[A case of spontaneous rupture of renal cell carcinoma].

There have been a few reports on the spontaneous rupture of renal cell carcinoma. A 67-year-old female patient complaining of vomiting and severe abdominal pain was referred to our hospital. Plain computerized tomography demonstrated large heterogenous mass in the right retroperitoneum. We suspected the hemorrhagic shock because of the rupture of the right kidney and therefore emergent laparotomy was performed. Simple nephrectomy for the right kidney was performed. A pathological report revealed renal cell carcinoma, granular cell subtype, grade 1, pT3a. The patient has been followed for one year and five months after the operation, there has been no evidence of local recurrence or distant metastasis of cancer. Thirteen cases of spontaneous rupture of renal cell carcinoma in the Japanese literature are reviewed.

[Anesthesia-free extracorporeal piezoelectric shock wave lithotripsy for urolithiasis].

In November 1991, a third generation extracorporeal shock wave lithotriptor (Piezolith 2500) was installed in our clinic. We examined the effective and safe aspect of this machine for urolithiasis. From November 1991 to October 1993, we experienced 530 sessions of ESWL treatment on 235 patients (270 cases). All patients except two underwent ESWL treatment without anesthesia, and in situ ESWL treatment was possible on 247 cases. The mean number of shock waves and sessions per patient of renal stone were 3369 and 2.1, respectively. Those of ureteral stone were 3970 and 1.9, respectively. The complete removal rate of renal and ureteral stone 3 months after the last session were 86% and 92%, respectively. This outcome was very satisfactory. On the other hand, endoscopic procedure was needed on 13 patients. In almost all cases hematuria was noted after ESWL, but major complications such as subcapsular hematoma or gastrointestinal hemorrhage were not experienced at all. It was concluded that Piezolith 2500 was very effective and safe in the treatment of urolithiasis.

[Expression of integrin molecule in urological tumor cell lines by using RT-PCR method].

Integrins are heterodimer molecule that are composed of one alpha subunit and one beta subunit. Integrins appear to be the major receptors by which cells attach to extracellular matrices, and some integrins also mediate important cell-cell adhesion event. In recent years signaling pathway via beta subunit of integrin molecule has been clarified, and 8 kinds of integrin beta subunit are known to exist. And so we investigated the expression of integrin beta subunit in various urological tumor cell lines by using RT-PCR method. Materials are composed of 8 renal cell carcinoma cell lines, 2 urinary bladder carcinoma cell lines, a testicular tumor cell line and a prostate tumor cell line. All 12 cell lines express integrin beta 1 subunit. The expression rate of beta 4 subunit in renal cell carcinoma lines are lower than that in other urological tumor cell lines. The expression of beta 6 subunit was observed in renal cell carcinoma cell lines and testicular tumor line. In testicular tumor cell line we also found the expression of beta 2 subunit which expression had been believed to be specific in leukocyte.

[Clinical statistics on outpatients, inpatients and operations in 1987].

Statistical studies were made on 1,859 outpatients, 587 inpatients and 601 operative procedures at our department in 1987. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, congenital urethral stenosis, benign prostatic hypertrophy and bladder tumor. A total of 601 operations were performed. The five major operations were hypospadias repair, optic internal urethrotomy, transurethral resection of prostate, ureterocystoneostomy and transurethral resection of bladder tumor.

[Clinical statistics on outpatients, inpatients and operations in 1986].

Statistical studies were made on 1,637 outpatients, 568 inpatients and 563 operative procedures at our department in 1986. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, benign prostatic hypertrophy, bladder tumor and congenital urethral stenosis. A total of 563 operations were performed. The five major operations were hypospadia repair, optic internal urethrotomy, transurethral resection of prostate, ureterocystoneostomy and percutaneous nephrolithotripsy.

[Clinical statistics on outpatients, inpatients and operations in 1985].

Statistical studies were made on 1,795 outpatients, 528 inpatients and 518 operative procedures at our department in 1985. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, stones and tumors. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, congenital urethral stenosis, bladder tumor and benign prostatic hypertrophy. A total of 518 operations were performed. The five major operations were optic internal urethrotomy, hypospadias repair, ureterocystoneostomy, and transurethral resection of prostate and of bladder tumors.

[A case of Paget's disease of the vulva with bladder metastasis].

A very rare case of bladder metastasis of the Paget's disease of the vulva is reported. A 83-year-old woman first experienced an eczematoid eruption on the vulva 12 years earlier. It was diagnosed as Paget's disease of the vulva and treated with radiation 8 years earlier. In March, 1985 a biopsy of the vulva revealed a recurrence of Paget's disease. In August, 1986 she had a sudden attack of left flank pain. The excretory urogram showed bilateral hydronephrosis and transurethral echogram of the bladder demonstrated large nodular tumors of the bladder. Transurethral biopsies of the bladder revealed Paget's disease. Total cystourethrectomy with bilateral ureterocutaneostomy and wide skin excision of the vulva with skin transplantation were performed. The pathological specimen showed several yellowish-white nodular tumors of the bladder, which obstructed both ureteral orifices. Microscopically typical Paget's cells were seen, some of which were stained with PAS before and after amylase and with alcian blue. Postoperatively she developed a severe complication of necrosis of the small intestine due to thrombosis of superior mesenteric artery and died of panperitonitis on the 55th postoperative day. Related reports were also reviewed.

[Clinical statistics on outpatients, inpatients and operations in 1984].

Statistical studies on 1,893 outpatients, 538 inpatients and 554 operative procedures at our department in 1984 revealed the following. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, benign prostatic hypertrophy, bladder tumor and congenital urethral stenosis. A total of 554 operations were performed on 534 patients, and five major operations were hypospadias repair (68), ureterocystoneostomy (57), optic internal urethrotomy (50), TUR-P (42) and TUR-Bt (33).

[Clinical statistics on outpatients, inpatients and operations in 1983].

Statistical studies on 1,990 outpatients, 574 inpatients and 606 operative procedures at our department in 1983 revealed the following. The most frequent diseases among the outpatients were urogenital infections followed by anomalies, tumors and stones. The major diseases among the inpatients were hypospadias, vesicoureteral reflux, congenital urethral stenosis, benign prostatic hypertrophy and bladder tumor. A total of 606 operations were performed on 559 patients, and the five major operations were hypospadias repair (80), TUR-P (54), optic internal urethrotomy (51), ureterocystoneostomy (40) and orchidopexy (34).

[A case of urinary schistosomiasis in a Japanese male].

Urinary schistosomiasis is an endemic disease mainly distributed in most of Africa and Southwest Asia, and caused by infestation with Schistosoma haematobium. The case presented here was a 33-year-old Japanese male who had suffered from schistosomal infestation in the endemic area, and diagnosed as urinary schistosomiasis by detection of Schistosoma haematobium ova in urine and specimens obtained by mucosal biopsy of the bladder. Radiographic and endoscopic examinations revealed neither obstructive uropathy nor urothelial malignancy. The patient underwent treatment with antimonyl sodium tartrate (Stibnal), and the disease is under good control.

[Histological statistics of malignant urogenital tumors].

A statistic survey was carried out on the histology of the 465 malignant tumors at our urological department during the last 10 years. The most frequent tumors were bladder tumor (50%), prostatic tumor (17%) and renal tumor (15%). Histological typing and grading were tabulated for each tumors.