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We report a case of metastatic micropapillary variant of the bladder that progressed from low grade non-muscle invasive bladder carcinoma. Lung, para-aortic and pelvic lymph nodes metastatic lesions were found in a 62-year-old woman, who had been followed due to non-muscle invasive bladder carcinoma. The bladder wall was found to be thick by computerized tomography (CT). She had had transurethral resection of bladder tumor (TURBT) at 60 and 61 years old, followed by intravesical therarubicin and bacille Calmette-Guérin therapy, respectively. Both TURBT specimens showed low grade, non-muscle invasive urothelial carcinoma. The thickened bladder wall was resected transurethrally and the pathological examination revealed that the recurrent tumor was entirely composed of micropapillary variant component. There must have been tiny lesions of a micro papillary variant component after the second TURBT. Several reports suggest that intravesical BCG therapy was ineffective for micropapillary variant. So the UC component was substituted for micropapillary component.

A right renal tumor was incidentally found in a 38-year-old woman by annual medical check up. She visited our hospital for further examination and treatment. She did not show typical symptoms of carcinoid. A computed tomography (CT) revealed a calcified solid tumor in the upper portion of the right kidney. The tumor was 6.0 cm in diameter and was not enhanced in either early or late phase. There was no evidence of extrarenal invasion or distant metastasis. Based on a clinical diagnosis of stage 1 renal cell carcinoma, laparoscopic nephrectomy was performed. The pathological diagnosis was renal carcinoid tumor. The tumor had trabecular and ribbon-like structures with a thin fibrovascular stroma. Immunohistochemicaliy, the tumor cells stained positive for chromogranin A, synaptophisin and CD56. The cell proliferation rate was estimated to be under 1% with Ki67 staining. To find the primary lesion, we performed upper and lower gastric endoscopy and chest computed tomography, but could not find any/other carcinoid tumors. At 1-year follow up, she had no evidence of local recurrence or metastasis.

We report a case of pancreatic metastasis from renal cell carcinoma detected 25 years after radical nephrectomy. A 74-year-old man, who had undergone radical nephrectomy for renal cell carcinoma at age 49, was found by computed tomography to have a strongly enhanced mass on the pancreatic head. The patient underwent pancreaticoduodenectomy and the pathological diagnosis was metastatic renal cell carcinoma. This was evidently a slow growing tumor because the metastatic pancreas tumor was well demarcated and the metastasis was found 25 years after the primary operation. Aggressive surgical treatment of isolated metastatic lesions offers a chance of long-term survival. Patients with a history of RCC should undergo a long-term follow-up to detect and evaluate metastasis to pancreas as well as other organs.

Paraganglioma is a rare neuroendocrine tumor which arises from extra adrenal paraganglionic cells of the autonomic nervous system. We report a case of a giant retroperitoneal paraganglioma. A 43-year-old man refered to our hospital for further examination of a retroperitoneal mass. The patient had neither familial nor past medical history. The blood and urine test, laboratory examinations including cathecolamines, were unremarkable. Abdominal computed tomography showed an enhancing solid mass 13 cm in diameter on the left kidney. The invasion to the left kidney was suspected. Angiography showed the left renal, splenic, middle suprarenal and left inferior diaphragmatic artery feeding the tumor. The splenic and left inferior diaphragmatic artery were embolized before surgical treatment. The tumor, left kidney, adrenal gland and spleen were surgically resected. Histological examination revealed extra-adrenal paraganglioma, and there was no invasion of the tumor to the left kidney, adrenal gland and spleen. The patient has now survived more than 10 months following the surgery without tumor recurrence.

