Experimental and theoretical study of harmonic generation at contacting interface.

The second harmonic generation behavior of a contacting interface has been evaluated experimentally and discussed theoretically in the light of a nonlinear interface model. Two aluminum blocks were mated together to constitute a contact interface and subjected to normal compressive loading. A 5 MHz longitudinal toneburst wave was sent to the interface in the normal direction and the transmitted wave was recorded, from which the fundamental and the second harmonic components were extracted. A nonlinearity parameter was obtained as the ratio of the second harmonic amplitude to the squared fundamental amplitude. From the measured contact pressure dependence of the transmitted fundamental amplitude, the linear and the second-order interfacial stiffness parameters were identified, which enabled the evaluation of the nonlinearity parameter based on the theoretical model. The theoretical contact pressure dependence of the nonlinearity parameter was found to be in good qualitative agreement with the experimental results.

[Binocular functions in amblyopia and strabismus].

Regarding the changing trends in the concept, definition, etiological classification, and criteria for diagnosis of amblyopia, we reviewed a total of 4,693 cases of amblyopia seen during the past 37 years. The amblyopia was divided into four types: strabismic, anisometropic, ametropic, and form vision deprivative. There was a definite trend for the incidence to decrease and for the diagnosis to be made during earlier age in recent years. Although favorable recovery of visual acuity is obtained after treatment of amblyopia and strabismus, there are difficulties in obtaining good binocular functions in early-onset amblyopia and strabismus. This feature was evaluated in regard to motion perception asymmetry (MPA) and binocular depth from motion (DFM). Many cases of early-onset amblyopia and strabismus showed no disparity stereopsis, or position stereopsis, in spite of the presence of DFM. The MPA appeared to be closely related to early-onset esotropia regardless of age, while it disappeared and motion perception became symmetric 4 to 5 months after birth in normal infants. The DFM seemed to play an important role in maintaining good motor alignment for several years after surgery. I developed a checkerboard pattern stimulator in 1978. This method proved to be useful in developing binocular functions and motor alignment by applying simultaneous bifoveolar stimulation and anti-suppression. Extensive exposure to the stimulation was essential for therapeutic success.

Renal oncocytoma treated by surgical enucleation: a case report.

We experienced a case of renal oncocytoma, in a 46-year-old woman. At a health examination, ultrasonography revealed a right renal tumor, and she was admitted to our hospital for evaluation. From the ultrasonogram, computerized tomography (CT) and angiography, we suspected a renal oncocytoma, but renal cell carcinoma was not completely ruled out. Since the location of the tumor seemed suitable for a local resection, we scheduled a surgical enucleation, but we intended to switch to a radical nephrectomy if examination of a frozen-section suggested renal cancer. Because the frozen findings were suggestive of an oncocytoma without malignancy, the surgical enucleation procedure was completed as scheduled. Pathological findings of the resected specimens were characterized by granular eosinophilic cytoplasm, and rounded nuclei without nuclear pleomorphism or mitotic figures. Electron microscopic studies revealed an increased number of mitochondria. The patient was accordingly diagnosed as having renal oncocytoma. We also reviewed the literature to elaborate procedures for a preoperative diagnosis and therapy for renal oncocytoma.

[Clinical study on stage PT1 and grade 3 transitional cell carcinoma of the urinary bladder].

