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Bladder tumor is a disease of older persons, but can also occur in young adults, because certainly an influence of environmental factors and a change of lifestyle. The aim of our retrospective analysis is to assess and evaluate the extent of the prognostic impact of age on the carcinological prognosis of invasive-muscle-bladder cancer treated by total cystotomy.To evaluate the association of patient age with pathological characteristics and recurrence-free and disease survival, we retrospectively reviewed 345 patients with invasive bladder cancer between January 2000 and January 2015.We divided our patients into two groups: patients under 65 years of age=150 cases (group 1), patients aged 65 years and over=195 cases (group 2). The 3-year survival rates for patients according to the age groups were 88% and 64% respectively, end the recurrence-free survival 66% and 28%. When age was analysed as a categorical variable, was associated with hydronephrosis (P=0.001), advanced pathological stage (P=0.034), high grade (P=0.026), nodal involvement (P=0.011) and lymphovascular invasion (P=0.008). The multivariate Cox model analysis showed that hydronephrosis and pathological stage was prognostic factors of survival (P=0.012 and P=0.035, respectively). Higher age is significantly associated with the risk of pathologically advanced disease and poorer global survival.This work allowed us to assert that advanced chronological age is significantly associated with an advanced pathological stage of the disease (volume, pT, grade, lymph nodes) and a low overall survival rate. This could be useful for selecting subjects who would require adjuvant therapy, as well as for planning early complementary therapies.3.

Inflammatory pseudotumors are benign neoplasms associated with local or general manifestations. Renal localisation seems exceptional, the etiology is unknown. The article raises the question of the problem in establishing a preoperative definitive diagnosis, as a correct diagnosis is often only confirmed following nephrectomy.

Renal oncocytoma represents a rare benign tumor accounted for 3-5% of renal neoplasms. It has been mistaken for and mistabled as granular or dark cell carcinoma. Between 1993 and 1998, 3 women with renal oncocytoma were recognized at formation and underwent radical nephrectomy. Sonography and the CT scan was performed but the Accurate diagnosis was not possible before performing surgery and histologic investigations. The mean Follow-up of 3 patients was 48 month and showed a benign clinical behaviour in all cases.

This rare but aggressive bladder tumour presents the morphological and immunohistochemical characteristic common to all neuro-endocrine tumours observed in other organs. The authors report a case of primarymalignant neuro-endocrine bladder tumour. Combined surgery-cisplatin-based adjuvant chematherapy is recommended.

Extra-corporeal Shock Wave Lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbers of ESWL, more patients prone to infectious complications. A 62-year-old man presented with cerebral abscess following ESWL. The authors discuss presenting conditions, risk factors and preventive measures.

The authors present two cases of verrucous carcinomas on Buschke-Lowenstein tumor. The Buschke-Lowenstein tumor is an epithelial sexually transmissible benign tumor of viral origin. Under the influence of oncogenic papillomavirus types 16 and 18 it can become malignant tumor which relations with the verrucous carcinoma, tumor with low grade and essentially local malignancy are still discussed. This evolution follows the alteration by a viral protein of the functions of the tumor suppressor protein P 53. The surgery remains the reference treatment although there is a possibility of frequent recurrences. Radiation therapy and chemotherapy were suggested as adjuvant treatments for the complicated sorts.

We reviewed our experience in managing anterior urethral traumatic rupture.Between January 1986 and December 1998 a total of 23 consecutive male patients with anterior urethral trauma were studied prospectively, including a clinical and radiographic of the pelvis examination, excretory urography and retrograde urethrography. The average patient age was 29 years (range 19 and 65 years). The mechanism of injury was represented by the blunt perineal trauma in 17 cases and the cavernous body rupture in six cases. Clinical manifestations are dominated by the urethrorragia (19 cases), urinary retention (16 cases), perineal hematoma (14 cases). Radiological imaging have shown a pelvic fracture (six cases), urethral rupture (17 cases) and bladder rupture (three cases). Therapeutic procedure realized in emergency in six patients having a cavernous body lesion and delayed repair in 17 other patients.The outcame was favorable in 12 patients and recurrence stenosis has occurred in 11 patients who are corrected by optical urethrotomy (four cases), end-to-end anastomosis (two cases), B. Johanson urethroplasty (three cases) urethroplasty by penile skin (one case), dilations (one case).Suprapubic cystostomy with healing control of the partial ruptures, delayed end-to-end anastomosis for total ruptures and immediate reparation of the urethral rupture when associated with a penile fracture are even the best warrant of a correct functional recovery.

The authors report a series of 13 horseshoe kidneys observed over a 22-year period. All patients are men with a mean age of 39 years (20-65 years). The clinical features were dominated by abdomino-lumbar pain (nine cases). The horseshoe kidney was associated with renal stones in nine cases, uretero-pelvic junction syndrome in five cases and pyonephrosis in one case. The specific anatomic and surgical features of this rare malformation are emphasized and the therapeutic features of each uropathy associated with horseshoe kidney are discussed.

