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981.
982.
Akira Komiya Takumi Endo Masayuki Kobayashi Woojin Kim Kazuhiro Araki Yukio Naya Hiroyoshi Suzuki Toyofusa Tobe Tomohiko Ichikawa Hideki Fuse 《International journal of urology》2009,16(11):874-880
Objectives: To examine the pre-emptive analgesic effect of the non-steroidal anti-inflammatory drug zaltoprofen against rigid cystoscopy-associated pain, and compare it with the effect of an anesthetic gel.
Methods: Forty men periodically undergoing follow-up office cystoscopy were enrolled in this prospective study. The effects of lidocaine gel alone or in combination with zaltoprofen, were examined. The following parameters were assessed using an 11-point numerical rating scale: pain during injection of gel into the urethra, insertion of rigid cystoscope, and the endoscopic examination of the urinary bladder, pain at the first urination after cystoscopy, and at the first urination in the following morning at home.
Results: Pain scores with pre-emptive zaltoprofen plus lidocaine gel were significantly lower than the ones with lidocaine gel alone at the time points of inserting rigid cystoscope into the urethra, viewing inside the urinary bladder and the first urination after cystoscopy. The efficacy of zaltoprofen was more significant in the patients with higher baseline pain score. There was no correlation between pain scores and bladder cancer grading, number of tumors, and time from surgery.
Conclusions: Pre-emptive zaltoprofen is able to control cystoscopy-associated pain, which translates into better quality of life for patients. Thus, its use is recommended in the management of these patients. 相似文献
Methods: Forty men periodically undergoing follow-up office cystoscopy were enrolled in this prospective study. The effects of lidocaine gel alone or in combination with zaltoprofen, were examined. The following parameters were assessed using an 11-point numerical rating scale: pain during injection of gel into the urethra, insertion of rigid cystoscope, and the endoscopic examination of the urinary bladder, pain at the first urination after cystoscopy, and at the first urination in the following morning at home.
Results: Pain scores with pre-emptive zaltoprofen plus lidocaine gel were significantly lower than the ones with lidocaine gel alone at the time points of inserting rigid cystoscope into the urethra, viewing inside the urinary bladder and the first urination after cystoscopy. The efficacy of zaltoprofen was more significant in the patients with higher baseline pain score. There was no correlation between pain scores and bladder cancer grading, number of tumors, and time from surgery.
Conclusions: Pre-emptive zaltoprofen is able to control cystoscopy-associated pain, which translates into better quality of life for patients. Thus, its use is recommended in the management of these patients. 相似文献
983.
Kazuhiro Ishizaka Tatsuya Machida Masaki Tanaka Naoko Kawamura Keisuke Nakamura Kazunori Kihara 《International journal of urology》2009,16(3):299-302
Objective: The management of lower urinary tract symptoms that persist after radical prostatectomy remains to be established. We investigated whether an α1-blocker, naftopidil, improves LUTS in patients ≥1 year after radical prostatectomy.
Methods: A total of 29 male patients received 25 mg/day of naftopidil for the first week, then 75 mg/day for 4 weeks. The frequency-volume chart, international prostate symptom score and quality of life index (QOL) were examined before and at the end of the 5-week administration in all subjects.
Results: Total international prostate symptom score (I-PSS) and I-PSS subtotals associated with voiding symptoms and storage symptoms were significantly decreased at 5 weeks compared with baseline ( P < 0.001 each). QOL index was significantly improved with naftopidil for 5 weeks ( P < 0.001). From analyses of the frequency-volume chart, mean and maximum volume/void were significantly increased ( P < 0.05 each).
Conclusion: Lower urinary tract symptoms detected in patients ≥1 year after radical prostatectomy were markedly improved with administration of naftopidil at 75 mg/day. These symptoms could represent a novel target for medical treatment by improved understanding of the symptom pathology in the near future. 相似文献
Methods: A total of 29 male patients received 25 mg/day of naftopidil for the first week, then 75 mg/day for 4 weeks. The frequency-volume chart, international prostate symptom score and quality of life index (QOL) were examined before and at the end of the 5-week administration in all subjects.
