Estimation of prostate cancer volume by endorectal coil magnetic resonance imaging vs. pathologic volume.

OBJECTIVE: Since tumor volume is recognized as an important predictor of clinical stage and disease outcome of prostate cancer, accurate preoperative estimation of tumor volume can play an important role in planning the appropriate treatment and establishing a patient's prognosis. We performed this study to evaluate the accuracy of the endorectal coil magnetic resonance (MR) technique for reliable prediction of tumor volume in patients with prostatic cancer. MATERIAL AND METHODS: Endorectal coil MR imaging was performed in 57 consecutive men who were suspected to have prostate cancer. Subsequent ultrasound-guided transrectal biopsy revealed prostate cancer in 44 cases. The pathological volume of the surgical specimens of 25 selected patients who underwent radical prostatectomy was retrospectively compared to the volume estimated by endorectal coil MR studies, and the Pearson correlation coefficient was calculated. RESULTS: In 15 patients the estimated size of the tumor was within 15% of the true tumor volume; in the remaining 10 cases MR imaging tended to underestimate large tumors and overestimate small ones. A significant correlation between the volumes as determined with MR imaging and measurements of surgical specimens was observed (r 0.94; slope 0.82). To our knowledge, this is the best correlation found between pathological volume and tumor volume as evaluated by any other imaging modality. CONCLUSIONS: Endorectal coil MR imaging is a powerful means of evaluating the prostate gland; however, further improvements in imaging and/or volume calculation are required to provide a more accurate preoperative assessment of prostate cancer volume.

Long-term oral treatment of urinary tract infections with single daily doses of a new antibacterial drug combination (Kelfiprim).

Of 30 patients with severe, complicated U.T.I. 27 have been given single daily doses of Kelfiprim (KP), a new sulfatrimethoprim combination, for 8 weeks. In 24 bacteriuria was lastingly controlled, one had a relapse, one had a reinfection, and in one, with bladder carcinoma, bacteriuria persisted. Three other patients received KP for shorter periods, as they presented gastric intolerance or skin hypersensitivity, but in two of them a lasting sterilization of the urine has been obtained. The usefulness of a single daily dose schedule is stressed.

A short-term study of trimethoprim-sulfamethopyrazine combination ('Kelfiprim') in hospital patients with acute or recurrent urinary tract infections.

Forty-nine hospital patients with symptoms of urinary tract infection and significant bacteriuria were treated with a fixed combination of 250 mg trimethoprim and 200 mg sulfamethopyrazine, 2 capsules on the first day and 1 capsule daily for a further 6 days. Mixed infections were frequent. A total of 67 infecting organisms was isolated on admission, and 85% of them were eradicated, as shown by urine cultures carried out 3 to 10 days after the end of treatment. Overall therapeutic results were assessed as excellent or good in 75% of the patients. Only one side-effect, of allergic type, was observed among the 49 cases treated. The combination of trimethoprim and sulfamethopyrazine is considered as suitable for hospital or home treatment of acute and recurrent urinary tract infections.

Study of the possible interactions of indoprofen on the diuretic effect of furosemide.

Twelve elderly in-patients undergoing chronic furosemide treatment (25 mg/day), with stable diuresis, were admitted to a cross-over, double-blind study to investigate the possible interactions between indoprofen and the diuretic. Indoprofen (200 mg t.i.d.) and identical placebo tablets were administered in randomized sequences for 4 days each. The sequence were preceded by a 4-day run-in observation period and followed by a 4-day follow-up. 24-hour urinary volume and the excretion of Na, K and endogenous creatinine were monitored, with serum Na, K, creatinine and creatinine clearance. Blood pressure and heart rate were measured and routine clinical blood chemistry tests and urinalysis were made for safety. The findings of this pilot study suggest that indoprofen does not alter the natriuretic action of furosemide; a tendency was noted towards a reduction of glomerular filtrate and urine volume, but the values after indoprofen were not significantly different from those after placebo.