Bilateral cryptorchidism associated with terminal deletion of 10q.

We report on an infant with terminal deletion of 10q (del10q26.11) presenting with bilateral cryptorchidism. Of 9 males previously reported with terminal deletion of 10q, 1 had an intersex phenotype, and the others all had combinations of cryptorchidism, micropenis, and hypospadias. Terminal deletion of 10q appears to include some genes indispensable for normal male genital development.

Influence of luteinizing hormone-releasing hormone analogues on serum levels of prostatic acid phosphatase and prostatic specific antigen in patients with metastatic carcinoma of the prostate.

Serum concentrations of luteinizing hormone (LH), testosterone, prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA) were measured in 16 patients with advanced prostatic cancer before and after treatment with luteinizing hormone-releasing hormone (LHRH) analogue. An initial rise of serum LH and testosterone levels was observed on day 2 of the treatment. Subsequently, serum concentrations of PAP and PSA showed a transient increase on day 5 of the treatment. This indicates that LHRH analogues had better be given in combination with antiandrogens in patients with metastatic carcinoma of the prostate.

[An experimental study of PAH clearance in chronic unilateral and completely obstructed kidney].

The following experiment was performed to estimate PAH clearance of chronic unilateral and completely obstructed kidney and to explore its change during obstruction period. Thirty adult male mongrel dogs were used. Unilateral complete ureteral obstruction was made by ligation of the left ureter proximal to the bladder. After 3, 5, 10, 20 and 40 days of obstruction, an experiment was performed. Under laparotomy, the left kidney was exposed and polyethylene catheter was inserted into the renal pelvis. Intrapelvic pressure was monitored by pressure transducer. In a condition that PAH (p-aminohippurate) was constantly infused intravenously, intrapelvic urine of the obstructed kidney was exchanged for physiological saline. After the exchange, intrapelvic PAH concentration was measured at hourly intervals for 4 hours. At each midpoint of the measurements, plasma PAH concentration was measured. At the end of the experiment, the obstructed kidney was resected and pelvic capacity was measured. PAH of the obstructed pelvis increased at hourly intervals after the exchange. The result showed that the clearance ability was maintained in the completely obstructed kidney. PAH clearance values were 16.3, 13.6, 1.0, 0.9, 0.9 ml/hr/kg b.w. at 3, 5, 10, 20 and 40 days obstruction respectively. PAH clearance decreased sharply during early stage of obstruction and tended to reach a fixed low value at over 10 days of obstruction. Our experimental method seemed to be available to estimate the clearance ability of chronically, unilaterally and completely obstructed kidney.

Cerebral alveolar hydatid cyst--case report.

A rare case of cerebral alveolar hydatid disease in a 41-year-old female is presented. The larval mass was subtotally removed and the presence of alveolar hydatid cysts established histologically. Postoperatively, slight mental disturbance persisted but paresis did not develop.

[Retroperitoneal mixed type liposarcoma: a case report].

Primary retroperitoneal tumors are reported to account for 0.2% of all malignancies. Furthermore, 10-20% of all primary retroperitoneal tumors are liposarcomas. Up to 1989, 213 cases of retroperitoneal liposarcoma have been reported in the Japanese literature to our knowledge. Mixed type liposarcomas were rare, and composed 13.8% of all retroperitoneal liposarcomas in this series. We described here a case of retroperitoneal mixed type liposarcoma. A 50-year-old man was admitted to our department with a mass in the left abdomen. Computed tomography and aortography revealed a huge and hypovascular tumor in the retroperitoneal cavity, not containing fat tissue. It was diagnosed as a retroperitoneal tumor and treated surgically. The tumor and the left kidney were encapsulated and could be removed en bloc. The size and weight of the tumor were 28 x 18 x 12 cm and 3,100 g, respectively. Histological examination of the mass proved it to be a mixed type liposarcoma. He was administered OK-432 as adjuvant therapy. After 11 months, bone metastasis to the vertebra appeared. Moreover, lung metastasis also occurred and he died of the disease 15 months after the operation.

Malignant lymphoma of the prostate. Report of a case.

A 63-year-old man with primary malignant lymphoma of the prostate is presented. The patient underwent total cystoprostatectomy and ileal conduit construction. The specimen revealed malignant lymphoma, diffuse small cleaved cell of the gland. Three months after the operation, local recurrence and enlarged lymph node development were demonstrated by computed tomography. The patient tolerated well a combination chemotherapy of VP-16, doxorubicin, cyclophosphamide and prednisolone for 5 cycles. Tumor recurrence and lymph node spread could never be recognized following this drug treatment. The patient has been asymptomatic after this chemotherapy for over 3 years.

