"Congelei com medo de me contaminar": tratando um caso de TEPT crônico com imobilidade tônica em uma fisioterapeuta da linha de frente na pandemia de COVID-19 / "I froze for fear of contaminating myself": treating a case of chronic PTSD with tonic immobility in a physiotherapist frontline during COVID-19 pandemic

RESUMO Objetivo: Neste estudo relatamos o caso de uma profissional de saúde com vivência de imobilidade tônica (IT) e posterior desenvolvimento de transtorno de estresse pós-traumático (TEPT) crônico em decorrência de trauma laboral por conta da COVID-19 que recebeu tratamento remoto com terapia cognitivo-comportamental focada no trauma (TCC-FT). Métodos: Relato de caso de uma paciente acompanhada por seis meses após o recebimento de TCC-FT remota. Resultados: Paciente do sexo feminino, de 36 anos, fisioterapeuta, que desenvolveu TEPT crônico e experienciou IT por medo da contaminação por coronavírus. As escalas psicométricas demonstraram que a TCC-FT reduziu consideravelmente os sintomas de TEPT e depressão e aumentou o apoio social e a resiliência. De acordo com o relato, o tratamento melhorou a concentração e a motivação, e reduziu o sentimento de culpa, a irritabilidade, a insegurança e o desconforto em lidar com outras pessoas. Conclusão: Este artigo demonstra que traumas decorrentes da COVID-19 podem ser capazes de desencadear IT e exemplifica um favorável desempenho da TCC-FT na melhoria global da saúde mental dos pacientes com TEPT crônico com vivência de IT.

ABSTRACT Objective: In this study, we report the case of a health professional with experience of tonic immobility (TI) and subsequent development of post-traumatic stress disorder (PTSD) as a result of occupational trauma due to COVID-19 who received remote treatment with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods: A case report of a patient followed for six months after receiving remote TF-CBT. Results: A 36-year-old female patient, the physiotherapist who developed chronic PTSD and experienced TI for fear of coronavirus contamination. Psychometric scales demonstrated that TF-CBT considerably reduced PTSD and depression symptoms and increased social support and resilience. According to the report, the treatment improved concentration and motivation, and reduced feelings of guilt, irritability, insecurity, and discomfort in dealing with other people. Conclusion: This article demonstrates that trauma resulting from COVID-19 can trigger TI and exemplifies a favorable performance of TF-CBT in the global improvement of the mental health of patients with chronic PTSD who experience TI.

Evaluation of Microbiological Quality of Halal Beef Intended for Export from Khartoum State, Sudan

Aims: To evaluate halal criteria of beef microbiological quality intended for export in two slaughterhouses. Study Design: A cross-sectional study. Place and Duration of Study: Khartoum State, Sudan between August and November 2022. Methodology: Samples were collected by using the non-destructive dry swab method for microbiological quality sampling of beef and a standardized checklist to evaluate good manufacturing practices (GMPs) and good hygienic practices (GHPs). Restraining methods were categorized as “modern method” where the full inversion rotary casting box was used which resembled slaughterhouse “A” or “conventional method” where a large-sized hammer for blowing the skull was used and this resembled slaughterhouse “B”. A total of 80 male beef cattle were investigated after arrival in the lairages of the designated slaughterhouses. Forty carcasses from each slaughtering method were randomly chosen and swabbed. Results: The results revealed that halal criteria for the slaughtering methods in slaughterhouse (A) was 100%, while slaughterhouse (B) was 83.2%. Also, this study revealed poor personal hygiene as slaughterhouse A scored 53.2%, while slaughterhouse B scored 33.2% for personal hygiene evaluation. The mean total bacterial count (TBC) was found to be 4.556 x 10? cfu/ml and 5.53275 X 10? cfu/ml in slaughterhouses A and B, respectively with highly significant differences compared to the standard permissible limits (1x 10?cfu/ml) with p ?0.05, while there were no statistically significant differences (0.847) within slaughterhouses with p ?0.05. Furthermore, the mean total coliform count (TCC) was found to be 16.4795 X10²cfu/ml and 47.8670 X 10²cfu/ml in slaughterhouses A and B, respectively with a highly significant difference compared to the standard permissible limits (1x10²cfu/ml) with p ?0.05 and also with highly significant differences (0.000) between slaughterhouses themselves with p ?0.05. Conclusion: The study concluded that both slaughterhouses failed to meet the requirements of the various beef halal criteria.

