著者

北山 太一

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.11, no.6, pp.435-465, 1965-06

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In 141 male urological patients, age ranged from 10 t o 76 years old, temperature of rectum, testicle, scrotal cavity and external inguinal ring region was measured by means of a hypodermic needle with a thermistor device. The patients were in operation room, kept quitely at supine position, mainly under spinal or general anesthesia, and their trunk and lower extremities were draped with cotton sheet but the external genital area was exposed to air. Room temperature was recorded at the same time with a mercury thermometer. Statistical analysis was made on records of every area. Out of the 141 cases studied, 111 cases were considered to be normal testicular group since their illnesses were not supposed to have effect directly on testicular temperature, and the remaining 30 cases were tentatively classified as abnomal testicular group because their illnesses originated in or around the testicle with possibility that the illness gave direct influence on testicular temperature. I. Normal testicular group : (1) Normothermic group (incl uding 83 cases in which rectal temperature ranged between 36.2 and 37.6°C) demonstrated that their rectal temperature was 37.0±0.05°C, testicular temperature 33.1±0.12°C in the right side and 33.2±0.13°C in the left, scrotal cavity temperature 32.6±0.12°C in the right and 32.6±0.12°C in the left and external inguinal ring region temperature 34.7±0.10°C in the right and 34.8±0.09°C in the left. Hyperthermic group (consists of 18 patients whose rectal temperat u re was above 37.7°C) showed that their rectal temperature was 38.2±0.10°C, testicular temperature 34.5±0.28°C in the right and 34.5±0.27°C in the left, scrotal cavity temperature 34.0±0.26°C in the right and 33.9+0.26°C in the left and external inguinal ring region temperature 35.8±0.18°C in the right and 35.8±0.21°C in the left. Hypothermic group (consists o f 10 cases in which rectal temperature was below 36.1°C) gave results of rectal temperature being 35.8±0.06°C, testicular temperature 32.3±0.20°C in the right and 32.3±0.18°C in the left, scrotal cavity temperature 31.8±0.17°C in the right and 31.8±0.18°C in the left and external inguinal ring region temperature 33.6±0.18°C in the right and 33.6±0.18°C in the left. (2) Between the normothermic and hyperthermic groups, average differences in temperature of rectum, testicle, scrotal cavity and external inguinal ring region were found to be 1.19°C, 1.40-4.30°C, 1.34-1.31°C and 1.14-X1.05°C respectively. Between the normothermic and hypothermic groups, they were 1.15°C, 0.86-0.87°C, 0.87-0.83°C and 1.12-1.18°C respectively. Between the hyperthermic and hypothermic group, they were 2.34°C, 2.26— 2.17°C, 2.16-2.14°C and 2.26-2.23°C respectively. These difference were statistically significant at the level of the risk below 1 %. (3) In every, groups, average differe nces between the right and left testicular temperature, between the right and left scrotal cavity temperature and between the right and left external inguinal ring region temperature were all found to be less than 0.14°C and statistically not significant at all. (4) In the normothermic, hyperthermic and hypothermic groups, differences in temperature between rectum and testicle were 3.8-3.9±0.11°C, 3.7±0.28~0.29°C and 3.5±0.17-0.19°C respectively, between rectum and scrotal cavity, were 4.4±0.11°C, 4.2~4.3±0.26-0.27°C and 4.0±0.16-0.19°C respectively, between rectum and external inguinal ring region, were 2. 