Title 副腎性高血圧症の手術経験近藤, 厚 ; 田中, 晋 ; 深町, 弘光 ; 清水, 純 ; 天本, 太平 Author(s) 兼成 ; 斉藤, 泰 ; 鍬塚, 寿 ; 坂口, 浩 ; 田崎, 享 ; 土山, 修 Citation 泌尿器科紀要 (1964), 10(12):

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875-890 Issue Date 1964-12 URL http://hdl.handle.

1 Title 副腎性高血圧症の手術経験近藤, 厚 ; 田中, 晋 ; 深町, 弘光 ; 清水, 純 ; 天本, 太平 Author(s) 兼成 ; 斉藤, 泰 ; 鍬塚, 寿 ; 坂口, 浩 ; 田崎, 享 ; 土山, 修 Citation 泌尿器科紀要 (1964), 10(12): Issue Date URL Right Type Departmental Bulletin Paper Textversion publisher Kyoto University

2 SURGICAL EXPERIENCES OF ADRENAL HYPERTENSION Atsushi KONDO, SUSUMU TANAKA, Hiromitsu FUKAMACHI, Jun SHIMIZU, Taihei AMAMOTO, Kaneshige MAEDA, Yutaka SAITO, Hisashi KUWATSUKA, Hiroshi SAKAGUCHI and Toru TASAKI From the Department of Urology, Nagasaki University School of Medicine (Director : Prof. A. Kondo) Hideo TSUCHIYAMA From the First Department of Pathology, Nagasaki University School of Medicine (Director : Prof. I. Hayashi) Osamu HABAKI From the Dermatological and Urological Clinic, Yamaguchi Prefectural Central Hospital (Director : K. Munehisa, M. D.) The clinical experiences of adrenalectomy in the eleven cases, in which adrenal hypertension was suspected, have been presented. In the two cases of Cushing's syndrome, symptoms were improved after removal of the left adrenal gland which was found to have adenomatous hyperplasia in one of them, and a complete recovery was obtained in the other one who had nodular hyperplasia of the adrenal gland which was subtotally removed. In the four cases of aldosteronism, two of them were primary and the others were secondary. One of the primary aldosteronism had adenoma and the other had adenomatous hyperplasia, and both of them were recovered after the left adrenalectomy. One of the secondary aldosteronism was possessed of diffuse hyperplasia and recovered by subtotal adrenalectomy. The other one of the secondary aldosteronism with chief complaints of hypertension and edema revealed micronodular hyperplasia of the zona glomerulosa and improved after the left adrenalectomy. In the three cases of clinically suspected pheochromocytoma, one of them was recovered

3 following the left adrenalectomy. In the other two cases, however, no tumor was found in the surgical explorations. In the other two cases of hypertension, the one revealed a histological picture of diffuse cortical hyperplasia and showed no clinical improvement following the left adrenalectomy. The other case, on the other hand, improvement of, clinical symptoms was achieved following the subtotal adrenalectomy, although no pathological change was found in the removed adrenal gland histologically. Based on the experiences obtained from these eleven patients, discussions were made on the problems of diagnosis and treatment of the adrenal diseases particularly on the radiological examinations, surgical techniques and replacement therapy. Histochemical findings of the adrenal gland were also described in regard to the relationship between the clinical pictures and the hormonal secretory activities.

近藤他一副腎性高血圧症の手術経験 4)宍戸仙太郎他: 5)楠隆光,前 6)市川篤二他:日 7)尾山力:手 8)松田イツ子:泌尿紀要,6;1088,1960. 9)黒田恭一他.日泌尿会誌,54:843,1963, 887.手術,15:31,1961. 川正信=一外科治療,5:1,1961.

