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A 54-year-old woman presented with repeated episodes of urinary retention during an approximately 7-month period of dysuria. Computerized tomography scan revealed a right ovarian cyst and a small uterine myoma. At operation, the ovarian cyst was deeply incarcerated into the pouch of Douglas displacing the bladder neck and the uterine cervix in the anterocephalad direction. Histological diagnosis of the resected cyst was benign mucinous cystadenoma. This is the 5th reported case of urinary retention caused by ovarian cyst in the Japanese literature.

A 64-year-old man was admitted to our hospital with the chief complaint of macrohematuria in March, 1980. Cystoscopic examination revealed two vesical tumors on the right lateral wall and apex. TUR-Bt was performed and the histological diagnosis was grade 2 transitional cell carcinoma. Recurrence was discovered in September, 1980. TUR-Bt was performed again, and the diagnosis was, histologically, grade 3 transitional cell carcinoma. The 2nd recurrence was discovered in September, 1981. Preoperative examination with cystoscopy, CT scan, angiography, revealed an ulcerative, non-papillary, invasive tumor in the right part of the bladder. Telecobalt radiation and pepleomycin injection were given as preoperative therapy. Total cystectomy and urinary diversion with ureterocutaneostomy were done on October, 1981. At that time, it was found that the tumor had infiltrated through the bladder wall. Histological examination of the extirpated bladder showed massive infiltration of atypical and pleomorphic cells and giant cells in the entire bladder wall with heterotopic ossification, and osteoid metaplasia of connective tissue and transformation of fibroblasts to osteoblast-like cells, but no cartilage or bone marrow. Precise histological diagnosis was primary vesical undifferentiated carcinoma (UC, UIT, INFγ, pT3b, lyO, v(-)). Moderately differentiated adenocarcinoma of the prostate was also recognized. This case suggests that carcinoma cells can induce osteoid metaplasia of the connective tissue, and that carcinoma cells become osteogenetic.

前立腺術後の感染防止に各種の抗生剤を使用後, PMPCを尿感染を指標に投与し感染治療効果と感染防止効果を検討した.術後の感染防止に使用した抗生剤と術後に検出した菌につき関連を検討した.1)前立腺摘除術後の67例でのPMPCの感染治療効果は53.7%であった.2)前立腺摘除術後化学療法で菌を検出しなかった34例でPMPCの感染防止効果は64.7%であった.3)前立腺摘除術(TUR-Pと被膜下摘出術)の術式によるPMPCの治療効果にほとんど差はなかった.4)術後の感染防止としCEPRあるいは単独または併用投与が主流をなしているためか, Serratia, Pseudomonasの検出頻度が高く, 感染防止に用いる抗生剤の組合わせにひとつの示唆を与えた.5)術前カテーテル非留置例でPMPCはすぐれた治療と感染防止効果を示した, Patients received pivmecillinam (PMPC) after prophylactic use of various antimicrobial chemotherapeutic agents following prostatectomy, and their clinical responses were assessed for effectiveness in the treatment and prevention of postoperative infection. The data were also analyzed to explore the relationship between bacterial isolates obtained during the postoperative course and the antimicrobial agents administered prophylactically against postoperative infection. Therapeutic effect of PMPC: Treatment of postoperative infections with PMPC was effective in 36 (53.7%) out of 67 patients who had undergone prostatectomy. Prophylactic effect of PMPC: The use of PMPC provided effective prevention of infection in 22 (64.7%) out of 34 patients from whom no bacterial pathogen had been isolated before postoperative antimicrobial chemotherapy. Therapeutic responses to PMPC, compared between different types of operative procedure: There was little or no difference in therapeutic effectiveness of PMPC against postoperative infection when compared between two types of operative procedure, transurethral prostatectomy and subcapsular removal of the prostate. Incidence and types of bacterial isolates following prophylactic chemotherapy with various agents after prostatectomy: Possibly because cephapirin (CEPR) and ticarcillin (TIPC) were mainly administered, alone or in combination, for prophylaxis against postoperative infection, Serratia and Pseudomonas were most frequently isolated. The findings offer suggestions as to the appropriate combination of antimicrobial agents to be used for prophylactic purposes. Effectiveness of PMPC in the presence or absence of a preoperative indwelling urethral catheter: The use of PMPC was more effective both in the treatment and prevention of postoperative infection in cases without preoperative indwelling urethral catheterization than in those with it.

Between August 1977 and April 1979, four cases of renal transplantation were performed at the Department of Urology, Nagasaki University. Two hundred mg of ALS (AHLBULIN) was administered for 35 days from the 5th day before transplantation in addition to Imuran and methylprednisolone. The skin test was performed every time just before using AHLBULIN and the titer of precipitin reaction was determined in the period of using the agent. One patient had positive skin reaction and pecipitin titer rose to 16 times for 8 days from the 7th to the 15th day after transplantation. No one had a side effect owing to administration of AHLBULIN. One of them had one acute rejection episode after 6 days from transplantation and was treated with the pulse therapy of methylprednisolone.

