Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report our experience with 3 uraemic patients who were found to have transitional cell carcinoma of the renal pelvis, ureter and urinary bladder after undergoing haemodialysis for an average of 18 months (range 11-28). The underlying causes of renal failure were chronic glomerulonephritis or pyelonephritis. Bloody urethral discharge was the cardinal symptom. Because of anuria, it was often discovered at a late stage. In spite of their poor general condition and advanced stage, palliative surgical intervention was still performed. After a mean follow-up of 9 months, progression of disease was noted in 1 patient. The importance of regular follow-up in patients with end-stage renal disease for early detection of concomitant cancer cannot be over-emphasised. Uraemic patients with urothelial cancer should be treated in the same way as non-uraemic patients, since aggressive surgical intervention may improve their quality of life and prolong their survival.
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PMID:Uraemia with concomitant urothelial cancer. 826 4

A total of 7 patients underwent cystectomy due to bladder malignancy and the ileum was used for lower urinary tract reconstruction (5 underwent bladder substitutions, 1 an internal ileal reservoir and 1 ileal conduit diversion). Antireflux mechanisms were created by submucosally tunneled ureters and in 1 case the continent mechanism was created by a submucosally tunneled ileal tube. In all cases the Yang needle was used, which consists of a needle portion and a forceps portion. The selected position of the ileum for ureteral and ileal tube implantation is injected with normal saline submucosally to form a wheal. The Yang needle is introduced submucosally, guided under the wheal for a certain distance and then directed through the ileal wall. Smooth dilation of the tunnel is achieved with the dilated portion of the needle without laceration of the mucosa. The needle portion is then removed. The ureter or ileal tube is grasped by the forceps portion of the needle and brought through the tunnel to the mucosal side of the ileal plate, followed by mucosa-to-mucosa anastomosis. For all 14 ureteral implantations only 1 ureter had reflux on postoperative radiographic studies and only 1 of 4 hydroureters remained. No additional obstructive lesions or pyelonephritis was noted postoperatively. The patient whose continent mechanism is formed by the submucosal tunneled ileal tube method is continent and free of an appliance. The Yang needle tunneling technique may be a choice in the creation of antireflux and continent mechanisms.
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PMID:Yang needle tunneling technique in creating antireflux and continent mechanisms. 834 94

The bladders of anaesthetised mice were illuminated with red laser light (630 nm) at intervals of 1 day to 4 weeks after i.p. administration of Photofrin. Light was delivered intravesically by inserting a fibre optic, with a diffusing bulb tip, into the centre of fluid filled bladders. A single light dose of 11.3 J cm-2 applies 1 day after 10 mg kg-1 Photofrin caused a severe acute response, with increased urination frequency (five to seven times control) and hematuria. Recovery was good, however, and by 10 weeks only a mild (approximately two-fold) increase in frequency remained. There was no reduction in the amount of acute bladder damage or in the rate of healing when the interval between Photofrin and light was increased from 1 to 7 days but a 2 to 3 week interval lead to a significant reduction in damage. For an interval of 4 weeks there was only a mild (less than two-fold) increase in urination frequency during the first week. A drug dose of 2.5 mg kg-1 given 1 day before illumination caused transient haematuria but no increase in urination frequency. Doses of 5, 7.5 or 10 mg kg-1 all caused photosensitisation and the amount of bladder damage was drug dose dependent. The bladder seems to be well able to recover from severe acute damage induced by PDT. Occasional incidences of pyelonephritis were seen, however, suggesting that urinary tract infection during the acute period may lead to permanent renal damage.
Br J Cancer 1993 Oct
PMID:Functional and histological bladder damage in mice after photodynamic therapy: the influence of sensitiser dose and time of administration. 839 91

