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We report 12 cases of lymphomas which occurred among 1670 patients with kidney or combined renal and pancreatic transplantation. Group 1 comprised nine patients presenting with the diffuse form of the disease where immunoblasts or mature plasma cells massively infiltrated all organs. The first symptom was a viral syndrome, associated with a restriction of heterogeneity of immunoglobulins; oligoclonal to monoclonal peaks of immunoglobulins appeared about 50 days after transplantation. All patients received antilymphocyte globulins (ALG), and seven were treated with cyclosporin. EBV infection could be demonstrated in almost all patients; three EBV lymphoblastoïd cell lines were established, their HLA phenotype being the same as the recipient of the graft. All patients finally died with renal and hepatic failure. Group 2 comprises three patients who presented solid B cell tumours of tonsils, lungs, and spleen at onset, extending to liver, kidney graft, lymph nodes, and brain. All received cyclosporin; two patients were treated with ALG, and one with OKT3. Immunoglobulins were polyclonal, oligoclonal, or decreased. Cell surface immunoglobulins were monoclonal on two tumours. EBV-DNA was positive within two tumours. Two patients presented EBV and CMV primary infection. CD4+T lymphocytes subsets were diminished at onset, and increased after cessation of immunosuppressive therapy. One patient died because of brain involvement; the two others are alive, one with perfect graft function. Therapy consisted of stopping immunosuppressive treatment, Acyclovir, and in two patients of group 2, monoclonal antibodies to pan-B and EBV receptor antigens. [ABSTRACT FROM PUBLISHER]

The hardness and frequent recurrence of cystine stones present a special challenge to the urologist. In this study, 15 cystinuric patients (11 males, 4 females; mean age 36 years, range 17-54) were treated and followed up over a period of 30 months (range 2-40). Most patients had a previous history of open surgery. The diagnosis of cystinuria was confirmed by metabolic studies and infrared spectrometry of stones. Over the follow-up period recurrence was observed in 23 instances in 11 patients, leading to 38 'stone treatments' on 74 cystine stones. The percutaneous approach was used alone in 9 cases and in association with extracorporeal shock wave lithotripsy (ESWL) in 9 cases. ESWL was used alone in 18 cases. Medical treatment included high fluid intake, alkalinisation and Thiola (tiopronin, N-(2-mercaptopropionyl)glycine) in 6 patients. The overall stone-free rate assessed 3 months after treatment was 44.7%, which compares poorly with the rate for non-cystine stones. The recurrence rate is very high and instrumental treatment should not therefore be used excessively; it is indicated only for stones that are symptomatic or refractory to intensive medical therapy. [ABSTRACT FROM AUTHOR]

- Two patients in end-stage renal failure and with neurogenic bladders due to spina bifida complicated by myelomeningocele were considered for renal transplantation. One patient had had a right nephrectomy and urinary diversion via an ileal conduit; the other, after various external drainage procedures (cystostomy, bilateral nephrostomy), had had a tubular ileocystoplasty. Both underwent 2 surgical procedures prior to renal transplantation: in case 1 we performed a left nephrectomy and then ileal conduit removal + Kock pouch; in case 2 a bilateral nephrectomy was performed via 2 posterior incisions and then we removed the ileocystoplasty and formed the pouch. The continent ileostomy was formed according to the original technique with slight modifications. The patients have been followed up for 12 and 15 months after transplantation. [ABSTRACT FROM AUTHOR]

- A miniature high frequency 10 MHz transurethral ultrasonography probe has been developed which is adaptable to any standard 17 F cystoscope sheath. High frequency contributed to a definite improvement in image resolution but did not allow distinct visualisation of different bladder wall layers. An 80% correlation between ultrasonographic and pathological staging was established after evaluation of 50 consecutive patients with newly diagnosed bladder tumours. Ta/T1 tumours tended to be overstaged with ultrasound. In some patients, the response to conservative treatment (external beam radiation therapy) of deeply infiltrating tumours could be assessed with the miniature probe on an out-patient basis. [ABSTRACT FROM AUTHOR]

