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<p><b>OBJECTIVE</b>To probe into and improve the diagnosis and treatment of tuberculosis (TB) in the male genital system.</p><p><b>METHODS</b>Fifteen patients with the male genital system TB established by microbiological and pathological examinations were retrospectively reviewed.</p><p><b>RESULTS</b>The male genital system TB was diagnosed by history, physical examination, semen analysis, TB culture and biopsy. Treatment consisted of antituberculous chemotherapy for all the patients before and/or after operation, including 5 cases of epididymectomy and 6 cases of orchi-epididymectomy.</p><p><b>CONCLUSION</b>The male genital system TB tends to be atypical and semen polymerase chain reaction of TB (TB-PCR) may provide a new specific means for diagnosis in case of clinical suspicion. Surgical approaches should be cautiously adopted, especially for young patients.</p>
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Adult , Aged , Humans , Male , Middle Aged , Antitubercular Agents , Therapeutic Uses , Polymerase Chain Reaction , Retrospective Studies , Tuberculosis, Male Genital , Diagnosis , TherapeuticsABSTRACT
Objective To study the changes of the semen quality and the spermatogoa ultrastructure in uremic patients before and after renal transplantation. Methods The semen was analyzed and spermatogoa were investigated under scanning electron microscopy (SEM) in 8 patients before and after renal transplantation and 5 normal volunteers. Results In uremic patients, there was significant decreases in sperm motility, survival rate and sperm density. Under SEM, the deletion of the acrosome, distinct vacuoligation in the nucleus, deficiency of the postacromal and postnuclear ring and ~absence of the middle segment of mitochondrial sheath were found. After renal transplantation, the semen main parameters were significantly improved (P
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Objective To discuss the diagnosis and management of adrenal cortical carcinoma. Methods 12 cases of adrenal cortical carcinoma were evaluated with regard to clinical,pathologic characteristics and prognosis.Of the 12 patients,6 were male and 6 were female with an average age of 37.The tumor was functional in 4 and nonfunctional in 8.The tumor was on the right side in 10 and on the left in 2.The diameter of the tumor was 3～30 cm.3 cases were Sullivan stage Ⅰ,3 stage Ⅱ,2 stage Ⅲ and 4 stage Ⅳ. Results Tolal ablation of the tumor has been conducted in 11 and biopsy only in 1.Estrogen receptor expression was positive in 5 out of 7 as deteted by immunohistochemistry assay.Five patient died within 1.5 years after operation whereas the other 7 are still surviving including 5 administered with tamoxifen. Conclusions Adrenal cortical carcinoma may be an estrogen-dependant tumor,so tamoxifen is an effective adjuvant drug in the treatment.Tumor size and stage appear to be strongly correlated with prognosis,larger size and higher stage are associated with a poor prognosis.
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Objective To report initial experience and the indications of retroperitoneal laparoscop- ic partial nephrectomy.Methods From December 2001 to October 2005,23 patients (including 14 cases of renal cell carcinoma,5 of hamartoma and 4 of duplex kidney) underwent retroperitoneal laparoscopic par- tial nephrectomy.One of the patients had solitary kidney.Results All the operations were successful ex- cept for only 1 requiring conversion to laparoscopic nephrectomy because of bleeding resulting from blocking anterior branch of renal artery.The mean operative time was 121 min (60-240 min),and mean ischemic time was 32 min (20-55 min).The estimated bleeding volume ranged from 100 ml to 300 ml,and no pa- tient needed blood transfusion.Pathology showed negative surgical margins in 14 cases of renal cell carcinoma and confirmed the diagnosis of hamartoma in 5 cases.One patient with duplex kidney required open partial nephrectomy because of renal cystic mass resulting from incomplete resection.Conclusions Retroperito- neal laparoscopic partial nephrectomy offers a new effective and minimally invasive treatment for selected pa- tients with renal mass.The long-term effects of the procedure need further investigation.
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ObjectiveTo study the diagnosis and trea tm ent of bilateral renal angiomyolipomas.MethodsThe clin ic data of 13 cases of bilateral renal angiomyolipoms were reviewed.There were 2 male and 11 female patients with an average age of 42.Preoperative ultrasonogra phy and CT scanning have been undertaken in all.Renal angiomyolipoma was diagnos ed in 11 and cancer nodules could not be ruled out in the other 2.Unilateral and bilateral renal sparing surgerys were carried out in 5 and 8 cases respectively .ResultsAll cases were examined with rapid frozen sect ion analysis at operations.The renal function of all the patients except 1 was n ormal after operation except 1 with a temporary rise in Scr (350 ?mol/L).The pa tients have been followed up 1 to 4 years after discharging from hospital and th e renal function became normal in all.No recurrence was found.Conc lusionsUltrasonography and CT are important methods to diagnose ang iomyolipoma with specific manifestations.Rapid frozen section analysis at operat ions is helpful to diagnose and to choose the correct surgical technique.Attenti on should be paid to reserve the renal tissues as much as possible and renal fun ction should be protected properly.
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ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.
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0.05).Compared with electrocautery resection group, more cases in HoLRBT group obtained accurate tumor stages, less cases needed bladder perfusion and had bladder perforation ( P