ISSN:0042-1138    

DOI:10.1159/000283025

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

It is well known that the expression level of the ICAM-1 and MHC is frequently altered in accordance with tumor progression, and the expression of oncogenes is significantly related to tumorigenesis, tumor progression, and/or metastatic potential. In this study, to investigate the relationship between the alteration in ICAM-1 and MHC expression with the tumor grade and/or cell differentiation, we examined the expression of ICAM-1 and HLA-DR before and after treatment with IFN-γ in 4 human bladder cancer cell lines. We also analyzed the expression of c-Ha-ras and c-myc. Using flow cytometry, highly constitutive expression of ICAM-1 was detected in all cell lines tested except RT4 (grade I, well-differentiated, superficial). IFN-γ was found to somewhat induce the expression of ICAM-1 in all cell lines except RT4. The constitutive expression of HLA-DR was not detected in any of the cell lines tested by flow cytometry and Northern blot. HLA-DR expression was induced by IFN-γ in RT4 and J82 (grade III, anaplastic, invasive). Codon 12 point mutation of c-Ha-rø5 (GGC→GTC; Gly→Val) was detected in T24 (grade III, epider-moid, superficial) through single-strand conformation polymorphism, and sequencing analysis. Another point mutation at codon 27 was detected in TCCSUP (grade IV, distant metastatic), but this mutation was found to be silent (CAT → CAC; His). Expression of c-myc was detected in J82 and TCCSUP by Northern blot. These findings, along with the clinical and pathological characteristics of the patients from whom the cell lines were established, might suggest that the expression of ICAM-1 seems to be associated with cell differentiation, and the inducibility of HLA-DR by IFN-γ seems to be associated with the degree of malignancy. Expression of c-myc seems to be associated with invasiveness. However, a significant correlation between c-Ha-ras activation and tumor grade could not b

ISSN:0042-1138    

DOI:10.1159/000283027

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and cathepsin D was performed on 60 transitional cell carcinoma (TCC) specimens from 60 patients with bladder cancer. The percentage of PCNA-positive cells (PCNA-labelling index) was determined by counting 500 or 1,000 cells, and cathepsin D expression was graded according to the extent of immunoreactivity to anti-cathepsin D antibody. The PCNA-labelling index was significantly higher in high-grade and high-stage tumors compared to that in low-grade and low-stage tumors. Cathepsin D was highly positive in grade-1 tumors. In contrast, 82% of grade-3 tumors and 76% of advanced tumors showed negative or low reactivity to anti-cathepsin D. Groups of high PCNA-labelling index and negative cathepsin D had significantly poorer prognoses compared to those of the low PCNA group and cathepsin D highly positive group, respectively, in univariate analyses. However, neither of these two factors were independent prognostic factors in multivariate analyses. These results suggest that the PCNA-labelling index and cathepsin D expression may indicate the malignant potential of TCC and may be able to provide additional information for predicting survival when stratifying for grade of bladder cancer.

ISSN:0042-1138    

DOI:10.1159/000283030

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We present a retrospective study using four different immunohistochemical markers (PCNA, Ki-67, 486p and p53) on paraffin sections from 104 selected cases with primary superficial transitional cell carcinomas of the bladder (59 cases pTa, 45 cases pTl, 40 cases Gl, 64 cases G2). 53 of the 104 patients experienced recurrence of their bladder lesion, while 51 remained free of tumor. The distribution of staging, grading and multifocality was comparable in both groups of patients. Overall, the tumors that recurred had a significantly higher proportion of labeled cells for PCNA (p ≤ 0.0001), Ki-67 (p ≤ 0.006) and 486p (p < 0.0001). The latter antigen proved to be the most reliable marker. A less significant difference in staining pattern was found for p53 (p < 0.01). Evaluating the predictive value of the various antibodies separately for the groups with Gl vs. G2 carcinomas and pTa vs. pTl tumors revealed a lower significance for all antibodies. The technique of immunostaining on paraffin sections facilitates further retrospective studies on archival material. These markers may provide additional information about the probability of recurrence of superficial bladder tumors. But at the moment they should only be utilized in selected ca

ISSN:0042-1138    

DOI:10.1159/000283032

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to understand the mechanisms by which capsaicin at high concentrations affects the micturition reflex and detrusor contractility, in vivo and in vitro whole bladder studies were conducted using ganglionic blockers and a neurokinin receptor antagonist. Thirty-eight adult rats were divided into control (normal saline cystometry) and experimental (1,000 µM capsaicin cystometry) groups. Both groups were subdivided to receive pretreatment with intravesical hexamethonium, perivesical hexamethonium, or intravesical spantide ([D-Arg1, D-Trp7,9, Leu11]-substance P). After in vivo cystometry, the bladders were removed and in vitro whole bladder contractility studies using electrical field stimulation as well as bethanechol and KC1 stimulations were performed. In the bladders pretreated with perivesical hexamethonium, the amplitudes of contractions and in vitro detrusor contractility under electrical stimulation were decreased. Other bladder preparations showed no significant differences from the controls. However, when 1,000 µM capsaicin was infused into the bladders, both control and experimental bladders showed an initial excitation and a final inhibition with an elevated basal intravesical pressure and retention. Capsaicin at 100 µM did not have this effect. The results of this study conclude that blockage of perivesical ganglia or neurokinin receptors in the submucosa did not influence the depressant effects of 1,000 µM capsaicin on the micturition reflex and detrusor contractility in rats. Nonspecific toxic effects on detrusor muscle or nerves is likely when intravesical high-concentration capsaicin is administe

