Adenosine deaminase, 5'nucleotidase, xanthine oxidase, superoxide dismutase, and catalase activities in cancerous and noncancerous human bladder tissues.

Activities of adenosine deaminase (ADA), 5'nucleotidase (5NT), xanthine oxidase (XO), superoxide dismutase (SOD), and catalase (CAT) enzymes were measured in cancerous and cancer-free adjacent bladder tissues from 36 patients with bladder cancer and in control bladder tissues from 9 noncancer patients. Increased ADA and decreased XO, SOD, and CAT activities were found in cancerous bladder tissues compared with those of cancer-free adjacent tissues and of control bladder tissues. Differences were also found between enzyme activities in the bladder of different disease stages and grades. In the cancerous tissues, only positive intracorrelations were found, but in the cancer-free adjacent tissues and control tissues, both positive and negative correlations were established between enzyme activities. Results suggested that purine metabolism and salvage pathway activity of purine nucleotides were accelerated in the cancerous human bladder tissues via increased ADA and decreased XO activities, probably together with changes in some other related enzyme activities and, free radical metabolising-enzyme activities were depressed in cancerous bladder tissues, which indicated exposure of cancerous tissues to more radicalic stress.

Analysis of the peripheral blood lymphocyte subsets in patients with bladder carcinoma.

OBJECTIVES: To evaluate the immune system of patients with bladder transitional cell carcinoma (TCC) by using peripheral blood lymphocyte subsets and to further compare the relationship between these subsets with respect to tumor stage and grade (superficial versus invasive and low versus high grade). METHODS: Thirty patients with superficial TCC of the bladder, 30 patients with invasive TCC of the bladder, and 30 age- and sex-matched control subjects without any malignancy or immunologic abnormality were included in this study. The peripheral blood lymphocyte subset analysis was performed in all patients before any treatment was performed. RESULTS: All lymphocyte subset values of patients with invasive bladder cancer, except B cell value, were significantly lower (P < 0.01) than the values of the control group. There were no significant differences between the lymphocyte subset values of patients with superficial bladder cancer and those of control subjects. The comparison of the lymphocyte subset values of the patients with superficial versus invasive bladder carcinoma revealed that in patients with invasive bladder carcinoma, the numbers of T and natural killer (NK) cells were significantly lower (P < 0.05) than those of patients with superficial bladder carcinoma. Patients with high-grade tumors had significantly fewer (P < 0.05) T and NK cells than patients with low-grade tumors. CONCLUSIONS: Our results indicate that analysis of mean NK and T cell values and the mean ratio of CD4+/CD8+ cells in peripheral blood might be a useful adjunct for the clinical evaluation of patients with bladder cancer.

In vitro effects of cadmium and nickel on glutathione, lipid peroxidation and glutathione S-transferase in human kidney.

The in vitro effects of cadmium chloride (CdCl(2)) and nickel chloride (NiCl(2)) on reduced glutathione (GSH) level, lipid peroxidation (LP) and glutathione S-transferase (GST) activity towards the substrate l-chloro-2,4-dinitrobenzene (CDNB) in human kidney 10,000 g supernatant were examined. For comparative purposes similar studies were also performed using rat kidney 10,000 g supernatant. No alteration was observed in GSH level of human or rat kidney as a result of either CdCl(2) or NiCl(2) at the concentrations studied (10(-3)-10(-7)m). In human kidney 10,000 g supernatant, CdCl(2) and NiCl(2) were not able to alter the LP at the concentrations studied. Similarly, apart from a slight decrease at a NiCl(2) concentration of 10(-3)m, no effect of either CdCl(2) or NiCl(2) was noted on the LP of rat kidney 10,000 g supernatant. In human kidney 10,000 g supernatant, CdCl(2) at high concentrations (10(-4) and 10(-3)m) inhibited the metabolism of CDNB by GST, whereas in rat kidney 10,000 g supernatant the enzyme was inhibited in a concentration-dependent manner by CdCl(2). The degree of inhibition was similar in kidney 10,000 g supernatants of both human and rat, with 10(-4)m (about 28% inhibition) and 10(-3)m (about 44% inhibition) CdCl(2). NiCl(2), however, did not affect the metabolism of CDNB by GST in either human or rat kidney 10,000 g supernatant.

