[Copper concentration in seminal plasma of infertile men: influence of hormone therapy on copper concentration in seminal plasma].

The copper concentration in semen was measured in 30 subjects with male sterility and in 7 normal males and the relationship with the concentration of sperms was investigated. Copper concentration in semen was also measured before and after hormone therapy in the other 10 cases. The mean and standard deviation of seminal copper concentration in the normal males were 89.71 +/- 80.84 micrograms/dl. The mean and standard deviations by sperm frequency were 39.75 +/- 29.35 micrograms/dl for less than 45 x 10(6) sperms/ml, 31.93 +/- 38.20 micrograms/dl for less than 15 x 10(6) sperms/ml and 19.54 +/- 10.89 micrograms/dl for azoospermia. A significant decrease in seminal copper concentration was found with decrease in the concentration of sperms. The copper concentration in the hormone-treated group increased 3-32 times or 11 times on the average after treatment compared with the pre-treatment values. In the ten subjects, the mean and standard deviations were 18.30 +/- 10.49 micrograms/dl before treatment and 159.80 +/- 148.81 micrograms/dl after treatment representing a significant post-treatment increase in seminal copper concentration.

[Metastatic tumor of the epididymis from pancreatic carcinoma: a case report].

A 58-year-old male who complained of painful left scrotal swelling consulted a local clinic in August 1998. Because his symptoms did not improve after antibiotic therapy, he was transferred and admitted to Jyouhoku City Hospital on September 14, 1998. Pelvic computed tomography (CT) was performed, and revealed left epididymitis. However, antibiotic treatment did not improve the condition. Then, because carcinoma of the epididymis was suspected, left inguinal orchiectomy was performed. We found a tumor in the spermatic cord and another tumor in the epididymis. The pathological diagnosis was adenocarcinoma, and metastatic carcinoma from the digestive tract was suspected. Therefore, examinations were performed to detect the primary cancer. CT and magnetic resonance imaging (MRI) demonstrated an invasive irregular tumor from the pancreas to the left kidney. Irregular mucosa was observed by gastrointestinal fiberscopy. A biopsy was performed and the pathological diagnosis was adenocarcinoma. Based on these findings, the patient was diagnosed as having a metastatic tumor of the epididymis and spermatic cord caused by pancreatic carcinoma. This is the 3rd case of adenocarcinoma of the pancreas that presented as an epididymal nodule, and this is the 12th case of adenocarcinoma of the pancreas that presented as a spermatic cord nodule.

[A case of mixed gonadal dysgenesis with structural abnormalities of X chromosome (Xp+)].

An abnormal extra band on the short arm of the X chromosome was found in a 7-year-old reared as a female, of mixed gonadal dysgenesis. She had ambiguous external genitalia, scoliosis, short stature, mental retardation and motor paralysis of the limbs. Chromosomal analysis revealed the karyotype of 46,Xp+ Y. An uterus with fallopian tube, a streak gonad on the left side and a testicle on the right side were discovered at exploratory laparotomy. Bilateral gonads and fallopian tube were removed. The chromosomal analysis of her normal mother showed the presence of the same abnormal X chromosome (46, X Xp+). In the literature, we found some cases of intersexuality with Xp+ in karyotype. The relationship between our own case and these Xp+ cases was discussed briefly. Thirty-five cases of mixed gonadal dysgenesis have been reported in Japanese literature, our own case being the 36th case.

[A case of male pseudohermaphroditism with structural abnormalities of Y chromosome (ring Y)].

A case of male pseudohermaphroditism with ring Y chromosome is reported. The patient was a 3-year-old boy with hypospadias and right cryptorchidism. Culture of peripheral lymphocytes demonstrated a chromosomal mosaicism of 45 X/46 X, r (Y). Moreover, the chromosomal study with high resolution Q-band method revealed the presence of double ring Y (ring Y and double ring Y with the ratio of 25: 5). A well-developed vagina was discovered by retrograde cystourethrography. Uterus and fallopian tubes were absent at exploratory laparotomy. The gonads existed in the scrotum on the left side and in the inguinal pouch on the right. Both gonads were proved to be testes histologically, but bilateral was deferens were absent and its remnant was found in the retroperitoneal cavity. Plastic surgery for the genital abnormalities was performed. Only 30 cases of ring Y chromosome have been reported in the world including our case and we briefly reviewed these cases.

