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We retrospectively reviewed the records of 35 patients with penile cancer, who had been treated at Gifu University Hospital and its affiliated hospitals between July 1994 and January 2009. The mean values of follow-up periods, ages, serum squamous cell carcinoma levels and maximum diameters of the tumor were 23.7±28.0 months, 72.3±10.5 year-old, 4.5±4.3 ng/ml, and 4.0±2.6 cm, respectively. Systemic chemotherapy and local radiotherapy were performed in six, and three cases, respectively. Ten patients died of penile cancer. By univariate analyses, maximum tumor diameter (＜− 4.3 cmvs ＞4.3 cm), T factor (＜T3 vs ＞− T3) and N factor (＜N2 vs ＞− N2) were significantly associated with cancer-specific survival. The five-year survival of stage N2 cases (28.6%) were significantly lower than that of stage N0 and N1 cases (68.4%) (p＝0.0003). By multivariate analyses N factor (＜N2 vs ＞− N2) was significantly associated with cancer specific survival (p＝0.020). We concluded that the development of effective systemic chemotherapy might be crucial to improve the prognosis of patients with metastatic diseases.

45歳女。腹部CTにて左腎腫瘍を認め、根治的腎摘出術を施行し、病理診断はrenal cell carcinoma、clear cell typeであった。約11ヵ月後の経腟超音波検査で左卵巣嚢胞を認め、内部にhigh echoicな腫瘤性病変を認めたためMRIを行い、腫瘤はチョコレート嚢胞と考えられた。その後腫瘍の増大、内部にlow echoic areaを認め、腹腔鏡下左卵巣摘出術を行った。術中、左卵巣と腹膜・広間膜の癒着、右卵巣の一部腹膜癒着を認め、術中迅速病理検査で境界悪性との結果が得られたため両側卵巣子宮摘出術へ変更した。病理組織診断はrenal cell carcinoma、clear cell carcinomaの転移であった。術後INFα治療は同意が得られず、無治療にて経過観察していたところ、肺転移巣などが徐々に進行し死亡した。, A 45-year-old woman underwent left radical nephrectomy in April 2002. Pathological diagnosis was a renal cell carcinoma, clear cell subtype, pT3a, v(-), NO. One year later, abdominal ultrasound revealed a left ovarian tumor which had an enlargement tendency. A laparoscopic bilateral salpingooophorectomy was performed. Immunohistochemical analysis confirmed the diagnosis of metastatic ovarian renal cell carcinoma. This is the 20th case in the literature.

39歳女.患者は17歳の時, 関節炎および蝶形紅斑, 発熱で発症し, 23歳時に全身性エリテマトーデス(SLE)と診断された.プレドニゾロンの内服治療を受けていたが, 発熱はじめ両下肢の脱力とともに排尿困難感を自覚した.更に呼吸困難, 全身の筋肉痛が出現, 3ヵ月後の退院時には排尿状態は自排尿可能であったが, 尿失禁を認めた.以後, 全身性浮腫が出現し, 腹部CTにて両側水腎症を認めた.腎盂腎炎を繰り返し, 膀胱尿管逆流, 膀胱憩室を認めた.膀胱憩室切除術, 回腸利用膀胱拡大術を施行した結果, 病理組織検査では, 高度の炎症細胞浸潤と肉芽組織の形成を認め, 膀胱憩室炎の診断であった.術後3ヵ月で水腎症, 尿失禁は完全に消失し, 膀胱容量は300mlまで増加した, A 39-year-old female with systemic lupus erythematosus (SLE) with a neurogenic bladder is described. She developed voiding disturbance with paraplegia and sensory disturbance on her inferior limb. Clinical findings suggested elevated activities of SLE with transverse myelitis. Although her symptoms were improved after one course of methylprednisolone pulse therapy, clean intermittent catheterization was required for urinary incontinence and residual urine. One year later, bilateral hydronephrosis and vesical diverticulitis developed, and thus augmentation ileocystoplasty was performed. After three months of the operation, hydronephrosis and urinary incontinence resolved with frequent clean intermittent catheterization. We should not overlook lower urinary tract symptoms in patients with SLE. We advocate performing a surgical procedure in cases in which conservative treatments are not effective.