- Twenty-six patients with an elevated recurrence rate of stage O or A bladder tumours were treated prophylactically after transurethral resection (TUR) with short-term intravesical instillations of mitomycin C in a non-randomised study. The data before intravesical chemotherapy (IVC) were taken as the internal control for each patient. Mitomycin C was administered in one course of 10 daily doses of 40 rng, starting 24 to 48 hours after TUR. The average follow-up was 13.9 months before and 28.5 months after IVC. Before IVC, the average number of recurrences was 2.6, with an average recurrence rate of 1 every 5.3 months. After IVC there was no tumour recurrence in 4 patients, with a mean of 12.2 months' follow-up, but there was tumour recurrence in 22 patients. For 17 patients (77%) the free interval averaged 2.3 times longer than the mean interval of recurrence before IVC and for 18 patients (82%) the recurrence rate averaged 3.3 times less than the recurrence rate before IVC. [ABSTRACT FROM AUTHOR]

A study was conducted of the circadian hormonal and metabolic patterns of 10 type I (insulin dependent) uraemic diabetic patients after pancreas and renal transplantation. A single 24 hour profile was obtained in each patient following as closely as possible his or her normal daily routine two to 15 months after transplantation. None of the patients were using insulin at the time of the study. Compared with a group of six normal subjects the transplant recipients had mildly raised blood glucose concentrations, hyperinsulinaemia between meals and at night, delayed postprandial insulin peaks, mild hyperketonaemia, and normal blood lactate and plasma glucagon concentrations. The findings showed that successful pancreas transplantation results in disappearance of the need for insulin and return to normal or near normal of the metabolic abnormalities of diabetes. The minor differences observed in comparison with normal hormonal and metabolic homoeostasis were probably due to intrinsic (reduced islet mass, denervation, peripheral hormone delivery) and environmental (immunosuppression, relatively impaired renal function) factors. [ABSTRACT FROM PUBLISHER]

Nephrotoxic serum nephritis as a potential effect of the administration of hetero- logous anti-lymphocyte serum was investigated in dogs. Horse anti-dog lymphocyte serum, prepared using lymph node cells, was demonstrated by immuno-fluorescent techniques to possess both in-vitro and in-vivo anti-glomerular antibody activity. Experiments were designed to eliminate as far as possible conditions which would allow a serum sickness type of nephritis to develop, while permitting expression of the putative anti-glomerular antibody activity. While none of the animals receiving anti-lymphocyte serum either subcutaneously or intravenously showed clinical evidence of glomerular injury, in some cases early histological changes were apparent and the reasons for their non-progressive nature are discussed. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on the results of bone marrow infusion associated with a facial transplantation.

- Twenty-one patients underwent endoscopic subureteric injection of Polytef paste for the correction of secondary vesicoureteric reflux (VUR) in transplanted kidneys. Ureteroneocystotomy was performed in renal transplants using an extravesical technique in 19 patients and the Leadbetter-Politano technique in 2 cases. Success was achieved in only 6 patients, including the 2 ureters reimplanted according to the Leadbetter-Politano technique. No significant complication relating to the technique was observed. Despite the low success rate (30%), endoscopic treatment of VUR in transplanted kidneys is justified as a first attempt in view of the morbidity of VUR and the difficulties of repeated surgical reimplantation in this population. [ABSTRACT FROM AUTHOR]

A correction to the article "Allogeneic donor bone marrow cells recovery and infusion after allogeneic face transplantation from the same donor" that was published in the 2008 issue is presented.

Serum PSA level is associated with peri operative and pathological prognostic indicators. Although there is a statistically significant relationship between serum PSA level and tumour extent, in cases of the same tumour volume or grade, serum PSA levels range from less than 4 ng/ml to more than 10 ng/ml. Previous immuno histochemical studies from human prostate cancer samples have failed to explain the variability of PSA production. The objective of our study was to assess the relationship between the level of tissue PSA RNA from normal and prostate cancer biopsies and the level of PSA. [ABSTRACT FROM AUTHOR]