Hinyokika kiyo. Acta urologica Japonica
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Review Case Reports
[A case of emphysematous pyelonephritis with emphysematous cystitis].
A 74-year-old woman with diabetes mellitus had a high fever, and was treated with antibiotics and insulin in another hospital. She was referred to our department, because CT scan showed the right hydronephrosis and the abnormal gas shadow in the right renal calyces. Ureteral catheterization was performed on the right side and cloudy urine was drained. ⋯ Administration of antibiotics and insulin and the ureteral catheter drainage improved her condition immediately. Abnormal gas shadow on CT scan and submucosal emphysema on cystoscopy disappeared. We reviewed 110 cases of emphysematous pyelonephritis and 23 cases of emphysematous cystitis including our case in Japan, and report their clinical characteristics.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Pretreatment with chlormadinone acetate in prostate cancer patients treated with a luteinizing hormone-releasing hormone analogue].
We evaluated the efficacy of pretreatment with chlormadinone acetate (CMA) in preventing the initial testosterone surge induced by luteinizing hormone-releasing hormone (LH-RH) analogue. A total of 44 patients with previously untreated prostate cancer was included in this study. Patients were randomly assigned to 2 treatment groups: Group I-CMA therapy was begun 4 weeks before the initial LH-RH analogue injection. ⋯ In group II, the mean relative PSA level decreased after LH-RH analogue administration. Objective response rates at 12 weeks were 83.3% and 93.8% in group I and group II. Our results indicate that pretreatment with CMA for 2 weeks appeared to be sufficient to prevent the initial testosterone surge induced by LH-RH analogue.
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Twenty-four previously untreated patients with a diagnosis of prostatic cancer were treated with chlormadinone acetate (CMA) alone (100 mg/day) for 4 weeks, and luteinizing hormone-releasing hormone analogue (LH-RHa) was added for the next 24 weeks. Marked decreases in blood LH, testosterone (T), prostate specific antigen (PSA), gamma-seminoprotein (gamma-Sm), and prostatic acid phosphatase (PAP) were observed after a single dose of CMA. T levels were significantly increased 3 days after the initial dose of LH-RHa, and did not return to the pretreatment level. ⋯ Overall evaluation showed PR or better in 75.0% of the patients. These findings suggest that prior administration of CMA followed by combined administration with LH-RHa is useful in the treatment of prostatic cancer. No negative effects on lipid metabolism were observed at any time during the treatment period.
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[The effects of LH-RH agonist alone or with flutamide in the treatment of stage D2 prostate cancer].
We compared the clinical efficacy of treatment with a luteinizing hormone-releasing hormone (LH-RH) agonist alone to combined androgen blockade (CAB) with a LH-RH agonist and fiutamide. A total of 66 stage D2 prostate cancer patients were enrolled from Nov. 1992 to Mar. 1996 (n = 30: LH-RH agonist alone, n = 36 CAB). Serum PSA levels after 3 months of treatment and progression-free survival rates (Kaplan-Meier curves) were compared. ⋯ Progression-free survival rates were longer in the patients treated CAB compared to LH-RH agonist alone (P = 0.041). Furthermore, in patients with poorly differentiated prostate cancers, longer survival rates were also observed with CAB (P = 0.030). However, there were no differences in high EOD (> or = 2) patients between the two treatments (P = 0.652).
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We report a case of retroperitoneal Castleman's disease. A 57-year-old woman was referred for evaluation of microscopic hematuria. ⋯ Although retroperitoneal Castleman's disease is an uncommon disease. We should always consider this tumor in the differential diagnosis of retroperitoneal tumors.