Evaluation of the prognostic value of LMR, PLR, NLR, and dNLR in urothelial bladder cancer patients treated with radical cystectomy.

OBJECTIVE: Our aim was to evaluate the association between preoperative LMR, PLR, NLR, dNLR, and survival of urothelial bladder cancer (UBC) patients treated with radical cystectomy (RC). We also analyzed the relationship between preoperative blood-based inflammatory biomarkers' levels and postoperative in-hospital complications. PATIENTS AND METHODS: This retrospective study included 144 UBC patients, who underwent RC between 2003 and 2015. The study endpoints were cancer-specific survival (CSS) and overall survival (OS). RESULTS: Univariable analysis revealed that continuous LMR, PLR, NLR and dNLR were significantly associated with CSS and OS. On multivariable regression model analysis, continuous LMR, NLR, and dNLR independently predicted both endpoints. Furthermore, the group of patients with lower LMR values had a greater chance of developing postoperative in-hospital complications. CONCLUSIONS: Our findings indicate that the cheap and simple blood-based biomarkers may be valuable in identifying UBC patients treated with RC, who are at higher risk of all-cause and cancer-related mortality.

The comparison of laparoscopic and microsurgical varicocoelectomy in infertile men with varicocoele on paternity rate 12 months after surgery: a prospective randomized controlled trial.

The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors' institution and designed as per protocol study. From 2012 till 2015 84 patients were randomly allocated to two groups. First group consisted of 42 patients who underwent laparoscopic varicocoelectomy, whereas patients from the second group underwent microsurgical varicocoelectomy. The indications for varicocoelectomy consisted of infertility >1 year, palpable left-sided varicocoele and at least one impaired semen parameter (sperm concentration <15 mln/mL; total motility<40%; progressive motility <32%, vitality <58% or normal morphology <4%). The primary goal was to show superiority of microsurgical varicocoelectomy over laparoscopic varicocoelectomy in terms of pregnancy rate. The secondary endpoints comprised assessment of sperm parameters in three-month intervals after intervention until one year. Other points included, LH, FSH and testosterone levels as well as testicle volume and International Index of Erectile Function. From each group five patients were lost during the follow-up period. The primary endpoint was not achieved - pregnancy rate in first and second group was 29.7% and 40.5% respectively (p = 0.34). Analysis of the sperm parameters after surgery revealed significant statistical difference in total motility, progressive motility and morphology in favour of microsurgical approach. Both methods showed improvement in all sperm parameters. There were no differences in hormonal levels as well as in erectile function and testicle volume between groups. Small number of patients in both groups are the main limitation of our study.

An inherited NBN mutation is associated with poor prognosis prostate cancer.

BACKGROUND: To establish the contribution of eight founder alleles in three DNA damage repair genes (BRCA1, CHEK2 and NBS1) to prostate cancer in Poland, and to measure the impact of these variants on survival among patients. METHODS: Three thousand seven hundred fifty men with prostate cancer and 3956 cancer-free controls were genotyped for three founder alleles in BRCA1 (5382insC, 4153delA, C61G), four alleles in CHEK2 (1100delC, IVS2+1G>A, del5395, I157T), and one allele in NBS1 (657del5). RESULTS: The NBS1 mutation was detected in 53 of 3750 unselected cases compared with 23 of 3956 (0.6%) controls (odds ratio (OR)=2.5; P=0.0003). A CHEK2 mutation was seen in 383 (10.2%) unselected cases and in 228 (5.8%) controls (OR=1.9; P<0.0001). Mutation of BRCA1 (three mutations combined) was not associated with the risk of prostate cancer (OR=0.9; P=0.8). In a subgroup analysis, the 4153delA mutation was associated with early-onset (age ≤ 60 years) prostate cancer (OR=20.3, P=0.004). The mean follow-up was 54 months. Mortality was significantly worse for carriers of a NBS1 mutation than for non-carriers (HR=1.85; P=0.008). The 5-year survival for men with an NBS1 mutation was 49%, compared with 72% for mutation-negative cases. CONCLUSION: A mutation in NBS1 predisposes to aggressive prostate cancer. These data are relevant to the prospect of adapting personalised medicine to prostate cancer prevention and treatment.