The objective of this study was to evaluate the efficacy and safety of low-dose docetaxel, estramustine and dexamethasone combination chemotherapy in patients with hormone-refractory prostate cancer (HRPC). Sixty-nine patients with HRPC were enrolled. Docetaxel was given at a dose of 25 mg/m2 on days 1 and 8 every 3 weeks, oral estramustine 280 mg twice daily on days 1 to 3 and 8 to 10, and oral dexamethasone 1mg daily throughout the course. Cycles were repeated every 21 days. Treatment was continued until disease progression or excessive toxicity. Patients were evaluated for response and toxicity. Patients received a median of eleven cycles (range : 1-25). Prostatic-specific antigen (PSA) was decreased greater than 50% in 53 (77%) out of 69 patients and median duration of PSA response was 10.2 months. Median time to progression and overall survival 10.2 and 24 months, respectively. Grade 1-2 fatigue was the most common toxicity observed in 10 (15%) patients. Grade 3-4 toxicities were observed in five (7%) patients (2 thrombosis, 2 bilirubin elevation, and 1 aspartate transaminase/alanine transaminase elevation). Low-dose docetaxel, estramustine and dexamethasone combination chemotherapy is an effective and well tolerated treatment for Japanese HRPC patients.

A 5-month-old-male was brought to our hospital in April 2004 with left scrotal swelling. His serum alpha-fetoprotein AFP and human chorionic gonadotropin-β levels were 6, 862.9 and ＜ 0.1 ng/ml, respectively. Computed tomography (CT) revealed no metastasis. Left high ligation of testis was performed. Pathological examination demonstrated Yolk sac tumor. He is alive without evidence of recurrence for 53 months postoperatively.

症例1(54歳男性)。健診で左腎腫瘍を指摘され, 画像所見により腎細胞癌が疑われた。初診1ヵ月後に左腎部分切除術を施行したところ, 病理組織学的所見では腫瘍は小型均一な腫瘍細胞が構成する乳頭管状構築からなっており, 免疫組織化学的所見ではCD57, WT-1が陽性であった。以上より, 本症例は後腎性腺腫と診断され, 術後1年経過現在, 再発の徴候はみられていない。症例2(40歳男性)。左側腹部痛を主訴とした。エコー上, 軽度の左水腎が認められ, CTでは左腎盂に造影効果を伴う壁肥厚が確認された。また, 左逆行性腎盂造影では上部尿管の狭窄がみられ, 尿管鏡下腎盂生検で尿路上皮癌G2と診断された。初発症状から2ヵ月後, 左腎尿管全摘除術を施行したところ, 切除腎の実質内に微小結節が偶発的に見い出され, 病理組織学的所見等により小型ながら後腎性腺腫に相当するものと考えられた。目下, 術後より10ヵ月経過で再発の徴候はみられていない。, We report 2 cases of metanephric adenoma a rare form of adenoma. One case occurred in a 54-year-old male preoperatively diagnosed with renal cell carcinoma who underwent left partial nephrectomy for a tumor 2 cm in size. Histology revealed a tumor with papillotubular structures consisting of small, uniform tumor cells. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1. Thus, the patient was diagnosed with metanephric adenoma. The other case occurred in a 40-year-old male who underwent left nephroureterectomy for carcinoma of the renal pelvis. Carcinoma of the left renal pelvis was diagnosed as pT3N0M0. Incidental micronodules 2 mm in size and consisting of immature tubular structures were noted in the renal cortex. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1, and the patient was diagnosed with metanephric adenoma. The aforementioned tumors frequently occur in middle-aged women and are often well-defined tumors that project from the renal surface outwards. On angiography, they have a hypovascular pattern and resemble papillary renal carcinoma. Preoperative differentiation of renal cell carcinoma and nephroblastoma is difficult. Mistaking such tumors for malignant tumors and subjecting patients to unnecessary adjuvant therapy must be avoided.

65歳男性, 71歳男性。患者は腎癌根治的腎摘出術後8年目, 9年目のCTにて左横隔膜下の腫瘍を認めた。いずれも局所再発の可能性も考えられたが, 術中の脾損傷により脾臓摘出術が施行されていたため, 脾臓シンチグラフィーを行った結果, 脾症と確定診断された。, Splenosis is autotransplantation of splenic tissue and usually follow traumatic or surgical rupture of the spleen. We report two cases of splenosis which presented as a local recurrence after radical nephrectomy for left renal cell carcinoma (RCC). The patients were a 65- and a 71-year-old male, who had been operated for RCC including splenectomy because of disrupture of the splenic capsule 8 and 9 years earlier respectively. In both cases, follow up computed tomographic scans showed small nodules under the left diaphragm. Although we initially suspected local recurrence, we considered the possibility of splenosis. Both patients underwent technetium-99m Sn colloid scans and were diagnosed with splenosis successfully. Therefore, we could avoid unnecessary surgical explorations.

