bluuebunny/crossref_metadata_2025_split huggingface dataset:
The implementation of Bachelor’s of Science in Nursing education in Pakistan
Authors: Upvall Michele J. , Rehmatullah Shamsah , Hashwani Saleema , Khan Shehla , Husain Perviz , Jan Rafat 
Published: March 2003

AbstractCurrently nursing education at the Aga Khan University in Karachi, Pakistan consists of a 3 year diploma program, a 2 year post‐registered nurse (RN) of Bachelor’s of Science in Nursing (BScN) completion program and a new 4 year generic Bachelor’s of Science in Nursing program. The purpose of this paper is to describe the evaluation process and findings of the newly implemented BScN program. The program is unique, as it is the first and only BScN program throughout Pakistan. Therefore, it has the responsibility of setting the standards for university nursing education for the entire country. Sampling for this qualitative evaluation study included the first class admitted into the BScN program, nursing faculty, and nursing staff involved in clinical experiences of the BScN students. The sample was divided into homogeneous focus groups to elicit the data. Focus groups were audio‐taped with results being categorized into themes. Findings from this evaluation study support a typology of learning discussed in the literature related to nursing education. In addition, faculty experiences of implementing the new program mirror those of faculty from other countries.
Early results of radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation
Authors: Homma Yukio , Akaza Hideyuki , Okada Kiyoki , Yokoyama Masao , Moriyama Nobuo , Usami Michiyuki , Hirao Yoshihiko , Tsushima Tomoyasu , Sakamoto Atsuhiko , Ohashi Yasuo , Aso Yoshio 
Published: March 2003

Background: The effects of preoperative androgen deprivation were explored in the patients who received radical prostatectomy and subsequent adjuvant endocrine therapy for prostate cancer. Methods: Stage A2, B or C prostate cancers were randomized to one of two groups: (i) group I (n = 90), who received androgen deprivation (leuploride and chlormadinone acetate) for 3 months preoperatively followed by radical prostatectomy and adjuvant endocrine therapy (leuploride only); and (ii) group II (n = 86), who underwent the surgery followed by 3 month androgen deprivation and subsequent adjuvant endocrine therapy. The effects of preoperative androgen deprivation on clinical relapse (serum prostate specific antigen (PSA) > 1.98 ng/mL, local recurrence or distant metastasis) and PSA relapse (PSA > 0.2 ng/mL) were evaluated at 2 years after randomization. Results: There was no significant difference in clinical or PSA relapse‐free survival and quality of life measures between the two groups, although relapses occurred significantly more frequently in patients who had more advanced stages, higher pretreatment PSA values or lower histologic differentiation in either group. Subgroup analysis indicated that clinical relapse‐free survival in stage C cancer tended to be better in patients with preoperative androgen deprivation than in those patients without it (P < 0.1). Conclusions: Preoperative androgen deprivation may be beneficial for stage C prostate cancer patients receiving radical prostatectomy and adjuvant endocrine therapy over the 2 year observation period. A longer follow up is needed to clarify the exact extent of benefit in terms of survival and quality of life.
The effect of papaverine on morphologic differentiation, proliferation and invasive potential of human prostatic cancer LNCaP cells
Authors: Goto Toshitaka , Matsushima Hisashi , Kasuya Yutaka , Hosaka Yoshio , Kitamura Tadaichi , Kawabe Kazuki , Hida Akino , Ohta Yasuyuki , Simizu Takahisa , Takeda Ken 
Published: March 2003

Background: Intracellular cyclic adenosine monophosphate (AMP) level changes are thought to play an important role in inhibiting cell proliferation and inducing differentiation in several types of cells. It has been reported that cyclic AMP analogs induce terminal differentiation in human prostate cancer cells. Consequently, phosphodiesterase inhibitors may be useful in delineating the role of cyclic AMP in the differentiation of these cells. Therefore, the effect of phosphodiesterase inhibitors on morphologic differentiation, proliferation and invasive potential of human prostate cancer cells was investigated. Methods: Three human prostate cancer cell lines PC‐3, DU145 and LNCaP were treated with one of the phosphodiesterase inhibitors, papaverine, 3‐isobutyl‐1‐methylxanthine (IBMX) or theophylline, for 6 days. Morphologic changes of these cells induced by phosphodiesterase inhibitors were observed by microscopy. Intracellular cyclic AMP levels in LNCaP cells were measured by radioimmunoassay using a cyclic AMP assay kit. The effect of papaverine on the proliferation and invasive potential of LNCaP cells were measured by cell counting and the MatrigelTM invasion chamber assay. Results: Of the three agents, examined papaverine (10–5 mol/L) is the most effective inducer of morphologic change and also raised intracellular cyclic AMP levels in LNCaP cells. However, unlike LNCaP cells, PC‐3 and DU145 cells treated with phosphodiesterase inhibitors, including papaverine, showed little change in morphology. Additionally, proliferation and invasive potential of LNCaP cells were significantly inhibited by papaverine. Conclusion: The results suggest that papaverine induces terminal differentiation in LNCaP cells, which is correlated with an intracellular cyclic AMP‐mediated pathway.
Neurogenic bladder dysfunction due to Behçet’s disease
Authors: Theodorou Ch , Floratos D , Hatzinicolaou P , Vaiopoulos G. 
Published: March 2003

