Numerical study on spindle positioning using phase field method.

A method of numerical simulation of cell division using phase fields is presented. The cell division plane is obtained as a result of the spindle position and orientation considered with the spatial distribution of the activated cortical force generators and the dividing cell shape. To exemplify the application of the proposed method, numerical simulations of the development of cysts and early embryos are performed. The numerical results demonstrate that the activated cortical force generators that are localized at the lateral cortices of the epithelial cells lead to the formation of a single central lumen. It is additionally shown that the linear distribution of the activated cortical force generators along the animal-vegetal axis of a spherical cell engenders a similar cell proliferation of the divided embryo generated by the 32 cell period in a sea cucumber.

Effective model hierarchies for dynamic and static classical density functional theories.

The origin and methodology of deriving effective model hierarchies are presented with applications to solidification of crystalline solids. In particular, it is discussed how the form of the equations of motion and the effective parameters on larger scales can be obtained from the more microscopic models. It will be shown that tying together the dynamic structure of the projection operator formalism with static classical density functional theories can lead to incomplete (mass) transport properties even though the linearized hydrodynamics on large scales is correctly reproduced. To facilitate a more natural way of binding together the dynamics of the macrovariables and classical density functional theory, a dynamic generalization of density functional theory based on the nonequilibrium generating functional is suggested.

Morphology of microphase separated domains in rod-coil copolymer melts.

We investigate the morphology of microphase separated domains in diblock copolymers where each chain consists of a stiff rod block and a flexible coil block. A simplified phenomenological model system is introduced, which is coarse-grained in terms of the local concentration difference between the two blocks and the local director field of the rod part. Computer simulations of this set of time-evolution equations in two dimensions show in the weak segregation regime that the elastic energy in the rod-block rich domains affects drastically the structures of microphase separated domains. A coil-to-rod transition is incorporated into the model system to examine the elastic and anisotropic effects. The effects of the external electric field are also investigated to control the domain morphology.

Metastatic renal cancer arising from adenoid cystic carcinoma of the parotid gland: a case report.

A 40-year-old woman underwent excision of the right parotid gland tumor in 1988. The pathological examination showed adenoid cystic carcinoma. In 1993 she underwent excision of a recurrent tumor on the right face and was referred to our department because of an incidental finding of left renal tumors. She underwent nephrectomy and was diagnosed with left renal metastasis on pathological examination. In 1997 computerized tomography demonstrated multiple metastases in the right kidney, liver, lungs and brain. She died of cancer in 1998. Secondary carcinoma of the kidney is usually identified at autopsy and represents a late and poor manifestation of primary disease when diagnosed during life. The present case is unique in its primary site, pathology and clinical course.

Cowper's syringocele causing voiding disturbance in an adult.

BACKGROUND: A 21-year-old man presented with a sudden onset of miction pain and post-void dribbling. The diagnosis was Cowper's syringocele due to the findings of retrograde urethrography and urethroscopy. METHODS/RESULTS: The patient underwent transurethral unroofing of the syringocele. The present case is of interest because Cowper's syringocele is usually diagnosed in male infants and children and is rarely found in adults. CONCLUSION: This lesion should be included in the differential diagnosis of voiding disturbances in adults.

[Clinical evaluation of estramustine phosphate and vinblastine in patients with hormone-refractory prostate cancer].

We evaluated the efficacy of the combination of estramustine phosphate and vinblastine in 13 patients with hormone-refractory prostate cancer. Of 12 patients with an elevated prostate specific antigen (PSA) level at the start of treatment, 5 (42%) had a greater than 50% decrease in PSA level. In a patient with cervical and mediastinal lymph node metastases, about a 57% decrease was observed in bidimensional measurement. Side effects were mild and manageable. The survival rate was not significantly different between patients who showed a greater than 50% decrease in PSA levels or regression of lymph node metastases versus the other patients.

Intra-arterial infusion of 5-fluorouracil, leucovorin and cisplatin for primary adenocarcinoma of the urinary bladder.

BACKGROUND: Primary invasive adenocarcinoma of the urinary bladder was diagnosed in a 59-year-old man with a 6-month history of macrohematuria. METHODS: He was treated with intra-arterial infusion of 5-fluorouracil, leucovorin and cisplatin and underwent radical cystectomy and construction of ileal conduit. RESULTS: The pathologic examination of the specimen revealed no viable malignant cells. CONCLUSION: 5-Fluorouracil combined with leucovorin and/or cisplatin has been used in the treatment of gastrointestinal adenocarcinoma and may be useful in primary adenocarcinoma of the bladder.

Spontaneous rupture of the urinary bladder is not a rare complication of radiotherapy for cervical cancer: report of six cases.

