Evidence for magnetic Weyl fermions in a correlated metal.

Weyl fermions have been observed as three-dimensional, gapless topological excitations in weakly correlated, inversion-symmetry-breaking semimetals. However, their realization in spontaneously time-reversal-symmetry-breaking phases of strongly correlated materials has so far remained hypothetical. Here, we report experimental evidence for magnetic Weyl fermions in Mn3Sn, a non-collinear antiferromagnet that exhibits a large anomalous Hall effect, even at room temperature. Detailed comparison between angle-resolved photoemission spectroscopy (ARPES) measurements and density functional theory (DFT) calculations reveals significant bandwidth renormalization and damping effects due to the strong correlation among Mn 3d electrons. Magnetotransport measurements provide strong evidence for the chiral anomaly of Weyl fermions-namely, the emergence of positive magnetoconductance only in the presence of parallel electric and magnetic fields. Since weak magnetic fields (approximately 10 mT) are adequate to control the distribution of Weyl points and the large fictitious fields (equivalent to approximately a few hundred T) produced by them in momentum space, our discovery lays the foundation for a new field of science and technology involving the magnetic Weyl excitations of strongly correlated electron systems such as Mn3Sn.

Experimental Determination of the Topological Phase Diagram in Cerium Monopnictides.

Experimental determinations of bulk band topology in the solid states have been so far restricted to only indirect investigation through the probing of surface states predicted by electronic structure calculations. We here present an alternative approach to determine the band topology by means of bulk-sensitive soft x-ray angle-resolved photoemission spectroscopy. We investigate the bulk electronic structures of the series materials, Ce monopnictides (CeP, CeAs, CeSb, and CeBi). By performing a paradigmatic study of the band structures as a function of their spin-orbit coupling, we draw the topological phase diagram and unambiguously reveal the topological phase transition from a trivial to a nontrivial regime in going from CeP to CeBi induced by the band inversion. The underlying mechanism of the phase transition is elucidated in terms of spin-orbit coupling in concert with their semimetallic band structures. Our comprehensive observations provide a new insight into the band topology hidden in the bulk states.

Time-, spin-, and angle-resolved photoemission spectroscopy with a 1-MHz 10.7-eV pulse laser.

We describe a setup of time-, spin-, and angle-resolved photoemission spectroscopy (tr-SARPES) employing a 10.7 eV (λ = 115.6 nm) pulse laser at a 1 MHz repetition rate as a probe photon source. This equipment effectively combines the technologies of a high-power Yb:fiber laser, ultraviolet-driven harmonic generation in Xe gas, and a SARPES apparatus equipped with very-low-energy-electron-diffraction spin detectors. A high repetition rate (1 MHz) of the probe laser allows experiments with the photoemission space-charge effects significantly reduced, despite a high flux of 1013 photons/s on the sample. The relatively high photon energy (10.7 eV) also brings the capability of observing a wide momentum range that covers the entire Brillouin zone of many materials while ensuring high momentum resolution. The experimental setup overcomes the low efficiency of spin-resolved measurements, which gets even more severe for the pump-probed unoccupied states, and affords the opportunity to investigate ultrafast electron and spin dynamics of modern quantum materials with energy and time resolutions of 25 meV and 360 fs, respectively.

Devil's staircase transition of the electronic structures in CeSb.

Solids with competing interactions often undergo complex phase transitions with a variety of long-periodic modulations. Among such transition, devil's staircase is the most complex phenomenon, and for it, CeSb is the most famous material, where a number of the distinct phases with long-periodic magnetostructures sequentially appear below the Néel temperature. An evolution of the low-energy electronic structure going through the devil's staircase is of special interest, which has, however, been elusive so far despite 40 years of intense research. Here, we use bulk-sensitive angle-resolved photoemission spectroscopy and reveal the devil's staircase transition of the electronic structures. The magnetic reconstruction dramatically alters the band dispersions at each transition. Moreover, we find that the well-defined band picture largely collapses around the Fermi energy under the long-periodic modulation of the transitional phase, while it recovers at the transition into the lowest-temperature ground state. Our data provide the first direct evidence for a significant reorganization of the electronic structures and spectral functions occurring during the devil's staircase.

[Anomalous origin of the right coronary artery from the ascending aorta].

