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1.
Chin Med J (Engl) ; 133(4): 424-434, 2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-31977553

RESUMO

BACKGROUND: Traditional tissue engineering methods to fabricate urinary tract patch have some drawbacks such as compromised cell viability and uneven cell distribution within scaffold. In this study, we combined three-dimensional (3D) bioprinting and tissue engineering method to form a tissue-engineered urinary tract patch, which could be employed for the application on Beagles urinary tract defect mode to verify its effectiveness on urinary tract reconstruction. METHODS: Human adipose-derived stem cells (hADSCs) were dropped into smooth muscle differentiation medium to generate induced microtissues (ID-MTs), flow cytometry was utilized to detect the positive percentage for CD44, CD105, CD45, and CD34 of hADSCs. Expression of vascular endothelial growth factor A (VEGFA) and tumor necrosis factor-stimulated gene-6 (TSG-6) in hADSCs and MTs were identified by Western blotting. Then the ID-MTs were employed for 3D bioprinting. The bioprinted structure was encapsulated by transplantation into the subcutaneous tissue of nude mice for 1 week. After retrieval of the encapsulated structure, hematoxylin and eosin and Masson's trichrome staining were performed to demonstrate the morphology and reveal collagen and smooth muscle fibers, integral optical density (IOD) and area of interest were calculated for further semi-quantitative analysis. Immunofluorescent double staining of CD31 and α-smooth muscle actin (α-SMA) were used to reveal vascularization of the encapsulated structure. Immunohistochemistry was performed to evaluate the expression of interleukin-2 (IL-2), α-SMA, and smoothelin of the MTs in the implanted structure. Afterward, the encapsulated structure was seeded with human urothelial cells. Immunofluorescent staining of cytokeratins AE1/AE3 was applied to inspect the morphology of seeded encapsulated structure. RESULTS: The semi-quantitative assay showed that the relative protein expression of VEGFA was 0.355 ±â€Š0.038 in the hADSCs vs. 0.649 ±â€Š0.150 in the MTs (t = 3.291, P = 0.030), while TSG-6 expression was 0.492 ±â€Š0.092 in the hADSCs vs. 1.256 ±â€Š0.401 in the MTs (t = 3.216, P = 0.032). The semi-quantitative analysis showed that the mean IOD of IL-2 in the MT group was 7.67 ±â€Š1.26, while 12.6 ±â€Š4.79 in the hADSCs group, but semi-quantitative analysis showed that there was no statistical significance in the difference between the two groups (t = 1.724, P = 0.16). The semi-quantitative analysis showed that IOD was 71.7 ±â€Š14.2 in non-induced MTs (NI-MTs) vs. 35.7 ±â€Š11.4 in ID-MTs for collagen fibers (t = 3.428, P = 0.027) and 12.8 ±â€Š1.9 in NI-MTs vs. 30.6 ±â€Š8.9 in ID-MTs for smooth muscle fibers (t = 3.369, P = 0.028); furthermore, the mean IOD was 0.0613 ±â€Š0.0172 in ID-MTs vs. 0.0017 ±â€Š0.0009 in NI-MTs for α-SMA (t = 5.994, P = 0.027), while 0.0355 ±â€Š0.0128 in ID-MTs vs. 0.0035 ±â€Š0.0022 in NI-MTs for smoothelin (t = 4.268, P = 0.013), which indicate that 3D bioprinted structure containing ID-MTs could mimic the smooth muscle layer of native urinary tract. After encapsulation of the urinary tract patch for additional cell adhesion, urothelial cells were seeded onto the encapsulated structures, and a monolayer urothelial cell was observed. CONCLUSION: Through 3D bioprinting and tissue engineering methods, we provided a promising way to fabricate tissue-engineered urinary tract patch for further investigation.

