We analyzed the alteration of int-2, c-erbB-2 and EGFR genes in 32 cases of transitional cell carcinoma of the urinary tract, 15 cases of renal cell carcinoma and 14 cases of prostatic carcinoma by Southern blot hybridization method.
Three-to 12 fold amplification of int-2 gene was observed in 4 (12.5%) of 32 transitional cell carcinomas. Of these 4 cases 3 were G3 tumor with muscle invasion and the remaining was G1, pTa tumor with subsequent recurrence of multiple tumors.
The other 2 cases (6.3%) with invasive transitional cell carcinoma showed amplification of c-erbB-2 gene. Neither amplification nor gross rearrangement of EGFR gene was detected in transitional cell carcinoma.
On the other hand, renal cell carcinomas and prostatic carcinomas had neither amplification nor gross rearrnagement of these 3 genes. These results suggest that the int-2 gene located in chromosome locus 11q13 and the c-erbB-2 gene have a specific role in carcinogenesis and in progression of transitional cell carcinoma through their gene amplifications.

View full abstract

Endoscopic operation of vesicoureteral reflux (VUR) has several advantages such as less invasiveness and technical ease with the procedure and shorter hospitalization for the operation in comparison with coeliotomy, but the cure rate achieved by endoscopic operation compares unfavarably with that by coeliotomy. The unsuccessful cases of VUR by endoscopic operation were investigated to promote the success rate by endoscopic operation. Of 66 ureters in 55 patients 50 were successfully treated with the first operation, and 4 of 8 ureters with the second one. All 15 infants were cured, but the cure rate in females between 17 and 45 year old was significantly low (57%). An equally high cure rate was obtained by the endoscopic operation even in patients who had a high grade VUR, , patulous ureteral orifices, an underlying neurogenic bladder, or episodes of urinary tract infection.
All ureters were cured just after operation. The recurrence of VUR occurred In 19 ureters (29%) and 16 ureters were discovered at one month examination after operation, which indicates that olive oil dissolving teflon paste was partly absorbed to bladder tissue. Teflon paste shifted to internal urethral orifice in 4 unsuccessful ureters.
Based on these findings, the endoscopic operation should be considered to be the preferred treatment among others in the management of VUR and the injection of sufficient volume of teflon paste into submucosal and muscular space of the bladder trigone could promote the cure rate.

View full abstract

During the past 5-year period from 1986 to 1991, a total of 54 patients received living-related renal allograft and has been managed with vagaries of cyclosporin A (CYA) immunosuppressive regimen. In order to determine the ideal form of induction regimen, combination drugs with CYA, the initial dosage of CYA and its blood trough level were retrospectively analyzed with particular reference to the possible factors relevant to the occurrence of acute rejection episode in the first three post-transplant months and graft survival.
The combination drugs with CYA were predonisolone (PRD) in 10 patients, PRD+azathioprine (AZA) in 19 and PRD+mizoribine (MIZ) in 25. The initial dosage of CYA was 6mg/kg B. W. in 6 patients, 8mg/kg in 17, 10mg/kg in 15 and ≥12mg/kg in 16. Blood trough level of CYA measured principally by high performance liquid chromatography was arbitrarily divided into <100, 100-150, 150-200, >200mg/kg ranges for the analysis. By arbitrarily dividing the post-transplant period into four (period I: 0-15th day, period II: 16-30th, period III: 31-60th and period IV: 61-90th), the correlation of the incidence of acute rejection episode and aforementioned factors was studied. Relevance of these factors to the graft survival was also studied.
The administration of AZA to MIZ to CYA+PRD had no suppressive effect upon the occurrence of acute rejection during the first three months and similarly it had no effect upon graft survival. Rejection episodes, however, occurred more frequently in the recipients with less than 150ng/ml of CYA trough level in the period I and less than 100ng/ml in the period III (p<0.01). Five-year graft survival rate of those patients whose blood trough level was adequately maintained at ≥150ng/ml in the period I and ≥100ng/ml in the period III was significantly better than that of the others whose trough level was inadequate with <150ng/ml in the period I and/or <100ng/ml in the period III (89 percent vs 61 percent, respectively. p<0.05).
We concluded that blood trough level of CYA should be maintained optimally at ≥150ng/ml in the period I and ≥100ng/ml in the period III as these are the only factors relevant to acute rejection episodes in the first three post-transplant months and subsequent graft survival.

