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Gomes CM, Hisano M, Souza JD, Henriques JVT, de Bessa J, Moromizato J, Bosi T, Mazoni R, Gismondi J, Camargo B, Sammour ZM, Bruschini H, Battistella LR, Nahas WC. Lower Urinary Tract Symptoms in a prospective cohort of COVID-19 survivors. Int Braz J Urol 2024; 50:287-295. [PMID: 38498685 DOI: 10.1590/s1677-5538.ibju.2023.0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To analyze the prevalence of lower urinary tract symptoms (LUTS) in patients who survived moderate and severe forms of COVID-19 and the risk factors for LUTS six months after hospitalization. MATERIALS AND METHODS In this prospective cohort study, patients were evaluated six months after hospitalization due to COVID-19. LUTS were assessed using the International Prostate Symptom Score. General health was assessed through the Hospital Anxiety and Depression Scale and the EQ5D-L5 scale, which evaluates mobility, ability to perform daily activities, pain and discomfort and completed a self-perception health evaluation. RESULTS Of 255 participants, 54.1% were men and the median age was 57.3 [44.3 - 66.6] years. Pre-existing comorbidities included diabetes (35.7%), hypertension (54.5%), obesity (30.2%) and physical inactivity (65.5%). One hundred and twenty-four patients (48.6%) had a hospital stay >15 days, 181 (71.0%) were admitted to an ICU and 124 (48.6%) needed mechanical ventilation. Median IPSS was 6 [3-11] and did not differ between genders. Moderate to severe LUTS affected 108 (42.4%) patients (40.6% men and 44.4% women; p=0.610). Nocturia (58.4%) and frequency (45.9%) were the most prevalent symptoms and urgency was the only symptom that affected men (29.0%) and women (44.4%) differently (p=0.013). LUTS impacted the quality of life of 60 (23.5%) patients with women more severely affected (p=0.004). Diabetes, hypertension, and self-perception of worse general health were associated with LUTS. CONCLUSIONS LUTS are highly prevalent and bothersome six months after hospitalization due to COVID-19. Assessment of LUTS may help ensure appropriate diagnosis and treatment in these patients.
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Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julia D Souza
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | | | - Jose de Bessa
- Departamento de Cirurgia, Universidade Estadual de Feira de Santana, Bahia, Brasil
| | - Julyana Moromizato
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Thulio Bosi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Rachel Mazoni
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - João Gismondi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Bruno Camargo
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Zein M Sammour
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Homero Bruschini
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Linamara R Battistella
- Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - William C Nahas
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
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Hisano M, Bruschini H, Gomes CM. Empiric antimicrobial treatment in women with recurrent urinary tract infection. Neurourol Urodyn 2021; 40:941-942. [PMID: 33604943 DOI: 10.1002/nau.24628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/23/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Marcelo Hisano
- Division of Urology, University of São Paulo, School of Medicine, São Paulo, São Paulo, Brazil
| | - Homero Bruschini
- Division of Urology, University of São Paulo, School of Medicine, São Paulo, São Paulo, Brazil
| | - Cristiano M Gomes
- Division of Urology, University of São Paulo, School of Medicine, São Paulo, São Paulo, Brazil
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Iscaife A, Marchini GS, Srougi V, Torricelli FCM, Danilovic A, Vicentini FC, Machado M, Hisano M, Tiseo BC, Bissoli JC, Cocuzza M, Hallak J, Srougi M, Nahas WC. The urologist's role in the fight of COVID-19 pandemic: mandatory mindset shift on the frontline. Int Braz J Urol 2020; 46:879-882. [PMID: 32459458 PMCID: PMC7822373 DOI: 10.1590/s1677-5538.ibju.2020.0316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Alexandre Iscaife
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Giovanni S Marchini
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Victor Srougi
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Fabio C M Torricelli
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Alexandre Danilovic
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Fabio C Vicentini
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcos Machado
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Bruno C Tiseo
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Júlio C Bissoli
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcello Cocuzza
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Jorge Hallak
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Miguel Srougi
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - William C Nahas
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
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Neumaier MF, Segall CH, Hisano M, Rocha FET, Arap S, Arap MA. Factors affecting urinary continence and sexual potency recovery after robotic-assisted radical prostatectomy. Int Braz J Urol 2019; 45:703-712. [PMID: 31136108 PMCID: PMC6837589 DOI: 10.1590/s1677-5538.ibju.2018.0704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/24/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.
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Affiliation(s)
| | | | - Marcelo Hisano
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Flávio Eduardo Trigo Rocha
- Hospital Sírio-Libanês, São Paulo, SP, Brasil.,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Sami Arap
- Hospital Sírio-Libanês, São Paulo, SP, Brasil.,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Marco A Arap
- Hospital Sírio-Libanês, São Paulo, SP, Brasil.,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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Nawashiro Y, Shiraki K, Yamamoto S, Takizawa K, Sasada Y, Suehiro M, Miura K, Hattori M, Daikoku T, Hisano M. Persistent Primary Cytomegalovirus Infection After Deceased Donor Kidney Transplant: Ganciclovir Susceptibility of Human Cytomegalovirus With UL97 D605E Mutation: A Case Report. Transplant Proc 2018; 50:3932-3936. [PMID: 30577289 DOI: 10.1016/j.transproceed.2018.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/05/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) could cause rejection in immunocompromised patients during early post-renal transplant stage. The American Transplant Society guidelines recommend prophylactic therapy with ganciclovir (GCV) for 3 to 6 months to prevent CMV infections in adult renal transplant patients. However, there is no recommended CMV treatment regimen for pediatric patients. MAIN FINDINGS We performed deceased donor kidney transplant from an anti-CMV antibody-positive donor to an anti-CMV antibody-negative 15-year-old female recipient with end-stage renal disease caused by bilateral renal hypoplasia. One month after transplant, increase in positive cells in the CMV antigenemia assay indicated a primary CMV infection in the patient, who immediately received GCV. She was switched to foscarnet after 4 months of anti-CMV therapy because of clinical GCV resistance. CMV was isolated from the peripheral blood mononuclear cells but neutralizing antibody was not detected. Isolated CMV was susceptible to GCV and foscarnet, although it carried the UL97 D605E mutation, assumed to be associated with GCV resistance. CONCLUSIONS The primary CMV infection presented a phenotypic clinical drug resistance, but all recovered CMV isolates were drug-susceptible even if isolated after prolonged anti-CMV therapy, indicating that immune status was more important for recovery from primary CMV infection than anti-CMV therapy.
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Affiliation(s)
- Y Nawashiro
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan.
| | - K Shiraki
- Department of Virology, University of Toyama, Toyama, Japan
| | - S Yamamoto
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - K Takizawa
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - Y Sasada
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - M Suehiro
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - K Miura
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - M Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - T Daikoku
- Department of Life Pharmacy, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan
| | - M Hisano
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
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Vicentini FC, Perrella R, Souza VMG, Hisano M, Murta CB, Claro JFDA. Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones. Int Braz J Urol 2018; 44:965-971. [PMID: 30088725 PMCID: PMC6237521 DOI: 10.1590/s1677-5538.ibju.2018.0163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/31/2018] [Indexed: 12/28/2022] Open
Abstract
Purpose: To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. Material and Methods: From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning. Complications were graded according to the modified-Clavien Classification. Success was considered if fragments ≤ 4mm were observed on the first postoperative day CT scan. Results: We analyzed 240 (46.4%) of 517 PCNL performed during the study period that were classified as GGS 3-4. Regarding patient positions, 21.2% were prone and 79.8% were supine. Both groups were comparable, although intercostal access was more common in prone cases (25.5% vs 10.5%; p=0.01). The success rates, complications, blood transfusions and surgical times were similar for both groups; however, there were significantly more visceral injuries (10.3% vs 2.6%; p=0.046) and sepsis (7.8% vs 2.1%; p=0.042) in prone cases. Conclusion: Supine or prone position were equally suitable for PCNL with complex stones and did not impact the success rates. However, supine position was associated with fewer sepsis cases and visceral injuries.