Evaluation of renal morphology and vascular function by color flow Doppler sonography immediately after extracorporeal shock wave lithotripsy.

Thirteen male and seven female patients with renal calculi were evaluated by color flow Doppler sonography (CFDS) for renal morphology and function before and after receiving 1000 to 2350 shocks with the Dornier MPL 9000 lithotripter. No significant morphologic change was encountered except for renal enlargement thought to be secondary to edema induced by shock wave application. Similarly, no significant differences were recorded in the systolic and diastolic flow rates or pulsatility (PI) or resistive (RI) indices of the renal vessels before and after treatment (P > 0.05). Color flow Doppler sonography appears to be a safe, noninvasive, and reliable means of evaluating kidneys subjected to extracorporeal shock wave lithotripsy.

Concurrent occurrence of three neoplasms including non-Hodgkin's lymphoma, renal cell carcinoma and leiomyoma in the same kidney.

A 53-year-old man with triple renal neoplasms in his left kidney presented. He was initially diagnosed intermediate grade non-Hodgkin's lymphoma (NHL) which involved gastrointestinal tract, left kidney, liver and pancreas. He underwent left nefrectomy because of a persistent renal mass after the completion of chemotherapy. The large renal mass revealed a renal cell carcinoma (RCC). Additionally, multiple small nodules of non-Hodgkin's lymphoma and a solitary leiomyoma were observed.

Palliative analgesic effect of Re-186 HEDP in various cancer patients with bone metastases.

UNLABELLED: The clinical picture of bone metastases is manifested by pain and loss of mechanical stability. Standard treatment options for bone metastases include external beam radiotherapy and the use of analgesics. Due to a large number of lesions in many patients, the use of radionuclide therapy with beta emitters may be preferable. Re-186 hydroxyethylidene diphosphonate (Re-186 HEDP) is one of the radiopharmaceuticals suitable for palliative treatment of metastatic bone pain. The aim of this study was to investigate palliative and side effects of Re-186 HEDP in patients with different types of cancers. MATERIAL & METHOD: Thirty one (17 male, 14 female) patients with various cancers (10 prostate, 10 breast, 4 rectum, 5 lung, 2 nasopharynx) and bone metastases were included in the study. Therapy was started with a fixed dose of 1295 MBq of Re-186 HEDP. If necessary, the same dose was repeated at least 3 times after an interval of 10-12 weeks; A total of 40 standard doses were given; 6 patients received repeated doses (3 doses in 3 patients, 2 doses in 3 patients). The patients with bone marrow suppression were excluded from the study. The pain relief was assessed the Eastern Cooperative Oncologic Group (ECOG) and the Karnofsky status index. All patients were evaluated with standard evaluation forms filled in daily for a maximum of 10 weeks. RESULTS: The mean response rate was 87.5% in patients with breast and prostate cancer, 75% in patients with rectum cancer and 20% in patients with lung cancer. The overall response rate was 67.5%. The palliation period varied between 6 and 10 weeks, with a mean of 8.1+/-1.3 weeks. The maximal palliation effect was observed between the 3rd and 7th weeks. No serious side effects were seen except mild hematologic toxicity. DISCUSSION & CONCLUSION: It is concluded that Re-186 HEDP is a highly effective agent in the palliation of metastatic bone pain in patients with prostate, breast and rectum cancer, but not effective in lung cancer. On the other hand, Re-186 seems to be a good alternative to Sr-89 because of its preferable physical characteristics (such as short half life and gamma energy emission), low side effect profile, early response and repeatability.

The efficacy of urinary cytology in the detection of recurrent bladder tumours.

In a prospective study, 71 patients with superficial transitional cell carcinoma of the bladder were given topical immunotherapy with bacillus Calmette-Guerin after transurethral resection and the impact of cystoscopy and bladder wash-out cytology in assessment of recurrent tumours was investigated. Sixteen recurrences were noted histopathologically during the follow-up and 15 of them were also diagnosed properly by wash-out cytology (sensitivity 93.8%). During the follow-up, 10 patients had positive cytology results without evidence of recurrent tumour and 6 of them had recurred cystoscopically in 3 months' time. However, the remaining 4 patients were still tumour-free cystoscopically after a follow-up of 6 months (specificity 92.7%, positive predictive value 78.9%). Although, some false-positive results may be obtained by urine cytology after topical immunotherapy, urine cytology seems to be a reasonable alternative to more invasive and expensive methods during the follow-up of bladder tumours.

