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The authors present a case of sclerosing hemangioma of the lung in which MRI was performed. The tumor had areas of various signal intensities on both T1- and T2-weighted images, including high-intensity areas and isointensity areas relative to muscle. We compared the signal intensity of the tumor with its pathological findings. The relatively high signal intensity of the tumor on T1-weighted images was thought to be a reflection of lipids of clear cells, and the isointensity relative to muscle on T1-weighted images to be a reflection of fibrosis. Hyperintensity was also seen on both T1- and T2-weighted images, and was intralesional hemorrhage. Use of Gd-DTPA strongly enhanced the tumor. This enhancement was thought to be abundant blood cavities, since not many capillaries were seen in the specimen. The signal intensity of the tumor corresponded closely to the pathognomonic findings, and it is thought that MRI may be helpful in diagnosing sclerosing hemangioma of the lung because of its high contrast resolution.

The efficacy, safety and usefulness of S6472 capsules (cefaclor, long-acting preparation) were investigated in non-catheterized patients with complicated cystitis using the double blind method with S6472 granules as a control. Each of the patients was orally administrated with 375 mg of the drug twice a day for 7 days, and clinical effectiveness was evaluated according to the Criteria of Drug Efficacy of UTI (the Third Edition). The following results were obtained. 1. There was no significant bias between the capsule-administrated group (A) and the granule-administrated group (B) in background factors. 2. The overall clinical efficacy rates were 78.7% in Group A and 80.5% in Group B, which showed no significant difference. No significant difference was observed also between groups IV and VI in the efficacy for any of the UTI groups. 3. Eradication rates in bacteriological response were 85.9% and 86.0% in Group A and B, respectively. 4. Clinical efficacy rates evaluated according to doctors in charge of patients were 78.7% and 74.7% in Group A and B, respectively, showing no significant difference between the two groups. 5. The incidences of adverse reactions were 3.0% in Group A (3 out of 101 cases) and 7.1% in Group B (7 out of 98), thus no significant difference was found between the two groups. Abnormal test values in laboratory examinations included 5 cases (in 4 among 75 patients) in Group A, but were not detected in any of the 76 patients in Group B. No statistically significant difference were observed between the two groups, however. 6. No significant difference between the two groups was observed in the usefulness evaluation including efficacy and safety profiles on an analog scale by the doctors in charge of patients. These results indicate that S6472 capsules have the same efficacy, safety and usefulness as S6472 granules, suggesting that both drugs are equally excellent for non-catheterized patients with complicated cystitis.

A 62-year-old man presented in 1987 with hematospermia. No abnormal findings were observed by cystourethroscopy. Ultrasound showed the enlargement of the right seminal vesicle. The right seminal vesicle could not be visualized by seminal vesiculography. Computed tomographic scan revealed a homogeneous mass at the right dorsolateral aspect of the prostate. Surgical exploration was performed. The prostate and bilateral seminal vesicle were resected. Pathological diagnosis was adenomyosis of the right seminal vesicle.

