PubMed Health⌕ Search

Biomedical subjects

A Hoznek

Publications and source records attributed to A Hoznek.

18 recordsLinked to original sources
PubMed1997

The prognostic value of p53 nuclear overexpression and MIB-1 as a proliferative marker in transitional cell carcinoma of the bladder.

BACKGROUND: There is controversy regarding the value of biologic markers as prognostic indicators independent of clinicopathologic parameters in transitional cell carcinoma (TCC) of the bladder. The authors examined the prognostic value of p53 tumor suppressor gene expression and the proliferative marker MIB-1 in TCC of the bladder. METHODS: Fresh frozen samples from 114 TCCs of the bladder and 13 normal bladders were studied by immunohistochemistry, using monoclonal antibodies MIB-1 for proliferation and PAb 1801 for p53 nuclear overexpression. Scores were determined in each case by counting at least 500 nuclei per slide in 3-5 selected regions. Patients were stratified for both markers into two groups for time-event analysis, according to the median number of nuclei stained. Patients with nuclear staining below the median value of the score were considered negative in the statistical analysis. Quantitative immunostaining was analyzed in relation to the time to recurrence, progression, and cancer death, and compared with clinical and pathologic parameters for prognostic significance in univariate and multivariate analysis (stepwise logistic regression). RESULTS: Median nuclear overexpression of p53 was 22% and that of MIB-1 28%. There was a strong association between proliferation and p53 nuclear overexpression (P < 0.0001). Progression free and disease specific survival rate estimates (log rank test) were significantly lower in patients with p53 or MIB-1 scores above 22% and 28%, respectively. Multivariate analysis indicated that stage as well as p53 and MIB-1 immunostaining provided independent prognostic information. CONCLUSIONS: Quantitative immunohistochemical evaluation of nuclear p53 and MIB-1 immunostaining inexpensively provides prognostic indicators in cases of TCC of the bladder.

Antibodies, Monoclonal↗
PubMed1997

Decreased expression of keratinocyte growth factor receptor in a subset of human transitional cell bladder carcinomas.

Growth factors and growth factor receptors are involved in tumor progression. The fibroblast growth factor receptor 2 gene encodes distinct isoforms. The isoforms which bind KGF (keratinocyte growth factor or FGF-7) are called KGF-R or FGFR2b. KGF-R is expressed in different epithelia and is involved in the control of epithelial-mesenchymal interactions. Expression of KGF-R mRNA was examined in normal human bladder and transitional cell carcinoma of the bladder (TCC) by semi-quantitative RT-PCR using TFIID and GAPDH as internal standards. In normal bladder, the KGF-R mRNA was detected in the urothelium but not in the underlying stroma. In TCCs, the level of KGF-R mRNA was generally either normal or low. Eighteen out of 54 TCCs had a KGF-R mRNA level below 30% of that found in normal urothelium. This decrease in KGF-R mRNA was not accompanied by an increase in BEK (FGFR2c) mRNA, the other major splice variant of the fibroblast growth factor receptor 2 gene. Expression of the KGF-R was also monitored by immunohistochemistry using a functional KGF-immunoglobulin chimera. The receptor was uniformly expressed throughout the normal urothelium except for the umbrella cells. Immunoreactivity for KGF-R was found to be negative in tumors with low levels of KGF-R mRNA, while the peritumoral normal urothelium was positive. Among patients with muscle invasive tumors, those exhibiting a low level of KGF-R mRNA had a significantly higher proportion of cancer deaths. Our results suggest that decreased expression of KGF-R can be considered as a marker of tumor progression in muscle invasive TCCs.

Adult↗
PubMed1996

[Problems raised by representation of activities in urology. Cooperative study by the urology services of the AP - HP (Public Services - Paris Hospitals)].

Paris public hospital urology departments conducted a study which had three objectives: - to test the indicators of activity to determine whether they were well adapted to measurement of the surgical activity performed, - to determine the contribution of the PMSI to the measurement of this activity, - to propose actions designed to improve the representation of the surgical activity actually performed by urology departments. The results of this study show that one half of the operations performed do not correspond to the field of PMSI (day-only admissions, outpatients department). The indicators currently used for budget allocation or interdepartment comparisons of activity are inadequate and, most importantly, induce deformities, variable from one department to another, which severely affect the image of the activity produced by these indicators. Two main reasons can explain these deformities: - the use of the NGAP and the score to measure activity: there is a marked variation of the score for the same operation, from one department to another. - the very poor census of activity performed in outpatient surgery. These two reasons are not related to the medical activity. Definition of a unique nomenclature for surgical procedures would constitute a great progress, provided that this nomenclature allows us to accurately describe our activity and can be modified according to our needs. Although the PMSI is a marked improvement of the information system, its application, in its current state, will not radically change the situation. The PMSI must be enlarged in one way or another, to outpatient activity including procedures performed in the outpatients department. For these measuring tools of activity, which determine the calculation of our budgets, to be adapted to our practice, we must be able to analyse their relevance and introduce changes. We need to develop this field of medico-economic research in urology.

