Objective  To find a means of bladder augmentation that would avoid the complications encountered with the use of bowel segments, using a newly developed acellular biomaterial, the bladder acellular matrix graft (BAMG), as a homologous graft. Materials and methods  Thirty‐four rats underwent a partial cystectomy (40–50%) and grafting with a BAMG of equal size. Eleven rats died within the first 72 h, probably from urinary leakage caused by obstruction of the bladder neck with stones or coagula; the surviving 23 were killed at varying intervals after cystectomy and examined. Results  After providing initial bladder enlargement, the graft was progressively infiltrated by the vessels and smooth muscle cells of the host; furthermore, the mucosal lining was complete within 10 days. After 4 weeks, all bladder wall components were evident histologically in the graft. The ingrowth was complete after 8 weeks, except for neural regeneration, which was only partial. At 12 weeks, the bladder wall muscle structure in the graft was so well developed that it was difficult to delineate the junction between host bladder and BAMG. Neural regeneration continued to improve. Normal bladder capacities were maintained throughout the study. Conclusion  The BAMG appears to serve, without rejection, as a framework of collagen and elastin for the ingrowth of all bladder wall components. The reason for the better acceptance of the BAMG than of other bladder augmentation grafts requires further investigation.

No abstract

The results of this study demonstrate that the detection of tyrosinase mRNA in cells in the peripheral blood by RT-PCR may be a useful prognostic marker for predicting tumor progression and poor clinical outcome in patients with malignant melanoma.

No abstract

Summary Current reports suggest serum S100 as a prognostic marker for disease progression in advanced malignant melanoma. In this study, we assessed serum levels of S100 and multiple clinical factors in relation to overall survival in 99 patients with metastatic malignant melanoma seen at our institution between May 1990 and April 1996. For statistical analysis, we used both univariate and multivariate Cox proportional-hazards models. Elevated serum levels of S100 correlated with poor outcome in metastatic malignant melanoma (P < 0.0001), univariate analysis). Upon multivariate analysis, however, S100 added no information to known clinical prognostic parameters.

No abstract

In experienced hands, laparoscopic pyeloplasty is an effective alternative treatment for symptomatic ureteropelvic junction obstruction (UPJO). Although laparoscopic surgery can clearly benefit patients, laparoscopic pyeloplasty using conventional instrumentation is complex. The purpose of this report is to evaluate the feasibility of robot assisted laparoscopic surgery. Eleven pyeloplasties for UPJO were performed via a laparoscopic transperitoneal approach exclusively with the da Vinci Surgical System. The mean procedure time was 197 min (range 110-310 min). All operations were completed laparoscopically with no intraoperative complications and negligible blood loss. All patients recovered rapidly after surgery with excellent functional results at the 1 year follow-up. Our initial experience suggests that robot assisted Anderson-Hynes pyeloplasty is a safe and effective alternative to conventional laparoscopic surgery. In our opinion, robot assisted surgery will allow urologists to perform complex procedures with greater precision, confidence, and better results, as well as enable them to adapt the whole spectrum of laparoscopic procedures to their field.

Objective To determine the decreased antigenicity of the capacity were higher in the hamster BAMG-grafted animals, whereas in vitro contractility and compliance bladder acellular matrix graft (BAMG) through xenotransplantation and to assess the in vivo and in vitro were best in the dog BAMG-regenerated bladders. All grafted bladders had significantly better capacity and functional properties of the rat urinary bladder thus regenerated.compliance than the autoregenerated bladders after partial cystectomy alone. Materials and methods After partial cystectomy (>50%), BAMGs prepared from hamster, rabbit and Conclusions The present in vivo and in vitro studies show that BAMG-augmentation cystoplasty can lead to mor-dog urinary bladders were grafted to male and female Sprague-Dawley rats; 10 control rats underwent par-phological and functional regeneration of the rat bladder, preserving its low-pressure reservoir function. tial cystectomy only. Urinary storage and voiding function were monitored in 15 animals using a Because BAMG-regenerated bladders show functional innervation that is similar to normal bladders, they specially designed 'micturition cage' and cystometry. After 4 months, organ-bath studies and histological can work in coordination with the host bladder components, thus generating adequate intravesical pressure techniques were used to evaluate bladder regeneration in vitro in the grafted animals.to produce sustained voiding. The decreased antigenicity makes heterologous BAMG transplants feas-Results Clinically relevant antigenicity was not evident; no animal died from rejection and all bladder wall ible without immunosuppression.