79歳女.子宮筋腫に対する子宮摘出術の既往があった.9年前, 左右側壁, 後壁の多発性膀胱腫瘍に対して尿道温存膀胱全摘術, 回腸利用代用膀胱造設術を施行した.病理組織診断は, 移行上皮癌, G2, pT2, INFβ, pL0, pV0, pN0であった.経過良好であったが, 術後8年目, 右腎結石による血尿を認め, 溢流性尿失禁のため間歇的自己導尿となった.その後, 導尿用カテーテル挿入時の抵抗感を感じるようになり, 尿道の視触診で尿道再発が疑われた.腹部・骨盤部CTにて, 代用膀胱背面にlow density areaを伴う8×7.5×6cmの腫瘤を認め, 尿道と連続していた.また, 肝S3のlow density area(直径1cm), 左骨盤壁に接するリンパ節腫大を認めた.膀胱鏡検査では, 尿道から吻合部にかけて広基性の腫瘍を認め, 内視鏡下腫瘍生検の病理組織像は, 移行上皮癌, G2であった.以上より膀胱癌の尿道再発・肝転移・骨盤内リンパ節転移と診断した.化学治療に対する同意は得られず, 全身状態悪化にて死亡した, We report a 79-year-old female with urethral recurrence and distant metastases of urothelial bladder cancer. She had undergone urethra-sparing cystectomy and orthotopic ileal neobladder at 70 years of age. Chemotherapy was not performed and the patient died 5 months later. We concluded that long-term follow-up for urethral recurrence in women with neobladders was necessary.

RT-PCR法による前立腺癌細胞の検出法は, 従来の病理学的方法或いは画像診断法に比較して高感度の検出法であり, 前立腺癌微小転移の検出には最適な方法と考えられる, We detected micrometastatic prostate cancer cells in lymph nodes and bone marrow using reverse transcriptase-polymerase chain reaction (RT-PCT) specific for prostate-specific antigen (PSA). RT-PCR revealed PSA mRNA in two lymph nodes obtained from two patients with negative histological and immunohistochemical analyses for lymph node metastases. Of 26 patients with negative bone scan imaging, 7 had PSA mRNA detected in the bone marrow by RT-PCR. The RT-PCR will be a relevant tool to allow a more accurate clinical assessment of lymph node and bone metastases in patients with prostate cancer.

1)小委員会判定が可能であった症例における有効率は急性細菌性前立腺炎(ABP)で100%(15/15), 慢性細菌性前立腺炎(CBP)で66.7%(18/27)と満足すべき成績がえられた。細菌学的効果はABPで100%(15/15), CBPで81.5%(22/27)の菌陰性化率であった。2)自他覚的副作用は100例中8例に, 臨床検査値異常変動は71例中9例にみられたが, いずれも臨床上特に問題となるものではなかった。3) ABPでは7日間, CBPでは14日間の投与期間で薬剤の有効性は評価可能である。4) ABPではE. coliをはじめとするGNRがおもな起炎菌であり, CBPでは, GNRあるいはE. faecalisは半数弱の症例でしか分離されず, 他の症例ではCNSが検出された, The clinical efficacy of temafloxacin (TMFX) was evaluated in the patients with acute prostatitis (AP: 31 cases) and chronic prostatitis (CP: 75 cases), and the criteria for clinical evaluation on bacterial prostatitis by the Japanese UTI Committee were re-examined. The clinical efficacy of TMFX on prostatitis was examined. The number of the evaluable cases by doctors in charge were 30 and 68 for AP and CP, respectively. The efficacy rates were as high as 96.7% for AP and 80.9% for CP. In the patients whose efficacy could be evaluated by the Committee, the efficacy rates were as high as 100% (15/15) for acute bacterial prostatitis (ABP) and 66.7% (18/27) for chronic bacterial prostatitis (CBP). The bacteriological eradication rates were 100% (15/15) for ABP and 81.5% (22/27) for CBP. Adverse drug reactions were observed in 8 of 100 cases (total evaluable cases) but they clinically did not consist any problems. Abnormal laboratory test findings were observed in 9 of 71 cases (total evaluable cases), whose changes were all slight and did not clinically cause any problem. Therefore, TMFX was concluded to be highly useful in the treatment of ABP and CBP. The criteria for clinical evaluation on bacterial prostatitis were re-examined. Concerning the treatment period, comparison of the evaluation at Day 7 with that at Day 14 in ABP revealed that the efficacy was evaluable at Day 7. In the same way, comparison of the evaluation at Day 14 with that at Day 28 in CBP revealed that the efficacy was evaluable at Day 14. Concerning the pathogens, in ABP, the major pathogens were considered to be GNR as well as E. coli. On the other hand, in CBP, GNR and E. faecalis, that were generally authorized to be pathogens, were detected in less than half of the patients, and CNS were detected in the other patients. Among the CNS cases, there were some cases that showed no relationship between improvement of clinical symptoms and bacterial response. Therefore, it is necessary to perform further studies on this matter. In conclusion, regarding the criteria for clinical evaluation on bacterial prostatitis proposed by the Japanese UTI committee, the treatment period for evaluation of efficacy was appropriate, and it is necessary to perform further studies in order to determine the pathogens in bacterial prostatitis.

