Relationship between dyslipidaemia and semen quality and serum sex hormone levels: an infertility study of 167 Japanese patients.

A prospective study was performed in the Reproduction Center of Ichikawa General Hospital (Chiba, Japan) to assess the relationship between dyslipidaemia and sperm quality and serum hormone levels in male patients in Japan. The semen parameters and blood samples were assessed in relation to several variables, including body mass index (BMI) and serum triglyceride (TG) levels. Between 2011 and 2012, 167 male partners of infertile couples aged 22-46 years (mean: 36.5 years) were referred to the reproduction centre. In total, 66 patients (39.5%) had hypertriglyceridaemia (TG level ≥ 150 mg dl(-1) ). There was no significant relationship between serum TG levels and sperm concentration or motility; however, the serum TG level was positively associated with the sperm morphological traits. Furthermore, the serum levels of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase were associated with the serum TG levels. By contrast, a negative relationship between serum testosterone and TG levels was discovered.

Recovery from azoospermia caused by a testicular injury: a case report.

Some cases of testicular trauma cause infertility especially when the injured testes are not removed. However, only a few long-term follow-up studies investigating endocrinological and semen parameters in patients who had testicular trauma have been conducted. Herein, we report an interesting case of a patient who spontaneously recovered from azoospermia due to a traffic injury and present in detail the results of the hormonal examination and semen analysis. The patient was a 22-year-old man with a history of left testicular injury and bilateral orchidopexy. Four months after the injury, the semen parameters improved but azoospermia occurred 1 year later. However, spermatogenesis spontaneously recovered without any treatment or without undergoing orchiectomy 6 months after the testicular injury.

Fluorimetric determination of isatin in human urine and serum by liquid chromatography postcolumn photoirradiation.

For the fluorimetric determination of isatin in human urine and serum, HPLC-postcolumn photoirradiation using a mobile phase has been developed. Isatin in the urine or serum sample was separated on a Capcell Pak C1 column (250 x 4.6 mm id). The mobile phase consisted of 70 mmol l-1 phosphate buffer (pH 7.2)-tetrahydrofuran (85 + 15% v/v) containing 5 mmol l-1 hydrogen peroxide, which was irradiated with germicidal light to induce fluorescence (lambda ex 302 nm, lambda em 418 nm). The addition of tetrahydrofuran to the mobile phase led to the peaks showing good separation as well as increased sensitivity. The calibration graph for isatin was linear over the range of 0.16-10.7 ng. The pretreatment of the acidified urine or serum samples consisted of diluting steps or deproteinizing steps using perchloric acid, respectively. The mean recovery of isatin from urine and serum was greater than 94%.

[Renal cell carcinoma in a patient with malignant lymphoma: a case report].

We herein report a case of renal cell carcinoma coexisting with malignant lymphoma. A 69-year-old male complained of an obstruction of the right nasal cavity due to a solid tumor in the paranasal sinuses. A biopsy of the tumor revealed diffuse, large cell and B cell type non-Hodgkin lymphoma. At the same time, just before the patient was scheduled to receive therapy, a left renal cell carcinoma was found. He therefore underwent a left radical nephrectomy.

Serum concentration of 5-S-cysteinyldopa in pediatric patients with giant pigmented nevi.

The serum concentrations of 5-S-cysteinyldopa (5-S-CD) in pediatric patients with giant pigmented nevi (GPN) were investigated and compared with those of pediatric patients with small- or medium-sized congenital nevi (CN), or non-melanocytic benign skin tumor (control group). Serum 5-S-CD levels in the GPN group (N = 21), particularly in patients less than 5 years old, were significantly higher (highest concentration 38.4, mean +/- S.D. 16.6 +/- 9.4 nmol/L) than those in the CN (N = 22) or control groups (N = 26). Serum 5-S-CD levels in the CN group were not significantly different from those in the control group. There was a significant correlation between the serum 5-S-CD level and size (surface area) of the GNP. There was a significant inverse correlation between the serum 5-S-CD level and age in the CN and control groups, but not in the GPN group. Serum 5-S-CD levels were transiently elevated immediately after treatment of patients with GPN with a combination of skin abrasion and cryotherapy with solid carbon dioxide. These results suggest that serum 5-S-CD levels in the GPN group reflected the 5-S-CD derived from GPN, particularly in patients less than 5 years old. This indicates that melanogenesis may be accelerated in infant patients in the GPN group.

