Effect of oral clodronate on bone pain. A controlled study in patients with metastic prostatic cancer.

Although osteosclerotic metastases are characteristic of prostatic carcinoma, bone resorption is also accelerated. Since clodronate inhibits bone resorption and relieves bone pain, we have given it to patients with painful bone disease from prostatic cancer after failure of hormonal therapy. All patients received estramustine phosphate orally. Simultaneously they were randomly allocated to clodronate (36) and placebo (39) groups. Clodronate was given by mouth. The dose was 3.2 g for the first month, thereafter 1.6 g. Pain relief was more distinct in the clodronate group where one third of patients were totally free of bone pain. The use of analgesics stopped in 38% of patients on clodronate and in 18% on placebo which effect probably belongs to estramustine phosphate. Serum calcium concentration decreased more markedly in the clodronate group. Clodronate dose of 3.2 g seemed to be more potent than that of 1.6 g. Side effects were uncommon and occurred equally in both groups. No significant differences were seen in median survival or survival rates between the groups.

Intravesical epirubicin with and without verapamil for the prophylaxis of superficial bladder tumours.

Seventy-five patients with recurrent bladder carcinoma were randomized after electroresection to receive either epirubicin (E) or epirubicin + verapamil (E + V) instillation of the bladder at regular intervals for 2 years. Samples of the bladder wall, tumour tissue and peripheral blood were taken from 20 patients. The average follow-up period was 21 months. Fifty per cent of the patients in the E group and 37% in the E + V group developed recurrent tumours. Recurrence rates (RR) were 6.3 and 4.7, respectively. Before the instillation therapy the RR was 16.0. There was a highly significant reduction of RR during the instillation therapies; in group E p less than 0.005 and in group E + V p less than 0.001. The difference between the treatment groups was not statistically significant. Verapamil increased epirubicin concentrations in both the bladder wall and the tumour tissue, but did not affect concentrations in the peripheral blood. Side effects were few and did not lead to discontinuation of treatment.

Renal cell carcinoma in horseshoe kidney associated with Turner syndrome and caval extension.

The first case of renal cell carcinoma in a horseshoe kidney associated with Turner syndrome is reported. Therapeutic and diagnostic aspects are discussed; the literature is reviewed.

[Doxycycline levels in serum and pulmonary tissue. Intravenous application of doxycycline in pulmonary surgery (author's transl)]. / Doxycyclin-Konzentrationen in Serum und Lungengewebe. Die intravenöse Anwendung von Doxycyclin in der Pulmonalchirurgie

Doxycycline levels were measured fluorimetrically in the serum and pulmonary tissue of 36 patients undergoing a pulmonary operation. Doxycycline 200 mg was given intravenously 20 hours before operation. The doxycycline concentration in pulmonary tissue (1.03 to 12.30 mug/g) were as high or higher than the serum doxycycline levels (0.94 to 7.82 mug/ml) in the majority of cases. This is possible as the lung has an ample blood supply and doxycycline is a lipophilic drug. There were large variations in the results, which was probably related to the underlying illness and to an altered blood circulation. The side effects were minimal. The daily infusions of doxycycline were continued over 5 days, no conclusions could be drawn about its possible prophylactic effect on postoperative infections.

Blood alcohol levels in injury victims at the emergency station of a rural central hospital.

Blood alcohol was determined in 182 consecutive adult injury victims at the emergency station of a rural central hospital during a fortnight in March 1974. In 30% of them alcohol was found in the blood. The percentage was 38 in males and 15 in females. No significant differences in alcohol involvement (AI) between social classes were noted. During the night 62% of the patients had ingested alcohol. The injuries on Saturdays were more often alcohol-involved (54%) than on other days of the week (26%). AI was very frequent (86%) in the victims of fights, assaults, and suicide attempts, while it was only rarely (9%) seen in industrial accidents. AI was clinically detected in 72% of the cases with positive blood alcohol concentrations. It can be concluded from the results of this and other studies referred to, that the AI rate for fresh injuries of adults at the Pinnish emergency stations was about 30-35%.