Testicular cancers occurring in brothers with cryptorchism

We report a case of familial testicular cancer associated with undescended testes in two brothers. The older brother (49 years) presented with a testicular tumor located in the right inguinal canal. The pathologic diagnosis was pure seminoma. Computerized tomography revealed iliac and retroperitoneal lymph node metastases. Four years later, the younger brother (44 years) developed bilateral testicular tumors, one located in the inguinal canal, the other located in the pelvic cavity. The pathologic diagnosis of both tumors was pure seminoma. Radiological examination revealed retroperitoneal lymph node metastases. Both patients received cisplatin-based combination chemotherapy as the initial treatment. The older brother suffered from repeated recurrences with lymph node metastases in the iliac and inguinal regions, but he was successfully treated with high-dose chemotherapy. The younger brother achieved long-term remission after retroperitoneal lymph node dissection following initial chemotherapy. We briefly review the reported cases of familial testicular cancer and discuss the association of the maldescent of the testes and familial testicular cancer cases.     

Hepatolithiasis in East Asia: Comparison between Japan and China

The incidence of hepatolithiasis is high throughout East Asia compared with the West, but the marked difference in the relative proportion of hepatolithiasis to all cholelithiasis cases exists even among countries of similar ethnic backgrounds. A retrospective study of cases was conducted in two areas in China with the aim of clarifying the presence of such regional difference in China itself. The relative proportion of hepatolithiasis was 21.2% in Shenyang, 9.2% in Beijing and 4.1% in Fukuoka, Japan. A significant difference in the location of stones was also found between Shenyang, Beijing and Fukuoka. Intra- and extrahepatic hepatolithiasis in all hepatolithiasis cases was 95% in Shenyang and 75% in Beijing. Involvement of both hepatic lobes was found in 73% in Shenyang and less than 60% in the other two, suggesting that hepatolithiasis of the old form or of an advanced stage still lingers in Shenyang. In conclusion, regional differences in the proportion and the type of hepatolithiasis exist in China itself, as well as in the Chinese population in Taiwan, Hong Kong and Singapore, as previously reported. The possible contribution of environmental factors to the occurrence of hepatolithiasis is again emphasized.     

Prevalence of appendectomy in Japanese families

We investigated the prevalence of appendectomy in Japan to determine the tendency of familial aggregation on appendicitis using a large scale study. A total of 517 Japanese women (aged 20 to 45 years) served as the subjects and were questioned regarding their family history of appendectomy due to appendicitis. We compared the prevalence of appendectomy in children (subjects + their siblings) of three groups of families: (i) both parents affected; (ii) one parent affected; (iii) no parents affected. The differences between groups were statistically significant using contingency table and Chi-squared test. Our results suggest that about 40% of children with both parents affected, and about 20% of children with one parent affected may develop the disorder during childhood. This study may provide useful information in the nature of the development of appendicitis.     

Activation of Cellular Immunity and Complement System in Immune-Deficient Aged Subjects by Streptococcal Preparation OK-432 (Picibanil)

In a study of 290 patients without malignancy, 10 aged subjectswere found to have impaired cellular immunity. They were givenlong-term therapy with a streptococcal preparation OK-432, andit was found that OK-432 potentiated cellular immunity in agedindividuals if 1KE of the preparation is given daily. The decreasein the third component of complement C3 in these patients duringtherapy indicates that the complement system was activated viathe alternate pathway.     

Studies on Ectopic ACTH-Producing Tumors: I. Measurement of ACTH in Tumor Tissue

A sensitive and relatively simple method for the extractionand measurement of ACTH by bioassay and radioimmunoassay fromtissues of nonendocrine tumors was established. ACTH in tumorswas extracted with acetic acid and partially purified by adsorptionon silicate. The minimum detectable value was 28 µU/gwet tissue by bioassay and 6 µU/g wet tissue by radioimmunoassay.ACTH in tumor tissue was measured by this method in 25 patientswith suspected ectopic ACTH producing tumor. ACTH was detectedboth by bioassay and radioimmunoassay in 13 patients but wasnot detected in the remaining 12 patients by neither method.This suggests that the method is reliable for the diagnosisof ectopic ACTH producing tumors.     

