bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of electrostimulation in detecting neurovascular bundle during radical prostatectomy
Authors: TSUJIMURA AKIRA , MIYAGAWA YASUSHI , TAKAO TETSUYA , MATSUMIYA KIYOMI , NAKAYAMA MASASHI , TSUJIMOTO YUICHIRO , TAKAHA NATSUKI , NISHIMURA KAZUO , NONOMURA NORIO , TAKADA TSUYOSHI , FUJIOKA HIDEKI , KUROKAWA KOHEI , AOZASA KATSUYUKI , OKUYAMA AKIHIKO 
Published: July 2006

Objective:  The reported rate of erectile dysfunction after nerve‐sparing prostatectomy varies according to physicians. Because exact preservation of the neurovascular bundle (NVB) solely depends on the judgment of the physician, he or she should try to correctly identify the NVB and also avoid neurophysiologic injury of the NVB during the procedure. The purpose of the present study is to assess the status of the NVB preservation by physician’s judgment at the operation, the changes in intracavernous pressure related to intraoperative electrical stimulation and postoperative histopathological examination.Patients and Methods:  Thirty‐eight patients who underwent nerve‐sparing radical prostatectomy judged by intraoperative electrical stimulation of the NVB were included in this study. Bilateral, unilateral and non‐nerve‐sparing procedures were performed in 18, 17, and 3 cases, respectively. The NVB preservation evaluated by intraoperative physician’s judgment was compared to that evaluated by postoperative histopathological examination. Furthermore, the NVB preservation evaluated by intraoperative electrical stimulation was compared to that by physician’s judgment and postoperative histopathological examination.Results:  For 68 of 76 NVB (89.5%), intraoperative subjective judgment and histopathological assessment were identical. For 66 of 76 NVB (86.8%), electrical stimulation findings and the physician’s judgments were identical, and for 70 of 76 NVB (92.1%), electrical stimulation findings and histopathological findings were identical.Conclusion:  Even if physicians are convinced of a successful nerve‐sparing procedure, there are some cases in which the NVB is not preserved accurately or neurophysiological damage is suffered. Therefore, intraoperative electrical stimulation of the NVB as well as the cavernosal nerve is very useful in evaluation of NVB preservation.
Comparison of 25 and 75 mg/day naftopidil for lower urinary tract symptoms associated with benign prostatic hyperplasia: A prospective, randomized controlled study
Authors: YOKOYAMA TERUHIKO , KUMON HIROMI , NASU YOSHITSUGU , TAKAMOTO HITOSHI , WATANABE TOYOHIKO 
Published: July 2006

Background:  The present study investigated the efficacy, safety, and utility of starting an α1d‐selective antagonist, naftopidil, at 75 or 25 mg/day in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).Methods:  In this prospective comparative study, the subjects comprised 153 patients with LUTS associated with BPH. Patients were randomized to receive either 25 mg/day (Group LD) or 75 mg/day (Group HD) of naftopidil for 4 weeks. The lower urinary tract disease symptom score (LUTDSS), the International Prostate Symptom Score (IPSS), the Quality of life assessment index, the maximum flow rate (Qmax), and the residual urine volume were compared between the groups.Results:  In both groups, the LUTDSS and the IPSS were significantly improved at the endpoint and no significant intergroup differences were identified. However, the improvement in the Qmax was significantly better for Group HD than for Group LD. The overall efficacy did not differ significantly between the groups. The degree of improvement in voiding symptoms and LUTDSS among patients with moderate symptoms was significantly greater for Group HD than for Group LD. The frequency of adverse reactions did not differ significantly between the groups.Conclusions:  Starting administration at 75 mg/day rather than 25mg/day is helpful for LUTS associated with BPH for patients with moderate symptoms, particularly in improving voiding symptoms. The 75 mg/day administration was considered to be a recommendable therapeutic dose in some patients.
Effect of prostate manipulation on the serum levels of complexed prostate‐specific antigen and total prostate‐specific antigen
Authors: LONG RONAN , GIRI SUBHASIS , DIVER SEAN , DUDDY LORNA , MCKEOWN DECLAN , MORAN KEVIN 
Published: July 2006

