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In approximately 4%-10% of patients presenting with renal cell cancer, the transluminal propagation of a tumour thrombus into the vena cava inferior or the right atrium comes to diagnosis. Recent investigations have indicated that the presence of neoplastic extension into the venous system does not reveal independent prognostic value regarding the clinical course of the disease. Although the complete surgical removal of vena cava thrombosis in patients without simultaneously occurring regional lymph node or distant metastases has become a well established treatment modality, several questions concerning this surgical strategy still remain the subject of ongoing discussions. In the present investigation that included 92 patients with renal cell cancer and intracaval neoplastic extension, it was clearly demonstrated that using cardiopulmonary bypass, deep hypothermia and circulatory arrest - preferably, during the removal of intracaval thrombosis extending into the right atrium - does not result in a substantially increased treatment-related intra- or postoperative mortality. However, in contrast to a previously reported observation, this treatment option did not reveal any substantial impact on the long-term survival of the patients following surgical therapy. Accordingly, the cranial extension of intracaval thrombosis was not identified as a biological variable of any prognostic importance for renal cell cancer patients.

Single modality bladder-sparing therapy for muscle-invasive bladder cancer, including transurethral resection (TUR), partial cystectomy, systemic chemotherapy or radiotherapy, have been demonstrated to result in insufficient local control of the primary tumour, as well as decreased long-term survival in the patients when compared to radical cystectomy. Therefore, multimodality treatment protocols that aim at bladder preservation and involve all of the aforementioned approaches have been established. Arguments for combining systemic chemotherapy with radiation are to sensitise tumour tissue to radiotherapy and to eradicate occult metastases that have already developed in as many as 50% of patients at the time of first diagnosis. It has been shown that the clinical outcome observed with this approach approximates that after radical cystectomy. Additionally, a substantial number of patients survive with an intact bladder. However, bladder-sparing approaches are costly, and require close co-operation between different clinical specialists as well as careful follow-up. The good long-term results that are observed after cystectomy and the creation of an orthotopic neobladder make the substantial advantage of a bladder preservation strategy questionable when the patient's quality of life is addressed. Additionally, bladder-sparing therapy-related side effects might result in an increased morbidity and mortality in those patients who need to undergo surgery due to recurrent or progressive disease. Multimodality bladder-sparing treatment is a therapeutic option that can be offered to the patient at centres that have a dedicated multidisciplinary team at their disposal. However, radical cystectomy remains the standard of care for muscle-invasive bladder cancer.

Extracorporal shock wave therapy (ESWT) has been postulated as an additional therapeutic option in nonunion after fracture treatment. We have reexamined patients with nonunions treated at our institution to evaluate the efficacy of the method. In a prospective nonrandomized study patients were investigated with a minimum duration of nonunion of 6 months. Following 2 cycles of ESWT with 2000 impulses/18 kV, the reevaluation was performed at 1, 3 and 6 months after treatment. A total of 27 pseudarthroses was reevaluated, in 11 one or more reosteosyntheses had been performed prior to ESWT. Following ESWT we found a success rate of 41 % (n = 11). The clinical evidence of subjective, clinical improvement was found in 5 of these patients within 1 month, in all of these patients within a period of 3 months. Radiologic evidence of improvement occurred in none of these patients within 1 month, in all of these patients within 6 months. ESWT appears to represent an additional treatment option in patients with longstanding nonunion. If no improvement occurs, the maximum delay of reosteosynthesis is three months.

Johann Friedrich Dieffenbach (1792–1847) wird als Begrunder der modernen plastischen Chirurgie angesehen. Neben allgemeinen Untersuchungen zur Physiologie und operativen Technik von Hauttransplantaten lag ein Schwerpunkt seiner Arbeit dabei in der wiederherstellenden Mund-, Kiefer- und Gesichtschirurgie. Diese Aspekte der plastischen Chirurgie und der Lebenslauf Dieffenbachs werden vorgestellt.

