Urinary basic fetoprotein in the diagnosis and follow-up of patients with urothelial carcinoma.

BACKGROUND: Urothelial carcinoma is one of the most common malignant neoplasms of the urinary tract and is characterized by a high local recurrence rate. However, no specific and reliable tumor marker has been identified for the diagnosis and follow-up of patients with urothelial carcinoma. METHODS: Urinary basic fetoprotein (U-BFP) levels were measured by enzyme immunoassay in 119 patients with urothelial carcinoma, 64 patients with other urologic malignancies, 144 patients with benign diseases, and 166 healthy individuals to evaluate it clinical efficacy as a marker of urothelial carcinoma. The histologic logic localization of BFP was also studied. A cutoff value was set at 14 ng/mL based on the maximum diagnostic efficiency. RESULTS: The specificity and sensitivity of U-BEP for urothelial carcinoma was 91.7% and 58%, respectively. THe U-BFP positive rate increased significantly with the histologic grade. The U-BFP positive rate was higher in both Tis and T2-4 than in Ta, 1 disease. The U-BFP level exceeded the cutoff value before curative therapy in 32 patients; U-BFP was normalized in 97% of these patients within 2 weeks after therapy. There was a total of 11 recurrences and the U-BFP level returned to abnormally high levels in all instances. Histologic localization of U-BFP was demonstrated in the cytoplasm of the tumor cells in 80% of the patients. CONCLUSION: Based on these results, U-BFP is a potential tumor maker of urothelial carcinoma. In particular, the test could be used to monitor patients whose U-BFP value is positive before therapy.

Microwave ablation of the adrenal gland: experimental study and clinical application.

OBJECTIVE: To evaluate the heating effect of microwave irradiation on the dog adrenal gland and to assess the clinical feasibility of microwave ablation of adrenal tumours. MATERIALS AND METHODS: The thermal distribution and histology were evaluated after dog adrenal glands were irradiated at different intensities with microwaves. Irradiation at 70 W for 30 s was also performed after laparotomy, on the adrenal tumour of a patient with primary aldosteronism. RESULTS: Microwave irradiation at 70 W for 30 s provided a sufficiently high temperature to produce coagulation within a 5 mm radius of the microwave electrode. The adrenal tumor in the patient with primary aldosteronism was coagulated successfully by this dose of microwave irradiation. CONCLUSION: Microwave ablation of the adrenal gland may be clinically applicable in the treatment of adrenal tumours.

Experimental study of microwave coagulation of a VX-2 carcinoma implanted in rabbit kidney.

This paper describes the results of an experimental study of the microwave coagulation of VX-2 renal tumors implanted in rabbits. The rabbits undergoing microwave treatment exhibited a satisfactory survival rate and a complete response to treatment, as verified by histological examination. All the rabbits receiving no treatment died within 6 weeks of implantation of the VX-2 carcinoma. These results indicate that microwave coagulation may be a curative method of treatment for a relatively small renal tumor. Intraoperative real-time ultrasonic scanning permits the percutaneous microwave coagulation of renal cancer in a clinical situation.

Effect of methylene blue on the vesicourethral function in the rats.

The bladder and urethral activities during the rhythmic bladder contractions were evaluated before and after the intraarterial administration of methylene blue, which prevents the activation of soluble guanylate cyclase. The methylene blue produced an increase in the bladder activity and a decrease in the urethral smooth muscle relaxant response induced with bladder contraction. The L-arginine/nitric oxide pathway seems to modulate the vesicourethral function.