日本泌尿器科學會雑誌
Online ISSN : 1884-7110
Print ISSN : 0021-5287
56 巻, 5 号
選択された号の論文の7件中1~7を表示しています
  • 木村 哲
    1965 年 56 巻 5 号 p. 455-475
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    Many aspects of the host-parasite relationship of Trichomonas vaginalis still remain either unanswered, or poorly understood. The following studies, involving clinical evaluation, cultivation on artifical media, and animal inoculation procedures, were designed to provide a fundamental knowledge of the complexities of the relationship of T. vaginalis. with both human and animal hosts.
    A selected group of 946 patients who visited the Urological Clinic of the Keio University Hospital with Symptoms of urinary infection such as unpleasant feeling, itching, pain and discharge were examined for T. vaginalis. A total of 1067 specimens were obtained from these patients, and cultured on a variety of artifical media. T. vaginalis so isolated were inoculated into a large series of surgieally altered, hormon-trerted, male albino rats.
    1) On the 946 patients, 67 were infected with T. vaginalis. Of the patients suffering from a prostatic discharge 9 percent were found to be infected. Other symptoms and materials which were related to a positive diagnosis are listed with their respective precentages. Urethral discharge 8.9 percent; semen, 5.3 percent; urin, 4.6 percent and smegma 2.4 percent.
    2) The symptoms which complained all 67 infected were not only particular as urinary infections but in 16 cases were complained nothing. The problems of symptomlos infection of T. vaginalis in male urinary tract will become more important on treatment in comming future.
    3) Specimens from the 67 infected patients, in contrast to those from the non-infected patients, were all relatively acidic, ranging from PH 5.6 to 7.8
    4) Of the 67 patients with T. vaginalis, 57 patients (70 percent) were positive for various other microorganisms such as Escherichia coli, Staphylococcus albus, and Pseudomonas. However, no paticular relationship between these organisms and T. vaginalis was noted.
    5) Among the 67 infected cases, 62 (91 percent) gave a history involving sexual intercourse, with some 47 cases (76 percent) having wives who had complained of trichomoniasis previously, In a group of married women suffering from “honeymoon cystitis”, 17 percent were found infected, as compared to a series of unmarried women with an infection rate of only 3.6 percent. From these data, it appears evident that trichomoniasis is a venereal disease, with the majar source of infection being sexual partners.
    6) T. vaginalis was inoculated into the urethra and forskin of human males. The parasite was found to survive for 3 days in the urethra and 7 days under the foreskin, but without any signs of multiplication.
    7) Various concentrations of saline extracts of human prostate and smegma were added to a standard culture medium of cystein-bouillon-serum, and their effects on the growth of T. vaginalis studied. It was noted that the trichomonad did not grow better in the extractenriched media than in the control medium, and that in media composed of prostate or smegma extract alone, the organism failed to grow at all.
    8) T. vaginalis serially maintained in cystein-bouillon-serum medium without a ccompanying bacteria were inoculated into muscle urethra, bladder, and seminal vesicle, of normal male albino rats; castrated male rats; and castrated, androgen-treated male rats.
    A) In muscle, T. vaginalis did not multiply, and disappeared in several days.
    B) In the bladder, of 4 cases, out of 14 control or castrated, and or androgen-treated rats could lived for 10 days long, but did not multiply any more.
    C) In the seminal vesicle of either normal or castrated rats, the inoculated T. vaginalis persisted for only 5 to 6 days. In the castrated, androgen-treated group of rats however, the parasite was able to multiply and survive for more than 2 weeks.
    9) The fact that T. vaginalis was able to live and multiply only in the seminal vesicle of the androgen-treated male castrated is believed dur to one of the metabolic effects of the androgens in males
  • 第7報 膀胱レ線像
    白岩 康夫
    1965 年 56 巻 5 号 p. 476-495
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    Many reports on cystometrogram obtained in the cases with experimental or clinical neruogenic bladder have been presented, but associated radiographic findings were not described clearly. Therefore, neurogenic vesical dysfunction was produced experimentally in adult dogs by uni- or bilateral section of the hypogastric, the pelvic, and the pudendal nerve, and moreover uni- or bilateral section of the ventral, the dorsal, the ventral and dorsal roots of sacral nerve, and uni- or bilateral resection of the spinal ganglion of that nerve, respectively. Cystogram was obtained pre- or post-operatively in these dogs, pouring 10cc/kg of NaI solution into the urinary bladder, and it was examined to clarify the pathological physiology of neurogenic bladder concerning to the various sections of nerves innervating the urinary bladder.
