Endoscope-assisted minilaparotomic radical retropubic prostatectomy

OBJECTIVE: To assess the clinical efficacy of endoscope-assisted minilaparotomic radical retropubic prostatectomy (EAM-RRP) compared with conventional radical retropubic prostatectomy (cRRP). METHODS: From September 2001 to December 2003, 30 patients with localized prostate cancer were treated by EAM-RRP. The surgical manipulation was performed through the wound with thoracoscopic assistance, using standard surgical instruments. In all cases, 800 mL of blood was collected from the patient for autotransfusion. For both EAM-RRP and cRRP, the internal iliac and obturator lymph nodes were dissected before the prostate removal. Clinical indicators such as operation time, blood loss, and duration of postoperative urine incontinence were analysed in the two groups. RESULTS: The postoperative period before ambulation and the duration of postoperative urine incontinence were significantly shorter after EAM-RRP than after cRRP, while no significant difference was found in operation time, blood loss, and duration of urethral catheterization. None of the cases required allotransfusion. CONCLUSION: EAM-RRP, which had a shorter postoperative period before ambulation and continence, is considered a safe and useful technique for radical prostatectomy.     

In-situ Ocular Absorption of Ophthalmic β-Blockers through Ocular Membranes in Albino Rabbits

Ocular membranes have been characterized by in-situ absorption of the ophthalmic β-blockers carteolol (hydrophilic) and timolol and befunolol (lipophilic) using a cylindrical cell. After introduction of drug solution into the cell on the cornea, sclera (bulbar conjunctival and scleral layer) or palpebral conjunctiva, the disappearance of the drug from the cell was determined as in-situ absorption. The ophthalmic drugs disappeared from the conjunctival and scleral membranes although disappearance from the cornea was hardly observed. The conjunctival membrane showed the highest permeability. Lipophilic drugs were more permeable than hydrophilic. In-situ apparent permeability coefficients of the ophthalmic drugs through the conjunctiva and sclera correlated with the lipophilicity of drugs. A high drug concentration in the aqueous humor was observed after corneal application. There is a relationship between concentrations of drugs in the aqueous humor and previously reported in-vitro apparent permeability coefficients of the drugs in the cornea. This in-situ method using a cylindrical cell is a useful method of investigating the ocular absorption of ophthalmic drugs.     

Histological Analysis of Triphalangism Associated with Polydactyly of the Thumb

ABSTRACT Wassel's classification of thumb polydactyly has some problems especially in categories IV and VII because it depends solely on X-ray findings. In order to improve his thumb polydactyly classification, we examined histologically untreated 182 bifid thumbs from 171 patients at Branch Hospital, Nagoya University in the past eight years. Ninety-five of these cases had proximal phalangeal separate type of polydactyly corresponding to Wassel's categories IV and VII. Forty-five thumbs of these categories were excised from 44 patients and classified into type I (24 cases), type II (12). type III (4), and type IV (5) in accordance with Kanno's classification. In distal phalanges, normal cartilage development was observed in Kanno's type I, whereas proximally elongated cartilaginous tissue was formed in the type II. Three distal phalanges from types II and III showed depression at the ulnar side of elongated cartilage of the distal phalanx where immature chondrocytes transversely distributed. Three cases with incomplete and one case with complete joint formation were formed in elongated cartilage of the distal phalanx, and endochondral ossification developed in the central area of elongated cartilage of the distal phalanx in four cases from types III and IV. All of the cases showed only minimal mobility of their involved joints. Their tendon development did not correspond to their anatomical characteristics. Histological studies indicated that there was no distinct difference between Wassel's category IV and category VII. It was postulated that the triphalang-     

INCREASED FEMALE DRINKING IN ACCORDANCE WITH POST-INDUSTRIAL URBANIZATION IN JAPAN

We studied the relationship between living in an urban areaand the alcohol-consumption habits of young mothers in lightof the recent increase of the female drinking population inJapan, particularly among those from 20 to 39 years of age.We conducted a survey in four areas in and around Tokyo, eacharea representing a different level of urbanization. The studypopulation consisted of 6418 mothers of 3-year-old children;an 84.9% response rate was obtained. Thirty-eight per cent ofthe respondents had drunk at least four units of alcohol (about44 g of pure ethanol) during the most recent month The proportionof current drinkers in a more-urbanized area was greater thanthat in a less-urbanized area, and this tendency was significant(P<0.001). Current workforce participation was significantlypositively associated with current drinking (P<0.01). Youngerage significantly increased chances of current drinking (P<0.05)Effects of living in a more-urbanized area on current drinkingof mothers of 3-year-old children after excluding the effectsof workforce participation and age was significantly positive(P<0.001). An increase in female drinking in Japan was consideredto be due to acculturation associated with urbanization in apost-industrial society.     