Abstract
Background
: Behçet’s disease is a chronic multisystem condition of unknown origin. Genitourinary tract involvement with genital apthous ulcers, epididymitis, urethritis and recurrent cystitis is encountered commonly. Neurogenic bladder dysfunction due to neural involvement of the syndrome, has been reported extremely rarely.
Methods

: A case of neurogenic bladder dysfunction due to Behçet’s disease is presented. The patient was 17‐year‐old young male with a long history of the disease and neurological affection, but with neglected lower urinary tract symptoms and urinary incontinence. The patient was diagnosed urodynamically to have hyperreflexic detrusor.
Results/Discussion
: After failure of medical treatment (oxybutynin chloride) the patient submitted to augmentation clam‐type sigmoidocystoplasty. Four years postoperatively, the patient is dry, on clean intermittent self catheterization twice daily and he is practically asymptomatic from lower urinary tract symptoms.
Diagnosis and treatment of pelvic lymph node metastasis in bladder cancer
Authors: Hoshi Senji , Orikasa Seiichi , Suzuki Ken‐Ich , Takahashi Toshiko , Ohyama Chikara , Sato Katsuko , Ono Kunio 
Published: March 2003

Abstract
Background and Methods
: Bipedal lymphography and percutaneous fine needle aspiration biopsy (FNAB) of pelvic lymph node was done in 200 patients with bladder cancer.
Results
: A diagnosis of metastasis to the pelvic lymph node was obtained by this method in 34 patients. Of these 34 patients, only 12 (35%) were positive or suspected of having pelvic lymph node metastasis by computed tomography. Sixteen patients (47%) had unequivocally positive or highly suspicious lymphogram and 18 patients (53%) had normal lymphogram. Seventy‐eight cases, including eight FNAB‐positive cases, were treated by radical cystectomy and regional lymph node dissection. Sensitivity, specificity, positive predictive value and negative predictive value of FNAB were 57, 100, 100 and 91%, respectively. Thirteen FNAB‐positive M0 patients could be treated by multimodality therapy and evaluated after neoadjuvant therapy by repeated lymphography and FNAB. All were changed to N0 by FNAB after neoadjuvant therapy. In eight patients treated by total cystectomy and lymph node dissection, four had down staged to pN0 but four had one positive node. In five follow‐up cases without surgery, one had recurrent pelvic lymph node metastasis 35 months later. Cause‐specific survival of these patients was 76% at 5 years and 57% at 8 years.
Conclusions
: Pretreatment diagnosis of pelvic lymph node metastasis and multimodality therapy may improve the prognosis of regional lymph node‐positive bladder cancer. Because it is difficult to diagnose pN1 using FNAB, radical operation should be performed even if neoadjuvant therapy is effective and down staging is obtained.
Patient‐reported quality of life after radical prostatectomy for prostate cancer
Authors: ARAI YOICHI , OKUBO KAZUTOSHI , AOKI YOSHITAKA , MAEKAWA SHINYA , OKADA TAKASHI , MAEDA HIROSHI , OGAWA OSAMU , KATO TETSURO 
Published: March 2003

