RESUMO
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction.</p><p><b>METHODS</b>We conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales (SF-PAIRS) , and compared the safety and efficacy of medication between the two groups of patients.</p><p><b>RESULTS</b>Totally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 +/- 2.9 vs 18.5 +/- 1.7) and 1 month after withdrawal (20.9 +/- 2.1 vs 17.9 +/- 2.3) (P < 0.05). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 +/- 6.9 vs 28.6 +/- 5.8) and 1 month after withdrawal (30.6 +/- 4.7 vs 27.9 +/- 6.5) (P < 0.05). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P < 0.05), even more significantly in the on-time than in the on-demand group at 1 month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups.</p><p><b>CONCLUSION</b>On-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than on-demand dosing at 8 weeks of medication and 1 month after withdrawal.</p>
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Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Carbolinas , Usos Terapêuticos , Esquema de Medicação , Disfunção Erétil , Tratamento Farmacológico , Inibidores de Fosfodiesterase , Usos Terapêuticos , Estudos Prospectivos , Tadalafila , Resultado do TratamentoRESUMO
Myxoid adrenocortical neoplasms are rare. Surgical resection of the mass is the first-line therapy. Here we reported a total of four patients, aged 44–66 years, diagnosed with myxoid adrenocortical tumor. The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias do Córtex Suprarrenal , Diagnóstico , Metabolismo , Cirurgia Geral , Biomarcadores Tumorais , MetabolismoRESUMO
Sporadic malignant pheochromocytoma, a rare disease with poor prognosis, is always difficult to treat due in part to lack of effective agents. We presented three patients with advanced malignant pheochromocytoma treated by sunitinib, which indicates that sunitinib is an effective agent for this malignancy.
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Suprarrenais , Tratamento Farmacológico , Indóis , Usos Terapêuticos , Feocromocitoma , Tratamento Farmacológico , Inibidores de Proteínas Quinases , Usos Terapêuticos , Pirróis , Usos TerapêuticosRESUMO
<p><b>BACKGROUND</b>Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field. Here we reported our experience on the treatment of proximal ureteral stones.</p><p><b>METHODS</b>From 2005 to 2010, 187 consecutive patients with proximal ureteral stones who underwent ureteroscopic lithotripsy were enrolled. The initial 52 patients treated by semi-rigid ureteroscope alone were classified as group 1. The subsequent 135 patients treated by semi-rigid ureteroscope with the aid of stone basket and flexible ureteroscope were classified as group 2.</p><p><b>RESULTS</b>In group 1, the overall stone-free rate was 67.3%. By a single procedure of ureteroscopic lithotripsy using a semi-rigid instrument, patients with ureteral stones below the 4th lumbar vertebra level achieved 91.7% stone-free rate, which was only 50% in patients with stones above the 4th lumbar vertebra level. Conversion to open surgery occurred in two patients since ureteral perforation was observed. In group 2, the stone-free rate achieved 93.2% with the aid of an N-Trap basket, which was significantly higher than that of patients without the aid of the basket (51.6%). Flexible ureteroscope was subsequently used in patients with fragment migration, thus making the overall success rate in group 2 increases to 97.0%.</p><p><b>CONCLUSIONS</b>Ureteroscopic lithotripsy is a safe and efficacious treatment for proximal ureteral stones. A single procedure of ureteroscopic lithotripsy using semi-rigid ureteroscope could achieve a satisfactory stone-free rate in patients with proximal ureteral stones below the 4th lumbar vertebra level. However, patients with ureteral stones above the 4th lumbar vertebra level experienced higher stone-migration rate, which would decrease the success rate. Fortunately, the stone-free state could possibly be achieved with the aid of an N-trap basket and flexible ureteroscope.</p>
