Congenital fibroepithelial polyp of prostatic urethra in an adult.

OBJECTIVE: To describe an unusual case of congenital fibroepithelial polyp of the prostatic urethra in an adult, presented with acute urinary retention. METHODS: Cystouretrographic, endoscopical and pathological investigations are discussed. RESULTS: The definitive diagnosis of the tenth case of this benign lesion was made only after endoscopic resection and pathological examination. The complete resolution of the symptoms has been quick. CONCLUSIONS: We stress this unusual pathology in order to focus its peculiarity in aetiopathogenesis, diagnosis and treatment.

[Granulomatous prostatitis as collateral effect of intravesical immunotherapy with BCG]. / Prostatite granulomatosa come effetto collaterale dell'immunoterapia endovescicale con BCG.

Twenty-five male patients with superficial bladder cancer underwent intravesical Bacillus Calmette Guerin immunotherapy. A high incidence of side effects has occurred using three different substrains of BCG. Our interest has been focused on BCG related granulomatous prostatitis: we have found four asymptomatic patients with histologically diagnosed disease. We suppose therefore that its incidence is underestimated.

[Qualitative and quantitative parameters for prognosis in renal carcinoma in early and advanced stages]. / Parametri qualitativi e quantitativi per la prognosi del carcinoma renale in stadio precoce ed avanzato.

AIM OF THE STUDY: A minority of stage I renal cell cancers have a bad prognosis, a minority of those in stage II-IV may behave favorably. Are there parameters which characterize such cases? In this study, a number of qualitative and quantitative parameters are used to detect differences between cases with at least 9 years of survival and those with a survival of less than 9 years. MATERIAL AND METHODS: 133 cases of renal cell cancer were subdivided into stage subgroups: Robson's I; Robson's II-IV. The following data and parameters were registered and/or measured: sex, stage, tumor size, histological type, mean nuclear profile area (mA) and pleomorphism (standard deviation of mean nuclear profile area--SDA) nuclear grade (NG) and combined nuclear grade (CNG), DNA index, cell proliferation, as determined by mitotic index (MI), per cent of PCNA positive cells (PCNA + cells %), per cent of S-phase cells (SP cells %), p53 and EGFR expression, intratumoral T lymphocytes. RESULTS: Older patients have a worse prognosis independently of the stage. Stage is the most discriminant qualitative parameter; tumor dimensions and both nuclear and combined nuclear grade are important too. Mean nuclear profile area and pleomorphism are also discriminant, while no prognostic value of histological type is shown and histology is not related to other parameters. Higher DNA index characterizes cases with worse prognosis, as well as MI, SP cells %, PCNA + cells %, and EGFR expression. No significant differences are detected for p53 expression and lymphoid infiltrates. A minority of patients with stage I tumors die within 9 years of diagnosis. They are older than survivors with the same stage, their tumors have larger nuclear area and greater pleomorphism, and are more frequently aneuploid with higher DNA index. A minority of patients with stage II-IV tumors survive at least 9 years from the time of diagnosis. They are younger than non-survivors in the same stages and have lower MI and PCNA positivity in the tumors, while other parameters are not discriminant.

[Oral therapy with ciprofloxacin in the prophylaxis of urinary infections in surgical patients with permanent bladder catheter]. / Terapia orale con ciprofloxacina nella profilassi della infezione urinaria in pazienti chirurgici con catetere vescicale a permanenza.

Urinary infections represent about 30% of all infections observed within a hospital environment in surgical patients with indwelling catheter. The aim of the research was to assess the effectiveness of ciprofloxacin the prophylaxis of bacteriuria in vesical catheter-bearing patients, during the post-operative period. A comparative investigation was carried out in 33 patients submitted to surgery and carries of vesical catheters during the post-operative period. The patients were divided into 2 group: one group of 23 patients received ciprofloxacin, and a group of 10 patients represented the control group. A urine culture was carried out in every patient before positioning the catheter, and urine cultures were taken every 72 hours; the urethero-vesical portion of the catheter was always submitted to cultural examination after its removal. Patients treated with ciprofloxacin received good protection against Gram- urinary infections, and catheter cultures also demonstrated inhibiting activity with respect to urethral colonisation on the part of Gram- infections. Confirmation of this results in larger series would be an indication for the use of ciprofloxacin in the prophylaxis of urinary infections caused by indwelling vesical catheters in the postoperative period.

Primary carcinoid tumor of kidney. Light and electron microscopy, and immunohistochemical study.

We present a case of primary renal carcinoid tumor with the appearance of type B carcinoid with trabecular and ribbon-like structure. All the immunohistochemical stains were negative. Electron microscopy revealed numerous cytoplasmic granules with polar distribution and masses of intermediate microfilaments. We believe only 8 cases have been reported in the literature.

Nuclear morphometry as an important prognostic factor in stage I renal cell carcinoma.

Although 60% of Stage I renal carcinoma patients die from tumor within 5 years postoperatively, a considerable percentage survive that period. Nuclear grading can help to predict the outcome, but many of the patients are Grade 2, and the prognosis of this subclass is uncertain. Therefore, nuclear morphometry was carried out in 41 patients with Stage I renal cell carcinoma. Of these, 24 died within 5 years and 17 have survived that period. Using a mean nuclear area of 32 micron 2 as the decision threshold, none of the 24 short-term survivors are below that threshold and three of the long-term survivors exceed that value (18% false-positives) (99% confidence limit). Separate analysis with sets for learning and testing and Grade 2 patients gave similar results. The results show the essential prognostic value of morphometry in this set of patients with Stage I renal cell carcinoma.

[Preliminary observations, at the ultrastructural level, on the reactivity of cerebral arteries from New Zealand rabbits to combined atherogenic stimuli (hypercholesterol diet and hypertension)]. / Osservazioni preliminari, a livello ultrastrutturale, sulla reattivita' delle arterie cerebrali di coniglio New Zealand a stimoli aterogeni combinati (dieta ipercolesterolica e ipertensione).

Both in monkeys (Rhesus and Cynomolgus) and in New Zealand rabbits fed an atherogenic diet, a marked delay in the appearance of atherosclerotic lesions of the cerebral arteries in comparison with other arterial districts has been observed. This appearance has been described in monkeys as relatively earlier if hypertension is added to the atherogenic diet. Preliminary observations on a little group of rabbits on a 3 months hypercholesterolic diet, subjected to Goldblatt aortic coarctation, have shown an increase of blood pressure and a severe gross atherosclerotic involvement of aorta, resembling the one obtainable after 6 months of atherogenic diet. Histologically, the aorta predominantly shows lesions of the fatty streaks type with necrotic areas in the deep; the carotid lesions show some lipid in smooth muscle cells disseminated in a sub-endothelial "edematous" space (rich in protein). The cerebral arteries do not show any lesion. At TEM, the aortic lesions look sometimes as advanced plaques with an initial fibrosis at the surface; the carotid lesions are characterized by a granular deposit in the sub-endothelial space in which some smooth muscle cells (with lipid in the cytoplasm) are present; in the cerebral arteries only the presence of collagen fibers among the smooth muscle cells of the media, never observed in the animals fed the atherogenic diet alone, has sometimes been noted.