[ correlation of urine and serum P53 protein in patients with transitional cell carcinoma of urinary bladder]

P53 is a tumor suppressor gene which is mutated in 50% of human cancers. The purpose of this study was to evaluate the association between the protein status in the serum / urine and tumors of bladder cancer. This descriptive study was done on 38 patients with transitional cell carcinoma of bladder who had no history of chemo- or radiotherapy or immune system disease. The sera and urine of these patients were analyzed for P53 protein by Enzyme Linked Immunosorbent Assay [ELISA] and tissue P53 by Immunohistochemical Technique. Individul and laboratory data were collected in questionnaire and analyzed by descriptive statistics and frequency distribution tables. Tissue P53 was detected in 29 of 39 [74.4%] patients, serum and urine P53 protein were detected in the serum and urine of 20 of 39 [51.3%] and 27 of 39 [69.2%] patients, respectively. The mean serum and urine P53 level in positive Tissue P53 patients were 1.45 and 2.27 U/ml respectively, which was significantly higher when compared with mean serum P53 level in negative tissue P53 patients [p< 0.01]. In patients with positive serum P53 [n=20] tissue P53 was positive in 18 [90%] patients and negative in 2 [10%], which was statiscally unsignificant. In negative serum P53 patients [n=19], tissue P53 was negative in 8[42%] patients and positive in 11 [58%]. In patients with positive urine P53 [n=27], tissue P53 was positive in 25 [93%] patients and negative in 2 [%7], which was statiscally unsignificant. Statiscally significant correlation was observed between tissue P53 with pathologic grade of tumor [p= 0.05], but for serum and urine P53 such correlation was not seen. This study shew a strong relationship between tissue P53 protein overexpression and level of P53 protein in serum and urine of TCC patients. Therefore both serum and urine of patients with TCC were found to have significant clinical accuracy for determination of P53 gene status in patients with TCC of bladder

[ comparison of two different diuretic renal Scintigraphy protocols in patients with dilated upper urinary tract]

Diuretic renal scan is preferred noninvasive investigation in evaluating upper urinary tract function and assessing upper tract dilatation or obstruction. There are several protocols for diuretic renal scan which are named according to timing of diuretic administration before, after or at the same time of radiopharmaceutical injection. Timing of diuretic administration is not universally standardized in renography. In the present study we compared F-15, F+20 diuretic renography protocols in patient with upper urinary tract dilatation. From Feb 2004 to Nov 2005, 21 patients were referred with flank pain and pyelocalyceal system dilatation without ureteral dilatation in ultrasonography and after history taking, physical exams and radiological studies such as IVP, retrograde pyelogram, serum creatinin measurement and urine analysis, F-15 and F+20 diuretic renal scans were performed. The pharmaceutical drug in this study was TC-EC [Ethylene dicysteine]. Renal function data, curves and renograms were recorded and patients were undergone conservative or surgical therapy and followed up with physical exams and IVP or diuretic renal scan after 3-6 months and then we compared results with two diuretic renal scan protocols. We used marginal homogeneity test to compare renograms and paired t-student tests to compare renal function in two protocols. Among 21 cases, 15 were male and 6 were female. Mean age was 16.3 +/- 25 years. Left pyelocalyceal system dilatation was reported in 15 cases and right side dilation was seen in 6 cases. Chief complain of patients was flank pain. Ultrasound showed pyelocalyceal dilatation without uretral dilatation. IVP findings included delayed pyelogram and pyelocalyceal dilatation without seeing the ureter. Of all renal diuretic scans, 52.2 percent of patients had obstruction pattern in F-15 and F+20 protocols. Results were equivocal in 23.3% of F+20 scans whereas they had complete obstructive pattern in F-15 scans.14% had normal pattern in F+20 and F-15 scans. 9.5% had nonobstructive pattern in F+20 but equivocal or obstructive pattern in F-15 scans. Obstructions were diagnosed in 52.2% of patient by F+20 scan and in 75.5% by F-15 scan. Renal split function didn't change in F-15 and F+20 diuretic renogram protocols. According to the equivocal results of F+20 diuretic renal scans, F-15 can reduce equivocal results of F+20 diuretic renal scans. Of course we recommend future investigations to approve or disapprove this hypothesis

effect of tamsulosin in facilitating of juxtavesical stones' passage

We evaluated the effectiveness of tamsulosin and nifedipine during watchful waiting in patients with juxtavesical ureteral stone. Between Oct 2003 and Feb 2004, 382 patients with renal colic referred to our center which 64 patients suffered from juxtavesical stone less than 1 cm where enrolled in the study and were randomly divided into 3 groups. The average sizes of the stones were 6.7 mm, 6.4 mm, 6.8 nun in Groups 1, 2, 3. Group 1 [20 Patients] received daily oral treatment of 0.4 rag tamsulosin and group 2 [20 Patients] received 20 mg nifedipine daily oral therapy, group 3 [24 Patients] were used as controls The patients were treated about 4 weeks and the patients were every 1 week and sonography was done for 4 weeks and whenever the stone was expulsed, we discounted the drug. Information about stones passage and time and complication was noted. Statistical analyses were performed with using the K 2 test We had 35 males and 29 females patients mean age of38 years. According to patients age, sex and stone size there was no significant difference between 3 groups. The stone passage rate was 90% [8 Patients], 75% [14 Patients] and 45% [11 Patients] in groups 1, 2, 3 respectively. The difference in group 1 and 2 with respect to group 3 was significant Average expulsion time was 16 days, 20 days and 18 days in 3 groups respectively. A statistically significant difference was noted between group 1 and 3. Two patients from group 1, five patients from group 2 and thirteen patients from group 3 underwent transureteral lithotripsy. Tamsulosin and nifedipine administration in renal colic due to juxtavesical calsuli increased the stone expulsion rate, reduced expulsion time and decreased need for hospitalization and endoscopic procedures