The patient was a 77-year-old man. In June 2008, he underwent off-pump coronary artery bypass (OPCAB) for unstable angina Intraoperative epiaortic echo showed an anomalous origin of theright coronary artery from the ascending aorta 4 cm above the sinotubular junction (STJ). The right coronary artery traveled through the planned proximal anastomotic site of the saphenous vein graft (SVG). If diagnosis of the anomalous origin of the right coronary artery had not been made, there would have been a high likelihood that the right coronary artery could have been injured. Thus, the usefulness of epiaortic echo was reaffirmed. An anomalous origin of the coronary artery is a rare congenital anomaly and its incidence is approximately 1%. An anomalous origin of the right coronary artery is very rare from the ascending aorta 4 cm above the STJ and only a few cases have been reported. An anomalous origin of the coronary artery can cause serious complications affecting the prognosis after open heart surgery. Thus, such an anomalous origin needs to be considered in preoperative evaluation.

Hayabusa2 arrives at the carbonaceous asteroid 162173 Ryugu-A spinning top-shaped rubble pile.

The Hayabusa2 spacecraft arrived at the near-Earth carbonaceous asteroid 162173 Ryugu in 2018. We present Hayabusa2 observations of Ryugu's shape, mass, and geomorphology. Ryugu has an oblate "spinning top" shape, with a prominent circular equatorial ridge. Its bulk density, 1.19 ± 0.02 grams per cubic centimeter, indicates a high-porosity (>50%) interior. Large surface boulders suggest a rubble-pile structure. Surface slope analysis shows Ryugu's shape may have been produced from having once spun at twice the current rate. Coupled with the observed global material homogeneity, this suggests that Ryugu was reshaped by centrifugally induced deformation during a period of rapid rotation. From these remote-sensing investigations, we identified a suitable sample collection site on the equatorial ridge.

The angiotensin-I-converting enzyme inhibitor perindopril suppresses tumor growth and angiogenesis: possible role of the vascular endothelial growth factor.

Angiotensin-I converting enzyme (ACE) inhibitor is used widely as an antihypertensive agent, and it has been suggested recently that it decreases the risk of cancer (A. F. Lever et al., Lancet, 352: 179-184, 1998). In this study, we examined the effect of several ACE inhibitors and angiotensin-II type 1 receptor (AT(1)-R) antagonists on tumor development and angiogenesis in a murine hepatocellular carcinoma model. Among ACE inhibitors, perindopril appeared to be a potent inhibitor of tumor development and angiogenesis, whereas AT(1)-R antagonists did not exert such an inhibitory effect. The inhibitory effect of perindopril was achieved even on established tumors. The level of the potent angiogenic factor, vascular endothelial growth factor (VEGF), in the tumor was significantly suppressed by perindopril. In vitro studies showed that perindopril-derived active form, perindoprilat, suppressed the endothelial cell tubule formation. Perindoprilat treatment also significantly inhibited VEGF mRNA expression in BNL-HCC cells in vitro. These results showed that the ACE inhibitor perindopril inhibited tumor development and angiogenesis independent from AT(1)-R blockage, and that VEGF alternation may be involved in the mechanism of this inhibitory effect. Because perindopril is widely used in clinical practice, it may represent an effective new strategy for anticancer therapy.

Gastric adenocarcinoma of fundic gland type (chief cell predominant type) with unique endoscopic appearance curatively treated by endoscopic submucosal resection.

Gastric adenocarcinoma of fundic gland type [chief cell predominant type; (GA-FD-CCP)] is a rare gastric cancer variant arising from non-atrophic mucosa without Helicobacter pylori infection in the upper third portion of the stomach. GA-FD-CCP originates deep in the mucosal layer; hence, endoscopic lesion detection is often difficult at an early stage because of a minimal change in the mucosal surface. Here we present a 66-year-old man with an early stage of GA-FD-CCP showing characteristic endoscopic features. Esophagogastroduodenoscopy demonstrated a flat, slightly reddish area with black pigment dispersion and irregular micro-surface structure at the gastric fornix. The tumor was resected by endoscopic submucosal dissection and was pathologically diagnosed as GA-FD-CCP. Prussian blue staining revealed that the black pigment was a hemosiderin deposition. We reported a rare case of successfully treated GA-FD-CCP with black pigmentation that aided in early lesion detection.

Intra-arterial chemotherapy for bladder cancer.

