Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

I.v. urography is often insufficient for visualization of the intramural and juxtavesical portion of the ureter. In 30 consecutive patients (July 1st 1993-January 31st 1994) where i.v. urography was inconclusive, but had evoked suspicion of pathology in--or adjacent to--the lower ureter, abdominal ultrasound (including color Doppler) and endoluminal (transrectal or -vaginal) ultrasound were performed. A final diagnosis was obtained in 26: Ureteric stone (14), prostatic cancer (4), bladder cancer (2), stricture of ureteric orifice (1), TURB sequelae (1), ureterocele (1), bladder stone (1), detrusor hypertrophy (1), normal ureter (1). Abdominal ultrasound scanning gave more, same, and less information than i.v. urography in 8, 8, and 10 cases, respectively. In 14 of 22 cases abdominal color Doppler revealed a unilateral abnormal "ureteral jet"--in 13 of the cases on the side with suspected obstruction. Endoluminal ultrasound scanning gave more, same, and less information than i.v. urography in 20, 4, and 2 cases, respectively. The 20 cases where endoscanning gave more information included detection of 14 distal ureteric stones. In 3 cases it identified other types of distal obstruction, in two cases it determined the length of cancer obstruction and in one it detected the presence of ureteral dilatation. It is concluded, that endoluminal ultrasound of the ureter is indicated when i.v. urography evokes suspicion of pathology in the intramural or juxtavesical part of the ureter.
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PMID:Transabdominal and endoluminal ultrasonic scanning of the lower ureter. 793 50

A 49-year-old male with left renal cell carcinoma and urothelial cancer (bladder and residual left ureter), which asynchronously occurred, was reported. He had received radical nephrectomy due to renal cell carcinoma 12 years earlier. He was followed up by his local physician for 7 years postoperatively, during which time no metastatic lesion was detected. However, he presented with macroscopic hematuria on January 7, 1992, and a diagnosis of urinary bladder cancer was made at our hospital. Computerized tomography demonstrated a non-papillary, broad-based tumor on the left wall of the urinary bladder, which histologically was transitional cell carcinoma (grade 3). Radical cystectomy, ureterectomy of the left residual ureter and ileal conduit were performed. Histological examinations showed that the urinary bladder tumor was transitional cell carcinoma, grade 3, pT-3b, and CIS (transitional cell carcinoma, grade 3) was found in the residual left ureter. Chemotherapy containing cis-platinum was performed as an adjuvant therapy, but multiple lung metastatic lesions appeared 2 months postoperatively, the histology of which was transitional cell carcinoma, suggesting metastasis from the urothelial cancer. Chemotherapy was ineffective, and he died of the disease 9 months after the operation. If this patient had been under long-term follow-up, the urothelial cancer may have been resected completely by transurethral resection. Our report indicated the importance of examination of the urinary tract in patients with such cancers, as well as the necessity of long-term follow-up.
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PMID:[A case of asynchronous renal cell carcinoma and urothelial cancer of the urinary bladder and left ureter]. 826 57

Temporal trends in the incidence of cancer of the renal parenchyma, renal pelvis, ureter, bladder, urethra and Wilm's tumor in the period 1943-88 were described. Log-linear Poisson models were used to estimate the changes over time and the geographical variations. We have found a steep increase in the incidence of pelvis and ureter cancer; and to some extent also for bladder cancer in men. The incidence of cancer of the renal parenchyma has increased more moderately while the rates of Wilm's tumor have been virtually stable throughout the period. These findings suggest that tumors in the urinary system differ with respect to risk factors and should be grouped by their histological origin as well as topographical site.
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PMID:Trends in the incidence of cancer of the kidney, pelvis, ureter and bladder in Denmark 1943-88. 829 Sep 11

The neurofibromatosis type 1 (NF1) gene is considered a tumor-suppressor gene whose product acts upstream of ras. The ras gene is an oncogene very commonly detected in human cancers and consists of three families, H-ras, K-ras and N-ras. These genes are converted to active oncogenes by point mutations in codon 12, 13, or 61. Examination was made of the mutations of these genes in 39 urothelial malignant tumors (31 bladder cancer, 6 renal pelvic tumor, and 2 ureter tumors) using polymerase chain reaction single-stranded conformation polymorphism and direct sequencing methods. Three of 39 (7.7%) cases showed mobility shifts in the ras family gene but no point mutations in NF1 and N-ras genes could be detected. Mutations were found in 1 case in H-ras at codon 13 (GGT-GTT/GGT) and K-ras at codon 12 in 2 cases (GGT-GCT/GGT, GGT-GTT/GGT). All 3 cases had progressed far beyond grade 2 and stage pT2. It follows from the above that NF1 and ras gene mutations are infrequent in the pathogenesis of urothelial tumors.
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PMID:Infrequent involvement of mutations on neurofibromatosis type 1, H-ras, K-ras and N-ras in urothelial tumors. 853 97

