Endorectal ultrasonography for the assessment of rectal wall invasion in intrapelvic tumor: a preliminary report.

BACKGROUND: The purpose of the present study was to determine the usefulness of endorectal ultrasonography (ERUS) in assessing rectal wall involvement in intrapelvic tumors. METHODS: Rectal wall invasion was assessed in 16 patients; 14 with deeply invasive bladder tumors, one with prostatic leiomyosarcoma, and one with prostatic leiomyoma. Computed tomography (CT), magnetic resonance (MR) imaging and ERUS with a flexible-type radial scanner (7.5 MHz) were used and the results were compared with the histopathologic findings in surgical specimens. RESULTS: The normal rectum was shown by ERUS to be a five- or seven-layer structure. Characteristic abnormal ERUS findings included disappearance of the perirectal fat tissue layer with or without disruption of the propria muscle layer. Endorectal ultrasonography accurately assessed rectal wall involvement in all four patients who had two bladder tumors, plus the one patient with prostatic leiomyoma and the one with prostatic leiomyosarcoma. However, ERUS overstaged one of 12 bladder tumors with no rectal wall involvement, which was strongly adhesive to the rectum because of an inflammatory change but had no tumor invasion. There were no cases of understaging by ERUS. In comparison, CT accurately assessed rectal wall involvement in two patients, but overstaged in three and understaged in two. Magnetic resonance imaging, which was performed in 14 patients, accurately assessed rectal wall involvement in two patients, but overstaged in three and understaged in one. CONCLUSION: This preliminary study suggests that ERUS more accurately assesses rectal wall involvement in intrapelvic tumor than CT or MRI.

Multidisciplinary treatment, including laser hyperthermia, for extensive regional metastasis of a penile tumor.

BACKGROUND: There is no reliable treatment for penile tumor with lymph node metastasis. METHODS: We report on a patient with a penile tumor with extensive regional metastasis that was successfully managed with combined laser hyperthermia, radiation and chemotherapy. RESULTS: The patient has survived more than 7 years without evidence of disease. CONCLUSIONS: Multidisciplinary treatment, including laser hyperthermia, may be useful for the treatment of regional metastasis of penile tumor.

[Antitumor activity of UFT and interferon-alpha against human renal cell carcinoma in athymic nude mice].

We examined whether a combined use of UFT with interferon against human KDR-1 strain cells was effective or not. KDR-1 strain derived from the patient with renal cell carcinoma was transplanted into nude mice. When the tumor grew large enough, the mice were divided into 4 groups. The group consisted of 1) oral use of 5% Acasia as a control, 2) oral administration of UFT, 3) combined use of UFT and IFN-alpha, 4) intraperitoneal injection of IFN. Each group was treated continuously for 16 days. Antitumor effect was not observed in group 2 and 4, but observed in group 3. The concentration of UFT in the tumor tissue did not show any differences between combination and UFT groups. Therefore, there is no evidence to prove that IFN-alpha makes UFT level higher. Antitumor effect was observed histopathologically in the combined regimen group, although a mechanism of synergistic effect is still unknown.

[Bacterial and clinical studies on imipenem/cilastatin sodium in urological infection].

Antibacterial activities of imipenem (MK-0787), cefazolin (CEZ), cefmenoxime (CMX) and cefoperazone (CPZ) were measured by using an agar dilution method against 243 strains of bacteria isolated from the patients with urinary tract infections. The MIC80 of MK-0787 against S. epidermidis, E. faecalis, E. coli, K. pneumoniae, E. cloacae, S. marcescens, P. mirabilis, P. vulgaris and P. aeruginosa was less than or equal to 0.10, 3.13, less than or equal to 0.10, 0.20, 0.78, 1.56, 3.13, 3.13 and 6.25 micrograms/ml, respectively. MK-0787 was more active than CEZ, CMX and CPZ against all bacterial species except Proteus spp. Imipenem/cilastatin sodium (MK-0787/MK-0791) 500 mg/500 mg two times a day for 5 days was given to 31 cases of chronic complicated urinary tract infections and a case of acute prostatitis. Overall clinical effectiveness rate judged by the criteria proposed by the Japanese UTI committee in 22 cases of chronic complicated urinary tract infection treated with MK-0787/MK-0791 was evaluated to be 86% including excellent in 6 cases, moderate in 13 cases and poor in 3 cases. As side effects, 2 cases encountered eruption or anorexia. Abnormal laboratory findings were observed in 6 cases.