Intra-arterial infusion chemotherapy with adriamycin (ADM) was carried out in 32 patients with bladder cancer prior to total cystectomy. An oblique incision approximately 12 cm long was made in the gluteal region to expose either the superior or inferior gluteal artery, into which a Teflon catheter was inserted and fixed. The distal end of the catheter was taken out from under the skin in the precordial region. Via this catheter, a single dose of 10 mg ADM was injected twice a week. Superior-gluteal-artery infusion chemotherapy was performed in 7 patients; the 5-year survival rate was 14.3%, which was not as high as expected. Inferior-gluteal-artery infusion chemotherapy was performed in 25 patients. Cisplatin (CDDP) was used with ADM in 8 patients. Radiation and/or hyperthermia were used in 11 patients. The 5-year survival rate in these 25 patients was 58.4%, which was considered to be satisfactory. Of these 25 patients, 5 were stage-T4 cases; for these, the treatment was ineffective, and all 5 died within 2 years. Of the 6 patients at stage T2, 1 died, as did 1 patient with carcinoma in situ (CIS). Of the 13 patients with bladder cancer at stage T3, 3 died; lymph-node metastases were found in all 3 of these cases. Of the 25 patients who received inferior-gluteal-artery infusion chemotherapy, 9 died of cancer; all 9 died within 2 years due to distant metastases. There was no evidence of recurrence in any patient who survived for 2 years or more after total cystectomy. Therefore, inferior-gluteal-artery infusion chemotherapy may be effective as a preoperative adjuvant therapy with no serious side effects.

Synthesis, crystal structure and antimicrobial activities of two isomeric gold(I) complexes with nitrogen-containing heterocycle and triphenylphosphine ligands, [Au(L)(PPh3)] (HL = pyrazole and imidazole).

Two isomeric gold(I)-triphenylphosphine complexes with nitrogen-containing heterocycles, [Au(L)(PPh3) (HL = pyrazole (1), imidazole (2)) were isolated as colorless cubic crystals for 1 and colorless plate crystals for 2, respectively. The crystal structures of 1 and 2 were determined by single-crystal X-ray diffraction. These complexes were also fully characterized by complete elemental analyses, thermogravimetric/differential thermal analyses (TG/DTA) and FT-IR in the solid state and by solution NMR (31P, 1H and 13C) spectroscopy and molecular weight measurements in acetone solution. These complexes consisted of a monomeric 2-coordinate AuNP core both in the solid state and in solution. The molecular structures of 1 and 2 were compared with those of related gold(I) complexes, [Au(1,2,3-triz)(PPh3)] (3, Htriz = triazole), [Au(1,2,4-triz)(PPh3)]2 (4) as a dimer through a gold(I)-gold(I) bond in the solid state, and [Au(tetz)(PPh3)] (5, Htetz = tetrazole). Selective and effective antimicrobial activities against two gram-positive bacteria (B. subtilis, S. aureus) and modest activities against one yeast (C. albicans) found in these gold(I) complexes 1-4 are noteworthy, in contrast to poor activities observed in the corresponding silver(I) complexes.

Cytotoxic effect of conjugated trienoic fatty acids on mouse tumor and human monocytic leukemia cells.

The cytotoxicity of fatty acids from seed oils containing conjugated linolenic acids (CLN) was studied. Fatty acids from pomegranate, tung, and catalpa were cytotoxic to human monocytic leukemia cells at concentrations exceeding 5 microM for pomegranate and tung and 10 microM for catalpa, but fatty acids from pot marigold oil had no effect at concentrations ranging up to 163 microM. The main conjugated fatty acids of pomegranate, tung, catalpa, and pot marigold were cis(c)9,trans(t)11,c13-CLN (71.7%), c9,t11,t13-CLN (70.1%), t9,t11,c13-CLN (31.3%), and t8,t10,c12-CLN (33.4%), respectively. Therefore, the cytotoxicities of fatty acids from pomegranate, tung, and catalpa were supposed to be due to 9,11,13-CLN isomers. To elucidate the cytotoxicity of these CLN, we separated each CLN isomer from the fatty acid mixtures by high-performance liquid chromatography and analyzed its cytotoxicity. The cytotoxicities of c9,t11,c13-CLN, c9,t11,t13-CLN, and t9,t11,c13-CLN were much stronger than that of t8,t10,c12-CLN. Therefore, the higher cytotoxicity of fatty acids from pomegranate, tung, and catalpa than those from pot marigold would be derived from the different activities of 9,11,13-CLN and 8,10,12-CLN. Since there was little difference in the cytotoxicities of c9,t11,c13-CLN,c9,t11,t13-CLN, and t9,t11,c13-CLN, it is suggested that the cis/trans configuration of 9,11,13-CLN isomers had little effect on their cytotoxic effects. The mechanism of the cytotoxicity of the four fatty acids above may involve lipid peroxidation, because the order of toxicity of the fatty acids was consistent with their susceptibility to peroxidation in aqueous phase. This was supported by the decrease in the cytotoxicity of the fatty acids by addition of butylated hydroxytoluene.

