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早大学位記番号:新8883

2019年度衝撃波シンポジウム (2020年3月4日-6日. 神戸大学 海事科学研究科（深江キャンパス)）神戸市, 兵庫県, Symposium on Shock Waves in Japan, FY2019 (March 3-4, 2020. Kobe University), Kobe, Hyogo Japan, 2019年度衝撃波シンポジウムは、新型コロナウイルスの感染拡大防止のため開催中止, 資料番号: SA6000148018, レポート番号: 1B1-3[若]

大気球シンポジウム 平成29年度（2017年11月9-10日. 宇宙航空研究開発機構宇宙科学研究所 (JAXA)(ISAS)）, 相模原市, 神奈川県, Balloon Symposium 2017 (November 9-10, 2017. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA)(ISAS)), Sagamihara, Kanagawa Japan, 著者人数: 12名, 資料番号: SA6000103023, レポート番号: isas17-sbs-023

We report 12 renal cell carcinomas in 6 patients with Von Hippel-Lindau (VHL) disease treated with radiofrequency ablation (RFA). The mean age of the patients was 46 (range 38-53) years (male : 4, female : 2). Computed tomography (CT)-guided transcutaneous RFA was performed under conscious sedation with local anesthetics. The mean size of the tumors was 2.4 (range 0.7-8.1) cm. Nine of the 12 tumors (75%) were locally well controlled. However, 3 tumors in 2 patients developed visceral metastases after RFA. While minimal flank pain, nausea, perinephritic hematoma and lumbago were observed, there was no major complication during or after the procedure. The therapy with CT-guided transcutaneous RFA is efficient and minimal invasive for renal cell carcinoma in patients with VHL, leading to preservation of renal function.

第17回宇宙科学シンポジウム (2017年1月5日-6日. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS)相模原キャンパス), 相模原市, 神奈川県, 17th Space Science Symposium (January 5-6, 2017. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS)Sagamihara Campus), Sagamihara, Kanagawa Japan, 資料番号: SA6000060196, レポート番号: P-154

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A 61-year-old man was referred to our department because of painless and stony hard mass beside the left testis. Serum levels of lactate dehydrogenase, α-fetoprotein and human chorionic gonadotropin were within normal ranges. The ultrasonography of the mass showed almost homogenous and relatively low intensity echogram. The mass which derived from the left spermatic cord and was partially surrounded by fat-like soft and yellow tissue, was removed with the left testis by usual orchiectomy. Histopathological diagnosis was liposarcoma, whose subtype was dedifferentiated type derived from well differentiated type. Postoperatively, a para-aortic mass, which resembled lymphnode metastasis, was pointed by computed tomographic scan and was removed surgically. However, it was histopathologically diagnosed as neurogenicganglioma irrelevant to liposarcoma. He has been free of disease for about 1 year without any adjuvant therapy.

A 48-year-oldman consultedour hospital complaining of painless swelling of the left scrotal contents that hadgrad ually increasedfor 5 years. Serum LDH, α-fetoprotein andHCG were within normal ranges. The ultrasonography showedheterogeneous echogram including high-echogenic spots andrelatively a lowechogenic hydrocele. Left high orchiectomy was performedandthe removedtissue was 24×16×15cm in size, which hadlarge cystic cavity filledwith cloudy andd eep-green mucin. Pathological diagnosis was mucinous adenocarcinoma. Postoperatively analyzedserum CEA, CA19-9 andPSA were within normal ranges. Systemic X-ray examinations, such as lung, abdominal and pelvic CT scan, upper GI series and barium enema, did not show any abnormal SOL suggesting carcinoma. Therefore, we diagnosed this case as a primary adenocarcinoma in the scrotal contents. The patient has been observed without any adjuvant therapy since operation, but no signs of recurrence have been identifiedfor one year andsix months.

大気球シンポジウム 平成27年度（2015年11月5-6日. 宇宙航空研究開発機構宇宙科学研究所 (JAXA)(ISAS)）, 相模原市, 神奈川県, Balloon Symposium 2015 (November 5-6, 2015. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA)(ISAS)), Sagamihara, Kanagawa Japan, 著者人数: 15名, 資料番号: SA6000044041, レポート番号: isas15-sbs-041

人は突然遭遇した驚愕する状況では普段では想像できない反応を示したり、あるいは普段ならすぐに対処できるはずのことに対処できなくなったりするようである。私は2年前に筑波大に赴任したが、前任地の新潟での忘れられない事件3件を ...

