Laparoscopic versus open radical nephrectomy for xanthogranulomatous pyelonephritis: Contemporary outcomes analysis

BACKGROUND AND PURPOSE: Early experience with laparoscopic nephrectomy for xanthogranulomatous pyelonephritis (XGP) was associated with high conversion and complication rates. We describe our institution's experience with this procedure compared with a contemporary cohort of patients with XGP treated by open nephrectomy. PATIENTS AND METHODS: Retrospective review of surgical pathology reports from radical nephrectomies at our institution between 1995 and 2005 yielded a diagnosis of XGP in 12 patients, 6 of whom had undergone laparoscopic surgery. Each patient's medical records were reviewed, with intraoperative and postoperative parameters, including complications, being recorded. RESULTS: Transperitoneal laparoscopic nephrectomy was successful in five patients (83%). Hand-assist ports were utilized in two patients because of failure to progress. The operative times were 301 +/- 106 minutes and 167 +/- 40 minutes in the laparoscopic and open-surgery groups, respectively (P = 0.03). There was no statistical difference with regard to estimated blood loss, transfusion rate, or parenteral analgesic requirements, but there was a trend toward a shorter stay for the laparoscopic group. Complications were noted in three and two patients in the laparoscopic and open-surgery groups, respectively. CONCLUSIONS: The outcomes of nephrectomy for XGP were similar regardless of surgical approach. The results in patients with XGP were similar to initial reports in the literature and may be dependent on surgeon experience. We believe that in experienced hands, laparoscopic nephrectomy may be offered to patients with XGP.     

改变检测波长HPLC法测定小檗属植物根中的生物碱

应用改变检测波长反相高效液相色谱法测定了5种小檗属植物根中的尖刺碱、小檗胺、异汉防已碱、非洲防己胺、药根碱、巴马亭和小檗碱。色谱柱为μ-Bondapakphenyl;流动相为0.02mol·L^-1磷酸二氢钾乙腈(7:3);0.0～10.0min用203nm检测,10.0～30.0min用346nm检测;流速1.0ml·min^-1。根据这7种生物碱的紫外吸收波长的不同在色谱过程改变检测波长,提高了分析的灵敏度和准确度。     

Polymorphisms in gene encoding TRPV1-receptor involved in pain perception are unrelated to chronic pancreatitis

Background  

The major clinical feature in chronic pancreatitis is pain, but the genetic basis of pancreatic pain in chronic pancreatitis is poorly understood. The transient receptor potential vanilloid receptor 1 (TRPV1) gene has been associated with pain perception, and genetic variations in TRPV1 may modify the presence and phenotype of chronic pancreatitis. The aim of our study was to investigate the genetic variation of TRPV1 in Dutch patients with chronic pancreatitis and healthy controls.     

Collagen synthesis is not altered in women with stress urinary incontinence

AIMS: The objective of this study was to demonstrate that weakened pelvic floor support of the lower genitourinary tract in women with stress urinary incontinence (SUI) is due, in part, to decreased collagen synthesis and secretion and/or an altered ratio of collagen III/I synthesis by the fibroblasts of the endopelvic fascia and skin compared to that of women without evidence of pelvic floor weakening. METHODS: Endopelvic fascia and skin biopsies were obtained from women with SUI (n = 14) and women without evidence of SUI or genital prolapse (n = 12). Fibroblast cultures established from the biopsies were incubated with 3H-proline in medium containing ascorbic acid for 3 hr. Conditioned medium was collected and cells were harvested. The radiolabeled collagens were precipitated and digested with collagenase. The collagen synthesized (as a percent of total protein) was determined. Collagen alpha1(III) was separated from collagen alpha1(I) and alpha2(I) by interrupted SDS-PAGE and the amount of (3)H-proline in each band was determined. RESULTS: Collagen synthesis, expressed as percent of total protein synthesis, was not significantly different between fibroblasts obtained from women with or without SUI. The mean of collagen III/I synthesized in fibroblasts was not significantly different between fibroblasts obtained from women with or without SUI. CONCLUSIONS: These data suggest that the lower collagen content in the endopelvic fascia and skin of women with SUI is not due to reduced collagen synthesis or selective reduction in synthesis of either collagen I or collagen III, compared to women without pelvic floor weakening.     

Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a double-blind,placebo-controlled randomised multicenter trial [ISRCTN38327949]

Background  

Infectious complications are the major cause of death in acute pancreatitis. Small bowel bacterial overgrowth and subsequent bacterial translocation are held responsible for the vast majority of these infections. Goal of this study is to determine whether selected probiotics are capable of preventing infectious complications without the disadvantages of antibiotic prophylaxis; antibiotic resistance and fungal overgrowth.     

Long-term treatment outcomes of CoreTherm microwave feedback thermotherapy

The gold standard for definitive management of symptomatic benign prostatic hypertrophy is transurethral resection of the prostate (TURP). Despite its efficacy, TURP has significant morbidity/mortality concerns such as hemorrhage and transurethral resection syndrome. This is especially worrisome for the medically high-risk patient, but the high rates of retrograde ejaculation found with TURP also pose a problem for young patients. A minimally invasive, outpatient alternative to TURP that has long-term efficacy, low morbidity/mortality, and provides a cost-effective advantage is in high demand. This review article discusses microwave thermotherapy as such an option and reports the longterm experience with the CoreTherm (CoreTherm Operations AB, Sweden) device.