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  • 1
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Standard severity criteria for benign prostatic hyperplasia (BPH) are needed to facilitate clinical and epidemiologic investigations in the common terminology.Patients and Methods: A total of 692 BPH patients from 8 institutions were judged by specialized physicians for their overall disease severity and severity in 4 domains: symptom, function, anatomy, and quality of life (QOL). The items measuring severity in these 4 domains were the International Prostate Symptom Score (I-PSS) questionnaire, uroflowmetry, transrectal ultrasonography (TRUS), and questionnaires on bother and I-PSS QOL index, respectively. By Spearman's rank correlation and multiple regression analysis using physicians' judgement as the criterion variable (gold standard) the items and their cut-off levels were selected so that high predictivity, practicality and clinical significance were maintained, while the number of items in use was minimized.Results: The item(s) and their ranges of values for each severity grade were summarized as follows; the evaluation domain (the selected item(s): range of mild, moderate, severe): symptom (I-PSS: 0–7,8–19, 20–35), function (maximum flow rate and residual urine volume: ≥ 1 5 mL/s and 〈 50 mL, ≥ 5 mL/s and 〈 1 00 mL, 〈 5 mL/s or ≥ 100 mL), anatomy (prostate volume on TRUS: 〈 20 mL, 〈 50 mL, ≥ 50 mL), QOL (QOL index: 0 and 1, 2 to 4, 5 and 6). The overall severity was efficiently predicted when defined according to the combinations of severity grades of the 4 domains. These criteria predicted physicians' judgement with accuracy of about 80% for overall severity and severity of individual domains.Conclusion: The proposed criteria are valid, practical, and would be useful for the common scale of the BPH severity in clinical and epidemiologic studies.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    International journal of urology 5 (1998), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 26-year-old female, who had been treated for cervical carcinoma, presented with high fever and right flank pain. A right renal abscess was initially suspected from the clinical symptoms and diagnostic imaging. However, pathologic findings for the right kidney revealed squamous cell carcinoma, which was consistent in type with the original cervical carcinoma. Demonstration of human papillomavirus 16 in tissues from both the renal tumor and the cervical carcinoma confirmed that the right kidney carcinoma was a metastasis from the cervical carcinoma. The role of interleukin-6 in occurrence of the unexplained fever is discussed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  We retrospectively evaluated the erectile function after nerve-sparing radical retropubic prostatectomy (RRP) and the efficacy of sildenafil for erectile dysfunction (ED) following RRP according to the preoperative erectile function.Methods:  We evaluated 48 Japanese patients who underwent nerve-sparing RRP at the Sapporo Medical University School of Medicine, Sapporo, Japan, between January 1996 and December 2001. Erectile function following nerve-sparing RRP was assessed by a simple mailed questionnaire that was constructed for the study.Results:  Of the 48 patients, 36 had normal erectile function preoperatively, but for 12, function was not sufficient to penetrate. The overall estimated recovery rates of any degree of erection were 50.6% at 36 months and 94.3% at 60 months. However, that of erection sufficient to penetrate was only 17.7% at 36 months and was only seen in bilateral nerve-sparing patients. Sildenafil was effective in 9 of 13 ED patients (69.2%) in both nerve-sparing groups. When patients were divided according to preoperative erectile function, no difference was found in the efficacy rate between patients with normal function and those with ED.Conclusions:  Even bilateral nerve-sparing RRP can not always guarantee a sufficient erection. However, sildenafil is effective for ED following nerve-sparing RRP regardless of the nerve-sparing procedure or preoperative erectile function. Thus, preoperative function alone, although depending on its severity, may not necessarily be a reason for exclusion from receiving nerve-sparing RRP if patients want to have the operation.