Twenty-six cases of penile carcinoma encountered during the sixteen year period of 1964 through 1979 were studied. The age range of these cases was 38 to 80 (mean 61.6) years. Twenty-five cases had phimosis. Twenty-six cases were classified by the Jackson staging. There were 12 stage I, 7 stage II, 7 stage III and no stage IV cases. Chemotherapy with Bleomycin and radiotherapy was performed to stage I cases. Since Bleomycin has been used, penectomy was not performed to stage I cases. The crude 5-year survival rate was 85.7% in stage I cases, 80% in stage II cases, 33.3% in stage III cases. The total crude 5-year survival rate was 73.3%. The crude 5-year survival rate was 87.5% in the cases to which Bleomycin was administered and 57.1% in the cases not administered.

複雑性尿路感染症106例にcefmenoximeを投与した.1)総合臨床効果は82例中61例(74.4%)が著効ないし有効であり, 膿尿に対する効果は53.2%, 細菌尿に対する効果は58.5%であった.2)起炎菌95株の菌消失率は76.8%で, 検出頻度の高かったSerratia 29株, Pseudomonas 13株の消失率はそれぞれ72.4%, 53.8%であった.3)副作用は106例中3例に認めたが, いずれも一過性で, 重篤ではなかった, Cefmenoxime (CMX) was intravenously administered to 106 patients with complicated urinary tract infection at a daily dose of 2-4 g for 5 days. An excellent response in overall clinical efficacy was seen in 15 cases (18.3%), a moderate response in 46 cases (56.1%) and poor response in 21 cases (25.6%). Pyuria was cleared in 20 cases (24.4%), decreased in 22 cases (26.8%) and unchanged in 40 cases (48.8%). Bacteriuria was eliminated in 41 cases (50.0%), decreased in 17 cases (20.7%), relapsed in 7 cases (8.5%) and unchanged in 17 cases (20.7%). Bacteriologically, 74 (76.8%) of the 95 strains isolated were eradicated by CMX, and 22 (23.2%) persisted. Side effects were observed in 3 (abdominal pain, diarrhea and elevation of trans amylase) of the 106 cases. Judging from the above results, CMX is considered to be a useful drug in the treatment of complicated urinary tract infections.

Cefoxitin (CFX) was intravenously administered to 106 patients with complicated urinary tract infection at a daily dose of 2-4 g for 5 days. The results were summarized as follows; 1. As to the overall clinical efficacy, excellent, response was seen in 25%, moderate in 32% and poor in 43%. 2. Pyuria was cleared in 33, decreased in 14, and unchanged in 53 cases. 3. Bacteriuria was eliminated in 51, decreased in 2, replaced in 18, and unchanged in 29 cases. 4. As to the bacteriological response to CFX, 94 (71 %) were eradicated, and 39 (29%) persisted out of 133 strains isolated. 5. Side effects were observed in 4 of 106 cases. Subjective side effects were not observed, but one case of mild pharyngeal edema and 3 cases of transient elevation of transaminase. From the above results, CFX would be a useful drug in the treatment of complicated urinary tract infections.

Eight cases of renal pelvis irrigation with stone solvents were reported. 1. The treatment was carried out in 7 renal staghorn calculi and 2 residual calculi after pyelolithotomy. The renal function was poor in 5 cases and 2 cases had single kidney. 2. Composition of the stones revealed 3 struvite, 2 struvite plus apatite, 1 cystine and 1 cakium carbonate. 3. EDTA was used in 5 cases, G in 2, and the combined in 1. 4. Stone solvent was irrigated by means of nephrostorny in 2 cases and ureteral catheterization in 6. 5. Out of 8 calculi, 1 (struvite) was completely dissolved. Three (1 calcium carbonate, 1 struvite, 1 struvite plus apatite) were partially, and 2 (1 struvite, 1 struvite plus apatite) were slightly dissolved, but 2 (1 struvite plus apatite, 1 cystine) remained unchanged. 6. Complications due to this treatment were as follows: fever (moderate 1, slight 5), flank pain (severe 2, slight 4), and/or vesical irritation (sever 1, moderate 1, slight 3). Symptoms were severe in 5% EDTA cases, but not remarkable in solution G cases.

Cefoxitin (CFX) was intravenously administered to 106 patients with complicated urinary tract infection at a daily dose of 2-4 g for 5 days. The results were summarized as follows; 1. As to the overall clinical efficacy, excellent, response was seen in 25%, moderate in 32% and poor in 43%. 2. Pyuria was cleared in 33, decreased in 14, and unchanged in 53 cases. 3. Bacteriuria was eliminated in 51, decreased in 2, replaced in 18, and unchanged in 29 cases. 4. As to the bacteriological response to CFX, 94 (71 %) were eradicated, and 39 (29%) persisted out of 133 strains isolated. 5. Side effects were observed in 4 of 106 cases. Subjective side effects were not observed, but one case of mild pharyngeal edema and 3 cases of transient elevation of transaminase. From the above results, CFX would be a useful drug in the treatment of complicated urinary tract infections.