During the past 20 years, 31 ureterocutaneostomies (UC), 101 ileal conduits (IC) and 107 colonic conduits (CC) were performed. In the UC group, most of the patients were aged or had unresectable invasive pelvic malignancies. The operative mortality was 6.5% and acute pyelonephritis was noted frequently (48.3%). Stomal stenosis also developed significantly (63.5%). The operative mortalities in the IC group and CC group were 6.9% and 9.3%, respectively. Although the incidences of bowel obstruction, bowel fistula and renal calculi were higher in the IC group (18.8% vs 7.5% and 6.9% vs 0%, respectively). The serum creatinine level was lowest in the CC group (0.90 +/- 0.46 mg/dl) and highest in the UC group (1.36 +/- 0.75 mg/dl). Conduit ureteral reflux was frequent in the UC group (66.7%) but rare in the CC group (1.3%). We conclude that UC should be indicated in the selected patients with high risk, and IC and CC are indicated in patients who may have good prognosis but not indicated for continent reservoir or neobladder. We prefer CC in the younger group.
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PMID:[Experience with incontinent urinary diversion--review of 31 ureterocutaneostomies, 101 ileal conduits and 107 colonic conduits]. 853 96

One hundred and nine patients underwent tubeless ureterocutaneostomy as a method of urinary diversion at the Department of Urology, Wakayama Medical College during the 22 years from 1972 to 1994. The follow-up period ranged from 4 days to 15 years, with a mean of 27.3 months. The primary disease was bladder cancer in 68 patients, uterine cancer in 23 patients, other pelvic malignancies in 11 patients and benign disease in 7 patients. We used 4 types of ureterocutaneostomy; transureteroureterocutaneostomy was done in 13 patients, bilateral ureterocutaneostomy through a single stoma in 30 patients, bilateral ureterocutaneostomy with two stomas in 4 and unilateral ureterocutaneostomy for one available kidney in 62 patients. The construction of stoma was done according to inverted U of Z-shaped skin flap method (30 cases), everted nipple stoma (37 cases) and Toyoda's method (42 cases). We evaluated the stomal condition in 72 patients who were followed more than 6 months postoperatively. Stomal stricture developed and necessitated periodic dilatation or intubation in 25 cases (34%). A better outcome was obtained in patients with dilatated ureter and everted nipple type stoma but no correlation could be found between the history of irradiation and stomal stricture. Long-term outcome of ureterocutaneostomy in 70 patients (129 renal units) was, compared to that of ileal conduit urinary diversion in 124 patients (248 renal units). Postoperative urographic findings showed progressive hydronephrosis in 14 renal units (23%) in the ureterostomy group, while 22 renal units (9%) in the ileal conduit group. However, there was no case of deterioration of renal function which was evaluated by BUN and creatinine in spite of progression of hydronephrosis. The incidence of urinary complications such as pyelonephritis and renal calculus in the successful ureterocutaneostomy group was less than that in the ileal conduit group.
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PMID:[Problems of postoperative care in urinary diversion: ureterocutaneostomy]. 853 99

In the department of urology of the Georgian Cancer Research Center creation of small intestinal detubularized reservoir for urine was practiced for 4 years (1990-1994). Of a total of 35 patients, 27 underwent cystectomy for bladder cancer, whereas 8 patients with secondary cancer of the bladder and rectum were subjected to exenteration of the small pelvis organs. In 29 patients the reservoir was made using invagination valvular mechanism (in 6 cases according to D. Skinner, in 23 according to an original technique). Non-invagination valvular device according to the authors' technique was used in the other 6 patients (group 3). In postoperative period 3 patients died. A mean follow-up lasted 18 months. With time, the reservoir volume increased with a parallel fall in pressure. Anatomical conditions of the kidneys compared to the baseline conditions have improved, reflux pyelonephritis was absent. Adequate valvular function recovered in group 3. Rejection of invagination valves diminishes the duration of the surgery, makes the operative procedure easier. Introduction of the original non-invagination valvular device proves to reliable sealing and easy catheterization of the reservoir.
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PMID:[A detubularized reservoir for the urine made from the small intestine]. 857 85

Renal metastases from solid tumors to both kidneys rarely result in acute renal failure (ARF). We present a case of squamous cell pulmonary carcinoma responsible for ARF due to (1) extensive (50% to 75%) bilateral parenchymal infiltration and replacement accompanied by tissue destruction, (2) widespread vascular invasion and thrombosis resulting in ischemia, and (3) histological evidence for foci of distal intratubular obstruction and pyelonephritis. Five additional cases, including one pulmonary cancer, causing ARF from extensive tissue replacement and destruction are reviewed. In a separate case, ARF resulted from lymphatic metastases rather than from parenchymal destruction or obstruction. Common findings in all six reported cases include bilaterally enlarged kidneys and progressive oligoanuria despite correction of prerenal or postrenal conditions. In our patient and in one other prior reported case, extrarenal obstruction was not considered important because invasive therapeutic procedures were unsuccessful in reversing ARF. In one case, irradiation of kidney tumor resulted in reversal of ARF. These cases emphasize the rare potential for solid tumors to metastasize to both kidneys and result in irreversible oligoanuric ARF. A high level of suspicion is required, and an early diagnosis may result in reversible ARF if the tumor is amenable to chemotherapy or irradiation.
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PMID:Acute renal failure secondary to solid tumor renal metastases: case report and review of the literature. 865 8

