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1.
Zhonghua Nan Ke Xue ; 23(11): 982-986, 2017 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-29738162

RESUMO

OBJECTIVE: To investigate the safety and effectiveness of radical retropubic prostatectomy (RRP) with adjuvant androgen deprivation or external radiotherapy in the treatment of prostate cancer (PCa) with pelvic lymph node metastasis (PLNM). METHODS: Twenty PCa patients underwent bilateral pedal lymphangiography (PLG) preoperatively, and 11 of them received lymph node aspiration for examination of the mRNA expressions of prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) in the lymph fluid by real-time RT-PCR. All the patients were treated by RRP with extended dissection of pelvic lymph nodes, and 3 of them by external radiotherapy in addition after recovery from urinary incontinence because of positive surgical margins, followed by adjuvant androgen deprivation therapy. RESULTS: Real-time RT-PCR showed positive mRNA expressions of PSA and PSMA in the lymph fluid of the 11 patients, all pathologically confirmed with PLNM. The median intraoperative blood loss was 575 ml, with blood transfusion for 5 cases. Positive surgical margin was found in 3 cases, lymphorrhagia in 2 and urinary leakage in another 2 each. There were no such severe complications as vascular injury and rectum perforation. The patients were followed up for 6-48 (mean 42) months, during which, biochemical recurrence was observed in 12 cases at a median of 12 months postoperatively and 2 patients died at 12 and 48 months respectively. CONCLUSIONS: Bilateral PLG and lymph node aspiration for examination of the mRNA expressions of PSA and PSMA in the lymph fluid help to confirm PLNM preoperatively. Radical retropubic prostatectomy with adjuvant androgen deprivation or external radiotherapy is safe and effective for the treatment of PCa with PLNM, but it should be chosen cautiously for those with Gleason 5+5.


Assuntos
Linfonodos/patologia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Antagonistas de Androgênios/uso terapêutico , Antígenos de Superfície/metabolismo , Quimioterapia Adjuvante , Glutamato Carboxipeptidase II/metabolismo , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Pelve , Período Pós-Operatório , Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/metabolismo
2.
Urol Int ; 95(2): 243-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26066307

RESUMO

Crossed fused renal ectopia combined with chyluria is extremely rare. Here we report the case of a patient who was admitted to our institution since milky urine and was finally found to have an L-shaped fused kidney and renal pelvis fistula. The patient was cured by renal pelvic instillation sclerotherapy.


Assuntos
Nefropatias/complicações , Rim/anormalidades , Urina/química , Doenças Urológicas/complicações , Quilo/química , Cistoscopia/métodos , Feminino , Fístula , Humanos , Rim/fisiopatologia , Pelve Renal/anormalidades , Pelve Renal/cirurgia , Pessoa de Meia-Idade , Radiografia , Escleroterapia/métodos , Resultado do Tratamento , Ureter/diagnóstico por imagem , Ureter/fisiologia
3.
Urol Int ; 94(2): 215-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25171183

RESUMO

OBJECTIVES: To evaluate the efficacy and safety of pedal lymphography (PLG) in the localization diagnosis of chyluria. METHODS: Cystoscopy was performed in 153 patients and PLG in 121 cases. Unilateral or staged bilateral ligation and stripping of renal lymphatic vessel were performed according to the results of cystoscopy and/or PLG. RESULTS: Unilateral and bilateral urinary excretion of chyle was detected in 123 and 1 case by cystoscopy, respectively. In 121 cases receiving PLG, 100 cases of unilateral fistulous connection between the renal pelvis and the lymphatic system, 18 cases of bilateral fistulas and 1 case of lymphatic bladder fistula were demonstrated. PLG has a higher diagnostic rate for the detection of bilateral lymphatic renal pelvis fistulas than cystoscopy (p<0.05). 28 cases received renal pedicle lymphatic disconnection only according to the results of cystoscopy, and 3 of them failed (10.1%). While 121 cases had the same operation according to the results of PLG, only 1 case failed the operation (0.8%). CONCLUSIONS: PLG was efficient and safe for the localization diagnosis of chyluria, with a higher detection rate of bilateral fistulas than cystoscopy. PLG might benefit the selection of appropriate therapy and improve the surgical effect.


