High-dose cutaneous exposure to mite allergen induces IgG-mediated protection against anaphylaxis.

BACKGROUND: The relationship among natural allergen exposure, induction of blocking antibody and the occurrence of atopic allergy-particularly in the presence of IgE production-is debatable. OBJECTIVE: To clarify the relationship between the dose of cutaneous exposure to dust mite allergen and susceptibility to the IgE-mediated allergic response in relation to IgG production. METHODS: NC/Nga mice were epicutaneously exposed to various doses of Dermatophagoides pteronyssinus allergen to induce atopic dermatitis-like skin lesions. We then evaluated the skin lesions, induction of mite-specific immune responses, and susceptibility to anaphylaxis. RESULTS: Dose-dependent exacerbation of atopic dermatitis-like skin lesions and increases in mite-specific IgG and IgE production were observed. However, mice exposed to relatively low doses of mite allergen showed hypersusceptibility to mite allergen-specific anaphylaxis. We also showed that adoptive transfer of total IgG from Dp-sensitized mice rescued mice from the hypersusceptibility seen in those exposed to low doses of mite allergen. CONCLUSIONS AND CLINICAL RELEVANCE: High-dose cutaneous exposure to dust mites induced effective blocking IgG production, even if accompanied by IgE production. Our data might support the concept that an increase in IgG titre, not a decrease in IgE titre, is a marker of clinical improvement in allergen-specific immunotherapy.

[An analysis of prognostic factors in patients with prostatic cancer after hormone therapy and radiotherapy].

To investigate prognostic factors for prostatic cancer, 110 patients who had received hormonal treatment (HT) and 43 patients who had received radiotherapy (RT) were studied. Age of the patients ranged from 49 to 92 years old (median 71 years old) and follow-up period ranged from 3 to 164 months (median 50 months). Survival rate was calculated by Kaplan-Meier method with statistical analysis based upon Cox's proportional hazards regression model. This analysis identified performance status as the most important factor for al patients, followed by histological grade for patients HAVING received HT, and lymph node metastasis for patients received having RT. The result suggests that routine clinical data provide a good indicator as to the prognosis of prostatic cancer.

Long-term results of endourologic treatment of urinary calculi: investigation of risk factors for recurrence or regrowth.

To evaluate the risk factors related to the long-term outcome of endourologic treatment of urinary calculi, we examined rates of recurrence and regrowth in 167 renal units. The following risk factors were examined: age; previous stone; location, number, size, and composition of stone; and procedures. In our study sample, the overall recurrence and regrowth rates were 17% and 10%, respectively. The earliest recurrence and regrowth appeared at 3 months after treatment, and 71% occurred within 2 years. In 22% of renal units that were estimated to be stone-free, stones appeared later, and 45% of inadequately fragmented stones enlarged. Stones located in a renal calix and pelvis, multiple stones, large stones (more than 20 mm), stones composed of calcium oxalate or calcium phosphate or both, and struvite stones were likely to be risk factors, but there were no significant differences statistically. Although the possibility of several risk factors was suggested in our study, thorough fragmentation of stones and complete removal of fragments, combined with extracorporeal shock wave lithotripsy or chemolysis if needed, is ultimately responsible for successful treatment of urinary calculi.

[Studies on the usefulness of a long-term, high-dose treatment of methylcobalamin in patients with oligozoospermia].

Methylcobalamin (CH3-B12) was administrated in a dose of 6 mg per day (group A, 16 cases) or 12 mg per day (group B, 23 cases) for 16 weeks to patients with oligozoospermia. There was no difference between group A and group B regarding vitamin B12 concentrations in the serum or seminal fluid. CH3-B12 appeared to be transported to seminal fluid very efficiently. However, results from group A and group B did not differ with respect to this parameter. The efficacy rate for group A was 37.5% and that for group B was 39.1%. From these results, it was concluded that a long-term, high dose treatment of CH3-B12 was useful for the treatment of patients with oligozoospermia. Since the efficacy rates were not different between the two groups, 6 mg per day would be the recommended dose. Clinical adverse reactions were observed in one patient in each group. Drug-related laboratory adverse reactions were observed in only one patient in group B.

[Combined administration of human chorionic gonadotropin and human menopausal gonadotropin in idiopathic male infertility].

