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Title: 前立腺に関する研究 (第1篇:前立腺捌出術の出血問題特にProstatic Fibrinolysisについて 第2篇:前立腺の65Zn摂取に関する研究)
Other Titles: Studies on the Prostate
Authors: 林, 来耀  KAKEN_name
Author's alias: LIN, Lai-Yau
Issue Date: Apr-1961
Publisher: 京都大学医学部泌尿器科教室
Journal title: 泌尿器科紀要
Volume: 7
Issue: 4
Start page: 481
End page: 503
Abstract: The studies were made on the management of bl e eding during and following prostatectomy with special reference to the prostatic fibrinolysis. Results obtained were summarized as follows : According to "enquk", the methods of prostatectomy performed in main clinics in Japan were examined. Results obtained were that the retropubic approach to the prostate is being the most commonly performed operation in this country and the suprapubic next . Analysis of the operated cases for the last five years in our department was made, an d the suprapubic method has been used as a routine measure by us with the same opinion as Prof. Ochiai's. Th e necessity of cystoscopy was acknowledged as the result of analysing the causes of the pre-operative bleeding cases. Introducing the stud y of Flocks on blood supply of the prostate. Flocks has shown that the lobes of a hypertrophied prostate obtain their blood supply from vessels which enter at the bladder neck, and I stressed that the managements of his so-called urethral group vessels are greatly concerned in the amount of hemorrhge. The prevention of hemorrhage during operation performed in main clinics were discussed, and was reviewed the literatures. The suitable management of urethral group vessels and retrigonisation are important. A transient bladder-neck hard-tying method originated in our departmen t was introduced. The post-operative management was simplified by using this properly. But there is, however, a possibility of post-operative stricture by this method and in fact, we unfortunately experienced four cases of stricture. It was not that the method itself was wrong, but the stricture was caused from an unadequete resection of the cut-edge and unsuitable cut-gut used for bladderneck tying. The replies of "en q uk" in the management of post-operative hematuria were analysed and the historical review was made. Emphasis was made that i n near future we would have to pay attention to preventing thrombosis and post-operative bleeding which stands in the opposite situation with the former.. Severe post-operative bleeding occured in about six per cent by "enquk" Ther e were eight cases of post-operative bleeding for recent five years in our department and the fully examination has been made for these cases. The management of the bladder ta m ponade was stated. A death case review was made of hematoemesis due to gastric ulcer following prostatectomy and published the replies of "enquk" about this preblem. When the patient of metastatic prostatic cancer was treated with large amount of Androgen for purpose of inhibition of a pituitary function, he showed bleeding tendency but it disappeared with administration of synthetic Estrogen and anti-plasmin preparation. The examination was made on the plasma fibrinolytic activity of t w elve healthy men, and all revealed negative. The examinatio n of pre- and post-operation plasma fibrinolysis was made on twenty-eight cases of acute appendicitis ; . three positive an hour before laparotomy, six positive immediately after appendectomy, but all turned to negative twelve hours later. A transient elevation of normal plasma fibrinolytic activity was n o ted following massage of the prostate gland and fibrinolysis of prostatic fluid obtained with massage also showed positive. The influence of surgical intervention on fibrinolysis in 17 cases of prostate hypertrophy was observed; . 25% of the cases was weak positive 48 hours before operation, 50% of these was weak positive an hour before operation, all of them showed strong positive during operation, and most of them turned to negative within several days after operation. Two cases of oozing, distinctly due to prostatic fibrinolysis following p r ostatectomy had been experienced. Bl e eding tendency could not be seen in 8 cases of prostatic cancer. But 5 cases of them showed positive with the modified method of MacFarlane, two of them turned to negative following castration. Fibrinol y sis of the extract fluid of the prostatic hypertrophy was examined and it revealed positive strongly. 65Zn upta ke of the prostate was investigated on the various age of male rat . 65Zn uptake of the prostate distinctly increased at mature period, so it is reasonable to presume that 65Zn uptake closely relates to prostatic function. The selective uptake of 652n can be seen distinctly in dorso-lateral lobe of the prostate between 24 hours and 96 hours after administration of it but it could not be seen in cranial and ventral lobe, vis. the selective uptake of 65Zn demonstrated that there are functional difference between dorso-lateral lobe and others of a rat's prestate. Th e influence on male, female hormon and castration of dorsolateral lobe of the prostate was observed.
URI: http://hdl.handle.net/2433/112128
Appears in Collections:Vol.7 No.4

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