Renal function of ectopic ureteral opening repaired by ureterocystoneostomy

Two girls (4 and 3-year old) visited our out-patient service complaining of daytime and nighttime enuresis. Both were diagnosed as ectopic ureteral opening to the vagina with a concomitant dysplastic kidney on the left side. These anomalies were repaired by ureterocystoneostomy according to a modified Grégoir's method. In the first case, three months later, DIP visualized left upper urinary tract which had not been seen before, but enhanced CT scan, renogram and scintigraphy with Tc-DMSA showed no change. In the second case, three years later, examination results were the same as in the first case. There was no renal development. Surgical repair of ureterocystoneostomy was valuable, with small surgical damage and cosmetic merit for the girls. Furthermore, renal function will be maintained at the same level or slightly higher than that before the operation.     

Role of the spleen in tumor immunity--with special reference to anti-tumor immunity induced by solubilized and purified tumor-associated antigen

The effects of post-operative immunization with purified tumor-associated antigen on the development of lung metastases following resection of the Lewis lung carcinoma (3LL) were studied. The soluble tumor-associated antigens were isolated from 3LL cells by detergent solubilization and purified by affinity chromatography on peanut agglutinin (PNA)-agarose. The immunization with subcutaneous injections of PNA-binding glycoproteins at early phase following resection of primary footpad tumors of 3LL resulted in a significant decrease in incidence and size of lung metastases. The delayed immunization, however, failed to suppress the development and growth of metastatic lung tumors after surgery. The suppression of postoperative development of lung metastases was found to depend on timing of immunization following local tumor resection. Splenectomy performed simultaneously with amputation of tumor-bearing leg was completely abolished the decrease in the development and growth of postoperative lung metastases in immunized-mice. Evidence of lymphoid system involvement in the control of metastatic tumor growth was also supported by the observation of in vivo tumor neutralization assay utilizing the spleen cells.     

Effect of porosity on strength and hardness of dental stone (author's transl)]

The strength and hardness of dental stone were found to have better a correlation with porosity than with water-powder ratio. Within the range of porosity of less than 34 vol-%, the strength and hardness varied logarythmically with a linear change in porosity.     

In vitro Sensitivity Test of Breast Cancer Cells to Hormonal Agents in a Radionucleotide-incorporation Assay

Breast cancer cell lines (MCF-7, T47D, BT-20 and STT-11) and fresh cells from malignant effusions of eight breast cancer patients were examined for their in vitro sensitivity to 17β-estradiol (E₂), tamoxifen and toremifene in a miniaturized, improved nucleic acid precursor incorporation assay (MINI assay). Seven of the eight patients received either tamoxifen or toremifene following a MINI assay and the correlation was examined between in vitro sensitivity and clinical responses to the hormonal agents. In cell lines, E₂ stimulated thymidine incorporation by estrogen receptor (ER)-rich cells, MCF-7 and T47D, but not by ER-poor cells, BT-20 and STT-11. Tamoxifen induced both ER-mediated and -unmediated effects in ER-rich cells. The latter effect was also observed in ER-poor cells. Toremifene had less ER-unmediated effect in all of the cells tested than tamoxifen did. The ER-mediated effect of toremifene was weaker than that of tamoxifen in cell lines but was equipotent to tamoxifen in fresh cells. E₂ affected thymidine incorporation by cells withdrawn from patients who showed a partial response to the anti-estrogens. No clear correlation was demonstrated between in vitro sensitivity to anti-estrogens of fresh cells and clinical response to these agents. The present results suggest that 1) the MINI assay is a useful system to investigate hormonal effects on breast cancer cell lines; 2) clinical responses to anti-estrogens are not predicted by in vitro response to the agents but might be predicted by the in vitro response to E₂; and 3) toremifene has a smaller non-specific effect on breast cancer cells than tamoxifen and is equipotent to tamoxifen in the ER-mediated effect in vitro .     