Background: Increasingly, quality of life (QOL) assessments are receiving greater attention in the management of malignancies, including prostate cancer. We evaluated the impact of radical prostatectomy on patient QOL 12 months or longer after surgery.Patients and Methods: We evaluated the impact of radical prostatectomy on QOL in 60 patients with prostate cancer. The patients comprised two groups: the first group (n = 32) was evaluated 12 months or longer after radical prostatectomy; the second group (n = 28) was evaluated while awaiting radical prostatectomy. General health‐related QOL was measured with the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire. Sexual function was assessed with the Sapporo Medical University Sexual Function Questionnaire. A newly developed instrument assessing urinary function was prepared only for the postoperative group.Results: No differences between the two groups were seen in comparisons of general health‐related QOL subscales. Men who underwent surgery reported significant deterioration in sexual function (decreased quality of erection, decreased sexual activity and decreased satisfaction with sex life) than those awaiting surgery. Of the 32 postoperative patients, 26 (81%) did not use pads at all, five (16%) used one or fewer pads per day due to occasional spotting and only one patient (3%) used two to four pads per day to deal with urine dripping. Twenty‐six postoperative patients (81%) stated that, given the choice, they would undergo radical prostatectomy again.Conclusions: General health‐related QOL does not appear to be compromised following radical prostatectomy. Patients are willing to accept some morbidity for a perceived survival benefit. Although minimal urinary dysfunction was reported, most patients were dissatisfied with postoperative sexual function. In preoperative counselling, greater emphasis should be placed on the risk of postoperative impotence.
Case of gonadoblastoma in a 9‐year‐old boy without physical abnormalities
Authors: HATANO TAKASHI , YOSHINO YASUMASA , KAWASHIMA YOSHIO , SHIRAI HIROSHI , IIZUKA NORIO , MIYAZAWA YOSHIO , SAKATA AKIHIKO , ONISHI TETSURO 
Published: March 2003

Background: A 9‐year‐old boy was admitted to Jikei University Hospital complaining of gradual enlarging of the left scrotal contents.Methods/Results: Physical examination was significant for bilateral descended testicles. No abnormalities were detected in the testicles or along the spermatic cords. Scrotal ultrasound showed that hyperechoic shadows were recognized in the central area of the left testicle. Subsequent testicular biopsy and histopathological examination showed intratubular malignant germ cells in the testicular tubules. One week later, left orchiectomy was performed.Conclusions: Histopathological evaluation revealed gonadoblastoma. Gonadoblastoma, a rare gonadal neoplasm, is composed of germ cells and sex cord derivatives and usually occurs in phenotypically female patients with gonadal dysgenesis. To date, only three cases of gonadoblastoma have been reported in anatomically normal male patients with scrotal testicles. We report on a case of gonadoblastoma unaccompanied by a germ cell tumor in a physically normal male.
Optimization of orthotopic colonic bladder: Implantation of tubularized mucosal flap from colonic segment into demucosalized urethra
Authors: Iizuka Keiji , Igawa Yasuhiko , Kato Haruaki , Kiyokawa Hideo , Nishizawa Osamu 
Published: March 2003

AbstractIf the urethral mucosa of a female could be replaced by another mucosa, one could augment the indication for orthotopic reconstruction of the bladder. A mucosal replacement technique for the female urethra is reported. A colonic mucosal flap formed from a colonic bladder was used in a patient with bladder cancer for whom cystectomy was indicated. For 3 years after the surgery, the patient has maintained satisfactory voiding and urethral function. There has been no evidence of a recurrence. The orthotopic bladder with the mucosal replacement technique can be applied to female patients who have a bladder cancer with a high risk of urethral recurrence.
Ruptured cerebral aneurysm not detected by magnetic resonance angiography in juvenile autosomal dominant polycystic kidney
Authors: Nakajima Fumitaka , Shibahara Nobuhisa , Arai Motohiro , Ueda Haruhiko , Katsuoka Yoji 
Published: March 2003

AbstractRecently, it has been reported that magnetic resonance angiography (MRA) is useful for screening and following up cerebral aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD). However, a patient was encountered with a ruptured cerebral aneurysm that was not detected by routine MRA. The patient, a 29‐year‐old man with ADPKD, was followed up at our hospital for more than 5 years. Ten months after an MRA examination, he suddenly developed severe headache. Brain computed tomography revealed subarachnoid hemorrhage. Digital subtraction angiography detected an aneurysm with a diameter of approximately 2 mm in the anterior communicating artery. Clipping of the aneurysm was immediately performed and he recovered without sequela after operation. Magnetic resonance angiography is useful to detect cerebral aneurysms, but it can not detect aneurysms measuring less than 4 mm.
Post‐voiding repeated renal ultrasonography for slight hydronephrosis detected during screening for asymptomatic microhematuria*
Authors: Nishimura Taiji , Abe Hiroyuki , Miura Takafumi , Uchikoba Takushi , Tsuboi Narumi , Yamamoto Hideki , Kobayashi Kyoko 
Published: March 2003

