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This report describes an unusual case of sarcomatoid carcinoma of the bladder in a 3-year-old girl. Although saving the patient's life is most essential, it is also essential to consider quality of life. The patient underwent neoadjuvant chemotherapy with gemcitabine and cisplatin for bladder preservation. The tumor considerably decreased in size. After 4 courses of chemotherapy, the patient underwent a partial cystectomy followed by postoperative irradiation with 2 courses of chemotherapy. Seventy months after the operation, she remains alive, showing complete remission with normal bladder function. Chemotherapy resulted in tumor shrinkage and allowed for bladder preservation.

Aims To determine the distributions of bothersome and non-bothersome nocturnal voiding and the differences between them using a community-based study. Subjects and Methods A total of 2,205 men and women aged 41–70 years from three Japanese towns responded to our postal questionnaire survey. The questionnaire included the International Prostate Symptom Score, Pittsburgh Sleep Quality Index (PSQI), Medical Outcome Study Short Form-8, medical history of several diseases, and history of cigarette smoking and alcohol consumption. We chose subjects who had one or two episodes of nocturnal voiding per night and divided them into two subgroups based on the answer to a question on trouble sleeping due to nocturnal voiding in the PSQI. We compared data regarding lower urinary tract symptoms (LUTS), sleep, and general health-related quality of life (GHQL) among these subgroups. Results Of the subjects: 314 (14.2%), 693 (31.4%), 149 (6.8%), and 168 (7.6%) had once-bothersome, once-non-bothersome, twice-bothersome, and twice-non-bothersome nocturnal voiding per night, respectively. Regarding LUTS, the twice-bothersome nocturnal voiding group had the worst and the once-non-bothersome group had the best scores while the once-bothersome and twice-non-bothersome nocturnal voiding groups had equivalent scores. Regarding sleep and GHQL, trouble sleeping but not the frequency of nocturnal voiding per se affected the scores. The twice-non-bothersome nocturnal voiding group generally had better scores than the once-bothersome group, while the former had more frequent nocturnal voiding. Conclusions Sleep and GHQL of subjects with mild (once or twice) night-time frequency are considerably impacted by sleeping troubles. Neurourol. Urodynam. 26:1014–1019, 2007. © 2007 Wiley-Liss, Inc.

We modified Studer's bladder substitute technique and constructed continent urinary reservoir for 7 patients with bladder tumors after transprostatic cystoprostatectomy. Studer's bladder substitute technique is characterized by both a tubular isoperistatic proximal limb of 20 cm of the ileum in continuity with the pouch constructed using the detubularized ileum and the ureters reimplanted into the proximal part of the limb using a simple lateral anastomosis of the ureters to the end of the limb. Our modifications, transprostatic resection, was that distal one third or fourth of the prostate was left after cystoprostatectomy followed by either enucleation of the whole residual prostatic tissue including the urethra (type II) or sharp resection of the tissue leaving the urethra (type III). A small hole in the lowest part of the pouch was anastomosed either to the residual prostatic capsule (type II) or to the residual prostatic urethra (type III). Our modified Studer's technique was simple, easy to perform, and had low risk of massive bleeding especially from the central vein overlying the appex of the prostate. Clinical results were as follows; 1) all patients were satisfied with the passing of their urine per urethra without any cutaneous stoma, 2) no patients had clinical signs of pyelonephritis after discharge, 3) urine was not infected.(ABSTRACT TRUNCATED AT 250 WORDS)

We conducted a community-based study to determine the relationship among night-time frequency, sleep disturbance and general health-related quality of life (GHQL).A total of 2271 participants, men and women, aged 41-70 and randomly selected in three Japanese towns completed a postal questionnaire survey. This questionnaire included: the International Prostate Symptom Score, the overall incontinence score of the International Consultation of Incontinence Questionnaire Short Form for lower urinary tract symptoms, the Pittsburg Sleep Quality Index for sleep problems, the Medical Outcome Study Short Form-8 for GHQL, and medical history of disease, cigarette smoking, and alcohol consumption. A multiple regression model was used for statistical analysis, and P0.05 was considered significant.Although night-time frequency by itself was closely associated with most aspects of GHQL, this association disappeared in four domains (general health perception, vitality, mental health and emotional role) and in the two summary scores of the Medical Outcome Study Short Form-8 after inclusion of the influence of sleep problems represented by the total score on the Pittsburg Sleep Quality Index. However, three domains (physical function, physical role, and social function) remained significantly associated with night-time frequency. Sleep problems were by far the worst risk factor for the deterioration of GHQL.Night-time frequency appeared to be associated with GHQL mainly by affecting sleep conditions, a symptom that independently influenced some aspects of GHQL.

OBJECTIVES To conduct a community-based questionnaire study to uncover the relationship between climates and lower urinary tract symptoms. METHODS A total of 6000 residents aged 41 to 70 years were randomly selected in three Japanese towns (Tobetsu in a subartic zone, Kumiyama in a temperate zone, and Sashiki in a subtropical zone). A self-administered questionnaire, which included the International Prostate Symptom Score, and overall incontinence score from the International Consultation on Incontinence Questionnaire Short Form was mailed to one half of the targets in the summer and the remaining one half in the winter. A logistic regression model was used for the main statistical analysis, with P

Background. A 43-yr-old man was admitted to our hospital after sudden onset of epigastric pain. He was diagnosed with acute pancreatitis by clinical, laboratory, and radiographic signs. Examinations for the etiology of acute pancreatitis revealed a duodenal tumor arising at the proximal portion of the descending limb, extending by a long stalk, and coming into contact with Vater's papilla. The tumor was snare-resected endoscopically. Histological examination showed an early carcinoma. Extra-ampullary carcinoma of the duodenum should be considered an unusual cause of acute pancreatitis secondary to obstruction of the major duodenal papilla. Endoscopic polypectomy is effective because of the difficulty in making a precise diagnosis by endoscopic biopsy.