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Affiliation(s)
- Fabio Carvalho Vicentini
- Departamento de Urologia, Setor de Endourologia e Litíase, Hospital Brigadeiro, São Paulo, SP, Brasil
| | - Rodrigo Perrella
- Departamento de Urologia, Setor de Endourologia e Litíase, Hospital Brigadeiro, São Paulo, SP, Brasil
| | - Vinicius M G Souza
- Departamento de Urologia, Setor de Endourologia e Litíase, Hospital Brigadeiro, São Paulo, SP, Brasil
| | - Marcelo Hisano
- Departamento de Urologia, Setor de Endourologia e Litíase, Hospital Brigadeiro, São Paulo, SP, Brasil
| | - Claudio Bovolenta Murta
- Departamento de Urologia, Setor de Endourologia e Litíase, Hospital Brigadeiro, São Paulo, SP, Brasil
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de Souza Melo PA, Vicentini FC, Beraldi AA, Hisano M, Murta CB, de Almeida Claro JF. Outcomes of more than 1 000 percutaneous nephrolithotomies and validation of Guy's stone score. BJU Int 2018; 121:640-646. [PMID: 29322602 DOI: 10.1111/bju.14129] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To present the experience with percutaneous nephrolithotomy (PCNL) at a high-volume Brazilian centre and to evaluate Guy's stone score (GSS) as a predictor of success and complications in PCNL. PATIENTS AND METHODS We prospectively evaluated patients who underwent PCNL between June 2011 and October 2016. Indications for PCNL included renal stones >2 cm in size and stones <2 cm in size in which first-line techniques had failed. All patients underwent a complete preoperative evaluation, including non-contrast-enhanced abdominal computed tomography (CT). Stone complexity was assessed using GSS. Success was defined as the absence of fragments >2 mm on CT on postoperative day 1. Complications were classified according to the Clavien grade. RESULTS A total of 1 066 PCNLs were performed on 891 patients. In all, 20.2% were classified as GSS1, 27.4% as GSS2, 35.0% as GSS3, and 17.4% as GSS4. The mean operating time was 108.44 min, and the mean fluoroscopy time was 13.57 min. The overall immediate success rate based on postoperative day 1 CT was 43.8%. Complications occurred in 14.9% of cases, and the mean length of hospital stay was 54.55 h. Stratifying patients according to GSS, success rate was inversely proportional to the calculus complexity: GSS1: 87.9%; GSS2: 62.1%; GSS3: 44.0%; and GSS4: 24.3% (P < 0.001). Higher GSS categories were significantly correlated with the number of puncture tracts (P < 0.001), operating time (P < 0.001), fluoroscopy time (P < 0.001), blood transfusion rate (P < 0.001), complications (P < 0.001) and length of stay (P < 0.001). CONCLUSION In a high-volume centre, PCNL was a reliable surgical technique, with low morbidity and short hospital stay. GSS was confirmed to be a very useful tool for predicting the outcomes of PCNL, and its use should be encouraged.
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Affiliation(s)
| | | | | | - Marcelo Hisano
- Division of Urology, Men's Health Centre, Hospital Brigadeiro, Sao Paulo, SP, Brazil
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Vicentini FC, Botelho LAA, Braz JLM, Almeida ES, Hisano M. Use of the Uro Dyna-CT in endourology - the new frontier. Int Braz J Urol 2017; 43:762-765. [PMID: 28338302 PMCID: PMC5557454 DOI: 10.1590/s1677-5538.ibju.2016.0413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 08/29/2016] [Indexed: 11/22/2022] Open
Abstract
We describe the use of the Uro Dyna-CT, an imaging system used in the operating room that produces real-time three-dimensional (3D) imaging and cross-sectional image reconstructions similar to an intraoperative computerized tomography, during a percutaneous nephrolithotomy and a contralateral flexible ureteroscopy in a complete supine position. A 65 year-old female patient had an incomplete calyceal staghorn stone in the right kidney and a 10mm in the left one. The procedure was uneventful and the intraoperative use of the Uro Dyna-CT identified 2 residual stones that were not found by digital fluoroscopy and flexible nephroscopy at the end of surgery, helping us to render the patient stone-free in one procedure, which was confirmed by a postoperative CT scan. Prospective studies will define the real role of the Uro Dyna-CT for endourological procedures, but its use seems to be a very promising tool for improving stone free rates and decreasing auxiliary procedures, especially for complex cases.
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Affiliation(s)
- Fabio C Vicentini
- Departamento de Urologia, Centro do Cálculo Renal do Hospital 9 de Julho, São Paulo, Brasil
| | - Luiz A A Botelho
- Departamento de Urologia, Centro do Cálculo Renal do Hospital 9 de Julho, São Paulo, Brasil
| | - José L M Braz
- Departamento de Anestesia, Hospital 9 de Julho, São Paulo, Brasil
| | - Ernane S Almeida
- Departamento de Enfermagem, Centro Cirúrgico do Hospital 9 de Julho, São Paulo, Brasil
| | - Marcelo Hisano
- Departamento de Urologia, Centro do Cálculo Renal do Hospital 9 de Julho, São Paulo, Brasil
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Melo PADS, Vicentini FC, Cohen DJ, Hisano M, Murta CB, Claro JFDA. Laparoscopic - assisted percutaneous nephrolithotomy as an alternative in the treatment of complex renal calculi in patients with retrorenal colon. Int Braz J Urol 2017; 44:405-406. [PMID: 29039891 PMCID: PMC6050574 DOI: 10.1590/s1677-5538.ibju.2017.0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/21/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - David Jacques Cohen
- Divisão de Urologia, Centro de Saúde Masculina, Hospital Brigadeiro, São Paulo, SP, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Centro de Saúde Masculina, Hospital Brigadeiro, São Paulo, SP, Brasil
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Sammour ZM, de Bessa J, Hisano M, Bruschini H, Kim CA, Srougi M, Gomes CM. Lower urinary tract symptoms in children and adolescents with Williams-Beuren syndrome. J Pediatr Urol 2017; 13:203.e1-203.e6. [PMID: 27876405 DOI: 10.1016/j.jpurol.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 10/04/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Williams-Beuren syndrome (WBS) is a genetic condition caused by a microscopic deletion in the chromosome band 7q11.23. Individuals with WBS may present with congenital cardiovascular defects, neurodevelopmental disturbances and structural abnormalities of the urinary tract. Lower urinary tract symptoms (LUTS) seem to be frequent in this population, but studies on this topic are scarce and based on small case series. OBJECTIVE To systematically evaluate the prevalence of lower urinary tract symptoms (LUTS) and the acquisition of bladder control in a large population with WBS. STUDY DESIGN A cross-sectional study evaluating 87 consecutive patients with WBS; there were 41 girls and 46 boys. Genetic studies confirmed WBS in all patients. Subjects were clinically evaluated with: a history of LUTS obtained from the parents and child, a structured questionnaire of LUTS, a 3-day urinary frequency-volume chart, a quality of life question regarding LUTS, and physical examination. A history regarding the acquisition of bladder control was directly evaluated from the parents. RESULTS Mean age of patients was 9.0 ± 4.2 years, ranging from 3 to 19 years. Based on the symptoms questionnaire and the frequency-volume chart, 70 patients (80.5%) were symptomatic. The most common symptom was urgency, affecting 61 (70.1%) patients, followed by increased urinary frequency in 60 (68.9%) patients, and urge-incontinence in 53 (60.9%), as shown in Summary Fig. More than half of the children reported nocturnal enuresis, including 61% of the girls and 52% of the boys. Twenty-three patients (25.6%) had a history of urinary tract infections. The mean age for acquisition of dryness during the day was 4.4 ± 1.9 years. Parents of 61 patients (70.1%) acknowledged that LUTS had a significant impact on the quality of life of their children. DISCUSSION A high prevalence of LUTS was confirmed with a significant negative impact on quality of life in a large population of children and adolescents with WBS. It was shown for the first time that the achievement of daytime bladder control is delayed in children with WBS. Although LUTS are not recognized as one of the leading features of the syndrome, it is believed that it should be considered as a significant characteristic of the clinical diagnosis of WBS. CONCLUSIONS LUTS are highly prevalent in children and adolescents with WBS and have a significant negative impact on patient's quality of life.