Prognostic value of immunohistochemically identified CEA, SC, AFP, and S-100 protein-positive cells in gastric carcinoma

Gastric tissues from 85 patients with advanced carcinoma were studied immunohistochemically for localization of carcinoembryonic antigen (CEA), secretory component (SC) and alpha-fetoprotein (AFP), and for S-100 protein-positive cells. Our objective was to determine if these factors could serve as prognostic indicators. Forty patients died of recurrence or metastases within 2 years (Group I), and the remaining 45 survived 10 years or longer (Group II) after resection. CEA-positive cells were present in 93% and 89% of Groups I and II, respectively. In case of staining for CEA, positive results were seen not only in the malignant cells but also in the stroma in 35% of Group I but none in Group II. The immunohistochemical status of SC was not essentially different between Groups I and II; the positive staining was recognized in 50% and in 57%, respectively. Gastric carcinomas rarely reacted to AFP. S-100 protein-positive cells, which play an important role in local immunity, were often present in Group II (47%) but rarely in Group I (10%). Thus, in addition to the various prognostic factors available to the surgical pathologist, the presence of CEA and the appearance of S-100 protein-positive cells in tumor tissue will aid in predicting the prognosis of patients with advanced gastric carcinoma.     

Adrenal hemorrhage in the newborn with evidence of bleeding in utero

A case is reported of adrenal hemorrhage in a newborn with evidence of bleeding while in utero. The patient had a large cystic mass on ultrasound at 36 weeks of gestation. Abdominal computerized tomography after birth also revealed the cystic mass above the left kidney, which became smaller with peripheral calcification when he was 5 months old. Thus, adrenal hemorrhage was presumed. The cystic mass had disappeared on followup ultrasound when the patient was 8 months old. This case suggests that adrenal hemorrhage can occur even before delivery.     

EXPRESSION OF PARATHYROID HORMONE-RELATED PROTEIN mRNA IN TUMORS OBTAINED FROM PATIENTS WITH HUMORAL HYPERCALCEMIA OF MALIGNANCY

Human parathyroid hormone-related protein (PTHrP) mRNA was detected in all fresh cancer tissues consecutively obtained from 6 patients with humoral hypercalcemia of malignancy (HHM). The primary sites of the cancers in these cases were distributed among different organs including the lung, esophagus, kidney and ovary. PTHrP mRNA was undetectable in all 10 fresh cancer tissues obtained from normocalcemic patients. These results suggest PTHrP as a major cause of HHM.     

Cervical sympathectomy affects adrenocorticotropic hormone and thyroid-stimulating hormone in rats

To examine the effects of bilateral cervical sympathectomy on the secretion of adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), growth hormone (GH), and prolactin (PRL), 18 male rats were divided into three groups: control (Cont), sham operation (Sham), and bilateral cervical sympathectomy (Symp). All rats were kept under a normal circadian rhythm for 2 weeks. Subsequently, blood was collected and plasma ACTH as well as serum TSH, GH, and PRL levels were measured. The difference in ACTH levels between the Cont and Sham groups was not significant, but ACTH levels in the Symp group were significantly higher than those in the other groups. The difference in TSH levels between the Cont and Sham groups was also not significant, but TSH levels in the Symp group were significantly lower than those in the Cont group. There were no statistically significant differences in GH and PRL levels among these groups. The present results suggest that cervical sympathectomy in the rat increases ACTH secretion and decreases TSH secretion in the pituitary. These effects seem to be due to a mildly increased secretion of melatonin in the pineal body that probably in turn increases corticotropin-releasing factor (CRF) secretion and decreases thyrotropin-releasing hormone (TRH) secretion in the hypothalamus. Extrapolation of these findings to humans suggests that longterm and repeated stellate ganglion block would affect the pituitary secretions of ACTH and TSH.     

Closure of a perineal sinus connected with the small bowel developing after radical surgery for rectal carcinoma: A report of the operative procedures used in two cases

A technique for closure of a perineal sinus connected with the small bowel is described herein. One patient who underwent Miles' operation and another who underwent total pelvic exenteration for rectal carcinoma developed a perineal sinus through which a large amount of intestinal fluid was discharged. The pelvic orifice of the sinus was successfully closed in both patients using a right rectus abdominis muscle flap. In one patient, the muscle flap was reflected with the peritoneal surface inside and fixed to the pelvic floor covering the pelvic orifice of the sinus. In the other patient, the flap was isolated without the attached peritoneum and the peritoneal side of the flap covered with omentum.