High-intensity focused ultrasound in prostate cancer: today's outcomes and tomorrow's perspectives.

High-intensity focused ultrasound (HIFU) is a minimally invasive therapy applied for prostate cancer that capitalizes on the coagulation necrosis that occurs at temperatures greater than 60°C. Owing to a lack of long-term follow-up data the procedure is still considered experimental treatment. As primary therapy, HIFU is indicated in patients aged ≥70 years with clinical organ-confined disease, although it has also been used, with encouraging results, as first line salvage therapy after definitive treatment, and in locally advanced (T3-4) and non-metastatic hormone-resistant prostate cancer.

Radiotherapy in cT3 prostatic carcinoma: retrospective comparison between neoadjuvant and adjuvant hormonotherapy.

Introduction: The aim of this study was to retrospectively compare the clinical outcomes achieved in 2 groups of patients with cT3 prostatic carcinoma undergoing neoadjuvant hormonotherapy and neoadjuvant hormonotherapy plus adjuvant hormonotherapy with external beam radiotherapy.

Patients And Methods: One hundred patients with cT3N0M0 prostatic carcinoma underwent radiotherapy to pelvic lymph nodes (45 Gy, 1.8 Gy/fraction) with a booster dose (65-70 Gy) to the prostatic cavity.

Hormono-radiotherapy in prostatic carcinoma: prognostic factors and implications for combined modality treatment.

The aim of this study was to evaluate the prognostic role of several clinical variables in a patient population undergoing neoadjuvant hormonotherapy (NHT) with external beam radiotherapy (ERT) to identify subsets of patients with an unfavorable prognosis who require intensified therapy. Eighty-four patients (mean age, 68.2 +/- 6.

Ureteral stent forgotten in renal transplanted patient. Its removal.

The emblematic case of a forgotten ureteral stent in a renal transplanted patient is reported. The removal was performed with no more difficulties than in a not transplanted patient, but we would emphasize the importance of removing the stent when its function of protecting the anastomosis finished, but before its permanence could compromise the graft.

The ileocaeco-urethrostomy with multiple transverse taeniamyotomies for bladder replacement: an alternative to detubularized neobladders. Morphological, functional and metabolic results after 9 years' experience.

Objective: To evaluate the results from the long-term follow-up of ileocaeco-urethrostomy with multiple transverse taeniamyotomies for bladder replacement.

Patients And Methods: Since 1987, 60 male patients have undergone bladder replacement using a technique of ileocaeco-urethrostomy with multiple transverse taeniamyotomies. Avoiding detubularization, sectioning the caecal taeniae improved reservoir morphology and reduced internal pressures and wall tension, limiting the potential complications of the operation.

Immunohistochemical quantitation of 4-aminobiphenyl-DNA adducts and p53 nuclear overexpression in T1 bladder cancer of smokers and nonsmokers.

An immunoperoxidase method, using a monoclonal antibody which recognizes 4-aminobiphenyl (4-ABP)-DNA adducts, was developed for the detection and quantitation of DNA damage in bladder tissue and applied to stored paraffin blocks of transurethral resection specimens of 46 patients with T1 bladder cancer. Mean relative staining intensity for 4-ABP-DNA adducts was significantly higher in current smokers (275 +/- 81, n = 24) compared to nonsmokers (113 +/- 71, n = 22) (P < 0.0001).

125I seeds implantation plus pelvic lymphadenectomy in the management of localized prostate cancer.

In this study the authors present their experience of treatment of intraglandular prostate cancer with 125I seed implantation. At ten years, the overall survival for T1 and T2 stages is 71% and 57% respectively; and for G1, G2 and G3 grades the survival rate is 84%, 54% and 44% respectively; NED ten-year survival is 53% and 52% for T1 and T2 stages, 84%, 40% and 33% for G1, G2, and G3 grades respectively. The statistical evaluation seems to confirm that iodine brachytherapy is suitable for well differentiated and small volume tumors.

Growth-inhibitory effect of quercetin and presence of type II estrogen binding sites in primary human transitional cell carcinomas.

