The Effect of Transfer of p21/WAF1 Gene on Kidney and Bladder Cancer Cell Lines / 대한비뇨기과학회지

PURPOSE: To identify antitumor effect, indication and antitumor mechanism of p21/WAF1 gene therapy in human kidney and bladder cancer. MATERIALS AND METHODS: We cloned cDNA of wild type human p21 gene by reverse transcription-polymerase chain reaction(RT-PCR) technology and constructed a mammalian expression plasmid vector carrying cDNA of wild type human p21 and CMV enhancer/promotor(pCMV-p21). pCMV-p21 was administered in vitro in complex with HDL cationic polyliposome into human kidney cancer cells(CURC-1 and CURC-2), bladder cancer cells(RT4 and T24), and liver cancer cells(Hep3B and HepG2), followed by analysis of viable cell number, cellular morphology, cell cycle distribution and development of apoptosis. RESULTS: The expression of p21 was preserved in p53-wild type cells and markedly decreased or absent in p53-mutant cells. Administration of pCMV-p21:HDL complex induced high level expression of p21 and significant suppression of growth in all of the cancer cells examined, regardless of their genetic status of p21 and p53. Transfer of p21 to cancer cells induced not only decrease of proportion of cells in G2+M/S phase but also apoptosis. CONCLUSIONS: HDL cationic polyliposome-mediated p21 gene transfer may become a promising therapeutic modality for human kidney and bladder cancer and that p21 may have a novel function to induce apoptosis to human bladder and kidney cancer cells. Further studies are necessary on in vivo antitumor effect of p21 gene transfer and molecular mechanism of p21 gene-induced apoptosis.

Comparison between Second and Third Generation Piezoelectric Lithotripsy in Children & Adolescents / 대한비뇨기과학회지

During a 9-year period 43 children and adolescents 2 to 18 years old underwent 140 extracorporeal shock wave lithotripsy (ESWL) treatments for 48 calculi. The second generation piezoelectric lithotriptor (LT01) was used in 28 cases (65%) while the remaining cases were treated with the third generation piezoelectric lithotriptor (LT02). LT02 lithotriptor differs from an earlier model LT01 in 2 important respects; a stone localization system consisting of ultrasound and fluoroscopy, and more energy per shock wave. The LT01 necessitated caudal anesthesia in 14 cases (50%) while the LT02 necessitated caudal anesthesia in 2 cases (13%) and intravenous anesthesia in 2 cases (13%). Two upper ureteral stones without ureteral dilatation and 1 mid ureteral stone, which were difficult to detect with ultrasound, could be localized by combined ultrasound and fluoroscopy on LT02. The success rate by LT01 and LT02 ESWL was 92.9% and 100%, respectively. The mean session of LT01 and LT02 ESWL was 3.6+/-.4.09 and 2.6+/-2.47, respectively, and the total storage of LT02 ESWL (93+/-97.8) was much less(p<0.05) than that of LT01 ESWL (363+/-380.3). There were no statistical differences in regard to success and the use of stents, stone size or location between the 2 lithotriptors. Six patients required adjuvant procedures, and ESWL complications were not required admission or surgical management. Therefore, LT02 piezoelectric lithotripsy, in comparison with LT01, is more efficient to localize stones and can lessen total storage by reducing treatment sessions in children and adolescents.