Hinyokika kiyo. Acta urologica Japonica
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In this study we investigated the influences of decreased levels of activities of daily living (ADL), especially in bedridden patients,on lower urinary tract dysfunction and urinary management during hospital care. All 1,106 non-urological inpatients (896 non-bedridden patients and 210 bedridden patients) with an indwelling urethral catheter treated at Noto General Hospital between April 2006 and October 2009 were retrospectively evaluated. Maximum bladder capacity and post-void residual urine volume (PVR) were evaluated with uroflowmetry or voiding cystourethrography at the time the catheter was removed. ⋯ Bedridden patients required urinary interventions at a higher rate than did non-bedridden patients (bedridden : 29.0%,non-bedridden : 17.6%). Although indwelling urethral catheters were reinserted in 13 patients in the bedridden group and 16 patients in the non-bedridden group,many patients in both groups could be free from the catheter. Our results indicate that patients with low ADL are vulnerable to impaired bladder emptying,and early diagnosis of impaired bladder emptying and active urinary management are required to solve their urinary problems.
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Case Reports
[A case of Fournier's gangrene in which Flexi-Seal was effective for evacuation management].
A 67-year-old male was referred to our hospital with septicemia from necrotizing fasciitis of the genitalia of unknown origin. He had a history of diabetes and cerebral infarction. Extensive debridement of necrotizing tissue was performed over an area extending from the lower abdomen to the light inguinal,scrotal and perianal regions. ⋯ There was no contamination of perianal wounds,allowing them to be closed without infection. The Flexi-Seal was successfully removed after around 3 weeks. This is the second case in which Flexi-Seal was used in Japan to treat Fourier's gangrene.
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Emphysematous cystitis is a rare condition characterized by air formation in and around the bladder wall by gas-forming organisms. An 89-year-old non-diabetic man with benign prostatic hyperplasia and neurogenic bladder presented at our hospital with fever and lower abdominal pain. ⋯ He recovered and the intramural gas appeared to have disappeared on the abdominal computed tomography after urinary drainage and antibiotic therapy. Ninty-nine cases of emphysematous cystitis have been reported in Japan including this case.
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Case Reports
[Malignant paraganglioma responsive to CVD therapy and radiation therapy : a case report].
The patient, a 55-year-old man, had undergone surgery for retroperitoneal paraganglioma at the age of 45. In February 2006, he visited our hospital with the chief complaint of metastatic tumors detected by a thorough checkup. Computed tomographic (CT) scan revealed a large tumor in the right kidney hilar region and a left supraclavicular lymphadenopathy. ⋯ Subsequently, palliative radiation therapy of 50 Gy in 25 fractions was administered and was temporarily effective. The CVD therapy and radiation therapy were considered to be effective for this case. In May 2008, he died 25 months after the start of CVD therapy.
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Review Case Reports
[A case of metachronous testicular tumor developing seven years after complete remission of retroperitoneal extragonadal germ cell tumor].
A 26-year-old man was admitted to our hospital with a chief complaint of left cervical lymphadenopathy. He was diagnosed as having seminoma by needle biopsy. Computed tomography revealed an aorto-caval retroperitoneal tumor. ⋯ Neither distant metastasis nor lymph node metastasis was detected by computed tomography. Right radical orchiectomy was performed and histology revealed seminoma with yolk sac tumor components. No recurrence has been seen after 10 months.