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Background In ischemic cardiomyopathy patients requiring coronary artery bypass grafting (CABG), the association of diabetic status with outcomes after surgery as well as survival benefit with bilateral internal thoracic artery (ITA) grafting remain largely unknown. Purpose We evaluated the associations of diabetic status with postoperative LV reverse remodeling, change in renal function, and late outcome following surgical revascularization, with focus on cases with severely impaired LV function. We also attempted to determine the survival benefit of bilateral ITA grafting over single ITA grafting according to diabetic status. Methods We classified 188 patients (mean age 67±9 years) with left ventricular (LV) ejection fraction ≤40% who underwent isolated initial CABG into non-diabetic (n=64), non-insulin-dependent DM (NIDM, n=74), and insulin-dependent DM (IDM, n=50) groups. Results At baseline, there were no differences between the diabetic and non-diabetic patients in terms of age, LV function parameters and degree of coronary artery disease, while the diabetic patients were more likely to present chronic kidney disease and peripheral vascular disease. During follow-up (68±47 months), the 5-year survival rate was 84% and 65% in the non-diabetic and diabetic patients respectively (p=0.034). After adjusting for all covariates, both NIDM and IDM were independently associated with increased mortality (NIDM: adjusted hazard ratio 1.9, 95% confident interval 1.0–3.7, p=0.049; IDM: adjusted hazard ratio 2.4, 95% confident interval 1.2–4.8, p=0.016) and composite adverse events defined as mortality and/or heart failure readmission (NIDM: hazard ratio 1.7, 95% confident interval 1.0–2.8, p=0.038; IDM: hazard ratio 3.0, 95% confident interval 1.7–5.1, p Conclusion Non-insulin- and insulin-dependent diabetes was significantly associated with worse long-term clinical outcome after CABG for ischemic cardiomyopathy. Bilateral ITA grafting has potential to improve survival in diabetic patients with ischemic cardiomyopathy.

Objective To examine the influence of the dietary intake of fatty acid on urinary oxalate excretion in calcium oxalate stone-formers in their fourth decade, as previous reports show that animal fat intake is associated with urinary oxalate excretion. Patients and methods The dietary intake of 58 idiopathic stone-formers in their fourth decade was recorded using the dietary-record method. The patients collected 24-h urine samples at home and their urinary oxalate excretion was measured in a clinical biochemistry laboratory. The results were used to determine the relationship between the dietary intake of fatty acids and urinary oxalate excretion. Associations between urinary oxalate excretion and dietary contents of animal fat, animal protein and various fatty acids were assessed using Spearman's correlation coefficient and multiple regression. Results The dietary content of arachidonic acid was positively correlated with urinary oxalate excretion, as assessed by univariate and multivariate analysis. Conclusion The association between arachidonic acid and oxalate excretion suggests that arachidonic acid increases the intestinal absorption of oxalate and increases the clearance of oxalate in the kidneys.

Aims Cystic partially differentiated nephroblastoma (CPDN) is an uncommon renal multicystic tumour, usually affecting early infants. To our knowledge, this report describes the first case of CPDN occurring in an adult. Methods and results A 45-year-old man was found incidentally to have a left renal cystic tumour, measuring 20 mm in diameter, at the lower pole far from the pelvis. The tumour was composed of multilocular cystic spaces of variable size and intervening septa without solid nodular areas. The cysts were lined by a single layer of flattened, hobnail, or columnar epithelium. The septa were made of mesenchymal cells, which were admixed with small numbers of loosely aggregated blastemal cells, occasional tubular structures in various stages of development, and a few glomeruloid structures. The tumour cells had no anaplasia, and mitoses were rare. Immunohistochemical and lectin histochemical studies revealed that the cyst lining epithelium and the tubular structures in the septa expressed predominantly the markers for distal tubules and collecting ducts. Ultrastructurally, the cyst lining cells closely resembled collecting duct cells while some tubular structures showed an immature nephrogenic morphology. The patient was alive and well without evidence of recurrence 11 months after surgery. Conclusions CPDN does occur in adults, as experienced in Wilms' tumour, though its incidence is extremely low. This study suggests that CPDN may show maturation intermediate between cystic nephroma and Wilms' tumour, even in adult cases.