To further clarify the need for routine adrenalectomy during the surgical treatment of renal cell cancer, as in the absence of clinically overt metastatic disease, tumorous lesions within the adrenal gland are found in only 2-10% of patients, with most being over-treated by adrenalectomy.The medical records of 819 patients undergoing adrenalectomy combined with nephrectomy, irrespective of the local extension of the primary tumour or the clinical stage at first diagnosis, were reviewed to determine the reliability of currently available imaging methods in predicting adrenal gland metastases. Several patient and tumour characteristics were correlated with the presence of intra-adrenal metastases, and their possible independent prognostic value was determined by a multivariate logistic regression model.There was metastatic spread into the adrenal gland in 27 of 819 (3.3%) patients. In only three of eight patients in whom the adrenal was identified as the only metastatic site were preoperative abdominal computed tomography scans interpreted as false-negative. On multivariate statistical analysis only the presence of distant metastases, vascular invasion within the primary tumour and multifocal growth of renal cell cancer within the tumour-bearing kidney were identified as independent predictors of the presence of intra-adrenal metastases.None of the patient or tumour characteristics evaluated reliably predicted the likelihood of adrenal metastases in patients with no evidence of disseminated metastatic spread. However, previously published data indicate that the frequency of metachronous metastases within the contralateral kidney (1.8-3.8%) is significantly higher than the risk of a preoperatively undetected isolated intra-adrenal metastatic lesion when currently available imaging modalities are applied. Therefore, routine adrenalectomy should not be recommended if the preoperative radiological examinations are normal.

The role of the sympathetic adrenergic nerves in mediating the constant tone of penile flaccidity and returning the erect penis to its flaccid state is fairly well established. However, it is not yet known whether additional nonadrenergic transmitters are involved in this process. The peptide endothelin-1 (ET-1) may be one of the factors contributing to such a control. Moreover, it has been speculated by various authors that ET-1 might be involved in the pathophysiology of erectile dysfunction. The present study was undertaken to determine whether or not there is a difference in the courses of ET-1/-2 plasma levels registered in systemic and cavernous blood cavities taken from healthy males and patients with ED during different penile conditions (flaccidity, tumescence/rigidity, detumescence). Thirty-two healthy adult males and 25 patients were exposed to visual and tactile erotic stimuli in order to elicit penile tumescence and, in the group of healthy volunteers, rigidity. Whole blood was aspirated from the corpus cavernosum and the cubital vein, and ET-1/-2 was determined in plasma aliquots by means of an enzyme-linked immunoassay (ELISA). Mean systemic and cavernous plasma level of ET-1/-2 in blood samples obtained from the volunteers was 0.2-0.7 fmol/ml. In the healthy males, no changes in ET-1/-2 levels were observed in the systemic and cavernous blood during penile tumescence, rigidity and detumescence. In the group of patients, mean plasma ET-1/-2 levels in the phase of penile flaccidity and detumescence were found to be higher in the systemic circulation than in the cavernous blood (flaccidity: 0.52+/-0.38 fmol/ml vs. 0.48+/-0.46 fmol/ml, respectively; detumescence: 0.53+/-0.33 fmol/ml vs. 0.27+/-0.11 fmol/ml, respectively). No differences in the plasma courses of ET-1/-2 were found between patients with an organogenic and psychogenic etiology of ED. In the phase of detumescence, the mean ET-1/-2 level was lower in the cavernous blood cavities taken from the patients than in the samples obtained from the healthy males. Our study revealed a difference in the profiles of ET-1/-2 registered in the cavernous blood of healthy subjects and patients with erectile dysfunction. Nevertheless, since this difference seems to be of no physiological significance, our data counteract the hypothesis of an ultimate importance of ET-1 in the control of penile flaccidity and detumescence and do not support speculations regarding an involvement of ET-1 in the pathophysiology of erectile dysfunction.

Since it is difficult to predict the probability of persistent teratoma or of a viable tumor in patients with normalized tumor markers and a normal CT scan following chemotherapy for advanced stage testis cancer, recommendations regarding adjunctive surgery have ranged from observation to surgical exploration for all patients. Suggested variables for patients in whom surgery can be omitted safely, include normal post-chemotherapy CT scans, residual abdominal masses of less than 1.5 cm, a 90% or greater decrease in the volume of the retroperitoneal mass with chemotherapy and no teratomatous elements in the orchiectomy specimen. In contrast, during several investigations, the application of the above mentioned criteria resulted in a false-negative prediction of approximately 20%. However, recognizing the morbidity of the operative procedure itself in addition to the fact that only 2-4% of patients will develop recurrent tumor confined to the retroperitoneal space that can then be managed surgically or by administration of further chemotherapy, secondary surgery should be avoided if a sufficient follow-up after chemotherapy is guaranteed. The extent of adjunctive surgery in patients revealing a residual tumor mass after first-line chemotherapy remains a subject of ongoing discussions. It has been indicated that extensive retroperitoneal surgery after chemotherapy is associated with significant clinical morbidity. A limitation of post-chemotherapy surgery to a resection of the residual mass with or without an additional modified template dissection appears to result in an acceptable frequency of retroperitoneal recurrences and a decreased complication rate.

