Comparative double-blind trial of KN-7 tablet and Robaveron injection in the treatment of neurogenic bladder

37施設で, 神経因性膀胱233例を対象に, ロバベロン注射剤を標準薬とし, KN-7錠剤の経口投与による排尿障害に対する有用性を, 二重盲検群間比較試験で比較検討した.解析対象例はKN-7群108例, ロバベロン群107例である.KN-7群は1日6錠投与した.改善度の効果判定では改善以上K群40.7%, R群38.7%, やゝ改善以上それぞれ76.9%, 72.6%と有意差はなかった.臨床所見中改善の良かった項目は, 尿意, 残尿感, 尿失禁, 排尿までの時間, 排尿時間, 尿勢-排尿力と尿線中断の改善などで, これらの改善以上はK群35.8%, R群30.8%で, 有意差はなかった.副作用はK群0.9%, R群6.8%, K群が有意に少なかった.両剤とも主として下痢で, R群ではその他頭痛, 頻脈, 肝機能障害, 発熱感などを少数例認めた.臨床検査値ではGOT, GPTの上昇が2例あった.有用度有用以上はK群46.3%, R群45.8%で有意差はなかった.疾患別では, 末梢神経疾患, 膀胱の性状では弛緩性, 時期では12ヵ月以内の例で特に改善率が高かった.以上から, KN-7錠剤は, ロバベロン注射剤に比べ, 同等の効果が期待でき, 安全性も高く, 長期投与あるいは外来患者の治療にも適するThe clinical effectiveness, safety and usefulness of KN-7 tablet as a new oral application of the prostatic extract, on urinary dysfunction of neurogenic bladder were compared with those of Robaveron injection by the double-blind test method. In the study, 2 tablets t.i.d. and a shot of intramuscular injection 1 ml a day were given successively for 3 weeks. A total of 233 cases were reported from 37 facilities belonging to the KN-7 Clinical Research Group. Some of them were excluded or dropped out. The number of cases used for analysing the effectiveness, safety and usefulness were 214, 232 and 215, respectively. There was no bias between the two groups with a significant homogeneity in the background. In the overall clinical effectiveness, the effective rate including excellent, moderate and slightly effective was 76.9% with KN-7 and 77.4% with Robaveron. In the clinical usefulness, the rate of usefulness of slightly useful or above was 75.0% with KN-7 and 75.7% with Robaveron. There was no significant difference between the two groups in the clinical effective and useful rates at a significant level of 5%. Side effects were observed in 1 of the 114 (0.9%) patients given KN-7 and 8 of the 118 (6.8%) patients given Robaveron. The incidence of adverse reactions with KN-7 was significantly lower than that with Robaveron. Based on the results, it was concluded that KN-7 tablets, 2 tablets t.i.d., would be as effective and useful as a Robaveron injection 1 ml daily and safer than the latter in the treatment of neurogenic bladder

水土保持草類根系之研究

植生為水土保持主要方法之一，草類覆蓋對於果園覆蓋及邊坡穩定均具有相當之成效 ．本試驗係使用水土保持常用之禾本科植生材料百喜草A４４（寬葉種）、A３３（ 窄葉種）、假儉草、地毯草、及鄉土植物兩耳草，以盆栽方式種植於根系固結網架上 ，進行根系調查試驗，探討各種草類種植於不同生育地土壤對土壤溫度變化之影響、 根群分佈情形、地表覆蓋能力及根系固結土壤能力等，並將試驗結果予以數值化後， 利用電腦繪製成根型並予以貯存，期為選擇植生材料之參考與應用．茲將試驗結果分 析如下： １．覆蓋作物具有緩和地溫波動之效果於冬寒季更具有保持土壤溫度之效，因而對作 物之生長有所助益．各草種間波動量差異不大，以百喜草A４４，A３３波動量最小 ，依次為假儉草、地毯草、兩耳草． ２．各種供試草類在不同地區土壤種植，其根系之生長與分佈均有顯著之差異，且各 草種根系大都分佈於土層３０公分以內，約佔全根量之８０∼９０％． ３．各種供試草類對立地條件之選擇不嚴，種植於四種不同地區之土壤中均可正常生 長． ４．供試五種品系草種，無論是種植於任何地區之土壤，其地上部覆蓋地表能力或地 下部根系固土能力，均以百喜草二品系最好，依次為地毯草、兩耳草、假儉草．而其 中假儉草地上部覆蓋地表能力較優於地上部根系固土能力． ５．白喜草A４４、A３３兩種品系，根型分佈呈側生狀，根系密集，生長方向與扦插 時之植生方向一致，因此在坡地種植百喜草似可考慮其扦插之方向，以加速莖葉與根 系之生長．假儉草根型呈放射狀，根系伸入土層甚淺，根徑纖細，平均根長甚短．地 毯草、兩耳草匐匍走莖甚為發達，鬚根甚多，走莖節間甚大；地毯草根型分佈呈於射 狀，兩耳草呈直立狀

A Case Report : FDG Uptake to Brown Adipose Tissue Activated by Elevated Serum Catecholamine in a Patient with Pheochromocytoma

A 69-year-old woman was admitted to the previous hospital because of a right adrenal tumor detected by a medical checkup. Although the tumor was diagnosed as non-functional adrenal adenoma, abdominal computed tomography (CT) revealed a left renal mass which was suspected to be renal cell carcinoma. Chest CT seeking for metastatic lesions revealed lung cancer of the left lung. First, laparoscopic radical nephrectomy was performed. After the surgery, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) CT performed for staging of the lung cancer demonstrated FDG uptake to the left lung mass, the heart, the right adrenal mass and perirenal regions of the right kidney. The patient showed elevated serum catecholamine level and hypertensive emergency. She was admitted to our hospital with a suspicion of pheochromocytoma of the right adrenal gland and multiple paraganglioma. CT and magnetic resonance imaging showed that the heart and the perirenal regions had no tumors. We considered these lesions brown adipose tissue. Under the diagnosis of pheochromocytoma of the right adrenal gland, laparoscopic partial adrenalectomy was performed. The clinical course after the surgery was uneventful. FDG PET-CT revealed that FDG uptake to brown adipose tissue disappeared 6 months after the partial adrenalectomy

Urolithiasis associated with Crohn's disease: a case report

症例は28歳女.治療はESWLでの砕石効果不良のため, TUL, PNLを行い, 完全な結石の砕石及び排石が行えた.結石の増大や再発防止のために厳重な食事制限と服薬指導が重要である.腎生検所見により, 画像で確認可能な結石以外にも尿細管レベルでの結石の形成が始まっていることが示されたWe report a case of urolithiasis caused by surgical treatment for Crohn's disease. A 28-year-old woman was referred to our department for further examination of renal stones from the medical department in September, 1995. She suffered from Crohn's disease and had a history of jejuno-ileal resection because of perforation of the ileum in 1988. Radiographs revealed multiple bilateral renal stones, and the urine oxalate concentration was elevated. She was treated with extracorporeal shock wave lithotripsy and the administration of sodium bicarbonate and citrate, but these treatments did not prevent recurrence and enlargement of stones. Renal function was gradually worsened and we performed transurethral lithotomy and percutaneous nephrolithotripsy. The stones were mainly composed of oxalate calcium monohydrate. A renal biopsy was performed at the operation, showing deposition of crystals in almost all renal tubules. Diet therapy (low oxalate and low fat) and the administration of sodium bicarbonate and citrate were performed strictly and recurrence was not recognized 10 months after complete removal of the stones

Adie症候群の１例

東京女子医科大学学会第287回例会　平成3年6月13日　東京女子医科大学中央校舎１階会議