[PRIMARY LOCALIZED AL AMYLOIDOSIS OF THE BLADDER MIMICKING RECURRENCE OF BLADDER CARCINOMA].

Primary bladder amyloidosis is a rare disease, with approximately 200 cases documented in the literature. We herein present a 85-year-old Japanese man who has undergone a transurethral resection of a bladder tumor (TURBT) and has regularly been followed up after surgery. Since cystoscopy revealed mucosal irregularity, he has got a TURBT again for a suspicion of recurrence. There were no malignant findings in pathological diagnosis and we diagnosed as amyloidosis because it showed positive by Congo-red staining. We added immunohistological diagnosis to diagnose as localized AL amyloidosis of the bladder finally.

[A clinical study concerning survival of operative cases for the transitional cell carcinoma of the upper urinary tract].

To identify prognostic factors influencing survival in transitional cell carcinoma (TCC) of the upper urinary tract, we retrospectively studied 189 (median age 70, 130 males and 59 females) patients who underwent surgical resection at our 3 hospitals from August 1980 to September 2006. After a median follow up of 47.8 months, 45 cases (23.8%) died of cancer and the 5-year and 10-year disease-specific survival rate (Kaplan-Meier method) was 70.5 and 67.1%. Because lymphatic and vascular involvements, pattern of infiltration and location of tumor had loss of data, only the univariate analysis was done. They were observed to be significantly different by the univariate analysis. The significant prognostic factors for survival using Cox-proportional hazard models were tumor stage, tumor grade, lymph node metastasis, and surgical margin status. Adjuvant chemotherapy was not the prognostic factor in our multivariate analysis.

[Multi-center trial on the early effects of silodosin on lower urinary tract symptoms associated with benign prostatic hyperplasia].

Silodosin (URIEF), a new so-called 3rd generation alpha-1 blocker, is widely expected to be effective and useful for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH), due to its high specificity to alpha-1A receptor. We evaluated the efficacy of Silodosin, on 187 males 50 years old or over with the diagnosis of BPH. Silodosin significantly improved the International Prostate Symptom Score (IPSS) and quality of life (QOL) score from the day after administration was started. Among 166 patients whose data were available for the analysis of efficacy of Silodosin, 77.5% showed apparent subjective improvement. Eighty three patients, who had been taking another alpha-1 blocker but without satisfactory effects, showed almost the same improvements in IPSS and QOL score after switching to Silodosin as the remaining 83 patients who had no preceding treatment with an alpha-1 blocker. The improvements were not only in voiding symptoms but also in storage symptoms. The patients, who had serious storage symptoms, responded rather well to Silodosin and showed significant improvement. Taken together, Silodosin showed a quick effect for improving subjective symptoms and QOL, and was found to be useful for the management of LUTS with BPH.

[Three cases of pulmonary hamartoma appearing after radical nephrectomy for renal cell carcinoma].

We report 3 patients with pulmonary hamartoma, all of whom had undergone nephrectomy for renal cell carcinoma. A lung tumor was detected 2 to 9-months following nephrectomy. Preoperative diagnosis was pulmonary metastasis from renal cell carcinoma and pulmonary tumor resection was performed in each case. There was a 9- to 12-month interval between the detection and resection of the lung tumor. The histological diagnosis of the lung tumor in all three patient was pulmonary hamartoma. Following the resection of the lung tumor, recurrence was not noted in any of the patients.

[The significance of urine cytology three consecutive days after transurethral resection as a predictor of superficial bladder cancer recurrence].

To determine whether there was any correlation between recurrence of superficial bladder cancer and the results of urinary cytology examined for 3 consecutive days after transurethral resection of the bladder cancer (TURBT), we retrospectively studied 64 patients with newly diagnosed Ta/T1 transitional cell carcinoma (TCC) of the bladder who had previously undergone TURBT. Urine cytology samples were reported as negative (class I, II) or positive (class III, IV, V). We used the Kaplan-Meier method to calculate the non-recurrence rate, and Cox-proportional hazard models to determine the prognostic significance of clinical and pathological findings. If any sample among the three consecutive cytology examinations was positive, we defined the case as positive. After a mean follow up of 19.5 months, 22 cases (34.4%) demonstrated recurrence probabilities of 24.1% and 42.3%, at 12 and 24 months, respectively. Of the positive cytology group (n = 33), 15 patients (45.5%) had recurrent tumor, while in the negative group (n = 31), only 7 cases (22.6%) developed recurrence. Multivarite analysis demonstrated that tumor size (p = 0.0022, Hazard ratio 8.9316), result of urine cytology for three consecutive days after TUR (p = 0.0051, Hazard ratio 4.5728), and age (p = 0.0124, Hazard ratio 3.7652) were associated with tumor recurrence. We suggest that positive results on urinary cytology for three consecutive days after TUR are indicative for tumor recurrence.