[Changes in C100-3, and N14 antibodies in patients with chronic hepatitis C treated with interferon].

In interferon therapy for chronic hepatitis type C, we assayed C100-3 and N14 antibodies, and also determined IgM-C100-3 and IgM-N14 antibodies as well as HCV-RNA. N14 antibody was assayed by an end point titer method. In patients responding to interferon therapy, C100-3 and N14 antibody titers were decreased and became negative. In patients irresponsive to interferon therapy, C100-3 antibody titers were hardly changed, while N14 antibody titers were markedly increased. IgM-C100-3 and IgM-N14 antibody levels were significantly higher in the patients non-responding to interferon therapy than in those responding to interferon therapy. The daily assays of C100-3 and N14 antibody titers are considered useful in judging the effectiveness of interferon against chronic hepatitis type C.

International cooperation with Islamabad Children's Hospital, Pakistan: the JICA project.

The experience gained during 7 years of cooperation between the Japan International Cooperation Agency (JICA) and the Islamabad Children's Hospital (JICA-ICH project, July 1986-June 1993) is described. Islamabad Children's Hospital achieved the goals of the project and became a centre for excellence in health care, education and research for children, fulfilling the objectives of the project. This achievement was evaluated as one of the most successful projects in medical cooperation ever performed by JICA by a third party evaluation team. The problems arising and the lessons experienced through the process are discussed. The importance of the role which should be undertaken by pediatricians in international cooperation with developing countries is emphasized.

PIP: The Japan International Cooperation Agency (JICA) provided the funds for the construction of the Pakistan Institute of Medical Sciences' children's hospital (ICH) in Islamabad. JICA worked with ICH between July 1986 and June 1993. Japan sent 67 specialists to ICH and Pakistan sent 34 counterparts to Japan for training. JICA also provided equipment. The high mineral content (e.g., calcium) of the local water damaged equipment. There is no competent Pakistani medical engineer to repair the equipment. The project has addressed the shortage of nurses. Feed back and horizontal discussions among physicians and nurses or paramedics are uncommon. Exposure to colleagues in Japan changed behavior of the Pakistani counterparts returning from Japan, resulting in greater competence and in them behaving responsibly, being loyal, and adopting problem saving attitudes. Inadequate understanding of management by most counterparts, except physicians or senior level professionals, hurt the function and efficacy of ICH. ICH was governed by budget controls of the Pakistan Ministry of Health and of the Pakistan Institute of Medical Sciences, which sometimes kept ICH from receiving essential operating costs. ICH had too many outpatients and limited space for the clinical laboratory. A filter-clinic set up in a new OPD building solved the space problem. A too bureaucratic policy initially hindered the project. Despite these obstacles, ICH is a center of excellence in health care, education, and research. 82 physicians and 113 nurses work at ICH. ICH carries out much maternal and child health activity. ICH serves as a postgraduate teaching institution for pediatricians and for pediatric nurses. The Canadian International Development Agency evaluated the JICA ICH project and rated ICH as one of the most successful JICA medical projects.

Chronic hypomagnesemia and hypokalemia due to renal wasting in siblings.

A 13 year old girl with carpopedal spasm is presented. Investigation values showed hypomagnesemia and hypokalemia. Her younger brother and sister demonstrated the same biochemical abnormalities without any symptoms. Their urinary excretion of magnesium and potassium were inappropriately high compared with their serum levels. Treatment with oral magnesium sulfate failed to correct the abnormalities, but serum levels of magnesium and potassium were just below the lower limits. This familial disease may represent congenital renal wasting of magnesium and potassium.