View full abstract

The role of bacterial adherence in association with complicated urinary tract infections (UTI) and the correlation between bacterial adherence and plasma endotoxin (ET) levels were experimentally investigated by using mouse UTI models. Mice with foreign bodies induced in the bladder or voiding dysfunction were more susceptible to UTI than untreated mice. But diabetic or granulocytopenic mice were little susceptible to UTI in comparison with other two models. Adherence activities. of 6 strains of E. coli to mice bladder epithelia in the 4 compromised models showed no difference when compared with those in normal control.
Binding patterns of 8 kinds of lectins and mouse uromucoid polyclonal antibody to the mice bladder epithelia in compromised models appeared to be almost the same as those in the normal bladder epithelia.
These results suggested that the reason for the susceptibility to UTI in the compromised mice was not necessarily explained based on the increased adherence of E. coli due to qualitative or quantitative changes in receptors on the bladder mucosa. Impairment of other host defense mechanisms may be considered in this regard.
Three strains of E. coli expressing type 1 pili adhered to the bladder epithelia in greater numbers in vivo than non piliated strains. E. coli No. 113 strain expressing both type 1 and p pili appeared to be the most virulent in vivo among all 6 strains.
Plasma ET levels increased 6 to 24 hours after inoculation of 2 strains of E. coli expressing only type 1 pili or p pili, while a little increase in the levels was observed in mice inoculated with non piliated E. coli. Bacterial adherence to the bladder epithelia may play an important role for the increase in ET levels.

View full abstract

To study the radiopacity of cystine calculi. We have compared them with oxalate and/or phosphate calculi on plain X-ray films (KUB).
Eleven pure cystine calculi from 5 people in 4 families, and 8 oxalate and/or phosphate calculi as controls were obtained from patients by lithotomy or spontaneous discharge in Dokkyo University School of Medicine and affiliated hospitals, since 1978.
The radiopacity of cystine calculi was measured by a densitometer PDA-60 (Konika Co.), comparing the density of the calculus with that of the area surrounding the calculus on KUB. All cystine calculi were easily recognized on KUB, and their densities were fairly identical with those of oxalate and/or phosphate calculi.

View full abstract

We made a trial of our method by which sperms are collected directly from epididymal duct, then subjected to in vitro fertilization. The subjects were a total of 22 cases comprising 14 of obstructed azoospermia and 8 of severe oligoasthenozoospermia, on which the surgery was, performed 26 times. Using the microscope, an epididymal duct was directly punctured to make a suction of the fluid or was slightly incised to make a suction of the outflow. Sperms thus collected were preincubated for 4 to 6 hours, then subjected to in vitro fertilization.
Condition of collected sperms; 32×10⁴-15300×10⁴ sperms were obtained in real number. Sperm motility rate was 0-82%, averaging 25.0%. Sperm forword motility were fairly good in 18 of 26 test cases. Sperm condition was so poor as to make the insemination impossible in 4 test cases (16%).
Fertility rate for cases of obstructed azoospermia was 53% (8/15 test cases) and 63% (55/87 eggs) in the test cases and the number of eggs, respectively, compared with 33% (2/6 test cases) and 5.4% (2/37 eggs), respectively for cases of oligo-asthenozoospermia.
Pregnancy; Successful pregnancy was obtained in 2 of the cases of obstructed azoospermia, in each of which sperms were collected from the head of the epididymis, then passed into the maternal body by zygote intra fallopian tubal transfer (ZIFT); with the one case resulting in uneventful delivery in November 1991 and the other in a miscarriage.
The above results suggested the present method would become an epoch-making approach in the treatment of severe male infertility.

View full abstract

Multifactorial analysis on 395 patients revealed important factors which prolong the pyuria after transurethral prostatectomy. They were the age of the patient, anemia and leukocytosis before surgery. These are factors which relate with the defense mechanism of the patient. Local factors, such as the duration of indwelling urethral catheter, the size of the prostate or prostatic bed and pre-operative infection, were not so important for prolonging the pyuria after transurethral prostatectomy. The time of the resection and weight of the prostate had an intimate relation each other, and the former was the more important factor. The use of antimicrobials probably controlled these local risk factors, thus making them unimportant in the prolongation of the pyuria after transurethral prostatectomy.

