Evaluation of the general therapies in the treatment of the adult patients with primary nephrotic syndrome

Background: Primary nephrotic syndrome in adult patients is a common sign of patients with primary glomerular disease. Objective: To evaluate the responsiveness of adult patients with primary nephrotic syndrome to corticosteroid alone or in combination with cyclophosphamid and the treatment - related complications. Subjects and method: Based on pathological findings 91 patients with primary nephrotic syndrome divided into 2 groups: group 1 (75 patients) were assigned to receive corticosteroid alone at 1 mg/kg/day, group 2 (16 patients) were assigned to receive the corticosteroid at 0.5 mg/kg/day and cyclophosphamid at 2 mg/kg/day. 11 non - responders from group 1 were switched to group 2 after 6 months of treatment by \r\n', u'corticosteroid alone. The response to therapy was assessed after 3 months and 6 months of treatment. Results:In group 1 the number of patients responding to corticosteroid alone was increasing from 38 after 3 months to 50 after 6 months. In group 2 the number of patients responding to combined protocol was increasing from 4 (14.8%) to 12 (44.4%). The most frequently seen corticosteroid - related complication was cushingoid which is reversible after reducing dose or stop treatment. Severe complications were not common. For the whole group taking cyclophosphamid leucocytopenia, was seen in 4/27 (14.8%) patients, in subgroup of women hypo - amenorrhea was observed in 3/15 (20%) of cases. Conclusions: Results of study encourage the prolongation of treatment. Sterility and if possible preventive measures should be taken into consideration when cyclophosphamid is selected for young patients in reproductive age.\r\n', u'

Results of retrograde endoscopic ureterolithotripsy with holmium laser in management of ureteral stones at the Post hospital I Hanoi

Background: Untill now, many minimal invasive methods have been applied in treating ureteral stones such as the endoscopic ureterolithotripsy technique of Perez-Castro and Martinez-Pinero (1980), the tetroperitoneal laparoscopic ureterolithotomy technique of Wickham (1979) and so on. Retrograde endoscopic ureterolithotripsy with holmium laser has been applied in management of ureteral stones at the Post hospital I Hanoi since 2003. Objective: To show results of retrograde endoscopic ureterolithotripsy with holmium laser in management of ureteral stones at the Post hospital I Hanoi. Subjects and method: A retrospective study was conducted in 183 patients who underwent retrograde endoscopic ureterolithotripsy with holmium laser at the Post hospital I Hanoi, from July/2003 to July/2005. Results:In 183 patients, female was more than male (54.7% versus 45.4%); the mean age was 45.4 (range 14-77). There were total 212 lithotrity stones, of which the rate of left, right, upper-third, middle-third and lower-third ureteral stone was respectively 51.9%, 48.1%, 43.2%, 22.4% and 34.4%. The mean size of ureteral stone was 15.1mm x 11.17mm and the average time of ureterolithotripsy was 48.1 minutes (range 15 -120). Conclusion: The rate of success for etrograde endoscopic ureterolithotripsy with holmium laser was high (92.9%), especially the success rate for lower-third ureteral calculi (100%) and the success rate for upper-third ureteral stones (84.8%). However, 5/165 patients (3%) who had follow-up examination for 2-4 years after surgery had ureteral stenosis. This complication was resulted from burned mucous membrane during endoscopic ureterolithotripsy with laser.

Renal complicated angiomyolipoma: discussion of diagnosis and management

Background: Angiomyolipoma (AML) is a benign renal neoplasm. Patients were often hospitalized in two situations: Renal AML unilateral or AML with Tuberous Sclerosis Complex. Objectives: To discover prospectively the clinical symptoms and evaluate the therapeutic of 5 renal angiomyolipoma unilateral operated in Viet Duc and Huu Nghi hospital from 2004 January to 2006 April. Subject and Methods: The record of 3 men and 2 women with a mean age of 46.2 years (maximum: 86, minimum: 32); flank pain: 3 patients, heamaturia: 2 patients. The mean lesion diameter was 7.9cm (minimum: 5.4 cm, maximum: 12cm). The mean follow up was 6.6 months. Result: All of the patients symptomatic with a mean giant diameter (7.9cm). One patient was operated on urgently, because of a tumor rupture post-traumatism. Two patients were operated on as diagnostic doubt. Conclusion: Renal angiomyolipomas are almost benign. Total nephrectomy on the size of tumor, their complications and the special conditions.

