摘要:

The use of gadolinium-DTPA enhanced MR imaging (Gd-MR) in detecting and staging of large and small renal neoplasm was investigated in 61 patients with 66 renal cell carcinoma confirmed at surgery. The purpose of the study was also to evaluate the signal intensity of the lesions and to correlate the contrast-enhanced pattern to the pathological components and architecture of the surgical specimens. Forty-four tumors were larger than 3 cm and 22 lesions were smaller than 3 cm. Unenhanced MRI detected all large lesions (44/44) and 63% (14/22) of small lesions, while Gd-MRI detected all large and small neoplasms (100%). The overall staging accuracy was 79 and 87% for plain MRI and Gd-MRI, respectively, but both modalities led to an overstaging of the disease. Enhanced MRI was an excellent staging modality for the evaluation of tumor vascular extension and tumor spread to adjacent structures. The most frequent Gd-MRI pattern of small RCC was hyperintensity, while large lesions were mostly hypointense. The presence of fibrohyaline components seemed responsible for the hyperintense pattern. No specific contrast-enhanced MRI pattern was observed according to the tumor architecture (alveolar, tubular or papular) of noncystic lesions. On the contrary, cystic lesion appeared as an area of low signal intensity and the use of contrast media improved detection and characterization. The inhomogeneous signal intensity increased the detectability of the lesion.

ISSN:0042-1138    

DOI:10.1159/000282704

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We retrospectively investigated the incidence of simple renal cysts in 1,288 healthy subjects, and monitored the growth and formation of such cysts in 39 subjects using abdominal computed tomography (CT). Simple renal cysts were detected in 138 (10.7%) of the 1,288 subjects. The incidence of simple renal cysts increased significantly with the subject’s age (p < 0.001). We found that cyst size increased significantly with age and over time on serial CT studies (p < 0.001). Exoparenchymal cysts, comprising greater than 50% of extrapar-enchymal lesions, were significantly larger than endoparenchymal cysts (p < 0.001), and showed a greater tendency to increase in size over tim

ISSN:0042-1138    

DOI:10.1159/000282705

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Renal cell carcinoma with inferior vena caval tumor thrombus extending to the level of the right atrium occurs in about 1 % of all cases. Dynamic two-dimensional transesophageal echocardiography is a minimally invasive safe technique that can demonstrate preoperatively the cephalad extent of the cavoatrial tumor thrombus with an accuracy that appears equal to or better than that of any other method currently available. When used intraoperatively, it provides invaluable data to aid in the anesthetic and surgical management of the patient, obviating the need for and potential risk of placing a Swan-Ganz pulmonary artery catheter before complete removal of the tumor thrombus.

ISSN:0042-1138    

DOI:10.1159/000282706

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Despite its marked effectiveness in the prevention of tumor recurrences, a great deal of information on the mode of action of Bacillus Calmette-Guérin (BCG) as an antitumor therapy modality is still lacking. In this prospective study, by performing lymphocyte subset analysis and quantitative assessment of delayed hypersensitivity skin reactions before transurethral resection of the detected tumor and 3-6 months after intravesical BCG administration in 23 patients with superficial bladder carcinoma, we tried to demonstrate the immunostimulatory effect of BCG therapy. We had 4 recurrences at 6 months’ follow-up. Evaluation of lymphocyte subset analysis readings in our group revealed a statistically significant difference (p < 0.05) in CD4+/CD8+ ratio between baseline values and that obtained following BCG administration at 3 and 6 months. However, there was no statistically significant increase of this value in 4 patients who had tumor recurrences. Evaluation of delayed hypersensitivity skin test score results revealed a statistically significant increase in the whole group at 3 months of follow-up (p < 0.05) but the same evaluation at 6 months of follow-up showed no statistically significant difference with respect to this evaluation. Again, no statistically significant difference was found in 4 patients who had tumor recurrences. These results support the idea that BCG-associated antitumor activity is an immune-mediated reaction and the assessment of T-lymphocyte subsets together with quantitative avaluation of delayed hypersensitivity skin reactions would give us a definite idea about the immunotherapeutic effects of BCG in such patien

ISSN:0042-1138    

DOI:10.1159/000282707

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We report on 10 kidney transplant patients with acute hemorrhagic cystitis caused by adenovirus, accompanied by the deterioration of kidney function. They developed macrohematuria with urgency, frequency and micturition pain for more than 7 days within 1 year after transplantation. Adenovirus type 11 was isolated from the urine of 6 patients, and complement-fixing antibody became positive in 9 patients. Hematuria and irritative voiding symptoms disappeared without any specific treatment; however, serum creatinine rapidly increased. The histological findings of the biopsy specimens indicated that renal impairment was attributed to acute rejection in some cases and virus-associated nephropathy in other cases. Acute hemorrhagic cystitis caused by adenovirus is an interesting complication after kidney transplantation, especially with regard to kidney impairment and treatment.