Abstract
Background
: There is not a well established method for further screening of asymptomatic microhematuria found through annual health examinations. However, it is apparent that a large number of examiners are using ultrasonography for screening. When slight hydronephrosis is found through screening, it is difficult to determine whether further examinations, such as intravenous pyelography (IVP), should be performed. In this paper, we discuss the usefulness of post‐voiding repeated renal ultrasonography, which was applied to 57 patients with slight hydronephrosis found in a screening.
Methods
: Ultrasonography in the kidney and the urinary bladder at the ultrasound laboratory of Toma Hospital was carried out on a total of 1906 patients with asymptomatic microhematuria, which was found by routine annual health examination, from January 1996 to December 1998. Slight hydronephrosis was found in 57 (14 males and 43 females) of 1906 patients and post‐voiding repeated renal ultrasonography was carried out on all patients.
Results
: Slight hydronephrosis had disappeared and IVP was avoided in 22 (38.6%) of 57 patients. Of 35 cases in which slight hydronephrosis persisted after urination, there were no abnormalities on IVP in 32 patients, while abnormalities were found in three patients. Two of these had ureteropelvic junction stenosis and the remaining one had a ureteral stone.
Conclusion
: The results of this study indicate that post‐voiding repeated renal ultrasonography is useful for avoiding unnecessary further examination to determine whether upper urinary tract obstruction exists, when slight hydronephrosis is observed upon screening by simultaneous renal and urinary bladder ultrasonography for asymptomatic microhematuria.
Congenital vesicovaginal fistula
Authors: Asanuma Hiroshi , Nakai Hideo , Shishido Seiichiro , Tajima Eiji , Kawamura Takeshi , Kawamura Takeshi 
Published: March 2003

AbstractCongenital vesicovaginal fistula is a very rare entity, the etiology of which has not been clearly elucidated because pathologic features have not been mentioned in previous reports. The case of a 4‐year‐old girl having incontinence resulting from a congenital vesicovaginal fistula joining with the left ectopic ureter from the hypoplastic kidney is described. This is thought to be the first presentation of congenital vesicovaginal fistula joining with ectopic ureter. A microscopic examination revealed the fistula consisting of transitional cell epithelium, suggesting an abnormal fusion of the ureteral bud and caudal end of the müllerian duct with the urogenital sinus.
Progression of prostate cancer to neuroendocrine cell tumor
Authors: Tanaka Masashi , Suzuki Yoshio , Takaoka Katsuyuki , Suzuki Noriyuki , Murakami Shino , Matsuzaki Osamu , Shimazaki Jun 
Published: March 2003

Abstract Background: The progression to endocrine therapy‐resistant prostate cancer is partly due to clonal change to neuroendocrine cell tumor. To elucidate this pathologic process, the clinical courses of four cases of neuroendocrine cell tumor that were found at autopsy are reported.Methods: Between 1995 and 1999, autopsies were performed for 20 cases of prostate cancer. Lesions predominantly composed of a neuroendocrine cell tumor (small cell carcinoma) were found in four men. The clinical courses of these cases were compared to 16 other non‐neuroendocrine cell tumors (adenocarcinomas).Results: The outstanding features of the neuroendocrine cell tumors were: (i) survival was brief after relapse, although the duration of control by employing endocrine therapy varied; (ii) the prostate‐specific antigen level did not increase after relapse; and (iii) the sites of metastasis were similar to those of common adenocarcinomas.Conclusion:The progression to a neuroendocrine cell tumor indicated a poor prognosis and slight (if any) changes in the serum prostate‐specific antigen level. This tumor might not appear to respond to any therapeutic attempt.
Dartos flap interposition in the surgical repair of rectourethral fistulas
Authors: Yamazaki Yuichiro , Yago Rie , Toma Hiroshi 
Published: March 2003