    The results obtained were as follows:
    1) Section of the pudendal nerve:
    The shape of the urinary bladder in cystogram was scarecely changed after unilateral section of this nerve, but slight transformation in cystogram was found after bilateral section of that nerve. The area of the urinary bladder reduced, suggesting the elevation of intravesical pressure following to uni- or bilateral section of the pudendal nerve. But in either case, residual urine could not be proved.
    2) Section of the hypogastric nerve:
    The shape of the urinary bladder in cystogram revealed almost normal findings, but the area of it slightly reduced following to the bilateral section of this nerve, despite of its normal shape.
    3) Section of the pelvic nerve:
    The area of the urinary bladder increased remarkably soon after the uni- or bilateral section of this nerve, suggesting a hypotonic state of the bladder. But within 4-6 weeks after the operation, cystogram became to almost normal. On the other hand, in 8-10 weeks after the bilateral section of this nerve, the shadow of the urinary bladder changed into round and vesicoureteral reflux appeared. These changes could not be found in the case with the unilateral section of this nerve.
    4) Section of the unilateral (the ventral, the dorsal, or the ventral and dorsal) sacral roots, 1, 2, and 3:
    In the case in which the unilateral ventral or the dorsal roots of sacral nerve were resected, the area of the urinary bladder increased temporarily soon after the nerve section. But in the case with the unilateral section of the ventral and dorsal roots as well as in the case with the unilateral resection of the spinal ganglion of sacral nerve, enlargement of shadow of the urinary bladder could not be seen. The shape of the bladder was recovered in all cases close to pre-operative state in the course of time.
    5) Bilateral section of the ventral root of sacral nerves, 1, 2, and 3:
    The area of the urinary bladder in cystogram enlarged after the nerve section, but contour of the bladder had smooth lining. Small wavelike countour of the bladder near the bladder neck was seen, and this had not disappeared over 6 weeks after the operation.
    6) Bilateral section of the dorsal root of sacral nerves, 1, 2, and 3:
    Changes in cystogram soon after the operation were very distinct, such as marked enlargement of area of the urinary bladder, such as the residual urine constantly found, and such as the overflow incontinence arised. Many dogs died by urinary infection or other causes in this time. On the other hand, in the survival cases, the bladder function recovered gradually and the shape and the area of the urinary bladder became almost close to pre-operative state.
    7) Bilateral section of the ventral and dorsal roots of sacral nerves, 1, 2, and 3:
    The results obtained in this case was similar to that in the case in which the section of the pelvic nerve was performed, but reduction in area of roundy shadow of the urinary bladder and dilatation of the urethral shadow was slight, compared to the latter case.
    8) Bilateral resection of the spinal ganglion of sacral ner
  • 第3報 膀胱内圧上昇時における尿管機能
    土田 正義, 木村 行雄, 染野 敬, 菅原 博厚
    1965 年 56 巻 5 号 p. 496-505
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    In twelve urologically normal patients and a patient with vesico-ureteral reflux the effects of the bladder filling with physiologic saline solution on the ureteral activity was examined by means of urometry and electro-ureterography.
    The results are summerized as follows:
    1) Urometrogram of Normal Patients
    When the intravesical pressure was raised, the interval between the contractions reduced markedly, compared to the mean values obtained before saline infusion. The reduction rate was 10-75% with an average of 32.8%. Intraureteral resting pressure increased with the increased intravesicl pressure, although some delay was noted. When the resting pressure rised, the contractile pressure increased markedly, presumably to overcome the increased intravesical pressure. The duration of contractions was slightly prolonged.
    2) Electro-ureterogram of Normal Patients
    When the intravesical pressure was elevated, the discharge interval reduced markedly, the reduction rate being 0.7-81.0% with an average of 48.3%. The amplitude of the action potential remained unchanged. The travel rate of the potential tended to delay, the average rate of delay being 12.3%. of the value before the infusion.
    3) Urometrogram and Electro-ureterogram of a Patient with Vesico-ureteral Reflux
    In the urometrogram ureteral pressure fluctuations characteristic of peristalsis were detected: The contraction interval, the resting and contractile pressure were within normal range. When the bladder was filled, increase in intravesical pressure was accompanied by a simultaneous rise in the resting pressure, although the contraction interval and contractile pressure altered similarly to those of the normal patients.