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Affiliation(s)
- Z M Sammour
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - J de Bessa
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - M Hisano
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
| | - H Bruschini
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - C A Kim
- Genetics Unit of the Pediatrics Department, Children's Institute, University of São Paulo, São Paulo, Brazil
| | - M Srougi
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - C M Gomes
- Division of Urology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
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Suzuki T, Miyake N, Tsurusaki Y, Okamoto N, Alkindy A, Inaba A, Sato M, Ito S, Muramatsu K, Kimura S, Ieda D, Saitoh S, Hiyane M, Suzumura H, Yagyu K, Shiraishi H, Nakajima M, Fueki N, Habata Y, Ueda Y, Komatsu Y, Yan K, Shimoda K, Shitara Y, Mizuno S, Ichinomiya K, Sameshima K, Tsuyusaki Y, Kurosawa K, Sakai Y, Haginoya K, Kobayashi Y, Yoshizawa C, Hisano M, Nakashima M, Saitsu H, Takeda S, Matsumoto N. Molecular genetic analysis of 30 families with Joubert syndrome. Clin Genet 2016; 90:526-535. [PMID: 27434533 DOI: 10.1111/cge.12836] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 02/02/2023]
Abstract
Joubert syndrome (JS) is rare recessive disorders characterized by the combination of hypoplasia/aplasia of the cerebellar vermis, thickened and elongated superior cerebellar peduncles, and a deep interpeduncular fossa which is defined by neuroimaging and is termed the 'molar tooth sign'. JS is genetically highly heterogeneous, with at least 29 disease genes being involved. To further understand the genetic causes of JS, we performed whole-exome sequencing in 24 newly recruited JS families. Together with six previously reported families, we identified causative mutations in 25 out of 30 (24 + 6) families (83.3%). We identified eight mutated genes in 27 (21 + 6) Japanese families, TMEM67 (7/27, 25.9%) and CEP290 (6/27, 22.2%) were the most commonly mutated. Interestingly, 9 of 12 CEP290 disease alleles were c.6012-12T>A (75.0%), an allele that has not been reported in non-Japanese populations. Therefore c.6012-12T>A is a common allele in the Japanese population. Importantly, one Japanese and one Omani families carried compound biallelic mutations in two distinct genes (TMEM67/RPGRIP1L and TMEM138/BBS1, respectively). BBS1 is the causative gene in Bardet-Biedl syndrome. These concomitant mutations led to severe and/or complex clinical features in the patients, suggesting combined effects of different mutant genes.
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Affiliation(s)
- T Suzuki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Y Tsurusaki
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - A Alkindy
- Department of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
| | - A Inaba
- Yokohama City University Medical Center, Children's Medical Center, Yokohama, Japan
| | - M Sato
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - S Ito
- Department of Pediatrics, Graduate school of Medicine, Yokohama City University, Yokohama, Japan
| | - K Muramatsu
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan
| | - S Kimura
- Kumamoto City Child Development Support Center, Kumamoto, Japan
| | - D Ieda
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - S Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - M Hiyane
- Division of Child Neurology, Okinawa Prefectural Southern Medical Center & Children's Medical Center, Okinawa, Japan
| | - H Suzumura
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - K Yagyu
- Department of Child and Adolescent Psychiatry, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - H Shiraishi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - M Nakajima
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - N Fueki
- Division of Rehabilitation, Nagano Children's Hospital, Nagano, Japan
| | - Y Habata
- Department of Pediatric Rehabilitation, Hokkaido Medical Center for Child Health and Rehabilitation, Hokkaido, Japan
| | - Y Ueda
- Nire-no-kai Children's Clinic, Hokkaido, Japan
| | - Y Komatsu
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | - K Yan
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | - K Shimoda
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Shitara
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Mizuno
- Department of Pediatrics, Central Hospital, Aichi Human Service Center, Aichi, Japan
| | - K Ichinomiya
- Department of Neonatology, Gunma Children's Medical Center, Gunma, Japan
| | - K Sameshima
- Division of Medical Genetics, Gunma Children's Medical Center, Gunma, Japan
| | - Y Tsuyusaki
- Division of Neurology, Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Kurosawa
- Division of Medical Genetics, Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Y Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Haginoya
- Department of Pediatric Neurology, Miyagi Children's Hospital, Sendai, Japan
| | - Y Kobayashi
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.,Academic Renal Unit, School of Clinical Science, University of Bristol, Bristol, UK
| | - C Yoshizawa
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan
| | - M Hisano
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - M Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - H Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - S Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Hisano M, Bruschini H, Nicodemo AC, Gomes CM, Lucon M, Srougi M. The Bacterial Spectrum and Antimicrobial Susceptibility in Female Recurrent Urinary Tract Infection: How Different They Are From Sporadic Single Episodes? Urology 2015; 86:492-7. [PMID: 26163810 DOI: 10.1016/j.urology.2015.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/28/2015] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyze and compare the etiological uropathogens and the susceptibility profile findings on urine culture between sporadic cases of community-acquired, uncomplicated urinary tract infection (UTI) and recurrent UTI cases in women. MATERIALS AND METHODS We retrospectively analyzed the clinical data of 1629 women with uncomplicated UTI evaluated at our hospital between January 2007 and December 2012. Patients were divided into 2 groups: (1) no recurrent UTI and (2) recurrent UTI. We analyzed the microbiological findings and compared susceptibility profiles between groups. RESULTS A total of 420 women were included. Group 1 had 233 (55.5%) patients and group 2 had 187 (44.5%). Escherichia coli was the most common agent in both groups (76.4% and 74.3%, respectively; P = .625), whereas Staphylococcus saprophyticus (8.2%) was the second most common in group 1, and Enterococcus faecalis was the second most common in group 2 (8.0%). Nitrofurantoin was the only oral agent that maintained the susceptibility profile in both groups (87.1% and 88.7%, respectively; P = .883). For E coli infections, only nitrofurantoin and amoxicillin/clavulanate maintained susceptibility rates more than 90% in both groups. CONCLUSION UTI episodes in patients with recurrent UTI had similar bacterial spectra, but different susceptibility profiles compared with those from patients with nonrecurrent infections. The susceptibility rate for nitrofurantoin in patients with recurrent UTI remained high and comparable to the observed in patients with sporadic UTI, reinforcing its indication for empirical treatment while waiting for urine culture results.