[Epidemiologic study on tegumentary leishmaniasis in the municipality of Corguinho, Mato Grosso do Sul -- Studies in the human population]. / Estudo epidemiológico sobre leishmaniose tegumentar (LT) no município de Corguinho, Mato Grosso do Sul-Estudos na população humana.

A study on the resident population of 150 inhabitants of Boa Sorte in the Municipality of Corguinho, Mato Grosso do Sul State, Brazil was made, from March 1991 to March 1994, to establish the prevalence of South American Cutaneous Leishmaniasis (SACL), and to characterize the affected population, in an area of recent transmission. Twelve of the inhabitants showed lesions suspected to be SACL, and in 8 cases it was possible to confirm this by biopsy and parasitology. The mucosal form was found in one patient only, the rest showed the following cutaneous forms: ulcerated (3), ulcero-verrucose (1), hyperkeratotic ulcer (1), infiltrated maccule (1), nodule with florid regional adenopathy (1). All patients reacted favorably to treatment with glucantime, with lesion scarring. Side-effects were rare. The parasite isolated from all patients was identified as Leishmania (Viannia) braziliensis. The Montenegro skin test, applied to the 150 inhabitants, showed 32 reactive ones. Of these, six were carriers of the disease, 21 showed sequelae suggestive of the disease and five showed no signs of infection. The age grouping of the cohort ranged from 22 to 78 years, 75% being male. To date, transmission is suspected to be in the peridomicile.

Comparison of the inpatients admitted during the recent 5 years (January 1994-December 1998) with those admitted during the previous 5 years (January 1989-December 1993): a clinico-statistical study.

As society ages, the composition of the diseases that occur within it changes accordingly. With that in mind, we examined the characteristics and trends in the recent inpatients and compared these recent inpatients with those of a previous report to identify the changes that accompany the aging of society. Subjects were 1,534 cases (men 56.9%, female 43.1%, average age 47.1 years) who were hospitalized at Kurume University Hospital for treatment during the 5-year period from January 1st, 1994 through December 31st, 1998. The ratio of inpatients over 65 years old was about 1.8 times higher than in the previous study, showing a clear trend toward an increased overall age of inpatients. As for the types of disease observed, the most common malignancies were epithelial tumor, followed by other benign tumors, as well as 76 cases which included diseases resembling tumor (epulis and exostosis etc.). A majority of the patients (55.6%) were directed to the Hospital by their dentist, a finding similar to that of the previous report. As for geographical distribution, 93.3% of the inpatients lived within 40 km of the center of Kurume City where our oral surgery is located, an increase of about 10% from the last report. In other words, our results showed a reduction in the sphere of treatment distribution.

[Intraoperative monitoring for functional neurosurgery during intravenous anesthesia with propofol].

We studied the effects of propofol on electrophysiologic monitoring for functional neurosurgery. In six patients with intractable epilepsy, electrocorticograms (ECoGs) were monitored for epilepsy surgery, and in two of them, somatosensory evoked potentials (SEPs) were monitored because of the focus adjacent to the central sulcus. In four patients with hemifacial spasm, brain stem auditory evoked potentials (BAEPs) and abnormal muscle responses (AMRs) were monitored during microvascular decompression (MVD). In two patients with Parkinson's disease and in one patient with post-traumatic tremor, neural noise levels were recorded from microelectrodes during posteroventral pallidotomy and Vim thalamotomy. In each case of epilepsy surgery, during intravenous anesthesia with propofol, spike activity was recordable enough to identify the resective area and the residual spikes. SEP phase reversal was obtained in two patients and an exact determination of the central sulcus was possible. BAEPs and AMRs were obtained in all MVDs. To record neural noise levels, the infusion of propofol was decreased in two cases of posteroventral pallidotomy, and it was stopped in one case of Vim thalamotomy. In these patients, neural noise levels were recorded and were useful for identifying the target. Propofol is a potentially useful anesthetic agent for electrophysiologic monitoring during functional neurosurgery.