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A 49-year-old woman underwent hysterectomy and bilateral adnexectomy after the diagnosis of a right ovarian tumor with paraaortic and pelvic lymph node metastases. The pathological diagnosis was undifferentiated carcinoma of the ovary. After the operation, a bladder tumor was discovered during the evaluation for microscopic hematuria. The bladder tumor was pathologically diagnosed as transitional cell carcinoma, pT1b, G3. Although the pathological findings of the bladder cancer and ovarian cancer were very similar, we could diagnose primary bladder cancer with ovary and lymph node metastases according to the immunohistochemical staining pattern of cytokeratins 7 and 20. Herein, the clinical usefulness of immunohistochemical staining using cytokeratins for making a differential diagnosis of the origin of a tumor in the pelvic cavity is demonstrated.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Our previous study showed that the growth rate of incidentally found renal cell carcinoma (RCC) varied, and that the initial clinical and pathological features did not predict subsequent growth of the carcinoma. The objective of this study was to determine the relationships between cell proliferation, apoptosis, angiogenesis and the growth rates of these RCC.Methods: We examined cell proliferation, apoptosis, and angiogenesis in 16 incidentally found cases of RCC. Cell proliferation was assessed by immunohistochemical staining with a Ki-67 antibody. Apoptosis was assessed by the terminal deoxynucleotidyl transferase (TdT) mediated deoxy-UTP biotin nick end labeling (TUNEL) technique. The Ki-67 labeling index (KI) and the apoptotic index (AI) were determined as the ratio of immunohistochemically positive cells per 1000 cancer cells. The KI/AI ratio was also determined. Angiogenesis was evaluated by CD34 immunostaining. Finally, we investigated the correlation between these parameters and the growth rate of primary lesions of incidentally found RCC.Results: The KI ranged from 7 to 73 (median, 20), AI ranged from 6 to 171 (median, 26), and microvessel density (MVD) ranged from 21 to 673 (median, 265) for incidentally found RCC. Ki-67 labeling index, AI and MVD were not closely correlated to each other. Furthermore, these parameters were not associated with growth rates of incidentally found RCC. Only the KI/AI ratio was strongly correlated to the growth rate of incidentally found RCC (r = 0.709; P = 0.0083).Conclusion : Our results suggest that the balance between cell proliferation and apoptosis partly determines the growth rate of primary lesions of incidentally found RCC.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Background : A prospective study was conducted to determine whether transurethral resection of the prostate (TURP) facilitates detection of prostate cancer that is missed with systematic sextant biopsies associated with transition zone (TZ) biopsies. Methods : A total of 139 consecutive patients underwent transperineal TZ biopsies of each lobe in addition to a transrectal systematic sextant peripheral zone (PZ) biopsy. Patients whose biopsies were negative for cancer received TURP for relief of lower urinary tract obstruction when indicated. Results : Cancer was detected in biopsy specimens of 40 patients. Of these cancers, 18 originated in the PZ alone and 22 were located both in the TZ and the PZ. No cancers were detected in the TZ alone. Of 99 patients who were proven not to have cancer by the biopsies, 18 were indicated for TURP. Five of these patients (28%) had cancer in the resected tissues. All cancers were clinically organ confined and their Gleason sum scores were 2–5. Cancer-positive chips accounted for less than 10% of all resected specimens. Of the 66 patients with negative biopsies and without indication for TURP, four (6%) were revealed to have an elevation of the serum PSA level during follow up. They were later proven to have cancer by a second biopsy. Conclusion : Routine use of TZ biopsy is not warranted for detection of cancer. Transurethral resection of the prostate can detect cancers in patients with negative PZ and TZ biopsies. However, cancers detected by TURP may not always be clinically significant and only four of 66 patients who were not indicated for TURP and received a close follow up were later found to have cancer, although their follow-up period was short. Thus, it still remains to be elucidated whether TURP is necessary for all patients with negative biopsies of the prostate.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The goal of this study was to evaluate the correlation between increments of penile tumescence and penile rigidity measured by the erectometer and the RigiScan, respectively.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Nocturnal penile tumescence (NPT) was measured in 25 volunteers (mean age, 49.5 years). The erectometer and the RigiScan were used simultaneously for a total of 47 nights. We studied the correlation between maximum penile circumferential changes determined by the erectometer and penile rigidity patterns measured by the RigiScan.