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

A self-catheterizable continent urinary reservoir has become one of the major options for urinary diversion in patients with invasive bladder cancer or other pelvic malignancies. We performed the Kock pouch, the Indiana pouch and the appendiceal Mainz pouch in 124, 51 and 4 patients with the mean followup periods of 50, 33, and 10 months, respectively. In the Kock pouch, the efferent and afferent nipple valve malfunction was seen in 16.7 and 21.3 percent each, requiring repair surgery, such as fixation of the efferent nipple to the pouch wall, reconstruction of an isoperistaltic nipple valve in the former, and removal of the Dacron fabric collar or re-anastomosis of the ureter to the pouch using LeDuc technique in the latter. In the Indiana pouch, stomal stenosis, an hourglass-like pouch deformity, difficult catheterization occurred in 3, 2 and 2 patients, respectively. Among the 4 patients with the appendiceal Mainz pouch, there were no major late postoperative complications except for mild stenosis of the conduit, handled with bougienage. As a whole, surgical revisions, related to urinary diversion, was done in 20.3, 10.6, 0 percent in the Kock, Indiana, Mainz pouch patients, respectively. Stone formation, mostly multiple and recurrent, occurred in 27.8, 6.4, 0 percent in the Kock, Indiana, Mainz pouch, respectively. Most of the stones were removed endoscopically via a stoma or by percutaneous approach. Acidosis was seen in 3 patients in both the Kock and Indiana pouch, and 3 patients with the Kock pouch suffered from symptomatic choleithiasis. At the time of the latest observation, continence was achieved in 90.2, 93.0, and 100 percent, whereas excretory urograms showed normal collecting systems in 64.5, 90.4, and 100 percent in the Kock, Indiana, and Mainz pouch, respectively. In conclusion, the Kock pouch, performed by an original method using unabsorbable polyester fabric collars and metallic staples, has an intolerably high rate of late complications, and either the modified Indiana pouch with ileal patch or the appendiceal Mainz pouch using the umbilicus as a stoma is recommended for a self-catheterization continent urinary diversion.
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PMID:[Postoperative complications of self-catheterizable continent urinary diversions (Kock, Indiana, and appendiceal Mainz pouch) and patient care]. 853 3

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible.
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PMID:Our experience with the Mainz pouch II: 40 patients; follow-up and complications. 855 96

The years following the first laparoscopic nephrectomy in man performed in 1990 were evidencing wide spread of transabdominal laparoscopic approach in operative interventions on the kidney, adrenals, ureter, urinary bladder, in iliac lymphadenectomy for prostatic and bladder cancer, in the treatment of varicocele, etc. Since 1993 we have made 4 nephrectomies using laparoscopic approach. The first operation in a 18-year-old male with parenchymatous hypertension lasted 7 hours, the following operations took from 2 hours 47 min to 1 hour 30 min. No complications occurred. Postoperative stay in hospital was, on the average, 7.2 days. The laparoscopic approach in urology and surgical nephrology of adults and children needs detailed studies, specification of indications and contraindications prior to its introduction into wide practice.
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PMID:[Laparoscopic nephrectomy in a patient with a parenchymatous form of nephrogenic hypertension]. 867 60

We reviewed 45 cases of transitional cell carcinoma of the renal pelvis and ureter with reference to the coexistence or subsequent development of bladder cancer. Bladder cancer was associated with an upper urinary tract neoplasm in 26 of the 45 cases. The 5-year survival rate for coexistence of bladder cancer was 56% and that for subsequent bladder cancer was 65.6%. The 5-year survival rate for 19 cases unrelated with bladder cancer was 46.7%. Therefore, there was no significant difference among the three groups. As to degree of the malignancy of the renal pelvis and ureter, the 5-year survival rate was 73.7% for G1 and G2 and 26.2% for G3. As to the depth of invasion, of the renal pelvis and ureter the 5-year survival rate was 71.8% and 31.1% in the patients with stage of T1, T2 and T3, T4. The prognosis of cancer of the upper urinary tract depended on the degree of the malignancy, and the depth of invasion. Ninety two percent of subsequent bladder cancer was detected within 2 years after resection of the primary cancer.
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PMID:[A clinical study of renal pelvic and ureteral cancer associated with bladder cancer]. 871 94

Urethral bladder substitution is traditionally suggested to good prognosis cystectomized patients. In our series this diversion was chosen for all but the salvage cystectomized men. Between the 1st of February 1991 and the 30th of April 1996, one hundred consecutive men underwent lower urinary tract reconstruction after radical cystoprostatectomy for bladder cancer. An orthotopic ileal neobladder was constructed (in 84 cases according to Kock's technique and in 16 to Studer's technique). Total early complication rate was 29% (29/100), including one perioperative death due to sepsis (mortality rate 1%). 13 patients required surgery (6 retroperitoneal hematomas, 2 wound dehiscences, 1 urinary fistula, 1 lymphocele, 1 rectal-neobladder fistula, 1 rectal-cutaneous fistula, 1 necrosis of the terminal ureter). The late complication rate was 19% (19/100); in 8 cases reparative surgery was required (1 mechanical ileus, 2 bladder neck stenoses, 3 stenoses of the ureteral anastomosis, 2 laparoceles). Four patients were lost at the follow-up; out of the 96 remaining patients only 85 were evaluable for continence: continence during the day was achieved in a period between there to six months in 78 patients (91.7%); night continence was achieved with planned awakenings in 60 patients (70.5%). Eight patients recovered potency, another 7 had successful intercourses after PGE1 intracavernous injection. Renal function based on creatinine value was mildly impaired in 5/78 evaluable patients (6.4%) (peak creatinine 2.8 mg%). In 29 patients tumour progression was observed (29%): 9 pelvic and 20 metastatic. Among the latter 2 urethral recurrences were observed (2%). Twenty-four patients died for metastatic cancer, one for primitive lung cancer, one patient for postoperative septic shock. Adjuvant chemotherapy was administered in 11 patients without complication with an indwelling catheter in the neobladder to avoid drug reabsorption. Four patients showed complete response (2 are alive after a mean of 12 months), 6 were non responders and 1 had a partial response. In our series the ileal neobladder is a feasible method of urinary diversion when urethral cancer involvement is ruled out. Early and late complications are proportionally decreasing with experience and overall continence is satisfactory. The fate of the neobladder depends on both the technique and patient's compliance. Only educated patients can cope successfully with neobladder diversion without major complications. All the patients operated for non salvage cystectomy deserve to be diverted with a continent urethral bladder substitution.
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PMID:[100 orthotopic neobladders in men after cystectomy: a 5-year experience]. 902 35


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