[A randomized long-term comparative study of clinical efficacy of alpha 1-blocker with or without antiandrogen therapy for benign prostatic hyperplasia: focusing on improvement of I-PSS].

This study was conducted to examine the efficacy of administration of tamsulosin hydrochloride alone or in combination with chlormadinone acetate (CMA) against lower urinary tract symptoms for a period of 52 weeks in 33 patients with benign prostatic hyperplasia. The patients were randomly allocated into a group administered tamsulosin alone and a group administered tamsulosin in combination with CMA. Based on the assessment of the total I-PSS (International Prostate Symptom Score), significant symptomatic improvement was noted 4 weeks after the commencement of drug administration in the tamsulosin + CMA group, whereas no significant improvement was observed in the tamsulosin group. Both irritative and obstructive bladder symptoms improved significantly at any time of assessment after 4 weeks of drug administration in the tamsulosin + CMA group; however, significant improvement was noted only at week 16 and week 52 for irritative symptoms and at week 16 for obstructive symptoms in the tamsulosin group. In particular, obstructive symptoms showed significant improvement at week 4 in the tamsulosin + CMA group, as compared with that in the tamsulosin group. The average value of peak urinary flow rate was significantly increased in the tamsulosin + CMA group (10.4 ml/s to 15.6 ml/s) as compared with that in the tamsulosin group (8.5 ml/s to 10.5 ml/s). These findings indicate that combined administration of tamsulosin and CMA resulted in early improvement of lower urinary tract symptoms in these patients. Long-term combined administration of tamsulosin and CMA thus appears to be a promising treatment strategy for the improvement of obstructive symptoms and peak urinary flow rate, particularly, 16 weeks onward after administration in patients with benign prostatic hyperplasia.

[A case of papillary cystadenoma of the epididymis].

We report a case of papillary cystadenoma of the right epididymis in a 48-year-old man. He consulted our hospital complaining of a small, painless mass at the upper pole of the right testis. There did not seem to be any remarkable problem of the mass. At 52 years old, the mass caused him pain, we diagnosed this case as chronic epididymitis, and performed right epididymectomy. On cut section, the tumor was multicystic and well encapsulated. The fluid within the cystic spaces was hemorrhagic. Microscopically, multimicrocysts were covered by tumor cells, which did not show any atypism or mitotic features. A papillary growth pattern was formed by vacuolated tumor cells around the capillaries in the microcysts, and a diagnosis of papillary cystadenoma of the epididymis was made. Papillary cystadenoma of the epididymis is considered a comparatively uncommon disease. To our knowledge, about 50 cases have been reported in the world literature, and this is the 17th case in Japan. Histologically, this tumor is similar in appearance to well-differentiated renal cell carcinoma, so it should be differentiated from metastatic renal cell carcinoma and multicystic papillary adenocarcinoma of the rete testis. The patient remains well with no evidence of recurrence or complication 8 months after excision. There is no evidence of renal cell carcinoma, nor features of von Hippel-Lindau's disease in this patient or his family.

[alpha-Interferon therapy in a patient with renal cell carcinoma and renal hypofunction].

A 60-year-old man who had renal cell carcinoma with renal hypofunction underwent partial nephrectomy followed by alpha-interferon therapy (LHBI 3 x 10(6) IU/day intramuscular injection for 4 weeks, then twice a week for 6 months). Glomerular filtration rate slightly decreased to 28. 5 from 32.6 ml/m after partial nephrectomy. On single injection of IFN, its serum level reached the maximum of 20.3 IU/ml, at 12 hours of injection, and 10.4 IU/ml at 24 hours. After 4 weeks, that was 50.6 IU/ml. NK activity and ADCC which were 32, and 68%, respectively before treatment, reduced to 6, and 28%, respectively after 4 weeks. After maintenance therapy they were shown to rise up to 26, and respectively 73%, and increased immunoactivity was confirmed.

[Transabdominal ultrasonography for detection of urologic diseases in the general health check].