Thirty-three patients who had transitional cell carcinoma of the bladder with stage PT1 and grade 3 components were treated between January 1980 and December 1992. Clinical study was done for these 33 patients on treatment modalities and it's problem, intravesical recurrence, disease progression and prognosis. Twenty-five of 33 patients underwent bladder-sparing surgeries and total cystectomy was performed for another 8 patients as initial treatment. Intravesical recurrence was observed in 18 (72%) of 25 patients who underwent initial bladder-sparing surgeries. Recurrence-free rate was 44% for 1 year and mean period to recurrence from initial therapy was 13.1 months. Although some adjuvant therapy after initial treatment was performed for 20 patients, it's efficacy in preventing intravesical recurrence could not be confirmed. Disease progression was recognized in 10 (40%) of 25 patients initially treated by bladder-sparing surgeries after median latent period of 33.7 months, whereas only one (12.5%) of another 8 patients who underwent total cystectomy showed progression, and 5-year progression-free rate after initial bladder-sparing surgeries was 55.6%. Three and five-year actural survival rate in all cases were 81.5% and 65.1%, respectively. According to initial treatment, 5-year survival rate was 62.2% for the patients treated by bladder-sparing surgeries, whereas it was 83.3% for the cases who underwent total cystectomy. However statistical significant difference was not recognized. In view of disease progression after initial bladder-sparing surgeries, patients with progression yealed a 45.7% 5-year survival rate compared to 81.5% for the patients without progression, and significant difference was demonstrated between them.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical experience with extracorporeal shock wave lithotripsy using Dornier MFL 5000-(U) for urinary stone].

Our hospital recently installed one of the newest types of extracorporeal shock wave lithotripters, a Dornier MFL 5000-(U). We conducted preliminary clinical trials with the apparatus from April to June 1991. In this report we discuss our experience with the first 40 patients (52 stones) treated in a total of 52 extracorporeal shock wave lithotripsy (ESWL) sessions. Follow up observation was conducted for three months. Except in one case, invasive anesthesia was not used. A double J-catheter was inserted in 13 cases, a ureteral catheter in 7 cases, and percutaneous nephrolithotripsy (PNL) was used after ESWL in one case. After one month of follow-up, 27 patients (67.5%) were completely free from stone fragments, while at 3 months after treatment, 34 patients (85.0%) were free from stone fragments. No serious complications were observed after ESWL. We concluded that the Dornier MFL-5000-(U) apparatus is effective for renal and ureteral stones and generates no serious complications.

[Annual changes of bacteria isolated from urinary tract infections and their susceptibility to new quinolone agents].

Statistical analyses were conducted on bacterial strains isolated from the urine of patients with urinary tract infections (UTI) in the Department of Urology at Aichi Medical University from January 1988 through December 1991. The drug sensitivity of the bacterial strains isolated from patients with complicated UTI between 1988 and 1991 was analyzed and compared. Among the outpatients with uncomplicated UTI, a total of 352 strains were isolated. E. coli was isolated the most frequently (90.1%). Among the outpatients with complicated UTI, a total of 829 strains were isolated. Enterococcus sp. was isolated the most frequently (21.2%). P. aeruginosa and S. aureus showed a tendency to increase. Among the inpatients with complicated UTI, a total of 671 strains were isolated. Enterococcus sp. was isolated the most frequently (22.5%). P. aeruginosa and S. aureus showed a tendency to increase, while E. coli and Enterobacter sp. showed a tendency to decrease. E. coli was highly sensitive to all drugs except ampicillin (ABPC). Proteus sp. and Klebsiella sp. were highly sensitive to norfloxacin (NFLX). P. aeruginosa was highly sensitive to gentamicin (GM). The frequency of NFLX-sensitive P. aeruginosa significantly dropped from 84.6% to 40.9% among the outpatients (P < 0.01), and from 75.0% to 44.4% among inpatients (P < 0.05). S. aureus was highly sensitive only to minocycline (MINO). The frequency of NFLX-sensitive S. aureus significantly dropped from 66.6% to 23.3% among inpatients (P < 0.05). Enterococcus sp. was highly sensitive to ABPC and MINO. Of the new quinolones, tosufloxacin (TFLX) had the strongest antimicrobial activity followed by (ciprofloxacin) CPFX on all the bacterial strains tested.

[Radiation therapy for human renal cell carcinoma transplantable to the nude mice].

