著者

稲田 務 片村 永樹 本郷 美弥

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.8, no.1, pp.56-73, 1962-01

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This report deals with our satisfactory result in o u r conservative treatment of carcinoma of the prostate, injecting Tespamin in the prostatic tissue. In 1953T hio-TEPAw as found to be an antileuk e m ic agent clinically used by Drs. Shay, Zarafonetis, Smith, Woldow and Sun for 49 leukemic patients. This medicine can be administrered in any way of intravenous, intramuscular, intracavital, intratumorous and oral. Thio-TEPAi s a powerful alkylating agent which combine with the nucleoprotei n o f the cell, followed by cell destruction especially inhibiting mitotic activity of immature cells resulting in nuclear pyknosis and destruction. Therfore, spermatogenesis becomes suppressed resulting in clinical castration. Method of Administration 1) Under local anesthesia in the perineum , occasionally epidural anesthesia, patient is placed in lithotomy position. 2) Thio-TEPA i s mixed with some hyaluronidase and given 20 or 30 mg. (0.5 mg/kg). 3) With the 10 ml. Luer-Syringe and gauge 17 or 15 long needle, the prostate is punctured, simultaneously being palpated rectally. Solution is injected to the several sites 1 or 2 cc each times. When the needle hits the carcinomatous tissue, we feel some resistance . 4) Patient receives the injection every 5 days to 7 days, or every 2 weeks . Tot a l doses ranged 150 to 300 mg. 5) Hematologic a lly, white cell count 4,000 and platelet count 100 ,000 are the standard for terminating this treatment. Presentation of Cases Case 1 : Y.U. A 64-year-old male had frequency since May 1958 and was seen in acute urinary retention June 1960. Rectal examination revealed enlarged prostate of egg-s,=- -hard ,irregular especiallerly on the right. Urethrocystography showed intravesical protrusion of the prostate without abnormality of the urethra (Fig. 1). Residual urine amounted 300 cc. Cystoscopy revealed chronic cystitis. Blood chemistry : Acid phosphatase 1.6 (normal title 0 to 3) ; Alkali phosphatase 1.4 (normal 1 to 4); Normal electrolytes level. Needle biopsy of prostate was repo r ted to be adenocarcinoma (Fig. 2 and 3). Laboratory examination : Examination of the blood ; white cell count 3,400 , with 68% of neutrophils and 20% of lymphocytes. Blood pressue was 108/64 mmHg. Treatment and course : Bilateral orchiectomy a nd administration of estrogen did not improve dysuria and unpleasment feeling in his perineum. Thio-TEPA (Tespamin ) 25 mg was first injected in the prostate weekly, biweekly later, amounting total dose of 200 mg. After initial injection of 25 m g Thio-TEPA, patient became free from dysuria ; and unpleasant feeling in the perineum also disappeared after injection of 75 mg. He also gained his weight and general condition much improved. After injection of Thio-TEPA 200 mg during 3 months, the prostate decreased in size, and induration became small-finger-sized, which was 1 year later noted as only flat, slightly indurated lesion. Phosphatase and hematology were normal. Histological change after injection of 25 mg of T e spamin was that tumor cells were polymorph, not uniform in size and irregularly arranged with nuclei abundant in chromatin. After injection of 125 mg, tissue developed remarkable fibrosis and narrowin g glandular lumen where tumor cells were only scattered. After injection of 200 mg, this tendency became remarkable with more poorly stained carcinoma cells and vacuole formation. The nuclei were atrophic. Tissue was mostly replaced to fibrous connective tissue of poor vascularity (Fig. 4 and 5). Case 2 : T.T. 75-year-old male first noticed frequency and dy s uria in September 1958. In May 1959, dysuria got worse with unpleasant perineum. He was admitted in October 1959. 1) Digital examination revealed egg-sized, enlarged, fixed prostate of bony hardness and irregular surface. 2) Ur o graphy. Urethrocystography (Fig. 6) showed elongated, irregular prostatic urethra with marked protrusion of prostate into the bladder on the left side. 3) Cystoscopy was performed with feeling of fixed cystoscope. Irregular bladder neck at IV to VIII o'clock was found. Residual urine amounted 400 cc. 4) Blood chemistry Acid phosp h atase 4.4 u. (normal level 0 to 4 u.), alkali phosphatase 2.1 u. (normal level 1 to 4 u.), 17 KS 6.12 mg/day (normal). Other electrolytes were normal. 5) Perineal needle biopsy of ;the prostate disclosed undiffer e ntiated adenocarcinoma of the prostate (Fig. 7 and 8). 6) Hematology : R.B.C. 365 x 104, Hb. 10.8 g/dl, color index 0.86, W.B.C. 5,400. neutrophils 68.0%, lymphocyte 29.7%, monocyte 4.5%. Treatment and Course : After bilateral orchiect o my, Thio-TEPA (Tespamin) was injected, as mentioned, 25 mg every 5 days or weekly into the prostate gland, amounting 200 mg in total dose. After Thio-TEPA 50 mg was injected, dysuria much improved ; and freq u ency disappeared after 75 mg injection. However, burning, unpleasant perineum, and cloudy urine were still present. A f ter 200 mg was injected, rectal examination showed that prostate became smaller in size with increased firmness. Periprostatic infiltration also seemed to have disappeared. Residual urine was 20 cc. Acid phosphatase also dropped to 2.5 u. and 17KS also decreased to 3.7 mg/day. Ur e t hrocystography showed the regular prostatic outline and much less protorusion into the urinary bladder (Fig. 9). Histologically, prostate showed remarkable fibrosis and smaller glandular lumen. Carcinoma cells seldom formed nest but exsisted in spotted way except for very few nests surrounded by fibrous tissue. Each carcinoma cell possessed prominent necleus with rich chromatin and showed protoplasmic destruction (Fig. 10,11,11,12,13). Case 3 : A.S. 60-year-old male with bony meta s tasis (Fig. 14). No remarkable improvement was obtained by orchiectomy and administration of Honvan. Dysuria and untoward feeling in the perineum disappeared after injection of Thio-TEPA (Tespamin) 150 mg. Seven months later, pubis appeared normal on x-ray (Fig. 15), acid phosphatase returned to normal. Needle biopsy of prostate showed adenocarcinoma (Fig. 16 and 17). After i n jection of 250 mg, histologically, tissue developed remarkable fibrosis and smaller glandular lumen (Fig. 18,19,20). Ca s e 4: S.N. 72-year-old male with history of simple prostatectomy 7 years previously, developed a big carcinoma of the prostate which became much smaller with disappearence of all troubles but dysuria after 300 mg of injected dose. Case 5 : K.K. 82-year-old. Big carcinoma of the prostate and bony metastasis. 300 mg of Thio-TEPA (Tespamin) injection gave no remarkable regression in size and slight improvement in dysuria. No side effects seen in all cases.