Background:  Recently there has been considerable interest in complexed prostate‐specific antigen (cPSA) as an alternative to total PSA (tPSA). Data regarding the variations of cPSA are limited. We performed a prospective study using different forms of prostate manipulation to demonstrate and compare variations between cPSA and tPSA.Methods:  The study included 113 men, 34 of whom had a digital rectal examination, 28 had a flexible cystoscopy, 17 had a rigid cystoscopy, 21 had a prostate biopsy, and 13 underwent a transurethral resection of the prostate (TURP). Blood samples were taken before and after manipulation for measurement of tPSA and cPSA.Results:  There was a statistically significant difference in the cPSA and tPSA before and after manipulation, with the exception of cystoscopy. On review of the data, it was clear that not all changes were clinically significant. The mean differences were greater for tPSA than for cPSA for all procedures. This was most apparent following prostate biopsy and TURP. Regression analysis also showed that cPSA and tPSA were affected differently by prostate manipulation.Conclusion:  Our results demonstrate that cPSA is less prone to variations when compared to tPSA.
Maximum tumor diameter is a simple and valuable index associated with the local extent of disease in clinically localized prostate cancer
Authors: MIZUNO RYUICHI , NAKASHIMA JUN , MUKAI MAKIO , OOKITA HAJIME , NAKAGAWA KEN , OYA MOTOTSUGU , OHIGASHI TAKASHI , MARUMO KEN , MURAI MASARU 
Published: July 2006

Background:  The present study was undertaken to investigate the association of pathological features, including the total tumor volume (TTV), maximum tumor area (MTA), and maximum tumor diameter (MTD), with the local extent of disease in clinically localized prostate cancer.Methods:  Serial whole sections of the prostate from 164 patients who underwent radical prostatectomy for localized prostate cancer were investigated. The correlations between the indicators of tumor size, including the TTV, MTA, and MTD, and other pathological parameters were evaluated.Results:  The MTD, MTA, and TTV were significantly correlated with each other. Multivariate stepwise logistic regression analysis indicated that the Gleason score, perineural invasion, microvascular invasion, and MTD were significant independent parameters associated with extraprostatic disease.Conclusion:  The histological tumor grade, perineural invasion, microvascular invasion, and tumor size were correlated with the local extent of disease. The MTD, a simple, easy, and inexpensive parameter, is a more significant pathological feature associated with the local extent of disease than the MTA or TTV.
Fournier’s gangrene: Report of thirty‐three cases and a review of the literature
Authors: TAHMAZ LUTFI , ERDEMIR FIKRET , KIBAR YUSUF , COSAR AHMET , YALCÝN ORHAN 
Published: July 2006

Background:  Fournier’s gangrene (FG) is an extensive fulminant infection of the genitals, perineum or the abdominal wall. The aim of this study is to share our experience with the management of this difficult infectious disease.Methods:  Thirty‐three male patients were admitted to our clinic with the diagnosis of FG between February 1988 and December 2003. The patient’s age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment, and outcome were analyzed. The patients were divided into two groups. The first 21 patients (Group I) were treated with broad‐spectrum triple antimicrobial therapy, broad debridement, exhaustive cleaning, and then they underwent split‐thickness skin grafts or delayed closure as needed. The other 12 patients (Group II) were treated with unprocessed honey (20–50 mL daily) and broad‐spectrum triple antimicrobial therapy without debridement. Their wounds were cleaned with saline and then dressed with topical unprocessed honey. The wounds were inspected daily and the honey was reapplied after cleaning with normal saline. Then, the patients’ scrotum and penis were covered with their own new scrotal skin.Results:  The mean age of the patients was 53.9 ± 9.56 years (range = 23–71). The source of the gangrene was urinary in 23 patients, cutaneous in seven patients, and perirectal in three patients. The predisposing factors included diabetes mellitus for 11 patients, alcoholism for 10 patients, malnutrition for nine patients, and medical immunosuppression (chemotherapy, steroids, malignancy) for three patients. The mean duration of hospital stay was 41 ± 10.459 (range = 14–54) days. Two patients in Group I died from severe sepsis. The clinical and cosmetic results were better in Group II than Group I.Conclusions:  Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Traditionally, good management is based on aggressive debridement, broad‐spectrum antibiotics, and intensive supportive care but unprocessed honey might revolutionize the treatment of this dreadful disease by reducing its cost, morbidity, and mortality.
Comparison of the effects of percutaneous and intraduodenal administration of oxybutynin on bladder contraction and salivation in rabbits
Authors: KONTANI HITOSHI , HAMAMOTO TETSUKAZU , TAKEUCHI SUNAO , NOMURA YUKARI , SAWANISHI HIROYUKI , SAITO HARUO 
Published: July 2006

