Renal cell carcinoma-associated immune impairment that may interfere with the response to cytokine therapy.

This prospective study was carried out to explore cytokine-related immune alterations in 69 renal cell carcinoma patients (RCC) and to look for changes which might potentially serve as a reliable predictors of response to cytokine-based therapy. Interleukin-2 (IL-2), its soluble receptor (sIL-2R) and tumor necrosis factor (TNF-alpha) levels produced in vitro by PHA activated and intact mononuclear cells (PBMC) were determined. Concentrations of IL-2, IL-4, IL-6, sIL-2R, TNF-alpha and CRP were measured in sera. Cytokine level was evaluated by enzyme-linked immunoadsorbent assay (ELISA) and CRP was determined by means of turbidimetric method. All measurements were performed in patients without any prior treatment. PHA activated PBMC of RCC patients were significantly defective in producing IL-2 and TNF-alpha comparing to controls (p < 0.03 and p < 0.001). The difference of sIL-2R was noted in metastatic stage only (p < 0.03). Unstimulated PBMC manifested decrease in IL-2 (p < 0.03) and increased level of TNF-alpha in advanced disease (p < 0.02). This impairment reflected tumor size and differentiation stage. Serum concentrations of IL-2, sIL-2R and TNF-alpha were within normal range. However, in relation to the clinical stage, significantly increased serum IL-2 was noted in combined Stage I and II as compared to controls (p = 0.012). IL-6 and CRP showed markedly elevated levels with a significancy which allowed to distinguish samples from metastatic patients. In conclusion careful comparisons of these data with clinical course of cytokine treated patients will disclose which of those tests may possess predictive power in the individual patients who are likely to respond to cytokine-based treatment.

[Personal experience with colpoureteral suspension using the Burch method]. / Nase zkusenosti s kolpouretrosuspenzí sec. Burch.

The objective of the work was to evaluate one approach of evaluation of the effect achieved by the mentioned corrective operation, i.e. the subjective evaluation by the patients themselves. In order to ensure comparability of evaluation at different time intervals, the authors used a questionnaire with 13 questions focused on continence and changes of micturition as well as on sexual aspects and changes in the social sphere. Sixty-nine patients were at least one year after operation. Evaluation 6 weeks after operation was implemented in 105 patients. The subjective sensation of complete recovery and satisfaction with treatment in 93.33% after six weeks and 94.20% after one year with minimal complaints regarding micturition indicates that the operation sec. Burch is a very good corrective operation, resolving stress incontinence of urine in women.

[Evaluation of the value of testicular phlebography]. / Zhodnocení prínosu testikulární flebografie.

The authors use testicular phlebography since 1979; they examined so far 72 patients (62 children and 10 adults). Phlebography was indicated in 54 patients with varicocele and in 18 children with an unpalpable testicle. The authors evaluate the method with regard to the surgical procedure in the treatment of varicocele. In unpalpable testicles phlebography proves in some cases useful in the differential diagnosis. The authors evaluate the importance of the examination. The new findings regarding anatomical and functional aspects are, no doubt, valuable. On the other hand, the authors draw attention to the complicated examination (in particular in children) to the invasive character of the examination and the irradiation load.

VM 26 (4-demethyl-epipodophyllotoxin-beta-d-thenylidine glucoside) in the treatment of urinary bladder tumors.

VM 26, a semisynthetic podophyllin derivative (4-demethyl-epipodo-phyllotoxin-beta-d-thenylidine glucoside) has been tested in 67 patients with urinary bladder tumors. In 25 patients with stage T 1 significant prolongation of the disease-free interval was reached. In 25 cases with state T 3-4, the effect of VM 26 was not favorable.