著者

佐藤 嘉一 丹田 均 中嶋 久雄 新田 俊一 赤樫 圭吾 半澤 辰夫 戸邉 武蔵 芳賀 一徳 内田 耕介 本間 一也

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 = Acta urologica Japonica (ISSN:00181994)

巻号頁・発行日

vol.59, no.5, pp.271-275, 2013-05

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Erectile dysfunction following radical prostatectomy (RP) is still a significant burden as a post-operative morbidity, despite advances in nerve-sparing techniques and penile (erectile function) rehabilitation (PR) programs. We assessed the effects of stimulation with the masturbation device "EGG" on enhancement of erectile response along with administration of phospho diesterase type 5 inhibitor. We also studied the change of self-esteem and motivation for continuation of PR after stimulation with EGG. Eight nonresponders for PDE5-I who underwent retropubic RP were enrolled. Patients' median age was 71.5 years old. No patients received adjuvant therapy for prostate cancer. The patients' erectile response in the penile rehabilitation session (masturbation) with PDE5-I+manual stimulation and PDE5-I+stimulation with EGG were evaluated by erection hardness score (EHS). Changes of self-esteem and motivation for penile rehabilitation were assessed by the self-esteem subscale of the Self-Esteem and Relationship (SEAR) questionnaire and one original question, respectively. PDE5-I + stimulation with EGG significantly enhanced EHS compared to PDE5-I+manual stimulation in the eight patients (p=0.027). Transformed score of self-esteem subscale score of SEAR questionnaire was significantly increased in the PR session with EGG compared to the PR session with manual stimulation (p=0.043). Six patients who showed a better erectile response with EGG retained motivation for continuation of PR. PDE5-I+stimulation with EGG improved the erectile response in post-RP patients. EGG as a masturbation device may have a potential for contribution to successful PR.