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Affiliation(s)
- Marcelo Hisano
- Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil
| | - Homero Bruschini
- Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil.
| | | | | | - Marcos Lucon
- Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil
| | - Miguel Srougi
- Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil
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13
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Hisano M, Raichev E, Peeva S, Tsunoda H, Newman C, Masuda R, Georgiev D, Kaneko Y. Comparing the summer diet of stone martens (Martes foina) in urban and natural habitats in Central Bulgaria. ETHOL ECOL EVOL 2015. [DOI: 10.1080/03949370.2015.1048829] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Motomura K, Sasaki A, Hisano M, Yamaguchi K, Ito Y, Ito R, Kasahara M, Matsumoto K, Sago H. A case report of neonatal hemochromatosis treated by high-dose intravenous immunoglobulin. J Reprod Immunol 2014. [DOI: 10.1016/j.jri.2014.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Sammour ZM, Gomes CM, de Bessa J, Pinheiro MS, Kim CAE, Hisano M, Bruschini H, Srougi M. Congenital genitourinary abnormalities in children with Williams-Beuren syndrome. J Pediatr Urol 2014; 10:804-9. [PMID: 24582571 DOI: 10.1016/j.jpurol.2014.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Williams-Beuren syndrome (WBS) is an autosomal dominant disorder caused by a gene deletion on chromosome 7q11.23. Patients with WBS usually show a group of features such as developmental delay, cardiovascular anomalies, mental retardation, and characteristic facial appearance. Abdominal wall defects, external genitalia anomalies, and structural abnormalities of the urinary tract have been scarcely evaluated and were the focus of our study. MATERIALS AND METHODS We prospectively evaluated 41 boys and 38 girls with WBS, with a mean age of 8.8 ± 4.1 (range 3-19 years). All patients were examined for the evaluation of inguinal and umbilical hernias and genital anomalies. All patients were offered a radiological evaluation, including urinary tract ultrasound, voiding cystourethrogram, and dimercaptosuccinic acid renal scintigraphy (DMSA scan). RESULTS Of the 41 boys, 30 (73.1%) had abnormalities on physical examination, including bilateral undescended testis in 13 (31.7%), retractile testis in four (9.7%), hypospadias in four (9.7%), and unilateral cryptorchidism in three (7.3%) patients. Of the 38 female subjects, 17 (44.7%) had at least one abnormality, including umbilical hernia in 11 (28.9%), unilateral inguinal hernia in four (10.5%), and bilateral inguinal hernia in three (7.8%) patients. Uroradiological abnormalities were found in 41 patients (51.9%). On sonography, six (7.6%) patients had unilateral hydronephrosis, three (3.8%) had a duplicated collecting system, and two (2.5%) had kidney stones. On DMSA, performed in 36 patients, four (11.1%) had unilateral renal scarring and two (5.5%) had bilateral renal scarring. Cystourethrography was obtained from 56 patients, of whom 27 (48.2%) had bladder diverticulum, 18 (32.1%) had bladder wall trabeculation, and three (5.3%) had vesicoureteral reflux. We found no association of urological abnormalities with cardiovascular defects. CONCLUSIONS Patients with WBS have a high prevalence of abdominal wall, external genitalia, and urological abnormalities, emphasizing the importance of proper physical examination and radiological investigation in this population.
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Affiliation(s)
- Zein M Sammour
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Cristiano M Gomes
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
| | - Jose de Bessa
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Marcello S Pinheiro
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
| | - Chong A E Kim
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Marcelo Hisano
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Homero Bruschini
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Miguel Srougi
- Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
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16
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Hisano M, Bruschini H, Nicodemo AC, Srougi M. Uncomplicated Urinary Tract Infections in Women in a Sao Paulo Quaternary Care Hospital: Bacterial Spectrum and Susceptibility Patterns. Antibiotics (Basel) 2014; 3:98-108. [PMID: 27025737 PMCID: PMC4790347 DOI: 10.3390/antibiotics3010098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/14/2014] [Accepted: 02/21/2014] [Indexed: 11/16/2022] Open
Abstract
Uncomplicated urinary tract infections (UTI) in women are very common. Regular analysis of bacterial flora is important to formulate updated guidelines. The objective of this study is to determine and compare the microbiology of UTIs and their susceptibility patterns in a quaternary care hospital. In a seven-year review, the urine culture results of 480 female patients with uncomplicated UTIs were analyzed. Patients were divided into three groups according to their diagnosis and treatment characteristics: Group 1, cystitis at outpatient basis; group 2, cystitis at the Emergency Unit; and group 3, pyelonephritis. Group 1 included older patients, with a higher incidence of concomitant diabetes mellitus and recurrent UTIs. E. coli was the most common pathogen, responsible for 75.1% of cases, mainly for pyelonephritis (87.3%). Of the oral antimicrobials tested for cystitis, amoxicillin/clavulanate and nitrofurantoin had the highest susceptibility profiles (84.4% and 87.3%, respectively). For E. coli only, their susceptibility profiles were as high as 90.8% and 97.4%, respectively. For pyelonephritis treatment, fluoroquinoles had a susceptibility profile <90%, while ceftriaxone and gentamicin had susceptibility >90%. Uncomplicated UTI treatment is becoming more challenging because the susceptibility profiles of oral antimicrobials are increasingly resistant. In our environment, cystitis can still be managed with nitrofurantoin. Uncomplicated pyelonephritis should be managed with ceftriaxone or gentamicin.
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Affiliation(s)
- Marcelo Hisano
- Division of Urology, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 7th floor, São Paulo 05403-000, Brazil.
| | - Homero Bruschini
- Division of Urology, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 7th floor, São Paulo 05403-000, Brazil.
| | - Antonio Carlos Nicodemo
- Infectious Disease Department, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 4th floor, São Paulo 05403-000, Brazil.
| | - Miguel Srougi
- Division of Urology, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 7th floor, São Paulo 05403-000, Brazil.
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17
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Watanabe N, Yamaguchi K, Motomura K, Hisano M, Sago H, Murashima A. Combination therapy with anticoagulants, corticosteroids and intravenous immunoglobulin for women with severe obstetric antiphospholipid syndrome. Clin Exp Rheumatol 2014; 32:299-300. [PMID: 24447427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 12/11/2013] [Indexed: 06/03/2023]
Affiliation(s)
- N Watanabe
- Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, 2-10-1, Okura Setagaya, Tokyo, Japan.
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Hisano M, Denes FT, Brito AH, Lucon M, Machado MG, Bruschini H, Srougi M. Laparoscopic ureteropyeloanastomosis in the treatment of duplex system. Int Braz J Urol 2013; 38:235-41; discussion 241. [PMID: 22555029 DOI: 10.1590/s1677-55382012000200012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2011] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not significantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment. MATERIALS AND METHODS Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent. RESULTS Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function. CONCLUSION Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system.
