[Small cell carcinoma of the prostate: a case report].

A 81-year-old man was admitted to our department with the chief complaints of pollakisuria and difficulty in voiding. He presented with increased serum PSA level (over 100 ng/ml). We performed biopsy of the prostate and found a moderately differentiated adenocarcinoma. Various urological examinations showed metastases to paraaortic lymph nodes and systemic bones. He was started-on hormonal therapy. Nine months from the start of hormonal therapy, this therapy was effective and the serum PSA level was decreased to 14 ng/ml. Thereafter, the serum PSA level and the tumor volume were increased and he died 29 months from the start of treatment. The autopsy revealed small cell carcinoma with adenocarcinoma of the prostate.

Quantitative determination of urinary 8-hydroxydeoxyguanosine (8-OH-dg) by using ELISA.

In order to establish a quantitative assay for 8-OHdG concentrations in urine, we examined the precision of a test for the recovery of 8-OHdG in urine by using an ELISA method. The coefficient of variation (CV) for assay with incubation in water or air ranged between 7.0% and 8.4% and between 19.2% and 30.6%, respectively. The data by using incubation in water gave higher accuracy than those in air. The recovery rates of 8-OHdG in urine sample ranged from 95 - 114%. Our results indicated that the excellent sensitivity of this ELISA kit by using incubation in water makes its use possible for the determination in urine with a good reproducibility and recovery of 8-OHdG-spiked samples.

Retroperitoneal bronchogenic cyst: report of a case and literature review.

A large cystic mass was found in the subdiaphragmatic region of a 46-year-old woman who had complained of continuous pain in the left flank . The cyst was located in the retroperitoneum just below the diaphragm and was adhered to the diaphragmatic skeletal muscle and abdominal aorta, but was separate from the spleen, pancreas, left adrenal gland and left kidney. The surgically resected cyst measured 8 x 8 x 7 cm and was filled with protein-rich fluid, which contained amylase and embryonal proteins such as carcinoembryonic antigen, CA125 and CA19-9. Histologically, the cyst wall was composed of a fibrovascular connective tissue containing thin smooth muscle layers and mucus-secreting glands and was lined by a ciliated pseudostratified or tall columnar epithelium without dysplastic changes. Thus, a diagnosis of bronchogenic cyst, which is usually discovered in the posterior part of the mediastinum, was made. A rare case of bronchogenic cyst and a literature review is presented.

Purification and characterization of an esterase involved in poly(vinyl alcohol) degradation by Pseudomonas vesicularis PD.

An esterase catalyzing the hydrolysis of acetyl ester moieties in poly(vinyl alcohol) was purified 400-fold to electrophoretic homogeneity from the cytoplasmic fraction of Pseudomonas vesicularis PD, which was capable of assimilating poly(vinyl alcohol) as the sole carbon and energy source. The purified enzyme was a homodimeric protein with a molecular mass of 80 kDa and the isoelectric point was 6.8. The pH and temperature optima of the enzyme were 8.0 and 45 degrees C. The enzyme catalyzed the hydrolysis of side chains of poly(vinyl alcohol), short-chain p-nitrophenyl esters, 2-naphthyl acetate, and phenyl acetate, and was slightly active toward aliphatic esters. The enzyme was also active toward the enzymatic degradation products, acetoxy hydroxy fatty acids, of poly(vinyl alcohol). The K(m) and Vmax of poly(vinyl alcohol) (degree of polymerization, 500; saponification degree, 86.5-89.0 mol%) and p-nitrophenyl acetate were 0.381% (10.6 mM as acetyl content in the polymer) and 2.56 microM, and 6.52 and 12.6 mumol/min/mg, respectively. The enzyme was strongly inhibited by phenylmethylsulfonyl fluoride and diisopropyl fluorophosphate at a concentration of 5 mM, which indicated that the enzyme was a serine esterase. The pathway for the metabolism of poly(vinyl alcohol) is also discussed.

Isolation, characterization, and sugar chain structure of endoPG Ia, Ib and Ic from Stereum purpureum.

Three endopolygalacturonases (endoPG Ia, Ib, and Ic) were isolated from the culture filtrate of Stereum purpureum, the causative fungus of apple silver-leaf disease. Their properties, including specific activities, optimum pHs, thermal stabilities, and kinetic parameters (K(m) and Vmax) were compared. Their properties were very similar to one another except for the substrate specificity and relative molecular mass. The sugar chains of endoPG Is were released by hydrazinolysis, and one major sugar chain common to endoPG Is was isolated. The pyridylamino sugar was characterized by a two-dimensional mapping method using HPLC, and identified as a high mannose type N-linked sugar chain, Man alpha 1-6(Man alpha 1-3)Man alpha 1-6(Man alpha 1-3) Man beta 1-4 GlcNAc beta 1-4 GlcNAc (designated as M5.1). Observation of the course of Western blot analysis for the proteins from the culture filtrate with endoPG I antibodies showed that the fungus secreted three endoPG Is into the culture broth during the growing period.

