Platelet and neutrophil cross-talk-mediating cancer growth and metastasis in patients with urinary bladder cancer

The initial selectin-dependent events that mediate tumor cell tethering to platelets, leukocytes, and vascular endothelium can regulate the extravasation and colonization of metastatic cells into distant tissues. We aimed to clarify the role of selectin-selectin ligand interactions in tumor growth and progression in patients with bladder cancer. Thirty patients with bladder cancer were the participants in this study classified as follows: locally invasive group [n = 10], urinary bladder cancer group with regional lymph node involvement [n = 10], and urinary bladder cancer group with regional lymph nodes and distant metastasis [n = 10]. Flow cytometry was used to determine both the platelet surface expression of P-selectin [CD62P] and the neutrophil surface expression of PSGL-1 [CD162], whereas enzyme-linked immunosorbent assay was used for the assay of soluble P-selectin. Neutrophil PSGL-1 expression among the different groups studied was not statistically significant. However, there was enhanced platelet activation as evidenced by increased platelet surface expression of P-selectin together with an increase in its soluble form, which was more prominent with advancement of the disease, especially in patients with distant metastasis. Also, a strong positive correlation was found between platelet P-selectin and its soluble form with the tumor grading. In addition, stepwise multiple regression analysis showed that both P-selectin and platelet count are significant independent determinants for the stage of bladder cancer, suggesting augmentation of P-selectin-ligand interaction. These data preclude that disease progression in patients with bladder cancer is dependent on the complex interaction between P-selectin and its ligand. Targeting of these molecules may represent a unique approach to tumor therapy and prevention of metastasis

Epidemiologic approach for early detection and control of renal and urinary tract diseases in rural populations

The dipstick testing, microscopic examination of urine and urine cytology were performed for inhabitants from two rural villages [El Shobak El Sharki, V.I and El Katta, V.2] in Giza G. The proliferating cell nuclear antigen [PCNA] and Schistosoma haematobium antigen were done by immuno-histochemical stain to confirm diagnosis. Also, they were subjected to medical questionnaire, clinical examination, ultra-sonography of kidneys and urinary tract. The results showed that V.2 had higher percentage of haematuria, proteinuria, glucosuria and lower urinary tract infection than V.I. Crystaluria was higher in V.I. Sensitivity of dipstick testing compared to microscopic examination was 26.6%, and specificity was 78.7%. Lower urinary tract infection cytologically detected was 44.2% sensitivity and 62.5% specificity compared to pyuria detected by microscopic examination of urine. Among those suffering variable urinary abnormalities, schistosome antigen was not detected in any fixed urine samples in comparison to corresponding confirmed positive controls. Urine cytology detected urinary tract infection, Crystaluria, dysplasia and atypia, squamous metaplasia and transitional cell carcinoma [TCC]. PCNA positivity was found in TCC [100%], dysplasia [50%] and squamous metaplasia [28.6%]. So, microscopic examination of urine proved valuable for tract abnormalities as pyuria, haematuria and crystaluria. Also, urine cytology is a must for malignancy of urinary tract especially in adult males

Extended pyelonephrolithotomy [modified resnick S technique] for the management of stagging renal stones

Seventeen patients with stagging renal stones extending mainly to lower calyces with or without multiple calyceal stones or extensions, 13 with intrarenal pelves were included in our study. We used a combination of Gil- vernet [s extended pyelolithotomy technique and Resnick[spyelo-nephrototomy technique. None of our cases needed blood Transfusion, none had serious post- operative bleeding and none developed hypertension during a follow- up period of 3 years. Only 1 patient had residual calyceal stone that was managed later by ESWL. We concluded that this is a safe operative technique for the management of some stanging renal stones, with low rate of complications.

hemodynamics of sexual dysfunction following nerve sparing Radical cystoprostatectomy

Fourteen patients with invasive bladder cancer underwent penile duplex scanning and dynamic infusion cavemosometry preoperatively to assess arterial and venous hemodynamics. Nine of these patients were impotent after nerve sparing Radical cystoprostatectomy and had repeated duplex scanning and cavemosornetry six months postoperatively. On penile duplex all 9 patients had arterial insufficiency on at least one side in-spite of individual vesical arteries ligation. On dynamic cavernosometry. 2 patients had the criteria suggestive of corporoveno-occlusive dysfunction. We concluded that impotence following nerve sparing radical cystoprostatectomy is predominantly arterial in nature. The possible causes and points of technique are discussed