Aim:  As only a few basic animal experiments have assessed the usefulness of percutaneous application of oxybutynin, we compared the effects of percutaneous application and intraduodenal injection of oxybutynin on urinary bladder contraction accompanied by micturition in conscious rabbits and salivation in anesthetized rabbits.Methods:  Bladder contractions were induced by continuous infusion of saline (2 mL/min) into the bladder. Salivary secretion was induced by pilocarpine (0.1 mg/kg, i.v.). Oxybutynin was administered at 15 mg/animal, and the plasma concentrations of oxybutynin and N‐desethyloxybutynin were measured by high‐performance liquid chromatography to clarify the effective concentration.Results:  The intercontraction interval (ICI) was prolonged from 0.5 h after intraduodenal injection of oxybutynin, and this effect continued for 2 h. The ICI prolongation after percutaneous application of oxybutynin appeared at 2 h and continued throughout the 6‐h experimental period. The saliva secretion induced by pilocarpine was inhibited to almost the same level by oxybutynin 3 h after intraduodenal injection and 6 h after percutaneous application. However, the sum of the plasma concentrations of oxybutynin and N‐desethyloxybutynin rose steeply to a very high level within 20 min after oral administration instead of intraduodenal injection and decreased within 3 h to about half of the level evident 6 h after percutaneous application.Conclusion:  We confirmed that percutaneous application of oxybutynin caused long‐lasting ICI prolongation in our rabbit model, as compared with that after intraduodenal injection, and produced weaker inhibitory effects on saliva secretion because it did not cause steep elevation of the plasma concentration.
Fertility‐preserving treatment for patients with malignant germ cell tumors of the ovary
Authors: Nishio Shin , Ushijima Kimio , Fukui Akimasa , Fujiyoshi Naoki , Kawano Kouichiro , Komai Kan , Ota Shunichiro , Fujiyoshi Keizo , Kamura Toshiharu 
Published: July 2006

AbstractAim:  The aim of this study was to investigate whether fertility preservation influences the clinical outcome in patients with malignant germ cell tumors of the ovary (MGCTO).Methods:  A case study analysis was performed on patients with MGCTO treated at Kurume University Hospital between 1986 and 2004. Thirty‐five patients were included in the study, 14 with immature teratoma, 11 with dysgerminoma, eight with endodermal sinus tumor, and two with mixed germ cell tumor. Twenty‐three patients had International Federation of Gynecology and Obstetrics stage I (Ia, 11; Ib, 2; Ic, 10), one had stage II, seven had stage III, and four had stage IV disease.Results:  Five patients with stage III or IV disease received radical surgery. Thirty patients underwent conservative surgery. As the adjuvant treatment, 30 patients received chemotherapy, while five patients did not receive any chemotherapy. The overall survival rate was 97.1%. One patient died of the disease. She was 13 years old with a stage IV endodermal sinus tumor. Twelve have attempted conception, and eight have achieved at least one pregnancy (66.7%).Conclusions:  Irrespective of the stage of the disease, conservative surgery and adjuvant chemotherapy for MGCTO can achieve a favorable outcome in terms of survival and fertility.
Metabolic disorders in patients with recent gestational diabetes mellitus
Authors: Eroglu Derya , Zeyneloglu Hulusi B. 
Published: July 2006