View full abstract

(1) The study was performed to elucidate the effects of afferent vagal stimulation and distension of the digestive tract on the micturition reflex in 21 acute decerebrate dogs immobilized with gallamine.
Electrical stimulation of the central cut end of the cervial vagus nerve with high voltage (17.5-25V) and moderate frequency (10-50Hz) elicited in most cases inhibition of the periodic bladder contractions and of outflows of the pelvic vesical branch which were induced by a sustained intravesical pressure of 10-15cmH₂O. Distension of the thoracic esophagus, the stomach, and the duodenum also induced inhibition of the bladder contractions and of the pelvic outflow to the bladder. Such inhibitions were abolished after bilateral cervical vagotomies except a few cases of distension of the duodenum. (2) Another series of experiments were undertaken to clear the effect of afferent vagal stimulation.on the electrical activity of the pontine micturition center in 10 acute decerebrate dogs. By means of an extracellular glass microelectrode method, unitary discharges synchronized with the grouping discharges in the pelvic vesical branch with a rhythm of 2.2-2.5Hz were recorded from the pontine micturition center in the dorsolateral pontine tegmentum. Such a type of discharges was detected in 6 of 59 units which discharged by afferent stimulation of the pelvic vesical branch. This type of discharges was inhibited by afferent vagal stimulation at the supradiaphragmatic level.
From these results, it may be concluded that the afferent pathway of the bladder relaxation reflex induced by distension of the upper digestive tract is mainly involved in the vagal nerves, but in some cases of the strong distension of the duodenum, the pathway is in splanchnic nerves, and that inhibition of the bladder contraction after stimulation of vagal nerve is induced by suppression of the pontine micturition centers.

View full abstract

To evaluate the effect of hydoronephrosis on the growth of contralateral normal kidney, following experiment was designed and performed.
Experiment: Three to four weeks old S-D rats weighing 80-90g were used. The kidney development of these rats is considered to be roughly equivalent to that of a one year old child. Those rats were deviled into three groups: (1) left nephrectomy (group N), (2) left ureteral ligation (group H), and (3) sham operation (group S). Bromodeoxy uridine (BrdU) was administered intraperitoneally on the 1st, 3rd, 5th, 7th and 14th days after operations. One hour after injection of BrdU, right kidneys were removed and wet weight and labelling index (LI) of BrdU were calculated.
Compensatory renal growth of right kidneys was observed in both group H and group N on and after 1st or 3rd day. In group N, the growth was accompanied by cellular proliferation, while in group H, hypertrophy was the major finding for up to 5th day. From 7th day on, when significant disorders became hystologically evident in the left hydronephrotic kidneys, cell proliferation was also observed in the group H.
The above results indicate that compensatory renal growth occurred in the contralateral normal kidney after unilateral ureteral ligation. Although proliferation of right renal tubular cells were recognized when significant tubular and interstitial damage of the left hydronephrotic kidneys were observed, hypertrophy was a major finding in an early stage. We suggest that these results were attributed to (1) reduction of nephron triggered to proliferate tubular cells and (2) the existence of hydronephrotic kidney inhibited tubular cell proliferation.

View full abstract

In order to improve the efficacy of chemotherapy against urogenital cancers, we developed a chemosensitivity test by measuring intracellular ATP in cancer cells. In the fundamental experiments using HeLa cells, a significant correlation was observed between intracellular ATP levels and.numbers of viable cells. We employed 8 drugs, ADM, VCR, VLB, MTX, 5-FU, PEP, MMC, and CDDP for the assay Thirty-four renal tumors, 68 urotherial tumors and 19 testicular tumors were tested, and evaluable results were obtained in 25 specimens of renal tumors (76%) 55 specimens of urotherial tumors (80%) and 17 specimens of testicular tumors (98%). According to the ATP assay, renal tumors were sensitive to ADM and MMC, urotherial tumors to ADM, MMC and CDDP and testicular tumors to ADM and MMC.
The ATP assay to determine the chemosensitivity to clinical specimens was sensitive and efficient. Thus the ATP assay could be applied for selection of anticancer drugs in the chemotherapy of urogenital cancers.

View full abstract

Urinary managements of 332 stroke patients in the chronic phase were performed at Bobath hospital. Cerebrovascular accidents (CVA) were caused by cerebral infarction in 178 (53.6%), intracerebral hemorrhage in 123 (37.1%) and subarachnoid hemorrhage in 31 (9.3%). Voluntary urination appeared in 124 patients before treatment, however in 29 of them occasional incontinence were observed. One hundred forty-three patients used diapers and 64 were controlled by indwelling catheters. The remaining one patient was treated by intermittent catheterization. Sixty-two patients who seemed to have communicative abilities in daily living were assessed with regard to their cerebrovascular dementia by Hasegawa's Dementia Rating Scale. After treatment 235 patients (70.8%) were able to urinate voluntarily, and only 15 of them remained incontinent and could use small pads successfully. TURP was effective for the stroke patients with benign prostatic hypertrophy (BPH) or bladder neck scleosis (BNS). Fifty-three patients (16.0%) with persistent urinary incontinence were managed by diapers or a system of condom drainage. Thirty-nine patients (11.7%) were kept dry with intermittent catheterization at home, and long-standing use of indwelling catheters were required in the remaining 5 patients (1.5%). These results indicate that the lower level of activity, mobility and mental state tended to prevent the stroke patients from improvement of urinary disorders.