BACKGROUND: Spontaneous intraperitoneal rupture of the urinary bladder is an extremely rare event. It has been reported to be a rare complication of radiation therapy for cervical cancer, but no studies have ever reported the incidence of this life-threatening complication. MATERIALS AND METHODS: From August 1981 through December 1988, 143 patients with carcinoma of the uterine cervix were treated with high-dose-rate intracavitary brachytherapy combined with external beam therapy at Kobe City General Hospital. RESULTS: Of these patients, three (2.1%) suffered spontaneous intraperitoneal rupture of the urinary bladder as a late complication of radiation therapy between August 1995 and February 1998. Three other patients, treated with radiation therapy for cervical cancer at other hospitals, were also admitted to our hospital with this complication between August 1995 and February 1998. All six patients underwent laparotomy and repair of the perforation. However, rerupture of the bladder occurred in three of these patients. CONCLUSION: Spontaneous intraperitoneal rupture of the urinary bladder after radiation therapy for cervical cancer is less rare than previously expected, and urologists must consider the possibility of occurrence of this life-threatening event following radiation therapy.

[Retroperitoneal schwannoma: a case report].

A 67-year-old man was admitted for a complaint of lumbago. The patient had had the three operations for the schwannoma in spinal cord at the Neurosurgical Department of our hospital. Magnetic resonance imaging (MRI) revealed a right infrarenal tumor by chance. The tumor compressed the right kidney and measured 6 x 5 cm in size. On the tentative diagnosis of the retroperitoneal tumor, the patient was referred to the department of urology in our hospital and the tumor was excised. The histological diagnosis of the removed retroperitoneal tumor was schwannoma, and was thought to be heterotopic recurrent schwannoma.

Measurement of urinary lactoferrin as a marker of urinary tract infection.

The usefulness of the measurement of urinary lactoferrin (LF) released from polymorphonuclear leukocytes and of an immunochromatography test strip devised for measuring urinary LF for the simple and rapid diagnosis of urinary tract infections (UTI) was evaluated. Urine specimens were collected from apparently healthy persons and patients diagnosed as suffering from UTI. In the preliminary study, the LF concentrations in 121 normal specimens and 88 specimens from patients (60 with UTI) were quantified by an enzyme-linked immunosorbent assay. The LF concentration was 3,300.0 +/- 646.3 ng/ml (average +/- standard error of the mean) in the specimens from UTI patients, whereas it was 30.4 +/- 2.7 ng/ml and 60.3 +/- 14.9 ng/ml in the specimens from healthy persons and the patients without UTI, respectively. Based on these results, a 200-ng/ml LF concentration was chosen as the cutoff value for negativity. Each urine specimen was reexamined with the newly devised immunochromatography (IC) test strip to calculate the indices of efficacy. Based on the cutoff value, it was calculated that the sensitivity, specificity, and positive and negative predictive values of the IC test were 93.3, 89.3, 86.2, and 94.9%, respectively, compared with the results of the microscopic examination of the urine specimens for the presence of leukocytes. The respective indices for UTI were calculated as 95.0, 92.9, 89.7, and 96.6%. The tests were completed within 10 min. These results indicated that urine LF measurement with the IC test strip provides a useful tool for the simple and rapid diagnosis of UTI.

Efficacy of an echo contrast agent, SH/TA-508, in color doppler sonography of mass lesions in urology.

We performed a clinical phase III study with a galactosebased ecoo contrast agent, SH/TA-508, to evaluate its efficacy, safety, and usefulness for mass lesions in urology. SH/TA-508 was prepared as a suspension containing stabilized micro-air bubbles by adding water for injection just before use. SH/TA-508 was administered into the antecubital vein at an initial dose of 300 mg/ml × 5 ml followed by higher doses of 400 mg/ml × 4 ml, 300 mg/ ml × 10 ml or 400 mg/ml × 8 ml when a sufficient effect was not obtained. Efficacy was evaluated by color Doppler signal enhancement, the duration of blood flow signal enhancement, and improvement of diagnostic capacity. Fifty-nine patients with mass lesions in the kidney, prostate, testis, adrenal gland, and bladder were enrolled in the study. Up to the third dose the cumulative efficacy rates (≥2+) of color Doppler signal enhancement and duration of blood flow signal enhancement were 92% and 87%, respectively. Consequently, diagnostic capacity in 76% of the patients was remarkably improved. A light transient angialgia occurred in one patient but no other clinically significant changes were observed. It was confirmed that SH/TA-508 is a safe echo contrast agent that offers satisfactory color Doppler signal enhancement in the urologic organs mentioned above.

A case of a methylmethacrylate foreign body in the bladder wall.

The authors report a rare case of bone cement protruding into the bladder wall. The patients exhibited an abnormal mass in the bladder wall during ultrasonography and was admitted to our department 21 mo after right hip joint replacement. Partial resection of the urinary bladder including the bone cement was performed. The patient made an uneventful recovery postoperatively. This is the third case reported of a foreign body in the urinary bladder associated with bone cement.

[A case of infrarenal left inferior vena cava with macrohematuria after contusion in the lumber region].