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Affiliation(s)
- Marcelo Hisano
- Urologic Clinic, Hospital das Clinicas, University of Sao Paulo, Brazil
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19
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Vicentini FC, Torricelli FCM, Mazzucchi E, Hisano M, Murta CB, Danilovic A, Claro JFA, Srougi M. Modified Complete Supine Percutaneous Nephrolithotomy: Solving Some Problems. J Endourol 2013; 27:845-9. [DOI: 10.1089/end.2012.0725] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Fabio C. Vicentini
- Section of Endourology, Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Section of Endourology, Division of Urology, Hospital de Transplantes do Estado de Sao Paulo, Sao Paulo, Brazil
| | - Fabio C. M. Torricelli
- Section of Endourology, Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Eduardo Mazzucchi
- Section of Endourology, Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Marcelo Hisano
- Section of Endourology, Division of Urology, Hospital de Transplantes do Estado de Sao Paulo, Sao Paulo, Brazil
| | - Claudio B. Murta
- Section of Endourology, Division of Urology, Hospital de Transplantes do Estado de Sao Paulo, Sao Paulo, Brazil
| | - Alexandre Danilovic
- Section of Endourology, Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Joaquim F. A. Claro
- Section of Endourology, Division of Urology, Hospital de Transplantes do Estado de Sao Paulo, Sao Paulo, Brazil
| | - Miguel Srougi
- Section of Endourology, Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
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20
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Musial K, Zwolinska D, Pruthi R, Sinha M, Casula A, Lewis M, Tse Y, Maxwell H, O'Brien C, Inward C, Sharaf E, Fadel F, Bazaraa H, Hegazy R, Essam R, Manickavasagar B, Shroff R, McArdle A, Ledermann S, Shaw V, Van't Hoff W, Paudyal B, Prado G, Schoeneman M, Nepal MK, Feygina V, Bansilal V, Tawadrous H, Mongia AK, Melk A, Kracht D, Doyon A, Zeller R, Litwin M, Duzowa A, Sozeri B, Bayzit A, Caliskan S, Querfeld U, Wuhl E, Schaefer F, Schmidt B, Canpolat N, Caliskan S, Kara Acar M, Pehlivan S, Tasdemir M, Sever L, Nusken E, Taylan C, von Gersdorff G, Schaller M, Barth C, Dotsch J, Roomizadeh P, Gheissari A, Abedini A, Garzotto F, Zanella M, Kim J, Cena R, Neri M, Nalesso F, Brendolan A, Ronco C, Canpolat N, Sever L, Celkan T, Lacinel S, Tasdemir M, Keser A, Caliskan S, Taner Elmas A, Tabel Y, Ipek S, Karadag A, Elmas O, Ozyalin F, Hoxha (Qosja) A, Gjyzari A, Tushe E, Said RM, Abdel Fattah MA, Soliman DA, Mahmoud SY, Hattori M, Uemura O, Hataya H, Ito S, Hisano M, Ohta T, Fujinaga S, Kise T, Goto Y, Matsunaga A, Hashimoto T, Tsutsumi Y, Ito N, Akizawa T, Maher S, Cho BS, Choi YM, Suh JS, Farid F, El-Hakim I, Salman M, Rajnochova Bloudickova S, Viklicky O, Seeman T, Yuksel S, Caglar M, Becerir T, Tepeli E, Calli Demirkan N, Yalcin N, Ergin A, Hladik M, Sigutova R, Vsiansky F, Safarcik K, Svagera Z, Abd El Monem Soliman N, Bazaraa HM, Nabhan MM, Badr AM, Abd El Latif Shahin M, Skrzypczyk P, Panczyk-Tomaszewska M, Roszkowska-Blaim M, Wawer Z, Bienias B, Zajaczkowska M, Szczepaniak M, Pawlak-Bratkowska M, Tkaczyk M, Kilis-Pstrusinska K, Jakubowska A, Prikhodina L, Ryzhkova O, Poltavets N, Polyakov V. Paediatric nephrology II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Hisano M, Vicentini FC, Agresta T, di Napoli MA, Kuriki P, Watanabe C, Murta CB, de Almeida Claro JF. 1992 SINGLE PORT TRANSVESICAL PROSTATECTOMY FOR BPH TREATMENT OF LARGE PROSTATES. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Abstract
PURPOSE To describe a case of a transvesical prostatectomy performed by a single port technique. PATIENT AND METHODS JLS, 64y, diabetic and hypertense, under treatment of LUTS for 8 years with 4mg doxazosin and 5mg finasteride. The IPSS score was 26. The digital rectal exam showed a more than 60g benign prostate. The Body Mass Index was 28.9. The total PSA was 5.4ng/mL and the free/total PSA was 22%. A 12-fragments prostate biopsy showed BPH. The sonography revealed a 106g prostate and the maximum urinary flow was 12 mL/s. The patient was under general anesthesia and was positioned in dorsal decubitus with Trendelemburg. The bladder was filled until that a bexigoma was visible. A 2 cm longitudinal infra-umbelical incision was done. The Gel Point Single Port System (Applied, Ca, USA) was placed inside the bladder and the pneumovesicum was done until 10mmHg. A peri-bladder neck incision was done and the adenoma dissection was performed until its remotion. The hemostasia was done under vision. A 3-way 24-Fr Foley catheter and an 8-Fr plastic catheter were placed inside the bladder. The adenoma was removed and the bladder and the abdominal wall were closed. RESULTS The procedure took 55 minutes and the blood loss was 180 ml. The patient evolved uneventfully, the bladder irrigation stayed for 24 h, the hemoglobin drop was 2.4g/dL and the patient was discharge after 36 hours. The urethral catheters stayed for 5 days. The postoperative IPSS was 6 and the maximum flow was 26 ml/s. CONCLUSION The surgery was safe and effective, showing that the single port transvesical prostatectomy can be an option in the surgical treatment of large prostates.
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Affiliation(s)
- Fabio C Vicentini
- Centro de Referencia da Saude do Homem, Hospital de Transplantes do Estado de São Paulo, Rua Dr. Alceu de Campos Rodrigues 46 / 21, São Paulo, SP, Brazil.
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Abstract
INTRODUCTION Although the retroperitoneal approach has been the preferred choice for open urological procedures, retroperitoneoscopy is not the preferred approach for laparoscopy. This study aims to develop a training model for retroperitoneoscopy and to establish an experimental learning curve. MATERIAL AND METHODS Fifteen piglets were operated on to develop a standard retroperitoneoscopic nephrectomy (RPN) training model. All procedures were performed with three ports. Intraoperative data (side, operative time, blood loss, peritoneal opening) were recorded. Animals were divided into groups A, the first eight, and B, the last seven cases. Data were statistically analyzed. RESULTS We performed fifteen RPNs. The operative time varied from 15 to 50 minutes (median 30 minutes). Blood loss varied from 5 to 100 mL (median 20 mL). We experienced five peritoneal openings; we had two surgical vascular complications managed laparoscopically. There was statistical difference between groups A and B for peritoneal opening (p = 0.025), operative time (p = 0.0037), and blood loss (p = 0.026). DISCUSSION RPN in a porcine model could simulate the whole procedure, from creating the space to nephrectomy completion. Experimental learning curve was eight cases, after statistical data analysis. CONCLUSION RPN in a porcine model is feasible and could be very useful for teaching and practicing retroperitoneoscopy.
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Affiliation(s)
- Marcelo Hisano
- CEPEC Vicky Safra, University of São Paulo, Division of Urology , São Paulo, SP.
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24
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Abstract
Since the first laparoscopic adrenalectomy, the technique has evolved and it has become the standard of care for many adrenal diseases, including pheochromocytoma. Two laparoscopic accesses to the adrenal have been developed: transperitoneal and retroperitoneal. Retroperitoneoscopic adrenalectomy may be recommended for the treatment of pheochromocytoma with the same peri-operative outcomes of the transperitoneal approach because it allows direct access to the adrenal glands without increasing the operative risks. Although technically more demanding than the transperitoneal approach, retroperitoneoscopy can shorten the mean operative time, which is critical for cases with pheochromocytoma where minimizing the potential for intra-operative hemodynamic changes is essential. Blood loss and the convalescence time can be also shortened by this approach. There is no absolute indication for either the transperitoneal or retroperitoneal approach; however, the latter procedure may be the best option for patients who have undergone previous abdominal surgery and obese patients. Also, retroperitoneoscopic adrenalectomy is a good alternative for treating cases with inherited pheochromocytomas, such as multiple endocrine neoplasia type 2A, in which the pheochromocytoma is highly prevalent and frequently occurs bilaterally.
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Affiliation(s)
- Marcelo Hisano
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Abstract
Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials.
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Affiliation(s)
- Marcelo Hisano
- Laboratory of Medical Investigation, Department of Urology (LIM55), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Duarte R, Brito A, Mitre A, Hisano M, Arap M, Passerotti C, Srougi M. 1492 ELABORATING A LEARNING PROGRAM ON LAPAROSCOPY: ASSESSMENT OF THE EVOLUTION OF THE NOVICES' PERFORMANCE ACCORDING TO INITIAL TRAINING WITH SIMULATOR OR ANIMAL MODEL. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Iron deficiency is the most common cause of anemia in pregnancy. Pregnant women with anemia are, in general, exclusively treated with iron supplementation. We observed that several pregnant women with anemia who were nonresponsive to iron supplementation also had vitamin B6 deficiency, and that anemia in these cases improved with the administration of vitamin B6. Our prospective study in healthy pregnant women showed that blood levels of iron, ferritin and vitamin B6, in particular, fell to the lower limit of the nonpregnant reference range by the third trimester. We conclude that it is important to take into account the deficiency of vitamin B6 besides iron in the evaluation of anemia during pregnancy.
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Affiliation(s)
- M Hisano
- Department of Perinatology, National Center for Child Health and Development, Tokyo, Japan.
