Enhanced computed tomograms provide accurate assessment of local extension and stage of bladder carcinoma

Abstract

The choice of appropriate treatment modality for bladder carcinomas depends on accurate preoperative assessment of the stage of the neoplasm (1). Both CT and MRI complemented by reconstructions can provide the needed accurate informations (2).This 52-year old white male presented with a history of gross hematuria, which intensified during the past 3 months. He had prior episodes of gross hematuria, 3 and 5 years ago, which were attributed to benign prostatic hypertrophy and treated first by TURP and later clinically.The laboratory data at this admission were RBC 4.1 M/CUMM, WBC 9400 /CUMM Hct 36.2%, Hb 12.4 g/dL, BUn 32 mg/dL, Creatinine 2.3 mg/dL, Albumin 3.2 gm/dL, ALK Ptas 12.7 U/L, AST 7U/L, ALT 22 U/L Total Protein 7.2 gm/dL Urine analysis of a voided specimen showed gross hematuria, but no blood clots, > 500 RBC/HpF, 40 -50 WBC/HpF, 20-30 bacteria / Hpf, spec gravity 1028; urine culture was reported as negative.Patient was moderately diaphoretic, BP 148/92, PR 84/min, lungs were clear to auscultation, on CXR there was cephalization of flow and basilar congestion, no infiltrates nor nodules were appreciated. The abdomen was negative. There was tenderness to percussion of the left back and flank.Four phase enhanced computed tomograms through abdomen and pelvis, complemented by coronal , sagital as well as volume reconstructions were performed.A 28-second delayed arterial phase CT demonstrates an enhancing tumor along the left lateral bladder wall extending through the muscularis into the perivesical fat. After a skip zone, hypervascularity is noted both along the anterior and posterior bladder wall reflecting submucosal tumor propagation. Some hypervascular stranding is noted extending from the anterior bladder wall into the space of Retzius and there is some nodular enhancing tumor anterior in the space of Retzius. One and one half to 2.1 cm enhancing nodes are noted in the left external iliac node chain ( Figure-1).CTs at a slightly lower scan level demonstrate the large intravesical component of the neoplasm, but also show a circumferential stain indicating

FTIR and 13C NMR Investigation of Coal Component of Late Permian Coals from Southern China

“…Guo et al 1 and Sun 11 characterized the chemical structure of lopinite from the Leping, Changguang, and Shuicheng coalfields using mirco-FTIR and made comparisons with other macerals. Wang and Tang et al 42 characterized several different coals using 13 C NMR and attempted to correlate their liquefaction reactivity with structural characteristics. However, little information on detailed chemical structural characteristics of barkinite has been obtained to date from studies that bring several methods to bear on the structural analysis.…”

Symptomatic Extraperitoneal Bladder Perforation Following Transurethral Bladder Surgery: Imaging with CT Urography

“…This case demonstrates an initially unsuspected case of extraperitoneal bladder perforation following TURBT, which was diagnosed by imaging. CT cystography is a reliable and fast method to determine the presence and location of suspected bladder perforation and to help guide appropriate therapy (4)(5)(6). For the detection of small dehiscences and non trasmural injuries post-voiding CT post-void phase after lavaging the bladder can be of used (7).…”

Synthesis and characterization of a new ion-imprinted polymer for the selective separation of thorium(iv) ions at high acidity

“…11 Ion-imprinted polymers (IIPs) are a new kind of adsorbent for SPE, and are usually prepared by the copolymerization of a functional ligand and a cross-linker in the presence of template ion. [12][13][14] Because of its memory effect on the template ion, the IIP can extract the target ion with good selectivity. Therefore, IIP is oen used to separate and pre-concentrate trace metal ions.…”