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Spatial and temporal variation in Microcystis species composition and microcystin concentration, quantified by enzyme-linked immunosorbent assay and high-performance liquid chromatography, were investigated during a 3-year period (1998-2000) in the Northern Basin of Lake Biwa. The Northern Basin generally had a concentration of 5 microg L(-1) or less, except at station 1 (Nagahama Bay) from July to October during the study period. The maximum concentration at station 1 was 22.7, 35.9, and 22.0 microg L(-1) in October of 1998, 1999, and 2000, respectively. Eleven species of cyanobacteria were observed: Microcystis aeruginosa, M. ichthyoblabe, M. novacekii, M. wesenbergii, Oscillatoria raciborskii, Anabaena oumiana, A. affinis, A. flos-aquae, A. ucrainica, A. smithii, and A. crassa. Of these, M. aeruginosa and M. wesenbergii were the main components observed. A high concentration of microcystin in the lake water was mostly a result of variation in the relative amount of toxic M. aeruginosa rather than of the total Microcystis cell number. This was supported by the analytical results for isolated strains. Microcystis spp. cell density in the Northern Basin appeared to increase gradually over the course of the study. This is the first study to have surveyed the Northern Basin of Lake Biwa, which supplies drinking water to 14 million people and is the largest lake in Japan., ((c) 2005 Wiley Periodicals, Inc.)

One-compartment bulk electrolysis and simultaneous spectroscopic measurements are realized in a conventional spectroscopic cuvette without separator by using a mesh-type working electrode with extremely large surface area and a wire-type counter electrode with very small surface area. Spectrophotometric monitoring revealed complete electrolysis in a first-order kinetics. This technique was applied to mediated titration of cytochrome c and bilirubin oxidase for determining their redox potentials. Kinetics for the solution redox reaction between protein and mediator is described. The subtraction of spectral background due to mediator adsorption is very easy because of high reproducibility. The experiments can be done under completely anaerobic conditions. Low-absorbance protein samples (of low concentrations or small absorption coefficients) and hydrophobic proteins (such as membrane-bound proteins) are acceptable for measurements.

P-glycoprotein (P-gp) expels various drugs from cells, resulting in multidrug resistance, including against glucocorticoids. Here, we present a case of systemic lupus erythematosus (SLE) that suggests the importance of initial intensive treatment in overcoming unresponsiveness due to P-gp overexpression on activated lymphocytes. A 28-year-old woman had been diagnosed with highly active SLE including severe pericarditis, hemolytic anemia, lupus nephritis, and retinopathy. The disease activity of SLE progressed despite 1 mg/kg per day oral prednisolone. At the time, P-gp expression was extremely high, as evaluated by flow cytometric analysis on peripheral lymphocytes. After intensive treatment with three courses of methylprednisolone pulse therapy and plasmapheresis, we succeeded in controlling disease activity in association with marked reduction of P-gp overexpression; namely, the clinical symptoms immediately improved along with the reduction of P-gp expression. These results imply that patients with highly active SLE might have drug unresponsiveness that is mediated by P-gp overexpression on lymphocytes. Therefore, downregulation of P-gp by initial intensive immunosuppressive therapy might be important for overcoming glucocorticoid resistance. We also propose that measurement of P-gp on lymphocytes is a useful test for prediction of drug resistance and may assist in the selection of appropriate initial treatment.

Interstitial pneumonia (IP) with mixed connective tissue disease (MCTD) often progresses despite immunosuppressive therapies that caused serious infections. Human urinary trypsin inhibitor (UT) inhibits inflammatory factors associated with IP, without immunosuppression. UT bolus infusion rescued a female MCTD patient with refractory IP and severe opportunistic fungal pneumonia. Her IP diminished with monthly UT bolus infusion despite tapering of prednisolone, without UT-related side effects. UT pulse therapy could prove beneficial for refractory IP in MTCD even with opportunistic infections.

