Aggressiveness of inflammation in histological prostatitis--correlation with total and free prostate specific antigen levels in men with biochemical criteria for prostate biopsy.

BACKGROUND AND AIMS: Although prostatitis can contribute to the lack of prostate specific antigen (tPSA) specificity, there is disagreement concerning the effect of histological inflammation on free PSA (fPSA). We investigated the correlation between aggressiveness of histological inflammation and tPSA, fPSA and f/tPSA in patients without detectable prostate cancer (PC). METHODS: The study included 106 patients with tPSA <10 ng/mL, without clinical prostatitis and with biopsy negative for PC. The inflammation in prostate biopsies was scored for aggressiveness using the four-point scale reported by Irani. The patients were divided into two groups of less aggressive and more aggressive inflammation and compared by use of regression analysis. RESULTS: The median tPSA, fPSA and f/tPSA levels were 6.39 ng/mL, 1.1 ng/mL and 16% in the less aggressive inflammation group and 7.3 ng/mL, 0.79 ng/mL and 10.7% in the more aggressive inflammation group, respectively. There was no significant between-group difference in tPSA levels (P=0.16), however, statistically significant between-group differences were recorded in fPSA and f/tPSA levels (P<0.001 both). Spearman's analysis yielded a significant negative correlation of inflammation aggressiveness with fPSA (r=-0.34; P<0.001) and f/tPSA (r=-0.45; P<0.001). Free PSA and f/tPSA were lower in the group with more aggressive inflammation. CONCLUSIONS: Histological inflammation has a high prevalence in cancer-free prostate biopsy specimens and exerts similar effects on fPSA and f/tPSA levels as PC. Our study suggests histological prostatitis to be an important cause of decreased fPSA and f/tPSA values; therefore, when it is identified, antibiotic or anti-inflammatory therapy should be introduced to reduce the percentage of men with a continuing indication for prostate biopsy.

Correlation between vimentin expression and morphological features of renal cell carcinoma.

The aim of this study was to analyze the correlation between the expression of vimentin and morphological features of renal cell carcinoma (RCC). We analyzed tumor tissue of 20 patients with RCC. There were 13 female and 7 male patients with RCC confined to the kidney (pT1, pT2). They were ranging in age from 36 to 80 years (mean age 60.6 years). Thirteen tumors measured > 5 cm and 7 tumors < 5 cm in diameter. Two tumors were papillary and 18 tumors showed a non-papillary pattern. Six tumors were composed of granular cells and 14 tumors of clear cells. Formalin fixed, paraffin-embedded tumor tissue was cut at 5 microns, deparaffinized, and stained with a monoclonal antibody to vimentin (Dako, Denmark). There were 4 tumors with nuclear grade I, 3 with grade II, 11 with grade III, and 2 with grade IV. Histopathologic examination showed vimentin expression in eight cases (40%), while 12 tumors (60%) were negative. Positive reaction for vimentin was observed in all four grade I tumors, none of three grade II tumors, four of 11 grade III tumors and in none of 2 nuclear grade IV tumors. In our study, there was no statistically significant difference between the expression of vimentin and morphologic features of RCC. Our study showed the lack of correlation between the expression of vimentin and nuclear grade, cell type and histologic pattern of RCC. Further studies on a larger series of tumors as well as follow-up of patients are obviously needed.

Adrenal cavernous hemangioma: MRI, CT, and US appearance.

Two cases of rare adrenal cavernous hemangiomas are reported, one imaged with conventional X-ray techniques, US, CT, and MRI, and the other with US and CT. The CT technique clearly demonstrated calcifications and the internal structure of the lesions in both cases and peripheral rim enhancement on the postcontrast scan in one patient. Although MRI demonstrated accurately the complex nature of the lesion, the inability to visualize the calcified areas do not allow to make a specific histologic diagnosis.

[Therapy of urinary incontinence with the AMS 800 artificial sphincter]. / Terapija inkontinencije mokrace umjetnim sfinkterom AMS 800.

The article deals with the possibility of the therapy of urinary incontinence by means of an artificial sphincter. Indications for the implantation of the artificial sphincter and results obtained after twenty implanted sphincters are shown as well.

Continent sigmoid bladder after cystectomy: 20 years' experience.

Twenty years' experience in the substitution of an isolated sigmoid segment after radical cystectomy for bladder carcinoma is described. The indication for surgery was isolated, non-transitional cell bladder cancer. The isolated sigmoid segment is placed longitudinally in the isoperistaltic direction. The study is made up of 73 cases. This operation does not make the procedure more radical since it does not increase survival for this illness. However, in relation to other bladder substitution methods, it guarantees a better quality of life after the operation.

Effects of local chemotherapy and immunotherapy on the recurrence and progression of superficial bladder cancer.

409 cases of superficial bladder carcinoma (pTa, pTi, Tis) are reported. They are divided into three groups: 171 patients treated by TUR alone, 124 treated by TUR and local thio-TEPA, and 114 patients treated by TUR and BCG vaccine locally. It was found that the frequency of recurrence fell by 56.7, 41.9 and 26.3%, while the progression of the illness declined correspondingly by 19.8, 16.9 and 11.4%. In other words, in terms of recurrence and progression, the poorest results were found for the group treated by TUR only, and the best results were found with the TUR and BCG group.