ISSN:0042-1138    

DOI:10.1159/000283035

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In a retrospective study we analyzed patients undergoing open stone removal in the Department of Urology of the University of Tübingen. In 2.7% of all urinary calculi, open stone surgery was necessary. Open operation was performed on all patients with complete staghorn calculi as well as on patients with renal pelvic stones and simultaneous morphological obstruction. Partial staghorn calculi were operated on only after endoscopic treatment had failed. Small renal pelvic stones and ureteral stones were surgically removed only after extracorporeal shock wave lithotripsy (ESWL) and endoscopic surgery had been unsuccessful. The treatment of choice for ureteral calculi is ESWL. If ESWL is impossible, an endoscopic approach is advisable. Open operations of ureteral calculi only have to be performed if endoscopic therapy has failed or if there is a simultaneous morphological obstruction. Meta-analysis of publications from 1981 to 1995 confirmed our approach regarding indications for open stone removal. Comparison of the results reported in the literature is very difficult because of the missing, but generally accepted definition of stone free. In addition different examination techniques to determine the status Ê»stone free’ make it difficult to compare the various stu

ISSN:0042-1138    

DOI:10.1159/000283037

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: Several surgical techniques have been applied for the treatment of cavernosal venous leakage, sufficient enough to create erectile dysfunction. In light of the variable success rates, we report our experience with deep dorsal penile vein arterialization for the management of severe cavernosal venous leakage. Patients and Methods: Twenty-four impotent patients with venous leakage were treated by the Virag-II type of end-to-end anastomosis of the inferior epigastric artery to the deep dorsal penile vein and ligation of the vein proximally. Diagnostic evaluation included color flow Doppler sonography before and after intracavernous 60 mg papaverine injection and dynamic cavernosometry/cavernosography, which indicated veno-occlusive dysfunction in 28 patients. Revascularization was technically possible in 24 of the patients, although in 4 anastomosis could not be achieved due to the poor quality of the inferior epigastric artery. Results: Five patients had early occlusion in the immediate postoperative period and 4 had late occlusion within 8 months. Potency was improved initially in 9 (38%) of the 24 patients in whom successful anastomosis had been achieved, with longer term improvement in 6 (25%) of 24 who realized restoration of erectile potency as defined by clinical investigations. The mean follow-up was 24 months (range 3-36 months). Conclusion: We believe that anastomosis of the inferior epigastric artery to the deep dorsal penile vein and ligation of the vein proximally in cases of venous leakage results in a low success rate due probably to a pancavernosal alteration in corporal tissue compliance.

ISSN:0042-1138    

DOI:10.1159/000283040

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Seventeen patients with invasive bladder cancer aged between 44 and 67 years underwent radical cystectomy and construction of the continent urinary reservoir from 20 to 25 cm cecoascendum reconfigurated a.m. Heineke-Mikulicz, and submucosally embedded tapered ileum as a continence mechanism – Ê»Tifiis pouch’. There were no perioperative mortalities and only minor complication but abdominal wound dehiscence occurred with a subsequent hernia in 1 obese patient. One patient died of urethral recurrence and malignancy progression 14 months after surgery. During the follow-up period of 9–37 months, all renal units remained unobstructed. Eleven of 15 preoperatively dilated units improved. No case of pouch stone formation, stomal stenosis or difficulties with catheterization was observed. All patients are continent but 4 need catheterization at 3-hour intervals. The functional capacity is in the range of 310–560 ml. The Tifiis pouch is a capacious reservoir in which the continence state is satisfactory, perioperative complication rate is low and quality of lif

ISSN:0042-1138    

DOI:10.1159/000283043

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Seven cases of adrenal myelolipoma comprising 5.8% of total adrenal tumors are described with a male-to-female ratio of 1.3:1. Five were symptomatic, of which 4 had a palpable abdominal mass, 2 cases detected incidentally were associated with carcinoma of the uterine cervix and renal cell carcinoma, respectively. The average age and duration of symptoms at presentation were 56 years (range 38–70 years) and 3.16 months (range 1–9 months). A CT scan was done in all cases, of which 5 showed a nonenhancing mass lesion with fat density diagnosed as adrenal myelolipoma. However, in 1 case radiological diagnosis of liposarcoma was maintained because of the huge size of the lesion whereas in another case the lesion was missed because of associated renal cell carcinoma. Interestingly the right adrenal was involved in all cases and the weight varied from 7 to 2,000 g. No recurrence was noted in the follow-up period (ranging from 3 months to 10 yea

ISSN:0042-1138    

DOI:10.1159/000283044

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Bladder hemangioma is a rare benign tumor occurring in any age group. We report the case of a 76-year-old woman having a bladder hemangioma. On cystoscopic examination no typical features of the bladder hemangioma were found. Biopsy of the lesion revealed a cavernous hemangioma. A partial cystectomy was performed for the control of macroscopic hematuria.

ISSN:0042-1138    

DOI:10.1159/000283045

出版商:S. Karger AG    

年代:1997

数据来源: Karger