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Vicentini FC, Botelho LAA, Hisano M, Ebaid GX, Lucon M, Lucon AM, Srougi M. Are total prostate-specific antigen serum levels in cirrhotic men different from those in normal men? Urology 2009; 73:1032-5. [PMID: 19286245 DOI: 10.1016/j.urology.2009.01.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 01/05/2009] [Accepted: 01/14/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the serum total prostate-specific antigen (tPSA) levels in cirrhotic men and compare them with those in noncirrhotic men. METHODS We prospectively evaluated 113 cirrhotic patients listed for liver transplantation using the serum tPSA, total testosterone level, and Child-Pugh liver function score according to age and severity of liver disease. The tPSA levels were compared with those of 661 healthy men. The Mann-Whitney U test was used for statistical analysis, with a significance level of .05. RESULTS The median age of the cirrhotic and noncirrhotic patients was 55 years (range 28-70) and 58 years (range 46-70), respectively (P < .01). However, when stratified by age group (<49, 50-59, and >60 years), this difference was not significant. The median serum tPSA level was 0.3 ng/mL (range 0.04-9.9) and 1.3 ng/mL (range 0.04-65.8) in the cirrhotic and noncirrhotic group, respectively (P < .0001). Stratifying both groups according to age, the cirrhotic patients had significantly lower tPSA levels than did the noncirrhotic patients. According to the Child-Pugh score (A, B, and C), Child-Pugh class C patients had significantly lower tPSA levels than did Child-Pugh class A patients and also had lower testosterone levels than did Child-Pugh class A and B patients. The tPSA levels correlated significantly with the testosterone levels in the cirrhotic patients (P = .028). CONCLUSIONS The results of our study have shown that cirrhotic patients have approximately 4 times lower serum tPSA levels than noncirrhotic men. Patients with more severe liver disease have lower tPSA and testosterone levels than patients less affected. The tPSA levels in cirrhotic men are affected by the total testosterone levels.
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Affiliation(s)
- Fabio C Vicentini
- Department of Urology, Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil.
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Mazzucchi E, Souza GL, Hisano M, Antonopoulos IM, Piovesan AC, Nahas WC, Lucon AM, Srougi M. Primary reconstruction is a good option in the treatment of urinary fistula after kidney transplantation. Int Braz J Urol 2007; 32:398-403; discussion 403-4. [PMID: 16953905 DOI: 10.1590/s1677-55382006000400003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2006] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES urinary fistula is a morbid complication after renal transplantation leading to graft losses and patient death. We review and update our data on urinary fistula after renal transplantation and the outcome after surgical and conservative management. MATERIALS AND METHODS the charts of 1046 renal transplants were reviewed. Transplants were performed through an extended inguinotomy; vascular anastomoses to the iliac vessels and urinary reconstruction accomplished through the Gregoir technique. Fistulae were diagnosed by urinary leaks through the incision or by the occurrence of a collection in the iliac fossa. Patient was treated surgically or conservatively according to the characteristics of the fistula and patient clinical status. RESULTS Thirty one fistulae were diagnosed (2.9%). Twenty nine leaks due to ureteral necrosis and 2 due to reimplantation fault. The incidence of leaks among cadaver and live donor transplants was 3.22% and 2.63%, respectively (p = 0.73). Among diabetic and non diabetic patients the incidence of urinary leaks was 6.4% and 2.6%, respectively (p = 0.049). Treatment consisted in anastomosis of the graft ureter or pelvis with the ureter of the recipient in 17 cases with success in 13 (76.5%). Prolonged bladder drainage was employed in 7 cases and the fistula healed in 4 (57%). Ureteral reimplantation was performed in 3 cases and did not work in any of them. Ureteral ligature plus nephrostomy was employed in two cases and worked in one (50%). Percutaneous nephrostomy and ureteral stenting with double J catheter were employed in one case each and worked in both. CONCLUSIONS The anastomosis of the graft ureter with the ureter of the recipient is a good method for treating urinary fistulae after renal transplantation when local and systemic conditions are good. Ureteral ligature associated to nephrostomy should be applied in cases of unfavorable local conditions or clinically unstable patients.
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Affiliation(s)
- Eduardo Mazzucchi
- Renal Transplantation Unit, Division of Urology, General Hospital, University of Sao Paulo Medical School, SP, Brazil.
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Hisano M, Souza FMM, Malheiros DMAC, Pompeo ACL, Lucon AM. Granulosa cell tumor of the adult testis: report of a case and review of the literature. Clinics (Sao Paulo) 2006; 61:77-8. [PMID: 16532229 DOI: 10.1590/s1807-59322006000100013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abstract
The purpose of this study was to clarify the contributing factors and their influences on temporomandibular joint internal derangement (TMJ ID) symptoms in subjects with mandibular asymmetry. Postero-anterior (PA) cephalograms of 187 pre-orthodontic treatment subjects (aged 18-45 years, mean 23.9 years) were used to investigate the inclination of the frontal occlusal (FOP) and frontal mandibular (FMP) planes to determine vertical asymmetry. Mandibular dental midline shift (DMS) and mandibular midline shift (MMS) were studied to determine transverse asymmetry. The degree of asymmetry was analysed in conjunction with the results from self-administered TMJ ID history forms. A prevalence of TMJ ID was most related to the inclination of the FMP (P < 0.01), with the symptoms being notably higher when the cant was greater than 3 degrees. The symptomatic side was related only to the inclination of the FOP and FMP. Symptoms confined to the ipsilateral side were primarily found in subjects with mild asymmetry, whereas symptoms on both sides and those on the contralateral side were greater in those with moderate and severe asymmetry, respectively. No significant correlation was found for DMS and MMS. The results suggest that the degree of asymmetry in the vertical dimension is significantly correlated with TMJ ID symptoms.
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Affiliation(s)
- B Buranastidporn
- Department of Orthodontics, Faculty of Dentistry, Chiang Mai University, Thailand.
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Buranastidporn B, Hisano M, Soma K. Effect of biomechanical disturbance of the temporomandibular joint on the prevalence of internal derangement in mandibular asymmetry. Eur J Orthod 2005; 28:199-205. [PMID: 16230327 DOI: 10.1093/ejo/cji082] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of the present study was to elucidate the relationship between biomechanical changes of the temporomandibular joint (TMJ) and internal derangement (ID) symptoms in mandibular asymmetry. Posteroanterior cephalograms (PA) of 140 patients with TMJ ID associated with mandibular asymmetry were used to investigate the inclination of the frontal occlusal plane (FOP), and were analysed in conjunction with the results of a report providing information on ID symptoms. A three-dimensional (3D) finite element model (FEM) of the entire mandible was created to investigate the distribution of TMJ forces during clenching. The inclination of the FOP was modified to simulate various degrees of vertical asymmetry. The stresses on the TMJ on the ipsilateral and contralateral sides were analysed and their values were compared with those of the standard model. The results showed that the symptomatic sides were significantly related to the degree of inclination of the FOP. Increasing its angulation resulted in a decrease of the symptoms on the ipsilateral side and an increase of those on the contralateral side. The analysis showed that stress-distribution patterns and overall stresses of the articular disc were influenced by the angulation of inclination of the FOP. These mechanical changes exhibited a distinct relationship with the prevalence of ID in the patients. These results suggest that disturbances in the stresses either in amount or direction due to occlusal inclination can be responsible for ID. Therefore, an attempt to establish a flat occlusal plane is an important orthodontic treatment objective in maintaining the normal health and structure of the TMJ.
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Affiliation(s)
- B Buranastidporn
- Department of Orthodontics, Faculty of Dentistry, Chiangmai University, Thailand.
