Collecting duct carcinoma mixed with common renal cell carcinoma: analysis of morphological characteristics using lectin histochemistry.

Recently, cases of collecting duct carcinoma have been reported which were thought to have arisen from the renal collecting ducts or distal tubuli. We present here a rare case of collecting duct carcinoma mixed with common (conventional) renal cell carcinoma. A 51-year-old man underwent right nephrectomy under the diagnosis of renal tumor. Histochemically, markers for the collecting ducts/distal tubuli, such as peanut agglutinin (PNA) and soybean agglutinin (SBA), were identified in the collecting duct carcinoma as well as on several luminar surfaces of the common renal cell carcinoma. Based on the results of histological, histochemical and chromosomal examinations, we speculated on the histogenesis of this collecting duct carcinoma.

[A case of renal cell carcinoma with solitary metastasis to the contralateral adrenal gland].

A 62-year-old female was admitted to our hospital with left flank pain and weight loss. Computerized tomography revealed a large left adrenal tumor and a small right renal tumor. A left adrenalectomy was performed initially to confirm sparing the left kidney. The left adrenal tumor weighed 650 g and was renal cell carcinoma histologically, suggesting a contralateral metastasis of the right renal tumor. Two months after the adrenalectomy, the right kidney was excised. The right adrenal gland was preserved. Pathologically, the renal tumor was also renal cell carcinoma. The patient has remained well for 34 months after the operation. The literature concerning the adrenal metastasis of renal cell carcinoma is briefly reviewed.

A quantitative analysis of testosterone action on FSH secretion from individual pituitary cells using the cell immunoblot assay.

We investigated the effects of testosterone on FSH secretion from male rat anterior pituitary cells in culture at the single cell level. Anterior pituitary cells cultured with or without 10 ng/ml testosterone for 72 h were mono-dispersed and subjected to cell immunoblot assays for FSH. Cell blots specific for FSH were quantified by means of a microscopic image analyzer. The number of FSH-secreting cells detected as immunoreactive cells blots on the transfer membrane represented 4.1% of total pituitary cells applied on the membrane. The amount of FSH secreted by single cells varied from < 20 to > 8,000 fg/cell/h. The number of FSH-secreting cells was not changed by the addition of 10 ng/ml testosterone into the culture medium. Testosterone administration increased the mean FSH secretion by 64% after 3 h incubation, resulting in a shift to the right in the frequency distribution of FSH secretion from single cells. The total amount of FSH, namely the sum of FSH secreted by each FSH-secreting cel, was increased by 92% by the addition of testosterone. However, mean amounts of FSH secretion by the top ten cells of the largest secretor subgroup (> 5 pg/cell/3 h) were not different between control and testosterone-treated groups. The present study analyzed, for the first time, FSH secretion from rat anterior pituitary cells at the single cell level. The results suggest that stimulation by testosterone of FSH secretion in vitro is not due to an increase in the number of FSH-secreting cells but to an increase in FSH secretion from each cell.

[Carcinoma of the renal pelvis and ureter following bladder carcinoma].

We followed 135 primary bladder carcinoma patients for at least 3 years. Subsequent carcinomas of the upper urinary tract were found in 5 patients (3.7 per cent) an average of 67 months after an initial treatment of the bladder tumors. Two patients underwent radical cystectomy and the remaining 3 patients received transurethral resections or partial cystectomy five to seven times for bladder lesions. Primary bladder tumor was multiple in all and one of them was accompanied by carcinoma in situ in the bladder and urethra. Except for one patient who presented with gross hematuria, four patients had no symptoms referable to the upper urinary tract tumor. However two of them had high stage disease. Positive urinary cytology was observed in only one patient. All patients underwent nephroureterectomy and the four got well but one died of acute heart failure. Regular urinary cytology and IVP should be done for an extended period of time for early detection of renal pelvic and ureter cancers in patients who had multiple and recurrent bladder cancers.

Significant role of 5 alpha-reductase on feedback effects of androgen in rat anterior pituitary cells demonstrated with a nonsteroidal 5 alpha-reductase inhibitor ONO-3805.

A 5 alpha-reductase inhibitor with nonsteroidal structure, ONO-3805, has been used to study the role of 5 alpha-reductase on positive and negative feedback effects of androgen on gonadotropin secretion in the rat anterior pituitary gland. Initially, the potential of ONO-3805 to inhibit the formation of 5 alpha-dihydrotestosterone (DHT) was evaluated. The activity of 5 alpha-reductase in rat anterior pituitary gland was approximately one-fourth of that in rat prostate gland or epididymis, with a Michaelis' constant (Km) value for testosterone of 5-6 x 10(-7) M. When homogenates of rat anterior pituitary glands were incubated with 14C-testosterone (14C-T) in the presence of > or = 10(-7) M ONO-3805, the formation of labeled DHT and its metabolite 5 alpha-androstane-3 alpha,17 beta-diol was inhibited by > 90%. The inhibition pattern was non-competitive, and the inhibition constant (Ki value) derived from Lineweaver-Burk plots was 3.9 x 10(-11) M. Dispersed pituitary cells (1-2 x 10(5)/ml) were cultured for 48 hours and then further incubated with or without androgen and/or the inhibitor for 72 hours (basal secretion). After this incubation, the media were saved, and 10 nM of luteinizing hormone-releasing hormone (LH-RH) with the same concentration of androgen and/or the inhibitor as used in the 72-hour incubation was added to the cultures for 6 hours (LH-RH-induced secretion). Secreted follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were assayed by radioimmunoassay (RIA). Both testosterone (T) and DHT stimulated 72-hour basal FSH secretion from cultured pituitary cells in a dose-dependent fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

Nucleolar organizer regions in bladder cancer: application to urinary cytology.