For an objective evaluation of the clinical efficacy, safety and usefulness of S 6472 (a long acting cefaclor) in non-catheterized patients with complicated urinary tract infections, a double-blind comparative study was performed using conventional cefaclor preparation (hereafter, CCL) as the control drug. S 6472 was administered orally at a single dose of 750 mg twice daily, and CCL at a single dose of 500 mg 3 time daily. The duration of the treatment was 5 days for either drug. Clinical efficacies were evaluated according to the criteria for evaluation of drug efficacy by the Japanese UTI Committee (3rd edition), and the following results were obtained. 1. The initial distribution of the patients' background characteristics was not significantly different between the S 6472 and CCL groups. 2. The overall clinical efficacy rates were 76.2% in the S 6472 group and 75.5% in the CCL group, indicating no significant difference between the 2 groups. When clinical efficacies evaluated according to different types of infections (UTI groups), the differences between the 2 drug groups were not significant in any of disease groups 2, 3, 4, and 6. 3. Clinical efficacy rates as evaluated by attending physicians were not significantly different between the 2 groups, either. 4. Bacteriological responses were evaluated as eradicated in 81.2% in the S 6472 group and 78.3% in the CCL group, suggesting no statistically significant difference. 5. The incidences of side effects were 2.9% (4/139) in the S 6472 group and 0.7% (1/141) in the CCL group, thus no significant differences existed between the 2 groups. On laboratory examination, 4 and 5 abnormal test values, respectively, were detected in 3/94 patients in the S 6472 group and 5/100 patients in the CCL group, but the difference was not significant between the 2 groups, either. All of these side effect symptoms and abnormal laboratory test values were mild in severity and transient. The results of the overall safety rating which was based on the evaluations of the side effects and laboratory test values indicated no significant difference between the 2 groups. 6. According to judgement by the attending doctors, the clinical usefulness rates evaluated based on the results of the efficacy and safety ratings were not significantly different between the S 6472 and CCL groups. These findings suggest that S 6472 produces excellent therapeutic results in complicated UTI patients without indwelling catheters and its clinical efficacy, safety, and usefulness are equal to those of the conventional CCL.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical studies on S 6472, a longer lasting preparation of cefaclor (CCL), were performed and the following results were obtained. S 6472 was administered orally to 102 patients with urinary tract infections including 16 with acute uncomplicated pyelonephritis, 32 with acute uncomplicated cystitis, 31 with complicated pyelonephritis and 23 with complicated cystitis. 95 patients were treated with 375 mg of S 6472 2 times daily and 7 patients were treated with 750 mg of S 6472 2 times daily. The overall clinical efficacy was evaluated on the basis of the criteria proposed by the Japanese UTI Committee. 1. Clinical efficacies in 11 cases of acute uncomplicated pyelonephritis were excellent in 10 and moderate in 1, with an overall efficacy rate of 100%. Bacteriologically, all 12 strains identified in the acute uncomplicated pyelonephritis cases were eradicated, with an eradication rate of 100%. 2. Clinical efficacies in 21 cases of acute uncomplicated cystitis were excellent in 17, moderate in 3 and poor in 1, with an overall efficacy rate of 95%. As to bacteriological responses, 22 strains identified in the acute uncomplicated cystitis cases (except 1 of Escherichia coli) were eradicated, with an eradication rate of 95%. 3. Clinical responses in 43 cases of complicated urinary tract infections were excellent in 20, moderate in 15 and poor in 8, with an overall efficacy rate of 81%. Bacteriologically, 39 strains, including only one strain of P. aeruginosa, in the complicated urinary tract infection cases (except 4 of E. coli, 1 of Klebsiella pneumoniae, 1 of Enterococcus faecalis and 2 of Enterobacter cloacae) were eradicated, with an eradication rate of 83%. As side effects, slight stomatitis and gastric discomfort were noted in 1 patient each but we were able to continue the medication. Abnormal laboratory test values found were: 1 case of a slight and transient increase of lymphocytes in peripheral blood and 1 case of a slight and transient increase of serum creatinine level.

Recent understanding of the pathogenicity of haemorrhagic tendency as well as advance of management of patients with this disease makes its surgical treatment possible. Since 1979 we have experienced three male patients with haemorrhagic tendency. The first case was a bladder carcinoma with hemophilia A. He had been given 2500 unit of Conco-eight (coagulation factor VIII) before transurethral resection of bladder tumor (TUR-Bt) and was given 1000 unit of Conco-eight every eight to twelve hours for seven days postoperatively. The second case was a bladder carcinoma with von Willebrand disease. This case was also pretreated by Conco-eight before operation and we had difficulty in controlling his coagulopathy for one month postoperatively. The third case was a benign prostatic hypertrophy with idiopathic thrombocytopenic purpura (ITP). He had been given a huge dose of gamma globulin for six days before operation and on the operation day his platelet count was normalized. Since his prostate was estimated to weight over 70 g, suprapubic prostatectomy was selected. All these three cases were operated uneventfully. From this experience we believe that with proper preoperative and postoperative management, patients with haemorrhagic tendency can be operated safely.

The comparative efficacy of pivmecillinam and amoxycillin in 243 patients with acute simple cystitis was determined in a randomized double-blind trial. Pivmecillinam was found to be significantly more effective on both clinical and bacteriological grounds. The superiority of pivmecillinam was primarily due to its efficacy in infections due to ampicillin resistant Escherichia coli. Fewer side effects were reported in patients who received pivmecillinam.

