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In Sapporo city, mass-screening for neuroblastoma by means of urine examination of infants started in April 1981, and the total number of 30, 974 was analyzed through August 1983. During this period 17 (0.05%) were referred to our hospital for further clinical survey. Of these, 4 cases of neuroblastoma were found and treated.The most important problem for a pediatric oncologist is the process of diagnosis which must be the most effective and time-sparing. Considering the data of our patients, we coped with this problem. Except for the elevation of VMA and HVA level in the urine, the final method which confirmed the diagnosis varied from case to case. At present we examine the suspected patients as follows.Each patient should be admitted to the hospital to collect 24 hour urine under strict routine. During the test diet, 24 hour urine is collected for the consecutive 2 days.The specimen is sent to the Sapporo Health Research Institute for the assay of VMA and HVA. In these three days, physical examination including abdominal palpation, blood pressure measurement, plane X-ray picture of chest and abdomen are done. If no abnormality is found, the patient is discharged temporarily until the results come back. If there are any abnormal results, then IVP, CT are followed, and then angiography and bone marrow aspiration are carried out in preparation for the surgical operation.Based on our experiences, the levels of VMA and HVA are not always high for a long time, and one of these some times even show low level. Therefore, the patient must be carefully followed-up, if one of these two metabolites show high value.
一般社団法人国立医療学会の論文

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一般社団法人国立医療学会 | 論文

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一般社団法人 国立医療学会 | 論文

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一般社団法人国立医療学会 | 論文