Outcome of radical prostatectomy as primary treatment for high‑risk prostate cancer patients.

CONTEXT: Recently, there has been considerable interest in the role of radical prostatectomy (RP) in men with high‑risk prostate cancer. AIMS: The objective of our study is to report the outcome of upfront RP in our patients with high‑risk prostate cancer (Stage ≥ cT2c, a pre‑operative serum prostate specific antigen >20 ng/ml or a biopsy Gleason score [GS] 8‑10). SUBJECTS AND METHODS: From 1996 to 2010, 208 patients of prostate cancer (high risk category D’Amico’s criteria) underwent open RP with bilateral pelvic lymphadenectomy. STATISTICAL ANALYSIS USED: The data was statistically analyzed using Kaplan Meier method and log rank test to calculate progression free, metastasis free survival (MFS) and cancer specific survival (CSS). Furthermore multivariate analysis (MVA) was carried out using SPSS 14 software. (IBM company). RESULTS: At 7 and 10 years, prostate cancer‑specific survival (PCSS) was found to be 79.7% and 65%, respectively, biochemical recurrence free survival (BRFS) was 42.4% and 36.7%, respectively and the MFS was 71.1% and 64.4% respectively. High GS was highly predictable of PCSS, BRFS and MFS. Node positivity was the single poor risk factor on MVA whereas biopsy GS, pStage (P = 0.016) and seminal vesicle invasion (P = 0.045) had statistical significance in predicting the MFS. CONCLUSIONS: RP provides accurate pathologic staging of patients with high risk prostate cancer, allows better stratification of patients for further adjuvant therapy and either as an initial approach or part of a multimodal regimen, can provide durable local control and provides excellent CSS.

Malignant peritoneal mesothelioma deciduoid or anaplastic variant? Point to ponder.

A case of peritoneal mesothelioma displaying unusual morphology, occurring in a 53 year old woman is described. The role of immunohistochemistry and electron microscopy in the evaluation of this tumor is stressed. The appropriate terminology to be used and possible etiologic factor are also discussed.

Malignant peritoneal mesothelioma deciduoid or anaplastic variant? A point to ponder.

A case of peritoneal meosthelioma displaying unusual morphology, occurring in a 53 years old woman is described. The role of immunohistochemistry and electron microscopy in the evaluation of this tumour is stressed. The appropriate terminology to be used and possible etiologic factor are also discussed.

Embryonal rhabdomyosarcoma of prostate in an adult--a diagnostic dilemma.

Embryonal rhabdomyosarcoma of the prostate is a rare. Highly malignant tumour. The median age of occurrence is five years, but sporadic cases have been reported in adults' To the best of our knowledge, till date, fewer than ten cases have been reported of which only two are above the age of sixty years. We report a case of embryonal rhabdomyosarcoma of prostate in a patient more than sixty years of age. If one is not aware of this entity, one can make a mistake in the diagnosis as well as treatment.

Prevalence of resistant Staphylococcus aureus at Aurangabad.

Seven hundred and eighty three isolates of Staphylococcus aureus isolated from pus (586), blood (78), sputum (25), urine (23), cerebrospinal fluid (23) and various other body fluids (48) were subjected to in-vitro antimicrobial susceptibility testing by modified Kirby-Bauer method. Almost all the isolates were resistant to penicillin (99.62 per cent) and ampicillin (99.62 per cent). Resistance to erythromycin, tetracycline and cotrimoxazole was observed in 88.5, 87.62, and 80.85 per cent isolates respectively. Resistance to gentamicin was 68.32 per cent. Resistance to most of the commonly used antimicrobial agents indicates a need to replace these drugs with other agents and maintenance of surveillance to detect changing patterns of resistance.

Changing aetiology of urinary tract infections and emergence of drug resistance as a major problem.

A study was undertaken to ascertain the spectrum of causative agents responsible for UTI and to detect the magnitude of anti microbial resistance in aetiological agents. Klebsiella species caused urinary tract infection in maximum number of cases (124, 37.35%) followed by Escherichia coli (114, 34.4%), Pseudomonas aeruginosa 32 (9.64%) and Staphylococcus aureus 23 (6.93%). Other organisms caused urinary tract infection in 39 (11.75%) cases. Resistance to gentamicin was observed in 83% S. aureus, 84.7% Klebsiella species, 78.1% Escherichia coli, 71.9% Pseudomonas aeruginosa and 94.8% of remaining isolates. A large number of isolates (> 90%) were resistant to ampicillin, Cotrimoxazole erythromycin, and chloramphenicol. All the isolates of S.aureus were resistant to penicillin. This observations indicate extremely high degree of resistance in urinary pathogen and warrant change in antibiotic usage as well as formulation of policy for rational use of antibiotics.

Primary carcinoma of fallopian tube--a case study.

Primary carcinoma of fallopian tube is a rare entity. We report an interesting case of primary carcinoma of fallopian tube with contralateral lymph node involvement. The clinicopathological findings and its management is presented.

Age related changes in ovarian follicular kinetics in the Indian skipper frog Rana cyanophlyctis (Schn.).