Cefmenoxime (2 g) and cefsulodin (1 g) were given twice daily for 5 days by concomitant intravenous drip infusion (mixed infusion) to 135 patients with complicated urinary tract infection (c-UTI) probably caused by Pseudomonas aeruginosa. The clinical efficacy was evaluated according to the criteria proposed by the UTI committee in Japan. Ninety one subjects met the criteria for c-UTI and were evaluable for drug efficacy. P. aeruginosa was detected in 44 cases (including mixed infection with other organisms). The overall efficacy rate was 73% of the 91 cases; 75% of the 44 cases with P. aeruginosa and 70% in the 47 cases without P. aeruginosa infection. As to bacteriological response, the eradication rate was 91% (105/116) for all cases. By organism, the eradication rate for P. aeruginosa, Serratia spp. and Citrobacter spp. were 82 (36/44), 100 (12/12) and 100% (10/10), respectively. The eradication rate for gram-negative rods was 93% (99/107). Twenty-three strains appeared after treatment, and the majority of them (13) were yeast-like organisms. There was only one strain of P. aeruginosa. As for side effects, eruption was found in 2 cases. Cefmenoxime and cefsulodin were administered concomitantly to patients with c-UTI which was suspected to be caused by P. aeruginosa. The high overall efficacy rate of about 70% on the average was obtained regardless of the causative organism and disease state. The eradication rate of as high as about 90% was obtained excluding Enterococcus faecalis. Neither severe side effects nor abnormal laboratory values were found. It appeared, therefore, that this dosage regimen was useful for the treatment of refractory complicated urinary tract infection.

This is a report of two cases of a fistula between the urinary and gastrointestinal tracts. One case was a 56-year-old female patient with a right pyeloduodenal fistula, and the other was a 38-year-old female with a left ureterodescending colon fistula. The chief complaint was right lumbago in the first case, and fever and left lumbago in the second case. Both cases were diagnosed by retrograde pyelography. In both cases, the ailing kidney appeared to be non-functioning, and the former was operated by nephrectomy, fistulectomy, and duodenectomy in the cuneate form, while the latter was operated by nephrectomy and fistulectomy. The cause of the formation of the fistula was considered to be chronic pyelonephritis accompanied by renal stones in the first case, and rupture of the colon diverticulitis in the second case. Postoperative prognosis was satisfactory in both cases.

In 17 post-operative patients, serum and operation cavity exudate levels after 2 g administration of various cephems (CZX, LMOX, CTX, and CPZ) by one hour drip infusion were evaluated. Drug concentration in exudate (actual levels) was corrected by using an equation for the purpose of excluding blood contamination. After 2 hours from the start of infusion, theoretical levels generally were similar to actual levels. CZX: Peak exudate level was 38.9 micrograms/ml at 4 hours. Maximum exudate level/maximum serum level (E/S) was 0.31. LMOX: Peak in exudate was 41.4 micrograms/ml at 4 hours. E/S was 0.59. CTX: Exudate peak level was 30.8 micrograms/ml at 2 hours, and E/S was 0.53. CPZ: Peak level in exudate was 74.0 micrograms/ml at 4 hours. E/S was 0.36. Generally, peaks occurred at 4 hours (3 hours later than serum peaks), and their range was between 30 and 80 micrograms/ml. At 8 hours, drug levels in exudate were 10 approximately 60 micrograms/ml, and they were higher than the corresponding serum level at that time.