[Clinical study of recombinant human granulocyte-colony stimulating factor (KW-2228) in pediatric field. 1. Effectiveness on neutropenia by various causes and safety].

The effect of KW-2228, a derivative of recombinant human granulocyte colony stimulating factor, on neutropenia in children was studied in 23 cases of aplastic anemia, 13 cases of chronic benign neutropenia, 6 cases of congenital neutropenia (Kostmann type), 2 cases of cyclic neutropenia, 2 cases associated with glycogenosis type Ib and 1 cases associated with immune deficiency. KW-2228 was administered at 1-8 micrograms/kg subcutaneously and at 2-16 micrograms/kg intravenously. As a principle, the administration was started at low doses and continued for 7-28 days increasing the doses in the cases who didn't respond to the treatment well. The response rate of all the cases by the physicians in charge was 81. 8% (36/44). The mean absolute neutrophil count was increased from 304 to 1,300/microliters in aplastic anemia, from 204 to 3,027/microliters in chronic benign type, from 125 to 2,193/microliters in Kostmann type, and from 360 to 2,007 microliters in others. KW-2228 did not induce any noteworthy serious side effects. These results indicated that KW-2228 is a useful drug to treat neutropenia in children.

[Clinical study of recombinant human granulocyte-colony stimulating factor (KW-2228) in pediatric field. 2. Effectiveness on neutropenia associated with administration of anticancer agent and safety].

The effect of KW-2228, a derivative of recombinant human granulocyte colony stimulating factor, on neutropenia associated with chemotherapy was studied in pediatric patients with malignant tumor. To patients repeatedly treated with the same chemotherapy, KW-2228 was administered subcutaneously at 1 microgram/kg or intravenously at 2 micrograms/kg once a day in the 2nd course of the chemotherapy. During the administration term of KW-2228, the nadir of neutrophils went up, and the duration of neutrophil count under 500/microliters as well as the interval for recovery of the count to 500/microliters were remarkably shortened, compared with those during the observation term. Further, the duration of fever in patients and the administration days of antibacterial agent were also reduced. The effective rate judged by attending doctors was as high as 78.9%, consisting of 83.3% in 42 cases of subcutaneous administration and 73.5% in 34 cases of intravenous administration. Side effects such as slight skeletal pain and slight fever in one case each (2.3% in total) were improved without treatment. It is concluded that KW-2228 may be a useful drug for treatment of neutropenia associated with chemotherapy in pediatric patients with malignant tumor.

Transient scoliosis in a child with juvenile rheumatoid arthritis.

An 8 year old girl was admitted to hospital complaining of arthralgia in a few large joints. According to the clinical course and serological tests, a diagnosis of a polyarticular type of juvenile rheumatoid arthritis was made. About 6 weeks after the onset, scoliosis was observed. The curvature regressed spontaneously over the following 6 months. Generally, scoliosis associated with juvenile rheumatoid arthritis has been noted a few years after the onset. A transient scoliosis in the early phase of this disease is rare.

Findings on magnetic resonance imaging of the spine and femur in a case of McCune-Albright syndrome.

Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright syndrome, is seen in the cranium, facial bones, bones of the extremities, and ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8-year-old girl with this syndrome, but 99mTc-methylene diphosphonate bone scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae. Multiple well-circumscribed areas of low signal intensity were seen on T1-weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans in this disease have never been reported, our findings in this case proved interesting for evaluating osseous lesions. MRI made it possible to differentiate between fibrous lesions (low signal intensity on T1- and T2-weighted MRI) and cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI).

Congenital skin fossae in the zygomatic region.

A unique case of a congenital skin fossa in the zygomatic region in a 3-year-old girl is reported. Little has been written about congenital fossae, or dimples. They are thought to develop in the wound resulting from the fetal tissue being compressed between a sharp bony point and the uterine wall. The skin and subcutaneous tissue become compressed and adherent, and when the pressure is released, surrounding parts can stand up, while the attached part remains tied down, forming small dimples or fossae, what have been called "pressure dimples." This is the first report of a skin fossa located in the zygomatic region, as far as we know.

