Focusing and spin polarization of atomic hydrogen beam.

We have developed a spin-polarized-hydrogen beam with a hexapole magnet. By combining the beam chopper and pulsed laser ionization detection, the time-of-flight of the hydrogen beam was measured, and the dependence of the beam profile on the velocity was acquired, which was consistent with the beam trajectory simulations. The spin polarization of the beam was analyzed by using the Stern-Gerlach-type magnet in combination with the spatial scan of the detection laser. The spin polarization was about 95% at a focusing condition due to the hexapole magnet. The polarization was, on the other hand, reduced to about 70% for the beam at higher velocities, which is consistent with simulation results.

Efficacy and safety of abiraterone acetate plus prednisolone in patients with early metastatic castration-resistant prostate cancer who failed first-line androgen-deprivation therapy: a single-arm, phase 4 study.

AIM: The aim was to evaluate the efficacy and safety of abiraterone acetate plus prednisolone in patients with chemotherapy-naïve early metastatic castration-resistant prostate cancer who failed first-line androgen deprivation therapy. METHODS: Patients with early metastatic castration-resistant prostate cancer with confirmed prostate-specific antigen progression within 1-year or prostate-specific antigen progression without having normal prostate-specific antigen level (<4.0 ng/mL) during first-line androgen deprivation therapy were enrolled and administered abiraterone acetate (1000 mg) plus prednisolone (10 mg). A minimum of 48 patients were required according to Simon's minimax design. The primary endpoint was prostate-specific antigen response rate (≥50% prostate-specific antigen decline by 12 weeks), secondary endpoints included prostate-specific antigen progression-free survival and overall survival. Safety parameters were also assessed. RESULTS: For efficacy, 49/50 patients were evaluable. Median age was 73 (range: 55-86) years. The median duration of initial androgen deprivation therapy was 32.4 (range: 13.4-84.1) weeks and 48 patients experienced prostate-specific antigen progression within 1-year after initiation of androgen deprivation therapy. prostate-specific antigen response rate was 55.1% (95% confidence interval: 40.2%-69.3%), median prostate-specific antigen-progression-free survival was 24.1 weeks, and median overall survival was 102.9 weeks (95% confidence interval: 64.86 not estimable [NE]). Most common adverse event was nasopharyngitis (15/50 patients, 30.0%). The most common ≥grade 3 adverse event was alanine aminotransferase increased (6/50 patients, 12.0%). CONCLUSIONS: Abiraterone acetate plus prednisolone demonstrated a high prostate-specific antigen response rate of 55.1%, suggesting tumor growth still depends on androgen synthesis in patients with early metastatic castration-resistant prostate cancer. However, prostate-specific antigen-progression-free survival was shorter than that reported in previous studies. Considering the benefit-risk profile, abiraterone acetate plus prednisolone would be a beneficial treatment option for patients with chemotherapy-naive metastatic prostate cancer who show early castration resistance.

The impact of a 4 cm. cutoff point for stratification of T1N0M0 renal cell carcinoma after radical nephrectomy.

PURPOSE: The 1997 TNM classification defines T1 tumors as those smaller than 7 cm. Recently, a cutoff point of 4 cm. has been proposed to create a subclass of T1 tumors. We evaluated the validity of this cutoff point by assessing the pathological findings and prognoses of patients with T1N0M0 renal cell carcinoma following radical nephrectomy. MATERIALS AND METHODS: We reviewed the hospital charts of 333 patients with T1N0M0 tumors, followed as long as 282 months (median 63) after radical nephrectomy. The validity of tumor size cutoff point for predicting survival outcome was tested in relation to other prognostic factors, including patient age, tumor position, nuclear grade, tumor histopathology and degree of microscopic venous invasion. RESULTS: During followup 32 patients (9.6%) had tumor recurrence and 21 (6.3%) died of renal cell carcinoma. A 5 cm. cutoff point maximized the differences in cancer specific survival rates and a 4 cm. cutoff point maximized the differences in disease-free survival rates. Tumor size was directly related to microscopic venous invasion and nuclear grade, which are significant prognostic factors, and a 4 cm. cutoff point enhanced these relationships. CONCLUSIONS: Tumor size is an important prognostic factor for patients with T1N0M0 renal cell carcinoma. A cutoff point of 4 cm. is practical for dividing the T1N0M0 classification into T1a and T1b subclasses.

