Pseudoangiosarcomatous squamous cell carcinoma of the penis: a case report with clinicopathological and human papilloma virus analyses / 中华男科学杂志

<p><b>OBJECTIVE</b>To further understand the clinicopathological, ultrastructural and molecular features of penile pseudoangiosarcomatous squamous cell carcinoma (PASCC), and improve its diagnosis and treatment.</p><p><b>METHODS</b>A 47-year-old male patient with penile PASCC was reported and the relevant literature reviewed. The main clinical manifestations of the patient were a typical surface ulceration with hemorrhage and purulent secretion with a foul smell, a papillary mass about 5.0 cm x 5.0 cm x 4.0 cm for 1 year on the foreskin of the penis, and 3 enlarged bilateral inguinal lymph nodes. CT scanning showed no enlarged lymph nodes in the abdomen and pelvis, and X-ray examination revealed no abnormality in the chest.</p><p><b>RESULTS</b>The diagnosis was established by biopsy. Partial penectomy and bilateral inguinal lymphadenectomy (T2N2M0) were performed, followed by adjuvant pelvic radiotherapy. Two months later, total penectomy was necessitated by penile flap necrosis and local recurrence. Eleven months after the first surgery, the patient died of extensive metastasis to the pelvis and lungs. Under the light microsope, the tumor was mainly composed of vessel-like lacunar reticularis spindle cells and a few local squamous cancer cells. Careful examination revealed some focal areas with evident transition from squamous nests to the more acantholytic areas extending towards the pseudoangiosarcomatous spaces. Pathogenetically, it appeared to be the variant of acantholytic squamous cell carcinoma. Immunohistochemically, most tumor cells were strongly positive for keratin (AE1/AE3) and focally positive for EMA, with the typical squamous cells focally positive for 34betaE12 and vimentin. The vessels that proliferated in the tumor were decorated by CD31, CD34 and factor VIII-related antigens, but the tumor cells were negative for HMB45, SMA, Desmin and CEA. HPV DNA (HPVpan, HPV6B/11, HPV16/18, HPV31/33) was not detected by in situ hybridization in the primary and metastatic tumors.</p><p><b>CONCLUSION</b>PASCC is a specific and extremely rare subtype of penile SCC with dramatic similarity to angiosarcoma under the microscope, with poor prognosis. Its diagnosis depends on histopathological, immunohistochemical and ultrastructural studies. Such a presentation underscores the importance of timely consultation, early diagnosis and prompt treatment.</p>

Expression of integrin-linked kinase in prostate cancer and its significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expression of integrin-linked kinase (ILK) in primary prostate cancer and its clinical significance.</p><p><b>METHODS</b>The expression of ILK was analysed in 50 prostate cancer and 16 benign prostatic hyperplasia samples by immunohistochemical staining.</p><p><b>RESULTS</b>The positive percentage of ILK was 46.0% (23/50) in primary prostate cancer. The higher the grade and the clinical stage of the tumor, the lower the expression of ILK. The positive percentages of ILK were 9.1% (1/11) in the well differentiated type, 56.4% (22/39) in the moderately and poorly differentiated type (chi2 = 12.28, P < 0.01), 24.0% (6/25) in the well and moderately differentiated type, 68.0% (17/25) in the poorly differentiated type (chi2 = 9.74, P < 0.01), 22.6% (7/31) at the A + B stage and 84.0% (16/19) at the C + D stage (chi2 = 11.8, P < 0.01). But in benign prostatic hyperplasia, it was only 6.2% (1/16), significantly lower than in primary prostate cancer (46.0%) (chi2 = 8.27, P < 0.01).</p><p><b>CONCLUSION</b>The abnormal expression of ILK plays an important role in the development of primary prostate cancer, and the detection of ILK may be useful for the judgement of tumor development and prognosis.</p>