P-glycoprotein, encoded by the multidrug resistance (MDR)-1 gene, expels various drugs from cells resulting in drug resistance. However, its functional relevance to lymphocytes and the regulatory mechanism remain unclear. Although MDR-1 is known to be induced by various cytotoxic stimuli, it is poorly understood whether the activation stimuli such as cytokines induce MDR-1 transcription. We investigated the transcriptional regulation of MDR-1 in lymphocytes by activation stimuli, particularly by interleukin (IL)-2. IL-2 induced translocation of YB-1, a specific transcriptional factor for MDR-1, from the cytoplasm into nucleus of lymphocytes in a dose-dependent manner and resulted in the sequential events; transcription of MDR-1, expression of P-glycoprotein on the cell surface, and excretion of the intracellular dexamethasone added in vitro. Transfection of YB-1 anti-sense oligonucleotides inhibited P-glycoprotein expression induced by IL-2. Cyclosporin A, a competitive inhibitor of P-glycoprotein, recovered intracellular dexamethasone levels in lymphocytes. We provide the first evidence that IL-2, a representative lymphocyte-activation stimulus, induces YB-1 activation followed by P-glycoprotein expression in lymphocytes. Our findings imply that lymphocytes activation by IL-2 in vivo, in the context of the pathogenesis of autoimmune diseases, results in P-glycoprotein-mediated multidrug resistance, and that P-glycoprotein could be an important target for the treatment of refractory autoimmune diseases.

The effect of desiccation on germination frequency of Anabaena akinetes was investigated to evaluate the practical usefulness of sediment drying in reservoirs as a measure of inhibition of Anabaena bloom formation. Sediment samples taken from a small reservoir, where an abundance of Anabaena blooms occur every summer were desiccated in the outdoors and in an incubator at 5, 10, 15, and 25 degrees C. As a result, the germination frequency of Anabaena akinetes was strongly inhibited in comparison with that of Anabaena akinetes preserved in a refrigerator without desiccation as a control. Greater inhibition of Anabaena germination found at a higher temperature was examined, and almost all akinetes lost the ability of germination at 25 degrees C after 3 days of the desiccation treatment. Therefore, sediment drying is considered to be a useful measure to reduce periods and scales of Anabaena blooms, and its effect will be enhanced by performance during the warmer seasons.

The NEDO Gyro PI-710 centrifugal pump (Gyro PI-710 pump) incorporates a double pivot bearing system of which the male pivot and female bearings are fabricated from Al2O3 ceramic and ultrahigh molecular weight polyethylene. The top female bearing is a critical component because the impeller is levitated by hydraulic force and is maintained in the top contact position. A long-term in vitro examination of the pivot bearings was conducted using a biventricular assist model. In 7 animal experiments, the depth change of the top female bearing was examined. Animal experiments up to 90 days revealed that there was no noticeable depth increase in the top female bearing. According to the in vitro study, the life of the pivot bearings of the left and right pump was estimated to be approximately 3 and 7 years, respectively. Further improvement of this pivot bearing system is currently underway.

A 18-year-old female had low grade fever, butterfly rush, proteinuria, leukocytopenia and hypocomplimentemia in 1988, and she was diagnosed as systemic lupus erythematosus (SLE) with lupus nephritis (WHOIIb). Treatments with prednisolone and mizoribine resulted in the remission for three years. In May 2001, she presented neurosis and polakisuria despite of the increase of prednisolone to 20 mg/day. Finally, she admitted in our hospital because of manic and repressive state and disorientaion. A brain MRI revealed high intensity lesions in bilateral basal ganglia in T2 weighted images, and cerebrospinal fluid showed elevated protein and IFN-alpha (421 IU/ml). In addition, she manifested neurogenic bladder, muscle weakness and hyperactive deep tendon reflex of bilateral lower limbs due to both supranuclear disorder and hypesthesia under the Th 10 level. Spinal MRI revealed marked atrophy and high intensity signals at the middle to lower thoracic spinal cord in T2 weighted images, indicating complication of lupus myelitis as well as cerebral involvement. Although the symptoms of CNS lupus did not respond to prednisolone, twelve monthly cyclophosphamide pulse therapy (IV-CY) has resolved urinary disturbance, muscle weakness and sensory loss, along with the improvement of both cerebral and spinal MRI images. Lupus myelitis and neurogenic bladder are the rare, but very refractory manifestation among CNS involvement of SLE. We here propose IV-CY as an invaluable choice for the treatment of not only active lupus myelitis but also neurogenic bladder resisted for steroid.

