Successful trachelectomy and re-vaginoplasty for cervico-vaginal stenosis following unsuccessful uterovaginal anastomosis and vaginoplasty in congenital cervical and vaginal aplasia: description of technique and a case report.

We describe a successful surgical technique of abdominal trachelectomy and re-vaginoplasty for cervico-vaginal stenosis following unsuccessful uterovaginal anastomosis and vaginoplasty in a patient with congenital cervical and vaginal aplasia. After the surgical procedure, cervico-vaginal stenosis was resolved and periodic menstruation without dysmenorrhoea resumed. While long-term follow-up is essential to ensure successful pregnancy and delivery, we conclude that this novel surgical procedure is a promising alternative for improvement of the quality of life and normal sexual function, and for preservation of fertility in patients with cervical and vaginal aplasia.

Erratum: Structural and Valence Changes of Europium Hydride Induced by Application of High-Pressure H_{2} [Phys. Rev. Lett. 107, 025501 (2011)].

This corrects the article DOI: 10.1103/PhysRevLett.107.025501.

Structural and valence changes of europium hydride induced by application of high-pressure H2.

Europium hydride EuH(x), when exposed to high-pressure H2, has been found to exhibit the following structural and valence changes: Pnma(x = 2, divalent) → P63/mmc(x = 2, 7.2-8.7 GPa) → I4/m(x > 2, 8.7-9.7 GPa) → I4/mmm(x > 2, 9.7 GPa-,trivalent). With a trivalent character and a distorted cubic fcc structure, the I4/mmm structure is the ß phase commonly observed for other rare-earth metal hydrides. Our study clearly demonstrates that EuH(x) is no longer an irregular member of the rare-earth metal hydrides.

Purification and properties of alkaline ribonuclease from human serum.

1. Five alkaline ribonucleases (EC 3.1.4.22) were purified about 140- to 1900-fold from human serum by phosphocellulose and DEAE-cellulose chromatographies and Sephadex G-75 filtration, with a total recovery of 22%. These were designated as RNAases 1-5. 2. Optimum activities were observed at pH 8.5-8.7 for RNAases 1-4, and at pH 7.5 for RNAase 5. The molecular weights of these enzymes were estimated by gel filtration as 45 000, 32 000, 20 000, 13 000 and 8500, respectively. 3. These RNAases were found to be heat-labile proteins but are markedly stabilized with bovine plasma albumin. The reaction was activated by Na+, K+, Mg2+ and Ca2+, and inhibited by Co2+, Fe2+, Cu2+ and Zn2+. EDTA had little effect on the velocity of the reaction. Spermine caused 2- to 7-fold activation. 4. Among the substrates examined, these RNAases preferentially hydrolyzed pyrimidine bodies and except for RNAase 5 had a higher affinity for poly(C) than poly(U) as substrate. Each enzyme was free from other nucleolytic enzymes and hydrolyzed only RNA.

Pindolol potentiates the effect of fluoxetine on hippocampal seizures in rats.

Recent studies have shown that behavioral and neurochemical changes induced by selective serotonin (5-HT) reuptake inhibitors such as fluoxetine are potentiated by coadministration of a 5-HT1A receptor antagonist. The present study assessed the effects of concomitant administration of fluoxetine and a 5-HT1A receptor antagonist, pindolol, on focal hippocampal (HIP) seizures elicited by electrical stimulation in rats. A 10 mg/kg dose of fluoxetine, which was ineffective by itself, produced a significant increase in the afterdischarge threshold of HIP seizures when combined with pindolol at 10 mg/kg. The inhibitory effect of this combination was eliminated by pretreatment with parachlorophenylalanine, a depletor of brain 5-HT. These findings suggest that treatments designed to increase 5-HT neurotransmission inhibit the generation of HIP seizures. A combination of fluoxetine with a 5-HT1A receptor antagonist could thus be therapeutically useful for the treatment of depressive symptoms in patients with epilepsy.

Purification and properties of urinary alkaline ribonucleases from patients with nephrotic syndrome.

