The effect of nifedipine and verapamil on rhythmic contractions of human isolated ureter

The effect of calcium antagonists nifedipine and verapamil on spontaneous rhythmic contractions of human isolated ureter obtained from donor subjects undergoing kidney transplantation was investigated in comparison with a nonsteroidal antiinflammatory drug indomethacin. Stop-times i.e. the time elapsing from application, were determined for each drug. The rank order of potency at 10(-8) and 10(-7) M concentrations of the drugs was: nifedipine > verapamil > or = indomethacin. However, no significant difference of the stop-times was observed at 10(-6) M concentration of the drugs tested. The rhythmic contractions were re-activated by PGF2 alpha after stoppage with indomethacin but not with nifedipine or verapamil. These results suggest that not only endogenous PG synthesis but also an influx of calcium from the extracellular space is responsible for the spontaneous rhythmic activity of human ureter. The beneficial effects of using calcium antagonists in the treatment of ureteric colic is discussed.

Peritoneal mesothelioma: sonographic findings in nine cases

Ultrasonographic findings in nine cases of peritoneal mesothelioma are presented. The most common findings were sheet-like or nodular peritoneal thickening, soft tissue masses, fixation of the intestinal loops, mesenteric thickening, and minimal ascites which was disproportional to the degree of tumor dissemination. The authors found that abdominal sonography, using 3.75-7.5 MHz transducers, is a useful imaging method for diagnosis of peritoneal mesothelioma in high-risk groups.

Strategies for the application of biomarkers for risk assessment and efficacy in breast cancer chemoprevention trials

Current chemoprevention trial designs based on epidemiological risk assessment and occurrence of cancer as an endpoint are inefficient and expensive. Novel biomarkers are needed to facilitate the development of chemopreventive interventions. The following four categories of biomarkers may be useful in prevention trials: histologic and morphometric markers; phenotypic markers of dysregulated proliferation, differentiation, and cell loss; specific oncogenes and growth regulators which are qualitatively or quantitatively altered in breast cancers; and markers of genetic and epigenetic instability. Some of these markers will be generally useful regardless of the chemopreventive approach used, whereas others may be uniquely useful in trials of specific chemopreventive agents [e.g., upregulation of progesterone receptor (PR) expression in response to tamoxifen]. The development of these markers requires three phases of study: "Phase I": assessing the prevalence of the putative marker in malignant and premalignant tissue from individuals who have developed breast cancer; "Phase II": assessing in vivo modulation of the biomarker by the proposed chemopreventive agent; and "Phase III": applying the proposed biomarker in larger-scale trials of chemopreventive agent in high-risk populations, either before or after the development of a primary breast malignancy. The use of these biomarkers may also allow identification of novel targets for chemoprevention.

Chromosome in situ hybridization on formalin-fixed mammary tissue using non-isotopic, non-fluorescent probes: technical considerations and biological implications

Fluorescent in situ hybridization techniques have provided an important tool for interphase cytogenetic studies of human neoplasms. However, these techniques are difficult to use on formalin-fixed archival tissue sections. We describe here a non-fluorescent, non-isotopic in situ hybridization (ISH) approach that is easily applicable to paraffin-embedded breast tissue sections. The technical steps that must be monitored and individualized to optimize signal generation and detection are discussed. This ISH technique has several advantages over fluorescent detection methods. The signal obtained can be viewed using an ordinary light microscope and does not fade with time. More importantly, the signal is observed and analyzed in the context of tissue morphology. The technique permits detection of numerical chromosomal abnormalities not only in malignant but also in apparently normal and potentially premalignant mammary tissue. This may allow identification of focal genetic abnormalities as well as field-defects and enable analysis of their evolution during the multistep transformation to mammary neoplasm. This technique is also suitable for analysis of tumor heterogeneity and the correlation of numerical chromosomal aberrations with histologic, immunocytochemical, and clinical features of breast tumors.

p53 protein expression in transitional mucosa and adenocarcinomas of the colorectum

Transitional mucosa, the nonneoplastic mucosa adjacent to colorectal adenocarcinomas, exhibits some morphologic and histochemical abnormalities. It is unclear, however, whether transitional mucosa is a preneoplastic or reactive phenomenon. Though normal p53 functions as a tumor suppressor, p53 gene alterations have been proposed as a step in malignant transformation, and aberrant p53 protein expression has been described in a high percentage of colonic adenocarcinomas. Since p53 protein normally has a short half-life, immunohistochemical detection of the protein is considered to be evidence of abnormal p53 expression. We analyzed p53 protein expression immunohistochemically on frozen tissue samples of transitional mucosa, normal mucosa, and tumor from 20 cases. In all 20 cases the transitional mucosa and normal mucosa failed to express p53, while 13 of 20 adenocarcinomas showed positive immunoreactivity characterized by intense nuclear staining. There was no correlation between tumor stage and p53 expression. The absence of staining for p53 protein in TM does not support the theory that transitional mucosa is a preneoplastic phenomenon.

