[Abscess of corpus cavernosum: a case report].

A 72-year-old man was admitted to our hospital complaining of a penile mass. The local biopsy indicated an abscess formation in the corpus cavernosum. In spite of antibiotic treatment, the abscess cavity ruptured to the dorsal skin and the urethra. After cystostomy formation, dorso-caverno-urethral fistula was closed by conservative therapies. Although the patient was followed up with antibiotics on an outpatient basis, necrotic changes in the right foot were noticed and he was diagnosed with arteriosclerosis obliterance in the right lower leg. Therefore, he was referred to an orthopedic clinic for amputation of his right lower leg with cystostomy catheter. This is the 7th case reported in Japan.

Evidence of stem cells in the adult prostatic epithelium based upon responsiveness to mesenchymal inductors.

Ductal tips approximately 300 microM in length from adult rat dorsal (DP), lateral type 1 (L1), and lateral type 2 (L2) prostates were combined with mesenchyme from the embryonic urogenital sinus (UGM), neonatal seminal vesicle (SVM), or neonatal bulbourethral gland (BUGM) and grafted underneath the renal capsule of syngeneic male hosts. Following 1 month of in vivo growth, all tissue recombinants formed large masses of prostatic ductal tissue, which represented massive growth of the original population of prostatic epithelial cells. Examination of secretory protein expression in these tissue recombinants indicated that each mesenchyme influenced secretory function in the adult prostatic epithelium in a characteristic way. SVM maintained expression of DP-1 and probasin in prostatic ducts of DP, L1, and L2, which normally express these proteins. BUGM induced expression of C3 in prostatic ducts of the DP, L1, and L2, which normally do not express C3. UGM induced the expression of DP-1, probasin, and C3 in prostatic ducts from all dorsal-lateral lobes. Mesenchymal induction of massive epithelial growth, new ductal branching morphogenesis, and change in prostatic lobe identity are indicative of the presence of stem cells in adult prostatic epithelium because high proliferative capacity, tissue regeneration, and pluripotency (change in functional differentiation) are hallmarks of stem cells.

Ductal heterogeneity in rat dorsal-lateral prostate.

Given the lobar complexity of the rat prostate at the morphological level, differences in secretory protein expression were investigated in individual prostatic ducts that constitute the subdivisions of the dorsal-lateral prostate, ie., the dorsal prostate, lateral prostate type 1 and lateral prostate type 2. For this purpose, individual prostatic ducts were microdissected from these prostatic lobes, photographed, and secretions subsequently collected from individual prostatic ducts and analyzed by Western blot for the expression of DP-1 and probasin, two major proteins expressed in rat the dorsal-lateral prostate. Many individual glands constituting the dorsal prostate, lateral prostate type 1 and lateral prostate type 2 co-express DP-1 and probasin, but at vastly different levels. DP-1 is a major secretory protein of the dorsal prostate and lateral prostate type 1, while probasin is the major secretory protein of the lateral prostate type 2. A small percentage of individual ducts of the dorsal prostate, lateral prostate type 1 and lateral prostate type 2 express either DP-1 or probasin. However, most of the individual prostatic ducts constituting the dorsal prostate and lateral prostate type 1 express DP-1 at high levels and probasin at low levels. Conversely, most of the individual prostatic glands that constitute the lateral prostate type 2 express probasin at high levels and DP-1 at low levels. This study emphasizes the morphological and functional heterogeneity within the prostate gland.

[Endorectal magnetic resonance imaging of the prostate and bladder].

Endorectal magnetic resonance imaging (MRI) using an endorectal surface coil has been evaluated basically and clinically. This new modality obtained increased resolution magnetic resonance images of the pathologic conditions of the prostate and bladder. Compared with images obtained with a body coil, the surface coil images clearly demonstrate prostatic intraglandular zonal anatomy. The clear images of prostatic capsule and neurovascular bundle seen on the surface coil may contribute to the local staging of prostate cancer. The staging diagnosis of bladder tumor located in the bladder neck will be the best candidate for endorectal MRI. Enhancement with gadolinium may improve the ability to differentiate superficial from deep bladder-wall tumors. We concluded that endorectal MRI is safely performed and is extremely useful for the local staging of prostate cancer and bladder neck tumor. Further studies will be required to evaluate the clinical significance of this new modality.