32.2±0.08-0.09°C, 2.4±0.16-0.20°C and 2.2±0.19~0.20°C respectively, between testicle and scrotal cavity, were 0.5-0.6±0.04°C, 0.5-0.6±0.11-0.08°C and 0.5-0.6±0.11--0.13°C respectively, between external inguinal ring region and testicle, were 1.6±0.08-0.09°C, 1.3±0.21 —0.16°C and 1.3±0.24-0.20°C respectively, while between external inguinal ring reg ion and scrotal cavity, were 2.1-2.2±0.09°C, 1.8-1.9±0.18-0.17°C and 1.8±0.17-0.16°C respectively. These figures are statistically significant at the level of risk below 0.1 % except the difference between testicular and scrotal cavity temperature. (5) In the normothermic group, average dif ference in temperature of rectum, testicle, scrotal cavity and external inguinal ring region between the age groups of 10 to 20 years and 30 to 40 years was 0.16-0.45°C which was not statistically significant. On the contrary, average differences in temperature of rectum, testicle, scrotal cavity and external inguinal ring region between the age groups of 10 to 20 and above 50 years were 0.38°C, 0.99-1.17°C, 0.80-0.79°C and 0.87,-0.79°C respectively, and between the age groups of 30 to 4 0 and above 50 years, were 0.38°C, 0.58-0.72°C, 0.62-0.55°C and 0.71-0.58°C respectively. These figures indicated that temperatures of these areas are lower in the advanced age groups than younger groups and showed statistically significant differences at the level of risk below 5 %. (6) In 111 cases, correlativities were determined between room temperature a nd rectal and scrotal cavity temperatures, rectal and testicular temperatures, scrotal cavity and and external inguinal ring region temperatures and testicular and scrotal cavity temperatures. The results showed almost complete positive correlation between testicular and scrotal cavity temperatures, moderately positive correlations between scrotal cavity and room temperatures and between scrotal cavity and rectal temperatures, but almost no correlation between rectal and room temperatures. (7) In 10 cases, of whic h age ranged from 28 to 75 years, the exposed external genital area was entirely draped with cotton sheet. The testicular temperature has risen, from the mean of initial temperature of 32.7°C (30.8-33.9°C), up to the mean of 34.3°C (32.4-35.9°C) in about 20 minutes after the draping. Removal of the sheet made the testicular temperature descended down to the mean of 32.6°C (31.0-33.8°C) in about 20 minutes. During these procedures, rectal temperature altered from the mean of 37.1°C (35.5-39.1°C) to 36.9°C (35.4-39.0°C). This experiment confirmed that testicular temperature will be varie d at the mean range of 1.6°C (0.8-2.3°C) by draping or exposing the external genital area. II. Abnormal testicular group (tentatively called) : (1) In 8 cases of chronic epididymal tuberculosis, no statistically significant difference in temperatures at every area tested from that of normal testicular group was demonstrated. This disease, therefore, was thought to have no effect on testicular temperature . (2) In 8 cryptorchid cases (testis located in the inguinal canal), the rectal, testicular, scrotal cavity and external inguinal ring region temperatures were 37.3±0.07°C, 35.7± 0.36°C, 34.9±0.18°C and 35.1±0.08°C respectively in 6 testes of the normothermic group and 38.1±0.26°C, 36.9±0.40°C, 36.1±0.26°C and 36.2±0.26°C respectively in 2 cases of the hyperthermic group. In each group, the testicular temperature was 2.6-2.4°C higher than that of in normal testicular group. This difference was found to be statistically significant. (3) In 3 cases of left spermatic varicocele, all of which belonged to hyperthermi c group, the temperatures of various areas tested have not differed from that of in normal testicular group. (4) In a case of left embryonal cancer (hen's egg-sized), only the tumor-bearing testis showed higher temperature, 36.3°C, than normal group, but the other areas tested showed similar temperature as that of normal testicular group. In a case of right teratoma (human fist-sized), however, the temperatures of not only the tumor-bearing testis but of the other healthy testis and scrotal cavity were higher than that of normal testicular group. Same phenomenon were seen in a case of left intra-scrotal hematoma. (5) In 3 cases of hydrocele, 2 cases of spermatocele, 2 cases of testicular atrophy and a case of aplasia of spermatic duct, the temperatures of all areas tested were not statistically different from that of normal testicular group.