Influence and mechanism of a tight control of blood glucose by intensive insulin therapy on human sepsis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of a tight control of blood glucose by intensive insulin therapy on human sepsis, and to explore the potential mechanism of the intensive insulin therapy.</p><p><b>METHODS</b>Eligible patients were randomized by a blinded pharmacist to receive tight control of blood glucose by intensive insulin therapy (maintenance of blood glucose at a level between 4.4 and 6.1 mmol/L) or to receive conventional treatment (maintenance of glucose at a level between 10.0 and 11.1 mmol/L). The expression of HLA-DR on peripheral monocytes was measured in 54 patients by flow cytometry on 24 h, 3 d, 5 d, 7 d, 10 d and 14 d of intensive care in parallel with serum c-reactive protein (CRP), severity of the disease (APACHE II score, SOFA score) and clinical data collection.</p><p><b>RESULTS</b>Patients receiving intensive insulin therapy were less likely to require prolonged mechanical ventilation. Tight control of blood glucose significantly reduced the number of days during which leukopenia or leukocytosis and the days with hypo- or hyperthermia (P < 0.05). Hypoglycemia occurred in 3 patients (10.7%) in the tight control of blood glucose group. There were no instance of hemodynamic deterioration or convulsions. Compared with the conventional treatment, tight control of blood glucose also increased the HLA-DR expression of peripheral monocytes, and there were significantly difference on 3 d, 5 d and 7 d (P < 0.05). Whereas it suppressed the elevated serum CRP concentrations, there was significantly difference on 7 d (P < 0.05).</p><p><b>CONCLUSIONS</b>Tight control of blood glucose by intensive insulin therapy expedited healing of human sepsis, and increased the HLA-DR expression of peripheral and suppressed the elevated serum CRP. So, it is necessary to use insulin to strict control the glucose levels in human sepsis.</p>

K-ras mutations in rectal cancer undergone preoperative radiotherapy / 中华外科杂志

<p><b>OBJECTIVE</b>To detect K-ras mutations in rectal carcinoma before and after preoperative radiotherapy, and study genetics effect of radiotherapy in rectal cancer.</p><p><b>METHODS</b>Forty patients with rectal cancer in pTNM stage II or III were enrolled. There were 20 males and 20 females. Sixteen tumours were pTNM II stage, 24 pTNM III. All patients received preoperative adjuvant radiotherapy. The treatment time is 4 weeks for 40 Gy in 2.0 Gy fractions and it is usually followed by an interval of 1-2 weeks before the operation. Tumor tissue and normal mucosa 2, 4, 6 cm to tumor were collected from patients before preoperative adjuvant radiotherapy and after operation. The K-ras mutations in codon 12 were investigated using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) in tumors and normal mucosa.</p><p><b>RESULTS</b>The frequencies of K-ras mutations before preoperative adjuvant radiotherapy in tumor tissue and normal mucosa 2, 4, 6 cm to tumor were 47.5%, 22.5%, 2.5% and 0. The frequencies of K-ras mutations before preoperative adjuvant radiotherapy were higher in tumor tissue than in normal mucosa, and were higher in normal mucosa 2 cm to tumor than 4 cm and 6 cm to tumor. The postoperative frequencies of K-ras mutations in tumor tissue and normal mucosa 2 cm, 4 cm, 6 cm to tumor were 25.0%, 5.0%, 0 and 0. Compared to same locations of control group, the frequency of K-ras mutations in tumor tissue and normal mucosa 2 cm to tumor significantly decreased after radiotherapy.</p><p><b>CONCLUSION</b>Frequency of K-ras mutations of rectal cancer issue and normal mucosa 2 cm to tumor were significantly higher than other normal rectal mucosa, and decreased significantly after radiotherapy. So radiotherapy can inhibit early events of carcinogenesis of mucosa nearby tumor. It was the potential reason of increased rates of resection and sphincter-saving after radiotherapy.</p>

Effect of preoperative radiotherapy as an adjunctive approach on proliferation and apoptosis of cancer cells in rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of preoperative radiotherapy as an adjunctive approach on proliferation and apoptosis of cancer cells in rectal cancer.</p><p><b>METHODS</b>Eighty patients with (p)TNM stage II or III rectal cancer were enrolled from April 2000 to December 2002. The patients were divided into two groups, which were group received surgical treatment alone (40 cases) and group received preoperative adjuvant radiotherapy with a radiological dose of 40 G( y ) (40 cases). The expression of Ki- 67 protein in rectal cancer was detected immunohistochemically and apoptosis was detected by TUNEL technique.</p><p><b>RESULTS</b>In radiotherapy group, the tumor volume shrank markedly in 14 cases, partially in 18,slightly in 8 with an overall efficiency rate of 80% .There was significant positive correlation between spontaneous apoptosis and Ki- 69 marker index in cancer tissues before radiotherapy(gamma =0.563P=0.027). The expression of Ki- 67 in rectal cancer tissues was significantly lower after radiotherapy than that before radiotherapy, as well as in the control group(P=0.017 vs. P=0.011).The expression of Ki- 67 in paratumor tissues 2cm from tumor was significantly lower after radiotherapy than that before radiotherapy. Apoptosis index (AI) in rectal cancer tissues was significantly higher after radiotherapy than that before radiotherapy, and that in the control group (P=0.013 vs. P=0.018).</p><p><b>CONCLUSION</b>Radiotherapy can inhibit proliferation and induce apoptosis of rectal cancer cells. The expression level of Ki- 67 can be considered as a screening index for preoperative radiotherapy.</p>

