ABSTRACT
We report an exceptional migration of ureteral stent in patient who underwent a robot-assisted laparoscopic right pyelotomy. After stone removal, an antegrade ureteral stenting (7-french; Double J) was performed without fluoroscopic control. A radiographic control was performed the next day and highlighted a migration into the cardiovascular system. The Double J was removed percutaneously through the right femoral vein under fluoroscopic guidance.
ABSTRACT
We compare testosterone (T) metabolism in primary cultures of epithelial cells and fibroblasts separated from benign prostate hypertrophy (BPH) and prostate cancer tissues. In all cultures, androstenedione (delta 4) formed by oxidation of T by 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) represented 80% of the metabolites recovered. The amounts of 5 alpha-dihydrotestosterone (DHT), formed by reduction of T by 5 alpha-reductase (5 alpha-R), were small: 5 and 2% (BPH) and 8 and 15% (adenocarcinoma) for epithelial cells and fibroblasts, respectively. Northern blot analysis of total RNA from epithelial cells (BPH or adenocarcinoma) attributed the reductive activity to the 5 alpha-reductase type 1 isozyme and oxidative activity to the 17 beta-HSD type 2. In cancer fibroblasts, only little 17 beta-HSD type 2 mRNA was detected. The 5 alpha-reductase inhibitors, 4-MA (17 beta-(N,N-diethyl)carbamoyl-4-methyl-4-aza-5 alpha-androstan-3-one) and finasteride, inhibited DHT formation with a preferential action of 4-MA on epithelial cells (BPH or adenocarcinoma) and of finasteride on fibroblasts from adenocarcinoma. Neither inhibitor acted on delta 4 formation. On the other hand, the lipido-sterol extract of Serenoa repens (LSESr, Permixon) inhibited the formation of all the T metabolites studied [IC50 S = 40 and 200 micrograms/ml (BPH) and 90 and 70 micrograms/ml (adenocarcinoma) in epithelial cells and fibroblasts, respectively]. These results have important therapeutic implications when selecting appropriate treatment options for BPH.
Subject(s)
Fibroblasts/metabolism , Prostatic Neoplasms/metabolism , Testosterone/metabolism , 17-Hydroxysteroid Dehydrogenases/genetics , 17-Hydroxysteroid Dehydrogenases/metabolism , Adenosarcoma/metabolism , Adenosarcoma/pathology , Androstenedione/metabolism , Azasteroids/pharmacology , Blotting, Northern , Cells, Cultured , Cholestenone 5 alpha-Reductase , Chromatography, High Pressure Liquid/methods , Dihydrotestosterone/analogs & derivatives , Dihydrotestosterone/metabolism , Dihydrotestosterone/pharmacology , Enzyme Inhibitors/pharmacology , Epithelium/drug effects , Epithelium/metabolism , Epithelium/pathology , Etiocholanolone/analogs & derivatives , Etiocholanolone/metabolism , Fibroblasts/drug effects , Fibroblasts/pathology , Finasteride/pharmacology , Humans , Male , Meningioma/enzymology , Meningioma/metabolism , Meningioma/pathology , Oxidoreductases/genetics , Oxidoreductases/metabolism , Placenta/cytology , Placenta/enzymology , Placenta/metabolism , Prostatic Neoplasms/pathology , RNA/analysis , RNA, Messenger , Tumor Cells, CulturedABSTRACT
The authors present 14 cases of renal cancers with a cystic appearance raising pre and intraoperative diagnostic difficulties. Although ultrasonography has become the first-line investigation, computed tomography is now the most accurate diagnostic examination. The diagnosis of complicated benign cyst must be proposed very cautiously and the persistence of doubtful images justifies surgical exploration. In order to be reliable, frozen section histological examination must include all of the cystic tumour. Polar nephrectomy with frozen section examination is therefore the recommended intraoperative diagnostic procedure in a case of suspicious cyst. The curative treatment of these cancers is classical radical nephrectomy.
