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Objective To study the value of renal CT scan in evaluating split renal function.Methods 147 patients undergone CT scan from June 2009 to June 2011 were involved in this study.There were 73 cases of obstructive hydronephrosis and 74 cases of renal tumors.66 patients were males and 81 were females with a mean age of 53 years ( range 17 - 87 years).GFR detected by single-photon emission computed tomography (SPECT) was used as the reference of split renal function.The kidneys were divided into 3 groups according to the GFR:normal renal function (113 cases,GFR ≥ 34 ml/min),mildly impaired renal function (66 cases,GFR:20 -34 ml/min) and severely impaired renal function (41 cases,GFR ＜20 ml/min).One-way ANOVA and linear regression analysis were used to analyze the relationship between the results of CT scan and split renal functions. Results There were significant differences in the cortical thickness among the normal renal function,mildly impaired renal function and severely impaired renal function groups.The cortical thicknesses were (0.62 ±0.11) cm,(0.45 ±0.10) cm and (0.26 ±0.07) cm,respectively (P ＜ 0.01 ).The renal cortical thickness was strongly correlated with GFR (r =0.806,P ＜0.01 ).There were significant differences in the enhancement during the cortical phase among the 3 groups,which were (162.1 ±25.3) HU,(121.6 ±21.0) HU and (63.5 ±20.0) HU,respectively (P＜0.01).The enhancement during the cortical phase was strongly correlated with the GFR (r =0.851,P ＜ 0.01 ).The enhancement during the parenchymal phase and excretory phase was moderately correlated with the GFR ( r =0.467 and r =0.451,P ＜ 0.01 ). Conclusions The renal cortical tbickness and the enhancement during the cortical phase detected by CT scan might be useful for the clinical evaluation of split renal function.
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Objective To investigate the methods of steroid supplement following adrenalectomy in the patients with Cushing syndrome.Methods The methods and outcome of steroid supplement following adrenalectomy in 75 cases of Cushing syndrome were retrospectively reviewed.Results Supraphysiological doses of glucocorticoid was given during the perioperative period,and the dosage was reduced gradually.Prednisone with a dosage of 5 to 7.5 mg was given once a day on discharge.In the patients with adrenocortical adenoma,4 to 15 month of steroid supplement was required.The patients undergoing bilateral adrenalectomy required lifelong steroid supplementation.Steroid withdrawal syndrome occurred during steroid tapering in 8 patients with adrenocortical adenoma,2 of them had normal plasma cortisol level.Conclusion In the patients with Cushing syndrome,even those with normal plasma cortisol level might have steroid withdrawal syndrome episodes during steroid tapering.
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Objective To evaluate the expression of multidrug resistance-related markers in renal pelvic and ureteral carcinoma. Methods The immunohistochemical expression of P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), lung-resistance protein (LRP) and glutathione S-transferase Pi (GST-?) were examined in 51 patients with renal pelvic or ureteral carcinoma.The correlation between the expression and some clinicopathological parameters was analyzed. Results The positive expression rate of P-gp、MRP、LRP and GST-? in renal pelvic or ureteral carcinoma was 35.3%(18/51),39.2%(20/51),58.8%(30/51) and 43.1%(22/51) respectively.The rate of P-gp positive staining was increased with the advance of tumor grade (P
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Objective To understand the pathogenesis and the clinical features of the bladder soft calculi. Methods A case of bladder soft calculi with emphysematous cystitis was reported.The patient,who had underwent partial cystectomy for bladder cancer,was 53 years old with diabetes and prostate hyperplasia. E.coli was found in his urine.KUB showed negative result.B-us and cystoscopy showed bladder mass.Some of other cases were also reviewed. Results The patient underwent surgical operation,and during the procedure a multilamellar yellow/brown internal structure of the calculi was observed.It presented as something like cellulose in the pathological study.The patient received antibiotic therapy after operation for two weeks,and recovered very well. Conclusions The formation of soft calculi is typically associated with urinary infection caused by proteus species.Diabetes mellitus is believed to be the most important predisposing factor for the formation of soft calculi.In most cases, surgical manipulation is required for their removal because they are not dissolved by any means yet known, and the antibiotic therapy is necessary too.