The redox behavior and mobility of the Cu ions in Cu ion-exchanged NaZSM-5 zeolites (Cu-NaZ) during oxidation of benzyl alcohol were examined by CO adsorption, IR absorption measurement of CO adsorbed on the Cu-NaZ, and diffuse reflectance spectra measurement. The properties and oxidation state of the Cu ions in Cu ion-exchanged SiO 2 (Cu-SiO 2 ) were also investigated by similar methods, focusing on the comparison with those in the Cu-NaZ zeolites. The Cu-NaZ zeolites with higher degrees of Cu ion exchange were found to have at least two different kinds of Cu ions, in contrast to the Cu-SiO 2 which showed the presence of only one kind of Cu ion

Human bladder cancer cell line (HAMT-1) was established from a transitional cell carcinoma of the bladder (T4N3M0, grade 3) of a 61-year-old male by using a serum-free medium. HAMT-1 cells in serum-free medium were non-adhesive to the flask wall or to other cells. The cells grew in attached form by the addition of fetal calf serum. Heterotransplantation of HAMT-1 cells into nude mice and the long-term subculture were successful. Tumor bearing nude mice showed an elevated serum tissue polypeptide antigen as in the patient.

The relationship among age, prostate-specific antigen (PSA) level and prostate volume in Japanese patients with lower urinary tract symptoms (LUTS) and histologically proven benign prostatic hyperplasia (BPH) was examined in order to assess the utility of PSA as a predictor of prostate volume. Two hundred eighteen patients with LUTS were confirmed to have BPH by histological examination for the reason of elevated PSA and/or abnormal digital rectal examination finding. Correlation among PSA, prostate volume and transition zone volume were analyzed in patients classified into age-stratified groups. Prostate volume increased with age. Mean serum PSA increased with age, and the correlation of PSA and prostate volume was determined to be statistically significant in each cohort of age. A correlation coefficient ranged from 0.315 to 0.439. In patients with LUTS and clinical BPH, serum PSA increased with age and was related to prostate volume. PSA might be useful for therapeutic decision making for patients with symptomatic BPH.

In order to examine the characteristics of patients with nonpalpable prostate cancer (T1c cancer) in Japan, patients treated with radical prostatectomy were compared with those with palpable (T2) cancer. Prostate-specific antigen (PSA) level in patients with T2b disease was significantly higher than those with T1c and T2a tumors. At the time of radical prostatectomy, 78%, 71% and 31% of patients with T1c, T2a, and T2b, respectively, had organ-confined disease. When insignificant cancer was defined as volume 0.5 ml or less and Gleason score less than 5, only 2 of 34 (5.9%) with clinical T1c disease were clinically insignificant. T1c cancers were clinically significant and clinicopathological features of Tlc tumors were similar to T2a tumors. PSA measurement could detect potentially curable prostate cancer.

To examine the influence of the dietary intake of fatty acid on urinary oxalate excretion in calcium oxalate stone-formers in their fourth decade, as previous reports show that animal fat intake is associated with urinary oxalate excretion.The dietary intake of 58 idiopathic stone-formers in their fourth decade was recorded using the dietary-record method. The patients collected 24-h urine samples at home and their urinary oxalate excretion was measured in a clinical biochemistry laboratory. The results were used to determine the relationship between the dietary intake of fatty acids and urinary oxalate excretion. Associations between urinary oxalate excretion and dietary contents of animal fat, animal protein and various fatty acids were assessed using Spearman's correlation coefficient and multiple regression.The dietary content of arachidonic acid was positively correlated with urinary oxalate excretion, as assessed by univariate and multivariate analysis.The association between arachidonic acid and oxalate excretion suggests that arachidonic acid increases the intestinal absorption of oxalate and increases the clearance of oxalate in the kidneys.