感染症の頻度や好発する感染症の種類を知るため発熱の原因を検討した。1)発熱の原因不明のものは26例中11例にみられた。発熱原因として腎盂腎炎が最も多くみられたが, 基礎疾患として水腎症の存在が重要と考えられた。2)発熱は末梢白血球数が2, 000/mm3以下の症例に多くみられた, To examine the frequency and the type of infection during cancer chemotherapy in the urological field, we studied the causes of fever in 67 patients with genitourinary cancer. Twenty-six patients had developed a fever of higher than 38 degrees C. Although fever without proven infection was seen in 11 patients (42.3%), fever caused by pyelonephritis was the most common infection. There was a relationship between fever and the presence of hydronephrosis. Fever was observed more often in patients with a leucocyte count of less than 2, 000 white blood cell/mm3. In conclusion, we recommend the interruption of cancer chemotherapy or the use of granulocyte colony-stimulating factor for the prevention of infection, when the leukocyte count is less than 2, 000 cell/mm3, especially in patients with hydronephrosis.

62歳女.主訴は右側腹部痛であった.CTにて右腎腫瘍を指摘され入院となった.精査によるCTで, 右腎結石, 右腎実質の菲薄化と右腎盂内に腫瘍性病変を認め手術となった.腰部斜切開したところ, 右腎と十二指腸の癒着が強く, 腎臓を摘出すると, 腎盂と十二指腸との瘻孔を認めた.又, 尿管も下大静脈壁と強く癒着していた為, 尿管摘除術は断念し, 瘻孔部の十二指腸を腹部正中切開にて部分切除し, 手術を終了した.病理では, 腫瘍は乳頭状腺癌で周囲への浸潤は認められなかった.瘻孔部及び十二指腸側への浸潤も認められず, 瘻孔の原因は急性及び慢性の腎盂腎炎による炎症と考えられた.術後7日目に創部感染を合併した為, 再縫合術を施行し, 7日後に退院となった.現在, 厳重に経過観察中である, A 62-year-old woman visited our hospital complaining of fever and right flank pain. On excretory pyelography the right kidney containing three renal stones was not visualized. Retrograde pyelography revealed an irregular filling defect in the right renal pelvis. Computed tomography revealed renal stones and a tumor mass in the right renal pelvis. From these findings, the pelvic tumor of the right kidney complicated by renal stones was diagnosed. Right nephrectomy was performed. Because a fistula between the renal pelvis and the second portion of the duodenum was found in the operation, partial resection of the duodenum was also performed. Pathological diagnosis was adenocarcinoma of the renal pelvis and pyeloduodenal fistula due to chronic pyelonephritis. Postoperative chemotherapy was not given. This is the first case report of adinocarcinoma of the renal pelvis coexisting with a pyeloduodenal fistula.

A 48-year-old man was admitted to our hospital because of high fever and left flank pain. Laboratory findings revealed a high white blood cell count, high C-reactive protein level, and severe pyuria. Sonographic examination revealed an enlargement of the cyst at the upper pole of the left kidney that had already been detected. Percutaneous drainage was performed for the cyst and 60 ml of purulent fluid was obtained. Bacterial culture of the fluid was positive for Propionibacterium acnes and gamma-Streptococcus. The drainage and administration of povidone-iodine was continued for 7 days. The size of the cyst was reduced with disappearance of symptoms.