Lipiodolized gelatin sponge: a simple method to make gelatin sponge radiopaque.

Gelatin sponge particles were rendered radiopaque by soaking them in small amounts of iodized oil (LP-GS). They were evaluated for their usefulness in transarterial embolization (TAE). The LP-GS particles were well visualized fluoroscopically during TAE. The duration of the opacity of LP-GS exceeded 24 hours both in vitro and in vivo. LP-GS are useful, and are an easily obtainable, radiopaque, embolic material.

Cloning and sequence analysis of cDNA encoding endopolygalacturonase I from Stereum purpureum.

Endopolygalacturonase (endoPG) I was obtained from Stereum purpureum by an improved easier purification procedure. It was found that EndoPG I consisted of three glycosilated proteins with the same isoelectric point and different molecular masses, 42, 45, and 48 kDa, respectively. However, the enzymatic deglycosilation product of endoPG I gave a single band at the position corresponding to 39kDa on SDS-PAGE. Furthermore, the N-terminal amino acid sequences of three endoPGs were identical one another up to 20 residues. A cDNA library was constructed and positive cDNA clones encoding endoPG I were isolated by using antibody raised against the purified endoPG I. Nucleotide sequence analysis of the cDNA disclosed a 1212-bp open reading frame that encoded 403 amino acid residues. The N-terminal amino acid sequence (residues 1-20) of endoPG I coincided with the deduced amino acid sequence starting from the 25th residue. Therefore, the sequence of the first 24 residues represented a signal peptide and the remaining sequence, consisting of 379 residues, was the mature protein with molecular mass of 39.1 kDa. The deduced sequence of endoPG I showed 30-45% similarity in comparison with those of bacterial and fungal endoPGs, and the sequence of putative active site residues reported for the endoPGs was highly conserved in the sequence of endoPG I.

Covalent attachment of 4-hydroxy-2-nonenal to erythrocyte proteins.

It has been established that the covalent modification of proteins occurs in vivo as a consequence of reaction with reactive lipids such as 4-hydroxy-2-nonenal (HNE). The fact that HNE occurs in blood under physiological as well as pathophysiological conditions suggests that erythrocytes undergo modification by HNE. Here we describe the immunochemical characterization of HNE-treated erythrocytes by demonstrating the Michael-type HNE addition to both membrane and cytosolic proteins. Exposure of erythrocytes to HNE (0-0.5 mM) for 2 h resulted in HNE labeling of multiple membrane proteins. Pretreatment of erythrocytes with a sulfhydryl reagent, N-ethylmaleimide (NEM), resulted in a significant decrease of HNE attached to the proteins, suggesting that HNE primarily reacts with the sulfhydryl groups of erythrocyte membrane proteins, whereas enhanced HNE labeling of the membrane proteins was observed when the erythrocytes were pretreated with H2O2 (0.1-5 mM) for 15 min. On the other hand, highly selective modification of a 30 kDa protein was observed in the hemolysates of erythrocytes treated with HNE. The protein, which represents a major intracellular target of HNE in erythrocytes, was identified as carbonic anhydrase, based on the observations that (i) a reverse-phase HPLC analysis of the chloroform/ethanol extract of HNE-treated erythrocytes detected two major proteins, which cross-reacted with anti-carbonic anhydrase antibody as well as with the anti-HNE adducts antibody, (ii) the chloroform-ethanol extraction of authentic carbonic anhydrase gave a similar HPLC pattern, and (iii) the HNE treatment of erythrocytes resulted in the partial inhibition of the carbonic anhydrase activity.

[Clinical management of hypertension in patients with pheochromocytoma].

Surgical treatment of 18 tumors in 17 patients with pheochromocytoma, containing unsynchronous bilateral adrenal tumors, was performed at our department between 1978 and 1995. As an index of management of hypertension before and after surgery, maximum systolic blood pressure except critical region (more than mean + 2 SD) was used in this study. As an index of control of blood pressure during surgery, the difference between maximum and minimum systolic blood pressure during palpating tumor was also adopted. The index before surgery was closely correlated with the index in surgery (R = 0.646, P = 0.0038); maximum systolic blood pressure before surgery was a useful index forecasting the variation of blood pressure in surgery. The management of blood pressure before surgery was the most difficult in the group with sustained hypertension with superimposed paroxysms. After surgery, 2 patients without hypertension before surgery had hypotension, 2 others remained hypertensive and the others had normal blood pressure. Our findings indicated that the index of management of hypertension before surgery used in this study was a simple, noninvasive and important marker for variation of blood pressure in surgery.