Role of epithelial-mesenchymal interactions in the differentiation and spatial organization of visceral smooth muscle.

Uterine mesenchyme from newborn (0-day) rats was grown in association with epithelia from the adult cornea, urinary bladder, oesophagus, mammary gland, 1-day skin, and 1-day uterus. Following 1 month of growth, the differentiation of uterine mesenchyme into actin-positive smooth muscle cells was assessed immunocytochemically with antibodies to smooth muscle actin. Whereas grafts of uterine mesenchyme produced only small amounts of myometrium, all types of epithelia induced extensive myometrial differentiation in the uterine mesenchyme, which indicates that this effect is non-specific. The role of cell-cell interactions in the morphological patterning of smooth muscle layers was assessed by analysing tissue recombinants composed of adult prostatic epithelium (PRE) plus mesenchyme of the urogenital sinus (UGM), or seminal vesicle (SVM), or adult bladder epithelium (BLE) plus UGM or SVM. Prostatic ducts developed in all of these tissue recombinants (UGM + BLE, SVM + BLE, UGM + PRE and SVM + PRE). When UGM was used (UGM + PRE and UGM + BLE recombinants), actin-positive smooth muscle cells became organized into thin sheaths resembling the prostatic pattern. Conversely, when SVM was grown in association with PRE or BLE, the induced prostatic ducts were surrounded by thick layers of smooth muscle cells exhibiting the seminal vesicle pattern of organization. Smooth muscle cells were unorganized in grafts of SVM or UGM alone. These observations suggest that in male urogenital glands the mesenchyme dictates the spatial organization of the smooth muscle layers.(ABSTRACT TRUNCATED AT 250 WORDS)

[A clinical study on renal cell carcinoma].

A retrospective study was carried out on 95 patients affected with renal cell carcinoma (RCC) between January 1973 and December 1988. Male to female ratio was 3 to 1 and the average age was 61 years. Hematuria was the most common initial symptom (44 patients, 46.3%), followed by incidental findings (18 patients, 18.9%). Five- and 10-year survival rates for all patients with RCC were 51.9 and 37.1%, respectively. Five-year survival rates for stage I, II, III, and IV were 82.7 54.7, 20.0, and 4.7%, respectively. Statistical analyses identified variables that significantly influenced survival, including lymph node metastasis (p less than 0.01) and distant metastasis (p less than 0.01). Cell type and renal vein involvement did not influence survival significantly. The three different forms of therapy (mitomycin therapy vincristine therapy and immunological therapy) did not influence survival significantly, but the beneficial effect of VBL therapy was obtained.

[A case of renal cell carcinoma and bladder carcinoma associated with von Hippel-Lindau disease].

A case of renal cell carcinoma and bladder carcinoma associated with von Hippel-Lindau disease is reported. A 31-year-old female was referred to the Department of Urology for further examination of right renal mass which was incidentally found on abdominal computed tomography (CT). The patient was operated on spinal hemangioma in May 19 and July 8, 1975, on cerebellar hemangioblastoma in July, 1976 and June 10, 1981 and on cerebellar cyst in June 20, 1988. Angiography revealed three hypervascular renal tumors in the right kidney. Cystoscopy revealed a papillary bladder tumor (TCC Grade 1). Transurethral resection of bladder carcinoma was performed on July 28, 1988. Right radical nephrectomy and lymphadenectomy were performed on August 2, 1988. Histopathologically, the tumor was renal cell carcinoma of clear cell type (Grade 1). Postoperative course was uneventful and the residual kidney is being followed up in the outpatient clinic.

[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.