Paris↗
PubMed1996

[Evaluations of protein p53 overexpression in cancer of the bladder: prognostic value].

Management of Transitional Cell Carcinoma (TCC) of the bladder depends on clinicopathological parameters at initial presentation. These criteria are insufficient predictors because of tumor heteterogeneity. Progress in tumor biology suggest that molecular markers may be used to dismember bladder cancer according to their biological behavior. Evidences have accumulated that cancer result from accumulation of molecular defect specially on tumor suppressor genes. In this respect we studied by mean of immunohistochemistry the prognostic value of p53 nuclear overexpression using monoclonal antibody P1801. The study was performed on 114 TTC and 13 normal bladders. Nuclear straining was quantified using an eye piece reticule at magnification 400x. Scoring was determined counting 500 nuclei in 3 to 5 arbitrary fields. Results between stage, grade and percentage of stained nuclei are as follow: TA 0,92-T1 0,144-T2 0,354-T4 0,622-G1 0,105-G2 0,212-G3 0,406. Comparison of mean nuclear straining between group with and without progression indicates a threshold of 16% for p53 nuclear overexpression. Using this limit there is a significant progression free survival rate for the all group (p < 0,0001) and for the group of superficial tumors (p = 0,0007). Multivariate analysis using stepvise logistic regression indicate a p53 prognostic value independent from stage and grade (OR 23,4). This result indicates that p53 overexpression which can be determined on routine preparation has a strong prognostic value and a certain clinical utility.

Adult↗
PubMed1995

Magnetic resonance imaging of penile rupture: aid to diagnosis.

We report on a patient with atypical clinical findings in whom magnetic resonance imaging confirmed the suspicion of penile rupture. The tear appeared as an obvious discontinuity of the low signal intensity of the tunica albuginea and was associated with a hematoma. We conclude that magnetic resonance imaging is useful for confirming the diagnosis of penile rupture when clinical findings are atypical, indicating surgical repair.

Adult↗
PubMed1993

Prognostic factors in superficial bladder cancer.

A large body of evidence suggests that intravesical prophylaxis using bacillus Calmette-Guérin can favorably alter the natural history of superficial bladder cancer. The search for prognostic factors impacting the clinical alternative between conservative and radical treatment has been the subject of numerous efforts and remains a major objective in improving the carcinological results and the quality of life patients with superficial bladder cancer. In this regard, information is available on three levels: clinicopathological parameters, quantitative analysis, and biological markers. Recent advances in as well as the limitations and pitfalls of the use of three kinds of information in prognostication are reviewed. The proper use of prognostic factors will modify our attitude toward superficial bladder cancer in the near future.

BCG Vaccine↗
PubMed1993

[Natural history and prognostic factors of superficial tumors of the bladder].

Forty-five patients with superficial bladder cancer managed by transurethral resection alone were studied longitudinally to identify factors associated with progression. Tumor grade, multiple tumor foci, and time to first recurrence were closely correlated with progression. Findings from this study are compared with previous reports. These data are useful to identify patients requiring more aggressive therapy, including intravesical anticancer drugs and BCG, and monitoring with closer-spaced cystoscopies.

Female↗
PubMed1993

[Results of the treatment of bladder tumors infiltrating the muscle].

Recent studies have shown improvements in survival in patients with invasive bladder cancer, perhaps as a result of stage selection and reduced perioperative morbidity rather than of increased effectiveness of treatments. The main ongoing therapeutic trials (combined use of chemotherapy with either surgery or radiation therapy) aim at controlling occult metastases which may be present in up to 50% of apparently localized bladder cancers. Identification of risk factors for metastatic disease is therefore crucial. In this study, factors potentially associated with response to treatment were analyzed on the basis of a review of outcomes reported with current treatments.

Combined Modality Therapy↗
PubMed1993

[Surgical cure of anomalies of the pyelo-ureteral junction with posterior vertical lumbar excision: report of 25 cases].

Posterior vertical lumbar (PVL) incision does not involve any muscle or nerve section. It is minimally painful, does not give rise to incisional hernias and reduces the hospital stay. Pyeloplasty for cure of the ureteropelvic junction (UPJ) is a good indication, as this incision provides access to the renal pelvis without renal mobilisation and without interference by the vascular pedicle and allows a more superficial operative field. This retrospective study is based on 25 PVL incisions performed between 1979 and 1992 in 24 patients (15 females and 6 males with a mean age of 31.8 years) on the left kidney in 11 cases, right kidney in 12 cases and bilaterally in 1 case. No intraoperative complications were observed. The anastomosis was stented with a Gil-Vernet ureteronephrostomy tube for an average of eight days in every case. Early complications (< or = 1 month) consisted of six cases of fever, one wound abscess and one urinary fistula. Normal feeding was always rapidly restored. Long-term follow-up did not reveal any incisional hernias, but two cases of recurrence (8%), two cases of stones and one case (4%) of refractory neuralgia (> or = 6 months) in the territory of the ilioinguinal nerve. In this indication, there is no gain in terms of hospital stay due to the need to maintain the ureteronephrostomy tube for at least five days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Experience with the Direx Tripter X-1].

