1/55. Diffuse alveolar damage in BCGosis: a rare complication of intravesical bacillus Calmette-Guerin therapy for transitional cell carcinoma.Intravesical administration of bacillus Calmette-Guerin is a relatively simple procedure used in the treatment of superficial transitional cell carcinoma of the urinary bladder. It is usually well tolerated with few major side effects. In rare instances, systemic complications can result in death. The usual autopsy finding is that of caseating and non-caseating granulomata in the affected organ. We report the second case of BCGosis in which granulomata together with acute and organising phase diffuse alveolar damage were found in the lungs.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/55. Granulomatous hepatitis following intravesical bacillus Calmette-Guerin therapy.Although intravesical bacillus Calmette-Guerin (BCG) administration is an effective method in the treatment of superficial urinary bladder carcinoma, some complications may arise such as a granulomatous reaction either in the urinary tract or, in rare cases, outside the urinary tract. We report in this paper a case of granulomatous hepatitis following intravesical BCG administration.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
3/55. Undiagnosed central anticholinergic syndrome may lead to dangerous complications.This report describes two cases of central anticholinergic syndrome, the first after general anaesthesia and the other during a prolonged stay in the intensive care unit. The symptoms in both patients resolved soon after physostigmine administration. There was a delay in the diagnosis of central anticholinergic syndrome, which resulted in acute lung injury and unanticipated intensive care unit admission. It is suggested that in cases of abnormal mental recovery after anaesthesia or sedation, the diagnosis of central anticholinergic syndrome should be considered.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/55. Invasive bladder cancer after cyclophosphamide administration for nephrotic syndrome--a case report.We report a case of invasive bladder cancer after cyclophosphamide administration for nephrotic syndrome, and briefly discuss the association of bladder cancer and cyclophosphamide. A 6-year-old boy, who was diagnosed as having nephrotic syndrome, was treated with oral administration of prednisolone and cyclophosphamide for 4 years, receiving a total dose of 49.5 g cyclophosphamide. At age 27, a gross hematuria with bloody clots appeared and he presented with postrenal renal failure. He underwent a radical cystourethrectomy and ileal conduit for stage a pT3a pN0 M0 transitional cell carcinoma of the bladder. He was not given any adjuvant treatments because of his renal insufficiency, and he died from the disease 14 months after radical surgery.- - - - - - - - - - ranking = 6keywords = administration (Clic here for more details about this article) |
5/55. Fatal systemic reaction after multiple doses of intravesical bacillus Calmette-Guerin for polyposis.OBJECTIVE: To report a case of fatal systemic reaction after intravesical administrations of bacillus Calmette-Guerin (BCG) for polyposis. CASE SUMMARY: A 72-year-old white man was treated by monthly injections of intravesical BCG immunotherapy for polyposis of the urinary bladder. He received a total of eight injections; four hours after the seventh injection, he presented with pyrexia associated with chills, sweating, headache, and vomiting, which quickly resolved. Four hours after the eighth injection, the patient presented with the same symptoms plus a left-hemisphere deficiency. Results of a cerebral scan performed at this time were normal. The clinical status of the patient quickly worsened, with the appearance of disseminated intravascular coagulation, acute anuric renal insufficiency, rhabdomyolysis, hemolysis, and cytolytic and cholestatic hepatitis. The patient required hemodialysis and symptomatic treatment. Lactic acidosis with hemolytic-uremic syndrome appeared, and he died as the result of a multivisceral (respiratory, renal, hepatic) deficiency. DISCUSSION: The patient presented with symptoms compatible with a severe systemic reaction to BCG therapy, a rare but possible adverse effect. CONCLUSIONS: BCG instillation is a valuable tool in the therapy of bladder carcinoma, but increasing reports of severe adverse reactions should continue to remind practicing urologists to be alert to the possibility of common and uncommon reactions after its use.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/55. pheochromocytoma of the urinary bladder: a case report.We present a 66-year old female patient with pheochromocytoma of the urinary bladder. We performed transabdominal needle biopsy of the tumor without suspicion of pheochromocytoma because of her well-controlled blood pressure and no characteristic symptoms following administration of antihypertensive medication. Hypertensive crisis (260/130 mmHg) occurred just after the needle insertion. The diagnosis was pheochromocytoma. The norepinephrine level in the serum and her blood pressure normalized without antihypertensive medication after partial cystectomy. pheochromocytoma should be suspected in cases of intramural bladder tumors, especially in a normotensive patients receiving antihypertensive medication.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/55. Systemic chemotherapy in patients with renal failure.The administration of systemic chemotherapy to patients with moderate-to-severe organ impairment remains a challenge. In renal failure, guidelines for dose adjustments exist for very few chemotherapy agents. Subsequently, oncologists typically withhold treatment with systemic chemotherapy for patients with severe renal dysfunction. We present the case of a patient with metastatic transitional cell carcinoma of the bladder and renal failure who underwent successful systemic chemotherapy with paclitaxel and carboplatin. The data on systemic chemotherapy in patients with severe renal dysfunction are reviewed.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/55. Dynamic MR imaging of bladder haemangioma.Haemangioma is a rare benign mesenchymal tumour of the bladder. We report a case of bladder haemangioma and describe the enhancement kinetics observed on MR images after gadolinium bolus administration, which is similar to that reported in liver haemangioma.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/55. Reactive arthritis after BCG immunotherapy: T cell analysis in peripheral blood and synovial fluid.OBJECTIVE: To investigate the pathogenic mechanism of reactive arthritis after instillation of Calmette-Guerin bacillus (BCG). Although the clinical features of reactive arthritis after BCG therapy are well described, only a few reports have studied the possible pathogenic mechanisms. methods: We analysed by flow cytometry the phenotype and T-cell receptor (TCR) expression of peripheral blood (PB) and synovial fluid (SF) T cells in a patient who developed reactive arthritis (ReA) following intravesical BCG immunotherapy for bladder cancer. The proliferative response of short-term T-cell lines (TCL) from PB of this patient to mycobacterial antigens was tested by bromodeoxyuridine incorporation. RESULTS: CD4( ) and CD8( ) SF T cells with activated and memory phenotype were observed at the onset of arthritis. We were able to detect BV-restricted expansion of CD8( ) T cells in PB (BV17) and in SF (BV5S1 and BV12). The percentage of PB and SF CD8( ) T cells that expanded diminished when the symptoms remitted. The strongest response of CD4( ) TCL from the patient in vitro was obtained for human hsp-60 in an inversely dose-dependent manner. Very important was the finding that CD8( ) TCL from the patient demonstrated no proliferative response to any antigenic challenge that was reversed after the addition of exogenous interleukin 2. CONCLUSION: Although the identity of the stimulating antigen that led to the expansions observed in this patient is not clarified by the present data, both CD4( ) and CD8( ) T cells might play a role in the development of ReA following intravesical administration of BCG.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/55. Ureteroileourethrostomy: 16-year followup.Ureteroileourethrostomy has been abandoned at our institution for replacement of the bladder because: 1) it compromised the cancer operation and 2) upper urinary deterioration forced conversion to ureteroileocutaneous diversion in 2 of 3 patients. The ureteroileourethrostomy may have future application if all of the prostate is removed when cystectomy is necessary for bladder cancer. The urinary retention can be satisfactorily managed with clean, intermittent self-catheterization. The hyperchloremic metabolic acidosis can be satisfactorily managed by reducing residual urine and potassium citrate administration. The upper urinary tract changes can be partially or wholely prevented with antirefluxing ureteroileal anastomoses.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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