Predictors of response to cognitive-behavioral therapy in patients with posttraumatic stress disorder: a systematic review / Preditores de resposta à terapia cognitivo-comportamental em pacientes com transtorno de estresse pós-traumático: uma revisão sistemática

OBJETIVO: O transtorno de estresse pós-traumático (TEPT) é um transtorno altamente prevalente e incapacitante. Mesmo quando tratado com uma intervenção de primeira linha, terapia cognitivo-comportamental (TCC), 45% dos pacientes continuam sofrendo desse transtorno. Portanto, conhecer os fatores que podem prever quem responderá à TCC seria de grande valor no tratamento desses pacientes. Por esse motivo, revisamos sistematicamente a literatura para identificar as variáveis que poderiam predizer a resposta à TCC em pacientes que sofrem de TEPT. MÉTODOS: Seguindo as diretrizes do PRISMA 2020, pesquisamos em banco de dados eletrônico como ISI Web of Science, Scopus, PsycINFO, MEDLINE e PTSDpubs até novembro de 2021. Dois autores conduziram independentemente a seleção do estudo e a extração de dados. Estudos que examinaram possíveis preditores de resposta à terapia, com amostra de adultos (18-65 anos) de ambos os sexos, com e sem comorbidades, foram considerados elegíveis. As características dos estudos foram sintetizadas em uma tabela. O risco de viés foi avaliado pela ferramenta de avaliação de qualidade de risco de viés da Cochrane. RESULTADOS: Vinte e oito estudos envolvendo 15 variáveis foram selecionados. Desses, oito mostraram baixo risco de viés, 19 mostraram algumas preocupações e um mostrou alto risco potencial de viés. A relação terapêutica foi a única variável considerada um preditor de boa resposta à terapia. Todas as outras variáveis apresentaram resultados conflitantes. CONCLUSÕES: A variável mais promissora, embora muito fraca cientificamente, é a relação terapêutica. Ensaios clínicos randomizados adicionais devem ser conduzidos para esclarecer o papel dessa variável como um preditor de resposta da TCC em pacientes com TEPT.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is a highly prevalent and disabling disorder. Even when treated with the first-line intervention, cognitive-behavioral therapy (CBT), 45% of the patients continue suffering from this disorder. Therefore, knowing the factors that could foresee who will respond to CBT would be of great value to the treatment of these patients. Thus, we have systematically reviewed the literature to identify the variables that could predict response to CBT in patients suffering from PTSD. METHODS: Following the PRISMA 2020 guidelines, we searched the electronic databases ISI Web of Science, Scopus, PsycINFO, MEDLINE, and PTSDpubs until November 2021. Two authors have independently conducted study selection and data extraction. Studies that examined possible predictors of response to therapy on a sample of adults (18-65 years), both genders, with and without comorbidities were considered eligible. The characteristics of the studies were synthesized in a table. The risk of bias was assessed by the Cochrane risk of bias quality assessment tool. RESULTS: Twenty- -eight studies comprising 15 variables were selected. Among those, eight showed a low risk of bias, 19 showed some concerns, and one showed a high potential risk of bias. The therapeutic relationship was the only variable considered to be a predictor of a good response to therapy. All other variables showed conflicting results. CONCLUSIONS: The most promising variable, although scientifically weak, is the therapeutic relationship. Additional randomized clinical trials should be conducted to clarify the role of this variable as a predictor of response to CBT in patients with PTSD.

