[A randomized study of pirarubicin (THP) versus adriamycin (ADM) for intravesical instillation therapy against superficial bladder cancer].

To determine the antitumor action by intravesical instillation prior to transurethral resection TUR, a randomized study on pirarubicin (THP) versus adriamycin (ADM) was performed for superficial, papillary and initially detected bladder cancers with participation of 21 Urological Clinics in 3 Tokai Prefectures. The instillation dose of 500 micrograms/ml was given 3 times per week for 3 weeks in both THP (n = 33) and ADM (n = 30) groups. The complete and partial response rates were 56.3% in THP group and 26.7% in ADM group. THP instillation was more effective against multiple tumors than a single tumor, stage Ta than T1 and grade G1 than G2 and G3. However, these findings were not statistically significant. Untoward effects were mainly bladder irritability and its frequency was 60.6% in the THP group and 23.3% in the ADM group. Contracted bladder was found in 2 of the 33 patients in the THP group and 2 of the 30 patients in the ADM group. The antitumor effect of a half dose of THP was equivalent to that of one dose of ADM, and the THP group showed a twofold higher frequency of side effects. Therefore, a clinical trial should be made comparing the effect of 500 micrograms/ml of THP and that of 1,000 micrograms/ml of ADM.

Prostate growth factor in the extracts of benign prostatic hypertrophy. Partial purification and physicochemical characterization.

The biochemical and physicochemical properties of prostate growth factor (PGF) in the extracts of benign prostatic hypertrophy (BPH) were investigated. The PGF activity stimulating the proliferations of fibroblasts (mouse 3T3 and human BUD-8 cells) was detected predominantly in BPH prostate, and also in normal human prostates and well-differentiated adenocarcinoma prostates. No significant correlation between PGF contents and BPH tissue weight or histological differences (fibromuscular or glandular type) was detected. Gel filtration and isoelectric focusing indicated that partially purified factor(s) by ion exchange column chromatography had a multimolecular form comprising three active components (80,000, 43,000 and 10,000 daltons) and acidic isoelectric points (pH 4.0, 4.3, and 6.0). The activity was susceptible to heat treatment at 80 degrees C for 10 min, and to trypsin, but the factor was devoid of esteropeptidase activity. Subcellular fractionation located the entire activity in cytosol fraction.

[A case of mixed gonadal dysgenesis with structural abnormalities of X chromosome (Xp+)].

An abnormal extra band on the short arm of the X chromosome was found in a 7-year-old reared as a female, of mixed gonadal dysgenesis. She had ambiguous external genitalia, scoliosis, short stature, mental retardation and motor paralysis of the limbs. Chromosomal analysis revealed the karyotype of 46,Xp+ Y. An uterus with fallopian tube, a streak gonad on the left side and a testicle on the right side were discovered at exploratory laparotomy. Bilateral gonads and fallopian tube were removed. The chromosomal analysis of her normal mother showed the presence of the same abnormal X chromosome (46, X Xp+). In the literature, we found some cases of intersexuality with Xp+ in karyotype. The relationship between our own case and these Xp+ cases was discussed briefly. Thirty-five cases of mixed gonadal dysgenesis have been reported in Japanese literature, our own case being the 36th case.

[A case of carcinoma of the bladder diverticulum].

Carcinoma of the bladder diverticulum is a relatively rare disease. However, its preoperative diagnosis is often difficult. Also, infiltration occurs easily because the diverticulum wall is thin, and prognosis is said to be relatively poor. Histologically, the occurrence rate of squamous cell carcinoma is markedly high. We have experienced a case of squamous cell carcinoma in the bladder diverticulum occurring simultaneously with transitional cell carcinoma of the bladder; and, report this case along with a review of the literature. The patient, a 79-year-old male, had sudden macroscopic hematuria on December 15, 1980, and went to the urology department of a separate hospital. IVU showed distortion of the right ureter, and the patient was referred to our hospital. Cystoscopy revealed a diverticulum in the right wall of the bladder. In the posterior wall of the bladder 2 papillary sessile tumors were also detected. Pathological diagnosis by cold punch biopsy done after the patient was admitted to hospital revealed a grade III transitional cell carcinoma. Total cystectomy + bilateral cutaneous ureterostomy was performed. The diverticulum was in the right wall of the bladder and a papillary sessile tumor with a diameter of 4 cm was found in the diverticulum. A papillary sessile tumor 2 cm in diameter was found in the left bladder wall. Histopathological diagnosis of the tumor in the diverticulum was squamous cell carcinoma ( pG2 , pT3b , ly1, v(-) INF beta) and that of the tumor in the bladder was transitional cell carcinoma ( ( pG3 , pT2 , ly1, v(-), INF gamma).(ABSTRACT TRUNCATED AT 250 WORDS)

Humoral immunity following double-freezing of the prostate in patients with prostatic cancer.

In these studies, 10 patients with a confirmed histological diagnosis of stage C and D carcinoma underwent double-freezing of the prostate. The clinical courses in the first group (five patients) were favorable. In the second group (two patients), death by cachexia occurred due to the cancer. In the third group (three patients), death 4 weeks after the second cryosurgery suggests the effects of cryoshock. In the first and second groups, the results of the immunological examinations after the second freezing did not attain the predicted levels. Comparing the results of the third group with those of the first and second groups the primary differences was that the percentages of gamma-globulins and IgE were higher in the third group preoperatively. These findings suggest that patients with high percentages of gamma-globulin and high IgE levels are contraindicated for cryosurgery of the prostate.

Chemotactic factors as cause of polyleukocyte urine in urinary tract infection: chemotactic activity of urinary protein fraction.

The possible cause of the excessive increase in the number of polymorphonuclear leukocytes in the urine of patients suffering from urinary tract infections was investigated in regard to the chemotactic factor(s) for the leukocyte. We separated urinary protein fractions of 2 controls and 10 patients with urinary tract infections by gel filtration on a Sephadex G-50 column, and tested chemotactic activity in vitro by using Boyden's apparatus and in vivo by injecting the protein fractions into guinea pig skins. Chemotactic activity was found in the urinary protein fractions of 6 patients. The fractions of these 6 patients showed typical infiltration of polymorphonuclear leukocytes in the local tissue of guinea pigs. A high correlation was found between the activity and the leukocyte increase, although there was no relation between the type of infecting bacteria and chemotactic activity. The data suggest that the marked increase in the number of urinary leukocytes is attributable to the chemotactic factor(s) in the urine.

Penile horn: verruca vulgaris.

A case report of penile horn is presented. It is a benign penile wart of uncertain pathogenesis characterized by excessive hypertrophy and cornification of the epithelium. Treatment consists of excision and/or application of bleomycin ointment.

Y-chromatin positive cells in the smear preparations of the gonad from a XX male.

An ambisexual male infant showed a normal female karyotype by the leukocyte culture technique in two different occasions. Cultured fibroblasts from the right gonad had also a 46, XX complement. They were Y-chromatin negative. To our surprise, Y-chromatin was observed in 96% of the nuclei in smears from the uncultured gonad. It is emphasized that the examination of the uncultured gonad by the quinacrine technique is mandatory in the study of "XX males".