18年間に浸潤性膀胱癌で膀胱全摘除術および骨盤内リンパ節郭清術が施行され, 3ヵ月以上経過観察が可能であった膀胱原発移行上皮癌104例を対象に, 生存率と予後規定因子について統計的に解析した.1)N(リンパ節転移を示す病理分類)-症例で, 郭清リンパ節数が多ければ予後の保証が得られ, 不十分なリンパ節郭清では正確な診断も得られず, 治療できるチャンスも少なくなると考えられた.2)単変量解析で有意差が存在した予後因子は, 腫瘍の大きさ, 腫瘍の形態, pT, N, pvであった.これら5因子について多変量解析すると, 腫瘍の形態とN因子が有意であり, N因子に最も予後因子としての重みが存在していた, The objective of this study was to know the effects of pelvic lymph node dissection on the survival of the patients who received radical cystectomy without neoadjuvant chemotherapy or radiotherapy. Between 1984 and 2000, 104 patients underwent operation at our institution for tumors clinically diagnosed as locally invasive bladder cancer (T2-4NxM0). Survival rates and 8 prognostic factors (age, sex, size, multiplicity, type, pT, N, pv) were analyzed by uni- and multivariate analysis. The significant factors were size, type, pT, N, pv by univariate analysis. Of these 5 factors, N factor was the most significant by multivariate analysis. Patients (N-) who had more than 20 lymph nodes retrieved showed better survival than the others.

We report a case of prolapse of a simple ureterocele presenting as perineural tumor. A 60-year-old woman presented with perineum pain and bleeding. A physical examination revealed a hard mass, 30 mm in diameter protruding from the external meatus. The computerized tomography, magnetic resonance imaging and cystography showed an uncharacterized tumor. Endoscopic examination was performed. However, just before resection the mass collapsed spontaneously and turned out to be a prolapse of ureterocele. No transurethral incision was performed. Eleven months postoperatively, the patient has not developed vesicoureteral reflux or urinary tract infection. Physicians should consider prolapse of a simple ureterocele in the differential diagnosis of the female meatal tumor.

A 19-year-old woman was admitted to our hospital with a complaint of residual feeling, frequency and pain on urination. Laboratory analysis revealed an elevated eosinophilia count in peripheral blood and white blood cell count in urine. Lymphocyte stimulation test of Chinese herb named "Seijoh-bohhuh-toh" showed a positive reaction. Bladder symptoms were improved after ceasing this Chinese herb. From these points, we considered that the Chinese herb might have caused eosinophilic cystitis. We report this rare case witha review of the literature.

A case of multiple renal leiomyoma of the right kidney in a 60-year-old woman, complaining of lower abdominal pain of two months duration, is presented. Ultrasonography, intravenous pyelography and CT scan showed the masses at the right renal sinus and hilus. Selective right renal angiography demonstrated very hypovascular tumors. Right radical nephrectomy was performed. There were two lobulated tumors with no connections, which were elastic hard in consistency and smooth in surface; one was 4 x 2 x 2 cm in size and located at the renal sinus between the upper and middle calyces, the other was 6.5 x 5 x 4 cm in size and located at the renal hilus, apart from the renal parenchyma, pelvis, artery and vein. Histological examination revealed these tumors to be benign leiomyoma. Both were covered with the Gerota's fascia, but not the renal capsule. The renal parenchyma was completely covered with the renal capsule histologically, although these tumors were closely attached to the parenchyma on gross examination. The tumor at renal sinus was considered to arise from the outer layer of the renal pelvis or from the blood vessel in the connective tissues at renal sinus. The tumor at renal hilus was considered to arise from the blood vessel in the connective tissues at renal hilus. This appears to be the first reported case as multiple renal leiomyoma in both Japanese and English literatures.

