Clinical statistics on operations for inpatients at Department of Urology, Tokai University Hospital 1975-1989]

Operations on inpatients during the 15-year period from 1975 to 1989 were analyzed statistically. A total of 3,791 operations were performed at our Department of Urology, including 717 operations on the kidney, 316 operations on the ureter, 583 operations on the bladder, 811 operations on the prostate, 136 operations on the urethra, 1,097 operations on the scrotum, 43 operations on the adrenal gland, 19 operations on the retroperitoneal space and 69 operations on other organs.     

Statistics on operations at the Department of Urology, School of Medicine, Tokai University (January, 1982 to March, 1984)

A total of 794 operations were performed at the Department of Urology, Tokai University Hospital between January, 1982 and March, 1984, including 5 operations on the adrenal gland, 64 operations on the kidney, 48 operations on the ureter, 93 operations on the urinary bladder, 124 operations on the prostate, 25 operations on the urethra, 124 operations on the penis, 190 operations on the scrotum and 19 operations on other organs.     

A controlled, double-blind, cross-over study of terodiline in motor urge incontinence

In a placebo-controlled, randomized, double-blind, cross-over study, terodiline (50 mg/d) was compared with emepronium (600 mg/d) in 20 patients with motor urge incontinence. Evaluation of clinical efficacy was based on changes in micturition pattern, flow measurements, residual urine, cystometry and patient preferences, and safety on adverse reactions, blood chemistry, urine examinations and ECG. The number of voluntary micturitions decreased from a mean of 21.5 per 48 h on placebo by 1.6 on terodiline and 2.8 on emepronium. Involuntary micturitions decreased from 3.6 per 48 h by 1.3 on both treatments (p less than 0.05). The maximal flow rate decreased from a mean of 24.5 ml/sec to 19.6 ml/sec on emepronium and increased to 25.4 ml/sec on terodiline. Residual urine decreased from a mean of 54 ml to 49 ml on terodiline and increased to 60 ml on emepronium. Volume at first desire to void in the supine position increased on emepronium by 44 ml (p less than 0.05) and on terodiline by 3 ml, on the upright position by 11 ml and 18 ml, respectively. Bladder capacity increased in the supine position on emepronium by 32 ml and decreased on terodiline by 8 ml, in the upright position increased by 9 ml and 5 ml, respectively. The bladder pressure at first desire to void in the supine position increased on emepronium by 2 cmH2O, and decreased on terodiline by 2 cmH2O. The intravesical pressure at strong desire to void decreased on emepronium by 6 cmH2O and on terodiline by 7 cmH2O, in the upright position by 2 cmH2O and 1 cmH2O, respectively. 39% of the patients preferred terodiline, 39% emepronium and 22% placebo.(ABSTRACT TRUNCATED AT 250 WORDS)     

Daily practices, consumption and citizenship

This paper promotes a reflection on the relationship between daily practices and consumption. Understanding how conflicts, resistance and consensus are generated from daily consumption practices opens up possibilities for reflecting on the construction of sustainability in the context of diversity, one of the landmarks of the globalized world. Within this socio-cultural context, the central issue is: can consumption generate citizenship practices? The concepts of subject and agent help one think about collective action and subjectivation processes and their interferences on the collective consuming behavior. Based on empirical data from a research carried out in the municipality of Estrela in 2007, in the Taquari Valley - Rio Grande do Sul (Southern Brazil) on local reality consumption practices, it was possible to conclude that various reasoning mechanisms and values underlie the daily consumption practices. Citizenship construction, based on consumption practices, depends on the subject's reflection capacity on his/her daily practices or on what goes through the circulation of environmental information based on sociability spaces.     

