[Clinical study on 17 cases of genitourinary tuberculosis].

Between 1987 and 1995, 17 patients with genitourinary tuberculosis were treated at Iwate Prefectural Central Hospital. The incidence of newly diagnosed genitourinary tuberculosis was 17 out of 16,363 outpatients (0.1%) during the 9-year period. Twelve patients had urinary tuberculosis and genital as well as urinary organs were affected in 5. Six (35%) patients presented in their fifties and 5 (29%) each in their forties and sixties. Nine (53%) patients had irritative voiding symptoms as the chief complaint. Only 29% had a known history of extra-genitourinaty tuberculosis. In addition to the standard multidrug chemotherapy, nephrectomy was performed in 5 patients and orchiectomy in 2 with epididymal tuberculosis. The incidence of tuberculosis has recently increased in many parts of our country and more attention should be paid to genitourinary tuberculosis.

[Lymphedema after radical prostatectomy: a case report].

We report a case of intractable lymphedema of the left leg following radical prostatectomy. The 69-year-old male patient complained of difficulty walking, caused by severe lymphedema. Intraarterial autologous lymphocyte transfusion therapy was performed because of failure of conventional conservative therapy, and the leg edema resolved almost completely. However, the treatment did not improve the penoscrotal edema necessitating excision of the edema and skin graft in a separate procedure. The post-operative course was excellent and the patient's performance status improved to 1 from 3.

[A case report of skeletal muscle metastasis of renal cell carcinoma effectively treated with interferon-alpha].

The skeletal muscle is a very rare site of metastasis in renal cell carcinoma. We report the third case of skeletal muscle metastasis of renal cell carcinoma effectively treated with interferon-alpha. The patient was a 74-year-old woman who had undergone radical nephrectomy on the left side for renal cell carcinoma on April 23, 1990, and had been observed as an outpatient. In June 1997, she was admitted with a diagnosis of metastasis in the left great adductor muscle and right sixth rib, as well as multiple lung metastasis. The metastatic lesion in the great adductor muscle decreased in size by more than 50% following concomitant intramuscular administration of natural interferon-alpha (nIFN-alpha). In the other metastatic lesions, nIFN-alpha-sensitive and resistant metastatic foci were intermingled. Thus, the primary focus in the present study was presumably composed of several clones with different sensitivities to nIFN-alpha.

[Recurrent spontaneous rupture of the urinary bladder: a case report].

The patient was a 67-year-old woman who had undergone radical hysterectomy and postoperative radiotherapy for cervical cancer at the age of 46 years. Spontaneous rupture of the urinary bladder occurred twice in 1997, and conservative treatment was performed on each occasion. She was admitted to our hospital for the third time of spontaneous rupture of the urinary bladder. She underwent bilateral cutaneous ureterostomy because of panperitonitis and paralytic ileus. A review of 11 cases of recurrent rupture of the urinary bladder reported in Japan including the present case revealed that, patients who had been conservatively treated tended to be subject to recurrence. However, the risk of recurrence remains when a partial cystectomy is performed. Therefore, especially in recurrent cases, augmentation cystoplasty or urinary diversion should be considered as the treatment for spontaneous rupture of the urinary bladder due to radiation cystitis.

A case report of a "necrotizing" entero-colo-proctitis in the adult.

We experienced a patient who died of diarrhea after an operation for glioblastoma. The mucosa of the small and large intestines were entirely denudated. Although the etiology is not clear, this case is supposed to be a very rare one of "necrotizing" enterocolitis in the adult occurring after an operation on a brain tumor.