Desulfovibrio desulfuricans bacteremia in a patient hospitalized with acute cerebral infarction: case report and review.

Desulfovibrio spp. can be found in soil, water, and sewage, as well as in the digestive tracts of animals and humans. We report a case of Desulfovibrio desulfuricans bacteremia during hospitalization with acute cerebral infarction following aspiration bronchopneumonia and severe diarrhea, and the case strongly suggests that Desulfovibrio spp. bacteremia can occur as an infection due to disturbance of endogenous gut flora including antibiotic administration. Because Desulfovibrio spp. is difficult to detect in short-time incubation, its bacteremia is possibly overlooked in hospitalized patients. A few clinical cases of D. desulfuricans bacteremia have been reported in Japan, and they are reviewed briefly in this article.

Trial of complete detachment of the whole prostate lobes in benign prostate hyperplasia by transurethral enucleation of the prostate.

INTRODUCTION: We tried a complete detachment of the whole prostate lobes for benign prostate hyperplasia (BPH) by transurethral enucleation of the prostate (TUE). The feasibility of a new modified TUE technique (transurethral detaching prostatectomy = TUDP) was assessed by retrospective analysis. MATERIALS AND METHODS: For 46 BPH cases the whole prostate lobes were detached from the surgical capsule completely by a prostate-detaching blade and resectoscope beak, and dropped into the bladder. The detached prostate lobes were removed by a soft tissue morcellator. The preoperative total prostate and adenoma volume by transabdominal ultrasound measurement (TAUS) were 47.75 +/- 25.63 and 27.8 +/- 17.33 ml. RESULTS: In all 46 BPH cases, the whole prostate lobes could be detached completely without a perforation. Transurethral resection (TUR) syndrome and blood transfusion were not seen. Operation time was 54.28 min. The mean of removed tissue weight, that of hemoglobin loss and that of decrease of serum sodium was 37.11 g, 1.65 mg/dl and 1.56 mEq/l, respectively. Postoperative prostate volume and PSA were decreased to 9.56 ml and 0.8 ng/ml with complete removal of an adenoma. CONCLUSIONS: TUDP could achieve complete removal of even a large adenoma without perforation, transurethral resection syndromes and blood transfusion safety.

Measurement of residual adenoma after transurethral resection of the prostate by transurethral enucleation technique.

OBJECTIVE: Transurethral resection of the prostate (TURP) leaves a lot of residual adenoma and has a high recurrence rate, but the residual adenoma weight has not been measured surgically. Using surgery we tried to measure the residual adenoma after TURP. MATERIAL AND METHODS: Total adenoma resection was performed via standard TURP in 64 cases with benign prostatic hyperplasia and the weight of the residual adenoma was measured by transurethral enucleation (TUE) of the prostate. RESULTS: Prostate volume averaged 37.4 ml and adenoma volume averaged 20.6 ml by TRUS. The average weight of the prostate removed by TURP was 9.8 g. After TURP residual adenoma was confirmed in all cases by TUE, and the average weight of the residual adenoma was 10.2 g. The total average prostate volume removed by TURP and TUE was 20.1 g. The average residual rate of the adenoma removed by TURP was 54.5%. CONCLUSION: TURP leaves about half of the adenoma. Therefore, TURP might be very difficult for complete resection of an adenoma.