The prostate-specific antigen (PSA) density of the transition zone (PSATZ) in 45 prostate cancer patients who received radical prostatectomy with a PSA value of 4.1-10 ng/ml was determined to see whether PSATZ was useful in the prediction of extracapsular invasion of prostate cancer. The value of PSATZ for the detection of extracapsular invasion was compared with that of PSA and PSA density (PSAD). Thirty-one patients (68.9%) had pathologically organ confined cancer while 14 (31.1%) had extracapsular disease. Patients with organ confined tumor had significantly lower PSAD and PSATZ than those with non-organ confined tumor. PSATZ was superior to PSA when analyzed by receiver operating characteristics curves. In those patients with a cut-off value of 1.0 ng/ml per ml of transition zone volume, the PSATZ had a sensitivity of 43% and a specificity of 90% for prediction of extracapsular extension. The present study demonstrated that PSATZ was superior to PSA as a predictor of extracapsular invasion in intermediate PSA levels. Measurement of PSATZ may be of additional value to indicate the need for radical prostatectomy.

To determine the changes in biological features of the prostate during the course of local recurrence of prostate cancer after endocrine therapy, histologic grade, proliferating activity and apoptotic indices were examined in prostate specimens obtained before treatment and at recurrence. A total of 16 patients, who had received endocrine therapy and eventually recurred in the prostate, were evaluated. Histologic grade was determined by the method of Gleason and the number of proliferating cells and apoptotic cells were counted. Tumors with a high grade Gleason score remained at a high grade. A statistically significant increase in the number of Ki-67 positive cells was observed from pretreatment biopsy to local recurrence. On the other hand, the apoptotic index decreased during progression. Patients with a higher number of Ki-67 positive cells before the initial treatment had a poorer prognosis than those with a lower number of Ki-67 positive cells. In conclusion, prostate cancer shows an increase of malignant potential as assessed by the number of Ki-67 positive cells, whilst the decrease in apoptosis might play some role in the course of progression.

To investigate whether chlormadinone acetate (CMA) could prevent the flare-up phenomenon induced by a luteinizing hormone-releasing hormone analogue (LH-RHa), we treated 4 cases of stage C and 17 cases of stage D prostate cancer with CMA for 4 weeks and CMA plus monthly injection of LH-RHa for following 24 weeks. Serum LH, testosterone, and prostate-specific antigen (PSA) levels were closely monitored before and 3 days, 1-, 2-, and 4-weeks after LH-RHa injection. Subjective and objective responses were also investigated. Serum LH and testosterone levels significantly elevated 3 days after the initial injection of LH-RHa. However, they resumed 1 week after LH-RHa injection with fluctuation under the normal range. Out of 21 cases, 3 cases (14%) consisting of 2 poorly and 1 moderately differentiated adenocarcinoma showed increased serum PSA levels 1 week after LH-RHa injection in spite of suppressed serum testosterone levels. The objective response of these 2 poorly differentiated cases was progressive disease at 24 weeks. No cases indicated worsening of clinical symptoms concerning flare-up phenomenon. CMA seemed to be capable of preventing flare-up phenomenon in advanced prostate cancer.

To examine the influence of dietary intake on urinary oxalate excretion in calcium oxalate stone formers in their forties.Dietary intake was recorded by using the dietary-record method in 58 idiopathic stone formers in their forties. The patients collected their urine for 24 h at home and their urinary oxalate excretion was measured. The relationship between the dietary intake of various nutrients and urinary oxalate excretion was examined by mono- and multivariate analysis.The intake of animal fat was correlated with urinary oxalate excretion by monovariate analysis, but that of total protein, animal protein, calcium and carbohydrate were not. By multivariate analysis, the intake of animal fat was correlated with urinary oxalate excretion and the intake of calcium was inversely correlated with urinary oxalate excretion.The intake of animal fat was positively and the intake of calcium was negatively correlated with the urinary oxalate excretion in stone formers in their forties. It was shown that animal fat plays an important role in urinary oxalate excretion.

