Teruo Mishina

Mitomycin C Bladder Instillation Therapy for Bladder Tumors

Patients with bladder tumors underwent a course of topical bladder instillation of 20 mg. mitomycin C in 20 ml. sterilized distilled water 3 times weekly for a total of 20 procedures. In 22 of the 50 patients (44 per cent) the tumors disappeared completely, while in 16 patients (32 per cent) there was partial disappearance and in 12 patients (24 per cent) there was no affect. Therefore, the total effective rate was 76 per cent. We concluded from our studies that mitomycin C topical therapy could be applied to low stage and low grade bladder tumors less than 1 cm. in diameter, without regard to the number of tumors. We now use mitomycin C topical therapy in all cases of bladder tumors. Local bladder reaction was noted in 3 cases but a complete course of therapy was accomplished in each case--in 2 cases without interruption of treatment and in 1 case by delaying treatment for 1 week. Abnormal values of hematocrit, white blood cells and platelets in blood were not observed during therapy.

Absorption of anticancer drugs through bladder epithelium.

Fundamental and clinical evaluations of ten anticancer drugs were performed. The required qualities of an anticancer drug ideal for bladder instillation therapy are thought to be as follows: (1) a high sensitivity for bladder tumor cells; (2) a pKa which provides a high percentage of nonionized molecules in a pH 6-7 solution; (3) a log P in the range from -0.4 to -1.2 or from -7.5 to -8.0; and (4) a molecular weight over 200.

Staging of bladder tumors by transrectal ultrasonotomography and U.I. Octoson.

The staging of bladder tumors was performed in 100 cases by transrectal ultrasonotomography and in 44 cases by U.I. Octoson. Complete agreement between histology and ultrasound was obtained in 80% of the cases by the former method and in 73% by the latter method for tumors arising from the corpus of the bladder. However, agreement was obtained in only 38% of the cases by the former method and in 59% by the latter method for tumors arising from the apex and fundus of the bladder. The possibility of improving the agreement for tumors in the apex and fundus by introducing real-time transrectal linear scanning is suggested.

Leiomyoma of the renal pelvis.

AbstractA case of leiomyoma arising from the upper calix of the renal pelvis in a 47-year-old woman is presented. We believe this to be the fourth reported case in the literature.

Transrectal Radial Cone Scanning for the Staging of Urinary Bladder Tumors

It is very important to determine the staging of urinary bladder tumors accurately for selecting an adequate treatment and for indicating the prognosis of the patient. Several types of examination have been proposed for this purpose, including cystoscopy, pyelography, biopsy around the tumor or bimanual palpation under spinal anesthesia. No technique has been available, however, to visualize the extent of tumor infiltration and the depth of tumor penetration in the picture.

Intravesical instillation of adriamycin for bladder tumors

SummaryIn the present series of trials, Adriamycin (ADM) intravesical instillation therapy was found to be effective against tumors of papillary morphology measuring <10 mm in diameter that were of low pathological stage and low histological grade. The rate of complete disappearance increased in proportion to the concentration of ADM and the duration of retention of the drug, although the efficacy rates were almost the same in each trial. On the other hand, side effects on the bladder were reduced when the instilled solution was lower in concentration and the retention time was short.

High-Risk Group for Benign Prostatic Hypertrophy

A case control study was conducted on 100 patients with benign prostatic hypertrophy (BPH) and 100 controls matched by age and residence. Interviews were performed by well-trained urologists using an original questionnaire. Matched-pair analysis revealed the following characteristics and relative risks (RR) as being significantly (P less than 0.05) different among the BPH patients versus the controls: higher educational background (RR = 2.77); not engaged in farming, forestry, or fishing (RR = 4.82); no environmental pollution at work (RR = 2.90); a present annual income of more than 2,400,000 yen (RR = 3.84); a previous annual income of more than 2,400,000 yen (RR = 3.82); practice the highest standard of living (RR = 4.24); more than two children (RR = 2.67); experienced first nocturnal emission before reaching the age of 20 (RR = 3.11); expanding more than 10 min to complete one act of sexual intercourse (RR = 2.43); having no episode of sexual impotence that lasted more than 1 month (RR = 2.29); no family history of gastric ulcer (RR = 7.98); no family history of breast cancer (RR = 8.25); regular consumption of milk (RR = 2.25); irregular consumption of green and yellow vegetables (RR = 3.91); and pickles not consumed at every meal (RR = 1.99). Characteristics that did not achieve a high level of statistical significance (0.05 less than P less than 0.10) between cases and controls were as follows: past history of gonorrhea, urethritis, or prostatitis and syphilis (RR = 1.84, 2.76, and 4.26, respectively), and daily meat consumption (RR = 3.18). On the basis of interviews of the patients and cases reported in this study, we conclude that dietary and sexual habits may be important factors which place individuals at a higher risk for developing BPH.

Development and clinical application of an AFC regimen (Adriamycin, Futraful, Cytosine arabinoside) for superficial bladder tumors

SummaryOur AFC regimen was originally developed to treat superficial bladder tumors. It consists of a daily intravesical administration of 20 mg Adriamycin (ADM) and 200 mg Cytosine arabinoside (CA) dissolved in 20 ml of sterilized distilled water, simultaneously with a daily rectal suppository of 750 mg tegafur (Futraful) for a total of 20 applications.Our study demonstrated the following characteristics of the AFC modality: (1) It is simple; (2) it is completed in 3 weeks, which is shorter than conventional bladder instillation therapy; (3) the effective rate is reasonable (70%); (4) no local side-effects were observed because the concentrations of ADM and CA were low; (5) interruption of therapy was unnecessary, because whatever general side-effects were caused, they disappeared within several days of completion of treatment.

Immunochemotherapy for advanced bladder cancer using FT-207, adriamycin and OK-432.

A combination therapy consisting of daily intrarectal administration of 1,500 mg of FT-207 suppository, daily or every three day bladder instillation of 40 mg adriamycin for a total of 20 applications, and once per week intramuscular administration of 5 KE OK-432 was described. The therapy was performed in 30 cases of advanced bladder cancer. The effectiveness evaluated by Karnofskys criteria was as follows: 8 cases of 0-0, 2 of 0-A, 1 of 0-B, 2 of 0-C, 7 of 1-A and 10 of 1-B, showing an effective rate of 57%. Local pain was observed in 20 cases (67%), pancytopenia in 1 (3%), hepatitis in 4 (13%), stomatitis in 5 (17%) and anorexia in 6 (20%). From this clinical trial, it is presumed that combination therapy administering FT-207 intrarectally, adriamycin intravesically and OK-432 intramuscularly might be used for the treatment of advanced bladder cancer provided sufficient care is taken of general side effects.