Efficacy of radiation therapy was studied using human renal cell carcinoma strain (AM-RC-3) implantable in nude mice. Cobalt 60 gamma-ray was used dosage of 5 Gy, 10 Gy, 15 Gy and 20 Gy in single, localized exposures of subcutaneously implanted tumors of the lower right femoral region. Therapeutic efficacy was determined using the Battelle Columbus Standard and evaluation of histological changes based on National Cancer Research Institute (Shimosato's classifications). Conclusion based on the obtained data are as follows: I) The T RW/C RW ratio on the tumor growth curve was 42% or less for all dosage groups except the 5 Gy group; dosages other than 5 Gy are believed effective. The 15 and 20 Gy dosage were particularly effective and the respective groups had RW of 0.96 and 0.95. II) Although Grade IIa and IIb changes were observed in the 15 and 20 Gy dosage groups, respectively, two weeks after irradiation, four weeks after irradiation all groups exhibited microscopic tissue formations that could be considered regrowth of tumor cells. Determination of histopathological effectiveness two weeks after irradiation is thought most suitable. III) Radiation therapy is appropriate as an adjuvant treatment in cases of renal cell carcinoma and should be used in combination with other therapies.

[Clinical evaluation of sultamicillin in the treatment of urinary tract infections].

Sultamicillin, a new semisynthetic oral beta-lactam antibiotic, was evaluated for its antibacteria susceptibility and clinical efficacy against urinary tract infection (UTI), and the following results were obtained. The sensitivity of sultamicillin (SBTPC) on 518 strains of clinical isolates from the urine were tested and compared to ampicillin (ABPC). S. aureus, S. epidermidis, Enterococcus sp., Streptococcus sp., E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, M. morganii and Acinetobacter sp. showed high sensitivity to SBTPC. The antibacterial activity of SBTPC was superior to that of ABPC in most strains and especially more superior in beta-lactamase producing strains. The clinical effectiveness rate on a total of 15 patients with acute uncomplicated cystitis was 93.3% and the eradication rate of causative organisms was 93.3%. On 15 patients with chronic complicated UTI, the clinical effectiveness rate was 73.3% and eradication rate was 76.5%. Side effects (diarrhea) were observed in 3 cases, but this symptom was not severe and soon disappeared. Abnormal laboratory data due to the drug were not observed.

A clinical study of total cystectomy for transitional cell carcinoma of the urinary bladder.

Fifty six patients with transitional cell carcinoma of the urinary bladder were treated by total cystectomy from January, 1979 through December, 1988. A retrospective study was conducted on 52 patients on whom prognosis could be followed up. There were 40 men and 12 women (male to female ratio: 3.3: 1), between 32 and 79 years old (mean age, 64.1 years old). The overall 1-, 3- and 5-year survival rates were 65.8%, 54.1% and 43.0%, respectively. The 5-year survival rates for patients with low grade (G, I, II) and high grade (G. III) were 41.9% and 42.7%, respectively: with no significant difference in the survival curves between the two groups. The 5-year survival rates according to histopathological stage were 78.9% for patients in low stage, 24.7% in high stage, and the difference in the survival curves between the two groups was statistically significant (P less than 0.001). The mortality in the 21 cases of the 33 high stage cases in which cisplatin was used was 42.9%, with 3- and 5-year survival rates were 53.1% and 36.8%, respectively. In the remaining 12 cases in which cisplatin was not used for post-operative chemotherapy, the mortality in the 12 cases was 83.3%, with 3- and 5-year survival rates of 25.1% and 12.3%, respectively. Thus, the patients who received post-operative chemotherapy showed a better survival rate than those who did not with a significant difference (P less than 0.05). The results of the present study suggest the usefulness of post-operative adjuvant chemotherapy in the high stage case.

[Detection of beta-lactamase-producing strains isolated from urinary tract and their drug susceptibility].

