Predictors of early postoperative pneumonia after oncologic surgery with the patients receiving professional oral health care: A prospective, multicentre, cohort study.

This study was a prospective, multicentre, cohort study on 685 patients who had undergone oncologic surgery. The patients were divided into two groups according to the presence or absence of postoperative pneumonia. The two groups were compared with respect to their background, index operation, food eaten, oral condition, contents of oral care and dental treatment, laboratory data, and bacterial flora. All postoperative pneumonias occurred in six cases within four days postoperatively. The multivariable logistic regression analysis showed that preoperative serum C-reactive protein was the strongest predictor of postoperative pneumonia. In addition, decreased postoperative Candida albicans colonies was an effective predictor of postoperative pneumonia. For patients with predictors of postoperative pneumonia, perioperative strategies for its prevention should be considered in addition to professional oral health care. This study was approved by the National Hospital Organization's Central Ethics Review Board and was also approved by the directors of the participating institutions.

[Evaluation of immediate androgen deprivation adjuvant therapy in patients with lymph node positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy].

PURPOSE: We assessed the outcome after radical prostatectomy and pelvic lymphadenectomy for lymph node positive prostate cancer retrospectively. Furthermore, we compared the efficacy of immediate androgen deprivation adjuvant therapy in node positive patients who have undergone radical prostatectomy. MATERIAL AND METHODS: We investigated 62 patients who have undergone radical prostatectomy and pelvic lymphadenectomy and have been found to have lymph node positive prostate cancer at our facility between January 1992 and January 2008. We researched the clinical stages, the pathological stages and Gleason scores for pathological pN1 + prostate cancer, retrospectively. The serum PSA levels were followed up every 6 months, and we considered that biochemical progression was PSA >0.4 ng/ml. We classified the groups treated with or without immediate androgen deprivation adjuvant therapy, the biochemical progression free survival and cause specific survival were analyzed by the Kaplan-Meier method, and the statistical significance was determined by the log rank test. RESULTS: The rate of lymph node positive patients who have undergone radical prostatectomy was 7.1%. The rate of 8 or greater in Gleason score of all the lymph node positive patients was 68.3%. The 5-year prostate cancer specific survival and 5-year biochemical progression free survival rates were 90.3 and 67.4% of all the patients. The biochemical progression free survival rate of the group of patients who have received immediate androgen deprivation therapy after radical prostatectomy was significantly higher than that of the group of patients who have not received immediately androgen deprivation therapy. CONCLUSION: It may be suggested that early androgen deprivation adjuvant therapy benefits patients with nodal metastases who have undergone radical prostatectomy and lymphadenectomy, compared with those who received deferred treatment, although in a retrospective nonrandomized study.

[Clinical study of bladder tamponade resulting from clots of blood].

PURPOSE: There were many case reports about bladder tamponade resulting from clots of blood. However, there were few reports about the clinical study that result from collecting cases of bladder tamponade. Thus, we performed a retrospective study about bladder tamponade resulting from clots of blood that we had managed. MATERIAL AND METHODS: We investigated 20 patients who had bladder tamponade and were consulted at our facility between October 2002 and September 2005. We researched causes of the bleeding, characteristics of the patients, the laboratory data of coagulation system and treatments of our experience in managing patients. There were 17 males and 3 females. The average age of the patients was 74.0 years old. RESULTS: 8 cases took anticoagulant drugs, 6 cases had medical history of cerebral infarction or cardiac infarction, 4 cases took anticholinergic drugs and 9 cases had benign prostate hypertrophy or urethral stricture. Bleeding was due to bladder tumor in 9, prostate cancer in 1, radiation cystitis in 3, chronic cystitis in 1, malignant lymphoma in 1, idiopathic causes in 3 and unknown causes in 2 cases. Except 1 case, in all cases, evacuation of the clots was the first procedure followed by saline irrigation. This initial line of treatment was able to control the hemorrhage in 40% of the patients. For the remaining cases, transurethral coagulation and resection of bladder tumor were used as the second line treatment, and furthermore, radical cystectomy was performed in 1 case. Surgical treatments were required in 12 cases. Blood transfusion was required in 4 cases. CONCLUSION: According to progress aging society, the amounts of taken anticoagulant drugs and the patients who had lower urinary tract dysfunction may increase. It may be suggested that the cases of bladder tamponade resulting from clots of blood without bladder tumor or radiation cystitis tend to increase.