bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family Decision Making for Elderly Patients in the Intensive Care Unit
Authors: Oh Heeyoung Lee , Lee Taewha 
Published: March 2003

Advances in health care and high technology have increased the survival rate of patients with critical health problems. When one's elder is admitted to an intensive care unit (ICU), the family members often face the challenge of having to make treatment decisions for an elderly patient who is incapable of decision‐making. Making health‐care decisions can be more complex when the patient is in a critical condition and decisions have to be made within a given time. Families experience conflict when they make choices among alternatives that are equally unacceptable. Assisting the family of an elderly patient in reaching the best decision is an integral part of the role of the nurses and other health‐care professionals. In order to enhance the family's decision‐making regarding their elder in the ICU, it is necessary to understand the family's perspective on making the required decision.The purpose of this study was to understand: (i) under what circumstances does a family, having to make a decision, perceive decision‐making to be most difficult? and (ii) what are the beliefs or preferences that influence family decision‐making? An exploratory, descriptive, qualitative study design was employed. Data were collected from 15 family members of 12 elderly patients in ICU at two urban university hospitals in South Korea. Subject selection was determined by collaborating with the head nurses of the three ICU to determine which subjects had ability to articulate their perspectives on decision‐making. Forty–fifty‐min, face‐to‐face, semistructured in‐depth interviews were conducted using an interview guide consisting of 11 open‐ended questions. All interviews were tape recorded and transcribed. Data were read line by line and content analysis was performed.
Electrical activity of the corpus cavernosum in denervated rats
Authors: Başar M , Yildiz Müslüm , Başar Halil , Ak Fikri , Akan Hakan , Atan Ali 
Published: March 2003

Background: We evaluated the electrical activity of the corpus cavernosum after intracavernous papaverine injection in rats that had been denervated experimentally. Methods: Twenty‐four male adult Sprague Dawley rats were divided into three groups: (i) controls (n = 8); (ii) unilateral cavernous nerve resection on the right side (n = 8); and (iii) bilateral cavernous nerve resection (n = 8). Through a suprapubic incision, the urinary bladder was retracted laterally to locate the major pelvic plexus on the lateral surface of the prostate. The major branch of the cavernous nerve, running caudally from the pelvic plexus, was isolated and excised using an operating microscope. Three weeks later, recording of the electrical activity of the corpus cavernosum (EACC) was performed by using a Neuropack‐2 EMG unit (Nihon Kohden, Tokyo, Japan) and coencentric needle electrode. Changes in amplitude were evaluated before and after intracavernosal papaverine injection. The results in the flaccid state and after papaverine injection were compared by using the Mann–Whitney U‐test in all three groups and paired t‐test between groups. Results: In the flaccid penis, the mean (± SD) amplitude of electrical activity of the corpus cavernosum was 17.42 ± 2.05, 12.42 ± 1.88, 9.71 ± 1.59 and 5.85 ± 0.96 μV in control rats, in unilaterally denervated rats (in which the cavernous nerve was intact on the left side), in unilaterally denervated rats in which the cavernous nerve was resected on the right side and in bilaterally denervated rats, respectively. In the flaccid state, EACC is lower in the bilaterally denervated group than in the control and unilaterally nerve‐resected groups (P≤ 0.05). The recording of electrical activity of the corpus cavernosum was continued for 20 min after papaverine injection. In the control group and in both groups of unilaterally denervated rats, we observed a significant decrease in the electrical activity of the corpus cavernosum in the first 5 min after papaverine injection (P≤ 0.05). However, no difference was observed in bilaterally denervated rats after injection (P ≥ 0.05). Conclusions: We conclude that electrical activity of the corpus cavernosum continues after unilateral nerve injury in rats. Cross‐innervation may play a role in penile innervation and corpus cavernosum electromyography shows electrical activity in denervated rats.
The significance of resections for residual masses after chemotherapy in metastatic testicular tumors
Authors: Suzuki Ken‐ichi , Orikasa Seiichi , Hoshi Senji , Yoshikawa Kazuyuki , Saito Seiichi , Ohyama Chikara , Sato Makoto , Kawamura Sadahumi , Numahata Kenji , Ito Akihiro , Tokuyama Satoru 
Published: March 2003