Surgical aid in acute hemorrhage due to cancer of the urinary bladder was rendered within 1986-1994 to 65 patients (53 males and 12 females) aged 30-50, 51-60, 61-70 and over 70 years (10, 11, 24 and 20 cases, respectively). The majority had the disease stage T2 and T3. In 42 (64.6%) patients with profuse hematuria complicated by bladder tamponade an urgent resection was performed: segmental in 22, hemiresection in 8, open bladder electroexcision of the tumor in 10 patients. 2 patients had sigmoid cancer with bladder involvement managed by subtotal resection of the bladder and resection of the sigmoid colon. Nephro- or cystostomy was performed because of grave condition (purulent pyelonephritis, azotemia) in 23 patients (35.4%). Total postoperative lethal outcomes made up 33.3% (14 patients): 6 patients died early after surgery, 8 patients 6 months to 8 years later. 27 patients (64.3%) are alive. Of them 10 are 5-8-year survivors. These patients had cancer stage T2 and T3 with tumor location on the lateral wall. In three 4-year survivors there were tumor recurrences 2 and 3 years after surgery which were treated by transurethral resection and electroexcision on the open bladder. Long-term outcomes of urgent surgery show that different kinds of resection of the bladder may be effective in the treatment of acute hemorrhages from bladder tumors.
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PMID:[The late results of organ-preserving operations in acute hemorrhages in patients with bladder cancer]. 867 44

Xanthogranulomatous pyelonephritis (XGP) is a specific form of chronic inflammatory kidney disease which may involve both sexes at any age. The disease presents either in the diffuse form or less commonly as a focal process which is almost impossible to differentiate from renal malignancy. XGP usually occurs in association with urinary tract obstruction, infection and/or renal stones. Symptoms are often vague and non-specific. The most common offending organisms are E. coli and Proteus mirabilis. In reviewing the literature we have found 197 cases in children during the last thirty years, and of these only 15 (7.6%) were of the focal form. A case of focal xanthogranulomatous pyelonephritis in a 6-year-old boy is reported which demonstrates the diagnostic difficulties encountered in this disease. We emphasize the importance of XGP in the differential diagnosis of renal tumours in children with recurrent or therapy-resistant urinary tract infection in spite of no evidence of renal stone, poorly or absent function in the kidney or urinary tract obstruction.
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PMID:Focal xanthogranulomatous pyelonephritis presenting as renal tumour in children. Case report with a review of the literature. 883 58

Mucinous cystadenoma with malignant transformation occupying the lower half portion of the right renal pelvis in a 69-year-old Japanese man was recorded. The patient had recent dysuria but no clinical history of pyelonephritis or urolithiasis. Under the clinical diagnosis of unusual renal cyst, the right total nephrectomy was performed. Grossly, the cystic tumor, 5 cm across, formed a monolocular lumen filled with mucins and showed no direct communication with the renal pelvis inside. Microscopically, the epithelial lining was characterized by a single layer of benign mucin producing columnar cells that scattered foci of non-invasive papillary projections with cell stratification and nuclear atypia suggestive of malignancy. Although there was non-specific chronic pyelitis, no pyelitis cystica et glandularis was encountered. Of circa 60 glandular neoplasms arising in the renal pelvis reported previously, adenomas are only five including two mucinous cystadenomas, while the remainder are adenocarcinomas. The histological findings of mucinous cystadenoma in the present case may represent the process of a transition from adenoma to adenocarcinoma. The result suggests the possibility that adenoma-carcinoma sequence may exist among the glandular neoplasma arising in the renal pelvis. The histogenesis was unclarified.
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PMID:Mucinous cystadenoma with malignant transformation arising in the renal pelvis. 908 36


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