International journal of urology : official journal of the Japanese Urological Association
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Comparative Study
Acute normovolemic hemodilution for radical prostatectomy: can it replace preoperative autologous blood transfusion?
Although preoperative autologous blood donation (PAD) is accepted as a standard of care for radical prostatectomy, it is costly, time-consuming and has risks associated with blood storage. Acute normovolemic hemodilution (ANH) is reported to be less expensive and to preserve blood components more effectively than PAD. In the present study, the efficacy and safety of these two autologous blood-collection techniques were compared. ⋯ The two blood-conservation strategies resulted in similar postoperative hematologic outcomes. Given its advantages, which include lower cost, lower risk and higher convenience, ANH is one of the procedures that may replace conventional PAD for use in radical prostatectomy.
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Although a mass screening urinalysis is a widely accepted procedure, it has not yet been shown if microhematuria is an appropriate and useful screening marker for urologic malignancies. ⋯ Microhematuria is an appropriate screening marker for urothelial carcinomas, particularly in elderly men, but not for RCC. However, it is unlikely that a mass screening urinalysis using a single voided urine sample would contribute to earlier detection of bladder carcinoma.
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Case Reports
Successful treatment with polymyxin B immobilized fiber of septic shock complicated by renal stone.
We describe a patient with septic shock that was spontaneously complicated by calyceal diverticular calculus. The patient recovered from shock within a few days with treatment by extracorporeal elimination of endotoxin using a blood purification cartridge consisting of polymyxin B immobilized fiber. Standard open nephrolithotomy was performed, and the patient was discharged from the hospital 2 months after admission.
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Comparative Study Clinical Trial Controlled Clinical Trial
Clinicopathological features of prostate cancer detected by transrectal ultrasonography-guided systematic six-sextant biopsy.
The objectives of this study were to compare the efficacy of 3 modalities (prostate-specific antigen (PSA) assay, digital rectal examination (DRE), and transrectal ultrasonography (TRUS)) in detecting prostate cancer which was pathologically confirmed by TRUS-guided systematic six-sextant biopsy, and to investigate the relationship between the number of positive cores and several clinicopathological parameters. ⋯ The serum PSA assay was more useful than either DRE or TRUS in detecting prostate cancer. The percentage of bone metastasis increased concomitant with the number of positive biopsy cores, and the positive biopsy rate of hypoechoic areas positively correlated with the PSA level.
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Clinical differential diagnosis between malignant and benign tumors is important in order to select a therapeutic strategy for a primary retroperitoneal tumor. ⋯ This study suggests that the size of tumor, the presence of symptoms, irregular margins, and the absence of calcification may be valuable predictors of primary retroperitoneal malignant tumor.