DSpace コレクション: 1992-06
http://hdl.handle.net/2433/116362
1992-062024-03-28T16:45:47ZComplicated Renal Cystに対するCT,MRIによる鑑別診断の比較検討
http://hdl.handle.net/2433/117586
タイトル: Complicated Renal Cystに対するCT,MRIによる鑑別診断の比較検討
著者: 山崎, 雄一郎; 東間, 紘; 中沢, 速和; 中村, 倫之助; 加藤, 尚子; 龍治, 修
抄録: 嚢胞性腎腫瘤のうち良悪性の鑑別が困難であったcomplicated cyst 12例に対しUS, CT, MRIおよび血管造影検査を施行した.血管造影所見は全例hypovascularもしくはavascular patternを呈し, 診断的価値は低かった.腎細胞癌の検出においてはdynamic studyを含むCT診断が優れていると考えられたが, false positiveとなった症例を5例認めた.MRIは濃度分解能が優れており, 特に出血性嚢胞やmultilocular cystの診断に有用と思われた.しかし現時点ではCTにて悪性を疑われた嚢胞性腫瘤に対しては補助診断としてMRIを施行し, 腎保存手術の適応を考える上で参考にするといった利用方法が望ましいと思われた; We report 12 cases of renal cystic lesions that could not be diagnosed preoperatively. Sonography, computed tomography (CT), magnetic resonance (MR) imaging, and angiography were performed in all cases. Angiography was not helpful in evaluating cystic lesions, because all cystic lesions were hypovascular or avascular within the cystic mass. CT was useful in depicting the fine structural abnormalities, and especially bolus-contrast CT study was useful in the differentiation of cystic renal cell carcinoma from simple renal cyst. However, there were 5 false positive cases. MR imaging is superior to CT in distinguishing a hemorrhagic cyst or multiloculated cystic mass. In conclusion, CT is currently the primary imaging modality for evaluating complicated renal cysts, and surgical exploration is warranted for the undiagnosed cystic lesion by CT. However, MR imaging also has an important role in detecting the benign complicated cyst. Therefore if complicated cyst is thought to be benign by MR imaging, parenchyma-sparing surgery should be considered preoperatively.1992-06-01T00:00:00ZPolymerase Chain Reaction-Single Strand Conformation Polymorphism (PCR-SSCP)解析法を用いたAdenine Phosphoribosyltransferase遺伝子異常の検出
http://hdl.handle.net/2433/117585
タイトル: Polymerase Chain Reaction-Single Strand Conformation Polymorphism (PCR-SSCP)解析法を用いたAdenine Phosphoribosyltransferase遺伝子異常の検出
著者: 金子, 嘉志; 竹内, 秀雄; 武縄, 淳; 吉田, 修; 高野, 誠一郎; 藤田, 潤
抄録: PCR-SSCP法はAPRT遺伝子の変異の検出に有用な検査法であり保因者の頻度を推定するためのスクリーニングにも応用できる.さらにこの方法を赤血球の酵素活性測定法と併用すれば, APRT欠損症を引き起こす新しい変異遺伝子を検出することも可能であろう; Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis is a rapid and sensitive method to identify point mutations in a given sequence of genomic DNA. We tried to apply the PCR-SSCP to the diagnosis of adenine phosphoribosyltransferase (APRT) deficiency, which is an autosomal recessive hereditary disease leading to 2, 8-dihydroxyadenine urolithiasis. Genomic APRT genes, with or without mutations, were amplified and labeled simultaneously with 32P-dCTP by PCR. When run in a 6% polyacrylamide gel containing 10% glycerol, two types of mutant genes, APRT*Q0 and APRT*J, gave bands clearly distinct from those of the respective normal APRT genes. Since heterozygotes as well as homozygotes for these mutant APRT genes can be detected in 2 days, PCR-SSCP should be a valuable method in the diagnosis of APRT deficiency and in screening a large population for APRT mutant genes.1992-06-01T00:00:00Z集団検診で発見された顕微鏡的血尿の臨床的検討
http://hdl.handle.net/2433/117584
タイトル: 集団検診で発見された顕微鏡的血尿の臨床的検討