Changes in ovarian follicular kinetics were studied in relation to aging in the Indian skipper frog Rana cyanophlyctis. Age was determined by skeletochronology, by counting the number of growth rings and lines of arrest of growth from the cross sections of 4th phalange of 4th toe. For follicular kinetics study oocytes were counted under binocular using 10% of Bouin’s fixed ovary and they were classified into first growth phase, medium-sized second growth phase, large-sized second growth phase and atretic follicles. Analysis of phalangeal cross sections indicated that frogs ranging 14–54 g in body weight and 4·9–8·9 cm in body size showed 1–7 year rings. Frogs that weighed 14–16 g showed 1 year ring, and contained immature ovaries; those with 18 g body weight had one to two year rings, in which second growth phase oocytes appeared for the first time in the primiparous ovary. Frogs with 20–54 g body weight showed 2–5 year rings in which ovary contained 5–24% of second growth phase oocytes. Further, body weight, body size, ovarian weight, number and size of second growth phase oocytes and total number of oocytes showed a significant (P < 0·05) positive correlation, while, the number of first growth phase and atretic follicles showed a poor correlation with age. The results suggest that in nature, the age of Rana cyanophlyctis ranges between 1–7 years. Phalangeal growth rings are formed annually. Females attain sexual maturity in 2nd year. Frogs with 2–5 years of age may constitute breeding females. Body weight, body size, ovarian mass, number of second growth phase and total oocytes, and egg size increase with age up to 5 years.

Superficial bladder cancer. A 10 year experience.

A total of 236 patients - 198 males and 38 females with superficial bladder cancer (stage A(TaT1)) were treated with transurethral resection of the tumours. Intravesical chemotherapy (84 patients) or immunotherapy (27 patients) was added in those patients considered to be at high risk of developing local recurrences or stage progression. The five and ten years survival in the single tumour group (117 patients) were 86 percent and 72.9 percent as compared to 72.5 percent and 70.7 percent respectively in the multiple tumour group (119 patients). The five and ten year survival rates for grade I tumours were 88.3 percent and 86 percent respectively, for grade II tumours 80.8 percent and 64 percent and for grade III tumours 56.9 percent and 46 percent respectively. The impact of tumour grade on survival was found to be independent of the number of tumours. The response rates to intravesical thiotepa was 54.9 percent mitomycin 60 percent and with BCG 71.5 percent. All the three reduced the local recurrence rates and increase the mean interval to recurrence but the stage progression rate was significantly lowered only with intravesical BCG. In our study, we have used the Danish strain of BCG available to us and have found it to yield response rates comparable to other centres using Tice or Pasteur strains.

Primary papillary adenocarcinoma of the seminal vesicle.

This paper describes a papillary adenocarcinoma solely confined to the seminal vesicle, in a 26 year old male. Imaging techniques and operative findings revealed an enlarged seminal vesicle, harboring a grossly papillary and friable tumor. Strict criteria for diagnosis have been applied, in this unusual case. The young age and unusual location of this papillary adenocarcinoma prompted us to report this case.

Synchronous bilateral parotid metastases from renal cell carcinoma. A case report.

An unusual case of bilateral synchronous parotid metastases from renal cell carcinoma presenting seven years after nephrectomy is reported. The patient underwent bilateral superficial parotidectomy and is alive free of disease three and half years after the metastatectomy.

Non-Hodgkin's lymphoma of prostate: a rare site of primary extranodal presentation (a report of two cases).

We report two cases of primary extranodal lymphoma of the prostate, an unusual site for extranodal presentation. The clinical presentation and treatment is discussed.

Species difference in intestinal drug metabolising enzymes in mouse, rat and hamster and their inducibility by masheri, a pyrolysed tobacco product.

Activities of several drug metabolising enzymes in the small intestine were investigated in Swiss mice, Sprague Dawley rats and Syrian Golden Hamsters fed 10% masheri, a pyrolysed tobacco product, in diet, for 20 months. The basal levels of enzymes in proximal (PI), medium (MI) and distal (DI) parts of the intestine in the three species were similar. However, the levels of cytochrome P-450, benzo(a) pyrene hydroxylase (B(a)OH) and glutathione S-transferase (GST) were highest in hamsters followed by rat and mice. Upon treatment with masheri, significant induction of cytochrome P-450 and B(a)PH was observed in PI and DI of all the three species. However, GSH and GST was depleted upon masheri treatment in all the three species again only in proximal and distal parts of the intestine. Thus increase in activating enzymes together with depletion in GSH-GST system upon exposure could be an important factor in the susceptibility of the small intestine to hazardous xenobiotic exposure.

Short-term and long-term effects of brown and black masheri (pyrolysed tobacco product) on vitamin A and vitamin C levels in mice and hamsters.

The short-term and long-term effects of two most commonly used brown and black masheri were studied in Swiss mice and Syrian golden hamsters. In short-term studies, both the types of masheri extracts (ME) at 3/4 LD50 dose given ip did not have any effect on either liver or plasma vitamin C levels (both species). However, a decrease in liver vitamin A was observed only in hamsters injected with black ME. Similar effect was not observed in mice injected with both the types of masheri extracts. In long-term studies, when both the types of masheri were fed through diet at 10% level for 20 months, no effect was observed on hepatic or plasma vitamin C levels in mice (both sexes), while an increase in vitamin C levels was observed in black masheri diet fed hamsters. A depletion in liver vitamin A was observed in hamsters fed both the types of masheri. Such an effect was observed only in black masheri diet fed Swiss mice (both sexes) and brown masheri diet fed Swiss females.