mRNA expression of G(1)-phase cell cycle regulatory molecules in bladder cancer

PURPOSE

Cell cycle regulation, which is important for normal cellular proliferation, is controlled by a complex network of intracellular proteins, with cyclins, cyclin-dependent kinases (CDKs) and cyclin-dependent kinase inhibitors (CD-KIs) playing a central role. This equilibrium is interrupted in cancer cells, resulting in uncontrolled cellular proliferation.

METHODS

In the present study we examined, by means of semi-quantitative RT-PCR, the expression of G(1)-phase cell cycle regulators MDM2, E2F1, Cyclin D1 (CCND1), CDK4, p19(INK4D), p21(WAF1/CIP1) and p27(KIP1) in a series of 32 bladder cancer specimens paired with adjacent normal tissues.

RESULTS

Cyclin D1 was overexpressed in 10/32 (31.2%) and downregulated in 8/32 (25.0%) bladder cancer specimens. Additionally, p21 was overexpressed in 9/32 (28.1%) and downregulated in 10/32 (31.3%) cancer samples. On the contrary, MDM2, E2F1, CDK4, p19 and p27 expression was normal in the majority of malignant specimens. Further statistical analysis revealed significant associations between increased p21 levels and bladder cancer patients with no exposure to chemicals (p=0.048), as well as with patients with no artificial sweetener intake (p=0.012), and between increased Cyclin D1 levels and study subjects with no artificial sweetener intake (p=0.012).

CONCLUSION

Based on these results, we conclude that Cyclin D1 and p21 mRNA deregulation seems to be an important event in bladder carcinogenesis. However, further studies are needed, in order to determine whether these two cell cycle regulators can be used as markers for the early detection of bladder cancer and to monitor its progression and recurrence.

Finasteride: a long-term follow-up in the treatment of recurrent hematuria associated with benign prostatic hyperplasia

OBJECTIVES

To assess the effectiveness and long-term results after finasteride treatment of recurrent hematuria associated with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

The study comprised 80 patients, aged 62-86 (mean 74) years, of whom 50 received finasteride 5 mg once daily for 4 years and 30 were used as controls. Patients with malignancy, severe hepatic or renal failure and hematologic disorders were excluded. Patients were divided into 3 groups according to the severity of hematuria (minor, moderate, severe). All patients were followed up at 3, 12, 24 and 48 months.

RESULTS

The follow-up ranged from 8 to 48 (mean 22) months in the finasteride group and 3-42 (mean 23) months in the control group. Hematuria recurrence rates were 6/50 (12%) and 23/30 (77%) in the finasteride and control groups, respectively. Surgical treatment was needed in 6 patients of the finasteride group and 19 of the control group. Patients with minor hematuria experienced no recurrence of symptoms in the finasteride group in contrast to 13 of 17 patients in the control group. For the patients with moderate hematuria, recurrence of symptoms was observed in 3 of 13 in the finasteride group and 3 of 5 in the control group. Three of six patients with severe hematuria had a recurrence of symptoms after finasteride treatment in contrast to 7 of 8 in the control group.

CONCLUSION

Finasteride has proved to be a safe, well tolerable and effective medication in reducing or preventing recurrent hematuria related to BPH.

Long-term results after percutaneous minimally invasive procedure treatment of symptomatic simple renal cysts

OBJECTIVE

To assess the effectiveness and long-term results of two repeated ethanol injections in the treatment of symptomatic renal cysts.

METHODS

Sixty-eight patients 47 to 75 years old with 77 large (6.3-14.8 cm; mean 8.62 cm) symptomatic cysts were included in this study. Of the 68 patients, in 4 cases there were renal cysts associated with renal calculi. An 8FR Pigtail catheter was inserted into the cyst under ultrasound guidance followed by aspiration of cystic fluid. Two repeated ethanol 95% injections were performed every 24 hours. Patients were followed-up by ultrasonography for a period of 12-48 months (mean 30).

RESULTS

In two patients the cyst puncture was not feasible because of poor visualization of puncture site while in one patient there was communication of cystic cavity with the pelvocaliceal system. In these patients surgical resection of cysts was performed. Complete and partial regression rates were 57/68 (83.82%) and 8/68 (11.76%) respectively. In four patients with renal stones and renal cysts, extracorporeal shock wave lithotripsy (ESWL) was successfully executed I month after sclerotherapy.

CONCLUSION

Our results suggest that percutaneous aspiration followed by two repeated ethanol injections is highly effective on reducing recurrence of simple renal cysts.

Ureteral drainage by double-J-catheters during pregnancy

PURPOSE

To access the safety and effectiveness of Double-J-stents in treating symptomatic hydronephrosis during pregnancy.

MATERIAL AND METHODS

From 1994 to 1999, 21 women were hospitalized in the Urology Clinic at the University Hospital of Crete. Fourteen patients presented acute pyelonephritis, six painful hydronephrosis and one spontaneous renal rupture. In four cases the hydronephrosis was caused by calculus in the upper 3rd quadrant of the ureters. In 13 out of 14 cases of urinary febrile infection and one with spontaneous renal rupture, the dilatation resulted from direct compression of the ureters by the gravid uterus. Using ultrasound guidance, 21 ureteral stents were successfully placed under local ane- sthesia.

RESULTS

In 14 out of 21 patients with urinary infection, we observed remission of fever during the first 24 hours after the placement of the ureteral stents. In the patient with spontaneous renal rupture the remission of symptoms was observed a few hours after the ureteral drainage. Complications were reported in six cases, such as, voiding symptoms and discomfort.

CONCLUSION

Double-J-ureteral stenting is an effective, simple and safe method in treating symptomatic hydronephrosis during pregnancy.