Clinical evaluation of surgical treatment for benign prostatic hypertrophy

1) 1978年1月より1982年12月までに日本医科大学附属病院にて施行された前立腺摘除術症例300例のうち, 集計可能であった290例について, その手術成績を中心に統計的観察を試みた.2)過去の報告と比較して, 全症例数, とくに, 高年齢症例の増加, およびTUR症例の増加が顕著に認められた.3)術式の選択に際しては, 術中術後経過などよりTURがすぐれていると思われるが, 症例によっては, open surgeryの有用性も充分考慮されるべきである.4)術前合併症の有無は, 術後合併症の発現に直接影響を与えないProstatectomy was performed on 300 patients at our Hospital for the period of 5 years from January 1978 to December 1982. Among those cases, clinical evaluation was made on 290 patients whose medical records were available. Ages of the subjects ranged from 53 to 92 years with an average age at 71.6. Retropubic prostatectomy (RPP) was performed on 81 cases, and suprapubic prostatectomy (SPP) and transurethral resection of prostate (TUR) on 39 and 170 cases, respectively. Surgery was made on 206 cases under epidural anesthesia, 82 cases under spinal anesthesia, and 2 cases under general anesthesia. Preoperative laboratory tests showed abnormalities in 62% of the total. The most frequent preoperative complications were circulatory abnormality and urinary tract infection. Average surgical time was 78.6 min. for RPP, 69.8 min. for SPP, and 76.9 min. for TUR. Average blood volume transfused during operation was 446.3 ml for RPP, 430.8 ml for SPP, and 80.7 ml for TUR. Average period of catheter retention after surgery was 9.2 days for RPP, 10.1 days for SPP, and 4.9 days for TUR. Average postoperative admission period was 18.6 days for RPP, 20.6 days for SPP, and 14.1 days for TUR. Average weight of the isolated adenoma was 41.8 g for RPP, 30.2 g for SPP, 11.5 g for TUR. Postoperative complications such as epididymitis, traumatic infection, and hepatic dysfunction were often found. Latent prostatic carcinoma found in the isolated adenoma was found in 11 cases (3.8%). The presence of anomalies in preoperative laboratory findings did not influence the frequency of postoperative complications

Clinical examination of torsion of the spermatic cord--review of 177 cases reported in the recent Japanese literature including our present 7 cases

Between January 1974 and December 1984, 16 patients underwent surgical exploration at our Hospital. Seven of these patients proved to have torsion of the spermatic cord and nine were strongly suspected to have this lesion in spite of lack of torsion during operation and the remaining 3 patients suffered from epididymitis. The 7 patients with torsion ranged in age from 14 to 22 years old. The left side was involved in 4 patients, and the right side in 3 patients. Six patients had internal rotation and 1 had external rotation. In all of them, intravaginal torsion was noticed at various degrees of twist (270 degrees-540 degrees). Orchidopexy was performed in 5 cases in which the operation could be done within 15 hours after onset of the symptom but in 2 cases in which 50, and 56 hours had elapsed orchidectomy was unavoidable. The 177 cases reported in the Japanese literature since Kumon's report including our present 7 cases were reviewed statistically in detail. Case reports of this lesion, especially in newborns, is increasing every year. The age distribution showed two peaks, one at the time of puberty (10-19 years old) and the other shortly after birth. There was a predominance for the left side, internal rotation and twisted degrees of 180 degrees to 360 degrees in this series. In the cases in which over 24 hours has elapsed before surgery, orchidectomy was performed frequently

A case of successful removal of a ureteral stone by using the Rutner balloon dilatation helical stone extractor: accompanied with percutaneous nephrolithotomy

A case of successful removal of a residual upper ureteral stone (9 X 6 mm) by Rutner balloon dilatation helical stone extractor which moved from renal pelvis during percutaneous nephrolithotomy for right renal pelvic stone (12 X 11 mm), is reported. This is the first successful case in Japan

ニュウガン トノ カンベツ オ ヨウシ コウ プロテイン ケッショウ ガ カンヨシタ ト カンガエラレル ニクガシュセイ ニュウセンエン ノ 1レイ

肉芽腫性乳腺炎は良性炎症性疾患であるが、乳癌と類似した所見を呈することがある。また、原因不明とされているが、高プロラクチン血症との関連も指摘されている。われわれは、乳癌との鑑別を要し、高プロラクチン血症との関与が考えられた肉芽腫性乳腺炎を経験した。症例は38歳、女性。2か月前からの左乳房のしこりを主訴に当科を受診し、超音波検査と針生検を施行し肉芽腫性乳腺炎の診断で経過観察していたが、さらに2か月後の超音波検査では腫瘍の増大と形状変化を認めた。マンモグラフィやMRIを施行したところ乳癌を疑う所見を認めたため手術する方針とした。左乳房部分切除を施行し手術標本の病理組織学的検査結果は肉芽腫性乳腺炎の診断であり悪性を示唆する所見は認めなかった。過去の文献ではMMGや超音波検査などの検査で肉芽腫性乳腺炎と判断したが、手術を施行した結果乳癌が存在した報告もあり、外科的切除も治療の選択肢と考えられる。また、高プロラクチン血症と肉芽腫性乳腺炎との関連も指摘されており、肉芽腫性乳腺炎を認めた際は高プロラクチン血症の有無を精査する必要があると考えられた。Granulomatous mastitis is a benign inflammatory disease that can similar breast cancer. They say that it has a relationship with hyperprolactinemia. We experienced granulomatous mastitis showing like breast cancer and probably caused from hyperprolactinemia. 38 year-old female were admitted with lump of left breast from two months ago. CNB showed findings of granulomatous mastitis, and we observed it. More two months later, the tumor was larger and changed to distorted shape. So we operated it. The pathological examination showed granulomatous mastitis and no malignancy. We think surgery is one of the treatments because they reported granulomatous mastitis coexisted with cancer according to past literature. On the other hand, we have to investigate the cause of hyperprolactinemia while diagnosing granulomatous mastitis

Microbial Conversion of Marine Industrial Waste to Resources

To extract polyunsaturated fatty acids and to remove cadmium from marine industrial waste like squid-waste-tissues, a microbial treatment of the tissues was examined using a bio-reactor of 200 L. During the sequential and mixed cultivation of proteolytic microbes and some strains of sulfate-reducing bacteria in the homogenized tissues, cadmium was removed significantly from the homogenate as the metal-sulfide precipitate. Characterization of polyunsaturated fatty acids extracted from the tissues are also discussed.特集 : 「環境調和型社会を指向して