A newly designed flexible inflow cannula has been developed for a biventricular assist device (BVAD). The inflow tip was designed for long-term ventricle drainage. Considering the anatomic differences between the right and left ventricles, a flexible inflow cannula, as a mass production model with a titanium tip, was developed and investigated in chronic BVAD animal experiments using the NEDO permanently implantable centrifugal blood pump. These flexible inflow cannulae consist of flexible plastic tubing with wire supported, titanium left and right tips. The right titanium inflow tip was designed with inner and outer stoppers to be inserted into the right ventricle wall and a beak shape to avoid sucking. The left tip was designed to be inserted into the left ventricle cavity. Five chronic BVAD bovine studies were performed to investigate the new beak shaped titanium tip. In these studies, the new beak shaped titanium tip and cannula prevented stenosis by a proliferation of pseudoneointimal, and supplied adequate blood flow to the pump without sucking. This newly designed inflow cannula with the beak shaped titanium tip was successfully implanted for 90 days.

A permanently implantable biventricular assist device (BVAD) system has been developed with a centrifugal pump which is activated by a hydraulically-levitated impeller. The pump impeller floats hydraulically into the top contact position; this position prevents thrombus formation by creating a washout effect at the bottom bearing area, a common stagnant region. The pump was subjected to in vitro studies using a pulsatile mock circulation loop to confirm the impeller's top contact position and the swinging motion produced by the pulsation. Eleven in vivo BVAD studies confirmed that this swinging motion eliminated blood clot formation. Twenty-one pumps im-planted for up to three months did not reveal any thrombosis in the pumps or downstream organs. One exception was a right pump which was exposed to severe low flow due to the kinking of the outflow graft by the accidental pulling of the flow meter cable. Three ninety-day BVAD studies were achieved without thrombus formation.

A 49-year-old Japanese woman was diagnosed with rheumatoid arthritis (RA) based on ACR criteria in May 1999. She developed liver injury after initiation of disease-modifying antirheumatic drugs (DMARDs) and was found to have contracted HCV infection. RA disease activity worsened following restriction of medication due to liver dysfunction. However, 3 mg/day of prednisolone (PSL) resulted in a temporary but marked improvement of RA in December 2001; but arthritis recurred along with Raynaud's phenomenon and palpable purpura. Differential diagnosis between arthritis caused by cryoglobulinemia and exacerbation of RA was important for the selection of appropriate treatment. She manifested non-erosive arthritis on medium and large joints with proteinuria, hematuria and hypocomplementemia. In addition, type III cryoglobulin was detected and chronic active hepatitis was observed on liver biopsy in March 2002. We considered that the main cause for the arthritis was HCV-related mixed cryoglobulinemia. Administration of IFN-alpha resulted in the disappearance of HCV-RNA and cryoglobulin followed by amelioration of arthritis without exacerbation of RA.

Abstract The aim of this study was to evaluate the efficacy and safety of mizoribine in patients with Sjögren's syndrome. Forty patients with sicca syndrome, whose conditions were definitely diagnosed as Sjögren's syndrome, were given mizoribine orally at a dosage of 150 mg/day for 12 months. The percentage change in salivary secretion after 3, 6, and 12 months of the therapy increased to +112.2% (P < 0.001), +119.9% (P < 0.01), and +147.3% (P < 0.001), respectively, compared with the baseline. Serum IgG levels decreased significantly throughout the study, and the level was 1969.4 ± 620.0 mg/dl after treatment for 12 months compared with the pretreatment value of 2094.3 ± 746.6 mg/dl (P < 0.05). The patient's assessment of clinical signs and symptoms on a 10-cm visual analog scale improved significantly from 7.2 ± 2.3 cm at the start of the treatment to 5.0 ± 1.9 cm after 12 months (P < 0.001). There was a similar improvement in the physician's assessment using the 10-cm visual analog scale: 7.1 ± 1.6 cm at the start of the treatment and 5.2 ± 1.9 cm after 12 months (P < 0.001). With regard to safety, no serious adverse reactions were observed. Although a controlled study would be required to clarify the efficacy of mizoribine, these preliminary observations indicate its efficacy for ameliorating glandular symptoms through improvements in immune abnormalities in patients with Sjögren's syndrome.