2.
Med Sci Monit ; 25: 8345-8351, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31691648

RESUMO

BACKGROUND The aim of this study was to investigate the diagnostic value of (F/T)/PSAD for prostate cancer detection in the Chinese population. MATERIAL AND METHODS Data were collected retrospectively from patients with prostate cancer or benign prostatic hyperplasia from July 2009 to September 2014. SPSS 19.0 software was used for the receiver operating characteristic curve (ROC), and calculating sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV), respectively. Comparison of the area under ROC (AUC) was performed using the MedCalc v. 10.4.7.0 software. RESULTS A total of 660 patients (including 251 patients with prostate cancer and 409 patients with prostatic hyperplasia) were included. Prostate volume (PV), prostate-specific antigen density (PSAD), free-serum PSA (FPSA)/PSAD, and free-to-total PSA (F/T)/PSAD had similar AUC (P>0.05), and had significantly higher AUC (P<0.001) than F/T, total-serum PSA (TPSA), and free-serum PSA (FPSA). Based on the optimal cutoff value, the sensitivity of (F/T)/PSAD and FPSA/PSAD was similar (P>0.05), and significantly higher than the PV and PSAD (P<0.05). The logistic regression model using a combination of age, FPSA, PV, PSAD, FPSA/PSAD, and (F/T)/PSAD showed higher AUC than each one alone (P<0.001). CONCLUSIONS (F/T)/PSAD can be used as a predictor for prostate cancer in the Chinese population aged >50 years and has a significantly lower false negative rate than PSAD and PV with a cutoff value of ≤0.731. A new parameter, FPSA/PSAD, has similar diagnostic accuracy comparable to (F/T)/PSAD. The diagnostic value of a combination of age, FPSA, PV, PSAD, FPSA/PSAD, and (F/T)/PSAD needs further investigation.

3.
Endocr J ; 65(3): 269-279, 2018 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-29279458

RESUMO

Primary macronodular adrenal hyperplasia (PMAH), also known in the past as bilateral macronodular adrenalhyperplasia or adrenocorticotropin (ACTH)-independent macronodular adrenal hyperplasia, is a rare type of Cushing's syndrome (CS) and is associated with bilateralenlargement of the adrenal glands. It accounts for <1% of all endogenous cases of CS. In order toidentify the pathogenic mutations in the causative gene of (AIMAH pedigrees, Whole-genome sequencing of three patients in family I was used to retrieve candidate causative genes. Meanwhile, the causative gene was identified by Sanger sequencing from the two pedigrees. Sequencing of ARMC5 exons of three patients was carried out to identify somatic mutations. Moreover, haploid clone of one tumor DNA sample was conducted. ARMC5 was the causative gene of two pedigrees confirmed by whole-genome sequencing (WGA) and Sanger sequencing. The variant sites of the two families were c.C943T (p.R315W) and c.C1960T (p.R654X), respectively. Autosomal dominant inheritance of AIMAH was confirmed by genotypes of one family member. Several somatic mutations were discovered in tumor DNA samples. In addition, haploid clone of tumor DNA was confirmed by germline mutation and somaticmutation, which suggested the pathogenic mechanism of "two-hit-model." ARMC5 was the causative gene of AIMAH pedigrees. This AIMAH in this study presented autosomal dominant inheritance, fitting to Mendelian inheritance law. However, the pathogenic mode of this disease showed as compound heterozygote.


Assuntos
Glândulas Suprarrenais/diagnóstico por imagem , Síndrome de Cushing/genética , Proteínas Supressoras de Tumor/genética , Adulto , Idoso , Proteínas do Domínio Armadillo , Síndrome de Cushing/diagnóstico por imagem , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Linhagem , Tomografia Computadorizada por Raios X , Sequenciamento Completo do Genoma
4.
Asian Pac J Trop Med ; 10(5): 515-519, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28647190

RESUMO

OBJECTIVE: To study the inhibitory effect of matrine on bladder cancer cell growth and invasion in vitro through PI3K/AKT signaling pathway. METHODS: Human T24 bladder cancer cell lines were cultured and treated with different doses of matrine (0.25 mg/mL, 0.5 mg/mL and 1.0 mg/mL) as well as 20 µmol/L PI3K inhibitor LY294002 for 24 h, and the cell proliferation activity, the number of invasive cells as well as the expression of p-PI3K, p-AKT, proliferation genes and invasion genes were determined. RESULTS: Different doses of matrine could decrease the cell viability value, the number of invasive cells as well as the expression of p-PI3K, p-AKT, MMP2 and MMP9, and increase the expression of p16, p21 and p27 in dose-dependent manner; p16, p21 and p27 expression in cells of 20 µmol/L LY29002 group were significantly higher than those of 0 µmol/L LY29002 group while MMP2 and MMP9 expression were significantly lower than those of 0 µmol/L LY29002 group (P < 0.05). CONCLUSIONS: Matrine can inhibit bladder cancer cell proliferation and invasion in vitro and regulate the expression of cell cycle-inhibiting molecules and invasion-related genes through PI3K/AKT signaling pathway.