Effectiveness of Counseling Based on Functional Analytic Psychotherapy with Enhanced Cognitive Therapy on the Sexual Quality of Life of Married Adolescent Women / Eficácia do aconselhamento baseado em psicoterapia analítica funcional - Com abordagem de terapia cognitiva aprimorada (FECT) na qualidade de vida sexual de mulheres adolescentes casadas

Abstract Objective Early marriage has many deleterious effects on the health of girls, such as sexual dissatisfaction, an inevitable result of the lack of sufficient knowledge about sexual issues at the time of the marriage. The goal of the present study was to determine the effectiveness of counseling based on functional analytic psychotherapy with enhanced cognitive therapy (FECT) on the sexual quality of life of married adolescent women. Methods This clinical trial was conducted between July and October 2019 on 150 married adolescent women who met the inclusion criteria. In the intervention group, FECTwas conducted in sixteen 90-minute sessions twice a week. The Sexual Quality of Life-Female (SQOL-F) questionnaire was used. When the study ended, the control group was given the choice of receiving the same intervention as the intervention group. Results The paired t-test showed a significant difference between the mean score of sexual quality of life before (52.33±23.09) and after (88.08±10.51) counseling in the intervention group (p<0.0001). According to the analysis of covariance, there was a significant difference between the score on sexual quality after counseling between the intervention (88.08±10.51) and control (60.32±23.73) groups (p<0.0001). There was also a significant difference between the mean score on the four dimensions of sexual quality of life in the intervention group (p<0.0001). Conclusion The results showed that counseling based on FECT improved the sexual quality of life in all dimensions in married adolescent women.

Resumo Objetivo O casamento precoce tem muitos efeitos deletérios sobre a saúde das meninas, como a insatisfação sexual, resultado inevitável da falta de conhecimento suficiente sobre questões sexuais no momento do casamento. O objetivo do presente estudo foi determinar a eficácia do aconselhamento baseado em psicoterapia analítica funcional com terapia cognitiva aprimorada (FECT) na qualidade de vida sexual de mulheres adolescentes casadas. Métodos Este ensaio clínico foi realizado entre julho e outubro de 2019 em 150 mulheres adolescentes casadas que preencheram os critérios de inclusão. No grupo de intervenção, FECT foi realizado em dezesseis sessões de 90 minutos duas vezes por semana. Foi utilizado o questionário Sexual Quality of Life-Female (SQOL-F). Quando o estudo terminou o grupo de controle teve a opção de receber a mesma intervenção do grupo de intervenção. Resultados O teste t pareado mostrou diferença significativa entre o escore médio da qualidade de vida sexual antes (52,33±23,09) e após (88,08±10,51) o aconselhamento no grupo intervenção (p<0,0001). De acordo com a análise de covariância houve diferença significativa entre o escore de qualidade sexual após aconselhamento entre os grupos intervenção (88,08±10,51) e controle (60,32±23,73) (p<0,0001). Também houve diferença significativa entre a pontuação média nas quatro dimensões da qualidade de vida sexual no grupo de intervenção (p<0,0001). Conclusão Os resultados mostraram que o aconselhamento baseado no FECT melhorou a qualidade de vida sexual em todas as dimensões em mulheres adolescentes casadas.

Boletim informativo residência multiprofissional em saúde coletiva - redes / Newsletter Multiprofessional Residence in Collective Health - REDES

O Boletim abrange vários assuntos referentes a educação continuada como acolhimento integrado, apresentação de WEB Conferencia para apresentação de TCR. Informações sobre as atividades realizadas pela equipe que faz a residência Multiprofissional em Saúde Coletiva- REDES da ESPPE.

Alterações do córtex cingulado anterior como um preditor de resposta à terapia cognitivo-comportamental / Alterations of anterior cingulate cortex as predictors of response to cognitive-behavioral therapy