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大気球シンポジウム 平成26年度（2014年11月6-7日. 宇宙航空研究開発機構宇宙科学研究所 (JAXA)(ISAS)）, 相模原市, 神奈川県, Balloon Symposium 2014 (November 6-7, 2014. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA)(ISAS)), Sagamihara, Kanagawa Japan, 著者人数: 17名, 資料番号: SA6000021025, レポート番号: isas14-sbs-025

大気球シンポジウム 平成26年度（2014年11月6-7日. 宇宙航空研究開発機構宇宙科学研究所 (JAXA)(ISAS)）, 相模原市, 神奈川県, Balloon Symposium 2014 (November 6-7, 2014. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA)(ISAS)), Sagamihara, Kanagawa Japan, 著者人数: 11名, 資料番号: SA6000021026, レポート番号: isas14-sbs-026

症例1は49歳女性で, 腹部超音波検査にて膀胱後壁に接する嚢胞様腫瘤を指摘され, 紹介来院した.排尿後の静脈性腎盂造影の立位像で膀胱下方に造影剤の貯留を認め, 逆行性膀胱尿管造影で尿道周囲に5×5×7.5cmの造影剤の貯留を認めた.MRIでは尿道全周を取り囲むように腫瘤が存在していた.以上の所見から尿道憩室と診断し, 経腟的尿道憩室摘除術および憩室口閉鎖術を施行した.病理組織学的所見では壁は炎症性肉芽組織が大半を占め内面は一部移行上皮で被われていた.症例2は36歳女性で, 第2子の妊娠5ヵ月頃より会陰部痛を認め, 産婦人科にて腟前壁の腫瘤を指摘され, 出産後に紹介来診した.腹部超音波検査で尿道を全周性に取り巻く多房性嚢胞を認め, 排尿時膀胱尿道造影で尿道周囲に3×3×4cmの造影剤貯留が認められた.CT・MRI所見で尿道全周を取り囲んだ憩室が認められ, 症例1と同様の手術を施行した.病理組織学的所見は炎症性肉芽組織を認めるのみであった, We report two cases of female urethral diverticula. A 49-year-old woman (case 1) complained of perineal pain when she voided urine. A 36-year-old woman (case 2) complained of perineal pain. In both cases, intravenous pyerography and urethrography revealed diverticula around their urethra, and we diagnosed them with urethral diverticula which surrounded their urethra by magnetic resonance imaging. We treated them by transvaginal diverticulectomy. Case 2 was successfully treated, but the diverticulum recurred after one year in case 1. There are over 200 reported cases of female diverticula in the Japanese literature, but a urethral diverticulum surrounding the urethra is rare.

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症例1は79歳女.右側の水腎症により発見された.大部分が扁平上皮癌, 一部が移行上皮であった.骨盤壁への浸潤のため外科的治療は行わず, 7ヵ月後に死亡した.白血球数は経過中に76200/mm3まで上昇し, 腫瘍組織の免疫組織学的検討によりG-CSFが高濃度に含まれていることが示された.症例2は80歳男.膀胱癌診断時に手術を拒否し, 2年後に尿管皮膚瘻を造設した.49500/mm3の白血球数増加が認められ, 放射線照射により一時的に減少した.放射線治療中及び治療後の血清G-CSF値はそれぞれ54pg/ml, ≦30pg/mlであった.免疫組織学的にG-CSFが腫瘍内に認められた.10ヵ月後に死亡した, Two cases of bladder tumor producing granulocyte colony-stimulating factor (G-CSF) are reported. The first case was in a 79-year-old female patient. A large bladder tumor was diagnosed as right-sided hydronephrosis. The tumor consisted mostly of squamous cell carcinoma with a few transitional cells. Total cystectomy could not be performed because of direct invasion by the tumor into the pelvis. The patient died without aggressive treatment about 7 months after admission. Her leukocyte count consistently increased up to 76, 200/mm3. The serum G-CSF levels were not analyzed. However, immunohistochemical examination revealed a high concentration of G-CSF in the tumor specimen. The other case was in an 80-year-old male patient. The patient, who had refused total cystectomy for bladder tumor (transitional cell carcinoma, grade 2, T2N0M0) 2 years earlier, underwent ureterocutaneostomy for obstructive renal insufficiency. Total cystectomy was not performed at this admission because of tumor invasion into the rectum and his advanced age. Radiotherapy was administered. However, he developed ileus caused by direct tumor invasion into the ileum. He died about 10 months after the urinary diversion. Leukocytosis, which improved transiently following radiotherapy, became more severe. The maximum leukocyte count was 49, 500/mm3 just before death. The serum G-CSF levels during and after radiotherapy were 54 pg/ml and < 30 pg/ml, respectively. Immunohistochemical examination revealed the presence of G-CSF in the tumor. These findings suggest the production of G-CSF by the bladder tumor.