前立腺癌11例(前立腺全摘除術4例, TUR-P 7例)を対象として, 術前UFT(600 mg/日, 分3, 5日以上)経口投与後の血清, 尿および組織内FT, 5-FUおよびuracil濃度を測定した.1)UFT服用後検体採取までの時間は, 全摘群で290±60分, TUR-P群では189±32分であり, TUR-P群の方が有意に短かった.2)腫瘍組織内5-FU濃度は全摘群で0.018±0.012 μg/g, TUR-P群で0.024±0.010 μg/gであり, 他臓器癌での値に比べ低値であった.また全摘群で, 腫瘍組織内濃度が0.018±0.012 μg/gであるのに対し, 正常組織内濃度は0.013±0.008 μg/gで, 有意差をみなかった.3)血清中5-FU濃度との比でも同様にそれぞれ2.20, 1.46であり, 両群の間に有意差をみなかった, The serum, urine and tissue concentrations of 1-(2-tetrahydrofuryl)-5-fluorouracil (FT), 5-fluorouracil (5-FU) and uracil were estimated in 11 patients with prostate cancer (4 cases treated by total prostatectomy and 7 cases by transurethral resection (TUR-P) after oral administration of UFT. The concentration of FT, 5-FU and uracil in the tumor tissue (micrograms/g) were 5.920 +/- 5.902, 0.018 +/- 0.012 (T/S; 2.20) and 7.785 +/- 4.151 in 4 patients treated by total prostatectomy and 1.943 +/- 1.355, 0.024 +/- 0.010 (T/S; 1.46) and 4.616 +/- 2.848 in 7 patients treated by transurethral resection of prostate. The concentrations of FT, 5-FU and uracil in the tumor tissue did not increase as compared with those in normal tissue in 4 cases treated by total prostatectomy.

$\alpha$放射性粉塵の粒子径測定方法のひとつとしてオートラジオグラフ法がある。この方法を日常の放射線管理により使い易いものにするため、1978年に曝射用カメラと蛍光膜を組み合わせたオートラジオグラフ装置(以下「ARG」という)が製作され、その装置を用いて粒子径測定方法が確立された。筆者らは、この粒子径測定方法での、ARG写真からのスポット像の読み取り及びデータ処理に、多大の労力と時間を費やしていることに着目し、読み取り装置とデータ処理を含くむシステムの自動化の検討と試作機(以下「画像解析装置」という)の製作並びに性能試験を実施した。この結果、以下のことがわかった。(1)スポット径の測定を自動化することで、分単位で粒子径の測定が可能となった。(2)PuO2粒子の最小検出径は、0.35MMが得られた。従来は光学顕微鏡の測定でオートラジオグラフのスポット径が0.42MMであった。(3)放射能強度よってもARG写真の露光時間が異なるが、最小検出径0.35MMを評価するためには、曝射用35disintegrationsが必要となりARGに要する露光時間は20時間50分となる。(4)プルトニウム燃料第三開発施設の粒度分布の測定結果は、質量中央径(MMD)で3.18$\sim$6.24$\mu$m、幾何標準偏差($\sigma$g)で1.27$\sim$2.25、空気力学的質量中央径(MMAD)で10.8$\sim$21.1$\mu$mであった。, None

A 47-year-old woman presented with the chief complaint of gait disturbance and pain of bilateral lower limbs. She was diagnosed as having necrotizing myelitis because myelography was normal and incidentally bilateral adrenal tumor was recognized by ultrasonography and computed tomography. Left adrenalectomy was performed under the diagnosis of bilateral non-functioning adrenal tumor or metastasis to the adrenal glands with unknown origin. The tumor was 10 x 6 x 3 cm in size and 175 g in weight. The pathological diagnosis was non-Hodgkin lymphoma (diffuse large cell type). After combination chemotherapy of vincristine, cyclophosphamide, prednisolone and adriamycin, residual right adrenal mass showed a remarkable reduction, but unfortunately she died 5 months later postoperatively because of complications of lung edema and pneumonitis.

During our past 13 years of experience, we have seen 3 cases of bilateral testicular tumors, which account for .5.6% of all the testicular tumors seen during this period. Pathologically the 6 tumors were confirmed to be seminomas, but each tumor was supposed to have developed independently of the other tumor. All of the patients were treated with inguinal orchiectomy, irradiation and chemotherapy, and they are alive free of tumors. The contralateral lesion appeared 3 months, 8 months and 9 years after the first tumor had appeared. A total of 161 cases of bilateral testicular tumors reported in Japan are summarized and studied concerning incidence, age, histology, interval, prognosis and mechanism of the tumorigenesis.