Morphological characteristics of spermatozoa before and after renal transplantation / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the changes of the spermatozoa ultrastructures before and after renal transplantation in uremic patients.</p><p><b>METHODS</b>The sperm of five uremic patients before and after transplantation and four healthy volunteers were collected and examined by scanning electron microscopy.</p><p><b>RESULTS</b>Abnormal spermatozoa were found in patients pre-transplantation; abnormalities included deletion of the acrosome, absence of the postacrosomal and postnuclear ring, dumbbell-like changes of the head, tail curling, and absence of the mitochondrial sheath in the mid-segment. After renal transplantation, most of the spermatozoa became normal.</p><p><b>CONCLUSION</b>There are many abnormalities with regard to the appearance and structure of the head, acrosome, mitochondria and tail of the spermatozoa in uremic patients. The majority of the spermatozoa returned to normal after renal transplantation, but a few still presented some abnormalities possibly relating to the administration of immunosuppressants.</p>

Expression of survivin in human gastric adenocarcinomas: correlation with proliferation and apoptosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of survivin, ki-67 and apoptosis index in patients with advanced gastric adenocarcinoma.</p><p><b>METHODS</b>Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki-67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas.</p><p><b>RESULTS</b>The survivin was detected in the cytoplasm of carcinoma cells in 59 (49.17%) of the 120 gastric adenocarcinomas, in 32 (64.00%) of the lymph node metastasis, and in 21 (17.50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki-67) in primary tumors was 7.55%, which was significantly lower than the mean proliferative index of 8.34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1.16%, which was significantly higher than the mean apoptosis index of 0.89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis (P < 0.05). There was negative correlation between weighted survivin score and apoptosis index (P < 0.05), but no correlation with proliferative index.</p><p><b>CONCLUSION</b>The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.</p>

A comparative study of male patient's sexual function before and after kidney transplantation / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate sexual function before and after kidney transplantation in patients with chronic nephrosis.</p><p><b>METHODS</b>Eighty-six male patients were divided into 3 age groups: young-age group (Group A), middle-age group(Group B) and elder-age group(Group C). Sexual function, including potency, frequency and satisfaction of intercourse before and after the sickening, and after transplantation, were recorded in each group.</p><p><b>RESULTS</b>All the patients were potent before suffering from nephrosis. The proportion of patients who were potent after catching the disease in Group A, B and C was 28.6%, 13.8% and 9.1%, respectively. Notably, the proportion of patients remaining potent after transplantation in Group A, B and C was 88.6%, 75.9% and 63.6%, respectively.</p><p><b>CONCLUSIONS</b>Quality of sexual life is significantly improved after kidney transplantation. The younger the patients, the better the improvement.</p>

Effects of different dosages of cyclosporine A on the semen parameters of renal transplant patients / 中华男科学杂志

<p><b>OBJECTIVES</b>To evaluate the effects of different dosages of cyclosporine A (CsA) on the main semen parameters and sperm morphology of the patients after renal transplantation.</p><p><b>METHODS</b>The semen of 18 patients after renal transplantation treated with different dosages of CsA was analyzed and the semen parameters and sperm morphology were compared with those of 12 normal volunteers.</p><p><b>RESULTS</b>There was not significant difference between the main parameters of the patients treated with 1.5-3.0 mg.Kg-1.d-1 of CsA and 3.1-5.5 mg.Kg-1.d-1 of CsA and those of the volunteers (P > 0.05), but the rate of normal sperm morphology was significantly different between the two groups(P < 0.05).</p><p><b>CONCLUSIONS</b>Different therapeutic dosages of CsA did not have any effect on most of the semen parameters of the patients after renal transplantation, but did affect the sperm morphology.</p>