The authors report the case of a 45-year-old patient who presented with a left latero-aortic paraganglioma associated with gastric schwannosarcoma. Treatment consisted of resection of the chromaffin tumour and the gastric tumour, with a favourable course at last follow-up. The authors review the literature on this subject.

Spontaneous subcapsular haematoma (SCH) of the kidney is a rare condition, secondary to kidney tumours in more than 50% of cases. Nephrectomy is justified in the presence of tumour or uncontrolled haemorrhage. When the aetiology cannot be determined, thin-slice CT follow-up of the patient's kidney can be performed. The authors report 5 cases of SCH of the kidney. A retropelvic aneurysm was responsible for the haematoma in one case; polyarteritis nodosa was the cause of bleeding in another case and the aetiology could not be determined in two cases. All patients were managed surgically. Nephrectomy was performed in 3 cases and simple evacuation of the haematoma was performed in 2 cases.

To evaluate the results obtained by rigid ureteroscopy to treat ureteral calculi.Between May 1998 and September 2000, 63 patients underwent 67 rigid ureteroscopies (URS) with three endoscopic retreatments and one bilateral URS, for 48 distal, ten mid and nine proximal ureteral calculi.After URS 77.6% of the patients were free of the stones. Success rate was respectively 85.4%, 60% and 55.5% in distal, mid and proximal uretero. Morbidity was 10.4% and there have been one stricture treated by endoscopy.Our series demonstrates that rigid URS is safe and effective procedure to treat distal, ureteral calculi. Thus, it should be considered a treatment of choice for distal ureteral calculi.

The authors report a case of sarcomatoid carcinoma of the prostate in a 49-year-old patient. The clinical symptoms were dominated by dysuria and frequency. Digital rectal examination showed a very large, hard and irregular prostate. Serum PSA was normal. Transrectal ultrasonography and abdominopelvic computed tomography showed a heterogeneous mass occupying the vesico-prostatic junction. The patient underwent cystoprostatectomy. Histological examination of the cystoprostatectomy specimen revealed a tumour composed of spindle cells expressing epithelial markers on immunohistochemical analysis and concluded on a diagnosis of sarcomatoid carcinoma of the prostate. The patient died seven months after cystoprostatectomy.

Hemangiopericytomas are a rare vascular tumours that are derived from Zimmermann pericytes. Retroperitoneal hemangiopericytoma is usually bulky, clinical silent, and malignant. We present a 48 years old man, with compressive symptoms and a painless mass due to a giant retroperitoneal hemangiopericytoma weighing 3 kg. We are prompted to present this case as it is believed to be the largest hemangiopericytoma reported to date.

We report three cases of retroperitoneal liposarcoma. Two patients required multiple surgical excisions for locoregional relapse diagnosed by surveillance based on CT-scan. One patient had radiotherapy. With the literature review we discuss the pathologic and therapeutic aspects of these lesions.

Analysis of the treatment of a series of patients with adrenal cortical carcinoma.This series consists of 22 patients (15 women and 7 men) with a mean age of 35 years (range: 23 to 58 years). 55% of patients had a non-secreting tumour; 45% of tumours were associated with excessive hormonal secretion. The tumour was located on the right side in 12 cases and on the left side in 11 cases (the tumour was bilateral in 1 case). Ultrasound and CT were sufficient for localization of the tumour. The patients were classified as stage I: 3 cases, stage II: 2 cases, stage III.: 8 cases, stage IV: 9 cases, according to MacFarlane's classification.Adrenalectomy was performed in 18 patients. Two patients died during the operation and another 8 died within the first four years. Eight patients are currently alive, including 7 with no signs of recurrence; one patient presented a large local recurrence 39 months after adrenalectomy.Surgery remains the only effective treatment at the present time. The diagnosis of adrenal cortical carcinoma must be made as early as possible.

Emphysematous pyelonephritis is rare. It is exceptionally associated with urolithiasis with obstruction of the collecting system. It is generally observed in female diabetic patients. It is caused by gas-producing bacteria. We report a case in which emphysematous pyelonephritis was caused by an acinetobacter, associated with pelvic ureteral junction lithiasis. Drainage and nephrectomy were necessary to overcome this life threatening situation.

The authors analyse of a series of 26 patients (17 females and 9 males) with a mean age of 32 years (range: 18 to 55 years) operated for adrenal phaeochromocytoma. All patients were hypertensive. The laboratory assessment (assay of blood catecholamines and urinary catecholamine metabolites) performed in more than 2/3 of cases confirmed the diagnosis in more than 80% of cases. The topographic diagnosis was facilitated by computed tomography. Fifteen patients received preoperative treatment with alpha-blockers or calcium channel blockers. Various incisions were used, but a lumbar incision was the most frequent. Blood pressure was controlled postoperatively in 24 patients. Two patients died 1 and 2 postoperatively. New diagnostic modalities (CT, MRI) have facilitated the diagnosis and the site of localization of phaeochromocytomas, thereby improving the choice of incision. Patient-specific preoperative preparation and appropriate anaesthesia facilitate successful adrenal gland surgery.