RESUMO Objetivo A terapia cognitivo-comportamental (TCC) tem eficácia bem-documentada na literatura científica para transtornos relacionados aos sintomas da ansiedade. No entanto, há uma parcela de pacientes que não responde ao tratamento psicoterápico. Por isso, os estudos sobre as alterações no córtex cingulado anterior (CCA) como preditoras neurais do tratamento têm contribuído para encontrar respostas sobre as diferenças nas respostas ao tratamento. O objetivo do presente estudo é descrever, por meio de revisão sistemática, os estudos encontrados até o ano de 2018 sobre o papel do CCA na predição de resposta à terapia. Métodos Foram realizadas buscas nas bases PsycInfo, Web of Science e PubMed com termos referentes ao tema "córtex cingulado anterior", "terapia cognitivo-comportamental" e "predição de respostas", incluindo estudos com neuroimagem estrutural e funcional. Resultados As buscas apresentaram 14 artigos sobre "transtorno de estresse pós-traumático (TEPT)", "transtorno obsessivo-compulsivo (TOC)" e "transtorno de ansiedade social (TAS)". Os estudos com neuroimagem estrutural apresentaram resultados promissores. A maior espessura do CCA foi preditora de melhor resposta ao tratamento para TEPT e TOC. Os resultados de neuroimagem funcional foram promissores para maior ativação como preditora de melhor resposta para TAS. Por outro lado, os resultados para TEPT apontaram que a menor ativação pode ser preditora de melhores respostas. Conclusão As alterações nos estudos de neuroimagem sugerem que o CCA tenha um papel de predição de resposta ao tratamento com TCC. Estudos posteriores com amostras maiores podem contribuir para a ampliação da eficácia nos tratamentos de tais transtornos.

ABSTRACT Objective The efficacy of cognitive-behavioral therapy (CBT) on the treatment of anxiety-related disorders has been well documented. However, a number of patients do not respond to psychotherapeutic treatment. Therefore, changes in the anterior cingulate cortex (ACC) as a neural predictor of treatment response have contributed to understanding the differences in treatment outcome. The aim of this study is to describe, through a systematic review, studies published until 2018 that investigate the role of the anterior cingulate cortex on the prediction of response to therapy. Methods Searches have been conducted in the PsycInfo, Web of Science and PubMed databases for articles related to the terms "anterior cingulate cortex", "cognitive-behavioral therapy" and "prediction of response", including studies with structural and functional neuroimaging. Results We selected 14 articles on "post-traumatic stress disorder (PTSD)", "obsessive-compulsive disorder (OCD)" and "social anxiety disorder (SAD)". Overall, Structural neuroimaging studies functional neuroimaging results were promising. A greater thickness on the ACC was associated with a better response to treatment for PTSD and OCD. Greater activation of the ACC was positively associated with a greater response to treatment for patients with SAD. On the other hand, for those with PTSD, lower activation may be a better predictor of improvement. Conclusion The structural and functional alterations observed in neuroimage studies suggest that the ACC has a role in predicting treatment response to CBT. Future studies with larger samples may contribute to the improvement of treatment efficacy in such disorders.

Effects of the bioactive parts of Xiongma Decoction on CGRP-CRLR/RAMP1 pathway in TCC of rats with nitroglycerin-induced migraine / 西安交通大学学报(医学版)

Objective To explore the effects of bioactive parts of Xiongma Decoction (parts of ethyl acetate and n-butanol extract) on the CGRP-CRLR/RAMP1 signal pathway so as to clarify its therapeutic mechanism on migraine.Methods We randomly divided 36 male SD rats into 6 groups with 6 in each:blank group,model group,groups of low-,medium-and high-dose Xiongma Decoction bioactive parts,and Sumatriptan group.By giving hypodermic injection of 10 mg/kg nitroglycerin,the migraine rat model was copied;Only 18 rats were found to have positive expressions of CGRP,CRLR,and RAMP1 in TCC with immunohistochemistry staining after heart perfusion.For the remaining 18 rats,TCC was stripped directly from the whole brain and divided into two parts,one part used to detect CGRP,CRLR,RAMP1 mRNA expressions by qPCR,and the other part to detect CGRP,CRLR,RAMP1 protein expressions by Western blot.Results The number of CGRP,CRLR and RAMP1 immunoreactive cells,the mRNA and protein expressions on TCC in model group were effectively increased,compared with those in the blank group (P＜0.05),indicating that the model copying was successful.Compared with those in the model group,the number of CGRP,CRLR and RAMP1 immunoreactive cells in Xiongma Decoction bioactive parts was significantlv decreased,and the expressions of CGRP,CRLR and RAMP1 mRNA and protein were reduced (P＜0.05).Conclusion The bioactive parts of Xiongma Decoction can reduce the activity of CGRP-CRLR/RAMP1 signal pathway in TCC of migraine rats.

