後腹膜鏡下ハンドアシスト法および開放腎尿管全摘除術の比較検討

The goal of this study is to compare surgical and oncological outcomes of laparoscopic nephroureterectomy and the open surgery using the concept of systemic inflammatory response syndrome (SIRS) in addition to common variables. Thirty-six and 23 patients having upper urinary tract urothelial cancer who were operated on with retroperitoneoscopic hand-assisted nephroureterectomy (RHANU) or standard open nephroureterectomy (ONU) retrospectively, were analyzed. Median operation time was 140 (range 70-200) and 60 (range 45-85) minutes, respectively in the RHANU group and the ONU group. The median days to ambulation and hospital stay of the RHANU group were significantly shorter than those of the ONU group. There was no significant difference in the incidence of SIRS and other surgical results between the two groups. In oncological outcome, no significant difference was found in the bladder recurrence rate (RHANU vs. ONU; 52% vs. 45%), local recurrence (0% vs. 0%), distant metastasis (11% vs. 13%) or survival rate (94% vs. 91%) between the RHANU group and the ONU group at 2-year follow-up. There was no port site recurrence in the RHANU group. Although the RHANU may have an advantage in terms of earlier recovery, there were no significant differences in the incidence of SIRS and oncological outcomes between the RHANU group and the ONU group.腎盂尿管腫瘍に対する体腔鏡下および開放腎尿管全摘除術につき手術成績、術後経過を比較検討する。全身的侵襲性の指標としてsystemic inflammatory response syndrome(SIRS)の発症頻度に関しても比較検討を行う。腎盂尿管腫瘍に対して腎尿管全摘除術を施行した体腔鏡下手術36例(2002年4月～2004年12月)開放手術(ONU)23例(1999年1月～2001年12月)を対象とした。体腔鏡下手術は後腹膜鏡下ハンドアシスト法(RHANU)を用いた。手術時間(中央値)はRHANU群140分、ONU群60分とONU群で有意に短かった。出血量は両群とも平均約150mlであった。RHANU群において歩行開始日が有意に短縮していた。SIRSの頻度はRHANU群17%、ONU群26%と有意差を認めなかった。膀胱再発率は52, 45%(以下RHANU群vsONU群)、遠隔転移11, 13%、局所再発は両群とも認めず2年での生存率は94, 91%であった。体腔鏡下手術では、歩行開始日が有意に短く早期の回復が示唆された。SIRSの頻度、再発・転移・生存率に有意な差を認めなかった。体腔鏡下手術のリスク、術式の患者への利点を充分考慮した手術方法の選択が重要と思われた。(著者抄録

Preparation of Transparent Film of Layered Double Hydroxide with Anionic Pyrene Derivatives and Its Luminous Toluene Detection Ability

To prepare the transparent solid film of layered double hydroxide, the filtration-film transfer (FFT) method using LDH nanosheet colloidal suspension was investigated. It was found that the homogeneous LDH solid film with enough transparency in the visible light range could be prepared by the FFT method. Moreover, anionic pyrene (Pyr−) molecules could be incorporated into the transparent LDH solid film by immersing in anionic pyrene solution. From both absorption and emission spectra of the transparent Pyr−/LDH solid film, Pyr− incorporated in the LDH solid film formed aggregates and mainly showed the strong excimer emission. Additionally, the luminous response of the transparent Pyr−/LDH solid film was investigated in ethanol-toluene mixed solution with various toluene contents. As results, the ratio of luminescence intensities from static excimer and monomer of incorporated Pyr− molecules depended on the toluene content, and excimer emission decreased with an increase in the toluene content. This luminous response can be caused by an increase of the monomeric Pyr− species, because Pyr− aggregates are broken by adsorption of toluene molecules into the LDH interlayer space. The obtained transparent hybrid film may be useful as a detectable material of toluene in solvent by luminous change

Survival of patients with bladder cancer from a UK hospital: a 10-year follow-up study.

OBJECTIVE: To compare 10-year overall (OS) and cancer-specific survival (CSS) of a cohort of consecutively presenting patients with bladder cancer of all pT categories from one UK institution. PATIENTS AND METHODS: Data were collected on 144 patients with newly diagnosed bladder tumours presenting from 1983 to 1985 followed up for 10 years. Histological variables were reviewed by one pathologist who had no knowledge of the clinical details. Bladder muscle was present in 95% of the transurethral resection specimens. Date and causes of death were ascertained through death certificates, primary care physicians and/or hospital case notes. Data were analysed using the Kaplan-Meier method and Cox model. RESULTS: There were 69 patients (48%) with pTa, 32 (22%) with pT1 and 43 (30%) with pT2/3/4 tumours. The 10-year OS was 54%, 34% and 16% and the CSS was 97%, 50% and 29%, respectively. There were only two cancer-related deaths in the pTa category whereas half the pT1 cases and half the muscle-invasive cases died within 5 and 2 years of diagnosis, respectively. CONCLUSIONS: This study compared the 10-year OS and CSS of a cohort of patients with bladder cancer from the UK, where such data are lacking, and showed marked differences. The CSS was higher in all pT categories compared with OS, especially within pTa cancers in which almost all patients died of competing causes. It is important to be aware of such a significant difference between the two survival measures and to use them appropriately in the right context