[The course and limitation of medical treatment for benign prostatic hyperplasia].

To clarify the effects and limitation of medical treatment for benign prostatic hyperplasia (BPH), 2,476 patients with BPH were analyzed in terms of symptoms, objective findings, treatment modality and whether surgery was required during the course of medical treatment. As initial therapy, 1,320 cases (53.3%) were treated with medicine and 783 cases (31.6%) underwent surgery. In the group of patients initially treated with medicine, 264 cases (20.0%) required surgery and most operations were performed within six months from the start of medical treatment. Those who required surgery had a larger prostate and more residual urine than those who continued medical treatment. This tendency was also observed in the patients treated with antiandrogen. Therefore, medical therapy might be inappropriate to treat the patients with more than 50 ml of residual urine or significantly large prostate such as goose egg sized or larger. In conclusion, medical treatment possessed potential usefulness for the management of BPH, however, there seemed to be limitation of the effects of medical treatment.

[Incidence of renal cell carcinoma in Chiba Prefecture, Japan; ten years experience].

Many reports about the increase of renal cell carcinoma patients have been published in Japan recently, however, the real fluctuations in the total number of patients in relation to the change of population have not been reported yet. Most of the patients with renal cell carcinoma in the last 10 years were examined in Chiba prefecture, which has a population of about five million and 25 active urological offices. Histologically confirmed cases were investigated by sending questionnaire letters. The items were as follows; sex, age, address, occupation, family history, past history, symptoms, examination methods that first detected the tumor, operation date, tumor diameter and clinical stage. Twenty two offices returned answers and 560 cases who lived in Chiba were found to have renal cell carcinoma from 1980 to 1989. Yearly incidence rates per 100,000 persons demonstrated a significant increase from 0.32 to 2.07. Small, asymptomatic and low stage cancers have been increasing rapidly, however, the rate of metastatic disease has not shown any decrease. The main cause of rapid increase seems to be attributed to progress in diagnostic methods and increase of early detection, but the possibility of an increase in some carcinogenic factors can not be ruled out.

A hematological remission by clonal hematopoiesis after treatment with recombinant human granulocyte-macrophage colony-stimulating factor and erythropoietin in a patient with therapy-related myelodysplastic syndrome.

We treated a patient with therapy-related myelodysplastic syndrome (MDS) with human recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (Epo). The patient achieved a hematological remission which continued for more than 16 months despite discontinuation of the treatment. Before the treatment with GM-CSF and Epo the patient had severe pancytopenia, required frequent red cell transfusions, and experienced episodes of severe infection, but after the therapy he no longer needed transfusion and no longer had the infection. While the patient remained in hematological remission, bone marrow examination revealed trilineage dysplasia, and cytogenetic analysis showed an abnormal karyotype [48, XY, +8, +der(1q5p)] in 100% of the metaphases examined. These findings suggest that the hematological remission of this patient may not result from the recovery of the non-clonal hematopoiesis of a normal clone, but result from the monoclonal hematopoiesis of a neoplastic clone.

Prophylaxis of superficial bladder cancer with instillation of adriamycin or mitomycin C.

A multicenter trial for postoperative prophylaxis of superficial Ta-T1, G1-G2 bladder cancer was performed. Intravesical instillation using either 20-30 mg adriamycin or 20 mg mitomycin C per dose was carried out for 4 weeks or 2 years. Patients without instillation served as controls. A total of 259 patients was considered eligible for the evaluation. The instillation group showed a better disease free survival rate than the control group. Better prophylactic effects of instillation therapy were observed when one of following factors was present: multiple tumors, large tumors, T1 and G2 bladder cancer. The total dose of drug instilled seemed to correlate with the effects, but there were no differences between adriamycin and mitomycin C. The side effects were minimal and temporary.

[Transarterial embolization in metastatic retroperitoneal tumor].

A case of retroperitoneal metastasis of a malignant testicular tumor treated by transarterial embolization (TAE) is reported. The tumor feeders were the intercostal and lumbar arteries. Improvement of the patient's condition could be obtained by TAE. It is suggested that TAE has some effectiveness for chemoresistant, radio-resistant or inoperable cases of metastatic retroperitoneal tumors.

[Effect of recombinant alpha-interferon on advanced renal cell carcinoma].

The present study was undertaken to assess the efficacy of single agent chemotherapy with alpha A-interferon or alpha 2-interferon for metastatic renal cell carcinoma. alpha A and alpha 2-Interferon were administered i.m. at a primary dose of 3 X 10(6) units/day to 13 patients. Two patients (15%) showed partial response; 1 patient (8%), minor response; 5 patients (38%), no change; 6 patients (46%), progressive disease. These preliminary observations indicate that these interferons are active antitumor agents in patients with renal cell carcinoma.