ISSN:0042-1138    

DOI:10.1159/000282708

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Five patients with a second penile cancer following irradiation of a primary squamous cell carcinoma of the penis were treated at our center. The first cancers had completely regressed within 4 months of irradiation. The second cancers developed in the radiation field at a mean latent period of 158 months (range 124–242). Further, all patients had experienced early radiation reaction and showed late radiation stigmata, pointing to the possible radiation-induced nature of the second cancer. Although all cancers were squamous cell carcinomas, the second cancers were uniformly invasive and of a higher grade than the first. Radiation-induced second cancers, although rare, should be considered a late complication of primary irradiation of squamous cell carcinoma of the peni

ISSN:0042-1138    

DOI:10.1159/000282709

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The densities of M1, M2 and M3 muscarinic receptors in human detrusor muscle were measured using 3H-pirenzepine (3H-PZP), 3H-AFDX-116 (3H-AFDX) and 3H-4-diphenyl-acetoxy-N-methyl-piperidine methidide (3H-4DAMP). The affinities of PZP, AFDX and 4DAMP for human detrusor were determined in inhibition experiments with ¾-quinuclidinyl benzilate (3H-QNB). Saturation experiments with 3H-PZP, 3H-AFDX and 3H-4DAMP revealed the presence of M1, M2 and M3 receptors in human detrusor. The KD values (nM) and the Bmax values (fmol/mg protein) (mean ± SD, n = 6) were 0.84 ± 0.15 and 13.04 ± 1.54 for 3H-PZP, 0.68 ± 0.21 and 9.30 ± 1.10 for 3H-AFDX, and 0.25 ± 0.13 and 102.1 ± 7.40 for 3H-4DAMP. These data indicate that the bladder muscarinic receptors consist mainly of the M3 subtype. Nonlabeled PZP, AFDX and 4DAMP inhibited the 3H-QNB binding to human detrusor with Ki values (nM) (mean ± SD, n = 6) of 243 ± 62.5, 59.7 ± 15.3, 2.69 ± 0.96, respectively. Human detrusor was found to have a high affinity for 4DAMP. These data suggest that M3 muscarinic receptors are biochemically predominant in human detr

ISSN:0042-1138    

DOI:10.1159/000282710

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We previously reported a patient who developed anti-glomerular basement membrane antibody-induced glomerulonephritis (GBM-GN) after extracorporeal shock wave lithotripsy (ESWL). To determine whether ESWL causes anti-GBM antibody production thereby inducing GBM-GN, we measured serum levels of type-IV collagen (the most major component of GBM) before and after ESWL. Serum samples were obtained from 13 patients with renal stones and 15 with ureteral stones. The serum type-IV collagen level was determined by a radioimmunoassay method. No significant changes were observed in the type-IV collagen level after ESWL in each patient group. Type-IV collagen was abundant in the GBM but was not released into the blood after ESWL. Therefore, in patients with urinary tract stones, it is not likely that type-IV collagen, a hidden antigen in the renal glomeruli, is exposed or released into the blood after ESWL, resulting in autoantibody production and GBM-GN.

ISSN:0042-1138    

DOI:10.1159/000282711

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Persistent residual stone fragments after extracorporeal Shockwave lithotripsy (ESWL), percutaneous nephrolitholapaxy (PNL) as well as pyelo- and nephrolithotomy represent a great problem in the treatment of stones. The choice of therapy for patients with insufficient renal drainage, poor renal function, and a high anesthetic risk also remains quite difficult. Between 1991 and 1993, 5 patients underwent percutaneous antegrading chemolysis with ‘Suby G’ solution. Two patients, presenting struvite and apatite stones, were free of stones afterwards. In 1 patient, where stone analysis revealed a predominant brushite component, a large decrease in stone size could be observed. In 2 other cases, with stones mainly consisting of whewellite and weddelite, chemolysis proved ineffective. Evaluating our own clinical experience and relevant medical literature, the present study goes on to prove that the indication of percutaneous chemolysis in risk patients as described above is dependent on stone analysis, and must be regarded as an effective adjuvant treatm

ISSN:0042-1138    

DOI:10.1159/000282712

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Negotiating a tortuous or obstructed ureter with a wire can be time-consuming and sometimes tiring. The principle of using a slippery floppy wire and then replacing it with a stiff wire through a 5-french open-ended ureteral catheter yields a high success rate. The ureteral catheter can be used for a radiocontrast study and allows access for a 0.035 ‘coaxial wire’, which can be used as a guide wire for a single or double J st

ISSN:0042-1138    

DOI:10.1159/000282713

出版商:S. Karger AG    

年代:1995

数据来源: Karger