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Maximum circumferential changes during NPT measured by the erectometer were well correlated to those determined by the RigiScan (correlation coefficient, 0.719). In addition, penile circumferential changes measured by the erectometer corresponded well to the penile rigidity pattern determined by the RigiScan (P = 0.0001). Specifically, maximum penile circumferential changes of more than 30 mm and less than 10 mm had 70% positive predictive value and 100% negative predictive value for predicting the normal rigidity pattern, respectively.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Penile circumferential changes measured by the erectometer were well correlated to penile rigidity measured by the RigiScan, particularly when the increments were larger than 30 mm or less than 10 mm. These results suggested that the erectometer was a useful tool to estimate the penile rigidity patterns of the RigiScan.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 7 (2000), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 63-year-old man with chronic renal failure who had received hemodialysis three times per week for 4 years developed neuroleptic malignant syndrome 10 days after taking amoxapine. His condition was characterized by muscle rigidity, elevation of body temperature and altered consciousness. Although he was treated with dantrolen and supportive care as well as discontinuation of amoxapine, his condition rapidly deteriorated, resulting in death. Because the pharmacokinetics of drugs, especially those such as antidepressants, in patients with chronic renal failure has not been fully clarified, one should be careful about giving such patients these drugs.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 6 (1999), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: AbstractPurpose: We report only the second known patient with pelvic lipomatosis associated with proliferative cystitis in the Japanese literature, a 43-year-old mildly obese Japanese male who demonstrated radiographic findings characteristic of pelvic lipomatosis.Methods: Cystourethrography revealed an elevated pear-shaped bladder and an elongated and anteriorly displaced prostatic urethra. Computed tomography demonstrated excess intrapelvic fat that exhibited a density identical to that of subcutaneous fat tissue. Cystoscopic and histologic examination revealed concomitant proliferative cystitis composed of von Brunn’s nest, cystitis cystica and cystitis glandularis, but no malignant cells.Results/Conclusions: As a result of dietary control for 15 months, the proliferative cystitis improved mildly, but the amount of fat was unchanged.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    International journal of urology 4 (1997), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background We reviewed the functional outcome and late complications of continent urinary reservoirs (CUR) constructed with a cecocolonic segment, including the Indiana pouch, in 37 patients treated in our clinic. Methods The CUR procedure was performed on 37 patients, creating partially detubularized (PD) reservoirs in 9 patients, totally detubularized (TD) reservoirs in 16 patients and reservoirs with an ileal patch (IP) in 12 patients. Continence was achieved by the nipple valve in 10 patients and by ileal plication in 27 patients. The mean follow-up period was 46 months (range, 15 to 87 months). The function of the reservoir was evaluated by measurement of the intrareservoir pressure. Results Patients with the TD reservoir had less frequent appearance of involuntary, phasic elevation of the intrareservoir pressure (30.8%) than those with the PD reservoir (62.5%). In contrast, this phasic elevation was found in only 1 patient with an IP reservoir. The IP reservoir had the largest capacity accompanied by the lowest maximum intrareservoir pressure. Total incontinence was observed in 2 patients with ileal plication due to disruption of the plicated sutures on the terminal ileum. Frequent difficulty in catheterizing the reservoir was found in 2 patients, and reservoir-ureter reflux was found in 3 renal units. The serum chloride level was significantly elevated after surgery, however, in most patients the levels remained within normal limits. Conclusion Our experience of the outcome and late complications of reservoirs indicates that the cecocolonic reservoir with an ileal patch and stapled ileal plication, i.e., the Indiana pouch, is a better choice for continent urinary diversion for patients who need a cystectomy.
    Type of Medium: Electronic Resource
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