A retrospective study of 315 patients with superficial transitional cell carcinoma (stages Ta to T2) and an adequate followup of 3 years or longer is reported. Transurethral resection was done in 80 per cent of the patients and open excision or resection was done in 20 per cent for cure or control. We herein demonstrate that, in addition to grade and stage, multifocal tumor growth and whether the tumor is primary or recurrent influence the frequency of recurrences and tumor progression. The over-all recurrence rate after resection of stages Ta, T1 and T2 tumors within 3 years was 60 per cent. Recurrences after a primary tumor were noted in 45 per cent of the patients and were followed by a second recurrence in 84 per cent, with solitary tumors occurring in 46 and multifocal tumors in 73 per cent. Tumor progression was observed in 24 per cent of patients with solitary tumors, 44 per cent of those with multifocal tumors, 20 to 25 per cent of those with primary and recurrent stage Ta and primary stage T1 tumors, and 56 per cent of those with recurrent stage T1 tumors. Therefore, when therapy is planned stage, grade, multifocal tumor growth and whether the tumor is primary or recurrent should be considered. Stage Ta tumors can be treated sufficiently by transurethral resection even in the case of several recurrences. More aggressive therapy should be considered when multifocal or recurrent stage T1 or T2 tumors recur as invasive carcinomas.

Schistosoma japonicum infection associated with a rectal carcinoid in an asymptomatic 44-year-old female from the Philippines is described. A systematic review of the literature could not identify similar reports, suggesting a rare coincidence. However, epidemiological data on the frequency of both conditions as well as published results of a colorectal screening programme from China indicate that underreporting of this concurrence is likely. Moreover, several studies suggest a causal link between schistosomiasis caused by S. japonicum and more common gastrointestinal malignancies such as colorectal carcinoma. Hence the presented case and the apparent neglect of this observation in the current literature allow speculation on a role of S. japonicum in the pathogenesis of rare gastrointestinal neoplasms such as carcinoid tumours as well. Future reports on similar observations could help to determine the need for systematic investigations and are strongly encouraged.

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Anabolic steroids can cause severe cholestasis and acute renal failure. In this case there was a notable temporal coincidence between the administration of ursodeoxycholic acid and the marked clinical improvement.

The epithela of the three divisions (coprodaeum, urodaeum, proctodaeum) of the cloaca of the hen, and of the excretory ducts (colon, ureter, vagina) which join the divisions, are described using light microscopy, and scanning and transmission electron microscopy. Each region of the cloaca has its typical epithelium. Special attention is focussed in this study on the boundaries between the different epithelia. The coprodaeal epithelium does not differ considerably from that of the colon; a transitional zone is not visible. Distinct border zones, however, are observed between the other regions (ureter--urodaeum; vagina--urodaeum and proctodaeum; urodaeum--proctodaeum; proctodaeum--cutis). Although the vaginal opening is generally thought to lie in the urodaeum, our investigations show that at the vaginal opening into the cloaca the ciliated epithelium changes, on one border to a secretory epithelium characteristic of the urodaeum and on the other border to that characteristic of the proctodaeum. These observations are discussed in relation to functional aspects.

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Zur Festlegung der TNM-Klassifikation beim Blasenkarzinom wurde 1978 von der Internationalen Union gegen den Krebs (U1CC) ein diagnostisches Minimalprogramm vorgeschrieben. Es umfaßt die klini-sche Untersuchung, das Ausscheidungsurogramm, die Zystoskopie, die bimanuelle Palpation unter Narkose sowie die Tumorbiopsie oder die transurethrale Elektroresektion. Zur Beurteilung multifokalen Tumorwachstums und der flächenhaften Ausdehnung exophytischer Karzinome sollte die einfache Tumorbiopsie durch ein multiples Biopsieschema in Verbindung mit der transurethralen Resektion ergänzt werden. Ebenso sollte die exfoliative Urinzytologie Bestand-teil des diagnostischen Routineprogramms sein; ihr Wert liegt in der primären Tumordiagnose und in der Kontrolle des histologisch ge-sicherten Differenzierungsgrades. Das Computertomogramm kann in ausgesuchten Fallen die klinische Einschätzung der Infiltrationstiefe verbessern. Zur Bestimmung der Lymphknotenmetastasen halten wir die Lymphographie für nicht geeignet und empfehlen vor jeder geplan-ten Zystektomie die Staging-Operation.