[Bilateral renal cell carcinoma with extension into the vena cava associated with von Hippel-Lindau disease: a case report and review of the literature].

We report a case of bilateral renal cell carcinoma with extension into the inferior vena cava associated with von Hippel-Lindau (VHL) disease. A 52-year-old woman was referred to our hospital for further examination of bilateral renal masses which were found on abdominal ultrasound examination. The diagnosis was confirmed with renal angiography, abdominal computed tomography (CT), abdominal magnetic resonance-CT (MRI), cavography and head MRI. Right adjunctive nephrectomy and removal of the tumor thrombus were performed. She has been treated with interferon-alpha after the operation. The analysis of her DNA by using single strand conformational polymorphism revealed a VHL gene abnormality.

[Neoadjuvant endocrine therapy prior to nerve-sparing radical prostatectomy in patients with stage T2 prostatic cancer].

Radical prostatectomy is the effective treatment for clinical T2 prostatic cancer. However, clinical T2 stage is often understaged preoperatively. The objective of neoadjuvant therapy is to increase the curability of surgery to understaged patients. The present study was based on patients who had had neoadjuvant endocrine therapy (LH-RH agonist) prior to radical nerve-sparing prostatectomy for T2 prostatic cancer. Sexual function were estimated before and after surgery. Ten patients with a mean age of 64.6 years (range 57-71 years) and biopsy-proven cancer received this treatment modality. No patients had evidence of lymph node metastasis by the pelvic computerized tomography and their bone scan was negative for metastasis. Clinical stage was T2a in 3 patients and T2b in 7. The grade of these tumors as assessed on prostatic biopsy before neoadjuvant endocrine treatment was well differentiated in 3 and moderately differentiated in 7. The duration of neoadjuvant endocrine therapy was 3.6 months (range 2-5 months) in average. Serum levels of prostatic specific antigen (PSA) were examined monthly and prostate volume was measured by transrectal ultrasonography before and after neoadjuvant treatment. Decrease in serum PSA values was observed from an average level of 8.6 ng/ml (range 3.1-17.5 ng/ml) determined prior to neoadjuvant treatment to an average of 1.1 ng/ml (range 0.6-3.3 ng/ml) determined after neoadjuvant treatment. An average reduction of prostatic volume was 25.3% (range 7.4-56.7%) after neoadjuvant therapy. Pathological effects of the neoadjuvant therapy by the criteria proposed by Japanese Urological Association were Grade (G) 0a in 3 patients, G0b in 4, G1 in 2 and G2 in 1. Of patients who had 10 stage T2 cancer before treatment, 4 had pT2 and 6 pT3.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study of prognostic factors for renal function in patients with autosomal dominant polycystic kidney disease].

To examine clinical features and the prognostic factors for renal function in patients with autosomal dominant polycystic kidney disease (ADPKD), a total of 118 patients (60 men and 58 women) were followed for 3 to 192 months (mean 77 months). The mean age of men at the diagnosis of ADPKD was younger than that of women. Main Symptoms were hematuria, hypertension and proteinuria. Forty-one % of the patients showed deterioration of renal function at the diagnosis. The rate of residual volume of renal parenchyma on CT findings was correlated well with renal function. Twenty-eight % of the patients preserved good and stable renal functions for over 5 years, while most of others had deterioration in their renal function. Thirty-four % of the patients started dialysis within 79 +/- 62 months from the diagnosis. The frequency of end stage renal failure was 7% at 40 years, 21% at 50 years, 36% at 60 years and 63% at 70 years old, respectively. Men needed hemodialysis at younger ages than women. Renal function of the patients with hypertension was worse than that of the patients without hypertension. The ratio of the value of P.S.P.120 to that of serum creatinine (PSP120/sCr), and the rate of residual volume of renal parenchyma revealed distinct prognostic factors for renal function.