Assuntos
Quilo/diagnóstico por imagem , Fístula/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Linfografia/métodos , Tomografia Computadorizada por Raios X , Adulto , Cistoscopia , Feminino , Fístula/terapia , Humanos , Doenças Linfáticas/terapia , Linfografia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X/efeitos adversos , Resultado do Tratamento , Urina
4.
Kaohsiung J Med Sci ; 39(6): 587-595, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37010151

RESUMO

Altered Krüppel-like factor 9 (KLF9) expression can regulate the progression of several cancers, including renal cell carcinoma (RCC). This study was conducted to investigate the role of KLF9 in the proliferation, invasion, and migration of RCC cells via regulation of stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4). The expression patterns of KLF9, SDF-1, and CXCR4 in the experimental cell lines were determined by real-time quantitative polymerase chain reaction and Western blotting. After transfection of the KLF9 siRNA and KLF9 pcDNA, cell proliferation, invasion, and migration were evaluated by experiments including cell counting kit-8, colony formation, and Transwell assays. The binding of KLF9 to the SDF-1 promoter was analyzed by chromatin immunoprecipitation and dual-luciferase assay. The rescue experiment was performed using the recombinant SDF-1 protein and KLF9 pcDNA. KLF9 was downregulated in the RCC cells. KLF9 knockdown induced the proliferation, invasion, and migration of RCC cells, whereas KLF9 overexpression elicited the opposite roles. Mechanically, KLF9 bound to the SDF-1 promoter, repressed SDF-1 transcription, and reduced the SDF-1/CXCR4 expression levels. Activation of the SDF-1/CXCR4 axis attenuated the inhibitory role of KLF9 overexpression in RCC cell growth. Ordinarily, KLF9 suppressed the proliferation, invasion, and migration of RCC cells by repressing the SDF-1/CXCR4 signaling.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Receptores CXCR4/genética , Carcinoma de Células Renais/genética , Quimiocina CXCL12/genética , Quimiocina CXCL12/metabolismo , Transdução de Sinais/genética , Proliferação de Células/genética , Neoplasias Renais/genética , Movimento Celular/genética , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica , Fatores de Transcrição Kruppel-Like/genética
5.
Zhonghua Nan Ke Xue ; 18(11): 994-8, 2012 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-23214249

RESUMO

OBJECTIVE: To search for an effective method of reducing intraoperative blood loss in radical retropubic prostatectomy (RRP). METHODS: 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. RESULTS: 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). CONCLUSION: 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.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Idoso , Técnicas Hemostáticas , Humanos , Masculino , Pessoa de Meia-Idade
6.
Am J Mens Health ; 16(6): 15579883221138192, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36412060

RESUMO

A community-based prostate cancer screening program was conducted to assess the morbidity and associated factors for prostate cancer among the subpopulation of men aged ≥50 years in Taizhou, China. Taizhou Integrated Prostate Screening (TIPS) is a large, observational, population-based study of prostate cancer screening data based on serum prostate-specific antigen (PSA) concentrations. A pilot census of all male residents aged 50 years or older was conducted in Luqiao District, one of the field sites of the TIPS cohort in the city of Taizhou, Zhejiang. The interviewer-administered questionnaire evaluated demographic characteristics and environmental exposure factors. A total of 1,806 out of 3,516 participants completed the questionnaire. The overall prevalence of PSA ≥4 ng/mL was 11.5%, and included participants at low risk (9.2%), moderate risk (1.7%), and high risk (0.6%). Participants aged 60-69, 70-79, and ≥80 years had a 2.7-fold, 4.2-fold, and 6.5-fold higher risk of elevated PSA, respectively, in comparison with those aged 50 to 59 years (p < .001). Eighteen patients were diagnosed with prostate cancer, of whom 11 (61.1%) underwent radical surgery. This community-based PSA screening program indicated the results for early detection of prostate cancer among men aged ≥50 years. Early screening and appropriate clinical therapy for the management of prostate cancer are essential in this subpopulation.