(Case 1) A 13-years-old female had multiple arthralgia and butterfly rush, when she admitted in our hospital in May 2001. Nephropathy, hemolytic anemia (Hb 6.3 g/dl and direct Coombs 3+) and high titers of antinuclear antibodies and anti-ds-DNA antibody were disclosed and she was diagnosed as systemic lupus erythematosus (SLE). Although combination therapy of PSL 60 mg/day with a steroid pulse therapy, cyclosporine or an immunosorbent treatment, severe hemolytic anemia remained. However, monthly cyclophosphamide pulse therapy (IV-CY), which was started for the steroid-resistant hemolytic anemia, has gradually become effective and Hb improved up to 11.4 g/dl after 6 courses of IV-CY. (Case 2) A 53-years-old woman diagnosed as SLE in 1978 and she had PSL 5 mg for over 10 years. Severe anemia (Hb 5.9 g/dl) was disclosed with a slight fever in June 2001, and she admitted in our hospital for further examinations. Progressive hemolytic anemia was revealed with marked decrease of Hb (3.4 g/dl) and high titer of direct Coombs (3+). Neither PSL (50 mg/day) nor steroid pulse therapy were effective against hemolytic anemia. In contrast, 3 courses of monthly IV-CY (500 mg/day) resulted in the resolution of hemolysis. It is well known that the steroid-resistant hemolytic anemia is extremely hard to treat and leads to miserable prognosis, but we here propose IV-CY as an alternative and invaluable choice for the treatment of refractory hemolytic anemia complicated with SLE.

A neurotoxin, homoanatoxin-a, was identified from a toxic strain of the cyanobacterium Raphidiopsis mediterranea Skuja (strain LBRI 48) isolated from Lake Biwa, Japan, as the major toxin component (0.57% of dry cell-weight). This cyanobacterium produced anatoxin-a and a new homoanatoxin-a derivative as minor components (0.04 and 0.06%, respectively). The structure of a new compound was assigned based on the spectral data as 4-hydroxyhomoanatoxin-a, which was not toxic to mice up to 2.0 mg/kg by intraperitoneal injection. The isolation of minor components was accomplished by improved extraction and separation procedures: (1) extraction with methanol-water (4:1) from dried cells, (2) adsorption of aqueous residue on ODS column (or cartridge) after evaporation of methanol, (3) cleaning up of the column by successive elution with water and 50% methanol/water, (4) elution of a toxic fraction by 20% methanol/water containing 0.1% TFA and (5) HPLC (ODS) purification with methanol/water containing 0.05% TFA. The procedures were effective in removing impurities and concentrating alkaloidal neurotoxins. It should be noted that this is the first report demonstrating the simultaneous production of anatoxin-a and homoanatoxin-a by the same strain of cyanobacterium.

A number of papers have claimed that at moderate to high contrasts, sensitivity is higher for shear motion than for uniform motion. We show in a 2 x 2AFC task, designed to minimize any potential artefacts due to criterion level or response bias, that sensitivities are essentially equal for shear and uniform motion under general conditions. It has also been claimed that position tracking enhances sensitivity for shear motion. We added moving sinusoidal gratings to stationary sinusoidal gratings of the same spatial frequency and orientation, to create stimuli in which position changes and motion energy have opposite directions, to show that shear and uniform motion are both subserved by motion-energy mechanisms at speeds above 2.0 deg/s and by position tracking at slower speeds.

Cyclosporin is a non-cytotoxic immunomodulating drug which inhibits NF-AT-dependent IL-2 transcription in lymphocytes. Cyclosporin is, therefore, beneficial as a monotherapy or as a combined therapy with methotrexate for refractory rheumatoid arthritis (RA). We also document that cyclosporin recovers the low concentration of intracellular multidrugs in lymphocytes by competitively binding to P-glycoprotein, a product of multidrug resistance gene-1, in vitro. Thus, cyclosporin could be used for the reversal of multidrug resistance, experienced in patients with longterm treated RA.