A 67-year-old patient with stage C giant prostate cancer was treated with a combination of endocrine administration and chemotherapy. After administration of diethylstilbestrol diphosphate (250 mg/D, 16 days), bilateral orchiectomy and subsequent CDDP administration (30 mg/D X 5 days, e. 3 weeks, 4 courses), the primary tumor was reduced by about 90%. Clinical response was evaluated as partial response. Serum acid phosphatase activity, prostatic acid phosphatase, prostate antigen and nuclear DNA histogram served as useful tumor markers and changed in parallel to clinical course.

A 74-year-old man was admitted to our hospital, complaining of gross hematuria and complete urinary retention. Right nephrectomy and suprapubic prostatectomy were performed under general anesthesia. On the second postoperative day, acute renal failure developed and peritoneal dialysis was begun. But, unfortunately he died the next day. Pathological diagnosis was malignant lymphoma infiltrating to the perirenal and periadrenal adipose tissue.

A 13-year-old boy visited our hospital with the chief complaint of right undescended testis and retardation of secondary sexual characteristics. Central hyposmia and sensorineural hearing loss were found. The plasma levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were low and the reaction to LH-releasing hormone (RH) test was poor. After repeated LH-RH tests, a good response in plasma levels of LH and FSH was observed. The diagnosis of Kallmann's syndrome was made from the above findings. The testicular biopsy specimen from him showed immature testis without any developed Leydig or Sertoli cells. To induce secondary sexual characteristics, 2000 I.U. of human chorionic gonadotropin (hCG) was administered to him twice a week for 3 months. The administration of hCG resulted in elevation of plasma testosterone level, swelling of testes, increase of pubic hair and spurt of height.

A nineteen-year-old man with a painless tumor in the right scrotal area was seen at our Department. The scrotal mass had been noticed from his childhood. The tumor was 8.2 X 5.2 X 5.0 cm weighed 47.3 g. Histological examination revealed hemo-lymphangioma.

健康人18例のCICの平均は2.7%で, SDは±3.0%であり, この成績より2SDに近い10%以下を正常値とした.泌尿器科的良性疾患患者9例のそれは2.9±2.7%であり, いずれの症例ほ正常値であった.腎細胞癌患者9例での陽性率は33%, 前立腺癌患者16例のそれは19%と比較的高値を示したが, 膀胱腫瘍患者21例の陽性率は5%と低く, さらに腎盂尿管腫瘍患者3例においては1例も陽性を認めなかった.なお, 腎細胞癌患者9例についての検討で, 摘出標本の大きさとCIC値との間に相関は得られずむしろ逆相関の傾向を認めた, Circulating immune complexes (CIC) were detected and quantitated in 49 patients with urological malignant diseases (9 cases of renal cell cancer, 3 cases of renal pelvic and ureter cancer, 21 cases of bladder cancer and 16 cases of prostatic cancer), 9 patients with urological benign diseases and in normal subjects by the polyethylene-glycol precipitation complement consumption test (PEG-CC test). The average CIC level was 2.7 +/- 3.0% in 18 normal subjects and the normal range was less than 10% of the CIC level. CIC level of patients with renal cell cancer was 14.3 +/- 20.1%, being elevated in 3 of the 9 patients, that of patients with renal pelvic and ureter cancer was 4.7 +/- 4.6%, being within the normal range in 3 cases, that of patients with bladder cancer was 4.7 +/- 4.4%, being elevated in 1 of 21 patients, and that of patients with prostatic cancer was 8.9 +/- 15.4%, being elevated in 3 of 16 patients. In urological malignant diseases such as renal cell cancer and prostatic cancer the CIC values were relatively high.