Assuntos
Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Lasers de Estado Sólido , Usos Terapêuticos , Litotripsia a Laser , Métodos , Cálculos Ureterais , TerapêuticaRESUMO
<p><b>OBJECTIVE</b>To search for an effective method of reducing intraoperative blood loss in radical retropubic prostatectomy (RRP).</p><p><b>METHODS</b>We performed RRP for 100 patients with prostate cancer, 50 (group A) with the Walsh or Poor method for handling the dorsal venous complex (DVC), and the other 50 (group B) through the following three additional procedures for hemostasis: first placing a #7 prophylactic suture in the distal position of DVC, then ligating the vascular bundle of the prostatic apex with continuous 4-0 Vicryl sutures, and lastly placing a 4-0 absorbable suture followed by freeing the neurovascular bundle (NVB) or freeing NVB before suturing the remained levator ani myofascia and the deep layer of Denovilliers' fascia above the rectal serosa with 4-0 Vicryl. We assessed the effects of the three hemostatic methods in RRP by comparing the volumes of intraoperative blood loss and transfusion, operation time and perioperative levels of hemoglobin.</p><p><b>RESULTS</b>There were no significant differences between groups A and B in age, PSA, Gleason score, clinical stage, prostate volume, operation time and perioperative hemoglobin levels (P>0.05). The volumes of intraoperative blood loss and transfusion were markedly higher in group A ([1103.00 +/- 528.03] ml and [482.00 +/- 364.60] ml) than in B ([528.00 +/- 258.96] ml and [140.00 +/- 266.28] ml) (P<0.05).</p><p><b>CONCLUSION</b>Intraoperative blood loss in RRP could be significantly decreased by placing a prophylactic hemostatic suture in the distal position of DVC, continuous suture of the vascular bundle of the prostatic apex after cutting off the urethra, and placing a fine absorbable suture above NVB or continuous suture of the remained levator ani mony fascia and the deep layer of Denovilliers'fascia above the rectal serosa with absorbable sutures after freeing NVB.</p>
Assuntos
Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Perda Sanguínea Cirúrgica , Técnicas Hemostáticas , Prostatectomia , Métodos , Neoplasias da Próstata , Cirurgia GeralRESUMO
The changes of blood perfusion of contralateral testis after unilateral testicular torsion remain controversial. In this study, 28 New Zealand white male rabbits were randomly divided into five groups. Group A (n = 8), the control group, underwent a sham operation on the unilateral testis without inducing testicular torsion. In groups B, C, and D (n = 5 each), unilateral testicular torsion was induced, and, after 3, 6 or 24 h, respectively, detorsion was performed. In group E (n = 5), permanent unilateral testicular torsion was applied. Contrast-enhanced ultrasound was used to observe the blood perfusion of the contralateral testis at the following stages: pre-torsion (preopration), immediately post-torsion (postopration), pre-detorsion, immediately post-detorsion, and late-stage post-detorsion (6-12 h post-detorsion in groups B-D) or at a similar time point (15-21 h post-torsion in group E). Time-intensity curves were generated, and the following parameters were derived and analyzed: arrival time, time to peak intensity, peak intensity, and half-time of the descending peak intensity. The analysis revealed that blood perfusion of the contralateral testis increased immediately after testicular torsion on the opposite side (P < 0.05), which increased with prolonged testicular torsion of the other testis. This research demonstrated that contrast-enhanced ultrasound was valuable in evaluating blood perfusion of the contralateral testis after unilateral testicular torsion.