Tolterodine is a new competitive muscarinic receptor antagonist developed for the treatment of the unstable bladder. A total of 242 patients were enrolled in a multicenter, multinational, randomized, double-blind, placebo-controlled study conducted over a period of 4 weeks in patients with detrusor overactivity and symptoms of frequency, urgency, and urge incontinence. The objective of the study was to compare the efficacy and safety of tolterodine given at 1 or 2 mg b.i.d. versus placebo. At week 4 a statistically significant increase in the volume at first contraction (p = 0.030) and maximal cystometric capacity (p = 0.034) was only in the tolterodine 2 mg b.i.d. group. Tolterodine was safe and generally well tolerated. The incidence of dry mouth, as the most commonly reported adverse event, was only 9% and of mild to moderate intensity.

The cyclic nucleotides cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) are second messengers involved in the regulation of contractility in various smooth muscle organs including detrusor smooth muscle. They are synthesized by activation of adenylate and guanylate cyclases, respectively, and inactivated by phosphodiesterases (PDEs). In order to delineate the intracellular regulation of porcine detrusor contractility by cyclic nucleotides and phosphodiesterases, functional organ bath studies and determinations of intracellular cyclic nucleotide contents were performed after incubation of porcine detrusor strips with forskolin (adenylate cyclase activator), sodium nitroprusside (guanylate cyclase activator), and various phosphodiesterase-inhibitors. Significant relaxant responses were achieved only by forskolin, the nonspecific phosphodiesterase-inhibitor papaverine, and the phosphodiesterase 1-inhibitor vinpocetine (62.4 +/- 5.6%, 73 +/- 4.3%, and 53 +/- 7.9%, respectively). Sodium nitroprusside and the selective PDE-inhibitors milrinone, rolipram, zaprinast, and dipyridamole were significantly less efficacious (26.9 +/- 3.9%, 15.5 +/- 3.8%, 15.3 +/- 3.0%, 13 +/- 4.0%, and 13.2 +/- 2.1%, respectively). Forskolin, papaverine, and vinpocetine elevated intracellular cAMP concentrations (7.3-, 1.9-, and 1.7-fold increase at 100 microM, respectively), whereas the other substances failed to enhance cAMP levels. cGMP levels were only increased by sodium nitroprusside (7.8-fold). The adenylate cyclase-cAMP system seems to be the more important signal transduction system involved in the relaxation of carbachol induced smooth muscle tone of the porcine detrusor. The role of the guanylate cyclase-cGMP system is less clear. In addition, the calcium/calmodulin-stimulated PDE I seems to be of major functional importance in regulating cAMP hydrolysis in the porcine detrusor smooth muscle in vitro.

Thirteen patients with midline pathology of the bladder or prostate and two normal volunteers were examined by Magnetic Resonance Imaging (MRI) using a variety of pulse sequences. The MRI results were compared with computed tomography (CT) and transrectal or transurethral ultrasound (US). This study demonstrates that MRI is capable of visualizing pathology of the bladder and prostate at least as well as CT and US. However, MRI seems to be more advantageous in identifying lesions of tumors in the roof and base of the bladder because of flexible imaging planes. MRI is also very promising in the staging of pelvic malignancies because of excellent contrast between tumor and nearby important anatomical structures. This indicates that MRI might become the modality of choice in urological disease of the bladder and prostate.

In this investigation differential kidney function studies were carried out for eight patients with obstructive uropathy and seven patients who did not suffer from obstruction. The aim of this investigation was to determine whether possible retention of 99Tcm-DMSA in the dilated system would lead to overestimation of the functional mass of an obstructed kidney. The clinical examination took place 4 and 24 h after i.v. injection of the 99Tcm-DMSA. From our results we conclude that this is not a major problem. It appeared that the 4 h values are as reliable as the 24 h values in the clinical situation.