View full abstract

A clinico-pathological study was conducted on 9 cases with inverted papilloma of the urinary bladder.
1. Clinical study
The incidence of inverted papillomas, when compared with transitional cell carcinoma of the urinary bladder, was much higher in men than in women in our study and in the literlitured dealing with this subject as well.
Eight of 9 inverted papillomas were localized in the bladder neck. Cystoscopic examination revealed that all tumors were pedunculated and 8 of the 9 tumors had non-papillary surfaces.
These clinical findings suggest that inverted papillomas localized in the bladder neck are very similar to posterior urethral polyps with prostatic type epithelium.
Transurethral resection (TUR) was performed in all cases. Recurrence was not observed.
2. Pathological study
Inverted papillomas were classified into two types according to their histological patterns, determined by Hematoxylin-Eosin (H-E) staining. One pattern was glandular and the another was trabecular. Of the 9 cases, 2 were glandular, 5 were trabecular and the remaining 2 were a mixed type.
Immunohistochemical staining with anti-prostate specific antigen antibody revealed 3 of the 9 tumors were stained positively, and these tumors were classified a glandular type.
Inverted papilloma were classified into two patterns according to their histological patterns, determined by immunohistochemical staining with anti-keratin antibody, namely a bladder tumor pattern and a urethral tumor pattern. Inverted papillomas with a urethral tumor pattern were of the glandular type and included anti-PSA antibody positive staining tumors.
These findings suggest that a portion of inverted papillomas may have arisen from neoplastic transformation of prostatic tissue.

View full abstract

Between 1970 and 1989, total prostatectomy was performed in 31 patients with prostatic cancer at the Department of Urology, Tokyo Metropolitan Fuchu Hospital. These cases were composed of 4 cases of stage A, 8 cases of stage B and 19 cases of stage C. The surgical procedures were perineal prostatectomy in 25 cases, combined method of perineal and retropubic prostatectomy in 5 cases and transsacral prostatectomy in one case. Blood loss was 762ml on the average. Blood transfusion was unnecessary in 15 cases all of whom underwent perineal prostatectomy. Endocrine or radiation therapy were administered after total prostatectomy to 23 or 13 cases, respectively. Postoperative complications included early postoperative death due to appoplexy in 1 cases, recto-vesioal fistula in 1, bladder neck or urethral stricture in 9 (mild 7, severe 2) and urinary incontinence in 20 (mild 13, moderate 4, severe 3). Frequency and grade of urinary incontinence tended to become higher as the pathological stage progressed. The 5-year survival rates for clinical stage A and B, and C were 83% and 63%, respectively.
We conclude that total perineal prostatectomy was less traumatic operation for prostatic cancer, and would be indicated in clinical stage A and B for radical operation and in stage C for one of the combination therapy.

View full abstract

The DNA ploidy of bladder cancers treated by radical cystectomy following pre-operative irradiation was analyzed by flow cytometry using paraffin embedded samples. The DNA ploidy and its changes by irradiation were studied. We used flow cytometry in 30 patients with transitional cell carcinoma of the bladder who received pre-operative irradiation (40Gy in 24 patients, 20Gy in 5 patients and 60Gy in one) with follow-up for at least 3 years. Total 140 paraffin embedded samples (4.6 samples per one patient) were available.
The effects of therapy were related to the DNA patterns before irradiation and to the DNA ploidy changes after irradiation.
1 Eight DNA diploid tumors and twenty-two DNA aneuploid ones were detected before irradiation. Although diploid group didn't change its DNA ploidy after irradiation, of 22 aneuploid tumors 18 were changed to DNA diploid and 4 were not changed in their ploidy.
2 The tumor eradicating effect of irradiation was shown to be higher (p<0.05) in the diploid group (5 of 8, 63%) than in the aneuploid group (5 of 22, 23%).
3 Overall survival rates were discussed in 3 groups (A, B and C), the group A was 10 of tumor free and 3 diploid tumors after irradiation, the group B was 13 of aneuploid tumors which changed to diploid ones and the group C was 4 of persistent aneuploid tumors. Each of 5 year survival rate was 100% (A), 58% (B) and 0% (C). Overall survival for C group was significantly shorter than for other groups (p<0.01).
These data suggest that DNA diploid in pre-irradiation is indication of a good prognosis irrespective of the presence of tumor and tumor disappearance rate of diploid is significantly higher than that of aneuploid. Although aneuploid tumors do disappear after irradiation, persistent aneuploid tumors predict a poor prognosis. In the choice of pre-operative irradiation, an analysis of tumor ploidy provides at least some basis on which radiation response can be predicted.