Altered expression of retinoblastoma protein and known prognostic variables in locally advanced bladder cancer

BACKGROUND

The clinical behavior of the tumor in patients with locally advanced bladder carcinoma is unpredictable. Current predictors of clinical behavior include depth of muscle invasion, presence of vascular invasion, proliferation rate, and loss of blood group antigens. Treatment selection would be facilitated by the development of a reliable marker of tumor progression. Functional retinoblastoma (RB) gene loss has been reported to occur in bladder carcinoma, but the significance of this loss is unknown.

PURPOSE

We have evaluated the frequency of functional loss of the RB gene in locally advanced bladder carcinoma and have compared the results to known prognostic factors in the same cohort.

METHODS

Forty-three study patients with pathologically well-characterized, locally advanced bladder carcinoma, who were placed in a protocol incorporating surgery and chemotherapy, were studied for known clinical and pathological prognostic indicators as well as for their Rb status. Formalin-fixed and paraffin-embedded archival primary tumor tissues were used for histological and immunohistochemical analyses.

RESULTS

Altered Rb protein expression was documented in 37% of the tumor specimens. The high rate of altered Rb expression found in this cohort with advanced urothelial tumors strongly suggests that RB functional loss may be associated with tumor progression in this malignancy. Altered Rb protein expression was found to be independent of other known prognostic variables. A significantly poorer tumor-free survival rate also was noted for those patients who had a tumor with an altered Rb protein with or without vascular invasion.

CONCLUSION

The high frequency of Rb alteration in locally advanced bladder carcinomas, plus the fact that a significant correlation could not be found between the Rb status and other known prognostic markers in this preliminary study, suggests that altered RB expression may be an independent prognostic marker of tumor progression in bladder cancer.

Thymoma. The prognostic significance of flow cytometric DNA analysis

The clinical course of patients with thymoma varies widely despite its histologically benign appearance. Treatment decisions are based on local invasion and the extent of resection. Because some patients have more aggressive tumors, the prognostic significance of flow cytometric (FCM) analysis of nuclear DNA content was examined. Adequate tissue from paraffin-embedded blocks was available for 25 patients. Using FCM, the percentage of cells in S-phase (%S) and the ploidy, based on the DNA index (DI), were determined. The mean patient age was 52 years, with a female-to-male ratio of 1.3:1 and a median follow-up of 64 months. Seventeen patients underwent total tumor resections, and 12 also received radiation therapy. Eight patients underwent subtotal resections, with five receiving radiation therapy (with or without chemotherapy) and three receiving chemotherapy alone. Based on invasion and intrathoracic dissemination, the tumors were classified into four stages. The mean %S was 5.6. There was no relationship observed between %S and patient outcome. The 5-year disease-free survival rate was 85% for the 16 patients with diploid (DI = 1) tumors and 33% for the 9 patients with aneuploid (DI more than 1) tumors (P less than 0.002). Similar significant differences were observed by stage and extent of surgery. For those who had total resection (n = 17), the disease-free survival rate was 89% when DI equaled 1 and 50% when DI was more than 1 (P = 0.01). Although the numbers studied were small, when stage, histologic findings, and type of surgery were subdivided by DI, a higher incidence of relapse was associated consistently with aneuploidy. The DI appears to be a useful prognostic parameter for identifying patients at high risk of relapse.

Genital infections in men associated with Chlamydia trachomatis

The advent of new diagnostic procedures has made it possible for urologists to detect chlamydial presence in genital infections. Many studies have shown chlamydial association with urethritis. However, its presence in prostatitis and epididymitis has not been clearly defined yet. In this study we investigated the presence of Chlamydia trachomatis using enzyme linked immuno assay (ELISA) antigen and antibody detection method in sexually active men with different genital infections. We have found that in 32.1% of patients with non-gonococcal urethritis chlamydial antigen is detectable. We also have been able to detect chlamydial antigen in two patients with chronic non-bacterial prostatitis, but in no patients with epididymitis. We conclude that besides its presence in urethritis, there is an association between chlamydia and chronic prostatitis. Yet, further studies are needed to delineate this association more clearly.

