p53 protein in serum and urine samples of patients with bladder transitional cell carcinoma and its overexpression in tumoral tissue

The aim of this study was to evaluate the levels of p53 protein in serum and urine samples of patients with bladder transitional cell carcinoma [TCC] and their relation with the overexpression of p53 in the tumoral tissue. A total of 39 patients with bladder TCC were evaluated for p53 protein in their serum and urine samples and the overexpression of this marker in their tumoral tissue. Of 39 patients with bladder TCC, 29 [74.4%] had tissue specimens positive for p53 protein overexpression, 20 [51.3%] had p53 protein in their serum samples, and 27 [69.2%] had this protein in their urine samples. A positive immunohistochemical finding was more common in higher grades of the bladder tumor [P = .03], but not in higher stages [P = .07]. Eighteen of 20 patients [90%] with a positive serum for p53 showed protein overexpression in the tumoral tissue of the bladder [P = .03]. Of 27 patients with a positive urine sample, 25 [92.6%] had p53 overexpression in their bladder tissue, and of the remainder 12 patients with a negative p53 protein in their urine samples, 8 [66.7%] had no evidence of p53 protein overexpression in their tumoral tissue [P < .001]. The grade and stage of tumor had no correlation with serum or urinary p53. According to our findings, a positive serum or urine sample for p53 protein is highly associated with the overexpression of p53 protein in the tumoral tissue of patients with bladder TCC

I.V.S.: a successful technique in treatment of the patients with stress urinary incontinence

One of the female problems, especially with aging and multiparity, is stress urinary incontinence. This can be treated with medical or surgical ways. Nowadays, minimal invasive techniques have some adherents. In this article we give the results of the I.V.S, technique. Since 2002 to 2004,135 patients with S.U.I, referred to our clinic. 72 patients had S.U.I, and 21 had M.U.I, with S.U.I, prodominency. We did not do this procedure for patients with grade 2 or 3 cystocele. In brief, 14 patients 28-65 years old [average: 42] were treated with I.V.S technique.6 patients had the history of colporaphy because of S.U.I. Before surgery we asked the patients for the history, ph.exm. and did routine exams,heart consult, renal and bladder sonography and P.V.R. In lithotomy position and with local anesthesia we did cystoscopy and marshal test and if positive, under spinal anesthesia we did anterior vaginal incision from bladder neck to midurethra. Then we dissected mucous from under layer and perforated endopelvic fascia and release of the retropubic space and placed special tape in midurethra portion. Tension on the tape protected from leak at the time of the increased intra abdominal pressure or a little leak. After that we repaired vaginal mucosa and placed catheter and vaginal mesh. Patients had complete bed rest for 1 day, and we removed the catheter, and after that the patients voided. There was no mortality in this procedure. In 1 patient the urethra was perforated, and we repaired it in. 3 layers. Tape was placed replaced, and the catheter was in place for 10 days. There is no retention or dysparonia. In 1 patient we had U.T.I. that was treated with antibiotics. We did sonography and P.V.R. after 1 month that was less than upper limits of the normal in all r/patients. This technique is simple with short time anesthesia. We can use I.V.S. for 2 kinds of S.U.I. [hypermobility or I.S.D.] and this procedure is recommended for patients without cystocele or grade 1 cystocele because of low complications, good results, and effectiveness

Kidney transplantation in older adults: does age affect graft survival?

There is a paucity of data on long-term patient and graft survival in the older kidney recipients. Our aim was to evaluate the long-term outcomes of kidney transplantation in patients aged 50 years and older and compare them with outcomes in younger recipients. Forty-seven recipients aged 50 years and older and 47 recipients aged younger than 50 years were randomly assigned to two groups [groups 1 and 2, respectively]. Patients who had received a cadaveric kidney allograft were excluded from the study. Data including demographic and clinical characteristics, early complications, early mortality, and actuarial patient and graft survival rates were collected, and the two groups were compared, accordingly. The rates of early complications and mortality were not different between the two groups. Patient survival rates at 1, 3, 5, and 7 years were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 86%, 86%, and 86% for patients in group 2, respectively [P=0.007]. Graft survival rates were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 85%, 85%, and 85% for patients in group 2, respectively [P=0.006]. Graft loss due to patient death was 33.33% in group 1 compared with 4.25% in group 2 [P<0.001]. Kidney transplantation should be considered in patients older than 50 years, since the graft survival rate is acceptable in this population, and early mortality and complications in this group are not different than those of younger recipients. Although older patients have a shorter life expectancy, they benefit from renal transplantation in ways similar to younger kidney transplant recipients