Un-methylation of the survivin gene has no effect on immunohistochemical expression of survivin protein in lung cancer patients with squamous cell carcinoma

Survivin is a member of the inhibitor of apoptosis (IAP) family. The function of the survivin protein is to inhibit caspase activation, thereby leading to negative regulation of apoptosis or programmed cell death. This has been shown by the disruption of survivin induction pathways leading to an increased apoptosis and decreased tumour growth. These data suggest that survivin may provide a new target for cancer treatment, which would distinguish transformed cells from normal cells. In the present study, we aimed to investigate exon 1 of the survivin gene by means of methylation-specific PCR and evaluate its impact on survivin protein expression following DNA isolation and bisulphite modification in paraffin-embedded normal and tumour tissues of lung cancer patients with squamous cell carcinoma. We used 41 squamous cancer tissues with methylation in exon 1 of the survivin gene and non-methylation in corresponding tumours. However, the immunohistochemistry staining of these samples demonstrated an increased survivin protein compared to normal tissue. While there is almost no other study to date on this subject matter, we believe that the absence of methylation in exon 1 of the survivin gene may not affect disease prognosis as it has no effect on expression, and possible promoter methylation or transcription factors (Tab. 1, Fig. 4, Ref. 15).

Comparison of home-based and outpatient clinic-based intravaginal electrical stimulation for the treatment of urinary incontinence

AIM

Aim of the study was to compare the effects of outpatient clinic-based versus home-based intravaginal electrical stimulation (ES) for the treatment of urinary incontinence.

METHODS

Women applying with the complaint of urinary incontinence and offered ES treatment were divided into outpatient clinic-based or home-based ES. Patients were instructed about home-based ES at the outpatient clinic by certified physiotherapy nurses. Bladder diary, 1-hour pad test, and King's-Health-Questionnaire (KHQ) were performed before and after treatment. ES was applied for 20 minutes, 6-8 weeks with pulses of 10-50 Hz square waves at a 300 μs or 1 ms pulse duration and a maximal output current of 24 to 60 mA with 5-10 Hz frequency, three times/week.

RESULTS

Twenty-four patients received outpatient clinic-based, 22 patients received home-based ES. Pad test, bladder diary and pelvic floor muscle strength parameters in both groups improved significantly after treatment, with no significant difference between the two groups. Seven patients (31.8%) were cured, six patients (27.3%) were much improved, and seven patients (31.8%) were improved in the home-based ES group. Nine patients (37.5%) were cured, six patients (25%) were much improved, and six patients (25%) were improved and in the outpatient clinic-based ES group. There was an improvement in quality of life in all domains in both groups when the pretreatment and post-treatment KHQ results were compared, with no significant difference between the two groups.

CONCLUSION

Home-based ES is as effective in the treatment of urinary incontinence as outpatient clinic-based ES with significant improvement in objective and subjective parameters.

Does tension-free vaginal tape and tension-free vaginal tape-obturator affect urodynamics? Comparison of the two techniques

AIM

To evaluate the effects of tension-free vaginal tape (TVT) and tension-free vaginal tape-obturator (TVT-O) operations on urodynamics and subjective and objective outcomes.

MATERIALS AND METHODS

Thirty-six patients with stress or mixed urinary incontinence underwent TVT or TVT-O. Bristol Female Lower Urinary Tract Symptoms (BFLUTS) Questionnaire-Scored Form, one-hour pad test, Q-tip test, perineometer, and urodynamics were performed before and after the operations. Blaivas-nomogram was used for assessment of postoperative voiding difficulty.

RESULTS

Nineteen patients underwent TVT-O and 17 patients underwent TVT. Mean follow-up was 18.4 +/- 6.8 months. There was no difference between two groups regarding demographic variables, degree of prolapse, type of incontinence, perineometer, Q-tip test, pad test, and urodynamics. There was a significant increase in the maximum urethral closure pressure (MUCP) and residual volume in TVT-O group. According to Blaivas-nomogram, five patients had mild, one had medium obstruction in the TVT-O group, whereas one had mild and three had medium obstruction in TVT group. Two bladder perforations occurred during TVT. One patient developed groin pain after TVT-O.