Evaluation of serum arginase activity in benign prostatic hypertrophy and prostatic cancer.

Activities of arginase, prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) were determined in sera of healthy male controls, benign prostatic hypertrophy (BPH) and prostatic cancer patients. Serum arginase activity in the cancer group (22.8+/-11.6 U/l) was significantly lower than in both the control (33.64+/-16.19 U/l) and the BPH group (58.8+/-11.6 U/l) (p<0.001, respectively), while the BPH group had significantly higher levels compared to the controls (p<0.05). However, serum arginase levels in all groups had no statistically significant correlation with PAP and PSA. Serum arginase activity correlated inversely with the Gleason grades. These results suggest that serum arginase assay may be used for the pretreatment evaluation of patients with prostatic diseases.

The significance of histopathological changes of the normal tunica albuginea in Peyronie's disease.

Five patients with Peyronie's disease were operated and the tissue specimens from the plaque involving the tunica albuginea and from the tunica of the unaffected contralateral side were obtained. The specimens were then subjected to histopathological examination and the findings were correlated with those of men proved not to have Peyronie's disease but operated for other reasons. In the specimen of plaque, the changes varied from collagen destruction to cartilaginous and osseous metaplasia. However, in the tunica of the contralateral side the changes such as disregularity of collagen bundles extending even to widespread focal areas, and appearance of pale, rough, eosinophilic collagen degeneration, instead of its characteristic bright birefringence, and focal mucinous degeneration were noted. Interestingly, these alterations were not observed in the specimens of normal tunica albuginea in the control group. But the existence of minimal alterations, the regularity in the apparently normal contralateral tunica albuginea specimens in Peyronie's disease implied that there was an active turnover in collagen production, and the possible factor causing collagen degeneration and so plaque formation was probably the microtraumatization of the tunica albuginea.

Thrombosis of the inferior vena cava by a testicular tumour.

We report on an unusual case of testicular tumour presenting as thrombosis of the inferior vena cava. The inferior vena cava thrombosis due to tumour invasion is a rare presentation of testicular tumour. After four cycles of chemotherapy, the tumour which invaded and obstructed the vena cava was replaced by scar tissue.

Evaluation and surgical treatment of patients with penile curvature.

In patients with adult penile curvatures the aim of treatment is to have a penis straight enough and firm enough to allow satisfactory sexual function. Several operative approaches have been used to correct this condition. Herein, we describe our experience with the evaluation and surgical treatment of 37 patients with penile curvature. When we have decided on surgery, we either preferred to elongate the ventral corpora cavernosa by interposition of a piece of dura mater (2 patients) or in most cases (the remaining 35 patients) only excised wedges of tunica albuginea at the arcs of the maximum curvature located with artificial erection (Nesbit's operation). In conclusion, our results showed that Nesbit's operation is a versatile procedure that proved to be useful for correction of penile curvatures in patients with Peyronie's disease. However, further studies and clinical trials are needed to determine if the dura mater is an alternative in the treatment of penile curvatures due to congenital aetiology.

Combined interferon alpha with levamisole in patients with metastatic renal cell carcinoma.

To evaluate the efficacy and toxicity of interferon alpha-2b (IFN-alpha2b) and levamisole treatment regimen in patients with metastatic renal cell carcinoma (RCC). Seventeen patients with metastatic RCC were treated using recombinant IFN-alpha2b at a dose of 10 MU/m2 body surface subcutaneously three times in a week, for 3 months, with levamisole 50 mg t.d.s orally on days 1-3 on alternate weeks. The mean follow-up period was 10.7 (range 2-23) months. We achieved 1 complete response (lasting for 12+ months) and 1 partial response (lasting for 15 months), for an objective response rate of 11.7%. A further 7 patients (41%) had a stabilization of disease. The overall toxicity was moderate, with mainly grade I or II side effects. Grade III toxicities reported among 3 patients including vomiting (2 patients) and anorexia (1 patient). There was no treatment related death. Although additions of levamisole to IFN-alpha do not result in any significant increase in treatment toxicity, the response rate appears to be no better than IFN-alpha monotherapy reported in the literature.