Background: After chemotherapy for metastatic testicular tumors, masses may remain, often in the metastatic sites. This study analyses the role of resections for the residual masses. Methods: Seventy‐seven patients with advanced (stage II, III) testicular tumors were treated. Of these, 38 patients, including eight with seminoma and 30 patients with non‐seminomatous germ cell tumors, underwent resection of residual masses after chemotherapy and have been followed for a median of 41.5 months (range 2–138) after the resection. Results: Residual masses were necrosis/fibrosis in 19 patients, mature teratoma in 11 and cancer in eight. The ratio of cancer in stage III (41.2%) was significantly higher than that in stage II (4.8%). Ten of 38 (26.3%) patients experienced recurrences in sites other than the resected sites, and five of 10 patients have died of cancer. Most recurrences (80%) occurred within two years. Recurrences after resection were detected in 4.8% of stage II patients, 52.9% of stage III, 16.7% of necrosis/fibrosis and mature teratoma, and 62.5% of cancer. The survival rate of patients with cancer was significantly lower in spite of adjuvant chemotherapy after surgery. Conclusions: Resection for residual masses after chemotherapy in metastatic testicular tumors was useful in confirming the tissue and in controlling the metastatic sites. Recurrences were often found in patients with cancer in the residual mass and the prognosis of patients with cancer was poor, therefore the development of more effective therapy for patients with cancer is required to improve the prognosis.
Characterization of ureteral lesions associated with impacted stones
Authors: Yamaguchi Kenya , Minei Sadatsugu , Yamazaki Toshihiko , Kaya Hitoshi , Okada Kiyoki 
Published: March 2003

Background: Few studies have addressed the various types of ureteral lesions apparent in patients treated for ureteral stones, especially in those with impacted stones. Macroscopic and microscopic analyses of ureteral lesions associated with impacted stones were therefore undertaken. Methods: From May 1994 to October 1996, 36 patients with ureteral stones, 21 of whom showed stone impaction, were treated with transurethral ureterolithotripsy. After ureteroscopic examination, biopsied specimens were obtained from six patients with impacted stones and were examined microscopically by conventional hematoxylin and eosin staining. Results: Ureteroscopy revealed two types of mucosal lesions in the patients with impacted stones: Type 1 lesions were defined as edematous or cystic hemispheric lesions and occurred in 18 patients, whereas type 2 lesions had a villous appearance and were present in three patients. Microscopically, type 1 lesions appeared as submucosal edema without specific findings, whereas type 2 lesions appeared as columnar mesenchymal tissue coated with several layers of transitional epithelium. With regard to factors that might contribute to lesion formation, duration of stone presence was significantly greater for patients with impacted stones than for those with‐non‐impacted stones. However, no differences in such parameters were apparent between patients with type 1 lesions and those with type 2 lesions. Conclusions: Two types of ureteral lesions associated with impacted stones were confirmed microscopically. The duration of stone presence is a potential contributing factor in the development of ureteral lesions, but factors that determine the type of ureteral lesion remain unclear.
Quality of life in patients having an ileal conduit, continent reservoir or orthotopic neobladder after cystectomy for bladder carcinoma
Authors: Kitamura Hiroshi , Miyao Noriomi , Yanase Masahiro , Masumori Naoya , Matsukawa Masanori , Takahashi Atsushi , Itoh Naoki , Tsukamoto Taiji 
Published: March 2003

Abstract
Background
: To compare the QOL in patients with ileal or colon conduits (IC), continent urinary reservoir (CR) and ileal neobladder (NB), a retrospective study was conducted using a questionnaire sent by mail.
Methods
: Seventy‐nine patients with a mean age of 60 years were included in this study. A total of 36, 22 and 21 underwent IC, CR and NB, respectively and were alive at the time of this study. A structured questionnaire consisting of 97 questions that covered general condition and physical condition, reconstruction‐related symptoms, psychological status, sexual life, social status and satisfaction with the treatment was employed.
Results
: The IC group frequently complained of changes in bathing habits and loss of using public baths in comparison with the CR and the NB groups. High scores for loss of sexual desire were obtained in the IC, the CR and the NB groups, in this order. Because of the nearly physiological voiding, the NB group desired a voiding condition like pre‐operative status as compared with the IC and the CR groups. However, for most of the questionnaire items no difference was seen among the IC, CR and NB groups concerning general condition, reconstruction‐related symptoms, psychological status, sexual life, social status, satisfaction with the treatment and global satisfaction with life and health.
Conclusions
: There was little difference in the QOL score of the questionnaire and satisfaction among the IC, CR and NB groups. It was suggested that almost every patient accepted and adapted to the present status of general quality of life in each group.
Prostate‐specific antigen adjusted for the transition zone volume versus free‐to‐total prostate‐specific antigen ratio in predicting prostate cancer
Authors: Moon Du Geon , Cheon Jun , Kim Je Jong , Yoon Duck Ki , Koh Sung Kun 
Published: March 2003