著者

小松 洋輔 友吉 唯夫 川村 寿一 岡田 謙一郎

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.16, no.1, pp.17-24, 1970-01

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Three cases of intrascrotal rupture of the testis were presented. Case 1: A 21-year-old student got a kick at his left scrotum during Kwarate training. On the third posttraumatic day, the ruptured tunica albuginea was surgically sutured. Case 2: A 25-year-old man fell from the height and got the right scrotum injured. On the third posttraumatic day, the ruptured tunica albuginea was sutured. Case 3: A 58-year-old man got an injury at his right scrotum due to traffic accident while on a motorcycle. It was on the tenth posttraumatic day that the operation was performed. Because the tunica albuginea was so extensively injured, orchiectomy was necessitated. Histological findings of the ruptured testes were described. The rat testes were experimentally ruptured and histological study was made several times after trauma in order to investigate the changes with time.

著者

松田 久雄 若林 昭 郡 健二郎 高田 昌彦 辻橋 宏典

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.3, pp.513-516, 1989-03

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Traumatic rupture of the testicle is rare because of the protection afforded by surrounding structures. Many clinicians now speculate that this entity is underreported due to misdiagnosis. However, the condition should not be overlooked because of the importance of early treatment for the preservation of testicular function. A more aggressive approach to scrotal hematoma has been advocated. A case of traumatic rupture of testicle in a 21-year-old patient is reported. The testicle was surgically explored 6 days after trauma to the scrotum. The tunica albuginea was repaired and the testicle was preserved. Discussion is made especially on the injury to scrotum.

著者

伊藤 悠城 二宮 彰治 古内 徹 萩原 正幸 金井 邦光 古平 喜一郎 中村 聡

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.7, pp.425-427, 2009-07

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A 63-year-old male presented with an intravesical foreign body. We could not remove it by a transurethral operation. We performed open surgery, and found the urinary bladder to be perforated by a foreign body which invaded the peritoneal cavity. To our knowledge, there were 10 similar cases in Japan.

著者

吉田 健志 木下 秀文 谷口 久哲 地崎 竜介 西田 晃久 川喜多 繁誠 日浦 義仁 大口 尚基 河 源 六車 光英 松田 公志

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.5, pp.323-325, 2007-05

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29歳男。陰茎腫脹と勃起が続くことに気付き緊急入院した。陰茎は硬く, 勃起状態で自発痛を認めた。持続勃起症の診断で陰茎海綿体内血液ガス分析を施行した。血液ガス所見より静脈系の流出障害と判断し19G翼状針で陰茎穿刺を行い, ヘパリン生食で凝血塊洗浄, α作動薬海綿体内注入を繰り返し経過観察した。勃起状態は軽度改善したが疼痛の増悪を認め, Hb低下, Ht低下から輸血の必要を説明したが宗教的理由で拒否された。白血病に関して血液主要な以下で骨髄穿刺を施行し慢性骨髄性白血病と診断された。ドロキシカルバミド内服を開始し, メシル酸イマチニブへ変更し骨髄穿刺で完全緩解した。再発は認めず経過している。A-29-year-old man visited our hospital with the complaint of a continuous rigid and painful erection which began two days before. We diagnosed ischemic type of priapism by aspiration of penile cavernosal blood analysis; an acidotic and hypoxic blood. The leukocyte count was 263,000/p, and chronic myelogenous leukomia (CML) was suspected. After the failure of conservative treatment, glans-cavernosal shunt (Winter procedure) was performed. The postoperative course was uneventful and the intercourse was possible at five months after the operation. CML was treated by administration of imatinib mesylate and no evidence of recurrence was observed.

著者

西野 昭夫 高島 三洋 中嶋 和喜 大川 光央 久住 治男 橋本 浩之 宮川 和彦 佐藤 保 野々村 昭孝

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.35, no.12, pp.2139-2143, 1989-12

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A 7-year-old boy was admitted to the department of pediatrics in our hospital with the complaint of sexual precocity manifested by a growth spurt, penile enlargement and pubic hair development. He was referred to our department because of the enlarged left testis. The diagnosis of Leydig cell tumor of the left testis was suggested by hormonal laboratory data and testicular ultrasonographic investigation. Left orchiectomy was performed. The histological examination revealed the characteristics of Leydig cell tumor. Twenty-four cases of testicular Leydig cell tumor reported in the Japanese literature until 1988 are clinically analyzed. We discuss the usefulness of ultrasonography in detecting and localizing the tumor.

著者

蘆田 真吾 片岡 真一 山崎 一郎 山下 元幸 大橋 洋三 森岡 政明 執印 太郎

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.43, no.8, pp.567-570, 1997-08

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45歳女.全身倦怠感,口渇,視力低下を主訴として入院,糖尿病を指摘されており血圧194/100mmHg,腹部CTで右副腎は雪だるま型,左は球状に腫大,副腎シンチグラムで両側副腎に集積がみられ,両側副腎多発腺腫又は結節性過形成によるクッシング症候群と診断手術右副腎に黄褐色の腫瘤とblack adenomaの2種類と左副腎に黄褐色の腫瘤が認められた.high performance liquid chromatographyにて右のblack adenomaと左副腎腫瘍のコルチゾール,11デオキシコルチゾール含量はもう一つの腫瘍及び左腫瘍周囲組織に比べて高かった.術後ハイドロコーチゾンの補充療法を行い,術後ACTHは正常範囲となり,CRH負荷試験も正常範囲に回復したWe report a case of Cushing's syndrome due to bilateral adrenal adenomas. A 45-year-old woman was found to have Cushing's syndrome during the course of treatment for diabetes mellitus. The diagnosis of Cushing's syndrome was based on the absence of a diurnal rhythm in plasma cortisol and failure to suppress plasma cortisol by 1 or 4 mg of dexamethasone. The plasma level of adrenocorticotropic hormone (ACTH) was below the normal range, and plasma cortisol responded normally to rapid ACTH injection. Abdominal computed tomography revealed bilateral adrenal tumors. Bilateral uptake of radiocholesterol by the adrenal cortex was observed in adrenal scintigraphy. Bilateral adrenalectomy was performed. Microscopic examination and analysis of steroid contents by high performance liquid chromatography showed that the tumor was cortisol-producting adenoma.