Open Access Scientific Evidence of Cognitive Behavioral Therapy for Patients with Fibromyalgia

Objective: To provide a summary of scientific open access resources Cognitive Behavioral Therapy interventions in patients with fibromyalgia. Method: Bibliographical search performed in Pubmed and PsycInfo, Latindex, Scielo and Redalyc online databases. No year of publication criterion was applied. Results: 377 citations were reduced to a list of 59 relevant publications, from 1993 to 2016. Most studies were performed in adult samples, in Spain or the United States, with pre-post quantitative design. Only 15 publications were open access. Conclusions: Empirical evidence is ample, yet mostly restricted. Open access material might promote interest in and encourage the design, implementation and evaluation of CBT interventions in the benefit of fibromyalgia patients, the health system and science.

Objetivo: Proveer un resumen de la evidencia científica de accesos abierto sobre intervenciones con Terapia Cognitivo Conductual en pacientes con fibromialgia. Método: Se realizó una búsqueda bibliográfica en las bases en línea de Pubmed y PsycInfo, Latindex, Scielo y Redalyc. No aplicó criterio por año de publicación. Resultados: Las primeras 377 citas obtenidas se redujeron a una lista de 59 publicaciones relevantes, publicadas entre 1993 y 2016. La mayoría de los estudios se realizaron en muestras de pacientes adultos, en España o Estados Unidos, con un diseño cuantitativo de tipo pre - post. Únicamente 15 publicaciones fueron de acceso abierto. Conclusiones: La evidencia empírica es amplia; sin embargo, el acceso a la misma es generalmente restringido. El material de acceso abierto puede promover el interés en las intervenciones con Terapia Cognitivo Conductual y estimular su diseño, implementación y evaluación, todo esto en beneficio de los pacientes con fibromialgia, los sistemas de salud y la ciencia.

Actividad antibacteriana in vitro de los extractos etanólicos y clorofórmico de Flourensis polycephala Dillon (Phauka) y elaboración de una forma farmacéutica tópica para su evaluación in vivo en infecciones dérmicas por Staphilococcus aureus en ratones albinos / n vitro antibacterial activity of the ethanolic and chloroformic extracts of Flourensis polycephala Dillon (Phauka) and preparation of a topical pharmaceutical form for in vivo evaluation in dermal infections by Staphilococcus aureus in albino mice

El presente trabajo tiene por finalidad demostrar la actividad antibacteriana in vitro del extracto etanólico y clorofórmico de las hojas de Flourensia polycephala Di/Ion (Phauka) y efecto antibacteriano in vivo elaborando una forma farmacéutica a partir del extracto que presentó mayor actividad antibacteriana in vitro, el extracto etanólico y clorofórmico de las de la hojas de Flourensia polycephala Dillon (Phauka), se ha obtenido por previa maceración con dichos solventes. Estos fueron sometidos al control microbiológico, para los microorganismos de salmonella, Coliformes fecales, mesofilos viables, hongos y levaduras, en lo que se comprobó que los extractos no presentaron contaminación alguna, se realizó el análisis fitoquímico determinándose los siguientes compuestos, esteroides, ácidos fenólicos y flavonoides. Mediante el método de Kirby Bawer o disco difusión en placa, se determinó la actividad antibacteriana in vitro, sobre cepas de Staphy/ococcus aureus A TCC 25923. Donde los diámetros de la prueba de disco difusión en placa para Staphy/ococcus aureus ATCC 25923, del extracto etanólico fue de 18.50 mm y del extracto clorofórmico fue de 14.00 mm a la concentración de 30.21 mg/disco para ambos extractos. La determinación de la actividad antibacteriana sobre cepas de Staphylococcus aureus ATCC 25923 se pudo ver que a la concentración de 3.24 mg/disco, el extracto etanólico presenta una actividad antibacteriana ligera con un halo de inhibición promedio de 8.1 mm, a la concentración de 30.21 mg/disco el extracto etanólico presenta una actividad antibacteriana marcada con un halo de inhibición de 18.50 mm, mientras que el extracto clorofórmico a una concentración de 4. 70 mg/disco presenta una actividad antibacteriana ligera con un halo de inhibición de 8.4 mm, a la concentración de 30.21 mg el extracto clorofórmico tiene una actividad moderada con un halo de inhibición de 14.00 mm. Con estos resultados se concluyen que el extracto etanólico de las hojas de Flourensia polycephala Di/Ion (Phauka) presenta mayor actividad antibacteriana. Se realizó la elaboración de la forma farmacéutica donde se probó diferentes formulaciones, eligiéndose la formulación que presentó mejor homogeneidad, y mejores características, siendo esta una emulsión 0/W a una concentración de 0.25 g de extracto etanólico de las hojas de Flourensia polycephala Di/Ion (Phauka). el que resultó más eficaz para curar la infección producida a los ratones de experimentación en menos días. Se concluye que los extractos etanólico y clorofórmico de las hojas de Flourensia polycephala Di/Ion (Phauka), presentan actividad antibacteriana in vitre frente las a la cepa en estudio en comparación a los fármaco patrón, mientras que para el efecto antibacteriano in vivo se concluye que la forma farmacéutica emulsión 0/W elaborada con el extracto etanólico de las hojas de Flourensia polycephala Di/Ion (Phauka) a la concentración de 0.25 gr, curó la infección en menos días.