Eight cases of transitional cell carcinoma (TCC) of the bladder were investigated for the presence of estrogen receptors (ER) and Type II estrogen binding sites (Type II EBS). All these tumors specifically expressed type II EBS, while only 3 of 8 cases contained low amounts of ER. All the cases assayed for the presence of both nuclear and cytoplasmic type II EBS revealed the presence of these binding sites in the two compartments.

Refluxes in orthotopic neobladders: can the ileocecal sphincter be considered an adequate antireflux mechanism?

Objectives: To evaluate the usefulness of the ileocecal sphincter in preventing ureteral refluxes in ileocecal orthotopic neobladder, thus avoiding the use of antireflux technique for ureteroileal anastomosis.

Methods: From 1980 to 1992, 95 patients underwent orthotopic bladder substitution. In 30 our detubularized ileal reservoir was used and in 65 first only an integral ileocecal segment was used and subsequently multiple transverse teniamyotomies on the cecal portion to increase the capacity and reduce the pressure.

Results of 4 years of experience with bladder replacement using an ileocecal segment with multiple transverse teniamyotomies.

Since 1987, 30 patients with bladder cancer underwent cystoprostatectomy with bladder replacement via ileocecourethrostomy. Multiple transverse teniamyotomies were made in the cecum to assure a large capacity reservoir with low pressures. The particular anatomy and physiology of the cecum, short length of the intestinal segment needed and teniamyotomies are the 3 factors that have allowed for good functional and metabolic results.

Anatomo-functional considerations on venogenic impotence.

The authors report their clinical experience with cavernosography and cavernosometry on impotent patients. The indications of method and its correct place in the diagnostic workup are underscored. The methods of evaluation are described, highlighting the advantages of a diagnostic pharmacological approach in respect to a near as possible physiological haemodynamic evaluation.

Acute idiopathic scrotal oedema: rare disorder or difficult diagnosis?

This study reports our experience in 6 cases of acute idiopathic scrotal oedema. Although children were the primary targets, this pathologic condition was also encountered in adults. Specific diagnosis of acute idiopathic scrotal oedema, opposed to other causes of scrotal swelling, is based on history, an objective examination, velocimetric Doppler exam and echography.

Bladder reconstruction after cystectomy: use of ileocecal segment and three-loop ileal reservoir.

We report on 11 patients who in 1980-1982 had bladder reconstruction, after cystectomy for bladder cancer, utilizing the ileocecal valve as an antireflux mechanism and a direct urethrocecal anastomosis. They received preoperative irradiation (2,000 rad) and had some early complications such as pelvic abscesses and temporary urinary fistulas. We have since omitted preoperative radiation on cases performed in 1984-1987 and they did not have these complications.

Biphasic effect of estradiol on luteinizing hormone response to gonadotropin-releasing hormone in castrated men.

This study was designed to investigate the possibility that in men estradiol (E2) has a stimulatory effect on the gonadotropin response to GnRH. Nine castrated adult men, who presented extremely low testosterone (T) concentrations, received 5 mg/day estradiol benzoate (E2B) i.m.

[Primary tumors of the common bile duct. Apropos of 24 cases].

Surgical management of 24 cases of primary carcinoma of the main extrahepatic bile duct are presented. This tumour forms less than 2% of the cases in which bile duct surgery is required and its intermittent appearance makes rational exploitation of surgical management difficult. Obstructive icterus is the main and constant symptom.

[Carcinoma fo the gallbladder. Experience and proposals].

Poor survival observed in a series of 40 females and 44 males with cancer of the gallbladder treated over a period of about 16 years ar referred to in the formulation of three proposals designed to achieve better results: I) Earlier and more reliable diagnosis based on selective arteriography, echography and careful intraoperative examination; II) More rational management based on more radical surgery, including, for example, resection en bloc of the gallbladder, hepatic fossa and adjacent liver, and cysticocholedochic, posterior pancreaticoduodenal and coeliac efferent lymphatics; III) Prevention based on prophylactic cholecystectomy in classes of subjects most at risk, such as women over 50 with cholelithiasis.