Frequent allelic losses on chromosome arm 13q are observed in carcinomas of the head and neck, breast, ovary, and pituitary gland. We analyzed 59 primary prostate tumors (stage B, 18 patients; C, 12 patients; D1, 4 patients; and endocrine therapy-resistant cancer death, 25 patients), as well as 18 metastatic tissues from 14 of the 25 cancer death patients for loss of heterozygosity (LOH) using 35 microsatellite markers on chromosome arm 13q. Of the 59 primary tumors, 31 (53%) showed LOH involving at least one locus. Detailed deletion mapping identified a distinct commonly deleted region in the I-cM interval flanked by D13S153 and D13S273 on 13q14 and this region overlapped a part of the RB1 gene. Paired DNAs were available from both primary and metastatic tumors in the 14 cases of cancer death; among those pairs, we detected LOH on 13q in seven (50%) primary tumors, and in all metastatic foci (P = 0.0029). Moreover, the regions lost in metastatic tissues were more extensive than those seen in the corresponding primary tumors. These results suggest that inactivation of a putative tumor suppressor gene(s) including the RB1 gene on 13q14 plays an important role in human prostate cancer.

This study qualified the severity and localization of reverse redistribution of technetium-99 m (Tc)-tetrofosmin rest imaging. Both Tc-tetrofosmin and thallium-201 (Tl) rest imaging with early images and delayed images were obtained in the subacute phase of myocardial infarction in 21 patients with first anterior myocardial infarction and with successful transluminal angioplasty (including stenting). Relative myocardial uptake (%uptake), degree of reverse redistribution (%), and washout rate (%) were evaluated quantitatively in 6 left ventricular segments (inferoseptal, anteroseptal, anterior, anterolateral, lateral, inferolateral and inferior) by circumferential profile analysis. The percentage reverse redistribution in the infarct area was larger in Tc-tetrofosmin imaging than in Tl imaging (p = 0.013). Reverse redistribution was most prominent in the anterior wall (anterioranteroseptalinferoseptal, p = 0.020). This suggests that infradiaphragmatic scatter is unlikely as the mechanism of reverse redistribution. The washout rate of Tc-tetrofosmin in the infarct area (reverse redistribution area) was higher than that in the normal area (non-reverse redistribution area), and was also higher than the washout rate of Tl imaging in the infarct area. The %uptake of delayed images in the infarct area was larger in Tc-tetrofosmin than that in Tl imaging, whereas %uptake of early images did not differ. The percentage reverse redistribution did not correlate with the degree of collateral circulation and the residual stenosis. In conclusion, reverse redistribution of Tc-tetrofosmin was more prominent in the infarct area, and this was due to the relatively lower uptake of reverse redistribution of Tc-tetrofosmin than delayed Tl images.

Cystic partially differentiated nephroblastoma (CPDN) is an uncommon renal multicystic tumour, usually affecting early infants. To our knowledge, this report describes the first case of CPDN occurring in an adult.A 45-year-old man was found incidentally to have a left renal cystic tumour, measuring 20 mm in diameter, at the lower pole far from the pelvis. The tumour was composed of multilocular cystic spaces of variable size and intervening septa without solid nodular areas. The cysts were lined by a single layer of flattened, hobnail, or columnar epithelium. The septa were made of mesenchymal cells, which were admixed with small numbers of loosely aggregated blastemal cells, occasional tubular structures in various stages of development, and a few glomeruloid structures. The tumour cells had no anaplasia, and mitoses were rare. Immunohistochemical and lectin histochemical studies revealed that the cyst lining epithelium and the tubular structures in the septa expressed predominantly the markers for distal tubules and collecting ducts. Ultrastructurally, the cyst lining cells closely resembled collecting duct cells while some tubular structures showed an immature nephrogenic morphology. The patient was alive and well without evidence of recurrence 11 months after surgery.CPDN does occur in adults, as experienced in Wilms' tumour, though its incidence is extremely low. This study suggests that CPDN may show maturation intermediate between cystic nephroma and Wilms' tumour, even in adult cases.

