DSpace コレクション: 1996-041996-04http://hdl.handle.net/2433/1151322024-03-29T11:35:16Z2024-03-29T11:35:16Z上部尿路上皮腫瘍に対するBCG灌流療法の経験森, 啓高宮地, 文也高橋, 雅彦松田, 香塚, 晴俊和田, 修青木, 芳隆秋野, 裕信村中, 幸二金丸, 洋史岡田, 謙一郎今村, 好章http://hdl.handle.net/2433/1157152021-09-15T09:57:47Z1996-04-01T00:00:00Zタイトル: 上部尿路上皮腫瘍に対するBCG灌流療法の経験
著者: 森, 啓高; 宮地, 文也; 高橋, 雅彦; 松田, 香; 塚, 晴俊; 和田, 修; 青木, 芳隆; 秋野, 裕信; 村中, 幸二; 金丸, 洋史; 岡田, 謙一郎; 今村, 好章
抄録: 1)上部尿路上皮腫瘍4例に対し経皮的腎瘻造設後又は逆行性にBCG灌流療法を行い, 2例に有効であった. 2)腎摘となった2例には広汎に結核性病変が認められた. 3)腎摘した1例では腫瘍が腎実質内へ浸潤していた. 4)腎血流量, 腎尿管壁の薄さを考慮して, 上部尿路BCG灌流療法の際には合併症, 癌の進行に関し慎重な対処が望まれる; Four patients with upper urinary tract transitional cell carcinoma were treated with bacillus Calmette-Guerin (BCG) via a percutaneous nephrostomy tube or a retrograde ureteral catheter. A 68-year-old female and an 80-year-old male had carcinoma in situ (CIS) in the left upper urinary tract (cases 1 and 2). A man aged 47 had CIS in the left upper urinary tract, bladder, and prostatic urethra (case 3). CIS in the left upper urinary tract was identified in a woman aged 63 with chronic renal insufficiency (case 4). Two patients (cases 1 and 2) responded to this therapy. In the other two patients nephrectomy was performed due to residual tumor. There were extensive tuberculous granulomas in the kidneys. In one resected kidney (case 4) carcinoma had invaded the renal parenchyma. The reviewed literature showed that BCG perfusion therapy was effective in 71% (27 of 38 renal units) for the upper urinary tract tumors and that there were 5 cases of severe complication, including sepsis in 2, high fever in 2, and ureteral stricture in 1. Based on the fact that the kidney receives a profuse blood supply and that the renal pelvis and ureter have a thin wall, careful management is mandatory to prevent severe adverse effects and insidious tumor progression.1996-04-01T00:00:00ZIntra-arterial chemotherapy for muscle-invasive urinary bladder cancerTAKAHASHI, NobuyoshiNISHIMURA, ShojiKAWAGUCHI, Toshiakihttp://hdl.handle.net/2433/1157142021-09-15T09:57:47Z1996-04-01T00:00:00Zタイトル: Intra-arterial chemotherapy for muscle-invasive urinary bladder cancer
著者: TAKAHASHI, Nobuyoshi; NISHIMURA, Shoji; KAWAGUCHI, Toshiaki
抄録: 局所浸潤性膀胱癌(T3-4, N0M0)を有する9例に対して, 骨盤内血流改変術を伴うリザーバーを用いたM-VEG動注療法(methotrexate 40mg, vinblastine4mg, epirubicin 40mg, cisplatin 100mg)を施行し, CR3例, PR3例, NC2例で全体の奏効率は75%であった.PRの3例は根治的膀胱全摘除術を施行したが, 2例にdown-staging(T3→pT1b)が認められた.病理組織学的には, 腫瘍以外の正常膀胱壁には軽度の筋層の線維化を伴った出血性膀胱炎に類似した変化が著しかった; A total of 9 patients with muscle-invasive bladder cancer (T3 or T4N0M0) were treated with a modified intra-arterial M-VEC (IA-M-VEC) regimen beginning in October 1992 to evaluate its therapeutic efficacy, and in 3 evaluable patients who subsequently underwent radical cystectomy, the possibility of bladder preservation was assessed. The responses of the 8 evaluable patients were rated as complete response (CRs) in 3, partial response (PRs) in 3 and no change (NCs) in 2. The objective response rate (PR + CR) was 75%. An obvious down-staging (T3 --> pT1b) was confirmed in 2 of the 3 evaluable