Treatment of chemotherapy-induced neutropenia in children with subcutaneously administered recombinant human granulocyte colony-stimulating factor.

Fifty-six children with various malignancies were treated subcutaneously with recombinant human granulocyte colony-stimulating factor (rhG-CSF, KRN 8601) for neutropenia induced by cancer chemotherapy. Patients received the first chemotherapy without rhG-CSF (control course). In the second course, rhG-CSF was given once daily, starting 3 days after completion of identical chemotherapy (day 3) and continuing until day 12. At day 12, the white blood counts and neutrophil counts were found to be 6.8 and 30 times higher in the rhG-CSF course than in the control course (P = .0001) Nadirs of white blood counts and neutrophils were significantly elevated in the rhG-CSF course (P = .003 and .0001, respectively). rhG-CSF administration shortened the neutropenic period in the majority of patients. Children tolerated the rhG-CSF administration well and we have hereby confirmed that rhG-CSF administration is useful for proceeding with chemotherapy in children with cancer.

Kawasaki disease in a father and son.

The pathogenesis and etiology of Kawasaki disease are unknown, but some studies suggest increased genetic susceptibility. The case is presented of an infant with Kawasaki disease whose father suffered from the same illness 21 years previously. The A, B and C loci of the HLA antigens were examined.

Precocious puberty caused by an hCG-producing tumor of the septum pellucidum.

A 6 year 9 month old boy with rapidly progressing precocious puberty was immunohistochemically and histologically diagnosed as having an hCG-producing mixed tumor consisting of choriocarcinoma and teratoma in the septum pellucidum. His serum hCG was elevated, but the serum LH was low as determined by LH immunoradiometric assay (IRMA). He did not exhibit a characteristic endocrinological pattern, e.g., high basal levels of LH and failure to respond with high LH levels to the LH-RH stimulation test using the conventional LH RIA method.

[The effect of recombinant human granulocyte colony-stimulating factor (rG-CSF) on childhood neutropenias].

The clinical effect of recombinant human granulocyte colony-stimulating factor (rG-CSF), produced by Chinese hamster ovary cells, was studied in 27 patients with childhood neutropenias. The sample consisted of 8 patients with congenital neutropenia (Kostmann type), 9 with neutropenia with miscellaneous causes (5 chronic benign, 2 associated with hypogammaglobulinemia, 1 drug-induced, and 1 hypoplastic type), 3 with cyclic neutropenia, and 7 with severe aplastic anemia. The rG-CSF was given subcutaneously (or in a few cases intravenously) at a dose of 2 micrograms/kg/day for 7 days and 5 micrograms/kg/day for additional 7 to 28 days in cases with poor response. The rG-CSF was effective in 18 of 27 cases (67%). Patients with congenital neutropenia and aplastic anemia responded less frequently and poorly. The mean level of absolute neutrophil counts of 8 congenital neutropenia cases increased from 88/microliters to 2,718/microliters. That of 9 miscellaneous cases changed from 189/microliters to 7,224/microliters at a dose of 2 micrograms/kg/day. In 7 aplastic anemia cases pretreatment level of 220/microliters rose to 851/microliters, usually after increasing the dose up to 5 micrograms/kg/day. The rG-CSF was apparently effective in 3 cases of cyclic neutropenia. In any type of neutropenia, the effect was largely transient; after the discontinuation of rG-CSF, the absolute neutrophil counts tended to decrease to pretreatment levels within 1 to 2 weeks. The G-CSF was well tolerated, and only one case with mild lumbago and another with minimal elevation of transaminases were observed. We conclude that the rG-CSF can be effective for treating various types of childhood neutropenia.(ABSTRACT TRUNCATED AT 250 WORDS)