Quantitative evaluation of the growth of established cell lines on the surface of collagen,collagen composite and reconstituted basement membrane

Summary As a step in the development of a system for assessing growth of human urothelium and transitional cell carcinoma, the growth of two established cell lines on collagen-based membranes has been evaluated. HT1080 (metastatic human fibrosarcoma) and WI38 VA13 (virus-transformed human fibroblasts) were grown on substrates of collagen, collagen/hyaluronic acid or chondroitin sulphate and reconstituted basement membrane (Matrigel). Cell growth was quantified using a new fluorimetric assay utilizing carboxyfluorescein diacetate. There were differences in morphology between cells grown on collagen and those grown on polystyrene. There were, however, no differences in growth of the WI38 VA13 cells on collagen compared with polystyrene, but growth of the HT1080 cells was increased on membranes of collagen/2:5% hyaluronic acid and collagen/5% chondroitin sulphate, and decreased on Matrigel. Adequate growth on collagen substrates is dependent on cell line. The fluorimetric assay used was suitable for quantifying cell growth on such substrates.     

对脊柱侧凸畸形手术矫治中整体观点的探讨

根据脊柱侧凸的三个主要畸形：某段脊柱的弯曲，凸侧剃刀背的隆起，及凹侧的塌陷。作者在哈灵顿手术的基础上，进行了剃刀背部分肋骨节段切除，弯曲脊柱的撑开和凹侧肋骨的提升等手术，对改善外观有明显效果。强调在矫形手术时，必须具有整体的观点。     

Dialysis outcomes and analysis of practice patterns suggests the dialysis schedule affects day-of-week mortality

The risk of death for hemodialysis patients is thought to be highest on the days following the longest interval without dialysis (usually Mondays and Tuesdays); however, existing results are inconclusive. To clarify this we analyzed Dialysis Outcomes and Practice Patterns Study (DOPPS) data of 22,163 hemodialysis patients from the United States, Europe, and Japan. Our study focused on the association between dialysis schedule and day of the week of all-cause, cardiovascular, and noncardiovascular mortality with day-of-week coded as a time-dependent covariate. The models were adjusted for dialysis schedule, age, country, DOPPS phase I or II, and other demographic and clinical covariates, and compared mortality on each day to the 7-day average. Patients on a Monday-Wednesday-Friday (MWF) schedule had elevated all-cause mortality on Mondays, and those on a Tuesday-Thursday-Saturday (TTS) schedule had increased risk of mortality on Tuesdays in all three regions. The association between day-of-week mortality and schedule was generally stronger for cardiovascular than noncardiovascular mortality, and was most pronounced in the United States. Unexpectedly, Japanese patients on a MWF schedule had a higher risk of noncardiovascular mortality on Fridays, and European patients on a TTS schedule experienced an elevated cardiovascular mortality on Saturdays. Thus, future studies are needed to evaluate the influence of practice patterns on schedule-specific mortality and factors that could modulate this effect.     

Surgical statistics of the Department of Urology, Isesaki Municipal Hospital during a five-year period (June 1998-May 2003)

We reviewed the surgical statistics of the Department of Urology, Isesaki Municipal Hospital between June 1998 and May 2003. A total of 1940 surgeries were performed. These consisted of 399 surgeries on the kidney, adrenal, and pelvis, 212 on the ureter, 433 on the bladder, 256 on the prostate, 149 on the urethra and the penis, 192 on the scrotum, 255 on the arteriovenous fistula and CAPD. In September 2003, a screening program for prostate cancer was started, and the number of prostate biopsies and total prostatectomies increased. As the adaptation of many procedures to laparoscopy expanded, the number of laparoscopic surgeries increased.     

Evaluation of knee instability in acute ligamentous injuries

The stability on clinical examination (CE) and examination under anaesthesia (EUA) was evaluated in 350 consecutive acute knee injuries. Valgus instability in knees with a medial collateral tear was observed on CE in 62 and on EUA in 67 cases (p less than 0.05). The anterior drawer sign was positive in 55 patients on CE and in 110 patients on EUA (p less than 0.0001), the corresponding figures for the Lachman test were 66 and 126 respectively (p less than 0.0001). The pivot shift-test was positive in 13 cases on CE and in 87 under anaesthesia (p less than 0.0001). Fresh total tears of the anterior cruciate ligament (confirmed at arthrotomy, n = 79) were detected by the Lachman test in 48 per cent on CE and in 96 per cent on EUA. Of the nine fresh, total tears of the posterior cruciate ligament three were disclosed by the posterior drawer test on CE and all nine on EUA. Anteromedial rotatory instability was observed on CE in 10 patients and on EUA in 47 (p less than 0.0001). In these patients 41 medial collateral tears, 23 posteromedial capsular tears, 21 medial meniscus and 40 anterior cruciate lesions were found. On CE only one anterolateral rotatory instability was found, whereas EUA disclosed 9 cases. Posteromedial rotatory instability was not confirmed on CE, though on EUA four cases were found. CE and EUA detected 2 and 3 posterolateral instabilities respectively. In conclusion, the use of EUA with an adequate mode of stability evaluation in acute knee injuries is strongly advocated. Clinical examination is considered highly unreliable with many false negative findings.     