CONCLUSIONS

TVT-O may lead to an increase in MUCP and residual urine volume. TVT-O is as efficient as TVT and leads to milder obstruction when compared to TVT.

The effects of simple and radical hysterectomy and radiotherapy on lower urinary tract symptoms and urodynamics

PURPOSE

To evaluate effects of simple/radical hysterectomy, radiotherapy, and their combination on lower urinary tract symptoms (LUTS) and urodynamics.

MATERIALS AND METHODS

Four groups were formed as simple hysterectomy; Group 1 (n = 20), Type-II hysterectomy; Group 2 (n = 11), Type-II hysterectomy + radiotherapy; Group 3 (n = 16), radiotherapy; Group 4 (n = 20). LUTS, bladder diary, pad test, Q-tip test, stress-test, urodynamics, bladder-wall-thickness measurement, King's Health Questionnaire (KHQ) performed prior and at six and 18 months after treatment.

RESULTS

Pre-treatment prevalence of LUTS was higher in Group 1 and decreased at six and 18 months. LUTS increased in Groups 2, 3, and 4 at six months; some of the symptoms decreased to pre-treatment levels at 18 months. Quality of life improved in Group 1 and worsened in the others. Maximum bladder capacity increased in Group 1 and decreased in Groups 2 and 3. Bladder-wall-thickness, maximum detrusor pressures increased, urine sensation decreased in Groups 2 and 4. Maximum vesical pressure increased and compliance decreased in Groups 2 and 3.

CONCLUSION

LUTS may decrease after simple hysterectomy. Radical hysterectomy and radiotherapy result in voiding dysfunction; however some of the symptoms may decrease to pre-treatment levels during follow-up.

Abstract PL-1: Hormones and the Breast: Local and Environmental Interactions

A woman's reproductive history affects her risk to get breast cancer. In particular, the number of menstrual cycles she experiences correlates with risk. We use tissue recombination experiments and different mouse mutant models to discern the roles of the ovarian hormones estrogens and progesterone act in the mammary gland. While estrogens drive pubertal development, progesterone is the major driver of proliferation in the adult mammary epithelium. Both steroids rely strongly on paracrine signaling to elicit cell proliferation and other biological effects.

Perinatal exposure to environmentally relevant concentrations of a high production volume chemical, bisphenol A, that is detected in human due to exposure through consumer products, results in persistent changes in the mammary gland. The cell number is increased in in adult females as is the response to progesterone.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PL-1.

Penile and scrotal involvement in Buerger's disease

Buerger's disease (thromboangiitis obliterans) is a recurrent inflammatory, nonatherosclerotic vasoocclusive disease, which typically affects small and medium-sized arteries, veins and nerves of the upper and lower extremities. Although the exact underlying causes of Buerger's disease are still unknown, the disease is strongly associated with tobacco smoking. Affected patients are mostly young male smokers who develop ulcers and gangrene of the toes and fingers as a result of vascular ischaemia. We report a 47-year-old man with scrotal and penile necrosis. Partial penectomy, scrotal debridement and urethra-cutaneous anastomosis were performed.

Pelvic actinomycosis mimicking ovarian malignancy: three cases

OBJECTIVE

Three cases of pelvic actinomycosis initially diagnosed as pelvic malignancy and treated surgically are reported.

CASES

The first case was a 38-year-old multiparous woman who was referred to our clinic because of bilateral ovarian solid masses. With the impression of ovarian carcinoma, a laparotomy was performed. During surgery adhesiolysis, total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, appendectomy, peritoneal washings, and peritoneal abscess drainage were performed. The second patient was a 37-year-old woman who presented with a left-sided fixed solid mass highly suggestive of pelvic malignancy. Both ureters were found to be dilated with hydronephrosis in the right kidney supporting the diagnosis of retroperitoneal fibrosis. Excision of the mass, colectomy and temporary diverting colostomy and stent insertion to the left ureter were performed. Colostomy repair was performed five months later. On the fifth day postoperatively, fascial necrosis developed so a Bogota-bag was placed on the anterior abdominal wall and left for secondary healing. The third patient was a 51-year-old postmenopausal woman incidentally diagnosed as having a pelvic mass while having been investigated for constipation and nausea. She had had a colostomy one year before and a reanastomosis two months after. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. In all cases, histopathologic staining of the specimens revealed chronic inflammation containing actinomycosis abscesses confirmed with microbiologic identification.