[Composite pheochromocytoma with ganglioneuroma in the adrenal gland: a case report].

A 67-year-old male demonstrated a right adrenal tumor at another hospital, and consulted our hospital for surgical treatment. Abdominal computed tomography revealed a 13 x 12 cm mass in the right adrenal region. Serum and urinary adrenaline levels were high, and the catecholamine levels in the blood sample of the selective adrenal vein were also high. The tumor was 1,325 g in weight and 13 x 9 x 18 cm in diameter. Pathological diagnosis was a mixed neuroendocrine-neural tumor. It was composed of pheochromocytoma and ganglioneuroma. This combination in the adrenal gland is rare. We reviewed 3 previously reported cases of composite pheochromocytoma with gangloineuroma in the adrenal gland in the Japanese literature, and this is considered to be the fourth case.

[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.

[Deoxycorticosterone-producing adrenocortical carcinoma--a case report].

A 39-year-old male presented with gross hematuria and left lower abdominal discomfort. Excretory urography showed a left ureteral stone and hydronephrosis. CT scans and magnetic resonance imaging showed a solid mass at the upper pole of the left kidney. Angiography revealed a hypervascular lesion at this area. The laboratory data showed a slightly decreased serum potassium level. In the endocrinological study, the serum deoxycorticosterone (DOC) level was markedly elevated. There was, however, no evidence of hypertension. The operation was performed on November 13, 1992. The tumor was almost separated from the left kidney, but an aberrant artery which divided from the renal artery and penetrated the renal parenchyma was found. Therefore, we had to carry out en bloc removal of the tumor together with the left kidney and the ureter which contained the ureteral stone. Pathological diagnosis was adrenocortical carcinoma. After the operation, hypokalemia and the serum concentration of DOC returned to normal range. Therefore, the tumor was diagnosed as DOC producing adrenocortical carcinoma. The patient was discharged 30 days after the operation with uneventful postoperative course. He received 2.5 g of op'-DDD a day. There was no evidence of distant metastasis or local recurrence 12 months after the operation. Nineteen cases of DOC producing adrenocortical tumor have been reported in the world literature. A case and a review of the literature are herein reported.

Role for enhanced faecal excretion of bile acid in hydroxysteroid sulfotransferase-mediated protection against lithocholic acid-induced liver toxicity.

The efficient clearance of toxic bile acids such as lithocholic acid (LCA) requires drug-metabolizing enzymes. We therefore assessed the influence of pregnenolone 16alpha-carbonitrile (PCN) treatment on LCA-induced hepatotoxicity and disposition of LCA metabolites using female farnesoid X receptor (FXR)-null and wild-type mice. Marked decreases in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities, and hepatic tauroLCA (TLCA) concentrations were found in LCA-fed wild-type mice co-treated with PCN. Whereas induction of Cyp3a and hydroxysteroid sulfotransferase (Sult2a) proteins was observed in FXR-null and wild-type mice, clear increases in biliary 3alpha-sulfated TLCA but not total 6alpha-hydroxy LCA (taurohyodeoxycholic acid and hyodeoxycholic acid) were only observed in PCN-treated wild-type mice. Biliary 3alpha-sulfated TLCA output rate was increased 7.2-fold, but accounts for only 4.2% of total bile acid output rate in LCA and PCN-co-treated wild-type mice. Total 3alpha-sulfated LCA (LCA and TLCA) was, however, the most abundant bile acid component in faeces suggesting that efficient faecal excretion of biliary 3alpha-sulfated TLCA through escape from enterohepatic circulation. FXR-null mice, which have constitutively high levels of the Sult2a protein, were fed a diet supplemented with 1% LCA and 0.4% dehydroepiandrosterone (DHEA), a typical Sult2a substrate/inhibitor. The faecal total 3alpha-sulfated bile acid excretion was reduced to 62% of FXR-null mice fed only the LCA diet. Hepatic TLCA concentration and serum AST activity were significantly higher in FXR-null mice fed DHEA and LCA diet than in FXR-null mice fed the LCA diet or DHEA diet. These results suggest that hepatic formation of 3alpha-sulfated TLCA is a crucial factor for protection against LCA-induced hepatotoxicity.

Bacterial flora in the digestive tract of cattle. I. Comparison of nonselective culture medium and changes in fecal bacterial flora with age.