Abstract
Background
: We performed this study to assess the efficacy of prostate‐specific antigen adjusted for the transition zone volume (PSATZ) and free‐to‐total prostate‐specific antigen (PSA) ratio (F/T ratio) in predicting prostate cancer in men with intermediate PSA levels of 4.1–10.0 ng/mL. Methods: Between March 1997 and September 1998, PSATZ was obtained from 67 patients who underwent ultrasonography guided systemic sextant biopsies and had a PSA of 4.1–10.0 ng/mL. PSATZ was compared with F/T ratio via receiver operating characteristic (ROC) curves.
Results
: Of 67 patients, 22 (32.8%) had prostate cancer and 45 (67.2%) had benign prostatic hyperplasia (BPH) on pathologic examination. Mean PSA, PSA density, F/T ratio and PSATZ were 7.96 ± 2.01 ng/mL, 0.28 ± 0.14 ng/mL/cc, 0.10 ± 0.06 and 0.70 ± 0.28 ng/mL/cc in patients with prostate cancer and 6.39 ± 1.68 ng/mL, 0.16 ± 0.06 ng/mL/cc, 0.15 ± 0.05 and 0.29 ± 0.10 ng/mL/cc in patients with BPH, respectively. The ROC curve analysis demonstrated that PSATZ predicted the biopsy outcome significantly better than F/T ratio in all 67 patients (P < 0.01) and in a subset of 53 men with normal digital rectal examination (P < 0.01). With a cut‐off value of 0.35 ng/mL/cc, PSATZ had a sensitivity of 86% and a specificity of 89% for predicting prostate cancer.
Conclusions
: These results suggest that PSATZ and F/T ratio may be useful in diagnosing prostate cancer with intermediate levels of PSA. Prostate‐specific antigen adjusted for the transition zone volume is more accurate than F/T ratio in distinguishing benign prostatic disease from prostate cancer. But large prospective studies are required to assess the precise role of PSATZ and F/T ratio in early prostate cancer detection.
Ratio of gamma‐seminoprotein to prostate‐specific antigen for the detection of prostate cancer: Its discrimination power could be influenced by the assay methods of PSA and/or gamma‐seminoprotein
Authors: Akino Hironobu , Suzuki Yuji , Oyama Nobuyuki , Kanamaru Hiroshi , Okada Kenichiro 
Published: March 2003

Abstract
Background
: The ratio of gamma‐seminoprotein (γ‐Sm) and prostate‐specific antigen (PSA) has been regarded as being superior over PSA alone as a discriminator between prostate cancer and benign prostatic diseases. In previous studies, PSA and γ‐Sm were measured by the Eiken kit and the old‐version or revised Chugai kit, respectively. We compared the power of γ‐Sm ratio with that of PSA alone when using Markit‐M PSA assay and the revised Chugai γ‐Sm assay.
Methods
: Fifty‐three patients with prostate cancer having no metastasis and 116 with benign prostatic diseases were enrolled in this study. Prostate‐specific antigen was measured by Markit‐M kit and γ‐Sm was measured by the revised Chugai kit. The discrimination power of γ‐Sm ratio and PSA alone was evaluated with receiver operating characteristic (ROC) curves. Comparisons between prostate cancer and benign diseases were performed with Mann–Whitney U‐test and Fisher’s exact test.
Results
: The optimal cut‐off value was set at 3.1 ng/mL for PSA and 0.935 for γ‐Sm ratio. Sensitivity, specificity and positive predictive value of PSA alone were 81.1, 81.0 and 66.2%, respectively, while those of γ‐Sm ratio were 73.6, 90.5 and 78.0%, respectively. There was no statistical significance in each value between PSA and γ‐Sm ratio. Areas under the ROC curves of PSA and γ‐Sm ratio were 0.881 and 0.866, respectively (P > 0.05).
Conclusion
: Contrary to the previous reports, γ‐Sm ratio and PSA were not different in the discrimination between prostate cancer and benign prostatic diseases, which suggested that the discrimination power of γ‐Sm ratio, and presumably that of the free PSA to total PSA ratio as well, could be considerably influenced by the assay kits for serum PSA and/or γ‐Sm (free PSA) used. Therefore, the clinical significance of γ‐Sm ratio should be evaluated for each PSA assay kit.
Surgical excision of a metastatic adrenal lesion in a patient with prostatic cancer
Authors: Sakamoto Naotaka , Eto Masatoshi , Ando Sadamu 
Published: March 2003