A total of 518 bacterial strains isolated from the urine of patients with various urological diseases in our Urological Department between November, 1987 and February, 1989 were studied for their beta-lactamase production and susceptibility to various antimicrobial agents was determined. beta-lactamase activity was determined by the acidometry disc method. There were 241 gram-positive cocci, 276 of gram-negative rods and 1 Neisseria gonorrhoeae. Thirty-four percent of the gram positive and 76.3% of gram negative rods produced beta-lactamase. S. aureus (81.3%), S. epidermidis (65.1%) in gram-positive cocci, E. cloacae (100%), S. marcescens (100%), C. freundii (100%), P. aeruginosa (97.2%), P. Rettgeri (88.9%), E. gergoviae (85.7%), K. oxytoca (84.6%), M. morganii (81.8%) and E. coli (69.0%) in gram-negative rods produced beta-lactamase at a higher rate. beta-lactamase produced by gram-positive cocci was entirely penicillinase, and that produced by gram-negative rods only penicillinase in 4.0%, only cephalosporinase in 44.2% and both in 25.4%. In S. aureus and S. epidermidis, the isolated rate of strains resistant to ampicillin (p less than 0.01) and piperacillin (p less than 0.05) in the beta-lactamase producing strains was significantly higher than that in the beta-lactamase non-producing strains. In E. coli, the isolation rate of strains resistant to ampicillin and piperacillin in the penicillinase-producing strains was significantly higher than in the penicillinase non-producing strains (p less than 0.01). But both cephalosporinase-producing strains and beta-lactamase non-producing strains showed high susceptibility to cephalothin. These results suggest that the penicillinase might present a clinical problem in the treatment of urinary tract infections by S. aureus, S. epidermidis and E. coli.

[Malignant mesodermal mixed tumor of the bladder: report of a case].

An 81-year-old woman was admitted to our clinic due to gross hematuria. A large bulky pedunculated mass was found in the bladder by cystoscopic examination. Subtotal cystectomy and bilateral cutaneostomy was performed on January 12, 1987. Histologically the tumor was composed of carcinomatous and sarcomatous elements. The carcinomatous element was composed fundamentally of grade 2, transitional cell carcinoma with numerous foci of squamous metaplasia. The sarcomatous element was composed of myxosarcomatous, chondro-sarcomatous pattern and non-differentiated malignant spindle cell component. Immunohistochemical examination demonstrated the presence of cytokeratin and epithelial membrane antigen in the spindle cell and more obvious carcinomatous regions, using the avidin-biotin conjugated immunoperoxidase technique. The patient died 3 months after operation. Autopsy findings showed multiple organ metastasis which were composed of carcinomatous and sarcomatous elements.

[A case of signet ring cell carcinoma of the urinary bladder].

A 67-year-old man was admitted for complaint of gross hematuria on April 9, 1986. Cytoscopic examination was revealed broad-base tumor, its size was thumb's head, at the right lateral wall of the bladder. Ultrasonography and computed tomographic scan of the bladder demonstrated no evidence of invasion to adjacent organs. The biopsy showed signet-ring cell carcinoma. Radiography of the digestive organs showed no abnormality. A partial cystectomy was performed. Histologically the tumor was limited up to submucosa, that is pT1b. The localization of carcinoembryonic antigen (CEA) on tissue of our case, using the peroxidase-antiperoxidase (PAP) method, was evidenced.

[Chronological changes in bacteria isolated from the urinary tract and their drug sensitivities].