To objectively evaluate the efficacy, safety and utility of lomefloxacin (NY-198), a new quinolone antibacterial agent, in the treatment of acute uncomplicated cystitis, a comparative double blind trial was performed using norfloxacin (NFLX) as the control drug. In both groups, the drug was orally administered after meals for 3 days in a dose of 100 mg t.i.d. and clinical efficacies were assessed on the 3rd day (the 1st assessment) according to the criteria by the UTI Committee in Japan. Subsequently, either the active drug (NY-198 or NFLX) or placebo was administered for 4 days and the 2nd assessment was performed on the 7th day. Further, in patients who showed excellent responses at the 2nd assessment, recurrence was examined on the 14th day (the 3rd assessment) and on around the 21st day (the 4th assessment) following a subsequent 7-day placebo treatment. 1. A total of 258 patients was treated, and among them clinical efficacies were evaluable in 207 patients (NY-198: 106, NFLX: 101) at the 1st assessment, and in 176 patients (NY-198-NY-198 which was the combination of the 1st and 2nd administrations: 47, NY-198-placebo: 43, NFLX-NFLX: 44, NFLX-placebo: 42). 2. In the evaluation of overall clinical efficacy by the committee at the 1st assessment, the overall efficacy rates in the NY-198 group and the NFLX group were 76.4% and 64.4% (excellent), respectively, or 100% and 99.0% (excellent and good), respectively. There was no statistically significant difference between the 2 groups. In the 1st assessment on effects of drugs on pain at micturition, pyuria and bacteriuria and on bacteriological response, no significant differences were observed between the 2 groups. 3. In the 2nd assessment by the committee, there were statistically significant differences among the 4 groups in the overall clinical efficacies and the effects on bacteriuria (P less than 0.05). No difference was observed between NY-198 group and NFLX group, but the groups administered with active drug for 7 days, i.e. NY-198-NY-198 group and NFLX-NFLX group were significantly superior to the groups administered with active drug for 3 days and placebo for subsequent 4 days, i.e. NY-198-placebo group and NFLX-placebo group (P less than 0.05). There were no differences in the effects on pain at micturition and pyuria among the 4 groups.(ABSTRACT TRUNCATED AT 400 WORDS)

To objectively evaluated the usefulness of the standard formulation of cefaclor (CCL) and the long-acting formulation of cefaclor (S6472) in noncatheterized complicated urinary tract infection (UTI), a double-blind comparison study was carried out using cephalexin (CEX) as a control. Patients were orally treated with either 500 mg of CCL 3 times/day, 750 mg of S6472 2 times/day, or 500 mg of CEX 4 times/day for 14 days. Overall clinical effect was evaluated on days 5 and 14 in accordance with the UTI therapeutic evaluation standard, with check for recurrence on day 21. There was no demographic difference between the groups. There was no difference in the effective rate on day 5 among the 3 treatment groups: 58.1% in S6472 group, 66.0% in CCL group and 61.9% in CEX group. Nor on day 14, was there any significant difference in the effective rate among the 3 groups: 70.8% in S6472 group, 63.4% in CCL group and 61.8% in CEX group. Stratification analyses (by UTI group, infection site, in- or out-patient, time of starting treatment, pretreatment severity of pyuria, total number of bacteria before treatment) revealed no significant difference among the 3 groups. Therapeutic effect evaluated by physicians in charge was not significantly different among the 3 groups on day 5 or day 14. In terms of overall therapeutic effect, all 3 products were very effective in patients infected with sensitive bacteria: On day 5, 85.4% in S6472 group, 84.4% in CCL group, and 83.7% in CEX group. There was no significant difference among the 3 groups on either day. The incidence of side effects was not significantly different among the 3 groups: 4 out of 129 patients treated with S6472 (3.1%), 2 of 131 treated with CCL (1.5%) and 2 of 128 with CEX (1.6%). Clinical laboratory tests revealed 4 abnormal findings in 4 patients treated with S6472, 6 findings in 4 treated with CCL, and 4 findings in 2 treated with CEX, showing no significant difference in incidence among the 3 groups. Both side effects and abnormal clinical laboratory findings were mild and reversible. Physicians in charge judged the usefulness of the 3 drugs on days 5 and 14, taking efficacy and safety into consideration. Significant difference was not observed. The presence of recurrence was examined 7 days after drug withdrawal in patients regarded as remarkable responders to 14-day treatment by overall therapeutic effect evaluation.(ABSTRACT TRUNCATED AT 400 WORDS)

This is a report of a case of poorly differentiated adenocarcinoma found 20 years after bladder augmentation ileoplasty. The origin of this tumor was proved to be the ileal part of bladder augmentation. Autopsy revealed metastatic lesions in the stoma (sigmoid conduit), lungs, liver, left femur, adrenal glands and lymph nodes. A review of the literature revealed only one other such case. This is a rare case of adenocarcinoma in the ileal part of bladder augmentation.