CONCLUSION

Pelvic actinomycosis is an uncommon cause of a pelvic mass. However, it should be kept in mind in the differential diagnosis of pelvic masses, especially in the patients with a history of IUD use to avoid an unnecessary extensive surgical procedure.

Non specific magnetic resonance features of chondromyxoid fibroma of the iliac bone

Chondromyxoid fibroma is a benign cartilaginous neoplasm. The tumor is rare, perhaps the rarest of all bone tumors. It is more common in long bones and rare in pelvic bones. We report a case of a 31-year-old woman with chondromyxoid fibroma arising from the iliac bone and presenting with leg pain due to compression on the femoral nerve. Magnetic resonance imaging (MRI) features were non specific for chondromyxoid fibroma. We emphasize the need to consider it in the differential diagnosis of chondrosarcoma.

L-carnitine deficiency and red blood cell mechanical impairment in beta-thalassemia major

L-carnitine is an essential element of intermediary metabolism and also was shown to be effective in maintaining normal red blood cell (RBC) function. This study aimed at investigating plasma free L-carnitine concentrations and effectiveness of L-carnitine supplementation in protecting deterioration of RBC properties in beta-thalassemia major patients. Plasma free L-carnitine concentrations were determined in the blood samples obtained before their regular transfusion (about one month after the previous transfusion). Each patient received 100 mg/kg/day oral L-carnitine supplementation. RBC deformability, lipid peroxidation and intracellular free calcium concentrations were investigated before and after this treatment. Plasma free L-carnitine levels and RBC deformability before the treatment were found to be lower whereas lipid peroxidation and intracellular calcium concentration in RBC were higher compared to those of the control subjects before the L-carnitine treatment. After one month supplementation of L-carnitine lipid peroxidation and intracellular calcium concentrations were found to be decreased and RBC deformability was improved, accompanying the significantly increased plasma L-carnitine concentrations. These results suggest that L-carnitine can be used as a supplement in beta-thalassemic patients, to prevent RBC deterioration.

Hemorheological parameters as determinants of myocardial tissue hematocrit values

It is well known that the hematocrit in microvessels with diameters smaller than 1000 microm is lower than either venous or arterial hematocrit, thereby resulting in significantly lower mean hematocrit values for vessels perfusing a given tissue (i.e., lower tissue hematocrit). The mechanisms that underlie this reduction of microvascular hematocrit include axial migration, plasma skimming and the Fahraeus Effect. It has been previously demonstrated in rats that a linear hematocrit gradient normally exists through the thickness of the left ventricular myocardium, and that this gradient is sensitive to alterations of the rheological properties of the circulating blood. The gradient is abolished if the RBC in the perfusate are rigid; fibrinogen infusions, and thus increases of both plasma viscosity and RBC aggregation, also affect this gradient. In a new series of studies, it has been observed that enhanced RBC aggregation affects the myocardial hematocrit gradient regardless of alterations of plasma viscosity. Although the exact mechanisms responsible for the myocardial hematocrit gradient, as well as its physiological significance, are not yet clearly known, it is possible to speculate that alterations in local hematocrit could adversely affect myocardial perfusion and function.

Inflammatory pseudotumor of the spleen with EBV positivity: report of a case

Inflammatory pseudotumor (IPT) of the spleen is a rare benign tumor with unknown etiology. It causes problems in the diagnosis because of mimicking some hematopoetic malignancies. Here we report the case of a 36-yr-old woman complaining of nausea and insomnia. Laboratory investigations were limited to increase of leukocyte and thrombocyte count. Ultrasonography and magnetic resonance (MR) imaging showed circumscribed solid lobulated mass, measuring about 6.5 cm in diameter, located in the dorsal region of the spleen. Splenectomy was performed with the differential diagnosis including hamartoma and lymphoma of the spleen. Histological examination of the sharply demarcated splenic mass consisted of myofibroblasts and admixture of inflammatory cells. Immunohistochemistry and in situ hybridization were performed. IPT of the spleen was diagnosed. Epstein-Barr virus (EBV) was detected in the tumor by in situ hybridization. This rare entity is presented because of its clinical, radiological and pathological difficulties in the differential diagnosis.