We document a case of 61-year-old woman with a 24 year history of rheumatoid arthritis (RA), who developed severe polyarthralgia, dry cough, paresthesia in the legs, frequent micturition, and severe macrohematuria. We diagnosed as severe RA with extraarticular manifestations based on interstitial pneumonia, mononeuritis multiplex, subcutaneous nodules, and high titer of rheumatoid factor. Ultrasonography demonstrated an intravesical mass lesion. A histological examination of the urinary bladder by endoscopic biopsy revealed marked deposition of AA amyloid. The diagnosis of secondary amyloidosis and bacterial cystitis were made based on histological findings and urine culture. At first, we administered antibiotics by intravenous infusion, which resulted in cure of cystitis and partial improvement of macrohematuria. Then combination therapy of corticosteroids and cyclophosphamide successfully reduced the disease activity of RA. There have only been a few reports published so far on the vesical amyloidosis in patients with RA. However, 5 of 10 patients (50%) in vesical amyloidosis died because of continuous massive hematuria, which induced disseminated intravascular coagulation and multiple organ failure. In conclusion, secondary amyloidosis of the urinary bladder should be considered as a possible cause of hematuria in patients with long-term RA and as an important prognosis factor of RA.

We studied vascular endothelial growth factor (VEGF) mRNA synthesis by peripheral blood mononuclear cells (PBMCs) in 30 patients with acute myocardial infarction (AMI) and 20 healthy individuals. PBMCs were isolated from all patients on days 3 and 14 after the onset of aMI, and from all of control individuals. To prepare samples containing identical amounts of GAPDH cDNA, competitive PCR was performed by co-amplifying serial dilutions of GAPDH mutant templates. Next, to measure VEGF cDNA quantitatively in the samples containing identical amounts of GAPDH, we also used competitive PCR by co-amplifying mutant templates of VEGF. The serum VEGF concentrations on day 14 in patients with aMI were measured by an ELISA method. Higher levels of VEGF mRNA in PBMCs were present on day 14 than either on day 3 or in the control group. Serum VEGF concentrations correlated with the VEGF mRNA levels of PBMCs on day 14. Peak serum CK levels correlated well with VEGF mRNA levels of PBMCs on day 14. The present findings suggest that PBMCs may be one of the candidates responsible for elevated circulatory VEGF protein following aMI. In addition, VEGF mRNA may be overexpressed in PBMCs in response to cardiac muscle damage.

We describe a technique to estimate the intrinsic phase shift between long-wavelength-cone (L-cone) and middle-wavelength-cone (M-cone) signals in the luminance mechanism with minimal contamination by chromatic mechanism(s). The technique can also estimate, simultaneously with the phase shift, the weight ratio of L and M cones for the luminance mechanism. We measured motion identification thresholds for a 1.0 cycle/deg, 12.0-Hz sinusoidal grating representing different vector directions in L- and M-cone contrast space. The physical phase of the L- and M-cone signals was varied over a broad range between -150 deg and +150 deg to investigate the effect on the threshold contours. The slope of the threshold contour in cone contrast space varied as a function of the physical phase. Estimates of the intrinsic phase shift between L and M cones are based on the change in slope of the threshold contour. The estimates are consistent with previous reports and show that whereas the L-cone signal lags behind the M-cone signal by approximately 35 deg for an orange background, the M-cone signal lags behind the L-cone signal by approximately 8 deg for a green background.

