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

Anuria secondary to hot weather-induced hyperuricaemia: diagnosis and management

There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait. Patients and Patients presenting to our urology unit as an emergency during the hot summer months of April to October [average temperature 40-55oC] were suspected of having hot weather-induced anuria secondary to hyperuricemia if they had a history of working in the sun for 6 to 8 hours per day and a progressive decrease in urine output to complete anuria. The diagnosis was confirmed by demonstration of elevated serum creatinine and uric acid, ultrasound findings of normal kidneys, ureters, and bladder [KUB] or mild to moderate hydronephrosis, but no features of chronic renal disease and little or no urine in the bladder. Management consisted of emergency cystoscopy, retrograde pyelogram, ureterorenoscopy [URS], and

Steinstrasse, prevention and management

Four hundred patients who attended stone centre were chosen with inclusion criteria and randomly allocated in two groups. Group [I] in which JJ stent was inserted prior to extracorporeal shock wave lithotripsy [ESWL] and Group [II] without JJ stent insertion. Out of these 400 patients, 38 patients developed steinstrasse [group [I] 6% and group [II] 13%]. Presenting symptoms varied from symptomless up to obstruction and sepsis. Treatment programs were not predetermined but dependant upon the hotness of progression. Follow up, ESWL to leading stone, retrograde manipulation, precutaneous nephrostomy and open surgery were attempted in this series according to certain indications. In conclusion Certain measures must be fulfilled to prevent steinstrasse formation debulking of large stone, stenting and to do shaving of the stone from distal part to facilitate regular expulsion of stone debris