From January 1981 through December 1986, 27, 513 individuals consisting of 17, 918 males and 9, 595 females underwent health examinations at Health Care Center in Obihiro Kosei Hospital. 14.2% of healthy and asymptomatic men and 29.1% of healthy and asymptomatic women had microscopic hematuria (one or more RBCs per HPF).
To evaluate the clinical significance of microhematuria, about one third of patients with asymptomatic microhematuria who had undergone complete urological examination were reviewed.
Genitourinary neoplasms were found in 0.21%(8 bladder cancers, 2 prostatic cancers and 1 renal cell cancer). The incidence of cancers increases proportionate to increase in age, furthermore, lesions were found more commonly in men than in women. We could find no relationship between the degree of hematuria and the cause. The results suggest that patients with asymptomatic microhematuria should undergo urological examinations.

We reported nine cases of metastatic skin carcinoma experienced at the Department of Dermatology, Obihiro Kosei Hospital during the period from April 1991 to March 1993. Lung was the most common primary lesion (four out of nine cases), followed by uterus (two) and stomach, breast, and kidney (one each). The clinical features of the metastases were classified into nodular (five cases), inflammatory (one case) and sclerotic (three cases) types. Peculiar zoster-like inflammation was seen in metastatic gastric cancer. Pathologically, adenocarcinoma was more common than squamous cell carcinoma. The average interval between the diagnosis of the primary cancers and the development of the skin metastases was about 30±25 months. The average life span after the detection of the skin metastases was 6.8±5.6 months. Poor prognosis of skin metastasis was thus reconfirmed.

Introduction: We report two cases of surgery under general anesthesia during cancer pain management of patients with methadone therapy. Case 1: A 57-year-old woman was started on methadone for pain from right breast cancer with multiple bone metastases, and right mastectomy was performed during the course of chemotherapy. There was no exacerbation of cancer pain due to methadone withdrawal, although analgesics were used temporarily for wound pain. Case 2: A 76-year-old man was placed on methadone for pain from lung cancer. There was concern that lower limb paralysis would develop from a compression fracture of the lumbar spine that had occurred during the course of treatment. Therefore, decompression and fixation surgery was performed. Ketamine was used to control intraoperative pain exacerbation, and fentanyl was used by continuous injection for re-exacerbation of pain after the patient had awakened from anesthesia. Conclusion: Since methadone is available only by mouth in Japan and the equianalgesic ratio between methadone and other opioids has not been established, caution is needed for perioperative pain control while oral methadone cannot be administered. Thus, pain and palliative care specialists prescribing methadone are expected to play an active role in adequate perioperative pain control.