During the years 1981–1985, 251 female patients with stress incontinence consulted the department. The average age was 47.3 years. Surgical treatment consisting of cystourethropexy ad modem Marshall-Marchetti-Krantz, Stamey-Pereyra, or by fascial sling and/or periurethral injection with Teflon was performed in 185 patients, with a total of 215 procedures. In a retrospective study, factors which could possibly predict the results of the procedures were investigated. Obesity, parity, bladder capacity, detrusor compliance, maximum voiding pressure, and urethral instability showed no statistically significant relation to the success rate of the various procedures. Previous pelvic surgery or detrusor instability impaired the results in this group. The overall success rates of the 215 procedures were: Marshall-Marchetti-Krantz 76% (54 procedures), Stamey-Pereyra 65% (49), fascial sling 40% (35) and Teflon injection 43% (77). Restricting the results to those procedures that were primary in patients with genuine stress incontinence did not change the success rate for Marshall-Marchetti-Krantz: 74% (38), but showed increased success rates for the other procedures: Stamey-Pereyra 88% (34), fascial sling 64% (22) and Teflon injection 54% (52).

Five years' experience using the Standard Version (SV) of the Silicone-Silver Penile Prosthesis is reported, based on evaluation of 1890 implantations done by 309 physicians. In 72.4% the indication was diabetes mellitus, vascular disease or postpelvic surgery; 81.2% of the patients were between 40 and 69 years of age. Early complications occurred in 5.1%, late complications in 2.8%. Of 1834 implantations, 19 (=1.04%) of the devices had to be removed. The overall success rate was 92.1%. To improve availability and lower costs, the Variable Version (VV) was designed, a device which can be trimmed down to appropriate size during surgery. Preparation of the prosthesis is described. The most recent modification is the Trimming-Tip Version (TTV). As the proximal end of this device can be shortened up to 3 cm, two pairs of prostheses per diameter (total: 4 pairs) are sufficient to fulfill all length requirements from 16 to 25 cm. Two further features of the TTV are: a conic distal end and a bulk diameter of 11 or 13 mm, both of which improve placement within the corpus and the cosmetic results.

A computer-controlled image-analysis system (LEYTAS) was used to classify 328 cytological urinary specimens automatically into positive and negative. Classification was based on the presence of cells with increased DNA content or high chromatin contrast. These cells are automatically detected by the LEYTAS system and stored in image memories. Fully automated slide classification on the basis of the total number of detected cells resulted in 33% false-positives and 2% false-negatives. Positively classified preparations were then further investigated by rapid visual evaluation of the image memories in order to eliminate any detected artifacts. After this procedure the results were: 12% false-positives and 4% false-negatives. Automated screening of urinary cytology specimens for the detection of bladder cancer, therefore, is feasible. Further analysis of the unbiasedly detected cells for parameters, such as chromatin distribution and nuclear shape, provides a way to gain objective information with respect to grading, therapy, and prognsois.

Urodynamic equipment is presented herein which combines recordings and X-ray. All information is primarily stored on an analogue magnetic tape with display on a multichannel memory oscilloscope. For the suprapubic bladder approach, a Swan Ganz catheter is used after removing the occluding balloon. For the transurethral approach, a specially designed 4-channel membrane catheter is used. The data was analyzed using checklists which were compiled strictly adhering to the ICS suggestions. The purpose of these lists is to offer practitioners and community hospitals standardized terminology in examinations to simplify urodynamic evaluation.

The purpose of this prospective study was to compare the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in the diagnosis and staging of renal masses. MRI was performed with an 0.5 T superconducting MR-scanner using conventional T1- and T2-weighted spin-echo pulse sequences. The results of MRI and CT were compared in 31 patients with a renal mass. In the diagnosis of benign tumors, similar information was obtained by MRI and CT. Regarding malignant tumors, one transitional cell carcinoma, imaged by CT, was not shown by MRI. CT appeared to be slightly more accurate in the determination of perinephric extension of renal cell carcinoma (stage I vs stage II). Similar results were obtained in stage III and stage IV tumors. The main diagnostic limitations which may lead to inaccurate staging of renal cell carcinoma are encountered in MRI as well as CT. They are: the assessment of tumor extension into the intrarenal vein, the differentiation between lymphadenopathy due to reactive hyperplasia and metastatic involvement and the differentiation between tumor extension into adjacent organs and adhesions without tumor spread outside the renal capsule. It is concluded that CT remains the method of choice in the diagnosis and staging of renal masses as long as no substantial improvements in MRI performance have been achieved.

