Objective To analyse the clinical and therapeutic conse-after the treatment was completed. The remaining two patients (three pyelo-ureteric systems) had persistently quences of bacillus Calmette-Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of the upper positive cytology. Of two patients who received BCG therapy through a ureteric catheter, one developed a urinary tract. Patients and methods Eight pyelo-ureteric systems in ureteric stricture and the other developed renal tuberculosis. five patients with cytologically confirmed CIS of the upper urinary tract were treated using perfusion of Conclusions Although long-term adaptation to a nephrostomy tube disturbs the quality of life of the BCG through a percutaneous nephrostomy tube in five and a retrograde ureteric catheter in three. Follow-patient, percutaneous perfusion therapy through a nephrostomy tube seems to be safer than retrograde up cystoscopy, retrograde pyelography and selective urinary cytology were obtained 4 weeks after the last perfusion through a ureteric catheter. Keywords Carcinoma in situ, bacillus Calmette-Guérin treatment and every 3 months thereafter. Results In three patients (five pyelo-ureteric systems) vaccine, upper urinary tract, percutaneous perfusion the cytology remained negative for 10-46 months and total cystectomy for CIS of the upper tract and

Background : The value of serum prostate-specific antigen (PSA) screening was examined to detect prostate cancer in men receiving hemodialysis. Methods : Forty-one male patients age 60-95 (median age, 70 years) receiving hemodialysis were investigated for PSA levels. We set the cut-off point at 4 ng/mL (the usual reference range). Digital rectal examination (DRE) and transrectal ultrasonography (TRUS) of the prostate were performed in patients whose PSA was more than 4 ng/mL and/or who expected further examination of the prostate. When prostate cancer was suspected, biopsy of the prostate was performed. In patients with prostate cancer, magnetic resonance imaging, computed tomography and bone scintigraphy were performed to diagnose the clinical stage. Results : The mean serum level of PSA was 2.10 ± 0.49 ng/mL. In this screening study, four of 41 men required further examinations for prostate cancer. Two of four refused further examinations. The other two were diagnosed with prostate cancer. The incidence of prostate cancer was at least 5% in our hemodialysis patients. One man, whose clinical stage was T2aN0M0, was treated with radical retropubic prostatectomy. Another man, whose clinical stage was T2bN0M0, was treated with luteinizing hormone-releasing hormone analogue. Conclusion : In our preliminary study, prostate cancer screening with PSA was useful for the early detection of prostate cancer in hemodialysis patients. If possible, DRE and TRUS should be performed in conjunction with PSA tests.

Background: Angiotensin-converting enzyme inhibitors (ACI) and angiotensin II receptor blockers (ARB) have been reported to increase recombinant human erythropoietin (rHuEPO) requirements. We performed a cross-sectional study to investigate an association of antihypertensive agents including these two with the rHuEPO dose in chronic hemodialysis patients. Methods: We studied 625 patients undergoing hemodialysis therapy in 11 dialysis units. The association between the rHuEPO dose and antihypertensive agents was statistically analyzed. Results: The mean hemoglobin (Hb) level and rHuEPO dose corrected by body weight were 10.5 g/dl and 95.2 U/kg/week, respectively. When the patients were subdivided into four groups according to the number of prescribed antihypertensive agents (G-0, G-1, G-2, and G-3; patients prescribed with no medication, 1, 2, and >3 drugs, respectively), a significantly low dose of rHuEPO was observed in G-0 compared to the other groups. Unpaired t test showed a higher dose of rHuEPO in the presence of ARB, α-blockers, or calcium channel blockers (CCB). The rHuEPO dose was higher in the elderly, in females, and in patients with diabetes or hypertension. In multiple regression analysis, age, sex, rHuEPO dose, serum albumin level, and duration of dialysis therapy but not antihypertensive drugs were independent factors for the Hb level. In contrast, the rHuEPO dose was significantly associated with a low level of Hb, age, females, and CCB use. However, since CCB use was strongly associated not only with rHuEPO dose but also with systolic blood pressure and the use of α-blockers and ARB, these findings might be caused by erythropoietin (EPO)-induced hypertension. Conclusion: There was an association between the number of antihypertensive agents and rHuEPO dose in chronic hemodialysis patients. However, no significant relation was indicated between ARB/ACI use and EPO requirements.

Objective To investigate the relationship between genomic heterogeneity and tumour grade, stage and DNA content in 30 transitional cell carcinomas (TCCs) of the urinary bladder. Materials and methods Tissue specimens from 30 patients (25 men and five women) with newly diagnosed TCC of the urinary bladder were examined for genomic heterogeneity using fluorescence in situ hybridization (FISH) with chromosome‐specific DNA probes; the copy number of pericentromeric sequences on chromosomes 7, 9 and 17 was detected within interphase nuclei in contact preparations from the tumour specimens. Results The aneusomy of chromosomes 7, 9 and 17 was significantly higher in aneuploid than in diploid tumours (P<0.001). Tumour grade and stage were strongly associated with aneusomy for chromosome 17 (P<0.01, P<0.001, respectively). The aneusomy of chromosomes 7 and 9 were significantly correlated with increasing tumour stage (P < 0.001), but not with tumour grade. Conclusion These results suggest that the measurement of aneusomy using FISH, especially for chromosome 17, in bladder cancer may offer a new objective and quantitative assay of the biological potential of individual tumours.

Flow cytometric DNA analysis was performed on 34 samples of prostatic carcinoma patients with stage D2 disease to study the relationship between DNA ploidy pattern, Gleason sum score, and prognosis. Nuclei were extracted from paraffin-embedded needle biopsy specimens. The DNA ploidy pattern was diploid in 53% of the tumors, tetraploid in 38%, and aneuploid in 9%. A significant correlation between DNA ploidy pattern, Gleason sum score, and prognosis was not proved. It was considered that DNA ploidy pattern and Gleason sum score of limited primary lesion did not allow a prognosis of the patients with stage D2 prostatic carcinoma to be made.