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Biological behavior of prostatic cancer is influenced by different tumor factors. The proliferative activity of the malignancies could be one of those parameters which serve as basis to design therapy and to estimate prognosis. Here ploidity and S-phase fraction of 44 prostatic cancer obtained by radical prostatectomy were compared to other known tumor characteristics (PSA, staging, grading). There are correlations between the PSA concentration, grading, staging and S phase fraction. The ploidity correlates with the grading. Neither of kinetic parameter correlated with the nodal involvement.

The biological behavior of prostatic cancer is influenced by many host and tumor factors. The proliferative activity of the malignancies can be one of those parameters which serve as the basis to estimate prognosis and design treatment. Here, DNA content and S-phase fraction of prostatic cancer samples obtained by radical prostatectomy from 46 patients were related to other known tumor characteristics (PSA, staging, grading). Nuclei from the paraffin embedded materials were isolated with overnight trypsin-ribonuclease mixture digestion. DNA content and cell cycle distribution were determined by flow cytometry. A correlation was found between the PSA concentration, grading and staging on the one hand and S-phase fraction on the other. DNA content correlated with grading. No kinetic parameter correlated with the nodal involvement. Due to the association between abnormal DNA content plus SPF > 5% with advanced stage and less differentiated appearance of the tumor, we can conclude that these parameters are useful to estimate prognosis.

The authors performed radical prostatectomy on 35 prostate cancer patients between 1986 and 1991. At the end of 1993 the authors were informed about 25 patients. The mean follow-up was 4.4. years. Two patients have died in tumour related diseases, one in intercurrent diseases. In six patients progression was observed. Five patients had to operated because of anastomosis stricture. One patient was operated because of total incontinence another one uses penis clamp.

The authors compared the PSA levels in 19 patients who had undergone radical prostatectomy between 1986 and 1991. Measurements were done preoperatively, 3-4 weeks postoperatively and at the end of 1993. The increase of the average preoperative level corresponds to the stage of the disease (local, local advanced, metastatic lymph nodes). Patients with high preoperative PSA levels have a higher risk for progression, even if their postoperative PSA values are normal. While the predictive value of low PSA levels measured immediately after prostatectomy is small, high postoperative PSA levels are unfavourable prognostic signs.

The authors investigated the sensitivity and specificity of four methods: rectal digital examination, prostate specific antigen (PSA), prostatic acid phosphatase (PAP) and transrectal ultrasound in the diagnosis of 100 prostate cancer and 50 suffering in benign prostatic hypertrophy patients. In 21 patients the prostate cancer was proved by perineal punch biopsy and in 79 cases by biopsy and by TUR as well. Because of its simplicity the rectal investigation has to be first one, after that the PSA has to be determined. The specificity of transrectal ultrasound is low. The determination of PAP in addition of PSA is not necessary.

It is already a textbook item that in patients with prostatic cancer stage T1-T2 N0M0 radical prostatectomy is the only curative treatment. Radical prostatectomy is indicated also for patients in stage T3 N0M0 who underwent antiandrogenic (Fugerel) treatment for 3 months with the aim of reducing tumour volume. In the following 35 cases will be scrutinized, with special regard to preoperative staging and early postoperative complications.

The authors treated 42 BPH patients with the Sabal extract Strogen forte for 12 months. The obstructive symptoms, residual volume, mean and maximum flow rates improved significantly by the 6th therapeutic month at the latest. The results seem to prove the effectiveness of the drug. Side effects have not been observed.

The authors treated 23 benign prostatic hyperplasia (BPH) patients with antiandrogen flutamide. Half of the patients were treated with 500 mg, the another part with 750 mg flutamide for three months, and after 3 months brake again for 3 months. The decrease of the residual urine and an increase of the flow were observed. The subjective parameters were improved, too. In some patients side effects (gynecomastia, loss of appetite and potency) were observed. There was no different in the effect of the two doses.

Our 5-year experience with BCG in the tumor stage pTis, pTa and pT1, G I-II shows a lasting remission of 88.5% (73%) in 78 (26) patients treated with BCG preparation Pasteur (Connaught) after transurethral resection. A complete remission in patients with carcinoma in situ (12 patients) could be found in 92%. The local and systemic side-effects, which are of limited duration, are tolerable, well treatable and fully reversible.