Es wird eine einfache und vom Patienten selbst im hauslichen Bereich durchfuhrbare Mesmethode zur Registrierung nachtlicher Erektionen beschrieben. Ein 18 × 2 cm langes Band mit Gleitschuh, durch den das Band hindurchgezogen wird, wird um den Penisschaft »in Ruhe« gelegt. Dieses Band besitzt eine Kalibrierung, um somit Penisumfang und Penisumfangzunahme bei nachtlichen Erektionen zu messen. Zur quantitativen Messung dient ein gelber bzw. ein gruner Gleitschuh. Es sind 250 Gramm (gelb) bzw. 450 Gramm (grun) erforderlich, um das Band durch den Gleitschuh hindurchzuziehen. Somit sind Messungen des Penisumfanges »in Ruhe« sowie die Penisumfangzunahme bei Erektionen qualitativ und quantitativ moglich. Bei unzureichender Erektion erwacht der Patient infolge Schmerzempfindung und kann manuell und visuell die Erektion kontrollieren. Das Erectiometer® ist eine einfache und preiswerte Moglichkeit, sicher und exakt in hauslicher Umgebung nachtliche Erektionsmessungen durchzufuhren. Somit ist eine reproduzierbare Aussage der konstanten Umfangveranderungen in Korrelation zur erforderlichen Kraft (Rigiditat) und eine sichere Differentialdiagnose der psychogenen und organischen Impotenz moglich. To register nocturnal erections, an easy and reliable technique is described which can be done by the patient at home. It consists of a 18 × 2 cm long band with a sliding collar through which the band may be pulled through. This band is positioned around the penis in »the resting position«. The band has a centimeter calibration to measure penile circumference and intumescence during nocturnal erections. To quantify measurements, two different collars are available, a yellow one in which 250 grams and a green one in which 450 grams are necessary to pull the band through the collar. In insufficient erections the patient wakes up due to pain and may control the erection manually and visibly. The erectiometer® is an easy and inexpensive possibility for exact measurements of nocturnal erections in an outpatient base. A reproducable information on the circumference changes (intumescence) in correlation to the power necessary (rigidity) and a good differential diagnosis of psychogenic and organic impotency are possible

In a retrospective study, paraffin-embedded cystectomy specimens obtained from 46 patients with bladder cancer (stage pT1 — pT4a, pN0, pN2) were analysed for tumor DNA ploidy and proliferation using automated image cytometry (LEYTAS). In 41 cases, DNA ploidy could be measured. Estimation of proliferation was possible in 26 tumors. The number of cells with a DNA content higher than 5C could be calculated in 38 of the tumors. All these three parameters are shown to correlate with patient outcome.

Summary— The treatment of prostatic carcinoma with diethylstilboestrol (DES) and ethinyloestradiol (Lynoral) has become less popular since the introduction of new forms of treatment such as antiandrogens, estramustine phosphate and LHRH analogues. One of the reasons for this decline in popularity is the risk of cardiovascular side effects during treatment with oestrogens. In the literature, different dosages of DES and ethinyloestradiol are recommended and different rates of cardiovascular side effects are reported. In a prospective study, 18 patients were treated with ethinyloestradiol 0.05 mg/day. In most cases this lowered the plasma testosterone permanently below castrate level during therapy. Also, because the acid phosphatase returned to normal in almost all patients, this treatment seemed adequate. In 4 patients the treatment was stopped because of side effects, in 3 of these because of cardiovascular complications. The cardiovascular side effect at this dose are considerable (29%) but comparable rates are reported in some studies following placebo treatment of patients with prostatic carcinoma.

There is a direct continuation between bladder and urethral musculature. The external sphincter consists of circular, striated muscle fibers, while the smooth ‘internal’ sphincter does not form a real ring, however, this sphincteric part, under resting conditions, maintains continence, which is demonstrated by an example. Smooth sphincteric insufficiency, too, is observed during general weakness of the pelvic floor, the symptom can be nocturnal incontinence, when the supporting help of the external sphincter is abolished. The voluntary sphincter is needed to maintain continence during stress and to stop the flow abruptly.

