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Objectives and methods of the study: Although superficial bladder carcinoma can be surgically eliminated by TUR, recurrence is common. Various attempts have been made to prevent recurrence, but to date an excellent prophylactic method with few adverse reactions has not been established. We conducted a clinical trial study for prophylaxis of bladder carcinoma recurrence, using intravesical instillation of bleomycin, a drug which cause little local irritation, in combination with bestatin, a recently developed immunomodulator. Bleomycin was selected on the bases of experimental results. That is, in beagle dogs, the 1-hour intravesical instillation of bleomycin gained a drug concentration in the bladder wall of 2.08 micrograms/g, which is approximately 4 times higher than that in the intravenous administration of the same dose. The above bleomycin concentration was thought enough to obtain a good clinical effect. A total of 124 patients were randomly divided into the two treatment groups: An only bleomycin intravesical instillation group (60 mg on each treatment day) (58 patients) and a bleomycin with bestatin (60 mg per every day) group (66 patients). In the 2-year follow-up period the recurrence of bladder carcinoma in the two treatment groups was studied. Analysis of non-recurrence rate by life-table method and Kaplan-Meier method: The non-recurrence rate of the bladder carcinoma every three months was calculated by the life-table and Kaplan-Meier methods. The non-recurrence rate in the bleomycin group was approximately the same as the rates in adriamycin or mitomycin reported in the literature. In the bleomycin + bestatin group, the recurrence rates at 9 months and 12 months were significantly (at P = 0.09 and P = 0.08, respectively) lower, and in addition, even the 2-year overall non-recurrence rate curves showed a nearly significant difference (P = 0.179). Especially in the case of papillary pedunculated tumors, the difference in the non-recurrence rate curves was almost statistically significant (P = 0.104). The stratified analysis on the basis of various tumor factors, were as follows. Pathological grade: Although no differences were found in Grades 1 and 2, the bleomycin + bestatin group had a lower recurrence rate in Grade 3 cases (P = 0.1).(ABSTRACT TRUNCATED AT 400 WORDS)

前立腺症(前立腺肥大症および膀胱頸部硬化症)に対するantiandrogen剤oxendoloneとα遮断剤bunazosin hydrochlorideの併用効果を検討するために, それぞれ単独および両剤併用の3群について比較検討した.自覚症状に対する効果, 他覚所見に対する効果およびこれらを総合した総合所見に対する評価ともに併用使用群が最も良好であった, Antiandrogen and alpha-adrenergic blockers have recently been tried in the medical treatment for benign prostatic hypertrophy and bladder neck contracture. We herein report our results of a randomized comparative study on the clinical efficacy of oxendolone, bunazosin hydrochloride (bunazosin) and their combination for the treatment of benign prostatic hypertrophy and bladder neck contracture. The attending doctors evaluated at twelve weeks the improvement rate for three treatment regimens, 400 mg/day oxendolone, 3 mg/day bunazosin and a combination of both. Oxendolone + bunazosin showed the highest improvement rate in the evaluation of each subjective symptom and objective finding and of both. Oxendolone + bunazosin tended to show a better clinical efficacy than the other of these regimens, when the improvement was defined as that with more than one degree in the severity of retarded voiding, prolonged voiding, urinary stream condition, abdominal pressure on voiding and residual urine sensation. The improvement of such subjective symptoms seemed to occur earlier with oxendolone + bunazosin or bunazosin than with oxendolone. A significant difference was shown among the three treatment regimens in the general improvement rate on four subjective symptoms, with oxendolone + bunazosin being the highest followed by bunazosin and oxendolone in this order. The improvement rates of maximum and mean flow rate which are most important parameters to evaluate the voiding condition, at twelve weeks were significantly higher with oxendolone + bunazosin. No serious side effects were observed in this study, although treatment regimens containing bunazosin caused some minor side effects. These side effects could be prevented by the use of initial low doses of bunazosin with a subsequent gradual increment up to 3 mg/day. Taking the differences in the mechanism of oxendolone and bunazosin and the results of our study into consideration, we believe that the combination of oxendolone and bunazosin would be more useful in a clinical situation.