14 近藤他一副腎性高血圧症の手術経験 4)宍戸仙太郎他: 5)楠隆光,前 6)市川篤二他:日 7)尾山力:手 8)松田イツ子:泌尿紀要,6;1088, )黒田恭一他.日泌尿会誌,54:843,1963, 887.手術,15:31,1961. 川正信=一外科治療,5:1,1961. 泌尿会誌,53:660,1962. 術,18:315,1964. ノ;ノご 10)Meyers,M.A.,DiseasesoftheadrenaI glands.c.c.thomas,spring丘eld,1963. 盛癬遡脳凹凹凹脳 11)Osbome,RW.andKallsen,R.J. Urol.,86:477,1961. 第3図 12)Flanagan,M.J.etal.:J.Uro1.,88:111, 13)土山秀夫=最第1例,クッシソグ症候群(別出標本) 大小2個の腺腫状過形成がみられる新医学,18:2893, )Mach,R.S.eta1.Schweiz.Med '写 Wschr.,86:1229,1955. 薙羅 15)Wolferth,C.C.eta1,:Bu11.NewYork 瀦溶 Acad.Med.,33:151,1957. (1964年8月24日受付) 傷痩1舷簸第4図第1例 _ 鯵羅欝クッシング症候群大結節における陽性穎粒の斑状分布 (NeotetrazoriumChloride染第1図第1例,クッシソグ症候群第5図第2図色) 第1例,クッシソグ症候群左副腎腺腫状過形成(PRP十Tomo) 第2例,クッシソグ症候群束状帯の結節状過形成.Sudan好ない(SudanIH染色) 性穎粒は少

15 近藤他一副腎性高血圧症の手術経験 888 -r陶 :. 驚磯欝i 鱒鳶器 }気戸,ピL, 灘娠〆ρ知 ' ハ. ドノ呪へも伽, ρ!'浅'}'一髪第9図第3例,アり. ルドステロソ症左半部腺腫におけるコレステロールの蓄積 γ虞第6図竃 " (Schultz反第3例,アルドステロソ症左副腎腺腫(PRP+Tomo) 応) / 一第10図第5例,アルドステロソ症一騨左副腎腫腺状過形成(PRP+Tomo) 第7図第3例,アルドステロソ症捌出標本(左副腎腺腫) そ駕ら避叡 :煽智二轡劉.,:t. ', 拳第11図第5例及び第6例,アルドステロソ症(易11出標本) 第8図第3例,アルドステロン症下半部腺腫における粗大穎粒の密集 (SudanIV染色) 下2つの副腎組織(第5例)にみられる2個の腺腫状過形成上はびまん性過形成の副腎(第6例)

16 近藤他一副腎性高血圧症の手術経験 889 し曼ぜ8 ら舜'ンで蘇 " ` ド炉〆/弓1 直秘謬..瀞:筑慈 L9 燃色妻 2 慧第12図犠乞第5例,アルドステロソ症第15図周囲皮質と右半部腺腫状過形成との移行 (SudanIV染第6例,アルドステロソ症? 球状帯の小結節状増殖(H,E.) 色) 鞭鰭 / 第13図第6例,アルドステロソ症? 譜多左副腎に腫瘍状の陰影多 (PRP十Tomo) 第16図第7例,褐色細胞腫左副腎の腫瘤(PRP) 画/.ノ' 騨雪. 竃: ; 1曳第14図第6例,大脾動脈に沿つて横長い陰影(a)と (b)が第17図動脈造影法みえる胃泡第7例,褐別出標本色細胞腫

Title 泌尿器科領域に於ける17-Ketosteroidの研究 17-Ketosteroidの臨床的研究第 III 篇 : 尿 Author(s) 卜部, 敏入 Citation 泌尿器科紀要 (1958), 4(1): 3-31 Issue Date URL

Title 泌尿器科領域に於ける17-Ketosteroidの研究 17-Ketosteroidの臨床的研究第 III 篇 : 尿 Author(s) 卜部, 敏入 Citation 泌尿器科紀要 (1958), 4(1): 3-31 Issue Date 1958-01 URL http://hdl.handle.net/2433/111559 Right Type Departmental Bulletin

Title 副腎性高血圧症の手術経験 近藤, 厚 ; 田中, 晋 ; 深町, 弘光 ; 清水, 純 ; 天本, 太平 Author(s) 兼成 ; 斉藤, 泰 ; 鍬塚, 寿 ; 坂口, 浩 ; 田崎, 享 ; 土山, 修 Citation 泌尿器科紀要 (1964), 10(12):

Title 副腎性高血圧症の手術経験近藤, 厚 ; 田中, 晋 ; 深町, 弘光 ; 清水, 純 ; 天本, 太平 Author(s) 兼成 ; 斉藤, 泰 ; 鍬塚, 寿 ; 坂口, 浩 ; 田崎, 享 ; 土山, 修 Citation 泌尿器科紀要 (1964), 10(12):