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膀胱癌を含む高次重複癌の4例.第1例は70歳男性で, 膀胱移行上皮癌, 前立腺小腺房性高分化型腺癌, 膵高分化型腺癌の3重複癌で, 悪液質で死亡した.第2例は69歳男性であり, 膀胱移行上皮癌, 陰茎扁平上皮癌, 喉頭扁平上皮癌の3重複癌で, 発症後6年経過したが, 再発を認めていない.第3例は78歳の男性で, 膀胱移行上皮癌, 胃中分化型腺癌, 前立腺小腺房性高分化型腺癌, 肺微小扁平上皮癌の4重複癌で, 胃癌の広汎転移により閉塞性黄疸・腎不全を併発し死亡した.第4例は76歳男性で, 膀胱移行上皮癌, 頸部鰓性癌, 頬部扁平上皮癌, 直腸高分化型腺癌の4重複癌であり, 第1癌発症後17年を経過したが, 再発なく生存している, Two cases of triple primary neoplasm and two cases of quadruple primary neoplasm including transitional cell carcinoma (TCC) of bladder are reported. The first case was a 70-year-old male who had bladder cancer, occult cancer of prostate (adenocarcinoma) and highly differentiated adenocarcinoma of pancreas. He died of cachexy. The second case was a 69-year-old male. This case was also triple primary neoplasm including bladder cancer, squamous cell carcinoma (SCC) of penis and SCC of larynx. The third case was a 78-year-old male who had bladder cancer, adenocarcinoma of prostate similar to that of the first case, adenocarcinoma of stomach, and SCC of lung. He died of obstructive jaundice and renal failure owing to massive metastases of gastric cancer. The fourth case was a 78-year-old male who had four primary neoplasms such as bladder cancer, branchiogenic epithelial carcinoma, SCC of buccal mucosa and adenocarcinoma of rectum.

1972年1月から10年間の原発性尿管癌24例の臨床的観察をおこなった.1)尿管癌が泌尿器科外来新患患者の0.17%を占めた.2) 41～84歳, 平均年齢は65歳であった.3)男:女は3:1であった.4)左側に多く, 下部尿管1/3に多かった.5)臨床症状は, 肉眼的血尿が19例ともっとも多く, ついで, 腰痛6例であった.6)尿細胞診は, 18例9例が陽性であった.7)膀胱鏡検査では, 腫瘍の尿管口からの突出を4例に認め, ついで尿管口部の隆起を2例に認めた.8)排泄性腎盂造影では, 24例中10例に陰影欠損を認め, 逆行性腎盂造影では10例全例に陰影欠損を認めた.9) CTは9例中4例に腫瘍部に一致しmassを認めた.10)腎尿管全摘除兼膀胱部分切除術あるいは膀胱全摘除術を14例に施行した.11)5年生存率は56.5%で, 予後は, 浸潤度, 悪性度と密接に関係した, A clinical survey was performed on 24 cases of primary ureteral tumors treated in our University Hospital between Jan. 1972 and Dec. 1981. The incidence of primary ureteral tumors was 0.17% among the outpatients in our urologic clinic. The patients ranged from 41 to 84 years old in age (average age: 65 years), and the male to female ratio was 3 to 1. The left ureter and the lower third of the ureter were involved more frequently. The most frequent initial symptom was macrohematuria seen in 19 cases (79%), followed by loin pain seen in 6 cases (25%). A cytologic study of the voided urine or ureteral urine was carried out in 18 cases and positive results were obtained in 9 cases (50%). Cystoscopic examination revealed a tumor protruding through the ureteral orifice in 16.7% (4 of 24 cases), followed by bulging orifice in 8.3% (2 of 24 cases). Excretory pyelography showed ureteral filling defects in 41.7% (10 of 24 cases). Retrograde pyelography showed ureteral filling defects in 100% (10 of 10 cases). CT showed a mass region in 44.4% (4 of 9 cases). A total of 14 patients underwent nephroureterectomy with partial or total cystectomy (66.7%). The overall 5-year-survival rate was 56.5% and could be directly associated with grade and stage of tumors.

UROCALUN, a new therapeutic agent for urolithiasis, was used with the following results. 1) Five out of eleven cases with ureteral calculus passed stone after administration of this drug for ten days or more. One of them passed a stone larger than 10mm in diameter. 2) Two cases of kidney stone were treated with long term administration of two to three months. In one case, it seemed effective. 3) This drug was useful for the patients with long term indwelling catheter to prevent calculi.

1.In an attempt to study its usefulness as a contrast medium for retrograde pyelography, a 2-fold dilution (33.4%) of sodium. iothalamate 66.8% (Conray 400) was used in 23 cases and the results were compared with those with 38% Urografin. The test medium was demonstrated to be not inferior to Urografin in its capacity of visualizing the renal pelvis. 2. In 20 (87%) out of the entire 23 cases the contrast medium gave a clear-cut pyelogram with no blurring of the picture which makes the film incompetent for diagnostic purpose as seen in any instances. 3. As compared to Urografin which was administered contra laterally, Conray 400 was found to be more excellent in 13% and equally satisfactory in 78.3% in its visualization. 4. No adverse reactions worthy of mention was noted. 5. An experiment on the rate of injection confirmed that Conray 400, being lower in viscosity, is far easier to inject than Urografin.

30 % Conray was used for drip infusion pyelography in 68 cases. It gave more excellent demonstration of pyeloureterogram than the regular excretory pyelography. The satisfactory result was obtained in 58 cases (85.2 %). Side effects were observed in 17.6 %, but no serious ones were encountered.

Non-steroid anti-inflammatory drug, "Riripen" (Daiichi P h arm. Co.) was administered to patients with various urological diseases. The results are summarized as follows. 1. The drug was given to a total of 28 patients consisting of 16 with a cute cystitis, 3 with acute epididymitis, 4 with urethral stricture, 1 with genital trauma and 4 with other diseases. 2. In patients with acute cystitis, a single treatment with "Riripen" showed no r emarkable effect, but a combination with other chemotherapeutic agents produced a secure effectiveness. 3. In patients with acute epididymitis, a combination therapy of "Riripen" wit h chemotherapeutic agents resulted in an excellent analgetic effect although the necessitate duration of drug administration was unable to be shortened. 4. In patients with urethral s tricture, the drug showed an excellent effect for elimination of urethral damages following bougienage. 5. Although case treated w as limited in only one, a patient with genital trauma showed an excellent response to the single treatment with "Riripen" 6. The drug was given to patients who w e re performed cystoscopic examination with a good effect for releasing pain. 7. In a few cases, t h e therapy with "Riripen" suggested a possibility that an administration of the drug may be used for auxotherapy or abolition of adrenocortical hormone therapy. 8. No noticeable side effect was encountered.

Among the 1103 urine specimens obtained from patients with urinary tract infections for the recent 3 years, Pseudomonas aeruginosa was isolated in 145 (13 %). All patients were suffering from chronic infection with other urogenital diseases and majority of them had received various antibiotics in the past. Kasugamycin was administered in 21 paitent with chronic urinary tract infection due to Pseudomonas aeruginosa. Excellent, good and poor responses were obtained in 4, 11 and 6 cases, respectively, showing effectiveness to be 70.1 % (15 cases). Side effects were minimal.