Safety and efficacy of exisulind for treatment of recurrent prostate cancer after radical prostatectomy.

PURPOSE: We evaluated the safety and efficacy of exisulind for delaying disease progression in men with increasing prostate specific antigen (PSA) after radical prostatectomy. MATERIALS AND METHODS: A total of 96 men with increasing PSA after radical prostatectomy were randomized to receive placebo (49) or 250 mg. exisulind twice daily (47) for 12 months. The primary efficacy parameter was the difference in change from baseline PSA between the placebo and exisulind groups. The PSA doubling time was also evaluated before and during study. A subgroup analysis classified patients based on the risk of developing metastatic disease. RESULTS: Compared with placebo, exisulind significantly suppressed the increase in PSA in all patients (p = 0.017). The results were also statistically significant in men at high risk for metastasis (p = 0.0003) and those who could not be classified according to risk (p = 0.0009). In addition, median PSA doubling time was lengthened in high risk patients on exisulind (2.12 month increase) compared with those on placebo (3.37 month decrease, p = 0.048). Exisulind was well tolerated. CONCLUSIONS: Exisulind inhibited the increase in PSA overall and prolonged PSA doubling time in high risk patients compared with placebo. These results suggest that Exisulind has the potential to extend the time from biochemical recurrence to the need for androgen deprivation therapy. Exisulind was well tolerated in this patient population. Our results support further study of Exisulind in the treatment of patients with prostate cancer.

Ambulatory extracorporeal shockwave lithotripsy.

The Kidney Stone Center in Fort Lauderdale, Florida, is an ambulatory ESWL facility where 226 patients have been treated since July, 1985. A total of 258 kidneys were treated over a period of five months with a success rate of 99 per cent. The post-treatment admission rate, both immediate and delayed, was 14.2 per cent. Outpatient ESWL treatment of both renal and ureteral calculi is feasible, medically safe, and cost-effective.

Oxalate absorption from intestinal segments of rats.

An animal experimental model was used to study oxalate absorption from the gut. It was found that the initial rate of [14C]oxalate absorption is rapid (6.5 per cent per min), and that after 5 min the rate of absorption decreases to about 0.6 per cent per min. Absorption of [14C]oxalate was greatest in the jejunum and least in the colon. On the basis of linear coefficients derived from the data, it is estimated that at least 8.6 per cent of a challenge dose of oxalate should be absorbed from the small bowel during normal transit. The high absorption rate, compared with the normal absorption of oxalate, in this model is most likely attributable to the oxalate's being completely dissolved in the gut. Magnesium and calcium in the test solution did not cause large changes in the rate or amount of oxalate transfer in this experimental model.

Renin-dependent renovascular hypertension in infant with abdominal aortic atresia.

A newborn infant was seen with severe and progressive arterial hypertension, congenital atresia of the abdominal aorta, and a renal venous renin activity ratio greater that 1:1.5 (1:3.1). Preoperative studies indicated that the renin-angiotensin axis was responsible for the production and maintenance of the severe hypertensive process. Right nephrectomy cured the arterial hypertension both above and below the area of coarctation. The possible roles of the pathogenic mechanism are discussed.

Post-prostatectomy impotence.

With the help of the principles of rapid eye movement sleep and nocturnal penile tumescence, 14 patients who underwent transurethral prostatectomy were studied by monitoring the electroencephalograph, electro-oculograph and penile plethysmograph activity preoperatively and postoperatively. No instance of complete loss of penile erection was found postoperatively. The need for objective rather than subjective data is emphasized.