著者

友吉 唯夫

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.31, no.2, pp.199-206, 1985-02

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In Japan, two scientific words are used for the testis, SEISO and KOGAN. SEISO is the word accepted by most of the bioscience societies and etymologically means the nest of sperms. KOGAN, is a word of Chinese origin and mainly used by urologists. Its etymologic meaning is unclear. About one to two hundreds years ago, many classical Japanese books of medicine used EKIGAN the Chinese character of which is quite similar to KOGAN, and which etymologically was described as "pleasure balls of man" by a contemporary anatomist in Japan, although I presume it was intended to mean "a couple of balls, side by side". In order to avoid terminologic confusion, SEISO, the standard word used in many academic fields, is recommended for universal use not only in scientific papers but in daily language in Japan.

著者

松村 善昭 奥村 和弘 今村 正明 東 新 松本 慶三 井本 卓 寺地 敏郎

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.48, no.10, pp.599-601, 2002-10

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55歳男.人間ドックで骨盤内腫瘤,左水腎症を指摘された.CTで仙骨前面に接し骨盤内臓器を腹側に圧排する13×11×15cmの腫瘤を認め,内容は嚢胞成分,脂肪織,石灰化等が混在していた.手術は,まず砕石位で下腹部正中切開から経腹膜的に直腸後方の腫瘍に到達した.その際,右総腸骨動脈部に右萎縮精巣を認め,摘除した.腫瘤と直腸との間の剥離を進めると,腫瘍は仙骨前面の一部と強く癒着していた.経仙骨アプローチを加えることとし,体位をJack knife positionに変え,仙骨後方に逆Y字切開した.S4,S5神経,尾骨神経根を結紮切断した後,S4以下の仙骨,尾骨を切断し腫瘍後面に到達した.鈍的に剥離を進めたが,S3仙骨と腫瘍との間に強い癒着を認めた.一部嚢胞壁が残存し嚢胞内容がこぼれたが,腫瘍を一塊に摘出した.組織学的には悪性所見を認めず,良性の成熟奇形腫と診断した.術後排便障害は1ヵ月で軽快し,尿閉を術直後に認めたが,1年後には自尿1回200mlと回復した

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.55, no.12, pp.791-793, 2009-12

著者

石塚 榮一 岩崎 晧 大内 秀紀 林 成彦 藤川 敦

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.51, no.2, pp.85-91, 2005-02

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片側精巣捻転症の臨床的検討と精巣固定術例における両側精巣を解剖学的に比較検討した.対象は,手術を行った片側精巣捻転症例48例であった.好発年齢は10歳代が29例と大部分を占め,40歳以上には認めず,捻転側は左33例,右15例であった.主訴は陰嚢痛,下腹部痛が多く,陰嚢所見は発症後8時間以内では仰臥位で精巣が体軸と直角方向の変位が多かった.そして時間の経過に伴って陰嚢内容の腫脹,陰嚢の浮腫,発赤が加わり,回転は左右どちら側も時計方向・反時計方向とも360度回転が多かった.治療は48例中20例に固定術,28例に摘出術を施行した.48例中5例に徒手整復を試み3例で成功し,7例では整復せず回転が元に戻り固定できた.精索や精巣と鞘膜の関係はすべてBell-clapper typeであった.精巣固定できた20例では,捻転側と反対側の精巣構造が同じ形が13例,異なる形が7例であった