A 33-year-old woman was admitted with macrohematuria after contusion in the left lumber region. The excretory urogram showed no abnormal findings, but color doppler and RI-angiography revealed infrarenal left-sided inferior vena cava (left IVC). The pressure in the dilated left renal vein was higher than that in the right one. Renal contusion in addition to the congestion of the left renal vein due to left IVC was thought to be the cause of hematuria in this case. Hematuria disappeared after retrograde instillation of 0.2% AgNO3 water solution into the left renal pelvis. Left IVC rarely presents clinical symptoms, and is usually found by chance on CT scan or ultrasonography during examinations for upper abdominal organs. Our case is the 69th one of left IVC in Japan, and belongs to Type 2' according to our classification of left IVC.

Mechanism of tracheoesophageal shunt phonation.

OBJECTIVE: To elucidate the phonatory mechanism of tracheoesophageal shunt speech after total laryngectomy, we examined the dynamics and origin of neoglottis in tracheoesophageal shunt speakers. DESIGN: We conducted the videofluoroscopic, strobofiberscopic, and electromyographic studies of the pharyngoesophageal segment in tracheoesophageal shunt photonation. SETTING: Academic referral medical center. PATIENTS: Twenty-five tracheoesophageal shunt speakers were examined. RESULTS: Videofluorescopic and fiberscopic examinations showed two bulges in the pharyngeoesophageal segment. The upper bulge was revealed to be the sound source of tracheoesophageal shunt speech by the stroboscopic examination; anteroposterior and undulating regular movements were observed. Electromyographic study elucidated the contribution of muscle contraction to the two bulges; the upper bulge is formed by the thyropharyngeal muscle, whereas the lower bulge corresponds to the cricopharyngeal muscle. CONCLUSION: The neoglottis was considered to be formed by the stenotic portion due to thyropharyngeal muscle contraction and mucosal vibration due to expiratory airflow. This new understanding of the phonatory mechanism will be indispensable in the treatment of cases with failing shunt speech.

[Microsurgical vasovasostomy and epididymovasostomy for seminal tract obstruction: cause of obstruction and operative outcome].

The surgical outcome in 42 patients with seminal tract obstruction who underwent microsurgical vasovasostomy or epididymovasostomy and were followed up for more than 3 months postoperatively is reported. Causes of the obstruction were vasectomy in 7 patients, childhood inguinal herniorrhaphy in 15, epididymitis in 5, Young's syndrome in 3 and others in 12. Twenty-eight patients had bilateral obstruction while 14 had unilateral obstruction. After 51 operations, including 11 reoperation in 9 patients, the anastomosis was patent in 83.3%, semen quality normalized in 21.4% and pregnancy was achieved in 31.0% of the 42 patients. Success rate of vasovasostomy and epididymovasostomy was 57.7% and 78.3%, respectively. Factors detrimentally affecting the operative outcome were obstruction due to Young's syndrome, obstruction for more than 10 years, absence of sperm in vasal fluid during the operation, elevated serum FSH levels and presence of seminal tract anomaly. Presence of serum antisperm antibodies had no effect on pregnancy rate. Microsurgical reanastomosis of the seminal tract resulted in restoration of fertility in many patients with seminal tract obstruction who had normal testicular spermatogenesis.

Remobilization of paralyzed vocal cord by anticus-lateralis muscle suturing.

A new method of dynamic reconstruction by suturing the cricothyroid (anticus) and the lateral cricoarytenoid (lateralis) muscles was devised for the treatment of unilateral recurrent laryngeal nerve paralysis. Eighteen adult dogs underwent this surgical procedure after sectioning a recurrent laryngeal nerve. Immediate postoperative observations revealed a marked increase in tension of the paralyzed vocal cords and remobilization to the median line of 17 of 18 dogs. More than 4 months later, fiberscopic examination revealed a satisfactory adduction of the cords. Electrophysiologic and histologic examination showed reinnervation of the affected lateralis muscle by the external branch of the superior laryngeal nerve. The clinical applications of this surgery may serve as a dynamic reconstruction for unilateral recurrent laryngeal nerve paralysis.

Anticus-lateralis muscle suturing. Treatment of recurrent nerve paralysis.

We have devised a new surgical method that sutures the cricothyroid (anticus) muscle to the paralyzed lateral cricoarytenoid (lateralis) muscle for the dynamic reconstruction of the larynx. Because this method achieved remobilization of the paralyzed vocal cord in dogs, we applied it to seven patients with unilateral recurrent laryngeal nerve paralysis (four patients had postsurgical paralysis and three patients had idiopathic paralysis). We obtained the following satisfactory results: (1) vocal cord tension and voice quality improved in all patients, and (2) in four patients, remobilization of the paralyzed vocal cord was obtained. We believe that this surgical method could serve as a new dynamic method of reconstruction for the treatment of unilateral recurrent laryngeal nerve paralysis.