1)健常人20例のDiamineの平均は16.6±5.8 μmoles/g.Cr., Spermidineのそれは4.7±2.0, Spermineのそれは0.99±0.51 μmoles/g.Cr.であった.M+3SDよりも高値に陽性を設置した場合, 上記3ポリアミンの陽性値はそれぞれ40, 15及び3 μmoles/g.Cr.であった.2)泌尿器科良性疾患25例では概していづれのポリアミンも陰性であったが, 前立腺肥大症ではDiamine, Spermidineが18例中1例に陽性を呈した.3)尿路性器癌の早期症例において30%の陽性率を超えたのは腎細胞癌におけるDiamineの43%と前立腺癌におけるSpermidineの40%であった.4) 3者のうちいずれか1つが陽性を示す場合の陽性率は腎細胞癌84%, 腎盂尿管腫瘍50%, 膀胱腫瘍50%, 前立腺癌41%であり, 早期症例に限っても腎細胞癌40%と比較的高い陽性率が得られ, 分別定量の有用性が示唆された, A new enzymatic method for isolation and determination of urinary polyamines was presented and basically studied in previous report 1 and 2 in comparison with existing techniques. Using the new method, urinary polyamines were isolated and determined in 56 patients with genitourinary cancer. Urinary polyamines were also determined in 63 controls consisting of 20 normal subjects, 25 patients with benign urological disease and 18 patients with BPH. The mean concentrations of Diamine, Spermidine, Spermine in 20 normal subjects were 16.6 +/- 5.8 mumoles/g Cr, 4.7 +/- 2.0 mumoles/g Cr and 0.99 +/- 0.51 mumoles/g Cr respectively. To emphasize the specificity to cancer, the level of positiveness was modified to a higher value than M+3SD. The positive values thus calculated were 40 mumoles/g Cr for Diamine, 15 mumoles/g Cr for Spermidine and 3 mumoles/g Cr for Spermine. The positive ratios of Diamine in patients with early cancer were 43% in renal cell cancer, 20% in pelvic and ureter cancer, 0% in bladder cancer and 20% in prostatic cancer. Those of Spermidine were 29% in renal cell cancer, 0% in pelvic and ureter cancer, 20% in bladder cancer and 40% in prostatic cancer. Those of Spermine were 29% in renal cell cancer, 20% in pelvic and ureter cancer, 20% in bladder cancer and 0% in prostatic cancer. In early diagnoses, Diamine indicated high positive ratios to renal cell cancer and Spermidine to prostatic cancer. Relatively high positive ratios were demonstrated, when any one of the isolated polyamines was found positive: namely, 57% in renal cell cancer, 20% in pelvic and ureter cancer, 30% in bladder cancer and 40% in prostatic cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

ポリアミンテスト-エンザイムのキットを用いて, 泌尿器科領域の悪性腫瘍患者74例(腎細胞癌12例, 腎盂尿管腫瘍13例, 膀胱腫瘍24例および前立腺癌25例), 前立腺肥大症患者7例, 泌尿器科的良性疾患患者20例および健常人20例の尿中ポリアミンを測定した.1)尿路性器癌におけるいずれの疾患群も健常人に比し有意の上昇を認めたが, 前立腺肥大症も同様に有意の上昇を認めた.2)健常人20例の平均+3SD (=50 μmoles/g.Cr.)を尿中ポリアミンの上限値とすると, 前立腺肥大症および泌尿器科的良性疾患において100 μmoles/g.Cr.以下の軽度高値の症例がかなり認められた.3) 100 μmoles/g.Cr.に上限値を設置した結果, 腎細胞癌の陽性率は33%(low stage 17%), 腎盂尿管腫瘍23%(low stage 14%), 膀胱腫瘍13%(low stage 0%)および前立腺癌4%(low stage 0%)であり, 特にlow stageの症例において陽性率が低かった, Using a polyamine-test enzyme kit, the urine polyamine concentration was determined in 74 patients with malignant urological disease (12 with renal cell cancer, 13 with pelvic-ureter cancer, 24 with bladder cancer and 25 with prostate cancer), 7 patients with BPH, 20 patients with benign urological disease and 20 normal subjects. The urine polyamine level was significantly elevated in all the patients with any malignant urological disease compared to normal subjects. It was also significantly high in the patients with BPH. Defining the mean +/- 3SD (= 50 mumole/g Cr.) of 20 normal subjects as an upper limit, slightly higher levels not exceeding 100 mumol/g Cr. were frequently observed in the patients with BPH or with benign urological disease. Setting the upper limit at 100 mumole/g Cr., the positive rate amounted to 33% (low stage 17%) in renal cell cancer, 23% (low stage 14%) in pelvic ureter cancer, 13% (low stage 0%) in bladder cancer and 4% (low stage 0%) in prostate cancer. The positive rate was low especially in low stage cases.

