Nihon rinsho. Japanese journal of clinical medicine
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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are generally considered rare tumor. According to the recent studies, the number of patients had been increasing and frequently diagnosed as advanced stages. Surgery is the only possible way to cure GEP-NENs. However, the indication of surgical treatment for the patients with advanced GEP-NENs is limited, and for those patients other therapies such as radiofrequency ablation, transarterial chemoembolization, and/or systemic medical treat...
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Painful peripheral neuropathy has been correlated with various voltage-gated sodium channel mutations in sensory neurons. Recently Navl.9, a voltage-gated sodium channel sub- type, has been established as a genetic influence for certain peripheral pain syndromes. Herein, we performed a genetic study in six unrelated, multigenerational Japanese families with episodic pain syndrome. Affected participants were characterized by infantile recurrent pain episodes, with spontaneous mitigation around ad...
Since the rate of elderly patients in cancer death is continuously increasing, elderly pa- tients are not special, but ordinary population in daily clinical settings. Geriatric assessment (GA) is recommended to evaluate elderly patients when they undergo anticancer chemother- apy. Geriatric 8 (G8) is an excellent screening tool to evaluate physical and mental function of elderly patients. By such screening tools, elderly patients are divided into 3 categories; "fit": standard regimen for non-eld...
Upper urinary tract cancer originates in the renal pelvis or ureter and is relatively uncom- mon. The predilection age is 65 to 79 years in Japan. Currently, a diagnosis is usually con- firmed using computed tomography urography. Although radical nephroureterectomy with bladder cuff excision is the gold standard treatment for localized disease, nephron-sparing surgery using a transureteroscopic approach has also been performed for unifocal, small, and low-grade tumors. For advanced disease, plat...
The majority of fragile elderly individuals, such as the elderly in institutions for the elderly and those in home care use diaper or indwelling urethral catheters without careful considera- tion. Lower urinary tract dysfunction is hardly life threatening, but it impairs the dignity and quality of life of individuals. Inappropriate urinary management of elderly individuals leads to adverse changes in immobilization and dementia, and would ultimately render the disease untreatable. In order to bu...
One of the major global demographic trends is the rapid ageing population, and the num- ber of people with ageing-related diseases has been increasing. In the urological field, ageing-related lower urinary tract symptoms (LUTS), especially detrusor hyperactivity with impaired contractility (DHIC), are commonly observed among elderly patients. However, such ageing-related LUTS and their backgrounds widely vary by individual. Previous reports using functional- and biological-investigations in rode...
Perioperative delirium and depression are characteristic of in elderly patients undergoing urological operation. The treatment for urological disease is stagnant, exchanged or inter- rupted by these complications. Furthermore, these complications may course to other more complications. Age, preoperative cognitive status, activities of daily living function, renal function and other factors were known for the risk factor of perioperative delirium. However, these complications should be managed im...
Most urological diseases are common in the elderly. Indolent cancer is a clinical dilemma in management of renal and prostate cancers, which are often incidentally found in the eld- erly. Bladder cancer usually needs urological intervention somehow even in highly aged pa- tients to prevent massive hematuria and clot retention. Voiding dysfunction and erectile dys- function affect negatively quality of life thus should be properly evaluated and managed. Ultrasound-assisted prompted voiding preclu...
Testosterone deficiency has recently drawn wide attention due to the high prevalence of hypo-gonadal symptoms in the aging male population. A number of studies have reported the beneficial effects of testosterone replacement therapy for men with late-onset hypogonadism (LOH) syndrome. Based on the study evaluating the age distribution of serum testosterone concentration, serum free testosterone less than 8.5 pg/mL is considered as a good indica- tion for testosterone replacement therapy among th...
The incidence of renal cell carcinoma (RCC) peaks between 60 and 70 years, and > 25% of newly diagnosed patients are > 75 years. However, clinical trials for the evaluation of drug therapy for metastatic RCC (mRCC) have generally under-represented the actual proportion of elderly patients in the general population of mRCC patients; therefore, limited data remain available with respect to the efficacy as well as safety of drug therapy for elderly mRCC pa- tients. In this review, therefore, we att...
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