著者

佐藤 信夫 李 瑞仁 藤田 道夫

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.35, no.11, pp.1877-1880, 1989-11

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Sixteen cases of testicular torsion were experienced between 1983 and 1988. Diagnosis was confirmed by surgical exploration in all cases. The patients' age was between 10 and 31 years. Fourteen patients (88%) were in their second decade. The left side was involved in 13 cases, the right side in 2 and both sides in 1. Shortness of spermatic cord of involved side was observed in 12 cases (75%). This seemed to be one of the most important signs in differential diagnosis between testicular torsion and other acute scrotum. Prehn's sign was not available. Body temperature was more than 37 degrees C in only 1 case. Urinary tract infection was not noted. Orchiopexy was performed in 12 cases. 9 cases (75%) were treated within 24 hours after onset of the symptom. Two cases (13%) were operated more than 72 hours after onset, but repaired testis was not atrophic one year after surgery.

著者

浜口 毅樹 後藤 紀洋彦 冨士原 正保 岡田 弘 荒川 創一 松本 修 守殿 貞夫

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.35, no.2, pp.367-369, 1989-02

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A clinical study was performed on 4 patients with paraquat poisoning treated between 1985 and 1987. The survival rate was 0% in our hospital.

著者

米田 傑 金城 孝則 種田 建史 竹澤 健太郎 野村 広徳 鄭 則秀 高田 晋吾 松宮 清美

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.58, no.11, pp.621-624, 2012-11

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Penile self-mutilation is rare. We report our experience with 3 cases of penile self-amputation. One case was in a 48-year-old man who had no background history of mental disorders. He amputated his penis using a utility knife. He was referred to our hospital and underwent suture of the wound, but he took his own life one week after the surgery. Another case was in a 42-year-old man who had intelligence impairment. He amputated his penis using a kitchen knife. The other case was in a 41-year-old man who had schizophrenia. He amputated his penis using a piece of broken glass.

著者

高村 真一 鈴木 靖夫 日江井 鉄彦 島田 永子 中島 伸夫 田中 純二 三宅 弘治 三矢 英輔

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.33, no.3, pp.453-457, 1987-03

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A case is presented of priapism resulting from disseminated intravascular coagulopathy (DIC), which was diagnosed by pathological studies of the amputated penis and skin biopsy. To our knowledge, this is the first case reported in Japan. This 72-year-old-man visited a hospital complaining of fever and cough, and was administrated for treatment of bronchitis and liver cirrhosis. A few days after admission, multiple purpura with edema and pain appeared over the skin regions on the bilateral knee joint, foot joint and upper extremities. A week after purpura appeared, priapism began. Regardless of irrigation and aspiration of corpora cavernosa and glans-cavernosa-fistula creation, penile necrosis developed. We had to perform penile amputation. The pathology of the amputated penis and skin, and blood coagulative examination suggested that DIC resulted in priapism. DIC was controllable by the use of FOY and heparin. He was discharged and is an outpatient.

著者

有地 滋

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.26, no.6, pp.719-724, 1980-06

著者

ISHIKAWA Hiromichi TAKESHIMA Hitoshi

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.30, no.9, pp.1201-1205, 1984-09

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45症例につき検討した.乏精子症患者のセロトニンの平均値は80.1±33.0 ng/dl,無精子症患者のそれは107.0±41.2 ng/dlであり,その差は有意であった.精索静脈瘤のある例のセロトニン値の平均は83.4 ng/dlであり,ない例のそれは94.0 ng/dl,また,慢性副睾丸炎などの閉塞機転のある患者での平均値は80.3 ng/dl,ない例のそれは92.1 ng/dlであったが,それぞれ有意差は認めなかった

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.53, no.4, pp.259-261, 2007-04

著者

高崎 登 古谷 太門 宮崎 重 斎藤 宗吾

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.35, no.8, pp.1361-1364, 1989-08