Clinical presentations and outcome of the urinary bladder sarcomas in adult: review and discussion of surgical treatment

Background: Urinary bladder sarcomas are rare in adults, accounting for 0.38-0.64% of bladder tumors. The most recognized treatment for malignant tumors is chemotherapy followed by radiotherapy, but there have been no large scale study to provide a definitive regimen for this condition. Objectives: To determine the outcome of patients with urinary bladder sarcomas. Subjects and method: Between January 2002 and December 2006, 6 patients diagnosed with urinary bladder sarcomas were examined at the Viet Duc Hospital. We retrospectively reviewed the records of these patients for information on clinical features, treatment and outcomes. Results: The mean age of patients was 39.6 years; male/female ratio was 3/1; 66% was leiomyosarcomas, 16.7% was rhabdomyosarcomas, 16.7% was myxosarcomas (n=6). Among these malignant tumors, 3/5 patients were in the advanced stage. Conclusion: Bladder sarcomas were rare in adults. Leiomyosarcomas were more common than rhabdomyosarcomas and had worst outcomes if it is in an advanced stage.

Cytomegalovirus in the kidney transplantation

Cytomegalovirus always is risk of complication and mortality for patients with kidney transplantation. The timely, effective diagnosis and treatment is a leading responsibility while waiting for vaccine responding with this virus. The diagnosis of cytomegalovirus based on the detection of pieces of cytomegalovirus in the cell, viral culture and serum test. ELISA is common method to detect the IgG and IgM. The treatment involved the use of anti-viral agents such as ganciclovir, foscarnet...

Telomerase and urological cancer

Telomerase is a ribonucleoprotein enzyme. Which is responsible for catalyst for increasing chains of telomere and limitation of shortening the chromosome terminal head. Telomerase has activity for the primary cells but inhibited differentiate cells. Telomerase was considered most significantly as a marker of cancer because 90% of cancer cells in human had positive telomerase. The telomerase was used to early diagnose and monitor as well as predict outcome. The antitelomerase therapy was a proper method to prevent relapsed cancer after the traditional treatments

Telomerase and urological cancer

Currently, the telomerase is being considered as a marker of cancer because 90% of cancer cells in human have positive telomerase. The telomarase used to early diagnose, monitor and predict after the treatment. In addition to, telomerase also is objective of many researches to treat the cancer. It had better combine the anti telomerase and chemotherapy

Results of treatment of benign prostate hypertrophy by endoscopic surgery during 1981 - 1996 in Viet Duc hospital

From 6/1981 to 6/1996 a total of 978 consecutive patients (mean age: 69) presenting with bladder outlet obstructive were admitted to Viet Duc hospital for elective transurethral resection of prostate). The feagure of TURP were increasing from year to year and the TURP/ open surgery ratio was 80% in 1996. The procedures were performed with low mortality (0.3%) and low morbidity (bleeding 0.6%, capsular perforation (0.7%). TURP syndrome (0.3%), dysuria (1.8%) incontinence (1.1%), urethral stricture (1.5%) Hospital stay: 5(2 days. Overall outcome: good: 77%, moderate 19%; unsatis factory: 4%.

Results of resection of adrenal tumor by method with initial control of adrenal vessels before removing the tumor

Between 1/1994 and 12/2000, 52 patients with 53 adrenal tumors were operated in the Department of Urology - Viet Duc Hospital. Through subcostal approach, the initial control of the main adrenal veins and arteries was performed in 84.6% cases (71% in the right and 100% in the left adrenal tumors). Hemodynamic is maintained at the first day of postoperative period (88.5%). The outcome was good in 96.2% of cases, exception for one death at the third postoperative day by acute adrenal failure and another from prolonged hypertension. No early hemorrhage was observed in the postoperative period. Improved surgical outcomes have been the result of advances in localization techniques, preoperative medical management and anesthetic practice.

Apoptosis and urological disease

Apoptosis is a 'programmed cell death' phenomenon that having the hereditary of nucleus cells. Apoptosis was described by Kerr in 1972 to introduced a popular phenomenon which is essential for the life, normal development of the body, the stability of tissue, elimination of inflammatory and tolerance of immunology

Results of extracorporeal lithotripsy by Storz Modulith SLX in Viet Duc hospital

From June 1996 to August 2000, we have prospectively followed 687 patients (476 renal stones, 224 ureteral stones) who underwent extracorporeal shock lithotripsy on a Storz-Modulith SLX in Viet Duc hospital. The member of stone - free cases in one session were achieved in 325 patients (46.4%). The effectiveness quotient, EQ was 62%. There were no severe complications, 12 patients underwent further operations and other thirty have had stone fragments to be removed by ureteroscopy. The success rates depend on following strick indications and improving performance on technical management on lithotriptor.