Objective To improve the diagnosis and treatment of renal oncocytoma. Methods The clinical data of 3 cases with renal oncocytoma treated from 1999 to 2002 were retrospectively analyzed and discussed with literature reviewed. The 3 tumors’size was 7.6 cm?8.5 cm?6.8 cm,10.0 cm?11.5 cm?9.8 cm,10.0 cm?8.0 cm?6.8 cm,respectively.The clinical features were atypical.Renal oncocytoma was characterized by homogeneous attenuation with a central, margined stellate area on CT scan. Results The 3 cases underwent nephrectomy,and the resected tumors were examined by pathology.On light microscopy,there was strong eosinophilic cytoplasm with granules,the tumor cells being tubular or adenoid in pattern with no necrosis and very rare or no mitosis.Enormous mitochondria were noted on electron microscopy.The immunohistochemical staining was positive for cytokeratin and EMA,whereas it was negative for vimentin.The follow-up lasted for 16 to 30 months without recurrence or metastasis. Conclusions Renal oncocytoma is a type of benign,parenchymatous tumor,and it has no specific clinical feature.The diagnosis can be established on histopathologic,immunohistochemical and electron microscopic studies.

Objective To construct a reliable continent tube, which is easy to catheterize and is surgically simple. Methods 10 patients with bladder cancer underwent a procedure in which ileal segment was tapered as an efferent tube,a part of which was placed between the back surface of the rectus muscle and wall of the ileal pouch. Internal orifice of the tapered ileum was anastomosed to the ileal pouch and external orifice of the tapered ileum was anastomosed to umbilicus. Urodynamic and radiological studies were carried out postoperatively on 9 patients. Results The stoma could be easily catheterized with a 16 F catheter in all the patients. One patient died of heart disease 55 days postoperatively. In the other 9 patients, 8 were completely continent day and night. The urodynamic study of the efferent tubes showed a maximum close pressure with a full pouch was significantly higher than those with an empty pouch (t=-7.14,P=0.000098 ). Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis. Conclusion This study suggested that the continent mechanism of tapered ileum can be greatly enhanced by fixing it between the abdominal and the pouch wall,allowing also easy catheterization and surgical simplicity.

Objective To present the preliminary experience on the operative approach in the surgical management of complex posterior urethral stricture. Methods The operative approach of 72 cases of complex posterior urethral stricture was reviewed. Results The total success rate was 89%(64/72). 34 cases were operated with simlpe transperineal approach and the success was rate 91%, transperineal inferior pubic approach was adopted in 14 and the success rate was 93%;simple transpubic approach was conducted in 6 with a success rate of 67% and transpubic perineal approach in 18 with a success rate of 89%. 41 cases with long posterior urethral stricture were operated with a success rate of 85% and 18 cases with complication with a success rate of 94%. Conclusions Each operative approach has it own advantages and disadvantages.Transperineal approach is preferred because the procedure is simpler,less traumatic with less occurrence of complication.

Objective To explore the curative effect of standard craniotomy with large bone flap of the treatment for frontal-temporal severe craniocerebral injury patients.Methods Standard craniotomy with large bone flap was performed on 63 patients with frontal-temporal severe craniocerebral injury.All postoperative patients were followed up.The curative effect was assessed according to GOS.Results All patients were followed up for 1 year.According to the GOS,28 cases recovered well,12 cases became moderately disabled,4 cases were severely disabled,3 cases was in vegetative state and 16 cases died.The mortality rate was 25.4%.Conclusions Standard craniotomy with large bone flap is the best method of the treatment for frontal-temporal severe craniocerebral injury.Timely and thoroughly standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients can significantly improve the the curative effect of the patients and reduce the rate of mortality.

Child ; Cord Blood Stem Cell Transplantation ; adverse effects ; Cytomegalovirus Infections ; etiology ; Humans

OBJECTIVETo investigate the effects of combination therapy with methylprednisolone (MP) and brain-derived neurotrophic factor (BDNF) on axonal remyelination and functional recovery after spinal cord injury in rats.

METHODSForty-five rats were randomly divided into three groups: Group A received MP and BDNF; group B received MP and cerebrospinal fluid (CSF); and group C received CSF only. Contusion injury to adult rat spinal cord was produced at the T(10) vertebra level followed by immediate intravenous MP or CSF, and was thereafter infused intrathecally with BDNF or CSF for 6 weeks. Axonal remyelination and functional recovery was observed using RT-PCR, immunohistochemistry and open field locomotion.

RESULTSAn increase of 28.4% +/- 2.3% in the expression of proteolipid protein (PLP) gene, an endogenous indicator of axonal remyelination, was demonstrated in group A 24 hours after injury. Ten weeks later, there were significant decreases in hematogenous inflammatory cellular infiltration in groups A and B compared to C (P < 0.05). Concomitantly, a significant amount of axonal remyelination was observed in group A compared to groups B and C (P < 0.05). Furthermore, combination therapy using MP and BDNF in group A resulted in stimulation of hindlimb activity as well as improvement in the rate of functional recovery in open field locomotion (P < 0.05).

CONCLUSIONSCombined therapy of MP and BDNF can improve functional recovery through mechanisms that include attenuating inflammatory cellular infiltration and enhancing axonal remyelination at the injury site. Such a combination may be an effective approach for treatment of spinal cord injury.

Animals ; Axons ; physiology ; Brain-Derived Neurotrophic Factor ; administration & dosage ; Drug Therapy, Combination ; Female ; Methylprednisolone ; administration & dosage ; Myelin Proteolipid Protein ; genetics ; Nerve Regeneration ; drug effects ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Spinal Cord Injuries ; drug therapy ; metabolism ; physiopathology