Assuntos
Animais , Masculino , Coelhos , Meios de Contraste , Modelos Animais de Doenças , Fluxo Sanguíneo Regional , Fisiologia , Torção do Cordão Espermático , Patologia , Testículo , Diagnóstico por Imagem , Patologia , UltrassonografiaRESUMO
<p><b>OBJECTIVE</b>To construct a recombinant bacillus Calmette-Guérin vaccine (rBCG) secreting human interferon-alpha 2b (IFN alpha-2b).</p><p><b>METHODS</b>BCG Ag85B signal sequence and IFN alpha-2b gene were amplified from the genome of BCG and of human peripheral blood by polymerase chain reaction (PCR), respectively. IFN alpha-2b gene was cloned in E. coli-BCG shuttle-vector pMV261 to get pMV261-IFN alpha-2b. A new recombinant plasmid pMV261-IFN alpha-2b was constructed by inserting BCG Ag85B signal sequence into pMV261-Ag85B-IFN alpha-2b. Then, BCG was transformed with this recombinant plasmid by electroporation, and designated as rBCG-IFN alpha-2b. The DNA and protein expressions of IFN alpha-2b gene in rBCG were determined by PCR and Western blot respectively. Also the quantity of IFN alpha-2b protein secreted by rBCG in culture supernatants was determined by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>By partial nucleotide sequencing, the DNA sequences of human IFN alpha-2b and BCG Ag85B were consistent with that in the Gene Bank, and were correctly inserted into the shuttle expression vector pMV261 to construct recombinant plasmid pMV261-Ag85B-IFN alpha-2b. BCG was successfully transformed with this recombinant plasmid by electroporation and the recombinant BCG (rBCG-IFN alpha-2b) was capable of synthesizing and secreting cytokine IFN alpha-2b. The concentration of IFN alpha-2b in culture supernatants was quantified by ELISA and calculated to be approximately 301.45 pg/ml.</p><p><b>CONCLUSIONS</b>Recombinant BCG secreting human IFN alpha-2b (rBCG-IFN alpha-2b) was constructed successfully and the specific IFN alpha-2b protein can be expressed highly and steadily by rBCG vaccine.</p>
Assuntos
Humanos , Vacina BCG , Genética , Alergia e Imunologia , Metabolismo , Expressão Gênica , Vetores Genéticos , Interferon-alfa , Genética , Metabolismo , Plasmídeos , Genética , Proteínas Recombinantes , Transformação BacterianaRESUMO
<p><b>BACKGROUND</b>Transitional cell carcinoma of the upper urinary tract (UUT-TCC) accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization (PNV) in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics.</p><p><b>METHODS</b>The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively.</p><p><b>RESULTS</b>Of our sample, 144 cases presented with gross haematuria (83.7%) and 12 with microscopic haematuria (7.0%). Forty-six cases (26.7%) were detectable by cytology. Filling defect identified 36 positive cases of 172 patients (20.9%), PNV was present in the images of 105 of 172 patients (61.0%). The detection rate by PNV (61.0%) was significantly different from that by cytology (26.7%) or by filling defect (20.9%) (P = 0.031, P = 0.001, respectively). Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors (P = 0.028; P = 0.031; P = 0.006, respectively). Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model (P = 0.042; P = 0.014).</p><p><b>CONCLUSIONS</b>Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células de Transição , Diagnóstico por Imagem , Rim , Diagnóstico por Imagem , Modelos Logísticos , Radiografia , Sensibilidade e Especificidade , Neoplasias Urológicas , Diagnóstico por ImagemRESUMO
<p><b>OBJECTIVE</b>To evaluate the factors for the conversion of transurethral resection of the prostate (TURP) to open prostatectomy and to provide clinical evidence for surgical options.</p><p><b>METHODS</b>From January 1997 to March 2005, we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics, clinical history, laboratory data, ultrasound results, and intraoperative complications of the patients. In addition, multivariate logistic regression was used to determine those variables predicting the conversion of TURP.</p><p><b>RESULTS</b>Thirty-nine (3.59%) of the TURP cases required conversion, mostly because of uncontrollable hemorrhage (71.79%). Multivariate analyses showed that a prostate volume > 85.2 ml (OR = 2.568, P < 0.01), intraoperative slit of capsula prostatic (OR = 1.916, P < 0.01) and a second midstream bladder specimen (VB2) white blood cell count of the urine > 13.5/HP (OR = 1.486, P < 0.01) predicted the conversion to open prostatectomy.</p><p><b>CONCLUSION</b>Benign prostatic hyperplasia (BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatic undergoing TURP are more likely to be converted. And uncontrollable hemorrhage, huge prostate and poor endoscopic vision are the major reasons for the conversion.</p>