[A new method of extravesical correction for vesicoureteral reflux]. / Nowy sposób zewnatrzpecherzowej korekcji odplywu pecherzowo-moczowodowego.

New technique of extravesical antireflux surgery was presented and the treatment results were estimated in 16 children. No vesicoureteral reflux was noted in any children after operation during control cystographies. In chosen cases the presented technique corrects ureterovesical reflux, is mildly invasive and shortens child's hospitalization.

[Studies on the behavior of some immunologic parameters after local, endoscopic autohemotherapy in children treated for vesicoureteral reflux]. / Badania nad zachowaniem sie okreslonych parametrów immunologicznych po miejscowej, endoskopowej autohemoterapii u dzieci leczonych z powodu odplywu pecherzowo-moczowodowego.

Evaluation of the effect of autologous blood injection into muscular layer on the immune system in children who were treated endoscopically for vesicoureteral reflux. There were 29 children examined after before and endoscopic autohemoinjection. The examination included determination of basic immunoglobulin levels in serum (IgA, IgG, IgM). Also the human lymphocyte subpopulations were determined. Initial and final values were compared, average values and standard deviations for respective age groups were determined. Autologous blood used for injections in endoscopic treatment of vesicoureteral reflux stimulates immune system, especially in young children.

[Retrospective evaluation of surgical results in children with a megaureter defect]. / Retrospektywna ocena wyników operacji u dzieci z wada moczowodu olbrzymiego.

We evaluated the efficacy of surgical treatment in 171 children with primary megaureters. Operations were performed between 1980-1997. The average time of follow-up was 7.8 years. The treatment was effective in 149 (87.1%) children. The results were good in 92.8% of cases with obturative type of megaureters and in 81.6% with refluxive type of M.O. The worst results were obtained in children aged under 2 years of live (21.9%). The primary amputation was performed in 48 (28%) children and the secondary in 14 (8.2%) children. In this number 11 was nephrectomies were carried out.

[Long-term surgical treatment results for hydronephrosis in children]. / Odlegle wyniki operacyjnego leczenia wodonercza u dzieci.

The aim of this paper is assessment the results of surgical treatment for hydronephrosis in 208 children, who were operated during the last 32 years. The most frequent surgical procedure (90.4%) was Anderson-Hynese method. The good results were obtained on an average in 91.8% to cases. The advantageous risk factors of operations were: female sex, age up to 1 year, the absence of other congenital anomalies and 2 degrees grade of hydronephrosis. Kidney dysfunction before the operation, kidney scintigraphy up to 25% capture or corticorenal index above 0.062% had unfavourable influence on the results.

[Results of Foure's antireflux surgery for bilateral vesico-ureteral reflux in children]. / Wyniki operacji przeciwodplywowej sposobem Foure'a w obustronnym odplywie pecherzowo-moczowodowym u dzieci.

The paper presents the results of the antireflux operation using Foure's method, performed in 27 children with bilateral vesico-ureteral reflux (VUR). The radiologic and laboratory control examinations were done between 14th month and 7.5th year, mean 3.9th year, after operation. The age of these patients ranged 3-12, mean 6.0 years. In 88.9% children complete resolution of the VUR was obtained. In one case (3.7%) the bilateral stricture of the new uretero-vesical junction, and in 2 others (7.4%) recurrent unilateral VUR was found. It is a simple method, which is recommended in patients with a small capacity of the bladder or great inflammatory changes within mucous membrane.

[Comparative study of anatomical changes and function in kidneys after reconstructive surgery of the urinary tract using scintigraphic and other imaging examinations]. / Ocena porównawcza zmian anatomicznych i czynnosciowych nerek po operacjach rekonstrukcyjnych dróg moczowych w badaniu scyntygraficznym i innych badaniach obrazowych.

