[Clinical efficacy of fluconazole in urinary tract fungal infections].

Fluconazole, a new antifungal agent was administered to 7 patients with complicated urinary tract fungal infections. Patients were 6 males and 1 female with ages of 29 to 83 years, with underlying conditions of bladder tumor (3 patients), neurogenic bladder (3 patients) and hydronephrosis (1 patient). Urinary fungi identified were Candida albicans in 5 patients and Candida tropicalis in 2 patients over 10(4) CFU/ml. These fungi were isolated at least twice in intervals of 5 to 7 days before treatment. Fluconazole was given either orally (4 patients) or intravenously (3 patients) in a dose of 50 mg per day. Clinical efficacies were excellent in 3 patients, moderate in 3 patients and poor in 1 patient, showing an efficacy rate of 85.7%. Mycologically, 6 Candida out of the 7 were eliminated. No side effects nor abnormal laboratory data were observed. In conclusion, fluconazole is effective and safe in the treatment of urinary tract fungal infections.

[Clinical effect of midodrine hydrochloride on the patients with urinary incontinence].

The effects of midodrine hydrochloride (Brand name: Metligine tablet 2 mg, Manufacturer: Taisho Pharmaceutical Co., Ltd.), alpha-1 adrenalin receptor agonist against urinary incontinence was examined on 5 female patients with stress urinary incontinence and 5 male urinary incontinent patients of various causes. Metligine was administered in the dose of 4 mg daily for 2 to 4 weeks. Eighty per cent of the stress incontinent patients showed improvement and five incontinent male also showed improvement of symptoms. No side effects were recognized.

[A case of testicular tumor in a patient with Down's syndrome: a case report].

A 20-year-old man with Down's syndrome was admitted to our hospital because of a painless, swollen mass in the left scrotum. High inguinal orchiectomy was performed under the diagnosis of testicular tumor, and pathological findings revealed mixed germ cell tumor. Seventeen cases including our case, reported as testicular tumor with Down's syndrome, are herein reviewed.

[Synchronous bilateral renal cell carcinoma in mass examination: a case report].

A 65-year-old female with bilateral renal cell carcinoma which was incidentally found by general check-up developed left hemiplegia following left nephrectomy. Marked metastasis of cervical spine was demonstrated by computerized tomography scanning, which was not evident before the operation by X-ray examinations. The patient died of respiratory paralysis one month after the operation. This case was difficult to treat, because the disease advanced so rapidly.

[Comparative studies of DL-8280 and pipemidic acid in complicated urinary tract infections by double-blind method].

The clinical efficacy, safety and usefulness of DL-8280 for the treatment of complicated urinary tract infections were compared with those of pipemidic acid (PPA) by a double-blind method. DL-8280 and PPA were orally administered at a daily dose of 600 mg (t.i.d.) and 2.0 g (q.i.d.) for 5 days, respectively. Of the 311 patients who received DL-8280 or PPA, clinical efficacy, safety and usefulness were evaluated in 228 patients (DL-8280, 115; PPA, 113), 306 patients (DL-8280, 153; PPA, 153) and 250 patients (DL-8280, 124; PPA, 126), respectively. There was no significant difference in the background characteristics between the two groups. In the DL-8280 group the overall clinical efficacy was excellent in 39.1% and moderate in 41.7%, the effectiveness rate being 80.9%, whereas in the PPA group it was excellent in 23.9% and moderate in 33.6%, the effectiveness rate being 57.5%. The efficacy in the DL-8280 group was significantly higher than that in the PPA group (P less than 0.001). According to classification by the type of infection, the overall clinical efficacy of DL-8280 in groups except group 2 (monomicrobial infection, post prostatectomy) and group 3 (monomicrobial infection, upper urinary tract infection) was superior to that of PPA, the difference being significant. Pyuria was cleared or improved in 59.1% of the patients treated with DL-8280 and in 46.0% of the patients with PPA. The difference was not significant. Bacteriuria was eliminated in 76.5% in the DL-8280 group and in 50.4% in the PPA group. DL-8280 demonstrated a significantly higher response than PPA (P less than 0.001). Of the bacteria isolated from the DL-8280 group and PPA group 89.0% and 72.1%, respectively, were eradicated after the treatment, a significant difference being observed between the two groups (P less than 0.001). The clinical efficacy evaluated by the doctor in charge was excellent in 46.1% and good in 37.4% of the patients treated with DL-8280 and excellent in 26.5% and good in 34.5% of the patients treated with PPA, the intergroup difference in the efficacy being significant (P less than 0.001). The evaluation of usefulness of DL-8280 and PPA was "satisfactory" for 71.8% and 47.6%, respectively, the difference being significant (P less than 0.001). Side effects were observed in 11 patients (7.2%) in the DL-8280 group and in 12 patients (7.8%) in the PPA group, but none were serious.(ABSTRACT TRUNCATED AT 400 WORDS)

[Comparative study on intravenous drip infusion of dibekacin once daily and twice daily in treatment of complicated urinary tract infections].

Dibekacin (DKB) was administered to patients with complicated urinary tract infections without any indwelling catheter to evaluate objectively and comparatively the efficacy, safety and usefulness of intravenous drip infusion once daily and twice daily in a well-controlled study. A 50 mg dose of DKB was administered twice a day to group A, and a 100 mg dose was given once a day to group B. In both groups the drug was given by 1-hr i.v. infusion for 5 consecutive days. Drug efficacy was evaluated in 72 (group A: 36, group B: 36) of the 83 patients treated, and the safety was evaluated on 81 patients (group A: 41, group B: 40). There were no significant differences in the background characteristics between the two groups. The overall clinical efficacy judged by the Committee for Evaluation of Clinical Efficacy was "excellent" in 14% and "moderate" in 50% of group A, and "excellent" in 17% and "moderate" in 64% of group B, the efficacy being higher for group B than group A, but the difference was not statistically significant. The overall drug efficacy rate for each type of infection excluding group 2, was slightly higher in group B, but this difference was not significant either. The overall clinical efficacy for each site of infection, was higher for group B but the differences were not significant. The overall clinical efficacy as judged by the attending physicians was "excellent" in 17% and "moderate" in 58% of group A, and "excellent" in 25% and "moderate" in 61% of group B. The intergroup difference was thus smaller than that judged by the Committee. The elimination rates against bacteriuria were 58% for both groups A and B, and the decrease rates including "cleared" were 42% against pyuria for both groups A and B. Bacteriological evaluation, showed that there was no significant difference in the eradication rates, between group A (65%) and group B (70%). But the eradication rate for gram-positive bacteria was 40% in group A and 81% in group B, there being a significant difference (P less than 0.05) between them. The evaluation of usefulness gave 44% and 53% "satisfactory" rates, respectively, for groups A and B. The results for the "average score" were also the same in both groups. There were no side effects in any of the 81 patients examined. Abnormal laboratory test values attributed to the drug were seen only in 3 and 2 patients in groups A and B, respectively, there being no difference between the groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Cortical cerebellar degeneration with testicular neoplasm.

Cortical cerebellar degeneration was found in a 28-year-old man with testicular neoplasm. The patient, who had undergone a left orchidectomy for the testicular tumor, developed progressive cerebellar symptoms with mental changes 7 months later. The autopsy revealed the spread of a malignant germ cell tumor of the testis, and cortical cerebellar degeneration in the central nervous system (CNS) which was characterized by almost complete loss of Purkinje cells and degeneration of the both dentate nuclei and superior cerebellar peduncles. The present case is the first of cortical cerebellar degeneration combined with testicular neoplasms.