Clinical experiences of HCG-HMG therapy for 56 cases of idiopathic male infertility were studied. Serum levels of LH, FSH and testosterone were measured before therapy. Sperm density improved in 25% of all cases. In the low FSH group, sperm density showed a high rate of improvement. The basal FSH was the best indicator to predict the prognosis of fertility. Additional measurements of LH and FSH response to GnRH gave further information on the prospect of fertility.

Treatment of post-traumatic priapism by intracavernous injection of alpha-stimulant.

A 6-year-old boy was seen for post-traumatic priapism which had been present for 4 days. Intracavernous injection of metaraminol was performed to reduce the arterial blood inflow of the penis. Within 30 min after the injection, the penis became flaccid, and the prognosis was good. Recently it was reported that there are two different types of priapism. Type 1 priapism is due to blood stasis. This type is well known and characterized by extremely hard corpora and painful penis. Type 2 is caused by increased arterial blood flow of penis. It differs clinically from type 1 by a more elastic consistency of the penis and the absence of pain. Generally the prognosis of type 2 priapism is favorable. In our case, the penis was relatively elastic and not painful. It was considered to be type 2 priapism.

[Clinical experience with oxendolone for treatment of benign prostatic hyperplasia. Clinical efficacy and effects on serum lipid and lipoprotein fraction levels].

Forty-three patients with benign prostatic hyperplasia were treated with weekly i.m. injections of 400 mg oxendolone for 12 weeks. The subjective symptoms were improved in 83% of these patients. Residual urine was decreased significantly and Qmax was increased by this treatment. Serum VLDL level was suppressed significantly, whereas the levels of LDL, total cholesterol, HDL-cholesterol and triglycerides were changed little. Atherosclerotic index and the ratio of (total cholesterol--HDL-cholesterol) to (HDL-cholesterol), was not influenced by the treatment. No severe side-effect was found. These findings suggest that oxendolone is the drug of choice for non-surgical treatment of benign prostatic hyperplasia.

The changes in the binding capacity of testosterone-oestradiol binding globulin (TeBG) following castration and DES-D administration in patients with prostatic carcinoma.

The levels of plasma testosterone, testosterone-oestradiol binding globulin (TeBG) and total serum acid phosphatase (TSAP) following antiandrogenic hormone therapy were investigated in 17 patients with prostatic carcinoma. The low levels of plasma total and free testosterone induced by castration decreased further after diethylstilboestrol diphosphate (DES-D) administration. Plasma TeBG binding capacity after castration was 118.9% of the pre-treatment level and increased to 193.9%, 204.0% and 212.7% at 1, 2 and 3 weeks after DES-D dosing. The in vitro binding of 3H-testosterone to TeBG was not influenced in the presence of DES-D or stilboestrol. Clinical response following the DES-D therapy was associated with a decrease in the levels of TSAP. A significantly inversed correlation was found between the decrease in TSAP and increase in TeBG at completion of DES-D therapy. These results suggest that the high binding capacity of TeBG lowers the biologically active fraction of testosterone and thus may produce clinical effects.

[A steady state polyacrylamide gel electrophoresis for the determination of testosterone-estradiol binding globulin (author's transl)].

Testosterone-estradiol binding globulin (TeBG) is known to change in various endocrinological environments such as estrogen administration, pregnancy and aging. Several methods, including dextran coated charcoal, equilibrium dialysis and ammonium sulfate precipitation, were used to measure the binding capacity of TeBG, but these were not simple and accurate. We therefore measured TeBG levels in human serum by means of a steady state polyacrylamide gel electrophoresis and found that this method was simple and accurate for the determination of the binding capacity of TeBG. The value of TeBG in normal adults (27 approximately 32 years old) was 3.88 +/- 0.45 x 10(-8) Mol and in patients with benign prostatic hypertrophy the value was high (5.49 +/- 1.35 x 10(-8) Mol compared to that of normal adults.

Retrocaval ureter with carcinoma of the renal pelvis: report of a case.

A case of retrocaval ureter associated with carcinoma of the renal pelvis has been presented. This is the 2nd such case out of 110 cases reported in Japan. It is suggested that long term stagnation of urine is the cause for such a high incidence of malignant neoplasm involving the renal pelvis.