著者

平山 暁秀 山田 薫 田中 洋造 平田 直也 山本 雅司 末盛 毅 百瀬 均 塩見 努 大園 誠一郎 平尾 佳彦

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.41, no.12, pp.985-989, 1995-12

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当科において平成5年7月より1年間の泌尿器科評価を行った18歳以上の二分脊椎症患者においてアンケートで性機能の評価を行った. 1)異性に対する興味,性に対する興味,性欲は男性で,95%, 95%, 100%であり,女性で83%, 75%, 75%であった. 2)男性において,勃起は視聴覚刺激によるものが95%,触覚刺激によるものは86%であり,勃起高度に満足しているものは73%,射精は77%可能であった.オーガスムを感じるものは67%であった. 3)女性において全体では月経の周期は96%が定期的にあり,分泌は88%に認めたが,陰部の快感は19%にしかなかった.これら項目についてSharrad分類,排尿筋-括約筋の活動性,年齢で比較したが有意な傾向はなかった

著者

小林 裕章 金子 剛 西本 紘嗣郎 内田 厚

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.56, no.1, pp.63-65, 2010-01

被引用文献数

1

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Penile strangulation is one of the emergent urologic disorders, because immediate release is the critical treatment to prevent penile necrosis, urethral injury, erectile disorder, and other unfavorable events. A 66- year-old man was transferred to the emergency room of our hospital for the penile swelling and pain, occurring by penile insertion to the beverage bottle for masturbation. The penis was completely relieved using an electric plaster cutter without any injury. The strangulation time was four hours and a half, and there were no complications. We recommend an electric plaster cutter as a useful tool for this incident.

著者

曽我 倫久人 杉村 芳樹

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.50, no.1, pp.37-40, 2004-01

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82歳男.前立腺特異抗原(PSA)が高値のため精査を行い前立腺癌(中分化型腺癌)と診断した.このとき腹部・胸部CTおよび頭部CTにおいて明らかな転移所見は認められず,病期分類T3aN0M0とした.LH-RH analogueによる去勢療法を開始し,PSAは順調に低下していたが,7ヵ月後に突然左側の上下肢脱力感を訴え,頭部CT・MRI所見から多発性脳転移と診断した.転移巣に対して放射線治療を行ったがADLの改善は得られず,前立腺癌の診断から1年1ヵ月後に呼吸不全のため死亡した

著者

田中 一志 武中 篤 楠田 雄司 原口 貴弘 山中 望

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.12, pp.741-744, 2002-12

被引用文献数

5 7

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80歳女.肉眼的血尿,嘔吐が出現し,膀胱鏡で全周性に粘膜の発赤,出血と気泡の形成を認めた.高度の炎症所見,高血糖,脱水を認め,補液,セフォゾプラン投与,レギュラーインシュリンを行った.その後全身倦怠感が増悪し,血液ガス所見で代謝性アシドーシスを認め,意識レベルが低下した.CTで膀胱壁内に著明なガス像を認め,緊急膀胱摘出及び尿管皮膚瘻造設術を行った.膀胱粘膜は全周にわたり暗赤色,浮腫状に変性しており,尿培養及び組織表面の細菌培養でEscherichia coliを認めた.病理所見で,粘膜の上皮細胞はほぼ壊死となって脱落しており,粘膜から粘膜下組織にかけて出血,壊死性の像を認めた.又,粘膜下組織には発生したガスによる著明な大小の腔隙を認めた.術後経過良好で,退院し糖尿病外来治療となったA 80-year-old female with insulin-dependent diabetes mellitus (IDDM) visited our hospital on November 24, 1999, because of nausea, vomiting and macrohematuria. Cystoscopy demonstrated a diffuse hyperemic mucosa and gas-filled vesicles in the submucosa. Despite treatment with antibiotics, infection was not controlled and metabolic acidosis was increased. Simple cystectomy and ureterocutaneostomy were performed. Histological examination showed whole mucosal necrosis and vacuolation with aerogenesis in the submucosa and muscle layer of the bladder. Urine and mucosal surface cultures revealed Escherichia coli infection. After operation, the general condition was improved. Thirty six cases of emphysematous cystitis have been reported in Japan including this case. Successful treatment with cystectomy under the life threatening condition was reported for the first time.