Inverted growth of transitional cell carcinoma in the ureter is reported. A 71-year-old female visited us for right flank pain and gross hematuria. Hematuria from the right ureteral orifice was found by cystoscopy. Intravenous pyelography revealed right hydronephrosis and a filling defect in the right ureter, but the filling defect moved to the lower ureter. Computerized tomographic (CT) scan demonstrated a tiny lesion in the right ureter. Under a tentative diagnosis of right ureteral tumor, flexible fiberoptic ureteroscopy was performed. As a pedunculated tumor with a smooth surface was found, biopsy was performed. Since pathological examination showed malignancy, right nephroureterectomy was performed. Histological diagnosis was transitional cell carcinoma, grade 1. Cancer was covered by normal transitional epithelium, and developed inverted growth. This is a rare case of inverted growth of the transitional cell carcinoma in the ureter.

A case of bladder cancer associated with a growth hormone (GH) producing pituitary tumor is reported. A 67-year-old male underwent hypophysectomy for a GH producing pituitary tumor, 31 months earlier. Although the serum GH decreased postoperatively, recurrence of pituitary tumor with increased serum GH was found and followed by a neurosurgeon. He was referred to our department for asymptomatic gross hematuria. Cystoscopy revealed a papillary pedunculated tumor. Under the diagnosis of superficial bladder tumor, transurethral resection (TUR) was performed. Pathological examination showed transitional cell carcinoma. As the bladder cancer recurred with a high level of serum GH seven months later, TUR was repeated. We reviewed and discussed the relationship between GH or GH producing tumor and bladder cancer.

We report a case of metastatic micropapillary variant of the bladder that progressed from low grade non-muscle invasive bladder carcinoma. Lung, para-aortic and pelvic lymph nodes metastatic lesions were found in a 62-year-old woman, who had been followed due to non-muscle invasive bladder carcinoma. The bladder wall was found to be thick by computerized tomography (CT). She had had transurethral resection of bladder tumor (TURBT) at 60 and 61 years old, followed by intravesical therarubicin and bacille Calmette-Guérin therapy, respectively. Both TURBT specimens showed low grade, non-muscle invasive urothelial carcinoma. The thickened bladder wall was resected transurethrally and the pathological examination revealed that the recurrent tumor was entirely composed of micropapillary variant component. There must have been tiny lesions of a micro papillary variant component after the second TURBT. Several reports suggest that intravesical BCG therapy was ineffective for micropapillary variant. So the UC component was substituted for micropapillary component.

A right renal tumor was incidentally found in a 38-year-old woman by annual medical check up. She visited our hospital for further examination and treatment. She did not show typical symptoms of carcinoid. A computed tomography (CT) revealed a calcified solid tumor in the upper portion of the right kidney. The tumor was 6.0 cm in diameter and was not enhanced in either early or late phase. There was no evidence of extrarenal invasion or distant metastasis. Based on a clinical diagnosis of stage 1 renal cell carcinoma, laparoscopic nephrectomy was performed. The pathological diagnosis was renal carcinoid tumor. The tumor had trabecular and ribbon-like structures with a thin fibrovascular stroma. Immunohistochemicaliy, the tumor cells stained positive for chromogranin A, synaptophisin and CD56. The cell proliferation rate was estimated to be under 1% with Ki67 staining. To find the primary lesion, we performed upper and lower gastric endoscopy and chest computed tomography, but could not find any/other carcinoid tumors. At 1-year follow up, she had no evidence of local recurrence or metastasis.

We report a case of pancreatic metastasis from renal cell carcinoma detected 25 years after radical nephrectomy. A 74-year-old man, who had undergone radical nephrectomy for renal cell carcinoma at age 49, was found by computed tomography to have a strongly enhanced mass on the pancreatic head. The patient underwent pancreaticoduodenectomy and the pathological diagnosis was metastatic renal cell carcinoma. This was evidently a slow growing tumor because the metastatic pancreas tumor was well demarcated and the metastasis was found 25 years after the primary operation. Aggressive surgical treatment of isolated metastatic lesions offers a chance of long-term survival. Patients with a history of RCC should undergo a long-term follow-up to detect and evaluate metastasis to pancreas as well as other organs.