This study consisted of clinical evaluation of estramustine phosphate for the patients of prostatic carcinoma with or without the previous treatment. The results were as follows. 1. In seven patients without previous treatment, five showed the objective effect, one the subjective, and one no response when evaluated on three months after treatment. The objective effect in these five patients continued from six to nineteen months. One patient in these, however, escaped from the treatment on the seventeenth month. One patient with subjective and one with no effect died of prostatic carcinoma within twelve months after treatment. 2. In six patients who had been resistant to or had relapsed from the previous treatment, there were four who showed the objective effect, when evaluated on three months after treatment. The objective effect in three patients lasted from twelve to twenty six months. Two patients with no effect evaluated on three months after treatment, died of prostatic carcinoma within six months after start of this study. 3. Side effects were evaluated in seventeen patients. All had the gastrointestinal disturbances. Two patients could not continue to have the treatment because of their severities. We also noticed the anemia as the side effect of bone marrow suppression to be intensified in patients with the marked bon emetastases. This was believed to have resulted from the alkylating action of estramustine phosphate. We had no side effects on breasts because of irradiation to them. 4. We concluded from this clinical study, first, oral estramustine phosphate showed good clinical effect in patients of prostatic carcinoma without previous treatment. Second, this drug was less effective for the patients with the previous treatment than for those without the previous one. Thirty or forty percent in these patients were supposed to have clinically objective effect. Because of the limited effect of other form of treatment we believed estramustine phosphate to be the first choice of treatment for carcinoma of the prostate, considering its minimal side effect.

Bacturcult, diagnostic culture tube, was tested for a clinical evaluation of urinary tract infections. 89 urine specimens obtained from 23 mid-voided urine by males and 66 samples from transurethral catheterisation in 39 females with urinary tract infections diagnosed on clinical symptoms and its clinical course and over 10 white blood cells per high power fields of urinary sediment, were poured into Bacturcult tube and incubated for 24 hours at 37℃. Bacterial counts were compared with other techniques. The results were as follows: 1. Of 38 urine samples showing the existence of more than 100, 000 organism per ml by pour plate technique, 37 were significant bacteriuria by Bacturcult. 2. Of 48 urine specimens which were positive in TTC test, 41 were significant bacteriuria by Bacturcult. 3. Presumptive identification of causative organism by color change of Bacturcult was good in lactose fermenters such as E. coli.

This study consisted of clinical evaluation of estramustine phosphate for the patients of prostatic carcinoma with or without the previous treatment. The results were as follows. 1. In seven patients without previous treatment, five showed the objective effect, one the subjective, and one no response when evaluated on three months after treatment. The objective effect in these five patients continued from six to nineteen months. One patient in these, however, escaped from the treatment on the seventeenth month. One patient with subjective and one with no effect died of prostatic carcinoma within twelve months after treatment. 2. In six patients who had been resistant to or had relapsed from the previous treatment, there were four who showed the objective effect, when evaluated on three months after treatment. The objective effect in three patients lasted from twelve to twenty six months. Two patients with no effect evaluated on three months after treatment, died of prostatic carcinoma within six months after start of this study. 3. Side effects were evaluated in seventeen patients. All had the gastrointestinal disturbances. Two patients could not continue to have the treatment because of their severities. We also noticed the anemia as the side effect of bone marrow suppression to be intensified in patients with the marked bon emetastases. This was believed to have resulted from the alkylating action of estramustine phosphate. We had no side effects on breasts because of irradiation to them. 4. We concluded from this clinical study, first, oral estramustine phosphate showed good clinical effect in patients of prostatic carcinoma without previous treatment. Second, this drug was less effective for the patients with the previous treatment than for those without the previous one. Thirty or forty percent in these patients were supposed to have clinically objective effect. Because of the limited effect of other form of treatment we believed estramustine phosphate to be th

Congenital unilateral multicystic kidney is a relatively rare disease. We have had 6 cases of congenital unilateral multicystic kidney from 1969 to 1975, and herein reported. These cases were 7 months old female infant, 18 years old woman, 59 years old man, 28 years old man, 12 years old man and 42 years old woman. Two cases (case No.5 and No.6) were diagnosed as congenital unilateral multicystic kidney before the surgical treatment. Nephrectomy was performed in all cases, and the extirpated kidneys were pathologically revealed as congenital unilateral multicystic kidney. Fifty-two cases of congenital unilateral multicystic kidney including our 6 cases have been reported in Japanese literature from 1961 to 1975, and are reviewed in this paper.