The criteria for clinical evaluation of the efficacy of antimicrobial agents on prostatitis were proposed. Nomenclatural definition, specifications of patients and criteria were as follows. Acute prostatitis: Target infection is acute bacterial prostatitis with no underlying condition in urinary tract. The findings of swelling and tenderness of prostate by rectal examination are essential. The patients are between 16 and 69 years old. They have fever greater than 37 degrees C and pain on micturition. Microscopic examination reveals white blood cells (WBCs) in VB1 or VB2 before treatment greater than or equal to 10 cells/hpf. Viable bacteria in VB1 or VB2 before treatment are greater than or equal to 10(4) bacteria/ml. Period of treatment is for 7 days. To evaluate clinical efficacy, 3 days after administration, changes of symptoms (fever and pain on micturition) are recorded. Seven days after administration, changes of symptoms, microscopic examinations and number of bacteria are recorded. The overall clinical efficacy is graded as "excellent", "moderate" or "poor" by combining changes in the above 3 parameters. Chronic prostatitis: Target infection is chronic bacterial prostatitis with no underlying condition in urinary tract. The patients are between 16 and 69 years old. Microscopic examination reveals WBC in EPS or VB3 before treatment greater than or equal to 10 cells/hpf. Viable bacteria before treatment are greater than or equal to 10(3)/ml (GNR) or greater than or equal to 10(4)/ml (GPC). Treatment period is for 14 days. To evaluate clinical efficacy, after 14 days of administration, changes of symptoms, microscopic examinations and number of bacteria are recorded. The overall clinical efficacy is graded as "excellent", "moderate", or "poor" by combining the changes in the 2 parameters, microscopic examination and number of bacteria.

Nineteen patients with malignant tumors were treated with a combination of bolus administration of mitomycin C with direct hemoperfusion over charcoal, and 15 patients were valuable. Mitomycin C of 1 mg/kg was administered via a catheter placed into the regional artery. Seven out of 14 patients with genitourinary cancers: 4 out of 9 patients with urinary bladder, 2 of 4 patients with renal and one prostate responded to the therapy. There were 4 responders out of 8 in the one-shot administration group, on the other hand, 7 cases receiving continuous infusion of 60 to 120 minutes responded. In both the one-shot group and the continuous group nausea and vomiting were observed in 21% and 11% respectively. Three patients receiving continuous administration of mitomycin C had local ulcerations. Myelosuppressions such as leukocytopenia and thrombocytopenia were observed in 37% of the both groups.

Spermiogram (morphology of sperm heads and tails) was evaluated in 21 men visiting our infertility clinic before and after the eradication of genital infection with Ureaplasma urealyticum. The percentage of coiled tails and fuzzy granular tails were decreased after eradication of Ureaplasma but there were no significant changes in the morphologic characteristics of sperm heads. Spermiogram was also analysed in 5 men who were unsuccessfully treated for genital Ureaplasma infection. In this group there were no significant changes in the morphologic characteristics of sperm heads and tails before and after chemotherapy.

This paper presents an autopsy case of primary malignant lymphoma of the urinary bladder. The patient, a 63-year-old man, consulted us because of macroscopic hematuria. Cystoscopy revealed a bladder tumor, which was diagnosed as an anaplastic cell carcinoma by transurethral punch biopsy. The tumor progressively increased in size, despite treatment with preoperative antineoplastic chemotherapy consisting of CDDP. Only ureterocutaneostomy and biopsy were performed at the operation although total cystectomy and ileal conduit had been planned, because the tumor had invaded into the perivesicular tissue. Biopsy revealed B cell lymphoma, which was characterized by specific staining with IgG by the PAP method. Although antineoplastic chemotherapy was performed again after operation, the patient gradually weakened and died 5 months after admission. At autopsy, a hen-egg sized, non-papillary tumor which invading into the perivesicular tissue was found at the anterior wall of the urinary bladder. There were many metastatic nodules in the thraco-lumbar vertebral columns, para-aortic lymphnodes and mesenteric lymphnodes. Lungs and liver were free from metastatic tumors.