Assuntos
Antígeno Prostático Específico , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/epidemiologia , Detecção Precoce de Câncer , Próstata , Programas de Rastreamento
7.
Zhonghua Nan Ke Xue ; 17(6): 523-6, 2011 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-21735651

RESUMO

OBJECTIVE: To summarize the experience and lessons from 100 cases retropubic radical prostatectomy performed in the past 10 years. METHODS: From July 1999 to July 2009, we performed 100 cases of retropubic radical prostatectomy, of which 84 were followed up for 3 - 120 months. We analyzed their preoperative age, PSA level, amount of intraoperative blood transfusion, operation time, urinary continence, penile erectile function, stricture of the anastomotic stoma and Qmax. RESULTS: The mean age, PSA level, amount of intraoperative blood transfusion, operation time were 66.8 yr, 20.1 ng/ml, 585.7 ml and 198.9 min; the recovery rates of bladder control at 3, 6 and 12 months postoperatively were 65.5%, 81.7% and 92.4%, respectively. At 12 months after surgery, penile erection was restored in 19 cases (42.2%), anastomotic stoma stricture developed in 5 (5.9%), Qmax averaged 20.5 ml/min, biochemical recurrence was found in 13, and 1 died from prostate cancer. CONCLUSION: Retropubic radical prostatectomy is a desirable procedure for the treatment of local prostate cancer, in which ligation of the puboprostatic ligament and prostatic venous plexus before cutting off the ligament helps improve urinary continence, protection of the neurovascular bundle and collateral pudendal artery contributes to the recovery of penile erectile function, and proper connection of urethral and bladder mucosa can reduce anastomotic stoma stricture. Postoperative external-beam radiotherapy for those with T3a or local lymph node metastasis could decrease biochemical recurrence.


Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Idoso , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade
8.
Zhonghua Wai Ke Za Zhi ; 48(20): 1565-8, 2010 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-21176672

RESUMO

OBJECTIVE: To clarify the significance of micrometastases in pelvic lymph nodes in patients with neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP). METHODS: Twenty-one patients with clinically localized prostate cancer who received NHT between August 2007 and March 2010 were observed. The patients were clarified into four groups: pathological examination was positive (group A), real-time PCR examination targeting prostate specific antigen (PSA) mRNA and prostate specific membrane antigen (PSMA) mRNA were positive (group B), pathological examination and real-time PCR examination targeting PSA mRNA and PSMA mRNA were both negative (group C), and the control group (group D). After a standard bipedal lymphangiography the films were reviewed carefully by an experienced radiologist. If positive lymph nodes were seen or suspected, a thin-walled 22 gauge needle were directed transabdominally under fluoroscopic control into the area of question and an aspirate was obtained. The expression of PSA and PSMA in aspirate were assessed by a fully quantitative real-time PCR. The specimens were regarded in which either PSA mRNA or PSMA mRNA were positive as showing the "presence of micrometastasis". Lymph node specimens were also stained immunohistochemically with an antibody PSA after RP. RESULTS: Pathological examination detected lymph node metastases from 3 cases, and real-time PCR further identified lymph node micrometastases from 14 cases with no pathological evidence of nodal involvement. The expression level of PSA mRNA and PSMA mRNA were statistically significant in patients with histological confirmed lymph node metastases and micrometastases detected by real-time PCR despite the lack of histological evidence, and the expression level of PSA mRNA and PSMA mRNA in aspirate were higher than the lymph node between the group A and group B. CONCLUSIONS: Although residual foci of atrophic prostate cancer cells in resected lymph nodes after NHT can be difficult to diagnose by pathological examination, the present results show the usefulness of quantitative real-time PCR targeting PSA and PSMA mRNA for detected micrometastatic tumour foci in pelvic lymph nodes from fine needle aspiration biopsy of lymph nodes before RP.