Twenty-six cases of penile carcinoma encountered during the sixteen year period of 1964 through 1979 were studied. The age range of these cases was 38 to 80 (mean 61.6) years. Twenty-five cases had phimosis. Twenty-six cases were classified by the Jackson staging. There were 12 stage I, 7 stage II, 7 stage III and no stage IV cases. Chemotherapy with Bleomycin and radiotherapy was performed to stage I cases. Since Bleomycin has been used, penectomy was not performed to stage I cases. The crude 5-year survival rate was 85.7% in stage I cases, 80% in stage II cases, 33.3% in stage III cases. The total crude 5-year survival rate was 73.3%. The crude 5-year survival rate was 87.5% in the cases to which Bleomycin was administered and 57.1% in the cases not administered.

Between August 1977 and April 1979, four cases of renal transplantation were performed at the Department of Urology, Nagasaki University. Two hundred mg of ALS (AHLBULIN) was administered for 35 days from the 5th day before transplantation in addition to Imuran and methylprednisolone. The skin test was performed every time just before using AHLBULIN and the titer of precipitin reaction was determined in the period of using the agent. One patient had positive skin reaction and pecipitin titer rose to 16 times for 8 days from the 7th to the 15th day after transplantation. No one had a side effect owing to administration of AHLBULIN. One of them had one acute rejection episode after 6 days from transplantation and was treated with the pulse therapy of methylprednisolone.

Cefmenoxime (CMX) was intravenously administered to 106 patients with complicated urinary tract infection at a daily dose of 2-4 g for 5 days. An excellent response in overall clinical efficacy was seen in 15 cases (18.3%), a moderate response in 46 cases (56.1%) and poor response in 21 cases (25.6%). Pyuria was cleared in 20 cases (24.4%), decreased in 22 cases (26.8%) and unchanged in 40 cases (48.8%). Bacteriuria was eliminated in 41 cases (50.0%), decreased in 17 cases (20.7%), relapsed in 7 cases (8.5%) and unchanged in 17 cases (20.7%). Bacteriologically, 74 (76.8%) of the 95 strains isolated were eradicated by CMX, and 22 (23.2%) persisted. Side effects were observed in 3 (abdominal pain, diarrhea and elevation of trans amylase) of the 106 cases. Judging from the above results, CMX is considered to be a useful drug in the treatment of complicated urinary tract infections.

Patients received pivmecillinam (PMPC) after prophylactic use of various antimicrobial chemotherapeutic agents following prostatectomy, and their clinical responses were assessed for effectiveness in the treatment and prevention of postoperative infection. The data were also analyzed to explore the relationship between bacterial isolates obtained during the postoperative course and the antimicrobial agents administered prophylactically against postoperative infection. Therapeutic effect of PMPC: Treatment of postoperative infections with PMPC was effective in 36 (53.7%) out of 67 patients who had undergone prostatectomy. Prophylactic effect of PMPC: The use of PMPC provided effective prevention of infection in 22 (64.7%) out of 34 patients from whom no bacterial pathogen had been isolated before postoperative antimicrobial chemotherapy. Therapeutic responses to PMPC, compared between different types of operative procedure: There was little or no difference in therapeutic effectiveness of PMPC against postoperative infection when compared between two types of operative procedure, transurethral prostatectomy and subcapsular removal of the prostate. Incidence and types of bacterial isolates following prophylactic chemotherapy with various agents after prostatectomy: Possibly because cephapirin (CEPR) and ticarcillin (TIPC) were mainly administered, alone or in combination, for prophylaxis against postoperative infection, Serratia and Pseudomonas were most frequently isolated. The findings offer suggestions as to the appropriate combination of antimicrobial agents to be used for prophylactic purposes. Effectiveness of PMPC in the presence or absence of a preoperative indwelling urethral catheter: The use of PMPC was more effective both in the treatment and prevention of postoperative infection in cases without preoperative indwelling urethral catheterization than in those with it.

Eight cases of renal pelvis irrigation with stone solvents were reported. 1. The treatment was carried out in 7 renal staghorn calculi and 2 residual calculi after pyelolithotomy. The renal function was poor in 5 cases and 2 cases had single kidney. 2. Composition of the stones revealed 3 struvite, 2 struvite plus apatite, 1 cystine and 1 cakium carbonate. 3. EDTA was used in 5 cases, G in 2, and the combined in 1. 4. Stone solvent was irrigated by means of nephrostorny in 2 cases and ureteral catheterization in 6. 5. Out of 8 calculi, 1 (struvite) was completely dissolved. Three (1 calcium carbonate, 1 struvite, 1 struvite plus apatite) were partially, and 2 (1 struvite, 1 struvite plus apatite) were slightly dissolved, but 2 (1 struvite plus apatite, 1 cystine) remained unchanged. 6. Complications due to this treatment were as follows: fever (moderate 1, slight 5), flank pain (severe 2, slight 4), and/or vesical irritation (sever 1, moderate 1, slight 3). Symptoms were severe in 5% EDTA cases, but not remarkable in solution G cases.