The relationship between the enzyme activity, lipid peroxidation and red blood cells deformability in hemizygous and heterozygous glucose-6-phosphate dehydrogenase deficient individuals

Glucose-6-phosphate dehydrogenase (G6PD) activity, red blood cell (RBC) lipid peroxidation and deformability were investigated in hemizygous and heterozygous G6PD deficient subjects and compared with normal individuals. None of the subjects were in acute hemolytic crises. G6PD activity was assessed based on the spectrophotometric determination of generated NADPH. Lipid peroxidation was measured as thiobarbutiric acid reactive substances (TBARS). RBC deformability was analyzed by ektacytometry. RBC lipid peroxidation was found to be significantly higher in hemizygous subjects compared to control and heterozygous subjects, while RBC deformability was found to be significantly impaired. However, although lipid peroxidation was higher than control, RBC deformability was not significantly different from control in heterozygous individuals, characterized by significantly lower RBC G6PD activity. There were no significant correlations between these three parameters when the three groups were analyzed separately, but a significant negative correlation was found to exist between G6PD activity and TBARS when the pooled data from the three groups were used for the analysis. This was also true for the relationship between RBC deformability and G6PD activity. It has been concluded that G6PD activity is not a good predictor of oxidative damage resulting in mechanical impairment in heterozygous individuals.

An assessment of the importance of pad testing in stress urinary incontinence and the effects of incontinence on the life quality of women

Our objectives in this study were to determine the severity of incontinence using pad testing and the effects of incontinence on the life quality of women with stress incontinence. Fifty women with a diagnosis of stress urinary incontinence were selected for the study. The Symptom Severity Index (SSI) and Symptom Impact Index (SII) were used to determine the severity and impact of incontinence. Afterwards the women were given a 1-h pad test. According to the pad tests 38% of women suffered severe to very severe incontinence. Women who showed severe incontinence on pad testing scored high in the SSI; on the other hand, no relationship was found between SII and pad test indicators. It was also observed that both SSI and SII scores increased with increasing age of the women (SSI: r=0.29, P<0.05; SII: r=0.30 P<0.05). It may therefore be concluded that the severity of incontinence makes no difference in the effects of incontinence on the life quality of women.

Aggregation behavior and electrophoretic mobility of red blood cells in various mammalian species

Differences of red blood cell (RBC) aggregation among various mammalian species has been previously reported for whole blood, for RBC in autologous plasma, and for washed RBC re-suspended in polymer solutions. The latter observation implies the role of cellular factors, yet comparative studies of such factors are relatively limited. The present study thus investigated RBC aggregation and RBC electrophoretic mobility (EPM) for guinea pigs, rabbits, rats, humans and horses; RBC were re-suspended in isotonic 500 kDa dextran solutions for the EPM and aggregation measurements, with aggregation studies also done in autologous plasma. Salient results included: (1) species-specific RBC aggregation in both plasma and dextran (horse > human > rat > rabbit approximately = guinea pig) with a significant correlation between aggregation in the two media; (2) similar EPM values in PBS for rat, human and horse, a lower value for guinea pig, and a markedly reduced EPM for rabbit RBC; (3) EPM values in dextran with a rank order identical to that for cells in PBS; (4) relative EPM results indicating formation of a polymer-poor, low viscosity depletion layer at the RBC surface (greatest depletion for horse RBC). EPM-aggregation correlations were evident and generally consistent with the Depletion Model for aggregation, yet did not fully explain differences between species; additional studies at various ionic strengths and with various dextran fractions thus seem warranted.

