Hinyokika kiyo. Acta urologica Japonica
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Comparative Study
[The clinical value of 3 tesla diffusion-weighted magnetic resonance imaging in the diagnosis of prostate cancer].
Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) method and is considered potentially useful for detecting prostate cancer. We evaluated the clinical value of DWI with apparent diffusion coefficient (ADC) maps in addition to T2-weighted imaging (T2WI) using 3 tesla (3 T) MRI. Thirty-three patients with elevated prostate specific antigen were evaluated by MRI with T2WI and DWI prior to transperineal template-guided mapping biopsy. ⋯ Mean ADC values were significantly different between cancer positive and negative cores (p＜0.001). The ADC value showed a negative correlation with increasing tumor length (p＝0.0047). Although further study with a large number of patients is necessary, DWI/ADC using 3 T MRI is a useful tool for detecting prostate cancer.
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Severe urinary tract infection occasionally causes urosepsis and disseminated intravascular coagulation (DIC). We experienced six cases of DIC with severe urinary tract infection from July 2009 to January 2011. Patients comprised two men and four women, ranging in age from 67-84 years old. ⋯ Under the diagnosis of DIC, the administration of antibiotics and anti-DIC treatment with recombinant thrombomodulin (rTM) were performed. rTM isa new drug for the treatment of DIC. rTM binds to thrombin to inactivate coagulation, and the thrombinrTM complex activates protein C to form activated protein C. Therefore, rTM actsasa negative feedback regulator of blood coagulation. Treatment with rTM improved in 5 of the 6 patients.
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The patient was a 72-year-old man with C4 incomplete tetraplegia incurred in a traffic accident in March, 2008. He managed his bladder with an indwelling Foley catheter. In August, 2009, the catheter obstruction induced autonomic dysreflexia (AD). ⋯ The main triggering factors are bladder overdistension and bowel distension. Most events subside after prompt recognition and removal of the triggering factors, but, it is a life threatening emergency that may lead to apoplexy. This life-threatening complication should be kept in mind in the patients with spinal cord injury.
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Comparative Study
[Use of 2-octylcyanoacrylate tissue glue for skin closure in radical retropubic prostatectomy].
2-Octylcyanoacrylate tissue adhesive (2-OCA ; Dermabond® , Ethicon, Inc., Sommerville, New Jersey) is a synthetic tissue adhesive recently used for skin closure in the treatment of minor lacerations and minor surgical incisions. We have been using this adhesive for wound closure in radical retropubic prostatectomy (RRP) since August 2006. Before that we used a skin stapler. ⋯ Wound dehiscence without SSI was seen in 1 patient in the glue group. The cost of surgery with 2-OCA was much lower than that with the skin stapler. Wound closure using 2-OCA following RRP is acceptable and has benefits in terms of surgical costs.
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Review Case Reports
[A case of empysematous cystitis which was found incidentally].
A 49-year-old female visited our hospital with a complaint of pelvic pain. She was under treatment for diabetes mellitus and dilated cardiomyopathy. Radiography revealed a radiolucent area in the bladder. ⋯ These findings were consistent with a diagnosis of emphysematous cystitis. The urine culture yielded Escherichia coli. After urinary drainage and antibiotic therapy, she was cured of emphysematous cystitis.