小林 峰峰

• East China Jiaotong University

1)総手術件数は10年間で2,532件,ESWLを除く手術件数は1,938件(年間142～226件)であった. 2)尿路結石手術の年次変遷は著しく,初期は内視鏡結石手術が増加し,中期は結石手術自体が激減した.後期はESWLが導入され,ESWL, TULによる治療が主体となった. 3)最も多く行われた手術は,TUR-P 416件であった.続いて,TUR-Bt 325件,環状切開179件,TUL 102件,精管結紮術88件などであった.悪性腫瘍に対する手術の増加は,去勢術以外は軽度であった A clinical statistic survey was carried out on the operations performed at the Department of Urology, Ha...

1988年より1996年迄に,名古屋大学医学部附属病院泌尿器科においてpoor-risk非セミノーマ胚細胞腫瘍の11例を治療した.化学療法施行中に縦隔原発腫瘍の2例が死亡.腫瘍容積の大きな縦隔腫瘍の治療では輸液量を最低限にする必要がある.導入化学療法によりマーカーが正常化したのは3例.導入化学療法中或いは後,マーカーが上昇した3例は結局全例癌死した.導入化学療法ではマーカー正常化をみなかった7例中5例で,救済化学療法によってマーカーが正常化し,そのうちの2例が長期に生存している.救済化学療法後,8例に残存腫瘍摘出を施行した.残存腫瘍の病理検査で壊死,線維組織であった5例中,2例で術後早期にマーカーの上昇をみた.結局,11例中8例にCRが得られたが,長期NEDは5例に達成されたのみであった B...

Clinical effect of Estracyt was investigated in prostatic cancer patients. Twenty seven patients had been previously treated and 20 had not received prior treatment. Improvement rate of subjective symptoms was 85% in the previously untreated patients and that of objective findings was 85%, while those rates were 44% and 50% in the previously treate...

56例の男子淋菌性尿道炎に対しNFLX, 600 mg/dayを7日間投与し,3日目,7日目にその効果を検討した.3日目で77.8%著効,7日目に94.4%が著効であり7日目までに100%有効と認められた.淋菌のMICを14株についてAMPCおよびNFLXについて測定した.AMPC, NFLXともに耐菌性は見られなかったが,NFLXはAMPCに比べMICの中央値は全体に低い値(0.05 μg/ml)を示した Fifty six males with gonococcal urethritis were administered 600 mg of norfloxacin (NFLX) daily for 7 days, before the effects were examined. Th...

A case of right adrenal malignant pheochromocytoma was reported. The patient was a 16-year-old boy who complained of severe right side abdominal pain due to spontaneous hemorrhage into the retroperitoneal space. Right adrenalectomy was performed on Feb. 22, 1988 but the preoperative high serous catecholamine level did not drop to the normal level....

Excretory urography was performed using iohexol (Omnipaque 300 and Omnipaque 350) on 388 patients requiring urography in the Department of Urology, Nagoya University School of Medicine and 10 affiliated hospitals. Adverse reactions were observed in 3 cases (0.8%), but they were all mild. Good image efficacy was obtained in more than 95% of the pati...

A case of ectopic ureterocele in a 50-year-old male is reported. He was admitted to the hospital with complaints of miction pain, cloudy urine and fever attack. He had had pain at voiding from time to time during the past 10 years. The prostata was swollen, edematous and tender. Cystoscopy revealed a large bulge in the left trigone to bladder neck,...

A case of vesico-uterine fistula which occurred after cesarean section is reported. Sixty cases of vesico-uterine fistula, including this case, in the Japanese literature have been reviewed. We have made a discussion on the etiology, symptoms and treatment of these cases.

25名の自律神経過反射を示す脊髄損傷者を対象として検討した.(1)脊髄損傷レベルでは第5胸髄以上が19名(76%),第6胸髄以下が6名(24%)であった.症状の発現時期は受傷後1年以内が20名(80%)と最多であった.症状は発汗,頭痛,悪心などであった.(2)血圧を同時測定しつつ膀胱内圧を測定した.収縮期,拡張期血圧ともに,膀胱最高容量時では注水前より有意に上昇し,排水後は最高容量時より有意に下降した.レギチン負荷後に同様の検査を施行したが,血圧の上昇率はコントロール値の2/3に軽減した.(3)治療は間欠導尿や経尿道的括約筋切開術で排尿効率の改善をはかるとともに,α-交感神経遮断剤(POB)や交感神経節遮断剤(インスリン)を併用して,22名(88%)で有効であった Autonomic hyp...

1984年7月から同11月までの間に当大学および関連19施設で経験した難治性の複雑性尿路感染症64例を対象として,新しく開発されたquinolone carboxylic acid系薬剤のNFLXを投与し,臨床効果を検討した.なお起炎菌が証明されなかったり,真菌の検出された20例は除外し,計44例を検討対象とした.投与方法は1日600 mg(分3),14日間とした.効果判定はUTI薬効評価基準に準じて行ない,MICも測定した.疾患別の有効率は単独感染62.1%,混合感染60.0%で,単独感染のカテーテル留置例の有効率は50%であった.従来の本剤による報告では有効率が52%～85%であり,今回の成績が平均61%とやゝ低いが,G-1, G-5のカテーテル留置例が多かった結果と考えられる.従ってカ...

A case of renal leiomyosarcoma seen in a 65-year-old man is reported. On November 15, 1985, he complained of right flank pain and high fever. On right renal angiography and computed tomography showed a mass on lower pole of the right kidney. On December 10, 1985, the patient underwent right radical nephrectomy. The histological diagnosis was leiomy...

We report two cases of perivesical abscess associated with neurogenic bladders. One patient suffered from diabetic neurogenic bladder, and the other spinal cord injury. Both patients had an uninhibited contraction at the low capacity on cystometry. They complained of difficulty in micturition and presented with large lower abdominal tumors. Althoug...

We evaluated the reliability of serum beta 2-microglobulin (beta 2-MG) in comparison with serum creatinine, blood urea nitrogen and creatinine clearance in 164 patients with spinal cord injury. The value of serum beta 2-MG demonstrated the highest correlation coefficient (r = -0.927) in relation to creatinine clearance. The beta 2-MG value reflecte...

Clinical effects and therapeutic usefulness of oxybutynin hydrochloride were evaluated in a long-term clinical trial on patients with unstable bladders and neurogenic bladders. Of the 46 patients entered into the trial, 37 were those diagnosed with an unstable bladder and 9 with a neurogenic bladder with overactive detrusor. In 37 of the cases (80%...