Development of urethral stricture after transurethral prostatectomy: a retrospective study

A total of 103 patients who were diagnosed to have benign prostatic hyperplasia (BPH) without preoperative urethral stricture and underwent transurethral prostatectomy (TURP) were evaluated retrospectively from patient charts. The incidence of urethral stricture development was calculated as 11.65% (12 out of 103 patients). Among the aetiologic factors analyzed, the most important ones appeared to be postoperative infection, age of the patient, duration of postoperative catheterization and histology of the disease, in the order of significance in the development of urethral stricture after TURP.

Analysis of calcium, iron, copper and zinc contents of nucleus and crust parts of urinary calculi

In this study we compared the concentrations of calcium, iron, copper and zinc in the nucleus and the crust parts of various kinds of urinary calculi. We found that the mean concentrations of iron, zinc and copper in the nucleus parts of the stones were statistically higher than those in the crust parts. We attempted to explain this finding by two different approaches. Inter- and intra-correlations were also sought between the elements in the nucleus and crust parts. These correlations suggested a complex relationship between the elements of the urinary calculi.

Sclerosing lipogranuloma of the penis. A case report

Sclerosing lipogranuloma of the male genitalia is a rather uncommon condition presenting with subcutaneous masses of the penis and the scrotum. The masses are composed of granulomatous tissue formed around an either exogenous or endogenous lipomatous substance. In case of incomplete resection the masses show a rapid recurrence, thus mimicking a neoplastic lesion. On the basis of a case report a review of this entity in the literature is presented here.

Screening of asymptomatic siblings of patients with vesicoureteral reflux

Familial trait in vesicoureteral reflux (VUR) has been revealed in many studies. This paper reports on 36 siblings of 25 patients operated for vesicoureteral reflux at our Department. Siblings aged 2 to 21 years were evaluated by urine examination, urine culture and voiding cystourethrogram (VCU) for VUR. All of the siblings were asymptomatic and VUR was found in only 4 of them (11%), unilateral in 3 cases and bilateral in one case. It is concluded that evaluation of siblings for VUR will be suitable for revealing the presence of urinary infection, and assessing them by VCU at the time they are first seen.

Sodium, potassium and chloride concentrations in the inner nucleus and outer crust parts of urinary tract calculi

In this study sodium, potassium and chloride concentrations were analysed in the nucleus and crust parts of various kinds of urinary tract calculi. Concentrations of these elements in the nucleus were found to be higher than those in the outer crust part. Moreover, some intra- and inter-correlations were established among the elements mentioned in these two parts of the stones. It was also determined that sodium, potassium and chloride concentrations in the nucleus and crust of various urinary tract stones exhibited statistically significant differences.

CT findings in malignant pleural mesothelioma related to nonoccupational exposure to asbestos and fibrous zeolite (erionite)

Endemic malignant pleural mesothelioma (MPM) in Turkey is related to two mineral fibers, tremolite asbestos and fibrous zeolite (erionite). Thirteen cases of MPM from the Cappadocian area, where the soil is rich in erionite, and 29 cases of MPM, from villages whose occupants have high asbestos exposure, were examined by CT. The CT findings of the two groups of MPM were compared with respect to the configuration of the pleural lesions, stage of disease, fissural involvement, pleural effusion, presence of calcified pleural plaques, and chronic fibrosing pleuritis. In erionite-related MPM the pleural lesions were flat and smooth in 69.1%; in asbestos-related MPM the lesions were nodular in 55.1%. Stage IV disease, calcified pleural plaques, and chronic fibrosing pleuritis were more common in the erionite-related MPM. The rest of the findings were similar in both groups. The early radiological diagnosis of erionite-related MPM may be even more difficult because of the similarity of the pleural lesions to chronic fibrosing pleuritis.