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資料番号: SA1002959000

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36例の腎盂尿管腫瘍について臨床的検討を行った。1)性別は2対1と男子に多く, 平均年齢は男子66.4歳, 女子68.4歳であった。2)主訴は肉眼的血尿が66.7%と多かった。3)尿細胞診陽性率, 全尿において41.7%, カテーテル尿において61.1%であり, grade 2以上の移行上皮癌では, カテーテル尿においてほとんど陽性であった。4)組織型では移行上皮癌が72.2%と多かった。5)Kaplan-Meier法による生存率は, 全症例で1年生存率:80.4%, 3年生存率:65.4%, 5年生存率:54.5%, gradeによる生存率の差が一番顕著であった, During the 9 years between 1983 and 1992, 36 patients with renal pelvic and ureteral tumors were treated in our hospital. There were 24 males and 12 females. The most common chief complaint was macrohematuria. Intravenous pyelography (IVP) revealed the finding of non-visualized kidney, filling defects and hydronephrosis in 99%. Histologically, 26 were found to have transitional cell carcinoma, one squamous cell carcinoma and one adenocarcinoma. The 5-year survival rate of this study was 54.5% according to the Kaplan-Meier's method. In our study the most important prognostic factor was histopathological grading.

過去10年間の15例は10～40, 平均21.1歳であった.右停留精巣の1例以外は全て左側に発生した.発症時刻が判明している13例中12例で睡眠中及び起床後1時間以内に発症していた.停留精巣1例以外の全例が精巣痛を訴え, 少数は鼠径部及び下腹部の疼痛を伴っていた.大多数で精巣の腫脹・圧痛が認められ, 精索の短縮は捻転及び2次的炎症によると思われ, 重要な所見であった.Prehn徴候及び発熱は数例にみられたが, 白血球数増加は10例に認められた.手術11例中10例で精巣固定術, 1例で精巣摘除術を行った.4例は自然整復例と判断された.健側の精巣固定は行わなかったが, 再発はみていない, We experienced fifteen cases of torsion of the spermatic cord during the past 10 years. The age distribution was from 10 to 40 years old and the average age was 21.1 years. All cases except one case of right undescended testis occurred on the left side. To our interest, the onset in 12 of the 13 cases with known onset time were during sleep or within one hour after waking up. All cases except one case in the undescended testis complained of pain of the testis and some of them were accompanied with pain in the inguinal and lower abdominal region. Swelling and tenderness of the testis were observed in most cases and shortness of the spermatic cord probably caused by torsion and secondary inflammation seemed to be important findings. Prehn's sign and fever up were observed in few cases but leukocytosis was seen in 10 cases. Eleven cases of surgical treatment consisting of 10 orchiopexy and one orchiectomy were performed. Four cases of spontaneous detorsion were included in our experience. Orchiopexy of the contralateral intact testis was not done, but, we have never experienced relapse of torsion.

A 51-year-old male patient with diabetes mellitus consulted his home doctor because of high fever and right flank pain. Urinalysis showed marked pyuria. Treatment with antibiotics was not completely effective, and he was referred to our hospital for further examination and treatment. CT scan showed an abnormal gas shadow in right renal parenchyma. He was diagnosed with emphysematous pyelonephritis and right subcapsular nephrectomy was done after the control of diabetes mellitus. We reviewed 57 cases of emphysematous pyelonephritis including our case in the Japanese literature, and we discussed about its etiology, symptomatology, choice of treatment and prognosis.

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