patients, suggesting the possibility of bladder preservation. Otherwise similar changes to hemorrhagic cystitis with minimal muscular fibrosis were conspicuous in the normal bladder wall. These pathological findings corresponded with those obtained by dynamic single photon emission computed tomography (D-SPECT) using 99mTC-macroaggregate albumin (99mTC-MAA). Besides a buttock-to-perianal erosion with neuralgia on the injection side, mild to moderate sensory disturbance of the sacral plexus was observed.1996-04-01T00:00:00Z病期D2前立腺癌の予後因子 : 単変量及び多変量解析による検討桝鏡, 年清秋元, 晋赤倉, 功一郎島崎, 淳村上, 信乃http://hdl.handle.net/2433/1157132021-09-15T09:57:47Z1996-04-01T00:00:00Zタイトル: 病期D2前立腺癌の予後因子 : 単変量及び多変量解析による検討
著者: 桝鏡, 年清; 秋元, 晋; 赤倉, 功一郎; 島崎, 淳; 村上, 信乃
抄録: 235例を対象として, 予後因子を検討した. 1)単変量解析ではperformancestatus, ヘモグロビン値, 血清アルカリフォスファターゼ値, 血清LDH, 組織学的分化度, 骨転移の拡がり(EOD), 内分泌療法の反応性が重要な因子であった. 2)以上の7項目を全て施行した196例を対象として, Coxの比例ハザードモデルを用いて行った多変量解析では血清LDH, 内分泌療法の反応性, 組織学的分化度, 骨転移の拡がり(EOD)が重要な因子であった.以上より, 治療前LDHの高値のものと治療後のマーカーの正常化しないものは, 内分泌療法の高危険群であった; To evaluate prognostic factors in stage D2 prostate cancer, 235 patients who had been treated with endocrine therapy were investigated. With univariate analysis, performance status, hemoglobin concentration, serum alkaline phosphatase, LDH, histological grade, extent of disease (EOD), and response of tumor markers at 3 months were shown to be significant prognostic factors. To compare these 7 factors, multivariate analyses was performed in 196 cases. Cox proportional hazard model demonstrated that LDH, followed by response of tumor markers at 3 months, histological grade, and EOD were significant for predicting prognosis. We concluded that the patients whose serum LDH was above the normal range and/or whose tumor markers were not or had not been normalized 3 months after the onset of endocrine therapy were in the high risk group, and should be given more aggressive treatment.1996-04-01T00:00:00Z成人病健診における前立腺検診 : PSAとAUA scoreによる検討米田, 勝紀曽我, 倫久人佐藤, 良子佐藤, 恵子鈴木, 竜一川村, 壽一http://hdl.handle.net/2433/1157122021-09-15T09:57:47Z1996-04-01T00:00:00Zタイトル: 成人病健診における前立腺検診 : PSAとAUA scoreによる検討
著者: 米田, 勝紀; 曽我, 倫久人; 佐藤, 良子; 佐藤, 恵子; 鈴木, 竜一; 川村, 壽一
抄録: PSAとAUAの問診票のみで, 成人病健診における前立腺検診を効率的に施行できるかどうかを検討した.簡便に前立腺癌を検出できる有効なシステムとの感触をえたが, 経時的な観察が必要である; From April 1994 to February 1995, we studied prostate cancer screening at Shakaihoken Hazu Hospital and Health Care Center. Among 1, 838 men, over 55, who had taken the total health care check, 857 applicants had had prostate cancer screening, using serum PSA (Delia kit; normal range < 11.7 ng/ml) and AUA voiding symptom score and bothersome score. According to the serum PSA level, they were divided into 4 groups, 11 with 8 ng/ml or more indicating requirement of further examination, 29 with 4-8 ng/ml indicating requirement of observation, 100 with less than 4 ng/ml and AUA score (approximately more than 10) indicating voiding disturbance and the other 717 were normal; Of 11 further examined cases, 6 applicants underwent random biopsy. We found 3 with prostate cancer (0.35%).1996-04-01T00:00:00Z