Assuntos
Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Logísticos , Análise Multivariada , Hemorragia Pós-Operatória , Prostatectomia , Métodos , Hiperplasia Prostática , Cirurgia Geral , Estudos Retrospectivos , Fatores de Risco , Ressecção Transuretral da Próstata , Métodos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To evaluate the roles of laparoscopic adrenalectomy (LA) and open adrenalectomy (GA) for treatment of adrenal gland diseases.</p><p><b>METHODS</b>The data of 486 patients with adrenal gland diseases was analyzed retrospectively during 5 years. A total of 478 patients received surgical treatments including 318 GAs and 160 LAs. The operation time, bleeding volume during operation, intestine function recovery time, pain postoperatively, hospital stay time postoperatively and postoperative complications in group GA and group LA respectively were compared.</p><p><b>RESULTS</b>All cases in group GA were successful. A total of 154 cases in group LA were successful, and 6 cases were converted to open surgery. In group LA, there were 9 cases whose tumor diameter exceeded 6 cm. There were 3 malignant cases in group LA, and no recurrence and metastasis were observed during 3-20 months follow-up. The average operation time was (112 +/- 16) mmn and (69 +/- 10) min in group GA and LA respectively. The average bleeding volume during operation was (286 +/- 23) ml, (56 +/- 10) ml in group GA and LA respectively. The average intestine function recovery time was (66 +/- 7) h, (24 +/- 7) h in group GA and LA respectively. The average frequency of treatment of pain was 1.9 +/- 0.4 and 0.5 +/- 0.1 in group GA and LA respectively. The average hospital stay time postoperatively was (10.3 +/- 1.1) d and (7.2 +/- 0.7) d in group GA and LA respectively. The rate of postoperative complications was 40.3% and 7.5% in group GA and LA respectively. All differences were significant (P = 0.023, 0.007, 0.039, 0.003, 0.029 and 0.001).</p><p><b>CONCLUSIONS</b>LA has the added benefit of shorter convalescent times, improving patients satisfaction and less associated complications, as it has proved to be as effective as OA.</p>
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças das Glândulas Suprarrenais , Cirurgia Geral , Adrenalectomia , Métodos , Seguimentos , Laparoscopia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of penile carcinoma in circumcised men.</p><p><b>METHODS</b>We reviewed 17 cases of penile carcinoma detected 1 month to 16 years after circumcision performed in our hospital from January, 1997 to December, 2004.</p><p><b>RESULTS</b>Of the total number, 11 cases were diagnosed as penile carcinoma 1 - 12 months and the others 3 - 16 years after the circumcision. Sixteen of them were treated by partial penectomy, anti 1 first by extensive circumcision and later by partial and total penectomy successively after recurrence. Cloquet nodes biopsy showed 16 cases to be pathologically well-differentiated and I case moderately differentiated penile squamous carcinoma. One died of extensive metastasis, but the other 16 remained disease-free survivals.</p><p><b>CONCLUSION</b>Circumcised adult men, especially those over 40 years of age, are likely to develop penile carcinoma. Patients with inflammation, plaque or ulcer in the prepuce should be checked by pathological biopsy and followed up closely. For Stage-I penile squamous carcinoma, partial penectomy is shown to be an effective therapeutic option, and Cloquet's nodes biopsy is necessary for all patients.</p>
Assuntos
Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas , Circuncisão Masculina , Seguimentos , Neoplasias Penianas , Fimose , Cirurgia Geral , Período Pós-Operatório , Estudos RetrospectivosRESUMO
Vasoactive intestinal polypeptide (VIP) is a potent vasodilator and smooth muscle relaxant, and also fulfils several of the criteria for a neurotransmitter mediating penile erection. VIP donor and gene transfer of VIP are a potentially promising and physiologically relevant strategies for the treatment of erectile dysfunction.