5.
Zhonghua Nan Ke Xue ; 23(7): 589-597, 2017 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-29723450

RESUMO

Objective: To investigate the effects of down-regulation of PTTG1 expression on the proliferation, invasiveness and apoptosis of androgen-independent human prostate cancer LNCaP-AI cells and their sensitivity to androgen antagonists. METHODS: Human prostate cancer LNCaP-AI cells were transfected with siRNA targeting the PTTG1 gene using the Lipofectamine 2000 transfection reagent. The proliferation, invasiveness and apoptosis of the cells were detected by MTT, Transwell assay and flow cytometry, respectively. The protein expressions of PTTG1, p-Akt, and p-ERK were determined by Western blot and the mRNA expression of PTTG1 measured by agarose gel electrophoresis. RESULTS: The siRNA expression vector markedly down-regulated the expression of PTTG1, which effectively suppressed the proliferation of the LNCaP-AI cells, with the inhibition rates of (19.47 ± 2.12), (24.01 ± 2.13) and (48.02 ± 2.22)% at 24, 48 and 72 hours, respectively, after transfection, with statistically significant differences among the three groups (P <0.05). The number of the cells passing through the polycarbonate film was remarkably decreased at 24, 48 and 72 hours (74.67 ± 9.85, 56.44 ± 8.66 and 37.33 ± 6.14) as compared with the baseline (111.11 ± 13.47) (P <0.01), while the apoptosis rate of the cells was significantly increased at 24, 48 and 72 hours (18.32 ± 0.94), (19.94 ± 1.30) and (21.73 ± 1.88)% in comparison with the baseline (ï¼»2.17 ± 0.49ï¼½%), (P <0.05). PTTG1 siRNA combined with androgen antagonist flumatide exhibited even more significant effects in inhibiting the proliferation and promoting the apoptosis of the LNCaP-AI cells than either used alone, and in a flumatide dose-dependent manner. The inhibition and apoptosis rates of the LNCaP-AI cells treated with 50 nmol/L flumatide were (27.13 ± 3.52) and (3.94 ± 0.48)%, and those treated with siRNA + 50 nmol/L flumatide were (67.51 ± 5.13) and (19.93 ± 1.72)%, respectively, both with statistically significant differences between the two groups (P <0.05). The inhibition and apoptosis rates of the cells treated with 100 nmol/L flumatide were (43.72 ± 3.90) and (5.33 ± 0.66)%, and those treated with siRNA + 100 nmol/L flumatide were (73.19 ± 4.78) and (23.43 ± 1.76)%, respectively, both with statistically significant differences between the two groups (P <0.05). CONCLUSIONS: The siRNA expression vector can down-regulate the expression of PTTG1, which can inhibit the proliferation and invasiveness of LNCaP-AI cells, promote their apoptosis, and increase their sensibility to androgen antagonists. Suppressing the expression of PTTG1 may enhance the effect of androgen-deprivation therapy on advanced prostate cancer.


Assuntos
Antagonistas de Androgênios/farmacologia , Apoptose , Proliferação de Células , Regulação para Baixo , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , RNA Interferente Pequeno/metabolismo , Securina/metabolismo , Linhagem Celular Tumoral , Humanos , Masculino , Invasividade Neoplásica , Neoplasias da Próstata/tratamento farmacológico , Securina/genética , Fatores de Tempo , Transfecção
6.
Fam Cancer ; 12(4): 657-67, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23754170

RESUMO

ACTH independent macronodular adrenal hyperplasia (AIMAH) is a rare disorder characterized by bilateral macronodular hyperplasia of the adrenal glands and increased cortisol production with subclinical or overt Cushing's syndrome. Although the family clustering of AIMAH is infrequent, we have tried our best to find such a familial affected pedigree with complete clinical information and successfully collect adrenalectomy tissue samples from two members of this family. Using whole exome sequencing and several variant prioritization strategies based on disease network analysis, we identified Endothelin receptor type A (EDNRA) Ser420Thr mutation as a causative mutation of AIMAH. EDNRA is a member of G protein coupled receptor family and is involved in cardiovascular or polycystic kidney disease. Our findings indicate that the mutation of EDNRA at S420T site should be regard as a potential AIMAH causative variation in familial and sporadic affected patients.