Background: A 64‐year‐old Japanese man with stage D2 prostatic cancer, after having responded dramatically to androgen ablation, demonstrated a solitary adrenal metastasis without disease progression to any other site.Methods: A surgical excision of the lesion and adjuvant systemic chemotherapy was performed.Results/Conclusions: The patient has since remained alive without any evidence of recurrence 21 months after surgery.
Bladder dysfunction after proximal urethrolysis in female dogs
Authors: Kato Haruaki , Igawa Yasuhiko , Khaleque Momeen, Abdul , Nishizawa Osamu 
Published: March 2003

Background: Functional changes in the bladder after proximal urethrolysis are not recognized, despite the development of neuroanatomical studies of the female urethra or functional studies of the urethra after cystectomy. The aim of the present pilot study is to investigate possible functional changes in the bladder after proximal urethrolysis in female dogs.Methods: The bilateral nerve branches to the urethra were resected by separating the urethra from the anterior vaginal wall in 10 female dogs. Pre‐ and postoperative cystometrograms were recorded under anesthesia and the bladder capacity, threshold pressure for micturition and bladder stiffness (the inverse of compliance) were compared.Results: Fourteen days postoperatively, the bladder capacity significantly decreased and the threshold pressure and bladder stiffness significantly increased. Eight weeks after surgery, the threshold pressure and bladder stiffness remained high, but the bladder capacity tended to return to baseline values.Conclusions: These results indicate that proximal urethrolysis with bilateral sections of the nerve branches to the urethra produces a low‐compliant bladder in the early postoperative period and suggest that afferent stimuli from the urethra may participate in maintaining a compliant bladder during filling.
Urinary nuclear matrix protein 22 as a new marker for the screening of urothelial cancer in patients with microscopic hematuria
Authors: Miyanaga Naoto , Akaza Hideyuki , Tsukamoto Taiji , Ishikawa Satoru , Noguchi Ryosuke , Ohtani Mikinobu , Kawabe Kazuki , Kubota Yoshinobu , Fujita Kimio , Obata Koji , Hirao Yoshihiko , Kotake Toshihiko , Ohmori Hiroyuki , Kumazawa Joichi , Koiso Kenkichi 
Published: March 2003

Purpose: The aim of the present study was to determine the clinical usefulness of nuclear matrix protein 22 (NMP22) as a new urinary marker for the screening of urothelial cancer in patients with microscopic hematuria, especially in comparison with that of voided urine cytology.Methods: Patients with microscopic hematuria detected at a health examination, who were advised by a consulted urologist to have a cystoscopical examination, were asked to enter this study. Urine samples were collected before cystoscopy and divided into two portions for a NMP22 test and voided urine cytology.Results: Of the 309 patients with microscopic hematuria, 22 cases (7.1%) of urothelial cancer and one case of prostate cancer were detected. For the other cases, 128 (41.4%) were of benign diseases and 158 (51.1%) were designated as having no evidence of disease (NED). The median NMP22 values for urothelial cancer, other diseases and NED were 35.5, 6.7 and 6.0 U/mL, respectively, with 95% confidence intervals of 19.9–228.2, 5.1–9.3 and 5.4–7.2, respectively. The sensitivity of the NMP22 test for urothelial cancer was 90.9% (20/22), whereas the sensitivity of voided urine cytology was only 54.5% (12/22).Conclusions: The present study indicates that urinary NMP22 is a useful tool for the screening of urothelial cancer in patients with microscopic hematuria.
Influence of 5‐hydroxytryptamine and the effect of a new serotonin receptor antagonist (sarpogrelate) on detrusor smooth muscle of streptozotocin‐induced diabetes mellitus in the rat *
Authors: Kodama Masahito , Takimoto Yukie 
Published: March 2003

