A Research of Treatment for urinary bladder tumor using ultrasound-tomography under cystoscipy

本研究的目的是(1)将微型超声探头与膀胱镜相结合，同时描绘肿瘤的超声图像和内窥镜图像，从而获得高精度的诊断能力和(2)利用超声波有效地治疗肿瘤部位。1.对26例经内窥镜等检查确诊为膀胱癌的患者，将25平方英尺的硬质膀胱镜插入膀胱镜，在视频监视下用从膀胱镜钳口插入的微型超声探头进行扫描，并对肿瘤进行扫描。此外，还对26例经膀胱镜检查等确诊为膀胱癌的患者，从膀胱镜的钳口插入微型超声探头，在视频监视下对肿瘤进行扫描可以将内窥镜图像和超声图像并排放置以进行观察。结果，发现微型超声探头的优点在于，由于可以在…下确认肿瘤的同时进行扫描，因此可以更适当地选择扫描平面并且可以更安全地接近肿瘤更像是一种内窥镜。此外，这种探头能够比老式探头更清晰地显示Enen小肿瘤。这一结果表明，利用微型探头的超声内窥镜诊断/治疗膀胱肿瘤是可能的。预计微型探头的进一步微型化将使这项诊断/治疗技术不仅应用于膀胱，还将应用于上尿路，并通过将该技术与使用超声波和冲击波的治疗相结合，对患者进行更准确和更少侵入性的治疗。以小鼠膀胱癌MBT-2肿瘤为模型，研究了高能冲击波(HEW)与抗癌药物的联合作用。为了获得显著的抗肿瘤效果，需要单独使用19 KV 5000次，并识别出HEW 5000次和顺铂1u/ml的联合作用。上述结果有力地表明，冲击波和目前用于治疗泌尿系结石和胆石症的抗癌药物的联合治疗将成为未来包括膀胱癌在内的癌症的多学科治疗之一。较少

AbstractThe aim of this study is (1) to depict the ultra-sonographic images of tumor simultaneously with the endoscopic images by combining a miniature ultrasound probe with cystoscope, thereby obtaining a diagnostic ability of high precission and (2) to effeciently treat the site of tumor by using ultrasonic waves.1.For 26 patients who were already diagnosed as having a bladder tumor by endoscopic examination, etc., a 25 Fr.rigid cystoscope was introduced into the bladder, and scanning was done while observing the tumor under video monitoring with a miniature ultrasound probe inserted from the mouth of forcepts of cystoscope.Furthermore, it was so arranged that the endoscopic image and the ultrasonographic image can be placed side by side for observation. As a result, the miniture ultrasound probe was found to be advantageous in that more appropriate selection of the scanning plane and safer approach to the tumor can be made since scanning can be done while confirming the tumor under … More an endoscope.Further, this probe was able to visualize enen small tumors more clealy than the old type probe. This result indicates the possibility of development to the diagnosis/treatment of bladder tumor with an ultrasound endoscope using a miniature probe. It is expected that further miniaturization of the miniature probe will enable this diagnostic/therapeutic technique to be applied not only to the bladder but also to the upper urinary tract and also that more accurate and less invasive treatment to the patients will be made possible by a combinational use of this technique and therapies using ultrasonic waves and shock waves.2. Combined effects of the high energy shock wave (HESW) and anti-cancer drugs were studied with mouse bladder cancer MBT-2 tumor. In order to obtain a significant anti-tumor effect with HESW alone, 19 kv 5000 shots were required, and combined effects of HESW 5000 shots and CDDP 1 u/ml were recognized.The results above strongly suggest the possibility that combined therapy with shock waves and anti-cancer drugs currently in use for the treatment of urolithiasis and cholelithiasis will make a grate stride as one of the multidisciplinary therapies for cancers including bladder tumor in the future. Less