Assuntos
Síndrome de Cushing/genética , Exoma/genética , Mutação/genética , Receptor de Endotelina A/genética , Síndrome de Cushing/patologia , Feminino , Seguimentos , Redes Reguladoras de Genes , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Prognóstico
7.
Asian Pac J Cancer Prev ; 13(7): 3083-8, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22994714

RESUMO

We investigated the prognostic value of pituitary tumor transforming gene 1 (PTTG1) expression according to clinicopathological features among localized or locally advanced prostate cancer cases receiving hormone therapy. A retrospective study involved 64 patients receiving combined androgen blockade treatment was performed. PTTG1 expression was determined by immunohistochemical staining using initial needle biopsy specimens for diagnosis. Associations of PTTG1 with various clinicopathological features and disease-free survival were examined via uni- and multivariate analyses. No association between PTTG1 expression and clinical T stage, Gleason score, pretreatment PSA levels, risk groups was found (p=0.682, 0.184, 0.487, 0.571, respectively). Univariate analysis revealed that increased PTTG1 expression, T3 stage and high risk group were associated with increased risk of disease progression (p=0.000, 0.042, and 0.001), and high PSA level had a tendency to predict disease progression (p=0.056). Cox hazard ratio analysis showed that PTTG1 low expression (p=0.002), PTTG1 high expression (p=0.000) and high risk group (p=0.0147) were significantly related to decreased disease-free survival. In conclusion, PTTG1 expression determined by immunohistochemical staining in needle biopsy specimens for diagnosis is a negative prognostic factor for progression in localized or locally advanced prostate cancer receiving hormone therapy.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Proteínas de Neoplasias/biossíntese , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/metabolismo , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/métodos , Progressão da Doença , Intervalo Livre de Doença , Seguimentos , Terapia de Reposição Hormonal/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Estadiamento de Neoplasias , Prognóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Securina
8.
Neuro Endocrinol Lett ; 33(3): 265-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22635081

RESUMO

Tumors originating from ectopic adrenal tissue are relatively rare. In this article, we describe a case with Cushing's syndrome caused by an ectopic adrenal adenoma. A 38 year-old male patient presenting with cushingoid appearance for 2 years was diagnosed to have ACTH-independent Cushing's syndrome based on endocrinological evaluation. Mutiple radiological examinations detected bilateral adrenal atrophy. When the images were investigated in a more expanded scope, a 3.0×3.5×5.3 cm mass was detected in the anterior of left renal hilum and left renal vein. The mass was successfully resected with intraoperative endoscopy and pathological evaluation revealed an ectopic adrenal tumor. It is suggested that when the endocrinlogically confirmed adrenal neoplasm could not be well and definitely localized, the possibility of ectopic adrenal should be presumed and further radiography examinations should extend to the field where ectopic adrenal usually presents.


Assuntos
Corticosteroides/metabolismo , Neoplasias do Córtex Suprarrenal/cirurgia , Adenoma Adrenocortical/cirurgia , Neoplasias Renais/cirurgia , Laparoscopia/métodos , Hipersecreção Hipofisária de ACTH/cirurgia , Córtex Suprarrenal , Neoplasias do Córtex Suprarrenal/metabolismo , Neoplasias do Córtex Suprarrenal/patologia , Adenoma Adrenocortical/metabolismo , Adenoma Adrenocortical/patologia , Adulto , Coristoma/patologia , Humanos , Nefropatias/patologia , Neoplasias Renais/metabolismo , Neoplasias Renais/patologia , Masculino , Hipersecreção Hipofisária de ACTH/patologia
9.
Surg Endosc ; 25(7): 2117-24, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21170658

RESUMO

BACKGROUND: Laparoscopic adrenalectomy has become the gold-standard for the surgical treatment of most adrenal lesions. This study evaluated the operative outcome of laparoendoscopic single-site (LESS) retroperitoneoscopic adrenalectomy (LESS-ARA) in comparison with the current standard operation procedure. METHODS: Between June and December 2009, 19 patients underwent LESS-ARA, and their outcomes were compared with a contemporary 1:2 matched-pair cohort of 38 patients who underwent standard ARA by the same surgeon. In LESS-ARA, a multichannel port was inserted through a 2.5- to 3.0-cm transverse skin incision below the tip of the 12th rib. The LESS-ARA procedure was performed using a 5-mm 30º laparoscopic camera and two standard laparoscopic instruments. The following parameters were compared between the two groups: demographics, details of the surgery, perioperative complications, postoperative visual analog pain scale score, analgesic requirement, and short-term measures of convalescence. RESULTS: The finding showed that LESS-ARA and standard ARA were comparable in terms of the estimated blood loss (30 vs 17.5 ml; p=0.64), postoperative hospital stay (6 vs 6 days; p=0.67), and postoperative complications (2 vs 3 patients; p=1.00) for patients with similar baseline demographics and median tumor size (2.1 vs 3.0; p=0.18) cm. The intraoperative hemodynamic values were similar in the two groups. The LESS-ARA group had a longer median operative time (55 vs 41.5 min; p=0.0004), whereas the in-hospital use of analgesics was significantly less (5 vs 12 morphine equivalents; p=0.03). CONCLUSIONS: The LESS retroperitoneoscopic adrenalectomy approach is feasible and offers a superior cosmetic outcome and better pain control, with perioperative outcomes and short-term measures of convalescence similar to those of the standard approach, albeit with a longer operative time.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/métodos , Laparoscopia/métodos , Analgésicos/uso terapêutico , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento
10.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 18(6): 1590-4, 2010 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-21176376