Paraganglioma is a rare neuroendocrine tumor which arises from extra adrenal paraganglionic cells of the autonomic nervous system. We report a case of a giant retroperitoneal paraganglioma. A 43-year-old man refered to our hospital for further examination of a retroperitoneal mass. The patient had neither familial nor past medical history. The blood and urine test, laboratory examinations including cathecolamines, were unremarkable. Abdominal computed tomography showed an enhancing solid mass 13 cm in diameter on the left kidney. The invasion to the left kidney was suspected. Angiography showed the left renal, splenic, middle suprarenal and left inferior diaphragmatic artery feeding the tumor. The splenic and left inferior diaphragmatic artery were embolized before surgical treatment. The tumor, left kidney, adrenal gland and spleen were surgically resected. Histological examination revealed extra-adrenal paraganglioma, and there was no invasion of the tumor to the left kidney, adrenal gland and spleen. The patient has now survived more than 10 months following the surgery without tumor recurrence.

We report a case of prolapse of a simple ureterocele presenting as perineural tumor. A 60-year-old woman presented with perineum pain and bleeding. A physical examination revealed a hard mass, 30 mm in diameter protruding from the external meatus. The computerized tomography, magnetic resonance imaging and cystography showed an uncharacterized tumor. Endoscopic examination was performed. However, just before resection the mass collapsed spontaneously and turned out to be a prolapse of ureterocele. No transurethral incision was performed. Eleven months postoperatively, the patient has not developed vesicoureteral reflux or urinary tract infection. Physicians should consider prolapse of a simple ureterocele in the differential diagnosis of the female meatal tumor.

We report a case of verrucous carcinoma of the penis. A 62-year-old man, who presented with penile swelling and pain, was referred to our hospital. Although, penile tumor biopsy revealed no evidence of malignancy, the patient presented with penile swelling and discharge. The penis was surgically resected and urinary diversion was performed. The pathological examination of the resected glans revealed verrucous carcinoma of penis. Furthermore, in situ hybridization revealed human papilloma virus (HPV) infection. This clearly showed that the verrucous carcinoma of the penis resulted from the HPV infection. The patient has survived for 14 months after surgery without local recurrence or metastasis.

The objective of this study was to evaluate the efficacy and safety of low-dose docetaxel, estramustine and dexamethasone combination chemotherapy in patients with hormone-refractory prostate cancer (HRPC). Sixty-nine patients with HRPC were enrolled. Docetaxel was given at a dose of 25 mg/m2 on days 1 and 8 every 3 weeks, oral estramustine 280 mg twice daily on days 1 to 3 and 8 to 10, and oral dexamethasone 1mg daily throughout the course. Cycles were repeated every 21 days. Treatment was continued until disease progression or excessive toxicity. Patients were evaluated for response and toxicity. Patients received a median of eleven cycles (range : 1-25). Prostatic-specific antigen (PSA) was decreased greater than 50% in 53 (77%) out of 69 patients and median duration of PSA response was 10.2 months. Median time to progression and overall survival 10.2 and 24 months, respectively. Grade 1-2 fatigue was the most common toxicity observed in 10 (15%) patients. Grade 3-4 toxicities were observed in five (7%) patients (2 thrombosis, 2 bilirubin elevation, and 1 aspartate transaminase/alanine transaminase elevation). Low-dose docetaxel, estramustine and dexamethasone combination chemotherapy is an effective and well tolerated treatment for Japanese HRPC patients.

A 19-year-old woman was admitted to our hospital with a complaint of residual feeling, frequency and pain on urination. Laboratory analysis revealed an elevated eosinophilia count in peripheral blood and white blood cell count in urine. Lymphocyte stimulation test of Chinese herb named "Seijoh-bohhuh-toh" showed a positive reaction. Bladder symptoms were improved after ceasing this Chinese herb. From these points, we considered that the Chinese herb might have caused eosinophilic cystitis. We report this rare case witha review of the literature.

We report 2 cases of metanephric adenoma a rare form of adenoma. One case occurred in a 54-year-old male preoperatively diagnosed with renal cell carcinoma who underwent left partial nephrectomy for a tumor 2 cm in size. Histology revealed a tumor with papillotubular structures consisting of small, uniform tumor cells. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1. Thus, the patient was diagnosed with metanephric adenoma. The other case occurred in a 40-year-old male who underwent left nephroureterectomy for carcinoma of the renal pelvis. Carcinoma of the left renal pelvis was diagnosed as pT3N0M0. Incidental micronodules 2 mm in size and consisting of immature tubular structures were noted in the renal cortex. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1, and the patient was diagnosed with metanephric adenoma. The aforementioned tumors frequently occur in middle-aged women and are often well-defined tumors that project from the renal surface outwards. On angiography, they have a hypovascular pattern and resemble papillary renal carcinoma. Preoperative differentiation of renal cell carcinoma and nephroblastoma is difficult. Mistaking such tumors for malignant tumors and subjecting patients to unnecessary adjuvant therapy must be avoided.