Allelotype analyses of human prostate cancer indicate that allelic losses on human chromosome arms 7q, 8p, 10q, 13q, 16q, 17q, and 18q are observed frequently. For the study of the possible biological significance of the frequently observed deletions on chromosome arm 7q in human prostate cancer, human chromosome 7 was introduced into highly metastatic rat prostate cancer cells by use of a microcell-mediated chromosome transfer technique. The introduction of human chromosome 7 resulted in the suppression of metastatic ability of the microcell hybrids, whereas no suppression of tumorigenicity was observed. To identify the portion of chromosome 7 containing the metastasis-suppressive function gene, the derivative chromosome 7 that was generated with the initial transfer was retransferred into rat prostate cancer cells. Human chromosome 7-containing rat prostate cancer cells could be used as the donor cells, because rodent cells produced a sufficient number of microcells with colchicine treatment. Cytogenetic and molecular analyses of these clones demonstrated that loss of segments on 7q was related to the reexpression of the metastatic phenotype. These results show that human 7q contains a metastasis suppressor gene or genes for rat prostate cancer. The findings also suggest that this gene may play an important role in the progression of human prostate cancer.

We treated 107 new patients with stage Ta, grades 1 and 2 transitional cell bladder carcinoma by transurethral resection during the past 23 years. The clinicopathological factors evaluated were grade, size, number and form of tumor. Fifty-five patients (51%) had recurrent tumors after initial resection and progression (muscle invasion or metastasis) occurred in four patients (3.7%). The 5-year and 10-year recurrence free rates were 47.3 and 29.8%, respectively. Seven patients (6.5%) had grade 3 tumor (grade-up) at recurrence. An increase in T category to T1 (stage-up) occurred in 13 patients (12%), only one of whom later developed an invasive tumor (pT4). The size of tumor significantly affected the rate of recurrence (p0.01). Sessile tumor were at a significantly greater risk for progression (p0.05). Stage-up did not have a significant effect on progression, but grade-up was significantly risky for progression (p0.01). Initial grade 2 tumors were highly related to grade-up (p0.05).

We report a case of neuroendocrine cell carcinoma of the urinary bladder. The patient was a 70-year-old man, complaining of pollakisuria. Cystoscopy and computerized tomography revealed a nonpapillary tumor. The tumor was removed by transurethral resection. Because of muscular invasion (T2) and histological grade, total cystectomy and ileal conduit were carried out. Examination of the resected specimen indicated pathological TO. He rejected our proposal to have chemotherapy. Twelve months post-operatively he was alive without recurrence.

Objective To investigate the influence of dietary intake on urinary oxalate excretion in calcium renal-stone formers. Patients and methods Dietary intake was monitored by using the dietary-record method in 60 idiopathic stone formers. The patients collected their urine for 24 h at home and their urinary oxalate excretion rate was determined. The relationship between the daily intake of various nutrients and urinary oxalate excretion was examined by both monovariate and multivariate analyses. Results By monovariate analysis, the intake of carbohydrate, total protein and fat were significantly correlated with urinary oxalate excretion, but the intake of calcium and body surface area were not. In addition, the intake of total protein was highly correlated with that of fat. By multivariate analysis, the intake of carbohydrate and fat were significantly related to urinary oxalate excretion, and the intake of calcium was inversely correlated with urinary oxalate excretion, but the intake of total protein showed no significant correlation. Conclusion The intake of carbohydrate and fat was positively and the intake of calcium was inversely correlated with urinary oxalate excretion in stone formers and, taken together, these findings suggested that fat plays an important role in urinary oxalate excretion and that protein has a minimal effect.

A 77-year-old man was admitted to our hospital complaining of gross hematuria. Cystoscopy showed an approximately 4-cm non-papillary tumor in and out of the diverticulum of the left posterior wall. Total cystectomy was performed. Histopathological diagnosis was pleomorphic leiomyosarcoma. According to TNM classification of bladder cancer, the stage of this tumor was pT3bpN0M0. The patient had local recurrence two months after the operation, and died a month later. This is the second case of leiomyosarcoma of the diverticulum of urinary bladder reported in Japan.