著者

松岡 崇志 井上 幸治 水野 桂 北 悠希 仲西 昌太郎 浅井 聖史 田岡 利宜也 宗田 武 寺井 章人

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.58, no.5, pp.223-226, 2012-05

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Anticoagulant and antiplatelet medications are commonly used for the treatment and prevention of cardiovascular diseases. We studied 84 patients who received heparin as a bridging anticoagulant and antiplatelet therapy during the perioperative period. Hospitalization was extended for adjusting anticoagulant and antiplatelet drugs and also bleeding complications in the perioperative period. There were 25 instances of bleeding complications (29.7%) in this study. These complications mainly occurred when anticoagulant and antiplatelet medications were restarted in the postoperative period. In transurethral surgery, patients taking warfarin and antiplatelet drugs (aspirin or ticlopidine) had a statistically significant increase in bleeding complications compared to patients taking warfarin alone. We compared 51 cases of transurethral resection of bladder tumor, transurethral resection of the prostate holium laser enucleation of the prostate, nephroureterectomy and percutaneous nephrolithotomy with heparinization were compared to 692 cases with no heparinization. The heparinization group had a statistically significant longer hospitalization period and an increase in bleeding complications. There was one instance of thromboembolism (1.2%) in our series. This involved stent thrombosis of a patient who had drug-eluting stent in the left anterior descending coronary artery. She died three days postoperatively. The number of patients taking anticoagulant and/or antiplatelet drugs is predicted to increase in the future due to aging of the population. Guidelines for the management of anticoagulant and antiplatelet therapy in the urological period are considered necessary.

著者

酒井 茂 熊本 悦明 恒川 琢司 広瀬 崇興 田端 重男 郷路 勉 猪野毛 健男 井川 欣市 田付 二郎 辺見 泉 丹田 均 加藤 修爾 吉尾 弘 生垣 舜二 上野 了 毛利 和弘 出口 浩一

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.11, pp.1747-1761, 1986-11

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札幌市における淋菌感染症120例について,症例の疫学的検討を行なうとともに,NFLXの淋菌感染症に対する基礎的,臨床的検討を行った.年齢分布は男女とも20代前半にピークを認めた.感染源は男子では10代はガールフレンド,pick-upなどの素人が70.6%を占め,女子では配偶者が50%,患者自身が特殊浴場従業女子であるものが50%であった.NFLXのN. gonorrhoeaeに対するMIC分布は,0.025 μg/mlにピークをもち,0.0125~3.13 μg/mlに分布した.penicillinase producing Neisseria gonorrhoeae (PPNG)は症例より分離したN. gonorrhoeae 104株中21株(20.2%)であったが,これらのNFLXに対するMICは18株(85.7%)が0.1 μg/ml以下に,3株(14.3%)が1.56~3.13 μg/mlに分布した.NFLX 200 mg経口投与後の血清中濃度は投与2時間後に平均0.72 μg/mlとピークに達し,尿道分泌中濃度は投与1時間後に平均0.5 μg/mlとピークに達した.NFLX 600 mg, 7日間経口投与による淋菌感染症に対する治療成績は,男子尿道炎における有効率が3日間投与で97.4%,7日間投与で93.1%であり,女子子宮頸管炎における有効率は3日間,7日間投与とも100%であり,本剤は淋菌感染症と対する化学療法剤として高い有効性が認められた.淋菌感染症におけるChlamydia trachomatid (C. trachomatis)感染の合併は,男子尿道炎で32.7%,女子子宮頸管炎で20%であり,これらの症例においてはNFLXによる治療後も陰性例よりも分泌物の残存率が高く,引き続きC. trachomatisに対する化学療法が必要と考えられた.NFLX投与による副作用は全く認められず,NFLXは安全に投与できる薬剤と考えられたWe studied the basic and clinical effects of norfloxacin (NFLX) in 120 patients with gonococcal infections (110 men with urethritis and 10 women with cervicitis)--all residents at Sapporo City; and epidemiologically analyzed the sources of their infections. The male patients were between 16 and 67 years old and the female patients were between 20 and 61 years old, with a peak in the early 20s both for sexes. 70.6% of the male patients in their 10s were infected from their girl friends or so-called pick-up friends and 50% of the female patients from their husbands. The other half of the female were workers serving at so-called special massage parlors. The minimum inhibitory concentration (MIC) of NFLX against N. gonorrhoeae distributed was 0.0125 approximately 3.13 micrograms/ml, with a peak at 0.025 micrograms/ml. NFLX inhibited 93.3% of the clinical strains of this species at less than 0.1 microgram/ml and 96.2% at less than 1 microgram/ml, where the inoculation was 10(6) CFU/ml. Twenty one (20.2%) of the 104 N. gonorrhoeae strains were penicillinase-producing one (PPNG). NFLX inhibited 18 of these PPNG (85.7%) at less than 0.1 microgram/ml and the other 3 strains at 1.56 approximately 3.13 micrograms/ml. Oral administration of 200 mg NFLX showed the average peak serum level of 0.72 micrograms/microliter in 2 hours and the average peak level in the urethral secretions of 0.5 micrograms/ml in one hour. These two concentrations of NFLX covered 95.2% of the MIC distribution against N. gonorrhoeae. The clinical efficacy of 600 mg NFLX (peros) was 97.4 and 93.1% for a 3-and 7-day treatment for male urethritis; and 100% for both 3-and 7-day treatment for female cervicitis. Complicated urethritis with C. trachomatis was noticed in 32.7% of the male urethritis and in 20% of the female cervicitis cases. Urethral secretions among about half of these patients were observed even after treatment with NFLX. As a subsequent treatment, another effective chemotherapeutic is required against C. trachomatis. No adverse reactions were detected with NFLX. All the above results demonstrate that NFLX is a highly effective and safe chemotherapeutic agent for treatment of gonorrhoea.