Assuntos
Linfonodos/patologia , Pelve/patologia , Neoplasias da Próstata/patologia , Idoso , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Cuidados Pré-Operatórios , Prognóstico , Antígeno Prostático Específico/genética , Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/cirurgia , RNA Mensageiro/genética
9.
Zhonghua Wai Ke Za Zhi ; 47(7): 545-7, 2009 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-19595217

RESUMO

OBJECTIVE: To evaluate therapeutic effect and reliability of bipolar transurethral plasma kinetic prostatectomy (TUPKP) for high risk level benign prostatic hyperplasia (BPH). METHODS: A total of 230 cases of high risk of BPH were treated with TUPKP. Among them, 132 cases with the residual urine of 40 to 420 ml had accepted long term but inefficient medical therapy, 98 cases were suffered with repeating acute urinary retention. One hundred and seventy-three cases with the functional capacity>4 MET were performed the standard transurethral resection of the prostate (TURP), the other 57 cases with the functional capacity<4 MET were accepted the minimally invasive TURP. Among them 12 cases complicated with bladder stones accepted Ho: YAG lithotripsy priory. The international prostate symptom score (IPSS), The maximal urinary flow rate (Qmax) and residual urine of the 2 groups before and after operation were analyzed. RESULTS: There was no transurethral resection syndrome occurred in both groups. After 3 to 12 months of follow-up postoperatively, the IPSS of the two groups were reduced from (21.9+/-5.7) and (23.7+/-5.0) to (4.4+/-2.3) and (5.5+/-2.4), residual urine were reduced from (61.8+/-18.4) ml and (103.9+/-77.3) ml to (13.0+/-6.2) ml and (15.8+/-6.1) ml, respectively. The Qmax was increased from (5.7+/-3.0) ml/s and (4.8+/-2.8) ml/s to (20.9+/-6.3) ml/s and (16.8+/-3.9) ml/s, there existed significant differences (P<0.01). However the IPSS, Qmax and residual urine of the standard group had progressed more obviously than the minimally invasive TURP group (P<0.05). CONCLUSIONS: It is safe and effective to use TUPKP for treating high risk patients of BPH with classic TURP and minimally invasive TURP according to different functional capacity. When the functional capacity is more than 4 MET, the standard procedures is preferred.


Assuntos
Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Resultado do Tratamento
10.
Zhonghua Nan Ke Xue ; 15(9): 806-8, 2009 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-19947563

RESUMO

OBJECTIVE: To assess the penile erectile function, urinary continence and voiding, and cancer recurrence in 18 bladder cancer patients after sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction. METHODS: Eighteen male patients with bladder cancer underwent sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction, and were followed up for cancer recurrence and such clinical outcomes as erectile function and urinary continence and voiding. RESULTS: The patients were followed up for an average of 41 months, of whom, all achieved day- and night-time urinary continence, but 2 with positive lymph nodes died of extensive metastasis at 10 and 15 months, respectively, after surgery. Among the total number, potency was maintained in 11 patients (61.1%), impaired in 2 and lost in 5, and the post-operative IIEF-5 score was (10.83 +/- 8.25) as compared with (13.72 +/- 6.39) before the operation, with a statistically significant difference (P < 0.05). CONCLUSION: Erectile function and urinary continence are fairly good in bladder cancer patients after sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction, and the oncological results are fairly acceptable, but still need to be confirmed by longer follow-ups and larger trials.


Assuntos
Colo Sigmoide/cirurgia , Cistectomia , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Disfunção Erétil/prevenção & controle , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Ereção Peniana , Incontinência Urinária/prevenção & controle
11.
Zhonghua Wai Ke Za Zhi ; 46(12): 926-8, 2008 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-19035152