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Animais , Bovinos , Cães , Humanos , Masculino , Ratos , Disfunção Erétil , Terapêutica , Técnicas de Transferência de Genes , Ereção Peniana , Fisiologia , Peptídeo Intestinal Vasoativo , Genética , FisiologiaRESUMO
Phosphodiesterase 5 inhibitors are recommended as first-line treatment of erectile dysfunction in many guidelines, because of their convenience, higher efficacy, and less side-effects. Since its first launch in 1998, sildenafil has been currently the best investigated phosphodiesterase 5 inhibitor with respect to long-term trails and quantity. Clinical trials showed the efficacy of sildenafil compared with placebo in many of the groups of patients who have ED, including those with cardiovascular disease, diabetes mellitus, depression, radical prostatectomy and dialysis. Typically the adverse effects reported in patients from clinical trials of sildenafil have been mild to moderate, and commonly include flushing and dyspepsia and transient visual disturbances. This article summarized recent reports on efficacy and safety of phosphodiesters 5 inhibitors in the treatment of erectile dysfunction.
Assuntos
Humanos , Masculino , Disfunção Erétil , Tratamento Farmacológico , Inibidores de Fosfodiesterase , Usos Terapêuticos , Piperazinas , Usos Terapêuticos , Purinas , Usos Terapêuticos , Segurança , Citrato de Sildenafila , Sulfonas , Usos TerapêuticosRESUMO
After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma. Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.
Assuntos
Idoso , Humanos , Masculino , Adenocarcinoma , Patologia , Anti-Infecciosos , Anti-Infecciosos Urinários , Biópsia , Infecções por Escherichia coli , Tratamento Farmacológico , Levofloxacino , Meningite , Microbiologia , Metronidazol , Ofloxacino , Neoplasias da Próstata , Patologia , Ultrassom Focalizado Transretal de Alta IntensidadeRESUMO
<p><b>OBJECTIVE</b>To investigate the clinical characteristics, diagnosis and treatment of urinary neurofibrosarcoma.</p><p><b>METHODS</b>Clinical data of 1 case of urinary neurofibrosarcoma was analyzed retrospectively and related literature reviewed. The 61-year old male patient had undergone TURP for benign prostate hyperplasia ten months before.</p><p><b>RESULTS</b>Total urethral cavernostomy, total cystectomy and ileal cystostomy were performed on the patient and pathological diagnosis pointed to urinary neurofibrosarcoma. Another operation was done for metastatic rectal mass, which revealed abdominal metastasis. With progressing consumptive constitution, the patient died 40 days after the second operation.</p><p><b>CONCLUSION</b>It is difficult to make a definite diagnosis in urinary neurofibrosarcoma, and the effective treatment for this highly malignant disease needs to be further studied.</p>
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neurofibrossarcoma , Diagnóstico , Patologia , Cirurgia Geral , Estudos Retrospectivos , Neoplasias Uretrais , Diagnóstico , Patologia , Cirurgia Geral , Procedimentos Cirúrgicos Urológicos , MétodosRESUMO
<p><b>OBJECTIVE</b>To investigate the effect of intravesical instillation of antifibrinolytic agents with bacillus Calmette-Guerin (BCG) on preventing recurrence of superficial bladder transitional cell carcinoma (BTCC) after surgical management.</p><p><b>METHODS</b>A total of 326 cases of superficial BTCC undergoing transurethral resection of bladder tumor (TURBT) or partial cystectomy were divided into 5 groups. Then the different dosage BCG with or without antifibrinolytic agents was regular instilled into bladders (once a week, then once a month after 6 times). Group A including 66 cases received intravesical instillation of 100-120 mg BCG plus 100 mg para-aminomethyl benzoic acid (PAMBA). Group B including 64 cases: instillation of 50-60 mg BCG plus 100 mg PAMBA; Group C including 65 cases: 100-120 mg BCG plus 2.0 g epsilon-aminocaproic acid (EACA); Group D including 64 cases: 50-60 mg BCG plus 2.0 g EACA; Group E (control group) including 67 cases: 100-120 mg BCG. All the cases had been followed up for 4 to 69 months (mean, 28.5 months). Not only was cystoscopy performed every 3 months, but also biopsy was carried out to identify recurrence when necessary. Side effect was recorded after instillation.