[A case report of Cushing's syndrome due to adrenocortical nodular dysplasia, with remission period of 6 years after unilateral adrenalectomy].

A 29 y.o. female had been associated with Cushing's syndrome, gradually, from 1977. She was advised to get further examination at our hospital on September 1980. A pre-operative diagnosis of Cushing's syndrome due to bilateral adrenocortical tumors was made and right adrenalectomy was performed on December 22, 1980, as the 1st of two stage operation. The right adrenal, 1.8 cm in diameter, had a pigmented nodule and multiple pigmented micronodules, which were diagnosed pathologically as primary adrenocortical nodular dysplasia. It was not necessary for this patient to maintain steroid therapy, but after 3 months she complained of the withdrawal syndrome and was administered dexamethasone. Since July, 1981, she had no symptom without adrenocortical steroid administration. In November 1986, she became cushingoid and on June 1, 1987, we performed left adrenalectomy on her. The appearance of the left adrenal was similar to the right. We have found no reports of the cases of adrenocortical nodular dysplasia such as delayed appearance of withdrawal syndrome after unilateral adrenalectomy. In this case, plasma ACTH had relatively poor correlation with cortisol. Her plasma ACTH was not always suppressed and sometimes within normal range. Her adrenals had not only autonomy but also pituitary dependency. It is concluded that in this case there may have been a pituitary-adrenal dual control.

Ureteral obstruction secondary to sigmoid diverticulitis.

A case of ureteral obstruction secondary to diverticulitis is described. The patient had a 2-month history of lower left quadrant pain before an operation. As an intravenous pyelogram showed persistent hydronephrosis, an operation was performed. At the operation, a fibrotic mass which encased the left ureter and sigmoid colon was found. Ureterolysis and segmental sigmoidectomy were carried out. The pathological specimen showed two diverticula and subserosal cicatrization.

[Metastatic malignant melanoma of the urinary bladder: a case report].

A 77-year-old male was admitted to our department with the chief complaint of positive occult blood in urine on July 30, 1984. Endoscopically, we found a dark red tumor on the left posterior wall of the urinary bladder, which seemed to have coagula covering it. On August 31, transurethral resection of the bladder tumor (TUR-Bt) was performed, and the pathological interpretation was malignant melanoma. Dermatologically and ophthalmologically, we could not found the primary foci. A month later, cystoscopy demonstrated multiple blue black spots consistent with diffuse melanoma of the bladder. On May 7, 1985, he was admitted to our clinic with right hypochondralgia. On physical examination, the liver was palpable with an irregular surface, and the echogram showed multiple metastasis in the liver. TUR-Bt was carried out again, on May 17, 1985. Ultrastructually resected specimens demonstrated a lot of mature melanosomes in the tumor cells. The course of the patient progressively worsened, and he died on May 30, 1985. At autopsy, we found metastases in the central nervous system, bone, genitourinary tract, gastrointestinal tract and other organs. The left eye ball, which had been diagnosed as ophthalmomalacia by glaucoma six years earlier, was filled by a melanoma mass, and it seemed to be the primary foci.

[Cancer of the bladder in a patient with spinal cord injury].

A case of cancer of urinary bladder in a 39-year-old incomplete C7 paraplegic male is reported. He was injured in 1962, and was admitted to our department in August, 1982 because of macrohematuria. Intravenous pyelography showed dilation of right ureter and pelvis. Cystography revealed filling defect on the right wall of bladder, but vesicoureteral reflux was not seen. Endoscopically, we found the tumor on the right wall, which seemed to invade to the trigone and right ureteral orifice. CT scan and pelvic angiography showed that the tumor extended extramurally of the bladder and metastasized to lymph-nodes. In November, 1982, bilateral ureterocutaneostomy, and 30 days later, total cystectomy were performed. The removed bladder demonstrated transitional cell carcinoma with undifferentiated tumor cells. The patient died of recurrence of the tumor in the small pelvic cavity, 60 days later. Ten cases of bladder cancer in patients with spinal cord injury were collected from Japanese literature including ours, and the importance of periodic cytology, cystoscopy and random biopsy for early diagnosis of bladder cancer on paraplegics were discussed.