RESUMO

The aim of this study was to compare cell proliferation and function of the T cells acquired under various culture conditions for establishing a simple, safe and efficient cell expansion protocol in vitro. The peripheral blood mononuclear cells (PBMNC) were isolated and stimulated with autologous dendritic cells (DC) and EBV-transformed B lymphoblastoid cell line (BLCL) weekly. The cell proliferation test, flow cytometry with PI and Annexin V double staining, Cr release test and ELISPOT test were used to detect the cell expansion level, frequency of IFN-γ producing T cells, killing activity of antigen-specific T cells, cell apoptotic status and cell differentiation potential, respectively. The results indicated that use of IL-2 combined with IL-7 and IL-15 resulted in the highest cell expansion comparing to the use of IL-2 alone and the use of CD3/28 Microbeads. Also the cells obtained under cultivating with IL-2, IL-7 and IL-15 together showed high frequency of IFN-γ producing cells, strong killing activity, high viability and high differentiation potential with large portion of CD3(+)CD8(+) population among the T cells. It is concluded that a protocol is established in which the use of IL-2 combined with IL-7 and IL-15 induces the biggest cell expansion, expanded cells show high viability, strong differentiation potential, high frequency of IFN-γ producing cells and strong killing activity.


Assuntos
Proliferação de Células , Células Dendríticas/citologia , Interleucina-15/farmacologia , Interleucina-2/farmacologia , Interleucina-7/farmacologia , Linfócitos T/efeitos dos fármacos , Linhagem Celular Transformada , Separação Celular , Células Dendríticas/metabolismo , Humanos , Linfócitos T/citologia , Linfócitos T/metabolismo
11.
Zhonghua Wai Ke Za Zhi ; 48(10): 761-3, 2010 May 15.
Artigo em Chinês | MEDLINE | ID: mdl-20646494

RESUMO

OBJECTIVE: To analyze the influence of benign prostatic hyperplasia (BPH) drugs on incidence and pathology grading of prostate cancer in China. METHODS: Retrospectively investigated the history of drug treatment in 1029 cases of BPH in patients from February 1998 to December 2004. According to the history of drug use, the patients were divided into 4 groups: finasteride group, alpha-receptor inhibitor group, finasteride and alpha-receptor inhibitor combination group and control group (untreated group). We gathered pathology sections of patients in all groups, and gave Gleason Score to each. The difference of incidence and pathology grading of prostate cancer were analyzed by Stata 7.0. RESULTS: The incidence of prostate cancer in the population of our study was 13.5%; The incidence in finasteride group, alpha-receptor inhibitor group, combination group and control group was 9.8%, 16.0%, 10.3% and 18.6%, respectively. There was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). In our study, the ratio of middle or high level pathology grading (Gleason ≥ 7) in prostate cancer patients was 58.3%, the ratio of middle or high level pathology grading prostate cancer patients in the four groups was 71.4%, 59.6%, 67.7% and 40.0%, respectively. In the comparison of composition ratio of middle or high level prostate cancer, there was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). CONCLUSIONS: Finasteride can lower the risk of prostate cancer, but increase the pathology grade of the prostate cancer which has occurred in the same time. The alpha-receptor inhibitor does not have the same effect.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Finasterida/uso terapêutico , Neoplasias da Próstata/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/patologia , Estudos Retrospectivos
12.
Urology ; 76(6): 1414-8, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20546872