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IMP患者についてその原因を検索するためのスクリーニングテストとして心電図R-R間隔CVを測定し,副交感神経障害に起因するものか否かについて検討した.CV 2.0以下のlow CVを呈し,副交感神経障害によるIMPと考えられた症例は,IMP患者762例中104例であった.このうちの50例に明らかな副交感神経障害因子が見出され,12例に副交感神経障害を起こす可能性のある因子が見出された.障害因子を見出すことができなかったものは42例であった

著者

田中 求平

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.19, no.1, pp.3-7, 1973-01

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Comparison was made between the series and the parallel connection of dialyzers in simultaneous hemodialysis of two patients with the dialysate supplier for single patient. 1) In the series connection, the top dialyzer showed the greater dialysis effect than the lower one, but the water deprivation effect was reverse. In the parallel connection, both dialyzers showed the equivalent work and the greater dialysis and water deprivation effect than either of the series dialyzers. 2) In the series connection, the patient of the lower dialyzer often complained chill due to lowering of the dialysate temperature. The parallel connection gave solution to this problem as well as to the psychological problem involved in the series connection. 3) In case of accident in the parallel connection, the dialyzer can be easily separated and the other dialyzer can continue dialysis without being disturbed.

著者

高羽 津 中新井 邦夫 生駒 文彦 佐谷 稔 岡本 英三

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.17, no.6, pp.401-413, 1971-06

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Complete reduplication of the urinary bladder is a rare con d ition. The patient here reported is 26-month-old girl, who visite d our hospital with chief complaint of anomalous external genitalia. Two external genita l i a were present at distance of about 10 cm, and further examinations revealed multiple malformations. These anomalie s consist in the urinary tract, female genital organs, gastrointestinal tract and skeletal system. In the low er urinary tract, complete reduplication of the urinary bladder was found. It was characteristic that each bladder had its own urethra and received one ureter. In the upper urinary tract left pelvic kidney was also demonstrated, w h ile right kidney was normal in position. Vesicouretera l refluxes were apparent bilaterally. Bilateral imperforated anuses with righ t perineal fistula were seen and roentgenologic examination gave a finding of duplicated rectum, but colonic duplications were not clearly demonstrated. Two appendices had been removed in the course of surgical repair for umbilical hernia at her age of 3 months in another hospital. Diastasis of the pubic bone, separated sacrum and a half vertebra with a rib were observed as the skeletal anomalies. Perineal ano p lasty was performed for a difficulty in defecation. Because of an immaturity and dysfunction of the urinary bladder, which are shown in the cystometrogram and electromyogram of the external vesical sphincter, cosmetic and urological reconstruction is now withheld. Thirty-one cases, i n cluding our own, of the complete reduplication of the urinary bladder were reviewed in the literature and discussed.

著者

町田 竜也 松岡 陽 小林 秀一郎 尾関 全 石坂 和博 岡 輝明

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.49, no.5, pp.257-259, 2003-05

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33歳男.会陰部腫瘤,歩行困難を主訴とした.4年前よりの会陰部腫瘤が徐々に増大し,歩行困難と坐位圧迫での疼痛をきたした.会陰部中央に小児頭大の腫瘍を認め,骨盤部MRIで壁の薄い嚢胞状腫瘤を認めた.内部は均一で,T1強調像にて低信号,T2強調像にて高信号を示し,液体成分と考えられた.骨盤内への浸潤や尿道,直腸との交通はなかった.会陰部の嚢胞状腫瘍の診断で腰痛麻酔下に腫瘍摘出術を施行した.嚢腫は球尿道海綿体筋を挟んで尿道とは離れていた.浸潤所見はなく完全摘除され,術後1年経過で再発も認めない.病理組織学的所見では内面は角化重層扁平上皮で覆われ,内腔に角化物質を多量に含んでいた.皮膚付属器や皮膚以外の組織は認められず,悪性所見も認められなかったためepidermal cystと診断された.会陰部のepidermal cystは稀で,自験例を含め本邦では6例の報告があるのみであった

著者

北山 太一 吉田 修 田中 正躬 久世 益治 広川 栄助

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.8, no.11, pp.663-672, 1962-11

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1. Twenty-two cases of foreign bodies in the bladder or u rethra were experienced at the Department of Urology, Kyoto University during past four years and four months. 2. Statistical study was made on 691 cases of foreign bodies in Japan s o far reported. It was concluded that recently foreign bodies such as suture materials were f requently seen in the patients who underwent gynecologic operation.