We investigated how transient changes of background color influence the L- and M- (long- and middle-wavelength-sensitive-) cone signals in the luminance pathway. Motion identification thresholds were measured for a drifting sinusoidal grating (1 cycle/deg) modulated along different vector directions in L- and M-cone contrast space. The color of a central 4-deg-diameter region was briefly altered (500 ms) by incrementing or decrementing either L- or M-cone excitation. Incrementing L-cone and decrementing M-cone excitation produced a field that appeared reddish relative to the yellow surround. Likewise, incrementing M-cone and decrementing L-cone produced a field that appeared greenish. Motion identification thresholds were obtained on the yellow field following the brief color transitions. The results show that the threshold for the L-cone direction was selectively elevated by the background substitution of incrementing L-cone and decrementing M-cone excitation (shift toward reddish color). The same substitution, however, did not affect the threshold in the M-cone direction. Similarly, the threshold for the M-cone direction was selectively elevated by the background substitution of incrementing M-cone, decrementing L-cone excitation (shift toward greenish) without affecting the threshold in the L-cone direction. Experiments using the motion quadrature paradigm confirmed that these effects occur within the luminance mechanisms. These results indicate that the activation of L-on plus M-off signals suppresses the L-cone signal and that the activation of L-off plus M-on signals suppresses the M-cone signals in the luminance pathway. We propose a retinal model based on the experimental results.

Electrocautery is essential in the modern operation. But if we use it carelessly, a severe complication can occur. Tracheotomy was performed by surgeons after laparotomy and drainage in a patient with severe pancreatitis. Endotracheal tube was ignited during hyperoxidation immediately after trachea was incised by electrocautery. Trachea and bronchi was damaged by heat. After the tracheotomy we examined his trachea and bronchi with a bronchoscope periodically. Electrocautery should be used carefully during hyperoxidation.

Activity hydrolyzing both N omega-phosphoarginine and glucose-6-phosphate was detected in rat renal microsome but not in hepatic microsome. Renal microsome was solubilized with 1% n-octyl-beta-D-thioglucoside and purified with DEAE-Sepharose column chromatography. Fractions hydrolyzing both N omega-phosphoarginine or glucose-6-phosphate were subjected to 7.5%-polyacrylamide gel electrophoresis in the presence of 0.1% sodium dodecyl sulfate. Phosphatase activity in the gels was detected by a lead nitrate stain using N omega-phosphoarginine or glucose-6-phosphate as substrates. Both substrates produced a stain in the region of the gel corresponding to a protein with a mass of 150 kDa. Extracts of slices from this region of the gel also hydrolyzed phosphocreatine, inorganic pyrophosphate, and O-phosphotyrosine. Moreover, the phosphatase had its optimal pH in the alkaline range and was inhibited completely by 20 microM sodium vanadate, 1 mM cysteine, and 1 mM tetramisole. All these properties indicate that the microsomal phosphoamidase (EC 3.9.1.1) of rat kidney was identical with alkaline phosphatase (EC 3.1.3.1).

A clinico-pathological study was conducted on 69 patients with bladder cancer who underwent total cystectomy. The one, three and five-year actuarial survival rates for the 69 patients were 73.3%, 48.6% and 44.1%, respectively. Survival rate was not significantly associated with sex, the number of tumors or the size of tumors. The survival rate in those aged 70 years or more was slightly worse than in those who were much younger. Patients with papillary tumors had a more favorable survival rate than those with non-papillary tumors but we could find no significant difference between those with pedunculated tumors and those with sessile tumors. The actuarial 5-year survival rates by grade were 71.9% in G1 + G2, 22.6% in G3 and 32% in non-transitional cell carcinoma; the rates by stage were 86.5% in pTa + pT1, 85.7% in pT2, 20.8% in pT3a, 18.2% in pT3b and 0% in pT4. When the stage reached pT3a, the survival rate fell remarkably. The rate of INF alpha (93.8%) was significantly better than that of INF beta (28.1%) and INF gamma (15.2%). The rate of ly0 (76.2%) was also significantly better than that of ly1 (25.5%) and ly2 (18.8%). There was no significant difference in survival between v(-) (50.7%) and v(+) (25.9%). We could find no significant difference between patients who underwent pelvic lymph nodes dissection and those who did not.(ABSTRACT TRUNCATED AT 250 WORDS)

The possible cause of the excessive increase in the number of polymorphonuclear leukocytes in the urine of patients suffering from urinary tract infections was investigated in regard to the chemotactic factor(s) for the leukocyte. We separated urinary protein fractions of 2 controls and 10 patients with urinary tract infections by gel filtration on a Sephadex G-50 column, and tested chemotactic activity in vitro by using Boyden's apparatus and in vivo by injecting the protein fractions into guinea pig skins. Chemotactic activity was found in the urinary protein fractions of 6 patients. The fractions of these 6 patients showed typical infiltration of polymorphonuclear leukocytes in the local tissue of guinea pigs. A high correlation was found between the activity and the leukocyte increase, although there was no relation between the type of infecting bacteria and chemotactic activity. The data suggest that the marked increase in the number of urinary leukocytes is attributable to the chemotactic factor(s) in the urine.

