著者

天野 俊康 今尾 哲也 竹前 克朗 水沢 弘哉 三浦 秀輔

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.54, no.4, pp.313-316, 2008-04

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19歳男性。患者は精巣の発育不良を主訴に著者らの施設にある小児外科を受診したところ, 性腺機能低下症を疑われ, 泌尿器科へ紹介となった。精査の結果, 視床下部性の特発性低ゴナドトロピン性性腺機能低下症と診断され, 20歳時よりLH-RH療法を開始したが, 1年後も男性機能面からは明らかな変化は認めなかった。そのため21歳時より週2回のHCG+HMG療法に切り替えたところ, 4ヵ月後には陰毛の増加, 精巣および陰茎の増大, にきび, 声が低くなる, 少量ながら射精可能となるなどの変化がみられた。内分泌学的にも総テストステロン値も正常化し, 1年4ヵ月後の精液検査では, 精液量0.5ml, 精子数0.7×10^6/ml, 運動率43%となった。以後, HCG+HMG療法を継続し, 26歳時に結婚, 28歳時にICSIにて挙児を得ることができた。A 19-year-old male, who had undergone bilateral orchiopexy at 5 years of age in the Department of Pediatric Surgery, was referred to our clinic presenting with bilateral small testes. Bilateral testis volume was 4 ml involving a small penis and scant pubic hair per Tanner Stage 2. Serum luteinizing hormone, follicle stimulating hormone and testosterone levels were low. Results of hormonal loading tests, including luteinizing hormone-releasing hormone (LH-RH) and human chorionic gonadotropin (HCG), were positive. Brain computed tomographic scan revealed no abnormal findings. The diagnosis of male hypogonadotropic hypogonadism was rendered based on these data. Administration of LH-RH for 1 year was ineffective. Subsequently, HCG and human menopausal gonadotropin (HMG) treatments were initiated. The symptoms of male insufficiency improved; moreover, sperm formation was apparent following HCG and HMG treatments. The patient has received HCG and HMG injections for eight years; furthermore, his wife delivered a boy consequent to the first intracytoplasmic sperm injection.

著者

羽間 稔 中野 正則 篠崎 雅史 藤澤 正人 岡本 恭行 柯 昭仁 岡 伸俊 浜口 毅樹 岡田 弘 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.34, no.6, pp.1047-1050, 1988-06

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A case of a 32-year-old paraplegic male who fathered a girl following artificial insemination after an intrathecal neostigmine injection is described. The patient became a complete paraplegic after injury to the spinal cord caused by a traffic accident in 1971, resulting in ejaculatory disturbance. In June, 1984 the first intrathecal neostigmine injection was tried and 2.7 ml of semen was collected and offered to artificial insemination. However, the first to ninth attempt did not result in fertilization. The tenth attempt was made in March 7, 1986, and 3 ml of semen presenting 240 X 10(6) spermatozoa per ml with 5% of motile sperms was collected. This resulted in pregnancy, and the patient's wife delivered a healthy girl weighing 2552 g by cesarean section on November 19, 1986. This is the fourth case of a paraplegic who fathered a child following artificial insemination after an intrathecal neostigmine injection in the Japanese literature.

著者

羽間 稔 中野 正則 篠崎 雅史 藤澤 正人 岡本 恭行 柯 昭仁 岡 伸俊 浜口 毅樹 岡田 弘 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.34, no.6, pp.1047-1050, 1988-06

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A case of a 32-year-old paraplegic male who fathered a girl following artificial insemination after an intrathecal neostigmine injection is described. The patient became a complete paraplegic after injury to the spinal cord caused by a traffic accident in 1971, resulting in ejaculatory disturbance. In June, 1984 the first intrathecal neostigmine injection was tried and 2.7 ml of semen was collected and offered to artificial insemination. However, the first to ninth attempt did not result in fertilization. The tenth attempt was made in March 7, 1986, and 3 ml of semen presenting 240 X 10(6) spermatozoa per ml with 5% of motile sperms was collected. This resulted in pregnancy, and the patient's wife delivered a healthy girl weighing 2552 g by cesarean section on November 19, 1986. This is the fourth case of a paraplegic who fathered a child following artificial insemination after an intrathecal neostigmine injection in the Japanese literature.