The authors report a case of renal metastasis from a thyroid adenocarcinoma in a 56-year-old man, occurring 3 years after isthmolobectomy for papillary thyroid carcinoma. He predominant clinical symptoms were low back pain, haematuria and deterioration of the general state. Ultrasonography showed a hypoechoic left renal mass, 56 mm in diameter, with a thickened wall. Renal CT showed a homogeneous low-density formation with a thickened wall in the left kidney. Iodine 131 whole body scan showed increased uptake in the left kidney. The patient wes treated surgically via a subcostal incision. The surgical procedure consisted of radical nephrectomy. Macroscopic examination of the lesion showed a cystic mass. Histological examination of the mass revealed a renal metastasis from moderately differentiated thyroid adenocarcinoma.

The 77 cases of sinusitis seen in 72 patients admitted to the Briançon Hospital between January 1, 1993, and June 30, 1996, were studied. One or both maxillary sinuses were involved in 96.8% of cases. Sinus aspiration was done in 95 cases. All aspirates were subjected to microbiological studies. Of the 45 aspirates that yielded positive cultures, 36 grew one or more pathogenic organisms. The most commonly isolated bacteria were Pseudomonas aeruginosa (n = 7), Streptococcus pneumoniae (n = 5), and Haemophilus influenzae (n = 5). Nosocomial sinusitis defined on a set of criteria including hospital stay duration at onset and an acute tempo of evolution contributed 32.5% of cases overall, 55.2% in the intensive care unit and 18.7% in all other departments combined. Nosocomial cases in the intensive care unit were associated with well-known risk factors, namely tracheal intubation with ventilation and presence of a nasogastric tube. Other study criteria included the type of organism recovered by culture and whether patients ventilated via a tracheal tube had the same organism in their sinus and tracheal tube aspirates. Some nonintensive care patients had none of the known risk factors for sinusitis; prompt diagnosis and treatment of these cases of sinusitis is important to avoid infectious complications, which are, however, less common than in intensive care patients.

Percutaneous pulmonary valvulotomy is the treatment of choice for isolated congenital pulmonary valvular stenosis in childhood. However, experience of this procedure in the adult is much more limited. Between January 1984 and December 1994, 34 patients with severe or moderate pulmonary valvular stenosis underwent percutaneous transluminal valvuloplasty. The age of the patients ranged from 20 to 47 years (mean 22 +/- 4 years). Cardiac catheterisation was performed using the femoral vein in 27 cases and the internal jugular vein in 7 cases. Success was obtained in 28 patients (81% of cases). Pulmonary artery-right ventricular pressure gradient decreased from 113 +/- 35 to 32 +/- 13 mmHg (p0.001) after valvuloplasty with one or two balloon catheters. The tolerance of transluminal valvuloplasty was generally good. The poor results were explained by cases of dysplasic valves or of infundibular reactions. There was one death which occurred 24 hours after the procedure. Clinical and echocardiographic follow-up was obtained in 20 patients, 3 to 36 months after valvuloplasty (average: 23 +/- 13 months). No cases of restenosis were observed. Percutaneous transluminal pulmonary valvuloplasty in the adult is feasible and gives good results which are maintained at medium-term; it has become the treatment of choice of valvular pulmonary stenosis and gives good results which are maintained at medium-term, thereby avoiding surgical valvulotomy.

Forty-five patients who had suffered from anterior myocardial infarction were examined by echocardiography in the M regimen and ECG recorded from 35 precordial leads. According to the extensiveness of the postinfarction scar, the patients were divided into 3 groups. The results of the examination showed that the value of the Q index (the number of leads with an abnormal Q wave) correlates with the clinical signs of circulatory insufficiency, the values of the systole and diastole phase analysis has a positive correlative connection with the end-diastolic volume of the left ventricle and the value of mitral-septal separation, but does not correlate with such values as the ejection fraction, the rate of circulatory shortening of the myocardial fibers and the degree of shortening of the left-ventricular small axis, which are calculated from the echocardiogram in the M regimen.

A total of 54 myocardial infarction survivors and 20 normal subjects were examined echo- and polycardiographically. The movement of left ventricular wall was studied within and outside the affected area. A hypokinetic zone was identified in all the patients after the posterior myocardial infarction. The measurement of posterior wall movement amplitude before expulsion is over improves the chances of echocardiographic identification of the hypokinetic zone in patients with lower localization of myocardial infarction. Apart from reduced amplitude and rate of contraction, and myocardial thinning, the hypokinetic zone reveals paradoxical myocardial thickening during the early diastole, and shorter duration of affected area relaxation, while intact myocardium relaxes early. It is suggested that disorders relaxation in myocardial infarction survivors precedes contraction disorders, with hypokinetic myocardium relaxing mostly passively, and intact myocardium relaxation being of a more active nature and independent of the filling phase.