Sodium sensitivity and its role in the maintenance of high blood pressure in two-kidney, one-clip renovascular hypertension after removal of the clipped kidney in rats.

AIM: The aim of the present study was to define the role of sodium balance and sodium sensitivity in the maintenance of two-kidney, one-clip renovascular hypertension in rats. METHODS: Six months after induction of hypertension, systolic blood pressure, sodium balance, water intake and urine excretion were measured under normal conditions, after nephrectomy of the clipped kidney, and under conditions of sodium load. RESULTS: No difference between control rats and rats with or without post-Goldblatt hypertension emerged during the development of renovascular hypertension and after nephrectomy of the clipped kidney. Under conditions of high sodium intake, the contalateral kidney of the post-Goldblatt hypertensive rats was unable to excrete surplus sodium. Sodium retention was not correlated with water retention. In contrast to the controls, systolic blood pressure increased in the animals with post-Goldblatt hypertension and those with post-Goldblatt normotension during the sodium load period. No correlation was found between blood pressure increase and sodium retention. The animals were considered sodium sensitive in relation to blood pressure. CONCLUSION: In the chronic phase of two kidney-one clip renovascular hypertension, the post-Goldblatt hypertensive and the post-Goldblatt normotensive animals showed sodium sensitivity of blood pressure. The contralateral kidney of the post-Goldblatt hypertensive animals was unable to excrete surplus sodium under conditions of high sodium intake. But this inability and the sodium sensitivity of blood pressure cannot be thought responsible for the maintenance of renovascular hypertension in this model.

Massive hematuria due to a congenital renal arteriovenous malformation mimicking a renal pelvis tumor: a case report.

INTRODUCTION: Congenital renal arteriovenous malformations (AVMs) are very rare benign lesions. They are more common in women and rarely manifest in elderly people. In some cases they present with massive hematuria. Contemporary treatment consists of transcatheter selective arterial embolization which leads to resolution of the hematuria whilst preserving renal parenchyma. CASE PRESENTATION: A 72-year-old man, who was heavy smoker, presented with massive hematuria and flank pain. CT scan revealed a filling defect caused by a soft tissue mass in the renal pelvis, which initially led to the suspicion of a transitional cell carcinoma (TCC) of the upper tract, in view of the patient's age and smoking habits. However a subsequent retrograde study could not depict any filling defect in the renal pelvis. Selective right renal arteriography confirmed the presence of a renal AVM by demonstrating abnormal arterial communication with a vein with early visualization of the venous system. At the same time successful selective transcatheter embolization of the lesion was performed. CONCLUSION: This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. In the case presented, a congenital renal AVM proved to be the cause of massive upper tract hematuria and flank pain in spite of the initial evidence indicating the likely diagnosis of a renal pelvis tumor.

Association between bone scintigraphy and serum levels of procollagen (I) and PSA in the detection of bone disease in prostate cancer patients.

PURPOSE: To evaluate the clinical usefulness of serum procollagen I carboxyterminal propeptide (PICP) and prostate specific antigen (PSA) in relation to bone scan results in Greek patients with prostate cancer (PC). PATIENTS AND METHODS: 108 patients (mean age 58+/-4.3 years; range 42-81) with PC and 52 healthy blood donors as control group were examined for serum PICP and PSA levels. The diagnosis of PC was confirmed histologically. Bone metastases were diagnosed in 68 of the patients with the use of (99m)Tc-MDP bone scan, while 40 patients had no bone metastases. During the one year follow-up new PICP and PSA measurements were obtained along with a new bone scan for all groups studied. RESULTS: The levels of serum PICP and PSA were significantly higher in patients with PC and bone metastases in comparison to patients with no bone metastases. The sensitivity and specificity of the combination of PICP and PSA were 78% and 96%, respectively. CONCLUSION: PICP could be useful for diagnosing early bone metastases of prostate adenocarcinoma and in combination with PSA and bone scan can be an additional tool in the follow-up of patients with PC.

Prognostic value of DNA analysis of prostate adenocarcinoma: correlation to clinicopathologic predictors.

The ability to accurately predict tumor behavior and patient survival is a problem in managing patients with prostate cancer. DNA ploidy provides important information for the evaluation of the prognosis of prostate cancer. The aim of this study was to investigate the DNA ploidy in imprints from prostate adenocarcinomas in a group of 70 patients in relation to Gleason score, tumor differentiation, stage and PSA serum levels. The DNA content was studied in Feulgen-stained imprint smears through the image analysis technique using a SAMBA 2005 Image analyzer. According to our measurements, a strong correlation was observed between DNA ploidy status and tumor differentiation (p<0.001). A statistically significant difference was found between DNA aneuploidy and increased pretreatment PSA serum levels (>4 ng/ml) (p<0.001), as well as between ploidy pattern and stage of the disease (p<0.001). Our results conclude that DNA ploidy status appears to be an additional marker in the field of prognosis of prostatic adenocarcinoma and could provide useful information on the potential behavior of prostate cancer.

Expression of p120, Ki-67 and PCNA as proliferation biomarkers in imprint smears of prostate carcinoma and their prognostic value.

The cell proliferation markers p120, Ki-67 and proliferating cell nuclear antigen (PCNA) recognize nuclear antigens. The expression of these proteins by immunostaining methods was reported to be of value in determining the prognosis of patients with malignant diseases. In this study, we evaluated the prognostic significance of the expression of nuclear antigens p120, PCNA and Ki-67 in prostate cancer and compared the results with other prognostic factors. Imprint smear samples obtained from 70 patients immediately after radical prostatectomy for prostatic carcinoma were immunostained with monoclonal antibodies against p120, Ki-67 and PCNA. The immunostaining results were correlated with Gleason score, tumour differentiation, stage and prostatic specific antigen (PSA) levels. Our findings demonstrate that p120, Ki-67 and PCNA expression in prostatic carcinoma smears, correlated significantly with the degree of Gleason score (P < 0.001). When combining p120, Ki-67 and PCNA positivity with tumour differentiation there was a significant association among these parameters (P < 0.001). Overexpression of p120, Ki-67 and PCNA, was also associated with increased PSA serum levels (>4 ng/ml) (P < 0.001). The distribution of p120, Ki-67 and PCNA expression in prostate carcinomas was not statistically significant for Ki-67 (P = 0.69) and p120 (P = 0.22) but was significant for PCNA (P < 0.001) as far as the histological stage (T2a, T2b, T2c, T3a). P120, Ki-67 and PCNA expression had significant prognostic value for disease-free survival. Our results conclude that nuclear antigens p120, Ki-67 and PCNA appear to be additional markers in the field of prognosis of prostatic carcinoma.

Telomerase expression as a marker in prostate cancer: correlation to clinicopathologic predictors.

The aim of this study was to investigate by an in situ hybridization procedure the Telomerase expression as a marker in prostate cancer and to correlate these results with several prognostic factors concerning this cancer. Imprint smear samples were obtained from 70 prostates removed from patients who underwent radical prostatectomy for prostate adenocarcinoma. Telomerase expression in cancerous prostate smears was studied using an in situ hybridization procedure. The results were correlated with prognostic factors such as pathologic staging, Gleason grading, PSA serum levels and tumour differentiation. Positive Telomerase expression was detected in 88.6% prostate cancer smears. Telomerase expression was significantly correlated with the Gleason score (p < 0.001), tumour differentiation (p < 0.001) and PSA serum levels (p = 0.002). The distribution of Telomerase expression according to histopathological staging was not statistically significant (p < 0.56). In conclusion Telomerase expression could be a marker indicating the malignant potential of prostate cancer.