Prognostic significance of P27 [Kip 1] and MUC1 in papillary transitional cell carcinoma of the urinary bladder

To examine p27 [Kip 1] and MUC1 expression in specimens of papillary transitional cell carcinoma [PTCC] of the urinary bladder and to correlate their expression with the tumor grades,stages and outcome. Paraffin sections from previously diagnosed PTCC bladder were graded, staged and the patients were followed up for 5 years. Ten non-neoplastic urological lesions diagnosed as polypoid cystitis were taken as control. Three sections of 4 um thickness were obtained from every case. One was hematoxylin and eosin [H and E] stained for diagnosis, reviewing and confirmation. The other two sections were immunohistochemically stained for both p27and MUC1. The data of immunohistochemical results were correlated with the following conventional prognostic variables: tumor grade, stage, distant metastasis and 5 year survival. The results showed a highly significant and an insignificant relationship between p27 expression and tumor grade and stage [P<0.01 and P>0.05], respectively. Correlating p27 expression with distant metastasis and overall survival showed a significant relationship with distant metastasis [P<0.05] and a highly significant one with overall survival [P<0.01]. The results showed also a significant relationship between MUC1 expression and both tumor grade [P<0.01] and overall survival [P<0.05]. p27 and MUC1 immunohistochemistry augment the classic histochemistry for the prognosis of PTCC of the bladder as well as improving the prediction of the patient outcome and survival

twelve-year experience in the management of calciphylaxis resulting in penile gangrene

To analyze the mode of presentation of patients with calciphylaxis induced penile gangrene and the outcome of management of the disease Prospective study [1998 - 2010] Urology Unit, Mubarak Hospital, Kuwait Patients presenting with penile gangrene secondary to calciphylaxis were analyzed. Intervention[s]: Patients with moderate to severe penile gangrene had penile amputation Main Outcome Measure[s]: Etiological factors, mode of presentation, patient characteristics and the outcome of management Eleven patients were managed in the 12-year period. All patients [100%] had end stage renal failure [ESRF] and nine patients [81.8%] were on chronic dialysis at presentation. Poorly controlled diabetes mellitus was a co-morbidity in 10 patients [90.9%]. Areas of gangrene were limited to the glans penis in nine patients [81.8%] and extending to the scrotum in two patients [19.2%]. All patients had generalized calcified blood vessels on plain X-ray of the abdomen and pelvis. Eight patients [72.7%] required partial or total amputation of the penis. Three patients were successfully managed by debridement while one of them was too ill for surgical intervention. Seven patients [63.6%] were dead within three months of the diagnosis of penile gangrene. Penile gangrene due to calciphylaxis is a rare disease seen mostly in patients with ESRF on chronic dialysis. Poorly controlled diabetes is a risk factor for the onset of penile gangrene. The disease has a high mortality in older patients with other co-morbid medical diseases. Immediate penile amputation may result in a satisfactory outcome in less than 50% of all patients