[Simultaneous bilateral testicular tumors: a case report].

We report a case of bilateral simultaneously-occurring testicular tumors. A 43-year-old man was admitted to our clinic with a complaint of right inguinal pain in May 1992. Under the diagnosis of bilateral testicular neoplasms, bilateral high orchiectomy was performed. Histological examination revealed typical seminoma of bilateral testes. The patient was diagnosed with stage IIIO seminoma, and he was treated with combination chemotherapy (PVB). No evidence of disease has been seen after chemotherapy.

[Urinary cytology in patients with urolithiasis].

Urinary cytological examination was performed on 1032 patients of urolithiasis at the Department of Urology, Chiba University Hospital between 1980 and 1990. Seven hundred twenty-four were male and 308 were female, and the mean age was 44 years. The results of cytological examination of I-II and IV-V were classified as negative and positive, respectively. Eleven patients (1.1%) were positive, 2 of whom were found to be with renal pelvic tumor. False-positive findings were noticed in 9 cases (0.9%), and the abnormal cytologic changes in these cases disappeared after the calculi were removed. In negative cytological cases, 2 cases of renal pelvic tumor were found, one at nephrectomy and the other at percutaneous nephrolithotripsy. These cases were with staghorn calculi with hydronephrosis. The significance of cytological examination in management of calculous diseases were discussed.

[M-VAC chemotherapy for patients with lymph node metastases and/or locally advanced bladder carcinoma].

Sixteen patients with lymph nodes metastases and/or locally advanced bladder carcinoma were treated with a combination chemotherapy regimen consisting of methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC) from November 1986 through September 1988. There were 14 men and 2 women. The median age was 61.9 years, with a range from 43 to 81 years. Complete response (CR) was observed in 6 of 16 patients (38%), partial response (PR) was confirmed in 5 of 16 patients (31%), and overall response rate was 69%. Median duration of response was 10.3 and 5.2 months in CR and PR patients, respectively. The myelosuppression with this regimen was tolerable. This study demonstrates that the M-VAC regimen is effective in the invasive bladder carcinoma with or without lymph nodes metastases. However, the duration of response is relatively short, and the true long-term benefits of this regimen remain to be determined.

[M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy in advanced renal pelvic and ureteral carcinoma].

Seventeen patients with advanced renal pelvic and ureteral carcinoma receiving M-VAC chemotherapy were evaluated. There were 10 men and 7 women ranging in age from forty-two to seventy-eight years with a mean of sixty-six years. The primary sites of carcinoma were renal pelvis in 4 patients, ureter in 12, renal pelvis and ureter in 1. Fifteen patients had transitional cell carcinoma, one patient had transitional cell carcinoma mixed with squamous cell carcinoma and the histology of one patient was not identified. The median number of treatment cycles was 2.6, ranging from 1 to 6. Significant remissions following the treatment were observed in 5 of 8 primary lesions, 6 of 11 lymph nodes, 2 of 3 lung lesions and 2 of 5 bone lesions, respectively. However, the responses were not seen in 4 liver lesions. Two patients achieved a complete response (CR), 7 had a partial response (PR), 6 had stabilization of their disease, 2 had progressed, and the overall response rate was 52.9%. Two CR patients remain free of disease. Relapse or recurrence was seen in 4 of the 7 patients who achieved PR, and the median duration of response was 6.4 months. While the myelosuppression with this regimen was tolerable, the decreases of white blood cell and platelets count were significant in patients who had undergone prior irradiation. These results indicate that the M-VAC regimen is effective in patients with advanced upper urothelial malignancy. Further, a short response and a poor effectiveness in the metastases of liver and bone remain to be overcome.

[Prophylactic effect of etretinate on the recurrence of superficial bladder tumors--results of a randomized control study].

