Cytokeratin 20 [CK-20] a prognostic marker in TCC of the bladder

This immunohistochemical study has examined the degree and pattern of expression of a recently identified cytokeratin [CK-20] in 10 cases of normal bladder urothelium and 15 cases of TCC with well documented clinical course, using immunoperoxidase technique. In normal urothelium the expression of CK-20 was found to be differentiation related and confined to the superficial highly differentiated "umbrella" cells. Correlation of the expression of CK-20 with the clinical course in TCC of the bladder revealed that 85.71 of superficial bladder tumour with good outcome had retained a high degree of expression of CK-20: in the surface cell layer, whereas 80% of muscle invasive tumours, with aggressive clinical course, showed negative expression of the antigen. These observations suggest that the degree and pattern of expression of CK-20 is parallel to the outcome of the tunour. which may make CK-20 a useful prognositc marker in TCC of the bladder. There was another group which showed heterogenous pattern of expression of CK-20. This group was represented mainly by 3 cases of T1 tunours and who had one or more recurrences during the period of follow-up

Evaluation of prostate - related complaints by transrectal ultrasonography, digital rectal examination and prostatic specific antigen

120 male patients with mean age of 55.1 +/- 8.1 years [40 - 78 years] presented with symptoms of prostatism. Symptoms were quantified using the American Urological Association [A.U.A] symptom score. They were subjected to digital rectal examination [D. R. E], prostates specific antigen estimation [P. S. A] transrectal ultrasound [TRUS] and biopsy was obtained from suspicious lesions by the biopsy gun and examined for histopathology. The results were analysed statistically. The results showed three groups of echopattern, isoechoic [46.2%]: hyperechoic [6.7%] and hypoechoic [29.1]. DRE suspected 6 lesions to be malignant. All proved to be hypoechoic by TRUS and confirmed malignant histologically. Of all the hypoechoic lesions biopsy, 8 patients including the six patients suspected by DRE had prostatic carcinoma. Sensitivity of DRE in detection of prostatic carcinoma was 75%, PSA [100%] and TRUS [100%] Specificity reached 93.3% in DRE but decreased to 87.5% using PSA and 70.8% by TRUs

Independent evaluation of venogenic impotence by colour duplex sonography and dynamic cavernosometery cavernosography

In twenty four patients 30 to 59 years old [mean 44 years] with suspected vasculogenic erectile dysfunction diagnosed on the basis of repeated negative response to intracavernous papaverine [60 mg] injection. Colour duplex sonography [CDI] and dynamic cavernosometery / cavernosography [CVM] were performed to all patients. The results were analyzed and correlated. The maximum systolic velocity [V max] was 36.35 +/- 9.14 cm/sec, the end diastolic velocity [V min] was 8.47 +/- 5.33 cm/sec. and resistance index [R.I.] was 0.77 +/- 0.13. By colour duplex, three patients showed arterial insufficiency [A.I] the remaining 21 patients, 16 patients [66.6%] showed venous leakage and 5 patients [20.9] showed no leakage. By dynamic cavernosometery/cavernosography: 15 patients [62.5%] showed venous leakage and 9 patients [37.5%] no leakage. Complete agreement was reached between two modalities in 20 patients. Specificity of colour duplex is 83.3% and predictive value of positive test index was 93.7% but sensitivity of the test and predictive value of the negative test reached 100%. In conclusion, the end diastolic velocity [V min] can be used as screening procedure to exclude venous leakage