[An electron microscopic study on osteoblastoma--ultrastructure and fine localization of alkaline phosphatase].

Three cases of osteoblastoma were studied by electron microscopy. They included two cases of conventional osteoblastoma and one case of aggressive osteoblastoma. In conventional osteoblastoma, ultrastructural features and location of alkaline phosphatase activity of the osteoblast-like cell were similar to those of normal osteoblast. On the other hand, aggressive osteoblastoma cell (case 3) showed different structure from those of a normal osteoblast; the nucleus of the tumor cell showed irregular surface with a small degree of heterochromatin, and poorly developed cytoplasmic organellae. Cytochemically, alkaline phosphatase activity was noted not only on the cytoplasmic membrane, but on the abundant vesicles in the cytoplasm. From these findings we conclude that the aggressive osteoblastoma cells are more immature in morphology and show increased synthesis of alkaline phosphatase.

[A case of male pseudohermaphroditism with structural abnormalities of Y chromosome (ring Y)].

A case of male pseudohermaphroditism with ring Y chromosome is reported. The patient was a 3-year-old boy with hypospadias and right cryptorchidism. Culture of peripheral lymphocytes demonstrated a chromosomal mosaicism of 45 X/46 X, r (Y). Moreover, the chromosomal study with high resolution Q-band method revealed the presence of double ring Y (ring Y and double ring Y with the ratio of 25: 5). A well-developed vagina was discovered by retrograde cystourethrography. Uterus and fallopian tubes were absent at exploratory laparotomy. The gonads existed in the scrotum on the left side and in the inguinal pouch on the right. Both gonads were proved to be testes histologically, but bilateral was deferens were absent and its remnant was found in the retroperitoneal cavity. Plastic surgery for the genital abnormalities was performed. Only 30 cases of ring Y chromosome have been reported in the world including our case and we briefly reviewed these cases.

[An electron microscopic study of malignant giant cell tumor of bone].

Three cases of malignant giant cell tumors were studied by light microscope and electron microscope. Light microscopic observation revealed three different types of tumor cells, namely, malignant stromal cells, fibrosarcomatous cell and osteosarcomatous cells. Electron microscopic observation revealed that fibrosarcomatous cells had ultrastructure similar to that of malignant stromal cells. Both types of cells showed nuclear pseudo-inclusions (NPI), and well developed organellae related to matrix synthesis in the cytoplasm. Polysaccharide staining of the same cells revealed positive products in the cytoplasm. Osteosarcomatous cells showed irregular nuclei which contained NPI and well developed r-ER. The cells were located in the non-calcified matrix which consisted of collagen fibers. No alkaline phosphatase activity was observed in this area. These facts suggest that: (1) malignant stromal cells and fibrosarcomatous cells synthesize collagenous stroma as normal fibroblasts do, and (2) osteosarcomatous cells are devoid of the ability to promote matrix calcification.

The treatment of bladder cancer by neothramycin.

Neothramycin (NTM), an anthramycin-group anticancer antibiotic, was used in the treatment of superficial carcinoma of the bladder. NTM was instilled into the bladder in the following dosages. Ten mg NTM in 20 ml of sterile distilled water was given first, and increased to 40 mg in 20 ml. This procedure was performed every second week to twice a day. Recently, in 2 patients, the treatment has been combined with 20 mg NTM intravenous administration. In 4 of the 11 patients (36%) the tumors disappeared completely, while in 6 patients (55%) there was partial disappearance of more than 50% and in one patient (9%) there was no effect. Three of the patients had irritable bladder symptom (temporarily). NTM was concluded to be effective for superficial carcinoma of the bladder.

[Statistics on outpatients and inpatients at the urological department of Kosei Hospital 1975-1982].

Statistical observations of 19,678 outpatients and 2,601 inpatients at our department from 1975 to 1982 revealed the following results. The new cases in the outpatient clinic were in decreasing order nonspecific infections (50.8%), urogenital tumors (11.9%), urolithiasis (9.3%) and urogenital anomalies (8.0%). The inpatients according to the organ were in decreasing order kidney (29.6%), prostate (25.5%), bladder (13.4%) and ureter (11.9%). Operations were performed 2,414 times. Frequent operations were in decreasing order phimosectomy (360 times, 14.9%), TUR-Bt (284 times, 11.8%), transurethral cryosurgery of the prostate (215 times, 8.9%), vasectomy (190 times, 7.9%) and orchiopexy (152 times, 6.3%). More young persons comprised the outpatients of our hospital than at other facilities.

