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Abstract Purpose: We assessed the accuracy of MR imaging in differentiating between cancer and other prostatic disorders, and evaluated the diagnostic criteria for various prostatic diseases. Material and Methods: A total of 74 endorectal coil MR studies were performed on 72 patients. Twenty patients had prostatic cancer, 20 benign prostatic hyperplasia (BPH), 4 acute bacterial prostatitis, 5 chronic bacterial prostatitis (2 also belonging to the previous category), 19 chronic non-bacterial prostatitis/chronic pelvic pain syndrome, and 6 were symptomless voluntary controls. All studies were interpreted by two experienced radiologists in random order. Radiologists were blinded to all clinical data including the age of the patients. Based on MR findings, both radiologists filled in a form covering diagnostic criteria and diagnosis. Results: Accuracy in diagnosing prostate cancer was 74%. Sensitivity was 50% and specificity 83%, and positive and negative predictive values were 53 and 82%, respectively. Bacterial prostatitis showed some features similar to carcinoma. Abundant BPH rendered cancer detection more difficult. No diagnostic criterion was clearly better than the others. Interobserver agreement on the MR diagnosis ranged from moderate to good. Conclusion: Without knowledge of accurate clinical data, MR seems to be too insensitive in detecting prostate cancer to be used as a primary diagnostic tool. [ABSTRACT FROM AUTHOR]

Twelve nephrectomies (NEs) were performed in 12 pigs (11-17 kg). Total NE was performed on the left side and partial NE on the right side (lower third of the kidney), thus two-thirds of the total kidney volume was removed. Renal function was studied with Tc-diethylenetriaminepentaacetic acid (DTPA) renography and serum urea and creatinine levels preoperatively, and 1 and 2 weeks postoperatively. The pigs were imaged in each session for 30 min by collecting 10-s frames from a posteroanterior (PA) view of an anaesthesized animal. The injected activity was 37 MBq. Serial blood samples were taken from the subclavian vein at 0, 1, 2, 3, 5, 15, 25, 40, 60 and 120 min (six animals) after Tc-DTPA injection. The DTPA disappearance rate (DDR) was determined from these samples and in other cases (six animals) a blood sample at 20 min was used. The DDR was also determined from the dynamic gamma imaging data: Regions of interest (ROI) were upper body, spleen, heart and kidneys. The ROI analysis correlated well with the blood sampling data ( r=0.97, P<0.0001). The reference values for pig DDRs were 0.99±0.08%/min. These values were 0.71±0.08%/min at 1 week postoperatively and 0.63±0.08%/min at 2 weeks. DTPA clearance rates were preoperatively 0.53±0.06 ml/s; at 1 week postoperatively 0.41±0.06 ml/s; and at 2 weeks 0.35±0.06 ml/s. There were no significant differences pre- and postoperatively in creatinine and urea concentrations. The DTPA clearance (ml/s) and disappearance rates (%/min) when determined per kidney area (cm) increased significantly ( P<0.001 at both 1 and 2 weeks); in 11 of 12 animals the function of the resected right kidney was higher than the split function of the whole right kidney preoperatively. Unilateral nephrectomy initiates a functional adaptation or a growth response in the contralateral kidney to compensate for the loss of a renal mass. These data also indicate that two-thirds of the kidney volume in young pigs can be removed without danger. [ABSTRACT FROM AUTHOR]

Enoxacin was administered to six patients undergoing nephrectomy; 200 mg was given orally twice a day for three days preoperatively. The last dose was given on the morning of the day of operation. Samples of blood, skin, subcutaneous fat, muscle, rib bone, and renal cortex and medulla were taken during the procedure. Urine was collected 24 h preoperatively. The concentrations of enoxacin in the different tissues were measured by an agar-well diffusion method. The mean (24 h) urinary excretion of enoxacin was 62·7% of the daily dose. The concentrations in renal cortex and medulla and muscles exceeded those in serum; the mean tissue/serum concentration ratios were 3·8, 3·2 and 1·4, respectively. The ratios for skin and fat were 0·8 and 0·2, respectively. Only four bone samples were obtained and two of them had no detectable levels. The results indicate that enoxacin may be effective for treatment of skin and soft tissue infections and infections in the upper and lower urinary tract. [ABSTRACT FROM PUBLISHER]

- Urinary oestrogen excretion was measured in 20 healthy middle-aged men (controls), in 30 patients with benign prostatic hyperplasia (BPH) and in 32 prostatic cancer (PC) patients. The mean oestradiol (E2) excretion was significantly lower in the PC patients than in the controls and BPH patients. No other significant differences were found in oestrone (E1), oestriol (E3) and total oestrogen (E1 + E2 + E3) excretion between the 3 groups. The decreased E2 excretion in the PC patients is in accordance with our previous finding concerning significantly lower E2 plasma levels in PC patients. It seems possible that elderly men with lower endogenous oestrogen levels are at higher risk of developing cancer. On the other hand, the age-dependent increased oestrogen levels may play an aetiological role in BPH. [ABSTRACT FROM AUTHOR]

- Acid phosphatase levels were determined using both an enzymatic method (32 cases) and radioimmunoassay (35 cases) in 35 patients with clinically localised prostatic cancer. All patients underwent total prostatectomy and pelvic lymphadenectomy. In cases of intracapsular prostatic cancer the level of prostatic acid phosphatase (PAP) measured by radioimmunoassay was 1.4 ± 0.8 μg/l. In patients with either local extraprostatic disease or pelvic lymph node metastases the mean level of PAP was 3.5 ± 2.8 μg/l. The difference was statistically significant. The specificity, sensitivity and accuracy of an elevated PAP (> 3.0 μg/l) in revealing extraprostatic extension of clinically localised prostatic cancer were 100, 37 and 66% respectively. When the enzymatic method was used, the level of acid phosphatase was elevated (> 13 u/l) in only 1 case. The specificity, sensitivity and accuracy of the enzymatic method were 100, 6 and 47% respectively. Elevation of PAP predicts, with a high degree of probability, either local extension outside the prostate or lymph node metastases. A normal PAP does not exclude extraprostatic extension of prostatic cancer. [ABSTRACT FROM AUTHOR]

- Two hundred and seventy-seven patients with advanced prostatic cancer were treated by either orchiectomy or oestrogen. During the 2-year follow-up period, the response to treatment was considered more favourable in the oestrogen group, and this response was particularly emphasised in patients with poorly differentiated tumour and metastases at the time of diagnosis. Further evaluations included the cardiovascular side effects of oestrogen therapy. [ABSTRACT FROM AUTHOR]