RESUMO

OBJECTIVE: To assess the therapeutic effects of low tension, anti-reflux Roux-y sigmoid neobladder. METHODS: A total of 21 patients (7 male and 14 female) were included, aged 43-87 years. All cases received radical cystectomy and low tension Roux-y sigmoid neobladder procedure for invasive bladder cancer were included in this study. The period of follow-up was from 8 to 79 months (the average was 36 months). Evaluations included urinary flow rate, post voiding residual and filling cystometry. RESULTS: The mean maximum urinary flow rate, the voiding time and the post voiding residual were 28.1 ml/s (21.4-38.4 ml/s), 17 s(9-28 s) and 0 ml respectively. The cystometric capacity was 480 m1 (350-560 ml). The volume of desire to void was 330 ml (120-410 ml). The bladder pressure was from 14.2 to 18.6 cm H2O (the average bladder pressure was 16.4 cm H2O) at high filling volumes. The maximum voiding pressure was 45.0 cm H2O (23.6-63.4 cm H2O). CONCLUSIONS: The Roux-y sigmoid neobladder has an adequate capacity at low pressure with a satisfactory continence, and it is an effective method for continent urinary diversion.


Assuntos
Colo Sigmoide/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/cirurgia , Cistectomia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Urodinâmica
12.
Zhonghua Wai Ke Za Zhi ; 44(6): 369-71, 2006 Mar 15.
Artigo em Chinês | MEDLINE | ID: mdl-16638343

RESUMO

OBJECTIVE: To discuss the effect of urine control after radical retropubic prostatectomy by preserve the membranous part of sphincter urethrae and the neurovascular bundle, or to rebuild the bladder neck. METHODS: The radical retropubic prostatectomy was performed on a total of 32 cases of prostate cancer. We preserve the membranous part of sphincter urethrae and the neurovascular bundle lateral to the prostate. We evaginate the posterior wall of the bladder adequately and make an additional folding stitch to rebuild the bladder neck. RESULTS: The follow up is of 6-72 months. All patients could void without difficulty, no tumor recurrence and only 2 cases occurred slight incontinence. Other 30 cases regained the ability of controlling their urinations within 6 months. CONCLUSIONS: The incontinence after radical retropubic prostatectomy could be reduced by the method of preserving the membranous part of sphincter urethrae and preserving the neurovascular bundle lateral to the prostate in operation. It could also be avoided by evaginate the posterior wall of the bladder adequately and make an additional folding stitch to the bladder neck.


Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Incontinência Urinária/prevenção & controle , Idoso , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Prostatectomia/efeitos adversos , Estudos Retrospectivos , Incontinência Urinária/etiologia
13.
Zhonghua Wai Ke Za Zhi ; 43(14): 944-7, 2005 Jul 15.
Artigo em Chinês | MEDLINE | ID: mdl-16083629

RESUMO

OBJECTIVE: To study the pathology, diagnostic and therapeutic method of primary pigmented nodular adrenocortical disease (PPNAD). METHODS: The data of 5 cases of PPNAD were analyzed retrospectively. Among the 5 cases, 2 were male and 3 were female. The range of age was from 12 to 53 years. All the 5 cases had symptoms of Cushing syndrome. The diagnose depended on the results of endocrine exams, ultrasound, CT, MR and pathological reports. All patients received operation of unilateral adrenalectomy. The therapeutic effects were determined by post-operative results, which concluded clinical symptoms and endocrine exams. RESULTS: The follow-up time was from 4 months to 3 years. All patients' symptoms of Cushing syndrome were relieved in 6 months after operation. The endocrine exam was normal in one case and obvious improved in the other four cases. Up to now, one patient drop out of the follow-up, the other 4 cases had no evidence of recurrence. CONCLUSION: PPNAD is a rare type of Cushing syndrome. Diagnose depends on endocrine exams and pathological results. Operation is the effective method for the disease.


Assuntos
Síndrome de Cushing/diagnóstico , Síndrome de Cushing/cirurgia , Adolescente , Adrenalectomia , Adulto , Criança , Síndrome de Cushing/patologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes de Função Adreno-Hipofisária , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
14.
Zhonghua Nan Ke Xue ; 9(8): 575-7, 2003 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-14689886

RESUMO

OBJECTIVE: To study the five-year postoperative effect of the ligation and resection of the deep penile vein for the patient of erectile dysfunction (ED) caused by penile venous leakage. METHODS: Sixteen ED patients received deep penile vein ligation and resection. Observations of the penile erection had been recorded for 5 years after surgery. RESULTS: Eight cases demonstrated erectile hypofunction after 18 months postoperatively and total ED after 21-30 months of which 6 were improved by chemotherapy, and 2 showed no improvement. Seven cases remained normal and 1 case get out of touch at the 24th month postoperatively. CONCLUSIONS: The ligation and resection of the deep penile vein can be considered as an easy and effective method to treat patients of ED caused by penile venous leakage.


