Voiding patterns in men and women with lower urinary tract symptoms combined with nocturia

AIM: We evaluated differences between men and women with lower urinary tract symptoms (LUTS) combined with nocturia. METHODS: A total of 71 age-matched female-male pairs (median 58, range 20-81 years) who had moderate to severe LUTS and nocturia of more than once per night were enrolled in this study. RESULTS: In the younger group (<50 years), the International Prostate Symptom Score (I-PSS) results of the sexes were not significantly different. However, although total I-PSS results in the elderly group (> or =50 years) were not significantly different, quality of life index scores for women were higher (P = 0.002). On frequency-volume (FV) charts, mean total daytime voided volume (DVV) was significantly higher in younger men than in younger women (P = 0.017), but the mean nocturnal polyuria index (NPi) for women was higher than that for men (P = 0.047). However, maximum DVV (P = 0.009), mean DVV (P < 0.0001), total DVV (P < 0.0001), and mean nocturnal urine volume (P = 0.009) were significantly higher in elderly men than in elderly women. However, numbers of daytime voids were not different. CONCLUSION: Elderly women with LUTS have lower functional bladder capacities than elderly men, as suggested by their smaller mean voided volumes. However, no significant differences were observed between numbers of daytime voids, which was probably due to the smaller total daytime voided volumes of elderly women. In addition, although NPi for younger women and nocturnal urine volume for elderly men was higher, no other differences were observed in terms of other night-time parameters.     

Cardiac metastasis of renal pelvic cancer

Abstract:   A 66-year-old man was referred to our hospital with chest discomfort and shortness of breath. Seven months previously he had undergone a laparoscopic left nephroureterectomy for a left renal pelvic tumor and was given two cycles of adjuvant chemotherapy (methotrexate, epirubicin and cisplatin). Echocardiogram showed an 8-mm sized mass extending from the right atrium into the right ventricle. On computed tomography, multiple lung tumors, as well as the right atrial and ventricular mass, were seen. The patient died of acute heart failure caused by right ventricular outflow obstruction. On autopsy, a right atrial and ventricular metastasis of the initial transitional cell carcinoma was found. The patient's cause of death was acute heart failure as a result of cardiac metastasis of his initial renal pelvic carcinoma.     

Long Fibre Growth by Axons of Embryonic Mouse Hippocampal Neurons Microtransplanted into the Adult Rat Fimbria

We have described a method for the microtransplantation of a suspension of a few thousand cells from mid to late embryonic mouse hippocampi into the fimbria of immunosuppressed adult rat hosts. There was close graft-to-host contact, across a non-scarred interface. The transplanted cells included CA3 type pyramids, and were enclosed within the host myelinated fibre tract, whose glial framework was largely undisturbed. Immunohistochemistry of two species-specific markers (M6 and Thy-1.2) showed that the donor mouse neurons grew fine (<0.5 μm diameter) axons which extended singly or in fascicles through the rat host fimbria for a maximum distance of at least 10 mm. The donor axons were intimately integrated among and closely aligned to the host tract axons and to the interfascicular glial rows of the host tract. The axons travelled (i) laterally through the ipsilateral fimbria, (ii) medially across the midline in the ventral hippocampal commissure to reach the contralateral fimbria and alveus, and (iii) rostro-medially to the septum. On approaching the terminal fields appropriate to hippocampal CA3 pyramidal cell axons, the transplant axons gave rise to fine preterminal branches which were continuous with a reticular or amorphous immunoreactivity in the stratum oriens and stratum pyramidale of the ipsilateral hippocampus, and in the lateral and triangular septal nuclei. The donor axons extended along the host fimbria at a rate of ∼ 1 mm per day, reaching their terminal field destinations by ∼1–2 weeks. At 7 weeks the projections were maintained, but with little further extension. These observations indicate that the microenvironment of myelinated adult fibre tracts is permissive for an abundant and rapid growth of axons from transplanted embryonic cell suspensions. These axons can leave host tracts to invade appropriate terminal fields.     

