[Current status and problems of a screening for prostatic cancer in the health facilities in Fukuoka Prefecture].

We analyzed the current status and problems of a screening for prostatic cancer (PCa) through a health examination in 12 hospitals in Fukuoka prefecture. From 1987 to 1991, a total of 16,126 subjects received this. The number of subjects who received this increased every year. In 5 hospitals in which such a screening is optional, however, only about 20% of subjects through a health examination received it each year. Furthermore, most of the subjects were in their 50s or 40s. Those in their 70s or more who are at higher risk for PCa rarely received such screening. PCa was detected in 6 subjects (0.04%) (well differentiated adenocarcinoma: 3, moderate differentiated adenocarcinoma: 3) in 5 years. Five were in stage B and treated with radical prostatectomy and one was in stage C and hormonal therapy was performed. The mean age of the 6 patients was 57.7 year old ranging from 51 to 66. The incidence of PCa detected by a screening in dock increased with age. Prostate specific antigen (PSA) was considered to be more useful for detecting prostate cancer in dock as compared with digital examination (DRE), transrectal ultrasonography or prostatic acid phosphatase because of its relatively high sensitivity (83.3%) and specificity (84.8%). The incidence of PCa detected with combination of DRE and determination of PSA was 0.15% and significantly higher than that detected with DRE alone, 0.01%. These results suggest the need for enlightenment on PCa and the significance of a screening with combination of DRE and determination of PSA through a health examination for detecting early stage of PCa.

[Combination chemotherapy of M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) for advanced uroepithelial cancer].

Seventeen patients with advanced uroepithelial cancer were treated with M-VAC regimen. Out of 17 patients, 10 were evaluable but 7 were not. Evaluable 10 patients comprised 7 males and 3 females ranging in age from 50 to 83 (median 69.5). The number of performed cycle ranged from 1 to 3 and the performance status was from 0 to 2. Complete response (CR) was observed in 2, partial response (PR) in 4 and no change (NC) in 4 out of 10 patients. The efficacy rate was 60%. Every site of the tumor responded well and CR was observed, in particular, in nodal and pulmonary metastasis. One of 2 CR patients relapsed and died. One of 4 PR patients died of cancer, 2 are alive with regrowing tumors and the other is alive without disease after surgical removal of all residual tumors. The same regimen was carried out again to 2 patients with regrowing tumors, but no response was observed. As to drug toxicity in total 31 cycles (17 patients), gastrointestinal disturbances, anorexia and alopecia were reversible but hematological toxicity was serious and 3 of 17 (17.6%) died of severe bone marrow suppression. M-VAC is an effective regimen for advanced uroepithelial cancer, but bone marrow suppression was serious. Therefore, special attention should be paid to myelosuppression.

[Clinical effects of terodiline hydrochloride for urinary frequency and sense of residual urine].

The clinical effects of terodiline hydrochloride were evaluated in forty-four patients with urinary frequency and/or sense of residual urine. After a four-week treatment with 24 mg terodiline hydrochloride once daily, subjective symptoms were improved and micturition frequency was decreased significantly. Slight dysuria was reported as a side effect only in one patient. Terodiline hydrochloride is considered to be superiorly effective and safe for the treatment of urinary frequency and sense of residual urine.

[Clinical studies of antimicrobial prophylaxis of recurrent urinary infection in women. Long-term, low-dose pipemidic acid for prophylaxis].

The prophylactic efficacy of long-term, low-dose antimicrobial treatment in urinary tract infection (UTI) was studied. Fifty-eight female adult patients with a history of at least two recurrent episodes of UTI in the past year were entered into this study, and the prophylactic regimen was not started until the existing UTI had been eradicated. Patients took 250 mg of pipemidic acid (PPA) daily at bedtime after voiding for 6 consecutive months. Incidence of recurrence of UTI in 48 patients with uncomplicated UTI and 10 patients with complicated UTI decreased to 0.15 and 0.29 per year, respectively, during the treatment compared with 3.5 per year before the treatment. At the end of the 6 months of prophylactic treatment, the patients were divided into two groups by the envelope method. Seventeen patients were treated for a further 6 months and 11 patients were followed up without further medication. Prophylactic efficacy of UTI was obtained in both groups, and there was no significant difference in the incidence of recurrence between the two groups. These findings suggest that the 6-month period of prophylaxis might be sufficient. Examination of the periurethral swab showed that E. coli and Klebsiella sp. were decreased during the treatment. This prophylactic treatment produced no resistant strains. Urinary levels of PPA in the morning urine of patients administered 250 mg of PPA at bedtime averaged 513 micrograms/ml. These values were about 2 times higher than those found in the evening urine after administration of the same dose in the morning.