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Abstract
OBJECTIVE To describe the clinical and urodynamic features of patients with chronic voiding dysfunction secondary to schistosomal myeloradiculopathy (SM), as the clinical involvement of the spinal cord is a well recognized complication of Schistosomiasis mansoni infection. PATIENTS AND METHODS We reviewed the records and urodynamic studies of 26 consecutive patients (17 males and nine females, aged 8-58 years) with chronic neurological and urinary symptoms secondary to SM. The voiding function history, radiological and urodynamic findings and therapeutic approaches were reviewed. Patients with and without upper urinary tract complications were compared in terms of age, duration of voiding dysfunction and urodynamic pattern. RESULTS The most common urinary symptoms were difficulty in emptying the bladder (17 patients, 65%), urinary incontinence (14, 54%), and urgency and frequency (13, 50%). Laboratory and radiographic evaluation showed urinary tract infection in eight (30%) patients, bilateral hydronephrosis in five (19%) and bladder calculi in five (19%). Urodynamics showed detrusor overactivity with detrusor-external sphincter dyssynergia (DESD) in 14 patients (54%), detrusor arreflexia in six (23%), detrusor overactivity with no dyssynergia in four (15%), and detrusor underactivity in two (8%). Comparing patients with and without upper tract complications showed no differences in age and duration of urinary symptoms, but there was a significant association of detrusor overactivity with DESD and upper urinary tract complications (P = 0.04). Urological management consisted of antibiotics, clean intermittent catheterization, anticholinergic medication and stone removal, as appropriate. Conservative treatment failed in three patients and they required an injection with botulinum-A toxin into the detrusor (two) or ileocystoplasty (one). CONCLUSION Patients with chronic SM behave clinically like those with other causes of spinal cord disease and neurogenic bladder dysfunction requiring lifelong surveillance. The severity of illness in these patients should re-emphasize the need for early recognition and treatment of this condition, to prevent or reverse the neurological deficits.
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Affiliation(s)
- Cristiano M Gomes
- Division of Urology, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
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Abstract
BACKGROUND Children with Henoch-Schonlein purpura (HSP) occasionally have allergic disease. We have previously shown that pranlukast hydrate was effective for purpura in HSP. Pranlukast hydrate is a leukotriene (LT) receptor antagonist; therefore, it is likely that LTs take part in the cause of HSP. Urinary leukotriene E4 (LTE4u) levels are a useful index of whole-body cysteinyl LT production in vivo. In this study, LTE4u was examined in children with HSP. OBJECTIVE The purpose of this study was to examine the relation between the level of LTE4u and the cause of HSP. METHODS Eighteen HSP children (six boys and 12 girls) and six healthy children were enrolled. RESULTS LTE4u levels in patients with HSP were significantly higher (P< 0.05) at the onset than those in healthy children. Four weeks therapy with pranlukast hydrate lowers LTE4u levels in patients with HSP (P< 0.05). There were no differences in LTE4u between the group of HSP patients with purpura nephritis and the group of HSP patients without purpura nephritis. CONCLUSION These results indicate that csyteinyl LTs may play a role in the pathophysiology of purpura in HSP.
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Affiliation(s)
- Y Tsuji
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan.
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35
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Iramaneerat K, Hisano M, Soma K. Dynamic analysis for clarifying occlusal force transmission during orthodontic archwire application: difference between ISW and stainless steel wire. J Med Dent Sci 2004; 51:59-65. [PMID: 15137466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The purpose of our study was to utilize the dynamic finite element analysis to clarify the difference between Improved Super-elastic Ti-Ni alloy Wire (ISW) and Stainless Steel Wire (SSW) on occlusal force transmission during orthodontic treatment. ABAQUS/Standard was used to analyze three finite models over a 30-ms period: ISW, SSW, and wireless models; which consisting of premolar, molar, periodontal ligament (PDL), and alveolar bone. Wire model was established by beam element. A Joint C, which exhibits viscoelasticity to buffer occlusal force, was applied between the wire and bracket. The load was applied on the occlusal surface. At load withdrawal point, the average amounts of von Mises stress on PDL in three models were of the same value. However as time progressed, the stress in wireless model became higher than ISW and SSW models. In contrast, as time progressed further, the stress in SSW model became higher than the other two models and maintained its higher level until the end of analysis. Results showed that high damping capacity of ISW had an ability to buffer the transmission of occlusal force to the PDL. Besides, the dynamic analysis demonstrated an advantage to investigate the stress alterative response between models versus time period.
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Affiliation(s)
- K Iramaneerat
- Orthodontic Science, Department of Orofacial Development and Function, Division of Oral Health Science, Graduate School, Tokyo Medical and Dental University, Japan
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Yomoda S, Hisano M, Amemiya K, Soma K. The interrelationship between bolus breakdown, mandibular first molar displacement and jaw movement during mastication. J Oral Rehabil 2004; 31:99-109. [PMID: 15009592 DOI: 10.1046/j.0305-182x.2003.01157.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to clarify the interrelationship between food bolus breakdown, mandibular first molar displacement and jaw movement during mastication. Finite element models were constructed of the maxillary first molar crown, the mandibular first molar consisting of crown, root, periodontal ligament and alveolar bone, as well as the food bolus were constructed. Based on the actual measurement of the jaw movement pattern and the characteristics of food bolus, the patterns of mandibular first molar displacement and bolus breakdown on time course in the progress of mastication were simulated, to investigate the biomechanical significance of tooth displacement and jaw movement during mastication, using finite element non-linear dynamic analysis. The results showed that the patterns of tooth displacement and jaw movement and characteristics of food bolus changed with an interrelationship to each other as mastication progressed. Particularly at the initial phase, it was suggested that the patterns of mandibular first molar displacement and jaw movement worked inter-dependently to accomplish an efficient hard-bolus breakdown.
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Affiliation(s)
- S Yomoda
- Orthodontic Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Amemiya K, Hisano M, Ishida T, Soma K. Relationship between the flow of bolus and occlusal condition during mastication--computer simulation based on the measurement of characteristics of the bolus. J Oral Rehabil 2002; 29:245-56. [PMID: 11896841 DOI: 10.1046/j.1365-2842.2002.00910.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the present study was to clarify the relationship between the flow of a bolus and occlusal condition during mastication. First, the characteristics of a bolus under mastication was measured in subjects having different occlusal conditions. Secondly, the flow of a bolus between the upper and lower first molars under mastication was simulated using finite element non-linear dynamic analysis. Measurement of the elasticity of the bolus clarified the phenomenon of its communition. The measurement of the viscosity of the bolus clarified the phenomenon of its mixing with saliva. In addition, a relationship between the elasticity and the viscosity of the bolus at the point of just before swallowing was investigated. The flow of the bolus under mastication was revealed to vary according to the occlusal condition. These results suggest a close relationship between the occlusal condition, the flow of the bolus and its characteristics.
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Affiliation(s)
- K Amemiya
- First Department of Orthodontics, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
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Yamaguchi K, Ushijima H, Hisano M, Inoue Y, Shimamura T, Hirano T, Müller WE. Immunomodulatory effect of gold sodium thiomalate on murine acquired immunodeficiency syndrome. Microbiol Immunol 2002; 45:549-55. [PMID: 11529562 DOI: 10.1111/j.1348-0421.2001.tb02657.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Induction of IL-2 production and increased expression of CD25 were observed in C57BL/10 mice after weekly treatment with gold sodium thiomalate (GST). LP-BM5 murine leukemia virus (MuLV) infected mice treated with GST survived longer, had less cervical lymph node swelling, lower spleen weight, and fewer abnormalities in the expression of the cell surface markers, CD4, CD8a and CD45R/B220 on spleen cells than those that were not treated with GST. Thus, GST treatment may be beneficial through a decrease in disease progression via IL-2 induction in MuLV infected mice. This may have application in human immunodeficiency virus-infected individuals.
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Affiliation(s)
- K Yamaguchi
- Department of Microbiology and Immunology, Showa University School of Medicine, Tokyo, Japan.