[Combination (RaHPP) of radiotherapy, hyperthermia and chemotherapy (peplomycin and picibanil) for bladder cancer].

Four patients with urinary bladder carcinoma were treated by combination therapy which consisted of hyperthermia vesical irrigation of two anticancer drugs (peplomycin and picibanil), intravesical instillation of those drugs and radiation. Following the therapeutic method we planned, 40 mg of peplomycin and 10 KE of picibanil in 1,500 ml of sterile distilled water was irrigated at 42 to 43 degrees C into the bladder for 3 hours; 40 mg of peplomycin and 10 KE of picibanil in 40 ml of sterile distilled water was instilled into the bladder; and, the focus was irradiated with 60Co to a focal dose of 200 rad 30 minutes later. This pattern of treatment was repeated once a week, 3 to 5 times in total. On the days this pattern was not taken, 5 KE of picibanil in 20 ml of sterile distilled water was instilled into the bladder cavity. Complete response was observed in one patient and partial response in 3 patients. The side effect was temporary irritable bladder symptom.

[Clinical evaluation of dynamic renoscintigraphy using 99mTc-DTPA in practical urology. I. Diagnosis of ureteral calculi, cystic kidney and hydronephrosis].

Clinical usefulness of the renoscintigraphy using 99mTc-DTPA in practical urology was investigated for two years. 99mTc-DTPA injection and injectable preparation kit (supplied by Nihon Medi-Physics Co.) were used. The dynamic blood flow of the renal parenchyma could be detected from serial images and curves on the perfusion phase. Information of clear nephrogram and function of the upper urinary tract could be obtained from serial images and renogram. Separate and total renal function could be evaluated. This method of examination is evaluated as very safe, because no side effects were produced and radiation dose is low. This examination may be a useful tool and the first choice in practical urology.

[Experience using the laser rod in urological surgery].

The clinical use of a new surgical tool the "Laser Rod" is presented. This rod is made of ceramics and utilizes a neodymium-doped yttrium aluminum garnet (Nd-YAG) laser. With the Laser Rod, the surgeon can cut tissue by mechanical contact and still feel the resistance from the target tissue. In this study, this device has been used in various urological surgical procedures, such as nephrolithotomy, retropubic prostatectomy, ileocecal conduit diversion, urethroplasty and circumcision of the penis. Our results showed that laser surgery using this device, enables bloodless incision with minimal damage to adjacent tissue. In conclusion, the Laser Rod will probably be very useful in urological surgery, and its indications should be expanded through further study.

[Clinical evaluation of Claforan (CTX) in aged patients with chronic complicated urinary tract infections].

Claforan (CTX) was administered for 5 days at a daily dose of 4 g in two divided doses by intravenous injection to 18 in-patients, all of whom were over 70 years old and had chronic complicated urinary tract infections. The overall clinical efficacy of CTX was excellent in 4 cases, moderate in 8 cases and poor in 6 cases, the overall effectiveness rate being 66.7%. Twenty seven out of 34 organisms isolated from chronic complicated urinary tract infections before administration of CTX were eradicated after treatment. Both clinical findings and laboratory findings revealed no side effects. It is suggested that CTX is useful and a safe drug for elderly patients.

[On the clinical effects of cefotiam on acute cystitis and changes in form of E. coli in the urine].

Cefotiam (CTM) was administered to female patients suffering from acute cystitis to examine its clinical efficacy and changes in form of the bacteria in urine. CTM was administered to 15 female patients with acute cystitis once a day for three consecutive days (1 g/time in 13 cases, and 0.5 g/time in 2 cases). The overall clinical efficacy was 100%. Bacteriological examination, revealed 13 cases of single infection by E. coli, and one case of E. coli and S. epidermidis (MIC: 0.78 micrograms/ml). MIC of E. coli ranged from 0.05 to 0.78 micrograms/ml. All of the strains were eradicated, the eradication efficacy being 100%. The forms of bacteria in the urine after the administration of CTM were examined in 8 cases (all due to E. coli). Bacteria in urine disappeared or formed a spherical form 5 minutes after the administration of CTM. Disappearance of E. coli was observed in 7 cases at 15 or 30 minutes after drug administration, and with the disappearance, improvements were also observed in the urinary findings. Of these cases, the urinary concentration of CTM was measured in 4 cases. It ranged from 296 to 6,893 micrograms/ml at 5 minutes after the administration. In one case of deficient excretion in urine, filamentation was observed, and with the rise in CTM concentration in urine, granular changes were observed in the shape of bacteria. CTM's excellent clinical efficacy was substantiated by the changes in the form of bacteria in urine.

