The combination of docetaxel and cisplatin appeared relatively well tolerated and moderately active in patients with advanced urothelial cancer. The patients most likely to benefit were those without weight loss and without lung or liver metastases.
Cystinuria is a rare cause of renal calculi, whose management presents a complex problem mainly due to the hardness and high recurrence rate of cystine stones. During the period 1987–1991, 28 established cases of cystine calculi were treated by extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotripsy (PCNL). These cases were divided into 5 groups, according to the position and size of the stones, and each group then followed a specific regimen, either ESWL monotherapy or a combined treatment comprising an initial ESWL treatment followed by PCNL or vice versa. ESWL monotherapy provided satisfactory results only in the group with pelvic stones (54.5% success rate), with 2.16 stone treatments/renal unit, and only with calculi smaller than 2.5 cm. The groups with multiple stones or staghorn calculi were treated with a combined treatment of ESWL and PCNL and had success rates of 50 and 67%, respectively. However, the group in which PCNL was followed by ESWL showed a clear advantage over the group in which ESWL was administered before PCNL, since it required a smaller number of ESWL treatments (1,5 stone treatments/renal unit as compared to 4.3 stone treatments/renal unit). Finally, attempts for ESWL in situ in the few cases of ureteral stones proved unsuccessful.
This study assesses the correlation of p53 immunoreactivity and DNA ploidy status with biochemical recurrence after radical prostatectomy. p53 protein expression and DNA ploidy were evaluated on 84 archival paraffin-embedded radical prostatectomy specimens. Patients were divided into two groups: those with low (38/84, 45%) and those with high (46/84, 55%) p53 immunoreactivity. The results were correlated with Gleason score, stage and serum PSA. Kaplan-Meier biochemical recurrence free survival and the Cox hazard-regression model were used for analysis. Multivariate analysis revealed p53, DNA ploidy, Gleason score, PSA and stage to be independent prognostic factors in this order. Kaplan-Meier analysis showed a significant difference in biochemical recurrence when p53 high expression and DNA aneuploidy were combined. The results of this study suggest that stratification for p53 expression and DNA ploidy status can provide additional prognostic information for patients with prostate carcinoma after radical prostatectomy.
Since the installation of an extracorporeal shock wave lithotriptor (ESWL) unit 12 months ago, 2000 lithotripsy procedures have been performed. Overall, 68.4% of patients were stone-free by the end of the first month. Residual lithiasis (fragments less than 0.5 cm) was seen in 19.7% of patients and significant lithiasis (fragments greater than 0.5 cm) was observed in 10.1%. Complications were obstruction, infection, headache due to the epidural anaesthesia, anuria, renal failure, perirenal haematoma and cardiac arrest. A number of patients required additional operative treatment; this was always endoscopic and no open procedures were performed. Hospitalisation averaged 1 day.
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