P53 mutations and other prognostic factors of renal cell carcinoma.

OBJECTIVE: Tumor stage, histological pattern, cell type, diameter and cell ploidy are the factor that have been proposed for predicting the prognosis of renal cell carcinoma (RCC). There is a wide variation in the reported incidence of p53 mutation in RCC, and its prognostic significance for this tumor is unknown. We investigated the prognostic value of p53 mutations among other prognostic factors. PATIENTS AND METHOD: We evaluated the stages, tumor diameters, histological grades, cellular patterns and the presence of mutant p53 protein in 50 cases of RCC. The survival function of each parameter was estimated by Kaplan-Meier and log-rank tests, and the significance of each parameter on survival was evaluated by logistic regression analysis. RESULTS: The p53 mutation incidence was 20% in the RCC cases included in the study (n = 50). The survival rates of stages pT(2), pT(3) and pT(2-3)N+ were 87.8, 61.0 and 0%, respectively (p = 0.0462). The survival analysis of grade 1-2 and grade 3-4 tumors revealed 92.3 and 51.5% survival rates, respectively (p = 0.002). The survival rates of mutant p53+ and mutant p53- cases were 33.3 and 84.2%, respectively (p = 0.0027). The logistic regression test analysis demonstrated that tumor grade, tumor stage and mutant p53 positivity status were the most significant prognostic factors (p < 0.03). The survival rates of mutant p53+ and p53- cases at stages pT(2), pT(3) and pT(2-3)N+ were 66.67 versus 91.48%, 33.3 versus 71.43% and 0 versus 100%, respectively (p = 0.0392). A similar finding was present at each stage for cellular grades (p = 0.0093). The survival rates of mutant p53+ and p53- cases for grades 3 and 4 were 33.33 and 74.48%, respectively (p = 0.2731). CONCLUSION: Our results suggested that many parameters can affect survival of RCC cases, but among these, tumor grade, tumor stage and p53 mutation status are the most important prognostic factors, but p53 mutation status and cellular grade can afford additional prognostic information at each stage.

A comparison of the histopathological findings after open and percutaneous needle testicular biopsy in adult male rats.

OBJECTIVE: To define the histopathological changes occurring as a result of open and percutaneous needle testicular biopsy in adult rats. MATERIALS AND METHODS: Percutaneous needle and open testicular biopsies were taken from 35 male albino rats (120-140 days old). Nine of the rats were killed 10 days after the biopsy, eight after 30 days and the other eight 60 days after the biopsy. A control group of six rats underwent orchidectomy with no preceding testicular biopsy. RESULTS: Significant tubulitis and obstructive findings were detected 10 days after needle biopsy (P < 0.05); epididymo-orchitis was frequent after open biopsy during this period. At 10-30 days after needle biopsy the mean seminiferous tubule diameters were significantly greater than in either the control group or after open biopsy (P < 0.05). The histopathological damage recovered 60 days after open and needle biopsy. CONCLUSION: Although percutaneous, a needle biopsy (as an alternative to open biopsy) causes tubulitis and frequent obstructive findings in the early period; therefore, repeat testicular procedures should be planned after these changes have resolved.

The best management of superficial bladder tumours: comparing TUR alone versus TUR combined with intravesical chemotherapy modalities?

To compare retrospectively the recurrence rates of TUR alone versus different intravesical chemotherapy modalities in superficial bladder cancer cases, 187 patients with stage Ta and T1 bladder tumours were treated with transurethral resection followed by adjuvant intravesical chemotherapy with mitomycin, BCG or epirubicin or by transurethral resection alone. All patients in this study had historically proven transurethrally resectable primary, category Ta and T1 transitional cell carcinoma (TCC) of the bladder. Group I included transurethral resection alone, and the other groups included intravesical mitomycin-C (Group II), BCG (Group III) and epirubicin (Group IV) therapies after transurethral resection. 146 male and 41 female patients (78% male and 22% female patients) in this study were diagnosed as primary TCC bladder tumours. Only 52 of them were stage Ta and 135 of them were stage T1 bladder tumours. Examining the histological grade of the bladder tumours, 88 (47%) of the patients had grade I, 53 (28%) had grade IIa, 30 (16%) had grade IIb and remaining 16 (9%) had grade III bladder cancers. The recurrence rates were 25% for Group I, 23.8% for Group II, 26.2% for Group III and 22.7% for Group IV. These values were given with disregarding the grade and volume of the bladder tumours. For solitary, less than 3 cm low grade tumours (grade I, IIa) recurrence rates were 16% for Group I, 15.4% for Group II, 17.8% for Group III, 17.2% for Group IV (p > 0.05). As a result of this retrospective study, for patients with low grade, stage Ta and T1 tumours TUR alone may be the best treatment modality. Although intravesical chemotherapy is effective in decreasing short-term incidences of tumour recurrence, it has not decreased long-term incidences of tumour recurrence. The high cost and adverse side effects of intravesical chemotherapy should also be taken into consideration in superficial, single, low grade tumours of bladder.

Comparing the anti-inflammatory effects of corticotherapy and non-steroid anti-inflammatory drugs in infertile patients with infectious aetiology.

To compare the anti-inflammatory effectiveness of corticotherapy and nonsteroid anti-inflammatory drugs (NSAID), we examined 126 infertile men with infectious aetiology. Seventy-seven patients were on corticotherapy and antibiotherapy (thirty-eight patients on high-dose and thirty-nine patients on low-dose corticotherapy). Forty-nine patients had antibiotherapy and NSAID. According to our results in both the high- and low-dose groups sperm motility significantly improved, but in the high dose group more side effects were reported. In order to overcome the effects of infections on male infertility, we prefer corticotherapy instead of NSAID because it is more effective than NSAID.

A large primary malignant melanoma of the female urethra.

We present a case of large, primary malignant melanoma of the female urethra with poor prognosis in this case report. Malignant melanoma is one of the rare tumors of the female urethra and accounts for 0.2% of all malignant melanoma cases. Large (5.6 cm in diameter), primary malignant melanoma of the female urethra is exceedingly rare.

Use of intraoperative venography in varicocelectomy.

We performed intraoperative venography in 22 patients, of whom 8 had persistent varicocele. The results of the outpatient procedure were encouraging.

Trifurcation of the urethra: a case report.

Trifurcation of the anterior urethra is an uncommon anomaly. We present a case of trifurcation of the anterior urethra with pelvic ectopia of the right kidney and complete left ureteral duplication.