From August, 1989 to December, 1992, 11,386 individuals consisting of 6,981 males and 4,405 females were examined in the general health check at Mito Saiseikai general hospital. Occult blood in dipstick urinalysis was detected in 190 of 6,981 males (2.7%) and 503 of 4,405 females (11.4%). Two renal cell carcinomas and ten bladder carcinomas were found out, but prostatic carcinoma could not be found out. None of these tumors were symptomatic. Two renal cell carcinomas, of which all patients had negative occult blood, were confirmed by computed tomography and angiography. Revealing the locally-confined tumor (Stage I) in the radiologic study, both tumors were resected with radical nephrectomy, and the pathological specimens showed pT2pNOpVO in both tumors. Of 10 bladder carcinomas seven transitional cell carcinomas, of which 6 patients had negative occult blood and one had positive occult blood, were confirmed by cystoscopy and TUR-BT. All of them were low-grade and low-stage tumors. Other three bladder carcinomas were detected by ultrasonography and cystoscopy, but these patient rejected TUR-BT. All of them had negative occult blood. We consider that the transabdominal ultrasonography is a very useful test for detecting the early stage of renal cancer and superficial bladder cancer. We recommend that transabdominal ultrasonography involving the kidney and the lower urinary tract should be performed in the general health check.

[Effects of lidocaine upon CCK-PZ and secretin producing paraneurons in the canine duodenum responding to luminal chemical stimuli (author's transl)].

Amino acid solution (50 mM tryptophan and 50 mM phenylalanine in saline) introduced into the canine duodenal loop causes an increased enzyme output from the pancreas, whereas administration of 0.1 N HCl into the duodenal loop causes an increased juice flow from the organ. Local anesthetic, lidocaine, introduced into the duodenal lumen suppressed the pancreatic enzyme releasing response to the intraluminal amino acid without affecting the juice flow response to the hydrochloric stimulus. Intravenously administered lidocaine did not block the pancreatic response to the intraluminal amino acid stimulus, suggesting that lidocaine affects the chemoreceptive, apical part of the endocrine cell or paraneuron which releases cholecystokinin-pancreozymin (CCK-PZ). Neither was the pancreas responding to an intravenous injection of CCK-PZ (5 Ivy Dog Units) suppressed by intravenously administered lidocaine even when its arterial concentration exceeded the convulsion level. This indicates that lidocaine affects the duodenal paraneurons recognizing the luminal stimuli but not the pancreatic cells responding to the hormones released by them. The results further suggest that in paraneurons as well as in neurons there seems to be a spectrum with regard to the susceptibility to anesthetics; thus the secretin releasing paraneuron is much more resistant to lidocaine than the CCK-PZ producing one.

[Combination therapy of intra-arterial chemotherapy and local hyperthermia for bladder cancer].

Fourteen patients (age range 50-79 mean 64.2) with locally advanced bladder cancer or CIS have been treated with combination of selective intra-arterial infusion of adriamycin (ADM) and/or cisplatin (CDDP) and local hyperthermia, prior to planed surgical resection. The follow-up periods ranged from 33 to 70 months (median 52). Clinical staging was based on biopsy, CT, Echo, chest X-ray, bone scintigraphy, and IVP. The initial tumor stage was Tis in 1 patients, cT2 in 4, and cT3 in 9. Catheterization technique: with the patient in the prone position, the gluteal muscles were dissected to expose the inferior gluteal artery, then catheter was inserted. The tip was wedged in the internal iliac artery below the bifurcation of the superior gluteal artery. ADM 10-20 mg and/or CDDP 10-20 mg were infused once or twice a week, more than eight times during hyperthermia. The total dose of ADM and CDDP were 40-360 mg and 50-360 mg. Local bladder hyperthermia was achieved with a radiofrequency generator. Novatherm IH-500 (Inter-Nova Co. Ltd, Japan). Intravesical temperature was maintained over 40 degrees C for an hour. Surgical resection included total cystectomy (10 patients), partial cystectomy (3) and TUR (1). Of evaluable 8 patients, CR was obtained in 2 patients, PR in 4, NC in 1 and PD in 1. The survival rate (Kaplan Meier method) at 3 years was 71.4% (n = 9) and at 5 years, 62.5% (n = 4). Five patients died, but two of them died of other causes (traffic accident and spinal cord injury). Severe toxicity, consisting of bone marrow suppression (3) perineal erosion (3) and ischialgia (1), was well tolerated. In conclusion, our result suggests combination therapy of intra-arterial chemotherapy and local hyperthermia is safe with minimal systemic side effects, and may prolong survival with invasive bladder cancer.