Erythropoietin-induced rheological changes of rat erythrocytes

The effects of recombinant human erythropoietin (rhEPO) on red blood cell (RBC) rheological properties were investigated in rats. Rats received intramuscular injections of 150 U/kg/d rhEPO for 5 d, following which blood samples were obtained 1, 5 or 10 d later. RBC deformability was assessed by determining cell transit times through 5-microm micropores (CTA) and RBC shape recovery time constants via photometry, aggregation in plasma and dextran was measured by photometry and RBC electrophoretic mobility was determined in a cylindrical electrophoresis system. RBC aggregation was found to be significantly decreased on day 5 after rhEPO treatment (P < 0.05), yet was unchanged from control on days 1 and 10. Mean RBC micropore transit times remained unchanged, but the distributions of transit times were altered; compared with control, the 5th percentiles on both days 1 and 5 were decreased and the 95th percentile on day 1 was elevated. Electrophoretic mobility of RBCs in phosphate-buffered saline was significantly increased on day 5 after rhEPO treatment (P < 0.05), with mobility measurements in dextran 500 (MW = 500 kDa) solutions suggesting that the cells' surface properties related to the formation of a 'depletion layer' may be altered on day 1. These results indicate that the rheological behaviour of RBC as a consequence of rhEPO treatment are temporal and are affected by the presence of reticulocytes as well as by the average age of the circulating cells.

Effects of swimming exercise on red blood cell rheology in trained and untrained rats

Red blood cell (RBC) mechanical properties were investigated after swimming exercise in trained and untrained rats. A group of rats was trained for 6 wk (60 min swimming, daily), and another group was kept sedentary. Blood samples were obtained either within 5 min or 24 h after 60 min swimming in both groups. In the untrained rats, the RBC aggregation index decreased to 2.60 +/- 0.4 immediately after exercise from a control value of 6.73 +/- 0.18 (P < 0.01), whereas it increased to 13.13 +/- 0.66 after 24 h (P < 0.01). RBC transit time through 5-microm pores increased to 3.53 +/- 0.16 ms within 5 min after the exercise from a control value of 2.19 +/- 0. 07 ms (P < 0.005). A very significant enhancement (166%) in RBC lipid peroxidation was detected only after 24 h. In the trained group, the alterations in all these parameters were attenuated; there was a slight, transient impairment in RBC deformability (transit time = 2.64 +/- 0.13 ms), and lipid peroxidation was found to be unchanged. These findings suggest that training can significantly limit the hemorheological alterations related to a given bout of exercise. Whether this effect is secondary to the training-induced reduction in the degree of metabolic and/or hormonal perturbation remains to be determined.

The value of the gonadotrophin-releasing hormone test as a prognostic factor in infertile patients with varicocele

OBJECTIVE

To determine the value of the gonadotrophin-releasing hormone (GnRH) test in selecting which infertile patients with varicocele would benefit from varicocelectomy.

PATIENTS, SUBJECTS AND METHODS

The study comprised 30 patients with varicocele who presented between November 1993 and May 1994, and 10 control subjects. The basal serum level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were determined and all participants given 100 micrograms of GnRH nasally. The levels of FSH and LH were then determined for up to 2 h. The patients then underwent varicolectomy and the response was evaluated by comparing sperm quality before and after treatment and between those with increased or normal FSH and LH levels in response to the GnRH test.

RESULTS

Those patients who had increased FSH and LH levels after the GnRH test had a mean 121% increase in sperm density (P < 0.001), a 23% increase in sperm motility (P < 0.001) and a 40% decrease in sperm abnormality (P < 0.05). The respective values for those with normal levels of FSH and LH were 15% (P < 0.05), 11% (P > 0.05) and 11% (P > 0.05).

CONCLUSION

The GnRH test is useful for determining those patients who should benefit from varicocelectomy.

Hydronephrotic type of bilateral multicystic dysplastic kidney. An unusual case

25 year-old pregnant woman was admitted at week 29 of fetal development for routine ultrasonic evaluation of growth. Sonography of the fetal body revealed two cystic anechoic septated structures bilaterally. At autopsy of the stillborn neonate pathology confirmed congenital multicystic dysplastic kidney. We believe this is the first case reported.