Studies were made on nonselective culture medium and the method of culture for the investigation of the bacterial flora in the digestive tract of cattle. With their results, further studies were done to clarify changes in the fecal bacterial flora in eight calves less than 6 months of age with the lapse of time. Three roll-tube media were used in the gas jet method. They were modified VL agar (VL medium), rumen fluid glucose cellobiose agar (RGCA medium), and Medium 10 (M 10). Moreover, glucose liver blood agar (BL medium) was used in the anaerobic jar method. In this method the steel wool method was applied after the substitution of carbon dioxide. Of the four media used, VL medium was proved to be the most efficient. It was followed by RGCA medium and M 10. BL medium was much less efficient than any other medium. When the fecal bacterial flora was examined in calves for changes with the advance in age, the total bacterial count and the enteric bacterial count decreased in the second half of the experimental period. The lactobacillary group count remained almost at a constant level of 7 approximately 9 (logarithmic value) per gram in breast-fed calves, but decreased to a level of 5 (logarithmic value) per gram in bottle-fed calves at about 2 months of age or later. The streptococcal group count showed no particular tendency to change. When the organic acid contents of the feces were estimated in calves in every stage of growth, the amount of total organic acids and that of propionic acid were larger in bottle-fed than in breast-fed calves.

Comparison of antigenic properties among several strains of weak beta-hemolytic treponeme isolated from swine and a dog.

Agglutinin-absorption and precipitin-absorption studies demonstrated that three strains of weak beta-hemolytic treponeme isolated from cases of diarrhea of swine and from a clinically normal dog were antigenically different from each other.

Computerized tomography in acute pyelonephritis: the clinical correlations.

Computerized tomography was performed on 19 patients diagnosed as having uncomplicated acute pyelonephritis. The relationship was investigated among the laboratory findings, presence of flank pain, clinical course and severity of the lesions detected by computerized tomography. In patients febrile for less than 2 weeks healing as assessed by computerized tomography took an average of 76 days. However, in patients with repeated febrile episodes occurring for longer than 2 weeks healing was delayed until an average 232 days after onset. Computerized tomography findings generally correlated well with the erythrocyte sedimentation rate, C-reactive protein level, and presence of pyuria and flank pain. However, in patients with a prolonged course computerized tomography proved to be a more reliable indicator of progress than either the results of laboratory tests or the symptoms. In conclusion, computerized tomography was useful in the diagnosis, assessment of severity and evaluation of healing of acute pyelonephritis.

A new technique of ureteric catheterization.

Insertion of an indwelling stent catheter or ureteric catheterization using a new guide wire (the Radiofocus guide wire) was carried out in a total of 24 subjects. The subjects comprised 16 patients in whom insertion of a conventional guide wire and ureteric catheter was not possible due to previous use of an indwelling stent catheter for extracorporeal shock-wave lithotripsy (ESWL), 2 cases in whom a conventional guide wire could not be inserted due to post-ESWL formation of a stone street, 4 patients with ureteric stenosis and 2 patients with normal ureters in whom catheterization was impossible by the usual methods. Insertion of a Radifocus guide wire into the renal pelvis was successfully accomplished in all 24 cases and an indwelling catheter could be passed in 21 cases. These results suggest that the Radifocus guide wire should make a useful contribution to ESWL therapy. It can also be applied to retrograde pyelography, ureteric obstruction, and the dilation of ureteric stenosis.

Various urinary properties in bladder tumor patients.

Urinary electrolytes, pH, urea nitrogen, creatinine, uric acid and osmolarity were measured in patients with bladder tumors and compared with those of a control group. There were 41 bladder tumor patients ranging in age from 29 to 87 (average 64) years with a male:female ratio of 32:9. According to histopathological classification of the bladder tumors, there were 34 transitional cell carcinomas (TCC) (21 G1, 10 G2, 3 G3), four squamous cell carcinomas, two adenocarcinomas and one inverted papilloma. The control group comprised 29 patients ranging in age from 35 to 80 (average 63) years with a male:female ratio of 26:3. Four urine samples were collected from each patient: early morning on the day of admission, just after admission, early morning on the day of return to hospital after temporary discharge, immediately after return to hospital after temporary discharge. The results indicated that the urinary Ca2+ and uric acid values were significantly lower in the bladder tumor group than in the control group. The urinary pH tended to be somewhat higher than in the control group, and the pH values tended to be especially high in the TCC G3 patients. There were differences in the various urinary properties between the TCC G1 and G2 and the TCC G3 patients.