Human bladder cancer cell line (HAMT-1) was established from a transitional cell carcinoma of the bladder (T4N3M0, grade 3) of a 61-year-old male by using a serum-free medium. HAMT-1 cells in serum-free medium were non-adhesive to the flask wall or to other cells. The cells grew in attached form by the addition of fetal calf serum. Heterotransplantation of HAMT-1 cells into nude mice and the long-term subculture were successful. Tumor bearing nude mice showed an elevated serum tissue polypeptide antigen as in the patient.

We analyzed 91 patients who had curative resection from 1982 to 1989 for stage I and II primary lung cancer. The 5-year survival rates were 71.4% for stage I and 44.7% for stage II. The 5-year survival rates were 86.6% for T 1 N 0 M 0, 47.3% for T 2 N 0 M 0, 56.3% for T 1 N 1 M 0, and 37.9% for T 2 N 1 M 0. There was no cancer death in patients with squamous cell carcinoma of T 1 N 0 M 0. For stage I, tumor diameter was significant factor to influence survival. Although there was a statistically significant difference between stage I and II in patients with adenocarcinoma, there was no significant difference in those with squamous cell carcinoma. Chemotherapy had no significant improvement in survival for stage I and II lung cancer.

X-ray findings of bone metastatic lesions from 81 cases of stage D2 prostatic cancer were examined before and following endocrine therapy. Untreated lesions were classified into five types; osteoblastic (15%), mixed, but mainly osteoblastic (31%), mixed, but mainly osteolytic (17%), osteolytic (10%), and undetermined with a positive bone scan (27%). Patients with two mixed types had a tendency of widely speeded areas of metastasis and elevated serum prostatic acid phosphatase. Temporal enlargement of sclerotic lesion immediately after the start of therapy did not indicate disease progression. In many cases, changes from osteolytic to osteoblastic patterns were noticed in the same lesion regardless of the effects of endocrine therapy. Remodeling to the sclerotic pattern appeared as curative changes. From these findings, it was concluded that the natural course of bone lesions showed a tendency to change from the osteolytic to osteoblastic type and relapse was often accompanied by an increase of the osteolytic type lesion. Evaluation of therapeutic effects based on remodeling, changes in number and areas of lesions, and the appearance of new lesion correlated well with prognosis.

Effects of chemotherapy to endocrine therapy (castration with estrogen/antiandrogen)-relapsed (24 cases) or endocrine therapy-resistant (14 cases) prostate cancer were compared. Pretreatment clinical stages in these groups were stage D1 (3 cases) and D2 (35 cases). Regimens of chemotherapy in this study were as follows: cis-platinum (CDDP) (1 case), phosphamide (3 cases), combination of vincristine, phosphamide and peplomycin (5 cases), combination of cyclophosphamide, adriamycin (ADM) and CDDP (8 cases) and combination of phosphamide, ADM, and CDDP (21 cases). Response to chemotherapy and subsequent survival in these two groups were examined. When evaluated at 3 months after the start of the chemotherapy, partial response and stable cases were 50% and 36% in endocrine therapy-relapsed and -resistant groups, respectively. Because the worse performance status contained more cases in the endocrine therapy-resistant group, the response was compared at the same base of performance status, and the response was almost equal in the two groups. Survival in the endocrine therapy-relapsed group was better than that in the therapy-resistant group. When compared at the same base of performance status, the difference in survival time between the two groups was not evident. In conclusion, the response of chemotherapy was similar between endocrine therapy-relapsed and -resistant patients, and performance status was a main factor influencing the prognosis of endocrine therapy-refractory prostate cancer.

A 46-year-old female was admitted to our hospital because of a left supraclavicular tumor. The chest CT scan and MR imaging revealed that the tumor arose from the left first rib and developed into the supraclavicular region. In this case, we tried to resect the tumor using the so-called "trap-door" thoracotomy. Although removal of subclavian vessels and brachial plexus from the tumor was easily performed, we could not enough treat the vertebral side of the first rib through this thoracotomy without the T1 nerves injury. In cases of superior sulcus tumors developing into the posterior chest wall, a posterior incision combined with an anterior one will be useful to remove these tumors safely.