Adult cystic Wilms' tumor (nephroblastoma): radiologic features with pathologic correlation.

Wilms' tumor is an uncommon disease in adults. Wilms' tumor typically presents as a large complex mass with cystic component and varying degrees of vascularity. The previously reported radiologic findings have reflected this complex appearance. We present a case of cystic Wilms' tumor in an adult patient. The tumor presented as a large, rapidly growing, hypovascular, multicystic mass with minimal solid component which showed as septation on ultrasound, contrast enhanced CT, and MR studies. The preoperative findings were suggestive of multilocular cystic nephroma. We suggest that Wilms' tumor should be included in the differential diagnosis of a patient who presents with a large, rapidly growing, multicystic renal mass.

Prognostic value of urokinase-type plasminogen activator in patients with superficial bladder cancer.

OBJECTIVES: A number of studies have demonstrated that urokinase-type plasminogen activator (u-PA) is one of the major enzymes in the development of cancer invasion and metastasis. We examined the possibility that u-PA content is an independent prognostic marker for superficial bladder cancer. METHODS: The u-PA content was estimated in superficial bladder cancer from 52 patients undergoing transurethral resection for the first time. The survival rates of the patients were calculated and the prognostic values for u-PA content (less than 8 ng/mg protein versus more than 8 ng/mg), Stage (pTa or pT1), grade (1 and 2 versus 3), number (single versus multiple), and size (less than 1 cm versus more than 1 cm) of tumor were determined by a multivariate regression model. RESULTS: Development of cancer invasion and metastasis was observed in 3 and 8 patients, respectively. The survival rate of the patients with high u-PA content was significantly lower than those with low u-PA content (P < 0.005). In the multivariate regression analysis, u-PA content was the most important risk factor for the prognosis, compared with the other factors: tumor stage, grade, multiplicity, and size. CONCLUSIONS: We have first shown that u-PA content is a new independent prognostic marker in patients with superficial bladder cancer.

[Treatment of advanced renal cell carcinoma with a combination of interferon alpha and gamma].

A total of 29 patients with advanced renal cell carcinoma entered a pilot study of combination therapy with interferon alpha (IFN-alpha) and interferon gamma (IFN-gamma). IFN-alpha (HLBI: 3 x 10(6) IU, BALL 1:5 x 10(6) IU, IFN-alpha-2a: 9 x 10(6) IU or IFN-alpha-2b: 6 x 10(6) IU) was given intramuscularly every day and IFN-gamma (IFN-gamma-1a: 3 x 10(6) JRU) was given intravenously by drip infusion 3 times a week (every 2-3 days). The treatment was continued for 3 months as the induction therapy, and then the tumor response was evaluated. Of the 22 evaluable patients, 4 achieved a partial response (PR), 10 showed no change (NC), and in 8 the disease had progressed (PD) during the therapy. Thus, the overall response rate was 18.2% [95% confidence interval (CI) 2.1-34.3%]. A favorable response tended to be obtained in patients with good performance status or small pulmonary metastases, or in those who had no prior therapy with IFN-alpha, who received this treatment immediately subsequent to radical nephrectomy, or who received IFN-gamma as much as possible according to this regimen. Toxicity was evaluated in 28 patients: fever, general fatigue, anorexia, leukocytopenia and impaired liver function were frequently noted, and 3 patients were withdrawn from the study because of such adverse effects. In patients who had a PR or NC, the same dosage of IFN-alpha was continued to be given intramuscularly 2-3 times a week (every 2-4 days) as the maintenance therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of suramin on metastatic ability, proliferation, and production of urokinase-type plasminogen activator and plasminogen activator inhibitor type 2 in human renal cell carcinoma cell line SN12C-PM6.

Effects of suramin, a polysulfonated naphthylurea compound, on metastatic ability, proliferation, and production of plasminogen activators and plasminogen activator inhibitors were studied using the highly metastatic human renal cell carcinoma cell line, SN12C-PM6. After renal subscapular implantation of tumor cells in nude mice, suramin significantly inhibited metastasis of tumor cells to the lungs and liver. In vitro growth of tumour cells was inhibited by suramin in a dose-dependent manner, at relatively low doses (ID50 = 105 micrograms/ml). Plasminogen activator inhibitor type 2 (PAI-2) production by tumor cells was enhanced by suramin (100 micrograms/ml), whereas urokinase-type plasminogen activator (uPA) production was suppressed. Thus, the increase in PAI-2 and the decrease in uPA production correlated with the inhibitory effects on tumour growth and metastasis by suramin. Therefore suramin may be beneficial for the treatment of patients with an early stage of renal cancer with potential risk of metastasis.

