Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma

BACKGROUND: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS: From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS: Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS: Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.     

A case of urethral prolapse in a young girl

Urethral prolapse is rarely reported in the pediatric literature. We report a 4 year old female with urethral prolapse and discuss the etiology and the treatments in children documented in the literature.     

Degradation of Insulin and Calcitonin and Their Protection by Various Protease Inhibitors in Rat Caecal Contents: Implications in Peptide Delivery to the Colon

The objective of this study was to examine the metabolism of insulin and calcitonin, and their protection by various protease inhibitors, in the large intestine. Fresh caecal contents were prepared from non-fasted rats and the degradation of insulin and calcitonin was studied in a suspension of rat caecal contents, as a model of the content of the large intestine. Both insulin and calcitonin were metabolized in suspensions of rat caecal contents, but the degradation of calcitonin was much faster than that of insulin. The degradation of insulin was fastest at pH 6.8. Protease inhibitors such as camostat and aprotinin inhibited the degradation of insulin and calcitonin in rat caecal contents, which was consistent with the high chymotrypsin activity of these contents. These findings suggest that care should be taken when administering peptide drugs to the large intestine for colon-specific drug delivery because they can be degraded in rat caecal contents. Protease inhibitors might be useful for increasing the stability of these peptides in the large intestine, thereby improving their large-intestinal absorption to the systemic circulation.     

Reduction of the DTH response is related to morphological changes of Langerhans cells in mice exposed to acute immobilization stress

There is a large body of evidence indicating that stress influences immune competence. For example, psoriasis and atopic dermatitis may be exacerbated by psychic stress and related to abnormalities in the cellular constituents of the immune system in the skin. However, the underlying mechanisms remain unclear. We therefore investigated the potential of acute immobilization stress to affect the DTH response in BALB/c mice. DTH was significantly reduced in an immobilization time-dependent manner when stress exposure was just before sensitization. Although the number of Langerhans cells (LC) did not change under these conditions, marked alteration of LC morphology was observed with a significant decrease in area. Recovery of LC was observed within 24 h when the DTH response was also restored. Expression of the calcitonin gene-related peptide (CGRP), which inhibits LC antigen presentation, was significantly increased up to 1.6-fold in nerve fibres of immobilized mice. We conclude that stress-induced suppression of DTH could be due to reduction of LC antigen presentation with morphological change in association with CGRP elevation.     

Cutaneous oxalate granulomas in a haemodialysed patient: report of a case with unique clinical features

We report a patient undergoing haemodialysis, who developed multiple subcutaneous nodules. Histology showed that the noduies were composed of deposits of crystals in the dermis, with an associated foreign-body reaction. The crystalline deposits were identified as calcium oxalate by histochemical staining, polarizing microscopy, and analytical electron microscopy.     

Anti-asthma effect of an antiviral drug, acyclovir: a clinical case and experimental study

Background Although acyclovir (9-(2-hydroxyethoxymethyl) guaninc) is an antiviral drug that inhibits DNA polymerase of herpes virus, we have had the experience of an asthmatic patient's peak flow rate being improved by oral administration of acyclovir. Objective The aim of this experiment is whether acyclovir has anti-asthma effects using an asthma model in guinea-pigs. Methods The airway response was induced by a single inhalation of calcium ionophore A23187 (2 mg/mL). The airway obstruction was estimated by the ratio of expiration to inspiration time (E/I). The peribronchial eosinophil infiltration and eosinophil influx into bronchoalveolar lavage (BAL) fluid 7 h after the inhalation were also examined. To assess the effects of acyclovir (1, 10, and 100 mg/kg), aminophylline (20mg/kg) and pemirolast potassium (TBX, 20mg/kg) on A23187-induccd asthmatic response, the drugs were intraperitoneally administered before the inhalation. Results The immediate airway obstruction was significantly suppressed by acyclovir (10 mg/kg) and aminophylline, whereas different doses of acyclovir (1 and 100mg/kg) and TBX showed only a small inhibitory effect on the airway obstruction. On the other hand, the peribronchial eosinophilia was most successfully inhibited by TBX. Acyclovir (10 mg/kg) and aminophylline also suppressed the eosinophilia significantly. Furthermore, acyclovir significantly suppressed eosinophil influx into BAL fluid, whereas aminophylline and TBX weakly suppressed the influx. Conclusion These results suggest that acyclovir exhibits not only antiviral but also anti-asthma activity.     

Physical functional status and factors contributing to disability in Japanese chronic dialysis patients

SUMMARY: Four hundred and eight non-hospitalized chronic dialysis patients were surveyed to evaluate functional status by the modified Karnofsky Performance Scale (KPS), and the correlation of clinical variables with functional status and the factors contributing to disability were assessed. Sixty-seven patients (16.4%) had a score less than 75, which indicated limited daily activities inside the home. the percentages of diabetic patients significantly increased in those with a low KPS level (P<0.0001). the mean KPS was significantly lower in the older age group, however there were no significant differences in the mean KPS among groups with different duration of dialysis except for between non-diabetic patients less than 5 years and those longer than 20 years. Serum urea nitrogen, serum creatinine, serum albumin and intra-dialytic weight gain tended to be lower in patients with a low KPS level. Visual impairment and muscle weakness of the extremities was the most common factor contributing to disability in diabetic patients and non-diabetic patients scoring less than 75, respectively. In addition, osteoarticular impairment was characteristically associated with disability in non-diabetic patients. In conclusion, although a great number of chronic dialysis patients maintain a good functional status, there is a small percentage of patients with poor physical activities. the aetiology of poor functional status is multifactorial, and visual impairment for diabetic patients, muscle weakness and osteoarticular impairment for non-diabetic patients require special attention and efforts to ameliorate various factors which negatively affect functional ability in these patients are needed.     

Synthesis of peptide inhibitors of human spleen fibrinolytic proteinase (SFP) and human leukocyte elastase-like proteinase (ELP)

Stereoisomers of specific substrates for SFP and ELP, Suc-L-Tyr-L-Leu-L-Val-pNA and Suc-L-Ala-L-Tyr-L-Leu-L-Val-pNA, were synthesized by the conventional solution method. Suc-L-Tyr-D-Leu-D-Val-pNA was found to be an effective and specific inhibitor of SFP and ELP. Suc-L-Tyr-L-Leu-L-Val-Pipe and Suc-L-Tyr-D-Leu-D-Val-Pipe inhibited only SFP very slightly and showed no inhibitory effect on ELP. Both Dan-L-Tyr-L-Leu-L-Val-pNA and Dan-L-Tyr-D-Leu-D-Val-pNA exhibited an inhibitory effect on both SFP and ELP.