Unusual histomorphological spectrum of urinary bladder cancers and their treatment modalities revisited: Our experience with series of five cases.

Background: Urinary bladder cancer is the eighth-most frequent carcinoma in men, commonly occurs in elderly male. Major risk factors are smoking, chronic cystitis, urinary stones. The most common histologic variant of bladder cancer is urothelial carcinoma (UC), but certain variants are unusual yet aggressive for which there is no consensus guideline of therapy. Those entities include neuroendocrine tumors both primary and metastatic, squamous cell carcinoma, and sarcomatoid carcinoma. Neuroendocrine tumors comprise carcinoid, small-cell carcinoma, and large-cell carcinoma. Aim: The present study is undertaken to highlight certain biological features of these unusual aggressive histological forms of bladder carcinoma and their recent treatment modality to prevent recurrence, metastasis, upgrading of tumor stage, and enable surprisingly complete remission. Methods: This piece of hospital-based perspective study was done from June 2018 to May 2020. Both transurethral resection of bladder tumor and cystectomy surgical samples of the symptomatic patients were collected from the urology department of our institute along with demographic data. Then processed, stained in both routine H and E stain and immunohistochemical stains (Immunohistochemistry [IHC]) like PanCK, NSE, synaptophysin, chromogranin, etc. Results: Total number of bladder cancer encountered was 42 cases; of these five rare variants were observed, i.e., one case each of primary and secondary small cell neuroendocrine carcinoma, one large cell carcinoma, one squamous cell carcinoma (SCC), and one case of sarcomatoid carcinoma. Histomorphology with IHC conferred the diagnosis then multimodality therapy (neoadjuvant/radiotherapy/surgery) was installed and followed up. Conclusion: The unconventional forms of UC can be easily diagnosed by histomorphology and can have better survival with the help of the recent multimodal treatment approach.

Immunohistochemical Analysis of p53, CD10 and Ki67 Expression as Prognostic Biomarkers in Urinary Bladder Carcinomas Correlating with Age, Histomorphology, Grade and Stage: An Institutional Study of One and Half Year.

Background: Bladder carcinoma ranks tenth among all cancers worldwide predominantly affecting elderly males. Common risk factors being cigarette smoke and aniline dyes. Immunohistochemical markers play a pivotal role for its diagnosis and prognosis. Aim: To analyze the immunohistochemical expression of p53, CD10, Ki-67 in bladder cancers correlating with demographic features, pathological grade, and stage and to establish as prognostic biomarkers. Materials and Methods: Surgical samples of total of 70 cases of bladder tumor were collected, processed, stained in routine hematoxylin and eosin followed by immunohistochemistry of p53, CD10, and Ki67 markers performed on randomly selected 30 cases only. Results: Out of 70 cases 69 cases (98.6%) were carcinomas; urothelial carcinoma being 71.4% (n = 50) with male: female ratio = 7.7:1 and mean age = 61.81 ± 12.83 years. Out of 30 cases, p53 was positive in 50% of cases, 30% - negative and 20% - equivocal. p53 positive expression pattern was more in high grade (HG) than low grade (LG). Significant difference was observed in the mean p53 scoring (%) and different stages (P = 0.043). CD10 expression was negative in 56.6%, (1+) in 16.6%, and (2+) in 26.6% of cases and significant difference in CD 10 expression was observed between the high and LG (P = 0.001). Ki-67 labeling index was appreciably higher in HG than the LG tumor (32.49% ± 24.35%; 6.86% ± 8.1%). Majority of Ki-67 expression was observed in stage pT2, followed by the pT1 stage. Conclusion: Cocktail of p53, CD10, and Ki67 is useful as potential prognostic markers in bladder cancers.

Investigation of titania nanoparticles on behaviour and mechanosensory organ of Drosophila melanogaster.

Titania nanoparticles are used in food, cosmetic, medicine, paint and many more domestic items. Its extensive use has raised the threat to the physiological system and thus the functioning of the body. In the current study, the toxicity of TiO2 is checked by adding it in food and using Drosophila melanogaster as a model organism. Various concentrations of TiO2 (50, 100, 200, 250mg·L-1) toxicity was assessed via oral route exposure. Survivability, life-cycle, mechanosensory behaviour and structure of various mechanosensory organs were monitored as a read out of nanoparticle toxicity. TiO2 NPs generate reactive oxygen species which can modify multiple signalling pathways and thus can alter the development and behavioural pattern of the fly.

Spontaneous puerperal extraperitoneal bladder wall rupture in young woman with diagnostic dilemma.

A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture.

Cytotoxicity of Al2O3 nanoparticles at low exposure levels to a freshwater bacterial isolate.

The cytotoxicity of Al(2)O(3) nanoparticles (NP) at very low exposure levels (1 µg/mL and less) to a dominant bacterial isolate from freshwater (lake water), Bacillus licheniformis, was examined. Sterile lake water was directly used as a test medium or matrix to simulate the freshwater environment. Exposure to 1 µg/mL Al(2)O(3) NP for 2 h caused a 17% decrease in cell viability (as determined by plate count and MTT assay). During the test period, the particles were found to be stable against aggregation in the matrix and exerted a nano-size effect on the exposed test organisms. The decrease in cell viability was proven not to be due to the release of Al(3+) ions from the nanoparticles in the dispersion. The zeta potential and FT-IR analyses suggested that the surface charge based attachment of nanoparticles on to the bacterial cell wall was responsible for flocculation leading to toxicity. The cell wall damage confirmed through SEM and the lipid peroxidation assay also contributed toward toxicity. This study warns of possible ecotoxicity of nanoparticles even at environmentally relevant concentrations. However, detailed studies need to be carried out to establish probable mechanistic aspects of this low concentration toxicity phenomenon.