Previous randomized studies have shown that in cases of superficial urothelial carcinoma or carcinoma in situ of the urinary bladder, complete and long-lasting remission can be obtained by immunotherapy with bacillus Calmette-Guérin (BCG). Such studies have shown that BCG reduces the recurrence rate significantly compared with transurethral resection alone. Our 6-year experience with BCG Pasteur strain (and Connaught strain, respectively) in tumour stages pTis, pTa and pT1 (G I-II) shows lasting remission in 88.5% (73%) of 78 (26) patients after transurethral resection of the tumour. A complete remission was found in 92% of patients with carcinoma in situ (12 patients). The local and the rare systemic side effects were all of limited duration, tolerable, easily treated and fully reversible.

The author compared the tumour markers of hundred virginell prostatic cancer patients. There were investigated the activity of prostatic acid phosphatase (SP) and its isoenzyme (SPP) by enzymatic method (PAP) as well. The concentration of prostatic specific antigen (PSA) was determined too. The sensibility of markers are growing on the row, SP, SPP, PAP, PSA. Summarising the results, the determination of PAP together with PSA seems to be not necessary. Because of the low price of SP, SPP their determinations is indicated in selected cases. Regarding of costs-benefit the author advises selected investigations in different stage and in different indications.

The authors measured serum prostate-specific antigen (PSA) and prostatic acid phosphatase concentration in histologically positive prostate hyperplastic and carcinomatous patients before, and 30-60 min and 24 h after prostate manipulation (rectal digital examination, cystoscopy and perineal punch biopsy). After rectal examination, PSA, and after other interventions, both markers changed significantly, although in different points of time and to a different extent. The authors call the attention to the importance of the point of time of the examination. Examination following prostate manipulation may result in wrong diagnosis or in erroneous therapeutic consequences in the follow-up period.

The authors investigated by conventional CT 66 urological tumorous patients before radical operations, and compared with the findings of the histological investigations of the lymph nodes removed by the lymphadenectomy. The coincidence between the two investigations were 80%.

A total of 71 prostatic tumour patients and 45 prostatic adenoma patients were tested for prostate-specific antigen (PSA), immunological prostatic acid phosphatase (PAP) concentration as well as serum prostatic phosphatase (SPP) and enzymic serum phosphatase. It was found among untreated patients that PSA showed the highest percentage of pathologic affection in each stage. PSA, on the evidence of clearance test in the initial days of therapy and after a follow-up period of several months, gave a good picture of the course that the disease had taken.

Zinc, calcium and sodium levels of the prostatic secretions in patients with prostatic adenoma were studied. In a control group of 20 patients, two samples of the secretion, taken on the first and the seventh day, were compared and found to show no difference. In the treated group of 20 patients, where a 7-day therapy of ERU (extractum radix urticae) followed upon the first sampling, the 7th-day specimen presented a significant drop in the Zn level. Correlation was found to exist between the Zn and Ca levels. From literary data the inference was drawn that ERU is producing a derangement in the zinc-testosterone metabolism and diminishes the zinc secretion in adenomatous tissue.

In two randomized patients groups suffering from benign prostatic hyperplasia (BPH) two exprimate samples were drawn at a seven-day interval. In the untreated control group no changes in the values of Ca, Na and Zn were found. In the other group the patients have been treated with ERU capsules (Radicis urticae) for 7 days and thereafter a significant decrease of Zn values were found.

The authors present the most typical forms of the prostatic cancer imaged by transrectal ultrasound. They compared the results of investigations of two tumor markers [prostatic specific antigen (PSA), prostatic acid phosphatase (PAP),] the transrectal ultrasound and the rectal palpation. The sensibility of PSA, the ultrasound and the digital investigation were almost the same. The valuability of the transrectal ultrasound investigation in the early diagnosis is limited, but important to determine the stage of the disease, monitoring the process, control of the proper treatment, and in some differential diagnostical problems of the prostate.

The authors carried out immunotherapy in bladder cancer patients in stage pTa-1 G1-2 NoMo. The strain Connaught BCG (120 mg) was instilled weekly for 6 consecutive weeks in 26 patients. Another 13 patients were treated with 150 mg BCG strain Pasteur. The patients were followed average 26 months in the first, 16 months in the second group. The recurring of the tumor were found in 26% and 15% as well. Side effects were experienced more often in the third group. The authors advice the BCG therapy of the superficial bladder cancer.

A case of schwannoma in a 55-year-old male patient is reviewed. The diagnostic difficulties are pointed out in view of the literature. Currently, it is still difficult to form a diagnosis without operation either by physical examination or by other diagnostic procedures. That is the authors' point in reviewing their case. The castrated patient has been well and free of complaints for 5 years after operation with no recurrence.