Four urinary alkaline ribonucleases (RNase, EC 3.1.4.22) were purified from patients with nephrotic syndrome using phosphocellulose, DEAE-cellulose and Sephadex G-75 chromatographiy. These enzymes were designated as RNases 1--4, respectively, in order of elution on phosphocellulose chromatography. The respective purification of each fraction was 41-, 23-, 34- and 27-fold with a total recovery of 25%. The pH optima of these RNases were around 8.5 with Tris/HCl buffer and the reaction was activated by mono- and divalent cations, such as Na+, K+, Mg2+ and Ca2+, but inhibited by Fe2+, Cu2+ and Zn2+. EDTA had little effect on the velocity of reaction. The molecular weights of RNases 1--4 were estimated by gel filtration as 45 000, 32 000, 20 000, and 13 000, respectively. Each enzyme hydrolyzed pyrimidine nucleotides preferentially with higher affinity for poly(C) than poly (U) as determined with synthetic polymers and was free from other nucleolytic enzymes. The patients with renal disorders excreted one to four RNases in urine and the number of enzymes increased as the concentration of urinary protein increased. On the other hand, normal subjects excreted a single fraction essentially identical to RNase 1.

Staphylococcal scalded skin syndrome I. Purification of exfoliatin and maternal transmission of neutralizing ability against exfoliatin.

Exfoliatin, an exotoxin produced by phage group 2 staphylococci, was separated and was analyzed. The toxin was separated in a single peak by Sephadex G-100 gel filtration and subsequent DEAE Sephadex chromatography. By acrylamide gel disc electrophoresis this single peak was found to contain 2 components both of which posessed exfoliative activity and the same antigenic properties. Their molecular weight, however, differed; the major component had a molecular weight of 30,000 and the minor component had 27,000. The toxin was stable when heated at 60 degrees C for 40 minutes, and labile at 100 degrees C for 20 minutes. The toxin was immunogenic to mice and produced antibody which could be transmitted to neonatal mice to neutralize exfoliative activity of the toxin. Innoculation of the bacteria caused the production of antibodies against both exfoliatin and alpha-hemolysin in mice. The antibodies were also transmitted to neonatal mice to neutralize the exfoliative activity of exfoliatin.

Staphylococcal scalded skin syndrome. II. Serum level of anti exfoliatin and anti alpha-toxin in patients with staphylococcal scalded skin syndrome or bullous impetigo.

In order to study the differences between staphylococcal scalded skin syndrome (SSSS) and bullous impetigo, the anti exfoliatin level was assessed in the sera from both groups of patients, and no significant difference in the level was found. However a significant difference was noted in the anti alpha-toxin levels in sera from both group of patients; that of SSSS patients was much lower than that of impetigo patients and of children in a control group. Five out of 6 patients with SSSS showed an unchaged level of anti alpha-toxin at the second examination, while an increased anti exfoliatin level was noted in 4 out of 6 SSSS patients.

Lack of evidence for existence of vitamin D and 25-hydroxyvitamin D sulfates in human breast and cow's milk.

The presence of water-soluble vitamin D and 25-OH-D sulfates in human breast and cow's milk was studied. We first confirmed that synthetic vitamin D2 and D3 sulfates could not be hydrolyzed by alkali but by acid. Breast or cow's milk was separated into milk whey containing water-soluble components and milk curd containing crude proteins and lipophilic components. The separated milk whey and curd were hydrolyzed by acid or alkali and each lipid extract was subjected to HPLC analysis. Neither peak due to vitamin D and 25-OH-D was observed in the chromatograms of acid- and alkali-hydrolyzed milk whey, whereas the peaks due to vitamin D3 and 25-OH-D3 were found in the chromatograms of both acid- and alkali-hydrolyzed milk curd and there was no significant difference between the respective peak heights. The eluates corresponding to the respective peaks observed on the latter's chromatograms were collected and subjected to UV, HPLC, GC-MS and GLC to identify the existence of vitamin D3 and 25-OH-D3, respectively. We concluded from these results that neither breast nor cow's milk contained water-soluble vitamin D and 25-OH-D sulfates, whereas they contained fat-soluble vitamin D3 and 25-OH-D3. The concentrations of vitamin D3 and 25-OH-D3 in breast milk were about 125 and 350 ng/liter, while those in cow's milk were about 420 and 270 ng/liter, respectively. The experiments on the transfer of 3H-D3 and 3H-25-OH-D3 perorally dosed to lactating rats into suckling pups through their milk also supported the above conclusion.

[Pharmacokinetic study of cefmenoxime concerning its transfer into tissues].

