reason, confined blasting was newly developed and in 50 cases microexplosion cystolithotripsy using confined blasting was completed successfully. As the next step, percutaneous nephrolithotripsy using confined blasting has been successfully performed on 12 cases including 3 of staghorn calculi.