In order to investigate whether DNA ploidy in a single area of a tumor could be representative of the entire tumor, flow-cytometric DNA analysis was performed for multiple samples (an average of 7 samples) obtained from the same tumor in 9 cases of transitional cell carcinoma of the urinary bladder. The incidence of DNA aneuploidy was 88.9% (8 out of 9 cases) and, furthermore, in 7 of these, intratumoral regional heterogeneity in DNA ploidy was evident. With high frequency, bladder carcinoma consisted of heterogeneous cell populations with different ploidy. There were 2 cases in which the tumor consisted of mixed subpopulations of diploid and aneuploid clones which were located in different parts of the same tumor. In such cases, an aneuploid line could not have been detected in a single specimen from the tumors.
The urinary N-acetyl-beta-D-glucosaminidase (NAG) activities were determined in acute pyelonephritis patients with spinal cord injuries. The urinary NAG activity was significantly elevated in 23 of 31 cases (74%) compared with normal controls. Out of 7 acute pyelonephritis patients without spinal cord injuries, 4 patients (57%) showed significantly elevated urinary NAG activities. The urinary NAG activities were within normal range in 20 patients with acute simple cystitis and 11 patients with chronic complicated cystitis. Out of 6 patients with urethritis, only one case (17%) showed a significantly higher level of urinary NAG activity. Significantly higher levels in urinary NAG activities were observed in 6 of 9 patients (67%) with acute prostatitis and 5 of 9 patients (56%) with acute epididymitis. In patients with spinal cord injuries, having frequent urinary tract infections and complicated pathophysiological conditions, urinary NAG is one of the helpful laboratory findings for the diagnosis of acute pyelonephritis.
To evaluate the significance of preoperative transvascular embolization in the radical nephrectomy, thirty-seven patients with renal cell carcinoma underwent transvascular embolization followed by radical nephrectomy one day after. Thirty-five cases became available for clinicopathological examination with reference to the perioperative blood loss, duration of operation and prognosis, comparing to those of twelve cases with nephrectomy alone.The degree of renal infarct induced by embolization was divided into four groups by the extent of cortical necrosis sparing the subcapsular areas, which was the histologic characteristic about 24 hours after the embolization.Among 35 cases with embolization, 18 cases (51. 4%) were grouped into Grade N, 10 cases (28. 6%) into Grade 111, 3 cases (8. 6%) into Grade II and 4 cases (11. 4%) into Grade I. Thus, it was proved that the renal infarct induced by embolization was various in extent about 24 hours after the embolization. And comparing the grade of renal infarct with the degree of radiological occlusion by viewing the progress of contrast medium, there was no definite mutual relation between them. Also, there was no mutual relation between the kind of embolant and the grade of renal infarct.Although embolization could make less significant decrease in the blood loss and duration of the operation, the blood loss of the Grade N group in embolization was proved to be least.The survival rate after embolization and nephrectomy was better than after nephrectomy alone, in particular, the survival rate of Grade N group was excellent.Our study demonstrated that it was important for getting better perioperative effect and prognosis to occlude the renal arterial flow completely by embolization, resulting in prohibiting the release of tumor cells from the primary site and the metastasis.
A 2-month-old girl with tyrosinase-positive oculocutaneous albinism (OCA) and severe muscle hypotonia is reported. She was admitted to our hospital because of poor sucking and poor weight gain. On physical examination she was found to have generalized muscle weakness and multiple anomalies including deafness, mental retardation, cataracta and a high-arched palate. A muscle biopsy showed marked variation in fiber size with bimodal distribution, suggesting a neuropathic process. Since electromyography showed a myopathic pattern, CK was definitely elevated and muscle histologic examination did not show any denervation of the type found in Werdnig-Hoffmann disease, the present disorder was assumed to be caused either by hardly developed motoneurons or by abnormal interaction between muscles and nerves.
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