A Comparative Study of the Pancreatogram and the Histological Findings in 2,2'-Dihydroxy-Di-N-Propylnitrosamine-Induced Pancreatic Carcinoma in Golden Hamsters

2,2'-dihydroxy-di-N-propylnitrosamine (DHPN) at a dose of 250mg/kg was injected subcutaneously into 28 male Syrian goldenhamsters once a week. They were sacrificed and dissected atintervals of one to two weeks beginning from the 8th week untilthe 20th week after the injection. Pancreatography was performedon every hamster and the chronological changes in their pan-creatogramswere compared with the histological findings. Marked atypicalhyperplasia almost indistinguishable from carcinoma in situwas observed his-tologically beginning at the 13th week, andinfiltrating adenocarcinoma was seen in all the hamsters inand after the 16th week. The pancreatography made it possibleto depict even minute changes at an early stage that correspondedto the histological findings. One example was that a slightstenosis in the branch was detected at the 13th week and thepicture of stenosis was observed in the main pancreatic ductat the 14th–15th week. This was followed by obstructionin and after the 16th week. These findings support the possibility that the neoplastic processin the hamster pancreas occurs in the branch region earlierthan in the main pancreatic duct.     

Influence of Sex on Antipyrine Metabolism in Patients with Gastric Cancer

The metabolism of antipyrine was studied in male and femalepatients with localized gastric cancer. Antipyrine eliminationis apparently decreased in female patients, suggesting thatthe sex of patients must be taken into account in cancer chemotherapy.     

COEXISTENCE OF STOMACH CANCER AND RENAL ADENOMA IN RENAL ALLOGRAFT

Autopsy findings of a 34-year-old Japanese male with stomach cancer in a renal allograft are presented. The renal graft was given by his 53-year-old mother, who had the same HLA type as the patient and showed negative response in the Mixed Leukocyte Culture Reaction test. Stomach cancer occurred 4 years and 5 months after the renal graft, and infiltrated widely into the abdominal cavity, causing rectal stricture. In his original left kidney, a small renal adenoma was found. The tumor cells of the adenoma were composed of clear cells. In the adenoma, infiltration of stomach cancer was found. The renal allograft functioned very well until his death in spite of several rejection episodes. This is the seventh reported case in Japan in which a renal allotransplant was accompanied by malignancies.     

Infusion of Cryopreserved Autologous Marrow in the Treatment of Acute Leukemia: A Preliminary Report

Autologous marrow was collected from patients with acute leukemiaduring their first remission, and cryopreserved. In relapse,four of the patients were treated with remission-induction chemotherapymore intensive than the previous treatment, followed by infusionof the cryopreserved autologous marrow. Autologous marrow infusioncaused relatively rapid hematological recovery from the bonemarrow depression induced by high-dose chemotherapy. All fourpatients achieved a second complete remission, but with no maintenancetherapy leukemic relapses were observed in three of them. Onepatient survived without leukemic relapse for 19 months, 13months longer than the previous remission period. Another effectof autoinfusion was reduction in blood products required duringthe bone marrow depression. These observations suggest thatcryopreserved autologous marrow may retain its hemopoietic activityand autologous marrow infusion may be effective in providingearly recovery or rescue from bone marrow failure.     

Functional and phenotypical activation of leucocytes in inflamed human colonic mucosa

Infiltrating leucocytes are activated to generate reactive oxygen species or to produce several molecules in inflamed colonic mucosa. To clarify the phenotypical and functional properties of activating cells in colitic mucosa, 23 patients with ulcerative colitis and 13 controls were studied using a combined method for determining in situ nitroblue tetrazolium reducing activity and immunohisto-chemical characterization. Antibodies 25F9 (anti-macrophage), EG2 (anti-eosinophil cationic protein), MAC387 (anti-calprotectin, expressed by activated myeloid-histiocytes lineage), and MAC-1 (anti-CD11b) were used. The proportion of EG2, calprotectin, and CD11b-positive cells were significantly increased in inflamed mucosa. The proportion of EG2, calprotectin, and CD11b-positive cells significantly correlated with the histological degree of inflammation. Proportion of EG2-positive cells but not calprotectin nor CD11b-positive cells was significantly correlated with nitroblue tetrazolium reducing activity. Aggregated cells reducing nitroblue tetrazolium seen in severely inflamed mucosa were found to be EG2 positive. Most of the calprotectin-positive cells were 25F9 negative. In addition to activation of neutrophils and macrophages, eosinophil activation has been shown to be involved in inflamed colonic mucosa.