Assuntos
Impotência Vasculogênica/cirurgia , Pênis/irrigação sanguínea , Complicações Pós-Operatórias , Adulto , Seguimentos , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Veias/cirurgia
15.
Zhonghua Wai Ke Za Zhi ; 41(3): 211-3, 2003 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-12887783

RESUMO

OBJECTIVE: To study the clinical causes of the erectile dysfunction (ED). METHODS: One hundred and thirty cases of ED were examined by hemonamometry and cavernosography with vasodilating agent. The data about penile brachial index, intracavernous pressure, maintenance flow rate, and pressure loss change were obtained and the status of the penile veins was detected. RESULTS: Among 130 patients with ED, 39 had venous leakage including penile arterial insufficiency simultaneous venous leakage in 15 patients. Various leakage sites were observed by using cavernosography. Twenty-eight patients showed deep dorsal veins only and the remaining crural veins. CONCLUSION: Hemodynamometry is effective to diagnose the cause of ED.


Assuntos
Disfunção Erétil/fisiopatologia , Hemodinâmica , Adulto , Idoso , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vasodilatadores/farmacologia
16.
Zhonghua Wai Ke Za Zhi ; 42(10): 587-9, 2004 May 22.
Artigo em Chinês | MEDLINE | ID: mdl-15265399

RESUMO

OBJECTIVE: To investigate the factors regarding the recovery of postoperative blood pressure of aldosterone producing adenoma (APA) patients. METHODS: Sixty-eight patients with APA were recruited and their data including retinal blood vessel by Doppler sonography, urinary trace albumin, pathological changes of renal biopsy and the adrenal tissues around the adenoma were analyzed in order to determine the correlation between these data and postoperative durative hypertension. RESULTS: Postoperative durative hypertension occurred in 14 cases (41.2%) with increased resistance of unilateral or bilateral central artery of retina, in 16 cases (66.7%) with increased level of urinary trace albumin. Fifteen cases underwent renal biopsy and all of them showed different pathological alterations, 11 cases (73.3%) of which presented with postoperative durative hypertension. The pathological changes of the adrenal tissues around the adenoma is either atrophy or non-atrophy (normal or hyperplasia), 8 cases (40%) and 10 cases (22.2%) of which showed postoperative durative hypertension, respectively. CONCLUSION: The renal pathological changes and increased resistance of retinal blood vessel are the main reasons leading to postoperative hypertension in patients with APA.


Assuntos
Neoplasias do Córtex Suprarrenal/cirurgia , Adenoma Adrenocortical/cirurgia , Pressão Sanguínea/fisiologia , Hiperaldosteronismo/cirurgia , Adolescente , Neoplasias do Córtex Suprarrenal/fisiopatologia , Glândulas Suprarrenais/patologia , Adenoma Adrenocortical/fisiopatologia , Adulto , Feminino , Humanos , Hiperaldosteronismo/etiologia , Hiperaldosteronismo/fisiopatologia , Hipertensão/etiologia , Rim/patologia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Artéria Retiniana/fisiopatologia , Estudos Retrospectivos , Resistência Vascular/fisiologia
17.
J Cardiothorac Surg ; 9: 8, 2014 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-24393538

