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Objectives. Clinical data indicate that drug resistance to chemotherapy may occur in all stages of transitional cell cancer (TCC). Glutathione S-transferases (GSTs) are a family of detoxification enzymes composed of four different classes, denoted alpha (GSTA), mu (GSTM), pi (GSTP), and theta (GSTT), each containing one or more homo- or heterodimeric isoforms (GSTA1-1, GSTA1-2, and so forth). GSTs...
To date, only 14 cases of myxoid liposarcoma of the spermatic cord have been reported in the literature. The growth is a rare, usually highly differentiated malignancy that tends to recur locally, rarely metastasizes, and has a good prognosis following complete removal. We describe a new case of a highly differentiated myxoid liposarcoma of the spermatic cord, combined with an angiolipoma. Left inguinal...
Objectives. To study the changes in renal resistive index (RI) and renal function before and after release of different grades of partial unilateral ureteral obstructions.Methods. Ten dogs were subjected to right partial ureteral obstruction. Grade 1 (mild) obstruction was applied to 5 dogs (group A) and grade 3 (moderate and severe) obstruction was applied to the other 5 dogs (group B). Obstruction...
Objectives. To evaluate subacute and chronic pelvic pain after radical retropubic prostatectomy (RRP) performed for clinically localized prostate cancer.Methods. Twenty-four consecutive patients undergoing RRP completed pain, quality-of-life, and incontinence questionnaires. They also wore pads for 24 hours to measure urine loss objectively before and after surgery.Results. Three patients had pelvic...
Objectives. Tumor heterogeneity can be measured by quantifying variance of nuclear characteristics by image analysis. Heterogeneity of cell nuclear features correlated with increased local progression in prostate cancer. In the present study, the influence of tumor heterogeneity on prostate-specific antigen (PSA) recurrence after radical retropubic prostatectomy was analyzed and tumor heterogeneity...
Objectives. To assess the initial results of an ambulatory, outpatient, multiple-component inflatable penile prosthesis (IPP) insertion protocol.Methods. Ninety-five consecutive men with organic impotence were implanted with a multiple-component IPP on an outpatient basis. Short-term complications were assessed by direct patient examination, phone interview, and office visits.Results. Complications...
Antiandrogens are combined with medical or surgical castration to achieve total androgen blockade in metastatic prostate cancer. Discontinuation of antiandrogens at disease progression has been associated with prostate-specific antigen (PSA) decrease, symptom improvement, and occasionally objective tumor regression. Two cases of metastatic prostate cancer demonstrating decrease in PSA of 92% and 56%...
Objectives. To determine if well-differentiated colonic-type adenocarcinoma of the urachus behaves in a benign fashion, and thus might be treated by segmental rather than radical cystectomy.Methods. A retrospective review of the literature since 1863 with one added case review is presented here. Only cases with photomicrograph confirmation were accepted.Results. Sixteen previously reported patients...
Objectives. Overexpression of p53, normally secondary to gene mutation, in invasive uroepithelial neoplasms (transitional cell carcinoma) and a high percentage of transitional cell carcinoma in situ (CIS) has been described; however, the role of p53 before and after bacillus Calmette-Guerin (BCG) treatment of CIS needs to be defined.Methods. Immunohistochemical reaction for p53 overexpression was...
Objectives. Eight patients with a history of pituitary dysfunction were seen in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania for evaluation of their prostate carcinoma. Because prostate cancer is a hormonally responsive cancer, hormonal abnormalities from pituitary dysfunction may have played a role in its development. In addition, many patients with pituitary...
We report the use of the lidocaine gel container for meatal dilation in men, distal urethral obstruction in women, and for easy and painless intravesical instillation of solutions such as heparin or oxybutynin chloride in women diagnosed, respectively, with interstitial cystitis and multiple sclerosis.
Oncocytomas of the adrenal gland are rare; only 9 cases are reported in the world literature. We report 2 new cases in which benign adrenal masses were detected during evaluation for microhematuria or flank pain. Subsequent to extirpation of the mass, pathologic examination established the diagnosis of adrenocortical oncocytoma.
Objectives. A new technique is described for primary realignment of prostatomembranous urethral disruptions using endourologic techniques.Methods. Realignment was achieved in 3 patients on the day of injury. Primary urethral realignment is achieved by passing a council-tip catheter over a guidewire inserted during antegrade flexible cystourethroscopy.Results. Three patients underwent successful realignment...
Objectives. The sigmoid colon lends itself well to bladder augmentation particularly in patients requiring reimplantation of ureters or Mitrofanoff valves for continence. We have modified the sigmoid augment to improve ease of catheterization and ureteral reimplantation.Methods. Seven children underwent sigmoid ''tail'' bladder augmentation for various indications. Appendix or tapered ileum was used...
Having ''a hand'' in the abdomen when performing laparoscopic surgery offers tactile feedback, rapid finger dissection, enhanced retraction capabilities, and simplified hemostasis for the operating surgeon. We utilized the Pneumo Sleeve for technically challenging laparoscopic nephrectomies. This device may have applicability in select urologic laparoscopic operations.
Objectives. To evaluate the management approach for vesicoureteral reflux (reflux) into a solitary kidney.Methods. Outcomes of all children with solitary kidneys and reflux managed between 1981 and 1996 were reviewed. Solitary kidneys were documented by nuclear renography and ultrasonography; reflux was graded after cystography. Management consisted of observation and antimicrobial prophylaxis or...
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