In nonselected patients 81.5% stone-free rate could be reached in 3 months. In authors's opinion Direx Tripter X-1 is suitable in the treatment of renal and ureteral calculi. They treated staghorn calculi by ESWL monotherapy with success. The Direx lithotripter was found to be effective and easy to operate; the potential cost reduction is of great significance. The treatment requires general anaesthesia and the equipment causes significant noise. After all, Direx lithotripter is a useful machine in the armamentarium of stone disease treatment.

Adolescent↗
PubMed1992

Experience with the Direx Tripter X-1 shock-wave lithotripter.

The authors give account of the experience they gained with the Direx Tripter X-1 (ESWL) apparatus. In a random material they succeeded to render 81.5% of the patients stone free within three months. They judge the apparatus suitable for in situ treatment of pelvic and ureteric stones and for the monotherapy of staghorn calculi. It is easy to handle, inexpensive to buy and maintain but noisy to operate, moreover the patient has to be anaesthetized. All in all it is highly useful in the treatment of renal lithiasis.

Adolescent↗
PubMed1991

Vacuum therapy in the treatment of erectal impotence.

The authors were the first in Hungary to use vacuum-induced erection in the treatment of erectal dysfunction. Negative pressure was induced by OSBON ERECAID SYSTEM. Erectal impotence was successfully treated with this non-invasive and complications-free method in patients with diabetes and psychic problems. The method was applied first for ameliorating sexual complaints due to virile climacteric and--based on the results--its application is recommended.

Adult↗
PubMed1990

[Results of treatment of superficial vesical tumors by transurethral resection alone and transurethral resection followed by an intravesical instillation of Calmette-Guerin bacillus].

Superficial bladder tumors treated at the Henri Mondor Hospital from 1984 through 1988 were analyzed for recurrence and progression using the following prognostic parameters: stage (TNM classification, 1978), grade (G1, G2, G3), size, number of tumors, and tumor malignancy index as defined by the Besançon group. Forty-five patients were treated with transurethral resection alone (TUR group) whereas 30 had TUR followed by the prophylactic instillation of fresh Calmette-Guérin bacillus in the bladder (BCG group). In TUR patients, parameters predictive of progression included grade G3, multiple tumors, stage T1, recurrence within 6 months of TUR, and a tumor malignancy index above 455. None of these criteria were predictive of a response to BCG. Results obtained in the BCG group were comparable to those reported in the literature and confirmed the efficacy of BCG instillations to prevent recurrence and progression of superficial carcinomas of the bladder.

Administration, Intravesical↗
PubMed1987

Pre- and postoperative examinations in intestinal tumours of the pelvis.

Pre- and postoperative urological and lower urinary tract urodynamic studies were made in patients operated for intestinal tumours of the pelvis. It was established that urological complications often arise and they often escape detection during the examination or under the conventional surgical care. An examination and a control scheme is recommended for the early detection of the possible complications and for starting an adequate treatment in due time.

Humans↗
PubMedDate not supplied

Surgical male contraception.

After giving a short account on the possible ways of male contraception, the authors outline the administration of surgical sterilization and its professional follow-up based on their own experience. Their suggestions concerning legal regulations aim, on the one hand, at the extension of the topic, on the other hand at supporting the specialists interested in surgical contraception.

Adult↗
PubMedDate not supplied

Clinical effect of cryptocur by undescended testicles.

As study of the clinical effectiveness of Cryptocur nasal spray (Hoechst) containing LH-RH in 46 cases of maldescended testicles of 40 children is presented by the authors. They concluded that its application has several advantages. Few side effects occur and the treatment is well tolerated by the patients. So the clinical use of Cryptocur is suggested.

Administration, Intranasal↗
PubMedDate not supplied

Hematospermia.

The appearance of blood in the seminal fluid is an alarming sign, with a rather inconstant origin. The causes of hematospermia are discussed based on a review of the literature and the authors' own experience with 84 patients. The importance of differential diagnosis is emphasized and a diagnostic scheme is presented. Therapeutic opportunities depending on etiology are discussed. It is concluded that although hematospermia is an often self-limiting sign, resolving in a few weeks, all patients should undergo a careful investigation to rule out the presence of malignancy or other significant disease.

Blood↗