著者: 西川, 泰世; 三浦, 尚人; 植田, 健; 鈴木, 和浩; 鈴木, 文夫; 伊野宮, 秀志; 小竹, 忠; 山口, 邦雄; 伊藤, 晴夫
抄録: 集団検診で発見された血尿を主訴に来院した症例は高齢になるほど, 尿路腫瘍の存在する率が高い.高齢者に対しては, 尿細胞診, 膀胱鏡, 腹部超音波検査, 静脈性腎盂造影を施行する必要があると考えられる; We clinically examined 445 patients with positive urine occult blood test found by mass screening examination. Among them, 41 cases had the history of macroscopic hematuria. Urological abnormalities were observed in 169 (41.8%) of the patients with microscopic hematuria, and in 22 (53.7%) of those with a history of macroscopic hematuria. Genitourinary neoplasms were found less frequently in the patients with microscopic hematuria (1.2%) than in those with macroscopic hematuria (22%). We couldn't find a correlation between the degree of hematuria and the severity of the underlying diseases. Hematuria is often thought to appear intermittently, and urinalyses of the patients with so-called significant disease may not be found at the first visit.1992-06-01T00:00:00ZIndiana pouchの晩期合併症と手技の改良
http://hdl.handle.net/2433/117583
タイトル: Indiana pouchの晩期合併症と手技の改良
著者: 荒井, 陽一; 寺地, 敏郎; 大石, 賢二; 岡田, 裕作; 竹内, 秀雄; 吉田, 修
抄録: 1) 1987年10月より1991年9月までにIndiana pouchによる尿路変更手術を39例に施行した.2)この間に, 結腸の完全なdetubularization, stapled plication, U-shaped ileal patch法などの手技の改良を行った.3)早期合併症は開放手術に共通する一般的なもので, continent urinary reservoir (CUR)に直接関連したものはなかった.4) 3ヵ月以上経過観察された37例の晩期合併症のおもなものは, pouch変形(2例), 導尿困難(2例), ストーマ狭窄(2例), アシドーシス(1例)などであった.5) 90%以上の症例で良好な尿のコンチネンスがえられ, 尿管への逆流を認めたものはなかった.6)本術式は, 術式が比較的簡単で重大な合併症も少ないことから, 今後もきわめて有用なCURであると考えられた; From October, 1987 through September, 1991, 39 patients underwent construction of Indiana pouch for cutaneous urinary diversion. There were 35 men and 4 women, and their ages ranged from 38 to 77 years (a mean age of 62 years). After the first 8 cases, Indiana pouch was constructed with several modifications which included complete detubularization of the cecum, construction of the pouch augmented with U-shaped ileal patch, and the use of stapled plication. There was no major early complication related to the pouch but one postoperative death of blood transfusion related graft versus host disease. End results were evaluated in 37 patients who were followed for 3 to 49 months. Late complications related to urinary reservoir occurred in 8 patients. The early two patients experienced pouch deformity due to incomplete detubularization of the colonic segment. Two patients had difficult catheterization due to a dilatation of the plicated ileum. One patient had metabolic acidosis requiring hospitalization. Patients perform self-catheterization 4-5 times during the day and 0-2 times at night for volumes ranging from 300 to 1, 000 cc. Of 37 patients 34 achieved acceptable urinary continence and one had significant leakage requiring cutaneous bag. The remaining two patients suffered mild nocturnal incontinence. Follow up examination with excretory urography showed no upper urinary tract obstruction except one with unilateral hydronephrosis due to ureteroanastomotic stricture. Reservoirgraphy showed no reflux into the upper urinary tract in all the follow up cases.(ABSTRACT TRUNCATED AT 250 WORDS)1992-06-01T00:00:00Z