Abstract Background: Multilayer closures are important techniques in urethral fistula repair. We report our experience with dartos flap interposition in the repair of rectourethral fistula.Methods/Results: A tip of a V‐shaped scrotal skin flap is mobilized and de‐epithelialized to develop a dartos flap. Two patients with a rectourethral fistula underwent fistula closure covered with this dartos flap. The surgical repair was successful in both cases and neither patient showed any late complication.Conclusions: A scrotal dartos flap is well vascularized and easy to mobilize. We believe this technique is helpful in preventing postoperative complications following complex posterior urethral surgery.
Effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume
Authors: Yuen John Shyi Peng , Ngiap James Tan Khiaw , Cheng Christopher Wai Sam , Foo Keong Tatt 
Published: March 2003

Abstract
Background: A filled bladder acts as an acoustic window for transabdominal ultrasound measurements of intravesical prostatic protrusion and volume. The aim of this study is to evaluate the effects of bladder volume on transabdominal ultrasound measurements of these parameters.
Methods: Twenty‐two patients undergoing transurethral resection of the prostate (TURP) were studied. Under general anesthesia just before TURP, a transrectal ultrasound measurement of prostate volume was obtained. The bladder was then filled in a stepwise manner with 100, 200, 300, 400 and 500 mL. At each volume, the intravesical prostatic protrusion and prostatic volume were measured transabdominally using ultrasound.
Results: There was an obvious trend of decreasing mean transabdominal intravesical prostatic protrusions with increasing bladder volume. The mean transabdominal intravesical prostatic protrusion at bladder volumes 100, 200, 300, 400 and 500 mL was 9.1, 8.8, 7.4, 5.8 and 4.6 mm, respectively. The bladder volume at which maximum prostatic protrusion occurred was between 100 and 200 mL. The mean transabdominal prostate volume at the five increasing bladder volumes was 50.6, 48.7, 49.2, 47.9 and 41.4 mL, and these were correlated to transrectal prostate volume, particularly when the bladder volume was less than 400 mL.
Conclusions: Transabdominal ultrasound measurement of prostatic protrusion is dependent on bladder volume. Transabdominal ultrasound measurement of prostatic volume correlates well with the transrectal measurement of the same parameter when the bladder volume is less than 400 mL.
Hyperbaric oxygen therapy for Wegener's granulomatosis with cyclophosphamide‐induced hemorrhagic cystitis
Authors: Kuroda Isao , Kuwata Yoshihiro , Kakehi Yoshiyuki 
Published: March 2003

AbstractA 49‐year‐old man with Wegener's granulomatosis, who had been treated with cyclophosphamide, was admitted to our hospital experiencing gross hematuria. The hemorrhage was refractory to multiple conventional treatments. It progressed but later was resolved after a course of hyperbaric oxygen therapy.
Penile metastasis of prostatic adenocarcinoma
Authors: ŞENKUL TEMUÇİN , KARADEMİR KENAN , Ş İLİT EMİR , İ ŞERİ CÜNEYT , ERDEN DOĞAN , BALOĞLU HÜSEYİN 
Published: March 2003

AbstractProstatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate with metastases to the penile shaft and glans penis is presented.
Differences in length of stay for Hospital in the Home patients: comparing simple clinical coding with medical record review
Authors: Ioannides‐Demos L. L. , Addicott R. , Santamaria N. M. , Clayton L. , McKenzie M. , Fairley C. K. 
Published: March 2003

Abstract Aim: To determine whether the apparently longer length of stay (LOS) reported for patients with cellulitis managed in Hospital in the Home (HITH) compared with those managed as inpatients was correct. Methods: Data, including LOS, from the Victorian In‐patient Minimum Database (VIMD) of all patients with cellulitis managed between July 1998 and June 1999 at a large metropolitan teaching hospital were analysed and compared with a retrospective medical record review of the same patients. Results: In the VIMD data, there were 266 episodes of cellulitis during the study period. However, the medical record review found that six episodes were not separate, but rather a continuation of treatment for the same episode of cellulitis, and that 18 were not episodes of cellulitis, but were pilonidal sinus infections. In the VIMD data set, the mean LOS for patients treated in HITH was generally longer than that for inpatients (7.2 days vs 5.1 days, respectively, P = 0.002). However, in the retrospective medical record review, the LOS for patients treated in HITH was similar to inpatients (7.3 days versus 7.0 days, respectively, P = 0.68). Conclusions: In contrast to the VIMD data, the medical record review demonstrated that, overall, patients with cellulitis had a similar LOS irrespective of whether they were managed at home or in hospital. This study confirms that caution is required in interpreting the VIMD data, highlights the importance of carefully monitoring the introduction of new treatment modalities and indicates areas for further research. (Intern Med J 2001; 31: 142–145)