A case of double cancer: renal cell carcinoma and transitional cell carcinoma of urinary bladder

This is a case report on a patient with double cancer of kidney and urinary bladder. The patient was a 65-year-old female, and she was admitted with the chief complaint of gross hematuria and right flank pain. After careful examinations, she was diagnosed with right nonfunctioning kidney caused by invasive bladder cancer. Computerized tomography incidentally revealed a mass in the upper pole of the left kidney. Selective left renal arteriography showed stretched arteries and irregularity and tortuosity of the smaller vessels. She was diagnosed with double cancer of bladder and left kidney. Owing to the damage of the right renal function, left partial nephrectomy, total cystectomy, right nephroureterectomy and left ureterocutaneostomy were performed. According to DMSA scintigraphy measured 15 days later, the uptake value of the left kidney was 13.25%, compared to the preoperative value of 25.62%. To date, this case is 36th reported case in Japan.     

Proximal displacement of the femoral head after Chiari pelvic osteotomy for coxarthrosis with dysplastic acetabulum

Proximal displacement of the femoral head can been seen sometimes after Chiari pelvic osteotomy. In order to clarify the causes of the displacement, a quantification analysis was performed to evaluate the factors of this osteotomy. The statistical analysis showed that 54% of the causes could be explained as being due to the angle of osteotomy, obesity ratio, the variation of the acetabular trochanteric distance, and other three factors. Paying attention to get good results: 1) making the angle of osteotomy from 11 degrees to 20 degrees, 2) keeping the variation of the acetabular trochanteric distance within 20mm, 3) the improvement of the lever arm ratio within 15%, and 4) the approximate acetabular index above 30%. In a case with the greater trochanter pulled down, a computer simulation showed that the centripetal force of the femoral head was decreased, and the displacement was increased.     

Effect of vitamin A deficiency on oxalate uptake by rat intestinal brush border membrane vesicles (BBMV) and its contribution towards urolithiasis

The intestinal uptake of [14C]oxalate, [14C]glyoxylate, and [14C]glycolate are studied in brush border membrane vesicles (BBMV) isolated from vitamin A-deficient and pair-fed control rats. The data obtained indicate that oxalate and its precursors are transported across the BBMV by passive diffusion. The intestinal uptake of glyoxylate and glycolate remains unaltered in vitamin A deficiency, while uptake rate of oxalate was significantly increased (p less than 0.01) in vitamin A-deficient rats as compared to pair-fed controls. In conclusion, the results indicate that vitamin A deficiency leads to hyperabsorption of oxalate through the gut.     

Circulating factors that modify lung cell DNA synthesis following exposure to inhaled oxidants. II. Effect of serum and lavage on lung pneumocytes following exposure of adult rats to 1 ppm ozone

Adult rats were exposed to 1 ppm (1.96 mg/m3) ozone or air for 2 wk. Animals were sacrificed at 3, 5, 7, or 14 d after the onset of exposure, and samples of plasma and lung lavage were obtained. Heat-inactivated plasma and lavage from animals exposed to ozone for 5 or 7 d significantly increased DNA synthesis by lung pneumocytes compared with plasma or lavage from air-exposed animals. Fractionation of plasma and lavage samples indicated that the factor responsible had an isoelectric point of 6.45-6.75, and a molecular weight of 38 +/- 3 kDa. This factor has a dose-dependent effect on lung pneumocyte DNA synthesis in culture. It has no effect on cultured fibroblast DNA synthesis, and is distinct from a previously described factor in the plasma of these ozone-exposed animals that enhances fibroblast DNA synthesis. The factor is detectable within 5 d of exposure, and may hold some promise as a marker of early oxidant lung injury.     

Aggregation inhibiting and anticoagulant effects of oligoamines. 13. Improvement in the storage of whole blood and erythrocyte suspensions with oligoamines

The impairment of the functions of red blood cells or their destruction during storage can be delayed or even inhibited by oligoamines especially RE 1492 (N,N',N'-Tris-(4-phenylbutyl)benzene-1,3,5-trimethanamine). When citrated whole blood (WB) is stored at 4 degrees C for 7 d half of the red blood cells (RBC) have lost their ability to form rouleaux. Addition of 100 mumols/L RE 1492 maintains 50% reaggregability up to day 28th of storage. When citrated WB is stored at 37 degrees C the reaggregability has declined to 40 percent after 10 h. With 100 mumols/L RE 1492 no reduction of this property is observed up to 48 h. These results are correlated with the maintainance of the discocyte form of RBC and a persistent filtrability of RBC suspensions through a 5 microns microporous membrane. With 100 mumols/L RE 1492 only one fifth of the haemolysis of untreated WB occurs. The efflux of potassium ions from RBC into the blood plasma during a 72 h storage is bisected by RE 1492. The binding of oxygen to RBC remains unchanged.     

Cyclophosphamide and etoposide therapy with GM-CSF for VAD-resistant multiple myeloma

Few effective regimens are available for patients with advanced multiple myeloma resistant to or relapsing after both alkylating agents and VAD. We treated 52 patients with advanced and refractory multiple myeloma with the combination of cyclophosphamide (3.0 g/m²) and etoposide (900 mg/m²) followed by GM-CSF at a daily dose of 0.125 mg/m² until recovery of granulocytes. 42% of patients responded with a median time of 19 d for recovery of granulocytes to 0.5 x 10⁹/1 and a 4% mortality rate. Eight responding patients received a second myeloablative treatment supported by either autologous bone marrow (six patients) or blood stem cells (two patients). The median survival time for all patients was 11 months and the median remission time for responding patients was 8 months. The combination of cyclophosphamide and etoposide provided an effective rescue treatment for many patients with advanced multiple myeloma resistant to conventional therapies. This programme also allowed early marrow or blood stem cell collection in support of subsequent myeloablative therapy for selected patients.