[Clinico-statistical study on tuberculous peritonitis and genital tuberculosis in elderly women].

We clinico-statistically studied 8 patients (0.77%) with tuberculous peritonitis (3 cases) and tuberculous endometritis (5 cases) aged 50 or older who visited our gynecological clinic for 6 years from July, 1986 to June, 1992 in Tokyo Metropolitan Tama Geriatric Hospital. The mean age was 72 years with a range of 52 to 82 years. Five cases with tuberculous endometritis were diagnosed based on the findings of endometrial cytology and bacteriology, and the incidence was 0.93% of 535 cases in which the uterine cavity could be examined. Three cases with tuberculous peritonitis were strongly suspected by the ascitic findings (cytology and adenosine deaminase level), and culture of ascitic fluid for acid-fast bacilli was positive in 2 of the three cases. Another case with negative culture was diagnosed based on the marked improvement of clinical findings and symptoms during chemotherapy for tuberculosis. No cases were complicated by active lung tuberculosis. All cases had a family and/or past history of pulmonary tuberculosis. The PPD skin test was positive in 7 of the 8 cases. In all cases, the clinical laboratory data and symptoms were markedly improved by chemotherapy for tuberculosis. Endometrial cytology and transvaginal ultrasonography were very effective methods for the diagnosis of tuberculous endometritis and peritonitis associated with ascites.

[Effects of cepharanthin on leukopenia and thrombocytopenia caused by CDDP-ACR-CPA therapy of ovarian cancer].

Effects of cepharanthin (50 mg/day, i.v.) an alkaloid of bis-coclaurin type, were studied on leucopenia and thrombocytopenia caused by CDDP-ACR-CPA (CAP) therapy against ovarian cancer. The study was carried out with 44 therapy courses on 17 patients of ovarian cancer receiving CAP administration. Nineteen of the 44 courescin loaded cepharanthin. The minimum number of leucocytes was found on 15.2 +/- 4.4 and 17.2 +/- 2.1 days after CAP-administration with and without cepharanthin, respectively. Leucocyte count 21 days after CAP-administration compared to that before the administration were 90.1 and 56.8% in cepharanthin and non-cepharanthin groups, respectively, which indicate a significant difference (p less than 0.05). As to the platelet count, cepharanthin group also showed attendant toward earlier recovery of thrombocytopenia than non-cepharanthin group. We conclude that the administration of cepharanthin during CAP therapy promotes the recovery from leucopenia and thrombocytopenia.

[Laser vaporization and incisional conization in cervical neoplasia as a conservative therapy].

We performed laser therapy for cervical neoplasia as a conservative therapy. Our materials were 202 cases (dysplasia-166, carcinoma in situ-36) treated by laser vaporization and 31 cases (dysplasia-7, CIS-7, questionable microinvasive cancer-17) by laser incisional conization. In addition to CO2 laser, we developed YAG laser and YAG/CO2 coaxial simultaneous laser for laser vaporization. On the other hand, we applied YAG laser for incisional conization with an attached laser rod (made of new ceramics) for use on an outpatient basis without anesthesia. Total cure rate after first treatment with laser vaporization was 93.0% (dysplasia 93.3%, CIS-91.7%). Pathological examination of the cone specimen revealed 8 cases of invasion (Ia stage-7, Ib stage-1). No abnormal findings could be found in follow-up cases. Complications were minimal in all cases. We thus demonstrated that simple and individualized management was possible for cervical neoplasia by applying either of these new methods.

[Intraperitoneal and intrapleural two channel chemotherapy by cisplatinum (DDP) and sodium thiosulfate for the treatment of ovarian cancer].

We administrated cis-platinum 70-100 mg/m2 bolus, intraperitoneally or intrapleurally without diluting in saline, simultaneously combined with intravenous injection of sodium thiosulphate 1 gr/hr for 12 hours continuously or additional loading of sodium thiosulphate 4-6 g bolus on the initiation. The procedure does not require transfusion of specific hydration and keeps urine volume at a certain level, much less diuretics. For the treatment of 6 gynecological malignancies (2 primary ovarian carcinoma, 1 recurrent ovarian carcinoma, 1 pseudomyxoma peritonei, 1 clear cell carcinoma of cul de sac and 1 metastatic pleuritis carcinomatosa due to uterine cervical carcinoma) 12 courses treatments have been performed, without inducing nephrotoxicity except mild vomiting. All six cases are evaluable for efficacy according to Saito-Koyama criteria at this time: 4 CRs including 2 CRs for ascites and pleural effusion, 1 NC and 1 PD. This Two-Channel Chemotherapy (TCC) seems to be an important modality of chemotherapy for ovarian carcinoma in future.