AbstractAim:  To determine metabolic disorders in patients with recent gestational diabetes mellitus (GDM) compared with controls.Methods:  Thirty‐six patients with recent GDM and treated with a diabetic diet only, and 33 controls with normal pregnancies, were included in the study. An oral glucose tolerance test, with corresponding insulin and hormone levels, was performed; the homeostatic model assessment scores were calculated to estimate insulin resistance; prevalence of polycystic ovarian morphology on ultrasound scan was assessed; and results were recorded 10–15 months after delivery.Results:  Waist : hip ratio and fasting cholesterol and triglyceride levels were significantly higher in women with recent GDM; high‐density lipoprotein cholesterol did not differ between groups. Fasting, 1‐h and 2‐h plasma glucose levels were significantly higher in the GDM group; no statistically significant difference was found between groups regarding fasting insulin levels, 1‐h and 2‐h insulin response, and homeostatic model assessment scores. Serum hormone levels did not differ between groups. The prevalence of polycystic ovarian morphology was greater in women with GDM. There was no difference in any metabolic parameter between women in the GDM group with polycystic ovaries and those with normal ovaries.Conclusions:  We found a higher prevalence of polycystic ovarian morphology in women with GDM than in controls. Among women with recent GDM, higher waist : hip ratios and fasting plasma glucose and triglyceride levels may indicate metabolic syndrome. In women with recent GDM managed by diet only, insulin resistance may not be detected in the short term.
Prospective study of non‐closure or closure of the peritoneum at cesarean delivery in 124 women: Impact of prior peritoneal closure at primary cesarean on the interval time between first cesarean section and the next pregnancy and significant adhesion at second cesarean
Authors: Komoto Yoshiko , Shimoya Koichiro , Shimizu Takashi , Kimura Tadashi , Hayashi Shusaku , Temma‐Asano Kumiko , Kanagawa Takeshi , Fukuda Hirotsugu , Murata Yuji 
Published: July 2006

AbstractAim:  The aim of this study was to evaluate the effect of non‐closure of the peritoneum at cesarean delivery on postoperative complications and the interval time to the next pregnancy, and to investigate the incidence of adhesion following cesarean and the association between adhesion formation and peritoneal closure.Methods:  One hundred and twenty four women scheduled for cesarean section were randomized to either closure of both the visceral and parietal peritoneum (C‐group, n = 70) or non‐closure (NC‐group, n = 54). At repeated cesarean, the levels and extent of adhesion, operating time, and any complications were examined.Results:  There was no difference in the incidence of postoperative complications at the first cesarean section. The operating time of the C‐group was significantly longer than that of the NC‐group. The frequency of analgesic use was significantly higher in the C‐group. The time interval from cesarean section to the next pregnancy in the NC‐group was significantly shorter than that in the C‐group. There are no significant differences between the rates of complications in the C‐group and the NC‐group at repeated cesarean. The incidence of adhesion in the C‐group was significantly higher than that in the NC‐group (P < 0.05). The mean total operating time and the mean interval time for skin incision to delivery in the C‐group were significantly longer than those in the NC‐group (P < 0.05 and P < 0.001, respectively) at repeated cesarean section.Conclusions:  Non‐closure of the peritoneum at cesarean delivery appears to have no adverse effect on postoperative recovery, it also decreases the number of analgesic doses and shortens the operating time and may be more desirable in achieving a next pregnancy. The present study demonstrated that surgical peritoneal closure resulted in more advanced adhesion formation. The practice of non‐closure of the peritoneum should be performed at cesarean.
Significance of CD44v6 expression in gynecologic malignancies
Authors: Hong Soon Cheol , Song Jae Yun , Lee Jae Kwan , Lee Nak Woo , Kim Sun Haeng , Yeom Bom Woo , Lee Kyu Wan 
Published: July 2006

AbstractAim:  Variants of CD44 have been proposed to be important in cancer invasion and metastasis. The purpose of this study was to evaluate the diagnostic and prognostic value of CD44v6 expression in gynecologic malignancies.Methods:  Immunohistochemistry was used to determine the expression of CD44v6 in samples from a series of 65 cases of early cervical cancer, 76 cases of endometrial samples and 57 cases of serous epithelial ovarian tumors. We analyzed the expression of CD44v6 and correlated the findings with clinicopathological factors.Results:  In the cervical series, CD44v6 was detected in 60 cases of cervical cancer (92.3%). The immunoreactivity was decreased when stromal invasion reached a depth of more than 5 mm (P < 0.05). However, it was not correlated with other clinicopathological factors. In the endometrial series, CD44v6 was detected in one endometrial hyperplasia (6.7%) and in 24 endometrial cancers (100%), while it was not detected in the proliferative endometrium (P < 0.05). Immunoreactivity was decreased in grade 2 and 3 endometrial cancers compared with grade 1 (P < 0.05). In the ovarian series, CD44v6 was not detected in the benign tumors, but it was detected in four borderline malignancies (27%) and 12 carcinomas (40%). Immunoreactivity was not correlated with clinicopathological factors of ovarian cancer.Conclusion:  CD44v6 may be involved in stromal invasion of early squamous cervical carcinomas and in the cellular differentiation of endometrial cancer. In addition, it may be useful for early diagnosis of endometrial cancer.
Small bowel perforation from a thermal burn caused by contact with the end of a laparoscope during ovarian cystectomy
Authors: Ito Masayuki , Harada Tasuku , Yamauchi Nobuhiro , Tsudo Toshiyuki , Mizuta Masayoshi , Terakawa Naoki 
Published: July 2006