著者

前川 正信

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.20, no.5, 1974-05

著者

冨田 雅之 前田 重孝 木村 高弘 池本 庸 大石 幸彦

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.4, pp.247-249, 2002-04

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69歳男.血塗れで倒れているところを発見され,陰茎が切断され,左上肢も受傷していた.創部の応急処置を行い,患者の不穏が強いため,ハロペリドールを投与し,陰茎は低温保存した.左上肢は橈側浅指屈筋腱が断裂し,下腹部が著明に膨満,超音波で膀胱内に著明な尿貯留を認めた.尿閉に対し緊急に膀胱瘻を増設後,創部を処置した.自傷の可能性もあり,陰茎再吻合は困難と判断し,家族とも相談の上,断端形成術を施行した.創部の経過は良好で尿道の留置カテーテルは術後16日目に抜去した.自己陰茎切断症は極めて稀な疾患で,自験例を含め24例のみであるSelf-mutilation of the penis is extremely rare. A 69-year-old man was admitted after having amputated his own penis completely from its root. He had no history of psychiatric illness, but his physical condition on admission was abnormal. We performed urethrocutaneostomy, rather than replantation of the penis, because of the danger that he would reinjure himself. The patient was treated by a psychiatrist under a diagnosis of alcoholic dementia. To our knowledge, this is the 24th case of self-mutilation of the penis reported in the Japanese literature.

著者

若月 晶 辻畑 正雄 三宅 修 伊東 博 板谷 宏彬 宇高 不可思

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.39, no.10, pp.891-897, 1993-10

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1)進行性核上性麻痺7例の膀胱尿道機能の検査の結果,蓄尿期では6例が過活動性膀胱で尿意の低下が見られた。コンプライアンスは良好であったが3例で膀胱容量が低下していた。2)排尿期では4例が低活動性膀胱で1例が無収縮であった。括約筋筋電図は1例で収縮筋括約筋協調障害3例で活動の低下がなく1例で無抑制弛緩がみられた。3)尿失禁の原因は神経学的には蓄尿期の過活動性膀胱と考えられたが痴呆とADLの障害も重要であった。残尿は排尿期の低活動性膀胱と括約筋の活動異常のいずれかあるいは両者が原因と考えられた。4)治療としてはαブロッカーがやや有効な症例もあったが,痴呆とADLの障害も大きな問題であり,排尿ベルの使用が尿失禁の看護には有効であったWe performed a vesicourethral function study on seven patients with progressive supranuclear palsy. In storage phase, 6 patients had decreased urinary sensation and overactive detrusor. Although bladder compliance was normal in all patients, maximum cystometric capacity was decreased in 3 patients. In micturition phase, detrusor contraction was underactive in 4 patients and acontractile in 1 patient. Sphincter electromyogram showed detrusor-sphincter-dyssynergia in 1 patient, no decrease in 3 patients and synergistic decrease in 1 patient. Six patients had urinary incontinence partially due to those neurological abnormality, partially due to dementia and lower activity of daily living. To facilitate the care of such functional incontinence, we devised a urinary alarm. The urinary alarm is a device to detect urine in a diaper. One can know the micturition in a diaper without being informed of micturition by the patient and change diapers as soon as possible. It was also useful to examine their frequency/volume chart.

著者

湯村 寧 菅野 ひとみ 小川 毅彦 斎藤 和男 佐藤 和彦 窪田 吉信 岩崎 晧 沢田 卓人

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.12, pp.727-734, 2003-12

被引用文献数

1

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症例1:42歳男.5年5ヵ月の不妊を主訴として受診し,無精子症を指摘された.全身所見で異常はなく,精液検査所見も無精子症であった.染色体検査では末梢リンパ球培養G band法で細胞20個において検査を行ったところ46,XXと女性の核型であった.また2番染色体短腕p11,長腕q13を切断点とする腕間逆位が認められた.以上の所見よりXX male症例と診断した.さらにPCR法によるsex-determining region Y(SRY)は陽性,deleted in azoospermia(DAZ)は陰性であった.患者は挙児は希望せず,現在も外来で経過観察中である.症例2:29歳男.1年3ヵ月の不妊を主訴として受診した.症例1と同様に無精子症を指摘され,全身所見で異常はなく,精液検査所見も無精子症であった.染色体検査でも症例1と同様に末梢リンパ球培養G band法で,細胞20個において検査を行ったところ46,XXと女性の核型であり,以上の所見より,XX male症例と診断した.また,PCR法による測定を行い,SRYは陽性,DAZは陰性であった.挙児を希望し,非配偶者間人工授精により正常男児がえられたWe report two cases of XX male with chief complaints of infertility. Physical examination of both patients aged 42 and 29 demonstrated normal male habitus except for small testes. Semen analyses demonstrated no spermatozoa. Endocrinological examinations showed hypergonadotrophic hypogonadism. Vesiculograms demonstrated normal seminal tracts. Histological examination of their testes did not reveal germ cells; one case lacked seminiferous tubules and there was hyalinization in the seminiferous tubule in another case. Chromosomal analyses of peripheral blood demonstrated 46,XX. The sex-determining region Y gene was positive and DAZ (deleted in azoospermia) gene was negative in both cases.

