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Biobank is the facility for preserving and providing biospecimens such as human cells, tissues and blood with their clinical data. Every year the establishment biobank has increased all over the world. The human biospecimens are rarely provided for researchers who want to use them for life-science research in Japan; the preservation is done well, though. Recently the ethical guidelines for life-science research using of human biospecimens have been amended. Through this revision, researchers can be easy to use these human biospecimens than before. It is expected this will provide the chances to progress life-science research. The next step of banking the human biospecimens is to examine the quality of the samples and to prepare the standard operating procedure. It is also extremely expected that biobank will be the basis for research toward the highly advanced medical technology.

私と筑波大学の縁は18歳で医学専門学群に入学した時に始まり今日に至るまで25年余りになります。そこで、学生として体験した医学教育と教官として関わった医学教育をふりかえって、これからの医学教育に関する ...

横浜市立大学泌尿器科およびその関連施設を加えた13施設で, TFLXを使用して有効性と安全性について検討した.1)女子急性単純性膀胱炎164例の総合有効率は98.78%であった.2)男子急性単純性膀胱炎4例, 急性単純性腎盂腎炎3例, 非淋菌性尿道炎1例, 複雑性尿路感染症7例にも投与して100%の有効率がえられた.3)原因菌の中で, グラム陰性菌は100%の消失率で, グラム陽性菌は90.60%の消失率であった.4)副作用発現は5例にみられ, その発現率は2.42%であった, We clinically evaluated the usefulness of a new oral antimicrobial agent, TFLX, in the field of urology. The dose administered was 150 mg t.i.d and the duration of administration was 3 days. The clinical effect was evaluated according to the criteria of the Japanese UTI committee. The clinical response obtained on 164 female patients with acute simple cystitis was excellent in 118, moderate in 44 and poor in 2 patients. The efficacy rate was 98.78%. The clinical response obtained on 4 male patients with acute simple cystitis was excellent in 2 and moderate in 2 patients. The efficacy rate was 100%. The clinical response obtained on 3 female patients with simple pyelonephritis was excellent in 2 and moderate in 1 patient. The efficacy rate was 100%. The clinical response obtained on one patient with non-gonococcal urethritis was excellent by doctor's evaluation. The clinical response obtained on 7 patients with complicated UTI was excellent in 3 and moderate in 4 patients. The efficacy rate was 100%. Three patients complained of stomach distress or malaise and 2 patients developed rash. No abnormal laboratory data were observed. Thus, TFLX appears to be safe and suitable for use in the field of urology.

1989, 【要旨】

1) 1976年より9年間の尿管S状結腸吻合は18例中1例を除きGoodwin法で実施した.2)原疾患は膀胱腫瘍14例, 前立腺癌2例, 女子尿道憩室腫瘍1例および尿道狭窄1例であった.3)術後の血清NaおよびK値はほとんど正常範囲内を変動した.高Cl血症は4例にみられたが, 術後1年以降は比較的安定した経過をたどった.BUNは術後1～2年を経過すると上昇傾向に転じたが, 血清creatinineは正常範囲内での変動であった.4)腎盂腎炎は3例にみられたが, 再発を繰り返すものはなかった.5)排泄性腎盂造影では術後2ヵ月では中等度ないしは軽度の水腎症が18例中9例にみられたが, 多くは1年以内に正常化した.6)排尿は昼間, 夜間ともにほぼ2～3時間に1回の割りであった.尿失禁は夜間熟睡時にのみ2例みられた.7)退院後3例が癌の再発で, 1例は肺炎で死亡した.現在外来通院中の14症例の術後の日常生活は健康人とまったく変わりない.外尿瘻のない本法の排尿状態は充分満足できる, Although various complications such as electrolyte imbalance and urinary infection are known to be induced by ureterosigmoidostomy, it is still a surgical technique difficult to ignore since it allows patients to lead an almost normal life without the encumbrance of external urinary devices. At our hospital, we performed eighteen ureterosigmoidostomy operations between 1976 and 1985. Herein, we review the postoperative conditions of electrolyte, renal function and other complications. The patients (16 male, 2 female) were between 53 and 72 years old, the mean age being 61.5 years. The primary diseases were bladder tumor (14 patients), prostatic cancer (2), carcinoma of the female urethral diverticulum (1) and urethral stricture (1). As to the electrolytes, both serum Na and serum K values fluctuated within the normal range. Hyperchloremia was detected in 4 cases (22.2%), but it was only slightly above the normal range and the conditions were more or less stabilized a year after the operation. Although blood urea nitrogen had a tendency to elevate one or two years after the operation, serum creatinine fluctuated within the normal range. During the observation period, only 7 of the 18 cases (38.9%) showed complications, the major complication being pyelonephritis (3 cases). Postoperative excretory urogram revealed slight to medium hydronephrosis two months after the operation in 9 of the 18 cases (50%), but most of these conditions were normalized within a year. Four patients died after leaving hospital; 3 due to the recurrence of cancer and one due to pneumonia. The 14 other outpatients are enjoying a normal life without the use of any external urinary device.

To evaluate the effect of a tissue adhesive agent (BI 0.022) on renal pelvic and ureteral surgery, the adhesive was applied for 44 patients with urolithiasis. The conventional suture method was performed in 87 patients as a control. The tissue adhesive is composed of fibrinogen, thrombin, factor XIII, aprotinin and CaCl2. The number of sutures for closure of the incision made on the rental pelvis and the ureter was significantly reduced by the use of the tissue adhesive (p less than 0.01). There was no tendency of increase in urinary leakage following the application of the method in comparison with the control. Furthermore, it was noteworthy that 10 in cases with less than a 1 cm ureteral incision were completely closed by the use of the adhesive agent. This tissue adhesive agent should be valuable for renal pelvic and ureteral surgery as a simple substitute for the conventional suture method.

本術式の自験89例を中心に検討した.術後の膿尿や血尿の持続時間と術前の尿路感染の有無との間には関連性を認めなかったが, 術後の膿尿の持続時間と摘出腺腫重量との間には相関関係が認められた.しかし, 血尿持続期間との間には関連性を認めなかった.恥骨後式前立腺摘出術に比較し, 本術式での術後の膿尿期間は遷延する傾向を示した.なお, 手術時間と術中出血量との間に相関関係が認められた, Suprapublic prostatectomies performed on 89 patients from January 1977 to December 1981 were retrospectively evaluated as regard to operative risk, preoperative and postoperative complications. The patients were from 56 to 87 years old with a peak distribution in the seventies. Common preoperative complications were urinary tract infection, coronary sclerosis followed by hypertension. The operation time for resection and weight of resected adenoma averaged 46.5 minutes and 35.1 g, respectively. Average blood loss during operation was 179 ml. The most frequent postoperative complication was acute epididymitis. There were no operative deaths. Prostatic incidental carcinoma was found in 3 cases of resected adenomas by histological examination. There were statistically significant correlations between adenoma weight and duration of postoperative urinary tract infection (r = 0.38, p less than 0.01) and between operation time and blood loss (r = 0.42, p less than 0.01). In contrast, preoperative urinary tract infection had no influenced on duration of postoperative urinary tract infection or postoperative gross hematuria.