    In the electro-ureterogram, when the bladdrr was empty, the discharge interval, amplitude and travel rate of the action potential were altogether within normal range. When the intravesical pressure was increased, the duration of the action potential was markedly prolonged, although the discharge interval, amplitude and travel rate varied within normal range.
  • 殊に拡張せる上部尿路腔縮小の可能性並びに腎動脈像の腎保存的手術適応決定上の価値
    岡 直友
    1965 年 56 巻 5 号 p. 506-517
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    In 1963, I made a report (Jap. J. of Urol. Bd. 54, p. 721) considering the indication for kidney conservative operation in clinical hydronephrosis. In this report another supplemental studies will be added.
    First of all, I introduce some statistical data of hydronephrosis treated in my clinic during past 5 years, 1959-1963 (Tab. 1-Tab. 5). Urinary calculus and aquired ureteral stricuture have played a major role in establishing hydronephrosis. Aquired ureteral stricuture shows higher hydronephrotic changes than ureteral stone. It is of much interest that not a few cases of congenital megaloureter show relatively slighter hydronephrotic changes, though the ureteral dilatation is severe.
    The results of functional improvement of hydronephrotic kidney after conservative surgery are as follows. In C and D degree hydronephrosis much improvement are guaranteed. Even in E degree a fair improvement can be noted, but in F degree the results are pessimistic. Tab. 6 summarises results in F, E degree hydronephrosis.
    Dilated renal pelvis and ureter can be spontaneously reduced in considerable amount after simple removal of ureteral obstruction. Renal function are improved and co-existing infection are removed with it.
    Tab. 7 shows values of pyelographic measurements in normal adults. For numerical description of the amount of dilatation, area of pyelogram is considered. In Tab. 8 reduction of size in pyelographic shadow, improvement of renal function and the fate of local bacterial infection are shown after releasing the ureteral obstruction in E, F degree hydronephrosis. Considering the reduction in pelvic dilatation in two divided parts (upper and lower), as in Tab. 9 is shown, the lower half does not always show its minority. Ureteral dilatation in moderate degree returnes to normal after releasing the obstruction. In highly dilated ureter considerable reduction is also noticed, but not perfectly. Renal function improves together with it and stabilized, at that. This fact proves that, inspite of remaining of some dilatation, the ureter gains its proper action, transportation of urine.
    From above mentioned data, I think the excision of the wall of the dilated upper urinary tracts is not always necessary, if one aims at the functional recovery of the kidney.
    As to renal aortograms in hydronephrosis, here in this report, I have measured the internal diameter of the renal artey and that of abdominal aorta on the film at the site shown in Fig. 1, for the purpose of studying on the indication of the kidney conservative surgery. Tab. 11 shows the thickness (internal diameter) of renal artery, that of aorta and ratio of the former to the latter in normal adults. Tab. 12 shows those values and postoperative improvement of renal function in E, F degree hydronephrosis. The data strongly suggest us that the results of kidney conservative surgery are poor or none in such a case, in which the internal diameter of renal artery is les than 3. 5 mm or so and ratio of renal artery to abdominal aorta is within 20%, at that.
    By the way, in no later than 5 months, in the half of six cases (Tab. 13) there can be seen much improved blood flow in the kidney, which is obvious from increase in diameter and ratio to aorta of the renal artery.
  • 大越 正秋, 生亀 芳雄, 藤村 伸, 工藤 三郎
    1965 年 56 巻 5 号 p. 518-536
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    In most patients with renal tumor, so-called three main symptoms such as hematuria, a palpable mass and flank pain develop and their diagnosis usually present little difficulty. However, in a significant number of cases, such symptoms are not present at the onset of this disease, and internist rather than urlogist is consulted for explanation for a fever of unknown origin, unexplained weakness, anorexia, loss of body weight and anemia. Besides these symptoms and signs, renal tumor, especially hypernephroma, may present with polycythemia, hypertension, high serum level of alkali-phosphatase, hypercalcemia, amyloidis and exanthema of the skin etc.
    Recently we experienced a case of hypernephroma accompanied with fever which continued one year its origin unknown. The patient was a 60 year old female and in February, 1962, because of fever (38-39°C) visited few hospitls where many kinds of examinations were carried out.