著者

武井 久雄

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.2, no.5, pp.293-297, 1956-09

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A case of priapism, 6 aged male infant, was reported. At a glance, this case was suspicious of male sexual precocity, but it was revealed as priapism by the quantative estimation of hormones. The cause in this case existed in the cerebrospinal changes. This patient was the youngest case in our country.

著者

江原 英俊 伊藤 慎一 泉 久美子

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.9, pp.519-521, 2012-09

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We report an unusual case of a 14-year old boy who presented with proteinuria and pyuria detected in a medical checkup at school. After denial of kidney disease, computed tomography of the pelvis showed a bladder stone with an internal low density and urethroscopy showed an odd stick at the prostatic urethra. Because of the failure of removal by the transurethral technique, he underwent suprapubic cystostomy against the foreign body stuck into the prostatic urethra. After surgery, he admitted that he had self-introduced a sewing instrument into the bladder for the purpose of masturbation one year three months previously.

著者

前川 正信 柏井 浩三 丸毛 博昭

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.5, no.2, pp.110-116, 1959-02

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A case of solitary cyst of the spleen in a 8-year-ol d girl is reported. The content of the cyst measured approximately 850cc. and it was dark brown, hemorrhagic and sparkling due to large amount of the cholesterol crystals contained in it. It is very difficult to clinically differentiate the paranephric cyst from the splenic cyst. Displacement of the stomach to the right and the splenic flexure of the colon and the left kidney downwards on the roentgenogram is the characteristic findings of the splenic cyst. The m arsupialization was performed in this case and the result was satisfactory.

著者

並木 重吉 高橋 洋

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.8, pp.512-517, 1962-08

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Chronic urinary tract infections, especially chro n ic cystitis in the females, were satisfactorily treated by simultaneous administration of UROCYDAL and YUBERA. No side effect was encountered. Gynecologic conditions are thought to be closely related to urinary tract infections in the females, and the effects of Vitamin E were discussed with emphasis on this point.

著者

鈴木 孝憲 沢康 中夫 黒沢 功 神保 進

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.4, pp.605-608, 1987-04

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A 29-year-old man noted a wart around the external urethral orifice. The lesion was diagnosed as condyloma acuminata and he had the tumor excised and circumcision on September 10, 1985. He complained of urethral bleeding on December 21, 1985. Physical and endoscopic examination revealed papillo-granular condyloma acuminata at the distal urethra. He received transurethral fulguration on January 17, 1986 and intraurethral instillation of 5-fluorouracil cream weekly. The lesions were successfully treated.

著者

岡田 洋平 川上 理 福田 博志 長浜 克志 斉藤 一隆 大塚 幸宏 木原 和徳 森田 隆 大島 博幸 江石 義信 菅野 純

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.43, no.10, pp.739-742, 1997-10

被引用文献数

2

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3ヵ月前に無症候性肉眼的血尿に気づいた50歳男で,膀胱左壁の非乳頭状広基性腫瘍を認め,臨床病期はT3N0M0であった.生検材料の病理診断は小細胞癌であった.最初に行ったシスプラチン-アドリアマイシンの動注術前化学療法は無効であり,根治的膀胱摘除を行った.腫瘍組織は明らかに均質で,管状ないし索状に配列した小細胞より成り,pT3bR1L2V0N0であった.電子顕微鏡上,神経分泌顆粒を持つ小細胞癌と確認された.術後,シスプラチン,エトポシド,及びイホスファミドより成るアジュバント化学療法を4クール行った.術後26ヵ月に腫瘍再発の証拠なしに生存しているA 50-year-old man presented with asymptomatic gross hematuria which he had first noticed 3 months earlier. Clinical examinations revealed a non-papillary, broad-based tumor on the left lateral wall of the urinary bladder with a clinical stage of T3N0M0. The pathological diagnosis of a transurethral biopsy tissue specimen was small cell carcinoma. Neoadjuvant intraarterial infusion chemotherapy using cisplatin and adriamycin was initially administered but proved to be ineffective. Thus, we performed a radical cystectomy. The tumor tissue was apparently homogenous and composed of small cells arranged in sheets and solid patterns, and was staged to be pT3bR1L2V0N0. An electron microscopic study confirmed small cell carcinoma with neurosecretory granules. Postoperatively, 4 courses of adjuvant chemotherapy consisting of cisplatin, etoposide and ifosfamide were administered. The patient is alive without any evidence of tumor recurrence 26 months after the operation.