Quantitative measurement of neurologic impairment in patients with multiple sclerosis.

Eleven patients with clinically diagnosed multiple sclerosis were simultaneously evaluated with history, physical, and neurologic evaluations and a series of objective neurophysiologic tests. Patients were then scored independently on clinical stage of their disease using a system based on symptoms in history or findings on physical or neurologic examination. Test scores on objective tests were compared with clinical scores with each evaluator. Patients with high test scores on clinical evaluation usually had high test scores on objective testing. Symptoms and physical findings were then correlated with abnormalities on objective tests. Objective abnormalities in visual evoked response and auditory evoked response on several occasions preceded the development of symptoms. All patients except for two had more than one abnormality on objective testing, suggesting a high likelihood that objective tests are helpful in the diagnosis of early-stage multiple sclerosis.     

不对称乳房美容整形治疗的探讨

目的探讨各种不同类型的不对称乳房的手术治疗方法。方法对48例不同类型的不对称乳房者，分别采用不同的乳房成形术进行矫治，其中包括两侧不同容积的乳房假体隆乳术(19例)，单侧隆乳术(11例)，切除两侧不同体积的乳房组织乳房缩小成形术(9例)，单侧乳房部分切除术(2例)，单侧乳房脂肪抽吸术(1例)，一侧巨乳房缩小成形术，一侧乳房悬吊术(3例)，一侧乳房悬吊，一侧隆乳术(2例)，单侧乳房悬吊(1例)。结果1例因乳房新皱襞下皮肤、皮下组织过多，进行了再次整复术。1例乳房悬吊术后半年，继发轻度下垂。1例因原乳腺组织切除过多且伴有乳房局部较大瘢痕，乳房前外侧稍有凹陷，形态不够满意。其余各例都取得了满意或基本满意的效果。结论对不对称乳房应针对不同的类型采用不同的术式治疗，不对称乳房的检查和测量应力求准确．以便达到尽可能的对称。     

Post-tonsillectomy pain: a prospective, randomised and double-blinded study to compare an ultrasonically activated scalpel technique with the blunt dissection technique

Thirty-two patients participated in a study to compare the use of an ultrasonically activated scalpel (Harmonic scalpel) for tonsillectomy on one side and a blunt dissection tonsillectomy on the other. Pain scores at rest and on swallowing expressed as the area under curves (AUC) during the 10 h after surgery, intra-operative blood loss and the need for electrocoagulation for haemostasis were significantly higher on the blunt dissection side than on the Harmonic scalpel side (p < 0.05). However, pain scores expressed as AUC at rest, on swallowing, the day's least, average and worst levels of pain, and the day's worst otalgia during the second week after surgery were significantly higher on the Harmonic scalpel side than on the blunt dissection side. In conclusion, we found that Harmonic scalpel tonsillectomy was associated with decreased severity in pharyngeal pain on the day of the operation but increased pharyngeal pain and otalgia during the second postoperative week.     

