Objective To evaluate the correlation betwe en operative procedures for pelviureteral carcinoma and the occurrence of postop ertive occurrence of bladder carcinoma. Methods 94 cases of pelviureteral carcinoma with postopertive occurrence of bladder carcinoma we re retrospectively studied. Results With nephrouretectom y without cuff resection of the bladder,the postoperative occurrence of bladder carcinoma was 54.5%(6/11),being obviously higher than nephroureterectomy with pa rtial bladder resection (23.5%,12/51) or nephroureterectomy with bladder mucosal cuff resection (33.3%,3/9,P0.05).The lap between the primary ope ration and the occurrence of bladder carcinoma was usually short and the occurre nce was mostly on the same affected side.In pelviureteral carcinoma with multior gan involvement,the postopertive occurrence of bladder carcinoma was as high as 72.2%(13/15) in spite of nephroureterectomy with partial resection of the bladde r . Conclusions Cuff resection of the bladder on the same side is the key point to prevent postoperative occurrence of bladder carcinoma.T he improved bladder mucosa cuff technique is a sound procedure to prevent tumor cell implantation.

Objective To study the diagnostic and therapeutic means of kidney cortex suppurative infection. Methods 27 cases of kidney cortical suppurative infection were studied retrospectively. Results 14 cases of acute bacterial nephritis and 7 cases of renal cortical abscess were cured on antibiotics therapy.Nephrectomy was performed for 2 patients with acute bacterial nephritis and 4 cases of renal cortical abscess greater than 5 cm in diameter were cured by surgical intervention. Conclusions These two diseases can be diagnosed by comprehensive evaluation of clinical manifestation,auxialliary examination and treatment trials.CT and B ultrasonography both play an important role.Renal cell carcinoma should be excluded in diagnosis because these two likewise show a mass on imaging.Antibiotics can be used in acute bacterial nephritis and in renal cortical abscess less than 5 cm in diameter whereas in abscess larger than 5 cm, surgical intervention is needed.

Objective To study the diagnosis and treatment of some incidental tumors of the adrenal gland. Methods Incidental primary aldosteronism and incidental Cushing's syndrome were reviewed and studied. Results 9 cases of incidental primary aldosteronism have been detected,5 of which demonstrated serum potassium level near the lower limit of normal range and in other 3 lower than normal.In 4 of the cases the plasma aldosterone was higher than normal and the plasma renin level was near the lower limit of normal range.Antisterone test was effective in 3.11 incidental Cushing's syndrome were detected.Serum cortisone was higher in 3 at 8 Am and in 4 at 4 Pm.In 6 cases,ACTH was slightly lower than normal or close to the lower limit of the normal range.High dose dexamethasone suppression test was undertaken in 3 with positive result in 2.Hormone supplement has been required after adrenalectomy in 4. Conclusions Primary aldosteronism and Cushing's syndrome may be incidentally detected on clinical manifestations,laboratoty findings and imaging examination.Adrenalectomy is indicated if there is autonomous hormone secretion or the tumor is larger than 2 cm in diameter or with trend of increasing in size.

OBJECTIVETo investigate the significance of telomerase activity in urine in the diagnosis and recurrence surveillance of urothelial carcinoma.

METHODSTelomerase activity in urine of 54 cases of urothelial carcinoma (urothelial carcinoma group) was estimated by polymerase chain reaction-enzyme-linked immunosorbent assay, and monitored continuously in 23 cases after tumor removal. 46 patients with benign urological diseases were also included as the control group.

RESULTSThe telomerase activity in urine of patients with urothelial carcinoma increased significantly as compared with the control group (P < 0.001), decreased into the normal range after tumor removal, and rose again upon intravesical tumor recurrence before the screening of recurrent tumors by cystoscopy. The higher the grade of tumor, the higher the telomerase activity; no correlation could be found between the preoperative level of telomerase activity in urine and recurrence.

CONCLUSIONSThe examination of telomerase activity in urine is helpful in the diagnosis of urothelial carcinoma and may be related to the differentiation degree of tumors. Its sensitivity is higher than that of cystoscopic examination and may become an important ancillary method in the screening of urothelial carcinoma recurrence.

Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; urine ; Sensitivity and Specificity ; Telomerase ; urine ; Urinary Bladder Neoplasms ; diagnosis ; urine

OBJECTIVE: To use super-selective renal artery embolization in treatment of patients with renal injuries. METHODS: From 1991 to 1998, 11 cases of renal injuries due to d ifferent causes underwent super-selective renal artery embolization. In these p atients, 91% of injury sites were segmental arteries and their branches. All the patients were treated with steel coil for embolization. RESULTS: Nine patients showed prompt cessation of hematuria, an d in 2 patients hematuria stopped 2-4 days after embolization. CONCLUSIONS: Super-selective renal artery embolization (SSRAE) is suitable for severe hematuria, limited size of kidney injuries, stable hemod ynamic parameters after conservative treatment and low reserve of renal function. Steel coil is an effective embolic material, rapid hemostasis can be fulfilled and renal function can be reserved. Super-selective renal artery embolization has low incidence of complications and can shorten hospitalization time.