The hormone receptor concentrations in tumour tissues from 20 renal carcinoma patients were determined before postoperative medroxyprogesterone acetate (MPA) therapy was started. Except for glucocorticoid receptors, the concentrations were either not measurable or were extremely low. The question is whether MPA therapy, solely on the strength of its character as a general roborant, is still useful in the treatment of renal tumours, even when it fails to exercise primary influence because of the absence of suitable receptors. None of the 20 patients was treated with MPA.

The authors investigated the cellular immune reactivity by measuring the lymphocyte blast transformation, immune globulins and some glycoproteins in the sera of patients with papilloma and carcinoma of the bladder. They found a change in the cellular immune reactivity, but none in immune globulin concentration. Among the glycoproteins the acute phase reactant proteins changed significantly.

30 patients with renal tumours were treated with Depo-Provera (Medroxyprogesterone). Among the 21 patients operated on without metastases and with an parallel metastasis (fibrous capsule, adipose capsule, peritoneum) in the course of 6 to 15 months no one died of a tumour progression. Among the 9 patients with a distant metastasis in one case the regression of the metastasis could be achieved, whereas in another case progesterone stopped the progression of the intraoperatively observed liver metastasis.

The case of a 50-year-old female patient who had been passing "calculi" containing cholesterol for 10 years is presented. Previously, abdominal surgical interventions had been carried out several times and therefore a fistula between the digestive and urogenital system was suspected. This, however, could not be confirmed either by radiological or laboratory techniques. A II/a type of hyperlipoproteinemia was found in the serum, but its correlation to the calculi could be excluded.

Urinary hydroxproline concentrations were measured in 36 prostatic cancer patients. Metastases were ruled out by radiography in 24, and confirmed in 12 cases.14 patients with no malignant disease served as controls. In patients with no metastases excretion was similar to that in the controls, in some of them it was higher. In the patients with higher values the studies were repeated six months later: deposits were found in all cases but one. In the group in which deposits had been present at the outset the values of the untreated patients were significantly higher than in the controls, whereas in the treated patients no consistent values were found.

Responsiveness to recall antigens was studied by the use of Multitest-Merieux in 20 cases of kidney tumour with and without deposits. The patients of either group, compared with the controls, had depressed scores of immunoreactivity. After surgical removal of the tumour-bearing kidney, immunoreactivity increased, regardless of the presence or absence of deposits. The number of reacting antigens also increased in every case. Lymphocyte transformation in vitro was also depressed, in comparison with the controls before surgery, but after the intervention the transformed blast cells increased in number. Multitest was found suitable for studies of delayed-type sensitivity.

Blast-cell transformation of lymphocytes in response to phytohaemagglutinin was examined in patients with urologic tumours and with nonmalignant urologic processes. A significant depression of immune reactivity was found in the malignant cases. The practical aspects of the findings are discussed.

A total of 30 patients with renal tumours were started on Depo-Provera (medroxyprogesterone) in December 1981 and followed up for 17 to 44 months. The survivors were checked in July 1985. In 2 of the 13 metastasis-free patients deposits of lethal outcome had formed, survival time averaging 27 months. One of the 8 patients with local metastases had died of renal tumour, average survival time being 26 months. Among the 9 patients with distant metastases there are 2 with survival times of 42 and 44 months, respectively. The liver metastases confirmed by ultrasonography in the first, and in the vena cava in the second case at the time of surgery are no longer demonstrable. Survival time in the last-named group averages 14.5 months.

This report on urological diagnostic is based on more than thousand ultrasonography scans. A set shows the most evident pathological situations in relation to the most evident complaints. The immense possibilities of ultrasound scan in urology are demonstrated through examples and the sense of the scan is discussed. Because there is no harm it is recommended that the ultrasound diagnostic should be used at the beginning of the diagnostic procedures.

We like to discuss the comment of our clinic: In case of an acute stone-conditioned renal blockage complicated by fever we immediately perform a decompression by means of elevation of the ureter catheter and the antibiotic therapy. A shivering attack accompanied by fever we regard as a threatening sign of pyelonephritis apostematosa and possibly after the first or second shivering attack we perform an opening. Apart from emphasizing the importance of the shivering attack we still might refer to the fact that for the establishment of the therapy of choice the complex evaluation of the clinical picture is necessary.

The authors describe a spectrographic method for the determination of zinc in solid matter. This method may be used to determine semiquantitatively the zinc-content of prostatic tissue. It has been found by this method that the ash from neoplastic prostatic tissue contained less zinc than that from adenomatous prostatic tissue.

