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Biomedical subjects

A A Bryden

Publications and source records attributed to A A Bryden.

13 recordsLinked to original sources

Ki-67 index in metastatic prostate cancer.

OBJECTIVE: Prostate cancer in bone is generally thought to progress more rapidly than in its primary site, a supposition that is supported by studies of prostate-specific antigen velocity. However, descriptions of proliferative rates in metastases have relied on inferred data from in vitro studies of cell lines derived from metastases. The aim of this study was to determine directly the proliferative rate within bone metastases arising from prostate cancer. PATIENTS AND METHODS: 10 bone biopsies containing metastatic deposits of untreated prostatic cancer were obtained. These were immunohistochemically stained for the Ki-67 protein with the monoclonal antibody MIB-1, using the streptavidin-biotin complex technique. Benign prostatic tissue was used as the control. Using an image analyser, the Ki-67 index (% of cells staining positively) in each specimen was determined. RESULTS: In the 10 specimens the Ki-67 index ranged from 0.15 to 7.82%. Wide overlap was seen between groups of differing tumour differentiation. CONCLUSION: The proliferative rate as determined by the Ki-67 index in bone metastases of prostate cancer is similar to that reported in primary tumours. There does not appear to be a relationship between tumour grade and proliferative index in these specimens.

Adenocarcinoma↗

The staged management of complex entero-urinary fistulae.

OBJECTIVE: To present the results of the staged management of complex entero-urinary fistulae. PATIENTS AND METHODS: Ten patients with complex entero-urinary fistulae were reviewed; all patients were referred to a national intestinal failure unit after failed treatment in other centres. Each patient was treated in three stages. The acute stage involved proximal defunctioning and distal drainage of both the gastrointestinal and urinary tracts to isolate the fistula, together with the eradication of sepsis. The recovery stage involved total parenteral nutrition, organ support, radiological planning of surgical reconstruction and intensive nursing. The reconstructive stage followed when the patient was stable, nutritionally replenished and intra-abdominal sepsis was controlled. Surgery was undertaken jointly by urological and gastrointestinal surgeons. RESULTS: The fistulae were treated successfully in all patients, with functional restoration in four, and/or diversion of the gastrointestinal and urological tracts in six. The mean (range) time to reconstruction was 5 (1-20) months. There were no postoperative deaths. CONCLUSION: A staged multidisciplinary approach with delayed reconstruction can achieve a successful outcome in the management of complex entero-urinary fistulae.

Adult↗

Paradoxical expression of E-cadherin in prostatic bone metastases.

OBJECTIVE: To determine whether the calcium-dependent cell adhesion molecule E-cadherin is expressed in metastatic deposits of prostate cancer in bone. PATIENTS AND METHODS: Ten bone biopsies containing metastatic deposits of untreated prostatic cancer were obtained and immunohistochemically stained for E-cadherin with the monoclonal antibody HECD-1, using the streptavidin-biotin complex technique. Benign prostatic tissue was used as the control. RESULTS: Of the 10 specimens, nine showed positive expression of E-cadherin, graded as strong in four. E-cadherin expression was strongest in well-differentiated metastases and decreased with increasing tumour grade. In some specimens there were mixed patterns of expression. CONCLUSION: E-cadherin is strongly expressed in prostatic bone metastases and the degree of expression appears to reflect local tumour grade. This suggests that loss of E-cadherin expression may not be critically linked to metastatic potential.

Biopsy↗

Apoptosis and expression of apoptotic regulators in the human testis following short- and long-term anti-androgen treatment.

Apoptosis and its augmentation by androgen withdrawal is an important event in the testis. In other tissues apoptosis is regulated by genes belonging to the bcl-2 family. However, little is known about these pathways in the human testes. Human testes were obtained from patients with prostate cancer, undergoing orchidectomy for permanent androgen ablative treatment. The patients were either untreated or had previously received short- or long-term anti-androgen therapy by cyproterone acetate or GnRH agonist (goserelin). In comparison with untreated patients, testicular testosterone concentrations were reduced by 83% in patients treated with cyproterone acetate and by 99% in patients treated with goserelin. Apoptotic cells were identified in tissue sections by in-situ end labelling of fragmented DNA. The expression of Bcl-2, Bcl-xl, Bax, p53 and poly(ADP) ribose polymerase (PARP) was demonstrated in tissue extracts by Western blotting. Apoptotic germ cells were present in the spermatogenic epithelium of untreated patients and patients who received short-term anti-androgen treatment. There were few or no apoptotic cells in the seminiferous tubules following long-term anti-androgen treatment. Following short-term treatment, the concentrations of the apoptosis-related proteins examined did not change. However, in the long-term treated testes, Bcl-xl and PARP expression declined, Bax and p53 protein concentrations were unchanged, and Bcl-2 was up-regulated. In conclusion, apoptosis occurs in spermatogenic cells of the human testis and may contribute to the regulation of germ cell populations. The apoptosis-related gene products which have been described in other tissues are present in the human testis and are modulated by androgenic stimuli.

Adult↗

Investigation of haematuria.

Haematuria is a common symptom and sign that may be encountered in almost all medical specialties. The possibility that haematuria may signal an underlying malignancy means that it must not be ignored. This article outlines the diagnostic procedures relevant to haematuria, such that serious causes of bleeding are identified and treatment may be initiated.

Cystoscopy↗