Subject(s)
Cystostomy/methods , Empyema/surgery , Surgical Stapling , Urinary Bladder Diseases/surgery , Female , HumansABSTRACT
OBJECTIVE: To document the presence of extensive transmural and perivesical fat necrosis in a series of radical cystectomies, and associate the surgical and pathological findings with the administration of intravesical chemotherapy. PATIENTS AND METHODS: The study comprised 12 patients with pT2+ transitional cell tumours who were referred to the West Middlesex University Hospital and who proceeded to primary radical cystectomy between November 1996 and April 1998. The association between the presence of widespread transmural and extravesical necrosis and the administration of a single dose of intravesical epirubicin or mitomycin C in the 24 h after the initial transurethral resection of bladder tumour (TURBT) was analysed using the two-tailed Fisher's exact test. RESULTS: The association between the presence of transmural and extravesical fat necrosis and administration of intravesical chemotherapy was highly significant (P=0.015). CONCLUSIONS: The depth and extent of the mural muscle necrosis and perivesical fac necrosis in patients receiving intravesical chemotherapy within 24 h of TURBT is remarkable and more florid than the usual muscle necrosis seen after TURBT. Clinically, the necrotic tissue makes the cystectomy significantly more difficult technically, and may even mimic extravesical spread of malignant disease. This was not borne out by the histology of the specimens, which showed no extravesical spread of the tumour. Surgeons should be aware of the possibility that such operative findings might be the result of intravesical chemotherapy.
Subject(s)
Antibiotics, Antineoplastic/adverse effects , Carcinoma, Transitional Cell/drug therapy , Epirubicin/adverse effects , Fat Necrosis/chemically induced , Mitomycin/adverse effects , Urinary Bladder Neoplasms/drug therapy , Administration, Intravesical , Aged , Carcinoma, Transitional Cell/surgery , Chemotherapy, Adjuvant/adverse effects , Cystectomy/methods , Female , Humans , Male , Middle Aged , Urinary Bladder Neoplasms/surgeryABSTRACT
Torsion of an accessory spleen is recognized as a rare cause of acute abdominal pain in childhood. A case is reported which, however, is unusual in that it occurred in a patient of 75, who had had no previous symptoms which might have suggested the presence of an accessory spleen.
Subject(s)
Spleen/abnormalities , Splenic Diseases/pathology , Abdomen, Acute , Aged , Female , Humans , Torsion AbnormalityABSTRACT
Pregnancy block caused by exposure of mated female mice to a strange male was significantly reduced by bilateral destruction of the vomeronasal organ. Treatment of newly mated females with alpha-bromocriptine also produced pregnancy block. Pregnancy block also occurred in mated females exposed to strange male odours, but the blastocysts which had failed to implant were still present in the uterus and were viable for up to 15 days after mating. Implantation was induced in such mice by administration of exogenous progesterone and oestradiol.