Activities of superoxide dismutase and glutathione peroxidase enzymes in cancerous and non-cancerous human kidney tissues.

The activities of superoxide dismutases (total, cytoplasmic and mitochondrial) and glutathione peroxidase were measured in 10 cancerous and 10 non-cancerous adjacent human kidney tissues. Total (T-SOD) and cytoplasmic (Cu, Zn-SOD) superoxide dismutase and glutathione peroxidase (GSH-Px) activities were found lower in cancerous tissues compared with those of non-cancerous ones. However, no difference was found between the mitochondrial (Mn-SOD) superoxide dismutase activities of the tissues. Similarly, no differences were observed between the enzyme activity values of the tissues at stage I-II and III-IV renal cancer. In correlation analysis the positive relation found between Cu, Zn-SOD and GSH-Px enzymes in the non-cancerous tissues was found to be absent in the cancerous ones. The results suggest that enzymatic free radical defense mechanism is significantly reduced in the cancerous human kidney tissues due to depressed Cu, Zn-SOD and GSH-Px activities.

Vaginal ectopic ureter in a duplex system with renal dysplasia. A case report.

A 12-year-old girl with vaginal ectopic ureter in a duplex system associated with an extremely dysplastic upper segment who presented with a complaint of vaginal discharge is reported. The diagnostic approach with special reference to ultrasonography and computerized tomography is discussed.

Ultrastructual changes of corpora cavernosa in vascular erectile dysfunction.

Corpora cavernosa of 4 impotent patients with arterial pathology and 6 with venous insufficiency were studied by electron microscopy. The findings in all of the smooth muscle samples were the following: pronounced thickening of the basal lamina; marked reduction of contractile myofilaments and electron dense bodies; finger-like cytoplasmic projections; increase in mitochondria with swelling and aggregation; huge protrusions of nuclear membrane into the cytoplasm; increased proportion of interstitial matrix to smooth muscle cells. These were more marked in the dark than in the light cells, which was considered as the beginning of degeneration. Another finding was degenerative changes in the endothelial cell lining of the sinusoids, especially denudation, fragmentation and marked thickening of the basal lamina. Severity of the symptoms did not change in any of the patients with different pathologies. So, we can assume that the pathological alterations may be due to chronic penile vascular insufficiency or vice versa.

Selection of patients for intravesical therapy for superficial bladder cancer.

In a nonrandomized retrospective study, 133 patients with superficial transitional cell carcinoma of the bladder were evaluated to identify any clinical prognostic features which indicate the necessity of intravesical therapy (IVT). The risk factors taken into account were stage, grade and multiplicity of the tumour. All patients were treated initially by complete transurethral resection (TUR); 27 patients received no further treatment after resection of the tumour, 106 patients received adjuvant IVT over a period of 6 weeks. The mean follow-up was 23 and 18.8 months in the TUR-only group and TUR+IVT group, respectively. In the TUR-only group 7 and in the TUR+IVT group 29 recurrences were encountered. Patient group with no risk factors (Ta, GI, solitary tumour) or with only one risk factor revealed no statistical difference in terms of the recurrence rate from the identical control group. So it does not seem worthwhile to give additional therapy in the low-risk group. Another notable outcome of this study was that the higher the potential risk factors, the higher the likelihood of recurrence. The results suggest that T1 tumours, multifocal tumours, and high-grade tumours have poor prognosis, making additional treatment necessary.

[Detection of candidiasis in non-gonococcal urethritis resistant to therapy]. / Tedaviye dirençli non-gonokoksik üretritlerde candida aranmasi.

In this study, candida sp. and all other microorganisms were attempted to be isolated in 30 patients with non-gonococcal ürethritis who hadn't responded to classical antimicrobial therapy. Candida sp. in 6, various bacteries in 11, salmonella in one and trichomonas vaginalis in one of them were detected. Not any microorganisms were isolated in 13, 4 of these candida species which were detected by sabouraud culture, were also evaluated by direct microspoic examination.