OBJECTIVES: We investigated the relationship between the numbers of nucleolar organizer regions (NORs) in nonmalignant reactive cells and those in transitional cell carcinomas using urinary exfoliated cell specimens. Another aim of this study was to determine whether higher numbers of NORs are correlated with tumors with higher pathologic grade. METHODS: Nucleolar organizer regions, which are important for regulating protein synthesis, were counted by means of a silver staining technique in urinary exfoliated cells from 34 patients with transitional cell carcinoma (TCC) and in 30 patients with other urologic diseases (controls). RESULTS: The number of argyrophilic proteins of the nucleolar organizer region (Ag-NORs) per cell (mean +/- SD) was 2.9 +/- 0.5 in the control group and 5.5 +/- 1.9 in patients with TCC, which was significantly higher than that in the controls (p < 0.001). It was 4.0 +/- 1.0 in patients with grade 1 TCC, 5.4 +/- 2.0 in those with grade 2 TCC, and 6.5 +/- 1.2 in those with grade 3 TCC. Although no statistically significant difference was observed between the groups, the patients with grade 2 TCCs with higher numbers of Ag-NORs showed a tendency to have more diffuse and/or invasive lesions. CONCLUSIONS: This method is simple and quick, and can identify low-grade malignancy. It could be used as a tool for further grading of grade 2 TCCs and for determining prognosis.

A partial characterization of a Sertoli cell-secreted protein stimulating Leydig cell testosterone production.

To examine whether immature rat Sertoli cells in culture secrete a factor(s) which stimulates testosterone production by mature mouse Leydig cells, Sertoli cell-enriched cultures were prepared from 3-week-old male rats with trypsin and collagenase. Sertoli cells were plated at an initial density of 3-5 x 10(6) cells/35 mm well and cultured in 3 ml serum free media supplemented with insulin (10 micrograms/ml). Sertoli cell culture medium (SCCM) collected every 3rd day was added to Leydig cells (10(6) cells in 1 ml of MEM with 2% steroid-free FCS) prepared from 10-week-old mice by mechanical separation and incubated for 3 h at 34 degrees C. Secreted testosterone was determined by RIA. SCCM 15 times concentrated by Amicon YM10 membrane demonstrated a dose-dependent stimulation of testosterone production, whereas there was no effect on testosterone secretion when Leydig cells were maximally stimulated by LH. Leydig cell stimulating activity was retained by both a dialysis membrane with a pore size of 24 A and an ultrafiltration membrane with a molecular weight cut-off of 10 kDa. However, activity was reduced by heating at 60 degrees C for 30 min and almost lost after incubation with 0.1% trypsin for 1 h at 37 degrees C. This activity was not retained by means of a Con A-Agarose column and was demonstrated only in break-through fractions. HPLC gel filtration of a 15 times concentrated SCCM preparation on a TSK gel G3000SW revealed Leydig cell-stimulating activity at approximately 13 kDa.(ABSTRACT TRUNCATED AT 250 WORDS)

Concordance rate between clinical and DIS diagnoses: a cross-cultural comparison.

Concordance rates between clinical and DIS-generated diagnoses were compared using data sets from Fukuoka University in Japan and Neuropsychiatric Hospital at the UCLA. An overall concordance rate of 35% between standard clinical diagnosis and DIS-Lifetime diagnosis was discovered in both samples. Next, concordance rates were analyzed by diagnostic category, and differential concordance rates among major diagnostic categories were found in both samples. The highest concordance rates were found in anxiety disorders and major depression. The lowest concordance rates were found in dysthymic disorder and schizophrenia. The Fukuoka sample contained more patients with anxiety disorders and major depression, while the UCLA sample has more patients diagnosed as dysthymic disorder and adjustment disorder. Future directions in cross-cultural psychiatric research are also suggested.

[Phase II study of 5-FU tablet in bladder tumor].

A cooperative-phase II study of 5-FU tablet at a dose of 200 to 300 mg/day (b.i.d. or t.i.d) on 27 patients with bladder cancer was performed at Yokohama City University and other affiliated hospitals. The therapeutic responses were evaluated by Koyama-Saito's criteria in 24 out of 27 patients, and 3 PR, 2 MR, 16 NC and 3 PD were obtained. The overall response rate was 12.5% (3/24). All of the responders received 5-FU tablets at a daily dose of 300 mg. Side effects were found in 2 out of 26 patients (7.7%). These were slight gastrointestinal symptoms. These results suggest that 5-FU tablet is a useful drug for bladder cancer.