Results: Total international prostate symptom score (I-PSS) and I-PSS subtotals associated with voiding symptoms and storage symptoms were significantly decreased at 5 weeks compared with baseline ( P < 0.001 each). QOL index was significantly improved with naftopidil for 5 weeks ( P < 0.001). From analyses of the frequency-volume chart, mean and maximum volume/void were significantly increased ( P < 0.05 each).
Conclusion: Lower urinary tract symptoms detected in patients ≥1 year after radical prostatectomy were markedly improved with administration of naftopidil at 75 mg/day. These symptoms could represent a novel target for medical treatment by improved understanding of the symptom pathology in the near future. 相似文献
984.
Mitsugu Sekimoto Atsushi Nishikawa Kazuhiro Taniguchi Shuji Takiguchi Fumio Miyazaki Yuichiro Doki Masaki Mori 《Surgical endoscopy》2009,23(11):2596-2604
Background
Laparoscope manipulating robots are useful for maintaining a stable view during a laparoscopic operation and as a substitute for the surgeon who controls the laparoscope. However, there are several problems to be solved. A large apparatus sometimes interferes with the surgeon. The setting and repositioning is awkward. Furthermore, the initial and maintenance costs are expensive. This study was designed to develop a new laparoscope manipulating robot to overcome those problems.Methods
We developed a compact robot applicable for various types of laparoscopic surgery with less expensive materials. The robot was evaluated by performing an in vitro laparoscopic cholecystectomy using extracted swine organs. Then, the availability of the robot to various operations was validated by performing a laparoscopic cholecystectomy, anterior resection of the rectum, and distal gastrectomy using a living swine. The reliability of the system was tested by long-time continuous running.Results
A compact and lightweight laparoscope manipulating robot by the name of P-arm was developed. The surgical time of an in vitro laparoscopic cholecystectomy with and without the P-arm was not different. The three types of operations were accomplished successfully. During the entire procedure, the P-arm worked without trouble and did not interfere with the surgeons. Continuous 8-h operating tests were performed three times and neither discontinuance nor trouble occurred with the system.Conclusions
The P-arm worked steadily for various swine operations, without interfering with surgeon’s work. 相似文献985.
Low-level activation of N-methyl-d-aspartate receptors (NMDARs) results in a decrease in the ability of tetanic stimulation to induce long-term potentiation (LTP). This NMDAR-mediated LTP inhibition is observed with low micromolar concentrations of NMDA or chelation of ambient extracellular zinc. In rat hippocampal slices, we examined whether LTP inhibition by 1 muM NMDA and zinc chelation share common mechanisms. We found that both forms of LTP inhibition involve nitric oxide (NO) synthase (NOS) and calcineurin. Furthermore, both forms of LTP inhibition are overcome by block of p38 mitogen-activated protein kinase (MAPK), but not by inhibition of extracellular signal-regulated kinase 1/2 or c-Jun-N-terminal kinase. A p38 antagonist also overcame the block of LTP by sodium nitroprusside, an agent that releases NO, suggesting that NO release occurs upstream of MAPK activation. Despite the involvement of p38 MAPK in NMDAR-mediated LTP inhibition, p38 antagonism did not enhance LTP induction in response to weak tetanic stimulation under baseline conditions. These results indicate that p38 MAPK is part of a complex NMDAR-driven signaling pathway involving calcineurin and NO that helps to regulate synaptic plasticity in the CA1 region. 相似文献
986.
Li GY Watanabe I Kunitake Y Sugataka K Muraoka T Kojima N Kawashima T Yamada S 《Psychiatry and clinical neurosciences》2008,62(5):562-567
Aims: A large number of studies on the monoamine systems in Alzheimer's disease (AD) have found abnormalities of the noradrenergic system in the brain, but there has been no report concerning the relationship between noradrenergic activity and cognitive function in elderly living in a community. The aim of the present study was to explore the relationship between saliva level of 3‐methoxy‐4‐hydroxyphenylglycol (sMHPG) and mental health in this population. Methods: The study was to examine the relationship between sMHPG and performance on the Mini‐Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Beck Depression Inventory (BDI) in 213 elderly people living in the local community. Results: sMHPG in female subjects was positively correlated with age (r = 0.24, P = 0.003) and negatively correlated with scores on the MMSE (r = ?0.26, P = 0.0016) and FAB (r = ?0.19, P = 0.024), even after controlling for the effect of age (MMSE r = ?0.20, P = 0.013). Notably, sMHPG was correlated with the pentagon drawing score (P = 0.0008) of MMSE. sMHPG was significantly correlated with BDI score in male subjects, but negatively correlated in female subjects. A gender difference was found in the relationship between the sMHPG and BDI score. Conclusion: The measurement of sMHPG may be a useful marker of mental health in elderly community‐dwelling subjects. 相似文献
987.