Toxocara canis adult worm antigen induces proliferative response of healthy human peripheral blood mononuclear cells

The proliferative response of human peripheral blood mononuclear cells (PBMC) from healthy donors to Toxocara canis adult worm antigens (TcA) was examined. PBMC from all donors examined ( n = 1) strongly responded to TcA in a dose-dependent fashion after six days of culture, irrespective of their serological reactivity. In contrast, cord blood mononuclear cells did not react to TcA. The proliferation of PBMC in response to TcA was completely inhibited by anti-HLA-DR antibody. Purified CD4⁺ T cells reconstituted with autologous irradiated antigen presenting cells (APC) vigorously proliferated in response to TcA, but this was abrogated by pretreatment of APC with paraformaldehyde. Significant IL-2, IL-3, IL-4, IL-5 andlFN-j mRNA expression was detected in PBMC stimulated with TcA, with expression peaking at 72 h after stimulation. IL-1β, IL-6, IL-10 and GM-CSF mRNA expression was also upregulated, peaking at 24 h after stimulation. Taken together, these results suggest that adult T. canis-derived antigens have the ability to activate human PBMC as conventional antigens, possibly due to their cross-reactivity, which may be involved in the host defence against helminth infection.     

Successful Radiofrequency Catheter Ablation for Macroreentrant Ventricular Tachycardias in a Patient with Tetralogy of Fallot After Corrective Surgery

CHINUSHI, M., et al .: Successful Radiofrequency Catheter Ablation for Macroreentrant Ventricular Tachycardias in a Patient with Tetralogy of Fallot After Corrective Surgery . Radiofrequency (RF) catheter ablation was applied to two macroreentrant ventricular tachycardias (VTs) documented after corrective operation for tetralogy of Fallot. The activation wavefront of VT with a right bundle branch block pattern was found to revolve in a clockwise manner around a presumed myotomy scar in the right ventricle, and VT with a left bundle branch block pattern revolved around the same anatomical obstacle in a counterclockwise manner. In both VTs, the biggest conduction delay was confirmed at the right ventricular outflow tract. RF applications to the slow conduction area terminated each VT within a few seconds but were insufficient to cure the VTs. RF lesions were then applied to the, slow conduction area in a line to intersect the macroreentrant circuit, and both VTs became noninducible.     

A survey of Japanese physicians' attitudes and practice in caring for terminally ill cancer patients

Abstract To clarify the psychiatric liaison issues in cancer care, questionnaires were distributed to physicians at 31 teaching hospitals in Japan, including cancer centers and psychiatrists at 197 teaching hospitals. Data from 329 physicians and 156 psychiatrists showed that the majority of the physicians felt troubled by the psychiatric problems of terminally ill patients. However, actual psychiatric referrals were infrequent. An important factor that interferes with appropriate psychiatric referrals for cancer patients is that most physicians do not usually inform patients of a cancer diagnosis. Thus, it seems that close communication between physicians and psychiatrists is essential in caring for terminally ill cancer patients in the context of Japanese culture, when the psychiatric consultations are offered.     

Oral clonidine advances spermatogenesis in oligozoospermic patients with spermatogenetic maturation arrest

BACKGROUND: Growth hormone (GH) plays an important role in the pubertal development of males and females, and influences the male reproductive function after puberty. The purpose of this study was to investigate the cause of GH deficiency in infertile men with spermatogenetic maturation arrest using the clonidine loading test (GH stimulation test). Based on the results of the loading test, we tried to con fi rm whether clonidine might be usable as a male infertility remedy. METHODS: We studied 75 infertile men (55 oligozoospermic and 20 azoospermic men) and 25 normal fertile volunteers. We used the oral clonidine (0.15 mg/m2) loading test to evaluate the GH secretory reserve. Histological diagnoses were performed using testicular biopsy and testicular sperm extraction specimens. RESULTS: The most important finding was that the clonidine loading test caused a good response in 41 out of 55 (74.6%) patients with oligozoospermia. We treated these 41 good-response patients with oral clonidine, and the sperm count improved in 34 (82.9%) cases, increasing to 12-79 million/mL. Spontaneous pregnancy was subsequently achieved by 10 (24.4%) couples. CONCLUSIONS: These findings also suggest that GH is necessary for spermatogenesis, at least for the process of spermatozoa maturation. Oral clonidine therapy improved the sperm count in patients who showed an excessive response to the clonidine loading test.