We performed a comparative evaluation of anatomical and functional changes in kidneys after urinary tract reconstructive procedures and in patients with history of urinary tract infections using renal scintigraphy and other imaging techniques. Statistically significant differences in the prevalence of pathological findings in imaging between these groups were shown. When children after the RVU are taken into account renal scintigraphy supplies us with objective and precise data about the renal scarring degree. In this group repeated renal scintigraphy should be warranted. After the reconstructive procedures due to hydronephrosis the images from ultrasonography and renal scintigraphy correlate well. Ultrasonography is a golden standard for screening these patients. Statistically significant higher degree of renal scarring in renal scintigraphy in patients after urinary tract infections without urinary tract defect proves the important role of infections in the pathogenesis of these changes. Children with recurrent symptomatic urinary tract infections should be submitted to renal scintigraphy imaging on regularly basis, as a risk group of higher chronic pyelonephritis prevalence.

[Complications of renal oligobiopsy with regard to highly selective renal artery embolization as a method treatment--case report]. / Powiklania oligobiopsji nerek z uwzglednieniem wysoce selektywnej embolizacji tetnicy nerkowej jako metody terapeutycznej--opis przypadku.

This report describes complications after renal oligobiopsy performed for verifying the diagnosis of glomerulonephritis (minimal change disease) in 16-year old boy treated since 2 years of age. Macroscopic hematuria with intracystic clotting and hematuria in lower renal pole occurred after the procedure. These complications were caused by arteriovenous fistula which was treated by high selective renal artery embolization.

Late results of operative treatment of intersexuality in children with advanced hypospadias and simultaneous cryptorchidism.

In a group of 52 patients operated on for advanced hypospadias with cryptorchidism 42% showed signs of intersexuality. The problem of operative sex determination was stressed. The social adaptation of those children during growing up was also observed.

[Evaluation of the usefulness of analysis of beta-glucuronidase levels in patients with superficial cancer and papilloma of the bladder]. / Ocena przydatnosci oznaczania beta-glukuronidazy u chorych na raka i brodawczaka pecherza moczowego.

Beta-glucuronidase activity in the blood serum, the urine, and tumour tissue has been assayed in patients with superficial bladder neoplasm and papilloma of the bladder prior to and after transurethral electroresection (TUR). Twenty five healthy subjects constituted a control group. It was shown that the activity of beta-glucuronidase may be a valuable test in the differential diagnosis of bladder neoplastic lesions as well as in the assessment of the results of therapy with transurethral electroresection.

Evaluation of the course of pregnancy, delivery and the condition of the newborn infant in women operated on for vesicoureteral reflux in childhood.

Evaluation of the course of pregnancy, delivery and the condition of the newborn infant in mothers after an antireflux operation performed in childhood has revealed differences to the disadvantage of women operated on after the age of ten. This is shown by a significantly more frequent incidence of EH gestosis and urinary tract infections. Pregnancy intensifies the already existing renal insufficiency but does not adversely affect an efficient kidney. No significant differences have been observed in fertility, way of delivery termination, and the newborn's condition between the studied and the control groups.

[The dynamics of kidney growth after antireflux operations in children]. / Dinamika rosta pochek posle antirefliuksnykh operatsii u detei.

Analysing the postsurgical status of patients with reflux nephropathy (RN) operated on for vesicoureteral reflux the authors evaluated the time course of hypotrophic kidney growth and noted a certain though insignificant increment in the renal length in patients with developed reflux nephropathy. The fact that in those with stages III and IV disease no increment in the length of the kidney was found could be regarded as a reason for removal of the kidney.

[A method of surgery in bilateral vesico-ureteral reflux in children with a double ureter]. / Sposob operatsii pri dvustoronnem puzyrno-mochetochnikovom refliukse u detei s udvoennym mochetochnikom.

An original method of bilateral ureteral transplantation for vesico-ureteral reflux is proposed. The technique described, based on 3 or 4 ureters being placed in a common submucosal canal, was used in 7 children. Clinical and radiologic follow-up demonstrated a good anti-reflux effect.

Operative treatment of bilateral vesicoureteral reflux by our own method of ureter reimplantation.

The results of treatment of 50 patients with bilateral vesicoureteral reflux (VUR) are presented. In all patients our own method of reimplantation of the ureters consisting in making a single, common submucosal tunnel situated on the back wall of the bladder was employed. The observations made and the results obtained prove the usefulness of the described operative technique in the treatment of bilateral vesicoureteral reflux.