Cefmenoxime (1 g) was intravenously administered by one shot to investigate its pharmacokinetic profile with respect to transfer into the kidney, vesical wall and prostatic adenoma. The concentration of cefmenoxime in the kidney reached a peak of 403 micrograms/g at 0.17 hour after administration. The biological half-life was 0.74 hour. In the vesical wall, the level of cefmenoxime reached a peak of 28 micrograms/g at 0.67 hour after administration. The half-life was 2.30 hours. The peak level of cefmenoxime in the prostatic adenoma was 22 micrograms/g at 0.39 hour after administration. The half-life was 2.90 hours. The concentrations of cefmenoxime in these urogenital tissues were higher than its MIC80 and MBC80 against various Gram-negative organisms.

[Upper urinary tract obstruction diagnosis and treatment of congenital hydronephrosis in children].

Twenty nine children under 2 years old with congenital hydronephrosis have been treated in the last 14 years in our department. We report 4 cases which we found difficult to diagnose and treat. The diagnosis and the treatment of congenital hydronephrosis in children are discussed, especially concerning those patients under the age of 2 years. Pyeloplasty has been performed in 28 renal units out of 35 renal units. The results of the procedure were good in 82.1%, fair in 10.7%, no change in 3.6% and a lost case in 3.6%. The Aderson-Hynes dismembered technic was employed except for one renal unit in which the extrarenal pelvis was resected. Hydronephrosis in two renal units and one with nephrostomy for one year and one month improved spontaneously. Endopyelotomy was performed in 2 renal units and will be performed in one renal unit. Nephrectomy was carried out in one renal unit with renal dysplasia. A kidney with dysplasia excreted urine of several ml/day. Post-enhanced-X-ray computed tomography and T1-weighted image of magnetic resonance presented loss of function in the kidney. Degree of stenosis, position of stenosis and function of pelvis and ureter were different in each child. Children are constantly growing up and the condition of stenosis was changed in some cases. In conclusion, we should estimate the stenosis in children using several examinations.

[A case of retroperitoneal malakoplakia].

A case of retroperitoneal malakoplakia is reported. A 50-year-old female was admitted with the chief complaint of right flank pain. Intravenous pyelography, computed tomography, selective iliac arteriography and abdominal echography revealed right pararenal abscess and the right renal tumor suspected. About one liter of yellowish fluid was drained from the retroperitoneal space, but no right renal tumor was found. Pathological diagnosis was retroperitoneal malakoplakia postoperatively. This is assumed to be the second case of retroperitoneal malakoplakia in Japan.

[Combination (RaHPP) of radiotherapy, hyperthermia and chemotherapy (peplomycin and picibanil) for bladder cancer].

Four patients with urinary bladder carcinoma were treated by combination therapy which consisted of hyperthermia vesical irrigation of two anticancer drugs (peplomycin and picibanil), intravesical instillation of those drugs and radiation. Following the therapeutic method we planned, 40 mg of peplomycin and 10 KE of picibanil in 1,500 ml of sterile distilled water was irrigated at 42 to 43 degrees C into the bladder for 3 hours; 40 mg of peplomycin and 10 KE of picibanil in 40 ml of sterile distilled water was instilled into the bladder; and, the focus was irradiated with 60Co to a focal dose of 200 rad 30 minutes later. This pattern of treatment was repeated once a week, 3 to 5 times in total. On the days this pattern was not taken, 5 KE of picibanil in 20 ml of sterile distilled water was instilled into the bladder cavity. Complete response was observed in one patient and partial response in 3 patients. The side effect was temporary irritable bladder symptom.

[Experience using the laser rod in urological surgery].

The clinical use of a new surgical tool the "Laser Rod" is presented. This rod is made of ceramics and utilizes a neodymium-doped yttrium aluminum garnet (Nd-YAG) laser. With the Laser Rod, the surgeon can cut tissue by mechanical contact and still feel the resistance from the target tissue. In this study, this device has been used in various urological surgical procedures, such as nephrolithotomy, retropubic prostatectomy, ileocecal conduit diversion, urethroplasty and circumcision of the penis. Our results showed that laser surgery using this device, enables bloodless incision with minimal damage to adjacent tissue. In conclusion, the Laser Rod will probably be very useful in urological surgery, and its indications should be expanded through further study.

[Statistics on outpatients and inpatients at the urological department of Kosei Hospital 1975-1982].