针刺对血浆骨动素,生长抑素及内皮素的影响及其意义

探讨针刺调整调整胃肠功能机理中胃肠激素的作用。方法：对４０名健康人对进行针刺胃肠相关穴位试验，随机分４组，即天枢组，巨虚组，非穴位刺激组及空白组。各针刺组均观察针刺前，中，后６次血浆ＭＴＬ，ＳＳ及ＥＴ水平的动态变化，空白组不行针刺，只观察同一时间蚋ＭＴＬ，ＳＳ及ＥＴ水平的自然波动。     

单用体外震波碎石治疗尿路结石的体会

本文报道1988年6月～11月,单独应用上海交通大学电力工程系研制的JT—ESWL—Ⅱ型体外震波碎石机,治疗尿路结石506例,其中肾结石304例(双侧12例)输尿管结石199例(双侧5例),膀胱结石3例。冲击能量15～40焦耳,每次治疗冲击波次数为400～2800次。本组无开放手术、无肾脏丧失、无死亡。效果满意者96.44％。其并发症主要有血尿、结石串。作者认为单用ESWL治疗小于3Cm的尿路结石安全可靠、无严重并发症。文中对单用体外震波碎石(ESWL)治疗尿路结石病例选择,如何减少并发症,提高治疗效果进行了讨论。     

尿路复合性恶性肿瘤（附21例报告）

报告２１例尿路复合性恶性肿瘤，位于肾盂２例，膀胱１９例。主要临床表现为血尿，绝大多数病人伴有尿路刺激症状。低分化的移行细胞癌（ＴＣＣ）与继发性复合肿瘤有密切关系。２１例中１例为ＴＣＣ复合肉瘤，１１例为ＴＣＣ复合鳞癌，７例为ＴＣＣ复合腺癌，２例为腺癌复合鳞癌。本组２例肾盂肿瘤分别行肾输尿管全长加膀胱袖口状切除术和肾部分切除术，术后存活６个月和１年；膀胱肿瘤１４例行膀胱部分切除术，已生存３年４例，１年２例，未满１年２例，３例１～２年内死亡，失访３例；２例根治性膀胱全切术已生存５年和３年以上；３例行ＴＵＲＢｔ，已生存３年１例，１５年１例，未满１年１例。对尿路复合性恶性肿瘤的组织学、临床和病理特征进行了讨论。     

Single-dose oral omeprazole for reduction of gastric residual acidity in adults for outpatient surgery

Omeprazole is a substituted benzimidazole that causes dose-dependent intracellular inhibition of gastric acid secretion in humans. This double-blind study examined the effect of omeprazole in decreasing gastric acidity and gastric residual volume in outpatient adults. Unpremedicated outpatients, ASA I-III, 18 years or older (n = 17), were randomly assigned to receive omeprazole 80 mg, or placebo by mouth the night before scheduled elective outpatient surgery. The patients were fasted for 8 h prior to surgery. After the patient was anesthetized, an orogastric tube was inserted with proper placement verified by auscultation for gastric sounds. Gastric residual contents were withdrawn into a Luken's trap, and pH was then determined and gastric volume indexed to weight (ml.kg-1). Data were analyzed by a t-test, with P less than 0.05 considered statistically significant. Patient characteristics of both groups were similar. There was a statistically significant difference between the two groups for pH (P = 0.02), but not between the two groups for gastric volume indexed to weight (P = 0.07).     

The callous elbow and aging of the upper arm

The author describes his surgical approach to the problems of the aging upper arm and elbow region. Surgery at an appropriate age can prevent the progressive wrinkling of the elbow which is further aggravated by aging of the upper arm. The author's operation is aimed at correcting both portions of the arm anatomy at the same time.     

经皮肾穿气压弹道碎石联合体外冲击波碎石治疗上尿路结石

目的 探讨提高上尿路结石碎石成功率的微创治疗方法。方法 采用经皮肾穿微造瘘输尿管镜气压弹道碎石，术中放置双J管，术后配合体外冲击波碎石术(ESWL)治疗上尿路结石48例。结果 结石总排净率为89．1％，结石最小排净率79．2％，无严重并发症发生。结论 该方法结石排净率高，创伤较小，手术并发症少，是上尿路结石较为理想的微创治疗方法。     

Bleeding from foveolar hyperplasia developing on a gastrointestinal stromal tumor of the stomach

A 52‐year‐old Japanese woman who presented with gastrointestinal (GI) bleeding underwent a proximal gastrectomy for a gastrointestinal stromal tumor (GIST) with a foveolar hyperplasia at the apex of the tumor, 4.5 cm in size, located in the upper body of the stomach. Although GIST are often asymptomatic and are found only incidentally, clinical symptoms such as bleeding, abdominal pain, or obstruction, occasionally lead to a premorbid diagnosis. When submucosal tumors present GI bleeding, the source of the bleeding usually is an ulceration of the mucosa over the tumor. However, in the present study, it was thought that the bleeding originated from the region of foveolar hyperplasia.