Splenosis is autotransplantation of splenic tissue and usually follow traumatic or surgical rupture of the spleen. We report two cases of splenosis which presented as a local recurrence after radical nephrectomy for left renal cell carcinoma (RCC). The patients were a 65- and a 71-year-old male, who had been operated for RCC including splenectomy because of disrupture of the splenic capsule 8 and 9 years earlier respectively. In both cases, follow up computed tomographic scans showed small nodules under the left diaphragm. Although we initially suspected local recurrence, we considered the possibility of splenosis. Both patients underwent technetium-99m Sn colloid scans and were diagnosed with splenosis successfully. Therefore, we could avoid unnecessary surgical explorations.

The objective of this study was to know the effects of pelvic lymph node dissection on the survival of the patients who received radical cystectomy without neoadjuvant chemotherapy or radiotherapy. Between 1984 and 2000, 104 patients underwent operation at our institution for tumors clinically diagnosed as locally invasive bladder cancer (T2-4NxM0). Survival rates and 8 prognostic factors (age, sex, size, multiplicity, type, pT, N, pv) were analyzed by uni- and multivariate analysis. The significant factors were size, type, pT, N, pv by univariate analysis. Of these 5 factors, N factor was the most significant by multivariate analysis. Patients (N-) who had more than 20 lymph nodes retrieved showed better survival than the others.

Inverted growth of transitional cell carcinoma in the ureter is reported. A 71-year-old female visited us for right flank pain and gross hematuria. Hematuria from the right ureteral orifice was found by cystoscopy. Intravenous pyelography revealed right hydronephrosis and a filling defect in the right ureter, but the filling defect moved to the lower ureter. Computerized tomographic (CT) scan demonstrated a tiny lesion in the right ureter. Under a tentative diagnosis of right ureteral tumor, flexible fiberoptic ureteroscopy was performed. As a pedunculated tumor with a smooth surface was found, biopsy was performed. Since pathological examination showed malignancy, right nephroureterectomy was performed. Histological diagnosis was transitional cell carcinoma, grade 1. Cancer was covered by normal transitional epithelium, and developed inverted growth. This is a rare case of inverted growth of the transitional cell carcinoma in the ureter.

A case of bladder cancer associated with a growth hormone (GH) producing pituitary tumor is reported. A 67-year-old male underwent hypophysectomy for a GH producing pituitary tumor, 31 months earlier. Although the serum GH decreased postoperatively, recurrence of pituitary tumor with increased serum GH was found and followed by a neurosurgeon. He was referred to our department for asymptomatic gross hematuria. Cystoscopy revealed a papillary pedunculated tumor. Under the diagnosis of superficial bladder tumor, transurethral resection (TUR) was performed. Pathological examination showed transitional cell carcinoma. As the bladder cancer recurred with a high level of serum GH seven months later, TUR was repeated. We reviewed and discussed the relationship between GH or GH producing tumor and bladder cancer.

A case of multiple renal leiomyoma of the right kidney in a 60-year-old woman, complaining of lower abdominal pain of two months duration, is presented. Ultrasonography, intravenous pyelography and CT scan showed the masses at the right renal sinus and hilus. Selective right renal angiography demonstrated very hypovascular tumors. Right radical nephrectomy was performed. There were two lobulated tumors with no connections, which were elastic hard in consistency and smooth in surface; one was 4 x 2 x 2 cm in size and located at the renal sinus between the upper and middle calyces, the other was 6.5 x 5 x 4 cm in size and located at the renal hilus, apart from the renal parenchyma, pelvis, artery and vein. Histological examination revealed these tumors to be benign leiomyoma. Both were covered with the Gerota's fascia, but not the renal capsule. The renal parenchyma was completely covered with the renal capsule histologically, although these tumors were closely attached to the parenchyma on gross examination. The tumor at renal sinus was considered to arise from the outer layer of the renal pelvis or from the blood vessel in the connective tissues at renal sinus. The tumor at renal hilus was considered to arise from the blood vessel in the connective tissues at renal hilus. This appears to be the first reported case as multiple renal leiomyoma in both Japanese and English literatures.