View full abstract

Patients with human T-cell lymphotropic virus type 1 associated myelopahty (HAM) have complaints of urinary disturbance frequently. Symptoms and urodynamic examinations were evaluated in untreated twenty-one patients with HAM. Although two cases (11%) had no urinary symptom, nineteen cases (89%) suffered from dysuria, pollakisuria, incontinence or urgency. The combination of irritative and obstructive urinary disturbance was a characteristic symptom in the HAM patients. In three cases the urinary symptoms preceded the gait disturbance which is a main symptom of HAM. In urodynamic study overactive bladder was found in fourteen cases (66%), although three cases (15%) showed underactive or acontractile bladder with disturbance of urinary sensation. There was no abnormal finding by urethral pressure profile (UPP), but detrusor sphincter dyssynergia (DSD) was revealed frequently by EMG. This typical dysfunction of the HAM patients was thought to be caused by destruction of the lateral column of the spinal cord.

View full abstract

From April 1983 to September 1991 total parathyroidectomy (PTX) and parathyroid autotransplantation were carried out in 27 patients for secondary hyperparathyroidism. Of these patients, 13 were males and 14 were females. Their average age was 43 years old and their mean duration of dialysis was 126.4 months. As preoperative clinical symptoms, bone pain was observed in 19 cases, joint pain in 18, decrease of height in 7, pruritus in 3, muscle pain in 2, red eyes in 2 and others in 2. As roentgenographic findings, subperiosteal bone resorption and skull-salt and pepper were demonstrated in 26 cases, rugger jersey spine in 15, soft tissue calcification in 11, and pathological fractures in 4.
Four parathyroid glands were removed in 23 cases, three glands in 4. Serum calcium level decreased remarkably within 24 hours after parathyroidectomy in all cases. The average total weight of parathyroid glands was 4.48g. The preoperative diagnostic accuracy of echogram was 94% and that of CT scan was 90%. The clinical improvement after PTX was excellent in 12 cases and good in 11. The roentgenographic improvement of skull and/or finger bone more than one year after PTX was excellent in 11 cases and good in 11. Judging from histopathological findings of the bone, the clinical and roentgenographic improvement was observed better in the osteitis fibrosa group than in mild group. A significant correlation was found between the level of preoperative c-PTH and the weight of resected parathyroid glands. The level of preoperative ALP correlated with intact-PTH and was higher in the osteitis fibrosa group than in the mild group. The recurrence with hyperplastic regrowth of transplanted parathyroid tissues occurred in 2 patients.
These results suggest that PTX is recommended in cases with a high level of c-PTH and osteitis fibrosa histopathologically. Therefore, it is important that the preoperative bone evaluation should be performed accurately and enlargement of four parathyroid glands should be observed by at least two different diagnostic methods.

View full abstract

A polymerase chain reaction (PCR) method was compared to standard methods (cultures for Neisseria gonorrhoeae and Chlamydia trachomatis and an enzyme-immunoassay for C. trachomatis) in diagnosis of gonococcal and chlamydial urethritis in 40 male patients with urethritis. Gonococcal urethritis was diagnosed by detection of a 206 by DNA fragment amplified by PCR with N. gonorrhoeae-specific primers. Chlamydial urethritis was diagnosed by detection of a 242 by DNA fragment amplified by PCR with C. trachomatis-specific primers. Gonococcal and chlamydial urethritis, gonococcal and non-Chlamydial urethritis, non-gonococcal and Chlamydial urethritis, and non-genococcal and non-chlamydial urethritis were diagnosed in 8, 10, 14 and 8 patients, respectively, by the PCR method. In 9 patients with gonococcal and chlamydial urethritis, 10 with gonococcal and non-chlamydial urethritis, 12 with non-gonococcal and chlamydial urethritis, and 9 with nongonococcal and non-chlamydial urethritis, diagnosed by the standard methods, the coincidence rates of the PCR to the standard methods were 78% (7/9), 90% (9/10), 100% (12/12), and 89% (8/9), respectively, The overall coincidence rate between the PCR and the standard methods in diagnosis of urethritis were high (90%). In addition, N. gonorrhoeae and C. trachomatis could be simultaneouly detected from one urethral sample in approximately 6 hours by means of the PCR. Thus, the PCR method could clinically be applied and would offer several advantages to diagnosis of urethritis, compared to the standard methods.