著者

岡本 重禮 里見 佳昭 稲葉 善雄

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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.13, no.6, pp.455-460, 1967-06

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A case of 22 years old juvenile prostatic cancer was p r esented. The lesion was unsuccessfully treated by antiandrogenic therapy. Despite radiation and chemotherapy, tumor grew rapidly and the patient expired after 6 months' hospitalization. A review of juvenile prostatic cancer in the l iteratures is added. As far as we have studied the following observations were common in all cases. 1. Histologically, the carcinoma is anaplastic in type. 2. The serum acid phosphatase activity is not ele v ated. 3. There is no response to antiandrogenic treat m ent.

著者

内倉 信康

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泌尿器科紀要刊行会

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vol.7, no.7, pp.741-746, 1961-07

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A sixty-year old man was admitted with a chief co m plaint of asymptomatic hematuria. By cystoscopy a thumb-tip sized papillary tumor at the left ureteral orifice w as seen, and left kidney was not revealed by intravenous pyelogram, and that impossible to insert the ureteral catheter. Under th e diagnosis of tumor at the bladder, ureter, and kidney, a total left ureteronephrectomy with partial cyatectomy was performed. The post operative diagnosis was transitional cell carcinoma of the lower ureter. The primary ureteral cancer with bl a dder tumor was third in Japan.

著者

鈴木 啓悦 山西 友典 井坂 茂夫 安田 耕作 島崎 淳 更科 広実

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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.3, pp.337-341, 1992-03

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A 20-year-old man was admitted on February 2, 1990 with the chief complaint of pollakisuria, miction pain and macrohematuria. Urinalysis revealed numerous leukocytes and Enterobacter was identified by urine culture. Cystoscopy revealed an edematous region. Contrast film of small intestines demonstrated vesicoileal fistula. Judging from these and the radiographic findings, we made the diagnosis of vesicoileal fistula with Crohn's disease. After medical therapy between February 22 and May 25, urinalysis became normal and we assumed that the fistula had closed. Now, it is about a year since the therapy began, the patient remains well, without urinary and enteric symptoms. Cystoscopy and urinalysis did not reveal recurrence of the fistula. Despite previous reports that vesicoenteric fistulas complicating Crohn's disease require surgical treatment, this case responded to medication, and required no surgical treatment. This case is a reminder of the importance of the principle of therapy.

著者

稲田 務 片村 永樹 本郷 美弥

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泌尿器科紀要刊行会

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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

友吉 唯夫

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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

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泌尿器科紀要刊行会

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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