Co-localization of GSTP1 and JNK in transitional cell carcinoma of urinary bladder

Transitional cell carcinoma (TCC) of urinary bladder belongs to glutathione S-transferase P1 (GSTP1) overexpressing tumors. Upregulated GSTP1 in TCC is related to apoptosis inhibition. This antiapoptotic effects of GSTP1 might be mediated through protein:protein interaction with c-Jun NH2-terminal kinase (JNK). Herein, we analyzed whether a direct link between GSTP1 and JNK exists in TCC. The presence of GSTP1/JNK complexes was analyzed by immunoprecipitation and Western blotting in 20 TCC specimens, obtained after surgery. Co-localization of GSTP1 and JNK was also investigated in the 5637 TCC cell line by immunofluorescence confocal microscopy. By means of immunoprecipitation we show for the first time the presence of GSTP1/JNK complexes in all TCC samples studied. A co-localization of GSTP1 and JNK was also demonstrated in the 5637 TCC cell line by means of confocal microscopy. Protein-protein interactions, together with co-localization between GSTP1 and JNK provide evidence that GSTP1 most probably inhibits apoptosis in TCC cells by non-covalent binding to JNK.

Simultaneous laparoscopic nephroureterectomy and cystectomy: a preliminary report

PURPOSE: Patients with muscle-invasive bladder cancer and concomitant upper urinary tract tumors may be candidates for simultaneous cystectomy and nephroureterectomy. Other clinical conditions such as dialysis-dependent end-stage renal disease and non-functioning kidney are also indications for simultaneous removal of the bladder and kidney. In the present study, we report our laparoscopic experience with simultaneous laparoscopic radical cystectomy (LRC) and nephroureterectomy. MATERIALS AND METHODS: Between August 2000 and June 2007, 8 patients underwent simultaneous laparoscopic radical nephroureterectomy (LNU) (unilateral-6, bilateral-2) and radical cystectomy at our institution. Demographic data, pathologic features, surgical technique and outcomes were retrospectively analyzed. RESULTS: The laparoscopic approach was technically successful in all 8 cases (7 males and 1 female) without the need for open conversion. Median total operative time, including LNU, LRC, pelvic lymphadenectomy and urinary diversion, was 9 hours (range 8-12). Median estimated blood loss and hospital stay were 755 mL (range 300-2000) and 7.5 days (range 4-90), respectively. There were no intraoperative complications but only 1 major and 2 minor postoperative complications. The overall and cancer specific survival rates were 37.5 percent and 87.5 percent respectively at a median follow-up of 9 months (range 1-45). CONCLUSIONS: Laparoscopic nephroureterectomy with concomitant cystectomy is technically feasible. Greater number of patients with a longer follow-up is required to confirm our results.