Relationship between serum prostate specific antigen and histological prostatitis in patients with benign prostatic hyperplasia.

The relationship between the serum values of prostate specific antigen (PSA) and the extent of histological prostatitis was investigated in 42 patients undergoing transurethral resection of the prostate for benign hyperplasia (BPH) without clinical evidence of prostatitis. Histological prostatitis was divided into three groups: acute, chronic-active, and chronic-inactive inflammation. The extent of histological prostatitis was expressed as the number of prostatic acinar and ductal glands with inflammatory infiltrate per total number of glands (%). The serum PSA values significantly correlated with the extent of acute and chronic-active prostatitis (correlation coefficient r = 0.765 and 0.656, P < 0.01). A relationship between PSA values and the extent of chronic-inactive prostatitis was not found. In the immunohistochemical study, prostatic epithelial cells with acute and chronic-active inflammation showed negative staining for PSA antigen. These results indicate that histological acute and chronic-active prostatitis is considered an important factor for inducing the high increase in serum PSA values via the leak phenomenon.

Significance of invasion to the muscularis mucosae on the progression of superficial bladder cancer.

OBJECTIVE: We tried to determine the significance of invasion to the muscularis mucosae on the progression of superficial bladder cancer. METHODS: We subclassified superficial bladder cancer showing lamina propria invasion into two groups: with (pT1b) or without cancer invasion to or near the muscularis mucosae (pT1a). RESULTS: Of 164 bladder cancers, 76 showed no lamina propria invasion and 88 did. In the tumors with lamina propria invasion, 60 were diagnosed as pT1a and 28 as pT1b. The progression rate of pT1b cancer (53.5%) was significantly higher than that of pT1a cancer (6.7%) (P < 0.01). Regardless of size, number, or grade of tumor, the progression rate of pT1b cancer was significantly higher than that of pT1a cancer (P < 0.01). CONCLUSIONS: We stress that patients with superficial cancer invading to or near the muscularis mucosae should be followed up carefully after transurethral resection.

The content of urokinase-type plasminogen activator and tumor recurrence in superficial bladder cancer.

The contents of urokinase-type plasminogen activator were estimated in superficial bladder cancer from 42 patients undergoing transurethral resection for the first time. Tumor recurred in 11 of 16 patients (68.8%) with high urokinase-type plasminogen activator content (8 ng. urokinase-type plasminogen activator per mg. protein and more) and in 12 of 26 (46.2%) with low urokinase-type plasminogen activator content. In the high content group 8 patients (50%) had disease progression compared to 2 (7.7%) in the low content group (p < 0.01). The progression rates in the high urokinase-type plasminogen activator group with stage pTa disease or tumors more than 1 cm. large were significantly higher than those in the low urokinase-type plasminogen activator group (p < 0.05). The recurrence and progression rates in the high content group with stage pT1, grades 2 and 3, single and multiple tumors, and tumors less than 1 cm. large were higher than those in the low content group. The progression-free survival rate in the high content group was significantly lower than that in the low content group (p < 0.005). In conclusion, urokinase-type plasminogen activator content may be a useful marker to predict recurrence and progression of superficial bladder cancer.

[Urokinase-type plasminogen activator antigen as a prognostic factor in bladder cancer].

The relationship between the urokinase-type plasminogen activator (u-PA) content in extracts of cancer tissues and the histological grade or the extent of the primary tumor as prognostic factors in bladder cancer were examined in 55 cases of bladder cancer. The patients were divided into 2 groups, high u-PA (8 ng/ml of protein and more) and low u-PA (less than 8 ng/mg of protein) groups. The incidence of vascular invasion was 37% in the high u-PA group, and 7.1% in the low u-PA group (p < 0.05). The incidence of high u-PA group increased with the grade of cancer and the extent of the primary tumor. The 3-year survival rates were 87.3% in low u-PA group and 42.6% in high group (p < 0.005). The survival rates of the patients in the high u-PA group were lower than in the low group, by grade or stage. In a multivariate analysis, the prognostic value of u-PA antigen content was the same as that of tumor grade and stage. Therefore, the content of u-PA may be a useful prognostic marker for bladder cancer in addition to tumor grade and stage although the prognosis of the patients with bladder cancer is considered to be determined by many factors.