    But no pathological finding except acceleration of blood sedimentation rate was disclosed and under presumptive diagnosis of pneumonia and others, she was treated with antibiotics, antipyretica and/or cortison. Neverthless her fever continued until nephrectomy which was performed by us in February, 1963, under the diagnosis of left renal tumor. Her blood count and blood chemistry were normal. After discharge her fever maintained normal level, but unfortunately she died in July, 1963 at her home and autopsy was not carried out.
    There are a lot of literatures discussing on the relation between renal tumr and fever, polycythemia, anemia, hypertension and several literatures on hypercalcemia, amyloidosis, high serum level of alkali-phosphatase and exanthema of the skin.
    In this paper we reviewed those literatures and discussed possibility and pathogenesis that hypernephroma presens with systemic manifestations such as fever etc.
    Because of the often onset with non-urological or atypical symptoms in case of this disease, a considerable period of time elapses and a delayed rather than an early diagnosis is made. Accordingly it is advisable to take intravenous pyelogram when a patient complains unexplained above mentioned systemic symptoms and manifestations. Then it will bring about more instances of correct diagnosis at an earlier stage of this disease and thereby improves the present poor end-results.
  • 土田 正義, 大越 高光, 黒坂 真, 渡辺 昌美, 木村 行雄, 染野 敬, 菅原 博厚
    1965 年 56 巻 5 号 p. 537-545
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    For the past 5 years 41 patients of solitary kidney were operated upon in our clinic on the remaining urinary system or other organs. These patients were observed with reference to pre-and postoperative alterations of renal function and serum electrolytes, postoperative complications and prognosis. They were divided into two groups: 9 cases without urinary tract obstruction as group A and 32 cases who had operative treatment to the obstruction of the tract as group B.
    The observation performed in these two groups are summerized as follows:
    1) Renal Function
    In many cases impaired renal function was revealed in the preoperative period. The impairment aggravated further 3-7 days after the operation and lasted 2-3 weeks. In group B renal function improved markedly at the time of discharge, although it still remained below the normal range. No postoperative imporvement was seen in group A.
    2) Alterations of Serum Electrolytes
    In many cases of group A high serum potassium level was noted in the postoperative period. In a few cases hyperchloremia was seen in both pre- and postoperative periods. In group B serum potassium level varied markedly in the postoperative period. Hyperchloremia was seen in more cases than in group A.
    3) Postoperative Complications
    Four cases died of acute renal failure or serum hepatitis during admission. The common complications other than the above-mentioned are pyelonephritis with high fever and cystolithiasis. High in cindece of complications was revealed either in the patients with highly impaired renal function or in cases who had the operation utilizing the intestines.
    4) Postoperative Follow-up
    Thirty-six cases were communicated with except for 4 cases died during admission and 1 case who did not answer. The result is as follows: 24 cases in good health, 7 cases preseumably healthy, 3 cases. prone to lie down and 2 cases dead.
  • 今村 一男, 中西 欽也, 丸山 行孝, 木地 孝幸, 近藤 常郎, 甲斐 祥生, 田代 浩二, 佐川 文明, 矢吹 栄佑
    1965 年 56 巻 5 号 p. 546-552
    発行日: 1965年
    公開日: 2010/07/23
    ジャーナル フリー
    In 1926, Abrikossoff reported a series of tumors which, he concluded, had grown from the stariated muscle, and he called them “Myoblastenmyome”. In foreign countries, more than 450 cases have already been reported, while in Japan, no more than 18 cases have been observed up to the present.
    We recently had a case of “Myoblastenmyom” (granular cell myoblastoma) developed near the frenum of the foreskin. The patient was a 23-year-old man who had had a gradually growing, asymptor matic tumor in the vicinity of frenum preputii for about six months. The tumor was as large as pigeon's egg when he first visited our clinic on September 23, 1963, and it was totally excised on October 9, 1963, as laboratory study of the biopsy specimen revealed a benign granular cell myoblastoma histologically.
    Crane et al. collected 157 cases, Murphy et al. 229 cases, and 136 cases have been encountered in the Surgical Pathology Laboratory of Columbia University. The reported cases of granular cell myoblastoma of the urogenital system are from the bladder, urethra, spermatic cord and so on, but none from the penis.
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