著者

豊田 和明 荒木 博孝

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.5, pp.719-723, 1987-05

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1)尿道炎症状を主訴として外来受診した160名の男性患者およびその性的パートナー22名に対して,抗クラミジアモノクローナル抗体を用いた直接鏡検法により,クラミジア感染症の細胞学的検索を行い,53名33%の男性患者,13名59%の女性患者にPAP陽性を認めた.2) ELISA法による血清抗体測定では,PAP陽性29例中8例26%に抗体価陰性を,PAP陰性44例中7例15%に抗体価陽性を認めた.3)淋菌性および非淋菌性尿道炎のクラミジア感染の割合は,前者が36例中11例31%,後者が63例中29例46%であった.4) Minocycline 0.2 g/日またはdoxycycline 0.2 g/日によるクラミジア治療により,35例中23例66%にPAP法によるクラミジア抗原の陰性化を認めた.また平均投薬日数は50日であったThe PAP-immunocytochemistry using a monoclonal antibody against Chlamydia trachomatis was applied to male patients with clinically manifest urethritis and their female sex partners. In addition, serum levels of the antibody were determined by means of an ELISA system. Immunoperoxidase reactions were recognized on urethral scrapes in 53 (33%) out of 160 cases, and on endocervical specimens in 13 (59%) out of 22 sex partners of PAP-positive patients. In patients with gonococcal urethritis, an infection of C. trachomatis was revealed immunocytochemically in 11 (31%) out of 36 cases, and in 29 (46%) out of 62 cases with non-gonococcal urethritis. Following medication with 200 mg of minocycline or doxycycline per day, PAP staining became negative in 23 (66%) out of 35 cases. The levels of serum antibody against C. trachomatis were undetectable in 8 (26%) out of 29 PAP-positive cases, but positive in 7 (15%) out of 44 PAP-negative cases.

著者

藤原 敦子 木村 泰典 三神 一哉 内田 睦 建部 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.48, no.10, pp.607-610, 2002-10

被引用文献数

2

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65歳女.肉眼的血尿で膀胱内腫瘍を指摘された.膀胱はコアグラタンポナーデの状態で,膀胱洗浄により血塊と共に悪臭の強い多量の壊死組織が排出された.膀胱鏡では左側壁から後壁を中心とする非乳頭状広基性腫瘍を認め,膀胱粘膜全体が表面不整であった.骨盤部造影CTで膀胱左側壁を中心とする8×6cmの腫瘍を認め,膀胱壁は全体に肥厚していた.1週間後の膀胱造影では左側壁からの造影剤漏出を認めた.膀胱癌T4N2M1と診断し,発熱が増悪するため膀胱全摘術及び両側尿管皮膚瘻造設術を施行した.摘出組織で表面を壊死組織で覆われた灰白色の腫瘍を認め,膀胱壁外に到達した部分に瘻孔が形成されていた.組織学的には表在性に位置する癌腫の部分と,優勢な肉腫様部分で構成され,両者の境界は明瞭であった.癌腫は扁平上皮に分化している細胞,肉腫様部分は未分化な紡錘形細胞で構成されていた.術後一時的に改善したが発熱が再燃し,2週後に敗血症で死亡したA 65-year-old woman was referred to our clinic with gross hematuria. Cystoscopy revealed a non-papillary and non-pedunculated tumor on the left lateral wall of the bladder. A piece of necrotic tissue obtained from the bladder irrigation was histologically squamous cell carcinoma. A perforation at the left lateral wall of the bladder was found on the cystogram. Bone scintigraphy showed multiple metastases and computed tomography scans showed multiple lymph node metastases in the pelvic cavity. The clinical diagnosis was bladder carcinoma of T4N2M1 stage with an abscess due to a spontaneous perforation. Total cystectomy with bilateral ureterocutaneostomy was performed. She died due to sepsis 13 days after the operation. Histologically, the tumor was composed of carcinomatous and sarcomatous elements. The carcinomatous element was compatible with squamous cell carcinoma and the sarcomatous element was composed of undifferentiated malignant spindle cells. Immunohistochemical examination showed that the carcinomatous component was positive for keratin and human chorionic gonadotropin (HCG) and the spindle cell component positive for vimentin, desmin and HCG. Therefore, we diagnosed the tumor as sarcomatoid carcinoma. We reviewed 56 cases of carcinosarcoma of the bladder in Japan and discussed the clinicopathology of the disease.

