Spontaneous retroperitoneal hemorrhage secondary to a renal cause.

Spontaneous rupture of normal renal parenchyma must indeed be rare. Virtually all patients in this paper had a significant abnormality that presented with bleeding. Our Case 5 is the only one without a clear underlying pathologic entity. We should stress the high incidence of associated disease in kidneys that bleed "spontaneously" and therefore the need for exploration and/or nephrectomy.

Unilateral abdominal mass: an unusual presentation of autosomal dominant polycystic kidney disease in children.

Autosomal dominant polycystic kidney disease is rarely diagnosed in infancy or childhood. The renal involvement is typically bilateral. We describe two children with ADPKD (autosomal dominant polycystic kidney disease) presenting with a unilateral renal mass. The value of a careful genetic history and the role of sonography will be discussed.

Complications of the non-refluxing colon conduit.

The non-refluxing colon conduit has been offered as a superior alternative to the ileal conduit for long-term supravesical urinary diversion. The main advantage would seem to be that the upper tracts can be protected by the formation of a ureterocolic anastomosis without reflux, thereby preventing the deterioration associated with ileal conduits, which is presumably secondary to reflux and ascending infection. Although a colon operation is potentially more hazardous than a small bowel operation the short-term complication rates are not significantly different. We report 2 cases of stenosis of the ureterocolic anastomosis to emphasize that this serious complication continues to be a potential problem with any procedure of this type. With long-term followup its present incidence in 8 to 10 per cent of the patients may exceed the incidence of conduits with reflux. In our 2 cases severe stenosis of the ureter within the tunnel was encountered at reoperation. Techniques that may help prevent stenosis include preservation of periureteral adventitia, careful formation and closure of the submucosal tunnel, forming an anastomosis free of tension and tapering the ureters, when necessary, adequately but not excessively. Correction of this complication may require lysis of surrounding adhesions, a ureterocolic anastomosis with reflux, transureteroureterostomy, transureteropyelostomy, replacement of the ureter with small bowel or nephroureterectomy.

Establishment and characterization of a new human urinary bladder carcinoma cell line (PS-1).

An epithelioid cell line (PS-1) has been established from a transitional cell cancer derived from human urinary bladder. Subcutaneous injection of the epithelioid cells into weanling athymic nude mice induced solid tumors histologically similar to the original tumor. A cell line was also established from a tumor induced in the athymic nude mouse (PS-1, T-1). Both cell lines exhibited essentially identical growth characteristics and formed a monolayer growth of epithelioid cells in culture. Electron microscopic studies confirmed epithelioid morphology. No fibroblastoid elements were observed. Chromosomal analysis revealed heteroploidy with persistent marker chromosomes; all cells contained a Y chromosome. The presence of tumor-specific antigen(s) in PS-1 cells was suggested by microcytotoxicity assays with peripheral allogeneic lymphocytes from other transitional cancer cell patients. Sera of urinary bladder cancer patients reacted with nuclear antigens of the established cells.

Recognition of virally transformed cells by lymphocytes from patients with prostatic cancer.

Data presented describe the first assay using human peripheral blood lymphocytes (PBL) against two unique virally transformed cell lines in vitro. Human cells transformed by a cytomegalovirus (CMV-Mj) isolated from normal human prostate tissue were used as target cells in microcytoxicity assays with lymphocytes from 100 patients. Three target cell types were used: control human embryonic lung cells (HEL), transformed HEL cells (CMV-Mj-HEL-2), and transformed HEL cells retrieved from tumors induced in athymic nude mice (CMV-Mj-HEL-2, T-1) by injection of CMV-Mj-HEL-2 cells. PBL preparations from 84% of all patients tested significantly killed CMV-Mj-HEL-2, T-1 cells. However, only PBL from patients with prostatic carcinoma were cytotoxic for CMV-Mj-HEL-2 cells significantly more often than for control HEL. The implications of this approach are discussed.

Lymphocyte reactivity against virally transformed cells in patients with urologic cancer.

Lymphocytes from patients with urologic cancer were tested in microcytotoxicity assays against human cells transformed by cytomegalovirus. Human lymphocytes were significantly cytotoxic against the transformed cell line when compared to a normal human control cell line. Patients with prostatic carcinoma demonstrated greater target cell reduction than those with benign prostatic hyperplasia.