The Study of Expression of Caspase-3 in Bladder Cancer and Renal Cell Carcinima / 대한비뇨기과학회지

PURPOSE: The caspase (ICE/CED-3) family of proteases have been implicated to play a important role in apoptosis and caspase-3(CPP32, YAMA, Apopain) exhibits the highest similarity to CED-3 which produced by CED-3 gene, the prototype of cell death gene in nematode. The objective of this study is to evaluate the prognostic value of expression of caspase-3 in bladder cancer and renal cell carcinoma. MATERIALS AND METHODS: Seventy five patients with bladder cancer and thirty eight patients with renal cell carcinoma were enrolled in this study. We performed immunohistochemical staining of caspase-3 in formalin-fixed and paraffin-embedded tissue section using goat polyclonal antibody, specific for the p20 subunit of caspase-3. The expression of caspase-3 were compared with TNM stage, Ash grade, and size of tumor in bladder cancer, and TNM stage, Robson stage, Fuhrman nuclear grade, and size of tumor in renal cell carcinoma. RESULTS: The expression of caspase-3 were significantly correlated with T stage and N stage in bladder cancer(p=0.04, p=0.03). However, there were no significant correlation between the expression of caspase-3 and other prognostic parameters in bladder cancer and renal cell carcinoma. Caspase-3 was diffusely stained in only 1 case of renal cell carcinoma. CONCLUSIONS: The prognostic value of expression of caspase-3 in patients with bladder cancer and renal cell carcinoma were insufficient, but caspase-3 paly an important role in apoptosis and more studies are necessary for evaluation of many steps in apoptotic cascade of many cancers.

Clinicopathologic Analysis of Four Cases of Primary Ovarian and Parovarian Transitional Cell Carcinoma / 대한부인종양콜포스코피학회잡지

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.

Prognostic Value of Expression of c-erbB-2 in Urinary Bladder Cancer / 대한비뇨기과학회지

C-erbB-2, one of epidermal growth factor receptor gene family, may have an important role in progression of transitional cell carcinoma (TCC of the urinary bladder. We herein immunohistochemically examined 52 bladder TCC specimens for expression of c-erbB-2 gene product to investigate its prognostic value. Interrelationship between expression of c-erbB-2 and stage, grade, expression of proliferating cell nuclear antigen (PCNA), and clinical outcomes were analyzed. Overexpression of c-erbB-2 was significantly higher in invasive tumors as compared with superficial tumors and in high grade tumors as compared with low grade tumors (p<0.005). However, there were no significant correlations between the degree of expression of c-erbB-2 and progression-free survival in patients with superficial bladder TCC as well as actual-survival in patients with invasive bladder TCC. There also was no significant correlation between the expression of c-erbB-2 and PCNA. These results suggest that c-trbB-2 may be an important marker of malignant potentials and invasiveness of bladder TCC, but immunohistochemical study for its expression in bladder TCC may not provide additional prognostic information to stage and grade of the tumors.

The Study on the Relevance between Human Papillomavirus (HPV) Infections and Transitional Cell Carcinoma of the Urinary Bladder in Korean / 대한비뇨기과학회지

The role of human papillomavirus (HPV) infection in the development of transitional cell carcinoma (TCC) of the bladder is highly controversial because the detection rates of the HPV in TCC of the bladder were highly variable in the previous published literatures. Two recent publications highlight this controversy, but they examined the paraffin-embedded specimens of TCC of the bladder. This study was designed to evaluate the conflicting results of the role of HPV in the development of bladder carcinoma using non-fixed fresh frozen specimens. 1tenty patients were underwent the transurethral resection of the bladder tumor from April 1995 to July 1995 and were diagnosed as pure TCC of the urinary bladder on pathologic examination. The prevalence of type 16 and 18 HPV was investigated with the polymerase chain reaction (PCR) on non-fixed fresh frozen specimens, from 20 cases of TCC of the bladder. Six samples of normal bladder obtained at cystoscopic examination were served as negative controls. Positive controls were CasKi cell line for HPV 16 and the HeLa cell line for HPV 18. HPV type 16 deoxyribonucleic acid (DNA) was detected in none of the 20 cases of transitional cell carcinoma of the bladder and in none of the normal urinary bladder cases. HPV type 18 DNA was detected in none of the 20 cases of TCC and in none of the normal urinary bladder cases. There was complete agreement between results of gel electrophoresis analysis and Southern blot hybridization. These results strongly suggest that HPV might play little role in the development of TCC of the urinary bladder in the general population of Korea.