The recurrence preventing effect of Etretinate on 174 superficial bladder tumors was examined by a randomized study using the envelope method. After transurethral resection of the bladder tumor, the tumor-free patients were divided into two groups, one administered one 10 mg capsule of Etretinate once a day, and the other group untreated (control group). As a rule, the patients were examined for recurrence every 3 months. There were 9 drop outs (9.6%) in the Etretinate group, and 8 (10%) in the control group. Therefore, 85 subjects in the Etretinate group and 72 patients in the control group were analyzed for statistics. The recurrence rate during the observation period of over 2 years was 38% in the control group and 18% in the Etretinate group, the number of relapsing cases in the latter group tending to be decreased (P less than 0.1). The cumulative recurrence inhibition rate for cases observed over one year tested by the Kaplan Meier method tended to be higher in the Etretinate group compared to the control group (P less than 0.1). Etretinate administration had a high recurrence inhibitory effect (P less than 0.05) in the cases of relapse, multiple tumors, and tumors less than 1 cm. Side effects of Etretinate administration were seen in 21 cases (22.3%). The major symptoms were dry lips, cheilitis, stomatitis, dermal desquamation, etc., and drug use was discontinued in 7 cases (7.4%). The symptoms all disappeared after drug administration was discontinued.

Loss of epidermal growth factor receptor on the renal neoplasm induced in vivo with Xenotropic pseudotype Kirsten murine sarcoma virus.

A characteristic feature of normal rat kidney (NRK) cells in their ability to bind epidermal growth factor (EGF) and loss of the ability to bind EGF in the renal neoplasm induced in vivo with C type RNA virus were demonstrated. Maximal binding capacity and apparent dissociation constant of NRK cells were 3.36 femtomoles of EGF bound per 10(6) cells and 2.85 X 10(-11) M, respectively. The binding of EGF to transformed cell in vivo with Xenotropic pseudotype Kirsten murine sarcoma virus was abolished.

ABO (H) blood group antigens and carcinoembryonic antigens as indicators of malignant potential in patients with transitional cell carcinoma of the bladder.

Immunoperoxidase methods were used to study ABO(H) blood group antigens and carcinoembryonic antigens in patients with transitional cell carcinoma of the bladder. In our study absence of blood group antigens in cancer tissues was not found to be correlated with histologic grade, stage and survival rate in patients with bladder carcinoma, while it was correlated with subsequent intravesical recurrences. In contrast, the presence of carcinoembryonic antigens in cancer tissues was correlated well with histologic grade, stage and survival rate. Our results suggest that immunoperoxidase detection of blood group antigens could not predict poor survival. In contrast, immunoperoxidase detection of carcinoembryonic antigens is of prognostic value in patients with transitional cell carcinoma of the bladder.

Complete deficiency of adenine phosphoribosyl transferase: report of a new family.

We report a case of 2,8-dihydroxyadenine urinary lithiasis with complete deficiency of adenine phosphoribosyl transferase. Adenine phosphoribosyl transferase activities in the erythrocytes, lymphocytes and granulocytes of the patient's family also were determined. The propositus and her younger brother were homozygotes for adenine phosphoribosyl transferase deficiency and her parents were heterozygotes. This is the third family with this disease to be reported.

[A study of combination chemotherapy with cis-diamminedichloroplatinum for advanced genitourinary carcinoma].

The patients with advanced testicular tumors and bladder carcinoma were treated by combination chemotherapies including cis-diamminedichloroplatinum. Four patients with advanced testicular tumors were treated with a combination chemotherapy, consisting of cis-diamminedichloroplatinum, vinblastine, and bleomycin or pepleomycin according to Einhorn's regimen. Three patients with advanced bladder carcinoma were treated with a combination chemotherapy consisting of cis-diamminedichloroplatinum, cyclophosphamide, and adriamycin according to Yagoda's regimen. These chemotherapy regimens produced 25% complete and 75% partial responses in testicular tumors and 100% of no change in bladder carcinoma. Although an overall response rate of three patients with bladder carcinoma was 0%, one patient was plateaustable for more than three months. We believe that the combination chemotherapy including cis-diamminedichloroplatinum is promising in the management of patients with advanced testicular tumors or bladder carcinoma.