著者

稲原 昌彦 甘粕 誠 永田 真樹 山口 邦雄

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.359-362, 2002-06

被引用文献数

1

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症例1(63歳女).右側腹部痛を主訴とし,KUBで右腎と左下部尿管に結石を認め,ESWLを行った.RA治療のためケイ酸マグネシウムを含むメサフィリンを20年以上投与されており,自排したのはケイ酸とシュウ酸カルシウムの混合結石であった.症例2(75歳男).膀胱腫瘍の経過観察中に結石を確認,翌日自排した.結石はケイ酸とその他の同定できない成分を含む混合結石であった.症例3(58歳男).右側腹部痛が出現し結石を自排した.メタケイ酸アルミ酸マグネシウムを含むキャベジンを3年間内服しており,結石は98%以上がケイ酸結石であった.症例4(60歳男).肉眼的血尿と左側腹部鈍痛を主訴とし,KUBで左腎に結石を認めESWLを行った.自排した結石は98%以上がケイ酸結石であったAmong four patients with silicate calculi, stones were spontaneously discharged in two and after extracorporeal shock-wave lithotripsy in two. Two of them had a history of taking magnesium silicate. Thirty two cases of silicate calculi previously reported in the Japanese literature were reviewed.

著者

小森 和彦 岩崎 明 池上 雅久 梶川 次郎 岸本 知己

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.46, no.1, pp.37-40, 2000-01

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An 88-year-old woman was hospitalized with the chief complaints of lower abdominal pain, miction pain and pollakisuria. Radiographs showed a giant bladder stone shadow, 12.0 x 9.0 cm in size. Cystolithotomy was performed under the diagnosis of bladder stone. The extirpated stone weighed 510 g, and measured 10.0 x 7.5 x 6.0 cm in size. The stone had four compartments of stratified lamellae composed of calcium phosphate and magnesium ammonium phosphate. The postoperative course was uneventful and the bilateral hydronephrosis improved markedly on DIP.

著者

安本 亮二 小早川 等 柿木 宏介 井関 達雄 梅田 優 川嶋 秀紀 守屋 賢治 前川 正信

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.32, no.6, pp.841-845, 1986-06

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前立腺炎症例における,尿中NAG,又は前立腺マッサージ後の尿におけるNAGを測定した.その結果,尿中NAG値は,健常人に比べ明らかに高い値を示しただけでなく,病態の推移に非常によく一致していた.尿中NAGの臨床的評価の際,前立腺の病変も考慮にいれることが大切である.尿中NAGの経時的測定は,前立腺炎の病変の(その中でも急性前立腺炎の)一指標になる

著者

際本 宏 神田 英憲 大西 規夫 江左 篤宣 杉山 高秀 朴 英哲 金子 茂男 栗田 孝

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.34, no.6, pp.1007-1010, 1988-06

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Tests for evaluating the function of the nervous system in patients with erectile impotence have been performed indirectly with the measurement of nerve conduction velocity in the extremities and other neurological procedures, since it has been technically difficult to measure the nerve conduction velocity of the dorsal nerve of the penis. Calculation of the nerve conduction velocity of the dorsal nerve of penis from values of the bulbocavernosus reflex latency was not reliable and the development of a technique to measure accurately the nerve conduction velocity of the dorsal nerve of penis has been awaited. Ten impotent men were studied, and a precise description was made about the procedure of measuring the orthodromic nerve conduction velocity of the dorsal nerve of the penis. The dorsal nerve of the penis was stretched optimally with a weight of 300 g, and its conduction velocity reached the maximal value. This new methodology is of use in the evaluation of erectile impotence.

著者

桑原 守正 松下 和弘 吉永 英俊 安芸 雅史 藤崎 伸太 香川 征

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.38, no.1, pp.5-8, 1992-01

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1)心不全・高血圧などの血中HANP濃度を上昇せしめる因子がなければ,血中HANP濃度は腎機能の悪化と相関して高値をとることはない.2)透析患者の血中HANP濃度はいずれも有意に上昇しているが,年齢,透析期間とは相関しない.3)透析による除水の量に従って血中HANP濃度は有意に低下する.4)心不全・高血圧などの合併症のない3群G4の透析患者で,CTRが50%以上の者は50%未満の者より透析後でも血中HANP濃度は有意に高かった.透析患者における血中HANP濃度の上昇は循環血液量の増加を反映していると考えられる.従って臨床的には血中HANP濃度は,透析患者における至適体重(D.W.)を決定するための良い指標となりえることが推定された