著者

小六 幹夫 丹田 均 加藤 修爾 大西 茂樹 中嶋 久雄 南部 明民 新田 俊一 赤樫 圭吾 佐藤 嘉一 半澤 辰夫

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.48, no.6, pp.333-336, 2002-06

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男性性感染症(STD)患者248例のアンケート調査結果について検討した.感染源は約70%の症例が友人やPick up(いわゆるナンパ)など,金銭の授受を伴わない相手であった.症状出現までに性交渉をもった相手の数は2.8人で,症状出現前のピンポン感染により一般のの人々にSTDが拡大している可能性が考えられた.STDに罹患したことをパートナーに伝えると回答した比率は,59.4%で高い比率では無かった.過去1年間の性交相手は平均5.8人で,若年層ほど高い傾向にあった.コンドーム装着率は12.4%(92/234)ときわめて低かった.Oral sexの頻度は82.0%(192/234)と高率であった.以上から,若年層において,広いsexual networkを形成し,無防備な性交が行われていることが考えられたIn Japan, there has been a rapid increase in recent years in the incidence of sexually transmitted diseases (STD), particularly in teenagers and people in their twenties. To determine the factors causing this increase in STD, we carried out a questionnaire survey on the sexual behavior of Japanese males. The subjects were 248 male patients who were treated at our outpatient clinic. The results of the survey showed that 1) about 70% of the male patients were infected through sexual intercourse with partners who were not paid for such services; 2) the average number of partners in the past year was 5.8, and the average number of partners was highest for the teenage group and decreased with age; 3) only 29 (12.4%) of the 234 males used condoms; and 4) 192 (82.0%) of the 234 males received oral sex. The results of the survey suggest that a large "sexual network" has been formed among young Japanese people and that a large percentage of young Japanese people are engaged in unprotected sex.

著者

塚本 哲郎 福井 巖 木原 和徳 後藤 修一 北原 聡史 小林 剛 児島 真一 大島 博幸

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.42, no.5, pp.351-356, 1996-05

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シスプラチンを含む全身化学療法を用いて治療したステージD2前立腺癌患者29例を3群に分けた. 1)H群:ホルモン療法が化学療法より4週を越えて先行したもの(9例). 2)C群:化学療法がホルモン療法より4週を越えて先行したもの,又は化学療法単独治療例(9例). 3)HC群:ホルモン療法と化学療法の関始時期の差が4週以内のもの(11例). Kaplan-Meier法による5年生存率は,H群が18%, C群が28%, HC群が78%で,HC群が他の2群に比べ良好であったWe retrospectively analyzed 29 patients with stage D2 prostatic cancer who had been treated with chemotherapy at the urological clinic of Tokyo Medical and Dental University Hospital between 1983 and 1992 to evaluate the efficacy of chemotherapy for advanced prostatic cancer. The patients were divided into three groups according to the starting time of chemotherapy in relation to hormone therapy; 9 patients who received chemotherapy more than four weeks after the initial hormone therapy (group H), 9 patients who received chemotherapy only or in combination with the hormone therapy more than four weeks previously (group C), and 11 patients in whom both therapies were started within four weeks (group HC). Follow-up period ranged from four to 108 months averaging 35. Combination chemotherapy including cisplatin was administered one to 17 times with the median of five. The five-year survival rates estimated by Kaplan-Meier method were 18% in group H, 28% in group C, and 78% in group HC, respectively (HC vs. C: p < 0.05, HC vs. H: p = 0.059). These findings indicate that a combination chemotherapy including cisplatin may improve the prognosis of patients with advanced prostatic cancer when it is started with the initial hormone therapy simultaneously.