Statistical observations of 19,678 outpatients and 2,601 inpatients at our department from 1975 to 1982 revealed the following results. The new cases in the outpatient clinic were in decreasing order nonspecific infections (50.8%), urogenital tumors (11.9%), urolithiasis (9.3%) and urogenital anomalies (8.0%). The inpatients according to the organ were in decreasing order kidney (29.6%), prostate (25.5%), bladder (13.4%) and ureter (11.9%). Operations were performed 2,414 times. Frequent operations were in decreasing order phimosectomy (360 times, 14.9%), TUR-Bt (284 times, 11.8%), transurethral cryosurgery of the prostate (215 times, 8.9%), vasectomy (190 times, 7.9%) and orchiopexy (152 times, 6.3%). More young persons comprised the outpatients of our hospital than at other facilities.

[Clinical evaluation of Claforan (CTX) in aged patients with chronic complicated urinary tract infections].

Claforan (CTX) was administered for 5 days at a daily dose of 4 g in two divided doses by intravenous injection to 18 in-patients, all of whom were over 70 years old and had chronic complicated urinary tract infections. The overall clinical efficacy of CTX was excellent in 4 cases, moderate in 8 cases and poor in 6 cases, the overall effectiveness rate being 66.7%. Twenty seven out of 34 organisms isolated from chronic complicated urinary tract infections before administration of CTX were eradicated after treatment. Both clinical findings and laboratory findings revealed no side effects. It is suggested that CTX is useful and a safe drug for elderly patients.

[Fungal urinary infection: report no. 1].

Clinical studies were performed on 115 fungal strains isolated from the urine of 36 patients. The predisposing factors were fungal urinary tract infections, antibiotics and indwelling catheter. Forty five strains of the 115 strains were Candida albicans, the most prevalent, followed by 25 strains of C. tropicalis and 22 strains of Trichosporon beigelii. Species of Torulopsis were rare, only 5 strains were isolated. Sixty strains (56%) co-existed with bacteria in urine. The co-existing bacteria most frequently isolated were Pseudomonas and Streptococcus. The minimum inhibitory concentration (MIC) of 5-FU was measured using the Bact-Morphology Agar medium. C. albicans, C. guillermondii, and Torulopsis glabrata showed an excellent MIC (under 0.78 microgram/ml), C. tropicalis, C. parapsilosis, T. beigelii, and T. cutaneum showed a poor MIC (over 100 micrograms/ml).

[Silicone pig-tail catheter for the upper urinary tract].

Experience with pig-tail designed silicone rubber catheter for upper urinary tract is reported. There are several sizes of catheter: the small size (5, 6 F) is adequate for cystoscopic ureteral stenting, and the large size (8-14F) is suitable for the purpose of urinary diversion e.g. nephrostomy, cutaneostomy. In cases of long-term indwelling catheter like nephrostomy and cutaneostomy, there were some advantages; remarkably decreased frequency of catheter exchange, and prevention and/or treatment of dermatitis around the urostoma with Varicare system II. As a splint catheter after urinary tract surgery e.g. pyeloplasty, ureteroplasty, pyelolithotomy, the catheter was excellent.

The treatment of bladder cancer by neothramycin.

Neothramycin (NTM), an anthramycin-group anticancer antibiotic, was used in the treatment of superficial carcinoma of the bladder. NTM was instilled into the bladder in the following dosages. Ten mg NTM in 20 ml of sterile distilled water was given first, and increased to 40 mg in 20 ml. This procedure was performed every second week to twice a day. Recently, in 2 patients, the treatment has been combined with 20 mg NTM intravenous administration. In 4 of the 11 patients (36%) the tumors disappeared completely, while in 6 patients (55%) there was partial disappearance of more than 50% and in one patient (9%) there was no effect. Three of the patients had irritable bladder symptom (temporarily). NTM was concluded to be effective for superficial carcinoma of the bladder.

[A study on accumulation of cholesterol in rat prostate].

An experimental model of prostatic hypertrophy was created by freezing the urethra at the opening of the ventral prostate in rats and administering a cholesterol-rich diet to induce cholesterol accumulation. Four-week-old Fisher rats were divided into a control group, a cholesterol-rich diet group (by adding 1% cholesterol to the diet), a frozen group, and a frozen and cholesterol-rich diet group, and were reared for 5 months. The animals were killed, and the ventral prostate was removed, weighed, and the lipid was extracted. Cholesterol content was measured by an enzymatic method. A cholesterol-rich diet without freezing had no effects on the ventral prostate, and after freezing alone, the weight of the prostate was smaller than that of the control group. However, in the group cholesterol-rich diet after urethral freezing, the cholesterol content per mg of tissue increased. This indicates that cholesterol accumulation can be induced in the prostate by administering a cholesterol-rich diet after creating the proper secretory disturbance.