RESUMO

OBJECTIVE: To describe the technique of laparoscopic-assisted partial nephrectomy melded with open procedure in resection of postero-medial renal tumors. METHODS: Six patients with postero-medial renal tumors were admitted between July 2008 and March 2009. They included 4 diagnosed renal cell carcinomas and 2 renal angiomyolipomas on preoperative imaging, and their tumors ranged from 2.5-4.3 cm in diameter. They underwent laparoscopic-assisted nephron-sparing surgery combined with a small-incision procedure. RESULTS: All 6 patients underwent successful resection. The mean operating time was 124 minutes and the average duration of pneumoperitoneum was 25 minutes. The duration of renal arterial blockage ranged from 19-36 minutes, with an average of 23 minutes. The intraoperative hemorrhage volume averaged 160 mL. Postoperative pathology revealed negative margins in all resected specimens. No urinary fistula or secondary hemorrhage occurred postoperatively, and renal function showed no impairment. The patients were followed for 1-8 months. Ultrasonographic or computed tomography examination revealed no recurrence. CONCLUSIONS: The laparoscopic-assisted partial nephrectomy combined with an open procedure is a novel technique for the resection of posterior medial renal tumors. The technique is safe and effective.


Assuntos
Angiomiolipoma/cirurgia , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Laparoscopia/métodos , Laparotomia/métodos , Nefrectomia/métodos , Perda Sanguínea Cirúrgica , Seguimentos , Humanos , Rim/irrigação sanguínea , Complicações Pós-Operatórias , Resultado do Tratamento
13.
Zhonghua Wai Ke Za Zhi ; 47(16): 1242-4, 2009 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-19781173

RESUMO

OBJECTIVE: To present the technique and experience of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system. METHODS: From December 2007 to September 2008, 4 patients underwent RARC and urinary diversion. The age of patients was 44 to 63 years old. The body mass index was 22.8 to 27.7. All their clinical stages were lower than T2N0M0. The technique for RARC involving ureters dissection, posterior dissection, lateral pedicle control, anterior dissection, dorsal vein complex control, neurovascular bundles sparing, lymphadenectomy, ureter-ileal anastomosis, urethra-neobladder anastomosis to either ileal conduit urinary diversion or neobladder reconstruction performed extracorporeally. RESULTS: All the operations were accomplished successfully. The urinary diversion of 2 case was ileal conduit and others was ileal orthophoria neobladder. The operation time was 300 to 450 min. The time of radical cystectomy was 150 to 180 min. The estimated blood loss was 100 to 500 ml. The postoperative hospital stay was 9 to 35 d. The bed rest time was 4 to 9 d. There was 1 patients who had incomplete intestinal obstruction at 8th postoperative day cured by conservative therapy. The patients were followed up for 3 to 12 months, all patients survived without tumor recurrence. The patients have satisfied urinary continence and normal renal functions without hydronephrosis after the operation. CONCLUSIONS: RARC is small incision and safe, the results are definite. It is one of the direction of minimally invasive urologic surgery.


Assuntos
Cistectomia/métodos , Laparoscopia/métodos , Robótica , Derivação Urinária/métodos , Adulto , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
BJU Int ; 104(2): 263-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19220257

RESUMO

OBJECTIVE: To evaluate the adhesion and growth of rabbit urethral epithelial cells (UECs) on a biodegradable unbraided mesh urethral stent, and to assess the feasibility and effect of the cell-seeded urethral stent for treating post-traumatic urethral stricture (PTUS) in a rabbit model. MATERIALS AND METHODS: Rabbit UECs were collected by biopsy from adult rabbit urethra and seeded onto the outer layer of a mesh biodegradable urethral stent. The growth of UECs in cell-scaffolds was assessed by scanning electron microscopy, immunohistochemical and fluorescence staining. In all, 32 male New Zealand rabbits were used, with either PTUS or uninjured, as a control group. Cell-seeded stents were implanted into the rabbits strictured urethra. The histological and immunohistochemical findings were assessed after death at 1, 2, 8, 12 and 24 weeks, respectively. The reconstruction and function were evaluated by urethroscopy and retrograde urethrography. RESULTS: The cultured UECs adhered to the stent and grew well. Immunohistochemistry showed that the cells were stained positively for cytokeratin. At 4 weeks, vs 2 weeks, the thickness of the papillary projections of the epithelium decreased and inflammatory cell infiltration diminished. At 24 weeks the injured urethra was completely covered by integrated regeneration of three to five layers of urothelium. There was no evidence of voiding difficulty, stricture recurrence or other complications. CONCLUSIONS: The unbraided mesh biodegradable urethral stent with autologous UECs seemed to be feasible for treating PTUS in the rabbit urethra, and provides a hopeful avenue for clinical application allowing reconstruction of PTUS.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Células Epiteliais/transplante , Stents , Estreitamento Uretral/terapia , Animais , Estudos de Viabilidade , Masculino , Coelhos , Resultado do Tratamento
15.
BJU Int ; 103(3): 352-6, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18778340

