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1)腎外傷において, 受傷時DIPにて, 腎盂像の描出あるものは, 軽度～中等度の損傷と考え, 保存的に治療をおこない, 腎盂像の描出のないものは高度の損傷と考え, 動脈造影をおこない, その損傷の程度にあわせた手術をおこなった.2)受傷時DIPにて腎盂像の描出良好のものでも, 再出血を繰りかえすもの, 血尿の持続するものは, 高度の損傷へ進展する可能性があるため注意深い観察が必要である.3)1例の尿管外傷は, 一般に言われているごとく, 特徴のない臨床症状のため診断が遅れ, 腎摘をせざるをえなかった.4)膀胱外傷では, 腹膜内破裂に対し閉鎖術をおこない, 腹膜外破裂に対しては, 可及的に, バルン留置のみとし, 裂孔の大きいものに対し, 閉鎖術をおこなった.5)前部尿道損傷では, バルン挿入可能例はそのまま留置し, 不能例に尿道端々吻合をおこなった.後部尿道損傷では, バルン挿入不能例に膀胱瘻造設し3ヵ月後に, 内視尿道切開術(安田法)をおこなうことを原則とした, Since 1968, we experienced 65 cases of urinary tract injury. These include a rare case of traumatic renal artery thrombosis which was later followed by renovascular hypertension, a rare case of complete ureteral disruption, and 2 cases of renal injury which were first treated conservatively but were nephrectomized later because of rebleeding. These cases are reported and discussion is made about the relationship between the clinical findings and the indication of nephrectomy. We used endoscopic management (Yasuda method) in the cases of complete disruption of posterior urethra accompanied by pelvic fracture and obtained good results.

Two cases of renal cell carcinoma on maintenance dialysis for chronic renal insufficiency are reported. The first case, a 40-year-old man, complained of hematuria after 9.3 years of dialysis. Nephrectomy was done and small renal cell carcinoma with acquired cystic disease of the kidney were observed. The second case, a 48-year-old man, was found to have renal cell carcinoma after 2.5 years of dialysis by means of routine examination without any symptoms. The kidney showed carcinoma with small cystic areas and four adenomas. Usefulness of routine examination with echogram is stressed for management of hemodialysis.

Ten cases of pheochromocytoma seen at our hospitals between 1960 and 1981 are presented. The ages of the patients differed greatly. Seven patients were females and 3 were males. Six patients had a right adrenal tumor, 3 patients had a left adrenal tumor, and one patient had an extra-adrenal tumor. In the clinical findings, hypertension was recognized in 9 cases, palpitation in 7 cases, headache in 6 cases, nausea and vomiting in 5 cases, headache in 6 cases, nausea and vomiting in 5 cases and sweatening in 2 cases. A diagnosis of renal cancer was made for the case without hypertension, which was found to be pheochromocytoma at autopsy. The urinary catecholamine levels in 24 hour collections were high in 8 cases excluding the paroxysmal-type case. The urinary level of adrenaline of the extra-adrenal case was higher than that of noradrenaline. For locating tumors, computed tomography, retroperitoneal pneumography, ultrasonography, aortography and so on were performed, the first two methods of which showed a diagnostic accuracy of 100%. Computed tomography which was not invasive was found the most helpful method. Blood transfusion and administration of phenoxybenzamine and propranolol were performed as preoperative management on 5 patients, but none of them developed hypotension after tumor extirpation. The blood pressure of9 patients who underwent operation became normal after operation.

IFN-αAを転移のある腎細胞癌患者9例に投与し, PR 1例, MR 1例であった.IFN-α2は4例に投与し, PR 1例であった.有効性の認められた転移部位は肺, 腹部腫瘤, 脳であった, The present study was undertaken to assess the efficacy of single agent chemotherapy with alpha A-interferon or alpha 2-interferon for metastatic renal cell carcinoma. alpha A and alpha 2-Interferon were administered i.m. at a primary dose of 3 X 10(6) units/day to 13 patients. Two patients (15%) showed partial response; 1 patient (8%), minor response; 5 patients (38%), no change; 6 patients (46%), progressive disease. These preliminary observations indicate that these interferons are active antitumor agents in patients with renal cell carcinoma.