Bacturcult, diagnostic culture tube, was tested for a clinical evaluation of urinary tract infections. 89 urine specimens obtained from 23 mid-voided urine by males and 66 samples from transurethral catheterisation in 39 females with urinary tract infections diagnosed on clinical symptoms and its clinical course and over 10 white blood cells per high power fields of urinary sediment, were poured into Bacturcult tube and incubated for 24 hours at 37℃. Bacterial counts were compared with other techniques. The results were as follows: 1. Of 38 urine samples showing the existence of more than 100, 000 organism per ml by pour plate technique, 37 were significant bacteriuria by Bacturcult. 2. Of 48 urine specimens which were positive in TTC test, 41 were significant bacteriuria by Bacturcult. 3. Presumptive identification of causative organism by color change of Bacturcult was good in lactose fermenters such as E. coli.

Antiandrogen and alpha-adrenergic blockers have recently been tried in the medical treatment for benign prostatic hypertrophy and bladder neck contracture. We herein report our results of a randomized comparative study on the clinical efficacy of oxendolone, bunazosin hydrochloride (bunazosin) and their combination for the treatment of benign prostatic hypertrophy and bladder neck contracture. The attending doctors evaluated at twelve weeks the improvement rate for three treatment regimens, 400 mg/day oxendolone, 3 mg/day bunazosin and a combination of both. Oxendolone + bunazosin showed the highest improvement rate in the evaluation of each subjective symptom and objective finding and of both. Oxendolone + bunazosin tended to show a better clinical efficacy than the other of these regimens, when the improvement was defined as that with more than one degree in the severity of retarded voiding, prolonged voiding, urinary stream condition, abdominal pressure on voiding and residual urine sensation. The improvement of such subjective symptoms seemed to occur earlier with oxendolone + bunazosin or bunazosin than with oxendolone. A significant difference was shown among the three treatment regimens in the general improvement rate on four subjective symptoms, with oxendolone + bunazosin being the highest followed by bunazosin and oxendolone in this order. The improvement rates of maximum and mean flow rate which are most important parameters to evaluate the voiding condition, at twelve weeks were significantly higher with oxendolone + bunazosin. No serious side effects were observed in this study, although treatment regimens containing bunazosin caused some minor side effects. These side effects could be prevented by the use of initial low doses of bunazosin with a subsequent gradual increment up to 3 mg/day. Taking the differences in the mechanism of oxendolone and bunazosin and the results of our study into consideration, we believe that the combination of oxendolone an

Objectives and methods of the study: Although superficial bladder carcinoma can be surgically eliminated by TUR, recurrence is common. Various attempts have been made to prevent recurrence, but to date an excellent prophylactic method with few adverse reactions has not been established. We conducted a clinical trial study for prophylaxis of bladder carcinoma recurrence, using intravesical instillation of bleomycin, a drug which cause little local irritation, in combination with bestatin, a recently developed immunomodulator. Bleomycin was selected on the bases of experimental results. That is, in beagle dogs, the 1-hour intravesical instillation of bleomycin gained a drug concentration in the bladder wall of 2.08 micrograms/g, which is approximately 4 times higher than that in the intravenous administration of the same dose. The above bleomycin concentration was thought enough to obtain a good clinical effect. A total of 124 patients were randomly divided into the two treatment groups: An only bleomycin intravesical instillation group (60 mg on each treatment day) (58 patients) and a bleomycin with bestatin (60 mg per every day) group (66 patients). In the 2-year follow-up period the recurrence of bladder carcinoma in the two treatment groups was studied. Analysis of non-recurrence rate by life-table method and Kaplan-Meier method: The non-recurrence rate of the bladder carcinoma every three months was calculated by the life-table and Kaplan-Meier methods. The non-recurrence rate in the bleomycin group was approximately the same as the rates in adriamycin or mitomycin reported in the literature. In the bleomycin + bestatin group, the recurrence rates at 9 months and 12 months were significantly (at P = 0.09 and P = 0.08, respectively) lower, and in addition, even the 2-year overall non-recurrence rate curves showed a nearly significant difference (P = 0.179). Especially in the case of papillary pedunculated tumors, the difference in the non-recurrence rate curves wa