Sporulation promoting factor in vegetative cells of Bacillus subtilis.

A simple experimental system for detection of sporulation promoting factors was presented. This system showed that there was a sporulation promoting factor in the vegetative cells of Bacillus subtilis cultivated on nutrient agar for 9 hr (at stage T0). The factor was partially purified from the sonicate of vegetative cells by ethanol fractionation, gel filtration, chromatography and preparative gel electrophoresis, and it was identified as manganese-containing protein.

Quantitative structure-inhibitory activity relationships of phenols and fatty acids for Bacillus subtilis spore germination.

Phenols and fatty acids were found to inhibit L-alanine-initiated germination of Bacillus subtilis spores without altering their heat resistance. Inhibitory effect was defined as the concentration necessary to cause 50% inhibition of the germination rate. The quantitative structure-inhibitory activity relationships for 39 phenols and 7 fatty acids were analyzed. The pH dependency of inhibition showed that the nonionized form of the molecule was responsible for inhibition. Hydrophobicity, which was expressed by the partition coefficient or the distribution coefficient of the compounds, was important for inhibition. In addition to hydrophobicity, the electronic effect, which was expressed by the dissociation constant, played a partial role in phenols. The correlation equation of the fatty acids was similar to those of the alcohols and other hydrophobic compounds, which had been reported earlier. That of the phenols, however, appeared to be different, indicating a different and more complex mechanism of inhibition. The type of inhibition by both compounds was mixed rather than competitive or noncompetitive.

The effect of oxidation-reduction potential on spore germination, outgrowth, and vegetative growth of Clostridium tetani, Clostridium butyricum, and Bacillus subtilis.

Spores of Clostridium tetani germinated in liver broth with +580 mV as the starting Eh value, and those of Clostridium butyricum germinated in liver broth with an initial Eh of +400 mV regardless of the presence or absence of a liquid paraffin covering. Spores of Bacillus subtilis germinated in liver broth with--100 mV as the starting Eh value. Also, it was found that there are two ranges of starting Eh values for germination and vegetative growth of Cl. tetani, Cl. butyricum, and B. subtilis. In the first range these spores germinated and grew, but in the second range they only germinated and then died without outgrowth.

Inhibition of Bacillus subtilis spore germination by various hydrophobic compounds: demonstration of hydrophobic character of the L-alanine receptor site.

L-Alanine-initiated germination of Bacillus subtilis spores was inhibited by various kinds of hydrophobic compounds. Good correlation of inhibitory effect with hydrophobicity of the compound was demonstrated by using regression analysis in which the hydrophobic character was expressed by the partition coefficient in an octyl alcohol-water system. The correlation coefficient for 20 alcohols was 0.959, and that for 19 miscellaneous compounds was 0.906. Regression lines of the alcohols and other hydrophobic compounds were almost identical, showing that hydrophobic interaction played an important role in inhibition. Diphenylamine was one of the most effective inhibitors examined. n-Octyl, n-nonyl, and n-decyl alcohols were the most effective alcohols. The mode of inhibition by diphenylamine and n-octyl alcohol was a "mixed type" (competitive plus noncompetitive type) with respect to L-alanine; that by D-alanine was competitive inhibition. Sites for diphenylamine, n-octyl alcohol, and D-alanine may have overlapped. Inhibition was reversible by washing; heat resistance, stainability, and germination rate of the washed spores remained unaltered. Thus, we confirmed that the inhibition may occur before the initial trigger reaction of germination and that it may be due to the interaction between a hydrophobic compound and a hydrophobic region closely associated with the L-alanine receptor site on the spore.