Levine AJ Hinkin CH Ando K Santangelo G Martinez M Valdes-Sueiras M Saxton EH Mathisen G Commins DL Moe A Farthing C Singer EJ 《Journal of clinical and experimental neuropsychology》2008,30(7):836-843
Central nervous system opportunistic infections (CNS-OI) are a significant cause of morbidity and mortality in AIDS. While current interventions are increasingly successful in treating CNS-OI, little information exists regarding long-term behavioral outcomes among survivors. In this exploratory study we examined neurocognitive data among three groups of adults with different AIDS-related CNS-OI: 15 with past cryptococcal meningitis (CM), 8 with toxoplasmosis encephalitis (TE), and 8 with progressive multifocal leukoencephalopathy (PML). A group of 61 individuals with AIDS, but without CNS-OI, was used as a comparison group. A battery of standardized neuropsychological tests assessing a variety of cognitive domains was administered upon entry. Results indicate that individuals with a history of CNS-OI were most impaired on measures of cognitive and psychomotor speed relative to the HIV+ comparison group. Among the CNS-OI groups, individuals with history of TE had the most severe and varied deficits. The results are discussed in relation to what is known about the neuropathological consequences of the various CNS-OIs. While this is the first systematic group study of residual CNS-OI effects on neurocognitive function, future studies employing more participants, perhaps focusing on specific CNS-OIs, will further characterize the long-term outcomes in AIDS-related CNS-OI. 相似文献
988.
989.
Miyakawa S Ishihara S Takada T Miyazaki M Tsukada K Nagino M Kondo S Furuse J Saito H Tsuyuguchi T Kimura F Yoshitomi H Nozawa S Yoshida M Wada K Amano H Miura F;Japanese Association of Biliary Surgery;Japanese Society of Hepato-Biliary-Pancreatic Surgery;Japan Society of Clinical Oncology 《Journal of Hepato-Biliary-Pancreatic Surgery》2008,15(1):7-14
No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts
for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile
duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated
type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and
pain in the upper right area of the abdomen. The first step of diagnosis is to carry out blood biochemistry tests and ultrasonography
(US) of the abdomen. The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography
(CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography
(PTC), and endoscopic retrograde cholangiopancreatography (ERCP). Because resection is the only way to completely cure biliary
tract carcinoma, the indications for resection are determined first. In patients with resectable disease, the indications
for biliary drainage or portal vein embolization (PVE) are checked. In those with nonresectable disease, biliary stenting,
chemotherapy, radiotherapy, and/or best supportive care is selected. 相似文献
990.
Two-stage operation for hepatocellular carcinoma with synchronous bilateral adrenal gland metastasis
Kondo K Chijiiwa K Nagano M Hamasuna R Yamashita A Marutsuka K Takahashi N Akiyama Y 《Journal of Hepato-Biliary-Pancreatic Surgery》2008,15(2):232-236
Hepatocellular carcinoma (HCC) frequently metastasizes to the adrenal glands. The surgical strategy for HCC associated with
bilateral adrenal gland metastasis is complicated because of the possibility of both postoperative hepatic failure and adrenal
insufficiency. We herein report a patient with HCC with synchronous bilateral adrenal gland metastasis that was treated successfully
with a two-stage operation. A 58-year-old man with HCC (12 cm in diameter) in the right lobe of the liver and bilateral adrenal
gland tumors (right, 4 cm in diameter; left, 5 cm in diameter) was admitted to our hospital. Extended right hemihepatectomy
and right adrenalectomy were performed simultaneously. The postoperative course was uneventful. Three months after this operation,
left adrenalectomy was performed via a retroperitoneal approach. Hydrocortisone supplement was given, and the postoperative
course was again uneventful. No recurrence was observed during the 10-month follow-up period. Two-stage surgery is a safe
treatment option for giant HCC with synchronous bilateral adrenal gland metastasis. 相似文献