Six cases of testicular torsion treated in the last 15 years are described and attention is drawn to the importance of thorough examination and early treatment.

By means of mathematical calculations the authors tried to find correlations between the clinical and histological stages of vesical tumours and the results of immunological tests. Density calculation showed what parameters follow the degrees of malignity. Moreover the significance of the chain and basic proportional factors of the parameters calculated for diagnosis and follow-up is pointed out.

A total of 25 patients with bladder tumour and 35 with prostatic tumour were tested for humoral and cellular immune responsiveness in 1977. Information on the subsequent course of disease was collected 5 years later and confronted with the results of these tests. The most marked deviations in the values of acute-phase proteins, complement and lymphocyte transformation tests were found in those patients who had died within the first year of the investigations. The results approached or attained the normal values parallel with the survival times. The parameters studied thus seem to lend themselves to diagnostic and monitoring purposes.

Thirty patients with prostatic hyperplasia stages I and II were administered Bazoton capsules (extract of Radix Urticae) for an average period of 3.5 months. Residual urine, mean and maximal flow were measured before and after treatment. A significant decrease in the volume of residual urine was found. Increase in mean urinary flow was also significant. Maximal urinary flow increased in 50% of the cases. A marked subjective relief was reported by the patients. Bazoton is regarded as suitable for the conservative treatment of prostatic hyperplasia stages I and II.

Ten patients who had undergone repeated surgical interventions for bladder papilloma with successive recurrences within intervals of a few months, were given levamisol in weekly doses of 300 mg over a year, and were followed up for various cellular immune reactions, as well as for serum globulin and for acute-phase protein concentrations in the course of treatment. Levamisol was found to act primarily on cell-borne responsiveness. The recurrence-free intervals increased in the course of treatment. Four patients have remained free from recurrences since the start of treatment.

Twenty-five patients suffering from acute painful testicular processes were subjected to scintigraphy. Testicular torsion in the early and delayed phases were diagnosed with 100% accuracy, but one out of 7 cases of epididymitis was wrongly recognized as negative. Interoperative diagnosis in two cases of hydatid torsion proved the foregoing scintigraphic finding to have been wrong. Nevertheless, scintigraphy was found to be reliable in testicular torsion diagnosis.

The serum and urine hydroxyproline levels of patients with prostatic cancer were regularly studied for 30 months. Bone metastases were found in 4 patients at the beginning of the study; metastases formed in 8 patients during the test period, and in 9 patients no metastases formed during the study. At the time of X-ray diagnosis of metastasis, significantly higher serum and urine hydroxyproline levels and enzymatic phosphatase were found, but in the tests performed 3 months earlier, in spite of the negative X-ray results, the hydroxyproline results differed significantly from the reference values. The above findings support the use of the hydroxyproline test for the diagnosis of metastases.

The authors examined the cellular and humoral immune reactivity in patients with carcinomas of the prostate gland and determined several glycoproteins. The blastic transformation of lymphocytes was found significantly decreased. However, the concentrations of the immune globulins were not changed. Significantly changes were the glycoproteins belonging to the group of the "acute phase reactant proteins" and the complement titre in the serum. On account of the decreased immune reactivity the authors propose an immune therapy in the carcinoma of the prostate gland.

The authors report on a malignant schwannoma originating in the capsule of the right kidney. By sonography, nephroangiography, cavography, computer tomography and bone scanning, metastases in the kidney or a retroperitoneal tumor could be diagnosed. After transperitoneal exploration, the right kidney and mesenteric metastases were removed. Due to tumor infiltration into the liver and tumor masses in the retroperitoneum, we confined our operation to nephrectomy and palliative excision of retroperitoneal metastases. The patient developed pulmonary metastases postoperatively and died three months after the operation.

After a brief review of the pertaining literature, the case of a 63 year old male patient with a histologically confirmed mesothelioma starting from the tunica vaginalis of the testis is described. The rare tumour developed after an injury of the testis suffered 15 years earlier.

The authors investigated 71 prostatic cancer patients and 45 BPH patients. The serum concentration of prostatic specific antigen (PSA), the prostatic acid phosphatase (PAP) by radio-immunoassay, the same enzyme (SPP) and the total acid phosphatase (SP) by enzymatic method were determined. In the untreated cancer patients the PSA concentration proved to be pathological in a higher proportion in all stage groups comparing to the results of the PAP, SPP, SP. The clearing of the PSA and PAP concentration on the following days and months after the beginning of the therapy reflects the excellent monitoring capability of the PSA determination. This was demonstrated by several cases too. The authors suggest more frequent use of this method in clinical practice.