Transfer of cefoperazone into exudate from postoperative wound

The levels of cefoperazone (CPZ) in the exudate from the postoperative would were measured in 10 cases for which CPZ was employed for prophylaxis of postoperative infections. The mean total volume of the exudate from postoperative wounds in these patients was 96.3 +/- 77.81 ml on Day 1, 14.6 +/- 17.1 ml on Day 2, 17.2 +/- 14.3 ml on Day 3, 32.0 +/- 17.0 ml on Day 4 and 34.0 ml (n = 1) on Day 5 of the postoperative period, and their CPZ level was, respectively 31.3 +/- 16.3, 31.2 +/- 19.4, 15.0 +/- 7.04, 13.4 +/- 6.78, and 2.45 micrograms/ml (n = 1), respectively with the level exceeding 30 micrograms/ml on Day 2 of the postoperative period and gradually decreasing thereafter. Recovery of CPZ during this period was 2941.1 +/- 2775.8 on Day 1, 375.3 +/- 445.9 on Day 2, 261.9 +/- 477.5 on Day 3, 371.4 +/- 10.5 on Day 4 and 83.3 micrograms (n = 1) on Day 5 of the postoperative period. In other words, of the total daily dose, 0.074, 0.009, 0.007, 0.009 and 0.002 appeared in the wound on Day 1, 2, 3, 4 and 5 of the postoperative period, respectively. Judging from the daily changes in the level of CPZ in the exudate and from the clinical results that all cases except one responded to this drug, it is evident that CPZ is highly useful for prophylaxis of postoperative infections, particularly for prophylaxis of infections of the postoperative wounds.     

MRI对椎体骨折与愈合过程的评价

目的总结与评价MRI对外伤性椎体骨折的诊断和愈合过程的诊断价值。方法回顾性分析62例椎体外伤骨折．共83个椎体．分为压缩性骨折、爆裂性骨折、隐匿性骨折。结果新鲜压缩性骨折T1WI信号，T2WI呈高信号，STIR序列呈高信号：陈旧压缩性骨折T1WI呈高信号，T2WI呈低信号，STIR序列呈低信号；爆裂性骨折T1WI呈高低混杂信号，T2WI呈高信号，STIR序列呈高信号。椎体呈分裂状：隐匿性骨折为T1wI及T2WI对应位置条状低信号，且于T1WI低信号周同见片状高信号，STIR序列呈高信号．结论MRI可以从椎体信号的变化来评价椎体外伤性骨折的程度与康复过程，且能够弥补传统X线与CT诊断椎体骨折的诸多不足之处。     

Effects of aminobenzyl penicillin (AB-PC), methylchlorophenyl isoxazolyl penicillin (MCI-PC) and 6-aminopenicillanic acid (6-APA) on the contractile response of guinea-pig urinary bladder

The present study was undertaken to investigate the effects of aminobenzyl penicillin (AB-PC), methylchlorophenyl isoxazolyl penicillin (MCI-PC), and 6-aminopenicillanic acid (6-APA) on the contractile response of guinea-pig urinary bladder. AB-PC, MCI-PC, and 6-APA, respectively, diminished the intramural electrical stimulation-induced contractile response. AB-PC had almost no effect on the contractile response to exogenous acetylcholine, while MCI-PC remarkably reduced it. The reducing effect of MCI-PC was greater on the intramural electrical stimulation-induced contractile response than it is on the exogenous acetylcholine-induced contractile response. 6-APA slightly reduced the exogenous acetylcholine-induced contractile response. The reducing effect of 6-APA was a little weaker on the exogenous acetylcholine-induced contractile response than it is on the intramural electrical stimulation-induced contractile response. By the addition of AB-PC, the amplitude of spontaneous contractile response of the tissue was reduced gradually with light lowering of the tonus level of the tissue was almost prevented with a little lowering of the tonus level of the tissue. The effects of AB-PC and MCI-PC on the spontaneous contractile response of the tissue mentioned above were also observed in the presence of tetrodotoxin. On the other hand, by the addition of 6-APA, the reducing effect on the amplitude of spontaneous contractile response of the tissue and increasing effect on its frequency were recognized with remarkable raise of the tonus level of the tissue. These phenomena which were induced by 6-APA were also observed in the presence of tetrodotoxin. From these results, the conclusion comes as follows: 1) AB-PC may affect not only on the muscle but also on the intramural cholinergic nerves. 2) MCI-PC may affect on the muscle, but its effect on the intramural nerves is also not likely to be negligible at this time. 3) 6-APA may affect mainly on the muscle.     