Eighty-eight cases of urinary bladder tumor were treated in our Department from 1976 to 1978. The effect of so-called immunopotentiators (OK-432, Levamisole and PSK) was studied in 23 patients. The following results were obtained. Pretreatment intracutaneous response to PHA was significantly lower in the high stage and high grade group than in the low stage and low grade group (P less than 0.025). However, there was no correlation between the effect of immunotherapy and PHA skin reaction. Of the immunoglobulins, only IgM was significantly lower in the high grade group than in the low grade group (P less than 0.025). The one-year survival rate for the patients in the high stage group was higher receiving immunotherapy than those not treated. This suggests that immunotherapy may be useful for prolonging the survival time of patients with advanced bladder carcinoma.

A case of inverted Y ureteral duplication accompanied by a calculus in an atretic ureteral segment is described. This anomaly was confirmed by surgical and histological explorations on the left side. Extirpation of the calculus, excision of the distended ureter below the bifurcation and Y-V plasty just above the bifurcation were performed. Urography suggested a similar ureteral anomaly on the right side but the patient has had no symptoms 2 years postoperatively.

Fifty-one cases of malignant lymphomas in patients under 20 years of age have been reviewed in Osaka, Japan. The breakdown of these cases revealed 6 cases (11.8%) of Hodgkin's disease (HD) and 45 cases (88.2%) of a non-Hodgkin's lymphoma (NHL). Both the HD and NHL cases were determined by using the Rye classification, as well as the Rappaport, Kiel, and LSG classifications, respectively. The results have shown that (1) the incidence of HD in childhood is the same as that seen in the adult in Japan; (2) that a NHL of the nodular type is rare in Japan as it is in Western countries; (3) that any significant differences were not present in the distribution of each histologic subtype in the cases of a NHL among Japan and Western countries, and that the lymphoblastic type was the most common. From this study it is concluded that geographical differences were not a factor in comparing cases of childhood malignant lymphomas in Japan and Western countries.

Twenty-two patients whose average age was 67 years and who had benign prostatic hyperplasia of stage I and II were treated with Cernilton for more than 4 weeks. Subjective symptoms were excellently improved and the improvement rate was over 85% in all of the evaluated symptoms of dysuria. In the overall evaluation, 18 out of 22 patients were rated as moderately improved or better, 2 were slightly improved and 2 remained unaltered. Aggravation of the symptoms was found in none of the patients. Objective findings such as residual urine volume and urinary flow rate were improved in 3 patients, although the shrinkage of the prostate was not observed on rectal palpation, retrograde urethro cystography or transrectal ultrasonography. No adverse reaction was observed during Cernilton therapy. In conclusion, it is suggested that Cernilton may be effective and safe for the conservative treatment of patients with early stage prostatic hyperplasia of non-surgical indication.

A male pseudohermaphrodite rat mutant showing a blind-ending vagina, small undescended testes, rudimentary male sex accessory organs and XY karyotype was investigated. Genetic analysis revealed an autosomal single recessive transmission of this defect and indicated that the gene action is restricted to males. Microscopic examination showed an absence of typical Leydig cells in testes of the mutant. Plasma concentrations of testosterone were extremely low and the values were comparable to those of castrated male rats and did not change after castration and/or after administration of hCG. Plasma concentrations of LH and FSH were remarkably high and the values were comparable to those of long-term castrated normal male rats which declined to basal levels after administration of exogenous testosterone. Weights of thymus and adrenal glands decreased and weights of preputial glands, kidneys and male accessory sex organs increased in response to exogenous testosterone. These results indicate that the primary defect in the mutant is an androgen deficiency probably due to a Leydig cell agenesis in the testes.