Tubeless ureterocutaneostomyの腎盂細菌叢の存在とその検出方法につき考察した.1) Single lumen catheterを使用するストーマからの腎盂導尿法は皮膚細菌叢の混入による汚染も少なく, 有用な方法になりうると想像した.2)腎盂内細菌叢の出現率は19腎・尿管中9/19であったが, うち, 膿尿(毎視野5個以上の白血球が存在)の合併は2腎・尿管のみであった.3)水腎症の存在と腎盂細菌叢の出現間には有意な関係は認めなかった.4)腎盂細菌叢の経時的変遷では菌交代または消失はS. faecalisにもっとも多く, その他, S. aureus, S. epidermidis, P. aeruginosaであった.この問題の詳細は不明であった, The presence of bacteria at the renal pelvis and the methods of their detection were studied in 11 patients with catheter-free cutaneous ureterostomy (tubeless ureterocutaneostomy). These patients had had total radical cystectomy due to bladder carcinoma. Of these, 5 patients had single-sided stoma with 9 kidney-ureter units and 6 patients had bilateral stoma with 10 units, excluding 2 ureters because of indwelling catheters. The urine obtained both from the renal pelvis with a single lumen catheter and from the pouch were used in the bacterial culture test and urinalysis. The aseptic swab after touching the skin around the stoma was also cultured for bacteria. Of 19 kidney-ureter units, 9 (47%) were found to have bacteria in urine obtained from catheterization. However, only 2 units (11%) were observed to be accompanied with pyuria. In this method, the rate of bacterial appearance was higher in single-sided stomas than in bilateral ones. There was no statistical correlation between the presence of hydronephrosis and the rate of bacterial appearance. In conclusion, the method of single lumen catheterization might be of great use for analysis of urinary tract infections in patients with such conditions.

10年間に経験した上部尿路癌は腎癌29例, 腎盂癌14例, 尿管癌9例の計52例で, これらについて臨床統計学的検討をおこなった.1)腎癌, 腎盂癌, 尿管癌はともに男子例に多い傾向をみとめた.左右差はとくにみとめなかった.2)腎癌の好発年齢は40歳代に比し, 腎盂癌は70歳代, 尿管癌は60歳代と, 腎癌のほうが若年齢層に多くみとめられた.3)初発症状はいずれも肉眼的血尿がもっとも多かったが, 腎癌の42%にたいし腎盂・尿管癌は60%と, 後者のほうが高頻度であった.4)腎癌と尿管癌の5年生存率が68%, 80%であるのにたいし腎盂癌は37%と予後不良であった.5)腎癌・腎盂癌・尿管癌の高深達度群は低深達度群に比し5年予後は不良であった.6)腎癌では初発症状発生より手術までの期間が短いほど, 予後は良い傾向であったが, 腎盂・尿管癌ではむしろ短いほど予後不良という傾向であった.7)腎癌では女子のほうが男子に比し予後が良い傾向であった.8)腎癌の摘出腎重量が大きいほど, 予後不良であった.9)腎癌の低深達度群においては治療法と予後との間にはあきらかな関連性をみとめなかった, A clinical survey was done on 52 patients with carcinoma of the upper urinary tract (29 renal carcinomas, 14 renal pelvic carcinomas and 9 ureteral carcinomas) treated in our Department during the recent 10 years (l970~1979). Renal, pelvic and ureteral carcinoma occurred more in males than in females. The age groups in which renal, pelvic and ureteral carcinoma were seen most frequently were the 40s, 70s and 60s, respectively. The most frequent primary symptom in these three carcinomas was gross hematuria. The 5-year survival rate of renal carcinoma and ureteral carcinoma were 68 and 80 %, respectively, while that of pelvic carcinoma was 37%. For all 3 kinds of carcinomas, the prognosis of patients with high stage cancer was significantly worse than that of patients with low stage cancer. The prognosis of the group of patients with renal carcinoma undergoing operations within 3 months was better than that of the patients undergoing operations after 3 months from the onset of primary symptoms. However, the reverse was the case for patients with pelvic or ureteral carcinoma. In renal carcinoma, the prognosis of female patients was better than that of male patients. In renal carcinoma, the prognosis of patients with a heavier kidney removed was significantly worse than that of the patients with a lighter kidney removed. There was no apparent relationship between the method of therapy and the prognosis of patients with low stage renal carcinoma.

A 50-year-old man with the symptom of anal pain was treated by pelvic exenteration, ileal conduit diversion and artificial anus. The pathologic diagnosis was leiomyosarcoma of the prostate. At 5 months post-operatively, the patient had no evidence of metastasis or recurrence.