View full abstract

Previously, we established an anti-androgen receptor (AR) monoclonal antibody. Using the antibody, we investigated immunohistological AR localization in human testes, epididymides, seminal vesicles and scrotal skins. The testes, epididymides and scrotal skins were obtained:from a prostate cancer patient without pre-hormonal therapy undergoing bilateral orchiectomy. The seminal vesicles were obtained from a bladder cancer patient undergoing radical cystectomy. The tissues were immediately frozen in liquid nitrogen and kept at -80°C until used. Cryostat-frozen sections were cut at 5μm and stained by an indirect method. We obtained the following results.
1) In the testes, nuclei of Leydig cells were stained though Sertoli cells were not 'stained. AR localizatin in Leydig cells which produce testosterone suggests autocrine or intracrine mechanism in the testis.
2) In the epididymides, nuclei of epithelial cells of epididymal ducts were stained, while mucles and connective tissues were not stained. In the seminal vesicles, nuclei of glandular epithelial cells were stained.
3) In the scrotal skins, the cells of squamous cell layer have positive stainings. The cells in the upper portion of squamous cell layer were stained more intensely than the cells in the lower portion. The basal layer was not stained. The cells of the outer root sheath of hair folliclesin in the scrotal skins were also stained.
4) In androgen target organs, AR-positive cells and AR-negative cells were mixed in the epithelium of a glandular duct, which suggests heterogeneity of AR localization in the androgen target organs.

View full abstract

Currently, urinary excretion of free γ-carboxyglutamic acid (γ-gla.), a terminal amino acid degradated from γ-gla. containing protein including bone Gla. Estimated to be a more specific marker for bone metabolism and useful clinically rathar than urinary excretion of hydroxyproline.
In addition, serum levels of BGP have proved to be a significantly valuable indicator for bone metabolism, especially for process of bone formation, in recent studies.
Therefore, we measured these parameters in 40 patients with idiopathic urinary calcium (Ca) stone and investigated bone metabolism in those patients.
However, in majority of cases studied, urinary levels of γ-gla. as well as that of hydroxyproline proved to be definite difference from that in healthy subjects (n=12) and failed to suggest the presence of abnormality in bone turnover in the background of stone formation.
Urinary excretion of hydroxyproline were 6.68±3.89μg/mg·Cr in the patients and 6.95±3.08 μg/mg·Cr in healthy sujects.
Urinary excretion of γ-gla were 55.0±15.8nmol/mg·Cr in the patients and 47.2±7.3 nmol/mg·Cr in healthy subjects.

View full abstract

A 27-year-old female was referred with an abdominal mass. Examination revealed a non tender firm mass in the right flank and hypertension (200/100mmHg). An angiomyolipoma was suspected on computed tomography and arteriography and a radical nephrectomy was performed. On cut section, the kidney was occupied by a well-capsulated, grayish tumor measuring 10×9cm. Pathological diagnosis was a renal hemangiopericytoma without involvement of the capsule. Her blood pressure has normalized after the operation. She has no evidence of recurrence after 18 months' follow-up.

View full abstract

A 61-year-old male visited us with chief complaints of macroscopic hematuria and bladder irritation symptons. Cystoscope, U/S, MRI, and CT showed an extensive non-papillary, wide-based tumor centering around the anterior wall of the bladder. Transabdominal U/S-guided full-thickness biopsy indicated a pT3a (Biopsy) primary small cell carcinoma of the bladder containing neuroendocrine granules. Immunohistochemical studies revealed Fuc GM1, an antigen related to small cell carcinoma of the lung. Neoadjuvant therapy consisted of preoperative irradiation at 50Gy and intraarteial infusion chemotherapy with CDDP and THP. Since a follow-up full thickness biopsy indicated pTO (Biopsy), total cystectomy was performed. Examination of the resected specimen also indicated pathological CR.

View full abstract