Reactive hyperemia in skin after cardiopulmonary bypass

OBJECTIVE: To study reactive hyperemia (RH) using a transcutaneous PO2/PCO2 combination electrode heated to 37 degrees C and tissue reflectance spectrophotometry in patients before and after cardiopulmonary bypass (CPB) to determine whether microcirculatory function of skin is altered. DESIGN: Prospective study. SETTING: Anesthesiology and critical care unit of a university hospital. PARTICIPANTS: Eight patients undergoing elective CPB under mild hypothermia. INTERVENTIONS: To produce RH, blood flow to the forearm was prevented by inflation of a cuff to 300 mmHg for an interval of 5 minutes. MEASUREMENTS AND MAIN RESULTS: Measurements were obtained on the day prior to surgery (DPS), on the day of surgery (DOS) rewarmed to 37 degrees C in the intensive care unit (ICU), and on the first (POD 1) and the third postoperative days (POD 3). The following parameters were recorded: preocclusive baseline cutaneous PO2, and PCO2 (B-PtcO2, B-PtcCO2), and microvascular hemoglobin saturation (B-HbO2); postischemic peak of PtcO2, PtcCO2, and HbO2; and 10 minutes after release of the cuff occlusion posthyperemic PtcO2, PtcCO2, and HbO2. B-PtcO2 was 3.5 +/- 1.2 mmHg on DPS, 2.6 +/- 0.7 mmHg on DOS, 1.5 +/- 0.3 mmHg on POD 1, and 3.5 +/- 3.5 mmHg on POD 3. B-PtcCO2 increased significantly from 40.1 +/- 2.5 mmHg to 52.2 +/- 2.0 mmHg on DOS (p = 0.01) and to 48.9 +/- 3.6 mmHg on POD 1 (p = 0.02). On POD 3, B-PtcCO2 was 40.6 +/- 2.6 mmHg. B-HbO2 declined from a preoperative value of 42.4% +/- 8.6% to 37.1% +/- 14.7% on DOS and further to 21.7% +/- 4.8% on POD 1, which was significantly different (p = 0.03). On POD 3, B-HbO2 still remained lower (30.7% +/- 6.2%) compared with the preoperative value. RH (deltaPtcO2, deltaHBO2) was quantified as the differences between peak PtcO2, HBO2 and B-PtcO2, B-HBO2. DeltaPtcO2 was 13.0 +/- 2.3 on DPS, 11.3 +/- 2.9 on DOS, 12.6 +/- 2.6 on POD 1, and 11.5 +/- 3.5 on POD 3. DeltaHBO2 was 42.0 +/- 5.6 on DPS, 40.0 +/- 7.1 on DOS, 49.9 +/- 2.5 on POD 1, and 52.9 +/- 6.4 on POD 3. The elimination rate of carbon dioxide from skin (ECO2) was calculated as difference between peak PtcCO2 and PtcCO2 after 3 minutes of reperfusion divided by the difference between peak PtcCO2 and B-PtcCO2. ECO2 was 1.0 +/- 0.2 kPa/min on DPS, 0.7 +/- 0.1 kPa/min on DOS, and 0.8 +/- 0.1 kPa/min on POD 1 and POD 3. CONCLUSION: Cutaneous microcirculation assessed by RH is well preserved during the immediate postoperative period in patients undergoing uncomplicated coronary artery surgery with CPB.     

Preliminary Observations on the Effect of Parity on First Day Ultrasonic Detection of Embryo and its Organs in Bovine

The aim of this study was to determine the effect of parity on the first day of ultrasonic detection of embryo and its organs using 8 MHz frequency. For this purpose, six nulliparous heifers, five primiparous cows and six multiparous cows of the Holstein breed were selected and mated by a single bull from the herd. From day 16 after mating, cows and heifers were examined by ultrasonography thrice weekly for the day of first detection of the embryo and its organs. The mean of first‐day detection in heifers, primiparous and multiparous cows was as follows, respectively: allantois on days 22.3, 23 and 25.8; embryo proper on days 21.8, 23 and 27; heartbeat of embryo on days 26.1, 26.6 and 31.1; amnion on days 31, 31 and 30.8; limb buds on days 29.5, 28.8 and 30.6; stomach (abomasum) on days 32.2, 38.6 and 36.8; spinal column on days 32.6, 33.4 and 37.3; placentomes on days 33.3, 37 and 35.3; eyes on days 35.1, 35.4 and 38.6 and lens on days 40, 41.4 and 44. Although the mean of first day observation of all structures in heifers tends to be earlier than in the other groups, statistically, allantois, the embryo proper and its heartbeat in heifers and primipara were visualized significantly earlier than in multiparous cows. However, there were no differences between heifers and primiparous cows.     

