Ⅰ Association Study Of Single Nucleotide Polymorphisms In Intron 1 And Promotor Region Of E-cadherin Gene With Transitional Cell Carcinoma Of Urinary Bladder Ⅱ Utilizations Of Laparoscopy In Renal Function Reserving And Reconstructive Surgery

Objectives: The single nucleotide polymorphisms in the proximum promoter, exon 1 and intron 1 regions of E-cadherin gene were detected; and their potential function were analysised by bioinformatics software. Materials and methods: We screened the proximum promoter, exon 1 and intron 1 regions of CDH1 for single nucleotide polymorphism in 60 Chinese using direct sequences. The allele frequencty of the single nucleotide polymorphism was calculated. The potential function of the single nucleotide polymorphism was analysised by three bioinformatics softwares.Results: Three single nucleotide polymorphisms were observed. Two of them (-160 C/A and -73 A/C) were in proximum promotor region and one (+178 C/T) in intron 1 region. The -160C/A and +178T/C polymorphisms are high frequency SNPs and the frequencies are 48.3% and 28.3% respectively. The frequenciy of -73A/C polymorphisms is 13.3%. Bioinformatics analysis showed that the -73C/A polymorphism is responsible for binding of several nuclear transcription factors and -160C/A polymorphism locates in one pomoter region.Conclusions: Three single nucleotide polymorphisms were observed. TheBioinformatics Analysis can provide useful information to facilitate thefurther study.Objectives: To investigate whether the three single nucleotide polymorphisms and haplotypes in the proximum promoter region and intron 1 of CDH1 are associated with transitional cell carcinoma of urinary bladder.Materials and methods: A hospital-based case-control study was performed on 130 patients with TCCB (male 96 and female 34, age form 29 to 84 years, mean 58.1 ± 14.7) and 60 normal controls (male 44 and female 16, age form 28 to 81 years, mean 58.1 ± 14. 7). Genomic DNA was extracted from blood samples of the subjects. Genotypes were determined using direct sequences. The allele, genotype and haplotypes frequencies of the three single nucleotide polymorphisms and their association withtransitional cell carcinoma of urinary bladder were analysised. Appropriate tests were selected for statistical analysis.Results: We observed a significantly higher frequency of the -160A allele in TCCB patients (76%) compared to that in the control group (64%) (P < 0.05). The A allele frequencies at the same position were also significantly higher in invasive TCCB than in superficial carcinoma(P < 0.05); however there was no statistical difference in the A allele frequency between high pathological grade and low pathological grade of TCCB (P >0.05). When compared TCCB patients to the control group, there was no statistical difference for the allele frequency in -73A/C and + 178C/T. The distribution of haplotypes is different in both groups. There is a a significantly higher frequency of -160A/-73A/+178T haplotype in TCCB patients (39.7%) compared to that in the control group (29.2%) (P < 0.001). Conclusions: The -160C/A single nucleotide polymorphism in the proximum regulatory region of E-cadherin gene is associated with TCCB; the -160A/-73A/+178T haplotype increases the susceptibility with TCCB, and this A-A-T haplotype might prove a useful marker.Purpose: To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic nephron-sparing surgery for the renal tumors.Materials and Methods: Between June 2002 and February 2004, 11 cases of renal benign tumor and 21 cases of renal malignant tumor underwent enucleation of the tumor and wedge resection of the tumor through retroperitoneal laparoscopy respectively. Tumor resection and hemostasis were achieved mainly by Harmonic Scalpel. Follow-up studies were performed with an evaluation for renal spiral computed tomography. Results: All procedures were technically successful. Mean operating time was 70 min for enucleation and 96 min for wedge resection. Mean estimated blood loss was 35 ml for enucleation and 65.5 ml for wedge resection. Mean hospital stay after operation was 6.5 days. No intraoperational complications occurred. Pathological examination confirmed renal cell carcinoma (RCC) in 21 patients and angiomyolipoma in 11. Pathological stage was pT_1a in 21 RCC patients. All resected tumor specimens had negative surgical margins for cancer. No local recurrence or trocar site metastasis was observed during a follow-up of mean 13 months.Conclusions: Our results indicate that retroperitoneal laparoscopic nephron-sparing surgery represents a feasible option for patients with localized renal tumors. This procedure could offer precise and complete tumor excision while minimizing morbidity, improving cosmesis and shortening convalescence.Purpose: We report our techniques and experience of retroperitoneal laparoscopicdismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction.Materials and Methods: From May 2000 to September 2004, 50 patients with UPJobstruction underwent laparoscopic dismembered pyeloplasty. A three-port,balloon-dissecting, retroperitoneal approach was used. All anastomoses were completedwith free hand intracorporeally suture techniques. Follow-up studies were performedwith IVU and renal ultrasonography.Results: All operations were completed laparoscopically and no open conversions wererequired. The mean operating time was 81.6 min (ranging from 55 to 180 min). Themean blood loss was 12 ml (ranging from 5 to 50 ml) and the mean postoperativehospitalization day was 7.6 days (ranging from 6 to 12 days). No intraoperativecomplications occurred. Aberrant artery vessel and primary stricture as cause of UPJobstruction was noted in 6 and 44 patients respectively. Anastomotic leakage occurredin 2 patients and one of them received open surgery for recurrent UPJ obstruction later.Radiographic assessment by IVU showed good results in 49 cases with a meanfollow-up of 22 months.Conclusions: Our experience with retroperitoneal laparoscopic dismemberedpyeloplasty demonstrates that this technique is an effective treatment for UPJobstruction and can be accomplished reasonably quickly.Purpose: To evaluate the clinical value of retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction as compared with open surgery. Materials and Methods: The clinical data of 56 patients who underwent retroperitoneal laparoscopic dismembered pyeloplasty were retrospectively compared with those of 40 patients who underwent open dismembered pyeloplasty through a retroperitoneal flank approach. Student t-test, Pearson Chi-sqiiare test and Mann-Whitney rank sum test were applied for statistical analysis as appropriate. Results: Patient's demographic data were similar between the two groups. In the laparoscopic group, operative time (80 versus 120minutes), estimated blood loss (10 versus 150mL), recovery of intestinal function (1 versus 2days), analgesic requirements (Diciofenac Sodium Suppository) (75 versus 150mg). incision length (3.5versus 21cm), and postoperative hospital stay (7 versus 9days) were better than those in the open group (P<0.001 for all). No intraoperative complications occurred in either group. Incidence of postoperative complications (2/56, 3.6% versus 3/40, 7.5%, P=0.729) and success rate (55/56, 98.2% versus 39/40, 97.5%. P=0.058) were equivalent in the two groups.Conclusions: Retroperitoneal laparoscopic dismembered pyeloplasty is a minimally invasive, safe and effective therapy for ureteropelvic junction obstruction with low morbidity, shorter convalescence and excellent outcomes and can be accomplished reasonably quickly in experienced hands.