RESUMO

OBJECTIVE: To explore the safety and clinical efficacy of continuous-wave laser vaporesection for the treatment of obstructive benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: We treated 72 consecutive patients with obstructive BPH using a 70 W 2-microm continuous-wave laser. The mean (range) age of the patients was 68.6 (52-86) years. Before laser treatment, the patients were examined. The mean (SD, range) prostatic volume was 65.8 (21.7, 36-108) mL. The operative outcomes assessed were: resection time, transfusion rate, catheter time, and haemoglobin and serum sodium levels. The following variables were assessed before and after vaporesection: maximum urinary flow rate (Qmax), postvoiding residual urine volume (PVR), International Prostate Symptom Score (IPSS), Quality of Life Index (QoL) and sexual function. RESULTS: All cases were successful using general (two cases), epidural (28) or sacral block regional anaesthesia (42). The mean (SD) vaporesection time was 56 (12.8) min. None of the patients required a transfusion. The mean (SD) catheter time was 1.7 (0.6) days. The mean Qmax increased from 5.7 (1.2) mL/s before to 20.8 (2.1) mL/s after vaporesection and the PVR decreased from 150 to 36 mL. The IPSS and QoL scores improved after vaporesection from 24.6 (4.5) to 6.8 (1.2) and 4.8 (0.2) to 1.4 (0.3), respectively (P < 0.05). Apart from transient dysuria (8%) and irritative symptoms (29%), all patients were satisfied with voiding outcome after vaporesection and none had incontinence. CONCLUSION: Vaporesection using the 2-microm continuous-wave laser for the treatment of obstructive BPH is a safe and effective ablative procedure with minimal morbidity and rare bleeding.


Assuntos
Terapia a Laser/métodos , Hiperplasia Prostática/cirurgia , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Terapia a Laser/efeitos adversos , Lasers , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Próstata/patologia , Hiperplasia Prostática/patologia , Qualidade de Vida , Resultado do Tratamento
16.
Zhonghua Nan Ke Xue ; 14(8): 685-9, 2008 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-18817338

RESUMO

OBJECTIVE: To investigate the role of the tumor suppressor gene BRCA1 in response to DNA damage and to confirm that the function of the BRCA1 protein is regulated by a variety of mechanisms including transcriptional control, phosphorylation and protein-protein interaction. METHODS: With the human breast cell line MCF7 as the positive control, we determined the subcellular distribution of BRCA1 in the prostate cancer cell lines LNCaP, DU145 and PC3 by immunohistochemical staining and Western blotting analyses. RESULTS: BRCA1 was present in the prostate cancer cell lines LNCaP, DU145 and PC3. Ionizing radiation induced BRCA1 nuclear export, increasing from 14% to 40% in the cytoplasma (P < 0.01) and decreasing from 46% to 21% in the nuclei (P < 0.01). This DNA damage-induced BRCA1 nuclear export occurred only in the p53 wild-type but not in the p53 mutant cell line. The apoptosis rate of LNCaP cells was as high as 40% after nuclear export, with an obvious increase of cleaved caspase-3, which was correlated with BRCA1 nuclear-cytoplasmic shuttling. CONCLUSION: Cytoplasmic relocalization of the BRCA1 protein may be a mechanism whereby the BRCA1 function is regulated in response to DNA damage. Its induction of a higher rate of cell apoptosis indicates BRCA1 to be another good biomarker for the treatment of prostate cancer.