</p><p><b>RESULTS</b>The rate of tumor recurrence of Group A, Group B, Group C and Group D was 12%, 10%, 9%, 9% respectively, which was significantly lower than that of Group E (30%) (chi(2) = 5.699, 6.818, 7.380, 7.867, P = 0.017, 0.009, 0.007, 0.005). And there was no significant difference of tumor recurrence rate between Group A and Group B or between Group C and Group D (Group A and Group C: high dosage BCG plus antifibrinolytic agents, while Group B and Group D: low dosage BCG plus antifibrinolytic agents) (P > 0.05). But the side effects developing in Group B and Group D after BCG instillation were less than those in Group A and Group C.</p><p><b>CONCLUSIONS</b>The efficacy of BCG on prevention the recurrence of superficial BTCC can be enhanced when combined with antifibrinolytic agents. Even if the dosage of BCG was reduced by half, the efficacy didn't changed. A new approach of low dosage BCG plus antifibrinolytic agents is recommended in the prophylaxis of recurrence of bladder cancer.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ácido 4-Aminobenzoico , Adjuvantes Imunológicos , Usos Terapêuticos , Administração Intravesical , Ácido Aminocaproico , Antifibrinolíticos , Usos Terapêuticos , Vacina BCG , Usos Terapêuticos , Carcinoma de Células de Transição , Tratamento Farmacológico , Cirurgia Geral , Terapia Combinada , Quimioterapia Combinada , Seguimentos , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária , Tratamento Farmacológico , Cirurgia Geral , para-AminobenzoatosRESUMO
<p><b>UNLABELLED</b>To study the androgen dependence of the neurotransmitter, calcitonin gene-related peptide (CGRP) in rat penis.</p><p><b>METHODS</b>Forty-four Sprague-Dawley rats were randomly divided into Group A (intact controls), Group B (castrated) and Group C (gavaged with finasteride 4.5 mg.kg(-1).day(-1)). Four and ten weeks later respectively, half of rats in each group were anaesthetized. Blood samples were taken for the measurement of serum testosterone and dihydrotestosterone (DHT) by means of radioimmunoassay. Penile samples were harvested for the investigation of calcitonin gene related peptide (CGRP)-immunoreactive nerve fibers with immunohistochemistry. The computer-assisted imaging analysis system was applied to calculate the area proportion of the CGRP-positive nerve fibers (CGRP-PNF) in each group.</p><p><b>RESULTS</b>1) Both 4 and 10 weeks later, testosterone and DHT levels in Group B decreased significantly compared with those in Group A, (P <0.05, P <0.01, respectively); DHT level in Group C was also significantly decreased in comparison with that in Group A for both 4- and 10- week animals (P <0.05); 2) There was no significant differences in area proportion of CGRP-PNF among Groups A, B and C 4 weeks after treatments (P >0.05); However, 10 weeks later, the proportion of CGRP-PNF in Groups B and C was significantly less than that in Group A (P <0.01); 3) The proportion of CGRP-PNF of 4-week animals in Groups B and C was significantly higher than that of 10-week animals (P <0.05).</p><p><b>CONCLUSION</b>The expression of neurotransmitter, CGRP may depend on androgens, including testosterone and DHT in rat penis.</p>
Assuntos
Animais , Masculino , Ratos , Androgênios , Metabolismo , Peptídeo Relacionado com Gene de Calcitonina , Metabolismo , Di-Hidrotestosterona , Sangue , Regulação da Expressão Gênica , Imuno-Histoquímica , Pênis , Metabolismo , Distribuição Aleatória , Ratos Sprague-Dawley , Testosterona , SangueRESUMO