For the purpose of carrying out an objective evaluation of the clinical efficacy and safety of cefotetan (CTT), a new cephamycin-type injectable antibiotic, in the treatment of complicated urinary tract infections, cefmetazole (CMZ) was employed as the control drug in a comparative study performed by the double-blind method. CTT was administered in a dose of 0.5 g or 1 g, while CMZ was used in a dose of 1 g; both of these drugs were administered by intravenous drip infusion twice a day for 5 days. The total number of treated cases was 393; 105 patients in the CTT 1 g group, 97 patients in the CTT 2 g group, and 96 patients in the CMZ 2 g group. The judgment of the clinical effects of these 3 therapeutic regimens was carried out in accordance with the criteria for evaluation of clinical efficacy of antimicrobial agents on UTI (2nd edition). The results are as follows. With regard to the overall efficacy of the drug treatments, the calculated efficacy rates were 54.3% in the CTT 1 g group, 63.9% in the CTT 2 g group and 52.1% in the CMZ 2 g group. The differences between these efficacy rates were not statistically significant. Regarding the efficacy of the treatments in terms of the bacteriuria, the bacterial cultures were seen to become negative in 40% of the cases in the CTT 1 g group, 54.6% of the CTT 2 g group and 42.7% of the CMZ 2 g group. Again, there were no statistically significant differences between the groups. Concerning the efficacy of the drugs against pyuria, by combining the cases found to be normalized and those seen to show improvement, the improvement rates were calculated to be 41.9% for the CTT 1 g group, 37.1% for the CTT 2 g group, and 37.5% for the CMZ 2 g group. These pyuria improvement rates show no statistically significant differences, respectively. The incidences of occurrence of side effects and laboratory test abnormalities thought to be caused by the drug therapy were as follows; 1.5% and 5.3% in the CTT 1 g group, 1.5% and 3.1% in the CTT 2 g group and 0% and 6.9% in the CMZ 2 g group. There were no significant differences between the groups. Based on the above clinical results, it can be concluded that, in the treatment of complicated urinary tract infections, we can expect CTT to provide the same therapeutic efficacy as CMZ when its dosage is the same or even half thereof. In addition, the safety of CTT is equal to that of CMZ. Therefore, CTT is concluded to be a useful drug.

A case of primary leiomyosarcoma of the inferior vena cava was reported. The patient, a 74-year-old man, consulted our hospital with complaints of back pain and abdominal mass in right flank. Probe laparotomy revealed a tumor situated in the retroperitoneum and multiple metastatic nodules in the liver. Biopsy was performed and diagnosed as leiomyosarcoma. He was intensively treated with antineoplastic chemotherapy, but his condition gradually aggravated. He died 4 months after admission. The autopsy revealed a right retroperitoneal mass (17 X 12 X 18 cm in size, 1,340 g in weight) that showed a yellowish appearance. There was also a thumb-tip sized tumor with a stalk in the lumen of inferior vena cava. Both tumors grew in continuity with each other through the wall of inferior vena cava. The tumors were diagnosed as leiomyosarcoma, which derived from inferior vena cava.

In order to elucidate the usefulness of cephacetrile (CEC), comparative trials with cefazolin (CEZ) were carried out in the patients with complicated infections of the urinary tract, and the following results were obtained: 1. There were no statistically significant differences or tendencies observed between the groups given CEC and CEZ in either of the global effects, bacteriological effects, rate of superinfection, relapse, relapse with bacterial alternation, drug usefulness, rate of improvements in symptoms and findings in all the cases. 2. According to a result of stratified analyses, there were statistically significant differences observed, showing more inferior results of CEC than CEZ in either stratum of "below 50" in the age, "acute" in the disease phase, "infections of the upper urinary tract" in the disease pattern, and "E. coli including mixed infections with gram-positive organisms" in the pathogenic strains. However, it should be taken into consideration that certain background factors influence greatly in the effects and there were some problems on deviated backgrounds in these strata. On the other hand, CEC displayed better bacteriological effects than those of CEZ in higher stratum of "chronic" in the disease phase and "Klebsiella, Proteus, Citrobacter, Enterobacter including mixed infections" in the pathogenic strains, and statistically significant differences were not observed. 3. In consequence of bacteriological studies, CEC showed stronger resistance than CEZ against beta-lactamase produced in all the strains of gram-negative bacilli. Particularly there were significant differences or tendencies observed in those of Proteus, Cirtobacter, and Enterobacter, and at the same time there were great differences in the activity of beta-lactamase between CEC and CEZ as the substrate. 4. In correlation of the MIC and effects, CEC showed weaker actions than CEZ against susceptible organisms, but slightly stronger actions against moderately or highly resistant strains. A study of the relationship between the MIC of pathogenic strains, beta-lactamase, and bacteriological effects, showed possibilities that even the high activity of beta-lactamase results in remarkable effects in susceptible strains and the drugs with stronger resistance against beta-lactamase given better results in moderately or highly resistant organisms. 5. The incidence rate of adverse reactions was 2 out of 51 cases in the CEC group (3.9%) and 3 out of 50 cases in the CEZ group (6.0%), showing no significant difference, and those symptoms were similar. In conclusion, when the usefulness of CEC in complicated infections of the urinary tract is compared with that of CEZ, the former is said to be equal to the latter without significant difference as a whole...

