Total bladder reconstruction after cystectomy.
A case of total bladder reconstruction after cystectomy for bladder cancer is reported. A combination of the Kock pouch and Camey procedure was used.
Biomedical subjects
Publications and source records attributed to E P Perinetti.
A case of total bladder reconstruction after cystectomy for bladder cancer is reported. A combination of the Kock pouch and Camey procedure was used.
Pilocarpine-stimulated canine prostatic secretions were subjected to gel filtration chromatography over Sephadex G-100 and Bio Gel P-4. Free zinc and the zinc in pilocarpine-stimulated canine prostatic secretions were observed to elute in the same fractions from the Sephadex G-100 column. In addition, Sephadex G-100 chromatography could not resolve free zinc from the small peptide bacitracin. However, a column packed with Bio Gel P-4 could resolve free zinc and bacitracin. When pilocarpine-stimulated canine prostatic secretions were chromatographed over the Bio Gel P-4 column, the major portion of the zinc eluted in the same fractions as did free zinc. No zinc was observed in the fractions where the small peptide bacitracin was found to elute. These results indicate that contrary to a previous report, zinc in pilocarpine-stimulated canine prostatic secretions was not bound to an eight amino acid peptide, but, rather, behaved chromatographically like free zinc.
With the development of nonsurgical methods of urinary diversion and the availability of new and more effective methods for treating cancer, an increasing number of patients will be candidates for palliative urinary diversion. Urinary diversion is clearly indicated to provide the time necessary to establish the correct diagnosis, to treat pain or sepsis, and to provide time for other treatments to control the underlying disease. When diversion is being considered solely for the purpose of treating uremia and the tumor has proved to be refractory to all known effective forms of treatment, the decision about whether to perform a diversion must be based on the individual circumstances of the patient including the age, type of tumor, and social and economic considerations. Methods of internal diversion such as ureteral stents are preferred when feasible. Percutaneous nephrectomy may be useful when internal diversion cannot be accomplished or when it can be anticipated that the diversion will be only temporary. When permanent diversion is required, loop cutaneous ureterostomy using the better kidney or bilateral cutaneous ureterostomy is effective only when the ureters are dilated. Diversion into an ileal segment is necessary when the ureters are of normal caliber.
We report on 14 patients with embryonal rhabdomyosarcoma of the genitourinary organs treated with combined modality therapy. Six patients with paratesticular lesions are free of tumor 7 to 72 months (mean 44) after diagnosis, while 6 of 8 with pelvic lesions are free of tumor 18 to 132 months (mean 61) following diagnosis. Two patients died of metastases. Over-all, 2-year survival free of relapse was obtained in 9 of 11 patients (81 per cent). Of 4 patients with pelvic lesions who were treated with primary radiation-chemotherapy without exenteration 3 were managed successfully but 1 required urinary diversion for vesical fibrosis. Current concepts in the management of embryonal rhabdomyosarcoma are discussed.
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