Abstract
Background
: We evaluated the changes in the response of detrusor muscle to 5‐hydroxytryptamine (5‐HT; serotonin) and its receptor mechanisms in pathologic bladder of diabetes mellitus rats.
Methods
: Eight‐week‐old male Wistar rats were given an intraperitoneal injection of streptozotocin (STZ, 60 mg/kg) in order to induce diabetes mellitus (4 weeks’ duration). The bladder strips (10 × 2 mm) were subjected to a tension of 1.0 g in organ baths for the measurements of isotonic contractile responses to 5‐HT or relaxation responses to 5‐HT antagonists.
Results
: Bladder strips from STZ‐diabetic rats responded to 5‐HT with greater contractions than did those of control rats, given vehicle alone. However, bladder strip weights gradually increased in the STZ‐diabetic rats as compared with control rats and when the contractile response to 5‐HT was expressed as a percentage of the response to 10–1 mol/L KCl there was no statistically significant difference between the groups. In both control and diabetic rats, the 5‐HT3 selective antagonist did not markedly inhibit the contractile response to 5‐HT. In contrast, the 5‐HT2A selective antagonist inhibited the contractile response to 5‐HT in a dose‐dependent manner.
Conclusions
: These results suggest that the increased contractile response to 5‐HT in diabetic rats’ bladder is related to smooth muscle hypertrophy and/or hyperplasia and indicate that this effect is mediated by activation of 5‐HT2A receptors.
Microsurgical vasoepididymostomy with sperm cryopreservation for future assisted reproduction
Authors: Hibi Hatsuki , Yamada Yoshiaki , Honda Nobuaki , Fukatsu Hidetoshi , Katsuno Satoshi , Ohshima Shinichi , Yamamoto Masanori 
Published: March 2003

Abstract Background Although obstructive azoospermia is treatable with microscopic seminal reconstruction, the number of patients who choose to undergo vasoepididymostomy is limited because of recent advances in assisted reproductive technology (ART). We attempted to define the outcome of surgical reconstruction in patients with suspected epididymal obstruction and no previous history of vasectomy.Methods We described 40 eligible end‐to‐side vasoepididymostomy procedures performed on 24 azoospermic patients who had either bilateral or unilateral epididymal obstruction.Results The overall patency rate following surgery was 54% (13/24) and for four patients (17%), natural intercourse resulted in pregnancy. Two pregnancies were initiated with intracytoplasmic sperm injections using frozen sperm collected during vasoepididymostomy.Conclusions In the era of modern ART, microsurgical vasoepididymostomy with cryopreservation of sperm collected during the operation is recommended for patients with epididymal obstructions.
Limited Wegener’s granulomatosis of the epididymis
Authors: Al‐Arfaj Abdurhman 
Published: March 2003

AbstractA case is presented of Wegener’s granulomatosis limited to the epididymis in a 32‐year‐old man. Tests for antineutrophils cytoplasmic antibodies were negative throughout. He showed excellent response to treatment with prednisolone, azathioprine and cotrimoxazole, following recurrence of his disease, after local complete excision. He remains free of disease 40 months after the discontinuation of all his treatment.
Tubularized incised‐plate urethroplasty for secondary hypospadias surgery
Authors: Hayashi Yutaro , Kojima Yoshiyuki , Mizuno Kentaro , Nakane Akihiro , Tozawa Keiichi , Sasaki Shoichi , Kohri Kenjiro 
Published: March 2003

Abstract Purpose: Reoperation for failed hypospadias has been considered to be seriously bothersome because abundant penile skin does not tend to remain for urethroplasty or for penile shaft skin coverage. In this study, the tubularization of incised urethral plate was employed for those who had no excessive penile skin after failure of hypospadias repair.Methods: Five patients with hypospadias underwent tubularized incised‐plate urethroplasty as salvage surgery. The surgical techniques necessary for the performance of the reoperation were not different from those for the primary repair. The urethral plate was incised sufficiently deeply in its midline from the tip of the glans to the regressed meatus. The incised urethral plate was tubularized without tension over a catheter of an appropriate size.Results: Four of those who underwent secondary tubularized incised‐plate urethroplasty were successfully repaired without complications. A urethrocutaneous fistula occurred at the corona in the remaining patient.Conclusions: The absence of preputial skin in reoperative cases makes tubularized incised‐plate urethroplasty the ideal option, although the series was small and postoperative duration is still short. In addition, this procedure can give excellent functional and cosmetic results even in patients who require revisional hypospadias surgery.