In a period of 7 years, 309 prostatectomies (suprapubic transvesical in the Harris-Hryntschak modification) were performed. There was no intraoperative mortality; overall mortality was 2.9%. Complications: leakage, 4.5%, and hemorrhage (requiring reoperation), 5.1%. In only 1.6%, a bladder neck contracture was observed, but 3.1% of the patients suffered from postoperative incontinence. The factors to reduce this complication are discussed. A late complication was the urethral stricture, which was reduced significantly by changing the catheter size from 22 to 18 F.

Zellen aus den Mesenteriallymphknoten gesunder, unbehandelter sowie mit Hammelblut immunisierter Ratten wurden untersucht. Licht- und elektronenmikroskopische Ergebnisse wurden an ein und derselben Zelle durchgefuhrt und die erhobenen Befunde miteinander verglichen. Dabei konnten mit Hilfe der Lichtmikroskopie zwei morphologisch unterschiedliche Zellgruppen ermittelt werden. 72–96 Std nach Immunisierung traten blastenahnliche Zellen auf, wahrend im Zeitraum von 96–144 Std sowie bei hyperimmunisierten Tieren vermehrt Plasmazellen beobachtet wurden.

Cefoxitin wurde an 27 Patienten in einer Tagesdosis von 3 g i. m. uber funf Tage an einem unselektionierten urologischen Krankengut getestet. Schmerzen bei der Injektion traten einmal auf, ebenfalls bei einem Patienten wurde ein allergisches Exanthem beobachtet. 24 der 29 Keime wurden eliminiert, 22 von 27 Patientenharnen waren nach Therapie steril. Die Ergebnisse waren fur die Anwendung von Cefoxitin in der Urologie ermutigend. Diese Substanz sollte jedoch der klinischen Anwendung vorbehalten bleiben.

Monoclonal antibodies recognizing various structures of the nephron were used to stain renal cell carcinomas and associated metastases. Generally, renal cell carcinoma is subdivided into tumors of a clear-cell type, tumors of a mixed-clear-cell/granular-cell type, and tumors in which spindle cells are present. The staining patterns observed with the monoclonal antibodies used correlated in part with the histological appearance of the carcinomas. One monoclonal antibody did not stain other carcinomas, sarcomas and melanomas tested. Notably the same monoclonal antibody stained 75% of primary tumors, whereas only 16% of metastases were stained. This finding indicates that metastases exist which are made up of less well-differentiated tumor cells than the primary tumors.

Treatment of hypernephroma presenting with atria-caval involvement without distant metastases is a surgical challenge. The procedures used in three different cases are described. In one case the caval thrombus extending into the atria-caval junction was delivered during clamping of the atrium without cardiovascular bypass. In another case the remaining atrial thrombus was removed in a second session with cardiovascular bypass. For the third case cardiac bypass was established immediately to permit safe and complete removal of the atria-caval thrombus. In order to plan the surgical procedure adequately, it appears essential to determine exactly the upper level of the thrombus. In cases with atrial involvement, cardiovascular bypass is advisable to perform radical surgery under the safest conditions.

A newly available compact urodynamic set-up is presented herein, consisting of a 2-channel CO2 pressure recording unit with flow registration. Flow, bladder and rectal pressure recording are considered the minimal requirements for obtaining sufficient information on functional changes of the lower urinary tract.

Tumor-bearing human kidneys were used in an ex vivo perfusion model to screen monoclonal antibodies, recognizing renal cell carcinoma-associated antigens for diagnostic potential in vivo. Perfusion of tumor-bearing kidneys with 99mTc-labeled G250 and RC38 antibody resulted in visualization of the tumor, whereas perfusion with two other monoclonal antibodies, RC2 and RC4, did not lead to tumor visualization. Uptake of radiolabel in normal kidney tissue was low for G250 and RC38 antibody. Tumor-to-kidney tissue ratios after perfusion with G250 and RC38 antibody were 2.7 and 2.2, respectively. After rinsing for 3 hr with unlabeled perfusion fluid the tumor-to-kidney tissue ratios increased to 8.6 for G250 antibody and to 2.7 for RC38 antibody. We conclude that perfusion of tumor-bearing human kidneys with radiolabeled monoclonal antibodies is a relatively simple way to evaluate renal cell carcinoma associated monoclonal antibodies as diagnostic agents in vivo.