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OBJECTIVES. To investigate use of the R.E.N.A.L. nephrometry score in relation to the choice of treatment and postoperative complications for renal masses. DESIGN. Case series. SETTING. A tertiary referral hospital in Hong Kong. PATIENTS. Data of patients undergoing nephrectomy were collected retrospectively from a clinical database and analysed. A R.E.N.A.L. nephrometry score was allocated to each renal tumour by a blinded qualified radiologist, utilising computerised imaging systems. Patient demographics, choice of surgery (radical vs partial), and approaches (open vs minimally invasive) were analysed with respect to their R.E.N.A.L. score. RESULTS. In all, 74 patients were included during the study period, of which 38 underwent partial nephrectomy and 36 underwent radical nephrectomy. No differences between the groups were found with respect to patient demographics. There were significant differences between the partial and radical nephrectomy groups in terms of their mean nephrometry score (6.9 vs 9.3, P<0.001). The mean nephrometry sum was also significantly different in the open approach versus the minimally invasive approach in patients having partial nephrectomy (7.8 vs 6.0, P=0.001). There was no difference in the postoperative 90-day morbidity and mortality in the partial nephrectomy and radical nephrectomy groups. CONCLUSIONS. The R.E.N.A.L. nephrometry score of a renal mass correlated significantly with our choice of surgery (partial vs radical) and our approach to surgery (open vs minimally invasive surgery), particularly in the partial nephrectomy group. It does not, however, correlate with postoperative complications. The nephrometry score provides a useful tool for objectively describing renal mass characteristics and enhancing better communication for the operative planning directed at renal masses.

The major phospholipid of the extremely halophilic coccus, S. morrhuae, was purified and compared with the major phospholipid of the extremely halophilic rod, Halobacterium cutirubrum. Analysis was by infrared and nuclear magnetic resonance spectroscopy, mass spectrometry, and thin-layer chromatography. The last two procedures established structural identity of the coccal lipid with that of the rod, which had been shown to be the I-phosphatidylglycerophosphate derivative (2) of 2,3-di-O-dihydrophytylglycerol (1).

The morphology of Cl. kluyveri is compared with that of CI. acetobutylicum. The multilayered cell wall of both organisms differ in the number of layers and total thickness. The plasma membrane of Cl. acetobutylicum is asymmetric in electron density and can be separated from the rest of the cell by plasmolysis. Tubular or vesicular structures are observed between the wall and the plasma membrane. In contrast, the plasma membrane of Cl. kluyveri is more symmetrical, with no structures between the cell wall and the plasma membrane.Intracytoplasmic membrane systems present in Cl. acetobutylicum are morphologically similar to the mesosomes of Gram-positive aerobes. The intracytoplasmic membrane systems' of ct. kluyveri are characteristically rough in appearance, and differ in general morphology from systems usually described as mesosomes. Roughness is attributed to membrane-bound ribosomes, these being smaller than those of Escherichia coli.Polygonal structures containing moderately electron-dense material (possibly DNA) were observed in C/. kluyveri. Cl. acetobutylicum possesses membrane-bounded inclusions containing electron-dense particles similar in dimensions to E. coli ribosomes. Rows of electron-dense bands were also observed.It is suggested that the polygonal structures and rough membranes of Cl. kluyveri are components of a system for the functional expression of genetic information.

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