Statistical studies were performed on bacterial strains isolated from the urine of patients with various urological disease in our Urological Department between January, 1983 and December, 1987. In 1987, sensitivity tests of antibiotics to various pathogens were carried out. From the outpatients, 5,725 bacterial strains were isolated. S. epidermidis was isolated most frequently (23.8%), followed by Enterococcus species (16.5%), E. coli (14.7%), Streptococcus species (12.6%), Proteus species (5.3%), other GNR (4.6%), P, aeruginosa (4.5%), Klebsiella species (4.4%), and others. From the inpatients, 4,747 bacterial strains were isolated. Enterococcus species was isolated most frequently (23.1%), followed by S. epidermidis (18.7%), Fungi (12.9%), P. aeruginosa (8.0%), other GNR (6.8%), Streptococcus species (5.4%), Enterobacter species (4.8%), E. coli (4.1%), S. aureus (4.1%) and others. Annual change of distribution of organisms indicated that S. aureus from outpatients had a tendency to increase and Streptococcus species had a tendency to decrease. Whereas from inpatients, E. coli, other GNR, Pseudomonas species and Enterobacter species had a tendency to increase, and Streptococcus species, P. aeruginosa, Proteus species and Klebsiella species had a tendency to decrease. S. epidermidis showed a high sensitivity to minocycline and cephalothin, and Enterococcus showed a high sensitivity to ampicillin and minocycline, but did not show good sensitivity to cefoperazone and latamoxef. E. coli showed a high sensitivity to all drug we tested. P. aeruginosa showed a high sensitivity to gentamycin and norflaxacin, but did not show good sensitivity to other many drugs we tested.

The study on cell surface antigens in epithelial tumor of the upper urinary tract: ABH-isoantigen and Thomsen-Friedenreich antigen.

ABH-isoantigen (ABH-Ag) and Thomsen-Friedenreich antigen (T-Ag) were investigated by the Avidin-Biotin-Peroxidase Complex (ABC) method on 47 patients with epithelial tumor of the upper urinary tract (all patients underwent nephroureterectomy including the cuff of the bladder; 30 patients were diagnosed as transitional cell carcinoma of renal pelvis and 17 ureteral organs). The correlations between ABC expression for ABH-Ag and T-Ag with histological grade, stage and prognosis (5 year survival rate) were studied. A correlation was observed between grade (p less than 0.05) and deletion of the antigenicity of ABH-Ag, but no correlation was evident with stage and prognosis. A high correlation was evident, however, between grade (p less than 0.01), stage (p less than 0.01) and prognosis (p less than 0.01) and deletion of the antigenicity of T-Ag. The analysis of ABC expression for ABH-Ag and T-Ag may therefore be valuable for predicting the malignant potential in transitional cell carcinoma of the upper urinary tract. T-Ag determination in particular may provide a useful prognostic probe should it find clinical application.

[Study of the Thomsen-Friedenreich antigen in bladder tumors].

Thomsen Friedenreich antigen (T-ag), ABH isoantigen (ABH-ag) in 106 cases with bladder tumor (all transitional cell carcinoma) of various histological grades and stages were investigated by the Avidin-Biotin-Peroxidase Complex (ABC) method. There was a correlation between histological grade, stage and deletion of the antigenicity (T-ag and ABH-ag). In a follow-up study of 45 patients with low grade and low stage tumor, the recurrence rate after surgery of the cases with abnormal antigenicity (T-ag and ABH-ag) was significantly higher than that of the cases with the normal antigenicity. Combination of two markers (T-ag and ABH-ag) was significantly more effective than the single marker.

[Study on heterotransplantation of human malignant urogenital tumors in nude mice: establishment of the tumor line in nude mice from human primary ureteral tumor and its characteristics].

The tumor line in nude mice is one of the most important experimental animal models for oncodevelopmental studies. We implanted a human ureteral tumor into nude mice, established the tumor line, AM-UT-1, and maintained it by serial transplantation. The characteristics of this tumor line in nude mice are reported. Histologically, the original tumor was a transitional cell carcinoma (grade II, stage B). The transplanted tumor grew locally and had a constant growth pattern during serial passage until the 13th passage in nude recipients and maintained the basic histological, immunohistochemical findings of the original tumor. Both original tumor and serial transplanted tumor had carcinoembryonic antigen (CEA)-producing activity. A high level of serum CEA was also recognized in nude mice.

[The study of the ABH isoantigen of bladder tumors].

