Impalement injury of the urinary bladder, especially secondary to rectal impalement, is extremely rare. In this case, a 31-year-old man sustained a steel pipe impalement injury through his perirectal region. He presented with gross hematuria, abdominal defense, and a penetrating wound. On the basis of the computed tomography findings and abdominal defense, we suspected a through-and-through bladder perforation from the rectal space to the intraperitoneum. Laparotomy revealed a through-and-through bladder perforation as well as damage to the right ureter, 3 distinct ileal injuries, and rectal anterior, anal, and right seminal vesicle injuries. Surgical repair of each damaged site was undertaken. The prompt diagnosis and surgical repair ensured good postoperative recovery.
Adult ; Hematuria ; Humans ; Laparotomy ; Rupture ; Seminal Vesicles ; Steel ; Ureter ; Urinary Bladder ; Wounds, Penetrating

The aim of this study was to investigate the dementia provision for elderly cancer patients in designated regional cancer centers. A survey was mailed to 389 designated regional cancer centers from February to June, 2015. A total of 188 facilities responded (response rate: 48.3%). 5.3% of the respondents used two manuals (on basic dementia care and the behavioral and psychological symptoms of dementia) to check whether these centers were following appropriate measures. About 50% of the respondents performed dementia assessments by the primary care team. 29.3% of the respondents maintained the system of the education and training of dementia care. Therefore, dementia provision for elderly cancer patients in designated regional cancer centers needs to improve the education of dementia care.

AIMTo evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography (US) to determine the critical testicular volume indicating normal testicular function by each method.

METHODSTotal testicular volume (right plus left testicular volume) was measured in 794 testes in 397 men with infertility (mean age, 35.6 years) using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length X width X height X 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more.

RESULTSMean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography.

CONCLUSIONTesticular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US.

Adult ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Male ; diagnostic imaging ; Luteinizing Hormone ; blood ; Male ; Organ Size ; Semen ; Sperm Motility ; Testis ; diagnostic imaging ; pathology ; physiopathology ; Testosterone ; blood ; Ultrasonography

Methods: We reviewed 125 patients (79 men and 46 women) who had lumbar spinous process splitting laminectomy (LSPSL) for LSS. We assessed the following clinical information: Japanese Orthopedic Association (JOA) score; numerical rating scale (NRS) for low back pain (LBP), leg pain, and leg numbness; Zurich Claudication Questionnaire; JOA Back Pain Evaluation Questionnaire; Roland- Morris Disability Questionnaire (RMDQ); and Short Form 8 (SF-8) as HRQOL. We compared the HRQOLs of men and women pre- and postoperatively. Results: Although the preoperative NRS results for LBP were significantly higher in women (p <0.05), there were no significant differences in clinical outcomes between men and women postoperatively. For HRQOL, the RMDQ scores were significantly worse in women preoperatively (p <0.05), but no significant differences were found postoperatively between men and women. Similarly, the SF-8 mental health score was also significantly lower in women preoperatively (p <0.05), but no significant differences were noted between the two groups postoperatively. Conclusions LSPSL greatly reduced LBP, leg pain, and leg numbness in both genders. There were limited differences in pain and several HRQOL questionnaire responses between men and women after surgery. We found that women had greater sensitivity to and/or lower tolerance for pain than men, which led to lower HRQOL mental health scores preoperatively.