AbstractAlthough laparoscopic surgery now replaces many gynecologic laparotomy procedures, serious complications unique to laparoscopy may occur, including vascular or bowel injury. In most cases of bowel injury during laparoscopy, the laparoscopic instruments that cause injury are the trocar, Veress needle, grasping forceps or scissors, electrocoagulator, or laser. We report a rare case of small bowel perforation after a thermal burn caused by contact with the end of the scope during laparoscopic ovarian cystectomy. Burns and perforations of the small bowel during laparoscopy are rare complications preventable by familiarity with the physical properties of the laparoscopic instruments.
Reduction of aquaporin‐8 on fetal membranes under oligohydramnios in mice lacking prostaglandin F2α receptor
Authors: Shioji Mitsunori , Fukuda Hirotsugu , Kanzaki Toru , Wasada Kenshi , Kanagawa Takeshi , Shimoya Koichiro , Mu Junwu , Sugimoto Yukihiko , Murata Yuji 
Published: July 2006

AbstractAim: To investigate the association between aquaporin‐8 (AQP‐8: a water channel protein) expression in fetal membranes and oligohydramnios during near‐term and postdate pregnancy, we set up an oligohydramnios model using prostaglandin F2α receptor (FP)‐deficient mice.Methods: Pregnant FP‐deficient mice from 14 to 21 gestational days (GD) were killed to measure the amniotic fluid volume (AFV), and fetal membranes were collected for the analysis of aquaporin‐8 expression.Results: The AFV was highest at 14 GD, and was significantly decreased to 28% and 0% at 20 GD and 21 GD, respectively, compared with the volume at 14 GD. Immunohistochemistry and immunoblot analysis showed that aquaporin‐8 was expressed in the basal component of fetal membranes, and that the protein level was significantly decreased to 60% at 20 GD compared with that at 14 GD.Conclusions: We demonstrated that AQP‐8 expression in the fetal membrane was decreased at post term in FP‐deficient mice. Our findings suggest that aquaporin‐8 in fetal membranes may be involved in the regulation of AFV, especially when oligohydramnios occurs.
Auto‐transplantation of the uterus in the domestic pig (Sus scrofa): Surgical technique and early reperfusion events
Authors: Wranning Caiza Almén , El‐Akouri Randa Racho , Lundmark Cecilia , Dahm‐Kähler Pernilla , Mölne Johan , Enskog Anders , Brännström Mats 
Published: July 2006

AbstractAim: To develop a method for auto‐transplantation of the uterus in the pig and to evaluate the early reperfusion events after short‐term cold ischemia.Methods: The bicornate uterus, with the cervix but without ovaries, was dissected and isolated with its bilateral feeding and draining vessels. The uterine arteries were cannulatedin situand the uterus was flushed with heparinized Ringer Acetate. It was stored at 4°C for 1–2 h during continuous flushing. The uterus was then placed in its original pelvic position and the uterine arteries and veins were anastomosed end‐to‐end to their origin. During approximately 100 min of reperfusion, blood samples and tissue biopsies were taken for monitoring of reperfusion events and detection of ischemia‐reperfusion injuries.Results: Out of 19 auto‐transplanted pigs, seven were considered well flushed and were kept for cold ischemia. Of these seven, four showed satisfactory reperfusion judged by change in gross appearance and presence of appropriate venous blood flow. Analysis of blood‐gas and metabolite parameters and histology indicated that at least two of these transplants were well reperfused, with no severe ischemia‐reperfusion injuries.Conclusion: In this first report ever on auto‐transplantation of the pig uterus it is demonstrated that an acceptable reperfusion can be achieved. Furthermore, it is suggested that because of the large total size of the pig uterus with long uterine horns and the small size of the vessels available for re‐anastomosis, the pig is a fairly difficult model for further studies on transplantation of the uterus.