Between April, 1984 and March, 1985 in 14 centers, 33 patients with prostatic cancer of our 14 centers were randomized to subcutaneously receive either 125, 250, or 500 micrograms/day of ICI 118,630, an LH-RH analogue, for 12 weeks, and the clinical efficacy, safety and endocrinal effects of the drug by dose were examined. An objective partial response was obtained in 44.4% of the 125 micrograms-treated group, in 50.0% of the 250 micrograms-treated group, and 42.9% of the 500 micrograms-treated group, showing no significant difference between the groups. General subjective response rates in these three groups were respectively 75.0%, 62.5%, and 85.7%, not differing from each other significantly. No significant difference was observed in endocrinal effect which was seen in 58.3%, 66.7%, and 100% of 125 micrograms, 250 micrograms, and 500 micrograms groups, respectively. Medical castration was attained in 4.1 +/- 2.0 weeks on average. Adverse reactions observed included fever up to 37 degrees C in 1 of the 13 (7.3%) patients treated with 125 micrograms, and hot feeling at the injection site and flare in 1 of the 8 (12.5%) patients treated with 500 micrograms, which were all mild. These patients responded to further ICI 118,630 therapy without requiring any treatment for the adverse reactions.

C-AMOX, a new prolonged acting preparation of amoxicillin was administered to 122 cases by oral administration of daily dosage 500 mg twice. Clinical effectiveness of C-AMOX was evaluated in 115 out of 122 cases (acute simple cystitis 87 cases, acute pyelonephritis 6 cases, complicated urinary tract infection 19 cases and others 3 cases), and the following results were obtained. 1. The clinical effect for 87 cases of acute simple cystitis was excellent in 54 cases (62%), moderate in 24 cases (27.6%) and poor 9 cases (10.3%), overall effective rate being 89.7%. 2. The clinical effect for 19 cases of complicated urinary tract infection was excellent in 6 cases (31.6%), good 8 cases (42.1%) and poor 5 cases (26.3%), overall effective rate being 73.7%. 3. Adverse reaction occurred in 2 patients, one gastric discomfort and the other one slight diarrhoea. No laboratory abnormalities attributable to C-AMOX were observed in the present study.

Fundamental and clinical studies on S6472, a new prolonged acting preparation of cefaclor, were performed and the following results were obtained. Serum level and urinary excretion. 750 mg of S6472, 500 mg of cefaclor (CCL) and 500 mg of cephalexin (CEX) were orally administered in 6 healthy adult volunteers by the cross over method to measure serum level and urinary excretion. The serum level-time curve of S6472 showed 2 peaks at 1 and 6 hours after administration. The peak serum level of S6472 was 4.2 micrograms/ml and 2.9 micrograms/ml, respectively, 1 and 6 hours after administration. The peak serum level of CCL and CEX was 5.8 micrograms/ml and 12.1 micrograms/ml, respectively, 2 hours after administration. The urine level-time curve of S6472 also showed 2 peaks at 0-2 and 4-6 hours after administration and the peak urine level was 1,320 micrograms/ml and 994 micrograms/ml, respectively, 0-2 and 4-6 hours after administration. The peak urine level of CCL was 1,337 micrograms/ml, 0-2 hours after administration and that of CEX was 2,079 micrograms/ml, 2-4 hours. The mean urinary excretion of S6472, CCL and CEX was 56%, 69% and 94% of dose at 12 hours after administration. Clinical evaluation. S6472 was tried in 200 cases of various urinary tract infections. For one group of 85 cases with acute uncomplicated cystitis, clinical effects were evaluated as excellent in 40 cases, moderate in 42 cases and poor in 3 cases, and the overall clinical effectiveness rate was 96.5%. For another group of 68 cases with complicated urinary tract infection, clinical effects were evaluated as excellent in 9 cases, moderate in 27 cases and poor in 32 cases, and the overall clinical effectiveness rate was 52.9%. Side effects. Side effects were observed in 7 cases with diarrhea, epigastralgia, stomatitis, eruption and facial swelling. Administration of S6472 was discontinued in 2 cases, but in 7 cases all symptoms were transient.