<p><b>OBJECTIVE</b>To investigate the clinical features, pathology, diagnosis and treatment of inverted urothelial papilloma.</p><p><b>METHODS</b>A total of 151 cases of urothelial inverted papilloma were analysed retrospectively. Of the cases, 134 were male and 17 were female, with a mean age of 54 years old. Most patients complained of painless gross hematuria. The diagnosis could be established mainly by ultrasonic, intravenous urography, retrograde pyelography, cystoscope and pathology. Among them, 7 cases who had the papilloma at upper urinary tract underwent nephroureterectomy except one. One hundred and forty-four cases had the papilloma at low urinary tract, with 124 treated by transurethral bladder tumor resection (TURBT), among which 11 cases accompanying benign prostatic hyperplasia were treated by transurethral prostatic resection, 3 by transurethral resection of prostatic urethral tumor, 15 by partial cystectomy, 2 by total cystectomy.</p><p><b>RESULTS</b>One hundred and eighteen cases were followed up 1 year to 12.5 years (mean 6.3 years). Intravesical recurrence was found in 5 cases. Of them 2 cases developed malignance in 8 and 30 months postoperatively, and 1 case underwent total cystectomy.</p><p><b>CONCLUSIONS</b>Inverted urothelial papilloma is a benign tumor, which appears male predominant. Most of the lesions are found in the bladder. TURBT is the preferred treatment choice for inverted papilloma of the bladder. Although this disease has a good prognosis, regular follow-up observations are necessary.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seguimentos , Papiloma Invertido , Diagnóstico , Patologia , Cirurgia Geral , Estudos Retrospectivos , Neoplasias Urológicas , Diagnóstico , Patologia , Cirurgia GeralRESUMO
<p><b>OBJECTIVE</b>To investigate whether different types of injury on bladder wall can influence bacillus Calmette-Guerin (BCG) attachment.</p><p><b>METHODS</b>The bladder mucosa of 24 rabbits were treated by electrocautery,cryocautery and incision on left lateral wall, right lateral wall and posterior wall, respectively. Then radiolabeled BCG ((3)H-BCG) was instilled into bladder. Two hours latter, the injured bladder wall with different methods and non-injured wall (anterior wall of bladder) were surgically removed and digested. The quantity of BCG of each specimen was determined by liquid scintillation counter.</p><p><b>RESULT</b>The quantity of BCG attachment to bladder wall with different injuries was significantly higher than that of non-injured wall (P<0.001), meanwhile there was no statistically difference among the BCG levels of different injury types (P>0.05).</p><p><b>CONCLUSION</b>BCG attachment is not influenced by different types of injury on the bladder wall.</p>
Assuntos
Animais , Feminino , Masculino , Coelhos , Aderência Bacteriana , Mycobacterium bovis , Fisiologia , Bexiga Urinária , Ferimentos e Lesões , MicrobiologiaRESUMO
<p><b>OBJECTIVE</b>To improve the operative procedure of the left renal vein nutcracker syndrome.</p><p><b>METHODS</b>Two patients underwent transposition of the left renal vein in the treatment of the left renal vein nutcracker syndrome.</p><p><b>RESULT</b>Renal ischemia, due to clamping of the renal artery, lasted 14 minutes and 13 minutes, respectively. The gross hematuria disappeared 1 day and 4 days respectively after surgery, and microhematuria ceased spontaneously 5 days and 7 days respectively after surgery. Transposition of the left renal vein effectively relieved the symptoms related to the left renal vein nutcracker syndrome. The patients had no recurrence of symptoms following up during 3 months.</p><p><b>CONCLUSION</b>Transposition of the left renal vein is a safe and effective surgical approach in the treatment of the left renal vein nutcracker syndrome.</p>