Immunohistochemical analysis of P-glycoprotein expression correlated with chemotherapy resistance in locally advanced breast cancer

We analyzed the expression of P-glycoprotein in samples from 48 patients with locally advanced breast cancer. Tumor samples from 40 patients were obtained at mastectomy, which was performed after three cycles of induction chemotherapy consisting of doxorubicin, cyclophosphamide, vincristine, and prednisone. P-glycoprotein expression distributed focally was observed in 20 tumors by the immunoperoxidase method using the anti-p170-monoclonal antibody C219. The percentage of the tumor cell population expressing P-glycoprotein varied from less than 5% to greater than 30%; expression was observed significantly more often in tumors that showed less than partial response to the preoperative chemotherapy. Furthermore, P-glycoprotein was not expressed in eight tumor specimens obtained at the time of diagnosis, prior to chemotherapy, from patients who subsequently had pathologic complete responses. A comparative study of P-glycoprotein expression before and after chemotherapy and upon recurrence of tumor was done on a limited number of samples. No significant differences in P-glycoprotein expression were found. Therefore, it is possible that an intrinsic, rather than acquired, drug resistance may play a role in the failure of induction chemotherapy for locally advanced breast cancer.

Iron, copper, cadmium, zinc and magnesium contents of urinary tract stones and hair from men with stone disease

Forty-seven urinary tract stones consisting of 5 pure magnesium ammonium phosphate (subgroup 1), 5 mixed calcium oxalate-magnesium ammonium phosphate (subgroup 2), 8 mixed calcium oxalate-calcium phosphate (subgroup 3), 6 mixed calcium oxalate-uric acid (subgroup 4) and 23 pure calcium oxalate stones (subgroup 5) and hair from these patients and control subjects were analyzed for iron, copper, cadmium, zinc and magnesium content by atomic absorption spectroscopy. Mean values +/- SD for each group were determined and statistical correlations were made to establish differences among the stone elements themselves, the hair elements themselves, and the stone and hair elements for group 5 (calcium oxalate stone group). We found significant differences among the element levels of the stones, patient hair and control hair. In particular, hair magnesium and cadmium levels of control and patient groups appear to have promising features for future work concerning urinary tract stone disease.

Immotile cilia syndrome including polysplenia, situs inversus, and extrahepatic biliary atresia

Here we report on 2 sibs with immotile cilia syndrome (ICS), born to consanguineous Arab parents. Both had the Kartagener triad. In addition, one sib had polysplenia and extrahepatic biliary atresia. This observation, together with other literature reports, suggests that the occurrence of ICS with polysplenia and extrahepatic biliary atresia represent the result of a single dysmorphogenetic process. It is concluded that polysplenia and extrahepatic biliary atresia are rare and unusual manifestations of ICS.

An immunohistochemical study of primary ovarian sarcoma. An evaluation of nine tumors

Nine cases of primary ovarian sarcoma were studied with a panel of 10 antibodies by using the avidin-biotin-complex immunoperoxidase technique. Original diagnoses included five mixed müllerian tumors (MMT) homologous type, two MMT heterologous type, and two pure sarcomas (PS). Cytokeratin immunoreactivity was observed in epithelial components of all MMTs, but was not observed in PS. Two tumors originally classified as MMT also showed cytokeratin positivity in spindle-cell components. All the PSs and the spindle-cell components in six of seven MMTs showed positive staining for vimentin. Positive staining for desmin and myoglobin was found in one MMT in which cells with cytoplasmic cross-striations were identified on hematoxylin and eosin sections. However, less differentiated rhabdomyoblastic cells also stained for desmin and myoglobin, facilitating their recognition. Immunoreactivity for epithelial membrane antigen was noted in well-differentiated epithelial components of six MMT cases. One case stained with antibodies to carcinoembryonic antigen, four with S-100 protein, five with alpha-1-antitrypsin, and four with muramidase. No staining of stromal hyaline droplets was observed with any antibodies. Because of the immunohistochemical staining pattern, two of the original diagnoses were changed. Application of immunohistochemistry to spindle tumors of ovary is discussed.

Trichobezoar associated with gastric polyposis

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Primary ovarian Wilms' tumor

A case of extrarenal Wilms' tumor presenting as an ovarian mass in a woman 56 years of age is described. Histologically, glomeruloid and tubular structures were identified within nests of undifferentiated epithelium. No teratomatous components were encountered. A review of the literature found three other reports of Wilms' tumor occurring in the female genital tract. This case represents the oldest patient with extrarenal Wilms' tumor in the literature.