A patient with vesicosigmoid fistula due to "collision" tumor between adenocarcinoma of the sigmoid colon and transitional cell carcinoma of the urinary bladder is presented. Resection of the sigmoid colon and partial cystectomy were performed. The clinical symptoms, diagnostic procedures and treatments are discussed.

A case of ectopia testis transversa was reported. A patient, 35-year-old male, was admitted to our hospital with swelling of left scrotal contents. At operation, two testes were situated in the left scrotal half, but the right half was empty. Including our case, 66 cases of ectopia testis transversa have been reported in Japan.

A case of ureteral endometriosis is reported A 42-year-old woman visited our clinic on December 3, 1985, with the complaint of right lumbago. Intravenous pyelography showed right hydronephrosis and retrograde pyelography revealed ureteral stenosis at 11 cm from right ureteral orifice and 2 cm long. Primary right ureter tumor was suspected. The operation was performed on January 16, 1986 and revealed periureteral mass. The mass was removed with ureter and ureteroureterostomy was performed. The pathological diagnosis was extrinsic ureteral endometriosis. Ureteral endometriosis has rarely been described and only 17 cases have been reported previously in Japan.

Statistical observations on operations performed in our department from 1976 to 1980 were reviewed, especially in comparison with the statistics for the preceding 10 years. Operations on the kidney were the most frequent, as they were in the preceding 10 years, but operations on the bladder have increased remarkably, in 1980 accounting for more than those on the kidney. During this period, operations for benign diseases such as lithotomy of the upper urinary tract and prostatectomy tended to decrease. On the other hand, operations for malignant diseases of kidney, bladder and scrotal contents steadily increased. Transurethral operations are still increasing, especially for bladder tumors. It has been established that bladder tumors should be treated by either TUR-BT or total cystectomy and not by partial cystectomy. As to urinary diversion, ileal conduit was the main procedure used during this 5-year period instead of cutaneous ureterostomy.

Semen analysis is important in evaluating human male fertility, but the subjectivity of the evaluation of sperm characteristics, especially motility, has troubled investigators for many years. Therefore, we have developed a bi- level picture processing system (called the BPP system), using a microcomputer for automatic, objective and quantitative evaluation of sperm characteristics.

Chromosomal abnormalities are found in a considerably high percentage of cases of male infertility, in particular azoospermia. We report a case of the XYY syndrome and review the literature. A 36-year-old man, a factory hand, presented with infertility. He was safely delivered at term as a fourth child when his father was 41 years old and his mother 38. He had no delinquent or criminal record. His height was 179 cm, weight 75 kg and distance of extended hands 184 cm. No gynecomastia was noticed. Both testes were 8ml in size and growth of pubic hair and penis were normal. Severe oligozoospermia was identified in semen analysis. Seminal vesiculography showed pathological dilatation of the seminal vas end. The testicular biopsy specimens revealed spermatogenic arrest for the most part. Chromosomal analysis showed 47, XYY karyotype; and, two Y-chromatin was revealed in cultured lymphocytes. Though plasma gonadotropin levels were high, testosterone, estradiol, prolactin, TSH, GH, T3 and T4 levels were within normal limits. Pituitary reserve function for secreting gonadotropins and Leydig cell reserve function to secrete testosterone have been found to be almost normal.

A very rare case of renal cell carcinoma of the horseshoe kidney that produced AFP and caused hypercalcemia is reported. The relationship between this renal cell carcinoma and hypercalcemia was obvious, but the mechanism of hypercalcemia was not revealed. The presence of AFP in cancer cells was demonstrated using the "ABC" method.