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Kimura T, Hisano M, Inoue Y, Adachi M. Tyrosine phosphorylation of the linker for activator of T cells in mast cells by stimulation with the high affinity IgE receptor. Immunol Lett 2001; 75:123-9. [PMID: 11137136 DOI: 10.1016/s0165-2478(00)00295-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aggregation of the high affinity IgE receptors (FcepsilonRI) on basophils and mast cells, members of the immune receptor family, initiates a cascade of events that results in the release of inflammatory mediators. This pathway involves the activation of several protein-tyrosine kinases, including Lyn, Syk, Btk, and Fak that induce the tyrosine phosphorylation of various proteins. The linker for activation of T cells (LAT), was originally found as a ZAP-70 tyrosine kinase substrate that linked T cell receptors to cellular activation, and was expressed in T cells, NK cells and mast cells. Here we show that LAT expressed in the RBL-2H3 rat mast cell line is tyrosine-phosphorylated after aggregation of FcepsilonRI. The tyrosine phosphorylation of the LAT was dramatically enhanced after receptor aggregation. Furthermore, a tyrosine-phosphorylated 80-kDa protein associated with LAT transiently after receptor aggregation. GST fusion proteins containing parts of PLCgamma or PI3 kinase can bind LAT. These results suggest that LAT plays an important role not only in T cell, but also in mast cell activation, and that the association among these signaling molecules is critical for FcepsilonRI-mediated intracellular signal transduction in mast cells.
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Affiliation(s)
- T Kimura
- The First Department of Internal Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan.
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Asano K, Mizutani T, Shimane T, Hisano M, Hisamitsu T, Suzaki H. The inhibitory effect of anti-allergic agent suplatast tosilate (IPD-1151T) on methacholine- and allergen-induced bronchoconstriction in sensitized mice. asakazu@med.showa-u.dc.jp. Mediators Inflamm 2000; 9:77-84. [PMID: 10958380 PMCID: PMC1781752 DOI: 10.1080/096293500411532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The influence of an anti-allergic agent, suplatast tosilate (IPD-1151T; (+/-)-[2-[4-(3-ethoxy-2-hydroxypropoxy)phenyl-carbamoyl]-ethyl] dimethylsulfonium p-toluenesulfonate) on allergic bronchoconstriction induced by allergen and methacholine (MCh) were examined in mice. BALB/c mice were sensitized by intraperitoneal injection of dinitrophenylated-keyhole limpet hemocyanin (DNP-KLH) mixed with A1(OH)3 (DNP-KLH). IPD-1151T was administered orally once a day for either 5 or 14 days in doses of 10, 30 or 100 mg/kg. Bronchoconstriction was measured 24h after the final drug administration. IPD-1151T inhibited both antigen- and MCh-mediated bronchoconstriction in actively sensitized mice. The inhibition induced was closely related to the dose and frequency of oral administration of the agent. We also examined the effect of IPD-1151T on IgE production in response to DNP-KLH immunization. IPD-1151T inhibited dose-dependently both total and specific IgE concentrations in serum prepared from mice 15 days after immunization. These results strongly indicate that IPD-1151T inhibits IgE production in vivo and results in attenuating effect on bronchoconstriction.
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Affiliation(s)
- K Asano
- Department of Physiology, School of Medicine, Showa University, Tokyo, Japan.
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Abstract
The energy used to break down food was calculated in Angle Class I and rigid interdigitation, as well as in various malocclusions using a computer simulation. As a result, the energy applied to the food was the highest in Angle's Class I molar relationship and rigid interdigitation, with a simple pattern of masticatory movement. This relationship also tended to produce maximum efficiency in the posterior teeth, including the premolars. Furthermore, energy decreased with the degree of malocclusion. Thus, we were able to provide an alternative definition of Angle's Class I molar relationship and rigid interdigitation. In addition, the extent of malocclusion could be evaluated quantitatively.
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Affiliation(s)
- M Hisano
- First Department of Orthodontics, Faculty of Dentistry, Tokyo Medical and Dental University, Japan.
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Abstract
The purpose of this study was to establish an index for evaluating occlusal conditions using energy levels. For this purpose, first, the movement of mastication under five occlusal conditions in which the positional relationship varied mesiodistally was simulated and the energy applied to the food being masticated was calculated, based on theoretical values of computing mechanics using finite element static analysis. As a model experiment, the energy generated under each occlusal condition was then measured using the electrical output from an occlusion pressure sensor composed of pressure-sensitive rubber. By comparing the theoretical values of computing mechanics and the measured values, the changes in the energy level under occlusal conditions were consistent with the trends, and the maximum value of the energy was obtained under the occlusal condition of Angle Class I and consisting of rigid interdigitation. In conclusion, our results demonstrated that occlusal conditions can be evaluated using the energy level as an index.
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Affiliation(s)
- M Hisano
- The First Department of Orthodontics, Faculty of Dentistry, Tokyo Medical and Dental University, Japan
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Yamaguchi A, Hisano M. [The availability of personality traits in the hierarchical structure: an exploration of the "basic level"]. Shinrigaku Kenkyu 1996; 67:195-203. [PMID: 8981672 DOI: 10.4992/jjpsy.67.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Personality traits have a structure that is hierarchically organized in terms of trait abstractness. Which level of the hierarchy is most available to the person perceiver? We started out with four levels, and tried to determine which was most available and therefore became the "basic level", as in the Rosch, Mervis, Gray, Johnson, and Boyes-Braem's natural categories (1976). Two methods were employed. First, rating of trait descriptiveness showed that information effectiveness was relatively high at the second level from the top. Second, subjects preferred the same level when they described target persons. These results suggested that a "basic level" indeed existed in the hierarchy of personality traits. However, social desirability of traits and who the target person was also affected the results. Implications are discussed about theories of cognitive style, especially cognitive complexity, which assume the generality of our cognitive system and have been in confusion with contradictory findings.
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Affiliation(s)
- A Yamaguchi
- Department of Educational Psychology, Faculty of Education, University of Tokyo
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Yamaguchi A, Kawahara T, Hisano M. [A study of hierarchical structure in personality traits: asymmetry judgments in category breadth and class inclusion]. Shinrigaku Kenkyu 1995; 66:345-53. [PMID: 8819745 DOI: 10.4992/jjpsy.66.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Many personality theorists postulate a hierarchical structure in trait words. However, most evidences are indirect, mainly because the theorists rely on factor-analytic methods. Assuming a global structure, the factor approach is not necessarily adequate to investigate concrete relationship among trait words. In this study, we used two direct measures to study the hierarchical structure: direct comparison of breadth and asymmetry class-inclusion judgment on trait concepts. Results of three experiments in general confirmed robustness of the hierarchical structure in the domain of personality traits. Traits were organized in the structure at several different levels of abstractness. But the structure was fuzzy in nature, unlike the taxonomy in biology. It was also found that inter-relations among traits could vary considerably from individual to individual. Cognitive complexity may be one of the variables that explain such an individual difference.
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Affiliation(s)
- A Yamaguchi
- Department of Educational Psychology, Faculty of Education, University of Tokyo
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Soma K, Hisano M, Kuroki T, Ishida T, Kuroda T. [High accuracy measuring device for dental cast--using device with flat laser beam]. Kokubyo Gakkai Zasshi 1992; 59:259-64. [PMID: 1607825 DOI: 10.5357/koubyou.59.259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A new system has been developed for measuring the surface morphology of the occlusal material. The main characteristic of the system is utilizing a flat laser beam to produce high accuracy measuring and to enable measuring 200 points at the same time on a line of 30 mm in length. It takes 8 to 10 minutes to digitize the whole morphology of a dental cast. The system has a central processing unit that assembles a series of digitized points into a data file of the dental morphology. It is also able to recognize the graphical image of the numerically reconstructed morphology on the CRT. Application of this measuring system enables the approach to the qualitative and quantitative evaluation of the spatial relationship between the opposing teeth at near the occlusal contact.
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Affiliation(s)
- K Soma
- 1st Department of Orthodontics, Faculty of Dentistry, Tokyo Medical and Dental University
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