Doctoral theses and memoirs about anesthesia. Documents for a history of Spanish anesthesia]

Based on the importance of document files and first-hand bibliographic sources for studying the history, we have recently investigated the chapter of Doctoral Thesis and Reports on anesthetic topics since we believe that these are fundamental to gain insight into the knowledge of our history. This investigation was planned to find such documents by reviewing the data of several Spanish archives and libraries. We collected 80 works: 14 Reports and 66 Doctoral Theses performed during a period of 95 years (heuristic limits 1847-1942). These papers were classified in several subgroups according to the subjects they deal with: 21 works on inhalation anesthesia, 7 on intravenous general anesthesia, 20 on spinal anesthesia, 10 on locoregional, 7 on anesthesia and metabolism, 12 on obstetric anesthesia, and 3 works on varied anesthesia issues. Analysis of these documents revealed that the authors (physicians and Spanish medical corporations) undertook an accurate consideration of the more relevant scientific subjects at the time of their investigation. We conclude that the works analyzed in the present study represented the beginning of the Spanish investigation on anesthesia. Further investigations may contribute to enrich our historiography.     

Expression of peroxisome proliferator-activated receptor-gamma in renal ischemia-reperfusion injury

The pathogenesis of ischemia-reperfusion injury is known to involve cytokines and particularly surface adhesion molecules, the expression of which initiates the attachment of inflammatory cells. Peroxisome proliferator-activated receptor (PPAR)-gamma is considered an important immunomodulatory factor as well as a fatty acid regulator. In this study, we researched the expression of PPAR-gamma in renal ischemia-reperfusion injury of the rat. The right kidney was harvested and left renal artery and vein were clamped under laparotomy. The kidney was reperfused after 90 minutes of ischemia, and rats were sacrificed at 0, 1.5, 3, 5, 12, and 24 hours after reperfusion. PPAR-gamma expression was analyzed by immunohistochemical staining using monoclonal antibody. In normal kidney, PPAR-gamma staining was weak on endothelial cells, including mesangial cells. On the other hand, PPAR-gamma staining was weak on interstitial cells and strong on collecting ducts of medulla. From 1.5 to 5 hours after reperfusion, PPAR-gamma staining was strong on endothelial cells, moderate on interstitial cells, and strong on collecting ducts. Twelve hours after reperfusion, PPAR-gamma staining was weak on endothelial cells, moderate on interstitial cells, and strong on collecting ducts. PPAR-gamma is induced on collecting ducts, interstitial cells, and endothelial cells in a rat model having renal ischemia-reperfusion injury.     

大网膜人工窦道预防胆管引流管拔出后胆漏的动物实验研究

目的探讨采用带蒂大网膜在胆管引流管周围做成人工窦道的方法及效果。方法建立实验兔胆管引流动物模型。100只新西兰大白兔随机分为2组,即实验组及对照组。每组再随机分成5个亚组,每亚组10只,在手术后3、6、9、12、15d分别剖腹了解5亚组中一亚组胆管引流管窦道形成情况,并取部分窦道壁送病理检查。结果实验组在不同时间点,窦道完全形成动物数分别为:3d8只,6d10只,9d10只,12d10只,15d10只;对照组分别为:3d1只,6d1只,9d2只,12d3只,15d4只。两组比较差异有统计学意义(P<0.01)。结论采用带蒂大网膜在胆管引流管周围形成人工窦道的方法简单、实用,不仅可缩短留置T管的时间,而且可有效防止拔T管后胆漏的发生,值得临床推广使用。