Postsynaptic alpha adrenergic receptor subtypes mediating contraction of human urinary bladder base and prostatic urethra were investigated in vitro. Alpha adrenergic receptor agonists, noradrenaline and phenylephrine, induced contraction dose-dependently in these tissues. Alpha adrenergic receptor antagonists, prazosin and yohimbine, competitively antagonized the contraction induced by these agonists in the bladder base as well as prostatic urethra. The mean pA2 values for the antagonists in the bladder base and prostatic urethra were as follows: 8.89 and 8.96 for prazosin and 6.30 and 6.45 for yohimbine, respectively. Comparison of pA2 values of prazosin and yohimbine in both the tissues with those values found in the literature for these compounds in a variety of tissues containing alpha-1 or alpha-2 adrenergic receptor indicates that the postsynaptic alpha adrenergic receptor subtype in the human urinary bladder base and prostatic urethra is the alpha-1 type, not the alpha-2 type.

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Clinical evaluation of 460 cases of urothelial tumors of the renal pelvis and ureter was performed using a new clinical classification system, since no systemic clinical classification such as the TNM system for bladder tumors has been available to date. ABC, and TS and TE categories were newly adopted. The former distinguishes tumor multicentricity, and the latter indicates the clinical tumor stage. Tumors arising in one organ and homolaterally are categorized as A, while those in both organs (ureter and renal pelvis) and/or in the bladder are B, and bilateral tumors are C. TS represents the tumors of pT1 and pT2, and TE represents pT3, and pT4. Tumors belonging to pB showed a poorer prognosis than pA tumors. The TS and TE staging system clearly reflected the histopathologic stage, and produced significant differences in relative survival rates. Regarding various prognostic factors, our series gave the same results as reported by other investigators. However, it should be stressed that female patients showed a poorer prognosis than male patients.

A cooperative study was carried out in 44 institutions in Japan to evaluate the clinical efficacy of two kinds of recombinant human leukocyte interferon (Ro 22-8181 and Sch 30500) and a human lymphoblastoid interferon (MOR-22) on metastatic lesions of renal cell carcinoma. Of 226 evaluable cases, efficacy was observed in 40 cases; complete response (CR) in 4 cases, and partial response (PR) in 36 cases, indicating an overall response rate of 17.7%. Although there were no statistically significant differences in age range, sex distribution, and performance status between responders and nonresponders, the incidence of poor response was significantly higher among patients in whom primary renal cell carcinoma had remained or in those who had prior chemotherapy and/or radiation therapy. When response was assessed with regard to individual metastatic sites of renal cell carcinoma, pulmonary metastasis was significantly susceptible to interferon treatment, compared to other metastatic sites. The median period to achieve CR or PR was 45 days (range, 22-211 days) and the median length to maintain CR or PR was 79 days (range, 29-278 days). The median of pulmonary metastatic area that was measured by the sum of the products of the largest perpendicular diameters was 7.2 cm2 (0.5-107.8 cm2), which was reduced to 1.1 cm2 (0-48.8 cm2) by alpha interferons. Cumulative survival of all responder patients was significantly longer than that of other patients with poor response.

Results of measurement of urinary steroid metabolite