Results of the treatment of prostatic cancer

Two hundred and twenty patients with prostatic cancer were treated in our clinic during the past ten years between April, 1977 and March, 1987. The age distribution was from 45 to 91 years old and more than half of patients were in seventies. Stages A, B, C and D were 3.5%, 19.7%, 21.2% and 55.6%, respectively. Hormonal therapy was given in 175 cases (79.5%) as an initial treatment. The first therapy showed effectiveness in 181 (83.8%) of 216 cases; in 153 (87.4%) of 175 cases treated by hormonal therapy. Reactivation after the initial treatment was observed in 59 (32.6%) of 181 cases; in 48 (31.4%) of 153 cases treated by hormonal therapy. The interval between the start of treatment and reactivation for the stage D was significantly shorter than that for the other stages. Elevation of serum alkaline-phosphatase levels, accelerated erythrocyte sedimentation rate and hydronephrosis were significant risk factors for reactivation. Of the 220 cases, 51 (23.2%) died of advanced cancer. The overall 5-year survival rate was 41.2%. High grade and high stage were significantly related to the poor prognosis. In our studies, as hormonal therapy, maintenance on 100 mg of diethylstilbestrol diphosphate daily was found effective for the treatment of prostatic cancer.     

Heading judgments during active and passive self-motion

Previous studies have generally considered heading perception to be a visual task. However, since judgments of heading direction are required only during self-motion, there are several other relevant senses which could provide supplementary and, in some cases, necessary information to make accurate and precise judgments of the direction of self-motion. We assessed the contributions of several of these senses using tasks chosen to reflect the reference system used by each sensory modality. Head-pointing and rod-pointing tasks were performed in which subjects aligned either the head or an unseen pointer with the direction of motion during whole body linear motion. Passive visual and vestibular stimulation was generated by accelerating subjects at sub- or supravestibular thresholds down a linear track. The motor-kinesthetic system was stimulated by having subjects actively walk along the track. A helmet-mounted optical system, fixed either on the cart used to provide passive visual or vestibular information or on the walker used in the active walking conditions, provided a stereoscopic display of an optical flow field. Subjects could be positioned at any orientation relative to the heading, and heading judgments were obtained using unimodal visual, vestibular, or walking cues, or combined visual-vestibular and visual-walking cues. Vision alone resulted in reasonably precise and accurate head-pointing judgments (0.3° constant errors, 2.9° variable errors), but not rod-pointing judgments (3.5° constant errors, 5.9° variable errors). Concordant visual-walking stimulation slightly decreased the variable errors and reduced constant pointing errors to close to zero, while head-pointing errors were unaffected. Concordant visual-vestibular stimulation did not facilitate either response. Stimulation of the vestibular system in the absence of vision produced imprecise rod-pointing responses, while variable and constant pointing errors in the active walking condition were comparable to those obtained in the visual condition. During active self-motion, subjects made large headpointing undershoots when visual information was not available. These results suggest that while vision provides sufficient information to identify the heading direction, it cannot, in isolation, be used to guide the motor response required to point toward or move in the direction of self-motion.     

Dual vascularized fibula transfer on a single vascular pedicle: a useful technique in long bone reconstruction

The use of dual vascularized fibula transfer on a single vascular pedicle for reconstruction of long bone defect is described. This technique involves dividing one length of donor vascularized fibula into two segments, without cutting the vessels. The vessels are then folded, thereby supplying blood circulation to both bones. Since 1985 the authors have treated six cases of bone reconstruction using this method. Two of these six cases are reported, with follow-up periods of over one year.     

Experience with cefmetazole in the urological fields

Recently, a new antibiotic of cephamycins, cefmetazole (CMZ) has been developed. In our clinic, CMZ was used to examine its clinical effect and adverse reactions, and the results were herein reported. The CMZ was administered to 8 patients for the prevention of postoperative infections, 7 with genitourinary infections and 1 with maxillitis complicated with uremia. For these patients, a daily dose of 1 to 6 g of CMZ was intravenously given for a period of 4 to 12 days. Among the 8 patients who received CMZ for the prevention of postoperative infections, there were 1 case with urinary tract infection, 1 with wound infection and 2 with fever of over 38 degrees C, but they had no serious infections. In the clinical observations on 3 cases with pyelonephritis, the CMZ showed marked effectiveness in 2 cases and effectiveness in 1 case. It must be noted that CMZ was proved to be markedly effective for pyelonephritis caused by Serratia marcescens. In the cases with acute epididymitis and prostatitis, a good effect of CMZ was obtained. Similarly in the case with maxillitis complicated with uremia, the maxillitis was improved by the effect of CMZ and hemodialysis. No cases with hepatic or renal dysfunction were observed after using CMZ. It is concluded that satisfactory effect of CMZ was obtained clinically.     

Evaluation of alpha-fetoprotein in early infancy.

Serum AFP concentrations of normal subjects were statistically analyzed in order to obtain the normal ranges in early infancy. The 95% prediction band would seem to offer a convenient means of evaluating serum AFP in the age range 0-300 days of life. Some illustrative cases, whose AFP values were formerly considered to be abnormally high but later proved to be within normal range, are presented.     

Presence and distribution of fibronectin on the surface of implanted intraocular lenses in rabbits

An immunohistochemical study was performed to observe cellular proliferation on the surface of implanted intraocular lenses (IOLs) in rabbit eyes. Rabbits were killed at intervals of 3 days and 1, 2, and 4 weeks after the operation. The IOLs were removed and examined by an immunoperoxidase staining method using antifibronectin (anti-FN) antibodies. The FN immunoreactivity was detected in macrophages and giant cells attached to the IOL surface. Prominent staining was observed in these cells 1 week after the operation, and staining for FN was less intense in the specimens obtained 2 and 4 weeks after implantation. These findings suggest that FN is produced by macrophages and giant cells on the IOL surface and may play an important role in cellular adhesion and motility. FN immunoreactivity decreased with time, which might be related to cellular activity.     

Experience in the treatment of acute fulminating myasthenia gravis]

During past 15 years, 188 myasthenia gravis (MG) patients underwent thymomectomy or thymectomy with extended resection of the adipose tissue around the thymus in our institution. Four of 188 patients (2%) had to be given respiratory support within 2 months after the onset of MG. We defined this MG as the acute fulminating type. There were 2 male and 2 female patients, ranging in age from 22 to 44 years (average, 32.5 years). Three of these patients had thymoma. One of these patients was post-thymomectomy myasthenia gravis and another patient was d-penicillamine induced myasthenia gravis. Two patients admitted on respirator for respiratory crisis. All patients underwent operation within 2 weeks after admission. The duration of respiratory support ranged from 10 to 120 days (mean 44) after operation. The period of the hospital stay ranged from 8 months to 2 years 1 month (mean 1 year 5 months). During acute stage after operation, the patients needed ACTH, steroid, immunosuppressants (azathioprine, Bredinin) and plasma pheresis depending on their severity of myasthenic symptoms. In 2 patients dose of steroid could be reduced without deterioration of the symptoms. They are doing well with small dose of steroid. In one patient plasma pheresis was performed 6 years after thymectomy. Various symptoms due to myasthenia gravis and rheumatoid arthritis has recurred 10 years after thymectomy. The titer of acetylcholine receptor antibody of this patient has been continuing in high level.