ヒニョウキカ シュヨウ ニ タイスル フククウキョウカ シュジュツ

Laparoscopic surgery for urological tumors are recently considered as standard operative procedures. From 1992 to August 2005, we performed 70 laparoscopic adrenalectomies for various adrenal tumors, 57 laparoscopic radical nephrectomies for renal tumors, 22 laparoscopic nephroureterectomies for upper urinary tract tumors, and 8 laparoscopic radical prostatectomies for early prostate cancer. Also, we performed several laparoscopic pyeloplasties for ureteropelvic junction obstruction cases, or laparoscopic nephrectomies for benign disease included pediatric cases. Laparoscopic adrenalectomy is standard operation for various adrenal tumors except for very large malignant tumors. Laparoscopic radical nephrectomy become standard operation for T1/T2 renal cell carcinoma indicated nephrectomy. Both transperitoneal and retroperitoneal approach are suitable. Laparoscopic nephroureterectomy for upper urinary tract tumors is also considered as a standard operative procedure, and retroperitoneal approach is usually selected. Laparoscopic prostatectomy is minimally invasive operative method for localized prostatectomy, however further observations are necessary to consider standard procedure

Matrix metalloproteinases and bladder cancer

Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes which degrade the extracellular matrix or components of the basement membrane. They have essential roles in tumor invasion and metastasis. In bladder cancer, elevated MMP-2 and MMP-9 expression in tumor tissues, correlated with tumor stage, grade or prognosis, were reported in several studies. Moreover, high levels of serum or urine MMP and TIMP were observed in patients with bladder cancer especially in advanced cases. However, the true roles of MMPs and TIMPs in bladder cancer progression are not yet clarified. Here, we discuss the roles and clinical implications of MMPs in bladder cancer

ジンガン ゼンリツセンガン ニ タイスル サイシン ノ ヤクブツ リョウホウ

As advanced renal cell carcinoma （RCC） shows resistance to anti-cancer drugs, immunotherapy had been the mainstay of systemic therapy. Recently, molecular targeted agents including VEGF and mTOR inhibitors have been introduced, and so systemic therapy for advanced RCC has been significantly altered. VEGF inhibitors show marked efficacy in regard to tumor size reduction, and the representative adverse events include hypertension, hand-foot syndrome, and hypothyroidism. mTOR inhibitors have modest effects for tumor size reduction, and the specific adverse events include stomatitis, hyperglycemia, hyperlipidemia, and interstitial pneumonia. The introduction of molecular targeted agents has improved survival in advanced RCC patients. Hormonal therapy is at the center of systemic therapy for advanced prostate cancer patients. Castration or LH-RH analogues suppress the proliferation of prostate cancer cells by decreasing androgen production in the testes. Anti-androgens inhibit the binding of testosterone to androgen receptors, and combination therapy of castration or LH-RH analogues and anti-androgens, called maximum androgen blockade, shows enhanced efficacy for advanced prostate cancer. Docetaxel is administered for castration-resistant prostate cancer, and prolongs survival compared to previously used anti-cancer drugs. Regarding new drugs for prostate cancer, an LH-RH antagonist, a CYP17 inhibitor of androgen production in the adrenal glands, and new anti-androgens with a higher affinity for androgen receptors have been developed for clinical use

トクシマケン ニオケル セイカンセンショウ Sexually Transmitted Disease : STD ノ ゲンジョウ : STD センチネル サーベイランス チョウサ ホウコク

The sentinel surveillance of sexually transmitted disease (STD) has been started in 8 model prefectures in Japan since 1998. The response rate of the surveillance in Tokushima was 87.7% in 1999, and 86.6% in 2000. From the results of the sentinel surveillance, the incidence rate of total STD per 100,000 person・year in Tokushima was about 410 in 1999, and about 440 in 2000. Chlamydial infection was most frequent especially in younger women, and the incident rate per 100,000 person・year was about 2,500 in the age ranged from 20 to 24 years old. Then, it seems important that the education about STD to young people and their parents

ジョセイ ノ コツバン ゾウキダツ ニョウ シッキン ノ サイシン チリョウ

Pelvic organ prolapse （POP） and urinary incontinence are not rare among the middle and advance aged woman. Although these diseases don’t cause life threatening, decrease the QOL （Quality of life） of patients. The patients of POP or urinary incontinence were hesitated to tell to another person so far, the opportunities to consult a medical institution increase by the enlightenment activity such as media. In this review, we describe the latest treatment for female POP and urinary incontinence

残尿測定

１）残尿測定とは、排尿直後に膀胱内に残った尿量を測定する検査のことです。 ２）50ml未満が一般的ですが、100ml以上の場合は、下部尿路機能障害があると考えられ、泌尿器科受診が必要です。 ３）なるべく複数回測定し、簡易型の残尿測定器による測定値が疑わしい場合は、腹部超音波検査を確認することが必要です

PSA screening in hemodialysis patients

We investigated the long-term outcomes of the Japanese hemodialysis patients with prostate cancer detected by prostate-specific antigen (PSA) screening. Clinical data of 646 male hemodialysis patients aged 55 years or older who started yearly PSA testing in the period from January 1, 2004 to December 31, 2012 and were followed until December 31, 2017 were analyzed retrospectively. The median follow-up period was 10.4 years. Nineteen (2.9%) patients were diagnosed with prostate cancer, of whom one patient died of the disease. Androgen-deprivation therapy (ADT) was selected for primary prostate cancer treatment in 17 (89.5%) of these 19 patients. Of six prostate cancer patients who underwent primary ADT (PADT) and died of other causes, three died of infectious disease, each one died of cardiovascular disease, liver cancer, and chronic renal failure. No significant difference was observed in regard to overall survival between the prostate cancer patients with PADT and non-prostate cancer patients. Prognosis of hemodialysis patients who were diagnosed with prostate cancer during yearly PSA screening examination and mainly treated with ADT was favorable without increasing cardiovascular events. This result indicates that PSA screening may be useful for detection and management of prostate cancer even in hemodialysis patients

Elucidation of the molecular signatures of renal cell carcinoma by gene expression profiling

Renal cell carcinoma (RCC) is the 10th most common cancer in United States. It is a heterogeneous disease with various histologic types. Since high-throughput technologies such as microarrays have been introduced, molecular confirmation of previously known findings in RCC has been made and new molecular findings have emerged. We review the accumulating advances in this field and their clinical implications. The published data so far have proved to be significant and promising, and numerous microarray studies with larger number of cases are currently ongoing or being planned. Although various clinical parameters are being refined for diagnosis and prognosis, these data obtained by microarray studies will undoubtedly contribute to both and eventually impacts the treatment of RCC