Expression of hsa-let-7b-5p, hsa-let-7f-5p, and hsa-miR-222-3p and their putative targets HMGA2 and CDKN1B in typical and atypical carcinoid tumors of the lung

Typical and atypical carcinoid tumors belong to the neuroendocrine lung tumors. They have low recurrence and proliferation rate, lymph node, and distant metastases. Nevertheless, these tumors have shown a more aggressive behavior. In the last years, microRNAs were screened as new tumor markers for their potential diagnostic and therapeutic relevance. The expression of hsa-let-7b-5p, hsa-let-7f-5p, hsa-miR-222-3p, and their targets HMGA2 (high-mobility group A2) and CDKN1B (cyclin-dependent kynase inhibitor 1B, p27^kip1) was evaluated in this rare small group of patients. We analyzed the clinical data of all typical and atypical carcinoid tumors of patients who underwent surgical operation at Marburg University Hospital (n = 18) from 2000. Quantitative reverse transcription polymerase chain reaction was performed in formalin-fixed paraffin-embedded tumor tissue versus four tumor-free lung tissue samples. HMGA2 was stable or downregulated; only one patient showed a significant overexpression. CDKN1B showed a significant overexpression or a stable level; it was downregulated in two samples only. Hsa-miR-222-3p resulted almost stable or overexpressed except for two samples (significantly downregulated). Hsa-let-7f-5p was stable or overexpressed in the majority of analyzed samples, whereas hsa-let-7b-5p was significantly downregulated. HMGA2 and CDKN1B are differently expressed between atypical and typical carcinoid tumors, thus representing valid biomarkers for the classification of the two tumor groups. Hsa-let-7f-5p and HMGA2 are inversely correlated. Hsa-miR-222-3p does not correlate with its predicted target CDKN1B.

[Transurethral punch resection of the prostate (cold punch). Results and complications]

In 1965 the cold punch technique of transurethral prostatic resection was introduced in Germany. The principal differences between the electroresectoscope and the punch resectoscope are explained. This report on the results and complications of cold punch resection of the prostate is based on 3030 patients who were operated upon by this technique. The average age was 71,6 years. 8,2% of the patients were 80 years or older. In 33,6% the operative risk was increased. Intraoperative, early and late complications of the procedure are reported. The mortality of 1,4% over the entire 20 year period was decreased to 0,65% for the last 10 years.

[Complications of radical prostatectomy]

Between 1969 and 1984 a radical prostatectomy was performed in 175 patients for localized carcinoma of the prostate. This corresponds to a percentage of 18,2% of 962 patients with cancer of the prostate admitted to this hospital during the same period of time. The intra- and postoperative complications following radical prostatectomy in this series of 175 patients are analyzed. In 144 patients a retropubic prostatectomy was performed, whereas in 31 patients the perineal approach was utilized. There was a mortality rate of 1.1% (2 patients). Rectal injuries in 7 patients and ureteral transsection in 2 patients accounted for intraoperative complications. In the early postoperative period non-fatal pulmonary embolism occurred in 4 and myocardial infarction in 3 patients. In 3 cases (1,7%) a transitory hemodialysis became necessary because of renal insufficiency. Lymphoceles had to be treated in 22 patients (12,6%) and hematomas in 9 patients (5,1%). Persistent total urinary incontinence was observed in 8 patients (5%) and stress incontinence of varying degree in 25% of cases. The causes of these complications are analyzed and possible ways of preventing and treating them are discussed.

[Gastrointestinal hemorrhage]

More than 90% of all acute gastrointestinal bleeding is localized in the upper gastrointestinal tract. Manifestation of bleeding elucidates a life-threatening situation. An immediate planned approach with rapid resuscitation from shock, localization of the source of bleeding, estimation of the intensity of bleeding, and local control is necessary. The outcome is influenced more by patient factors and type of bleeding than by therapy. If local control of the source of bleeding is not feasible, a definitive procedure must be employed rapidly.