In laparoscopic operations for renal tumor and upper urinary-tract transitional-cell carcinoma (TCC), three approaches - the transperitoneal, retroperitoneal, and transperitoneal hand-assisted - have ...been reported. We have performed hand-assisted retroperitoneoscopic radical nephrectomy (RN) since 1999 and nephroureterectomy (NU) since 2000. The surgical techniques and the operative results of 95 cases of RN and 54 cases of NU are described and analyzed. These procedures were effective and safe for renal tumors and upper urinary-tract TCC.
To examine the predictive value of ultrasonic measurements obtained by transrectal ultrasonography for infravesical obstruction as evaluated by pressure flow studies.
In 85 men with moderate to ...severe lower urinary tract symptoms, ultrasonic measurements including prostatic volume, transition zone volume, transition zone index (transition zone volume/prostatic volume) and presumed circle area ratio (PCAR) were compared with urodynamic parameters obtained by pressure flow studies.
There were significant interrelationships between these ultrasonic measurements, which were all significantly greater in the obstructed patients than in the unobstructed patients. A simple regression analysis demonstrated that prostatic volume (
r = 0.362,
P < 0.001 ), transition zone volume (
r = 0.373,
P < 0.0005), transition zone index (
r = 0.331,
P < 0.005) and PCAR (
r = 0.487,
P < 0.0001) correlated significantly with the Abrams-Griffiths number. More importantly, a multiple regression analysis demonstrated PCAR to be the only independent determinant of the Abrams-Griffiths number. A receiver operator characteristics curve analysis showed that 0.8 was the most suitable cutoff value of PCAR for the prediction of infravesical obstruction with a diagnostic accuracy of 76.5%.
PCAR is useful as a transrectal ultrasonic measurement in assessing the severity of infravesical obstruction in men with lower urinary tract symptoms.
Full text
Available for:
IJS, IMTLJ, KILJ, KISLJ, NUK, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Objectives. To evaluate the relationship between bedwetting and development in infancy.
Methods. Questionnaires concerning micturition habits and development at 3 and 5 years of age were completed by ...the parents of 157 children who had had their health checked by pediatricians at a group checkup at 3 years of age.
Results. The percentage of bedwetters in whom the frequency of bedwetting was at least once a month was 53% at 3 years of age and 21% at 5 years of age. The prevalent resolution period of bedwetting in infants was 2.5 to 3.5 years of age. The head circumference for boys at birth differed significantly between the bedwetters and nonbedwetters at both ages. Daytime symptoms were more frequent among bedwetters at both ages. Earlier toilet training had no influence on bedwetting at 5 years of age, although it led to earlier control at night at a younger age. Delays in speaking and walking might be factors connected to bedwetting. The prevalence of bedwetting in boys was higher than that in girls. Multiple logistic regression analysis revealed that daytime incontinence and sex were significant factors for bedwetting at 5 years of age.
Conclusions. Daytime incontinence and sex were the significant factors for bedwetting in infancy. Head circumference for boys and developmental delays in speaking and walking might also be important factors.
Full text
Available for:
IJS, IMTLJ, KILJ, KISLJ, NUK, SBCE, SBJE, UL, UM, UPCLJ, UPUK
We clarified the relationships of the renal resistive index, reflux and renal scarring.
The resistive index in the interlobar artery was measured using power Doppler ultrasonography in 22 patients ...with reflux (reflux group), 13 with postoperative or resolved reflux (previous reflux group) and 20 who served as controls.
Resistive index values in 11 kidneys with mid or high grade reflux were significantly higher than in 22 with low grade reflux and in the 40 normal kidneys. The resistive index in the 11 kidneys with reflux and scarring was significantly higher than in the 22 with reflux and without scarring, and in the 40 normal kidneys. The resistive index in the 14 kidneys with previous reflux and scarring was significantly higher than in 12 with previous reflux and without scarring, and in the 40 normal kidneys. Receiver operating characteristics curve analysis in 25 kidneys with and 34 without scarring revealed that a discriminatory resistive index value of 0.71 was optimal for detecting renal scarring. When the resistive index cutoff value was 0.71, there was 76% sensitivity for diagnosing renal scarring, 91% specificity and 85% overall accuracy.
Our results show the possibility that an increased resistive index in kidneys with reflux predicts renal scarring. The resistive index measured with power Doppler ultrasonography may be a noninvasive and useful alternative for screening and following renal scarring.