Assuntos
Proteína BRCA1/metabolismo , Dano ao DNA , Western Blotting , Linhagem Celular Tumoral , Humanos , Imuno-Histoquímica , Masculino , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Proteína Supressora de Tumor p53/metabolismo
17.
J Endourol ; 22(3): 539-43, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18355150

RESUMO

PURPOSE: To assess the clinical efficacy and safety of photoselective laser vaporization of the prostate (PVP) in the treatment of patients with acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Forty-two patients (mean age 72 +/- 5 years, range 65-89) with AUR because of BPH were treated with a prospective trial of PVP with the potassium-titanyl-phosphate (KTP) laser. The treatment outcome was evaluated with subjective and objective tests at 1, 3, 6, and 12 months after PVP using the International Prostate Symptom Score (IPSS), disease-specific quality of life (QoL) score, postvoid residual (PVR) urine volume, and maximum urinary flow rate (Qmax). The International Index of Erectile Function questionnaire and a self-designed ejaculatory questionnaire were completed at different follow-up times to determine patient satisfaction and changes in sexual function. RESULTS: After preliminary urine drainage and adequate preoperative preparation, PVP was performed and bladder outlet obstruction was effectively relieved. The mean prostate volume was 62.5 +/- 11.7 cc, and the mean residual volume with retention was 650 mL (range 240-1200 mL). Mean operative time was 28.6 +/- 5.7 minutes. Mean catheterization duration was 5.6 days (range 3-14 d). There was significant subjective improvement of symptoms and objective improvement in urinary flow rates at 12 months. The mean IPSS and QoL score decreased significantly (P < 0.05). Mean PVR volume also decreased. The mean Qmax was 16.2 +/- 4.6 mL/sec after treatment. Only two patients had recurrent urinary retention during follow-up. There were no intraoperative or postoperative adverse events. CONCLUSIONS: The early clinical results suggest that the PVP is a promising safe, effective, and less-invasive treatment with minimal morbidity for patients with urine retention secondary to BPH.


Assuntos
Terapia a Laser , Prostatectomia , Retenção Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , China , Humanos , Masculino , Hiperplasia Prostática/complicações , Resultado do Tratamento , Retenção Urinária/etiologia
18.
Zhonghua Nan Ke Xue ; 14(1): 30-3, 2008 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-18297808

RESUMO

OBJECTIVE: To study the expression of Livin, an apoptosis inhibitor gene, in prostate cancer, and to investigate its clinical and pathological implications. METHODS: The expressions of Livin were detected in 62 cases of neoplastic prostate tissues and 10 cases of normal prostate tissues by RT-PCR and immunohistochemistry (SP method). RESULTS: The Livin gene was highly expressed in neoplastic prostate tissues, but not in normal ones. Positive expression of Livin proteins was observed in 37 of the 62 (59.7%) tumor samples and accounted for 28.6%, 60.0% and 83.3% in the high, middle and low differentiation prostatic carcinoma groups respectively, with significant difference between the high and low groups. Livin positivity was also significantly correlated with tumor stages, increasing with tumor progression. CONCLUSION: Livin may play an essential role in prostate carcinogenesis and serve as a marker for the prognosis of prostate cancer.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Inibidoras de Apoptose/genética , Proteínas de Neoplasias/genética , Neoplasias da Próstata/patologia , Proteínas Adaptadoras de Transdução de Sinal/biossíntese , Idoso , Progressão da Doença , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Proteínas Inibidoras de Apoptose/biossíntese , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/biossíntese , Estadiamento de Neoplasias , Prognóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa
20.
Zhonghua Wai Ke Za Zhi ; 45(12): 833-5, 2007 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-17845785

RESUMO

OBJECTIVE: To improve the treatment of renal neoplasm with tumor thrombus in the inferior vena cava. METHODS: From May 2005 to May 2006, 9 cases of renal neoplasm with tumor thrombus were treated with balloon catheters to block inferior vena cava under the level of liver vena during the operations. Among the patients, 6 were male and 3 were female. The patients were from 20 to 76 years old (average 53). RESULTS: All cases were succeed by transabdominal incisions. The average length of tumor thrombus was 5.0 cm (3.0 - 6.7 cm). The blood pressure and heart rate were stable during operations. No intraoperative or postoperative complications occurred. The follow up ranged from 6 to 18 months. One patient died at 6 months after surgery. The others lived well. CONCLUSION: The use of balloon catheter during surgical treatment of renal neoplasm with inferior vena cava thrombus is suitable for type II and III tumor thrombus.


Assuntos
Oclusão com Balão , Embolectomia/métodos , Embolia/cirurgia , Neoplasias Renais/cirurgia , Veia Cava Inferior , Adulto , Idoso , Embolia/etiologia , Feminino , Seguimentos , Humanos , Neoplasias Renais/complicações , Fígado/irrigação sanguínea , Fígado/patologia , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Resultado do Tratamento
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