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PURPOSE: To establish whether the expression of markers of cell differentiation (CK7, CK14, CK20, GATA3), apoptosis (p53), proliferation (Ki67, STAG2) and peri-tumoural lymphocytes (CD3, CD8), provides specific information about urothelial carcinogenesis in neuro-urological patients with bladder cancer (NBC). METHODS: Tissue samples from NBC were retrieved from 15 centres in France and compared to control samples from non neuro-urological patients with bladder cancer (NNBC) and from neuro-urological patients without bladder cancer (NB). The expression of CK7, CK14, CK20, GATA3, p53, Ki67, STAG2, CD3 and CD8 markers was analysed using immunohistochemistry of tissue microarray sections. RESULTS: Overall, tissue samples from 124 patients were included in the study (n = 72 NBC, n = 26 NNBC and n = 26 NB). Muscle invasive bladder cancer (MIBC) was found in 52 NBC patients (72.2%) and squamous cell differentiation in 9 (12.5%). In NBC samples, the expression of CK20 and GATA3 was significantly more frequent in NMIBC compared to MIBC (p = 0.015 and p = 0.004, respectively). CK20 and GATA3 were significantly more expressed in NBC compared to NNBC (p < 0.001 and p = 0.010, respectively). The expression of CK14, Ki67, CD3 and CD8 was significantly more frequent in NBC than in NNBC samples (p = 0.005, p < 0.001, p < 0.001 and p < 0.001, respectively). The expression of CD3 and CD8 was similar in NBC and NB samples. CONCLUSION: In NBC, markers of basal differentiation, proliferation and peri-tumoural lymphocytes were significantly more expressed compared to NNBC controls. These results suggest the aggressiveness of NBC and the role of chronic inflammation in the carcinogenesis of bladder cancer in neuro-urological patients.
Asunto(s)
Neoplasias de la Vejiga Urinaria , Urología , Biomarcadores de Tumor/metabolismo , Carcinogénesis , Humanos , Antígeno Ki-67/metabolismo , Proteína p53 Supresora de Tumor , Neoplasias de la Vejiga Urinaria/metabolismoRESUMEN
Controlled atomic scale fabrication based on scanning probe patterning or surface assembly typically involves a complex process flow, stringent requirements for an ultra-high vacuum environment, long fabrication times and, consequently, limited throughput and device yield. We demonstrate a device platform that overcomes these limitations by integrating scanning-probe based dopant device fabrication with a CMOS-compatible process flow. Silicon on insulator substrates are used featuring a reconstructed Si(001):H surface that is protected by a capping chip and has pre-implanted contacts ready for scanning tunneling microscope (STM) patterning. Processing in ultra-high vacuum is thereby reduced to a few critical steps. Subsequent reintegration of the samples into the CMOS process flow opens the door to successful application of STM fabricated dopant devices in more complex device architectures. Full functionality of this approach is demonstrated with magnetotransport measurements on degenerately doped STM patterned Si:P nanowires up to room temperature.
RESUMEN
OBJECTIVES: To evaluate the effects of a practical introduction to urology session on the recruitment of Parisian interns since introduction of the National Classifying Examination. MATERIALS AND METHODS: Since 2004, all surgery interns appointed in Paris have participated in a practical introduction to urology session before starting work in hospital. They were asked to complete a questionnaire. The prospective survey studied: age, gender, urology training as a medical student and the intern's preferences in relation to 11 surgical specialties. Interns were recontacted annually to determine their choice of specialization. RESULTS: Population. 255 interns participated, including 145 females (56.9%) and 110 males (43.1%). The mean age was 24.6 +/- 5 years (range: 22-31). 173 interns were attached to a Parisian teaching hospital (67.8%) and 82 (32.2%) were attached to a provincial teaching hospital. 52 interns (21.2%) had completed at least one attachment in a urology department during their medical training. Surgical specialties. Orthopaedics was most frequently listed (n = 48 ; 28.9%). Urology was chosen by 32 interns (12.5%), 28 of whom had completed an urology attachment during their medical training. At the end of the introductory training sessions, 18 interns were tempted by urology. At one year, 31/34 interns (91.2%) confirmed their choice in favour of urology. CONCLUSION: A practical training sessions very early in the training of young surgeons is a good solution to introduce them to urology. Based on a more informed choice, the most motivated interns are encouraged to preferentially choose this discipline.
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Cirugía General/educación , Internado y Residencia , Selección de Personal , Urología/educación , Adulto , Factores de Edad , Actitud del Personal de Salud , Selección de Profesión , Toma de Decisiones , Femenino , Estudios de Seguimiento , Hospitales de Enseñanza , Hospitales Urbanos , Humanos , Masculino , Ortopedia , Paris , Estudios Prospectivos , Factores Sexuales , Especialidades QuirúrgicasRESUMEN
The growing frequency of prostate cancer discovered at a localized stage, about 20% of which are treated by radiotherapy, justifies an analysis of the adverse effects of this treatment modality. The risks of impotence and gastrointestinal and urinary irritative disorders after radiotherapy are well known. The objective of this article is to review the less well known risks of radiation-induced tumours based on the data of the literature and to discuss possible modifications of the conventional modalities of follow-up. The risk of radiation-induced tumours is well known in gynaecology, but the link is more difficult to establish after radiotherapy for prostate cancer. The most recent series report an increased relative risk of bladder cancer (RR = 1.63) and rectal cancer (RR = 1.6 to 1.7): the risk of second tumour is 15% at 5 years in the irradiated population and 34% at 10 years. Finally, although follow-up is still too short, new conformal radiotherapy techniques do not appear to decrease this risk. These data indicate the need for caution in patients combining several risk factors, such as smoking for bladder cancer and bladder and rectal endoscopic surveillance for more than 5 years should be proposed in patients treated by radiotherapy for prostate cancer.