RESUMO

PURPOSE: To identify the value of unilateral pedal lymphangiography (LAG) with non-contrast CT in the location and treatment decision of idiopathic chylothorax after failure of thoracic duct ligation. MATERIALS AND METHODS: Twenty four patients aged 9-84 year old (median 44 yr) who had idiopathic chylothorax were involved, and unilateral pedal LAG with non-contrast CT was performed in every patient. All patients failed to previous right supra-diaphragmatic thoracic duct ligation. RESULTS: The amount of iodized oil used was 6-14 ml with no related complications. LAG demonstrated 8 patients with thoracic duct leaks and 10 patients with leaks elsewhere, but no visible chylous leak in 6 patients. Ligation of thoracic duct was performed as the primary treatment in all 8 cases as having thoracic duct leakage and cured 7(87.5%) patients. For 8 patients not having thoracic duct lesion under LAG, the successful rate of thoracic duct ligation was 25% (2 out of 8 patients), which was significantly lower than patients due to thoracic duct lesions (P=0.02). Meanwhile, non-operative therapy had significantly higher successful rate (87.5% vs 25%, P=0.02). CONCLUSIONS: Unilateral pedal LAG with non-contrast CT could identify the causes and locate the leaks of idiopathic chylothorax in 75% of patients after failure of thoracic duct ligation. Two thirds of patients were found not to have thoracic duct leakage and would be better managed by non-operative treatment.


Assuntos
Quilotórax/diagnóstico por imagem , Tomada de Decisões , Linfografia/métodos , Ducto Torácico/cirurgia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Quilotórax/cirurgia , Feminino , Seguimentos , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ducto Torácico/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
18.
Med Oncol ; 31(1): 775, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24338338

RESUMO

The expression of survivin, an inhibitor of apoptosis can be seen in most tumors and is correlated with the angiogenic factor vascular endothelial growth factor (VEGF). But little is known about their contribution in small-cell lung cancer (SCLC). This study was designed to investigate the expression of survivin and VEGF in SCLC, and to explore their correlation with clinical-pathological feature and prognosis. Forty-five patients with pathological histology of SCLC were entered into this study. Forty-five cases of matched adjacent non-tumor samples and 10 samples of operated patients with benign lung tumor were also included as control. The expression of survivin and VEGF was detected by immunohistochemistry (IHC, SP). These two sets of data were processed and tested for correlation with major patients' characteristics, and overall survival. The correlations between survivin and VEGF expressions and the clinical-pathological features were evaluated by chi-square test. The correlation between survivin and VEGF expressions was analyzed by Spearman's rank correlation test; the overall survival was analyzed by the Kaplan-Meier method; and the relationship between clinical and pathological features and overall survival was analyzed by the Cox proportional hazard models. Positive expression rate of survivin and VEGF was significantly higher in SCLC than those of adjacent non-tumor tissues and benign lung tumor tissues (73.3 vs. 15.6 vs. 0 %, P < 0.05) and (75.6 vs. 20 vs. 0 %, P < 0.05), respectively. Survivin and VEGF expressions were significantly associated with lymph node metastasis (P = 0.003, 0.011) and clinical stage (P = 0.006, 0.021). The expression of survivin was significantly coincident with the expression of VEGF (r = 0.644, P = 0.000). The median overall survival in survivin positive group and VEGF positive group was significantly shorter than those in survivin negative and VEGF negative group, respectively (log-rank P = 0.000). Moreover, multivariate analysis showed that survivin expression (HR 0.224; 95 % CI 0.074-0.675; P = 0.008) and VEGF expression (HR 0.172; 95 % CI 0.054-0.559; P = 0.003) were statistically independent predictive factors of poorer prognosis for SCLC patients. Our results indicated that survivin and VEGF were over-expressed in small-cell lung cancer, each of them may be an independent poor prognostic factor.


Assuntos
Regulação Neoplásica da Expressão Gênica , Proteínas Inibidoras de Apoptose/metabolismo , Neoplasias Pulmonares/metabolismo , Carcinoma de Pequenas Células do Pulmão/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Idoso , Carcinogênese , Progressão da Doença , Feminino , Perfilação da Expressão Gênica , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Carcinoma de Pequenas Células do Pulmão/mortalidade , Survivina
19.
Asian J Androl ; 16(1): 115-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24369143