ABH isoantigens in 82 cases with bladder tumor of various grades and stages were investigated by the avidin-biotin-peroxidase complex (ABC) method. Correlation of ABC expression for isoantigens with pathological findings on the grading and staging system of the bladder tumors were as follow: Of 60 cases of low grade tumors, 34 (56.7%) were positive and of 22 cases of high grade tumors, 21 (95.5%) were negative. Of 63 cases of low stage tumors, 35 (55.6%) were positive and all 19 cases of high stage tumors, (100%) were negative. The isoantigens in the tissue of the bladder tumors tended to disappear as the histologic anaplasia of the tumor progressed. There was a high correlation between the histological grade, stage and ABC expression (p less than 0.01). In a follow-up study of 38 patients with low grade, low stage, initial transitional cell carcinoma, 9 of the 24 patients positive for ABC expression (37.5%) showed recurrence during the 1 to 6 year follow-up period, whereas 10 of the 14 patients negative for ABC expression 10 (71.4%) did. There was a high correlation between the recurrence rate and ABC expression (p less than 0.05). Therefore, the analysis in the bladder tumors may be valuable for prediction of malignant potential, especially for the low grade, low stage tumors.

[Clinical experience with T-2588 in complicated urinary tract infections].

The clinical effectiveness and safety of T-2588 were evaluated in 21 patients with complicated urinary tract infections. Six hundred mg of T-2588 per day was administered orally in three divided doses for 14 days. The results were excellent in 7 cases (33.3%), moderate in 8 cases (38.1%) and poor in 6 cases (28.6%), and the effectiveness rate was 71.4%. The effectiveness rates of the single infection group and mixed infection group were 91.7% and 44.4%, respectively. The overall bacteriological eradication rate obtained was 77.1%, and those of gram-positive cocci and gram-negative rods were 62.5% and 81.5%, respectively. None of the 21 cases, had any significant side effects and abnormal laboratory findings. From the above results, T-2588 is considered to be a useful antibiotic in the treatment of complicated urinary tract infections.

[A study on the levels of cefoperazone in urological organs].

The concentration of Cefoperazone (CPZ) in urological organs and serum was measured after the intravenous administration of 2 g of CPZ. Serum levels on healthy adults attained a maximal value of 122.1 +/- 4.2 micrograms/ml at 30 minutes. Serum levels of patients operated under general anesthesia attained a maximal value of 159.0 +/- 13.9 micrograms/ml at 30 minutes. Serum concentration on operated cases continued to be 1.3-2.2 fold higher than that of the healthy adults. Prostate tissue levels attained a maximal value of 80.9 +/- 3.6 micrograms/g at 30 minutes, vesical tissue levels were 52.1 +/- 1.3 microgram/g at 60 minutes and renal tissue were 94.0 +/- 14.5 micrograms/g at 90 minutes. Judging from the minimal inhibitory concentration of CPZ, CPZ seemed to be clinically useful in the treatment of urological infections.

[A clinical study on testicular tumor].

The 19 cases of testicular tumors treated at our Hospital between 1974 and 1983, were reviewed retrospectively. The incidence of testicular tumors among the male outpatients in our urologic clinic was 0.31%. The patients ranged in age from 1 to 76 years old (average: 27.8 years old). The affected side was the left side in 11 and the right side in 8 cases. The most frequent symptom was a painless mass of the testis. Histopathological diagnosis according to the classification by Dixon and Moore was type I in 9 cases, type II in 4 cases, type II in 1 case, type IV in 4 cases. Thus germinal tumors accounted for 18 (94.7%) of the cases. One case (5.3%) of malignant lymphoma was non-germinal. As for the age distribution, two peaks were noted in testicular tumors, especially in cases with potential embryonal carcinoma, between 1 and 2 years and between 19 and 32 years. On the other hand, the cases with potential seminoma showed one peak between 25 and 44 years. The treatment consisted of high orchiectomy alone, orchiectomy with radiation, orchiectomy with chemotherapy or orchiectomy with radiation and chemotherapy. Retroperitoneal lymphadenectomy was not done in any case. The over-all 3-year and 5-year actual survival rates were both 92%.