Between 1975 and 1989, 90 patients with prostate cancer in clinical stage A2 to C underwent pelvic lymphadenectomy. Median follow-up period was 38 months. Almost all of the patients with pN0-1 (49) and 4 of pN2 were treated by curative treatment, such as radical prostatectomy (7) or radiation therapy (45). The remaining pN2 (26), pN3 (4) and pM1 LYM (6) received endocrine therapy. Pelvic lymph node metastasis were noticed in 50 cases (56%). Rates of positive node and degree of nodal extension were related to clinical stage and histological grade. Disease-free survival of the patients with pN0-1 was better than that of the patients with more than pN2. There was no difference in disease-free survival between the patients with pN0 and pN1. We concluded that the patients with pN0 and pN1 were the candidates for curative therapy and recommend that the patients with more than pN2 be treated with endocrine therapy.

Prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PSA) were examined on 120 cases of stage D2 prostate cancer between 1979 and 1989. All patients received endocrine therapy as the first treatment; castration and immediate administration of estrogen or antiandrogen (101), LH-RH analogs (13), estrogen (3) and antiandrogen (3). The actuarial survival rates were calculated by the cause-specific survival method. Pretreatment levels of PAP, gamma-Sm and PSA did not influence prognosis. After start of treatment, the relationship between the changes of the markers and prognosis were examined. At 1 month after the start of the treatment, normalization of PAP or gamma-Sm was not reflected in the following course. On the contrary, at 3 and 6 months, groups with normalization of PAP or gamma-Sm showed better prognosis than those with elevated levels. The same tendency of PSA was obtained at 6 months after start of treatment. In patients with normalized PAP at 3 months, abnormal gamma-Sm showed worse prognosis than normalized gamma-Sm. Therefore, the significance of determination on the two markers was manifested. As histological grade influenced the following course, poorly differentiated adenocarcinoma with normalized PAP at 3 months showed better prognosis than those with elevated levels. In conclusion, it is worthwhile to measure multiple markers for predicting the prognosis of stage D2 prostate cancer treated with endocrine therapy.

To clarify factors affecting prognosis following endocrine therapy, stage D2 patients who died from prostatic cancer within 3 years and those under well-controlled state longer than 5 years were compared with respect to background factors and response to endocrine therapy. Thirty-five and 18 cases, respectively, were studied. Differences between the two groups were bone pain, anemia, tumor grade, number of bone metastasis, and response to endocrine therapy. Performance status in long-term survival groups tended to be better than that in short-term cancer death groups.

The presence of androphilic protein identified histochemically with R 1881-CMO-BSA-FITC correlated with response to endocrine therapy and prognosis. Ras P21 was not a useful indicator of the subsequent course of the disease. Conventional X ray assessment of boney metastases still seems of use in monitoring overall progress of the disease.

The energy confinement characteristics of ICRF-heated Tokamak plasmas are studied at high input power density approximately 2 MW m-3 volume averaged, on the JIPP T-IIU device (R=0.91 m, a=0.23 m). High electron and ion temperatures (Te approximately 2.5 keV, Ti approximately 2.0 keV, at each maximum) have been achieved by the operation at a plasma current IP of 280 kA, plasma line-averaged electron density ne of 7*1013 cm-3 and input power of 2 MW, with a suppression of total radiation loss (30-40% of the total input power) by a carbon coating on the vacuum vessel. The fraction of ICRF power absorbed by the plasma, alpha , is determined experimentally from the decay of the stored plasma energy just after the ICRF pulse is terminated. The value of alpha increases slightly with increasing electron density and decreases from 90 to 70% as the ICRF power is increased from 1 to 2 MW m-3 volume averaged. The global energy confinement time tau epsilon , defined by WP/(POH+ alpha Pr.f), decreases by a factor of 2 approximately 3 from that in Ohmic plasmas as the heating power increases up to 2 MW. It is found that the energy confinement time has a strong line-averaged electron density dependence as tau E varies as ne0.6, which is obtained by the use of the measured absorbed power, while the Kaye-Goldston scaling predicts tau E varies as ne0.26.