RESUMO

To evaluate the efficacy of nephrostomy balloon dilation (NBD) for patients who developed vesicourethral anastomotic stricture (VAS) following radical prostatectomy. NBD was performed in patients who developed VAS following radical prostatectomy. Quality of life (QoL), International Prostate Symptom Score (IPSS) and maximal urinary flow rate (Qmax) were evaluated. Four hundred and sixty-three prostate cancer patients underwent radical retropubic prostatectomy (RRP), and 86 underwent laparoscopic radical prostatectomy (LRP). Most patients (90.3%) had T2 or T3 prostate cancer and a pathological Gleason score of ≤ 7. Forty-five (8.2%) and four (4.7%) patients developed VAS due to radical or LRP, respectively. Forty (89%) patients underwent NBD, including three cases of repeat dilation. The median Qmax was 4 ml s-1 (interquartile range (IQR), 2.3-5.6) before dilation and improved to 16 ml s-1 (IQR, 15-19) and 19 ml s-1 (IQR, 18-21) at the 1- and 12-month follow-up, respectively (P < 0.01). Fifteen (37.5%) patients had urinary incontinence prior to dilation, whereas only three (7.5%) patients had incontinence 12 months following dilation (P < 0.01). The median IPSS score improved from 19 (IQR, 17-24) before dilation to 7 (IQR, 6-8) at 12 months following dilation, and the QoL score improved from 5 (IQR, 4-6) before dilation to 2 (IQR, 2-3) at 12 months following dilation (P < 0.01 in both). VAS occurs in a small but significant proportion of patients following radical prostatectomy. NBD offers an effective remedy for VAS.


Assuntos
Constrição Patológica/cirurgia , Dilatação/métodos , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Idoso , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Neoplasias da Próstata/patologia , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
20.
J Cancer Res Clin Oncol ; 140(2): 235-41, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24292502

RESUMO

OBJECTIVE: To determine the feasibility of prostatic-specific antigen (PSA) mRNA and prostatic-specific membrane antigen (PSMA) mRNA measurement in detection of pelvic lymph node (PLN) micrometastasis for prostate cancer (PCa) after hormonal therapy (HT). METHODS: Fifty-four patients diagnosed as high risk localized PCa were given HT for 3 months before radical prostatectomy. Under bipedal lymphangiography, a needle was punctured into involved lymph nodes (LN) and aspirated lymphatic fluid was obtained preoperatively. The expression of PSA mRNA and PSMA mRNA in aspirated fluid was assessed by a fully quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) and also in LN specimens from pelvic lymphadenectomy during prostatectomy. RESULTS: Median follow-up was 36 months (range 18-58 months). Without histological evidence of PLN metastasis, twelve patients showed positive PSA and/or PSMA mRNA expressions and regarded as having micrometastases to PLNs. Biochemical recurrence (BCR) rate and interval between prostatectomy and BCR in patients with micrometastases (group B) were not significantly different to histologically proven PLN metastatic patients (group A) (58.3 vs. 83.3 %, P = 0.26; 10.9 vs. 9.2 months, P = 0.29, respectively), but significantly different to those with no PLN involvement (group C) (58.3 vs. 11.1 %, P = 0.002; 10.9 vs. 21.3 months, P < 0.001, respectively). Kaplan-Meier analysis showed both groups A and B had significantly lower non-BCR rate than group C (P < 0.001, P < 0.001, respectively). CONCLUSIONS: For PCa patients receiving HT, measurement of PSA mRNA and PSMA mRNA in aspirated PLN fluid by real-time RT-PCR could effectively detect PLN micrometastases without surgical intervention.


Assuntos
Antígenos de Superfície/genética , Antineoplásicos Hormonais/uso terapêutico , Biomarcadores Tumorais/genética , Glutamato Carboxipeptidase II/genética , Linfonodos/patologia , Neoplasias Pélvicas/diagnóstico , Antígeno Prostático Específico/genética , Neoplasias da Próstata/tratamento farmacológico , Idoso , Seguimentos , Humanos , Linfonodos/cirurgia , Masculino , Pessoa de Meia-Idade , Micrometástase de Neoplasia , Estadiamento de Neoplasias , Neoplasias Pélvicas/genética , Neoplasias Pélvicas/cirurgia , Prognóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa
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