The effect of adjuvant M-VAC(methtrexate, vinblastine, doxorubicin and cisplatin) chemotherapy on advanced transitional cell carcinoma of the upper urinary tract / 대한비뇨기과학회지

We treated 11 patients with advanced transitional cell carcinoma of upper urinary tract with adjuvant M-VAC chemotherapy and their median survival time was compared with 9 patients without M-VAC chemotherapy as e historical group. The total number of cycles per each patient ranged from 1 to 5 with a mean of 3.4. Of these patients, 8 patients could be evaluated for response and 4 patients were responded (2 complete and 2 incomplete. response rate 50%). The median duration of response was 26 months for complete responders and 4.5 months for incomplete responders. The median duration of survival for all chemotherapy group, complete responders, progression and historical control group were 22, 23+, 14 and 21 months. respectively. Median survival was 22 months in all 11 patients. 23+ months in clinical responders, 14 months in progression and 21 months in historical control group. Although overall survival was not prolonged significantly in chemotherapy than the historical control group, M-VAC was effective in small proportion of patients (CR: 2/8). The duration of survival of the patients with complete remission was prolonged significantly.

Value of flow cytometric analysis of nuclear deoxyribonucleic acid as a prognostic parameter in transitional cell carcinoma of the upper urinary tract / 대한비뇨기과학회지

To investigate the clinical significance and application of DNA ploidy pattern in transitional cell carcinoma of the upper urinary tract, a total of 36 patients underwent flow cytometric analysis of DNA ploidy from paraffin-embedded tumor tissues. Diploidy presented in 28 patients(77.8%) and aneuploidy in 8 patients(22.2%). There was excellent correlation between histologic grade and DNA ploidy(p<0.005), but DNA ploidy pattern was not significantly associated with tumor stage. The mean percentage of S-phase fraction was higher in high grade, aneuploid group compared to low grade, diploid group respectively. And this flow cytometric parameter in patients with tumor progression was significantly higher than in patients without progression(p<0.025). Three-year disease-free survival rate was 64% in diploid group, but all patients with aneuploid pattern showed subsequent vesical neoplasms or distant metastases within follow-up duration of 27 months. Actuarial survival was influenced by tumor grade, stage and DNA ploidy. In patients with high stage tumor, the actuarial survival rate of patients with aneuploid pattern was significantly lower than patients with diploid pattern (p<0.005). And the actuarial survival rates between aneuploid and diploid group in patients with low stage tumor were different statistically(p<0.001). These data suggest that flow cystometric DNA analysis in patients with transitional cell carcinoma of the upper urinary tract may provide a useful prognostic information in addition to tumor stage and grade. And DNA ploidy pattern may be a useful parameter to identity high risk group in patients with same stage, especially with low stage transitional cell carcinoma of the upper urinary tract.

Value of DNA flow cytometric determination of proliferation index as a complementary prognostic parameter on bladder tumor / 대한비뇨기과학회지

The analysis of DNA proliferation by flow cytometry was performed successfully on 93 paraffin-embedded TCC specimens. We defined the proliferation index as hyperdiploid populations on DNA histogram and divided it into two groups, low-(35%) proliferation index. On the basis of this criteria, proliferation index was evaluated as a complementary predictor of survival of the patients with bladder tumor. Proliferation index was well correlated with T stage (p=0. 0019) and grade (p=0.0152). For high proliferation group survival of patients with bladder tumor was significantly lower than low proliferation group (p=0.0063). Proliferation index, T stage, grade and lymph node involvement were significant variables as prognostic parameters in univariate, analysis but only T stage was a significant variable in multivariate analysis. In the intermediate groups, proliferation index was a good predictor of survival of the patients with muscle invasive. bladder tumor (T2, T3a) (p=0.0131) but not with grade II bladder tumor (p=0.7107). In conclusion. proliferation index is valid as a complementary prognostic parameter in TCC of the bladder, especially in the muscle invasive group.