Dibekacin (DKB) was administered to patients with complicated urinary tract infections without any indwelling catheter to evaluate objectively and comparatively the efficacy, safety and usefulness of intravenous drip infusion once daily and twice daily in a well-controlled study. A 50 mg dose of DKB was administered twice a day to group A, and a 100 mg dose was given once a day to group B. In both groups the drug was given by 1-hr i.v. infusion for 5 consecutive days. Drug efficacy was evaluated in 72 (group A: 36, group B: 36) of the 83 patients treated, and the safety was evaluated on 81 patients (group A: 41, group B: 40). There were no significant differences in the background characteristics between the two groups. The overall clinical efficacy judged by the Committee for Evaluation of Clinical Efficacy was "excellent" in 14% and "moderate" in 50% of group A, and "excellent" in 17% and "moderate" in 64% of group B, the efficacy being higher for group B than group A, but the difference was not statistically significant. The overall drug efficacy rate for each type of infection excluding group 2, was slightly higher in group B, but this difference was not significant either. The overall clinical efficacy for each site of infection, was higher for group B but the differences were not significant. The overall clinical efficacy as judged by the attending physicians was "excellent" in 17% and "moderate" in 58% of group A, and "excellent" in 25% and "moderate" in 61% of group B. The intergroup difference was thus smaller than that judged by the Committee. The elimination rates against bacteriuria were 58% for both groups A and B, and the decrease rates including "cleared" were 42% against pyuria for both groups A and B. Bacteriological evaluation, showed that there was no significant difference in the eradication rates, between group A (65%) and group B (70%). But the eradication rate for gram-positive bacteria was 40% in group A and 81% in group B, there being a significant difference (P less than 0.05) between them. The evaluation of usefulness gave 44% and 53% "satisfactory" rates, respectively, for groups A and B. The results for the "average score" were also the same in both groups. There were no side effects in any of the 81 patients examined. Abnormal laboratory test values attributed to the drug were seen only in 3 and 2 patients in groups A and B, respectively, there being no difference between the groups.(ABSTRACT TRUNCATED AT 400 WORDS)

1981年1月1日から5年間に当院を訪れた前立腺癌の新来患者74例の集計を行った.1)初診時年齢の平均は72.2±7.7歳であり, 65歳から85歳までが87.9%を占めた.2)主訴は, 排尿困難(75.7%), 頻尿(52.7%)が多かった.3)進行癌(病期C, D)が70%を占めた.4)初回治療法としては, 内分泌療法が88.9%(64/72例)であり, エストロゲン療法とLH-RHアナログ単独療法の割合は1.7:1であった.5)初回内分泌療法施行例の21.9%(14/64例)は再燃・増悪で治療を中断した.6)病理組織学的には, 低分化型が約半数をしめた.7) 5年間の経過観察中, 確認できた死亡例は22例(29.7%)であった.うち前立腺癌死は全体の12.1%(9/74例)であった, Seventy-four new cases of prostatic carcinoma treated between 1981 and 1985 were analyzed. The patients were between 40 and 86 years old with a mean age of 72.2 +/- 7.7 years. More than 70% of the patients had clinical stage C and D carcinoma. All cases proved histologically to be adenocarcinoma of the prostate. Eighteen patients had well differentiated, 21 moderately differentiated and 35 poorly differentiated adenocarcinoma. Various hormonal treatments were performed as the initial treatment in 88.9% (64/72) of the cases. Among them, 37 cases were treated by estrogen and 22 cases by luteinizing hormone releasing hormone analogues. Fourteen of 64 patients (21.9%) who received hormonal treatment discontinued the therapy within 10.1 +/- 9.1 months because of relapse of the disease or no therapeutic response. Salvage therapy following hormonal treatment were chemotherapy (9/14) and radiation therapy (4/14). During the 5-year follow up 12.1% (9/74) of the patients died due to prostatic carcinoma.